Permit ,, CITY OF TIGARD MASTER PERMIT
; COMMUNITY DEVELOPMENT Permit #: MST2011 -00194
Date Issued: 12/06/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S108AB04500
Jurisdiction: Tigard
Site address: 15422 SW CACHE CREEK LN
Subdivision: BRENTWOOD ESTATES Lot: 7
Project: Brentwood Estates, Lot 7
Project Description: New SF, with accessory dwelling unit.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 2127 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 31.5 Bathrooms: 4 Second: 2554 sf Garage: 840 sf Front: 20 Smoke
Dwelling Units: 2 Third: 0 sf Right: 5
Detectors: Yes
Total: 4681 sf Value: $524,529.92 Rear: 15
PLUMBING
Sinks: 2 Water Closets 4 Washing Mach: 2 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 6 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! 500 sf: 10 201 -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 4681
Owner: Contractor:
BRENTWOOD HOMES BRENTWOOD HOMES Required Items and Reports (Conditions)
15170 SW FINIS LANE 15170 SW FINIS LN 1 Ersn Cntrl 503 - 681 - 4444
TIGARD, OR 97224 TIGARD, OR 97224 2 geo tech report required prior
to footing inspeection
PHONE: 503 -407 -1101 PHONE: 503 -407 -1101
FAX:
Total Fees: $23,684.72
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 '• - .:. •ce 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. •TTENTION: Or -:.n I- equires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
952 r01 -0010 through OAR • -001-I/ •0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. /
Iss ed By: Permittee Signature: /�
Call 503.639.4175 by 7:00 a.m, for the next available inspect •. • date.
This permit card shall be kept in a conspicuous place on the job site unt . ompletion of the project.
Approved plans are required on the job site at the time of each inspection.
I t
• Building Permit Applicati ,
Residential A FOR.OFFICE USE ONLY
City of Tigard NOV 0 9 2011 Received _
lig v g Date/R f� 4 Permit No • i ./d l t, / r
13125 SW Hall Blvd., Tigard, OR 97223 – v ♦
L
l'.: Phone: 503.718.2439 Fax: 503.5§ %1 TIGARD Plan R eview
Date /B It� Other Permit. oa —00 15"
TIGARD Inspection Line: 503.639.4175 BUILDING D Date Read•.. 1 Juris ® See Page 2 for
Internet: www.tigard - or.gov Notified /M•thod• # , 4 // Supplemental Information
v
• :. . TYPE OF. WORK. '. : •... . R Q "'RED DATA 1 =,AND 2 =.FAMILY DWELLING • •,
® 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 CONSTRILCTION ` -- work indicated on this application.
® I- and 2- family dwelling ❑ Commercial /industrial Valuation: $ "5 1 5 .n2-
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms: 4 _
JOB SITE INFORMATION aN D "VOCATION Total number of Moors: 2,
Job site address: 15422 SW Cache Creek Ln New dwelling area: ee‘ r square feet
City /State /ZIP: 97224 Gajge /carport area: e square feet
Suite /bldg. /apt. no.: Project name: Brentwood Job #473 Covered porch area: 754_ square feet 25
Cross street /directions to job site: 155th Deck area: square feet Z` 2.7
Other structure area: r /ZI square feet '
REQUIRED ` DAT COMMERCIAL -USE CHECKLIST
Subdivision: Brentwood Estates 1 Lot no.: 7 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
r• equipment, materials, labor, overhead, and the profit for the
, 'ESCRIP;F ION$ OF WORK.;' - work indicated on this application.
Valuation: S
Existing building area: square feet
New building area: square feet
- .. ®.PROPERTY OWNER - • .. El TENANT Number of stories:
Name: Brentwood Homes Type of construction:
Address: 15170 SW Finis Lane Occupancy groups:
City /State /ZIP: Tigard Oregon, 97224 Existing:
Phone: (503)407 -1101 Fax:( ) New:
"•® APPLICAN:1', : ❑CONTACT PE
BItIVDlNG I ERMI'i'I FES
Business name: Brentwood Homes
(Please `refer to f { +.
Structural plan review fee (or deposit):
Contact name: John Noffz
FLS plan review fee (if applicable):
Address: 15170 SW Finis Lane
Total fees due upon application: ,
Ciry /State /ZII :Tigard Oregon, 97224 F] �
Phone: (503) 407 -1101 Fax:: ( )
Amount received: •
E-mail: John @brentwoodhomesoreon.com ill OTOV OLTA1C'SOLAR PANEL SYSTEM.TEES*
-. — Commercial and residential prescriptive installatio, t
GON I RACTOR roof -top moun Photovoltaic Solar Panel . • em.
