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Permit 111 �� CITY OF TIGARD f 1 MASTER PERMIT a' ��� Date Issued: 03/09/2012 COMMUNITY DEVELOPMENT i Permi # : MST2012 -00014 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S111CB00104 Jurisdiction: Site address: 10152 SW MURDOCK ST Subdivision: 1990 -084 PARTITION PLAT Lot: 2 Project: Davidson Project Description: New SF. 9/24/12, adding backflow preventer for irrigation (Garcia Plumbing). BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 3 First: 2659 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 20.5 Bathrooms: 3 Second: 0 sf Garage: 879 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2659 sf Value: $313,566.56 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs /Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 1 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: 5 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: 6 201 -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 asin Y Other: N Other Description: Ecom P 9 BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R -3 2659 Owner: Contractor: DAVIDSON, GREGG & DIXIE TIMBERRIDGE DEVELOPMENT INC Required Items and Reports (Conditions) 10457 SW LADY MARION DR 9929 NW UPTON CT 1 Ersn Cntrl 503- 681 -4444 TIGARD, OR 97224 PORTLAND, OR 97229 PHONE: 503 - 349 -4886 PHONE: 503- 803 -9184 FAX: 503- 297 -9029 Total Fees: $18,993.87 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. AT ION: • "on law requires you to follow the rules adopted by the Oregon Utility Notification Center. \ Those rules are set forth in OAR 952 -00 010 through OAR • 52 -0r 'r 90 You may obtain a copy of the rules or direct questions to OUNC by callin .232.1987 or 1.8410.332.2344. Issue By: ' 44 . I L ) Permittee Signature: 47/ se �s 1 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. Plumbing Permit Application._ RECEIVED Building Fixtures Received iiii City of Tigard 4 2312 n 2 Date/By: Permit No.: y�ao�� a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review 17 Phone: 503.718.2439 Fax: 503 D Other Permit No.: Date /By: Line: 503.639.4175 CITY OFTIGARD Date Ready/By: Juris: ® See Page 2 for T I GnRD B Internet: www.tigard - or.gov BUILDING DIVISION Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE kNew 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 11 1- and 2- family dwelling 12 CommerciaUindustrial SFR (2) bath 437.78 SFR (3) bath 500.32 ❑ Accessory building ❑ 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: I 0 IS L -s /14 U rd, C . Sl Catch basin or area drain 18.76 Drywell, leach line, or trench drain 18.76 City/State /ZIP: --/- 6 r 04 0 l2 • 9 7 2 ( Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: I 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: I Lot no.: Fixture or item: Tax map /parcel no.: Backflow preventer 31.27 61 a` DESCRIPTION OF WORK Backwater valve 12.51 I V G( b C-c f ft) LJ J Ci ' / J Clothes he sher 25.02 I � t � �� Dishwasher 25.02 Drinking fountain 25.02 Ejectors /sump 25.02 ❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: Fixture /sewer cap 25.02 Floor drain/floor sirdc/hub 25.02 Address: Garbage disposal 25.02 City /State /ZIP: Hose bib 25.02 Phone: ( ) Fax: ( ) Ice maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON 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 CONT TOR Water closet 25.02 J Water heater 37.52 Business name: �.�_ ( L4_$14- Pm Water 1 P f� WV 56.29 Address: o Other: 25.02 City/State /ZIP: Subtotal j / • Phone: ( ) Fax: ( ) Minimum permit fee: $72.50 l' CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee) �' L State surcharge (12% of permit fee) 3.7 l Authorized signature: qh - I r TOTAL PERM FEE y' . Q 9` Print name: 3 O ( 0, p c c I Date: y - L'Y --,2_ This permit application expires if a permit is not obtained within 180 days after it has been accepted as com plete. *Fee methodology set by Tri-County Building Industry Service Board. 