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Permit (121)
Is CITY OF TIGARD ��i� MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2017-00382 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/21/2017 Parcel: 1 S134DC13200 Jurisdiction: Tigard Site address: 11427 SW SUZANNE AVE Subdivision: MISSION MEADOWS Lot: 4 Project: Mission Meadows, Lot 4 Project Description: New SF. 1/12/2018: REPRINT permit to remove laundry tray. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1513 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 26 Bathrooms: 3 Second: 1505 sf Garage: 406 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3018 sf Value: $363,777.49 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 4 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: 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 3018 Owner: Contractor: MISSION HOMES NORTHWEST LLC MISSION HOMES NORTHWEST LLC Required Items and Reports(Conditions) PO BOX 1689 PO BOX 1689 1 Ersn Cntrl 503-639-4175 LAKE OSWEGO,OR 97035 LAKE OSWEGO,OR 97035 PHONE: 503-591-5324 PHONE: 503-381-3753 FAX: 503-214-8524 Total Fees: $32,140.60 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 throug AR 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. /` ,v � / Issued By: G-. .. Permittee Signature: '9/1/ '/ G/e4.770/1 Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. FOR OFFICE USE ONLY-SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 'PI Transmittal s ttal Letter cu n it tl 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: I Cki DATE RECEIVED: DEPT: BUILDING DIVISION ED RE.0 EN iL JAN 8 2018 FROM: JALQ % is L k BUILDING D VL O COMPANY: /55 v o y�P f PHONE: 50 3 - f .3-,32-x/ By: / RE: // if 2 7 S V"- 5- 1. u,7/7-e A-A-c. mil-20/7 - 60.3 72_ (Site Address) / ermit Number) S►c e p,66ti-S /D Li(.1 /' roject name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: p t,1 o vc vidk7 S,WT FOR OFFICE USE ONLY Routed to Permit Technician: Date: ) g- f-7 Initials: Fees Due: I,Yes E] No Fee Description: Amount Due: . ----- )-)v- pi 4... re....%-eAd $ j_ks $ $ $ Special Instructions: Reprint Permit(per PE): ® Yes IDNo [ Done Applicant Notified: tate: Initials: I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 CITY OF TIGARD MASTER PERMIT 14 , n COMMUNITY DEVELOPMENT Permit#: MST2017-00382 Date Issued: 11/21/2017 TWARD Arg D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S 134 DC 13200 Jurisdiction: Tigard Site address: 11427 SW SUZANNE AVE Subdivision: MISSION MEADOWS Lot: 4 Project: Mission Meadows, Lot 4 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1513 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 26 Bathrooms: 3 Second: 1505 sf Garage: 406 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3018 sf Value: $363,777.49 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain0 Storm Sewer: 100 Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 4 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: 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 3018 Owner: Contractor: MISSION HOMES NORTHWEST LLC MISSION HOMES NORTHWEST LLC Required Items and Reports(Conditions) PO BOX 1689 PO BOX 1689 1 Ersn Cntrl 503-639-4175 LAKE OSWEGO,OR 97035 LAKE OSWEGO,OR 97035 PHONE: 503-591-5324 PHONE: 503-381-3753 FAX: 503-214-8524 Total Fees: $32,140.60 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 - -dopted by the Oregon Utility Notification Center. T�.hh • rules are set forth in OAR 952-001-0010 through•.R 952-001-0090. You•. •• -'. -copy • the rules or.'ect questions to OUNC by calling 503.232.1987• is X0.332.2344. Issued By: .6."-'1.0.0e--- - --' Permittee Signature: — Call 503.