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Permit CITY OF TIGARDMASTER PERMIT '' COMMUNITY DEVELOPMENT � �: Permit#: MST2016-00572 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 • Date Issued: 04/25/2017 ( � 9 Parcel: 25111 DA22900 Jurisdiction: Tigard Site address: 15547 SW APPLEWOOD LN Subdivision: HERITAGE CROSSING Lot: 48 Project: Heritage Crossing, Lot 48 Project Description: New SF. 6/26/17, REPRINTED to correct#of hose bibs to(2). BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 3 First: 701 sf Basement: 0 sf Left: 4 Parking Spaces: 0 Height: 35 Bathrooms: 3 Second: 991 sf Garage: 340 sf Front: 15 Smoke Dwelling Units: 1 Third: 327 sf Right: 4 Detectors: Yes Total: 2019 sf Value: $244,690.31 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 Storm Sewer 100 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 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<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'500 sf: 3 201-400 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 2019 Owner: Contractor: DR HORTON INC DR HORTON INC PORTLAND Required Items and Reports(Conditions) 4380 SW MACADAM AVE STE 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: $28,397.13 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 .. • .ugh 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 = , � �t/�_/ . Permittee Signature: �_�4r-t'<r 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. r CITY OF TIGARD MASTER PERMIT II: COMMUNITY DEVELOPMENT TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Permit#: MST2016-00572 Date Issued: 04/25/2017 Parcel: 2S 111 DA22900 Site address: 15547 SW APPLEWOOD LN Jurisdiction: Tigard Subdivision: HERITAGE CROSSING Project: Heritage Crossing, Lot 48 Lot48 Project Description: New SF BUILDING Garage: 340 sf Front: 15 Smoke Stories: 3 Bedrooms: 3 Floor Areas First: 701 sf Reouire dge ks Rem a Height 35 Bathrooms: 3 Basement: 0 sf Second: 991 sf Left: 4 Parking Spaces: 0 Dwelling Units: 1 Third: 327 sf Total: 2019 sf Right 4 Detectors: Yes Value: $244,690.31 Rear 15 nks: 1 ater Closets: 3 PLUMBING Lavatories: 4 Washing Tach: 1 aun•ry rays: 0 Dishwashers: 1 S Floor Drains: 0 'aDrain: 1 rivals: 0 Tubs/Showers: 3 Garbage Disp: 1 Sewer Lines: 100 Water Heaters: 1 SF Rain Storm Sewer 100 Footing Drain: 0 Ice Maker: 1 Water Lines: 100 Drains: 0 Hose Bib: 1 Backwater Value: 1 Bckflw Prevntr: 0 Catch Basins: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: Fuel Tvoes MECHANICAL Air Conditioning: N Vent Fans: 5 Natural Gas Heat Pump: N Clothes Dryers: 1 Furn<100K: 1 Hoods: 1 Other Units: p Vents: 0 Woodstoves: 0 Furn>=100K: 0 Gas Outlets: 4 Residenunit ELECTRICAL Service Feeder 1000 sf or less: 1 �—' Temp Srvc/Fenders 0-200 amp: 0 B►anch_ ire`its_ Ea add'I 500 sf: 3 0-200 amp: 0 W/Svc or Fdr: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: p 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 Class of Work: BUILDING INFO NEW Type of Use: Type of Constr: SF Occupancy Group; Owner: VB Square Feet: Contractor: R-3 2019 DR HORTON INC DR HORTON INC PORTLAND Required 4380 SW MACADAM AVE STE 100 4380 SW MACADAM AVE SUITE 100 1 Ersn Cntrl 503-639-4175ms and Reports(Conditions) PORTLAND,OR 97239 PORTLAND,OR 97239 PHONE: 503-222-4151 PHONE: 