1:\Building\Permits\PLMU- PermitApp.doc 10/01/09 440- 4616T(10 /02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule:' Residential Fire Suppression Systems: Site Utilities Qty. , JFee (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 P and including $10,000.00. Inspection of existing plumbing or for $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for which no fee is specifically indicated 90.00/hr 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 ; Baptistry/Font ❑ Any new commercial building with water service 2" and 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 tall 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 ID 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 WaterCloset - Toilet plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF- PermitApp.doc 08/04/2011 2 II q CITY OF TIGARD MASTER PERMIT a COMMUNITY DEVELOPMENT Permit #: MST2012 -00014 T I GA R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/09/2012 Parcel: 25111 CB00104 Jurisdiction: Site address: 10152 SW MURDOCK ST Subdivision: 1990 -084 PARTITION PLAT Lot: 2 Project: Davidson Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 3 First: 2659 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 20,5 Bathrooms: 3 Second: 0 sf Garage: 879 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2659 sf Value: $313,566.56 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 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 Drywell- Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Fum <100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 5 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'I 500 sf: 6 201 -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 2659 Owner: Contractor: DAVIDSON, GREGG 8 DIXIE TIMBERRIDGE DEVELOPMENT INC Required Items and Reports (Conditions) 10457 SW LADY MARION DR 9929 NW UPTON CT 1 Ersn Cntrl 503- 681 -4444 TIGARD, OR 97224 PORTLAND, OR 97229 PHONE: 503- 349 -4886 PHONE: 503- 803 -9184 FAX: 503 - 297 -9029 Total Fees: $18,958.85 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 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the`rect questions to OUNC by calling 503.232.1987 r 1.800.332.2344. Issued By — ■i. E _ � Permittee Signature: Call 503.6 ; _ �00 a.m. for the next available Inspection date. r This permit card shall be kept conspicuous place on the job site until completion of the project. C) Approved plans are required on the Job site at the time of each Inspection. Building Permit Application Ll.4,20/1 -00°05 Residential FOR OFFICE USE ONLY of Tigard P ermit No.: ��I City g ` Date /B : Received to, /, h{5 f�dl 13125 SW Hall Blvd., Tiga .: ' �" ' ' Z0 \ti Plan Review • it Phone: 503.718.2439 Fax: '1 Da /B : • her Permit • 0 Cl � :N e 1 1 �` % �o�a —��� I _ I 1. t � Inspection Line: 503.639.41 '. c � ;�® Date R eady : y: a /��� 1uris: ® See Page 2 for Internet: www.tigard-or.gov �(` WI Noll e d /M tho 0 ,�' � , / S iplemental Infix ation (.11„iii...Aar.„1: TYPE OF � REQUI t D DATA: I- AND 2 FAMILY DN . ° N a New construction '�'benmolition 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. 0.1- and 2- family dwelling ❑ Commercial /industrial Valuation: $ '3 ( �j 1 5, ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: 2. IA JOB SITE INFORMATION AND LOCATION Total number of floors: i Job site address: /D/5:2 Su. All v rd OG k- S - • New dwelling area: 14, so square feet City/State /ZIP: 1-114,01 O %Z . 9722# Garage /carport area: $'? square feet Suite /bldg. /apt. no.: I Project name: S v CTrcc 4 r Covered porch area: jJ. square feet Cross street/directions to job site: 41 vrdo . k 4 i o Srat Deck area: square feet Other structure area:. `?5 W3 square feet '2(.7, REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: fl1(Vr t o ek Was I Lot no.: I Permit fees* are based on the value of the work performed. Tax map /parcel no.: Z $ ndicate the value (rounded to the nearest dollar) of all CO C 00 equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. Si 4 1 r� Ws1' y /'YSt rt..jGC. Valuation: $ Existing building area: square feet New building area: square feet IA PROPERTY OWNER I ❑ TENANT Number of stories: Name: (j). or L= Y pot petaidse vn Type of construction: Address: `Ou{ t 1 Stw Coady N .17124 ,Ar; DN 'a.1 V C. Occupancy groups: City/State /ZIP: T f d O Existing: Phone: (SI ) 39 98 34 Fax: ( ) New: APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: Structural plan review fee (or deposit): Contact name: 7�v* 14 1 \ -- ) FLS plan review fee (if applicable): Address: Total fees due upon application: City/State /ZIP: , y_ t Amount received: Phone: ( ) I Fax: matt\ ) E -mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of 1 roof -top mounted PhotoVoltaic Solar Panel System. Busin =.s name: I % N1 r�,.05e ptvt�, (or/{ntNf 241 Submit two (2) sets of roof plan with connection details 9 And .