Permit p CITY OF TIGARD MASTER PERMIT
a ' COMMUNITY DEVELOPMENT Permit#: MST2015-00115
T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/05/2015
Parcel: 2S 102CA00600
Jurisdiction: Tigard
Site address: 13402 SW BARNUM DR
Subdivision: FREWING'S ORCHARD TRACTS Lot: 18
Project: Ashwood Estates, Lot 8
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: 25 Bathrooms: 3 Second: 1347 sf Garage: 689 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2545 sf Value: $321,359.36 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
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: 5
F urn>=100 K: 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'I 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 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: $22,622.16
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. AT egon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-00 010 through OA 952- -0 90. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1 8001.2.2
Issue By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completi•. • • e project.
Approved plans are required on the job site at the time of each inspection.
RECEIVE')
' Building Permit Application
Residential JUN 3 0 2015 ` FOR OFFICE USE ONLY
• Received
City of Tigard ' Y OF TIGARD Date/By. /34) //S Permit No.: � T !5.60/iS
13125 SW Hall Blvd.,Ti ard,O' ^r((f
'� e M g a INC DIVISION Date/By.e /I f Other Permit e
Phone: 503.718.2439 Fax: 50 � � ) 9 IV S--tom 7
I I G A R D Inspection Line: 503.639.4175 Date ReadyBy: Juris: El See Page 2 for
Internet: www.tigard-or.gov Notified/Method: /Jd/5 Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
New construction El Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
El Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1-and 2-family dwelling El Valuation:Commercial/industrial 3.1 ,35 -$U 4 � TFFJ
El Accessory building El Multi-family Number of bedrooms:
El Master builder El Other: Number of bathrooms-5,
JOB SITE INFORMATION AND LOCATION Total number of floors: 2_
Job site address: iS 4 0 a 3W R Nu M OR New dwelling area: 254 5 % square feet3�3
City/State/ZIP:Tigard,OR 97223 Garage/carport area: 6g 9 square feet
Suite/bldg./apt.no.: Project name:Ashwood Covered porch are' — square feet 21 7
Cross street/directions to job site: Deck area square feet i 9 8
Other structure area: square feet r
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I Lot no.: / 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 El 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 El 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
Total fees due upon application:
City/State/ZIP:Lake Oswego,OR 97035 },75-z.) C
Phone:(503)209-7555 I Fax: :( )
Amount received: `TD
E-mail:jwyland @jtsmithco.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel Syst- .
Business name:JTSC,LLC Submit wo(2)sets of roof plan with connec': details
and fire de ent access,along with 010 Oregon
Address:5285 Meadows Rd.Ste 171 Solar Installan S,ecialty Code -cklist.
City/State/ZIP:Lake Oswego,OR 97035 Permit Fee(i d . an review $180.00
and . t ative fees):
Phone:(503)657-3402 Fax:( )
State surc . ge(12%of pe ' fee): $21.60
CCB lic.:200237
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is I t obtained
within 180 days after it has been accepted as complete.
Print name:John Wyland Date: b 30 i-1 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESP itApp.doc 02/24/2011 440-4 13T( 1/02/COM/WEB)
Pr
Electrical Permit Ass I heat',L cEIVE 1(tl;Ut I It I t S1 O i
L. R«etvea
City of Tigard / permnNo.:
j f . 13125 SW Hall Blvd.,Tigard,OR 97223 Date/B /. i ,_I E frpu "Cb j
g Plan Review _
.. _ Phone: 503.718.2439 Fax: 503.598 Date/B : Other Permit:.. la•O 5— j 7 ,
Inspection Line: 503.639.4175 JUI 3 0 2015 Dale Read/B Iuris:
i 1 G�y K 13 P Ready/By: El See Page 2 for
Internet: www.tigard-or.gov / Notified/Method: Supplemental Information
10 New construction ❑.�dll[II �fI Sti91T/r�. ttl')F(y�lON Please chccl:all that apply(submit 2 sets of plans u:items checked bi lotr):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑ Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION rytld i t exceeds 10,000 amps at 1)0 volts or Floating buildings.
