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Permit City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT `► Request for Permit Action h i s 2014 T t c i A.RD 13125 SW Hall Blvd. • Tigard,Oregon 97223 • 503-718-2439 •www.tigard-ox raGnM'S'ON TO: CITY OF TIGARD Building Division 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigarci-or.gov 1� I ( JI Y FROM: Owner ❑ Applicant ❑ Contractor ❑ City Staff Chcck(✓)uric REFUND OR Name: INVOICE TO: (Business or Individual) ..-fliti a, 4 *414,4, „/,�(! Mailing Address: /2 L 7 0l SW j;S tlt Mr./ .SG.1 k 3O City/State/Zip: /1 ;,L,{ I7 `f'2.2 3 Phone No.: SG'3.. b Z e - g k6 0 PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (i): r CANCEL/VOID PERMIT APPLICATION. (Jkii i 16',73)12afkit 41 2 4)13 - ERMIT FEES (attach copy of original receipt and provide explanation below). I I -N O CEP SR FEES DUE (attach case fee schedule and provide explanation below). r• �s' OVE/REPLACE CONTRACTOR ON PERMIT(do not cancel permit). $T Permit#: M2 o 13 00"act it Site Address or Parcel#: f ,�/g ,s-1v /2 2 iid -17/, Project Name: '�ri), I� 1a t _/_ Subdivision Name: Lot#: 7 y EXPLANA-T�ION: 0 ,oL')Jh r bi-L (4 0—t q Iy_ 5/e E t >-&p 7 l SD ncz (.0c":_4104,. b LJ1 1 C 41 3.: 12 t,ki- e • Signature: �.,X-1 Date: // / 1_40,1 Print Name: �ILt.I�L- Refund Policy 1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of: • Any fee which was erroneously paid or collected. • Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended. • Not more than 80%of the application or permit fee for issued permits prior to any inspection requests. 2. All refunds will be returned to the original payer in the form of a check via US postal service. 3. Please allow 3-4 weeks for processing refund requests. FOR OFFICE l!Sl-:°NI A Route to Sys Adtnin: Emiormon B A-. Route to Records: Date //0m, B ALVADM Refund Processed: Date a B' •:' - - Invoice Processed: Date az/j,F-1/7 y By 41''-, 1 Permit Canceled: Date B t' Parcel Ta-Added: Date B 1:1,Building\Forms\RegPermitAction_0' 114. nc • City of Tigard • COMMUNITY DEVELOPMENT _ Building Division 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TIGARD INVOICE TO: Timberland Homes, Inc. Customer ID: 141715 Attn: Laura Blake Invoice No.: INV2014-00005 12670 SW 68th Ave., Suite 300 Invoice Date: 11/18/2014 Tigard, OR 97223 Date Due: 12/18/2014 Case No. Site Address Subdivision-Lot#or Project Name Amount Due MST2013-00241 14818 SW 122^d PI Troy Park,Lot 7 $606.41 Invoice Total: $606.41 E Please see attached fee schedule for description of fees due. (Detach and return this portion with payment.) Case No.: MST2013-00241 Customer ID: 141715 Site Address: 14818 SW 122^d P1 Invoice No.: INV2014-00005 Project: Troy Park,Lot 7 Invoice Date: 11/18/2014 Date Due: 12/18/2014 Invoice Total: $606.41 Amount Paid: $ Office Note: Route copy of receipt to Dianna Howse. Please mail payment to: City of Tigard, Building Division Attn: Dianna Howse 13125 SW Hall Blvd. Tigard, OR 97223 I:\Building\Accounting\Invoice.doc 01/14/2011 liq CITY OF TIGARD FEE AND PAYMENT HISTORY I i .ill 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD MST2013-00241 - 14818 