Permit Vi i
CITY OF TIGARD MASTER PERMIT
■ COMMUNITY DEVELOPMENT Permit#: MST2016-00299
13125 SW Hall Blvd.,Ti and OR 97223 503.718.2439 Date Issued: 08/31/2016
Ti[;Alif� 9
Parcel: 2S 112C B 18800
Jurisdiction: Tigard
Site address: 8060 SW BARNUM ST
Subdivision: CORBIN ESTATES Lot: 5
Project: Corbin Estates, Lot 5
Project Description: New SF. 3/15/2017: REPRINT permit to add A/C.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1206 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 25 Bathrooms: 3 Second: 1415 sf Garage: 628 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right 5 Detectors: Yes
Total: 2621 sf Value: $328,282.97 Rear: 20
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer 100
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Drains: 0
gWater 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!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 Descr n:
tio - nP- Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2621
Owner: Contractor:
JT ROTH CONSTRUCTION INC J T ROTH CONSTRUCTION Required Items and Reports(Conditions)
12600 SW 72ND AVE,STE 200 12600 SW 72ND AVE#200 1 Ersn Cntrl 503-639-4175
TIGARD,OR 97223 TIGARD,OR 97223
PHONE: PHONE: 503-639-2639
FAX: 503-624-0239
Total Fees: $30,145.70
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 , ou. OAR 95 -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 : .' / CFi'�-�' Permittee Signatu --- �Q/17/�� "
Call 503.639.4175 by 7:00 a.m.for the next availabl- spec ion date.
This permit card shall be kept in a conspicuous place on the job site untilLcompletion oma.. p
Approved plans are required on the job site at the time of each inspection.
CITY OF TIGARD MASTER PERMIT
! COMMUNITY DEVELOPMENT Permit#: MST2016-00299
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/31/2016
Parcel: 2S112CB18800
Jurisdiction: Tigard
Site address: 8060 SW BARNUM ST
Subdivision: CORBIN ESTATES Lot: 5
Project: Corbin Estates, Lot 5
Project Description: New SF.
BUILDING
Floor Areas Reauired Setbacks Reauired
Stories: 2 Bedrooms: 5 First: 1206 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 25 Bathrooms: 3 Second: 1415 sf Garage: 628 sf Front: 15 Smoke
Yes
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors:
Total: 2621 sf Value: $328,282.97 Rear: 20
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
0
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea 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 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 VS R-3 2621
Owner: Contractor:
JT ROTH CONSTRUCTION INC J TROTH CONSTRUCTION Required Items and Reports(Conditions)
12600 SW 72ND AVE,STE 200 12600 SW 72ND AVE#200 1 Ersn Cntrl 503-639-4175
TIGARD,OR 97223 TIGARD,OR 97223
PHONE: PHONE: 503-639-2639
FAX: 503-624-0239
Total Fees: $30,048.34
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You - •• - .py of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By s! - Permittee Signature: �����
f /" Call 503.639.4175 by 7:00 a.m.for the next available inspec ion date.
This permit card shall be kept in a conspicuous place on the job site until completion of t.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application X251 `e i �-
,$
Residential - ',z l ' wiz til• ( 1: I Si. Oy1.'t
ReceivedPermit No.:
City of Tigard ^; DateBy: 7 j(.. ,407-- if 1 c 1�"CX 4�I
1,1 4f 13125 SW Hall Blvd.,Tigard,OR 97223 , :i a 5r.I;1.6 Pian Review Other Permit: /
Phone: 503.718.2439 Fax: 503.598.1960 I`-' Date/B : "3 ') / ' r+
1 1 c t,t, Inspection Line: 503.639.4175 Date Ready/By: y/� A H See 'age 2 for
Internet: www.tigard-or.gov e Notified/Method:p/ I�/ 16 Supplemental Information
®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
work indicated on this application.
j :. ? A. ,. , -ry ..n . ., _ ., Valuation: $3703
® 1-and 2-family dwelling 0 Commercial/industrial `� i.)....
