Permit W CITY OF TIGARD PLUMBING PERMIT
'x'11 le COMMUNITY DEVELOPMENT , ' ,. Permit#: MST2013-00236
7. '' i ' Date Issued: 12/18/2013
T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 'r"
3%-6 gT 1 Parcel: 2S110BC12300
f I Jurisdiction: TIGARD
Site address: 14787 SW 122ND PL
Project: Troy Park,Lot 9 Subdivision: TROY PARK Lot: 9
Project Description: New SF. 5/6/14:Reprinted permit to include backflow for irrigation.
Contractor: TIMBERLAND HOMES INC Owner: PRESTIGE INVESTORS LLC
12670 SW 68TH AVE STE 300 12670 SW 68TH AVE#300
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503-620-8860 PHONE:
FAX: 503-598-9081
FEES
Quantity Description Date Amount
1 ea Building Permit-New 12/18/2013 $1,795.74
Specifics: Construction
1 Plan Review 12/18/2013 $751.34
1 ea 12%State Surcharge- 12/18/2013 $215.49
Type of Use: SF Building
Class of Work: NEW
0 Plan Review 12/18/2013 $415.89
Type of Const: VB 1 ea DC Provision Review,SF- 12/18/2013 $70.00
Occupancy Grp: R-3 Ping
Stories: 2 1 ea DC Provision Review,SF- 12/18/2013 $10.00
LRP
14 ea Info Process/Archiving-Lg 12/18/2013 $28.00
$2.00(over 11x17)
64 ea Info Process/Archiving-Sm 12/18/2013 $32.00
$0.50(up to 11x17)
1 ea Metro Const.Excise Tax- 12/18/2013 $371.40
Residential Use
1 ea Tig-Tual School CET- 12/18/2013 $3,025.56
Residential
1 ea Park-SDC-SF Detached, 12/18/2013 $5,996.87
Duplex
Total $21,147.50
Required Items and Reports(Conditions)
1 Ersn Cntrl 503-639-4175
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 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: - --� 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.
Plumbing Permit Application
Site Utilities
City of Tigard
1111 • 13125 SW Hall Blvd.,Tigard,OR 972 RECEV1t .s/Wrn Permit No.: �' ��. ,'Lx �
' Plan Review W
Phone: 503.718.2439 Fax: 503.598. 960 Date/By: Other Permit No.:
Inspection Line: 503.639.4175 MAY 0 6
I I c.,\i I Z•Q 14- Date Ready/By: luris: See Page 2 for
Internet: www.tigard-or.gov Notified/Method: 'c6,I B Supplemental Information
TYPE OF WORK cm QF TIGARD F> _
®New construction ❑yelkiktmiNGIENGINEEFtiNG 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 e ach utility connection)
CATEGORY OF CONSTRUCTION r SFR(1)bath 312.70
® 1-and 2-family dwelling ❑Commercial/
i I SFR(2)bath 437.78
ff�� SFR(3)bath 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other:
Fire sprinkler( sq.ft.) Page 2
/OR sera INFORMATION AND LOCATION Site utilities:
Job site address:14787 SW 122"Place Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name:Troy Park Lot 9 Manufactured home utilities 50.03
Cross street/directions to job site:SW Winterview Drive Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision:Troy Park I Lot no.:9 Fixture or item:
Tax map/parcel no.: Backflow preventer 1 31.27 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Single Family Residence Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name:Timberland Homes,Inc. Fixture/sewer cap 25.02
Address:12670 SW 68th Ave.,Suite 300 Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP:Tigard,OR 97223 Hose bib 25.02
Phone:(503)620-8860 Fax:(503)598-9081 Ice maker 12.51
® APPLICANT 0 CONTACT num Interceptor/grease trap 25.02
Business name:Timberland Homes,INc. Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Laura Blake
Roof drain(commercial) 12.51
Address:12670 SW 68th Ave.,Suite 300 Sink/basin/lavatory 25.02
City/State/ZIP:Tigard,OR 97223 Solar units(potable water) 62.54
Phone:(503)6204860 Fax::(503)598-9081 Tub/shower/shower pan 12.51
E-mail:laura @timberlandhomes.net Urinal 25.02
CTOR Water closet 25.02
CONTRA -
Water heater 37.52
Business name:Trademark Landscapes,Inc. Water piping/DWV 56.29
Address:PO Box 2410 Other: 25.02
City/State/ZIP:Oregon City,OR 97045-4545 Subtotal58),)..7
Phone:(503)631-3893 Fax:(503)631-4737 Minimum permit fee: $72.50 /
Plan review (25%of permit fee) r/
