Permit rt CITY OF TIGARD MASTER PERMIT
14 t ' COMMUNITY DEVELOPMENT Permit#: MST2015-00155
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/15/2015
Parcel: 2S110CB11400
Jurisdiction: TIGARD
Site address: 15212 SW HARVEYS VIEW AVE
Subdivision: SOUTH VIEW HEIGHTS Lot: 2
Project: Southview Heights, Lot 2
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 945 sf Basement 0 sf Left: 5 Parking Spaces: 0
Height: 21.5 Bathrooms: 3 Second: 1322 sf Garage: 482 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2267 sf Value: $282,590.25 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 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
Fum<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 5
Fum>=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 add9 500 sf: 3 201-400 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 2267
Owner: Contractor:
STONE BRIDGE HOMES NW LLC STONE BRIDGE HOMES NW LLC Required Items and Reports(Conditions)
4230 GALEWOOD ST,STE 100 4230 GALEWOOD STREET#100 1 Ersn Cntrl 503-639-4175
LAKE OSWEGO,OR 97035 LAKE OSWEGO,OR 97035
PHONE: PHONE: 503-387-7577
FAX: 503-387-7615
Total Fees: $22,478.06
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 a •.•-nce 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. A," NTION: 0 -!on law .quires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-0' -0010 through OAR 001-•691. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344./Issu d By: Permittee Signature: ' i —rdta'/
Call 503.639.4175 by 7:00 a.m.for the next available inspection da e, r
This permit card shall be kept in a conspicuous place on the job site until comple on of the .roject.
Approved plans are required on the job site at the time of each inspection.
I
Building Permit Application
Residential .-t-CE V ED i t it 01 11( I I. I.OM 1
Cl of Tigard p Received 'M�ep✓_ Permit No.:ti..57-; 51660 155"
• 13125 SW Hall Blvd.,Tigard,OR 97223U G 2 6 2015 Plan Revie
Other Permit: ft Phone: 503.718.2439 Fax: 503. 0 Plan Re: �3 7 i —�/Q
T t GARD Inspection Line: 503.639.4175 �TY OF TI'Gr n D Date Ready/By: luris: ® See Page 2 for
Internet: www.tigard-or.gov r:: _D �G DIVISION! Notified/Method: I/di/6_ Supplemental Information
' L.U./b'► ',QTAAlt.
TYPE OF WORK REQUIR4D 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
application. a1. p
CATEGORY OF CONSTRUCTION•" work indicated on this a
� �8I� 1 D r a_.,g'
Valuation: $ -T 1 1�4
® I-and 2-family dwelling ❑Commercial/industrial
❑Accessory building ❑Multi-family
Number of bedrooms: • L{
❑Master builder ❑Other: Number of bathrooms:
Total number of floors: �)+s)
v JOB SITE: INFORMATION AND LOCATION �.
Job site address: I 52-12 Svc HAR-VeliS V I P4 AVE. New dwelling area: 1.7,181- square feetaaTi t}9
City/State/ZIP:Tigard,OR 97224 Garage/carport area: 1..02, square feet
Suite/bldg./apt.no.: Project name:Southview Heights Covered porch an • Nr a lal square feet j 3 e
Cross street/directions to job site:SW 122"Ave&SW Beef Bend Rd Deck area: _gO square feet 9 4.6' S
Other structure area: square feet +
U1R D DATA:COMMERCiAL-USE CHECKLIST
Subdivision:Southview Heights Lot no.: 2 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. J
new,single family residence Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER El TENANT Number of stories:
Name: Stone Bridge Homes N�1,LLC Type of construction:
Address:4230 Galewood St,Suite 100 Occupancy groups:
City/State/ZIP:Lake Oswego,OR 97035 Existing:
Phone:(503)387.7577 Fax:(503)387.7615 New:
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: same as above
Structural plan review fee(or deposit):
Contact name:Deirdre Britt
FLS plan review fee(if applicable):
Address:
Total fees due upon application:
City/State/ZIP: — e )
Phone:( ) Fax::( i Amount received: X7571
E-mail:dbritt!a�stonebridgehomesnw.com
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:same as above Submit two(2)sets of roo Ilan with connection • .its
and fire department access, long with the t • Oregon
Address: Solar Installation Specialty ••e chec t.
