Permit q CITY OF TIGARD MASTER PERMIT
' "! 3 COMMUNITY DEVELOPMENT Permit #: MST2013 -00239
T 16 A RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/02/2013
Parcel: 1 S125DC06100
Jurisdiction: Tigard
Site address: 9645 SW SHADY PL
Subdivision: ASH CREEK GATES Lot: 3
Project: Ash Creek Gates, Lot 3
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1805 sf Basement 0 sf Left 5 Parking Spaces: 0
Height: 26 Bathrooms: 4 Second: 901 sf Garage: 497 sf Front 20 Smoke
Dwelling Units: 1 Third: 0 sf Right. 5
Detectors: Yes
Total: 2706 sf Value: $313,054.05 Rear 15
PLUMBING
Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs /Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 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 Tvoes 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
Furn > =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: 5 201 -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 & 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 2706
Owner: Contractor:
RIDGECREST CONSTRUCTION CO INC RIDGECREST CONSTRUCTION CO INC Required Items and Reports (Conditions)
13565 SW TUALATIN- SHERWOOD 6600 SW 92ND AVE SUITE 100 1 Ersn Cntrl 503 639 - 4175
RD PORTLAND, OR 97223
SHERWOOD, OR 97140
PHONE: PHONE: 503 - 246 -8808
FAX:
Total Fees: $21,221.68
This per 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 e 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
d s. ATTENTION: Oregon I :quires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
2-001-0011 through OAR •- - 001 -009 u may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
r
I ued By: — � �• I�" i i L � %� _ Permittee Signature: /
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 RECEIVE r
Residential FOR 01.I I( 1. 1 S1: ONI.1
City of Tigard NOV 14 2 013 Date/B: / � , Permit No. /41.S. i l3"d 0013 13125 SW HaII Blvd., Tigard,OR 97223 Plan Revie tom,
Phone: 503.718.2439 Fax: 503.598.1960 CITY OF TIGA�D Date/B : ai_� Other Per R� j3 �� 7
T I G n R D
Inspection Line: 503.639 BUILDING � c Date Read B : Jut ® See Page 2 for
Internet: www.tigard- or.gov �+�/ILD�� tl� D I VI JIo� Not ified/Method: ���� / [� Supplemental Information
1'VM Y e rn; LGH RA
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
`Iew 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.
1- and 2- family dwelling ❑ Commercial/industrial Valuation: $ J ' J,t�� 05--
❑ Accessory building El Multi-family Number of bedrooms: S
❑ Master builder ❑ Other: Number of bathrooms: 3 • $''
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: q 4'.4 .5— SL0-) S t( V P L • New dwelling area: I7 p L. square feet
City/State /ZIP: T 1 4 ft-it o in Garage /carport area: L ci 7 square feet
Suite/bldg. /apt. no.: 1 1 Project name: ,S jf e irrx c..„ Covered porch area: (/D 3 square feet ci b
Cross street/directions to job site: Deck area: square feet {�(
Other structure area: ?20'? square feet '-
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 15 `Z 5 0 C. Op) 00 Indicate the value (rounded to the nearest dollar) of ,
equipment, materials, labor, overhead, and the • :it for the
DESCRIPTION OF WORK work indicated on this application.
, � I N r F k Valuation: $
�eGV .- f Existing building area square feet
New building area: square feet
$)PROPERTY OWNER ❑ TENANT Number of stoii ..
Name: Type of c. truction:
Address: Occ .. cy groups:
City /State /ZIP: ," Existing:
Phone: ( ) Fax: ( ) New:
,APPLICANT CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: l)6 f - E e'' (Li' 1 (-7--S Structural plan review fee (or deposit):
Contact name: 1 11 XP-1 FLS lan review fee (if applicable):
Address: I `7 .77 y N tpFG4 C i. I Y bE kV
P ( PP )
City /State /ZIP: Dx r) .4 9 7 Z Z Q Total fees due upon application:
\
Phone: () ) 3 do 5 al) Fax: : ( ,0) -Litt, 'Z (l 3 O Amount received:
E -mail: 1�$ e F e _ \ E Q-M 1 _ /! GJ.,�•I PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
Business name: 12-4 0 I C_(1- M r S Submit two (2) sets of roof plan with connection details
1 and fire department access, along with the 2010 Oregon
Address: `3.$1p.SS t J [ v goo_ 1 A) -) 6 D'V O a 1'0 6 oo Solar Installation Specialty Code checklist.
