Loading...
Permit CITY OF TIGARD MASTER PERMIT 11 1 I . COMMUNITY DEVELOPMENT Permit #: MST2012 -00167 TI G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/03/2013 Parcel: 1 S 136CA08100 Jurisdiction: TIGARD Site address: 11036 SW LEGACY OAK WAY Subdivision: WHITE OAK VILLAGE Lot: 2 Project: White Oak Village, Lot 2 Project Description: New SF BUILDING Floor Area 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: 8.58 Smoke Dwelling Units: 1 Third 498 sf Right: 3 Detectors Yes Total: 2034 sf Value: $219.34016 Rear: 15 PLUMBING Sinks: 1 Water Closets 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Unnals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tuba /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 Drywall- Trench Drain: 0 Other Fixtures: 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 Fum > =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'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 Descnption 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: $17,299.75 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 it work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notificatio. Center. T.. - - ru s are set forth in OAR 952- 001 -0010 t- -0090. You may obtain a copy of the rules or direct qus to OUNC by calling f Call 503.639.4175 by 7:00 a.m. for the next available inspect • • e. This permit card shall be kept in a conspicuous place on the job site until co pletion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application 6u0 `l gf Residential FOR OFFICE USE ONLY Rzc eiv "td / • City of Tigard , . ©�, Permit No p - q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie∎ =IE 8 t ( �! a► Phone: 503.7503.718.2439 Fas: 503.598.1%0 .. 0 Date: By: lb Other Permit 1 Inspection Line: 503.639.4175 Date Ready : q / Jun ® See Page 2 for TIGARD Internet: wwvv.tieard or.gov Notitied, �7 , e - ° ' � Supplemental Information VM w j 7'i 'V 1 to ( ¢ak col a44∎ 3- TYPE OF WORK • "•- -_':'� REQUIRED DATA: l- AND 2- FA o, M1LY DWELLING �N ['"New construction ❑ Demolition Permit fees* are based on the value of the work performed. P Indicate the value (rounded to the nearest dollar) of all 6' ❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the work indicated on this application. CATEGORY OF CONSTRUCTION 4 r1�(n I Valuation: S r` 0 • L�J E] 1 - and 2- family dwelling ❑ Commercial /industrial Number of bedrooms: ❑ Accessory building ❑ Multi-family '' d y Number of bathrooms: ❑ Master builder ❑ Other: r'` : JOB SITE INFORMATION AND LOCATION Total number of floors: - New dwelling area: p,03 square feet Job site address:�� pi.. - ��� y 6',.4,,t! `��� 4.18 7 : 9 , � Garage/ carport area: square feet City/State/ZIP: � "i,- : ; -;t /.i ( ,k� i f 7 t Suite/bldg. /apt. no.: Project name: / ' - -/ - . / - //:( _/ %- Covered porch area: _ IN square feet Tte Cross street /directions to job site: Deck area: auare feet / l f{ Other structure area: ?2 (4_ .,uare feet REQUIRED DATA: COMMERCIAL - USE CHECKLIST Subdivision: %!:. /7 L 1 %r /, ,�C ''� 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: S —., r " (/� - , 4�- -"' - 7 , f -� v Sly = %% , �i /7-'/%1,-' 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: Uf APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* r (Please refer in fee schedule) Business name: /...,:, ' ` r t. ' ? ;77--t2,,,, — �� - l Structural plan review fee (or deposit): Contact name: r =73 / L, --N' 5 ,,i / 1J' , ;?,.?-.'r;'V , FLS plan review fee (if applicable): Address: ' . 41 / 7 ` "�� ' t" Total fees due upon application: City/State /ZIP: & 7 / -,) �, /2 `J 7 %- Amount received: Phone: (,;?_:3 ) c 7 ;_i _r 74-ff, Fax:: k;„:5 ) ` -96,1::;,/ / 6, 1 l PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E -mail: — - __//;;7'.1 ;2. (�(• .%_- /% , � GA7 Commercial and residential prescriptive installation of CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System. Business name: GO ., 'Lt _, 1.__I -. • Submit two (2) sets of roof plan with connection details and fire department access, along with the 2010 Oregon Address: I (r7 5i-,0 � , 4 'h 44 L-''p Solar Installation Specialty Code checklist. . a C// Permit Fee (includes plan review S 130.00 City/State /ZIP �,�� 7��7i and administrative fees): Phone: j� Cam% ) . -7 ` t '( f ^ 2L Fax: ( ' J 29 `o oi 9 f State surcharge (12% of permit fee): 521.60 CCB lie.: Total fee due upon application: 5201.60 ?7 Authorized " - .