Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Permit
INCITY OF TIGARD MASTER PERMIT . COMMUNITY DEVELOPMENT Permit#: MST2017-00303 T E GARD D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/20/2017 Parcel: 2S112CB00700 Jurisdiction: Tigard Site address: 15158 SW CHANDLER LN Subdivision: MANGOLD SUBDIVISION Lot: Project: Mangold, Lot 5 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1221 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1663 sf Garage: 606 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf • Yes Right: 5 Detectors: Total: 2884 sf Value: $359,839.69 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 Tubs/Showers: 4 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: Y 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: 5 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 addl 500 sf: 5 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: NEW Occupancy Group: Square Feet: SF VB R-3 2884 Owner: Contractor: WESTWOOD HOMES LLC WESTWOOD HOMES LLC Required Items and Reports(Conditions) 12700 NW CORNELL RD 12700 NW CORNELL RD 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97229 PORTLAND,OR 97229 PHONE: 503-406-2442 PHONE: 503-330-2215 FAX: 503-342-2403 Total Fees: $31,836.84 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 ' suspended for more the if. days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. T rules ar- set forth in/.A R 952-001-0010 through OAR 952-001-0090. You may btain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1 d0.332.23:c' • �. Issued By: f..e. Permittee Signature: _�/ Call 503.639.4175 by 7:00 a.m.for the next available inspection 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. Alfred g Permit Application evidential ro Ii OFFic,: l s►:om City of Tigard EELW y 572,o _c' ,sPermit No IN 1" OR 97223 \D !°°" — I Phone: 503.718.2439 Fax: 503.598.19 Date : : 1 -)O . 7 '$1 Other Permit: /2 o0— 7, Inspection Line: 503.639.4175 /4.l —rte T I C;A R D Internet: www.tigard-or.gov r 2 `��� Notified/Method:te Ready/By: J'A'S See Page 2 for . Supplemental Information 14 TYPE OF WORK ,, or�\C* S\0' REQUIRED DATA:1-AND 2-FAMILY DWELLING ®New construction 0 Dct�i i1i °' Permit fees*are based on the value of the work performed. ❑Addition/alteration/replacement 0 ®ear:: 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. ® 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ ❑Accessory building 0 Multi-family Number of bedrooms: ❑Master builder3$9 S3 0Other; Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: 7 41 9.4 0 r [ et Job site address;rs IS I . Sof �/�`1'4 ratty- la.yvt New dwelling azea:L�� square feet City/State/ZIP: • � G t�' I OK `t ( Z -3 Garage/carport area: `0 square feet Suite/bldg./apt.no.:I Project name: Covered porch area: /04? square feet, 6 63 Cross street/directions to job site: Rick area: -----' aa 1 square feet Other structure area: square feet / REQUIRED DATA:COMA RCIAL=USE CHECKLIST Subdivision: 1 j')E 0toe Lot no..5 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: $ Existing building area: square feet New building area: square feet ® PROPERTY OWNER 0 TENANT Number of stories: Name:Same as applicant Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: Phone:( ) Fax:( ) New: ® APPLICANT 0 CONTACTPERSON BUILDING)PERM'TEES* Business name:Westwood Homes LLC ' CJcrmbJeeseJWirk} Contact name:Matt Fricke Structural plan review fee(or deposit): Address:12700 NW Cornell Rd FLS plan review fee(if applicable): City/State/ZIP:Portland,OR,97229 Total fees due upon application: Phone:(503)406-2442 Fax::( ) Amount received: E-mail:Matt@westwoodhomesllc.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted Photo Voltaic Solar Panel System. Business name:Same as applicant Submit two(2)sets of roof plan with connection details Address: and fire department access,along with the 2010 Oregon Solar Installation Specialty Code checklist. City/State/ZIP: Permit Fee(includes plan review $180.00 Phone:( ) Fax:( ) and administrative fees): State surcharge(12%of permit fee): $21.60 CCB lic.:195597 Total fee due upon application: $201.60 Authorized signature: —1r�"� /,:,./":":7./. This permit application expires if apermit is not P obtained within 180 days after it has been accepted as complete. Print name:Matt Fricke Date:--7174�/7g *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) nical Permit Application City of Tigard i term: Permit 151 9/7 L�Ct30,3 13125 SW Hall Blvd.,Tigard,OR 9722311111111MIIMMIIIIIIIIIIIIM Plan Review Phone: 503.718.2439 Fax: 503.598.1960 �Q;(Da�: Other Permit: Inspection Line: 503.639.41754 :„ H See Page 2 for Internet: www.tigard-or.gov �c3 , �dY�: : {�j it.' A ,• Supplemental Information -rt TYPE OF WORK CA` ` N , �� COMMERCIAL FEE* SCHEDULE— USE CHECKLIST �� Mechanical permit fees*are based on the value of the work construction ❑Addition/alteration/repl �nt performed.Indicate the value(rounded to the nearest dollar)of all emolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIUENI'IAL EQUIPMENT/SYSTEMS FEES* ® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. 0 Multi-family 0 Master builder 0 Other: Description Qty. Fa. