Permit Building Permit Application EX` 1 R D
Residential RECEIVED Ittll (11,,( l l Sl tl.l.l
City of Tigard ee/1p g A l Permit No.: j�/g
13125 SW Hall Blvd.,Tigard,OR 97i�d7 N 1 7 2008 Plan Review !rj,)Qjg F
C Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 Date/B :
Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Suns Supplemental S a Pge 2 information
T'C Internet: www.tigard-or.go"BUILDING DIVISION Notified/Method:
®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
-- , ---,.., - t c , work indicated on this application.
', 1:-4'..: a Y F . - C .
Valuation: S180,000
® 1-and 2-family dwelling ❑Commercial/industrial
❑Accessory building ❑Multi-family Number of bedrooms: 3
❑Master builder ❑Other: Number of bathrooms: 2.5
J ti °*�* �.f Total number of floors: 3
rs. tF't rs.i('"`4 t 1111 " I c'£ _
Job site address:' hg JU -) f--T--f:i..}rnck.vt A New dwelling area: 1834 square feet
City/State/ZIP:Tigard,OR Garage/carport area: 541 square feet
Suite/bldgJapt.no.: Project name:Village at Summer Creek Covered porch area: 36 square feet
Cross street/directions to job site: Deck area: 664 square feet
Other structure area: square feet
Subdivision: Lot no.: 1 Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials.labor,overhead,and the profit for the
-.:1'-',. ,"i!,' 'e - ra F c ` � ` r . ' work indicated on this application.
. � Im , e, Y NSFR Valuation: S
Existing building area: square feet
New building area: square feet
.,? .'a115 ti/pdsiR il<" WJ srexe ° " 3 Number of stories:
Name:JLS Custom Homes Type of construction:
Address:16280 NW Bethany et Occupancy groups:
City/State/ZIP:Beaverton,OR 97006 Existing:
Phone:(503)533-4006 Fax:(503)533-4306 New:
r a - td -.A -' z,' -f.G It t�- 1 -�} b �` ,t,, a -•
Business name:JLS C m#Iaaes All contractors and subcontractors are required to be
Contact e:Nicole Paulsen licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:16280 NW Bethany ct jurisdiction in which work is being performed.If the
applicant is exempt from licensing,the following reasons
City/State/ZIP:Beaverton,OR 97006 �� apply:
Phone:(503)533-4006 Fax::(503)533-1306 5 C rtiFY t C6 t-� t v`
E-mail:nicolc 'jlscustomhomes com P4421 ei..4-.) r
finA '/
A
Business name:JLS Custom Homes r`'t 'tm tie z s 1 16 Ii CUES*-�
Address: 16280 NW Behthany ct ✓ d fir.
Structural plan review fee(or deposit): (� • ft
City/State/ZIP:Beaverton,oR 97006 t/ �+
✓ Fax:(503)533-4306 FLS plan review fee(if applicable): CJ
Phone:(503)533-4006 tales
Total fees due upon application: ��Q
(Q I.,16 CCB lic.:139970 g C.-i VE- / s//,2, ��-
I � ✓ / Amount received: '� 7�
v Authorized signature: \b.. I I�1 A f/ I This permit application expires if a permit is not obtained
fl/l/ `A�" within 180 days after it has been accepted as complete.
Print name: Date: * Fee methodology set by Tri-County Building industry
Service Board.
I:\Building\Permits\BUP-RES PermmitApp.doc 11/6/07 440-4613T(11/02/COM/WEB)
Mechanical Permit Applicatio FOR(1FF1( I: 1'SF O\1.\
71 • City of Tigard CEIV ED Date/By: e, /7 OS, M5 ,�!-c O 9
+ Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97 23
Ig Phone: 503.639.4171 Fax: 503.598.1960 Plan Review Other Permit: n
Inspection Line: 503.639.4175 JUN 17 2008 Date/By: �, ��
I G A R D Date Ready/By: Juns ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TIGARD
CITY OF t�
311PE gDF LNG DIVIvIC�t'1 GOMMERGIAG MEE*-SCHEDULE--.--USF CIEGICLIST
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.
