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Permit (10) „ CITY OF TIGARD MASTER PERMIT s . COMMUNITY DEVELOPMENT Permit#: MST2015-00187 T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/09/2015 Parcel: 2S103AC09700 Jurisdiction: TIGARD Site address: 11430 SW FONNER ST Subdivision: 2014-023 PARTITION PLAT Lot: 3 Project: Bean Partition, Lot 3 Project Description: New SF. DEMO credits from BUP2014-00124 applied to this permit. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 3 First: 1850 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 2 Second: 0 sf Garage: 524 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 1850 sf Value: $231,974.22 Rear: 15 PLUMBING Sinks: 1 Water Closets: 2 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 2 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 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Typos Air Conditioning: Y Vent Fans: 3 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 SrvciFeeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp• 0 W/Svc or Fdr: 0 Ea add.'500 sf: 1 201-400 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 1850 Owner: Contractor: LHL HOMES INC LHL HOMES INC Required Items and Reports(Conditions) 11580 SW 67TH AVE 11580 SW 67TH AVE 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97223 TIGARD,OR 97223 PHONE PHONE: 503-348-3003 FAX: 503-639-5523 Total Fees: $6,245.40 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. NTION: • -gon law requires you to follow the rules adopted by the Oregon Utility Notification nter. Those rules ar set forth in OAR 95 01-0010 through OA' 9 •1 •r90. You may obtain a copy of the rules or direct questions to OUNC by calling 503. •• 1987 or 1.800. 344. I ued By: f .........._..._....11.— „,,Azii, _./ , Permittee Signature: 1, ( , Call 503.639.4175 by 7:00 a.m.for the next available inspecti>n 'e. This permit card shall be kept in a conspicuous place on the job site until comp etion of the project. Approved plans are required on the job site at the time of each inspection. '' Buildin2 Permit AnDlicatioRECElvEl Residential 1l•�� I ()I I I ICE.E l 11 1 1 City of Tigard OCT 2 0 2015 Date Ved yy:: /0/2,4 /S i•°r Permit Noyl�!'R/ /Je/�i, 13125 SW Hall Blvd.,Tigard,OR 9722 Plan Review I .-{ Other Permi ,//l��lO� c'�`f�� Phone: 503.718.2439 Fax: 503.598.Jrft, Date/By: i i/1 /1- J A 1` Inspection Line: 503.639.4175 1, OF i HJAKV Date Ready/By: Juris ® See Page 2 for Internet: www.tlgard-oi.gov BUILDING DIVISION Notifi:. ethod: 2. V/5" C 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 0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: S ' a•-%)_z_ and 2-family dwelling 0 Commercial/industrial * j 0 Accessory building 111Multi-familyNumber of bedrooms: a�o� 0 Master builder 0 Other: Number of bathrooms: 2 JOB SIl r, INFORMATION AND LOCATION Total number of floors: / Job site address://K 3 � s /- 1 r 77- are,/ �2Z3 New dwelling area: /S square feet a.3 J 4 _0_,_ Y r City/State/ZIP: Garage/carport area: S 1y square feet Suite/bldg./apt.no.: Project name: Covered porch area: 410 square feet Cross street/directions to job site: Deck area: _. square feet Other structure area: .— square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: 130..% i)q4 A A-• — l,ot no.: --1.) Permit fees*are based on the value of the work performed. •InTax map/parcel no.: r 3 Indicate the value(rounded to the nearest dollar)of all PIGS .tl/Y G2 ?cote t equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. Valuation: $ Existing building area: square feet New building area: square feet g PROPERTY OWNER 0 TENANT Number of stories: Name: e . !e!