Loading...
Permit R MASTER PERMIT l' i . CITY OF TIGARD I n 4 � COMMUNITY DEVELOPMENT Permit #: MST2010 -00025 T f GARQ 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/17/2010 Parcel: 2S 109DD09800 Jurisdiction: Tigard Site address: 15605 SW RAPHAEL LN Subdivision: BELLA VISTA Lot: 28 Project: Bella Vista Project Description: New SFR. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 4 First: 1502 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 29 Bathrooms: 3 Second: 1065 sf Garage: 451 sf Front: 20 Smoke Dwelling Units: 1 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: 0 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 Furn > =100K: 1 ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits 1000 sf or less: 1 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add'l 500 sf. 5 20 1 -400 amp: 0 201 -400 amp: 0 1st W/0 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: 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: 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 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. 10 : O e on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -0 -0010 through OAR 5 . 011 '10' You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issu By: '` PermitteeSignature: lC E Lee_ ./4." - r rry"4 CITY OF TIGARD SEWER CONNECTION PERMIT ,,,,g,- q '1` . ffi - COMMUNITY DEVELOPMENT Permit #: SWR2010 00025 , Date Issued: 06/17/2010 - cARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 t t ,, # ,,, Parcel: 2S109DD09800 Jurisdiction: Tigard Site address: 15605 SW RAPHAEL LN Subdivision: BELLA VISTA Lot: 28 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 S3,600.00 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: 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 questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued ( I .. ( e�! / Permittee Signature: ) / q / p 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. Building Permit Application Residential P F ( ' CI r P ; , ' ; r , _ s o =N _ ,,,a lam ` grfAtIM . r✓ ) L a - .._ Re City of Ti and Permit o.: - ' sF; , 131?5 SW Hall Blvd.. Tigard. OR 972 3 Date 'By: � U p /i�TZ61 • �6 2 t FEB 18 2010 I'.an Re,;e ►, 41. tt r y , Phone: 5(13.639,4171 Fax: 503.59x.196(1 ��r� k 1� other Pcrmi}eJ k? fi` 7x"' Inspection Line 503.639.4175 Date Read, � F1ri, i l A I I G A K L�, Y n p 1 1.-b � ® Sec Page , .for ?atiiik F?ili www.tigard-or.gov w.ngard- or.gov CI ► OF I IGARD Noti(iecl.Method:. -) • k 1 Supplemental Information BUILDING DIVISION to — 6A r • 41 ,,,e)( - . _ , TYPE' OF WORK REQUIRED DATA: I.; AND 2- .4M1LY DWELLIN( , / 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. /I- and 2- family dwelling ❑Commercial /industrial Valuatiol ( �, ❑ Accessory building ❑ Multi - family Number of bedrooms: f ❑ Master builder 111 Other: Number of bathrooms: JOB SITE INFORMATION ..4ND LOCATIO ' Total number of floors: 3 Job site address: / 5 a, j 5-4,..) Ai/v E _ 4:t /• New