Permit Iii CITY OF TIGARD MASTER PERMIT
.,
_ COMMUNITY DEVELOPMENT Permit #: MST2010 00217
13 125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/11/2011
Ti . . Parcel: 2S104BB12500
Jurisdiction: Tigard
Site address: 14037 SW WALNUT CREEK WAY
Subdivision: WALNUT CREEK Lot: 42
Project: Walnut Creek lot 42
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 796 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 25 Bathrooms: 3 Second: 996 sf Garage: 441 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 1792 sf Value: $190,611.37 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
Drains: 0
Tubs /Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell- Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn <100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn > =100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc /Feeders Branch Circuits
1000 sf or less: 1 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0
Ea add! 500 sf: 3 201 -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 SF VB R -3 1792
Owner: Contractor:
MATRIX DEVELOPMENT CORP LEGEND HOMES Required Items and Reports (Conditions)
12755 SW 69TH AVE #100 12755 SW 69TH AVE #100 1 Ersn Cntrl 503 - 681 - 4444
TIGARD, OR 97223 TIGARD, OR 97224
PHONE: PHONE: 503 - 620 -8080
FAX: 503 - 598 -8900
Total Fees: $15,764.84
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 .'.e rules o' •irect questions to OUNC by calling 50 .232.1987 or 1.800.3 .2344.
Issued By. Permittee Signature:
Call 5 i 3.6 ,..:4 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 complete• e project.
Approved plans are required on the job site at the time of each inspec •
B Permit Application
Residential -c , <.'; ` FOR OFFICE USE ONLY,
1
City of Tigard Date /B a-3 / M 9 1) Permit No.: M. ] Ia ., 0 02 1
Other " 13125 SW Hall Blvd., Tigard, 1 ?' S ' 'w '\ .�'" , y +e4
f P lan Review
1
er P f
Phone: 503.639.4171 Fax: 5�` '8.1960 Date /B : Received 1 i _u0 —� , 11, Inspection Line: 503.639.4175 ( � Date Ready/By: / El See Page 2 for
TIGARD Internet: www.tigard or.goV O�� IN �'� `; N otifed /Me iod: ('/ / Supplemental Information
' `
TYPE OF '`tc * - cy . • : :v ' +° REQUIRED DATA:`1' -AND 2='FAMILY DWELLING.
fir Permit fees* are based on the value of the work
® New construction ��g�, "Demolition performed. Indicate the value (rounded to the nearest
❑ Addition /alteration /replacement ❑ Other: dollar) of all equipment, materials, labor, overhead, and
» .0 tTEGORY�OF CONSTRUCTION „ ' the profit for the work indicated on this application.
Valuation: $ HO� (,'�
® 1- and 2- family dwelling 1=1 Commercial /industrial
❑ Accessory building El Multi-family Number of bedrooms: 3
® Master builder ❑ Other: Number of bathrooms: 3
1 - JOB, SITE INFORMATION AND 'LOCATION ,' . ' ` Total number of floors: 2
Job site address: 14037 Sw Walnut Creek Way New dwelling area: 1,762 square feet
City /State /ZIP: Tigard, OR 97223 Garage /carport area: 441 square feet
Suite /bldg. /apt. no.: Project name: Walnut Creek Covered porch area: square feet
Cross street/directions to job site: Barrows & Walnut Deck area: square feet / ( ,
Other structure area: '2°z0` j square feet 2%3
REQUIRED DATA COMMERCIAL=USE
Subdivision: Walnut Creek I Lot no.: 042 Permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest
Tax map /parcel no.: 2S104BB 12500 dollar) of all equipment, materials, labor, overhead, and
DESCRIPTION OF .tiWORK r' the profit for the work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
,`, la 'OWNER+ , ,x: R .' i. I TENANT ; + Number of stories:
Name: Legend Homes Type of construction:
Address: 12755 SW 69 Avenue, Suite #100 Occupancy groups:
City /State /ZIP: Portland, OR 97223 Existing:
Phone: (503) 620 -8080 Fax: (503) 598 -8900 New:
-11 ® 'APPLICANT'''",'—! . ' 0 a. CONTACT PERSON - NOTICE •
Business name: Legend Homes All contractors and subcontractors are required to be
Contact name: Steve Lucas licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 12755 SW 69 "' Avenue, Suite #100 jurisdiction in which work is being performed. If the
City /State /ZIP: Portland, OR 97223 applicant is exempt from licensing, the following reasons
apply:
y:
Phone: (503) 620 -8080 I Fax: : (503) 598-8900
E -mail: slucas @legendhomes.com
': w : ' - •. , C O■TRACTOR P,
Business name: Legend Homes . BUILDING PRMITFEES *, .
