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Permit r! CITY OF TIGARD .,. p t' , " MASTER PERMIT 11 .4 'g COMMUNITY DEVELOPMENT I AI Permit #: MST2011 -00069 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/06/2011 - Parcel: 2S110CB09800 Jurisdiction: Tigard Site address: 15227 SW ARLINGTON TER Subdivision: ARLINGTON HEIGHTS NO. 3 Lot: 86 Project: Arlington Heights No. 3, Lot 86 Project Description: New SF. 6/15/11, reprinted to correct owner information. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1262 sf Basement: 0 sf Left: 5 Parking Spaces. 0 Height: 24 Bathrooms: 3 Second. 1556 sf Garage: 440 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2818 sf Value: $318,753.74 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 0 Tubs /Showers: 3 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 Temp Srvc /Feeders Branch Circuits 1000 sf or less: 1 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add'I 500 sf: 5 201 -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 2818 Owner: Contractor: SKYLINE HOMES & DESIGN SKYLINE HOME & DESIGN INC Required Items and Reports (Conditions) 6021 SE MILWAUKIE AVE 5609 SE MILWAUKIE AVE 1 Ersn Cntrl 503 - 681 -4444 PORTLAND, OR 97202 PORTLAND, OR 97202 PHONE: 503- 235 -3810 PHONE: 503 - 235 -3810 FAX: Total Fees: $18,652.26 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 don accordance with 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 r-• ire you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 01 -0010 rough OAR 952 -• • ∎ -009' Yi u may obtain a copy of the rules or direct questions to OUNC b 2.1987 or 1.860.332.2344. Iss d By: / / Permittee Signatu . 4 Call 503.639.4175 by 7:00 a.m. for the next available inspection dat . 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. 1 CITY OF TIGARD MASTER PERMIT p :rill 2 COMMUNITY DEVELOPMENT Permit #: MST2011 -00069 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/06/2011 Parcel: 2S110CB09800 Jurisdiction: Tigard Site address: 15227 SW ARLINGTON TER Subdivision: ARLINGTON HEIGHTS NO. 3 Lot: 86 Project: Arlington Heights No. 3, Lot 86 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1262 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1556 sf Garage: 440 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2818 sf Value: $318,753.74 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 5 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 Fum <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'I 500 sf: 5 201 -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 2818 Owner: Contractor: COLUMBIA STATE BANK SKYLINE HOME & DESIGN INC Required Items and Reports (Conditions) BY JECK, AL 5609 SE MILWAUKIE AVE 1 Ersn Cntrl 503 - 681 -4444 17800 SE MILL PLAIN BLVD, STE PORTLAND, OR 97202 10 VANCOUVER, WA 98683 PHONE: PHONE: 503- 235 -3810 FAX: Total Fees: $18,652.26 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 ' ec • dance with approved plans. This permit will expire if work is not started within 180 days of issu.nce, is suspended for more the 180 days. TTENTIO Oregon law requires you to follow the rules adopted by the Oregon Utility Notificatio Ce � • •se rules are set forth in OAR 952 -0 1 -0010 through •:' - •.1 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503 324- 60.332. 344. 1 .