The URL can be used to link to this page

Permit CITY OF TIGARD MASTER PERMIT i - COMMUNITY DEVELOPMENT Permit#: MST2015-00083 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/27/2015 Parcel: 2S 102 DC05000 Jurisdiction: Tigard Site address: 9190 SW EDGEWOOD ST Subdivision: 2006-051 PARTITION PLAT Lot: 3 Project: Teny Partition, Lot 3 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First 1288 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 28 Bathrooms: 3 Second: 1683 sf Garage: 328 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2971 sf Value: $354,009.51 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 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 SrvclFeeders 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 2971 Owner: Contractor: TENY,GEORGE WESTWOOD HOMES LLC Required Items and Reports(Conditions) 9200 SW EDGE WOOD ST 12700 NW CORNELL RD 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97223 12700 NW CORNELL RD PORTLAND,OR 97229 PHONE. PHONE: 503-330-2215 FAX: 503-342-2403 Total Fees: $23,867.19 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 th= 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Thos- rules .re set forth OAR 952-001-0010 through OAR 952-001-0090. You may obtain a cop�rect questions to OUNC by calling 503.232.1987 0o-•".332. Issued By: //�i_ �� Permittee Signature: CaII 175 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 projec Approved plans are required on the job site at the time of each inspection. 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 Transmittal Letter i ;, , i i 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: ate DATE EIVED: DEPT: BUILDING DIVISION LU E. 1VE D W,( //I GKS AUG 1 9 2015 FROM: - _wwwir - CITY OF TIGARD i 1�5 ! S BUILDING DIVISION COMPANY: Gtr �p PHONE: 3-b3 -57S-- ZQ4 -lc- ► By: RE: `/ ,) .,_ -' ,.,. S: A '�-„4,- ...5, 9-6,-, ite • •'ress I. (Permit Number) (Proame or ssu iv'isio ame and li 4, r) %.\ .. e ATTACHED ARE THE FOLLO G E S. Copies: Description: Copies: Description: Additional set(s)of lans. Revisions: Cross section(s) d de i . Wall bracing and/or lateral analysis. Floor/roof frame g. Basement and retaining walls. Beam calculate ns. Engineer's calculations. Other(expla. : REMARKS: ,_ ,6 ` / F-Llst> LAyouz-j- f- C•4(,LS 3 S&. RE.enF R`t5S L-.4>/ 1_47- -. 4>/ j?` ? EN1.3-1 d ic' /11/6— 1 , 1 { ! , ■ , " ( i Routed to Permit -clinician: Date: '''' ( 1 EMEINZAIM Fees Due: C' es ■ No Fee Descri.tion: Amount Due: _ _ $ 4d $ $ $ Special Instructions: Re.rint Permit .er PE : ❑ Yes o • Done A..licant Notified: j „' Date: ?-z. 'L I:\Buil ding\Forms\TransmittalLetter-Revisions.doc 05/25/2012 CITY OF TIGARD SEWER CONNECTION PERMIT 1111 1t COMMUNITY DEVELOPMENT Permit#: SWR2015-00057 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/27/2015 Parcel: 2S102DC05000 Jurisdiction: Tigard Site address: 9190 SW EDGEWOOD ST Project: Teny Partition,Lot 3 Subdivision: 2006-051 PARTITION PLAT Lot: 3 Project Description: New SF. Contractor: Owner: TENY, GEORGE 9200 SW EDGEWOOD ST TIGARD, OR 97223 PHONE PHONE: FAX: FEES Description Date Amount Specifics: Sewer Connection Fee 07/27/2015 $4,900.00 Sewer Inspection-Residential 07/27/2015 $35.00 Type of Use: Class of Work: Install Type: Fixture Units: Number of Dwelling Units: Total $4,935.00 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-001. • • •• •AR 952-001-0090. You may obtain a copy of the rules or direct question to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: ��// / f% Call 503.6 •.