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Permit CITY OF TIGARD t MASTER PERMIT "! it • COMMUNITY DEVELOPMENT . 0 Permit#: MST2014-00037 T I G AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 • �'�►=r Date Issued: 05/27/2014 Parcel: 2S109DA18400 Jurisdiction: Tigard Site address: 12723 SW WILLOW POINT LN Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 113 Project: Arlington Heights No. 3, Lot 113 Project Description: New SF. 8/26/14, reprinted to add a/c, placement of a/c unit must comply with manufacturer's clearance requirements. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 945 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 28 Bathrooms: 3 Second: 1310 sf Garage: 493 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2255 sf Value: $273,809.63 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Tvoes Air Conditioning: Y 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 Fum>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temo Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea addl 500 sf: 4 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio 8 Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Ecom Y assn 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 2255 Owner: Contractor: STONE BRIDGE HOMES NW LLC STONE BRIDGE HOMES NW LLC Required Items and Reports(Conditions) 4230 GALEWOOD ST#100 4230 GALEWOOD STREET#100 1 Geo tech report required prior LAKE OSWEGO,OR 97035 LAKE OSWEGO,OR 97035 to footing inspection 2 Ersn Cntrl 503-639-4175 PHONE: PHONE 503-387-7577 FAX: 503-387-7615 Total Fees: $20,633.01 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done i0 , • •ance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. 'TTENTION: ► =•on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 001-0010 through OA- 95 101-7b0•0. You may obtain a copy of the rules or direct questions to OUNC by calling 50 32.1987 or 1.800.332.2344. Iss ed By: 1 _/I ..�.. .1 Permittee Signature: 4 ! r,-�.. Call 503.839.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the Job site at the time of each inspection. ~ CEIVEl1 Mechanical Permit Applicatio► FOR OFFICE USE ONLY City of Tigard Dat�eBy: , °1i /y Permit No.: ��/ ^ �j -- a 13125 SW Hall Blvd.,Tigard,OR 97?A2 1 r 2 6 2014 Plan Review '/ Phone: 503.718.2439 Fax: 503.598. V Date/By: Other Permit: TI G A R D Inspection Line: 503.639.4175 , Date Ready/13y: rods ® See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARII Notified/Method: Supplemental Information ,,.'*• """'DIVISION TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees*are based on the value of the work ❑New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description 1 Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling: /01.7 ....-3 �� I Air conditioning / 46.75 �i•7s Job site address: 1(Q W1Oi„) 6- Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: ,4 iJCo rvt .11. Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision: Lot no.: f/3 Other: 23.32 _ Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 f� / Flue vent for water heater or gas - ce 4-/e, fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 ❑ PROPERTY OWNER I ❑ TENANT Other: _ 23.32 --- - Environmental exhaust and ventilation: Name: Range hood/other kitchen equipment 33.39 Address: Clothes dryer exhaust 33.39 City/State/ZIP: Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:( ) Fax:( ) Attic/crawlspace fans 23.32 Cl APPLICANT ❑ CONTACT PERSON Other: 23.32 Business name: Fuel piping: S14.15 for first four;$4.03 for each additional Contact name: Furnace,etc. Address: Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( ) Fax::( ) Fireplace Range E-mail: Barbecue CONTRACTOR I Clothes dryer(gas) Cey-(4jer �,P� 7 Other:Business name: MECHANICAL PERMIT FEES" Address: Subtotal 4.75 _ City/State/ZIP: Minimum permit fee($90.00) — Phone: Plan review(25%of permit fee) - ( ) Fax:( ) State surcharge(12%of permit fee) $y 5'61 CCB lie.: TOTAL PERMIT FEE RV-310 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signature: ' Fee methodology set by Tri-County Building Industry Service Board Print name: Date: I:\BuildinglPermitsVMEC_PermitApp_0401 I 3.doc 440-46171(11/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi-Family Fee Schedule: Total Valuation: Permit Fee: $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and $2.54 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I:\Building\Permits\MEC_PermitApp_040113.doe 2 II CITY OF TIGARD MASTER PERMIT ;'� s COMMUNITY DEVELOPMENT Permit#: MST2014-00037 T 1A.RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/27/2014 C. Parcel: 2S109DA18400 Jurisdiction: Tigard Site address: 12723 SW WILLOW POINT LN Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 113 Project: Arlington Heights No. 3, Lot 113 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 945 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 28 Bathrooms: 3 Second: 1310 sf Garage: 493 sf Front 15 Smoke Dwelling Units: 1 Third: 0 sf Right. 