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Permit a CITY OF TIGARD MASTER PERMIT 'F1 2 :' . . COMMUNITY DEVELOPMENT Permit #: MST2012 -00153 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/01/2012 Parcel: 1 S 136CA08800 Jurisdiction: TIGARD Site address: 11061 SW LEGACY OAK WAY Subdivision: WHITE OAK VILLAGE Lot: 9 Project: White Oak Village, Lot 9 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 3 First: 669 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 33 Bathrooms: 3 Second: 967 sf Garage: 219 sf Front: 11 Smoke Dwelling Units: 1 Third: 473 sf Right: 3 Detectors: Yes Total: 2109 sf Value: $227,804.64 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: 2 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: 4 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Fum <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'l 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 2109 Owner: Contractor: WESTLAND INDUSTRIES INC WESTLAND INDUSTRIES Required Items and Reports (Conditions) 12670 SW 68TH AVE #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: $17,463.81 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 iss or if work i- •ended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notificat- ter. ose rules are set forth in OAR 952- 001 -0010 through O R 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 5 i :7 or 1.800.332.2344. Issued By: t? � /�ar — 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 he project. Approved plans are required on the Job site at the time of each inspection. H - ii -a -. WU✓ / � / / J�� / Building Permit Applicad5 Ia.� j .. � K .i 4 L Residential JUN 2 8 2012 FOR OFFICE USE ONLY /, Cl of Tigard Received / �� /, Permit No.:�gMY�'�(,7� `J '� �V� ' i .;: r, Date /B co"' 13125 SW Hall Blvd., Tigard, OR 9A� 3 ' • • " 1 Plan Rev `�a� I 2 t9,01 p, : : ,' :I r I le OtherPennit '�`� Lam+ Phone: 503.718.2439 Fax: 503. : ! Date /By: r " ° i , / / _ / Iuris: ®See Page 2 for TIGARD Inspection Line: 503.639.4175 Date Ready /:y: , (/ 0 � 1 / l Supplemental Information Internet: www.tigard- or.gov Notified/Method: PP ap w // TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING lew 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. j Valuation: $ 227 s O - LJ 1 - and 2- family dwelling ❑ Commercial /industrial Number of bedrooms: ❑ Accessory building ❑ Multi- family ❑ Master builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: 3 Job site address: // 5 1 50dilistfC y 0,,4e. 1.174Y New dwelling area: t p.l ®i square feet City/State /ZIP: 176 - titi4 � Q� 7 29 :. l Garage /carport area: 2 .. m square feet 4---7 Suite/bldg. /apt. no.: Project name: 41j7 /f /[ L/' � Covered porch area: .— square feet q(:- Cross street/directions to job site: Deck area: .ei square feet b,(07 Other structure area: 2,.328 square feet ✓� REQUIRED DATA: COMMERCIAL - USE CHECKLIST Subdivision: M f , 7 04--- g( L_{' f, Lot no.. Permit fees* are based on the value of the work performed. /� / 3b Q �� 1 Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: C DO equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. " P �9"/ii Gy �/: Valuation: $ /o/GsT�'c:T /1/e'-.4) S�t'�� i 1/ r� 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* t (Please refer in fee schedule) Business name: M., 97 _/.hi/7t 7— ,'E 5 /tL Structural plan review fee (or deposit): Contact name: /20,3 e / //t � ,j' /i,Jr —vim FLS plan review fee (if applicable): Address: /726 70 514) A9 `Adr✓ Total fees due upon application: , City/State /ZIP: ��� , � // e. 9? 