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Permit Ai CITY OF TIGARD MASTER PERMIT Ir., COMMUNITY DEVELOPMENT Permit#: MST2016 00092 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/24/2016 Parcel: 2S111BD04700 Jurisdiction: Tigard Site address: 9926 SW MURDOCK ST Subdivision: 2016-005 PARTITION PLAT Lot: 1 Project: Murdock Street Partition, Lot 1 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1427 sf Basement: 0 sf Left: 5 Parking Spaces; 0 Height: 23 Bathrooms: 3 Second: 1726 sf Garage: 976 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 2 Detectors: Yes Total: 3153 sf Value: $400,682.69 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 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: 6 201-400 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 3153 Owner: Contractor: SAGE BUILT HOMES LLC SAGE BUILT HOMES Required Items and Reports(Conditions) 1815 NW 169TH PL,STE 1040 16280 NW BETHANY COURT 1 Ersn Cntrl 503-639-4175 BEAVERTON,OR 97006 BEAVERTON,OR 97006 PHONE: PHONE: 503-502-6623 FAX: 503-533-5164 Total Fees: $30,910.24 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 TENTION:-• -.on Is, requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 9 -001-0010 through OAR/• -001-0"0•: You may obtain a copy of the rules or direct questions to OUNC by calling 503. 32. 987• 1.800.332.234 r i sued 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 the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application , , Residential IOR OI I It I I ',I. ()NI 1 Received City of Tigard D DateB : 3 Permit No.: o/(i 1 13125 SW Hall Blvd.,Tigard,OR 972 ` ' '�� J $ �1V Plan Review' ) . Other Permit: i _ , � Phone: 503.718.2439 Fax: .�� '6' DateB : L Inspection Line: 503.639.4175 6 Date ReadyBy: ® See Page 2 for Internet: www.tigard-or.gov 2Q� Notified/Method: 1011 Supplemental Information MPR 1 • �: r TYPE OF t `DATA:;I« ®New construction '�R �, on 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 CA RY OF CT1ON work indicated on this application. 1-and 2-family dwellin Valuation: $ it 00 6 PQ. ® g ❑CommerciaUindustrial -At ❑Accessory building 0 Multi-family Number of bedrooms: 4 ❑Master builder 0 Other: Number of bathrooms:�5,� JOB SITE INIMsAc'fN AAS )LOCATION Total number of floors: 2 Job site address:9926 SW MURDOCK STREET New dwelling area: 3153 square feet4 j cel l City/State/ZIP:PORTLAND,OR 97224 Garage/carport area: 976 square feet Suite/bldg./apt.no.: Project name:MURDOCK Covered porch area: 148 square feet j 7 0\6 Cross street/directions to job site:SW 100TH AVENUE Deck area: square feet 111X) Other structure area: square feet REQUIRED DATA:KOMMERCIAL-USE CHECKLIST Subdivision:MURDOCK Lot no.: 1 Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the DESCRIPTION UF'YORK work indicated on this application. NEW RESIDENTIAL CONSTRUCTION Valuation: $ Existing building area: square feet New building area: square feet ® PROPERTY OWNER 0 TENANT Number of stories: Name:SAGE BUILT HOMES LLC Type of construction: Address:1815 NW 169TH PL.SUITE 1040 Occupancy groups: City/State/ZIP:BEAVERTON,OR 97006 Existing: Phone:(503)533-5167 Fax:(503)533-5164 New: g§ APPLICANT 0 CONTACT PERSON BI U_Jfl JG PERMFEET* Atm refer ofre Business name:SAGE BUILT HOMES LLC { alftittildt# Structural plan review fee(or deposit): Contact name:KYLIE HOFENBREDL FLS plan review fee(if applicable): Address:SAME AS ABOVE Total fees due upon application: City/State/ZIP: Amount received: Phone:(971)221-4597 Fax::( ) E-mail:KYLIE@SAGEBUILTHOMESLLC.COM PHOTOVOLTAIC-SOLARPAIL SYSTEM P--. Commercial and residential prescriptive installation of roof-top mounted PhotoVoltaic Solar Panel System. Business name:SAGE BUILT HOMES LLC Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:SAME AS ABOVE 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.:189330 Total fee due upon application: $201.60 Authorized signature: ()Al\-) ! 