503-222-4151 Total Fees: $28,397.13 FAX: 503-222-1304 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 days. ATTENTION: Oregon law requiresAll work will 952-001-0010 through OAR 9/2-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR //�� more the 180 Issued By: �, , / 4I ,; .L" ��'�Lit Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspection date. C �� r 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. Builaline Permit Application s( 37U�t �� Residential , „ s . ., ,) t 1012 III I1(1 ( sl-ONLV City of Tigard . Ree i.ed Penn"N� C T 'a Phone: W HallBlvd.,243.,Tigard,OR 97223 Datc ri): a / /� J/d`U.VVt�'0( Z,? ' Plan ltcciee I ii 0[ " E 503.718 2439 Fax. 503.598.19(i(1 '; Date By. other Penuit: Inspection Line. 503.639 4115 Date Ready By lurks RI See Pat 2 for Internet: www.tigard-or.gov yotitliextMethod. 7I177/7p lementat Information ✓dr#t6 / GIca( r'f�>" TYPE OF WORK`` ' ' • ' REQUIRED DATA:1-AND 2-FAMILY DVS ELLiNG a New construction 0 Demolition Permit fees*are based on the%alue of the work performed. Indicate the value(rounded to the nearest dollar)of all 0 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. _i Q 1-and 2-family dwelling D Commercial'industrial Valuation: S aYq ❑ Accessory building 0 Multr-family Number of bedrooms: 3 ❑Master builder 0 Other: Number of bathrooms. f' JOB SITE INFORM ATION AND LOCATION - Total number of floors._3 Si Job site address: 7 1 / go . . . —a New dms etting arca: ab tet square feet 7 City/State/ZIP:Tigard,OR 97223 Garage:carport area: (.3y0 square feet 1 / Suitebldg.lapt.no.: Project namt '- ri viz l/Y 1' 5 y\1 Cohered porch area: Cl3 square feet a / Cross streetidirections to job site: Deck area. square feet ff Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Lot no.: -lc( 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: S New SFR Existing building area: square feet New building area: square feet in PROPERTY OWNER 0 TENANT Number of stories' Name: DR Horton Inc. Type of construction: Address: 4380 SW Macadam Ave Suite 100 Occupancy groups: City/StateiZIP:Portland, OR 97239 Existing: Phone:( 503) 222-4151 Fax:( ) Nev.: 0 APPLICANT * CONTACT PERSON BUILDING PERMIT FEES* (Please refer toiee schedule Business name: DR Horton Inc. Structural plan review fee(or deposit): Contact name:Emerald Weeks -- FLS plan reviev. 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 xl 107 Fax.:( ) E-mail: esweeks@drhorton.com PHOTOVOL rAK SOLAR PANEL Sl STEM FEES 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 � Solar Installation Specialty Code checklist. ' Permit Fee(includes plan review CityiStaterZIP: Portland, OR 97239 and administrative fees): 5180•(10 Phone:(503 )222-4151 Fax:( ) State surcharge(12°' of permit fee): $21.60 CCB tic.: 130859 Total fee due upon application: 5201.60 Authorized signature: i f This permit application expires if a permit is not obtained i + within 180 days after it has been accepted as complete. "Fee methodology set by Tri-County Building Industry Print name: , , , i .', j I v 1 t t . ' Date:2016 — Service Board. 1:Building.Pcrtnits B111-RESPcnnitApp.doc 0224.2011 446.461371 11:02 COM'WEB i % 1lechanpical l'erp. 124it 14 Af p,,t.. ie(l1) ii -•,-,, , }f R it ,' I 4(IS _I_ . _ . I1if,., ,, 1,4. 44,4 i' 1 .