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Permit (100) CITY OF TIGARD MASTER PERMIT F COMMUNITY DEVELOPMENT . Permit#: MST2017-00086 T(GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 W®���`IG- l Date Issued: 04/17/2017 Parcel: 2S 104AC 14900 Jurisdiction: Tigard Site address: 12825 SW 133RD AVE Subdivision: WALNUT RIDGE Lot: 3 Project: Walnut Ridge, Lot 3 Project Description: New SF. 7/12/17: REPRINTED permit to show 80 sq. ft. patio cover. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 5 First: 1352 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1533 sf Garage: 491 sf Front: 0 Smoke Dwelling Units: 1 Third: 0 sf Right 0 Detectors: Yes Total: 2885 sf Value: $349,698.58 Rear: 0 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain 0 Storm Sewer 100 Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Bckflw Prevntr: 0 Catch Basins: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 5 201-400 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 G NEW p yrou Group: Square Feet: SF VB R-3 2885 Owner: Contractor: RIVERSIDE HOMES LLC RIVERSIDE HOMES LLC Required Items and Reports(Conditions) 17933 NW EVERGREEN PKWY, 17933 NW EVERGREEN PKWY 370 1 Geotechnical Inspection #370 BEAVERTON,OR 97006 Required before foundation BEAVERTON,OR 97006 2 Ersn Cntrl 503-639-4175 PHONE: PHONE: 503-645-0986 FAX: 503-690-2942 Total Fees: $30,820.27 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503,232.1987 or 1.800.332.2344. Issued By: -.46.er-, ` Permittee Signature: G . C.-'':"0 4. 39.4175 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. FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Transmittal Letter 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or ov TO: TOM HOCHSTATTER DATE 1 (1 vED DEPT: BUILDING DIVISION JUL 10 2017 FROM: BRETT GROVES CITY OF TIGARD COMPANY: RIVERSIDE HOMES BUILDING DIVISION PHONE: 503-581-3138 RE: 12825 SW 133RD AVE MST2017-00086 (Site Address) (Permit Number) WALNUT RIDGE, LOT 03 (Project name or subdivision name and lot - •er) ATTACHED ARE THE FOLLOWING � S: 3 Additional set(s)of p1.1 Revisions: Cross section(s) and d . . Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. 3 Other(explain): S E PLANS TO SHOW COVERED PATIO REMARKS: ADDED THE COVE' 'r PATIO -WAS NOT INCLUDED IN THE ORIGINAL SUBMISSION Ro =e to P t Technician: Date: 7 _ ) ) )7 Initials: Fees Due. 02 Yes ❑No Fee De cription: Amount Du-. � . 1 r' p) c.., Y'ci: 9 .4 $ s $ cial Instructions: Reprint Permit(per PE): Yes ❑No ❑ Done Applicant Notified: ate: 7//2.//7 Initials: 5/00/4L J'?) 46.1.4.-1449 I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 CITY OF TIGARD MASTER PERMIT F ! 2:''' COMMUNITY DEVELOPMENT Permit#: MST2017-00086 T k.G,AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/17/2017 Parcel: 2 S 104AC 14900 Jurisdiction: Tigard Site address: 12825 SW 133RD AVE Subdivision: WALNUT RIDGE Lot: 3 Project: Walnut Ridge, Lot 3 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 5 First: 1352 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1533 sf Garage: 491 sf Front: 0 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: 2885 sf Value: $347,912.98 Rear: 0 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 5 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 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 5 201-400 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 2885 Owner: Contractor: RIVERSIDE HOMES LLC RIVERSIDE HOMES LLC Required Items and Reports(Conditions) 17933 NW EVERGREEN PKWY, 17933 NW EVERGREEN PKWY 370 1 Geotechnical Inspection #370 BEAVERTON,OR 97006 Required before foundation BEAVERTON,OR 97006 2 Ersn Cntrl 503-639-4175 PHONE: PHONE: 503-645-0986 FAX: 503-690-2942 Total Fees: $30,730.27 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. ain a cooi rules or direct questions to OUNC by calling 03.232.1987 or 1.800.332.2344. Issued By: / ,� Permittee Signature: 03.639.4175 by 7:00 a.m,for the next available inspection d ' 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. Building Permit Application Residential ' City of Tigard r Date/By: pl) Received � ;/ /7 y PermitNo.: 57-16� ;� 13125 SW Hall Blvd.,Tigard,OR- 3 A kk�� � -��� � S Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/By: p1-�7- i 7 Other Permit: )(J7(7„.,,e). .7S 1 �. 