City/State/ZIP: Permit Fee(includes pla• •view $180.00
and adminis W v- fees):
Phone:( ) Fax:( ) State surcharge(I 'o of permit --): $21.60
CCB tic.: 173318 Total fee due upon appTiC. ',• $201.60
Authorized signature This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: �Q.,,,� Date: ib *Fee methodology set by Tri-County Building Industry
Q�i ?JKI �� VI�'l`S Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(1l/02/COM/WEB)
Electrical Permit ApIR€Q 1€ IVED FOR OFFICE USE ONLY
Received (� /� r
Cllr W Tigard
Blvd., Date/By: b ��!a!5 Permit No.: 1 S�
a 13125 SW Hall Blvd.,'1'igardA#C s 2015 plan Review ;16,17.901S.7-400
I t: Phone: 503.718.2439 Fax: 503.39 196(1 Date/By: Other Permit:
TIGARD Inspection Line: 503.639 41 75 • P}r, I� D DateReady/Byt turfs PJ See Page 2 for
�� ��- Notified/Method Supplemental Ilemental Information
Internet: www tigard-or.gov 1 1
TYPE OF WORK PLAN IIE3'IEW
®Nett/cunsUuction ❑Addition/alteration/replacement
I'I,.r,t,l,:dk all dial (submit 2 seas of I lat .wil'erls,.pecked below).
❑Serwce of feeder 100 amps or mote ❑Building over!hie,:storks
❑Demolition ❑Other: where the available fault cutest ❑Marinas and boatyards.
CATECORY OF CONS Flt1 fl'ION exceeds 10,000 amps at ISO volts or ❑Floating buildings.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
® I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑ Multi-family ❑ Master builder ❑Other: ❑Fire pomp. ❑Installation of l 50 KVA or
-- -------- �, F��r r ▪Emergency system, larger separately derived system,
{On SITE li'4'I'OJV'sL%'I'iON AND LOCATION _" ',C, fr ❑Addition of new motor load of ❑"n" 'E" I-2" 't-3"
` 1001IP or more, occupancy.
Job no.: 19p6r� I Job site address:' 62.12SwtHAk-Vt is VIEHVr#S• 0 parks.
I I ❑Six or more residential units, p�
City/State/ZIP:Tigard,OR 97224 ❑Health-care facilities ❑Supply voltage for more than
❑l lazardous locations, 600 volts nominal.
Suite/bldg./apt,no.: Project name:Southview Heights ❑Service or feeder 600 amps or more.
fie'- :.:s 4 •-elT r6 7,,
Cross street/directions to job site:SW 1220 Ave&SW Beef Bend Rd Descry lion 1103211® Mal •
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision:Southview Heights 1 Lot no.: 2 1,000 sq.ft,or less J 168-54 4
11 • Ea add'I 500 sq.ft,or portion ,_/3 33.92 I
Tax map/parcel no.: ,. Limited energy,residential
`. '..c:k r 4= $'
(with above sq.IL) 1 75.00 2
Limited energy,surfs-funily
_.. _._ _.. 7500 2
new,single family residence residential(with above sq.IL)
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
200 amps or less 100.70 2
201 amps to 400 amps 133.56 2 '
Name:Stone'Bridge'Homes NW,"L.LC 401 amps to 600 amps 200,34 2
•
Address:4230 Calewood St,Suite 100 601 amps to 1,000 amps 301,04 2
Over 1,000 amps or volts 552.26 2
City/Stale/ZIP:Lake Oswego,OR 97035 Temporary services or feeders installation,alteration,and/or
Phone:(503)387.7577 Fax:(503)387.7615 relocation
2(10 amps or less 59.36 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 168.54 2
Owner signature: Date: Branch circuits—new,alteration,or extension,Rer panel
® APPLICANT? 6,, 4 . A_Fee for branch circuits tfee,
�'' ,w � £ above service or feeder fee,
7,42 2
