Permit (100) CITY OF TIGARD MASTER PERMIT
' COMMUNITY DEVELOPMENT ,°" Permit#: MST2018-00247
�' Date Issued: 10/29/2018
T-1( A it l) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ll „'' 7��,
Parcel: 1S125DA03700
Jurisdiction: Tigard
Site address: 6618 SW WALNUT TER 4 '
Subdivision: WALNUT TERRACE PARTITION Lot: 3
Project: Walnut Terrace, Lot 3
Project Description: New SF. 5/6/19: REPRINT to add backflow preventer.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1310 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 25 Bathrooms: 3 Second: 1826 sf Garage: 587 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 3136 sf Value: $404,297.80 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: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 1
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: 4 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 3136
Owner: Contractor:
KOVALEV,VITALY&ANITA GLOBAL HOUSING INC Required Items and Reports(Conditions)
6990 SW CANBY ST 4111 SW 52ND AVE 1 Ersn Cntrl 503-639-4175
PORTLAND,OR 97223 PORTLAND,OR 97221
PHONE: 503-313-4259 PHONE: 503-315-4259
FAX: 503-477-4444
Total Fees: $34,003.51
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: Ore.•- 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 2-001-0.•:. Yo -y obtain copy14
./he rules or direct questions to OUNC by calling�` 232.19877 oro1.800.332.2344..2
or
Issued By: i 4 '1 / Permittee Signature: sv f3l/< V l� iclt'V
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.
Plumbine Permit Avolicatio11,1Elje FIVFP
Building Fixtures 4144.44i000.#1440*.TOR OFFICE: VSE ,0 N IN Aft:401410 -
. City offigard AUG 30 2018 ' RD:::91 Pr"1"°•:/)-4,W7sit-ve,21i'7 .
1111, 13125 SW Hall Blvd.,Tigard,OR 97223 . , piiiiite,;isw
A ....i.. Meet 5033182439 Fine 303.54f 1,01/0 r tit;ARD DitaIty: Other Pernik No.: ,
Inspreiloa Ling 503.639.4175 , , Dile Raedy/Br as& IS ha raga a he
6, • ' • bustangt: www•Iirrherr' 13 ij 1 I J r IN(..! IIIVIS r, ‘,4 '. '' .:;%•-•:'1, . ishnnaterin
\'' - '''. ' • ',. _:' ' ' TYPE OF WORK ' . '• . Z,":...-. :l0VP - , PEE* SCHEDULE
;KNOW construction [ Demolition 7'%\ ArpriWiliv- Ro"pecounianyiatiawaye.enfewhg-
,parAgf'"47 .P.;'•-• •PtiOn I *y. i Ea I Total
13 Addition/alterationfreplacement - :13 Other: 11!"-- New 1-241trally dwellbtp„Itincludet Apo It.timr egeh utility feltigeti0e)
CATEGORY OF;tobTraticrioN '; . . : . i ; WFW41101111? 312.70
•
sA and 24krnily dwelling 13 Commercial/industrial SFR,42)bah 437.711
SFR(3)bath 1/ 500.32
4 V) 13 Accessory building (:3 bdulti-hmily
U .l additional bathkitehan ' 25.02 ',
0 Master builder 0 Other, •Firesprinftlee‘,_._sq.0.) PaSe2
.1108 SITE INFOILMATION AND LOCATION Site tallith,:
Ith she address: GG/ 51.3 toAt(vIAT 7E ? .Catch bisin ar areal:balm 1 15.76
Orwell,kadt line.ay!melt digit , It%
City/Stater/3P: 7)C•ARb !, On 17 22 3 , Footing drain(no.linear R. ,) Page 2
,)%... Suite/bldg./apt.too.: 1 Project name: <-
IhantIsclaret1 borne ariliOM ...I-
50.03
005$street/direcdons to job site: • Manbides 11176
- i
Stc) 0 IC" *( (074/41 r 1 Rah tIndo reartcour 1t76
I
Snew ..hoe.tt&j f Pio 2
Storm sewer(no.lintaw R.:____) Page 2
\ Winer ser4te(nc*lakaar g,; 22) i Page 2 ,
kI\ Subdivision: 1 Lot no.; ' Fixture arils" - - -
, Tax mapiparcel no.: hlahnepreeenter j 31.27
DESCRIPTION OF WORK :.....;. ; : ..1. Backwater'1111" 1 12.51
V) pE kl con5TR4 cr/ON
Didtwasur s 25.02
ngfa 25a2—
gicaorwmap ..
