Permit CITY OF TIGARD MASTER PERMIT
IN :' COMMUNITY DEVELOPMENT Permit#: MST2016-00567
A RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/16/2017
T[t' 9 Parcel: 2 S 104AC 14800
Jurisdiction: Tigard
Site address: 12805 SW 133RD AVE
Subdivision: WALNUT RIDGE Lot: 2
Project: Walnut Ridge, Lot 2
Project Description: New SF. 1/26/17, DEMO CREDITS FROM BUP2015-00344 APPLIED TO THIS PERMIT.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1179 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1447 sf Garage: 379 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2626 sf Value: $313,470.23 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
0
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0
Bckflw Prevntr: 0
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: 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: 4 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
10004-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 2626
Owner: Contractor:
RIVERSIDE HOMES LLC RIVERSIDE HOMES LLC Required Items and Reports(Conditions)
17933 NW EVERGREEN PKWY, 17933 NW EVERGREEN PKWY 370 1 Ersn Cntrl 503-639-4175
#370 BEAVERTON,OR 97006 2 Geotechnical Inspection
BEAVERTON,OR 97006 Required before foundation
PHONE: PHONE: 503-645-0986
FAX: 503-690-2942
Total Fees: $8,731.98
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 anter. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. Yo. .- •• -'i a cop of the rules bs4rect questions to OUNC by calling 503. . ..1987 o 1.800.33 2344.
a // -
Issued By: _.-� _ 'y_ �.,. •e . ',nature: 7 A r
Cal ' 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.
Building Permit Application
'- Residential
��V _ FOR OFFICE CSE 011.1
C. of Tigard
Received 2y
g ��� Date/By: ` r[7 '� Permit No.: M ^� tJ
u 13125 SW Hall Blvd.,Tigard,OR 97223 t fru
{p7
Plan Review
1111 a Phone: 503.718.2439 Fax: 503.598.1960 "c Other Permit: ,
Date/By: ,�,� � � �'`�
1 f c;\R[) Inspection Line: 503.639.4175 i.n k Date Ready/By: a V ' lens: I 0 See Page 2 for�C "��
Internet: www.tigard-or.gov /'t Aim,- g tified/Method:i ,)--47 As •v 7-. .,-e, Supplemental Information
15 ,1)` j3 ,* s'-y 1 , _ / • v-O4xe-d J Nf
.;x ' s .'6.,. t t G , y .i ,t`'Sf ! - l //-i�
emolition Permit fees*are based on the value of the work performed.
®New construction 0 i
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
Tt , % f .t a "� work indicated on this application.
1-and 2-family dwelling ElCommercial/industrialµ Valuation: $3)3J Lf /
❑Accessory building ❑Multi-family Number of bedrooms: 4
❑Master builder 0Other: Number of bathrooms: 3
` r, ` . s
1'' t a t .� ri i t € c Total number of floods 2 3 0
Job site address:12805 SW 133rd Ave New dwelling area: 2626 square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: 379 square feet t
Suite/bldg./apt.no.: I Project name:Walnut Ridge Covered porch area: 33 square feet j / 9 /
Cross street/directions to job site:SW Walnut and SW 133rd Ave Deck area: square feet j ) 7 9
Other structure area: square feet
'' ',„6.,!:..; c r 1.,,,,,?'
'',4.q.4.1,'',..,4:-.`4‘,.
Subdivision:Walnut Ridge I Lot no.:002 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
''.r }•. ai ;;;"4•./et: t • work indicated on this application.
Construction of SFR Home Valuation: $
Existing building area: square feet
New building area: square feet
wvi'' .: .,, t 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:
Business name:Same as Above t + •r r.
