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Permit NI . a CITY OF TIGAR MASTER PERMIT P COMMUNITY DEVELOPMENT Permit #: MST2012 00309 T l G AR 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/29/2013 Parcel: 2S104DB05700 Jurisdiction: Tigard Site address: 13257 SW MAPLECREST CT Subdivision: MAPLECREST Lot: 4 Project: Maplecrest Lot 4 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 4 First: 682 sf Basement: 0 sf Left: 4 Parking Spaces: 0 Height: 31.5 Bathrooms: 4 Second: 1142 sf Garage: 592 sf Front: 20 Smoke Dwelling Units: 1 Third: 1463 sf Right: 4 Detectors: Yes Total: 3287 sf Value: $373,393.40 Rear: 15 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 6 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs /Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 ' Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Drywell- Trench Drain: 0 Other Fixtures: 0 • Other Fixture Units: MECHANICAL _ Fuel Types . Air Conditioning: N Vent Fans: 6 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Fum <100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Fum > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits 1000 sf or less: 1 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add 500 sf: 6 201 -400 amp: 0 201 -400 amp: 0 W/O Svc/Fdr: 0 Mfd Home /Feeder /Svc: 0 401 -600 amp: 0 401 -600 amp: 0 601 -1000 amp: 0 601 +amp- 1000v: 0 1000 +amp /volt: 0 ELECTRICAL - RESTRICTED ENERGY SF Residential Audio 8 Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R -3 3287 Owner: Contractor: RICHARDS, M DALE WINDWOOD CONSTRUCTION INC Required Items and Reports (Conditions) ADAMS, HEATHER M. 12655 SW NORTH DAKOTA 1 Ersn Cntrl 503 - 639 - 4175 12655 SW NORTH DAKOTA TIGARD, OR 97223 2 geo tech report required prior TIGARD, OR 97223 to footing inspection PHONE: PHONE: 503- 625 -6526 FAX: 590 -7606 Total Fees: ,$21,284.95 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ENTION: 0 - :gin law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -0 -0010 through OAR • :2-• • - , 0 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. � f ` tssu By: % �i� Permittee Signature: f 1�r' Call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept In a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application Residential FOR OFFICE USE ONLY ece / City of Tigard DateB : ( a ( � S Permit No/ t) /X--)) rn 0 • 13125 SW Hall Blvd., Tigard,OR 97223 Plan Revie • Awr I x Phone: 503.718.2439 Fax: 503.598.1960 DEC 1 8 2 01 Date/I3 : Other P ermit; Q, O( )O )1)- �. G `�. Inspection Line: 503.639.4175 Date Ready : y: loc El See Page 2 for Internet: www.tigard - or.gov CITY OFTIG' ' otified/Method: /! 3 1 w Supplemental Information BU 1 1 u 1\ trz.. WI TYPE OF WORK REQUIRED DATA: I- AND 2- FAMILY DWELLING pf(ew construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ,2'<'and 2- family dwelling ❑ Commercial/industrial Valuation: 3� 1� _ ❑ Accessory building ❑ Multi- family Number of bedrooms: 1/ ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: 3 Job site address: I, 2 $() 47 a `er v SI L �7 New dwelling area' 3z S 7 square feet City /State /ZIR: 0 772 -3 Garage /carport area: im square feet ( �'3 Suite/bldg. /apt. no.: v Project name: Covered porch area: 75 square feet i f4-Z Cross street/directions to job site: a Deck area: 354 square feet ( Other structure area: 36 square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: 174C4,0cres / I Lot no.: / Permit fees* are based on the value of the work performed. Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. A ft-r.4./ ,9/.7-,---- Valuation: $ Existing building area square feet New building area: square feet ROPERTY OWNER ❑ TENANT Number of stories: ■ Name: (// , ` , / et 1 ,i� or./ /aij S / /�, " C Type of construction: Address: /'' —� O " 4 S 5 j ,1t ` '1 -, /- . " � A� //� Occupancy groups: City /State /ZIP: 77 a_,,-, 2 s--- �Q7223 Existing: Phone: ( ) 7 �J_ G/,37 Fax: ( ) 570— 7‘,X New: ❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: ff"Q Structural plan review fee (or deposit): Contact name: / 7),„,,_ � ,� — /"c FLS plan review fee (if applicable): Address: Total fees due upon application: City /State /ZIP: Phone: ( ) F es; ; ( ) Amount received: E -mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof -top mounted PhotoVoltaic Solar Panel System. Business name: 5=zik.e.__ Submit two (2) sets of roof plan with connection details and fire department access, along with the 2010 Oregon Address: Solar Installation Specially Code checklist. City /State /ZIP: Permit Fee (includes plan review $180.00 and administrative fees): Phone: ( ) Fax: ( ) State surcharge (12% of permit fee): $21.60 CCB lic.: 6---&/ Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: C C Date: ! // 7 � ( /_ 1 L * Fee methodology set by Tri -County Building Industry 7 Service Board I:\ Building \Permits\BUP- RESPermitApp.doc 02/ 24/2011 440- 4613T(I 1/02 /COM/WEB) Building Permit Application Checklist One- and Two - Family Dwelling loll; OFFICE USE ONLY Received City of Tigard Date/R Permit No.: 1 11 4 a 1 3125 SW Hall Blvd., Ti ard,OR 97 223 y • g Associated permits: C Phone: 503.718.2439 Fax: 503.598.1960 I IC ARD 24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www.tigard- or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ • 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: El El ❑ 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑ basin protection, etc. 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. I 1 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑ there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑ furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑ floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. A 16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non- ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and /or any beam/joist carrying a non - uniform load. 20 Manufactured floor /roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required ❑ ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Ore Ion and shall be shown to be a' .licable to the 'ro'ect under review. JURISDICTIONAL SPECIFICS 23 Three (3) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". ❑ ❑ ❑ 24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale" indicates standard architect or engineer scale. ❑ ❑ ❑ 28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations, driplines, ❑ ❑ ❑ and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks, patio covers (over non- impervious surface) and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. I: Building \Permits\BUP- RESPermitApp.doc 02/ 24/2011 440- 4613T(l1/02 /COM/WEB) Plumbing Permit Application Building Fixtures RECEIVED City of Tigard Received - r� / 1 S Date /By: / / /Z Permit N 5 I o� .. OU 3p a 13125 SW Hall Blvd., Tigard, OR 9722®�C 2012 v C Plan Review �1 0i3 'DODO, Phone: 503.718.2439 Fax: 503.598.1960 Other Permit N � D� Date/By: � 2 TI G n K D Inspection Line: 503.639 CITY OF