*CAWEGORtx.OFFCONSTRUCTION Value:$
RESIDENTIALEQUIPMENT/SYSTEMS=FEES*
❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building
For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
fOB SITE ORNIATION AND xL'OCAPJON - Heating/cooling
Job site address: �r Air conditioning or heat pump
LJ—J�� C , �� I (requires site plan showing placement) I 14.00
City/State/ZIP:Tigard,OR Furnace 100,000 BTU(ducts/vents) I 14.00
Furnace 100,000+BTU(ducts/vents) 17.90
Suite/bldg./apt.no.: Project name:Village at Summer Creek Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
Residential boiler(radiator or
hydronic) 14.00
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 14.00
Flue/vent for any of above 6.80
Subdivision: Lot no.: I -
Other: 10.00
Tax map/parcel no.: Other fuel appliances
i S-:',---1 --.'-.7.;:-- ayEsa part1.J r `o 'WORK ,,.^ , _ Water heater I 10.00
Gas fireplace I 10.00
Flue vent for water heater or gas
fireplace '2. 10.00
Log lighter(gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
Chimneyniner/flue/vent 10.00
IPROPE-RTY---OWNER -
TENANT - Other:
10.00
Name:JLS Custom Homes Environmental exhaust and ventilation
Address: 16280 NW Bethany et Range hood/other kitchen
equipment I 10.00
City/State/ZIP:Beaverton,OR 97006 Clothes dryer exhaust I 10.00
Single-duct exhaust(bathrooms, 1� ii
Phone:(503)533-4006 Fax:(503)533-4306 toilet compartments,utility rooms) 41 6.80
__1. APPLIOAN!'"' ❑ CONTACT 2E-RSON - Attic/crawlspace fans 10.00
Other: 10.00
Business name:JLS Custom HOmes
Fuel piping _
Contact name:Nicole Paulsen $5.40 for first four;$1.00 for each additional
Address:16280 NW Bethany ct Furnace,etc.
Gas heat pump
City/State/ZIP:Beaverton,OR 97006 Wall/suspended/unit heater
Phone:(503)533-4006 Fax: :(503)533-4306 Water heater
Fireplace
E-mail:nicole @jiscustomhomes.com Range
_ 4-CONTRACTOR Barbecue
Business name:TBD Clothes dryer(gas)
Other:
Address: ;a 1 MECHA"NICAL=PERMITFEES*
City/State/ZIP: Subtotal
Minimum permit fee($72.50)
me:( ) Fax:( )
Plan review(25%of permit fee)
CCB lie.: l State surcharge(12%of permit fee)
)\.) `� TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: • Fee methodology set by Tri-County Building Industry Service Board
1:\Building\Permits\MEC-PermitApp.doc 01/19/07 440-4617T(I1/02/COM/WEB)
i
Plumbing Permit Application
. Building Fixtures RECEIVED FOR OFFICE USE ONLY
City of Tigard Received /. l 7 Q!g Permit No Nyr e-6099
n 13125 SW Hall Blvd.,Tigard,OR 1 7 200 Date/By:
t�
• - Phone: 503.639.4171 Fax: 503. 1960 Plan Review n`Y�
Date/By: Other Permit No.: �1 ^-Q
TI GARD
Inspection Line: 503.639.4171TY OF TIGARD Date Ready/By: ions ® See Page 2 for
Internet: www.tigard-or.gov ``,, tt NotifiedaMethod: Supplemental Information
"TYPE a D.- 1j N -FEE* SCHEDULE
❑New construction ❑Demolition For special information use checklist
Description 1 Qty. 1 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 249.20
