Permit INCITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2017-00147
T 1 G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/08/2017
Parcel: 2S111AA11500
Jurisdiction: Tigard
Site address: 14405 SW 90TH AVE
Subdivision: GREENSWARD SOUTH Lot: 9
Project: Greensward South, Lot 9
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1213 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1439 sf Garage: 532 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes
Total: 2652 sf Value: $326,508.56 Rear: 15
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
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0
Catch Basins: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Bckflw Prevntr: 0
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 6 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'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 2652
Owner: Contractor:
GP4 LLC FOUR D CONSTRUCTION Required Items and Reports(Conditions)
PO BOX 1577 PO BOX 1577 1 Ersn Cntrl 503-639-4175
BEAVERTON,OR 97075 BEAVERTON,OR 97075
PHONE: PHONE: 503-720-7445
FAX: 503-590-1751
Total Fees: $30,189.46
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 A EN Oregon law requires you to follow the rules adopted by the Oregon Utility Notification er. T.. - rules are set forth in OAR
95 -001-0010 through R 95 -001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.23 .198 or,,:.:60:33 -:,4.
Is ued By: Permittee Signature: Xt.
Call 503.639.4175 by 7:00 a.m.for the next available inspe on date.
This permit card shall be kept in a conspicuous place on the job site until completion o the project.
Approved plans are required on the job site at the time of each inspection.
' Building Permit Application
Residential FOR oFFI('t: t'51::ON 1.1
City of Tigard RECEIVED Received
(f
Date/By: r /917 Permit No.:1‘4,-,---21,517_6,7/ 7
13125 SW Hall Blvd.,Tigard,OR 97223 Pian Review `
`llit Phone: 5033.718.2439 Fax: 503.598.fr 19 2017 Date/ eyv y'-a F-r- 0 .r) other pera it,` a.,,,_,,,,_oe,/3 5--
i i k \E1 p Inspection Line: 503.639.4175 Date Ready/By: , J Juris: BI See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Methodh�'l/Li/ /7 Supplemental Information
BUILDING DIVISION >s1 mar�.�ll04k,-4
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
'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
CATEGORY OF CONSTRUCTION work indicated on this application.
Dif 1-and 2-family dwelling 0Commercial/industralValuation: $ a6 I QQQ
❑Accessory building ❑Multi-family Number of bedrooms: -1
❑Master builder 0 Other: Number of bathrooms: 3 l,
JOB SITE INFORMATION AND LOCATION Total number of floors: 2- 3 18 T
Job site address: ' LI 4 05 S. k</ 90 1-14- Ave New dwelling area: Z(p S 7.-square feet
City/State/ZIP: -1-1 (,a lv_1) 0 R 9 72.1V Garage/carport area: 53 Z square feet
Suite/bldg./apt.no.: Project name: (9 ti.sy; zl� 7 Covered porch areaSs�square feet I 439
Cross street/directions to job site: p area: i a a square feet j�i 3
_ Y
1414 U- 81_v.0 v 61 e-eivSeo AIL° LAN - 90 1-14- Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 6 ge E, 5-t,,14-(2.0 ,S:1 4•7--)-4- Lot no.: cl 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.
