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Permit
y a � CITY OF TIGARD MASTER PERMIT � , - COMMUNITY DEVELOPMENT Permit#: MST2015-00094 T I G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/06/2015 Parcel: 2S103BB06100 Jurisdiction: Tigard Site address: 12588 SW 124TH AVE Subdivision: BROOKWAY Lot: 61 Project: English Hayes Partition Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1820 sf Basement 0 sf Left: 5 Parking Spaces: 0 Height: 19 Bathrooms: 3 Second: 1151 sf Garage: 456 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2971 sf Value: $359,512.41 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 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 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Tvoes 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 SrvciFeeders Branch Circuits 1000 sf or less: 1 0-200 amp 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'l 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 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 2971 Owner: Contractor: WESTWOOD HOMES LLC WESTWOOD HOMES LLC Required Items and Reports(Conditions) 12700 NW CORNELL RD 12700 NW CORNELL RD 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97229 12700 NW CORNELL RD PORTLAND,OR 97229 PHONE: PHONE: 503-330-2215 FAX: 503-342-2403 Total Fees: $23.846.04 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. ATT • : -•on law requires you to follow the rules adopted by the Oregon Utility Notification Center. T se rules are set forth i AR 952-00 •010 through OAR • 2-6.1-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 00.332.2 4. Iss =d By: f / I Permittee Signature: , /,..7 Call 503.639.4175 by 7:00 a.m.for the next available inspectio ate. 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. f " Building Permit Application Residential y FOR OFFICE I SI:O\1.1 III City of Tigard �{�c iNt , L Permit No.: �Y�� a �_ y 13125 SW Hall Blvd.,Tigard,OR 97223 1<I Plan Revie . -7►� Q Phone: 503.718.2439 Fax: 503.598.1960 e : .��( __ Other Permit: , , • S— -41 r T I G A K I) Inspection Line: 503.639.4175 AAl1 , 4 zo15 Date Ready:y: i 63 See Page 2 for Internet: www.tigard-or.gov ,ulV Notified/Method: B drip Supplemental Information `t g a 1 _f� 't ' ��M°`,I,..4 ( + h"-4k.2' TYPE OF WORKOA L 1��tN'�ISVP REQUIRED DATA:1-AND 2-FAMILY DWELLING ®New construction ❑Dembiiti'tia'r Z?'t ( 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 CATEGORI OF CONSTRUCTION work indicated on this application. Valuation: ® 1-and 2-family dwelling 0 Commercial/industrial 3��)5 -,�( El Accessory building ❑Multi-family Number of bedrooms: / ❑Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: -Z Job site address: r L j 8 g St- air Ay 2- New dwelling area:2 77/ square feet City/State/ZIP:Tigard,Oregon 10,`*4:1-/carport area: re feet Suite/bldg./apt.no.: Project name;^ E„r`tljt, }k,,��` �'',�- -d porch area: -3/�square feet k v-.5--t Cross street/directions to job site: PGI--f, rajfv �+ Deck area: square feet ( ,2a Other structure are 'Z`-Z square feet /1 REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: -irk nt d, ME es Pet 4.1.1;pn Lot no.: ( 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. new detached sfr Valuation: $ Existing building area: square feet - New building area: square feet ® PROPERTY OWNER ❑ TENANT Number of stories: Name:Westwood Homes LLC Type of construction: Address: 12700 NW Cornell Road Occupancy groups: City/State/ZIP:Portland OR 97229 Existing: Phone Q?(— C45.-501g Fax:(503)342-2403 New: ® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* lease Business name:Westwood Homes LLC fP `�°1Df� �"t`� Structural plan review fee(or deposit): Contact name: Mali gf■a t• FLS plan review fee(if applicable): Address: 12700 NW Cornell Road Total fees due upon application: City/State/ZIP:Portland OR 97229 Phone 11/— 67?,- 501 S Fax::(503)342-2403 Amount received: J E-mailfhtil@WestwoodhomeslIc.