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Permit CITY OF TIGARD l MASTER PERMIT IIII 2 COMMUNITY DEVELOPMENT Permit#: MST2012 -00022 T I GA RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/07/2012 Parcel: 1 S136CA09300 Jurisdiction: TIGARD Site address: 11037 SW LEGACY OAK WAY Subdivision: WHITE OAK VILLAGE Lot: 14 Project: White Oak Village, Lot 14 Project Description: New SF. 5/11/12, reprint to correct setback information. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 3 First: 690 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 30.5 Bathrooms: 3 Second: 950 sf Garage: 198 sf Front: 10 Smoke Dwelling Units: 1 Third: 520 sf Right: 3 Detectors: Yes Total: 2160 sf Value: $228,248.01 Rear: 13 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 ' Drywell- Trench Drain: 0 Other Fixtures: 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 Fum <100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 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: 3 201 -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 2160 Owner: Contractor: WESTLAND INDUSTRIES WESTLAND INDUSTRIES Required Items and Reports (Conditions) 12670 SW 68TH AVE STE #400 12670 SW 68TH AVE 1 Ersn Cntrl 503 681 - 4444 TIGARD, OR 97223 TIGARD, OR 97223 PHONE: 503 -571 -0746 PHONE: 503 - 245 -9715 FAX: 503 -598 -9081 Total Fees: $17,413.63 This permit is • e'ii subje` to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done i 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. A ENTION: Oregon law re.: es you to follow the rules adopted by the Oregon Utility Notifi • Center. Those rules are set forth in OAR 952 -001 0010 th •ugh OAR 952 -01 -0090. You may obtain a copy of the rules or direct questions to OUNC by ng 503.232.19 O(1.800.332.2344. Issued y: _ /i/�� �!�1 Permittee Signet • ! 1 Call 503.639.4175 by 7:00 a.m. for the next available inspe , : r. ''! This permit card shall be kept in a conspicuous place on the job site until co . letion of the project. Approved plans are required on the Job site at the time of each inspection. • CITY OF TIGARD MASTER PERMIT `1 2 COMMUNITY DEVELOPMENT Permit #: MST2012 -00022 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/07/2012 Parcel: 1 S136CA09300 Jurisdiction: TIGARD Site address: 11037 SW LEGACY OAK WAY Subdivision: WHITE OAK VILLAGE Lot: 14 Project: White Oak Village, Lot 14 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 3 First: 690 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 30.5 Bathrooms: 3 Second: 950 sf Garage: 198 sf Front: 11.83 Smoke Dwelling Units: 1 Third: 520 sf Right: 3 Detectors: Yes Total: 2160 sf Value: $228,248.01 Rear: 13 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 Drains: 0 Tubs /Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: '1 Other Fixtures: 0 Drywell- Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: 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 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: 3 201-400 amp: 0 201 -400 amp: 0 W/O Svc/Fdr: 0 Mfd Home /Feeder /Svc: 0 401 -600 amp: 0 401 -600 amp: 0 601 -1000 amp: 0 601 +amp- 1000v: 0 1000 +amp /volt: 0 ELECTRICAL - RESTRICTED ENERGY SF Residential Audio & Stereo: N HVAC: N Security Alarm: N Vaccuum System: N • Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R -3 2160 Owner: Contractor: WESTLAND INDUSTRIES WESTLAND INDUSTRIES Required Items and Reports (Conditions) 12670 SW 68TH AVE STE #400 12670 SW 68TH AVE • 1 Ersn Cntrl 503 -681 -4444 TIGARD, OR 97223 TIGARD, OR 97223 PHONE: 503 -571 -0746 PHONE: 503- 245 -9715 FAX: 503- 598 -9081 Total Fees: $17,413.63 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 susp- • • - - for •more the 180 days. A • ' ION: : -gon law requires you to follow the rules adopted by the Oregon Utility Notification ' -n - . Those ' e. - set forth in OAR 952 -00 -0010 through OA' 95 0 -009 You may obtain a copy of the rules or direct questions to OUNC by calling 503'32.198 r • Issue. ' ' _ • jai mod_ Permittee Signature: ArtA. Call 503.639.4175 by 7:00 a.m. for the next available inspection da This permit card shall be kept in a conspicuous place on the job site until comple • . of the project. Approved plans are required on the job site at the time of each inspection. • Building Permit Application A 2 Residential RECEIVE I . / ro is i i r r I (. r 1. I ONLY i ., City of Tigard Da , _ egg /G fi7 PermitNa: 11s/41// 6,04„2..2.. 