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Permit (113) CITY OF TIGARD MASTER PERMIT IN--- 411 COMMUNITY DEVELOPMENT Permit#: MST2017-00498 T 1 A;RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/27/2017 Parcel: 2S109AC06700 Jurisdiction: Tigard Site address: 13249 SW MADDIE LN Subdivision: MADELINE HEIGHTS Lot: 5 Project: Madeline Heights, Lot 5 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 5 First: 1384 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1508 sf Garage: 494 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2892 sf Value: $357,414.21 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 Drains: 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw 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: 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'I 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 2892 Owner: Contractor: LENNAR NORTHWEST INC LENNAR NORTHWEST INC Required Items and Reports(Conditions) 11807 NE 99TH ST STE 1170 11807 NE 99TH STREET SUITE 1170 1 Ersn Cntrl 503-639-4175 VANCOUVER,WA 98682 VANCOUVER,WA 98682 PHONE: PHONE: 360-949-9128 FAX: 360-258-7901 Total Fees: $31,897.26 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 0 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. i a Issued By: 'C.( I,, 1 i - . Permittee Signature: cG of/i&L- /L r.G1 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 t . .. , .., , ... INN t10- Residentlal FOR OFFICE USE ONLY Cityof Tigard Received `� 7 A zr 1 I J %/� Permit No./1157:20/�ry j II r 13125 SW Hall Blvd.,Tigard,OR 97223 tt,�c A % c Plan Review Phone' 503.718.2439 Fax: 503.598.1960ll Date/By. ��-��� Other Pen-n.:.54.,./19 �7'lid ii� T I GA R D Inspection Line: 503.639.4175 %` "�' Date Ready/By: Juris: See Page 2 for Internet: www.tigard-or.gov ,2,1A , �AS !.Notified/Method: l /A 0' / Supplemental Information • „> 4" , '-, �. ` @ '&1:1-fesc'? Ya e s B TIP,,,:.:4t,,,,,,,,OF '' REQ IREAu)ATA''''f'',71- 11' L 1 p IMiNew 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 - CATGORY SRt 9 . r , work indicated on this application. sdC . , fi.- : LL [�1-and 2-family dwelling ❑Commercial/industrial Valuation: $ 352, III Accessory building ❑Multi-family Number of bedrooms: 5j 3 S 7/ Lt) tt//1 LI Master builder El Other: Number of bathrooms: 3 1. ©1 o t 8 6 �. :W Total number of floors: 2 33 Job site address: 13249 SW Maddie Lane New dwelling area: 2892 square feet City/State/ZIP: Tigard, OR 97223 Garage/carport area: 494 square feet Suite/bldg./apt.no.: Project name: Covered porch area: i square feet'S^b B Cross street/directions to job site: Deck area: square feet)3 814. er stru e 1 square feet y mac. I REQ R.t-D I t i l Subdivision: Madeline Heights Lot no.: 5 Permit fees*are based on the value of the work performed. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the ]I 1° �tl�QtT,iRTK - ' work indicated on this application. NSFR Valuation: $ Existing building area: square feet New building area: square feet P ' OPER O ER it *WI E iVANC1,1 ri Number of stories: Name: Lennar NW Inc. Type of construction: Address: 11807 NE 99th Street,#1170 Occupancy groups: City/State/ZIP: Vancouver, WA 98682 Existing: Phone:(360)258-7900 Fax:(360 ) 258-7901 New: I APPL1C '%',',i,,,,ia :; '?E ,: .., .; d - 7 ����PERSON i4 � x` t `BiTIIDING PEPIV�T'iN CESS* 1- " .,-t-,: (Please refer to feesclredute ;:` .. .-:2.-'„,; '!Pkg. Business name: Lennar NW Inc. Structural plan review fee(or deposit): Contact name: Juls Call FLS plan review fee(if applicable): Address: SAME AS ABOVE Total fees due upon application: City/State/ZIP: Phone:(360-)258-7906 Fax::( ) Amount received: E-mail: juls.call@lennar.com - ,P?OTO O TA1OSOL RPANELSY = MMES*, i t a i, 1 , Commercial and residential prescriptive installation of t Clf Oimooi, ,w. . -4i!:-1,- _ -%�.