� Jn / � � and fire department access, along with the 2010 Oregon Ad. ess: 7 1 - h C Sola Instal /alion Specialty Code checklist. Cit /State /ZIP: pr o Permit Fee (includes plan review $ 180.00 ^ ' / 9 and administrative feesL Ph e: ( ) 80)-1 it 1 1 ,9 I ' . x: (5 ) 211 / 7 — 1 0 - State surcharge (12% of permit fee): $21.60 CCB tic.: 07 sy1 ilik Total fee due upon application: $201.60 Authorized signature: �� )4, wi days T permit application expires ef a permit is not obtained • within 180 days shas after it has been accepted as complete. • [ Print name: Ja/, f{ .etime i„ Jr . Date: Z 1-1Z * Fee methodology set by Tri- County Building Industry Service Board. I:\ Building \Permits \BUP- RESPermitApp.doc 02/24/2011 440- 4613T(I I /02 /COM /WEB) . Building Permit Application Checklist One- and Two - Family Dwelling FOR OFFICE USE ONLY IN City of Tigard Received Permit No.: 1 3125 SW Hall Blvd., Tigard, OR 97223 Associated permits: C Phone: 503.718.2439 Fax: 503.598.1960 - . f C; A R D 24 - Hour Inspection Line: 503.639.4175 ❑ Electrical ❑Plumbing ❑Mechanical Internet: www.tigard - or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N /A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑ 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: . ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑ basin protection, etc. 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑ there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑ furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑ floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non- ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ • systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ . ❑ over 10 feet long and/or any beam /joist carrying a non - uniform load. 20 Manufactured floor /roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. identify the prescriptive path or provide calculations. A gas piping schematic is required ❑ ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Ore.on and shall be shown to be as I licable to the sro'ect under review. JURISDICTIONAL SPECIFICS 23 Three (3) site plans are required for Item 11 above. Site plans must be 8 -1/2" x I I" or I I." x 17 ". ❑ ❑ ❑ 24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building -plans will not be accepted. ❑ ❑ ❑ 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. . . ❑ ❑ ❑ 27 "Drawn to scale" indicates standard architect or engineer scale. • ❑ ❑ ❑ 28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ ' ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations, driplines, ❑ ❑ ❑ and protection measures must be drawn to scale and must include the project arbtirist's signature of approval. 30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. , 1:\ Building \Permits \BUP- RESPetmitApp.doc 02/24/2011 440 -4613T(I 1 /02 /COM /WEB) Mechanical Permit Application I Oli ou- ici.: usl: o,N1.y City of Tigard V Da wed ° 13125 SW Hall Blvd., Tigard, OR 97223 l y 'L y '' Phone: 503.718.2439 Fax: 503.5' ;.t � V Plan Review ; Other Permit: Date/By: l' I G A R U Inspection Line: 503.639 % �0\� Date Ready/By: kris: 63 See Page 2 for Internet: www.tigard or.gov �� G '` Notified/Method: Supplemental Information T� * COMMERCIAL FEE* SCHEDULE — USE CHECKLIST !h(O TYPE OF WO 00 Ceti " New construction ❑ Addition/alterat Mechanical permit fees* are based on the value of the work cement 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* (L 1- 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: ( 0 I SZ S W M Ura° JJ cf< E 7 l ; (requires site plan showing placement) I 46.75 Furnace 100,000 BTU ( ducts/vents) 1 46.75 City/State /ZIP: 7i 94 eo1 of?. c3 2 v( Furnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg. /apt. no.: Project name: Heat pump (requires site plan showing placement) 61.06 Cross street/directions to job site: "J " a h (/D o - 11 — Go $ ra 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: 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 N S 'FR vii-c. Gas fireplace/insert 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 ❑ TENANT Chimney/liner/flue/vent 23.32 Other: 23.32 Name: Crrc l 0 I x' e OA P coil °Gl Environmental exhaust and ventilation: Address: J '^ �f Range hood/other kitchen ` SW C6 0 ( Y / a / /1) 0 !