• 9.417 A 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 p ,ject. Approved plans are required on the job site at the time of each inspection. Building Permit Application Residential RECEIVE City of Tigard Received / IINII Date By: !-o/ia/f? Permit N Go 3 13125 SW Hall Blvd.,Tigard,OR 97223 OCT 9 2017 0/7_44,53?) I Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/By: )0. i .. j l Other Permit: U/7—00 S/Av, I I C.:11Z I) Inspection Line: 503.639.4175 CITY OF E s. ARD Date Ready/By: / Juris: la See Page 2 for Internet: www.tigard-or.gov BUILDINGDIVISION Notifted/Method� / /� Supplemental Information 666 TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING (3,1 New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY';,OF CONSTRUCTION work indicated on this application. ® 1-and 2-family dwelling ❑Commercial/industrial Valuation: 9459AQ0 ,3 6 3) tS II'7"' ❑Accessory buildingMulti-familyNumber ofboms: 4 0 7T 777 0 Master builder ❑Other: Number of bathrooms: 3 JOB SITEINFORMATION AND LOCATION Total number of floors: 2 ,3o J Q—3 I 4,c)..11 Job site address: 11427 SW SUZANNE PL New dwelling area: 6.154.1„... square feet City/State/ZIP:Tigard Or 97223 Garage/carport area: 406 square feet Suite/bldg./apt.no.: Project name:Mission Meadows Covered porch area: 83 square feet lgd Cross street/directions to job site:Springwood ST to 115th AVE '--I3eekaree: 30€0. Qabeek square feet S-•1 a Other structure area:, square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision:Mission Meadows Lot no.:4 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 ,___ -.__ _,9_.. . — R> -op-W --_!, _ --------- work indicated on this application. Valuation: $ New Single Family Residential Construciton Existing building area: square feet New building area: square feet .' PROPERTY OWNER ❑ TENANT Number of stories: Name:Mission Homes NW Type of construction: Address:PO BOX 1689 Occupancy groups: City/State/ZIP:Lake Oswego OR 97035 Existing: Phone:(503)5935324 Fax:(503)2148524 New: : APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* Business name:Mission Homes NW (Pleaserefer tojeesckedule) Structural plan review fee(or deposit): Contact name:Ben Dalbey FLS plan review fee(if applicable): Address:PO BOX 1689 Total fees due upon application: City/State/ZIP:Lake Oswego Or 97035 Phone:(503)5935324 Fax: :(503)2148524 Amount received: E-mail:benldalbey@gmail.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted Photo Voltaic Solar Panel System. Business name:Missiom Homes NW Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:PO BOX 1689 Solar Installation Specialty Code checklist. City/State/ZIP:Lake Oswego OR 97035 Permit Fee(includes plan review $180.00 and administrative fees): Phone:(503)5935324 Fax:(503)2148524 State surcharge(12%of permit fee): $21.60 CCB lic.:186849 Total fee due upon application: $201.60 Authorized signature: do,Z..._ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Ben Dalbey Date:8-8-17 *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) 1 • Mechanical Permit Application RECrtllt.FFlcl, l Si: 0yl,' I MI •eceived City of Tigard Date/BPermit N. AL .--0 • 13125 SW Hall Blvd.,Tigard,OR 97223 o C T 92 17 Plan Review Date/By: V Phone: 503.718.2439 Fax: 503.598.1960Other Permit: TIGAIl) Inspection Line: 503.639.4175 CITY OF TtOAR Date Ready/By: Juris: H See Page 2 for Internet: www.tigard-or.gov BUILDING Di;dfs tified/Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees*are based on the value of the work ®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ® 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special infornwiion use checklist. 