1
/ s A/6 4-Cr �iJ 1.`/t 1.,, % E5/DeNC.6 Valuation: $
,4
�VL6 .5./
f
Existing building area square feet
New building area: square feet
PROPERTY OWNER 0 TENANT Number of stories:
Name: Type of construction:
Address: SPA/16 143 c ,R61-04/` Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( )
New:
APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer tolee schedule)
Business name: Foto._ D cc,N=5 TR u Cr' 13
Structural plan review fee(or deposit):
Contact name:
f'Y1P DE 14A.,.24)Pour
FLS plan review fee(if applicable):
Address: ic',0. Box i S 7 7
Total fees due upon application:
City/State/ZIP: BEA ve R r-o 1 c 7 p 7 5
(65 3) "7 0 "71,y'5 Fax::(� ) 590 -' /757
Amount received: /7573Phone: a
E-mail: 'au 1r22..D Co A/57-6." evis r CO r PIiO TOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name: Submit two(2)sets of roof plan with connection details
l O v L.T and fire department access,along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
G;f Permit Fee(includes planreview $180.00
City/State/ZIP: ✓ and administrative fees):
Phone:( ) Fax:( )
State surcharge(12%of permit fee): $21.60
CCB lic.: 7/03'
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Date: c4 *Fee methodology set by Tri-County Building Industry
v) --r' �� �I��Q°J 7'J��� Service Board
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Application FOR OIIRT 1 SE ONl"l
City4. 5 ofW Tigard Receiv�C E C tl ED Date/By: Permit No.:114,r1964 7--66/47
lig • 13125 SW Hall Blvd.,Tigard,OR Plan Review
= Phone: 503.7182439 Fax: 503.598.1960Other Permit:
Inspection503.639.4175Date/By:
l I C;:�[.D Inn LinAPR 19 2017 Date Ready/By: loris: Id See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
CITY OF TIGARD
TYPE MING DIVISION COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
%New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
. Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
lif 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: / t/1j/Q,$ $.v/. 90 rri ig YC Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: r,,,,_12.4) o g- C/ 7 2.-LY Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name: Heat pump 61.06
Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
/4-F1t-L B LVb &REEIVSt,,auto 4/v .- 9'® r-f-{ hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision: Lot no.: 9
Other: 23.32
('2,E E/V "ia.i 1-12
s -
T Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
fireplace 23.32
{�6_ Log lighter(gas) 23.32
/y&L+1 S /1L.7 (:V C..C PY'/./1 I I.-y i" S) D ry A3 LAE Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
PROPERTY OWNER 0 TENANT Other: 23.32
4%
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: 5 14146- p...S 13 1 El.OW Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
Ir APPLICANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name: fou.R. C) ce)A3 srizaC'li 0 kj, $14.15 for first four;$4.03 for each additional
Contact name: 1)AV'1 P D E 144t-V--PPtAZ-r Furnace,etc.
Gas heat pump
Address: Pi (`I , 4 Ly 15 R7. f-y Wall/suspended/unit heater
City/State/ZIP: 13�=pv E(Z l ' 1:11,R.._ 9 7 07 S Water heater
Phone:(j C3) -2 0 ._ 7`/`/ S Fax::(503 5 70 .. (-is I Fireplace
Range
E-mail: Fora ILO CO i6 Si-E /;t/r Jl)i CO Mi Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: ,r+ Other:
&Aril A I - r- C- MECHANICAL PERMIT FEES*
Address: P.o , Box '433 Subtotal
City/State/ZIP: C kA �fJ ( e f C) t Minimum permit fee($90.00)
t Plan review(25%of permit fee)
Phone:(5c:13) 65 4,- / c7'o ' Fax:( ) -656-3 S brie State surcharge(12%of permit fee)
CCB lic.: /76 ‘;,--2,( V TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
. ___/
Print name: !.�''✓j .3. D .../../0/464,c2.4.Date: V. f c3-/7
T:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(I 1/02/COM/WEB)
•
, Electrical Permit Application 101.1 (71:H( 1 t ',NI- (,y 11
City of Tigard ��IVE Det B Permit#: v rc9/ 7-C (9 7
II 13125 SW Hall Blvd.,Tigard, Plan Review
Phone: 503.718.2439 Fax: 503.598.1960DateJBy: Related Permit#:
Inspection Line: 503.639.4175 APR 19 2017
11 .,4;I) Ready Date/By: (oris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
a TIGARD
TYF :, a ,,tQ PLAN REVIEW
New construction ❑Addit ti ort acem`eeni" Please check all that apply(submit a sets of plans w/items checked):
0 Service or feeder 400 amps or more ❑Building over three stones.
0 Demolition ❑Other;
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑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 0 Master builder 0 Other: ❑Fire pump. ❑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:
05 Si 90 TN AVC' lOOHPormore. ❑"A""E","1-2 "1-3",
City/State/ZlP: C� 1� ❑Six or more residential units. occupancy.
' (�A 12..4) c 1 12.7
0 Healthcare facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name: 0 Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: B /� yFEE SCHEDULE
Nil Lc.. P L V I) - I�RE LE IN 1 J G..A1 -- 9°6 r/-4 i New DescriptionesI Qtr. I Loeb I Total I s
New residential single-or multi-family dwelling unit.