/ / . equipment ( 33.39 City /State /ZIP: ' / , G „ 72, q, Z Z Clothes dryer exhaust 1 33.39 � / , G Single -duct exhaust (bathrooms, Phone: ) / Fax: ( ) toilet compartments, utility rooms) S 23.32 3 ....t 4 ❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32 r^• n n � Other: _ 23.32 Business name: IYh /,/G1'? f u 4 C hot Fuel piping: Contact name: Jo L A nV h C4P) $14.15 for first four; $4.03 for each additional Address: 1121 Nw Y/ ( fi ci , Furnace, etc. ( Gas heat pump City /State /ZIP: f j � f ((, p ef D /?. 9 7 22.7 Wall /suspended/unit heater Phone: ( 3) So3 „ Q (/ ()32 Q? '�, O 2� Fireplace ater iI E - mail: H 01. S/ \ de 0 ,f `f t1 C�t'1 CS . CIY1/ Range 1 CONTRACTOR Barbecue ' Business name: r r r CO D/ pM� ./ / 'rl % h G . Clothes dryer (gas) Other: Address: /6 S'S �` W ' `r 1 V' - 4 S. 't fj * J • I' MECHANICAL PERMIT FEES City/State /ZIP: T;, 4 P C( 01' 9' 2. 2 Y Subtotal '351. Minimum permit fee ($90.00) Phone: (S LIS) Zfoo --') gQ We ) Fax: ( ) Plan review (25% of permit fee) CCB lic.: S' 6 6 3s- I if iii," State surcharge (12 %ofpermit fee) W., a--) TOTAL PERMIT FEE 34 3' r Authorized signature: This permit application expires if a permit is not obtained wit 180 J da after it has been accepted as complete. Print name: V e4 h W irt c0) I Date: 3 -- 9 -12, • Fee methodology set by Tri-County Building Industry Service Board 1:\ Building \Permits\MEC- PermitApp.doc 09/09/10 440- 4617T(I1 /02/COM/WEB) • Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi- Family Fee Schedule: Total Valuation: Permit Fee: $0.00 to $500.00 Minimum fee $69.06 $500.01 to $5,000.00 $69.06 for the first $500.00 and $3.07 for each additional $100.00 or fraction thereof; to and including $5,000.00. $5,000.01 to $10,000.00 _ $207.21 for the first $5,000.00 and $2.81 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and $2.54 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and- . . $2.49 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $2,608.71 for the first $100,000.00 and • $2.92 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require sets of plans. • I:\ Building \Pennits\MEC- PertnitApp.doc 09/09/10 2 • Mar 05 12 12:36p TimberRidge Development • 5032979029 p.1 Mar 05 12 12:14p Rachel Graham oua -ouo-4110 r• Plumbing Permit Anplientii3ECEIVED Building Fixtures FCYn OFFICE I'SE ONLY 0 62012 Ci of T' rd Ie «e "� �' � Ixa.•11.•: pm* No.: li T�lj''' OGp ` n 13125 SW Hall Blvd. - Tigard. OR E+ia. Mom: 303.7111 439 Fs: $ .i Nan `ar. C lnrpcc 503.639.117 .. G DIV �� Mir: c 8 S 2fur . p T I G A 2 D Istic act: ww ^' I lark Rcmh.7t�: hair: I ® 5er Pa cr 2 fur w•.tigard nr.gov Nofitial :M bod ON SupldemenIAInformalina rr�aett 1'11 OF WORK FEEO SCHEDULE tpl•/etrcmestnt elion ❑ Iktmnlilion For specialWorn:arimrixrcheek's,. Ic.criptiou 1 city. ) Ku. 1 Total in Arkin ion!.l rent iun/r4lacranent ❑ Olhrs: New 1- 24amity &nal 1(I(I h. rot Cad' wilily canlux:Ii n) I CAVEConvv OF C:C)NST131'C11ON SFR(I)baih ( 312.70 , Cal- :red 2- family dwelling ❑ Commucialrndustrial SF& (2) bath ( 337.38 ❑ Auassor3• building 0 Multi- family SFk (3) bath SWr.32 ad' additional hada/k itchen 23.02 ❑ Master builder ❑ Other: Fire apr(nkla( set. IL) ( Page JOB sm.:: INFOILVINI1O. AND LOCATION r Site utilities: j°1) site addn:rS. 18152 50 .t g4' f ' Catch 1>asua,karcs drain I8.76 orywdL Leath line. or match drain 7_ 18.76 City /5unea!P. 1ei 0 '2 ' " Q 1lt Footing drain (co linear R.:�) Pap; 2 • Suite/bldg /apt. Ito.: I ProjtixY name.: \iaufutwtzl borne Militia 311.03 Cross Arccs/directions to job site: I0°; 0 . / ocs d be+144. , Manholes 18.16 C Rain Drain %Tweeter 18,76 ' Sanitary sewer (no. I iiu ar 0.:12_, f Page 2 . Storm sewer (rm. linear Il.: 3AL1 + , Rigc 2 R 42 Water service (no. linear , ) l Paget ,_ Subdivision: I Lot Ito.: I - i :tnrr or item: - Tax m:yvparal na:'nit V ( 400 104 Oackllow pnyaltei ( 31.21 DEtiC:RIPTIO( OF WORK Backwater ►nlvc (? tl r i(� Clothe,: washer l f 25.02 ti jf F- f Q u rt, 1 4 0 Dishwasher J 25.02 Drinking founinio 25.11 • Ejectors/sump 25.02 ❑ I9IOPERIY OWNER l ❑ TFNANT L :spar:slim Tank 12.51 1 Fixture /SCw1S cup 25.02 I�.VYC: ' ViQ ; GCrtg 4 DIxte, 01/0. , :IaorlraiaJltonrsialvintb 25.173 Address: 104 S7 SW .Leaf Mair;orl Ole; ve Crartm Ji i � Ec spusul 25A2 City!Suste/Zll' : ! t t:(i on... Ql'i'ir'V Now bib . 