"' ` less to ground,or exceeds 14,000
6 ❑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
JOB SITE INFO12M11.4 T ION AND LOCATION ❑Emergency system. larger separately derived system.
. ❑Addition of new motor load of ❑"A" "E" "l-2' 'I-3"
Job no.: Job site address: 11 Li p4 5W l3ARNt�IM OR, ix or mu more. Recreational❑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. AS{-1\g%.0 - .S.-TAT es ❑Service or feeder 600 amps ur Sore.
..:',':;MO:-'' FEE SCHEDULE
Cross street/directions to job site: Description i Qy. I Fee. I Total I
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 3 1,000 sq.ft.or less 168.54 4
Ea.add'I 500 sq.ft.or portion 'j 33.92 1
Tax map/parcel no.:
Limited energy,residential
DESCII<IPTIb I OF', { (with above sq.ft.) I 75.00 2
Limited energy,multi-family
Electrical for new single family residence 75.oU 2
e Y residential(with above sc(.ft.j
Renewable Energy: ❑,See Page 2
Services or feeders installation,alteration,and/or relocation_
®
•J?R.OI'ER 1'Y OWNER 200 amps or less I, 100.70 2
❑ TENANT
201 amps to 400 amps 133.56 2
Name: ' L.F 4 I LA_C 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. 40)amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits—new,alteration,or extension, er panel
® APPLICANT ❑ CONTAC I- PERSON A.Fee for branch circuits with
Business name:JTSC,LLC each branch cire 11eder fee,
7.42 2
B.Fee for branch circuits without
Contact nam 'O‘ N W Y LA N.D service or feeder fee,first
branch circuit 56.18 2
Address:5285 Meadows Road Suite 171 Each add'I branch circuit 7.42 2
City/State/Z1P:Lake Oswego,OR 97035 Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84
Phone: 503 2oq dwelling,service and/or feeder
Phone:(503) ~! 5 lax: ( ) Reconnect only 67.84 2
E-mail: , ,O y{O111 d @ j +S rn I V h c f} . C 0 m Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: *lint l Q ( '� Signal circuit(s)or limited-energy See
( L—•w r panel,alteration,or extension. Page 2 2
Address: ,2- AO $1--- 1-3 rV OI'C4Jt2O'eve ' 34--(1161- Each additional inspection over allowable in any of the above
City/State/ZIP: pi 1.1512OYD 6k °I'7 ).3
Additional inspection(I mi O hr min) 66.25/hr
[�' Investigation(I hr min) 66.25/hr
Phone:(9)3) �, 1I a,2— Fax: v (�V„�. ,, ,s- Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is 90,00/hr
CC13 Lie.: /,2/1501 Electrical Lie.: / C. p : specifically listed(Y,hr min)
� r' ELECTRICAL PEKM1T FEES
Suprv. Electrician signature,required: / t���/ ---
F LL..i 7'.,. Subtotal:
Print name: (i► Date: Plan review(25%of permit fee): --
f State surcharge(12%of permit fee):
Authorized signature:` R M_ TOTAL PERMIT FEE:
'I'his permit application expires if a permit is not obtained within 180
Print name: ( ,L,E{ `r^Q f[ /� — Date: days after it has been accepted as complete.
Levy` * Number of inspections allowed per permit.
