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Permit (42) CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT ��„,�/ j Permit#: MST2017-00291 T I C;; it.f 7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 � ►, �l� Date Issued: 09/14/2017 Parcel: 2S110AC00200 Jurisdiction: Tigard Site address: 10994 SW ANNAND HILL CT Subdivision: ANNAND HILL SUBDIVISION Lot: Project: Annand Heights, Lot 24 Project Description: New SF. 3/20/18: REPRINT to change address from Annand Ct.to Annand Hill Ct. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 998 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1367 sf Garage: 440 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right 3 Detectors: Yes Total: 2365 sf Value: $291,259.65 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer 100 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Bckflw Prevntr: 0 Catch Basins: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add!500 sf: 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:Y Square Feet: NEW SF VB R-3 2365 Owner: Contractor: ANNAND HILL LLC WINDWOOD CONSTRUCTION INC Required Items and Reports(Conditions) BY RICHARDS,M DALE 12655 SW NORTH DAKOTA 1 Ersn Cntrl 503-639-4175 12655 SW NORTH DAKOTA ST TIGARD,OR 97223 2 Fire Rated Eaves-Both TIGARD,OR 97223 Sides PHONE: 503-768-4375 PHONE: 503-625-6526 FAX: 590-7606 Total Fees: $30,444.22 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 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: rets‘.. (k� C Permittee Signature: gre- ��/jam/(t._`7y” k. Call 503.639.4175 by 7:00 a.m.for the next available inspection date. r` / This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. CITY OF TIGARD MASTER PERMIT III is COMMUNITY DEVELOPMENT Permit*: MST2017-00291 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/14/2017 Parcel: 2S110AC00200 Jurisdiction: Tigard Site address: 10994 SW ANNAND CT Subdivision: ANNAND HILL SUBDIVISION Lot: Project: Annand Heights, Lot 24 Project Description: New SF. BUILDING Floor Areas . Required Setbacks Required Stories: 2 Bedrooms: 4 First: 998 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1367 sf Garage: 440 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes Total: 2365 sf Value: $291,259.65 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Catch Basins: 0 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: 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 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 2365 Owner: Contractor: ANNAND HILL LLC WINDWOOD CONSTRUCTION INC Required Items and Reports(Conditions) BY RICHARDS,M DALE 12655 SW NORTH DAKOTA 1 Ersn Cntrl 503-639-4175 12655 SW NORTH DAKOTA ST TIGARD,OR 97223 2 Fire Rated Eaves-Both TIGARD,OR 97223 Sides PHONE: 503-768-4375 PHONE: 503-625-6526 FAX: 590-7606 Total Fees: $30,444.22 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: t- _ Permittee Signature: Call 503.639.4176 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application • L,'✓ 7-4,7"e j� j5 Residential ^ tl°, 1)p , ' FOR OFFICE USE ONLY City of Tigard Received IPIIDate/B F Permit N T a 13125 SW Hall Blvd.,Tigard,OR 97223 U L 2017 y" (/ /�� sl�U��` �"� ` I Plan Review q Phone: 503.718.2439 Fax: 503.598.1960 Date/By. „a/ a U ') Other Permit:5/4 4 7. `) c7c TIGARD Inspection Line: 503.639.41752 T'iw \r Date Ready/By: loris: p See Page2 for Internet: www.tigard-or.gov r3 N2L_+UTh mC D'$i v J Notified/Method. Supplemental Information TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING f iNew construction 0 Demolition Permit fees*are based on the value of the work performed. r Indicate the value(rounded to the nearest dollar)of all 0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY'OF CONSTRUCTION _ work indicated on this application. and 2-familydwellingValuation: $ �/1, p ❑Commercial/industrial 7 lr 0 Accessory building 0 Multi-family Number of bedrooms: („ 0 Master builder 0 Other: Number of bathrooms: = JOB SITE INFORMATION AND LOCATION