❑ 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 350.00
❑Accessory building ❑Multi-family SFR(3)bath 399.00
Each additional bath/kitchen 45.00
❑Master builder ❑Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 1 35(A V rTt , o...11.` ` \yl Catch basin or area drain 16.60
City/State/ZIP:Tigard,OR Drywell,leach line,or trench drain 16.60
Suite/bldg./apt.no.: Project name:Village at Summer Creek Footing drain(no.linear ft.:_) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Subdivision: Lot no.: Water service(no.linear ft.:_) Page 2
Fixture or item
Tax map/parcel no.:
Absorption valve 16.60
DESCRIPTION-OF WORK Backflow preventer Page 2
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
E PROPERTY OWNER Drinking fountain 16.60
❑ TENANT
Ejectors/sump 16.60
Name:JLS Custom Homes Expansion tank 16.60
Address:16280 NW Bethany ct Fixture/sewer cap 16.60
City/State/ZIP:Beaverton,OR 97006 Floor drain/floor sink/hub 16.60
Phone:(503)533-4006 Fax:(503)533-4306 Garbage disposal 16.60
APPLICANT El CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name:JLS Custom Homes Interceptor/grease trap 16.60
Contact name:Nicole Paulsen Medical gas(value:$ ) Page 2
Address:16280 NW Bethany ct Primer 16.60
City/State/ZIP:Beaverton,OR 97006 Roof drain(commercial) 16.60
Phone:(503)533-4006 Fax::(503)533-4306 Sink/basin/lavatory 16.60
Tub/shower/shower pan 16.60
E-mail:nicole@jIscustomhomes.com Urinal 16.60
CONTRACTOR Water closet 16.60
Business name:TBD Water heater 16.60
Address: Other:
City/State/ZIP: Subtotal
Minimum permit fee: $72.50
phone:( ) Fax:( ) Residential backflow minimum permit fee: $36.25
CB Lic.: n PI ng Lic.no.:i,),4 Plan review (25%of permit fee)
` 1/ u� r State surcharge(12%of permit fee)
�`/'/
Authorized signature: JUy r
TOTAL PERMIT FEE
Print name: Date: This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permita\PLMF-PermitApp.doc 12/27/06 440.46167(10/02/COM/WEB)
Electrical Permit Applicatio FOR OFFICE USE ONLV
• City of Tigard 'DECEIVE I Datee ved® o� Permit No.: rrsr g'--6Y: 4/
111 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 JUN 1 2003 Date/B : ocher Permit: 2 0�0$ 9y
IGARD Inspection Line: 503.639.4175 Date Ready/By: 351,5 El See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
-LAiN-REViEw -_
21YPE-oFINUIE�DING DIVISION
®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked below).
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
fCIMIIEGORY tOF==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
4 _ -;4 ❑Emergency system. larger separately derived system.
SOB`SIFL;INFORMATION-AND ASOCATION �`° * >' ❑Addition of new motor load of ❑°A" "E" "1-2" "1-3"
Job no.: Job site address: ,�,�,,` ` I OOHP or more, occupancy.
1 �. C '� • ..\) ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:Tigard,OR 1 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name:Village at Summer Creek ❑Service or feeder 600 amps or more.
