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Permit (14) CITY OF TIGARD MASTER PERMIT S^." COMMUNITY DEVELOPMENT >t_ s Permit#: MST2017-00055 TFGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 +l` !. , Date Issued: 02/16/2017 Parcel: 2S112C619300 IMIMM Jurisdiction: Tigard Site address: 15022 SW CORBIN ST Subdivision: CORBIN ESTATES Lot: 10 Project: Corbin Estates, Lot 10 Project Description: New SF. 3/13/2017: REPRINT permit to modify plumbing fixtures. 5/2/17: REPRINTED permit to include NC unit. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 4 First: 1289 sf Basement: 818 sf Left: 5 Parking Spaces: 0 Height: 30 Bathrooms: 4 Second: 1404 sf Garage: 680 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3511 sf Value: $434,165.59 Rear: 15 PLUMBING Sinks: 2 Water Closets: 4 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 6 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: 7 201-400 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 3511 Owner: Contractor: ANDERSON HOMES&CONSULTING LUWESTLAND INDUSTRIES Required Items and Reports(Conditions) 12600 SW 72ND AVE,STE 200 12670 SW 68TH AVE STE#400 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97223 TIGARD,OR 97223 2 Geotechnical Inspection Required before foundation PHONE: PHONE: 503-245-9715 FAX: 503-598-9081 Total Fees: $32,487.51 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all • .- applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of ' --•ce - ' ork is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Not-cation 1 nter;� Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a=••, . •-rules or direct questions to OUNC by call g 503.reo-,'. 9J 1.800.32.2344. Issued By: !�_� —_.. -•• Signature: 1 .63.639.4176 by 7:00 a.m.for the next available inspectio rate. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. M G ilIlcUi i11c211 PeicmiIt oilllC.4 s' x ,� 3 0O r�L�l�i 7 0l�I,P, CIlt✓o f TIlgBrd J Received Date/By: Permit No.: C7.�!, j� ��n �•�t ]3125 SW Hall Blvd.,Tigard,OR 97223 J ..r t I„1,' I Phone: 503.718.2439 Fax: 503.598.1&o Plan Review JJ _'UZio)I Inspection Line: 503.639.4175 S �]Il Date/ Oilier Permit: 1 Internet: www.tigard-or.gov Date Ready/By: .runs: El See Pave 2 for /Ory T G.4RI) Notified/Method: Supplemental Information ���� TI TYPLt,F111I WING DIVISION OKIV'En RCIAL FEE* SCHEDULE- USE CRECICLIST New construction t 0 Mechanical permit fees*are based on the value of the work ❑Addition/alteration/replacement mitrmed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition 0 Other: ,A�( 9 ?. echanical materials,equipment,labor,overhead,and profit. fleilki CATEGORY OF CONSTRUCTION 1W "� Value:$ A1 and 2-familydwellingt NTIAL EQUIPMENT/SYSTEMS FEES* - 0 Commercial/industrial 0 Accessory build:. SW ' �E or special information use checklist. 0 Multi-family 0 Master builder �A 0 Other. "description ' Qty. EaTotal JOB SITE INFORMATION AND LOCATION- l eatusg/cooiimg: Job site address: 1 co� �.` .. (31e 3 I,V\ - Air coni. '.g 46.75 ( .�j' w C..F'Js"'✓1 . o"�0�,E.+0 BTU(ducts/vents) $ 46.75 City/State/ZIP: C 17. c (2 Q '' 10,00!+BTU(ducts/ventsli' � 54.91 Suite/bldg./apt,no.: Project name: Heat.u.•- 61.06 ict work Q 23.32 Cross street/directions to job site: R p 1 Zk oan 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 �I �,� h Flue/vent for any of above 23.32 Subdivision: _�C�4� I Lot no.: / f/ Other 23.32 �� 1 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF WORD{ Gas fireplace/insert 33.39 �,�,r-� Flue vent for water heater or gas y'`t'J.� I l._,....; fireplace 23.32 Log lighter(gas) 23.32 /1 /C j�/ Wood/pellet stove 33.39 • x/47 / 7 7 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 8--PROPERTY OWNER I ❑ TENANT Other: 23.32 Name: t, - Environmental exhaust and ventilation: ps� � �tI /' Range hood/other ldtchen Address: d�00 -(2' E UD 14-. , odryer t 33.39 6`� " ' � Clothes exhaust I� 33.39 City/State/ZIP: �i 6--i OR /2� .