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Permit . CITY OF TIGARD MASTER PERMIT ' COMMUNITY DEVELOPMENT Permit #: MST201000026 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/17/2010 T IGAAD` 9 Parcel: 2S109DD09900 Jurisdiction: Tigard Site address: 15589 SW RAPHAEL LN Subdivision: BELLA VISTA Lot: 29 Project: Bella Vista Project Description: New SFR. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First 1502 sf Basement: 0 sf Left. 5 Parking Spaces: 0 Height: 30 Bathrooms: 3 Second: 1065 sf Garage: 451 sf Front, 20 Smoke Dwelling Units: 0 Third', 0 sf Right 5 Detectors: Yes Total: sf Value: $281,154.56 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach 1 Laundry Trays: 0 Rain Drain: 1 Catch Basins: 0 Lavatories: 4 Dishwashers: 1 Floor Drains 0 Sewer Lines: 100 SF Rain Other Fixtures: 0 Tubs /Showers: 3 Garbage Disp: 1 Water Heaters', 1 Water Lines: 100 Drains: 100 Bckflw Prevntr: 0 MECHANICAL Fuel Types Air Conditioning N Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Fum <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Fum > =100K: 1 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 addl 500 sf: 5 20 1 -400 amp: 0 201 -400 amp: 0 1st W/O Svc/Fdr: Limited Energy: 401 -600 amp: 0 401 -600 amp: 0 Ea add Br Cir: 601 -1000 amp: 0 601 +amp- 1000v: 0 1000 +amp /volt: 0 ELECTRICAL - RESTRICTED ENERGY SF Residential Audio & Stereo: Y HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: Y All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: Owner: Contractor: Required Items and Reports (Conditions) RIVERSIDE HOMES INC RIVERSIDE HOMES LLC 1 MST Ersn Cntrl 503 - 681 - 4444 1300 DEXTER AVE NORTH #500 17933 NW EVERGREEN PKWY 370 2 MST Other Report Geotech signoff required SEATTLE, WA 98109 Beaverton, OR 97006 PHONE: PHONE: 503- 645 -0986 FAX: 503 - 690 -2942 Total Fees: $16,137.31 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. ATT • • ': • -gon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -00 6010 through OA 9 X01 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800 332.2344, Issue. - i ' Permittee Signature: k 27. ee a CITY OF TIGARD "-, ; SEWER CONNECTION PERMIT COMMUNITY DEVELOPMENT Permit #: SWR2010 -00026 Date Issued: 06/17/2010 TiGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S109DD09900 Jurisdiction: Tigard Site address: 15589 SW RAPHAEL LN Subdivision: BELLA VISTA Lot: 29 Project: Bella Vista Project Description: Connect new SFR to sewer. FEES Owner: RIVERSIDE HOMES INC Description Date Amount 1300 DEXTER AVE NORTH #500 Sewer Connection Fee 06/17/2010 $3,600.00 SEATTLE, WA 98109 Sewer Inspection - Residential 06/17/2010 $35.00 PHONE: Contractor: PHONE: FAX: Type of Use: SF Class of Work: NEW Install Type: Line Tap and Building Sewer Fixture Units: Number of Dwelling Units: 1 Total $3,635.00 Required Items and Reports (Conditions) 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 -0100. You may obtain a copy of the rules or direct questio C by calling 503.246.6699 or 1.800.332.2344. Issued By: Permittee Signature: € l/�.aT1.