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 proje• . Approved plans are required on the job site at the time of each inspection. . ,. Building Permit Application Residential FOR OFFic't: t ti l:0'.l.1 City of Tigard RECEIVED Received C� �J Permit No.: DateB ,I/�� • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Other Permit: /� II Phone: 503.718.2439 Fax: 503.5 4A 602 7 2U13 Date/B : `I, Jm� �oys---- S/ T t c;,t R D Inspection Line: 503.639.4175 Date Ready/By: / /- Juris: ® See Page 2 for w. Internet: wwtigard-or.gov CITY OF TIGARD Notified/Method: (/ i 40 6- / Supplemental Information - BUILDING niviStON ; ,(,� �- TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING ®New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the work indicated on this application. CATEGORY OF CONSTRUCTION I Valuation: ��1 ( ® 1-and 2-family dwelling 0 Commercial/industrial i ❑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: if/fa %./ t4 t,/ed c, I- New dwelling area:-L9 7) square feet City/State/ZIP:Tigard,Oregon Garage/carport area:.2)7_,g square feet C-8 3• Suite/bldg./apt.no.: Project name:. 6 2't/CV IfIrits.4d porch area:Z square feet Cross street/directions to job site: Few/y Grit' .V I Deck area: square feet �� Other structure area: .2C9 square feet Z 'l REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: J#1 y P(.1 P1 f f/0.; Y k Lot no.: ' Permit fees*are based on the value of the work performed. j' 1 / / 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?(- C rl- )Olg Fax:(503)342-2403 New: 0 APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* Business name:Westwood Homes LLC lPlaaserermfiescJred�le) Structural plan review fee(or deposit): Contact name: filtd-4 p'r a t. + FLS plan review fee(if applicable): Address: 12700 NW Cornell Road Total fees due upon application: t, City/State/ZIP:Portland OR 97229 {dJj r Phone 1 l'� 67 c- Amount received: 7�'C � ,�($ Fax::(503)342-2403 E-mailflitt@WestwoodhomeslIc.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top . nted Photo Voltaic Solar Panel System. Business name:Same as applicant Submit two(2 • of roof plan with connection •-.. s and fire department a •• s,along with the 20 : •regon Address: Solar Installation Special .••e checkl'-. City/State/ZIP: Permit Fee(includes plan $180.00 and administr: ' - fee Phone:( ) Fax:( ) State surchar_e •o of permit fee): $21.60 CCB lic.: 195597 Total fee due upon application: 01.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:/ G!1 / /l Ct Date: *Fee methodology set by Tri County Building Industry Service Board. 1:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Electrical Permit Applicak)a,_ FOR OFFICE USE ONLY City'of Tigard CLIVE® D;-8. '7 fl f5- , PerusitNo.: h a-p/5--64V5 ra 13125 S W Hall Blvd..Tigard,OR 97223 Plan RnneN '�2+nfS f.1 r Other Permit. Chi�, Phone: 503.715 2439 Fax. 503.5941, 0 A 7 2015�5 DateBs. Inspection Line: 503,639.4175 4 Date Read;-'By ya t ® Ste Page 2 for TIe3ARD Internet wwwtigard-or,gov CITY Notified/Method: Supplemental Information T�'> , 17)F TICARD PLAN REVIEW r/fFYC t I VISA(� Please check all that apply(submit 2 sets of plans w'iiems checked below): 13 New construction ❑Addition/alterationIreplacemen ❑Service or feeder 400 amps or more ❑Building ovm three stories. ❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards CATEGURS' OF (O\ti TRl1C1 l0\ exceeds 10,000 amps at 150 volts or ❑Floating buildings kw to ground,or exceeds 14.000 0 Commercial-use agricultural ® I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations buildings. ❑Multi-family ❑Master builder ❑Other: ❑Fire punm ❑Insceilanon of 150 KVA or 3(1R SITE INFORMATION AND LOC'AlIO\ CI Emergency system larger separately derived system.) DAddjt)orrofsru