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Permit (10) CITY OF TIGARD MASTER PERMIT 1Il1 ._,. COMMUNITY DEVELOPMENT ` Permit#: MST2015 00308 T[Ga4.R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/28/2016 Parcel: 2S 110BA12600 Jurisdiction: TIGARD Site address: 14103 SW 118TH CT Subdivision: MEDALLION MEADOWS Lot: 19 Project: Medallion Meadows, Lot 19 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 3 First: 524 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 27 Bathrooms: 3 Second: 1989 sf Garage: 691 sf Front: 20 Smoke Dwelling Units: 1 Third: 641 sf Right 5 Detectors: Yes Total: 3154 sf Value: $390,076.18 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer 100 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Drains: 0 Water Lines: 100 Catch Basins: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Bckflw Prevntr: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea 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:Y Square Feet: NEW SF VB R-3 3154 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 2 A geotechnical report is TIGARD,OR 97223 required before the footing PHONE: PHONE: 503-590-0805 FAX: 503-590-1751 Total Fees: $24,992.98 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--_ • he rules or direct questions to OUNC by callZ(e5e./..,Z1-1/ 4 14. Issued B.1::'","- ••rmittee Signature: .•39.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. ' Building Permit Application l��sidential /C- City of Tigard f,t } Received i II 13125 SW Hall Blvd.,Tigard,OR 9722] `+� Date/By: % /(5—Iv— 'l Permit No.: M IN Phone: 503.718.2439 Fax: 503.598.1960 a{n Plan Review d'l ! 'Jr71C�� Inspection Line: 503.639.41751 '1�} 1 Date Re J )31 J C Other Permit:5'l T I G n R D p � Date Ready/By: Ell e`��r7or �� Internet: www.tigard-ocgov �)`_ Anis. SSee Page 2 for q Notified/Method:/ /4/4� Su x ,,1%is5^r,,k� ✓'l I Supplemental Information TYPE OF WORM}to a b) ,+, F, � 3, : REQUIRED DATA:'1-AND 2-FAMILY DWELLING NNew construction o D 11t ii u Permit fees*are based on the value of the work performed. ID Additiorialteration/replacement 0 Other: Indicate the value(rounded to the nearest dollar)of all er: _ equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. 1Z1-and 2-family dwelling 0 Commercial/industrial Valuation: $ J 1 IJ I 0 C j ❑Accessory building 0 Multi-family Number of bedrooms: �J J ❑Master builder ❑Other: Number of bathrooms: 27/Z, JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: /i7903 S t w/ /l 0 r c New dwelling area: 3 j S y square feet y ii`� City/State/ZIP: T i(of 12.S3 , ov__.. 9722 Garage/carport area: ��/ square feet 6 I)Suite/bldg.lapt.no.: I Project name: eift1 / //Idol square rpudi 4'y_i 1 Covered porch area square feet j 9 c 9 Cross street/directions to job site: ' ' 9.} TN R yA JZp� Deck area: 27 V square feet S..a„,4. Other structure area: square feet Subdivision: M,...:-_--- REQUIRED DATA:COMMERCIAL-USE CHECKLIST b A L L 10 MEA D J w,5 I Lot no.: /9 Permit fees*are based on the value of the work performed. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. N'�W ...5/i`V OLS 11" -/t ILV ' zes i J ETA)(-r Valuation: $ Existing building area square feet New building area: square feet ri4PROPERTY OWNER I ❑ TENANT _— Number of stories: Name: Address: {� Type of construction: i3 me- 'A� R Z L-Si L i Occupancy groups: City/State/ZIP: Phone:( ) Existing: Fax:( ) APPLICANT New: ❑ CONTACT PERSON BUILDING PERMIT FEES* Business name: i, l_'9t�112. D 1v,.s7. (Please refertofeeschedule) iLr� ij Contact name: i�Y io Structural plan review fee(or deposit): De Hp►.PPOlz-c Address: F'0% X )S 7 7FLS plan review fee(if applicable): City/State/ZIP: R Cyt!R roN.) 0 c.7 07 Total fees due upon application: Phone:(5e3) 590 ._ O Ei 0 S Fax::( .) S9 0- 175 , Amount received: E-mail: l7�„( 12 C, 6 JJ S-r e. M s iki t CVPHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted Photo Voltaic Solar Panel System. Business name: Submit two(2)sets of roof plan with connection details Address: c A n J and fire department access,along with the 2010 Oregon rJ Solar Installation Specialty Code checklist. City/State/ZIP: e /13Permit Fee(includes planreview Phone:( ) I Fax:( ) and administrative fees): $180.00 CCB lic.: '7) State surcharge(12%of permit fee): $21.60 7 Total fee due upon appication: $201.60 Authorized signature: 7 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:D v t fl Date: _2 _ *Fee methodology set by Tri-County Building Industry C �t , I Service Board I:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) , Electrical Permit Aaplication FOR OFFICE USE ONLY City of Tigard Received 13125 SW Hall Blvd.,Tigard,OR 97223 F' Date/B : Permit#: .t Phone: 503.718.2439 Fax: 503.5 I r - Paan Review = js Inspection Line: 503.639.4175 , . Related Permit 4: TIGARD -. Date/B Internet: Line:gard-or.gov ?