City /State /ZIP: S U v ' .� �J J Permit Fee (includes plan review $180.00
I ' and administrative fees):
Phone: (SIP )ti
/ ;•1 1j Fax: ( ) State surcharge (12% of permit fee): $21.60
CCB lic.: . Z V Total fee due upon appication: $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: r� y Date * Fee methodology set by Tri -County Building Industry
' Service Board.
I:1Building\Permits\BUP- RESPermitApp.doc 02/24/2011 440 -4613T(11 /02 /COM/WEB)
lAl
Building Permit Application Checklist
One- and Two - Family Dwelling FOR OFFICE USE ONLY •
City of Tigard R eceived
Permit No.: - • III q 13125 SW Hall Blvd., Tigard, OR 97223 Associated : 9 Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical
I' I C. A R D Internet: www.tigard - or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No /A
I 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: . ❑ ❑ ❑
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:
11 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.
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 as 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. ... III ❑ ❑
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. Y • •
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- RESPertnitApp.doc 02/ 24/2011 440.4613T(I1/02 /COM/WEB) •
Mtiov. 27. 2013 2.43P1� & Scr,s teat ng :nc. No. 5699 P.
City of Tigard Received _ '
I III
13125 SW Flail Blvd . Tigard. OR 97223 Vary. Permit No.:
3 • Phone 503.718 2439 Fax: 503.598.1960 Plan Rehew __
Inspection Line: 503.639.4175 DAf Rc Other Parma:
T!GARD p
Internet: WWW Tigard- or.gov Date Ready/(jy: toric 1Z1 See Pace 2 for
Not iried/lNdlwd:
Supplemental la formation
TYPE OF WORK •
CORIMLRCIAL FEE* SCHEDULE —USE CHECKLIST
Mechanical permit fees' are based on the value of the work
❑ New construction iii Addition /alteration /replacement
performed. Indicate the value (rounded to the clearest d011ar) of all
❑ Demolition ❑ Other: mechanical matena • . ui mept labor, overhead. and roftt.
CATEGORY OF CONSTRUCTION ' Value- S
• RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
❑ I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
❑ Multi - family ❑ Master builder FOrspecin /inJormwrlon /f/
❑ Other: Dcxnption I
JOR SITE INFORMATION AND LOCATION p/coolirt : I Qty. I Ea Total
Newlin R
lob site address: An condi[iontn• 46.75
Furnace 100 000 BTU ducts/veins 46 75
City /Statc/7lP: Furnace 100,0004 BTU (daclstvents) 54.91
Suite/bldg. /apt. no.: Project nacre: Heat pump 61.06
Cross suect /directions to job site: Duct work 23.32
Hvdrenie hot waters tern 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall in -duct s .ended etc. 46
Flue/vent for any of above 23.32
Subdivision: I no : Other: 23.32
Tax map/parcel no.:
i Other fad a liaxces:
Water heater 23.32
DESCRIPTION OF WORK Gas fire .Iacc/insert 33.39
Flue vent for water heater or gas
ti ,lace 23.32
Log lighter () 23.32
wood/. Ilet stove 33.39
Wood fireplace/ittscrt 23.32
Chimne /liner/flue/vent 23.32
❑ PROPERTY 'OWNER • 1:7 TENANT Other: 23.32
Name Environmental exhaust and ventilation:
Range hood/other kitchen �
Address: equipment
Clothes dryer exhaust
h
City /State/ZIP: 33.39
Single-duct exhaust (bathrooms,
Phone: ( ) I toilet coin,
nmcnts Otilil rooms 23.32
Fax: ( ) Atlic/crawlspace fans 23 32
❑ APPLICANT ' [❑ CONTACT PERSON Other - 23.32
Business name: I i a • Fuel i 'In _:
�` ` • $14.15 for first roar; $4.03 for each additional
Contact name: (`]1'