TIGARD Date Ready/By: 7u See Pa 2 for Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: ( f Supplemental Information TYPE OF WORK FEE* SCHEDULE New construction ❑ Demolition For special information use checklist Description I Qty. I Ea. I Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 312.70 ja<and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 437.78 SFR (3) bath 500.32 ❑ Accessory building ❑ Multi - family Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: /3 25 S,., /14io kir5} G'i Catch basin or area drain 18.76 Drywell, leach line, or trench drain 18.76 City /State /ZIP: '7- q,✓� � c_ 0 � - 1 t s Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: I Project name: Manufactured home utilities 50.03 Cross street/directions to job site: a a.,/ Manholes 18.76 i Rain drain connector 1 8.76 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 ,/ Water service (no. linear ft.: ) Page 2 Subdivision: pi 90 4-G� �( 7 Z I Lot no.: Fixture or item: Tax map /parcel no.: f Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 j Si."-=, washer 25.02 " Dishwasher 25.02 Drinking fountain 25.02 Ejectors /sump 25.02 ❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Fixture /sewer cap 25.02 Name: Z u ja r tc,a (ifs,X Floor drain floor sink/hub 25.02 Address: / ;,2 s---6- SS n ,,�, / k d e kolz ,s t_ / / t /° /` Garbage disposal 25.02 City /State /ZIP: 77, Gnu Or 07.2;23 Hose bib 25.02 Phone: ( ) 53 ^ 7/'O -'/3? r Fax: ( ) 0- 7y ( Ice maker 12.51 - CPPLICANT .0'CONTACT PERSON Interceptor /grease trap 25.02 Business name: Set Medical gas (value: $ ) Page 2 Primer 12.51 Contact name: Roof drain (commercial) 12.51 Address: Sink/basin/lavatory 25.02 City /State /ZIP: Solar units (potable water) 62.54 Phone: ( ) Fax: : ( ) Tub /shower /shower pan 12.51 E -mail: Urinal 25.02 CONTRACTOR Water closet 25.02 Water heater 37.52 Business name: K P lb Water piping/DW V 56.29 Address: / 6 It [/ j' ,J 4h 4U Z )G •t . Other: 25.02 .Q�l City /State /ZIP: at- 7- - S t Subtotal // �' f Phone: (s 042_ _ 36 ^i3 Fax: ( ) Minimum permit fee: $72.50 CCB Lic.: /03 y ,1 6 Plumbing Lic. no.:P/57O Plan review (25 % of permit fee) 7 State surcharge (12% of permit fee) Authorized signature: 11„ "..„7/................. TOTAL PERMIT FEE Print name: i, 1 5 r ,1-0-,7 I Dat t ` // ) / / Z This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. I :\ Building \Permits\PLMU- PermitApp.doc 10 /01/09 440- 4616T(10 /02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee: Footing drain - 1 100' 50.03 0 to 2,000 $121.90 Footing drain - each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer - 1st 100' 62.54 7,201 and greater $327.54 Sewer - each additional 100' 37.52 Water Service - 1st 100' 62.54 Medical Gas Systems: Water Service - each additional 100' 37.52 Valuation: Permit Fee: Storm & Rain Drain - 1st 100' 62.54 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for Other Inspections or Fees Qty. Fee (ea) Total each additional $100.00 or fraction thereof, to l� and including $10,000.00. Inspection of existing plumbing or for $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for which no fee is specifically indicated 90.00/hr each additional $100.00 or fraction thereof, to (minimum charge - 1/2 hour) and including $25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for hours (minimum charge - 2 hours) each additional $100.00 or fraction thereof, to Reinspection Fees 90.00/hr and including $50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for (minimum charge - 1/2 hour) each additional $100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping, adding or replacing fixtures? if "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees * . Plan Review for Plumbing Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate Baptistry/Font ❑ Any new commercial building with water service 2" and greater, except systems designed and stamped by licensed Bath: - Tub /Shower - Jacuzzi/Whirlpool engineer. Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure Drive tall as defined in OAR918- 780 -0040. Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system. Domestic ❑ Any complex structure as defined in OAR918- 780 -0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: - 2" 3" Isometric or Riser Diagram ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain Garbage Domestic non -food that meet the qualifications above. Disposal: - Domestic food related - Commercial food related - industrial food related Ice Mach./Refrig. Drains Comments regarding fixture work: Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower: -Gang -Stall Sink: - Lav/Bar non -food related - Bradley - Com/Serv/Util food related - Service *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EDUs, a sewer permit will be issued and Washer - Clothes fees assessed for the sewer increase must be paid before the Water Extractor Water Closet - Toilet plumbing permit can be issued. Urinal Other Fixtures: 1:\Building\Permits\PLMF- PermitApp.doc 08/04/2011 2 Mechanical Permit Application RECEIVED FOR OFFICE USE ONLY City of Tigard DEC 18 2012 Received J (! a0 �� 3 11111 • Date/By: I9_/ I a S r Permit No. s 1 Q q 13125 SW Hall Blvd Tigard,OR 97223 • Plan Review ' Phone: 503.718.2439 Fax: 503.598.1960 CITY OFTIGARD Date/By: Other Permi ]L 1d (' - VDU O I' I G A K D Inspection Line: 503.639 I Date Ready/By: Page DNISIO Juris: Supplemental See Pa e 2 for Internet: www.tigard-or.gov Notified/Method: 776 ) Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees* are based on the value of the work k New construction ❑ Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. Value: $ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES* J ' ":-nd 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning Job site address: /3 7 gr.,...) 4,0 �sCTs- (7' (requires site plan showing placement) 46.75 ^� / f Furnace 100,000 BTU (ducts/vents) 46.75 City /State /ZIP: I a.'il Gi X1 7 )-.2-3 Furnace 100,000+ BTU ( ducts/vents) 54.91 Suite/bldg. /apt. no.: Project name: Heat pump (requires site plan showing placement) 61.06 Cross street/directions to job site: I,6,4( Duct work 23.32 Hydronic hot water system 23.32 Residential boiler (radiator or hydronic) 23.32 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 46.75 Subdivision: C S Lot no.: 4/ Flue /vent for any of above 23.32 Q� Other: 23.32 Tax map /parcel no.: Other fuel appliances: DESCRIPTION OF WORK Water heater 23.32 � Gas fireplace/insert 33.39 A i-C,t/ .9/- Flue vent for water heater or gas ■ fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace /insert 23.32 ❑ PROPERTY OWNER ❑ TENANT Chimney/liner /flue /vent 23.32 Other: 23.32 Name: /, r - f i 0 / 6c S ` Environmental exhaust and ventilation: Address: V ` 24 5—j- s- l h� �/ �� s ' /. Range hood/other kitchen / equipment 33.39 City /State /ZIP: Ar/ v , -C 01 Clothes dryer exhaust 33.39 Single -duct exhaust (bathrooms, Phone: ( ) 7 O --4375 Fax: ( ) toilet compartments, utility rooms) 