Permit (40) CITY OF TIGARDMASTER PERMIT
�1 ' COMMUNITY DEVELOPMENT _ ' Permit#: MST2016-00571
/ Date Issued: 05/16/2017
T[CARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2•ti�>r7 8'.9-- Parcel: 2S111DA21800
Jurisdiction: Tigard
Site address: 8783 SW SCHMIDT LOOP
Subdivision: HERITAGE CROSSING Lot: 37
Project: Heritage Crossing, Lot 37
Project Description: New SF. 8/22/17, REPRINTED to add a/c.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 720 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 25 Bathrooms: 3 Second: 1028 sf Garage: 330 sf Front: 15 Smoke Yes
Dwelling Units: 1 Third: 0 sf
Right: 5 Detectors:
Total: 1748 sf Value: $212,376.66 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF RainStorm Sewer: 100
0
Drains: Catch Basins: 0
Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Bckflw Prevntr:
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0
Drywell-Trench Drain: 0 Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 4 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 Y
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 1748
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: $27,804.27
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. ATTENT• • -••n law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-06 •through OAR•.2-0, c r9�You may obtain a copy of the rules or direct questions to OUNC by calling 503 .1987 or 1.800.332.2344. //n
11
�/ :L/ Ad Permittee Signature: .moi.
Issued :y: _ '�� —
Call 503.639.4175 by 7:00 a.m.for the next available ins•: •• • --
This permit card shall be kept in a conspicuous place on the job site until co•••etion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit A.PPlttfi' li1
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Cite of Tigard „ Y Mtirda 10-e:25,57/
13125 W hall Bivd.,Tigard,OR 97223 a cv n
M.
F'hcwr: rt13.7111.2439 Fax: stT3.5`. ttateny tliherl teap:
;mix-ohm Li tt3.t,.V s 17 r�r i 7 1 t it ,ny: „ 0 sor /tar
Internet: w 4x.ir rid Y . xati tertitieetAtrux,d:
C1i1,'OF TIGA ---m- -.a.------�.._.m..____.... --
''be ,, K M M =-= der ii , "i6 d
Stechartical pcnna fees.are based on.the value girth work
r }Newconstruction 0 Additionialteraitonimplacrinent Reefottned Indicate the value-troweled tatetdollar)ufall
0 Deinolition 0 Other; mechanical materials,equipment,labor,overhead,and Profit
Value:S
,V.,';;t4/ et; a l''.'. ° ,'lith /: ,'",:"//'''x. i t .am4P+ a a r>..•,1,w k i .. .,, ">
I-and 2.farnr"ty dwelling 0 Corntetereial:industrial Q Accessory brrihlrng F vadat . eaE obeekfist,
0 Multi-handy 0 klastcr builder 0 Other Description I Qty, i Eit.. I Taal
g� 4 1''i $ f 'i 3 r-` t ,r#$�s _ s 1 Vi IPir, llestk tsp r x,75
-- —,,t "- ' ' Air C ttiKM ing
Job tote address: :Y-v &*, c✓"" ( 3V1 i 3'u 109, BTU tdaets l 46,71 ..�
c'ity'Stt+?,.11P: Ti:and OR 97223 kuru t t*OtOT t w ri , 54-91c ^ heat pomp61.06
+uiti/trlalg.alri,no.; Project parr ' " A •. d IL Oect num 23.32
Cross street!directioris to job site: 0 flpironie hot water syttem /3,32 ,.,
ltitieritial boiler Iredtataw or
hydrottiej2=:32
.. 'unit t tlbel-type,not t ectrre).
in-wall,imdtiet,troperided.etc. 46.75
fluaVvern for ari or above 2233,32
other; 23.22
Saslrilivisiow, II.utfo.:(37 o0.1
• sect
rp 23'32
Tax n ppreel oto,: Water heater '
11 x; ;, zrw t ,-. a��it ,_2477:,11 t r`traala+u,° 13.39
.: : 2222..
