Permit q CITY OF TIGARD MASTER PERMIT
l ''! : COMMUNITY DEVELOPMENT Permit #: MST2011 -00135
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/24/2012
Parcel: 1S 133CA13600
Jurisdiction: Tigard
Site address: 11036 SW SAGE TER
Subdivision: Lot:
Project: Village at Summer Creek, Lot 59
Project Description: Building 17. New SFA
BUILDING
Floor Areas Required Setbacks Required
Stones: 3 Bedrooms: 2 First: 38 sf Basement: 0 sf Left: 3.5 Parking Spaces: 2
Height: 33.5 Bathrooms: 3 Second: 573 sf Garage: 480 sf Front: 12 Smoke
Dwelling Units: 1 Third: 573 sf Right: 3.5
Detectors: Yes
Total: 1184 sf Value: $136,890.00 Rear: 10
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 2 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
Drywell- Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 4 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Fum <100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3
Fum > =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: 2 201 -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 SFA VB R -3 1184
Owner: Contractor:
CENTEX HOMES CENTEX HOMES Required Items and Reports (Conditions)
ATTN: OCHSNER, JOHN 16520 SW UPPER BOONES FERRY 1 Ersn Cntrl 503 - 681 - 4444
11241 SLATER AVE NE, STE 100 RD, STE 200
KIRKLAND, WA 98033 PORTLAND, OR 97224
PHONE: PHONE: 503- 608 -3060
FAX:
Total Fees: $12,698.30
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -00 s roug •AR 95 = =1 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By _ i. � _ - !J... . iI � Permittee Signature: ( /t9
Call 503.639.4175 by 7:00 a.m. for the next available Inspection date.
This permit card shall be kept In a conspicuous place on the job site until completion of the project.
Approved plans are required on the Job site at the time of each Inspection.
Building Permit ApplicatioRE D
Resid' al ,1 2 2 2011 _ ' FOR OFFICE USE ONLY_
City of Tigard DCCed 7�l� /7' y ...40 A D� el Permit No.:
_ ° 13125 SW Hall Blvd., Tigard, OR 9 OF •TIG Plan Review Phone: 503.639.4171 Fax: 503. Other Pemtic �I DNISIO N 17rte : o G� 7
TIGARD Inspection line: 503.639.4175 Date Ready/By: turis ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
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® New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
`^ R ? -,,. • a��� inn- r e''.: application.
' ir" - C _ 9.6RY o - S�fRU ON r:.� . 2 -� 1 ' ,y" s work indicated on this a
..W�� :.,,a .. u "'4$' s`� �(' M:�r�x- de���..��::R"_ '� fy $i��::s`vs3�.s:
® 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $136,890.34
❑ Accessory building ❑ Multi- family Number of bedrooms: 2
❑ Master builder ❑ Other: Number of bathrooms: 3
R O JO S E �INE4RM Ti o '( t kl 9 Total number of floors: 3
'�• OQA, u U1,V� � �-
Job site address: f / 3 .6 4,1 I 7-60e New dwelling area: 1186 square feet
City/ State/ZIP: TIGARD OR, 97223 Garage/carport area: 480 square feet
Suite/bldg. /apt. no.: I Project name: VILLAGE AT SUMMER CREEK Covered porch area: 18 square feet
Cross street/directions to job site: CORNER OF SW BARROWS RD, Deck area: 128 square feet
SW 135 AVE, AND SW SCHOLLS FERRY RD Other structure area: square feet
;REo.aal 3Da i c o %_i ID! C+r' ` i1DOHEE a S
Subdivision: VILLAGE AT SUMMER CREEK Lot no.: S, 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
r.`r ,, �� t S ' O ` U V0 2fCa w ' ' At work indicated on this application.
NEW SFR TOWNHOUSES Valuation: $
UNIT C 1186 SQ. FT. Existing building area: square feet
New building area: square feet
�I. jg i s -..
