Permit CITY OF TIGARD MASTER PERMIT
111 ! COMMUNITY DEVELOPMENT Permit#:
MST2016 00276
T r r.';A l;p 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/03/2016
Parcel: 2S102DC01900
Site address: 9280 SW EDGEWOOD ST Jurisdiction: Tigard
Subdivision: EDGEWOOD Lot: 15
Project: Crisp-Davila Partition, Lot 3
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1198 sf Basement: 0 sf Left: 5
Height 26 Bathrooms: 3 Parking Spaces: 0
Second: 1347 sf Garage: 748 sf Front 15 Smokeke
Dwelling Units: 1 Third: 0 sf Yes
Right: 5 Detectors:
Total: 2545 sf Value: $323,959.17 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: 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: 4 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener N All
Other: N Other Description: Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr:
NEW Occupancy Group: Square Feet:
SF VB
R-3 2545
Owner: Contractor:
NJSJDS II LLC JTSC LLC Required Items and Reports(Conditions)
5285 MEADOWS RD STE 171 5285 MEADOWS RD,SUITE 171 1 Ersn Cntrl 503-639-4175
LAKE OSWEGO,OR 97035 LAKE OSWEGO,OR 97035
PHONE: 503-657-3402 PHONE: 503-308-7324
FAX: 503-684-0102
Total Fees: $29,341.18
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 AR 952-001-009 . obtain a co• of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: 1 s�rrrr Permittee Signature: C �' �`
a '13.639.4175 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 completio of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application L. / 3
Residential i x , FOR OFFICE USE ONLY
e 1 Received /
City of Tigard Date/By: CV 30 / Ck—i.e. Permit No.: 4
1)14/4 00027W
el 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1��Q it Ilk
Date/By: or/V/(p 7 Other Permit: 16, .GDa 3„2____
1 ,, ,\,,i t Inspection Line: 503.639.4175 Date Ready/By/ .hurls: El See Page 2 for
Internet: www.tigard-or.gov : , Notified/Method.i:///GB I Supplemental Information
eLf?la.-- , f"J
TYPE i.:tiiiikkG n,ivisfN REQUIRED DATA:1-AND 2-FAMILY DWELLING
®New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1-and 2-family dwelling 0 Commercial/industrial Valuational3j 9s-1 $ J f
0 Accessory building 0 Multi-family Number of bedrooms: 4 J
0 Master builder El Number of bathrooms:
` JOB SITE I t 4 TION AND LOCATION Total number of floors: 2 3 9 3
Job site address: C(2 g0 t.-to 4E w aD 0 c r New dwelling area: 21 54 square feet
City/State/ZIP: Garage/carport area: 14 g square feet
Suite/bldg./apt.no.: Project name: C r2 I S 3 pow II. A . Le 1-3 Covered porch area: ? square feet i31-1 7
Cross street/directions to job site: Deck area: square feet 1
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: GNU ?ups -000o5 Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: 3 Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
NEW SINGLE FAMILY RESIDENCE Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 TENANT Number of stories:
Name:NJSJDS II,LLC Type of construction:
Address:5285 MEADOWS RD STE 171 Occupancy groups:
City/State/ZIP:LAKE OSWEGO,OR 97035 Existing:
Phone:(503)657-3402 Fax:( ) New:
® APPLICANT 0 CONTACT PERSON
BUILDING PERMIT FEES*
Business name:JTSC,LLC (Please refer to fee schedule)
Structural plan review fee(or deposit):
Contact name:NATHAN SMITH
Address:5285 MEADOWS RD STE 171 FLS plan review fee(if applicable):
City/State/ZIP:LAKE OSWEGO,OR 97035 Total fees due upon application:
Phone:(503)358-5001 Fax::( ) Amount received:
���®�
E-mail:NSMITH@JTSMITHCO.COM PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic Solar Panel System.
Business name:JTSC,LLC Submit two ' ets of roof plan with c i i-- ion details
and fire departmen . ess,alo t• th the 2010 Oregon
Address:5285 MEADOWS RD STE 171 Solar Installation SpeciaP,". .de checklist.