-1 *) -,.11 . •••-• .-- A ...-- — A 111114„-A 11c*ti 1 WV iti3 big I14 1\:,' ' 1 '1 / , 0 1/11 1,,,..' t1. rn,..:1,,, ttoc,,,,ct 1.1.51.M tliz.ird 01.t,..•• 1,uppliturnial 6111,11999944-94 `. .1 - - ; ' 1-. '• --- .,,_________,,_ . . -- --.--------- , COMMERCIAL EE FSCHEDULE USE(.11Ecklis I TVP11,4#'1NomAk.y,-, .., , 1.\'.'.'. ..:031Ntili;SIOD 0 Viita1.11%:1,114 ql 'Vrti,.4-..1);.. , 1,,!.,111.01 ilf,11,II, .tils',ilUt!,t,1..",it'd I o ft,..-1,...11.,, Liir,,uov fif-r ,,,of,...ul :),J1,1.pe'...,0 1/0110111101 0 1.11.11.0 4 — - t , CATEGORY OF CONSTRUCTION , ! RESIDENTIAL EQUIPMENT i SYSTEMS EVES- ,..._,_ larmit ,tsciirly, 0( ,.min ,mt mdit,I,I,o 0 \,,,,,,,•:, =,.ii,tp,,.. 1 4,pc,)4 wfolluatu,"ee‘e."we A114 . . - 0 Nitiitt•tainth LI eri,,,,,4:1 hultdo C'ni,, , JOB SITE INFORMATION AND IATCATION , J.„,,, 4-1 4Hi,. .4,4, /11°- Ti aid C. 9 711 1 .... , ... h11 ,,, ; p,,,,,1 1AA1.,. -V....AAAt r ). k., ' ; .... . ,_ . . ... 4 4 4,-..,-11/..-t1 4-1.„--,II,/hi,*.-'1--.4," 11.4,h,,,-,, ,- , ,- ...-.4.- . _ - A'1 AA, A • . I 11'41,4_0i',11.1,1 t'qt; ,t;t•11A's 1 ,, , 1•1 ‘,..t1-,,,ilt 411,1 ...1.1,,,,..'Ad „'1, 1, • —. __ . . + -4 . 1 11-...“;,,,,,-1141,4.--;!:ol .41.4‘. , .. • 1.4 th I 1 14.111,10 pon„cl 1. A/ter t,..e.,/y/ --. * -- ,--- DESCRIPTION OF WORK ! ),.1.1.:!...-0,.., • • t - , — . ....—...... _ -- -- ii,,,. 94411,14 999,0,-.4 N CU'SFR , ,„q1,1.1 i . . ; • — — " „ t•11,4,11tet :t.' ..t . . % 4 '1 .-i• ... -.,.., _,„„,,,,.. ...... h'oottc, .0,94:' 4%.c•,,,...1 1 . . 1....,..... _ ,,.,.., _...,.._..,,,,,„...„, . PROPERTY OWNER I 0 TE9111-w NANI i ! DR Horton Inc. R rtort/,.,,,4.141-1,./.1,14.01;41' . .... t ' .,,,,i,c,,,,-., _ „; • — \JAI,–480S\\ Maamrc Sut,: 100cadAi ... ... , 1 . ..; ,h,,,,,,.„L.-,0.,, ,, I , ,Is ‘4-41,"iiP Portland.()R p7239 1 ,L",••".: '''''t'i. ''*-41•''''''•-' , • 11,011,.: ,F,03 ) 222-4151 1.1, 1 , ,44,, , 4,',.1-..., h.lt, . =. ; --- ...--. 0 0 CONTACT PERSON I • , , , _ ....._....L.„........_.... .......... --- i fuel pipin: 1 1c"#.4"14c Unt Horton inc. . . ......_.. ... „...... %14 11t fur firm lour.',rt.01 lot tor Is trItItttonal ; 1‘1114,1 132IM,' limerald tVecks „ . .. ,. ‘4141i,s- 4380SW Nlacadarn A Vt.' ,S0111: 100 . . '4.441,,,,,Trtn4,.I in 4,-14s4 ( ON 99'.t.44,. /ft Portland,(.)R 97239v,It-,Art1 419' , 1 • - 1 • ... t r..,,r- , 01 222- -1151 s I 107 , i ,‘ , , I . . . . .. ... , 1, es weeksta,tirhorton.coni 1_-I-- - '--– ' --- ' carrigh,crOR i - , _ -- 1115 - 14,-1•,?‘, 441114 - X.:A (4, t' .., , „,,,,,, ,.. , MECHANICAL PERMIT FE} ' rv,. 4) ,i/ ,hit itA, , -,),- ,,,,,,t„L I r II, 4, /IP 1 f,. .-1 / A _.-„...._ ..., , ., ' -' th440oh .., . - , • _ ,_•. _ .,. 11, • 1 '1'0 1.'k '- tt, ; • 1 rt i,A44, tt --1...., ,"! : 5, 1 *j...'. ..'. YI 4 4 ';, , , ..4'' 1.':.rf it)I II PI RS111 iff I ht.,I.1 14;44111/1111,*10•0 44 ror*5 4 A I.t Mil 9999 PIM 441•A904t1 4.5411455 1115 .. 3.l,iii*t if hat NS,.At*tilted A,CitfTtithli Ad 4404.111311.1. • , . . Ti III rt 01 ..-. "- t - I 4t.. .., --- ..