Permit N ei CITY OF TIGARD MASTER PERMIT
. - 'tz ,` C OMMUNITY DEVELOPMENT P ermit #: MST2011 -00082
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/08/2011
Parcel: 1 S125DC08600
Jurisdiction: Tigard
Site address: 7144 SW ASH CREEK CT
Subdivision: ASH CREEK ESTATES Lot: 19
Project: Ash Creek Estates, lot 19
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 3 First: 923 ' sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 26 Bathrooms: 4 Second: 1244 sf Garage: 592 sf Front: 8 Smoke
Dwelling Units: 1 Third: 1286 sf Right: 3
Detectors: Yes
Total: 3453 sf Value: $382,600.92 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 4 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: Y Vent Fans: 6 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 5
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: 7 201 -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 3453
Owner: Contractor:
WNDWOOD CONSTRUCTION INC WINDWOOD CONSTRUCTION INC Required Items and Reports (Conditions)
12655 SW N DAKOTA 12655 SW NORTH DAKOTA 1 Ersn Cntrl 503 - 681 - 4444
PORTLAND, OR 97223 TIGARD, OR 97223
PHONE: 503- 780 -4325 PHONE: 503- 625 -6526
FAX: 590 -7606
Total Fees: $19,717.80
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 d in accord 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
d s. ATTENTION: Oregon - . re. ,ires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
9 2- 001 -0010 T hrough OAR ! -r191. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.23
Is ued By: , « /'if/�l l l Permittee Signature /
T _ Call 503.639.4175 by 7:00 a.m, for the next . . . e ction 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
Residential /
c \_� FOR OFFICE USE ONLY
Received
II City of Tigard „\\ DateB : I i>ri Permit No.: u - (/
13125 SW Hall Blvd., Tigar % Plan Rev ,.q I
' Phone: 503.718.2439 Fax: 5 8. ` 19 A �Q1 �� DateB : �j:`i���r Other Permit: // r a .r
Inspection Line: 503.639.4175 \� \ C.,P - �� 0 ate . ea. :: June: See Page 2 for
T 1 G A R D
Internet: www.tigard- or.gov \ �S Notified/Method: .. 7/ � _ Supplemental Information
*�! C ^ LV' .fz.r ; Le
TYPE OF WORK REQUIRED DATA: I- AND 2- FAMILY DWELLING
„Err - cw construction ❑ Demolition Permit fees* arc 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.
and 2- family dwelling ❑ Comercial /industrial VValuation: $ 3 CJ2 t `j2
m
❑ Accessory building CI Multi-family Number o °bedrooms: 3
❑ Master builder ❑ Other: Numbero - bathroom; -
JOB "SITE INFORMATION AND LOCATION ht tuber of floors: 3
Job site address: - 7 ! eiel sh f / Od C/ New dwelling area: square feet
City/State /ZIP: 76 ca— &-r a--12-)'7 Garage /ca_port area: 41rl" , square feet 1-28c, Suite/bldg. /apt. no.: Project name:/ Aj/ /L?i{ ` Covered porch area: (2A4- quare feet �
Cross street/directions to job site: / /�� '" Deck area 3 (5 (p square feet C
? CS L. 4' Other stru:ture area: 40445 square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: m 4) Sri AA I Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: !S /� "`��� G �6G� indicate the value (rounded to the nearest dollar) of all
eogtpmgp materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK NM°ted on this application.
/v�, 5 � Valuation: $
Existing .wilding area: square feet
New building area: square feet
r -el - PROPER Y OWNER ❑ TENANT Number o, stories:
Name: tA ( a ,,,„V C�,.y1 < Type of construction:
Address: /2-co ,S' f.., , firj -k D. 4,//t__ Occupancy groups:
City/State /ZIP: pr ar
! .� ell' Q7'.)-...)-- Existi>g:
Phone: 67 !!! 8a 25- Fax: ( 5 ?5 S fQ- 2 0 t New:
1.1CANT ❑ CONTACT PERS BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: l 4-1 L/ Structural plan review fee (or deposit):
Contact name: �w
review fee (if applicable):
Address:
City/State/ZIP: Total fees due upon application:
Amount received:
Phone: ( ) I Fax:: ( )
E-mail: PHOTON OLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR tAnlme[Llal and residential preseriptice installation of
roof -top mounted PhotoVoltaic Solar Panel System.