1 a I l V This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:KYLIE HOFENB EDL Date: *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) / Mechanical Permit Application ��Ie9 i lz ()H R I I '.I ON l l VReceived City of Tigard �G 16Dat�y. Permit No.: 111 il 13125 SW Hall Blvd.,Tigard,OR 9722 O\ Plan Review Phone: 503.718.2439 Fax: 503.598.19 ,. Other Permit:^ � Date/By: I I G:\R i) Inspection Line: 503.639.4175 Mr '( GPR��, Ready/By: Inns: El See Page 2 for Internet: www.tigard-or.gov �\ O• `1`'l\S\',otified/Method: Supplemental Information • : - - -._.. Mechanical permit fees*are based on the value of the work ®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATS GORY OP ICt;I > N 1 1140 l`04QilllPMEP- i'f'/ _ ® I-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 SITE IN Al N'ND LOCATION" Heating/cooling: Air conditioning 1 46.75 46.75 Job site address:9926 SW MURDOCK STREET Furnace 100,000 BTU(ducts/vents) I 46.75 City/State/ZIP:PORTLAND,OREGON 97224 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name:MURDOCK Duct work 23.32 Cross street/directions to job site:SW 100Th AVENUE 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 Oth Subdivision:MURDOCK Lot no.:1er' 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 1 23.32 23.32 DESCR riot ©F woRK Gas fireplace/insert 1 33.39 33.39 Flue vent for water heater or gas NEW RESIDENTIAL CONSTRUCTION fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other. 23.32 PROPERTY'�R ©-TENANT.. Environmental exhaust and ventilation: Name:SAGE BUILT HOMES LLC Range hood/other kitchen equipment I 33.39 33.39 Address:1815 NW 169TH PL SUITE 1040 Clothes dryer exhaust 1 33.39 33.39 City/State/ZIP:BEAVERTON,OR 97006 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 4 23.32 23.32 Phone:(503)533-5167 Fax:(503)533-5164 Attic/crawlspace fans 1 23.32 23.32 0 APPLICANT ❑ CONTACT PERSON Other: 23.32 Business name:SAGE BUILT HOMES LLC Fuel piping: $14.15 for first four;$4.03 for each additional Contact name:KYLIE HOFENBREDL Furnace,etc. Address:SAME AS ABOVE Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:(971)221-4597 Fax::( ) Fireplace Range E-mail:KYLIE@SAGEBUILTHOMESLLC.COM Barbecue CONTRACTOR Clothes dryer(gas) Business name:GRAMER HEATING&COOLING Other: MECHANICAL/MORT TRW Address:53725 NW Old Wilson River Road Subtotal City/State/ZIP:Gales Creek,Or 97117 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(503)720-2636 Fax:(503)536.6734 State surcharge(12%of permit fee) CCB lie.:161571 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. CoVNAuthorized signature: = Fee methodology set by Tri-County Building Industry Service Board Print name:KYLIE HOFEN DL Date: 51 �2�=�(i0I:\Building\Permits\MEC_PermitApp_040113.doc 440-461 Il/02/CO ► B) Electrical Permit Application ``ff�0 I O11 ()l I k 1 I �, ON I 1 City of Tigard �`V Received Date/By:ive Permit 8: �-• 13125 SW Hall Blvd.,'fig 3 `5% Plan Review ' B Phone: 503.718.2439 Fax: 503.598.�Q6�0 ` 016 DateB : Related Permit#: Inspection Line: 503.639.4175 MQ� ® Ready Date/By: /uris: 01 See Page 2 for I I\i A iZ D Internet: www.tigard-or.gov �1�IW w, Notified/Method: `' ,`, Supplemental Information TYPE lir• �`J" PLAN REVIEW ' ®New construction 0 Additi , t replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition ❑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 2-family dwelling 0Commercial/industrial 0Accessory building amps for all other installations. buildings. 0 Multi-family 0 Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: Job site address: 9926 SW Murdock Street 10OHP or more. ❑"A,"E^,"1-z^,`1-� , City/State/ZIP:Tigard, Oregon 97223 0 Six or more residential units. occupancy. ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: Murdock Street Partition 0 Hazardous locations. 