7- 23 /l� / Amount receiV- ` ✓ v Phone: (c/3 ) 572-- f)7lf� Fax:: (j p j ) �fPj��fO�l { FEES* E -mail: _.rj,,�0� t / y , PHOTOVOLTAIC SOLAR R(NEL SYSTEM FE T _ ✓✓ C o ld U k/4 ' C0fri/ Commercial and residential prscriptive installation of CONTRACTOR roof -top me unted PhotoVol'aic Solar Panel System. u � Business name: ( j i ��1A Submit two = sets of riot plan with connection details and fire depart -lit ar.:ess, along with the 2010 Oregon Address: 0 c,"1, �eb y Solar Installation „ ecialty Code checklist. _ City/State/ZIP. ,1 I fi ��Qt 6. ,� CJ / 77i? Permit Fay (inc des plan revie . and admin ativ ' -es): $180.00 � Phone: ) • ( 7 Fax: ( 9 ~�a. 1 State - .trcharge (12°/ , ' pe 't fee): $21.60 CCB lie.: 6, 2.. Total f = . ue upon applicatio • $201.60 — Authorize. • 3o.. This per • 1 t application expires if a pern ' is not obtained within 180 days after it has been accepte. +s complete. * Fee methodology set by Tri- County Building I • ustry alga. ' ..-• . IA 11 ir Date: `,,. t. Service Board. I:\ Building \Penni. \BUP- RESPennitApp.doc 02/24/2011 440 -4613T(I 1/02 /CON» /WEB) Plumbing Permit App ' on - i ' '-. + " i / • Building Fixtures FOR OFFICE USE ONLY City f Tigard JUN 2 8 2012 Received / /A y 4 1 - Pamit No.: a 13125 SW Hall Blvd., Tigars� t97 °Ir . / r- Other PemitNo. Phi Re Review I II��JJ�� // � / � 7 ' C Phone: 503.7182439 Fax: X503.59 .1'960 ' � •j�' �o� ONO , Date/By. T I C A K. D Inspection Line: 503.639. i D N ( 1.1' t ; ;t, Date Ready/By: Imis Id See Page 2 for Internet www.tigard-orgov Notified/Method: Supplemental Information TYRE OF WORK . * ; S ULE ew construction ❑ Demolition For special information use dteck/ist Description I Qty. I Ea Total ❑ Addition/ alterationheplacement ❑ Other New 1- 2 -family dwellings (includes 100 R. for each utility comedian) CATEGORY OF'ONSYRUGTIOIY SFR (1) bath f 312.70 • ", , i 2- family dwelling ❑ (2) bath 437.78 WJ+'�o SFR (3) bath t( 500.32 ❑ Accessory building ❑ Multi-family Each additional bath/kitchen 25.02 ❑ Master builder - ❑ Other: Fire sprinkler (__ sq. 8) Page 2 . JOB SITE INFOIFM�ITIOI�f AND LOC,AT* N'. Site utilities: Job site address:§U �� Catch basin or area dram 18.76 Drywall, leach line, or trends drain 18.76 City /State/ZIP: r 2 - - Footing drain (no. l inear $: _) Page 2 Suite/bldg./apt. no.: Project name: 49r. aidifyi- Manufactured home Willies 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer (no. linear ft.: _) I Page 2 Storm sewer (no. linear It: _, / Page 2 Water service (no. linear $: I I Page 2 Subdivision: l %- A , a , . ' Lot no.: Fatnre or item: Tax map /parcel no.: / / 71 G 4 it - rO O a _Bacldlow presenter 3127 Backwater valve 12.51 DESCRIPTION OF WORK f'� ��j / Clothes washer 1 25.02 A i / /- IV� Ak _ - ihiJ/C ' l!1 /1'° Dishwasher I / 25.02 Drinking fountain 25.02 . Ejectors/sump 25.02 ❑ PROPERTY OWNER I d TENANT Expansion tank 12.51 • - - Fixture/sewer cap 25.02 Name: Floor drain/floor sink /hub 25.02 Address: Garbage disposal i 25.02 City/State/7 : Hose bib 7. 25.02 Phone: ( ) i Fax: ( ) Ice maker ( 12.51 (I' PLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02 1 � � . , 1 ' f Medical gas (value: $ ) Page 2 Business name: l ` fv1 12.51 Contact name: � $ / S f ,i Primer Roof drain (commercial) 12.51 Address: e )409e) 6 6S 7/) Sink/basin/lavatory 25.02 i7 l' City/State/ZIP: /rJT 64- 47a-z " Solar units (potable water) 62.54 Phone: ( .7 n - Q6�� I Fax: : ( 8r9M i Tub/shower /shower pan 12.51 ,t` 5 C, / � S2;18 _,QM 25.02 • E -mail: � l LJ 25.02 ter - "' Water closet CONTRACTOR Water heater / 37.52 ig /jf / Business name: / 1- 1 c4 i j N 6' c. (Is Water piping/DWV 56.29 7 Address: ' / i Other. 