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Permit CITY OF TIGARD MASTER PERMIT IN !II COMMUNITY DEVELOPMENT Permit#: M _ ST2017 00483 T t[ ;4 Id I) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 „+ ; Date Issued: 02/20/2018 IParcel: 2S112CB00700 a 6 Jurisdiction: Tigard Site address: 15140 SW CHANDLER LN c j Subdivision: MANGOLD SUBDIVISION Lot: Project: Mangold, Lot 4 Project Description: New SF. 8/26/18: REPRINT to add(1)laundry tray. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 5 First: 1745 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 4 Second: 1361 sf Garage: 470 sf Front: 20 Smoke Dwelling Units. 1 Third: 0 sf Detectors: Yes Right: 5 Total: 3106 sf Value: $379,884.15 Rear: 15 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 LaundryTrays: 1 Y Rain Drain: 1 Urinals: 0 Lavatories: 6 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 Bckflw Prevntr: 0 Catch Basins: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 6 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'l 500 sf: 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 G NEW P yrou Group: Square Feet: SF VB R-3 3106 Owner: Contractor: WESTWOOD HOMES LLC WESTWOOD HOMES LLC Required Items and Reports(Conditions) 12700 NW CORNELL RD 12700 NW CORNELL RD 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97229 PORTLAND,OR 97229 PHONE: PHONE: 503-330-2215 FAX: 503-342-2403 Total Fees: $32,515.24 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: ' ./ —,! ' Permittee Signature: cro"'C il Lbw I 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. Plumbing Permit Application 4 /VI 572.0/7 d p 4 g 3 Building Fixtures FOR 0111(i: ( sL OVL.Y /l „ 4 o City of Tigard `,,' '` ` ,°i Received to 13125 SW Hall Blvd., �' AIM I ���,` ? Tigard,OR 97223 Plan Review I J Phone: 503.718.2439 Fax: 503.598.1960 Other Permit No.: Inspection Line: 503.639.4175 Date/By' TIG,' D p Date Read/B r o torts: ! S See Pagel Inc Internet: www.tigard-or.gov Notified/Method: ! SupptemeatanformaOon TYPE OF WORK FEE. SCHEDULE ®New construction ❑Demolition For special Information use checklis4 ❑Addition/alteration/replacement ❑Other: Description I Qty. I Ea. I Total 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 I SFR 2 ❑ SFR( )bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.01 ❑Master builder 0 Other Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: i V 6-w C,114,41 a/e,r La.,h Catch basin or area drain 18.76 Drywall,leach line,or trench drain City/State/ZIP:Tigard OR 677224 1i� �` Le 71- 4 Footing drterm(noho linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name: i�+ G( 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 JI - f Water service(no.linear ft.: ) Page 2 Subdivision: 1 Lot no.: `( Fixture or item: Tax map/parcel no.: Badctlow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes new SFR • ' t 4�L.Q -0 44d lavas 4-q Dishwasherhet 25.02 ) 25.02 ( n'€I0k'' -(X161;1 o1T rt"" 4- Drinking fountain 25.02 NNE LDJtT ? DDyg3 Ejectors/sump int0rs/sump 25.02 ® PROPERTY OWNER 0 TENANT Expansion tank 12.51 Name:Westwood Homes LLC Fixture/sewer cap 25.02 Address: 12700 NW Cornell Road Floor drain/floor sink/hub 25.02 City/State/ZIP:Portland OR 97229 Garbage disposal 25.02 Hose bib 25.02 Phone: 1 7't•- 67. '-col r Fax:(503)342-2403 Ice maker 12.511111 0 APPLICANT 0 CONTACT PERSON Interceptor/ grease tang 25.02 Business name: lehhitijettft (-toile, it( Medical gas(value:S ) Page 2 Contact name: 1 1 u sim Primer 12.51 `"' Roof drain(commercial) 12.51 Address: 5 gtline !4!5 d. Sink/basinilavatory L 25.02 Z5•o City/State/ZIP: Solar units(potable water) 62.54 Phon 3)"7/3- (4;2"11-1 Fax::( ) Tub/shower/shower pan 12.51 E-mail; 1i t i(i i 101 es kvoQdkOme .Ls!.Z, Urinal 25.02 CONTRACTOR Water closet 25.02 Business name:H&H Mechanical Water heater 37.52 Water piping/OW V 56.29 Address:5757 SE Willow Lane Other: 25.02 City/State/ZIP:Milwaukie OR 97267 Subtotal Phone:(503)975-9787 Fax:(503)659-2979 Minimum permit fee: 572.50 CCB Lie.:178122 Plumbing Lic.no.: Plan review (25%of permit fee) Authorized signature], ° �,` � State surcharge(12%of permit fee) TOTAL PERMIT FEE Z, ,, Print name:Dusti+ 'ague Date: This permit application expires if a permit is not obtained within 184 days atter it bas been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I\BuildinglPermits\PLMU-PenniiApp.doc 10!01,09 440.4618T(10/02/CoM/wEB) CITY OF TIGARD M 'N 2 • COMMUNITY DEVELOPMENT PermitMASTER#: MST2017-004PER83IT T1G.ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/20/2018 Parcel: 2S 112 CB00700 Site address: 15140 SW CHANDLER LN Jurisdiction: Tigard Subdivision: MANGOLD SUBDIVISION Lot: Project: Mangold, Lot 4 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 5 First: 1745 sf Basement 0 sf Left 5 Height: 24 Bathrooms: 4 Parking Spaces: 0 Second: 1361 sf Garage: 470 sf Front 20 Smoke Dwelling Units: 1 Third: 0 sf Yes Right: 5 Detectors: Total: 3106 sf Value: $379,884.15 Rear: 15 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 LaundryTrays:Y 0 Rain Drain: 1 Urinals: 0 Lavatories: 6 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 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Catch Basins: 0 Hose Bib: 2 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 6 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'l 500 sf: 6 201-400 amp: 0 201-400 amp: 0 P 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: Y Ecompasing: BUILDING INFO Class of Work: Type of Use: NEW Type of Constr: Occupancy Group: Square Feet SF VB R-3 3106 Owner: Contractor: WESTWOOD HOMES LLC WESTWOOD HOMES LLC Required Items and Reports(Conditions) 12700 NW CORNELL RD 12700 NW CORNELL RD 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97229 PORTLAND,OR 97229 PHONE: PHONE: 503-330-2215 FAX: 503-342-2403 Total Fees: $32,487.22 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 thro.,h OAR 95 -00 0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued c Permittee Signature: //V -i--/X)4./6.9-7-7e&/ 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 x City of TigardE ,, , ea rolz c�rrlcl I Si;0\1.1 13125 SW Hall Blvd.,Tigard,OR 97223 DateB : AmmPermit No.:4 , I Phone: 503.718.2439 Fax: 503.598.1960 'fl Plan Revie T t G n t;D Inspection Line: 503.639.4175 1J 0 v 3 0 201 ,, Date/B : _ -_ ; ') Other Permit: Date Ready/By:' �-� f. �' — .M 1 Internet: www.tigard-or.govy�'yq� See Page 2 for C r I ('.) " A a t e ' 'ga �I�-'��I �//,0' Supplemental Information TYPE OF "RK BUILDING DIVISION` REQUIRED DATA:1-AND 2-FAM1LY DWELLING ®New construction o Demolition Permit fees*are based on the value of the work performed. 0 Addition/alteration/replacementIndicate the value(rounded to the nearest dollar)of all 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ® 1-and 2-family dwellingValuati . " ❑Commercial/industrial -r" C 3-7q Q � (.� 0 Accessory building 0 Multi-family Number of bedroom �J V I ❑Master builder ❑Other: Number of bathrooms:/ ` JOB SITE INFORMATION AND LOCATION Total number of floors: "2 ,3S»7 6 Job site address: t� �• Q 5 ( (r� 5 (i t dilitl t e, (a i New dwelling area: j/06'" square feet City/State/ZIP: Gara e/c 5(Q g arport area: 7 0 square feet Suite/bldg./apt.no.: I Project name: Covered porch area: Ai.Z S square feet)3 6 ' Cross street/directions to job site: P +. ZQ-c) square feet )7'is- Other structure area: square feet Subdivision: (f tit } c__ REQUIRED DATA:COMMERCIAL-USE CHECKLIST E,<--,�+ 1' 2" I Lot no.: t{ Permit fees*are based on the value of the work performed. Tax map/parcel no.: t Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK: work indicated on this application. New SFR Valuation: $ Existing building area: square feet New building area: square feet ®.PROPERTY OWNER I 0 TENANT Number of stories: Name:Same as applicant Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: Phone:( ) Fax:( ) New: I APPLICANT 0 CONTACT PERSON DUD.ARXCt PEIT RM ' rES* Business name:Westwood Homes LLC �,. easereferW ,rtAedu Contact name:Matt Fricke Structural plan review fee(or deposit): Address:12700 NW Cornell Rd FLS plan review fee(if applicable): City/State/ZIP:Portland,OR,97229 Total fees due upon application: Phone:(503)406-2442 I Fax::( ) Amount received: E-mail Matt@westwoodhomesllc.