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Permit CITY OF TIGARD n MASTER PERMIT I I II l : • COMMUNITY DEVELOPMENT P ermit #: MST2012 -00168 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/30/2012 Parcel: 1 S136CA08300 Jurisdiction: TIGARD Site address: 11044 SW LEGACY OAK WAY Subdivision: WHITE OAK VILLAGE Lot: 4 Project: White Oak Village, Lot 4 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 3 First: 618 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 30 Bathrooms: 3 Second: 918 sf Garage: 180 sf Front: 8.5 Smoke Dwelling Units: 1 Third: 498 sf Right: 3 Detectors: Yes Total: 2034 sf Value: $219,340.16 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Tubs /Showers: 2 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 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 2034 Owner: Contractor: WESTLAND INDUSTRIES INC WESTLAND INDUSTRIES Required Items and Reports (Conditions) 12670 SW 68TH #400 12670 SW 68TH AVE STE #400 1 Ersn Cntrl 503 - 639 -4175 TIGARD, OR 97223 TIGARD, OR 97223 PHONE: 503 -572 -0746 PHONE: 503- 245 -9715 FAX: 503 - 598 -9081 Total Fees: $17,335.37 • 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, • if work is suspende• for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification :nter. Those rules a : set forth in OAR 952- 001 -0010 through O • - 9 2- 001 -0.90. You may obtain a copy of the rules or direct questions to OUNC by calling 503. 2.198 .....33 - . Issued By: _.� l - . .L,' / Permittee Signature: Call 503.639.4175 by 7:00 a.m. for the next available Inspection da e. This permit card shall be kept in a conspicuous place on the job site until completion of the p •' ect Approved plans are required on the job site at the time of each Inspection. Building' Permit Applicatioa - I' ;; -, ` ' F+ FOR OFFICE USE ON Residential q ���' ' � . ONLY • Ci ty of Tigard JUN ' 2 8 r . D ata6 •: 1 ��e Permit iM ?O,�'� / i 14 b n - �rt3 «"�Ql �+ • 13125 SW Hall Blvd.. Tigat'd, OR 97223 `` Plan Rev i"� ll� p Phon 503.713 2439 Fax: 503.593. �, 1 Date /By:4V V • Other Permit: K Inspection Line: 503.639.4175 .; s" , Y )uris: 0 See Page 2 for � '�� Date Rea. � � TIGARD Internet: www.ugard- or,gov �_��° . I� L Notitied \Izthod: . 12 Supplemental Information !1 .�f �wc.5 } E t�ii: 1 r t� i r• - s ' C .), ^ TYPE OF WORK ' I L''i-rfli REQUIRED DATA: 1- AND 2- FAMILY DWELLING [l' ew construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: s 2 19 340 . ( • C 0 l- and 2- family dwelling ❑ Commerciallindustrial ❑Multi - family Number of bedrooms: ❑ Accesso ry building ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: 3 ! Job site address: OWE/ < - 6,.: y ,j2_' `i,% � New dwelling area: O square feet 7 — y— /> r 9 7 9 . 7 Garage /carport area: '� Z square feet 4° City /State /ZIP: ! j(;�i`a':.z.� �., � / Yl -� +�V I Suite /bldg- /apt. no.: Project name: Gam!, t Kkif -- /':'( / Covered porch area: square feet 8 Cross street/directions to job site: Deck area: square feet ( to Other structure area: ZZ14, square feet REQUIRED DATA: COMMERCIAL - USE CHECKLIST Subdivision: 764.1' - 7 6,),,,,r'4_ // L f__ Lot no.: Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: _ equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. / Valuation: $ (4, =, i✓.' 1 L / . ' ' % c ' ) , , ( C, - 1 (/ - ;i Ic / %t Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: Type of construction: Address: Occupancy groups: City/State /ZIP: Existing: Phone: ( ) / Fax: ( ) New: APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* (Please refer in fee schedule) Business name: 4 !,t . 't't`: ,j v„ y/) ,i x ; %,,',, ;�, - 5 /itt Structural plan review fee (or deposit): Contact name: 2 )� } =''� i i J ;^7 G— ' , i:- !� !