Permit (54) 7aCITY OF TIGARD MASTER PERMIT
11:' COMMUNITY DEVELOPMENT Permit#: MST2017-00149
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/28/2017
TIGARD 9 Parcel: 2S111AA11600
Jurisdiction: Tigard
Site address: 14412 SW 90TH AVE
Subdivision: GREENSWARD SOUTH Lot: 10
Project: Greensward South, Lot 10
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1382 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 25 Bathrooms: 3 Second: 1515 sf Garage: 606 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2897 sf Value: $360,312.03 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
Drains: 0
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y 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: 6 201-400 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 2897
Owner: Contractor:
FOUR D CONSTRUCTION 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: $30,873.21
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 require you to follow t e rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through 0 952-00 0090. j 9u may ob .in a c••y of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: %� Permittee Signature: C,
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.
Building Permit Application LS
Residential FOR ou llt l: 141: oy 1.1
l
City of Tigard
Received 1i
g v Date/By: 7 / t7 � 77 Penult No.:
illi13125 SW Hall Blvd.,Tigard,0•VI 4r._ 'V// /"25r"7GIt�'j�L �
_ Plan Review
Phone: 503.718.2439 Fax: 503. 9.. '60 Other Permit: _
Inspection Line: 503.639.4175 2�`� Date Re. 3 /7 ` '" e Page ,` �
i(:; \h f� p �?��/ Date Ready/13y: � Juris: fig See page Z for
Internet: www.tigard-or.gov ��Gp Notified/Method: /) /7,'i Supplemental Information
TYPE OF;% 's.; REQUIRED DATA:1-AND 2-FAMILY DWELLING
New construction ■ Demolition Permit fees*are based on the value of the work performed.
❑Addition/alteration/replacement ❑Other: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Dir I-and 2-familydwellingValuation: $ D l2 12
0Commercial/industrial �`�' J t
❑Accessory building 0 Multi-family Number of bedrooms: 3
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors: Z.
Job site address: 1 41-1 2 S W. 90 Tµ Ave. New dwelling area: z,59 7 square feet'
City/State/ZIP: '-Ft (,)A.'!Z 1) 012 972-2-5/ Garage/carport area: b t7 to square feet
Suite/bldg./apt.no.: Project name: Covered porch area: 70 square feet 'SI 5
Cross street/directions to job site: Deck area: )2,..0 4,0
square feet ,21D „,/
K A U.- 1-30/Dv CgeNScv A -o L.N - 90 D-/f- ther s ructur area: /2.0 square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 6 g cm,:s,c4i tgv RD e y 4-7—)4_ Lot no.: 1 Q 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.
A/LW 5//VC 1=pi,Y► 1(.4 RE5iDeM- Valuation: $
Existing building area square feet
New building area: square feet
PROPERTY OWNER 0 TENANT Number of stories:
Name: Type of construction:
Address: A/16- / 5 R5Lo Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
OAPPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: Fou 0- D C o M5 TRtt CT/v i� Structural plan review fee(or deposit):
Contact name: I py l s 1 E. 14)4-2-P p6 g-1—
p FLS plan review fee(if applicable):
�
Address: 1 ,0, Bu x f S 7 7
City/State/ZIP: EES ve g ro d 7o 7 5 Total fees due upon application:
`7 C7 7 I y Fax::( 590 --
J 7 / Amount received:
Phone:
E-mail: / 0 CI r2 b COWS T-E 611,S.i • CO/41- PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic Solar Panel System.
Business name: T Submit two(2)sets of roof plan with connection details
Address: and fire department access,along with the 2010 Oregon
,�,�/� I Solar Installation Specialty Code checklist.
City/State/ZIP: 5 P'IN Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: 7/037 Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
/4W--
within 180 days after it has been accepted as complete.
Print name: . *Fee methodology set by Tri-County Building Industry
V 1.D .-5- DE i ARept,qtr`Date: 1.1_1 9— 17 Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
1
Mechanical Permit Application FOR OFF ICF 1SF ON Ll
Received
Cityof Tigard �.qDate/By: Permit No.:
114 li 131SW Hall Blvd.,Tigard,OR 97223 ,,ie•• Plan Review M�' �/ 7T ` f
: Phone: 503.718.2439 Fax: 503.59' "St' C + Date
By. Other Permit:
i i ;n 1t I> Inspection Line: 503.639.4175 r)01 Date Ready/By: Juris. 0 See Page 2 for
Internet: www.tigard-or.gov `?%' Notified/Method: Supplemental Information
TYPE OF WOOL[ ;AG.vs "d COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
�\rr���� Mechanical permit fees*are based on the value of die work
tirNew construction 0 Addition/atter t�acement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT 1 SYSTEMS FEES*
ira 1-and 2-family dwelling 0 Comniercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 1 46.75
Job site address: 1 LI y(2. S. W 90 T It 14 ve Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: r 1(.e-12-.0 0 c 7 ZZ y Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
/4-A L-1- ? Lvb &ReENscvArto t°.N — 70 r-i4 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
Other: 23.32
Subdivision: 62R '&'-'e.Ns`,.)RI-2,r) 'i-p+ Lot no.: L D 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
Log lighter(gas) 23.32
N&t4-; s /to C3 L-E Fit M 1 Ly g eS i D e xi(-LE Wood/pellet stove 33.39
Wood fireplace/insert 23.32
elk _ ) / `� a),46,--a),46,-- Chimney/liner/flue/vent 23.32
E}-L-/�, tez _(�jJ Other: 23.32
La PROP ER ❑ TENANT Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: $A t,46- ps 13 r OLsJ 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
pir APPLICANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name: FOU R. D C'( i0 g4 L(.