-------77--- This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. * Fee methodology set by Tri- County Building Industry 'tint ran i S - lLl 9i Dater �.1 r . I S Board. 1 I: Building `Perri.'BUP- RESPennitApp.doc 02,2412011 440- 4613T(II /O2 %COM ;WEB) Pl Permit Application oil/ ,,)-(- Building Fixtures FOR OFFICE U SE ONLY `/ City of Tigard Received Permit No.: �y/ O DD / '�L ( P 7 , - I - • - v 13125 SP/ Hall Blvd., Tigard, OR 97223 DateBy. � � � - Phone: 503.7182439 Fax 503.598.1960 _ Plan ffiy: OtherPemritNo.: ��i /yL�ts� DatelBy: T [CARD Inspection Line: 503.639 D a t e Ready/By: Iris: Eg See Page 2 for Internet www.tigard or.gov Notified/Method: Supplemental Information TYPE' OF WORK . - - FEE*: SCHEDUtiE New construction ❑Demolition - For special information use checklist Description I Qty. I Ea. I Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2 -family dwellings (includes 100 It for each utility connection) - " - -; CATEGORY OF CONS'PRUCITON' :'-;.- - • Skit (1) bath r 312.70 d 2- family dwelling S ( bath 437.78 n ❑ CommerciaUbufustrial SFR (3) bath II 500.32 ❑ Accessory building ❑ Multi- family Each additional bath/kitchen 25.02 ❑ Master builder - ❑ Other: Fire sprinkler L_ sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: ffOop i Catch basin or area drain 18.76 ` Drywell, leach line, or trench drain 18.76 City/State/ZIP: /� � y, `'��� r , "( J Footing drain (no. linear ft: Page 2 Suite/bldg. /apt. no.: Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer (no. linear ft.: _) ( Page 2 Storm sewer (no. linear ft: -.____) I Page 2 �o�y J �j _ Water service (no. linear ft: _.J t Page 2 Subdivision: e/ / a.-= /1/0..42.- Lot no.: Fixture or item: Tax map /parcel no.: Back flow preventer 31.27 / " " Backwater valve 1251 DESCRIPTION O WORK � Clothes washer / ) 25.02 57 1 iO 'i % /II /G i!/e Dishwasher / 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Floor drain/floor sink/hub 2.5.02 Address: Garbage disposal / 25.02 City/State/ZIP: Hose bib 2/ 25.02 Phone: ( ) Fax: ( ) Ice maker ( 12.51 Lld'APPLtCAiNT ❑ CONTACT PERSON Interceptor /grease trap 25.02 t �// Medical gas (value: $ ) Page 2 Business name: 104'l / ' ' /0(L 2. '� �� � Primer 12.51 Contact name: ; j �-y c_ 'u / �r � '� (commercial) �, Roof drain commercial 12.51 Address: (� ?d L / £) �" �' (06 Sink/basin/lavatory C 25.02 City/State /ZIP: �� �� 6L- QQ-72.-z-, Solar units (potable water) 62.54 Phone: (ci .1 - • y Fax: • ( r i! r, _ 400/..: � Tub/shower /shower pan r 12.51 E -mail: r - Urinal 25.02 �� t %I /lel_. • C6)(1 Water closet 25.02 CONTRACTOR /� Water heater 1 37.52 Business name: ,6l0 e _ p tlga/ l 6 ( L Water piping/DWV 56.29 Address: b t li vi /) Other. 25.02 City /State �� C71 er-q60B AL g7/ b Subtotal Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Plan review (25% of permit fee) CCB Lie.: 3 Plumbing Lic no 3 - S{W ( State surcharge (12% of permit fee) Authorized signature: TOTAL PERMIT FEE - Point IIam e 1AeA - ._. t Date his permit application expires if a permit is not obtained within 180 days �A. 1 1r 6 IS- - Sr i after it has been accepted as complete. Fee methodology set by Tri- County Building Industry Service Board. 1:\ BuildingTermits \PLMU- PemtitApp.doe 10/01/09 440 -4616T(10 /02/COMIWEB) AV r Mechanical Permit Applicati - FOR OFFICE USE ONLY City of Tigard - Da riser `�. % Permit No.: 5/34/.91.24, / , 7 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.1960_. Date/By: Other Permit: dk,/,. DQ/ TIGARD. Inspection Line: 503.639.4175 - ' Date Ready/By: runs: H 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 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. 1 Ea. I Total JOB SITE LNFORMATION AND LOCATION Heating/cooling: �-*�� Air conditioning Job site address:/1 j/! $ �� ^ }� (requires site plan showing placement) 46.75 IIII `` J ///���� C� % 1 / Furnace 100,000 BTU (ducts/vents) _ i 46.75 City/State /ZIP: � ( '� '9'7 ).- _Furnace 100,000+ BTU (ducts/vents) , 54.91 Suite/bldg. /apt. no.: Project name: ��,i -) N��_ t,' t { 1 -s�+� Heat pump I _ (requires site plan showing placement) 61.06 Cross street/directions to job site: •. .-74. 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 Y Flue /vent for any of above 23.32 Subdivision: \ F ark_ �� f � �- Lot no.: 23.32 Other: Tax map /parcel no.: Other fuel appliances: DESCRIPTION OF WORK Water heater , 23.32 / / i { /.