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Permit CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2015-00279 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/04/2016 Parcel: 2S110CB13400 Jurisdiction: TIGARD Site address: 12068 SW AUTUMNVIEW ST Subdivision: SOUTH VIEW HEIGHTS Lot: 22 Project: Southview Heights, Lot 22 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1117 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 32 Bathrooms: 3 Second: 1633 sf Garage: 514 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2750 sf Value: $337,324.93 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers' 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 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 FuelTypes 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: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Tema SrvclFeeders 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: Ecompasin g Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2750 Owner: Contractor: STONE BRIDGE HOMES NW LLC STONE BRIDGE HOMES NW LLC Required Items and Reports(Conditions) 4230 GALEWOOD ST,STE 100 4230 GALEWOOD STREET#100 1 Ersn Cntrl 503-639-4175 LAKE OSWEGO,OR 97035 LAKE OSWEGO,OR 97035 2 Geo-Tech report needed prior to foundation inspection PHONE: PHONE: 503-387-7577 FAX: 503-387-7615 Total Fees: $24,060.52 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 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by call in 1987 or 1.800.332.2344. Issued By: _ Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspection Mafe. This permit card shall be kept in a conspicuous place on the job site until completion dahe project. Approved plans are required on the job site at the time of each inspection. Building Permit Application ,! Residential RECEIVED EQ City of Tigard DEC 2 2 2015 ReceBive:d t 1 t 2 ` it N Date 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review i Other Perrnu�jQ `� Phone: 503.718.2439 Fax: 503.598"1M"�'til" TIGARD Dat eB : I Inspection Line: 503.639.4175 p{ !pp (�(�' Date Ready/By: 1°ris: ® See Page 2 for a Internet: www.tigard-or.gov BUILDING OMSIO `� Notified/Method./ 6 �- Supplemental Information ®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. ® I-and 2-family dwelling ❑Commercial/industrial Valuatiow-W $ / ❑Accessory building ❑Multi-family Number of bedrooms: q ❑Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION ARM, Total number of floors: 1- Job site address: J 2 D(oib -gW A�)"jl)M N V JEW S -, New dwelling area: 215 p square feet, City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet Suite/bldg./apt.no.: I Project name:Southview Heights Covered porch area: 7 square feet Cross street/directions to job site:SW 122""Ave&SW Beef Bend Rd Deck area: JA l7 square feet Other structure area: square feet REQUIRI~U AA,Ttt:,,COM IE9USE CHECKLIST Subdivision:Southview Heights Lot no.: a'J. Permit fees*are based on the value of the work perlormed. Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the DESCRTPTION 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:Stone Bridge homes NNN,LLC Type of construction: Address:4230 Galewood St,Suite 100 Occupancy groups: City/State/ZIP:Lake Oswego,OR 97035 Existing: Phone:(503)387.7577 Fax:(503)387.7615 New: ® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* Business name:same as above (Please refer to ee sehedu(e Structural plan review fee(or deposit): Contact name: Deirdre Britt FLS plan review fee(if applicable): Address: Total fees due upon application: City/State/ZIP: ' Phone:( ) Fax::( ) Amount received: JIM E-mail:dbritt@stonebridgehomesnw.com Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name:same as abo%a Submit two(2)sets of roof plan with connection details -- 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: 1 State surcharge(12%of permit fee): $21.60 CCB tic.: 173318 Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Print name:�RP(��, _$RITT Date: (2/Z� J rj Service Board. 