Permit (120) CITY OF TIGARD ,"; ,`? MASTER PERMIT
crf
1 COMMUNITY DEVELOPMENT T r i Permit#: MST2017-00350
TIC;,,\1.1:D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/21/2017
Parcel: 2S 110AC00200
Jurisdiction: Tigard
Site address: 11017 SW ANNAND HILL CT
Subdivision: None Lot: None
Project: Annand Heights, Lot 13
Project Description: New SF. 2/12/18: REPRINT to change address. 3/20/18: REPRINT to change address from
Annand Ct.to Annand Hill Ct.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 998 sf Basement: 0 sf Left 3 Parking Spaces: 0
Height: 25 Bathrooms: 3 Second: 1367 sf Garage: 400 sf Front: 15
Smoke
Dwelling Units: 1 Third: 0 sf Detectors: Yes
Right: 3
Total: 2365 sf Value: $289,456.05 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 LaundryTrays: 1
Y Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain
0 Storm Sewer 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains:
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'l 500 sf: 4 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy G
NEW P yrou Group: Square Feet:
SF VB
R-3 2365
Owner: Contractor:
ANNAND HILL LLC WINDWOOD CONSTRUCTION INC Required Items and Reports(Conditions)
BY M DALE RICHARDS 12655 SW NORTH DAKOTA 1 Fire Rated Eaves-Both
12665 SW NORTH DAKOTA ST TIGARD,OR 97223 Sides
TIGARD,OR 97223 2 Ersn Cntrl 503-639-4175
3 Geotechnical Inspection
PHONE: PHONE: 503-625-6526 Required before foundation
FAX: 590-7606
Total Fees: $30,569.36
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: Permittee Signature:
/CZ
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
_.f._ e-q-- - &-7,r/1 .-CC.717-el_
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 ,, c , MASTER PERMIT
COMMUNITY DEVELOPMENT >/ v Permit#: MST2017-00350
:1114 IIT r( R I.1-) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 g.1
i Date Issued: 11/21/2017
Parcel: 2S110AC00200
Jurisdiction: Tigard
Site address: 11017 SW ANNAND CT
Subdivision: None Lot: None
Project: Annand Heights, Lot 13
Project Description: New SF. 2/12/18: REPRINT to change address.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 998 sf Basement 0 sf Left 3 Parking Spaces: 0
Height: 25 Bathrooms: 3 Second: 1367 sf Garage: 400 sf Front 15
Smoke
Dwelling Units: 1 Third: 0 sf Right 3 Detectors: Yes
Total: 2365 sf Value: $289,456.05 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
0 Storm Sewer: 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains:
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!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 M DALE RICHARDS 12655 SW NORTH DAKOTA 1 Fire Rated Eaves-Both
12665 SW NORTH DAKOTA ST TIGARD,OR 97223 Sides
TIGARD,OR 97223 2 Ersn Cntrl 503-639-4175
3 Geotechnical Inspection
PHONE: PHONE: 503-625-6526 Required before foundation
FAX: 590-7606
Total Fees: $30,569.36
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 9 001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By:
/7/1 CZ>Permittee Signature: �r 4 A_
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. 7
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
Permit#: MST2017-00350
COMMUNITY DEVELOPMENT
Date Issued: 11/21/2017
T(GA:RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110AC00200
Jurisdiction: Tigard
Site address: 11917 SW ANNAND CT
Subdivision: None Lot: None
Project: Annand Heights, Lot 13
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 998 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height 25 Bathrooms: 3 Second: 1367 sf Garage: 400 sf Front: 15 Smoke Yes
ht: 3 Detectors:
Dwelling Units: 1 Third: 0 sf Ri 9
Total: 2365 sf Value: $289,456.05 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 Rain0 Storm Sewer: 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0
Drywell-Trench Drain: 0 Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 4 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Y
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2365
Owner: Contractor: Required Items and Reports(Conditions)
ANNAND HILL LLC WINDWOOD CONSTRUCTION INC
BY M DALE RICHARDS 12655 SW NORTH DAKOTA 1 Ersn Cntrl 503-639-4175
12665 SW NORTH DAKOTA ST TIGARD,OR 97223 2 Fire Rated Eaves-Both
TIGARD,OR 97223 Sides
3 Geotechnical Inspection
PHONE:
PHONE: 503-625-6526 Required before foundation
FAX: 590-7606
Total Fees: $30,569.36
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 ma obtajf the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ' /!✓fit � Permittee Signature: -''��
��rL't A403.639.4175 by 7:00 a.m.for the next available ins.-ction 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.
