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Permit (81) . CITY OF TIGARD MASTER PERMIT 1. COMMUNITY DEVELOPMENT Permit#: MST2016-00282 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/18/2016 Parcel: 2S 111 AA07500 Jurisdiction: Tigard Site address: 14473 SW 90TH AVE Subdivision: GREENSWARD PARK NO.4 Lot: Project: Greensward South, Lot 7 - Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1742 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 25 Bathrooms: 3 Second: 1920 of Garage: 480 sf Front 15 Smoke Dwelling Units: 1 Third: 0 sfYes Right: 5 Detectors: Total: 3662 of Value: $440,598.06 Rear: 20 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 0 Storm Sewer 100 Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Bckflw Prevntr: 0 Catch Basins: 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: 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: Square Feet: NEW SF VB R-3 3662 Owner: Contractor: GP4 LLC H&H HOMES LLC Required Items and Reports(Conditions) PO BOX 1577 19305 SUNCREST DR 1 Ersn Cntrl 503-639-4175 BEAVERTON,OR 97075 WEST LINN,OR 97068 PHONE: PHONE: 503-784-9198 FAX: Total Fees: $32,553.39 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. AT ' c •regon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-00 -0010 through 0•- 952-..1-0090. You may obtain a copy of the rules or direct questions to OUNC by callin. '3.232.1987 or 1.800.332.2344. I ued By: ____ 0 /'i -/j _/` , Permittee Signatu �= ,-Z47.-W lr't Call 503.639.4175 by 7:00 a.m.for the next available inspec io. late. — This permit card shall be kept in a conspicuous place on the job site until mpletion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application Residential x. EGF. FOR OFFIC E ISI 0 1.1 City of Tigard " 1 Received 1111 • 13125 SW Hall Blvd.,Tigard,OR 97223 �� 7 2016 Date/By: -1 7 /(p Permit No.:t-tG9€7/�60 a 0 Phone: 503.718.2439 Fax: 503.5 2 0 Plan Revie TI G A R D Inspection Line: 503.639.4175 I I s- ` ''F Date/By: Ey Other Permit 7 e2_to y Internet: Line:www.tigard-or.gov , e l t^ A R r Date Ready/By: //f /j, Juris gy3 r t VH See Page 2 for •G..�+I{y<" i f)`‘ f4,°+p h J Notified/Method: ,..,!,„„,,,2-1 Supplemental l ntormatian 14e4 01#47- TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING "'New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. 1-and 2-family dwelling ❑Commercial/industrial Valuation: $ Ci � g Accessory building ❑Multi-family Number of bedrooms: i r` 0 Master builder 0 Other: Number of bathrooms: 3 JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: t 4 7 ` `�, J 5 IN Atte- New dwelling area: g 44_ � square feet L.) I !ta City/State/ZIP: 1-[ �� � Q Q "1C(Aa i 0q7 22_4Garage/carport area: Li Bo square feet r Suite/bldg./apt.no.: Project name: a c--e-er,5-g`� t .,..6...AIN Covered porch area: .6-t) square feet 1 ° Cross street/directions to job site: Deck area: Q.418 square feet 17 ti Other structure area: square feet `subdivision: %).4144140 REQUIRED DATA:COMMERCIAL USE CHECKLIST '`� C � 01/4/1-14" I Lot no.: "7 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 DESCRIPTION OF WORK equipment,materials,labor,overhead,and the profit for the work indicated on this application. S Ft k- — cC`1.o1SwValuation: $ Existing building area: square feet New building area: square feet ILI PROPERTY OWNER I 0 TENANT Number of stories: ''' . Name: 6l' (Z.`l t =-N Inttk`t)t`� Address: `q 3 © 5 �L C / - �VW'r7 LC-C._ Type of construction: � City/State/ZIP: � r �� 1)21,v&--- Occupancy groups: � 0 R 47�9 b Existing: Phone:( 5'.1 'J 6� ,c t 9 0 Fax:( ) . ❑ APPLICANT. New: ❑ CONTACT PERSON BUILDING PERMIT FEES* Business name: t.# >P t-j ti-c,u 4 [T 1 V .4 ZpLi c (Please refer to fee schedule Contact name: I Structural plan review fee(or deposit): Lt. Address: f "t-'�e A FLS plan review fee(if applicable): City/State/ZIP: (,, Total fees due upon application: Phone:( ) I Fax: : ( ) Amount received: 76-0-Pc' E-mail: �t { ' 111, (I E'r1/i/i�' �+� zwtcE��l PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of Business name: �j (.4 -Q. �� roof-top mounted Photovoltaic Solar Panel Syste i` u_c Submit two(2 -ts of roof plan with connec.r"details Cr �— S /�I� and fire departmen : cess,along with 2010 Oregon Address:y/ ZIP: `-v�� ¶&t U Solar Installation Speci. 