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* 3 CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted Photo Voltaic Solar Panel System. Business name:Same as applicant Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: Solar Installation Specialty Code checklist. City/State/ZIP: Permit Fee(includes plan review $180.00 and administrative fees): Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.:195597 Total fee due upon application: $201.60- Authorized Signature: This permit application expires if a permit is not obtained r within 180 days after it has been accepted as complete. Print name:�ia-fl' Date: v 1 i C I *Fee methodology set by Tri-County Building Industry �r� G 1 Service Board. I:\Building\Permits\BUP-RESPermitApp doc 02/24/2011 440-4613T(I 1/02/COM/WEB) A , r Electrical Permit Application C FOR OFFICE USE ONLY Ctik,N-VV R _ City of Tigard Datc13). I Permit No.• �S r S ettfi it it a ° 13125 SW Half Blvd.,Tigard,OR 97223 A 'LP Plan Review l Other Permit Phone: 503.718 2439 Fax: 503.598.1960 `\N 'i Date.Bs TIGARI) Inspection Line: 503.639.4175 J Date Read;'By Pilo HI Sec Paget for Internet: w'ww.tigard-or.gov s- t("1�y, Notified/Method. I I Supplemental Information TYPE OF W(FIt. .k� ..`-Win: ' I PLAN REVIEW ®New cons action CI Please check all that apply(submit 2 sets of plans w'items checked below) ❑Service or feeder 400 amps or more ❑Building over three stones. 1 ❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards CATEGORY' 01' 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 ❑Commerciallindustnal th ❑Accessory building amps for all other installations. buildings ❑Multi-family ❑Master builder C Other: ❑Fire pump ❑Installation of 150 KVA or ❑Emergence system larger separately derived system. NM SITE 1NFORS1ATION AND l.O(:ATIOr ❑Addition of new motor load of ❑-A","E"."1-2","1-3-, 1 100HP or more. oxupancy. Job no.: I Job site address: . 5�� SL✓ ,�,y�• �V{7 ❑Six or more residential units. ❑Recreational vehicle parks. (1t}.State/ZIP:Tigard OR DHealth-care facilities D Supply voltage ter more than ❑Hazardous locations. 600 volts Doming! Su itefbldgJapt.no.: Project name: H- i ❑Service o-feeds 600 amps or more 12"� ' IOC ' FEE SUIED11II. Cross street/directions to job site: Description 14't•. I fee. I Tam l • New residential single-or multi-family dwelling unit- s Includes attached garage, Subdivision: Ey∎?It 54 Ifyte PCIe-1-'4"i'C,1 Lot no.: 1 ( 1,000sq ft.or less I 1 168.54 4 Es add')500 sq ft or portion 3392 ! 1• Tax map/parcel no.' Limited energy,residential DE,KRIPTIO't OF WORE; (with above so ft.) 75.00 2• I Limited energy,multi-family new SFR • • residential(with above sq.ft.) 75 00 2 Renewable Energy ❑ See Page 2 Services or feeders installation,alteration,and/or relocation E) PROPERTY OWNER 1------ 0 '1 ENANT 200 amps or less 100 70 2 201 amps eo 400 amps 133.56 2 Name:Westwood Homes LLC 401 amps to 600 amps 1 200.35 2 Address: 12700 NVI'Cornell Road 601 amps to 1,000 amps 301.04 2 Over 1.000 amps or volts I 552.26 12 Cit)'State/ZIP:Portland,OR 97229 Temporary services or feeders installation,alteration,and/or Phone: 91 -C 1-GC"(S- Fax:(503)342-2403 relocation 200 amps or lets 59.36 1 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. 