4 Furnace, lc.
Add ress: Gas asheat heat pump ■�
—
City/State/ZIP:
�- Wall/suspended/unit heater �
� 1 L. 1 . � c� ��, 1Va[er er heater
PhOne:._1b� — r• ,7 •
Fireplace
) r ~ ;:S Jtlr p
E-mail: Ilan : e
I 1 I III /`, (, s . , • / A. /.. S r _114,i Barbecue
CONTRACTOR
a Clothes dryer (gas)
Business name: i
\ 1 • 4 •_`/ S ,,� 6 Other:
Address; $ ; MECHANICAL PERMIT FEES*
Subtotal
�, / , dl I / . Minimum permit fee (590.00)
Phone •�,�) in _ a Fe , , Plan review (25%4 of permit fee)
CC13 tic.: + State surcharge (12°A of permit fee)
TOTAL PERMIT FEE
This permit application expires if • permit Is not obtained within 150
Authorized 'grata . days after it was been accepted as complete.
_ /� • Fee methodology set by 1'rt- Count snorting Indo Service Board
7 1 1% — Date: 1 i — 2 - I
I:rBmi ie - t tens App t1Wtt3.4p <144-461 7T (1 1/02.1COMM'EB1
Plumbing Permit Applig
Building Fixtures i oiZ ol ri( t. t sr. ()NA l
City of Tigard DEC 2 2 013 a Permit No.: �1 r.-0.e9 3 ..-6,40,A 3 7
. 13125 SW ball Blvd., Tigard, OR 97223
Plan Review
Phone: 503.718.2439 Fax(W.19Upq'IGARD Date/By Other Permit So.:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris ( 55 See Page 2 for
Internet: www.tigard - or. gRUILDING DIVISION Notified/Method: 1 Supplemental Information
TYPE OF WORK FEE* SCHEDULE
C] New construction CI Demolition For special information use checklist
Description I Qty. l La. 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
❑ 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 437.78
SFR (3) bath 500.32
❑ Accessory building ❑ Multi - family
Each additional bat /kitchen 25.02
❑ Master builder ❑ Other Fire sprinkler( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: t S Catch basin or area drain 18.76
cl ' - -5 ; i n t•' _t L n Drywcll, leach line, or trench drain 18.76
City /State/ZIP: ` s 3t y � Cc. r 1
Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: Project name: .- Manufactured home utilities 50.03
• Cross street/directions to job site: Manholes 18,76
Rain drain connector 18.76
Sanitary sewer (no. linear ft.: Page 2
Stone sewer (no. linear It: ) Page 2
Water service (no. linear ft.: _) I Page 2
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: Backliow preventer 31.27
DESCRIPTION OF WORK -
_}
12.51
- Clo water washer ve 25.02
LtJ Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
_ Fixture/sewer can 25.02
Nam
Floor drain /floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/ State/ZIP: Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
Business name: 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
Water closet 25.02
CONTRACTOR
_ Water heater 37.52
Business name: kvl .1 4, - rcle) I ` U' t n3 2_ i C. Water piping/DWV 56.29
Address: . !; .6 ...\ .� '� Other: 25.02
City/State/ZIP: r 7 t 9S) 6 Y"4'P 0 / c. J ) L Subtotal
Phone (. c,i) 7 ') ') `� Fax: ( ) Minimum permit fee: $72.50
1 ' Plan review (25% of permit fee)
CCB Lic.: 14-6 . Plumbing Lic. no.: pp, ... 1 - v
L J /f State surcharge (12/0 of permit fee)
`
Authorized signature �--��� TOTAL PERMIT FEE
J!r"`
Print name: -t 1 !l ., �� „' Date: f) i•1 .a i 5 This permit application expires if a permit is not obtained within 180 days
r . ��:,i! (! C% after it has been accepted as complete.
*Fee melhodology set by Tri -County Building Industry Service Board.
