Permit (39) CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2018 00360
GGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/28/2019
T-
Parcel: 2S 111 AA07400
Jurisdiction: Tigard
Site address: 8697 SW GREENSWARD LN
Subdivision: GREENSWARD PARK Lot:
Project: Butterfield Park, Lot 1
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 4 First: 2290 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 15 Bathrooms: 3 Second: 0 sf Garage: 703 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2290 sf Value: $304,853.90 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 WDrains: 0
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: 0 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: 4 201-400 amp: 0 201-400 amp: 0 W/O SvcfFdr: 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 2290
Owner: Contractor:
FOUR D CONSTRUCTION Required Items and Reports(Conditions)
PO BOX 1577 1 Ersn Cntrl 503-639-4175
BEAVERTON,OR 97075
PHONE: PHONE: 503-720-7445
FAX: 503-590-1751
Total Fees: $31,546.66
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obt ' e f the rules or direct questions to OUNC by calling 503. r.1987 or 800.332 .• - •
s
i✓
Issued By: Permittee Signature: e
all 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 project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Residential FOR 01-11( L 1'Sl,oyl.v
C E Received
City of Tigard -� Date/By: //2./ 7/i -�r--- Permit No.:�v % !%4 Jul �(�t1
13125 S50 hall Tigard,OR 97223 Plan Review ! P
i ; , I � 1 Other Permit: ,,Gyje, IjQ rA`I f
Phone: 503.7182439 Fax: 503.598.1960�� 2 "p n pp DatelBy: V
Inspection Line: 503.639.4175 J E C. i 7111(t Date Ready/By. Ju1.....-6,:,
ri�st � la See Page 2 for
T ",E`[ p N�,d/Method: / l •7�? Supplemental Information
Internet: www.tigazd-or,gov
CITY OF TIGAR1
TYPE OF )A
1G )(VJ S I(l'% REQUIRED DATA:1-AND 2-FAMILY DWELLING
%New construction 0 Demolition C� 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
work indicated on this application.
CATEGORY OF CONSTRUCTION ()Cf I
Valuation:
ill-and 2-family dwelling 0 Commercial/industrial $
❑Accessory building 0 Multi-family Number of bedrooms: q
❑Master builder 0 Other: Number of bathrooms: -7,
q
JOB SITE INFORMATION AND LOCATION Total number of floors: / Z 63 /3
Job site address: ]b�7 5,w" 612�/(/s Amt, 1.4,14 t New dwelling area: 2 TZt� square feet 2Z1 L a
City/State/ZIP: Tt (.'P D 0 R 9 7 2.19 Garage/carport area: 70 3 square feet
Suite/bldg./apt.no.: Project name: Z c_,.,(-- p j-1 1,i I;r Covered porch area >i< square feet
Cross street/directions to job site: oc. (-r ,1- L ( A/4iit /f1 i9iK- Deck area: square feet
ft i U.- BLVD -- r,g_ /ystU Aitb - 90 r-)4- Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: - ` • i- � - I Lot no.: / Permit fees*are based on the value of the work performed.
Indicate the value(rotnded to the nearest dollar)of all
Tax map/parcel no.:
R,41-1-.4",:p'1.-:. L1.> PAitz. .., equipment,materials,labor,overhead,and the profit for the
,2 i:-6 r j'>&1-i t to J DESCRIPTION OF WORK TRPc.r- c...„.. work indicated on this application.
A/6--co j il/6 L-G P-}\iyt i(y RE 5 i DC-NC.c Valuation: S
Existing building area square feet
New building area: square feet
PROPERTY OWNER 0 TENANT Number of stories:
Name: Type of construction:
Address: SPA/16- 14,5 RSL-Oy(/° Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: FCU IL D Cc,M5 TRW CTIO KJ
Structural plan review fee(or deposit):
Contact name: ''�
PY 1� De 14 4-V-P P o gT FLS plan review fee(if applicable):
Address:
P` • x s 7 Total fees due upon application:
City/State/ZIP: c , ci 7 a�7 p
VE✓ rot,...) Amount received:
Phone:(.5o3) 7 RO -'7 V y S Fax: (5.4.3)
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: F b t1 Yom- Cts WS 7'P 6y1 S , C (3 ML Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name: Submit two(2)sets of roof plan with connection details
` T and fire department access,along with the 2010 Oregon
5
Address: ' Solar Installation Specialty Code checklist.