25.02 City/State/ZIP: / f b Subtotal _ I Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Plan review (25% of permit fee) CCB Lic.: 3 ar � Plumbing Lic. no.: 3 4- 74 S fff State surcharge (12% of permit fee) Authorized signature: TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days Print rain=. l - vy‘ t e3A ` . Date: after it has been accepted as complete. +Fee methodology set by Tri -County Building Industry Service Board. I: \ BuildinglPermitsWLMU- PermitApp.doc 10/01/09 440-0616'x(10 /02/COM/WEB) / r I 1Vfechailical Permit Applicati5 gr":i ! 10w ' FOR OFFICE USE ONLY M 9°. Received . /0 1111 II City of Tigard / Date/By: Y "� Ji $ PermitNo.: S7 e/02107/53 13125 SW Hall Blvd., Tigard, OR 97223 JUN 2 8 2012 Plan Review `_ ^!02'601 0 . Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: ddC7tL 7 T LG A RD Inspection Line: 503.639 4 I i �: OF 9 ( r „� r Date Ready/By: Juris: 0 See Page 2 for Internet: www.tigard - or.gov 2U1! D , . 7 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 Value: $ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES* and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist ❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: �� j am• Air conditioning cal J Job site address/kb/ /y i b e j j f / (requires site plan showing placement) 46.75 City /State /ZIP: ``` " ����� ''' 1 - 1( /r P v' ^ + }I Furnace 100,000 BTU (ducts/vents) ` 46.75 � OA '�7) 2 3' Furnace 100,000+ BTU (ducts /vents) 54.91 Suite/bldg. /apt. no.: Project name: C -I Nile,- 0 t L(•t.- Heat pump - (requires site plan showing placement) 61.06 Cross street/directions to job site: C; , \ -7i. 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: i / Vt ! ' e � I K- V 1 U , �jp„. Lot no.: f/ Flue /vent for any of above 23.32 r �! "-' — Other: 23.32 Tax map /parcel no.: I S i 3 ( „ Cp. D 8 P Other fuel appliances: j�'�t� DESCRIPTION TION OF WORK Water heater ( 23.32 C�A��Y' J i( � fl � Flue vent Gas fireplace vent 33.39 ( 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: Environmental exhaust and ventilation: Address: Range hood/other kitchen equipment 33.39 City/State /ZIP: Clothes dryer exhaust I 33.39 Fax: Single -duct exhaust (bathrooms, Phone: ( ) ( ) toilet compartments, utility rooms) ' 23.32 'APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans ((ll 23.32 1 , Other: 23.32 I Business name: ! 1 ,w__..• Fuel piping: Contact name rJ � $14.15 for first four; $4.03 for each additional � ' I Address: 0.- 7 d_�� Furnace, etc. � /// ((( { , r Gas heat pump 1 City/Stat //ZII 11r` ' ► ' ` ' F — Wall /suspended/unit heater Phone: t(V i�, ) SI .2._ = r ' �K�1 )gtb 1 ? : ( ` s e t?� , cp i ( Water heater I E -mail • / I t / J A k* [� l ` � , Fireplace I _ I !� ill ii • ( hi . fps _ !) Range I CONTRACTOR Barbecue II Clothes dryer (gas) Business name: Other: Address: MECHANICAL PERMIT FEES* City/State /ZIP:'" Subtotal Phone: ( w r c ( ) (25% Minimum permit fee ($90.00) e . Plan review (25 of permit fee) CCB lic.: j ell l State surcharge (12% of permit fee) I { TOTAL PERMIT FEE Authorized si nature: This permit application expires if a permit is not obtained within 180 g days after it has been accepted as complete. Print name: _- Date: / / ),,c / * Fee methodology set by Tri -County Building Industry Service Board I:\Building\Permi -Per p c 09/09/10 440-46 71 T (11 /02 F.7 + .T" ' 'S Nam ^\ A 7 `1 klech~ical Permit Applicatlroi :4'.- E . 