I lnuilding4PetmitcELC permitApp_ELR_ERE.doe Rev 05/21/2013 • .t40-4615Tf11/05/COMAVEB
L
Mechanical Permit ApplicatiREI CEI%�j J) FOR OFFICE USE ONLY
�/
City of Tigard Received
Permit No.: y-f
Date/By: 3v �5 1 !177--go/s--e_knj/5
(, r 13125 SW Hall Blvd.,Tigard,OR 97223 g Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 U N 3 O 2 Q 5 DateBy: Other Permit:&; �S-0507 5
TI G AR I Inspection Line: 503.639.4175 ` Date Ready/By: Juris ® See Page 2 for
Internet: www.tigard-or.gov CITY OF TJGARll Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑ Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Job site address: 1340 t gti„) Air conditioning 46.75
eAa�up, O A Furnace 100,000 BTU(ducts/vents) l 46.75
City/State/ZIP: T` GATLD I Op_ q`t,a,z3 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: 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
p� Other: 23.32
Subdivision: Lot no. D Other fuel appliances:
Tax map/parcel no.: Water heater l 23.32
DESCRIPTION OF WORK Gas fireplace/insert \ 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 I ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name:LF 4,LLC Range hood/other kitchen
Address:5285 Meadows Rd Ste 171 equipment 33.39
Clothes dryer exhaust \ 33.39
City/State/ZIP:Lake Oswego,OR 97035 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 4 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. 1
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 1
E-mail:jwyland @jtsmithco.com Barbecue l
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: b301 t t y
11Building\Permits\MEC_PermitApp_040113. 440-4 ITT(1 I/02/COM/WEB)
L
. Plumbing Permit Application ;45
Building Fixtures RE CEIVEP FOR OFFICE USE ONLY
, City of Tigard Received >^ / J
g Date/By: W 3u0�c ! Permit No.:1"(6.T 9 /. -L t)//S
IN
- • 13125 SW Hall Blvd.,Tigard,OR 97223 \\
Plan Review
Phone: 503.718.2439 Fax: 503.598.196�U N 3 0 2015 Date/By: Other Permit No.)Q 90 5"---1000 75
Inspection Line: 503.639.4175 Date Read B hid s H See Page 2 for
TIGARD Ready/By: g
Internet: www.tigard-or.gov CITY TI RD Notified/Method: Supplemental Information
TYPE OF W 0 ' r�i�(;DIVISION FEE* SCHEDULE
®New construction a1 i 1 LDR1f DIVISIO sl 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
®
1-and 2-family dwelling SFR(2)bath 437.78
g ❑Commercial/industrial
❑Accessory building ❑Multi-family SFR(3)bath 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: 1 340 a so l3ARNv►M Op_
basin or area drain I 18.76
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.: l Project name:ASH WOOD 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-) 1 Page 2
Storm sewer(no.linear ft.: 2C.) ( Page 2
Water service(no.linear ft.: 25) I Page 2
Subdivision: I Lot no.: 4 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer i 25.02
Plumbing for new single famiy residence 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 5 25.02
City/State/ZIP:Lake Oswego,OR 97035 Solar units(potable water) 62.54
Phone:(503)209-7555 Fax: :( ) Tub/shower/shower pan 12.51
E-mail:jwyland@jtsmithco.com Urinal 25.02
Water closet 3 25.02
CONTRACTOR
Water heater 1 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.: 31-i- A 001 Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name:John Wyland Date: b •30 1 i4 This permit application expires if•permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
IL
1114 City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
•
T I G A R D Building Permit Review — Residential
Building Permit #: H S i / 5 -DD j j ' NI Loa_g-o/S-60ei 75-
Site Address: /3‘171o.2 Sec, •
Project Name: /93A4)0'ce .k c Lot #: 63
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review^ / /�
Proposal: / J 4) .S --7f�t// . f<F'sJ? 0 t!J. ____
L!d' Veri site address/suite# exists and active in permit s ste .
fY P Y }
fiver Terrace Plan District: ❑ Yes g No
Sit: lan Elements:
tt r ree(3)copies of site plan : 'sting structures on site
MS' e plan must be on 8-1/2"x 11"or 11 x 17"paper V Footprint of new structure (including decks)with finished
IC I awn to scale (standard architect or engineer scale) 96or elevations
tI .rth arrow y, tility locations(required for new,may apply for additions)
IP " e address,project or subdivision name and lot number"vi .cation of wells/septic systems
l plicant information(name and phone number) rAErosion control(including drainage-way protection,silt fence
t dimensions and building setback dimensions sign,location of catch basin,etc.)