Total number of floors: .2 a3 g 5 . ago Job site address: /a#41/q 5k AlAand,/ ' (2 k�- New dwelling area: square feet O City/State/ZIP: 77- *.2p t!LL 9 7 -3 Garage/carport area:' tt square feet Suite/bldg./apt.no.: I Project name: nil n4no// ileA Covered porch area: a 6 square feet)3 67 Cross street/directions to job site: /a J9 ff Deck area: I �/ square feet ci Q$ Other structure area: square feet I REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: /,i nQ Ali-e‹, �h /5 Lot no.: '. i,,/ Permit fees*are based on the value of the work performed. Tax map/parcel no.: [i ( 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. !d'o i7P/2=2 Valuation: $ Existing building area: square feet New building area: square feet 0 PROPERTY OWNER 0 TENANT Number of stories: Name: 1,( f-,n, D ki-c90 ) CU,LSr/Jw/7 tO �"' Type of construction: Address: /�4�-5 5& �'I a!1 7 t Dva/�id 6'1•r l Occupancy groups: City/State/ZIP: �7 a /V /��2-2-3 f 9` Existing: Phone:(�3 704e_443-7c Fax:(J�t3) �9U'7��v New: 0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* Business name: /YZ (Please refer to fee schedule Structural plan review fee(or deposit): Contact name: Address: FLS,_plan review fee(if applicable): City/State/ZIP: Total fees due upon application: Phone:( ) Fes::( ) Amount received: E-mail: 1101/1[� rkdeid OM /t, ®, qAL ail,(-0'nPHOTOVOLTAICSOLAR PANEL SYSTEM FEES* CONTRACTOR N/ Commercial and residential prescriptive installation of roof-top mounted Photo Voltaic Solar Panel System. Business name: lordd� �i�s� ]� Submit two(2)sets of roof plan with connection details ��" and fire department access,along with the 2010 Oregon Address: A-6 5--5 c> 4 f 1,� ,/)4 k Il- Solar Installation Specialty Code checklist. City/State/ZIP: 7j5� �2 9-7 2.-.2--3 Permit Fee(includes plan review ,6��' and administrative fees): $180.00 Phone:(0 'J,ge _L 7c Fax:(157/3 6-90—ZadL State surcharge(12%of permit fee): $21.60 CCB lic.: 6---0./94, Total fee due upon application: $201.60 Authorized signature — --- _—__________ _— This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. int name: *Fee methodologyset byTri-Conn !�. 2 s Date: "'' Tri-County Building Industry Service Board. tilding\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Applicata ' ,, , Fl. JFFICE USE ONLY City of Tigardl ° �` Received 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: Permit N Phone: 503.718.2439 Fax: 503.598.1960 1111 JUL 2 7 2017 Plan Review /�S/� '"�i— l Other Permit:Date/By:Ins Inspection Line: 503.639.4175TIGARD Internet: www.tigard-or.gov ; l Date Ready/By: orris: I H See Page 2 for t l \11::::-! Notified/Method. Supplemental Information °T1'PE OF"WORK COMMERCIAL FEE* SCHEDULE USE CHECKLIST ew constructionanmit araswork ❑Addition/alteration/replacement performed.Mechical Indicateperfees*the valueeb(roundededon the to value the nearestofthe dollar)of all 0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. CATEGORY OF CONSTRUCTION Value:$ �.. r. RESIDENTIAL EQUIPMENT/SYSTEMS FEES* and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi family 0 Master builder 0 Other: Description I Qty. I Ea. I Total 2,!;.2.,;.;:'...:::...:,.-,;:-..,„''': --46B SITE=-IlO'ORM I,TION AND ri,PCATION a Heating/cooting: Job site address: ) jAna/LW1 Air conditioning 46.75 j /2E71/4/Q�t,- Furnace 100,000 BTU(ducts/vents) ..'"' 46.75 City/State/ZIP: ``."a� (i.e. 972_23 Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt,no.: Q I Project®name: ///�� Heat pump 61.06 � ��A�.44 Duct work 23.32 Cross street/directions to job site: /0, Hydronic 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 23.32 Subdivision: /9-An4 n4/ /.../e0 h I Lot no.: ! Other: 23.32 Tax map/parcel no.: Other fuel appliances: Water heater g..--"" 23.32 r° .DESC1tIP.TION O,F WORK'' Gas fireplace/insert ." 