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Permit (142) INU CITY OF TIGARD MASTER PERMIT I. COMMUNITY DEVELOPMENT 1 Permit#: MST2015-00262 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 wirw Date Issued: 02/22/2016 ��(p Parcel: 1S136AA13000 Jurisdiction: TIGARD Site address: 10381 SW 67TH AVE Subdivision: OAK STREET ESTATES Lot: 25 Project: Oak Street Estates, Lot 25 Project Description: New SF 3/27/2016: Demo credits applied from BUP2015-00091. 3/31/16: Reprinted permit to show address correction from 10386 to 10381 SW 67th Ave. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1198 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1250 sf Garage: 523 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 2 Detectors: Yes Total: 2448 sf Value: $300,184.06 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach. 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 4 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: 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 adel 500 sf: 4 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2448 Owner: Contractor: LENNAR NORTHWEST INC LENNAR NORTHWEST INC Required Items and Reports(Conditions) 11870 NE 99TH ST,STE 1170 11807 NE 99TH STREET SUITE 1170 1 Ersn Cntrl 503-639-4175 VANCOUVER,WA 98682 VANCOUVER,WA 98682 PHONE: 360-258-7900 PHONE: 360-216-6423 FAX: 360-258-7901 Total Fees: $15,154.83 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 co. - - les or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By:‘— �z Permittee Signature: ,......2D C. "39.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. /UST , UIS-- lj0ZG ) j17 ? 54,) G771, L • TIGARD City of Tigard March 9, 2016 Lennar Northwest Inc. Attn: Juls Call 11807 NE 99th St., Suite 1170 Vancouver,WA 98682 • Re: Permit No. Various New SF Residential Permits - See Attached List Dear Applicant: • The City of Tigard has processed a refund for fees on the above referenced permit(s) as follows: Site Address: Various Project Name: Oak Street Estates - Lots 1-23 and 25-31 Job No.: Refund: ® Check #220393 in the amount of$338,059.00. ❑ Credit card "return" receipt in the amount of$ . Note: Please allow 2-5 days for this refund transaction to be credited to your account by the company that issued your card. E Trust account "deposit"receipt in the amount of$ . Comments: Refund for SDC fees paid prior to available credits applied from demolition permit BUP2015-00091 for armory building and SF residential building. See attached spreadsheet for SDC credit balance and list of permits that credits were applied to. If you have any questions please contact me at 503.718.2430. Sincerely, re a Dianna Howse Building Division Services Supervisor Enc. 13125 SW Hall Blvd. ° Tigard, Oregon 97223 4 503.639.4171 Y ig City of Tigard TIGARD Accela Refund Reques t This form is used for refund requests of land use, development engineeri=ng and building permit application fees. Receipts, documentation and the Request for PermitActio form (if applicable)must be attached to this request form. Refund requests are due to Accela System Administrator by each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts Payable will route refund checks to Accela System Administrator for distribution to applicant. PAYABLE TO: Lennar Northwest Inc. DATE: Attn: 3/7/2016 uls 1 Call 11807 NE 99th St., Suite 1170 REQUESTED BY: Dianna Howse Vancouver,WA 98682 TRANSACTION INFORMATION: Receipt#: Various Case#: Date: Various Various Pay Method: CreditCard Address/Parcel: Various Project Name: Oak Street Estates EXPLANATION: Refund for transportation development and parks system development fees paid prior to demolition credits for armory structures and (1)residential structure. Received final inspection for BUP2015-00091 on 2/10/2016 so credits car' be applied and all SDC fees paid by developer shall be refunded. REFUND INFORMATION: Fee Description From Receipt Revenue Account No, Exam.le: Buildin: Permit Fee Exam.le: 2300000-43104 Refund Washin:ton Coun Trans.ortation Develo.ment Tax 405-0000-43320 $Amount Parks SDC-Im.rovement 425-0000-43300 $237,723.00 Parks SDC-Reimbursement 425-0000-43301 20,203.00 Sewer Connection 500-0000-25500 3,633.00 X1,890,90 ' ,g 6 SO.