Business name:same as above each branch circuit
B.Fee for branch circuits without
Contact name:Deirdre Britt service or feeder lee,first 56,18 2
brands circuit
Address: Each add'I branch circuit 7.42 2
City/State/ZIP: Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 12
Phone:( ) Fax: :( ) dwelling,service and/or feeder
Reconnect only 67,84 2
N-nma11 dbr•itt(ostonebridgehnniesnw•com Pump or irrigation circle 67,84 2
C'ON TR tc l'OIt Sign or outline lighting 67.84 2
Business mane:City Electric Signal ciicuit(s)or limited-energy Sec
panel.alteration,or extension. Page 2
Address:55568 SW Schaltenbrand Ln Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
City/State/ZIP:Sherwood,OR 97140 Investigation(I hr min) 66,25/hr
Phone:(971)404.1714 Fax:(503)625.3052 Industrial plant(1 hr mill) '78.18/hr
Inspections for which no fee is
CCB Lie.: 42422 Electrical Lie.: 26-289C Suprv. Lie,: 35925 specifically listed(V1 hr nun) )0 00/hr
- - -- – ELECTRICAL PERMIT FEES
Suprv. Electrician signature,required: en.-2_,...., — tinhlotal
Print name: Chuck Friesen Date:
Plan review(259 of permit Ice):
.__.._ _....._.__... �..._
Slate surcharge(12%of permit lee):
Authorized signature: TO'rn1.PERMIT III
... .......................
Print name: L)atc: 'fhis permit:q)plirgion expire,if a permit is nut;"btaincd,r;iId"1 80
days after it hors been accepted as complete.
• Number of inspections allowed per permit
I lltuitriinciK imitM-t.t' 'rn"ii,Ary 1.1,14, PRIG.,ku Rev+rif?t/?41.1 .I•fu lt.t51311A)5/eomiwi tt
. _
_P E,` '°�/ED
1
Mechanical Permit Applici,tjor 6 2015 FOR OFFICE USE ONLY
City of Tigard G a"ei�"I `
Date/11y: i- _ :�J Permit No ,�,//'�r�L���`C)Gf�S
p 13125 SW'I loll I31vd.,'I'igard�l�tL7�?3.'TIGARD
pp Y t i J
i 0 2439 Fax: c 1960 '�hn� Plan Review Other Permit:
Phone: SU3.718,243) 503.5)ILll6U +)fia {f1(;l Date/Ily:
TIGARD Inspection Line: 503.639.4175 Date Ready/By. Jnris: ® See Page 2 for
Internet: www.tigard-or.gov Nutilied/Method Supplemental Information
I YPE: OF 1'.'Ottti COMMERCIAL FEE*,SCHEDULE - USE C t1ECKLIST
-' —" Mechanical pcnnit fees*are based on the value of the work
®New construction ❑Addition/alterationireplacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,e9uipment,labor,overhead,and profit.
Value b i
: , W gf w ,t , " R to °r i RESIDENT1\LEQLIIPMENTISYSTEMS FEES*
-
® I-and 2-tbmily dwelling III Commercial/industrial ❑Accessory building For special information use checklist.
❑ Multi-family ❑Master builder ❑Other: Description I Qty. 1 Fa. I Total
s:' -.t +- ;! i , ter ep 20 .;°: I lea ling/cooling:
�� 'as 4 °.,1'r. ." IIa ' _.3 �,-,, Air conditioning 46.75
lob site address: 15212 cw l4�V n S V I By �V�, Furnace 100,000 BTU(duets/vents) 1 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000-F BTU(dlrcts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: ( Project name:Soutliview Heights Duct work 23.32
Cross street/directions to job site:SW 122nd Ave&SW Beef Bend Rd Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32 ,
.- Unit heaters(fuel-type,not electric),
,�,,,,,w,,. in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any,of above _ 23.32
Other: 23.32
Subdivision:Southview heights 1 Lot no.: Z -
Other fuel appliances: ...