1 1� Inspection Line: 503.639.4175 1 '4017 Date Ready/By: 4.// Minn s:: H See Page 2 for Internet: www.tigard-or.gov EB . Notified/Method / �99 venlr�. )��L_V I Supplemental Information TYPE 0C F d IG RD REQUIRED DATA:1-AND 2-FAMILY DWELLING ®New construction 3U ItC>iC Ill forN 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 CATEGORY OF CONSTRUCTION work indicated on this application. ® 1-and 2-family dwelling ❑Commercial/industrial Valuation: $ ,347) J la ❑Accessory building 0 Multi-family Number of bedrooms: 5 ,_}.� 0 Master builder 0 Other: Number of bathrooms:� . 3 ,/ JOB SITE INFORMATION AND LOCATION Total number of floors: 2 3 3 7 / Job site address:12825 SW 133'"Ave New dwelling area: 2885 square feet 1? City/State/ZIP:Tigard,OR 97223 Garage/carport area: 491 square feet Suite/bldg./apt.no.: Project name:Walnut Ridge Covered porch area: 45 square feet , 5 3 3 Cross street/directions to job site:SW Walnut&SW 133"Ave. Deck area: 0 square feet j 3 S'el Other structure area: 0 square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision:Walnut Ridge Lot no.:03 Permit fees*are based on the value of the work performed. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. Construction of SFR Home Valuation: $ Existing building area: square feet New building area: square feet ® PROPERTY OWNER 0 TENANT Number of stories: Name:Riverside Homes,LLC Type of construction: Address:17933 NW Evergreen Parkway,Suite 370 Occupancy groups: City/State/ZIP:Beaverton,OR 97006 Existing: Phone:(503)645-0986 Fax:( ) New: 14 APPLICANT 0 CONTACT PERSON BUILDINGPERMIT FEES* Business name:Same as Above (Please refer to fee schedule.) Structural plan review fee(or deposit): Contact name:Brett Groves FLS plan review fee(if applicable): Address: Total fees due upon application: City/State/ZIP: Amount received: Phone:( ) Fax::( ) E-mail:bgroves@riversidehome.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System. Business name:Riverside Homes,LLC Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:17933 NW Evergreen Parkway,Suite 370 Solar Installation Specialty Code checklist. City/State/ZIP:Beaverton,OR 97006 Permit Fee(includes plan review $180.00 and administrative fees): Phone:(503)645-0986 Fax ( ) State surcharge(12%of permit fee): $21.60 CCB lic.:189148 Total fee due upon application: $201.60 Authorized signature: ei.,.....,-- This permit application expires if a permit is not obtained n within 180 days after it has been accepted as complete. Print name:Brett Groves Date:2/20/17 *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Application FOR OFFI(F I. O\I.\ City of Tigard Received g FIVED DateBy: Permit No.: / ), I 13125 SW Hall Blvd.,Tigard,ORit { i Plan Review Phone: 503.718.2439 Fax: 503.5 Date/By: Other Permit: 1 1(,A R I) Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov1 Notified/Method: FEBC7 2 1 2l Supplemental Information -4-_,,,, Mechanical permit fees*are based on the value of the work ®New construction ❑Additiol lLc 1 4 y, performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: L mechanical materials,equipment,labor,overhead,and profit. a _ Value:$ i I a_ - t �I .,y, s� x:�, , fir' ® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessorybuilding n g For special information use checklist. ❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total at# 1: 'kM € y '''0',7, Heating/cooling:4a :a m i t tAir cnditioning 1 46.75 46.75 Job site address: 12825 SW 133rd Ave. Furnace 100,000 BTU(ducts/vents) 1 46.75 46 75 City/State/ZIP: Tigard, OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: Walnut Ridge Duct work 1 23.32 ?3 39 Cross street/directions to job site: SW Walnut&SW 133rd Ave. 