- Single-duct exhaust(bathrooms, ^ toilet compartments,utility rooms) moi. 23.32 Phone: e)3 6-39'_��b 7A Fax:( -3 6@2..n I^ 6 2.39 Attic/crawlspace fans 23.32 ' `7 PPLICANT ❑ CONTACT PERSON Other: 23.32 Business name: I�� Fuel piping: 6 ,r' , "mss° $14.15 for first four;$4.03 for each additional Contact name: Q ,,,,c.4 Furnace,/`e, fl Furnace,etc. il Address: Wei _! " ''JJ t f� -�a4,° Gas heat pump City/State/ZIP: r� g� Q Wall/suspended/unit heater Q Q Mb (01,--:** U B`'7 Water heater (t Phone:( . 5h ` ego12P� Fax:: 53 cgs Qog 1p Fireplace H - Range fl E-mail: ( [„'afi�o , L i ( t( 4 Barbecue -�„ CONTRACTOR Clothes dryer(gas) - Other:name: ei4 1f,-1�� M� r, 1P�� MECHANICAL NICAL PERMIT FEES* Address: 5 04 r. QDCi a I� Subtotal /1462. 7C� City/State/ZIP: NMinimum permit fee($90.00) Phone:(SO 1p e 'q_77,2 -0 0 4,�t Fax:( ) Plan review(25%of permit fee) 1 State surcharge(12%of permit fee) S. k r CCB lic.: 2 O S c"fI '; TOTAL PERMIT FEE c j(0/ This permit application expires if a permit is not obtained-within ISO Authorized signatu + \ 4,,�/ days after it has been accepted as complete. '� -- * Fee methodology set by Tri-County Building IndustryService Board Print name: 17yri).)-( etI 4 r^•r 1.�� VU,t^35Bate: "16/ 1 7" '�( � 111 �. ,,,,_• 4dn.ea1 rr0Iu01irOMny5Bt CITY OF TIGARD MASTER PERMIT t ►� .i1, COMMUNITY DEVELOPMENT Permit u: MST2017-00055 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/16/2017 Parcel: 2S 112C B 19300 Jurisdiction: Tigard Site address: 15022 SW CORBIN ST Subdivision: CORBIN ESTATES Lot: 10 Project: Corbin Estates, Lot 10 Project Description: New SF. 3/13/2017: REPRINT permit to modify plumbing fixtures, BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 4 First: 1289 sf Basement: 818 sf Left: 5 Parking Spaces: 0 Height: 30 Bathrooms: 4 Second: 1404 sf Garage: 680 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3511 sf Value: $434,165.59 Rear: 15 PLUMBING Sinks: 2 Water Closets: 4 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 6 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: 7 201-400 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 r)thst u 00 i. C ng. y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 3511 Owner: Contractor: ANDERSON HOMES&CONSULTING LLMIESTLAND INDUSTRIES Required Items and Reports(Conditions) 12600 SW 72ND AVE,STE 200 12670 SW 68TH AVE STE#400 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97223 TIGARD,OR 97223 2 Geotechnical Inspection Required before foundation PHONE: PHONE: 503-245-9715 FAX: 503-598-9081 Total Fees: $32,435.15 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 throu. 00R•R•101 00•0. You may obtain a copy of the rules or direct questions to OUNC by calling 5 ...... .1987 or 1.800.332.2344. Issued By: Air Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspec' n date. This permit card shall be kept in a conspicuous place on the job site until completion of th project. Approved plans are required on the job site at the time of each inspection. III CITY OF TIGARD MASTER PERMIT • COMMUNITY DEVELOPMENT Permit#: MST2017-00055 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/16/2017 T t C.,�R Dg Parcel: 2S112CB19300 Jurisdiction: Tigard Site address: 15022 SW CORBIN ST Subdivision: CORBIN ESTATES Lot: 10 Project: Corbin Estates, Lot 10 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 4 First: 1289 sf Basement: 818 sf Left: 5 Parking Spaces: 0 Height: 30 Bathrooms: 4 Second: 1404 sf Garage: 680 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3511 sf