Permit (77) CITY OF TIGARD MASTER PERMIT
11. COMMUNITY DEVELOPMENT Permit#: MST2018-00100
TE1•.aARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/03/2018
Parcel: 2S110AC03700
Jurisdiction: Tigard
Site address: 11029 SW ANNAND HILL CT
Subdivision: ANNAND HEIGHTS Lot: 14
Project: Annand Heights, Lot 14
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 4 First: 998 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1367 sf Garage: 496 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
Total: 2365 sf Value: $295,363.19 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 4 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
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<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: 3 201-400 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 2365
Owner: Contractor:
ANNAND HILL LLC WINDWOOD CONSTRUCTION INC Required Items and Reports(Conditions)
BY RICHARDS,M DALE 12655 SW NORTH DAKOTA 1 Ersn Cntrl 503-639-4175
12655 SW NORTH DAKOTA ST TIGARD,OR 97223 2 Geo Tech Report Required
TIGARD,OR 97223 Prior to Pour
3 Fire Rated Eaves
PHONE: PHONE: 503-625-6526
FAX: 590-7606
Total Fees: $30,510.89
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- •• nf the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
r
Issued By: Permittee Signature:
503.639.4175 by 7:00 a.m.for the next available inspection d.• �
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 Applicatio •
n
ResiCdential a �� FOR OFFICE USE ONLY
itjCity of Tigard .. s eceived
II ill P ateBy: �} Pemit No.: r �,y jo o
13125 SW Hall Blvd.,Tigard,OR 97223 PlanReview
d7/ �Q ,,,6;p7___
/� a? J W`l
Phone: 503.718.2439 Fax: 503.598.1960 PDateBy: LittO (,v 14*" Other Permits�,�_drr�„Crt4t?6.c
TIGARD Inspection Line: 503.639.4175 ri� 2 201 Date ReadyBy. ` loris: p See Page 2 for
Internet: www.tigard-or.gov I Notified/Method: Z7-3.,155; Supplemental Information
4 y 't X r
y7 y
TYPE OF W . pip`.('rtiVIcloA. 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
0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for .-
CATEGORY OF CONSTRUCTION work indicated on t ts,alication.
Mechanical Permit Applicatio• Ft.. OFFICE USE ONLY
:11
- Cityan
Of Tigard Received
g Date/By: Permit No.:y ,'Jo�, 'C .,
a 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: loris: El See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
li,TYPE OF,WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
lal<w construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
�❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
, .. .t' ' «CATEG'cORY 1)F-CONSTRUCTION" EES*
' Value:
� RESIDENTIAL EQUIPMENT/SYSPEMS F
and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
0 Multi-family 0 Master builder ❑Other: Description Qty. Ea. Total
--"':','-':''4'i ;4OB,SITE'INFORMATION AND'LOCATION: ' Heating/cooling:
: ' Air conditioning 46.75
Job site address: /1001,."--tor1-71 A alta, /.74//l[/04 I-I/ Furnace 100,000 BTU(ducts/vents) 46.75
J �',
City/State/ZIP: ard (7,t. 9'22 3 Furnace 100,000+BTU(ducts/vents) 54.91
��/� Heat pump 61.06
Suite/bldg./apt.no.: Project name:�n �A„, 4 bDuct work 23.32
Cross street/directions to job site: ,/e9¢ t..4 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: L fin4 / /�,h Lot no.:
Other: 23.32
r "(J i ii
Other fuel appliances:
Tax map/parcel no.: Water heater .O 23.32
DESCRIi'TIUN,UF FORK" Gas fireplace/insert 33.39
A s Flue vent for water heater or gas
4/C t1 SIP"— fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
;,: , ROPERTY_OWNER: ❑".TENANT
e Environmental exhaust and ventilation:
Name: /A)/it cif
� it 51 j-h. Range hood/other kitchen
/���"` �7 equipment 33.39
Address: Ifo 5-5' 6 �/Cdr/.h A, 5/,fel Clothes dryer exhaust 33.39
City/State/ZIP: �" �1 Single-duct exhaust(bathrooms,
7,,,,,,,,,/
� �� �` ��2,3 toilet compartments,utility rooms) 0 23.32
Phone:( 5-03 76d -J./37c- Fax:c0 3) 0 .--7G�G Attic/crawlspace fans 23.32
PLICANT ' in CONTACT PERSON Other: 23.32
Fuel piping:
Business name: 60Ati.e
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax: :( ) Fireplace
f, �� Range
E-mail:
toil (1u -ddc, 11`t5 Ivo..) gia-iI, (0/M Barbecue
'CONTRACTOR' Clothes dryer(gas)
y - Other:
rJrlr
Business name: -F ( 1//7-r, (,,,A,4,7 /
/t MECHANICAL PERMIT FEES*
Address: /3/Sl) z/ ieinw5 /c ,t. D . Subtotal
City/State/ZIP: l LfA_ 6 070/) o f J Minimum permit fee($90.00)
0 Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
CCB lie.: 72 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: f19 /1 * Fee methodology set by Tri-County Building Industry Service Board
Print name: ` `1��j / Date:
40,
T 1Ruildine\Permits\MEC PermitAoo 0401113 doc 440-46t7T(11/02/COM/WEB)
Electrical Permit Application. Ft JFFICE USE ONLY
City of Tigard Received
Plan R
13125 SW Hall Blvd.,Tigard,OR 97223 y
1/11
■ 1210/111111.111 ,
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
Date/B : Related Permit 4:
T I G A R D Inspection Line: 503.639.4175 Ready Date/By: Juris
Internet: www.tigard-or.gov S See Paget 2l nr
g c Notified/Method: InformationSupplemental
TYPE OF WORK PLAN REVIEW
New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Other:
where the available fault cunent 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or
❑Floating buildings.