� �.ti.', ft/ J! FLS plan review fee (if applicable): ) Address: ' i- " 1 9' -, ____- �( Total fees due upon application: City/State /ZIP: 176- ( /� 6/ 7 2 Z 3 ��( l.� ,r AAO `' ' r �',' ` Fax:: ^ .. Amount received: K �J Phone: (. s _5) r -0 '`7 ( 7 �' 7 ) 75J'�L C. r . , PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: _ r j " i - 'C . &M' /G .C / Commercial and residential prescriptive installation of CONTRACTOR roof -top mounted Photo Voltaic Solar Panel System. Business name: 1•0( (`)b 3,\' Submit two (2) sets of roof plan with connection details and fire department access, along with the 2010 Oregon Address: i.; \ ., d2_ T` Solar Installation Specialty Code checklist. Ci /State /ZIP. /� Permit Fee (includes plan review S 180.00 ty I'�� "l 7 �i7i and administrative fees): _ Phone: ) • ` - (v Fax: (9 • It _0 . V 1 State surcharge (12% of permit fee): 521.60 CCB lic.: s 6 . '7 Total fee due upon application: 5201.60 Authorized '-Irr - •.--77-.--- This permit application expires if a permit is not obtained ■Ili within 180 days after it has been accepted as complete. ,/ ' Fee methodology set by Tri-County Building Industry t nan - Date:b.g • 1 I' Service Board. I:`• Building \Penni[\i\BUP - RESPennitApp.doc 02/24;20II 3404613T( II,'02 /CO \•IiWEB) Hall Blvd., Tigard, 97223 �' ;I I L- , r nai# A>a�l icatiou i1 ,t I. wit/ .Y 'PlumbingPe Lj Building Fixtures •; -•,, .; .� F . rr , t 3: _ o ot oF u o ` '� , j r L� 9 �( (-_ l ��j r neat, D q 13 25 S of Tigard j - �F = (G �. = i Received a Q /� ` Permit No.: ��a "� 131P! �� �,+ ; a , Date/By � Rernew ,� /� ���� 3 Phone: 503.7182439 Fax 503.598.1960 Other Peaait No.: i C T l GA RD Inspection Line: 503.639.4175 D ate R ea d y /B y kris: El See Page 2 for ,- Internet www.tigard -0on �, Notified/Method: Supplemental Information f. TYPL OF WORK-''.:: • . EE SCHEDULE - New construction ID Demolition For special information use checklist: Description I Qty. I Ea 1 Total ❑ Addition/alteration/replacement ❑ Other. New 1- 2- family dwellings (includes 100 ft. for each utility connection) 312.70 :'. -, CATEGORY OF - CONSTRUCCION: ... -:.. • . - . SFR (1) bath 437.78 nd 2- family dwelling ❑ Commercial/mdustrial SFR (2) bath SFR (3) bath - Q 500.32 ❑ Accessory building ❑ Multi- family Each additional bath/kitchen 25.02 ❑ Master builder - ❑ Other: Fire sprinkler L___- sq. ft) Page 2 • :. JOB SITE INFORNTATIOW. LOCATYQN Site utilities: J Catch basin or area drain 18.76 Job site address: / 1 y / ! - r l Drywell, leach line, or trench drain 18.76 City/State/ZIP: P ; �� �° p / Footing drain (no. linear ft: _) Page 2 � Suite/bldg. /apt no.: ! l Project name: i9t.. adeatic 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.: ____) r Page 2 Water service (no. linear f .: _� I Page 2 Subdivision: / �I - �(' A Lot�o.: Fixture or item: Tax map /parcel no.: Bacldlow preventer 31.27 / " - Backwater valve 12.51 DESCRIPTION Or WORK y'A�I V Clothes washer / p 25.02 _ ./ i. ._/ v/ / i ��C� /GY D ishwasher � 25.02 Drink ing fountain 25.02 Ejectors/sump 25.02 • ❑ PROPERTY OWNER I ❑ 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 t 4PPLICANT ❑ • CONTACT PERSON Interceptor /grease trap 25.02 Business name: y % 4? A Medical gas (value: $ ) Page 2 s r2446 !Jr Primer 12.51 Contact name: / /� - �9` /f� `� Roof drain (commercial) 12.51 Address: ( )9) La) 0 "R/4/h. (6 - Sink/basin/lavatory 25.02 City/State /ZIP: • At p OZ.- ' Solar units (potable water) 62.54 Phone: (r 7 - in6zk, Fax:: (8-qa / Tub /shower /shower pan 12.51 ,f, Urinal 25.02 E -mail: W I . . 0 2 .1.41A • Water closet CONTRACTOR j 37 1 _ /� // . C Water heater .52 Business name: J 64) r P r�g4jFh 61 t 1"C- Water pipingiDWV 56.29 Address: • /7,4T- /`/�,�n ) �� Other. 25.02 City/State/ZIP: � T��fj'' r // l ��Cb Subtotal Phone: ( ) Fax: ( ) / Minimum permit fee: $72.50 � J _ Plan review (25% of permit fee) CCB Lic.: q..) 3 r � Plumbing Lic. no.: 3 4 - A Sr s l State surcharge (12% of permit fee) Authorized signature: TOTAL PERMIT FEE Print name:{.