Permit (165) CITY OF TIGARD MASTER PERMIT
I COMMUNITY DEVELOPMENT �.
3 Permit#: MST2018-00196
T 1 C, P.f7 A 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 '
Date Issued: 08/20/2018
z �` ��� Parcel: 2S104AC15900
Jurisdiction: Tigard
Site address: 12807 SW 132ND AVE �
Subdivision: 2018-026 PARTITION PLAT Lot: 1
Project: Csokas Partition, Lot 1
Project Description: New SF. 9/17/19: REPRINT to add NC. A/C unit must meet manufacturers placement
requirements.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1516 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1855 sf Garage: 573 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 3371 sf Value: $428,452.95 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add!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 Group: Square Feet:
NEW SF VB R-3 3371
Owner: Contractor:
HT REMODELING&DESIGN LLC HT REMODELING&DESIGN LLC Required Items and Reports(Conditions)
21271 ROCK RD 21271 SW-ROCK RD 1 Etsn Cntrt 50S-639-4175
ALOHA,OR 97003 BEAVERTON,OR 97003
PHONE: 503-887-8247 PHONE: 503-887-8247
FAX:
Total Fees: $37,531.85
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090 You m, obtain a copy• e rules or•' -ct questions to OUNC by calling 503.232.1987cre
or 1.800.332.2344.l ,v
Issued By: ( .i Y wAr,L ii Permittee Signature: ' %�!�/ `
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. I V
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application Fol'OFFICE USE:ONIA'
City of Tigard ,...::4,- ,... . Received
//? A....-_ JO: ..,, . )„,„.
f'T- '57— .1Z2.CZ-9. ( .ce..._
.1 13125 SW Hall Blvd.,Tiard,OR 97223
14 Plan Review
° 1111 . Phone: 503.718.2439 Fax: 503.598.1960 . - ,,. ,, .. Other Permit:
Date/By:
T i G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: Fil See Page 2 for
Internet: www.tigard-or.gov , Notified/Method Supplemental Information
,r '';''-, ''fil ;,. . -:'''',"-",l'i,:;:;:,:•X'%'.',4#!;.:,,+;.,.451,i''''':'''''''1.--7,--7,..',$:';;3!;' ,.',T-r,i';-'- '' ,..`,,,: , 141'4°:,0:-;11''1''',C.14,1/4,4;3115,1)':".41‘1''''''-:--7-,'PK;4,..•;:i27.q.,:%4f'
' Mechanical pennit fees*are based on the value of the work
Dig New construction 0 Addition/alteration/replacement .‘X.. - ia performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition El Other: ***1-t.7:04 'il. mechanical materials,equipment,labor,overhead,and profit.
Value:$
t*-.-4,,,i,,'
cATEGOtti3Oktlitticnori l','',!!!:77$74: Lill ' -,:',-,,,,„-. „--- -
, - - , ' p „ ,...... .„, ,, , . ..i,,,..,,
'.' lis . '', ' „ •igi.s.,'-5,2. , . .,-'.4,,,s..414.1,P'Z,:1' '' '...''‘,. ,it,44,4e!:'''''' ,
1-and 2-family dwelling 0 Commercial/industrial 0 Access() • ding For special information use checklist
0 Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. 1 Total
JOB-iffilii400tAnor4 .A.1:**-10,-.-ti,TtoN'-,:'4!'<...i:‘,--;:, .,...,,,i, Heating/cooling:
Air conditioning1 46.75 1
Job site address: t 2,g 0I StA.I .. h 2,11 A1k,*-40..14.--- Furnace 100,000 BTU(duetslvents) 46.75
City/State/ZIP: Tilsp,..,cik. i 0 F.... 51410-- Furnace 100,000+BTU(duets/vents) 54.91
bleat pump 61.06
Suite/bldg./apt.no.: Project name: Cs*tr **-S, Pc*rt:-Vi*3-7'`.1 Duct work 23.32
Cross street/directions to job site: tisj.iit. "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
Other: 23.32
Subdivision: Lot no.:
, - Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
' `'-' l,t"--' '',,, , (ins fireplace/insert 33.39
004,,,IPTIONVOP,WORV',:',-, ''4 a-' --, , '
-- , ,- -..„,, ' Flue vent far water heater or gas
C)t*X" ' 4r E
i C. tX:ki-il 1-4,g,T2-01R —00196
. g&. . fireplace 23.32
Log lighter(gas) 23.32
# ' 1 Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
°P-E#T*1-6174,1141W'f-T; ',.4LL1-- ''''',Y;5:,',1': 1:1111,,k, '-,110''''' ::'5i1V- Environmental exhaust and ventilation:
Name: Range hood/other kitchen
1 equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32 '
23.32
1:3.,",'4F,C44TA,,'Lf;','"±-'-"" `!;°:',..,.!rf-:''" sso,:., • er.
Fuel piping:
Business name: litfc .L94 4...
$14.15 for first four;$4.03 for each additional
Contact name: ..., I do . Furnace,etc.
I Gaheat pump
0 1
Address: .2.,t 2 ( 9,4 • . _\Vs ail/suspended/unit heater ,
City/State/ZIP: '
iA P ---6 ..... ---4--174;;---5 Water heater
IL
-- Phone:4-04-e t-+.......it. -.4. Fax:4-(--- -.) Fireplace
Range - I"
E-mail: C rbiltAir...fte - (344kk L••• • CotA Barbecue
taril, 6,04„..;:,-3.-, — Clothes dryer(gas)
Other:
Business name: ..:72.?,7-, ' Zgg' 1t -74*
Address: Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
—.---- _ ,..........,__.
CCB lie.: TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 1130
days after it has been accepted as complete.
Authorized signor 4 : I * Fee methodology set by Tri-County Building Industry Service Board
Print name: I. ' 0,4e-, Date: .14
''' Illi1VE111
.
i 12/COMIWF(1)
^,BuildingTermits\MK yermilAp 4' 1 i cco teNs
1' 44
440-4617i(1 .
.3 CITY OF TIGARD MASTER PERMIT
v �
a: COMMUNITY DEVELOPMENT Permit#: MST2018-00196
T[ AR•D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/20/2018
Parcel: 2S 104AC 15900
Jurisdiction: Tigard
Site address: 12807 SW 132ND AVE
Subdivision: 2018-026 PARTITION PLAT Lot: 1
Project: Csokas Partition, Lot 1
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1516 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1855 sf Garage: 573 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 3371 sf Value: $428,452.95 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 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: 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 Group: Square Feet:
NEW SF VB R-3 3371
Owner: Contractor:
HT REMODELING&DESIGN LLC HT REMODELING&DESIGN LLC Required Items and Reports(Conditions)
21271 ROCK RD 21271 SW ROCK RD 1 Ersn Cntrl 503-639-4175
ALOHA,OR 97003 BEAVERTON,OR 97003
PHONE: 503-887-8247 PHONE: 503-887-8247
FAX:
Total Fees: $37,369.49
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 fort in OAR
952-001-0010 through OAR 952-001-0090. btain a c,.y of the es or direct questions to OUNC by calling 503.232.1987 or 80 .33322. I
344.
