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Permit (20) CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2018-00279 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/07/2019 T l c;;k h I 9 Parcel: 2S112BD14100 Jurisdiction: Tigard Site address: 7679 SW CORNUTT ST Subdivision: ELDERBERRY RIDGE Lot: 37 Project: Elderberry Ridge, Lot 37 Project Description: New SF. DEMO CREDITS FOR TRANSPORTATION AND PARKS APPLIED FROM BUP2018-00114. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1179 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 23 Bathrooms: 3 Second: 1447 sf Garage: 379 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2626 sf Value: $329,165.90 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 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: 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: 5 201-400 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: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2626 Owner: Contractor: RIVERSIDE HOMES LLC RIVERSIDE HOMES LLC Required Items and Reports(Conditions) 17933 NW EVERGREEN PL STE 17933 NW EVERGREEN PKWY 370 1 Ersn Cntrl 503-639-4175 370 BEAVERTON,OR 97006 BEAVERTON,OR 97006 PHONE: 503-645-0986 PHONE: 503-645-0986 FAX: 503-690-2942 Total Fees: $9,118.06 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-#11-009# You may o•ain a copy of the rules or direct questions to OUNC by calling 503.232.19 or 1.800.332.2344. Issued By: ��,��� -A - mittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application Residential _ 1 oiz oil rlc : l SL 0\11 City of Tigard Received 1 ! // , 0/r , \� `, 13125 SW Hall Blvd.,Tigard,OR 97223 n E Date/By: %(/]l r,(.(1//J / Plan Review p , �yP I Phone: 503.718.2439 Fax: 503.598.1960: t , :.0 1I Date/By: IO 1-7 Ip 4F'-cb-2,3 I IC,AP 1 Inspection Line: 503.639.4175 e Ready/By: / ure Page 2 for / Internet: www.tigard-or.gov i otified/Metho,/ ' /l/ /� Supplemental Information EBUU...t.L...bi L,+i\r,..D:CN /e1 ,i i TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING El New construction 0 Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ✓ 1-and 2-familydwellingValuation: $ 3 2-1 1 `kic ❑ ❑Commercial/industrial IDAccessory building 0 Multi-family Number of bedrooms: 4 ❑Master builder 0 Other: Number of bathrooms: 3 2 SITE INFORMATION AND LOCATION Total number of floors: 2 3c c> 5— Job site address: W Cornutt Ln New dwelling area: 2626 square feet '914-7 City/State/ZIP: Tigard, OR 97224 Garage/carport area: 379 square feet ) 1 7 C Suite/bldg./apt.no.: Project name: Elderberry Ridge Covered porch area square feet 1 Cross street/directions to job site: SW Bonita Rd &SW 76th Ave Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Elderberry Ridge ( Lot no.: .4.35 b51 Permit fees*are based on the value of the work performed. Tax map/parcel no.: 2S 112BDOO6OO 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. Construction of SFR Valuation: $ Existing building area: square feet New building area: square feet ❑✓ PROPERTY OWNER 0 TENANT Number of stories: Name: Riverside Homes, LLC Type of construction: Address: 17933 NW Evergreen Pl., Ste 370 Occupancy groups: City/State/ZIP: Beaverton, OR 97007 Existing: Phone:( 503)645-0986 Fax:( ) New: 0 APPLICANT ❑✓ CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: Riverside Homes, LLC Structural plan review fee(or deposit): Contact name: Wes Boisvert FLS plan review fee(if applicable): Address: 17933 NW Evergreen Pl., Ste 370 Total fees due upon application: City/State/ZIP: Beaverton, OR 97007 Phone:(503)645-0986 Fax::( ) Amount received: E-mail: wboisvert@riversidehome.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name: Riverside Homes, LLC Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 17933 NW Evergreen Pl., Ste 370 Solar Installation Specialty Code checklist. City/State/ZIP: Beaverton, OR 97007 Permit Fee(includes plan review $180.00 and administrative fees): Phone:(503)645-0986 Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.: 189148 Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Nikki Pr ett Date: 10/11/18 *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPetmitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB) Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE l SE ONLY City of Tigard Rec Received Dateive Permit No.: 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits: Phone: 503.718.2439 Fax: 503.598.1960 24-Hour Inspection Line: 503.639.4175 ❑ Electrical 0 Plumbing 0 Mechanical T 1 G n R D Internet: www.tigard-or.gov 0 Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW l es No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 ❑ 0 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 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 0 6 Sewer permit. 