Tax map/parcel no.: Water heater 1 23.32
Gas fireplace/insert 1 33.39
f .. l,..-._ Flue vent for water heater or gas
new,single Amity 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
— Other: 23.32
Environmental exhaust and ventilation:
Name:Stone Bridge Homes NW,LLC Range hood/other kitchen t
eqipment 1 33.39
Address:4230 Galewood St,Suite 100 Clothes dryer exhaust 1 33.39 I
City/State/Z_1P: Lake Oswego,OR 97035 Single-duct exhaust(bathrooms,
toilet comrartments,utilit rooms 23.32
Phone:(503)387.7577 Fax:(503)387.7615 Attic/crawlspace fans 23.32
® APPLICANT 0 LON'Tic f PERSON .Other: 23.32
Fuel piping:
Business name:same as above
55t4.15 fur first four;5.1,03 for each additional
Contact name: Deirdre Britt Furnace,etc. 1
Address: Gas heat pump
. Wall/suspended/unit heater
City/Stale/ZIP: Water heater I
Phone:( ) Fax::( ) Fireplace I
Range
F-mail:dbritirnistonehridgehomcsnw. llancecuc
C UNTIL C1'OR Clothes dryer(gas) I
(bier:
Business name:Comfort Zone
------- .IECI1.ANIC.. L PERMIT FEES*
Address, 1032 NW Corporate Dr Subtotal
City/Slate/I.IP.Troutdale,OR 97060 Minimum pcnnit fee('590.00)
- Plan review(25%of permit lee) I
Phone:(503)667.5595 Fax:(5113)491.8252
State surcharge(12%of pcnnit fee)
CCII lie.: 110091 TOTAL PERMIT FEE
�.__..._._—....._..___ —_._...-._ This permit application expires if a permit is not obtained within ISO a
Authorized signature: �'`��'''� -C --
days after it has been accepted a s complete. '
E c �—" ^^^^— Fee nwllmxkduEy set by 1'ri-('sxrnty Budding Wooly ticrvicc Uuanl s
IPrint name:David Ilekisial) I Date; 1
I lnu,riurykretw so,tl.t'.S iiiiidpp udri iit;h.: •I:Il1•11,I TI(t t/n2/('1Mt/Wtill) #•
i
• riECRVED
Plumbing Permit Application
Building Fixtures AUG 2 6 2015 FOR OFFICE USE ONLY
MilCity of Tigard F �✓' f !`%/y�D Dalr!Ov: •ii��1 ` Pumii Nn.: ��j'�yJS Gl�lS
a
13125 Sly flail Blvd.,Tigard,i3R 97Y ��V(S{QN I'I:m Itcvic
Phone: 503.718.2439 Fax: 503.598.1960 Dale/By. Oilier Permit No
TIGARD Inspection Line: 503,639A175 Dale Ready/11y: ions, 0 See Page 2 for
Internet. www.tigard-or,gov Noliticd/Method: Supplemental Information
'-' �i �1YPE-OFD WORT "� 4, FEE* SCHEDULE
-
®New construction ❑Demolition For special it ura:ariurl use checklist
r scription I City, I Ea. I Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utilit connection)
c= -tc ! ! ( ' ' '..�; SFR(1)bath 312.70
® I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath i 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other:
Fire sprinkler( sq.ft,) Page 2
' . !- . , 4 ' 11 ! ! _ Site utilities:
. '. - . q= swaa; �.. -
Job site address: 15212 SM/ N/tR.V N S V I Hull A-VG. Catch basin or area drain 18.76
Urywell,leach line,or trench dram 18.76
City/State/ZIP:Tigard,OR 97224
Footing drain(no.linear II.:_) Page 2
Suite/bldg./apt.no.: I Project name:Southview Heights Manufactured home utilities 50.03
Cross street/directions to job site:SW 122°Ave&SW Beef Bend Rd Manholes 18.76
Rain drain connector I 18.76
Sanitary sewer(no.linear ft.:h Page 2
Storm sewer(no.linear ft.:J . ) Page 2
Water service(no.linear ft.:)n Fy ) Page 2
Subdivision:Southview Heights I Lot no.: 2, Fixture or item:
Tax map/parcel no.: Hacktlow preventer 31.27
a ' - Backwater valve ) 12.51
. tr' H ..... ,,,. -.. 11`� : !. ! ! 41 Clothes washer ,
I 25.02
new,single family residence Dishwasher I 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