.FETE.SCHEDULE
Cross street/directions to job site: Description I Qrv. I Fee. I Total 1 •
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: ` 1,000 sq.ft.or less I 145.15 4
Ea.add'l 500 sq.ft.or portion 4.-. 33.40 1
Tax map/parcel no.: Limited energy,residential 75.00 2
_ :DESCRIPTION OF VOR;K = = (with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Services or feeders installation,alteration,and/or relocation
200 amps or less 80.30 2
_D RROPERTN&OWNER -E T TENANT 201 amps to 400 amps 106.85 2
Name:JLS Custom Homes 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
.dress: 16280 NW Bethany ct Over 1,000 amps or volts 454.65 2
City/State/ZIP:Beaverton,OR 97006 Temporary services or feeders installation,alteration,and/or
relocation
Phone:(503)533-4006 I Fax:(503)533-4306 200 amps or less 66.85 1
Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 133.75 2
Branch circuits—new,alteration,or extension,per panel
Owner signature: Date: A.Fee for branch circuits with
APPLIC 1T'- I :❑-CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name:JLS Custom Homes B.Fee for branch circuits
Contact without service or feeder fee,
ontact name:Nicole Paulsen q 46.85 2
first branch circuit
Address: 16280 NW Bethany ct Each add'l branch circuit 6.65 2
Miscellaneous(service or feeder not included)
City/State/ZIP:Beaverton,OR 97006 Each manufactured or modular 90.90 2
dwelling,service and/or feeder
Phone:(503)533-4006 Fax: : (503)533-4306 Reconnect only 66.85 2
E-mail: nicole @jlscustomhomes.com Pump or irrigation circle 53.40 2
,- = . ;;.k, 1CONT'RAC3TOR - - . - = Sign or outline lighting 53.40 2
Business name:TBD Signal circuit(s)or limited-
energy panel,alteration,or
Address: extension.Describe: Page 2 2
City/State/ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone:( ) Fax:( ) Investigation per hour(1 hr min) 62.50
CCB Lie.: Electrical Lie.: Suprv.Lie.: Industrial plant per hour 73.75
ELECTRICAL PERMIT:FEES
tprv.Electrician signature,required: Subtotal:
Print name: Date: Plan review(25%of permit fee):
I ) State s urcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
Print name: Date: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\Building\Permits\ELC-PermitApp.doc 05/23/06 440-4615T(11/05/COM/WEB
•
i .
IN Building Division
One & Two-Family Dwelling
ricnKD Fees Checklist
PERMIT INFORMATION:
Permit #: ins-t 2 008 C'1 O o 9`T Plan #: Date: 7. 2 . 08
Site Address: I3S C2 cS -R 0 Se Parcel #:
Subdivision: v i k,q e a&,t,r i r 2 r l r ,tt Lot #: t Zoning:
Jurisdiction: -r,,, vSetbacks: Front: Rear: Left: Right:
Class of Work: Aeu> Stories: 3 First Floor: G'j Es
Type of Use: x(1(1 V Height: 3C) Second Floor: 1 q 14
Construction: [.) Floor Load: CJQ Third Floor: 9 Q to
Occupancy Group: ?j _ Dwelling Units: Bonus Room: 2f
Valuation: 01r1/43 1 y Z,Z.0 21 Bedrooms: 1 Total Floors: • 01
Bathrooms: 3 Basement:
Decks: ( Up Garage: Lo •
Porches: `.3 Lo Other: 0
FEES: Description: Fee Amount: Amount Paid: Balance Due:
Plan Check: Building: _C�M . n _ 7 5a.00 S-7 ,
Extra Set: 0
Permit: Building: _ .I 2-1-1-2 .2(,
Tax: 1 Ut C1 0—2 _
Metro CET:
School CET: i0
>1 Mechanical (2u , ?j a
1 Tax: 6l, US
Plumbing: 3C Ck. C70