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning Il 46.75 Job site address: 514 (it 4 N ci v l ce14,e Furnace 100,000 BTU(ducts/vents) I 46.75 City/State/ZIP: )4 d,i 1lZ. 6,' ,'Z z 3 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: Duct work 1 23.32 Cross street/directions to job site: 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 23.32 v/ �Oth23.32 C Subdivision: Lot no.: Other fuel appliances: Tax map/parcel no.: Water heater i 23.32 DESCRIPTION OF WORK Gas fireplace/insert 1 33.39 Flue vent for water heater or gas 1 New SFR fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 ® PROPERTY OWNER 0 TENANT Other: 23.32 Environmental exhaust and ventilation: Name:Same as applicant Range hood/other kitchen Address: equipment 1 33.39 Clothes dryer exhaust 1 33.39 City/State/ZIP: Single duct exhaust(bathrooms, toilet compartments,utility moms) 1 23.32 Phone:( ) Fax:( ) Attic/crawlspace fans 23.32 <-APPLICANT ❑ CONTACT PERSON Other: 23.32 Business name:Westwood Homes LLC Fuel piping: $14.15 for first four;$4.03 for each additional Contact name:Matt Fricke Furnace,etc. Address:12700 NW Cornell Rd Gas heat pump Wall/suspended/unit heater City/State/ZIP:Portland,OR 97229 Water heater I Phone:(503)406-2442 Fax::( ) Fireplace 1 Range E-mail:Matt@westwoodhomesllc.com Barbecue r CONTRACTOR Clothes dryer(gas) Business name:Central Air Inc. Other: MECHANICAL PERMIT FEES* Address:PO Box 433 Subtotal City/State/ZIP:Clackamas,OR 97015 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(503)656-1908 Fax:( ) State surcharge(12%of permit fee) CCB lic.:178624 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 //�t days after it has been accepted as complete. Authorized signature: '"`'� A" i✓t..--./ * Fee methodology set by Tri-County Building Industry Service Board Print name:�..i G'Ptn i ly„a,,{-749rrq�Ji Date:---)i(2/(.-. I:\Building\Permits\MEC_PermitApp_040113.doc,/ / 440-(((4617T( 2/COM/WEB) lectrical Permit Application Ft NZ OFFICE(SE ONLY City ofTigard Received : Ciff ►7,/.� i� �/l1 ill r 13125 SW Hall BIvd.,Tigard,OR 97223 llama Pica Review ! Phone: 503.718.2439 Fax: 503.598.1960 pate/B: 1=2:11111111111 Inspection Line: 503.639.4175 Ready Dateifty: EMI 1 IC.A t I? Internet: www.ti rd-or. ov otifkdlMethod: See mage 2 for !Ser 8 Supplemental Information °w,V ilrr V s\�tYr 1�i�r�'3 r+' t 1,`" k }, �,,� y .a'i` '� - 9 e c ',.\... dv.i 5'.1 A ,W.+Vu, Y ..L V �.a 1 . ,...-�.k-.I�.,,x g, yTi zm ,.:;,.; �;, 11`,��jr v _,��..� "'r`s�,,�'�,:S,�F.+nL��.'?F���,� ��a.z<rve-+��.3`vs5..,di}4�::�'�V�yxr�:'�,1,��`[u��t� ,;!a�o- '.�u�t kwt'",�a�z'w,�.� � ������°l�u�t� �..+'.dgr .ti g New construction El Addition/alteration/replacement Please check all that apply(submit as sets of Assn wiitems checked): D Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition 0 Other ;;art, rt, ,k e oy> t h where the available Emit current I Marinas and boatyards. GCIf Y'flF ;,.,,s, ..„,�., .,...,.,.:�, _., s,.,.:..x.__...iZ ,... .,`.'��?),iS°I12.fJ ria,01�;�;,> ,,,. .,� .::, ,�...` `�,,�`„„�';° exceeds 10,000 amps at 150 volts or D Floating buildings. ►� �_ less to ground,or exceeds 14,000 0 Commercial-use agricultural and 2-family dwelling 0 Commercial/industrial 0 Accessory building 0 Multi-family 0 Master builder 0 Other arnpa for all other hrstailatiorts buildings. KVA or ;L ttax r"}r,'.ts g °,x 3 , fiSY. OORMAT a is; '� �`T5r' 1 1h b ©FFAs tem. installation of ly15d rive �. __._.... .•.,�,.:.�,. _�,.:,� t��;lka-.aa�t..,#:<.„,: 5's larger separately derived Job#: -Job site address: /5 //yy�� / D Addition of new motor load of system. i ( _ 1,,Ll 'UC if t"l LPl tall , 100HP or more. City/State/ZIP: 0 Six or more residential wilts. occupancy. ty ' [1 C✓C) V �. C ( Iieaith.care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: j Project name: DItaardous Inca does. 0 Supply voltage for more than 0 Service or feeder 600 amps or more. 600 volts norama. Cross street/directions to job site: terns + a a .',' ,. :a} a s , to De/capon 1y Qh. i Ieadh 1 r'atai !1 New residential single-or multi-family dwelling nait. Subdivision: no,n coif�'[ 5hr{, sLot#: Includes attached gars e. . Tax map/parcel#: / - 1000 sq.ft.or less 3 168.54 4 g<n b��e41 `'ra'�.A :: rw '• , 0;.,. .w$,w( ' i> x. 't 1"�`5t�afi zv,<1: Ea.add'I 500 sq.ft.or portion 33.92 1 . - t t,. ,4 .��` Limited energy,residential /l /Q 1� F (with above sq.8.) 75.00 2 y/ 6 ( Limbed energy,mnlff-tltrnily 75.00 2 residential(with above sq.RL) w C s k ;r t 401.4440130 h , #� � r,° Renewable Energy 0 See Page 2 tt inn y �ttt*i' '"' '� `�``1.44 130...:. 4 § ,i` Services or feeders instailatio alterationiand/or relocation Name: I6i i r5 in z yr1- 200 empe or less 100.70 2 Address: ( _ 201 amps to 400 amps ' 133.56 2 401 amps to 600 maps 200.34 . 2 City/State/ZiP: 601 amps to 1,000 amps 301.04 2 n Phone;( ) I Fax:( ) Ova 1,000 amps or volts 552.26 2 Email: Temporary services or feeders Installation,alteration,and/or relocation A Owner installation:This installation is being made on property that I own which is not 200 amps or less d 59.36 I t 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 ttts` } ,',, 14 .i,,„d.,ev,',,_�,„Ui.' . ,4,, r 0,:. � a Branch circuits—new,alterstio or extension, panel A Fee for branch circuits with Business name:Westwood Homes LLC above service or feeder fee, each branch circuit 7.42 1 Contact name:Matt Fricke B.Fee for branch circuits withow Address:12700 NW Cornell Rd service drat branch cizcuit eoribedarf56.18 2 City/State/ZIP:Portland,OR 97229 Each add'iManch circuit 7.42 2 Miscellaneous(service or feeder not Included) Phone:(503)406-2442 I Fax::( ) Each manufactured or modular 67.64 ? Email Matt®westwoodhoansltc con dwelling,service and/or feeder Reconnect S 67.84 2gas: , yr,, sL, � F g ” aa" " , . moot,.