Permit (53) Plumbing Permit Application
Site Utilities
RECEIVED FOR OFFICE USE ONI.I
City of Tigard Received
11 13125 SW Flail14 Blvd.,Tigard,OR 972233.��.p. t� 2017 Date/By: �42_4� PermitNo.: �j
= Phone: 503.718.2439 Fax: 503.598.19ptlI�Y 31 Plan Review �ST�U�7 �U�1
TIGARD
Inspection Line: 503.639.4175 Date/By: 6 26-/7 4{., Other Permit No.:
Internet www ti and or ovDate Ready/By: ® Page2
g g CITY OF TIGARDJans See for
Notified/Method:5 n , ��d1 i/,"l Supplemental Information
. .. ,. W,;. x"`�„�' � '-'94,-- -;,;•,:'' ;.c�*$.;W%'.a AMYrT�,Tx '‘':N
For special information use checklist
®New construction ID Demolition
❑Addition/alteration/replacementDescription Qty. Ea. Total
❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
.,..< +4 * ,: ;, ., SFR(1)bath 312.70
❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building ®Multi-family SFR(3)bath 500.32
❑Master builder Each additional bath/kitchen
❑Other: 25.02
Fire sprinkler(1,221 sq.ft.) -- Page 2
iQB iii?gsifC iw " I�` *. W A .* Site utilities:
Job site address:13576 SW Beach Plum Terrace Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain 18.76
Suite/bldg./apt.no.: I Project name:NW River Terrace Footing drain(no.linear ft.: ) Page 2
Manufactured home utilities 50.03
Cross street/directions to job site:
Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Subdivision: Water service(no.linear ft.: ) Page 2
I Lot no.:213 Fixture or item:
Tax map/parcel no Backflow preventer
31.27
'' A ` 1 1� i� �`-000000 . < Backwater valve 12.51
Multipurpose Fire Sprinkler System Clothes washer 25.02
Permit#MST2017-00082 Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
r,1... gds 1 t ; i , Expansion tank
12.51
Name:Polygon Northwest Fixture/sewer cap 25.02
Address: Floor drain/floor sink/hub 25.02
City/State/ZIP: Garbage disposal 25.02
Phone:( ) Hose bib 25.02
Fax ( ) Ice maker
12.51
-,::::,". ..4,,',141:410044:44. 04..,.,. � �iiii, .4 - Interceptor/grease trap 25.02
Business name:Alliance Plumbing,LLC Medical gas(value:$ ) Page 2
Contact name:Robert Dishman Primer 12.51
Address: 146 W Historic Columbia River Hwy Roof drain(commercial) 12.51
Sink/basin/lavatory 25.02
City/State/ZIP:Troutdale,OR 97060
Solar units(potable water) 62.54
Phone:(503)492-3490 I Fax::(503)912-6438 Tub/shower/shower pan 12.51
E-mail:robert.dishman@allianceplumbing.net Urinal 25.02
.�... �. .. ', 4 : Water closet 25.02
V ; , Water heater
Business name:Alliance Plumbing,LLC 37.52
Water piping/DWV 56.29
Address: 146 W Historic Columbia River Hwy
Other: 25.02
City/State/ZIP:Troutdale,OR 97060
Subtotal
Phone:(503)492-3490 Fax:(503)912-6438 Minimum permit fee: $72.50
-
CCB Lic.:184601 Plumbing Lic.no.:PB732 Plan review (25%of permit fee)
Authorized signature: r J/ State surcharge(12%of permit fee)
TOTAL PERMIT FEE
Print name:Gavin Thornes I Date:5/24/17 I 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-PermitApp.doc 10/01/09
440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
.s���x;, � �>... �°��1�.., .., .,,�,: _<. $121 90
Footing drain 1''100' 50.03 0 to 2,000
2,001 to 3,600 $169.69
Footing drain-each additional 100' 37.52 3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
r� � i p `yam
Water Service-each additional 100' 37.52 �.."� � � :' � �-:��
Storm&Rain Drain-1st 100' 62.54 --'$1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
each additional$100.00 or fraction thereof,to
leFvei '004
�� � and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge—1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge—2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
$50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
90.00/hr
Additional plan review for revisions each additional$100.00 or fraction thereof.
(minimum charge—1/2 hour)
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*.
44041,1 by* titre. .,
tar Type fqr Plan review is required for any of the following.
Its, 9
aittet
i� reiibrt -,;.; ., ... Please check all that apply.
Baptistry/Font 0 Any new commercial building with water service 2"and
Bath -Tub/Shower greater,except systems designed and stamped by licensed
-Jacuzzi/Whirlpool engineer.
Car Wash -Each Stall ❑ New exterior plumbing site utilities for any complex structure
-Drive Thru as defined in OAR918 780 0040.
Dishwasheruspidor/Water Aspirator D ❑ Medical gas and vacuum systems for health care facilities.
-CommercialAny multipurpose fire sprinkler system.
Domestic ®
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-004 .
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink -2"
_4„ < f 'O1
Car Wash Drain ❑ Isometric or riser diagram is required for new buildings
Garbage -Domestic-non-food that meet the qualifications above.