of area,building coverage area,percentage of coverage and �freet names
pervious area (applicable if R-7,R-12,R-25&R-40) [/S'eet tree size,type and location
Property corner elevations(2 foot contour lines if more than (2txisting trees to be retained with drip line,and tree
4 foot differential) protection measures
NYAlean Water Services—Service Provider Le�tte (lot platted prior to 9/10/1995):
Required: El Yes,applicant was notified I,d' No Received: El Yes El No
LJ Public Facil, s Improvement(PFI) Permit:
equired: NJ Yes,applicant was notified El No Applied For: es ❑ No,stop intake
rind Use Case#: `J ,6 JL�f 0Q
, oning: — y_
U Setbacks: Front .(.) Rear /s Side S Street Side / Garage e'O
CA Landscape Requirement: Aj/4 %
J4', of Coverage Maximum: jaiza % j 1i
k1/Building Height: Maximum Height a, Actual Height c 7' b
IV Visual Clearance
I vakksements
NI 'sensitive Lands: ❑ Yes lam' No Type
it Urban Forestry Plan
❑ Conditions "Met"prior to issuance of buil ' g permit
Notes: cryi8 III! p /7 .9,r-- 74) J S66,2/1C.P c
w//d/n f .m►/ e
Approved By Planning: ----Ad_�� 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\BldgPennitRvw_RES_031015.docx
Building Permit Submittal
Original Submittal Date: (..Q 50 i/c
Site Plans: # _
Building Plans: # 3
Building Permit#: Et—Enter building permit#above.
Workflow Routing: Et Planning . —Engineering 3-Permit Coordinator C-Building
Workflow Sign-off: s Sign-off for Planning(include notes from planning review)
Route Application Documents: 2 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: C 0„ Date: /5---
Engineering Review
Slope at building pad: /73
m'Conditions "Met"prior to issuance of building permit
E ements (encroachments)per engineering conditions of approval and plat
X'ater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes 11: •
Assess Water Quantity Fee in-lieu: ❑ Yes %�r
LIDA Facility on lot: ❑ Yes IC7 No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: di,- Date: 7
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: Cl Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
o `
Z-41
Approved, NOT Released: 0.67)41-101 Date: �/� —"
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: d I# Date: 8/3// S
I:1 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
13402 SW BARNUM DR, TIGARD, OR, 97223
Residential - Master Permit
199 Electrical final
PASS
MST2015-00115
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
13402 SW BARNUM DR, TIGARD, OR, 97223
Residential - Master Permit
199 Electrical final
FAIL
MST2015-00115
David Young
Finish installing gfci at back porch, plug not secured and weatherproof cover not
installed.
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
13402 SW BARNUM DR, TIGARD, OR, 97223
Residential - Master Permit
699 Mechanical final
PASS
MST2015-00115
David Young
No AC installed at time of final inspection. Provide permit and inspection 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
13402 SW BARNUM DR, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
PASS - C of O
MST2015-00115
Jeff Grove
Street tree
Moisture content
Lighting efficiency
All forms recieved
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
III ■ Transmittal a Letter
f i l l ■i s I , 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: ( t •\'\/' 4C t 9 cot-CI DATE RECREVE MED
DEPT: BUILDING DIVISION
PI_ 2 2 2015
FRONMI _ -3"ANku _ .I._I!6.\. U CITY OFT►GAKU
COMPANY: TT S 1.-k T I-; CO �1PA N I es
BUILDING pIVIS10N
PHONE: _c,.}0/, � 4 oa' By.
RE: 134 0 a- Sw GA,PAItAH oR T l G A RD , O R Israo t'5 - o4 l 15
(Site Address) (Permit Number)
ASIA WOa D E.:ST N'f 5 LO T"
(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 OFFICE USE ONLY
Routed to Permit Technician: Date: Initials:
F ees Due: • Yes • No Fee Descri stion: Amount Due:
$
t '6u w. $
' 4,,"1"''.:4'
Special
Instructions:
Re s rint Permit G er PE : • Yes ❑No • Done
A. slicant Notified: Date: Initials:
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012