Permit (32) •
CITY OF TIGARD ► . MASTER PERMIT
''' COMMUNITY DEVELOPMENTIN Permit#: MST2016 00086
Date Issued: 06/13/2016
T[GA.RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S109DB07300
Jurisdiction: Tigard
Site address: 13067 SW KOSTEL LN
Subdivision: SUMMIT RIDGE NO.5 Lot: 141
Project: Summit Ridge No. 5, Lot 141
Project Description: New SF. 8/16/16,fire sprinklers added
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 3 First: 919 sf Basement: 195 sf Left: 5 Parking Spaces: 0
Height: 32 Bathrooms: 3 Second: 997 sf Garage: 450 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2111 sf Value: $258,386.15 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
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<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 add9 500 sf: 3 201-400 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
Y
Other: N Other Description:
Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2111
Owner: Contractor:
DR HORTON INC DR HORTON INC PORTLAND Required Items and Reports(Conditions)
4380 SW MACADAM AVE SUITE 4380 SW MACADAM AVE SUITE 100 1 Ersn Cntrl 503-639-4175
100 PORTLAND,OR 97239 2 A geotechnical report is
PORTLAND,OR 97239 required before the footing
3 Special welding inspection
PHONE: 503-222-4151 PHONE: 503-222-4151 required before shear wall
FAX: 503-222-1304
Total Fees: $28,266.78
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 calling 503.232.1987 or 1.800.332.2344.
Issued By: ,i lam•-•1/1 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.
FOR OFFICE USE ONLY—SITE ADDRESS:
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
-r± ,rr R l) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: C irh �'f 1 V\'‘ eke'1 DATE RECEIVED:
DEPT: BUILING DIVISION '.;4'.1° `' •
FROM: '- 7'li'v r,.A. AUG 0 2 ?H1,;;
COMPANY:
PHONE: �b — ��et (l/tel / BuriaDiNGDIvivr(,_„lb
\�
RE: 130(D7 5 1 5 G- 4,�' )•-12�aoi l0-oDO S<
(Site Address) (Permit Number)
".5L74\ M,,,,,;1- --r"d� ,, /x/ -i /
(Project name or subdivision itcdne and lot n.41 I
4
ATTACHED ARE THE FOLLO , NG ITE .
�'Cda t , . ka 7 tl P( ,av ri r air x k
,o eps�"` ;:. & B ;,.1: ;ti r 7ti - IIP ,',, T3'U i.,.•i" F ^#�`;.1'-'.'r- 1,. ,� z,� _„
Additional set(s) of lan Revisions:
Cross section(s) details. Wall bracing and/or lateral analysis.
Floor/roof framin . Basement and retaining walls.
Beam calculation . Engineer's calculations.
v," Other(explain): r" ;_,, i,n k62_,(-
REMARKS:
xSi ar _e�r n ,fi 3r 14' .-.,
,.,'" 'i4 n O' er �iinn i, k'r ' s:
Routed to Pe ur•t Technician: Date: Initials:
Fees Due: '4Yes ❑ No Fee Description: Amount Due:
" i e $ /609, 60
41, e t 1
1 i' ; 411 Siii 6f
2k —::R , x::.. 't / q [ J$ ! T
Special
Instructions:
Reprint Permit(per PE): ❑ Yes \lo Don Y��
Applicant Notified: Date: //,P1/(t& ( I itials.
I:\Building\Forms\TransmittalLetter-Revisions_061316.doc
III
CITY OF TIGARD MASTER PERMIT
°�! a. COMMUNITY DEVELOPMENT Permit#: MST2016 00086
1 A RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/13/2016
T[t' g Parcel: 2S 109DB07300
Jurisdiction: Tigard
Site address: 13067 SW KOSTEL LN
Subdivision: SUMMIT RIDGE NO.5 Lot: 141
Project: Summit Ridge No.5, Lot 141
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 3 First: 919 sf Basement: 195 sf Left: 5 Parking Spaces: 0
Height: 32 Bathrooms: 3 Second: 997 sf Garage: 450 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2111 sf Value: $258,386.15 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
Drywell-Trench Drain: 0 Other Fixtures: 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<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!500 sf: 3 201-400 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 2111
Owner: Contractor:
DR HORTON INC DR HORTON INC PORTLAND Required Items and Reports(Conditions)
4380 SW MACADAM AVE SUITE 4380 SW MACADAM AVE SUITE 100 1 Ersn Cntrl 503-639-4175
100 PORTLAND,OR 97239 2 A geotechnical report is
PORTLAND,OR 97239 required before the footing
3 Special welding inspection I
PHONE: 503-222-4151 PHONE: 503-222-4151 required before shear wall I
FAX: 503-222-1304
Total Fees: $28,076.83
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 oug *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.