r -11111111 i
Building Permit Application
Resi.tlential FOR OFFICE USE ONLY
' Received Permit No.: y�
City of Tigard DateBy: �L//l / " rTt?r7 C✓�� .c
IIII . 4 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Other Permit:
Phone: 503.718.2439 Fax: 503.598.1 's w ;` ;, DateBy: /7-a)210
ao, ' Juris p Seefor L b
Inspection Line: 503.639.4175 , ' Date Ready/By: / �7-�.
T L GARD p tified/Metho �! //I' .. Supplemental Information
Internet: www.tigazd-or.gov ��
TYPE OF WORK E F 1 4 all, REQUIRED DATA:1-AND 2-FAMILY DWELLING
Q L 1ittl'd`: , ? Permit fees*are based on the value of the work performed.
( New construction Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement C t te'T"77:'-'!":.
k, ri. ' .-, . equipment,materials,labor,overhead,and the profit fort e
work indicated on this application.
CATEGORY OF CONSTRUCTION j
�
'"and 2-family dwelling 0 Commercial/industrial Valuation: �—`}{
Number of bedrooms: 42.V41- 44.5 6
❑Accessory building 0 Multi-family
Number of bathrooms: '^3
❑Master builder 0 Other:
JOB SITE INFORMATION AND LOCATION Total number of floors: 2 a'7 6
Job site address: e 2i4 P-1 New dwelling area: 2 6' square feet
vn-
City/State/ZIP: .��6*n43 ®',¢_�; Q '722-3 Garage/carport area: L`et, square feet
Suite/bldg./apt.no.: Project name: An n q nd j9' h Covered porch area: 9 6 square feet)3 4
Cross street/directions to job site: J J fill Deck area: square feet 918
Other structure area: square feet
1� REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:
n nQtid �-tt{,/y f 1 /S Lot no.: /3 Permit fees*are based on the value of the work performed.
V Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTIONOF WORK work indicated on this application.
/v
Valuation: $
s5 P12.
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
�t Type of construction:
Name: 1-U k-)D (uOc ) CQ/1-Sr' I .p®.f� P
Address: k14. -5- 541/4-) 127--it Da 'o i `^ ��te-1 Occupancy groups:
City/State/ZIP: 77 a✓(/ 4,--)'3_23 / Existing:
Phone:(;-3 7oS Lr376- Fax:(5t3) U 7 J4. New:
0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: file Structural plan review fee(or deposit):
Contact name: FLS plan review fee(if applicable):
Address: Total fees due upon application:
City/State/ZIP:
Amount received:
Phone:( ) Fax: :( )
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: (Ai/navel-ad/0i Q//11 L$/ll 1tJCj /1!Ct C A o(OA
Commercial and residential prescriptive installation of
CONTRACTOR �J roof-top mounted PhotoVoltaic Solar Panel System.
® �� J� Submit two(2)sets of roof plan with connection details
Business name: //I1 fin dt� (�l� r5��'"� and fire department access,along with the 2010 Oregon
Address: A-6,5-5— (j1J /(/dr 0 /241b1 r Si `le/ Solar Installation Specialty Code checklist.