2.5,02
I 13 PROPERTY OWNER . 1 , . . aTENANT . '. ...:.: Expat 'sien tank 1/51 --
4 '
Fichare*WerniP 25.02
draindleor Arkin*
ri \ Address: 4
ChhagehsPhO 1 2502
; .Oty/StatcriW: . .Awe balk ; 2 ' 25.02'r
, . .
none ( ) Fax ( ) hesitater . i 1231
APPLICANT ' . - 0 ammo' PERSON .:,• ' klete,tortrasettaP 25.112 ,
'
Business failic 6 Lb ta.At 1101siN6 -T-WC• Medical gis(value;; ) Page,2 7
Contact tone: gi( kociAlEv
i77v 4 1231
PAO*
i4 Add. 11111 SG) 52. i.oi lira 94°T1.1.raill.t,991mh0113„
I' Sinlitashilanatory 12.51
: 3 : • us2
cityistaterppL popri.4AID OR 411 2-2 f (
, Soltruaits OW*wilted
• 6254
1
i 1 PbOrtei iv) 313 #251_ req.:( ) .• : ItibliovvrialisAvar vita
, Z , 1231,
E'rtii11:' kg,240ou G PDX elittuek corn , !idol , 2502
. .
Business mirar•At+5,171+c—rcreotrij4110/7.444,ca.A64)^..,Water pipintOWV i 37.52
56.29
Madras: .454,1-•-6{-44yrePr6TTINr/14 Dr. Pe ark LID1,47"6tha: --- 35.02
r city/Sta,e/ZIP: TZ22. . iiievea:tig,t•' 111, a
•Phone:I4007"-T75-7-;"nrrrai I 114 hi=( Y
• . ,
Shaba
lialOnorallish 09;-;1240 . .
CCB Lir": iii3S092 %fhb:Lie.BM.: jI 8 124 7; _ , Ilas;eget,(41%ofpennit he) 1
State surtitarga(12%(Wpm*fee)
I`- •• Authorized erotism .
iVrALPERtar FEE
.,I , ,Mai name YtIr`; 141Klutk 1:Nag 7inti s . Thberradt antIlleathiatartleat. W tarsi&k aokabtaised woman la.day.
Art kiosks's Al telptiltak,
! . .. . ' ..• *CIMI 114/11"1"1"1/611 bY*WCIWIV **WV brit*elesst
I Ware hoar k 14 LI*444 a....Ah.1.61..wor '
1
CITY OF TIGARD MASTER PERMIT
Permit#: MST2018-00247
r 2: COMMUNITY DEVELOPMENT Date Issued: 10/29/2018
-CLGAF,D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S125DA03700
Jurisdiction: Tigard
Site address: 6618 SW WALNUT TER
Subdivision: WALNUT TERRACE PARTITION Lot: 3
Project: Walnut Terrace, Lot 3
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1310 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 25 Bathrooms: 3 Second: 1826 sf Garage: 587 sf Front: 20 Smoke Yes
Dwelling Units: 1
Third: 0 sf Right: 5 Detectors:
Total: 3136 sf Value: $404,297.80 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
Tubs/Showers: 4 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: Y Vent Fans: 4 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 Y
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 3136
Owner: Contractor:
KOVALEV,VITALY&ANITA GLOBAL HOUSING INC Required Items and Reports(Conditions)
6990 SW CANBY ST 4111 SW 52ND AVE 1 Ersn Cntrl 503-639-4175
PORTLAND,OR 97223 PORTLAND,OR 97221
PHONE: 503-313-4259 PHONE: 503-315-4259
FAX: 503-477-4444
Total Fees: $33,968.49
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 ,•rk 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 th-. rules adoptee - the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. •• - _ - •f the rules or direc questions to OUNC by calling 503. 32.1987 or 1.800.332.2344.
Issued By .. _ _ _— Permittee Signature:
Call 14 ��5 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.