�' � C Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 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. uilding Perm i Residentiail REC EIVEr' :: ',41:`,7"'...,14:,, . ;A„-. .,",:r ,1,1,;,, %VW -'-''. ,`,.'"-/ • ' 4:;',:tlit'"`":4=yv,a,, vIA-1.4 - to ti 'OF Pi 6•Fi'll5F'ON1 VP , '" ,11- 'W' 4 ' . ' "v ' ' - ,'. ..,e4t4 , ,• . •t;,: , 4*.:..?.tg;,,,t i •-; 44.4e.ai ffr14 City of Tigard • Received l'eri I mt Nonit OCGar pi 1 ' 13125 SW Hall Blvd.. Tigard. OR _97223 111 Date By. FEB 1 20i , 1 an iew p k , , u ' an 0, , , , fil-4, >i Phone: 503.639.4171 Fax. 503.:s98.11mo Dai, 1, # 0 ()the' Perm'. Ilir fp- • Au . FE Se 2 for alr&kito' Inspection Line: 5(13.o39.4175 CITY OF TIGARD N 3/ 4/ 1 ti Internet: w%.vw.tigard-or.twv • •C? Supplemental Information BUILDING DIVISION TYPE OF WORK REQUIRED DATA: I- AND 2-FATVilLY DWELLING New construction 7 E Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all 0 Addition/alteration/replacement E Other: equipment. materials. labor. overhead. and the profit for the work indicated on this application. CATEGORY OF CONSTRUCTION -481 61 71_ and 2-fam m Valuation: S ' ily dwelling 0 Com ercial/industrial • ..€1 - 0 Accessory building 0 Multi-fam Number of bedrooms: il Number of bathrooms: 0 Master builder 0 Other: 2-',.. JOB SITE INFORMATION AND LOCATION Total number of floors: 3 New dwelling area: 2s, square feet Job site address: / 558 53' 52() / e / 5/. 7 0,094:: Z . City/State/ZIP: OP4e0 , 4 ie 9 ? 021/ Garage/carport area: .4S7 square feet Suite/bldg./apt. no.: Project name: &gee,/ 1//' 7 Cohered porch area: f. square feet Cross street/directions to job site: e o fee/ r ..,4qedi 46 ie.0 . Deck area: e...) square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL-USE CHECKLIST I Subdivision: e'. e-- A k/C, 77k Lot no.: „,..2fy 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: S Existing building area: square feet ,• New building area: square feet /PROPERTY OWNER 0 TENANT . Number of stories: Name: A /OE 6-n /z/c . Type of construction: Address: / 9133 iv 4-_- i i. - ..k ki i i 3,24 Occupancy groups: City/State/ZI P: 6 VOX 72)/1 2 .1/24:2. Existing: Phone: (se,3 404/•. ey,g‘,,, Fax: (6 4 ,.:74, 4 , „?e, 1 / 2 ._ New: 'pr APPOCANir ' .: 0 CONTACT. PERSON - . • - - • • .NOTICE . : . • . .. Business name: if— AA /1 All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board Contact name: U-/A . evA./...c.-;,e under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the applicant is exempt front licensing. the following reasons City/State/ZIP: apply: Phone: ( ) Fax: : ( 1 1 DT 3 (0 -1 q atI / : kY3 E-mail: - 7 ; 36i)4 ‘ 5e11. 7 4(7 - t erY,Vi - 15 , 14 / 1■ 0 01-4 i 8 I 1 (43 ( QUalk : iiL5 Business name: " S AA. • ‘'. .. (81111ILDHNG PIERIWT • ' : 1 .. .: ' . refer to fee sebetliek . . . • . ... Address: Structural plan review fee (or deposit): City/State/ZIP: FLS plan review fee (if applicable): Phone: ( ) Fax: ( 1 Total fees due upon application: CCB lic.: Amount received: Authorized signature: c--- ( . 