�J -�7�C. Type of construction: Address: , r-l tc s eU e 7 tt ave, Occupancy groups: City/State/ZIP: l;ti/9.,2,.2 _ OR 9 7 a .3 Existing: Phone:(c ) 6.2 '-771 y fay:(4 t ) 4-3 Y-SS 2.3 New: APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) _ Business name: S4 net,L Structural plan review fee(or deposit): Contact name: FLS plan review fee(if applicable): ( Address: Total fees due upon application: City/State/Z1P: Amount received: Phone:( ) Fax: :( ) E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System. Business name: Submit two(2)sets of roof plan with connection details .S and fire department access,along with the 2010 Oregon Address: Solar Installation Specialty Code checklist. City/State/ZIP: Permit Fee(includes plan review $180.00 and administrative fees): Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.: /Sy 7.2.7 _ Total fee due upon application: $201.60 Authorized sign • This permit application expires if a permit is not obtained Print name: 4 ...-:: within 180 days after it has been accepted as complete. „.:z(t.....,.. *Fee methodology set by Tri-County Building Industry Date: Service Board. 1:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440.4613T(11/02/COM/WEB) RECEl1V :,' Electrical Permit Application OCT 2 0 2015 i l)lt Of FI( I I L O.I ' City of Tigard Received Pctmii K. / thiterfly -/-5oil D0/Oe 7 II 13125 SW Flab Blvd_,Tigard,OR 97?�3(T{7 OE 1 I/ ARI Ptah Review Related Permit�. Phone 503.718.2439 Fax: 503.598. i Dateifty: inspection Line: 503.639.4175 Ready uatcnly -- J,rc I �J See Page 2 for TIC:NR/-). Internet: www.ti and-or. 3UIUIJII' n1ViSlO Notifed/Method sec R --- — j ptdemenW Information TYPE`.OF WORK.: PLANREVIEW- E New construction ❑Addition/alteration/replacement Please chi is all that apply(submit 7 sets of plans whams checked) 0 Demolition 0 Other: 0 Service or feeder 400 aps or mmore 0 Building aver three stories What the available fauft current 0 Marinas and boatyards ' ' .CA1BGIWirel)F'COI FRUC1101V.' . ---�-- - (10 exceeds 100amps at ISO volts OT ❑Floating building`s. ❑ 1-and 2-family dwelling ❑Commercial/industrial ElAccessory building less to prouad,or exceeds 14,000 13 t o,nrrlerciat-use agricultural amps for all Debet installations. buildings. ❑Multi-family ❑Master builder U Other: 0 Fire pump- 0 Irtsrallalx?n of 150 KVA or :, - rJUB S>rlR-31*-011114.4 =AA(p,tJQCA1'IOIV+ ; ,>::' OEniergeney s, tem larger separately derived ❑Addiction anew motor load of :}lain Job#: Job site addresslly3n t00HP or more. I Y Kr City/State/ZIP:[P: OStr or arae residential nails occupancy. d Z3 ❑Hrekh-erre fdeditiew. Q Recreational vehicle parks. Suite/bldg,/apt.#: Project name: 0 Ilarardous localures 0 Supply voltage for more than ❑Scrvicc a feeder 600 amps or mare. 600 volts nominal .I - • ::7-7;.'7.--_,--.. _ � Cross street/directions to job site: Description i Qty. I l:xi I-Toll I-• —__ New residential single-or multi-family dwelling unit. Subdivision: 114N f 4Q 0/r' Lot#: Includes attached garage. I,000 sq.tt or less j 168.54 4 Tax map/parcel# ?IG d!Y Q 13 9041_tel 03 Ea.addl 500 sq.ft.or portico 1 3392 I —_�--- .TiF~ ti.)r 1[>i RK`^ . _ Limited energy,residential / 75.00 2 h1s..".S 4. /� (with above sq.R.) r �� Limited energy,muni-family residential(with above 0/x1.ft.) 75.00 2 — Renewable Energy 0 See Pa -- ge 2 - a -__.._ ` -OWNER -. 'i'LNAINT --- Services or feeders installation,alteration,and/or relocation Arome- 200 amps or less !';:i 7.1 i i Address: 201 amps to 400 amps 1M133.56 0 401 amps to 600 amps - 200.34 _© City/State/ZIP: 601 amps to 1,000 amps 301.04 Phone:( ) Far:( ) Over 1,000 amps or volts 552.26 II ._.....___ - __ Temporary services or feeders installation,alteration,and/or Email: relocation _ Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 __ 1 intended for sale,lease,rent,or exchange,according to ORS 447,449.670,and 701. 