5 Detectors: Yes Total: 2255 sf Value: $273,809.63 Rear 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 4 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 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvGFeeders 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: 4 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio 8 Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2255 Owner: Contractor: STONE BRIDGE HOMES NW LLC STONE BRIDGE HOMES NW LLC Required Items and Reports(Conditions) 4230 GALEWOOD ST#100 4230 GALEWOOD STREET#100 1 Geo tech report required prior LAKE OSWEGO,OR 97035 LAKE OSWEGO,OR 97035 to footing inspection 2 Ersn Cntrl 503-639-4175 PHONE: PHONE: 503-387-7577 FAX: 503-387-7615 Total Fees: $20,580.65 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 co. .f the ruBS.or direct questions to OUNC by calling 582232.19 1.800.332.2344. Issued By: ' / _— Permittee Signature: Cal . 'y; •. 5 by 7:00 a.m.for the next available inspection date. This permit card sha • kepnn 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. CITY OF TIGARD SEWER CONNECTION PERMIT COMMUNITY DEVELOPMENT Permit#: SWR2014-00029 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/27/2014 Parcel: 2S109DA18400 Jurisdiction: Tigard Site address: 12723 SW WILLOW POINT LN Project: Arlington Heights No.3,Lot 113 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 113 Project Description: New SF. Contractor: Owner: STONE BRIDGE HOMES NW LLC 4230 GALEWOOD ST#100 LAKE OSWEGO, OR 97035 PHONE: PHONE: FAX: FEES Description Date Amount Specifics: Sewer Connection Fee 05/27/2014 $4,800.00 Sewer Inspection-Residential 05/27/2014 $35.00 Type of Use: SF Class of Work: NEW Install Type: Line Tap and Building Sewer Fixture Units: Number of Dwelling Units: 1 Total $4,835.00 Required Items and Reports(Conditions) 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: OF — Permittee Signature: `/\ _• r I � Call 50 .• .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. Raildine Permit Application Residential PiN�t1 FOR OFFICE USE ONLY Received City of Tigard Dat : . Permit No..` 3 III . ` 13125 SW Hall Blvd.,TFax: I;,V' Plan Revie,�' � n •her Permit. Phone: 503.639.4171 Fax: l .598.1960 �� DateB : t/,,-- tA7 ez — U/ v�9 Inspection Line: 503.639.4175 A 4 Vi Date Reai y :,: ris See Page 2 for TIGARD Internet: www.tigard-or.gov MQA p Notified/Method: V`3/A e/ J Supplemental Information 0 TYPE r ii., 0 / RE UIRED DATA: I-AND 2-FAMILY DWELLING ®New construction R molition Permit tees 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 Valuation �o9��3 ® �' 'LC� ❑Commercial/industrial ■ El Accessory building ❑Multi-family Number of be rooms: 4 ❑ Master builder ❑Other: Number of bathrooms: 2. JOB SITE INFORMATION AND LOCATION Total number of floors: 2 Job site address: Iwo,, tw wi Kew Po rµ? 1.44, New dwelling area: 22,5g square feet City/State/ZIP:Tigard,OR 97223 Garage/carport area: 4015 square feet Suite/bidgiapt.no.: Project name:Arlington Heights Covered porch area:` 1 square feet `310 Cross street/directions to job site: Deck area: — square feet r� Other structure area:--z-7.43 square feet 12,8 REQUIRED DATA:COMMERCIAL-USE CHECKLIST I Subdivision:Arlington Heights Lot no.: +'3 Permit lees*are based on the value of the work performed. 2.S I�� Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: 1 a equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. New,Singk Family Residential Valuation: $ Existing building area: square feet New building area: square feet ® PROPERTY OWNER ❑ TENANT Number of stories: Name:Stone Bridge Homes Type of construction: Address:4230 Galewood St,Suite 100 Occupancy groups: City/State/ZIP:Lake Oswego,OR 97035 Existing: Phone:(503)387-7577 Fa.:(503)387-7616 New: ❑ APPLICANT ❑ CONTACT PERSON NOTICE Business name:SEE ABOVE All contractors and subcontractors are required to he Contact name:Deirdre Britt licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed.If the City/State/ZIP: applicant is exempt from licensing,the following reasons apply: Phone:( ) Fax::( ) E-mail:dbritt@stonebridgehomesnw.com