,, r O t O R ' ' i a) - r.€ -z : - .T ';'^ ' s .,t Number of stories:
Name: CENTEX HOMES Type of construction:
Address: 16520 SW UPPER BOONES FERRY RI), STE 200 Occupancy groups:
City/State/ZIP: PORTLAND OR, 97224 Existing:
Phone: (503)608 -3060 Fax: (503)608 -3061 New:
z.; : ®k Y C " ° °t `' Y "+ :'3; ® @ONTA`' �i E1RS €,G== E..'` elre W.-7'-' 71 .tr + 4`.31 �f ''''''W--k'53
Business name: CENTEX HOMES , � � U �„ ;r� 3o � j,
All contractors and subcontractors are required to be
Contact name: GARY CULP licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 16520 SW UPPER BOONES FERRY RD, STE 200 jurisdiction in which work is being performed. If the
City / State/ZIP: PORTLAND OR, 97224 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 608 -3060 I Fax: : (503) 608 -3061
E -mail: gary.culp @pultegroup.com
r W'r�a„�:„. .p���s� >:�' '-_-:= R��6� -r�,ms ram c- , S sr^-.. -.z --
Business name: CENTEX HOMES r .`. -•
t -'. J �3 �: 9 �r- � r". xB�D�i�1�Rl ;��FSF,s� ^ *
sa
Address: 16520 SW UPPER BOONES FERRY RD, STE 200 .•%''`" ' 21 '1'Lf=' = le er schediii ::
Structural plan review fee (or deposit):
City/State/ZIP: PORTLAND OR, 97224
FLS plan review fee (if applicable):
Phone: (503) 608 -3060 I Fax: (503) 608 -3061
CCB lie.: 182591 Total fees due upon application:
' Amount received: ? -
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: GARY CULP / I Date: .7- • e( • Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building \Permmits\B11P -RES PermitApp.doc 10/01/09 440- 4613T(11/02 /COM/WEB)
RECEIVED
Electrical Permit Application s x' z- FOR OFI;,ICEU
JUL22 2011 , x= e p.. ..,. ,
; fr City of Tigard Dale/By:
Permit No.: �f�`/r0° 1 3
l ; 5 't 13125 S W Hall Blvd., Tigard, OR / 1 OF �Gp� Plan Review /
. _ - "' -: Phone: 503.639.4171 Fax: 50 , ` U t Other Permit: o1lrt)�d6I D 0 /fi
Date/By:
4'' `` Inspection Line: 503.639.4175 Imo ING DIVISION Date Ready /By: -curs: See Page 2 for
TIGARD
3 ° 1.t' -°?- Internet: www.tigard -ocgov Notified/Method: Supplemental Information
-- : •_ `TYPE _0(' 11'ORI{ `,; - .;,,Y-, i- ... `PLA'N RE ' .... . _ ...
® New construction ❑ Addition /alteration /replacement Please check all that apply (submit 2 sets of plans , /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
r',:_. ' ' ' '",-;'' '' . - - - .= : : - _: EG
. C • ATORY:.OF_ CONSTRUCTION'- 's ":2: "= _ - ` _ exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
_ -. "•':::_ - - _ ' -- , ::: t' ,_ ' .`, -', - - 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: 0 Fire pump. ❑ Installation or 75 KVA or
larger separately derived syste
L' ❑Emergency system. m.
s J,OI1 SITE ;INFORMATION` ''AND=lOCATION ' `,` �"
' , z....:. . ,.:....,,_k: --- - -- .r - _ __, - ...a. . .. a ❑Addi ❑ "A" "E" "1 - , '1 -3 ".
Job no.: Job site address: 2/ y� too or or more. occupancy.
I / /O3 0 90 ❑ Six or more residential units. ❑ Recreational vehicle parks.
City / State/ZIP: TICARD OR 97223 ❑ Health-care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. . 600 volts nominal.
Suite/bldg. /apt. no.: Project name: VILLAGE AT SUMMER CREEK D Service or feeder 600 amps or more,
-
'F:EE' SCHEDULE'•_,, `: ; .:1;.-:-',T _ ° `:_` ',
Cross street/directions to job site: CORNER OF SW BARROWS RD, oeserpuon I otv. I Foe. I_ Total I •
SW 135 ND SW SCROLLS FERRY RD New residential single- or multi - family dwelling unit.
AVE, + Includes attached garage.
Subdivision: VILLAGE AT SUMMER CREEK Lot no. 1,000 sq. ft. or less 1 168.54 168.54 4 j
Ea. add'I 500 sq. ft. or portion 2 33.92 67.84 1
Tax map/parcel no.:
Limited energy, residential 1 75.00 75.00 2
':'''
' = .x: F ` -, 1, (with abovesq.ft.)
- - � , . DLSCRII'TION' � WORh,; -: "__ �:: _._ ._: .