Tax: 4'l. S"6
Electrical: 2115.3x&
Tax:
9.414
Low Voltage:
Tax: ■Q'
CDC: CDC Ping. Rev.: t.. OQ
CDC LRP Fee: , . . •
SDC: Parks: , 64)
TIF Res.: 2.51 ,O .00
TIF MT: OO
Erosion Permit: .QQ
Erosion CWS: 78. CCC)
Erosion COT: 28.(C 0
Water Quality: feS\
Water Quantity:
SUB-TOTAL: 13 (4 dc. 3(2 _ t o rg3133
Sewer: Permit:
Inspection:
SUB-TOTAL:
TOTAL MST & SWR:
I:\Building\Forms\ResPlanCheckFees.doc 01/19/07 Page 1
PLUMBING FEES (for special information use checklist) MECHANICAL FEES (residential equipment/systems)
Description I Qty. I Fee(ea.) I Total Description Qty I Fee(ea.) I Total
New 1-&2-family dwellings Heating/Coolin
(includes 100 ft.for each utility connection) Air conditioning or heat pump* 14.00
SFR(1)bath 249.20 Furnace 100,000 BTU(ducts/vents) 14.00
SFR(2)bath 350.00 Furnace 100,000+BTU(ducts/vents) 1, 17.90
SFR(3)bath ` 399.00 Gas heat pump 14.00
Each additional bath/kitchen 45.00 Duct work 10.00
Rain Drain,single family dwelling 65.25 Hydronic hot water system 14.00
Fire sprinkler-sq.ft. 0 to 2,000 115.00 Residential boiler
Fire sprinkler-sq.ft. 2,001 to 3,600 160.00 (for radiator or hydronic system) 14.00
Fire sprinkler-sq. ft. 3,601 to 7,200 220.00 Unit heaters(fuel,not electric)
Fire sprinkler-sq.ft. _ 7,200 and greater 309.00 (in wall,in-duct,suspended,etc.) 14.00
Site Utilities Flue/vent(for any of above) 6.80
Catch basin/area drain 16.60 Repair units 12.15
Drywell/leach line/trench drain 16.60 Other Fuel Appliances
Footing drain- Pt 100' 55.00 Water heater 10.00
Footing drain-each additional 100' 46.40 Gas fireplace I 10.00
Manufactured home utilities 110.00 Flue vent(water heater/gas fireplace) 10.00
Manholes 16.60 Log lighter(gas) 10.00
Wood/Pellet stove 10.00
Rain drain connector 16.60 Wood fireplace/insert 10.00
Sanitary sewer- 1 100' I 55.00 Chimney/liner/flue/vent 10.00
Sanitary sewer-each additional 100' 46.40 Other: 10.00
Storm sewer- 1" 100' 1 55.00 Environmental Exhaust&Ventilation
Storm sewer-each additional 100' 46.40 Range hood/other kitchen equipment 1 10.00
Water service- 1 s` 100' ' 55.00 Clothes dryer exhaust 10.00
Water service-each additional 100' 46.40
Fixture or Item Single duct exhaust
Absorption valve 16.60 (bathrooms,toilet compartments,
6
Backflow preventer 27.55 utility rooms) 6.80•
Backwater valve 1 16.60 Attic/crawl space fans 10.00
Clothes washer I 16.60 Other: _ 10.00
Fuel Piping
Dishwasher I 16.60 **(55.40 for first 4,$1.00 each additional)
Drinking fountain 16.60 Furnace,etc. 1 **
Ejectors/sump 16.60 Gas heat pump **
Expansion tank 16.60 Wall/suspended/unit heater **
Fixture/sewer cap 16.60 Water heater I **
Floor drain/floor sink/hub 16.60 Fireplace I **
Garbage disposal 1 16.60 Range I **
Hose bib 16.60 BBQ **
Ice maker 1 16.60 Clothes dryer(gas) **
Interceptor/grease trap 16.60 Other: **
Primer _ 16.60 Total:
Roof drain(commercial) 16.60 Mechanical Permit Fees
Sink/basin/lavatory 1 /0 /(4 ..2 16.60 Subtotal: $ 9,-i.3 6
Tub/shower/shower pan 3 16.60 Minimum Permit Fee$72.50 $
Urinal 16.60 Plan Review Fee(25%of Permit Fee) $
Water closet 3 16.60 State Surcharge(12%of Permit Fee) $ I L - l¢
Water heater _ 1 16.60 TOTAL PERMIT FEE $
Other:
Other:
Plumbing Permit Fees ELECTRICAL FEES (residential single-or multi-family)
Subtotal $ Description Qty. Fee Total Insp
Minimum Permit Fee$72.50 $ 1,000 sq.ft.or less 145.15 4
Plan Review(25%of Permit Fee) $ Ea.add'1500 sq.ft.or portion 33.40 1
State Surcharge(12%of Permit Fee) $ Limited energy,residential 75.00 2
TOTAL PERMIT FEE $ Each manufactured or modular
dwelling,service and/or feeder 90.90 _ 2
Electrical Permit Fees
Subtotal: $ 2.45,2,5
Plan review(25%of permit fee) $
State surcharge(12%of permit fee) $ 7 C(,y 14
TOTAL PERMIT FEE $
I:\Building\Forms\ResPlanCheckFees.doc 01/19/07 Page 2
CITY OF TIGARD FEE AND PAYMENT HISTORY
i C 13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
TIGARD
MST2008-00094 - 13568 SW ROSEMARY LN
Revenue Payment
Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt# Due
[BUPPLN] Pin Rv Deposit 245-0000-433000 $750.00 $750.00 $750.00 6/17/08 Check 2720080000 $0.00
0000002095
[CDCPLN]CDC Pln Rev 100-0000-433060 $46.00 $46.00 $46.00
[LRPF] LR Planning Surcharge 100-0000-438050 $6.00 $6.00 $6.00
[BUPPLN] Pin Rv Balance 245-0000-433000 $57.47 $57.47 $57.47
[BUILD] Bldg Permit 245-0000-432000 $1,242.26 $1,242.26 $1,242.26
[TAX] Build 12% State Surchrge 100-0000-207020 $149.07 $149.07 $149.07
[METCET] Metro Const Excise Tx 245-0000-229202 $241.71 $241.71 $241.71
[BEACET] Beaverton School CET 245-0000-229204 $1,798.00 $1,798.00 $1,798.00
[MECH] MEC Permit 245-0000-431010 $97.30 $97.30 $97.30
[TAX] MEC 12% State Surcharge 100-0000-207020 $11.68 $11.68 $11.68
[PLUMB] PLM Prmt 3Bth 245-0000-431000 $399.00 $399.00 $399.00
[TAX] PLM 12% State Surcharge 100-0000-207020 $47.88 $47.88 $47.88
[ELPRMT] ELC Permit 220-0000-431510 $245.35 $245.35 $245.35
[TAX] ELC 12% State Surcharge 100-0000-207020 $29.44 $29.44 $29.44
[PKSDC]SF Park SDC 270-0000-450000 $5,215.00 $5,215.00 $5,215.00
[TIF-R]TIF Resident 210-0000-448001 $2,960.00 $2,960.00 $2,960.00
[TIF-MT]TIF Mass Tr 210-0000-448005 $240.00 $240.00 $240.00
[ERPRMT] Erosion Control 100-0000-207307 $88.00 $88.00 $88.00
[ERPLN] Erosn Pln Rv CWS 100-0000-207308 $28.60 $28.60 $28.60
[EROSN] Erosn Pln Rv COT 245-0000-433010 $28.60 $28.60 $28.60
Totals for Fees $13,681.36 $13,681.36 $750.00 $12,931.36
/,> ( 7
Revenue Payment
Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt# Due
Receipt# Payment Method Check# Payor: Receipt Date Receipt Amount
27200800000000002095 Check 912179 06/17/2008 $750.00
Total Payments: $750 00
Balance Due: $12.931.36
•
CITY OF TIGARD-SITE PLAN REVIE _
BUILDING PERMIT NO.:/j PLANNING DIVISION: Not A roved
v, v t S'ummer C 4' SANITARY SEWER A oved ❑ pP 4 SA ITAR1' SEWER Required Setbacks: � pp*
4' SA ITARY SEWER Side: Street Side: _
4' SANITARY 5EWt, _ _ G age: $ Rear: ie
B ECEIVED ` Visual Clearance: [ Approved ❑ Not Approved
SuuId;n flan, C tit ' 2008 12' STORMLINE. 1111ftlimiNiPftwer Maximum Building Height feet
RD
Illef____} C WS Service Provider Letter Required: ❑ Yes ❑ No
,,// CITY pF TIGA . S W Date: �I lv�ved
Lots : 7, 2, 3, BUII�IMG DIVISION 12' WATER LINE R SEMA -Y
_ Ai I'FE Plait. DEP TMENT:
rj� - off 4' SANITARY SEWER `� _,, Actual Slope: % Approved ❑ Not A oved
l/in1��: �l G ���•� Site �APProved of • , s ,ved
�,� —_,. B�. Date: .