CONTRACTOR Business name:SEE ABOVE BUILDING PERMIT FEES* Address: (Please refer to fee schedule) City/State/ZIP: Structural plan review fee(or deposit): Phone:( ) Fax:( ) FLS plan review fee(if applicable): CCB lic.:173318 Total fees due upon application: • Amount received: Authorized signature's �� This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:--Deliapitz MLITT Date: 3/24,'I * Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RES PermitApp.doc 10/01/09 44046131(1I/02/COM/WEB) • Plumbing Permit Application Building Fixtures FOR OFFICE USE O L\ Received City of Tigard Caw Date/By: Permit No.:,n��! _ • 13125 SW Hall Blvd.,Tigard,OR 97.7 y 7111 - r Plan Review I Phone: 503.639.4171 Fax: 503.598.'.V'•�t Date/By: Other Permit Na.: Inspection Line: 503.639.4175 & 14 I I G A R[) Internet: www.tigard-or.gov 2 #�O Date Ready/By: Jur s: 171 See Page 2 for Notilied/Method: Supplemental Information TYPE OF WORK FEE*FEE* SCHEDULE ®New construction ❑De t�i�Vin. `lw kSl- For special information use checklist. • H Description I Qtly. I Ea. I Total ❑Addition/alteration/replacement ❑c> tAl h New 1-2-family dwellings(includes 100 ft.for each utility connection)_ CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ® I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 SFR(3)bath ) 500.32 ❑Accessory building ❑Multi-family . Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 11113 S IN 1 wow Po 1 MT 1.N. Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard,OR 97223 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name:Arlington Heights Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_1 Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision:Arlington Heights I Lot no.: 113 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater vane 12.51 Clothes washer 25.02 New,Single Family Residential Dishwasher 75.02 Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER 1 ❑ TENANT Expansion tank 12.51 Name:Stone Bridge Homes Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 16869 SW 65th Avenue#505 Garbage disposal 25.02 City/State/ZIP:Lake Oswego,OR 97035 Hose bib 25.02 Phone:(503)387-7577 Fax:(503)387-7615 Ice maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor grease trap 25.02 Business name:SEE ABOVE Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Deirdre Britt 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: dbritt(Ustonebridgehomesnw.com Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name: Jardine Plumbing Water piping/DWV 56.29 Address: ro Box 186 Other: _ 25.02 City/State/ZIP: Estacada,OR 97023 Subtotal Phone:(503)351-8532 Fax:(503)6302882 Minimum permit fee: $72.50 CCB L.ic.: 108747 Plumbing L.ie.no.: t Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: S `�` g ��(/ TOTAL.PERMIT FEE Print name: Date: This permit application expires if a permit is not obtained within 180 days Jay Jardine after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1:\Building:Permits1PLMl i•PermitApp.doc 11/01/09 440-46167(10,027 OM/WI74I • Mechanical Permit Application FOR OFFICE UST•. t)N I 1 Received City of Tigard ��jv1j Date/By: Permit No.: r� 111 a • 13125 SW!fall Blvd., Tigard.OR 9722 s Plan Review Phone: 503.639.4171 Fax: 503.598.19 Y Other Permit: Date/By: T I Ci A R D Inspection Line: 503.639.4175 Date Ready/By: saris: ® See Page 2 for Internet: www.tigard-or.gov `A^ A 41°4 A Notified/Method: Supplemental Information TYPE OF WORIii,.C�(�V�l�r�Owl COMMERCIAL FEE* SCHEDULE – USE CHECKLIST ��Y i IVIS 1� Mechanical permit fees*are based on the value of the work ®New construction ❑Addition%alteratio i��10/1 tr perthrmed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: _ 1 l� mechanical materials,equipment,labor.overhead,and protit. CATEGORY OF CONSTRUCTION Value:$ RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ® 1-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 Heating/cooling Job site address: '3,172 S� � IA w PO 1�1 �� Air conditioning 7 (requires site plan showing placement) 46.75 City/State/ZIP:Tigard,OR Furnace 100,000 BTU(ductslvents) ( 46.75 Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: Project name:Arlington Heights Heat pump 61.06 Cross street/directions to job site: Duct work 23.32 Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision:Arlington Heights Lot no.: 113 Other: 23.32 Tax map/parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 23.32 Gas fireplace ( 33.39 New,Single Family Residential Flue vent fir water heater or gas fireplace 23.32 Log lighter