City/State/ZIP:LAKE OSWEGO,OR 97035 Permit Fee udes plan rev . $180.00
. d administrative fees):
Phone:(503)657-3402 Fax:( ) State I charge(12%of permit fee): $21.60
CCB lic.:200237 7
E I _ .. I ..upon application: $201.60
Authorized signature: s This permit application expires if a permit is not obtained
f within 180 days after it has been accepted as complete.
Print name:JOHN WYLAN I j Date: Ui 3G 116 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RE 'ermitApp.doc 02/24/2011 440-4613T(l1/02/COM/WEB)
t. c0O, ::, .-, ::--, :i ,• :., ! .,., .,..„.„,,..,. .. „ ,,„...,„,_,,,:.l.„EietriaI Permk App4ddtvin 1L000l47„1,t
,..:..._.:,
III-,USE,ONLV:12, ::.,..3,,;i-, •; ..';:,i, .,e-s-' 5,'A
:':1•-•'%'''''''''-.:::4_'-',-.,%'''4.';'' City of Tigard „L! ,,, s,,, •)i-ilf., itowo;-7, -"--.'"--'- -.-----:,, .....p--- li
Datell3.: Permit'No.: 4 r090,w-0„,„..4.7,,i
13125 SW Hall Blvd.,Tigard,VA:41721h ':' , ''""
Planleview
7.: ,,-- 4,j.F•'-'-'' Phone: 503.718.2439 Fax: 503.598.1960
-,,5.;...,:',•,,; =:',:' Date/B : Other Permit:
UKR.01 Inspection Line: 503.639.4175 '''.' '':'-''..: , ''' -'.
Date Ready/By: Ions: 11 See Pa ge 2 for
,;,:;:i. g....k.:,•...1: Internet: www.tigard-orgov•''' •: Notified/Method: Supplemental Information
mpriromMIOMMAMMIEW6ritlatteAKVINIMA:::NR-MRWORMaig 61,1AUMM.0410:EigiibMitOtik"fteikatUptirag*
0*w construction 0 Addition/alteration/replacement
Please check all that apply(submit 2 Satiizif Plans w/iterns checked below):
:
0 Service or feeder 400 amps or more 0 Redding over three stories.
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
010,,ROM,f,afa1M,,,,;:kig:4,00nowrowEitomiroviopm.:].,:womompap exceeds 10,000 amps at 150 volts or Dl loating buildings.
')'''""'"'.'it'i''''"":'''''''"'.3'.'"‘"-''''''''''''''' ''t. 41ll '"""'"'"'''''''Th'-'"'''''''''''''''''''' less to ground,or exceeds 14,000 0 Commercial-use agricultural
0 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
-,,,,,,,,, 0 Emergency system. larger separately derived system.
2,13,112§{90#01KONASNINIOnatotonamastim .Addition anew motor load of I:1"A""E" "1-r "1-3''.
100HP or more occupancy.
Job no.: Job site address: 41 3. -03 ZOGE WON? ST 0 Six or more residential units. 0 Recreational vehicle parks.
0 Supply voltage for more than
0 Health-care facilities.
City/State/ZIP: -:n.c,Az 0 , 0 R
o Hazardous locations. 600 volts nominal.
SU I te/bIdgiapt.no.: Project name:'CP-‘5 P Oisa I L A 0 Service or feeder 600 amps or more.
NIUMENSMENORMINgendinan
Cross street/directions to job site: Description I tIti• I Fee, I Total I *
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: 10,‘...P3.o t vi- 0000 5 Lot no.: 1,000 sq.ft.or less I , 168.54 4
Ea,add'I 500 sq.ft.or portion i.p. .13\ 33.92 1
Tax map/parcel no.: p/1,9-CE-L- 3 Limited energy,residential
MINSMERIESSIN007.4.000,010WEENEMMENO (with above sq.fl.) 75.00 2
Limited energy,multi-family
75.00 2
Electrical for new single family residence residential(with above sq.ft.)
,ItitiiiV'ftlitaiiefkil.:,"',.:'•"'::!.'•.:.'.;::.i:'.-Al:..Sriik;:e.:2'.'