SW 122ND PL, TIGARD, OR 97224 Revenue Payment Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt# Due Plan Review 230-0000-43106 $751.34 $751.34 $750.00 11/19/13 Check 194002 $1.34 Plan Review 230-0000-43106 $525.07 $525.07 $525.07 DC Provision Review, SF-Ping 100-0000-43112 $70.00 $70.00 $70.00 DC Provision Review, SF-LRP 100-0000-43117 $10.00 $10.00 $10.00 Totals for Fees $1,356.41 $1,356.41 $750.00 $606.41 Receipt# Payment Method Check# Payor: Receipt Date Receipt Amount 194002 Check 3328 Timberland Homes, Inc. 11/19/2013 $750.00 Total Payments: $750.00 Balance Due: $606.41 & I5 •. 1tlildinz Permit Applica oil S 1 414 C. ■Residential / FOR 01 I ICE USE O\I , 11) 18/71 '`,•' Received City of Tigard I Date/B (3 y'� Permit No.: IeiiO r y 13125 SW Hall Blvd.,Tigard,OR 97 Plan Review � / ti Phone: 503.718.2439 Fax: 503.598. �3 Date/B : AND �IN Other Permit: • t� _ r• T I G A R[� Inspection Line: 503.639.4175 1 pJ `�0 Date Ready/By: I tuns ® See Page 2 for \1 1 Notified/Method: Internet www.tigard-or.gov w\OV ��O /1)111 8. t , �'L, Supplemental Information TYPE OF WORK , ."r t� REQUIRED DATA:1-AND 2-FAMILY DWELLING 0 New construction ❑ DemQliti i r-" r 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: $ %77,47) ((CAc ,e ` ❑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: Job site address: 14818 SW 122nd Place New dwelling area: 2ifi 1 g square feet City/State/ZIP:Tigard,OR 97224 Garage/carport area: 148 b square feet Suite/bldg./apt.no.: Project name:Troy Park Lot 7 Covered porch area: ': 1,5---- square feet EC t-2_.Cross street/directions to job site:SW Winterview Drive Deck area: square feet r294_, Other structure area: '7 1 T square feet r7� REQUIRED DATA:COMMER/CIAL-USE CHECKLIST Subdivision:Troy Park Lot no.:7 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 DESCRIPTION OF WORK work indicated on this application. Single Family Residence Valuation: $ Existing building area: square feet New building area: square feet 0 PROPERTY OWNER ❑ TENANT Number of stories: Name:Timberland Homes,Inc. Type of construction: Address: 12670 SW 68th Ave.,Suite 300 Occupancy groups: City/State/ZIP:Tigard,OR 97223 Existing: Phone:(503)620-8860 Fax:(503)598-9081 New: 0 APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* Business name:Timberland Homes,Inc. (Please refer ro fee schedule) Structural plan review fee(or deposit): Contact name:Laura Blake 68th FIS plan review fee(if applicable): Address: 12670 SW 68 Ave.,Suite 300 Total fees due upon application: City/State/ZIP:Tigard,OR 97223 Phone:(503)620-8860 Fax: :(503)598-9081 Amount received: E-mail:laura@timberlandhomes.net PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name:Timberland homes,Inc. Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 12670 SW 68th Ave.,Suite 300 Solar Installation Specialty Code checklist. City/State/ZIP:Tigard,OR 97223 Permit Fee(includes plan review $180.00 and administrative fees): Phone:(503)620-8860 Fax:(503)598-9081 State surcharge(12%of permit fee): $21.60 CCB tic.: 141715 Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Date: *Fee methodology set by Tri-County Building Industry Print name: Laura Blake l l /I 0 3 Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-46613T(111/02/COM/WEB) A Plumbing Permit Application ik Building Fixtures 0 t FOR OFFICE USE ONLY Received II City of Tigard rL%\ >��By: Permit No.: 115T(�! �U 4 • 13125 SW Hall Blvd.,Tigard,OR 97223 l 3 plat[Review Phone: 503.718.2439 Fax: 503598.1 w\tJ� G` tides : Other Permit No.: T I G A R D Inspection Line: 503.639.4175 \\�� '( Internet: www.ti ard-or. ov `\ ,�` �l,ice •yBy` Jun, I Supplemental Page 2 for g" g % - , tiftted/Method: I Supplemental information TYPE OF WORK V` g FEE* SCHEDULE ®New construction ❑Demohtii' For special information use checklist. Description 1 Qty. I Ea. J 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 ®l-and 2-family dwelling El Commercial/industrial SFR(2)bath 437.78 SFR(3)bath f 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:14818 SW 122.1°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.: Project name:Troy Park Lot 7 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 Lot no.:7 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 1231 Clothes washer 25.02 Single Family Residence Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER f ❑ TENANT _ Expansion tank 1231 Name:Timberland Homes,Inc. Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:12670 SW 68th 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 1251 0 APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name:Timberland Homes,Inc. Medical gas(value:$ ) Page 2 Primer , Contact name:Laura Blake Roof drain(commercial) 1251 Address:12670 SW 68th Ave.,Suite 300 Sink/basin/lavatory 25.02 City/State/ZIP:Tigard,OR 97223 Solar units(potable water) 6254 Phone:(503)620-8860 Fax::(503)598-9081 Tub/shower/shower pan 12.51 E-mail:laura@timberlandhomes.net Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 3732 Business name:G&B Plumbing&Sons,Inc. Water t m WV 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: $7250 Plan review (25%of permit fee) CCB Lie.:184372 {t,_ _ p Plumbing Lic.no.:PB634 State surcharge(12%of permit fee) Authorized signature: ,i F )3 `die—`+— / TOTAL PERMIT FEE Print name:Steve Fowler 444NNN���""" Date: (/1 v j, 3 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. "Fee methodology set by"Fri-County Building Industry Service Board. I:\BuildingWermitssl.MU-PermitApp.tkir 104)1/09 440-4616T(10■02/COM/WEB) . * Mechanical Permit Application `�t 1 FOR OFF IC I:1 I.t,a.1 City of Tigard +� li • 13125 SW Hall Blvd.,Tigard,OR 97223 \ !' � � �� �Review Phone: 503.718.2439 Fax: 503598.1960 `1 Date/By: Other Permit: i I `is I Inspection Line: 503.639.4175 N�V 7I. ..yBy: Julia: RI See Page 2 for Internet www.tigard-or.gov g.,,x_lxv ., ethod: Sopplmeatal Information T Or WORK COMMIRCLAL 1W SCIMIIII1-MR CIIRCIDAST Mechanical permit fees*are based on the value of the work ®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATaC C Y 01r C0111BI1tDC1iOlnl RISHIRNITAL agawasair/SYSTEM MB* ® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description Qty. I Ea. 1 Total JOa MS DIFORMATfON AND LOCATION Heating/cooling: Air conditioning 1 46.75 4(2.