13125 SW Hall Blvd., Tigard, OR 97223 ' Phone: 503.7182439 Fax: 503.598.1960 FEB 2 2 2012 p ,. , irin QM otherPermit.a '/J?-a2:12 ' r I G . I : u motion Line: 503.639.4175 Date Ready/By: : ® See Page 2 for Internet: www.tigard- or.gov CITY OF TIGAR a Notife Supplemental Information _ BUh DING D IVISION TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING New construction ❑ Demolition Permit fees' are based on the value of the work performed. - Indicate the value (rounded to the nearest dollar) of all ❑ Addition/alteration/replacement ❑ Other. equipment, materials, labor, overhead, and the profit for the CATEGORY OF . CONSTRUCTION work indicated on this application. 11- and 2- family dwelling ❑ Commercial/mdustrial Valuation +, Q I ❑ Accessory building ❑ Multi- family Number of bedrooms: 3 ❑ Master builder ❑ Other. Number of bathrooms: . JOB. SITE INFORMATION • AND LOCATION - Total number of floors: Job site address: /f or Sp) L 1-6-,ic a4+e Mil New dwelling area: 2 6 O square feet City / State/ZIP: whet), ' , Die 7 z 3 Garage/carport area: I Q fa -- . square feet Suite/bldg. /apt. no.: I Project name: /J/L/7 'Q, r ¢ { -,4 44 Covered porch area: t _ I square feet Cross street/directions to job site: . Deck area: 45- square feet Other structure area: 2'3 6 square feet .-3 e'„7 REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: pH a 124/4 01.4-#6-6. I Lot no.: / Permit fees* are based on the value of the work performed. Q Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: / 5 71 CA19 (3,y v_. •'' equipment, materials, labor, overhead, and the profit for the n DESCRIPTION OF WORK work indicated on this application. U/ , 7V1/CT /WO 3/M , q L,/ �_E Valuation: $ �+'� Existing building area: square feet New building area: square feet • ❑ PROPERTY OWNER I ❑. TENANT Number of stories: Name: Type of construction: Address: Occupancy groups: P cYBrou P City/State/ZIP: Existing. Phone: ( ) Fax: ( ) `ter New: VAPPLICANT ❑ CONTACT PERSON BUILDING PERMITFEES *. Business name: As 7 0usT S (Please refer to fee schedul J name: Structural plan review fee (or deposit): Contact �o6 f1�0 -�0,() - g� &�ND,e%tte� FL S plan review fee (if applicable): Address: /? 6 70 c0/ ap & 4/ _5.- t1 app Total fees due upon application: City/ State/ZIP: 776,...A.40 oe, G! ?223 Phone: (S D ) 577 - -074 Fax: : on ) IIg'9 Amount received: E-mail: Jre j q ao 2 6,, L/ t , CodA N/606 - 7z -. )*' / C27/4 P$o rbVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commerci:. , d residential prescriptive installation of roof -top noun ' hotoVoltaic Solar P; ystem. Business name: itigS7-44.-ND �� T /£S` Submit two (2) sets . f plan wi . nnecti on details and fire department acc •, alo . _ Ili 2010 Oregon Address: 0 24 7 ! � #'8,6. c ST !f(7 _ Solar Installation Special • e checklist City/ State/ZIP: 771-1t,17-4 / / dE Q 7 23'5 Permit Fee (in • • es pl:,. review $180.00 : f; . : five :.-.): Phone: (95) 790 -06 2 I Fax: (50 3) O4 - gag ( State surc : : (12% of permit $21.60 CCB lic.: 0 -) 0 , 33" Total fee due upon application: $201.60 Authorized signature: '41 4( This permit application expires if a permit is not obtained � within 180 days after it has been accepted as complete. * Fee methodology set by Tn -County Building Industry Print name: ___T, �_ �p fi 1 f� I Date: /� Service Board. 1:\Buil ding \Permits \BUP- RESPermitApp.doc 02/ 24/2011 440- 4613T(11 /02/COM/WEB) . Electrical Permit Application FoR t F V I C l: ]SE (1N1.1 City of Tigard RF�-1i� ,2 /, Parmit No.: " e t a-- 000? 