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Permit MASTER PERMIT CITY OF TIGARD a' COMMUNITY DEVELOPMENT14 Permit#: MST2016 00159 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/12/2016 T[Ct.A R.D 9 Parcel: 2S104AD06900 Jurisdiction: Tigard Site address: 12927 SW PARKDALE AVE Subdivision: OLSON WOODS Lot: 5 Project: Olson Woods, Lot 5 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 3 First: 2401 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 23 Bathrooms: 2 Second: 0 sf Garage: 730 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2401 sf Value: $308,387.85 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 Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<10OK: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp 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: 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 VA R-3 2401 Owner: Contractor: WNDWOOD CONSTRUCTION INC WINDWOOD CONSTRUCTION INC Required Items and Reports(Conditions) 12655 SW NORTH DAKOTA ST 12655 SW NORTH DAKOTA 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97223 TIGARD,OR 97223 PHONE: 503-780-4375 PHONE: 503-625-6526 FAX: 590-7606 Total Fees: $28,979.00 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 ma •• ='• :co•y of a rules or•irect questions to OUNC by calling 503. 1987 or 1.800. 2.2344. k MIPP i Issued By: /Ll—.f.. _ -- Permittee Signature: _ %/a,t_./ - _ • Call •-�( 5 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. ill to Building Permit Application q�0 Residential ] FOR OFFICE LSE ONLY Cl of Ti and RECEIVED Received t'- g Date/By: y A !/ 6 . Permit No.: r,o1 v,.60!57 II13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review (� /� Phone: 503.718.2439 Fax: 503.598.1960 APR 2 2016 Date/By: `l Jp� 1� Other Permit. 29•0(4-,:/)i'1 Inspection Line: 503.639.4175 Date Ready/By: Sufis: El See Page 2 for o� IIC,,\RD p "� `l Internet: www.tigard-or.gov CITY OF 1'GA t.i Notified/Method: /1. Supplemental Information BUILDING 'iiVISIC ,:l vdue (.4 TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING, ONew 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..'OE CO•NSTRUCTION work indicated on this application. Valuation: 830 7 -41 j''1-and 2-family dwelling 0 Commercial/industrial 8/3 g Number of bedrooms: .30 Accessory building 0 Multi-family ❑Master builder 0 Other: Number of bathrooms: �- JOB SITE INFORMATION'AND LOCATION �0 f/. Total number of floors: / 3 I Job site address: / 9 _.----i ph-tag-4 , fes„ y�F' New dwelling area: ::i),. square feet City/State/ZIP: T�.,a /4/,?%.j /. , 7 72' Z Garage/carport area: 730 square feet Suite/bldg./apt.no.: Project name: GL.SON GtJQaOs Covered porch area: ael O square feet Cross street/directions to job site: ,/f G/./k T Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: /)/° 0;2„/ el,,,/ i d 2)s I Lot no.: 5 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 OF WORK work indicated on this application. ae,. .5,� Valuation: $ �v Existing building area: square feet New building area: square feet ..'PROPERTY OWNER. 0 TENANT Number of stories: Name: kt.l.frr/(l y0 w c a0 C 04-'57 "x/(.. Type of construction: Address: s"' sc....) f?jd,, ,.7 ft1 ,Q/^,/" '704 5,7-41,..z,-;--47 Occupancy groups: City/State/ZIP: 7.4...17,,,,-,,61 " } c f7,/,,` ,j??,,, Existing: Phone:(`'r, 4 750- L/37S Fax:(.`;':',.)3) S f.,4} /6 0`" New: .BAPPLICANT -8-t bNTACT PERSON BUILDING PERNHT FEES* (Please refer to fee schedule) Business name: -��f}';=- _ Structural plan review fee(or deposit): Contact name: , ._. . ) /7_,-2..._„,-(-//-: . -% FLS plan review fee(if applicable): Address: Total fees due upon application: City/State/ZIP: �j Phone:(> `)) 1 Fax::( ' Amount received: ! 