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Permit (47)
CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT IN Permit#: MST2015-00309 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/28/2016 Parcel: 2S 11 OBA12700 Jurisdiction: TIGARD Site address: 14091 SW 118TH CT Subdivision: MEDALLION MEADOWS Lot: 20 Project: Medallion Meadows, Lot 20 ' Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 3 First: 1306 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 27 Bathrooms: 3 Second: 960 sf Garage: 866 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2266 sf Value: $294,869.00 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: 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 2266 Owner: Contractor: JT ROTH CONSTRUCTION INC FOUR D CONSTRUCTION Required Items and Reports(Conditions) FOUR D CONSTRUCTION CO PO BOX 1577 1 Ersn Cntrl 503-639-4175 12600 SW 72ND AVE#200 BEAVERTON,OR 97075 TIGARD,OR 97223 PHONE: PHONE: 503-590-0805 FAX: 503-590-1751 Total Fees: $22,946.10 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. hose rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a f the rules or direct questions to OUNC by calling 503.232.1987• .800.3 •4 Issued By: Ar...rt....e.---- i---"-- Permittee Signature: '� !�C 03.639.4175 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. titildin2 Permit Application Residential c LS l� 3o 1 y FOR OFFICE USE ONL1' City of Tigard t* ' Received G Date/By: �a 3(t ��`' PermitNo.: G. 13125 SW Hall Blvd., Tigard,OR 9723 '- / �j) ' /tlS"-TAU 5 ` ()3C' j Phone: 503.718.2439 Fax: 503.598.1960 ? �'s Plan Review Date/By: 1' Other Permit: _ T I G A R D Inspection Line: 503.639.4175 ` ate Ready/By: tris ��"��'�r fJa3 Internet: www.tigard-or.gov O ® See Page 2 for , ,'� Na otified/Method: 1/62.3111, / -7' � pp 4 r c��k�,,y� Su Iemental Information TYPE OF WORK -vv.,v v .Civ \ REQUIRED DATA:1-AND 2-FAMILY DWELLING New construction s� �°' ` ❑Demoittion Permit fees*are based on the value of the work performed. ❑Addition/alteration/replacement ❑Other: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. 01_and 2-family dwelling 0 Commercial/industrial Valuation: $ 9 ` a9 t; c36 -1' 0 Accessory building 0 Multi-family Number of bedrooms: ❑Master builder 0 Other: `--�7'" ,y Number of bathrooms -} / JOB SITE INFORMATION AND LOCATION Total number of floors: 3 Job site address: /90/ / St a t/ 7/e .7,-,y et New dwelling area: '2 (, square feet3 J City/State/ZIP: 1 i�d P�-/D YY. t kz— 9722 ii Garage/carport area: sS6(0 square feet Suite/bldg./apt.no.: 1 Project name: /y�, �, Coveredporch area (� z "�(�Cmt l�r�C�1 /�[,�.F�'�:�vC C+t�:.�(3 square feet 9 V Cross street/directions to job site: 1 t ,? 1 , 1 ��s A`f�I;Z.i�� Deck area: �(p square feet)30 6 Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: _ b A `i j /`/1t= Lot no.: "` s >�D ry I (j Permit fees are based on the value of the work performed. Tax map/parcel no.: Indicate the value(romded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. /�f'�W S'/Ai l/t_t` j=WM iLy P-0S I De--A,Lt` Valuation: $ Existing building area: square feet New building area: square feet g PROPERTY OWNER I 0 TENANT Number of stories: Name: Address: Type of construction: d} Occupancy groups: City/State/ZIP: Phone:( ) Fax:( ) Existing: pq New: Cit,APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* Business name: r 0 t.t.