Structural plan review fee(or deposit):
Contact name:Brett Groves
Address:
FLS plan review fee(if applicable):
City/State/ZIP: Total fees due upon application:
Phone: Amount received:
( ) Fax::( )
. i
E-mail: bgroves@riversidehome.com i 4.fit .kt t
"� "'., , — t Commercial and residential prescriptive installation of
, 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
and administrative fees): $180.00
Phone:(503)645-0986 Fax ( ) State surcharge(12%of permit fee): $21.60
CCB lie.:189148
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:Brett Groves Date:12/19/2016 *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 -10 FOR 0E11( t SE ONE
City of Tigard V74'i Received
II
rtS)NO Date/By: Permit No.:
4LA "" X 13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 Mill11111 Other Permit:
Ri.) Inspection Line: 503.639.4175 CY- D BJuris:y:
Internet: www.tigard-or.gov OkA • • ethyo:d: Ei See Page 2 for
Supplemental Information
".!4
- Mechanical permit fees*are based on the value of the work
El New construction 0 Addition/alteration/repl.cement performed.Indicate the value(rounded to the nearest dollar)of all
o Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
• 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
O Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
Heating/cooling:
:
)„ ,I,OCATION g
' Air conditioning 46.75
Job site address: 12817 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 73 32
Cross street/directions to job site: SW Walnut&SW 133rd Ave. Hydropic 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 Lot no.: 002 Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 1 23.32 23.32
Gas fireplace/insert 1 33.39 33 3c)
Flue vent for water heater or gas 1 23.32 23.32
Consto lotion of SFR fireplace
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
°
•• . - Environmental exhaust and ventilation:
Name: Riverside Homes, LLC Range hood/other kitchen
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) 4 23.32 93.28
Phone:( 503) 645-0986 Fax:( ) Attic/crawlspace fans 23.32
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
Gas heat pump
Address:
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace 1 14 15
Range 1 14 15
E-mail: b9roveseriversidehome.com Barbecue
OR Clothes dryer(gas)
Other:
Business name: Pyramid Heating &Cooling
Address: 9409 NE Colfax St. Subtotal 375_93
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
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: Brett Groves Date: 12/19/2016
1:\Building\Permits\MEC_PennitApp_040113.doc 440-4617T(11/02/COM/WEB)
i
(ANN t'AV
Electrical Permit ApplicationVkt FOR MI ICE USE O\I.1
t
CityofTigard d(1-W\
ReceivedrEli
11114 g r Date/B �/ //
u 13125 SW Hall Blvd.,Tigard,OR 97223 D\P\, ;Review
Phone: 503.718.2439 Fax: 503.598.1960 ry f*at q.,• Related Permit#:
Inspection Line: 503.639.4175 ,.g' i *ONG:.t '1 .te/By: Jug ® See Page 2 for
1 I( 1 I I) Internet: www.tigard-or.gov OA I ����)V otified/Method: Supplemental Information
�'''.N ,le t ' 0 'tv -3 ,,I, ,.4:,,,:,,,144 444it ,' -,
'
®New construction 0 Addition/alteration/r-. acement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
9c, t t, a & l i 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 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
' ';'„;y, Emergencys stem. larger separatelyderived
::1-7r.,, ��" _ °, ���z ">h!° � t . ,. ! f Y g
Job#: Job site address: 12817 SW 133rd Ave __,0
A 0HP o of new motor load of system.
100HP or more. ❑"A" "E" "1-2" "1-3"
City/State/ZIP: Tigard, OR 97223 ❑Six or more residential units. occupancy.
g 0 Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: I Project name: Walnut Ridge 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: SW Walnut&SW 133rd Ave. z -
.':SC1tE x ,,,
Description I Qty. 1 Each I Total *
New residential single-or multi-family dwelling unit.
Subdivision: Walnut Ridge I Lot#: 002 Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 1
-,, i • ::-'*„ 41 7,1'.:7..14r°t ter a -. . ti., 3 ,
�%. .,: 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.)
• r�, t,,,, Renewable Energy 0 See Page 2
t . " -. t L ''' = 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 I Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: wboisvert@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
s ''
' Branch circuits—new,alteration,or extension,per panel
m
,,.fir • • v • " f)�„"x .S_. ��f tt� _. '
A.Fee for branch circuits with
Business name: Same as above above service or feeder fee,
each branch circuit 7.42 2
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:( ) I Fax: :( ) Each manufactured or modular
67.84 2
dwelling,service and/or feeder
Email: bgroves@riversidehome.com Reconnect only 67.84 2
<s; .tQ ;:: a 1 _,,a_NTA" . ‘,,,S3 a5.. '?i,7":„1::::,!°7-:, Pump or irrigation circle 67.84 2
Business name: Garner Electric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy ❑ See Page 2 2
Address: 2920 SE Brookwood Ave#1 panel,alteration,or extension.
