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Permit (125) CITY OF TIGARD MASTER PERMIT P ig COMMUNITY DEVELOPMENT Permit#: MST2018-00081 GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/20/2018 ( 9 Parcel: 2S102CC03400 Jurisdiction: Tigard Site address: 10345 SW MCDONALD ST Subdivision: FRELEON HEIGHTS Lot: 2 Project: Hampton Project Description: 657 sf addition of(2)bedrooms and (1)bathroom with laundry. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 0 First: 639 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 15 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 20 Smoke Dwelling Units: 0 Third: 0 sf Right: 5 Detectors: Yes Total: 639 sf Value: $72,750.15 Rear: 15 PLUMBING Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 0 Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 72 Ice Maker: 0 Hose Bib: 1 Backwater Value: 0 Drywell-Trench Drain: 1 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 1 Clothes Dryers: 1 Heat Pump: N Hoods: 0 Other Units: Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 5 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: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ADD SF VB R-3 639 Owner: Contractor: HAMPTON,DANIEL L&CHERISSE M PAUL MILLARD OLSON Required Items and Reports(Conditions) 10345 SW MCDONALD 11933 SE SUNNY WAY 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97224 HAPPY VALLEY,OR 97086 PHONE: PHONE: 503-698-3444 FAX: Total Fees: $3,121.70 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 Ce Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a cop • ,- les or direct questions to OUNC by calling 503.232. •: or 1.800.332.2344. Issued By:,. ;-,--.0.6____ / •ermittee Signature: / / F=" 1 .639.4175 by 7:00 a.m.for the next available inspection dat. 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. ' 1'3uildin2 Permit ApplicatiolyK " ' y1kyA 5:F Residential > City of Tigard M�� C�n rj Received "°/�% Date/B v Permit �� e t eep/ 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review. f! Phone: 503.718.2439 Fax: 503.59 f90 ,ii 'lh ' Other Permit: c e i d a w f Date/By: T 1 G A R D Inspection Line: 503.639.4175 Date Ready/By. Jur s: See Page 2 for Internet: www.tigard-or.gov #1 f, m a I , C:'..,i ,s'0 k Notified/Meth._• l ��� Supplemental Information TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING ❑New construction 0 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 profi for e CATEGORY OF CONSTRUCTION work indicated on this application. "-b-, � [ 1-and 2-familydwellingValuation: $ ❑Commercial/industrial , ❑Accessory building 0 Multi-family Number of bedrooms: Z 0 Master builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors:63 9 i Job site address: C d 3 1 c j•v.,) 1to1L.pc j ALD New dwelling area: I �"' square feet City/State/ZIP: 71 GAT-L, 01 - Q 7 Z Z9- Garage/carport area: e: square feet Suite/bldg./apt.no.: Project name: 0..-At.A.Q Q :To; G Covered porch area: C;: square feet Cross street/directions to job site: Deck area: C square feet f:12-f:"f'1 1,-.'`j 9 61 66: E.. 'IT Chi r-1.410C p"A•LiDcir, Other structure area: C square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: I Lot no.: 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. Valuation: $ CS? a r'1 ', D 1 Tie`i3 ©P C2) 6 °,7_s _ q C) 45L7-7//2_0e/t7 Ce/Gr9-a/,°L /; Existing building area: square feet New building area: square feet (3PROPERTY OWNER 0 TENANT Number of stories: Name: ' A•0 $ Cj+ (45 L- e-{. - Type of construction: Address: ( C'-•j 4 5 5‘....:1, (-t e Pc 0 Atp 51---- Occupancy groups: City/State/ZIP: fi(tk1 V e(Z r(72,2`I _ � Existing: Phone:(9 ) 6e r -2 e(, C' Fax:( ) E rAPPLICANTNew: / 0 CONTACT PERSON BUILDING PERMIT FEES* Business name: , (Please refer w fee schedule) r.,r±VIA 0E51Lif) Structural plan review fee(or deposit): Contact name: PALii_ CI. ��'lj Address: c wt.i.