25.02 !hone: tail 1 . 3 ' 8r g[„ Y 1`a.K ( ) (x ram- 12.5 ❑ APPLICANT ❑ C:ONTACT PERSON intcrcepiottgraasetrp ,_C.II? 13ucirxx5 CUM Medial PS (setae: S bran: 2 414C • •il Jio+ Primer gPrimer t I2.51 Contact name: i Adder: ggn q) , l Roof (Win (armnxxei:ll) 12.51 /ti 18 h Sink/bcrcinll.t.aron• - 7 2.3.02 Cilr/Slale /ZIP 0,�'J ;Cj2_ Q � Solar units o 54 q ( (pntablc�vala) 6_ Piton= l�� 7 1T . ? I Fax::0!:,12:0 r,, •I•ub/shuw�»'shwen l .. 12.51 1•: -unit: )121k11 • Pl ICA t ireC4C.NaSit'OL I4001.1QS. Col& theta/ 25.02 Water class 25.412 CONTRACTOR Rosiness name: /' Water heater 37.52 (."&i,4 to t lc t iv.., Li, t 4.,, L. L L wotcr pipingll)WV 36.24 Addoss: '1 ;qtr - I - "s Other: 25.02 CitylSlatr:/ZIP: f"r107 .e. .. oC 4 . 7 1 () . T ?3 S i Subtotal Irtta7u.15t;!3) F I- Le OW Fax :O�73) 466 - [•f / 7� Min £72.50 Li g.: Planflti (15% of pima it feel CC( ! ,I c-3 ;s-f it � `t a P lumbing . Lic. n o.: r..4 76 � r5 Sutc surehargel12° ofp mill fail Autdori:!cdsignalllrc: _ 10 . 7�1 �rN 'TOTAL PERMIT l:, l l'rint norm:: .A.,..'-c4- ✓ ✓ �' `` //J� - J � 4 Thk puma appliea1 nn u obtained capirus if permit isnot oained ...anin ITW d )� a 1�' <'i < � Dalc: r �! :� after 11 ha. Imes accepted as eaoupkar. Y -Fee axA:MoF} se: by 1'ri.County Unilditte Industry tiriie I)aord uneihisor rasa r.s.v rerompr IrmO . 4-111-1GpillraA2l[OIWWI3)) From: Elite Electric Group Fax: (888) 901 To: Fax: +1 (503) 598-1960 Page 2 of 2 3/5/2012 6:38 . • . . .. , .. , . . . • . • ... . • ... " • • • ....• • - . •.., .. „ . . . . . .,.... ,...-..-.. • •,.... •• Electrical Permit Apnlica • co D .,,-;..,.::,..,:...,,.......,..•.._ City of Tigard Pennit I Ft(: - Y . -- '••• ..----.. • : " , , • • - " ••:- . '., 1- ... -'•'•':. t %VI- Rectmed Datertv: : o . : t'Orat) 0.--aajr/ Plan Review , • .;.- 4 13125.SW Hall BM., Tigard, OR 9722, k‘k m 6 I N - 2 . FIMPM i •,,,I ' . - . .:.:, Phone: 503;718,2439 Pax: 503.598.1 VOIIA Daway: 'T t Gri Inspection Line: 03.639.4175 ,... / 1G P1/4 . % Date Ready/By: • ruri3, 85 Sec Page 2 for . :•.: '. .', ;' .- . Internet: www.tigartb nr. or.gov ,,t i 1 tmOysl NotifiediMettiod: .. - . ..-. -.. . . ...... .. ....... . .. ,. - CI\ VI 1 - . --- --. • - • . ... . Supplemental Inforrantion .. • ..-..-......• •.• . Plea check all that apply (iatnnit 2 sets of plam weitem3 chrdi.ed tarkm): Ds' New construction 0 Addition/alter ion/replac 0 Service or feeder 400 amps Or more 0 Building over iliac muties 0 Demolition 0 Other; whoa. the available pudic:La-tett 0 Marin3s and bmtyurds. . . _ _ . . .... .. . . ... . . . ,.. - ...• ' - .' ...- • - ... • :- -..'civrEGoity.iopt(rcs-yittiirrios . - • ............-... ••••••••••. . -• ••• .....--- . es mats )n) (XI)) Ann S ra 156 ,III s IT 0 n0.11ing tmildlop. - Ics to ground, at e3eced3 14.000 0 outtmercial.osc awl cultut 3i 21 l. and 2-family dwelling 0 Commercialindustrial 0 Aetessnry building amps for all miler itinallanans. twifillass 0 M.ulti-family 0 Master builder 0 Other: 0 Fire pump. 0 Installatirm of 75 KVA Pr larver cparately derived 1.y.f.' - ' . ..- 3.010 .s.rrEANFortm.v.rtw.:Asp-..LocATION.-..:.-::-.--... ---- -.- -- .. .:. 0 Addition ritoc moult load u( 16911P or muse. oceimanty. Job no.: Job site address:101 3 L4 (vh„ yoc,k sf. . 0 Sir OT Tare residential units. 0 Rectentioal vehicle parks. Cily/StateiZIP: . t j'efrci 072. 2 2 i-/ o Health-earc facninev. 0 Supply volmgc tbr mart arm 0 liazardotis toestions. 600 volts nominal 1 Suiteibldglapt. no.: 1 Project name: 0 senice. Pr feeder 600 amps or more.. ..:...:.." - '.. -...' . .:" • 1 - FEE SCITEI)ULS...' Cross stn. (Glob site: to ? r 64 , / 0 OA_ , ihstripthm I i f rem; 1 . New residential single- or multi-ftimily dwelling unit. Includes attached garage. I - - - no.: 1,000 so. ft. or less I 168.54 4 , S{i bc.1 z v !Sion: t 1 Ltd 17a. MEM 500 sq. ti. or portion 3192 . I . l 'ax map/parcel no.: 2.t kc-1 0 ts 1 oLt Limited energy, residential 75.(3) ' : • - '.-. ' :.....1).RSCRITTION OF •WORK -- - ...---...--....- - • •••• •.:.-. • -. -..-. (with abme sq. (t-) . Limited view, mulli-family 75.00 1 - N) S e Q. eLt-uff i 4 4 ( residential (with above sq. 11.) Services or feeders installation, alteration, andror relocation 200 slaps or less 100.70 2 .0 PR(lPF.R.Ti•siTSVSER..: -• -: ' :". -.:••••••• ''-:-. : ."