Issued By: �n'L ✓ ^ ' • ' - Signature: (7/7
' 03.639.4176 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 I KR , .s" Received FOR OFFICE USE ONLY I b I
,•,, City of Tigardii
w 13125 SW Hall Blvd.,Tigard,OR 97223 Date/B : �( �i r rj� I �/1►
Plan Review ®� l
' I Phone: 503.718.2439 Fax: 503.598.1960 .I��, 3 2,018 Date/B : �J � � Other Pe ,i C,G24„. , .-„,,,,.
TIGARD Inspection Line: 503.639.4175 Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard-or.gov CIS' 01. f(4ARE) Notified/Method: Supplemental Information
91)11 [)!NCI L.I `8S4 . , . .
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING.
[ New construction ❑Demolition Permit fees*are based on the value of th or p r .
Indicate the value(rounded to the i14i r f `
❑Addition/alteration/replacement
Et equipment,materials,labor,overhead,an.the'.ro
CATEGORY OF CONSTRUCTION work indicated on this a.• tion. — =-
.�
Valuation: 4rs $ '�_ _
[�1-and 2-family dwelling ❑Commercial/industrial 4� -_-_
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION. Total number of floors: 2, 3
t1 Li Li-
Job site address: 1 2 ✓(J 1 s w /32 ' Av.C, New d llatea: ....square feet 1 y2 t.-j
City/State/ZIP: . b e,'-Cly c j� Garage/carport area: C 73c square feet 1 5.1 -
Suite/bldg./apt.no.: Project name:/'`(4S �tl iv i 4n .2 30ce Covered porch area: ju re feet
Cross street/directions to job site: /svi /� Deck area: square feet
CrJ\A/ Ai 1 Ot,t fc.e.i- i 32 n A V e.. Other structure area: square feet
n REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 5 0 K. j }'l r,.-1-1---f;c,rt 1 Lot no.: I Permit fees*are based on the value of the work performed.
Taxmap/parcel no.: Indicate the value(rounded to the nearest dollar)of all
ma
p pTZ S (R\ i/v J GL- I a,K Lc,+ 30 0 equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
At
`. Valuation: $
•
t`i S .R` Existing building area: square feet
/ 4 New building area: square feet
2(PROPERTY OWNER 0 TEN, T Number of stories:
Name: ki-r' 2om0D,cW,4,6 besiga ' Li-C. GetS% IM9i3 Type of construction:
Address: Ztv-i1 . ., Rdu.0 ea. Occupancy groups:
City/State/ZIP: A.c*1�, I DK 4160$ Existing:
Phone:(60$)_�r 997 9, y-1 Fax:( ) PJJ4k New:
L+7 APPLICANT +U/ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: SIT RE+ �wh.uAlb b€s 4 6,4
/' I I'�'r' Structural plan review fee(or deposit):
Contact name: ,r., ra &t•-e3 S Cel.A e, 1/
FLS plan review fee(if applicable):
Address: zIzit fit ?v( 17.10.
Total fees due upon application:
City/State/ZIP: ALMA• go IC. 4100.S —
Amount received:
Phone:(� ? 5 d 3 ._5.447— </99
E-mail: b 31'e°‘ *,....S.-i-0^L e'`dz C U rn PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
—
V Commercial and residential prescriptive installation of
CONTRACTOR '`*--°t"' roof-top mounted Photo Voltaic Solar Panel System.
Business name: 1.4t- lacivk 6 DESt1,S L.L.C. Submit two(2)sets of roof plan with connection details
I and fire department access,along with the 2010 Oregon
Address: Zti'L11 Sft, > Solar Installation Specialty Code checklist.
City/State/ZIP: Permit Fee(includes plan review
Y <�b I O 9']003 and administrative fees): $180.00
Phone:(50s) $$l.$zti( Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.: Igalits
_
J�J� Total fee due upon application: $201.60--.,
Authorized signature: 5O 3 - U. / - c i 9 This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:�-r-cl G
G *Fee methodology set by Tri-County Building Industry
,fir L(( Date: //(, Service Board.
L:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received
Permit No.:
a 13125 SW Hall Blvd.,Tigard,OR 972 c .. �
& Plan Review
_ Phone: 503.718.2439 Fax: 503.598.1 6 Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 2018 Date Ready/By: huffs. H See Page 2 for
Internet: www.tigard-or.gov , U L e Notified/Method: Supplemental Information
�,. o .._, COMMERCIAL FEE*`SCHEDULE USE CHECI LIST
' toll TYPE OF ING w ,
Mechanical permit fees*are based on the value of the work
[ New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑ Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION„' RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
�1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑ Multi-family ❑Master builder ❑ Other: Description Qty. Ea. Total
JOB SITE,INFORMATION,AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: Furnace 100,000 BTU(ducts/vents) C 46.75
City/State/ZIP: Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:
Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
cl Residential boiler(radiator or
5 Vv Vvc1t.(n.,.' " �J tr'z~.c4 /Svt, /32 ,AV 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
Subdivision: Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 1 23.32 f
DESCRIPTION OF WORK Gas fireplace/insert 1 33.39
Flue vent for water heater or gas
fireplace 23.32
MS f� Log lighter(gas) 23.32
i Wood/pellet stove 33.39
Wood fireplace/insert 23.32
...../ Chinmey/liner/flue/vent 23.32
(i PROPERTY OWNER 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: itr IZE►ftoss.0 4- be (.4LLC. Range hood/other kitchen
1 equipment ( 33.39
Address: 2I7,-7( j.Dcy( RD. Clothes dryer exhaust I 33.39
Single-duct exhaust(bathrooms,
City/State/ZIP: itLOK4Olt- 9700
� N toilet compartments,utility rooms) 23.32
Phone:(503) 86,7. 02.47 Fax:( ) Attic/crawlspace fans 23.32
APPLICANT,. Er CONTACT PERSON Other: 23.32
Business name: Fuel piping:
NT /be 1 Ibegz, 1A,C.. $14.15 for first four;$4.03 for each additional
Contact name: -tlw4,4S 341Lo Furnace,etc.
Address: 2.,Z„-7 i*. Gas heat pump
QO K' g Wall/suspended/unit heater
City/State/ZIP: A►bNl4 aR 1106i Water heater
1
Phone:(So3) gg7. ev4-) Fax::( ) Fireplace
Range
E-mail: 4( oK,AS a 6 4,14 • c......, Barbecue
lJ .CONTRACTOR Clothes dryer(gas)
Business name: Other:
��DU t(E�►T W6 Cant-t�t6 MECHANICAL PERMIT FEES*.
