Permit (73) CITY OF TIGARD MASTER PERMIT
: COMMUNITY DEVELOPMENT 'WRUZECOIIMII Permit#: MST2016-00285
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/11/2016
T t i.; It n g Parcel: 2S104AC10900
Jurisdiction: Tigard
Site address: 13330 SW DOE LN
Subdivision: Lot:
Project: Walnut Ridge, Lot 9
Project Description: New SF. 10/24/16 REPRINT to convert den to guest suite,add guest bath&add fireplace.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1392 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 25 Bathrooms: 4 Second: 1533 sf Garage: 491 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2925 sf Value: $349,498.43 Rear: 20
PLUMBING
Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 4 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: 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: 5 201-400 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 2925
Owner: Contractor:
RIVERSIDE HOMES LLC RIVERSIDE HOMES LLC Required Items and Reports(Conditions)
17933 NW EVERGREEN PKWY 17933 NW EVERGREEN PKWY 370 1 Ersn Cntrl 503-639-4175
#370 BEAVERTON,OR 97006 2 A Geotechnical report is
BEAVERTON,OR 97006 required before the footing
3 Fire Sprinklers Required
PHONE: PHONE: 503-645-0986
FAX: 503-690-2942
Total Fees: $30,073.91
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By( _ Permittee Signature: /
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application 6/Zs
Residential f. .:. - \11;,t 1.0R01.1.1( I:l ‘,1.0\1.\
City of Tigard ❑❑ Received
d . '7 r�r, Permit NgI�s j�ij6 �p.7,$
13125 SW Hall Blvd.,Tigard,OR 91.14N p 8 ?_016
Plan Review-
Phone: 503.718.2439 Fax: 503.598.1960 Da�B : �> c•
,a Other Perm 4/C`,,e/6 eacrzy
I I t : 7Inspection Line: 503.639.4175 Date Ready/By: /�/G /4e/� Juris. l See Page 2 for
Internet: www.tigard-or.gov Notified/Methodd// Supplemental Info
rmadon
3E 11 ,v�� C� ' ii,t,r+ ,
No rift± ix'c/
>, , ii:`.^n'''' ,,« Com, .1..r.:,-,',,,- it,.,,s,,N..... , t-.-1,' �.i <:: :.:::,,I, "`. _..v. R i. ". .._. ,,-"ii.i.'4‘....‘..q, _:# -.. t...of."dse-,+k..,':
®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 0 Other: equipment,materials,labor,overhead,and the profit for the
Att.orary{I ,' ^N * V V h, work indicated on this application.
® 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ Lr
❑Accessory building 0 Multi-family Number of bedrooms: 5 ■I
0 Master builder 0 Other: Number of bathrooms:""J+ .
:`' ?rr ': ;P", a ', ' Total number of floors: 2 '
Job site address:13330 SW Doe Ln New dwelling area: 2885 square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: 491 square feet
Suite/bldg./apt.no.: Project name:Walnut Ridge Covered porch area: 45 square feet I C n
Cross street/directions to job site:SW Walnut and SW 133rd Ave Deck area: square feet '5
Other structure area: square feet
Subdivision:Walnut Ridge Lot no.:009 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
*Ittitif..,,� 1.`k kr ' '•_' , .• work indicated on this a..lication. ,
Construction of SFR Home Valuation: $
Existing building area: square feet
New building area: square feet
r . u Number of stories:} ,,mi,:0 °s,rx .', ,. �. rTz,i£' 5.ii.Aisix _. 3. . .
Name:Riverside Homes,LLC Type of construction:
Address:17933 NW Evergreen Parkway,Suite 370 Occupancy groups:
City/State/ZIP:Beaverton,OR 97006 Existing:
Phone:(503)645-0986 Fax ( )
' ' New:
� y
� k i
®yi . , k, rtn�.�l�°"&£�!WJ K. � ,. . .�.uz..,�.a.x n .m i-k� Si'�lY .ii.t.
I Business name:Same as Above "
Structural plan review fee(or deposit):
Contact name:Wes Boisvert
Address: FLS plan review fee(if applicable): _.
City/State/ZIP: Total fees due upon application:
Phone:( ) Fax::( ) Amount received:
E-mailwboisvert@riversidehome.com
,*
v . Commercial and residential prescriptive installation of
��"7+1, ; .ivir. ..,«_ . : ., x.'=, -
, ,.- <i., ` ,h .,i . . _ roof-top mounted Photovoltaic SolarPanel System.
