Permit p CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2015-00255
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/25/2016
Parcel: 2S110BA11900
Jurisdiction: TIGARD
Site address: 14253 SW 118TH CT
Subdivision: MEDALLION MEADOWS Lot: 12
Project: Medallion Meadows, Lot 12
Project Description: New SF
BUILDING
Floor Areas RR9ouired Setbacks Required
Stories: 2 Bedrooms: 3 First: 1255 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 23 Bathrooms: 3 Second: 1767 sf Garage: 589 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 3022 sf Value: $372,017.27 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
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
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 5 201-400 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 3022
Owner: Contractor:
JT ROTH CONSTRUCTION INC FOUR D CONSTRUCTION Required Items and Reports(Conditions)
FOUR D CONSTRUCTION CO PO BOX 1577 1 Ersn Cntrl 503-639-4175
12600 SW 72ND AVE#200 BEAVERTON,OR 97075
TIGARD,OR 97223
PHONE: 503-590-0805 PHONE: 503-590-0805
FAX: 503-590-1751
Total Fees: $24,676.09
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. I egon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
95 -001-0010 through OA 95 -001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.23 . 7 or 1.80 .332.234 .
A � ^
Iiisued 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 completion of th project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Residential 1--OR OFFICE L'SE ONLN'
City of Tigard Received Permit No.:
Date/By:
13125 SW Hall Blvd.,Tigard,OR 9722j!'-
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Pennit:�p-ut'6-7;�9 Vo
Inspection Line: 503.639.4175 ; z
Date Ready/By: Juris: 0 See Page 2 for
Internet: www.tigard-or.gov MNotified/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILYDWELLING
P(New construction 0 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.
I-and 2-family dwelling ❑Commercial/industrial Valuation: $—a
❑Accessory building ❑Multi-family Number of bedrooms:
El Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: —5, KI, //,q f,4( C/— New dwelling area:3<) square feet
City/State/ZIP: R-D C)� 9-72Zc/ Garage/carport area: 9 square feet
Suite/bldg./apt.no.: name: Covered porch area ' i) square feet 7
Cross street/directions to job site: ► wA Deck area: square feet 1;a
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: M-F—ID JA L',.10 � MCFADOWS. I Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: indicate the value(romded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $
&AF-W -5z/\/000 IL S CivLiC
Existing building area: square feet
New building area: square feet
PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: 0\45 AS BL U� Occupancy groups:
City/State/ZIP: Existing:
Phone: Fax: New:
APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to'ee schedule.
Business name:
Structural plan review fee(or deposit):
Contact name: '�R-V I D Z)eV4 g jl-p PO 9--r FLS plan review fee(if applicable):
Address: 'F-0, 2 C-X I S-72 Total fees due upon application:
City/State/ZIP: P>apovc—F—To 0 0 9-70-7S Amount received:
Phone:(5�-3) 59 0 C) 0 C)S Fax::(Si13) S9 1-7 5 1
E-mail: �O't 1Z. PC-6t'I'ST— (a MSAi PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaie Solar Panel System
Sub (2)sets ofroof plan with connect' 'tails
Business name: 'in 01
0 2)
two
tw
Mht art
and fire ment access,along with 010 Oregon
with list.
al list.
Address: Solar Instal n Specialty Cod�:,Weck
City/State/ZIP:
Permit Fee anreview
JQ W4;-- min five fees): $180.00
Phone: Fax:
State sviCharge(12%of perm[ e): $21.60
CCB lie.: '71 Q S-7 Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Date: --- Fee methodology set by Tri-County Building Industry
Print name:'j) t C) DC— 122 ?, Service Board
1:1Building\Permits\BUP-RESPermitApp.doc 02t242011 4404613T(I 1/02/COMIWEB)
Electrical Permit Application INIGUILIKIN
City Of Z'Igar(1 : .. g Received
Date/By: �ar/8� !�j Permit#: I Z�Jj _Dp
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Related Permit#:
Inspection Line: 503.639.4175 Ready Date/By: )oris. ® See Page 2 for
Internet: www.tigard-or.gov L Notified/Method: Supplemental Information
TYPE OF,jNY41RI� PLAN REVIEW
New construction ❑Add1t101fE@r$tjQXt/1CplaetllQttt Please check all that apply(submit 2 sets of plans w/items checked):
❑Demolition El Other: ElService or feeder 400 amps or more ElBuilding over three stories.
where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
❑ I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATIONAND LOCATION ❑Emergency system. larger separately derived
/ ❑Addition of new motor load of system.