Services or feeders installation,alteration,and/or relocation
yikorof motiv,m,pmEN Rig;:!,:,:,:,;:kov.:otimaliiritor.alza,,,, ,:grg,N 200 amps or less I I 0a 70
2
201 amps to 400 amps 133.56 2
Name: WISZOS 'III L.A. C 401 amps to 600 amps 200.34 2
Address:5285 Meadows Road Suite 171 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP: Lake Oswego,OR 97035
Temporary services or feeders installation,alteration,and/or
Phone:(503)657-3402 Fax:( ) relocation
200 amps or less 59.36 t
Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701.
... :: 401 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits-new,alteration,or extension, er panel
AIMENSSWArettantainignaWalentenn, A'aFbe:vr:rsie)rrvainecehocri rill tesr";,":
Business name:JTSC,LLC each branch circuit 7.42 2
B.Fee for branch circuits without
Contact name:' NATHAN SMITI4 service or feeder fee,first
56.18 2
branch circuit
Address:5285 Meadows Road Suite 171 Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
City/State/ZIP: Lake Oswego,OR 97035
Each manufactured or modular
67.84
Phone:C ' 5045 /II 1 5041 Fax: :( ) dwelling,service and/or feeder _
Reconnect only 67.84 2
E-mail:•ihi S tal IT 14 e 7-T- 1411-14(0. COm . Pump or irrigation circle , 67.84 2
WHIMMISOntaletaga,rgsMatinantettait aMrig Sign or outline lighting 67.84 2
Business name: tifitinty. .--tbiltierL.,.. Signal circuit(s)or limited-energy See
panel,alteration,or extension. _ Page 2 2
Address: ,2.--,C102v0 6E; l' r)ote1Q91.961../41/6 i 34--.41-- Each additional inspection over allowable in any of the above
Additional inspection(I hr min) J 66.25/hr
City/State/ZIP: i5J90Y0 Ok 6/7 )3 Investigation(I hr min) 66.25/hr
_
Phone:(9)3)6 .S.4/: „.2_ • IOW 64Q-:-'7W Industrial plant(I hr min) _ 78.18/hr
Inspections for which no fee is
CCI)Lic.: / 2/i 561 Electrical Lie,: AfFil ,tipr,:' c: 319 6 ei s.eci fi cal ly listed Ph hr min) 90.00/hr
Ar. .
, ,,.. .:-..
• . . ' ,r,•- ,,,?,- -- BLIERVIWN;W::::a.MTERVC.10,6611,24
—-• ''` " ' -
Suprv. Electrician signature,required: 1111//' ' ''....vW—°-•
..41§4' ..,,,._ -.A6'. . 1L-1.-----::------ Subtotal:
. .:' .,- - 1!• Date:
Plan review(25%of permit fee):
Print name: C,,hut...,./:' -4,W411
State surcharge(12%of permit fee):
Authorized signature: 'ilr-W- , ,,. ,:,i-:
-:41411111k/' • ., TOTAL PERMIT FEE:
:.. .- '
— This permit application expires ifit permit is not obtained within 180
Print name: c,htu...K Date: days after it has been accepted as complete.
