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Permit (63) CITY OF TIGARD MASTER PERMIT ,14. �' Permit#: MST2016-00537 COMMUNITY DEVELOPMENT Date Issued: 03/27/2017 T[ A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S111DA18200 Jurisdiction: Tigard Site address: 8781 SW SCHMIDT LP Subdivision: HERITAGE CROSSING Lot: 1 Project: Heritage Crossing, Lot 1 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 936 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height 24 Bathrooms: 3 Second: 1361 sf Garage: 573 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2297 sf Value: $286,852.20 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain 0 Catch Basins: 0 Storm Sewer: 100 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 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: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<10OK: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'500 sf: 4 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N Ecompasi All Y Other: N Other Description: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2297 Owner: Contractor: Required Items and Reports(Conditions) DR HORTON INC. DR HORTON INC PORTLAND 4380 SW MACADAM SUITE 100 4380 SW MACADAM AVE SUITE 100 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97239 PORTLAND,OR 97239 PHONE: 503-222-4151 PHONE: 503-222-4151 FAX: 503-222-1304 Total Fees: $29,148.24 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through 0 R 952-001-0090. umay obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: " �/� />•";‘41"K 41Permittee Signature: cr r' [/�� --. .--7Y()-1--7Call 503.639.4175 by 7:00 a.m.for the next available inspection date. F This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. guildin Permit Application 3 7G,21/ iti 2- Residential k. i ' � ' ,,; City of Tigard Received ,,:, ($ _ j '�i r Date.0),I \ a Permit N of G / .S 7 13125 SW Hall Blvd.,Tigard,OR 97223 I��' 8 :20 I:, (�` s Phone: 503.718 2439 Fax. 503.598.1960 Plan Iter Ica Other Permit: Inspection Line. 503.639 4115 ClayDate By: �/� �� I I,,.,tit k0•11'+ x j' Date R lura 0 See Page 2 fur Internet: www.tigard-or.gov '� Not' ed Met jzIagy L '' rr Supplemental Information T -,E: t's; S, ,�, i 117 f F e-rWg TYPE OF WORK JIRED DATA:1-AND 2-FAMILY DN ELLING II 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 ❑Other equipment,materials. labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. _ Valuation: $ a$'6` $sa Q I-and 2-family dwelling 0 Commercial/industrial ❑ Accessory building ❑Multi-family Number of bedrooms: 1/ ❑Master builder r ❑Other: Number of bathrooms.G� JOB SITE INFORMATION AND LOCATION Total number of floors. a, a,, 87 Job site address: 21-?cl(.5((.5(A./ ,.5414‘4(1.A1., c,375( ,.5414‘4(1.,.5414‘4(1.A1., l, i.ip New duelling arca: a�07 square feet City/State/ZIP:Tigard,OR 97223 "`" Garage carport area: ,63 square feet MM Suitebldg.lapt.no.: Project name Coi h Cos ered porch area: @o'I)3 square feet i 3 g) Cross street/directions to job site: Deck area. square feet q 3 c Other structure area: square feet REQUIRED DATA:COMMERC IAL-USE CHECKLIST Subdivision: l Lot no.: I 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. valuation: 5 New SFR Existing building area: square feet New building area: square feet illt PROPERTY OWNER 0 TENANT Number of stories: Name: DR Horton Inc. Type of construction: Address: 43$0 SW Macadam_Aye Suite 100 Occupancy groups: City/State/ZIP: Portland,OR 97239 Existing: Phone:( 503) 222-4151 Fax:( ) New 0 APPLICANT • CONTACT PERSON BUILDING PERMIT FEES* (Please refer to lee schedalJ Business name: DR Horton Inc. Structural plan review fee tor deposit): Contact name:Emerald Weeks FLS plan review fee(if applicable): Address: 4380 SW Macadam Ave Suite 100 Total fees due upon application: City/State/Zip:Portland, OR 97239 Amount received: Phone:(503 )222-4151 x1107 Fax: :t ) PHOTOVOL TALC SOLAR PANEL Sl STEM FEES° E-mail: esweeks@drhorton.com Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photovoltaic Solar Panel System. Business name: DR Horton Inc. Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:4380 SW Macadam Ave Suite 100 i Solar Installation Specialty Code checklist. ' Permit Fee(includes plan review City;StatetZlP: Portland, OR 97239 and administrative fees): S 180'00 Phone:(503 )222-4151 Fax:( ) State surcharge(12°' of permit fee): 5;21.60 CCB lie.: 130859 1 Total fee due upon application: 5201.60 Authorized signature This permit application expires if a permit is not obtained JJJ within 180 days after it has been accepted as complete. Print name: k Date:2016 x Fee methodology set by 1 ri-County Building Industry i ,, - Service Board. I:Building,Permits BI'P-RESPennitApp.doc 02 24,201 I 440-4013Tt 1102 COM'WEB t lechaniraH'euntit A licri. 1 , RI # cfNi ,ti 4 Citof Tigard 711111111111=Mg="111111111111.1111. . , l, lig pl,,,,,, tt,t—1..".•..4;‘, I, ,,, ..5 t,,,,,. o',..,i'(' -4 _ _ ......._ , 11,1t-m,, .1,A, !IV;r•I;••• ::;,'; '• -,:;•).; ••,• '!I il.- ...‘ •4, 1 ....NIL rf1,14,Al 101tfot ItlIf.1. A ,- ......--............. -.... — TA—Piq.411114rXDIVMUIV— I.OMMIERCIA.I. FEE' SLVEDITE USE(11E4,-Ells I •No.. ,:„..•..,w........11 \ , CATEGORY' OF CONSTRE.CTION , RESIDENTIAL EQVIPMENT/SYSTEMS Ells- 0 \,,,,,,,,,,,, ,,, ,,,1,,,_ i I,v1/4.0.1(tniffriftuithf,,u-fi 1 iie,4.1i,t 0 ‘t,iin•f....io, [ .........__ 0\L-si, 1,,,,itk, — — Ej I p!,.., .„....... ,.... ., . JOB SITE INFORMATION AlD LOCATION * ,....„, : .._____— . — I., . .- . ---- 4 1 ., ' , ,,'0,,= 14:: s, , h 'ii I OR.(i-223 1,... ... , ... . .. • , , C/4(-0 k1 • 4-.-4‘. .... _._. .. .. _. .... . i tt her fuel a .. . _ A.Ma:,p.••,„,•'/;; :‘ ; • DESCRIPTION OF WORK j . ... i NOV SFR _ • - • . ,. „ _.,. . . . ... , . ..,. """ • , 1 . _ .. 0 TENAN1 — 40.4. ' , 1 _ - i n,turnmentin cdtawd and‘cnidatnnc 1 ••• • . { 91- 1)1( Ii0tton Inc, 4..Oio SW Macadam Ave Sulk. 100 ... .., ' I Is \1-0,'ii' Portland,OR 972;44 .., . , P1.01., , ;f13 I11/.-4151 ' . _ ___ i . .. . 0 APPLICANT a (t . (1 PERSON , ''' I UI I ming ,. : .. .'4:45"4: NZ Horton Inc. ...... , ,k I 3 1...hot'6,0 IOW t..1 Ili 15,4,,,,,,h Ad,ht,,,,,i t t^ttl,ht t'lliti.., Lineraid NVI:t.„"k'S. . . . . , . . 45 4 \J,Itc,` 4.1g0 S\V Macadam Ave Stme 100 • • , , . . .. .. . u.s I "' `‘L"-ill' Pm t1a0,d,OR 97239 , - • . 222- -111. x1107 . . . ._ . . esweaso dithiritm t.I . ..... ,. ..._. CON'I'RACTOR mEARANic Al.PERNIllETES. ii„, //i/f..'i 7 _ Subtotal . . t 't.. t.it, lir' ..- :i i., I., ,i' : -''' .A ' :, ( ' ! _. Sn . I I, ,-, , - 7-7 - s. MI 1,1 P110111 iii .h.,I..,0,4 si.o.,.f.ou,Ipft, I A err t mot oi rt,t1...Holt,.t'l.MU. -- .1.,...At.t 1 1101 Isf I n 11.,+ pit sI at,,s..1414,1(Is \gO ', ..I..,,..,,,.+,.4..; !!,414.: ' 1),A, Electrical Permit Application I n i. ()IIII( I_ t ',I ()NI City of Tigard Received .