0 0 0 7 Water district approval. i 0 0 8 Soils report. Must cavy original applicable stamp and signature on file or with application. 0 0 9 Erosion control 0 plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- '4 0 0 basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state V 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. .y� 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if Kl 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 15' 0 0 and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 1g 0 0 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- 151' 0 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 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- 14 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 IN 0 0 locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 0 VI 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 1`C 0 0 over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. 1P 0 0 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required -ju 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 Ion and shall be shown to be a I.licable to the .ro'ect 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". 0 0 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 'El 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. t 0 0 27 "Drawn to scale"indicates standard architect or engineer scale. 0 0 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 15Z 0 0 Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, X 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\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Application FOR OFFICE USI?()NIA Received_`_ / �r,C 7 114 . City of Tigard Date/By: Permit No. 7�1 r(/ 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: T 16 A It I) Inspection Line: 503.639.4175 Date Ready/By: Suns: See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Inf ormafion T]tP> .,.t4` t `. . , 7 F4„F'.S. tSi E #JSECf IST.. Mechanical permit fees*are based on the value of the work ✓Q New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition D Other: , mechanical materials,equipment,labor,overhead,and profit. �,.. - 4 � r: Value:$ I I 111 Illi ' t t t i t i tler 14 iS S tlii El1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. 0 Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total ;� MI t ,a" `A t q t r ;, Heating/cooling: • Air conditioning 1 46.75 46.75 Job site address: - SW Cornutt Ln Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75 City/State/ZIP: Tigard, OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: Elderberry Ridge Duct work 23.32 Cross street/directions to job site: SW Bonita Rd &SW 76th Ave Hydronic hot water system 23.32 Residential boiler(radiator or hydronie) _ 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: Elderberry Ridge Lot no.: 915 0 Other: 23.32 Other fuel appliances: Tax map/parcel no.: 2S112BD00600 Water heater 1 23.32 23.32 ,,,,;',.v„.„r.',•.1‘•,:: ;1 t t ',--,,t`(J Gas fireplace/insert 1 33.39 _ 33.39 ,r r „`'' ' . r' ''"`° -'4 .. Flue vent for water heater or gas Construction of SFR fireplace _ 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other: 23.32 o 7.1 1 .:TENOT Environmental exhaust and ventilation: Name: Riverside Homes, LLC Range hood/other kitchen equipment 1 33.39 33.39 Address: 17933 NW Evergreen PI., Ste 370 Clothes dryer exhaust 1 33.39 33.39 City/State/ZIP: Beaverton, OR 97007 Single-duct exhaust(bathrooms, v,5 toilet compartments,utility rooms) C 23.32 93.28 Phone:(503 )645-0986 Fax:( ) Attic/crawlspace fans 23.32 4 t $r 1" k ,, E nt z Other: 23.32 Business name: Riverside Homes, LLC Fuel piping: $14.15 for first four;$4.03 for each additional Contact name: Wes Boisvert Furnace,etc. 1 14.15 Gas heat pump Ste 370 Address: 17933 NW Evergreen PI., Wall/suspended/unit heater City/State/ZIP: Beaverton, OR 97007 Water heater 1 14.15 Phone:(503 )645-0986 Fax::( ) Fireplace 1 14.15 Range 1 14.15 E-mail: wboisvert@riversidehome.com Barbecue , '' IfI ® Ivir Clothes dryer(gas) Other: Business name: Pro Heating &Cooling Address: 2095 NW Alocleck Rd.