leas) 23.32 Wood/pellet stove 33.39 Wood fireplaceiinsert 23.32 0 PROPERTY OWNER l 0 TENANT Chimney/liner/flue/vent 23.32 Other: 23.32 Name:Stone Bridge Homes NW,LLC Environmental exhaust and ventilation Address:16869 SW 65'`Avenue#505 Range hood/other kitchen equipment ' 33.39 City/State/ZIP:Lake Oswego,OR 97035 Clothes dryer exhaust r' 33.39 Single-duct exhaust(bathrooms. Phone:(503)387-7577 Fax:(503)387-7616 toilet compartments,utility rooms) 23.32 ❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32 Other: 23.32 Business name:same as above Fuel piping Contact name: Deirdre Britt $14.15 for first four;$4.03 for each additional Address: Furnace,etc. 1 Gas heat pump City/State/ZIP: Wall/suspended/unit heater Phone:( ) Fax::( ) Water heater t Fireplace k E-mail: dbritt(gstonebridgehomesnw.com Range CONTRACTOR Barbecue _ Business name:Comfort Zone Clothes dryer(gas) Other:_ Address: 1032 NW Corporate Drive MECHANICAL PERMIT FEES* City/State/ZIP:Troutdale,OR 97060 Subtotal Minimum permit tee($90.00) Phone:(503)667-5595 Fax:(503)491-8252 Plan review(25%of permit fee) CCB lie.:110091 State surcharge(12%of permit fee) TOTAL PERMIT FEE Authorized signature: .2.—...—.--- -- This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:David Heldstab Date: • Fee methodology set by Tri-County Building Industry Service Board lr.Buildingd'ennitu\Ml.C:-PermitApp.doc 10/01/151 44o.4617I(11/02 COMN1Eh) ' Electrical Permit Application 1NtV I OR t,1 1 It 1 t "I (I\1.1 City of Tigard l�l Received y g R � tale/B i.1 r at 1 3125 SW}call Blvd.,Tigard,OIF'7223 p Plan Review 7 3 Phone: 503.639.417 I Fax: 503.598.1960 q 4 7.019 Date/B : Other Permit: 1 I t;.�K t Inspection Line: 503.639.4175 MAR p Date Ready/By: Funs: ® See Page 2 for Internet: www.tigard-or.gov N Y f-Nt),� Notified/Method: Supplemental Information 144'A TYPE OF mat v��Ss\PIS PLAN REVIEW l•►' " Please check all that apply(submit 2 sets of plans witems checked below): 21 New construction ❑Addition/altoI{ ent +'* ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition ❑Other: Al' 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 ® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for 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 ❑"A",`•E","I-2","I-3", Job no.: Job site address: t 1 U, / 1(w HP or more. occupancy. I4 y I I�� , SW•' ' A NT • ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP:Tigard,OR 97223 ❑Health-care facilities. ❑Supply voltage for more than ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: Project name:Arlington Heights ❑Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description I Qq. I Fee. I Total ] * New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision:Arlington Heights Lot no.:10 1,000 sq.ft.or less 1 168.54 4 Tax map/parcel no.: Ea.add'I 500 sq.ft.or portion 33.92 1 Limited energy,residential �j � DESCRIPTION OF WORK (with above sq.ft.) ? l ^4*- y) Limited energy,multi-family 67.84 2 residential(with above sq.ft.) Services or feeders installation,alteration,and/or relocation 200 amps or less 100.7() 2 ® PROPERTY OWNER I 0 TENANT 201 amps to 400 amps 133.56 2 Name:Stone Bridge Homes 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: 16869 SW 65th Avenue#505 Over 1,000 amps or volts 552.26 2 City/State/ZIP:Lake Oswego,OR 97035 Temporary services or feeders installation,alteration,and/or relocation Phone:(503)387-7577 Fax:(503)387-7615 200 amps or less 59.36 I 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. 40I amps to 599 amps 168.54 2 Branch circuits—new,alteration,or extension,per panel Owner signature: Date: _ A.Fee for branch circuits with ■ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7.-12 2 each branch circuit Business name:SEE ABOVE B.Fee for branch circuits without service or feeder fee, Contact name: Deirdre Britt _ first branch circuit 56.18 2 Address: Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) City/State/ZIP: Each manufactured or modular 67.84 2 dwelling.service and/or feeder • Phone:( ) Fax: :( ) Reconnect only 67.84 2 E-mail: dbritt(a?stonebridgehomesnw.com Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 • Business name:City Electric Signal circuits)or limited- energy panel,alteration,or Address:55568 SW Schaltenbrand Lane extension.Describe: Page 2 2 City/State/ZIP:Sherwood,OR 97140 Each additional inspection over allowable in any of the above Phone:(971)404-1714 Fax:(503)625-3052 Per inspection 66.25 Investigation per hour I I hr mini 66.25 CCB Lie.: 42422 Electrical Lie.: 26-289C Suprv.Lie.: 35925 Industrial plant per hour 78.18 ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: Chuck Friesen Date: Plan review 425°%of permit fee): State surcharge(12%of permit fee): Authorized signature: �� TOTAI,PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. • Number of inspections allowed per permit. I:\Building\Pemtit..'