Business name:Riverside Homes,LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:17933 NW Evergreen Parkway,Suite 370 Solar Installation S•eclat Code checklist.
City/State/ZIP:Beaverton,OR 97006 Permit Fee(includes plan review $180.00
and administrative fees :
Phone:(503)645-0986 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.:189148
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after It has been accepted as complete.
Print name:Wes Boisvert Date:06/10/2016 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
■
{R,ARE)
Building Permit Review -- Residential
Building Permit #: /`7Si 46 -- 00 ,?...f-5"-
1
Site Address: 13330 Sw Doe lin.
Project Name: W Gl I no t (-6'al.Gy, Lot #: C
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: N.MAJ S g-R.
21'Verify site address/suite#exists and active in permit system.
ca' River Terrace Neighborhood: Xi No 0 Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
,Three(3)copies of site plan Esting structures on site
;kite plan must he on 8-1/2"a 11"or 11 x 17"paperootprint of new structure(including decks)with finished
4Drawn to scale(standard architect or engineer scale) floor elevations
/North arrow -qty locations(required for new,may apply for additions)
Site address,project or subdivision name and lot number Jbeeation of wells/septic systems
lApplicant information(name and phone number) ZExisting trees to be retained with drip line,and tree
Iiitot dimensions and building setback dimensions protection measures •
Eot area,building coverage area,percentage of coverage and )Street tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) ,efstreet 9eProperty corner elevations(2 foot contour lines if more than
4 foot differential)
Clean Water Services-Service Provider Lett (lot platted prior to 9/10/1995):
Required: 0 Yes,applicant was notified No Received: 0 Yes 0 No
Public Facilities Improvement(PFI)Permit: _zo,S- 00iO3
Required: 0 Yes,applicant was notified 0 No Applied For: 0 Yes 0 No,stop intake
ja Land Use Case#: SU6Z0)4 - 0001 (
1Z1 Zoning. R, cl, S
,01 Setbacks: Front _ 1 S' Rear I S Side S Street Side I 0Garage 2.0I 1 Landscape Requirement
A Lot Coverage Maximum:
PS Building Height: Maximum Height g 0 Actual Height 2i
AVisual Clearance
0Easements
,p 1 Sensitive Lands: 0 Yes 0 No Type
Urban Forestry Plan
Conditions"Met"prior to issuance of building permit
otes: Vii tCC0I tcJ COn01)1102 OJ to 1'Jt° /ne-l- Prior
isS'vo�7(.e.._ oc tovii ty per•r�)r
Approved By Planning: /14 D ✓) j ceti al n al,fA,t,t, Date: 0/2-46/ /1=a
Revisions(after B iding Submittal only) Reviewe , ate
Revision 1: 0 Approved 0 Not Approved �— 0
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
I:\Building\Fonns\BldgPennitRvw RES_060116.docx
Building Permit Submittal
Original Submittal Date: 4/Zelc
Site Plans: #
Building Plans: # 3
Building Permit#: f'1`Enter building permit#above.
Workflow Routing C --Planning ErEngineering C9 P rmit Coordinator 'El3uilding
Workflow Sign-off: Ca-Sign-off for Planning(include notes from planning review) +
Route Application Documents: C]-Engineering. (1)copy of permit application,(1)site plan,(1)building plan and
original plan review routing form.