dwelling area: '25o,7 square feet City /State /ZIP: 7,6 , D,e 9' 72 .21/ Garage/carport area: 4S square feet (o(' _ Suite /bldg. /apt. no.: Project name: ae&e4 l/r ' T74 Covered porch area: f3 square feet 1.5O 1 . Cross street /directions to job site: .6. Ze".1 -46 jg Deck area e2 square feet Other structure area: 2q square feet -UA� REQUIRED, DATA: COMMERCIAL USE.,CHECKLIST . Subdivision: et Llq 1//S Lot no.: 2_€ 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 WORE Work indicated on this application. Valuation: $ Existing building area: square feet New building area: square feet ( PROPERTY OWNER ❑TENANT Number of stories: • Nance: ) ,9j v / ,0E .Aten /iiG . Type of construction: Address: , 9 3 3 Am) �v / 3/ )Lf 3941 Occupancy groups: City /State /ZIP: /, 66AV 42 ' � ,/ Existing: Phone: (5a3 , °� et s • /‘j Fax: (s7CV CO316 d OC 7 7 New: ..:. - • ' pr APPLICANT ❑ CONTACT PERSON.. ` -. : ' NOTIC E Business name: //5 a 4 All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board /LL ,qh�/�/ under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City /State /ZIP: applicant is exempt from licensing. the following reasons apply: Phone: ( ) Fax ( 1 E-mail: 73u)a Dnfz, rl Pt V ei ie—ho . cp44 `e CO ACTOR Business name: ".S A 4 ,, BUILDING PERMIT FEES° Address: (Please refer to fee setednk� . Structural plan review fee (or deposit): City /State /ZIP: FLS plan review fee (if applicable): Phone: ( ) Fax: 1 ) Total fees due upon application: CCBIic.: �� 4----..5---a,.( Amount received: Authorized signature: This permit application expires if a permit is not obtained l /� within 180 days after it has been accepted as complete. �/ Print name: GL '��, D!4/6� Date: /7/ * Fee methodology set by Tri- County Building Industry Service Board. I:A Building \ Permits \BUP -RES PennitApp.doc 1(1 %(11/09 44(1- 4613T(I1i02/COM,WEB) •• Electrical Permit Application FOR OFFICE USE ONLY City of Tigard Rte11\ed Permit No.: g FEB 1 8 2010 Date B\: (�Y1 V2010 - o0O , 13125 SW Hall Blvd.. Tigard. OR 972_'3 flan Rr+ic++ O Phone: 503.639.4171 Fax 5(13.591.19611 Other Permit: Date t3\: TIGARD Inspection Line: 503.639.4175 CYO G> .... ;T•4: ai Date Ready 11): lures ® See Page 2 for Internet: ww\v.11 or.go\ :'i , . p +-;Fx r'+ •'7r,,.+; Notified Methud: Supplemental Information TYPE OF WORK PLAN RE%IEW New construction ❑Addition altciationn'eplacement Please check all that apply (submit 2 sets of plans tc items checked helm. 1. ❑ Service or feeder 400 amps or more ❑ Building over three Nunes. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boat\ardr CATEGORY OF CONSTRUCTION exceeds 10.000 amps al 150 \olis or ❑ floating buildings. less to ground. or exceeds 14.000 ❑ (lnnmereuiI -use agricultural p i r 1- and 2- fancily dwelling ❑ Commercial /industrial ❑ Accessory building amp, for all other installations. buildings ❑ Multi - family ❑ Master builder ❑ Other: ❑ Inc pump ❑ Installation of 75 KVA of JOB SITE INFORMATION .YIVD LOCATION ❑ hm h ergenc+ system larger separate clerked s■stent ❑ Addition of new motor load of 1(16 no.: I Job site address: /,5 � ,�A ®/ I( is mars. urcupani■ ❑ 1111 , �`- v ❑Six O r more residential units. Recreational +chicle parks. City/State/ZIP: �6 /LL� O ? � / �22� ❑ Health-care facilities. ❑ Suppl■ collage tin more than /T� ` ' \ n - 1 / ❑ Hazardous lucahuns. 