Business name: Same as Applicant Submit two (2) sets . roof plan with : nection details
and fire department ace.. along ith the 2010 Oregon
Address: Solar Installation Special , 'r'e checklist.
City /State /ZIP: Permit Fee (in ".ies plan re•.-
a , administrative fees):
Phone: ( ) Fax: ( ) States • arge (12% of permit fee):
CCB lie.: 18115
Total fee due upon application:
Authorized signature: /a / This permit application expires if a permit is not obtained
,. ,„„../a.,....-- -
within 180 days after it has been accepted as complete.
Print name: NiO4 k -✓ /(.9v e * Fee methodology set by Tri- County Building Industry
�s Date: /
/ � Service Board.
I: \Building \Permits \BUP- RESPermi1App.doc 02/24/201 1 440 4613T(I 1 /02 /COM /WEB)
I., .
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•
Electrical Permit ApplicationRE FOR OFFICE USE ONLY
City of Tigard NOV 0 9 2011 �By: f/ 9 /i 4111. / Permit No.: 1.lyrA0a -en/
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C Phone: 503.718.2439 Fax: 503.598. I Date /By. Other Permit: 4- 441-00/5 '
TIGARD
Inspection Line: 503.639.4175 ' f 1' OF TIGARD Date Ready /By: Juris: ® See Page 2 for
Internet: www.tigard - or.gov BUILDING DIVISION Notified /Method. Supplemental Information
TY PE 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 ❑ Other: where the available fault current ❑ Marinas and boatyards.
' CATEGORY OE 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
• - ❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND 'LOCATION °_ ❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "I -3 ",
Job no.: 473 Job site address: 15422 SW Cache Creek Lane 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard Oregon, 97224 ❑ Health -care facilities ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: Brentwood Homes Job # 473 ❑ Service or feeder 600 amps or more.
EE'E SCHEDULE, _ `
Cross street/directions to job site: 155 terrace Description I Qty. I Fee. I Total I
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Brentwood Estates Lot no.: 7 1,000 sq. ft. or less ( • 168.54 l toe, 4
Ea. add'I 500 sq. ft or portion 1(D 33 92 33`1, ni
Tax map /parcel no.:
Limited energy, residential
DESCRIPTION OF WORK .. - (with above sq n ft.) 75 .00 ;
( Cp 2
.._- - " --' -'-`- - - - Limited energy, multi - family
75.00 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
401 amps to 600 amps 200.34 2
Name: Brentwood Homes
601 amps to 1,000 amps 301 04 2
Address: 15170 Sw Finis Lane Over 1,000 amps or volts 552.26 2
City /State /ZIP: Tigard Oregon, 97224 Temporary services or feeders installation, alteration, and /or
relocation
Phone: (503)407 - 1101 Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits – new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
APPLICANT , above service or feeder fee,
❑ .. , . ., - ' ❑. CO NTAC°I' PERSON, _- 7.42 2
each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: branch circuit
Each add'I branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mail:
Sign or outline lighting 67 84 2
�_ w_ _.. - _ _gym _._ CONTRACTOR. _ _ _ _ _ S ignal circuit(s) or limited-energy
Business name: Kodiak Electric panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 8486 Sunnyside Road Additional inspection (1 hr min) 66.25/ hr
Investigation (I hr min) 66.25/ hr
City /State /ZIP: Salem Oregon, 97036 Industrial plant (I hr min) 78.18 / hr
Phone: (503) 881 - 1259 Fax: (503) 391 - 2611 Inspections for which no fee is 90.00 / hr
specifically listed (% hr rain)
CCB Lic.: 161998 Electrical Lic.: 24528C Suprv. Lic.: 5113S 'ELECTRICAL PERMIT, FEES s .
Suprv. Electrician signature, required: Subtotal: I �4--
Plan review (25% of permit tee):
Print name: Randy Seiber / ' t Date: 11 - - 2011 State surcharge (12% of permit fee): (4
TOTAL PERMIT FEE: 5 - , Vi
Authorized signature: �_ ` -�;
#0 This permit application expires if a permit is not obtained within 180
t I 1 / days after it has been accepted as complete.