�'�� —. —® `, _
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.< n i ' Ea-tern Redbud<. fU‘I. PROVIDE A MINIMUM 8' DEEP GRAVEL BASE FOR ALL
z DRIVEWAY AREAS. 2' Eastern Redbu= : �i _ r , x •
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MAXIMUM DRIVEWAY SLOPE SHOULD BE VERIFIED WITH , ,
THE BUILDING DEPARTMENT PRIOR TO CONSTRUCTION. — E
3. PROVIDE A MINIMUM 4' DEEP GRAVEL BASE FOR ALL W g•
SIDEWALK AND PATIO AREAS. �. i
tt J,
4. PIPE ALL STORM DRAINAGE FROM THE BUILDING TO A
DISPOSAL POINT APPROVED BY THE BUILDING Q� Cs
DEPARTMENT. r I 0 •••......1
Unit A O O ;
5. PROVIDE AND MAINTAIN POSITIVE DRAINAGE AWAY �� v
FROM BUILDING ON ALL SIDES. Unit A 1 C"-••• Lll
2
6 �,
. NON-STABILIZED FILL MUST NOT EXCEED 2:1 SLOPE Z §
1. NO CUTTING OR FILLING SHALL TAKE PLACE WITHIN TRACT "B" c.--, 1•
THE DRIP LINE OF AN EXISTING TREE UNLESS THE
EXCEPTION IS APPROVED BY THE BUILDING DEPT. •
111111/1111
8. AFTER COMPLETION OF CONSTRUCTION, THE CONTRACTOR , < r< • g in
— �— _ ''
SEED THE EXPOSED SOILS. ` ' 4 < CV•
VIEW
PROTECT STOCK PILES FROM OCTOBER 1st THRU ~-°-` _�, ,<1_� 0, ,/ CITY OF TiGARD-SITE PLAN
U vCO APRIL 30th PER THE EROSION CONTROL HANDBOOK. ' ` BUILDING PERMIT NO:
TRACT "A" ❑ Na Approved
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DATE
TRANSMISSION VERIFICATION REPORT
TIME : 07/09/2008 13: 43
NAME : TIGARD BUILDING DEPT
FAX : 5036243681
TEL .
SER. # : BR0D4J479592
DATE,TIME 07/09 13:41
FAX NO./NAME 5035334306
DURATION 00: 01: 51
PAGE KS) 05
RESULT OK
MODE STANDARD
City of Tigard, Oregon • 13125 SW Hall Blvd. • Tigard, OR 97223
July 9, 2008
Nicole Paulsen TIGARD
JLS Custom Homes
16280 NW Bethany Ct.
Beaverton, OR 97006
Building Permit: MST2008-00094 Construction Type: 5B
Address: 13568 SW Rosemary L.n. Occupancy Type: R3
Area: 1798 Sq. Ft. Stories: 3
The plan review was performed under the 2005 Oregon Residental Specialty Code. The review of
the submitted plans will be completed when the following information is provided.
1. The elevation shows crickets of 5'. Details 1/8, 2/8, and the plan sheet 6 show a cricket
less than 30". Correct the discrepancy and provide two copies of revised plan sheets.
2. The mechanical permit applications show heat pumps are to be installed, please clarify if
they are exterior, in which case they need to be shown on the site plan also.
3. All general notes at the cover sheet reference codes not used, change all references to the
2005 ORSC.
4. No manufactured floor framing is provided with this submittal. Provide two copies of
manufactured floor framing showing the beams in the same locations as the engineered
design.