'y ‘, P' FOR OFFICE USE ONLY City of Tigard JUN 2 8 2012 Received te � r �& / y PermitNa.: Nsry0/a -67075 - 3 ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other p 6e0/2. it: .QO /. g. —7 ' ! Phone: 503.718.2439 Fax: 503.59 ( , ;_, 11j , •.,l Date/By: Inspection Line: 503.639.4175 ' ' ' e. . Date Ready/By: Jade I EI See Page 2 for Internet www.tigard-or.gov lit U A R D. q U �!l r :.l: " , ., a ,a: ,. . , e ; Notified/Method Supplemental Information e, - . TYPE OF WORK ,r. •PAN R�Y7E1!iiS : ,;.: Please check all that apply (submit a sets of plans w/items checked below): kfNew construction ❑ Addition/alteration/replacement ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CAT$6QRY OF - CONSTRUCTION . • exceeds 10,000 amps at 150 volts or ❑ 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- 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 ", "B ", "1 - ", "1 - ", 10011P or more. occupancy. Job no.: • Job site address / L -AC(f OW 4 ❑ Six or more residential units. ['Recreational vehicle parks. r' El Health-care locations. es. ❑ Supply voltage for more than City/ State/Z1P: t�l I � 7.�� ❑ Hazardous locations. 600 volts nominal. Suite/bldg apt no.: , r Gf Project name: `l iT r , (9/4e. /a.,4.6- f ❑ Service or feeder 600 amps or more FEE SCHEDULE Cross street/directions to job site: Description I Qty. I Fee. I Toed I • New residential single- or multi - family dwelling unit. Includes attached garage. /, /i*trc 0�g 1464&€- 1,000 sq. R or less 1 168.54 4 Subdivision: � Lot no.: Ea add'1 500 sq. ft. or portion ; j 33.92 1 Tax map /parcel no.: Limited energy, residential ` 75.00 2 DESCRIPTION OF WORK. (with above sq. ft) 1 Limited energy, multi - family 75.00 2 7 t 6 ,0 'cw /VEIL) r l� ! l� , `- // �/ ,, Uu/ / 5 [' /J /� lg 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 2 401 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: ( ) Fax: ( ) 200 amps or less 5936 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 above service or feeder fee, 7 42 2 , �pp�CANT I ❑CONTACT PERSON each branch circuit Business name: /1/CSTe/1.7/4t ; /0vf7"�/E_ 5 B. Fee for branch circuits without service or feeder fee, fast 56.18 2 Contact name: gob AN 6ogia`d,(J /T/tyt 021 branch circuit l`� Each add'1 branch circuit 7.42 2 Address: id_ 5iV 6 6 -7O _4' 4 $a t y"- 4 0 Miscellaneous (service or feeder not included) Each manufactured or modular 67.84 2 City /State/ZIP: .--7 / ©,e_ 172,33 dwelling, service and/or feeder (�03 ) — Reconnect only 67.84 2 Phone: )72 _ Fax:: � Pump or irrigation circle 67.84 2 E -mail: • Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited -energy Business name: panel, alteration, or extension. Page 2 2 G �� �(tP,-/, �!4 �� Each additional inspection over allowable in any of the above Address: / 3 56.3 , Additional inspection (1 hr min) 6625/ hr Investigation (1 hr min) 6625/ hr City/ State/ZIP: ArA �• . ' L 97(9 / Industrial plant (1 hr min) 78.18/ hr Phone: V ) ) 3 5 - 6 1 e c e Fax: ( g )11b Q .6Q Inspections for which no fee is 90.00 / hr specifically listed (14 hr min) CCB Lic.: 6 6912 l Electrical Lic.: A.. kqc Suprv. Lic. ~VJS2 ELECTRICAL PERMIT FEES Subtotal: Suprv. Electrician signature, required: Plan review (25% of permit fee): Print name: ( I l 1U 1/t Date: 6, y s • ,2,..- 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: Date: s Number of inspections allowed per permit. I :' Building \Permits\ELC- PermitApp.doc 07/01/10 440- 4615T(11 /05 /COM/wl:B . / / ate _ W Zvi Uj "Patt, 1 -44 Buildin Division ° . g Development Code Provision Review T 1 C A R D Residential Projects Building Permit No: H ( a — co i 5 5 CWS Service Provider Letter Received: Yes ❑ No ❑ N/A tit Routed Plans: Original Plan Submittal Date: , � g 17' 1st Revision Submittal Date: 7/ V ❑ Site Plan Only 2nd Revision Submittal Date: . �, 9.