°.z.,. Ready Date/By: Juris: Notifie3/Method: ® See Page 2 for TYPE OF WO' s Supplemental Information I►� New construction 0 Addition/aheratio replace u ❑Demolition cat'} d400 amPlease check all that apply y(submit 2 sets of plans w/items checked): ❑Other: r F' , 0 Service or fe1111111111111111111 eer s or more 0Building over three stories. .. � ' P CATEGORY OF CONS where the available fault current a 0 Marinas and boatyards. exceeds 10,000 amps at 150 volts or 0 Floating buildings. El 1-and 2-family dwelling 0 Commercial/in# stCiairr ❑Accessory buildingless to ground,or exceeds 14,000 ❑Multi-family 0 Commercial-use agricultural 0 Master builderamps for all other installations. 0 Other: 0 Fire pump. buildings. JOB SITE INFORMATION AND LOCATION0 largerelsepa of ly d KVA or Job#: 0Emergency system. separately derived Job site address: ❑Addition of new motor load of system. City/State/ZIP: 100HP or more. ❑"A","E","1-2","1-3", �� Z Z Z t, ❑Six or more residential units. occupancy, ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#; Project name: 0 Hazardous locations. 0 Supply voltage for more than Cross street/directions to job site: , ❑Service or feeder 600 amps or more. 600 volts nominal. 1 is a VP G IVIA R-a€ FEE SCHEDULE. / 1 v Descri,tion 0 Subdivision: .0 C r New residential single-or multi-family Each oral dwelling unit. G.D A t-ltl N.) /' 'h 's Lot#: / Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 11111 168.54 _� DESCRIPTION OF WORK Ea.add'I 500 sq.ft.or portion i 33.92 _Li Limited energy,residential at' with above s..ft. 75.00111 Limited energy,multi-family ■ residential with above s..ft. 75.00 -© Irl* PROPERTY OWNER Renewable Energy 0 TENANTEl See Page 2 Services or feeders installation,alteration,and/or relocation Address: 200 amps or less 100.70 tile- 2 s * ^LO 201 amps to 400 amps 133.56 City/State/ZIP: 2 401 amps to 600 amps 200.34 2 Phone:( ) 601 amps to 1,000 amps 301.04 2 Over 1,000 amps or volts 552.26 Temporary services or feeders installation,alteration,and/or relocatin2 Owner installation:This installation is being made on property that I own which is not 200 amps or less intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 52 Owner signature: 201 amps to 400 amps 1255.08.08 Date: 401 amps to 599 amps 2 IvaAPPLICANT 168.54 2 0CONTACT PERSON Branch circuits-new,alteration,or extension,per panel r COLI A.Fee for branch circuits with Business name: D ��01/4.3s Tait(.tiz:.f\,1 above service or feeder fee, ip�)0 each branch circuit Contact name: 7.42 2 a - 12..PFklt2 Address: 10,_(3B.Fee for branch circuits without �' LS 7 "1 service or feeder fee,first City/State/ZIP: branch circuit 56.18 2 ,. e •1.3 Oa, - 707Each add'l branch circuit Phone: m 742 2 3) �� - Q�QS Fax: :(S�3) ���_ 7 S 1 Miscellaneous(service or feeder not included) Email: hEach manufactured or modular U 11... ✓ �,tl N-S`r' N_ dwelling,service and/or feeder 67.84 2 CONTRACTOR . Reconnect only 67.84 2 - Pump or irrigation circle 67.84 2 Business name: i L LE(MI, r L\vi • Sign or outline lighting 67.84 2 Address: �,'$ f Signal circuit(s)or limited-energy t E Nr) E)1Z. -lL /0 V panel,alteration,or extension. 0 See Page 2 2 City/State/ZIP: p®R,(-1_�/ G1' 7 zEach additional inspection over allowable in any of the above Z I. Phone:(SS) Z-,--7p2 Fax: Additional inspection(1 hr min) 66.25/hr G1 (154) Vo i — ,?/ V Investigation(I hr min) 66.25/hr Email: ELoreeLe[_T (-6 (7vtd y� -Mt Industrial plant(1 hr min) 78.18/hr CCB Lic.: 1 9, 2.7_ Electrical Lic.: 5 Inspections for which no fee is /47 « Suprv.Lic.: '��Lspecifically listed(V.hr min) 90.00/hr Suprv.Electrician signature,required: i? ELECTRICAL PERMIT FEES % /�+_ ilrIIIIIIIII Print name: P Subtotal: • , 4,, ^, _ 2." _ Date:/2.