-tt-- 4 ,... •, ' Electrical Permit Applicatiolt I ,,,z(>1 I I( 1 I ,I ()NI \ Received City of Tigard Datailly: Permit No,;4,t5 7 )/(,--cx,62 , 'PI ---e 13125 SW Hall Blvd.,Tigard,OR 97223 ., ,, Plan Review ir: Phone: 503.718.2439 Fax: 503.598.066 ` ', - Date/By: Other Permit Inspection Line: 503.639.4175 Date Ready/By: Jerk El See Page 2 for - Internet: www.tigard-or.gov , . . , Natifiedfhiethod; Supplemental Information .. - TYPE OF WORKq -• - •' , -,, . ' - PLAN.REVIEW 0 New construction 0 AdditiOniatterationireplacement Please check all that apply(submit I sets of plans wAtems checked below): 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 snips at 150 volts or 0 Floating buildings. less to gonad,or exceeds 14,000- Cl Corismercild-use avicultinal 0 1-and 2-family dwelling 0 Commercial/industrial- 0 Accessory building amps for all other installations. buildings. 0 Multi-family 0 Master builder ' 0 Other: El Fire puny, 0 Installation of 75 KVA or 0 Emergency system. larger separately derived system. JOB SITE INFORMATION AND LOCATION 0 Addition of new motor load of 0"A","E","1-2'11-3", 10011?or more. occupancy. Job no.: Job site address: I$fq7 3(A., Ip , 0 Six or more residential units. 0 Recreational vehicle parks. City/State/ZIP: 7' tri A or, ,,,,,,,, .Health-care facilities. 0 Supply voltage for more than 0 Hazardous canons. 600 volts nominal. Suite/bldg./apt no.:L) project name: ‘Aco- ciL. cArr)....c. v.,• oservice or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: I Deserted,. I Qty. I Per. I Tend I " New residential single or multifamily dwelling unit. Includes attached garage. Subdivision: Lot no.: ItTc 1,000 sq.ft.or less I 168.54 4 Ea.add'I 500 sq.R.or portion - 33.92 1 Tax map/parcel no.: Limited energy,residential 75.00 2 DESCRIPTION OF WORK • (with above sq It) Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Services or feeders installation,alteration,and/or relocation 200 snips or less 100.70 2 0 PROPERTY OWNER ' 0 TENANT I 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 amps 200.34 2 ' . 601 amps to 1,000 aims 301.04 2 Address: Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or City/State/ZIP: 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 201 amps to 400 amps 125.08 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2 • Brandi drcuits—new,alteration,or extension,per panel Owner signature: Date' A.Fee for branch circuits with — above service or feeder fee, 0 APPLICANT 0 CONTACT PERSON i 7.42 2 each branch circuit . Business name: DR Horton Inc B.Fee for branch circuits without service or feeder fee,first Contact name: Emerald Weeks branch circuit 56.18 2 Address: 4380 SW macadam Ave Each add'I blanch circuit 7.42 2 Miscellaneous(service or feeder not included) City/State/ZIP: Portland OR 97239 , Each manufactared or modular dwelling,service and/or feeder 67.84 I 2 Phone:(503) 222-4151 Fax::( ) i Reconnect only 67.84 2 ... E-mail: _. Pump or irrigation circle 67.84 2 Sign or outline lighting 67.84 2 • CONTRACTOR . i• - Signal circuit(s)or limited-energy Business name: %SA 14 ila 44- g(e ,..„..4-r,.;c panel,alteration,or extension. Page 2 2 Each additional inspection over allowable in any of the above Address: 2 goi/ a WE GrIlt 741,e- - t--"Cti- Additional inspection(1 hr min) 6625/hr hr m City/State/ZIP:: 14.1e)C 0£4 -. • 1///4 ,9fc C/ Investigation(1 in) 66.25/hr Industrial plant(1 hr min) 78.18/fir Phone:(3‘a .5-jf.... 7-5"..9 I Fax:oca) ssc... 966 67 bupections for win&no fee is specifically listed OS hr min) 90.00/hr CCB Lic.:1. 