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Permit 7/ p CITY OF TIGARD MASTER PERMIT $ . COMMUNITY DEVELOPMENT I!1 Permit#: MST2015-00057 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/17/2015 Parcel: 2S110BA11200 Jurisdiction: TIGARD Site address: 14146 SW 118TH CT Subdivision: MEDALLION MEADOWS Lot: 5 Project: Medallion Meadows, Lot 5 Project Description: New SF. Demo credits from BUP2014-00189 to be applied to this permit. 11/5/15, REPRINTED to add a/c. V BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1255 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 25 Bathrooms: 3 Second: 1390 sf Garage: 552 sf Front: 20 Smoke Detectors: Yes Dwelling Units: 1 Third: 0 sf Right: 5 Total: 2645 sf Value: $323,090.93 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 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 Types 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 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-t 000v: 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 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 2645 Owner: Contractor: JT ROTH CONSTRUCTION INC FOUR D CONSTRUCTION Required Items and Reports(Conditions) FOUR D CONSTRUCTION CO PO BOX 1577 1 Ersn Cntrl 503-639-4175 12600 SW 72ND AVE#200 BEAVERTON,OR 97075 TIGARD,OR 97223 PHONE: PHONE: 503-590-0805 FAX: 503-590-1751 Total Fees: $8,659.93 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 - -- , ace 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. • TENTION: 0 ;.on law requires you to follow the rules adopted by the Oregon Utility Notification Center.. Those rules are set forth in OAR 952-'401-0010 through OA• • -.11-•'90. You may obtain a copy of the rules or direct questions to OUN • - 'n. • . 2.1987 or 1.800.332.2344. Iss =d By: / _ i i �� / Permittee Signa _ / iy - 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. Mechanical Permit Applicati jj;; FOR OFFICE USE ONLY City of Tigard 'i+�, ��VL' keeei`ed _ City Tigard Dale/By: l� S /5--- � Penult No t151:::90/� 00,5-`] : 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598 1960 DatelDy: t lihcr Prrmn: I I,. i' Inspection Line: 503.639.4175 N n V 5 2015 Date Ready/By: 1.1. ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information CITY OF flGARD E* SCHEDULE — USE CHECKLIST Mechanical permit Ices*are based on the value of the work j2] New construction ❑ Addit ion/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑ Demolition ❑ Other: mechanical materials,equipment.labor,overhead,and profit. Value:S CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* 1-and 2-tamily dwelling ❑ Commercial industrial ❑ Accessory building For special information use check list. ❑ Multi-family ❑ Master builder ❑ Other: Description 1 Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning / 46.75 Job site address: I V 1 1 11..1 , L.)_ I I -t-14- Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: Furnace 100,000+BTU(ducts/vents) 54.91 (� p Heat pump 61.06 Suite/bldg./apt.no.: Project name: i �Q v.,.�j 1&—t-`_. 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 Other: 23.32 Subdivision: I Lot no.: Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 _ Flue vent for water heater or gas ti-/-/ '1 fireplace 23.32 c_ lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 — -- - - — Other: 23.32 ❑ PROPERTY OWNER I ❑ TENANT 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:(.5Z) ?AO v5 Fax:( ) Attic/crawlspace fans 23.32 Other: 23.32 _ Fuel piping: Business name: $14.15 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: �`JP1t 1 ��j�f— c� S�. �1 it/1 