Address: i J ?-k-LS--- 54.) 17 77\ e7 Subtotal
City/State/ZIP: 10.-
f l,$.("lie S 611---- c7 Q3 Minimum permit fee($90.00)
(� Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
CCB lic.: /Z-(7 c 'gs- `1 1 TOTAL PERMIT FEE
/ I ! This permit application expires if a permit is not obtained within 180
Z,////c....",
days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name: -r e e (..•_0,,,,,,,.. // Date:
-4613 a
I :ABuilding\Permits\MEC_PernitApp_040 I oc 44 7T(11/02/COM/WEB)
, Electrical Permit Apolicatifiii Fite-N,f.:71‘91.-zn H.D.•,.„,(-.. , si.,()N1
‘,..tt-t,- fissativetl
at.. 1 Cit y qt-Tigaird . .Da.t,emy: Permit
17,125 SW Hall Blvd..TTarcl,OR 47773 i 1 i i o ,),1 1 Q plan Review
,ri 1 Phony, 503.718.2439 Fax: 503.5913.1906°1. '1' -1.)10 rower I<aithat
Inspection Line: 501639.4175 ''' '
„,,, _ Rawly IlLateiSy: I
'.‘1`i). 411191•114: WWW.ligaiTt 04.gOV LA Pti- ()F TUAPI) r4
GAR "'''''''''' '' S
ZII::::! Grteull itatarmatiffil 1
?!;:iti-i-1,:r:t4::31:5,..;;;,',.;',',.V.',,,?:.;.:.;.,. ,;_::-.;', ;: ..*:•;'..]:::,,, ,,itil3;;;;j0..Welltaiiij.111041-73Nt:t.it:;,..,11-',-;:;,;;,:;,;:.,- _r,-,f.:::.;..•:;,:.;,...,!'1,....t: '....;:y4:4111,,:tiitit&iltitylWri0.;:,;;O :;!..:g-;,.,:,', :.i,;:t,;4
IC New tantstruction
Ej Additionfatterat ion/repl acement
Ej Other PIOUS chock ad non spray(submit 2 sets of plans witicres clicekern
0 service or feeder 400 amps or more El HA I'lli08 over Ouse stories.
LiDemolition
where the available fault current 0.1.4:nimw mei toostystklat,
02%t''..-?,4::''SV::•:'',': :':••$ ;',S3";:ij'';,:;etg00*...i., :r :004.. I.V.,104:171`41;:,...iiik'..{:"i';'V.j'f"'="':,-'":''•:::", ..-4.'100°""'Imei I 5°wk'or CI mating b"ildiugs
I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building 4,.to ground,or exceeds 14,000 0 Commercial-um agricultural
amps for all other installations. building',
El Multi.family 0 Master builder 0 Other: 0 h It pomp. 0 1,,,,kiluitn,(qt.%)K VA or
4°14'.4i'..441""giti:'''' .'"(*.°4°:6::ji4:'i'''':'11:''''''''Inl.:':''''''''''''':. 8,=E inie:f.'n eY 3:nnii.w.or to ad o f Lugar separately derived
Nytaurti
Job!': Joh site address:
I 00)IP or more.
0 Ilk or wit rositiowittl wits. ocupaitcy.
eity(State/L I l't
C Recreational vabiekt mks. ,
CI 1-Icalth.eare Ileillem.
Suite/bldf4lapt.tr: 1 Project name: 0 Itazardous tocat Ions 0 Supply voltage kir more than
0 SO ViCa or lixolo;NMI siltrn to;Imre 60010IIS 11017110111.
CrONS gtreethiirections to job sl te:
_________________,.;lits:41.47.Lt:tiSO:fi§0117-tiiiiriCti ,..:,"R'Ll .-:',',4: 3,::„'::,ri?1
SVAi Wa k A 4+ SI-rec.4- .. '‘,"1./ 1 3-2 ''.4---- A•01 d rvivintit.' - -- 1 0,.. r Each j Total / "
New residential single-or multi-family dwelling unit.
Subdivision; Lot It: I Includes attached garage.
, ._...._
1,000 sq.ft.or less ;68.54 4
'fax map/parcel Ti'
.. ,,,,n, Ea.addl 500 sq.ft.at pcminn 33.92 I
f.",,Ia•I;II.,,I 4$0,ifitIlibfliII:bIKR„f:AII:n.......'' ',.:f.:'":..,:.",..,=:;.I.I.4.';II,I'7•J ;:; 11.6tml energy,ismideatiot
78.00 7
(with shove sq.ft.) ,
t4scit.
Limill.A.;ntrgy,multi-farnily
75.00 2
residential(with above so.it-)
wekiiptilii(iievoito ,.. .,,,„ ,.:„..lic,...,,,,. . ,;.4.?4t•17,,T,ItAt,4-Aio- .!, ,'!:,, ..'" '',':' rierm""b1P 17""IY . CI See Page 2
-72g'''..7..•.L.,,-.: i.":i- !,.... .'.,,...'. : ... A ... .,Y, '',.•',i.',.•: .'.,,,':...•V- '..•.''P4 P',. •-„..,.4-,..,,.,',''• ' --- ',." Services or feeders instaliattonolteration,anti/or relocation
N111110;, io- 149464.0.0,s4 boliid 1 1-1.4.e 200 amps or lets 100.70 I 2
201 amps to 400 mons 133,56 2
I_Askirls: Z.1 Zi i $14s floa.K. PAR.
401 amps to(Matting 20034 2
1 City/State/ZIP: ,ki,e,s,A 4 Oa. 41.41 601 amp to I.000 anifIS 101,04 2
--..
Kmu (S1
cY3) SO. 81441 Fax.( ) ii,i4 Over 1,000 straps or wilts
., ....__ 552.26 2
1reinpuritry services or feeders installation,alteration,and/or
Elouil: 4* 14C3014(exeissiatau,•Z.41•0." relocation
Owner I nfitaflatinn:Ili A installation is being made on property that I own which is not 300n111 or laic 5936 1 i
intended for sale,lease,rent,or=change,according to ORS 447,449,670,tun'701. 201 loom to 400 amps 125.08. 2 t tr
. ._
t 1wftee signature: Date: 401 arena to 599 snips 168..51 7 1 '
......._ .