;' :.._ .;' : - - .... ' Limited energy, multi- family 75.00 2
NEW SFR TOWNHOUSES residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 100.70 2
;, - ®:EROPERTY'OWNER: . ,c; .TENANT ,: 201 amps to 400 amps 133.56 2
Name: CENTEX HOMES 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: 16520 SW UPPER BOONES FERRY ROAD, STE 200 Over 1,000 amps or volts 552.26 2
City/State/ZIP: PORTLAND OR, 97224 Temporary services or feeders installation, alteration, and /or
tY relocation
Phone: (503)608 -3060 Fax: (503 -503 -6031 200 amps or less 59.36 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
ti - I er 7 42 2
.- -r.., ®,0 - _ _ .,Q CONTACT`P;ERSOW
: ... each branch circuit
Business name: CENTEX HOMES B. Fee for branch circuits without
service or feeder fee, first
Contact name: GARY CULP branch circuit 56'18 2
Each add'l branch circuit 7.42 2
Address: 16520 SW UPPER BOONES FERRY RD, STE 200 Miscellaneous (service or feeder not included)
Each manufactured or modular
City/State/ZIP: PORTLAND OR, 97224 dell
dwelling, service and/or feeder 67.84 2
Phone: (503) 608 - 3060 Fax: : (503) 608 - 3061 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2 ;
E - mail: gary.culp@pultegroup.com
Sign or outline lighting 67.84 2
_:-�..___. -.,.., _ "•._ .,f-- •.-- ---- __.__. ___..- ._,i -� _.... .t`...•. -- -- . .._. _. -- Signal circuit(s) or limited-energy
Business name: GARNER ELECTRIC panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 2920 SE BROOKWOOD AVE, STE A Additional inspection (I hr min) 66.25/ hr
City /State/ZIP: HILLSBORO OR, 97123 Investigation (I hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 648 - 4552 Fax: (503) 642 - 7925 Inspections for which no fee is 90.00 / hr
specifically listed (.4 hr min)
CCB Lic.: 182591 Electrical Lic.: 34 -305C Suprv. Lic.: , , :''ii';_ _ ; ELECTRICAL PERMIT .FCESf.` _ "2::.: ; ,;:
- Subtotal:
Suprv. Electrician signature, require. " ,
Plan review (25% of permit fee):
Print name: CHUCK GA' "ER Date: State surcharge (12% of permit fee):
/,/ TOTAL PERMIT FEE:
Authorized signature: r ': ''
4 ' - _ -, ._ This permit application expires if a permit is not obtained within 180
days after it bas been accepted as complete.
Print name: Date: 7 ` . vt ( • Number of inspections allowed per pem,it.
t:\ Building \Permits \ELC- PmnitApp.doc 07 /01 /10 440- 46t5T(11105 /COM /\VEB
RE CEIVED
Mechanical Permit Application FOR OFFICE USE ONLY.
:
City of Tigard Z Z 2011 Received n � /
11/41 Date y 3
a 13125 SW H all Blvd., Tigard, OR 97223 Re
It Phone: 503.639.4171 Fax: 503.598. � OF TIGARD Date/Plan B : view Other Permit: 1 •
TIGARD Inspection Line: 503.639 ILDING D[VIS Date Read /B : S uns: g
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
;�+•. -r. �±:r - �-_r -�'=_� - r-�r'y �: °;�. _ .:,-. _.�- .:y .r• >� ��: :r -��, _ Ec-a-:- �,,: -�- =^+� �.= yn
),' tom+ � �, ..4•: - ^. L :j -F•e . 1
g r. ^ >W, rem -- =4` IP U - YORKA" a.` ;ii :: -"``, 4.,§VI_ER@IALglE USI CNECrO r
® New construction ID 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.
"� t t =. 91_ TE CsO . .x- . Value: $
K r .• CQ._, O x,60 ST d--. ;: :,.. T-' ��x ri ,„ k —. �• a=te d T r, • RESID RI_Fr Q IN /+SYS MS 7
CO 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
❑ Multi - family ❑ Master builder 0 Other: For special information use checklist.