motor land of ❑"A", E","1-2","1-3", } / i 100HP in more. occupancy' Job no.: Job site address: g( �� *W e4-10.1/012717 1, , ❑Six or more residential units. ❑Retreat veal vehicle parks. City:State/ZIP:Tigard OR ❑Eiealth can facilities ❑Supply voltage for more than El(laza dour locations 600 volts nominal SuSuite/bldg./apt. r apt.no.: I Project name: ee,44, ✓oo of ❑Service a:feede600 amps orMOM FEE SC RED(:1.E Cross street/directions to job site: 4 Description 1 Qrs. 1 Fee. I Total r • f New residential single-or multi-family dwelling unit Includes attached garage. Subdivision: -re 0 F24 rf"I-�/'0k1 1 Lot no.: 3 1,000 sq.ti or less 1 168.54 . i 4 Es.add'1 500 5q ft or ponionit, 33.92 11- ,Tax map/parcel no.: r Limited energy,residential DESCRIPTION or WORE (with above s0.ft,) 1 75.00 2 Limited energy,multi-family 75 00 I 2 new SFR residential(with above sq ft.) Renewable Energy i ❑ See Page 2 Services or feeders installation,alteration,and/or relocation ® PROPERTY OWNER ❑ TENANT 200 amps o:less 1 100,70 2 201 amps to 400 amps 133.56 2 Name:Westwood Homes LLC 401 amps to 600 amps 20034 2 Address: 12700 NN'Cornell Road 601 amps to 1.003 amps 301.04 2 Over 1,000 amps or volts 552.26 2 Citv'StateJZIP:Portland,OR 97229 Temporary services or feeders installation,alteration,and/or Phone: 7j1-Cr r-'c'i'( Fax:(503)342-2403 relocation l 200 amps or less , 1 1 Owner installation:This installation is being made on property that 1 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 165.54 1 2 Owner signature: Date: Branch circuits-new,alteration,or ex tension,per panel ® APPLICANT I ❑ CONI ACT PEILSON ■ A.Fee for branch circuits with above service or feeder fee, Business name:Westwood Homes LLC each branch circuit 7.42 2 �� rr - B.Fee for branch r circuits first rice Contact name: !G service or feeds firs[ 56.18 2 branch circuit Address:12700 NW Cornell Road , Each add'l branch circuit 7.42 2 City/State/ZIP:Portland OR 97229 1 Miscellaneous(service or feeder not included) h Each manufactured or modular 67 2 4771-67- er I Phone: �—�G I Fax::(503)342-2403 1 dwelling.service and/or feeder Reconnect only 1 67.84 2 E-mail 10Westwoodhomcsllc.com Pump or irrigation circle 67.84 2 CONTRACTOR i Sign or outline lighting 67.84 2 Business nit ci-NA..S� �Vec L Signal circuit(s)or limited-nergv See Y�-� panel,alteration,or extension. Page 2 _ 2 Address: t 1 L-kqC), Se, J f�Ip(tom en-T- Each additional inspection over allowable in any of the above Additional inspection(1 hr min) I 66.25/hr City'State/ZIP: et�A�� ,J, ere_ �'1O1S Investigation(1 hr min) 6625/hr Phone:5 - " Qa-8CS� fi Fax:n-Da---i D2-- kqz., t Industrial plant(1 hr min) 78.18/hr ? p Inspection for which no fec is I 900p/hr CCBLic.:1b�b�g Electrical Lie.:3. (�Suprv.Lie.: �O� specifically listed(i4 hr min) , / ELECTRICAL PERMfl FEES Suprv.Electrician signature,required: ./ifJ•LLt.4-' - Subtotal: Print name ptIt � Date:lJt 1 l� Plan review(25%of permit fcc): S State surcharge(12%of permit fee). Authorized signature: TOTAL PERMIT FEE: ibis permit application expires if a permit Is not obtained within 180 Print name: I Date: days after it has been accepted as complete_ • Number of inspections allowed per permit I,Burtdir*Pernii,F.LC_Pennnnpp_ES.R_FRE doe Rev 051210013 440-46151(1 tm1 0M:WE9 Mechanical Permit Application FOR OFFICE. l SF ONLY City of Tigard Received 7 7 yr _��U DateBy: Q` r Permit No.: -3 ■ 13125 SW Hall Blvd.,Tigard,OR 97 C E I VE D Plan Review � Q fors 7 Phone: 503.718.2439 Fax: 503.598 Date/By: Other Permit: (� 1 I(i A Id D Inspection Line: 503.639.4175 Date Ready/By: Suns 0 See Page 2 for Internet: www.tigard-or.gov