�L FLS plan review fee(if applicable): City/State/ZIP: C'1 Total fees due upon application: � �.,tit:.c, k j z ( G 4'e(, - - Phone:( �) �Ct5,-3tf,f a Fax::(9j ) 61. G 3 7 Amount received: 73 Es E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted Photo Voltaic Solar Panel System. Business name: e't, 1 A`) -veFL te.%-.1-' 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 lic.: la2CtG. 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: Irl(L G;l zjG+= Date: I *Fee methodology set by Tri-County Building Industry Service Board. I:\Buildmg\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Building Permit Application Checklist I e One- and Two-Family Dwelling FOR 0E1 I( SSE Oyl.) City of Tigard Received Permit No.: Date/By: IP/ 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits: = Phone: 503.718.2439 Fax: 503.598.1960 ❑ Electrical ❑ Plumbing ❑ Mechanical 24-Hour Inspection Line: 503.639.4175 T I G A R D Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW 1`s 'O v.it 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ U • 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 ❑❑ 6 Sewer permit. 00 00 0 7 Water district approval. 0 ❑ 0 8 Soils report. Must carry original applicable stamp and signature on file or with application. 9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 0 0 ' protection,etc. 0 0 0 (....---15 3 omplete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ilding 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 opyright violations exist. 11 ite/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if 0 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. 0 0 0 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size and location. 0 0 0 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 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. 0 0 0 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. 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. 0 0 0 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- prescriptive path analysis provide specifications and calculations to engineering standards. 0 0 0 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 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. 0 0 0 20 Manufactured floor/roof truss design details. 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. 0 0 0 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or architect licensed in Ore on and shall be shown to be a licable to theproject under review. 23: ree(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". 0 0 0 Two(2)sets each are required for Items 16,19,20 and 22 above. 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ 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. 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. 0 0 0 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, 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 ApplicationV FOR OFFICE USE 0\EV Received City of Tigard MP 62 iciR DateBy: Permit blo/-52 ,v, 00 cf 111 13125 SW Hall Blvd.,Tigard,OR 97223 • lig Phone: 503.718.2439 Fax: 503.598.1Plan Review M . Date;By: Other Permit: TIGARD 1" 2*,1,P Inspection Line: 503.639.4175 , Date Ready/By: Juris: 65 See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE- USE CHECKLIST Mechanical permit fees- are based on the value of the work 0 New construction IE/Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:S CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* 21-.-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. o Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total Heating/cooling: JOB SITE INFORMATION AND LOCATION Air conditioning 46.75 Job site address: 103 t.41" Skt,) ti,CD0i3 Ati) ST. Furnace 100,000 BTU(ducts,vents) 46.75 City/State/ZIP: TA&Mat) 012_ 9-1224- Fumace 100,000+BTU(ducts vents) 54.91 ) Heat pump 61.06 Suite/bldg./apt.no.: Project name: k„..t AtAY .3-0 Duct work 3 23.32 Cross street/directions to job site: 1-00064 (.6)1 q q Hydronico hboiler (radiator or hot system 23.32 Residential Ao- e>,.) 