`� Pump or irrigation circle 67.64 2 Business name:Pyramid Electric LLC Sign or outline lighting 67.84 2 Address:12700 NW Cornell Rd Signalneliteratio)or extension. U See Page 2 2 panel,alteration or extension. City/State/ZIP:Portland,OR 97229 Each additional Inspection over allowable In any of the shove Additional inspection(1 hr min) 66.25/hr Phone:(503)406-2442 Fax:( ) investigation(1 hr min) 90.00/hr Email:officeQa pyramidelecit'iclic.com Industrial plant(1 hr mini 7$.18!hr Inspections forwhich no fee is CCB Lie.: 217341 Electrical Lic.: C1320 Suprv.Lie.: apew31ioa11y1lsird(h ghrmm} hr r i.r Al ' ti 's` 4 ' Sr WStit r Suprv.Electrician signature,required: .a.tl 1,041,4101/0 Subtotal: Print name: Jeff Evans ''TT l Dafe: 1.//Zc//t El Plan Review Regtured.(25%ofpermit fee): State surcharge(12%of permit fee): Authorized signature: l TOTAL PERMIT FEE: �� This permit applicaeoa expires if a permit Is not obtained within 180 Print name: Date: days after it bas been accepted u complete. * Number of inspections allowed per permit r:':Bundioshrmasta[.t_PamitApp,.BLR_ERE.doe RevQ6/172015 440-461 IT(11N5.'COMrwEB Plullnbin2 Permit Application Building FixturesV \\1 l O R 01 Fl y l: ( S I: O\I 1 City of Tigardr-Na ' q Received 13125 SW Hall Blvd.,Tigard,OR 97 .1Q��" Plate/By: PermitNo.:�s U/?��? : li Phone: 503.718.2439 Fax: 503.598.1960 r Plan Review \9 Other Permit No.: I I c;n I.[) Inspection Line: 503.639.4175L'Avate Ready/By: Internet: www.tigard or.gov toJam: Supplemental See Page 2 for (OI cr , Notified/Method: Supplemental Information AA TYPE OF WORK -- \ ` FEE* SCHEDULE ®New construction ` ❑De pion For special information use checklist Description Qty. I Ea. ❑Addition/alteration/replacement 0 Other: New 1-2-famil dw Total y elliags(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 0 Accessory building 0 Multi-family SFR(3)bath , 500.32 ❑Master builderEach additional bath/kitchen 25.02 0 Other: Fires er prinid ( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: Gj 1/}/ Gil.G nil l v✓ l q Catch basin or area drain 18.76 City/State/ZIP: Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name: Manufactured home utilities 50.03 Cross street/directions to job site: 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: /lig vic 76./i I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer I 31.27 DESCRIPTION OF WORK Backwater valve 12.51 New SFR Clothes washer I 25.02 Dishwasher 1 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER I © TENANT Expansion tank 12.51 Name:Same as applicant Fixture/sewer cap 25.02 Address: Floor drain/floor sink/hub 25.02 Garbage disposal I 25.02 City/State/ZIP: Hose bib Z 25.02 Phone:( ) Fax:( ) Ice maker 12.51 Z APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name:Westwood Homes LLC Medical gas(value:$ ) Page 2 Contact name:Matt Fricke Primer 12.51 Roof drain(commercial) 12.51 Address:12700 NW Cornell Rd Sink/basin/lavatory � 25.02 City/State/ZIP:Portland,OR 97229 Solar units(potable water) 62.54 Phone:(503)406-2442 Fax::( ) Tub/shower/shower pan 3 12.51 E-mail:Matt®westwoodhomesilc.com Urinal 25.02 CONTRACTOR Water closet 25.02 Water beater f 37.52 Business name:H&H Mechanical Water piping/DWV 56.29 Address:5757 SE Willow Lane Other: 25.02 City/State/ZIP:Milwaukee,OR 97267 /A6 Subtotal Phone:(503)975-9787 Fax:( ) 7/i Minimum permit fee: $72.50 CCB Lic.:178122 J Plumbing Lic.no.: ` Plan review (25%of permit fee) l �� ` / State surcharge(12%of - permit fee) Authorized signature: 1 _ �' TOTAL PERMIT FEE applicationexpirespermit is not obtained within 180 days Print name:Dustin . gue Date:-7"r(7 /f This permit afterthas if a / it hbeen accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) City of Tigard illill " COMMUNITY DEVELOPMENT DEPARTMENT O T I G A R D Building Permit Review — Residential Building Permit #: &57-20/7-'00,?63 Site Address: ( S 15 Ii3 S vv Ch at 4-1 c( l_2_, - Cri , Project Name: Ni (A n 90 I Lot #: S' (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: S ( 1\/.&/ AVerify site address/suite#exists and active in permit system. 0 River Terrace Neighborhood: 0 No ❑ Yes,See River Terrace Review Addendum Attached Site Plan Elements: lfAThree(3)copies of site plan BExiating structures on site ite plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished Drawn to scale(standard architect or engineer scale) floor elevations JZi /ZiSNorth arrow Utility locations&easements (required for new and additions) ite address,project or subdivision name and lot number ZSidewalk/driveway approach Applicant information(name and phone number) ❑Locarion of wells/septic systems ,Lot dimensions and building setback dimensions )Existing trees to be retained with drip line,and tree -P bare footage of buildings to be demolished protection measures ]Letarea,building coverage area,percentage of coverage and ,Street tree size,type and location impervious area(applicable if R-7,R-12,R-25&R-40) eStreet names Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced?�QYes ❑No 4 foot differential) If yes,is a storm water quality facility shown? -DYes fila Cie Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified gNo Received: ❑ Yes ❑ No T Public Facilities Improvement(PFI) Permit: Required: I=1 Yes,applicant was notified .