MAY 2 7 2015 Notified/Method: Supplemental Information TYPE OF @Ntlt OF TIGARD COMMERCIAL FEE* SCHEDULE — USE CHECKLIST ti j 111_Il L fy IAS c Mechanical permit fees*are based on the value of the work ®New construction ❑Additio cam t0N 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 spedoi information use checkilst. ❑ Multi-family ❑ Master builder ❑Other: Description I Qty. Ea. Total JOB SITE INFORMATION AND LOCATION/ Heating/cooling: Job site address: 9(i6/ (..,/ ,ta v'at,c c-/- Air conditioning ( 46.75 r�� i f Furnace 100,000 BTU(ducts/vents) ( 46.75 City/State/ZIP:Tigard OR Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: Project name: 4y0o/ Heat pump 61.06 Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision 7,,,t/1,41 PQ ,f 1:671/‘ Lot no.:3 Other: 23.32 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 1 Address: 12700 NW Cornell Road equipment 33.39 Clothes dryer exhaust I 33.39 City/State/ZIP:Portland OR 97229 Single-duct exhaust(bathrooms, � / toilet compartments,utility rooms) S 23.32 Phone: 171''4,-i "5.01 g Fax:(503)342-2403 Attic/crawlspace fans 23.32 El 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: P/01-ti Fri tre, Furnace,etc. 1 Address: 12700 NW Cornell Road Gas heat pump Wall/suspended/unit heater City/State/ZIP:Portland OR 97229 Water heater ( Phone: TN-6 5/'50 ii. Fax::(503-)342-2403 Fireplace I - Range l E-mail:Mmt4westwoodhomeslIc.com Barbecue CONTRACTOR Clothes dryer(gas) 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 if a permit is not obtained within ISO days after it has been accepted as complete. Authorized signature: • Fee methodology set by Tri-County Building Industry Service Board Print name:Jon Montgo ' Date: 1\BuildingWermits'MEC_PermitApp_0401I3.doc 440-4617r(11/02/COM/WEB) [Plumbing Permit Application Building Fixtures RECEIVED City of Tigard Received a7 Permit No.: ' - d 3 III • 13125 SW Hall Blvd.,Tigard,OR Y 2 7 2015 Date/By: Plan Review Other Permit No.: 1"J�tJ`v 5/ ■ Phone: 503.718.2439 Fax: SQ3.598.1960 Date/By: Inspection Line: 503.639.4175CITY OF TIGARD Date Ready/By: / / luris See Page 2 for Internet: www.tigard-or.goBUILDING r 1VISION Notified/Method: co � j5- Supplemental Information rmation TYPE OF WORK (IMAcv-ipici - F FEE* SCHEDULE ®New construction ❑Demolition 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 Z 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 1 500.32 ❑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: I I 7o y1,1/ kal,Leivepd 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.: l Project name +,J„. Manufactured home utilities 50.03 Cross street/directions to job site: -T Pair-14-J1-2)^1 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: 13 Vl.y Pa(4'1:I^t DP I Lot no.: Fixture or item: Tax map/parcel no.: f Backflow preventer 1 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer / 25.02 new SFR Dishwasher r} 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER 1 ❑ 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 1 25.02 City/State/ZIP:Portland OR 97229 Hose bib L. 25.02 Phone: /7-i- 6 1-1-''Oir Fax:(503)342-2403 Ice maker 12.51 ® APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name: InkAjati frriel?e5 lC(, Medical gas(value:$ ) Page 2 LL F` � Primer 12.51 `'TT Contact name: 'e Roof drain(commercial) 12.51 Address: rj ape 45 ('„l j'l„e{- Sink/basin/lavatory � 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:6?( )6 1` - 9715 Fax::( ) Tub/shower/shower pan 12.51 E-mail4Il*t westwoodhomesllc.com Urinal . 