CCB Lic.: ` Plumbing Lic.no.: State surcharge(12%of permit fee) i3, -)s---
Authorized signature: /0 , TOTAL PERMIT FEE
Print name: / /, / Date: s S / Thin permit application expires if a permit is not obtained within 18 days
[ � ( after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
t:\Building\Pertnits\PLMU-PermitApp.doc I0/01/09 440-4616T(10/02/COM/WEB)
CITY OF TIGARD MASTER PERMIT
i ll 11 COMMUNITY DEVELOPMENT Permit #: MST2013 -00236
13125 SW H all Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/18/2013
T ! (:,.„\ K O g Parcel: 2S110BC12300
Jurisdiction: TIGARD
Site address: 14787 SW 122ND PL
Subdivision: TROY PARK Lot: 9
Project: Troy Park, Lot 9
Project Description: New SF.
BUILDING
Floor Areas Reauired Setbacks Required
Stories: 2 Bedrooms: 3 First: 1288 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1366 sf Garage: 502 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right 5
Detectors: Yes
Total: 2654 sf Value: $309,498.76 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 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 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods. 1 Other Units 0
Furn<100K: 1 Vents 0 Woodstoves 0 Gas Outlets 4
Furn > =100K: 0
ELECTRICAL
Residential Unit Service Feeder Temo SrvclFeeders Branch Circuits
1000 sf or less: 1 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0
Ea addl 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
asin Y
Other: N Other Description: Ecom p g
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R -3 2654
Owner: Contractor:
PRESTIGE INVESTORS LLC TIMBERLAND HOMES INC Required Items and Reports (Conditions)
12670 SW 68TH AVE #300 12670 SW 68TH AVE STE 300 1 Ersn Cntrl 503- 639 -4175
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: PHONE: 503- 620 -8860
FAX: 503- 598 -9081
Total Fees: $21112
This rmit is issued sul;At the regulations contained in the Tigard Municipal Code, State of OR. Special, Cod s and all • . er ap• cable law. All work will
done in accordance with a• •roved plans. This permit will expire if work is not started within 180 days of issuan -, if w• k is s pended for more the 180
ys. ATTENTION: Oregon la eq ire you to follow the rules adopted by the Oregon Utility Notifi• , tion r =n r. T •se rules are set forth in OAR
52- 001 -0010 rough OAR 952 ■ "1-0090 You may obtain a copy of the rules or direct questions to OUNC by calling •03 23..19 7 o 1.8 '. 3 .2344.
/ 1
I ued By: P ermittee Signature: 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 • . , project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application , 3 lI03c lx s
Residential FOR OFFICE I. SE ONLN
City of Tigard �� / 'Z ea II .�� Permit No.: ? • i
II ' • 13125 SW Hall Blvd., Tigard, OR 97223 1 - c) Plan ttevie Other Permit: ,•
Phone: 503.718.2439 Fax: 503.598.1960 ° DateB : i i t '1 i �r ) G
r� V T 1 c, n R D Inspection Line: 503.639.4175 v l Date Read /B ]arts: ® See Page 2 for
Internet: www.tigard - or.gov NO died/Meth • f AS / 3 j (p Supplemental Information
AI
TYPE OF WORK CO O ,1 G j REQUIRED DATA: 1- AND 2-FAMILY DWELLING
® New construction ❑ Demolitio ,1' 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
® I_ and 2- family dwelling ❑ Commercial /industrial ' Valuation: 5 ? -49 i r 76,
❑ Accessory building ❑ Multi- family Number of bedrooms: 3
❑ Master builder ❑ Other: Number of bathrooms: 2.5
JOB SITE INFORMATION AND LOCATION Total number of floors: - 'L
Job site address: 14787 SW 122 Place New dwelling area: 2 4 5-ti square feet
City /State /ZIP: Tigard, OR 97224 Garage /carport area: 56'7 square feet
Suite/bldg. /apt. no.: Project name: Troy Park Lot 9 _ Covered porch area: ( 6 square feet l 3
Cross street/directions to job site: SW Winterview Drive Deck area: square feet (left
Other structure area: '�, square feet '
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Troy Park I Lot no.: 9 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.