—21-45 0 Plan Review Required(25%of permit fee): State surcharge(12%ofpermit fee): ), _ TOTAL PERMIT FEE: Authorized signature: Print name: /�� This permit application expires if a V 0 i 436 4„ A 'git ,,,.'' Date: _29_/ p permit isnoto pleie. within 180 days after it has been accepted as complete. I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 04/21/2014 * Number of inspections allowed per permit. 440.4615 T(11/05/COM/WEB Mechanical Permit Application FOR OFFICE USE ONLY j City of Tigard t Received _ . i"'r Date/By: Permit No.: 6----r,* ,i 13125 SW Hall Blvd.,Tigard,OR 97223 ;:i 14 ,. Phone: 503.718.2439 Fax: 503.598.1960 '.'44`,-1;-''111 Plan Review Other Permit: Date/By: TI G A R D Inspection Line: 503.639.4175 Date Read/a Jung: Internet: www.tigard-or.gov Notified/Method: Supplemental y See Page 2 for Information TYPE OF WORKo.t. 't ,1 COMMERCIAL FEE* SCHEDULE - USE CHECKLIST New construction ❑Addition/alteration/re .6(4 Mechanical permit fees*are based on the value of the work 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/SYSTEMS FEES* 56-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi-family 0 Master builder 0 Other: Description p Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning / 46.75 Job site address: // /// 3 , )47. /18 7-14 c r Furnace 100,000 BTU(ducts/vents) I 46.75 City/State/ZIP: •-r-1&i .\Z) i C 9 7 c-/ Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: Duct work 23.32 Cross street/directions to job site: t 1 t3 11-1 _i-Ia 24 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: NI C p LLc7Lot no.: / G� Other: 23.32 C �L���`t+'s / Other fuel appliances: Tax map/parcel no.: Water heater J 23.32 DESCRIPTION OF WORK Gas fireplace/insert j 33.39 Flue vent for water heater or gas A/C- <Sf to to C.6" f M 1 y (P--E i P Mt fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 ,�/ Chimney/liner/flue/vent 23.32 1py„PROPERTY OWNER. 0 TENANT Other: 23.32 Environmental exhaust and ventilation: Name: Range hood/other kitchen equipment 33.39 �r Address: S tp L- P.3 13 e----Lo----) 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 0 CONTACT PERSON Other: 23.32 Business name: Fuel piping: (..i R.. I) t>J S-r12_,J.cT t-a L.) $14.15 for first four;$4.03 for each additional Contact name: I) i v 1 D De-Nom, p j-- Furnace,etc. Address: P O 0) 1S-2-7 Gas heat pump Wall/suspended/unit heater City/State/ZIP: Z E V L ro i..D i Q (4 '1 0 7 --S. Water heater Phone:(j 3) $cio ^ 0 90 S Fax::(5-43) zs:9O - I-7 s / Fireplace E-mail: ey a!L-D CO /1/4.3 SrRange -' �"s�' CO����- Barbecue CONTRACTOR Clothes dryer(gas) Other: Business name: � .1V(-0--A L A-1,12._ 2'1\+t-- MECHANICAL PERMIT FEES* Address: P-o BziX 43 3 Subtotal City/State/ZIP: Lk.C., =-A MI AS cD f�. 9'701S Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(�d3) 6 S c, t clog' (Fax:6413) (05 Q ..-32,? State surcharge(12%of permit fee) CCB lic.: 17-.0 b2-L/f TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 7 `.----26/ . days after it has been accepted as complete. Authorized signature: `� * Fee methodology set by Tri-County Building Industry Service Board Print name: pi,„,0 ,T,De, n- Date: 12-a f- /S ' Plumbing Permit Application ,--v.14. Building Fixtures 3 �1° ` , FOR OFFICE USE OM1.) City of Tigard {{��,yl`, Received ft rolDate/By: PennitNo.: <��_`,�C J�XiYJ l`� IN 13125 SW Hall Blvd.,Tigazd,OR 97223 Plan RevBy: (7l = Phone: 503.718.2439 Fax: 503.598.1960 \\.: i t' ateBy: Other Permit No.: Inspection Line: 503.639.4175 'f �� T I G A R U , A: t Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov i 47'''4 .9^ s ' Nbtified/Method: Supplemental Information fi.,4.t- �i' TYPE OF WORK ; ,t )a FEE* SCHEDULE N',2' `ig/_k ANew construction ❑Demolition For special information use checklist Description I Qty. I Ea. Total ❑Addition/alteration/replacement 0 Other: New I-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 0 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building ❑Multi-family SFR(3)bath 500.32 - 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: /9/0 3 S', � ii csl r�„ < 