Business name: C Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
City/State /ZIP: Permit Fee (includes plan review $180.00
and administrative fees):
Phone: ( ) I Fax: ( ) State sure large (12% of permit fee): $21.60
CCB lie.: 5&/5 3 / ) ( ( 3 Tots fee due upon application: $201.60
Authorized signature: �— This permit application expires if a permit is not obtained within 180 days
�f ( �� after it has been accepted as complete.
/
Print name: 27 C !`14 Date / * Fee methodalogy set by Tri -County Building Industry
I:\ Building \Pennits\BUP- RESPermitApp.doc 02/24 /2011 440- 4613T(11 /02/COM/WEB)
,e \\,1% 11110.01401014VF:...•::,:
Electrical Permit Application onotfteuensPoNtA.:.•
E- C,ity of figard OR lik:Si,k)V-:‘ Rea.:eived
M'i - 4 13125 SW Ilan 'Blvd,. Tigard, ei'i2N1 \ % (-
cl )1\1\
Phon -- rt a ii t i ei tct 13: evieWt --- - -- -- - -
'tilt:- iti 5 itSila e 503.639,417 1 Fax: 5 03,598 .1960 0
1 111
Datitilas: i re u ri h r er ' Z : n ffi : 574°11 ---CIL).'g2.-
_ t
ttilielittenliOil' Inspection Line: 5O36394 75 ^ N. Date Ready/LI iarii 1 2 Scie Page 2 for
'.itittriiiWiiii , ..c V"! ' ,r\V -- '• '
F:m: tnrernet: avwvt'.tigtird i o'ct. , \i\ itsoutrediNtlethort: ,,.,_ , ,, ,,. ,., 1 suppletuentat tnformartaa
i„
I"
TYPE OF WOR P v c-1
,
, .......
'PLAN REVIEW '
; Please chezk all that apply (submit 2 atts cif plans mditaais chnektid beiow'y
,,[2rew construction 0 AdditioWalteratio ? placement
, 1 0 Service or feeder 400 amps et Inora 0 Building osier three stones.
, 0 Demolition [] Other: where the available fault cm-rent 0 Masi:ins and boinyartis,
CATEGORY OF CONSTRUCTION F eucads 10,00 stops at 1.50 i.uits. (a 0 Floating buildings
: !cos to ground, or exceeds 4.000 0 Ccanincretal-usi: agnctili ural
1r and 2-family dwelling 1:11 Commercial/industrial E Accessory building alopri erri all nth.' inliatiamS. bujidmgb,
0 mutti-family 0 Master budder 0 Other. I 0 le pump 0 inritallation or 75 KVA in .
I 0 Onset too syminta tat go; iieparrAniy dot to al ii
JOB SITE INFORMATION AND LOCATION I 0 Addition of mnv motor load of
i Job no 1 Job site address: 7/yy5,)/)0,-/,,t‘o.-/ IC:0111' 0 lli nil 0 i
OC
I Sis or mon.: reide wigs ni.;ciiaiiiiii,a
= City/Statei."ZIP, 9_, I 0 1 iealithcare incilitinti. 0 Supply voltage :nil more Om
i• ! 0 Nazar:ion-a lc KM volts norninai
StittelblilgiaPt. no,: Project naine://4 C 4...3,44 0 Service ra ilteaet 600 amps or 11101"e, —1
, FEE SCI1EPULE ,
: Cross istreetlilirect ions to p .11) site:_ _ _ ,,..,. : Itrati$0414 I '
New re.sidential single- or mulfi-farnity dwelling unit,
Includes attached garage,
i Subdivision' /9. A or _ /........ . ,/„., 1 L no , /9 i i sq 11, or less 1 ( 1 168,34 ' 1 ( 4 '
- ''' - ' r ' : ' , "" ------- ' i I Ea, addil 500 sq. ft. ot pontos) 7 B92
Tax map/I no
ww, ed/ I C _ 0!iir 1 Lorded energy, residential
1 , 75 00 l 7.6 2 ,
•ESCRIPTION Of WORK ! (with above sq ft.)