❑ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑Multi-famil amps for all other installations. buildings.
Y ❑Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job 4: Job site address:I(/� /� 0 Addition of new motor load of system.
add
A-4 n 4/101 f/�f�4./%/ l 00HP or more. ❑ `A„ E„ 1.2„ "l_3„
City/State/ZIP: itc. �72-�3
0 Six or more residential units. occupancy.
5r 0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: Am,,,d ie, ` 0 Hazardous locations. 0 Supply voltage for more than
0 til �jZ ,Lvh ❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site:
FEE SCHEDULE
Description Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision: n^nani At?) /5 Lot#: Includes attached garage.
Tax map/parcel#: V / 1,000 sq.ft or less 168.54 4
DESCRIPTION OF WORK Ea.add'1 500 sq.ft.or portion 33.92 I
Limited energy,residential
A,GO 5r, (with above sq.ft.) f 75.00 2
Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
�"P1>"OPERTY OWNER 0 TENANT Renewable Energy 0 See Page 2
Services or feeders installation,alteration,and/or relocation
Name: to I' mad„/ /;,mss/7__ th 200 amps or less 100.70 2
Address: IgQSS 6� a /, Pia Ic 6 a 201 amps to 400 amps 133.56 2
City/State/ZIP: 76 *j, / f7 .� ? 401 amps to 600 amps 200.34 2
V v a- 1� 601 amps to 1,000 amps 301.04 2
Phone:(1r3 • 7h0 ? 7S— Fax:(5i3 7 )5O —2444 Over 1,000 amps or volts 552.26 2
Email: #J/("'���-tota,"�,y t'S M 6�� I ,C�� 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 I
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
LICANT 0 CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: (5Q:Ave above service or feeder fee,
Contact name:
each branch circuit 7.42 2
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
Phone: Miscellaneous(service or feeder not included)
( ) Fax: :( ) Each manufactured or modular
Email:
dwelling,
service and/or feeder 67.84 2
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Sign Business name: 4,..eCt/�Uft-gC friZ(,�,r/L g or outline lighting 67.84 2
SiAddress: ��/ ,��- c� /1160,4
o , �„/ d, PI panel!alte alteration,or circuit(s)or extension 0 See Page 2 2
City/State/ZIP: ciaA, �)� C/''1 r1-�� Each additional inspection over allowable in any of the above
Phone: 3) 5-/9 /r.-��� C�F�. •fes' p Additional inspection(1 hr min) 66.25/hr
I 'Zs �/�) y rb-_97.3 Investigation(1 hr min) 90.00/hr
Email: Industrial plant(1 hr min) 78.18/hr
G Inspections for which no fee is
CCB Lic.:®[4,2,2_4Electrical Lic.:4— fe Suprv.Lic.:'ZO_ specifically listed('/z hr min) 90.00/hr
-
Suprv. Electrician signature,required: ELECTRICAL PERMIT FEES
Subtotal:
Print name kr-05 hi 4.AciDate: /°? `��`, 0 Plan Review Required(25%of permit fee):
! State surcharge(12%of permit fee):
Authorized signature:^ — * TOTAL PERMIT FEE:
Print name:
This permit application expires if a permit is not obtained within 180
C T, , met r1 Date: 3'/�y,/�r days after it has been accepted as complete.
ff * Number of inspections allowed per permit.