- :•. '0 irENAT:: - :• '• • ' • 7 201 amps to 40 umPs 13156 2 401 amps to 6Cr0 arnps 200.34 2 Name; CT( e * , 1 (ie (11'060 4 601 amps to I,000 arnps I 301.04 .... Address: /0 ti 5-1 Ss( LAIL Mar I 0 rt Orilic Over 1,000 amps or volts I 552.26 , - City/Stale/ZIP: ,--1 r Temporary services or feeders installation, alteration, an d/or I r '54, 04 , O q. ) z2-/ relocatin. , , !toner{ 5..) 5 ) 3'i - Fax: ( ) 200 amps or less 1 59.36 I 1 s I Owner' installation: This installation is being made on property that I own which 201 amps to 400 amp 125.08 1 is not • I intended for sale, lease, rent, or exchange. according to ORS 447, 449. 070, and 401 Tulips to 599 amps 165.5.1 2 701. Branch circuits - new, alteration, or extension, per panel (Niter signature: _ Dme: , A. Fee For branch circuits with . . Li c . E• APPLICAN Tf . • ' ' ''' • - 0 . CONTACT PERSON hov service or feeder fee, '4' , - each branch circuit rlItisirtess name: Joh evic4 or) ' ii/P1 id5e DI l ie 4 i fiT-- 1---_-__ B. Fee for brunch circuits wirhon: service ur feeder Fee, rust :i.O. I X 2 r Contact name: 4,, q, c‘611- I??S'Y / branch circuit - . Each add' 1 branch 7.42 2 circuit I Address: 1 nit„) v cf. ..... Nliscella aeons (service or feeder out included) Each manufactured or modalar I P , ft, ,pt oil. 2 7 z 7, cit 67.34 , - dwellinl, service andlor feeder Plione: ( S gD 3 -el S y Fax: : ( ) Reconnect only __ 67 64 - ' - Pump or irrigation circle ti7.84 1 _ E-mail: )774; di.I4G4 11 p 1 1 E. u air.4.7 400145 - C0+ Sign or outline lighting 67.64 ' - .._______. - -- • COTICAOOiC •-:-.:'' ' • -':. - •• .. ':' : ' ' Signal - circuit(s) or limited io - encr ..... _____ 1 ! ..ir i BLISirICSS name: . : . :/ji .. c e--/ j,e j.. ,,, . 61. __ r.,,....:i. ult,...ration, or extension. Page 2 1 2 1 Each additional iaspection over allowable in any of the bi awe I - r--1 Address: IN r o Box S2 1001C 1 Additional inspection (i lir min) I 66:25.; ht 1 1 i I City/State/4111: uei A qi 615C- 1 Investigation (I hr min) 66.25. hr • 0 / - --- Phone: (561 7 737 - it ti, 0 Fil,': ( ?o: - MY 41///i Industrial plant (1 hr min) ' 7a.liti lit (TB Lie.: 11/ ' I a7 (.,/ i Electrical Lie,: 2 I • • . .-...., 7 i c: -tprv. Lie.: S 7 4 as.... Inspections for v.hich no ca. is 90.00' hr 1 ---- spi...cificalhe listed t ...-: hr min t Sitprv. Electrician e n signatu, required: - / e. e ......--c' . , •-•.::.:.:•:-..,': .::-. ' .EI,E(7fRICA:1, PKR.3111' FEES • .......20:? Subutial: '' RiTit name: Oelt, ifkr ns,c.r.eloxs. 2.- I Date: I ..._.._i . Plan review (25;•.; of permit fee): Atithori/.et1 siertature: Slate suteharge (12% or permit feel: 1 1 i Print name: Mekx PeA,A3-11 Date: TOTAL PERMIT FEE: • I , ltuazirvOefIvoial.C.PowitAriinc 07;01 /IS 440 MIL A✓i 50 ;1 a ° Building Division 14: 4 ao 11- o000 Development Code Provision Review T I G n R D Residential Projects Building Permit No: 1 ST 9 • - COO ` RPOL/ cg / 7.- ' 5 c)u BN /fTi rJro CWS Service Provider Letter Received: Yes ❑ No N/A ❑ w PTN 6.1.05# Routed Plans: Original Plan Submittal Date: .1/it)//a 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 SAAAA4.4,1 at 503 - 718 - lr tigard- or.gov) Land Use Case No„,, 1 - 1 -4_ / 2..0l C. OOGWme �• O ( !, t d"� ❑ Zoning 3. 5 ❑ Setbacks: / Front Rear I b Side ..1" Street Side 19Z Garage. ❑ Maximum Building Height 3D Actual Building Height S ❑ Visual Clearance Cr Easements ❑ Sensitiv L ds Typ :L Notes: d' e07, " z, -43, O N I4QLO Original Plan: Approved ,...12r Not Approved ❑ Date: r0O /4a i � � V Revision 1: Approved ❑ Not Approved ❑ Date: K Z //4 //z. - ®� Revision 2: Approved 7 / , t4 o ❑ Date: 5Intd 1 - P44011 U•A Lott - a0OU Engineering Review (contact ' e *te at 503 - 718 -2464 or MikeW @tigard - or.gov) fl4( C J Actual Slope: / % 4r Notes: G - - c, 44s "e/ /A S. 4° Original Plan: Approved Not Approved ❑ Date: Z /v / 1 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) / Street Trees Oa Protected Trees Notes: Original Plan: Approved d Not Approved •D Date: Revision 1: Approved ❑ Not Approved 0 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 tqq Iss of Building Permit Notes : C 1- —1;3 6'�1 el - 4.44.41L i rt CI w td +-/re-L. • y o", (.L4 2 r] • OCJQ 5 - / Are r »I- f Original Plan: Date Sent to Applicant: - Revision 1: Date Sent to Applicant Revision 2: Date Sent to Appli t . Okay to Issue Permit: Yes No- , • Date Routed to Building: _ te r% .4. V ./ Wi/i • : • . • ._, • • . • t , • • ' V . • • Page 2 of 2 • � . b 21 12 03:55p TimberRidge Development Alic � 5032979029 gti p.1 D .:v' 1 \ Gt,e \0 N C Clean Water Services File Number FEB 2 1 2012 ✓ CleanWater 1: itic0 t (TUN - 3 3 12 - (T By Sensitive Area Pre-Sera/1A Site Assessment 1. Jurisdiction: C. ) O I T r� 4 r et 2. Property information (example 1S234A601400) 3. Owner Information Tax lot ID(s): ?.5 111 C. 13 00 joy Name: CTreg)5 a ()ix"( 'N ✓ 6 SV ti Company: - I 0 N S? SW Cady /Vi yrlort De Address: Site Address: sW /Vfv cK S City, State, Zip: T i y4 r d o TL . 