� No Applied For: ❑ Yes ❑ No,stop intake /1 Land Use Case#: .S U{.20 13 - 0 0(7O 3 7 Zoning: 1Z- 4 S Required Setbacks: Front -2,0�� 5 Side 5 Street Side N/At GarageZ O 0 Landscape Requirement: N i fd Lot Coverage Maximum: Pi/ A ,Z Building Height: Maximum Height g 3g Actual Height NA Visual Clearance Sensitive Lands: ❑ Yes Ai No Type 0 Urban Forestry Plan a Conditions "Met"prior to issuance of building permit Notes: j> t? IVB f- I Ss v v 'lb t 'ic°i fi (: r-c`j S . Approved By Planning: 111),g .-_____ -' - Date: / Z / 17 Revisions (after Building Submittal only) Reviewer Revision 1: CI Approved ❑ Not Approved Date Revision 2: El Approved ❑ Not Approved Revision 3: El Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw RES 061417.docx Building Permit Submittal V21/7, / Original Submittal Date: O/2//!7 Site Plans: # Building Plans: # Building Permit#: 6-- nter building permit#above. Workflow Routing: 'P-- lanning Engineering [ rmit Coordinator uilding Workflow Sign-off: rI Sign-off for Tanning(include noteslfrom planning review Route Application Documents: Mi 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: - � iiiBy Permit Technician: Date: Engineering Review Slope at building pad: 2) [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 I No Assess Water Quantity Fee in-lieu: ❑ Yes No LIDA Facility on lot: ❑ Yes No Date: ❑ NOT Approved by Engineering: Watsro--. �J� Notes: G/'f�G C9� �/� / n. Idrie>r �.J� --`-y Approved by Engineering: Ilet,0 Date: 3 ` Revisions (after Building Submittal only) Reviewer Date Revision 1: El Approved El Not Approved Revision 2: ❑ Approved El Not Approved Revision 3: El Approved Cl Not Approved Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit ,/ if (ii to f i 4"-- /7pproved,NOT Released: / �tt"L Date:CliroieNtM/1 4- i Notes: /tea'ili (yr% 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: 7 C Fees Entered: Wash Co Trans Dev Tax: Yes El N/A Tigard Trans SDC: Yes El N/A Parks SDC: , Yes ❑ N/A LIDA El Yes 4/A ,-'..: s . to Issue Permit Approved by Permit Coordinator: Date: 61G 10 ..ss - rr rn.tti ITc evrd— tuo v,.n- 'Litt)/U1 I:\Buildmgg \Forms\Bld PermitRvw_RES_061417.doc ACKNOWLEDGEMENT OF RISK AND HOLD HARMLESS AGREEMENT 1. PARTIES This Acknowledgement of Risk and Hold Harmless Agreement ("Agreement") is between Westwood Homes,LLC ("Owner") and the City of Tigard(the "City"). 2. PURPOSE OF AGREEMENT The purpose of this Agreement is to identify the terms and conditions under which the City will agree to issue building permits for three proposed single family houses located at 15134, 15158, and 15164 SW Chandler Lane in Tigard (the 'Properties"), and referred to herein as the Project." Owner has requested that the City issue the following permits and conduct the following reviews (collectively, the "Permits"): A. MST2017-00302 for 15124 SW Chandler Ln.; 13. MST2017-00303 for 15158 SW Chandler Ln.; C. MST2017-00310 for 15164 SW Chandler Ln.; D. Any additional permits required by the City to construct the Project and related site improvements. Owner desires to proceed with construction associated with the Permits based on City's Land Use Decision SUB2013-00003 (the "Decision"),notwithstanding the fact that final approval of the submitted plat has not yet been received from Washington County. The City is willing to allow the Owner to perform the work associated with the Permits prior to receipt of a copy of the recorded plat as long as all work done is consistent with the approved Permits, the Decision, and pursuant to the terms of this Agreement. 3. ADDITIONAL CONDITIONS In addition to all other conditions stated in this Agreement and required by law, Owner agrees to the following: A. The Owner acknowledges that Washington County may fail to approve and may require revision of the submitted plat for the Project and that Owner shall be responsible for any and all modifications,revisions, corrections, resubmittais, or reconstruction in order to comply with the plat as approved and recorded by the County. S. The Owner acknowledges that the issuance of the Permits is based on the conditions set forth in this Agreement. The Owner shall be responsible for correcting any and all deficiencies in work conducted on the Project in reliance on the Permits or changes required by the City as part of the City's inspection process. Page 1-Hold Harm less Agreement 2613264 3ORP 72A2017 4 C. The Owner acknowledges that the City cannot guarantee that the plat will be approved by the County as submitted, nor can the City guarantee that any such approval will meet the construction schedule for the Project. The Owner further acknowledges that any work done pursuant to the Permits shall be subject to a stop work order posting, penalties, and any other legal remedies available to the City to enforce any stop work orders issued on the Project. D. The Owner acknowledges and agrees that no final building inspection will be performed and no Certificate of Occupancy issued for the Project until a copy of a properly recorded plat is received by the City. 4. EFFECTIVE PERIOD This Agreement will be effective upon execution by both parties and will remain in effect until the plat,as submitted or as revised,is approved and recorded by the County,all appeals have concluded, and all timelines for any future appeals have expired("Effective Period"). 