Permit (84) 741 CITY OF TIGARD MASTER PERMIT
'' COMMUNITY DEVELOPMENT Permit#: MST2018 00332
.1. �.. Date Issued: 02/06/2019
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 c. -,
. � Parcel: 2S107AA08400
\ Jurisdiction: Tigard
Site address: 14449 SW 169TH AVE
Subdivision: ROSHAK RIDGE Lot: 84
Project: Polygon at Roshak Ridge, Lot 84
Project Description: New SFA.-Model Home. 09/19/2019: REPRINT to add fire sprinkler system.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 2 First: 90 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 30 Bathrooms: 3 Second: 562 sf Garage: 430 sf Front: 8 Smoke
DwellingUnits: 1 Detectors: Yes
Third: 562 sf Right: 0
Total: 1214 sf Value: $164,352.30 Rear: 0
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 1
Other Fixtures: 1
Drywell-Trench Drain: 0
Other Fixture Units: Fire sprinkler system
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: 3
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: 2 201-400 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+a m p/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 SFA VB R-3 1214
Owner: Contractor:
POLYGON WLH LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
703 BROADWAY ST STE 510 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175-
VANCOUVER,WA 98660 VANCOUVER,WA 98660 2 1 hour fire rated eaves
PHONE: 360-695-7700 PHONE: 360-695-7700
FAX:
Total Fees: $24,767.60
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 obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332..23^�444../
Issued By: `A_� /�}\ r Permittee Signature: r1 �.,''
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.
'? .,('N .... ‘‘.\4,t X \5
Plumbing Permit Application
Building Fixtures rolz OFFICE 1.sr: o'i.'
Received _ _
City of Tigard Date/B Permit No.. 0. �� _�
13125 SW Hall Blvd.,Tigard,OR 97223 y' �" � ��� � � V - '
= Plan Review
Phone: 503.7182439 Fax: 503.598.1960 /4/� Other Permit No.:
1 I( A K D
Inspection Line: 503.639.4175
Date ReDate/Re V/ �y %rv�.i
Ready/By: kris: RI Sec Page 2 for
Internet: www.tigard-or.gov . , Notified/Method: �YS '..,._.-4
Supplemental information
.,,, , "s ,,. fk , ,,,;,,, ' ,,„, „ rrcr,x m :.u.sE roe z ;-'7:(.'cx t ;t
.
..:A Pr ; �y ' ` . ;-0. _ ,./NJ .1 . 0r" is.`- . NM .E.. ,:� �+ 7uaN4ha. ` � , 1r f F^. t' ;
t 2;,
IA For special information use checklistNew construction ❑Demolition
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement 0 Other:
� lt l . New 1-2-family dwellings(includes 100 ft.for each utility connection)_
. w � to i, ,i Aei-;1 .�lv"�; ��.
i3"� i w�,k ; SFR(1)bath 312.70
❑ 1-and 2-family dwelling 0 Commercial/ind .,i., (,` ' SFR(2)bath 437-78
❑Accessory building 0 Multi-family wv _ SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other
Fire sprinkler(a/ysq.ft.) Page 2
, 2� �- ?, tr`.3 k, '¥.xi fr:W; 3. 4;T,VMrbvk 3:I 3f ,
- Site utilities:
Job site address: / 91) qct s"� 14, T-L/ 4 LI Catch basin or area drain 18.76
1 i �f l� / „ 2.�� if Drywell,leach line,or trench drain 18.76
City/State/ZIP: G/�
n Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: (c� Project name: /�8d w tet j Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: .) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: I Lot no.:
Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
r • -} , Backwater valve 12.51
Clothes washer
25.02
_---./..