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) 6484552 Fax:( 503)642-7925 Investigation(1 hr min) 90.00/hr
Email: a arnerelectric.com , Industrial plant(1 hr min) 78.18/hr
g @g 1 I:5-c_ Inspections for which no fee is
90.00/hr
CCB Lic.: 121159 Electrical Lic.: ,3.7-er ' Suprv.Lic.: 37 ? specifically listed %hr,min) , ,
:,,, . it,:., J." CAL PE! ; a a;_
Suprv.Electrician signature,required: adaleAk Subtotal:
Print name: Chuck Garner —I Date: 12/19/2016 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
@;yp,Ada TOTAL PERMIT FEE:
�V'"`'' This permit application expires if a permit is not obtained within 180
Print name: Brett Groves Date: 12/19/2016 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELCPermitAppELR_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:
WO ONLY"'
Fee for all residential systems combined: $75.00_ Ue Qty. Each I Total
3r Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
❑X Garage Door Opener* >100 kva(fee in accordance
552.26 2
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 7.42 3
❑ Vacuum Systems* >100 kva-no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑
Other Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
s.:ificall listed Y.hr min
Subtotal(Enter on Pagel):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*
LI Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I\Building\Permits\ELC_PennitApp_ELR_ERE.doc Rev 06/17/2015
Plumbing Permit Application
Building Fixtures Cki47'
0 FOR Orrice use ONEl
•
City of Tigard Received PermitNo.: 1P
:� 13125 SW Ha7
ll Blvd.,Tigard,OR 9 1 c Date/By: :M� ��'lr% "!'✓i.��i
Phone: 503.718.2439 Fax: 503.59:' •.0 lb Plan Review
��\ @ate/By: Other Permit No.:
Inspection Line: 503.639.4175 at-Read/B Juris: ® See Pae 2 for
I I('AKI) iReady/By: 8
Internet: www.tigard-or.gov C- ' r *� 01.-..s ,_ ethod: Supplemental Information
®New construction ❑Dem o For special information use checklist
` Description I Qty. I Ea. I Total
❑Addition/alteration/replacement 0 Oth.=44 New 1-2-family dwellings(includes 100 ft.for each utility connection)
`<' -'° SFR(1)bath 312.70
N 11 �� '� x i �� - t, t � k ,y'`r*,
SFR(2)bath437.78
® m
1-and 2-family dwelling 0 Commercial/industrial
SFR(3)bath 500.32
❑Accessory building 0 Multi-family
Each additional bath/ldtchen 25.02
❑Master builder 0 Other: Fires ler sq.
prink (- ft.) Page 2
ti ''''I''''''''''"5:
1t ; I c i'' ,,. x •0.0Site utilities:
Job site address: 12805 SW 133rd Ave Catch basin or area drain 18.76
Drywell,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.: 002 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
,x Backwater valve 12.51
a k I i tf .:;moi `..= �- ,._ :
Clothes washer 25.02
Construction of SFR Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
:,,,,,444. ,,,,,,.,z, I 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
( o (.' ' Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name: Same as above
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: bgroves@riversidehome.com Urinal 25.02
Water closet 25.02
Water heater 37.52
Business name: H &H Mechanical Waterpiping/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
CCB Lic.: 178122 Plumbing Lic.no.: PB414 Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name: Brett Groves Date: 12/19/2016 This permit 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:\Building\Pesmits\PLMU-PeemitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
V
INCity of Tigard
q COMMUNITY DEVELOPMENT DEPARTMENT
T I G A R D Building Permit Review — Residential
Building Permit #: /457---,20/60--e0.56 7
Site Address: I Z g C7 S ry r I S 3
Project Name: kikhilit(\ U i-- t2'ctC) € Lot #: Z
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: N QAiV S C4 _
VVerify site address/suite# exists and active in permit system.
V. River Terrace Neighborhood: X No ❑ Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
Three(3)copies of site plan .Disting structures on site
Site plan must be on 8-1/2"x 11"or 11 x 17"paper C 1 ootprint of new structure(including decks)with finished
/Drawn to scale(standard architect or engineer scale) floor elevations
/North arrow ❑Utility locations(required for new,may apply for additions)
/Site address,project or subdivision name and lot number "Intoc-Stion of wells/septic systems
/Applicant information(name and phone number) .,.sting trees to be retained with drip line,and tree
/Lot dimensions and building setback dimensions „protection measures
°
/Lot
building coverage area,percentage of coverage and treet 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
4 Public Facilities Improvement (PFI) Permit:
Required: E Yes,applicant was notified ❑ No Applied For: E Yes ❑ No,stop intake
Land Use Case#: U Q 2,0t4 — °°C) 1 1
2( Zoning: 12_ 1 . s
LI Required Setbacks: Front 10 Rear 1 S Side c Street Side i s Garage
Landscape Requirement:
Lot Coverage Maximum: — %
yr Building Height: Maximum Height s0
Actual Height 1
Visual Clearance
Easements
/p Sensitive Lands: ❑ Yes ❑ No Type
r Urban Forestry Plan
ZI Conditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: /14161 _ Date: 1 Zi '2/ I (v
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Fonns\BldgPermitRvw_RES 091216.docx
Building Permit Submittal
Original Submittal Date: /akf1 t'
Site Plans: #
Building Plans: # 3
Building Permit#: riter building
,��perm��it-#-�-above.