City/State/ZIP: `� rCq-79-.2--3/ Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(5-&3) �'"$d —L 7s Fax:( 6L3 6-90---zadState surcharge(12%of permit fee): $21.60
CCB lic.: 5-29/94,. Total fee due upon application: $201.60
_ This permit application expires if a permit is not obtained
Authorized signature:gn ���-- = within 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry
Print name: ✓ % —j, LL S Date: ' Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
V __________
Permit Application FOR OFFICE USE ONLY
;' :' DIte By- Permit No.:�
City of Tigard 1�teBy:
ili - 'I 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Permit:
DateBy: Otherris: 8 See Page 2 for
Phone: 503.718.2439 Fax: 503.598.1960 01..-,,,,
X I Date Ready/By:
Inspection Line: 503.639.4175 Supplemental Information
T I GA R D Notified/Method:
Internet: www.tigazd-or.gov .,,r.
ri- } '
COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
TYPE OF W o � 1 � I ` Mechanical permit fees*are based on the value of the work
0 Addition alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
Mfew constructionmechanical materials,equipment,labor,overhead,and profit.
❑Demolition ❑Other:
CATEGORY'OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
Accesso building For special information use checklist.
and 2-family dwelling ❑Commercial/industrial ❑ n Description Qty. Ea. Total
Master builder 0 Other:
❑Multi-family 0 Heatin_/coolint: _
,JOB SITE INFORMATION`AND LOCATION Air conditioning
46.75
: . / - 1 A Q / �' 46.75
/�� Furnace 100,000 BTU(ducts/vents)
Job site address: �� 'Ana Furnace 100,000+BTU(ducts/vents) 54.91
61.91
City/State/ZIP: �: _ �3 Heat sump
lir06
;/ 4; Duct work 23.32
Suite/bldg.lapt.no.: Project name: ',AL , , ' 23.32
ir Cross street/directions to job site: /a r Hydronic hot water system Rhesidential boiler(radiator or 23.32 Unit t heaters(fuel-type,not electric), . 46.75
in-wall,in-duct,suspended,etc.
Flue/vent for any of above 23.32
Other: 23.32
Lot no.: Other fuel a..liances:
v.
Subdivision: nn� Ili �" 1...,'" 23.32
Water heater
Tax map/parcel no.: .� 33.39
Gas fireplace/insert
'DESCItiI'I7ON,Q*=M ORS Flue vent for water heater or gas 23.32
• ` fire.lace
L ( 23.32
Lo:
Wood/.eli:hterllet stove 33.39
Wood fire.lace/insert 23.32
Chimney/liner/flue/vent 23.32
Other 23.32
ROPERTY:OWNER'
0.TENANT ' Environmental exhaust and ventilation:
Range hood/other kitchen
�
equi.ment 33.39
�� �
'
°/ - / 'te.--/ Clothes dryer exhaust .� 33.39
Address: ;P � dr/41 ` •,��'"A Single-duct exhaust(bathrooms,
�r�1�23 toilet corn.artments,utili rooms) 23.32
City/State/ZIP: �� Y � 23.32
/� Fax:ci 3) r 9.Q .7`06 Attic/crawlspace fans
Phone:( �j 23 32
Other:
6 APPLICANT ❑ CONTACT PERSON; Fuel si.int:
e $14.15 for first four;$4.03 for each ddit
ional
Contact name:
Business name: Furnace,etc.
-• ==
Address: B
Wall/sus.ended/unit heater
Water heater ==
City/State/ZIP: Clill rem
Phone:( ) Ran:e ==
i 1, es/'VO-,® a Barbecue
E-mail: ca ® " Clothes d er(.as)
CONTRACTOR Other: --
MECHANICAL PERMIT FEES*
Business name: t r r r / Subtotal
Address: '3/5-0 "' / '/1.45 12b��/lt. Minimum permit fee($90.00)
CitylState/ZIP: 6 er //1 y Plan review(25%of permit fee)
�y� wrill State surcharge(12%of permit fee)
Phone:( ) TOTAL PERMIT FEE
CCB I1C.: --7 This permit application expires if a permit is not obtained within 1
days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry Service Boan
Authorized signature: / '�
L ) Date: '9 M.7
Print name: / f/ U'��
4•i-4617T(11/02/COM/WEB)
Electrical Permit Application FOR OFFICE USE ONLY
Received ���J
City of Tigard t.telly:
t, ,' 141Review Related Permit#:
q 13125 SW Hall Blvd.,Tigard,OR 97223 ,� P ;�i � ,�.,, � � � 'dile/13 : p See Page 2 for
Phone: 503.718.2439 Fax: 503.598.1960 , , •• Ready Date/By:
Supplemental Information
Inspection Line: 503.639.4175 Notified/Method:
TIGARD Internet www.tigard-or.gov PLANREVIEW
s - l
TYPE OF WORK J Please check all that apply(submit 2 sets of plans w/items checked):
❑ Please
c ' �'$ ❑Service or feeder 400 amps or more ❑Building over three stories.