B'iBuilding original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: 7///co
Engineering Review
Slope at building pad: 3I
onditions"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: 0 YesNo
Assess Water Quantity Fee in-lieu: 0 Yes No
LIDA Facility on lot 0 Yes No
❑ NOT Approv, . ,y Engine '. 1: Date:
4 Notes: _ i r . _Air A��t al �.T�C� . as,'.- =.w
.i z2
Approved by Engineering: S � '7 Date: af 6.-g
�j
Revisions(after Building Submittal only) Reviewer Dat
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
Permit Coordinator Review
0 Conditions"Met"prior to issuance of building permit?rli �J/ /
pproved,NOT Released /�,/' Date: /� �le
Notes: ( i.a C!//7 e�✓+�"�
Revisions(after Building Submittal only) S
Revision Notice 1: Date Sent to Applicant /
Revision Notice 2: Date Sent to Applicant 1✓ J I0 1'
A�/ pl
Revision Notice 3: Date Sent to Applicant pr (11)-
"a i�
n Wash Co Trans Dev Tax: TO es 0 N/A w‘ 5�f'
4;s0r
�1 SDC Fees Entered: e
Ck Tigard Trans SDC: r.d' Yes 0 N/A
Parks SDC: ►:'Yes 0 N/A
�
!, K to Issue Permit. .;
Approved Permit Coordinator: Date: / /iC '
/4#1- — lv/r4
I:\Building\Forms\Bldee mitRvw_RES_060116.docx
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
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 •www.tigard-or.gov
TO: ---C—o DATE RE
s+ZWEIVED
DEPT: BUILDING DIVISION
OCT 4 2016
FROM: j Y �. Cla� V t,4- [ �t OF"T G: RD
Ce------
l BUILDING DIVISION
COMPANY: `e- 1 U t-7 h ��t 1--\D"I'tc"
PHONE: '3 460 1 -z,13121) By:/ 1=
RE: \'23331) S� D 0,- L 1-, '(Y157-z Dl to — bU_L4 S
(Site Address) (Permit Number)
\J (1 , L ni `i
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
k w .
Additional set(s)of plans. "3 Revisions: Ci i'4, •rc p[t ,
Cross section(s)and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(ex 1a 4
REMARKS: /a AAs�t1 s L,.I k o n k1v� \oPk 1, C catA ,51-vowtv -oi 1A,i___ _Ul (2)
Routed to Permit Technician: Date: --[- j ,C EIMMIIIIII
Fees Due: 113 Yes ❑No Fee Descri.tion: Amount Due:
in
$ ..)e-—
$ 4/5„
/5 Cr,iogromariimismisill
A , $ fr' ' '
$ 5. 7
Special /.a
Instructions:
Re•rint Permit .er PE : ❑ Yes ❑No 0 j ; e - 1i
A. •licant Notified: Date: Initials:
135.1'4
I:\BuildingWonns\TransmittalLetter-Revisions 061316.doc
CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMEN r
T Permit
#: MST2016-00285
TI ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/11/2016
Parcel: 2S104AC10900
Site address: 13330 SW DOE LN Jurisdiction: Tigard
Subdivision:
Lot:
Project: Walnut Ridge, Lot 9
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1352 sf Basement: 0 sf Left: 5
Height: 25 Bathrooms: 3 Parking Spaces: 0
Second: 1533 sf Garage: 491 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Yes
Right: 5 Detectors:
Total: 2885 sf Value: $347,245.43 Rear: 20
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 LaundryTrays: 0
Y 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: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Catch Basins: 0
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'I 500 sf: 5 201-400 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 SecurityAlarm: N
Vaccuum System: N Garage Opener N All
Other: N Other Description: Y
Ecompasing:
BUILDING INFO
Class of Work: Type of Use:
NEW Type of Constr: Occupancy Group: Square Feet:
SF VB
R-3 2885
Owner: Contractor:
RIVERSIDE HOMES LLC RIVERSIDE HOMES LLC Required Items and Reports(Conditions)
17933 NW EVERGREEN PKWY 17933 NW EVERGREEN PKWY 370 1 Ersn Cntrl 503-639-4175
#370 BEAVERTON,OR 97006 2 A Geotechnical report is
BEAVERTON,OR 97006
required before the footing
3 Fire Sprinklers Required
PHONE: PHONE: 503-645-0986
FAX: 503-690-2942
Total Fees: $29,940.25
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
day
be do ATTENTION: e�gce wonith approved
wrequires yplans.ou Thisto permit
follow willthe expirerules if work is not started within 180 days of issuance, or if work is suspended for more thein OAR 180
adopted by the Oregon Utility Notification Center. Those rules are set forth
9 -001-0010 through OAR 2-0 -8090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
ca
Is ued By: _ Permittee Signature: X g(1��
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
t
Building Permit Appiication 6/Vs
Residential ,�1,,h ,r FOR OFF1( 1. 1SI.ONl.)