Print name: Randy Seiber / Date: 11 - - 2011 ,
Number of inspections allowed per permit
1 \Building \Permits \ELC- PermitApp doc 07/01/10 440- 4615T(I I /05 /COM /WEB
t�
. 1
1Vlechanical Permit Application FOR OFFICE USE ONLY
\' Cl of Tl and Received ate
II
q g Date/By: it , ' Permit No �/ ` — , /r^
13125 SW Hall Blvd., "Tigard, OR 97223
7. Phone: 503.718.2439 Fax: 503.598.196 g • IVED !!
P Review Other Permit /
Date/By: o wtao /� �C0/S;
T t G A R D Inspection Line: 503.639.4175 Date Ready /By turfs See Page 2 for
Internet: www.tigard- or.gov i�, V 0 9 2011 Notified /Method Supplemental Information
TYPE O F Wd Y. OF TIGARD - - - ,COMMERCIAL ,FEE* SCHEDULE_ = USE CHECKLIS T_
13 ILDIG DIVISION- - _ - 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.
Value: $
- - CATEGORY OF CONSTRUCTION' . RESIDE /SI F MST�E E S *
® 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total
, JOB SITE INFOR_MAT1ON AND .LO Heating /cooling:
, _ .
Air conditioning
Job site address: 15422 SW Cache Creek Lane (requires site plan showing placement) t 46.75
Furnace 100,000 BTU (ducts /vents) 1 46.75
City /State /ZIP: Tigard Oregon, 97224 Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: Brentwood Homes Job # 473 Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: 155 terrace 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: Brentwood Estates Lot no.: 7 Flue/vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
bESCRIPTION' OF wORk- .. ` - - Water heater i 23.32
- - -- -- - —_ -- -_�.� _- �s� - • =� -° - -- - - - ° � Gas fireplace '7..---' 33.39 ,
New construction Heating and cooling. u 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
• ,, _
El PR "OPERTY OWNER ,r ,i TENANT,
Chimney /liner /flue /vent 23.32
Other: 23.32
Name: Brentwood Homes Environmental exhaust and ventilation:
Address: 15170 SW Finis Lane Range hood /other kitchen ii
equipment \ 33.39
City /State /ZIP: Tigard Oregon, 97224 Clothes dryer exhaust f.' 33.39 (0(p 48
Single -duct exhaust (bathrooms,
Phone: (503)407 -1101 Fax: ( ) toilet compartments, utility rooms) 10 23.32 tr. l c.,��
❑
APPLICANT -
❑ C ONTACT ,PERSON ^ Attic /crawlspace fans 23.32
Business name: Brentwood Homes Other: 23.32
Fuel piping:
Contact name: $14.15 for first four; $4.03 for each additional
Address: Furnace, etc. (4, J
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater 1
Fireplace 7i A.oa
E -mail: Range ( 4,0'3
'`; CONTRACTOR ' , , ..'
Barbecue
Business name: Rumbolt Heating Clothes dryer (gas)
Other:
Address: PO Box 397 - MEEIIANICAI PERNII,P FEES", ..
City /State /ZIP: Beaver Creel Oregon,97004 Subtotal . 4 -ri
Minimum permit fee ($90.00)
Phone: (503 -) 656 -0475 Fax: (503) 632 -8669
Plan review (25% of permit fee)
CCB lie.: State surcharge (12% of permit fee) 53, 5
TOTAL PERMIT FEE ` 9 , i li
Authorized signature: �/ This permit application expires if a permit is not obtained within 180
!v/ days after it has been accepted as complete.
Print name: John J. Kloer Date: 11 -9 -2011 * Fee methodology set by Tri- County Building Industry Service Board
I - \Building \ Permits \MEC- PermitApp.doc 09/09/10 440 -4617T (I I /02 /COM/WEB)
'ii .. ,.