401 amps to 599 amps 168.54 2 Owner signature: _ Date: ( Branch circuits-new,alteration,or extension.per panel I • ®.APPLICANT I [] CONTACT PERSON A.Fee for branch circuits with above service or feeder fee, Business name:Westwood Homes LLC 1 each branch circuit 7.42 2 B.Fee for branch circuits Contact name:/ O" f Pr!G service m feed==r,first branch circuit 56.18 2 Address: 12700 NW Cornell Road , Each add'I branch circuit I 7.42 2 Ci /State/ZIP:Portland OR 97229 Miscellaneous(service or feeder not included) Each manufactured or modular 67.84 �I dwelling.service end/or feeder 2 Phone: "I �ttiJ f{—�G I Fax::(503-)342-2403 Reconnect only I 67.84 I 2 E-malitit(tiilWestwoodhomesllocom Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business nu Y42✓ 31A SP...., '.'":1,24_31,2_1 L ' Signal circuit(s)or limnod.ertagv See I panel.alteration.or extension. Page 2 I 2 Address: 1 4c117 Se, J -'1•• Iro( S-J--- Each additional inspection over allowable in any of the above Additional inspection(1 hr min) I 66.25/hr City.'State/ZIP: e_A GIL> was e,.2 CV-1 01-S Investigation(1 hr mm) 6625/hr_ Phone:58'c�0SS Fax:6-0a.--t 102 Indttstnal plant(t hr min) 78 18/hr Inspections for which no fcc is I 90,00/hr CCB Lic.:j 1 La' l Electrical Lic.:3.3 C,Suprv.Lie.: 3�g.S specifically listed(5 hr min) L"�� / ELEC"TRICAL. PERMIT FEES • Suprv.Electrician signature.required: Lt/1�r.�4 a, .�i�.d� - Subtotal: Print namcnib, ., S Date:)_ % l'S— Plan review(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: This permit applimtion expires if a permit Is not obtained within 180 Print name: _ I Date: J days after it has been accepted as complete.• Number at inspections allowed per pcaut 1,Buitdiek Perren.ELC_PermhApp_ETR_ERE don Rev 05010015 440.1615111 I r05VOM.'WEB I ' Mechanical Permit Application FOR 014 ICE I SF. ON I.) 4iVWED City of Tigard 'CV Received Date/By: Permit No MST,L. u. 13125 SW Hall Blvd.,Tigard,OR 972 Plan Review • Phone: 503.718.2439 Fax: 503.598.1960 G Other Permit: Inspection Line: 503.639.4175 n lG Date/By:Re T I G A R D 1,N 20 J Date Ready/By: Juris la see Page 2 for Internet: www.tigard-or.gov Jl1 Notified/Method: Supplemental Information yok 13 t;PAW TYPE OF WORK r DIVISION 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 I Qty. Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling: �7 Air conditioning / 46.75 Job site address: 12,5 8 E Sw )Zf�' nve_ Fumace 100,000 BTU(ducts/vents) I 46.75 City/State/ZIP:Tigard OR Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: Project name: 1 . — /a Heat pump 61.06 Z ' 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 LH 54 /la ,,S Pt, f'#1 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 new SFR 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 ❑ TENANT Other: 23.32 Environmental exhaust and ventilation: Name:Westwood Homes LLC Range hood/other kitchen equipment / 33.39 Address:12700 NW Cornell Road Clothes dryer exhaust 33.39 Single-duct exhaust(bathrooms, •,' City/State/ZIP:Portland OR 97229 (,, �- toilet compartments,utility rooms) .c, 23.32 t Phone: i✓11"C 1Z sn/t Fax:(503)342-2403 Attic/crawlspace fans 23.32 ® APPLICANT ❑ CONTACT PERSON Other: 23.32 Business name:Westwood Homes LLC Fuel piping: $14.15 for first four;$4.03 for each additional Contact name: Mvv17 Frit4e, Furnace,etc. % Address: 12700 NW Cornell Road Gas heat pump Wall/suspended/unit heater City/State/ZIP:Portland OR 97229 Water heater / Phone: '11-/-6 j -cailt Fax::(503-)342-2403 Fireplace 1 Range f E-mail:Moa westwoodhomesllc.com Barbecue / CONTRACTOR Clothes dryer(gas) 1 Business name:Central Air Other: - MECHANICAL PERMIT FEES* 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 it'll permit is not obtained within 180 / days after it has been accepted as complete. Authorized signature: 11,,_ / I..4. • Fee methodology set by Tri-County Building Industry Service Board Print name:Jon Montgo t - Date: I:\Building\Permits\ME.C_PermitApp_040113.doc 440-4617r(11/02/COM/WEB) I. ' Plumbing Permit Application Building Fixtures FOR 01.I•I( I. 1 SI O\l.l