Address: 12755 SW 69"' Avenue, Suite #100 (Please.iejerrojeescdedule)'
Structural plan review fee (or deposit):
City /State /ZIP: Portland, OR 97223
FLS plan review fee (if applicable):
Phone: (503) 620 -8080 Fax: (503) 598 -8900 -
Total fees due upon application: ', I t�
CCB lie.: 55151 11114 y
Amount received: �.'.
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Steve Lucas Date: 12/22/2010 * Fee methodology set by Tri- County Building Industry
Service Board.
E Permit Application FOR OFFICE USE ONLY
City of Tigard Received Date/By: f MI/ Permit No.: d 4 , ' k)
��
III
- ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review c
Phone: 503.639.4171 Fax: 503.598.1960 Date /B : Other Permit: Jt� .`'� — I
TIGARD Inspection Line: 503.639.4175 Date Ready /By: ® See Paget for ry
Internet: www.tigard or.cov Notified /Method: ► Supplemental Information
1'YPE.OF WORK PLAN REVIEW .
® New construction ❑ Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition E] other:
where the available fault current ❑ Marinas and boatyards.
• CATEGORY OF C ONSTRUCTION -- ' '' . . , ` . exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
® 1- and 2-family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ® Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
. JOB. SI IN FORMATION`, AND LOCATION , ❑Emergency system larger separately derived system.
. ❑ Addition of new motor load of ❑ "A» "E" "1 -2 ", "I -3 »,
Job no.: Job site address: 14037 Sw Walnut Creek Way IOOHP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: Walnut Creek ❑ Service or feeder 600 amps or more.
" FEE; :SCHEDULE
Cross street /directions to job site: Barrows & Walnut Description I Qty. I Fee. I Total I R
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Walnut Creek Lot no.:042 1,000 sq. ft. or less 1 168.54 168.54 4
Tax map /parcel no.: 2S104BB 12500 Ea. add'I 500 sq. ft. or portion 33.92 wf , g., I
Limited energy, residential
to , .. 'i: r I 5- Le , �5. (X) 2
��- D�ES @RiiP�T[ON� - WORK �;�,a.us _ (with above sq. ft.)
Limited energy, multi - family
67.84 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 100.70 2
., ,® _PROPERTY ' ; _,, - ' . ❑. TENANT.. „ 201 amps to 400 amps 133.56 2
Name: Legend }Tomes 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.40 2
Address: 12755 SW 69 Avenue, Suite #100 Over 1,000 amps or volts 552.26 2
City /State /ZIP: Portland, OR 97223 Temporary services or feeders installation, alteration, and /or
relocation
Phone: (503)620 -8080 Fax: (503)598 -8900 200 amps or less 59.36 I
Owner installation: This installation is being made on property that I own which is 201 amps to 400 amps 125.08 2
not intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 401 amps to 599 amps 168.54 2
701 Branch circuits - new, alteration, or extension, per panel
A. Fee for branch circuits with
Owner signature: Date: above service or feeder fee, 7.42 2
® NT
A ❑ 'CONTACT, PERSON each branch circuit
B. Fee for branch circuits
Business name: Legend Homes without service or feeder fee, 56.18 2
first branch circuit
Contact name: Steve Lucas Each add'I branch circuit 7.42 2
Address: 12755 SW 69 Avenue, Suite #100 Miscellaneous (service or feeder not included)
Each manufactured or modular 67.84 2
City /State /ZIP: Portland, OR 97223 dwelling, service and /or feeder
Reconnect only 67.84 2
Phone: (503) 620 - 8080 Fax: : (503) 598 - 8900 Pump or irrigation circle 67.84 2
E -mail: slucas @legendhomes.com Sign or outline lighting 67.84 2
'' CONTRACT_ OR: , Signal circuit(s) or limited -
Business name: Garner Electric energy panel, alteration, or
extension. Page 2 2
Address: 2920 SE Brookwood Avenue #A Each additional inspection over allowable in any of the above
Additional Inspection (I hr min) 66.25/ hr
City /State /ZIP: Hillsboro, OR 97123 Investigation (t hr min) 66.25/ hr
Phone: (503) 648 - 4552 Fax: (503) 642 - 7925 Industrial plant (1 hr min) 78.18/ hr
Inspections for which no fee is 90.00 / hr
CCB Lic.: 121159 Electrical,• ? . -305C - Suprv. Lic.: 3707 - specifically listed (1/2 hr min)
• - ELECTRICAL PERMIT :FEES _ _
Suprv. Electrician signature, require Subtotal: .n_�,�
Print name: Chuck Garner �� / / ? t 1 -M:- /22/2010 Plan review (25% of permit tee): , �-
State surcharge (12% of permit fee): 4i y. {-
Authorized signature: TOTAL PERMIT FEE: 3 e t 7 4
Print name: Date: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
* Number of inspections allowed per permit.