33.39 � � il/� I � Flue vent for water heater or gas fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 RY OWNER Other: TENANT 23.32 OPERT Name: ritritutad 5_/ J7� Environmental exhaust and ventilation: /� T Range hood/other kitchen Address: /65-5- 6-� A�dr„�iL �j- / _ 5 equipment 33.39 �" (/–f► y(pG,�� Tc Clothes dryer exhaust d''''' 33.39 City/State/ZIP: �Z q7.2�3 Single-duct exhaust(bathrooms, Phone: d ?� toilet compartments,utility rooms) 0 23.32 ( 6"5 I Fax:c,3) r�'rio ��'a(� Attic/crawlspace fans 23.32 LICANT' jl [�"CfOlNT�ACT PERSON Other: 23.32 Business name: 60A� Fuel piping: Contact name: $14.15 for first four;54.03 for each additional Furnace,etc. Address: Gas heat pump City/State/ZIP: Wall/suspended/unit heater Phone:( ) Water heater Fax: :( ) Fireplace E-mail: C /vim® (am Range tiV! ( ttJY9d/ tS ��jn't�'�� Barbecue ' CONTRACTOR': V- Clothes dryer(gas) Business name: .Ftr5/ AI/ Other: Address: /3/5v v�' /_ `�� /1r. MECHAIITICALPERMIT FEES* �J / C��S � �j' Subtotal City/State/ZIP: .,,.0 d� 45 moi+ ,f 0.4 a�v� Minimum permit fee($90.00) Phone:( ) , `� v rpax:( ) Plan review(25%of permit fee) CCB lac.: '7.2.6r7/3State surcharge(12%of permit fee) TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 Authorized signature: "011days after it has been accepted as complete. * Fee methodology set by Tri-County,/ Building Industry Service Board Print name: /bra et/j eli I LII)0 Date: 1\Ruildinu\Permit.,\MEC PermitAno 04h3 doc 440-4617T(1 1/02/COM/WEB) , Electrical Permit ApplicataAE! T— FO,c OFFICE USE ONLY ill . City of TigardReceived2 7 2017 Received R 13125 SW Hall Blvd.,Tigard,OR 97223JUL Phone: 503.718.2439 Fax: 503.598.1960r, Plan Review Inspection Line: 503.639.4175 l� r- `' -rtrr' Date/B Related Permit 4: TICARD r i,h,-. DIi5t e =. ,; ReadyDateBy: Internet: www.tigard-or.gov 1 ) 1 Juns: E7 See Page 2 for Notified/Method: TYPE OF WORK. Supplemental Information PLAN REVIEW construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): 0 Demolition Other: ❑Service or feeder 400 amps or more where the available fault current 0 Building over tohtyea stories. CATEGORY OF CONSTRUCTION' ❑Floating and boatyards. ]_ 2-family dwellingexceeds 10,000 amps at 150 volts or ❑Floating buildings. 0 Multi-family and2-fa 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural ❑Master builderamps for all other installations. buildings. 0 Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived Job 4: I Job site address:A 191Aem. M/�n QA( 4L d�tiq{/�/ 1 OOHPddition or moreofnew motor load of ❑"systA" "E" "l-2" City/State/ZIP: ® „ q,)2�3 0 "1_3,, .3 , V0 Six or more residential units. occupancy. Suite/bldg./apt.4: 0 Health-care facilities. 0 Recreational vehicle parks. Project name: Ama1,d L/yt /� ❑Hazardous locations. // G1 �jZ, y/{, 0 Supply voltage for more than Cross street/directions to job site: ✓69 f� V ❑Service or feeder 600 amps or more. 600 volts nominal. I FEE SCHEDULE Description I Qty. I Each New residential single-or multi-family dwelling unit. tat Subdivision: 71-AAa/Ii /lroI /J I Lot#: Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 168.54 q DESCRIPTION OF WORK Ea.add'1 500 sq.ft.or portion 33.92 1 Limited energy, fr� gyf ,residential 5F (with above sq.ft.) 75.00 2 Limited energy,multi-family residential(with above sq.ft.) 75.00 2 _"PROPERTY OWNER 0 TENANT RenewEnergy ❑ See Page 2 Name: t ,rte_/Wcd� / is JAL Services able or feeders installation,alteration,and/or relocation �� `{� �-O X11 Z 200 amps or less 100.70 Address: ��SS S'cc) Nor- 0 d� tl (7 �1 2 201 amps to 400 amps 133.56 City/State/ZIP: f �,.