Job#: Job Site address:
Z. 5 3 ,j j/P 100HP or more. ❑"A» "E» "1-2»`9-3»
City/State/ZIP: i e t ❑Six or more residential units. occupancy,
kX o 0 Z ❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name: ❑Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: .] f�AAP— FEE SCHEDULE
Description I Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision: L L_0 L.3 M _---Pq-Ayv S Lot#: Includes attached garage
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'1500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential 75.00 2
�- with above sq.ft.
- I tC Limited energy,multi-family
residential with above sq.ft. 75.00 2
PROPERTY OWNER ❑ TENANT Renewable Energy 1 ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 100.70 2
Address: p/yi.e�
201 amps to 400 amps 133.56 2
� BSL
401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2
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 to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
APPLICANT El CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: FOS (.Tt-cttl above service or feeder fee, 7.42 2
each branch
Contact name: B.Fee for branch circuit circuits without
Q P1/►J� � �2Pf�t2T"
Address: � service or feeder fee,first 56.18 2�S7 branch circuit
City/State/ZIP: �P_ 97 0-7 5 Each add']branch circuit 7.42 2
q Miscellaneous service or feeder not included
Phone:(�s 3) Jr/ 'V�®S Fax. :(S.7j) jgc�— (� S Each manufactured or modular 67.84 2
Email: dwelling,service and/or feeder
(1�. �,d i�S`j" / <-i t`Ir't Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: L — LEStR I PL,.,9P Sign or outline lighting 67.84 2
J'' S� 6 ND -0 I® 4 Signal eircuit(s)or I imited-energy Address: lC! el alteration or extension. ❑ See Page 2 2
Ci /State/ZIP: O/ b Each additional inspection over allowable in anyof the above
City/State/ZIP: R®P-T L_0,lJ V + 7���-' Additional inspection(1 hr min) 66.25/hr
Phone:(_ �'�"� 37Ufa Fax:(x4) '70 i -- 7 9/ � Investigation(1 hr min) 66.25/hr
Email: CL Y ESL EGr 1L;o�� 1,Y__ �!+'v i�4% Industrial plantmin) 78.18/hr
x w Inspections for which no fee is
90.00/hr
625s specifically listed %:hr min CCB Lic.: jgZ7 Electrical Lic.: Su rv.Lic.: �
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,requir Subtotal:
Print name: - Date:/Z - Z Z -/ ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
_ This permit application expires if a permit is not obtained within 180
Print name: za�/ d Date: Z_Z 2_� days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:1Building\Permits\ELC PermitApp_ELR ERE.dm Rev 04/21/2014 440.4615T(l1/05/COM/WEB
Mechanical Permit Applies
City of Tigard Received Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: gab 5� "h �4z)rkevs—n:5 gs-s—
I'� i "1" 1 1 Plan Review
0 Phone: 503.718.2439 Fax: 503.598 1960 Date/By: Other Permit: 3!!5w'
Inspection Line: 503.639.4175Date Ready/By: Juris: 0 See Page 2 for
Internet: www.tigard-or.gov
Notified/Method: Supplemental Information
4
TYPE OF;Wbkk COMMERCIAL FEE* SCHEDULE – USE CHECKLIST
Mechanical permit fees*are based on the value of the work
P(New construction E]Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
El Demolition El Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
�I-and 2-family dwelling E]Commercial/industrial El Accessory building For special information use checklist.
El Multi-family El Master builder 0 Other: Description Qty. Ea. I Total
I JOB SITE INFORMATION AND LOCATION Heating/cooling:
Job site address: //;Z53 S. lb Air conditioning 46.75
" c/-, Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: •T -1-7 Furnace 100,000+BTU(ducts/vents) 54.91
Heat
Suite/bldg./apt.no.: Project name: um 61.06
p
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
MGDAL-LlOtl MEA Do 4,A)S Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplacelinsert 33.39
Flue vent for water heater or gas
Maci 61 1.3('1 PAW I (—V Affsl pe;Aitc fireplace 23.32
-Log lighter as 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32 1
9PROPERTY OWNER ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment J 33.39
Address: -J Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone: Fax: Attic/crawls ace fans 23.32
(%APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel
Business name: �7_Cx_tp_ Q')#,,3Sc)
TpacT1L�) piping:
$14.15 for first four;$4.03 for each additional
Contact name: D Furnace,etc.