"F1rtr tit.for hearer tri gat
New SFR litenlate 2132
Itahter ) r 23.32
h., t . Woodyellet stove w 3319
-
11111111111111111111111111111111A111116 ,Wcxxi fhtp ats411 23.32
iiiiirilwrifir
Chi , -'fittattluesem _ 2132
# r�,i4',1"///':::/''''-, ` , e tir"ia � ...4 g a�.1- Environment/AI stund.entlholler; 23,3
n
•
Name DR Horton rton Inc, Range hood/other kitchen
-----.--- a tspritminit 33.39
A 43O SW Mac ad im Ave Suite 100 _ c lothes dryer t 33"39
t'ityt'atate 71P,Portland,OR 97239nailert ronentsexhales tunlitr rrxtaris 23.12
Ph(at :1503 ) 222-4151 Fax:( ) l cicraw {int a_� /3.32
:r : a t ,tea t.#rlll -
I 2132
r
I url
1344z iratas DR Horton Inc Sl4.lS for arw tone;sect€or nut. tit
Canino :Emerald Weeks Furnace,etc
tias hem putim
Address:4380 SW Macadam Ave Suite 100 dia
Wall nile"i`nnii beater
C'rryrStirte IP:Portland,OR 97239 waive hewer�.. _ ��- , - 2222..
Phraire:(503 )222-4151 x1 X07 l'ax;:t l Raise
1:-mail: esweeks( drharton.cont Barbecue
.rawer s a ''. .. e, mai '1- r dr cr.Igat} ........
u- gid. �
Business name: Ma tte, tSubtotal
Trher:
rlaldrexs. : . /Ott/ A/' ( 107-691,,,,,, 1749‘-•
( r ittntnt permit rot($00.00)
t`ity"state QIP: g "r s' , !P. i`h 'j review;2S%orpermit fee)
Plume: tglil
.* s�' Far: .4111 d -^ Ai" r sate surrtrargct1sit ofparrnitfeet
woc
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(-CB1ie.: 0'lwTOTAL PERMIT FE -'5a.3c4
> This Wadi cxpiess ifs person isnot uksistil whin*ISS
tIsys eke II bac baea amino,as
Authorized,'..:s , / ` t" logy set by'riid."teary 1#.ia' 4 s est
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CITY OF TIGARD MASTER PERMIT
Permit#: MST2016 00571
II: COMMUNITY DEVELOPMENT
Date Issued: 05/16/2017
T G7 D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S111DA21800
Jurisdiction: Tigard
Site address: 8783 SW SCHMIDT LOOP
Subdivision: HERITAGE CROSSING Lot: 37
Project: Heritage Crossing, Lot 37
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 720 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 25 Bathrooms: 3 Second: 1028 sf Garage: 330 sf Front: 15 Smoke
Yes
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors:
Total: 1748 sf Value: $212,376.66 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0
Bckflw Prevntr:
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 4 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 Y
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 1748
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: $27,751.91
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 9 -001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.23C32.1987 or 1.800.332.2344.
Issued By: ,/.Z Permittee Signature: ccer CL'/� /C Gt 0�
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.
37 ill,BuildinE Permit Applicatio> � , ,t tr............s.
= Residential4. ti.
1 ou (11�1 !CI. 1 .lONI Y
City of Tigard 6 S
E Received / , /�
13125 SW Hall Blvd.,Tigard,OR 97223 Oatc.13): [ Permit N c7,20/6„-Qos'7/
Phone; 503.7118 2439 Fax 503.598 191+0 Plan Ir ie>,
t t- t Inspection Line. 5(13.639 4I�5 "¢ Darc Dv: - $ Other Pennia '^x`
Date Read)By — Jur �` �,�
Internet: K'ww.11gard-or.g0\ ��n���ppp $! See PagC rUr
e Notified Method. �j0 [�/J- ? ZJ- Supplemental Information
/� u� LfL.I'/t..2 ii.. r Tri
Tl'PE OF WORK REQUIRED DATA:1-AND 2-FAMILY DN ELLING
811 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.
e I-and 2-family dwellingValuation:
0 Commercial/industrial
$ au, 3 7 6
❑ Accessory building
❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathroom -. '2
JOB SITE INFORMATION AND LOCATION / Total number of floors; c —,
Job site address: O 8 3 c w Q_ h ( '-^� 7
�f/ rw►� �!1 New dwelling area: ''��� square feet
City/State/ZIP:Tigard,OR 97223 / _
Garage:carport area: 30 square feet
Suite bldg./apt.no.: i Project name 'icAn- Qet, /' r ), f
l/Y VJ Coeered porch area: „33 square feet j o as?