0 Supply voltage for more than 0 Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: SW 100th Avenue FEE SCHEDULE Description I Qty, 1 Each 1 Total 1 • New residential single-or multi-family dwelling unit. Subdivision: Murdock Lot#: 1 Includes attached garage. 1,000 sq.ft,or less / 168.54 4 Tax map/parcel#: Ea.add'I 500 sq.ft_or portion 6 33.92 I DESCRIPTION OF WORK Limited energy,residential 75.00 2 NEW RESIDENTIAL CONSTRUCTION (with above sq.ft.) Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 PROPERTY OWNER ( 0 TENANT Services or feeders installation,alteration,and/or relocation Name:SAGE BUILT HOMES LLC 200 amps or less 1 100.70 2 Address: 1815 NW 169TH PL.SUITE 1040 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:BEAVERTON,OR.97006 601 amps to 1,000 amps 301.04 2 Phone:(503)533-5167 Fax:(503)533-5167 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 I 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 I ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel A,Fee for branch circuits with Business name:SAGE BUILT HOMES LLC above service or feeder fee, 7.42 2 each branch circuit Contact name:KYLIE HOFENBREDL B.Fee for branch circuits without Address:SAME AS ABOVE service or feeder fee,first 56.18 2 branch circuit City/State/ZIP: Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Fax: :( ) Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email:KYLIE@SAGEBUILTHOMESLLC.COM Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name:Ross Electric Sign or outline lighting 67.84 2 Address:2870 SE 75th Avenue,203 Signal circuit(s)or limited-energy ❑ See Page 2 2 panel,alteration,or extension. City/State/ZIP:Hillsboro,Oregon 97123 Each additional inspection over allowable in any of the above Additional inspection(I hr min) 66.25/hr Phone:(503)642-2800 Fax:(503)642-5815 Investigation(1 hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lie.: 157891 Electrical Lie.: 34-436C Suprv.Lie.:/�-3'1 specifically listed(V2 hr min) ELECTRICAL PIE1tMW FEES Suprv.Electrician signature,required: :/ ,,fJt Subtotal: Print name: �/ • Date: 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: 1/Nr7f\i-\--_ . "TOTAL PERMIT FEE: J} This permit application expires If a permit is not obtained within 190 Print name: Kylie Hofenbredl DateID)/41/U/ days after it has been accepted as complete. 1 * Number of inspections allowed per permit. I.\Building\.Permits\F1.C_PermitApp_ELR_ERE.doe Rev 06/17/2015 440-4615T(l l/05/COM/WEB Plumbing Permit Application Building Fixtures POLI of l 1( I 1 til (1\l 1 o City of Tigard Received D Date/By: Permit No.: 11 u 13125 SW Hall Blvd.,Tigard,OR 9722,3 v '" Plan Review II Phone: 503.718.2439 F 503.598. Date/By: Other Permit No.: Inspection Line: 503.639. 75 {C Date Read B loris ® See Page 2 for 1 I(.;i's R D 2o`U Ready/By: g Internet: www.tigazd-ocgov1,16i Q Notified/Method: Supplemental Information TYPE,OF I: •'$ Fes*, - ®New construction $•,..:4:01- ,:, "lJ0�n"`'i For special information use checklist _ Description Qty. Ea. I Total ❑Addition/alteration/replacement Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF,; Rt/crioN SFR(1)bath 312.70 ® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 1 500.32 500.32 ❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 • JOB SITE INFORMATION AND LOCATION Site utilities: Job site address:9926 SW Murdock Street Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Portland,Or 97224 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name:Murdock Manufactured home utilities 50.03 Cross street/directions to job site:SW 100th Avenue Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision:Murdock I Lot no.: 1 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRU'TION OF WORK Backwater valve 12.51 Clothes washer 1 25.02 New Residential Construction Dishwasher 1 25.02 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 0.:1 pROPERTY owNEE i 0 TENANT Expansion tank 12.51 Name:Sage Built Homes,LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 1815 NW 169th Place,Suite 1040 Garbage disposal 1 25.02 City/State/ZIP:Beaverton,Oregon 97006 Hose bib 1 25.02 Phone:(503)533-5167 Fax:(503)533-5164 Ice maker 12.51 sI AppUCAN`r 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name:Sage Built Homes,LLC. Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:Kylie Hofenbredl Roof drain(commercial) 12.51 Address:Same as above Sink/basin/lavatory 5 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:(971)221-4597 Fax::( ) Tub/shower/shower pan 3 12.51 E-mail:kylie@sageuilthomesllc.com Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name:Ed Mullen Plumbing Wateri in WV 56.29 P�P P Address:1601A SE River Road Other: 25.02 City/State/ZIP:Hillsboro,Or 97123 Subtotal Phone:(503)640-0113 Fax:( ) Minimum permit fee: $72.50 CCB Lic.:92689 Plumbing Lic.no.:34-260PB Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: ).(J.,19A (j/ l TOTAL PERMIT FEE '!�IPrint name:Kylie Hofenbredl t Date: This permit application expires if a permit is not obtained within 180 days w{ CCC after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-PennitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) r City of Tigard 71 ■ 11 COMMUNITY DEVELOPMENT DEPARTMENT T l C,A R D Building Permit Review — Residential Building Permit #: a7` lle_F " Site Address: 9926 SW MUYfrock .. Project Name: Mugdoek_ Sk. Pa '++i on _ Lot #: (New dwelling=subdivision name;.Addition or:Alteration=last name of owner) Planning Review Proposal: UVJ SF NIVerify site address/suite# exists and active in permit system. River Terrace Neighborhood: No ❑ Yes,See RiverTen-ace Review Addendum Attached VPlan Elements: ,itree (3)copies of site plan "Existing structures on site tree plan must be on 8-1/2"x 11"or 11 x 17"paper ootprint of new structure (including decks)with finished DdDrawn to scale (standard architect or engineer scale) oor elevations 1 North arrow KlUtility locations (required for new,may apply for additions) ite address,project or subdivision name and lot numbertsi of wells/septic systems gdi pplicant information(name and phone number) 7 rosion control(including drainage-way protection, silt fence of dimensions and building setback dimensions esign,location of catch basin,etc.) --Biot area,building coverage area,percentage of coverage and reet names pervious area(applicable if R-7,R-12,R-25&R-40) Street tree size,type and location IN:Property corner elevations (2 foot contour lines if more than $Existing 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: ❑ Yes,applicant was notified VL No Received: ❑ Yes ❑ No Public Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified 'Ile No Applied For: ❑ Yes ❑ No,stop intake E Land Use Case #: &P2 DI,,S `OOOO I • Zoning: R- 3.5 VSetbacks: Front 20 Rear 13 Side 5 Street Side — Garage 20 --IE• Landscape Requirement: Lot Coverage Maximum: % 1 ' Building Height: Maximum Height 30 Actual Heigh>"L7 N( usual Clearance Easements ensitive Lands:iS El Yes No Type Urban Forestry Plan • Conditions "Met"prior to issuance of building permit Notes: Approved By Planning: —II mY 6n Date: 31101 ` 6 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:ABuilding\Forms\BldgrennitRvw RES 012116.docx Building Permit Submittal Original Submittal Date: 3 it /L Site Plans: # � Building Plans: # 3 Building Permit#: L�{�n�t - building permmiit# above. Workflow Routing: LLYI'lanning neeringt Coordinatoruilding Workflow Sign-off: ( ig—n-off for Planning(include notes from planning review) Route Application Documents: Sneering: (1) copy of permit application, (1) site plan, (1) building plan and ori 'nal 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: 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: E Yes ❑ No LIDA Facility on lot: XYes E No ❑ NOT Appr i ve• by Engineering: Date: Notes: , , __,/ /R';-. ; .i I..