Inspections (15) City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13190 SW MADDIE LN, TIGARD, OR, 97224 July 27, 2018 at 11 :03:45 AM
Record Type: Record ID:
Residential - Master Permit MST2018-00063
Inspection Type: Inspector:
699 Mechanical final Jeremy Burrows
Result:
PASS
Comments:
A/C installed
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13190 SW MADDIE LN, TIGARD, OR, 97224 July 27, 2018 at 11 :12:56 AM
Record Type: Record ID:
Residential - Master Permit MST2018-00063
Inspection Type: Inspector:
199 Electrical final Jeremy Burrows
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13190 SW MADDIE LN, TIGARD, OR, 97224 August 31 , 2018 at
10:59:26 AM
Record Type: Record ID:
Residential - Master Permit MST2018-00063
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS
Comments:
Water pressure = 65 psi
Violation Summary:
Inspector Contractor
Building Permit Application
Residential
r— FOR OFFICE USE ONLYCity of Tigard .Fi t e - :`t
x ,,,.,:1 Received
13125 SW Hall Blvd.,Tigard,OR 972230C pp
Date/By: ,Z/ t� ',emit No.A�I �� �_b�„�'
Phone: 503.718.2439 Fax: 503.598 1960�1� G 2013 1„,
Plan Review �l�/66(t�L(�^`��'`1� 1/��C"`�G(gJ
Inspection Line: 503.639.4175 Date/By: a�� J Other Permit: (J/ r/(�
I <r'4 i; p Date Read/B
Internet www.tigard-or.gov Ready/By: IaC15 I H See Page 2 for
�q ) Notified/Method: 2 1j„Z l�
F3�d 1- c., /� Supplemental Information
TYPE`OF,WORK R QUIRKED DATA:1-AND 2-FAMILY DWELLING -,
° New construction 0 Demolition Permit fees*are based on the value of the work performed.
0 Addition/alteration/replacement Indicate the value(rounded to the nearest dollar)of all
❑Other: equipment,materials,labor,overhead,and the profit for the
_ CATEGORY OF'OONSTRUCTION „%-r-. work indicated on this application. �A �n .y,
[�1-and 2-family dwelling 0 Commercial/industrial Valuation: $� /
El Accessory building 0 Multi-family Number of bedrooms: 4 3S.3) 7 t1
Vic 0 Master builder 3 ZS
❑Other: Number of bathrooms: �[,�
x - . JOB SITE iINIORMATION AND LOCATION,... Total number of floors: 2 3 ^� 9 C
Job site address: 13190 SW Maddie Lane oC
New dwelling area: 2832 square feet
City/State/ZIP: Tigard, OR 97223
Garage/carport area: 464 square feet
Suite/bldg./apt.no.: I Project name: Madeline Heights
Covered porch area:• / 1 square feet 6 q y.
Cross street/directions to job site: bOl
p�D,Deck area: $� l}, square feet i) 3 g
i ntha �.
square feet
t ea
QUIRED DATA'CO c`I
RA7 >ISE CHECKLIST;:='
Subdivision: Madeline Heights
P
Lot no.: 9 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
• equipment,materials,labor,overhead,and the profit for the
DESCRIPTION;OF WORK - work indicated on this application.
NSFR Valuation: $
Existing building area: square feet
New building area: square feet
¶4 = PROPERTY °WNL 0=TENANT Number of stories:
Name: Lennar NW Inc.
Type of construction:
Address: 11807 NE 99th Street, #1170
Occupancy groups:
R' City/State/ZIP: Vancouver, WA 98682
Existing:
Phone:
(360)258-7900 Fax (360 ) 258-7901
APPLICANT New
CONTACT P,I RSON - BUILDING PERMIT.FEES*
Business name: Lennar NW Inc. (Pfeasereferiafees hedrrpe);
Contact name: Juls Call Structural plan review fee(or deposit):
FLS plan review fee(if applicable):
Address: SAME AS ABOVE
City/State/ZIP: Total fees due upon application:
Phone:( 360)258-7906 I Fax::( ) Amount received:
E-mail: juls call@Iennar.com
PilOTOVOLTAIC SOLAR PANEL-SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic Solar Panel System.
