Permit CITY OF TIGARD MASTER PERMIT
N , ,,
N
COMMUNITY DEVELOPMENT Permit#: MST2015-00114
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/21/2015
t I�'' t'n g Parcel: 2S102CA00600
Jurisdiction: Tigard
Site address: 9736 SW ASHWOOD ST
Subdivision: FREWING'S ORCHARD TRACTS Lot:
Project: Ashwood Estates, Lot 7
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1198 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24.5 Bathrooms: 3 Second: 1347 sf Garage: 449 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2545 sf Value: $310,981.83 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
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 5
Fum>=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'I 500 at 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:
DEM SF VB R-3 2545
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: $22,867.56
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. ..;.OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued B • Permittee Signature: 4—x......_
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
'Building Permit ApplicatRECEIVEP
Residential FOR OFFICE USE ONLY
JUN 3 0 2015 Received I
City of Tigard
Date/By. 6/41/6 r' Permit Na
" 13125 SW Hall Blvd.,Tigard,O (I /� Plan Review 1p) t/61-c �S�it7/
Phone: 503.718.2439 Fax: 50��1 6NFTIlIAI� Date/By:
(�/�Z/�5
Other Permit:6%o�(}/r 74/
TI G A R D Inspection Line: 503.639.41713UILDING DIVISION Date ReadyBy: p// Q ��� Julie ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method G: / ✓ • Supplemental Information
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
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1-and 2-family dwelling ❑Commercial/industrial Valuation
❑Accessory building El Multi-family
Number of bedrooms: 4.1
❑Master builder ❑Other: Number of bathrooms: a.5
JOB SITE INFORMATION AND LOCATION Total number of floors: a
Job site address: Lt1 '3 Co S' AsµW00 ST New dwelling area:354 s square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: 4 Li ci square feet
4elii#4d Suite/bldg./apt.no.: Project name:Ashwood porch 9 1,,, square feet I 347
Cross street/directions to job site: Deck area: square feet tile,
Other structure area:'2 square feet ,`-
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 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 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 Stel 171 Occupancy groups:
City/State/ZIP:Lake Oswego,OR 97035 Existing:
Phone:(503)657-3402 Fax:( ) New:
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:JTSC,LLC
Structural plan review fee(or deposit):
Contact name:JohnWyland - - —
FLS plan review fee(if applicable):
Address:5285 Meadows Rd Ste.171
City/State/ZIP:Lake Oswego,OR 97035 Total fees due upon application:
Phone:(503)209-7555 Fax: :( ) Amount received: 47�'C r
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 cone.•.n details
and fire dep. . ent access,along wi . e 2010 Oregon
Address:5285 Meadows Rd.Ste 171 Solar Installat. Specialty Code • ecklist.
City/State/ZIP:Lake Oswego,OR 97035 Permit Fee • eludes • review $180.00
and a• •• strative fees):
Phone:(503)657-3402 Fax:( ) State Burch. _- (12%of. -. it fee): $21.60
CCB lie.:200237 Total fee due upon application. $201.60
Authorized signature: This permit application expires if a permit i of obtained
within 180 days after it has been accepted as complete.
f ( *Fee methodology set by Tri-County Building Industry
Print name:John Wyland Date: bf 3 a Service Board.
I:\Building\Permits\BUP-RES itApp.doc 02/24/2011 440-4`613T(11/02/COM/WEB)
I P ...,,,. . : : .„ . . . ..
Electrical Permit ApplicaaCtiVt OR 0E11( I.t.51:()NA
City of Tigard Received �
Dale/B `J �.Li Permit NO STo9 II I/.. :
• 13125 SW Mall Blvd.,Tigard,OR 97 N 3 O 2015 Plan Review
fi Other Pemut. /5- 7 4
_1 Phone: 503.718.2439 Far: 503.598. 60 Datc/B : 6 �
Inspection Line: 503.639.4175 Date Read B kris' 21 See Page 2 for
t�� -... - p %I IaGAR Ready/By: g
�,q Internet: wow ttgard or govg �1�I Notified/Method: Supplemental Information
. K.y�`_.']?` T* ,4 - S r4�33 _ .� i.'t .do-,'_..:.;w.`3't !3i' ,.
2 �; ... is
®New construction El Addition/alteration/replacement
Please check all that apply(submit 2 sets of plans w/iteins checked below):
❑Service or feeder 100 amps or more ❑Building over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
4'ATE4'i61 Y c OQNSTRUCTIQ exceeds 10,000 amps at 150 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 pump. ❑Installation of 150 KVA or
❑Emergency system. larger separately derived system.