0 Multi-family ❑Master builder ❑Other: Description I Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 1 46.75 Job site address: 11427 SW SUZANNE PL Furnace 100,000 BTU(ducts/vents) 1 46.75 City/State/ZIP:Tigard Or 97223 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name:Mission Meadows Duct work 23.32 Cross street/directions to job site:Springwood St to 115th AVE 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:Mission Meadows Lot no.:4 Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 1 23.32 DESCRIPTION OF WORK Gas fireplace/insert 1 33.39 Flue vent for water heater or gas New Single Family Construction fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 and PROPERTY'OWNER 0 TENANT Other: 23.32 Environmental exhaust and ventilation: Name:Mission Homes NW Range hood/other kitchen equipment 1 33.39 Address:PO BOX 1689 Clothes dryer exhaust 1 33.39 City/State/ZIP:Lake Oswego Or 97035 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 4 23.32 Phone:(503)5935324 Fax:(503)2148524 Attic/crawlspace fans 23.32 0 APPLICANT ❑'CONTACT PERSON Other: 23.32 Business name:Mission Homes NW Fuel piping: $14.15 for first four;$4.03 for each additional Contact name:Ben Dalbey Furnace,etc. 1 Address:PO BOX 1689 Gas heat pump Wall/suspended/unit heater City/State/ZIP:Lake Oswego Or 970335 Water heater 1 Phone:(503)5935324 Fax: :(503)2148524 Fireplace 1 Range E-mail:benldalbey@gmail.com Barbecue 1 CONTRACTOR Clothes dryer(gas) Business name:Advantage Heating LLC Other: MECHANICAL PERMIT FEES* Address:2355 Hyacinth ST NE Subtotal City/State/ZIP:Salem Or Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(503)3935315 Fax:( ) State surcharge(12%of permit fee) CCB lic.:174260 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 /� 6--7--------- �--�r � days after it has been accepted as complete. Authorized signature: ✓ Cd * Fee methodology set by Tri-County Building Industry Service Board Print name:Ben Dalbey Date:76.).-6 r77 I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB) Electrical Permit Application RECEIVE ',oii torrid: l se OONI.1 • City of Tigard OCT 9 2017 RDateeceiBved IZZEZRMIngigill 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 I Date/B : Related Permit#: Inspection Line: 503.639.4175 BUILDING DlV SteadyDateBy: Juris: 0 See Page 2 for Internet: www.tigard-or.gov 'Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: Job site address: 11427 SW SUZANNE PL I00HP or more. ❑"A "E","1-2",°°I-3", City/State/ZIP:Tigard Or 97223 ❑Six or more residential units. occupancy. ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name:Mission Meadows 0 Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site:Springwood ST t oll5th AVE FEE SCHEDULE Description I Qty. I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision:Mission Meadows Lot#:4 Includes attached garage. 1,000 sq.ft.or less 1 168.54 4 Tax map/parcel#: Ea.add'1 500 sq.ft.or portion 4 33.92 1 DESCRIPTION OF WORK Limited energy,residential 1 75.00 2 New Single Fmaily Construction (with above sq.ft.) Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy ❑ See Page 2 : PROPERTY OWNER I 0 TENANT Services or feeders installation,alteration,and/or relocation Name:Mission HOmes NW 200 amps or less 1 100.70 2 Address:PO BOX 1689 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:Lake Oswego Or 97035 601 amps to 1,000 amps 301.04 2 Phone:(503)5935324 Fax:(503)2148524 Over 1,000 amps or volts 552.26 2 Email: Temporary services or feeders installation,alteration,and/or relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 0 APPLICANT 1 0CONTACT PERSON Branch circuits-c new,alteration,or extension,per panel A.Fee for branch circuits with Business name:Mission HOmes NW above service or feeder fee, each branch circuit 7.42 2 Contact name:Ben DAlbey B.Fee for branch circuits without sAddress:PO Box 1689 ervice or feeder fee,first 56.18 2 branch circuit City/State/ZIP:Lake Oswego Or 97035 Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(503)5935324 