'i;II"-:^I'''.',Iikt-':-.'-,-,7-.;Iitf.':','---t_tell'I44,' "..',,,,,,-n,‘&f:•.;"4..(I.Tl.!III.'' ':','''I''. i`I. iirunch circuits-new,alteration,or extension,per panel
.,-.!"-f.7,;,Lli.;',;:-',J..;:';,'''-."."'.. .." •-,:-,5.. 0=e.t'-`1'... K i'-'''''',:c:'' ',' ''''"""'"-';‘'. '"'''''.:1'''+'-w''-"'"'''"''2-:'-'''''''''-' A,Fee for brancb circuits will, 1
1 Illsine8A name: kr 12nrAtiact.1,1% ; bSIZ.1 ,i.i.c. above service or feeder fee,
742 2 i
each branch circuit
Contact name: . 144a,
Ft,Fee for Winch elisions trithoza
se.vice e.realer foe,nisi
2
3
Address: 7,4 tit olio itioc vitt
Manch oilmiii e.i.3
Each WTI Mandl Momil 7.42 2
City/Statc/ZIP
: imAK,4 i otZ IlaMiscellaneous(service or feeder mit inclurkd)
Pil°ne:(Sbir) eV?. $2,41 Fax::( ) 144 Failmatniladuresi ui modular I
2
do'ellt Oh,Sereitte ttudsur feeea 07.64
Rraail.: tif,...1•01(Ai.de ititIt.. e ja.11:airl,, ., Racunneut only 67,84 2
i''.f.,-..1-T4:,1!,3:,•,,,;,,:,,,,-;,',„..::',....:..;1],,-,, ..j . ,..',,,'aiTil.-iNfiIT:::ftkii0.trOlir'ii.:1. --• ...':,':isi-,1-'.",::', ..4";i",---,"i':-b$Y,,"':-..L.,":-"'":'.. PLunp or irtigotinn cirolo 67.84 i 2
Business twee: Ecog, agrareatC- lett' Sign or out hoc lighting 67.84 I 2
Signal circuit(s)or hinited-onorgy I 2 I
Address: ?o rose, 3g pallet,alteration,or exteitsion, age 2
. 0 Seel
_ Each ------additional -
inspemiuu over ellownbto in ens of the above
City/State/ZIP: b0,16,41)4 5 ir... etltni" Additional inspection(I hr rein) 66.2.5i hr
Phone:(f'93)i/8, (US- Fax:( ) Investigation(I hr min) 90.01)/hr
Industrial plant(1 In min) 78./8/hr
Email: Pluit-b'esiS & lesist-GazziCe.C-.(.4arti
Inspections for which no fee is
90.00Ai
i:(31 I i.k.: 1citiol Electrical Lie.: Zii,10•14. Suprv.Lic.55 s.1,5i1 ..!..) f( Ti.,,.9. r,,..,,.,,...,
-- . . . ry,orctliooptfos*trot$,Nr...N:...,.,',;-. 1.,A2 :
Suprv.Electrician signattne,mtuirecl:, ,G;
Subtotal:
_
liana name: 6204,e_ ....<" /4.:. , rnit, /,,e/9vicr,...._ El PI-ial:.1.eview Tim-tidied(2.5%of pound fee):
- State stirrharee(12%ot pedutt fee):
Authorized sitmaturc: TOTAL PERIVET TEE:
I- - . -
Irk porno!opitlfoolitot oattit;a it it lwrrail IS not obtained within 1K0
I Print name: i Date: I days atter it has been accepted as complete.
I
--- * Number nr ittaptclikiat alicove pm!wail,
lAtlutlirotatrat.oiLtOka,:fora,,i/Swo bLR,ERE ds,Roy 06117lNES .446461ST(1:fluicenx,wan
i
Plumbing Permit Application
Building Fixtures FOR OFFICE USE ONLY
c of Tigard ,Received
CityIIIII g "r' l� fin.,,' Date/By: Permit No.:
• 13125 SW Hall Blvd.,Tigard,OR3 97223
Phone: 503.718.2439 Fax: 503.598.1960 (iIDate Beview
I I 3 Other Permit No.:
Inspection Line: 503.639.4175 �� y
TIC ARD p Date Ready/By Juris: 0 See Page 2 for
Internet www.tigard-or.gov x Nottfied/Method Supplemental Information
tO Mlle 'S' 411 iU tk,6�r+ eta ' k+ as rp ' � � r"# �}' a _
.�� °` �ta �^ri�Jta (�r ii��.,s 0 i r i' ali "':ri iii s'' * 4 ( l' �5i ,' 'a = 'p' form 1 9���1� --
'',, s Ora ,
LJ New construction ID Demolition
For special information use checklist.
Description Qty. Ea. Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
fit[ r 1 _ r_islr ill ®x-14 ��i 33 1;a r� r j
ry =_ _ SFR(1)bath 312.70
1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 3 500.32
0 Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
0 Master builder ❑Other:
_ Fire sprinkler(_sq.ft.) Page 2
iV ) PSl p , v y �t I r. 0 P- 1 i T i t F a' I i Site utilities
ai�i hi L•,i"�,i ,.i.e�.Ei ,.,#.e a. t 4v ur.,A-r.i a
•
Job site address:
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.: I Project name: Manufactured home utilities 50.03
Crossstreet/directions- to job site: / Manholes 18.76
S\W \'�r�w l F‘4'1-. s-tom=-c-•' / 5 w �L ' /1 V 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
�, �! Backwater valve 12.51
ri�i s = + RIMI i°'tl o- orb 4,'x i e �^ii', i
W' ,-t h =gilts a_ d�' �'rt.�'� m .z.�[
Clothes washer 25.02
Dishwasher 25.02
1,15R. Drinking fountain 25.02
Ejectors/sump 25.02
3 r 0 NC"4 ;;IiI 3 t +, Expansion tank 12.51
. a n aai14,11 .d a �i.>L J t IP amu - a
Name: Fixture/sewer cap 25.02
k'r 1r:fe+MeD£L11J� �' DEst�J l 4lC Floor drain/floor sink/hub 25.02
Address: 247,11ga•K pro. Garbage disposal 25.02
City/State/ZIP: BONA ` o- ooto% Hose bib 25.02
Phone:(1 O ) �7 $247 Fax ( ) Ice maker 12.51
w Yrypll�� ird rl y '' K Interce tor/ easetra 25.02
"' "'' N : 1 i i1` E I P t� P
iIVN
Business name: wr Rfctob 1..4 AL j Dt+� L Lr_
Medical gas(value:$ ) Page 2
I Primer 12.51
Contact name:
TAw►4S Roof drain(commercial) 12.51
Address: Z1Z,1) gout PA*•
Sink/basin/lavatory 25.02
City/State/ZIP: SNA 1.o� 91003 Solar units(potable water) 62.54
Phone:(�3) $Z�-> Fax::( ) Tub/shower/shower pan 12.51
EmailUrinal MA
25.02
14 C-51,141. 0_1 A1 CpprI
�� T " 1: 1 �'i 4 t ��Ilioggp r Water closet 25.02
r `t^'4�i�4�i,+;;�h , + r yV r or n�M1i�,� ii ,1714�
E Ii7 Water heater 37.52
Business name:
f ! c 1I2iL �k kl�� Water piping/DWV 56.29
Address: 73 S U) e� / J ),/ �_ Other: 25.02
(
City/State/ZIP: I:I(Jr f� /�j 7 Subtotal
Phone:(�p3) f � """, ��`� lFax:( ) 7//�� Minimum permit fee: $72.50
CCB Lic.:7,G.(, oZ I v/r Plumbing Lic.no.ab`Ll��� Plan review of permit fee)
State surcharge((2125%%
12(25/o%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name: 6-c- .Cc,s nr_( Date: 7/31, This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by TrCounty Building Industry Service Board.
