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Permit (177) CITY OF TIGARD .., ofq MASTER PERMIT 1 COMMUNITY DEVELOPMENT /2 0 +' •i Permit#: MST2018 00120 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/28/2018 T t ''� g Parcel: 2S 110AD 11600 Jurisdiction: Tigard Site address: 10944 SW ANNAND HILL CT Subdivision: ANNAND HEIGHTS Lot: 28 Project: Annand Heights, Lot 28 Project Description: New SF. 12/10/2018: REPRINT permit to add NC. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 774 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 30 Bathrooms: 3 Second: 1135 sf Garage: 396 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes Total: 1909 sf Value: $235,195.29 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 2 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 Tvoes 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 TemD 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 Ecompasing: Y Other: N Other Description: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 1909 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 Required Prior to TIGARD,OR 97223 Pour 3 1 Hour Fire Rated Eaves PHONE: PHONE: 503-625-6526 FAX: 590-7606 Total Fees: $29,398.08 p This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through R 952-0 090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: 6 s -.I-4—C-- Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available Inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Applicat',0, GEIVED FOR OFFICE USE ONLY City of Tigard Received DEC1 2018 Date/By: �.Z // /. r:%/s/ •ermit N,. 5 /I. O/42 d w 13125 SW Hall Blvd.,Tigard,OR 97223Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Other Permit: Date/By: T 1 G A R[7 Inspection Line: 503.639.4175 CITY O C h GARD Date Ready/By: Juris: !a See Page 2 for Internet: www.tigard-or.gov L� 1 tnV`/!± r.eNotified/Method: Supplemental Information 13UILDING DIVISIO 3'YPE` F J 'o is COM11�IiCIAt,FEE SCHEDULE —'4V..*.,„,CHECKL1 1 � +". Mechanical permit fees*are based on the value of the work New construction �' 'y" dit"ion/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ C►1"E °Y O' 0NS RU ON .' k. �"' EQUH'ME /SYSTEMS.FEES* . ,� gm� RESIDEIV '!AL �: 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building' For special information use checklist. { 0 Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total " JOBOCATHeating/cooling: 'i—'1,. Air conditioning 46.75 Job site address: / y� /�L��C�//��/ /,(� Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: // t ,/ Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: Project name: Heat pump 61.06 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.a v Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 .�. s 64 ,4 IO -! t t`1. M1 'r Gas fireplace/insert 33.39 :uk. ' '' "` Flue vent for water heater or gas �V /9-r. e 75//� l J /i- ..c enfireplace 23.32 Log lighter(gas) 23.32 /� 1 / j Wood/pellet stove 33.39 / ' c7 )/ d t Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 13'ROP �; .,r c Other: 23.32 m - Environmental exhaust and ventilation: Name: fru i1 i Cl"C. CI � Gs7 S Z Range hood/other kitchen 33.39 Address: 'f ,j� � ui ment /.,1c----� �,1� if if=1 f. /),..4,h,..., ClothesCldryer exhaust 33.39 City/State/ZIP: 1l 6� 2/ (Ye-- �`��)� Single-duct exhaust(bathrooms, - --e3)-6/' LLL C toilet compartments,utility rooms) 23.32 Phone:( ) / e'G—‘73 77 Fax:( ) Attic/crawlspace fans 23.32 .u, . i. . .t � . I:coWiciii. s,c, Mi.,, Other: 23.32 Fuel piping: Business name: 7 (�-", $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 Range E-mail: Barbecue Clothes dryer(gas) Business name: Other: . Address: ,.m .. - .. ALrE _EE`S*s� re Subtotal City/State/ZIP: Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:( ) Fax:( ) State surcharge(12%of permit fee) CCB lic.: TOTAL PERMIT FEE Ste, 3 This permit application expires if a permit is not obtained within 18 " ----- days®— days after it has been accepted as complete. Authorized signs, r * Fee methodology set by Tri-County Building Industry Service Board Print name: Date://` I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(I 1/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial& Multi-Family Fee Schedule: Total Valttn:. Permit Fee: $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and $2.54 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I:\Building\Permits\MEC_PermitAPP_040113.doc 2 CITY OF TIGARD MASTER PERMIT : s COMMUNITY DEVELOPMENT Permit#: MST2018-00120 