Value: $434,165.59 Rear: 15 PLUMBING Sinks: 2 Water Closets: 1 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 6 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 6 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: 7 201-400 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 3511 Owner: Contractor: ANDERSON HOMES&CONSULTING LLCWESTLAND INDUSTRIES Required Items and Reports(Conditions) 12600 SW 72ND AVE,STE 200 12670 SW 68TH AVE STE#400 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97223 TIGARD,OR 97223 2 Geotechnical Inspection Required before foundation PHONE: PHONE: 503-245-9715 FAX: 503-598-9081 Total Fees: $32,435.15 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. 1 r Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. T. rules are set forth in OAR 9 -001-0010 through♦A R 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503. 19; '.800. .2.2344. Issued By: # Apt/ �. 1 —i Permittee Signature: ;/ Call 503.639.4175 by 7:00 a.m.for the next available inspection �� This permit card shall be kept in a conspicuous place on the job site until comp ion of the project. Approved plans are required on the job site at the time of each inspection. Buiidhww Permit Avplic tfail Residential RECFIvr ,,. ,. ..,„. �; ;�' � . X655 K Received 7 Permit No.:is a City of Tigard Date/By: 7.'006,50 i l Bone SW 711 Blvd.,Tigard'503.598.'19-6W Q3 98'1 6' p ,LI 1` Plan Review a �"' 17 Other Permit: Phone: X03.71!.239 Fax 403.6 5.1 6' t� /_ .- Date/By: l7_ � u s: p See Page 2 for Inspection Line: �03.639.4I75 Date Ready/By: Supplemental Information Y�* D= , T pGA Notified/Mietliod: f /7 / pp' ��, •.,. � Ilntelnet: www.tigard-or.gov 1....,i�& 9 �i � REQUIRED-DATA:1-AND 2-FAMILY DWELLING NPemvt fees*are based on the value of the`Fork performed. New construction ❑Demolition Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the ❑ dditio ilalteratior/replaczmznt ❑Other: work indicated on tl s application. 43(T 1+1____LG_‘.__ CATEGORY OF Cbl'dSTR.IACTIOAI Valuation: S (=��=Z� ±: and 2-family dwelling ❑Commercial/industrial is Number of bedrooms: ❑Accessory building ❑Multi-family � � Number of bathrooms:❑Master builder ElOthe, JOB SITE INFORMATION AND LOCATION Total number of floors: '7 - � a� New dwelling area square feeit Job site address: a�js 0 v City/State/ZIP: ''� ^1 �► 4,7l►� Garage/carport area: ,0 6 square feet 4 , __ . +� Covered porch area: square feet t^► a Suite/bldg./apt.no.: Project name: 4 l�y � � i� '-=r 1� Cross streeddirections to job site: 0 '7° ,i tik Deck area: _Au,- square feet Other structure area: a square feet REQUIRED DATA:COI t E EIA L-USE CHECKLIST Subdivision: GS"r Lot no.: D 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.: equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. —_ t� Valuation: $ Existing building area: square feet New building area: square feet PROPERTY OWNER 0 TENANT Number of stories: Name: TI4 gc: 11* _ Type of construction: Address: 1'1...4(00 0 474--:'. ' Occupancy groups: City/State/ZIP: t lF� .7Existing: _ -sus Phone:( �yier? 1-,1,7,45.2,_--= Fax:( 6' �: 40 _.. New: - ! - I3C?IILII�GFEf �Ip FEES* t_' 0 ec ACT >aE> fRdare i-Ar t®.^e a kcdulil Business name: s `ice..t=1„ _,.iii.,,, ,,_; ' n, RStructural� lan review fee(or deposit): Contact name: aji i,e.1 : FLS plan review fee(if applicable): Address: ___1/4_,>: A. Total foes due upon application: j City/State/ZIP: tr 1, 1 jt ' me- '`e Amountreceived: sJ t----.