Single Family Residence Valuation: 5
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: Timberland Homes, Inc. Type of construction:
Address: 12670 SW 68"' Ave., Suite 300 Occupancy groups:
City /State /ZIP: Tigard, OR 97223 Existing:
Phone: (503)620 -8860 Fax: (503)598 -9081 New:
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: Timberland Homes, Inc. (Please refer ta fee schedule)
Structural plan review fee (or deposit):
Contact name: Laura Blake
Address: 12670 SW 68 "' Ave., Suite 300 FLS plan review fee (if applicable):
City /State /ZIP: Tigard, OR 97223 Total fees due upon application:
Phone: (503)620 -8860 I Fax: : (503)598 -9081
Amount received:
E -mail: laura@timberlandhomes.net PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof -top mounted Photo Voltaic Solar Panel System.
Business name: Timberland Homes, Inc. Submit two (2)lets of roof plan with connection • : ails
and fire departmerlt along with th : I Oregon
Address: 12670 SW 68 Ave., Suite 300 Solar Installation Spesteity Code c • ist.
City/State /ZIP: Tigard, OR 97223 Permit Fee (incl espla• -view
$180.00
and adminis.. . fees):
Phone: (503) 620 -8860 Fax: (503) 598 -9081
State surcharge (1 ' . of permit f• • $21.60
CCB lie.: 141715
Total f•.= 'ue upon application: $201.60
Authorized signature: ' This permsit appltc'ation expires if a permit is no toed
within 180 days after it has been accepted as complete.
* Fee methodology set by Tri -County Building Industry
Print name: Laura Blake Date: l� ,3 Service Board.
LlBuilding�Permits \BUP- RESPermitApp.doc 02/24/2011 440 613T( /COM/WEB)
/ . •.
Plumbing Permit Application
Building Fixtures
i\ N i i E FOR OFFICE USE ONLY
Cit of Ti and Received /y, p �)
14 • y g Date/By: Permit No.: ill i ¶ 7- i 1 — VC+ 2. (,
13125 SW Hall Blvd., Tigar , Plan Review
• Phone: 503.7182439 Fax: 5035 , ) 1,960 I A Other Permit No.:
`J Date/By:
Inspection Line: 503.639.4175 D ate Read /B runs: B See Pa e 2 for
I ii,ARD Ready /By: 6
' Internet: www.tigard it ^ �Q(1 Notified/Method: Supplemental Information
i (E1 New construction a TTYPE ;f � • SCHEDULE
e ti( . t ton For special information use checklist. 'v
Description [ 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
0 1- and 2- family dwelling ❑ CommerciaVindustrial SFR (2) bath 437.78
SFR (3) bath L 500.32
❑ Accessory building ❑ Multi - family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: AA�
Fire sprinkler ( sq. ft.) Page 2 V
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 14787 SW 122 Place Catch basin or area drain 18.76
City /State /ZIP: Tigard, OR 97224 Drywell, leach line, or trench drain 18.76 41
Footing drain (no. linear ft.: ) Page 2
Suite/bldg.apt. no.: f Project name: Troy Park Lot 9 Manufactured home utilities 50.03 \�
Cross street/directions to job site: SW Winterview Drive Manholes 18.76
Rain drain connector 18.76 Q
Sanitary sewer (no. linear ft.: ) Page 2 t �
Storm sewer (no. linear ft.: ) Page 2
Water service (no. linear ft.: ) Page 2
Subdivision: Troy Park , Lot no.: 9 Fixture or item:
Tax map /panel no.: Backflow preventer I 1 L_3 }27 X1-1
DESCRIPTION OF Backwater valve 1251
Clothes washer 25.02
Single Family Residence
Dishwasher 25.02
0 .\I
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER l 0 TIITLAa Expansion tank 1251
Name: Timberland Homes, Inc. Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 12670 SW 68 Ave., Suite 300
Garbage disposal 25.02
City /State /ZIP: Tigard, OR 97223 Hose bib 25.02
Phone:(503)620 -8860 Fax: (503)598 -9081 Ice maker 12.51
® APPLICANT 0 CONTACT PERSON Interceptor /grease trap 25.02
Business name: Timberland Homes, Inc. Medical gas (value: $ ) Page 2
Pruner 1251
Contact name: Laura Blake
Roof drain (commercial) 1251 •
Address: 12670 SW 68 Ave., Suite 300
i Sink/basin/lavatory 25.02