Issued By: k . L Permittee Signatur • t a4--....,
Call 503.639.4175 by 7:00 a.m.for the next available inspection e.
1 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.
`( o A-c
Building Permit Application dg
Residential RECEIVED '-OR 01.1-1( I. ISL O.1 ,
City of Tigard RDateeceiBy:ved # 0 Permit No.: /
13125 SW Hall Blvd..Tigard,OR 9722 rA5at- 42
'� Phone: 503.718.2439 Fax: 503.598.19.-u
R 9 2016 Plan r11,14 other Permit6W�&a� QS/
By:
Date;By: /
t I;,Al:I, Inspection Line: 503.639.4175 Date Ready-By: d,ihats- ® See Page 2 for
Internet: www.tigard-or.gov CITY OFTIGARD NotifiediMethod: /-
I�u �� Supplemental Information
BUILDING DIVISION
TYPE OF WORK REQUIRED DATA: 1-AND 2-FAMILY DWELLING
II New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑ Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Q I-and 2-familydwellingValuation: $
0 Commercial/industrial
❑ Accessory building 0 Multi-family Number of bedr5oms:
0 Master builder 0 Other: Number of bathrooms: 3
JOB SITE INFORMATION ANDLOCATIONTotal number of floors: 3
Job site address: 1�0(— �� J� os-A.� e New dwelling area:2 k 1 square feet C I
City/State/ZIP:Tigard, OR 97223 1 `V� L Garage/carport area: 4 GO square feet �!J
Suite/bldg./apt.no.: Project name:Summit Ridge Covered porch area: GD square feet 99-7
Cross street/directions to job site: Deck area: square feet 9)q
Other structure area: square feet )94—
REQUIRED
94—
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.:1 LI I 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.
New SFR Valuation: $
Existing building area: square feet
New building area: square feet
a PROPERTY OWNER 0 TENANT Number of stories:
Name: DR Horton Inc. Type of construction:
Address: 4380 SW Macadam Ave Suite 100 Occupancy groups:
City/State/ZIP: Portland, OR 97239 Existing:
Phone:( 503) 222-4151 Fax:( ) New:
0 APPLICANT $ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule
Business name: DR Horton Inc.
Structural plan review fee(or deposit):
Contact name: Emerald Weeks
FLS plan review fee(if applicable):
Address: 4380 SW Macadam Ave Suite 100
Total fees due upon application:
City/State/ZIP: Portland, OR 97239 p pp
Phone:(503 )222-4151 x1107 Fax: :( ) Amount received:
E-mail: esweeks@drhorton.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: ubmit two(2)sets of roof plan with connection details
DR Horton Inc.Iand fire department access,along with the 2010 Oregon
Address:4380 SW Macadam Ave Suite 100 Solar Installation Specialty Code checklist.
City/State/ZIP: Portland, OR 97239 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503 )222-4151 • Fax:( ) State surcharge(12%of permit fee): 521.60
CCB lic.: 130859
Total fee due upon application: 5201.60
n
Authorized signature: ') 9%' f, I� ( GI`� This permit application expires if a permit is not obtained
i f t'r�( within 180 days after it has been accepted as complete.
Print name: i, 14 /���� Date:2016 *Fee methodology set by Tri-County Building Industry
Service Board.
I:'Building`\.Pertnits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Electrical Permit Application Foiz 01:1:1c1: t Si.O'l.\
City f gandReceived o Ti RECEIVED : Permit a: rl igo«—ago g6
II 13125 SW Hall Blvd.,Tigard,OR 97223 �teN
s Plan Review
Phone: 503.718.2439 Fax: 503.598.19tW /i R 9 Date/Bv: Related Permit ii:
Inspection Line: 503.639.4175 11VYIIHR 2016 ReadyDate/By: kris
la SeePage2fort It,\1.I)
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
.. QF TIGARD
TITE O .
' . ,! .: c DIVISION : , PLAN REVIEW ,
al New construction 0 Addition/a teratto rep acement Please check all that apply(submit 2 sets of plans w/items checked):
❑Demolition ❑Other: 0 Service or feeder 400 amps or more 0 Building over three stories.
where the available fault current 0 Marinas and boatyards.
CATEGORY'"°NSTRU ON _4:40,V,..-:-.,-:,,',.-1-,,Vizexceeds 10,000 amps at 150 volts or 0 Floating buildings.
4 I_and 2-family dwelling 0 Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
ants for all other installations. buildings.
