Permit q CITY OF TIGARD MASTER PERMIT
1/11 s COMMUNITY DEVELOPMENT Permit#: MST2014-00023
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/01/2014
Parcel: 2S112BD07900
Jurisdiction: Tigard
Site address: 7755 SW HANSEN LN
Subdivision: BRITTANY MEADOWS Lot: 15
Project: Brittany Meadows, Lot 15
Project Description: New SF.
BUILDING
Floor Areas Reauired Setbacks Required
Stories: 2 Bedrooms: 4 First 1293 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1430 sf Garage: 430 sf Front 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2723 sf Value: $312,376.28 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: 3 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 Types Air Conditioning: N Vent Fans: 5 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'I 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
Ecom asin Y
Other N Other Description: P 9
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2723
Owner: Contractor:
PACIFIC EVERGREEN HOMES LLC ALAN NATHANIEL GOFFMOORE Required Items and Reports(Conditions)
7410 SW OLESON RD#133 13950 SW BARLOW RD 1 Ersn Cntrl 503-639-4175
PORTLAND,OR 97223 BEAVERTON,OR 97008
PHONE: PHONE: 503-664-6423
FAX:
Total Fees: $21,484.06
This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of OR. Specialty Code- 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 issuan•=, or if work is suspended for more the 180
days. ATTENTI e 6.: Oregon law requires you to follow the rules adopted by the Oregon Utility Notificatio• r enter. Those rules are set forth in OAR
952-001-Or r through a•R 952-/01-00090. You may obtain a copy of the rules or direct questions to OUNC by calling 50 2 '.1987• 1.800 -
Issuer By: _ 952-
tLa•_.i Permittee Signature: !iliirthe.irA&Ile
Call 503.639.4175 by 7:00 a.m.for the next available inspection .
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.
• a
Buibding Permit Application 1 _
Residential FOR OFFICE USE ONLY
Received
City of Tigard Permit No.:
Iii
' 13125 SW Hall Blvd.,Tigard,OR 97223 Date/8 ` w 1,s�,� j �f
Phone: 503.718.2439 Fax: 503.598.1960 F EB 2 2014 Plan Rcv�� .! �r7`e-'i7 �
•Date/B ' a her Permit:
Inspection Line: 503.639.4175 e, Date Read B Judi:Ready/By: .�{a7 �y I Supplemental See Pagel for
TIGARD Internet: www.tigard-or.gov CITY O 1GARD No'fie( ethod: iT� Supplemental Information
gip' o''.Z7/r/ Al k9 1( Qa,-tr
TYPE OF WORK / . REQUIRED DATA:ATA:I-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 dollar)of all
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the 1,
CATEGORY OF CONSTRUCTION work indicated on this application. �7! P
Valuation: $ 3 t7' (,.. �-
® I-and 2-family dwelling 0 Commercial/industrial
❑Accessory building ❑Multi-family Number of bedrooms: 4
❑Master builder ❑Other: Number of bathrooms: 2.5 —t.
1
JOB SITE INFORMATION AND LOCATION Total number of floors: 2
Job site address .7/6 S s .2 N PFr.St+NJ Li,/ New dwelling area: z7-4-3 square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: 1430 square feet
Suite/bldg./apt.no.: Project name:Brittany Meadows Covered porch area: j&L( square feet i-13o
Cross street/directions to job site:Bontia Deck area: square feet (('z ar3
Other structure area: ✓153 square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Brittany Meadows Lot no.:j!> Permit fees*are based on the value of the work performed.
nc 11 � � Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: `J equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
New Home
Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER I ❑ TENANT Number of stories:
Name: PA-ca r-Ja A5aI-l2e&J r14w4,e-S Lr'L Type of construction:
Address: 71//u 5,J O 'SoYJ (211) ,S-r� l 33 Occupancy groups:
City/State P(NL,1 ,-.)0 elk_, q-2 u Y Existing:
Phone: 503 qdL L l t.f 9 Fax:( ) New:
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: Pacific Evergreen Homes LLC Meuse refer to fee schedule)
Structural plan review fee(or deposit):
Contact name:Alan GoffMoore
FLS plan review fee(if applicable):
Address:7410 SW Oleson Rd Ste 133
City/State/ZIP:Portland,OR.97223 Total fees due upon application:
Amount received:
Phone:(503-)664-6423 Fax::( )
E-mail:alangoffmoore @gmail.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name:Alan Goff bore Construction Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 13950 Sw Barlow Rd Solar Installation Specialty Code checklist.
