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Permit (138) 11111 CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2016-00411 T[GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/29/2016 Parcel: 1 S 125DA03800 Site address: 6620 SW WALNUT TER Jurisdiction: Tigard Subdivision: KINGS VIEW Project: Kovalev Lot: 23 Project Description: New SF. DEMO CREDITS APPLIED FROM BUP2016-00231. BUILDING Floor Areas Required Setbacks Stories: 2 Bedrooms: 4 Required First: 1500 sf Basement: 0 sf Left: 3 Height: 26 Bathrooms: 3 Parking Spaces: 0 Second: 1700 sf Garage: 657 sf Dwelling Units: 1 Third: 0 sf Front: 20 Smoke Yes Right: 3 Detectors: Total: 3200 sf Value: $399,042.39 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Urinals: 0 Tubs/Showers: 4 Sewer Lines: 100 SF Rain Storm Sewer: 100 Garbage Disp: 1 Water Heaters: 1 Footing Drain: 0 Ice Maker: 1 Water Lines: 100 Drains: 0 Hose Bib: 2 Backwater Value: 1 Bckflw Prevntr: 0 Catch Basins: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Tvoes Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Furn<100K: 1 Hoods: 1 Other Units: 0 Vents: 0 Woodstoves: 0 Furn>=100K: 0 Gas Outlets: 4 ELECTRICAL Residential Unit Service Feeder ------_ Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 1 W/Svc or Fdr: 0 Ea add'I 500 sf: 6 201-400 amp: 0 201-400 amp0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: W/O SvGFdr: 0 : 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 Other: N Other Description: All Ecompasing: Y BUILDING INFO Class of Work: Type of Use: NEW Type of Constr: Occupancy Group: SF VB Square Feet: Owner: R-3 3200 Contractor: KOVALEV,VITALY&ANITA GLOBAL HOUSING INC 6990 SW CANBY ST Required Items and Reports(Conditions) PORTLANDSW , B T23 7917 SW NIMBUS AVE 1 Ersn Cntrl 503-639-4175 BEAVERTON,OR 97008 PHONE: PHONE: 503-315-4259 FAX: 503-296-0612 Total Fees: $10,226.51 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 • ..-. obtain a .. o .- les or direct questions to OUNC by calling . 32.1987 or 1.800.332.233 °4. Issued By: Yt VVIL �-, Permittee Signature: (, a , .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. I 'Building Permit Application Commercial � �� I FORo11k1. t 011.1 7 '''''.1. Received City of Tigard AO d. ' Date/By ltd//3 F ' 7377— Permit No.: AlA/ !.X(J16 66*/1 13125 SW Hall Blvd.,Tigard,OR 97 � Plan Review b �/J /� /� ���y��_ Phone: 503-718-2439 Fax: 503-5960 Date/By: i) • I fa" j Related Permit: 41.4RV167—l�.rg T 1 G A R D Inspection Line: 503-639-4175 A` �r,,1� Date Read/B J��: Internet: www.tigard-or.gov ,,� Notified/Method: // �1 , ,�^�� 0 See Page 2 for �� a /�,,r'f/` A i " --ev I Supplemental Information i `1,V N ked/! /bet✓L( 1 TYPE OF W4811% .1A11394.)" REQUIRED DATA:1-AND 2-FAMILY DWELLING "Vt[New construction �i ilIh Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all pi-Addition/alteratio t�/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: $ 3`? Si_and2-family dwelling 0 Commercial/industrial 9 _ 0 Lt:. (Y) 0 Accessory building 0 Multi-family Number of bedrooms: (t/ 0 Master builder 0 Other: Number of bathrooms: 3 '3 Total number of floors: ~ JOB SITE INFORMATION AND LOCATION Z �3 S-:-..' Job site address: 6/-//'�`9 New dwelling`JC.J ltlAL/V(s(f ��(� area: gr`7.00 square feet "�+ City/State/ZIP: j ieimci D R Garage/carport area: square feet Suite/bldg./apt.