Permit (77) CITY OF TIGARD MASTER PERMIT
11,....„ .4
8: COMMUNITY DEVELOPMENT Permit#: MST2017-00364
Date Issued: 12/11/2017
T-[G ISD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.243• ,: I
Parcel: 2S104AD07400
e
(D j f Jurisdiction: Tigard
Site address: 12958 SW PARKDALE AVE
Subdivision: OLSON WOODS Lot: 10
Project: Olson Woods, Lot 10
Project Description: New SF. 6/6/18: REPRINTED permit to include A/C.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1551 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1973 sf Garage: 509 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes
Total: 3524 sf Value: $434,621.41 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0
Catch Basins: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Bckflw Prevntr: 0
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: 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: 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: 6 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 3524
Owner: Contractor:
WINDWOOD CONSTRUCTION INC MCM NORTHWEST LLC Required Items and Reports(Conditions)
12655 SW NORTH DAKOTA ST 5335 MEADOWS RD SUITE 250 1 Ersn Cntrl 503-639-4175
PORTLAND,OR 97223 LAKE OSWEGO,OR 97035 2 Geotechnical Inspection
Required before foundation
PHONE: PHONE: 503-319-9997
FAX:
Total Fees: $33,581.13
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 set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obt.'- - opy o e les or direct questions to OUNC by calling 503.232.1987 or 1.800.332.234 .
Issued By: <_., � Fermin tures L_WyC
. 1503.
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.
• CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENTIL
Permit#: MST2017-00364
TGA D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/11/2017
Parcel: 2S104AD07400
Jurisdiction: Tigard
Site address: 12958 SW PARKDALE AVE
Subdivision: OLSON WOODS Lot: 10
Project: Olson Woods, Lot 10
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1551 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1973 sf Garage: 509 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 3524 sf Value: $434,621.41 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0
Bckflw Prevntr: 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<10OK: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 6 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description:
Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 3524
Owner: Contractor:
WINDWOOD CONSTRUCTION INC MCM NORTHWEST LLC Required Items and Reports(Conditions)
12655 SW NORTH DAKOTA ST 5335 MEADOWS RD SUITE 250 1 Ersn Cntrl 503-639-4175
PORTLAND,OR 97223 LAKE OSWEGO,OR 97035 2 Geotechnical Inspection
Required before foundation
PHONE: PHONE: 503-319-9997
FAX:
Total Fees: $33,528.77
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 obta' of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.2
Issued By `3?��. < <� Permittee Signature: �L .R..t j
C ..&.%r
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Residential _ FOR 011 I( 1. L SI:OyLl
) ) 1 �.,- 5
City of Tigard „ Y,r :',, s , ;, ;;,_'Received
Date/By: /3)I � Permit No.: MTC'�"-!y.7 /j�
13125 SW Hall Blvd.,Tigard,OR 97223 N / , �.0 4
_ Plan Review B
Phone: 503.718.2439 Fax: 503.598.1960 s Other Permit: p `
Date/By: 1 o 9 )7IL�{ ...00-301
11 C;A R D Inspection Line: 503.639.4175 x C Date Ready/By: 60 4, Juris: See Page 2 for
Internet: www.tigard-or.gov No'fied/Metltod: U!trO/ / l Supplemental Information
x ;-
TYPE OF Wt +1,1 1 I DIVISION REQUIRED DATA:1-AND 2-FAMILY DWELLING
-k 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 ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORYOF CONSTRUCTION work indicated on this application.
1-and 2-family dwellingValuation: $�3431+ ^1
0Commercial/industrial f a
Number of bedrooms:
❑Accessory building 0 Multi-family S
❑Master builder 0 Other: Number of bathrooms: 3
`2�JOBB SITE INFORMATION AND LOCATION Total number of floors:a 40 3 3
i
Job site address: - 201,kete_ )�AQ New dwelling area:35aL_. square feet
City/State/ZIP: iapr
Al �2 (;l-1 2�2, Garage/carport area: 09 square feet
Suite/bldg./apt.no.: G Project name: O\'. 1,Aiy.x , L 10 Covered porch area: $ 0 square feet 19 73
Cross street/directions to job site: , t,a u,-) \0J
,-) 1L,1J �- Deck ara: 19a square feet Lys- i
Rher s <cture area: )ga square feet
Govw
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: c:11.,.1 c9,5 Lot no.: 10 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.