� D CoN S Y CT/©I.:t (P[ensere/e to fee schedutJ Contact name: 'b f>Y I p f Structural plan review fee(or deposit): Address: 'f?tD* fix i S...1 FLS plan review fee(if applicable): City/State/ZIP: e�Ye_g--r.0 t.) 0F_ Ct 7 O7 Total fees due upon application: Phone:(5c,3) 59 0 •- O 2 Q S I Fax::(,.5k.3) s'90— 1-75 i Amount received: E-mail: 0 12, D C-O ilS r e.. Nl s A,+ co i". PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted Photo Voltaic Solar Panel System. Business name: r Submit two(2)sets of roof plan with connection details Address: Q=' and fire department access,along with the 2010 Oregon P s Solar Installation Specialty Code checklist. City/State/ZIP: 7113 t,fi� Permit Fee(includes planreview $180.00 Phone:( ) l Fax:( ) and administrative fees): CCB lic.: 710 S 7 State surcharge(12%of permit fee): $21.60 Total fee due upon application: $201.60 Authorized signature: / This permit application expires if a permit is not obtained 'f within 180 days after it has been accepted as complete. Print name:D p v to 4 I)( . inr--Date: f Z-2 *Fee methodology set by Tri County Building Industry [T y Service Board. I:\Building\PermitsuBUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Electrical Permit Application City of Tigard `� FOR oFrlcc USE ONLY,"� Received 13125 SW Hall Blvd.,Tigard,OR 97 ._**i ,. ,F Received CEIIIMINEEMI Phone: 503.718.2439 Fax: 503.598 "111 PlanReview T t G A K D Inspection Line: 503.639.4175 Date/B Related Permit#: Internet: Line:www.tigard-or.gov ov Ready Date/By: rods: r vt` Notified/Method: ® See Page 2 for TYPE OF WOSupplemental Information 47 New construction • � �`` ❑Addition/alteration/re Fadement Please check all that a I ❑Demolition PP Y(submit 2 sets of plans w/items checked): ❑Other: 0 Service or feeder 400 amps or more 0 Building over three stories. CATEGORY OF CONSTRUCTION where the available fault current exceeds 10,000 amps 0 Marinas and boatyards. ❑ I-and 2-family dwelling 0 Commercial/industrial e s 1 ,000 or ❑Cloatin buildings.ua ❑Accessory building less to ground,or exceeds 14,000 ❑Multi-family ❑Commercial-use agricultural 0 Master builder ❑Other: amps for all other installations. buildings. JOB SITE INFORMATION AND LOCATION 0 Fire pump. 0 Installation of 150 KVA or Job#: 0 Emergency system. larger separately derived Job site address: vs/s- /� /,J911 Cr- ❑10tH Addition more motor load of system. City/State/ZIP: ` � / 100HP or more. ,�.` ❑Six or more residential units. occupancy. Suite/bldg./apt.#: ❑Health-caze facilities. 0 Recreational vehicle parks. Project name: 0 Hazardous locations. 0 Supply voltage for more than Cross street/directions to job site: 600 volts nominal. VD ❑Service or feeder 600 amps or more. �`'� � �MA R-i�'"- FEE SCHEDULE Descri•tionEach T Subdivision: so New residential single-or multi-ffaam�ily dwelling unit.Drat 'tG D A L L_jc,IJ l ENN3w s Lot#: .....0 Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less u 168.54 _MI Ea.add'I 500 sq.ft.or portion 33.92 III 500 DESCRIPTION OF WORK Limited energy,residential ll I with above s.,ft. 75.00 -© Limited energy,multi-family - Er; PROPERTY OWNER residential with above s..ft. 75.00 -© ❑ TENANT Renewable Ene : 0 See Pa!e 2 —. Services or feeders installation,alteration,and/or relocation 200 amps or less 11111 100.70 _© " 2. 5 CLQ 201 amps to 400 amps 133.56 _© Address: A t City/State/ZIP: 401 amps to 600 amps El _© 200.34 Phone:( ) 1111601 amps to 1,000 amps 1111 301.04 =© Over 1,000 amps or volts 552.26 Temporary services or feeders installation,alteration,and/or Owner installation:This installation is being made on property that I own which is not 200 amprelocation s or less intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 111111 2 .06 _0 Owner signature: 201 amps to 400 amps 1255.08 —© Date: 401 amps to 599 amps 11111 168.54 _© APPLICANT 0 CONTACT PERSON Branch circuits-new,alteration,or extension, ler anel Business name: tl� A.Fee for branch circuits with S Lef`J above service or feeder fee, Contact name: 14.vl each branch circuit 7.42 .© E ' p2.PacbtZ Address: B.Fee for branch circuits without �,-c) ' r; is 7 -7 service or feeder fee,first II circuit 56.18 .