C",7n/('dS 6 ? Ser -1" &•••• Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
�s c y,,. Me 5 � .�, d , {rp
V'1g 'gib_-,_,W-._`..- � :... � "- '�r' w x:: Va{ k. 4 Expansion tank 12-51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
. '.'[ �Cr � --�1 . '"'a. , 4c.*'r 4;e;-. .�)".`r14. Interceptor/grease trap 25.02
Business name: e. �f A-4, w Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
V t ? 3a ey Water closet 25.02
�, :.s� . .: t✓' �,'x��. ;"'�2aaW" `,� �, ' 37.52
�"�`�" ," �'� to,!....',' �n f Water heater
Business name: .# , L F of 1 i / I L /J C Water p p
t mV W 56.29
Address: /�e (,Fa)
J /, Other: 25.02
City/State/ZIP: Cog YE 1T, (if(, q 7 O17 Subtotal
Phone:(`r7/) 23.5_ 05'6 L/ Fax:(!! ) ! Minimum permit fee: $72.50
/ / Plan review (25%of permit fee)
CCB Lic.:/86 15 ci,�' Plumbing Lic.no.: /5732
-
/� State surcharge(12%of permint fee)
Authorized signature: /-^\ . TOTAL PERMIT FEE
Print name: /61-1916r..."7_, Date:S This permit application expires if a permit is not obtained within 180 days
"r" after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:UBuilding\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
CITY OF TIGARD MASTER PERMIT
IN-1 COMMUNITY DEVELOPMENT Permit#: MST2018-00332
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/06/2019
T I G ti Is.! Parcel: 2S107AA08400
Jurisdiction: Tigard
Site address: 14449 SW 169TH AVE
Subdivision: ROSHAK RIDGE Lot: 84
Project: Polygon at Roshak Ridge, Lot 84
Project Description: New SFA.-Model Home
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 2 First: 90 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 30 Bathrooms: 3 Second: 562 sf Garage: 430 sf Front: 8 Smoke
Dwelling Units: 1 Third: 562 sf Right: 0
Detectors: Yes
Total: 1214 sf Value: $164,352.30 Rear: 0
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 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: 3
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: 2 201-400 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 SFA VB R-3 1214
Owner: Contractor:
POLYGON WLH LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
703 BROADWAY ST STE 510 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98660 VANCOUVER,WA 98660 2 1 hour fire rated eaves
PHONE: 360-695-7700 PHONE: 360-695-7700
FAX:
Total Fees: $22,270.23
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You m obtain a copy of the rulesordirect questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ., /i�f'�2(��� '��„"" Permittee Signature: (C / (i ei?
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. j
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.
•
. cEivE .
' Building Permit Application 1:\ �ResidentialR FOR OFFICE USE ONLY
T
' 4
Cl Of Tl and Receivedrn t`Jg r f r DateBy: ,r ` S�; Permit No.\\1c�'��} —��
111 ■ 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review r
C Phone: 503.718.2439 Fax: 503.598.1960 r�'+ .Date/By:ate/By: , 1 148 itk Other Perm�t,jl ' `4,Qt --� �-t
TIGARD Inspection Line: 503.639.4175 TAly<� )plateReady/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov BUILDING Dtyty (T ed/Method: Supplemental Information
TYPE OF WORK Il j u REQUIRED DATA:1-AND 2-FAMILY DWELLING
►/ New construction ❑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 ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.t1
ill 1-and 2-family dwelling 0 Commercial/industrial
Valuation: $ 1 \ �'5��
ElAccessory building ElMulti-familyNumber of bedrooms:
0 Master builder 0 Other: Number of bathrooms: 3
00 JOB SITE INFORMATION AND LOCATION Total number of floors: 3 t ft `I
Job site address: l`l`-1 L. () ' t / l t oi. Ave New dwelling area: Iv L square feet 7'_
1 UV)(-0,
City/State/ZIP: 4y D Vj (.C - �J� Garage/carport area: 49)0 square feet S(62_,S(62_,Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge .A m( Covered porch area: 4 square feet d
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:Polygon at Roshak Ridge Lot no.: VI 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: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 TENANT Number of stories:
Name:Polygon WLH LLC Type of construction:
Address:703 Broadway Street t-fr 510 Occupancy groups:
City/State/ZIP:Vancouver,WA 98660 Existing:
Phone:(360)695-7700 Fax:(360)693-4442 New:
El APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:Polygon WLH LLC (Please refer to feeschedule)
Structural plan review fee(or deposit):
Contact name:Amanda Gavin
FLS plan review fee(if applicable):
Address:703 Broadway St.Ste 510
Total fees due upon application:
City/State/ZIP:Vancouver WA 98660
Amount received:
Phone:(360)695-7700 Fax::(360)693-4442
E-mail:permitsubmittals@polygonhomes.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR: . roof-top mounted PhotoVoltaic Solar Panel System.
Business name:William Lyon Homes,Inc. Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:703 Broadway St.Ste 510 Solar Installation Specialty Code checklist.
City/State/ZIP:Vancouver WA 98660 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60
CCB lie.:207247
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
Ail
within 180 days after it has been accepted as complete.
h ) *Fee methodology set by Tri-County Building Industry
Print name:Amanda Gavin Date: v `J Service Board.
I:\Building\Perrnits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
____--,-----"
,---
, .
Mechanical Permit Applicatinti FOROFFICE ISE ONLI.