• Phimbing Permit Application
Building Fixtures RECEIVED FOR OFFICE USE ONLY
R eceived
City of Tigard Permit No.: /p
a 13125 SW Hall Blvd., Tigard, OR 97223; 0 9 2 fl i Date /By: l S /� �f Q��^�� (
Plan Review
G
Ph 503.718.2439 Fax: 503.598.1960 D ate /B y: Other Permit No.: �j, 1Xa0/4��0(5
Inspection Line: 503.639.4175 a See Page 2 for
T I GA RD CITY OF TIGARI) Date Ready /By: luris
. Internet: www.tigard or.gov Notified /Method Supplemental Information
BUILDING DIVISION -
TYPE. OF WORK . NYE*. SCHE
® New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. 1 Total
❑ Addition /alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION' A ; -.- - SFR (1) bath 312.70
® 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78
111 Accessory building El Multi-family SFR (3) bath 500.32
4.--5
Each additional bath/kitchen l 25.02 , Z, 1 5; Q
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB ,SITE' INFORMAT[ON ANU 'LOCATION Site utilities:
Job site address: 15422 SW Cache Creek Lane Catch basin or area drain 18.76
City/State/ZIP: Drywell, leach line, or trench drain 1 8.76
Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: 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: 1 Lot no.: Fixture or item:
Tax map /parcel no.: Backflow preventer 31.27
• .DESCRIPTION OF W,ORk- - , ., Backwater valve 12.51
- •: - Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors /sump 25.02
-❑: PROPERTY OWNER ' - ❑-TENANTh - . Expansion tank 12.51
Name: Fixture /sewer cap 25.02
Floor drain /toor sink /hub 25.02
Address:
Garbage disposal 25.02
City /State /ZIP: Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51
. ❑ APPLICANT - . ❑ CONTAGT NERSON Interceptor /grease trap 25.02
Business name:
Medical gas (value: $ ) Page 2
Primer 12.51
Contact name:
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: Urinal 25.02
' CONTRACTOR . . _ Water closet 25.02
- °'- - - - .- '' ' I - ` -' Water heater 37.52
Business name: Craftwork Plumbing Inc. Water piping/DWV 56.29
Address: 7736 SW Cirus Road Other: 25.02
City /State /ZIP: Beaverton Oregon, 97008 Subtotal #52�� - 4-
Phone: (503 -) 644 -8698 Fax: (503) 644 -5989 Minimum permit fee: $72.50
CCB Lie.: 79666 Plumbi g Lic. no.: -148P6 Plan review (25% of permit fee)
State surcharge (12% of permit fee) tC� .5, CA
Authorized signature: TOTAL PERMIT FEE �8
Print name: Peter P and Date: 11 - - 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( I 0 /02 /COM /WEB)
71 B uilding Division
: ■
Development Code Provision Review
TIGARD Residential Projects
Building Permit No: M f51 ,ZO 11 1 b0 I Q
CWS Service Provider Letter Received: Yes ❑ No ❑ N/A
Routed Plans:
Original Plan Submittal Date: /1 / /Dig
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 eft only if a roved. .fir
Planning Review (contact ► S {. t 503 -718 - L Y.SLor Lig,..._...., @tigard- or.gov)
Land Use Case No. 5 Za a? •Otx10Z,Name &(,%fiW OOS €17Der•t% 3
Cl Zoning ^ 7
lik Setbacks: e •
Front IS Rear / S Side ^7 Street Side / Garage �.
V Building Height 3.5 Actual Building Height 3 1
ID"' Visual Clearance
Cik/Easements ,4
G ''ensitive Lands Type:
Notes: i ! S At # v •••.16 do ro #4. e.4'te , Z c.o. y,,a,,,,f
Original Plan: Approved Not Approved ❑ Date: l i / Sit/ - o -C-c cat c.Po .se.4
Revision 1: Approved ❑ Not Approved ❑ Date: t∎ tai 4 0 - '\ \ v5 10
Revision 2: Approved ❑ Not Approved ❑ Date:
Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @tigard- or.gov)
zr Actual Slope: 1 . S - %
Notes:
Original Plan: Approved Zr Not Approved ❑ Date: I /6
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
Citty Review (contact Todd Prager at 503- 718 -2700 or todd @tigard - or.gov)
L1,treet Trees
3 Protected Trees
Notes: t• k cj r /v.t 44
Original Plan: Approved ❑d Not Approved ❑ Date:
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or Abert @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 .0 • • a • °
Date Routed to Building: /
•
Page 2 of 2
This form is recognized by most Building Departments in the Tri- County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
II „ City of Tigard
" e - Buildin g Division
T [ GAR D
TRANSMITTAL LETTER
TO: , Do, DATE RECEIVED•
DEPT: BUILDING DIVISION
Fi_.,_IVED
EC 7 20
FROM q tr 1 A - —dam , /CITY OF GARD
�/ ` !' 4E� / �UILDI DIVIS eN
COMP Y: q PHONE: 0 3 — — �a t / By' '�
RE: — 2 4r, LO/ / /Hcpic /9c1
1 e • • s ress WY /( Permit Number)
'ro ect name su.. iviston name an' of num s er j
ATTACHED ARE THE FOLLOWING ITEMS: 1
Copies: Description: Copies: ,/ escription:
Addition set(s) of plans. / Revisions:
Cross section(s) and details. / Wall bracing and /or lateral analysis.