4 Code^ ecklist. WA--- u f."1� 02 qZo(s%Q„ Permit Fee(includes • i review Phone:(03 '^7 8 —ciI,dQ 1 Fax:( ) and adn ' 'strative s): $180.00 CCB lie.: a Ciytt��VVState surcha ! 12%of permit fee): $21.60 Authorized signature: V Total fee due upon application: $201.60 1t k l / This permit application expires if a permit is not obtained ,,�� within 180 days after it has been accepted as complete. Print name: � L(y `j 0 41 1 N4 I Date: 7/6/46 I *Fee methodology set by Tri-County Building Industry Service Board. 1:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-461 3T(11/02/COM/WEB) Building Permit Application Checklist FOR OFFICE USF. ONLY One- and Two-Family Dwelling Received Permit No.: City of Tigard AssociatedDate/By: ■ 13125 SW Hall Blvd.,Tigard,OR 9722374 permits: IPhone: 503.718.2439 Fax: 503.598.1960Plumbing0 Mechanical 0 Electrical 0 24-Hour Inspection Line: 503.639.4175 Q Other T 1 G A R D Internet: www.tigard-or.gov Yes 10 \/.4 THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW 0 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 0 0 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0 3 Verification of approved plat/lot. 0 0 ❑ 4 Fire district approval required. Name of district: 0 0 0 5 Septic system permit or authorization for remodel. Existing system capacity _ 0 0 0 6 Sewer permit. ❑ ❑ 0 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. 9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 0 0 basin protection,etc. ❑ 0 0 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if 0 0 there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. ❑ 0 0 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size and location. ❑ 0 0 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- 0 0 0 floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. ❑ 0 ❑ 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 0 0 0 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing 0 0 0 locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 0 systems.see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists0 0 0 over 10 feet long and/or any beam/joist carrying a non-uniform load. 0 0 0 20 Manufactured floor/roof truss design details. 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 0 for four or more appliances. ❑ 0 0 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or architect licensed in Ore.on and shall be shown to be as slicable to the .ro'ect under review. JURISDICTIONAL SPECIFICS 0 0 0 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". 0 0 0 24 Two(2)sets each are required for Items 16,19,20 and 22 above. 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 0 0 ❑ 0 0 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 0 ❑ 27 "Drawn to scale"indicates standard architect or engineer scale. 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 0 0 Street Tree List. ❑ 0 0 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, and protection measures must be drawn to scale and must include the project arborist's signature of approval. 0 0 0 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. 1:ABuilding\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/W EB) Mechanical Permit Applicata .,, v Gi °' ,. FOR OFFICE USE ONLY City of Tigard Received • r 13125 SW Hall Blvd.,Tigard,OR 97223 JUL 7 2016 Date/By: PennitNo.: 5� I1 . .O - '- f Phone: 503.718.2439 Fax: 503.598.1960 Plan Review l�0 T I G n IZ D Inspection Line: 503.639.4175 Cr( Date/By: Other Permit: 3��`F Internet: www.ti and-or. ov l��14��= r"tit Com; Date Ready/By: .turfs: ® See Page 2 for g g til n1N _ i it 0rt Notified/Method: � t, Supplemental Information Mechanical permit fees*are based on the value of the work E1 New construction 0 Addition/alteration/replacement 0 Demolition performed.Indicate the value(rounded to the nearest dollar)of all ❑Other t mechanical materials,equipment,labor,overhead,and profit. °• a Value $ Its . T : ,!r1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi family 0 Master builder 0 Other: Description . �`0� - I Qty. J Ea. I Total . _ ..? 