#: Project name: 1/0 jGt I i:i,), 414_Covered porch area: � square feet OCs �� I 7 Cross street/directions to job site: Deck area: 370 square feet J SQ 0 6 `g 4 w "IL A u T Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST 4Subdivision: //�J S �J J E(,tl Lot#: Permit fees*are based on the value of the work performed. Tax map/parcel#: 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. RepL4e`tic wt 14et /3 W i-106.t5a, N_ ( coN5ttce_06'0c-i Valuation: $ Existing building area: square feet New building area: square feet 0 PROPERTY OWNER 0 TENANT Number of stories: Name: I/if q7f A M k O L"/l(1 V Type of construction: 07 Address: 196 NI SW z/ R Nay f 5 4 Occupancy groups: City/State/ZIP: PQ g 1.-4,g/tit, 0 R 77 Z 23 Existing: ct Phone:( 6)3) 522.-P y5I Fax:( ) New: APPLICANT 0 CONTACT PERSON ( BUILDING PERMIT FEES* ''- -) Business name: (Please refer to scheduk) Structural plan review fee(or deposit): Contact name: Address: FLS plan review fee(if applicable): City/State/ZIP: Total fees due upon application: Phone:( ) Fax::( ) Amount received: E-mail /L>E� 4(�j PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted Photo Voltaic Solar Panel System. Business name: 6&, I L ffoccsi Ai 6 i Ar C. + Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: L///( S'(..) 52,14A AVE Solar Installation Specialty Code checklist. City/State/ZIP: R."j f!a/)b OR 9??2 Z I Permit fee(includes plan review $180.00 and administrative fees): Phone:(9)3) 3/3 y231 Fax:(tea 3) (79? ' c(f,vf" State surcharge(12%of permit fee): $21.60 CCB Lic.: /4/6 2? g Total fee due upon application: $201.60 Authorized signature: NO? k //!� c7/Q`t�/ This permit application expires if a permit is not obtained V within 180 days after it has been accepted as complete. Print name: �p � V ®v�L F(0 Date: AO—/2 /6 * Fee methodology set by Tri-County Building Industry Service Board. ilding\Permits\BUP COM PennitApp.doc Rev.04/21/2014 4404613T(11/02/COM/WEB) City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Accessibility: Barrier Removal Improvement Plan ' '� Commercial & Multi-Family - Additions or Alterations TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241. (1) Every project for renovation,alteration or modification to affected buildings and related facilities shall be made to insure that the path of travel to the altered area and the restroom, telephones and drinking fountains are readily accessible to individuals with disabilities unless such alterations are disproportionate to the overall alterations in terms of cost and scope. (2) Alterations made to the path of travel to an altered area may be deemed disproportionate to the overall alteration when the cost exceeds twenty-five percent(25%). VALUATION: Total of all renovation,alteration or modification being done, excluding painting and wallpapering: [1] $ MULTIPLIER(25%barrier removal requirement): x .25 TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ ELEMENTS: In choosing which accessible elements to provide under this section,priority shall be given to those elements that will provide the greatest