City Of Tigard itcccivcd
Ptrrnit NoS
. 15125 SW Hull atva.,Tient&Oli. 97213 • .
ipl . Dme/Sy:
Plan Revsew
1 X ' Phori gr3.7182439 Fax; 5598.1960 c\ji:oher --t" ..,
PtriiIM ‘'-'0,1• \
DatoThr:
Ti GA RD ImpactionSI3.:639.4175 Daic R=tymy: fans '' PI Ste Pne 7.fur
intemot oro-w.tiouni-or.gaw NotifiecliMethucl: Supplemental information
„,... .
ii . . iii5w7::,.,7,7,-:!:::::-.F.;:72,: ::::77:::;::::-:7;":::77-17:::::,:77 j::7P;W-NIEclit..77E ,':' c.'1iE))11:1. k1:1,5relle.K14$1:77.-z.-
14,1echanical permit fees?,are based on the value of the work
New construction 0 A'dditionlaht.'rati0nireptacernern Iperformed.Indieste the wine(rounded to the nearest dollar i of all
•
0 Demolition 0 Other mechanical tnaterials.egfikstildid.labor_merhead.and motit.
Value:S
C
...i .,:.,...:',1-11.i.-„.,-„,-..,.7,-.,?,.;7,7.,•,..;:,-_-_•=7!.:::.i..i:c?.::::?,-...:.;,.N;•••:,.::. Aji fyit,..i!,:-.6 ,..i.70,;. 1:.kijefibiSi.,..:::,: . = __.:*_._::::::;. ,--...,f.: -
0 I-and 2--fily dwellitta 0 Commerciallindustrkti 0 Aecesscay building For special informothur use chealist
' r Ntitti-ftaily 0 Master builder 0 Oiher. Description Qty. En. I Total ,
-- .-L"--2:.,r1-14F-;:.iii 4613:::iiTE.ittiPoit14.iT1tiril.8.N3):- Ai1irinii::::
Ail'COdditiarsizig 1 . 46,75
Job site addt.cm: ot k,\ ,\a\ 711A) 3kp o\Wpc bti.e9
I ' Furnace 100100 BTU 1,1sc154ents1 I 463$.
i City,:•tatellf.P.:Tigard,OR 97224 (.....) Furnace 1013_000+BTU ttints) • 54_91
61.06
Strneolitjapt.no.:
Plviect naraer-VO\ iO\0V ,Ott V-OS\Alkl , Duet1. pump
2332
Cro*streetidirections to job.site: j 3 -A° 11?1\ Hvdronic hot water system 23.32
Residential hosier(nariator or I "
01,veR, Fr hytirtatie) .5„.,31
Unit heaters(fuel-type,not eitetrk),
in-wall.in-duct.susp.ttridetf,etc. 46.75
Flu-event for env of above 1 , 23,32
Other: : '73.31
Subdittisiott kjcr- -r ecrae..e OS Lot no.:
q1,11-
Other fuel appraanet=
Tax.tnapipareel no.: Water heater „:„ 23_32
,•;;. 7.:•...;..r.!,.,::..::-..,- ,:!„•'::!:"..:.•,:.:::::7..,••::1V.SegirtiON:Ot',i4;okk.i339
..:F: -:,.:.:7-:..i,,',.:;.:;:.:T,:.1 ::.:,:.L- .5,-..-. .1:;5. eres rtreillaeertmert , I 3 ,
. .
Flue wet for water heater or gas ,
fireplace •• 23.32
- Log Tighter teas) 23.32
- i
- .,Wocargellet at 33.39
Wood freplaettiasett 23.32 .1
Chimumlliner)flucivent • 23.32
1 1 3 2
* isttiFi2-1';'-'5.';.:;-':, ,:-''-ii41.'-',---::-.'''.'. 0'fi,-6t.-6-.:.7 '-' ' ,.:',':- Other-. ' .. ',-- -• .: - Envirournentai exhaust nod ventilation':
Name: I vo\0,v\oy\ .V\Lk./ki VI,,li Rance boo:limber kitchen
equipment 1 1 33 39
Address: ' 1013 i0.0,(A;VV St S-i0Z c\ID Clothes drver mhatast 1 I I 33.39
CilYiStalog-Th‘. s VOI VI W RvOink, ok540 Single-duct exhaust(hathromn& i 1
toilet eumpastrustuts.utility morns) 1 1,3.32
Phone: V V iot : Ank.terawlspaee fans 1
i23_32
•- ''''''' 'El"ApriacANT,,,2. •,..- . •' . :' ,.:i'.--7-,,,,•.-la CONTACT PERSON...---.:--:-:'.• Other I 2332
Fuel piping:
BunineSs name:Polygon WI14LLC
,
• . 14,l5 far firs4 filer:SAM far earl stittirmast
Contact name-, yy\a/v\clikSont(A)
' . F
A urnace.e&. I
Ad•CirrS'''. 10-6 .--- Y-00.1titi-D 0Lb S— % 5ke• 1 C), ' GZ,heat pump I 1
WallisttspeudedArait heater I I
City/StdetZIP.Vanctutver,WA 98660 : Waterheater I
Phone:(360)695-7700 I Fax::(360)693-4442 Fireplace
I Rama
E-traq17.-- e_rlrsi\kA-SO.S.ZIrt,i, .‘-e-xS ra-)RoLtsurVttkerre-5'.ClY 11/1 I Barbecue
r: i;: .WIL..,:.:. 1.7 ..._ :!..., ,::COStriAtiO -::,f.jj.::' ," 4.i-..,-..'1a::::':::';::: ' . ' Clothes drrcr f gas)
Ogler
BISintSS sat=Am Air LLC : :
Mdress:18004 NE 72"Ave H: .':!7'.-Igickiltrit.C4iktititigik' -.17t85' t'. .'':
Subtotal 1
City/StateiZIP:VXXICOOVer,WA 98686 I Minimum pennit fee($90.00.1 , I
Plan review(-15%af pk..iutit fee) I
Phan=OM 342-8109 . I Fax (360)3244769 State surcharge(12%aperinit Teen 1
Ca3 lic..-:2030344TOTAL PERMIT FEE
Tii,prrrait application espiret if a permit is not obtainelt witisin
days after Sr bas bees accepted sserittipietiv.