* Number of inspections allowed per permit,
hiluilding,,Per mits.,ELC_PertnitApp_ELR_ERE.doe Rev 05/2i120t] ti. .14045151T I I/051COMIWER
,
. , . , .•
Aissihanical Permit Applicati*:, , i , ,,•, f i otz ot i ici t
City of Tigard Received
Date/By' Ce 3ollrfffill Penn'''. ) /57.7 '.'/ "C)C.)A7%
!IN . 13125 SW Hall Blvd.3 Tigard,OR 97223 , rc ,,c.t t 1„,
Plan Reyiew
Phone: 503,7182439Fax: 503.598.1960 ': ' ''' '' '' Date/By Other Permit:
1 I , \1,I, Inspection Line: 503.639.4175 . . . Date Ready/By: Juri la See Page A for
Internet: www.tigard-orgov ' Notified/Method: Suppienientat Information
TYPE OF Vvbiiii COMMERCIAL FEE* SCHEDULE— USE CHECKLIST
Mechanical permit fees*are based on the value of the work
0 New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition El Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
t.I 1-and 2-family dwelling D Commercial/industrial 0 Accessory building For special information use checklist
0 Multi-family 1:1 Master builder 0 Other: Description Qty. Ea, Total
100 SITE INFORMATION AND LOCATION Heating/cooling:
•
- Air conditioning 1 46.75
Sob site address: ta a_To E..oa E L000D si- Furnace 100,000 BTU(ducts/vents) 1 46.75
City/State/ZIP: -1-1 C,A 12-0 , Q R Furnace 100,000+BTU(ducts/vents) _,. 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: 6 P-)S? 'DAV ) 1,- A Duct work 1 23.32
_
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
'Hint heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. _ 46.75
Flue/vent for any of above 23.32
Other: 23.32
Subdivision; 'ALP a_01%-1 - 00005 Lot no.:
Other fuel appliances:
Tax map/parcel no.: c) AP-c.:c-- L., Water heater 1 23.32
DESCRIPTION OF WORK Gas fireplace/insert / 33.39
Flue vent for water heater or gas
MECHANICAL FOR 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
Other, 23.32
01 PROPERTY OWNER 0 TENANT
Environmental exhaust and ventilation:
Name:NJSJDS II,LLC Range hood/other kitchen
equipment I 33.39
Address:5285 MEADOWS RD STE 171
Clothes dryer exhaust f 33.39
City/State/ZIP:LAKE OSWEGO,OR 97035 Single-duct exhaust(bathrooms, 6"—A(
toilet compartments,utility rooms) 23.32
Phone:(503)657-3402 Fax:( ) Attic/crawlspace fans 23.32
131 APPLICANT 01 CONTACT PERSON Other: 23.32
Fuel piping:
Business name:JTSC,LLC
$14.15 for first four;$4.03 for each additional
Contact name:5285 MEADOWS RD STE 171 Furnace,etc.
Address:5285 MEADOWS RD STE 171. Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:LAKE OSWEGO,OR 97035 Water heater
Phone:(503)348 5001 Fax::( ) Fireplace
Range
E-mail:NSMITH@JTSMITHCONOM
Barbecue
CONTRACTOR Clothes dryer(gas)
1
Business name: I V%)1'E G RA-TY Ai P. II. C
Other
MECHANICAL PERMIT FEES* -
Address: 1 0 I SW icAeLG' it4 Cir 500 Subtotal
City/State/ZIP: P otkT LA N 0 , OR oil 3.2 0 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(1503 51 2,.. s5 A Li Fax:( )
State surcharge(12%of permit fee)
CCB lie.: 2.1030,, 1 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:John Wyland Date: Gi 301 i(3
IABuildingTermits\MEC_PermitApp_ 13.doe 440-4617T(11/02/COM/WEB)
:,
Plumbing Permit Application ; T
Building Fixtures iOR Of Flt 1. ISL () L\
City of Tig$1't1 Received
0[Permit No, ,. . //—06 x378-
IN
M 13125 SW Ball Blvd.,TigardOR 9 223 t Plan Review
Phone: 503 718.2439 Fax: 503 598.1960 Datefa;: Other Permit No..