- Issue : , # Permittee Call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application 1: e Xi .7D / / E. X K Residential R ECE FOR OFFICE USE ONLY l ; , ' City of Tigard APR 2 7 2011 ey Permit No.: /,� 0 9 � ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ► Phone: 503.718.2439 Fax: 503.598.19 Dig : �` �� ■ Other Permit:�r it _ b �/„ e / Inspection Line 503 p ���` OF TI G I 0 Date ReadyBy: �/'� � Iuris: 0 See Page 2 for TIGARD BUILDING n C''.' at et hod: Internet: www.tigard -or.gov NG Dno .l i, Supplemental Information TYPE OF WORK REQUIR ^4,i DATA 1- AND 2- FAMILY DWELLING N ew 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. w 1- and 2- family dwelling ❑ Commercialindustrial Valuation: $ [J Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: 3 JOB SITE INFORMATION AND LOCATION Total number of floors: . Job site address: 65 ' a t a 6tTbijr o e a-n y, New dwelling area: (s square feet • City/State/ZIP: "� D =rJ ` Garage/carport area::_ square feet Suite/bldg. /apt. no.: Project name: Covered porch area: > l4 square feet f 'j Cross street/directions to job site: /1 �-c� ATV � -t f t d 4r3 Q '3 Deck area: P' square feet i Z 62_ �lI Other structure area: )Z� square feet REQUIRED DATA COMMERCIAL - USE CHECKLIST' Subdivision: 0.6-i.rel tieu.1,475-, Lot no.: ek 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. 4 - i a. iiG ( Valuation: $ — Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: Type of construction: Address: Occupancy groups: City/ State/ZIP: Existing: Phone: ( ) Fax: ( ) New: — ❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* Business name: � E ry i &- i d, lac , (Please refer to fee schedule) Structural plan review fee (or deposit): • Contact name: 112ext tota.. LE Z, _ FLS plan review fee (if applicable): Address: (0021 di,. M 11.. 1 Au w e G Total fees due upon application: City/State/ZIP: r fr X17202 _ — �_ Amount received: — 4,�. Phone: (S2S 2 .36' a Fax: : (15D3) 735 - .206, PHO'I'ON'OLTAIC SOLAR PANEL SYSTEM FEES* E - mail: T p i oc e CJ tit ( /� , /fi�l r CONTRACTOR � Commercial and residential prescriptive installation of roof -top mo ed Photo Voltaic Solar Panel System. Business name: •1 // Submit two (2) • - of roof plan with conne on details and fire departmen • cess, along ' • • e 2010 Oregon Address: Solar Installation Spe ' . C. checklist. City/ State/ZIP: Permit Fee (incl an review $180.00 an. 'nistra - fees): Phone: ( ) Fax: ( ) State s • arge (12% of permit e • $21.60 CCB lic.: , Y1 -1 S Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: "(�•�"� 'p 4 01 6 ._ , Date: 41 V (I 'Fee methodology set by Tri- County Building Industry , Service Board. I:\ Building \Permits\BUP- RESPermitApp.doc 02/24 /2011 440- 4613T(11 /02/COMJWEB) Apr 27 11 09:05a Electrical Permit Application 1 APR 2 7 FOR OFFICE USE ONLY 2011 •. Nitil F s of T Tiard, OR 97223 ' I , I Mons: 503,718.2439 Pax: 503.598.1 If Received ,/ A Date/fly, •r• p 9CITY OF TIGARD ' 1'41,7:iew Iii ,crtnr. No 2 Other Perrin. - eutzt22 ,, GARD Inspection Lint: 503.639A115 BUILDING DIVISION . m0eRsadvaly , itiot re 'See Page 2 for Interact: www.tigard-ofgov Nonfied/Mothod: Supplemental In formnion i f , :4•4" : 4,I..V . „,:i....*44 04 - ..,i, •• ,,........._,_____*. .:•: . ttA,:z.:f'-': 5 4::,4•*M7..A 414 g"7 I F, •••,, ., • , lotwi . nEview P/e ehecl all 1, apply (subrnii 2 sots of plans ...items checkctibtiou ----- essi construction 0 AdditiontaiteratiOnfreplgOateM 0 Service or feeder 400 amps or mere 0 Outding over tree store 0 Demolition 0 Other: ',viva Ott available huh currer? 