#1103 Subtotal City/State/ZIP: Hillsboro, OR 97124 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:( 971)205-4989 Fax:( ) State surcharge(12%of permit fee) CCB lic.: 209001 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signat * Fee methodology set by Tri-County Building Industry Service Board Print name: Nikki Pruett Date: 10/11/18 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-Famil Fee Schedule: t '. $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and $2.54 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional$100.00 or fraction thereof Note: All new commercial buildings require 2 sets of plans. I:\Building\Permits\MEC_PermitApp_040113.doc 2 Electrical Permit Application FOR OFFI( I I SE()NI.) City of Tigard Received //ST /e - C' Plan Permit# ,— `,/ � 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review = Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#: Inspection Line: 503.639.4175 Ready Date/By: tum: la See Page 2 for I I C,A L D Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑✓ New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑Demolition ❑Other: 0 Service or feeder 400 amps or more 0 Building over three stories. where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. Q 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural ❑Multi-family 0 Master builderamps for all other installations. buildings. 0 Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFO LOCATION 0 Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: Job site address: W Cornutt Ln IOOHP or more. ❑"A","E","1-2","1-3", City/State/ZIP: Tigard, OR 97224 ❑Six or more residential units. occupancy. ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: Elderberry Ridge 0 Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: SW Bonita Rd &SW 76th Ave FEE SCHEDULE Description I (s'. I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision: Elderberry Ridge Lot#: 9a5 V3. Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: 2S112BD00600 Ea.add'l 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential Construction of SFR (with above sq.ft.) 75.00 2 Limited energy,multi-family 75.00 2 residential(with above sq.ft.) ElPROPERTY OWNER 1 © TENANT' Renewable Energy 0 See Page 2 Services or feeders installation,alteration,and/or relocation Name: Riverside Homes, LLC 200 amps or less 100.70 2 Address: 17933 NW Evergreen Pl., Ste 370 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: Beaverton, OR 97007 601 amps to 1,000 amps 301.04 2 Phone:(503)645-0986 Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 ❑APPLICANT ❑✓ CONTACT PERSON Branch circuits—c new,alteration,or extension,per panel A.Fee for branch circuits with Business name: Riverside Homes, LLC above service or feeder fee, 7A2 2 each branch circuit Contact name: Wes Boisvert B.Fee for branch circuits without service or feeder fee,first Address: 17933 NW Evergreen Pl., Ste 370 branch circuit 56.18 2 City/State/ZIP: Beaverton, OR 97007 Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(503)645-0986 Fax::( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: wboisvert@riversidehome.com Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: Sunlight Electric Inc Sign or outline lighting 67.84 2 Address: 2804 NE 65th Ave. St. D Signalnel, lern or limited-energy 0 See Page 2 2 panel,alteration,or extension. Each additional inspection over allowable in any of the above City/State/ZIP: Vancouver, WA 98661 Additional inspection(1 hr min) 66.25/hr Phone:(360)518-7589 Fax:( ) Investigation(1 lir min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: 172549 Electrical Lic.: C230 Suprv.Lic.: specifically listed(%2 hr min) ELECTRICAL PERMIT FEES / Suprv.Electrician signature,required: K..,_ Subtotal: Print name: Cheste Garrett , Date: 10/1 1/18 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): 1 Authorized signature: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Nikki Pruett Date: 10/1 1/18 days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: s _Description Qty. Each Total Fee for all residential systems combined: $75.00 Renewable electrical energy systems Check Type of Work Involved: 5 kva or less 100.70 2 5.01to15kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 kva(fee in accordance 552.26 2 with OAR 918-309-0040) ✓❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 ❑ Vacuum Systems* >100 kva—no additional charge 0.0 3 Each additional inspection over allowable in any of the above: ❑ Other: Each additional inspection is 66.25/hr 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed %:hr min . _ z % "ot l°, i It l' O s R ��4 1 ' .-."w.. Fee for each commercial system: $75.00 Subtotal(Enter on Page 1): * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations l:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 Plumbing Permit Application Building Fixtures FOR OFFICE USE ()NIA ' City Dateived �7.-1,/,'''e)0,)' . ` r i'"�, of Tigard Date/By: Permit No. �' III III 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review 0 Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.: T 1 G A R D Inspection Line: 503.639.4175 Date ReadyBy: Jur s: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information New construction 0 Demolition For special information use checklist Description Qty. Ea. Total 0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) ?t t z�7^ SFR(1)bath 312.70 ... 