Permit CITY OF TIGARD MASTER PERMIT
11111 2 COMMUNITY DEVELOPMENT Permit #: MST2012 -00034
Date Issued: 03/08/2012
TIGARD 13125 SW Flail Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S109AB16000
Jurisdiction: Tigard
Site address: 13332 SW PIPIT LN
Subdivision: ALPINE VIEW Lot: 41
Project: Alpine View, Lot 41
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 4 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 31 Bathrooms: 3 Second: 942 sf Garage: 784 sf Front: 20 Smoke
Dwelling Units: 1 Third: 1037 sf Right: 5
Detectors: Yes
Total: 1979 sf Value: $239,606.89 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs /Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 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
Fum > =100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits
1000 sf or less: 1 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0
Ea add! 500 sf: 4 201 -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 8, 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 1979
Owner: Contractor:
LENNAR NORTHWEST INC LENNAR NORTHWEST INC Required Items and Reports (Conditions)
12013 NE 99TH ST #1650 25 ENTERPRISE 1 Ersn Cntrl 503 - 681 -4444
VANCOUVER, WA 98682 ALISO VIEJO, CA 92656
PHONE: 360 - 258 -7900 PHONE: 360 - 258 -7900
FAX: 360 - 258 -7901
Total Fees: $17,351.91
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done '• - r - • - nce with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days •TTENTION: • -gon I. • re• ires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
95 001 -0010 through OA • : -001-' .• 00• u may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.3 344.
I ,/ / ;/ f •
Iss • • d By: , Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available Inspection date.
This permit card shall be kept In a conspicuous place on the Job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building'•Permit Application
Residential FOR OFFICE USE ONLY
City of Tigard CE � Received Date/B : ot AAtlIM Permit No.: Nl3� /a..
II
13125 SW Hall Blvd., Tigard,OR 97223 Plan Review
z Phone: 503.718.2439 Fax: 503.598.1960FEB A 2O Date/B : /.-„ �� Other Permit: aQ /� 3$'
TIGARD
Inspection Line: 503 2 7 12 Date R - • : �� Juris: RI See Page 2 for
Internet: www.tigard - or.gov C - hod: I ! Supplemental Information
O_ "/ An.: 'arum
. TYPE OF WO . D 6 6 . 1 j 'RE.' I ' ED DATA:4- AND 2- FAMILY DWELLING, '
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.
f nd 2- family dwelling ❑ Commercial /industrial Valuation: $ az.� .
❑ Accessory building ❑ Multi- family Number of bedrooms: Q� —�� "' •
❑ Master builder ❑ Other: Number of bathrooms �J? •
,•JOB SITE INFORMATION AND LOCATION, Total number of floors: 3 :
•
Job site address: ,J 33 7/ k . bo ,6 GQ >� New dwelling area: (l'79l square feet
City /State /ZIP: ? fl / D i ' ' 7 Garage /carport area: `? _ square feet
Suite/bldg./apt. no.: I Project name: 0.....a tirl,e (,"� A 1 p4 3
J Covered porch area 75- square feet 1 Cy3
�1r� Cross street/directions to job site: �� w • ° C Deck area: J r square feet t747
Other structure area: 27 (- square feet 1:3 1
.' REQUIRED DATA: COMMERCIAL- USE•CHECIJdST
Subdivision 0 1)4 Lot no.: il / 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.
Valuation: $
•
Existing building area square feet
New building area: square feet
. 04 OPERTY OWNER _ ' . ,❑ TENANT : Number of stories:
•
Name:La/0106c,L c - Type of construction:
Address: p !Q 3 fL . 0 / ` Occupancy groups:
City /State /ZIP: ��`� casiu li g ,/ - e.e4. Existing:
Phone: (-Na 2 - 7 vao Fax: ZSg T- 796/ New: •
,,LICANT . •, . , ❑ CONTACT PERSON' . . BUILDING PERMIT FEES *, 1 '! ' ,
(Please iefer to fee schedule) • -
Business name:/?j/1}4,., -- 21e f t, t4 . Structural plan review fee (or deposit):
Contact name: e�„2 iLe zo...A FLS plan review fee (if applicable):
Address: -,/ 3 h.9 r T /-2 e 5:
Total fees due upon application:
City /State/ZIP: , Utz I.c.B'L gW' C+<J
� 9p, �- _ p Q Amount received: • :
Phonc: �' 7....5-g _ /mod Fax: (3(�) �e _s /�/
• .. 'PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* .