£•�=�,- �-, � �_ ._. ��n ��ry.; ;—�, Va . ., _;,} roof-top mounted Photovoltaic Solar Panel System. Business name: SAME AS ABOVE Submit two(2)sets of roof plan with connection details 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 lie.: 195307 Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Date: *Fee methodology set by Tri-County Building Industry Juls Call Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Applicatio �' FOR OFFICE USE ONLY of ,] ,�° *` - '"4 t" Received City Tigard Date/By: Permit Ns , /7„,. j'9 11/41 a . 13125 SW Hall Blvd.,Tigard,OR 97223 1711 Phone: 503.718.2439 Fax: 503.598.1960Date/By:n Review 3 1 �+ Other Permit: Inspection Line: 503.639.4175 t. .�'' �I Date Read B Juris: See Page 2 for TIGARD Ready/By: S Internet: www.tigard-or.gov Notified/Method: Supplemental Information CITY O T IGA .1. TXPk=OF .`r 4}I I I ' COIrw-KIAL TEE*.SCHEDULE USE 4 HLGKLIST'; gn .,; '...,.. ''-'' is t-. . . .:1� . .. . . .o Mechanical permit fees*are based on the value of the work [ New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Y .. Value:$ ini lipitp ;o- ,1 OFi O UGIOIz , , -im ... . , RESIDE ' QUII'MENT1,sy SFEES* 121'1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total Heating/cooling: . ,..milliga, -*fit pB SITE INFORM 'vA4N.RXO,pATTOI, ,., . .< Air conditioning 1 46.75 46.75 Job site address: 13249 SW Maddie Lane Furnace 100,000 BTU(ducts/vents) 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: 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: Lot no.: Other: 23.32 Madeline Heights 5 Other fuel appliances: Tax map/parcel no.: Water heater 1 23.32 23.32 aD u Ei I® 0;',, ,p f ! ,` Gas fireplace/insert 1 33.39 23.32-.,- .: . - ;. . r „ T: . . '« a1 . _. Flue vent for water heater or gas NSFR fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 23.32 141';16'':- .OFERT, i', .,; =I '*`' 0 R ' *:'' - Environmental exhaust and ventilation: Name: Lennar NW Inc. Range hood/other kitchen equipment 1 33.39 33.39 Address: 11807 NE 99th St.#1170 Clothes dryer exhaust 33.39 City/State/ZIP: Vnacouver, WA 98682 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 4 23.32 93.28 Phone:(360) 258-7900 Fax:(360) 258-7901 Attic/crawlspace fans 23.32 to E(APPLI T `1, 41) ` e , ® ACT PERSON P;V< Other: 23.32 Fuel piping: Business name: SAME AS ABOVE $14.15 for first four;$4.03 for each additional Contact name: Juls Call Furnace,etc. Address: Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:(360)258-7906 Fax::( ) Fireplace Range E-mail: juls.call@lennar.com Barbecue � � � -- 3 Clothes dryer(gas) �„ � yl- 4 „ W rCf Other: Business name: Development Northwest Inc. dba Wolcott Plumbing ME,C[I�1l�1TG:-.:I'FBMIT FEES*,, t. _y- Address: 1075 W Historic Columbia River Hwy Subtotal $220.06 City/State/ZIP: Troutdale, OR 97060 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:( 503) 667-1781 Ext. 3007 Fax:(503 ) 667-9891 State surcharge(12%of permit fee) CCB lic.: 112220 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board Print name: Dennis L. Dunning Date: 10/19/17 IBuilding\Permits\MEC PermitApp_040113.doc 440-46t7T(11/02/COM/WEB) Electrical Permit ApplicationR ' i _ FOR OFFICE USE ONLY City ofTigard Received MJ 7— /� `J g !) DateB Permit#:/! L � 111 ® 13125 SW Hall Blvd.,Tigard,OR 97223 F 1. 1 3 C 011./ Plan Revie• w a Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#: Inspection Line: 503.639.4175 ', tf. d e_ 3qy� Ready Date/By: Ions: 61 See Page 2 for TIGARD Internet www.tigard-ongov $ h lan, Notified/Method: Supplemental Information . _1161 '€) t lr i `TYPE OF_,e. i i ro. V . ..__. ,t •,.... -48110, . °` ._ � �.. . „ 1P1LAN IiEyIEW ,`� �:r g New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards. TAM.A45-4.;„ "�-4 SP-i CAIPGORY OF CONSTRUCTION„ „ .._` exceeds 10,000 amps at 150 volts or `� - f � 0 Floating buildings. f 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or it,V z" `-�`c � JOR.SITE FORMATIO �I.ND OGQ1,'TJO:T �,_ ` ❑Emergency system. larger separately derived Job#: Job site address: 1R 2. „3249 SW Maddie Lane y 0 Addi100HP otionr ofmnewore. 0 motor load of system. City/State/ZIP: Tigard, OR 97223 ❑Six or more residential units. ooccupancy. ❑Health-care facilities. ❑ ecreational vehicle pazks. Suite/bldg./apt.