4�+T vt Heating/cooling: Job site address: t 114 X73 s 9,o .� pr,,, Air conditioning L6 46.75 City/State/ZIP: q -7 - -{� Furnace 100,000 BTU(ducts/vents) / 46.75 V a , 1 / Z-- 1 Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: Project name: �i NS v j C w ii Heat pump 61.06 Cross street/directions to job site: �� ��"11 Duct work 23.32 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: Sc�c• C '7' - Other: -7C . ,.� � I Lot no.: / 23.32 �e� Tax map/parcel no.: Other fuel appliances: 0,4 :.... Water heater 1 23.3214 x v E, ` 4 1I £ 7 tGas freplaceinsert I 33.39S ""•,,,...; ,� ,, t= _ , ; <, 7- s Flue vent for water heater or gasp�- a C • fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 c Other23.32F 1 > • ' " r 4R F04Es.. .a " ` ; ° v r, • Environmental exhaust and ventilation: Name: Range hood/other kitchen Address: .(q,,r� �tJ equipment 33.39 City/State/ZIP: Clothes dryer exhaust 1 33.39 Single-duct exhaust(bathrooms, Phone ( ) Fax ( toilet compartments,utility rooms) if 23.32 Attic/crawls ace fans 23.32a el A 7 s Other:� 23.32" .Y . , _ R 44 or Business name: k n 1 1� ux Fuel piping: Contact name: A!1C't• 1.�� j A, $14.15 for first four;$4.03 for each additional ‘,4 Q �1'�� ,Y Furnace,etc. Address: 4 ` , 3 , (4c /I Gas heat pump City/State/ZIP: ‘065-r- LA OK (� CI/0 Water heater unit heater Phone: Q '` p�� Water heater 3 U��l Ts I Fax::( ) Fireplace E-mail: � NUJ ( C)M JJ i Range *X� Barbecue �w gr Clothes dryer(gas) Business name: n`S � y � � Other: Address: i� [ L fat :, . ..;$ :- r:tt 'et`Z 9 . 4M,t,u.43°„ukl,.e A zdre. h , . .a. .Subtotal _ F'.:;, City/State/ZIP: � S - j.. 0 R `� Subtotal Minimum permit fee($90.00) Phone:6b-N `� (..�; —- ; i I Fa : is_.) 3r 3 '^2, Plan review(25%of permit fee) CCB lic.: t 44 I ` { `� State surcharge(12%ofpennit fee) TOTAL PERMIT FEE .' � This permit application expires if a permit is not obtained within 180 Authorized signature: ,air days after it has been accepted as complete. * Fee methodology set by Tri-County Building Industry Service Board Print name: /7 1-6)yL I Date: 7a r 1.Buildmg Permits MEC PermitApp_0401 13.doc 440-4617T(11/02/COM/WEB) Mechanical Permit Application - City of Tigard y Page 2 - Supplemental Information Commercial & Multi Family Fee Schedule: $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first 0.00 and 3 07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 47.71 for the first$10,000.00 and $2.54 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $2and .49 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2.608.71 92forand for eacht additional al$100 00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I:\Building\Permits\MEC_PennitApp_040113.doc 2 Electrical Permit Application Current Planning --,,►-. Washington County, 155 N. I"AV,Suite 350.MS 12,Hillsboro.OR 97124, Approval .,,r{.,,_ Phone:503-846-3370, Fat:503-836-3993, Project# Inspection Requests:503-836-3699,ti,.,,,,cosashimtton.or.us TYPE OF WORK PLAN REVIEW en con,<truetit)n E_Addition alteration replacement 7 Other: Please check nil that app ❑ Sers ice or fe der 400 amps❑ l i r e dou•i cation, r nt rr 1\here th•as,tilahie❑ ave Seorteed rt�(Klaanp n more CATEGORY OF CONSTRUCTION J ..._--- --_--._ ___ I Ault urrent s ed. 0 Budding mer three.to e, 1 and 2-tamilc dtyellin g ❑Commercial industrial E Acccsxu} huildan l In 00" Iml, .It Int)"'II'"t ❑ k1nn,u and boa ts arid, [1]Multi-(arms ❑\Iister builder 0 Other: tc >raund t r e�cced: 14400 amp, for Ill other ❑ flt umg hurl JOB SITE INFORMATION AND LOCATION nt t,lilatron.. ❑ (onunercru t agnwbt Jeb no.: Joh address: ily73ti— ❑ ills pump building w `lj ❑ In tallation of 151 R\_A or larger ;City Slate ZIP: s Ti D.2 j •ptrttcic " T tf,‘,A 0 1rlditl to t n,�+ t...t.