1:\Building\Permits\PLMU-PemitApp.doe 10/01/09 440-4616T(10/02/COM/WEB)
Albert Shields
From: Kim McMillan
Sent: Wednesday,August 1, 2018 5:34 PM
To: 'msprague@pd-grp.com'
Cc: Albert Shields; Khoi Le; Kenny Fisher
Subject: Stormwater Fees
Hi Matt,
Albert and I dug out the fee schedule and the fees are as follows:
Water Quantity SDC$299.75
Water Quality SDC$245.25
Water Quality fee-in-lieu $2640
These fees are charged to each of the three lots.
Kim
Kim McMillan
lili m City of Tigard
: r,. Assistant City Engineer
503-718-2642-work
503-866-5784-mobile
13125
SW Halt BoulevardTigard,OR 97223
` ^
DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail
may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained
by the City of Tigard in compliance with the Oregon Administrative Rules"City General Records Retention Schedule."
Albert Shields
From: Albert Shields
Sent: Thursday,July 12, 2018 11:17 AM
To: 'greg@stoneridgecustom.com'
Cc: Allyson Armstrong
Subject: Csokas Partition, MST2018-00196, MST2018-00198, MST2018-00199
Greg, on reviewing your application and plans for the above 3 permits Engineering has noted that in each case a revision
to the site plan is required to show a water quality facility(LIDA) on the plan between the home and the storm
line. Accordingly, I am coding these applications as "Revision Required". Plan Review will proceed but the permits will
not be issued until a satisfactory revised plan has been received. Please submit revisions at your earliest convenience.
Please let me know if you have any questions. Albert Shields.
1
Lina Smith
From: Matt Sprague <MSprague@pd-grp.com>
Sent: Thursday,July 26, 2018 2:02 PM
To: Monica Bilodeau; Khoi Le; Lina Smith
Cc: Albert Shields; ross@stoneridgecustom.com
Subject: Walnut Street Partition (Csokas Partition)
Hi Lina,
Nice chatting with you.You mentioned Monica was on leave which is great but that you would help me track down
someone who could address this with Albert Shields.The builder has been requested by the City Engineering
department to provide LIDA rain gardens for each new home as a part of obtaining a building permit. However, at the
pre-app conference it was stated and again confirmed in the conditions that the applicant would pay a fee in lieu for
stormwater quantity and quality instead of constructing facilities. If we were required to construct LIDA's they would
have been initially shown on our Engineering plans.The condition of approval is number 15 which reads "prior to
commencing site improvements,pay storm water quantity and quality fees." I presume the applicant, in order to
obtain site development permits, has already paid their equivalency fees for each 2,640 SF of impervious area. If they
have not,then it was missed and they need to do so. Could you please help get this rectified?
Thanks, % 2_ /6- dtAllzj
Matthew Sprague PRINCIPAL I PLANNING PROJECT MANAGER I D 971.708.6249
PIONEER DESIGN GROUP, INC. CIVIL I LAND USE PLANNING I SURVEY
9020 SW Washington Square Rd. Suite 170 Portland, OR 97223 P 503.643.8286 pd-grp.com
Disclaimer:
i his e-mad Indy gsrogmetary, and/or privil ad information. If you a not the it+tended r ,r,o,t .f r,r e k,ceirred th;x e.nr in •N),
pease rlotif, tfrtt seetcfer immediat^I, k, r.t3':ail or telepht>rr_';f03'643•8286)6 and d(,i( rmnige :rio ng;..t.,.. - ,tea,hrn4^rns bbithotar
eon rrs,Any.<r€tastnzsrrze:?t<.g,,rt 3.r i:,.#casMe r,; spstrrf 3 r. : material€rn i}>=
44)(; sf, not?>r h ahm fo rn thattge5 mado ttt€electronic data Distnilmtpnn 0t• otht ts de theexpress,
it-on sousero..of PDC.
C_
1
Albert Shields
From: Albert Shields
Sent: Thursday,July 26, 2018 3:24 PM
To: 'Matt Sprague'; Monica Bilodeau; Khoi Le; Lina Smith; Kenny Fisher
Cc: ross@stoneridgecustom.com; 'greg'
Subject: RE:Walnut Street Partition (Csokas Partition) -- MST2018-00196, -00198, & -00199.
Matt, installation of a LIDA might not have been required at the time of the Pre-App Conference on 12/15/15 but,
effective 4/22/18 CleanWater Services(CWS) changed the stormwater treatment requirements to require a LIDA. The 3
permits in question were all submitted on 7/5/18 so they are subject to CWS's revised requirements. Accordingly,
please revise your plans to include LIDAs as per my 7/12/18 email below to Greg.
There are also stormwater quantity and quality fees to be paid, as noted in Condition#15, but these are not fees-in-
lieu. Those fees are$245 for Lot 1 MST2018-00196, $300 for lot#2 MST2018-00198, and $270 for lot#3 MST2018-
00199 and I've added them to each permit.
If you have any further question about the LIDA or the fees please contact Khoi Le in our Engineering Department.
Albert Shields
Permit Coordinator
From:Albert Shields
Sent:Thursday,July 12,2018 11:17 AM
To: 'greg@stoneridgecustom.com'<greg@stoneridgecustom.com>
Cc:Allyson Armstrong<AllysonA@tigard-or.gov>
Subject:Csokas Partition, MST2018-00196, MST2018-00198, MST2018-00199
Greg, on reviewing your application and plans for the above 3 permits Engineering has noted that in each case a revision
to the site plan is required to show a water quality facility(LIDA)on the plan between the home and the storm
line. Accordingly, I am coding these applications as"Revision Required". Plan Review will proceed but the permits will
not be issued until a satisfactory revised plan has been received. Please submit revisions at your earliest convenience.
Please let me know if you have any questions. Albert Shields.
From: Matt Sprague<MSprague@pd-grp.com>
Sent:Thursday,July 26, 2018 2:02 PM
To: Monica Bilodeau<MonicaB@tigard-or.gov>; Khoi Le<khoi@tigard-or.gov>; Lina Smith<LinaCS@tigard-or.gov>
Cc:Albert Shields<albert@tigard-or.gov>; ross@stoneridgecustom.com
Subject:Walnut Street Partition (Csokas Partition)
Hi Lina,
Nice chatting with you.You mentioned Monica was on leave which is great but that you would help me track down
someone who could address this with Albert Shields.The builder has been requested by the City Engineering
1
' department to provide LIDA rain gardens for each new home as a part of obtaining a building permit. However, at the
pre-app conference it was stated and again confirmed in the conditions that the applicant would pay a fee in lieu for
stormwater quantity and quality instead of constructing facilities. If we were required to construct LIDA's they would
have been initially shown on our Engineering plans.The condition of approval is number 15 which reads "prior to
commencing site improvements,pay stormwater quantity and quality fees." I presume the applicant, in order to
obtain site development permits, has already paid their equivalency fees for each 2,640 SF of impervious area. If they
have not,then it was missed and they need to do so. Could you please help get this rectified?