i 22-7 --
Limited energy, multi-family i
/1/A1 ..Cit- . residential (with above sq IL) i
1 1 75.0o t
_
i Services or feeders lomWlafiontafteration, and/or relocation
r .. 1 ,
2IX) amps or le. 1 100,70 i
-
1 PROPERTY OWNER El TENANT .1-7,
i _01 tongs to 400 am - 2 1
ps 1 1 133 36 1 1
1 t i
s 1
1 401 arnits to 600 amps 200 34
3 ' '
Name. A A, e/ (iitt.0
- . i I eel amps ai I 600 anivii i 300041 1 2 1
Add / 5 - 5 -- „st 4 _- / 9 e / e ,4 2 1 . _ 0 1,000 amps or volts 1 1 tss7 ttt() 1 2
• 'tli___ _ _ _
I City/State/ZIP: r,e./ 92
-7 e ,..2.A.3 Temporary services or feeders install n n
installation, alteration, adic o
I , relocation
, t ,
Phon: (Z) 9 70,1/325 I Fax: (5-)3) 5-9,-7iaa 1 i 2 00 amps or less
i i - 3.6 1 7 59 1
. ,
: 201 amps to 00 4 sanps 1 :2308i 1 2 1
1
1 Owner installation: This installation is being made on propert:i that I own which is not ;--- I I .
t 1 2 I
intended for sak, lease. rent, or exchange, tut:cording to ORS 44 449 670 401 amps to sop amps 1613 54 . rind 701. ; -....,...
1 ; Branch circuits - new, alteration, or extension, er handl
Owner Signature: Date: t , 1 [ A. Foe to; branch circuits with
....... __ .............:_.:.._ 7 1 :
i above service or feeder fo,,, 1 1 7,42
a APPLICANT -g-.C( PERSci)N
i each branch circuit i : a
— t
____ „ .„._
7 r
I 42 Business m -
ess nae: I B. Fee for branch circuits withut o i ,
1 :
;---- ' ' 64 _ „ ; service or feeder ke, litst 1
on na
tact me; --
___ .... taxci : branch circuit I
— 6
C Addres 6,18 ' 2 - 1
r --
rsi
1 - 5.11--e-..... _ -- 1 Each add"; braluth CITCU L a i
- - ;
1 I
r Miscellaneous — (service or feeder flat ineittdCd)
-,- -,---4
Each manuflictered or modulr 1
a [
CitylSittit(ZEP: i 67 0-1 t a :
i, dwellin t service and or 1t1 1 - -
L ( ) -e-4...01,-C. : 19tx. : ( ) i Reconnect only. 67,84 t 1 :2 1
- _„__ '-- ------- --- Pump or irrigation circle
--11 _, 67,84 1
li [ 3 i
mail: - t
._ .. „_. O :i. _„, Sign or outline lignting 1 o7 84 1
CNTRACTOR ._- „,,,..„...._ ,
Signal sareitatts) or lirrated-enurgy
Business name: n IT
X1 F14 (- i i/C.-/ _ rand A
, eration, or extension 1 . i Pane 2 I : 6
:
.. 76..,
---_,......_ Inch additional inspection over allowable in Ally of the above _
.,
Address ; ) -" ? - 30X - 15
h
t
Additional inspecion (1 hr min)
1 66.259 hr
FT: St Ue ZIP' ton (1 hr lir min)
‘01. 9 1 r---- --
i t
Industrial plant il mint 78.181 hr 1 t ,
Phone: (9:)5) # 4 t — ,,,t 4 I Fax: t--3/2)) :›en..... 2.2.,
! ec::o fhich no ree rs i
l 90 00 , hr ' ' 1
1 '
"--”' — Insp tim or ta
: sixtedittalty fisted (ts h r min) i '
CCIB Lie.: 1551-- ELE
t 9 Electrical Lie. m— ric, i Stipris. I ic - , iC 1 7 2 - 7.‹-; 1 . ,
CTRICAL PERMIT FEES
i . ' ' ; .' ',,,
i i Subtotal: ,
1 Suprv, Electrician sign at ,._ _ ure. required: - .41011.,.„_„--"
Pli111 TeVi (25% Of permit
. . . .. ,
,
It rint name: - br t't i c
1 l. ,,z 8,- - ( 2 3.. ke ile 1 psi( a- St ate surcharge 1.12 % of permit fee) 7 7 z
: I i-, i
......_
N.f.7......v 1...„ . .....__A-,L.L.....Lik.....__.