�t. �� I ruI I1I011P >r more 0 ..,•••••,...._.1_,."-,,,,.,,,,:„,„ Suite bldg.an-no.: � ❑ ❑ R c Ilional(chi 1 I un i 1 Project 0,1 -Qe,S, � si"""t r r�_id miai unit. { ❑ 11 Ihh-euro I t,utes ❑ tiunplc cuk I Ib.;sot.that, : Cross street direction,to;oh site: (Ute salts nominal — - FEE SCHEDULE Description Subdr Ilion � i Qh. � Fee i Total �y lSz.-s. -.G4`� � I Lot no._ Residincludes entialalt singlshede-ormelt garage. -farnilc dwelling unit. Lax map parcel no.: — 1.0m sq.P.or I s t 4 ----- -DESCRIPTION OF WORK i[t.add 00 sq ti or portion n nn Iiami d nergt re,idennal it nh abts c sq.h.) `rnl Limited energt.multi-tjlnih esidenrral nc s h abutrq-ii. :n4 no ❑ PROPERTY OWNER 0 TENANT — services or feeders installation,alteration,and/or relocation lame: — l 'On amps or ICF. Uj no i --t --i r 2 0 I amp:to 400 amps 1 as.rlt l— Adta'ess (11 amps to WO ante, City State ZlP: fill amps to I our amps i 44„t) . _ 0\er I Una amps or toils n:a ntt f Phone.1 FIs: Temporary senrces or feeders installation,alteration.and^or Oent r m t dl int n t . .t t r t 1 ,r 1 t t tl Pt't' t rte - • relocation tt1 I J.ttt: ,art.t I tit,r;,I e,.t n not t Itrtictl ,. t et.�r.n c,,.-_tat.tt t)5 1 a-�int ,,Ed,'t;Gut I- X00 amps of Ihs ;O�uO i t 'CII ant 01Aner signature: Ps to 400 amps ��o0 Date: —__--` 701 amp to X49 amp, 1 - cl.uo i 0 APPLICANT ❑ CONTACT PERSON Branch circuits-rely,alteration,or extension,per panel - Business name: A.Fee tel branch circuits with —_ abot sir\to:or fccdcr lei. Cont tet name: each blanch ter circuit B.lee!'or hia lrh it ells — —� Address: rlithout,,,,'s tee or Ieeder t .tut — —� fee.last branch circuit , ------------ ----------------- ( Is State ZIP. -- -- I re t add 1 brush utteuh �+'> `—1 Phone:t ) i Miscellaneous(service or feeder not included) Eau:t 1 -ach mann ractured or modular ---E-mail: Ittelli,i seri ice,and or(ceder �` Reconnect onitns t no CONTRACTOR — ___ ____.__. I Pump of !mg:Alton circle t u I I3usiness name:Elite Electric GroupLLC 2 Stan or outline lighting utl Address:PO BOX 823026 yt anal cIrcu itt.,,,t hunted- n r..Nucl.alteration.or Cit.. State/i P:�/ancouver WA 98682 Stensitll I)tscrih : I Phone:1 503 1277-3788 ! Fax:t 888 1901-7914Each additional inspection oser allocable in an of the above 1 er inspection n u5.urt l E-mail:ellteelectricgroup©gmail.�j' (:C13 lis.no.:191274 int { c,ugtnnt Ice,. ott Electneal lie,no.:C639 City or metro lir.: ((titer Superstsm- electrician �/✓7 ELECTRICAL PERMIT FEES �/ — — — signature.required: t G Subtotal Prim name Bob Armendariz Plan ret lets i of permit feel D rte: luthonred — — State ulreharec I I' of permit tie( •iLn(lure y -- y •s' IOTA( PF.RMI1 FEE Print name:Max PanfitbV . D tic': This permit application expires if a permit is not obtained —application cithin NH dais after it has been accepted as complete •\umher t tri'c,I n n alto-oed pet prtn-i flet t..,trt) !2 Plumbing Permit Application . Building Fixtures RECFIVEI FOR OFFICE USE ONLY City of Tigard Received U 13125 SW Hall Blvd.,Tigard,OR 97223 J U L 4 2016 Date/By: Permit No.: �1�1 . o(L_ Phone: 503.718.2439 Fax: 503.598.1960 Plan Review Other Permit No.: I1CAR > Inspection Line: 503 639.4175 u e Date Rd /B Juris: See Page 2 for www.tigard-or.gov s.v , ; hfid/Method Supplemental Information rmauon .18 New construction ❑Demolition For special information use checklist. IDAddition/alteration/replacement 0 Other: - Description I Qty. I Ea. I Total New 1-2-family dwellings(includes 100 ft.for each utility connection) �wP8a t' $. SFR •'� �° 1( )bath 312.70 ®-1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 0 Accessory building ❑Multi-family SFR(3)bath 500.32 ❑Master builderOther: Each additional bath/kitchen 25.02 ❑Other Fire sprinkler sq.ft.) • .".1:;:#,,,#„-,446„.„ � � Site utilities: Job site address: p k-j,i-�.7 3 `1,,� ��t0.�� Catch basin or area drain 18.76 City/State/ZIP: t / Drywell,leach line,or trench drain 18.76 lFooting drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: Project name: Ge� �r.?_. 