Thanks,
Matthew Sprague PRINCIPAL I PLANNING PROJECT MANAGER I D 971.708.6249
PIONEER DESIGN GROUP, INC. CIVIL I LAND USE PLANNING I SURVEY
9020 SW Washington Square Rd. Suite 170 Portland, OR 97223 P 503.643.8286 pd-grp.com
Disclaimer:
This e-mail may contain proprietary,confidential,and/or privileged information.If you are not the intended recipient(or have received this e-mail in error),
please notify the sender immediately by email or telephone(503-643-8286)and delete this message along with any attachments without copying or
disclosing the contents.Any unauthorized copying,disclosure or distribution of the material in this e-mail is strictly forbidden. Pioneer Design Group, Inc.
(PDG)shall not be liable for any changes made to the electronic data transferred. Distribution of electronic data to others is prohibited without the express
written consent of PDG.
2
City of Tigard
711Iv COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review — Residential
Building Permit #: %i,S 7;)-0/F ppfc`c-
Site Address: 1-200 7- -V`/0 /,cQ 7_ 4/-€)91, e
Project Name: C7s67) ,-.712'71)�"YL___ Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: AMO ,29e_
ICJ V rift'site address/suite# exists and activ in permit system.
ver Terrace Neighborhood: �J No ❑ Yes,See River Terrace Review Addendum Attached
SityPlan Elements:
tree(3)copies of site plan �1;� sting structures on site
o plan must be on 8-1/2"x 11"or 11 x 17"paper i,Footprint of new structure(including decks)with finished
rawn to scale(standard architect or engineer scale) elevations
Orth arrow V1 4 tility locations&easements (required for new and additions)
T e address,project or subdivision name and lot number 1d i. walk/driveway approach
�i plicant information(name and phone number) \SI 0.cation of wells/septic systems
0 .t dimensions and building setback dimensions X. xisting trees to be retained with drip line,and tree
Al..uare footage of buildings to be demolished tection measures
►l ot area,building coverage area,percentage of coverage and reet tree size,type and location
pervious area(applicable if R-7,R-12,R-25&R-40) Street names
'en
operty corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced Yes ❑ o
4 foot differential) If yes,is a storm water quality facility shown? 'toy' ■Yes No
nl rt lean Water Services—Service Provider Lett (lot platted prior to 9/10/1995):
squired: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No
VIII Public Facilitiy mprovement(PFI) Permit: �' _(�11,—0�
• -quired: Yes,applicant was notified ❑ No Applied For: 11Yes CI No,stop intake
X/—and Use Case#: !V l 1J0 J(p --0006-IQ
{Roning: >— �'
equired Setbacks: Front Q Rear tc' Side S" Street Side /s— Garage Q
0(Landscape Requirement: %
IILA 1 ot Coverage Maximum: cyo
FA/Building Height: Maximum Height 50 Actual Height .23 '
Visual Clearance
11 ,;-nsitive Lands: ❑ Yes ❑ No Type
E Urban Forestry Plan
❑ Conditions "Met"prior to issuance of building permit
Notes: _I A/ l/i 1 A '1_. �' IA" 1 i ) ► s II _, i /:i i/ii
s
Approved By Planning: -- _,....4-4. Date: -- 3/10
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: Cl Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw RES_061417.docx
Building Permit Submittal
Original Submittal Date:
Site Plans:
Building Plans: #
Building Permit#: P nter building permit#above.
Workflow Routing: IP! Planning [Engineering trmit Coordinator Building
Workflow Sign-off: I 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: Z—* G�( Ac: ���'(/(�.d Date: _7t /'1
Engineering Review
0 Slope at building pad: o
❑ Conditions "Met"prior to issuance of building permit
O Easements (encroachments)per engineering conditions of approval and plat
cif Water Quality/Quantity Facility:
Assess Water Quality Fee in lieu: LE("2 Er No
Assess Water Quantity Fee in-lieu: Yes No
LIDA Facility on lot: Rt./until aYes o
NOT Approved by Engineering: f 'r S 141R Date: 7 /2_.../A
Notes: 54-ow LC orr€�.�.t_/ O L, IL.I ISA\ 01i P/A►J •e. -r tt4 A0.7-- ,4,,.t el
S-s-z.�,,,,� 1 i�c. /V!J p.,--t ;.t.)-/ . i'er -,..z. - I�e . ,/ �f�
Approved by Engineering: / Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
jevisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant: 40r-'-eftei.--t� wKvr, 'ler--
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
vtrDC Fees Entered: Wash Co Trans Dev Tax: ':1` Yes 1=1 N/A _r�lji/�' �
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: ! s ❑ N/A
fr
LIDA 10- Y-s XN/A 1(//
OK to Issue Permit
Approved by Permit Coordinator: Date: f (Y/
I:\Building\Forms\BldgPemiitRvw RES 061417.docx
FOR OFFICE USE ONLY-SITE ADDRESS:
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
rIN
Transmittal Letter
i r t,n E, D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: &OVG(/li i DATE RECEIVED:
DEPT: BUILDING DIVISION
3 si -
FROM: &rC oci 5Can pc 1I AUG 2 9, 2018
COMPANY: 44 -r" U .etlnbG1 .(; ,i
�'
PHONE: So3- 5L}-7 - S) 9 7 By: /
RE: / Z80 SW / 32 �d Ave- MST 201,5-000b
(Site Address) (Permit Number)
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: 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.
Other(explain):
REMARKS: 1 A
1) =7 T1( U..q// c e fesf: l )Cr 4 Sc6rd
2) 7 /4 4--/- Sur vGv I M
FOR OFFICE USE ONLY
Routed to P echnician: Date: Initials:
Fees Due: Yes ID Fee Description: Amount Due:
$ 0
I/ Q1A (Wt $ yS.
$
sirs' ecr,v a&w elf--r ra ...,--e6 $
Special £'7E' AJ/-Lie v'®i /° 17-c/CCAl
Instructions: ""
Reprint Permit(per PE): ❑ Yeso ❑ Done
Applicant Notified: Date: OP/p3/4," Initials
.441-
ce-gx '3--A sA CZ. rD /°EZZ Al/7-
I:\BuildingWorms\TransmittalLetter-Revisions_061316.doc
I:\Building\Forms\TransmittalLetter-Revisions_061316.doc
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
12807 SW 132ND AVE, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Master Permit MST2018-00196
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
FA I L
Comments:
Provide permit for ac installed without permit.