City/State/ZIP: Tigard, OR 97223 Solar units (potable water) 62.54
f Phone: (503) 620 - 8860 Fax: : (503) 598 -9081 Tub/shower /shower pan 12.51
E -mail: laura ®tlmberlandhomes.net Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 3752
Business name: G & B Plumbing & Sons, Inc. Water piping/DWV 5629
Address: PO Box 92 Other 25.02
City /State /ZIP: St. Paul, OR 97137 Subtotal
Phone: (971) 563 -3268 Fax: (503) 633 -8378 Minimum permit fee: $7250
CCB Lic.: 184372 Plumbing Lic. no.: PB634 Plan review (25% of permit fee)
t , ` State surcharge (12% of permit fee)
l
Authorized signature: [I+it
TOTAL PERMIT FEE
Print name: Steve Fowler Date: VI/ This Permit application expires if a permit is not obtained within 180 days
! 3 after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Scant.
I:\ 13uildmg Wbmuts∎PLMU- PcnnitApp.doc 'MI /09 440-46I6T(iOn2 COM/W®)
' 4
Mechanical Permit Applica C „'\J ED FOR OFFICE USE ONLY
City of Tigard Received
Permit No.: -�
• 13125 SW Hall Blvd., Tigard, OR 97223 NOV 7 20{ 1 Date/By: 1'5! �(� tiC o� (
Plan Review
Phone: 503.7182439 Fax: 503598.1960 D4te/By: Other Permit:
Inspection Line: 503.639.4175 -�/ 0FTIG PiRD
T I G A RD CI Ty llt Internet www.ti azd -or. ov C �� Ready/By: Juris B See Page 2 for
g g ' VI C +If1 No. Supplemental Information
�J7
BUILDING DIV 1,�VJ
TYPE OF WORK COMMERCIAL FEB• SCHEDULE — 115.E CHECKLIST
Mechanical permit fees* are based on the value of the work
® New construction ❑ Addition /alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition El Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $
C A T E G O R Y OF C O N S T R U C T I O N
RESIDENTIAL EQUIPMENT / STSTEMS PIQ '
® 1- and 2- family dwelling El Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. I Total
JOB STFE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: 14787 SW 122 Place Furnace 103,000 BTU (ducts/vents) I 46.75
City/State /ZIP: Tigard, OR 97224 Furnace 100,0001- BTU ( ducts/vents) 54.91
Suite/bldgJapt. no.: Project name: Troy Park Lot 9 Heat pump 61.06
Duct work 2332
Cross street/directions to job site: Hydonic hot water system 2332
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, induct, suspended, etc. 46.75
Flue/vent for any of above 2332
Subdivision: Troy Park Lot no.: 9 Other: 2332 -
Other fuel appliances:
Tax map /parcel no.: Water heater ) 2332
Disoarnast OF WORK Gas fireplace /insert ( 3339
Flue vent for water heater or gas
Single Family Residence fireplace 2332
Log lighter (gas) 2332
Wood/pellet stove 3339
Wood fireplace/insert 2332
Chimney/liner /flue /vent 2332
® PROPERTY OWNER I 0 =tea Other: 2332
Environmental exhaust and ventilation: _
Name: Timberland Homes, Inc. Range hood/other kitchen
equipment ( 3339
Address: 12670 SW 68'h Ave., Suite 300
Clothes dryer exhaust ( 3339
City/State /ZIP: Tigard, OR 97223 Single-duct exhaust (bathrooms,
toilet compartments, utility rooms) 5 2332
Phone: (503)620 -8860 Fax: (503)598 -9081 Attic /crawlspace fans 2332
® AP?IZCAN1 ❑ CONTACT PICRSON Other: 2332
Business name: Timberland Homes, Inc. Fuel piping:
$14.15 for first four; $4.03 for each additional
Contact name: Laura Blake Furnace, etc. I
Address: 12670 SW 68 Ave., Suite 300 Gas heat pump
Wall/suspended/unit heater
City/State /ZIP: Tigard, OR 97223 Water heater I
Phone: (503) 620 -8860 I Fax: : (503) 598 -9081 Fireplace 1
E -mail: Marna @timberlandhomes.net Range
Barbecue
CONTRACTOR Clothes dryer (gas)
Business name: Central Air Other:
MECHANICAL PERMIT MS*
Address: PO Box 433 Subtotal
City/State /ZIP: Clackamas, OR 97015 Minimum permit fee ($90.00)
Plan review (25% of permit fee)
Phone: (503) 656 -1908 I Fax: (503) 650 -3898
State surcharge (12% of permit fee)
CCB tic.: 178624 in (15 / (i TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Authorized signature: / . /?� days after it has been accepted as complete.