(rd 11.111111111111111111111111111111111111111111 TOTAL REFUND: ,$3337449701 APPROVALS: SIGNAT �;_._ S DATE: If under $5,000 Professional Staff fra 111 � i f If under$12,500 Division Manager _3/0 If under $25,500 Department Manager If under$50,000 City Manager i - If over$50,000 Local Contract Review Board ..L4jEcj P1/4./0 FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY Case Refund Processed: Date: ''/ B : p CITY OF TIGARD MASTER PERMIT ligs COMMUNITY DEVELOPMENT Permit#: MST2015-00262 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/22/2016 Parcel: 1 S136AA13000 Jurisdiction: TIGARD Site address: 10386 SW 67TH AVE Subdivision: OAK STREET ESTATES Lot: 25 Project: Oak Street Estates, Lot 25 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1198 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1250 sf Garage: 523 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 2 Detectors: Yes Total: 2448 sf Value: $300,184.06 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain 0 Storm Sewer: 100 Tubs/Showers: 4 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 Fuel Tvees Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 I Fum<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Fum>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temo Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add''500 sf: 4 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2448 Owner: Contractor: LENNAR NORTHWEST INC LENNAR NORTHWEST INC Required Items and Reports(Conditions) 11870 NE 99TH ST,STE 1170 11807 NE 99TH STREET SUITE 1170 1 Ersn Cntrl 503-639-4175 1 VANCOUVER,WA 98682 VANCOUVER,WA 98682 PHONE: 360-258-7900 PHONE: 360-216-6423 FAX: 360-258-7901 Total Fees: $23,267.83 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 AR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. ,, / fc4 - Issued By: -F Permittee Signature: ©/ti p1Pel -770A/ /e770A Call 603.639.4175 by 7:00 a.m.for the next available Inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. . Building Permit Ap licatio ,r _ Residential t ' . 1 i FOR OFFICE USE ONLY • Received ,,,,l City of Tigard �' 212015 DateBy: /a dye//� Permit No.:M L)��/S 21 I_21 'q 13125 SW Hall Blvd.,Tigard,OR 97223' _ PlanRevie i ' ` P/� ' C Phone: 503.718.2439 Fax: 503.598.1969 Date/By: 0 8/�� Other Permit: e s / T I G A fill Inspection Line: 503.639.4175 t,11 j k Ir` '' k I) Date Ready/By: Juris: I H See Page 2 for �Ai Internet: www.tigard-or.gov 31.11L9ING 1,R1.1101‘ Notified/Method: Supplemental Information TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING ®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 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ® Valuation :300 1-and 2-family dwelling 0Commercial/industrial .300 rm.' $ Q J .4.) ❑Accessory building ❑Multi-family Number of beooms: .. 0 Master builder 0 Other: Number of bathrooms: 3 JOB STTE INFORMATION AND LOCATION Total number of floors: 2.— Job Job site address:jD36:)z sw 6 77g /4VL= _ New dwelling area:4 4_4 g square feeta9- I City/State/ZIP: 776 AR))i OR q '7 2 2/ Garage/carport ar :• 523 square feet Suite/bldg./apt.no.: Projectname: Covered porch area: square feet)asCj Cross street/directions to job site: Deck area: ' ) ' square feet I 9 7 Other structure area: square feet tO� REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: 2i94.