City of Tigard Received Permit No.: �s f� III 13125 SW Hall Blvd.,Tigard,OR 97223 y ✓n`S�tl Pla s Phone: 503.718.2439 Fax: 503.598.1960 an Review Dan Other Permit No.: Inspection Line: 503.639.4175 T I V A 2 D Date Ready/By: luris I H See Page 2 for Internet: www.ti ard-or ov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE 0 New construction ❑Demolition For special information use checklist Description I 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 312.70 ® 1-and 2-family dwelling El Commercial/industrial SFR(2)bath 437.78 SFR(3)bath l 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: (2E,,g g 4 W 21#4' Av.? Catch basin or area drain 18.76 City/State/ZIP:Tigard OR Drywell,leach line,or trench drain 18.76 - Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: 1 Project name: ( t4 /4 1 Manufactured home utilities 50.03 Cross street/directions to job site: 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: Lh 7/I 5-4 q e, p0,--(7-1,on I Lot no.: l Fixture or item: Tax map/parcel no.: Backflow preventer / 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer / 25.02 new SFR Dishwasher / 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 0 PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name:Westwood Homes LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 12700 NW Cornell Road Garbage disposal / 25.02 City/State/ZIP:Portland OR 97229 Hose bib / 25.02 Phone: /7-/- 63'(''O/g Fax:(503)342-2403 Ice maker 12.51 0 APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name: inigArtjali ft;, ie L`( Medical gas(value:$ ) Page 2 ^A` LL r_` /k. Primer 12.51 Contact name:3"/ "rT �"f' Lr K Roof drain(commercial) 12.51 Address: 4 4 0,,,,41_2 r Sink/basin/lavatory '3 25.02 City/State/ZIP: Solar units(potable water) 62.54 ('ry7► Phone: t )67-1..- 5045 Fax::( ) Tub/shower/shower pan 2- 12.51 E-mail44t westwoodhomesllc.com Urinal 3 25.02 CONTRACTOR Water closet 25.02 Water heater I 37.52 Business name: H&H Mechanical Water PS� 1 P to WV 56.29 Address:5757 SE Willow Lane Other: 25.02 City/State/ZIP:Milwaukie OR 97267 Subtotal Phone:(503)975-9787 Fax:(503)659-2979 Minimum permit fee: $72.50 CCB Lic.: 178122 Plumbing Lic.no.: Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: - /,77, ,,. /./. / //> TOTAL PERMIT FEE Print name:Dusti ague �j Date: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by In-County Building Industry Service Board. 1\Building\Pernits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/021COM/WEB) City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT R Building Permit Review — Residential Building Permit #: /15-1;20/S----(56-06(q Site Address: ( 2,5$S sW t21-1-4) ivP,. Project Name: 5-Igi i Sh- \o� e S Lot #: i (New yelling=subdivisidn name;Addition or Alteration=last name of owner) Planning Review Proposal: nem SF ViVerify site address/suite# exists and active in permit syst . cr River Terrace Plan District: ❑ Yes RNo SitePPlan nipiree(3)copies of site plan xisting structures on site Si : elan must he on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished C p rawn to scale(standard architect or engineer scale) or elevations Pi orth arrow Utility locations(required for new,may apply for additions) tte address,project or subdivision name and lot number = .cation of wells/septic systems gpplicant information(name and phone number) a Erosion control(including drainage-way protection,silt fence at dimensions and building setback dimensions 9esign,location of catch basin,etc.) J4 Lot area,building coverage area,percentage of coverage and LvJ Street names /impervious area(applicable if R-7,R-12,R-25&R-40) /61 reet tree size,type and location ®/Property corner elevations(2 foot contour lines if more than • =' xisting