_ __ Description Qty. Ea. I Total
- i�`cU , S O TIO ZOCvAT U ,* _
T�Il�1��,�M���P � ������'r��*aj�
Heating/cooling
Job site address: X1 fe - Air conditioning
(requires site plan showing placement) 46.75
City/State/ZIP: TIGARD OR, 97223 Furnace 100,000 BTU ( ducts/vents) I 46.75 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: I Project name: VILLAGE AT SUMMER CREEK Heat pump 61.06
Cross street/directions to job site: CORNER OF SW BARROWS RD, Duct work 23.32
SW 135TH AVE, AND SW SCHOLLS FERRY RD Residential n t 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: VILLAGE AT SUMMER CREEK Lot no.: Flue/vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances
F $ „. s. ' _" """"`'''° - ff _ -~ Water heater 1 23.32 2332
Gas fireplace 33.39
NEW SFR TOWNHOUSES
for Flue vent for water heater or gas
UNIT C 1186 SQ. FT. fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
a =. ®• :'Ii0'ERN O VE ` :. ;y;f,I -f . - i ftEWM Other 23.32
- — Other: 23.32
Name: CENTEX HOMES Environmental exhaust and ventilation
Address: 16520 SW UPPER BOONES FERRY RD, STE 200 Range hood /other kitchen
equipment 1 33.39 33.39
City/ State/ZIP: PORTLAND OR, 97224 Clothes dryer exhaust 1 33.39 33.39
Single -duct exhaust (bathrooms,
Phone: (503)608 -3060 Fax: (503)608 -3061 toilet compartments, utility rooms) 4 23.32 93.28
3 ` A te r 1MA g _f Wir D eaf:, 7,, Attic/crawlspace fans 23.32
Business name: CENTEX HOMES Other: 23.32
Fuel piping
Contact name: GARY CULP $14.15 for first four; $4.03 for each additional
Address: 16520 SW UPPER BOONES FERRY RD, STE 200 Furnace, etc. 1 14.15
Gas heat pump
City/State/ZIP: PORTLAND OR, 97224 Wall/suspended/unit heater
Phone: (503) 608 -3060 Fax: : (503) 608 -3061 Water heater 1
Fireplace
E - mail: gary.culp @pultegroup.com Range 1
: i,.. ,'iSOt= z .7. . '_; O NI> ea ' z ',:7 p 7 r : Barbecue
Business name: MUEHE QUALITY HEATING INC.
Clothes dryer (gas)
Other.
Address: 7301 SW 'CABLE LANE, STE 500> xk� /T`_' ' :k `='� . ` q "s'J' ='
c�:: R• I•_ �f'. z"_ '` ?�s �CH:AIV�AL�P,�E�VI17t�FEF.S :�'`-`' ,'� „ '`
City/State/ZIP: PORTLAND OR, 97224 Subtotal
Phone: (503) 598 -0966 I Fax: (503) 598 -8498 Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: 50096 State surcharge (12% of permit fee)
TOTAL PERMIT FEE
This permit application expires it a permit is not obtained within 180
Authorized signature: / days after it has been accepted as complete.
Print name: KYLE t • - I Date: � - g / I • Fee methodology set by Tri -County Building Industry Service Board
I:\ Building \PemriU\MEC- PermitApp.doe 10/01/09 440- 4617T(1 i/OLCOMAVED)
, • RECEIVED
Plumbing Permit Application
Building Fixtures JUL 2 2 2011 FOR OFFICE USE ONLY
City of Tigard CITY OF TTGA[I) Received Pcnnit No.: � 35
i
q 13125 SW Hall Blvd.. Tigard, OR R N INGDSIG Date/By: V '� r 1 4
Phone: 503.639.4171 Fax: 503.598.1960 Plan Review DateiBy: Other Permit No. 0j 9.4,!'..01 f .
Inspection Line: 503.639.4175 Date React !R lttris: 0 See Page 2 for
TIGARD Internet: www.tig Notified/Method: Ready /By: Supplemental Information
• TYPE OF WORK FEE" SCHEDULE . •
® New construction 0 Demolition For special information use checklist.
Description I Qty. j Ea. I Total
❑ Addition/alteration/replacement ❑ Other: New I- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF. CONSTRUCTION - - ' SFR (1) bath 312.70
® I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78
SFR (3) bath 1 500.32 500.32
❑ Accessory building ❑ Multi - family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2
TOB SITE INFORMATION AND LOCATION ' Site utilities:
Job site address: 03/ r- Catch basin or area drain 18.76 'VOL
City/State/ZIP: TIGARD OR, 97223 Drywell. leach line, or trench drain 18.76
Footing drain (no. linear ft.: 10(1) I Pane 2
Suite/bldg. /apt. no.: I Project name: VILLAGE AT SUMMER CREEK Manufactured home utilities 50.03
Cross street/directions to job site: CORNER OF SW BARROWS RD, Manholes 18.76
SW 135 AVE. AND SW SCHOLLS FERRY RD Rain drain connector I 18.76
Sanitary sewer (no. linear ft.: 100) 1 Page 2
Storm sewer (no. linear ft.: 100) I Page 2
Water service (no. linear ft.: 10Jf) I Page 2
Subdivision: VILLAGE AT SUMMER CREEK I Lot no.:0 Fixture or item:
Tax map /parcel no.: Backllow preventer 31.27
Backwater valve 12.51
DESCRIPTION OF WORK : .