26.-- ,9 Electrical Lic.:.CZ.50 Suprv.Lic.: /7?I S : ELECTRICAL PERMIT FEES Subtotal: Suprv.Electrician signature,required: ) tir D..44......._41 Plan review(25%of permit fee): , Print name:C4 E -A, 6 a,6-•ft . Date: State surcharge(12%of permit fee): _ - . Authorized signature: ,/‘ ---- TOTAL PERMIT FEE This permit application expires it a permit is not obtained within 180 days after it has been accepted as complete. Print name: , Date: 9€90K . Number of inspections allowed per permit. L1BuddingTeraitsUILC.PennitApin 440.4615TOI/05./COWWEIB k .Electrical Permit Application—City of Tigard Page 2—Supplemental Information (e Limited Energy Permit Fees: Renewable Energy Permit Fees: . . RESIDENTIAL WORK ONLY: FEE SCHEDULE - Dew',tion ri5i471— Esc1-7*— Fee for all residential systems combined: $75.00 I Renewable electrical energy systems: 5 a or less 100,70 2 Check Type of Work Involved: 5.01 to 15 Iva 133.56 11 A• udio and Stereo Systems* 1501 to 25 k‘a 200.34 Wind .eneration systems in excess of 25 kva: ri B• urglar Alarm 25.01 Li 50 kva 111111=1 2 50.01 to IOU lo Ell 552.20 2 XI Garage Door Opener* >100 Ica(fee in iwcondance with(1AR1016-30)-0040) 1 552.2t F-1 H• eating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* --r- I ach additional kva over 25 E Vacuum Systems* .100 1(14 to additional chdrge 0.0 Each additional ins ection over allowable in any of the above: I Other: Each additional inspection I'. 66.25 hr char'ed al an hourly(1 hr min) 1Inspections lOr which no lee is 1)000 s led field) listed( hr min) lii COMMERCIAL WORK ONLY: ELECTRIC AL PERMIT FEES Fee for each commercial system: $75.00 Subtotal(Enter on Page 1). Number of inspections allowed per permit. (SEE.OAR 918-309-0000) Check Type of Work Involved: O Audio and Stereo Systems n Boiler Controls n Clock Systems E Data Telecommunication Installation • Fire Alarm Installation El HVAC' I Instrumentation I I Intercom and Paging Systems F Landscape Irrigation Control* El M• edical [11 Nurse Calls n Outdoor Landscape Lighting* P• rotective Signaling O• ther: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I.Buildiw Per Mr+i LC Po:nitApp LLR ERF de( tt. u' VLf:15. a. Plumbing Permit Application Building Fixtures I OR oil lc l: I S1 0NL1 Cityof Tigard . Received Penult Nq.(67AO/6,'GbS7� Phn 131SW Hall Blvd.,Tigard,OR 97223 Renew Other Permit No.: 11 Phone: 503.718.2439 Fax: 503.598:1960 DateDy: [(CARD Inspection Line: 503.639.4175 '' Date Ready/ay: mom: R See Pap t ter Intend: www.tigard-ar.gov , -u Nwified/Method: , Supplereutal lafruado■ Thrr>s OF Y ORKA .FEE' SCETEDUU `.: .;,, ' � For spedal information use checklist ❑New construction ❑Demolition Description I gt.X. I Ea. I Total Q Addition/alteration/replacement 0 Other. New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRtiICIION SFR(I)bath 312.70 ❑1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78_437.78 SFR(3)bath ❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler(__sq.ft.) Page 2 JOB°OM.)f l 01149*!1:SAND LOCATION Site utilities: SG., /pik4.,tA/ �i Catch basin or area dtrn 18.76 lob site address: �'s�7 Drywell,leach line,or trench drain 18.76 City/StatelZlP: - Footing drain(no.linear ft.: _ ) Page 2 Suite/bidgJapt.no.: [Project name: 0.