Provide protection Ballard in garage for appliances. M1307.3.1
Seal condensate pipe at foundation vent left side. R408.2
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
12807 SW 132ND AVE, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Master Permit MST2018-00196
Inspection Type: Inspector:
199 Electrical final David Young
Result:
FA I L
Comments:
Provide permit for ac installed without permit.
Provide breaker lockout for dishwasher and furnace if no cutoff switch in furnace
closet. 422.31
All else appears ok.
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
12807 SW 132ND AVE, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Master Permit MST2018-00196
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
FA I L
Comments:
Provide pry for water pressure exceeding 100 psi, 80 psi maximum per code. 608.2
Cleanouts to be gas and water tight. 707.3
Secure T&P at water heater per manufacturer requirements.
Freeze protect waterlines in garage. 312.6
Seal and secure bath cabinets to wall. 402.2
Provide permit for landscape irrigation Backflow devise installed without permit.
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
12807 SW 132ND AVE, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Master Permit MST2018-00196
Inspection Type: Inspector:
299 Final inspection David Young
Result:
FA I L
Comments:
Provide approved final erosion control inspection prior to building final.
Provide approved trade final inspections prior to building final. R109.1 .6
Provide permit for ac installed without permit.
Provide permit for landscape irrigation Backflow devise installed without permit.
Steps and landing in garage not complete.
Provide required fire separation at garage ceiling at beam locations with living space
above. R302.6
Provide city required documents at final inspection, moisture content, barrier forms, high
efficiency lighting form, insulation certification and duct seal test report.
Not ready for inspection, work not complete.
No further inspection done at this time.
Violation Summary:
Inspector Contractor
Electrical Permit Application ,, . ... ' FOR 0E111'E USE.°NIA
City of Tigard 1 ,. ' . litc.Z.IrX0A Permit Vti...177,20/CP 1,...., 13125 SWF Ian Blvd,.Tigard.OR 9722. ee 4Ft / - , pi.Ke,,,ew
irs' Phone: 503 _
.718.2439 Fax, 503. 9.S 19 Date.IlL Related Permit
Inspection Line: 503.6394175 Reads Date ER. tuns: El See Page 2 for
Internet: www.tigard-orgov Notitied Method Supplemental Information
ElitilliilliSrititEr:.ZiaritPT&i'::VtttAr,Afrilillttaltaiff -mti',Tatitititi ,Vii11317MINVIMINIZ:
i r...4 New construction 0 Addition/alteration/replacement
0 Service or feeder 4(h)amps or more 1J lauding over three stones.1
I 0 Demolition 0 Other:
r',4tWCXV;,CigariattLitlant*/flira'-;ICLL'e,giarti .:,,n4113,1,',W; exceeds 10,1100 amps at 150 volts or 0 Honung buildings
1 74 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building 1:sp`sof:aaulln'L:.:Irei:Zel'Ill:til:n's0,00 0=negrccnil•use agnculawal
E3 Multifamily El Master builder 0 Other: °Fire pump. 0 Installation of 150KVA or
ARICIMILIMULt'79:15:134).::::,''IVIESIZEZIMINEliriVAL BEA:re,"cm' iii'
1,r-gef''eParatelY desiv"i
, Job ri: Job she address,: . , i -- -s - s • II 'T i loom rir mons DA,'"E''.-1-2-,-1-3",
City/State/ZIP:11. s Oil Ott, 31 12,5 / ft 9 /3,:".2, l'"--t B t',',',71,:==:.1.1'"us' 0(12(e.(c=ialyelnele parks
Suite/bldg./apt.4; Project name: C5...V..AS, PA c4-171„1-10c4 I amps or more 0 Supply voltage for more than
Cross street/directions to job site: iltilfigAMIRDIEDIEMBIEWitetLanni
Description Ow. Each 11*1
New residential single-or multi-family dwelling unit.
Subdivision: Lot 4: I Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax mars/parcel#:
, . , Ea add'I 500 sq.ft.or portion , , 1
qtr. r.421Z,:-ITALI ,24 -!..* v:'citt7M71:1z::::.i,VZIMITi Limited energy,residential 33 92
75 00 2
(with above sq.ft.)
C &-1t & 're C01411sik CTI)9,.... 0 14 esi,s.nr1/4cr 9 eitti Cr Limited energy.multi-family
75 00 2
1 MST'2.01A-Do 1.54 j residential(with above sq ti.)
' 0 See Page 2
IIRMIT:14rx.arm„-,,jilartnitlIWAIr .;,',411041,1?-;,'''',,*'!7,,',ia.,,V','A.;-k,:44Ni‘s°' Services or feeders installation,alteration,and/or relocation
Name:WV 9-grif)t -IAG g- beck's 61-4i'l 200 amps or less 100.70 2
201 amps to 400 amps 133,56 2 Address: z 1 zq 1 5.k..,,, (Lout_
401 amps to 65$)amps 2(:)0 34 2
City/State/ZIP: rk-Lokiik. k 0 fe– •( 4,40,If 3 601 amps to 1,000 amps 301.04 2
I
Phone: sal, —azii-/- j Fax:t ) over LOoo amps or volts 552 26 2
r Temporary services or feeders installation,alteration,and/or
1 Email' H C tcAs Q & 1At L, G M relocation
Owner installation. Tins installation is being made on propons that I own which is not 200 amps or less 59)6 , 1
•
I intended for sale,lease,rent,or exchange,according to 01(5 447.449,670.and 701. 2o1 amps to 400 amps 125.08 , 2
Owner signature: Dater _, _____ 401 amps to 599 amps 16R 54 2
1:1:11$2,1C.1:0circuits1-c-117:1,,awlittehration,or extension, ier panel
1 Business name: sA tic As As,v,.4 e
742 2
Contact name: ,
lB.Fix fisr branch circuits ii ithour
sers ice or feeder fee,first 56.18
I Address:
City/State/ZIP: , _
Each ad/Il branch circuit 732 2
Miscellaneous(service or feeder not included)
Phone:( 1 I i ax: :( I Each manuhrtured or modular
dv,etlxng,service and/or teder
67.84 s 1
Email: Reeontii only
67.84 2 1
itakr44)::ArkiitilfMAA74.,In ),*, 'Ami-OPktogri•twitiamfai,,:: pomp or mr,gmmn circle 67.84 2
1 Business name: IC,c,bt AK,. s Le c .-„.. 1 c_ Sign or outline lighting 67 15.4. 2
Signal etretni(s)or limited-energy t5iiICl alteration,or cxtcflsiofl 0 see page 2
-'--- ! ‘ddres'I 248G Sy too s roe 9--(6
Each additional inspection over allowable in any of the above
City/State/ZIP: .S ALem , oe,.. .9i-3043 Additional inspection(1 hr min) 66 25.1hr
1 - 1
Phone:(g03) a&( — f 2.,,s--5 .Fax:( ) Investigation(I hr mm) 90 00/hr
Email: 7 Industrial plant(1 hr min) 78,181 hr
90.00i hr
likAtglitairktta(„. ,-!•4 1 Z,1151.7.,Vinntt;P'E
Suprv.Electrician signature,required:
Subtotal:--- (111
Print name: F.,..Pdst DN.( se I R... Date: ii zb 1 S 0 Plan Rev test, Required(25%of permit fee):
State surcharge(12%of permit fee),
Authorized signature: TOTAL PERMIT FEE
-
l This permit application expires if a permit is not obtained within ISO
IPrint name: -rpm . s srpt,i44„. . Date: it 1,761 adius after It has been accepted its complete.