0J/&C) 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 Other: 23.32 Subdivision: Lot no.: Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF WORK Gas fireplace'insert 33.39 Flue vent for water heater or gas A01) °LA-C-1114d, TO A 01)I/1 OW )=-7-e/C- fireplace 23.32 Log lighter(gas) 23.32 ( ) aF2S/2.VeViSf (f) #7-7,,72.eier/ 7771 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimneyiliner/flue/vent 23.32 g : 23.32 4ROPERTY OWNER 0 TENANT Other Environmental exhaust and ventilation: Name: v p4 4 c,k4.645c (4,44.AR to Range hood/other kitchen equipment 33.39 Address: \ "a 45 5‘4 ppi3Atvr. Clothes dryer exhaust I 33.39 City/State/ZIP: Tibtoris la_ 9 7z 7 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) I 23.32 Phone:(So 5) 62 0-2gi 6 0 Fax:( ) Attic'crawlspace fans 23.32 E /APPLICANT ErCONTACT PERSON Other: 23.32 Fuel piping: Business name: ")kik-01)14- 066 te.ri $14.15 for first four;$4.03 for each additional Contact name: ?Aut._ 01,5 e" Furnace,etc. Address: 0133 56 Lif,„*.)./ tjAm Gas heat pump Wall/suspended/unit heater City/State/ZIP: N_Vxp2/ VAt C) er-to s(. Water heater Phone:(51,73) 3t411 Fax::(5P3) age.,4,5-31 Fireplace Range E-mail: 5 e hot-mot:I I CV NI Barbecue CONTRACTOR Clothes dryer(gas) Other: Business name:Tri County Temp Control MECHANICAL PERMIT FEES* Address: 13150 S Clackamas River Drive Subtotal City/State/ZIP:Oregon City,OR 97045 Minimum permit fee(S90.00) Plan review(25%of permit fee) Phone:(503)557-2220 Fax:(503)557/0919 State surcharge(12%of permit fee) CCB lie,:72623 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 Authorized signature: 76L-ts-Vt-,2 days after it has been accepted as complete. * Fee methodology set by Tri-County Building Industry Service Board Print name:Diane Mason Date: ZN2,01g I:•Building,Permirs MEC_PerrnitApp_0401 I 3.(loc 440-16171(I I 02,('OMVE13) 'CEJ Electrical Permit Application i IM 01.1.I - I Sf OM l 1 City of Tigard M13 ,1- Received Permit � / J�_. n 13125 SW Hall Blvd.,Tigard,OR 97223 Dan R : ��a Phone: 503.718.2439 Fax: 503.598.19 0; ' °-4,.,:- J ''r: Dates view Related Permit#: Inspection Line: 503.639.4175 .m„ s Ready Date/By: auris• BI See Page 2 for TI G A R D Internet: www.tigard-or.gov 1'{' t', J'1 ,. _ 1 Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑New construction V Addition/alteration/replacement Please check all that apply(submit 2 sets of plans mortems checked): El Demolition Other: 0 Service or feeder 400 amps or more 0 Building over three stories. where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. 44 I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived '\�" 0 Addition of new motor load of system. 1V Job#: Job site address: 45 5� inepttto IOOHPormore. ❑"A", E, 1-2^,�t-3 , City/State/ZIP: ; Q S-1 a.. .\1 ❑Six or more residential units. occupancy. �I ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: G�cl,C. \..1 (2., 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: r+flnt.,� I I uj-i cet ((-;)42r pa,r FEE SCHEDULE 01 Kt J)C,** AVID � Description09. I Each I Total 1 • New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 168.54 4 Ea.add'l 500 sq.ft.or portion 33.92 1 DESCRIP'T'ION OF WORK ` Limited energy,rgy,residential J� 75.00 2 o t ) MA c -- ble*�� 5 �' �C� Limite(withdenergyabove sq_Rt) � ,multi-family 1.6114".5r ev„.