"wi New construction / '� ' i• (3 x Marinas and boatyards.
t. where the available fault current 0
0 Other: 4 r e exceeds 10,000 amps at]50 volts or 0 Floating buildings
0 Demolition 9' Commercial-use agricultural
CATEGORY OF CONST =f less to ground,or exceeds 14,000 0 buildings.
Commercial/industrial 0 Accessory building amps for all other installations. g
❑ ❑Fire pump. ❑Installation of 150 KVA or
0 1-and 2 family dwelling 0 Other: largerstaseparately KVA
❑Multi family 0 Master builder0 Emergency system. system.
erived
LOCATION . ❑Addition of new motor load ofE•• "t 2„ "1 3„
JOB SITE INFORMATION AND • � h ❑..A„ ..
7 n�R Six or100Hor moremores occupancy.
Job#: Job site address: 0 Six or residential units. ❑Recreational parks.
7-3 0 Health-care facilities. 0 Supplyrevoltageal vehicleof par than
City/State/ZIP: / a t /� ['Hazardous locations. 600 volts nominal.
Project name: Awn i 4 ❑Servrce or feeder 600 amps or more.
Suite/bldg./apt.#: � FEE SCHEDULE
/ �� `4th Each Total
am
Cross street/directions to job site: Dees
Neww residential single-or multi-family dwelling unit.
Includes attached garage. ,�
168.54
. Lot#: _13.
Subdivision: n�qn 1,000, sq.ft.or less
.. _
Ea.add'1 500 sq.ft.or portion
imi 33.92lia
Tax map/parcel#: Limited energy,residential rifi 75.00 NJ
DESCRIPTION OF WORK (with above s..ft.)
Limited energy,multi-family 111 75.00 In
residential(with above sq.ft.)
Renewable Ener_ 0 See Pa_e 2 —IIII
0 TENANT Services or feeders installation,alteration,and/or relocation 2,ea
P1�OPERTY OWNER' 100.70 _
200 amps or less 2
OM W , 01 1 201 amps to 400 amps 111111 133.56 _
�. . 6/4- L v I+'nom - 200.34 2
i a-LU� 401 amps to 600 amps 2
Address: �� S ,5-co N`f`� 2-3 301.04 _
/��,�w 601 amps to 1,000 amps 2
City/State/ZIP: / C.�t ��� 111111 552.26 _
/�� Over 1,000 amps or volts
Fax:(6(J3) Y•'� P �" Temporary services or feeders installation,alteration,and/or
Phone:( jO 7s--- Fax:
- relocation
Email:
0.1 -CS it A ..4 1 54.36 _ 1
�� ,ne�d� that I own which is not 200 amps or less 2
125.08 _
Owner installation:This installation is being made on property 201 amps to 400 amps 2 MI
401 amps to 599 amps
]68.58
intended for sale,lease,rent,or exchange,according to ORS 447,ODate:670,and 701.