\-- (2, Ir}1t7) 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 Water service(no.linear ft.:__,_) Page 2 Subdivision: 1 Lot no.: 1/S Fixture or item; Backflow preventer 31.27 Tax map/parcel no.: - Backwater valve 12.51 • •• DESCRIPTION OF:WORK •, 25.02 _ . _ . Dishwasher 25.02 t c> \--- Drinking fountain 25.02 Ejectors/sump 23.02 , •O PRS' OWNER . 0 .1 ❑ TENANT Expansion tank 12.51 , l Fixture/sewer cap 25.02 Name: j (J1� \V� - Floor drain/floor sink/hub 25.02 Address: U( } es. \ \\1\49\.Oi i .. 1 -k )- Garbage disposal , 25.02 ' City/State/ZIP: 6,14._ )e. 01,h0. Hose bib 25.02 i Phone:' P) -,, �. - --\-\. Fax:( ) Ice maker 12.51 Interceptor/grease trap 25.02 0 AtPLtCANT ' � CONTACT PERSON Medical gas(value:S ) Page 2 Business name: ›V__. \� t Primer 12.51 Contact name: `�1 Oi Roof drain(commercial) 12.51 Address: Sink/basin/lavatory , 25.02 City/State Z1P: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pen 12.51 E-mail: e��tiebiG6 okVi, u/rj� .C"v/k Urinal Water closet 25.02 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/LIP:HiLLSBORO,OREGON 97123 - Minimum permit fee: S72.50 Phone:(503)640-0113 I Fax:(503)640-4483 Plan review (25%of permit fee) CCB Lie.:94689 Plumbing Lie.no.:34-260PB State surcharge(12%of permit fee) � TOTAL PERMIT FEE r Authorized signature: ` 4111• ��Jr 'this permit apptiestiea expires ifs permit Is mor obtalaed within IRO days Print name:RAY M ULI.EN Date: atter it has bees accepted as complete. •Fee methodology set by Tri-County Building Industry Service Board. 1:1nu hiPamibVLMU•hrwitAtp.doe Iwo IMO e604616Tt10l02/COMM'E51 1111 City of Tigard " COMMUNITY DEVELOPMENT DEPARTMENT 11 r 1 c A R o Building Permit Review — Residential Building Permit #: /fjj`S 7--,z016, - OUs7,\ Site Address: /S-S-71--/-7 ,c7tC) rPfilitiOcil 24=2it.e Project Name: nt Q r S:in Lot #: .01 (New dwelling subdivision name; eration=last name of owner) Planning Review Proposal: &IA) 2Fi Verify site address/suite# exists and actio in permit s stem. gaiver Terrace Neighborhood: y No ❑ Yes,See River Terrace Review Addendum Attached SiS4 Plan Elements: V(ree(3)copies of site plan p: Isting structures on site e plan must be on 8-1/2"x 11"or 11 x 17"paper .7.Footprint of new structure awn to scale(standard architect or engineer scale) ore elevations (including decks)with finished rth arrow tility locations (required for new,mayapply for ' e address,project or subdivision name and lot number r\'... ( q pP y additions) b��/ . anon of wells/septic systems .licant information(name and phone number) I �sting trees to be retained with drip line,and tree FP .t dimensions and building setback dimensions , otection measures 7 .t area,building coverage area,percentage of coverage and 74 reet tree size,type and location pervious 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) O lean Water Services—Service Provider Lett (lot platted prior to 9/10/1995): equired: ❑ Yes,applicant was notified No Received: PElublic Facili ' Improvement(PFI) Permit: Yes ❑ No equired: 01 Yes,applicant was notified ❑ NoApplied For: re Yes ❑ No,stop intake Land Use Case#: � Qr)'c- . X000 ,� zZ na20j� C` iS Zoning: _i L2t,Required Setbacks: Front /,..c— Rear Side IStreet Side Garage andscape Requirement: ,Jot Coverage Maximum: 0 uilding Height: Maximum ht Hei g SS- Actual Height 3/ tsual Clearance Easements rEN b:-ensitive Lands: ❑ Yes L✓J No Type IG Urban Forestry Plan ❑ Conditions "Met"prior to issuance of building permit Notes: 46 AengS'f?u/� hp Approved By Planning: �---� N "� WIF;) Date: ai Revisions (after Building Submittal only) , Reviewer Date Revision 1: ElApproved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved 1:\Building\Forms\B1dgPermitRvw_RES 091216.docx Building Permit Submittal Original Submittal Date: Site Plans: # Building Plans: # Building Permit#: Enter building permit#above. Workflow Routing: ' Planning1..-Engineering —Permit Coordinator Building Workflow Sign-off: `Sign-off for Planning(include notes from planning review) Route Application Documents: grEngineering: (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: �, .4,,� ,L7�.4rAeit,,,� , Date: /2,12/4 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: ❑ NOT Approved by Engineering: Notes: �/ j� Approved by Engineering: 1�e'er ,/ Date: /:2,--,:2,2—71- 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 Rtf 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: . 'SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: Yes ❑ N/A Uv OK to Issue Permit Approved by Permit Coordinator: C IA i C Date: ID -a3 -1 S° I:\Building\Forms\BldgPernutRvw_RES_091216.docx City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15547 SW APPLEWOOD LN, TIGARD, December 20, 2017 at OR, 97224 1 :02:56 PM Record Type: Record ID: Residential - Master Permit MST2016-00572 Inspection Type: Inspector: 199 Electrical final David Young Result: FA I L Comments: Front door locked, 1 :01 pm. Provide access for inspections. R109.1 Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15547 SW APPLEWOOD LN, TIGARD, January 19, 2018 at OR, 97224 9:52:49 AM Record Type: Record ID: Residential - Master Permit MST2016-00572 Inspection Type: Inspector: 299 Final inspection David Young Result: PASS - CofO Comments: No lawn irrigation installed at this time. No ac installed. Final erosion control approved. Street tree certification received. Moisture content form received. High efficiency lighting form received. Blower door test report received. Insulation certification checked. C of 0 left on site with contractor. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15547 SW APPLEWOOD LN, TIGARD, January 17, 2018 at OR, 97224 10:50:50 AM Record Type: Record ID: Residential - Master Permit MST2016-00572 Inspection Type: Inspector: 699 Mechanical final Chip Barnett Result: PASS Comments: Previous inspection corrections completed Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15547 SW APPLEWOOD LN, TIGARD, January 17, 2018 at OR, 97224 10:51 :08 AM Record Type: Record ID: Residential - Master Permit MST2016-00572 Inspection Type: Inspector: 399 Plumbing final Chip Barnett Result: PASS Comments: Previous inspection corrections completed Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15547 SW APPLEWOOD LN, TIGARD, January 17, 2018 at OR, 97224 10:51 :47 AM Record Type: Record ID: Residential - Master Permit MST2016-00572 Inspection Type: Inspector: 199 Electrical final Chip Barnett Result: PASS Comments: Previous inspection corrections completed Violation Summary: Inspector Contractor