-/ j f I ,e(,(Iti�e/ ` Date r) ( / tr . This permit ap expires if a permit is not obtained within 130 days V � alter it has been accepted as complete. 'Fee methodology set by Tri - County Building Industry Service Board. I I: \BuildinePerrniu\PLMU-PermitApp.dac 10/01/09 440-4616T(10 /02/COM/WEB) i , ti -, 4 F ICE r ya , ;.L x 10/Isc1>Ea»�ecal Permit Apietio _ - y '' � : C ity of Tigard I l J � S ? ,/7019 ` Permit Received 6 i �� , ��i G� IO g 11 Date/By: t 13125 SW Hall Blvd., Tigard,OR 97223 Pfau Review Other Permit: oQ�ia,�5— _' ";; ; Phone: 503.718.2439 Fax 503593. 60.. t.' ' " '! t . Date/By: TCGL D' In L in e : 503 .639.4 1 7 5 - - Date Ready/By: kris: El See Page 2 for �.ii:,i'. =j.;4Gs�' Internet: www.tigazd- or.gov n' .), -'' _ ; r:.`+ : =,":;�� Notified/Method: Supplemental Information TYPE OF WORK - COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees* are based on the value of the work 12Ke construction ❑ Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit Value: $ CATEGORY OF CONSTRUCTION EQUIP VIENT / SYSTEMS FEES* land 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist ❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: _ 0414, / / + Air conditioning Job site address: 1 / � I n , �d , li` (requires site plan showing placement) placement) r `� / Furnace 100,000 BTU (ducts/vents) 46.75 City/State /ZIP: �L-- 1',T) U G- ��3' '' Furnace 100,000+ BTU (ducts /vents) _ 54.91 Suite/bldg. /apt. no.: Project name: j ( s - ( \ . _1- 4 .... i) t L/ Heat pump 61.06 (requires site plan showing placement) Cross street/directions to job site: 5 -- ci . 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: ' \ t r Lot n o.: Flue /vent for any of above 23.32 �: i l� �- I/ C -l�-i I L. , Other: 23.32 Tax map /parcel no.: Other fuel appliances: DESCRIPTION OF WORK Water heater 23 I l i (7 �� L Gas fireplace ;/ f ,. >hf_• j 1 � d G 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 Chimney /liner /flue /vent 23.32 ❑ PROPERTY OWNER ❑ TENANT 23.32 Other: Name: Environmental exhaust and ventilation: Address: Range hood/other kitchen 1 equipment 33.39 City/State /ZIP: Clothes dryer exhaust 1 33.39 Single -duct exhaust (bathrooms, , i Phone: ( ) Fax: ( ) toilet compartments, utility rooms) .-- 2.3.32 - Attic/crawlspace fans t 23.32 0 ❑ CONTACT PERSON P - Other: 23.32 Business name: ' :VI _v . i . - s _) Fuel t m P g: Contact name tit °'' - �r / �L c' t i , -'t.1 i S14.15 for first four; 54.03 for each additional Furnace, etc. v / `"•'ter tt 1 Address: j (C-7 b (�O 6 41 ` Z; Gas heat pump _ P P City/State/ZIP: / / Wall/suspended/unit heater fC �- Water heater t Phone: t ( )j7 - / k / - 4�'84t:: ( �� - 7 59S � -, i tt//� n r / / `]t � / Fireplace 1 E -mail: 2,: ? , C. ( I tr� • ( \ f . L 7 r �IC. j tt �/I% -( f l Range j . v: CONTRACTOR _Barbecue _ Clothes dryer (gas) Business name: i;\ ' l! Other: - Address: V -7-17,„,../., { j MECHANICAL PERMIT FEES* City/State /ZIP: . Q •� I I .r1( 1-9 Subtotal ��� /(�, �- Minimum permit fee ($90.00) Phone: ( `�,!� ?'" "� Fa�c: ( ) Plan review (25% of permit fee) CCB lic.: i 2:42. r ` 1 State surcharge (12% of permit fee) / t TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 Authorized signature: days after it has been accepted as complete. Print name: / •/ -i "'— Date: • Fee methodology set by Tri-County Building Industry Service Board 1:\ Building \ Permits UvfEC- PennitApp.d°e 09/09/10 440- 4617T(11 /02/COM/WEB) �y a ■.a.. .tt?v a ri ' ' "Y 1t w + 4 � Electrical Permit AppI1c do a : ', � ? ` b` F.O[,,.... ICG ruSCONLi t� c r M : Y City of Tigard ' `4 B r - Received t! I N�j aZO�� — lJ6llo g v: „W Permit No.: 13125 SW Hall Blvd., Tigard, OR 97 231I 12 8 30 T3 e Plan Review Other Permit Q, /l - C p /S' 3.