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/28/2018 T r c;;+ I:L� 9 Parcel: 2S110AD11600 Jurisdiction: Tigard Site address: 10944 SW ANNAND HILL CT Subdivision: ANNAND HEIGHTS Lot: 28 Project: Annand Heights, Lot 28 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 774 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 30 Bathrooms: 3 Second: 1135 sf Garage: 396 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes Total: 1909 sf Value: $235,195.29 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 2 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: 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 1909 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 Required Prior to TIGARD,OR 97223 Pour 3 1 Hour Fire Rated Eaves PHONE: PHONE: 503-625-6526 FAX: 590-7606 Total Fees: $29,345.72 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 952-0�-0090. You ma obtain a copy f the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: '7.. _A--{ .�ittee Signature: I ' _ II. __ / 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. 1 Building Permit Application• • Residential a. ,i " .. # FOR OFFICE USE ONLY Received 1, / Permit No.:/1,157014). of Ti andi „,if City g Date/By: / i � Other Permit: 18,-....xi:�j- II a 13125 SW Hall Blvd.,Tigard,OR 97223 i 2 Plan Review I j Phone: 503.718.2439 Fax: 503.598.1960 = DDate/By: � �p'U ��ckir_ /2 ' T I GARD Inspection Line: 503.639.4175 Date Ready/By: loris: 0 See Page 2 for Internet: www.tigard-or.gov • No ed/Method: 5/ // � 9TlZfi Supplemental Information TYPE OF WORK ” ' rt a " REQUIRED DATA:I-AND 2-FAMILY DWELLING 'New construction 0 Demolition Permit fees*are based on the value of the work performed. I 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 this application. ^ , -- ` h l-and 2-family dwelling 0 Commercial/industrial Valuation: $ o3S, 11S- ❑Accessory building 0 Multi-family Number of bedrooms: / ❑Master builder 0 Other: Number of bathrooms:`f' 3 JOB"_SIyT�E INFORMATION AND LOCATION:: Total number of floors: 2, bS Job site address: j ll L� f c.54i 4nn4�d /1,i/ (O4/--1 ` New dwelling area: ro,1 square feet 1 ( - City/State/ZIP: J_��'6/l�� ��; 9� Garage/carport area: /c��CJ square feet �,y Suite/bldg./apt.no.: Project name: /Q,n n GA ' /lC(' A Covered porch area: square feet 1 a Cross street/directions to job site: /(79*A I6 Deck area: square feet Other structure area: square feet 4 REQUIRED DATA:COMMERCIAL-USE CHECKLIST' - Subdivision: /n/la/ld j t A 15 Lot no.: 2 g Permit fees*are based on the value of the work performed. . Indicate the value(rounded to the nearest dollar)of all . Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the ' DESCRIPTION OF WORK work indicated on this application. / e-it) i P/2 Valuation: $ Existing building area: square feet New building area: square feet 0 PROPERTY OWNER 0 TENANT Number of stories: Name: /( PJJ (Lido") CU/l-SrLT QL) PX- Type of construction: Address: /c22,45.--5- 5t1/4..) fifd12,, I)aet.6, fC. '0/- re.IC Occupancy groups: City/State/ZIP: Tiya,(7// en 2_23 Existing: Phone:(. 3 7S-'-(37c Fax:(5-03) S3U-7L d4 New: ❑ APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* (Please refer to Business name: �e Structural plan review fee(or deposit): Contact name: FLS plan review fee(if applicable): Address: Total fees due upon application: City/State/ZIP: Amount received: Phone:( ) Fax::( ) E-mail: idti/AOftmc e 's OMG$/U IL? �C 9/r a- l t CUA PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* v Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System. I�J Business name: �A -id� "-S L Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: ,4 5-5- ci O Aloft t,4 /)4 /4.. t1 Irzel Solar Installation Specialty Code checklist. City/State/ZIP: 7/ ait G� �r q'722-3 Permit Fee(includes plan review $180.00 / and administrative fees): Phone:(5r3) gp' -- 7$r Fax:( 613 6-90--zae, State surcharge(12%of permit fee): $21.60 CCB lic.: 5-27/96, Total fee due upon application: $201.60 Authorized signaturei'� This permit application expires if a permit is not obtained � "�_= within 180 days after it has been accepted as complete. Print name: Q s- Date:Date: *Fee methodology set by Tri-County Building Industry �� Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) • Mechanical Permit Applicatioi)F""r FU .OFFICE USE ONLY City of Tigard Dateiv Received Permit No.: 5 - "I 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 DateBy: Other Permit: T I G A R D Inspection Line: 503.639.4175 Date Ready/By: luris: H See Page 2 for Internet: www.tigard-or.gov - Notified/Method: Supplemental Information a COMMERCIAL'FEE* SCHEDULE- USE CkILCKLIST a TYPE OF W1 ' Mechanical permit fees*are based on the value of the work dew construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CA ITGO OF,CONST RLTC I30N; RESIDENTIAL EQTJPMENT-/SYSTEMS FEES* and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist ❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total tZ 3o.