Asthoritzed signature: . * Pee ratttivylolati•set by Tti-Ciiiinty Binfidiag Indetury&ay.=Bitard
....„....-i-,
Mat name: i 44os,, / Irrat ‘ ; rl 4 Lk.1 IV?'
Ilauji6eg,PerroizseddEC_P,ersmit0.mpad'it 1.1 doe 40, 07"1-(I i.,17,2rr.NME-11
•
Electrical Permit Application - FOR OFFICE USE ONLY• ,
-i-114 City of Tigard Received
Date/B : Permit g:
" 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
- '. - Phone: 503.718_2439 Fax: 503.598.1960 Date/Sy: Related Permit g. --t 4-.A. ....(d-sit; 5-,t,
Inspection Line: 503.639.4175 Ready Date/By: kris: El See Page 2 for
T 1 GARD - -
Internet: www.tigard-or.gov Notined/Method: Supplemental Information
er0X-TM2W1i,.. -41tig-g-X5TYMOWSP.,41;galtelRgitiKtgillagegfIgtarair mafxtme.mggofPLAN oyymotgg-giESMIA
[ZI New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
•
D Service or feeder 400 amps or snore 0 Building over three stories.
0 Demolition Ei Other:
where the available fault current 0 Marinas and boatyards.
ai-gaiggaV1g,=-1 0.0.:Mlik*Togit ]1altstititivisgmagtfigR exceeds 10,000 arrp,at 150 volts or 0 Floating buildings.
[E] 1-and 2-family dwelling 0 Commercialthichistrial 0 Accessory building less to ground,or exceeds 14,060 0 Commercial-use agricultural
amps for all other installations. . buildings.•
0 Multi-family - 0 Master builder 0 Other: El Fire pump. 0 Installation of 150 KVA or
ft441CSKt.g.1:10Z7..1:: 11Ift18tilk'P41g0Icill,M:Sg5g.':!:',Z,':?;:gig.,,V,i, 0 Emergency system. larger separately derived
0 Addition of new motor Ioad of system
Job#: Job site address: it4440t,5 VU lu,(414A kv_e_, IOOHP or more.
City/State/ZIP:Tigard,OR 9722,4 0 Six or more residential units. occupancy.
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt,#: Project name: 9• , a• 1 ott !di.. , • II 4,,, 0 H.azardons locations. 0 Supply voltage formore than
• ID Service or feeder 600 amps or more. 60ovolts
non=at. _
,
Cross street/directions to job site: Alta if. iiglaiNemamilogg0W-Kgilgla--I.Niadet-*
Description I Qiy. I Each I Total I .
New residential single-or multi-family dwelling unit.
Subdivision:I plreyle VvvuLti(talk Lot#: St+ Includes attached garage.
1.000 sq.ft or Jess 1 168.54 4
Tax map/parcel#:
Ea.add'1500 sq.ft.or portion I 33.92 1
twatmo-mwriggietotAWPAglitilgilmitommettignam Limited energy,residential 4 75. 200
(with above sq.ft.)
