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Permit CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit #: MST2009 -00227 Date Issued: 01/07/2010 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S1046B09900 Jurisdiction: Tigard Site address: 14093 SW WALNUT CREEK WAY Subdivision: Lot: 0 Project: Walnut Creek Project Description: New SF • BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 3 First: 843 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 27 Bathrooms: 3 Second: 1124 sf Garage: 395 sf Front 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: sf Value: $219,153.10 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Catch Basins: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Other Fixtures: 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Bckflw Prevntr: 0 MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Fum <10OK: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Fum > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/ Svc or Fdr: 0 Ea add, 500 sf: 3 20 1-400 amp: 0 201 -400 amp: 0 1st W/O Svc/Fdr: Limited Energy: 401 -600 amp: 0 401 -600 amp: 0 Ea add! Br Cir: 601 -1000 amp: 0 601 +amp- 1000v: 0 1000 +ampNolt: 0 ELECTRICAL - RESTRICTED ENERGY SF Residential Audio & 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 Owner: Contractor: Required Items and Reports (Conditions) MATRIX DEVELOPMENT CORP MATRIX DEVELOPMENT 12755 SW 69TH AVE #100 CORPORATION TIGARD, OR 97223 12755 SW 69TH AVE #100 TIGARD, OR 97224 PHONE: 503 - 620 -8080 PHONE: 503- 620 -8080 FAX: 503 -598 -8900 Total Fees: $11,545.60 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. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952-001-0100. You may obtain a copy (1 � ��P off the � rupees or direct questions to OUNC by calling 503.246.6699 or 1.800.3 .2344. Issued By: Yin n Q,rLQ (-Z,8 Permittee Signature: l k 'Building Pe Application iv Residential RECEIVED FOR OFFICE USE ONLY City of 'Cigar( 9 2009 Pete /By /a /9 D9 Permit No.: l'i ace p..Qp / ' ° 13125 SW Hall Blvd., Tigard, OR 97223 DEC 09 Plan Review' • ge t / Phone: 503.639.4171 Fax: 503.598.1960 Date /By: r' l H ? Other Permit: i f de / z \, TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date 7u ris: ® See Page 2for ' Internet: www.tigard- or.gov R�ILDING DI VISION No /Met hod: �/ 4.. ' id Supplemental Information TYPE OF WOR ' / EQUI ED DATA: 1 -AND 2- FAMILY DWELLING ®New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest ❑ Addition/alteration/replacement ❑Other: dollar) of all equipment, materials, labor, overhead, and CATEGORY OF CONSTRUCTION the profit for the work indicated on this application. ®I - and 2- family dwelling Valuation: —'2.4 ( , 10 ❑ Commercial /industrial \O I 0 Accessory building ❑ Multi- family Number of bedrooms: 3 ® Master builder 0 Other: Number of bathrooms: 3 1013 SITE INFORMATION AND LOCATION Total number of floors: 2 dO Job site address: 14093 SW Walnut Creek Way New dwelling area: 1,967 square feet 'C' City /State /ZIP: Tigard, OR 97223 Garage /carport area: 395 square feet Q Suite/bldg. /apt. no.: Project name: Walnut Creek Covered porch area: square feet Cross street/directions to job site: Barrows & Walnut Deck area: trp square feet tiO Other structure area: ..?6 square feet Ck . REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Walnut Creel; I Lot no.: 016 Permit fees' are based on the value of the work Tax map /parcel no.: 251041313 09900 performed. Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and DESCRIPTION OF WORK the profit for the work indicated on this application. Z Valuation: $ \ Existing building area: square feet New building area: square feet ® PROPERTY OWNER ❑ TENANT Number of stories: G+ Name: Legend 'tomes Type of construction: Address: 12755 SW 69 Avenue, Suite #100 Occupancy groups: City/State/ZIP: Portland, OR 97223 Existing: Phone: (503) 620 -8080 Fax: (503) 598 -8900 New: v ' ® AI'l'LICANT ❑ CONTACT PERSON NOTICE VJ � . Business name: Legend Homes All contractors and subcontractors are required to be � L Contact name: Steve Lucas licensed with the Oregon Construction Contractors Board • Q under ORS 701 and may be required to be licensed in the Address: 12755 SW 69 Avenue, Suite #100 jurisdiction in which work is being performed. If the Q N) City/State/ZIP: Portland, OR 9722 applicant is exempt from licensing, the following reasons apply: Phone: (503) 620 -8080 Fax: : (503) 598 -8900 1 r L/� .e — V� C E-mail: slucast✓Icgcndlunnes.co /i\ �, IA - - P CONTRACTOR (J (�( J]� 1c PA VN `Business name: Legend !Ionics BUILDING PERMIT FEES* 4 Address: 12755 SW 69: Avenue, Suite #100 (Please refer zofee schedule) Structural plan review fee (or deposit): City /State /ZIP: Portland, OR 97223 FLS plan review fee (if applicable): Phone: (503) 620 -8080 Fax: (503) 598 -8900 Total tees due upon application: CCI3 Iic.J.4.313 55'/S j Amount received: ►7 7672 A Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Steve Lucas Date: 12/08/09 • Fee methodology set by Tri -County Building Industry Service Board. I: \Building \Permits \BIJP -RES PcrmitApp.doc 11/6/07 440- 4613T(II/02/COM /WEB) 1 Electrical Permit Application RECEIVED FOR OFFICE USE ONLY 1 Received _ City of Tigard ' Q Date /B : r P / ( r 13125 SW I - tall 13Ivc1.,'I igard, OR 97223 U 9 7 O9 Plan Review Permit g' /A Phone: 503.639.4 171 Fax: 503.598.1960 Date /By: Other Permit: 0 0 p 2 0/5 T I GARD Inspection Line: 503.639.4175 ARD Date Ready /By: kris: el See Page 2 for Internet: w•ww.ligard- ur.gov CITY OFT] j vi S 1� milled/Method: Supplemental Information TYPE OF wO�IJlLDINO D PLAN REVIEW ® New construction • ❑ Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ® I - and 2 dwelling ❑ Commercial /industrial 0 Accessory building amps for all other installations. buildings. ❑ Multi - tinnily ® Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or IOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "l -2 ", "1 -3 ", Job no.: Job site address: 14093 SW Walnut Creek Way I OOHP or more. occupancy. ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State /LIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: Project name: Walnut Creek ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street /directions to job site: Barrows & Walnut Description I Qty. I Fee. I Total I • New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Walnut Creek Lot no.:016 1,000 sq. ft. or less 1 168.54 168.54 4 Ea. add'I 500 sq. ft. or portion 3 33.92 101.76 1 Tax map /parcel no.: 251041111 09900 Limited energy, residential DESCRIPTION OF WORK (with above sq. R.) I 67.84 67.84 2 Limited energy, multi - family 67.84 2 • residential (with above sq. ft.) _ Services or feeders installation, alteration, and/or relocation 200 amps or less 100.70 2 ® PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2 