# e ' !1`d I - Expansion tank 12.51
Name:Stone Bridge Homes\W,LLC
Fixture/sewer cap 25.02
Floor drain/toor sink/hub 25.02
Address:4230 Galewood St,Suite 100
Garbage disposal J 25.02
City/Statc/ZiP: Lake Oswego,OR 97035 Hose bib 25.02
�
Phone:(503)387.7577 Fax:(503)387.7615 Ice maker ' 12.51
�. , i v`. : Interceptor/grease trap
2502
Business name:same as above Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Deirdre Britt
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory SJ 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) I Fax::( ) Tub/shower/shower pan J 12.51
Is-maiI:dhritt(a))stonehridgehomcsnw.com Urinal 25.02
K_ s 1e - Water closet 3 25.02
Walcnccalcr I_ 37.52
Business name: Max Plumbing IN C"
/ Water pipinJDWV 51.29
Address: PO Box 5597 Other: 25.02
City/Stoic//-II': Beaverton,OR 97006 Subtotal
._- _ Minimum permit lee' 1,72 50
I'hunc (971)275.0198 _
1'ae:( )
._ �s Q3
Ilan review (251 of permit fee)
(C 13 Lie.: ZOrJJ9'L, Plumbing Lie.no.: `g 158 -----
____.__ State surcharge(I2,n of pernul lee)
Authorized signature: _�■ rt)'rnl.Platnn I H:F
i Print name:Jason HRrxner Dale: 1 phis permit appticalion cvpire>if a permit is unl obtained aithiu IRO days
1 after it has been accepted as complete.
"Per melhndulup SCI h■ fn-tlnmiv Rmldior hrdu;u■ Sc, 1,c Ruud
I ln,ia;5 e,i cnno.:Pl t`Il-Von•.i I'l'doe Iwi;IR! 4.l".401o0 i l''/0(1)D:UwFm)
ill City of Tigard
s
COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review — Residential
1111 1
Building Permit #: .ra-.0(c-0U1 Sc
Site Address: /S-la c ?t r ) /�N Vi-ao ,4-e
Project Name: S---)01,t.)/-Avr;ea ,, �, Lot #:
(New dwelling=subdivision name; di on or Alteration=last name of owner)
Planning Review
Proposal: Al ) S �
/Verify site address/suite# exists and active in permit systee .
Miver Terrace Neighborhood: ❑ Yes M No
Sit Ian Elements:
ee(3)copies of site plan 1i� �. : structures on site
)(plan must 12g on 8-1/2"x 11"or 11 x 17"paper II ootprint of new structure(including decks)with finished
!l b wn to scale(standard architect or engineer scale) fl.,; elevations
1yY' arrow I I tility locations(required for new,may apply for additions)
address,project or subdivision name and lot number I. ..' ation of wells/septic systems
plicant information(name and phone number) V rosion control(including drainage-way protection,silt fence
N • dimensions and building setback dimensions , sign,location of catch basin,etc.)
U •t area,building coverage area,percentage of coverage and 5tteet names
im rvious area(applicable if R-7,R-12,R-25&R-40) V et tree size,type and location
perty corner elevations(2 foot contour lines if more than xisting trees to be retained with drip line,and tree
ro e
4 foot differential) protection measures
/41ean Water Services–Service Provider Lette of platted prior to 9/10/1995):
/Required: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No
IV Public Faciliti(Improvement(PFI)Permit
quired: � Yes,applicant was notified ❑ No Applied For. B Yes ❑ No,stop intake
E d Use Case#: 3� e)000t�
lid' oning•. –
retbacks: Front /S Rear 7S Side Street Side /D Garage QO
ndscape Requirement: 02() %
Coverage Maximum: 00 %
S ding Height: Maximum Height S / Actual Height (2' /(0 "
ve Visual Clearance
✓ sements
i t
len sittve Lands: ❑ Yes ❑ No Type
ban Forestry Plan
Conditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: — – „; I` Date: a:07/.