Limited energy,multi-family
75.00 2
residential(with above sq.ft.)
lig-1-.,'It474-4,-TraiTAINSM---i - .;31.: sReernvielcesTabol er feedersEnergYinstallation,alEiteraSectionP,aagned/2or relocation
Name: RA inovl vulkt litki 200 amps or less 100.70 2
Address:' 1trowt.voc,(A4_stsi32, 0 201 amps to 400 amps 133.56
401 amps to 600 amps
200.34 2
2
City/State/ZIP VaY1WIAAte2ICIA.X.A.ASdak 601 amps to 1,000 amps 301.04 2
Phone: ''' ( 0 te tits 11 up Fax:( tor))(06.31.4-LIIV Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: Pe YW1 1 t5(41011441VO ?..901te-trePA-140-140, -'GO:VIAI relocation
Owner installation:This installation is iag rn e on property that I own which is not 200 amps or less 5936 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
R.A.S1A-MT,MIWAVAg'ViriFf.-:.4S-,gpii.,Mprrowft-tk-o-vcjong.yf::.n. 1,633enec.1.7.0iirp•Icaluli:1-new lalteration,or extension,per panel
Business name: ?0 ‘j)(/..301,‘.., VOuli \IL above service or feeder fee,
7.42 2
each branch circuit
Contact name Npl‘iy\RM...Q.,. axiw, B.Fee for branch circuits without
service or feeder fee,first
Address:
-101) 46T 0 Gq(k0ClAIN ct SkC ID branch circuit56.18 2
City/State/ZIP:Vancouver,WA 98660 Each addl branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(360)695-7700 - I Fax::(360)693-4442 Each manufactured or modular
67.84 2
dwelling,service and/or feeder
Email:4 1?"(YvIA#c kik )vvinAtiil(qpcAvexv-vv\AvYtke,(‘ Reconnect only 67.84 2
niMI . 1#11-#014MOIQVAIIiiiitilK4MATIII Pump or irrigation circle 67.84 2
Business name:Garner Electric Washington,LLC . Sign or outline lighting 67.84 2
......:. Signal circuit(s)or limited-energy r.,
Address:6101 NE St Johns Rd panel,alteration,or extension. ' See Page,,` 2
Each additional inspection over allowable in any of the above
City/State/ZIP:Vancouver WA 98661
Additional inspection(1 hr min) 66.25/lir
Phone:(253)320-1657 Fax:( ) Investigation(1 hr min) 90.00/hr 1
Industrial plant(1 hr min) 78.18/hr
Email:bdarnels@gweusa.com
Inspections for which no fee is
90_00/hr 1
CCB Lie.: C1158 Electrical Lie.: 208174 _J Suprv.Lie,: 4496S specifically listed C4 hr rain) I
.,. .._., .. -.,-,. ....... 1V--F...%;g57.51;i$1,tM,,,_:_elroxitslav___...,,,__,,:#4.,.:.„as,57-..,--TA,Asio.,ra,:it
Suprv.Electrician signature,required: - 2y1.11/ p., /-,-.7 ile,(„L, - r Subtotal: ,
Print name: Joan P Albert • Date: 1,2,14 le 0 Plan R_eview Required(25%of permit fee): i•
State surcharge(12%of permit fee):
.::, Authorized --- -
signature: Z.:L____
'-•'--- - ----.- --------_-
_ TOTAL PERMIT FEE: 1
Date: „:, liii 9 1 1—[—. 1, This permit application ztricornipnisres if sarerattitedp isa:octwo.iliptitneed within 180
Print name: Bill Daniels been
V * Number of inspections allowed per permit j
',:::: .;::',I:\Builliing\PeraiitsIELC_PertnitApp_ELIt,ER.Ecloc Rev 06/17/2015 440-4615T(11/05/COM/WES 1
•:..,::i:..:'::,':::',•:,
Plumbing Permit Application
Building Fixtures
City of Tigard Received unit No.:
13125Iiii . SW HallBlvd,Tigard,OR Date/By:
,. � 97223 Plan Review C'
Phone: 503.718.2439 Fax: 503.598.1960 Dat I3y: Other Permit o.:M - \c.--WWj �
T l G AR D Inspection Line: 503.639.4175 Date Ready/By Iurts: RI See Page 2 for
Internet vSzvw.tigard-of-gov Notified/Method: Supplemental Information
TYPE`OF WORK FEE*SCHEDULE
1` New construction ❑Demolition For special in}ornsution use checklist.
Description I Qty. I Ea- I Total
Ill Addition/alteration/replacement 0 Other: New I-2-family dwellings(includes 100 ti.for each utility connection)
ATF.t.EI)gT' QF yG(I.?R?S t'itI3CFI0*►
SFR(1)bath 312.70
' ".r. • SFR(2)bath 437.78
! 1-and 2-family dwelling ❑Commerciatimdustrial
SFR(3)bath , 500,32
D
0 Accessory building CD Multi-farnily Each additional bativkitchen 25.02
0 Master builder 0 Other: Fire sprinkler( sq,fl.) Page 2
JOB SITE INFORMATION AND LOCATION '.