•ELC-PemsitApp.doc 10/01419 440"46151(I V05:COM/W EH • Building Permit Number: 1 ,2c.W-con37 I le Building Permit Review Residential Projects TI( ARD Si t Address: III 23 SW W ti I bv'J Point L"tie- E Verify site address is valid. Project Name & Lot #: AOttr1giDn \-1e ff 1 , L�F 11 Clean Water Services —Service Provider Letter: (lot platted prior to 9/10/1995) Required: Yes ❑ No J Received: Yes ❑ No ❑ Site G�' Plan Elements: -- // L�JSite plan must be on 8-1/2"x 11"or 11"x 17"paper Phree(3)copies of site plan Drawn to scale(standard architect or engineer scale) Gorth arrow L M p and tax lot number,site address,project or subdivision L1 ootprint of new structure(including decks)with finished ,� �name,lot number,and zoning fli r elevations L�:ipplicant information(name and phone number) Lei of and building setback dimensions I Pfoperty corner elevations(2 foot contour lines if more than [t area,building coverage area,percentage of coverage and 4 foot differential) impervious area. Gititility locations E" .cation of wells/septic systems. G' sting structures on site [ rface drainage R` �xi reet names Greet tree size,type and location Cs5iosion control(including drainage-way protection,silt fence [ sting trees to be retained with drip line,and tree design,location of catch basin,etc.) protection measures Planning Review Ili--"rand Use Case Number: 5c ,20 7C o-onex) 1a-Zoning: R--i Cetbacks: Front ICJ Rear I S Side 6 Street Side Garage 7(. [Y Landscape Requirement: 2 0 R Lot Coverage Maximum: eo Building Height: Maximum Height 35feet Actual Height ±2,B 1 C> 'Visual Clearance sements / Sensitive Lands: 2 Yes Type 2C✓70 S(opes ) [Day Veit Iu- . V4+ L'U ban Forestry Plan D'-Conditions Satisfied Approved by: ' Date: 312-14 (1`4 Notes: *53 me lY1ert is ho aia.�itl resdLiu' whet- S S telt`{ak4 St fi( ixtsi. Revisions (after Building Submittal only) Reviewer Date Revision 1 Approved ❑ Not Approved ❑ Revision 2 Approved ❑ Not Approved ❑ Revision 3 Approved ❑ Not Approved ❑ I:\Bu it ding\Forms\BldgPermitRvw_RES_123013.docx • -., • Building Permit Submittal Original Plan Submittal: Date: 7/ `f/y By: fs,—a4 Site Plans: # Building Plans: # Create Case Record#: ErEnter case#above for Building Permit Number. Workflow Routing: B lanning 0r$ngineering hermit Coordinator F - iilding Workflow Sign-off: 2---Sign-off for Planning staff,including notes from planning review(page 1) Route Application Documents: la/Engineering: (1) copy of permit application, (1) site plan, (1)building plan and original plan review routing form. ��uilding. original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Reviewed By: Date: ) '� /L Notes: ,/ Engineering Review—reviewed by: Y- u ri'r1,rZ Actual Slope: /5% El Conditions Satisfied Notes: Approved by: _ Date: 2 5/-i' Revisions(after Building Submittal only) Reviewer Date Revision 1 Approved ❑ Not Approved ❑ Revision 2 Approved ❑ Not Approved ❑ Revision 3 Approved ❑ Not Approved ❑ 'e • it Coordinator Review IPA 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 App t e Okay to Issue Permit- /' Date: 3/ 1:\Building\Forms\Bl dgPermitRvw_RES_123013.docx 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 12723 SW WILLOW POINT LN, TIGARD, OR, 97224 Residential - Master Permit 399 Plumbing ﬁnal FAIL MST2014-00037 George Heimos 1. Provide lawn irrigation backﬂow device approval. PLM2014-00231 2. Cleanout plug outside, needs approved thread sealant at: left side by AC unit. 316.1.1 3. Provide cleanout ﬁtting with plug, right side front under deck. 4. Provide cover for back water valve riser, right front corner. 5.'complete rain drain leader, right front to 3" riser. 6. Re-caulk kitchen sink. 503-266-2091 7. Correct leak at main ﬂoor lav. 310.0 8. Remove cast iron cleanout cover for sanitary sewer in driveway. 103.5.4 Stopped inspecting at 1st ﬂoor kitchen/main ﬂoor bath. All else not inspected, have plumbing contractor go over ﬁnish plumbing and when completed, recall inspection. 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 12723 SW WILLOW POINT LN, TIGARD, OR, 97224 Residential - Master Permit 199 Electrical ﬁnal PASS August 26, 2014 at 12:33:39 PM MST2014-00037 Jeff Grove Violation Summary: Inspector Contractor