6(1(1 volts nominal K e, Suite /bldg./apt. no.: I Project name: C ❑ Service or feeder 600 amps or more. /� ��'.........XXXiii / � d 1 / j / YYY! t� FEE SCHEDULE Cross street /directions to job site: /s -Ec /-it /Q 20 Descript I Qx• I Fee. l 'Total l z ��..7�4 �L l�L NC% residential single- or multi-family dwelling unit. Includes attached garage. Subdivision: 6t/,4 11/5'77 Lot no.: c ,2 . g, I.000 s ft. or less j I 165.54 1(t8.� - 4 Ea. add 500 sq. ti. or portion 5- 33.92 167. ( 1 Tax map /parcel no.: Limited energy. residential DESCRIPTION OF WORK (with above sq. R.) 67.84 67. Limited energy. multi - ti 2 67.2{4 residential I with above sq. ft.) 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 2 Name: , /c/ ' S/ e 146 $ /. /G' . 401 amps to 600 amps 200.34 2 ,v /� 601 amps to 1.000 amps 301.04 2 Address: /7133 /yak Eve iez e.,/ i y 3 b Over 1.000 amps or volts 552.26 2 City /State /ZIP 45"64l/ 7 --, t i dR 477i�& Temporary services or feeders installation, alteration, and /or relocation Phone: (5 03 ‘,15 Q,g4,„ di Fax: 603) ..90 02.9 �� 200 amps or less 59.36 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 40(1 amps 125.08 2 intended for sale. lease, rent, or exchang' according to ORS 447, 449, 670• and 701. 401 amps to 599 amps 168.54 2 Branch circuits - Hex+, alteration, or extension, per panel Owner signature: / (.( Date: Z i A. Fee fh• branch circuits with e gr APPLICANT 1 ❑ CONTACT PERSON above service or feeder tie. i each branch circuit 7.42 2 Business name: /iC A� e B. Fee for branch circuits n'1!lr0ui service or feeder fee. Contact name: 56.18 2 1jt/ c)".i6� first branch circuit /L L fi Address: Each add'l branch circuit 7.42 2 Miscellaneous (service or feeder not included) CityiState /ZiP: Each manufactured or modular 6784 2 dwelling. service and 'or feeder Phone: ( ) Fax:: ( ) Reconnect only 67.84 2 E -mail: �/o)a . 9. il Ve h/pite g 60 rt...( Pump or in•igation circle 67.84 2 ONTRACTOR Sign or outline lighting 67.84 2 name: Signal circuit(s) or limited- Business Ha SZ f eeY^ 9 . VC( il r t energy panel. alteration. or extension. Describe: Page 2 2 Address: S 111,441 ,s`�' / City /State /ZIP: t' 0 7 Z -a__"3 Each additional inspection over allowable in an of the above Per inspection 66.25 Phone: (563) 5 -7 / O i Fax: ( ) s� e 57� Investigation per hour (1 Iu min) 66.25 CCB Lic.:/ 3 y c Electrical Lic.: ,3L/-06C Suprv. Lic.: Y6)_ Industrial plant per hour 78.18 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: g Print name: ,..