Floor /r6of framing. f Basement and retaining walls.
Beam /calculations. Engineer's calculations.
Othel? (explain): '
REMARKS:
K.
FOR OEFI E USE ONLY
Routed to Permit Technic�ia ' Date: (elf -� 1 ( Initials:
Fees Due: [1] Yes .R &o Fee Description: Amount Due:
$
$
$
$
Special
Instructions:
Reprint Permit (per PE): ❑ Yes ,To ❑ Don
Applicant Notified: Date: /R/e/ / 414.e___ w Initial �,!`
I:\ Buildin Forms \TransmittalLetter - Revisions.doc 02/08/2011 ,
RECEIVED
g 3) I I / NOV 9 2011
—/ CITY OF TIGARD
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° Building Division -
: ,
Development Code Provision Review Z-d
TIGARD Residential Projects •
Building Permit No: `'7 6T rs20 / l — clO t Qe/ I P/ CWS Service Provider Letter Received: Yes ❑ No ❑ N/A tpo PP /
Routed Plans: �LS�i Cam!« -eR_
Original Plan Submittal Date: / /O / d-tfat
151 Revision Submittal Date: �8 I ❑ 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 eft pnly if a roved. - „, Plannin Review (contact ■ / teehti t 503 - 718 - L Y Lor /SI a r` " ti and -or. ov )
g ( Q I0 � @ g g
Land Use Case No. 5'4.bZ�Q''Otx0OZ,Name Sire- a%tWoodl Esloo -i 3
W Zoning Q • 7
Iii Setbacks: •
Front ,( s Rear / c Side .5 Street Side / Garage .__
AI Building Height � Actual Building Height 3 1 l�2
l" Visual Clearance
[{V'Easements .4.
III/Sensitive Lands Type:
Notes: * I f Fr f v a+� i o vs 44.4.1-10b. ,� t c.... a+•s...t•
Original Plan: Approved Li Not Approved ❑ Date: R / S f / _ pr � c�ols
Revision 1: Approved El Not Approved ❑ Date: J� / ,,Ott i k\ - ■\ \vi h i
Revision 2: Approved ❑ Not Approved ❑ Date:
Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @tigard - or.gov)
Id Actual Slope: 1.- S k %
Notes:
Original Plan: Approved Not Approved ❑ Date: l6
Revision 1: Approved Not Approved ❑ Date: 3 l
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
• Cii Review contact Todd Pra . er at 503- 718 -2700 or todd @ti:. rd -or. : ov
/ Street Trees
o Protected Trees /
Notes: >' k apPvJ pL o.� Fr ' tit, lyc,) agcy,
Original Plan: Approved 27d Not Approved ❑ Date: P t14 0I1
Revision 1: Approved Not Approved ❑ Date: 3 /r/d
Revision 2: Approved ❑ Not Approved ❑ Date:
Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albcrt @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: Y:.` No 0 • • • • ‘, •
Date Routed to Building: 1/
3140 .
Page 2 of 2
Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I,
Can A} off f Z , am the general contractor or the owner - builder
at the following address:
Site Address: /Sy22_ 5 �-� Cr « K
City:
f,
Permit #: 28 ' po I -
Subdivision/Lot #:
C 3 Es ��,Tcs A o T
C c- c.,.'tw c� o
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: �Z /l
eneral Contractor or Owner - Builder
I \Building \Form \RES- MoistureSensrtrveWood doc 09/25/08
Oregon Residential Specialty Code N1107.2
HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: in S T x--6P-f--—e=•/?471 Jurisdiction:
Site Address: .SY 2 2 S
Subdivision/Lot #: r x
� � s 7'�.s !oT 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)
Signature: G Date: 7 2 l
Owner /General Contractor t orized Agent
Print Name: --I � /tic) 5�
' 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\ Forms \RES- HighEfficiencyLighting doc 07/01/08
STREET TREE
I..
TIGARD CERTIFICATION
owner/ agent for cam•.. w
(PLEASE PRINT) (PERMIT HOLDER)
do hereby certi 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.
201
PERMITNO.: MST oft, - 00 / 9 '5/
SI"1 E ADDRESS: /SY 2 2 S c-,1
SUBDIVISION: TI � 1 LOT #: 7 -
SIGNATURE: ' / DA1 E: y2 / 2,
(OWNER /AGENT)
RECEIVED & l
VERIFIED BY: DA 1 E: 7 7
G TIGARD)
❑ Tree location verified per approved site plan.
I \ Building \ Forms \ StreetTreeCertificate 04/01/2011