2/ Z------■ This permit application expires if a permit is not obtained Print name within 180 days after it has been accepted as complete. : 1 9 /4 4 . , ,,9 ewe : /0. /9 * Fee methodology set by Tri-County Building Industry Service Board. I:\Building \ Perinits \ BUP-RES PermitApp.doc 10;01/09 440-4613T( I 1/02;COM'WEB1 Plumbing Permit Application RECEI Building Fixtures � . .a r 7 ! . Ai,,,' ` t I'y { �Ft� .,F 0 NLti "; 4 y M+ � , f f Mr � . = �`�e '�_ v� r-.• , c , ,,:17.- a,.�t f'r� ., ...:f .M. � f � t ° �r '�°`[ � + Received ,..�'- ,�c.�-hv .1 �t +z��.1 .J.., r�,. r ,, City of Tigard FE 1 8 2010 Date 13, Perini( No ry1 . l / 'a 13125 SW Hall Blvd . Tigard. OR 97223 I /����� ' Q 00 �IQ . 8,. flan Itevief+ 1111":;''' r . :, Phone: 9).1 i + )thee hermit No.'. � ` � - OF TIG Date I3, Inspection on Linn: 5(13.639 Fax 503.5 TyI:CxA. g t- b BUILDING DIVISION Delc Read\ 13• 1,,,i See Pare 2 for , `+, Interne(: �sw\\*.II'ard- or.'c'v Notified P1elhod. S Supplemental Information TV PE OF WORK FEE* SCHEDULE For special information use checklist. Nev, construction ❑ Demolition P f Description Qty, Ea. Total ❑ Addition /alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 Ii. life each utility connection) CATECORV OF CONSTRUCTION SFR (1) bath 312 7(1 71- and 2- fancily dwelling ❑ Commercial /industrial SFR hash 437.72 SFR (3) bath d 500.32 WO : 52 ❑ Accessory building ❑ Multi - family Each additional bath kitchen 35.(12 ❑ Master builder ❑ Other: Fire sprinkler ( sq. 0 ) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: `�� d � C � /�� / /' / Catch basin or area drain 18.76 .76 Job site address: / _ 7 � j � / 5 ,!� `'` L -�'/ Dry yell. leach line. or trench drain 18.76 Cit■/State /ZIP: / // L) ae '2 2 Z2 � / Footing drain (no. linear fi_: ) / Page 2 Suiteibldg. /apt. no.: Project name: ,6:6 Manufactured home utilities 50.03 Cross street /directions to job site: Manholes 18.76 Rain drain connector / 18.76 Sanitar sewer (no. linear 11.: ) / Page 2 Stone sewer (no. linear 11.: ) f Page 2 '/ Water service (no. linear 11.: _) l Page 2 Subdivision: 6ttGA Yes Lot no.: oP / Fixture or item: Tax map /parcel no.. Backllow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer / 25.02 Dishwasher / 25.02 Drinking fountain 25.02 Ejector's /sump 25.02 'PROPERTY OWNER • I ❑ TENANT Expansion tank 12.51 ` l e/ 1 ,oF / Li (/G • Fixture %sewer cap 35,02 Name: Floor drainitloor sink hub 25.02 Address: i ? 3 j ,4 j ��i�`7 37e) Garbage disposal 25.02 City /State /ZIP: 8 V 7A ° )'7 Hose bib 1 0 .Z 25.02 Phone: (5OO 4 l 5 407,6i Fax: 6 6,494 9 Ice maker 12.5) • APPLICANT • .. . ❑. CONTACT- PERSON, Interceptor /grease trap 25.02 Business name: a y Medical gas (value: 5 ) Page 2 �/1 G Q�� Roof 12.51 Contact name: �l `e- ��Ktt ////'7- Roof drain (commercial) / 12.51 Address: Sink /basin /lavatot)(',, 1 ,C..) q 25.02 City /State /ZIP: Solar units (potable water) 62.54 Phone: ( ) Fax: : ( ) Tuh'shower /shower pan 12.51 mail: Urinal 25.02 E - �a) ,4jaylxr � ,0/ile, e_o.