Permit CITY OF TIGARD MASTER PERMIT
IIII._q.• COMMUNITY DEVELOPMENT Permit #: MST2012 -00114
T [ G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/12/2012
Parcel: 2S109DA18200
Jurisdiction: Tigard
Site address: 15185 SW SUMMERVIEW DR
Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 111
Project: Arlington Heights No. 3, Lot 111
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 1104 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 28 Bathrooms: 3 Second: 1520 sf Garage: 665 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2624 sf Value: $304,316.96 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
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
Drywell -Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Tvpes 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 SrvclFeeders Branch Circuits
1000 sf or less: 1 0 -200 amp: 0 0-200 amp: 0 W/ Svc or Fdr: 0
Ea add'l 500 sf: 5 201 -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 +ampNolt: 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 2624
Owner: Contractor:
STONE BRIDGE HOMES STONE BRIDGE HOMES NW LLC Required Items and Reports (Conditions)
4230 GALEWOOD ST SUITE 100 16869 SW 65TH AVE # 505 1 Ersn Cntrl 503 - 681 -4444
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035 2 Ersn Cntrl 503 - 681 - 4444
PHONE: 503 - 387 -7577 PHONE: 503 - 387 -7577
FAX: 503- 387 -7615
Total Fees: $19,078.54
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 a .. • _ ice 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 ' TION: Or - , •n law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001 '010 through OAR 9 -• • 1 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800 32.2344.
Issued B • • _ /. !_'JL• ,.∎ 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 7 � 4?\77 IL,
Residential FOR OFFICE I :ON1,1
MAY 2 9 2012 ed ` .57-y44 /
G�it of Tigard Date/ Receiv : J� / t� Permit No.: -(3O(/
G • 13125 SW Hall Blvd., Tigard, OR 97223 / ® ir!GA Plan Re
t:
Phone: 503.639.4171 Fax: 503.598.196t� Date/B : �� / i 2 I'L Other Permi i5W e d , 1000 7 m
T i n it D Inspection Line: 503.639.4175 BUILDING DW1 SIGN Date Rea. • ': : Juris: ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
0 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.
0 1- and 2- family dwelling El Commercial/industrial Valuation: $ / � - 1 b
❑ Accessory building ❑ Multi - family Number of bedrooms: 3
❑ Master builder ❑ Other: Number of bathrooms: '1 ,5
JOB SITE 1 IN / GUM 1 ATION AND LOCATION Z
�h Total number of floors:
DV
Job site address: 151 Cn M MaV I •VK• New dwelling area: 21124 square feet
City/State /ZIP: Tigard, OR 97223 Garage /carport area: (11/5 square feet
Suite/bldg. /apt. no.: I Project name: Arlington Heights Covered porch area 2," m square feet I rp
Cross street/directions to job site: Deck area: ---. square feet 110
Other structure area: 32E9 square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Arlington Heights J Lot no.: 1 I I 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.
New, Single Family Residential Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER I ❑ TENANT Number of stories:
Name: Stone Bridge Homes Type of construction:
Address: 4230 Galewood St, Suite 100 Occupancy groups:
City/State /ZIP: Lake Oswego, OR 97035 Existing:
Phone: (503)387 -7577 Fax: (503)387 -7616 New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: SEE ABOVE All contractors and subcontractors are required to be
Contact name: Deirdre Britt licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City /State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone:( ) I Fax::( )
E -mail: dbritt@stonebridgehomesnw.com
CONTRACTOR
Business name: SEE ABOVE BUILDING PERMIT FEES*
Address: (Please refer to fee schedule)
City/State/ZIP: Structural plan review fee (or deposit):
Phone: ( ) I Fax: ( ) FLS plan review fee (if applicable):
CCB lic.: 173318 Total fees due upon application:
Amount received: f7,5-
Authorized signature:
This permit application expires if a permit is not obtained
Print name: 1�I �
b ' within 180 days after it has been accepted as complete.
• Dp�� I Date: 2� II �
Fee methodology set after
Tri been Building Industry
Service Board.
