Permit CITY OF TIGARD MASTER PERMIT
I `'1 2 COMMUNITY DEVELOPMENT # Permit #: MST2011 -00028
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Wo
Date Issued: 04/01/2011
Parcel: 2S110CB10400
Jurisdiction: TIGARD
Site address: 15444 SW ARLINGTON TER
Subdivision: ARLINGTON HEIGHTS NO. 3 Lot: 92
Project: Arlington Heights No. 3, Lot 92
Project Description: New SF. 5/3/11, reprinted to add owner information.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 5 First: 1451 sf Basement: sf Left: 5 Parking Spaces: 0
Height: 33 Bathrooms: 3 Second: 1784 sf Garage: 605 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 3235 sf Value: $345,795.09 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs /Showers: 4 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 SrvciFeeders Branch Circuits
1000 sf or less: 1 0 -200 amp: 1 0 -200 amp: 0 W/ Svc or Fdr: 0
Ea add'I 500 sf: 8 201 -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: Ecompasin g: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet
NEW SF VB R -3 3235
Owner: Contractor:
STONE BRIDGE HOMES STONE BRIDGE HOMES NW LLC Required Items and Reports (Conditions)
16869 SW 65TH AVE #505 16869 SW 65TH AVE # 505 1 Engineered Soils
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035 2 Ersn Cntrl 503 - 681 -4444
PHONE: 503 - 387 -7577 PHONE: 503 - 387 -7577
FAX: 503- 387 -7615
Total Fees: $20,256.40
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. AT TIO : •regon I- re•uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-1110 t rough O • - 9 -001 • i • I. You may obtain a copy of the rules or direct questions to OUNC by cal • = I . 32.1987 o 1.800.332.234
/ ,
Issued B . Permittee Signat : • ,..
Call 503.639.4175 by 7:00 a.m. for the next available inspectio d.
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.
d , CITY OF TIGARD MASTER PERMIT
I - I
S it COMMUNITY DEVELOPMENT Permit #: MST2011 -00028
TIGAR.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/01/2011
Parcel: 2S110CB10400
Jurisdiction: TIGARD
Site address: 15444 SW ARLINGTON TER
Subdivision: ARLINGTON HEIGHTS NO. 3 Lot: 92
Project: Arlington Heights No. 3, Lot 92
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 5 First: 1451 sf Basement: sf Left: 5 Parking Spaces: 0
Height: 33 Bathrooms: 3 Second: 1784 sf Garage: 605 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 3235 sf Value: $345,795.09 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
0
Tubs /Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 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 Tem Srvc/Feeders Branch Circuits
1000 sf or less: 1 0 -200 amp: 1 0 -200 amp: 0 W/ Svc or Fdr: 0
Ea add, 500 sf: 8 201 -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 3235
Owner: Contractor:
STONE BRIDGE HOMES NW LLC Required Items and Reports (Conditions)
16869 SW 65TH AVE # 505 1 Engineered Soils
LAKE OSWEGO, OR 97035 2 Ersn Cntrl 503 - 681 -4444
PHONE: PHONE: 503 - 387 -7577
FAX: 503 - 387 -7615
Total Fees: $20,256.40
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 iss -I e, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility . _ 'cation Cente Those rules are se in OAR
952- 001 -0010 through 0 • : • - 001 -0090. You ma • - • • ` . questions to OUNC • calling 503.2 .1987 . 1.800.332.2344.
Issued By• = � / / ii • • rmittee Sig nature: %� / —� C. , !.. •Y ... "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 yo =
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Residential FOR OFFICE USE ONLY
City of Tigard RECEIVED Received qq
Date/By: oC (( 4 ' Permit No.: �{ �tl
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review n n /_� t� Q
I Phone: 503.639.4171 Fax: 503.598.1960 } Date/By: . 1(5 (( • Other Permit: IGOI 1 it 7
T I G A k l7 Inspection Line: 503.639.4175 Date Ready/By: / Juris: El See Page 2 for
Internet: www.tigard- or.gov Noti /7 Supplemental Information
CITY OF TIGARD
TYPE'WOttK REQUIRED DAT : 1- AND 2- FAMILY DWEL G DIVISION
® 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.