0 13125 SW Hall Blvd., Tigard,)6R i Plan R ev i ew ' C Phone: 503.718.2439 Fax: 503.598.1960 DatrlBy: ` � C? O�v /a� r��p� 7 Tic; A i i , Inspection Line: 503.639.4175 F EB 2 2 2012 Date R ® See Page 2 for Internet www.tigard-or.gov Notified/Method: Supplemental Information • - TYPE Q1ij .,: . •,. ' ...p AN *!.:;.,:. -• . ',.; : .. _ • ; - ,. ....:7 lease cheek a8 that apply (submit 3 sets of plans wfitema chedced below): , New construction ❑ Additi ., • 1 .....T.. : , i : a„ent ❑ Service or feeder 400 amps or mom ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF. CONSTRUCTION 10,000 amps at 150 volts or ❑ Floating br ldings. • dwelling less to ground, or exceeds 14,000 ❑ Commercial-nse agricultural 2-family ling ❑ Commercial mdustri�a ❑ Accessory build amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other. ['Fire pump. ❑ Installation of 75 KVA or ❑$masons JOB SITE INFORMATION LOCATION..; system. >�separately -3 ❑ Addition of new eau motor load of ❑ "A", "E", "1 -2", " "11 -3 ", Job no.: Job site address Six or or more. occ . I 1� /O � �� ❑ Six or more residential units. ❑ Recreational vehicle parka T City/State/ZIP: 42 _ , ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 vette nominal. Suite/bldgJapt no.: Project name: Pair (9 Ma,41. ❑ Service or feeder 600 amps or more. FEE SCHEDULE • Cross street/directions to job site: Dereriptl I Qtr. I Fee. I Total I • New residential single- or multi - family dwelling unit Includes attached garage. Subdivision: Ai• ,rc fi, 0 Lot no.: ` � 1,000 sq. ft or less 1 168.54 11 4 /� Ea_ add'l500 sq. ft. or portion '' 33.92 10( , P, I Tax map /parcel no.: / /36 C g3terz) Limited energy, residential 75.00 �7 — � 2 DESCRIPTION OF WO v (with above sq. R) 1 Limited energy, multi - family 75.00 2 dt/s-fxric- - // 51 4 lkil residential (with above sq. &) Services or feeders installation, alteration, and/or relocation 200 amps or less 100.70 2 ❑ PROPERTY OWNER I ❑ .TTPIANT 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 amps 200.34 2 • 601 amps to 1,000 amps 301.04 2 • Address: Over 1,000 amps or volts 552.26 2 Ci / State/ZIP: Temporary services or feeders installation, alteration, and/or �' . relocation Phone: ( ) Fax: ( ) 200 amps or less 59.36 1 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not 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 APPLICANT I 0 CONTACT PERSON above service or feeder fee, 7.42 2 each branch circuit Business name: B Fee for branch circuits without �S7 Ji) �,t/�//$7 S ut service or feeder fee, fast 56.18 2 Contact name: p branch circuit �J N ®E2a `J l Q�'� Each add'l branch circuit 7.42 2 Address: /a. 6 Re/ 60. 4 $a / 400 Miscellaneous (service or feeder not included) � Each manufactured or modular 67.84 2 City/State/ZIP: ,--77 � / e� 172,33 dwelling, service and/or feeder Phone: ( j )5" 2. - o7444, Fax: : (yb 3 lop — gp g Reconnect only 67.84 2 E -mail: • Pump or irrigation circle 67.84 2 Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited-energy • c panel, alteration, or extension. Page 2 2 Business name: GG //U1911� 7-75 Each additional inspection over allowable in any of the above Ads: ri` J 3 5E. t 23,,, & Address: Additional inspection (1 hr min) 66.25/ hr City/State/ZIP: y�� � , / n' Investigation (1 hr min) 6625/ hr ' VT .3+ -�t{,s v Industrial plant (1 hr min) 78.18/ hr Phone: (y3)) 3 5 - 2 3 — 6leg Fax: ( 971) 71 (5' OZ ;10 Inspections for which no fee is 90.00 / hr specifically listed (54 hr min) CCB Lic.: , 6q (2_ Electrical Lic.: • F . t1,g9 Suprv. Lic.x,''hi ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: �� i P a / Plan review (25% of permit fee)): : Subtfta `7�, ? � ,, per Print name: ( '1a ► l 1 5 Date: 02 !) p y State surcharge (128% of permit fee): q' I h . 4 4 ' I TOTAL PERMIT FEE: 3 8 5,7 'r Authorized signature: - 1Lis permit application expires if a permit is not obtained within 180 111.111.'""-- Print norm- Date: days after it has been accepted as complete. N um b er of inspections allowed per permit I: \BuldingWermita\ELC-PermitApp.dnc .'/01 /10 4404615T(IIM5/COM/WEB Mechanical Permit Applicatio H R i> P F I i l:; LSE O ` L.1 0 o City of Tigard D , soon Permit No.: li ,6 , A 13125 SW Hall Blvd., Tigard, OR 97223 FEB 2 2 2012 p�;� IIII Phone: 503.7182439 Fax: 503.598.1960 DatriBy. Other Permit: r p e , • a .. 00 1 'i I G n R D Inspection Line: 503.639.4175 CITY OF TIGARD D Ready/BV: Sarin In See Page 2 for UeW . Internet www. NotifiedlMethad Supplemental Information BUILDING DIVISIO OF WORK t 06001 4, i _8cenrirai -- usi cocoa r.