- ` " ° ,;4 Phone: 503.7182439 Fax: 503.59 &146 Date/By: Lass: Q See Page 2 for . :GAR .D Inspection Line: 503.639.4175 ' i'. F - • -i, • r Date Ready/By: Supplemental Information +S=- :Ya..i in.i Internet www.tigard- or.gov , ^' Notified/Method TYPE OF WORK: ; , .. • . PLA Pi REVIEW; . ° • • • eW construction check all that apply (submit 2 sets of plans wfitems checked below): ❑ Ad dition/alteration/replacemetit ❑ Service or feeder 400 amps or mom ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATKORY OF. CONSTRUCTION . exceeds 10,000 amps at 150 volts ar ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial-use agricultural and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings. Multi-famil Master builder Other: ❑ Fire pump. ❑ Installation of 75 KVA or 10 y ❑ ❑ laz larger separately derived ❑Emergency system. g P Y system. JOB SITE INFORMATION AND LOCATION. ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", IOOHP or more. occupancy Job no.: • Job site addreslf y i0 ZL6-46y O A- ( ❑ Six or more residential units. ❑ Recreational vehicle parks. FFF / ( mot ❑ Health -care facilities. ❑ Supply voltage for more than City /State /ZIP: / I &340) t / 7 .- ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt no.: Project name: ! /a I At/ • T -, (9,4 &...t/f{ -t ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description I orr. I Fee. I Total I New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: ij» -/Tc 0,49 Vil-Airrc, Lot no.: - - 1,000 sq. ft. or less I 168.54 4 Ea_ add'1500 sq. ft. or portion `} 33.92 1 Tax map /parcel no.: Limited energy, residential 75.00 2 DESCRIPTION OF WORK. (with abovesq. ft) Limited energy, multi- family 75.00 2 LEl / �w C�� �C� � �G� / /� 4/ �, 1 5c ! residential (with above sq. ft) 4 v M 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 2 401 amps to 600 amps 200.34 2 Name: • 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation, alteration, and/or City /State /ZIP: relocation Phone: ( ) 1-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 t�Aabove service or feeder fee, • 7 42 2 • PPLICANI' ❑ CONTACT PERSON each branch circuit Business name: //V L�.,,/d n/QUS L/E- 5 B. Fee for branch r circuits without T � service or feeder fee, fast 56.18 2 Contact name: /Zo6 / N f7 f;/2.50.0 /j/fl- c774-,(40/21.1-K-- branch circuit Each add'I branch circuit 7.42 2 Address: g 6-7 $ o 6;„_‘..- ' 50 r r- - 1/0 Miscellaneous (service or feeder not included) � Each manufactured or modular 67.84 2 City /State/ZIP: • / ! i� / ©A g723 > dwelling, service and/or feeder Phone: (415 ).5 a. -o7/6 Fax:: (4 s e - l g / Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E -mail: • Signor outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited -energy c .r panel, alteration, or extension. Page 2 2 Business name: GG £ £R / V 5 Each additional inspection p over allowable in any �,t //U��(/�" i ' of the above Address: r, A ei 3 SE, ,23,).� / Additional inspection (1 br min) 6625/ hr Investigation (1 hr min) 6625 / hr City /State/ZIP: ��.i sC CC ' ig x®ief' Industrial plant (1 hr min) 78.18 / hr Phone: (9 Phone: 3, — G o gee ` L Fax: (e 11 1 i b- 01.60 Inspections for which no fee is 90.00 / hr specifically listed (A hr min) CCB Lic.: , c, t Electrical Lic.: • ,_ kCifL e Suprv Lic... ELECTRICAL PERMIT FEES Subtotal: Suprv. Electrician signature, required: Plan review (25% of permit fee): Print name: i A Date: ( .2 , ,-- I il_! State surcharge (12% of permit fee): TOTAL PERMIT FEE: - Authorized signature: 1 �� This permit application expires ifa permit is not obtained within 180 l days after it has been accepted as complete. Print name: Date: = Number of inspections allowed per permit. t:\ Building \Permirs\EL.C- PerrnitApp.doe 07/01 /10 410- 46157(1t /05 /COM/wi llaz/y G- Ce3/t& 'Oak (Jiff koiL Building Division cz r Development Code Provision Review T i e n ii Residential Projects Building Permit No: 1 67 6b / L - dO I 62t CWS Service Provider Letter Received: Yes ❑ No ❑ N/A g Routed Plans: Original Plan Submittal Date: . I Y 1st Revision Submittal Date: aZ ❑ Site Plan Only 2" Revision Submittal Date: • 7 /y. ❑ 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 /sir at 503-718- 2 or @tigard or.gov) Land Use Case No. ?OR 2 1 ( - • I / Name t i 2 L �' LI (14 ..12 Zoning J ' Setbacks: /� �/ Front /8 - 7 y Rear ICS) Side 5 Street Side a Garage Z C ❑ Maximum Building Height '7 Actual Building Height . El Visual Clearance E Easements b. S P� ❑ Sensitive Lands Type: /l1 / ` Notes: &-f$ ' M-'.» t5 f l a , e p efr f`e`'(,Jl1liGl5. Lit-re 2-'v . ¶ Llece -.1 5 L is' ! 7ttvv ro49- IA- 7014e4.4AI > {! r>6,A4U4 . ecQ * Original Plan: Approved r ; Not Approved, Date: 7' 30 Revision 1: Approved % Not Approved ❑ Date: 8 -7- ( Z Revision 2: Approved ❑ Not Approved ❑ Date: Engineering Review (contact Mike White at 503- 718 -2464 or MikeW @tigard- or.gov) Actual Slope: 5 Notes: Original Plan: Approved Not Approved ❑ Date: li3 / I/ l z Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved • Not Approved ❑ Date: & 7 jZ (Review Continues on Page 2) Page 1 of 2 City Arborist Review (contact Todd Prager at 503- 718 -2700 or todd @tigard- or.gov) e' Street Trees B' Protected Trees Notes: Original Plan: Approved ,0' Not Approved ❑ Date: 7 -31 - 12. Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved Not Approved ❑ Date: 1g - 7" / 2i 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 A o e r# Date Routed to Building: � ia .7" Page 2 of 2 FOR OFFICE USE ONLY — SITE ADDRESS: This form is recognized by most building departments in the Tri- County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Transmittal Letter T i G; A RD, 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard- or.gov TO: DATE_REC_,,,.aVER:Fo DEPT: BUILDING DIVISION t , ;t v L. - AUG 0 7 NIZ FROM: f C� ;' O� i IG D COMPANY: N � - PHONE: By R E: I t� d § . 1,) Y',,,,,,_00,Je. i`1 Aro /� - 6 //v 5 � Site A dre s) (Permit Nu er) Lok:JC at \i' 1, 4-04 (Project name or subdivision name and lei umber) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. Revisions: . Cross section(s) and details. Wall bracing and/or lateral analysis. Floor /roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other (explain): 41,...,itz.._P REMARKS: (A 6-v...0 G) ' - p 1 ( ( ...,k- .A. 0 . # \ -P FOR FFI E USE ONLY Routed to Permit Technician Date: e � y f ( - 2 _ Initials: 9' Fees Due: ❑ Yes IT IU- Fee Description: Amount D ue: $ $ $ $ Special Instructions: Reprint Permit (per PE): ❑ Yes I ❑ No ❑ Done Applicant Notified: Date: Initials: I:\ Building \Forms \TransmittalLetter - Revisions.doc 05/25/2012 D ill RECEIVED AUG • 7 2012 ; ► II SITE PLAN NOTES: AUG 0 7 2012 I. ALL EXCESS GRADING MATERIAL TO BE EXPORTED TO AN APPROVED DISPOSAL LOCATION. � j�^''�7�l1��1d/// CITY OF TIGARD � 2. ALL FILL AREAS ie: UNDER GARAGE FLOORS, SIDEWALKS, DRIVEWAYS, ETC... TO BE '- " / -- — – – ' J1 i VISION PLANNING /EN.�I E / / COMPACTED GRANULAR FILL. 1 20 0 34 2� i 1V1V 3. THERE WILL BE A SLIGHT OVER EXCAVATION TO PROVIDE CONCRETE FORMING ALL AROUND NEW STRUCTURE. 4. PROVIDE COUNTY /CITY APPROVED SEDIMENT FENCING AROUND EXCAVATED AREA 1' OVERHANG W/ PRIOR TO EXCAVATION AND CONSTRUCTION. W/ FIRE RATED PLYWD. N89D 2 9'04 " 69.53' EE. 0.0 W 5. PROVIDE COUNTY /CITY APPROVED STABILIZED GRAVELED CONSTRUCTION ENTRANCE 1 -\ r PRIOR TO EXCAVATION AND CONSTRUCTION. I EE. 0. 0' X X X I X--0 6. STOCKPILES MUST BE COVERED WITH MULCH OR PLASTIC SHEETING BETWEEN 01\ Q ,{ OCTOBER I AND APRIL 30. I ).– IS 16'4" 1. CONTRACTOR/ SUB- CONTRACTOR TO VERIFY LOCATION OF ALL UTILITIES PRIOR TO ...