H
Building Permit Application '', c ri k.' 1 V F U
E; , 41
Residential FOR OFF K I. l SI ON I 1
0
City of Tigard AA, :3 8 /018 DRDeaactteee/B/iBved:: , s....t.,..
Permit No.AsN13:USs--N Nr '74
11 13125 SW Hall Blvd.,Tigard,OR 97223
II Plan Revie iffir I Other Permitijj . \
OI
I Phone: 503.718.2439 Fax: 503.598.140 ri si:1) r 1 4 A k t) -IQ AllA
ns IZI See Page 2 for
I 1 CARD Inspection Line: 503.639.4175 Date Ready/By. Ju
Internet: www.tigard-or.gov -,r t'i I ri I (,' u;.ty i t, otified/Method:0, otified/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
.1:SrNew construction El Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
El Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit fore
work indicated on this application.
CATEGORY OF CONSTRUCTION
4/0 V ozi
) 1.1-and 2-family dwelling 0 Commercial/industrial Valuation: $ 7
)10.5
0 Accessory building 0 Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors: z
Job site address: 66-/g 51_,) walwaT --ir RR New d46\ 41:„2,....- square feet 16:62Le
—,..
City/State/ZIP: / i 6 ARD DR cr? i2 Garage/carport area: square feet I I D
Suite/bldg./apt.no.: Project name: Covered porch area: square feet
Cross street/directions to job site: Deck area: 2.00 square feet
514) 614 _ 50 IthelLAlcfr-Tert- Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: 3 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.
Valuation: $
NEW C0h5-1-24ec-fe-oct
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name: 6(.5 0,4z.116:3 .,761 ,tctc ,
cd---- (Please refer to fee schedule)
Structural plan review fee(or deposit):
Contact name: 1,74 qe"-k Vkl) ,W 4 f/ FLS plan review fee(if applicable):
Address:
Total fees due upon application:
City/State/ZIP:
Amount received:
Phone:( ) Fax::( )
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: OZ0444/.(0/e. 1015PDX(DoRgp4 ..Ctrai
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
0C(51/1/6. --C/Y.0 i, Submit two(2)sets of roof plan with connection details
Business name: 616SOL 09
and fire department access,along with the 2010 Oregon
Address: ii-1/1 516 57 iv( liWE Solar Installation Specialty Code checklist.
City/State/ZIP: p 0 A-7m/vb OR 9'? 221 Permit Fee(includes plan review
$180.00
and administrative fees):
Phone:(. ;)30 i./252/ Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: /Li 6 ?7 Total fee due upon application: $201.60
Authorized signature: ik., am/eV
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: priagpf V teey if,9LV Date: 7,fil/(g. *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPenflitApp.doC 02/24/2011 440-4613T(11/02/COM/WEB)
4amommommummlagg11111111
Building Permit Application Checklist
One- and Two-Family Dwelling FOR orrlc1: FSI: Oy1.1
City of Tigard Received
Permit No.:
Date/By:
_ 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
Phone: 503.718.2439 Fax: 503.598.1960
T l G A IZ n 24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW les 'No N
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ■ ■
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ 0 0
3 Verification of approved plat/lot. 0 0 0
4 Fire district approval required. Name of district: . 0 0 0
5 Septic system permit or authorization for remodel. Existing system capacity . 0 ❑ 0
6 Sewer permit. ❑ ❑ 0
7 Water district approval. 0 0 ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0 0
9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 0 0
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ 0 0
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if 0 0 0
there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements
and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction
indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and
surface drainage.
12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size ❑ 0 0
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ ❑ ❑
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- ❑ ❑ 0
floor,wall construction,roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings
and foundation,stairs,fireplace construction,thermal insulation,etc.
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. 0 0 0
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- ❑ 0 0
prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing ❑ 0 0
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ 0 0
systems,see item 22,"Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists 0 0 0
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. 0 0 0
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 0 ❑
for four or more appliances.
22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or ❑ 0 0
architect licensed in Ore on and shall be shown to be a licable to the ro'ect under review.
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. 0 0 0
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ 0 0
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ 0 0
27 "Drawn to scale"indicates standard architect or engineer scale. 0 0 0
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ ❑
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 0 0
and protection measures must be drawn to scale and must include the project arborist's signature of approval.
30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, 0 0 0
including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9, 1995.