-4e- 13v125 SW Hail Elva.,Tigard,OR 97223 Penult 1.191445721.Ott,(YY S`3 J � Phone: 503.718.2439 Fax 503.5 8. •")(, Plan Review a k •,i)1, � �:�-A�� e Date/By: Other Permit Inspection Line: 503.639.4I75 ',A 4' Date Resdy/By: lair. fa See2 for �� Internet www. v 6 )l',::;`�` .r'� NotiSodNMethoQ Pine ,"R�)�».,a� ��i� " °�`� Supplemental Information TYPE OF WORK{ - ?PLAN REVIEW ®New construction 0 Addition/alteration/replacement Pleasecheck apply(snbmit1 sets of plans wfitenns checked below): []service or feeder 400 amps or more 0 Building over three stories. ❑Demelitlon ❑Other: whore the available fault current 0 Marinas and boatyards. CATEGORY'OF CONSI*CTION exceeds 10,000 amps at 150 volts or O Floating buildings. less to ground,or exceeds 14,000- 0 Commercial-use agricultural ❑ I-and 2-family dwelling 0 Commercial/industrial- 0 Accessory building amps for all other installations. buildings. ❑Multi-family 0 Master builder ' 0 Other: D Fere pump. ❑Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION Emergency system. larger separately derived system. ❑Addition of new motor load of CI"A",'7:","1-2","1-3", Job no.: Job site address: &1 (St,' r1 Iro�mmore. ey tLl.P ❑Six err more residential units. ❑Recreational vehicle paks. City/State/ZIP: a /r, ❑Health-care facilities. 13 Supply voltage for more than f r.f y V , � ��) w ❑Se actio locations. 600 volts nominal. Suite/bldg./apt no. Project name: c vx 0 Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: nercrisd.. I Qty. I Fee. . I Teta I " New residential'single:or multi-family dwelling unit. Includes attached garage. Subdivision: Lot no.: I 1,000 sq.ft or less1 168.54 4 Ea.add'!500 sq.ft.or portion / il 33.92 I Tax map/parcel no.: Limited energy,residential DESCRIPTION OF WORK • (with above sq.It) 75.00 2 -, Limited energy,multi-family 75.00 2 residential(with above sq.I) Services or feeders instaWdon,alteration,and/or relocation 200 amps or less 100.70 2 0 PROPERTY OWNER '00 TENANT 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 amps 20034 2 601 arts to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 • City/State/ZIP: Temporaryservices or feeders installation,alteration,and/or relocation Phone:( ) Fix:( ) 200 amps or less 59.36 1 Owner installation:This installation is being made on property that I own which is not 2m amps to 400 amps 125.08 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 to 599 amps 168.54 2 • Branch circuits—new,alteration,or extension,per panel Owner signature: _ Date: v A.Fee for branch circuits with O APPLICANT I 0 CONTACT PERSON above service or fender fa, 7.42 2 each branch circuit Business name: DR Horton Inc B.Fee for branch circuits without Emerald Weeks service or feeder fee,first Contact name: branch circuit56.18 2 Address: 4380 SW macadam Ave Each add'!branch circuIt 7.42 2 Miscellaneous(service or feeder not included) 1 City/State/ZIP: Portland OR 97239 or modular 67.84 12 dwelling,service and/or feeder Phone:(503) 222-4151 (Fax::( ) ./ Recotmectonly 67.84 2 E-mail: 1 Pump or irrigation circle 67.84 2 Sign or outline lighting 67.84 2 • j J1C-TLL.�ONTRACCCTINt i J— „ Signal circuit(s)orlfmrted.cnergy Business name: A 1/111 t -t/ iP�G�16 c —we__ panel,alteration,orextension. Page 2 2 d, r!_ Each additional inspection over allowable In any of the above Address: 2 yR(o yl WE 6' 4� - II .40 Additional inspection(I hr min) 66.25/hr City/State/ZIP: 1%GY1 C o 14 ve (i . �4. %SVC Cf� • Industiiatp plant hu hr min) 78.18/ hr Phone:(3t t/f— .�S6'J Fax: [� Industrialplfntw hrmoe) 78.18/hr ,� �� - c7(�6 Q Inspections for which no fee is 90.00/hr 1 —2specifically listed('h lir min) specifically Lic.:IZ6- , V9 Electrical Lic.:-CZ 30 Suprv.Lic.: /.T9 ' s ELECTRICAL PERMIT FEES Suprv.Electrician signature,required:e �J Subtotal: /t''la Plan review(25%of permit fee): Print name:Ch t=S.1is`4 fl a r i I Date: State surcharge(12%of permit fee): Authorized signature: r TOTAL PERMIT FEb This permit application expires if a permit is not obtained within 180 Print name: !