E -mail: da/dPiZ• /nek /11 CeNivan •Core[
A Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted Photovoltaic Solar • . el System.
Business name :4 • -7iJB� 14./.6.5-6- 6 ` , Submit two (.) - s of roof plan 't connection details
/ ` . f it , j _e. /t Solar fire departmen .ccess, Code h ec the . Oregon
Address: ./19.0.6 jt.9 • , � So /ar /nsla/ /anon S. • ia1 Code checklist.
City /State /ZIP: l)Gl44evzsrx�i !�C/ �� Permit Fee (in ..es plan review $180.00
f� and .dmin •trative fees):
Phone: (-j� Z5 "7900 Fax: (1 66) ys'— --7Q0/ State surch.:e (12% of . -unit fee): $21.60
CCB lic.: _ . Tot fee due upon alp.. ation: $201.60
Authorized signature: '; ' This permit application expires i a permit is not obtained
I, ', - within 180 days after it has been accepted as complete.
�. Date: g * Fee methodology set by Tri -County Building Industry
Print name: �/4 Service Board.
•
I:\ Building \Permits \BUP- RESPermitApp.doc 02/24/2011 440 -4613T(I 1/02 /COM/WEB)
•
C r -
Electrical Permit AnalECEVED FOR OFFICE USE ONLY
City of Tigard CCGG p Received � Ow / pc.....
: a g g �,lU� 9f 2 12 Date/I : A„, i . . /I/
lA
1 C 13125 SW Hall Blvd., "fi a Plan Review Other Permi 0 —aV
Phone: 503.718.2439 Fox: 503.598.1960 Datc/Ily:
TI G A R D Inspection Line: 503.63 Date Ready/By: furls: ® See Page 2 for
Internet: aww.tigard - or. OF TIGAItD Notified/Method: Supplemental Information
- B ILDING DIVISION
TYPE OF WORK PLAN REVIEW
' New construction ❑ A ddition /alteration/replacement Please check all that apply (submit sets of plans a /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over deco stories.
. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
■ CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
X I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations, buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of75 KVA cr
❑Emergency system. larger separately derived system.
• • JOB SITE INFORMATION AND LOCATION DMdition of new jirotor load of ❑ "A ",'E ","I- 2 ", "l -
Job no.: Job site address: - - / ' ' ' IOOHP or mere. occupancy.
_ A�' � . -. ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP' ❑ Health -cnrc facilities, ❑ Supply voltage for snore than
/ /�Jl / � � o Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: U Project name: j ie 4 / a, 0 Service or feeder 600 amps or more.
/F' FEE SCHEDULE
Cross sheet/directions to job site: Derertptton I oty. 1 Fe,. I Taint 1 •
� / / ��� r �� New residential single- or multi-family dwelling unit.
Includes attached garage. •
(14-0,24,a/.41..1.2 1 / 1,000 sq. R. or less 168.54 ((10 ,6k. 4
Subdivision: . -- I Lot no. 1
Ea. add'1 SOO sq. R. or portion It 33.92 1. j,($ I
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. R.) 1 75.00 75 ed 2
// f , / Limited energy, multi- family
75.00 2
/ L ,/ /
ei 5 n7/ f - 7 w/`7 - 7// G/ I/d'// residential (with above sq. R.) _
Services or feeders Installation, alteration, and/or relocation
200 amps or less 100.70 2
Z PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: L F iNie /VO.t?7rw/lt"E7 .7 a ' 601 amps to 1,000 amps 301.04 2
Address: ,2/`I3 NE i�9f4. J/f �� / 'j
e , j Over 1,000 amps or volts 552.26 2
J Temporary services or feeders installation, alteration, and/or
City /State/ZIP: 1,�/ /p bee/ li 94e, "Co relocation
j p 1 200 amps or less 59.36 I
Phone: 0�Q) , j��_ 79 pp Fax: (�Gp) �5�. 7/ L 201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on properly that I own which is not
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, der panel
Owner signature: Date: A. Fee for branch circuits with
JeS! APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7 42 2
each branch circuit
�is 4 S B. Fee for branch circuits without name:
llf� service or feeder fee, first
/,� , `/ / brunch circuit 56.18 2
Contact namc: dip t v' ////4 /% �j L f
✓ 1 Each add'I branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular 67.84 2
City /State/ZIP: . dwelling, service and/or feeder
Phone: ( ) I Fax: : ( ) Reconnect only 67.84 2
• Pump or irrigation circle 67.84 2
