Permit — .1
i ICITY OF TIGARD MASTER PERMIT
I . COMMUNITY DEVELOPMENT Permit#: MST2015-00047
T[(J AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/04/2015
Parcel: 2S102CA00600
Jurisdiction: Tigard
Site address: 13515 SW ASH AVE
Subdivision: FREWING'S ORCHARD TRACTS Lot: 18
Project: Ashwood, Lot 4
Project Description: New SF. 5/28/15, Demo credits from BUP2015-00035 applied to TDT& Park fees.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1043 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 23.5 Bathrooms: 3 Second: 1470 sf Garage: 399 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2513 sf Value: $294,867.21 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: 4 201-400 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 2513
Owner: Contractor:
LF 4 LLC JTSC LLC Required Items and Reports(Conditions)
9700 SW FREWING ST 5285 MEADOWS RD,SUITE 171 1 Ersn Cntrl 503-639-4175
TIGARD,OR 97223 LAKE OSWEGO,OR 97035
PHONE PHONE: 503-308-7324
FAX: 503-684-0102
Total Fees: $8,114.76
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 th6 rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may ob-' a copy of the rules or direct questions to OUNC by calling 503.232.1987 .33 2344.
/ ,--------
Issued By• 'i`r,-_,„____ Permittee Signature:
��1 503.639.4175 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 completroffof the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Residential FOR OFFICE USE ONLY
Received
City of Tigard �G�v Dat = : / Permit No.. �/ /��
Phone:SW Hall Blvd.,Tigard,503. G Plan Review�� tan Other Permit: '/2-gel 0
Phone: 503.718.2439 Fax: 503. Date/B : �f�sti
TI G A R n Inspection Line: 503.639.4175 4 1 56 Date Ready B : Juris 0 See Page 2 for
Internet: www.tigard-or.gov ��R 3 RD Notified/Method: Supplemental Information
TYPE OF 10'P REQUIRED DATA:1-AND 2-FAMILY DWELLING
®New construction ❑ 10 ttion Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1-and 2-family dwelling ❑Commercial/industrial Valuation: 39,a-Tern
Number of bedrooms:
❑Accessory building ❑Multi-family 5
h
of bathrooms:oatrooms:
❑Master builder 0 Other: Number 1,5
JOB SITE INFORMATION AND LOCATION Total number of floors: z
Job site address: \3 t,t�{`. A Ave New dwelling area 25(ware feetc b 3
City/State/ZIP:TIGARD,OR 97223 Garage/carport area:34q square feet
Suite/bldg./apt.no.: Project name:ASHWOOD Covered porch area: a square feet
Cross street/directions to job site: SW FREWING STREET AND SW ASH AVE Deck area: b_ square feet
Other structure area 2t9 square feet 2`3
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: AS 4W00 D Lot no.:y Permit fees*are based on the value of the work performed.
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.
NEW SINGLE FAMILY RESIDENCE
Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: LF 4,LLC Type of construction:
Address:5285 MEADOWS RD STE 171 Occupancy groups:
City/State/ZIP:LAKE OSWEGO,OR 97035 Existing:
Phone:(503)657-3402 Fax:( ) New
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name:JT SMITH COMPANIES (Please refer to fee sc6edute)
Structural plan review fee(or deposit):
Contact name:JOHN WYLAND
FLS plan review fee(if applicable):
Address:5285 MEADOWS RD STE 171
Total fees due upon application:
City/State/ZIP:LAKE OSWEGO,OR 97035
Phone:(503)209-7555 Fax::( )
Amount received:
E-mail:JWYLAND@JTSMITHCO.COM PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name:JTSC,LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:5285 MEADOWS RD STE 171 Solar Installation Specialty Code checklist.
City/State/ZIP:LAKE OSWEGO,OR 97035 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503)657-3402 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.:200237 I
/`�/ 7 Total fee due upon application: $201.60
Authorized signature: ((( This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry
Print name:JOHN WYLAND Date:3 �� �� Service Board.