�'.'C a 4 Date: Plan review (25% of pennit fee): State surcharge (12% of pennit fee): ioee, '72 Authorized signature: TOTAL PERMIT FEE: iii--.5 7 d Print name: 5 c This permit application expires if a permit is not obtained within 180 �� Date: days after it has been accepted as complete. Number of inspections allowed per permit. 0 Building Prnni(s Fr('- PermiuApp.doc 10 01 (1 440 4(1 u5 ('0x1 \ \'ED 12/10/2009 16:40 5036503898 CENTRAL AIR INC PAGE 02/02 From: 12/09/2009 09:25 #443 p.0021002 Mechanical Permit A p, : 6 „.; .fr oa c,I 1•.I ,,T,„, F 1) : m 4, ,_ F11 t; v ,,,,,,; r'^' v,,r : 1..,..c. .S-ats +R .1 ° .„t a4..... „1 m s s . r ' ' Cit\ of Tigard n uay: lyli) 2616'owZ(9 now y: Pannll v.,.: 1315 S11 Hall Bbd . Tigaal. OR 97223 FEB 1 2010 Pu+n tic, ian 4+1 1 Phone'. 503.619 4 171 FAX: 503.595 Whll pate 11:•: Other Pennn: 1 : Inspection trine 51))M39.4 175 CITY OF r IGARD Dale xeed lB : tun H tiro Prig(' 2 for 1It tl t,' 4 - 1# Internet www nyu+d 0+ 3m 1)t r A 1 01 14): wuylam, atal lnfnrA BUILDING DIVIS ON y li`w�'S" rY+P�1 ,�, F�i,n. 1�� ��( RM. � f t W � �} � ���� 11 �KJ ] t JRls It"r +.C'r�""F',!-. 1 rr: �t[i•. j r C r f l 1 1' a � i `ti ,u r^` ��tJyl :7,41LIl t a ,t.�'n�uI�tl" d ...,• .:15'it:, � .r i' *, .Z. i gXdPa ., + h.au „_ ',,S'�v A J W t .. J. y; mechanical p.rnut live" arc based on the value claw wtn k 11 co118trui:tinn ❑ Adtliti [ntralicratinniteplacCmen[ performed. indicate the value (rounded to the nearest dollarl01 all ❑ Demolition ❑ Other: mechanical nla,criuts, ctkuq incio. 1QMn. twain:ad. and rotit. ,,AA�� r� h e' St'^'•P tr:�tcsi ,t,¢s•'y �t y.*,, Value S 7�.'2,k`.•S,. t�j 1, ti`IKI. rr I rt+c. �6 C! ' K+I. 1 I, ! 4 3.. t7 �L, i..a. t,, r��Kyq.[ �'++ _• ii r'' s 7t 7 •,;° f t , •TA N 'st��JltiGg >i 1 �S . r \1 141 YdLlj: Pr I1- and 2- fftnily dwelling ❑ Com mcrcialrinduspiul 0 Accessory huildinF Fu+' y >rt idl ruin nenion u,l ( �1ia,. ❑ Multi family ❑ Master builder ❑ Other: Arscnpuon Qty. En. Tout lie :t ri' i Y ? e � f `i ^ t '1 ^ r tsi� , fie t"e • I. Hcatin coolit[ __ °�`�Y,t:13w . : 5>F� xrk$ �1 [ �I �retur.' ✓t r . rrd }hw.�. ..,, 1 FJ R Air conditioning Job site address. /1 k.) . �� • ireoum. lan.hnu iva , )t+ccraann - Cig /State!ZIP: ���d p^ - n 22. Furnace 1110.[) BTU (duets ,can i 46. 75 L -� _ �/e < 1 / �� ` Fumat c 100.11p0+ BTU (owls t•.',u<! 1 34.91 M( Suite/bldg./apt. n0.; Project name l �� - Idea[ hump 61.06 Ross 51reN4jirectionS to job si,e: I Ourt work 23 32 _ .. --- �- H drimic hin water 1 stein 23.32 Residential boiler traclialoi or - 1 h •ironicl 23.32 4 .I Unit heaters )fuel iypa•. not ckctri. ). in -wall. In-duct. suspended, etc. 46.75 Flue vent for an of uhuvc 33.32 Subdivision; git� Lot no.: . Other: M� 7a» mop/parcel t10.: Other fuel appliances µ °1 ""; : ' / ry @ ;��1 'F ' e'w fpi 7.i ' ilo .7 � _ .'.:.7. >�� .$ Wale' . :3 heater 23,32 2g, ,_a' [4• x'1: / r_ c - :ltiJic.:•.aia' car _ii ..,vie.. . �i �xt• w., I.. Gas lily )i 33.39 JI Flue vent 1br water heater 01 gas tin lace 23.322 MB . Log l4htcr (east 23.32 Wood /pellet stove 33.39 Wood liireptace.!insttt 23.32 s c,^ g,s vY • F sa : . Chimn Diner /liue/v.iu 23.3_ r 12T h l , ^ (� ! F( ��> � I .A r,Y� It r"t ' 451..;>' ittit !, 11 r, , - �, � •?s i. a t � x is ^ F 'r o ��,ui1..