- "• Mechanical permit fees* are based on the value of the work New c ❑ Addition/alteration/replacement performed. Indicate the value (rounded to the neatest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit Value: $ CATEGORY OF . CONSTRUCTION RESIDENITAL OtormE197 / SYSTEM FEES* ( and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building Fos spedalInformation use c*eddtst. ❑ Multi - family ❑ Master builder ❑ Other. Description I Qty. I Ea. 1 Total JOB SITE INFORMATION AND LOCA/ITON Healing/cooling: Air conditioning Job site address: /10 � / i f (regimes site plea showing placement) 46.75 City /State/ZIP: G �' ' 2- Furnace X00000* T )) 46.9 Suite/bldg apt no.: P roject name: (ATE' G V � Heat pump 'i .r (requires site plan showing placement) 61.06 Cross street/directions to job site: Duct work 23.32 Hydronic hot water system 2132 Residential boiler (radiator or hydronic) 2332 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 46.75 v An t z% ' 1 ( Flue/ventforanyof above 23.32 Subdivision: CTIt -. !/(L " r — r�, I Lot to.: Other. 2332 Tax map /parcel no.: / 5 / 3 6 /'r ,�/) � a Other fuel appliances: DESCRIPTION OF WO ;'7(J ' J Water heater 2332 /�� 1 Gas fireplace t Flue vent for for water heater or gas 33.39 lll !lIJJJ����� 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. 2332 Name: Environmental exhaust and ventilation: Address: Range hood/other kitchen equipment 3339 City/State/ZIP: Clothes dryer exhaust 33.39 Single -duct exhaust (bathrooms, �, Phone: ( ) I Fax: ( ) toilet compartments, utility rooms) 23.32 ( / l.2-, E _PLICANr • ❑ CONTACT PERSON Attic%rawlspace fans 2332 Business name: Other. F uel piping: - 2332 - Contact name: f $14.15 for first four; $4.03 for each additional Address: ;rel- (F,O'l ' ( Furnace, etc, I 14 . t'S - � d /� Gas heat pump n ��k}}} City/State/ZIP: �/ g q/�/� Wall/suspendedhmit heater Phone: ( r -/ ) f e 5 3 Fax: : ( ^� Water heater I _ Fireplace I E -mail: Range CONTRACTOR Barbecue Business name: A IP. i d ` 1i A Clothes dryer (gas) Other: Address: MECHANICAL PERMIT FEES' City/State/ZIP: Y 1461( �fl / /` d f° Cf'� 7 p S ($9 o a -Z�•CO Minimum permit fee ) Phone: ( Dr.- �� Fax: ( r)— Plan review (25% of permit fee) CCB lie.: /��Ig State surcharge (12% of permit fee) G. I2. TOTAL PERMIT FEE '?� , I ( Thi perm application expires if a permit is not obtained within n 180 Authorized signature: d ays after it ? has been accepted as complete. Print name: ge6Lf I Date: 0 1.0-.. i )/ I • Fee methodology set by Tri -County Building Industry Service Board I: WuildingTennit sMEC- PermitApp.doe 09/09no 440.4617T ( I 1/02/COM/WEB) . , in • Plumbing Permit Application Building Fixtures RECEIVED • f 0 I: U F Her_ USA : ()NIX 13125 of Tigard 2 2 2012 .�;-,;;' , rinign j P�tNo.: l4 . Phone: 503.718.2439 Fax: 503.598.1960 Pitern: Review t]AraPt�itNo. �Q(� / //� 7 r. c n a D Inspection Line: so3.639.4175C1TX OF TIGARD 8 cad. in See Page 2 for Internet www.tigaII 1 -or.:. • , i , 1 ON Notified/Mesita of WORK. ..- .. • •. . :. ' ue. • G ew construction ❑ Demolition For spedal infametlion use checklist Description I Q'Y. I Ea. Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2-family . 11* , ■(includes 100 ft for each utility coroectinn) CATI;GOKY • OF lCONSPRucrE)N SFR (1) bath 312.70 �d 2- family dwelling ❑ SFR (2) bath 437.78 Conniuscialimdustrial ❑ Accessory bolding ❑ Multi- family SFR ( bath Q 5 0 2 Each additional 25.02 ❑ Master builder • ❑ Other. Fire sprinkler (__ s q. ft.) Page 2 • JOB 5117;• IPIBO1 fAT,[41`F AD LOt:ATioN . Site utilities: Catch basin or area drain 18.76 A r - - "�� �' � Drywall, leach line, or trench drain 18.76 -a / . bl l' • P * - / / .! Footing drain (no. linear It: _.J Page 2 Suite/bldg./apt no.: Project name: .ad i�/ /�%`, J . 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: _ J Page 2 Water service (no. linear ft: _) Page 2 Subdivision: l / i / J ( - Lot no.: / is Fixture or item: Tax map/parcel no.: Balckflow preventer 3127 D v 1 I I WORK valve 1251 Clothes washer 25.02 . / _ : : _. / A /) - - !:";/////‘ J! ?