I:\Building\Pennits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
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64
Electrical Permit Applicatio �4�`�'} 4 I ' F41'C
City of Tigard R`""°d
13125 SW Hall Blvd,Tigard,OR 97223 r `I l' ,5 L`�.i 8 Review Pa�txo Vii./ -v 1-17
Oma Parole
Phone: 503.718.2439 Fax: 503.598.110. , ., ., Daddy. » B Bee 2 Sar
Inspection Line: 503.639.4175 /t.n.i, ''l (,_ ' 0 ,%^r- (i Dere Pep
Internet: www.tiga d-or.gova �srsaKw
TYPE 0 Ii h t "OW 1St( i' -- P>E;�1AI l V
%New construction 0 Addition/alteration/replacement E Please cheek a8 that apply(ambmit I sets of plans whams&coked below):
CiService or feeder 400 amps or more ❑Budding over three stories.
El Demolition E]Mtn
where de available fault mined ❑Idarimas and boatyards.
CATEGORY:OF t 7 nktuCflON.• atoeede 10,000 amps at 150 volts or ❑Floating bred,
less to groaml,or exceeds 14,000' ❑ apiculture'
Al-and 2-family dwelling 0 Co mncrciel industrial 0 Accessory building amps for an oma installations. buildings.
0 Mufti-family 0 Master builder ' '0Other: Ohre pump. ❑lmtaflationof75KVAcr
JOB SITE INFORMATION AND LOCATION O ey larger separately derivedsyttcm.
❑Addition of new motor load of 0"A",`r,,-i-r,"1-3^,
r �^ t0ofPormore. occupancy.
Job no.: Job site address �C!(S 5L� �p GNU I -T R ❑Six a recce residential units. O Roaeanonal vehicle parka
city/state/ZIP: 7 R R D OR 9 223 OIfeahb-ease locations.
0 Supply voltage for more than
❑lleza<ao1 low 600 volts nominal.
Suite/bldg./apt.no.: I Project name: ❑service or Seeder 600 amps or more.
FEE•
Cross street/directions to job site: Dearman i on i » . 1 Twat 1 •
j C>�a f-r` New residential Single--or mtdd-fainSy dwelling unit.
r5 Le) q - SWW r(tl 1N u 7 rem- Includes attached gunge.
Subdivision: Lot no.:
1000 aq.S arloas ' 1 168.54 4
ft33.92 1
Tax map/parcel no.: i energy,residential or portion /j 75.00 2
DESCRIPTION OF WORK.. . • (wide above 84.ft)
Limited 75.00 2
NEW C6N57(c?'?onl residential(witie It.)
Services or feeders insteRadonka1teraBon,and/or rdocatan
200 amps or less 100.70 2
0 PROPERTY OWNER •1 ,❑TENANT 201 amps to 400 amps 133.56 2
• - 401 amps to 600 amps 200.34 2
Name: • 601 amps to 1,000 amps30104_ 2
Address: • Over 1,000 amps orvohs 552.26 2
City/Stat /ZlP:
Temporary services or feeders talladon,aitnadon,and/or
relocation
Phone:( ) Ixax:( ) 200 amps or lees 59.36 . 1
201 amps to 400 aps 125.08 2
Owner installation:This installation is being made on property that I oven which is ret 401 to 599
intended for sale,lease,rent,or exchange,according to ORS 447,4495 670,and 701. � 168 S42
• Branch circuits--new,alteration.or extension,per panel
Owner signature: Date:—__ _ A.Fee for band circuits wide
0 APPI I.ICANT E 0 cONTACf PERSON above
eunuch Mundt7.42 2
eacbBusiness name: 6 C6 cl h(0C( /NCS: �'N , B.Fee for tettcircuits without
a 56.182
service feeder
Contact name: 17 f a RK U t'`i i�oy,PJ // b MoutBad adtrl -arit .62
Address: 41/( sl co nrj -11 C.% F Y MlsaBaneons(service or feeder not nneladaa)
City/State/Z.IP: .�)1 (�r7/y'/!l DR.:n.221�'- 22 l y Each manufedured or modular
67.84 1 2
Phone:( )3( y25 Fax::( ) a Reconnect only 67.84 2
`"
Pmnp or irrigation circle 67.84 2
E-mail: FlO8fll l/OU PDX &f74 4oa4 COf2 -
Sign or outline lighting _ 67.84 . 2
Signal circuit(s)or limited—energy
Business name: G t altaatis%cel• Page2 2
.>t.�Ll l i Oy it/E ,Gi lQ� 1�G Each ikon over Moveable b any
Address: 2 goy-U /I/E 10 r7 ������t}}-2.. p /�/,�Vr4 (I brink) , 66?s/hr of the above
City/State/ZIP: \A Y)c 0 U 1/ t/-. 1/144. Yf t� tI (I hr min) 66251br
r�� /� Industrial plant(i humin) 78.18/hr
Phone:(3‘,a57,- .�✓�'. Fax:QC g, " 96b Q for which no fee a
90.00Vhr
1 •2,6"49CZ _ /795 $ spa lrli dt'/,humin)
CCB Lic.: Electrical Lia: 3uprv.Leo.: '• EIsCRiO(-,AI,PERMIT FlC$g
Suprv.Electrician signature,ro4uired. ! .`j"), - __`__4 Subtotal: .