trees to be retained with drip line,and tree oot differential) protection measures Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): /Required: ❑ Yes,applicant was notified V No Received: ❑ Yes ❑ No NI Public Facili s Improvement(PFI)Permit: Required: NYes,applicant was notified ❑ No Applied For: VYes ❑ No,stop intake Ni/Land Use Case#: Mi.?2o1 y —QOQC)L f Zoning: R- lI •5 ❑ Setbacks: Front 201 Rear \S Side 10 Street Side — Garage 20 —a Landscape Requirement: cyo of Coverage Maximum: % Building Height: Maximum Height 30 Actual Height t 9 Et/Visual Clearance asements EM Sensitive Lands: ❑ Yes iNo Type 0/Urban Forestry Plan StAorni+i'a,1 l Conditions "Met"prior to issuance of building permit No :--> Ti not\ cA\ca- nod rec-o(c — do no+ 1 SSu,p_, Approved By Planning: Date: 6j"4%'lS.---- Revisions (after Building Submi only) Reviewer Date Revision 1: El Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: El Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw_RES_031015.docx Building Permit Submittal Original Submittal Date: 6*//5 Site Plans: # 3 Building Plans: # 3 Building Permit#: 0--L er building permit#above. Workflow Routing: gi-135 �Engitteering t Coordinator ��uilding Workflow Sign-off: D�S ff for Planning(include notes from planning review) Route Application Documents: ngineering: (1) copy of permit application, (1) site plan, (1) building plan and orig_i_pl plan review routing form. wilding: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: Date: 6/11/I5 Engineering Review .B--Slope at building pad: Z 70 ❑ Conditions "Met"prior to issuance of building permit ❑ Easements (encroachments)per engineering conditions of approval and plat Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ;7. es No Assess Water Quantity Fee in-lieu: o LIDA Facility on lot: : ❑ No ❑ NOT Approved by Engineering: Date: Notes: PJ 1) {�L4T (.4.1> Approved by Engineering: At I Vc— W . Date: (&/!ST Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved El 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) / moo, Revision Notice 1: Date Sent to Applicant: G,9//S li!?!�r/f7 Revision Notice 2: Date Sent to Applicant: Revision Notice 3: Date Sent to Applicant: A'OK to Issue Permit — a/P 'RC w✓a e-'1 0 a 4 v e C-e vt • Approved by Permit Coordinator: " LA _, Date: (c) -15 1:\Building\Forms\BldgPermitRvw_RES_031015.docx Upctricalfermft Am 0ARECEIVED f 01:(11 1 ie t f \t ,►., City Ihi of Tigard SEP 16 2015 ,-.n 13123 SW Hall Blvd,,Tiger oil 97223 -..,/ �i i Phone 303-711.2439 Fax: 503-59e.10frY OF TIGARG m On Lse: 0/9.239A1 73 BUILDING D I v ISIO leedxboa;ternet: www.tigard-orgov .., ,�,,y,v'�Its��71•4 r ;rlr��rhR 0i,y � ,�-ir` �r� iq��s,n y� s� ,�:+ ��, .�New aonatrus�I� '4{.4i a liAddition/Aeration/rep]e 7.:c S•. i* ic�7.!�.l�(.{'mKAII -41,,1e41 1i14-41:T 177-4'T f"r,57;:..e h 7 04:14'll ocorneat sseae eatak at ta.f i:. am ate".ma Pr �" Dartt011tion 0 Other: D Service errfledar4o0 a wcore plum Wham o"!'r'� C q t .a . tF,r. ' !.? n �' � 1 !+7 ! 1't�.+�� •�" �Ytl!!e t1M aYillebl0&L11 0011118 [a MIflYb gad 10d1. ->.taart:el:)tis -.,...2mb,..jl,;,�ti c...sg Yal 4' t` '�5 at 130 vol �A '�a�'.Fct :k<: .sRe.asl0.0oQertpc vela or DFbatt�btdtd E-and 2-family dwelling 0 ContmereiaVindustrinl ❑Accessory building ion to woad.err eagoode 1e.0eo ❑ramalerstef-wtep lcu►tunt _ amps mrd i etc.io rt llatites b„❑Muh-$m ■ Master buder 0 Pitt ❑lastallshoe of 70 [VA of fn`s rae:n; ) ? L: yAZW:E i u, t t� pLTi aw ❑TrieIlia + a law up rawly darlrDG Jab site addrees: 125P1 SW 124th 9,w ❑Adliionernew nowt Laid of Minh. 70010 or soar City/Sate/Z[9:Tigard,OR 97223 Q Si.or Iantiet aria. woupaaq•• G Haetut•che hotlines ❑Ratrstimnal vanilla pals. Suite/bldg./apt,*' Project name: ❑]raordoas Wcanon. 