City of Tigard Received '-'1,0,;:2,3-
IN
13125 SW Hall Blvd.,Tigard,OR 9 ? te/B `� •• Permit N /
2 ' i� 9Si�oi
11
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review--
1 I c ;t It I Inspection Line: 503.639.4175 H 4_.: ; ;�, :6 Date/B : C, , 11 Other Perms/VX Page
2 f�dv�
1,, Date Ready/By:�� Awls ® See Pa
Internet: www.ti and-or. ov BUILD,$ 3 e ar i t a ge 2 for
g g Notified Method �� Supplemental Information
®New construction 0 Demolition 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
i r l. equipment,materials,labor,overhead,and the profit for the
" ' r � e t " work indicated on this application.
® 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ z 5 Lt �+�;;�
❑Accessory building 0 Multi-family Number of bedrooms: 5 , 7 3C
❑Master builder ,
❑Other Number of bathrooms:�5 .1
, .1;-' - i " 't 4. ' : _ ,. & iiko Total number of floors: 2 -3 `/ /.
Job site address:13330 SW Doe Ln New dwelling area: 2885 square feet 't1
City/State/ZIP:Tigard,OR 97223 Garage/carport area: 491 square feet
Suite/bldg./apt.no.: Project name:Walnut Ridge
Covered porch area: 45 square feet j C n
Cross street/directions to job site:SW Walnut and SW 133`d Ave
Deck area: square feet 1 p
�,
Other structure area: square feet `
Subdivision:Walnut Ridge Lot no.:009e e r
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
p
"` � �._ �s work indicated on this application.
Construction of SFR Home Valuation: $
Existing building area: square feet
New building area: square feet
' tca k ¢ .• Number of stories:
Name:Riverside Homes,LLC
Type of construction:
Address:17933 NW Evergreen Parkway,Suite 370
Occupancy groups:
City/State/ZIP:Beaverton,OR 97006
Existing:
Phone:(503)645-0986 Fax:( )
New:
-+::::'±.5 �en.� r� -. ��,'' 'a f � , to S; � _,,.�.
•
Business name:Same as Above : ¢ .
Contact name:Wes Boisvert Structural plan review fee(or deposit):
Address: FLS plan review fee(if applicable):
City/State/ZIP: Total fees due upon application:
Phone:( ) Fax::( ) Amount received:
E-mail:wboisvert@riversidehome com
`� ,-. _ CommercialP
and residential prescriptive installation of
roof-top mounted Photovoltaic Solar Panel System.
Business name:Riverside Homes,LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:17933 NW Evergreen Parkway,Suite 370
Solar Installation Specialty Code checklist.
City/State/ZIP:Beaverton,OR 97006 Permit Fee(includes plan review
Phone:(503)645-0986 Fax:( )
and administrative fees): $180.00
State surcharge(12%of permit fee): $21.60
CCB lac.:189148
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Wes Boisvert I Date:06/10/2016 I *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Apr) rolz orrlcF: ��sl:otil.�
City of Tigard Received
Permit No./y 7" g/6, a� r2
13125 SW Hall Blvd.,Tigard,OR 9722�3M Date/By: T
Phone: 503.718.2439 Fax: 503.598.1 V 2 ' 2016 Plan Review Other Permit:
i II
Date/By:
1 G,�lin Inspection Line: 503.639.4175 Date Ready/By: Juris:
Internet: www.tigard-or.gov ' ' ¢:, ... ' l q'- See Page 2 for
E ; a - ;,^ Notified/Method: Supplemental Information
[31 1LD11�: '�,.I( N
a
k ,s_ ad z,^ K .�.0 & �s4. 'ill:
.�f� - �� I i r.y ,;� a s s# f AV, t, i•I'
y esu "' Mechanical permit fees*are based on the value of the'Work
®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
1 •' ,: Value:$
•
® 1-and 2-family dwelling 0 Commercial/industrial " "
❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder
❑Other Description I Qty. I Ea. I Total
,, Heating/cooling:
# I t .! ,,� t M a k t i ;� � g'
Air conditioning 46.75
Job site address: 13330 SW Doe Ln Furnace 100,000 BTU(ducts/vents) 1 46.75
46 75
City/State/ZIP: Tigard, OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: Walnut Ridge
Duct work 1 23.32 23 32
Cross street/directions to job site: SW Walnut&SW 133rd Ave. 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 1 23.32 23.32
Subdivision: Walnut Ridge Lot no.: 009 Other' 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 1 23.32 93 32
1 33 39
ter' 1" t : a Gas fireplace/insert 33.39
Flue vent for water heater or gas 23.32
Construction of SFR fireplace 1 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
'J •o # : . Other: 23.32
Environmental exhaust and ventilation:
Name: Riverside Homes, LLC Range hood/other kitchen
Address: 17933 NW Evergreen Parkway, Suite 370 equipment 1 33.39 33.39
Clothes dryer exhaust 1 33.39 33.39
City/State/ZIP: Beaverton, OR 97006 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 5 23.32 116.60
Phone ( 503) 645-0986 Fax ( )
Attic/crawlspace fans 23.32
r r, R J ,_, a • i ,` Other: 23.32
Business name: Fuel piping:
Same as above
$14.15 for first four,$4.03 for each additional
Contact name: Wesley Boisvert Furnace,etc. 1 14 15
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) I Fax::( ) Fireplace 1 14 15
E-mail: wboisvert@riversidehome.com b 1 14 15
Bar ecue
Clothes dryer(-gas:...*.....,.-,,„,
gas)
Business name: pyramid Heating &Cooling
Cl t .Y4,.