/i) t �s'�•'" �"1�---- Pian review(2S9'.of permit lune
Print name:Ch 6 di it 6 4 E j# Date:: Slate surcharge(1236 of permit feed —
TOTAL PERMIT PM:Atitiforizedsigtiattire: q This perm#atplicadan Kap tisnoteMabeedwimta180 —
Print name: �- F r Date: '2 i/ /- * &weeder it has been accepted aaaarpWe.
f/) Number ofismections shooed per pewit
ElkildingePansitABLaPeraitApi 440.461Sr(I1/05/C05OWEB
W.
Ptunnbine Permit Applicatia F t` .Ft ;
Building Fixtures . �. . , AOR_ FFaci .Ywi
: Received City of Tigard A J L 3 0 2018 Deceive Permit No.:/,.)11,7),61 ry 2It 7
74 -.4 13125 SW Hall Blvd.,Tigard,OR 97223 pbniieview
Phone: 503,710,2439 Fax: 503.5 € Other Permit No,:
Inspection 1.100 503.634.4175 ` r i a A} ,, Dale Ry:
T4 at it) 5 ti r p,p,r v c c c n r Date Readyi#y: heir El See Page 1 for
Internet: www.tigard.or.gov �v y` I i, s i 4 i#h's4 Notitled.'?dctbad, Supplemental information
TYPE OF WORKFEE* SCR DULE
New construction . 0 Demolition special information ase riterl:fist.
Description , I OW, } Ea. ! Total
0 Addition/alteration/replacementOther.
0 New 1-2-fatally dwellings(isacltsdcs 100 ft.for each utility connection)
CATEGORY Ot01tcsT8ltlCCTflIV ,
SS FF (I}bath 312.70
Xl-and 2-family dwelling [ Commercialiindustrial SFR(2)bath 437.78
Accessory building [ Multi-familySPR(3)bath ✓ 500.32
Each additional bath/kitchen 25.02
Q Master builder ❑Other: Fire sprinkler( sq.fl.:) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
667 8 513 O A t N ti i TT Cash basin or area drain 1076
Job site address: -
n G n� Drreell.leach lime.or trench drain 10.76
City/State/ZIP: Ti(/1 R , OP ! (� Footing drain(no.linear ft.:_ ) Page 2
Suite/bldg./apt.no.: 1 Project name:
Manufactured home utilities 50,03
job street/directions to".j15 site: = Manholes 15.76s�
54) C5-{C ;0 (,c /Nu C Rain drain connector 18.76
Sanitary sewer(no.linear f.:20 ) 1 Page
Storm sew r(no.linear ft.:._._) Page 2
Water service(no.ling ft; Zc ) I Pap,e 2
Subdivision: Lot no.; Fixture or item:
Tax snap.pareel no.: E3ackfkaw prewertrer 1 31.27
DESCRIPTION OF'WORK .. • '4 Sarkwauer valve I 12.51•
Clothes westun 1 . 25.02
NEW C on S R U c7/0' Al •
Dishwask►tr.