1:1 340 venial sec more elan Cross street/directions to jOb slate OR�rioadrMtlw000 a.• amore, 600 7c11111°00041. «tom i bt u ma Nov rnld®Ilml es or rstti-isatily dwelling malt.sublivislaoEElias!)Rows Partition Lot M:3 tacaaet a bM 8arst8ah fax atapfparud*: 1,000 eq,L.or 4e 4 a ^'j•f'�F' 4 ` i�# ;�r."r .:WI�.' t:wa.S ":' T "1{[14 `.�, �:rk"r�1�Y < ,' Ea.sdd'1l00 •.itapottion 33..92 1 1 eWAI reddrnti Now SFR �i;EC Tf2lC f/L SON / ' ► {wkb I m s4. 759,0 2 1,'k�•i`.�T 4 Sid:"_:5�..'�3.:AI; it fit"+j e�� iFOFa ynr` $ �x .q'1;'�i,- t n +4�y,- •]�' ..,.,alays �E.. TIDO NM 2 Name;Westwood Hoofer LLC s $lftshilottoa,alurmiert,a :,do�,rtwa 200 amps or less 100.70 2 Maras:12700 NW Canon Rd J sot 11121p to 400 amps 133 36 � r/s�+zlr:Portland,OR 99129 601 ease lo ,000 200.34 MOM Phone: 71675.5018 aka 301.04 2 {� ) Pax: ( _ ) Ova 1,000 amps or vette 552.26 2 litnnill TimporAry unless or feeder'tna{olladen,alteraden,eadPor relocation Owner Ieutai az'Ms installation is being made an property drat]own whieh is no 200 some re Iota 59,35 1 intended for tale,Wee,rent or exchange,aeoording to ORS 447,449,670,and 701. 201 amp to 2 O Wnt . . . 400 �Otl lVMb hid e t Data 4411 W 339 i mps 1dais 11111.10 yy 1_ alr .tr:. ica�Fy e;:tCi.t.ii ..12'k ,:1!Lit n1�„ -nCh a a- •1.ts sIterseio• or me. , 6r Business tie:genie es Owner above senior or feeder kc, Correct name; tore iamb awe 79,2 8,Fee fa each et roan whose e Atitdrsne service et leader fey Real ... branch emit 3b18 IIII Phone:( ) Pmt: ( ) A9acsila _ a: or des. der 742 �� cl . 6784 Email; 1 -- ©u ^4 ., eitb R � � tl y 2M1524C ]wi i �"ticeg Fulmar ini _*de Business name: Its ss G ,., +v,L->t Stpeorentire douni Addre+es: r w , - - 67.82 '1/17 •� -Sr7 Panel,akruati!c,or' pion. �] ilea page 1 City/&fftblLIP: Bsclt etddtttoaal ba; ®�• C5 ` . allowable.2 , e tl,oabove _ - • t� Minions:inspection 11 air mta) 66.23/br Phoac i,V ) L Fox:Go )/�i J-Z- ° lntpeKti�itian(1 br min) 90.0N hr Ell ]email: #+ _ . - l' )r1 G 5�'f�C�7 Induedrial l t(1 bi taint) 78,18/Iv i e.epMan i,a. hr he b CCB Lao: C EleotrJoa]l.ic.: 1 _ _ 8►tprv•1 ia: Mani, ,. 00.Oa lr Suprv.Elccttioi.rs ad�ti0art, uired: � i �k3 lineal "`•;S''-ecr.t•>:• n. .,, 159 a: iiV _ Subtotal: I' Print namC L" .` . eo Date.. 0 Mon Reviver Requited 14 of mord fee)_ — State atachetBe(12%Open*far Authorized signature: TOTAL PEAM1T FE Pf9nt stsanst: { 1 Tee�k awaken.*'spine tT•yarv[t le oat*kilned stets 160 I DIM f thee after if tea bona accepted es console is. Lam+ S lt emeaitAay.1111L110.4ac Poe 041171M ' Namberpf p foal allows Rs P b awaisItIlR uWMIW Electrical Permit Application City of Tigard Page 2—SapplemeatnJ Iaformatiou Limited Energy Permit Fees: Renewable Energy Permit Fees: �' ►t C } e. S r '.:f1: . -6 H7e2.1.��,:�"�i;0) T°. t7"'F�-£',f;�:x, -gr,{* .7. I* ',v.:,ii!z' liAg wff o ;r t LL,r +f"}.°7p1 .RE `K.T'T..r mem Fee fora residential systems combined: S75.00 .==M1=1■a161 weble 4lendral . systi; Check Type of Work Involved: 5 Ina 100.10 s 501 to IS kn II.1 13156 MI 2 ❑ Audio and Stereo Systems* 15.01 a25 kva MIIIEMPII 2 Burglar Alarm ,= • asp ti, r Wash ,.eau of 33 kvat 35.01 10 50 bib - 301,a a al Garage Door Opener* 50111 to lgokw 552.44 �0 rIw&v.AK91 ee . 9.0040 MIEMIMIND o Heating,Ventilation and Air Conditioning i�roNt9t bier pacrenoa women la noon 0(15 km I awe additiauat kvt over 25 7,42 3 ❑ Vacuum Systems* �leolKra—noadditioaalehuye J 0.0 other; Lc sddi1br►1 L......---.., avar.lowabstla , arta.elbows _51T tc-fur tL �•, i 0 . 11r oa.riwa.: ho (1t:tmn) �Q >a.vaotrooa vibieb oo a.it S __ _ II )�; mY,tj;JY:.r-'i [.�' .4+�'� �tY , j'.x,3:r�-,yy�yti►[}�° ��t,;., ��{ �y :,;^"r, �a{ ' {,�,.�(.