Cross street/directions to job site:
'" Deck area: square feet 7 z r)
Other structure area: square feet ;
Subdivision:
REQUIRED DATA:COMMERC IAL-USE CHECKLIST
I Lot no.:37 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,
New SFR Valuation: S
Existing building area: square feet
New building area: square feet
It PROPERTY OWNER , 0 TENANT Number of stories:
Name: DR Horton Inc.
Type of construction:
Address: 4380 SW Macadam Ave Suite 100
Occupancy groups:
City/State/ZIP:Portland, OR 97239
Phone:( Existing:
S03) 222-4151 Fax:( )
Nems:
0 APPLICANT x CONTACT PERSON
Business name: DR Horton Inc. BUILDING PERMIT FEES'
(Please refer roJee arAedrrle)
Contact name:Emerald Weeks Structural plan review fee(or deposit):
Address: 4380 SW Macadam Ave Suite 100 FLS plan reviemm fee(if applicable):
City/State/ZIP: Portland, OR 97239 Total fees due upon application:
Phone:t503 )222-4151 x1107 , Fax::( ) Amount received:
PHOTOV'OLfAt( SOLAR PANEL Sl STEM FEES°
E-mail: esweeks@drhorton.com
CONTRACTOR Commercial and residential prescriptive installation of —
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 Cbde checklist.
City/State/ZIP: Portland, OR 97239 Permit Fee(includes plan review
Phone:(503 )222-4151 I Fax ( and administrative fees): S180.00
CCB lie.: 130859 State surcharge(12 of permit fee): $21.60
1 Total fee due upon application: $201.60
Authorized signature: i I This permit application expires if a
+ i p permit is not obtained
within 180 days after it has been accepted as complete.
I Print name: i "Fee methodology yp
' s t t Date:2016gy set ct by Tri-Count'Building Industry
Service Board.
I.Building Permits B(_!P-RESPennitApp.doe (t2 24-201 I
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CATEGORE OF COKSTRECTION
RESIDENTIAL EQUIPMENT/SYSTEMS FEES:* ,
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TENANT --« - i t.tho
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47m: DR Horton Inc. R' e 6,4,4,46,-4.i‘ii,ho,
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0 1 ' 222- 4151 x i 107
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CONTRACTOR
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Electrical Permit Annlication s
ink t)l it( l: t ,r ().1
City of Tigard ,'[ Received
n Permit Ne%.j 57.--.Z42/6,-09.5.--,7/
.114 -- 13125 SW Hall Blvd.,Tigard,OR 97223 ph,Review
Phone: 503.7182439 Fax: 503.59&.1961 Date/By: Other Permit
t, Inspection Line: 503.639.4175 Dau Ready/Br ter.
Internet: www.tigard-or.gov a ;,Nodfernfethod B See Pane 2 for
• Supplemental Ia[ormtion
TYPE OF WORK, - !LAN.REVIEW
-
®New construction 0 Addition/alteration/replacement Please check all that apply(submits sets of plans wfiteras checked below):
0 Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition 0 Other:
where the available fault current ❑Marinas and boatyards.
CATEGORY•OF CONSTRICTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
mmerciaUindustrial 0Accessory building - lass to go"ltd,or exceeds 14,000• ❑Co a Bial-use agricultural
❑ 1-and 2-family dwelling 0 Co
reaps for all other installations.
;t .
❑Multi-family 0 Master builder
0 Other: OFue puny. ❑Installation of 75 ICVA or
JOB SrrE INFORMATION AND LOCATION CI Emergency system, larger separately derived system.
0 Addition of new motor load of 0"A",'S''',"1-2","1-3",
Job no.: Job site address: i'lt5-3 cS..•i 100HP or more. occupancy.
❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: f" �� Gr_ 9 7/..?..3 ❑Health-core facilities. Ci Supply voltage for more than
yVV� .-t / a 0 Hazardous 600 volts aorninal.
Suite/bldg./apt.no.: Project name: N � (�� ❑Service or feeder 600 amps or more.