% Dishwasher 25.02 Drinking fountain 25.02 . Ejectors/sump 25.02 ❑ PROPERTY OWNER I d TENANT Expansion tank 12.51 Name: - • - Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone: ( ) Fax: ( ) Ice maker 12.51 (! APPLICANT a CONTACT PERSON Interceptor /grease trap 25.02 Business name: % _Iii I Medical gas (value: $ ) Page 2 Primer 12.51 Contact name: 1 / s 1 /J =t'�► %J.� Roof dram (commercial) 1251 Address: i )4,96 0 79/4. Qt4 Sink/basin/lavatory KO 25.02 City/State/ZIP: A ' 'r -. '�(/✓ 62.54 Phone: (61;f: -1 - /)4 Fax: : ( f, • i d _ Cll3 I Tub/shower /shower pan 12.51 '-' ( Urinal 25.02 E -mail: _ ` _ .41.1 ; 4 In . .1/41 Water closet IIII 25.02 • CONTRACTOR ,�n It t D� ! Water heater 37.52 Business name: /61/ p,g 4 (I- (_ Water piping/DWV 56.29 Address: A). b Other. 25.02 City/State/ZIP: 4 / / i 0 4)7/ L() Subtotal '3 • Phone: ( ) Fax: ( ) / Minimum permit fee: $72.50 Plan review (25% of permit fee) CCB Lic.: Plumbing Lic. no.: 3 4. 74 S State surcharge (12% of permit fee) Le r 0 '' Authorized signature: TOTAL PERMIT FEE e:1 .. • 17 f l i . I permit application expires d a permit is not obtained within 180 days �1.� Print nam Date:o2,, 74. I , after it has been accepted as complete. 'Fee methodology set by •Ili- County Building Industry Service Board. L• IBu ildiaalPermintPLMU- PermitApp.dae 10/01f09 4404616r(IOt 2/COM/WSa) (r‘ ,. -4 10 /// r o A k/t 1-1-4ae._ Building Division � O Y • 0 b Development Code Provision Rev TIGARD Residential Projects ' Building Permit No: It 6 0%/ - 400 CWS Service Provider Letter Received: Yes ❑ No ❑ N /A. RECEIVED Routed Plans: �� � FEB 2 2 Original Plan Submittal Date: ,,��'' . . 2012 N 1st Revision Submittal Date: ," Site Plan Only C I7'y '- 2nd Revision Submittal Date: ❑ Site Plan Only BUI LDIN G D VISIO 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. krox Planning Review (contact r 1 s-fw PmdlMiq h at 503- 718 - 2, 1$2 or • re. @tigard- or.gov) Land Use Case No. S'.,p 2.aoL aoob Name W k 0o1 V, <<a3 , L .Zoning F -rt. /D O _ 12.• Setbacks: e.P .. Front _' : /O ° R ear • %�J S i de .3 Street Side 8 Gara e ._ , 0 5 . [ s Maximum uilding Height � Actual Building Height 3 C) 2 • Q/• Visual Clearance . COY Easements -/ i r it _ %77 ' t ,� — a "ofzte -o p -J-- -. ■ GY Sensitive Lands Type: 0IW • M Notes: f - rcd.v...4 atek b....k.. ra.r4J 1 W FI «4 orJJv' 40 // - 0 / PG a r• - 2 4.3 I. b., I-0 r .. - - ' -- - -. ' 6 . -- ' --44 - dm* e _ . _ _ _ ____ . ... / ` . u p re.`, t t v�e c,:. h . / On lan: roved r.:' gin ph Q Not Approved 4 Date: 2 ( 4 I L Revision 1: Approved Not Approved Date: C I Revision 2: Approved ❑ Not Approved C' Date: � - a Engineering Review (contact Mike White at 503- 718 -2464 or MikeW @tigard - or.gov) Actual Slope: 5 Notes: Original Plan: Approved Zr Not Approved ❑ Date: 2 1'2. Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Pal of 2 , \� City ,rborist Review (contact Todd Prager at 503 - 718 -2700 or todd @tigard - or.gov) V Street Trees Protected Trees Notes: Original Plan: Approved LJ Not Approved ❑ Date: 2 - - 20l Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert@tigard-or.gov) ❑ Conditions of Approval Prior to Issuance of Building Permit Notes : Original Plan: Date Sent to Applicant: Revision 1: Date Sent to Applicant Revision 2: Date Sent to Applicant Okay to Issue Permit: Yes r#No, . Date Routed to Building: _ _ - • • Page 2 of 2 • /1gs Tado IA- did 2 1 RECEIVED . .. , 1 FEB 2 9 2012 CITY OF TIGARD BUILDING DIVISION ■ - SITE PLAN NOTES: R EIS , ED (I W L AU- GRADING MATERIAL TO BE EXPORTED TO AN APPROVED DISPOSAL y �9 /2 LL 00E86 LOCATION r Z 2. ALL PILL Ci le UNDER GARAGE FLOORS, aDEUwLKe DRIVEWAYS, ETC.. TO BE I =IMPACTED GNRJNilLAR FILL TIT< ■111■1 3. THERE WILL BE A SLIGHT OVER EXCAVATION TO PROVIDE CONCRETE POR11Thb ALL ARANO NEW 8TRl1C1'GF. HOMES 4. PROVIDE CONINTTAaTY APPROVED SED2130 FENCING ARCM) EXCAVATED AREA I1' - Im 11/32' PRIOR TO EXCAVATION AND CONSTRUCTION. 13' -1 11/16 ° I. PROVIDE CO NTY/CTI' APPROVED STABLL.I>??