$ S',iF.Td4,44IRI1 %'IiON LOCATLON,, l'' Heating/cooling: Air conditioning 46.75 Job site address:/d q! y ..5-,„- �qAc f74//A Furnace 100,000 BTU(ducts/vents) ..' 46.75 r- City/State/ZIP: - Furnace 100,000+BTU(ducts/vents) 54.91 a'v` 0,-e, 9-7,22,3 Heat pump 61.06 Suite/bldg./apt.no.: Project name:�� lla ,G% Duct work 23.32 Cross street/directions to job site: i/o/ t:-.4 Hydronic hot water system 23.32 7� 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 ft y15 Lot no.: 2.. Other 23.32 Subdivision: All A/14 n � '; v• Other fuel appliances: Tax map/parcel no.: Water heater ✓ 23.32 DESCTiiiriA N(*:wciRK. ; Gas fireplace/insert 33.39 -, ` . `-- ' Flue vent for water heater or gas i V/ f 5'P-,- 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 f ,_, K©F � EB N E Environmental exhaust and ventilation: Name: I®4 /A��� d &t.571 1 G Range hood/other kitchen V/- equipment 33.39 Address: /a4,5-5- 5c /(fdr$'� , . S Clothes dryer exhaust .°' 33.39 City/State/ZIP: �j�,, c,,Z q-7�?i3 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 0 23.32 Phone:( 5 426 d - ? Fax:cO 3) gyo 406 Attic/crawlspace fans 23.32 :; PLIGANT ..`❑ CONTACT PERSON Other: 23.32 Fuel piping: Business name: 60 fit er $14.15 for first four;$4.03 for each additional Contact name: Furnace,etc. Gas heat pump Address: Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( ) Fax: :( ) Fireplace Range E-mail tu!fi (, 1 C cfc fr,<S/1/6,_)®� Jt"La (7M Barbecue ,CON17tAMTOR';.. ' Clothes dryer(gas) Business name: - / Other: * F l T�p` ��l �// MECHANICAL PERMIT FEES Address: f/3, /5V ,(i Cm4,5 �<- -- 4J'- Subtotal City/State/ZIP: dk (ar[� �' do l/ ys Minimum permit fee($90.00) ` f Plan review(25%of permit fee) Phone:( ) Fax:( ) State surcharge(12%of permit fee) CCB lic.: 7.4TOTAL 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: / 7T �,1 Date: Lf y I\Ruildine\Permits\MEC PermitAno 040440-46 (11//02/COM/WEB) Electrical Permit Application• Fc .IFFICE USE ONLY . . City of TigardillDateived 1 v 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/13 : EIMENEINIBM Related Permit#: Inspection Line: 503.639.4175 .„, Ready Date/By: Juris' a See Page 2 for TI G A R D Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK ,,: N" ` PLAN REVIEW AfforNew construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings, O 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family 0 Master builder El Other: ['Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ['Emergency system. larger separately derived } � �/ 0 Addition of new motor load of system Job#: Job site address:/e) Vy /44 n qi(_�!/J,4 i 100HP or more. ❑"A","E","1-z","1-3", 0 Six or more residential units. occupancy. City/State/ZIP: 97203 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: }5L^ �c/ 1# 0 Hazardous locations. 0 Supply voltage for more than /, 0 Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: /AO tb FEE SCHEDULE 117 Description I Qty. I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision: /.c,LS t is Lot#: Includes attached garage. /411/1Q/tel V 1,000 sq.ft or less / 168.54 4 Tax map/parcel#: Ea add'1500 sq.ft.or portion ,2,, 33.92 1 DESCRIPTION OF WORK Limited energy,residential � + (with above sq.ft.) 75.00 2 ilia.) r/�� Limited energy,multi-family residential(with above sq.ft.) 75.00 2 Renewable Energy ❑ See Page 2 'PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name: toy."Ladd 6„ s ti,,,,,, pr_ 200 amps or less 100.70 2 Address: p�!�((/5-S 6 �� CO NY ” pa-F-L(,,A. S a 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: -70cure,/y T f72.23 601 amps to 1,000 amps 301.04 2 Phone:(3 . 760—17/3 7 Fax:6e8 )570 —74,44 Over 1,000 amps or volts 552.26 2 V���1(�ft�l� / ZS Mw �j� �(/� Temporary services or feeders installation,alteration,and/or Email: i 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 ICANT 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name: j � above service or feeder fee, 7.42 2 l./`' each branch circuit Contact name: B.Fee for branch circuits without service or feeder fee,first 56.18 2 Address: 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: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: Orca ir)4 _g( *I-cc:A L Sign or outline lighting 67.84 2 / Signal circuit(s)or limited-energy Address: 1 ' ce_J (dn panel,alteration,or extension. 