Disposal -Domestic-food related
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes increase of sewer EDUs,a sewer permit will be issued and
Water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
\\up-dc2\home\gavin\My Documents\Fire Sprinklers\RT\City of Tigard Pqmit.doc
CITY OF TIGARD MASTER PERMIT
II ~ ii
- COMMUNITY DEVELOPMENT Permit#: MST2017-00082
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/13/2017
Parcel: 2S 106DB21300
Jurisdiction: Tigard
Site address: 13576 SW BEACH PLUM TER
Subdivision: RIVER TERRACE NORTHWEST Lot: 213
Project: River Terrace Northwest, Lot 213
Project Description: New SFA. Building/unit 13.3
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 2 First: 97 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 32 Bathrooms: 2 Second: 562 sf Garage: 453 sf Front: 8 Smoke
Dwelling Units: 1 Third: 562 sf Right: 0
Detectors: Yes
Total: 1221 sf Value: $161,959.20 Rear: 5
PLUMBING
Sinks: 1 Water Closets: 2 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 2 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain0 Storm Sewer: 100
Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 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: 3 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: 2 201-400 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 Y
Dtt '_g -Other Ecompasing'
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SFA VB R-3 1221
Owner: Contractor:
ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
BY FORSUM,MICHAEL 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175
7600 E DOUBLETREE RANCH RD VANCOUVER,WA 98660
STE 1
SCOTTSDALE,AZ 85258
PHONE: 602-964-4031 PHONE: 360-695-7700
FAX:
Total Fees: $22,693.84
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•,R 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. J
---
„0111111/ /974//'Lid 'L`
Issued By: r — Permittee Signature: Zl�� ��
Call 503.639.4175 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.
C
Building Permit Application " ; �'
Residential FOR OFFICE USE O\L'
City of Tigard t,,=(' ; )( i F wed 212(11? ��� Permit 1,,,,,;1449-A0/?'(x�
13125 S W Hall Blvd-,Tigard,OR 97223 PlanReview C �Q pc
II 3. ' ,54.4 12"arm
Phone: 503.718.2439 Fax: 503.598.196@ D��Y
Inspection Line: 503.639"4175 H See Page 2 for
^ Date Ready/By. � "' F
T]G A R D Inteimet www.tigard-or.gov II, f Notified/Method:.S 17 Supplemental Information
LCI
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€ te` ° l : ,�# f '. - a ; 3 :4-.
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' -r _r.=--x-'`_ ...:" :,:r.,....,,,,,,-1,-:-._----,- _�� x".�t __.;v.3sT�= ,.-r 3- _. _= :Ir_.1.r.1..._s -....Y4. �,_ y
L®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
❑Addition/alteration/replacement 0 Other. equipment,materials,labor,overhead,and the profit for the
Wit, ,'s ej >Q ` - i- —Valuation:�t6 $ _`
- work indicated on this application.
Val n: 6
-tti,k) t
— 1-and 2-family dwelling ❑Commercial/industrial j. j
Number of b
❑Accessory building Multi-family oms: Z
Number of bathrooms: a"9
❑Master builder 0 Other:
--, � 4 - Total number of floors:
Job site address: / 351(o SW eNN ?k m Te, `ikt, Nevv dwelling area 1 square
feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: (. 57) square feet S L k
Suite/bldgJapt.no.: /3 i J Project name:River Terrace Northwest Covered porch area: 3(40 square feet,s" ,
Cross street/directions to job site: Deck area: lI' 7 6 square feet 9 7
Other'sfruucture area 7 6 square feet
Subdivision:River Terrace Northwest Lot no.: -LI 3 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
•�- "` a -"g �j"y-`"fit`' �7 ' T-' ` �'^� " " work indicated on this application.
� ,.
Valuation:
Existing building area: square feet
New building area: square feet
- � -.s-` µ - f. j d- Number of stories:
u�.v F • _::nom.-__._s.._ .�i:C x�_ v.1Z�—� .____.+".,nS'i:_"iNgr tr £-'-b,,-vr_
Name:ADVL Land Holdings,LLC Type of construction:
Address:7600 E Doubletree Ranch Road Occupancy groups:
City/State/ZIP:Scottsdale,AZ 85258 Existing:
Phone:(602)694-4031 Fax:( ) New:
`T,. i�_--x _.,.1Fs:7" �.f'4 4 k- 1£# :,0.' T ''u!":.g;+E* ..:i wo =�:.•�•ssc a d �- t1 :. '
..._._ _ :"`rte 1� ,� r� ;•-.
Business name:Polygon WLH,LLC Structural plan fee(or deposit):
Contact name:Angela Grajewski FLS plan review fee(if applicable):
Address:109 East 13th Street
Total fees due upon application:
City/State/ZIP:Vancouver WA 98660
Amount received.
Phone:(360)695-7700 I Fax::( )
E-mail Angela.GrajewskiQpolygonhomes.com
,_ _ •` � `°:t} i..._ _- rooCommercial
op mounted PhoiottoVo talprescriptive
Solar Paninstallation
l System.of
Business name:William Lyon Homes,Inc Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 109 East 13th Street Solar Installation Specialty Code checklist.
Permit Fee(includes plan review $180.00
City/State/ZIP:Vancouver WA 98660 and administrative fees):
"gone:(360)695-7700 Fax(360)693-4442 State surcharge(12%of permit fee): $21.60
1 _.,B lic.:207247 Total fee due upon application: $201.60
This permit application expires if a permit is not obtained
Authorized signature: � _ within 180 days after it has been accepted as complete.
�wVVV�
Print name:Angela Grajewski Date: i t-j i n � '/ Fee methodology set by Tri County Building Industry
� � /) Service Board.
\
L\Building\PermitsBUP-RESPermitApp.doc 02/24/2011 440-4613T(111'/02/CO 'M/WEB)
J
City of Tigard Pmt ha: ....__�
/.1IN.--r:- ST
. 13125 SW Hid!Blvd,,Tigard,OR 97223 r '�iY,fJ
Plan Review• Phone: 503.718.2439 Fax: 503598i960 Date/By: Other Permit: t
Inspection Line: 503.639.4175
T I ci ,..t) DAM Reahy/By, rerie ffiPage 2 for •-
Internet: www.tlgard-or.gov Notified/Method: Sttppil teatt�i information
i , E
-.