Permit Fee(includes plan review
City/State/ZIP: and administrative fees): $180.00
Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: 7/6)3'7 Total fee due upon appication: $201.60
Authorized signature: � This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Date: *Fee methodology set by Tri-County Building Industry
�1 Z7 _ - I�PP61zt'' / '2 7'/ Service Board
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(1 l/02/COM/WEB)
Mechanical Perm- A t t lication FOR 01.11(I I SI, Oy1,1
Received
City of Ti.r.ar Permit No.: +
III4 13125 SW Hall i Ivd.,+i ard,OR 97223 +ateBy. > )M/5(-do Je,(.1
_ Phone: 503.718.2 t 39 .ax: 503.598.1960 Date/By:am Review Other Permit:
I
i(,A R t) Inspection Line: 5 t .63 .4175 Date Ready/By: Juris: H See Page 2 for
Internet: www.tig• ---'.gov DEC 2 7 e2018 Notified/Method: Supplemental Information
TYPE OF WOI 1 Y Of [A GARO COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
g Tz �� � Mechanical permit fees*are based on the value of the work
%New construction 0 Addition/alter OXIi w A performed.Indicate the value rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT I SYSTEMS FEES*
13 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
0 Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
� Air conditioning 1 , 46.75
Job site address: 3 6q 7 S,(.J, 6r slrA\itb 1_,\) Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: r)(;.2f- C.)-52-.. Ci '7 2-Z-y Furnace 100,000+BTU(ducts/vents) , 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: - Lor PA _.rl rlc i,) Duct work 23.32
Cross street/directions to job site: u,r= jaC r LSi�Y1fLp -
Hydronic hot water system 23.32
j Residential boiler(radiator or
/4-A l--L- a Lvb &g /V,Stunrtra LN - 7° r-N 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: Other: 23.32
. ra.r) '1 '- Lot no.:
Other fuel appliances:
Tax map/parcel no.: at f"`re j ri (L j) A,LIC..-, Water heater . 23.32
Z for �/Ytr i Mt t*--) DESCRIPTION OF WORK 5--VAc - Gas fireplace/insert 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter(gas) 23.32
N&IA-1 S /10 OLE P1 M i Ly g e-S) j)t - CAE Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
I,a PROPERTY OWNER 0 TENANT Other: 23.32
d
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: *'
f�/1-� p.S. B d_Et OW Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawispace fans 23.32
6t APPLICANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name: FO LL R. C) C b 03 S.712,A.C.1-(tj $14.15 for first four;$4.03 for each additional
Contact name: `fl P.V.I P 'E 14-P-12PPC -r- Furnace,etc.
(� Gas heat pump
Address:
Pa (� ' 46 L`)( ) S 7 7 Wall/suspended/unit heater
City/State/ZIP: 13Ex1/EIL1 J ,AZ 9.7 0! S Water heater
175 1 Fireplace 5
. •.- '7`,S .3 f i ..
Phone:(j ii,j) (3 ` Fax::( C;.}
Range
E-mail: ' (3t.1,IU)Co,►v ST e l /0, CO MI Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: ,�,� �y Other:
& �` ' ILA A ) - t" MECHANICAL PERMIT FEES*
Address: P.0 t t ox 93.E Subtotal
City/State/ZIP: 'C...c7 C. .-i,tikil X15C1 .. �7 a 1 5 Minimum permit fee($90.00)
PSI Plan review(25%of permit fee)
Phone:($c ) &.5.6..- J y?0 g" Fax:( ) 650-3g 9S' State surcharge(12%of permit fee)
CCB lic.: /763 ...,----4( y TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: 2/ * Fee methodology set by Tri-County Building Industry Service Board
Print name: ��i, - Date: / Z?,_./�
1:\Building\Permits\MEC PermitApp 040113.doc 440.4617T(11/02/COM/WEB)
Electrical Permit Application t O1z (111.1( I. 1 ',l: (1y1.1
' CityofTigard Received Permit 4:
g Date/By: /1'!°j -Hi tr-,,c,j,„0
lig 13125 SW Hall Blvd.,Tigard,OR 9 q Plan Review
■ ' Phone: 503.718.2439 Fax: 503.59CEIVED Date,/By: Related Permit 4:
Inspection Line: 503.639.4175 Ready Date/By: hag: 81 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF woilE C 2I) 2.0 8 PLAN REVIEW
KNew construction 0 Addition/alte " re r rt Please check all that apply(submit 2 sets of plans w/items checked):