JOB,SZTeiNtilR R 0R�}1k 1110, . ,4',X*1160. ❑Addition of new motor load of ❑.•A" "E^ „1-2^ .'1_]„
Job no.: Job site address: '134 SW 1UUor or more. occupancy.
as N wood sT 0 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.: I Project name• AS-Ioppo s-E AT es ❑Service or feeder 600 amps or more
Cross street/directions to job site: Description I O__ I Fee. I 'rota' I "
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: 1 Lot no.: :
1,000 sq.ft.or less 1 168.54 4
Ea.add'1 500 sq.ft.or portion .C- 33.92 1
Tax map/parcel no.: Limited energy,residential 75.00 2
DESCKU'TION OF"WORK "? (with above sq.0.)
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
200 amps or less 100.70 2•®rP+RQ'ERTY' —"•.QWNER 1 ❑ TENET-.. _: 201 amps to 400 amps 133.56 2
Name: ` L. 4 i L L G 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 I 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. 40I amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits-new,alteration,or extension,per panel
a A.Fee For branch circuits widr
• ,j 0,�Q�LtiT _ I ,.,. ® COLVT,�.iL�P�RSt�Pj _ .. above service or feeder fee,
Business name:JTSC,LLC each branch circuit 7.42 2
B.Fee for branch circuits without
Contact nam Sp l\N V.1/LA ND service or feeder fee,first 56.18 2
branch circuit
Address:5285 Meadows Road Suite 171 Each add'I branch circuit 7.42 2
City/State/ZIP: Lake Oswego,OR 97035 Miscellaneous(service or feeder not included)
Each manufactured or modular
67.84 2
dwelling,service and/or feeder
Phone:(503) 'lock -7 5 5 5 I�tte: :( ) -
Reconnect only _ 67.84 2
E-mail: ) r„J y latn d e J +S rn t k' h e n C 4 rn Pump or irrigation circle 67.84 2
`-'-q c f 'a,,}tat r yr> e t �`.':a r,�,,t�C'�`Q ..7 i .::
,.,,-. , .... .. A�'+� ,. ;"`' +,; :. '. Sign or outline lighting 67.84 2
Business name: *tint/.0 y1 Signal circuit(s)or limited-energy See
_ �Ypanel,alteration,or extension. Page 2 2
Address: I AO nboiewadct t , 3 J/- Each additional inspection over allowable in any of the above
Pl. t t5 J'_ !` " 07 ) Additional inspection(I hr min) 66.25/hr
City/State/ZIP: e V'/Y1
Investigation(I hr min) 66.25/hr
Phone:(%+}3) q�_ Fax:��. (p4.2- WI Industrial plant(I hr min) 78.18/hr
I Inspections for which no fee is
CCI3 Lie.: /c2//5c1 Electrical Lie.: / # pr ,1:'c: Sri U/C' _specifically listed(/=Iir min) 90.00/hr
e s ELEECTRICAL- 1 FEES':
Suprv. Electrician signature,required: 1.. Subtotal:
Print name: Lj ,Qi2 / 41 Date: s Plan review(25%of permit fee): _`
• ` �/r State surcharge(12%of permit fee):
Authorized signature: :4" •,• TOTAL PERMIT FEE:
C Ij�t t (j 6.4u/ — 'Phis permit application expires if a permit is net obtained within 180
Print name: fr 1,tl, ,-y} Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
\Ruitding:Permits.ELCPermiuApp ELREREdoe Rev 05/21/2013 6 445-iCi5T1It/OVCOAVIVEli
Mechanical Permit Applicati(ECEIVEP FOR OFFICE USE ONLY
Received (f
NI City of Tigard Date/By: eC / Permit No.: 47-�7,../S'c6//
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review �v
a Phone: 503.718.2439 Fax: 503.598.1960 JUN 3 0 2015 ° Permit: 6w rL ant S- ` l')7L/
Date/By:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: turfs- B See Page 2 for
Internet: www.tigard-or.gov CITY OFTIGARU Notified/Method: Supplemental Information
TYPE OF VakkOING DNISIOL� COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
CO 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*
® I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description I Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Job site address: Air conditioning 46.75
°t'13 G 5\ psv W00 0 S-T Furnace 100,000 BTU(ducts/vents) ( 46.75
City/State/ZIP: 1-, 4ARD / o R 41 0,1$ Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldgiapt.no.: Project name:Ashwood 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: Lot no.:�-
Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 1 23.32
DESCRIPTION OF WORK Gas fireplace/insert 1 33.39
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 ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name:LF 4,LLC Range hood/other kitchen
equipment I 33.39
Address:5285 Meadows Rd Ste 171 Clothes dryer exhaust 1 33.39
City/State/ZIP:Lake Oswego,OR 97035 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) t 23.32
Phone:(503)657-3402 Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT ❑ CONTACT PERSON Other: 23.32
Business name:JTSC,LLC
Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:JohnWyland Furnace,etc.