� 3 ONTRACTOR Water close) 25.02 Water heater i 37.52 Business name: 6/.;■-tf /17�.Xiiaif Lt (/ Water PP g r in DW \' 56.29 J Address: TN 7 7 f Glii // /, t Other: 25.02 City /State /ZIP: ri,-7/! -✓„0U k rDJL_ 7L G 7 Subtotal Minimum permit fee: 572.50 � Phone: (Soy') q 7S -. t'J 7 F-7 Fax: LC67_7) 6``"c7 '. G l 7 7 P' y �0� . Z Plan review (25 °o of penult fee) CCB Lic.: / 7 / _ Z Plumbing Lic. no.: Ts 4 / 1 ' / State surcharge (13 °io of permit fee) (4,0 Authorized signature TOTAL PERMIT FEE 6G® This permit application e\pires if a permit k not obtained kithin 180 days Print name: !/ J r�ir / 6� Date: after it has been accepted as complete. 'Fee methodology set by 1ri- County Building Industry Service Board. 1 Building l'rrmit, P1 511' -Per App. doe 1(101 09 440- 451!■11 / u 112 ('U\1 WEB) 12/16/2669 16:46 563656369E CENTRAL AIR INC PAGE 62/62 F rom: A }�� 12/09/2009 09:25 #443 P.0021002 • • RECEIVE „ "�'`r'!F- "Si.r` f'>F ' v r Y. c s v r .•>, " � Wrc �. li�lechan Per mit Applic�ti ®� I 1 , 4 , o iai t ^k: (),,kil` ' , .; `' ; ' ; City of Tigard FEB R. m r 1 ! LOIN l)au u, : PcrnlitN. • - 4r 1 ” 1 't 1312$ SW Hall Bled .?i trd. OR 1 )722) �� �( P I run R. 8 �: \y, Phone' 503.0 41? FA, : ?113.59) I ahl on OF TIG�1R Oak: If, . olive, 110,1.1. of > d fwt" i InsPccul Lint:. SI I3 .n39 175 Darr Reed' N )vnr. ®tint Pat(? (o, ' we; In■one•I 1 ' et.tig,tnl_, ., BUILDING DIVISI N''''''' ''<''''''' Supptemestat Intara,anon Ye'7ew�r' t� .r ty,, "` � rte, r,�7 c t ` G. .0 r.4 i • fi+ I'vy eFi'i '�c"'';,, �i ((``�,�.+t M ' r eta t ! .'tri.MY --y R '�' * I y . e t , - 1 . +. • ] C: 1 , r i t St ], r a ht "t.d:..3`:+ �iG� �. S,�S.M : 'a lie �• fa�%� I �X�icir J.�,�4. : " � Ut��S!, •' - � � .5�., •J..'a::; "S•.G� hY,c a.W � r.. �!� Mechanical p.rnnt 1e •e are tad on the vntur o1 the nv N/ Nr,t t;ol1 <Ifuetil ❑ Addieitmraitcl ntionnrplarelnunl performed Indicate the value Imundc'J to the nearest dollar/ Itf aII 1 0 Denlnlitltin ❑ Other: am:har re al mal 0 0)1Eent. leMn. t , d an n tit. Fmf• +"1ppyps��t�,'`'tt�� use nrF���ci rcfly'e7�f � �./.r�Fat,���p'. Yulue 5 eY w s'1sr�'7F;creli<'. L '*m*.'.rcamEr, . '.7,1c.�Lt`'f z t, "+'Y' -'S,'u 4•y t( rJR it'Y.FF : J- �\ . .. �,,, { � } a,et� ` t�� L � t ,FYi� r Jr; (-1{,, II.�l,' :A.AA35.`11,(' ,'ttc?.y..Y�7J•ti 0, . .s� 11. . -.�.f. /% ad 2- ,seen,)' d,l'elling ❑ Cnnranert:lal'industrlal ❑ Act.esson• building r„,• y >rctrd inlnrnKUion us, (-be, k!j. r. 0 Multi family ❑ MaFtcr builder 0 Othu: pe cnpuon Qty Eli /'Dial t n r. mar r a, 1 r w C a m �c, O ; ;,$ °...4 a,f Iii. a/i � ,\itl T.;�. Ql� + 'aW { - '.�',A},.^t`A:':'S .MS+.,..: I Heaths 'ooIin� -- ` , / �, ! Ai, c,,ndillon Sddres S. ssv 5a) ��• /� IIDJUin• •iu ran ng �bml my •IHectU.'nll _ Job ite a Cit■/State %21P: / 9'22-0 T� to ' Furnace I00.000 BTU (nucts t cm 1 M- 46 75 ' , • it / - j Fulllncl' )(10,000+ )(10,000+ BTU Idlnl- .,eau) 1111111=111 Suite ;bldg.'apt. no.: 1 Project Ha nle: i .