1 7 iij' City, State, Zip: T 0n . 9//- z Phone/Fax: 5 ° ? 3(/ 5 - yp�C, Nearest Cross Street: /1 I/rdack 4 i d 1 d E -Mall: - f'SCL 3 131 0 r.0 +i %4 % / -c oi4 4. Development Activity (check all that apply) 6. Applicant Information gip Addition Addition to Single Family Residence (rooms, deck, garage) Name: 1 ' + ? 1 P l a f ” 0 .eve topb+, e h'f — It ' Lot Line Adjustment ❑ Minor Land Partition Company: dela n pvnL4n ❑ Residential Condominium ❑ Commercial Condominium Address: q5l 9 API) Of fro A Cf • ❑ Residential Subdivision ❑ Commercial Subdivision ID Single Lot Comme O Multi Lot Commercial City, State, Zip: 90,144"s" o( 9 722.9 Other blItn) dt;tiett �IS� Phone /Fax: (') 9p'1-11$ 4 94-7-q ? o 2-4? U E -Mail: 10t✓rn dv PIC. srt (' •f-ra Cvi f b"44nt•l(s Co J pit 6. Will the project involve any oMslte work? ❑ Yes lag,No ❑ Unknown • Location and description of off-site work 7. Additional comments or information that may be needed to understand your project This application does NOT replace Grading and Erosion Control Permits, Connection Permits, Building Permits, Site Development Permits, DEQ I 1200 -C Permit or other permits as Issued by the Department of Environmental Quality, Department of State Lands and /or Department of the Army COE. All required permits and approvals must be obtained and completed under applicable local, state, and federal law. By signing this form, the Owner or Owner's authorized agent or representative, acknowledges and agrees that employees of Clean Water Services have authority to enter the project site at all reasonable limes for the purpose of inspecting project site conditions and gathering information related to the project site. I certify that I am famirrarwith the In contained in this document, end to the best of my knowledge and belief, this Information is true, complete, and accurate. Print/Type Name t/D 64 on , n C Ct N1 C° 6% 'h'�` ' 1— Pri nt/Type Title ^ Signature ekk-- Date Z - 5 —' L • FOR DISTRICT USE ONLY ❑ Sensitive areas potentially exist on site or within 200' of the site. THE APPUCANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties, a Natural Resources Assessment Report may also be required. ❑ Based on review of the submitted materials and best available information Sensitive areas do not appear to exist on site or within 200' of the site. This Sensitive Area Pre - Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered. This document wit serve as your Service Provider letter as required by Resolution and Order 07 -20, Section 3.02.1. All required permits and �.,( approvals must be obtained and completed under applicable local State, and federal law. U Based on review of the submitted materials and best evadable Information the above referenced project will not significantly impact the existing or potentially sensitive area(s) found near the site. This Sensitive Area Pre - Screening Site Assessment does NOT elimhate the need to evaluate and protect additional water quality sensitive areas if they are subsequently discovered. This document will serve as your Service Provider letter as required by Resolution and Order 07 -20, Section 3.02.1. All required permits and approvals must be obtained and completed under appicable local, state and federal law. 13 This Service Provider Letter Is not valid unless CWS approved site plan(s) are attached. ❑ The proposed activity does not meet the definition of development or the lot was platted after 9/9195 ORS 92.040(2). NO SITE ASSESSMENT OR SERVICE PROVID R LETTER IS RE UIRED. Reviewed by' . 1.C. Date Z/2. 7 Z 255(1 Sl^11- lilht'oro i light :cry • Hillsboro, Oregon 97123 • e ro.ii:: (503) 631 -5101 • Fa::: (502; 031 -4439 • rJ . cle i inv,Erte (services .oru r t PROPOSED HOUSE LOCATION PLAN FOR: i GREG DA V I D S O N I HMC Harris - McMonagle SITUATED IN THE NORTHWEST QUARTER OF SECTION 11, since Associates, Inc. TOWNSHIP 2 SOUTH, RANGE 1 WEST OF THE WILLAMETTE MERIDIAN, 1968 ENGINEERING - SURVEYING - PLANNING CRY OF TIGARD, WASHINGTON COUNTY, OREGON. 