1:\Building\Pemtits\3UP-RESPermitApp.doc 02/24/2011 4404613T(II/02/COM/WEB) -CEI ` Electrical Permit Application FOR OFFICE USE ONLY �. L� '�C 2 ✓ 2015 Received Cit of Tigard Permit No s��/S City o?7 ,"11 v: 1312 s SSV hall Blvd., I igard,OR 9722-3 r r� Phone: 503.718.2439 Fax5034198.060' t( '+ J plan Review • •- - Other Per` �pp %t I Dale/By: � InspeclionLmc: 503.639.4175 ,..r'E,$) iJi`1vl�.,)�v DatcRcady/By: Luis E7 See Page 2for laterite[: www,ligard-or.gov Notified/Method' Supplenrentallnformation `TYPE OF WORK REVIGW ®Nc%v consuttction ❑ Plcasc ch-,❑II ileo ,poly(snbow 2 eels of planswinems checked below) ❑Demolition l l Ohl ❑Se,vice or Iceder X100 amps or more ❑Building over three stories. ❑Othcr: where the available fault current ❑Marinas and boatyards. C',>Fht;OR4 OV CONS 17ON' exceeds 10,000 amps at 150 volts or ❑Floating buildings. ------ less lu ground,or,exceeds 14,000 ❑Commercial-ose agricultural ® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings. ❑Multi-fvnily ❑ Master builder ❑Other: ❑Fire pump, ❑Installation of 150 xvA or — — —-- -- ------- ----- ❑Emergency system, larger separately derived system: 1 JOB SITE IN1=ORMATION .kNl) LOCATION ❑Addition of new motor load of ❑''A" "r "1-2""t-3", Job no.: Job site address: 100111,Ur more, occupancy. ❑Six or more residential units. ❑Recreational vehicle parks.. City/State/"LIP:Tigard,OR 97224 ❑l lcahh-care facilities. ❑Suppl-y voltage for more than 011aUnrdous locations,, 600 volts nominal. Suite/bldg./apt.no.: Project name:Southview Heights ❑Service or feeder 600 amps or more: x ., Cross street/directions to job site:SW 122"'t Ave&SW Beef Bend Rd n4srri run I 01y. I F-, I Tord New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision:Southview Heights Lot no.: 'R 1,000 sq ft or less 168.54 4 ____... Fa,add']500 sq,fl,or portion 33.92 1 Tax map/parcel no.: Limited energy,residential I)F SC IIII'I I(}, ' �� K _ Ovith above si.11.) 75.00 2 -— ---. - Limited energy,multi-family new,single family residence residential(with above sq,fl.) 75,00 2 -". Renewable Ener ay d See Pa ie 2 ." Services or feeders installation,alteration,and/or relocation �(}tiY`1�R - ❑ 1 F:N,%N1' 200 amps or less 100,70 2 _. 201 mnps to 400 amps 133,56 2 Name:Stone Bridge Homes NW,LLC 401 amps to 600 amps 200,34 2 Address:4230 Galewood St,Suite 100 601 amps to 1,000 amps 301.04 2 Over 1,000 amps or volts 55126 2 City/State/ZIP:Lake Oswego,Oil 97035 Temporary services or feeders installation,alteration,and/or Phone:(503)387.7577 Fax:(503)387.7615 relocation 200 amps or less 5936 1 Owner installation:This installation is being made on properly 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 70 L 401 mnps to 599 amps 168.54 2 Owner signature: Date: Branch circuits-new,alteration,or extension, cr panel A.pee for branch circuits Ivirlr above service or feeder fee, 7 42 2 j Business name:same as above each branch circuit - - B.Fee for branch circuits without Contact name:Deirdre Britt service or feeder tee,first 56.18 2'-' branch circuit Address: Each add'I branch circuit 7,42 2 Miscellaneous(service or feeder not included) City/State/IIP: Each mmnllactured or modular 67.84' 2 Phone:( ) Fax::( ) dwt:lfinRtservice and/or feeder Reconnect only 67,84 2 E-mail dbritt,ii)stonebrid);ehnmesnw•com Primp or irrigation circle 67.84 2 rA .<_ _. :.'` � Sign or outline lighting 67.84 2 Business name:City Electric -Signal circuits)or limited-energy See ancl,alteration,or extension. Page 2 2 Address:55568 SW Schaltenbrand Ln Each additional inspection over allowable in any of the above Additional inspection(I hr min) t:6^.5/hr CityiState/ZIP:Sherwood,OR 97140 Investigation(1 hr min) 66.25/hr Phone:(971)404.1714 Fax:(503)625.3052 Industrial plant(1 hr min) 78.1 R/hr - Inspections for which no ec i CC13 Lic.: 42422 i;leelrieal Lic.: 26-2890 Suprv.Lic.: 35925 tip 61-1- oily listed(s hr mi:)) )Otho!hr '--- �J - ELECTRICAL PERMIT FEES -- Sul)rv. flecU•ician signature, required: V �� 5ublulal Print name: Chuck Friesen Date: Pl_an twiny(25:6ol permit lie): __._.._._ �.