� ��, l� I Heat rump o1 On Cross streetidirection5 to job silt: ` ' Uurt wn:i _ - H dnmic hen wales s steal w 23.32 IM _ Residential boiler mtcliator or I h •dlnnk) 23.3' - 4 Unit heater: (fuel - lyp. not electric I. 11111M in- wall. In -duel. su. )ended, etc. a _ 11.111M1 — Flutn'emt far an of ;Aloe ya - Lotna Other. Tax map/parcel no.: Other fuel a /��\ p a . ; � y G� > v,rgp. �,r,)}•,A t F:�` � ti � a b Wal , t/ )teal t:l.. 'fiances 23,32 �____ MIN I�' �r *'''�:L. '.�`isc�,s �:f'1�'l�b.�_ r)� L •iy. �` )a L�.:..';_.: :]?:. u::, , �, u: L Gas fir: )�cc f! 3t 19 -/ Flue vent lw water healer 01 gas tiro lace 23.32 Lc) li•htert; 23.32 IESMISI 33.39 ICEEMSENIE 23.32 Mil tit - �r;^r Yom { •n �. ,�{e w u Kr" c r rt ° R r' r On inn /linerf)u'/vem ME 23.12 IIIIIII !•'YF 1 a. Ir f Ft J 0. f 1z i ft1 t,.. F /•.: . ate' r E h l , r { r( , 1 1111111113211 Of.:Ii 4 y&t c.c :2 .z� z�,..:�1! ->.S L• .t1, hr :4;. , ....r _rcts.: t., fix Qthti: ?)aide: `. / ‘625 - / / tees, / . Environmental exhaust and ventilation Address: 1°713 3 N� Ev �A� p�v 3 I:,mgehottl4xhykitchnt 1 �a e•uitmcnt 33.39 CR � / 33.39 Mitt Ciry,rStatrlZlP: r� / ®�f� Singh:Aix, exhaust(bathrnoins. Phone: ..ea ' 5 ,■' Fe " y lo 29 '- Z_ milt/ corn - limalls, utilil' moms) Pil 23. Lll O f y rc.,7 r �� 'w• r,3'F / > f � " : I. r . , ny 1 sl - : � T .!....!,:,,,..,,- , y , 7 - r t ; AtliCicruu9s •ace flub 23.12 k i f y 4 :x , 'e ',1 t r ' � l 1' 4 1 1 G .. ,. (. d.: ,�� c- �..SS.•_:r'�x i._:.''Ld, - .� ?w ;' : ._,1 ■ . .: , 'A ( S ^ Other: 23.32 IIIIIIIII Business name. / T k Fud •i •in: Contact name: ^ �(L[_ � $14,5 for first four: $4.03 for oseh additional Address: _ MIME.. City/State/ZIP: I wall /suspended /nit heater .. Water hinter MIE Phone:! 1 Fla::( ) E mail ..,c i9 445 i 51 f r .pc1. j ..7 ,. ..�. sk • 777 fc Ir ¢a �C ^, ° � / ;k,, •�. /� l ti',• 'r �, ,, t ,, 1 . -. ....._lei! r..2s..,; ., ,. r., i. T,3t,o,... . - Clothes d) cr (:as) Business name: CossTejoa c . Other Mr Address: •-o 3 ,a,, r.:rk t l jl T r' s t i {�� . . L�..l<!". ._G _.,. sic=.. _.� -... .... ..,.... .__ +;:, 5, ._.: Cit /Statc'ZIP: CCAC..A , 5 c ' •?O � Subtotal WARM e / Q / MhUtn alt permit tit (SQ0.00) Phone: ($s3 g,Sa st0 1Qes Fax: ( S 1 C7 � "zs q is Pon review (:!94 ol'pennit teal CCB lit.: 6.1 t{ ___ TOTAL PERMIT FEE - 7. 10 Thh permit appllnnunexpire. It , uI notobtal mlthin tau Authorized signature: - ds)a after h hat been artepzM ttF traaplete• Pfi111 name' t Date: fa f �e/ o _ e ):•v whon„lno n•l by Tn-Cotitlt) BuiI1inc Initmlry Set iet Doti d 1: n„malnp 1.0 me, ■1F.r- f. 1001 Ir, .101.4 1 , 1 o: en 1 a1;1.11 Electrical Permit Application RECEIVE -17: a t } 5 y l t i r .t`t ..