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 23.32 Subdivision: Walnut Ridge 1 Lot no.: 003 Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 1 23.32 93 39 P 1 u w s 8 > t !fit , `_ Gas fireplace/insert 1 33.39 33 39 Flue vent for water heater or gas Construction of SFR fireplace 1 23.32 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 t t Other: 23.32 ., Environmental exhaust and ventilation: Name: Riverside Homes, LLC Rangehood/otherkitchen equipment 1 33.39 33.39 Address: 17933 NW Evergreen Parkway, Suite 370 Clothes dryer exhaust 1 33.39 33.39 City/State/ZIP: Beaverton, OR 97006 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 5 23.32 116.60 Phone:( 503) 645-0986 Fax:( ) Attic/crawlspace fans 23.32 r. „ .. a a t 471.:',,117t; Other: 23.32 Fuel piping: Business name: Same as above $14.15 for first four;$4.03 for each additional Contact name: Brett Groves Furnace,etc. 1 14 15 Address: Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater 1 14.15 Phone:( ) Fax::( ) Fireplace 1 14.15 Range 1 14.15 E-mail: bgroves@riversidehome.com Barbecue <ro A , k Clothes dryer(gas) Business name: Pyramid Heating &Cooling Other: . iF ANi '',45'4.:.!)'' * ;r , Address: 9409 NE Colfax St. Subtotal 460 15 City/State/ZIP: Portland, OR 97220 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:( 503) 786-9522 Fax:(503)786-3432 State surcharge(12%of permit fee) CCB lic.: 59382 TOTAL PERMIT FEE I/ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signature: f * Fee methodology set by Tri-County Building Industry Service Board Print name: Brett Gro, Date: 02/20/2017 I:\Building\Permits\MEC_PertnitApp_040113.doc 440-4617T(I 1/02/COM/WEB) Electrical Permit Application rolz orrlcl: t.Sl:0\l.1 b � 0 Ci o Tigard ' `J f g i 1 i t; Permit#: .5 L f ,. o if .� 01 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 2 DateB : Related Permit#: Inspection Line: 503.639.4175 :—FB 1 2 0 Ready Date/By: orris: 0 See Page 2 for I I G A R I) Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORKon GARD PLAN REVIEW ®New construction ' Please check all that apply(submit 2 sets of plans w/items checked): 0 Addition/alterati r 4 1-411/111 ki3 Y ,,'1 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. 0 Multi-family ❑Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: Job site address: 12825 SW 133rd Ave 100HP or more. ❑"A","E","1-2","1-3", 0 Six or more residential units. occupancy. City/State/ZIP: Tigard, OR 97223 ❑Recreational vehicle parks. 0 Health-care facilities. Suite/bldg./apt.#: Project name: Walnut Ridge 0 Hazardous locations. 0 Supply voltage for more than 0 Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: SW Walnut&SW 133rd Ave. FEE SCHEDULE Description I Qty. I Each I Total I New residential single-or multi-family dwelling unit. Subdivision: Walnut Ridge Lot#: 003 Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 168.54 4 Ea.add'1500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential Construction of SFR (with above sq.ft.) 75.00 2 Limited energy,multi-family 75.00 2 residential(with above sq.ft.) (� PROPERTY OWNER ❑ TENANT Renewable Energy 0 See Page 2 Services or feeders installation,alteration,and/or relocation Name: Riverside Homes, LLC 200 amps or less 100.70 2 Address: 17933 NW Evergreen Parkway, Suite 370 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: Tigard, OR 97223 601 amps to 1,000 amps 301.04 2 Phone:( 503) 645-0986 Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: bgroves@riversidehome.com 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 0 APPLICANT ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name: Same as above above service or feeder fee, 7.42 2 each branch circuit Contact name: Brett Groves B.Fee for branch circuits without Address: service or feeder fee,first 56.18 2 branch circuit City/State/ZIP: Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Fax: :( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: bgroves@riversidehome.com Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: Gamer Electric Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address: 2920 SE Brookwood Ave#1 panel,alteration,or extension. 