f
1.4,billdingWermi6sLIC PennitApp UR Ltd doe Rev 1M2i4 s 440.460101,A 1 C Nt 0,FE
Plumbing Permit Application
Building Fixtures
orrt
or,,,t1cArr'it ' - Foa ici: . ()Nil
111 ...mom- Received ,. / z
City of Tard
i/72 fAaall I I Dare Tiv `17felpf 4474-- Permit Naytt'S 7"-- .0,te D
- o yt,..._.,..- 13125 SW flailigBlvd_Tigard,OR 97223 ..• 1..,/,,n Rev,ew
Other Permit No.
Phone: 503.7182439, Fax- 50.1 598 1960
Date ily
Inspection Line: 503.639.4117:p
Dine Ready fly
'Turk' ierte
iSelePnagetaformation
21 Information
Internet: www.ugard-orgov Noffi wd Merawd So, ...„.,,., ,
'3!r1";:iiitrz9Iii;:l'1,--45,A .al Ig.nfor'sL.''"t*---"'''I''44!-a*J'"L'hvath
lotyrmation use checklist 71 New construction 0 Ihimolit ion o
; t----
I kseription Qty. Ea. Total
1 0 Addition/alteration/replacement 1 0 Other: New I-2-family dwellings(includes 100 ft.for each utility connection)
* k,5"--8,118018111°441,85*Inatillt-ilti SFR(I)bath MIIIIEEIIMIIIIIII
111111-11110111123111nitiwitriiiai.: 4:u‘4.i..414-.I'lrqatilMAUFRNinf."',till 1
437.78 RI 1-and 2-family dwelling 0 Commerciallindusirial SFR(2)bath
h" SFR(3)bath 500.32
0 Accessory building 1 0 Multi-family
C ; Each additional bath/kitchen 25.02
1 0 Master builder 1 0 Other:
J Fire sprinkler( sq. ft.) Page 2
`55:,-143:51(°,..us-„inimkk,..y4l.Nttlilinril'i,°,l(3i'll1-!'//(il'i ':'i',Ar"°..T,aillimi'°'il.11t.°'(q•fa'ieit4t:*',Csr'4'-'°7 Site utilities:
46iilgtWartsc....)-izitrma.u.k..iww.g...A.......A....,••••- - --541r),--i .........a. ...L.._ Catch
basal or area
drain 18.76 Job site address: .144".5r1 MJ - •'
- ' - -. . /LS
Drywell.leach lute,or trench drain 18.76
°
Cit /State/ZIP:--licike,b., oe--- '61' 22.3
Footing drain(no,linear ft: ) Page 2
Suite/bldg./apt.no.: Project name: CS a Kat(..5. t/A 9-..1-1Ti O TManufaetured house 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: lot no,: I Fixture or item:
I
Backlit-1w prevemer 31.27 Tax map/parcel no.:
''Ist.! Backwater valve 12.51
I \de-fit-t2C-- CliPttAG-ttal-- LICE GrA ''' . (To(k.o r4 eXt,sr"Vms.4 Gs Dishwasher 25.02
i c'et.ritv, r-ksr Zola - ooleG Drinking Muntain 25.02
:
Ejectors/sump 25.02
17,,,..., •••.•,-,s•---°5-•;.(.,•"1,°,555°5-2-imr s°,11.,(•°5°.‘1,,,,,P,.41,-,e,-;:hori-,..;;OV -f..PAit r Sci:::P:itt Expansion tank 12.51
'' " Fixture/sewer cap 25.02
I Name: 44T-LttioDel-frA 6 4 DCcie-r,3 1, U.C. I mt-AAs 3AY-0 .
Floor drain/floor sink/hub 25,02
I Address: Z.1 Z1-1 .5,04 9--aCIC-. li? isl°
Garbage disposal. 25.02
I CitytState/ZIP: PiAnti A I 0(4- 65100
I lose bib 25.02
I Phone:(503) 2& -41Vi ' Lax:( ) Ice maker 12,51
,
A'''r'.l""t.a`IltliiiiilitiktitS''l:'l,'lirM44'. vsst`l- tiAintailltteintriftnl,35.:44!:.1. Interceptor/grease trap
....._ 25.02
medicalgas(value,$ )
Page 2
Business name: Ski:At /1/4,6 10k,e)o‘ie,„'
Primer 12.51
Contact name:
Root drain(commercial) 1/.51
Address:
Sink/basin/lavatory 25.02
Cit /State/ZIP: Solar units(potable water) 62.54
•1 x
I°
Phone:( ) i'l ' Tubishowerw
lshoer pan 12.51' )' .
Luna! 25.02
li-ruail: .
25.02
s 3(4 Water closet
F: ,.-I,Aitto:,-;;Ativrkotri:s:i,v:b !,z,14,:4'tli,,tt s.'25:$451,4165,40iti.;•,it•ti,o,(104(""l'.. w„ter heater 37.52
1 Ill'iness name: -146-fil"L-itt416-3-Phir Pi IL.CEA goGbAt.1t Water piping/DWV 56.29
° Address: VS SI 2... S Mike,,K,e-r srg-e-6T Other. 25.02
City/State/ZIP: Po Fl.„11A t.41) I OF,. 512-3.3'
iSubtotal
:
Phone:(603) 2974 If - 11 0 0 Fax:( ) Minimum permt fee $72.50
Plan review (25%of permit fee)
CCI1 lie.: eguLt 17... r71 I- pitinthir4z I ic,,,,,,., za-Lc
State surcharge(12%of permit fee)
Authorized signature:
t. A TOTAL PERMIT FEE
I rust namecs 3-14 i i in/ This permapp
it lication expires if a permit is not obtained within 180 days
' : Ill,tot ik '... Date: , alter it has been accepted as complete.
..
',lice icialoakilogy set by Tri-County Building industry Service Board.
440-46 I oil 16021'+,,MAVI,B)
I.BuddinwsPeriniisiPLlidli-Pa RAApp.doc 10:01,09