- S;----e&-g,T 6_7:c 7-4 77[5 Lot no.: 2 5 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. NSFR Valuation: $ Existing building area: square feet New building area: square feet ® PROPERTY OWNER 0 TENANT Number of stories: Name:LENNAR NW,Inc. Type of construction: Address:11807 NE 99th Street,Suite 1170 Occupancy groups: City/State/ZIP:Vancouver,WA 98682 Existing: Phone:(360)258-7900 Fax:(360)258-7901 -New: B1 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* Business name:Lennar NW,Inc. (Please referrtofee schedule) Structural plan review fee(or deposit): Contact name:Charles Webb Address:11807 NE 99th Street,Suite 1170 FLS plan review fee(if applicable): City/State/ZIP:Vancouver,WA 98672 Total fees due upon application: Phone:(360)258-7900 Fax::(360)258-7901 Amount received: E-mail:PORPermits@lennar.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic Solar Panel Syste. Business name:same as above Submi two(2)sets of roof plan with connect'• details and fire.:.artment access,along with • " 110 Oregon Address: Solar Install. .• Specialty Code •"c ist. City/State/ZIP: Permit Fee b... . an review $180.00 and adult • alive fees): Phone:( ) Fax:( ) State surcharge(12%of perm' ee): $21.60 CCB lic.: 1 953c,3c, 7 Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained ,i within 180 days after it has been accepted as complete. Print name: Date: `` s-- *Fee methodology set by Tri-County Building Industry /f t Cy L«}� lZ-I7- Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011/ 440-4613T(11/02/COM/WEB) Electrical Permit Applica . ' CEIVEP 1.(W 01-I I( L. I '1' 1)v1.1 City of Tigard Received 9041111 IIIIMIll Permit No.:10467-30/5-_6096.,_ 2 • 13125 SW Hall Blvd..Tigard,OR 94223'- 1 5 Plan Review Phone: 503.718.2439 Fax: 503398.1960 DatwBv:Date/B•: Other Permit: 1 i \t,1) Inspection Line: 503.639.4175 qq g \, �' ikfu Date Ready/By: kris- VI See Paget for L 11 I �. �1: Internet: www.tieard-or.gov TT ff gy ii NotifiediMnhed: Supplemental Information TYPE gF10Itic �I��il° PLAN REVIEW New constructionPlease check all that apply(submit 2 sets of plans w/items checked below): 00 Addition/alteration/replacement ❑Service or feeder 400 amps or more 0 Buildine over three stories. ❑ Demolition 0 Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. less to ground,or exceeds 14.000 0 Commercial-use agricultural 0 I-and 2-family dwelling 0 CommerciaUindustrial 0 Accessory building amps for all other installations. buildings. ❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or ❑Emergency system. larger separately derived system _ JOB SITE INFORMATION AND LOCATION 0 Addition of new motor load of ❑"A",-E ,"I-2"."I-3", Job no.: Job site address: /a3 86 S w t, 77.A. /Q jet. 1 or more, occupancy. ❑Six x or more residential units. 0 Recreational vehicle parks. City/State/Zlir: 777,1413D GE 9 72 2 2 EJHealth-carefacilities. 0 Supply voltage for more than G . 0 Hazardous locations. 600 volts nominal. Suitt/bldg.lapt.no.: Project name: 0 Service or feeder 600 amps or more, FEE SCHEDULE Cross street/directions to job site: Description I tom. I Fee. I Tow I • New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: /, 5-7:964-6.-: / - Lot no.: 1,000 sq.ft.or less 168.54 4 `�4fr 7 C�s74�L S 2 Ea.add'!500sq.ft,orportion433.92 I Tax map./parcel no.: Limited energy,residential 75.00 2 DESCRIPTION'OF WORK (with above sq.ft) Limited energy.multi-family 75.00 residential(with above sq.ft.) - Renewable Energy 0 See Page 2 Services or feeders installation,alteration,and/or relocation • r-' PROPERTY OWNER - -. 0 TENANT. . 200 amps or less i 100.70 201 amps to 400 amps 133.56 2 Name: - JI 4 Y 1 401 amps to 600 amps00.34 2 2 Address: 601 amps to 1.000 amps 301.04 2 • t` Over 1.000 amps or volts 552.26 2 City/State'ZIP: �Q Rau vr/r I,/J f w60'2 Temporary services or feeders installation.alteration,and/or Phone: O ) 5-.0- 1 9.3 // v Fax:(AZ)05t 1101 - 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 115.08 12 intended for sale.lease,rent_or exchange.according to ORS 447.449.670.and 701. 