I:\Building\Permits\BUP-RESPermi p.doc 02/24/2011 440-4613T(I1/02/COM/WEB)
Electrical Permit Applic ICEIVEP FUIL(1FF1( 1: l tiF O\Ll
City of Tigard Received Permit No.: C
�Y Dale/B : tl/LL�1 �lp�/5--�'�
�.` 13125 SW Flail Blvd.,Tigard,OR MA 3 1 2015 Plan Review A
: Phone: 503.718.2439 Fax: 503.598.1960 Daft/B Other Permit: �d[r yL2C4/S—ar
I I G A R 15 Interne on Line: 503.63.4175 i v ITY OF Ti�'A�[>t Date Ready/By. turn El See Page 2 for
Interact: www.tigard-or. ov t 7 Notified/Method: Supplemental Information
T 3 z)I I, l i - PLAN;
®New construction ❑Addition/alteration/replacement
Please check all that apply(submit 2 sets of plans w/items checked below):
❑Service or feeder 100 amps or more ❑Building over three stories.
Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
❑Emergency system. larger separately derived system.
JOB.SITE.INFORMATION e1411p:,I;OCATION .~ ❑Addition of new motor load of ❑
Job no.: Job site address: ' IOOHP or more. occupancy.
135 1 rj j�L� >�J N �U e 1 ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:Tigard,OR 97223 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: A S'\w 0 t 0 ❑Service or feeder 600 amps or store.
FEE SCHEDULE
Cross street/directions to job site: : ' n W 1 NI(. ' ) Description I Qty. I Fee. I Total 1 •
A New residential single-or multi-family dwelling unit.
as K A V e Includes attached garage.
Subdivision: As g ww D Lot no.: LA 1,000 sq.ft.or less I I. 168.54 I D'.54 4
Tax ma ! arcel Ea.add'I 500 sq.ft.or portion 33.92 1
P P Limited energy,residential
DESCRIPTION OF WORK sq. ) k 75.00 2
(with above ft.
Limited energy,multi-family 75.00 2
Electrical for new single family residence residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
® PROPERTY OWNER 0 TENANT 200 amps or less I 100.70 2
201 amps to 400 amps 133.56 2
Name: L ' y t i_ - , 401 amps to 600 amps 200.34 2
Address:5285 Meadows Road Suite 171 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP: Lake Oswego,OR 97035 Temporary services or feeders installation,alteration,and/or
Phone:(503)657-3402 Fax:( ) relocation
200 amps or less 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
® APPLICANT ❑ CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee, 7 42
Business name:JTSC,LLC each branch circuit
B.Fee for branch circuits without
Contact name. service or feeder fee,first
70NN W /LAND 56.18 2
branch circuit
Address:5285 Meadows Road Suite 171 Each add')branch circuit 7.42 2
City/State/ZIP: Lake Oswego,OR 97035 Miscellaneous(service or feeder not included)
Each manufactured or modular
67.84
Phone:(503)358-8955 Fax: :( ) dwelling,service and/or feeder
//�� ��" Reconnect only 67.84 2
E-mail:t i wy I Qnd t� ,{'SIY■(- C±). CO 111 Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: 4i ',r---( Signal circuits)or limited-energy See
_ pp I_j panel,alteration,or extension. Page 2 2
Address: ,J 210 J31/boewUOCt'/L ` S 1'eJ Each additional inspection over allowable in any of the above
" > Additional inspection(I hr min) 66.25/hr
City/State/ZIP: �1,1sh0-ye) ON /3,,,,..,! )3
^y L Investigation I I hr min) 66.25/hr
Phone:(g03) � � � Pax: rr (pl�oc 7��5' Industrial plant(I hr min) 78.18/hr
s Inspections for which no fee is UO 001 hr
CCB Lie.: �//5c1 Electrical Lit.: / f pr_, 'c: 3170'5 specifically listed(%hr min)
e--r <'' ELECTRICAL PERMIT FEES
Suprv. Electrician signature,required: 74 `4 Subtotal: 31 I • 00
F ' � Plan review(25%ofpermit fee):
Print name: I il; l A Date: 3 1 31 I1 J
/ State surcharge(12%of permit fee): y (4 .5 a
Authorized signature: { TOTAL PERMIT FEE: l_1 5. 5
Print name: (, `f
/` (I Date: 3 7 1J 1 'S This permit application expires if a permit is not obtained within 180
�'Y days after it has been accepted as complete.