fl� Gas heat pump
Address:
1 3_71S Wall/suspended/unit heater
2
City/State/ZIP: A- '; 9 '�L Water heater
Phone:(<,,3) 517.D 0 Fax: Fireplace
Range
E-mail: -J::! Ll f,,-J> Co 1-3 S T- MS AJ< <0 W-\_ Barbecue
CONTRACTOR -Clothes dryer as
Other:
Business name: (f laNy'2A L_ )q- lfL XIT�6_ MECHANICAL PERMIT FEES*
Address: V_o. Bax 43 3 Subtotal
City/State/ZIP: C� G W11AS 0'9— cr 7 0 S Minimum permit fee($90.00)
— Plan review(25%of permit fee)
Phone:(_5ky3) Fax:(5o3) &)_SO --,3 0 ?K
0— State surcharge(12%of permit fee)
CCB lic.: TOTAL PERMIT FEE
17 This permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
* Fee methodology set by Tri-County Building industry Service Board
Print name: Date:/2_Z 2-/_S
Plumbing Permit Application
Building Fixtures ; s
City of Tigard Received �/
`� g
r 13125 SW Hall Blvd.,Trgarc(,QI� 922
Date/By: /2V'/j Permit No.: l
C Date/By:Plan Review
Phone: 503.718.2439 Fax:; 03.59$.1966 Other Permit
Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gpv, +' Notified/Method: Supplemental Information
TY>Py a�F;'VE{ORK FEE* SCHEDULE
JWNew construction ❑Demolition For special information use checklist
Description Ea. 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
>kx 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
❑Accessory building ❑Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder ❑Other:
Fire sprinkler C_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 5 ' ` j Catch basin or area drain 18.76�t VV• � t/� �r
City/State/ZIP: .T.)&AUD 0 V, 9 '1 L Drywell,leach line,or trench drain 18.76
Z
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03
Cross street/directions to job site: i -r Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_� Page 2
Storm sewer(no.linear It.:_) Page 2
Water service(no.linear It.:_) Page 2
Subdivision: A L` 0A) Lot no.: , Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
_ Clothes washer 25.02
"C4'j N 1 [, Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
(Q PROPERTY OWNER T ❑ TENANT Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Address: 5 _ � Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker ) 12.51
a APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:
Medical gas(value:$ ) Page 2
Contact name: Primer 12.51
�U
Dg:k6=ft Roof drain(commercial) 12.51
Address: (� / Sink/basin/lavatory 25.02
City/State/ZIP: 0_7,S_ Solar units(potable water) 62.54
Phone:63) ni L> d�o� Fax::(3,3) 5-Clo Tub/shower/shower pan 12.51
E-mail: '®i l'VZ D tOSkr hA S/\) Afn Urinal 25.02
CONTRACTORWater closet 25.02
Water heater 37.52
Business name: u L LAZIJ 4fOM p A" Water piping/DWV 56.29
Address: I bo I A S, ,E i Vee_ "-" - Other: 25.02
City/State/ZIP: 4 1,L LS Bee-0 r- c? Z-3 Subtotal
Phone:Q�(j3) &`/O -(„)/ I(3 Fax:( ) Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lic.: �2-&� Plumbing Lie.no.:31j/_Z(�� �g
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name: Date: 12---22- This permit application expires if a permit is not obtained within 180 days
J after it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board.
L\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/C0M/WEB)
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
i
Building Permit Review — Residential
Building Permit #: t16-1.9-015- 00955-
Site
1h%8-0!Sf d0 o 55-
Site Address: H2-52) SCJ t�Sh C+-
Project Name: ytt&l on meladowlb Lot #: \\ L.
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: ntS4:�
Verify site address/suite# exists and active in permit system.
M River Terrace Neighborhood: ❑ Yes No
Sipe Plan Elements:
�7 ree(3) copies of site plan xisting structures on site
�te plan must be on 8-1/2"x 11"or 11 x 17"paper WFootprint of new structure(including decks)with finished
rawn to scale(standard architect or engineer scale) oor elevations
�orth arrow Utility locations (required for new,may apply for additions)
SZSSite address,project or subdivision name and lot number ocation of wells/septic systems
L� pplicant information(name and phone number) VE,,sion control(including drainage-way protection,silt fence
L1dLot dimensions and building setback dimensions ,,,������////design,location of catch basin,etc.)
$f.ot area,building coverage area,percentage of coverage and eet names
pervious area(applicable if R-7,R-12,R-25&R-40) E reet tree size,type and location
roperty corner elevations (2 foot contour lines if more than VExisting trees to be retained with drip line,and tree
4 foot differential protection measures
Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995):
equired: ❑ Yes,applicant was notified 1?; No Received: ❑ Yes ❑ No
9 Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified ❑ No Applied For: 9/Yes ❑ No,stop intake
Land Use Case #: SUP,)2013—00006
oning: R._ LA''5
L� Setbacks: Front -2-p"— Rear Side 3 Street Side — Garage Z
—S—Landscape Requirement: %
-0-'Lot Coverage Maximum: %
i
❑ Building Height: Maximum Height :30 Actual Height �5
LtiJ Visual Clearance
Easements
X,$ensitive Lands: ❑ Yes iZ No Type
®/Urban Forestry Plan
-VConditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: ( Date: j
JILZhs
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
L•\Building\Fonns\B 1dgPermitRvw_RES_070915.docx
Building Permit Submittal
Original Submittal Date:
Site Plans: # 3
Building Plans: # 3
Building Permit#: CT Enter building permit#above.