+ !� ss -.Ay i Approved by Engineering: )4L—V Date: ,�j;��Z L',_ Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: E Approved ❑ Not Approved Permit Coordinator Review E 4/p.n.• ons "Met"prior to issuance of building permit Approved, NOT Released: Date: 3A s/i' Notes: ,44e 1//q`2e4. /J-ei bra:( 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: (DC Fees Entered: Wash Co Trans Dev Tax: 'es ❑ N/A Tigard Trans SDC: ,� Yes ❑ N/A Parks SDC: Yes E N/A OK to Issue Permit // / Approved by Permit Coordinator: Date: /� / I: Building\Foimis.BldgPennitRvw_RES_(1121 16.docx Clean Water Services LIDA Sizing Form Project Title: _ LDEJ2 11J, 1.,5' Zol6- voeigt Project Location: SIV AILADock Lal' Contact Name/Title/Company: _. �__l3v5LQL_SaN_S_u_ttll �ll► _ Phone/e-mail: CS03) 6pfgrk _�p�ageerl�-,G STEP 1: Determine Impervious Area Requiring Treatment Total Site Area (acres): 10,O0S Total Existing Impervious Area (sq.ft.): 0 Proposed New Impervious Area (sq.ft.): 3173 Impervious Area Requiring Treatment (sq.ft.) 2550 (Refer to Design&Construction Standards Chapter 4 for instructions to calculate this area,which will be less than or equal to the new plus existing site impervious area.) STEP 2: Deduct Impervious Area LIDA Credits Porous Pavement (sq. ft.): Green Roof(sq. ft.): ___ 0 Other Credits as approved (sq. ft.): _ ___T� Total Credits (sq. ft.): Remaining Impervious area (sq. ft.) (Total from Step 1 —Total Credits): L2.550_.—. STEP 3: Size LIDA Facilities for Remaining Impervious Area IA: Impervious SF, Sizing LIDA facility size area treated Factor (sq.ft.) (IA x SF) (sq.ft.) Infiltration Planters/Rain 0.06 Garden Flow-through Planter 2550 0.06 153 LIDA Swale 0.06 Vegetated Filter Strip 0.06 Total Impervious ('Must equal total from Step 2 or additional LIDA 2�5 O facilities or Water Quality Facilities must be Area treated (sq.ft.) added.) 16 Low Impact Development Approaches Handbook CleanWaterr Services City of Tigard 1' COMMUNITY DEVELOPMENT DEPARTMENT ■ T 1 G A RD Building Permit Review — Residential Building Permit #: MST a of (o - p oU 9 A Site Address: 9 ' to S LJ /"L u,d o c.L S4 Project Name: h-{tt y do a S�- Pa- u Lot #: (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: RFU S-td ne L.JS Cof-R 1.-1‘(+1^- p Lftr rt-I v Ca +e d ear+ --11) w e J f S ; d e 0C -k-e_ h o ry t e - [ Verify site address/suite# exists and active in permit system. [River Terrace Neighborhood: [lir No ❑ Yes,See River Terrace Review Addendum Attached Site Plan Elements: I`Three(3)copies of site plan Existing structures on site site plan must be on 8-1/2"x 11"or 11 x 17"paper qFootprint of new structure(including decks)with finished EIDrawn to scale(standard architect or engineer scale) floor elevations ItSlorth arrow ,utility locations (required for new,may apply for additions) RI-Site address,project or subdivision name and lot number Location of wells/septic systems Applicant information(name and phone number) ['Erosion control(including drainage-way protection,silt fence ItLot dimensions and building setback dimensions design,location of catch basin,etc.) )Lot area,building coverage area,percentage of coverage and IkStreet names /impervious area(applicable if R-7,R-12,R-25&R-40) �reet tree size,type and location Property corner elevations (2 foot contour lines if more than _xisting 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: ❑ Yes,applicant was notified O''No Received: ❑ Yes ❑ No Public Facilities Improvement (PFI) Permit: Required: ❑ Yes,applicant was notified No Applied For: ❑ Yes ❑ No,stop intake Ni Land Use Case#: 1AA LP a C) 15—boo c ER'Zoning: R- 3 , S Er Setbacks: Front ,„2 o Rear 1 S Side 5 Street Side a e Garage , o -Landscape Requirement: a-Lot Coverage Maximum: [a Building Height: Maximum Height 3 D Actual Height .79 a Visual Clearance .2 Easements ,'Sensitive Lands: ❑ Yes No Type yErUrban Forestry Plan Conditions "Met"prior to issuance of building permit Notes: Approved By Planning: Chu+ eco Date: 5- 3-I So Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved 1:\Building\Forms\BldgPermitRvw_RES_012116.docx Building Permit Submittal Original Submittal Date: 5/ /10 Site Plans: # �j Building Plans: # �j Building Permit#: 2'Enter building permit#above. Workflow Routing: Er Planning ❑'Engineering .ermit Coordinator --EJ Building Workflow Sign-off: Efi Sign-off for Planning(include notes from planning review) Route Application Documents: E-Engineering: (1) copy of permit application, (1) site plan, (1) building plan and ginal plan review routing form. fil Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: l By Permit Technician: __:.-t.../ Date: 5/;3/,( Engineering Review l ❑ 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: ___ Date: 44-��-12Z 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: rDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A (( Tigard Trans SDC: Yes ❑ N/A Parks SDC: es ❑ N/A OK to Issue Permit /2-1//Arr y roved b Permit Coordinator: D /,,ate: v � 1:\Building\Fonns\BldgPermitRvw_RES_012116.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 9926 SW MURDOCK ST, TIGARD, OR, 97224 Residential - Master Permit 699 Mechanical ﬁnal FAIL MST2016-00092 David Young Provide access for inspection, door locked. 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 9926 SW MURDOCK ST, TIGARD, OR, 97224 Residential - Master Permit 399 Plumbing ﬁnal FAIL MST2016-00092 David Young Provide access for inspection, door locked. 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 9926 SW MURDOCK ST, TIGARD, OR, 97224 Residential - Master Permit 299 Final inspection FAIL MST2016-00092 David Young Provide access for inspection, door locked. 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 9926 SW MURDOCK ST, TIGARD, OR, 97224 Residential - Master Permit 699 Mechanical ﬁnal PASS MST2016-00092 David Young Finish sealing penetrations in garage, will check at building ﬁnal inspection. Note: no AC installed at time of 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 9926 SW MURDOCK ST, TIGARD, OR, 97224 Residential - Master Permit 299 Final inspection FAIL MST2016-00092 David Young Provide approved plumbing and landscape Backﬂow ﬁnal prior to building ﬁnal inspection. Provide approved Lida box ﬁnal prior to building 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 9926 SW MURDOCK ST, TIGARD, OR, 97224 Residential - Master Permit 399 Plumbing ﬁnal FAIL August 16, 2016 at 8:51:37 AM MST2016-00092 David Young Corrections from previous inspection not complete. Complete all corrections prior to scheduling ﬁnal inspection. Provide permit and approved inspection for landscape Backﬂow devise. 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 9926 SW MURDOCK ST, TIGARD, OR, 97224 Residential - Master Permit 399 Plumbing ﬁnal PASS August 19, 2016 at 8:12:01 AM MST2016-00092 David Young Corrections complete. PRV installed in crawl space. 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 9926 SW MURDOCK ST, TIGARD, OR, 97224 Residential - Master Permit 299 Final inspection PASS - C of O MST2016-00092 David Young Provide approved landscape Backﬂow devise ﬁnal as noted on previous inspections, inspection scheduled for following Monday per contractor. Final erosion control approved. Street tree certiﬁcation received. Moisture content form received. High efﬁciency lighting form received. Blower door test results received. Insulation certiﬁcation checked. Violation Summary: Inspector Contractor