Number of bedrooms: 5
❑Accessory building ❑Multi-family
❑Master builder 0 Other: Number of bathrooms: 3
Total number of floors: 2 9
Job site address:8060 SW Barnum Street New dwelling area: 2621 square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: 628 square feet
Suite/bldg./apt.no.: Project name: Ccr_(,,x - l ,,,i_j Covered porch area: g 4'Square feet j 1}
Cross street/directions to job site:Bonita Road to 81"Ave. eck area: square feet I a 0
Other structure area: j it,Q square feet
� sJ k
iAt i# t1s"$ V f:•kt 3 t Iat 3 ,t
Subdivision:Corbin Estates Lot no.:5 Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.:
ZS I(ice,\i3e30 equipment,materials,labor,overhead,and the profit for the
r s work indicated on this application.
._ Valuation: $
Construction of new single family residence
Existing building area: square feet
New building area: square feet
Number of stories:
Name:J.T.Roth Construction Inc. Type of construction:
Address:12600 SW 72°d Ave. Occupancy groups:
City/State/ZIP:Tigard,OR 97223 Existing:
Phone:(503)639-2639 Fax:(503)624-0239 y New:
Business name:J.T.Roth Construction Inc. Structural plan review fee(or deposit):
Contact name:David Jensen
FLS plan review fee(if applicable):
Address:12600 SW 72°d Ave.
Total fees due upon application:
City/State/ZIP:Tigard,OR 97223
Amount received:
Phone:(503)806-0602 Fax (503)624-0239 ,
{
Email davidj@jtrothnc.com
OVE : - . Ali` A x,,v:
a`
Commercial and residential prescriptive installation of
1, !t, so f¢ roof-top mounted PhotoVoltaic Solar Panel System.
Business name:J.T.Roth Construction Inc Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:12600 SW 72°d Ave. Solar Installation Specialty Code checklist.
City/State/ZIP:Tigard,OR 97223 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503)639-2639 Fax:(503)624-0239 State surcharge(12%of permit fee): $21.60
CCB lic.:31700 Total fee due upon application: $20'
This permit application expires if a permit is not o"
Authorized signature / within 180 days after it has been accepted as r
*Fee methodology set by Tri-County Building I-
Print name:David Jensen Date:07/19/2016 Service Board.
I:\Building\Pennits\BUP-RESPermitAppI2/24/2011 440.4613T(11/02/COM/WEB)
Mechanical Permit Application roll Or►.,( II l "1 OMI.I
City of Tigard , . r. . y Da By Permit No.: i A• (d .. .,-,1 y -L.
13125 SW Hall Blvd.,Tigard,OR 9722 Plan Review
e Phone: 503.718.2439 Fax: 503.598.1960IPI
Date/By: Other Permit.
T t G r1 K D Inspection Line: 503.639.4175 p Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov , u i 2. Notified/Method: Supplemental Information
- q,k _ya " `. s ±'C''': "'t''' ''' v f" °"b" I' ''` " Mechanical permit fees*are based on the value of the work
®New construction 0 Addition/alt'eiatiieil/rrplacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
,... .. ., x S y „9 ., .. . ,h`1<. ,,r ''''',,56',4
f ,. ,.. ,. .,,r . „ . .. : , , — . ,,,,14,1' ,,.2
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
Heating/cooling:
Jam' lilw .. ., . :
- -• - r Air conditioning 46.75
Job site address:8082 SW Barnum Street Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97224 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:Bonita Road to 81°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 23.32
Subdivision:Corbin Estates Lot no.:5 Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
z
�A Gas fireplace/insert 33.39
. , �� 0` °'` Flue vent for water heater or gas
HVAC installation of new single family residence fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
23.32
0 , t� ` Other:
,,, „ .. w ',I ,. . ,,,, = . :, . , .
Environmental exhaust and ventilation:
Name:J.T.Roth Construction Inc. Range hood/other kitchen
equipment 33.39
Address:12600 SW 72nd Ave. Clothes dryer exhaust 33.39
City/State/ZIP:Tigard,OR 97223 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503)639-2639 Fax:(503)624-0239 Attic/crawlspace fans 23.32
'. j,„,,,„,,,,,-„,,,,,,,,,,„,„„,,,,,„, . Other: 23.32
Fuel piping:
Business name:J.T.Roth Construction Inc.
$14.15 for first four;$4.03 for each additional
Contact name:David Jensen Furnace,etc.