25.02 CONTRACTOR Water closet 25.02 Water heater / 37.52 Business name:H&H Mechanical Water piping/DWV / 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: $72.50 CCB Lic.:178122 Plumbing Lic.no.: 1911 Plan review (25%of permit fee) (/ �--7 / 2.4../ State surcharge(12%of permit fee) Authorized signature: �r�/ r t j� TOTAL PERMIT FEE• j/ This permit application expires if a permit is not obtained within 180 days Print name:Dusti ague / Date: after it has been accepted as complete. *Fee methodology set by Tn-County Building Industry Service Board. I:\Building\PermitsWLMU-PermitApp.doe 10/01/09 440-4616T(10/02/COM/WEB) r City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Review — Residential I i ( s ,\RI) Building Permit #: r • p9o15—00o$J Site Address: cal l ol a S W cje wood. s+ Project Name: Gcl y2-w000A Lot #: (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review n Proposal: tVt?W in k F{M;11 Ices 1cL.QX1 X Verify site address/suite#exists and active in permit system.•$River Terrace Plan District: ❑ Yes No Site Plan Elements: /Three(3)copies of site plan (xisting structures on site /Site plan must ii&on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished gfiDrawn to scale(standard architect or engineer scale) floor elevations North arrow Utility locations(required for new,may apply for additions) Site address,project or subdivision name and lot number $f`cation of wells/septic systems/.J/ft.- Applicant information(name and phone number) ❑Erosion control(including drainage-way protection,silt fence $Lot dimensions and building setback dimensions design,location of catch basin,etc.) ' _Jbet area,building coverage area,percentage of coverage and ,'Street names _/impervious area(applicable�f I3-7,R-12,R-25&R-40) -street tree size,type and location IgProperty corner elevations(Z`f000t contour lines if more than ,Existing trees to be retained with drip line,and tree 4 foot differential) protection measures cff Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): / f Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No J4 Public Facilities Improvement(PFI)Permit: Required: ❑ Yes,applicant was notified El No Applied For: ❑ Yes ❑ No,stop intake X Land Use Case#: M/' L P ' 2.130 c — 0000 I Pa rte. 3 IX Zoning: R —`t 5 Setbacks: Front t.o Rear ` S Side 5 Street Side I S Garage 7-0 Landscape Requirement: 0 % /, Lot Coverage Maximum: cyo g(Building Height: Maximum Height 3 0 Actual Height 2.6 —5—Visual Clearance J)Pr .Z Easements Sensitive Lands: ❑ Yes 9/No Type Urban Forestry Plan l% onditions "Met"prior to issuance of building permit Notes: carAlfutlo n 2a - ()Ulnl^ Wi W °yV t h ca., kr- lot 3 rt7, . iisvcit' ildA Ie-e.^'Ct.4- r Approved By Planning: �l O VI Ii-ti`- it Oorte-(ic.,./- Date: 5/2.1 / 15 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw_RES_031015.docx Building Permit Submittal Original Submittal Date: Site Plans: # 3 Building Plans: #E� Building Permit#: Enter building permit#above. �� Workflow Routing: Planning 0-Engineering h Lr ermit Coordinator Building Workflow Sign-off: Or§ign-off for Planning(include notes from planning review) Route Application Documents: J2—Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan 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: Date: 5/a2laA-- Engineering Review Slope at building pad: 5 .7b ❑ 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: ,Er Yes ❑ No Assess Water Quantity Fee in-lieu: Yes ❑ No LIDA Facility on lot: ❑ Yes No No ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: /'k 1 Va-- w Date:5 z 8 'L° 1Y- Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: El Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions"Met"prior to issuance of building permit El Approved,NOT Released: Date: Notes: 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: Date: ��ys I:\Bui I ding\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 '1 s Transmittal Letter Tic ;,\is I , 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: IQr I 44/ t2 DATE RECEIVED: DEPT: BUILDING DIVISION /kr& RECE IVED FROM: ' C7. 