' .___5.,:e
I Authorized signature: i „.„, -
Thia pertmt application eoptrea if a permit to not obtained within ISO
i —
1 tilty after it has brel3 accepted aa complete.
I Print name: I 12ate. 1 ' Somber of inspecitnins allowed per permit,
, . ..,._,.._
i-diaildin&c•iiniid■ndc .Pon,:tAisp t:o.:,:. 07:0:, in 44.) -se t, s !Ai'. COM.AV,..ii
=s%. ' ) f `: - -- , , ,- ` g am . i ;a
Mechanical Permit Application ` FO`R OFFICE USE ONL ' - "
a City of Tigard ®N,t @;r' e Received
DateBy. '. 1 Permit No.: M S T� II — <-) � , y,
.2._
r " 13125 SW Hall Bh�d OR 3 4 � a Plan Review
= Phone: 503.639.4171 Fax: 503.5•'. ,10 , r % \ Date/By- Other Permit:
Insp Line: 503.639.4175 % Allis- ; / TI CARD 1 Date Ready /By: Allis- 0 See Page 2 for
, f Internet: wwrw.tigard- or ' 1 0 r OD Notified/Method: Supplemental Information
'�\ ∎� - \ a
TYPE OF. WOIIt i 41, )' tv COMMERCIAL FEE* SCHEDULE - -USE CHECKLIST
w construction ® Addition /alteratireplacement 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: $
® 1- and 2- family dwelling ❑ Commercial /industrial
RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
❑ Accessory building
. For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: --7/9/ /_ - - / Air conditioning / ��j
y �J ,�j � (, /l� � (requires site plan showing placement) 46.75 '
City/State /ZIP: c Z C 77)-2 3 Furnace 100,000 BTU (ducts /vents) / 46.75 .7'J
L � - _ % � !/'�
v Furnace 100,000+ BTU (ductslvents) 54.91
'Suite/bldg./apt. no.: Project name: / � Heat pump _ 61.06
Cross street/directions to job site: Duct work 23.32
/ b
� /�4Q---- Hydronic hot water system 23.32
Residential boiler r (radiator or
hydronic) _ 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: /.`j Grri , s Lotno.: /� Other: 23.32
Tax map /parcel /5/ 2 e x/ CC j" 00/ Other fuel appliances
DESCRIPTION OF WORK Water heater / - 23.32 '2....3.-'32_
Gas fireplace .— 33.39 "3,=-5
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
Chimney /liner /flue /vent 23.32
ROPERTY (
ER ❑ TENANT Other: 23.32
Name: / 1 /,,` '7 Environmental exhaust and ventilation
Addres p S � AL.,--A �"Y� �v "t J A 0 , ( � �` Range hood/other kitchen Vie+
J equipment / 33.39 J . ✓
- City /State /ZIP: _ 7,.. Q/�� 9.2.2.2 . Clothes dryer exhaust . 33.39 ��j .99'
L — t Single -duct exhaust (bathrooms,
Phone: Sd3) ?j'p'_- 7 r Fax: (d3) 5 7D,6 toilet compartments, utility rooms) 23.32
►t APPLICANT El CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name: Same as contractor -
Fuel piping
Contact name: Diane Mason $14.15 for first four; $4.03 for each additional
Address: Furnace, etc. / (A- r I'S
Gas heat pump Q�j
City/State /ZIP: Wall /suspended/unit heater _
Phone: ( ) Fax:: ( ) Water heater /
Fireplace l
E -mail: Range _/ —
CONTRACTOR Barbecue l _— __
Business name: Tri County Temp Control Clothes dryer (gas) —
Other:
Address: 13150 S Clackamas River. Drive MECHANICAL PERMIT FEES*
City/State /ZIP: Oregon City, OR 97045 Subtotal ' 09
Minimum permit fee ($90.00) .