—
t -T . Number of inspections allowed per permit.
I'nuilding'..Permits-ELC PermitApp_ELR_ERE doe Rev 55121/2011 • 440-W 5TtI I/O5/COM/WEI
Mechanical Permit Applic do FOR OH I( I' I sF ON1.1
11111 City of Tigard litEIVEP Date/By:e �� Permit No.: ) ( �
iii 13125 SW Hall Blvd.,Tigard,OR 97223 ®�� �� S
g Plan Review `_
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: 5(Ai-9j/s—C'j)349
I I t;,�I:I., Inspection Line: 503.639.4175 MAR 3 1 2015 015 Date Ready/By: runs. MI See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
CITY OF TI6ARI)
TYP MMO •DIVISION COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees'are based on the value of the work
New construction ID Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
VaketoOSNK
❑Demolition *AC; ❑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 Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address:97_0U C1i `ve ng k N5 i rj SW AS N A V ) I 46.75 4(a.15
Furnace 100,000 BTU(ducts/vents
City/State/ZIP:Tigard,OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:Ashwood Duct work 23.32
Cross street/directions to job site:SW Frewing and SW Ash Ave 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:Ashwood Lot no.:4
Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater I 23.32 .2 3.3,2,
DESCRIPTION OF WORK Gas fireplace/insert ) 33.39 .33-3Q
Flue vent for water heater or gas
Mechanical for new single family residence 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 I 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name:LF 4,LLC Range hood/other kitchen
equipment 1 33.39 33,39
Address:5285 Meadows Rd Ste 171. Clothes dryer exhaust 1 33.39 33.3q
City/State/ZIP:Lake Oswego,OR 97035 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32 C)3,aV
Phone:(503)675-3402 Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT Q CONTACT PERSON Other: 23.32
Fuel piping:
Business name:JTSC,LLC
$14.15 for first four;$4.03 for each additional
Contact name:John Wyland Furnace,etc. a I 1 -15
Address:5285 Meadows Rd Ste 17. Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Lake Oswego,OR 97035 Water heater i
Phone:(503)209-7555 Fax::( ) Fireplace I
Range I _•
E-mail:jywlyand @jtsmithco.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Integrity Air Other:
MECHANICAL PERMIT FEES*
Address: 12042 SE Sunnyside Rd Ste 693 Subtotal 3,:g.1.4,3i
City/State/ZIP:Clackamas,OR 97015 Minimum permit fee($90.00)
Phone:(503)572-3594 Fax:( ) Plan review(25%of permit fee)
State surcharge(12%of permit fee)
CCB lit.:203869 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: • Fee methodology set by Tri-County Building Industry Service Board
Print name:John Wyland Date: 3_131((5
r.\Building\Permits\MEC_PermitApp_0401 I3" 440 6171(I I/02/COM/WEB)
Plumbing Permit ApplR iCEIV fl
Building Fixtures FOR OFFICE USE ONLI
City of Tigard MAR 3 1 2015 Received iIFQ/ IC Permit ,900/45--a6 7
• 13125 SW Hall Blvd.,Tigard,OR 97223 f
Date/By: if J 22
Phone: 503.718.2439 F V AD Plan Review Other Permit No.: S- Z rJ�
Inspection Line: 503.63 4
Date/By:
I I GARD _;n NC DIVISION' Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or ,I�I,�'T Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
®New construction ❑Demolition For special information use checklist.