E - mail: / 1 4 r f pr','r'!, /1 /q 4'l 7 //?/ /flee, /1!9/11 Sign or outline lighting 67.84 2
•CONTRACTOR Signal circuit(s) or limited- energy •
Business name: far/ 77/ LLe CL,/ .2, %,/ <// f C / t ° G/ / �G panel, alteration, or extension. Page 2 2
L 1 Each additional inspection over allowable In any of the above
Address: 6-6/ .� " /3 "I1 /hit? ✓ Additional inspection (1 lit min) 66.25/ hr
City/State/ZIP: y /J Investigation (I hr min) • 66.25/hr
D /- / -,, , D� Industrial plant (I hr min) 78.18 / hr
Phone: (5N) ) 7GD— .5-7A,t I Fax: (5-43) 7e,;� - /t��23 Inspections for which no fee is 90.00/ hr
specifically listed (%, hr min)
CCB Lie.: /23.f Electrical Lie.: 3 -33,261 Suprv. Lie.: 55 9e5 ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: 0 l" - —� , &J e Subtotal: `1,22
P g 9 Plan review (25% of permit fee):
Print name: 7)enn /3 ieek 1 . I Date: State surcharge (12 %ofpemtit feet 4 .51
� /�� 7
/14 TOTAL PERMIT FEE: ,
L-�f �
Authorized signature: t / /,/ix • ., this permit application expires if a permit is not obtained within 1811
/'D'� days after It has been accepted as complete.
Print name: ,` - > / /e . • Date: , * Number of inspections allowed per permit.
I:% auildmalpesmits'ELC-PamitApp.doc 07/01/10 440.46IST(I I/OS/COAtfSVSD
r - •
Mechanical Permit Application D FOR OFFICE USE ONLY
City of Tigard i�+r�� �� Date/By: LYBECIM Permit No.: W en ,,, ?„
a 13125 SW Hall Blvd., Tigard, OR 97223 w ✓
' C Phone: 503.718.2439 Fax: 503.598.1960 lan Review ^w
FEB �Eg 2 4 2012 Date/By: Other Permit:�e 0 �/,._ d • .. ,
T I G A R Inspection Line: 503.639 Date Ready/By: Juris: El See Page 2 for
Internet: www.tigard C OF �G� Notified/Method: Supplemental Information
twiLDING DIVISIO
TYPE OF VVORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
Iew 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 RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
ra <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:
Air conditioning
Job site address: / 3 3 3 2 a , pip n i ...4241......e...4241......e_. p ,.,,, (requires site plan showing placement) 46.75
�, `/ • Furnace 100,000 BTU (ducts/vents) F 46.75
City/State /ZIP: �1. 4z P7 „Are, % ' ' ) Furnace 100,000+ BTU (ducts/vents) r 54.91
Suite/bldg./apt. no.: Project name: / 1 �� ., Pte' Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: 6 �' r l , e - 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: p ir✓P � , f I Lot no.: / ( Flue /vent for any of above 23.32
//`"' Other: 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 1 23.32
Gas fireplace 1 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 I ❑ TENANT Chimney/liner /flue /vent 23.32
Other: 23.32
Name:La/VA/a-1L / p ` /i2t G'4J� \ _L C - Environmental exhaust and ventilation:
Address: �p Range hood/other kitchen r
tit Aye Z 9 �`� equipment 1 33.39
City/State /ZIP: ela ��� Lo2 ' g� 11. Clothes dryer exhaust 1 33.39
!,, Fax: / Single -duct exhaust (bathrooms,
Phone: c
'C - 5 - ���'OQ (3 Z 5'R- 7Q 7 / toilet compartments, utility rooms) =7 23.32 ( «,
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
: Other: 23.32
Business name
/1 /� / rat �� Fuel piping:
Contact name: e w / 2 ' L i C , 7 t - $14.15 for first four; $4.03 for each additional
Address: -Z/ �� / 7 �, �L � �. Furnace, etc. 1 14,15 .ra Gas heat pump
City /State /ZIP: e b _ r _ e ad _ a „,_ ez_fiec_ 9 go6 cio Wall /suspended/unit heater
Phone: ('J?4j 7�g g j�'�� I Fax: : ( 3 60 ) 7 - �go/ Water heater 1
/` Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: 7 �� ��� Clothes dryer (gas)
Address: Other:
3 7s z 5 MECHANICAL PERMIT FEES*
City/State /ZIP: e24 , / i7 ��, 9 -7D4zS� Subtotal 5�,
� Minimum permit fee ($90.00)
Phone: (9 ✓` 6 7-7 7 v F ax: 60.5 .s 57 (99/9 Plan review (25% of permit fee)
CCB lie.: 72 a, Z State surcharge (12% of permit fee) 36. , (Z
!! / / TOTAL PERMIT FEE 7 j 37 , I
Authorized signature: //� This permit application expires if a permit is not obtained within 180
> .. . .1 days after it has been accepted as complete.