+ G .n. t,rl �fxgµriCL �yga�� 7i� sr .*fa"•' i, yririt.- _.. x9M
Mechanical permit ccs"are based an the Value
of the work
®,New construction ❑Addition/al teration/repiaticnicnt performed.Indicate the value(rounded tri the nearest dollar)of all
0 Demolition ❑:Oilier: mechanical materials.equipment,labor,'Overhead,and profit.
5 y y ''.Y'^4nn�y�'sr (.�.{�)# t"�y'�}�(. ..:.-, j '�*zt x d ti j .:..-.•4 ..0 L. E vallte .S ! 3x
❑i--and 2-family dwelling 0Commernia3/indtistrial ❑Accessorybuilding Ferspedallnfornutttonask cherktrsi:.
®Multi-family 9 Master builder 0 taller, Description. j City. ; Ea. Total
,,,,} Wi ,'w ;F figgilM}w� 3s,t,,� n�; ..+r. }M*✓uN�'-> }d r� ur !i'tt8�!'AQitrt
�
` ` Air conditioning• 46.75
Job site 4idd. ss. /3✓ l
')/# SW P e P Uty Te1tfra Ce . Furnace 109,009 BT•U(dams/vents) I 46.75
City/Stated,ZLP:Tigard,OR-97224 Furnace 100,000+BTU tdriers/�ents) t 54.91
heat lump 61,06
suite/bldg:lapt,no.:/7,7, Project name:I2:y jrRi i?, Af1:r'rht J sf Diet-work • ii 2332
Gross street/directions to job site: flydronic-hot water system 23.32
Residential boiler(radiator or
hydronic) li 23.32
Unit heaters(fuel-type,not electric), i
• in-wall;induct,suspended,etc. it 46.75
^� AO/vent for.any.of above I 2332
SubtFtvisron Ver. v/vett-,Aiarr �wert"` i:.otn.94 L.,1 Other: 23.32
lit t ince''Aid inniladees:
.
Tai iriaplpat!ne1:na: Water heater. a
�; 23:32
;{7'j`:F d Y �:. .: j„ J,.v�e ti,yyn h "<¢4- 'r^ 3�[aSx4;
,�rs.. ,,E¢2 n� ,,$i°..� �, :. .t! C^R''�" f3 eetigr nNi Gas fkepiace/in9ert / 33.39
�. ��w� � •
, ,: � Fide vent for Water heater or gas 1.
new borne construction 1lrerilace „ i 2.3.32
:::.. ...... ...
.. ."—
'Loa liglust(Etas) • I 2332
Woodlpellet stove I 33.39
. . • ., •Wuodllreplar nsert 1 ' 23.32
ChlnineyJliner/flue/vent r 23.32
ti '.tom �a cf ., �H e,.t' �.. ' »_ ! -, , .;x''`t a� r<'r Envi ,. .... --- 2332
Etivlroainratgl exhaust and venb'tatiod:
Natpe;ADVLL nsl:HoidingsiLt,C. .. , Rangeitood/dOterkitchen
eptiipment . -33.39
Address:7601' ;Oourbletree Ranch Road Clothes dryer exhanst i 33.39
Sin e-duciexhaust(bathrooms, i;
City/State/Z,IP:5rottlsdiile,A7,,85258 � �
toilet ronipailmcnts,utility rooms) tt 2332
l'hoite::(601.0` 3I Fax:( ) AUic/crawlspace-fans. [l 23.32
. ;I : st. . !r° Wa "ry x n 506.- :., o,:. �El z. �'� �����: Other 1 23:32 •
_
Businessnatrte:William x yott 1 Qtnes,lt►r. .Fuel el Oiling: 1
Contac#name:ligeht Gtajewiiki .Piiiiiace,:tsc. .. . ' I . .
Addiess.'109 East 13t1t:•Street Gas heatpnntp 1
Wall/suspended/unft heater '
City/Stute!L1P. eo
Ysauver,WA 96660 Water heater t
Phone:(360)69S-7700 f Fax::(360)6934442 .. Fireplace 1i
E-mail:Amgeta-Grsje0�sk&01ygonhtmtes eom Range
8arbeQtre
1AJ " ia; 6JG � . ' iawtl�4 � . ...
dQ1he7 (gas)
Business name:Andersen Mechanical,roc. Oft '
.. -. . . .. AC.lther'
•
Addr�ess:15E'..Ave `uMotatl
C 1Y4lstgl Tl$2rd,OR 97224 Minimum potmlt fee $9000}
Plan review(25%ofpermit fee)
Phone:(503)992.6664 Fax:(503)536-6615 -stoic surcharge(12%of pcirttit fee)
lie,:3004 TOTAL FERN ilEIT FEE,
This permirappiieatioa expires if a permit r not obtained within 130
........;;,. days after ii has been aeeepaed' complete.
AilgOilistiti*titmice:lu ' Fee.inetltedoltgys t by"Di-C'ountyBuiJdin industtySerciceBoard
{ Print Raine:040.1 Graj veld . Pate:.8/2246 . -
I
Inalitits4itusantinsU_ tteritnpp otot3mt,c 444411t'0itir•ieott WEB 1
Electrical Permit Application FOR OFFICE us ONLY.