I:\Building\Permits\BUP -RES PernitApp.doc 10/01/09 440- 4613T(11/02/COM/WEB)
II -
Plumbing Permit Application
Building Fixtures
City of Tigard Date/By: ' S Pitt / Permit No.: �5 %90 t' _ () I i
INI 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
■ Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other P ermit No. (9-eo o Q 6q
- I' I c ; A R D Inspection Line: 503.639.4175 Date Ready/By: Jan,: El See Page 2 for
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE' SCHEDULE
® New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑ Addition/alteration/replacement ❑ Other: New I- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 312.70
® I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78
Accessory building SFR (3) bath 1 500.32 601'32-- ❑ ry 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:
1 SW su MM mV I �JW Dia • Catch basin or area drain 18.76
Drywell, leach line, or trench drain 18.76
City/State /ZIP: Tigard, OR 97223
Footing drain (no. linear ft.: _) Page 2
Suite/bldg. /apt. no.: I Project name: Arlington Heights 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: Arlington Heights I Lot no.: III Fixture or item:
Tax map /parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
New, Single Family Residential Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: Stone Bridge Homes Fixture /sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 16869 SW 65 Avenue #505 Garbage disposal 25.02
City/State /ZIP: Lake Oswego, OR 97035 I -lose bib 25.02
Phone: (503)387 -7577 Fax: (503)387 -7615 Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
Business name: SEE ABOVE Medical gas (value: $ ) Page 2
Primer 12.51
Contact name: Deirdre Britt 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: dbritt @stonebridgehomesnw.com Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name: Jardine Plumbing Water piping/DWV 56.29
Address: PO Box 186 Other: 25.02
City/State/Z1 P: Estacada, OR 97023 Subtotal
Phone: (503)3514532 Fax: (503) 6302882 Minimum permit fee: $72.50
Plan review (25% of permit fee)
CCB Lic.: 108747 Plumbing Lic. no.: 93- 1185347
v /Ir State surcharge (12% of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name: Ja Jardine Date: This permit application expires if a permit is not obtained within 180 days
y after it has been accepted as complete.
*Fee methodology set by Tri - County Building Industry Service Board.
I:\ Building \Pcmrirs \PI.MU- PcrmilApp.doc 10/01/09 440- 4616 /02/CUMM9iii)
4
Mechanical Permit Application FOR OF1sIcl; tis1: ONi.Y
a �
City of Tigard Received Date /By: "7 9 l 9- ✓ 1/ Permit No.: 1441aoip. f I
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
III ll Phone: 503.639.4171 Fax: 503.598.1960 Date /By: Other Permit: g_ •
T i G A I: D Inspection Line: 503.639 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
® New construction ❑ Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
Master builder For special information use check list.
Multi -famil
❑ Multi ❑ ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: (5I cM S SV M M ERV 1 Air conditioning
W �1N DR (requires site plan showing placement) 46.75
City/State /ZIP: Tigard, OR Furnace 100,000 BTU (ducts/vents) ( 46.75 4(17 ri
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: I Project name: Arlington Heights Heat pump 61.06
Cross street/directions to job site: 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: Arlington Heights I Lot no.: I (I Flue/vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater I 23.32
Single Family Residential Gas fireplace 33.39
New, Sin
g Y 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: Stone Bridge Homes NW, LLC Environmental exhaust and ventilation
Address: 16869 SW 65 Avenue #505 Range hood /other kitchen
equipment 33.39
City/State /ZIP: Lake Oswego, OR 97035 Clothes dryer exhaust I 33.39
Single - duct exhaust (bathrooms,
Phone: (503)387 -7577 Fax: (503)387 -7616 toilet compartments, utility rooms) 5 23.32 1 It, LO
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name: same as above -
Fuel piping
Contact name: Deirdre Britt $14.15 for first four; $4.03 for each additional
Address: Fumace, etc. 1 14 .I"
Gas heat pump
City/State /ZIP: Wall /suspended/unit heater
Phone: ( ) I Fax :: ( ) Water heater 1
Fireplace
E -mail: dbritt@stonebridgehomesnw.com Range I
CONTRACTOR Barbecue
Business name: Comfort Zone
Clothes dryer (gas)
Other:
Address: 1032 NW Corporate Drive MECHANICAL PERMIT FEES*
City/State /ZIP: Troutdale, OR 97060 Subtotal
Minimum permit fee ($90.00)
Phone: (503) 667 -5595 Fax: (503) 491 -8252 Plan review (25% of permit fee)
CCB lie.: 110091 State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Authorized signature: This permit application expires If a permit is not obtained within 180
days after it has been accepted as complete.