Site utilities:
Job site address: I H IA g°1 W I(0°1 t l v& Catch basin or area drain 18.76
Dtywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name: 1O y o3ovt u* s tiJA� Manufactured home utilities 50.03
Cross street/directions to job site: "� pay..a Manholes 18.76
rq Rain drain connector 18.76
V b ��(U�� SaniMly sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.: ) Page 2
._ G '' Water service(no.linear ft.: I Page 2
Subdivision l' 1,1/61"T.C/y'v iiii,s Lot no.:164 Fixture or item;
Tax map/parcel no.: �+ Baekflow preventer 1 31.27
73EON:OF WORK, Backwater valve
92.5 3
� - Ciothesswasher 25.112
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
• Expansion tank 12.51
` - I'RUP9�T'Yt?�?'rIEit " T1'sNANT '
Exp
31 F turelsever cap 25.02
Name: V O V' VJL\ LFloor drain/floor sink/hub 25.02
Address: 12t/VOV� Garbage disposal 25.02
City/State/ZII U(4+nWnU / VW\ 0\ t,(10 Hose bib 25.02
Phone: b0 VOIST100 Fax (8 1))06P)Iu4rl/
lee maker 12.51
F --`07:0;aAPPLICANT""- CONTAcr PERSOP7 Interceptor/grease trap 25,02
Business name: Vol VJVOA, \A)L Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: 1 „Q, & t� Il L ( Roof drain(commercial) 12.51
Address: -In-Inf✓V O(ita )(11/1/1 (q J
v 'o Sink/basin/lavatory 25.02
City/State/ZIP:Vancouver,WA 98660 ""1 Solar units(potable water) 62.54
Phone:(360):6955-7760 Fax::(360)6934442 Tub/shower/shower pan 12.51
E-mail: ?ervr)it5LAbWi t Oils FUlVJ0)l�1&1�,OYUJ S • LO Wt' Water 2502
W25.02
ater
iICTOB ' 37.52
ter closet
Business name: G4.:__.6 viwtil i\',. 74,46,__ Water in WV 56.29
((�� �•�;j P1F* �
Address: `1"Q` �" at Other: 25.02
City/State/4LP: 57-, 94.4 ore, 411131 Subtotal
Phone:( 5b3 ,s - i'Yii Fax:(it!V..-741-47 Minimum permit fee: X72 S0
}} t Plan review (25%of permit fee)
CCB Lie: Jtli „„ Plumbing Lie.no.Pb
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name: - V . tyke__ Date 12.I ii I If) I Phis 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 Inriusrry Service Board..
I:tatTildingtPermifslPi b4U-n rmi App.doc 10/1/09 4401i6t6T(to10eOM/WEB)
City of Tigard
IIIM COMMUNITY DEVELOPMENT DEPARTMENT
T c A},n Building Permit Review — Residential
:a
Building Permit #:
Site Address: 14/2/2/ ? J /6' ,A
Project Name: 1-)0 47IL 1i Lot #: 6
(Ne, : lling=subdivision name;Addition or Alteration et name of owner)
Planning Review
Proposal: New -'749-P
4ver
erify site address/suite#exists and active in ermit stem.
Terrace Neighborhood: ❑ No Yes,See River Terrace Review Addendum Attached
SitPlan Elements:
V�J ree(3)copies of site plan WE ,.sting structures on site
IItoplan must be on 8-1/2"x 11"or 11 x 17"paper n Footprint of new structure(including decks)with finished
awn to scale(standard architect or engineer scale) or elevations
• rth arrow ''ty locations&easements(required for new and additions)
01to address,project or subdivision name and lot number haS dewalk/driveway approach
IBJ. .plicant information(name and phone number) I, L4 ation of wells/septic systems
FA • dimensions and building setback dimensions I': ,sting trees to be retained with drip line,and tree
II"�•uare footage of buildings to be demolished ' otection measures
Voi Lot area,building coverage area,percentage of coverage and V, treet tree size,type and location
pervious area(applicable if R-7,R-12,R-25&R-40) Street names
IIVProperty corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replac ? /Yes ❑ o
4 foot differential) If yes,is a storm water quality facility shown r ❑Yes No
can Water Services—Service Provider Lett (lo ot platted pReceiverior to 9/ d:
10/1995):
equired: El Yes,applicant was notified N
PP CI Yes ❑ No
Public Facili ' s Improvement(PFI)Permit: PFl'2O/e"0O/03
equired: Yes,applicant was notified ❑ No Applied For: Yes ❑ No,stop intake
01i2dsrid Use Case#: JbeQ.Q S --6DOD�
ning /� 62)D)
quired Setbacks: Front e Rear ^, Side Street Side ara e
P Requirement: o2
ndsca a Q % v �� �I g
�
Z'1
e .t Coverage Maximum: U
Building Height Maximum Height 01.P' Actual Height ,..'.. 0
JWisual Clearance
!] ....ensitive Lands: ❑ Yes �No Type
J Urban Forestry Plan
O Conditions "Met" or to 'ssuance of building pe. 't
Notes: 10 / 41/. 1. • ' 114--CF n Qr— 7L01 s
❑ Approved By Planning: — T ,ZIF Date: A.2_Ae//A
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved 0 Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw RES 061417.doex
r
Building Permit Submittal i
Original Submittal Date: ra 1 tS
Site Plans: #
Building Plans: #
Building Permit#: d Enter building permit#above.