Business name: SAME AS ABOVE Submit two(2)sets of roof plan with connection details
Address: and fire department access,along with the 2010 Oregon
Solar Installation Specialty Code checklist.
City/State/ZIP: Permit Fee(includes plan review
and administrative fees):
Phone:( ) I Fax:( )
CCB lic.: 195307 State surcharge(12%of permit fee):
Total fee due upon application:
Authorized signature: rS°IQ- This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: I U IS Cal I Date: 216/1 I *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling
FOR OFFICF, USE ONLY
IICity of Tigard Received
U 13125 SW Hall Blvd.,Tigard,OR 97223 Date By: Permit No.:
Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
T I G A R D 24-Hour Inspection Line: 503.639.4175
Internet: www.tigard-or.gov ❑ Electrical ❑ Plumbing 0 Mechan cal
0 Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A
1 Land use actions com t leted. See'urisdiction criteria for concurrent reviews.
In2 Zoning. Flood plain,solar balance points,seismic soils desi•nation,historic district,etc. il
E3 ❑
El
3 Verification of a t t roved t lat/lot. ❑ ❑
4 Fire district a t proval ret wired. Name of district: MA LI 0 ❑
5 Septic system permit or authorization for remodel. Existing system capacity ❑
-----------
6 Sewer t ermit. ❑ 0 0
7 Water district a t s royal. El El ❑
8 Soils re t ort. Must c. ori•inal as'licable stamp and sitnature on file or with application. CI ❑ ❑
9 Erosion control FA plan ❑permit re uired. Include drainage-way El El FA g y protection,silt fence design and location ofcatch- El0
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size ❑ 0
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions; ro e
rty corner elevationsthere is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements(if El ❑
and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction
indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and
surface draina•e.
12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size
and location. � ❑ ❑
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater,
furnace,ventilation fans, plumbin_fixtures,balconies and decks 30 inches above grade,etc. CI ❑
14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- 7
floor,wall construction,roof construction. More than one cross section may be required to clearly portray CI ❑
construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings
and foundation,stairs,fireplace construction,thermal insulation,etc.
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels.
Vi
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. ❑ ❑
Full-size sheet addendums showin• foundation elevations with cross references are acce stable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non-
prescriptive path anal sis provide specifications and calculations to en•ineering standards. ❑ ❑
17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing (�
locations. Show attic ventilation. ❑ ❑
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered
systems,see item 22,"En•ineer's calculations." ❑ 0 ❑
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists �I,
over 10 feet lona and/or an beam/'oist car int a non-uniform load. ❑ ❑
20 Manufactured floor/roof truss desi'n details
11
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 ❑ El
for four or more a.'fiances. 0 0
22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or
architect licensed in Orem on and shall be shown to be as slicable to the project under review. ❑ ❑
JURISDICTIONAL SPECIFICS
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17".