- J 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 at 503 - 718 - '2`13 or @ tigard- or.gov) Land Use Case No. 5v fit. - /u Name CJ0 6 - ('.11, E] Zoning Z I L if Setbacks: Front / 1 Rear /3 Side 3 Street Side Garage 2-6 '❑ Maximum Building Height Actual Building Height s Visual Clearance ❑ Easements - 0 Sensitive Lands Type: si/ 4? ly Notes: Original Plan: Approved Not Approved ❑ Date: '7 2 - 5 --/ 2_. Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @tigard - or.gov) ' Actual Slope: .S Notes: Original Plan: Approved Not Approved ❑ Date: 1 12-47 n- Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) I Page 1 of 2 City Arborist Review (contact Todd Prager at 503 - 718 -2700 or todd @tigard - or.gov) /Street Trees Of Protected Trees ' 1 .} / I Notes: At, (` 1 l✓Le S(1e °rp f At-4.. 6o 7 f l, fi�� -�r•fi -- ,Si gee Pk Original Plan: Approved ❑ / Not Approved III Date: 7 -.26. -Po/ X. Revision 1: Approved Not Approved ❑ Date: 9 '5"'" / z Akr 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 App • nt Okay to Issue Permit: Yes No�r�� Date Routed to Building: _' /,, i Page 2 of 2 „; I R0 r F ` a Q L \1 6 . _ � �� Ft.> I I� _ � Q MARK STEWART � 1 l� 13 /T II /TI��II ' � �/ HOME t ›..4 = � // �0 2�S[[ // 1 E.E. 0.0 ^ Z "4- 73. O O E E. 0 0' — — — — — = — �, w t, � '_0 — - m — � ! � d nt I N . S ��� - -, P. E. — — — — ri C. C, ' PORTL/ 91209 y ti k 10 O cA , G BLE �u ARACsE x PHONE 21°.� S Ql 2 FT. �� :r�� � 4 CHAS / I Q 15m3) B85.8311 P �' 1 er � ;. ���� 1 Q i, / / I (503) 2 F p wlaunarketeya j1 A , *, � j' . , i t 4u I II N 3 • -� o 6 • I ® . � lam `L ❖ . ❖. ❖. ❖ . o ❖.� ►� PL UJN I T ♦11.1... O O O O CI 1 VI ACHE LOT �- �p o 0 0 0 < \ Q. ......... ►. — O O O o a � 1 ,1111 •......� ►. L� �v O O O O A ' �� ``�1�� 11i1i1i1i�1i1i1i1i1i1i1i " 1j � 1 a � V' ! ............� .� IV ji b 0 . <1 C. ,� _S VI) / Ii * •-. 'N ii W 1 v 1-.1 6 E.E. 0.0' q f � (� Stock Home Plane J Cuetom Dee1'n Cn iii 44.84 E.E. 0.0' S0‘. . Btu or Marketing es ttn 9 (j) Since 1982 T... plans •d Us &wigs Mel LOT INFOR iATION 1 -tit 11" FERVIOUS AREA'S: . 'M►..~ `" -C O LOT AREA 2,166 SQ. FT. 159 SQ. FT. DRIVEWAY L 0 T » {t9 Important Disolostre IMPERVIOUS COVERAGE 1,439 SQ. FT. 32 SQ. FT. PORCH Please Mogi BUILDING COVERAGE 66% 14 SQ. FT. WALK BUILDING HEIGHT APPROX - 30' -5' 16 SQ. FT. PATIO " ..p1w a — pb.. � . rU ..ueU.n a ai I. a 244 SQ. FT. OVERH m � �� ANGS SCALE: 1/8 = 1 ' _ 0 " w � 914 SQ. FT. BUILDING COVERAGE " ''�'O�`"°"' —` .. aa r a. � 4: a .d ... •�.oae r mod m. os hdi l p y . y 1,439 TOTAL SQ. FT. IMPERVIOUS AREAS � OOA N V - °i .1 1 n° "4: :.. " colmmi R Y o.lwl mY.00r b m..... Vu d�v6.Alrq aSry M. = WOODEN CURB RAMP /�, p,,�,� n , .7"4:1 V. w� STREET TREE /� / f" Ca' �'�1� � ..o .toAy God. o sakenram 1. 1 ..� .� ..ro.. Ay balktIg M. = CATCH BASIN PROTECTION ill oath ° O O ° 0 I = WORK STAGING/ MATERIAL STORAGE WESTLAND HOMES j/ = CONSTRUCTION ENTRANCE ww AK VILLAGE •;1;1;1;1; = COVERED STOCKPILES g1� ���� womb JUG 2012 = SEDIMENT FENCE JULY 2012 PAM N . - PERMANENT LANDSCAPE IN PLACE 71L SITE • ( ■ FOR OFFICE USE ONLY — SITE ADDRESS: / /i5 / ) , D This form is recognized by most building departments in the Tri -County area for tra ittinformation. 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 7 1 a Transmittal Letter T i �, n it 0,, 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard- or.gov TO: 1 ____)GticN, DATE RECEIVED: ,.,,, DEPT: BUILDING DIVISION \ O 3u L 242012 FROM: [ 5(0_ l tt raA910 C M COMPA Y: 4X 1Z ( � Val c��l B ' � 1��VSIOt. PHONE: (B7): RE: 0 ) x 136 4 7 --- ; r i — c/5 rte • ' Tress) (Permit um er) (Project name or subdivision name and t nuner) 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): REMARKS: ( ca Gc.41 —" FOR 9FFIE USE ONLY Routed to Permit