.t..1.,.''''::;:;.,
i " t"<" :AM��'Y�R AJC..�+�.� �� �b" �.
Address: 9409 NE Colfax St. Subtotal
399 �5
City/State/ZIP: Portland, OR 97220 Minimum permit fee($90.00)
Phone:( 503) 786-9522 Fax: review of permit fee)
(503)786-3432 State
Plansurcharge(12%(25%of permit fee)
CCB lic.: 59382 TOTAL PERMIT FEE
This permit application expires if a permit is not obtai(tdned within 180
pais,,, 3 ,4 days after it has been accepted as complete.
Authorized signature: f * Fee methodology set by Tri-County Building Industry Service Board
Print name: Wesley Boisvert Date: 6/20/2016
440-4617T(11/02/COM/WEB)
I:\Building\Permits\MEC_PermitApp_040113.doc
Electrical Permit Applicatio
rFOR OFFICE: l'SI.O\L1
City of Tigard Received
13125 SW Hall Blvd.,Tigard,OR 97223 JUN 2 2016 0 6 Date/B : Permit#:/4157",„20/6,,—,00„:2 4
Phone: 503.718.2439 Fax: 503.598.196 1 Plan Review
Inspection Line: 503.639.4175 Date/B : Related Permit 8:
I
I G:1 R I) Internet: www.tigard-or.gov y Date/By: Jur s: ® See Page 2 for
CITY O �',i 9r\ It 3 NOtiReadfLDateethod:
Supplemental Information
®New construction ., . - ,% 45�.. 2 . " °" ;:.
❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Demolition 0 Other: ❑Service or feeder 400 amps or more
�; P 0 Building over three stories.
where the available fault current 0 Marinas and boatyards.
exceeds 10,000 amps at 150 volts or 0 Floating buildings.
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessorybuildingless to ground,or exceeds 14,000
❑Commercial-use agricultural
❑Multi-family 0 Master builder 0 Other: 0 amps for all other installations. buildings.
.,.. .vrk ..< yid 9` )4 `q:. ', i 7,0 •. t '. _ ' .. . '° pump.
Fire m ❑Installation of 150 KVA or
Jobsite address: 13330 S W�0 � ' ❑Emergency system. larger separately derived
Doe Ln ❑Addition of new motor load of system.
Job#:
100HP or more. ❑'`A" "E" `1-2" "1-3'
City/State/ZIP: Tigard, OR 97223 ❑Six or more residential units. occupancy.
❑Health-care facilities.
Suite/bldg./apt.#: I Project name: Walnut Ridge0 Recreational vehicle parks.
0 Hazardous locations. 0 Supply voltage for more than
Cross street/directions to job site: SW Walnut&SW 133rd Ave. ❑Service or feeder 600 amps or more. 600 volts nominal.
74 ? ..aft i' .� q!' ``
Description Qty. Each I Total j
Subdivision: Walnut Ridge New residential single-or multi family dwelling unit.
Lot#: 009 Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less F 168.54 4
: ;x C r :,','0.!...:: Ea.add I 500 sq.