City/State/ZIP:Beaverton,OR '7008 Permit Fee(includes plan review $180.00
Phone:(503)664-6423 / (i : and administrative fees):
( ) State surcharge(12%of permit fee): $21.60
CCB lic.: 187268 Total fee due upon application: $201.60
Amme..� This permit application expires if a permit is not obtained
Authorized signature: 1111.7•` within 180 days after it has been accepted as complete.
Print name:Alan GoffMoore Date:•Z-/ZSl� *Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(1 I/02/COM/WEB)
. •
Plumbing Permit Application
lirlA\li3.•,. ) . .
• ,
Building Fixtures , : F O R OFFICE USE O•! 5
.,..„...---- „ • - ,
City of Tigard ,,
ri 1.5g\h‘ thainedy.._ I Penn*No
* F3125 SW liall Heti.,Tigard 01A9Nr a ci, ■ rainvito,7,,,;-":—"
,
;F1 • !tont So.718.2439 I'M 503.598.1*k_U - „,,,KlaD I iltireit 1 Other Permit No:
Inspection Line: 503.639.4175 .•17.101'31'^`' 3f3areite'ady/By. I Jens, g See rsae 1 for 1
•-i...1)
inte.-iwt: www.tigard-urgov Ntairicdfstrthod I Stakskstiesetai Informitian
,
r1''V..':',,,'''''''.::. . . .''':....-`:'tv! OF wat46. -::Fr'.: .: • jr,gg*,1:0'egi0..i.i*-,,,f;',:1- :.
For special information sue checklist
I ria':' ts'aW constraction ..' -- i 0 Demolition
4 Description _____L Qty._I Ea j___;taiat----
0 Aiiiiitionalixantionirephseenicn( 0 Other: New I•2-faraily dwellings or:hides 1.00 ft ter emit utility connection)
.t.t.•,„- :,,t.,,,,„-,,..-.:„y.,-,3..-..-7-7,':".-,71*.'ir :','"'"-. .4'''''' '.',I-'•:-',4-cr-1,_'5.-,i.-....',:.- ,47,-; sFR(1)ham 312 70
, ...
437.7R I
IZ 1-and 2-family dwelling 0 Com SFR(2)WA mercial/industrial -1
1 — — — SFR(..3)bath 1 L30032
0 Acec.sory building 0 Multi-family-- Each additional bath:kitchen 1 25.02
0 Master builder 0 Other: Fire sprinkler( sq.ft.) -,--
Page 2
--7,s7.7..,"rYF T.t"".'"vs,c-:i''' •-•:4- . .4. '-Titdifti • __
Job site address: /155 svu I-14N5 Lt..) Catch basin or arta drain 18.76
-• ! Orywel1,leach line,or trench drain 18.76
City/State.21P:TIGARD,OR
__... 1-Footing drain(no.linear ft- ) 1 Page 2
Suite/bIdg.lapt.no.: Lp.roject name:BRITTAN1'MEADOWS
• Manufactured home irritates —.t---.
, 50.03
'
,....__._.. __
Cross street/directions to job site: so...) -7 eiW. Ay&
....._......___.. ,.:. ..................... ... . .„
, ,..:4:1:ilf.E■i.t...;,F 06-r
_________ - ' .. i L sew
Page 2
-sanuary ei;no linear ft .1
'. 'Storm sewzr linear '11 i 1 Page 2
, _
1-- .. 1 Water$ZTVILC In° imettrI)- ) . I Plat 2 .
i Sttrit.,o.r,:iin.BRA I TANI MF.A.DtPri IS 1 F.01110.: J 5 or. _
,--- .... ... ..._........_.. .....„ .. _ i
Backtlow present:A
lax map.parcei no.