1 1€1 m ?l �# -. n _w.2 RI l 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 1 500.32 0 Accessory building El Multi-family Each additional bath/kitchen 25.02 0 Master builder 0 Other: Fire sprinkler�_sq.ft.) Page 2 W-'!-T.,',;'. ., o 4 e r ` t At` Site utilities: Catch basin or area drain 18.76 Job site address W Cornutt Ln Drywell,leach line,or trench drain 18.76 City/State/ZIP: Tigard, OR 97224 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name: Elderberry Ridge Manufactured home utilities 50.03 Cross street/directions to job site: SW Bonita Rd &SW 76th Ave Manholes 18.76 Rain drain connector 1 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: Elderberry Ridge ( Lot no.: 031 Fixture or item: Tax map/parcel no.: 2S1126 D00600 Backflow preventer 31.27 ,� ,} Backwater valve 12.51 ,,` = I'M ,yk ,. ` t 1' .' , i t t..s*s a i- Clothes washer 1 25.02 Construction of SFR Dishwasher 1 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 , ,p p Ro r t.. .','"V'' j t 7 3 � ;y Expansion tank 12.51 Name: Riverside Homes, LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 17933 NW Evergreen PI., Ste 370 Garbage disposal 1 25.02 City/State/ZIP: Beaverton, OR 97007 Hose bib 2 25.02 Phone:(503)645-0986 Fax:( ) Ice maker 1 12.51 . t -A �terceptor/grease trap 25.02 Medical gas(value:$ ) Page 2 Business name: Riverside Homes, LLC Primer 12.51 Contact name: Wes Boisvert Roof drain(commercial) 12.51 Address: 17933 NW Evergreen PI., Ste 370 Sink/basin lavatory 6 25.02 City/State/ZIP: Beaverton, OR 97007 Solar units(potable water) 62.54 Phone:(503)645-0986 Fax::( ) Tub/shower/shower pan 4 12.51 Urinal 25.02 E-mail wboisvert@riversidehome com v„^tea.. ,� ��t; �,ry ;, 5 Water closet 3 25.02 Water heater 1 37.52 Business name: H & H Mecanical Water PtPing/D WV 56.29 Address: 5757 SE Willow Ln Other: 25.02 City/State/ZIP: Milwaukie, OR 97267 Subtotal Phone:( 503 975-9787 Fax:( ) Minimum permit fee: $72.50 CCB Lic.: 178122 . • bing Lic.no.: P 6414 Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signatur TOTAL PERMIT FEE Print name: Nikki Pruett Date: 10/11/18 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. 440-4616T(10/02/COM/WEB) I/Building\Permits\PLMU-PermitApp.doc 10/01/09 Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: C=V ; ,>k... f te, ,s` .qua oo „+! ° I I l a;, Footing drain-1"100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Storm&Rain Drain-1st 100' 62.54 i �' �` � � $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 each additional$100.00 or fraction thereof,to and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr ■ each additional$100.00 or fraction thereof,to (minimum char_e-1/2 hour) and including$25,000.00. Inspections outside of normal business - 90.00/hr - $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours minimum char_e-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 char:.e-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*. r re Fixture Type for ! Work Perform pfie ed ;este. 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 0 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 0 Any multipurpose fire sprinkler system. Drinking Fountain 0 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 _ ,at it.s !r ® ,vn '`': . tri : Garbage Domestic-non-food 0 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/Lay -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter *Note: If the fixture work under thisermit results in an Washer-Clothes p 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\npruett\Downloads\PLMF_PermitApp.doc 2 • Plumbing Permit Application Building Fixtures FOR OFFICE USE ONEv Received -� - City of Tigard Permit No . n ✓% 1111‘ II 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: rti/�5 �1,� Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.: T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information ElNew construction Demolition For special information use checklist. Description I Qty. I Ea. I Total 0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) • ; I • t :' . ` 'r. SFR(1)bath 312.70CA r Fs ✓ 1-and 2-familydwellingSFR(2)bath 437.78 ❑ 0 Commercial/industrial SFR(3)bath 500.32 ❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder p Other: Fire sprinkler( sq.ft.) Page 2 x +1: 1N1FOR111ATION AND LOCATION: ,- --c,,- Site Site utilities: Job site address: f W Cornutt Ln Catch basin or area drain 18.76 Drywell,leach line,or french