7SZ`� '� ,�; - 7� Ste' ) >.:/- ? ,1G / PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: f;;1; ,;�U d U-"7A Di-,'r'.....'✓G"-'' /Il / , ( U.11 Commercial and residential prescriptive installation of CONTRACTOR roof-top moun -d Photo Voltaic Solar Panel System. Business name: (i()J iv F)(w pdD (U j✓S? jam c_ Submit two(2)se of roof plan with connectio. : •tls and fire department a -ss,along with .- 110 Oregon Address: �/f2.1 L Solar Installation Specia • Co., - ecklist. City/State/ZIP: Permit Fee(inclu.-: :.n review $180.00 and • inistrati•- fees): Phone:( ) Fax:( ) State surcharg- (12%of permit -e): . $21.60 CCB lic.: .64:," / . Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permi " not obtained within 180 days after it has been accepted a complete. Print name: Date: �, *Fee methodology set by Tri-County Building Industry ���� { / ri— ✓•" Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) , p), -- {'1 Electrical Permit Applictkogl ' 7016 FOR OFFICE USE OtiLI' City of Tigardp;; ed 1`L�al4n—DD(3 Permit No.: 13125 SW Hall Blvd.,Ti :OIL 0223 c ‘,..1,'.f Plan Review = Phone: 503.718 2439 Fa 5() ,5 $L9W,, t/-- Date/By: Other Permit Inspection Line: 503.4 t'15 ` a 1:i ) ' Date Ready/By: Juris: 0 See Page 2 for T I G A R D Internet: www.tigard-or.gov Notified/Method: Supplemental Information _ �, ftN .:7 •:, ^� 'Y~..s�rr.--' • � w` tn: :-� `'cR ;,:iXY.w..� 'F'>�?i i'_�f,�i� _~x :;:'. lew construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/Items checked below' 0 Service or feeder 400 amps or more 0 Building over three stories 0 Demolition 0 Other. where the available fault current 0 Marinas and boatyards y'+ ° (-4 50 volts or 0 Floating buildings. c � � Q exceeds ground, 1 ,� a,p amps at � '� �" '`'"' less to or exceeds 14,000 ❑Commercial-use agricultural -and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings. ❑Multi-family 0 Master builder ❑Other Fire pump. 0 Installation of i 5 KVA 0or ,.,,2..-.;-t,:;.;,-,-,„• .m a« ,. ,,,, � 0 , y i �net ncy system. larger separately yrivesystem ,,. ilv ,S94 .) t a s.m ».,fit k1..2f'' 0 Addition of new motor load of ❑"A" E "I-2 I 1 Job no.: Job site address:h�� 7 �l7A, Lni'G�4 I oP or more. 0 Six or more residential units. 0occupancy. Recreational vehicle parks City/State/ZIP: �/—/ �J� 7,a2 .1 ❑Health-care facilities. ❑Supply voltage for more than T-CJ/j !V Q�' ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: Project name: 1") '5O4/ (e.„/C,C) 0 Service or feeder 600 amps or more. ... •'' �'A"'*EE SCHEDULE Cross street/directions to job site: �.ej�-1..fjji,e,7- Description I Qty. I Fee. I Total I • New residential single-or multi-family dwelling unit. Includes attached garage. , Subdivision: ( 31 A0)t,-) et,reiCiaS Lot no.: 1,000 sq.ft.or less i 168.54 4 Ea.add'I 500 sq.ft.or portion 4 33.92 I Tax map/parcel no.: Limited energy,residential /'75 00 #�"• !4 , . , itaf i*.kiQI A(3 ''V O*C`W ter'£', + 1, .r (with above sq.ft.) / /� Limited energy,multi-family 75 lX) -,v 4� 6'7 /2- residential(with above sq.ft.) - Services or feeders installation,alteration,and/or relocation • 200 amps or less 100.70 - ��$APER ' -�' 201 amps 10 400 amps 133.56 2 .,_.; _.. ���`:.:.. ...-'�l1-fit'-_��:. £.�� � �..... .. .... I n 401 amps to 600 amps '200.34 2 Name: vv4.!LOGO 'OiT, ..Z71 ( 601 amps to 1,000 amps 301.04 Address: /c2 .--ec. S 64-) Na17L y j9,44- j4 6 7Z4.17 Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or City/State/ZIP: r „Ler hie. ,,j 4)E. - 9')a, -1relocation Phone:(.-473) -250 -1328 Fax:(p3)3.