71- Catch basin or area drain 18.76 GJ Drywell,leach line,or trench drain 18.76 City/State/ZIP: "�"1 ,j:i 0 I!. 9 1 Z Li Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03 Cross street/directions to job site: I t E 'T A k GR f1'r I 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: Er)A LL )& jry t,,,,S Lot no.: / e7 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Me(A) Clothes washer 25.02 cc1 N L,L t'" RM i t y 'S/ L '_ Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 Eit PROPERTY OWNER 0 TENANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Floor drain/floor sinlc/hub 25.02 Address: 5PM p S Seco u-/ Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 a APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: r., `^, ,^ D �,Tratexto fu Medical gas(value:$ ) Page 2 T Primer 12.51 Contact name: AV i.0 1) AN"f r" i^ Roof drain(commercial) 12.51 Address: L0i 70 /S-7 7 Sink/basin/lavatory 25.02 City/State/ZIP: J3cVc' 7-1.1 - q'7 0-7,S Solar units(potable water) 62.54 Phone:( )-3) 3'90 d S p<, Fax::(53) 5 io I-)S I Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 ��trt- O Nst" C . sl)t co Water closet 25.02 r q� CONTRACTOR G�fC,f•Ilr•/ Water heater 37.52 Business name: 4-4-4pe- i il IA LLA:-`,) .:0° ,t,,,f,A LJ y Water piping/DWV 56.29 Address: I 7c I A S, t I✓L---1Z ;4'e - Other: 25.02 City/State/ZIP: 141L.LS B t 0 r 9' 7 t;a 3 Subtotal Phone:(5"03) 6 Lic.) 0 l(3 Fax:( ) Minimum permit fee: $72.50 GI Plan review (25%of permit fee) CCB Lic.: l 2_6?8 ci Plumbing Lic.no.:3I Z 6 0 pb State surcharge(12%of permit fee) Authorized signature: //` -' TOTAL PERMIT FEE Print name: 1)r�w/D S /.,it: Date: z_Z I This ptrmit 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(I0/02/COM/WEB) City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT s T I G A R D Building Permit Review — Residential Building Permit #: 711,5VO15 20 d Site Address: /21/0 S 'A) //EVA ebar--71 . Project Name: Appealhbn niAtlug c Lot #: (New dwelling= subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: AJ? \S')ie Verify site address/suite# exists and active inpermit syste N1Yiver Terrace Neighborhood: ❑ Yes No Sit Ian Elements: coof site plan p 1k *ti sting structures on site eree plan(3) pies must be on 8-1/2"x 11"or 11 x 17"paper IF ootprint of new structure(including decks)with finished P awn to scale(standard architect or engineer scale) or elevations •rth arrow Utility locations (required for new,may apply for additions) 'K e address,project or subdivision name and lot number ,:cation of wells/septic systems A t dcant information(name and phone number) It rosion control(including drainage way protection,silt fence p�` •t dimensions and building setback dimensions sign,location of catch basin,etc.) Nf.! area,building coverage area,percentage of coverage and r eet names i pervious area(applicable if R-7,R-12,R-25&R-40) S eet roperty corner elevations (2 foot contour lines if more than stitreeng trsize,type and location ees to be retained with drip line,and tree 4 foot differential) protection measures Vim' :lean Water Services-Service Provider Letter (lot platted prior to 9/10/1995): equired: ❑ Yes,applicant was notified E No Received: E Yes E No Public Faciti/RI mprovement (PFI) Permit: equired: ��Yes,applicant was notified ❑ No Applied For: I� Yes ❑ No,stop intake lei and Use Case#: --CZ/ 0a/3— e.)006)� oning: R- . c Pr Setbacks: Front ` 6 Rear /S �7 Side Street Side tc- Garage cS' 3 Se dscape Requirement: 0/0 ' of Coverage Maximum: Building Height: Maximum Height 3(7 Actual Height9- tat isual Clearance vp Easements 0 sensitive Lands: ❑ Yes Zlo Type it rbFtry an Conditianonsores"MePlt"prior to issuance of building permit Notes: Approved By Planning: "- 11111"11ii. //� Date: eQ go S— Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Fonns\BldgpennitRvw RES 070915.docx Building Permit Submittal Original Submittal Date: /.01/36 /1'c Site Plans: # 3 Building Plans: # 3 Building Permit#: nter building permit#above. Workflow Routing: C '1'Tanning L -£ veering rmit Coordinator g Workflow Sign-off: t Sign-off for Planning(include notes from planning review) Route Application Documents: gineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. 