0 Demolition Other: / 0 Service or feeder 400 amps or more ❑Building over three stories.
CATEGORY OF ~ ���,���Lt where the available fault current ❑Marinas and boatyards.
exceeds 10,000 amps at 150 volts or ❑Floating buildings.
pi„I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
( � C 0 Addition of new motor load of system.
Job#: Job site address
4J�7 17 ..w, fN ^=+1 J11) LA.11 10oHP or more. 0"A",••E,,,"1-2 "1-3",
City/State/ZIP: '-r-'-j(,A RD d '/7 lZV 0 six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: 0 Hazardous locations. 0 Supply voltage for more than
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Each I Total I
1-4 14 LL. 8 L.V D Co Rte t-.4/6 ,IN I I-A/ _ ?ti T/4 New residential single-or multi-family dwelling unit.
`= -
Subdivision: ` Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: '. °s "� j 0=.,j i,- Xl JL Ea.add'l 500 sq.ft.or portion 33.92 1
;,Z L5 * PAa. /r A p,) DESCRIPTION OF WORK -ft „r Limited energy,residential
Nei'‘';' E_ (with above sq.ft.) 75.00 2
N� ..-5/IV Ls f- C= i t-V t`c SQ DEJVC.== Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
0 PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 100.70 2
201 amps to 600 amps 133.56 2
Address: LS.A ML-' /4-5 13 E LO 2
t-t_.1
401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) 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 l
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-new,alteration,or extension,per panel
A.Fee for brach circuits with
Business name: F pt.(,t•i } C,0 fa5 j(au cf-,0/i,,,} above service or feeder fee,
7A2 2
each branch circuit
Contact name: d)A' //0 j)e)4)4 R I e,taT B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address: P.o, I3 ci'x 1.5-77 branch circuit
City/State/ZIP: 1 t ? 9 Each add'i branch circuit 7.42 2
y �i 'pYC"'}Z-Tt�iL �' � �� "� Miscellaneous(service or feeder not included)
Phone:663)-7„„20 7 v`•f S Fax::(, 3 ),5c70 --17 S 1 Each manufactured or modular 67.84 2
O L�{s., > dwelling,service and/or feeder
Email:
1 � t...15,1„ 5�rC Ms/i. Cof Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: L .r6 L,eci-iz.1C6. 6fluP Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy 0 see Page 2 2
Address: /l.� /5 0 ,k. 5?Aft, 174S JO V panel,alteration,or extension.
City/State/ZIP: Each additional inspection over allowable in any of the above
1 1.l �>� � ' Additional inspection(1 hr min) 66.25/hr
Phone:(5 X03) L7 7 3 7,99 Fax:(S.3 ) f0/"` 79/Y Investigation(1 hr min) 66.25/hr
Email: --..1._6.-7- -e:.;•46--:-.c;:r-A/c--6 gect Industrialspecoplant w(1 ishr nmo 98.18/hr
+� ���MA I�' , � � Inspections for which no fee is
el/Z.7 G/ 63 C,7 p 5762. S specifically listed('A hr min) 90.001 hr
CCB Lic.: a Electrical Lic.:C / Suprv.Lia:
,�� / ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:`'7rrJJ J„fes.„A., Subtotal:
Print name: k V 13 orL.To /IA 0 L J./Tl,gg/Z_Date: /7.2 6..../e 0 Plan Review Required(25%of permit fee):
State surcharge(12/s of permit fee):
Authorized si re: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: % Date: 7 � � days after it has been accepted as complete.
dt
• Numbed of inspections allowed per permit.