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ❑ ❑ ❑
25 Buildin• plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ 0 0
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. El ❑ El
27 "Drawn to scale"indicates standard architect or engineer scale. ❑ ❑ ❑
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and Cityof Tigard gard ❑ ❑ ❑
Street Tree List. ❑ ❑ ❑
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑
and protection measures must be drawn to scale and must include the pro'ect arborist's si_nature of approval. ❑ ❑
30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions,
including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings ❑ El CI
on a lot of record a.proved prior to September 9, 1995.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011
440-4613T(1 l/02/COM/WEB)
Mechanical Permit Application
FOR OFFICE USE ONLY
INCity of Tigard t�F4 ,1\p}' D Received
'I 13125 SW Hall Blvd.,Tigard,OR 97223 1 Date/By:
Permit No
60
Phone: 503.718.2439 Fax: 503.598.19n Plan Review
1 G A R D Inspection Line: 503.639.4175 DD 6^ 2013
Date By: Other Permit:
Internet: www.tigard-or.gov Date Ready/By: Juris: Fa See Page 2 for
Notified/Method: Supplemental Informafion
BUiLi, 4-42C Di ViSION
TYPE OF WORK" COMMERCIAL FEE* SCHEDULE='USE CHECJaJ5T
Mechanical permit fees*are based on the value of the work
[ New construction ❑Addition/alteration/replacement
❑Demolitionperformed.Indicate the value(rounded to the nearest dollar)of all
❑Other: mechanical materials,equipment,labor,overhead,and profit.
r CATEGORY OF''CONSTR'CONSTRUCTION Value:$
,, 1-and 2-family dwelling ❑Commercial/industrial RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ,.", ,
❑Accessory building Fors
special information use checklist.
ID Multi-family
❑Master builder ❑Other: Description
JOB SITE INFORMATION AND LOCATION ` g/coolin : Qty. Ea. Total
'. _ ; Heatin g
Job site address: 13190 SW Maddie Lane Air conditioning 1 46.75 46.75
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: Tigard, OR 97223
Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: I Project name: Heat pump
61.06
Madeline Heights
Cross street/directions to job site: Duct work 23.32
Hydropic hot water system 23,32
Residential boiler(radiator or
hydronic)
23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision: Madeline Heights ILot no.: 9 Other:
23.32
Tax map/parcel no.: Other fuel appliances:
Water heater 1 23.32 23.32
DESClttt'1'ION OF-WORT' Gas fireplace/insert 1
33.39 23.32
NSFR Flue vent for water heater or gas
fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
. =PROPER-T-1;;°:"- -!:-:"---::''''''-
Y O�YNOther:
1---' I_] TENAiIT, 23.32
Name: Lennar NW Inc. Environmental exhaust and ventilation:
Range hood/other kitchen
Address: 11807 NE 99th St.#1170 equipment 1 33.39 33.39
City/State/ZIP: Clothes dryer exhaust 33.39
Vnacouver, WA 98682 Single-duct exhaust(bathrooms,
Phone (360) 258-7900 Fax toilet compartments,utility rooms) 4 23.32 93.28
(360) 258-7901 Attic/crawlspace fans
APPLICANT, 23.32
CPNT.A T PERSON ',. Other: 23.32
Business name: SAME AS ABOVE Fuel piping:
Contact name: Juls Call $14.15 for first four;$4.03 for each additional
Furnace,etc.
Address: Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Water heater
Phone:(360)258-7906 I Fax::( )
Fireplace
E-mail: fuls.call@lennar.corn Range
Barbecue
:, CONTRACTOR ,. Clothes d er
` ��' ry (gas)
Business name: Development Northwest Inc. dba Wolcott Plumbing Other:
Address: 1075 W Historic Columbia River Hwy .3 eHANIeALPER )TFEEs*
City/State/ZIP: Troutdale, OR 97060 Subtotal $220.06
Minimum permit fee($90.00)
Phone:( 503) 667-1781 Ext. 3007 I Fax:(503 ) 667-9891 Plan review(25%of permit fee)
CCB lie.: 112220 State surcharge(12%of permit fee)
TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Authorized signature: •
days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry Service Board
Print name: Dennis L. DunningI
I Date: 10/23/17
I:Building\Permits\MEC_PermitApp_040113.doc
440-4617T(11/02/COM/WEB)
•
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
Total Valuation: 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_o40113.doc 2
Electrical Permit Ap lication
„ t",\, f
FOR OFFICE USE ONLY
City of Tigard gra: s ''.-' Received
14 13125 SW Hall Blvd.,Tigard,OR 97223 Sq DateM :
sQ Phone: 503.718.2439 Fax: 503. 960 (U' 2QifJ Plan Review / �,� - i
Inspection Line: 503.639.4175 Date/B Related Permit#:
T I GA R D Internet: Line:g rd-or.gov - - ReadyDate/
By:Y Ions: gl See Page 2 for
CITY 1 (d', ) Notified/Method:
-' - - �-aq� c.111"
Information
- _ TYPE;j1 •n� " ■tv ;nt
7 New construction 0 Addition/alteration/replacement PLAN REVIEW
Please check all that apply(submit 2 sets of plans w/items checked):
0 Demolition 0 Other: ❑Service or feeder 400 am s or more
? - _ P ❑Marinas
r over three stories.