0 Multi-family 0 Master builder ❑Other: Q Fire pump. 0 Installation of 150 KVA or
JOB''SiTE INFORMATION AND LOCATION - -' O Eenc
rgcncy system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address:(W rn4 (J.W �p GO I00HP or more. ❑"A E i-2 'I-3
city/State/ZIP:Tigard, OR 97223 `� ,/� • ❑Six or more residential units. occupancy.
Lort. ❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: Summit Ridge 0 Ilazardous locations. 0 Supply voltage for more than
b ❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Descilpnoa I Qty. I Each I Total ) •
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: 141 Includes attached garage.
1,000 sq.ft.or less 1 I 168.54 4
Tax map/parcel#: En add'I 500 sq.ft.or portion 3 33.92 1
DESCRIPTION OF WORK },i'- rner�ry,residential Limited `
New SFR (with above sq.fi.) 1 75.00 ?
Limited energy,multi-family
75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
R PROPER' -OWNER I, ❑ TENANT- ' Services or feeders installation,alteration,and/or relocation
Name: DR Horton Inc. 200 amps or less 1 100.70 2
Address: 201 amps to 400 amps 133.56 2
4380 SW Macadam Ave Suite 100
401 amps to 600 amps 200.34 2
City/State/ZIP: Portland, OR 97239 601 amps to 1,000 amps 301.04 2
Phone:(503 )222-4151 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: esweeks@drhorton.com 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
C C 1 CON'ACT PERSO
Branch circuits—new,alteration,or extension,per panel
A.Fcc for branch circuits with
Business name: DR Horton Inc. above service or feeder fes,
7.42 2
each branch circuit
Contact name:Emerald Weeks B.Fee for branch circuits without
Address: 4380 SW Macadam Ave Suite 100 ce or feeder fee,first 56 18
branch circuit 2
City/State/ZIP:Portland, OR 97239 Each add'I branch circuit 7.42 2
-
Miscellaneous(service or feeder not included)
Phone:(503 )222- 4151 x1107 Fax::( ) Each manufactured or modular
67.84 2
dwelling,service and/or feeder
Email:esweeks@drhorton.com Reconnect only 67.84
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Wright 1 Electric
Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy See Page 2 2
Address: 11490 SE Jennifer St. panel,alteration,or extension.
City/State/ZIPEach additional inspection over allowable in any of the above
Clackamas,OR 97015 Additional inspection(1 hr min) 66.25/hr
Phone:(503) 760-8522 Fax:(5o3) It
i,, -) `IJ_, � ���S Investigation(1 hr min) 90.00/hr
v�
Industrial plant(1 hr min) 78.18/hr
Email: rlane@wrightlelectri.com
Inspections for which no fee is 90.00/hr
CCB Lic.:162368 Electrical Lic.:3-3320Suprv.Lie.:3i ifs specifically listed('r hr min)
/ ELECTRICAL PERMIT FEES
Supra.Electrician signature,required: g) .. Subtotal:
- f
Print name:""DnNtS tX AJ. � Date: 2016 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized sign ure: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Date: 2016 days after it has been accepted as complete.
• Number of inspections allowed per permit.
1:Building Permits ELC PermeApp_ELR ERE.doe Res.06 17 2015 440-46151011 05 COM'WEB
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✓ I
Mechanical Permit ApplicatilECEIVE , FOlt 011.1( r t 'l O\l '
City of Tigard Received ��/
g Date/By: Permit No.: -9/ 9^ &—t •
14
• 13125 SW Hall Blvd.,Tigard,OR 97223 MAR 9 2016 Plan Review
Date/By: roW
Phone: 503.71 8.2439 Fax: 503.598.1960 Other Pert:
T 1 U 1 R D Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/Fly- June ® See Page 2 for
Internet: www.tigard-or.gov Notitied/Method: Supplemental Information
BUILDING DIVISIO
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees°are based on the value of the work
101 New 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*
illi 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:
VIDCA12A
Air conditioning 46.75
Job site address: `)O.* G 1�, ! Furnace 100,000 BTU(ducts/vents) 1 46.75
City/State/ZIP: Tigard, OR 97223 Furnace 100,000+BTU(duclsvents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: Summit Ridge Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision: 14 I Other: 23.32
Lot no.:
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
New SFR fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
le PROPERTY OWNER 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: DR Horton Inc. Range hood/other kitchen
equipment , 33.39
Address:4380 SW Macadam Ave Suite 100 Clothes dryer exhaust " 33.39
City/State/ZIP:Portland,OR 97239 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503 ) 222-4151 Fax:( ) Attic/crawlspace fans . 23.32
0 APPLICANT is CONTACT PERSON Other 23.32
Fuel piping:
Business name: DR Horton Inc.