�eti- 5�� Valuation: $
Existing building area: square feet
New building area: square feet
44 PROPERTY OWNER
et] TENANT Number of stories:
Name: \ \,-0( /6 Yr LIC Type of construction:
Address: s-2)3, - kA pc.cs)CL 9j .3t v_k_c_ _A.-Km Occupancy groups:
City/State/ZIP: 1_,,,.!,432._ CSu.Jeym1 u g7O. Existing:
Phone:(Sa3 ) 1,i - 4c5,q--7 Fax:( )
New:
{ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: (Please refer to fee schedule)
K x ,1/4,,,,,,Q0-1,LA),..sA-k_..i..i.
Structural plan review fee(or deposit):
Contact name: h,.Ao-}- kJI(4.%-:c-Qi�
n FLS plan review fee(if applicable):
Address: S3124- M.e.�ytt.. 2J‘ - „,,,\t_i -)C--.0
City/State/ZIP: 9 Total fees due upon application:
oAc2 ,0,0 : c z q-7c3S'
Phone:( 2, 314-94g�
) Fax::( ) Amount received:
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
�# --Q M(.414A0/Nl4Afi-e S� . C a il,‘
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Submit two(2)sets of roof plan with connection details
Business name: 54A At, �g Q
and fire department access,along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
City/State/ZIP: Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( ) Fax:( )
State surcharge(12%of permit fee): $21.60
CCB lic.:
Ie yi4,g, 87 s-y G/�9
!� Total fee due upon application: $201.60
Authorized signature: J
P`/ V�I�y....4 This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: i;. IL AcO �ill._ Date: q P 2 0 �--)
*Fee methodology set by Tri-County Building Industry
1 Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling roll orr►cl: I sI: o�l.�
City of Tigard ReceivDate/Bea Permit No.:
gl 13125 SW Hall Blvd.,Tigard,OR 97223 y
g Associated permits:
■ Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
T I L A K l7 Internet: www.tigard-or.gov 0 Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW les No N1
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. • • •
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0
3 Verification of approved plat/lot. 0 0 0
4 Fire district approval required. Name of district: • 0 0 0
5 Septic system permit or authorization for remodel. Existing system capacity 0 0 0
6 Sewer permit. 0 0
7 Water district approval. 0 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0 0
9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 0 0
basin •rotection,etc.
10 a iiii+ Must be drawn to scale,showing conformance to applicable local and state • ■ ■
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ❑ 0 0
there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements
and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction
indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and
surface drainage.
12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size 0 0 0
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 0 0 0
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- 0 0 0
floor,wall construction,roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings
and foundation,stairs,fireplace construction,thermal insulation,etc.
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. 0 0 0
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- 0 0 0
prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing 0 0 0
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 0 0
systems,see item 22,"Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists 0 0 0
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. 0 0 0
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 0 0
for four or more appliances.
22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or 0 0 0
architect licensed in Oreton and shall be shown to be as Ilicable to the ,ro•ect under review.
It RISDICTIONAL SPECIFIC'S
t&• - ""°""-i e required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17. ■ ■ ■
24 Two(2)sets each are required for Items.4•6,-9, and- -above.
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 0 0 0
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 0 0
27 "Drawn to scale"indicates standard architect or engineer scale. 0 0 0
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 0 0
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 0 0
and protection measures must be drawn to scale and must include the project arborist's signature of approval.
30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, 0 0 0
including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9, 1995.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Application FOR OFFICE USE ONE)
City of Tigard Received
g Date/By: Permit No.: .s ',
_ 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.196(1 , 4 x ' A Date/By: Other Permit:
Aa TI G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: Eif See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
i
TYPE OF W COMMERCIAL FEE* SCHEDULE USE CHECKLIST
,�I `" t 'A." Mechanical permit fees*are based on the value of the work
(21 New construction ❑Addition/alteratlonLrQpl0cement performed.Indicate the value(rounded to the nearest dollar)of all
�" mechanical materials,equipment,labor,overhead,and profit.