�� Date' days atter it has been accepted as complete. '�'l� — * Number of iaq>apons allowed per permit. INBdwi V 440.461541r/O5/COM/WEB Electrical Permit Application—City of Tigard ' -- Page 2—Supplemental Information A s Tz 0/(e-oos-37 Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: t' itx 4 ri T'C.: 04 .^0 FEE SCHEDULE noeription Kim Each Tomi Fee for all residential systems combined: $75,00 Renewable electrical energy systems: 5 kva or lcss loo.70 1 Check Type of Work Involved: ! 2 501 to 15 kva 133.56 ri A• udio and Stereo Systems* 1501 to 25 loa EN2t,0,34 _ Wind generation systems in excess of 25 kva: n Burglar Alarm 25.01 to 50 kva 301.04 Sill to IVO kNa 552.26 I XI Garage Door Opener* ,i()ow(fet:in accordance 552.26 with OAR 91h-309-0040) rx- H• eating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* T I 1 ach additional Eva ow 25 I '7,42 3 I V• acuum Systems* 1011 additional charge 0,6 I 3 1 Each additional ins.ection over allowable in any of the above: I Other: Each additional inspection is III 61 char ed at an hourly(1 hr min) 6 25 hr Inspections for which no lee is III 00 00 hi ; acificall listed('.;hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 Subtotal(Enter on Page I): " Number of inspcclions allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: 17:1 Audio and Stereo Systems 11 Boiler Controls • Clock Systems 0 Data Telecommunication Installation O Fire Alarm Installation H• VAC 1--1 Instrumentation I I Intercom and Paging Systems ri L• andscape Irrigation Control* ri Medical E Nurse Calls I I Outdoor Landscape Lighting* • Protective Signaling ri Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations BLiJidinc Porn,I LC KtmitApp LLR ER] k. R. u1" Plumbline Permit Aaalic tinier:' -,,t',�'. ��. Building Fixturesi OR of MCG ISE 07\1_1 City SWTigard Received: Pe""i'y�'a$ (C -OOS37 1114 n 13123 SW Hall Blvd.,Tigard 01k O F� I t• ,a pb,l Review 8 Phone: 503.718.2439 Fax 503S 50338.190 '� Other Pernik No.: Inspection Line: 303.639.4173 J i-,,,‘,.,-;,NG ; r'4 a f'1'' p eReady/8y: 1�.; D See Page 1 ter r i c,�It L) Internet: www.dgard or.gov NotifiadlMethad: Supplemental laterwaaoa .1, • TYPE OF WORK. .FE>E;" SCREDULII�s`:', �: For special Information use eheeklht Neve construction ❑Demolition Description f Qt) I Ea. I Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 R for each utility connection)_ CATEGORY OF CONSI'Rt[I11ION SFR(I)bath 312.70 0 I-and 2-famil dwelling0 Commercial/industrial SFR(2)bath 437.78 YSFR(3)bath ( 500.32 ❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder ❑Other Fire sprinkler( sq.ft.) Page 2 JOB.'S U 11FO100N:AND LOCATION Site utilities: (+ 1_'_� Catch basin or area drain 18.76 lob site address:t�7g C3 ' c�(�rlirl�� _trio - Drywall,leach line,or trench drain 18.76 City/State/ZIP: Footing drain(no.linear ft.: ) Page 2 Suite/bldgJapt.no.: I Project name: V*yk Q9 f.,7111 Manufactured home utilities 50.03 Cross sheet/directions to job site: U Manholes 18.76 Rain drain conn 18.76 Sanitary sewer(no.linear ft.:_.J Page 2 Storm sewer(no.linear ft.:_,) Page 2 Water service(no.linear ft.:.,..,_) Page 2 Subdivision: ` Lot no.: j Fixture or item: Backflow preventer 31.27 r Tax map/parcel no.: _ 12 51 �,--r,- Backwater valve . DESCPJFflON•OF:WORK Clothes washer 25.02 Dishwasher 25.02 ivc�F Drinking fountain ' 25.02 Ejectors/sump 25.02 . ..� 0 TENANT Expansion tank 12.51 ❑ PROP OWNIEFixture/sewer cap 25.02 � Name: Z f\7 �f 1/R 1 \V" �, l Floor drain/floor sink/hub 25.02 Address: �2) 1�. ) V\-11 oDi � �\ A Garbage disposal 25.02 r C7� 25.02 City/State/ZIP: _dl-/Z- O�. r_ Hose bib Fax:( ) Ice maker 12.51 Phone:W3 -\\5, El APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 �M Medical gas(value:S ) Page 2 Business name: ` � ' ` A C.) Primer Primer 12.51 Contact name: V-r �Q \i\ ./�il.] of ..