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted PhotoVoltaic Solar Panel System. Business name:Same as applicant Submit two(2)sets of roof plan with connection details Address: and fire department access,along with the 2010 Oregon Solar Installation Specialty Code checklist. City/State/ZIP: Permit Fee(includes plan review Phone:( ) I Fax:( ) and administrative fees): $180.00 CCB lic.:195597 State surcharge(12%of permit fee): $21.60 ^_,./ ,,, Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Matt Fricke I Date:/7/74'X/ *Fee methodology set by Tri-County Building Industry I Service Board. I:\Building\Pennits\BUP-RESPetmitApp•doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Application FOR ()II I( ( SI Oy►.1 City of Tigard III 13125 SW Hall Blvd.,Tigard,OR 97223 _` Permit No.: 1 f>!. C Phone: 503.718.2439 Fax: 503.598.1960 RECEIVE n Review l I c,A It n Inspection Line: 503.639.4175 DateBY: Other Permit: Internet: www.tigard-or.gov NOV p Date Ready/By: lois: El See Page 2 for O a 3 0 2017�y Notified/Method: Supplemental Information TYPE OF WORC�ryN�9 OF FIGAR COMMERCIAL FEE* SCHEDULE— USE CHECKLIST ®New construction 0 Addition/altera i , °I, i,.,1► I E1tD a 1,4 N Mechanical permit fees*are based on the value of the work ❑Demolition 0 Other: `r) performed.Indicate the value(rounded to the nearest dollar)of all mechanical materials,equipment,labor,overhead,and profit. CATEGORY OF CONSTRUCTION Value:$ ® 1-and 2-family dwelling 0 Commercial/industrialRESIDENTIAL EQUIPMENT/SYSTEMS FEES* 0 Accessory building For special information use checklist ❑Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total JO SITE INFORMATION AND LOCATION Heating/cooling: f// ,ffs. Air conditioning S/ 0 1.4,4/ C 11 tiv�C to fr 6 46.75 Job site address: Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: I Project name: Heat pump 61.06 Duct work I 23.32 Cross street/directions to job site: Hydropic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision: / �s o Lot no.: Other: 23.32 Tax map/parcel no.: Ki tltt Other fuel appliances: Water heater i 23.32 DESCRIPTION OF WORK Gas fireplace/insert 1 33.39 New SFR Flue vent for water heater or gas fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 lEl PROPERTY OWNER TENANT Other: 23.32 Name:Same as applicant Environmental exhaust and ventilation: Range hood/other kitchen J Address: equipment / 33.39 Clothes dryer exhaust 11 33.39 City/State/Z1P: Single-duct exhaust(bathrooms,toilet compartments,utility moms) C 23.32 Phone:( ) Fax:( ) APPLICANT Attic/crawlspace fans 23.32 El CONTACT PERSON Other: 23.32 Business name:Westwood Homes LLC Fuel piping: Contact $14.15 for first four;$4.03 for each additional name:Matt Fricke Furnace,etc. Address:12700 NW Cornell Rd Gas heat pump City/State/ZIP:Portland,OR 97229 Wall/suspended/unitleater Water heater / Phone:(503)406-2442 I Fax::( ) Fireplace E-mail:MattGtr)westwoodhomesllc.com Range r Barbecue CONTRACTOR Clothes dryer(gas) Business name:Central Air Inc. Other: Address:PO Box 433 MECHANICAL PERMIT FEES* Subtotal Minimum permit fee($90.00) City/State/ZIP:Clackamas,OR 97015 Phone:(503)656-1908 I Fax:( ) Plan review(25%of permit fee) CCB lic.:178624 State surcharge(12%ofpermit fee) TOTAL PERMIT FEE A _ t This permit application expires If a permit is not obtained within 180 Authorized Signature' days after it has been accepted as complete. `4:74a'1,'e--`-``'-- * Fee methodology set by Tri-County Building Industry Service Board rlf=A' >✓ Date: 7/ I:\Building\YermitAMEC_Pan itApp_040113.doc 440-4617T(11/02/COM/WEB) Electrical Permit Application FOR OFFI( I: t SI.OyFv City of Tigard .a "? ;11.111111.11 Permit •#: '`1� tit 7 0c-'�'f 5 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date ; : Related Permit#: Inspection Line: 503.639.4175 t dy Date/By: See Page 2 for T I R D Internet: www.tigard-or.gov