Print name: Mt f j k Date: ff, - • Fee methodology set by Tri- County Building Industry Service Board
I:\ Building \Permits�C- PermitApp.doc 09/09/10 440 /02/COM/WEB)
L.
n e p
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 09/09/10 2
Plumbing Permit Applicat`WWII.• �ED
Building Fixtures FOR OFFICE USE ONLY
City of Tigard FEB 2 4 2012 Date/By: - 'r 49 . A ,. i Permit No.: 4 9/790 Y Ai,
17
a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review^ ^ `p , ��� a � Phone: 503.718.2439 Fax: •®pfTIGARD Date/By: Other Permit No. C Q
T I G A R D Inspection Line: 503.639 BUILDING DIVISION Date Ready/By: Juris: Ei See Page 2 for v
Internet: www.tigard or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
1/ . For construction ❑Demolition For special information use checklist
Description I Qty. I Ea. I Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 312.70
I!d4d m
2- family dwelling ❑ Comercial/industrial SFR (2) bath 437.78
building SFR (3) bath 1 500.32 ',3Z_
❑ Accessory g ❑ Multi - family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: / 3 3 7 , A , W l e,, h it � � C basin or area drain 18.76
City /State/ZIP: 7G /1� t�2 • / Z Footing leach line, or trench drain 18.76
/ Footing drain (no. linear ft.: _) Page 2
Suite/bldg. /apt. no.: project name: /
/L _ Manufactured home utilities 50.03
Cross street/directions to job site: / // L Manholes 18.76
Rain drain connector 18.76
• Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: Page 2
f vLe t! e I 4f,
Water i t (no. linear ft.: ) I I Page 2
�� / Subdivision: l Lot no.: Fixture a or or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors /sump 25.02
001145;ERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: Z aftiIL X 82 ( P15 _,���� • Fixture/sewer cap 25.02
` Floor drain/floor sink/hub 25.02
Address: 2. 1 1(
3 9 ' c Z a_ d`� 1Z
g P_ Garbage disposal 25.02
City/State /ZIP: fi! /�6e / /i...,t.• 9 4A‘ Hose bib 25.02
Phone: 7) g - / 1 „, Fax: , _io S: _- .- Ice maker 12.51
EkAPPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
Medical gas (value: $ ) Page 2
Business name, e.4512r02 2 ' ey..r 4 ../O�tl
Primer 12.51
Contact name: �j / • �ti �O � /� Q Roof drain (commercial) 12.51
Address to 5 ,n `.' e / ziC/ r c��.'Lcv
q
/' Sink /basin/lavatory 25.02
City/State /ZIP: ' AA „,„ , ■ Ire . - Solar units (potable water) 62.54
Phone: (3160 52'- /....??6,0 Fax : : (37) Z %^ �/ Tub /shower /shower pan 12.51
E- mail: !! �� Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name: rn� Q,Iaet.e ../,la, %. 1*!G' Water piping/DWV 56.29
Address: 4 , V j a i , J v Other: 25.02
City/State /ZIP: )4 ,) 40, • 41-7/614+ Subtotal X 32.
Phone: ( - ,�', y . Fax: 9; t j. r t , _ Minimum permit fee: $72.50
CCB Lic.: 60 J ?. , P umbin_• Lic. no.: l�/ •Z Plan review (25 % of permit fee)
State surcharge (12% of permit fee) O r 04-
Authorized signature: r' /r L ii /� TOTAL PERMIT FEE � C. Wes
Date :�7� This permit application expires if a permit is not obtained within 180 days
�, /� i 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(l /02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
•
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee:
Footing drain - 1 100' 50.03 0 to 2,000 $121.90
Footing drain - each additional 100' 37.52 2 001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer - 1st 100' 62.54 7,201 and greater $327.54
Sewer - each additional 100' 37.52
Water Service - 1st 100' 62.54
Medical Gas Systems:
Water Service - each additional 100' 37.52 Valuation • Permit Fee:
Storm & Rain Drain - 1st 100' 62.54 $1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for
Other Inspections or Fees Qty. Fee (ea) Total each additional $100.00 or fraction thereof, to
and including 50 ot e first $ .00.