Branch circuits—new,alteration,or extension, .er panel
Owner signature: 0 CONTACT PERSONA.Fee for branch circuits with
•t' ' above service or feeder fee, 7.42 2
_
each branch circuit
Business name: y _ B.Fee for branch circuits without .
service or feeder fee,first 56.18 2
Contact name: branch circuit
Address: Each add'1 branch circuit
1111 7.42 _
Miscellaneous service or feeder not included
City/State/ZIP: Each manufactured or modularIII 67.84 :
0111111111111111111111111111111111
Phone:( dwelling,service and/or feeder 67 84 11111111Reconnect only 11111 111111113311111111CONTRACTOR Pump or irrigation circle -
Sign or outline lighting
67.84
j Signal circuit(s)or limited-energy ❑ See Page 2
Business name: 1ff .anel,alteration,or extension.
r1 / 4 11 Vii, Each additional ins section over allowable in any of the above
Address: vr�'®`' g��5 66.25/hr _
C‹ Additional inspection(1 hr min) -
City/State/ZIP: �; ��'� 90.00/hr
111111111
2 -477?-3Investigation(]hr min) -
Fes'��J� �� Industrial plant(1 hr min) -�_
Phone:f�U3) s� 7
Inspections for which no fee is III 90.00/hr
s.ecifically listed('h hr min
q/ 7 ` ,m. � Suprv.Lic.:11i ELECTRICAL PERMIT FEES
CCBOS Lic.: (/ �-V Electrical Lica Subtotal:Suprv.Electrician signature,required: ❑plan Review Required(25%of permora):
Date: State surcharge(12%of permit fee):
Print name �,rj 4TOTAL PERMIT FEE:
—7 This permit application expires if a permit is not obtained within 1
Authorized signature:,' days after it has been accepted as complete.
'1W."'----
Print
� Date: * Number of inspections allowed per permit.
Print name:
i 440-4615T(1 l/05/COM/WEB
1.\BuildingWermits\ELC PermitApp_ELR_ERE.doc Rev 06/1 --i-'5
Plumbing Permit Application
Building Fixtures FOR OFFICE USE ONLY
City of Tigard Received Permit No.:/h5 Taw i ...L)L�.,r-'L�
e
, - q 13125 SW Hall Blvd.,Tigard,OR 97223 elan Review
e Other Permit No_:
Phone: 503.718.2439 Fax: 503.598.19660: i4 i ' -1 Date/By: Other
it See Page 2 for
Inspection Line: 503.639.4175 Date Ready/By: SupplementalJuris Information
TIGARD Internet: www.hgard-or.gov Notified Method
/(,,, FEE* SCHEDULE
TYPE OF WORK j For special information use checklist
0 Demolition-, x ~v Description I Qty. 1 Ea. 1 Total
,04j2
ew construction 4 P
11Addition/alteration/replacement 0 Other'.'~ -,- t" k {'y' New 1-2-family dwellings(includes 100 ft.for each utility connection)
Alai ,ffi5o , r. 312.70
SFR(1)bath
CATEGORY OF CONSTRU SFR(2)bath 437.78
and 2-family dwelling 0 Commercial/industrial 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
utilities:
JOB SITE INFORMATION AND LOCATION Site Site u basin or area drain 18.76
Job site address: ' �� �{/ /!/1Q/ti _ . - fat4 Drywell,leach line,or trench drain 18.76
City/State/ZIP: T � o Lt 9'72-2,' Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name: j�nGn � f� I�
� � b Manufactured home utilities 50.03
18.76
®® �
Cross street/directions to job site: Manholes Rain drain connector 18.76
le,9 Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.:, )
Page 2
j Water service(no.linear ft.: ) Page 2
/yt
Subdivision: - i Ad 46410 /L/ Lot no.:/3 Fixture or item:
.- p! Backflow preventer 31.27
Tax map/parcel no.: Backwater valve 12.51
DESCRIPTION OF WORK Clothes washer 25.02
Aft,i--) 5.14='/2- Dishwasher
25.02
Drinking fountain 25.02
Ejectors/sump 25.02
Expansion tank 12.51
0
PROPERTY OWNER 0 TENANT 25.02
/ Fixture/sewer cap
Name: Pi Ind Z'a/t-sT-p ��4'��ii����`L Floor drain/floor sink/hub 25.02
Address: / S"S'LS&D �6r`, a"' "s h�d Garbage disposal 25.02
Hose bib 25.02
City/State/ZIP: 77 f t�� -7 �g 12.01
( � U 7S Fax:( 7.3 J--'U-!(/C/4" Ice maker
Phone: 25.02