0 See Page 2 2 City/State/ZIP: Hillsboro, OR 97123 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:( 503) 648-4552 Fax:( 503)642-7925 Investigation(1 hr min) 90.00/hr Email: ge@gamerelectric.com 34/e 305`C.- Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is CCB Lic.: 121159 Electrical Lic. 75 Suprv.Lic.:3 71'7 , specifically listed(%z hr min) 90.00/hr ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: AZA Subtotal: Print name: Chuck Garn Date: 02/20/2017 ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): #47,Authorized signature: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Brett C�TOVBS , Date: 02/20/2017 days after it has been accepted as complete. • Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB . Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: MinliMEEMUIFIMMEM Fee for all residential systems combined: $75.00 °e Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less III 100.70 _© 5.01 to 15 kva 133.56 _© ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 _© Wind eneration s stems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 _© E Garage Door Opener* 50.01 to 100 kva 552.26 © >100 kva(fee in accordance ■ 552.26 —© with OAR 918-309-0040 ❑X Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 III 7.42 _© ❑ Vacuum Systems* >100 kva—no additional charge 0.0 _© Each additional ins•ection over allowable in an of the above: ❑ Other: Each additional inspection is ■ 66.25/hr _111 char•ed at an hourl 1 hr min Inspections for which no fee is ■ 90.00/hr _. s :ificall listed %lir min 4 Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 • Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 Plumbing Permit Application • Building Fixtures OFFICE ISE Otil.N City of Tigard �' .1 g V ''' eived Date/By: Permit No.'"57--Jed.7 c r�yy III III 13125 SW Hall Blvd.,Tigard,OR 97223v{� I Plan Review Phone: 503.718.2439 Fax: 503.598.1960rti ,i 1 Date/By: Other Permit No.: Inspection Line: 503.639.4175 2 j L I I c,A I:1) p Date Ready/By: Jur s: H See Page 2 for Internet: www.tigard-or.gov .tified/Method: Supplemental Information p�� s ®New construction 0 D $ 1 , +�I For special information use checklist Description I Qty. I Ea. I Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) �ai . t t , tz• 0,-.Alk:- SFR(1)bath 312.70 ® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Firesprinkler(_sq.ft.) Page 2 v ` ,, t 1 "",. r:t a ; Site utilities: Job site address: 12825 SW 133rd Ave. Catch basin or area drain 18.76 Diywell,leach line,or trench drain 18.76 City/State/ZIP: Tigard, OR 97223 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name: Walnut Ridge Manufactured home utilities 50.03 Cross street/directions to job site: SW Walnut&SW 133rd Ave. Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: Walnut Ridge I Lot no.: 03 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 u:" itrBackwater valve 12.51 Clothes washer 25.02 Construction of SFR Home Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 .. <t AT' .<1.., ._ r Expansion tank 12.51 Name: Riverside Homes, LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 17933 NW Evergreen Parkway, Suite 370 Garbage disposal 25.02 City/State/ZIP: Beaverton, OR 97006 Hose bib 25.02 Phone:(503) 645-0986 Fax:( ) Ice maker 12.51 L _3. s tiw. t , Interceptor/grease trap 25.02 Business name: Same as above Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Brett Groves Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 12.51 E-mail: brroves@riversidehome.com Urinal 25.02 Water closet 25.02 : : . < Water heater 37.52 Business name: H &H Mechanical Water piping/DWV 56.29 Address: 5757 SE Willow Ln Other: 25.02 City/State/ZIP: Milwaukie, OR 97267 Subtotal Phone:(503) 975-9787 Fax:( ) Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lic.: 178122 P robing Lic.no.: PB414 State surcharge(12%of permit fee) Authorized signature: _kir TOTAL PERMIT FEE Print name: Brett Gro Date: 02/20/2017 This permit applicationxpaisrbseefn apmietd isasnctomlaeitnee.d within 180 days *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) A City of Tigard III 'I COMMUNITY DEVELOPMENT DEPARTMENT T I G A R D Building Permit Review — Residential Building Permit #: 7^r57- /7-c:.Y r ; Site Address: A32_C ,S)A) /33d A--e_ Project Name: A /nu7I- ,gicr , Lot #: :,. (New dwelling=subdivision nddition or Alteration=last name of owner) Planning Review ��(��(////// Proposal: UIJ S -te V. Verify Y site address/suite#exists and activ in permit system. ¶ver Terrace Neighborhood: No ❑ Yes,See River Terrace Review Addendum Attached Si Plan Elements: ree(3) copies of site plan . 