5. When responding, provide an itemized letter stating in what way each issue has been
addressed in the revision.
RECEIVED
Jeremy Krueger
Jkru Design AUG 2 8 2008
8217 SW Seminole Tr CITY OF TIGARD
Tualatin, OR 97062
(503)-577-8781 BUILDING DIVISION
Loraine Sellers, Plans Examiner
loraine@tigard-or.gov
Phone: 503.718.2708
Fax: 503.624.3681
Ms. Sellers:
This letter is intended to address the issues in the recent plan check for JLS Custom
Homes Village at Summer Creek Lot 1, located at 13568 SW Rosemary Ln. Permit
number MST2008-00094 .
Item 1 - The elevation shows crickets of 5'. Details 1/8, 2/8, and the plan sheet 6 show a
cricket less than 30". Correct the discrepancy and provide two copies of revised plan
sheets.
Details 1/8 & 2/8 revised to show cricket greater than 30"tall.
Item 2- The mechanical permit applications show heat pumps are to be installed,please
clarify if they are exterior, in which case they need to be shown on the site plan also.
Not addressed by Jkru Design L``U. aCA ylifk ?u v S
Item 3-All general notes at the cover sheet reference codes not used, change all
references to the 2005 ORSC.
Notes updated to reflect current code usage.
Item 4 -No manufactured floor framing is provided with this submittal. Provide two
copies of manufactured floor fra • g showing the beams in the same locations as the
engineered design y-0\1\
Not addressed by Jkru Design
Sincerely,
Jeremy Krueger
RESIDENTIAL PERMIT APPLICATION REVIEW
Permit No.: MST2008 -00094
Site Address: 13568 SW Rosemary
Subdivision: Village @ Summer Creek
Lot No.: 1
Contact Name: Nicole Paulsen
Business: JLS Custom Homes
Street: 16280 NW Bethany Ct.
City: Beaverton State: OR Zip: 97006
As required by the 1999 Legislative action (Senate Bill 587), your residential permit application and
plans have been reviewed to determine if it is complete and if the plans are deemed "simple" or
"complex" as defined in ORS 455.467 and 455.469.
The application is complete.
❑ The application is incomplete for the following reason:
❑ The submitted plans will be reviewed; however, a permit cannot be issued until the above
information is reviewed and /or approved.
❑ The submitted plans cannot be reviewed until the above information has been submitted
and /or approved.
❑ The plans are deemed "simple ".
n The plans are deemed "complex ".
•
Signature: Jun oc�
Name: Brandon Shaw Date
Title: Plans Examiner
Phone: 503- 718 -2425
E -Mail: BrandonS @tigard - or.gov
I: \ Bull ding\ Forms \RIBS- PcrmitAppRevw- Blank.doc 1/18/07
This form is recognized by most Building Departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
;I ■ BUILDING DIVISION
TIGARD TRANSMITTAL LETTER
TO: LW-V.-0-WL3-- DATE
DEPT: BUILDING DIVISION D
AUG 2 8 20(
FROM: ). \_( CITY OF TIGARD
BUILDING DIVISION
COMPANY:-RS LOScz ek\--tV QS
PHONE: SOS • -\ 5 fib (-----By:Is
RE: ✓<.-\J i Ur)S .."4'1, -o y -( [
MJ
(Site Address) a'ernvt/se umber)
t �rn V Mme. 1�
ro dCt n or b vi on nam�t
J e and lot numl3er)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: 1 Copies: Description:
Additional set(s)of plans. Nin Revisions: 1r. U.QS
Cross section(s)and details. Wall bracing andifair later analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS:
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: Initials:
Fees Due: ❑ Yes ❑ No Fee Description: Amount Due:
$
$
$
$
$
Special
Instructions:
Reprint Permit(per PE): ❑ Yes ❑ No ❑ Done
Applicant Notified: Date: Initials:
I:\Building\Forms\TransmittalLetter-Revisions.doc 4/4/07