�„
® 1- and 2- family dwelling ❑ Commercial/industrial Valuation: / $ 3 f 71r. 0
❑ Accessory building ❑ Multi- family Number of bedrooms: S
❑ Master builder ❑ Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors: � ✓ 52.'5S
Job site address: f 5 Sw ,arp� AJ�ac.) 0" New dwelling area: square feet / 8
City /State /LiP: Tigard, OR 97223 Garage /carport area: (p 05 square feet iv f S
Suite/bldg. /apt. no.: Project name: Arlington Heights Covered porch area: 154 square feet B/ Q
Cross street/directions to job site: Deck area: /SO square feet
Other structure area: 0 square feet L /( O
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Arlington Heights I Lot no.: g2 Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
New, Single Family Residential Valuation: $
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER El TENANT Number of stories:
Name: Stone Bridge Homes Type of construction:
Address: 16869 SW 65th Avenue #505 Occupancy groups:
City /State /ZIP: Lake Oswego, OR 97035 Existing:
Phone: (503)387 -7577 Fax: (503)387 -7616 New:
❑ APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: SEE ABOVE All contractors and subcontractors are required to be
Contact name: Gayland Forsberg licensed with the Oregon Construction Contractors Board
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: ( ) I Fax:: ( )
E -mail: jimd @stonebridgehomesnw.com
CONTRACTOR
Business name: SEE ABOVE BUILDING PERMIT FEES*
Address: (Please refer to fee schedule)
City /State/ZIP: Structural plan review fee (or deposit):
Phone: ( ) I Fax: ( ) FLS plan review fee (if applicable):
CCB lic.: 173318 Total fees due upon application:
Amount received:
Authorized signature: th u. �_ In. _ _
� �- __ ■ This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Khitkin NI q,gVa,ntA Date: * Fee methodology set by Tri- County Building Industry
Service Board.
I: \Building\Permits\BUP -RES PermitApp.doc 10/01/09 440- 4613T(11/02 /COM/WEB)
Electrical Permit Application RECEI\� FOR OFFICE USE ONLY
City of Tigard ; : ; �� Permit No.: ) �� �
• 13125 SW Hall Blvd., Tigard, OR 97223 FEB 1 1 1 Iv
an Review ��
= Phone: 503.639.4171 Fax: 503.598.1960 RD Other Permit: .96//- ■
TI G A R L) Inspection Line: 503 CITY OF TIG ' I R eady/By' inns: ® See Page 2 for
Internet: www.tigard- or.gov J ,` h • . Method: Supplemental Information
BUILDING DIV -
TYPE OF WORK PLAN REVIEW
® New construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition
❑ where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
® I- 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 SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "I -3 ",
Job no.: J ob site address: ,/ 1 � 100HP or more. occupancy.
14 (3 � / / � % N /,‘,--,, �.IC
0 Six or more residential units.
0 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.: I Project name: Arlington Heights ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Oh. I Fee. I Total I "
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Arlington Heights I Lot no.: 92 1,000 sq. ft. or less 168.54 4
Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.92 1
Limited energy, residential 67.84 2
DESCRIPTION OF WORK (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 OWNER ❑ TENANT 201 amps to 400 amps 133.56 2
Name: Stone Bridge Homes 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: 16869 SW 65th Avenue #505 Over 1,000 amps or volts 552.26 2
City/State /ZIP: Lake Oswego, OR 97035 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503)387 -7577 Fax: (503)387 -7615 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 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
A. Fee for branch circuits with
® APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7.42 2
each branch circuit
Business name: SEE ABOVE B. Fee for branch circuits
Contact name: Gayland Forsberg without service or feeder fee 56.18
first branch circuit
Address: Each add'l branch circuit 7.42 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 67.84 2
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
E -mail: jimd(astonebridgehomesnw.com Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Signal circuit(s) or limited -
Business name: City Electric energy panel, alteration, or
Address: 55568 SW Schaltenbrand Lane extension. Describe: Page 2 2
City/State /ZIP: Sherwood, OR 97140 Each additional inspection over allowable in any of the above
Per inspection 66.25
Phone: (971) 404 -1714 Fax: (503) 625 -3052 '
Investigation per hour (I hr min) 66.25
CCB Lie.: 42422 Electrical Lic.: 26 -289C Suprv. Lie.: 35925 Industrial plant per hour 78.18
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal:
Print name: Chuck Friesen Date:
Plan review (25% of permit fee):
State surcharge (12% of permit fee):
Authorized signature: �� TOTAL PERMIT FEE:
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.