1 'Gk JUN 1 0 2015 COMPANY: //Vte4 /Q‘30` % kk?S CITY OF TIGARD I BUILDING DIVISION PHONE: gY-/ ` 6 -7 F- 5a/ g RE: r try G�O d 7'2 ST (s---G)v13 (Site Addr s� (Permit Number) (Project name or subdivision n and of num er ATTACHED ARE THE FOLLOWING ITEMS: Copies: I Description: I Copies: Description: Additional set(s) of plans. X Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. _ Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: -,24 -,--44 ' w /Q/, , ,- - :j,—! FOR I FF, CE USE ONLY Routed to Permit Technician: Date: ( I (, -= Initials`. -'� Fees Due: • Yes L!Io Fee Description: Amount ue: $ $ $ $ Special Instructions: Reprint Permit(per PE): ❑ Yes ❑No ❑ Done Applicant Notified: Date: Initials: l:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 Dec 04 2015 3: 24PM HP LASERJET FAX P, 2 Electrical Permit A DVIR EIVED City ofTiprd ��3 7 2015 1"V-1616 Forook 5Y.7.S1_ 13123 SW Hall BIS�,Tigard,0 �y�p Fyn agvbw Otter Wmdt Pbdlo: 303.639503. Pex:�01S9BVf TIGARD ab ,nrlr Impadian Line. 503.67951 amtq/ey: Ste Peptter Internet: DIVISION ! H0p6i °d a e.mttdermtao" New construction Addition/alteradon/replacomsent In be ❑ won", Demolition Other: 1;2 sern'oeake0w400 emq atnem O 8�1°swr'ar�e wham the nmmble Wt ote ma [2Mmiamegadbeteyerde - ., •. . aaeeda WOOD WIpa M ISO wee m O noreml Mlldimp. ho to Woods'I-and 2-famlly dwelling Commercial/industrial Accessory building4r YuourI 0 ❑bCue�wvw elpWWtmel Multi-fbmily Marler builder Cl Other Ilawtana of 73 KVAa ❑&herpmaygermt, law mparmly d'vv6d tysteln. OAddilloearnw•malabador O`A","r.'17",14. Jab no.: lob sl[a addross: IOOIWamom awn QQj. six w tops Mold" d MAL ❑RmaMiomd vehble pinks. City/StattlZ(P: [ , R. OHeellbemtracultim O!apply volute;rm anon than 1.7 Raaerdmaa kemleaa 600 vne wmktel. Suitdbld0w.no.: I Project deme: w 690 Itleta Cross sucevdi ections to Job site: Ncw milpeviW1�M py 0r muld•lamlly dwt114 t unit. Subd'vislon: Lot no.: IA00 p.A.of 1M 16134 1 1 a Ba.aWd'170o ,8.a 3392 I Tac me aroel n0.: '101152 413 f gfl0rgy,R11dg"dal 67.14 2 n� s , G-Y "} iced clergy,muh•Mai 67.64 2 eta.111009.slprpdaa dor relocaftoo '*_* I qy I 100.70 2 201 . t 40040 133.36 2 N arae: 401.4aps to 600 Rape 200.34 2 601 4MM, 000 t 701.M 2 Address: I volts "E" z _I Clry/StaWZIP: emporary setvias or f gn atollation,sitenllwN sad/or Phone( ) Fax:( ) lea! 59.36 I Owner installation;This installation is being made on property that I own which Is Int 3 1 pros oD40 solos 1 125.01 1 2 intended Por sale,lease,rent,or exchange,according to ORS 447,449,670,end 701, 4 1 168.54 2 » o or extension. Anel Owner signatum: Datta; A.1FWTor#WAcOrtuits wr Abov6 feMYide or Ilcdcr ho, 7.42 2 Business mime; fbr OM4 e wW4W lgvloe or hider lita, Contact name: t $6.18 2 Address: 1. 7A2 2 n Ciry/Slata/ZlP: 67.84 2 Phone:( ) Pax:i 440110110A lady67.60 1 1 2 E-mail: AI ZOIC 67.14 2 'i `" i 67.94 1 2 MPM ked- Business name:Ross Electric,Inc ! ao41fe0 t a io QiY Pte,alteration,or Address: 2870 SE 75`d Avg,0 203 ebtoon•Describe: FsBc 2 2 City/State/ZIP:Hillsboro,Or 97123a opal leagard2a over dl a of about Phono:(503)6423800 1 Pax:(503)642-5813 p 4r I 66.26 11 O he min 66,23 CCB Lie.: 157891 Ilia-141,' Electrlcgl Lia.: 34.436C SOprv.Lia: 4233$ 1 71,111 Supm. Elocuiclan signature,rcqulmd: - ppblayl; - Printnamd; Stephen Ross Date; Ma)p ,;P - mlwr 2S%of It