STT ' au S14.15 for first four;$4.03 for each additional
Contact name: AV/ P D e A-. -e Pe,r2."C' Furnace,etc.
Gas heat pump
/`
�
Address: r i 6 , ,a t~`..`x I 5 7.7 Wall/suspended/unit heater
City/State/ZIP: j3-E,J\/E R_T c 1j C`), 9 7 0 7 S Water heater
C
Phone:(.5 03) 7A a ._ -7' it S Fax::($L3 5 /0 .. 1-ss I Fireplace
Range
E-mail: FOCI ILO CO/U ST- t4 jt.n), (CAA Barbecue
CONTRACTOR Clothes dryer(gas)
Other:
Business name: e&A r- L A i 1, --, L MECHANICAL PERMIT FEES*
Address:
0 i Box 933 Subtotal
6(2-• C-1-1 0 Minimum permit fee($90.00)
City/State/ZIP: t L.Q C.l -P.M AS
Plan review(25%of permit fee)
Phone:(g 3s) 5 6._ i vo ' Fax:( ) 650-3 s fs State surcharge(12%of permit fee)
CCB lic.: /76 &12., (.7/ TOTAL
LTOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature:2j'- ' Fee methodology set by Tri-County Building Industry Service Board
Print name: Dgy„p v07d7e /etch--- Date: y-/4:7 -/?'
040113.doc 440-4617T(11/02/COM/WEB)
I:1Building�PermitslMEC PermiWpp_
Electrical Permit Application rt l l~; ()I11( 1- I ',1 O N l.1
Received
. N._ City of Tigard
13125 SW Hall Blvd.,Tigard,OR 97223 eik...v ■ aate/By:Ian Review Permit#: /t'1,` T i7 -00/41
_ Phone: 503.718.2439 Fax: 503.598.19 1r O rP Date/By: Related Permit#:
Inspection Line: 503.639.4175 -1 Ready Date/By: Jude ® See Page 2 for
i .. \I�.i) Internet: www.tigard-or.gov pD a Q 7.13\` Notified/Method: Supplemental Information
TYPE OF WORK P4i� .�1GRLD*� PLAN REVIEW
{Kew construction 0 Addition/alteration/ret: F �`t t�roiv Please check all that apply(submit a sets of plans w/items checked):
gl.s01�® 0Service or feeder 400 amps or more ❑Building over three stones.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRON exceeds 10,000 amps at 150 volts or 0 Floating buildings.
10,1-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.
❑Multi-family 0 Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address: l ooHP or more. ❑"A","E","i-z","1-3",
City/State/ZIP: y— / 1y2-� �t-� 2- ❑Six or more residential units. occupancy.
i A tom-t/ . 7 ❑Recreational vehicle parks.
0 Health-care facilities.
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: FEE SCHEDULE
Description I Qty. I Bach 1 Total 1 *
—14 }I-A— pj L V D V/ZE E//+S4,J 1;124'J I.A1 - 96 r/-4 New residential single-or multi-family dwelling unit.
Subdivision: 6 z e&— /360 pr Ito Soc.r )4--pt Lot#: 1 0 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#:
Ea.add'1500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
(with above sq.ft.) 75.00 2
II1 .5 i tV 4-& f=A pen t.-,j g es Dem,is Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
Or PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 100.70 2
201 amps to 400 amps 133,56 2
Address:
„SAM-6 AS 43 E LA-) 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,and/or
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I
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
l�APPLICANT 0CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
�+ A.Fee for branch circuits with
Business name: Fc,a,x2_ }t-/S /Z(J cr-j(y kJ above service or feeder fee,
7A2 2
each branch circuit
Contact name: d.)Nv/0 Da 14A 12_?- tz r B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address: p.0. Box 15'7'7 branch circuit
City/State/ZIP: BE Aye,� 3 p'V... 9 70-7 s Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:6,I3)'7.2 0..'7 y y S Fax::($' ),S990 m i 7,j / Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: FO LA V. D c_ ,$$j"t 5v h!t Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: >�( Sign or outline lighting 67.84 2
�Z 1-6- �� Signal circuit(s)or limited-energy
Address: Zt ❑ See Page 2 2
�� /fi j� ��� ��N�7 �� /b � panel,alteration,or extension.