111 ui ding: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: ‘,...-"`' Date: /�/ is-- Engineering Review Slope at building pad: ,5-�� Conditions "Met"prior to issuance of building permit f�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 o ❑ NOT Approved by Engineering: Date: ��' Notes: 9'� -f ya U.t Approved by Engineering: 42_, � Date: 42...3/._/5-- Revisions zd3l-/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: "ADC Fees Entered: Wash Co Trans Dev Tax: es ❑ N/A Tigard Trans SDC: ❑ Yes )avN/A Parks SDC: 'N► Yes ❑ N/A WOK to Issue Permit Approved by Permit Coordinator: Date: //1A-4, I:\Building\Fonns\BldgPennitRvw_RES_070915.docx 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 14103 SW 118TH CT, 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 21, 2017 at 7:14:56 AM Record ID: MST2015-00308 Inspector: David Young Provide approved final erosion control prior to building final inspection. No inspection done at this time. Violation Summary: Inspector Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 14103 SW 118TH CT, TIGARD, OR, 97224 Record Type: Residential - Master Permit Inspection Type: 199 Electrical final Result: PASS Comments: Corrections from previous inspection complete. Violation Summary: Tel: 503.718.2439 Inspection Date: February 23, 2017 at 10:20:32 AM Record ID: MST2015-00308 Inspector: David Young Inspector Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 14103 SW 118TH CT, TIGARD, OR, 97224 Record Type: Residential - Master Permit Inspection Type: 199 Electrical final Result: FA I L Comments: Tel: 503.718.2439 Inspection Date: February 21, 2017 at 10:23:07 AM Record ID: MST2015-00308 Inspector: David Young Provide breaker lock for dishwasher not plug and cord connected. 422.30 Dining room not arc fault or gfci protected. 210.12A All else ok. Violation Summary: Inspector Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 14103 SW 118TH CT, TIGARD, OR, 97224 Record Type: Residential - Master Permit Inspection Type: 399 Plumbing final Result: FA I L Comments: Tel: 503.718.2439 Inspection Date: February 21, 2017 at 9:34:51 AM Record ID: MST2015-00308 Inspector: David Young T&P not secured at water heater per cpvc manufacturers requirement. No hot water at kitchen sink. No water pressure on right master sink. Provide hard cap for un used rain drain stand pipes. Not ready for final inspection, work not complete. Violation Summary: Inspector Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 14103 SW 118TH CT, TIGARD, OR, 97224 Record Type: Residential - Master Permit Inspection Type: 699 Mechanical final Result: PASS Comments: Corrections from previous inspection complete. Violation Summary: Tel: 503.718.2439 Inspection Date: February 23, 2017 at 10:22:23 AM Record ID: MST2015-00308 Inspector: David Young Inspector Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 14103 SW 118TH CT, TIGARD, OR, 97224 Record Type: Residential - Master Permit Inspection Type: 299 Final inspection Result: PASS -CofO Comments: Final erosion control approved. Street tree certification received. Moisture content form received. High efficiency lighting form received. Blower door test report received. Insulation certification checked. C of O left on site with contractor. Violation Summary: Tel: 503.718.2439 Inspection Date: Record ID: MST2015-00308 Inspector: David Young Inspector Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 14103 SW 118TH CT, TIGARD, OR, 97224 Record Type: Residential - Master Permit Inspection Type: 699 Mechanical final Result: FA I L Comments: Tel: 503.718.2439 Inspection Date: February 21, 2017 at 10:29:23 AM Record ID: MST2015-00308 Inspector: David Young Protect AC lines and line set tubing in contact with ground and concrete landscape blocks. ORSC M13 Violation Summary: Inspector Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 14103 SW 118TH CT, TIGARD, OR, 97224 Record Type: Residential - Master Permit Inspection Type: 399 Plumbing final Result: PASS Comments: Corrections complete from previous inspection. Violation Summary: Tel: 503.718.2439 Inspection Date: February 23, 2017 at 10:18:43 AM Record ID: MST2015-00308 Inspector: David Young Inspector Contractor