25.02
Drinking fountain 25.02
EjWorsisun 23.02
0 PROPERTY OWNER 0 TENANT' ExPansierl tank 12.51
Name: caP 23.02
Floor drainifloor sinklub 25.02
Address: w
CitySratc'ZIP: Garbage disposal 1 25.02
Hose bib 2 25.02
Phone:( ) i"as. ( ) Ice maker i 12.51
• 0 APPLICANT 0 CONTACT PERSON tnterceptorrgreasetrap 25.02
Business name: 6 Lo,AAL d/ot(5/N6 Medical gas(value:5 ) p 2
Contact,name: 177,17 R V kOvr'a L&V INC, Puma 1 S I ^
Roofdrain(commercial)
� 12:5t
Address: 11111 5ci in I"t�l./ rh r Va sinkrbas rtllavatonyr
t IP: 23:02
City/State/ZIP:
PO AVD OR `/122/ Solar(oats(potable water) 6154
Phone:(9)3) 313 q259 Fax::( ) .. Tutishower/shower pan Z 12.31.:
-mail: - GtOp,4l�/DU$a�NG PD)(,„@1,5 44, cbf'►'t i a 502
u►tate' 1 25.02
, ",;: , .. . •.:.. Water heater ,
Business name:
31.52
` '"'"ilZ�'.ay.. �1�,'7 Water PiptstStUWV 56.29
Address: .. r, 'T Dr. /d� ,.
l G' ��. J� cJ , / other:
25.02
City/State/ZIP: 1 772 Yy,�has c;a.•t/t.�l.>g4' Subtotal
Phone: 1 '"TY 1 4,1 11.A,TFFa/x11:�(,� ) 7 rpe permit fee.572.50
CCB Lic.: i`�j 849E ra b'i Plan review (2514 ofpennit fee)
n8 Lie.art
Authorized signature: State sis targe(12%of Ferrant fee)
>1 TOTAL,PERhotrf FEE
Prim names 7 tt r i‘. Lilt iiC q k Data: 7/11A S permitThis application a to s permit is not obtained�ritdi8 ISO a ns
accepted as complete.
*Fee methodology set by Tei-Conary Building industry Service Board.
titeodeutPertain Pt sAl 4 Poove.o.t«.A.. Ao.
• """
Clean Water Services File Number
18-002665
CIcanWater Services
Sensitive Area Pre-Screening Site Assessment
1. Jurisdiction: WASY/01/6TeMi COaiterlY _
2. Property Information(example I S234A801409) 3. Owner Information
Tax lot ID(s): 1S125DAQ3700 Name: VI7ALY ko VolLEV
Company: .
Address: 6990 CANS 9.- Sr
OR Site Address: 66/8 5'43 tORLAIUT TERR City,State,Zip: r4fD OR 922..3
city,State,Zip 716/1RP 041 91Z25 1073 PhollefFax: g>3 52Z—
Nearest Cross Street: 54.) ef E-Mail:pi.•,•• VaEYU41ft5 coc,f4eiwe
4. Development Activi [chock all that apply) S. Applicant Information
CI Addition tii• -ngle Family Residenc4.:`rooms,deck,.ga rage) Name: HARk /kat/41.61/
ta Lot LJne Adjustment U Minor Land Partition Company. 6th9:,'• f(xisiA/C
1:11 Residential Condominium la Commercial Condominium Address /I/ 4) .2 114
: •.
U Residential Subdivision la Commercial Subdivision Cay
State,Zip: ZAA/Z) OR "4;2(
ck Single Lot Commercial CI Multi Lot Commercial
doer sVECii., ROL(St.. PhonetFax: 953 3/3 11257
E-Mad:4Z0ML#414'5ittS 1X P ciaida•C6M
6. Will the project involve any off-site work? 1]'Yes, No El Unknown
Location and description of off-site work
7. Additional comments or information that may be needed to understand your project NEW Ce.)/f/3-ibre.ccicat-c
S7Aia4g riri I/001
This application does NOT replace Grading and Erosion Control Permits,Connection Permits,Building Permits,Site Development Permits,
• DEO 1200-C Permit or other permits as issued by the Department of Environmental Quality,Department of State Lands and/or Department of
the Army CDE. All required permits and approvals must be obtained and completed under applicable local,state,and federal law.