#: Project name: ❑Hazardous locations. ID Supply voltage for more than ❑Service or feeder 600 amps or more 600 volts nominal Cross street/directions to job site: 22t7,F: ' ;1, E1'`SCHEDULE „ ,.ice Description I Qty. I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision: Madeline Heights Lot#: 5 Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel# � t O Ea add'l 500 sq.ft.or portion 33.92 1 �. - :_ :,'. ;. -v-_ I .NC � ,.. _ _• t .;,-;iiiirrlie Limited energy,residential 75.00 2 NSFR (with above sq.ft.) Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewesableor Energy ❑ See Page 2 '�14 PRO I I r * 7__. _� 1 ..,. .,. ,'I ,_ . TE.' 1`4T`'- ..� . , ' Servicinstallation,alteration,and/or relocation Name: Lennar NW Inc. 200 amps or less 100.70 2 Address: 11807 NE 99th St. #1170 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: Vancouver, WA 98682 601 amps to 1,000 amps 301.04 2 Phone:(360 )258-7900 Fax:(360 ) 258-7901 Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: 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 `'<` "31 S$,:,::::::2, , ,,.:,,,._ '`. `a` OONTAOT�PERSON' `., A.Fee for branch circuits with Business name: Same as above above service or feeder fee, each branch circuit 7'42 2 Contact name: J u is Call 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: Huls call@lennar corn Reconnect only 67.84 2 ii. . ;, .` itI 0:NTRACITOR, ` "`,.,.. . r;;.,,.. „ Pump or irrigation circle 67.84 2 Business name: Lantil LLC dba Three Phase Electric Sign or outline lighting 67.84 2 Address: Signal circuit(s)or limited-energy 0 See Page 2 2 11490 SE Jennifer St. panel,alteration,or extension. City/State/ZIP: Each additional inspection over allowable in any of the above Clackamas, OR 97015 Additional inspection(1 hr min) 66.25/hr Phone:( 503) 908-8058 Fax:(503 )726-1823 Investigation(1 hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr rlane@threephaseelectric.com Inspections for which no fee is CCB Lic.: 162368 Electrical Lic.: 3-332C Suprv.Lic.: 3398S specifically listed(%hr min) 90.00/hr $ t Suprv.Electrician signature,required: =.. - ELECTRICAL PERMIT FEES„ `fr .; «,: e,�'•"'"�' , ''L Subtotal: Print name: Dennis Welch Date: 10/23/17 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: — ,,,...—e.---,---Q._. TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Robert Lane Date: 10/23/17 days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC PermitApp ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: S xEsinErlTlAi waxx arr><,Y,. 5 ,Y4OgIOn. .' FE y CHEDTJLE # "`_ . Description I Qty. I Each I Total I * Fee for all residential systems combined: $75.00 Renewable electrical energy systems: 5 kva or less 100.70 2 Check Type of Work Involved: 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 50.0IV Garage Door Opener* >100 kva(to fee kva 552.26 2 >100 in accordance 552.26 2 with OAR 918-309-0040) 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 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listedl' JO (rh hr mm) 'Jc =x= _ _ Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC I I Instrumentation ❑ Intercom and Paging Systems n Landscape Irrigation Control* ❑ Medical n Nurse Calls ❑ Outdoor Landscape Lighting* n Protective Signaling ❑ Other: Total number of commercial systems: _ *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_PermitApp_ELR ERE.doc Rev 06/17/2015 Plumbing Permit Application C • ,Building Fixtures Ft, � ' �" FOR OFFICE USE ONLY Cityof Tigard Received ilie 131SW Hall Blvd.,Tigard,OR 97223 a� i Date/By: Permit No./17:5 i�/7_eje�lp� �` Phone: 503.718.2439 Fax: 503.598.1960 D E�' 9 1-111 DPate/By: Review Other Permit No.: Inspection Line: 503.639.4175 DateBy: T I G A R D Internet: www.ti and-or. ov 1 4--,' I-,q, F'pp Date Ready/By: Juris: H See Page 2 for g g C 11 ° I t,DAKI1Notified/Method: Supplemental Information r 14 *-K TYPE SOF kWO J . - is Vt N . _ lige , FEF- SCHEDULE i p2 New construction ❑Demolition For special information use checklist Description I Qty. I Ea. I Total ❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) 2 0, k . CATEGORY`O `C:WOWcTION< -..000040;000000:v00000 