0 CONTACT PERSON' Interceptor/grease trap
0• APPLICANTPage 2
Medical gas(value:$ )
Business name: 5-rt/el Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Sink/basin/lavatory 25.02
Address:
Solar units(potable water)
62.54
City/State/ZIP: - 12.51
(
Phone:( ) I Fax: : ) Tub/shower/shower pan Urinal 25.02
E-mail: l ftci ,-0 er, ifitJA.,-e5 N L4-7 (49dote i
• /
<< Water closet 25.02
CONTRACTOR. �/ Water heater 37.52
/'A il�(l It 6 1,Iy ofe) Water piping/DWV 56.29
Business name: j�p,t-r �/ 25.02
Address: / c�j JJ 7 ? Other:
����(� [ � yam. Subtotal
City/State/ZIP: �� V O/1 ` 114 �a. 5 f Minimum permit fee: $72tal
Phone: 3) 3 ^�f� Fax:(p3) 3�J "I Plan review (25%of permit fee)
CCB Lic.: ii.:2 /39 Plumbing Lc.no.: State surcharge(12%of permit fee)
TOTAL PERMIT FEE
Authorized signature:
I Date:47//),./141 A /���� I This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
Print name: � (�k C 1 *Fee methodology set by Tri-County Building Industry Service Board.
I\BuildingU'ermitaLMU-PermitApp.doc 10/01/09
440-4616T(10/02/COM/AEB)
City of Tigard
a COMMUNITY DEVELOPMENT DEPARTMENT
I=
Building Permit Review — Residential
TIGARD
Building Permit #: M57-0VJi 7- CO3�
Site Address: // / l )n 0L. 0)1,/r21—
Project
Name: i` L71' Lot #: –,1---S--
(New dwelling=subdivision Addition or Alteration=last name of owner)
Planning Review
Proposal: AJ �) <S - i/ //'7.` / - /9-in(_Sr— �'4 —C
Xerify site address/suite# exists and actio permit system.
OKO(R,'ver Terrace Neighborhood: lZJ N o ❑ Yes,See River Terrace Review Addendum Attached
River g
Sit,C Plan Elements:
j ree(3)copies of site plan IN T'•►�sting structures on site
er plan must be on 8-1/2"x 11"or 11 x 17"paper ootprint of new structure(including decks)with finished
lrawn to scale(standard architect or engineer scale) poor elevations
•rth arrow U ty locations&easements(required for new and additions)
:?,'te address,project or subdivision name and lot number Sidewalk/driveway approach
splicant information(name and phone number) r ation of wells/septic systems
I4 Lot dimensions and building setback dimensions 1. xisting trees to be retained with drip line,and tree
ill!p uare footage of buildings to be demolished •tection measures
`l •t area,building coverage area,percentage of coverage and tI�itreet tree size,type and location
pervious area(applicable if R-7,R-12,R-25&i R-40) Street names
ropertycorner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? Yes ❑ o
4 foot differential) If yes,is a storm water quality facility shown? , EYes 4/JNo
O'fflean
fie'' c ta-e_
Water Services—Service Provider Lett-. (lot platted prior to 9/10/1995):quired: ❑ Y ,applicant was notified VI No Received: E Yes 77��❑ No /
Ig Public Faciliti s Improvement(PFI)Permit: I'"F/ /&-i Ct-`��./
equired: Yes,applicant was notified ❑ No Applied For: Yes ❑ No,stop intake
and Use Case#: L� �� / �� Z � ��— C
oning:
Ac- --A2 r
Required Setbacks: Front /(j Rear / Side Street Side Oct- Garage c�Q
ndscape Requirement:
of Coverage Maximum: _ % _
Building Height: Maximum Height ' ,.� Actual Height �,S
P1!%f isual Clearance /
VA :ensitive Lands: Yes ❑ No Type 3/eel) <S'/
IF Urban Forestry Plan !o/
❑ Conditions "Met"pri„or to issuance f l�uildin permit
Notes: C..409 ifk)2?� �' // Lv ,I- /9vdY— 7 f elfin i 7L / aOr r'(�
Approved By Planning: 44 Date: Oiev
Revisions (after Building Submittal only) n^ Reviewer Date
Revision 1: '1 V
Approved ❑ Not Approved I "------.' 1 S
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_RES_061417.docx
Building Permit Submittal
Original Submittal Date: V4117
Site Plans: # 3
Building Plans: # 3
Building Permit#: g--rimer building�pe�rmit#above.