CityofTi , rd Received „Li T, Utz da,D_
g Permit 0:
II, 13125 SW Hall Blvd.,Tigard,OR 97223`. ., Phar,Review
ESCEMIIIIIIIII
Phone: 503.7182439 Fax: 503.598.1960 Date/8 :
T i GA R D Inspection Line: 503.639.4I-75 Ready Date/By: McH See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
:r?: "_ ma y. s.,. a F' :P.'i :,401',.%`4,01.1,,. :,,, �,. .i iii:,•:—,*Fjl` ro,.c^. .f=�.. �e. e, . �,x°1kda ik . '-iF "1
®New construction �2 z.F ::�..„ =�= ......., .-4-����.�� �{��. �
0 Addition/alteration/replacement 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
'g-a= mo -n:. 4,r ,,, G.. • gtrt,- 4, F, aki- ,174? ;" i .
•. exceeds 10,000 amps at 150 volts or 0 Floating buildings.
1-and 2-family dwelling 0 Commercial/itidtistrial 0 Accessory building less to ground,or exceeds 14,000 D Commercial-use agricultural
i1 Monti-family ElMester builder Q( amps for all other installations. bad
stallags.
}� D Fire pump. ❑,Installation of 150 KVA or
'x - e ,.;.. '.:r ,G °,,,.. -:J ` 'moiai AR ^' D&me em. separatelyderived
i.'��,;;�, ,,M'.°``f� a. . .. „. 1eE���„� ,:�.,1�"r��' .r�• ?�ta� ��`�• SAY� larger
Job : Job Site address: 357 S ❑Addition ofnew motor load of system.
Plum T-Grr 10051?or more D�A-,^�:-1-2-,-1_s•,
City/State/ZIP:Tigard,OR 97224 D Six or more residential units. occupancy,
D Health-care facilities. 0 Recreational vehicle parks,
SnitribldgJapt,it: /322 Project name:Ay, ( eyra � N,�A/„ E7 Flamrdans tooationc. 0 Supply voltage tot mons than
V Vt ❑Se vice or Seeder 1500 amps or more 600 volts nominal.
Cross street/directions to job site: .. ',{° rv4r 7 `„,`` r pivi_,4F_f 'il t S.. i".- ---.,;'Z)7',,.a
Description I Qty. t Each I Total 1 t.•.
!_ New residential single-or multi-family dwelling unit.
Subdivision �t. C..e a/.r 1.I we r ye— Lot#:2 I Includes attached garage
Tax map/parcel#: r v u L[�L1,000 sq.ft.?Mess 1 168.54 4
4
p
b r r^:.. .:..-=�`'je-� -:11:7:tKO'ts s. as 'S' . �r, . .,s41``° i..` ' k ' fie enres ential on {
500s2 33.92 f
Limited energy,residential
(with above sq.ft.) 75.00 2
Limited energy,multi-family
75.00 2
residential(with above sq.ft.)
s .y t jl4 t 1 7!$J.� _ t.b'�' e F w 3 rs h ar t ,2 e�y}R�w 4k�.. t-a': Renewable Energy U See Page 2
., , Services or feeders installation,alteration,and/or relocation
Name:ADVL Land Holdings,LLC 200 amps or loss 100.70 2
Address:7600 L Doubletree Ranch Road 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2^
City/State/ZIP:Scottsdale,AZ 85258
601 amps to 1,000 amps 301.04 2
Phone:(602)694-4031 I Fax:( ) Over 1,000 amps or volts 552.26 2
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 5936 I I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 1 1 125.08 1 2
Owner signature: Date: • 401 amps to 599 amps 168.54 2
i IM yr%,,de ,,;® it L ,t a.A, :- ,` r. o vr,ctm g ; u Branch circuits-new,alteration,or extension,per panel
`”, ~�, " �n,� A.Fee far branch t:ixcuiis rrtth
Business name:William Lyon Homes,Inc. above service orfeeder fee, 742 2
each t>tanch circuit
Contact name:Angela Grajevvslul B.Pee for branch circuits without
Address:109 East 13th Street service uremia-fee,first 56.18 2
Manch circuit
. , .. . ,,:i _ - rmn MAIr 1.43111611wr r.uu - — 1,42 2
Miscellaneous(service or feeder not included)
Phone:(360)695-7700 - •.' Fax::(360)693-4442 Each manufactured or modular
67.84 2
Email:Angela.Grajevvski@polygonhomes.com
ipolygonhomes.com dwelling serviceand/orfeeder
5 Reconnect only 67.84 2
r... - �•: Pump or irrigation circle 67.84 2
Business name:Garner Electric Washington,LLC Signor outline lighting 67.84 2
.r..,:
Address:6101 NE St Jahns Rd Signal circuits)or limited-energy D See Page 2 2
panel,alteration,or extension.
City/State/ZIP:Vancouver WA 98661 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(253)320-1657 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:bdarliels@gwensa.cotrl Industrial plant(1 lir mitt) • 78.18/hr
Inspectionsfor which no fee is
CCB Lie.: C1158 Electrical Lie.: 208174 I Suprv.Lie,: 4496S s. r listed hr mkt) 90.00/hr
-.. °air _(�Y�Lty�w31P2 ESS
Suprv.Electrician signature,required: • f'. L �(�, •,•.. . ,
Print name: Joan P Albert • Date; 4/26/2016 0 Plan Review RequiredSubtotal:
e9 (25%of permit fee):
<'~ _ Statesurcharge(12%ofpermitfee):
Authorized signature: ,_ - : TOTAL PERMIT FEE:
This permit application expires if a permit Is net*Walnut within 180
Print name: Bill Daniels Date: 4/26/2016 days after It has been accepted as complete.