` . ° . K , ` a k - y 4}, » Pi. ,, *��3' '` { � �� r � I w rw t'""� '� t, x • y � , .. •. . , / ()EEICE USE ON +, City ' 0f Tigard Recened ,� "' Date t3 +: + a 1 3125 S ' Hall Bled.. Tigard. OR 9 7223 FEB 1 '� nj flan Rr+icu Dale �. tg 5 ((f Lf PhtPhone: (13.6i ).4171 Fax SIIi,59h.1 )till H■ Other Perrin: Tit R;A .RD Inspection Line: 5113.639.41 75 CITY OF TIGI�RD Date Readv R+ I ®Ste Page 2 for Internet: +'�+'+ +'.Tigard- or.g(n Notilird A1rlho0: Supplemental information BUILDING DIVISION TYPE OF WORK PLAN REVIEW New . �\+ incase check an 11101 apply (,nhmil 2 x•ls of plan: „ item, checked below): construction ❑ Addition'alterationv replacement ❑ Sr eice or feder -11(11 amps 01 more ❑ nuildinp I 1(I Three ,inrie,. ❑ Demolition El Other: nIicre the available fault current ❑ Marina, and hoat+aid,. CATEGORY OF CONSTRUCTION exceed, 10.000 amp, at 150 \oll, of 01 loating building,. Ie■ to ground of exceeds 14 -1100 ❑ (lunmercial -u,e apricultutal 71- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amp, fiu all other in,lnllalion,. building,. ❑ Multi - famil ❑ Nlaster builder ❑ Other: ❑ rile pm1tp. ❑ If :lanationof K\ A of JOB SITE INFORMATION .1ND LOCATION ❑ hnrergenc■ ,sstenr larger ,epaialel+ &Med,c, aent. l j ❑ Addition of 110\ 1110101 load of ❑ \- - 1 . -: - . ..I 2 .. l Job no Job site address: /5509 5-4) R %/,✓/ Z7 IIIl1H1' ur more. ,,„ �J'((//// ❑ Six or more rc >rdentinl unit,. ❑ Recreational vehicle park,. City /St at e P: / / / 6R T022 ❑ Health-cafe lacililie,. ❑ Suppl+ +ohage tin inurr tha r� / ❑ Hazardou, location,. 600 +oh, nominal. Suite /bldg. /apt. no.: Project name: 6'1._409 /, 5774 ❑ Service or feeder 60(1 amps 01 11101V. Cross streetidirections to job site: YYYY FEE SCHEDULE �� /A-1 21D Description I Qty. j Fee. 1 Total wW New residential single- or multi - family dssellinp unit. Includes attached garage. Subdivision: 6 C44,9 lb5 7-x'1 Lot no.: 4) 1.000 sq. 11. or less r 168.54 1 6 4 ��C Ea. add 500 sq. ft. or portion 5 33.92 Rp9, V) 1 Tax map/parcel no.: Limited energy. residential i . DESCRIPTION OF WORK (with above sq. ti.) 67.84 0 Olk 2 Limited energy. multi - family 67.84 2 residential (with above sq. 11.) Services or feeders installation, alteration, and /or relocation 200 amps or less 100.70 2 . PROPERTY OWNER ' ❑ TENANT 201 amps to 400 amps 133.56 Name: /e /V6e5/ 0e A1 /,� / /° • 401 amps to 600 amps 200.34 / /�G/ 601 amps to 1.000 amps 301.04 Address: /7/33 /t/a) ,e ei ( 3?� Over 1.000 amps or volts 552.26 2 City /State /ZIP: en r� eR -77vo & / Temporary services or feeders installation, alteration. and /or relocation Phone: SO 3 ,.y5 ®215.4,,, I Fax: 6031 4,9® c .2Q3+/2__ 200 amps or Tess 59.36 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2 intended for sale. lease, rent. `t' exchang' according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Branch circuits - new, alteration, or extension, per panel Owner signature: Date: Z A. Fee for branch circuits with APPLICANT I ❑ CONTACT PERSON above service or feeder tie. fff �� �� i each branch circuit 7.42 2 Business name: B. Fee for branch circuits without service or feeder lee. Contact name: � G L i - (/Ir// -f ��� lirst branch circuit 2 56.18 Address: Each add branch circuit 7.42 2 Miscellaneous (service or feeder not included) City /State /ZIP: Each manufactured or modular 67.84 1 dwelling. service and'or feeder Phone: ( ) Fax: ( �pI 