Revisions (after Building Submittal only) Reviewer Dite
Revision 1: ❑ Approved ❑ Not Approved _
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
1:\Buil ding\Fonns\BldgPermitRvw_RES070915.doc x
Building Permit Submittal
Original Submittal Date: 1 ,RO ri-
Site Plans: #
Building Plans: # `3
Building Permit#: Er Enter building permit#above.
Workflow Routing: .0 Planning 2"Engineering .12-"Permit Coordinator 16 Building
Workflow Sign-off: 2 Sign-off for Planning(include notes from planning review)
Route Application Documents: El Engineering: (1)copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
e Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc./ f�
Notes: l' ,0_L1, . ♦ 1 -Wloi r�O/ 2O 2 / 7r & veti.cs•4I.
By Permit Technici. dr`, ,, ,__ Date: T P-lp s-
//
E,,�SI n��gineering Review
LG a at building pad:
LdC ditions "Met"prior to issuance of building permit
Easements (encroachments)per engineering conditions of approval and plat
.'ater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes No
Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No
LIDA Facility on lot: ❑ Yes ❑ No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: 1-z "7 Date: - -
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions"Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
.evision Notice 1: Date Sent to Applicant:
levision Notice 2: Date Sent to Applicant:
?Pvision Notice 3: Date Sent to Applicant:
SIC Fees Entered: Wash Co Trans Dev Tax: aYes ❑ N/A
Tigard Trans SDC: 0 Yes �N/A
Parks SDC: Yes ❑ N/A
OK to I;sue Permit /
Approved b) Permit Coordinator: , Date:
.1/261/ C
I:\Building\Fonns\BIdFPermitRvw REs 070915.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
15212 SW HARVEYS VIEW AVE, TIGARD, OR,
97224
Residential - Master Permit
699 Mechanical final
FAIL
MST2015-00155
David Young
Microwave fan not working, sounds like vent stuck, fan not operational.
Seal penetration at foundation block out to underfloor.
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
15212 SW HARVEYS VIEW AVE, TIGARD, OR,
97224
Residential - Master Permit
699 Mechanical final
PASS
MST2015-00155
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
15212 SW HARVEYS VIEW AVE, TIGARD, OR,
97224
Residential - Master Permit
299 Final inspection
FAIL
MST2015-00155
David Young
Provide approved mechanical final inspection.
Provide approved plumbing final inspection.
Deck lateral bracing not per approved plans.
Note: no AC installed at time of final inspection, permits required at time of installation.
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
15212 SW HARVEYS VIEW AVE, TIGARD, OR,
97224
Residential - Master Permit
199 Electrical final
PASS
MST2015-00155
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
15212 SW HARVEYS VIEW AVE, TIGARD, OR,
97224
Residential - Master Permit
399 Plumbing final
FAIL
MST2015-00155
David Young
Hard cap unused rain drain stand pipe.
Clean outs need approved thread sealant. 316.1
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
15212 SW HARVEYS VIEW AVE, TIGARD, OR,
97224
Residential - Master Permit
399 Plumbing final
PASS
January 29, 2016 at 8:32:50
AM
MST2015-00155
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
15212 SW HARVEYS VIEW AVE, TIGARD, OR,
97224
Residential - Master Permit
299 Final inspection
PASS - C of O
MST2015-00155
David Young
Corrections complete.
Final erosion control approved.
Street tree certification received.
Moisture content form received.
High efficiency lighting form received.
Blower door test report checked.
Insulation certification checked.
C of O left on site with contractor.
Note: no AC installed at time of final inspection, permit and inspection required at time of
installation.
Violation Summary:
Inspector Contractor