$14.15 for first four;$4.03 for each additional
Contact name: Emerald Weeks Furnace,etc.
Address: 4380 SW Macadam Ave Suite 100 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Portland, OR 97239 Water heater
Phone:(503 ) 222- 4151 x1107 Fax::( ) FireplaceRange
E-mail: esweeks@drhorton.com Barbecue
CONTRACTOR Clothes dryer(gas)
Other:
Business name: Birchfield Heating&Air
MECHANICAL PERMIT FEES*
Address: a ,3o S 0 Z Subtotal
City/State/ZIP: A /OA rt v i- GI 7 3 Z ) Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(54 i ) 4 Z 4,- 13 -7 kt Fax:(9.j) ) ' Z b-- 7 1"7 I' State surcharge(12%of permit fee)
CCB lie.: �- O c STOTAL PERMIT FEE
Thls permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: 0,1/ /$ 'l ' Fee methodology set by Tri-County Building Industry Service Board
Print name: ,,f a.to y 1?,',-(`'NF-1P. I V Date:
j
I.\Building\PermitsSM EC-Permit App_0401 I3.doc 440-46171(11/02/COM/WEB)
1
Plumbing Permit Annlic� V EI` 11
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Y14 9L
Building Fixtures t It1R III It I I vI (Al
City of Tigardgi
LIAR 2 9 2016 DateBy: 1'/y�o?�1l�-G�S�
Date/By: Permit No..13125 SW Hall Blvd.,Tigard OR 223 Plan Review
Phone: 503.71k
Line: 5 3. Fax: j8dti68A F6(� O G },�D
Date/By:
Received Other Permit No:
Inspection Line: 503.639.417 1 1��+,/r� t 1t/ , ( ihtcReadYBY: Juno la Seep 2 for
Internet: www.tigerdor.go '��L��1��.� � ' NoUfiedlMethod: Supplemeentalhfurmadon
1Y!'F OF WORK _ • FW SCHEDULE
❑New construction 0 Demolition For special iaforrn ttion use check/in.
Description I Qty. 1 Ea. 1 Total
❑Addition/alteration/replacement 0 Other: New 1-2-fatally dweRings(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
❑Accessory building 0 Multi-family SFR(3)bath 500.32
❑Master builder Each additional bath/kitchen 25.02
❑Other Fire sprinkler(Lill sq.ft.) 1 Page 2
J011 SITE INPORNIA rCI AND LOCATION ' Site utilities:
Job site address: P2, f�Gf. /„J I, Catch basin or area drain 18.76
I / / S t✓ r^ TG> [�+� Drywell,leach line,or trench drain 18.76
City/State/ZIP: 11 04 9 7 Z ZY
l Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt,no.: Project name: Summit Ridge 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 tt.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: 1 Lot no.:
Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
QFSCRtFl7ON OF WORK Backwater valve 12,51
Clothes washer 25.02
Dishwasher 25.02
NSFR Drinking fountain 25.02
Ejectors/sump 25.02
• 0 PAOPIERSY Mink I 0 Ia8Arrr Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib
25.02
Phone:( ) Fax:( ) ke maker
- 12.51
0 IAMBI-tool ❑ CONTACT PERSON interceptor/grease trap 25.02
Business name: DR Horton Inc Medical gas(value:S ) Page 2
Contact name: Emerald Weeks moi" 12.51
Roof drain(commercial) 12.51
Address: 4380 SW Macadam Ave Ste. 100
Sink/basin/lavatory 25.02
City/State/ZIP: Portland, OR 97239 Solar units(potable water) 62.54
Phone:(503 ) 222-4151 ext 1107 Fax::( ) Tub/sbower/showerpan 12.51
E-mail: esweeks@drhorton.com Urinal 25.02
CONTRACTOR Water closet 25.02
• t (, • Water heater 37.52
Business name,GraV1.k� 1t>.1Ac9tukl v\C Waterpiping/DWV 56.29
Address: NCI' 5-- S•r`-1/41
-Tv-i J)J.. Other: 25.02
City/State/ZIP: Orelan C4-1-� Da- (j1O4.S Subtotal
Phone:(5 b1) liCi 0_Yt(o3 t Y J Fax:(971 ) ZSo-Zjs O fa Minimum permit fee: 572.50
Plan review (25%of pennit fee)
CCB Lie., l9t.i50 ` , c Plumbing Lic.no.: pf5 i D105
arge .of permit fee)
Authorized signature: ,....\.).._,..}....Q....,iTOT(IALALPERMIT FEE
Print name: 3-0 y�� �l � Date: Tho permit applicadoa expires if
State surcharge
permit Is sot obtained within l$I days
ager h hzs been ateepted as complete.