• Clothes washer I 25.02
NEW SFR TOWNHOUSES
Dishwasher I 25.02 I
UNIT C 1186 SQ. irT. Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER 1 ' ❑ TENANT Expansion tank 12.51
Name: CENTEX HOMES
Fixture/sewer cap 25.02 j
Floor drain /floor sink/hub 25.02
Address: 16520 SW UPPER BOONES FERRY RI), STE 200 Garbage disposal 1 25.02
City /State /ZIP: PORTLAND OR, 97224 Hose bib 2 25.02
Ice maker 1 12.51
• ❑ APPLICANT ® CONTACT PERSON Interceptor /grease trap 25.02
Business name: CENTEX HOMES Medical gas (value: $ ) Page 2
Primer 12.51
Contact name: GARY CUI.,P
Roof drain (commercial) 12.51
Address: 16520 SW UPPER BOONES FERRY RI), STE 200 Sink/basin/lavatory 5 25.02
City /State/ZIP: PORTLAND OR, 97224 Solar units (potable water) 62.54
Fax: : (503) 608 -3061 Tub /shower /shower pan 2 12.51
Urinal 25.02
E -mail: gary.culp@pultegroup.com
Water closet 3 25.02
CONTRACTOR •
Water heater I 37.52
Business name: CRAFTWORK PLUMBING INC. Water piping/DWV 56.29
Address: 7737 SW CIRRUS DR Other: _ 25.02
City /State/ZIP: BEAVERTON OR, 97008 Subtotal
Minimum pemtit fee: $72.50
Plan review (25% of permit fee)
CCB Lie.: 79666 Plumbing Lie, no.: 20 -148PB
State surcharge (12% of permit fee) --
Authorized signature: , TOTAL PERMIT FEE
` This permit application expires if a permit is not t obtained within 180 days
Print name: PETER POLLARD Date: g'i (.../e) after it has been accepted as complete.
"Fee methodology set by Tri- County Building Industry Service Board.
1 ABuildingTermits`.PI.N1U- Permit App.doc 1001/09 440 .46I6T(10 /01CO\1.M'EB)
. a
,11
IGARD
City of Tigard
March 2, 2012
Pulte Group
Attn: Ron Spahman
11241 Slater Ave. NE, #100
Kirkland, WA 98033
Re: Permit No. MST2011 -00135
Dear Mr. Spahman:
The City of Tigard has processed a refund for fees on the above referenced permit(s) as
follows:
Site Address: 11036 SW Sage Terrace
Project Name: Village at Summer Creek, Lot 59
Job No.:
Refund: ❑ Check # in the amount of $
® Credit card "return" receipt in the amount of $3,976.00.
Note: Please allow 2 -5 days for this refund transaction to be
credited to your account by the company that issued your card.
❑ Trust account "deposit" receipt in the amount of $
Comments: Refund TDT fees paid by applicant as fee is to be paid by credit voucher for
this project.
If you have any questions please contact me at 503.718.2430.
Sincerely,
Dianna Howse
Building Division Services Supervisor
Enc.
\ Buildin \Refun 1525;5 ltidalialia zeiai►; rtiai Oregon 97223 • 503.639.4171
TTY Relay: 503.684.2772 • www.tigard- or.gov
City of Tigard
TIGARD Accela Refund Request
This form is used for refund requests of land use, development engineering and building application
fees. Receipts, documentation and the Request for Permit Action form (if applicable) must be attached
to this request. Refund requests are due to Accela System Administrator by Wednesday at
5:00 PM for processing by the following Wednesday. Accounts Payable will route refund
checks to Accela System Administrator for distribution. Please allow up to 2 weeks for processing.