-75 Job site address:14818 SW 122°d Place Furnace 100,000 BTU(ducts/vents) I 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: Project name:Troy Park Lot 7 Heat pump 61.06 Duct work 2332 Cross street/directions to job site: Hydronic hot water system 2332 Residential boiler(radiator or hydronic) 2332 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 2332 Subdivision:Troy Park Lot no.:7 Other: 2332 Other fuel appliances: Tax map/parcel no.: Water heater f. 2332 DESCRIPTION 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 Other: 2332 El nonurfy ow= I ❑ Environmental exhaust and ventilation: Name:Timberland Homes,Inc. Range hood/other kitchen equipment I 3339 Address:12670 SW 68th Ave.,Suite 300 Clothes dryer exhaust f 3339 City/State/ZIP:Tigard,OR 97223 Single-duct exhaust(bathrooms, ..r toilet compartments,utility rooms) 2332 Phone:(503)620-8860 Fax:(503)598-9081 Attic/crawlspace fans 2332 ® APPLICANT ❑ CONTACT PEON Other: 2332 _ Business name:Timberland Homes,Inc. Fuel piping: S14.15 for that four;$4.03 for each additional Contact name:Laura Blake Furnace,etc. Address:12670 SW 68th Ave.,Suite 300 Gas heat pump Wall/suspended/unit heater City/State/ZIP:Tigard,OR 97223 Water heater Phone:(503)620-8860 Fax::(503)598-9081 Fireplace 1 _ Range E-mail:laura®timberlandhomes.net Barbecue CONTRACTOR Clothes dryer(gas) Business name:Central Air Other: IdIRCHANICALPRIIMITFIZSP 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 Fax:(503)650-3898 State surcharge(12%of permit fee) CCB lic.:178624 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 Authorized signature:�� —1--,�./L days after a has been y Buikling as complete. Se g ,.....z.../,.................". ' Fre methodology sex by Tri�Counry Building Industry Service Board Print name:Andrew Scheidt Date: (( (0 T `3 t'1Buildiig�PtmutstslC_PermitApp_040113d°c 440.46 (11/02COM/WEa) • RECEIVED R Electrical Permit4Dulication - 5 2014 1 oR OF-tt ICE LSL OM N e{tY of Tigard TIGARD I Perm:No_ D i -00?,q i • 19125 3W t7.,11 Hlvd.,21.gaotd,OR 71223 ' PM RtWt4' 1 fir„/ Phone:503.7181439 Fax 503"9983940 �11 ���InA clatorar Odom Permit. 1.1„,k(: Imp:coon Lino:503b39A175 t7nmmeetynsy Imam 1 $($ec rage Vat. iatemet: wwwiiisal4-ccgov i NatlF3o6rMednd ICmaDteJ]nfaersatiaa • TYPE OF WORK PLAN R13V/Ew igi Now construction CrAdditionla1tesarionirepluecment Please dere an that apply(thdatmt 2 Seer of playa willcuo aims t wl- CI aetvtez or lcoder 400.spo or mac 0 Eamdmg cum twee stories. D Demolition 0 Other: where the evait.hla fault moral Ll Merest sod MatyaICe. — [mamas 10,000.taps ai 150 voh,oa 0 Mourne b.i:dinta. CAT'Lri'Okt CM CONSiTRtiellON Tess to graced.or=meth 14 pom 0 Comme2nS-ase agnesatanl Ifg 1-and?-family dwelling r••�Commetriaifindustrial 0 Accessory building =pi,so,..11 saw nrwl«io s w:taega. 0 Multi-faintly 0 Masser builder CI Other: C Fns.l.�p. C3 isms 1 P of t9]YYA m SOS SITE INPORMA'17ON ARIA LOCATION (I 0 of offin. "A-," -.-1-2"-.*1-3", gy6ttsa. f 0 Addition of met raolof kid Of ❑"A","li."!-2`."1-3". 1111 i0lti{pwatac. %- i�no:Tl''X sob race address:t g r 8 s,� W."'� P� s�o<� �al,�>. a 1+ 0004 ven+titpolo. C /gtfar.a:p;Tigard,OR 97224 011ealth.mte:In lttic- ©Sapp!)wiliage foe rove stun - _ - a aara ta",lenr;eds_ 600 vac twnanal. Suite/bidg/apt.no.: Project name:Tray Paris Lot 7 o s.