I:\ Building \Permits \ELC- PennitApp.doc I0/01/09 410-46151(11/05 /COM/WEB
Mechanical Permit Application RECEIVED FOR OFFICE USE ONLY
City of Tigard FEL DateBy: , 1 t
•
M
13125 SW Hall Blvd., Tigard, OR 97223 Received
^+d Permit No.: aQ�I DOQp
Phone: 503.639.4171 Fax: 503.598.1960 Plan Review
Date/By: Other Permit:J-0)4_04`! "eteca?
TIGARD Inspection Line: 503.639 CITY OF TIGARD Date ReadyBy: Juris: 8 Sec Page 2 for
Internet: www.tigard - or.gov BUILDING DIVISION Notified/Method: Supplemental Information
IF TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
® New construction ❑ Addition/alteration /replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® 1- and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi family ❑ Master builder ❑ Other: Description Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooliog _
G ,� ) �/ J i x.2/2. Air conditioning
Job site address:
�, JT� S`✓ � �� /(/ �p � (requires site plan showing placement) 46.75
City/State /ZIP: Tigard, OR Furnace 100,000 BTU (ducts/vents) 46.75
Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: Arlington Heights Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
h)dronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Flue /vent for any of above 23.32
Subdivision: Arlington Heights Lot no.: 92 Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace 33.39
New, Single Family Residential 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 OWNER I ❑ TENANT Chimney /liner /flue /vent 23.32
Other: 23.32
Name: Stone Bridge Homes NW, LLC Environmental exhaust and ventilation
Address: 16869 SW 65 Avenue #505 Range hood/other kitchen
equipment 33.39
City/State /ZIP: Lake Oswego, OR 97035 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (503)387 -7577 Fax: (503)387 -7616 toilet compartments, utility moms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32
Other: 23.32
Business name: same as above
Fuel piping
Contact name: $14.15 for first four; $4.03 for each additional
Furnace, etc.
Address:
Gas heat pump
City /State /ZIP: Wall/suspended/unit heater
Phone:( ) Fax::( )
Water heater
Fireplace
E - mail: jimd @stonebridgehomesnw.com Range _
CONTRACTOR Barbecue
Business name: Comfort Zone Clothes dryer (gas)
Other:
Address: 1032 NW Corporate Drive MECHANICAL PERMIT FEES*
City /State /ZIP: Troutdale, OR 97060 Subtotal
Phone: (503) 667 -5595 Fax: (503) 491 - 8252 Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: 110091 State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: David Heldstab I Date: * Fee methodology set by Tri - County Building Industry Service Board
I:\ Building \Permits1MEC- PennitApp.doc 10/01/09 440- 4617T(11 /02/COM/WEB)
Plumbing Permit Application
Building Fixtures RECEIVE r FOR OFFICE USE ONLY
City of Tigard ] Q 1 j Received /(/ Permit No.:
7
13125 5W Hall Blvd Tigard, OR 97223 F EB 1 Z Dat eBy: ( J7 O!( -1Xa0 o2g
Plan Review
C
Phone: 503.639.4171 Fax: 503.598.1960 Other Permit No.: 54490 `/ a
Inspection Line: 503.639.4175 CITY OF TIGARD Date/By:
T l G A R D to R ead y B y : furl~: Ell See Page 2 for
Internet: www.tigard- or.gov AUILD[NG D[V[S Supplemental Information
TYPE OF WORK FEE* SCHEDULE
® New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑ Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 312.70
® I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78
Accessory building SFR (3) bath 500.32
El ry g ❑ 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: 14144 ,1 Catch basin or area drain I I 18.76 I
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.: I Project name: Arlington Heights 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: Arlington Heights I Lot no.: 9 2 Fixture or item:
Tax map /parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
New, Single Family Residential
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: Stone Bridge Homes Fixture /sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 16869 SW 65 Avenue #505
Garbage disposal 25.02
City/State/Z1P: Lake Oswego, OR 97035 Hose bib 25.02
Phone: (503)387 -7577 Fax: (503)387 -7615 Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
Business name: SEE ABOVE Medical gas (value: $ ) Page 2
Primer 12.51
Contact name: Gayland Forsberg
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: jimd stonehridgehomesnw.com Urinal 25.02
I CONTRACTOR Water closet 25.02
Water heater 37.52
Business name: Legacy Plumbing
Water piping/DWV 56.29
Address: 8985 Hazelvern Way Other: 25.02
City/State /ZIP: Portland, OR 97223 Subtotal
Phone: (503) 816 -8887 Fax: (503) 297 -4587 Minimum permit fee: $72.50
CCB Lic.: 159281 Plumbing Lic. no.: 26 -517PB Plan review (25% of permit fee)
State surcharge (12% of permit fee)
Authorized signature: ' /L „ TOTAL PERMIT FEE
Print name: Matt Nelson I 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(10102/COM/WEB)
STONEBRIDGE OBE:
HOMM0 Nw LLC RECEI LOT: 92
10809 13W data: ANTE., # 0015 DATE: 2/9/11
L•311 OS•SGo, OB1ifi0N 97035 PROPERTY: ARLINGTON
(503)387 - 75'7'7
EL .2 - ' ' / 1 C—e_ HEIGHTS
'� , - � = - - 269' CITY: TIGARD =:
,�
5' WIDE LM'1E — — —if) SCALE: 1 " -20'
260 PLAN No.: 170
22 IIIII OPTION 11 ELEVATION
15' WIDE SSE
i
( 1
A 1 1
N "IIIIIIIIIIIIII
N
N 14' 18'x10'
DECK -6
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N i .