Description Qty. I Ea. 1 Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
® l-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
Accessory building SFR(3)bath I 500.32 50032
El ry g ❑Multi-family
Each additional bath kitchen 25.02 a
❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
lob site addre 1135‘vi S W Ns 4\ Q Catch basin or area drain 18.76
V Drywell,leach line,or trench drain 18.76
City/State/ZIP:TIGARD,OR 97223
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name:ASHWOOD Manufactured home utilities 50.03
Cross street/directions to job site:SW FREWING STREET AND SW ASH AVE Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft 1 r Page 2 J
Storm sewer(no.linear ft. 9 1 Page 2
Water service(no.linear tt Page 2
Subdivision:ASHWOOD I Lot no.:4 Fixture or item:
Tax map/parcel Backflow preventer - 31.27
DESCRIPTION OF WORK Backwater valve 12.51 I
Clothes washer 25.02 _
Plumbing for new single family residence Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name:LF 4,LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:5285 MEADOWS RD STE 171
Garbage disposal 25.02
City/State/ZIP:5285 MEADOWS RD STE 171 Hose bib 25.02
Phone:(503) 657-3402 Fax:( ) Ice maker 12.51
® APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:JT SMITH COMPANIES Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:JOHN WYLAND
Roof drain(commercial) 12.51
Address:5285 MEADOWS RD STE 171
Sink/basin/lavatory 25.02
City/State/ZIP:LAKE OSWEGO,OR 97035 Solar units(potable water) 62.541
Phone:(503)657-3402 Fax::( ) Tub/shower/shower pan 12.51
E-mail:JWYLAND@JTSMITHCO.COM Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name: "'r he Hulk% CO .Aba ttiwan)Kaki, PI%W1hl ■y Water piping/DWV 56.29
Address: 14 01 A SE Await ?..0A0 J Other: 25.02
City/State/ZIP: t)%Ll sb0 it0 t O R 91123 Subtotal
.rVS) CIL � 0113 Minimum permit fee: $72.50
Phone:( ax:( )
Plan review (25%of permit fee)
CCB Lic.: Ci k trot Plumbing Lic.no.:b{,f.1•0 i>t b
r State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
I t This permit application expires if a permit is not obtained within 180 days
Print name:John Wyland Date: J M!!� after it has been accepted as complete.
"""777 *Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doe 10/01/09 440-4616T(I0/02/COM/WEB)
. .
City of Tigard Ilq
_ , COMMUNITY DEVELOPMENT DEPARTMENT x 1-11-0
hrn T I G CR D Building Permit Review — Residential
Building Permit #: Hirc96/ 3 do2Y 7
Site Address: a G i ∎. - 11 ' • , /Z5-75 ao 4eail y4OL
Project Name: A5hyJo Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: nevi SF on ex s-� n� q \o- prloc to subd\vl�on FI fecoidlno'
1hoi,ne, will be mrldW,l Ildme. durl su,b-VW cons �rucr l JJ
I/Verify site address/suite# exists and active in permit syst .
m River Terrace Plan District: ❑ Yes No
Site Plan Elements:
Vree(3)copies of site plan gi: sting structures on site
V ►�fe plan must be on 8-1/2"x 11"or 11 x 17"paper
"o otprint of new structure (including decks)with finished
IYJrawn to scale(standard architect or engineer scale) oor elevations
t North arrow LYJ Utility locations(required for new,may apply for additions)
1e address,project or subdivision name and lot number ocation of wells/septic systems
pplicant information(name and phone number) Erosion control(including drainage-way protection,silt fence
Lot dimensions and building setback dimensions sign,location of catch basin,etc.)
$Lot area,building coverage area,percentage of coverage and Street names
impervious area(applicable if R-7,R-12,R-25&R-40) ®/Street tree size,type and location
VProperty corner elevations (2 foot contour lines if more than '$Lxisting trees to be retained with drip line,and tree
4-„foot differential) protection measures
Le Clean Water Services—Service Provider Lette of platted prior to 9/10/1995):
/equired: ❑ Yes,applicant was notified C No Received: ❑ Yes ❑ No
LI Public Facilitti Improvement(PFI) Permit: ��
Required: V Yes,applicant was notified ❑ No Applied For: Lid Yes ❑ No,stop intake
{ f'Land Use Case#: Sy B2_0114- 1-1
N Zoning: R- I-1 .CJ
0Setbacks: recv j f,J ( j) Front Rear `c (2g') Sides ( )Street Side (j(z�')Garage42d (27'
$ Landscape Requirement: % zo N s'+de 1 }
'CI Lot Coverage Maximum: % q.5,on 3W .`de' LP�n 1 r9 `r'ecoide
❑ uilding Height: Maximum Height 30 Actual Height-s/23
J
isual Clearance I
Easements
L11 ensitive Lands: ❑ Yes LJ(No Type
Urban Forestry Plan
'$-Conditions i`Met"prior to issuance of building permit
Notes: t-,€ SF on E Ins 1, PCYfhI r 6) ri3iii-
Approved By Planning: I ji • re Date:
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: ,g/ /
Site Plans: #
Building Plans: # 4
Building Permit#: Enter building permit#above.