Address:12600 SW 72nd Ave. Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Tigard,OR 97223 Water heater
Phone:(503)806-0602 Fax::(503)624-0239 Fireplace
Range
E-mail:davidj@jtrothinc.com Barbecue
t
t t a Clothes dryer(gas)
Business name:All Time Heating Inc. Other:
Address:PO Box 1341 Subtotal
City/State/ZIP:Lake Oswego,OR 97035 Minimum permit fee($90.00)
Plan review(25%of pennit fee) I
Phone:(503)208-2276 Fax:(503)208-2276 State surcharge(12%of permit fee)
CCB lic.:184575 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
,. - days after it has been accepted as complete.
Authorized signature: �` ,, _ * Fee methodology set by Tri-County Building Industry Service Board
Print name:Aaron Svo ova Date:07/19/2016
I:\Building\Permits\MEC PermitApp 040113.doc 440-4617T(11/02/COM/WEB)
Electrical Permit Application ► 0R 01•r►( 1. l 'l_()\l 1
CityofTigard Received . , r, o' �l c
g Permit#:
1 DateB :
- *I 13125 SW Hall Blvd.,Tigard,OR 97323' Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#:
Inspection Line: 503.639.4175 Ready Date/By: Juris: ® See Page 2 for
TI G A R D Internet: www.tigard-or.gov ,. 1?._ ; -}0 Notified/Method: Supplemental Information
®New construction 0 Addition/alteratton/replagement '
Please check all that apply(submit 2 sets of plans w/items checked):
,, 0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition 0 Other: • • where the available fault current 0 Marinas and boatyards.
J 't; 5, :I.:::,;'" t �a `", ' exceeds 10,000 amps at 150 volts or El Floating buildings.
� � less to ground,or exceeds 14,000 0 Commercial-use agricultural
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings.
❑Multi family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
I1 M4 ..,.., .,` ❑Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address:8060 SW Barnum Street 100HP or more. ❑"A","E","l-2","l's�,
0 Six or more residential units. ocetty'
City/State/ZIP:Tigard,OR 972240 Health-care facilities. 0 Recreational vehicle parks.
0 Hazardous locations. 0 Supply voltage for more than
Suite/bldg./apt.#: Project name: 600 volts nominal.
❑Sernce or feeder 600 amps or more
Cross street/directions to job site:Bonita Road to 81st Ave. ,r y i, `:' `
Description 1 Qty. r Each I Total I
New residential single-or multi-family dwelling unit.
Subdivision:Corbin Estates Lot#:5 Includes attached garage.
1,000 sq.ft.or less1 168.54 -` " 4
Tax map/parcel#: Ea.add'l 500 sq.ft.or portion .°5x 33.4q -,01
.. �,j iT l,,Irrtill *. 4 , .... u .n am-. t,..,. . Limited energy,residential 1 75: 2
(with above sq.ft.)
Construction of new single family residence
Limited energy,multi-family
75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
ti ►4.P*,� f' , ,. _„, -, w. , , .,.., .ta_.,VZ Services or feeders installation,alteration,and/or relocation
Name:J.T.Roth Construction Inc. 200 amps or less 100.70 2
Address:12600 SW 72°d Ave. 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Tigard,OR 97223 601 amps to 1,000 amps 301.04 2
Phone:(503)639-2639 Fax:(503)624-0239 Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
h circuits-new,alteratio r extension'
xtent ,per
e panel Branc n o on r a
A.Fee far branch circuits with
Business name:J.T.Roth Construction Inc. above service or feeder fee, 7.42 2
each branch circuit
Contact name:David Jensen B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address:12600 SW 72°d Ave. branch circuit
City/State/ZIP: Each add'l branch circuit 7.42 2
Tigard,OR 97223
Miscellaneous(service or feeder not included)
Phone:(503)806-0602 Fax: :(503)624-0239 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:davidj@jtrothinc.com Reconnect only 67.84 2
r a M"7 # ,,, i. , Pump or irrigation circle 67.84
Business name:Dreamhouse Electric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy 0 See Page 2 2
Address:13075 SW Canyon Road panel,alteration,or extension.