401 snips to 599 amps 168.54 1 2 Owner signature: Date: Branch circuits-new,alteration,or extension,per panel A.Fee for branch circuits with APPLiCANk3' , •_., , ❑ CONTACT PERSON: above service or feeder fee. � ,Q �� 7.42 2 Business name: x 4 A rAr 1/ NI, I I �t each branch circuit I v V N w '' B.Fee for branch circuits without Contact name: r• ��Q��/�, , �i� service or feeder fee,first 56.18 t/0�. s r'/"' V" //�� 1 branch circuit Address: t 2)V ' I V 1 -y%, - , I-10 Each add'I branch circuit 7.42 2 City State/ZIP: nt1lJ ✓(� 1 _( Miscellaneous(service or feeder not included) �Ci 11("()U 4 l F'CJ� Each manufactured or modular Phone:130) r� .- l e y'j) Fax: 9-S' -7 dwelling,service and/or feeder 67&1 ��/`"'`` s� n/� �' Reconnect only 67.84 2 E-mail: Pn `�'m r el � C 01Y1 t Pump or irrigation circle 67.84 CONTRACTOR Sign or outline lighting 67.84 2 Business name: l?bwe4 V;, T��Gat. -+�� Signal circuit(s)or limited-energy See panel,alteration,or extension. Pace 2 2 Address: cb�0� ` e e� , - Each additional inspection over allowable in any of the above Additional inspection(I hr mm) 66.25.'hr Cit)/State/ZIP: Ci7frn I_ ' are- CV-TZ Investigation t 1 hr min) 66.25;hr Phone:(cr1 I �c15-3f Fax:( ) Industrial plant(1 hr min) 78.18-hr 1 vv t Inspections for which no fee is 90.00'hr CCB L.ic.: rT6 Electrical Lie.: C,, Vz) Suprv. Lic.:5 305 5 specifically-listed(%:hr min) ELECTRICAL PERMIT FEES Supn.Electrician signature,required:��"" " " _ Subtotal: � Plan review(25%of permit fee):name: jGrf � K ,- r( ate: — State surcharge(12% • of permit fee): Authorized signature • ©w ,� (, TOTAL.PERMIT FEE: This permit application expires if a permit is not obtained within ISO Print name: 1n.c.n� \f 0`oJe4� I Date: �, days after it has been accepted as complete. * Number of inspections allowed per permit. 1 IB uildincTermits.ELC_PermitApp_ELR ERE doc Rev O5^52011 ,40-46151'1 11,05'COM1rWEB Mechanical Permit Application FOR OFFICE USE ONLY Received Cityof Tigard Permit No.: 111‘ q 131SW Hall Blvd.,Tigard,OR 9jCEIVEPr, DateMy: g2//s ptv9 I"(GjT 'Yj_OU a1(0 ■ ¢r° Plan Review Other Permit: Phone: 503.718.2439 Fax: 503.59 Date/By: Inspection Line: 503.639.4175 Date Ready/By: auris: td See Page 2 for TIGARD y Y g Internet: www.tigard-or.gov I.n -r, 2 1 Y.315 Notified/Method: Supplemental Information TYPE OF4 9I Ot I1(1ALlW COMMERCIAL FEE* SCHEDULE —USE CHECKLIST Mechanical permit fees*are based on the value of the work ®New construction ❑AdditiongtuthotwovsjoiN. performed.Indicate the value(rounded to the nearest dollar)of all O Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: 1, �7 Air conditioning i 46.75 Job site address: /02296 5141 f/0 '/ 41/6-.- Furnace 100,000 BTU(ducts/vents) 1 46.75 City/State/ZIP: 6"/922),/ v!2 q 722 Furnace 100,000+BTU(ducts/vents) 54.91 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 -S� Other: 23.32 Q7f, Subdivision: ,5-77-'266--C / r C: 7-4z-es Lot no.: 2/j Other fuel appliances: Tax map/parcel no.: Water heater 1 23.32 DESCRIPTION OF WORK Gas fireplace/insert 1 33.39 Flue vent for water heater or gas NSFR 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 0 TENANT Other: 23.32 Environmental exhaust and ventilation: Name:LENNAR NW,INC Range hood/other kitchen equipment 1 33.39 Address: 11807 NW 99th Street,Suite 1170 Clothes dryer exhaust 1 33.39 City/State/ZIP:Vancouver,WA 98682 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 5 23.32 Phone:(360)258-7900 Fax:(360)258-7901 Attic/crawlspace fans 23.32 ® APPLICANT 0 CONTACT PERSON Other: 23.32 Business name:LENNAR NW,Inc Fuel piping: $14.15 for first four;$4.03 for each additional Contact name:Charles Webb Furnace,etc. Address:11807 NW 99th Street,Suite 1170 Gas heat pump Wall/suspended/unit heater City/State/ZIP:Vancouver,WA 98682 Water heater Phone:(360)258-7900 