:-:.:1''' 1 '. . . .-.' ---7 -:- - -k ' ,• ---. : • •:' . .-,- .... . . • A : Backwater valve 1 I 12 51 1,
T 25.02
NEW HOME
Dishwasher 25.02
---_ _
Drinking fowitain 25.02
Ejectors/sump 25.02
0 ''.:t;', '4,7•••••:.,...-s'. '4...1Y.---.,-."'"?.::•';;-..,-: :::7111*- "4.'4:1110060-464I.A...;'..,,v,-,..".,',. Expansion tank 12.51
. , ..
Na= FA(...t .r.e., £\ L ,4. &i HvvoEl LI.,C Fixture/sewer cap 25,02 I
Floor drainifloor sink/hub 2102 i
Address: /Lt/C1 Se") CX.e...5014-1 (2..0 s-rE )33 I 1
Garbage disposal 2102 1
City/Stale l: f,oa,..-ri...44f..0 vest. cil.zza Hose bib 1 25.02 [ I
Phone:( so3 Q02- 'ILI? T-Fax:( ) Ice maker I 12.51 ,
1 A
•'''..:'**1-0404tejiiit•.:'7377":71 ...':-;.,10.•,6*iiiii.7.i`kR.4.0N : Inle.N.eptorgreaso trap
1- 1---- f-;
, ..,4, 1
: : ‘.,le:•..;;;:lii ext ixaluc.S i 1 Filar 2
Business name:PACIFIC EVERGREF.N lit:IMES 1,I.0
.
Contact mune:MAN GOFFM04)11E • . ,
: Flor!i dram i‘.1: ,lv,-1,t,1 : :2
Atliire.,- 7410 SW 01-ESO'S HI)STE 133 . ..-.
/Ai'.NH4'1 LAND.OR.9'22.) ,..i:u unit,::,.r....-t-",. :..:i.:::,
— 1 --i- --1—
. Patine. 503-:664-642-3 i lax:.( .
i tin in OW er,slito.er par. i 12 SI ----i
........ _z_ _ _
: Urinal
•
1:-mail:.11 AN Gt)FTMOORE4,0MA I IA 03-1 25.02....
-"- ----- -: , ).■aLr 6:1,<:: ■ 25 02 i
COSTRAC'EOR.
I 1 .37.52
Rosiness name:EDWARD MUIL.t.EN PLUMBING
v•:'ater pipingiD:li V
1 56.29
Address:1601 SE RIVER ROAD Other: 25.02
City/State/ZIP:IIILLSBORO,OREGON 97123
Subtotal
inimum permit fee. 2
Phone:(303)640-0113 I Fax:(503)640-1483 M S750
CCB Lie.:92689 Plumbing Lk.no.:34-260PB — Plan review (25%of permit fee)
Authorized signature: ..i ' .// ... State surcharge(12%of permit fee)
TOTAL PERMIT FEE.
Print name:RAY MULLEN .rhili permit application expires if a permit is not obtained*Rhin ISO lays
L.-..- ORME after it has been*twisted an complete.
'Fec Mel hP4OlOgy SCI by Tri-County Building Industry Service Board
■audon*PcsmnsPLNIT.,-PrInnkpr Am i tvo IX.?
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it l (iec[1&I1:iC4l Permit ; pjiC8llO a la -4 ! -' t}I,i Ft 1 1 tii �)�i;�
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y c uu. Peru,Iva.. •
City of Tigard ne,: ,et • - '
13125 SW Han Blvd.,Tigard,OR 97223 t Plan Review
r7 2014 outer Permit
Phone: 543.713.2439 Fax.: 503.598.1964 1.:._� � I Dau:'BY:
P Inspection Line: 503.639.4175 Ugh Rcadyrt3y: hvfs' H See Page 2 for
T t C;,1 t:L)
Internet www.tigard-or.¢ov 1 Datlued method: Supplemental information
v t t 1 !IV in
a(ylla 1. COMMERCIAL FEE* SCHEDULE- USE CHECKLIST
i Ti PE GE WO'+ t •, Mechanical permit fees*are based on the value of the work
r ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
New t txtstruction
mechanical materials.equipment,labor,overhead,and profit.