Cross street/directions to job site: FEE SCHEDULE
Demise.. i cry. i Fm I Total I
New residential-single=or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.:37 1,000 sq.ft.or less I 168.54 4
Ea.Tax map/parcel no.: a add'1 500 sq.ft.or portion oi 33.92 1
DESCRIPTION OF WpmLimited energy,
tdmtial 75.00 2
(with above sq.ft.)
Limited energy,multi-family
residential(with above sq.ft.) 75.001 2
Services or feeders installation,alteration,and/or relocation
200 amps or less 100.70 2
0 PROPERTY OWNER I 0 TENANT 201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
Address: 601 amps to 1,000 aims 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation,alteration,and/or
relocation
Phone:( ) Fix:( ) 200 amps or less 59.36 I 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
Owner si Use Branch circuits-new,alteration,or extension,.per panel
Tim Date: A.Fee for branch circuits with
❑ APPLICANT t ❑ CONTACT PERSON above service or feeder fee, 7.42 2
DR Horton Inc each branch circuit
Business name: B.Fee for branch circuits without
Emerald Weeks service or feeder fee,fust
name: branch circuit 56.18 2
Contact
Address: 4380 SW macadam Ave Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
City/State/ZIP: Portland OR 97239 Each manufactured or modular 67.84 12
503 222-4 151 dwelling,service and/or feeder
Phone:( ) I Fax::( ) ✓ Reconnect only 67.84 2
E-mail: - Pump or irrigation circle 67.84 2
. CONTRACTOR ;. Sign or outline lighting 67.84 2
p Signal circuit(s)or limited-energy
Business name: `,�GA whit? 2(P�!iT(/1't� J-° panel,alteration,orextension. Page 2 12
�`G ti:/-�rf_ Bch a ��inspection��allowable in any of the above
Address: 2 f?t� /1'E o' ' l f l� Additional in ( )
�ti.Q� speetion 1 hr titin 66.25!hr
City/State/ZIP: O 0 co Gtv�`, [/t/�* 9 pc / Investigation(1 hr min) 66.25/hr
Phone:(3� .5"/If �sQ 9 Fax:QC T31 — 9 b Industrialpleat(1 ihrs no 78.18/hr
— G � �j�j� Inspecriorls for which no ice is 90.00/hr
CCS Lic.:/. 2s-4.,..9 Electrical Lic.:•C'Z 3O up _ / specifically listed(y4 Ar min)
�� Suprv.Lic.- 79 r $ ELECTRICAL-PERMIT FEES
Suprv.Electrician signature,required:eV�� oZ b Subtotal:
Print name:Ch 6 a i� : ( Date: State Plsurcharge(12%of%of permit fee):
4 b _ permit fee) _
Authorized signature: i0Z. TOTAL PERMIT FEE
This permit applicationabaH a is not obtained
within 180Print name: +LV I Date: = days afer it baa been accepted as complete.• Number of inspections
allowed per permit.
L4BdIdingWerraitAELC-PerrattAPP 490-46151(11/OS/CAM/waB
P--
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information )410--- t c
At5tpZO/((-WS77
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SC HE[lt(LE
Fee for all residential systems combined: $75.40 Descript1on r?ry 1 aet 7brai
Renenable electrical energy systems:
Check Type of Work Involved: 5 k.a or 1.s. 100,70
5.01 to 15 kva 133.56
1 Audio and Stereo Systems*
I5.01 to 25 koa '00.34
ind generation systems in excess of 25 kva:
n Burglar Alarm
25.01 to 50 kva 301.04
(X] Garage Door Opener* s'}.t}( to 1 vu k%a 552.21 2
(ice in accordance
with(;AR 91l_109-004U) 5c22h -
(X Heating, Ventilation and Air Conditioning excess Solar generation systems in excess of 25 kva:
System* — — _ r _a
hath additional k3 a<.rcr 25 22 t
�❑ Vacuum Systems* 100 k:a—Pro additional chane 0
Each additional ins•ection over allowable in any of the above:
I Other: h additional tinic
char ed at an houily(1 hr min) 65._^5 hr ! i
Inspections lir which no Ice is
s ( hr III,cificall listed - ruin) 9.00 hr 1
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1).