Ci /State/ZIP: Each additional inspection over allowable in any of the above
ty J O i rt. + d� / 727 Additional inspection(1 hr min) 66.25/hr
Phone:{ )3) 177 j 7133 Fax:(5.3 ) 90/ " 75/V Investigation(1 hr min) 6625/hr
Email: --4.6.-7-6-6.---,�,i crus L 6 IZiicr Industrialspeoplantr which(1 hr nmo ?8.18/hr
rt ,l1 r't- , tI/I Inspections for no fee is
CCB Lic.:i 7/2,76 6,3� Electrical Lic.: � Suprv.Lic.:5 76 L
specifically listed('h hr min) 90.00/hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:R4 - Subtotal:
Print name: k 6 13 e-12..7o f3/;yI//jf,. ie/Z.Date: y_/9- /7 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signaturra&---- TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: V E q�4' ptt� Date: �./_ 9 17 days after it has been accepted as complete.
Number of inspections allowed per permit.
r:\Buiiding\Pevnits\ELC PermitApp_ELR ERE.doc Rev 04/21/2014 440-4615T(11/05/COM/WEB
Plumbing Permit Application
Building Fixtures -9 I Olt t)FI R l: I ,,l0\l_1
• City of Tigard ®� Eew
Permit No.: �ri 7 � j`t 1II 'II 13125 SW Hall Blvd.,Tigard,OR 972. : �� p
Phone: 503.718.2439 Fax: 503.598.1'` cOther Permit No.:
inspection Line: 503.639.4175 P�� P' �;. ;, /B June ® See Page2 for
1 ft;;1f:1) t� y'
Internet: www.tigard-or.gov �1c , ed/Method: Supplemental Information
TYPE OF WORK c\ 0,�` FEE* SCHEDULE
Di New construction 0 Demg jt t\•"' For special information use checklist
FJ Description Qty. Ea. I Total
0 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
9i 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site addresst.�LI � 2 D Yf✓ Catch basin or area drain 18.76
' .5. Drywell,leach line,or trench drain 18.76
City/State/ZIP: -1-i &,f i R c 7 2.Z.V Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
i? A LZ- B LvI CREGN54,A11-D isiv - 90 i-#- Rain drain connector 18.76
7 Sanitary sewer(no.linear ft.:__,) Page 2
Storm sewer(no.linear ft.: Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: tr / /tr 5a)A},2,t SOL/i-; Lot no.: , 0 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
Backwater valve 12.51
DESCRIPTION OF WORK
K
^� _ Clothes washer 25.02
A/140A/140IV$ 6 C 6 r- t M A Ly i/i E1'' Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
PROPERTY OWNER 0 TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name:
Floor drain/floor sink/hub 25.02
Address: 5/117E A-S )3 LOW Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
aAPPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name:
roc()2,, D co / gLl5 7'/c/l/ Primer 12.51
Contact name: 0 A V i ) D E-11 P.?PC)1&r Roof drain(commercial) 12.51
Address: T. 0. ,aX I S '7 7 Sink/basin/lavatory 25.02
City/State/ZIP: BEt vvg7Z)#/ a R / 7 C3 .5 Solar units(potable water) 62.54
Phone: t)3 ) -7,g0.-.-7 v ,, Fax::c5"03).59'0..i 7 5/ Tub/shower/shower pan 12.51
Urinal 25.02
E-mail: P 0 U I:Z- D(O/+/S j C. A/75/1/. G 0/17 Water closet 25.02
CONTRACTOR Water heater 37.52
Business name: 1-f H.(✓ A/7 L(L L n/ C) t 1 A JL/ Water piping/DWV 56.29
Address: /66/A „cj,c. RI //,;;12 Rat i Other:
25.02
City/StatefZlP: :/4//4,4.5130x„,10 /i-- 9 /2.3 Subtotal
/ Minimum permit fee: $72.50
Phone:(j ) 6.yo U j/3 Fax:( ) Plan review (25%of permit fee)
CCB Lic.: r.2 6g 9 Plumbing Lic.no.:-FV-26e PdState surcharge(12%of permit fee)
Authorized signature: e / TOTAL PERMIT FEE
�.__-;v
This permit application expires if a permit is not obtained within 180 days
Print name: Dow/A, ,...T. 4.g DE"Li, pjji p4 Date: y_pi 9- 1 7 after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
t:\Building\Pennits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
A
City of Tigard
q COMMUNITY DEVELOPMENT DEPARTMENT
■
T I G A R D Building Permit Review — Residential
B ilding Permit #: //1,57).0/7-6,u/Ly/
Si Address: /Lill) amu) ?K2-7/h /v
Proje t Name: E12t� Spu 4 Lot #: /CD
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Plannk'' g Review
Proposa : A) �
1Z('
J Verifyite address suite# exists and actio m
/ permit system.