Workflow Routing: h2' Planning R' Engineering Permit Coordinator 2" Building
Workflow Sign-off: g 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.
El/Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: ��- ��` a
..kms ...3, ..4.:, ,.�.;: 0-.. ., ., 2 o. :
Engineering Reviewc�
Ki-Slope at building pad: & d
❑ Conditions"Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
later Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes E. No
Assess Water Quantity Fee in-lieu: 0 Yes No
LIDA Facility on lot: 0 Yes No
❑ Final Plat Recorded:
NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: /A(ICC- Date: I 2—//V4
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
LI-)Conditions"Met"prior to issuance of building permit
�❑ Approved,NOT Released: Date:
Notes: 0Y-- 10 Wck.L.12 P`'r M tte, t 4G wI u hv► CIANaltiLelq. tC. Thic 1,01c(
Revisions (after Building Submittal only) "ft CAVAA MOCLL h'eS,.
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: &Yes ❑ N/A
LIDA ❑ Yes ciit N/A
144- OK to Issue Permit
Approved by Permit Coordinator: A76\i‘ v3
°&‘4°1/ —
Date: (2 11-7 )11
I:\Building\Forms\BldgPermitRvw_RES_010118.docx
,. •
City of Tigard
a COMMUNITY DEVELOPMENT DEPARTMENT
I
T 1 c A a D River Terrace Building Permit Review Addendum
`"' @_4t.T:4:.,Ar :, .'.r_:.a-z4.ti.7.,A,W. -- ,42-1 a -ts 1,.m. M a,,s, .=:uesdiw:,k', mr,,,Ay �„„... ..r3: wVis.-
Building Permit #: (Y��-C'a(;A ` a .
Site Address: )/1)1 / ,0 //e /q1,,.e__
Project Name: o %i ., (_is _ ,� ,_,, Lot #:
(New dwe •e �bdivision name;Addition or Alteration=last nam-Owner
Planning Review of River Terrace Plan Dist4ef Design Standards (18.640.070.1.):
Is the project subject to the plan district design standards?Vd Yes LI No
1.Articulation: a minimum of 1 element per each street-facing facade that has 30-60 ft. of frontage.An additional
element required for lots with over 60 ft. of street frontage shall be provided every 30 ft.
Balcony w/ access 2 Window Projection Vertical Wall Offset a
Porch min. 5 . deep Gabled dormer
ft. deep min. 2ft., 5 ft.wide min. 2 ft.,6ft.wide
❑ ❑ ❑ ❑
2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: //E' tQ v
0
3. trances:At least one entrance must meet both of the fon.. ' g standards:
'FA Parallel to street,angle no more than 45° from street,
Max. 8 ft. setback from long street- facing wall
or open onto porch
isqEntr nce opens to a porch: Yes El No
If es,all the following apply:
.ft.min.
ne street facing entry ft. max.roof above floor of porch
17, 5 ft. depth min. 30%min. porch roof coverage
4. P t iled Design:All buildings shall include a min. of five of the following elements on all street-facing facades:
in overed porch min. 5 ft.wide x 5 ft. deep El Recessed entry area min. 5 ft.wide x 2 ft. deepll offset min. 16 inches ❑ Dormer min. 4 ft.wide
Roof eave min. 12 inch projection ❑ f offset min. of 2 ft.
❑ Roof shingles either tile or wood VGable,hip or gambrel roof design
❑ Roof pitch oriented south min. 500 sq. ft. ❑ Hyrizontal lap siding min. 3-7 inches wide
❑ Accent siding min.40%of street facadeindow trim min. 2 1/2"wide by 5/8" deep
❑ Window recess min.3 inches for all street facing ❑ Bay window min. 5 ft.wide by 2 ft. deep
❑ Balcony min. 5 ft.wide x 3 ft. deep with inside access ❑ Attached garage is 35%or less of street facade
. •es and Carports:May face the front or side t line on a corner lot.