❑Demolition ❑Other: i Value:S CATEGORY.RY Ob CONSTRUCTION RESIDENTIAL E(2t.7FMENT/SYSTEMS FEES*
1{ xESlo
❑ I-and 2-tumily dwelling ❑Commercial;industrial ❑Accessory building For s/xc;at/ntornrar;onluse checklist
blaeterbuilder Other '-Descrption Uty_ Et t. ' Total
❑Multi-fatnily- ❑- ❑C tiles' ----_- ,
t _ Heating,"cooling:JOB SITE INFORMATION AND LOCATION I Air conditioning 46.75
Job site address: --7155 Sw 14 R,3soN 1 Furnace l(x),000 BTU(ducts/vents) % 46.75
ii (� Furnace IOt).t�)0+BTU(ducts/vents) 54.91
City/State ZIP: '� -1/� 1 ? �l Heat pump 61.06
Project name: YY1 yy 23.32
Suite/bldg./apt.no.: I Project g(r.��AIJ`� S i f Duct _
Cross streetidirections to job site: �,,J -fah A i Hydronie hot water system 1 23.32
Residential boiler(radiator or -"J
hydmnic) 23.32
- - - --` Unit heaters(fuel-type,not eleuric).
in-wall in-due sus ualla.etc. _- 46.75
Flue/vent for an'of above I 23.32
Other. 23.32
Subdivision: y .j'( /•IlhoVJS I Lot no.: 1 i Other fuel appliances:
Tax map/parcel no.: Water heater 1 23.32
W
O
UESCRIPTIU(V F. O
Gas rcplace insert it 33.39
.. . ft- -- 1 Flue vent for water heater or gas '
finplxce 23.32
C.tn) NuvL{F_ --_ __.-_ i
� - ------ Log tighter(gas) _ 23.32
�_. ` Woodrilet stove : 33.39
- - 1 Wood fireplace/insert 23.32
- I Ch. lint:/tlucavent 23.32
-- _ - I i Other: _ 1 23.32
G3-PROPERTY OWNER . I ❑ TENANT I Environmental exhaust and ventilation:
Name: P�} .ui SVait.64( t) nV,i1t Range hood other kitchen
t equipment 33.39
X1410 Sr,_at.ES0" 1(210 Sre ) 3
Address: � - i Clothes dryer exhaust 33.39
City/State/ZIP: Q ��A+.") Mt.. Q.7�Z`/ Single-duct exhaust(bathrooms.
I __.
toiiet compartments,utility rooms) t/ 1 2332
Phone:(56115)q02... l` f.l 1 Fax:( ) Anic.crawlsace tans ' 23.32
-- Other. 1 23.32 1
B APPLICANT,' D CONTACT PERSON
Fuel piping:
Business name: S14.15 for first four;54.03 for each additional
Contact name: Furnace,etc. I
w,: -�! Gas heat pump
Address: V - G alI/suspendedunit heater
City/State/ZIP: Water heater
((( Fireplace
Phone:( ) l Fax::( ) Range '
E-mail: 4jari @ (1 r�• IretAl arrieS. CC/"N' _.__ Barbecue
CONTRACTOR Clothes dryer(gas)
- �- O.hn: •
Business name:Central Air,inc. ______.----_� ( MECIi) iCAI PEIti►IITFEES*
Address:Po Box 433 } - Subtotal
-J I Minimum permit fee(590.00)
City/State.-21P:Clackamas,U697015 i Planrevicw(25%ofpermitfee)
Phone:(5031656 19{18 , tr1 I Fax:(503)650-38923 -1 ; State surcharge(12°,0 of permit fee)
TOTAL PERMIT FEE
CC:B lit:.:178624 -__--. This permit application expires if a permit L not obtained within 180
•04 � y (k) days after it has born acupted as complete.
`�„i(• • Pee:netnedoivgy set by Tri-County Building Industry Service Board
Authorized signature:
Print name:Andrew Scheidt j Date: _-�
1,.tlsiidicYPermHs,MrC_PcmuAPP..
040113.dec 440-461,T(11-91'COM.WEB)
. •
s J y' 5?"t o- T.'11 l u ^ 5"r x a' 3. %,.'