g / • F ee methodology set by Tri -County Building Industry Service Board
Print name: Andrew Scheidt Date: / i r / 3
I:\ BuildingV }rmits)MEC_PermitApp_040113 doc 440 .. 17r (11 O./COM/WEB)
Electrical Permit A lI E ``\JE® FOR OFFICE USE ONLY
City of Tigard I 20 3 DDatdBy: Permit No.: f )T d 1 3. 1')(
i 13125 SW Hall Blvd., Tigard, OR 9** Plan Review > ?/lo
Phone: 503.7182439 Fax: 503 598.1960 Date/By: Other Permit:
11 Inspection Line: 503.639.4175 (+ '(N Oki -- � Date Ready/By: Juris: 0 See Page 2 for
Internet: www.tigard or.gov U t ` G �1 \11S MoN Notified/Method: Supplemental Information
TYPE � PLAN REVIEW
® New construction ❑ Addition/alteration/replacement Please check all that apply (submit I 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 10000 amps at 150 volts or ❑ Floating buildings.
® 1 -an 2-family dwelling less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
y g ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A" "E" "I -2" "1 -3"
rd IOOHP or more. occupancy.
Job no.: TP9 Job site address: 14787 SW 122 Pl ac e
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: Tigard, OR 97224 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg /apt. no.: Project name: Troy Park Lot 9 ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site:
Description I Qty. I Fee. I Total l •
New residential single - or multi-family dwelling unit.
Includes attached garage.
Subdivision: Troy Park Lot no.: 9 1,000 sq. ft. or less I 168.54 4
Ea. add') 500 sq. ft. or portion 'J 33.92 1
Tax map /parcel no.:
Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft) / 75.00 2
Limited energy, multi- family 75.00 2
Single Family Residence residential (with above sq. ft.)
Renewable Energy ❑ See Page 2
Services or feeders installation and/or relocation
la r I 0 TENANT 200 amps or less 100.70 2
J 201 amps to 400 amps 133.56 2
Name: Timberland Homes, Inc. 401 amps to boo amps 200.34 2
Address: 12670 SW 68 Ave., Suite 300 601 amps to 1000 amps 301.04 2
City / State/ZIP: Tigard, OR 97223 Over 1,000 amps or volts 55226 2
Temporary services or feeders installation, alteration, and/or
Phone: (503)620 -8860 Fax: (503)598 -9081 relocation
200 amps or less 5936 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447,449, 670, and 701. 401 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
® APPLICANT 1 ❑ CONTACT PERSON/ A. Fee for branch circuits with
above service or feeder fee,
7.42 2
Business name: Timberland Homes, Inc. each branch circuit
B. Fee for branch circuits without
Contact name: Laura Blake service or feeder fee, first 56.18 2
branch circuit
Address: 12670 SW 68 Ave., Suite 300 Each add') branch circuit 7.42 2
City/ State/ZIP: Tigard, OR 97223 Miscellaneous (service or feeder not included)
Each manufactured or modular 67.84 2
Phone: (503) 620 -8860 Fax: : (503) 598 -9081 dwelling, service and/or feeder
\ Reconnect only 67.84 2
E - mail: laura @timberlandhomes.net Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: Neel Electric, Inc. Signal circuit(s) or limited-energy See
panel, alteration, or extension. Page 2 2
Address: 2931 Redfir Ct. NW Each additional inspection over allowable in any of the above
City / State/ZIP: Salem, OR 97304 Additional inspection (1 hr min) 6625/ hr
Investigation (1 hr min) 6625/ hr
Phone: (503) 701 -6257 Fax: ( ) Industrial plant (1 hr min) 78.18 / hr
Inspections for which no fee is 90D0/ hr
CCB Lic.: 194105 Electrical Lie.: C74' Suprv. Lic.: s pecifically listed (1 hr min)
j t _, >c ELECTRICAL PERMIT FE1ES
Suprv. Electrician signature, required: /II . � Subtotal:
Print name: Mike Neel Date: il/ i // 3 Plan review (25% of permit fee):
State surcharge (12% of permit fee):
Authorized signature: M2 ., TOTAL PERMIT FEE:
Print name: Mike Neel ( I ` Date: / /// / /� This liee
permit appt expires era permit is not obtained within ISO
t / days after rr it has been accepted as complete.