'1'0`'.0:'' t4 �^ t ,!* energy,
sdeportion J
�; �If' � 33.92 ;
` " . Limited energy,residential
Construction of SFR (with above sq.ft.) / 75.00 2
Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
"'�` .i` ' 4 ` . g 4 ` � Renewable Energy ❑ See Page 2
�' , �" ,"
Name: Riverside Homes, LLC Services or feeders installation,alteration,and/or relocation
200 amps or less 100.70 2
Address: 17933 NW Evergreen Parkway, Suite 370 201 amps to 400 amps 133.56
2
City/State/ZIP: Tigard, OR 97223 401 amps to 600 amps 200.34 2
Phone:( 503) 645-0986 601 amps to 1,000 amps 301.04 2
Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: wboisvert@riversidehome.com
Owner installation:This installation is beingmade onpropertysrelocation
intended for sale,lease,rent,or exchange,according to ORS 7,449,670,and 701.not 2001 amps toor 100ess 59.36 ;
201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54
n mi —„ 2
,;;a v z"� Branch circuits new,alteration,or extension,per panel
Business name: Same as above A.Fee for branch circuits with
above service or feeder fee,
Contact name: Wesley Boisvert each branch circuit 7.42 2
B.Fee for branch circuits without
Address: service or feeder fee,first
branch circuit 56.18 2
City/State/ZIP: Each add'l branch circuit
7.42 2
Phone:( ) I Fax::( ) Miscellaneous(service or feeder not included)
Each manufactured or modular
Email: wboisvert a@riversidehome.com
dwelling,service and/or feeder 67.84 2
g Reconnect only
67.84 2
Pump or irrigation circle 67.84
Business name: Garner Electric 2
Sign or outline lighting 67.84 2
Address: 2920 SE Brookwood Ave#1 Signal circuit(s)or limited-energy
panel,alteration,or extension. 0 See Page 2 2
Each additional inspection over allowable in any of the above
City/State/ZIP: Hillsboro, OR 97123
Phone:( 503) 648-4552I Additional inspection(1 hr min) 66.25/hr
Fax:( 503)642-7925 Investigation(1 hr min)
90.00/hr
Email: ge@garnerelectric.com _30. Industrial plant(1 hr min) 78.18/hr
3 5C, Inspections for which no fee is
CCB Lic.: 121159 I Electrical Lic.: -076 I Suprv.Lic.:3/a 9..5- s i_ficall listed %hr min 90.00/hr
Suprv.Electrician signature,required: r = , 7, 1'74 . 'y; S t't�
Print name: Chuck Garner Subtotal.
Date: 06/20/2016 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: "$
TOTAL PERMIT FEE:
Print name: Wesley Boisvert I Date: This permit application expires if a permit is not obtained within 180
6/20/2016 I days after it has been accepted as complete.
I:\Building\Perri[s\ELC_Pem�itApp_ELR_ERE.doc Rev 06/17/2015 * Number of inspections allowed per permit.
440-4615T(11/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
:'.REMEN /A14 {•?.'®n° 4, • ., s*
Description
Qty. I Each Total I *
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01to15kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
El Garage Door Opener* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
❑X Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
s vtficall listed %hr min
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
* Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015
i
Plumbing Permit Application
Building FixturesliEGE; . FOR OFFICE usl: ONl.l
City of Tigard E"'R Received
Date/By: Permit No.:/47.5r,„261/6-,-OoFS
13125 SW Hall Blvd.,Tigard,OR p1�712t,A 3c�
0 Phone: 503.718.2439 Fax: 503539811989 8 2016 Plan Review
Other Permit No.:
Inspection Line: 503.639.4175
I I I A I:[) - - r Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov CI fY()tw a;$ Ah tg.