PAYABLE TO: Puke Group DATE: 3/2/2012
Attn: Ron Spahman
11241 Slater Ave. NE #100 REQUESTED BY: Dianna Howse
Kirkland, WA 98033 DEB
TRANSACTION INFORMATION:
Receipt #: 185673 Case #: IVIST2011 -00135
Date: 2/24/2012 Address /Parcel: 11036 SW Sage Terrace
Pay Method: CreditCard Project Name: Village at Summer Creek Lot 59
EXPLANATION: Refund TDT fees paid that are to be paid by TDT credit voucher.
REFUND INFORMATION:
Fee Description From Receipt Revenue Account No. Refund
Example: Building Permit Fee Example: 2300000 -43104 $ Amount
TDT - Trans Dev Tax 405- 0000 -43320 $3,976.00
TOTAL REFUND: $3,976.00
APPROVALS:
If under $5,000 Professional Staff
If under $12,500 Division Manager 1U,
If under $25,500 Department Manager
If under $50,000 City Manager
If over $50,000 Local Contract Review Board
FOR TIDEMARK SYSTE ADMINISTRATION USE ON .Y
Case Refund Processed: Date: - B :
1:\ Building \ Refunds \RcfundRcyucst.doc x 09 /01/2010
C
ih t Community Development
TIGARD Request for Permit Action
TO: CITY OF TIGARD
Building Division Services Supervisor
13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov
FROM: ❑ Owner ❑ Applicant El Contractor , City Staff
(check one)
REFUND OR Name: n �
INVOICE TO: (Business or Individual) 0 6 0 / 4 . / 114 t i - Pu L�r ae_o t p
Mailing Address: //AO dam- 1- A-T'.Q A t)f,Ju KZ S,00
City/State /Zip: kICk(.,,Rt.Th bi-)R Q$033
Phone No.: ( tZL w, ctu t 97/ 0754- * /V/ 7)
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓):
❑ CANCEL PERMIT APPLICATION.
AS REFUND PERMIT FEES (attach copy of original receipt).
❑ INVOICE FOR FEES DUE (attach case fee schedule and explain below).
❑ REMOVE CONTRACTOR FROM PERMIT (do not cancel permit).
Permit #: Hs-r3o//- 00/ 35�
Site Address or Parcel #: 1/03 (p o� ) � l i C°_ t__
Project Name: Vt 1-1 --4j t /1-1 p }ia -(£,e zfg-
Subdivision Name: < < F a (1 Lot #: Cj 7
EXPLANATION: tcu,0 - D 1T �Ec , ,j o 3g P4 -. 3r - 7 - 5r -
,, r Vo u.0 //i/L
Signature: / / .1i._„A _i ,j , Date: aZ /A9 //�
Print Name: EQ -/ t. 4 6b4 Ski
///
Refund Policy
I. The Director or Building Official may authorize the refund of:
a) any fee which was erroneously paid or collected.
b) not more than 80% of the land use application fee when an application is withdrawn or canceled before any review effort has been expended.
c) not more than 80% of the land use application fee for issued permits.
d) not more than 80% of the building plan review fee when an application is canceled before any plan review effort has been expended.
e) not more than 80% of the building permit fee for issued permits prior to any inspection requests.
2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 2 -4 weeks for processing refunds.
FOR. OFFICE USE ONLY
Rte to S s Admin: Date ,,,T7MINL TJ Rte to Bld: Admin: Date AMU B , '`,
Refund Processed: Date J 2 /2. By 4 ;- , Invoice Processed: Date By
Permit Canceled: Date /j / 4- By Parcel Tag Added: Date By
Receipt # /f.56 23 Date A/2 y� Method c e_ Amount $
I:\ Building \Forms \RegPermitAction.doc Rev 4/26/2011
1 ,1 2 ° Building Division
Development Code Provision Review
T I G A R D Residential Projects
Building Permit No: I r J o / f — ) O / — _
CWS Service Provider Letter Received: Yes ❑ No ❑ N/A F,
Routed Plans:
Original Plan Submittal Date: 74,d//
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 alon left onl if approved.