23.32 ❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32 cn `' Other: 23.32 Business name: �1�— Fuel piping: Contact name: ! Niclicizei 514.15 for first four; $4.03 for each additional Address: Furnace, etc. Gas heat pump City /State /ZIP: Wall /suspended/unit heater Phone: ( ) Fax: : ( ) Water heater Fireplace E -mail: Range CONTRACTOR Barbecue Business name: 7R 01 5 Other: Clothes dryer (gas) J C /1 Address: /3 /� J * ierAAI /J //e'er / /20/ MECHANICAL PERMIT FEES* J J � � 97° 1/51 /V Subtotal City /State /ZIP: O J 7 tJ Fax: ( ) Minimum permit fee ($90.00) Phone: ( ) �ys- .7.7/ Plan review (25% of permit fee) CCB lic.: —224,2,3 State surcharge (12% of permit fee) TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: 24 t4 I Date: 70,//2 • Fee methodology set by Tri -County Building Industry Service Board 1:\ Building \ Permits UMEC- PermitApp.doc 03 /07/12 440- 4617T(II /02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi - Family Fee Schedule: • Total Valuation: Permit Fee: $0.00 to $500.00 Minimum fee $69.06 $500.01 to $5,000.00 $69.06 for the first $500.00 and $3.07 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and $2.81 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and $2.54 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and • $2.49 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $2,608.71 for the first $100,000.00 and $2.92 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I:\Building\Perrnits\MEC- PermitApp.doc 03/07/12 2 E1ecti•i..111 Permit Application RECEIVE rot, Or" ICI: UNE t /NIS , Cal° of Tigard , .... t - -1:*4 'A iilll lih 4 1 Igz.7 ( IR ,, '72..t aL " \ ' aC TeX/ a- - 06 3d r .r.. v.. a ' ?!.irt • .%. :.“0 I .1.X ! 3 !.‘; ii 1'44 DEC 1 8 2012 ,,,,,;: ‘,..','`err-51,0(L c w:3; 3 _,, / ),- y -y-7 CITY OF TIGARD - - 11.n4 R;,,.?... lip — ..,.. _ ---... !..... , . ie Seg rats .2 t4 r . frac-Tref wuv. N,„tra,:f p■sN BUILDING DIVISION _,.‘,?t,;.,?, ____ TEI & ,,, ScippltatztAllolotthvhsr. __ — . — TYPE OF WORK ] _ 0 1 _ .4,1L:::w..,11tecatityi , -t<awr ‘....4:. • :hat N'c',..... , 4,3="in 0 ■,,, , - , - ..4 , , .f,ce..... .4 ..; t C!!!.1.1t .... •,,■,• v. 0 Dn 0 Ono' CATEGORY OF CONSTRUCt ION i : -:%,...*.--:., .u, ..,'. Art.75.4:: ''.', l, ''' , r4 01%,,4 ,I 70 t, rp,......• :t tv.zA '-' C2 ,-, .., , :—r. - ...- 4,.. ■ . =.. ..! .. ck- 4r.,,l 2.7.4fni is, .4%■.,...1.1:•„? 0 Cornrrn164ar.,1v1 0 Ac' 7 . , n% r O :1 ., e 4 , .1 ' inf„. . _ NIult;.1.=:ly 0 MAstc t:'...nLIcz 0 ()ther , 1 , ,..,4..•Ip ='!. ...!' "'"-----" 1 0sr,‘, .:0. . , : i .,...t t: Jos INFORMATION AND LOCATION 0 k' f no,. ,(110 . I 0 A , L . „ .2 , j Job no.: 1 .7,on 9:C t4.1.C'V■ / .97 ,..ca---',/huzi 4- ( n% ,. , 0-..;. -,,,,z, .,.,./,'. ,,:•.- L. te." Y.CPP ' q 2-.2.2-3 : Ot -.AIL '41..■Iral.) 0 ',C„,...7.52% 1 , ,,,,'Af .: ',, • • -,, „ - -„,,,===== -===.====•.=====*. i,,442.7k=k4=1 '...= ...,x1 .*:-.( i, 0.:,0,.,, SU:1C ht ;sr +XI Pr f„),yet.1 r.....,^rr4`.. -- , 0 Se-,-..„..c ...-■ (cyder ... .-‘,-. .-, ----- - --""-- FEE SCIIEDI LE O .11."tr t, i :(,)0} . , 0...'V".--_—__ qt: _ ..._____ ...._ ..____.„ ....... S micknrial u`rig*.t or rnottilarnilv : - Inclotirs strartted za race. - — . — /2 it'C'e 5/ I i r; no '., f ..-:.. In s --- „ , — / _ 114.‘ "k 4 • 4, 4' . .. ,...; ti ts; ror .-m (.7 .. s , ..,....: Mors pa,r - i „ . 1 snr!,•c: vr..-Ir., c.:Wer.n1.<1.. DESCRWTION OF 1A'ORK -- - — ' I ,....tS ahkr.c _ — -------------"- " ' ' ‘— : :1 !,e )t c- d *, i _ .` . 7+ , .