0 �� Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.:_) Page 2 Subdivision: Cwt s w j I Wateruseor (no.linear ft.: ) Page 2 Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 ' "c, t t" Backwater valve ,..4 ., 12.51 1� Clothes washer 5F R &S i ,� iQ�7 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 g. x, _ •,,w.x .. Expansion tank 12.51 Name: t- (4- � i Fixture/sewer cap 25.02 Floor drain/floor sink hub 25.02 Address: ttc2f� t_ "jW35 JT- Vik, Garbage disposal 25.02City/State/ZIP: 1A40. -1.-- L4,4/1/4,1�- On 7 co CHose bib 25.02Phone:6 bj 78 --4( 8 Fax:( ) Ice maker 12.51 .„ :„� :.4,..,X5" .„-4 *A..f, 1 Interceptor/grease trap 25.02 Business name: �.. . F l4 ikkt t l �� Medical gas(value:$ ) Page 2 mer Contact name: ( � 1+15--/q 1 14RPoofd 12.51 Roof drain(commercial) 12.51 Address: �. L y. Sink/basin/lavatory 25.02 City/State/ZIP: .✓I!_ Solar units(potable water) 62.54 Phone:( ) i Fax: :( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 einovna.c.MVM .rrett,7 ' Water closet 25.02 444.4' .:C; Water heater c 37.52Business name: �" "d /_Mi I/€ kil6 t Water piping/DWV 56.29/6)fd3 , ^W d Other: 25.02 City/State/ZIP: Ais6,crr� c 7 71r13 Subtotal Phone:( ) Fax:( ) Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lic.: Plumbing Lic.no.: Authorized signature: State surcharge(12%of permit fee) TOTAL PERMIT FEE Print name: Date: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:ABuilding VPermits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard ' Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Footing drain-1"100' 50.03 0 to 2,000 $121.90 37.52 2,001 to 3,600 $169.69 Footing drain-each additional 100' 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas S stems: Water Service-each additional 100' 37.52 ' !!1" t Stonn&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for fi A t a 2. each additional$100.00 or fraction thereof,to xr > and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for each additional$100.00 or fraction thereof. (minimum charge-1/2 hour) Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to .. _ , ant accurately report fixtures could result in increased sewer fees �� i, 4 t o •� 111 l uariatriv ixturetype- Plan review is required for any of the following. Fixture Typ€-tor ' ~a'teplace Please check all that apply. Capped Added Relocate Work Performed: Capped ❑ Any new commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool ❑ New exterior plumbing site utilities for any complex structure Car Wash: -Each Stall as defined in OAR918-780-0040. -Drive Thru ❑ Medical gas and vacuum systems for health care facilities. Cuspidor/Water Aspirator 0 Any multipurpose fire sprinkler system. Dishwasher: -Commercial ❑ Any complex structure as defined in OAR918-780-0040. -Domestic Drinking Fountain Submit 2 sets of plans with any of the above. Eye Wash Floor Drain/sink: -2" s : 4" ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain that meet the qualifications above. Garbage -Domestic non-food Disposal: -Domestic food related -Commercial food related -Industrial food related Comments regarding fixture work: Ice Mach./Refrig.Drains Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -Lav/Bar non-food related -Bradley -Com/Sery/Util food related -Service *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and Washer-Clothes fees assessed for the sewer increase must be paid before the Water Extractor plumbing permit can be issued. Water Closet-Toilet Urinal Other Fixtures: I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 City of Tigard li .II DEVELOPMENT DEPARTMENT TIC;f1 R Building Permit Review — Residential Building Permit #: LS i c t Co -cc c9"-Cc Site Address: y 1 (SVJ - OIVI 4 Project Name: . � _ 3 �. � �� � -4` Lot #: (New dwelling=subdivision name;Addition or Alteration last name of owner) Planning Review Proposal: S —* Verify site address/suite# exists and active in permit system. River Terrace Neighborhood: ,2-"No ❑ Yes,See River Teirace Review Addendum Attached Site Plan Elements: three(3)copies of site plan _ ,jd'Site plan must be on 8-1/2"x 11"or 11 x 17"paper � Existing structures on site iof rawn to scale(standard architect or engineer scale) '�floorelevationsw structure(including decks)with finished orth arrow ite address,project or subdivision name and lot number At locations(required for new,may apply for additions) �pplicant information (name and phone number) � �Location of wells/septic systems , Erosion control(including drainage-way protection,silt fence of dimensions and building setbK dimensions A(.