Phone: (503) 557.2220 Fax: (503) 557.0919 Plan review (25% of permit fee)
CCB tic.: 72623 e State surcharge (12% of permit fee) � 01
TOTAL PERMIT FEE
/', ,;-„: This permit application expires if a permit is not obtained within 180
Authorized signature: - days after it has been accepted as complete.
_ I .
Print name: f i anc, moon Date: * Fee methodology set by Tri - County Building Industry Service Board
r t
I:\Building\Permits\MEC- PermitApp.doc 10/01/09 440-4617T (I 1102 /COMRUEB)
Plumbing Permit Application AN
Building Fixtures ��( FOR OFFICE USE ONLY
IT I �
City of Tigard , ` 1 \ � Received PennitNo.:
1312 SW Hall Blvd., Tigard, 0 , � , y
Phone: 503.718.2439 Fax: lit" T , 0 Plan Rev ie;;
,� t i' DateB Other Permit No.:
Inspection Line: 503.639.4175 e
T I GA R D `� Q ,� + _G Date Ready /By: funs: See Page 2 for
Internet: www.tigard or.gov �` ``` Not M Supplemental Information
,.i r.
TYPE OF WORK Pant name: . Date
ew construction s De Rion
Addition/alteration/replacement ! Other: z`i °'. FEl: SCHEDULE
- , s t r,t,,t For special information use checklist.
a, ,, m, .v ° ", m : , pOP,TSTRUCTION
se.cx a i on 1 Qty. 1 Ea. 1 Total
"', 1- and 2- family dwelling a Commercial /industrial New 1 2- family dwellings (includes 100 ft. for each utility connection)
Accessory building Multi- family () bath 312.70
SFR ( bath a 437.78
0 Master builder 0 Other
--
- - -- ! )bath 500.32 u'<�- ' , - »'jam
JOB SITE INFORMATION AND IOC ' ~ ' , t ate ;� ditional bath/kitchen a 25.02
Job site address: 7/1 S&J AA t 66 ,, Fire sp 'nkler sq. ft.) Page 2
City/State/ZIP: Site u lilies:
MINIM �� .4.., �� Basin or area d ra i n a 18.76
Suite /bldg, /apt. no.. f Project name: i • ' IMMI,leach line, or trench drain a 18.76
Cross street/directions to job site: �j Footin . drain (no. linear ft.: ) Page 2
7 " - 54,4 Manu ctured home utilities 50.03
Manh, es a 18.76
Rain , . in connector 5 18.76
, 8.1 i .ii sewer (no. linear ft.: ) n Page 2
Subdivision: )16 �r',�i Lot no
� • -•• .ewer (no. linear ft.: ) Page 2
Tax map /parcel no /5/ <5 a j "a GO Water .ervice (no. linear ft.: M ) Page 2
DESCRIPTION OF WORK Fixtu • or item:
Sr T3ackfl %w preventer 31.27
Limit ter valve a 12.51
washer a 25.02
Dishes. sher a 25.02
„i2 OWNER ❑ TENANT •. . , g fountain 25.02
2 Y.
Name: E but A44Jc/ac (y,s01.- - cilItc Ejecto s/sump a 25.02
�S w / v ~ / Expan ion tank 12.51
Address: , J l't-*
a sewer cap a 25.02
City/State /ZIP �� n,�3
OW ain/floor sink/hub 25.02
Phone: (' a5 7 7 4 /37r Fax: (; ,03.3' - 2't Garba;edisposal 5 25.02
,4PPLICANT ❑ CONTACT PERSO Hose .b a 25.02
Business name: S Q . < Ice m. er 12.51
Contact name: ��_- Interc for /grease trap M 25.02
Address: __ Metli • gas (value: $ ) 5 Page 2
Primer 12.51
City/State /ZIP:
Roof d in (commercial) a 12.51
Phone: Fax: : Si . in/lavatory M 25.02
E -mail: Solar , its (potable water) a 62.54
.1 y C �; via d •wer /shower pan a 12.51
-M ill 25.02
Business name:
�' , e� ` _ � loset 25.02
Address: / La•,. ki �- / C L1i/ /[,�MIL eater a 37.52
City/State.1_IP: / - fi - - En iping/DWV a 56.29
Phone: ( 5 - 6)3 /, / 3 Fax: Other : » , a 25.02 "Y""'r >Z
CCB Lie.. x /61 _ Plumbing Lic. no.: ;, � / Subtotal
J Minimum permit fee: $72.50
Authorized signature: �� Plan review ( _ mit fee)
h\ Building \Pcmmits \PLMU- PermitApp.doc 10/01/09 4404616T(10/02/COM/WEB) 5tk,i3k
Building Division
Development Code Provision Review
TIGARD Residential Projects
Building Permit No: (Y15T)-() 1 1— c) . 2 2-
CWS Service Provider Letter Received: Yes ❑ No ❑ N/A Ifs
Routed Plans:
Original Plan Submittal Date: S //'31 ii
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. L
Planning Review (contact e Q(a n at 503 -718- Z Y5 - 2—or ,/� -r<S @tigard- or.gov)
Land Use Case No. jU.46 2.0O 3 • 0 OCavName I SA '2r- t. 6S -{asc'
IWZoning j2 ' /..S po
I "Setbacks:
Front 8 Rear _ IS Side 3 Street Side 1 - S Garage 2.0
C� Maximum Building Height .30 Actual Building Height 2. C
0/Visual Clearance
Er Easements nn
Sensitive Lands Type: t e-*6 le P110 SLR., 1003 •OOoa3
Notes:
Original Plan: Approved EK Not Approved ❑ Date: - 7 ///
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: I
Notes:
Original Plan: Approved (6 Not Approved ❑ Date: vim / 7
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
City / Arborist Review (contact Todd Prager at 503 - 718 -2700 or todd @ tigard - or.gov)
Q treet Trees
L7 Protected Trees L r
Notes: a (fir { awl 3 tiia -c f(7V.ed At S u13 1D JJ c.Jl 4 7? s / %%-doll
Original Plan: Approved Not Approved ❑ Date: 5-/i - ,1011
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: YesXl No ❑ ,
•
Date Routed to Building: �/ /
•
Page 2 of 2
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Oregon Residential Specialty Code N1107.
HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: 4 - - .)-O l/ 00 Jurisdiction:
Ti50-rri
Site Address:
7/tic/ 3 w t
Subdivision/Lot #: ,, /—/q
and/or
Map and Tax Lot #: A9 4,
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: `11 ?/t/
i•■tier /General Contractor /Authorized Agent
Print Name: I (C1/14
1 ORSC Section N 1107.2. 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: BBuildineForms \RES- HighEfliciencyLighting.doc 07/01/08
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Residential Specialty Oregon p ty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
Ay , am the general contractor or the owner- builder
at the following address:
Site Address: 7/ L/ V 5 w 175 4 6re C 7
City:
7-2(9 - /
Permit #: , / , v Uv 0
Subdivision/Lot #: A6 y
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: l//.,.2/
y/
G eral Contractor or Owner-Builder
I:\ Building\ Form \RES- MoistureSensitiveWood.doc 09/25/08
..........
,,
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STREET TREE CERTIFICATION
Owner/Agent for 6 1104U• h% `�C
I, /�� � �
(PLEASE PRINT) (PERMIT HOLDER)
Do hereby certify that the following location meets
City of Tigard land use and development standards
for street tree installation.
ADDRESS 7/q 61 AA 6t(el Z(/
SUBDIVISION: AA i A A Je.s LOT: J�
SIGNATURE: . - DATE: `/ /
(OlVN GENT)
RECEIVED BY: `a/NNNI■ DATE: 1 i
(C'' 0 ' '4 GARD)
I: \Building \Forms \StreetTreeCertificate 01/19/07