C. Number of inspections allowed per permit
:•L'1auIding}pmnktbE.C_Permit -45157 11fo5/COM1WEs
App$1a EaS.doc Ravodn7/2als 44O
Plioribing.Permit Applicatio11, .. , . , , ,,_, . _ .
Rufiding'Fixthres 1.(w ovi 1( 1 I ',1. (1\1 \
.
Dateer Permit N5;14 gri,„0/7_0 00 6 .
)1 ,•-.. • 131,2$SW Hall Blvd.,Tigard,OR 97223 , min Revioi, I .
16, ,. Phone: 503.7.18.2439 Fax: 503.598.1960, miesk Other Permit Ho.:
- .. • •Inspection Line: 503.639.4175 , „ Date Readyiny: lurir RI*ie Page 2.for
Internet: Www.tigard-or.gov 7 ' '' ..,2 , - NotifiertMethod: ,„ . .,. ,. . ,.,_ _., suPEleir±enta.1.11,49111.7ti.°° ..
•07,-",-,-,..,;,.;-;.i.;3'., i4.?;;;.•••.i:,:., '''.`,A...'1!•_:•-z*i...41/**Arst-iifite",r01,1"-4142.41101-R7rOTT.4-0.7..AiM.XPAt4:13agt*If.41,1,05F.,i'f..,..,:i: ' . :...:-
For spaded Information we eftecklre.
New eceeruction . -0 Demolition
Description. 1 Qtx: i Eit 1 Total 1
0.Additionfaitmationireplacement 0 Other: ,.New 1-2-family dwellings(includes 100 ft.for each utility connection) i
T...1,..-•:''',.e..,:'44;:." ...-'''!•-t.,;_'.'.•'-',gejz1,71:e40)%ff5t7 ',..4 -10144.3ipig4iPTI;g04.1r4, SFR(I)bath 312.70
•- .•'4••-w1..-:".1 .1.4{14: 34!;,-.....4. 4.4,1'1, -,,,L,.1,.',...4:474,,,,C0',...4,41,'Pl,r,(..glti,:a-tql 4riti•,:it,..1,11:,!.....,,,15,,,:•,,-.'4,61 ..• . ,
•anti24amily dwelling 0 Commercial/industrial SFR.(2)bath 437.78
SFR(1)beh i'•
n Accessory building pi Multi-family i 500.32
Each additiOnal bath/kitchen 25.02 i
0 Master on":-Alitter- . . . 0 Other: ,
• Firesprinkler( sq,ft.) Page 2 .1
,A.'i:-•';'•'717....,:rf,:'"4:1i••••:••••441t,- ,- •`'`,.'!":1. '•:-Sri-.0,•It, ,e r e,IV11**-PicA3(0) ii ' '''''4,: '!-=-4';''''/.11.r...:M' Site utilities:
' ..t ',.....„.„4.,...,i,..,., ,,..,tf-;7, ", .
Jati'Site 41d4r.ss: /3citio Sw Pie dr, PI
a catch basin or arerOrain ., 18.76
18.76 i
atY/State/i1P::Tigard,OR 97224 (41/4 Mil'ace-- Drywell,leach line,or trench drain
• - 1
Footing drain(no.linear ft.:. ) Page 2 1 I
Stritefbldgiapt.no.:/3(l) Project name:gi vet/ MilfaC 1. Nd rrt:LWe fr Manufactured home utilities 50.03 1
I
..,
.CroSS•Strem/direetions tidal)site: Manholes . 18.76
Rain drain connector 18.76 1
. . . .
Sanitary sewer(no.linear ft.:_____) Page 2
.. • • . • ' Storm sewer(no.linear ft.: ) Page 2 I
1
• . . Water service(no.linear ft.: 1 Page 2S 1
.. - 1
'tib.Fli*liS19n: Aver Itiveit2 No{714wedt- , Lot no.: "2.1. Fixture or item: • _I
BeclrfloVe.PreVenter . I , 31.27
Tax Map/I:Oval no.: .. *
. '
I. Backwater valve i 12.51
,:;:-'.'-'•••••'•"&"-•-n •7-'••=4•74•2.',- VAt'')-13%-:';•41•'•,V,.:.r.t-v-1:•-avt•-.-64-r,'. • -Y4•*t.gtin'1.-rAtgt";,- ••• • -• i
4,':-?..-;••-t-Z.-•'...4...•. •:','--. :44-•:,V-4ez,f;t4'-i"-;'---''',- ;•-•w'•• ,'"•"••,-4:•;c" -.'"''''''''' ''''''.4'::''''''''.1:--'-'b' ''`*;..4".r''''-:-.k.''.' "dlOtheS NM* , 25.92. .
.,...... -- • • • • -- • • • '- • .:Dialtvrasher •
. . -•, Dihilcing fountain . . ., 25.02
. .
.• •Eie.ot,i;t*stioll) . 25.02
- ... .. . . .
:7, ...,,,„4.,-,..,..--_:=w,--,,',-4',4f-,-4',,A4r,j•-,-i',ri'''.'-:',':'.'....F.,:llt.i'4';i.4141;4'".s.-....4i gr.ty4t. :Ir,;;7441/:-'447';'..i44.
Expansion tank' 12.51 ,. 1
'-'-'r'..:F.,YA'''!?:-1:'.1'.•'''':4,-4-1.i.?---..-;',)-7-'.1;•',0?'"-P-I4-,-,''.ii. .:• >.9:3•Zrs,-,.•:::,,-•Fz.,•-,• .,........1:- ,4N;ir,,...,,,4,-, ...S:rS".,-,.. . . . I
Fixture/sewer cap 25.02
hhime:-ADYL;tand Holdings,L.Le ..