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
`RESIDENTIAL. *OW ONL•Y:,
Fee for all residential systems combined ... $67.84
Check Type of Work Involved:
N Audio and Stereo Systems*
N Burglar Alarm
• Garage Door Opener*
E Heating, Ventilation and Air Conditioning System*
E Vacuum Systems*
n Other:
COMMERCIAL WORK ONLY t
Fee for each commercial $67.84
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
n Audio and Stereo Systems
Boiler Controls
n Clock Systems
n Data Telecommunication Installation
n Fire Alarm Installation
n HVAC
n Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control*
I Medical
I Nurse Calls
Outdoor Landscape Lighting*
n Protective Signaling
n Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I: \Building \Permits \PLMP- Permi1App.doc 12/27/06 440- 4616T(10 /02 /COM/WEB)
f t ..►
Mechanical Permit Application , FOR OFFICE USE ONLY
1114 Received 9
1312 Of Tigard Date /By: J / »3/() - Permit No.: ,MC ->�`1J jU -(� '7
13125 SW Hall Blvd., Tigard, OR 97223 I 1 J l OCJ I
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Other Permit: t ti (0....60 /6.6
Date /By: [
TIGARD Inspection Line: 503.639.4175 Date Ready /By: .turfs: See Page 2 for
Internet: www.tigard or.eov Notified/Method: riepey Supplemental Information
' - . ' T YP E ' O F WOR COMMERCIAL; FEE *h SCHEDULE - USE CHECKLIST
® New construction ❑ Addition /alteration /replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
'CATEGORY tOr_ CONSTRUCTION : . - -' Value: $
® 1 and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building RESIDENTIAL EQUIPMENT) / S .. .. .S FEES*
For special information use checklist.
❑ Multi family ® Master builder ❑ Other:
Description Qty. Ea. Total
JOB SITE 'INFORMAT.ION• AND LOCATION ' . Heating /cooling
Job site address: 14037 Sw Walnut Creek Way Air conditioning
(requires site plan showing placement) 46.75
City /State /ZIP: Tigard, OR 97223 Furnace 100,000 BTU (ducts /vents) I 46,75 46.75
Suite /bldg. /apt. no.: 1 Project name: Walnut Creek Furnace 100,000+ BTU (ducts /vents) 54.91
Gas heat pump 61.06
Cross street/directions to job site: Barrows & Walnut Duct work 23.32
•
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. • 46.75
Subdivision: Walnut Creek Lot no.: 042 Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: 2S104BB 12500 Other fuel appliances
" DESCRIPTION OF WORK` - Water heater 1 23.32 23.32 •
Gas fireplace 1 33.39 33.39
Flue vent for water heater or gas
fireplace 23.32
•
Log lighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplace /insert 23.32
® PROPERTY" OWN ;I- • TENANT "' " - - ,
. Chimney /liner /flue /vent 23.32
Other: 23.32
Name: Legend Homes Environmental exhaust and ventilation
Address: 12755 SW 69 Avenue, Suite #100 Range hood /other kitchen
equipment - 1 33.39 33.39
City /State /ZIP: Portland, OR 97223 Clothes dryer exhaust I 33.39 33.39
Single -duct exhaust (bathrooms,
Phone: (503)620 -8080 Fax: (503)589 -8900 toilet compartments, utility rooms) 5 23.32 116.60
' ®,APPLICANT ', - '.�, , ❑. CONTACT' CT' PERSON Attic /crawlspace fans 23.32
Business name: Legend Homes Other: 23.32
Fuel' piping
Contact name: Steve Lucas $14.15 for first four; $4.03 for each additional
Address: 12755 SW 69` Avenue, Suite #100 Furnace, etc. I
Gas heat pump
City /State /ZIP: Portland, OR 97223 Wall /suspended/unit heater
Phone: (503) 620 -8080 Fax: : (503) 598 -8900 Water heater I
Fireplace I
E -mail: slucas @legendhomes.com Range 1 14.15
. " ° ,; CONTRACTOR ; : ' ` K - Barbecue
Business name: Tri County Temp Control Clothes dryer (gas)
Other:.