-F-9c) z� Phone: "�a� f,y�- Fax: :( �� ( �'-�d . ti� = _ ���_ `` PHOTOVOLTAIC SOLAR PANEL��'ST'EINI FEES:* E-mail: L �, ` �� � ���: •�` t ' 1 Commercial and residential prescriptive installation of CONT CTOi roof-top mounted PhotoVoltaic Solar Panel System. , ` Submit ,o(2)sets of roof plan with connection d- s Business name: �� � I n and de.artneacross,along with t Address: Solar Insra •tion Specially Code cklist. . � Permit e(includ_ .'an review 5180.00 City/State/ZIP: 1 - lit- q an. = inistrativenfees): Phone:( 0, � - . Fax ( `-= 6-1,00 i State sur rge(12>.of permit fee): 521.60 CCB lie.: otal fee due upon ap anion: 5201.00 Authorized signature: ( _ Tilts permit-Pprcatio,expires it a .'t is not obtained ,>ithin ISO days after i.I-ras been accepted as complete. ,� ` *Fee methodology set by Tri-County Building Industry Print name:CA-1; n. Wte...i&L— Date: pit° I '7 Service Board. TVi1 1[lld1L Ile1 I k111/nllt1!D�^lilIlc4i x y j� Tom© iiCi[ iysi D ��� City ofTigard .d Date/By: Permit No.:i.,7570-x,/7,--e $3 `, 13125 SW Hall Blvd.,Tigard,OR 97223 C tl A a Plan Review /1" f'' Phone: 503.718.2439 Fax: 503.598.1 Other Permit: ::'Y $ D p Date/By: Inspection Line: 503.639.4175 I`�1I�D C3 2 J 1 ruris: 0 See Page 2 for i f�I.c� J Date Ready/By: Internet: www.tigard-or.gov Notified/Method: Supplemental Information � ��yy�� Y TIGOF TYPIPt�Flllwiti II I)IMO%1 COMYT.RCIAL FEE* SCHEDULE - USE CHECKLIST New construction Mechanical permit fees*are based on the value of the work ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* --and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATIONHeating/cooling: I -66O� ` $2 - Airconditioning0, 00 46.75 Job site address: •`w, Furnace 100,000 BTU(ducts/vents) ( 46.75 City/State/ZIP: p;'1�•-�� R'???;7) Furnace 100,000+BTU(ducts/vents) 54.91 �,� iill�� �� k ��?� 61.06 Suite/bldg./apt.no.: Project name: Heat pump Duct work l 23-32 Cross street/directions to job site: 0 II --ojlt �fvU 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 h Flue/vent for any of above 23.32 Subdivision: r" -1 p ,1''? Lot no.: I /� Oma' 23.32 'e� 1 1 • moo- v Other fusel appliances: Tax map/parcel no.: Water heater (I 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 Flue vent for water heater or gas r "� 7-9, 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 PROPERTY OWNER ❑ TENANT Environmental exhaust and ventilation: Name: 3 -- � Range hood/other Idtchen r� 1 � equipment k 33.39 Address: jVi oD,O e,2 , G' 1' 'l 2_'v 1 33.39 1� �� � Clothes dryer exhaust �, City/State/ZIP: 0 9 /� Single-duct exhaust(bathrooms, u 4 � (�� � toilet compartments,utility rooms) c k 23.32 Phone:(-,70-3.__ L 611° � �-l '��J� Fp� Fax:( �3 �,�ha — d2. SR Attic/crawlsace fans 23.32 Attic/crawlspace VI-APPLICANT ❑ CONTACT PERSON Other: Business name: p �� �l �� `� Fuel piping: U��s1l"'���%vijel 1 �� =t S-, r�/E,5 D� _(S° $14.15 for first four;$4.03 for each additional Contact name: r ,,,,,..4 l to AMP-i)A Furnace,etc. il lr g I u•�, Gas heat pump Address: ° -�j, 1` - Cy Walllsuspended/unithcater City/State/ZIP: T%6aA(A l U q7 a,`'/ Water heater Phone:( Sp`'-'2,? „ 1I : 010 o Fax::(Qt, v 1 1p Fireplace _Range 11 Email: 1511cu',,e11pD 1b_ )1 II Barbecue CONTRACTOR Clothes dryer(gas) ti Other:name: `� Lv r Q'r 5 i I,4 ...ii` � 1<. r rLCHANICAL PERMIT FEES* Address: c 04 P--,'Ql) uQ .-- i''S1b Subtotal Minimum permit fee($90.00) City/State/ZIP: Plan review(25%of permit fee) Phone:(cry' - qt5g -0 e 4 ) Fax:( ) State surcharge(12%of permit fee) CCB lie.: 2,l S Toil i; TOTAL PERMIT FEE k,,'"------ This permit application expires if a permit is not obtained within 180 1 days after it has been accepted as complete. Authorized !11 T�1= signal n J i- d * Fee methodology set by Tri-County Building Industry Service Board ��,1� / 1 7 Print name: ((�� s �U Cate: aan-CF,7T rn im/COMAVEBI 1 ¶ n z. ra i 1IeC�\u�c111t ) C2Tf IrL ii I�I1Cc11 Qf I] !lITV rt ? v 1 ti llf r-, ��J 0. 1 Received Tigard City®fIlgaDate/By: Permit#: S r p i7_e`v r �-o p°. 