Fax: :(503)2148524 Each manufactured or modular 67.84 2 Email:benldalbey@gmail.com dwelling,service and/or feeder Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name:Connections Electric Sign or outline lighting 67.84 2 Address:5287 Portland RD NE Signal t(s)or limited-energy 0 See Page 2 2 panel,alteration,or extension. City/State/ZIP:Salem Or 97305 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(503)3907914 Fax:( ) Investigation(1 hr min) 90.00/hr Email:connectionselectric@hotmail.com Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: 65444 Electrical Lic.: 24-248C Suprv.Lic.: specifically listed('/hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: L`779` Subtotal: Print name: Marvin Bergevin Date: /o 0 Plan Review Required(25%of permit fee): -6<6--" State surcharge(12%of permit fee): Authorized signature:/ Z---------- ignature: ��------ TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Ben DAlbey Date:/6'"(."�, days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015 440-4615T(11/05/COM/WEB I Plumbing Permit Application Building Fixtures RECE v FUR (H.11( I, ISG ()yl.l City of TigardReceived 9 q Permit No.: 7- IN 13125 SW Hall Blvd.,Tigard,OR 97223 201 i pan Review s/ � 3 I Phone: 503.718.2439 Fax: 503.598.1960 ateB F. Other Permit No.: CITY Oi.. 1GART y: See Page2for i i c,n It t) Inspection Line: 503.639.4175 r s Ready/By: Jugs: Internet: www.tigard-or.gov ��1�-�1�i �y JI` Notified Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ®New construction ❑Demolition For special information use checklist Description I Qty. I Ea. 1 Total 0 Addition/alteration/replacement ❑Other: New 1-2-family dwellings(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 SFR(3)bath 1 500.32 ❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02 0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Catch basin or area drain 18.76 Job site address:11427 SW SUZANNe PL Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard Or 97223 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name:Mission Meadows Manufactured home utilities 50.03 Cross street/directions to job site:SPringwood St to 115th AVE Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision:Missiom Meadwos I Lot no.:4 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 Backwater valve 12.51 _-__ -....,,.-._._--. R `PI1 'well* Clothes washer 1 25.02 New Single Family Construction Dishwasher 1 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 : PROPERTY OWNER 1 0 TENANT Expansion tank 12.51 Fixture/sewer cap 25.02 Name:Mission Homes NW Floor drain/floor sink/hub 25.02 Address:PO BOX 1689 Garbage disposal 1 25.02 City/State/ZIP:Lake Oswgo Or 97035 Hose bib 1 25.02 Phone:(503)5035324 Fax:(503)2148524 Ice maker 1 12.51 El APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name:Mission Homes NW Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:Ben Dalbey Roof drain(commercial) 12.51 Address:PO BOX 1689 Sink/basin/lavatory 5 25.02 City/State/ZIP:Lake Oswego OR 97035 Solar units(potable water) 62.54 Phone:(503)5935324 Fax: :(503)2148524 Tub/shower/shower pan 3 12.51 Urinal 25.02 E-mail:benldalbey@gmail.com Water closet 3 25.02 CONTRACTOR Water heater 1 37.52 Business name:Pipe It Plumbing LLC Water piping/DWV 56.29 Address:2229 NE BURNSIDE ST#81 Other: 25.02 City/State/ZIP:Gresham OR 97030 Subtotal Phone:(503)5440477 Fax:( ) Minimum permit fee: $72.50 pig"?' Plan review (25%of permit fee) CCB Lic.:174351 Plumbing Lic.no.: 1b State surcharge(12%of permit fee) Authorized signature: ‘,/4-(j'c- 2/f/2-e) TOTAL PERMIT FEE Print name:Ben Dalbey Date: 10/6/17 This permit application it expire has es if ape mit s not aof obtai e within 180 days af*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 IN ' COMMUNITY