(SEE OAR 918-309-0000
Number of inspections alloy,ed per permit
Check Type of Work Involved:
❑ Audio and Stereo Systems
(1 Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
I Instrumentation
❑ Intercom and Paging Systems
(1 Landscape Irrigation Control*
❑ Medical
C Nurse Calls
• Outdoor Landscape Lighting*
C Protective Signaling
C Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
1.-Huildin}Pelic-ILC Prmir4pp LLR t3RI_dc.: f:n 4h5 1`:013
1
Plumbing Permit Application
Building Fixtures PrI c I OR Oi l I(l: (Si: ONE.)
HE
Ci of Tigard '� Received
III • 13125 SW Hall Blvd.,Tigard,OR 97223 DaWBr• Penait No.:„.415Ta10/6"GAS 7/
I Phone: 503.718.2439 Fax: 503.59$1960 Other Permit No.:
I i c,\R a Inspection Lite: 503.639.4173 >...Due Ready/By: .rusts: B See Pane 2 for
Internet: ww.tigard-or.gov `?1 ""Noariedmehod: S&viewesal idermadoa
,., a,. TYPE OF WORK . .FEE" SCB DUI* ' ,
❑New construction 0 Demolition For special tnforntarton use checklist
•
Neww 1 i-Ne
❑Addition/alteratiodreplacement 0 Other on ) �X Ea Total
2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONiSIRticnON SFR(I)bath 312.70 J
❑I-and 2-family dwelling 0 Commercial/industrial 7 SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500 32
❑Master builder Other Each additional bathJidtchen 25.02
Fire sprinkler( sq.ft.) Page 2
• . ' JOB•SITE,( PORii�f.49/1f:,AHD LOCATION Site utilities:
Job site address: c' L r / Catch basin a area drain 18.76
d 7$3 <5i," LfAr Drywetl,leach line,or trench drain 18.76
City/State/ZIP: Trot 1.4qa, i 7_ .4, - Footing drain(no,linear ft.: )
Suite/bldgJapt.no. Project name: Ad 11 1 , Manufactured home utilities 50.03
Cross street/directions to job site: ,ljManholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:J Page 2
Storm sewer(no.linear ft.:____) Page 2 •
Water service(no.linear ft.:_-,J Page 2
Subdivision: Lot no-:d 7 Fixture or Item:
Tax map/parcel no.: Backflow prevents _ 31.27
DESCR1PTiON.OF:WORK .- Backwater valve 12 51
Clothes washer 25.02
�\ Dishwasher 25.02
v Drinking fountain 25.02
Ejectors/sump 25.02
1:1 PROMO. OWNER . • ,.1 0 TENANT . Expansion tank 12.51
Name: � U V 4- `�C Fixture/sewer cap 25.02
�� c ' �O.0L V`- Garbage
Floor drain/floor sink/hub 25.02
Address: - Garbaggee disposal 25.02
City/State/ZIP: O\e_ On 0_,Pb9 Hose bib 25.02
Phone:l 3 a -\`. j, Fax:( ) Ice maker 12.51 -1
• o APPLICANT CoNrACr PERSON Interceptor/grease trap 25.02
Business name: ›Y__,
\'\ tv ' l !Ill C.) Medical gas(value:S_!) Page 2
\\ 1 01 "L}j x Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) ,�( 1,Fax:�:(/►��) Tub/shower/shower pan 12.51
E-mail: e ,,w-ef J C5(es ekv Y t. v✓ 1 4' .COVV1 Urinal 25.02
-CONTRACTOR Wats closet 25.02
Water heater 37.52
Business name:EDWARD MULLEN PLUMBING Water piping/DWV 56.29
Address:1601 SE RIVER ROAD Other 25.02
City/State/ZIP:HILLSBORO,OREGON 97123 Subtotal
•Phone:(503)640-0113 Fax:(503)640-4483 Minimum permit fee: $72.50
CCB Lic.:94689 4 Plumbing Lic.no.:34-260PB Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: ` 41#. �... , __-_ TOTAL PERMIT FEE
Print name:RAY MULLEN i Date: This permit application aspires if a permit is sot ebtaised within 180 days
after it has bees accepted as complete.
'Fee methodology set by Tri-County Building Industry Service Board.