01 haver errace Neighborhood: No ❑ Yes,See River Terrace Review Addendum Attached
r
Sit lan Elements:
ree(3)copies of site plan m,... , ting structures on site
e plan must be on 8-1/2"x 11"or 11 x 17"paper II Footprint of new structure(including decks)with finished
It I awn to scale(standard architect or engineer scale) oor elevations
•rth arrow V Utility locations(required for new,may apply for additions)
S'ittaddress,project or subdivision name and lot number 1.121ation of wells/septic systems
plicant information(name and phone number) .\ ting trees to be retained with drip line,and tree
I t dimensions and building setback dimensions rotection measures
l urea,building coverage area,percentage of coverage and reet tree size,type and location
fn
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)
`lean Water Services—Service Provider Lett (lot platted prior to 9/10/1995):
Pequired: El Yes, notified applicant was No Received: El Yes CI No
ublic Faciliti Improvement(PFI) Permit:
/Required: Yes,applicant was notified El No Applied For: Yes ❑ No,stop intake
re/Land Use Case#: S'C/, r O
P- �_S'
voning:
quired Setbacks: Front e2.0 Rear Side Street Side Garage
0 aandscape Requirement:
of Coverage Maximum: 0/0
'►d Building Height: Maximum Height e7 Actual Height ,,---1,2
II
V"' ,'isual Clearance
r4 Easements
il :
Building Permit Submittal
Original Submittal Date: /, //7
Site Plans: # 3
Building Plans: # 3
Building Permit#: - iter building permit#above.
Workflow Routing: fanning Cl-"Engineering C ermit Coordinator ding
Workflow Sign-off: a—Sign-off for Planning(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.
aBuilding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: v , _ Date: 7i/iZ97j 2
Engi ening Review
She at building pad: $2
Conditions "Met"prior to issuance of building permit
41ments (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
El NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: !� 47)� Date: .5"--F—e7
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 Trans Dev Taxes CI N/A
( Tigard Trans SDC: Yes ❑ N/A
Parks SDC: Yes ❑ N/A
OK to Issue Permit
Approvedby Permit Coordinator: /// 3ate: OA
I:\Building\Fonns\BldgPennitRvw_RES 091216.docx
L
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
14412 SW 90TH AVE, TIGARD, OR, 97224 March 27, 2018 at 9:23:10 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00149
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
FA I L
Comments:
Seal base of upper main bath tub/ shower. 407.2
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:
14412 SW 90TH AVE, TIGARD, OR, 97224 March 27, 2018 at 9:22:31 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00149
Inspection Type: Inspector:
199 Electrical final David Young
Result:
FA I L
Comments:
Moved Lights not installed in master bath above lays, exposed wiring not protected and
metal boxes not grounded.
Wiring not done at kitchen island.
Work not complete, not ready for electrical final inspection. R109.3
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
14412 SW 90TH AVE, TIGARD, OR, 97224 March 27, 2018 at 8:59:23 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00149
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS
Comments:
Ac installed.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
14412 SW 90TH AVE, TIGARD, OR, 97224 April 2, 2018 at 9:02:03 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00149
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.
Duct seal test report received.
Insulation certification checked.
C of 0 left on site with approved plans.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
14412 SW 90TH AVE, TIGARD, OR, 97224 April 2, 2018 at 8:59:38 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00149
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS
Comments:
Corrections from previous inspection complete.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
14412 SW 90TH AVE, TIGARD, OR, 97224 March 30, 2018 at 9:02:27 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00149
Inspection Type: Inspector:
199 Electrical final David Young
Result:
FA I L
Comments:
Corrections from previous inspection not done.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
14412 SW 90TH AVE, TIGARD, OR, 97224 March 30, 2018 at 9:03:51 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00149
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
PASS
Comments:
Correction complete from previous inspection.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
14412 SW 90TH AVE, TIGARD, OR, 97224 March 30, 2018 at 9:11 :59 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00149
Inspection Type: Inspector:
299 Final inspection David Young
Result:
FA I L
Comments:
Provide approved electrical final inspection prior to building final inspection. Corrections
from previous inspection not done.
Not ready for building final at this time.
Violation Summary:
Inspector Contractor