� GRAVELED CONSTRUCTION EWTRANNCE /--- 48 -0" Skyline Homes MECO TO EXCAVATION AND CONSTRUCTION 6021 SE Milwaukee Ave. 6. STOCKPILES MUST BE COVERED WITH T ULI N OR PLASTIC MEETING DETUEER OCTOBER I AND AM. 30. ). Pnrtland. OR 97287 at 1. CONTRACTOR/ SUB- CONTRACTOR TO VESTRY' LOCATION OP MITES P AU. PRIOR TO - ' e � mO 41 A EE. mO 50.235.3810 EXCAVATION AND CONSTRUCTION et) \ & BOUNDARY AND TOPOGRAPHY NPOR1AT10N HIM BEEN FRONDED TO SKYLINE HIOf E6 iMhW.skyGneplanS.eom 44' AND DESIGN INC. SKYLINE HOMES AND DESIGN. INC, WILL NOT BE WELD LIABLE POR THE ) . I 4 7' CAL • • ACCURACY OP THIS INPCRIATION, T II TIE SOLE REePCNSIBILTY OP THE CONTRACTOR Ni O /MGR TO WIMPY ALL SRE CONDITIONS INCLUDING RU. PLACED ON IITE PLAN 3044 A 3 ' . . , lb E. TOPOGRAPHY ELEVATIONS WERE COLLECTED FROM ACTUAL SITE SURVEY. i i .' . i BD FS � 1 \ . • RIO I �1 Im. ELEVATION LEGEND. (7, :.. � O . J9 E XA1H SAN SEVER LINE EE. EXISTING GRADE ELEVATION ,x ~ } GM LINF V J FE. FINAL GRADE ELEVATOR A b • - ' _ o . DRI P.V.C. WATER MAN FFE• FNeFED FLOOR ELEVATION \ m , ; 1'..A J Wen E PROVIDE INI DS A MYI GRAVEL BASE UNDER ALL DRIVEWAY AIREAS \ I , . -I t17 r Q LL 1DE P A 4' MN0111 GRAVEL BABE UNDER AU. eLLALK AND PATIO AREA& in EE mm Waft @ mm OT O. PIPE ALL STOW DRAINAGE FROM THE BUILDING TO A COUNTY/CM DISPOSAL Q POIT/COiNECT1ON. 13' -0' 4I' - 6 " I S' - 6 " O F Q 14. MAX@AM SLOPE OP OUTS AND ELLS TO BE IWIO n) HORIZONTAL TO ONE (IX / / ii VERTICAL FOR BULL. DINGS, STRUGflIRES, FONDATIONS, AND RETAINING; WW L& ® STRJCIII� CH AU- BIDET UAW SLOPE Q 6 119401111 N -0'. AUU4T FROM ^ I- V' 0 IMPERVIOUS AREA'S: N rto SO. FT. DRIVEWAYS SS SO. FT. PORCH 13 50. FT. WALK TOO PATIO II ■ 160 130. FT. OVERHANGS PLAN Nos 3044 886 SO. FT. BUILDING COVERAGE D RAUN: TF 1386 TOTAL SO. FT. IMPERVIOUS AREA'S LOT 14 DATE:02 -20 -2012 LOT INFORMATION: WHITE OAK VILLAGE SCALE: I' =20' -0' TIGARD.OR ■ PLOT • LOT AREA, 1,911 SQ FT. IMPERVIOUS COVERAGE' 1,386 SO. FT. BUILDING ILDG COVERAGE, 10 ,r PLAN BUILDING HEIGHT' APPROX••- •3P -6' MIN. BUILDING SETBACKS' 1W FRONT, 18' REAR 3' SIDES. / I • • I • • Oregon Residential Specialty Code R318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM I, 65 066 , am the general contractor or the owner- builder at the following address: Site Address: //37 C� ja. y City: �7 li Permit #: 57- Subdivision/Lot #: G'v �1 fi G � 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. t 6 — ar -- /g Signature: / .21// Gen J" ontractor or Owner - Builder I:1Butl ding\ Form \RES- MoistureSensitiveWood.doc 09/25/08 Oregon Residential Specialty Code N1107.2 HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: /57; W ---o0,0; 2 Jurisdiction: 726 Site Address: D 37 J C S � 0 4/4 f Subdivisioraot #: m /f, 1� # 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: / ALIAW Date: S 'er /General Contractor /Authorized Agent %� ,� Print Name: `�`� /46 ORSC Section N1107.2. High - efficiency interior lighting systems. A minimum of fifty (50) percent o the permanently installed lighting fixtures shall be installed with compact or linear fluorescent, or a lighting source that has a minimum efficacy of 40 lumens per input watt. Screw -in compact fluorescent lamps comply with this requirement. The building official shall be notified in writing at the final inspection that a minimum of fifty percent of the permanently installed lighting fixtures are compact or linear fluorescent, or a minimum efficacy of 40 lumens per input watt. I:\Building\Forms\RES- HighEfficiencyLighting.doc 07/01/08 STREET TREE TIGARD E T C R IFICA TION I, ©& 41/.064.4,„,J , owner/ agent for A67 7/;/a/57727s_5 , (PLEASE PRINT) (PERMIT HOLDER) do hereby certifil 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.: /75T0?0 /d? -00 2 HIE ADDRESS: / 10 37 ‘ SUBDIVISION: LOT #: SIGNATURE: 114t DA 1 E: r I� f / (OWNER/AGENT) RECEIVED & VERIFIED BY: DAM: ( " ��d F TIGARD) Y Tree location verified per approved site plan. I:\ Buildin \Forms \StreetTreeCertificate 04 /01/2011 Program Use Only ' Form 640S Fastlrad( ID EnergyTrust Completion Certification—Site Inspection New Homes Program — Single Family Data check by of Oregon (Initials) To be completed by verifier Portland Energy Conservation, inc. (PECI) is a Program Management Contractor for Energy Trust of Oregon. Flret:llliapection' . Second Insp Date: tipt 1 Verifier Name: Pee,m,rJ , Date: 1 Verifier Name: Incentive Payee Company Name: Builder or Company: ,y 1•L,A�4n /•tJD• Contact Name: ,y Performance Testing Company: Technician Name: ' Site Information' Lot Number: REM /Rate SCO Project ID: r ' Development (required from verifier it act S Name: File #. project la ENERGY STAR Site Address: h - 1 _,_ .r. id ' City: i toA�4, State OR Zip: ( T is 3 r,t Unattached ❑ Attached Number of Stories: 2.