rrrth,s feir.,,the owtie; Nines autrivizrA'agOt or reprWlatiVeaCkl(M11,,dgeS and agf CVS mat etriployoes of Clean Water'services nave autholity to enter
lbs croiset site at all reasonable onee ler to purpose of trispeetinq prolect site conditions and nattering imidrmation related to the project site. I certify It I an
familiar ixt tie edurrnation contained io mis docudieni,and to toe best bit nti kneiii‘sidge and beitel.tis information is true,comiete,and actuate
Print/Type Name itlfA r Print/Type Title PRE6742651/-
Signature rik054 b/kOM4.77 Date 7/)'67/1/41r
FOR DISTRICT USE ONLY
J Sensitive areas pienlially exist on Lw or within 200'rot lbe sae, THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A
SERVICE PROVIDER LETTER. If Sensitive,Areas exist on the site or within 200 feet on adlancret properties;a Natural RCSMACPS Assessment Report may also
be required,
L71 hsed ori re\qtew tho submitted materials and best available information Sensitive areas on rat appear to exist on site or within 200'of ire site,This Sesitrys
Area Sciretii no Site Assessmei it does N07 demi-ate the Item to evaluate arid ptotect water quality sensitive areas if trey are subsequeritly discovered.Mei
Cowmen i will serve as your Service Pt eviler letter as requited by Resdution and Gras:17-05. Section 3,02,1, All required permits and approvals most be
obtained odd neimpleted under applied*local,State and tederal law
XBased no mi./ivy or the'3utmilted materials and best available informatkm ire above reteriwinietif clot srgnlcaratl imp tire erstfrig fit Polielltialliit
sensitive arearst found rear the she.This;Sensitive Area P -Sereening Site Assessment does NOT eliminate the need to evaluate ann prIed andihonal water-duality
orICC areos if they are tAZarauerely discovered.This document Will serosas your Service Provider leiter as=.-equlie0 by Resolution and Order 17-05.Seitiide
3.D2.1, All requires;permits and approvals must CO obtained and completed under applicable total stale and federal law;
L.] This Service Provider Letter Is not valid unless CWS approved site plan(s)are attached.
j trio proeosed adiOy does .at meet me definition of development or roe to was plated after 919S95 ORS 02.040(2), NO SITE ASSESSMENT OS SEFWICE
PROVIDER LETTEC IS REQUIRED,
Reviewed by • • . Date 5/28/15
Once complete,email to:SPLReview leanwaterservices.org • Fax (503)681-4439
OR mail to: SPL Review, Clean Water Services. 2550 SW Hillsboro Highway, Hillsboro,Oregon 97123
City of Tigard
s COMMUNITY DEVELOPMENT DEPARTMENT
Ili a
T 1 n R Building Permit Review — Residential
Building Permit #: '‘.\\r .--r
Site Address: 6 t g £tn/ i l ,di- l' rrta
Project Name: 3
*wO• -t, a��, ,, Lot #:
(New dwelling s.bdivision name;Addition or Alteration=last name of owner)
Planning�Rev ewe >g2e4C �—
Proposal: Kik/ ,ct=)
erify site address/suite#exists and activyrn permit system.
rE River Terrace Neighborhood: l!d No ❑ Yes,See River Ten-ace Review Addendum Attached
Sit lan Elements:
ee(3)copies of site plan
S plan must be on 8-1/2"x 11"or 11 x 17"papers structures on site
IrEpawn to scale(standard architect or engineer scale) t°o a newof structure(including decks)with finished
rth arrow ,/
�I ty locations&easements (required for new and additions)
yte address,project or subdivision name and lot number
,�A licant information(name and phone number) Sidewalk/driveway approach
�l.ot dimensions and building setback dimensions � 'cation of wells/septic systems
i Existing trees to be retained with drip line,and tree
quare footage of buildings to be demolished
p
,� otection measures
! Lfdof area,building coverage area,percentage of coverage and S et tree size,type and location
)slipervious area(applicable if R-7,R-12,R-25&R-40) agtreet
Property corner elevations(2 foot contour lines if more than >1,000 s f onofies f impervious
4 of differential) 0 area created or replaced? LIXY�s ❑No
If yes,is a storm water quality facility shown? es ❑No
Clean Water Services-Service Provider Lett9t7(lot platted prior to 9/10/1995):
equired: ❑ Yes,applicant was notified [l' No Received:
rIllr
aPiPublic FacifitiiIrnprovement(PFI) Permit:
, Yes ID No
equired: Yes,applicant was notified El No Applied For:
Iti nIiYes IDNo,stop intake
and Use Case#: CAL )16 —O0o ,f FZ ZU l 1-0013S
IP. oning -`1-S
°Required Setbacks: Front 2,0 Rear 1 S Side
ri Landscape Requirement: % S Street Side (lIr¢ Garage 2,0
t FA of Coverage Maximum:
( ) Height wilding Height: Maximum 3 rrY"'`
V isual Clearance Actual Height LS 0(._ iy �0 C
V ensitive Lands: 0 Yes Ll No
Type
rban Forestry Plan
Conditions "Met"prior to issuance of building
otes: (�C 11 V A4 9— 'IV (10 46) r,,+ i .f faAu.