Address: 13150 Clackamas River Drive " ' MECHANICAL.PERMIT FEES*
City /State /ZIP: Oregon City, OR 97045 Subtotal jaD, I
Minimum permit fee ($72.50)
Phone: (503) 557 -2200 Fax: (503) 557 -0919 Plan review (25% of permit fee) i
CCB lie.: 72623 State surcharge (12% of permit tee) 1
TOTAL PERMIT FEE '3.57. [ {
Authorized signature: "4. This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete.
Print name: Steve Lucas Date: 12/22/2010
* Fee methodology set by Tri- County Building Industry Service Board
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation:: � 'Permit Fee
$1.00 to $500.00 Minimum fee $69.06
$501.00 to $5,000.00 $69.06 for the first $500.00 and $3.07
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $207.21 for the first $5,000.00 and
$2.81 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $347.71 for the first $10,000.00 and
$2.54 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $1,363.71 for the first $50,000.00 and
$2.49 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $2608.71 for the first $100,000.00 and
$2.92 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I
, PluKthing Permit Application
Building Fixtures FO OFFICE USE ONLY
City of Tigard Received /
Date /By: %f, PennitNo.:S `. O `
'� 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review J
Phone: 503.639.4171 Fax: 503.598.1960 Other Permit No.: , /
Inspection Line: 503.639.4175 Date /By: i �.�
Ins
TIGARD p Date Ready /By: El See Page 2 for
Internet: www.ti <gard or.gov Notified(Method: SupplementalI'nformation
T g FEE *.: , SCHEDULE
® New construction ❑ Demolition For special information use checklist.
Description Qty. 1 Ea. Total
❑ Addition /alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
' ' . CATEGORY OF .CONSTRUCTION , t SFR (1) bath 312.70
® I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78
SFR (3) bath 1 500.32 500.32
❑ Accessory building ❑ Multi- family
Each additional bath/kitchen 25.02
® Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2
JOB _SITE, INFORMATION AND LOCATION` , , . • Site utilities
Job site address: 14037 Sw Walnut Creek Way Catch basin or area drain 18.76
City /State /ZIP: Tigard, OR 97223 Drywell, leach line, or trench drain 18.76
Footing drain (no. linear ft.: _) Page 2
Suite /bldg. /apt. no.: Project name: Walnut Creek
Manufactured home utilities 50.03
Cross street/directions to job site: Barrows & Walnut 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: Walnut Creek Lot no.: 042 Fixture or item
Tax map /parcel no.: 2S104BB 12500 Backflow preventer 31.27
DESCRIPTION OF WORK ' ' Backwater valve 12.51
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors /sump 25.02
, PROPERTY ,OWNER r. ' • - , , r, ❑'TENANT ' ' n Expansion tank 12.51
Name: Legend Homes Fixture /sewer cap 25.02
Address: 12755 SW 69` Avenue, Suite #100 Floor drain /floor sink /hub 25.02
Garbage disposal 25.02
City /State /ZIP: Portland, OR 97223
Hose bib 25.02
Phone: (503)620 -8080 Fax: (503)598 -8900 Ice maker 12.51
' ` ®. APPLICANT' ' " , ', ❑ C AC
ONTT, }PERSON, Interceptor /grease trap 25.02
Business name: Legend Homes Medical gas (value: $ ) Page 2
Contact name: Steve. Lucas Primer 12.51
Roof drain (commercial) 12.51
Address: 12755 SW 69 Avenue, Suite #100
Sink/basin/lavatory 25.02
City /State /ZIP: Portland, OR 97223 Solar units (potable water) 62.54
Phone: (503) 620 -8080 Fax: : (503) 598 -8900 Tub /shower /shower pan 12.51
E -mail: slucas@legendhomes.com Urinal 25.02
ti , CONTRACTOR Water closet 25.02