Name: Legend Homes 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: 12755 SW 69 Avenue, Suite #100 Over 1,000 amps or volts 552.26 2 City /State /LIP: Portland, OR 97223 Temporary services or feeders installation, alteration, and/or relocation Phone: (503)620 -8080 Fax: (503)598 -8900 200 amps or less 59.36 1 Owner installation: This installation is being made on property that I own which is 201 amps to 400 amps 125.08 2 not intended for sale, lease. rent, or exchange, according to ORS 447, 449, 670, and 401 amps to 599 amps 168.54 2 701 Branch circuits — new, alteration, or extension, per panel A. Fee for branch circuits with Owner signature: Date: above service or feeder fee, Z APPLICANT CONTACT PERSON each branch circuit 7.42 2 13. Fee for branch circuits Business name: Legend Domes without service or feeder fee, 56.18 2 first branch circuit Contact name: Steve Lucas Each add'l branch circuit 7.42 2 Address: 12755 SW 69' Avenue, Suite #100 Miscellaneous (service or feeder not included) Each manufactured or modular 67.84 2 City/State/ZIP: Portland, OR 97223 dwelling, service and/or feeder Reconnect only 67.84 2 Phone: (503) 620 -8080 Fax: : (503) 598 -8900 Pump or irrigation circle 67.84 2 _ E -mail: slucas@legendhomes.com Sign or outline lighting 67.84 2 . CONTRACTOR Signal circuit(s) or limited - energy panel, alteration, or Business name: Garner Electric extension. Describe: Page 2 2 Address: 2920 SE Brookwood Avenue #A Each additional inspection over allowable in any of the above City /State /ZIP: Millsboro, OR 97123 Per inspection 66.25 Investigation per hour (I hr min) 66.25 Phone: (503) 648 -4552 Faa (503) 642 -7925 Industrial plant per hour 78.18 CC13 Lie.: 121159 Electrical 1 : 1 -3050 Suprv. Lic.: 3707 -S ELECTRICAL PERMIT FEES Subtotal: 338.14 Suprv. Electrician signature, require.]: /. , / Plan review (25% of permit fee): — — Print name: Chuck Garner _ ; ' ,i 4,. r• • /08/09 State surcharge (12% of permit fee): 40.58 TOTAL PERMIT FEE: - 378 .72.. Authorized signature: This permit application expires if a permit is not obtained within ISO Print name: Date: days after it has been accepted as complete. • Number of inspections allowed per permit. I:\ Building \I'cr mils \Iit.C- I'ermiiApp.doc 03 /23/06 r ' Plum.bing Permit Application Building Fixtures CE FOR OFFICE USE ONLY C City of Tigard 9 'LI ived C, 9 / Permit No.: ' 13125 S11' Hall Blvd.. Tigard, OR 97223 L Date/By: /2 / Q/Q' (12,6 , I. �. ' eview 777 Phone: 503.639.4171 Fax: 503.598.1960 �('� a ll . , : n,: Other Permit No.: jo 0 .....e,,,.0 r Inspection Line: 503.639.4175 (-� ��11r Dl � eady /By: luris: ® See Page 2 for I TIGARD Internet: tvww ti:;artl- or.gov IBu1J,v Notified/Method: Supplemental Information • TYPE OF N'ORK 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 CONSI'RUCI'ION SFR (I) bath 312.70 ® I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78 ❑ Accessory building ❑ Multi - family SFR (3) bath 1 500.32 500.32 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 .1013 SITE INFORMATION AND LOCATION Site utilities Job site address: 141)93 SW Walnut Creek Way Catch basin or area drain 18.76 City /State /ZIP: Tigard, OR 97223 Drywell, leach line, or trench drain 18.76 Suite/bldg. /apt. no.: Project name: Walnut Creel: Footing drain (no. linear ft.: _) Page 2 Manufactured home utilities 50.03 • Cross street/directions to job