N`(�vt` 3 0 2 v!Notified/Method: 7 : ® Supplemental Information ... .............. . .... .. ,�^•� _ TYPE OF WORK I $fig,i i-u L1i T PLAN REVIEW ®New construction ❑Addition/alteration/real1 Please check all that apply(submit 2 sets of plans w/items checked) ❑Demolition ❑Other: 115 3E ON ❑Seryice or feeder 400 amps or more 0 Building over three stories. where the available fault current 0 Marinas and boatyards. CATEGORY OF cows 1CI'ION. exceeds 10,000 amps at 150 volts or 0 Floating buildings. ® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family 0 Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or JOB'Sin INFORMATION MD LOCATION .-rr 0 Emergency system. larger separately derived c_I 1 / Job#: Job site address: t C i G ( ❑Addition of new motor load of system. tj{r r�: r l)� mow or more. 0"A","E","1-2","1-3", City/State/ZIP: ❑Six or more residential units. occupancy. ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: 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: FEE SCHEDULE Description I Qty. I Each I Total I 1f residential single-or multi-family dwelling unit.�/714,1,y11(4 (-7„-1--,.:„11-12-, Lot#: Includes garage. 1,000ft. less Tax map/parcel#: sq. or 168.54 4 Ea.add'l 500 sq.ft.or portion 33.92 1 DES HIPTYQN VP WORTC•. , 'k .. 5 f` Limited energy,residential �� 75.00 2 (with above sq.ft.) Limited energy,multi-family residential(with above sq.ft.) 75.00 2 Renewable Energy 0 See Page 2 PROPERTY OWNER 0 TENANT' Services or feeders installation,alt ration,and/or relocation Name: 04,11,, 047 0( r 1 c` ,1 f°,f 200 amps or less / 100.70 2 Address: �Y— 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: 601 amps to 1,000 amps 301.04 2 Phone:( ) Fax:( ) 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 0 .APPLICANT° C, NTAc Branch circuits—new,alteration,or extension,per panel 4-4`ti. A.Fee for branch circuits with Business name:Westwood Homes LLC above service or feeder fee, 7.42 2 each branch circuit Contact name:Matt Fricke B.Fee for branch circuits without Address:12700 NW Cornell Rd service or feeder fee,first 56.18 2 branch circuit City/State/ZIP:Portland,OR 97229 Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(503)406-2442 Fax: :( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email:Matt@westwoodhomsllc.com Reconnect only 67.84 2 CONTRACTOR n Pump or irrigation circle 67.84 2 Business name:Pyramid Electric LLC Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address: 12700 NW Cornell Rd panel,alteration,or extension. 0 See Page 2 2 City/State/ZIP:Portland,OR 97229 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(503)406-2442 Fax:( ) Investigation(1 hr min) 90.00/hr Email:office@pyramidelectricllc.com C9// / Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is CCB Lic.: 217347 Electrical Lic.: C 1320 Suprv. specifically listed(%z hr min) 90.00/hr ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: r egg Subtotal: Print name: / V Date: fi � ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: 4 f/i-tf TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Date: 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 Almilimiummmimimimmimi Plumbing Permit Application Building Fixtures 1-()R ()F IA( F ( S F: ()NI 1 City of Tigard Received ill 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: Permit No.: sT i _ iC:3 Plan Review l Y IN = Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.: T 1 ^1�i� Inspection Line: 503.639.4175 Date Ready/By: Internet: www.tigard-or.gov mss: See Page 2 for Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ®New construction 0 Demolition For special information use checklist Description I Qty. I Ea. I Total 0 Addition/alteration/replacement 0 Other: New 1-2-famil dwellin:s(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 ❑Accessory building 0 Multi-family SFR(3)bath f 500.32 ❑Master builderEach additional batb/1°tchen i 25.02 0 Other: Fires sprinkler prinkl sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: I J 1 ` i y e l/ /,,,,. 4,. *. Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: 1 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: 4 / 3 �'( ',ci.. Lot no.:r Fixture or item: Tax map/parcel no.: Backflow preventer , 31.27 Backwater valve DESCRIPTION OF WORK 12.51 Clothes washer New SFR 25.02 Dishwasher 1 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 e4 PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name:Same as applicant Fixture/sewer cap 25.02 Address: Floor drain/floor sink/hub 25.02 Garbage disposal / 25.02 City/State/ZIP. Hose bib 2- 25.02 Phone:( ) Fax:( ) Ice maker 12.51 ® APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name:Westwood Homes LLC Medical 8 (value:$ ) Page 2 Contact name:Matt Fricke 12.51 Roof drain(commercial) J 12.51 Address:12700 NW Cornell Rd Sink/basin/lavatory t? 25.02 City/State/ZIP:Portland,OR 97229 Solar units(potable water) 62.54 Phone:(503)406-2442 Fax::( ) Tub/shower/shower pan 3 12.51 E-mail:Matt@westwoodhomesllc.com Urinal 25.02 CONTRACTOR Water closet i''' 5.02 Water heater 37.52 Business name:H&H Mechanical Water piping/DW V 56.29 Address:5757 SE Willow Lane Other: 25.02 City/State/ZIP:Milwaukee,OR 97267 Subtotal Phone:(503)975-9787 Fax:( ) 7 f, /lie) Minimum permit fee: $72.50 CCB Lic.:178122 Plumbing Lic.no.:i�YJL'/tf d' Plan review (25%of permit fee) /� State surcharge(12%of permit fee) Authorized signature: r sc` WA, /`2 f v • ' vd. / i TOTAL PERMIT FEE Print name:Dustin Hague / Date: (1/7v7/. - 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. MBui1dng\Permits\PLMO-PwmitApp.doe 10/01/09 440-4616T(10/02/COM/WEB) City of Tigard IICOMMUNITY DEVELOPMENT DEPARTMENT r 1 c A R D Building Permit Review — Residential Building Permit #: ,,n 5 17 -,ccs Site Address: 1 5 11 0 Sw C iftG4 n GI,(Lc. Lir' Project Name: M en nD 01 a. L moi►i-e-.- Lot #: 4 (New dwelling—subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: N • '� F 42 Verify site address/suite# exists and active in permit system. 0 River Terrace Neighborhood: X No ❑ Yes,See River Terrace Review Addendum Attached Site Plan Elements: /Three(3)copies of site plan *misting structures on site Site plan must be on 8-1/2"x 11"or 11 x 17"paper �`�ootprint of new structure(including decks)with finished Drawn to scale(standard architect or engineer scale) floor elevations /North arrow Utility locations&easements(required for new and additions) ite address,project or subdivision name and lot number Sidewalk/driveway approach al Applicant information(name and phone number) ❑4,.,,a ion of wells/septic systems XJLot dimensions and building setback dimensions BEItisting trees to be retained with drip line,and tree re footage of buildings to be demolished protection measures C-fvt area,building coverage area,percentage of coverage and .Street tree size,type and location impervious area(applicable if R-7,R-12,R-25&R-40) ,Street names �{ Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced?�JYes ❑No 4 foot differential) If yes,is a storm water quality facility shown?replaced/Yes cs ❑Ne Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): &tits Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No 71 Public Facilities Improvement(PFI) Permit: ?Pr- J i S d©0 U Required: ❑ Yes,applicant was notified ❑ No Applied For: Yes ❑ No,stop intake Land Use Case#: Sly 6 O V 3 O 000--- V U®`3L Zoning: 4 ,. S 71 Required Setbacks: Front 10 Rear 15 Side G Street Side -- Garage 7,0 Landscape Requirement: 2.....0 Lot Coverage Maximum: V(.--T % Building Height: Maximum Height Actual Height Q Visual Clearance Sensitive Lands: ❑ Yes / No Type V(Urban Forestry Plan XConditions "Met"prior to issuance of building permit Notes: R h GLL PI 0} v " " h Q, (Z'Co ic, c ill)r fizz ISS tiC✓t tin Approved By Planning: ( v ` (}4-'.