Subdivision: 6'zee-m.5 60 Alto SW ti,j. Lot#: 9 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
P (with above sq.ft.) 75.00 2
11Vb 6-i 6 a. G- C=p NI r L,y ES / ii/L t� Limited energy,multi-family .
residential(with above sq.ft.) 75'00 2
Renewable Energy 0 See Page 2
PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less' 100.70 2
Address: ,SAME--
_ 201 amps to 400 amps 133.56 2
A Mt AS BELOW LOW 401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2
' Temporary services or feeders installation,alteration,an(Vor
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 l
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
tif
APPLICANT ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: F oL1,1Z DK/,5 rR(,1 cm fj above service or feeder fee,
7.42 2
each branch circuit
Contact name:
}N\/I 0 E )4124,'potz_--r B.Fee for branch circuits without
service or feeder fee,first
Address: p'o. B Cj X is-7'7 branch circuit 56.18 2
City/State/ZIP: BE.Aveg S-tg/0 C,g 9 7 )7 S Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone: 6(�jd3)-7.,2 0 -7 y t.5 Fax::(5"20 ),.5-90 -i 7 j / Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: 0 LI ¶2. 1-) C.6 SSC ���'• �-�h� Reconect onl
67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: EL -re- .& c r-/2I t;- 6 Pea P Sign or outline lighting 67.84 2
Address: /,s No OI4 l/0 V Signalnl,circuit(s)or extension.ionergy ❑ See Page 2 2
�, /fi j C3 ��, panel,alteration,or
City/State/ZIP: Each additional inspection over allowable in any of the above
ty Po a r L.}4../O && 9'72Z Additional inspection(1 hr min) 66.25/hr
Phone:(So3) z.7 7 3 746)9 Fax:(5;�3 ) ?t/ /,/ Investigation(1 hr min) 66.25/hr
Email: €G6177-- L.�Crj j L C gear C6 F\t ez :A Industrialspectplant hr min) 78.1 s/hr
Inspections for which no fee is 90.00/hr
CCB Lie.:/c//Z—i V Electrical Lic.:C(,3 5 Suprv.Lie.:5 76 2. S specifically listed('/2 hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:�.4.....AL Subtotal:
Print name: k(,13 itj2.:.7 r Aj.0 4.---.A0/9/217_Date: y-/g-i-7 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature:.4 .1 TOTAL PERMIT FEE:
T ^ Als �w_� I / /7 This permit applicationsrbas
if na cc pre is not complete. within NO
Print name:J p�,Q s. Ji/) Date: �/ . days after it hss been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Pennits\ELC_PermitApp ELR ERE.doc Rev 04/21/2014 440-4615T(11/05/COM/WEB
•
Plumbing Permit A li •
. Building Fixtures EIVE
City of Tigard APR 1 9 2017 Received Hh r �(,i5 / 7
Ijate/g Permit No.:
1, il 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Renew
0 Phone: 503.718.2439 Fax: 8 01'1 CARD Date/By: Other Permit No.:
1 1<..'\F_i) inspection Line: 503.639.4ILDI NG DIVISION Date Ready/By: Iuris: H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
New construction 0 Demolition For special information use checklist
Description Qty. Ea. Total
❑Addition/alteration/replacement 0 Other: , New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
0 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
❑Master builderEach additional bath/kitchen 25.02
0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: I W`i 05 s,v/, Rb ri4 A-YE Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: -J-1 ('(:)12,D Co R. C)'7 2.2-4/
Suite/bldg./apt.no.: Project name: Footing drain(no.linear ft.: ) Page 2
Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
I* 1 LL (3 LV i7 .- c.,g E Gi fs 4 # Ito ziv - 90 r „ Rain drain connector 18.76
J Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: 6.--"gs�FEA 54`✓4 alt D Sex-, c�ry- - Lot no.: 1 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
,VA) ,S/A/ .6 � API/Ly i?Gs/Dr /V( _ Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 5 Ab'7E AS BELOW f Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name: g04t)2., D CoA/.57'7zti67,../L3 "1
ijPrimer 12.51
Contact name: 0 fa v i D D ry# I~P PGS.7- Roof drain(commercial) 12.51
Address: T, O. 43.,x j S "7 7 Sink/basin/lavatory 25.02
City/State/ZIP: Ela vtEgTo ® R 9 7 p 7S Solar units(potable water) 62.54
Phone:003 ) 7 0.-7%y.5 Fax::(313)„5-90..175/ Tub/shower/shower pan 12.51
Urinal 25.02
E-mail: r 6 UR_ D 66 ti/S7-& A/75A/ G 697
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name: f-H.G.: /(4 C(., Ili CO M 1,iu/ Water piping/DWV 56.29
Address: / )// 3.,C.. P i l/t R Rd.. Other: 25.02
City/State/ZIP: ,/G L„.S -,/ C.42,„ Subtotal
6 p- 7/3 Minimum permit fee: $72.50
Phone:( ) Fax:( )
CCB Lic.: /h 6g Plumbing Lic.no.:3Y 26 t /34.3Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: ��.:.- TOTAL PERMIT FEE
Print name: VAI„,./ /..j �tr�9 �7-- Date: S/_/S-1 7 Thispermit 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:1Buitding\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COMIWEB)
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
■
T I G A R D Building Permit Review — Residential
Building Permit #: h-(5��/?-6a 1117
Site Address: 1 140 S SW 9l+h olv e .