1 ,,� A Reconnect only 67.84 E -mail: t�I(1a(0��. ® /� is B" /�e-p�' .? iteee /T//.0'I , G�j ,4,, Pump or in circle 67.84 2 ONTRACTOR Sign or outline lighting 67.84 2 Business name: Signal circuit(s) or limited- g _ :i _ - � �J ' t L - ' energy panel. alteration. or Address: • oa S lid �1 s �- � / • extension. Describe: Page 2 2 City /State /ZIP: 1 ' • �. ( Z -1_2 Each additional inspection over allowable in any of the above Per inspection 6625 Phone: (€ 3) 5 -z i Fax: ( 78, s -2/ e5 Investigation per hour (1 hr niin) 66.25 CCB Lie.: /n L-// c 1 Electrical Lic.: ,31-1-O6 C 1 Suprv. Lic.: Y6)., Indust ial plant per hour 78.18 Suprv. Electrician signature, required: " ELIECTItiC.#I. PER Subtotal: 1O5 . 9� Print name: �' 9 Date : Plan review (25% of permit tee): State surcharge 112% of'permit fee): y6 .1 Authorized signature: TOTAL PERMIT FEE: i51 f 0 1 P rint name: � e , vA-4 -' Dat This p ermit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Number her of inspections allowed pet permit. I: Buildin■ Permits I L('- PerntilApp. doe 10 01 59 445.4(151111 55 ON WEB Oregon Residential Specialty Code N1107.2 1I �L�j f 2vi O--ow � HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: Jurisdiction: MST Zo l o— oo®z(a. T► arci Site Address: i 5509 svJ Kafka d LA h Subdivision/Lot #: Ie.I Ia ' r _ 29 and /or l.l�T Map and Tax Lot #: By my signature below, I certify that a minimum of fifty (50) percent of the permanently installed lighting fixtures in the above mentioned building have been installed with compact or linear fluorescent, or a lighting source that has a minimum efficacy of 40 lumens per input watt. (Oregon Residential Specialty Code N1107.2) Signature: F4),,He D ate: g —f 5 — 7-40 Owner eneral Contracto IA horized Agent R ' ej— of e; L L c_ Print Name: L ee (() ' ORSC Section N1107.2. High - efficiency interior lighting systems. A minimum of fifty (50) percent o the permanently installed lighting fixtures shall be installed with compact or linear fluorescent, or a lighting source that has a minimum efficacy of 40 lumens per input watt. Screw -in compact fluorescent lamps comply with this requirement. The building official shall be notified in writing at the final inspection that a minimum of fifty percent of the permanently installed lighting fixtures are compact or linear fluorescent, or a minimum efficacy of 40 lumens per input watt. 1:\ Building\ Forms \RES- HighEfficiencyLighting.doc 07/01/08 Oregon Residential Specialty Code R318. MOISTURE CONTENT ACKNOWLEDGEMENT FORM 1, ) I veal S id e, pr es L Lc— , am the general contractor or the owner - builder at the following address: Site Address: 155si SW )n,pkie,1 h City: yird Permit #: MST 2,010- ©ocD Z c Subdivision/Lot #: Q[ i V l � Sick Lot- T 1 2 9 and /or Map and Tax Lot #: To conform with the 2008 Oregon Residential Specialty Code (ORSC), Section R318.2 and OAR 918- 480 -0140, I am notifying the building official that I am aware of the moisture content Requirement of ORSC Section R318.2 