�/ 2 C 't./� Q-72.23 401 amps to 600 amps 200.34 2 Phone:( a 601 amps to 1,000 amps 301.04 2 Email: 7b ..._..z/3 ,r I Fax:�/� )�0 �� Over 1,000 552.26 amps or volts 2 /e _ / fi _ - S �� vif✓d Qr�/LO/AZ ®Al' / `�� Temporary services or feeders installation,alteration,and/or relocatin Owner installation: This installation is being made on property that I own which is not 200 amps or less intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 55.08 1 Owner signature: 201 amps to 400 amps 125.08 Date: 401 amps to 599 amps 116285.5048 68.54 2 LICANT 2 ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel Business name: Sant A.Fee for branch circuits with (,,,/'�t above service or feeder fee, Contact name: each branch circuit 7.42 2 Address: B.Fee for branch circuits without service or feeder fee,first City/State/ZIP: branch circuit 56.18 2 Each add'l branch circuit 7.42 Phone: 2 ( ) I Fax: :( ) Miscellaneous(service or feeder not included) Each manufactured or modular Email: dwelling,service and/or feeder 67.84 2 CONTRACTOR Reconnect only 67.84 2 Business name: S *7� �/c.: Pump or irrigation 67 84 4e-ca/t�lUu- C 2 Sign or outline lighting 67.84 2 Address: .i..r / 5c,__, 6104p/ Signal circuit(s)or limited-energy / 6 panel,alteration,or extension. 0 See Page 2 2 City/State/ZIP: VD;),--11-/At 4.'2.1-.3-5Each additional inspection over allowable in any of the above Phone: j3) s- Additional inspection(1 hr mm) 66.25/hr /9 -r!s7tl I Fax:b--,,,- ) 4-5i:j"'97 3 Investigation(1 hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr CCB LiC.:oCj�� Inspections for which no fee is Electrical Lic. 90.00/hr " Suprv.LiC.:� Qs specifically listed(V2 hr min) Suprv.Electrician signature,required: ELECTRICAL PERMIT FEES Print namee,'. 1 t4/hSubtotal: !Vn S �Ct,�.0 I Date: 0Plan Review Required(25%of permit fee): Authorized signature;,, ,� _ ! � State surcharge(12%of permit fee): TOTAL PERMIT FEE: Print name: C T This permit application expires if a permit is not obtained within 180 ni-4 Aciit". Date: a � days after it has been accepted as complete. I:1Building\Permits\ELC_PermitApp_ELR_EAE.doc Rev 06/1 s * Number of inspections allowed per permit. 440-46151(11/05/COM/WEB Electrical Permit Application—City of TigardR C�" " Page 2—Supplemental Information =fin= �, Limited Energy Permit Fees: JUL 207 Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: 131, D;: Fee for all residential systems combined: FEE SCHEDULE $^15 00 Description Qty, I Each I Total Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to I S kva 133.56 2 • Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 E Burglar Alarm Wind generation systems in excess of 25 kva: 25.01 to 50 kva 301.04 2 n Garage Door Opener* 50.01 to 100 kva 552.26 2 >]00 kva(fee in accordance n Heating, Ventilation and Air Conditioning with OAR 918-309-0040) 552.26 2 System* Solar generation systems in excess of 25 kva: Each additional kva over 25 7.42 3 • Vacuum Systems* >100kva—no additional charge 0.0 3 nEach additional inspection over allowable in any of the above: I I Other: Each additional inspection is charged at an hourly(1 hr min) 66.25!hr 1 Inspections for which no fee is specifically listed(%hr min) 90.00!hr 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 allowed per permit. Check Type of Work Involved: n A• udio and Stereo Systems Fl B• oiler Controls n C• lock Systems n D• ata Telecommunication Installation • Fire Alarm Installation n HVAC n Instrumentation n Intercom and Paging Systems El L• andscape Irrigation Control* n M• edical n N• urse Calls n O• utdoor Landscape Lighting* n Protective Signaling n Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1 Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 Plumbing Permit Applicatio• Building Fixtures E FOR OFFICE USE ONLY 111 City of Tigard „JUL 2 7 2017 Received - Date/By: Permit No.'A' 4 13125 SW Hall Blvd.,Tigard,OR 97223 ,v/STi��/f� J�j� Phone: 503.718.2439 Fax: 503.598 19 Plan Review Inspection Line: 4 503.639.4175: ' l(;P.R0 Date/By: Other Permit No.: TIGARD Internet: www.tigard-or.gov 2 1 s,/ �� Date Ready/By: loris: 8 See Page 2 for Notified/Method. Supplemental Information TYPE OF WORK FEE* SCHEDULE ew construction ❑Demolition For special information use checklist Description Qty. Ea. 1 Total 0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(I)bath 312.70 and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 0 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: /a T Y j 4u j4A ngn./ 41 //,/a4,4 Catch basin or area drain 18.76 City/State/ZIP: / G Drywell,leach line,or trench drain 18.76 776/ O L� 7-22--.2,3 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name: clifi<J k h /1/1C//J Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 /®9 t-b 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: M rod ///1"e0 11//5 I Lot no.: q Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 f� Clothes washer 25.02 / v.) �� Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER. 0 TENANT Expansion tank 12.51 Name: �ji!