site: Barrows & Walnut Manholes 18.76 Rain drain connector 18.76 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: Walnut Creek Lot no.: 016 Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: 2S104138 09900 - Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors /sump 25.02 ® PROPERTY OWNER ❑ TENANT Expansion tank 12.51 Name: Legend Homes Fixture /sewer cap 25.02 Address: 12755 SW 69 Avenue, Suite #100 Floor drain /floor sink/hub 25.02 City /Stale / ZIP: Portland, OR 97223 Garbage disposal 25.02 Phone: (503)620- 8080 Fax: (51)3)598 -8900 Hose bib 25.02 Ice maker 12.51 0 APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02 Business name: Legend !tomes Medical gas (value: $ ) Page 2 Contact name: Steve Lucas Primer 12.51 Address: 12755 SW 69' Avenue, Suite #100 Roof drain (commercial) 12.51 City/State/ZIP: Portland, OR 97223 Sink/basin/lavatory 25.02 Phone: (5113) 620- 8080 Fax: : (503) 598 -8900 Solar units (potable water) 62.54 Tub /shower /shower pan 12.51 E -mail: shicas@legendhomes.com le Urinal 25.02 CONTRACTOR Water closet 25.02 . Business name: Wolcott Plumbing Water heater 37.52 Address: 1075 W. Historic Columbia River Hwy Water Piping/DWV 56.29 Other: 25.02 City /Slate /ZIP: Troutdale, OR 97060 Subtotal 500.32 Minimum permit fee: $72.50 CCI3 Lie.: 112220 Plumbing Lie. no.: 26 -824PB Plan review (25% of permit fee) • State surcharge (12% of permit fee) 60.04 Authorized signature: (n 10-;7'FCt_(A. j Q,,4L TOTAL PERMIT FEE '*. This permit application expires if a permit is not obtained within Print name: Gloria Hawes Date: 12/08/09 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. V • Mechanical Permit Application FOR OFFICE USE ONLY City of Tigard C,E L'eeeived `J Date/By: a / Permit No.: ,�,/ " 13125 SW Hall Blvd., Tigard, OR 97223 w 9 � 7 / /0T aa7 Plan Review Ma Phone: 503.6.19.4171 Fax: 503.598.1960 DEC U 9 2 QO. Date/By: Other Permit: !y ee ga Inspection Line: 503.639.4175 G Dat Read /B Juris: V ® Pe e 2 for TIGARD Ready /By: S Internet: www.l -ur � IVOF TIGA D,otified/Method: Supplemental Information 1'1'1'11 OF WORK Ru�ING1)11 ON COMMERCIAL FEE* SCHEDULE - USE CHECKLIST ® New construction ❑ Addition /alter Lion /rep acelnent Mechanical permit fees' are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit CATEGORY OF CONSTRUCTION Value: $ RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ® I- and 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 Ileating/cooling Air conditioning Job site address: 14093 SW Walnut Creek Way (requires site plan showing placement) 46.75 City /State /ZIP: "Tigard, OR 97223 Furnace 100,000 BTU (ducts/vents) 1 46.75 46.75 Furnace 100,000+ BTU (ducts/vents) 54.91 Suite /bldg. /apt. no.: I Project name: \Valnut Creek Heat pump 61.06 Cross street/directions to job site: Barrows & Walnut Duct work 23.32 l- lydronic 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 _ Flue /vent for any of above 23.32 Subdivision: Walnut Creek I Lot no.: 016 Other: 1 23.32 Tax map /parcel no.: 2S10413It 09900 Other fuel appliances DI':S(:RII'TION OF WORK Water heater 1 23.32 23.32 Gas fireplace 1 33.39 33.39 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 I Chimney /liner /flue /vent 23.32 ❑ TENANT Other: 23.32 Name: Legend Homes Environmental exhaust and ventilation Address: 12755 SW 69 Avenue, Suite #100 Range hood/other kitchen equipment I 33.39 33.39 City /State /ZIP: Portland, OR 