-... ._ _... . -__._.__ Stale surcharge(121.0 of pefntit fec): Authorized signature: TO'I'A1,111:RM1 I PIT: Print 11an1C' Oa1C: This permil application e%pires if a pernul is nor obtained"ithur 1811 days after it has been accepted as complete. ..............._............. __.____.-._... ._.._.__ Nund,cror inspections allowed per permil 1.114uilrlhi r FmiI,H I C,.j nuil:5p1,J LK_F!Lb:.Joc K.:v r+i21l241i 6b.tot 51`11 Ib 1WON1-wl n Mechanical Permit Applicatio'RE(;F1 y EFOR OFFICE USE ONLY l 9 acec;vcd It Of I 1 s1 Ct� 2 n/ Penni[NoS ../37 P 13125SW I lallgBlvd-•ligand,Olt 97223 DEC 2 2�1 Dalt IkQ S Plan Review phone: 503.718,2439 Pax: 503.598.1960 ` 0 Other Pennic am �k�Y V�' Dale/B}•: Inspection Line: 503.639.4175 1\f. 1 Date Reidy/13y: )uris: 0 See Page 2 for Internet www.tigard-or.gov �� ,`S Nol;lied/Method Supplemental Information 1111' OF WORK GOh11IF,RCIAL FF.E- SCHEDULE - USE CNFCKLIST"" -- - Mechanical pcnnit Ices'me based on the value of the work ®New construction ❑Adclition/alteeation/t-eplacement peFflormcd.Indicate the value(rounded to the nearest dollar)of all ❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. V:d uc CA FECOItY O ('ONSTRUCTION RtS1UE\"1T.�LF(�tllPtit:N"t /S1:5TF SSF'Eliti' ❑ I-and 2-1•amily dwelling ❑Commercial/industrial ❑Accessory building korspecial infornrationuse checAlisr. ❑ Multi-family ❑ Master builder ❑Other: Description Qty. Ea. 1-otal JOB SITE INFORMATION AND LOCA'VION Ileatin coolin : Air conditioning 46.75 lob site address: Furnace 100,000 BTU(ducls/vents) 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100.000+RTU ducts/venls) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name:Southview Heights Duct work 23.32 Cross street/directions to job site:SW 122nd Ave&SW Beef Bend Rd Hydronic hot water system 23.32 Residential boiler(radiator or h•dronic) 23.32 Unit heaters(fuel-type,not electric), in-wall in-duct suspended,etc. 46.75_ F_lue_/vent for any_of above 23.32 Subdivision:Southview Heights Lot no.: �Z Other: - 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DFSC'RIPTION OF WORK Gas fireplace/insert 33,39 ..._.__ ._ Flue vent for water heater or gas new,single family residence Fireplace 23.32 Log lighter(gas) 23.32 -- - - - -- Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chinmc /liner/fluelvent 23.32 -- — —— — Other: 23.32 �'p'I2 ,�,�1�'[zY`01�11LR�� _�_��,��❑ '1-CNAN7• � Environmental exhaust and ventilation: Name:Stone Bridge homes NW,LLC Range hood/other kitchen ---- _5ay men[ 33.39 Address:4230 Calewood St,Suite 100 Clothes dryer xhau.-.._... _ _ Clothes dr cr exhaust . 33,39 City/State/ZIP: Lake Oswego,OR 97035 v Single-duct exhaust(bathrooms, toilet com arunents,utilit rooms) 23.32 Phone:(503)387.7577 Fax:(503)387.7615 Attic/crawls ace fans 23.32 ® APPLICANT Q'CONT'AC"t' PERSON Other: _ _ 23.32 ---` Business name:same as above Fuelpiping: '(14.15 for first four;53.03 for each additional Contact name: Deirdre Britt Furnace,etc. Address: Gas heat pump ---- Wall/suspended/Unit heater City/Stale/ZIP: Water heater Phone:( ) Pax::( i Flee 11CC ----— Ran e F-mail clbrittCn')stonebridgehamesnw.com Barbecue CON'TRACTOR Clothes dryer(gas) Business name:Comfort Zone Oihc[ h1FC'IIANICAI,PF,RN11'I'FF,FS* Address: 1032 NW Corporate Ar -- Subtotal -._ ------------ .................._....._- - -- .. . --___._�_-_. City/Stale/"LII':Trouldate,OR 97060 Minimum permit fcc('590.00) __—_......�_._....._........._.__-- Plan review(25%of permit I•ee) Phone:(503)667,5595 Fax:(iO3)491.8252 � _.--------- Slatc surcharge(12%of permil fee) -- - .........._�._.. C01 lic.: 110091 TOTAL PFI2MIT'FFI. ......_..._..._._�_._._................___.._.___._..__-__...._. _. ._.