❑Demolition 0 Other:
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
(V 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist.
0 Multi-family 0 Master builder ❑Other: Description Qty. Ea. Total
JOB SITE'INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: Ml e�.�-$ 17ø'b '„/Q� •� Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: fL Ail. Furnace 100,000+BTU(ducts/vents) 54.91
1 wford 1 Q�- a�122�
JJ Heat pump 61.06
Suite/bldg./apt.no.: Project name: 01c,,e) kk. k5 Duct work 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
Subdivision: 1 ^� n Other: 23.32
o1Cx I CSS Lot no.: \(:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
EPTITOFOR !, ,1 Gas fireplace/insert 33.39
Flue vent for water heater or gas
ijp(,1 SFS 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 ': 0 TEN,
Other: 23.32
"��` �� "� ''�� '�� �`'�` T .'e,' eA Environmental exhaust and ventilation:
Name: kAC I^ vo 1oc54_ L ti..., Range hood/other kitchen
Address: �I equipment 33.39
�S 1J`yeC4CC 2�A �(.t cf..c44--/c--D
Clothes dryer exhaust 33.39
City/State/ZIP: L,ke �� 0Z 4 7t)'�S— Single-duct exhaust(bathrooms,
S l toilet compartments,utility rooms) 23.32
Phone:(263) 3iel— -) Fax:( ) Attic/crawlspace fans 23.32
( 'APLICAPI 'Ai [ f C0 e Other: 23.32
Business name: , Fuel piping:
>G1t�C. 05 `^'r $14.15 for first four;$4.03 for each additional
Contact name: A i /'C(2 ,jf,` Furnace,etc.
Address: '` Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace
Range
E-mail: MB( 6 vicirifty"ht esiz CTMh Barbecue
''"st a'e.e,e- " -,. GONT ? TQ �ke ,; ''''''''0 Clothes dryer(gas)
=gree* eeee„.:,. tame- ee,s." Nike 'et;y:.. "`)'
Business name: 1' (( Other:
1":(5 (r E` ITds,l- ,'MEcHAMI�``L P IITT+' ES*,x;'.
/ "� t
Address:
3150 (1 at C 6rt1 s �0Et- j7r Subtotal
City/State/ZIP: Cavo,,on C f t � Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(5--t6) 2_2,1 _ 33 I l Fax:( ) State surcharge(12%of permit fee)
CCB lic.: 72(0 23 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
4 days after it has been accepted as complete.
Authorized signature: r, I * Fee methodology set by Tri-County Building Industry Service Board
Print name: ► ►$/i11 _, _;V, Date: 6,12ci 17
I.\Building\Permits\MEC_PermitApp_0401 .doc 440-4617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to$500.00 Minimum fee$69.06
$500.01 to$5,000.00 $69.06 for the first$500.00 and
$3.07 for each additional$100.00 or
fraction thereof,to and including
$5,000.00.
$5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and
$2.81 for each additional$100.00 or
fraction thereof,to and including
$10,000.00.
$10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and
$2.54 for each additional$100.00 or
fraction thereof,to and including
$50,000.00.
$50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and
$2.49 for each additional$100.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first$100,000.00 and
$2.92 for each additional$100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I:\Building\Permits\MEC_PermitApp_040113.doc 2
i
Electrical Permit Application FOR 01 F 'I: I'SE ONLv
City of Tigarde r"' ID°eceived/B EMEMIMINE
r
q 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
C Phone: 503.718.2439 Fax: 503.598.1960DateB Related Permit#:
Inspection Line: 503.639.4175 ReadyDate/By: loris:
T 16 A R D r T ( 11� ' H See Page 2 for
Internet: www.tigard-or.gov i0 C 1 �r j.l.' Notified/Method: Supplemental Information
. TYPE WORKrrrti OFTIC IkitiVg , „ ' PL4N itEVIE v. 5,r. ,..,
®New construction 0 Addition/alteration placement Please check all that apply(submit 2 sets of plans w/items checked):
r. ❑Service or feeder 400 amps or more ❑Building over three stories.