97223 Clothes dryer exhaust 1 33.39 33.39 Single - duct exhaust (bathrooms, Phone: (51)3)62(1 - 8080 Fax: (503)589 89(10 toilet compartments, utility rooms) 5 23.32 116.60 ® APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32 Other: 23.32 Business name: Legend Homes Fuel piping Contact name: Sieve Lucas $14.15 for first four; $4.03 for each additional Furnace, etc. 1 Address: 12755 SW 69 Avenue, Suite #100 Gas heat pump City /State / /_II': Portland, OR 97223 Wall /suspended/unit heater Phone: (503) 620-8080 I Fax: : (5(13) 598 -8900 Water heater 1 Fireplace 1 E - mail: slucas@legendhomes.com Iegcndhomcs.com Range 1 14.15 CONTRACTOR 13arbecue Clothes dryer (gas) • Business name: Tri County Temp Control Other: Address: 1315(1 Clackamas River Drive MECHANICAL PERMIT FEES* City /State /ZIP: Oregon City, OR 97045 Subtotal :43::). Minimum permit fee ($90.00) Phone: (503) 557 - 2200 Fax: (503) 557 -0919 Plan review (25% of permit fee) CC13 lie.: 72623 State surcharge (12% of permit fee) .i2..„ TOTAL PERMIT FEE 337. ( Authorized signature: 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 Print name: Sieve Lucas Date: 12/08/09 I:Uluilding \ Permits \NII:C- PermitApp.doc 01/19/07 440-4617T (I I /02/COM/w'En) . . • • , • • , •• . • ' • '• ; CITY OF TIGA BUILDING PERMIT NO: - SITE PLAN REVIEW Street Trees: Protectedjapf. ' Approved 0 Not ADomved BY: MAK Approved , • •- - - • 1 - 1 NO1 Approved Notes: Date: yv • • CITY OF TIGARD - SITE PLAN REVIEW • BUILDING PERMIT NO.: "All■ • attA • PLANNING DIVISION: Required Setbacks: 0 Approved 0 Not Approved Side: Street Side: IQ Front. r: (iartwe: ---- Rear: IC Visuni Clearance: 0 Approved 0 Not Approved tvlaximum Building Height _1.. feet CWSe.' Provider Letter Required: 0 Yes 0 No • I4ceived tl 4_ Date. (WO ENGINE-;ERIN DEPARTMENT: Actual lope: - % ApproVed 0 Not Approved Site Pin: e-Approved 0 it App oved B: A Date: Notes: airt...6V-e-b- "v/4, 60.4_44.s.v • . =l:.0T PL AN " v6( 2009 -- 002 -Z7 Ft= LOT *O16 WALNUT CREEK 14093 SW WALNUT CREEK WAY NE 1/4 SECTION 4, T. 25, R. 1W, W.M. RECEIV ED I. • 20' -0' CITY OF TIGARD WASHING=TON COUNTY, OREGON DEC 1.8 2009 LEGEND 1. :7 i.. 1 HOMES CITY OF TIGARD a 1 111111 18755 s. 6913 LVL 0ma 603) ego -6060 11 PUt!NN1t�GlEP1(aIMEEIIIR "nu emes 100 FAX 101 698 -1000 7 ° `•; E POIMAND. 97881 �.�161 •. . �— u • 0/ W' W r al - !L N e ' �- • -a '\ _\,‘ . 5 858.02510' 1" pc__ _ _r i . 00 • . r •15 \\ 10 x 10/0\ \S i t - 741111110.).<15 1\ ODEC. \ —\ r 1 224.5' ■ X4.00 v > � ;��., I � i 225 —I- 2 in ` " I � /LOT /,1 26 i : r �0 /.3 8b5 9G7FT i 111 1 / wiLLOw B / / ;, LOT 1"1 to 11 ........ 1 / �K FLR ■2 213.5'// I W I /GAR FLR X221.5•// Din .J W I I\ / / / z % I �� I / // /. 1 . / ii 226.13' / Cn , � ■\ \■ 2 i I.3 2 29 \ I i <,,, \ ' \ .L 1 [u I k \ \ 9 Qs •.,t_,. _ W I .� = J \ 226.5' 1 -, W - - -- WATER LINE I ' � ` L I, 8 PUE • 55 — — — — SANITARY SEWER I a ` 88�I9'a6 "E SD -- - - — STORM DRAIN ; I I .• / / • 1 I > .. � � •'� • � • • ' • .� j � • :� 'SIDEWALK cE —o-- ¢ OF EROSION REET GE cl•IAN GL ER P EAR am /J 0 WATER METER I ; 3 \ \ -4X-__ 0 MANHOLE i— --- _I_ \ "Cal p er \ ` I ® IN P ¢ LI:: \ W W CIR - - _ r _ \ A' 0 STREET LIGHT I # - - - ivy - ' - — ¢ N ( r 4 I FIRE HYDRANT N N N PROVIDE EROSION ' CONTROL FENCE . PER COMMUNITY • EROSION PLAN • SETBACKS : FRONT YARD • 15 FEET GARAGE • 20 FEET REAR YARD • 15 FEET SIDE YARD • 4 FEET STREET SIDE YARD • 10 FEET