'Fee methodology set by Tri-County Building industry Service Board.
I:\Building\Puwin\PLMU-PsmitApp.duc 10/01I04 440-46161.(I0/U2/COM/WEB)
City of Tigard
r COMMUNITY DEVELOPMENT DEPARTMENT
■
r 1 G n 1Z n Building Permit Review — Residential
Building Permit #: HGj j j/b-ct,D 0
Site Address: 131)&17 SO/ ICOS-1-e 1 (,(V
Project Name: S U m rM I-I- 12 i d 9e - Lot #: 14/ / °`G.
(New dwelling= subdivision name;.Addition or.Alteration=last name of owner)
Planning Revi w
Proposal: e W S c_12_
/Verify site address/suite#exists and active in permit system.
River Terrace Neighborhood: ,,,ZNo ❑ Yes,See River Ten-ace Review Addendum Attached
Site Plan Elements:
Three (3)copies of site plan xrExisting structures on site
Site plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint 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)
//Site address,project or subdivision name and lot number bocation of wells/septic systems
CVApplicant information(name and phone number) Erosion control(including drainage-way protection, silt fence
/Lot dimensions and building setback dimensions design,location of catch basin,etc.)
❑Lot area,building coverage area,percentage of coverage and %treet names
impervious area (applicable if R-7,R-12,R-25&R-40) Jtreet tree size,type and location
'roperty 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 ❑ No Received: ❑ Yes ❑ No
Public Facilities Improvement(PFI) Permit: Pc- 2,01 s 99 �04
Required: ❑ Yes,applicant was notified ❑ No 1 -app e or: ❑ Yes ❑ No,stop intake
Land Use Case#: SU B ZOfS —00007 i S'Liz Zo1 S-- Co 004 / VA& 201c-000u- Z7
/Zoning: Ra -
Setbacks: Front 1 S Rear 1S Side ' Street Side C 0 Garage 2. 0
yLandscape Requirement: ,t/`� %
Lot Coverage Maximum:
Building Height: Maximum Height 3 S Actual Height 30
Visual Clearance
Easements
pif Sensitive Lands: ❑ Yes ❑ No Type
toUrban Forestry Plan
Conditions "Met"J prior to issuance of buildingpermit
tes: Goo dA 0o 11 rejnC/l YlmC -t"0 he (rtA." prI(7r
1 issuofnce of OviIc�t P. 1 -1i +-
Approved By Planning: e'1.�� � Date: 3/07/ / (o
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\B1dgPermit R vw_RES_012116.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: ❑ 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
lope at building pad: ÷- 1, .....9......,: i _ i,
Conditions "Met"prior to issuance of buildin• c•rmit
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: ,4J _7 Date: 3—/e9-f4
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: I' es CI N/A
Tigard Trans SDC: Yes Cl N/A
Parks SDC: Yes ❑ N/A
OK to Issue Permit
Approved by Permit Coordinator: / ' ° Date: S/ ///0
l:ABuilding\Foams\BldgPennitRvw_RES_012116.docx
RECEIVED
Mechanical Permit Application
City of Tigard s.EF, 2 1 2016 ,,":;;:d9,pg '"--/7.57420/6 --egOeF0
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13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
13067 SW KOSTEL LN, TIGARD, OR, 97224
Record Type:
Residential - Master Permit
Inspection Type:
299 Final inspection
Result:
FA I L
Comments:
Tel: 503.718.2439
Inspection Date:
February 22, 2017 at 10:17:54
AM
Record ID:
MST2016-00086
Inspector:
David Young
Provide approved final inspection and test report for lawn irrigation Backflow devise prior
to final inspection. PLM 2016-00131
Uncover required entry light.
Grading to slope away from house 6" in 10' or provide approved drainage swale. R401.3
Remove debris from both crawl areas, R408.4.
Violation Summary:
Inspector Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
13067 SW KOSTEL LN, TIGARD, OR, 97224
Record Type:
Residential - Master Permit
Inspection Type:
299 Final inspection
Result:
FA I L
Comments:
Tel: 503.718.2439
Inspection Date:
February 22, 2017 at 10:17:54
AM
Record ID:
MST2016-00086
Inspector:
David Young
Provide approved final inspection and test report for lawn irrigation Backflow devise prior
to final inspection. PLM 2016-00131
Uncover required entry light.
Grading to slope away from house 6" in 10' or provide approved drainage swale. R401.3
Remove debris from both crawl areas, R408.4.
Violation Summary:
Inspector Contractor