• Number of inspections allowed per permit.
I:\ Buildmg\P erimtsiELC_PemutApp_ELR_ERE.doc Rev 05/212013 440-4615T(I I n5/COM/WEB
Building Division
Development Code Provision Review
T l U A R° Residential Projects
Building Permit No.: "ro/C/3
Project /Subdivision Name: T AO( 134--'7 , Lot #: q
Site Address: /'77 g7 5:. 0) /it
CWS Service Provider Letter
Required: Yes G No L9
Received: Yes ❑ No ❑
Plans Routed:
Original Plan Submittal Date: /1 7 / Routed By: e '
1" Revision Submittal Date: l / / Cl' Site Plan Only Routed By: n7)
2nd 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 (✓) 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. v
Planning Review (contact aJ � ✓,- ,' a (2. at (503) 71824 or 0 6Kr ' @tigard-
or.gov)
Land Use Case No. SUB7.O01 — DOD I1
Zoning R`
Setbacks: i s
ront G S Rear I S Side 5 Street Side v I 1 Garrge 2D
/ Maximum Building eight: %' Actual Building Height 24
O Visual Clearance Nik
Ia asements
t ' Sensitive Lands Type: NON r/
❑ Street Trees
❑ Protected Trees
Noes: Specrfy Stre't(e , n 1iD 1)nitvA11(--\ J C`r*-PS a relvlurl
mono -hn.,- WP cl- rrntir r_
Original Plan: Approved ❑ Not Approved Date: I 1 I .
Revision 1: Approved Not Approved ❑ Date: t 1 1
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)
2' Actual Slope: (o
Notes:
Original Plan: Approved .0" Not Approved ❑ Date: / I/ Z` 1 3
Revision 1: Approved Z. Not Approved ❑ Datc: I1 f 24 1 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 , - J
Okay to Issue Permit: Yes 'A, No R i jl./ 3
Date Routed to Building:
/1 ;id / 7 ifg -------------
Page 2 of 2
I: \CURPLN \Masters \Development Code Provision Review \ DCPR_RES.doc Rev. 01/16/13
RECEIVED
NOV 19 2013
CITY OF TIGARD
BUILDING DIVISION
SITE PLAN A14 NOTES=
I. AU. DOMO MTN* MATTI& TO IT IMPORT, 10 AN APPRIO D DISPOSAL
LOCATION. }
2. AU. � WL 110011 NCMLIOL DR v AAM IITC.. TO IT .
A MOM HSD $11LlCTIMIL �I pCAVA110N 10 PROMO CO MM. TRIM .111 111g® NM
41,ROM. I ,I .�.ONI.I ,R�.D .»„m A�,
HONE DESIGN
PRIOR TO 11 'IAN AID O01r110C11A1
R PROVIDE COMIT.GRT APPROTD STAOLDTSD MAT TO OO *1RIICTION ONMANCE Lp.�'
P RIOR TO OCAVATTOH AND COMP ICTIOL .•
O. IL S!• MUST - WARM, gIM PILOH OR PLAT= AIW W e�1
ll 1
OCTOrI I AND APR SO
1 OLIAMC CT INT.OTT CTOR TO ' TO meow LOCATION CP AU. U11J1 PRIOR TO
& OOUDARY AO TOPO/M IiV MORMATIM HAS TM MOTTO TO TWIT DIMON.