Technicial�• Date: ) d t ( (Z Initials: ) Fees Due: ❑ Yes [J'NO Fee Description: Amount Due: $ $ $ $ Special Instructions: Reprint Permit (per PE): ❑ Yes ❑ No ❑ Done Applicant Notified: Date: Initials: I:\ Building \Forms \TransmittalLetter - Revisions.doc 05/25/2012 Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 11061 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 699 Mechanical final 03/08/2013 00:00 MST2012-00153 PASS Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 11061 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 299 Final inspection 03/12/2013 00:00 MST2012-00153 PASS - C of O NOTE all necessary documentation provided. CofO to come Plumbing final PASS Violation Summary: Inspector Contractor Oregon Residential Specialty Code N1107.2 HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: 4157-; 049 — 00 /S 3 Jurisdiction: 73-'‘--"be6 Site Address: // 6 / s �/ / Gy 0/414- it . / Subdivision/Lot #: / f re D ic 0 , 4 ,, r _ 1o # 9 andlor 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) 11 A ":41 ir Signature: ' Date: 7-t 3 0. . r /General Contractor /Authorized Agent Print Name: 4Qa,J ORSC Section N1107.2. High - efficiency interior lighting systems. A minimum of fifty (50) percent o the permanently installed lighting fixtures shall be installed with compact or linear fluorescent, or a lighting source that has a minimum efficacy of 40 lumens per input watt. Screw -in compact fluorescent lamps comply with this requirement. The building official shall be notified in writing at the final inspection that a minimum of fifty percent of the permanently installed lighting fixtures are compact or linear fluorescent, or a minimum efficacy of 40 lumens per input watt. 1:\Building\Forms\RES- HighEfficiencyLighting.doc 07/01/08 Oregon Residential Specialty Code R318. MOISTURE CONTENT ACKNOWLEDGEMENT FORM I, 445.04i , am the general contractor or the owner- builder at the following address: Site Address: /(Ob / , / £ C y/ /24- hy City: Permit #: M 57 a o i - — 00/.5-3 Subdivision/Lot #: 4),t 64-e_ v/e_L46--6._ /or 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 framin I members. e =+. Date: 3 — 7- / 3 Signature: G- - Contractor or Owner - Builder 1:\Building\Form\RES- MoistureSensitiveWood.doc 09/25/08 STREET TREE TIGARD CERTIFICATION I, i 4g/ego/I/ , owner/ agent for Nisrept,6 .7j6w57-,e(e__s , (PLEASE PRINT) (PERMIT HOLDER) do hereby certift that the following location meets City of Tigard land use and development standards for street tree installation and is consistent with the approved site plan. PERMIT NO.: /757o - 00 AC HIE ADDRESS: 11 Q I I 541 it ts_-tc Y &'- S UBDII/ISION. - ©ft_ /1 c(-4f' LOT #: 9 SIGNATURE: Ir�a DA 1 E: 3-- 7-13 (0 ER /AGENT) RECEIVED & VERIFIED BY // DA1 E: 3 (i _ (CITY OF TIGARD) ❑ Tree location verified p approved site plan. I:\ Building \Forms \StreetTreeCertificate 05/30/2012 Program Use Only \f; Form 640S FastTrack ID 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 Inspection Second Inspection Date: 1 -3 -12 Verifier Name: preston kuckuck Date: 3 -6 -13 Verifier Name: preston kuckuck Incentive Payee Company Name: Builder or Company: Westland industries Contact Name: Performance Testing Company: Fireside Home Solutions Technician Name: Pk Site Information Development Lot Number: REM/Rate SCO Project ID: Name: white oak Fi le tt: (required from verifier if 9 project is ENERGY STAR ') Site Address: 11061 SW white oak village city: Tigard State OR Zip: ❑ Unattached ❑ Attached Number of Stories: 3 Total Building Square Footage: 2183 Number of Bedrooms 3 Basement ❑ None ❑ Full Basement ❑ Half Basement XXJ Crawlspace