--;90 -7606 200 amps or less 59.36 I 201 amps to 400 amps 125.08 2 Owner installation:This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 intended for sale,lease,rent,or exchange,according to ORS 447.449,670,and 701. Branch circuits-new,alteration,or extension,per panel Owner signature: Date: A.Fee for branch circuits with t Y ; T'd"1 above service or feeder ice, each branch circuit B.Fee for branch circuits without Business name: ��-jC service or feeder fee,first 56.18 2 Contact name: /9i::-4 /-Z '/,4e - branch circuit Each add'1 branch circuit 7.42 2 Address: Miscellaneous(service or feeder not included) Each manufactured or modular 67.84 City/State/ZIP: dwelling,service and/or feeder Phone:( ) Fax::( ) Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E-mail: 1 ♦1./ 4'4../;:i al;:/E, li9' ) ,;:.-:7., ti / I Sign or outline lighting 67.84 2 _,;;":. ONTR*Ci'OR t• ( 1. ..,,. .ArtfkAtte.:' ''.'')'-° x-_ff ' Signal circuit(s)or limited-energy panel,alteration,or extension. Page 2 Business name: Dream House Electric,LLC Each additional inspection over allowable in any of the above Address: 221 SW Moonridge Place Additional inspection(I hr min) 66.25/hr City/State/ZIP: Portland,OR 97225 Investigation(1 hr mi n) 66.25/hr Phone:(503) 519-6711 Fax:(503)648-9723 Industrial plant(I hr min) 78,18/hr CCB Lic.: 196726 Electrical Lie.: C-848 Suprv.Lic.: 4560S Inspections for which no fee is 90.00/hr specifically listed('V2 hr min) Suprv.Electrician signature,required: ':EL1Ee'fRiCAI:l'ERMI'2``::FEIsS. Subtotal: Print name: Chris Mahon Date: Plan review(25%of permit fee): Authorized signature: / State surcharge(12%of permit fee): /7iTOTAL PERMIT FEE: Print name:l�IKS /4pLjU, tv I Date: 3/U/I� I'.auildingWermits\ELC-PetmitApp dot 07/01/10 e 4404615T(I I/OS/COM/WEB ,, I i /-',, Mechanical Permit Application FOR OFFICE USE ONLY City �'% Received s- of Tigard �� i7 �1�+ Date/By: Permit No.: �� �l6—r� J e 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review C Phone: 503.718.2439 Fax: 503 598;1960.; Date/By: Other Permit: T I G A R D Inspection Line: 503.639.4175. \, 1': Date Ready/By: Juris 0 See Page 2 for Internet: www.tigard-or.gov.; •, Notified/Method: Supplemental Information TYPE OF LWORK COMMERCIAL FEE* SCHEDULE USE CHECKLIST Mechanical permit fees*are based on the value of the work construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* )2-1---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 JO$'SITE.INFORMATION AND LOCATION Heating/cooling: n ^ Air conditioning 46.75/e5,27.7Job site address: l; /e5,27.7V'�/-�k,,04.4r ,i,`f/��' Furnace 100,000 BTU(ducts/vents) j 46.75 City/State/ZIP: �) 1 72_2 3j Furnace 100,000+BTU(ducts/vents) 54.91 _ 0 2 Heat pump 61.06 Suite/bldg./apt.no.: Project name: -/�•,j/•:j (.ci 0 0; Duct work 23.32 Cross street/directions to job site: ,!,,,ii,/,7.7 ' r - I 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 �� `> ��� -- '- '� Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 Flue vent for water heater or gas fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other: 23.32 OPERTY OWNER 0 TENANT Environmental exhaust and ventilation: Name: !j!,,_; jJ (e_ f! - Range hood/other kitchen equipment 33.39 Address .' r l Clothes dryer exhaust 33.39 City/State/ZIP: i_ r� -7Single-duct exhaust(bathrooms, 7--76-- - �- " toilet compartments,utility rooms) 23.32 Phone: _.? Fax:(`,0) S-7,o r. Attic/crawlspace fans 23.32 APPLICANT 0 CONTACT PERSON Other: 23.32 l Fuel piping: Business name: )i - $14.15 for first four;$4.03 for each additional Contact name: , 4/,‘Z ,i2.,./(r..,' /7/ i Furnace,etc. , Address: Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( ) Fax: :( ) Fireplace J / Range E-mail: to/y1,::;,rvUciL-I/1 0A,,-±.-.;/..JU .'