SFR(1)bath 312.70 ® 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 III Accessory buildingSFR(3)bath 1 500.32 500.32 El Multi-family Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 x11 iii 1 ORMATION$ LOAj N aSite utilities: . . Catch basin or area drain 18.76 Job site address: 13249 SW Maddie Lane 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: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: Madeline Heights I Lotno.:5 Fixture or item: Tax map/parcel no.: Backflow preventer 1 31.27 31.27 -01,4 _ I ' Backwater valve 12.51 NSFR Clothes washer 1 25.02 25.02 Dishwasher 1 25.02 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 y, _`` PROPER ,--O x0- 0 ' Expansion tank 12.51 Name: Lennar NW Inc. Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 11807 NE 99th St.#1170 Garbage disposal 1 25.02 25.02 City/State/ZIP: Vancouver,WA 98682 Hose bib 2 25.02 50 04 Phone:(360)258-7900 Fax:( 360) 258-7901 Ice maker 12.51 t0; I„ pLGANTnlig '.., Q 'TAPERSON Interceptor/grease trap 25.02 Medical gas(value:$ ) Page 2 Business name: SAME AS ABOVE Contact name: Juls Call Primer 12.51 Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 5 25.02 125.10 City/State/ZIP: Solar units(potable water) 62.54 Phone:(360)258-7906 Fax::( ) Tub/shower/shower pan 3 12.51 37 50 E-mail: Juls call@lennar com Urinal 25.02 - -. io - , Water closet 3 25.02 75.06 ., rte`" _ 4- COON-WRT4OR 4 t F ioi .. �'" Water heater 1 37.52 37.52 Business name: Development Northwest Inc., dba Wolcott Plumbing Water piping/DWV 56.29 Address: 1075 W Historic Columbia River Hwy Other: 25.02 City/State/ZIP: Troutdale, OR 97060 Subtotal 931.87 (503) 667-1781 ( 503)667-9891 Minimum permit fee: $72.50 Phone: Fax: CCB Lic.: 112220 Plumbing Lic.no.: 26-824PB Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: tie ,a4t ol TOTAL PERMIT FEE Print name: Dennis L. Dunning Date:10/19/17 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-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) City of Tigard i i ® COMMUNITY DEVELOPMENT DEPARTMENT T I G A R D Building Permit Review — Residential Building Permit #: /7377,20/7—Old 4/98 Site Address: M4I1 SW ilk J i k Project Name: k kL,\-t lk 9 03 Lot #: g (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: C ,A,. S- n,. S F 1° E21 V rift'site address/suite# exists and active ' permit system. ver Terrace Neighborhood: o ❑ Yes,See River Terrace Review Addendum Attached Sit Ian Elements: ree(3)copies of site plan /2 ' • sting structures on site ite plan must be on 8-1/2"x 11"or 11 x 17"paper E ootprint of new structure(including decks)with finished awn to scale(standard architect or engineer scale) fl r elevations Orth arrow ty locations&easements(required for new and additions) tSe address,project or subdivision name and lot number idewalk/driveway approach L` plicant information(name and phone number) ❑ ation of wells/septic systems L`1Lot dimensions and building setback dimensions sting trees to be retained with drip line,and tree Zis uare footage of buildings to be demolished protection measures t area,building coverage area,percentage of coverage and 'Syreet tree size,type and location pervious area(applicable if R-7,R-12,R-25&R-40) treet names DProperty corner elevations (2 foot contour lines if more than >1,000 sf of impervious area created or replaced? W Ye' s No 4 .of differential) If es,is a storm water suali facili shown? 0Y1 51.!No P. Clean Water Services—Service Provider Lettterr of platted prior to 9/10/1995): equired: ❑ Yes,applicant was notified Lid'No Received: ❑ Yes ❑ No ` H Ly' Public Facili,.,_t,ie�s mprovement (PFI) Permit: 14 'U Required: IL Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑PF-120i6 No,stop intake Land Use Case#: �S U132O)6 --o0003 t---, --(o I N Ly Zoning: R-q ❑ Required Setbacks: Front 15 Rear , S Side S Street Side ia4 Garage 2 d ❑ Landscape Requirement: 10 ❑ Lot Coverage Maximum: 8 0 ? ❑ Building Height: Maximum Height J Actual Height 5 isual Clearance �/. Sensitive Lands: ❑ Yes N_d" No Type ,� Urban Forestry