�` (y �.r�` F0.4[�1�' t ,�r„ 1 T :. \ 1 M �4 I k F X1:4 i r . C�. LI Grim fed Y.nt.d..yl . t l-'rd r as 1 ~ Fes for k commercial system: $75.00 sauoosl : or on •1 MEM (SEE OAR 9t$-309-0000} r et tempo•• allowed Check Type of Work Involved: 1 ❑ Audio and Stereo Systems [] Boiler COMMIS ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ' ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* 1 ❑ Medical f El Nurse Calls I. ❑ Outdoor Landscape Lighting* 3 Protective Signaling ❑ Other: 1 Total number of commercial systems: I *No licensee are required. Licenses are required for all I other Ln.taltadolne LADegeint iennit oiX_Pescher 14[t.eee aeo 06/1 711011 l r • 3 Form 640S \V� Cornpleti:in Certification—Site Inspection seN, r`*" ^ LnrYTrust � / -ce.y/7V Pby `)NcT6 xJJ Lel CI of Oregon To be completed Verifier Portland Energy Conservation,Inc.(PECI)is a Program Management Contractor for Energy Trust of Oregon,Inc. Payment information Incentive Payee Company Name: Is this payment redirected?: Builder or Company: Westwood Homes LLC Contact Name: Verifier Payee Company Name Performance Insulation Technician Name James Hayes Energy Trust Pathway: Percent Improvement Low Income Incentive No,doesn't meet low income requirements Solar Ready Builder Incentive: None Solar ReadyVerifier Ir None Site Information Development: Lot 1 Axis ID: REM/Rate®ID: Address: 12588 SW 124th Ave City: Portland State: OR Zip: 97223 Apt/Suite: Multi-Famil) No Custom No Number of Stories: 2 Total Conditioned Area: 2971 sqft#of BRs 4 Foundation Type: Crawlspace Electric Provider: Pacific Power Gas Provider: NW Natural • Solar installed None Solar Installer Name/Company: Electric Meter Number(must be permanent meter number): Gas Meter Number(must be permanent meter number): 32 832 934 9078 4342 Verification Type Actual Model Equipment Details&Notes Insulation Vaulted Ceiling R- 38 Insulation Type Blown-in Framing Type: Above Grade Walls R- 21 Insulation Type Blowin-in Intermediate R- Frame 30 Insulation Type Batts Doors Door R- Windows Windows U- 0.30 SHGC 0.30 Skylights U- SHGC Window Area(Glazing) % Total window area Lighting Indoor and Outdoor 96.0 % #Fixtures: 53 #ENERGY STAR fixtures or CFLs: 50 Appliances ENERGY STAR Dishwasher Yes EF: Model; Cooling Air Conditioning SEER: 13 Btu/Hr: Primary Heat Source/Type: AFUE: 95 Brand: Lennox Source Gas Furnace HSPF: Model#: ML193DF090XP48C-57 SEER: Serial#: 1715G10158 Comment: COP: Location: Conditioned Outdoor Unit(for heat pumps) ECM: No Model# Serial#: Water Heater Type: Gallons: 0 Brand: BRADFORD WHITE Gas Tankless EF 0.82 Model# RG275H6N Location: Conditioned Serial#: MJ36745805 Ventilation Energy Trust of Oregon's Mechanical Ventilation Type Meets Energy Trust Mechanical Ventilation Requirements? yes System Ventilation Requirement Not clear HRV/ERV Model: Airflow measured or why untestable? Who Tested? JH Ducts Ducts Inside: No %ducts inside: 50.0 Ducts in Conditioned Space Ducts Insulation: 8 Duct Seal w/Mastic Yes If claiming incentive for ducts inside,check one of the followin Tested Performance Testing&Duct System Information Duct Leakage Air Changes per CFMWhole House House (CFM)@r 103(178 MAX) Hour(ACH)@ 3.5 25,848 5211-a: Leakage 50Pa: Volume: Notes: ventilation is exhaust...Air King 2.0 sone fan,switched in Laundry Insulation Details Flat Ceiling R- 38 Insulation Type: bib Vaulted Ceiling R- 38 Insulation Type: Scissor Truss R- Insulation Type: Above Grade Walls R- 23 Insulation Type: bib Below Grade Walls R- Insulation Type: Floor Over Unheated Space R- 30 Insulation Type: batt Floor Over Garage R- 30 Insulation Type: batt Rim Joist R- 21 Insulation Type: batt Appliances Refridgerator % Model: Clothes Washer MEF Model: Dryer % Model: 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 12588 SW 124TH AVE, TIGARD, OR, 97223 Residential - Master Permit 199 Electrical final PASS MST2015-00094 Jeff Grove 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 12588 SW 124TH AVE, TIGARD, OR, 97223 Residential - Master Permit 399 Plumbing final PASS MST2015-00094 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 12588 SW 124TH AVE, TIGARD, OR, 97223 Residential - Master Permit 699 Mechanical final FAIL MST2015-00094 David Young Re hook up separated duct work in garage. Correct back pitched B vent in garage. 