`•140 or feeder boo maps at mare. 11 s Cross street/directions to job site: �.,... I . roa T ! `- New residential single-or anikl-fmail dwelling mail. Includes alacbed garage. Subdivision:Troy Path Lot no.: 7 ` 1,000 sq.Ito;1w I I 16854 ; ' 4 - lit.add'l 300 sq.&or p0rdon 3332 1 J 'fax map/parcel no.: _ _ Limited energy.tecitruns' �o WORK (with above ac.ft.) r 75'� 3 Lowed eaergy.malc-fa®sy 750 2 F Single y Residence residentla.l(with abaci art,s1 ff — ! *gro rffi ❑cr Pane 2 Services or feeders, p,,.. - sadlnrrelocation I_h PROPERTY OS W ? 0 TI+74ANT t 200 amps or lost 40,70 2 201 amps to 400 ealpa 13336 2 Name:Timberland Homes,inc. 4a1 erase to 600 mega 2E034 2 j• • Address:12670 S'PV 68°Ave-,Suitt 300 1_60I slaps m l j:90 amps i 30144 2 I OW;10a0 amps or r 332,26 2 City/State/MP:Tigard,OR 97223 Temporary swains or feedars Insta7etima,alteration,an4lor ' Fhotu:(503)6204SW rFax:(503)596.9081 ; relocation Owner iastallarkin:This installation is being made on ' 200 amps or less 1 5936 I : 1 sing property that I own which is not 20l amps a 400�etapc _ 123-Ott 1 ' 2 intended for sole,lease,rent,or exchange,according to ORS 447,449,570,and 701,- 401 amps m 55t9 more 16854 , - z Owner signature:, . _ ! _Date: •Nrancharobs-new,stttaetion.arc iom,perpcnd I ® AP'11.3cAr T _ ) Li CON'TAC'T PERSON ' •O••Pon for Winch,clicltia wo.h T [bore aervicc or fonder fee, 7,42 2 S asiness name:Timberland Homes,Inc. cacti branch dual: , — R.Pee For branch&mica,vitimu t I Contact same:Laura Blake ,cr.rico«t,odor fa.Ern 56.18 2 branch cimutt Addrael:12670 S W 61l°a Ave.,Suite 300 Facer add 1 branch circuit 7.42 i 2 - _ - C dY 13taor/ZIP 8 OR 47223 Misodtanflan(service err feeder cot ioraded) l xch maaufecturett of Modular ' Phone:(503)620-8660 ■ Fes!:(503)598-9081 dweIltog.servicea0d/OrIatder I 6744 - 2 - Reeomiect arty 6734 2.. t lrutail:Tsars®timtterL9ndhotnt�nei - .. .- PPalv?or trttCanonBarth 6744 21• - Sim 0I000t W &. 6784 1 2 Business nun: J11l1ELliMYIfW``54 tPGFNiG . L gisaand,,Ate e;on.areatendoo. ! Page 2 .�•�� ii Ewb atidLtionalsa•aactIOn ovr alwsebla i•an of the&am; ° [[•p+� � DO h v t tS qql (14L' ' Additional iasnemon(l tented 66251 hr J 1 City/S1atc12]P: per to 1 0!(Lemma CiZ.3' Ten uvoica(I ilfatiu) 66.25/I ; ---i Pt' SC . 1'•t-407 1,r Fax'(509(9(16-c]7,3 ,....,.,.,.-t ul,�at(t Dr mini 71.1[/m j saperSiOrts:4rrMirhmfar is i LCCB Lac.;AG- 7 Ne Electrical Lie.: al l3 ±YSuprv.Lies.: q900 5 I 37,111,211y dame 05 hrmL0 9000l In ; SLPC rktrAL F RiefTP FRS bllpiv, It{tritaan signature,required: ��..� f/ J Sm isgel: Print name J Date: j/LI Plan review(259;of permit tin)_ 7 I State unbar(1246 of permit MO AuthpriYad signature! I TOTAL/15MIT l' e:, I __ ___I 1..i nasty hates 1 Tate Wrist!appllattkm[?pies d a perm*is net obtained,within 110 h day,anew a ilia been waled.s®pieta. Number of o pee ia.s alleau6 pr.p.+a'dc NaaDdIrTP..vslEL.0 e.,fkNsR •RFREcia an'CYII/ID11 4w4t0111 osrcatnvra Mar. 5. 