• Floor.driiin/floor sink/hub 25.02
Address;7680 E Doubletree Ranch ,,Road
Garbage disposal 25.02
-------1
City/State/21P:Scottsdale,AZ 85258Hose bib„. . 25.02
..1. . „ •• • ••
Phone00204-4031 Fax:( • .) . lee Maker .12.51.
.,',;:.•''''-'7'5'-'!".. .:E'..:-.g.''''-',.'.f'1;f1•:(7.7.4•}Y-.4..,a" ;;:-Y-W V-i."',....--tc.',.,..,'4'ky;''-'fiA'•,-4.KV:;"::7•`?:.'0',"..'6-1,.:41.4 Intereciuorigrease trap . 25.02
,'..:„..,...,-,... ..-,:;,,-....:.•;‘,.:-.;,,:ri..:::,-;.,,„It...,...-......:_-.., ....-..‘,..":1,- ViK,.:,4",, ;;VO-,...,,- •...,.....g,P,;4,47.4,--4,,i..;-,.4,..i.,..,.,''',.S.,.....
-'' ...71 . 10.111111W.-S---,. .)- . --
Business nantif.iitiTiliiii Lyon Boma,Ine.
. .. Primer : 12.51
'''•ContaOtnante:Aagehi ritjetriski •
Roof drain(cornmercial) 12.51
Address.109.East 13tb Street • Siniobatinflavatori ,• 25.02 j
• City/Slate/ZIP:Vancbliver,WA 98660 Solar units(potable weer) .. 62.54 i
,.... ... . . -...•
thopet 060)0s-170o • Fax::(360)693-4442 ,Tub/shower/shower pan . 12.51
,...,..... ,..... .., .. .
• , .Urinal 25.02
t-mail •
at1çset . - 25.02 I.
r.0••,-..•;,,,..,....,...„,:„....ei;-•..7,72•;.-„,..... ...-...J..-„,,,. •415:75,,..,,nizsvIA-,.::-.•,;,id•••57••••.,.?4:-.'„1••••.4-..•••,..-:i.;;•7-4...iki,,2r.,,,,,,,..1,...;;,,i'ii..i.v.•:,.!..:4Z:-.4-P-..r .nni:-&:•I'• •
, -;•.,..;•...!i•c,,!-..-,...„-.-..,-...,,,,;-1.,--4:.5.••:•-,:,::::-.•:;••• •-- :1-_-. •••.:..-.-..:-.i.*•k••.\--k,,,--4,----%,:r<1•'1;•'•'',,•-•'-:'''•,'-'•-•:zi-,,---5-4." •''",•'-'; '1••=`'''••-'A- Water heater 37.52
Business triune:Antatiet thimble*LIE ,
• Water.pipingDWV 29
/ 56. 1
Address:146W HiiiiiiieColimitlibi River Hwy 664: 25.02
,City/StateeZiPi'T.reirtdale,OR 97060 . . Subtotal
...,.. .- _ .
' Phone (W)492-3490 Fax:(S03)912-6438 • Minimum permit fee: $72.50• 1
I
. Plan review(25°4 of permit fee) • I
•CCB Lie.:184601 Plumbing 1.4c,no.:PB732 ,
.. r. . .. .... .. • - . State surcharge.(12%of Pent:IR.fee) 1
- -'•
Authorized sighattire: TOTAL PERMIT FEE 1
1
,' • - .. . , • This permit applitathin expires If*permit is 1101 obtained within 180 dos
Printminie:Reibeti Disbud'', Date:5/23,2016 ' after it has been accepted as cnniplete. -
*Fee methodology set by Tri-Countilding Industry Service Board.
IABuikringWainits‘PL444.4•PermilApp,doc 10/01/09 44045167(1 0/02X0WWES)
City of Tigard
illq COMMUNITY DEVELOPMENT DEPARTMENT
■
T 1 G A R D Building Permit Review — Residential
Building Permit #: .S'TA 7— ,
Site Address: 3S- it) 460C- Pkot /-�'/, -�_..
Project Name: /I/er ' a7CP /1) ALot #: c>9/`
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review //��/ y/�
Proposal: e4) -S'/It - 4iiii/ ca.4 4, 6z40/2704
erify site address/suite#exists and active in permit stem.
R River Terrace Neighborhood: ❑ No Yes,See River Terrace Review Addendum Attached
Sit/Plan Elements:
ree(3)copies of site plan ta:f:sting structures on site
e plan must be on 8-1/2"x 11"or 11 x 17"paper Fr ootprint of new structure(including decks)with finished
awn to scale(standard architect or engineer scale) 7•or elevations
i. •rth arrow IG U • •ty locations(required for new,may apply for additions)
T •. e address,project or subdivision name and lot number Bcation of wells/septic systems
Vplicant information(name and phone number) � isting trees to be retained with drip line,and tree
t dimensions and building setback dimensions rotection measures
t area,building coverage area,percentage of coverage and treet tree size,type and location
}eipervious 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)
tCANlean Water Services-Service Provider Lett (lot platted prior to 9/10/1995):
equired: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No
Public Facilt Improvement(PFI)Permit:
-quired: Yes,applicant was notified ❑ No Applied For: Yes ❑ No,stop intake
rrA/Land Use Case#: P862-0/S-11 6 '),C') r _'�f,�Q4 - l e)
/ .. • fir•- -
TA 'equired Setbacks: Front 0 Rear Side Street Side Ma Garage #
A Landscape Requirement: :Q )-- o
o
( %
lerof Coverage Maximum: 930 %
111 1:uilding Height: Maximum Height Actual Height Or
' tsual Clearance
1//Easements
nsitive Lands: Vces ❑ No Type ‘- v,Z/ lig-1—
Urban Forestry Plan
❑ Conditions "Meett" 'rior��to issuance of b ding permit /
Notes: /1eith;Er r k ,4 7/ Le /itp` ` pit. ✓`�v I.SS'40/te-(.._
Approved By Planning: cr ,. Date: 0Q / /•
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: 0 Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPennitRvw_RES 091216.docx
Building Permit Submittal
Original Submittal Date: /2/wl i9
Site Plans: # j.