0 Demolition 0 Otherwheretheavailable
—1.!'":
x y il avaz a e fault current ❑Marinas and boatyards.
,,, A � ST if`N , - 4.1' ,.., 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:
❑Fire pump. 0 Installation of 150 KVA or
„ „ JOB SIS 11? A ION i )CATION 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address:4Si8 SW Parkdale Ave I00HP or more. ❑"A","E","t-2",°`t-3",
City/State/ZIP:Tigard,OR 97223 11-1-3-6 ❑Six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Olson Woods ❑Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site:SW Walnut St
r ,. . FEE �EDIJLE:r
Description I Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision:Olson Woods Lot#:10 Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
�y yt a.add'I 500 sq.ft.or portion 33.92 1
u � EA O of q f'4 a. 'g,"tA
��� „° -� • �„ �� �-���. - ��. x �x� Limited energy,residential
75.00 2
New SFR (with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
AePROPERTY U ER C ' ,Q'TENANT Services oer Eneedregrys installation,alteration,
Paagnd2/o
r relocation
Name:MCM Northwest LLC 200 amps or less 100.70 2
Address:5335 Meadows Rd Suite#250 201 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)319-9997 Fax:( ) 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
Branch circuits—new,alteration,or extension,per panel
"' " `pN A.Fee for branch circuits with
Business name:Same as above above service or feeder fee, 7.42 2
each branch circuit
Contact name:Matt McBride B.Fee for branch circuits without
Address: service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP: Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax: :( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email:matt@mcmnorthwest.com Reconnect only 67.84 2
;;.: - .. CONTRACTOR .
v iPump or irrigation circle 67.84 2
Business name:Dreamhouse Electric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address: 13075 SW Canyon Rd panel,alteration,or extension. 0 See Page 2 2
City/State/ZIP:Beaverton,OR 97005 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(506)648-5144 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:dreamhouseelectric@gmail.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 196726 Electrical Lic.:C g Suprv.Lic.: y�j specifically listed(Y2 hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: C Av\s ! 1, ti lI Subtotal:
Print name: Chris Mahoney 0 ate: 9/20/17 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: //c,', ,,tcc 4,I A.,. TOTAL PERMIT FEE:
V' �`Vlx�� This permit application expires if a permit is not obtained within 180
Print name: Chris Mahoney Date: 9/20/17 days after it has been accepted as complete.
* Number of inspections allowed per permit.
1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
Electrical Permit Application—City of Tigard
Page f—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY =. Ey I
Fee for all residential systems combined: $75.00 Description I Qts., Each � Total I
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
El Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is
90.00/ r
specifically listed(V2 hr min)
COMMLRC WOR ONLY.
ELECTRICAL .
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
(SEE OAR 918-309-0000) * Number of inspections allowed per permit.
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015
Plumbing Permit Application
Building Fixtures FOR OFFICE USE ONE.v
` City of Tigard •
Received
Permit No.: �y
Date/By: STS�'/"C3l
13125 SW Hall Blvd.,Tigard,OR 11)22 Lf
■ Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
Date/By: Other Permit No.:
TIG A R 17 Inspection Line: 503.639.4175 1, 1 Date Ready/By: Jur H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
; TYPE OF moon!OF 1C4R9 FEE* SCHEDULE
Eil New construction ,D Demolition :: For special information use checklist
Description I Qty. Ea. I Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OFNCONSTRUCTION X SFR(1)bath 312.70
p 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building ❑Multi-family SFR(3)bath 500.32
❑Master builderEach additional bath/kitchen 25.02
0 Other: Fire sprinkler( sq.ft.) Page 2
y JOBS E;°INFORMAflON4AND.LOCATION Site utilities:
- 12.61
Job site address ' 5> pc( (t_ Catch basin or area drain 18.76
Drywel
City/State/ZIP: 3a (I q-p FFootinl leach
linear ft trench line,or drain 18.76
Footing (no. _) Page 2
Suite/bldg./apt.no.: Project name: ôí - w s Manufactured home utilities 50.03
Cross street/directions to job site: ) (A15,14 u,{ 1- 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: n
01.50,\ ct�l�xQS Lot no.: rb Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
ESCiUPtiON OF WO Backwater valve 12.51
Clothes washer 25.02
k2 e_i,` S(r_1Z
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
.PROPERTY OWNER'' I cl TE iAN Expansion tank 12.51
Name: A .L (t u_L Fixture/sewer cap 25.02
�l� Floor drain/floor sink/hub 25.02
Address: . ;.3 - c, Rd. 5i., 4Y ' �fic.