Address:5285 Meadows Rd Ste.171 Gas heat pump
Wall/suspended/unit heater _
City/State/ZIP:Lake Oswego,OR 97035 Water heater
Phone:(503)209-7555 Fax::( ) Fireplace 1
Range
E-mail:jwyland @jtsmithco.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Integrity Air,LLC Other:
MECHANICAL PERMIT FEES*
Address:7301 SW Kable Ln Ste 500 Subtotal
City/State/ZIP:Portland,OR 97224 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)572-3594 Fax:( ) State surcharge(12%of permit fee)
CCB lic.: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: '���(,
I1 6ui1dineermitsMEC_PermitApp_040113 ce 440 617T(1I/01JCOM/WEB)
Plumbin Permit A lica ' COVED vsig
Building Fixtures FOR OFFICE USE ONLI
City of Tigard Received 60 / No5raa s Ob Il5/
LL 1l��,,11 c Date/By: Permit No.:
• 13125 SW Hall Blvd.,Tigard,OR 9'41M 3 O 2015 1�
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 ((� Date/By: Other Permit No.: 1 .aeu 5.---C45$750/
I l G A R D Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Juris H See Page 2 for
Internet: www.tigard-or.goV � �DIVISION Notified/Method: Supplemental information
TYPE OF FEE* SCHEDULE
®New construction ❑Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)_
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
® 1-and 2-family dwelling El Commercial/industrial SFR(2)bath 437.78
❑Accessory building ❑Multi-family SFR(3)bath 3 500.32
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: CM 3 Co 3t,6 Q S 14 woo D ST lo Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97223 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name:ASHWOOD Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:24 ) I Page 2
Storm sewer(no.linear ft.: 2C) I Page 2
Water service(no.linear ft.: 2() I Page 2
Subdivision: I Lot no.: 7 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Plumbing for new single famiy residence Clothes washer 25.02
Dishwasher I 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name:LF 4,LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:5285 Meadows Rd Ste 171
Garbage disposal I 25.02
City/State/ZIP:Lake Oswego,OR 97035 Hose bib 2 25.02
Phone:(503)657-3402 Fax:( ) Ice maker 12.51
® APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:JTSC,LLC Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:John Wyland
Roof drain(commercial) 12.51
Address:5285 Meadows Rd.Ste 171 Sink/basin/lavatory S 25.02
City/State/ZIP:Lake Oswego,OR 97035 Solar units(potable water) 62.54
Phone:(503)209-7555 Fax::( ) Tub/shower/shower pan 3 12.51
E-mail:jwyland @jtsmithco.com Urinal 25.02
CONTRACTOR Water closet 3 25.02
Water heater 37.52
Business name:The Mullen Co.dba Edward Mullen Plumbing Water piping/DWV 56.29
Address:1601 SE River Rd Other: 25.02
City/State/ZIP:Hillsboro,OR 97123 Subtotal
Phone:(503)640-0113 Fax:( ) Minimum permit fee: $72.50
CCB Lic.:92689 Plumbing Lic.no.:
Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name:John Wyland Date: t,(3 Q 15. 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 Service Board.
I\Building\Permits\PLMU-PermitApp.doc 10/ 1/09 440-4616T(10/02/COM/WEB)
14 City of Tigard
■
COMMUNITY DEVELOPMENT DEPARTMENT
T I G A R D Building Permit Review — Residential
Building Permit #: H T26/ 5 - Od l 141 °J- 6.0a00/s---.00071.1
Site Address: =�3e3(!:. J ,I(4 oci -3-/-
Project Name: /*`jk - /e c Lot #: _
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review /,
Pro osal: /l,/e4() & -- 'h// 72.62SA �N
VVerify site address/suite# exists and active in permit syste.
1miver Terrace Plan District: C] Yes LVJ No
Sit: lan Elements:
►. P ree(3)copies of site plan : 'sting structures on site
!A S. e plan must lle on 8-1/2"x 11"or 11 x 17"paper n Footprint of new structure(including decks)with finished
It I awn to scale (standard architect or engineer scale) bor elevations
It .rth arrow Utility locations(required for new,may apply for additions)
lP . e address,project or subdivision name and lot number of wells/septic systems
plicant information(name and phone number) n Erosion control(including drainage-way protection,silt fence
r .t dimensions and building setback dimensions sign,location of catch basin,etc.)