Water heater 37.52
Business name: Wolcott Plumbing
Water piping ?DWV 56.29
Address: 1075 W. Historic Columbia River Hwy Other: 25.02
City /State /ZIP: Troutdale, OR 97060 Subtotal 500.32
Phone: (503) 667 -1781 Fax: (503) 667 -9891 Minimum permit fee: $72.50
CCB Lic.: 112220 Plumbing Lic. no.: 26 -824PB Plan review (25% of permit fee)
State surcharge (12% of permit fee) 60.04
Authorized signature: 5 f7'/ l_� 5g),-.36'
�lf I TOTAL PERMIT FEE
Print name: Gloria Hawes Date: 12/22/2010 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.
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty: ,Fee. (ea) Total Sguare Foot a ;._Permit Fee , f
Footing drain - 1S' 100' 50.03 0 to 2,000 $121.90
Footing drain - each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer - 1st 100' 62.54 7,201 and greater $327.54
Sewer - each additional 100' 37.52
•
Water Service - 1st 100' 62.54 Medical Gas Systems:
Water Service - each additional 100' 37.52
Storm & Rain Drain - 1st 100' 62.54 Va'hiation . Permit .F,ee �
$1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each
Other Inspections or Fees' Qh Fee (ea)' Tota14 F additional $100.00 or fraction thereof, to and
including $10,000.00.
Inspection of existing plumbing or for 90.00 / hr $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
Which no fee is specifically indicated each additional $100.00 or fraction thereof, to
(minimum charge — 1/2 hour) and including $25,000.00.
Inspections outside of normal business 90.00/ hr $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
hours (minimum charge — 1/2 hour) each additional $100.00 or fraction thereof, to
Reinspection Fees 90.00/ hr and including $50,000.00.
Additional plan review for revisions 90.00/ hr $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
(minimum charge — 1/2 hour) each additional $100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping, adding or replacing fixtures? If "yes ", ' "Plan iReview for•Plumbin'g. Installations
please indicate work performed by fixture. Failure to Plan review is required for any of the following.
accurately report fixtures could result in increased sewer fees * . Please check all that apply.
• Quantity by (Fixture) Work Performed ❑ Any new commercial building with water service 2" and
Fixture Type: ' Replace greater, except systems designed and stamped by licensed
Previous; Capped Added . Existing engineer.
Baptistry/Font
Bath - Tub /Shower El New exterior plumbing site utilities for any complex structure
as defined in OAR918- 780 -0040.
- Jacuzzi /Whirlpool
Car Wash Each Stall 111 Medical gas and vacuum systems for health care facilities.
Drive Thru ❑ Any multipurpose fire sprinkler system.
Cuspidor /Water Aspirator ❑ Any complex structure as defined in OAR918- 780 -0040.
Dishwasher - Commercial
Domestic Submit 2 sets of plans with any of the above.
Drinking Fountain
Eye Wash ' .I Diagram ,
Floor Drain /sink - 2" ❑ Isometric or riser diagram is required for new buildings
that meet the qualifications above.
- 4»
Car Wash Drain
Garbage - Domestic
Disposal - Commercial
- Industrial Comments regarding fixture work:
Ice Mach. /Refrig. Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar /Lavatory
- Bradley
- Commercial *Note: If the fixture work under this permit results in an
- Service increase of sewer EDUs, a sewer permit will be issued and
Swimming Pool Filter fees assessed for the sewer increase must be paid before the
Washer - Clothes
Water Extractor plumbing permit can be issued.