access. Elements shall be provided in the following order: (a) Parking $ (b) An accessible entrance: $ (c) An accessible route to the altered area: $ (d) At least one accessible restroom for each sex or a single unisex restroom: $ (e) Accessible telephones: $ (f) Accessible drinking fountains:and, $ (g) When possible,additional accessible elements such as storage and alarms: $ TOTAL(shall equal line [2] of Valuation Computation): $ I:\Building\Permits\BUP_COM_PermitApp.doc Rev.12/18/2014 ...",.;: : ..1-"...1c.':,i."-,,, ,,,,,,,,.:5;,i*,:•li'";,,%V.,,'"•,7„,:ci';`);`,'-;/`-';.;?.>2iiii4‘4,-,,,,,,...?„...,.A...44$:,',..4'.,....,,,,,4::'' C''''1-..'"",".,,V=i;',1:.''!,..,,':,„7,7;.','AP,,I^:.;•`-',4.3t9;.'"''''''',-AVV,..'N'AS;-•':ctttip.tt.""t.tA".., .st...",,,4",'WI'''t'"'att.t"i f''',4, . , ,,.„.,,.....". 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"•.,'''''.'17, ,l'''..,.,,I,,•''t,',tti..'17,t.;•'' 'Ati4rie.,.44-X., ' . ;,.000114:,:14.*Iti:01414/t0i:, :',1;:::,•k. ;,:,f,,..:,- 4;, '',,-.:.„,,,c.: ,.,. .,„A,Q .7,2. .,,.,,, :4str , -,-,., , 2‘,„.,,,„..;.,' ,,, ,Wi , .,. : ''''.''• ,.,;.,':,,' ..t:.&',',/ct,',.."fti:ttt',...,t<.,;„:Z:;',."''t't,'tt:$?t,":'''.2.:;"...,t-t'.,.,' .. , ... :'t . .t. . t.t.t. -;-,..-,-..,...,.,-„,,,.tv,„„500.441....4,.. - 41,v411,10t*..I.,,,,;,''...,,... -:,•,:',,,-.-.,-,.:,, -.. . .: --,'..,,,--, ,'4-tivi , , otelbrffitit*utak * ,i : mobaiticon... ;-, - :,.'7,-1'. -: 1:3.staili;.. .,.:: ?;;,::,-.:' -,,-,.: ,,:f.,,pt,k3',-7 ' '., . .'• , .,.:,,,, ..,,..,41.--, - ..): ,. ,,,,.._;„,,i..-.;...,,r,, ,-.. , ,,,,:,..-..--,.::..42:,:'''',-,;',;--1 .'-': t4ettr . , . .. ,..., .....,/,...... ... ... ., ... . . .. , vit t.and 244#41)7 tiiNOfing• 0poinii6ifgoistsfiestitst 0 Aoccosoxy buitals ' : ' - ' ' .. .**irsokoik ' 113 Mufti-60,0Y ' MAIta.citi buitdek , , - °Other, ' • , -.H.- ' • . • '' init 4. :' ,,, -..,:, '. , ad ",,,,s,, 64 7,...„ .41"11- , , ,. , ,,,,..-.,-- A.44 fUltnatte' '41.1...t , .., , . ........- NM 6t Sok0114d6.411:0-no--; .firs*00tVilthez , ' " ..,' ' -86 allM rAICISWerk 1111111111F141/11 -.11/63.^-^-^".''....."'"........1134r''''''''''''''''" ' ' ' "'''• ''' 6:14 Water'S'Stts/ 23..32 . . . '• 6t7 ''' f CAI ilitleCet. Residential holler tradunor or 2*Ironic , 3,32 unit heaters truel-tYPn,not etnctrIci. I i . _ . . in-wall.in-duct,s s•- , ...etc. i 46.75 s Flue/vent for any of above 2132 / ......_. Other: $ 23,32 [ Subdivision: Lot no,: ---- _________—._____________ Other fuel a,t iances: Tax mapipareet do.: i 23 32 , .7,;, ,,r,„:.:,„ Gas liieplsa____eeilnsen-----------1---- 33 34----- ..._._..../;6LS2hyg,i.._........Ef/--if°7":i___A)_e tire lace f 0 ei c‘,0 . ..,22.2.1 ciii z.;, ,, ,.'..Ef.•,,,---..."---..---- Wmat 6 Het stove I '1 33 39 1 r Pip/A4 ifit,'2> Voir 7— A '3 e..‹/....„ vvood rire21..accinIsert ---1---.723, 2 1 , — --f------' Cin liininevAeritlucivent i r,,:74,:iilo.. ,,;;;;-.1'17,,!`"t7,..,. ,•:.,.„..,:e .'--1`,'. .''- ' " ..1;1/tujaftr ' ''- -• _Environmental exhaust and ventilation: Name: Range htxxliother kitchen 1 1 , u/pment _ I 33.39 i Address' --.4_1-----'-_i-lir- --3T4-1----- ____ ____.__ .._ _ Eli...tikes Jr:N,er exhaust ('ItyrStareVIP: Single-duet exhaust(bathrooms, _T__________.____._______...