Plan L 'Conditions "Met"prior to issuance of building permit� r Notes: CA1-4 i- ,I C �1,ra U�t 1 aLy t)(kfrwt. I Approved By Planning: J/'-.2 CL Date: 1 2-1')-f 9— Revisions Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: 0 Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw_RES_061417.docx Building Permit Submittal Original Submittal Date: /02//-3//7 Site Plans: # 3 j Building Plans: # 3 Building Permit#: Er-Enter building permit#above. Workflow Routing: C-Planning [u- Engineering C ermit Coordinator Building Workflow Sign-off: L'Sign-off for Planning(include notes from planning review) Route Application Documents: IL-"Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. CBuilding: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: OA / Date: /2.-A0 2 Engineering Review Slope at building pad: 3% [ onditions "Met"prior to issuance of building permit ©/Easements (encroachments) per engineering conditions of approval and plat Z--Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes 2'-No Assess Water Quantity Fee in-lieu: ❑ Yes LS No LIDA Facility on lot: ❑ Yes 2/No ❑ Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: Y 4544i4.12-, Date: /2, - /4.-i 1 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: r2SDC Fees Entered: Wash Co Trans Dev Tax: yes ❑ N/A , Tigard Trans SDC: Yes ❑ N/A Parks SDC: yes ❑ N/A LIDA ❑ Yes FN/A � OK to Issue Permit Approved by Permit Coordinator: 1411/14-ate: /2114//7 I:\Building\Forms\BldgPermitRvw RES_l 1 1617.docx City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13249 SW MADDIE LN, TIGARD, OR, 97224 May 21 , 2018 at 12:48:25 PM Record Type: Record ID: Residential - Master Permit MST2017-00498 Inspection Type: Inspector: 699 Mechanical final David Young Result: PASS Comments: Ac installed. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13249 SW MADDIE LN, TIGARD, OR, 97224 May 21 , 2018 at 12:47:41 PM Record Type: Record ID: Residential - Master Permit MST2017-00498 Inspection Type: Inspector: 399 Plumbing final David Young Result: FA I L Comments: Glue cleanout bodies in place and provide approved thread sealant for caps. OPSC 707.3 Finish sealing base of main level shower at floor. OPSC 407.2 Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13249 SW MADDIE LN, TIGARD, OR, 97224 May 21 , 2018 at 12:47:07 PM Record Type: Record ID: Residential - Master Permit MST2017-00498 Inspection Type: Inspector: 199 Electrical final David Young Result: FA I L Comments: Seal gaps around electrical outlets in kitchen area. 314.21 All else appears ok. Ac installed. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13249 SW MADDIE LN, TIGARD, OR, 97224 July 3, 2018 at 12:30:41 PM Record Type: Record ID: Residential - Master Permit MST2017-00498 Inspection Type: Inspector: 299 Final inspection David Young Result: FA I L Comments: Provide plumbing final for landscape irrigation Backflow devise prior to building final inspection. PLM 2018-00210. Remove non pt wood in contact with ground right garage wing under stone. Provide access for inspection, house locked. 12:30 pm. No further inspection done. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13249 SW MADDIE LN, TIGARD, OR, 97224 July 6, 2018 at 8:57:21 AM Record Type: Record ID: Residential - Master Permit MST2017-00498 Inspection Type: Inspector: 299 Final inspection David Young Result: FA I L Comments: House locked no access for inspection. Investigative fee for re inspection applied for second final building inspection with no access due to locked house. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13249 SW MADDIE LN, TIGARD, OR, 97224 July 11 , 2018 at 10:50:22 AM Record Type: Record ID: Residential - Master Permit MST2017-00498 Inspection Type: Inspector: 299 Final inspection Aaron Cillo-Gobel Result: PASS - CofO Comments: Previous corrections completed. All other building final appears ok. Final erosion control passed Street tree certificate received Moisture content form received Moisture barrier acknowledgement 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