�.J Roof drain(comm rcial) 12.51 Address: _ Sink/basin/lavatory 25.02 City/States/Z1P: Solar units(potable water) 62.54 12.51 Phone:( ) I Fax::( ) Tub/shower/shower pan E-mail: ect,_j,ei.iVJ( L/ V Y, CA1-0n/1 C014/k Urinal Water closet 2512 25.02 ,CONTRACTOR Water heater 37.52 Business name:EDWARD MULLEN PLUMBING Water piping/DWV 56.29 Address:1601 SE RIVER ROAD Other: 25.02 Subtotal City/State/ZIP:HILLSBORO,OREGON 97123 Minim permit fee: 572.50 Phone:(503)640-01iia Fax:(503) Plan review (25%of permit fee) CCB Lic.:94689 [ Plumbing Lia no.:34-260PBState surcharge(12%of permit fee) i '' TOTAL PERMIT FEE Authorized signature: 440 _' permit Is get obalaed aithla ISO days This permit appiintiee expires if a I Print name:RAY MULLEN Date: after is has bele accepted as complete. "Fee methodology set by Tri-County Building Industry Service Board. I:tBw16niVamitrVLMU-MwkApp.doe 10r01109 44Oa616TI I OIO'VKOMAVEBI City of T IN .. N COMMUNITYigard DEVELOPMENT DEPARTMENT T 1 G A R D Building Permit Review — Residential Building Permit #: M ,57;2-0 7(l -a3 7 Site Address: .1S I S'VV SC-In Vh;c1t Lco p Project Name: He ri tri 67.E, or-o s-s i r- (New dwelling=subdivision name;Addition or Alteration=last name of owner) Lot #: Planning Review Proposal: N ev S c-R Verify site address/suite#exists and active in permit system. River Terrace Neighborhood: ;Z No ❑ Yes,See River Terrace Review Addendum Attached Site Plan Elements: Three(3)copies of site plan �ite plan must be on 8-1/2"x 11"or 11 x 17"paper ��J�g structures on site of ADrawn to scale(standard architect or engineer scale) le) floore leva elevations structure(including decks)with finished VNorth arrow Utility locations(required for new,may apply for additions) /Site address,project or subdivision name and lot number AA hcant information(name and phone number) -1�L.,,,dtion of wells/septic systems J2lipP c-DE,si ting trees to be retained with drip line,and tree ot dimensions and building setback dimensions )rotection measures /Lot area,building coverage area,percentage of coverage and :dr Street 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: I/ Public Facilities Improvement(PFI) Permit: ❑ Yes ❑ No Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake Land Use Case#: "lOn 2.Uis' ._ 0 0o , SLie`Z4:015 ocio1S Zoning: R - 1 0 Required Setbacks: Front I S Rear I S Side 5 Street Side , Garage f�Landscape Requirement: 0 % g � /Lot Coverage Maximum: ) ' Building Height: Maximum Height Visual Clearance S Actual Height �i Easements JZSensitive Lands: ❑ Yes 0 No Type Urban Forestry Plan 62 Conditions "Met"prior to issuance of building permit Notes: CO()GL(+ 0 fS +0 $)Q (be+ prro r to /" SS Ucj V7 m Approved By Planning: 4,70 v; ig/jvc +° Date: j r / Revisions (after Building Submittal only) Revision 1: ❑ Approved ❑ Not Approved Reviewer Date Revision 2: ❑ Approved ❑ Not Approved Revision 3: 0 Approved 0 Not Approved i:\Building\Forms\BIdgPermitRvw_RES_091216.docx Building Permit Submittal .G �/. Original Submittal Date: Site Plans: # Building Plans: # 3 Building Permit#: C nter building permit#above. En neerin el Permit Coordinator ,Building Workflow Routing: � Planning � $1 g Workflow Sign-off: A Sign-off for Planning(include notes from planning review) Route Application Documents: Zr 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: 4/teltre, Date: `��`lBy Permit