______ toatt c,.)rlipanrricnts,utilia rooms) '' t 23 32 ' Phone:1 t• 1, Fax.( ) -1------i--- , Atticicrantsvec fans "! ', 2;,4, z :'-1--'.':':...:1'''. .ni.'?:::•0.'"S'. '''!...', ''''.. ..''''''',-..;.:';..-1'.`.;.:.,....,L,-,'2.,/'', . a'CONTACT PERSOPi ' ()In'T _ __L1.132 Business name: 6.4,fid 1 L/Ai#67 i,.. :it?c ...E.1.1..fl....0.P.!91;...._ S1-1,15 for first four 14,03 for each additional Contact name: Ili GI cfc__,V pi(Jit.40.'V I unlace.,etc i " . ....•.... „ 65s4J 62.10( ......_._______________ c) .1: K — i 7 zai 7- . --------------f---- .,---4------i Water neater -........._______ _ )'hiwit:(605) t't•••W6Y -...1._ _ 1 itsestace 1 I ... I.-mail, ilactiecue , . _______ _,-------_-- ,, . , ' CiktritACTOR ciothts till et(.as} i lther . , Business name: ill 12, .rfx111E.VP1-7:,/,__3:11ar... — -"---=-- Jo' -------- ME:0E00404k ratidErnItSe Aii.ire,is. /6 -_ rfi,,,'SLite/II' --fig/2r.11.-11-)J2 / .e),2%._, q 2,1,1....... ......... ... Niinimuni pillIlli lee t$90()ti ! Plan revicvi-f2S. ,)of permit lee) 1 ....... C 60 Staic sttrcharce i 1 2to ktf peritut fee) i ., . ___ .... t. li Ia... It)TAI.Pt:RN-11f 1 if iir -: ihia permit application expires if a detain io net obtamett aithitt Veit do...)after it haa bees accepted ir.runvic€0. .. . N e.tuin..lra.e..s.1 signature "..e, 0 . ,cc titctil.xi,:tog, ••.i.4 1,',. : .(.',>‘.3.,1‘Ittoidolg c 1, i'r,L1 11,aarie I PI, " Odic: if.I' oi, ....... A„."- db. • 44“.....ii,...';,I•$,..`1.(Ai lAf 151 Electrical Permit Application a, ,ti `�� ; 1 t)1Z( htli 1_t�1:4JSi',} City Of Tigard , - preen 4 y 13125 SW Hall Blvd.,Tigard,OR 97223 3� t3ete/Review Permit Na: ' '?) 14c' l)�1/ , Phone; 503.718.2139 Fax: 503.598.1960 Plan Review 71 -L1 c,n P 1) Inspection Line; 5f/3,639,4175 - �� <<��nay. Other fermi'. 1, Internet aww.tigard-or.gev ,�C,t } Dale ltaady113y; rvr s: shod: Bee Peso l for 8 TYPE OF WORT[ , n, lir`• _ q __�_ Supplemental V_ :� i 6 Ic PLAN R Num �� a i New construction ',,,,'i ,,'9 1 0 Addition(elteraticrn/re�}t�:ett��t1�• { 3 , Please shade all that apply(submit jvets of piens w/tuns chadced below): ry D Ucmcyltion ©Other: ! �. t © De or feeds 400 craps or more 0 Building over three stones. 1, 0 Marinas nod bo CATEGORY OF � What the aysileb(c fault earrmtt boatyards CONSTRUCTION exceeds 10.000 otoPs at1SOvolts or QFloalmcboildags ►: 1-and 2-family dwelling []Commercial/industrial Accessory building leas to tscx�.or exceeds 14,000agricultural 0 Comings.l•use amps for ell other installations D Multi-family 0 Master builder , 0 Other: ©En, budding`. ©lastallatiaa 01 25 KVA or JOB SITE INFORMATION ANI) LOCATION 0 Emergency system. larger separately derived system. 0 Addition of new motor load of C3"A","E-."i-2""1-3", Job no.: Job site address: 6�L t00HPormore. t„J VV vV? v-1y.. icy. _.. ❑six a mere te,7dertual units City/State/Lip: ©Rectea voltage vehicle parks. 3 r E Q Hwlth-care facilities- 0 sappiy voltage For more than - (3Hazardous location600 vohs nominal.USuitelbld .(u tno I Project name: - 0 service or feeder 600amps or more. Gross street/directions tojob site: FEE SCHEDULE -- . __- rsgcrhgtee 1 4h• I Ree. I TW1 , ' ��� �'_ New residential single-or multi-family dwelling unit. Includes attached garage. F.._Subdivision I Lot no.: 1,0)0 sq,ft,or less 8,54 --1 ___.._ .. r.