< .i. EXCAVATION AND CONSTRUCTION. : Q I G " 0 r. S. BOUNDARY AND TOPOGRAPHY INFORMATION 144.5 BEEN PROVIDED TO SKYLINE HOMES 0 AND DESIGN INC. SKYLINE HOMES AND DESIGN, INC, WILL NOT BE HELD LIABLE FOR THE W G AGE PATIO X N HOMES ACCURACY OF TH19 INFORMATION, IT 15 THE SOLE RESPONSIBILITY OF THE CONTRACTOR G \ /OWNER TO VERIFY ALL SITE CONDITIONS INCLUDING FILL PLACED ON SITE. l FFE ' S. TOPOGRAPHY ELEvATIONS WERE COLLECTED FROM ACTUAL SITE SURVEY. Skyline Homes 10. ELEVATION LEGEND: O 0 B V 2_3'1" _ 6021 SE Milwaukie Ave. EE• • EXISTING GRADE ELEVATION 2160 50. FT. c\I (Si Portland. OR 97202 FE• FINAL GRADE ELEVATION f/_ �� 3 BDRM. Q 503.235.3810 FFE • FINISHED FLOOR ELEVATION , ` P.V.G. WATER MAIN 2 .5 BATH X 0 www.skylineplans.com I � II. PROVIDE A MINIMUM GRAVEL BASE UNDER ALL DRIVEWAY AREAS. * I . 5 • 12. PROVIDE A 4" MINIMUM GRAVEL BASE UNDER ALL SIDEWALK AND PATIO AREAS. GAS LINE , � i Q - FFE: 1.5' . ■ 13. PIPE ALL STORM DRAINAGE FROM THE BUILDING TO A COUNTY /CITY DISPOSAL POINT /CONNECTION. tj SAN. SEWER LINE ,' �' 14. MAXIMUM SLOPE OF CUTS AND FILLS TO BE TWO (2) HORIZONTAL TO ONE (I) �J ► ,� 4 2 VERTICAL FOR BUILDINGS. STRUCTURES, FOUNDATIONS, AND RETAMING WALLS. CAMBRIDGE , v � � 111 •� 15. PROVIDE AND MAINTAIN FINISH GRADE WITH POSITIVE DRAINAGE AWAY FROM TREE L , /� X X 1 X I M STRUCTURE ON ALL SIDES WITH A SLOPE of 6' MINIMUM IN 10' -0•. ' „ 1' OVERHANG W/ NS�JD 29'04 "W 69.48' ��� ~ " EE. 0.0' W/ FIRE RATED PLYWD. EE. 0.0' 'n IMPERVIOUS AREA'S: . , 160 SQ. FT. DRIVEWAYS �(.- V IV 19 S FT. PORCH V) 8'-'1 I /16" 1 46c0" 15 1/8" m 0 32 50. FT. WALK —� I / Q 0 i r 100 PATIO Li 150 SQ. FT. OVERHANGS Z (15 825 SQ. FT. BUILDING COVERAGE � 1,286 TOTAL SQ. FT. IMPERVIOUS AREA'S _ I= li — LOT INFORMATION: LOT AREA 1,816 SQ. FT. IMPERVIOUS COVERAGE: 1,286 SQ. FT. • lif BUILDING COVERAGE: 61 PLAN No.: 3053 BUILDING HEIGHT: APPROX---- 31' -0" MIN. BUILDING SETBACKS: 11.5' FRONT, 15' REAR 3' SIDES. DRAWN: T.F. DATE: 8-6-2012 SCALE: I " :10-0" EROSION CONTROL PLAN A • PLOT • r PLAN COVERED STOCKPILES WOODEN CURB RAMP )( SEDIMENT FENCE O ` CATCH BASIN PROTECTION CONSTRUCTION ENTRANCE a KB.: COVER ALL AREAS OF BARE LOT 4 SOIL UNTIL PERMANENT LANDSCAPE IS IN PLACE WHITE OAK VILLAGE N 11 WORK STAGING/ MATERIAL STORAGE TIGARD, OR r11 CITY OF TIGARD n MASTER PERMIT I I II l : • COMMUNITY DEVELOPMENT P ermit #: MST2012 -00168 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/30/2012 Parcel: 1 S136CA08300 Jurisdiction: TIGARD Site address: 11044 SW LEGACY OAK WAY Subdivision: WHITE OAK VILLAGE Lot: 4 Project: White Oak Village, Lot 4 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 3 First: 618 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 30 Bathrooms: 3 Second: 918 sf Garage: 180 sf Front: 8.5 Smoke Dwelling Units: 1 Third: 498 sf Right: 3 Detectors: Yes Total: 2034 sf Value: $219,340.16 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Tubs /Showers: 2 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 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 2034 Owner: Contractor: WESTLAND INDUSTRIES INC WESTLAND INDUSTRIES Required Items and Reports (Conditions) 12670 SW 68TH #400 12670 SW 68TH AVE STE #400 1 Ersn Cntrl 503 - 639 -4175 TIGARD, OR 97223 TIGARD, OR 97223 PHONE: 503 -572 -0746 PHONE: 503- 245 -9715 FAX: 503 - 598 -9081 Total Fees: $17,335.37 • 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, • if work is suspende• for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification :nter. Those rules a : set forth in OAR 952- 001 -0010 through O • - 9 2- 001 -0.90. You may obtain a copy of the rules or direct questions to OUNC by calling 503. 2.198 .....33 - . Issued By: _.