DEVELOPMENT DEPARTMENT 1 TIGARD Building Permit Review — Residential Building Permit #: ,4z 57/ 7— 3 g- Site Address: j /1/ 7 SR) Suzanne f'/. Project Name: 447S50rs. NlGa(le Lot #: q (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: A) $1Z. 7,erify site address/suite# exists and active i ermit system. .River Terrace Neighborhood: No ❑ Yes,See River Terrace Review Addendum Attached Site Ian Elements: �� i Three(3)copies of site plan /❑Existing structures on site ite plan must be on 8-1/2"x 11"or 11 x 17"paper 'ffipootprint of new structure(including decks)with finished „)Drawn to scale(standard architect or engineer scale) flor elevations Z2North arrow 'QUtiltty locations&easements (required for new and additions) lte address,project or subdivision name and lot number idewalk/driveway approach Applicant information(name and phone number) $ tietihf wells/septic systems .1,-;of dimensions and building setback dimensionsxis g ees be retained with drip line,and tree —OSquare,footage of buildings to be demolished protection measures iJ.errarea,building coverage area,percentage of coverage and ipetrgt tree size,type and location impervious area(applicable if R-7,R-12,R-25&R-40) reet names roperty corner elevations (2 foot contour lines if more than >1,000 sf of impervious area created or replaced? Yes E No 44f000t differential) If yes,is a storm water quality facility shown? ❑Yes �'I� o Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: E Yes,applicant was notified 0Er No Received: ❑ Yes E No ,Public Facilities Improvement(PFI) Permit: Required: E Yes,applicant was notified .No Applied For: ❑ Yes E No,stop intake .2-Land Use Case#: S ug 01o) —0000 I f Zoning: R- i.S Required Setbacks: Front ap Rear 15 Side 5 Street Side AJ/_ Garage pei Q"Landscape Requirement: .1 Lot Coverage Maximum: 0/0 Building Height: Maximum Height 30 Actual Height (29 Visual Clearance r Pensitive Lands: + ❑ Yes .2f No Type t.,Urban Forestry Plan- &`1 a�t/� g Conditions "Met"prior to issuanc of bpilding.ermit Notes: . . A — /1 _. 0 1�.� � . - •e _ - - .. - / - ..-. Approved By Pla ming: C' Da : 10/74y/7 Revisions (after Building Submitta n y Reviewer Date Revision 1: St Approved ❑ Not Approved y�(d�'! ii (41 ((1 Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw_RES 061417.docx Building Permit Submittal Original Submittal Date: '©/, a? Site Plans: # Building Plans: # 3 Building Permit#: Enter building permit#above. Workflow Routing: Planning Engineering 7 Permit Coordinator Building Workflow Sign-off: Sign-off for Planning(include notes from planning review) Route Application Documents: 7 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: By Permit Technician: ./..e- ,I C` - ,'"� Date: /04-0/72 E�neering Review E Slope at building pad: /, (7d [ ', onditions "Met"prior to issuance of building permit L1 Easements (encroachments)per engineering conditions of approval and plat ❑ Water Quality/Quantity Facility: 1..3 Q F dA/5/Te- Assess AJ5/TE'Assess Water Quality Fee in-lieu: ❑ Yes ❑ No Assess Water Quantity Fee in-lieu: ❑ Yes E No LIDA Facility on lot: ❑ Yes ❑ No ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: Date: /VW< Revisions (after Bui ing Submittal only) e ' er Date Revision 1: Approved ❑ Not Approved /1 0/G/17 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: , r , I Revision Notice 2: Date Sent to Applicant: Revision Notice 3: Date Sent to Applicant: DC Fees Entered: Wash Co Trans Dev Tax: i. es `i N/A Tigard Trans SDC: es irN/A Parks SDC: P Yes - /A LIDA' ❑ Yes !� N/A OK to Issue Permit ) Approved by Permit Coordinator: Date: j°/t y Y I:\Building\Forms\B1dgPernutRvw_RES_061417.docx AIWA P6-4/A. II(xft7 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 111 _ Transmittal ansmlttal Letter 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED NOV 9 2017 FROM: es,c , /21/by !Tl°'_ (� OFI l b RD COMPANY: /n s-cyfrVtl /7 'YLe.,J ///k/ ! ®� DIVISION PHONE: is S--9" - S 3.aLi By: RE: /pi;( Addr jit. cs1-t 2 w - !