Print name: David Heldstab I Date: • Fee methodology set by Tri- County Building Industry Service Board
I :\ Building \PcrmirsW1GC- PcmiiApp.doc 10/01/09 440 .46171 (1I /02,COMM
/145TZorx-0-0 11y
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard Received Permit No.:
Date/8v'
114
° 1 3125 SW Hall Blvd.,'figard, OR 97223 Plan Review
C Phone: 503.639.4171 Fax: 503.598.1960 Date/B Other Permit:
Inspection Line: 503.639.4175 Date Ready /By: turfs: 0 See Page 2 for
T I (; A RD
Internet: www.tigard- or.gov Notified Method: Supplemental Information
TYPE :OF WORK . . _ ' .• . ,... PLAN REVIEW -., .,
Please check all that apply (submit 2 sets of plans w /items checked below):
® New construction ❑ Addition /alteration /replacement
0 Service or feeder 400 amps or more 0 Building over three 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
® I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION, AND LOCATION ; ' `. ❑ Addition of new motor load of ❑ "A ". "E' : ` I -2", `I -3",
Job no.: 141 Z Job site address: 1 I �� ������' �A, *y.�. 100HP or more. occupancy.
5 L • • 1� ❑ Six or more residential units.
0 Recreational vehicle parks.
❑ Health -care facilities. ❑ Supply voltage for more than
City/Suite /ZIP: Tigard, OR 97223 ❑ Hazardous locations. • 600 volts nominal.
Suite /bldg. /apt. no.: Project name: Arlington Heights ❑ Service or feeder600 amps or more.
FEE .SCHEDULE
Cross sheet/directions to job site: Description I Qtv. I Pee. I Total I
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Arlington Heights Lot no.: ( I 1,000 sq. ft. or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map/parcel no.: Limited energy, residential
(wi th above ft.) 67.84 2
DESCRIPTION OF WORK sq.
Limited energy, multi - family 67.84 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 100.70 2
® PROPERTY OWNER I ❑ 'TENANT 201 amps to 400 amps 133.56 2
Name: Stone Bridge Homes 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: 16869 SW 65th Avenue #505 Over 1,000 amps or volts 552.26 2
City/State/ZIP: Lake Oswego, OR 97035 Temporary services or feeders installation, alteration, and /or
relocation
Phone: (503)387 - 7577 Fax: (503)387 - 7615 200 amps or less 59.36 1
Owner installation: This installation is being made on property that 1 own which is not 201 amp to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
0 APPLICANT I .0 CONTACT PERSON above service or feeder fee, 7.42 2
each branch circuit
Business name: SEE ABOVE B. Fee for branch circuits
without service or feeder fee, 56.18 2
Contact name: Deirdre Britt first branch circuit
Address: Each add'I branch circuit 7.42 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
67.84 2
dwelling, service and /or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
E -mail: dbritt ®stonebridgehomesnw.com Pump or irrigation circle 67.84 2
• . - . CONTRACTOR. - • Sign or outline lighting 67.84 2
r N1.10VA l I � panel, Signal circuit(s) or limited -
Business name: LEC RI CAL ( energy panel alteration, or
Address: 22:soc 50u11-1 L_e W etkeN1 PA extension. Describe: Page 2 2
City /State /ZIP: AV ' C 126 ic-, 0(Z 91 C o4 Each additional inspection over allowable in any of the above
Per inspection 66.25
Phone: 503 — (rr 32 tjt! I F 1 Ilq
/4 //3 Investigation per hour (I hr min) 66.25
CCB Lie.: C96 41.., y _ (, -o
lectrical Lie.: -24 lc Suprv. L ie.: 3 4o. 1 3 Industrial plant per hour 78.18
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal:
Print name:. 'Teri-PI Z H Date: Plan review (25% of permit fee):
State surcharge (12% of permit fee):
Authorized signature' TOTAL, PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
1 •\ttuil ding \I'cmtiLs1F1.C- PcmiilApp.doc 10/01/09 44o- 4615'1'(1 /COM/Wlin
as/ t .4 0 l S .fr-s., 5 t Lot I'J
/5�$S atsJ NHi/Z111 E u)
e ° Building Division
Development Code Provision Review ..
T I G A R D Residential Projects
Building Permit No: ' r ,90 r00 / / g
CWS Service Provider Letter Received: Yes ❑ No ❑ N/A
Routed Plans: � A9/ 02 " Original Plan Submittal Date:
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 on if approved.