//BLot area,building coverage area,percentage of coverage and design,Street namamlocetion of catch basin,etc.) ) impervious area (applicable if R-7,R-12,R-25&R-40) es (Property corner elevations (2 foot contour lines if more than Street tree size,type and location 4 foot differential yExisting trees to be retained with drip line,and tree protection measures ...LI–Clean Water Services–Service Provider Letter(lot platted prior to 9/10/1995): 1/S1/IJ)/vi f i'-7' p,�,, Required: ❑ Yes,applicant was notified .❑ No Received: ❑ Yes ❑ No L1 Public Facilities Improvement(PFI) Permit: Required: 2-"Yes,applicant was notified ❑ No Applied For: -15"--Yes ❑ No,stop intake a-Land Use Case#: cud )f -moo/ 0 T Zoning: I, es ni'Setbacks: Front 2y Rear 8-- Side 5 Street Side �'✓ - Landscape Requirement: % y Garage ZV I✓j}-0 Lot Coverage Maximum: .R Building Height: Maximum Height 30 l •.-ErVisual Clearance Actual Height 7 12' Easements .ErSensitive Lands: ❑ Yes Urban Forestry Plan g.-10 Type .cnI'"Conditions "Met"prior to issuance of building permit Notes: Approved By Planning: AMAIMMIL y, Revisions (after Building Submi al only) v /' Date: Revision 1: ❑ A roved Reviewer Date pp ❑ Not Approved Revision 2: ❑ Approved 0 Not Approved Revision 3: 0 Approved 0 Not Approved 1:\Bui lding\Fonns\BldgPennitRvw_RES_012116.docx Building Permit Submittal7(? r Original Submittal Date: 1 1 6 Site Plans: # 3 Building Plans: # ' Building Permit#: Enter building permit#above. ..2"-Building Workflow Routing: Planning Engineeringermit Coordinator g Workflow Sign-off: D- 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. Er Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: - ►'i ce h L eD_cA-\,)rn ,g2 - By Permit Technician: , �� �- � Date: 7/7((4 � > � Engineering Review Slope at building pad: 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: ❑ NOT Approved by Engineering: Notes: / 1„) 742,—/ZApproved by Engineering: '4 Date: 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: C -,VI es ❑ N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: Yes ❑ N/A OK to Issue Permit l� Approved by Permit Coordinator: Date: 971/ J A' 1:\Building\Fonns\B1dgPennitRvw_RES_012116.docx City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 14473 SW 90TH AVE, TIGARD, OR, 97224 May 1 , 2017 at 1 :21 :23 PM Record Type: Record ID: Residential - Master Permit MST2016-00282 Inspection Type: Inspector: 399 Plumbing final David Young Result: PASS Comments: Corrections from previous inspection complete. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 14473 SW 90TH AVE, TIGARD, OR, 97224 May 5, 2017 at 8:09:01 AM Record Type: Record ID: Residential - Master Permit MST2016-00282 Inspection Type: Inspector: 299 Final inspection David Young Result: FA I L Comments: House locked, provide access for inspections. 8:09 am. R109.1 Provide approved plumbing final inspection for lawn irrigation Backflow devise prior to building final inspection. PLM-2017-00137 Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 14473 SW 90TH AVE, TIGARD, OR, 97224 May 9, 2017 at 3:20:47 PM Record Type: Record ID: Residential - Master Permit MST2016-00282 Inspection Type: Inspector: 299 Final inspection Aaron Cillo-Gobel Result: PASS - CofO Comments: Final erosion control passed Street tree certificate received Moisture content form received High efficiency lighting form received Insulation certification verified Blower door and/or duct seal test certificate received C of 0 left on counter. Violation Summary: Inspector Contractor