Barbecue w * �" CONTRACTOR Clothes dryer(gas) _ Business name: Other: MECHANICAL PERMIT FEES* Address: Subtotal City/State/ZIP: Minimum permit fee(590.00) Plan review(25%of permit fee) Phone:( ) Fax:( ) State surcharge(12%of permit fee) CCB lie.: TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signatur * Fee methodology set by Tri-County Building Industry Service Board„Z2/9/j_t_ 1------ Print name: Date: I:Building,Permits`MEC_PmnitApp_040I I 3.doc 440-4617f(I 1 i02/COIN/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\M EC_PennitApp_0401 13.doc 2 Ill CITY OF TIGARD MASTER PERMIT °�1 * COMMUNITY DEVELOPMENT Permit#: MST2015-00057 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/17/2015 Parcel: 2511 OBA11200 Jurisdiction: TIGARD Site address: 14146 SW 118TH CT Subdivision: MEDALLION MEADOWS Lot: 5 Project: Medallion Meadows, Lot 5 Project Description: New SF. Demo credits from BUP2014-00189 to be applied to this permit. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1255 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 25 Bathrooms: 3 Second: 1390 sf Garage: 552 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2645 sf Value: $323,090.93 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 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 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 Srvc/Feeders Branch Circuits 1000 sf or less 1 0-200 amp- 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add!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 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 2645 Owner: Contractor: JT ROTH CONSTRUCTION INC FOUR D CONSTRUCTION Required Items and Reports(Conditions) FOUR D CONSTRUCTION CO PO BOX 1577 1 Ersn Cntrl 503-639-4175 12600 SW 72ND AVE#200 BEAVERTON,OR 97075 TIGARD,OR 97223 PHONE: PHONE: 503-590-0805 FAX: 503-590-1751 Total Fees: $8,659.93 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 h OAR 952-001-0090. Youu may obtain a copy of the rules or direct questions to OUNC by calling 503. 1987 or 00.332.2344. Issued By. C °"~`��— '—'14 Permittee Signature: _ _ /L. �/. i Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. , -r Bliildina Permit Application Residential aCYAN�� Ree e.�ed FoR()EFRY: I sl:O\L1 ill City of Tigard Datcll : S Permit No.: Jr�r5- j5-7 . 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Rev! Phone: 503.718.2439 Fax: 503.598.19( p a 2 15 Date/B : i►�!._� Other Pernit /5 Q�C/3 Inspection Line: 503.639.4175 A R f► Date Read T I G A R D Y �Y Jurir: ® See Page 2 for Internet: www.tigard-or.gov ��U Noti6ed/Metho&:205- Supplemental Information L`TY{UGD1V1S�(lly Ifei/7•� AvfMV/� TYPE O IN REQUIRED DATA:1-AND 2-FAMILY DWELLING N' New construction Permit fees*are based on the value of the work performed. ❑Demolition pe Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Valuation` c- ,`, -$ O- ` 1-and 2-family dwelling ❑Commercial/industrial 3zC1 ��t� // El Accessory building ❑Multi-family Number of bedrooms: L{ , ❑Master builder ❑Other: Number of bathrooms: Z 1/ r JOB SITE INFORMATION AND LOCATION Total number of floors: 2, Job site address: /6/7 y6, .$ W //8 TH. C'r` New dwelling area: �i`7 4/5 square feet City/State/ZIP: 1—k lo I\RD l OC . c-1-7 2.2 y Garage/carport area: .5.s-z_ square feet 1 Suite/bldg./apt.no.: Project name: Covered porch area: 57‘..., square feet ( (,, 4 Cross street/directions to job site: Deck area: square feet t--•�' � � �OTH � C�A'AR.QC q 12 J � Other structure area: 319 7 square feet 2!".3 REQUIRED DATA:COMMERCIAL-USE CHECKLIST L\ Subdivision: M c p IN L`1 O 0 M(EA De ws Lot no.: S Permit fees*are based on the value of the work performed. 