% ;. r1,:t /• 7 j il•-I Barbecue J CONTRACTOR Clothes dryer(gas) I ;'' Other: Business name: �/ MECHANICAL PERMIT FEES* Address: Subtotal City/State/ZIP: Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:( ) Fax:( ) State surcharge(12%of permit fee) CCB lic.: 5-7)/9- •• TOTAL PERMIT FEE -S This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized sign * Fee methodology set by Tri-County Building Industry Service Board Print name: `%Jl A/j ; Date:3//G//4 I.\Building\Permitss'MEC_PermitApp_0401 13 doc 440-4617T(11/02/COM/WEB) t Plumbing Permit Appli °P -,4;'x) ,,'• 141 BuildingFixtures a � " - ' ' FOR OFFICE USE ONLY City of Tigard r `/ Received 1 '�j�/� 60! �a = ) y Permit No.: �""/ I al,04 J / 11 13125 SW Hall Blvd.,Tigard,Otc, 7 2 Plan Review Phone: 503.718.2439 Fax: 503.598.1960Date/By: Other Permit No.: Inspection Line: 503.639.4175 E '_' , ‘,12e t;' Date Ready/Byluris: 8 See Page 2 for r!G !.D Internet: www.ti ardor. ov g P> r y .may , 1 �t�i, Notified/Method: _ Supplemental Information TYPE ._ FEE* SCHEDULE grSIew construction ❑Demolition For special information use checklist Description I Qty. Ea. Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) f '' CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 -and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath Y 500.32 ❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 -:;t*-',- SAB SITE'INFORMATION AND LOCATION Site utilities: Job site address: /a 90,2_/ /n ° e-/3/1,:'_,Z,.',_./7,;):',:,.;.: Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: 1 ,r,. Footing drain(no.linear ft.: ) Page 2 Suite/bldg-/apt.no.: I Project name: ,)7r-,J//j ,r:),,,:,,e.,)`, Manufactured home utilities 50.03 Cross street/directions to job site: ,',.j.'t,' j~:''7 Manholes 18.76 Rain drain connector 18.76 i Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: ) ' 3/1, .'. (./ , p ) ` I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 ' DESCRIPTION OF WORK Backwater valve 12.51 „ Clothes washer 25.02 7 $/C E. Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 'PROPERTY>OWNER I 0 TENANT Expansion tank 12.51 Fixture/sewer cap 25.02 Name: G'U.1-/V 1^x:,,,„/,,,,::,),,,,::,)4), ) ( /:,/ , Address: / CL) / 7 Floor drain/floor sink/hub 25.02 � :� 'i �'- �� � r' ! aedis al Garbage disposal 25.02 City/State/ZIP: '/2 __)Z.,:_;-7j)-).2 • Hose bib 25.02 Phone:( - ) '2✓(2- 32,7 Fax:r.-_; )-: ,:/,,:„,--% , Ice maker 12.51 PPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: f)i..0„".- Medical gas(value:$ ) Page 2 Contact name: r:' / '-, Primer ]2.51 Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 25.02 City/State/ZIP: (' Solar units(potable water) 62.54 Phone:( ) Fax: :( ) Tub/shower/shower pan 12.51 E-mail AJ c%.:. •,f(-) y) /"� .J , ;' -„,;• Urinal 25.02 Y Water closet 25.02 CONTRACTOR ' /, Water heater 37.52 Business name: �(�%1 U ��G %/�-e/1 C Water piping/DWV 56.29 Address: p? -) /-:, }: '�; Other: 25.02 City/State/ZIP: 42.1 / 1 i-) .') . ',./.: 7' Subtotal Phone:( ,_.) 7,,,/,_-; -- c'.1;- Fax:( ) Minimum permit fee: $72.50 CCB Lic.: J PlumbingLic.no.: Plan review (25%of permit fee) /3 �):7,..) ' - ice) -� State surcharge(12%of permit fee) Authorized signature: - �.. TOTAL PERMIT FEE Print name: / Date: 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 Service Board. I\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(I 0/02/COM/WEB) IN City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT T I G A R D Building Permit Review — Residential Building Permit #: H51c2 /( 00/5? Site Address: ( 2.61 2 1 Po►r k d a LL borece. C ) Project Name: 01E0 el WOOdS Lot #: 6 (New dwelling= subdivision name;Addition or Alteration=last name of owner) Planning Review