� l - . .L,' / Permittee Signature: Call 503.639.4175 by 7:00 a.m. for the next available Inspection da e. This permit card shall be kept in a conspicuous place on the job site until completion of the p •' ect Approved plans are required on the job site at the time of each Inspection. • Oregon Residential Specialty Code R318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM I, g6 , am the general contractor or the owner- builder at the following address: Site Address: / j 0 1/q 5' k) Lei-ACV I , 074-y City: -77e.71 Permit #: /1j15r: - 00/68 Subdivision/Lot #: (,ijff 1r V/z-L-46, L and/or C/ 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. .1 Signature: - Date: / 3 /3 GGral Contractor or Owner - Builder I:\Building\Form\RES- MoistureSensitiveWood.doc 09/25/08 Oregon Residential Specialty Code N1107.2 HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: f ill 5 (2 - 01d - -0 01 f D Jurisdiction: 176-4g1) Site Address: ( 10 r Jq C j turAGy Q*r Subdivision/Lot #: 1 W true O ' i w 1-oi and/or V �( 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: 1 3 15 Ow er eneral ontractor /Authorized Agent Print Name: t P7 Au bui.5.0 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 CERTIFICATION I, 26 AD f12_56,0 , owner/ agent for of.s7-41-vp �Da fS , (PLEASE PRINT) (PERMIT HOLDER) do hereby certifi 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.: /k5TI? - 00 /68 ST1 E ADDRESS: l/o L/4,4 s ' J L mcy O,¢. SUBDIVISION: f i(2 ., LOT #: q SIGNATURE: /_�_�� DATE: /- 3 / ?j r I (OWNER/AGENT) RE CEIVED & VERIFIED BY DA1 E: I S ( TIGARD) ❑ Tree location verified per approved site plan. I: \Building \Forms \StreetTreeCertificate 05/30/2012 Program Use Only � Form 640S FastTrack ID 71N Completion Certification —Site Inspection EnergyTrust 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. First Ins ection Second Inspection 10-23 -12 Date: Verifier Name: preston kuckuck Date: 12 -4 -12 I Verifier Name: preston kuckuck Incentive Payee Company Name: Builder or Company: Westland industries Contact Name: Performance Testing Company: Fireside Home Sol Technician Name: Pak Site Information Development Lot Number: REM /Rate SCO Project ID: Name: white oak File #: (required from verifier if 4 project is ENERGY STAR) Site Address:11044 legacy oak way City: Tigard State OR Zip: LY Unattached ❑ Attached Number of Stories: 3 Total Building Square Footage: Number of Bedrooms 3 2183 Basement ❑ None ❑ Full Basement ❑ Half Basement XXJ Crawlspace Type ❑ Garage /basement combo ❑ Slab on grade ❑ Other Electric Provider ] PGE ❑ PAC ❑ Other: Gas Provider `] NWN ❑ CNG ❑ Other: Electric Meter Number: 24699487 Gas Meter Number: 41951598 (must apply to permanent meter) (must apply to permanent meter) 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 [A Path 2 ENERGY STAR ❑ Envelope Upgrade ❑ Ducts & HVAC Equipment Inside © Equipment Upgrade ❑ 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 Renewable ❑ Solar Ready Electric (SRPV) ❑ Solar Ready Water Heating (SRWH) Energy ❑ Qualifies for Solar Ready Incentive (must attach checklist) Solar Installer: Name: Company: Low Income ❑ Yes ® No Does this project qualify as Low Income? (must provide documentation from builder) Accessory ❑ Yes © No Is this home an ADU? Dwelling Unit ❑ Yes ( No Is the ADU separately metered? If so, provide meter numbers above Other ❑ Earth Advantage — Certification Level: Certifications ❑ LEED -H - Certification Level: ❑Other (please specify): 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 newhomes@energytrust.org J • \li Form 640S i 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 Insulation Flat Ceiling R- 49 Insulation Type: bib Framing Type: Vaulted Ceiling R- 38 Insulation Type: batt 8 Standard Scissor Truss R- Insulation Type: Intermediate bib ❑ Advanced Above Grade Walls R- 23 Insulation Type: Framing Below Grade Walls