�.f �.. zti'..Ci �. +� ,�RlYS.�l��4aahu�° w:� -o�.. ,. ...4 �ati..�..:t�cother Name: .'/ ( ,,e / /t ic . Environmental exhaust and vcntllat1on 933 Na.) �V�� atl pay 3 R u [tie od4xhtt kitchen 11 Address: 41 equi aunt 33 City/State/ZIP: �3 4v2� , �R ?006 clothes Myer exhaust t 33.39 ; ..<- 29 Single -duct exhaust (bathrooms. Phone . 1/5 + , Fax ( ,3 i 90 , / Z. toilet emu .omens. utilit moms) 23.37 M.- "+ 7 , • -• " h e - I.. r l . ` +! rJ , M � t ; ; fi r � 7 , c t� R f ° f P [ YY Attn:/crawls-ace •ace thin 3.. 2 ;:....rt.._.. ..••r:e.� .rt : :: it-,5, >s.- may, ; :.i.,ac.: :- .,t ! ?d: -: ,5,. +•xs1 Other: - ® � Business nAme: A A Fuel .1 • in. Contact name: . [.1// jitlE..,Q_ $14.15 for first four S4.03 for each additional Furnace, etc. I K. Address: Gus heat uul City /State/ZIP: 1 Wall!suspended/ mit healer Mil IMO -_ Water heals Phone; ( 1 Fax: ; ( 1 - Fir lace , 1 r E-mail: F Ranh t L. . 'ip'F HC rt � a tt �S - . M •��*a �+T"`�"':�•ri t c�, 4 u , + r aa�� J ,X t �C. � �� , garl'fecu ti i. I STr _' . . :o., ..•tcu:�i.n1 U) . . .•.-.A ra. ::l,L:w • i,.2:+.a`"sS r l•. =:s .,,: Vii, �, T.d.t,.t.4 Clothes di 'el' (:n5l Business name: rf p L pag fir. , Other 11=111111111 Address: fO Box 7 L:.7 : 4 .}.: 3dfill'Z::. 11f . f..'.' I1 .. - J;,Ly `_ '. I Ciry/Statc!ZIP: CCAcZa • S - /10 13- Subtotal V / -. .1 ' Phone: (511 (S90.001 Plan review t21gi F ax: ( 503) i Mh,inuun pc,mit t it Oath CCB tic.: / 796a 3 I �5� IQCS GSo -� 9� of permit surehar c i 12% of Damn fee) 1. i r TOTAL PERMIT FEE i . 2 ` 10 This permit application capita. Ira permit 101 on Inrd Aldan 1aa Authorized signature: -.-- S tate days ater 11 has been screp,td ac complete. l Print mane. (acN .t I Dare: 40140q ` Fee nw•Ihodnlos7' 1e1 by Tr .Cabot) f 1Il ding IntlamtrF• Scr, iet Dowd I: 11x001 Pet 01 a derv.,+„ ilAno•dt•rr 10 0 i U0 + JO t - , 01 u_ 0111 WWI a s Plumbing Permit Applicationfrf ii ri� Building Fixtures , ` , " :, is F j „F:- i 1, I r F ' apla.�S OFFIO USE ON 1 , r � 44 ` City of Tigard FEB 1$ 2010 Received T 1� / Dare 13y: Permit No.: « Zan , L1. z20 n 13125 SW Hall Blvd.- Tigard. OR 97223 flan Review t� Jul 1 .cc z2 Phone: 503.639,4 171 Fax: SU3.592 CflE>�1�/ OF I IGA D Date 13�: (the r Penult No.: - ,_ ..._ y•, r ' Ins Line: 5(13 75 I Darr i)eadc:8": uri �r.r� . ti1i "� BUILDING DIVISION See Pate 2 for Internet w•ww.tigard or.gov Notified Method: Supplemental Information TYPE OF .WORK .FEE* SCHEDULE ,�f For special information use checklist. �Q New construction ❑ Demolition f / Description Qty. Ea. Total ❑ Addition /alteration /replacement ❑ Other: New I- 2- family dwellings (includes 100 ti. for each utility connection) . CATEGORY OF CONSTRUCTION SFR 11) bath 312.70 71- and 2- family dwelling 111 Commercial /industrial SFR (2) bath 437.78 SFR 13) bath / 500.32 '32-- ❑ Accessory building ❑ Multi- family Each additional bath kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler ( sq. 0.) Page .JOB SITE INFORMATION AND - LOCATION •. • Site utilities: Job site address: / .56,0 5-4-4.) . / �OhG/ Li . Catch basin or area drain 18.76 Drywell. leach line. or trench drain 18.76 City /State /ZIP: /7 D ae '9 Z2 y / Footing drain (no. linear ti.: ) / Page 2 Suite /bldg. /apt. no.: l Project name: /6�iCGA 0S774 Manufactured home utilities 50.03 Cross street /directions to job site: Manholes 18.76 Rain drain connector f 18.76 Sanitary sewer (no. linear 0.: ) / Page 2 Stonn sewer (n linear ti.: _) i Page 2 _ Water service (no. linear 0.: _) l Paget Subdivision: 6 t/l Sir-7g I Lot no.: e;72S Fixture or item: Tax map /parcel 110.: Backtlow preventer 31.27 DESCRIPTION OF WORK • - • • - Backwater valve 12.51 Clothes washer / 25.02 Dishwasher / 25.02 Drinking litunlain 25.02 Ejectors /sump 25.02 7 PROPERTY OWNER;- -` ' . I ' • D TENANT Expansion tank 12.51 Name: ,P, vees - / � / � /ae / • Fixture/sewer cap ?5.()2 / 3 /1/� ej ' ' � r7 Floor ge disposal sink/hub 25.02 Address: ��� /Q Garbage di sposal i 25.02 City /State /ZIP: S LAV 764/ / pe �7G Hose bib 2 2 5.02 Phone: (503 . D pv 0j Fax: 603 *dam .2 ��L Ice make / 12.51 APPLICANT 0 , CONTACT: PERSON. Interceptor /grease trap 25.02 Business name: t J/ AA. 7 Medical gas (value: S I Page 2 Prier � / Q � Ro 12.51 Contact name: /' 7 C � C �`L Roof drain (commercial) / 12.51 Address: Sink/basin /lavatory 4 25.02 City /State /ZIP: Solar units (potable water) 62.54 Phone: ( ) Fax: : ( ) Tub/shower/shower pan 12.51 E-mail: Water closet 3 25.02 Urinal 25.(12 a�� o r vas /dmome, ONT RACTOR. Water heater / 37.52 Business name: /1 J yJP."Xiom J J. Zt Water in 'DWV 56.29 1 I pp g Address: J 7J 7 ;de- 1 .//,'3_.' L q 1 Other: 25.02 City /State /ZIP: /�i/LA../ /'/ - /: i M1 ?to7 Subtotal 1 j, G 7 Minimum permit fee: 572.50 Phone: (sDT) q 7,r -• r'J 7 F-7 Fax: roy) 6` •, _, 7 Plan review (25% of permit ter) CCB Lic.: / 7 / L - Plumbing Lic. no.: T/3 eip State surcharge 112% of permit fee) (C6,0 Authorized signature y // TOTAL PERMIT FEE ,:3 j This permit application expires if a permit is not obtained within 180 days Print name: Date: //r� //` , p�j G °� after it has been accepted as complete. *Fee methodology set hw 'In-County 13uildimw Industry Service Board. I: 13uildinr •Permits.PI.Ml:- I'ermilApp.doc 10 111 09 440-40 0,11 10 02 ('OM WEB) ' 1/x/1 ! `[0/ l) ,300 ' L ' ..� Oregon Residential Specialty Code N1107. HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: Iv 1 S O l0 o o 2 5 Jurisdiction: a . � T cor Site Address: La 06 Sw Raft/14c( ` a ti � Subdivision/Lot #: � Z� D Q,��q Us54 and /or 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: _ Date: 5-15 /0 Owner /Genera o tractor / , • horized Agent T ∎iei r5t c.