lag): State/utt4mrge(12%of perm it M): Authorimd signature: 70TALPERMTF6Et b perm t4pr to ppin. 5per®thnN Maw{IHe ISO Print name: Data: qqyy!aiNhlfLgl 6eea,aedNtrdutpmpleM Nmmhpr of iryllgplOes snowed yer Iritmlt I�e.Jd'inaWmmnraLC-reeNl/,ypdx IWI/aG Nayl!!t•IIQNWMnY4k 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 9190 SW EDGEWOOD ST, TIGARD, OR, 97223 Residential - Master Permit 699 Mechanical ﬁnal FAIL MST2015-00083 David Young Vents on exterior blocked with tape and paper. Seal ceiling penetrations in garage. Seal furnace termination at exterior wall outside. No AC installed at this time, provide permit and approved inspection if installed after ﬁnal inspection. Note: gas Oder coming from ﬁreplace, underﬂoor insulators moving gas line around while installing underﬂoor insulation. 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 9190 SW EDGEWOOD ST, TIGARD, OR, 97223 Residential - Master Permit 199 Electrical ﬁnal PASS MST2015-00083 David Young Replace broken faceplate in upper level bath prior to building ﬁnal. 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 9190 SW EDGEWOOD ST, TIGARD, OR, 97223 Residential - Master Permit 399 Plumbing ﬁnal FAIL MST2015-00083 David Young Provide approved water service inspection as noted on previous failed inspection dated 8/12/15. Secure lower water heater strap to wall framing. Pulls drywall away from wall. Clean out plugs need approved thread sealant. 316.1 Fix cracked grout at backsplash in master. 310.4, 407.2 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 9190 SW EDGEWOOD ST, TIGARD, OR, 97223 Residential - Master Permit 399 Plumbing ﬁnal FAIL January 8, 2016 at 7:58:36 AM MST2015-00083 David Young Correction for master bath not 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 9190 SW EDGEWOOD ST, TIGARD, OR, 97223 Residential - Master Permit 699 Mechanical ﬁnal PASS MST2015-00083 David Young Note: for ﬁnal, seal around condensate drain at foundation vent and ﬁnish sealing around gas line at back garage wall. Violation Summary: Inspector Contractor p• 2 Dec 04 2015 3: 24PM HP LASERJET FAX Electrical Permit AppiiREIVE® - - . . 11,01:dpH.i„,.'d? .INE:tSl'kQ.i, -' City of Tigard Reed e 13123 SW Hal!Blvd,Tigard,01JJ 3 7 2015 D+ ' /%'A / Ai permit�o. LS'C?Cxs 7, '~ Phone: 503.639.4 t 1 Fan:,�5{1r4 9 ,�QQ0 plan Review .1 iciAlttr Inspection Line; 503,639,411 'i t T ii TIGARD gate Ready/By:ity: Other Permit: Internet: www,ligar -oc Hcalurk l RBUILDING DIVISION Notified/Met : Su, "pin i Gtlarma on ”.- "J ....,.. ".:,e-.t.,,i1 14n1T i 1 t:l aria .r:.. „.,.. '..,. 11�11 � „ 1: New construction II Addition/alteration/replacement Pease colt {hetap,yin:nit este ofp tomseheeked below): a Service or feeder 400 amps or more 0 Building over three stories, ❑Demolition ■I Other ,,., • , wvrrr �r 1 e r al _v+ , - ab �� ,y - when the shit le thufl current .`'r,c.oJI,�.•,A. ,,41'.,SWIr;:ei-wn,:a..:L .Wr�r.,•11'.ii11c�.i 7Arii.-� .,,5i'.1.4).' r „ ..'. 0 amps a1 ISO volts Cr a. Harting told i boom& emends l0 Oil ❑Floating buildia�e, „-.. ,_ leg to ground,or excccda 14,000 1S1'I.and 2-family dwelling II for all Commercial/industrial ■ Accessory building OComanervprl•useegioultnrnl other instillations, iaey,, twd, Wilding.Nlti-Ilimiiy • Master bulider MI Other0Firepum>• ❑Installation n o75 KVA or ' ti L1� t, �= 9��V�I �- rA1 - ! aa: rf� : : 0 Emergency system, larger letwrately derived s ystem,.• ..- •• , I. -7"3rg+ c ,.Lew4rk u... .uw.nr;L.,Id : . a ; ❑Addition of naw malar load of Q". Job no.: Job site address ' 0 47- R� 100HPormore, occupancy, ❑Six or more residential units. 