Building Plans: #
Building Permit#: \► nter building permit#above.
Workflow Routing: 72 Planning gii'Engineering 9SPermit Coordinator ( •Building
Workflow Sign-off: kr Sign-off for Planning(include notes from planning review)
Route Application Documents: [2'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:
cian �, � L,,,,,,,/,,,....JI. ate
/1/7
t -a. . . .,�1. 1_ xMa ;
Engineering Review
Slope at building pad: J'/!'
(Conditions "Met"prior to issuance of building permit .. ' 4/
❑ Easements (encroachments)per engineering conditions of approval and plat
El 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: ❑ Yes ❑ No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: WZ, p Date: (_2 .-/7
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El Approved ❑ Not Approved
Revision 2: El Approved ❑ Not Approved
Revision 3: ❑ Approved Cl 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:
7 DC Fees Entered: Wash Co Trans Dev Taxes El N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: Yes ❑ N/A
AA K to Issue Permit
///
Approved by Permit Coordinator: Date:3
I:\Building\Forms\BldgPermitRvw_RES_091216.docx
City of Tigard
im
COMMUNITY DEVELOPMENT DEPARTMENT
:111111 III
T 1 c A R o River Terrace Building Permit Review Addendum
Building Permit #: 4 $T,Z.o/?-- 0a)gZ
Site Address:
Project Name: iac Lot #: /2)
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan Dist ct Design Standards (18.660.070.1.);
Is the project subject to the plan district design standards? Yes ❑ No
1.Articulation: a minimum of 1 element per each street-facing facade that has 30-60 ft. of frontage.An additional
element required for lots with over 60 ft. of street frontage shall be provided every 30 ft.
Balcony w/access 2 Window Projection Vertical Wall Offset a
in
Porch m . t. deep ft. d p min. 2ft.,5 ft.wide min. 2 ft., 6ft.wide Gabled dormer
tje
❑ ❑ ❑
fr°/(1)( ° famust include windows or entrance doors.
2. Eyes on the street: a minimum of 12/o of each street facing ade ,
Percentage Shown: 'rib ` 04 c �-, s/e
13. ntrances:At least one entrance must meet both of the foll • g standards:
Max. 8 ft. setback from longe street- facing wall Parallel to street,angle no more than 45° from street,
or o en onto porch
Entrance opens to a porch: Yes ❑ No
Vs,all the following apply: (25 sq.ft.min.
Ane street facing entry ft.max. roof above floor of porch
5 ft. depth min. 30%min.porch roof coverage
4. etailed Design:All buildings shall include a min. of five of�the following elements on all street-facing facades:
Covered porch min. 5 ft.wide x 5 ft. deep'/ Recessed entry area min. 5 ft.wide x 2 ft. deep/
❑ all offset min. 16 inches ❑ ormer min.4 ft.wide y0
V Roof eave min. 12 inch projection Voof offset min. of 2 ft.f'
0 Roof shingles either tile or_woncl - --_ ''a.ble.,hip or gambrel roof design
▪ oof pitch oriented south min. 500 sq. ft. orizontal lap siding min. 3-7 inches wide f—'7
011 Accent siding min.40%of street facade Window trim min. 2'/2"wide by 5/8"dee --
El Window recess min. 3 inches for all street facing ❑ Bay window min. 5 ft.wide by 2 ft. deep `
❑ Balcony min. 5 ft.wide x 3 ft. deep with inside access ❑ Attached garage is 35% or less of street facade
5. Garages and Carports:May face the front or side lot line on a corner lot.
Setbacks:
No closer to front or side lot line, than longest street-facing wall. ❑ Yes No. If No (Check one):
May extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch.
ay extend up to 5 ft.where the garage is part of a two-story building and there is a window at the second story
abov the garage that faces the street with a min. area of 12 sq.ft.
W the (Check one)
12-foot-wide garage door ❑ 40%max. of street facade
❑ 50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: 4- Date: /' k-.
I:\Building\Forms\B1dgPermitRvw_RES_RT_062216.docx
Mechanical Permit Application IOR OFFICE l SF(-1\1.1
City of Tigard
13125 SW Hall Blvd.,Tigard,OR 97223 Plan,Review ! r
Phone: 503.718.2439 Fax: 503.598.1960 F T._. a r, r, / Date/BT Other Permit:
inspection Line: 503.639.4175 Date ReadylBy: H See Page 2 for
TIG:11t i] II. Supplemental Information
Internet www.tigard-or.gov Notified/Method: PPI.
e xx 4 . r.',-;.2.-75.. 4 ('''Q;':''`1 ..r,,�:� a -'"f t''‘I---A14,'„',., ., . ,.-k� S*°.f+
h ., t # 1 ' 22 F Mit:-1,-0,7';'?"-T;{C 1� ..C.,;'�' ''� _ ...