Water Closet - Toilet
Urinal
Other Fixtures:
FJ qT FLAN I— 0 �4 2 WALNUT CREEK
1403 SW WALNUT CREEK WAY
NE 1/4 SECTION 4, T. 25, R.1W, W. M. t
11 CEIVE t .. =
CITY OF T I r 20.-0" GARD
WASH INGTON COUNTY, O REG ON ---....0 EL-2. 3 2010 .
T I E 1 N Ilift't „ VI ';11 4 : • , .7R'.i. :. . -, '"1; ; ,,.....,...„
11. PJ G 1.1 4 ''' '' '''. ''" '''''' "" ' '' • ''. ; • 1 - - - - — •.- --. '
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ii H 0 M ES- ----- - --- , - - - . - -- -, 7.. '; : :;i' . tit-DANd DIVISION
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c‘t / ' ---- F---0 — \
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04
o 0 EROSION FENCE
5TREET TREE:
q q OF STREET CHANTICLEER PEAR
21 WATER METER 2" Ca liper
MANHOLE
MI CATCI-1 BASIN
PROPOSED
STREET TREES
.,..-
111 STREET LIGI-IT .
W., FIRE I-IYDRANT SETBACKS :
• YC
ROvIDE EROSION
FRONT YARD .. IS FEET
P GARAGE = 20 FEET
CONTROL FENCE . REAR YARD . IS FEET
PER COMMUNITY 51DE YARD . 4 FEET
EROSION FL AN STREET SIDE YARD = 10 FEET
I ,
• CITY OF TIGARD - SITE PLA$ REVIEW
.BUILDING PERMIT NO.: p'15 7;771M l - 7 077
• • PLANNING DIVISION:
Required SetbIcks IA Approved 0 Not Approved
Side: jr tr Street Side: to
Front. Garatie •
Rear: /.5
Visual Clearance: 0 Approved 0 Not Approved
Maximum 131.iiiUing
CWS Servi' Provider Letter Required: 0 Yes A No
Receiyed
ENGINEERlN9, EPANMENT7
Actual SI pe: r % T Approved 0 Not Approved
Site Pla • dApproved 0 N. 4pp
B : Date:
Notes:
CITY 0 TIGARD - S '
. BU/LDING PERMIT ITE PLAN NO:
( 7-6)6/0—cie, vi
ErApproved strai
Street Trees:
Protected Tree...vs: 6 Approved No()It iip°15prrpovveedd
:
Notes: Date: 0
4
■
. 1
Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
i, i r��vt/ /:u /4/161301-1) , am the general contractor or the owner - builder
at the following address:
Site Address: /i4d37 5 e
City: •
/< € y
Permit #: to lQ -- ®00a /7
Subdivision/Lot #:
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: S• Date: 5- /4 /f
Gener. e I tractor or ,e ner : uilder
I:\Building\Porm\RES- MoistureSensitiveWood.doc 09/25/08
Oregon Residential Specialty Code N1107.
HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: 0!G _ ���7 Jurisdiction: / ���
Site Address:
3•2 s zv • zeie C�►,,��
Subdivision/Lot #:
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: 400 ' _ '
Date: J -- l s'--e-/
O n j . 1 Co tractor /Authorized Agent
•
Print Name: fjc) Le-- 41-3
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.
I:\ Building\ Fonns \RES- HighEfficiencyLighting.doc 07/01/08
STREET TREE CERTIFICATION
I, k i 10/6-60a) , owner/ agent ent o L .�vb
g r e f
(PLEASE PRINT) (PERMIT HOLDER)
do hereby cert that the fllovzng l�catzon meets
City of Tigardiland use and developme standards
for street tree- installation andis consistent
,with the approved :site plan.
SITE ADDRESS:
/4/637
SUBDIVISION: /�iiv�7 -- LOT #: •
SIGNATURE: j; ` DATE: s - --/ g "qv _ (O . - R /AGENT)
RE CEIVED &
VERIFIED BY DATE:
(CITY OF TIGARD)
Tree location verified per approved site plan.
I: \Building \Forms \StreetTreeCertificate 07/01/2010