n Proposal: NSW Sr 14- 7 Verify site address/suite# exists and active in permit system. River Terrace Neighborhood: 7 No ❑ Yes,See RiverTeiraie Review_ Addendum Attached Site Plan Elements: ree (3) copies of site plan . ii res on site Site plan must kg on 8-1/2"x 11"or 11 x 17"paper ootprint of new structure (including decks)with finished /Drawn to scale(standard architect or engineer scale) floor elevations /North arrow /Utility locations(required for new,may apply for additions) S to address,project or subdivision name and lot number 7T.oration of wells/septic systems pplicant information(name and phone number) trosion control(including drainage-way protection,silt fence 1lot dimensions and building setback dimensions design,location of catch basin,etc.) 0-Lot ai,..a,L,;ding coverage area,percentage of coverage and treet names impervious 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 n ..e t{D be retained with drip line,and tree 4 foot differential) protection measures VClean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified ❑ No Received: E Yes ❑ No VPublic Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake /Land Use Case#: S Ug t01 4 — OQQ�O S Zoning: if S ZSetbacks: Front 2,0 Rear ( S Side s" Street Side 15 Garage W Landscape Requirement: — 0/0 Lot Coverage Maximum: �7 X Building Height: Maximum Height 30 Actual Height I l3 Visual Clearance Easements 4.Sensitive Lands: El Yes ❑ No Type Urban Forestry Plan Conditions "Met"prior to issuance of building permit Notes: Approved By Planning: /11 0 61 IZ'A 61 1 0 dLe_Gt/✓l_ Date: I /20 /1 (o 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\BIdgPennitRvw_RES_O 12 116.docx r Building Permit Submittal Original Submittal Date: 2/4941 1(p Site Plans: # Building Plans: # Building Permit#: [-Enter building permit#above. Workflow Routing: Er PlanningeEngineering-En gi g IL''Permit Coordinator Building Workflow Sign-off: C'T Sign-off for Planning(include notes from planning review) Route Application Documents: B Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. It Building: original permit application,site plans,building plans, engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: 0602...444A-LO Date: 43le/,b Engineering Review Ei"/Slope at building pad: /e55 ti a Q 7o ILVConditions "Met"prior to issuance of building permit ID-nEasements (encroachments) per engineering conditions of approval and plat Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: E Yes �No ,,,���/// Assess Water Quantity Fee in-lieu: ❑ Yes o LIDA Facility on lot: ❑ Yes E. No ❑ NOT Approved by Engineering: / Date: Notes: COr1 71/orl3 /YJL4S/de ,)it. �ploy 'iv LOAS '/YGGh 1 Approved by Engineering: Date: 4-4/47k_____ 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 COConditions "Met"prior to issuance of building permit .iNt"Approved, NOT Released: C Date: 5- .3 —(h Notes: CncIT UAZ.Lci a,-,s `'prc aB u i 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'SDC Fees Entered: Wash Co Trans Dev Tax: L Yes ❑ N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: 'Yes ❑ N/A gOK to Issue Permit Approved by Permit Coordinator: �' wry EJ Date: ,7) 1:\Building\Fonns\BldgPennitRvw RES 012116.docx Building Permit Application el Residential Received . FOR OFFICE CSE ONLY City of Tigard RECEIVED DateBy: 7 014 /6o , Permit No.:),- raCllo-O0I 53 \ 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review 3 Phone: 503.718.2439 Fax: 503.598.1960 APR 2 6 2016 Date/By: Other Permit: Inspection Line: 503.639.4175 Date ReadyBy: Suns: El See Page 2 for I IGARL) s'�iyy Internet: www.tigard-or.gov CITY OF Notified/Method: Supplemental Information _ TKA t. k �31i1LniNNG