CATEGORY OF'CONSTRUCTION where the available fault current
0 Ming and boatyards
1-arid 2-familydwelling exceeds 10,000 amps at 150 volts or 0 Floating buildings.
Commercial/industrial 0 Accessory buildinglegs to ground,or exceeds 14,000
o Multi-family ❑Master ❑Commercial-use agricultural
builderamps for all other installations. buildings.
0 Other: 0 Fire pump.
JOB,SITE INFORMATION AND LOCATION 0 Installation of 150 KVA or
❑Emergency system. larger sepazately derived
_ ❑Additionofnewmotorloadof system.
Job#: Job site address: 13190 SW Maddie Lane
City/State/ZIP: looxP or more. ❑`'A' °°E",°`1-z","1-3",Tigard, OR 97223 ❑Six or more residential units. occupancy.
Suite/bldg./apt.4: 0 Health-care facilities. 0 Recreational vehicle parks.
Project name: Madeline Heights
❑Hazazdous locations.
0 Supply voltage for more than
Cross street/directions to job site: ❑Service or feeder 600 amps or more. 600 volts nominal.
Subdivision: Madeline Heights
' . :: FEE SCHEDULE
Description _. .._I Qtv j Each . Tetal= I- ..
New residential single-or multi-family dwelling unit.
Lot#: 9 Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less
. 4
DESCRIPTION OF WORK Ea 500 sq. or portion 33.9216854 I
Limited ted energy,residential
(with above sq.ft.) 75.00 2
Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
�I PRakER OlhTER- TE1�IAltiT Renewable Energy ❑ See Page 2
- Services or feeders installation,alteration,and/or relocation
Address: 11807 NE 99th St. #1170 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
City/State/ZIP: Vancouver, WA 98682 401 amps to 600 amps 200.34
2
601 amps to 1,000 amps 301.04 2
Phone:(360 )258-7900 Fax:
(360 ) 258-7901 Over 1,000 amps or volts 55226
2
Temporary services or feeders installation,alteration,and/or
Owner installation:This installation is being made on property that I own which is not 200 amprelocation
s or less
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 25.08 1
Owner signature: 201 amps to 400 amps 125.08 2
Date: 401 amps to 599 amps 168.54
APPLICANT 2
_ P CONTAC '° ERSOI4 Branch circuits—new,alteration,or extension,per panel
Business name: Same as above A.Fee for branch circuits with
above service or feeder fee,
Contact name: Juls Call each branch circuit 7.42 2
Address:
B.Fee for branch circuits without
service or feeder fee,first
City/State/ZIP: branch circuit 56.18 2
Each add'l branch circuit 7.42 2
Phone:( ) Miscellaneous(service or feeder not included)
Fax: ( ) Each manufactured or modular
Email: 'uls.Call • lennar.com
dwelling,service and or feeder 67.84 2
CONTRACTOR Reconnect only 67.84 2
Business name: Pump or irrigation circle 67.84 2
Lantil LLC dba Three Phase Electric Signor outline lighting
Address: 67.84 2
11490 SE Jennifer St. Signal circuit(s)or limited-energy
City/State/ZIP: panel,alteration,or extension. ❑ See Page 2 2
Clackamas, OR 97015 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:( 503) 908-8058 Fax:
(503 )726-1823 Investigation(1 hr min) 90.00/hr
Email: rlane@threephaseelectric.com Industrialplant(1 hrmin) 78.18/hr
CCB Lic.: 162368 Electrical Lic.: Inspections for which fee is
Suprv.Lic.: 3398S specifically listed(h hrr min) 90.00/hr
3-332C S
Suprv.Electrician signature,required: r ELECT RIG L PEI2MTCotal =
.Gx.z„L. G-ticLz-�
Print name: Dennis Welch subtotal:
Date: 10/23/17 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: G
` "'``= TOTAL PERMIT FEE:
Print name: Robert Lane DThis permit application expires if a permit is not obtained within 180
Date: 1/5/18 days after it has been accepted as complete.