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Electrical Permit ApplicatIOY/ ECF VE � p�Jtv,,,„ :ttii:tl�.t.t ....,...:,..
........... .....„ ?ec•_i�ed permit Nn
City of Tigard NOV 14 2013 . Date.'Bv nAc=ei34Ja
•
7 13125 5 at Hall Blvd., Tigard,OR 97223 f Plan Review 503.634.4171 Pax: _03.598.1 t 1 0� FIGARO rateBy, 1 OiherPermiOther-Permit; Jnspccti0n Line: 543.639.a 175
lV� ' ® Doe Rca dy'Dv t urns. i See Paw 2 for
..1.10 vk[7 Internet: w,vw.tignrd- or.gov BUILDING DIVISION yeti" "'''t; . Supplemental Information
TYPE OF WORK _ PLAN REVIEW
ew construction ❑ Addition/alteration /replacement
Please check al that apply (sooner 2 sets of plans w.htems eheeked helnw):
❑ Semite or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: 1 where the available fault current 0 marinas and boatyards.
CATEGORY OF CONSTRLCTOON exceede 10,000 smile At 150 voles or ❑ Floating wildinga.
less tp around, or exceeds 14,000 ❑ Commereial -use agricultural
Igor and 2- family dwelling ❑ Comrncrcial/indus riai ❑ Accessory building I amps for all other installations. buildings.
❑ Multi - Fancily ❑ Master builder ❑ Other: ❑ Fire pump. ❑ installation of 75 KVA or
JOB SITE INFOR�t�TI0�1 AND LOCATION D P, system. larger separately derived system,
❑ Addition of new motor load of ❑ "A ". "E "1 - Z" "1-
lob no.: Job site address: ? S� 100I?P a morn R c re
WV 4 . ❑ Sic or or ros,demtial �tni ❑ Rtxreadonat vehicle pares.
City/Stst:lZlP: 0 Etcalth.carc facilities. ❑ soma) voltage for mete than
❑ Ptmanleus locations. 600 volts nominal.
Suite /bldg. /apt no.: I Project name: ❑ Service or feeder 600 amps or nave.
FEE SCHEDULE
Cross street/directions tO job site: bneri t)rx• Secs Total I •
New residential single- or multi- family dwelling unit.
Includes attached Garage.
Subdivision: Lot no 1.000 sq, ft. or less 1 j 145.15 I 4
Tax map /parcel no. Ea. add'l 500 sq. ft or portion `j' 33,40 1 i
Linutcd energy, residential t 75,00 2
DESCRIPTION OF WORK (with Above sq. ft.)
t Limited energy, multi- family 75.00 2
FA. It residential (with above e4, R)
I Services nr feeders installation, alteration. and /or relocation
200 amps or less 1 80.30 1 2
y "i PROPERTY OWNER ❑ TENANT ! 201 amps to 400 amps 106.85 2
Name: J' i 0 C � rf ' r r 401 amps to 600 amps 160.60 2
�J 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or valts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less I 66.85 I 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 1 100.30 ; 2
intended for sage, lease, rent, or exchange, according to ORS 447, 449, 670. and 701. 401 amps to 599 amps 1 133.75 I 2
Owner signature: Date: Branch circuits— new, alteration. or extension, per nand
A. Fee for branch circuits with
PPLYCAh"f E1 CONTACT PERSON above service or fader fee, 6.65 1 2
each branch circuit
Bt:sincss n e . F -,,is P & I B Fee for branch circuits Contact isms: (
_ 1 . aV►,� fLJ f1 wr h, yr service or feeder fee,
first branch circuit 46.85 2
_
Address: - I ; / f a E t _ I Each. add'I branch circuit 6.65 I ! 2
V M.tiscelianeotts (service or feeder not included)
City/State/ZIP! y Each manufactured or modular i
D p/ �` ` Q 7 I_ dwelling, service arsi/or feeder ! 90.90 2
Phone: � ; 3 g , U i Fax: sin Zg 6 -2 6,3 c) Reconnect only ' 66.85 2 ;
E- ,n '� ail: A ,iS 7. `�N44 � LrA
• ati i Pump or irrigation circle 53.40 , 2
CONTRACTOR ' Sign or outline lighting 53.40 l 2
Business name; Cf cl�1Lh De c g t (c Cl c j Signal circuit(s) or limited- ` I
. JJ energy panel, alteration or
Address: t t 1 7K , ,�[•C' ci6: 57 I exteasipn, 17cscrbe: i Page 2 2
City /Statt;rZ.IP; 7c Q / a�iK r Kr ,,,,,2_ p Each additional inspection over allowable in any of the above
.'