I. .t area,building coverage area,percentage of coverage and Xreet names
pervious area (applicable if R-7,R-12,R-25&R-40) (ltSyeet tree size,type and location
Property corner elevations(2 foot contour lines if more than Utxisting trees to be retained with drip line,and tree
4 foot differential) _ protection measures
Nitiftlean Water Services-Service Provider Lette (lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified V No Received: ❑ Yes ❑ No
M Public Facilit<Improvement (PFI) Permit:
equired: ® Yes,applicant was notified ❑ No Applied For: es ❑ No,stop intake
wilt
nd Use Case #: ' , � JL71. o 3o
/Zoning: - Li-
II
,,_, Setbacks: Front Rear 6— Side Street Side Garage C t
Ci andscape Requirement: AIM %
11'• of Coverage Maximum: % / II/` /�
L! Building Height: Maximum Height go Actual Height (Q41 te"
IV Visual Clearance
&/) sements /
tdif
'.ensitive Lands: ❑ Yes 6 No Type
1G Urban Forestry Plan
❑ Conditions "Met"prior to issuance of buil g permit
Notes: a Cyla 11 .14) % /7(`.-)f- *7 itSS4,62/lei t ,
6'zirlei Ts Approved By Planning: _.� Date: 1 _S_
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: 6 3L)l 1 S Site Plans: #
Building Plans: # 3
Building Permit#: [ Enter building permit#above.
Workflow Routing: Planning EL—Engineering ❑Permit Coordinator ' Biding
Workflow Sign-off: Q —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.
uilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: 50// S
0
En§neering Review
Lit Sl pe at building pad: .`r]
'Conditions "Met"prior to issuance of building permit
I?YIa ements (encroachments) per engineering conditions of approval and plat
L(JJ(Flater Quality/Quantity Facility: ��
Assess Water Quality Fee in-lieu: ❑ Yes U N
Assess Water Quantity Fee in-lieu: ❑ Yes N��
LIDA Facility on lot: ❑ Yes L9'No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: ,4/ 17 Date: 7,Z-/5
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved El Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit l
Approved,NOT Released: (m....i.�`� - S Date: 9-! V.
r�
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:
4a K to Issue Permit - /
Approved by Permit Coordinator: 0 Date: 3/3/a
I:\Building\Forms\B 1dgPermitRvw_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
114 ■ Transmittal Letter
etter
i i i 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: CI k-y O c T c 9Q,-1 DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
FROM -
�AN�LLB _ U�.1 a. <) JUL JUL 2 2 2015
COMPANY: 07 S M IT H Co (v4 pp IQ ( rS CITY OF TIGARLI
PHONE: 5Q3- Cp5`) - q oa BUILDING DIVI.VN
RE: c , S1l:AsHWOOO ST -T1GARD, OR pisT 0t5- OOIIy
(Site dress) (Permit Number)
AsHwooO S7ATF; LO r -
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: I Copies: Description:
Additional set(s)of plans. 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:
FOR 0 FICE USE ONLY
Routed to Permit Technici. • Date: (.. • EN
Fees Due: • Yes I!'o Fee Descri s tion: Amount •ue:
.A: $
tit $
A _,
., 1 ` L
?' .._• itit ,1 ` R ;t• $
Special
Instructions:
Re Print Permit .er PE : ❑ Yes ❑No • Done
A, •licant Notified: Date: Initials:
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
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
9736 SW ASHWOOD ST, TIGARD, OR, 97223
Residential - Master Permit
699 Mechanical final
PASS
MST2015-00114
David Young
No AC installed at time of final inspection.
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9736 SW ASHWOOD ST, TIGARD, OR, 97223
Residential - Master Permit
199 Electrical final
FAIL
MST2015-00114
David Young
Install lights in master hanging by wire nuts.
All else ok.
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
9736 SW ASHWOOD ST, TIGARD, OR, 97223
Residential - Master Permit
199 Electrical final
PASS
MST2015-00114
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
9736 SW ASHWOOD ST, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
FAIL
MST2015-00114
David Young
Provide grade away from house right side. R401.3 rear also.
Provide city required documents for final inspection.
Seal ceiling penetration in garage at duct penetration, insulation pulled down from
ceiling.
Remove obstruction from egress window upper level.
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
9736 SW ASHWOOD ST, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
FAIL
MST2015-00114
David Young
Grade not fixed per code as noted on previous inspection. Back and right side.
Standing water at back foundation, water entering foundation vents.
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
9736 SW ASHWOOD ST, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
FAIL
MST2015-00114
David Young
House locked, no access for inspection.
Grading for slope away from house not done right side as noted on previous final
inspection, no access to check final grade at rear.
Provide access for inspections.
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9736 SW ASHWOOD ST, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
PASS - C of O
MST2015-00114
David Young
Note: provide missing vent well at left rear foundation vent with ground grade at vent
opening level.
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 at kitchen counter.
Violation Summary:
Inspector Contractor