Planning Review (contact at 503 - 718 .20 or It @ tigard- or.gov)
La Use Case No. ' �O!/ 1 Name i z j L� mss./
(Zoning • —7
Er Setbacks:
( ront I S Rear / Side < Street Side / v Garage a
M aximum c Building Height 3 S' ' Actual Building Height ziret--r 7 •
C"Visual Clearance
112 Easements
❑ Sensiti e Lands T +e: e ' , _
No1. .. iii/ 4 '/;M ._' /a/ L,/ /i i w i ��'� /S
G . Via.' i L. J i Ar. ',„ ' /. 1, "^ 9 44-7/4 9 .../ //12t V /C 7 L7,4p -,
Original Plan: Approved 0 Not Approved E Date: �a /� ' (f'
i' Revision 1: Approved Not Approved ❑ Date: lP /
Revision 2: Approved ❑ Not Approved ❑ Date: 0-1'
•
Engineering Review (contact Mike White at 503- 718 -2464 or MikeW @tigard - or.gov) (//7 G .
£( Actual Slope: I 0 cy
Notes:
Original Plan: Approved of Approved ❑ Date: g
Revision 1: Approved Not Approved ❑ Date: .e�
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
•
Ci rborist Review (contact Todd Prager at 503 - 718 -2700 or todd @ tigard - or.gov)
t reet Trees
Protected Trees
Notes:
Original Plan: Approved N tApproved ❑ Date: 5'3 - ? o
Revision 1: Approve Not Approved ❑ Date: 6 G
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
i"1 Okay to Issue Permit: Yes No FA
Date Routed to Building: /_
/ AP"'
Page 2 of 2
-- •S D STONE BRIDGE OBE: 1482 1
• RECENED LOT: 111
D
• HOMES NW DATE: 5/9/12
4230 GALEWOOD ST. SUITE 100 • MAY 2 9 2012 PROPERTY: ARLINGTON
LAKE OSWEGO, OR 97035 CITY OFTdGARD CITY: TIGARD GETS
(5 387-7577 BUILDING DIVISION SCALE: 1
/& PLAN No.: 198 -MOD
i OPTION 3 ELEVATION
le d
PL 1111pailiit
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a SIDE
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if rJa
al
434
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& CONC. 25 • s'‘' 4 � � ` 1
9 PATIO
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EL•499' EQ _ _C , _ _ ,, , gininling., I ..
P Q in u.ME ,
W • -0-4-41
LOT COVERAGE LEGEND
LOT AREA: 6,694 SQ. FT.
0
BUILDING AREA: 2,154 SQ. FT. — STREET TREES:
PERCENTAGE: 32% RAYWOOD 451
- FRAXINUS OXYCARPA-
NOTES:
ALL GRADE AND PROPERTY LINES ARE ESTIMATES OF CURRENT LOCATIONS.
ALL DIMENSIONS AND SQUARE FOOTAGE ARE APPROXIMATE FIGURES.
ALL RETAINING WALL HEIGHTS AND LOCATIONS ARE ESTIMATES.
THEY MAY VARY AND BE SUBJECT TO CHANGE. LOT *III
DRIVEWAY MAY DIFFER DUE TO LOCATION OF UTILITY BOXES,
STREETLIGHTS, AND OTHER SITE CONDITIONS. 6,694 Si. ft.
Oregon Residential Specialty Code N1107.2
HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: Jurisdictio
Site Address: i s 5 -� � b r
Subdivision/Cool :
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: •
Owner /General Contract uthorized Agent •
Print Name: � V vZ / c5 4 S
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.
(:\Building\ Fortes \RES- HighEfficiencyLighting.doc 07/01/08
Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, `ti: 1/-e_ l .5 40 - , am the general contractor or the owner- builder
at the following address:
Site Address: / 57 S �.,� ��......,..9- `✓vii -c�,J �^ \
City:
Permit #:
ii/ 7.0 / 2_ — C IL/
Subdivisi t //
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: v Date:
General Contractor or Ow�uilder
I: \Building\Form\RES- MoistureSensitiveWood.doc 09/25/08
1
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Energy Trust New Homes C..1NGE R7
Certified Residential Air I.Duc-t System -44 rigrzy'.4
EnergyTru.i.s
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(JeL OnicLuil L ci . 14Lid S.-6(3b Date 7
Combu0 AppItarde Zone 1st,
Main Zone Zone 2, if appilii
W Outside Pa Pa
Baseline (WRT Ouiside, Thu s oti) Pa Pa
NE'r C AZ Pressure (subtrac(
isisehou hun1 CAZ WRT outside) Pa Pa
Dt e ct ..C .: kageffk 6 utpile:stipl*I5erINet'sytteirfr; .