•- Total Building Square Footage: Z 160 Number of Bedrooms.?] Basement ❑ None ❑ Full Basement ❑ Half Basement Crawlspace Type ❑ Garage /basement combo CI Slab on grade LJ Other Electric Provider [XPGE ❑ PAC ❑ Other: Gas Provider g_NWN ❑ CNG ❑ Other: Electric fr Number: 3 `0` c/ Z. 3 Z, Gas Meter Number: J , 1 3 7& (must apply ly to o permartenf meter) / T 1 (must apply ply to permanent meter) '^� 3 G v _ Additional: Project Information (please mark all that apply) ❑ Code plus Best Practices (meets minimum Best Practice requirements with improvements above code) ❑ Path 1 EPS Best Practices (path 2 ENERGY STAR Cl Envelope Upgrade ❑ Ducts & HVAC Equipment Inside Equipment Upgrade 7❑ Path 3 ENERGY STAR with ducts inside ❑ Path 4 Performance Plus with ducts Inside _ ❑ Path 5 Advanced Performance ❑ Zonal Electric Efficient ❑ Advanced Electric Resistance . ❑ Solar Electric (PV) ❑ Solar Water Heating (SWH) ❑ Small Wind ❑ Solar Ready Electric (SRPV) ❑ Solar Ready Water Heating (SRWH) Renewable Energy ❑ Qualifies for Solar Ready Incentive (must attach checklist) Solar Installer. Name: Company: Low Income ❑ Yes riKe Does this project qualify as Low Income? (must provide documentation from builder) Accessory ❑ Yes , Is this home an ADU? LtYlv Dwelling Unit ❑ Yes o Is the ADU separately metered? If so, provide meter numbers above Other • ❑ Earth Advantage - Certification Level: ❑Other (please specify): Certifications ❑ LEED -H - Certification Level: . Form 640S v10 120101 Page 1 of 3 Return completed form to: Energy Trust New Homes Program—Single Family 100 SW Main Street. #1600 • Portland. Oregon 97204 1.877.283.0698 • Fax 1.855,575.4315 newh omen @e nergytrust org • Form 640S 4' Completion Certification —Site Inspection EnergyTrust New Homes Program—Single Family of Oregon To be completed by verifier Portland Energy Conservation, Inc. (PECI) Is a Program Management Contractor for Energy Trust of Oregon. Veriflcatlon -Type Actual Value Equipment Details & Notes• Category • Insulation Flat Ceiling R- Ct �1 Insulation Type: Framing Type: Vaulted Ceiling R- ( Insulation Type: ❑ Standard Scissor Truss R- Insulation Type: 1 ❑ IAdvane Above Grade Walls R- 2, I Insulation Type: Framing Below Grade Walls R- Insulation Type: Size: Floor Over Unheated Space R- Insulation Type: Floor Over Garage R- 7e7 Insulation Type: Slab Floor (unheated) R- ❑ Full Slab ❑ Perimeter Doom Door R- Windows Windows U- Window Frame Material: SHGC: 11'At • Skylights U- SHGC: Window Area (Glazing) % Total window area: Lighting Indoor and Outdoor 1 -Ci % # fixtures: # of ENERGY STAR fixtures or CFLs: Appliances ENERGY STAR Dishwasher Yes ❑ No EF Cooling Air Conditioning SEER: Btu/Hr: Primary Heat 0 Fireplace AFUE: / 5 S Brand: R RC. 3 y4� Outdoor Unit (for heat Source Gas Furnace pumps) ❑ Electric Boiler • J HSPF: Model #: i � c040 ifte ' i A. Model 0: �her: as Heat Pumps: SEER: Serial #: � 1 � ! 27 ! O Serial Ot ! 33 ❑ A Source (ducted) CO P: BtulHr: ❑ Mini Split (ductless) 4,011"' ❑ Ground Source . Location: ECM: ❑ Yes ❑ No Heat um 1:1 Radiant Floor Heat pump commissioning Electronic Air Cleaner: ❑ Yes ❑ No report attached or ❑Cadets confirmation for ground ❑ Zonal Backup fuel: ❑ Electric ❑ Gas ❑ Other source heat pumps that ❑ Other: manufacturer's start up . 