0 Marinas sod boiloyerds CI exc . 19900 417ip 10 volts co 0 Flat lag buildi e 5ongs ,...", ' • f • :' , ',..' .. P..-'44.! -41.?.$0;f'R1,s'... .:, ; . ' - ..., eds less to ground, or exceeds 14,009 M Contrive tal-are al:nudism 1,M I- and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all mar installations. buildings, 0 Mtliti 0 Master builder 0 Other: 0Fire pimp, 0 hail:atom of 75 KVA or ,. ' ., T. . 0Ernergescy system :area separately derived system ' k:,,,t.V. •,,..1*it , .::::'.. ' - ' ,.:., 0,14400m of new motor load „f 10011P or more, occupancy. , Job no.: i°b site ad dreU 8: /6 /3 or more residential units 0 Reertiorionel vehicle parks I City/State/ZIP: 0 Hatt-care facilities 0 Supply wine co, mare Iva- 0 Hazardous location& 600 mks nominal. Suiticibldgfapt. no.: Project name: 0 serViCe at feeder 690 amps or more, , ... FEE SCIIEDULE Cross street/directions to job site: anirivoio• 1 on'. 1_, Rte. 1 Trial Ncw residential single.. or multi-family dwelling, unit. — Includes attached garage. ....— i t Subdivision: Cl m44 ir me klo to nos: ty& 1,000 s o. ft. or less Ea. adifi SOO sq. it. or portion $ i 6/.54 Oil iSA4-1 33.92 -• - . iW1 • , Tax map(parcel no.: Limited energy, residential 7 00 2 I ,:." A l 4 ; , Z:- 4: 11 '''• 5' 4: E.- = - :: 4 ' : '' ., ', ,.: v " „ ;,...,, .: „.•:,. -i,,,,i: ,,,,,,,,,.., a (via above sq. Al --l ;..,..„. - • ..aa.a• --•.:i - - - - -,-----• - - ' - -so" '• '''"V - — Limita energy, nufamily COTAYMC4k msidential (with above sq ft ) I 75 " - 75 - 40 2 , ....Services or feeders Installation, eitcratkilt, issrdlor fc 1 • 200 amps or less 1 00,70 2 flntitiPORItztaVtit T : ' , .. - ta,.. : - „.: -- , , ,:. i 201 amps to 400 amPs 1:3355 s , ...... . 401 sings to 600 amps 20034 Name: 2 l ' 601 amps In 1,000 anus 1 301.04 2 ' — , --4--' Address Over 1,.003 amps or v OHS 1 552.25 , 2 .........____.—. Temporary services or fecders nistallation. alteration. and/or City/Stale/ZIP: relocating ; Phone: ( ) [ Fax: ( ) 200 amps or leSS 59,36 ail amps to 400 amps 125 08 : 2 Owner installation: Tit. installation is being made on property that I own which is not 401 amps 1 intended for sale., lease, rent, or exchange, according to ORS 447, 449, 670, attd 701. to 599 amps 68 Si 4 2 Braise) circuits - new. alteration. or extension, er anel . Owner signature: Date: A Fce for branch circuits with 1 .. ' : = 5 l':•; f't .:*:f .ti • . .. 7- is ... ......,,........ l above service or feeder fee, 7 42 '2 . ,..4.....-- - --,•- M "-,,,,, "•, each branch cumin Business name: gv.44(..t ae 4.1.0 i 6 H. Fee for braneti 'circuits without ---- tervice or feeder fee, first 56.18 • 2 , COritatt. name: -az uu.3 Len, branch circuit — - — — Each add': tiranch „.„ 7 42 2 Addres5: 0 ZI O ( tOk) (44 14;6 Di* E Miscellaneous (service or feeder owl included) Each rearnaractured or modutar City/State/ZIP: ibrattgArp_4 • 4 1 . 7 20 2* _ dwelling. service andior feeder 67.84 2 Phone: 9:3•;) Sor , ..57.7 F , t sta ) a 3 �/7 Reconnect only 67,8a 2 "-r. Pomp or irrigation circle 67.84 - 7' E-mail: Sign or Donate Imating 67.84 2 a 1 :;;; ; :: ,;,:: e.,:: .,-...., ::il..*:11 gt s•4 -.. , -7. , • , 14..- •.', :,,,, :.• .-. . :• ,-:.• :- _.: : • , , - ,..::: Signal circa SO) ot iiinited.energy Rosiness name: p ELE-e ,s 1 panel, alteration, or extension. Page 2 2 Each additional inspection over allowable in any of the above . ,....