Description of Area System Serves
co, Hi Floor Area System Serves (f)
0 yes no Air Handler in conditioned space?
p yes 0 no Air Handler present during test'?
if "yes' for either, then ituktittituu CFM is 75 CFM(5:00 Pa or
floor area x 0.0( -A _CFM@,50 Pa, whicht ver is greater.
1"o" for both, then maxitutun CFM is 50 CFM(q15C Pa or
floor area s 0.04 = .C.FM(i450 Pa, whichever is greater.
Test Method: 0 Leakage to Outside or IdTotzil Leakage
Test Result a. C1=111(c450Pa
Ian Pressure/LT Pa Gauge type: 0 DG- orM-DG-70(
it; (circle One) Opel! I 2
Duet Blaster Location L 'Tr
PrCtiStn'e . l'ap Location ..&t.fr://,„/
. . . . .
. • • . STREET TREE - , .. - •
TIGARD � � IFICA _
C R TION
, owner/ a ent or c ,v 9 'C' c: /
agent t
(PLEASE PRINT) (PERMIT HOLDER) "
do hereby certify 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.: AN5 I 'i \t - co I
S T I E ADDRESS: ) 5 ) 8 . 5 5 J � � > 71)
SUBDIVISION: AR v�z} -�c `�—z , (-""i S LOT #: J I - .
SIGNATURE: ✓ a9 DAI E: Gj - i /
(OWNER/AGENT)
RE CEIVED d�
VERIFIED BY DALE:
(CITY OF TIGARD)
- ❑ Tree location verified per approved site plan.
I: \Building \Forms \StreetTreeCertificate 05/30/2012
CV O/ eON776fC — . 1
Electrical Permit Application D FOR OFFICE USE ONLY
Received
City of Tigard J U L 1 1 2012 oats : P 1 / /A- .., Permit No.:•Vcja QIa ""I i / 'e
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C . Phone: 503.639.4171 Fax: 503.598.1960 D ate/B : Other Permit:
f t G A It U Inspection Line: 503.639.4175 ` rI E OFTIG� Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard - or.gov BUILDINGDIVISIO .I otified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
® New construction ❑ Addition /alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "l -2 ", "l -3 ",
Job no.: Job site address: /s/ R Sw Svc bo or more. aP�er•
t r1,-A, Oh ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: Arlington Heights ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qt . I Fee- I Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Arlington Heights Lot no.: / ii 1,000 sq. ft. or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential 67.84 2
DESCRIPTION OF WORK (with above sq. ft.) _
Limited energy, multi - family 67.84 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 100.70 2
® PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2
Name: Stone Bridge Homes 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: 16869 SW 65th Avenue #505 Over 1,000 amps or volts 552.26 2
City/State/ZIP: Lake Oswego, OR 97035 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503)387 -7577 Fax: (503)387 -7615 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
A. Fee for branch circuits with
® APPLICANT I ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 7.42 2
Business name: SEE ABOVE B. Fee for branch circuits
Contact name: without service or feeder fee, 56.18 2
Deirdre Britt first branch circuit
Address: Each add'l branch circuit 7.42 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 67.84 2
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
E -mail: dbritt @stonebridgehomesnw.corn Pump or irrigation circle 67.84 2
/1/E/4/ NTRACTOR Sign or outline lighting 67.84 2
Business name: City Electric Signal circuit(s) or limited -
energy panel, alteration, or
Address: 55568 SW Schaltenbrand Lane extension. Describe: Page 2 2
City/State /ZIP: Sherwood, OR 97140 Each additional inspection over allowable in any of the above
Per inspection 66.25
Phone: (971) 404 -1714 Fax: (503) 625 -3052
Investigation per hour (1 hr min) 66.25
CCB Lic.: 42422 Electrical Lic.: 26 -289C Suprv. Lic.: 35925 Industrial plant per hour 78.18
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal:
Print name: Chuck Friesen Date: Plan review (25% of permit fee):
State surcharge (12% of permit fee):
Authorized signature: �> TOTAL PERMIT FEE: 90 , trd e/
Print name: Date: This permit application expires if a permit is not obtained within : t
days after it has been accepted as complete. 4 1111P2A
• Number of inspections allowed per permit. igi!•
1: 1Building 'Pennits\ELC- PcnnitApp.doc 10/01 /09 440- 4615T(l1/05 /COM/WEB