Per inspection 6250
Phone :(•)C'F� ag? - %ce ) Fax: (>D� 0( e o `� p ) (
�' investigation cr hour ;' h r min 62.50
CCB Lie.: C) F er cal. ,tc e, eL Su rv. Lic.: s i Industriai p1w,t per hou 73 75
l' S ^�(� ' - Suprv. O C —
s /i1+� Z" / ELECTRICAL PERMIT FEES
Sup r, >✓iccuic;,, tt a regLire ,t . � ',
t : .r t .,�, �../� f' / ld I Subtotal:
Print narrte: /2._ Q IL A, /f I / ( Plan. rt. v r- -v (25% of permtt fee):
f ` Oa t.',
State 'urc11ar ;; (12% of permit fcc).
Authorized signature:
TOTAL PERMIT FEE!
Print name: ( This p ail application expires if a permit is not obtained within 1811
Date:
dnys After it has been accepted a cemptere.
I 4'i utldingv ^er+ItalSI.c.wr,.l iACr - dcc 052' .04 • Numb::: of :o °n.^U aiir cd ocrperrut.
atn.ar : :1 aMACr.:.a
• Building Division
Development Code Provision Review
T I (' n R D Residential Projects
Building Permit No.: /V.-7,2 D/3 — DO 2 3 g
Project /Subdivision Name: Athe l'it 4. C - S , Lot #:
Site Address: 16 yS Set) s5/A9 itO L,
CWS Service Provider Letter:
Required: Yes ❑ No .
Received: Yes ❑ No ❑
Plans Routed: II
Original Plan Submittal Date: / / y Routed By: - -iii ,
1St Revision Submittal Date: // M9 /i 3 E' Site Plan Only Routed By: ; J ,
2n Revision Submittal Date: ❑ Site Plan Only Routed By:
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 (1) 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 only if approved.
Planning Review (contact f - / UWa(2- at (503) 718- 242 or AO heS @tigard-
or.gov)
Land Use p.se No. SU& B22, f
Zoning y •5
/Setbacks: 1
ront /0 Rear l Siiie S Street Side \ Garage
t aximum Building Height: 3) Actual Building Height.0
I9" isual Clearance
of Easements f t,
Live Lands Type: M OCC°r(- 'i kUe iv I "rI
re tr Trees
P rotected Trees
Notes: ',i w CCU{ Ih ao-64 can , A, i ,R, it' P I% f chic
Owl prer- 7 1 i<f.i' v'• -tree. po- frct - !r -1. g ' v t
t
Original Plan: Approved ❑ Not Approved Date: 13
Revision 1: Approved -Sr Not Approved ❑ Date: I 2-0119,
Revision 2: Approved ❑ Not Approved ❑ ' Date:
(Review Continues on Page 2)
Page 1 of 2
I : \CURPLN \Masters \Development Code Provision Review \DCPR_RES.doc Rev. 01/16/13
Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @ tigard - or.gov)
,Er Actual Slope: / 2 % 4 7rd2-
Notes:
Original Plan: Approved, Not Approved ❑ Date: 11_44/13
Revision 1: Approved Di Not Approved ❑ Date: 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 Applicant
Okay to Issue Permit: Yes ❑ No ,$ //
Date Routed to Building:
Page 2 of 2
I: \CURPIN \Masters \Development Code Provision Review \DCPR_RES.doc Rev. 01/16/13
R:\ 221228 \22122B- RIDGECRES1 SITE\LT3 -ASH CREEK GAT S- RIDGECREST.DWG Al /5/2008,KEVIN BANTON
SITEPLAN NOTES IISI.!I pp, 4 .fts
1. EXCAVATION MATERIAL REMAINING „ - , F c 1 lk
ON SITE IS TO BE CONTAINED BY
APPROVED SEDIMENT BARRIER. / 1
(BUILDER TO VERIFY LOCATION).