-- Address: ( 9444441 5— N I vi 0 AR D czA v t.., Additional inspection 0 hr min) 1 66.25i lir Investigation (1 hr min) 66.25/ br City/State/ZIP: ' th or . f ) "' cli .... , . Industrial plait (1 hr min) 78.18/ br Phone: L5):3 ) Cote I 344. Fax 36 . O(3 Inspectiors for Mick no fee is ' 90.00i hi i .- spairwally Ilvs,e4 (A hi min) ' Cell Lie.: 014.9276 1 Electrical Lic.: 54..-yrL3l Suprv. Lie: /t 7c f5 s,: 1,.. . ..., i xopritivo FEES Suprv. Electrician signature, required: ( 741 i_y( ......_ Subtotai: ikl" ,11.1, ....... Plan review (25% of peritsit fa): Print name: Z c KAAPit' Date: 4 ,.. 1 State surcharge (12% of permit fa): 41... 6 ._ Authorized signature en clgg,..- rOTAL PERMIT FEE: 4 ( 7.. .7 2 This Permit NINtikalioll expires ir A Mink i$ 601 4tbiainal WithiP 1s0 - Print name, F ,. t. L .1. & ir f. z.„. Data: k-r).'7 —is i days after it iiiiS bait accepted as erisoplete. ' Bombs: of inspea ions al lcnved pet permit. I ViuddingTes miitT.I.C•PerntAppiac Olt il IQ 4 404615T(14/03/COMAVE it Mechanical Permit Ap FOR OFFICE USE ONLI City of Tigard , t t' Permit No.: �t / IIM •J Date/By: 7 a7 0 / [ . , , /� (0o(Q9 W 13125 SW Hall Blvd., Tigard, OR 97223 g 7 R 2 7 2 011 Pr Plan Review Other Permit: D / �/y�� Phone: 503.639.4171 Fax: 503.598.1960 Date/By: z.0 T I G A R D Inspection Line: 503.634 CITY GAR D ITY OF TI Date Ready/By: rubs: ® See Page 2 for Internet: www.tigard- or.gov 1 Notified/Method: Supplemental Information PIT n'Nr- DIVISION TYPE OF WORK COMMERCIAL FEE* 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 OF CONSTRUCTION Value: $ RESIDENTIAL EQUIPMENT / SYSTEMS FEES* En- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description ' I Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling �• `\ ` D /� Air conditioning Job site address: 1 a3,-7 )� AB / J `p / 2 i ) rr i .e. • (requires site plan showing placement) 46.75 City/State/ZIP: Furnace 100,000 BTU (ducts/vents) 1 A"VPS- Furnace rnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg. /apt. no.: Project name: Lt 1�.1`O k) ( 3 •3 Heat pump 61.06 Cross street/directions to job site: i 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: 44m ' 4-i s &A Lot no.: Flue/vent for any of above 23.32 t Other: 23.32 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 1 23.32 "/, 4 04:34 4 L1 Flue fireplace vent f for 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 OWNER ❑ TENANT Chimney/liner/flue/vent 23.32 Other: 23.32 Name: Environmental exhaust and ventilation Address: Range hood/other kitchen equipment r 33.39 ��✓ City/ State/ZIP: Clothes dryer exhaust 1 33.39 Single -duct exhaust (bathrooms, 5 Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 2 3.32 1(3, vr APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32 Other: 23.32 Business name: t.. 141st) G 4" Ilk, ..A • Fuel piping Contact name: '••,fir —, L.m.-12--_ $14.15 for first four; $4.03 for each additional _ Address: / l G� WI t 14 Q VE Gas h ea t etc. 1 •1`� (y Gas heat pump City/State/ZIP: P C 1 • 4'7 e2 ., Wa11/suspended/unit heater Phone: ( SCED 235.3$( d Fax: : (So ?) Water heater ! Fireplace E -mail: Range 1 CONTRACTOR Barbecue y�,5 �, Clothes dryer (gas) Business name: )(7j t Tiax"� t at,/ Other: Address: MECHANICAL PERMIT FEES* City/State/ZIP: Subtotal :), e rr Phone: Minimum permit fee ($90.00) (So 3 p SIS 5 ?t, 3 Fax: ( ) Plan review (25% of permit fee) CCB lie.: r /9,4 '75 State surcharge (12% of permit fee)• L TOTAL PERMIT FEE '?-2-7. 