Electrical Permit Application 1.k f) rowo incE,USr ON1 ix ,
3
". m' c ity of Tigard Received
-
Permit No.:
Datdlly:
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
! Phone: 503.718.2439 Fax: 503.598.1960 DateiBv. Other Permit:
TLGARD' Inspection Line: 503.639.4175 Date Ready/By: mfr I El See Page 2 for
. - - Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK. PLAN REVIEW
®New construction ❑Addition/alteration/replacement Please check all that apply(submit a sets of plats 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 10,0(10 amps at 150 volts or ❑Pleating buildings.
less to ground.or exceeds 14,000 ❑Commercial-use agricultural
® I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps 1'or all other installations. buildings.
❑ Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑installation of 75 KVA or
_ ❑Emergency system. Larger separately derived system.
JOB SITE INFORMATION AND„LOCATION ❑Addition of new motor load of ❑°:\".°L". 't-2' 1-3
't n ►�•T WOW or more. occupancy.
Job no.: Job site adds ��55 �(� 1frf�' ..J L� ❑Six or mart 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: Brittany Meadows ❑Service or feeder 600 amps or more.
— FEE SCHEDULE
Cross street/directions to job site: SCA) "7q Q Description I Qty. I Ere. I Total I "
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Brittany Meadows Lot no 15 1,000 sq.iI.or less 168.54 4
Ea.add'I 500 sq.ft.or portion 33.92 1
—Tax map/parcel no.: Limited energy,residential
> (with above sq.Ii. 75.00 2
DESCRIPTION OF WORK - q• )
Limited energy,multi-family 75.00 2
&, i) ,,,,,f 4 residential(with above sq.ft.)U/� K Services or feeders installation,alteration,and/or relocation
200 amps or Im s 0)0.70 2
® PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
�^ci. �- £vu-v In, _ 14` 401 amps to 1,0 amps 20().34 2
Name: t�'� '�- 1/4J j-L,C. I 2
G01 amps to I,OOU amps 3U 1.04
Address -71.110 St") CkLeS(Jr-) co sye 133 Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
City/State/Z pcht3-rLA)0Q Cht 67001 relocation
Phone:( so3 901_ ipil Fax:( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation:This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701.
Branch circuits-new,alteration,or extension,per panel
Owner signature: Date: A.Fee for branch circuits n1d, I
® APPLICANT ❑ CONTACT PERSON above service or lender fee,
7.42 2
each branch circuit
Business name: Pacifice Evergreen Homes B.Fee for branch circuits without
service or feeder ice,first 56.18 ?
Contact name:Alan GoffMoore branch circuit
Each add'I branch circuit 7.42 2
Address:7410 SW Oleson Rd Ste 133 Miscellaneous(service or feeder not included)
Each manufactured or modular
67.84 2
Clty/State/ZiP: Portland,OR.97223 dwelling.service and/or feeder
Phone:(503)664-6423 Fax::( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E-mail:alangoffmoore@gmait.com Sign 01 outline lighting 67.84 2
CONTRACTOR Signal circuit(s)or limited-energy
Business name:Garner Electric panel,alteration.or extension. Pa e 2 2
Each additional inspection over allowable in any of the above
Address:2920 SE Brookwood Ave Ste A Additional inspection(1 hr min) 66.25/hr
- Investigation(1 hr min) 66.25/hr
City/State/ZIP: Hillsboro,OR 97123 Industrial punt(1 hr min) 78.18/hr
Phone:(503)648-4552 i/fax: 503 42-7925 Inspections for which no fee is
( 90.00/hr
specifically listed('/•hr min)
CCB Lie.: 121159 Electr• al -To:^: 343$5C Suprv. Lie.: 3707-S ELECTRICAL PERMIT FEES
�' .,' Subtotal:
Suprv.Electrician signature,required. Mar.review(25r&of permit fee):
Print name: Chuck Garner i'.7 Date. State surcharge 112%of permit fee):
TOTAL PERMIT FEE:
Authorized signature: This permit application expires if a permit is not obtained v+ilhin ISO
• days after it has been accepted as complete.
Print name: Date: - . Number of inspections allowed per permit.