I\BuildingWermits\ELC_PermitApp_ELR_ERE.doc Rev 06/15 440-461ST(11/0S/COWWEB
•
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Fee for all residential systems combined: $75.00 Description Qty. Each Total *
y Renewable electrical energy systems:
Check Type of Work Involved: s kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
E Burglar Alarm 25.01 to 50 kva 301.04 2
n Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance 552.26 2
with OAR 918-309-0040)
L 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:
n Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(/2 hr min)
COMMERCIAL WORK ONLY•• ELECTRICAL PERMIT FEES
$75.00
Fee for each commercial system: Subtotal(Enter on Page 1):
* Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
n Audio and Stereo Systems
n Boiler Controls
n Clock Systems
n Data Telecommunication Installation
n Fire Alarm Installation
n HVAC
n Instrumentation
❑ Intercom and Paging Systems
n Landscape Irrigation Control*
❑ Medical
n Nurse Calls
n Outdoor Landscape Lighting*
Protective Signaling
n Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
1:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015
Plumbing Permit Applicatio.
Building Fixtures FOR OFFICE USE ONLY
•
City of Tigard Received
Date/By:13125 SW Hall Blvd.,Tigard,OR 97223 Permit No.:
Plann Review
� C✓�` L)
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.:
Inspection Line:ww.t503.639.4175
TIGARD
Internet: Line:gard-or.gov Date Ready/By: Juns: 8 See Page 2 for
Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
s;' ew construction
0 Demolition For special information use checklist
0 Addition/alteration/replacement 0 Other: Description Qty. Ea. Total
New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
,2`1-and 2-family dwelling SFR
❑Commerctal/industrial (2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
0 Master builderEach additional bath/kitchen 25.02
0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION
Site utilities:
Job site address: /I!' (5 AA ng _ _/ ih ii 64 / Catch basin or area drain 18.76
City/State/ZIP: l ` V� /�tFir r7� r'T Drywell,leach line,or trench drain 18.76
/ge A. Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name: !`
/I/lA/1 v Manufactured home utilities 50.03
Cross street/directions to job site: Manholes
18.76
/®9 .j 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: /I6IL1 llzo 4,/5 I Lot no.: /�"y Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF'WORK Backwater valve 12.51
Clothes washer 25.02
Nr� 5-/=-4. Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER 0 TENANT Expansion tank 12.51
/ ® S }'�,e Fixture/sewer cap 25.02
Name: �/dld/2(�C✓2'I dtt, �O/, �.' C,
Address: /01‘ 4: �1 ,f) _ /�_./� 5-,is-1.,,-./
Floor drain/floor sink/hub 25.02
(/`(� 7�'�l> fie. G 1<<// Garbage disposal 25.02
City/State/ZIP: 7c a/ e5L q"73
Phone:( Hose bib 25.02
/ 7r- Fax:(Se/3 5 -76 t Ice maker
0 APPLICANT ' 12.51
0 CONTACT PERSON Interceptor/grease trap 25.02
Business name: �j- Medical gas(value:$ ) Page 2
Contact name: Primer 12.51
Address:
Roof drain(commercial) 12.51
Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
Urinal 25.02 WI ' idifUin,r5 A/c.� / ! d �G
CONTRACTOR Water closet 25.02
t ® df4�L '� Water heater 37.52
Business name: �O� /tf/Z / 9 l!/Jy
Water piping/DWV 56.29
Address: /. //3 6* 6f 1/ Other:
25.02
City/State/ZIP: O/' eA Al e),1 f'2.0Subtotal
Phone:(5'23) 7g3 r-grg Fax:(p3) ,5�6/ Minimum permit fee: $72.50
CCB Lic.: yo ,,2 9 Plumbing Lic.no.: 5„� R3 Plan review (25%of permit fee)
S ���'°f State surcharge(12%of permit fee)
Authorized signature:
TOTAL PERMIT FEE
Print name: ci)ciit to/ Date: rj f . 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(]0/02/COM/WEB)
City of Tigard
p COMMUNITY DEVELOPMENT DEPARTMENT
11,1 _
c A R o Building Permit Review — Residential
Building Permit #: fr)5 779z lY'—66 I 0 0
Site Address: 1102_1 5\,,/ A,,, ,4 [HI C.I.
Project Name: A 04 14( 111Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: Wt.,/ Sl=K
21/yerify site address/suite#exists and activin permit system.