04.• Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. Q Valuation: $ \( /V'�W ...5//\/t;at_C 1=4at-A try 9-t~S i D" "ULC J' Existing building area square feet New building area: square feet 14 PROPERTY OWNER ❑ TENANT Number of stories: 1 Name: Type of construction: Address: ckj t t AS B L L.i Occupancy groups: City/State/ZIP: Existing: Phone:( ) Fax:( ) \.. .,\` New: Ca,APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: r 0,rz_ D 6914 S T'(2.4.4.cri 0 0 Structural plan review fee(or deposit): Contact name: 1:-.3 AY 10 D e H p IZ)PO ez-(' — — � FLS plan review fee(if applicable): p Address: l `0, 2 15--7-7 p Total fees due upon application: City/State/ZIP: 2,eAye.RTo L) O 1-7 07 S h (5,3) 59 0 D 3 4 S Sc)0 I-7 S , Amount received: �rj� Phone: u Fax: ( ; Q E-mail: u,..( � P C c.�1 S'�- e. M s N t OTOVOLTAIC SOLAR PANEL SYSTEM FEES* co CEV tF� Commercial and residential prescriptive installation of \N CONTRACTOR roof op ,unted Photo Voltaic Solar Panel Syst- 1.) Business name: � Submit two = sets of roof plan with conne on details L.' and fire dep. - t access,along with • 2010 Oregon Address: Zti Solar Installation '•.•cialty Code c , ist. City/State/ZIP: ^ 1 V P Permit Fee(inc •'es pl.1 -view $180.00 S/'' and admini e fees): Phone:( ) J Fax:( ) State surcharge i r of permit fee): $21.60 CCB lic.: 7 1 0 37 T. .. '-e 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. *Fee methodology set by Tri-County Building Industry m Print nae:D p v L fl ,. D t= , r +1, �/ Date: / -2_7_iS Service Board. I:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/W EB) ■ ' Electrical Permit Application lull Ol l I( l I tie (l.l 1 City of Tigard Vtli'' Received '/ , 'I 13125 SW Hall Blvd.,Tigard,OR 97223 DareB : y �s [ Permit#: ijf�j�5=Q(JQ t)"/� = Phone. 503.718.2439 Fax: 503.598.19Ity,Cti Plan Review Date/B : Related Permit#: 6tci i-90/5-61:::1 3 Inspection Line: 503.639.4175 Q 0 Ready 5 Read Date/B y: J°"" e1 See Page 2 for T[c ;�h[ Internet: www.tigard-or.gov L NPR 2 O 01 Notified/Method: Supplemental Information New construction TYPE OF WORK T►(t►At�V PLAN REVIEW Tv.❑Addition/alteration/ttp � 1 IllgOn Please check all that apply(submit 2 sets of plans w/items checked): ❑Demolition ❑Other: ILY)1 L �1 7 ❑Service or feeder 400 amps or more l+� p ❑Building over three stories. CATEGORY OF CONSTRUCTION where the available fault current ❑Marinas and boatyards. exceeds 10,000 amps at 150 volts or ❑Floating buildings. ❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived � �' ❑Addition of new motor load of system. Job#: I Job site address: /y/ 6 J id -*y c"' 1 OOHP or more ❑ A E> l_2 , 1.3> City/State/ZIP: T��1Z OR- 'I z Y ❑Six or more residential units. occupancy. ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: I Project name: ❑Hazardous locations. ❑Supply voltage for more than Cross street/directions to job site: ❑Service or feeder 600 amps or more. 600 volts nominal. 1 -t o. to CniNAP--0E.. FEE SCHEDULE Description I Qty. I Each I Total I • New residential single-or multi-family dwelling unit. Subdivision: fr►L D A L 1.-4,0 N /VLEA jkj W S I Lot#: S Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less ` 168.54 4 DESCRIPTION OF WORK En.add'I 500 sq,ft.or portion 5 33.92 I Limited energy,residential �jj (with above ) ( 75.00 2 c-/E4j S/NVe. t2PtY I / 12thiDe JC.,t� Limited energy, ft gy,multi-family 75.00 2 residential(with above sq.ft.) 0 PROPERTY OWNER I ❑ TENANT Renewable Energy ❑ See Page 2 Name: Services or feeders installation,alteration,and/or relocation 200 amps or less 100.70 2 2 Address: 201 amps to 400 amps 133.56 sAN1 PS 6. 