• •c.,...:4•7„.1 - 1 Scrs stet or firrdcro installanoo alitrarinn. a niVor rei.N4 664 ., Tr- ,.: . . ...,...,_. _, ,.., ..„ i : , e TY r;)-TROPEROWNER 0 TENANT r , - -.--- f4.:1 Ad4lIC /.2-„,r .C1: : 7 '&) J1 t...htt .; txtl,f 4.:r.10, v. ..:;:5 - . 4 . -- " ' — — — 1 t I triporsr) stnges or fretkr* 411.“/11:4114.13, t 14: IW 10 , Ili, ..lf C11.,p Sti:c /Mt , roAid 47.c. — 9222-3 1 I rein( klat.n ...... _ , I I • fl:, a r 0 46‘ ■ 4 p, ,-.-.. ° —" ' ' j :1:1 1. 10 4' el ..tt.r.Te ;:', ()inner installation: I 317.% .1r. ‘1.41: elor. h t'virg .1.1•.',14k or rfCcrrtA lltal I co.. ri s‘hi f> is:v. 1 r — -4- I i .arlps. `. ;nti.:ni:td tor s..11c., Ic.1...c., rcf or ‘ Ai* orslio:i. 7,4,0 1XS 4 477, 4 4%r„ 670, .i.mi 70! iv a, 1 i Hea nth cirruitt - nat.., al irra — t nn,'Wri r.:tr'pl pants - - t hs re; ‘'.4:ruf:.* Flatc.' i r A C... f■Otcon. H.r4 I „.... p.*PPLICANT 1 0 CONIAC1 PERSON 1 t ___ — . ra: t.t glz --0;7■ -- . tt.Atfle' PAM:: ..... ) it t cc• O.: a...AN+ -74, 441 t• 4;k-ke , ° ci nari:t 17 ge -. - %Itscettaarc•us Run e or trelact cio.t I SIX:" lit' .„......" 1 *, foze.',:r, ' • " - ' - , ._.„, _-- ! 1 v ' ( I, , a."..411 . , , 1-114:1 ; strrl or ‘2..1:ry Lev-a e 84 — — CONTRACTOR ..1 orio. s!r,.1 I r (('\ '. ., ... „. „ . , r .1.-0,21, ..)..,,,,t rtt...,,,.,,,____ ,. 1 r,„,,, L14 i L i ('' _ Esc h stfditiostal inspectrtm 4)* tr lakes 'We tA ant astir ahotc__ r A . W , n.C ,.-N, r i, ," e 1 . ---t-- - : ,, h; m r-v-n 4 t N t..". 2' • !If. _ .„..„ ___— _ t,. St;t1g 4.1P ?) 1 ‘a- C. it V?? .0-5 , . ... „_„,„ : ', . . — , _ , - a, I N Il• F-.1, t50 -4 i 91,4 .4. 1 i 1 — 1 F..t.v: tc,;(0 c riC; (i • CC 1 il. 1 '\L, - !»V' i 0,,tr it:31 L,c,.. . t Supr. Lii : i *3o.. ELECTRICAL PERM rT FEES - _— — : St....pr* :,.. 4%1, -i;,:11uer., tcv.sr cd / • 111P, ; -------- - - ---- - ---- -- 1.1 tt-+ - :”:;-t rem-y1 - ce.: ! ...,.., _ — , _ .. . .. ' Print 11.11 ( ,.c /44 11-.1tc! 1 . ,. sier "-V ...01.1.4 1::"*. of purr, if 1:6 i ,„,.____. ..... 4 7....C7.< y _ ..— — I Authrnur...! — s,...r...2r.srt.' ,--- TN. prrom I ppbt a tit" rtpirri■ 4 a perms a■ not aCained lo :that 1:0 after rt kat tera bcreptee, 1111. Print n.3r.le 0.Tz' ....... _ — -- - III Building Division Development Code Provision Review TIGARD Residential Projects Building Permit No.: _ M-V - 0! o1- 31) Site Address: 3 ZS 7 �� s Project Name & Lot No.: P t T Ain q CWS Service Provider Letter Required: Yes ❑ No Pg Received: Yes ❑ No ❑ Routed Plans: / Original Plan Submittal Date: id- Q8'( �. 1st Revision Submittal Date: a / A ' ❑ Site Plan Only 2nd Revision Submittal Date: ❑ Site Plan Only To the Applicant: Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies to the Building Division. Only checked (✓) items are approved. Items not approved and those listed in the notes must be revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed above each section. Staff: please check items along left onl if approved. Planning Review (contact Are. at 503 -718 or @ti or. Land Use Case 's/Di�Z - I)I' 0 s Zoning g `/, 5 C pD2 ■ Q� - �p� '' L� Setbacks y / , Front J^ 12 Rear /J' Side 0 Street Side [ J Garage IrecMaximum Building Height: .M Actual Building Height V L►1 Visual Clearance Er Easements ❑ ,_,Sensitive Lands Type: L7 Street Trees X ❑ Protected Trees �,�i�n �i /,�, , n Notes: 7 2YVW d �t'/I hiiii` � (/w9 I-e qo pr , L. ,.._, „. 