1 This permit application expires if a permit is not obtained within 180 Authorized signs d ays after it has been accepted as complete. Print name• Date: * Fee methodology set by Tri- County Building Industry Service Board I:\ Building \Permits\MEC- PermitApp.doc 10/01/09 440 4617T(11 /02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi- Family Fee Schedule: Total Valuation: Permit Fee: $0.00 to $500.00 Minimum fee $69.06 $500.01 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. $5,000.01 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. $10,000.01 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. $50,000.01 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 $2,608.71 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:\Building\Permits\MEC- PermitApp.doc 10/01/09 2 Plumbing Permit Application Building Fixtures RECEIVED City of Tigard Received [/ n / III - g an 7 4t r r I ` Permit No.: il L_t�1� w 13125 SW Hall Blvd., Tigard, OR 97223APR 27 2011 Date sy: / vr� Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date /By: Other Permit No • �j�Q�/ D�/ Inspection Line 503 639 4175 CITY OF TIGARD v �4^'s! �+' T I G A R D s Date Read /B l uris El See Page 2 for Internet www tigard or gov ,.. , i . Not Supplemental Information -. o 44 1 r , i .. ,. n � ' l� � 1:g1vew construction 0 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) ittYj I t .. ... SFR (1) bath 312.70 and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78 ❑ Accessory building ❑ Multi - family SFR (3) bath I 500.32t `��a Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire k ire sprin ler ( , sq. ft.) Page 2 t _ . m ,:: 1 R A�'T3< ''p" /,, i;4 ,.. h Site utilities: 0`O . 7 - 2L1 ►�caTO 0 Catch basin or area drain 18.76 Job site address: / 6 Drywell, leach line, or trench drain 18.76 T(j Pa City /State /ZIP: ,� Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: 1 Project name: 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: [11 (4 Lot no.: Fixture or item: Tax map /parcel no.: '•'1 Backflow preventer 31.27 I r r AI s `' i y _ Backwater valve 12.51 Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors /sump 25.02 �I�i Expansion tank 12.51 mss. Name: Fixture /sewer cap 25.02 Address: Floor drain/floor sink/hub 25.02 Garbage disposal 25.02 City /State /ZIP: Hose bib 25.02 Phone: ( ) Fax: ( ) Ice maker 12.51 V . n y � "' Interceptor /grease trap 25.02 • Business name: G• (t i 4 �� `uG Medical gas (value: $ ) Page 2 �Att 'o F Primer 12.51 Contact name: `-j �'�'Y Roof drain (commercial) 12.51 Address: X90 z 45 rYt c t...“04.4 46 t: Sink/basin/lavatory 25.02 City /State /ZIP: .rbizri4411r, t az . pr 7207 Solar units (potable water) 62.54 Phone: (. ) 2s5 , t7 ,g(O Fax: : (93) 23t7 3a&cr Tub /shower /shower pan 12.51 E -mail: '� C J Lila, p-�a�s . ak". Urinal 25.02 Water closet 25.02 Water heater 37.52 Business name: S� ti� - ��� Water piping/DWV 56.29 Address: ' S � (} , /t /�.- 1�IG/ , Other: 25.02 City /State /ZIP: Ob"- /,,'`�°'�eR, /_ t ,, • ¶7 7132 Subtotal Phone: (t7yf V j ) �i g ��'"'``���� Fax: ( ) Minimum permit fee: $72.50 CCB Lic.: Aoly� -, i ryfi :, Plumbing Lic. no.: 17 cj Plan review (25% of permit fee) v ' State surcharge (12% of permit fee) (c)0,04- Authorized signatul !