0 Recreational vehicle parka, City/State/ZIP: 1 f R QHealth-oare 1acilhfes, Supply voltage for mon than ca ©He Hazard loeiUorra 600 volts nominal. Suite/bldg./apt.no.: I Project name: n•:..a el.or '.i A 600..0 ., fl0i Cross street/directions to Job site: New resldeodai single.or multi-family dwelling unit. Includes attached=rage. Subd`viston: 1 Lot no., 1.000 sq.ft.or less 168.54 4 Tax ma• parcel no,: • -"• Ea.add'!300 sq.ft.ar portion 33.92 ?t1+tr;},,,-?.e'..�,t'.r slif�p4'.,w�},.11_r,.i�' ;�:-..-..a„,. -. - urtlte �.residential i-1 � .,,r : '.Ut q�X5,7,1d� �,7}r S�'^ - 8 2 ,.. :... :....... �...:' ' � 67. 4 , (with, Rw so.$.) JJ ;';l Z , nl A ‘4.'y-K C•I „j.,J fmited energy,multifamily 67,84 t 'y�q i y•A,) _ 'e•• Cit I 1//5-i- :kr)LT! r0(�$ artoeil r ( eliF staliat(ail„alteratton,�tgd/orreloc>iti 4 z • '^.wa':�:;;�; c�1:1} �,:., 1 -X60 amps t}r lege 300.70 2 u ',;r•eta.. o_-"A' .61i4.,}.'r;:;, ;k)f,' :,'cti : ,.".r=�.:,._,,. ,., M: , _. . _. _ 'C. 2gi{urlpsIp400OMNI__ 133.56 2 - Name: i 4Ql,Amps to 600 amps 200.34 2 Nddress: 60}amps0_1,,000,amps _ 301.04 2 Over.,1,000 into)Cr yolts 552,26 2 Cl ry/S tate/ZIP: I Temporary bervices or teedsrr lanai lotion,alteration,and/or rep,P00tt Phone:( ) Fax:( ) 200 mp0Or,lest 59.36 S. 1 Owner Installation;This installation is being mado on property that 1 own which Is not 2'1 ' "8 -.40, -vs 125.08 2 intended fbr sale,lease,rent,or exchange,according to ORS 447,449,670,and 701, 4'1ante td' =RIM 168.54 2 Owner signature' _ _ ore ton r ;, ...�:r .;.:..,.:.,...,.., - .....,,,.• i — -.. EfOn er'and f !"�,i:•. :�:f.L:;ijtr»f-';::r''^"c:."F '�":',.,, • ��.•f1r• Y, Cl "tilts Wr S.r,•:4 s? -:.-tet i i •rt.. rdac4i� -,;id;.f, ., 4, ,n r-I fil*o get t'jQsor Feder 14,Business name: 1 7.42 2 1'b � I I _ a.no fbr broneh eirodits Contact name: wJ/houl stole:or feeder ti+e, Address: ;flr914., -.,.ii 1 56.18 2 ' ,•►,''111 p)1: " it 7.42 2 Clry/State/ZIP: 7P'11h .,. "LULL:L -b ,DM bud ,1 ' Phone:( ) i Pax:;( ) '-i- l• •I•i W.-...i. moo of 67,84 2 Email s Irl 67.84 2 • u lt p •t, # t Abt�(ClC 67.84 2 0r '.. 9rrx�,"G:Fil:,1kt ; �0,; i ,,f::1 :,.--_ _r: .' ,.,u. t 1•, tbi. �I� I. t. 67.84 2 - . ,) 17 f Business name:Ras Electric,Inc a"11"11 or im energy panel,alteration,or Address: 2870 SE 75`I'Aye,0 203 i extef9ian.Describe: Page 2 2. City/State/ZIP:Hillsboro,Or 97123 ! •:-.12§70," o•_l tn., don over alio a'lel. .. of the above Phone:(503)642-2800 ,et in 90 , 66.25 Pax: (503)642-5815 al • 11m 1'tit ”t .r bon (1 Iv min) 66,25 CCB • Lie.: 157891 1 - S rlectrictil Lie.: 34-436C Suprv,LIG,: 4232$ . 1,.,, rmttttiwmumi rp ; , � , '' r, : ; '- suryEloccriclan signature required: , l , ttotal: ,, , :p review-Print name; Stephen Ross Date; 21 /2010 ^� State surcharge(12%of permit!be): Authorised signature: _ TOTAL PBRIvflTF6Is: Print name: Date it's p }t gelation*giro 1,ipermit li not••tatoad within Ino �- tl Shehttlin beenfee•oted a complete. I lauildinglPennka43LC•PermnApp,dx JWO,'09 ' Num(r9rorIR Juni allowed per pbrmit. 44046 I 3T(I 101) Ml1V$al 1. ..,.;r:,... v 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 9190 SW EDGEWOOD ST, TIGARD, OR, 97223 Residential - Master Permit 399 Plumbing ﬁnal PASS MST2015-00083 David Young Corrections 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 9190 SW EDGEWOOD ST, TIGARD, OR, 97223 Residential - Master Permit 299 Final inspection PASS - C of O MST2015-00083 David Young Final erosion control approved. Street tree certiﬁcation received. Moisture content form received. High efﬁciency lighting form received. Insulation certiﬁcation checked. Duct seal test report checked. C of O left on site with contractor. Violation Summary: Inspector Contractor