Fax::(360)258-7901 Fireplace Range E-mail:PORPermits@Lennar.com Barbecue CONTRACTOR Clothes dryer(gas) • Other: Business name: Wfi D L C`O % pt. !N a!A1 4 r� / MECHANICAL PERMIT FEES* Address: I©7 5 iv, f//S TUR/c Co L G64/di 4 MT/ee1J2 u, Subtotal City/State/ZIP: /R©U%DAL 6" G 9'7o/ Q Minimum permit fee($90.00) // i CO Plan review(25%of permit fee) Phone:(3 d3) 6 ‘7../79/el,.."360 Fax:(5-03 ) c‘7- 989/ State surcharge(12%of permit fee) CCB lic.: 1/ 222 U b 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: iff, / a,„, Fee methodology set.by Tri-County Building Industry Service Board Print name: a/Fr'. � w/yn,U Date: 9,rd , 15- I:\Building\PermitsVvtEC_PermitApp_0401133..doc 440-4617T(11/02/COM/WEB) EP Plumbing Permit Applicati CEt% ,, Building FixturesFOR OFFICE USE ONLY n 2 1 7 015 Received Cityof Tigard Permit No.: 131SW Hall Blvd.,Tigard,OR 7 i d Date/By: /2- �7 /S� HL,ra yS%-ez h,2_ ■ Phone: 503.718.2439 Fax: 503.1011960'�� d HARD Plan Review Other Permit No.: Inspection Line: 503.639.4175 ')`LJ ILDI I`I C DIVISION Date Date/By: Other Juris: ® See Page 2 for T I G A R D Internet: www.ti ard-or. ov g g Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ®New construction 0 Demolition For special information use checklist Description I Qty. I 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 ® 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 1 500.32 ❑Accessory building 0 Multi-family 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: /03e 6 5h1 6 777.4A vL Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: `; Fi RD I 7 R 9 '7 2.23 � Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: 1 Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: OA f; S> L-757q?ES I Lot no.: 25- Fixture or item: Tax map/parcel no.: Backflow preventer 1 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 1 25.02 NSFR Dishwasher 1 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER 0 TENANT Expansion tank 12.51 Name:LENNAR NW,Inc Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:11807 NW 99th Street,Suite 1170 Garbage disposal 1 25.02 City/State/ZIP:Vancouver,WA 98682 Hose bib 2 25.02 Phone:(360)258-7900 Fax:(360)258-7901 Ice maker 1 12.51 ® APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name:LENNAR NW,Inc Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:Charles Webb Roof drain(commercial) 12.51 Address:11807 NW 99th Street,Suite 1170 Sink/basin/lavatory 5 25.02 City/State/ZIP:Vancouver,WA 98682 Solar units(potable water) 62.54 Phone:(360)258-7900 Fax::(360)258=7901 Tub/shower/shower pan 3 12.51 E-mail:PROPermits$Lennar.com Urinal 25.02 CONTRACTOR Water closet 3 25.02 Water heater 1 37.52 • Business name: 'Wo t C n 77 PLUM im l3(V'? Water piping/DWV 56.29 Address: /07 5 w . kit 5 TO,P/C CSL a m i3 i,4 y 4pr: 25.02 City/State/ZIP: 7-fog 7444&-/ a/17 y70 60 Subtotal Phone:(5c )66 7,/79(4 X7325 f Fax:(5O3) 6 6 7_ gcf?9(- Minimum permit fee: $72.50 CCB Lic.: /1 2 2200 Plumbing Lie.no.:1'4.-824 1D5 Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: MLA/ l L /.71JlLvf,4slri TOTAL PERMIT FEE �� /� Date: This permit application expires if a permit is not obtained within 180 days Print name: C4i/ L/Q///i�.�.(/ �'��r+' after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) 7 City of Tigard .:71 I r COMMUNITY DEVELOPMENT DEPARTMENT T I G A R D Building Permit Review — Residential Building Permit #: I ' c C/5 -o v a-(o 7- Site Address: /0366 `3/) 694 A4) Project Name: Qvi' •,STJT 121 FS'f S Lot #: cQ (New dwelling= subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: A/4.3 ` i€ //Verify site address/suite# exists and active in permit syste . lV�Iver Terrace Neighborhood: ❑ Yes V No Sitg'Plan Elements: _/ I Ple ree(3)copies of site plan ti'xisting structures on site e plan must l: on 8-1/2"x 11"or 11 x 17"paper 1F Footprint of new structure (including decks)with