© City/State/ZIP: C e ea$.3 OR, - 7o-7..S Each add'l branch circuit - Phone: 0 7.42 _© 3) 3-7 C> ^ ON'©S Miscellaneous service or feeder not included Email:oneEll : D 1 Each manufactured or modular III�,tl N� Ails ` dwellinservice and/or feeder 6784...., . CONTRACTOR Reconnect only _© 67.84 Business name: L Pump or irrigation circle 67.84 _© L�c..i ` a[r w1 0 Sign or outline lighting all 67.84 _© Address: �'S.0 A/ • Signal circuit(s)or limited-energy t.E Nr) D F. -" /0 V 'anel,alteration,or extension. 0 See Page 2 © City/State/ZIP: P®RI is j OR_ ey 7 Each additional ins•ection over allowable in an of the above Phone:( } r� F ax: ) Additional inspection(1 hr min) 1111166.25/hr _■ L.� 70 (f — 7 f/ V Investigation(1 hr min) 1111 66.25/hr _■ 9 Email: EL E r.e t e L,I- I L 6 lac,u.e& cG Industrial plant(1 hr min) 78.18/hr II CCB Lic.: 1 Z: Electrical Lic.: °�/ Inspections for which r fee is III . �� Suprv.Lic.: 5762. S s. cificall listed %hmin 90.00/hr Suprv.Electrician signature,required: % ELECTRICAL PERMIT FEES i Print name: p - �A Subtotal: 0O ✓} ' S,■ _ Date: 2_- > 0 Plan Review Required(25%of permit fee): — Authorized signature• _ / / State surcharge(12%of permit fee): ! TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 ' Print name: L /ip - 11P j.-- nom, Date:1 2-Z is days after it has been accepted as complete. IABuildingTermits\ELC_PermitApp_ELR_ERE.doc Rev 04/21/2014 * Number of inspections allowed per 440-4615T(1l/05/COM/WBB P permit. Mechanical Permit Application „.' ';, FOR OFFICE USE ONLY City of Tigard -c. { Received Date/By: Permit No.: 1 !IN " 13125 SW Hall Blvd.,Tigard,OR 97223 ; 1-' t5.--_c) 503.718.2439 Fax: 503.598.1960 ' Plan Review 111 Phone: Permit: a t� s,bateBy: TI G A R D Inspection Line: 503.639.4175t , headll' y/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov ' :' '°n t *,''i ied/Method: Supplemental Information `0'''‘V t. TYPE OF WORK . '`\.‘, ' COMMERCIAL FEE* SCHEDULE- USE CHECKLIST Mechanical permit fees*are based on the value of the work IgNew construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT I SYSTEMS FEES* 5(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: Air conditioning / 46.75 Job site address: A4-) S1 W.. //u '0.1 G-t Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: •-f--i&4 9---D OF-. 9'71-$, Furnace 100,000+BTU(ducts/vents) 54.91 i J Heat pump 61.06 Suite/bldg./apt.no.: Project name: Duct work 23.32 Cross street/directions to job site: 1 , E3 ..t-H V.9 G A-90-1-1) 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: 61 G DAL.,( a N.../ / �A Do`i s Lot no.: 0 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 ,V SeI•.J6C.e PAM 1 L P---i ./ p /JC 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 OWNER,, 0 TENANT Environmental exhaust and ventilation: Name: Range hood/other kitchen i equipment 33.39 Address: SP- A Bel-0 Clothes dryer exhaust 33.39 City/State/ZIP: Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone: ( ) . Fax:( ) Attic/crawlspace fans 23.32 I APPLICANT ❑ CONTACT PERSON Other: 23.32 Fuel piping: Business name: �`O kid- I tom S-gU c T l Ct IJ $14.15 for first four;$4.03 for each additional Contact name: t v 1 Zt� N "p0A_I- Furnace,etc. Address: R C> 33,6 x' 1 S,-7 Gas Wall//sussus pumppended/unit heater City/State/ZIP: ESV z'r0 ilk B QP.- 9 a 7 S Water heater Phone:(5-4;3) 590 9j d - ID 9 0 s Fax::(�'.3) 'c?a -1 S I Fireplace Range E-mail: O U IZ t) Co IST- , MS/0, C O I/'L Barbecue CONTRACTOR Clothes dryer(gas) Business name: avg., Other: ��" t..... lr'R � MECHANICAL PERMIT FEES* Address: B6)( 433 Subtotal City/State/ZIP: C.LpG ! 0'9._ 9'7 0 i Minimum permit fee($90.00) �) Plan review(25%of permit fee) Phone:(.5(1-3 6 gc c . �, v (Fax:(5.S3) bSC.) .