- (.,-\_---.....L. Date: I i/ 301 17 Revisions (after Building Submittal only) Reviewer Date Revision 1: Z Approved ❑ Not Approved 24w t Revision 2: 1=1 Approved ❑ Not Approved 6 Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw RES_061417.docx Building Permit Submittal Original Submittal Date: /f T) 117 Site Plans: # 1 Building Plans: # Building Permit#: enter building permit#above. Workflow Routing: g'1ianning engineering 13'Permit Coordinator 5'15;ilding Workflow Sign-off: [ - fgn-off for Planning(include notes from planning review) Route Application Documents: ❑— gineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. C[LB'uilding: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: e 2t7-9 Date: 7/0,7 Engineering Review Slope at building pad: /`v ❑ Conditions "Met"prior to issuance of building permit `�r t e2rEasements (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 ❑ Final Plat Recorded: ArNOT Approved by Enine-ring: Date- No _moi , i r-' tes: ,i., _ 0(-•":11,,, d ! L_ ��/,�� f . _��r�1� i.si, Approved 'y ngineering: , Date: /(-- 7 Revisionsafter B ildin Submittal only) eviewz7 Date Revision 1:pApproved ❑ Not Approved r Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit eApproved,NOT Released: , ,,/ 1��7/14 u ' `f , s ate: !2/ij�7" 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: , SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A Tigard Trans SDC: ►Yes ❑ N/A Parks SDC: !'' es ❑ N/A LIDA ❑ Yes N/A OK to Issue Permit � � M 'Date:Approved by Permit Coordinator:- /✓ �' C''►� 4 /5 A s I:\Building\Forms\BldgPermitRvw_RES_111617.docx City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15140 SW CHANDLER LN, TIGARD, OR, 97224 July 17, 2018 at 2:41 :14 PM Record Type: Record ID: Residential - Master Permit MST2017-00483 Inspection Type: Inspector: 199 Electrical final Aaron Cillo-Gobel Result: PASS Comments: A/C installed Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15140 SW CHANDLER LN, TIGARD, OR, 97224 July 20, 2018 at 12:43:49 PM Record Type: Record ID: Residential - Master Permit MST2017-00483 Inspection Type: Inspector: 399 Plumbing final David Young Result: FA I L Comments: No back splash installed in master bath, cabinet not sealed to wall. OPSC 407.2 Laundry tray is rough in only at this time per contractor. Provide approved hard cap at sink drain. OPSC 402.11 Permit will be required at time of finish installation for code compliance. Provide approved thread sealant on all cleanout caps. OPSC 707.3 Other previous corrections complete. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15140 SW CHANDLER LN, TIGARD, OR, 97224 July 26, 2018 at 9:51 :43 AM Record Type: Record ID: Residential - Master Permit MST2017-00483 Inspection Type: Inspector: 399 Plumbing final Aaron Cillo-Gobel Result: PASS Comments: Corrections completed Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15140 SW CHANDLER LN, TIGARD, OR, 97224 July 27, 2018 at 10:59:32 AM Record Type: Record ID: Residential - Master Permit MST2017-00483 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: 15140 SW CHANDLER LN, TIGARD, OR, 97224 July 27, 2018 at 11 :01 :23 AM Record Type: Record ID: Residential - Master Permit MST2017-00483 Inspection Type: Inspector: 299 Final inspection David Young Result: FA I L Comments: Inspection cancelled by contractor. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15140 SW CHANDLER LN, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2017-00483 Inspection Type: Inspector: 299 Final inspection David Young Result: Scheduled Comments: Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15140 SW CHANDLER LN, TIGARD, OR, 97224 August 3, 2018 at 9:07:41 AM Record Type: Record ID: Residential - Master Permit MST2017-00483 Inspection Type: Inspector: 299 Final inspection David Young Result: PASS - CofO Comments: Contractor has tempered window ordered. Contractor has window fall prevention devises on order, will install prior to new owners taking possession. Picture of corrections to be provided prior to occupancy. Final erosion control approved. Street tree certification received. Moisture content form received. High efficiency lighting form received. Insulation certification checked. Blower door test report checked. C of 0 left on site with contractor. Violation Summary: Inspector Contractor