finished awn to scale(standard architect or engineer scale) oor elevations orth arrow Utility locations (required for new,may apply for additions) to address,project or subdivision name and lot number 41�..cation of wells/septic systems plicant information (name and phone number) 7i Erosion control(including drainage-way protection,silt fence Lot dimensions and building setback dimensions sign,location of catch basin,etc.) 1111 1 ot area,building coverage area,percentage of coverage and reet names iiimpervious area (applicable if R-7,R-12,R-25&R-40) treet tree size,type and location Property corner elevations(2 foot contour lines if more than Of fisting trees to be retained with drip line,and tree 4 foot differential) protection measures oftc Water Services—Service Provider Lett (lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No Public Facili ' s Improvement (PFI) Permit: Zes Required: Yes,applicant was notified ❑ No Applied For: ❑ No,stop intake •Land Use Case#: SJ Q J</_ e.7)/ oning: g 11. tZ Setbacks: Front c2I) Rear A-- Side `7 Street Side /c- Garage Q(3 Landscape Requirement: % i CI ' ot Coverage Maximum: % / ` /' ETA/Building Height: Maximum Height ) Actual Height Visual Clearance Easements ensitive Lands: ❑ Yes liNo Type Yl� [ '/Urban Forestry Plan Urif Conditions "Met"prior to issuance of building permit Notes: Approved By Planning: `" *I/A-- Date: Revisions (after Building Submittal on y) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved 1:\Bui Iding\Fonns\BldgPennitRvw_RES_070915.docx Building Permit Submittal Original Submittal Date: /14/'//c Site Plans: # '3 Building Plans: # -J' Building Permit#: [2' Enter building permit#above. Workflow Routing: D- Planning Engineering 'ermit Coordinator .O"Building Workflow Sign-off: C' Sign-off for Planning(include notes from planning review) Route Application Documents: 0 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: Ale�i`��. ' Date: /,1/ 9.A— En,,,gineering Review re Slope at building pad: 2°,.3; AConditions "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: E Yes ❑ No LIDA Facility on lot: ❑ Yes ❑ No ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: idG 017 Date: .-.44,-W,0-- � 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: 1SDCFees Entered: Wash Co Trans Dev Tax: yr Yes ❑ N/A Ir Tigard Trans SDC: ❑ Yes 40="N/A Parks SDC: Yes ❑ N/A [OK to Issue Permit Approved by Permit Coordinator: / Date: /Z/AO//S 1:\Building\Foims\B1dgPennitRvw_RES_070915.docx 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 10381 SW 67TH AVE, TIGARD, OR, 97223 Record Type: Residential - Master Permit Inspection Type: 699 Mechanical final Result: PASS Comments: Violation Summary: Inspector Tel: 503.718.2439 Inspection Date: Record ID: MST2015-00262 Inspector: Chip Barnett Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 10381 SW 67TH AVE, TIGARD, OR, 97223 Record Type: Residential - Master Permit Inspection Type: 299 Final inspection Result: PASS -CofO Comments: CWS final erosion approval Moisture content: received I efficiency interior lighting systems form: received Street tree CERT: received Violation Summary: Tel: 503.718.2439 Inspection Date: Record ID: MST2015-00262 Inspector: Chip Barnett Inspector Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 10381 SW 67TH AVE, TIGARD, OR, 97223 Record Type: Residential - Master Permit Inspection Type: 399 Plumbing final Result: PASS Comments: Violation Summary: Inspector Tel: 503.718.2439 Inspection Date: Record ID: MST2015-00262 Inspector: Chip Barnett Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 10381 SW 67TH AVE, TIGARD, OR, 97223 Record Type: Residential - Master Permit Inspection Type: 199 Electrical final Result: PASS Comments: Violation Summary: Inspector Tel: 503.718.2439 Inspection Date: Record ID: MST2015-00262 Inspector: Chip Barnett Contractor