/"c-. / ' /Sro d 17- c,r (Permit umber) //7)SS' / 0-10IS y (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s)of plans. Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. , Engineer's calculations. 3 Other(explain): ,5'* 2 ,- j REMARKS: Z(l1.3=-Col Sr p , 1 P� dagiae- , FOR OFFICE USE ONLY Routed to Permit Technician: Date: ),)1 )-7 Initials: Fees Due: ❑ Yes No Fee Description: Arnot Du�: Special Instructions: Reprint Permit(per PE): ❑ Yes Done Applicant Notified: Date: Initials: I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 Plumbing Permit Application Building Fixtures a City of Tigard ��t .'t "r i\. .':';7-,k-}� Received ll 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: U/`� Permit No C/�(,�� /a j �� R Phone: 503.718.2439 Fax: 503.598.19601 A j\N `3 2018 Plan Review J !�� Other Permit No.:Date/By:Ins Inspection Line: 503.639.4175I ( 1 :I) Internet: www.tigard-or.gov gg i r r,„,-, -, Date ed/Mef Ready/By: Juris I H See Page 2 for )t I y (..1i- z 9 s Notified/Method: Supplemental Information TYPE OF W lLDIt4(3 DIVISIO .. FE *;SCHEDULE, 1 For special information use checklist ®New construction CI Demolition 1 ' �; ifs . Description Total ❑Addition/alteration/replacement 0 Other: 1 Qty. I Ea. v ,� ! 71 New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRuJCTION ,_ SFR(1)bath 312.70 ® 1-and 2-family dwelling 0 Commercial/u e. I.ial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 1 500.32 ❑Master builder Each additional bath/kitchen 25.02 ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE.INFORMATION AND LOCATION Site utilities: Job site address: it/2-7 SW Suzanne PL Catch basin or area drain 18.76 City/State/ZIP:Tigard Or 97223 Drywell,leach line,or trench drain 18.76 Suite/bldg./apt.no.: I Project name:Mission Meadows Footing drain(no.linear ft.: ) Page 2 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 Subdivision:Mission Meadows Water service(no.linear ft.:_) Page 2 I Lot no.: Fixture or item: Tax map/parcel no Backflow preventer 31.27 , z UtScR ION OF 'W Backwater valve iii 12.51 New Single Family Home Constriction Clothes washer 1 25.02 Dishwasher 1 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 " PRc)PEIt OwNE1 1 . JJ TEISTANT' Expansion tank _. 12.51 Name:Mission Homes NW Fixture/sewer cap 25.02 Address:PO BOX 1689 Floor drain/floor sink/hub 25.02 City/State/ZIP:Lake Oswego OR 97035 Garbage disposal 1 25.02 Hose bib 1 25.02 Phone:(503)5935324 Fax:(503)2148524 Ice maker 1 12.51 'AI APPI:I£ , 1T a CONTACT P ItsoN Interceptor/grease trap 25.02 Business name:Mission Homes NW Medical gas(value:$ ) Page 2 Contact name:Ben Dalbey Primer 12.51 Address:PO BOX 1689 Roof drain(commercial) 12.51 Sink/basin/lavatory 5 25.02 City/State/ZIP:Lake Oswego OR 97035 Solar units(potable water) 62.54 Phone:(503)5935324 I Fax::(503)2148524 Tub/shower/shower pan 3 12.51 E-mail:benldalbey@gmail.com Urinal 25.02 CONTRACTQR Water closet 3 25.02 Business name:The Mullen Company Water heater 1 37.52 Water piping/DVW 56.29 Address: 1601A SE River RD Other: 25.02 City/State/ZIP:Hillsboro OR 97123 Subtotal Phone:(503)6400113 Fax:( ) � Minimum permit fee: $72.50 CCB Lic.:92689 Plumbing Lic.no.:3 1--(20/6, Plan review (25%of permit fee) Authorized signature: State surcharge(12%of permit fee) TOTAL PERMIT FEE I Print name:Ben Dalbey I Date: 1-24-18 I This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\BuildingTermits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) I City of Tigard • COMMUNITY DEVELOPMENT NT DEPARTMENT _IIIRequest for q Permit