i:\Building\Permits\ELC P itApp_ELR ERE. Rev 04/21/2014 440-4615T(11/OSKOM/WEB
Plumbing Permit Annlication
• ' Building FixturesI OR Ol I I( I l til O\1.1
City of Tigard RECEIVE" '.eceived
y"mayG�L1
74
13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: �ti�t�
Phone: 503.718.2439 Fax: 503.598.1960an Review Permit No.:
Oth
Inspection Line: 503.639.4175 DEC`� '� Date/By' �Permit No.:
1 i i:A E:i) Date Ready/By: anis: 0 See Page 2 for
Internet: www.tigard-or.gov CITY Of F I 1 A Notified/Method: Supplemental Information
TYPE OF WO
;.111LDING DIVISION FEE* SCHEDULE
�Newconstruction .Demolitionspecialinformation For in ormation use checklist
Description Qty. I Ea. I Total
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
gi 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( ,sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Catch basin or area drain 18.76
Job site address:
X697 5,44j. C 06ums 0 L.Ai
r�J Drywall,leach line,or trench drain 18.76
City/State/ZIP:
1 W414,D C R g 7 2..Z / Footing drain(no.linear ft.:_J Page 2
Suite/bldg./apt.no.: Project name: -E, Lt.,r PAR_ i rio t..) Manufactured home utilities 50.03
Cross street/directions to job site: c -r- r c 1 -EN ,tf,nb OC_ Manholes 18.76
14 14 Z .- 0 LVD Co R E SNS v ik Ito LA/ - 90 7_0. Rain drain connector 18.76
J Sanitary sewer(no.linear ft.: Page 2
Storm sewer(no.linear ft.: Page 2
Water service(no.linear ft.: ) I Page 2
Subdivision: ,r iii - D ( Lot no.: 7 Fixture or item: 1
Tax map/parcel no.: u-rr E j c -1.),u,..,(..... Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
T/1/ 44-)
/��-T �' Clothes washer 25.02
/Y ' S//✓( -C F./4/'I Ly R Es-!f)eA/e..k7 Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
12(PROPERTY OWNER ' 0 TENANT Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: ,,.SA/f1E /-S 13 CLaw' Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
(j" APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name: �'p i(iz„ Dco A/ Li cr/ti Medical gas(value:$ } Page 2
j j Primer 12.51
Contact name:
�- /4 vi 17 D&n g p Pug-r Roof drain(commercial) 12.51
Address: T, O. 43bX / S .7 7 Sink/basin/lavatory 25.02
City/State/ZIP: ,B&">A vvp Tb Al c R 9 7 p 7S Solar units(potable water) 62.54
Phone:L5133 ) 7 O•-7 vy 5 Fax::(,5-J3).59'o..f 75, Tub/shower/shower pan 12.51
E-mail: ,c 0 UP- )e.b A/6r e NNisi/ C o Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: `-r if(r, I4 GAL Z✓t Al 6.3 M P 14 A-:,/, Water piping/DWV 56.29
Address: /6e)/ A ,3,C. i 1/a j2 Rd Other: 25.02
City/State/ZIP: /G L,.S 9 7/Z3 Subtotal
Phone:(5 3) yo-. 61/3 f Fax:( ) Minimum permit fee: $72.50
c� Plan review (25%of permit fee)
CCB Lic.: /...26 g 9 Plumbing Lic.no.:, V-26e I'd State surcharge(12%of permit fee)
Authorized signature: / TOTAL PERMIT FEE
Print name: u j la pe)r u--- Date: i 2, L 7_/ This peimit applicafteration it haexpsires if
been aaccepted permit isas notcomplete obtained within 180 days
"Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Pecmits\PLMU-PennitApp.doc 10/01/09 440-4616T(I0/02ICOM/WEB)
114 City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
111111
T AR Building Permit Review — Residential
r..
Building Permit #: ---/ _ y v � � .
Zc�t8"_ � -3f,)c)
Site Address: g(p°i SW reet,IS\iva12Q Louhe,
Project Name: BirttAISVVM Pjy 1\10.9, -WA Ytrhov, Lot #: H
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: We,// 'V-
'tVerify site address/suite#exists and active in permit system.