inspection Line: 503 639 41.75 `C' ,', ; Date Read,/B kris ® See Pagel for
I t‘;-v I'1) Internet: www,ta and-or. v y Yi
Notified/Method; Supplemental Information
TYPE OF WORK FEE* SCHEDULE
e New construction ❑Demolition For special information use checklist
Description (_ Qty. I Ea, Total
0 Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(l)bath 312.70
O. 1-and 2-family dwellingSFR(2)bath 1 437,78
❑Commercial/industrial
SFR(3)bath 500.32
❑Accessory building El Multi-family _—
Each additional bath/kitchen 25.02
O Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address;
a_$O E t G E S T Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: -r I. A R 17 1 COR _
Footing drain(no,linear ft.; ) Page 2
Suite/bldg./apt.no.; I Project name; C 2Z‘S Q 0 AU IL 4
Manufactured home utilities 50.03
Cross street/directions to job site; Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.; Z.2) 1 Page 2
Storm sewer(no,linear ft,; ?A) I Page 2
Water service(no,linear ft.;_ILL) 1 Page 2
Subdivision: 14L-20-01\-\- 00005 I Lot no.: Fixture or item:
Tax map/parcel no.: c..)JQ RCE`,,, lb Backflow preventer 1 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 1 25.02
PLUMBING FOR NEW SINGLE FAMILY RESIDENCE Dishwasher 1 25.02
Drinking fountain 25,02
Ejectors/sump 25.02
Eg PROPERTY OWNER I El TENANT Expansion tank 12,51
Name:NJSJDS II,LLC Fixture/sewer cap 25,02
Floor din/floorAddress:5285 MEADOWS RD STE 171
Garbage disposalsink/hub 1 25.02
City/State/ZIP:LAKE OSWEGO,OR 97035 I-lose bib 1 25.02
Phone:(503)657-3402 Fax:( ) Ice maker I 12.51
01 APPLICANT �� CONTACT PERSON Interceptor/grease trap 25.02
Business name:JTSC,LLC Medical gas(value:$ ) Page 2
Contact name:NATHAN SMITH Primer 12.51
Roof drain(commercial) 12,51.
Address:5285 MEADOWS RD STE 171.
Sink/basin/lavatory 1 25,02
City/State/ZIP:LAKE OSWEGO,OR 97035 Solar units(potable water) 62.54
Phone:(503)348-5001 Fax::( ) Tub/shower/shower pan 3 1251
E-mail:NSMITH@JTSMITHCO.COM Urinal 25.02
Water closet 3 25.02
tbIAILPb CONTRACTOR Water heater 37.52
Business name: MU u„E N (pm?ANN Y Water piping/DWV 56.29
Address: tie 0 I A SE 1$U e fit. RA A, O Other: 25.02
City/State/Z1P: u 4 tic so PO , • ft A 112 3 Subtotal
Phone:( ) Fax:( ) Minimum permit fee: $7250
CCB Lie.: 01111,40Q'All Plumbing Lic,no.:St% • 1-40
Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name:JOHN WYLAND Date: 434/6 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.
C\Building\Pennits\PLMU-PermitApp.doc 10/01/09 440-4616'r(10/02/COM/WEB)
City of Tigard
114q COMMUNITY DEVELOPMENT DEPARTMENT
f
T l G A R D Building Permit Review — Residential
Building Permit #: H 5 i c7no (.a -,U ----74.0
Site Address: 9c ) ` -'LL) i,y cx4 c7L
Project Name: �S• '- /iiz 2iM AD)-•__ Lot #: 3
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: ,eC SP/C._
V/J Verify site address/suite#exists and active An permit system.
id/Over Terrace Neighborhood: V No ❑ Yes,See River Terrace Review Addendum Attached
Sit Plan Elements:
Y ree(3)copies of site plan ►\.. :k ting structures on site
N S. e plan must be on 8-1/2"x 11"or 11 x 17"paper IE Footprint of new structure(including decks)with finished
IG I rawn to scale(standard architect or engineer scale) oor elevations
IP .rth arrow Utility locations(required for new,may apply for additions)
I, ie address,project or subdivision name and lot number to ation of wells/septic systems
�J .plicant information(name and phone number) 0 'sting trees to be retained with drip line,and tree
A .t dimensions and building setback dimensions : otection measures
[J ,f area,building coverage area,percentage of coverage and IF'S eet tree size,type and location
ypervious area(applicable if R-7,R-12,R-25&R-40) treet names
ad Property corner elevations (2 foot contour lines if more than
4 foot differential)
/°p/ Lean Water Services-Service Provider Let (lot platted prior to 9/10/1995):
'equired: ❑ Yes,applicant was notified t.n No Received: ❑ Yes ❑ No
II. Public Facilitie mprovement(PFI) Permit:
Required: Yes,applicant was notified ❑ No Applied For: IIS'Yes ❑ No,stop intake
!', ..nd Use Case#: /14Z-A2-6P-7/- 0600\c"
IR/Zoning: R-"7'-C-
Iv Setbacks: Front 0 C) Rear /5— Side 5---- Street Side /g-'Garage %o
toandscape Requirement:
0418t Coverage Maximum:
icti
luilding Height: 0/0
Maximum Height Actual ht
21-7/
jii f isual Clearance
►I Easements
ensitive Lands: ❑ Yes ❑ No Type
LJ Urban Forestry Plan
❑ Conditions "Met", •or to issuance of buil • g permit
Notes: L lr')1'j06/cGti2 S7 `` I/ ,?ta/ 9 7?J- 7 pf7Mf2 S- )9 4fai rcc
Approved By Planning: PPP— <„' Date: ®%
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_RES_060116.docx
Building Permit Submittal l f
i
Original Submittal Date: i!)/ lL
Site Plans: #
Building Plans: # 3
Building Permit#: Enter building permit#above.