Notified/Method: Supplemental Information
®New construction 0 Demolition For special information use checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
. ',ot1 t' t' t, ,. t ht .. :. SFR(1)bath 312. 70
® 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
,,,,,,•:,,
' l t "t 0' Site utilities:
Job site address: 13330 SW Doe Ln Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: Tigard, OR 97223
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: 1 Project name: Walnut Ridge Manufactured home utilities 50.03
Cross street/directions to job site: SW Walnut&SW 133rd Ave. Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Stonn sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: Walnut Ridge I Lot no.: 09 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
„� ,. , �`�� r ftir` �,"° q�1r Backwater valve 12.51
Clothes washer 25.02
Construction of SFR Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
W. _ , ,. e,' . 4, kN.' • 7);a .4::,,,,,,. Expansion tank 12.51
Name: Riverside Homes, LLC Fixture/sewer cap 25.02
Address: 17933 NW Evergreen Parkway, Suite 370 Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP: Beaverton, OR 97006 Hose bib 25.02
Phone:(503) 645-0986 Fax:( ) Ice maker 12.51
a r Interceptor/grease trap 25.02
Business name: Same as above Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: Wesley Boisvert
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: wboisvert@riversidehome.com Urinal 25.02
a ., r � �._v , Water closet 25.02
Water heater 37.52
Business name: H & H Mechanical WaterPiP g/i in DWV 56.29
Address: 5757 SE Willow Ln Other: 25.02
City/State/ZIP: Milwaukie, OR 97267 Subtotal
Phone:(503) 975-9787 Fax:( ) Minimum permit fee: $72.50
CCB Lic.: 178122 Plumbing Lic.no.: PB41 4 Plan review (25%of permit fee)
L State surcharge(12%of permit fee)
Authorized signature:
I e TOTAL PERMIT FEE
Print name: Wesley Boisvert Date: 6/20/2016 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\PLMIJ-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
IIICity of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
T 1 c a R D Building Permit Review — Residential
Building Permit #: /7,S7-,20/6 _.. 00 F S'
Site Address: 1 3 33 0 St j Doe Lr).
Project Name: Wm) nu T 2i Aye Lot #: c
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: N & 2
C7f Verify site address/suite# exists and active in permit system.
L2" River Terrace Neighborhood: ,Z1 No ❑ Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
,Z1Three(3)copies of site plan B—xisting structures on site
/Site plan must be on 8-1/2"x 11"or 11 x 17"paper ootprint of new structure(including decks)with finished
,Z1 Drawn to scale(standard architect or engineer scale) floor elevations
/North arrow - ty locations(required for new,may apply for additions)
Site address,project or subdivision name and lot number .LLT,,eoeation of wells/septic systems
Applicant information(name and phone number) .BExisting trees to be retained with drip line,and tree
IA Lot dimensions and building setback dimensions protection measures
Tot area,building coverage area,percentage of coverage and ,J Street tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) ,Street names
IVP roperty corner elevations(2 foot contour lines if more than
/ 4 foot differential)
C/Clean Water Services-Service Provider Lette (lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No
gr Public Facilities Improvement(PFI) Permit:
03
Required: ❑ Yes,applicant was notified ❑ No Applied For: Pes CI r S-stop �intake
pP CI Yes ❑ No, intake
jZ Land Use Case#: S UL3 20)y - OOQ 1
Z Zoning: R. `-I , S
,ei Setbacks: Front 1 S Rear I S Side S Street Side I 0 Garage '
g Landscape Requirement:
.Fl Lot Coverage Maximum:
e Building Height: Maximum Height g 0 Actual Height 7)
AVisual Clearance
gi Easements
ASensitive Lands: ❑ Yes El No Type
Urban Forestry Plan
❑ Conditions "Met"prior to issuance of building permit
otes: (fn ftC�01J1c1 C4nd)fiib 0J to Joe m2-j- Prior
1 ssvcinu._ oc ioviidavi, permirr
Approved By Planning: /14 0 * fl cam.. /2)0 G_per,` Date: (o/Z', / /6
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El Approved El Not Approved
Revision 2: El Approved El Not Approved
Revision 3: ❑ Approved El Not Approved
I:\Building\Forms\B1dgPermitRvw RES 060116.docx
Building Permit Submittal
Original Submittal Date: �p�2��l�r
Site Plans: #
Building Plans: # 3
Building Permit#: Er Enter building permit#above.
Workflow Routing: a Planning a-Engineering [ermit Coordinator 'B -Building
Workflow Sign-off: 2—Sign-off for Planning(include notes from planning review)
Route Application Documents: :J.-Engin eering: (1) copy of permit application, (1) site plan, (1)building plan and
original plan review routing form.