5. NON-TRANSFERABILITY This Agreement is between City and Owner and is not transferable to any other party. In the event Owner sells,transfers, leases or otherwise conveys any interest (but not including a mortgage or deed of trust, including in connection with Owner's construction financing) or right of possession in Property, this Agreement shall terminate automatically. 6. ACKNOWLEDGEMENT OF RISK A. Owner understands that by allowing construction to commence on the Property pending the approval of the submitted plat by the County, the City's review and approval of the final plans may result in Owner being required to change or remove the work done during the Effective Period. B. Owner understands that construction work must be consistent with the plans submitted to the City,or any changes to the plans the City requires as the review proceeds that the City determines are necessary to bring the Project into compliance with applicable building code and zoning requirements. C. The City reserves the right during the Effective Period to stop work if: (1) Owner fails to provide sufficient information necessary for City staff to determine consistency with applicable building codes and zoning requirements to the City within five (5)business days of a request by the City; (2) if the City determines the plans are inconsistent with applicable building code or zoning requirements; or(3) if construction that takes Page 2-Hold Harm less Agreement 76160-NMI;16."7077 (. t place within the Effective Period is inconsistent with the plans submitted to the City and/or applicable building code and zoning requirements. D. Nothing in this Agreement limits the City's authority or ability to issue a stop work order if the City identifies violations of building code and/or zoning requirements involving construction on the Property. E. Owner agrees that any expenditures or construction Owner undertakes during the Effective Period are undertaken at Owner's sole risk and expense. F. Owner agrees not to assert any claims whatsoever against the City arising out of expenditures or construction Owner undertakes during the Effective Period. G. Owner agrees that failure to comply with any of the terms or conditions set forth in paragraphs A through F, above,may result in the initiation of code enforcement proceedings. 7. HOLD HARMLESS AND INDEMNIFICATION AGREEMENT A. Owner agrees to hold harmless, defend, and indemnify the City and the City's officers, agents, officials, and employees against all claims, demands, actions, and suits, including all reasonable attorneys' fees and costs, brought against any of them arising from allowing construction on the Property to proceed during the Effective Period. B. Owner hereby expressly assumes all risk of damage to Property, and loss or impairment of the use and enjoyment thereof, and including all risk of personal injury or death, and including loss of any and all expenditures in any manner arising out of or attributable to allowing construction on the Property to proceed during the Effective Period. C. Further, in the event an action is brought contrary to this Agreement and a court of law upholds this Agreement,Owner agrees to pay all reasonable costs and attorneys' fees incurred by the City including any reasonable costs and fees associated with appeals. 8. REMEDIES Owner agrees that in the event that the construction work must be removed, altered or otherwise changed,it will be removed, altered,or changed within sixty (60)days after the date permits are withdrawn or required to be revised by the City,and required permits to effect that change are approved.Further,Owner agrees that in the event the construction work is not removed, altered.or otherwise changed,it is a nuisance and may be removed by the City,and the cost ofremoval, including all direct and indirect costs,will become a lien against the property. In the event the costs are not paid by the Owner to the City after entry Page 3-Hold Harm less Agreement 26/3160 31DRF 7282w of the lien,the City may foreclose against the Property at such time as it elects to do so,if the costs remain unpaid. 9. OREGON LAW AND FORUM This Agreement shall be construed according to the laws of the State of Oregon even if Oregon's choice of law rules otherwise would require application of the law of a different jurisdiction. Any litigation arising under or regarding this Agreement shall occur, if in the state courts, in the Washington County Court having jurisdiction thereof,and if in the federal courts,in the United States District Court for the District of Oregon, Portland Division. Any arbitration or other form of alternative dispute resolution arising out of this Agreement shall take place in an appropriate forum within Portland,Oregon. 