Workflow Routing: D.—Planning p"-Engineering D'Permit Coordinator Building
Workflow Sign-off: D—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.
D.—Building: original permit application,site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes: 1 _, e)-71-1 Atic9°1 5----("°
By Permit Technician: `�-04 Date( /
Engineering Review
[!(Slope at building pad: 5 V
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments) per engineering conditions of approval and plat 7N/S J 5 rasZttC•1 844 •
❑ Water Quality/Quantity Facility: TO A.J Y Day. 'or -
Assess Water Quality Fee in-lieu: ❑ Yes ❑ No
Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No CO 44 TC
LIDA Facility on lot: ❑ Yes ❑ No
❑ NOT Approved by Engineering: Date:
Notes: /%1 o / N /=-0444_s:7-a , c-Ti! c r_40e rTs2 N!c 17--- 17 Y' .y.
Approved by Engineering: �/ Date: 1.1 . i /5-
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
rA pproved, NOT Released: I , Date: / Se
Notes: E iC G27-2 t.�6 C- `+1--- —jeleP
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: y,
I:\Building\Forms\BldgPermitRvw_RES_031015.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
13515 SW ASH AVE, TIGARD, OR, 97223
Residential - Master Permit
199 Electrical final
PASS
MST2015-00047
Chip Barnett
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
13515 SW ASH AVE, TIGARD, OR, 97223
Residential - Master Permit
699 Mechanical final
PASS
MST2015-00047
Chip Barnett
No A/C installed at this time
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
13515 SW ASH AVE, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
FAIL
MST2015-00047
David Young
Provide city required documents for final inspection.
Street tree certification, moisture content form, high efficiency lighting form, duct seal test
report and insulation certificate.
Upper level bedroom by stairs smoke detector not interconnected to others.
Finish grade to slope away from house 6" in 10' or have approved drainage swale.
R401.3
Seal ceiling penetration around duct work in garage.
Dining area window by patio door to be tempered within 24" of hinged side of door.
R308.4.2
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
13515 SW ASH AVE, TIGARD, OR, 97223
Residential - Master Permit
699 Mechanical final
PASS
January 15, 2016 at 11:20:53
AM
MST2015-00047
David Young
Mechanical passed at previous inspection dated 12/21/15.
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
13515 SW ASH AVE, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
PASS - C of O
MST2015-00047
David Young
Note: contractor installing protection Ballard in garage for gas line protection.
Street tree certification received.
Moisture content form received.
High efficiency lighting form received.
Insulation certification checked.
Duct seal test report checked
Final erosion control approved.
C of O left with 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
Transmittal Letter
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.243y/www.tigard-or.gov
TO: ( i qR D DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
AUG 1 7 2015
FROM: J A N zz LLC. GUI AO CITY OF TIGARD
COMPANY: ST j' M I TN Col 4 PA^) r BUILDING DIVISION
PHONE: 50 ) ` (D 57 - 3 L4 Oa By:
RE: 13 SVJ AS !-\ AV" M S-rr1O 15- 000 y -.
(Site Address) (Permit Number)
A u CsT - ' Cs (. 4T4
(Project name or subdivision name ; d o number)
ATTACHED ARE THE F 1 OW G I MS:
Copies: Description: ,Lc.oi>ui:,.:,,_flscriptiion:
Additional .et(s) of pl. s. 3 Revisions: i CO K- A IJ 0 P,PC,- PATIO
Cross sec ion( ) and •-tails. Wall bracing and/or lateral analysis.
Floor/r.•f fr. 'ng. Basement and retaining walls.
Beam 'alculatio Engineer's calculations.
Other(explain):
REMARKS:
FOR OFACLOE
Routed to Permit T chnician: Date: Initialsa
Fees Due: es ❑No Fee Description: Amount
w y:,
O\DID n 1E vtt $ ' D .
$
J $
;d
Special
Instructions:
Reprint Permit(per PE): ❑ Yes No ❑ Done
Applicant Notified:Jai,v, f Date: riat if s— Initials: iQ
L.fr,
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012