Workflow Routing: lanning Ir—"ftel-mit Coordinator ti rsutlding
Workflow Sign-off: EL-Rip-off for Planning(include notes from planning review)
Route Application Documents: . ngineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
[ B'i-ding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: ! i
r:1
Engineering Review
Slope at building pad: /671
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: El 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: 4/ D Date: j.�4_,/l
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: El Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
EP/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: CE Yes ❑ N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: 2rYes ❑ N/A
.[ 'OK to Issue Permit
Approved by Permit Coordinator: C'_ � t • &4.4.-A-4-.... Date: 1
I:\Building\Forms\BldgPermitRvw_RES_091216.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12805 SW 133RD AVE, TIGARD, OR, 97223 October 24, 2017 at
1 :50:52 PM
Record Type: Record ID:
Residential - Master Permit MST2016-00567
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:
12805 SW 133RD AVE, TIGARD, OR, 97223 October 24, 2017 at
1 :50:09 PM
Record Type: Record ID:
Residential - Master Permit MST2016-00567
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS
Comments:
Provide impact protection for appliances located in the garage (ORSC M1307.3.1 )
(OPSC 507.5) located at water heater.
All other plumbing appears ok.
Note: correction to be completed prior to building final.
Violation Summary:
Inspector Contractor
CITY OF TIGARD MASTER PERMIT
111 .. COMMUNITY DEVELOPMENT Permit#: MST2016-00567
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/16/2017
Tf �� ,E•l� g Parcel: 2S104AC14800
Jurisdiction: Tigard
Site address: 12805 SW 133RD AVE
Subdivision: WALNUT RIDGE 0, .
I
Project: Walnut Ridge, Lot 2
Project Description: New SF. 1/26/17, DEMO CREDITS FROM BUP2015-00344 APPLIED TO THIS PERMIT.
10/23/17: REPRINT to add 56 SF deck.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1179 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1447 sf Garage: 379 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2626 sf Value: $314,720.15 Rear: 15
PLUMBING
Sinks: 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: 4 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'l 500 sf: 4 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N 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 2626
Owner: Contractor:
RIVERSIDE HOMES LLC RIVERSIDE HOMES LLC Required Items and Reports(Conditions)
17933 NW EVERGREEN PKWY, 17933 NW EVERGREEN PKWY 370 1 Ersn Cntrl 503-639-4175
#370 BEAVERTON,OR 97006 2 Geotechnical Inspection
BEAVERTON,OR 97006 Required before foundation
PHONE: PHONE: 503-645-0986
FAX: 503-690-2942
Total Fees: $8,784.81
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 01-0090. You ay obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987.2� �or 1.800.332.2344. �7(
Issued By: 1 ' Permittee Signature: TR2- .-7,I C i/G
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.
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
= r Transmittal Letter
1 6 n D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: 0 V— DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVE!)
FROM: j �,1-t '10 V ;" 2 3 2 017
( CITY OF TIGARI)
COMPANY: C V(,t`-,1,U' 1-q yw--5 BUILDING DIVI e ,
PHONE: 51). tf7 , - -1) 1'YBy: ►/
RE: OA 175 SLS (�� ' l'YyST -10 (0 - 00510
lJ
(Site Address) (Permit Number)
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s)of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS:
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: io - �3- 1-) Initials: 11
Fees Due: 'C Yes ❑No Fee Description: Amount Due:
•�'
He Jaiah V -vsre.✓ $
$
$
Special
Instructions:
Reprint Permit(per PE): Yes [] No r"i one
Applicant Notified: Date: / 4//j nitials:
I:\Building\Forms\TransmittalLetter-Revisions_061316.doc
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Impervious Area 2, 091
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HMC Harris-McMonagle WALNUT RIDGE
Since Associates, Inc, RIVERSIDE HOMES, LLC LOT 2
1968 17933 NW EVERGREEN PKWY 12805 SW 133 RD AVE.
IENGEEt5URVEY1NPL4NNING BEAVERTON,OR 97006 /\.
503-645-0986 CA
12555 SW Hall Blvd. Tigard, Oregon 97223 „_ ,
Tel (503)639-3453 Fax(503)639-1232 wri , COPY
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