/ /II I( r • i TOTAL PERMIT FEE, Print name: j 'h p Date: d. • 24 / • �{ 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(10 /02 /COM/WEB) III " Building Division i II Development Code Provision Review r i c „A ii D Residential Projects Building Permit No: I -( - AO1 I -Coo Coq CWS Service Provider Letter Received: Yes ❑ No ❑ N/A N pr Routed Plans: Original Plan Submittal Date: 1 i 97 /1 1st Revision Submittal Date: .,AW /r lir 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 1J' w" at 503-7184-4 or p l-t r(12.1 @tigard - or.gov) Land Use Case No. S Ct8 d nig - ,jVL' i Name (A it rh/&f C , )c tom ❑ Zoning P1 ❑ Setbacks: Front f 7 Rear N Side Street Side /0 Gapge ❑ Maximum Building Height 35 Actual Building Height ❑ Visual Clearance ❑ Easements I ❑ Sensitive Lands Type: at---f 5 3( U pe S 5 r�. - (fd -u/, - -0' tt , I L C b a.ii 5� Notes: C Original Plan: Approved Er Not Approved ❑ Date: if (2% I I 1 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) -Yi Actual Slope: / D Notes: Original Plan: Approved Efr Not Approved ❑ Date: 5/ Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 City Review (contact Todd Prager at 503- 718 -2700 or todd @tigard - or.gov) 0 St reet Trees Protected T ees I Notes: kt 7 b�. a`' cjr. 1 7 '•r k,,_ pky Ic( //3\ J fl-r oyyv✓u -„d �8 Original Plan: Approved ❑ Not Approved 04 Date: 5 `( .?a ii Revision 1: Approved Not Approved ❑ Date: i of 11 Revision 2: Approved ❑ Not Approved El 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 No ❑ Date Routed to Building: Page 2 of 2 rn �� i _� 28 _ " RECEIVED! as m APR 27 2011 r -- CITY OF TIGAD © :® S3 ' BUILDING DIVISION 111 ' D ,� r 6U I tDtiNG D ;VISIOC� cD x-- la • - 1a ,- aD / / ffp N 1 k s i i. I v Q 20' PUE NED WATER LINE 01 _'_'_' 2 2r 2,3"2/1 / Did NATURAL . - :.. :. I I _ 1 P g - -15! ( 1 _.1 _ ____ ____ _ _ 541\11T4tR)' SEWER LINE _.__ -- 70-------- a .-. r r . r r r I -P kV 4 ; 1 13 c o , g 1 Z 4 s'..:"f:':: - D .: : -..,„„. .,.. • 1 ` — --+ 1 (M 4 r rr I O 0 . _i...- — lip 4 NJ T. d 4 Z, t\s= 1 P 1 2 — 1 r— . 31'10" i N I i/ B 2r rr \ • 1 .. %.ks i‘ I Z 4 _1 +3 rri <yr '1 A 4 PAP .11 ni '∎ 0 ITI __, 100. 3 , __,, II I as N N � N r 1 ► /, P. (,0 18 —2 1 " L 5 � STREET TREE . .. ET'''' i CERTIFICATION I, --c-,0(4F0, „I 1—e v- , owner /agent for G u,IE i ' t7.4.-,t(o , (PLEASE PRINT) (PERMIT HOLDER) do hereby certift 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.: 20 - -e SITE ADDRESS: 15227 ` p..i-.( -1e--IT17k - TAR . SUBDIVISION: -- 4 y 1 2 LOT #: 8Co SIGNATURE: �lr� DA"I E: - 1. ' • l l (OWNER /AGENT) RECEIVED & VERIFIED BY: DATE: (CITY OF TIGARD) Tree location verified per approved site plan. I:\ Building \forms \StreetTrecCertificate 04/01/2011 Oregon Residential Specialty Code N1107.2 HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: _ Lo Jurisdiction: r2 — i lmA 1217 M�r� l! Site Address: - ,�2� 1 t. - rop. - rev. Subdivision/Lot #: P- 1 1 [ t Oce and/or T � Map and Tax Lot #: O e. D q e209 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: 1 • /i . U Owner General Contractor /Authorized Agent Print Name: TRocl f4_2, 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 R318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM I �1 ,( VotaL R , am the general contractor or the owner- builder at the following address: Site Address: ‘Vw ikI2-4,IL.I(2T04 -- TEP. City: Permit #: M‘6r _00 Subdivision/Lot #: M 14 � # s aLo and/or Map and Tax Lot #: 237 ((0010 9 jOO 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. • za � Signature: Date: 1 General Contractor or Owner - Builder l:\ Building\ Form \RES- MoistureSensitiveWood.doc 09/25/08