4 l —ge.S Original Plan: Approved Not Approved V Date: r 2 l //2-- Revision 1: Approved ❑ Not Approved ❑ Date: l l . G Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @ tigard - or.gov) W Actual Slope: 369 Notes: Original Plan: Approved Zr Not Approved ❑ Date: 1/- 111/ Revision 1: Approved 17' Not Approved ❑ Date: / 0/ (3 Revision 2: Approved ❑ Not Approved ❑ Date: Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert@tigard-or.gov) ❑ Conditions of Approval Prior to Issuance of Building Permit Notes : Original Plan: Date Sent to Applicant: Revision 1: Date Sent to Applicant Revision 2: Date Sent to Applica t Okay to Issue Permit: Ye No , y l9 Date Routed to Building: � 1 Page 2 of 2 • FOR OFFICE USE ONLY – SITE ADDRESS: /- 3 2 S 7 S2 /y/9-/ L -- This form is recognized by most building departments in the Tri -County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard ° COMMUNITY DEVELOPMENT DEPARTMENT .111 . Transmittal Letter T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard- or.gov TO: - 9 A/ /✓�Z d /✓ DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: )Rte (00) ) JAN 0 3 2013 i A l CITY OF TIGARD �� COMPANY: �1�1 Ouvcn BUILDING DIVISIOr PHONE: 5 7E B RE: /3°Z-5 7 c) / 7 MST 2011— 003 p (Site Address) (Permit Number) / (Project name or subdivision name and lot number) - ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. Floor /roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other (explain): REMARKS: , J hk )Gl yt i? , FOR O FI E USE ONLY Routed to Permit Technician: Date: 1 /7 /1 Initials: M1 1 Fees Due: ❑ Yes ❑-No Fee Description: Amount Due: Special Instructions: Reprint Permit (per PE): ❑ Yes ❑ No ['Done Applicant Notified: Date: Initials: l: \Building\ Forms \TransmittalLetter - Revisions.doc 05/25/2012 Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 13257 SW MAPLECREST CT, TIGARD, OR, 97223 Residential - Master Permit 225 Post/beam structural 03/27/2013 00:00 MST2012-00309 PASS Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 13257 SW MAPLECREST CT, TIGARD, OR, 97223 Residential - Master Permit 235 Shear walls/anchors 05/22/2013 00:00 MST2012-00309 PASS Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 13257 SW MAPLECREST CT, TIGARD, OR, 97223 Residential - Master Permit 315 Post/beam plumbing 03/27/2013 00:00 MST2012-00309 PART Partial for lower, lower level plbg Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 13257 SW MAPLECREST CT, TIGARD, OR, 97223 Residential - Master Permit 242 Interior shear walls 05/22/2013 00:00 MST2012-00309 PASS Violation Summary: Inspector Contractor rr a. y �� N,: F i ET TIME k :,!:.„, .:::,m r_}If,GARO) CER TI1�ICA TI N I, //(.ii �l-rr ° ;;13/---1)K• owner/agent for AA ke/6-c'rc k i)l-C (PLEASE PRINT) (PERMIT HOLDER) do hereby cert.ift that the following location meets City of Tigard land use and development standards for street tree installation and is consistent with the approved site plan. PERMIT NO.: /22 SJ'- r -&)/2 .` O( 0 HIE ADDRESS: /3,,2s s t,, Aff,o / ' ti,--/ SUBDIVISION: //`_,h -S7 LOT #: L/ SIGNATURE: _r, - r DA 1 E: /// //_.3 (OWNER/AGENT) RECEIVED & VERIFIED BY: a--/7 , - DA 1 E: /1/7/13 ( GARD) Tree location verified per approved site plan. I:\Building\Forms\StreetTreeCertificate 05/30/2012 Oregon Residential Specialty Code N1107.2 HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: Jurisdiction: Site Address: / 6,04-cs,/ G/ 27f a Subdivision/Lot#: � �� ,/,07L Ai V. and/or Map and Tax Lot#: By my signature below, I certify that a minimum of fifty (50)percent of the permanently installed lighting fixtures in the above mentioned building have been installed with compact or linear