�<,.�,, „M, ,`,1' r.,�.:.� ,1,_. .... ..:.... .r_.r ....x .m,.x.r..... ,..'''',..6.2-2,1::.,,'-i,..�-t Mechanical permit fees*are based on the value of the work
®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Other: mechanical materials,equipment,labor,overhead,and profit.
❑DemolitionValue:$
-c:i,2:-47:=7,---;'2 : t. prrt- t.iF ck Et t.t i4"_-_-_,....-z....._._–_:.'...-',,....:::. ry 2y�f U,GF, F..° t22) iR..2,LeCti' APat,4iht3;1.k'. ,�J',„y
.�_.w.,.� .vim..,n::2-.4.`-...',L-4_..:r__. ._ . .. ._..... _�
❑1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building Forspedal Information use checklist
®Multi family 0 Master builder 0 Other: Description ( Qty. I Ea. I Total
Heatteg/cooling:
._�.„ _., .:,i t Airconditioniug 1 46.75 46.75
Job site address: 1351 ``/) a•�, f)t u m-reX .
y-rtc, ., Furnace 100,000 BTU(ducts/vents) 1 46.75
City/State/ZTP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
~Suite/bldg./apt.no.:133 ( Project name:River Terrace Northwest Duct work 23.32
Cross street/directions to job site: 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 1 23.32
I �� Other: 23.32
Subdivision:River Terrace Northwest L Lot no.:7, Other fuel appliances:
Tax map/parcel no.: Water heater 1 33 39
A t -Z X . f 6)'tr t E t y i'�� €' r f l a E ,:,,,r.,--7,.:..... 1 i:::: �.r....,...:.t Gas fireplace/insert
ie la insert eater or gas
Contractor Change fireplace 23.32
tit snt
" Log lighter(gas) 23.32
L
Wood/pellet stove 3339
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
4 ^,`,.:-.',/,,,:-,,' 5 ; 1 ' 1'. �. -_7 ICV,( wv
Other: 1 23.32
r F .kbd yi _e^,1t ,. u .� w :-"- _,. ,e.,.-__-..--w�_r .
Environmental exhaust and ventitaHon:
Name:ADVL Land Holdings,LLC Range hood/other kitchen
equipment 1 33.39
Address:7600 E Doubletree Ranch Road Clothes dryer exhaust 1 33.39
City/State/ZIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 4 23.32
Phone:(602)694-4031 Fax:( ) Attic/crawlspace fans 23.32
:::-J.,-7-`,,,1::...;1 i,,,, i > H - t _ '7'7,-;'1'`2,-.1,
',V.;: n, .a —Other:
23.32
.,. .. ... _ . ._ ., w
_,. .. ...�,_ . � 1 _ . � Fuel piping:
Business name:William Lyon Homes,Inc. 514.15 for first four;$4.03 for each additional
Contact name:Nichole Thorpe Furnace,etc. I
Gas heat pump
Address:703 Broadway ST Suite 510 Wall/suspended/unit heater
City/State/Z1P:Vancouver,WA 98660 Water heatex __
Fax::(360)693-4442 rreplaCe —1
Phone:(360)695 7700 Range 1
E-mail:Nichole.Thorpe®polygonhomea.com Barbecue
Other
Business name:Pro Heating and Cooling,INC a e y t ;i4 F t ', f ,,',,,,,;:t
J `i
Address:2095 NW Aloclek DR Suite#1103 Subtotal
Minimum permit fee($90.00)
City/State/ZIP:Hillsboro,OR 97124 Plan review(25%of permit fee)
Phone:(503)4435692 Fax:(503)9415075 State surcharge(12%of permit fee)
TOTAL PERMIT FEE
CCB lic.:209001 This permit application expires if a permit is not obtained within I80
days after it bas been accepted as complete.
Authorized signature:� 7 ' Fee methodology set by Tri-Comity Building Industry Service Board
1
Print name:Niehole Thorpe Date:9/19/2017
1:lnuild'ing\PcrmtuWEC PemutApp 040113.doc MO-46177(I1/02/COM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13576 SW BEACH PLUM TER, SHERWOOD, March 1 , 2018 at 8:59:55 AM
OR, 97140
Record Type: Record ID:
Residential - Master Permit MST2017-00082
Inspection Type: Inspector:
699 Mechanical final Aaron Cillo-Gobel
Result:
PASS
Comments:
No A/C installed
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13576 SW BEACH PLUM TER, SHERWOOD, March 1 , 2018 at 8:58:23 AM
OR, 97140
Record Type: Record ID:
Residential - Master Permit MST2017-00082
Inspection Type: Inspector:
199 Electrical final Aaron Cillo-Gobel
Result:
PASS
Comments:
No A/C installed
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13576 SW BEACH PLUM TER, SHERWOOD, March 1 , 2018 at 8:59:11 AM
OR, 97140
Record Type: Record ID:
Residential - Master Permit MST2017-00082
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS
Comments:
Water pressure = 65 psi
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13576 SW BEACH PLUM TER, SHERWOOD, March 7, 2018 at 2:00:46 PM
OR, 97140
Record Type: Record ID:
Residential - Master Permit MST2017-00082
Inspection Type: Inspector:
299 Final inspection David Young
Result:
PASS - CofO
Comments:
Final erosion control approved.
Street tree certification received.
Moisture content form received.
Vapor barrier form received.
High efficiency lighting form received.
Blower door test report checked.
Insulation certification checked.
C of 0 left on site at kitchen island.
Note: no ac installed at final inspection, permit and approved inspection required at time
of installation.
Violation Summary:
Inspector Contractor