10. SEVERABILITY Each provision of this Agreement shall be independent and severable. The invalidity or partial invalidity of any provision thereof shall not affect any of the remaining portions of that or any other provision of this Agreement. [Signature Page to Follow) In Witness Whereof, this Agreement has been duly executed on 76137b0 35DRf:18/5817 Page 4-Hold Harm less Agreement r . �/ �� ,2017. OWNER CITY Westwood Homes,LLC City of Tigard 1 R/ By: Name:�c t Name: 7;5/21 !" G i re— Title:/ �,`�►._ Title: 4sy/,. L p j i tee.c'f- r Date: w Date: /l/2,0// STATE OF OREGON ) )SS. County of {,kAli,44\-CM) This instrument was acknowledged before me on 4\/Q,Wt\7e(' tt�� , ' g v ,2017, by—3 ` t\ w a jc r as V ; f Westwood Homes,LLC. 110 QFFC$ALSTAW UNO�SAY E ADAMS D .aq NOTARY PUBLIC FOR OREGON vvc ea 9 12 M Commission dANW►RY2t, p Y E xpires: ®1 -tel 1 -aO c� o Page 5-Hold Harm less Agreement 1611160 31DRF R16,2017 Albert Shields From: Albert Shields Sent: Tuesday,August 08, 2017 4:32 PM To: 'Matt Fricke' Subject: Mangold Subdivision, MST2017-00302 &00303. Mark, in the course of reviewing your plans and application for the above permits Engineering has noted that the applications cannot be approved at this time because: 1. A lot-specific geotechnical report is required due to the nature of the fill. 2. Multiple Conditions of Approval of the underlying Land Use Case, SUB2013-00003, remain Not Met. Accordingly, I will code these applications as Approved but Not Released and will keep them on Hold until the above issues are addressed. Nonetheless, Plan Review will continue. Please let me know if you have any questions. Albert Shields 1 r FOR OFFICE USE ONLY—SITE ADDRESS: 57S� -k d/rig 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 S Transmittal Letter 1 i, n Et 1) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: 70141 DATE RECEIVED: DEPT: BUILDING DIVISION . FROM: 4IH Fi, t,,. JAN 4 1i$ COMPANY: I (P/,,Oo/ii,, U M ) / Ci.'_Y O !1LiAR a 3UU D r- Divis!cm PHONE: Ills 67( — S(2) By: RE: ( hr')c7fi l 0 45 ,e Addres "'ermit I um' (Project name or subdivision name and lot number) / \4, i ATTACHED ARE THE FOLLOWING ITEMS: ' / Copies: Description: op'• it escription: 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): �1 REMARKS: —�.--_:--r - =..:! S re til 5-Cd I.) �01 9.-el 0(iy`'1 rG ° / t) 64 fl WV 0/17 ✓CQF 1,v+e FOR O}'HCE USE ONLY I Routed to Permit Tec '•'.. : Date: f - $ - ) ' Initials: Fees Due: ►:1 Yes N. o Fee Description: Amount Due: -- .S1-1 r Plc.., rc\r.e._ $ 1-1,..4-- $ A Special JLInstructio• : ,.....,,, Repri • 'ermit(per PE): ❑ Yesr/;,,___✓ El Done Applicant Notified: Date: 1 > Initials: 7-A-- I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15158 SW CHANDLER LN, TIGARD, OR, 97224 May 10, 2018 at 2:14:42 PM Record Type: Record ID: Residential - Master Permit MST2017-00303 Inspection Type: Inspector: 399 Plumbing final David Young Result: FA I L Comments: No water out of hot side, main bath Lay. Master bath WC not flushing. Water pressure exceeds 80 psi at hose bibs. Install pry and expansion tank for water heater as necessary. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15158 SW CHANDLER LN, TIGARD, OR, 97224 May 10, 2018 at 2:15:22 PM Record Type: Record ID: Residential - Master Permit MST2017-00303 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS Comments: 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: 15158 SW CHANDLER LN, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2017-00303 Inspection Type: Inspector: 210 Foundation walls David Young Result: PASS Comments: Initial erosion control approved. Setbacks appear ok per strung property lines. No geotechnical report required per approved plans. Ufer ground tagged. Holdowns installed. Low point drain sleeves installed. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15158 SW CHANDLER LN, TIGARD, OR, 97224 May 17, 2018 at 9:41 :30 AM Record Type: Record ID: Residential - Master Permit MST2017-00303 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 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15158 SW CHANDLER LN, TIGARD, OR, 97224 May 17, 2018 at 9:38:02 AM Record Type: Record ID: Residential - Master Permit MST2017-00303 Inspection Type: Inspector: 699 Mechanical final Aaron Cillo-Gobel Result: PASS Comments: No A/C installed Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15158 SW CHANDLER LN, TIGARD, OR, 97224 May 17, 2018 at 9:37:04 AM Record Type: Record ID: Residential - Master Permit MST2017-00303 Inspection Type: Inspector: 399 Plumbing final Aaron Cillo-Gobel Result: PASS Comments: Previous corrections completed. Water pressure = 65 psi Violation Summary: Inspector Contractor CITY OF TIGARD MASTER PERMIT 1111 2 COMMUNITY DEVELOPMENT Permit#: MST2017-00303 T GA RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/20/2017 Parcel: 2S112CB00700 Jurisdiction: Tigard Site address: 15158 SW CHANDLER LN Subdivision: MANGOLD SUBDIVISION Lot: Project: Mangold, Lot 5 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1221 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1663 sf Garage: 606 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2884 sf Value: $359,839.69 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 Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Catch Basins: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Bckflw Prevntr: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y 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: 5 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: 5 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2884 Owner: Contractor: WESTWOOD HOMES LLC WESTWOOD HOMES LLC Required Items and Reports(Conditions) 12700 NW CORNELL RD 12700 NW CORNELL RD 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97229 PORTLAND,OR 97229 PHONE: 503-406-2442 PHONE: 503-330-2215 FAX: 503-342-2403 Total Fees: $31,836.84 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 ' suspended for more the 1. days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. T rules ary set forth in •A R 952-001-0010 through OAR 952-001-0090. You may.btain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1 00.332.23,.' Issued By: A�� Permittee Signature: -�'!' 