Workflow Routing: E'P. ening [YEngineering rmit Coordinator [9- '
Workflow Sign-off: g
:gn- ff: ign-off for Planning(include notes from planning review)
Route Application Documents: �'Tngineering: (1) copy of permit application, (1) site plan, (1) building plan and
original/ plan review routing form.
!-��Suilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: >
!L , „old' ,Il Date:
Engineering Review S
Slope at building pad: ?j Go
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
-BWater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes -0' No
Assess Water Quantity Fee in-lieu: Cl Yes .B"-No
LIDA Facility on lot: ❑ Yes -2"-&o
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: ni.( 1<IL__ 14) 4 Date: 2-a /7
Revisions (after Building Submittal only) Reviewer D, e
Revision 1: ....L:-Approved ❑ Not Approved )14 1 ri.- ,u> . /4 l,
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: E''Yes ❑ N/A
Parks SDC: >i, Yes ❑ N/A
LIDA ❑ Yes N/A
OK to Issue Permit
pproved by Permit Coordinator: /late:.9/747/. -----
I:\BuildingTorms
---_I:\BuildingTorms\BldgPermitRvw RES 061417.docx 4/111 1/146171 i,1`"40' ' (71)b 1
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
_ Transmittal Letter
i c; \K I) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: 7/)-N DATE RitIto
DEPT: BUILDING DIVISION G iVED
NOV 132017
FROM: /k-1 711 c,&V+ - Ci7Y ot- I1 AR'D
BUILDING DIVISION
COMPANY: ESC trK9L.-crrti �'cf,5 ;c V")
PHONE: 4 ) I — 7�'lQii Bye:' —
RE: he t�ddress (7l A) iGnikt J (i(i (Permit/.1) -dev 7-61135-o
(VI9 , .0 l
( roject name or sub ivisu name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s)of plans. 3 Revisions: p eI., ,e 4s
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: Rcele oc �,�,c-"� ons 0,-1-1- fees Fa P,rc "ter ,3
f '- 4,S �� �1
FOR OFFICE USE ONLY 7.--
Routed toe it Technician: Date: t JJr 7 Initials:
Fees Due: Yes ❑No Fee De cfipt on: `'► Amount Due:
// $ 770
'/ ( p l G-i✓l ,r,c tA —) $ gir.,
1
$
\ vs $
Special
Instructions:
Reprint Permit(per PE): ❑ Yes ❑No ❑ Done
Applicant Notified: Date: Initials:
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:
11017 SW ANNAND HILL CT, TIGARD, April 18, 2018 at 2:27:26 PM
OR, 97224
Record Type: Record ID:
Residential - Master Permit MST2017-00350
Inspection Type: Inspector:
199 Electrical 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:
11017 SW ANNAND HILL CT, TIGARD, April 23, 2018 at 1 :27:49 PM
OR, 97224
Record Type: Record ID:
Residential - Master Permit MST2017-00350
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:
11017 SW ANNAND HILL CT, TIGARD, April 20, 2018 at 11 :37:34 AM
OR, 97224
Record Type: Record ID:
Residential - Master Permit MST2017-00350
Inspection Type: Inspector:
399 Plumbing 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:
11017 SW ANNAND HILL CT, TIGARD, April 20, 2018 at 11 :36:32 AM
OR, 97224
Record Type: Record ID:
Residential - Master Permit MST2017-00350
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS
Comments:
Correction from previous inspection complete.
Violation Summary:
Inspector Contractor