7--C-C)LA-) 2 City/State/ZIP: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Phone:( ) I Fax:( ) Over 1,000 amps or volts 552.26 2 Email: Temporary services or feeders installation,alteration,and/or relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I I intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 APPLICANT I ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name: FULL D co#.3s-rfaa(x L�;t\] above service or feeder fee, each branch circuit 7.42 2 Contact name: s"Vi 0 D t` OP,j7 ( 'f B.Fee for branch circuits without Address: service or feeder fee,first "X is 7 -1 branch circuit 56.18 2 City/State/ZIP: j - 3.ye-- O1,3 D11? Q'7 7 5 Each add'I branch circuit 7.42 2 Phone: o I Miscellaneous(service or feeder not included) 3) `�7 0 - O�0$ I Fax: :(51.)-3) J�9c)-- 1' $ I Each manufactured or modular Email: Fju Ps. (1 C,0 N-S-r- e �s c, n".. dwelling,service and/or feeder 67.84 2 ' Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 Business name: &L. /� _ 2 tit �LE(r2.1L 6,„2,,,,P Sign or outline lighting 67.84 2 Address: ((p 1 S-0 E t Ci L Np Cog., -1 /0 y Signal circuit(s)emo or limited-energy Al��/ panel,alteration,or extension. ❑ See Page 2 2 City/State/ZIP: 1 0 94-LAq t Op_ 9 7 z Z Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(-+ �c� �?,� z' ? 6 78 Fax:C(4) 70 1 — 7 9/ y Investigation(1 hr min) 66.25/hr Email: EL E i*Et;tL E cT'Li C u P 1� LZ; ■ Industrial plant(I hr min) 78.18/hr Inspections for which no fee is CCB Lic.: i 91 2-781 I Electrical Lic.: C 4,3 9 Suprv.Lic.: 5762 5 specifically listed(%z hr min) 90.00/hr Suprv.Electrician signature,required:. /,_p, / - ELECTRICAL PERMIT FEES `"� ",�—c+� Subtotal: Print name: ROBrRTC., 4 euDA1,_, Date: y—Z7.,/S ❑Plan ReviewRequired(25%of permit fee): State surcharge(12%ofpermit fee): Authorized signature: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: D'pv j 0 -- Date: "'2 7 -1.5 J days after it has been accepted as complete. • Number of inspections allowed per permit. 1:1BuildingTemliu\ELC_PermitApp_ELR_ERE.doc Rev 04/21/2014 440.4615T(11/05/COM/WEB Mechanical Permit Application MR 01+1(l( I. l SE ONE) City of Tigard �rj��Fj Datee/Bya Art( « Permit No.: i-41;96.,5—ODG 5-7 ■ 13125 SW Hall Blvd.,Tigard,OR 9722 l.1 = Plan Review e �, �`� Phone: 503.718.2439 Fax: 503.598.19 Date/By: Other Permit' r-�CJ �jv f TI G A R D Inspection Line: 503.639.4175 2015 Date Ready/By: luris: fa See Page 2 for Internet: www.tigard-or.gov APR 8 L Notified/Method: Supplemental Information eve TYPE OF WORKI!. t !3r `��A.�N COMMERCIAL FEE* SCHEDULE - USE CHECKLIST `'��S�O Mechanical permit fees*are based on the value of the work ,New construction ❑Addition/alteratMi/O 8hlttlt 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* Cir1-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: f// L/l Air conditioning 46.75 / Job site address: T 7 f0 ;14/ //8 T/f 6 r_ Furnace 100,000 BTU(ducts/vents) ( 46.75 City/State/ZIP: •-t--,&49--D (, .F. 9 Q--Z$/ Furnace 100,000+BTU(ducts/vents) , 54.91 1 Heat pump 61.06 Suite/bldg./apt.no.: Project name: Duct work 23.32 Cross street/directions to job site: 1 ( E .t H 1Z9 G At=\vz-p 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 Other: 23.32 Subdivision: M C D A LL"1!•J L Apo.v S Lot no.: 5 M Other fuel appliances: Tax map/parcel no.: Water heater ( ] 23.32 DESCRIPTION OF WORK Gas fireplace/insert ( 33.39 Flue vent for water heater or gas /J L.) Si t,;)(0 t-.i FPM 117 / PCJ�-C fireplace 23.32 / Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert I 23.32 Chimney/liner/flue/vent 23.32 PROPERTY OWNER ❑ TENANT Other: 23.32 Environmental exhaust and ventilation: Name: Range hood/other kitchen equipment 1 33.39 Address: S .