201 amps io 400 amps - 125.08 2 1 (honer signature: _. Date: 401 amps to 599 amps 168.54 1 2 Branch circuits-new,alteration,or extension, r .and A.Fee for branch circuits wifk Business name: above service or feeder fee, Il — each branch circuit 7 42 Contact name: 13.Fee for branch circuits without - Address: service or feeder fry first 56.18 2 branch circuit _ City/State/ZIP: Each add'i branch circuit 7.42 — 2 1 Miscellaneous(service or feeder not included) Phone:( ) I Fax: :( ) Each manufactured or modular ! 2 — —— dwelling,service and/or fonder 67.84 I Email: Reconnect only 67.84 El CONTRACTOR- 'z y r3':- k;A Pump or irrigation circle I iii in EI Businerss name L f >l Si or outline 1 tinS en2 !( brad t e rG L Signal sennet(:)or limited-energy 2 • Page Address: 2/6 Y r a ! panel,alteration or extension O 2 City/State/7IP: / Each additional inspection over allowable io any of the above 4 l Ct r ' 7C7 3 Additional inspection(1 hr min) 66.251 hr ! Phexle:(573 ) 8 go-b3 e y FOX:(57 j) g z _5 7 Investigation(1 hram)m) 90.00/hr ii l� 1 Industrial plant(1 hr nun) 78.18/hr I Ernie:L/ l CV e.feC, Y i�-6'.5/ 'la/l co A4 Inspections for which to fee is CCH Lie.: Elecfiricai L Su Lie.: specifically listed(Va hr mm) 90.e>Of hr �s4�sv :3y 3G/C 34s Y s E ECIWA . .-IRS.- A Suprv.Ele cttician signature,required: ' _ .�/ subtotal. Print name:gitnatii ts' men Date: it, D Plan Review Required(7.5%of permit neer I - state surcharge(12%4 permit feet F —_-- Authorized si. TOTAL•Pf RNI lT FEE: This permit application aspires if a permit is out obtained within 180 I Print name: , I Date: 1 days after it has bees accepted as complete. i,i — -. • Number of inspections allowed per permit. i-1Buiidi::g1PnmitAr.t'Per;onApp.11_R_EREdoc Rcv X/f7/2015 a40.461 ST(ItroS/COM/WEB Mechanical Permit Applicatiot ,ECEIVEJ) FOR OFFICE ISE ONLY a City of Tigard Received Date/By: ea 7 Re eve Permit No/f/3-2- 6,45-___ ,,,f. 13125 SW Hall Blvd.,Tigard,OR 97223e II OCT 2 U 2 015 Date By: Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Other Permit: Inspection Line: 503.639.4175 OF e / u' Date Ready/Byruns El See Page 2 for I I l; �IZ 0Internet: www.tigard-or.gov CITY I'IGAIW Notified/Method Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees*are based on the value of the work -Eris..re.w construction 0 Addition/alteration/replacement performed. Indicate the value(rounded to the nearest dollar)of all ❑ Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* J}'I'and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist. ❑ Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 1 46.75 Job site address: f/K3S, rSCAJ Furnace 100,000 BTU(ducts/vents) 1 46.75 City/State/ZIP: 7;j.,:i f �2 ??2_3 Furnace 100,000+BTU(ducts/vents) 54.91 v` Heat pump 61.06 Suite/bldg./apt.no.: Project name: 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 l li Other: 23.32 Subdivision: PC(12.f� * • Lot no.: 3 [{1KI+ Other fuel appliances: Tax map/parcel no.: f'l.+ er 1 ON,� Q 13 Water heater 1 23.32 DESCRIPTION OF WORK Gas fireplace/insert 1 33.39 Flue vent for water heater or gas fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 lia PROPERTY OWNER 0 TENANT Other: 23.32 Environmental exhaust and ventilation: Name: L/o Range hood/other kitchen equipment 1 _ 33.39 Address: Clothes dryer exhaust 1 _33.39 City/State/"LIP: Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 3 23.32 Phone:( ) Fax:( ) Attic/crawlspace fans 23.32 0 APPLICANT 0 CONTACT PERSON Other: 23.32 Fuel piping: Business name: $14.15 for first four;$4.03 for each additional Contact name: Furnace,etc. 1 Gas heat pump 'at- Address: Wall/suspended/unit heater City/State/ZIP: Water heater t Phone:( ) Fax::( ) Fireplace I Range , E-mail: Barbecue CONTRACTOR Clothes dryer(gas) Business