I:\Building\Permits\ELC_PermitApp_ELR ERE.doc Rev 06/17/2015 * Number of inspections allowed per permit.
440-4615T(11/05/COM/WEB
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. I Each I Total I
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
LIBurglar Alarm Wind generation systems in excess of 25 kva:
25.01 to 50 kva 301.04 2
MGarage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
Heating, Ventilation and Air Conditioning
System* Solar generation systems in excess of 25 kva:
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
Ell
Each additional inspection over allowable in any of the above:
Other: Each additional inspection is
charged at an hourly(I hr min) 66.25/hr 1
Inspections for which no fee is
specifically listed('/z hr min) 90.00/hr
CO O:c1c L WO* OILY. ELECTRJCAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
(SEE OAR 918-309-0000) * Number of inspections allowed per permit.
Check Type of Work Involved:
Audio and Stereo Systems
n Boiler Controls
I Clock Systems
Data Telecommunication Installation
Li Fire Alarm Installation
❑ HVAC
❑ Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control*
❑ Medical
Nurse Calls
n Outdoor Landscape Lighting*
n Protective Signaling
n Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015
Plumbing Permit Application
Building Fixtures ' , �
ti 7 FOR OFFICE USE ONLY of Tigard •W„ed �y���
• 13125 SW Hall Blvd.,Tigard,OR 97223 FEB Date/By. Permit NAA[ /j� L���/(I�
= Phone: 503.718.2439 Fax: 503.598.1960 LD�(� Plan Review �!/[✓/ f/
Inspection Line: 503.639.4175 °1€i
Date/By.
Permit No.:
1 I C ,1 D t , 1Date Ready/By:
Juris. l
EI See P
agforInternet www.tigard-or.gov ar mt Notified/Methd. Supplemental
Information- i., { *TYPE OF WORK FEE* SCHEDULE pNew
construction ❑Demolition For special information use checklist
0 Addition/alteration/replacement Description Qty. Ea. Total
❑Other. New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION = SFR(1)bath
312.70
1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR O bath 1 500.32 500.32
0 Accessory building 3
❑Multi-family
❑Master builder Each additional bath/kitchen 25.02
❑Other:
.JOB SITE INFORMATION AND LOCATION utilities:Site kler( sq.ft.) Page 2
Site
Job site address: 13190 SW Maddie Lane Catch basin or area drain 18.76
City/State/ZIP: jgard, OR 97223 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: ,I Project name:
Cross street/directions to job site: Manufactured home utilities 50.03
Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.: ) Page 2
Subdivision: Madeline Heights Water service(no.linear ft.:_) Page 2
Lot no.: 9 Fixture or item:
Tax map/parcel no.: Backflow preventer
1 3127 31.27
DESCCRIPTION OF CORK Backwater valve 12.51
NSFR Clothes washer 1 25.02 25.02
Dishwasher 1 25.02
25.02
Drinking fountain 25.02
Ejectors/sump 25.02
-.,) ,, ,[ PROP.EItTY OWNER 0 TENNNAN'£ ; Expansion tank
, 12.51
Name: Lennar NW Inc. Fixture/sewer cap 25.02
Address: 11807 NE 99th St.#1170 Floor drain/floor sink/hub 25.02
City/State/ZIP: Vancouver, WA 98682 Garbage disposal 1 25.02 25.02