/Z��d cfc- 6ar-S� ¢� Fixture/sewer cap 25.02 �"i / Floor drain/floor sink/hub 25.02 Address: /J '$43 �144-/2 Jo/z 5;41-e„--..1 r � , Garbage disposal 25.02 City/State/ZIP: 9 / a,/-41 02, � 3 Hose bib 25.02 Phone:(6°--C/3 7Y o ..L/'20 7,$" Fax:($Z3 5",•/-7it'' Ice maker 12.51 0 APPLICANT( ` ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name: Q Medical gas(value:$ ) Page 2 Contact name: Primer 12.51 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: rinal 25.02 -mail: �d perC/Afj/'l-tSNw Qr-/f"/ta! le< CONTRACTOR Water closet 25.02 ® 'A4 f t is Water heater 37.52 �[?r Business name: "(/�" ,(� g Q-� Water piping/DWV 56.29 Address: / //G? 5 f 11 i !'r Other: 25.02 City/State/ZIP: Orem Z 614 1'7a 5- Subtotal Phone:(�G3) 7r..3 -�gfg� Fax:(5-e3) -.7,„a,5Minimum permit fee: $72.50 CCB Lic.: /, /39 Plumbing Lic.no.:3S-kjN� Plan review (25%of permit fee) Authorized signature: l! /,u) State surcharge(12%of permit fee) TOTAL PERMIT FEE Print name: c "it 4.}.k1 Date: 'I 14 11 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. 1:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(t0/02/COM/WEB) 1111 City of Tigard ' COMMUNITY DEVELOPMENT DEPARTMENT T 1 c A R D Building Permit Review — Residential Building Permit #: idz_.52;k2z -2_-___-0_21/___O Site Address: J®c1GI I- SW Pr h noi r d Hi1 c t, Project Name: A r n c' n cel. h e i 1 f t-s Lot #: 21 (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: N�v�/ c----a. Verify site address/suite#exists and active in permit system. River Terrace Neighborhood: No ❑ Yes,See River Terrace Review Addendum Attached /Sit Plan Elements: Three(3)copies of site plan REsting structures on site /Site plan must be on 8-1/2"x 11"or 11 x 17"paper /Footprint of new structure(including decks)with finished Dawn to scale(standard architect or engineer scale)s/gi floor elevations North arrow /Utility locations&easements(required for new and additions) Site address,project or subdivision name and lot number '(Sidewalk/driveway approach /Applicant information(name and phone number) ElLocaticin of wells/septic systems /Lot dimensions and building setback dimensions g trees to be retained with drip line,and tree ❑Square footage of buildings to be demolished protection measures Lot area,building coverage area,per tage of coverage and Ai Street tree size,type and location impervious area(applicable if R-7, -1 ,R-25&R-40) JZ&treet names S uQ Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? ❑I',.s ❑No 4 foot differential) If yes,is a storm water quality facility shown? ❑Yes ❑No 7i 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: P c_.i l 6 -_ Required: CI Yes,applicant was notified CI No Applied For: O Yes ❑ No,stop intake S V(Land Use Case#: P_D R Z o(S -- C 0008 S U e 20\ s -- 000 \ 3 71 Zoning: y Z ,1 Required Setbacks: Front i 5 Rear j S Side 3 Street Side Garage 2 0 Ai Landscape Requirement: Z..C % V.Lot Coverage Maximum: 9 0 % 1p Building Height: Maximum Height '3 S Actual Height ?0 ,21 Visual Clearance gt Sensitive Lands: ❑ Yes ❑ No Type i?1-Urban Forestry Plan 4 Conditions "Met"prior to issuance of building permit Notes: Approved By Planning: M 6.A...