(1/River Terrace Neighborhood: LTJ No ❑ Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
ree(3)copies of site plan E,��E 'sting structures on site
e plan must be on 8-1/2"x 11"or 11 x 17"paper IbAr'ootprint of new structure(including decks)with finished
rawn to scale(standard architect or engineer scale) poor elevations
/north arrow 11dUi' ty locations&easements(required for new and additions)
MIIK e address,project or subdivision name and lot number RSidewalk/driveway approach
[ 'Applicant information(name and phone number) Location of wells/septic systems
PB t dimensions and building setback dimensions Lxisting trees to be retained with driline,and tree
IA •uare footage of buildings to be demolished p
. otection measures
0 Lot area,building coverage area,percentage of coverage and IP2 3reet tree size,type and location
i9apervious area(applicable if R-7,R-12,R-25&R-40) treet names ��
roperty corner elevations (2 foot contour lines if more than >1,000 sf of impervious area created or replaced? L�'I'es ❑No
�4 foot differential) If yes,is a storm water quality facility shown? ❑ ❑No
E Clean Water Services—Service Provider Letter of platted prior to 9/10/1995):
,��quired: El Yes,applicant was notified [ 'No Received:
❑ Yes El No � v►�
[B Public Facilities,_,_�Improvement(PFI) Permit:
,,_,/Required: [ Yes,applicant was notified ❑ No Applied For:
� Yes ❑ No,stop intake
(2(;,and and Use Case#: pO�ZQjc—0000g
A Zoning: K-12_ 1 U)
I� i2_ quired Setbacks: Front IS Rear lc Side 3 Street Side N4 Garage Zo
IUZLandscape Requirement: J„) %
IT/Lot Coverage Maximum: g() 0/0
EY Building Height: Maximum Height g 3S Actual Height Zci
V/isual Clearance
,� (12(Yes nsitive Lands: es ❑ No Type Ver
`91-41 �L Z S/
[�V, �Urban Forestry Plan
CD Conditions "Met"prior to issuance of building permit
Notes: , 2 S4`rte y Siln,rn o f‘ cot eku, iti 4,. di4vGd-
[a � � 1 rcC elm, 0m lir( Ip
lo l.nJl,� LAdh4-rcc 1� J']C dr� ts7/Approved
By Planning: 1
� 41,____ Date: '3-Zq _ly
Revisions (after Building Submittal only) Reviewer
Revision 1: ❑ Approved ❑ Not Approved Date
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw RES 061417.docx
Building PeSubmittal
Original Submittal Date: 3I47/l(S'
Site Plans:
Building Plans: # 3
Building Permit#: nter building permit .above.
Workflow Routing: lanning gieering ti-mit Coordinator ming
Workflow Sign-off: [-Si -off for Planning(include notes from planning review)
Route Application Documents: [ngineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
iiLekitiiding: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: ' '--,
Date: J� 7 r
En ineering Review 1,41�
lope at building pad:
❑ Conditions "Met"prior to issuance of building permit
❑ asements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility: (1
Assess Water Quality Fee in-lieu: 0 Yes ,EI-No C510(-(
Assess Water Quantity Fee in-lieu: 0 Yes -D No ,
LIDA Facility on lot: 0 Yes ,'No S 21 Lf3'
Final Plat Recorded:
0 NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: ' 1,4e tA, t Date: 1-- `► f f,
Revisions (after Building Submittal only)
Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
Permit Coordinator Review
0 Conditions "Met"prior to issuance of building permitill I c/
NOT Released: TA„,,,eif ypi.4461re-,---ider) Mter. Date: 4 l4/iApproved,
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
7
C Fees Entered: Wash Co Trans Dev Tax: Oa..-s 0 N/A
Tigard Trans SDC: ijYes 0 N/A
Parks SDC: 7./" es 0 N/A
LIDA 0 Yes T/A
J(OK to Issue Permit
Approved by Permit Coordinator: 4-kl.,
Date: 5 3 l
I: I\Building\Forms\BldgPermitRvw_RES_010118.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11029 SW ANNAND HILL CT, TIGARD, December 5, 2018 at
OR, 97224 10:56:45 AM
Record Type: Record ID:
Residential - Master Permit MST2018-00100
Inspection Type: Inspector:
699 Mechanical final Jeremy Burrows
Result:
PASS
Comments:
Note: no A/C
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11029 SW ANNAND HILL CT, TIGARD, December 18, 2018 at
OR, 97224 1 :14:30 PM
Record Type: Record ID:
Residential - Master Permit MST2018-00100
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS
Comments:
Correction from previous inspection complete.
No ac installed at this time.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11029 SW ANNAND HILL CT, TIGARD, February 25, 2019 at
OR, 97224 12:51 :32 PM
Record Type: Record ID:
Residential - Master Permit MST2018-00100
Inspection Type: Inspector:
299 Final inspection Aaron Cillo-Gobel
Result:
PASS - CofO
Comments:
Final erosion control passed
Moisture content form received
High efficiency lighting form received
Insulation certification verified
Blower door and/or duct seal test certificate received
C of 0 left on counter.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11029 SW ANNAND HILL CT, TIGARD, February 25, 2019 at
OR, 97224 11 :34:28 AM
Record Type: Record ID:
Residential - Master Permit MST2018-00100
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS
Comments:
Previous corrections completed.
Violation Summary:
Inspector Contractor