name:.._I/ ��+n C UcdIG , /)- Other: MECHANICAL PERMIT FEES* Address: C.74/6/1.4)/;,5 �d! X L> 1' �1 Subtotal City/State/ZIP: _ O R 971 lc) Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:( ) Fax:( ) _ State surcharge(12%of permit fee) CCB lie.: 3 gZTOTAL PERMIT FEE ' This permit application expires if a permit is not obtained within 180 t G: days after it has been accepted as complete. Authorized signature: s * Fee methodology set by Tri-County Building Industry Service Board Print name: R« gala 1 Date: N )3�fr I Building\Permits\MECPermitApp_040113.doe 4 440 617T(111/02/COM/WEB) •• Plumbing Permit Application,ir CEIVEP BuildingFixtures 1 "' FOR OFFICE USE ONLY • City of Tigard OCT 2 0 2015 Received Permit Ny/J%, /3 7 /� Date/B 11 13125 SW flail Blvd.,Tigard,OR 97223 Plan Review e Phone: 503.7(8.2439 Fax: 503.598.1969 'GARD Other Permit No.: 'GARP Inspection Line: 503.639.4175 l,i 1.Y U1,I'GARD Date Ready/By: loris ® Sec Page 2 forI _ - Internet: www.tigard-or.gov a�ILDING DIVISION Notified/Method. Supplemental Information TYPE OF WO FEE* SCHEDULE El New construction El Demolition For special information use checklist. Description Qly. Ea. Total 0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 IDI-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building 0 Multi-fancily Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: / 4/3 (� 5� nen 5 Catch basin or area drain 18.76 4 V [ v 1 Drywell,leach line,or trench drain 18.76 City/State/ZIP: / TU QJ'xG • „ Q?t• 3 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector I 18.76 Sanitary sewer(no.linear ft.:l0o ) Page 2 Storm sewer(no.linear ft.100 ) Page 2 • Water service(no.linear ft.:)*0 ) Page 2 Subdivision: cc(v 4-.. 1-1 Lot no.: 3 Fixture or item: Tax map/parcel no.: I l .� 14 D...4 f y -Q x Backflow Preva,tc '� I 3:." DESCRIPTION OF WORK Backwater valve t 12.51 Clothes washer ) 25.02 Dishwasher J 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 PROPERTY OWNER 0 TENANT Expansion tank 12.51 Name: [.� L Fixture/sewer cap 25.02 ` rAvt S Floor drain/floor sink/hub 25.02 Address: Garbage disposal I 25.02 City/State/ZIP: Hose bib a. 25.02 Phone:( ) Fax:( ) Ice maker I 12.51 0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 �/ Medical gas(value:$ ) Page 2 Business name: 4/../...c_ ~T~' 4‘...v s . Primer 12.51 Contact name: Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax: :( ) Tub/shower/shower pan a 12.51 E-mail: Urinal 25.02 Water closet Z. 25.02 CONTRACTOR Water heater t 37.52 Business name: 7 412 d l ))4.10 1Ta• Water piping/DWV 56.29 Address: pz. yy Other: 25.02 � c City/State/ZIP: _tum /-r-.e.:C tV. Q Z-_70/ Subtotal Minimum permit fee: $72.50 Phone:( ) Fax:( ) CCA Lic.10 3 7- 2 lambing l.ic.no_:3. Plan review (25%of permit fee) pi--- State surcharge(12%of permit fee) Authorized signature: r TOTAL PERMIT FEE Print name: Date: This permit application expires if a permit is not obtained within 180 days t a • (/ t>1 fJ�� after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I.\Building\Permits\PLMU-PermitApp.doe 10/01/09 440-4616T(10/02/C0191/WEB) City of Tigard 1111 COMMUNITY DEVELOPMENT DEPARTMENT 11 G A R t) Building Permit Review — Residential Building Permit #: ,f57;20/..5---00 he Site Address: . 1114 30 s W v4,r Project Name: (h ep r ea r h h o n Uo+ 3 Lot #: 3 (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: 'S F l2. Cc' Lof 3 erify site address/suite# exists and active in permit system. 6DV 0 River Terrace Neighborhood: ❑ Yes .0.