Setbacks: Pr
No closer to front or side o - an longest street-facing wall. ❑ Yes ❑ No. ''e Check one):
❑ May extend up to 5 ft.if there is a cover-. .nt porch and garat- e:- not extend beyond the front porch.
❑ May extend up to 5 ft.where the garage is part of a . - -• •r building and there is a window at the second story
above the garage that faces the street with . • area of 12 sq.ft.
Width: (Check one)
❑ 12-foot- :,- •. age door ❑ 40%max. of street facade
i'o max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: -.L.-____________—_:__ — Date: h/f L//0
I:\Building\Forms\B1dgPermitRvw_RES_RT_121417.docx
FOR OFFICE USE ONLY-SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
lii
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
= Transmittal Letter
T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: - '`tiS l V 1 Rivy\Wnho DATE RECEIVED:
DEPT: BUILD/2\1G DIVISION
FROM: h mot v\ enV I V, JAN 3 2019
c` ` ' r F.�`1
COMPANY:
POI 1(i 0K ) kowtQS BU:�C,��CA �i ,
PHONE: '✓W V l!1 1i 0O By
RE: Lot (64— 1k4tAL1Q ` :. °u.. 1 MST20\b-00 2
rte •.. ess (Permit Number)
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: , Description::
Additional set(s) of plans. -A Revisions: lY'(•1/t .c gitL5la(2
Cross section(s) and details. Wall bracing and/or lateral analysis. D
Floor/roof framing. Basement and retaining walls. U 4) _
Beam calculations. ',Engineer's calculations. tA
X Other(explain): V 55 ( r�w t Vl S I G t'l D 5
REMARKS:
FO O ICE USE ONLY
Routed to Permit Tec ic,ia Date: (� Initials: h-A—
Fees Due:
❑ Yes o Fee Desc ipti n: Amount Due:
, $
$ )(2. -" --
N) b N..) _
„,----'
$ 1
Special
Instructions:
Reprint Permit(per PE): ❑ Yes No ❑Done
Applicant Notified: `ky- Date: 112_37 Initials:
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
Plumbing Permit Application ,
Building Fixtures Am,;t' °. .. FOR OFFICE USE ONLY
1111 City of Tigard L!l 1. 1, 9 01 J ed G �; Permit No. ���
q 13125 SW Hall Blvd.,Tigard,OR 9722 Date/By: ,1`-''t4 ;T ` -v`'3
Plan Review
Phone; 503.718.2439 Fax: 503. 9449,,(70:.y l p , ^ t e t Date/By: Other Permit No.:
Inspection Line: 503.639.4175
TIGARD Internet: www.ti and-or. ov '11J€ a!4i(-' r 4�,+f ti!„E °' DateReady/By: kris: ET See Page 2for
g gNotified/Method: Supplemental Information
_, ,. 4,,J :',,,•�` T,,.YP.E,OF WORK
' , - , <,f.hw,FEE* SCFIEDULE :"
s
®New construction 0 Demolition '��% For in ormation use checklist
special
ADescri.tion • . Ea. Total
0 Addition/alteration/replacement 0 Other: v '! - ew 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building ®Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOBS;SITE INFORMATION AND LOCATION `' ' Site utilities:
Job site address: k i(Lit/q 1(pct--n-t. P-i' Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.:i) Page 2
Suite/bldg./apt.no.: Project name:Roshak Ridge Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
�?
Subdivision:Roshak Ridge l Lot no.: b Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
,,� " �� "�n c} Clothes washer 25.02
& kf- v-vIJl4* R t3\/` V "-HJT �t 0^ 065'52--j'2-_ Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY.OWNER. I 0 TENANT , , , Expansion tank 12.51
Name:Polygon WLH,LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:703 Broadway St.,Ste 510 Garbage disposal 25.02
City/State/ZIP:Vancouver,WA 98660 Hose bib 25.02
Phone:(360)695-7700 Fax:( ) Ice maker 12.51
0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:Polygon WLH,LLC Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Tonja Morris
Roof drain(commercial) 12.51
Address:703 Broadway St.,Ste 510 Sink/basin/lavatory 25.02
City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54
Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51
E-mail:permitsubmittals@polygonhomes.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:BDL Plumbing LLC
Water piping/DWV 56.29
Address:PO Box 85 Other: 25.02
City/State/ZIP:Corbett,OR 97019 Subtotal
Phone:(503)351-3903 Fax:( ) Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lic.:180345 Plumbing Lic.no.:PB1582
State surcharge(12%of permit fee)
Authorized signature: 0,.
'r """ ide TOTAL PERMIT FEE
Print name:Brandon Lanter Date: 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(I0/02/COM/WEB)