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ' 'N.I Phone: 503.718.2439 Fax: 503.59,. 0 5 ?L H Date/By: Related Permit#: ` '1'`- a Inspection Line: 503.639.4175 Ready Date/By: Jvris: Q See Page 2 for t Internet: www.tigard-or.gov CCTV IC k Notified/Method: Supplemental Information TYP � °,3c � rrt . PLAN REVIEW '�°°� '` `` #n Please check all that apply(submit 2 sets of plans w/items checked): New construction ION ❑Additi era'iion7repIacemeS ❑Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings. n,.1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 El Commercial-use agricultural baMulti-family ❑Master builder 0 Other: for all other installations. buildings. ❑Fire pump. ❑Installation of 150 KVA or SOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: Job site address: I��32. k _ 100HP or more. ❑"A","E","1-2","1-3", `•� T, 0 Six or more residential units. occupancy. City/State/ZIP: O C c`1..A- 6'9— !/77,› ;G-' —,3R 9 ❑Recreational vehicle parks. J 0Health-care facilities. 0 Hazardous locations. ❑Supply voltage for more than Suite/bldg./apt.#: Project name: 600 volts nominal. 0 Service or feeder 600 amps or more. Cross street/directions to job site: EA sf tr , le4u �rtFEE SCHEDULE Description 1 Qty. I Each I Total 1 * New residential single-or multi-family dwelling unit. Subdivision: Ca (i'ST A g P Lot#: /D Includes attached garage. ` 111 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential �_ C �n`'' (with above sq.ft.) 75.00 2 �J1 � Limited energy,multi-family 75.00 2 residential(with above sq.ft.) "')POPERT' OWNER4 t Renewable Energy 111 See Page 2 0 TENANT Services or feeders installation,alteration,and/or relocation Name: 200 amps or less 100.70 2 201 amps to 400 amps 133.56 2 I-1 401 amps to 600 amps 200.34 2 City/State/ZIP: q Q( r 0 t `2 2�� 601 amps to 1,000 amps 301.04 2 Phone: r N�15��D �' Over 1,000 am s or volts 552.26 2 cp 1031 a - Fax:( �3 (0 akil 0 P Email: Temporary services or feeders installation,alteration,and/or relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 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 X.APPLICANT I ❑ CONTACT PERSON Branch circuits–new,alteration,or extension,per panel A.Fee for branch circuits with Business name: Wabove service or feeder fee, ��lh=1 � 7.42 2 each branch circuit Contact name: (co Ail J1` R I ° /j,( B.Fee for branch circuits without service or feeder fee,first (l 2,4910 r p1� l0 f It -. branch circuit 56.18 2 Address: l City/State/ZIP: ' _p t n' q 7 ,..5. Each add'l branch circuit 7.42 2 Phone: �,e Fax:: ry Miscellaneous(service or feeder not included) (9 end >a�7 ( �,) -Rc�,q®�V Each manufactured or modular 67.84 2 C dwelling,service and/or feeder Email: rC? —t i iE �y A ,J ® �� '4 � s�Il A Reconnect only 67.84 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: 9 Sign or outline lighting 67.84 2 Address: p.c.) l'''' ® Signal circuits)orlimited-energy ClSee Page 22, o panel,alteration,or extension. City/State/ZIP: jj Each additional inspection over allowable in any of the above <0 it _ 7-6� C � Additional inspection(1 hr min) 66.25/hr Phone:( ) Fax: (` � u�� � I'� Investigation(1 hr min) 90.00/hr Email: (9 � I�� Industrial plant(1 hr min) 78.18/hr u�1 " ` " "9iy "a_���'( ��� Inspections for which no fee is 90.00/hr CCB Lic.: Q OD ill 7,- Electrical Lic.: gJ a 57) (9- ayrv.Lick)p o 5 specifically listed(%lar min) F ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: al 'fb� 9 1 F,CAI) Date: S 1 7 0 Plan Review Required(25%of permit fee): 11 -{ State surcharge(12%of permit fee): TOTAL PERMIT FEE: Authorized signature: ,, 1 This permit application expires if a permit is not obtained within 180 Print name: r Jai , (� �� Date: Li/ I days after it has been accepted as complete. l �� II * Number of inspections allowed per permit. I5.Building\Permits.ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615 (It/OS/COM/WEB UIlild g ifixtuTre§ ,' 4_.iiiTcn D1RI1�1-az 1. ls DMZ City of Tigard Received I Permit �,. j J) 8 2 0,C Date/By: "1.. {0 13125 SW Hall Blvd,Tigard,ORFa3 Plan Review h �� Phone: 503.718.2439 Fax 503.59816 Other Permit No.: Date/By: '-t: Inspection Line: 503.639.417€in Or GARB. d See Page 2 for Th R�I Date Ready/By: Jwis: Internet: www.tigard-or.go i r , T ~!.x ,r . Notified A4ethod: I Supplemental Information �� TYPE 11�.r;u •{ i FEE* SCHEDULE '5-7-New construction ❑Demolition For special information use checklist. Description I Qty. Ea. 1 Total ❑Addition/alteration/replacement ❑Other: New fl-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath t 312.70 -and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 SFR(3)bath ❑Accessory building I I 500.32 ❑Multi-family Each additional bath/kitchen 25.02 Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 I JOB SITE INFORMATION AND LOCATPON Site utilities: rob site address: 6°012.0, �j( �' Catch basin or area drain I 18.76 Drywell,leach line,or trench drain 18.76 ilia'/State/ZIP: p} -- ��;;�J c----,'(.7-7,_-7, °lJ`� i h�J�ir- Footing drain(no.linear ft.: Page 2 >uite/bldg./apt.no.: Project name: Manufactured home utilities I 50.03 I ;Foss street/directions to job site: Manholes 1 18.76 C(� /( e �6� A�--FA„ Rain drain connector I 18.76 Sanitary sewer(no.linear ft.:_) ( Page 2 Storm sewer(no.linear ft.:_) I I4 Page 2 �� _� Water service(no.linear ft.:_) ➢ Page 2 'ubdivision: 1 U i�S9 Ai r_11/1 Lot no.:10 Fixture or item: 'ax map/parcel no.: Backflow preventer I 31.27 I Backwater valve i I 12.51 DESCRIPTION OF WORK Q 25.02 h\-3\--e-A-1 z-- Clothes washer �� �'--' Dishwasher 25.02 I Drinking fountain 25.02 I Ejectors/sump 25.02 I PROPERTY OWNER El TENk P Expansion tank 12.51 ame: ( ' (24ç .4 ^� e. _ Fixture/sewer cap 25.02 ddress: /+ ����' l�� ��y Floor drain/floor sink/hub 2502 �^�'V,Fj, � �� Garbage disposal 25.02 ity/State/ZIPr( ir 0 Q7 7 Hose bib .- 25.02 Sone: tos , Vp'2A Fax:( t .:__..-'3 Ice maker 11 12.51 DIAPPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 usiness name: U ,_,q1,-,_.,,,,,-,-) Medical gas(value:S ) Page 2 a ,, (Li J���° Primer 12.51 ontact name..p oft -1-.G�-b A�je- ddress: �� a p Roof drain(commercial) 12.51 7> 7� ,_, b 1� z V L Sink/basin/lavatory atory � 25.02 ity/State/ZIP: fp(5 ____ �c�� Solar units(potable water) 62.54 I tone:( /% so 2 Fax::(9V r_X78 o 5 (2,_ ` Tub/shower/shower pan 12.51 mail: UUrinal 25.02 Water closet 25.02 CONTRACTOR isiness name: �j CJ C Water heater 37.52 trZAf�pJ16' )���'/ Water pipins/DWV 56 29 3dress: it ---)AS' Opp-4 SII L= 25.02 Other: ty/State/ZIP: 7)fizr0 '�'0-9 0l'�' �7 phi J, Subtotal lone:( ) I Fax:( ) l Minimum permit fee: 572.50 7,B Lic.: q(0)''' --Plumbing Lic.no.: 2- �'J o ep StztePlan surchargereview ((2125%% ofof pperermitmit ffeeee)) ithorized signatore R tteofuta, TOTAL PERI RIT FEE o int name: G' ^ s This permit application expires if a permit is not obtained within ISO days ipop Date: ��� ��� i IIS ( � o 11 after it has been accepted as complete. 'Fee methodology set by Tri-County Building Industry Service Board. ,,il,m,epPrm:!c\Pr 1,41 i_PP.-n ir5.....:n.. In/nl/no nnn ACiCT/in/nn/r�r�nl,rn City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT ■ T 1 G A R D Building Permit Review — Residential Building Permit #: H 6T am 7 - OoO 5-5— Site sSite Address: I S 022 S W C c r b t,r I f Project Name: CX)c b i n Es iT�}-e j Lot #: i0 (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: N of V ,� 'r LI Verify site address/suite#exists and active in permit system. 