Each additional inspection over allowable in any of the above
City/State/ZIP:Beaverton,OR 97005 Additional inspection(1 hr min) 66.25/hr
Phone:(503)648-5144 Fax:(503)648-9723 Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email:dreamhouseelectric@gmail.com inspections for which no fee is
9000/hr
CCB Lic.: 196726 Electrical Lic.: C-848 Suprv.Lie.: it 5 sp.,a fically listed c%hr mm) e
r
- Suprv.Electrician signature,required: Subtotal:
(11
Print name: Chris Mahoney Date: 07/19/2016 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
TOTAL PERMIT FEE:
Authorized signature:��
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:1Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
Plumbing Permit Application
,Building Fixtures • � ' IOk OFF1( 1 ISE OM.)
City of Tigard D eByy Permit No.: ./y) 7` 1�
w 13125 SW Hall Blvd.,Tigard,OR 97223 ' Plan Review l
I Phone: 503.718.2439 Fax: 503.598.1960DateBy: Other Permit No.:
1 1 c \R l� Inspection Line: 503.639.4175 Date Ready/By: )oris: 0 See Page 2 for
Internet www tigard-or gov Notified/Method Supplemental Information
®New�construction ❑Demolition For special information use checklist
Description I Qty. I Ea. I Total
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
t')r Q 'a. t 1'A tr
SFR(1)bath 312.70
�f - ,. <•., , ,. ,.: .�`3,3n:3.13 333n3 ter.
® 1-and 2-family dwelling 0 Commercial/industrial
SFR(2)bath 437.78
SFR(3)bath 1 500.32
❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
t4 Site utilities:
Catch basin or area drain 18.76
Job site address:8060 SW Barnum Street
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: Manufactured home utilities 50.03
Cross street/directions to job site:Bonita Road to SW 81"Ave 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:Corbin Estates I Lot no.:6 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
e._ vi. Backwater valve 12.51
i,. 17 , i,f,.. t . , ,
Clothes washer 25.02
Plumbing of new single family residence Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
, t , Expansion tank 12.51
ar,=,,,,,„,„„„.....,_,,,.,,,,,.__„,,,..-.,==
��• � ,..��,., . .. �� .r_
Fixture/sewer cap 25.02
Name:J.T.Roth Construction Inc.
Floor drain/floor sink/hub 25.02
Address:12600 SW 72ud Ave. Garbage disposal 25.02
City/State/ZIP:Tigard,OR 97223 Hose bib 25.02
Phone:(503)639-2639 Fax:(503)624-0239 Ice maker 12.51
r �A epi Interceptor/grease trap 25.02
Business name:J.T.Roth Construction Inc. Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:David Jensen Roof drain(commercial) 12.51
Address:12600 SW 72°d Ave Sink/basin/lavatory 25.02
City/State/ZIP:Tigard,OR 97223 Solar units(potable water) 62.54
Phone:(503)806-0602 Fax::(503)624-0239 Tub/shower/shower pan 12.51
Urinal 25.02
E-mail:davidj@jtrothinc.com
Water closet 25.02
37.52
, . ... •� {.. ...,. , .,F . .,� . „ ,�°.,. , . .. .,Y Water heater
Business name:ALL Plumbing LLC Water piping/DWV 56.29
Address:9312 NW Skyline Blvd. Other: 25.02
City/State/ZIP:Portland,OR 97231 Subtotal
Phone:(503)520-0313 Fax:(503)469-1470 Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lic.:194089 Plumbing Lic.no.:PB-1022 State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name:Aaron Luchs Date:07/19/2016 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\PLMU-PemtitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
O
City of Tigard
IIIR COMMUNITY DEVELOPMENT DEPARTMENT
■
T 1 G A R D Building Permit Review — Residential
Building Permit #: P25j 0?0i6.7-- ' 99
Site Address: p° SW P at2_nLi m Si-,
Project Name: 000011/1 -F-GrirS Lot #: 5
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: New g-I2---
Verify site address/suite# exists and active in permit system.