Inspection of existing plumbing or for
which no fee is specifically indicated 90.00/hr $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
y each additional $100.00 or fraction thereof, to
(minimum charge - 1/2 hour) and including $25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
hours (minimum charge - 2 hours) each additional $100.00 or fraction thereof, to
Reinspection Fees 90.00/hr and including $50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
(minimum charge - 1/2 hour) each additional $100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping, adding or replacing fixtures? If "yes ",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees * . Plan Review for Plumbing Installations
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate ❑ Any new commercial building with water service 2" and
Baptistry/Font greater, except systems designed and stamped by licensed
Bath: - Tub /Shower
- Jacuzzi/Whirlpool engineer.
Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure
Drive Thru as defined in OAR918- 780 -0040.
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher. - Commercial ❑ Any multipurpose fire sprinkler system.
Domestic ❑ Any complex structure as defined in OAR918- 780 -0040.
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: - 2"
3" Isometric or Riser Diagram
❑ Isometric or riser diagram is required for new buildings
-Car Wash Drain
Garbage Domestic non -food that meet the qualifications above.
Disposal: - Domestic food related
- Commercial food related
- Industrial food related •
Ice Mach/Refrig. Drains Comments regarding fixture work:
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -LavBar non -food related
- Bradley
- Com/Serv/Util food related
- Service *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDUs, a sewer permit will be issued and
Washer - Clothes fees assessed for the sewer increase must be paid before the
Water Extractor P
Water Closet Toilet plumbing permit can be. issued:
•
Urinal
Other Fixtures:
•
I: \Building\Permits\PLMF- PermitApp.doc 08/04/2011 2
C.Q. li 1 cJ/
111111 m " Building Division
r c ; it r) Development Code Provision Review
L ra2 n Residential Projects
d
Building Permit No: H -O/ " c13/
CWS Service Provider Letter Received: Yes ❑ No ❑ N/A
Routed Plans:
Original Plan Submittal Date: Ali 4'
1st Revision Submittal Date: ❑ Site Plan Only
2nd Revision Submittal Date: ❑ Site Plan Only
To the Applicant:
Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies to the
Building Division. Only checked (✓) items are approved. Items not approved and those listed in the notes must be
revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed above each section.
Staff please check items along left only if approved.
Planning Review (contact S �� at 503 - 718•.. r
@tigard- or.gov)
Land se Case No s taf2cE -O Q) Name ALA geig vie-61
Z oning 0-1 Setbacks: /
Front g. Rear i Side .< Street Side Garage Z
l� Maximum Building Height -6 Actual Building Height 31
( isual Clearance
E G
ements 0 nUe
Sensitive Lands Type: NIQ-
Notes:
Original Plan: Approved Cr Not Approved ❑ Date: a4 i( //a..
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)
c
❑ Actual Slope: /?/
Notes:
Original Plan: Approved .0' Not Approved ❑ Date: ?i Z g(2---'
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
City orist Review (contact Todd Prager at 503- 718 -2700 or todd @tigard - or.gov)
St reet Trees
Protected Trees
Notes:
/ Original Plan: Approved Not Approved ❑ Date: 9 - lD.
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 Ap cant
•
Okay to Issue Permit: Yes No ❑
•
Date Routed to Building: e (//
Page 2 of 2 .