River Terrace Neighborhood: tk No 0 Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
.A'I'hree(3)copies of site plan el; xisting structures on site
►Lite plan must be on 8-1/2"x 11"or 11 x 17"paper ►_ ootprint of new structure(including decks)with finished
411Irawn to scale(standard architect or engineer scale) floor elevations
orth arrow
XJtility locations&easements (required for new and additions)
Site address,project or subdivision name and lot number
,�,�idewalk/driveway approach
Applicant information(name and phone number)
Wocation of wells/septic systems
'ILot dimensions and building setback dimensions Jxisting trees to be retained with drip line,and tree
V.quare footage of buildings to be demolished protection measures
P. .t area,building coverage area,percentage of coverage and
impervious area(applicable if R-7,R-12,R-25&R-40) treet tree size,type and location
Street names
Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? s ❑No
4 foot differential) �7(i
If yes,is a storm water quality facility shown? 17-4 ❑No
lig—Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995):
Required: 0 Yes,applicant was notified '' No Received:
Public Facilities Improvement(PFI)Permit: ❑ Yes 0 No
Required: 1,.Yes,applicant was notified
Y1 No Applied For: 0 Yes El No,stop intake
iii-Land Use Case#: M L ) () 17-0000 3
1 Zoning: 'R_y,s
Required Setbacks: Front 2.0 Rear t 5 Side S' Street Side I S Garage 2-0
(..Landscape Requirement:
tgift-/Lot Coverage Maximum: 0/0
1tf Building Height: Maximum Height
SO Actual Height t IS
iSr Visual Clearance
%Sensitive Lands: 0 Yes , No Type
la Urban Forestry Plan
Conditions "Met"prior to issuance of building permit
Notes: \Nntl+ to re. i vG 12Apr r CON Df-?LF . -- P rrc v 1 -C) lo I.Ss .'-e.
❑ Approved By Planning: A7C it n
Date: \aN la7 J I
Revisions (after Building Submittal only) Reviewer
Revision 1: 0 Approved 0 Not Approved Date
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
I:\BuildingWorms\BldgPermitRvw RES 061417.docx
Building Permit Submittal 7ir
Original Submittal Date: / /�
Site Plans: #
Building Plans: #
Building Permit#: 2-• nter building permit#above.
Workflow Routing: E' Tanning Ji__Engineering [ 'ermit CoordinatorBuilding
Workflow Sign-off: ► Sign-off for PYanning(include notes from planning review)
Route Application Documents: ,,Engineering: (1) copy of permit application, (1) site plan, (1)building plan and
original plan review routing form.
( Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: �, 4W" ��/2.) 1--
�,��/✓�� Date.
By Permit Technician: .41 . v .I /A
Engn ineering Review
Er Slope at building pad: ?j JJ/o
Q Conditions"Met"prior to issuance of building permit
g/Easements (encroachments)per engineering conditions of approval and plat
[ Y Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes No
Assess Water Quantity Fee in-lieu: 0 Yes No
LIDA Facility on lot: 0 Yes No
Ei/Final Plat Recorded:
0 NOT Approved by Engineering:
Date:
Notes:
R/Approved by Engineering:'' �
4' 4 g, F
v Date: 12 - 31 - 2018
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
Conditions"Met"prior to issuance-of building p r i*
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
14 SDC Fees Entered: Wash Co Trans Dev Tax: Igt Yes 0 N/A
Tigard Trans SDC: 0 Yes 0 N/A
Parks SDC: X Yes 0 N/A
LIDA 0 Yes S N/A
OK to Issue Permit I \31 ,
Approvedby Permit Coordinator: Date: 2�
iS
,J
I:\Building\Forms\BldgPermitRvw_RES_010118.docx
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
8697 SW GREENSWARD LN, TIGARD,
OR, 97224
Record Type: Record ID:
Residential - Master Permit MST2018-00360
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS
Comments:
Contractor installing protection Ballard for water heater gas controller protruding beyond
adjacent wall.
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
8697 SW GREENSWARD LN, TIGARD,
OR, 97224
Record Type: Record ID:
Residential - Master Permit MST2018-00360
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:
8697 SW GREENSWARD LN, TIGARD,
OR, 97224
Record Type: Record ID:
Residential - Master Permit MST2018-00360
Inspection Type: Inspector:
299 Final inspection David Young
Result:
PASS - CofO
Comments:
Contractor to install impact protection Ballard in garage and fix slope away from structure
at front landscaping.
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