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 12588 SW 124TH AVE, TIGARD, OR, 97223 Residential - Master Permit 699 Mechanical final PASS MST2015-00094 David Young Correction complete. 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 12588 SW 124TH AVE, TIGARD, OR, 97223 Residential - Master Permit 299 Final inspection FAIL MST2015-00094 David Young Final erosion control approved. Moisture content form received. High efficiency lighting form received. Insulation certification checked. Provide approved duct seal test report. Provide street tree certification. 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 12588 SW 124TH AVE, TIGARD, OR, 97223 Residential - Master Permit 299 Final inspection PASS - C of O MST2015-00094 David Young Corrections complete, required documents received. Street tree certification received. Moisture content form received. High efficiency lighting form received. Duct seal test report received. Insulation certification checked. Final erosion control approved. C of O left at City of Tigard permit center for contractor. Violation Summary: Inspector Contractor 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 lig Transmittal Letter F I G A i 1 1 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: DATE NEVPINEP DEPT: BUILDING DIVISION /�rl�f�� JUL 2 3 2015 7 FROM: CITY OF MAD COMPANY: le 01A/OCOl Hal e S /it BUILDING DWIS -i" PHONE: ■ - -- a S? By. RE: 1 P'—s— ou3 /,9A/ AUL Ht9Tobt - 9tcz rte ess (Permit Number) e"o� a subdivision n and o�ect�rr►e or it n t:-per) J-:4 ATTACHED ARE THE FOLLOWING I ' .1 ': Copies: I Description: '--- 1 Copies: Description: Additional set(s •f plans. Revisions: Cross sectio and de .• Wall bracing and/or lateral analysis. Floor/roof ' aming. Basement and retaining walls. Beam c. culations. Engineer's calculations. Othe explain): — REMARKS: - - / 1�- % FOR OFFICE SE ONLY Routed to Permit Techn�ici�a • Date: 7 2:75�l°,j Initials: ` Fees Due: ❑ Yes Ly"No Fee Description: Amount Due: $ $ $ $ Special Instructions: Reprint Permit(per PE): ❑ Yes I io one Applicant Notified: j"jf-r. Date: -7/Dr A 5 _ Initials: T 1:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 I/ 1st/1.61.y 's FOR OFFICE USE ONLY—SITE ADDRESS: /�S7 3 1v?`t' G. Le / 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 II Transmittal Letter T I c;A 1i i 1 1 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: -- DATE 1ECElVEJ)IIVED: PT: BUILDING DIVISION JUL 2 8 2015 FROM: { l_ C�Qi.----' CITY OF f .'' Ri, COMPANY: BUILDIN I I PHONE: CO l — eirl 2'— 1J ,) RE: lade f t'V t Number) l 5 ?e7. IILA / N roject e or subdivision nam d lot number) f.3 i i ATTACHED ARE THE FOLLOWINGL EMS: Copies: Description: ►i :><gs:),Description: Additional set(s)of plans. 1 1 '1 Revisions: Cross section(s) and details. ` v 6 -1 Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Nl g g Beam calculations. Engineer's calculations. M Other(explain): ^ <1 REMARKS: h i — 6:9\a ,4)t cl Z FOR OFFICE USE ONL ''---- Routed to Permit ' '. ', Date: Initials: c#14 Fees Due: El ►o ee Description: Amount Due: $ $ $ Special Instructions: Reprint Permit(per PE): ❑ Yes (" " l' o I ❑ Don Applicant Notified: Date: 7Ai Initials /� c......;7/-74- 011 i LA__ - I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012