-, / S' State surcharge(12%of permit fee) CCB lic.: 17.0 j -Li 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: 7:2/ * Fee methodology set by Tri-County Building Industry Service Board Print name: I? u . a Date: >2,-79-- 1S % Plumbing Permit Application Building Fixtures FOR OFFICE USE ONLY City of Tigard I''',",!..',,`' Received Date : PermitNo.: 'I3TCie „.7i1??0el.,Tigard,O 7 ` Phone: 503.718.2439 Fax: 503.598.1960 l 1 •;1 Plan/By: w T I G A R D Inspection Line: 503.639.4175 , - Date/By: Other Permit No.: Internet: Line:www.tigard-or.gov or.gov Date Ready/By: inns: H See Page 2 for Notified/Method: Supplemental Information TYPE OF WORK `'' FEE* SCHEDULE ttiolt�'I3ti . For special information use checklist 'New construction ❑D ❑Addition/alteration/re lacement Description Qty. I Ea. J Total P Q'(ther' New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 itgl 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 ❑Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: ,rV(9y „5,,a/ //t G Catch basin or area drain 18.76 City/State/ZIP: "r �P�p 0 I2. Drywell,leach line,or trench drain 18.76 1 p `�7 2 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name: Manufactured home utilities 50.03 Cross street/directions to job site: 11 B -1.-\� g GA Fve_o e Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Subdivision: iy1 EO A L. o ©w Lot no.: ��} Water service(no.linear ft.: ) Page 2 5 ,�Gd Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 A/6-1,t) Clothes washer 25.02 cc)/0 C'`E' FFVM i c_y ' -elf tt Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 Er PROPERTY OWNER 0 TENANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Address: > Floor drain/floor sink/hub 25.02 �,�h'1� p 3 B (_Cx� Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 la APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: r1) etctio Medical gas(value:$ ) Page 2 Contact name: i u 1 D •✓D€!/'1 12 Romer 12.51 Roof drain(commercial) 12.51 Address: > Lo' c i57 ! Sink/basin/lavatory 25.02 City/State/ZIP: Ve 0 9-7 C)'7 Solar units(potable water) 62.54 Phone:(5)3) 5C c3 o S I Fax::(5c3) 5-90.- I-7 5, Tub/shower/shower pan 12.51 E-mail: o aft- 0 coN ss."fi'+ Jose)s JQ 1 �.o At Urinal 25.02 CONTRACTOR Water closet 25.02 - Water heater 37.52 Business name: -1--14 E iv)lA c Leki ec7ikil'A N S � Address: I k.)1 4 ,�-�7nn Water piping/DWV 56.29 R t v�lz_ '"rte - Other: 25.02 City/State/ZIP: 141L u I. e a O ' 0 i. 9 ) i a 3 Subtotal Phone:(.5'03) �v - i3 Fax:( ) Minimum permit fee: $72.50 CCB Lic.: 1,Z t, l Plumbing Lie.no.:31-/-Z6(j p� Plan review (25%of permit fee) e� ., State surcharge(12%of permit fee) Authorized signature: /�/ TOTAL PERMIT FEE Print name: /4.1///2) //1 / ate: /2-29 - /� 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:1Building\PermitslPLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) City of Tigard rIli COMMUNITY DEVELOPMENT DEPARTMENT s T f G A R D Building Permit Review — Residential Building Permit #: ,7-)ts-7-Rer s-.— _ -,O(/ Site Address: /1-'09/ ) J/ �,l 02 4-4 Project Name: /91,040///0y1 �1t� ?'1 ru.)S Lot #: ,,ID (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: e t) /Verify site address/suite#exists and active inermit p syste 4,4iver Terrace Neighborhood: ❑ Yes No Si/Plan Elements: Nil ree(3) copies of site plan 'fly;4 isting structures on site e plan must be on 8-1/2"x 11"or 11 x 17"paper IEFootprint 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 111:•cation of wells/septic systems /pplicant information(name and phone number) 1; ° osion control(including drainage-way protection, silt fence of dimensions and building setback dimensions sign,location of catch basin,etc.) t area,building coverage area,percentage of coverage and Street names 4 Jm• pervious area(applicable if R-7,R-12,R-25&R-40) Ii eet tree size,type and location Property corner elevations (2 foot contour lines if more than 1F xisting trees to be retained with drip line,and tree 4 foot differential) protection measures 11!'