Technician: / Engineering Review Slope at building pad: Conditions "Met"prior to issuance of building permit Easements (encroachments) per engineering conditions of approval and plat Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes No Assess Water Quantity Fee in-lieu: ❑ Yes No LIDA Facility on lot: ❑ Yes No Date: CINOT Approved by Engineering: Notes: 17,-Approved by Engineering: __VDate: /Z2f 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: C Fees Entered: Wash Co Trans Dev Tax: , Yes ❑ N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: ,'es ❑ N/A OK to Issue Permit Date: //-/ l),p l�'p Approved by Permit Coordinator: I:\BuildingWorms\BldgPermitRvw_RES_091216.docx Plumbing Permit APPliclEr 1 VED Building Fixtures cult 01,l 1( r 1 SI 0y11 City of TigardSi AUG 8 2011 Received �:... ✓r ,( Mho l b 00537 Date:H> / Permit No.: 13125 SW Hall Blvd,Tigard.OR 97223 l > Plan Review Phone: 503.718.2439 Fax: 50 °t T ` � J D uateB) Ma Pi sit Na. Inspection Line! 503.639 417 `.ILDiVGryivSI®^ Dale ReadyTly Jun, See Page 2 for Internet: wwwtigard-ot gov Notified/Method: Supplemental Information TYPE OF WORK FF.E* SCHEDIII.E ❑New construction 0 Demolition For special information use checklist Description I Qty.-1---G71 Total ❑Addition/alteration/replacement 0 Other: New t-2-family dwellings(includes 100 ft.for each utility connection) _ CATEGORY OF CON4TR11CTION SFR(I)bath 312.70 ❑ I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building 0 Multi-family • Each additional bath/kitchen 25.02 ❑Master builder 0 Other: lire sprinkler( sq.ft.) Page 2 JOB 811E INFORMATION AND I.00ATH)N Site utilities: Job site address:i1.4 1 1 �G` Lq t / Catch basin or arca drain 18.76 "�C• '� nryacll.leach hoe.or trench drain 18.76 City/State/ZIP: L(5�3 r �,� + Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name: kVA j 1(J�- (./' ", ,, _anufactured home utilities 50,03 i /.I+" l Cross street/directions to job site: holes 18,76 in drain connector 18.76 Sanitary sewer(no-linear ft.:_) Page 2 Storm sewer(no.linear ft.: 1 Page 2 Water service(no.linear II.: ) Page 2 Subdivision: _ _ I_o1 no.: 1 -Fixture or item: Tax map/parcel no.: Backflow preventerT— 31.27 DESCRIPTION OF WORK Backwater valve 12x1 Clothes washer 25.02 e'1/4AC k 6 ` t ,h/ t i j Dishwasher 25.02 Drinking fountain 25.02 l?jectors/sump 25-02 0 PROPERTY OWNER 1` 0 TENANT lixpansion tank 12.51 Nanre.�� ,11ry. L x� Fixture/sewer cap 25.02 Address: 'z)c ' L ^ �'� �/ -r( Garbageloor disposal drain/floor sink/hub 25.02 , / "� / Garbage disposal 25.02 City/State/ZIP: I:00( £Nc✓ C1-1/:,_:.)9_ Hose bib 25.02 Phone t..4 l Fax:( ) F_�_ lee maker 12.51 0 APPLICANT 0 CONTACT PERSON Inlerccptor/grease trap 25.02 Business name: Medical gas(value:S ) Page 2 Contact name: - Primer 12.51 Roof drain(commercial) 12-51 Address: Sinklbasin/lavatory 25.02 - City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 12.51 E-mail: Urinal -- 25.02 Water closet 25.02 CONTRACTOR Water heater 37.s2 Business name:Wolcott Plumbing Water piping/1)W V 56._9 Address:1075 W.Historic Columbia River Hwy Other: +l— 25 02 City/State/ZIP:Troutdale Or.9060 Subtotal Phone:(503)667-1781 Fax:(503)667-9891 Minimum permit fee: $72.50 ___� —•-- Plan review (25%olpermit lee) COI Lie.:112220lumbing Lie,no.:26-824P13 --- State surcharge(12%of permit fee) Authorised sigpatur r-)�- /...P........ ['MAI PI RMIT FLt. Print name:Mark Baleme Date:2/17/17 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete- *lee methodology,el by tn-Coot}Building Indostf y Senna:hoard, i`.nodding\Pcnointit MI-PerntitAppdts. 1W11.114 -W4010110,.211-Ohl wl'.ri)