drain 18.76 City/State/ZIP: Tigard, OR 97224 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name: Elderberry Ridge Manufactured home utilities 50.03 Cross street/directions to job site: SW Bonita Rd &SW 76th Ave 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: Elderberry Ridge I Lot no.: 0 ?? Fixture or item: Tax map/parcel no.: 2S 112B D00600 Backflow preventer 1 31.27 31.27 r . { s : wx Backwater valve 12.51 Construction of SFR Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 t # , ,,;s, � Expansion tank 12.51 Fixture/sewer cap 25.02 Name: Riverside Homes, LLC Floor drain/floor sink/hub 25.02 Address: 17933 NW Evergreen Pl., Ste 370 Garbage disposal 25.02 City/State/ZIP: Beaverton, OR 97007 Hose bib 25.02 Phone:(503)645-0986 Fax:( ) Ice maker 12.51 4 � ` y 0 t °,,# Interceptor/grease trap 25.02 Medical gas(value:$ ) Page 2 Business name: Riverside Homes, LLC Primer 12.51 Contact name: Wes Boisvert Roof drain(commercial) 12.51 Address: 17933 NW Evergreen Pl., Ste 370 Sink/basin/lavatory 25.02 City/State/ZIP: Beaverton, OR 97007 Solar units(potable water) 62.54 Phone:(503)645-0986 Fax::( ) Tub/shower/shower pan 12.51 E-mail: wboisvert@riversidehome.com Urinal 25.02 ,1 Water closet 25.02 .. , n '4'..!4°:, 1 , '•' Water heater 37.52 Business name: TruScapes, LLC Water piping/DWV 56.29 Address: 21600 SW Amberwood Dr. Other: 25.02 City/State/ZIP: Hillsboro, OR 97124 Subtotal Minimum permit fee: $72.50 Phone:(503)531-9216 _ Fax:( ) CCB Lie.: LCB#7962 Plu ing Lic.no.: Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorizedsignature: TOTAL PERMIT FEE Print name: Nikki Pruett Date: 10/11/18 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Su. s ression Systems: 1r pe6s\ r:1144404.Fp4. _ a F s . ..� 24. Footing drain-1"100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas S stems: Water Service-each additional 100' 37.52 Storm&Rain Drain-1st 100' 62.54 $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 each additional$100.00 or fraction thereof,to and including$10,000.00. Inspection of existing plumbing or for ■ ■ $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum char:e-1/2 hour and including$25,000.00. Inspections outside of normal business - 90.00/hr - $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours minimum char_e-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 char_e 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*. ® nanb Fixture Type E d, °" Fixture`rye fof Replace/ ; Capped ` Added Relocate Plan review is required for any of the following. Work Performed. _r.� Please check all that apply. Baptistry/Font Bath Tub/Shower 0 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 0 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 0 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 . ' Garbage Domestic-non-food 0 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 *Note: If the fixture work under this permit results in an Washer-Clothes 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\npruett\Downloads\PLMF_PermitApp.doc 2 Julie Drinkwater From: Dianna Howse Sent: Tuesday, November 27, 2018 10:47 AM To: Nikki Pruett Cc: #Building Permit Technicians; David Young Subject: Elderberry Ridge - Demo Credits Hello Nikki, We have completed plan review on lots 36, 37 and 38, and they are ready for post-review, however there are three outstanding demo permits that need to pass a final building inspection so that we can apply the SDC credits to these three lots before we complete post-review and invoicing of fees. The last inspection on the demo permits was performed on 5/11/2018 and they were failed by the inspector, David Young,for the following: • Provide approved initial and final erosion control inspections prior to scheduling demo final inspection. Done and PASS 5/14/2018. • Provide pump receipt for tank removed. Please provide. • Tank hole inspection and structural backfill if required to be done by site engineer. Please provide. • Inspection codes listed on green sheet issued with permits. Applicant did not follow the order of inspection codes required when permit was issued. The demolition of these buildings was done without initial erosion control measures inspected and approved by Clean Water Services in advance of demolition work and soil disturbance. Technically,these permits should be expired as they are now over 180 days passed the last activity, and therefore no credits should be applied towards new construction. And, as a standard practice,SDC credits are to be applied towards the first lots submitted for new construction. Please provide the outstanding items listed above to David Young at davidy@tigard-or.gov and