2.1 River Terrace Neighborhood: A No ❑ Yes,See River Terrace Review Addendum Attached Site Plan Elements: AThree(3)copies of site plan -BM-listing structures on site •Site plan must be on 8-1/2"x 11"or 11 x 17"paper -B'Footprint of new structure(including decks)with finished Drawn to scale(standard architect or engineer scale) floor elevations North arrow j2rUtility locations(required for new,may apply for additions) Site address,project or subdivision name and lot number ,DLec-ation of wells/septic systems Applicant information(name and phone number) n ,g trees to be retained with drip line,and tree pLot dimensions and building setback dimensions protection measures -BLOT area,building coverage area,percentage of coverage and JZStreet tree size,type and location impervious area(applicable if R-7,R-12,R-25&R-40) C 'Street names Property corner elevations(2 foot contour lines if more than / 4 foot differential) PiClean Water Services-Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified E No Received: ❑ Yes ❑ No Public Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified El No Applied For: ❑ Yes ❑ No,stop intake Land Use Case#: S UA 2-L) 1 z-1 — 0 U C o C7 0 Zoning: R-, 1 , /`J Required Setbacks: Front 2,C Rear I S Side 5 Street Side 1 c' Garage -LP V Landscape Requirement: — 0/0 Lot Coverage Maximum: — 0/0 Building Height: Maximum Height Actual Height 2 S. 3 gVisual Clearance basements ❑ nsitive Lands: ❑ Yes ❑ No ift-TTrban Forestry Plan U_.Cenditions "Met"prior to issuance of building permit Notes: Approved By Planning: /t/k n-(2.._ -- e,f lc cL Date: z/ I I Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved El Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw RES 091216.docx Building Permit Submittal Original Submittal Date: Site Plans: # Building Plans: # Building Permit#: ❑ Enter building permit#above. Workflow Routing: ❑ Planning ❑ Engineering ❑ Permit Coordinator ❑ Building Workflow Sign-off: ❑ 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. ❑ Building: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: Date: Engineering Review Slope at building pad: /3•4 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 if No Assess Water Quantity Fee in-lieu: ❑ Yes No LIDA Facility on lot: ❑ Yes No ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: id_Z___P___ Date: _07/4).4 7 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: ?6) DC Fees Entered: Wash Co Trans Dev Tax: r'. es ❑ N/A Tigard Trans SDC: r Yes ❑ N/A Parks SDC: •4111 Yes ❑ N/A OK to Issue Permit J y Approved by Permit Coordinator: Date: .).../y.) -- � I:\Building\Forms\BldgPermitRvw_RES_091216.docx City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15022 SW CORBIN ST, TIGARD, OR, 97224 August 21 , 2017 at 1 :28:38 PM Record Type: Record ID: Residential - Master Permit MST2017-00055 Inspection Type: Inspector: 199 Electrical final Aaron Cillo-Gobel Result: PASS Comments: Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15022 SW CORBIN ST, TIGARD, OR, 97224 October 11 , 2017 at 11 :19:10 AM Record Type: Record ID: Residential - Master Permit MST2017-00055 Inspection Type: Inspector: 299 Final inspection David Young Result: FA I L Comments: Provide permit and test report for landscape irrigation backflow devise. Caulk and secure sinks in upper level main bath. Provide duct seal test report or blower door test report. Provide insulation certification. Provide street tree certification. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15022 SW CORBIN ST, TIGARD, OR, 97224 October 17, 2017 at 11 :55:19 AM Record Type: Record ID: Residential - Master Permit MST2017-00055 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 kitchen island . Violation Summary: Inspector Contractor