- _.<-_-- 168,54� 4� I add' portion 33.43 i Tax map/parcel no.: ____........ I __... Limited i DESCRIPTION' OF WORK energy, .f t) nal 75:00 I---_-'- - (with above sq.ft,} e.�'t✓ C ,y' re Litresid energy,nth above sq. L -� ! r(z k• rcsidentiatSwith above 9q,it) 75.00 7 Services or feeders installation,attention,snd/or relocation 200 amps or less 100.70 , 0 0 PROPERTY yOWNER- .© TENANT 201 amps to 400 am Name: � 133.56 „ _- 6 401 amps to 600 amps 21 01 amps to 1,000 301.04Address: ;_I Over 1.000 amps or volts 1 .... 552.2E City/State/ZIP: Temporary aervicea or feeders installation,alteration,and/or relocation Phone;( ) j Fax:(: ) 200 amps or leas / 3 Le 8 ., throe'installation:This installation is being made on property that I own which is not 20I am to 400 snips 125 . intended for sale,lease,rent,or exchange, 401 according to ORS 447,449,67(l,and 7D1. a" to 599 amps 168.54 1 , 2- Owner signature:-, Date: Branch circuits--new,alteration,or exteasioa, r-panel_ __. ---a,r.--._ A.Pao for branch circuits with - © APPLICANT 0 CONTACT PERSON above service or feed`'fee, 7.a2 ` ( ( Feeeeboranch hcuit 2 Business name • jv, _.w.. _i_.•,-.7.. f2., LZ � � - B. for b'a'tch cimaib without _ Contact name 0?aQ(� V Lttx/� brmsersch or feeder fee first 56.18 2 bronellt circuK Address; ���1 541 ✓1"��l�C /QUC'� _—_ Each add'I branch circuit 7.42 _ - ._. 2 .. Miscellaneous City/State/ZIP: (aerviee or feast'not i>tctaderi-m. - .._-'._ OI POA? gizZ( Each rotamanufacturedice a or wor fes lar t dwelling,service staf/or realer 67,84 Phone:( ! ) [4 2 , -- 3�3 7 ��j Fax::( ) Reconnect only 784 2 t E-mail:ALO;? D '. G-�i� P - on co _ Pump or g circle67.84 CONTRACTOR RACIOR Sign or outline lighting 67.84 1-2 Business name; Signal circuit(s)or limited-energy ! 4 r G f� (i t + t alteisti,..Or extension. Rub additioaat imspeetioa ever allowable in of the above_"l Address: 2„ 0"7 / 6 ` ' ,i •Qr 1,4./.74 �/ /�- {� -Additional inspection(!hr min) 66.25/hr (i ty,State1ZiP; 3i u ii, 5,r . b r Investigation(1 hr min) 66.25/hr -7:5.--„0,...9In imolalai Phone:(3 �e- Fax: dam{l h'min) G{!' c7'��i © inspections for xAtich rte fee s CCB Ltc., Z$ ,l (Electrical Lic.:• specifically listed Y hr min) ��' `7•J� l CZ I Suprv.Lie.: ) _ L- , ____ �?9 S 5 F�•�'RICAG`PIGRMIT�>s Suprv,Electrician signature,required: %` 11 ,tit Subtotal: Print name: �/' !J s Pian review(25%ofpermit feet h,_-4.14.-A., : , 4,- Date: (, 12.._I ee): jjhafge(1296 of y -_, ri� l� 'rpermit te Authorized signature: TOTAL PERMIT FEE: ���'� Print`tune: This permit dppl at aspires if per`#la oat ehtaitted within Yeti Date; to ,.'1 2 '(L accepted=complete. Number of:asp:crime allowed per permit I Ewki-mg`ei+ermiuUil.C-Femitapp . 440-4613TO 1/05/C014/WEB Plumbing Permit Application Site Utilities ,,,��� FOR OFFICE USE ONLY . City of Tigard - ,r v 5 s t Received A ' . ,, Date/By: Permit No.: .