schedule a final building inspection (code 299)on all three of the demo permits listed below at your earliest convenience. We will hold the release of any further permits until these demo permits pass final inspection and are closed. Please let the building permit technicians know at TigardBuildingPermits@tigard-or.gov as soon as these final inspections have passed so that we can resume processing permits for this subdivision. We need these demo permits closed as soon as possible so that all of the proper agencies can be notified to remove these existing addresses and structures from utility billing, emergency services, county tax assessor, etc. The process for demolition of existing structures and applying of SDC credits was something that we discussed in our meeting prior to beginning the development of this subdivision. Thank you and please let me know if you have any questions. Dianna L. Howse Building Division Services Supervisor City of Tigard I Community Development 13125 SW Hall Blvd I Tigard, OR 97223 503-718-2430 Direct 1503-718-2439 Permits From:Julie Drinkwater Sent: Monday, November 26, 2018 10:53 AM To: Nikki Pruett<NPruett@riversidehome.com> 1 Cc:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Subject: RE: Permit MST2018-00278 Good morning Nikki In order to apply demo credits to the new single family permits,the demolition permits must pass the final building inspection. Please schedule the final building inspection for the demo permits listed below. Willow Brook Demo Permits Address Permit# 14775 SW 76 BUP2018-00114 14825 SW 76 BUP2018-00115 14830 SW 76 BUP2018-00116 I have post reviewed Lot 21, of Elderberry Ridge, and I have attached the invoices for the building and sewer permits for your review. If you wish to apply demo credits for parks and transportation SDC fees to this permit,you will have to final one of the demo permits listed above. Thank you and please let us know if you have any question. Julie Drink-water Permit Technician City of Tigard I Building Department 13125 SW Hall Blvd Tigard, OR 97223 503-718-2804 From: Nikki Pruett [mailto:NPruett@riversidehome.com] Sent: Monday, November 26, 2018 6:03 AM To:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov>;#CD PoD<CDPoD@tigard-or.gov> Subject: Permit MST2018-00278 Good morning! Would it be possible to get the building permit fees for MST2018-00278 today? Thanks, Nikki Pruett 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." 2 • FX'q • Nikki Pruett From: Dianna Howse <Dianna@tigard-or.gov> Sent: Thursday, November 15, 2018 11:17 AM To: Nikki Pruett Cc: #Building Permit Technicians Subject: RE: Meeting Request Hello Nikki, :4400 reserved conference#3 in the Permit Center for Monday,Noveriber 19th at 10:00 am for you to revise plans for permit MST201 00279 to move plans from lot 35 to lot 37 as follows: • , Bring(1)additional set of plans to replace the one already sent to Washington County_ ,k 0 Correct the address/lot number on all(3)sets of construction plans 0 Correct the address/lot number on all(2)sets of engineering calculation documents • Revise the address/lot number on all permit application forms • Provide(3)copies of the site plan for lot 37 Once the above items are complete,the building permit technicians will review the revised documents. If acceptable,you will then be directed to the planner on duty to review the new site plan and revised construction plans. If approved,the building permit technician will then route for re-review by engineering technician, permit coordinator and building plans examiner. Please note that additional fees will be assessed for administrative costs to correct permit records(MST and SWR) in the database,and additional plan review fees as applicable. Thank you and please let me know if this appointment date/time will work with your schedule. Dianna L. Howse Building Division Services Supervisor City of Tigard I Community Development 13125 SW Hall Blvd I Tigard,OR 97223 503-718-2430 Direct 1503-718-2439 Permits From: Nikki Pruett<NPruett@riversidehome.com> Sent:Wednesday, November 14,2018 3:30 PM To:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov>;#CD PoD<CDPoD@tigard-or.gov> Subject: Meeting Request Good afternoon! I'd like to schedule a meeting for Monday, Nov. 19 or Tuesday, Nov. 20. Per my conversation with Diana in order to move permit MST2018-00279 to another lot she requested I schedule a meeting to do so. Thanks, Nikki Pruett Operations Manager ell Riverside Homes 17933 NW Evergreen Place, #370 11111 City of Tigard 14 COMMUNITY DEVELOPMENT DEPARTMENT C T l c A R.D Building Permit Review — Residential Building Permit #: 5 ,,,ZO iff—cv'`7 