2014 5:08PM No. 9965 P. 4 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Request Permit Action T ,,F.n 13125 SW Hall Blvd. •Tigard, Oregon 97223 • 503.718.2439 • .14!h rk e.r TO: CITY OF TIGARD MAR -6 2014 Building Division Services Supervisor 13125 SW Hall Blvd.,Tigard,OR 97223 CITY OF TIGARD Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-o DING DIVISION FROM: ® Owner ® Applicant 0 Contractor ❑ City Staff (check one) REFUND OR Name: Timberland Homes, Inc. INVOICE TO: (Buse orInd�hduaq Mailing Address: 12670 SW 68th Ave.,Ste. 300 City/State/Zip: Tard,OR 97223 Phone No.: 503-620-8860 PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓): ❑ CANCEL/VOID PERMIT APPLICATION. ❑ REFUND PERMIT FEES (attach copy of original receipt and provide explanation below). ❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below)_ REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit). Permit#: 2013-00241 Site Address or Parcel#: 14818 SW 122nd Place,Tigard Project Name: Troy Park Lot 7 Subdivision Name: Troy Park Lot#: 7 EXPLANATION: We have a new electrician-DzeamHouse Electric,LLC.They submitted anew permit already,and no electrical inspections have taken_place yet on this job. Signature: Linz Qr- Date: 3/5/2014 Laura BOre Print Name: $rfimd Policy 1. The Director or Building Official may aurhot+ze the refund of a) any fee which was eeroneously paid or collected. b) not more than BO%of the land use applicarion fee when an application is withdrawn or canceled before any renew effort has been expended. c) not more than 80%of the land use application fee for issued permits. d) nor more than 80%of the building plan review fee when an application is canceled before any plan review effort has been expended. e) not more than 80%of the building permit fee for issued permits prior to any inspection requests. 2. Refunds will be retuned to the original Payer in the same method in which payment was received Please allow 2-4 weeks for mewing refunds. Rte to Sys Admin: Date /1/ y _ Rte to Bldg Admix: Date By Refund Processed: Date By Invoice Processed Date By Permit Canceled: Date By Parcel Tag Added: Date By Receipt# Dare Method Amount$ I'\8uiltiirtg\Forms\RegPeanitAcrion.doc Rev 05/25/2012 Building Division Development Code Provision Review I I( A R t) Residential Projects Building Permit No.: f")$7 ;1 3--Go Yo Project/Subdivision Name: r- ) v I i !_c,i-7 , Lot #: 1 Site Address: l L�'/r Ste% /�q?i /'L. • i • :. : :.,7 ; %: . .: ! ' CWS Service Provider Letter: Required:Yes ❑ No Er---- Received:Yes ❑ No ❑ Plans Routed: Original Plan Submittal Date: /I 11 I Routed By: r.5 i. 1't Revision Submittal Date: //9 I�/ ❑ Site Plan Only Routed By: /'%- 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. Planning Review (contact A-3 IBS t'V (7 at (503) 718-2L1 2 I or Ag r►eSE @tigard- .—.4 or.gov) Land Use Case No. SIA R2C0-1 — OW I Zoning ❑ Setbacks: l _1 'p i 7Front E,2_ Rear Sid Street Side OP Garage 2_ dd Maximum Building Height: 3S Actual Building Height i 30 EV Visual Clearance N+Pr ❑ yasements hY_Sensitive Lands Type: 0 we ?