TNT A A 4• M GOER ELEV. 10020'
TILER MOT LAC•aJ. Mar y INLD UAT.11 PORI . U
' , `��
TOT R O
W ALL NTS CIORICTI MLions P11.1. C CONTACTOR S 86
CORNER ELEV. 100.00 D38'31 W 10 �.I v
t TCPOO S4}HT SYVATIOO TM CO.LSCI PISal ACT AL NR SuTMT. G X � a.�� � X'�' ^ ^ ^ �� I I
kaalMn 4N.. lc. x — X --'
d. DIMTNS OIRADt O.N ATIOH "_- "'_____--- S ' IIL 4" - . .. , —' j 1 ..•�
R. TM PHOTO FLOOR WAT ION ` \ ` F _ n �' , a .. }; ' b,,; ,. N IL PRO � /� L PnoNa A TOW TROT. TAT TOM TOM ALL ONVDI4Y ATT. Witt r , V J
UD! NgSI ORM& OAT UDIT ALL SDOMLK AID PATIO ATM& I T
O PPS ALL TOM PlASi . . TIM SRLONS 1O A COSRYA DSMOSAL :r.;.1,..:-:,1:i.
,., .• I
PCWT lC110NL iiiL
141140011 SLOT CP CUSS AND PILLS TO S WO 0.1 MITITTAL TO CIO N . f y O C(�
1L F
VlISIIGL R'7S OILDStlq SIISIG1US11R POUDA11Otl� I10 1lTASUtl WALLS. ' ` ' , r. +• • , . `��' i -, I L t � (� T—
�1 j/- N
FRONDS[ AM MAMAN PSIISII MOOS SRSN POSPOSITS DRW {DONNA= TOP, I� z . ^`
STRCIIR ON ALL SOT SIN A SLOPS CP Y PM1M N 1/ M N I . ' - 5 A , : S F µ'4 ; ,II LL1 a ›-
F �'� .� L 4 • T � � � �► r z o 40
oi uN , s r
EROSION CONTROL 1 L14N X g, $ �I� W '4 Q CD
' pin 0
d L l r : Ey_T 9/16! „1. ` n 3 /4 WATER MAIN
}-
COY£REP STOCKPILES O �. ����"' , / 0 NW ; - E O :::
x —x —x &EDI-TENT FEE
S . . Dan FlR 4 OA+
i 111111111M
,; S 860 35'31 W 992
j CONSTRUCTION FNTRAr'IC CORNER ELEV. 100 0'
CORNER ELEV. ' 1 00.00'
WORK STAGING/ MATERIAL STORAGE O PLAN No: 3093
I
DRAM IF.
DATE: 10 -31 -2013
SOIL N �` C UNTIL LANDSCAPE
DRA
IS IN PLACE SCALE: I -0' Q CATCH BASIN PROTECTION N s I PLOT
• WOODEN CURB RAMP 0 =A1► ` PLAN
14 x$
%:: f'Is LOT S IINFORMATION: I
LOT AREA. IAN Sa PT.
OULDND AMA. 21014 SSA. FT.
CONCITTI AREA 404 !a PT.
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
14787 SW 122ND PL, TIGARD, OR, 97224
Residential - Master Permit
199 Electrical final
PASS
MST2013-00236
Jeff Grove
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
14787 SW 122ND PL, TIGARD, OR, 97224
Residential - Master Permit
399 Plumbing final
FAIL
MST2013-00236
George Heimos
1. cleanout plugs need approved thread sealant at: 2-ea in front. 316.1.1
2. Provide sized expansion tank for water heater as per manufacturers installation
instructions. 310.4
3. Recall inspection when corrections have been completed. Re-inspection required.
103.5.6.1
All else ok
NOTE: backflow device pass. 1" febco model 850, serial no. H038132
Violation Summary:
Inspector Contractor