(4\ 6: PS B G Clothes dryer exhaust 1 33.39 City/State/ZIP: Single-duct exhaust(bathrooms, s--,� toilet compartments,utility rooms) ✓ 23.32 Phone:( ) Fax:( ) Attic/crawlspace fans 23.32 V.APPLICANT ❑ CONTACT PERSON Other: . 23.32 Business name: Fuel piping: �'�� ST1 Ct l $14.15 for first four;$4.03 for each additional Contact name: 11) PA/1 D )e: N p g p ,-c Furnace,etc. Address: P $aX L S 7--1 Gas heat pump Wall/suspended/unit heater City/State/ZIP: ,a ENV&Z-t-D g.,3 l . 9 )0 7 S Water heater I Phone:(5-43) 5 o - 0 905 Fax::(5t.),3) ,s-qo - 1 7 S i Fireplace I Range E-mail: i O u j) Co y J Sr C. MS&J r G 0 Barbecue CONTRACTOR Clothes dryer(gas) Business name: Other: � ."-� t- A L R__—X '� MECHANICAL PERMIT FEES* Address: p O Ba x Lt 3 3 Subtotal City/State/ZIP: G' Crp�-l�- n S (`3 C)7© i s Minimum permit fee($90.00) ?S" Plan review(25%of permit fee) Phone:(sto) (9 g tom, ( log (Fax:(S3) 4:36 O --3 d State surcharge(12%of permit fee) CCB lic.: 1 7 j2-Li TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Authorized signature: 4-/ 4,. • Fee methodology set by ThriCounty Building Industry Service Board Print name: Dy y/ ... , f)6.1 .04.14.7-14 ate: 2?— / Plumbing Permit Application Building Fixtures t 10 Received City of Tigard CYAN Date/By: lif /5 PermitNo.: Mhj&0/S OerD 5 il 13125 SW Hall Blvd.,Tigard,OR � / Plan Review 114 I Phone: 503.718.2439 Fax: 503.598.1960 Q V\S Date/By: Other Permit No.:5a)2_,90/5 N Inspection Line: 53.639.4175 A � 2 v T 1 G A R U Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov F` U Notified/Method: Supplemental Information TYPE OF WORD{1 4 i 11)iti ` 1sil FEE* SCHEDULE IgNew construction [,f 4►A1 7 For special information use checklist Description I Qty. I Ea. I Total ❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(I)bath 312.70 A I-and 2-family dwelling SFR(2)bath 437.78 y g ❑CornmerciaUindustrial ❑Accessory building ❑Multi-family SFR(3)bath t 500.32 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: I L//�(/, S, //8 T H C T Catch basin or area drain 18.76 / / Drywell,leach line,or trench drain 18.76 .� City/State/ZIP -1--1(7ARD 0 r, 9 '7 Z �7 2 Footing drain(no.linear ft.: ) Page 2 Suite/bldgJapt.no.: I Project name: Manufactured home utilities 50.03 Cross street/directions to job site: `i 9 T\ 2, (,p aj17 Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Subdivision: Lot no.: Water service(no.linear ft.: ) Page 2 /'y ED A L.A.10A) 11/L w S -S Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 NCW .S l 'J L _t- FA4 l L y / t t Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 EI PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Floor drain/floor sink/hub I 25.02 Address: SIeNL&� P S BLS.. Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 la APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name: F.,, ` D c snzaetto Medical gas(value:$ ) Page 2 `^^ �1_ Primer 12.51 Contact name: S)P.0 10 D` - �'�- Roof drain(commercial) 12.51 Address: (P O, £70 /57 '? Sink/basin/lavatory 25.02 City/State/ZIP: ci3aiV N-1 6 9 7 0-7.S Solar units(potable water) 62.54 Phone:(4,3) 590 --. 