___._� _ -- 'Chis permil appticalinn expires if a permit is not obtained w•ilhin IRO ,r days after it hos been accepled as complete. $ Aulhorized si-,llmure: Qk Pee mcilimfulopy scl by Tri-Cowuy Holding IudnsVy Service noald I'rinl nano:David Ileldslah Dale: 1'•.INuldbw;l'trr+it.V1.0 P,•nni:.\I+r 4u11.:.Jn. I ill-•/h 171(tli:+?K'U\VtVl:n) Plumbing Permit Application CEIVEn Building FixturesUSE GEC 2 2 2015 ,/�� ✓ g ONLY Cit of Tigard Pc,,,,;1 N M- alp 13125 SW Hall Blvd_Tigard;OR 97223 Plan e -- ,'])one: Review ,']torte: 503.718,2439 Pax 5(13.598,1961) Datc/13y, 01hei-PermitNo:; Inspection Line: 503,639,4175 Dale Readyilly: hoist 0 See Page 2 for - Internet: www.tigard-or.gov Noliticd•Rvtelhod: Supplemcnlallnfor,nnlion "TYPE OF WORK FEE*'SCTIEDIILE r ®New construction ❑Demolition For special int urntrrfion use checklist. TfeSenptton _._ _ t1t F.a. I Total ❑Addition/alteration/replacement ❑Other: New 1 2-family dwellings(includes 100 ftL,,for each utiht connection) SFR(1)bath 312.70 ® 1-and 2-family dwelling ❑Conunercial/industrial SFR(2)bath 437.78 E]Accessory building ElMulti-family SFR(3)halh 500.32 ---- Gach additional bath/kitchen 25.02 ❑Master huildcr ❑Other: -- Fue sprinkler( sq.ft,) Page 2 s,E 4 Site at111[[es: Job site address "" est jj �W A,;xt.3Mip�j V I SW 47, Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard,OR 97224 - Footing drain(no.linear 11,;_) Page 2 Suite/bldg./apt.no.: Project name:Southview Heights Manufactured home utilities 50.03 Cross street/directions to job site:SW 122"'t Ave&SW Beef Bend Rd Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no,linear f1.:_) Page 2 Storm sewer(no.linear ft.: _ ) Page 2 Water service(no,linear tt. _) Page 2 Subdivision:Southview Heights Lot no.: Fixture or item: _ - 1'ax map/parcel no.: Backtlow preventer 31..27 _ - -� = Backwater valve 12.51 ^; MW DL;SC`RWIMN Oill Ay'O Clothes washer 25.02 new,single family residence __ . .. Dishwasher 25.02 Drinking fountain 25.02 1-jectors/sump 25.02 1 t 1 r Cxpanslon lank_. 12.51 Name:Stone Bridge}fomes NW,LLC Fixiure/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:4230 Galewood St,Suite 100 ____. _._._ ._ .._..............._. .- Garbage disposal 25.02 City/State/ZIP:Lake Oswego,OR 97035 Hose bib 25.02 Phone:(503)387.7-577 Fax:(503)387.7615 Ice maker 12.51 Interceptor/grease(rap 25.02 Business name:same as above Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:Deirdre Britt Roof drain(commercial) 12.51 Address: Sink/basirdlavatory 25.02 City/Stale/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 12.51 - Winal 25.02 I:-mail:dhritt«t?sloncbridi;chumcsnw.com �._ - _..._. ----- --- Water closet 25.02 CONTRACTOR Water heater 37.52 Business name: Nlax Plumbing - - ---- ._ Water pipinl:/DWV 56,29 Address:PO Box 5597 Other, 25.02 City/State//II': Beaverton,OR 97006 Subtotal Phone:(971)275.0198 ax: Minimum permit lce $72,50 " Plan -- { 3 ievlexv (?5a,til permit 1cc)('01 Lic.: Plumbing to :2_ ....- ... .. S1a,c s:ircItarrc(12.E ohperniit fee) Aulhurlrul signature: ( 'I'OTA],I'RMff 1 lifi l 'I'h,r permit application expire,if a permil is not oblained within 180 days lutln.une:.lason 11Ar<ner Dade: I - _ after it has been aeayHed as cany±kte- "I cc n,elh,±,Iningv>cl he Ti i-('uunlp ISuiidirtg buh,:oe Sc, icc Board. 111Auldinp:Pa mi,.s,Pl,hn 1-Pei mii.4pp Ane I,VnIp±M J4u..loloT(lgrC"(O;.lFNVI:li) City of Tigard �. COMMUNITY DEVELOPMENT DEPARTMENT ■ Building Permit Review — Residential Building Permit #: O fes 79 Site Address: i2b6R sw Au-tumn Vi,e.W :3+ , Project Name: -50(A View �OjawLot #: ZZ. (New dwelling=subdivision n e;Addition or Alteration=last name of owner) Planning Review Proposal: new SF 5(Verify site address/suite#exists and active in permit system. OK River Terrace Neighborhood: ❑ Yes No Sip6 Plan Elements: ee(3)copies of site plan -DExisting structures on site S' a plan must bg on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished rawn to