f Site Address: -(p-0( Sw CCIll ..C(t 1_.1,ne. , Project Name: • ,r D- i / e Lot #: 37 (New dwelling=subdi ion name;A:la ition or Alteration=last name of owner) Planning Review Proposal: NC Verify site address/suite#exists and active in permit system. River Terrace Neighborhood: No El Yes,See River Terrace Review Addendum Attached Site Plan Elements: ree(3)copies of site plan Wasting structures on site U ite plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished Drawn to scale(standard architect or engineer scale) floor elevations orth arrow Utility locations&easements(required for new and additions) Q ite address,project or subdivision name and lot number ,,��,,// 1�I�idewalk/driveway approach Applicant information(name and phone number) '4j sLocation of wells/septic systems XLot dimensions and building setback dimensions Wxisting trees to be retained with drip line,and tree r.g.•uare footage of buildings to be demolished protection measures :: of area,building coverage area,percentage of coverage and ►_ treet tree size,type and location impervious area(applicable if R-7,R-12,R-25&R-40) ►�� treet names Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? {Y"s/U No 4 foot differential) If yes,is a storm water quality facility shown? • i\No 25.11—Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: El Yes,applicant was notified No Received: ,'\ El Yes El No in Public Facilities Improvement(PFI)Permit: Required: ❑ Yes,applicant was notified No Applied For: pp CI Yes ❑ No,stop intake lk Land Use Case#: p'pa20l(a—CCCOcj M Zoning: Q-1 ( Pi) N Required Setbacks: Front 1 5 Rear 15- Side 5 Street Side nJf Garage Landscape Requirement: Xi Lot Coverage Maximum: % ❑ Building Height: Maximum Height 35 i Actual Height Visual Clearance Sensitive Lands: Yes 0 No Type jUY1S�.(�rini,P a rban Forestry Plan � [CifiSd e' Conditions "Met"prior to issuance of building permit Notes: Approved By Planning: Date: It.Id I CI I Revisions (after Building Submittal onl Reviewer Revision 1: CI Approved ❑ Not Approved Date Revision 2: ❑ Approved 0 Not Approved Revision 3: 0 Approved ❑ Not Approved I:\BuildingWorms\BldgPennitRvw RES 061417.docx Building Permit Submittal Original Submittal Date: If/(ilit Site Plans: # ,3 Building Plans: # Building Permit#: nter building permit#above. Lam /fig Workflow Routing: an g �.Effglneering ermit Coordinator - itl Workflow Sign-off: ign-off for Planning(include notes from planning review) Route Application Documents: �rri.;ineering: (1) copy of permit application, (1) site plan, (1) building plan and orial plan review routing form. Lam}-'Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: :-., Al - i.. S—', , .01:74- 4 i d / MEW B i y Permit Technician: �r.�_ _ j�'/ Date: Y . , // I`f Ib' Engineering Review ❑ Slope at building pad: 2/1 0 Conditions"Met"prior to issuance of building permit ❑ Easements (encroachments)per engineering conditions of approval and plat ❑ Water Quality/Quantity Facility: d/ Assess Water Quality Fee in-lieu: 0 Yes No Assess Water Quantity Fee in-lieu: 0 Yes LIDA Facility on lot: 0 Yes No EJ Final Plat Recorded: 0 NOT Approved by Engineering: Date: Notes: /- Approved by Engineering: r,S /`a A/ Date: /1172GJ/16 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 , 1, - . •n.:..-: D ---: ❑ Condttlons "Me p o —_ O Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: R Sion Notice 3: Date Sent to Applicant: SDC Fees Entered: Wash Co Trans Dev Tax: Yes 0 N/A Tigard Trans SDC: Yes 0 N/A Parks SDC: t9' Yes 0 N/A LIDA 0 Yes *, ;4' N/A OK to Issue Permit Approved by Permit Coordinator: Date: /1 JI-- I:\Building\Forms\BldgPeimitRvw_RES_010118.docx City of Tigard Tel: 503.718.2439 Location: Inspection Date: 7679 SW CORNUTT ST, TIGARD, OR, 97224 April 22, 2019 at 2:00:57 PM Record Type: Record ID: Residential - Master Permit MST2018-00279 Inspection Type: Inspector: 199 Electrical final Jeremy Burrows Result: PASS Comments: Note: no A/C Violation Summary: Inspector Contractor City of Tigard Tel: 503.718.2439 Location: Inspection Date: 7679 SW CORNUTT ST, TIGARD, OR, 97224 April 22, 2019 at 2:01 :24 PM Record Type: Record ID: Residential - Master Permit MST2018-00279 Inspection Type: Inspector: 699 Mechanical final Jeremy Burrows Result: PASS Comments: Note: no A/C Violation Summary: Inspector Contractor City of Tigard Tel: 503.718.2439 Location: Inspection Date: 7679 SW CORNUTT ST, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2018-00279 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. Insulation certification checked. Finish installing last 2 house address numbers. C of 0 left on site with contractor. Violation Summary: Inspector Contractor