Approved ByPlanning:ng: )22tDate: 8*-3v-
(
Revisions (after Building Submittal only)
Revision 1: A pp d 0 Not Approved roveReviewer Date
�9
1,
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved ❑ Not Approved
I:\Building\Fonns\BldgPennitRvw RES_061417.docx
Building Permit Submittal
Original Submittal Date: % 1 �\\c
Site Plans: #
Building Plans: #
Building Permit#: 21 Enter building permit#above. Building
(3(En eerie Permit Coordinator
D
Workflow Routing: C�/Planning $m g
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: (Engineering: (1) copy of permit application, (1) site plan, (1)building plan and
original plan review routing form.
Fe-Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: A; Date: ok 5\,k
Engineering Review ts
al4fope at building pad: .2S%
nditions"Met"prior to issuance of building permit
Easements (encroachments)per engineering conditions of approval and plat
raklUater Quality/Q antity Facility
Assess Water Quality Fee in-lieu: 0 Yes 0 No
Assess Water Quantity Fee in-lieu: 0 Nps 0 No
LIDA Facility on lot: IWYes 0 No
4a1 Plat Recorded: Date: g b/ /�
Engineering:V NOT Approvedby E ng'ln ring•
Notes: 5/51d43 �'-S6'di 64,73. •f C 0�iD I r 10,,A43u
s iv�l6 7—
Date:
Approved by Engineering:
Revisions (after Bu' mg Submittal only) .iii"-wer
at
Revision 1: Approved 0 Not Approved ,400.1r:,,,...4,1411111" I
WLR'
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
Permit Cs , •inator Review
Co- a tions"Met"prior to issuance of building permit
ate: 1/ /r---
iI� Approved,NOT Released: _ ley F3,,a,-; ( /#K 2/
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision No • e 2: Date Sent to Applicant:
Revisi otice 3: Date Sent to Applicant:
SDC Fees Entered: ��/'
Wash Co Trans Dev Tax: /r Yes 0 N/A
Tigard Trans SDC: 'LSI Yes 0 N/A
Parks SDC: �'Y ❑ N/A
LIDA Yes 0 N/A
/•�J OK to Issue Permit 4r i 1,/i
i1��'_ Date:
Approved by Permit Coordinator:
I:\13uildineForms\BldgPermitRvw_RES_0I O 118.docx
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
6618 SW WALNUT TER, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Master Permit MST2018-00247
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS
Comments:
Corrections from previous inspection complete.
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
6618 SW WALNUT TER, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Master Permit MST2018-00247
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS
Comments:
Corrections from previous inspection complete.
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
6618 SW WALNUT TER, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Master Permit MST2018-00247
Inspection Type: Inspector:
299 Final inspection David Young
Result:
FA I L
Comments:
Not ready for building final inspection.
Provide approved Lida final.
Provide approved erosion control final.
No inspection done at this time.
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
6618 SW WALNUT TER, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Master Permit MST2018-00247
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
PASS
Comments:
Corrections from previous inspection complete.
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
6618 SW WALNUT TER, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Master Permit MST2018-00247
Inspection Type: Inspector:
299 Final inspection David Young
Result:
PASS - CofO
Comments:
Final erosion control approved.
Moisture content form received.
Moisture barrier form received.
High efficiency lighting form received.
Duct seal test report checked.
Insulation certification checked.
C of 0 left on site with contractor.
Violation Summary:
Inspector Contractor