Workflow Routing: 2" Planning _2 Engineering Permit Coordinator Building
Workflow Sign-off. 0- Sign-off for Planning(include notes from planning review)
Route Application Documents: Ef 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: Date:
Engineering Review
Slope at building pad:
onditions "Met"prior to issuance of building permit
asements (encroachments) per engineering conditions of approval and plat
Water 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: Dater
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)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: ❑ Yes N/A
Parks SDC: Yes ❑ N/A
OK to Issue Permit
/ Approved by Permit Coordinator: Date:J
1:\Building\Forms\B1dgPennitRvw_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
14253 SW 118TH CT, TIGARD, OR, 97224
Residential - Master Permit
135 Low voltage rough-in
FAIL
MST2015-00255
Herb Stabenow
Added duplicate 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
14253 SW 118TH CT, TIGARD, OR, 97224
Residential - Master Permit
199 Electrical final
FAIL
MST2015-00255
David Young
Not ready for electrical final.
Provide breaker lock for dishwasher. 422.32
Notes at multiple switches and plugs to be changed per notes on wall.
Under cabinet outlets not gfci, gfci in dining rm not resetting.
Call for final when final plugs and switches are in place.
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
14253 SW 118TH CT, TIGARD, OR, 97224
Residential - Master Permit
399 Plumbing final
FAIL
July 20, 2016 at 1:15:16 PM
MST2015-00255
David Young
Provide PLM final for Backflow devise for lawn irrigation.
Provide approved thread sealant on clean out caps. 316.1
Cap unused rain drain stand pipe right rear.
Remove master shower drain plug. 310.4
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
14253 SW 118TH CT, TIGARD, OR, 97224
Residential - Master Permit
699 Mechanical final
FAIL
July 20, 2016 at 1:02:00 PM
MST2015-00255
David Young
Seal ceiling penetrations in garage by mechanical equipment. R302.5.3
Provide missing insulation on line set in garage. N1106.1
Seal line set penetration thru foundation wall in garage. R408.2
Seal around future vac system pipe in garage. R302.5.3
Provide installation instructions for fireplace to check mantel clearances.
Seal foundation vent penetrations. R408.2
Violation Summary:
Inspector Contractor
Location:
Record Type:
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Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
14253 SW 118TH CT, TIGARD, OR, 97224
Residential - Master Permit
699 Mechanical final
PASS
MST2015-00255
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
14253 SW 118TH CT, TIGARD, OR, 97224
Residential - Master Permit
399 Plumbing final
PASS
MST2015-00255
David Young
Rain drain stand pipe to be used as area drain tie in. Will check at building final
inspection.
Backflow devise for landscape irrigation not complete at this time. Will check at 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
14253 SW 118TH CT, TIGARD, OR, 97224
Residential - Master Permit
299 Final inspection
PASS - C of O
MST2015-00255
David Young
Note: Final inspection for back flow devise to be scheduled on correct permit as noted on
previous inspection.
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 with approved plans.
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
14253 SW 118TH CT, TIGARD, OR, 97224
Residential - Master Permit
399 Plumbing final
PASS
July 28, 2016 at 12:41:00 PM
MST2015-00255
David Young
This inspection passed previously. PLM final for Backflow devise to be scheduled on
correct permit as noted on previous 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
14253 SW 118TH CT, TIGARD, OR, 97224
Residential - Master Permit
199 Electrical final
PASS
MST2015-00255
David Young
Correction 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
14253 SW 118TH CT, TIGARD, OR, 97224
Residential - Master Permit
399 Plumbing final
CNCL
July 27, 2016 at 1:54:23 PM
MST2015-00255
David Young
Duplicate inspection.
Plumbing final passed at prior inspection dated 7/25/15.
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
14253 SW 118TH CT, TIGARD, OR, 97224
Residential - Master Permit
299 Final inspection
FAIL
MST2015-00255
David Young
Schedule final for landscape Backflow devise and provide approved test report. PLM
2016-00383
Front street tree on site,not installed at this time.
Screen mechanical vent at front porch lid.
Recall building and plumbing final inspections for approval after corrections complete.
Violation Summary:
Inspector Contractor