Type ❑ Garage/basement combo ❑ Slab on grade ❑ Other Electric Provider n PGE ❑ PAC ❑ Other: Gas Provider n NWN ❑ CNG ❑ Other: Electric Meter Number: 25327297 Gas Meter Number: 42446493 (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 ❑ Path 2 ENERGY STAR ❑ Envelope Upgrade ❑ Ducts & HVAC Equipment Inside B 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 R 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): Fomi 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 . . Ali_ Form 640S ijc 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- Insulation Type: ❑ Standard Scissor Truss R- Insulation Type: Intermediate Above Grade Walls R- Insulation Type: bib ❑ Advanced 23 Framing Below Grade Walls R- Insulation Type: 30 Size: Floor Over Unheated Space R- Insulation Type: bats Floor Over Garage R- Insulation Type: Slab Floor (unheated) R- ❑ Full Slab ❑ Perimeter Doors Door R- Windows Windows U- .30 SHGC: .30 Window Frame Material: vinyl Skylights U- SHGC: Window Area (Glazing) % Total window area: Lighting Indoor and Outdoor 81 % # fixtures: 44 # of ENERGY STAR fixtures or CFLs: 36 Appliances ENERGY STAR Dishwasher N Yes ❑ No EF Cooling Air Conditioning SEER: Btu/Hr: None Primary Heat (J Fireplace AFUE: 95.5 Brand: fraser johnston Outdoor Unit (for heat Source Gas Furnace pumps) ❑ Electric HSPF: Model #: TG9S060A 1 OMP 11 A ❑ Boiler Model #: ElGas Heat Pumps: SEER: Serial #: W 1 h2143820 ❑ Other: ❑ Air Source (ducted) COP: Btu /Hr: 60,000 Serial #: ❑ Mini Split (ductless) ❑ Ground Source Location: ECM: ❑ YesT3 No Heat pump commissioning ❑ Radiant Floor Heat ❑Cadets cond �C Electroni Air Cleaner: ❑ Yes [J No report attached or 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: ❑ Electric xlTankless Rinnai 7❑ Gas EF: 82 Model #: RL 75i Location: Serial #: Dg.ca-066328 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 mi l" 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 Cycler ❑ Heat Recovery ERV /HRV Model #: Ducts ❑ Ducts Inside % ducts inside: Ducts in Conditioned Space If claiming incentives for ducts inside, check one of the following: Ducts Tested ❑ Visual Inspection per RTF specs Duct Insulation R- 8 Duct Location 50 attic 50 cond space Duct Sealing w/Mastic Paste )15t 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 greater. Multiple tests may be required. Duct Cubic Feet Per Minu a Duct )( Leakage Air Handler In Yes Air Handler Present If Yes Leakage: (CFM) @ 50Pa: 1 b9 NPass ❑ Fail Conditioned Space ❑ No During Test ❑ No Fan Pressure ❑ DG3 Fan Ring Type ❑ 0 ❑ 2 Leakage Test TITotal Leakage Gauge 0(DG700 Pressure: 47 (check one) ❑ 1 3 Method ❑ Leakage to Outside Dud Blaster Pressure Tap Location: Bath Area Tested: 2 1 83 Location: Main return Whole House Air Changes per Hour Envelope Tightness Cubic Feet Per Minute Leakage: (ACH) @ 50Pa: 3.6 [Pass ❑ Fail (CFM) © 50Pa: 1 190 House Volume: 19647 Ci2ze Practices Requirements ra requirements t (bGa"X t(13 iii Energy Performance Score) • Thermal Enclosure Checklist Complete ] Pass ❑ Fail Thermal Enclosure Checklist attached? ❑ Yes • Insulation Quality Inspection Performed M Yes ❑ No 4 (complete insulation verification section below) • Approved Mechanical Ventilation Installed M Yes ❑ No 3 (complete mechanical ventilation section below) • Zonal Pressure Relief — All zones comply KI Yes ❑ No If no, state reason for failure: • Combustion Appliance Zone Testing Net CAZ Pressure: Pa If not applicable, please explain: 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 D ate: Signature: Preston Kuckuck Name: Preston Kuckuck 3 -6 -13 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