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. ' int Permit Application boli orr►c l: I �►:c�\►.1 �� es�dential Received iN�h Permit No• 5 '-( 11,1 City of Tigard �� � � • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ,r Q .' - Other Permit:-�� /?..._06 1' 1 `% S Da • Phone: 503 Line: Fax:503.639.4175 503.598. ,41., y y Date Ready/By: kris: ® See Page 2 for Inspectionerne: r.gov 2 �1{ Notified/Method: Supplemental Information Z i<;n t:D Internet: www.tigard-or.gov s ti TYPE OF WORK F' T-0-') S• ' REQUIRED DATA:1-AND 2-FAMILY DWELLING . � Permit fees*are based on the value of the work performed. ®New construction 0 D '�' Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement ❑ c equipment, materials,labor,overhead,and the profit for the work indicated on this application. CATEGORY OF CONSTRUCTION Valuation: $ 0 Commercial/industrial ) ® 1-and 2-family dwellingNumber of bedrooms: 39 $3 ❑Accessory building ❑Multi-family Number of bathrooms: 3 El Master builder ❑ �' u q.q o Total number of floors: JOB SITE INFORMATION AND LOCATION '���� square feet _ / L 4 +e,- / yvt. New dwelling area: Job site address'is 5 _. (. ( square feet q Z2,� Garage/carport area: ‘c t City/State/ZIP: ��. Covered porch area: square feet Project name: o,,® 1663 q Suite/bldg./apt.no.: Project Ilk area: square feet ,�a Cross street/directions to job site: +,1 `o Corr P Other structure area: — square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST d AI Lot no.. Permit fees*are based on the value of the work performed. Subdivision: ISE/ aIIIIIIIIIIIIIIIIIIIII Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the work indicated on this application. DESCRIPTION OF WORK Valuation: $ New SFR Existing building area: square feet New building area: square feet 0 TENANT Number of stories: ® PROPERTY OWNER Type of construction: Name:Same as applicant Occupancy groups: Address: Existing: City/State/ZIP: Phone:( ) Fax:( ) New: 0 CONTACT PERSONBUILDING PERMIT nEs* APPLICANT 0 CON �" ;; (new sea tofee Schedule) . Business name:Westwood Homes LLC ` Structural plan review fee(or deposit): Contact name:Matt Fricke FLS plan review fee(if applicable): Address:12700 NW Cornell Rd Total fees due upon application: City/State/ZIP:Portland,OR,97229 Amount received: Phone:(503)406-2442 Fax ( ) PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail:Matt@westwoodhomesllc.com Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photovoltaic Solar Panel System. Submit two(2)sets of roof plan with connection details Business name:Same as applicant and fire department access,along with the 2010 Oregon Solar Installation Specialty Code checklist. Address: Permit Fee(includes plan review $180.00 City/State/ZIP: and administrative fees): Phone: Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.:195597 ,...i." ,,,,,, ,,,/,`,,,,,"? Total 95597Total fee due upon application: $201.60 /// This permit application expires if a permit is not obtained Authorized signatttre � G'e within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Print name:Matt Fricke I Date.,---/7//27772, Service Board. I:\Building\Petmits\BUP-RESpernitApp.doc 02/24/2011 440-4613 T(11/02/COM/W EB) nical Permit Application City of Tigard ` �teisy: Permit yet5/�/7 C:k:(�(.� 13125 SW Hall Blvd.,Tigard,OR 97223 � ` Plan Review Phone: 503.718.2439 Fax: 503.598.1960 4) 1%\1Dete/By: Other Permit: Inspection Line: 503.639.4175 rr� cj - s: .•eadyBy loris: ® See Page 2 for Internet: www.tigard-or.gov ,,\.\3 k.'1'' 4*thod: Supplemental Information '� N COMMERCIAL FEE* SCHEDULE USE CHECKLIST TYPE OF WORK J, \ � Mechanical permit fees*are based on the value of the work construction 0 Addition/alteration/repl �nt performed.Indicate the value(rounded o the nearest dollar)of all emolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ® 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist. 0 Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: h p / J Air conditioning 1 46.75 Job site address: 5j 14 (/.Gj -t V (C4{ei-me Furnace 100,000 BTU(ducts/vents) _ 1 46.75 City/State/ZIP:1:y 4 p. ' op_ ( 17½-Z 3 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: Duct work 1 23.32 Cross street/directions to job site: 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 Other: 23.32 Subdivision: /t7e? ,vi 1/ Lot no.: Other fuel appliances: Tax map/parcel no.: Water heater i _23.32 DESCRIPTION OF WORK Gas fireplace/insert i 33.39 Flue vent for water heater or gas New SFR fireplace l _23.32 Log lighter(gas) 23.32 Wood/pellet stove , 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other: 23.32 ® PROPERTY OWNER 0 TENANT Environmental exhaust and ventilation: Name:Same as applicant Range hood/other kitchen equipment I _ 33.39 Address: Clothes dryer exhaust 1 33.39 Single-d ct exhaust ms, City/State/ZIP: toilet compartments,utiliVrrooms) 7 23.32 Phone:( ) Fax:( ) Attic/crawlsspace fans 23.32 El APPLICANT ❑ CONTACT PERSON Other: _ 23.32 Fuel piping: Business name:Westwood Homes LLC $14.15 for first four;$4.03 for each additional Contact name:Matt Fricke Furnace,etc. / Gas heat pump Address:12700 NW Cornell Rd _Wall/suspended/unit heater _ City/State/ZIP:Portland,OR 97229 Water heater I Phone:(503)406-2442 Fax::( ) Fireplace I — _ Range 1 _ E-mail:Matt@westwoodhomesllc.com Barbecue I CONTRACTOR Clothes dryer(gas) - Other: Business