Workflow Routing: 2'Planning ,C-Engineering 0 Permit Coordinator Er Building
Workflow Sign-off: ❑- Sign-off for Planning(include notes from planning review)
Route Application Documents: El-Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
Z. Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:By Permit Technician: 1 0 , . " ' Date: 61867
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: El Yes ❑ No
LIDA Facility on lot: Cl Yes ❑ No
❑ NOT Approved I . E• .ineering: Date:
Notes: ai, ar a A.:; _ .'��_, .: �' �' NV.-J. Of^..i..tu
Approved by Engineering: Z, Date: �� •.vzj
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: El Approved ❑ Not Approved
Permit Coordinator Review
El Conditions "Met"prior to issuance of building permit
Ea
pproved,NOT Released: /6/ Date: '��J7'/�O
Notes: C �� 7w'-�
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:
DC Fees Entered: Wash Co Trans Dev Tax: E.# es CI N/A
Tigard Trans SDC: Q.Yes ❑ N/A
Parks SDC: Yes ❑ N/A
4/4161 K to Issue Permit
Approved by Permit Coordinator: Date: i/ 1 l
I:\Building\Forms\BldgPermitRvw_RES 060116.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9280 SW EDGEWOOD ST, TIGARD, OR, 97223 April 3, 2017 at 10:04:58 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00276
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
FA I L
Comments:
AC covered by painters, not accessible for inspection.
Ceiling penetration for HVAC in garage not sealed.
Work not complete, not ready for inspection.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9280 SW EDGEWOOD ST, TIGARD, OR, 97223 April 3, 2017 at 10:00:52 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00276
Inspection Type: Inspector:
199 Electrical final David Young
Result:
FA I L
Comments:
Provide access to exterior outlets for inspection, taped over by painters.
Provide face plates on all kitchen outlets.
Work not complete, not ready for inspection at this time.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9280 SW EDGEWOOD ST, TIGARD, OR, 97223 April 3, 2017 at 10:36:44 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00276
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
FA I L
Comments:
Seal backsplash at kitchen sink.
Provide permit and final inspection for lawn irrigation Backflow devise.
Finish sealing around master tub, tile not done.
Not ready for inspection, work not complete.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9280 SW EDGEWOOD ST, TIGARD, OR, 97223 April 5, 2017 at 11 :57:45 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00276
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
PASS
Comments:
Contractor on site finishing caulking at master bath.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9280 SW EDGEWOOD ST, TIGARD, OR, 97223 April 5, 2017 at 12:01 :20 PM
Record Type: Record ID:
Residential - Master Permit MST2016-00276
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9280 SW EDGEWOOD ST, TIGARD, OR, 97223 April 6, 2017 at 8:06:19 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00276
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 checked.
Insulation certification checked.
C of 0 left with contractor.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9280 SW EDGEWOOD ST, TIGARD, OR, 97223 April 5, 2017 at 12:03:13 PM
Record Type: Record ID:
Residential - Master Permit MST2016-00276
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS
Comments:
Corrections from previous inspection complete.
Violation Summary:
Inspector Contractor