2. GRAVEL DRIVEWAY:
8" REQ'D. MIN. 20' FT. Root protection fencing
3. DRIVEWAY MAX. SLOPE :
UPHILL 20%
DOWNHILL 13% ;;I' 224' N
4. GRAVEL SIDE WALK AREAS WITH \ 'II' 226'
N O42'16'E 222' _ 'o - 1
MIN. OF 4" INCHES OF ROCK WHEN
REQ'D. BY SITE CONDITIONS. _ #3_4
F 5. PROTECT STOCKPLIES OCT.1- APR.30 `�
� )I
PER EROSION CONTROL HANDBOOK.
�. Td S.D.E. =
>i
Boulder Wall
2 A. _ Max height 3
° ti Z �� r Upper T.O.W = 226'
I Lower T.O.W. = 222"
I o d —. NC • 0` ' / I '
ti� � ti 6 1:10 . 2" Maple
'> Ili I) \ Street Trees
'� w " ° z
5 ,0. ■ENO ENO ;�
Q
te-4 It m
It 222' Q
. D m
• X
UPPER F • • ' ` • EL =:234 {. ‹.-
Fi 224'
•
•
I . ! 5 . . .
I STREET 226'
. 9 LIGHT
5-O
FIRE
\ a - HYDRANT
• . 4' CONC.
1 DRIVEWAY V h \
i (3500 P.S.I.) i j 12 228'
•
a —
t 0 •
3 �6 1? ti
r N 0 °01 W �'
L
i - 38.11. , 230
PROPOSED \ 6 TREE TO KEEP 341.
'L ° q s10 Y' ' PAO= 232'
PROPOSED TREE TO R MOVE 6 CURB 2 st N(/ SHADY P1A
1 1/4" Wirsbo 2 t reet tree Maple
Water
SCALE : 1" = 20'
MIN wBLE
A F FORR TS1E DESIGN ASSOCIATES INC. IS NOT 111 /I8 L��Y V �cl��s 1
TNEACCU +ETOVOCRAVHV
....,,/,/(
g■ INFORMATION. IT IS THE SOLE RESPONSIBILITY OF THE
BUILDER TO VERIFY ALL SITE CONDIFIONS ,INCLUDING O REGON
ANY FILL PLACED ON THE SRE AND NOTIFY POTENTIAL OWNERS OF ANY POTENTIAL FEID MODIFICATIONS LOT 3, ASH CREEK GATES, TIGARD,
TIONS.
C C L , [ C T ' '. RIDGECREST CUSTOM HOMES
DRN 11/9/2007 KRB
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9645 SW SHADY PL, TIGARD, OR, 97223
Residential - Master Permit
399 Plumbing final
FAIL
MST2013-00239
George Heimos
1. Expose 2-ea back water valves as noted on inspection dated, 01/08/14, cannot be
more than 30 deep, unless listed. 103.5.1.4/103.5.1.3/315.3
2. cleanout plug needs approved thread sealant at: front and rear outside cleanouts.
316.1.1
3. Protect water pipes in garage from freezing at water heater
4. Provide access panel for main water shutoff valve. 310.0
5. Support water heater CPVC pressure relief tube a maximum of 3' vertically.
Installation standards.
Recall inspection when corrections have been completed. Re-inspection required.
103.5.6.1
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9645 SW SHADY PL, TIGARD, OR, 97223
Residential - Master Permit
199 Electrical final
PASS
August 1, 2014 at 12:46:18
PM
MST2013-00239
Jeff Grove
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9645 SW SHADY PL, TIGARD, OR, 97223
Residential - Master Permit
135 Low voltage rough-in
PASS
MST2013-00239
Herb Stabenow
Violation Summary:
Inspector Contractor