fluorescent, or a lighting source that has a minimum efficacy of 40 lumens per input watt. (Oregon Residential Specialty Code N1107.2)1 Signature: - Date: `V4 3 Owner/General Contractor/Authorized Agent Print Name: G�/7/'--4 / -/1`S/7f'2c Me,124 ,,,AzkeZerff ' ORSC Section N1107.2.High-efficiency interior lighting systems. A minimum of fifty(50)percent o the permanently installed lighting fixtures shall be installed with compact or linear fluorescent,or a lighting source that has a minimum efficacy of 40 lumens per input watt. Screw-in compact fluorescent lamps comply with this requirement. The building official shall be notified in writing at the fmal inspection that a minimum of fifty percent of the permanently installed lighting fixtures are compact or linear fluorescent,or a minimum efficacy of 40 lumens per input watt. I:',Building\Fors\RES-HighEfficiencyLighting.doc 07/01/08 Oregon Residential Specialty Code R318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM , am the general contractor or the owner-builder at the following address: Site Address: if,,s-rz67 City: 77(i a-/V Permit#: r 7/2 _ egns999 /77 Subdivision/Lot#: and/or Map and Tax Lot#: To conform with the 2008 Oregon Residential Specialty Code (ORSC), Section R318.2 and OAR 918-480-0140, I am notifying the building official that I am aware of the moisture content Requirement of ORSC Section R318.2 and have taken steps to meet this code requirement. [Section R318.2 is provided for reference]. R318.2 Moisture Content: Prior to the installation of interior finishes,the building official shall be notified in writing by the general contractor that all moisture-sensitive wood framing members used in construction have a moisture content of not more than 19 percent by dry weight of dry framing members. Signature: Date: ( //‘//-3 General Contractor or Owner-Builder I:'Building\Form\RES-MoistureSensitiveWood.doc 09/25/08 ;x t tir • �� ,�` ` ��TRI COUNTYuiEMP�CON�TROL'% y�t, -� r� Heating 'Air Conditioning, 13150 S.Clackamas River Dr Oregon City,OR 97045 3 JAI 503-557-2220 (2 I www.tricountytemp.com 0(2-517 /" Work Order Date Summary: Tech: �� P.O.#: 68502 6/3/2013 ROUGH IN RNC INST 1305-0547 Bill To: Job Name: Windwood Construction Maplecrest Lot 4 12655 SW North Dakota l301-S) 4£997tW Maplecrest Ct Tigard,OR 97223 Tigard,OR 97223 DALE 503-780-4375 Description of Work Plan 22154A/3400 Sq Ft. Gas piping: Furnace, water heater, (2)fireplaces, BBQ &cooktop Venting: Furnace,water heater, bath/exhaust fans, dryer&range Pro 4000 thermostat Duct sealing and duct blasting Duct blast: Sq ft X 0.06= @ 50 PA Duct Blast actual: (p @ 50 PA Aprilaire 8126 fresh air intake system TDH1 B065A9421A XR95 Gas Furnace, Single Stage 1.0 Model#TDH1 B065A9421 A All material is guaranteed to be as specified. All work to be completed in a professional manner according to standard practices. Any alteration or deviation from above specifications involving extra costs will be executed only upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon delays beyond our control. Purchaser agrees to pay all costs of collection,including attorneys fees. Signature Date r-+h GREEN PLUMBING 14424 NW LENNOX LANE PORTLAND OREGON 97231 CCB 103426 BPI ID 5020661 11/5/3013 WINDWOOD CONSTRUCTION INC. 12655 SW NORTH DAKOTA STREET TIGARD OREGON 97223 BLOWER DOOR TEST AT 13257 SW MAPLECTEST COURT TIGARD OREGON 97223 MST 2012-00309 TEST COMPLETED 11/5/2013 CFM 50 WAS 3987 AND ACH WAS .5 ERIC OFFM� THANK YOU