0 8 O S Fax::(5.3) 590 _ 1-7 S I Tub/shower/shower pan 12.51 Urinal 25.02 E-mail: �'o,,,b(L D '. h.a5/), CO A/1 _ Water closet 25.02 �1 CONTRALTO I t/�6t �Ll�,y�i�� Water heater 37.52 l Business name: i(/1 IA L LEI �/c,,l P A N y/ Water piping/DWV 56.29 Address: I 60 I A S. E . R 1 t,/eiZ izell - Other: 25.02 City/State/ZIP: 14 1 L LS Bc .a 1 O P- 9 '? t Z 3 Subtotal Phone: 13) (`p�(.) -'CO 11 3 Fax:( ) Minimum permit fee: $72.50 CCB Lic.: /Zia 8 - Plumbing Lic.no.:39-2 6(7 pg Plan review (25%of permit fee) ' ./ State surcharge(12%of penult fee) Authorized signature: TOTAL PERMIT FEE Print name: DA v�Q f /�,�j ,�f _ Date: Z - 7 S This permit application expires if a permit is not obtained within 180 days �` N!"r'Tr after it has been accepted as complete. .Fee methodology set by Tri-County Building Industry Service Board. 1.\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) . i City of Tigard ,.r' COMMUNITY DEVELOPMENT DEPARTMENT I Building Permit Review — Residential Building Permit #: )--I�r49bl5 " G`'57 Site Address: ( L 146 SW 117,441 CA- . Project Name: MUlali'ton Me •4owS Lot #: 5 (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: f piN S . iKfierify site address/suite# exists and active in permit syste P . C' River Terrace Plan District: ❑ Yes A No SitPlan Elements: NIA ree(3)copies of site plan •xisting structures on site 0S plan must lie on 8-1/2"x 11"or 11 x 17"paper e4 Footprint of new structure(including decks)with finished awn to scale(standard architect or engineer scale) or elevations orth arrow U U. • locations(required for new,may apply for additions) to address,project or subdivision name and lot number ii •cation of wells/septic systems plicant information(name and phone number) ■ rosion control(including drainage-way protection,silt fence t dimensions and building setback dimensions sign,location of catch basin,etc.) Lot area,building coverage area,percentage of coverage andreet names pervious area(applicable if R-7,R-12,R-25&R-40) Uftreet tree size,type and location ig Property corner elevations(2 foot contour lines if more than gExisting trees to be retained with drip line,and tree 4 oot differential) protection measures Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified 4Y No Received: ❑ Yes ❑ No RI/Public Facilities Improvement(PFI) Permit: 2/ Yes Yes,applicant was notified ❑ No Applied For: [ Yes ❑ No,stop intake Ii/Eand Use Case#: SVB20i3- O0006 LV/Zoning: R-Li .S L10 Setbacks:red;(ac11.41) Front 20(2 ).ear IS (3y) Side S'(Sis Street Side -- Garage 20(2,46) --Eh-Landscape Requirement: % $ ot Coverage Maximum: 1 ) IV/Building Height: Maximum Height 2 Actual Height 2 S M Visual Clearance &I -Easements _ /• ensitive Lands: ❑ Yes 6G No Type • Urban Forestry Plan ❑ Conditions "Met"prior to issuance of building permit check o n 4 I t 4 Z Notes: Approved By Planning: - (load() Date: u 2$`t S Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved l:\Building\Fomis\BldgPennitRvw_RES_031015.docx 1 .- Building Permit Submittal Original Submittal Date: 4//g/ Site Plans: # 3 Building Plans: # r- Building Permit#: enter building permit#above. Workflow Routing: 2-Planning ❑-Engineering Et Permit Coordinator ErAuilding Workflow Sign-off: 0 Sign-off for Planning(include notes from planning review) Route Application Documents: (Engineering: (1) copy of permit application, (1) site plan, (1) building plan and /original plan review routing form. I� Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: rak.,n".n awl P C90/ 11—CO/g ? -4 A.4._ By Permit Technician: Date: /,y//5 Sneering Review Ly'Slope at building pad: g Z ❑ editions "Met"prior to issuance of building permit ,� Eas ments (encroachments)per engineering conditions of approval and plat L`_T Water Quality/Quantity Facility: �� Assess Water Quality Fee in-lieu: ❑ Yes L�J No Assess Water Quantity Fee in-lieu: ❑ Yes ,�2 , LIDA Facility on lot: El Yes Id-1No ANOT Approved by ' eering: Z- :/ . „.tyg e5 Date: Notes: e Lf� ,tom, tri 6/ tQey`.e--#.0,- Approved by Engineering: , G ‘_' /.”, Date: 57/r/s Revisions (after Building Submittal only) ' Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit Approved,NOT Released: i Ccn /3 ht. f efla c. 4,Date: 4/247/1"E Notes: ay)", Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: Revision Notice 3: Date Sent to Applicant: OK to Issue Permit Approved by Permit Coordinator: s ; �/ S 1:\Building\Forms\BldgPermitRvw_RES 031015.docx ' FOR OFFICE USE ONLY-SITE ADDRESS: 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. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT iN : e. ". Transmittal Letter T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.govi !r TO: .-------11-r-1 -A"- DATE ' 3CE i :t DEPT: BUILDING DIVISION NI ® 2015 ' XV Of SFROM: U1 � ('(�1Z� BUILDING DJ DIVISION COMPANY: jou ti-- .. 6,/v 5T-t2+-cct/o iU 1 PHONE: S-L)3 - -?;Z v - 7(/'-/ S _) RE: 11/411 Address)5. ,-,J • I 1 �` ct- kly pill.St- a of S -- OO 0 5 7 (Site ddress) Permit Number) t--Or S A.4 c'bA L\-Z ry-/ ,P .-t (Project name or subdivision n. - .•. • nu ,---- _ . /1ftE - ATTACHED ARE THE FO . OWING IT +'S: U�-- Copies: Description: Copies: Description: . Additional se s) of p ns. Revisions: Cross sectio (s) and d tails ' Wall bracing and/or lateral analysis. Floor/roo'framing. Basement and retaining walls. Beam c- culations. Engineer's calculations. 2 5'. --T> Other/xplain): i L rit_ L ' pN o a c PLO r'PLF LFA-1 REMARKS: 0 aC t)e. -A I L.S r),...) (pA to L= 6 DC) (y s l_ rg_rplz_4_,i . A6, 4,-;_kliLe_y--„, ,t.k, . FOR OFFICE USE ONLY Routed to Pe • t Technician: Date: 11,1 1 1 a o 1 s" Initials: Fees Due: tt 1 Yes ❑ No Fee Description: Amount Due: P1c_r re.v;e_vJ $ 90' $ $ $ Special Instructions: ��,/ Reprint Permit (per PE): ❑ Yes NI o ❑ Do Applicant Notified: Date: f�/� I,5'- d w� Initial : 'j I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 City of Tigard ligCOMMUNITY DEVELOPMENT DEPARTMENT C .. .� Building Permit Review — Residential ,00:0 D Building Permit #: 1- r $ot 5---0°6 57 Site Address: to,(( Sly) mirk-1r) - Project Name: IV4 ion Mkw3 Lot #: 5 (New dwelling=subdivision name;Addition or Alteration=last name of towner) Planning Review ^ 11 _ i Proposal: fe' I 8(2,8(2,0_,\K pia, n 4ol� nPknl SF . cc+ 1"I� OIkl t On }atainkto . Sem alio RSTW S- 40057 si Verify site address/suite# exists and active in permit system. River Terrace Neighborhood: E Yes No Si5,R,Plan Elements: lOri Tree(3) copies of site plan `E�xisting structures on site iVite plan must be on 8-1/2" x 11"or 11 x 17"paper lGh'ootprint of new structure(including decks)with finished LSA D awn to scale(standard architect or engineer scale) floor elevations V,_T aith arrow $utility locations(required for new,may apply for additions) 0 ite address,project or subdivision name and lot number Elii6cation of wells/septic systems plicant information (name and phone number) Erosion control (including drainage-way protection, silt fence �t dimensions and building setback dimensions esign,location of catch basin,etc.) Lot area,building coverage area,percentage of coverage and treet names i pervious area (applicable if R-7,R-12,R-25&R-40) Street tree size,type and location roperty corner elevations (2 foot contour lines if more than ❑Existing trees to be retained with drip line,and tree 4 of differential) protection measures Clean Water Services—Service Provider Lette (lot platted prior to 9/10/1995): quired: E Yes,applicant was notified 'LIQ No Received: E Yes E No Public Facilities Improvement (PFI) Permit: quired: ❑ase Yes, #: applicant a as notified