name:Central Air Inc. MECHANICAL PERMIT FEES* Address:PO Box 433 Subtotal City/State/ZIP:Clackamas,OR 97015 Minimum permit fee($90.00) - Plan review(25%of permit fee) Phone:(503)656-1908 Fax:( ) State surcharge(12%ofpetmit fee) CCB lic.:178624 _ TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days after ithas been accepted as complete. Authorized signature: ®'` * Fee methodology set by Tri-County Building Industry Service Board Print name: }uttyl M fyl, 0 1r Date:--")./t (( 1:\Building\Pecmits\MEC_PemitApp_040113.doc� J 440-((((((4617T( 1/02/COM/WEB) Iectricai Permit Application FOR OFF((s tSC 011.1' City of Tigard ceived Re einmeniummrifIii yt - ar 13125 SW Hall Blvd.,Tigard,OR 97223 Pian Review s Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Inspection Line: 503.639.4175 Reedy Date/By: 111/111111111 Bl See page 2 for 1 1 t:A lI i) Internet: www.tigand-or.gov Notified/Method: Snppleraeata!lnformatlon \*w'Y..; >•e��*i.��h i°.'�.t� F 5,... x t,:-. �y,i ,mss 'M:itisi' F i..:.:8 U'i= �t t ti3 kM*yy. ` 1. 3-t�.. a 'int:9�.,h: ,x; ,r, ,q'i;. {. N"k:"1 M, ,�"'t`C', tit �i�c e_�'. �ak;s,l rK�';";�5,�.F.+nL yr�ri'�i�,��3FY.s m3�1;�a:a?Cd.,��.r,�...v.'R."�. �t:V:k�i�'�:tt�r iW�w?,kity, kap.F3F.�i:��ii��t?K �3:{w',�a�X :. �.. i i,.h�'w5;,t�„�<.?.�.��.���5�a- ��i n���;::,� IS New construction ❑Additioai/alteration/replacement Please check all that apply(submit a sets of piens wiitetms checked): 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition ❑Othear where the available fault current 0 Marinas and boatyards 7 + a .r _ {. OtoOktOj , )TXl�U rN eityd Nir ! exceeds 10.000 elope at 150 volts or rJ Floating buildings. i2 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 Ci Commercial-use agriculturei amps for all other installations. buildings. 0 Multi-family 0 Master builder 0 Other, Cl Fire pomp. !"1 installation of 150 KVA or a@+ka ile2 v 10' l@ s '. �• tis 4M w, y wyrr{ 7,! s �i�,��+����, �������.{i'���.Aa y���.b`�, �![l1'!�1"�"O �.,>si�U�� � � ,,:W4tnf ,��i��>:..' ❑ BAY sl's�1 load of larger separately derived M Job#: ~Job site address:i /� GQ C ii 0(� { ran( 1001-1 Addition of ote rooter system 100}iP or more. ❑ 0 Six or mare raideliner units, occupancy. City/State/ZIP: `/ -'/ CZZ QHcalth-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: 1 Project name: Dilazardous 1pcaaona. 0 Supply voltage for mom than ©Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: tr��s ,aij3. a�""�M ,'.ro ` Desa$anon Qty. I Each I Tatar 1 + i- y New residential single-or mnitI-family dwelling unit. Subdivision: n�of �1�"(�S Lot#: Includes attached garage. . Tax map/parcel#: 1,000 sq.ft.or less 3 168.54 4 Ea add'1500 sq.R or portion 33.92 l .a i:Au." .<:r `.i ; t g b W4,RICI" k+u,',: t x. `i`•, �,:, , '{' Limited energy,residential 75.00 2 (with above sq.8:) Limited energy,lmtlti-titmmill 75.00 2 residential(with above sq.S.) a rs Renewable Elternp See Pa/e 2^ -"Am,, r; , 4,atpy 'fi i g. , ',f'. ,i '' . y `.._ �,� .f . Services or feeders inatallatio alteration,and/or relocation Name: 5(�r 5 t L yn+ 200 amps or less 100.70 2 tri 201 amps to 400 amps133.56 2 Address: 401 amps to 600 amps ' 200.34 2 City/State/ZIP: 601 amps to 1,000 amps 301-04 2 Phone;( ) I Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders instillation,alteration,and/or Email: relocation Owner Installation:This installation is being made on property that I own which is not 200 amps or lees59.36 t intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 1 1 125.08 1 1 2 Owner signature: Date: r 401 amps to 599 amps 168.54 2 7.ii: Branch circuits—new,alteration,or extension, panel pt a '"` '`€3.; ,"._,e ;�,'4'..a�' r�'_�': wr: .,' 'Ak3 .E Vr, A.Fee for broad,circuits with t Business name:Westwood Homes LLC above service or feeder fee, 7.42 2 each branch circuit ' Contact name:Matt Fricke B.Fee for branch circuits without servicAddress:12100 NW Cornell Rd rtuodarfee,Bot branchcircuit 56.18 2 City/State/ZIP:Portland,OR 97229 I Each add'l branch circuli 7.42 2 Miscellaneous(service or feeder not included) Phone:(503)406-2442 I Fax::( ) Each manufactured or modular dwelling,service and/or feeder 67.64 2 Email:Mauls westwoodhomslic coo Reconnect only 67.84 2 Ila , :y ,',, n4 : a, tO' �,u;rwI VIRSX_ 611 d Pump or inigatioc circle 67-64 2, Business name:Pyramid Electric LLC Sign or outline lighting 67.84 2 Address:12700 NW Cornell Rd pasta circuit(a)ation or limited-energyeextension. 0 See Page 2 2 pane alteration,or euctension. City/State/ZIP:Portland,OR 97229 Each additional inspection over allowable in sox of the above Additional inspection(1 hr min) 66.25/hr Phone:(503)406-2442 Fax:( ) investigation(1 hr min) 90.00/hr Email:office@pyrarnidelectricilc.cOtn Industrial plant(1 hr min) 78.1$/hr _ Inspections forwhrch no fee Is 90.00/hr CCB Luc,: 217347 Electrical Lie.: C1320 Suprv.Lie.: tyy�listed(/hr ora) a, k y r iitat+�1r°t,n'..,;1,.` t�i �Sa rk +fi f+ viz;: Suprv.Electrician signature,required:de !,,•01,01.... / Subtotal: Print name: Jeff Evans "T I Date: tri/ ty/t .E1 Plan Review Required(25%of permit fee): If t State surcharge(12%of permit fee): Authorized signature: f tf in4,,z 1 TOTAL PERMIT'FEE: This permit application expires If a permit is not obtained within 180 Print name: Date: days after it bas bean accepted as complete. * Number of inspections allowed per permit. r:'9aad /omits\Ele PamitApp_EUt-ERE.doc Rev 06/172015 4404615T(11/05 w'EB