scale(standard architect or engineer scale) oor elevations Forth arrow Utility locations(required for new,may apply for additions) Ep address,project or subdivision name and lot number cation of wells/septic systems plicant information(name and phone number) rosion control(including drainage-way protection,silt fence dimensions and building setback dimensions sign,location of catch basin,etc.) area,building coverage area,percentage of coverage and Leet names 34pervious area(applicable if R-7,R-12,R-25&R-40) Street tree size,type and location 01perty corner elevations(2 foot contour lines if more than $Existing trees to be retained with drip line,and tree 4 foot differentialprotection measures 7 Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): /equired: ❑ Yes,applicant was notified -X No Received: ❑ Yes ❑ No public Facilities Improvement(PFI) Permit: —/ Required: ❑ Yes,applicant was notified ❑ \o Applied For: L� yes ❑ No,stop intake PP P El Land Use Case#: W-62-01'6-00005 NJ zoning: R— Setbacks: Front S Rear S Side S Street Side -- Garage 201 Landscape Requirement: 20 EZ Lot Coverage Maximum: �S ,/Building Height: Maximum Height .�S' Actual Height 32' �!J Visual Clearance Easements Sensitive Lands: ❑ Yes No Type Urban Forestry Plan `W Conditions "Met"prior to issuance of building permit Notes: Approved By Planning: M, 71 M Lp,}� - Date: 12 22 IS 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_070915.docx Building Permit Submittal Original Submittal Date: /.;2/�_`/-� Site Plans: # /_ Building Plans: # y Building Permit#: R-Enter building permit#above. Workflow Routing. [Planning 9-T-ngineering 9-Permit Coordinator Building Workflow Sign-off 2-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 on plan review routing form. ER Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: Iq By Permit Technician: Date: /2 Engineering Review lope at building pad: 4:2 e:�� Conditions "Met"prior to issuance of building permit Easements (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: Date: f�" 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: (�Res ❑ N/A Tigard Trans SDC: ❑ Yes ,EN)N/A Parks SDC: Yes ❑ N/A OK to Issue Permit Approved by Permit Coordinator: 1:\Bui lding\Forms\B1dgPermitRvw_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 12068 SW AUTUMNVIEW ST, TIGARD, OR, 97224 Residential - Master Permit 199 Electrical ﬁnal FAIL MST2015-00279 David Young Remove smoke detector cover from main ﬂoor den, and upper level front bedroom to test interconnection of devices. 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 12068 SW AUTUMNVIEW ST, TIGARD, OR, 97224 Residential - Master Permit 699 Mechanical ﬁnal PASS MST2015-00279 David Young Note: no AC installed at time of mechanical ﬁnal inspection. Permit and inspection required at time of installation. Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 12068 SW AUTUMNVIEW ST, TIGARD, OR, 97224 Residential - Master Permit 199 Electrical ﬁnal PASS MST2015-00279 Chip Barnett Violation Summary: Inspector Contractor City of Tigard 111 ~ COMMUNITY DEVELOPMENT DEPARTMENT T 1 G A R D Building Permit Review — Residential Building Permit #: l•-t S%oa-a E t--- o -7? -��' Site Address: 7Q06e ,SA) /}u�i A) ion v, i ,S2):- Project Name: ;9k 1/jei , ° AA Lot #: c (New dwelling=subdivision name;Ad on r Alteration=last name of owner) Planning Review Proposal: pq/i_SPI Cie-SerP, die-L_ AO/ -2,47/%"S /Verify site address/suite#exists and activ to permit system. ftiver Terrace Neighborhood: 1 No ❑ Yes,See River Terrace Review Addendum Attached Sits Plan Elements: 7hree (3) copies of site plan pa: sting structures on site to plan must be on 8-1/2"x 11"or 11 x 17"paper r ootprint of new structure(including decks)with finished Drawn to scale(standard architect or engineer scale) or elevations $iVorth arrow IldUtility locations(required for new,may apply for additions) OAte address,project or subdivision