Planning Review (contact t 3 �Q,� Lr�A.� at 503 - 718 - LV 5 or �/J @tigard - or.gov)
Land Use Case o. 4.6t. b -1 WI Name V .t d # �' ^4
B"Zoning • 2..4 P h
[Setbacks: _
Front ___ Rear 10 Side 3.5 Street Side $ Qaragg 6' -2 :2)
3--Maximum Building Height 9S Actual Building Height 3 1
El - Visual Clearance
ILl' sements -
LN� Sensitive Lands Type: C� 0
Notes:
Original Plan: Approved 0V Not Approved ❑ Date: 7(z-511)
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:
Notes:
Original Plan: Approved ❑' Not Approved ❑ Date:
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
r
City Arborist Review (contact Todd Prager at 503 - 718 -2700 or todd @ tigard - or.gov)
g Street Trees
Protected Trees -NO;
Notes:
Original Plan: Approved Not Approved ❑ Date: s-4-11
Revision 1: Approved 0 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 toA pplicant
Okay to Issue Permit: Yes No ❑
Date Routed to Building: t/04/ g
Page 2 of 2
Vill at '' ��
JUL2.2?nil
_ _,..,,,,
C TY OFTIGARD
S ummer Creek
s _____
....,.._
SW MALLOW TERRACE
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Building Plan: 17 ,a , , — , _ _. _ : ____ 1 I -
Lots 57, 58, 59, & 60 /' ,r
Units A -B -C -B , ' ;'; 57 1 58 59) 1 6® I
I / 1 r FF/TOw 192.28 FF/TOW , 91.28 1 I
r 191.28 FF /TOw 191.28
/ / , f I GS 191.58 GS 190.58
SITE PL.AN1 = • G5 y TO ! P 191.74 / • TOP 1 9 1.74 I TOP 191.74 I
Scale: 1 " -10' � / ' f ' i i 1.______, I +
I . Pi EI�D5
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/ • - f t wo Fi'<
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• i 1 5.5' 3.5 `
- - E i l i -- -; -- , -. --1 _ - - 15. ^ 18.5' Q 0 I -
..5 14.5 �, - ,J -
i ,, 1.2:5
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o. %x,.G,�]!r�;:.F/:v�ir�''"'.�ia: !�; t•J�,.. � >yrs- i, .. .. .. ��-.., • 'y:ql /•'iuiyJy , rK':t:diu/yu.iYfl '• 1:•ui7!
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: : �NTICLEETt
. _• i .....::..... :::.....:::::.• ::::; ;:,..::, ii........ ::..::::::..:.....::::::::::::: SW SAGE TERRACE
,_ r �
: � ': ENGINEERING ASSOCIATES CORPORATION
17757 Kelok Road _ _ Lake Oswego, OR 97034 —
— — I I r
Tel. (503) 636 -4005 Fax (503) 636 -4015
Oregon Residential Specialty Code N1107.2
HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS
Ooaii32, GC's'
Permit No.: X35 _ S G
Jurisdiction:
//cv io
o - //o Z'!
Site Address: _
/!o3( - Ito YY L S46 — e. lic —
Subdivision/Lot : SuMMtR _CiL- — — —.
and/or
Map and 'l'ax Lot r: 57_ 6 b
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: ZI 'L
Owner/ e neral lam / Contractor /Authorized Agint
Print Name: J 1 4 ) W fro
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 of40 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:`13uddiII t' onns`. I& LS- itighi-17icicncyl.ighting.dnc imoti1K
Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
6-a40.4 i. 1L am the general contractor or the owner- builder
at the following address:
` llbto - 11uZ`I
Site Address: 1 0 36 1 1 o - K ,S ) S6% erg -e�e
City: I t GrCk •
Permit : 11457 Zo
0011, ! o e3'( o_S OD/
Subdivision /Lot #: C S 7 ��
and /or c �
Map and Tax Lot r: 9 (,
To conform with the 2008 Oregon Residential Specialty Code (ORSC), Section R318.2 and
OAR 918- 480 - 0140,1 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 8318.2 is provided for reference].
83182 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: �t ? t//
Gener Contractor or Owner - Builder
imuildin,lForru Kls- :\toicturesensimc\V d.dnc 09!25z08
S TSTREET TREE C
I, .B, k1 \) , owner/ agent for �e,,,.. -x 4- 10,,,,..�� ,
(PLEAS.F PRINT) (PERMIT I IOLDER)
do hereby cert j 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.
SITE ADDRESS: 110 36 - 11044 SA Y 7-av .cue
SUBDIVISION: Sj v&(L C12 LOT #: 57 C-O
SIGNATURE: L✓ DATE: 6/2.1// 2
(O IG7VER /A G HN ! )
RE CEIVED
VERIFIED BY r .,. ` , DATE:
(CITY OF 11Gr-i RD) -
Tree location verified p •r approved site plan.
l: \Budding \Pones\ Strecal'recCcrtiticate 07/01 /2010