- q 13125 SW Hall Blvd.,Tigard,OR 2 �..,= �'►15i�� , -‘1041./1 C Plan Review Phone: 503.718.2439 Fax: 503.5 $0 Date/By: Other Permit No.: T1GARD Inspection Line: 503.639.4175 )(\1 � Internet: www.tigard-or.gov (1 Not Ready/By Juns ® See Page 2 for '" TYPE OF WORK i �t Notified/Method: Supplemental Information J :•', FES*'SCHDITLE New constructionr ❑ F- `-t�lrttoa � �� . "'-' . For special information use checklist 1 F1� Description I Qty. I Ea. I Total ❑Addition/alteration/replacement ❑"--112A1‘1.)"' New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 [g 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 ❑Master builder Each additional bath/kitchen 25.02 ❑Other: Fire sprinkler( sq.ft.) Page 2 -"JOB SITE--114FOR1WATI©N AND,LOCATION Site utilities: Job site address: c 2,c_; WA LNu r iF'RR Catch basin or area drain 18.76 I City/State/ZIP: Ti G/IRD , o R Drywell,leach line,or trench drain 18.76 Suite/bldg./apt.no.: I Project name: Footing drain(no.linear fr.:_) Page 2 Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 65 r wltG,V(ei Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water serviceno.linear ft.: Subdivision: I Lot no.: ( -) Page 2 Fixture or item: Tax map/parcel no.: Backflow preventer 1 31.27 DESCRIPTIt flit•,OE WORD, Backwater valve 12.51 NEW CCS Clothes washer 25.02 �ftlC-(roct Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ' 0`PROPERTY OWNER I TENANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Address: Floor drain/floor sink/hub 25.02 City/State/ZIP: Garbage disposal 25.02 Hose bib 25.02 Phone:( ) Fax:( ) Ice maker APPLICANT12.51 0 CONTACT PERSON Interceptor/grease trap 25.022 Business name: 66,ORL ffous� -i'7Ct Medical gas(value:$ ) Page 2 Contact name: IifARk V Ko VR (/ Primer 12.51 Address: ���� SQ ���� d�� Roof drain(commercial) 12.51 !r Sink/basin/lavatory 25.02 City/State/ZIP: Po RAGA 1i g 9322 Solar units �?�a) 3� Ax. !_ (potable water) 62.54 3 "2� ?G 1p 5 :ax:06: Tub/shower/shower pan 12.51 E-mail: Phone:(6� u �fll ( ) Urinal 25.02 Water closet 25.02• Water heater 37.52 name: M/ANZr/uRA P!u/l8' NG Water piping/DWV 56.29 Address: p 0 G DX 820 2 9 I I Other: 25.02 City/State/ZIP: VA NCO(4VER , WA 98682 Subtotal Phone:(360) 772 _$/cls Fax:( ) Minimum permit fee: $72.50 CCB Lie.: 71 76 Plumbing Lic.no.: P 8 Cl/3Q Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: 17 ‘u� TOTAL PERMIT FEE Print name: ,/m 'r MQh z ura I /0-13-/C I Thispermit applicationexpirespermitdays 1 1% Date: / J J if a is not obtained within 180 da s after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I.\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) City of Tigard .74 ' COMMUNITY DEVELOPMENT DEPARTMENT ■ T 1 G A R D Building Permit Review — Residential Building Permit #: Site Address: 8 S W WC^ I 11L Te r r Project Name: IC,OVA, [{y ,S-Fr. (New dwelling=subdivision name;Addition or Alteration=last name of owner) Lot #: Planning Review Proposal: Neu Srtz 7Verify site address/suite#exists and active in permit system. 7 River Terrace Neighborhood: 1 No ❑ Yes,See River Terrace Review Addendum Attached Site Plan Elements: Three(3)copies of site plan Site plan must be on 8-1/2"x 11"or 11 x 17"paper eftisting structures on site of Drawn to scale(standard architect or engineer scale) floor e levahitenewct or e structure(including decks)with finished (North arrow /Utility locations(required for new,mayapply for additions) 121/8ite address,project or subdivision name and lot number pP y Applicant information(name and phone number) ❑�C'nrion of wells/septic systems /Lot dimensions and building setback dimensionsprotection measures retained with drip line,and tree • t'area,building coverage area,percentage of coverage and O'S reet tree size,type and location impervious area(applicable if R-7,R-12,R-25&R-40) Street names /Property 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: 2 � .e.