I:mudei,eerru PteU-Prw.4Arp.doc 10/01109 440.4616T110702/COMAVE91
City of Tigard
IN g
4 COMMUNITY DEVELOPMENT DEPARTMENT
TicRD Building Permit Review — Residential
�`'. "> e�s�.,.;;.N spa_.._..:7a_�.e .F.:.=: n.. .,< �ss';a-.;rc....; u<a.:# x�:a:;::..e�_z<. ,.::_ _'",-'. ___...•. .s. ..,_..;;:: _.�, ::�:c.
Building Permit #: ,S �pte �S- 7
Site Address: ?43 ) C t Locyo
Project Name: Pente end in Lot #: 377-
(New dweubdivision name;Additio eration=last name of owner)
Planning Review
Proposal: N2Fie
Verify site address/suite#exists and actio in permit system.
t1'iver Terrace Neighborhood: a4 No ❑ Yes,See River Terrace Review Addendum Attached
SiVie Plan Elements:
ree(3)copies of site plan 1+''�!sting structures on site
U S e plan must be on 8-1/2"x 11"or 11 x 17"paper 1.Footprint of new structure(including decks)with finished
awn to scale(standard architect or engineer scale) •or elevations
rth arrow
ITA Utility locations(required for new,may apply for additions)
ife address,project or subdivision name and lot number ,NV..3 ation of wells/septic systems
.licant information(name and phone number)
INiii t Sting trees to be retained with drip line,and tree
I7 .t dimensions and building setback dimensions otection measures
Y .t area,building coverage area,percentage of coverage and ,u[,�( seet tree size,type and location
pervious area(applicable if R-7,R-12,R-25&R-40) c�'Street names
Property corner elevations(2 foot contour lines if more than
4 foot differential)
teilklean Water Services—Service Provider Lett (lot platted prior to 9/10/1995):
Pequired: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No
ublic Facili Improvement (PFI)Permit:
equired: Ael Yes,applicant was notified ❑ No Applied For: Yes CI No,stop intake
Land Use Case#: �'j�- ' '�i�j �'Z�f� /' c1 ) S'
VRRequired
oning: -IQ
Setbacks: Front /S Rear /r" Side S' Street Side 1O 1,Garage QC'
,Z
andscape Requirement: 0
dot Coverage Maximum:
1LI uilding Height: Maximum Height Actual Height c2
isual Clearance
11Lf Easements
°:ensitive Lands: ❑ Yes /No Type
Ir. Urban Forestry Plan
❑ Conditions "Met"//prior to issuance of building permit
Notes: 11r, >ticav�q S'4 �� 2-4em a i p7f)c 'A ,f-Pahl >sk rC'f
Approved By Planning: . _ Date:
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: f/ //c4
Site Plans: # 3
Building Plans: # y
Building Permit#: 0 _ nter building permit#above.
Workflow Routing: Planningengineering [h.P.ermit Coordinator Building
Workflow Sign-off: ign-off for lanning(include notes from planning review)
Route Application Documents: 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: .A „ , `��N %� % Date:
i
Engineering Review
Slope at building pad: y
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: CI Yes ❑ No
❑ NOT Approved by Engineering: ' Date:
Notes:
Approved by Engineering: W..Z., Date: / - �X
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
ri 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:
12r SDC Fees Entered: Wash Co Trans Dev Tax: Pit Yes ❑ N/A
Tigard Trans SDC: 3" Yes ❑ N/A
Parks SDC: li'Yes ❑ N/A
PrOK to Issue Permit
Approved by Permit Coordinator: eu vv� Date: / ) ,)3 -!
I:\Building\Forms\BIdgPermitRvw_RES_091216.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8783 SW SCHMIDT LOOP, TIGARD, OR, 97224 September 29, 2017 at
11 :52:44 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00571
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8783 SW SCHMIDT LOOP, TIGARD, OR, 97224 September 29, 2017 at
12:01 :22 PM
Record Type: Record ID:
Residential - Master Permit MST2016-00571
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.
Blower door test report checked.
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:
8783 SW SCHMIDT LOOP, TIGARD, OR, 97224 September 29, 2017 at
11 :51 :26 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00571
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS
Comments:
Ac installed.
Violation Summary:
Inspector Contractor