6rocedure was performed • Additional notes on primary heating: Notes an secondary heating: Water Heater ❑ Storage Gallons: Brand: RI. wNA I ❑ Electric ZTankless ® Gas EF: Model 0: Q 0 T `� Location: Serial #: C 04 72 .r2._ , Btu/Hr: CG eh " J � Form 640S v10 120101 Page 2 of 3 Return completed form to: Energy Trust New Homes Program— Single Family • 100 SW Main Street, #1800 ♦ Portland, Oregon 97204 , 1.877.283.0698 • Fax 1.855.575.4315 newhomes �eenergytrustorg ‘r., Form 640S 11\ Completion Certification—Site Inspection EnergyTrust New Homes Program — Single Family of Oregon To be completed by verifier Portland Energy Conservation, Inc. (PECI) is a Program Management Contractor for Energy Trust of Oregon. Verification . Type Actual Value Equipment Details & Notes Category Ventilation Energy Trust Mechanical ❑ Exhaust Meets Energy Trust Mechanical Ventilation Requirements System Ventilation Requirement ❑ Supply Yes ❑ No ❑ Exhaust & Supply ti (,l,Y 0---- ❑ Heal Recovery ERVIHRV Model S: Ducts ❑ Ducts Inside % ducts inside: ' % Ducts in Conditioned Space If claiming incentives for ducts inside, check one of the following: ❑ Ducts Tested 0 Visual Inspection per RTF specs Duct Insulation ,/ R - rS Duct Location l� 11. .� L C,.A. _ Duct Sealing w/Mastic Paste 1$ Yes ❑ No Performance Testing & Duct System Information Ducts Duct leakage must not exceed 0.06 CFM ®50 x floor area, or 75 CFM 0350, whichever is greater. When tested without the air handler, leakage must not exceed 0.04 CFM ©50 x floor area, or 50 CFM050, whichever is greater. Multiple tests may be required Duct Cubic Feet Per Minute Duct Leakage Air Handler In K( es Air Handler Present Yes Leakage: (CFM) 6 50Pa Q7 ass ❑ Fail Conditioned Space ❑ No During Test ❑ Fan Pressure ❑ DG3 Fan Ring Type ❑ 0 'Leakage Test ,Total Leakage Gauge p•DG700 Pressure: 3$ , (check one) ❑ 1 3 Method ❑ Leakage to Outside Duct Blaster J p�M Location: 2 Yl.i�/� at iL'i Pressure Tap Location _et Area Tested: i Whole House Air Changes per Hour elope Tightness Cubic Feet Per Minute pp Leakage: (ACH) 50Pa:'1) [ Pass El Fail (CFM) ®50Pa: (Lo House Volume: /7 Best Practices Requirements (Ail requirements must be met to recemve an Enerrly Per foonance Score) • Thermal Enclosure Checklist Complete • Pass ❑ Fail Thermal Enclosure Checklist attached? ❑ Yes • Insulation Quality Inspection Performed ['Yes ❑ No 4 (complete insulation verification section below) • Approved Mechanical Ventilation Installed Q Yes ❑ No i (complete mechanical ventilation section below) • Zonal Pressure Relief - AU zones comply ['Fes ❑ No If no, state reason for failure: • Combustion Appliance Zone Testing Net CAZ Pressure: Pa If not applicable, please explain: (required) A(,�}. Forced air system operation must not depressurize Combustion Appliance Zone (CAZ) by more than 3 Pascals (Pa.) •All shaded sections are required for Best Practices. Applications will not be processed without these sections completed. Teebrticat Compliance Options. (please list all that apply) If any values on this form do not meet Builder Option Package ( BOP) requirements, please indicate which Technical Compliance Option(s) allow the variance and explain which component was traded. TCO 5: Explanation: A 44tionai Notes: . Signature: . By my signature below, I certify that I have performed the tests as described, that the form is complete, and that all information on the form is ac rate. / Signature: Verifier � Verifier Name: Date: /, itZr Si ` KC 1.' (.4„4.___- �t l RR4' II4JnspgCtlOn Signature: Name: Date: Form 6405 v10 120101 Page 3 of 3 Return completed form to: Energy Trust New Homes Program — Single Family 100 SW Main Street, 51600 • Portland, Oregon 97204 1.877.283.0698 • Fax 1.855.575.4315 newhom es @ene rgyt ru st. org CITY OF TIGARD BUILDING DIVISION PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 iVi Inspection Requests (24 Hrs.): (503) 639 -4175 !� ° 'II- INSPECTION WORKSHEET FOR DATE:6 / / _ 2 _______, TIME: PAGE: SITE ADDRESS: CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: ,, / " PHONE#: DESCRIPTION: 1/ 0 3, S if./ L F6e4C / O A k, w 1` OWNER: CONTRACTOR: 5- / o eU i _� a ��� PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspectio D scription Confirm # Contact # Message 4 L Corrections /Comments /lnstru tions: ri ' . SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CAL OR INSPECTION ❑ADDITIONAL FEES ASSESSED / )-- Inspect % Date: -(y` one #: (503) 718-