River Terrace Neighborhood: No ❑ Yes,See River Terrace Review Addendum Attached
Site Plan Elements: ��//
j�'I'hree(3)copies of site plan rilnrixisting structures on site
-Site plan must be on 8-1/2"x 11"or 11 x 17"paper ATFootprint of new structure(including decks)with finished
.Drawn to scale(standard architect or engineer scale) floor elevations
%.s
North arrow Utility locations(required for new,may apply for additions)
ite address,project or subdivision name and lot number 1/' 'cation of wells/septic systems
Applicant information(name and phone number) 12 xisting trees to be retained with drip line,and tree
SLot dimensions and building setback dimensions protection measures
kalaLot 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) .Street names
[ 'roperty corner elevations(2 foot contour lines if more than
4 foot differential)
Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No
ek Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified 121'No Applied For: ❑ Yes ❑ No,stop intake
Land Use Case#: S 12 0)4- 00D0 9
J---Zoning: Lt.S
Setbacks: Front 7 Rear Side 5 Street Side i cJ Garage 23
A- Landscape Requirement: r// A
,`ti' of Coverage Maximum: y'J/ ft
Building Height: Maximum Height -- 0 Actual Height
Visual Clearance
Easements
[ Sensitive Lands: El Yes No Type
Urban Forestry Plan
Conditions "Met"prior to issuance of building permit
Notes: SPc. C diff n /haft' Gh C r fC pino \S h! he ixc JbL loL i {vL- ID
pro vic,C-r 2 v' fw k,-+tl ,n i-4 (pcfil2c-l(
Approved By Planning: 'To •4 4 2L4 4 Date: 7/2S/I Co
Revisions (after Building Submittal .nly) Reviewer Date
Revision 1: El Approved ❑ Not Approved
Revision 2: ❑ Approved El Not Approved
Revision 3: ❑ Approved El Not Approved
1:\Building\Forms\BldgPermitRvw_RES_060116.docx
,
Building Permit Submittal
Original Submittal Date: 7/-25/4
Site Plans: #
Building Plans: # )
Building Permit#: mer building permit#above.
Workflow Routing:
11---ii g ngineering Izfmit Coordinator ®—Building
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: ngineering: (1) copy of permit application, (1) site plan, (1) building plan and
oriplan review routing form.
Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: ���� /
By Permit Technician: .��cs.,__.�__�. ��,. Date: 7///c,
Engineering Review
Slope at building pad: ;A
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments) per engineering conditions of approval and plat
O Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ❑ No
Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No
LIDA Facility on lot: ❑ Yes ❑ No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: /1144_117 Date: 7:2 7.—/Z
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: 0 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:
laDC Fees Entered: Wash Co Trans Dev Tax: k7. Yes ❑ N/A
Tigard Trans SDC:
no es ❑ N/A
Parks SDC: 7Yes ❑ N/A
IOK to Issue Permit
Approved by Permit Coordinator: / Date: Z, ���
I:\Building\Forms\BldgPermitRvw_RES_060116.docx
I
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8060 SW BARNUM ST, TIGARD, OR, 97224 March 14, 2017 at 8:32:38 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00299
Inspection Type: Inspector:
199 Electrical final David Young
Result:
CNCL
Comments:
This inspection passed previously, see inspection dated 3/6/17.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8060 SW BARNUM ST, TIGARD, OR, 97224 March 14, 2017 at 9:21 :12 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00299
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
FA I L
Comments:
Seal penetrations for HVAC in garage. R302.5
Provide separate mechanical and electrical permit for AC installed without permit and
inspections.
AC not part of this permit and inspection.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8060 SW BARNUM ST, TIGARD, OR, 97224 March 15, 2017 at 2:22:29 PM
Record Type: Record ID:
Residential - Master Permit MST2016-00299
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS
Comments:
Electrical final for AC ok.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8060 SW BARNUM ST, TIGARD, OR, 97224 March 15, 2017 at 2:26:18 PM
Record Type: Record ID:
Residential - Master Permit MST2016-00299
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS
Comments:
Corrections complete.
Mechanical final for AC ok.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8060 SW BARNUM ST, TIGARD, OR, 97224 March 15, 2017 at 2:28:55 PM
Record Type: Record ID:
Residential - Master Permit MST2016-00299
Inspection Type: Inspector:
299 Final inspection David Young
Result:
PASS - CofO
Comments:
Final erosion control approved.
Street tree certification received.
Moisture content form received.
High efficiency lighting form received.
Duct seal test report received.
Insulation certification checked.
C of 0 left on site with contractor.
Violation Summary:
Inspector Contractor