and have taken steps to meet this code requirement. [Section R318.2 is provided for reference]. R318.2 Moisture Content: Prior to the installation of interior finishes, the building official shall be notified in writing by the general contractor that all moisture - sensitive wood framing members used in construction have a moisture content of not more than 19 percent by dry weight of dry framing members. Signature: at( • Date: `- (�" 2 -'f 0 g � General Contractor or Owner- ilder /Ivusi rn es t.crL I: \Building\ Form \RES- MoistureSensitiveWood.doc 09/25/08 STREET TREE CERTIFICATION I, Lee Owner /Agent for R',ve.rsiri e _ dam e_s L L (- (PLEASE P ) i : ( PERMIT HOLDER) Do herebyi certify that the °following location meets City of Tigard land use and 'development standards for street tree installation. AA S F ADDRESS: 15589 SW Raphoel Lave- Ms 06 - 027 SUBDIVISION: 3elia V i s4-a LOT: 2 9 SIGNATURE: ELle / / DATE: 9 / S — to l (jJ -R/AGE RECEIVED BY: DATE: (CITY OF TIGARD) a I: \ Building \ Forms \Streetl'reeCertificate 01 /19/07 YA3V2 -0 o ' ooa r . / 5 9 ) /e. EL L.L R= 20.00, 257 -z___ L =4.41' RECEIVED S Z/ o TAN =2.22 � DELTA =12 °38' 35" FEB 18 2010 � ,Q /� CI OF TIGARD ('i) " i /4" BUIL, NG DIVISION % X i 7'. / 9F T� ST S 4 ,,,,,,_ wk.; ci- 4 /.1.4,, ..... ..: ...::. .. : .. • _ . /�� s •• •• • • 51 / ;,, . . . ... ( • • • •••• • ..... • -/-yee_.5 (O i ft* • ' . 4 , - .', f //\/ • 4 0 . t '1' 4* • . • -;/ '/.11i . 2- CV , i / ,... Al* , i .... . Dc / 1 OP ' , y -y , . 1 , / • , , 7 i / '. ' ' / , i , � o , •- , ` /" • a c c • •s. 22/ ., / . / 5 :14 \, ' • ' ' / u r `�o 4 / SURVEY r POINT Q N :'/ 0,. .--... S -. c C / Q f,, ,'• / F 5 a L .. a__, ; , / T X L /4f -- \ C_ 0 y r � 4 r./ o I c BELLA VISTA LOT 29 SCALE: 1 " = 20} { ENGINEERING & LAND SURVEYING , uESIGNED: PREPARED FOR: RJ 6 8835 SW Canyon Ln. DRAWN: RIVERSIDE HOMES /�V �/..4?" \ Suite 402 1925 NW AMBER GLEN PKWY, SUITE 200 - ® � � \� Portland, OR 97225 SW BEAVERTON, OR 97006 i CHECKED: 503) 645 -0986 C * �_I / 1 w H R J (503) 690 -2942 cc . � .� - ® \ �` DATE: 4 •, 3 (503) 291 -9398 6/20/03 (Fax) 291 -1613 J c. s f ' CITY OF TIGARD - SITE PLAN REVIEW BUILDING PERMIT NO.: Y1V3X2o • 00 00.( 0 PLANNING DIVISION: Required Setbac is: CrApproved ❑ Not Approved Side: - Street Side: From. ...L..‘_, i _ G rage: dy Rear: Visual Clearance: Appr ved ❑ Not Approved � Maximum Building Height feet CWS Service Provider Letter Required: ❑ Yes ❑ No 1 ❑ Received B : � A 4 ct- 2 rya Date: call r2J /0 ENGINEERING DEPARTMENT: • • Actual Slope: 2O % MApproved 0 Not Approved '..:.. • •••• • :..... Site Play: `'�'E p ® Approved J] of pproved • ...... .. By: Date: ?3 Go • • • • ... • ..... . • • • • N af s - •..... • • .... . . • . .... . .. •• •• • • • • • • • • ..... • •• •• • .....• • • . ..... .. •• ..... • ...... .. • • • .. • •••• • • • • CITY 0 TIGARD - SITE PLAN • VIEW BUILDING pRMT[ NO' roved ❑ t'° ed 0 S . ,; A v g • Not Not App Aw c Trees: P • • - • � _ Notes: a �� II _ % , r / Ie 3 1rttl$ T6ie5 — w