8740 SWScofns Street Tigard, Oregon 97223 DATE: FEBRUARY 10, 2012 Tel. (503) 639-3453 Fax (503) 639 -1232 SCALE: 1 "= 20' RECEIVED JOB No. 11 -15 GENERAL CONSTRUCTION NOTES; ® PERMIT REQUIRED - CITY OF TIGARD TO INSTALL WATER SERVICE. FEB 10 2012 02 PERMIT REQUIRED - CITY OF TIGARD TO INSTALL INSERT -A -TEE CITY O TIGARD (EXISTING SANITARY SEWER APPROX. 16' DEEP AT MAIN) BUILDING DIVISION O3 CONSTRUCT SANITARY LATERAL - 4" PVC D-.30.34 SERVICE LATERAL. (END OF PIPE TO BE 7' DEEP AT PROPERTY LINE - CAP FOR FUTURE CONNECTION. ® INFILTRATION TRENCH - 2' WIDE x 6' LONG x 3' DEEP FOR RAIN DRAINS. (FILLED WITH 2' CLEAN DRAIN ROCK WRAPPED WITH FILTER FABRIC.) N O5 TOTAL LOT AREA = 13,909.70 S.F. THE IMPERVIOUS HOUSE AND DRIVEWAY AREA = 5321 S.F. IMPERVIOUS AREA = 38.2% PERCENT OF LOT AREA. S i l t Chce XXX 1C © _ lx(5?W- L4'+ r te 0 �°cio"" SW MURDOCK BEET (CR ,760) , S_ s� , lir _ tea' N cs o k `- - - I- W - --�r- - - ---1- - - ` - 1 I. ` , ' W , 8 —r _. FP-- ` — EP-/ : r - 7 ' : 9.74' ' ` o 1 \ : gtit1 RE .5' A% 'El • TIOH x '_1 - — — r- ro N ©c/) : N \ '' %Sf (� t o o.< o o 4 oo :•:1:2;04 ` , , � N , • , � I N '1 1 - �: .- ' I 2.00' GRAVEL ' - SHOULDER <TYP> is : , - - - -- o - •, - 12" DEEP . _ �� •: • t', I FLOW DISSIPATOR 1 , t iT 1 1 ,PROP$E'd:•.DRI x , ,` : 5 y4RE C X8.8.: S.F ;.. "• , x ,t EXISTING HOME Ulf 1P, : .: X Z — 1 _ - 0 L___1 2,-J ., Z Ok ., 0 s( Iv O -1 1 , V ,_ :X Li; , ■ PROPOSE► 'ESId CE \ , I 0) CA . o A 347 S 0) - 1 1 1 r�. I' • 1 1 , Cr I ` cm CA 1 I s N Cl O o I , x O ' 6 (, __, 1 • 11 . 4'x; T 1 - - - 1 , 5.00' I 1 Y ` I ' S. 0 SIDE I YARD .� I ,' ~I ~ ', SE YARD SETBACK 1.1t I � ` , I ' TBACK L' N 0 ; I x ►IA o o P ', I 'L L ' - - - - w +4 ',I NJ t3cil o I ' x X x _ ` o t ( ` 1ST: _ YCLON _FENCE) X N. x' � _ - N' 89'32'04" E 89.74' uuiIuuuuuuuuuuuumuuuuII 0 20' 40' SCALE: 1 "= 20' RECEIVED OCT 2 5 2012 CITY OFTIGARD Oregon Residential Specialty Code N1107iILDING HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: M C T 'Lu 11. - O o O l y Jurisdiction: ` Site Address: w �5 '4W ' e Sw Murdock Sr. Ii' cr Subdivision/Lot #: v e oLo ` k k: (�S and/or Map and Tax Lot #: s 5 r l ` C n Oa Jk( 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) 1 Signature: Date: 10 2s- Owner/ eneral Contract/; uthorized Agent Print Name: 30(e, ►t v r c G J ' ORSC Section N1107.2. High - efficiency interior lighting systems. A minimum of fifty (50) percent o the permanently installed lighting fixtures shall be installed with compact or linear fluorescent, or a lighting source that has a minimum efficacy of 40 lumens per input watt. Screw -in compact fluorescent lamps comply with this requirement. The building official shall be notified in writing at the final inspection that a minimum of fifty percent of the permanently installed lighting fixtures are compact or linear fluorescent, or a minimum efficacy of 40 lumens per input watt. 1: \Building\Forms\RES- HighEfficiencyLighting.doc 07/01/08 • RECEIVED Oregon Residential Specialty Code R318.2 ' ' r T 2 5 2012 CITYOFTIGARD BUILDING DIVISION MOISTURE CONTENT ACKNOWLEDGEMENT FORM I, Jot r v hLG , am the general contractor or the owner- builder at the following address: /p /5.2...d - !VM/y Site Address: (� w M u rd o..k 44 City: ;760- o( Permit #: %s 20 t L - 00014 Subdivision/Lot #: vi docA 11; Us 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: I O -Zs= fl- Genet4_ Contractor or 0 er- Builder I:\Building\Form\RES- MoistureSensitiveWood.doc 09/25/08 V.IY D STREET TREE OCT 25 2012 BUILD IIGARD TIGARD CERTIFICATION 1NGDIVISION I, jai ON /9 `h 1-1 owner /agentfor 0740 Vc t (J , (PLEASE PRINT) (PERMIT HOLDER) do hereby certift that the following location meets City of Tigard land use and development standards for street tree installation and is consistent with the approved site plan. PERMITNO.: MST 20 (2 — ao .( ,Y. -/o !S� ME E ADDRESS: io f rla 5(A) fr v r c S ' y at G{ SUBDIVISION: ✓ rc(t ✓k f4: I ( 5 LOT #: SIGNATURE: Corre DA]E: (J (OWNER/ ENT) RECEIVED & VERIFIED BY DA 1 E: (CITY OF T7GARD) ❑ Tree location verified per approved site plan. I: \Buil ding \Forms \StreetTreeCertificate 05/30/2012