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v v
N , A 3,2316 ea . Zs
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N
low
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19'10'
:.
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20'2'
PORCH p
�;p 12'2'
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> •. n 2"19.
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4§45crise •, .
28 ' U�' :: ,� � .
1� i ` ....
.,,,,,
LEGEND
EL. ■215'
0
' 1 — STREET TREES:
� RAYWOOD ASH
t - FRAXINUS OXYCARPA-
LOT COVERAGE
LOT AREA: 6,960 SQ. FT. 1 1 1
BUILDING AREA: 2,383 SQ. FT.
PERCENTAGE: 342% 4 1.01 ' i q N N
NOTES: <_____N__4„. ,
ALL GRADE AND PROPERTY LINES ARE ESTIMATES OF CURRENT LOCATIONS.
ALL DIMENSIONS AND SQUARE FOOTAGE ARE APPROXIMATE FIGURES.
ALL RETAINING WALL HEIGHTS AND LOCATIONS ARE ESTIMATES. LOT
THEY MAY VARY AND BE SUBJECT TO CHANGE.
DRIVEWAY MAY DIFFER DUE TO LOCATION OF UTILITY BOXES, 6,960 BCi. ft.
STREETLIGHTS, AND OTHER SITE CONDITIONS,
>, . vka , v.
STONE BRIDGE F OBE: 1463
HONES NW 1.41.0 EB LOT: 92
10808 OW 0St3s AYE.. 66 606 DATE: 2/9/11
0911390, L•Ks oes9o, ORsGON 97036 C
(4505)387-7577 s Y os)se7 -7677 5•• ,� '� ARLINGTON
EL BUILDING DIVISI *O g OPERTY: HEIGHTS
•M' CITY: TIGARD
5' WIDE u i — — --i.,._ SCALE: 1 " =20'
260 — PLAN No.: 170
262 a OPTION 11 ELEVATION
7 _ 15' WIDE SSE— — T —a -
€ V lo p
a 1 PA
A t ry
in
1
1
1
n
,p 18 ' —{
n' I¢ , 18'x10'
DECK 0
1 269
P 269
A
N
r
N
c.
c
N\ ` a N
Nr
12'10' •
N � in
• 19'10' \
gi e0. FT7
5' % 2 is
PP -2.85' ;c 5 ,_ 0 ,
ce,, i o 6'10'
�� r 13'
I-
♦ ' .: PORCH
c0 : •' . `28 54 in 12'2' •
215
Aiirlcir ; .o.
- b j'4r
3 ` C D b/A3
EL. •zee �: >F/4'1___ tu
z a i ': ;u , .
C °' \
/ LEGEND ij \ — STREET TREES:
� RAYWOOD ASH
-\ ?, t., - ' ,- ' TI: FRAXINUS OXYGARPA-
LOT COVERAGE
LOT AREA: 6,960 SQ. F i
BUILDING AREA: 2,383 SQ. FT. ' XI
PERCENTAGE: 342% 4 'I X I
NOTES: -ti—
ALL GRADE AND PROPERTY LINES ARE ESTIMATES OF CURRENT LOCATIONS.
ALL DIMENSIONS AND SQUARE FOOTAGE ARE APPROXIMATE FIGURES.
ALL RETAINING WALL HEIGI -ITS AND LOCATIONS ARE ESTIMATES.