4 'sting structures on site e plan must be on 8-1/2"x 11"or 11 x 17"paper 1/Footprint of new structure(including decks)with finished V/awn to scale(standard architect or engineer scale) oor elevations orth arrow Utili locations(required for new,may apply for additions) to address,project or subdivision name and lot number ation of wells/septic systems .plicant information(name and phone number) xisting trees to be retained with drip line,and tree PI,Lot .' ensions and building setback dimensionsrotection measures a 0. area,building coverage area,percentage of coverage and atreet 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 lean Water Services—Service Provider Lett r(lot platted prior to 9/10/1995): Required: ❑ Y s,applicant was notified No Received: ❑ Yes ❑ No 11 Public Faciliti s Improvement(PFI) Permit: equired: Yes,applicant was notified/ ❑ No Applied For: Yes ❑ No,stop intake and Use Case#: -�, t(6Q0 j 7" e toning: �� p- �., ' Required Setbacks: Front Qo Rear S— Side e--- Street Side A49..Garage II l andscape Requirement: 0/0 et Coverage Maximum: % / ! nn it !I Building Height: Maximum Height 3O Actual Height c �Q 1 t isual Clearance LT, Easements i el l.ensitive Lands: ❑ Yes No Type 1I Urban Forestry Plan II Conditions "Met"prior to issuance of building permit Notes: 67 Approved By Planning: -- -� _ Date: 02 7///'-.7_ Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw_RES_091216.docx Building Permit Submittal Original Submittal Date: 421/41/1 7 Site Plans: # '3 Building.Plans: :i.Building Permit#: nter building permit#above. Workflow Routing: L - Th ring 2-"Egineering E-1Te�rmit Coordinatorut cling Workflow Sign-off: 'Si -off for Planning(include notes from planning review) Route Application Documents: Engineering: (1) copy of permit application, (1) site plan, (1) building plan and of al 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: „f „�.,e.,,_ Date: ?XVI 7 Engineering Review Slope at building pad: /L2 Conditions "Met"prior to issuance of building permit ,, ,,21.Easements (encroachments)per engineering conditions of approval and plat ❑ Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: El Yes I 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: 'f IZ I) Date: .„7-_,,(57.--/7 Revisions (after Building Submittal only) Reviewer Date Revision 1: El Approved El Not Approved Revision 2: El 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: (SIDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: C , Yes 1 ❑ N/A K to Issue Permit 3 / /2 Ap roved by Permit Coordinator: Date: 7 I:\Building\Fonns\BldgPermitRvw_RES 091216.docx City of Tigard $4COM■ MUNITY DEVELOPMENT DEPARTMENT T I G A R Building Permit Review — Residential Building Permit #: to T7"arE 7—0(-1-3E--- Site C(-3r3E---Site Address: /2 9 `?it) j5 ®��1 L LC),Jl Project Name: c - / Lot #: (New dwelling=subdivision Addition or Alteration=last name of owner) Planning Review CCC���JJJ//J Proposal: AA() &r-le ! . Verify r i` verify site address/suite#exists and actio permit system. itilKver Terrace Neighborhood: No 0 Yes,See River Terrace Review Addendum Attached Si'Plan Elements: tie(3)copies of site plan ' ,;sting structures on site Ste lan must17"paper r p �g on 8-1/2' a 11'or 11 x a r Vi Footprint of new structure(including decks)with finished rawn to scale(standard architect or engineer scale) ,oor elevations orth arrow vA U:' locations(required for new,may apply for additions) gtr e address,project or subdivision name and lot nnmbrr f ! ,tion of a,ells/septic systems (1 .plicant information(name and phone number) !!.