-� -� � residential(with above sq.R.) 75.00 2 rit PROPERTY OWNER 0 TENANT Renewable Energy 0 See Page 2 Services or feeders installation,alteration,and/or relocation Name: Day \40,.,,Ifyli., 200 amps or less 100.70 2 Address: SGS 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 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, t r panel CrAPPLICANT 0 CONTACT PERSON A.Fee for branch circuits with Business name: 5 4,n IA °D 651614 above service or feeder fee, each branch circuit Contact name: 7.42 2 pAiA L 0L-6(:)13 B.Fee for branch circuits without Address: 33 5 - ��Y service or feeder fee,first branch circuit 56.18 j k,.1% 2 City/State/ZIP: 14AC )* J A. 1, 1 Q R- Ri p e 6 Each add'I branch circuit 4 7.42 Qc b� 2 Phone:(50 N Miscellaneous(service or feeder not included) 3 ) �4�' 3414 N Fax:=t:(go ) G 4tS'6 5 3 1 Each manufactured or modular Email: 1 dwelling service and/or feeder 67.84 2 S Q�1 a s, Q I1D4f Y,A+I v L cm Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: p @ e_. . � ^ Signor outline lighting 8 67.84 2r Address: pc /.,` Signal circuit(s)or limited energy n 4. panel,alteration,or extension. 0 See Page 2 2 City/State/ZIP: �A,)I ),, ®I:`i) 111 e_ 0 R �...--1 z.-- 1 Each additional inspection over allowable in any of the above Phone: `� g:,,--1111„ Additional inspection(I hr min) 66.25/hr 3) ,s ,_ ��" Fax:(5.o ,5 '� , fJ t f v Investigation(1 hr min) 90.00/hr Email: c '1 Q.0 0� ,... ` �� Cl"4 Industrial plant(1 hr min) 78.18/hr CCB Lie.: Inspections for which no fee is 90.00/hr ,�j"1 I b Electrical Lie.: ? —3-15‘Suprv. ic. specifically listed(%z hr min) Suprv.Electrician signature,required: 1,, Z„,02,--,,(/ '` ELECTRICAL PERMIT FEES n i t'Lv°/ subtotal: � .Wb Print name: j •"y•1'. 00{y i-io,j, Date: —5=l q, 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): j D, ,I. Authorized signature: ^ TOTAL PERMIT FEE: 46, � t This permit application expires if a permit is not obtained within ISO Print name: 4 Date: 3 —S t� accepted as complete. days after it has been 111 • Number of inspections allowed per permit. 1.1BuiIding\PermitstELC_PmnitApp_ELR_ERE.dac Rev 06/17/2015 440-4615T(11/OS/COM/WEB • . Plumbing Permit Applicatio y- i T Building Fixtures i oa UI L U : I II ov 1.1 City of Tigard •M1M1 Received y 14MAR T /t .5 Date/By: Permit No. S7 JPO ' 1kfy 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ■ Phone: 503.718.2439. Fax: 503.59$196�,.,z ,s Other Permit No.: " DateB f I c_ v R 1, Inspection Line: 503.639.4175 " 4 r i. +,r.; Y Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.govrc,r ',, -, .f !Notified/Method: Supplemental Information TYPE OF wt ,l.lJiiit.a 4,z i a:vimQ: FEE* SCHEDULE 0 New construction 0 Demolition For special information use checklist ,_,/ Description I Qty. Ea. I Total lip Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 -and 2-family dwelling 0 Commercial/industrial ' SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 ❑Master builder Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: t 0344 S .15‘,0 r t'DOis)A 1, s•-r. Catch basin or area drain 18.76 City/State/ZIP: �1 Or3 Q-7ZZrl Drywell,leach line,or trench drain r 18.76 l 1'a 1 Footing drain(no.linear ft.: ) 12, Page 2 Suite/bldg./apt.no.: I Project name: 4A t?- os.) z/5 Manufactured home utilities 50.03 Cross street/directions to job site: 500 rt W.W.I- t-1 ct 0 Manholes 18.76 e'AtiN T a Nt e p(,11JA l a 5-r. 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: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 3/4 fa A t�9/a h W 1 I,.A u+3 p R-( Clothes washer 25.02 Dishwasher 25.02 "IS,i /T%0A/ 2/ (V -3 C��0O/`7S , (/) Drinking fountain 25.02 67777Lel 13, 42/7 (_ a r /e Ejectors/sump 25.02 LE PROPERTY OWNER ( 1_1 TENANT Expansion tank 12.51 Name: 9 A+} it c,4672445 E i+A,nP't 4 Fixture/sewer cap 25.02 Address: I D 3 4f5 5%.,0s Doh)A� ��, Floor drain floor sink/hub 25.02 ' Garbage disposal 25.02 City/State/ZIP: T t 6 AcTIO i0 12 C 7 Z Z t"� Hose bib ( 25.02 Phone:(9;1) 4,240.4.`"160 Fax:( ) Ice maker 12.51 [APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: 5r,4001,6, , )E t 6 4 Medical gas(value:$ ) Page 2 Contact name: v7 Primer 12.51 PAUL.