Hose bib 9 25.02 50 04
Phone:(360)258-7900 Fax:( 360) 258-7901 Ice maker
12.51
I �PPLICA s T E;CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name: SAME AS ABOVE
Contact name: Juls Call Primer
12.51
Address: Roof drain(commercial) 12.51
City/State/ZIP:
Sink/basin/lavatory 5 25.02 125.10
Solar units(potable water) 62.54
Phone:(360)258-7906 I Fax:
( ) Tub/shower/shower pan 9 12.51 95 02
E-mail: Juls.call@lennar.com Urinal 25.02
CONTRACTOR .s, Water closet 3 25.02 75.06
Business name: Development Northwest Inc., dba Wolcott Plumbin Water heater 1 37.52 37.52
g Water piping/DWV 56.29
Address: 1075 W Historic Columbia River Hwy Other:
City/State/ZIP: 25.02
Troutdale, OR 97060
Subtotal 919.39
Phone:(503) 667-1781 Fax:(503)667-9891 Minimum permit fee: $72.50
CCB Lie.: 112220 Plumbing Lic.no.: 26-824PB Plan review (25%of permit fee)
Authorized signature: idef.ct 41.4 State surcharge(12%of permit fee)
"J TOTAL PERMIT FEE
Print name: Dennis L. Dunning I Date: 10/19/17 I 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.
I1Building\Permits\PLMU-permitApp.doc 10/01/09
440-4616T(1o/o2/COM/wBB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site UtilitiesQty. Fee(ea) Total Square Footage• Permit Fee•
Footing drain-15`100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
Sewer-1st 100' 62.54 3,601 to 7,200 $233.20
7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54
Water Service-each additional 100' 37.52 Medical Gas Systems:
Storm&Rain Drain-1st 100' 62.54 Valuation:, Permit Fee:
$1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
. Qty Fee'.(ea) Total each additional$100.00 or fraction thereof,to
Other Inspections or Fees
Inspection of existing plumbing or for and including$10,000.00.
which no fee is specifically indicated 90.00/hr $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof,to
Inspections outside of normal business and including$25,000.00.
90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*.
Quantity by Fixture Type Plan,Review,for Plu Bing Installations
Fixture Type for Replace/
Work Performed: Capped Added Relocate Plan review is required for any of the following.
Baptistry/Font Please check all that apply.
Bath -Tub/Shower ❑ Any new commercial building with water service 2"and
-Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink 2" Submit 2 sets of plans with any of the above.
-3"
Car Wash Drain Isometric or-Riser,:Diagram
Garbage Domestic-non-food ❑ Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter
Washer-Clothes *Note: If the fixture work under this permit results in an
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
C:\Users\JuCall\Downloads\PLMF PermitApp(1).doc 2
City of Tigard
M COMMUNITY DEVELOPMENT DEPARTMENT
III ■
T I G A R n Building Permit Review — Residential
Building
Permit #• AA
Site Address: /3/`70 ) �? /
Project Name: i;t ; - ` her
(New dwelling=sub. vision name;Addition or Alteration=last name of owner) Lot #:
Planning Review
Proposal: A}).63-10
R(erify site address/suite#exists and
active 1n permit system.