--Public Facilities Improvement(PFI) Permit: 10 r� � No Re aired: pp WA- Required: T q ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake V Land Use Case#: 1.1 Pt 7. 6 " (le) J Zoning: /C y y S Required Setbacks: Front �, gg) Rear 1 ii S Side Street Side ❑ Landscape Requirement: oy0 S S Garage u In—lot Coverage Maximum: 2(Building Height: Maximum Height Z.(y g Actual Height -g—Visual Clearance 2—Easements -a—Sensitive Lands: ❑ Yes ❑ No Type - 'Urban Forestry Plan - Conditions "Met"prior to issuance of building permit Notes: Approved By Planning: (In Q' \. Date: i©h. Li( (,v Revisions (after Building Submittal only) Revision 1: ❑ Approved ❑ Not Approved Reviewer Date Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\B1dgPermitRvw RES_091216.docx Building Permit Submittal Original Submittal Date: /6C/93/0 Site Plans: # '7 Building Plans: # '3 Building Permit#: - ter building permit# ove. it Coordinator "�- Til g Workflow Routing: Tanning ngineering erm Workflow Sign-off: Q-Sign-off for Planning(include notes from planning review) Route Application Documents: a riiiineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. agttilding: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: Date: k�/'d�`�I� By Permit Technician: . ' ?•�G_ Engineering Review 7Slope at building pad: s • ❑ 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: CINOT Approved by Engineering: Notes: Approved by Engineering: ,ii Y Date: /jam—%7--14j 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 Date: ❑ Approved,NOT Released: 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: C Fees Entered: Wash Co Trans Dev Tax: // es ❑ N/A Tigard Trans SDC: i Yes ❑ N/A Parks SDC: /!I Yes ❑ N/A N AK to Issue Permit ,�- JJ Date: / 0//� `'� Approved by Permit Coordinator: I:\Building\Forms\B1dgPermitRvw_RES_091216.docx RECEIVED Clean Water Services Rite Number OCT 182016 16-003912 CRY OF I IGARV BU IL 1 a:4:7 ;,+ti Area Pre-ScreeningSite Assessment 1. Jurisdiction: tdW'a hingtr�n County TIGARD /11577920/6 2, Property Information ie.SIEm':ta.re t S 34A8014{i::i 3. Owner Information __.m.. Tax lot IDis� 5#2? _l>A 0,, S.00 Marne: VI'7,y4L; /40.3/4Le V_ Company_ . wm ora'iY 64,g0 Address ? 5 i Si oi?. Site Address: G+1'R lGf1(e t } _ Guy State zip. Ql c) 22 City, State Zc „„,,,, T/E6LoCRD OR. Phone/Fax: .50 522- NeaFes Croross Str077.0,f bG lio 6,74.6;4..__coin 4. Development I: ... • mit :i all that apply; 5. Applicant Information(pf 3>wa• r Single ;-es dcnc�e worn de tgara je) Narrme. OV/M t " j Lot Line Adiusfiner .J Minor Ladd H Pater 640_,A44 `/ • Resideni a/Con r 1Ii ' in Commercial erci G inn 7 i•°T �. ika trilt3 sir.,, ^ a ,dt ' ._. 5-2 . • Residential „jd,< �r�e��rt� `tta�ct��siGrr .._._._ , I'tgle Let t..f:'r?7'? ('...tri' Muni Lot Commercial City. State. LM ioi f oR7,1A b D 9GC-f Ogler N Gw Iihone?I'ax SOL - _.......,..._ . )fes ... ..