Project Name: C re-Pins Ward SOu-frh Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review n
Proposal: (V&t1/ SP 1�.
Verify site address/suite# exists and active in permit system.
Fi River Terrace Neighborhood: /6 No ❑ Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
Three(3)copies of site plan xtsting structures on site
Site plan must be on 8-1/2"x 11"or 11 x 17"paper ootprint of new structure(including decks)with finished
Drawn to scale(standard architect or engineer scale) floor elevations
North arrow ,2fTtility locations(required for new,may apply for additions)
/Site address,project or subdivision name and lot number ❑i,uLation of wells/septic systems
Applicant information(name and phone number) lsting trees to be retained with drip line,and tree
Lot dimensions and building setback dimensions protection measures
jetot area,building coverage area,percentage of coverage and 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: ❑ Yes ❑ No
Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake
Land Use Case#: S Ug 14 - O 00 ( O
lz Zoning: It '1, S
gr Required Setbacks: Front 'j0 Rear ( ,S Side S Street Side jc Garage Zip
.2-liandscape Requirement:
C'rot Coverage Maximum: /' %
Building Height: Maximum Height 3 0 Actual Height 24'1I
/`J Visual Clearance
,i Easements
izr Sensitive Lands: ❑ Yes ❑ No Type
eUrban Forestry Plan
Conditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: M,fl'1/t-�, �`� Date: / / ici/
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: %V/ 9//7
Site Plans: # 3
Building Plans: # 3
Building Permit#: L Enter building permit#above.
Workflow Routing: [Planning L-Engineering Permit Coordinator D-$uilding
Workflow Sign-off: la Sign-off for Planning(include notes from planning review)
Route Application Documents: .12" Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: „ ��. , _! Date: S/ / /
Engineering Review
Slope at building pad: 71
---if Conditions "Met”prior to issuance of building permit
'Easements (encroachments)per engineering conditions of approval and plat
„AeWater 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
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: 42' J7 Date: 1:-:27--(7
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
SDC Fees Entered: Wash Co i',11& es
❑ N/A
Tigard TransTrans SDCD:v Tax: �%'Yes ❑ N/A
Parks SDC: ('Yes ❑ N/A
10 OK to Issue Permit 1 / p-
Approved by Permit Coordinator: Date:�� ` G
I:\Building\Forms\BldgPermitRvw_RES_091216.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
14405 SW 90TH AVE, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Master Permit MST2017-00147
Inspection Type: Inspector:
399 Plumbing final Jeff Grove
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
14405 SW 90TH AVE, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Master Permit MST2017-00147
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
14405 SW 90TH AVE, TIGARD, OR, 97224 January 16, 2018 at
10:18:42 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00147
Inspection Type: Inspector:
299 Final inspection David Young
Result:
FA I L
Comments:
Provide guardrail at back patio over 30" above grade measured 3' horizontal. R312
All else appears ok.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
14405 SW 90TH AVE, TIGARD, OR, 97224 January 18, 2018 at
9:20:52 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00147
Inspection Type: Inspector:
299 Final inspection David Young
Result:
PASS - CofO
Comments:
Correction complete.
Final erosion control approved.
Street tree certification received.
Moisture content form received.
High efficiency lighting form received.
Duct seal test report received.
Insulation certification checked.
C of 0 left on kitchen counter.
Violation Summary:
Inspector Contractor