Di4IISICli _ TYPE OF,WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY..OF CONSTRUCTION z,; work indicated on this application. �1-and 2-family dwelling Valuation: $ ❑Commercial/industrial 3 ❑Accessory building 0 Multi-family Number of bedrooms: ❑Master builder 0 Other: Number of bathrooms: 1" JOB SITE INFORMATION:AND LOCATIONI)ti Total number of floors: / Job site address: / New dwelling area: 2. square feet � 9'�� p�--��p�}� /��`�p': "'`•�U City/State/ZIP: T7.6,4/4 } 7/' 7 r1 Garage/carport area: 730 square feet Suite/bldg./apt.no.: Project name: ,( Z..5.-624.) ‘,4 Covered porch area: square feet Cross street/directions to job site: Ai/5Z G/t/tx T Deck area: square feet Other structure area: square feet _ REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: /1/ 0/t•/' e) 4d S Lot no.: 6 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 OF WORK . work indicated on this application. ,/e .1 SP.g. Valuation: $ Existing building area: square feet New building area: square feet .JyypROPERI1OWNER 0 TENANT Number of stories: Name: /,J M i,GvorA0 CQ,l} r f/J( Type of construction: Address: / 53-- S w 4,041,.9 /3/,,,,f-a74 "71/74, -.A.:7 Occupancy groups: City/State/ZIP: 7./-_,-,r;./4',4 ©44 2 2,2...2-- Existing: Phone:c..,77: 44 3? ax:(`:");:_13) �/a! Z. 7 J(Jr !� � F ,c.,;.', -,-__)-- C New: 'APPLICANT ' 8.-161-CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedu Business name: -<�V}i_^ le) Structural plan review fee(or deposit): Contact name: ,.. / 2, r(/://2 _ ;. —� FLS plan review fee(if applicable): Address: Total fees due upon application: City/State/ZIP: ?' / ' Fax:: ' / / Amount received: 7S� Phone: (57:3 ✓`�) (S ) >✓` _A,: � PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: ii,(...:r it; U"s d Us(A J-1 1 , / rJ Commercial and residential prescriptive installation of CONTRACTOR roof-top moun -d PhotoVoltaic Solar Panel System. Business name: l.(/Jr,//JGvDoJ) "J i'✓S 7 �}✓C-- Submit two(2)se,of roof plan with connectio. : .ils and fire department a -ss,along with .- 110 Oregon Address: ,n-4/%1 L Solar Installation Specia • Cos. - -cklist. Permit Fee(inclu.-: :. review City/State/ZIP: $180.00 and inistratr•- fees): Phone:( ) Fax:( ) State surcharg- (12%of permit -e): . $21.60 CCB lic.: .Z, / C/ G Total fee due upon application: $201.60 Authorized signature: - This permit application expires if a permi ` not obtained within 180 days after it has been accepted a complete. Print name: 1 Date: *Fee methodology set by Tri-County Building Industry ��,/— �� f c /Y fes. ✓. Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I I/02/COM/WEB) 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 12927 SW PARKDALE AVE, TIGARD, OR, 97224 Record Type: Residential - Master Permit Inspection Type: 199 Electrical final Result: PASS Comments: Violation Summary: Inspector Tel: 503.718.2439 Inspection Date: December 13, 2016 at 8:26:48 AM Record ID: MST2016-00159 Inspector: Jeff Grove Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 12927 SW PARKDALE AVE, TIGARD, OR, 97224 Record Type: Residential - Master Permit Inspection Type: 399 Plumbing final Result: PASS Comments: Corrections completed Violation Summary: Tel: 503.718.2439 Inspection Date: December 21, 2016 at 10:14:02 AM Record ID: MST2016-00159 Inspector: Aaron Cillo-Gobel Inspector Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 12927 SW PARKDALE AVE, TIGARD, OR, 97224 Record Type: Residential - Master Permit Inspection Type: 699 Mechanical final Result: PASS Comments: Violation Summary: Inspector Tel: 503.718.2439 Inspection Date: December 13, 2016 at 8:26:36 AM Record ID: MST2016-00159 Inspector: Jeff Grove Contractor