Garbage disposal 25.02
City/State/ZIP: L s>/G 2 Oa`t3 n I Cat ,3-7(335-
"' Hose bib 25.02
Phone:(sr ) 3/05_ ✓7 Fax:( ) Ice maker 12.51
'..APPLICANT - [] CONTACT PERSON Interceptor/grease trap 25.02
Business name: 1,4.4(_. as /i� Medical gas(value:$ ) Page 2
Contact name: V " MC,!i(1
Primer 12.51
62-
Roof drain(commercial) 12.51
Address:
Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
E-mail: _d Urinal 25.02
11 Ill n,'7 h�1g,'(d1^ Water closet
25.02
CONTRACTOR
'':,, Water heater 37.52
Business name: !�i (-�� ,f.~ PL._L_, �5 Water piping/DWV 56.29
Address: I 11 O . RI l ht-Co ar Q Other: 25.02
City/State/ZIP: orae C c t t12co o,fs- Subtotal
Phone:
D3) -]-Z 3_ gg p O Fax:( ) Minimum permit fee: $72.50
CCB Lic.: ( i2 i le? Plumbing Lic.no.: Plan review (25%of permit fee)
3�53a aQli State surcharge(12%of permit fee)
Authorized signature: r k Gir"�n
1` l TOTAL PERMIT FEE
Print name: D I 1.1„,-, Date: Giin 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:\Building\Permits\PLMU-PemiltApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities , Fie(ea) °tal ` Square Footage: Permit Fee:
Footing drain-1 t 100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52 -,
Valuation: Permit Fee:. n �'
Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Fee f o i each additional$100.00 or fraction thereof,to
Other Inspections or Fees Q ( ) and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
each additional$100.00 or fraction thereof.
(minimum charge-1/2 hour)
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*. Plan Review for Plunl<'bing Installatio!ls
Quantity by Fixture`type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate ❑ Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower engineer.
-Jacuzzi/Whirlpool 0 New exterior plumbing site utilities for any complex structure
Car Wash: -Each Stall as defined in OAR918-780-0040.
-Drive Thru
0 Medical gas and vacuum systems for health care facilities.
Cuspidor/Water Aspirator
-Commercial 0 Any multipurpose fire sprinkler system.
Dishwasher: - ommeommeic 0 Any complex structure as defined in OAR918-780-0040.
-D
Drinking Fountain Submit 2 sets of plans with any of the above.
Eye Wash
Floor Drain/sink: -2"
3„ Isometric or Riser Diagram
4"
0 Isometric or riser diagram is required for new buildings
-Car Wash Drain that meet the qualifications above.
Garbage -Domestic non-food
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -Lav/Bar non-food related
-Bradley
-Com/Serv/Util food related
-Service *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and
Washer-Clothes fees assessed for the sewer increase must be paid before the
Water Extractor plumbing permit can be issued.
Water Closet-Toilet
Urinal
Other Fixtures:
I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2
City of Tigard
11 . .. COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review — Residential
e
Building Permit #: PSTc t 7—CO
Site Address: /o?q 5q St,U ,,v-L oCIR_ Xve
Project Name: 0150 Gcr.,S . Lot #: `n
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: A)e ) . *fl
JXCTerify site address/suite# exists and active in n't system.