°Clean Water Services—Service Provider Lett (lot platted prior to 9/10/1995): /equired: ❑ Yes,applicant was notified No Received: Public Facili . s Improvement(PFI) Permit: ❑ Yes E No equired: W Yes,applicant was notified ❑ No Applied For: Apes ❑ No,stop intake and Use ase : >LC # oning: E > Setbacks: Front .:::20 Rear j Side r� ��I / Street Side �� Garage �l andscape Requirement: IP, i of Coverage Maximum: 0/0 It Building Height: Maximum Height > i g ��(`J Actual Height �� isual Clearance Easements 4:' °,ensitive Lands: ❑ Yes No Type Vrban Forestry Plan onditions "Met"prior to issuance of building permit Notes: Approved By Planning: _ --..''' ��_ ;� Date: �►Mir Revisions (after Building Submittal only) Revision 1: ❑ Approved ❑ Not Approved Reviewer Date Revision 2: ❑ Approved 0 Not Approved Revision 3: 0 Approved 0 Not Approved 1:\Building\Forms\B1dgPermitRvw RES_070915.docx Building Permit Submittal Original Submittal Date: /04/34 Site Plans: # 3 Building Plans: # 3 Building Permit#: Ei" rater building permit#above. Workflow Routing: anning [neeringpit Coordinator g-13iiilding Workflow Sign-off: off for Planning(include notes from planning review) Route Application Documents: rigineering: (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: Date: By Permit Technician: Engineering Review ,zl Slope at building pad: /2 la 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 Date: ElNOT Approved by Engineering: Notes: `j-7 Date: /13'/—/5j Approved by Engineering: �L/, r1/ 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: /g3 Yes ❑ N/A ((( Tigard Trans SDC: ❑ Yes p' N/A Parks SDC: C jYes ❑ N/A ?OK to Issue Permit % ate: /0' Approved by Permit Coordinator: I:\Building\Fonns\B1dgPennitRvw_RES_070915.docx City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 14091 SW 118TH CT, TIGARD, OR, 97224 March 28, 2017 at 9:42:34 AM Record Type: Record ID: Residential - Master Permit MST2015-00309 Inspection Type: Inspector: 199 Electrical final David Young Result: FA I L Comments: No power to upper level master and hall. Arc fault breaker not re setting. Missing outlet in garage. Re call after corrections complete. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 14091 SW 118TH CT, TIGARD, OR, 97224 March 28, 2017 at 9:46:17 AM Record Type: Record ID: Residential - Master Permit MST2015-00309 Inspection Type: Inspector: 699 Mechanical final David Young Result: FA I L Comments: No power to master bath fan. All else appears ok. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 14091 SW 118TH CT, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2015-00309 Inspection Type: Inspector: 199 Electrical final Jeff Grove Result: PASS Comments: Violation Summary: Inspector Contractor 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. ON City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT e Transmittal Letter 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 •www.tigard-or.gov/. TO: / IC1, DATE F.41 `i,` 1 : . DEPT: BUILDING DIVISION JU 0 2016 C ° OF TIGARD FROM: DPU 1 D n& g-PPLD2- • SWING DIVISION COMPANY: F-exk1'L 1.) Cpw5Ti2t t c fi 010 PHONE: 5 63 — -72o ^ 7 (i`l S By:B.r RE: ) '1b q. t 5,W . 11. 3 i'14 Cr pitSr 0/ S-0d309 (Site Address) (Permit Number) P Lk.I o FJ tit -119 b u-iS 1-O"1'-' ? (Project name or subdivision name and lot num,er) ATTACHED ARE THE FOLLOWING IT 4!;/,;j 0 .J Additional set(s) of planr �` Revisions: Cross section(s) and detai Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: P_ (.v lat. . Des—v.t L.— c" Routed to Pe ' Technician: Date: -7-w - I ,t Initials: +-I' Fees Due: 1!' Yes ❑No Fee Description: Am • .3- Hr p1c.h rev 1 cue Special Instructions: Reprint Permit(per PE): ❑ Yes liNo ❑Done Applicant Notified:0 Ail,lt. D. Date: 7/,1/f/(0 Initials: Q" I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012