Action 1 I t,A ut l> 13125 SW Hall Blvd. •Tigard,Oregon 97223 • 503-718-2439 •www.tigard-or.gov TO: CITY OF TIGARD Building Division 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPernuts@tigard-or.gov FROM: I� Owner Applicant 0 Contractor 0 City Staff REFUND OR Name: ( INVOICE TO: (Business or individual) elf-/1- Al 0,1 j V4-'1Mailing Address: Alf & X , / f 1 4:`.4 City/State/Zip: 4-)h? ()7 L-ve j 0 0R 1'7 d 3 5- Phone Phone No.: [03-s?3 7 ?2—V PLEASE TAKE ACTION FOR THE ITEM(S)CHECKED(1): ❑ CANCEL/VOID PERMIT APPLICATION. ❑❑ REFUND PERMIT FEES (attach copy of original receipt and provide explanation below). INVOICE FOR FEES DUE(attach case fee schedule and provide explanation below). J REMOVE/REPLACE CONTRACTOR ON PERMIT(do not cancel permit). Permit#: Site Address or Parcel#: L1 )7 /--s cj Project Name: /4 /55/ v AA��(( 1U1e c,,40u -.r Subdivision Name: 44/SS/un 4,,Levt5 Lot#: EXPLANATION: 3 ftl Y, P e1 Signature: 044-4"--4....--------- Date: (-9(),-/, Print Name: 8e,' 0,-A, Refund Policy 1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of: • Any fee which was erroneously paid or collected. • Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended. • Not more than 80%of the application or permit fee for issued permits prior to any inspection requests. 2. All refunds will be returned to the original payer in the form of a check via US postal service. 3. Please allow 3-4 weeks for processing refund requests. Route to Sys Admin: Date By Route to Records: Date Refund Processed: Date By Bp Invoice Processed: Date By Permit Canceled: Date By Parcel Tag Added: Date I:\Building\l orms\ReypetmitAction 092314.doc By City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 11427 SW SUZANNE AVE, TIGARD, OR, 97223 April 25, 2018 at 11 :52:46 AM Record Type: Record ID: Residential - Master Permit MST2017-00382 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS Comments: No ac installed. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 11427 SW SUZANNE AVE, TIGARD, OR, 97223 April 25, 2018 at 11 :51 :53 AM Record Type: Record ID: Residential - Master Permit MST2017-00382 Inspection Type: Inspector: 399 Plumbing final David Young Result: FA I L Comments: Fix hose bib in rear with no handle, broke off. Stopper not working correctly at main level bath, sink not filling to test overflow. No water pressure at master shower with sinks on or off. Fix items not working per installation requirements. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 11427 SW SUZANNE AVE, TIGARD, OR, 97223 April 27, 2018 at 12:06:30 PM Record Type: Record ID: Residential - Master Permit MST2017-00382 Inspection Type: Inspector: 399 Plumbing final Aaron Cillo-Gobel Result: PASS Comments: Corrections completed. Water pressure =60 psi Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 11427 SW SUZANNE AVE, TIGARD, OR, 97223 May 1 , 2018 at 7:10:08 AM Record Type: Record ID: Residential - Master Permit MST2017-00382 Inspection Type: Inspector: 299 Final inspection David Young Result: FA I L Comments: Provide approved approach and sidewalk inspection prior to building final inspection. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 11427 SW SUZANNE AVE, TIGARD, OR, 97223 May 7, 2018 at 3:01 :42 PM Record Type: Record ID: Residential - Master Permit MST2017-00382 Inspection Type: Inspector: 299 Final inspection David Young Result: PASS - NoCofO Comments: Correction from previous inspection complete. Final erosion control approved. Street tree certification received. Moisture content form received. Moisture barrier form received. High efficiency lighting form received. Blower door test report checked. Insulation certification checked. C of 0 left on site with approved plans. Violation Summary: Inspector