� e ,M S L. — C. Print Name: L e- e- 5e_ (I 1 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 fmal 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. I: \Building\ Forms \RES- HighEfficiencyLighting.doc 07/01/08 Oregon Residential Specialty Code R318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM I, R‘ V ex 5d9 _ ifo r+� eS L L c. , am the general contractor or the owner - builder at the following address: Site Address: Goo � S \v Q7 e_ I La w City: -- 1 l 1 gC r ci. Permit #: ` MST 2010— 0 o02S Subdivision/Lot #: 5.6 a. V ! StA. L- 0 -f Zi 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: -- l / 04 Date: 9 .1 — (a General Contractor • Owner -Builf RiV T[OmeS CA.._ C._, 1: \Building\ Form \RES- MoistureSensitiveWood.doc 09/25/08 • 1 ., STREET TREE CERTIFICATION 4 �a ri s $x + ,.x .. ,m n * a 5 . � k y , � Uz '` ,emu � r M F,� �4 �, t� ,a wn � '"� I i_e_e 21 O / A fo � d LC (PLEASE 1 RIlV�1) 1�'`I r l 14 , 7 1 : (PE &VIII HOLDER) i 'certi t t he _ foll Do hereby , owii g lb cation meets Ci ty of Tig land Ise and devel % pment standards for street t tree $ inst�ailat ion -t `J `' 4,i 5 i V Y Pn P. Ati' her+ '3 1- x� -�` � 1W'5 `` f 4-' *m , � � i;' C ADDRESS: 15(00,5 5W (, Lane_ / s 7- aofa -©00 c SUBDIVISION: 13eRc \J . 15 -t-p LOT: 2S o SIGNATURE: _ %/ �` /I� DATE: 9 _i s --7) 0 (O IT " ' / 7 GENT) v) RECEIVED BY: DATE: (cJ Y OF TIGARD) I:A Building \ Forms \StreetTreeCertificate 01/19/07 , r - i`rlg--ZO1 000 I • . c � „ � �, a f qy / V ��/ 2 S ' 7 i ., Ti FEB 18 2010 - / CITY OF TIGARD � BUILDING DIVISION ru 41. f-T� /Q XI c ST ./;-eS kee___ _j,, _.& / � � _ �� • ' / \ \ ' ° - -/ , , 0) � , \�y Ste/ R 4,4,4,/ \ ./ 7 .44k t , 4 ., **vs; / , \ \ --, wi■ -y-',. 4.:, ; v./. . .,. oO 1 I i ` \ . • - \ 1 viiii��/� L/ c litr 1 4. \ i, '6, i __ / / n i lt‘T'Ll I' .1 ; 1 "C" /� ryi 4° 6 iiii/ c / o0 ck )4p i \ / S AS Ste/ �O ; 7 l ' � ,e4-e #•GL /4-r / . SURVEY 2 . 2 POINT X I • • BELLA VISTA LOT 28 SCAM: = 20:i ENGINEERING & LAND SURVEYING � ESIGNED: PREPARED FOR: RJ 8835 SW Canyon ln. DRAWN: RIVERSIDE HOMES s �O: \ Suite 402 1925 NW AMBER GLEN PKWY, SUITE 200 �'�. L... 000 ..1:0 Portland, OR 97225 SW BEAVERTON, OR 97006 CHECKED: (503) 645 -0986 � 191010 Inc. RJ (503) 690 — 2942 / 4 3 50 x) 291 - 291 -1613 9398 DATE: 6/20/03 ( Fa CITY OF TIGARD - SITE PLA REVIEW BUILDING PERMIT NO.: h/\ 201Q • 4 OG 2 5 PLANNING DIVISION: Approved Required Setba s: EYApproved� N ot A ❑ pp Side:. Street Side: �� Front. IC Ga age: ? Rear: Visual Clearance: [Aprpx p'ed ❑ Not Approved Maximum Building Height 'SS feet e--/ CWS Service Provider Letter Required: ❑ Yes ❑ No ❑ Received By d Date: abet l [ D ENGINEERING DEPARTMENT: Actual Slo e: 2 ° % (3 Approved ❑ Not Approved Site Plan pproved ❑Not pproved By: Date: a Z. 10 Notes: 1 2 Wn , -v-Ld tp_tk, U-'-W% ''o gtve, --) /5 05 1 t AEL LN CITY OF TIGARD - SITE PLAN RtVIEW BUILDING I'ERM1TNO: Street Trees: ❑ Approved ❑ Not Approved Protected T Ca Approved Not Approved BY: - Date: a5 -J/o Notes: I -- d I e r 7 f � t1 1 e