09
,n
il '4 - •
..► 2 _ FFR + 2 2 42
I s P PIT LANE CITY OF TIGARD
ROSION CON • 01. 6
STORM T
Le -SAN T I BUILDING DIVISION
45.18
� w
PROP
I— � a :r ��� , • �
ill . CURBERTYLINE
} ` STREET TREE (TYP)
§ i - 9 ?` Z
30-1' . . 40
1
Q
: IIIIIIIIII■ ..,. ,, 'd % 1
, s,' ID 30,4. H
if Aild CL
• GAR A GE NDEP •... • • f • COVERED 1953A
'
PATIO •' : "OAK WOODII COVER D'•.•: ^ � '� I • ' r o $ •
in
I I _
• AMERICAN '� : t a N
DEC•
GABLE •." • ; °'1
EROS ON CON • OL FENCING ,, y ��
50.00 50.00 — — •• 8.00
13.1 }• 2847 36'-7}' - - - - -
I
4C 39
. 1 I
DRAWN 02/22/2012 SHG SITE P LA N
Contractor is responsible to check ALPINE VIEW
site plans and notify designer of any SITUATED IN THE N.E. 1/4 OF SECTION 9, TOWNSHIP
errors or omissions prior to start of 2- SOUTH, RANGE 1 -WEST OF THE WILLAMETTE MERIDIAN
construction. Also plans and CITY OF TIGARD, WASHINGTON COUNTY, OREGON
specifications shall be approved by
local building authorities prior or 13332 S.W. PIPIT LANE
start of construction.
5,781 SQ. FT.
LOT 41
LOT COVERAGE: SETBACK REQUIREMENTS: e
LOT AREA: 5781 SQ FT REAR YARD: 15' (FROM P.L.)
BUILDING COVERAGE: 1223 SQ FT FRONT (HOUSE): 15' (FROM P.L.)
LOT COVERAGE: 22% FRONT (GARAGE): 20' (FROM P.L.) SCALE
STREET SIDE: 10' (FROM P.L.)
1"=20'
SIDE: 5' (FROM P.L.)
IMPERVIOUS AREA: 707 SQ FT REAR YARD: 15' (FROM P.L)
FOR OFFICE USE ONLY — SITE ADDRESS: l 333.2 4 P / i r Lk) `
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. •
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
1111 a + Transmittal Letter
- r I C, A R F) =W Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard- or.gov
TO: DATE ' .i?
DEPT: UILDING DIVISION ° km-. tIVED
JUN 14 2012
FROM: . 5 / iFTIGARD
COMPANY: G(y L L4 PIING tl�Ui eIOA•
PHONE: g . 7 / Z / 4 3
RE: • A"A ( � � _ Dlvt� / 4" v Cory \` 20I 2-- 3/
(Site Address) ' (Permit Number)
(5 PI Pct
(Pro'. t name or subdivision name and 'i i ber)
ATTACHED RE THE FOLLOWING IT D'i
Copies: D . scription: • opi :: Description:
/• dditional set(s) of plans. Revisions:
Cross .ection(s) and details. 1 ■ . Wall bracing and/or lateral analysis.
Floor /r f framing. / r Basement and retaining walls.
Beam ca , ulations. Engineer's calculations.
Other (exp .. in):
RE ARKS: • g ,
•
W RO FICE USE ONLY
Routed to Permit T Datj=MIN �► ri
Fees Due: • •' I o Ire ription: Amount Due:
$
$
$
$
Special _
Instructions: •
Reprint Permit (per PE): ❑ Yes No ❑
Applicant Notified: Date: Offig .6,t■ Ini ials: J
1:\Building\ Forms \TransmittalLetter- Revisions.doc 05/25/2012
Oregon Residential Specialty Code N1107.2
HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.:1 (J Jurisdiction: k � C
Site Address: •337.__ 5.1Af P‘t•
Subdivision/Lot #: Al pile: 'At
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: Date: Z
Owner /Gener onnt Agent
Print Name: 6.5 frylti
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:\ BuildingWorms \RES- HighEfficiencyLighting.doc 07/01/08
Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
L&i.'v ‘A.G1 , am the general contractor or the owner- builder
at the following address:
Site Address: r 5 5 p
City: Gv0,
5
Permit #: bZ`" coc j 4
Subdivision/Lot #: Al `�� I
P 1
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: 3 ' 7i
General Contr ctor or Owner - Builder
1: 1Building\Form\RES- MoislureSensitiveWood.doc 0925/08
„, _
STREET TREE
TIGARD
CERTIFICA TION
S ky154t r eirs , owner/ a ent or L /M4i v L EASE P f (P ) (PERMIT HOLDER)
do hereby cert5 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.: WC:L.- 65 0 9 %
SITE ADDRESS: ( 533 Z S Li P, i Zriv -Ie,
SUBDIVISION: fri t ' ) hn LOT #: 4 I
SIGNATURE: , A DATE: 51
(o: , NT)
RECEIVED & 1r
VERIFIED BY: , _ DA"1 E: (_ f :/, 'C
�TTYOFTIG
❑ Tree location verified per approved site plan.
1: \Buildin \Forms \StreetTrceCcate 051301 1