No S Applied For: ❑ Yes ❑ No,stop intake Lid Land Use C igf/Z vC32�` '�� oning: R `J , IJ Setbacks: Front ZOO Rear 1 51 Side SI Street Side — Garage Zit `❑ Landscape Requirement: OA ❑ Lot Coverage Maximum: ❑ Building IIeight: Maximum height Actual Height Zisual Clearance asements Sensitive Lands: ❑ Yes riNo Type -8/Jrban Forestry Plan �' Conditions "I\2et" prior to issuance of building permit Notes: re,V1SIon Approved By Planning: ,7 --�', '(�jQC� Date: l 1 3b `1 S Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: E Approved E Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Fonns\BldgPeniiitRvw_RES_07091 5.docx Building Permit Submittal Original Submittal Date: fJt 5 1 0i 11/51//c)) Site Plans: # 3 Building Plans: # Building Permit#: ►i Enter building permit# above. kuilding Workflow Routing: E Planning ❑ En 'leering ❑ Pert oordinator Workflow Sign-off: Sign-off for Planning(include notes from anning review) Route Application Documents: ❑ Enginee (1) copy of permit application, (1) site plan, (1) building plan and original an review routing form. Building: original permit application, site plans,building plans, engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: ,1Date: ///.5,//3" Engineering Review ❑ Slope at building pad: ❑ Conditions "Met"prior to issuance o uilding permit ❑ Easements (encroachments) per enginee ..ig conditions of aper• and plat ❑ Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ 'es ❑ No Assess Water Quantity Fee in-lieu: ❑ . ❑ No LIDA Facility on lot: ❑ es ❑ No ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: Date: Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to A. licant: Revision Notice 2: Date Sent to pplicant: Revision Notice 3: Date Sen to Applicant: ❑ SDC Fees Entered: Wash 'o Trans Dev Tax: ❑ I-s ❑ N/A Tiga d Trans SDC: ❑ Yes ❑ N/A Parks SDC: ❑ Yes ❑ N/A ❑ OK to Issue Permit Approved by Permit Coordinator: Date: I:\Building\Forms\BldgPennitRvw_RES_0709I 5.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 14146 SW 118TH CT, TIGARD, OR, 97224 Residential - Master Permit 699 Mechanical ﬁnal FAIL MST2015-00057 David Young No access for inspection, front door locked. Provide access for inspections. 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 14146 SW 118TH CT, TIGARD, OR, 97224 Residential - Master Permit 399 Plumbing ﬁnal FAIL MST2015-00057 David Young No access for inspection, front door locked. Provide access for inspections. 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 14146 SW 118TH CT, TIGARD, OR, 97224 Residential - Master Permit 199 Electrical ﬁnal FAIL November 30, 2015 at 9:25:32 AM MST2015-00057 David Young No access for inspection, front door locked. Provide access for inspections. 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 14146 SW 118TH CT, TIGARD, OR, 97224 Residential - Master Permit 199 Electrical ﬁnal PASS MST2015-00057 David Young 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 14146 SW 118TH CT, TIGARD, OR, 97224 Residential - Master Permit 699 Mechanical ﬁnal PASS MST2015-00057 David Young Note: seal penetrations in garage ceiling and wall by furnace for ﬁnal 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 14146 SW 118TH CT, TIGARD, OR, 97224 Residential - Master Permit 299 Final inspection PASS - C of O MST2015-00057 David Young Final erosion control approved. Moisture content form received. High efﬁciency lighting form received. Street tree certiﬁcation received. Insulation certiﬁcation checked. Duct seal test report received. C of O left with approved plans in kitchen.hhs Violation Summary: Inspector Contractor