- ®4S 0,4 Roof drain(commercial) 12.51 Address: I t g 3 3 '56 S("`' 1 F Any 'Sink/basin/Iavatory _ 25.02 City/State/ZIP: 4 A Lit,Of Solar units(potable water) 62.54 Phone:(3)3) l:qc g- 3%4144 Fax::(,5 3) 4 t7 ft-4,„537 Tub/shower/shower pan I 12.51 E-mail: 6j 4G Q►mat G.. 5C �' hp+r+A 1 I i 4 pet L Urinal 25.02 CONTRACTOR Water closet ` 25.02 W 1 r����Q o • Water heater 37.52 W Business name: G ,u,w (A G 4 C Water piping/DWV 56.29 Address: /Q bOX a-t/J Other: 25.02 City/State/ZIP: l'ha4// eiK - Ooze- Subtotal Phone:469) '34 /6).00 Fax:( ) Minimum permit fee: $72.50 CCB Lic.: /4,7,47V Plumbing Lic.no.: 3;ea iig Plan review (25%of permit fee) ---4444MLA State surcharge(12%of permit fee) Authorized signature: V K� TOTAL PERMIT FE1:T1 Print name:Xt f (' wgikg Date:3/3/ )4? This permit application expires if a permit is not obtained within 180 days r 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/WnB) C � Efl R VAT VA VET) MAR $ Q1i! Clean Water Services File Number a , / -6,U( ?3� vf, ate \ Services iti jo Sensitive Area Pre-Screening Site Assessment 1. Jurisdiction: 116 2. Property Information(example 1S234AB01400) 3. Owner Information Tax lot ID(s): Name: P AO ft Caerzt.5g6 13/ ^d-P 1'0 t� Company: Address: f-t.V (,tea Site Address: (03 4 S S W It4'1,044k1:0 yam, City,State,Zip: City,State,Zip: 11(DAV 1 , (v't2. cf 7 ZZ,f Phone/Fax: (603) 42 0-2.i 612 Nearest Cross Street: (tun q5 E-Mail: 4. lopment Activity(check all that apply) 6. Applicant Information Addition to Single Family Residence(rooms,deck,garage) Name: ?AIA L 01,4200 ❑ Lot Line Adjustment ❑ Minor Land Partition Company: 1tJ}i-)®yirai e,009 Residential Condominium 9 Commercial Condominium Address: tlq'3 5ut 'j c�Ay ❑ Residential Subdivision ❑ Commercial Subdivision LI Single Lot Commercial la Multi Lot Commercial City, State,Zip: �� `i l) tit ~( i Irl ')1J � Other Phone/Fax: 14;03 ) C f g—341411 01)3)6114-637 E-Mail: .5S r?kv - t(( yep 6. VVIII the project involve any off-site work? ❑Yes Io ❑Unknown Location and description of off-site work 7. Additional comments or information that may be needed to understand your project G.C.7 5C kisrti Fool" /k921,100 1O /26 51t. CC This application does NOT replace Grading and Erosion Control Permits,Connection Permits,Building Permits,Site Development Permits, DEQ 1200-C Permit or other permits as issued by the Department of Environmental Quality,Department of State Lands and/or Department of the Army COE. All required permits and approvals must be obtained and completed under applicable local,state,and federal law. By signing this form,the Owner or Owner's authorized agent or representative,acknowledges and agrees that employees of Clean Water Services have authority to enter the project site at all reasonable times for the purpose of inspecting project site conditions and gathering information related to the project site. I certify that I am familiar with the Information contained in this document,and to the best of my knowledge and belief,this information is true,complete,and accurate. Print/Type Name 'Am X16` = Print/Type Title eolatrz.'�-��°f"z - / Signature `.~ " .__ - Date l61 d FOR DISTRICT USE ONLY ❑ Sensitive areas potentially exist on site or within 200'of the site. THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties,a Natural Resources Assessment Report may also be required. ❑ Based on review of the submitted materials and best available information Sensitive areas do not appear to exist on site or within 200'of the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order 17-05, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local,State,and federal law. Based on review of the submitted materials and best available information the above referenced project will not significantly impact the existing or potentially sensitive area(s)found near the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect additional water quality sensitive areas If they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order 17-05,Section !" 