❑ Street Trees 1 ❑ Protected Trees Notes: ShG W 1 D' eel Sil nit.0 rx-k;S11cA4 -tr& prUttc-1-r,4{r k-c iv,` ,, on ex s'1 rs,cl 11,x';:. -� u wo v oil St(et4 i ( CA-t is;),)‘‘,14.) Dt ec ndt i-004.c etY ic..k S. Original Plan: Approved ❑ Not Approved Date: i 2--D Revision 1: Approved E Not Approved ❑ Date: t Revision 2: Approved Not Approved ❑ Date: : le_�r plann,naf rev is%or1S dressed on 1 1 9 subrn;i+al i n o (Review Continues on Page 2) rnq@,s on 1115 Su mitt taae 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) ❑ Actual Slope: Notes: Original Plan: Approved ❑ Not Approved Date: //-- i - I Revision 1: Approved ❑ Not Approved X. Date: 1- 1 - It M .d Revision 2: Approved Not Approved ❑ Date: / '/4 " / t f{bv�1 ai M-,ct'tp-( 040.1 tr.. e__ aGe-i � o 447- GAS OI-t ft_A-1-1 &J R6,� Permit Coordinator Review(contact Albert Shields at(503) 718-2426 or albert @tigard-or.gov) ❑ Conditions of Approval Prior to Issuance of Building Permit Notes : Original Plan: Date Sent to Applicant: Revision 1: Date Sent to Applicant Revision 2: Date Sent to Applicant Okay to Issue Permit: Yes No //�43/ Date Routed to Building: f / �y g Page 2 of 2 I:\CURPLN\Masters\Development Code Provision Review\DCPR_RES.doc Rev.01/16/13 CITY OF TIGARD ' A II pproved by Tanning 617E PLAN NOTES: Date: 1 1 s ti al L ALL OMR*dDO NATLAL TO EE INPORit P D TO M1 APPROVED ED O�SFOISAL V MN 1• Initials: 2.ALL Pa.L ALAI w ROM*ARMEE FLOORS,4CSYALK1.DItlARWAY*.ETC`TO Of ICI Q „ COMPACTED OrANLAR PILL a V • Tra)R;SLL w A SLALI4T OPEa EXCAVATION TO R ROADIE CONCRETE POPPING ALL AROISC MTE EMILICERE. 1:4 • PONCES AROISC EXCAVATED AREA TO EXCAVATION ATION OONaRCTION. I- Q NOME + DESIGN • PROVIDE CO NTYCITY APPROVED STABILIZED GRAVELED CONSTRUCTION!(TRAICR - 1 Mai PRIOR TO EXCAVATIO/AM COPOPEI GTON. A. STOCTO'.M PINT RE GO. WITH IILQ4 OR PLASTIC«aeT) ELTI I 4 - B =room I AM APRIL*O. Z 1.COMPACTOR/EM-CONTRACTOR TO WY LOCATION OP AU.UMLR1S PRIOR TO '4- EX:AVATCN MC CONSTRLCTKK • alawARY AND TOPOORAPI4T NPORIATIO4 14A•!a4 PROVCSD TO SKYLSS FILMS AND DLb10T4 NC SKYLM MOM AND CROW PC,SILL NOTE:MD LIABLE PCR Tot AOMACY OP 11*NIGR1A7101.R N ER SOLE IRSOPg/OLRY CP TI!GONRRACTOP! �y Li R>� T MAPLe 7 1 CORNER ELEV. 500.00' « /PERM TO VIIIIr r AU.SITE CO IXTOND NCLADNG Pal PLACID CIE am �/ 81?»' a rGPG/laM'14r ELEVATIONS un!ca.LCTa PROPt ACTUAL srre PURVEY. CORNER ELEV. 5•••A,••A' 1®'PUE .\ `' Q IRO.ELEVATION Li1t0. ���� ;y �,(� I/y ern P�Pe•REAL r+tial�ILao EMOTION I -11� '•.4 Mall PO O. 4'Or1�t L PROVOS A PER114 GRAVEL EAU UNDO!AU.DRVI•AY ANAL 4 4; ON D.PROMO A 4'P!a•IN GRAVEL SAAR 1!C!!ALL=WALK AND PATIO AMA& a LC d DRAxAGe Waal T/e aaow TO A ca1*rtncrtr DSP DSAL J �ri r.�. i IN ill I I L ~ Ol■ IA.PuwLN SLOPE Cr OPUS MC FLLI 10 EE MO(V I- 4TAL TO CNN(V } s ®® J VERTICAL PO R a4LDNOR ETRC1Ur POUR:SATTOI*,AMP IETAMO MALL& 44 �11 r" P ' IL PROVIDE ALA PW4TAN PORN GRADE UTE PORTS!!DRAMA=ALLAY PROs ~ f•A,•' _• • `�• �'-i'Hall D011i!�!4' O N•NI•LC1taE ON ALL a4DE0IETN A SLOPE Q AT 1111411/1 N Wes. Z 1,rI1 MI •r�:: . ` 1 QID ITV f LAME .. a rt. �11 • r GR/VRA\CONTROL SR/V ,A.',. •�t. �•r•, '�. x R Sam MO FT. r I u r - Yr— - 0 11_ .f ,w BORK r ^ a I- ,15 15.4114-1 I l� D STOCKPILES � -, r� ��. I O r L— ,�wrv�.sw. 1 X X X SEDIMENT FENCE In �i�I PRa• � —a 4 ST ORM tirilv ON j C17N61 RUCTION ENTR.8 z C.' 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