THEY MAY VARY AND BE SUBJECT TO CHANGE. LOT ma
DRIVEWAY MAY DIFFER DUE TO LOCATION OF UTILITY BOXES, 6,960 eq. ft.
STREETLIGHTS, AND OTHER SITE CONDITIONS.
tir
lig _ Building Division
Development Code Provision Review
T I G n R D Residential Projects
Building Permit No: -- — (gQ / / — 000A u
CWS Service Provider Letter Received: Yes ❑ No ❑ N/A
Routed Plans:
Original Plan Submittal Date: 1/ if
1st Revision Submittal Date: ❑ Site Plan Only
2nd Revision Submittal Date: ❑ Site Plan Only
To the Applicant:
Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies to the
Building Division. Only checked (✓) items are approved. Items not approved and those listed in the notes must be
revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed above each section.
Staff: please check items along left only if approved.
Planning Review (contact �{4 £ tug at 503 - 718 -.:- .45" ( or y� ✓ @tigard- or.gov)
Land Use Case No. + COL'' " C000 I Name Rai �G -1-c 1415 t
a Zoning 21
❑ Setbacks:,,,. r
Front I .) Rear i 6 Side 6 Street Side l Ga9ge = C,>
❑ Maximum Building Height 3s Actual Building Height
a Visual Clearance
�
D Easements , `, SSC
Q ' Sensitive Lands Type: CS Oee3 CIY1�' ti-45 ti-45 SIvpes
Notes:
Original Plan: Approved El Not Approved ❑ Date: 44 I
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @ tigard - or.gov)
Actual Slope: Z
Notes:
N &IL s ?fl L 1 s7`t1 i c-' To Iu )7�.
A-S *5 Ft F r c..� r
Original Plan: Approved ki. Not Approved ❑ Date: Z I i
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
i
City Review (contact Todd Prager at 503 - 718 -2700 or todd @tigard - or.gov)
Street Trees
Protected Trees
Notes:
Original Plan: Approved V Not Approved ❑ Date: . y-
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert @tigard- or.gov)
❑ Conditions of Approval Prior to Issuance of Building Permit
Notes :
Original Plan: Date Sent to Applicant:
Revision 1: Date Sent to Applicant
Revision 2: Date Sent to Applicant
Okay to Issue Permit: Yes P. No ❑
Date Routed to Building: i ,l./
Page 2 of 2
Oregon Residential Specialty Code N1107.2
HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: �Y7— 7o/ / - U O O 7 Jurisdiction:
Site Address: rS wzi I 4 /I j&- S
Subdivision/Lot #: /7
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)
Signatur: _1 A` Date: 2) /
Owner /General ontractor /Authorized Agent
Print Name: K R- S6(
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.
a .. The building official shall be notified in writing at the final inspection that a minimum of fifty percent of the
t permanently installed lighting fixtures are compact or linear fluorescent, or a minimum efficacy of 40 lumens per
input watt.
•
1:\ Building\ Forms \RES- HighEfciencyLighting.doc 07/01/08
Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I,
,LAfrN U� I $ , am the general contractor or the owner- builder
at the following address:
Site Address: /5 L i S W r I 9 (,
/ v
City:
Permit #:
S 2G I _ UV b?_
Subdivision/Lot #: Z
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: - Date:
General Contractor or Owner,Builder
1:\ Building\ Form \RES- MoistureSensitiveWood.doc 09/25/08
STREET TREE
.vto-4,,,,„ r
CER TIFICA TION
I, J i fr. ✓-( 5-4 �� , owner/ agent f -�17` -° .r c/7c // "`-`-f-s A F /
(PLEASE PRINT) (PERMIT HOLDER)
do hereby cent that the following location meets
City of Tigard land use and development standards
for street tree installation and is consistent
with the approved site plan.
PERMIT NO.: Nt. 57 20 I ( 000
ME ADDRESS: 75 ti 5 A-r1 , 5tL- , J/oiy % 5 (3)
SUBDIVISION: /�?� t; it,."._ pt; 5 c._7 C LOT #: `1—
SIGNATURE: CZ-, 1/-."� DA'] E: ( - 2-3 - ( /
Ik R /AGENT)
RE CEIVED &
VERIFIED BY: DA"1 E:
(CITY OF TIGARD)
Tree location verified per approved site plan.
•
I:\ Building \Forms \Street 1'recCertificate 04/01/2011