=�„ - _ Date: 7/1-1 I ( -7 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved 0 Not Approved Revision 2: 0 Approved ❑ Not Approved Revision 3: 0 Approved ❑ Not Approved I:\Building\Forms\BldgPemutRvw_RES_061417.docx Building Permit Submittal / Original Submittal Date: 7,j, //) Site Plans: # Building Plans: # Building Permit#: Enter building permit#above. Workflow Routing: , Planning Engineering D--Permit Coordinator Q Building Workflow Sign-off: pi, Sign-off for Planning(include notes from planning review) Route Application Documents: C, 11 Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. ,C7 Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: // By Permit Technician: 1 � Date: �' Engineering Review Slope at building pad: /0l 0 ❑ 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 -E'No Assess Water Quantity Fee in-lieu: ❑ Yes -t1 No LIDA Facility on lot: ❑ Yes -Er No ❑ NOT Approved by Engineering: Date: Notes: tc./ / 7" ✓n-- AA-7- ' -cicr by Engineering:Approved E ineerin : hi/k(Zte Date: 2--1/7 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: DC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A Tigard Trans SDC: c2t3Yes ❑ N/A Parks SDC: 1Z4 Yes ❑ N/A LIDA ❑ Yes T2'"N/A 0 OK to Issue Permit c7�4//9' Approved by Permit Coordinator: Date: / I:\Building\Forms\BldgPernnitRvw_RES_061417.docx " . �S-ice E-5C/° //& 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 III r Transmittal Letter r'(i,A R n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: 77-?/7 DATE IR A , ► . ED DEPT: BUILDING DIVISION AUG 2 3 2017 FROM: C==--L- /2--( (- / L.6..S CITY OFTIGAR COMPANY: G�/'/ 64/0 O C�if/57,-c7C 77D� BUILDINGDIVISION PHONE: 3 — 7,G -- 273 7S c - RE: / 99 V St) /9-�i/A/e4rv.,6 l -C.T�o/ (Site Address) �� a/� (Permit Number) //.k/,51-,V /9cT7f s Lo i 4:2 y. (Project name or subdivision name and lot numbs) ATTACHED ARE THE FOLLOWING ITEMS: I Copies: I Description: I Copies: 1 Description: I Additional set(s)of plans. •c.3 Revisions: /I/& d /°4 -,vS 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: /S C'"..9-2.Z , (r), (it -/we1-( //L,-,,)-A/.S FOR OFFICE USE ONLY Routed to Permit Technician: Date:q- c-. j ? Fees Due: IN Yes ❑No Fee Description: Initials: �u Amount Due: .4- 1-)r p1 "„., ✓cv.; t... $ 48—_____ $ Special $ Instructions: Reprint Permit(per PE): 1 Yes I 0 No ❑Done Applicant Notified: e: + Initials: I:\Building\Forms\TransmittalLetter-Revisions 061316.doc City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10994 SW ANNAND CT, TIGARD, OR, 97224 March 16, 2018 at 1 :46:16 PM Record Type: Record ID: Residential - Master Permit MST2017-00291 Inspection Type: Inspector: 399 Plumbing final David Young Result: FA I L Comments: Not ready for inspection. Shower strainer not installed in master shower. OPSC 404.1 Master tub full of debris. No access to inspect master Lay right side, box of tile debris in way. Grouting at master tub not done. Grouting at upper level main bath base of tub not done. Provide thread sealant on cleanout caps. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10994 SW ANNAND CT, TIGARD, OR, 97224 March 16, 2018 at 1 :38:20 PM Record Type: Record ID: Residential - Master Permit MST2017-00291 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS Comments: Protect exposed Romex above microwave, vent cover appears not installed. Will check at final inspection. No ac installed at this time. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10994 SW ANNAND CT, TIGARD, OR, 97224 March 16, 2018 at 1 :37:52 PM Record Type: Record ID: Residential - Master Permit MST2017-00291 Inspection Type: Inspector: 699 Mechanical final David Young Result: PASS Comments: Seal around condensate drain at foundation vent left side. Will check at building final inspection. No ac installed at this time. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10994 SW ANNAND HILL CT, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2017-00291 Inspection Type: Inspector: 299 Final inspection Aaron Cillo-Gobel Result: PASS - CofO Comments: Final erosion control passed Street tree certificate received Moisture content form received High efficiency lighting form received Insulation certification verified Blower door and/or duct seal test certificate received C of 0 left on counter. Violation Summary: Inspector Contractor