0 See Page 2 2 City/State/ZIP: �(..-- A 4 4)� Gf �5j Each additional al inspection inspectionIhri over allowable in any of the above Additional (I hr min) 66.25/hr Phone:r z.3) °y/l .�'7(l Fax:(j '2) f fh'..-97Z3 Investigation(1 hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.:/qt,z,24 Electrical Lic.&—"fe Suprv.Lic.:Y5OS specifically listed(A hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: J Subtotal: Print name !Vn 5 A k C�� //Date: b! 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): I: — TOTAL PERMIT FEE: : Authorized signature This permit application expires if a permit is not obtained within 180 Print name: c,A j-1'D ma itcme Date: L//j 4//f bi days after it has been accepted as complete. G/ * Number of inspections allowed per permit. 1'Budding\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/] 5 440-4615T(11/05/COM/WEB 1 • 1110 Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE I * Fee for all residential systems combined: $75.00 Deeniwon Qty. Each Total y Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 n Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: Ti Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 0 Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 2 ❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 Ti Vacuum Systems* >100 kva—no additional charge 0.0 3 Each additional inspection over allowable in any of the above: Ti Other: Each additional inspection is charged at an hourly(I hr min) 66.25/hr Inspections for which no fee is 90.00/hr specifically listed(V2 hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES 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 C Boiler Controls Ti Clock Systems n Data Telecommunication Installation n Fire Alarm Installation ❑ HVAC ❑ Instrumentation E Intercom and Paging Systems • Landscape Irrigation Control* ❑ Medical ❑ 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 116uilding\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015 Plumbing Permit Application• ,i , Building Fixtures -1 FOR OFFICE USE ONLY 1: Received City of Tigard Date/By: Permit No.: 02,0 IIIa 13125 SW Hall Blvd.,Tigard,OR 97223 �5��"'J � Plan Review Phone: 503.718.2439 Fax: 503.598.1960 . n Date/By: Other Permit No.: T I GARD Inspection Line: 503.639.4175 Date Ready/By: Juris: Er See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK '' ` ` FEE* SCHEDULE •xcI% ew construction ❑Demolition For special information use checklist Description I Qty. Ea. Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION 1 SFR(1)bath 312.70 /" and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ®®®' SFR(3)bath 500.32 ❑Accessory building ❑Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 9Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: - J O'/L� T 723 ���y�o n�G���� Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name: C!` A b Manufactured home utilities 50.03 CJ Cross street/directions to job site: Manholes 18.76 i®9 0 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: M naILi //to it,/5 1 Lot no.: .CO _Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 c`" Clothes washer 25.02 /vv ) Sf/Z Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 PROPERTY OWNER 0 TENANT Expansion tank 12.51 Name: kJ/tic/taw ord lams p Fixture/sewer cap 25.02 � Floor drain/floor sink/hub 25.02 Address: -S--s' NoT fr j-/94466_ l.e.„.1Garbage disposal 25.02 City/State/ZIP: 'V a, gz, /77,3a. ....3 Hose bib 25.02 Phone:( 7 --Li'70 7S Fax:(c'3 SC/-7oj0.4" Ice maker 12.51 ❑ APPLICANT " 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: 50,/y1 Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 12.51 E-mail: A./IMS ord iii JM-i N(v 'l / . / c Urinal 25.02 Water closet 25.02 CONTRACTOR /A S 4 Water heater 37.52 Business name: �O!- �4 M I �� Water piping/DWV 56.29 Address: � ,HO 5 iSeil `i /',/ Other: 25.02 City/State/ZIP: O/- i e Jo, C14 f70- 5- Subtotal Phone:(5zi3) ` g...3 ^ s Fax:(5-e3) 7,_3,5 / Minimum permit fee: $72.50 CCB Lic.: jii‘04 k3 7 Plumbing Lic.no.: Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name: kLDate: �,/� ii, 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. 1:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(]0/02/COM/WEB) r City of Tigard 7111 COMMUNITY DEVELOPMENT DEPARTMENT T I G A R D Building Permit Review — Residential Building Permit #: ,iys 7-49,6 i i100, Site Address: 10 C141 A SvA/ A n i l(4n c& k- I I c -- Project Name: PYt rt Art ck- H-ej`j h"IT Lot #: 2-S (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: (V eAAiSE(. Verify site address/suite# exists and active in permit system. River Terrace Neighborhood: if No ❑ Yes,See River Terrace Review Addendum Attached Site Plan Elements: )21hree(3)copies of site plan Exitingstructures on site Site plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished )2trawn to scale(standard architect or engineer scale) floor elevations p'North arrow ,2ttility locations&easements(required for new and additions) 'Site address,project or subdivision name and lot numberidewalk/driveway approach /Applicant information(name and phone number) ❑Lesation of wells/septic systems JL'Lot dimensions and building setback dimensions , txisting trees to be retained with drip line,and tree ame_€ootage of buildings to be demolished protection measures ,I/J J� /Lot area,building coverage area,percentage of coverage and reet tree size,type and location impervious area(applicable if R-7,R-12,R-25&R-40) SCJ Street names /Property corner elevations (2 foot contour lines if more than >1,000 sf of impervious area created or replaced? Aes ❑No S)1J3 4 foot differential) If yes,is a storm water quality facility shown? ❑Yes,O`No ,Z1 Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995): Required: E Yes,applicant was notified ,e No Received: E Yes ❑ No Public Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified E No Applied For: ,Yes ❑ No,stop intake Land Use Case#: r D R 2'C i C 0 000S 5 V 8 2A) I S - 0 O 013 Zoning: e I Z ,'Required Setbacks: Front 15 Rear 15 Side 5 Street Side g Garage 2.<.. Landscape Requirement: -'z, gLot Coverage Maximum: 0 0 % 2 eZ Building Height: Maximum Height 15 Actual Height '0 Visual Clearance Sensitive Lands: ❑ Yes No Type Urban Forestry Plan Conditions "Met"prior to issuance of building permit Notes: Approved By Planning: AA n 1 " (A�' Date: It 2,-4, 1 (`J'c� Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw RES_061417.docx J Building Permit Submittal Original Submittal Date: l /1 Site Plans: # 3 Building Plans: # Building Permit#: �� erer::building permit#above. Workflow Routing: [ 1h1 nntng ®--Eri i eeringrmit Coordinator Gilding Workflow Sign-off: [ Sign-off for Planning(include notes from planning review) Route Application Documents: D.-Errgineering: (1) copy of permit application, (1) site plan, (1) building plan and ori �a1 plan review routing form. 2"Building: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: �� Date: /01? /� Engineering Review Slope at building pad: 40 Conditions "Met"prior to issuance of building permit eS Easements (encroachments) per engineering conditions of approval and plat ,,Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes Er No Assess Water Quantity Fee in-lieu: ❑ Yes 'No LIDA Facility on lot: ❑ Yes �No 2"Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: ki/1, I tit) Date: 11-' Revisions (after Building Submittal only) Reviewer ate 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: SDC Fees Entered: Wash Co Trans Dev Tax: !S1.-Yes ❑ N/A Tigard Trans SDC: -Yes ❑ N/A Parks SDC: R"Yes kU N/A LIDA ❑ Yes N/A OK to Issue Permit Approved by Permit Coordinator: ZA iv`401' Date: 1-\\39°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: 10944 SW ANNAND HILL CT, TIGARD, December 21 , 2018 at OR, 97224 8:49:57 AM Record Type: Record ID: Residential - Master Permit MST2018-00120 Inspection Type: Inspector: 199 Electrical final Jeremy Burrows Result: PASS Comments: Note: A/C installed. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10944 SW ANNAND HILL CT, TIGARD, December 21 , 2018 at OR, 97224 8:49:27 AM Record Type: Record ID: Residential - Master Permit MST2018-00120 Inspection Type: Inspector: 399 Plumbing final Jeremy Burrows 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: 10944 SW ANNAND HILL CT, TIGARD, December 27, 2018 at OR, 97224 9:19:52 AM Record Type: Record ID: Residential - Master Permit MST2018-00120 Inspection Type: Inspector: 699 Mechanical final Jeremy Burrows 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: 10944 SW ANNAND HILL CT, TIGARD, January 4, 2019 at 9:27:01 AM OR, 97224 Record Type: Record ID: Residential - Master Permit MST2018-00120 Inspection Type: Inspector: 299 Final inspection Jeremy Burrows Result: PASS - CofO Comments: 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