Contractor fl. . .. TIGARD City of Tigard March 1, 2018 Mission Homes Northwest LLC Attn: Ben Dalbey PO Box 1689 Lake Oswego, OR 97035 Re:Permit No. MST2017-00382 Dear Applicant: The City of Tigard has processed a refund for overpayment of permit fees on the above referenced permit for the following: Site Address: 11427 SW Suzanne Ave. Project Name: Mission Meadows,Lot 4 Job No.: N/A Refund: ® Check#227730 in the amount of$28.02. ❑ Credit card"return"receipt in the amount of$ ❑ Trust account"deposit"receipt in the amount of$ Notes: A change in the scope of work to remove laundry tray resulted in overpayment of permit fees;refund difference. If you have any questions please contact me at 503.718.2430. Sincerely, Dianna Howse Building Division Services Coordinator Enc. I:\Building\Refunds\1 a s n\ efiaYfle 'ylOgOt9regon 97223 • 503.639.4171 TTY Relay: 53.684.2772 • www.tigard-or.gov City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Ifl M Request for Permit Action TIGARD 13125 SW Hall Blvd. •Tigard, Oregon 97223 • 503-718-2439 • www.tigard-or.gov TO: CITY OF TIGARD Building Division 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov FROM: ❑ Owner ❑ Applicant ,)Contractor ❑ City Staff Check(✓)one REFUND OR Name: INVOICE TO: (Business or Individual) /7/j Si c A,/ < /` e,,�&----.5- /rG,� z 7get f �� z Mailing Address: /0 4 6 f �V �C /7 City/State/Zip: 2_4—IL e C2SC)Z 6-O 0,...._ `'tis.$ Phone No.: C7 3 — 3,p/ —3 7.515 PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): • - VOID PERMIT APPLICATION. .Ii REFUN.v_DRMIT FEES (attach copy of original receipt and provide explanation below). •r INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below). D REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit). Permit#: /t/S7-.9--c) /7 2O .:3,f-.,2. Site Address or Parcel#: //4/02 7 eS S el, 2,9tiv,,,f c- "1-1,/&-.-- Project Name: �/S'5(0A) /-7 -;d CrzzS .i Subdivision Name: Lot#: it EXPLANATION: / 7 ?it,'?_'?_' /: P. ,6 , —u f'O//l y 7z ,/ /2-- —/A7 t Z/�-S /%-C,'-/ die-;e772/V/'T Signature: 1►' ,/j . " Date: `Vier Print Name: /, /A, " /fd7t,i5 ` Refund Policy '."-li L L- �Z- F /-71,1.74,6 -,v% {•4-- - E 1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of: • Any fee which was erroneously paid or collected. • Not more than 800/s of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended. • Not more than 80%of the application or permit fee for issued permits prior to any inspection requests. 2. All refunds will be returned to the original payer in the form of a check via US postal service. 3. Please allow 3-4 weeks for processing refund requests. Route to Sys Admin: Date By Route to Records: Date _a:/„ //' By Refund Processed: Date02/2 11,__ Invoice Processed: Date By Permit Canceled: Date.t//f B Parcel Tag Added: Date By L•\Building\Forms\RegPermitAction_092 14.doc 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 I (,,\f: I) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: J C DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED JAN 8 2018 FROM: / ..ed-N, a./ e CITY OF FIGAR s COMPANY: /55/04 /43v/ o he's BUILDING DMSIO " PHONE: $() 3 - f' 3-02—y By: i RE: /l tile? SV`-f,". ,7/7-e A-k-c. pf ra)/7 - 60_5,2_ (Site Address) mit Number) l5/rbe\ A dt 0,5- /or Perli Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: _Description: Copus: "I Description: Additional set(s) of plans. Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: PtMovc_ Lv� 5'i/il"r/{& 2 FOR OFFICE USE ONLY Routed to Permit Technician: Date: , g- f Initials: It Fees Due: E,Yes ❑No Fee Description: Amount Due: •s""Hr- pi Lrt rev... . J $ y.- $ $$ Special Instructions: Reprint Permit(per PE): kc Yes ❑No ❑Done Applicant Notified: ate: Initials: I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012