R- Insulation Type: 30 Size: Floor Over Unheated Space R- Insulation Type: batt Floor Over Garage R- Insulation Type: Slab Floor (unheated) R- ❑ Full Slab ❑ Perimeter Doors Door R- Windows Windows U- .30 SHGC: 3 0 Window Frame Material: v i ny l Skylights U- SHGC: Window Area (Glazing) % Total window area: Lighting Indoor and Outdoor # fixtures: 37 81 % # of ENERGY STAR fixtures or CFLs: 30 Appliances ENERGY STAR Dishwasher Yes ❑ No EF Cooling Air Conditioning SEER: No Btu /Hr: Primary Heat Fireplace AFUE: 95,5 Brand: fraser Johnston Outdoor Unit (for heat Source 0 Gas Furnace pumps) p Electric ❑ Boiler HSPF: Model #: TG9S060A l OMP 11 A Model #: a Gas Heat Pumps: SEER: Serial #: W 1 E2760433 ❑ Other: ❑ Air Source (ducted) COP: Btu /Hr: 60,000 Serial #: ❑ Mini Split (ductless) ❑ Ground Source Location: ECM: ❑ Yes ti No pump commissionin ❑ Radiant Floor Heat �{ p p g ❑ Cadets Electronic Air Cleaner: ❑ Yes d No report attached or cond confirmation for ground ❑ Zonal Backup fuel: ❑ Electric ❑ Gas ❑ Other source heat pumps that ❑ Other: space X manufacturer's start up procedure was performed 0 Additional notes on primary heating: Notes on secondary heating: Water Heater ❑ Storage Gallons: Brand: Rinnai ❑ Electric XaTankless EF: 82 Model #: R175i )O Gas Location: Serial #: DF.ca- 055555 cond space Btu /Hr: 180,000 Form 640S v10 120101 Page 2 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 newhomes @energytrust.org Ali Form 640S Completion Certification —Site Inspection Energy Trust 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 P Suppl )*Yes ❑ No xhaust & Supply ❑ Heat Recovery ERV /HRV Model #: Ducts ❑ Ducts Inside % ducts inside: Ducts in Conditioned Space I Ipiming incentives for ducts inside, check one of the following: iucts Tested ❑ Visual Inspection per RTF specs Duct Insulation R- Duct Location 5u attic �U cond space Duct Sealing w /Mastic Paste ) Ef Yes ❑ No Performance Testing & Duct System Information Ducts Duct leakage must not exceed 0.06 CFM @50 x floor area, or 75 CFM @50, whichever is greater. When tested without the air handler, leakage must not exceed 0.04 CFM @50 x floor area, or 50 CFM @50, whichever is greate& Multiple tests may be required. y Duct Cubic Feet Per Minute Duct Leakage Air Handler In Yes Air Handler Present LJ Yes Leakage: (CFM) @ 50Pa: 97 l Vass ❑ Fail Conditioned Space ❑ No During Test ❑ No Fan Pressure ❑ DG3 Fan - 235 Ring Type ❑ 0 ❑ 2 Leakage Test Total Leakage Gauge ❑(DG700 Pressure: (check one) ❑ 1 iq 3 Method ❑ Leakage to Outside Duct Blaster Pressure Tap Location: Bath Area Tested: 2) 83 Location: Main return Whole House Air Changes per Hour Envelope Tightness Cubic Feet Per Minute Leakage: (ACH) @ 50Pa: [Pass ❑ Fail (CFM) @ 50Pa: 954 House Volume: Best Practices Requirements (All requirements must be met to receive an Energy Performance Score) • Thermal Enclosure Checklist Complete Pass ❑ Fail Thermal Enclosure Checklist attached? ❑ Yes • Insulation Quality Inspection Performed lij Yes ❑ No 4 (complete insulation verification section below) • Approved Mechanical Ventilation Installed Yes ❑ No 4 (complete mechanical ventilation section below) • Zonal Pressure Relief — All zones comply Yes ❑ No If no, state reason for failure: • Combustion Appliance Zone Testing Net CA ressure: Pa If not applicable, please explain: All dv (required) 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. Technical 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 #: Explanation: Additional 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 accurate. Verifier Verifier Signature: Preston Kuckuck Name: P reston Kuckuck Date: 12-4-12 Red Tag Inspection (if needed): Signature: Name: Date: Form 640S v10 120101 Page 3 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 newhomes @energytrust.org