EY-Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: ,41 '_k Date:
7/7AA(to
Engineering Review
Slope at building pad: ,�
�
onditions "Met"prior to issuance of building permit
Easements (encroachments)per engineering conditions of approval and plat
)2/
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
El NOT Approv:d .y Engineeri .: Date:
Notes: i .1 ..... A i �� .fir �.. i_ �.�-- �.r
Approved by Engineering: Date: 7....(2-2/4,
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved El Not Approved
Revision 2: El Approved ❑ Not Approved
Revision 3: El Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions"Met"prior to issuance of building permit
�pproved NOT Released: , Date: 97/.//6
Notes: rd^'+et/GI `
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant: / / �, S L'
Revision Notice 2: Date Sent to Applicant: �✓'
Revision Notice 3: Date Sent to Applicant: P V
'►�1 SDC Fees Entered: Wash Co Trans Dev Tax: MO es ❑ N/A 1 ( v` 9t 1
Tigard Trans SDC: id Yes ❑ N/A J' ,
Parks SDC: ►i Yes CI `'
! K to Issue Permit
ovedbyPerm1tC00tdinatm: �//i4Date:
I:\Building\Forms\B1dgPermitRvw_RES 060116.docx
Albert Shields
From:
Sent:
Albert Shields
Wednesday,July 13, 2016 9:43 AM
To: 'wboisvert@riversidehome.com'
Subject: FW: MST2016-00281, 285, &286,
Attachments: Conditions - 07-12-2016.pdf
Wes, same story for these 3 permit applications. Albert.
From:Albert Shields
Sent:Tuesday,July 12, 2016 6:37 PM
To: 'wboisvert@riversidehome.corn'<wboisvert@riversidehome.com>
Subject: MST2016-00280, 13310 SW Doe Lane
Wes, as you know and as is shown on the attached list of conditions of approval for SUB2014-00011, numerous of the
conditions have still to be met and must be met before we can issue building permits. Accordingly, I have marked this
application as Approved but Not Released. Plan Review will proceed but the permit will not be issued until the requisite
conditions have been met.
Albert Shields
1
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
13330 SW DOE LN, TIGARD, OR, 97223
Record Type:
Residential - Master Permit
Inspection Type:
699 Mechanical final
Result:
FA I L
Comments:
Tel: 503.718.2439
Inspection Date:
December 30, 2016 at
10:54:11 AM
Record ID:
MST2016-00285
Inspector:
David Young
Vent for gas range not to exterior. M 1501.1, M1 505.1, M1507.2
Seal line set penetration to crawl space. R302.5.3
Violation Summary:
Inspector Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
13330 SW DOE LN, TIGARD, OR, 97223
Record Type:
Residential - Master Permit
Inspection Type:
199 Electrical final
Result:
FA I L
Comments:
Tel: 503.718.2439
Inspection Date:
December 30, 2016 at
10:23:32 AM
Record ID:
MST2016-00285
Inspector:
David Young
Not ready for final inspection, all exterior lighting covered by painters on site.
Recall when ready for final inspection.
Violation Summary:
Inspector Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
13330 SW DOE LN, TIGARD, OR, 97223
Record Type:
Residential - Master Permit
Inspection Type:
699 Mechanical final
Result:
CNCL
Comments:
Tel: 503.718.2439
Inspection Date:
February 3, 2017 at 9:06:11
AM
Record ID:
MST2016-00285
Inspector:
David Young
Inspection canceled by contractor, no access due to ice.
Violation Summary:
Inspector Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
13330 SW DOE LN, TIGARD, OR, 97223
Record Type:
Residential - Master Permit
Inspection Type:
199 Electrical final
Result:
CNCL
Comments:
Tel: 503.718.2439
Inspection Date:
February 3, 2017 at 9:09:27
AM
Record ID:
MST2016-00285
Inspector:
David Young
Inspection canceled by contractor, no access due to ice.
Violation Summary:
Inspector Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
13330 SW DOE LN, TIGARD, OR, 97223
Record Type:
Residential - Master Permit
Inspection Type:
299 Final inspection
Result:
FA I L
Comments:
Tel: 503.718.2439
Inspection Date:
February 13, 2017 at 10:16:05
AM
Record ID:
MST2016-00285
Inspector:
David Young
Seal line set penetration to crawl space in garage.
Provide duct seal test report for duct work in crawlspace per radon mitigation
requirements.
Provide insulation certification.
Provided approved site plan with street tree locations.
Correct landscape grade at side of rear porch. R401.3
Violation Summary:
Inspector Contractor