name and lot number tc) cation of wells/septic systems pplicant information(name and phone number) p sting trees to be retained with drip line,and tree t dimensions and building setback dimensionsp tection measures I ZLot area,building coverage area,percentage of coverage and VSeet tree size,type and location pervious area(applicable if R-7,R-12,R-25&R-40) Street names 1p 'roperty corner elevations(2 foot contour lines if more than 4 foot differential) t1lean Water Services—Service Provider Lett (lot platted prior to 9/10/1995): gutted: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No I(d Public Facilities mprovement(PFI) Permit: Required: VYeIs,applicant was notified ❑ No Applied For: 1/Yes ❑ No,stop intake and Use Case#: S'l/,BO/3- OOCX» ,/Zoning: 2-3- I etbacks: Front 1S— Rear /S— Side S Street Side N15.Garage 4Q andscape Requirement: c,20ot Coverage Maximum: �.) l0/0 Building Height: Maximum Height 3c 1 Actual Height /0 pi sual Clearance Easements ensitive Lands: ❑ Yes /N.() Type red Forestry Plan Conditions "Met"prior to issuance of building permit Notes: Approved By Planning: Date: - ,a/. Revisions (after!Hciilding Submittal only) Reviewer Date Revision 1: V Approved ❑ Not Approved -4,:t_ _ZilVlie Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved 1:\Building\Forms\BldgPermitRvw_RES_060116.docx Building Permit Submittal Original Submittal Date: Site Plans: # Building Plans: # Building Permit#: ❑ Enter building permit#above. Workflow Routing: ❑ Planning ❑ Engineering ❑ Permit Coordinator ❑ Building Workflow Sign-off: ❑ Sign-off for Planning(include notes from planning review) Route Application Documents: El Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. ❑ 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: Conditions "Met"prior to issuance of building permit Easements (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:, 1:3PDate: z.-7_lb Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: El 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: L i C Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ( 1/A / Tigard Trans SDC: ❑ Yes N/A Parks SDC: ❑ Yes N/A FiDK to Issue Permit Approved by Permit Coordinator: Date: /_ / .71 If C\Building\Forms\B1dgPermitRvw_RES_060116.docx A FOR OFFICE USE ONLY—SITE ADDRESS: j th Ce Aures, 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 Transmittal Letter 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 •www.tigard-or.go� TO: TO/A. 4 DATE RE EIV' : DEPT: BUILDING DIVISION ^ ; H, EIVED FROM: JUN p 6 2016 COMPANY: �j �z �rr, ,� CITY OF TIGARD PLANNING/ENGINE .IN6 42 • PHONE: ? —3' 7--75'7 7 A RE: 1,D b gw /1/1.v \J � ,�1/lST 2f� l — �O?1C1 (�ite Address) lPermit Numb 0„.." vs RECEIVED (Project name or subdiv on name and lot n b= LA —3191JUN 6 2016 ATTACHED ARE THE F t LOWING ITE S: Additional s: (s)of pl.�s s. Revisions: PrX,,)- S\-a,k v s }aL �' -es-v- Cross secti (s)and deta. s. Wall bracing and/or lateral analysis. Floor/roo framing. Basement and retaining walls. Beam c. culations. Engineer's calculations. Other(r xplain): REMARKS: J06,361. v-s Dc 04. Routed to Permit Te ician: Date: C) / ) c Initials: Fees Due: ►S Ye �� No Fee Description: • ount )e: ., T q p pt, d Tet Ace) q $ $ //L , Special Instructions: Reprint Permit(per PE): El Yes IA No II t one A 9 s licant Notified: Date: (e(t (p -I -' k� Initials:0/4/ r 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 12068 SW AUTUMNVIEW ST, TIGARD, OR, 97224 Residential - Master Permit 399 Plumbing ﬁnal FAIL MST2015-00279 David Young Provide access for inspection, door locked. R109.1 Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 12068 SW AUTUMNVIEW ST, TIGARD, OR, 97224 Residential - Master Permit 299 Final inspection FAIL MST2015-00279 David Young Provide approved plumbing ﬁnal inspection for PLM2016-00237. Provide access for inspection, door locked. 9:35 am. R109.1 Violation Summary: Inspector Contractor