�...„...._._� p ii el> 9 E. Will the project involve any off-site work? j Yes Nc iJ tJnSnowri Locution and description of oft-site work T. Additional comments or information that may he needed to understand your project C o ore lie c gfl�� fiLam #7644 � ..� This application does NOT replace Grading and Erosion Control Permits,Connection Permits, Building Permits,She Development Permits, • DEO 1200-C Permit or other permits ac issued by the Department of Environmental Quality, Department of State Lands andior Department of ' the Army COE. All required permits and approvals must ho obtained and completed under applicable focal,state,and federal Iatv.me stoics sits aim tommatimi Mons le:sn minstn st'imititirin Erns:-toi . Eimaititsitt on ri tt t.. a. - cp � vra .g !EPEE _. �.. vv . - i. ,. .ve e�j twirl ,`�S . s t !y j Print/Type Name M 'Oy 4f Print/Type'Title a ,12,33 r' Signature -eliqakaV o Date. 1 _: '" ___ . FOR DISTRICT USE ONLY '..1 'r , °' ;_ v i „ i': THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER ` >s. ., i iiio a ,3 ,;?. {..,rii ?u 1 . ,� • r a # This Service Provider Letter is not valid unless CWS approved site planrei are attached. Date .0._ _w..m...._.._._._..�._._............._..�_ E. r1,Jie'" caml.p , "� .:.. ,. 1Q/i7/16 OR Once complete, er railato: PL evio r cle n atehr ervice .org • Fax ( 03) 6814439 :''?mall too: SPL review, Gear Water SOrec ejn 2_J50 Sk'1 Hillsboro�- liro t^Igh!j'c3;J Hillsboro, Oregon 97123 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 6620 SW WALNUT TER, TIGARD, OR, 97223 May 19, 2017 at 11 :57:18 AM Record Type: Record ID: Residential - Master Permit MST2016-00411 Inspection Type: Inspector: 399 Plumbing final David Young Result: FA I L Comments: Secure CPVC t&p piping at water heater per manufactures requirements. Secure loose lower strap on WH. Provide approved plumbing final inspection for landscape irrigation Backflow devise, PLM 2017-00194 Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 6620 SW WALNUT TER, TIGARD, OR, 97223 May 19, 2017 at 12:00:45 PM Record Type: Record ID: Residential - Master Permit MST2016-00411 Inspection Type: Inspector: 699 Mechanical final David Young Result: PASS Comments: Provide separate mechanical permit for AC installed without permit. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 6620 SW WALNUT TER, TIGARD, OR, 97223 May 19, 2017 at 11 :59:36 AM Record Type: Record ID: Residential - Master Permit MST2016-00411 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS Comments: Note: provide separate permit for AC installed without permit. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 6620 SW WALNUT TER, TIGARD, OR, 97223 May 23, 2017 at 9:07:50 AM Record Type: Record ID: Residential - Master Permit MST2016-00411 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 at kitchen island with approved plans. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 6620 SW WALNUT TER, TIGARD, OR, 97223 May 23, 2017 at 9:04:58 AM Record Type: Record ID: Residential - Master Permit MST2016-00411 Inspection Type: Inspector: 399 Plumbing final David Young Result: PASS Comments: Corrections complete. Violation Summary: Inspector Contractor