3.02.1. All required permits and approvals must be obtained and completed under applicable local,state and federal law. ❑ This Service Provider Letter is not valid unless CWS approved site plan(s)are attached. ❑ The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2). NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER EQUIRED. Reviewed byDate 3/&It? Once complete, email to: SPLReview@cleanwaterservices.org • Fax: (503)681-4439 OR mail to: SPL Review, Clean Water Services,2550 SW Hillsboro Highway, Hillsboro, Oregon 97123 Revised 8/2017 5w He .(D1,1Ai,9 r , 1 — 122' N . ' 1 . I 1 ,(0.21..1c, vaic,, . . 1 I DR]ye:WAY . , . ; ; i • . , . i 1 . • .: 25'•16 ._ , ; ; I / __ , ,. • 1 `r-------? i 3Gto" - . • 4.- 1 1 . , — .• . A //' .•V' .1 . I ' N r. ! I ; - (t..]0 WO Kli ) N i N / // . . . 1 \I -7 ''/4Prri Old.- -- - . L((:). ed" •• , \ i ! , , I t - : ..?°‘ / .// '/../' k tr: 17 V /40 wo p_e) ( Ko vilw j i , ,/,J,, • v / ,,, ,,, ___,_________ . ..... , ; . • V i 0-1.1V-V./ L7 rf WEL-I— ; 1 . I 1 , 1 1 1 . I i , . ; . 1 I I I to NI r . ! , I 1 12.3 ,. ?Li ° .- F_.., ..___A.\\,.. i 1 5c-ALE '• C ..= sot - o " . e _ Ni41)0- 1,,,IA [ I ..) ''.-- I( 3 '''sr—‘ — e'`. ._—,? , ..,. ._, ----;31 ,„--. (....„ K . 1 i . , IN City of Tigard " COMMUNITY DEVELOPMENT DEPARTMENT T 1 c A lz o Building Permit Review — Residential Building Permit #: /7_57,20/OP" - ©O0 e/ Site Address: /0 L,/5 S ) //41)0,A.Sof l' Project Name: 1.110.11,\ il-r'al Lot #: (New dwellin =subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: 657 f j"„31--R 4 /I /'0 ��� 2-a2o riis; ��� / moi- - L, t<„�/�� erify site address/suite#exists and active in permit system. River Terrace Neighborhood: Erico ❑ Yes,See River Terrace Review Addendum Attached ��S' e Plan Elements: ree(3)copies of site plan sting structures on site / tte plan must be on 8-1/2"x 11"or 11 x 17"paper ,, p'ootprint of new structure(including decks)with finished i D rawn to scale(standard architect or engineer scale) floor elevations orth arrow ergo tility locations&easements(required for new and additions) to address,project or subdivision name and lot number .gi i.ewalk/driveway approach rt .plicant information(name and phone number) it "ocation of wells/septic systems IG of dimensions and building setback dimensions gees to be retained with drip line,and tree ,I 'Square footage of buildings to be demolished protection measures � '3 ,„*. gcne area,percentage of coverage and ,type and location pervious area(applicable if R-7,R-12,R-25&R-40) eet names ru roperty corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? CI Yes i 10 �4 f�of differential) If yes,is a storm water quality facility shown? ❑Ye = , W/Clean Water S ices—Service Provider Letter(lot platted prior to 9/10/1995): Pquired: g Yes,applicant was notified ❑ No Received: Zes CI No ublic Facilities Improvement(PFI) Permit: / �equired: El Yes,Yes,applicant was notified nd Use Case#: WAAppliedFor: CI Yes ❑ No,stop intake aoning: _3.S- 1,,Ip_, Required Setbacks: Front 70 Rear IS Side S Street Side Garage Landscape Requirement: VA' LJ of Coverage Maximum: / /, 6a Building Height: Maximum Height 30 IQ �r �• g Actual Height _1earance .2-Sensitive Lands: ❑ Yes L id"No Type Or Urban Forestry Plan ❑ Conditions "Met"prior to issuance of building permit Notes: II/ Approved By Planning: _a Date: 3/Vie C9/PL- Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: El Approved ❑ Not Approved I:\Building\Forms\BldgPennitRvw RES 061417.docx Building Permit Submittal Original Submittal Date: ._.:_q76/41" Site Plans: # 3 Building Plans: #��/ . Building Permit#: J Enter building permit#above. Workflow Routing: Q'Planning engineering hermit Coordinator wilding Workflow Sign-off: Sign-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. Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: /� } By Permit Technician: �° ,r Date: .,.....0//1--i �y. Engineering Review 7t) ,Slope at building pad: ❑ Conditions "Met"prior to issuance of building permit El Easements (encroachments)per engineering conditions of approval and plat ,Er Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes Td' No Assess Water Quantity Fee in-lieu: ❑ Yes Z No LIDA Facility on lot: El Yes .J No Final Plat Recorded: i/k— ❑ NOT Approved by Engineering: Date: Notes: .12r Approved by Engineering: /ht.J Date: 1 g Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: El Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review El 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: 2ZSIDC Fees Entered: Wash Co Trans Dev Tax: El Yes N/A Tigard Trans SDC: ❑ Yes N/A Parks SDC: ❑ Yes N/A LIDA ❑ Yes N/A47,7,,,,,..--- !prvIDK to Issue Permit oveornator: %f : 3I /' I:\Building\Forms\BldgPermitRvw_RES_010118.docx FOR OFFICE USE ONLY-SITE ADDRESS: h ?II v /Helaarlidi This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Ns Transmittal Letter f!6 n iz n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: /G/ DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: PAL- OL,.5 MAR 14) 2018 COMPANY: SK/�tJDr�, D£�lG� CITY O& rIGARD BUILDING DIVISION PHONE: 503 (01'6 - 3 ` 9'f I BY: RE: I o)'(3 w n`AO q) 5i— /fjj5i 0/ �47/ (Site Address) (Permit Number) �-1 µ'PTu0 SDB' (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: I Description: I Copies: I Description: Additional set(s) of plans. Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. x Other(explain): X 55 '0E7/A l S 110, t i r1 b ! i4 Ai.S TV REMARKS: At, R `�`� BL,vvh- 1� t,4sucA-no FOR OFFICE USE ONLY Routed to Permit Technic' /Date: Initials: Fees Due: ❑Yes d/ Fee Description: Amount Due: $ $ Special Instructions: Reprint Permit(per PE): p Yes Applicant Notified: Date: ,3//T� I ❑ Done Initials: AL— I:\BuildingTorms\TransmittalLetter-Revisions 061316.doc City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10345 SW MCDONALD ST, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2018-00081 Inspection Type: Inspector: 335 Rain drain Aaron Cillo-Gobel Result: PART Comments: Rain drains tied into existing 3" perf piping. Ok to cover. Note: rain drains to be added to permit prior to post and beam structural inspection. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10345 SW MCDONALD ST, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2018-00081 Inspection Type: Inspector: 310 Crawl drain Aaron Cillo-Gobel Result: PASS Comments: Note: crawl drain tied into exterior existing 3" perf piping Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10345 SW MCDONALD ST, TIGARD, OR, 97224 June 15, 2018 at 10:08:55 AM Record Type: Record ID: Residential - Master Permit MST2018-00081 Inspection Type: Inspector: 399 Plumbing final Aaron Cillo-Gobel Result: PASS Comments: Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10345 SW MCDONALD ST, TIGARD, OR, 97224 June 15, 2018 at 10:09:27 AM Record Type: Record ID: Residential - Master Permit MST2018-00081 Inspection Type: Inspector: 199 Electrical final Aaron Cillo-Gobel Result: PASS Comments: Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10345 SW MCDONALD ST, TIGARD, OR, 97224 June 15, 2018 at 9:53:45 AM Record Type: Record ID: Residential - Master Permit MST2018-00081 Inspection Type: Inspector: 699 Mechanical final Aaron Cillo-Gobel Result: PASS Comments: Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10345 SW MCDONALD ST, TIGARD, OR, 97224 July 16, 2018 at 1 :01 :57 PM Record Type: Record ID: Residential - Master Permit MST2018-00081 Inspection Type: Inspector: 299 Final inspection Aaron Cillo-Gobel Result: PASS - CofO Comments: Violation Summary: Inspector Contractor