I'9luildieg.Pcrmiit'ELC-Permit App doe 07:0t/Ip 444.45151(II:05.'C'OMat'titl
Building Permit Number: /1/5j-,20 iI_ y3
a
• Building Permit Review
Residential Projects
TIGARD
Si t Address: .11 S SW hanc -r 1_Y)
LMVerify site address is valid.
Project Name & Lot #: p2,241±-an,/ MrcS i 1,,t
Clean Water Services—Service Provider Letter: (lot platted prior to 9/10/1995)
Required: Yes ❑ No X Received: Yes ❑ No El
Siite%lan Elements: �
D'Si e plan must be on 8-1/2"x 11"or 11"x 17"paper DI ree(3)copies of site plan
L'Drawn to scale(standard architect or engineer scale) rth arrow
Clap and tax lot number,site address,project or subdivision Footprint of new structure(including decks)with finished
name,lot number,and zoning floor IyA elevationsy4„
plicant information(name and phone number) L�d'Lot and building setback dimensions
Property roperty corner elevations(2 foot contour lines if more than CJI .-t area,building coverage area,percentage of coverage and
4joot differential) impervious area.
)ility locations a6cation of wells/septic systems.
2-Existing structures on site airurf�ce drainage
L,��treet names treet tree size,type and location
L't;rosion control(including drainage-way protection,silt fence xisting trees to be retained with drip line,and tree
design,location of catch basin,etc.) protection measures
Planning Review
l ' ndUseCaseNumber: 9 jj- c x S 'vPI Q2Ql4-00004
LU' oning: R Li-5
El Setbacks:
Front --0 Rear 1 '� Side S_ ,,p� Street Side 0 J� Garage 2,id
['Landscape Require••, : A7,6,_ % St
( ot Coverage Maximum: %
®building Height: Maximum Height a Actual Height '-214
Visual Clearance
❑- asements
Sensitive Lands: El Yes Type
Crban Forestry Plan
Wonditions Satisfied
Approved by: C 4 Date: 31251 14
Notes: re,VeSk. -c0,r rorn+ s Moo4c.ii ad;lit&1 rn 'In rev► Qw — 2 111 1 ///0
Vatelalnce a pprtwec1 112--1 N
Revisions (after Building Submittal only) Reviewer Date
Revision 1 Approved ❑ Not Approved ❑
Revision 2 Approved ❑ Not Approved ❑
Revision 3 Approved ❑ Not Approved El
I:\Building\Forms\BldgPermitRvw_RES_123013.docx
. .
Building Permit Submittal
Original Plan Submittal: Date: )//tt By: /3 T
Site Plans: #
Building Plans: #
Create Case Record#: ❑ Enter case# above for Building Permit Number.
Workflow Routing: ❑ Planning ❑ Engineering ❑ Permit Coordinator ❑ Building
Workflow Sign-off: ❑ Sign-off for Planning staff,including notes from planning review(page 1)
Route Application Documents: ❑ Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
❑ Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Reviewed By: Date:
Notes:
Engineering Review—reviewed by:
Actual Slope:
❑ Conditions Satisfied
Notes:
Approved by: Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1 Approved ❑ Not Approved ❑
Revision 2 Approved ❑ Not Approved ❑
Revision 3 Approved ❑ Not Approved ❑
Pe I it Coordinator Review
onditions Met-Prior to Issuance of Building Permit
Notes:
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant
Revision Notice 3: Date Sent to A cant
Okay to Issue Permit- Date:
3/3-GI/�
1:\Building\Forms\B1 dgPermitRvw_RES_123013.docx
TROXEL 'S HOME DESIGN
1778 S.W. 26TH CT.
GRESHAM, OR. 97080
,N :99 11-'4E
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LEGEND PERMIT NO.VAR201y-011o4
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NAME:—__-- DATE: ?HP 14 —
SCALE:_1'•20-00. — PLAN:PLAN#1413 — DRAWN BY: DENNIS TROXEL
ADDRESS:--
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
7755 SW HANSEN LN, TIGARD, OR, 97224
Residential - Master Permit
199 Electrical final
PASS
MST2014-00023
Herb Stabenow
Violation Summary:
Inspector Contractor