-No Site Plan Elements: Three(3)copies of site plan existing structures on site ,Prgite plan must be on 8-1/2"x 11"or 11 x 17"paper '$Footprint of new structure(including decks)with finished Drawn to scale(standard architect or engineer scale) floor elevations 2fNo ., arrow )2Ittility locations(required for new,may apply for additions) .ite add•-ss,project or subdivision name and lot number 'Location of wells/septic systems , 1pplicant information(name and phone number) .Erosion control(including drainage-way protection,silt fence ) tot dimensions and building setback dimensions design,location of catch basin,etc.) -BLet area,building coverage area,percentage of coverage and Z&reet names impervious area(applicable if R-7,R-12,R-25&R-40) PStreet tree size,type and location ,Pfroperty corner elevations(2 foot contour lines if more than 2xisting trees to be retained with drip line,and tree 4 foot differential) protection measures Clean Water Services–Service Provider Letter(lot platted prior to.9/10/1995): Required: Cl Yes,applicant was notified , 'No Received: ❑ Yes ❑ No Zf Public Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified ❑ No Applied For ❑ Yes 0 No,stop intake ,0 Land Use Case#: M LIQ 2008 --bOooq ,6 zoning: r4-4.5 Setbacks: Front Za Rear S 5 Side S Street Side I S Garage 2 0 2Landscape Requirement: — % Lot Coverage Maximum: — -Building Height: Maximum Height .3D Actual Height \7• Li Visual Clearance --Ei Easements 'f'Sensitive Lands: 0 Yes 0 No Type d Urban Forestry Plan OVConditions "Met"prior to issuance of building permit Is o s 4---e.ew �,-�.N ..^-�— Notes:• � � _ /� .yy - t rl 2 - �_/�if.�� n ,d t-t� 3 �r cs� rd I-c`{' GAP C f V y` `� (!� 1 c-:: j a 1(ed. t r :,J f-1 S+- K_p o r't' S,..1.,-,..`,i d . Approved By Planning: •V10111-1-4 ;l o k2-CAA4.- Date: 10/1A.2/ IS Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved ❑ Not Approved Revision 2: 0 Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw_RES_0709I 5.docx Building Permit Submittal Original Submittal Date: kA/45 Site Plans: # .3 Building Plans: #�--3 Building Permit#: e Enter building�peermnit#above. Workflow Routing: Manning 1~.ngineering rmit Coordinator iuilding Workflow Sign-off: c2-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. --C(Building: original permit application,site plans,building plans, engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: Date: /d/jam/,(5 Engineering ,,(ngin e ering Review JlJ Slope at building pad: 5, -f ✓✓✓ Conditions "Met"prior to issuance of building permit Easements (encroachments) per engineering conditions of approval and plat A Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes ❑ No Assess Water Quantity Fee in-lieu: ❑ Yes E No LIDA Facility on lot: ❑ Yes E No ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: QeicsiOr'/ifa) ,1L I, Date: fao 70/:6. - Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved E Not Approved Revision 3: ❑ Approved E Not Approved Permit Coordinator Review E Conditions -Met-prior to issuance of building permit l 7_,Approved, NOT Released: Date:/D/ Notes: //id/4 6 ifr4A1"+ 7 ill 9--//;,. ..,:€4.0, Kee -A..%"1¢eiw ' N,7"p(J..719s- Revisionsafter Buildin Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: Revision Notice 3: Date Sent to Applicant: ISSDC Fees Entered: Wash Co Trans Dev Tax: ' Yes El N/A 1111 Tigard Trans SDC: ❑ Yes N/A Parks SDC: til, Yes ❑ N/A OK to Issue Permit Approved by Permit Coordinator: a caA.: - Date: P--- / —I.5 I:\Building\Fonns\BldgPennit R vw_RES_0709I 5.doc x 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 11430 SW FONNER ST, TIGARD, OR, 97223 Residential - Master Permit 699 Mechanical ﬁnal PASS MST2015-00187 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 11430 SW FONNER ST, TIGARD, OR, 97223 Residential - Master Permit 299 Final inspection PASS - C of O MST2015-00187 Jeff Grove Moisture content Lighting efﬁciency Blower door test All forms received C of O is on the counter Violation Summary: Inspector Contractor