111''.1'Over Terrace Neighborhood: 27No
❑ Yes,See River Terrace Review Addendum Attached
Sit/Plan Elements:
Lg/Three(3)copies of site plan
e plan must be on 8-1/2"x 11"or 11 x 17"paper & txistmg structures on site
Vin D 'Footprint
awn to scale(standard architect or engineer scale) oe lvationsw structure(including decks)with finished
p .rth arrow
M S' e address,project or subdivision name and lot number VP .fit'locations&easements(required for new and additions)
Sidewalk/driveway approach
IV .plicant information(name and phone number)
& of dimensions and building setback dimensions � ' 'cation of wells/septic systems
Z Existing trees to be retained with drip line,and tree
! °•uare footage of buildings to be demolished
M Lot area,building coverage area,percentage of coverage and 'eet teen measures
pervious area(applicable if R-7,R-12,R-25&R-40) S reet tree names
ize,type and location
( PP� [� ,�
Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? MYes ❑
4 foot differential)
If es,is a storm water •uali facili shown? Elo
L% Clean Water Services—Service Provider Lettertter(lot platted prior to 9/10/1995):
t equired: ID Yes,applicant was notified tN" No ��Pary
' Vi 1
1,C Public Facilitie Improvement(PFI) Permit:aire : Received: El ye��{]] No
Required: 144 ✓it
q Yes,applicant was notified ❑ No
Applied For: al/Yes ❑ No,stop intake
Land Use Case#: S Ue 2-016-0000 3
EZ/Zoning: 11-7
0/Required
2016 -001 6
iRequired Setbacks: Front Rear
5 Side _� Street Side Q Garage �Q_
0/Landscape Requirement: 2_0 %01/L
of Coverage Maximum: --L
Building Height: Maximum Height 35
isual Clearance Actual Height ^--'(>2 73
[]Sensitive Lands: 0 Yes li
fLTJ No Type
N14 Urban Forestry Plan
dConditions "Met"prior t issuancet� of building permit
Notes: Aacit JhIa 11.‘i-,v .� a.1 of Z-6- f al ike•,,t Tr,- S42016-00003 1Gscct..
G
0 Approved By Planning:
Revisions (after Building Submittal only) Date:
Revision 1: GIA roved Reviewer Date
pp ❑ Not Approved
Revision 2: 0 Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\BuildingTorms\BldgPermitRvw RES_061417.docx
Building Permit Submittal ��
Original Submittal Date:
Site Plans: #
Building Plans: #
Building Permit#: nter building permit#above.
n eere Permit Coordinator BuildingWorkflow Routing: Planning gn' ig
Workflow Sign-off: Sign-off for P anning(include notes from planning review) and
Route Application Documents: Engineering: (1) copy of permit application, (1) site plan,(1 building plan
original plan review routing form.
Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: j I, Date: /
By Permit Technician: ..7-, 1-.L. ( �VW
Engineering Review
[,eS ope at building pad: )1;
Conditions"Met"prior to issuance of building permit
fasements (encroachments)per engineering conditions of approval and plat
2 Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes g-"No
Assess Water Quantity Fee in-lieu: 0 Yes Q'No
LIDA Facility on lot: 0 Yeso
-Final Plat Recorded:
Date:
0 NOT Approved by Engineering:
Notes:
Date: 2 _ �. F 9�
proved by Engineering: x
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 permit
Date:
0 Approved,NOT Released:
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:
DC Fees Entered: Wash Co Trans Dev Tax: ...,es 0 N/A
Tigard Trans SDC:
R- Yes 0 N/A
Parks SDC: Yes 0 N/A
LIDA 0 Yes N/A
nes K to Issue Permit Pte, /
4 i Date:
Approved by Permit Coordinator:
I:\Building\Forms\BldgPermitRvw_RES_010118.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13190 SW MADDIE LN, TIGARD, OR, 97224 September 10, 2018 at
12:55:58 PM
Record Type: Record ID:
Residential - Master Permit MST2018-00063
Inspection Type: Inspector:
299 Final inspection David Young
Result:
PASS - CofO
Comments:
Scheduled PLM final for backflow devise for contractor.
Final erosion control approved.
Street tree certification received.
Moisture content form received.
Moisture barrier form received.
Blower door test report checked.
Insulation certification checked.
Backflow test report received.
C of 0 left at kitchen island with approved plans.
Violation Summary:
Inspector Contractor