❑ River Terrace Neighborhood: i� No ❑ Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
4?" -I1 ree(3)copies of site plan -'B£� . ' tures on site
tte plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished
ra n to scale(standard architect or engineer scale) floo levations
,01corth arrow locations&easements(required for new and additions)
ite address,project or subdivision name and lot number t ewalk/driveway approach
,P-A— information(name and phone number) -]T tion --"wells/septic systems
of dimensions and building setback dimensions ting trees to be retained with drip line,and tree
0o age of buildings to be demolished pro ection measures
coverage area,percentage of coverage and treett tree size,type and location
inr�perviou ,tJ
s-area(applicable if R-7,R-12,R-25&R-40) gtreet names
.1Ci‹.erty corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? es No
4 foot differential) If yes,is a storm water quality facility shown? ❑Yes.12-2dbS
)ch"
Clean Water Services-Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified 2'No Received: ❑ Yes ❑ No
iiblic Facilities Improvement(PFI) Permit: pF/ oZ.e:)/5-O0076
Required: ❑ Yes,applicant was notified 2--No Applied For: ❑ Yes ❑ No,stop intake
,B-Land Use Case#: S uE DO/2/- OCoO F
0---coning: R_11,5
Required Setbacks: Front Vo Rear 15 Side 5 Street Side I c Garage Q
❑ Landscape Requirement: •----- %
❑ Lot Coverage Maximum: __
ee"Building Height: Maximum Height t) Actual Height
_Visual Clearance
.2"-Sensitive Lands: ❑ Yes 4-No Type
Jrban Forestry Plan
Conditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: Date: Q
37
Revisions (after Building Submittal on y Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw REs o61417.docx
Building Permit Submittal
Original Submittal Date: (e3/0
Site Plans: # 3
Building Plans: # 3
Building Permit#: iter building permit#above.
Workflow Routing: Q.P ening engineering —ermit Coordinator uilding
Workflow Sign-off: Z.-at-gm-off for Planning(include notes from planning review)
Route Application Documents: ®'engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original
plan review routing form.
l5"Swlding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: 1 Date: lJ��7
Engineering Review
Slope at building pad: A,;
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 No
Assess Water Quantity Fee in-lieu: ❑ Yes No
LIDA Facility on lot: ❑ Yes No
❑ NOT Approved by Engineering: `/ Date:
Notes:
Approved by Engineering: ADate: .717
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
7 SDC Fees Entered: Wash Co Trans Dev Tax: r.: Yes N/A
Tigard Trans SDC: Its Yes i! N/A
Parks SDC: Yes ii.N/A
LIDA ❑ Yes N/A
OK to Issue Permit Approved by Permit Coordinator: 4/FS Date: /4/47//.2"----
I:\Building\Forms\BldgPennitRvw_RES_061417.docx
/ 9 /I:\Building\Forms\BldgPermitRvw_RES_061417.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12958 SW PARKDALE AVE, TIGARD, OR, 97223 June 7, 2018 at 11 :12:30 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00364
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS
Comments:
Corrections complete.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12958 SW PARKDALE AVE, TIGARD, OR, 97223 June 7, 2018 at 11 :14:37 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00364
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12958 SW PARKDALE AVE, TIGARD, OR, 97223 June 6, 2018 at 12:46:36 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00364
Inspection Type: Inspector:
199 Electrical final David Young
Result:
FA I L
Comments:
Provide permit for ac installed without permit.
Front exterior recessed lights above garage not finished.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12958 SW PARKDALE AVE, TIGARD, OR, 97223 June 6, 2018 at 12:44:38 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00364
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
FA I L
Comments:
Provide permit for ac installed without permit.
Provide impact protection for furnace appliance in garage in path of travel. M1307.1
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12958 SW PARKDALE AVE, TIGARD, OR, 97223 June 7, 2018 at 11 :13:53 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00364
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS
Comments:
Corrections complete.
Protection Ballard installed.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12958 SW PARKDALE AVE, TIGARD, OR, 97223 June 11 , 2018 at 9:17:20 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00364
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