•listing trees to be retained with drip line,and tree 71 •t•',.erasions and building setback dimensionsrotection measures • I.• area,building coverage area,percentage of coverage and V t tree size,type and location impervious area(applicable if R-7,R-12,R-25&R-40) Street names !A Property corner elevations(2 foot contour lines if more than 4 foot differential 0 s lean Water Services—Service Provider Lett (lot platted prior to 9/10/1995): Required: 0 applicant was notified No Received: 0 Yes 0 No ►I Public Faciliti s Improvement(PFI)Permit: itequired: Yes,applicant was notified 0 No Applied For. Yes 0 No,stop intake d Use Case#: .gGL6�.d>±�_Q I Required Setbacks: Front ae) Rear S" Side t•-- Street Side ) e II 1"andscape Requirement: % - � ���'' RI •t Coverage Maximum: % IA Building Height: Maximum Height c ) Actual Height H I t t titl)f)pisual Clearance Easements j Il A.ensitive Lands: 0 Yes VNo Type '1 Urban Forestry Plan j rA Conditions"Met"prior to issuance of building permit Notes: Approved By Planning: Date: Revisions(after Building Submittal only) Reviewer Date Revision 1: lg Approved 0 Not Approved 1 j I D 1 11 Revision 2: 0 Approved ❑ Not Approved 11 Revision 3: 0 Approved 0 Not Approved I:\Building\Forms\BldgPennitRvw RES_091216.docx Building Peimit Submittal Original Submittal Date: 2/ I/f 7 Site Plans: # 7 Building Plans: # Building Permit##: nter building permit#above. Workflow Routing: arming El-Sriiineering ElnIrrrmit Coordinator L $ Workflow Sign-off. 0''S -off for Planning(include notes from planning review) and Route Application Documents: Q Engineering. (1)copy of permit application,(1)site plan,(1)building plan o al plan review routing form. ding: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: Date: a2/j„0-71 7 Engineering Review Slope at building pad: /C77 Conditions"Met"prior to issuance of building permit Easements (encroachments)per engineering conditions of approval and plat 0 Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: 0 Yes No Assess Water Quantity Fee in-lieu: 0 Yes No LIDA Facility on lot 0 Yes No 0 NOT Approved by Engineering: Date: Notes: Approved byEngineering: > JJ Date: ,7:1,e167-1 Reviewer Date Revisions(after Building Submittal only) lx / V Revision 1: rg Approved 0 Not Approved 1&t.r.' Y)S 14 tI P.1 -'1' f, .I .0 Revision 2: 0 Approved 0 Not Approved ei7V Revision 3: 0 Approved 0 Not Approved Permit Coordinator Review 0 Conditions"Met"prior to issuance of building permit 0 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 0 N/A Tigard Trans SDC: Yes 0 N/A Parks SDC: L Yes 0 N/A /q �►i B to Issue Permit "Or-Date: 3/1//9- Ap'roved by Permit Coordinator: I:\Building\Forms\BldgPermitRvw_RES 091216.docx City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 12825 SW 133RD AVE, TIGARD, OR, 97223 September 6, 2017 at 10:27:51 AM Record Type: Record ID: Residential - Master Permit MST2017-00086 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: 12825 SW 133RD AVE, TIGARD, OR, 97223 September 6, 2017 at 10:29:38 AM Record Type: Record ID: Residential - Master Permit MST2017-00086 Inspection Type: Inspector: 399 Plumbing 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: 12825 SW 133RD AVE, TIGARD, OR, 97223 September 6, 2017 at 10:28:55 AM Record Type: Record ID: Residential - Master Permit MST2017-00086 Inspection Type: Inspector: 699 Mechanical 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: 12825 SW 133RD AVE, TIGARD, OR, 97223 September 12, 2017 at 1 :19:09 PM Record Type: Record ID: Residential - Master Permit MST2017-00086 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. Insulation certification checked. Blower door test report received. C of 0 left on site with contractor. Note: contractor on site installing fall prevention device on upper level back bedroom and closing triangle openings on stairs in garage. No ac installed at time of final inspection. No rail required at front entry less than 30" 3' horizontal of landing. Violation Summary: Inspector Contractor