- / ,-i Gas fireplace r 33.39 ` t' �� ^ i I • Flue vent for water heater or gas fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace /insert 23.32 ❑ PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 23.32 Other: 23.32 Name: Environmental exhaust and ventilation: Address: Range hood/other kitchen equipment 1 33.39 City/State /ZIP: Clothes dryer exhaust I 33.39 Single -duct exhaust (bathrooms, Phone: ()--,/ Fax: ( ) toilet compartments, utility rooms) i 23.32 !✓I APPLICAiNT ❑ CONTACT PERSON Attic/crawlspace fans I 23.32 Other: 23.32 Business name: � , 1 i �� 'P e t; � `C • Fuel piping: /\ 1i � : PP g Contact name i \ 6i !-., . t $14.15 for first four; $4.03 for each additional Address: � Furnace, etc. t �/ 7 ti 7) ' t Gas heat pump City/State /ZIP: �c 0 Wall /suspended/unit heater Phone: QB )_>' ., 7 C , C �'\ Water heater ! Fireplace 1 E-mail: _, i �� (.r l(� ) \ -4ct `� (> Range i CONTRACTOR 1 Barbecue Business name: 3# . /1-7 c - r e- 4 _ ��,�� ,v� Clothes dryer (gas) Other: Address: 19 9 L1 � L /' 19-vr" MECHANICAL PERMIT FEES* City/State /ZIP: Sq -Ai� ✓ I r O� ! '7t Q S Subtotal J Minimum permit fee ($90.00) Phone nt , if Fax: ( ) Plan review (25% of permit fee) CCB lic.: /9 79/ / State surcharge (12% of permit fee) 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: ' • / Date: • Fee methodology set by Tri -County Building Industry Service Board � ✓ / ` t J_ ,� l 1 I:\Building\Permits1MEC- PermitA pp. doc 09109/10 440 -4617T(It /02/C0MIWEB) V __ - • Electrical Permit Application - ._ FOR OFFI USE ONLY Received : City of Tigard na:ea : U _ Pe rmit No.//5T�4/ i ("/‘ ° 13125 SW Hall Blvd., Tigard,OR 94223 Plan Review Other Permit i — /5 2 Phone: 503.718.2439 Fax: 503.598.1960 ' ' - ` Date/By• kris: H See Pa 2 far . T i c R. Inspection Line: 503.639.4175 Date Ready/By: r. Supplemental Information Internet www.tigard- or.gov Noti fied/Method: - pp - pEAN REYIEVix ?:;.: TYPE OF WORK sets of plans wfi . New construction ❑ Addition/alteration/replacement Please check all that apply (submit ?< ❑ B�� tems checked below): El Service or freder 400 amps or more g over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 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 pomp. ❑ Installation larger 5 1(1 A or ❑ Emergency system. g separately system. JOB SITE INFORMATION AND LOCATION - ❑ Addition of new motor load of ❑ "A ", "E ", "1 - 2 ", "1 - 3 ", Job no.: lob site ad drts 110011P or morn, occupancy. • ❑ �f 0 0 ) Z g�X ' y ❑ Six or more residential units. Recreational vehicle parks. y ! 7 ' ❑ Health-care facilities. ❑ Supply voltage for more than City/ State/ZIP: �� (1� `7 ` � � ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt no.: Project name: 4:471. 7 -- (94.. & f,-f ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description I Qty. I Fee. I Total 1 • New residential single- or multi- family dwelling unit. _ / Includes attached garage. Subdivision: 6 J/ /r - a ./ j/iii�, Lot no.: I y 1,000 sq. ft. or less 1 168.54 4 f�' / Ea. add'l 500 sq. ft or portion "' 33.92 l Tax map /parcel no.: Limited energy, residential DESCRIPTION OF WORK (with above sq. R) t 75.00 2 Limited energy, multi- family 75.00 2 6 I r G1- /V 5 -k residential (with above sq. f .) fJ (/w /� ! /� 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: ( ) I Fax: ( ) 200 amps or less 59.36 1 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with APPLICANT ❑ CONTACT PERSON above service or feeder fee 7.42 2 each branch circuit Business name: /, , (,kit /✓Jv5 ,��� 5 B Fee for branch circuits without //V service or feeder fee, fast 56.18 2 Contact name: /Z06 circuit , j A D E �,v 1-6*-t. S71q-,e40/2/4 Each add'1 branch circuit 7.42 2 Address: /? 61 p 5'U 69.`` ,41,-6, 5U ire- 7�t� Miscellaneous (service or feeder not included) - Each 4 / ©/e_ q r , dwel in, service or modular 67.84 2 City/State/ZIP: rf �? � dwellingg, service a nd /or feeder Phone: 5 ).5 73. -014 Fax: : (4 )5 — to 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 1 'r- panel, alteration, or extension. Page 2 2 Business name: 6_4 e. � .viuf/r¢ �� Each additional inspection over allowable in any of the above Address: / s3 5e. ;3 - , / Additional inspection (1 hr min) 66.25/ hr Investigation (1 hr rain) 6625/ hr City / State/ZIP: Fcj/,r t; �' c'$f . ' Z 9 7 t , Industrial i� plant (1 hr min) 78.18/ hr Phone: (5 j) 35 - 6 ge? Fax: ( 8'71 ) /1f5- j 6o Inspections for which no fee is 90.00 / hr _ specifically listed (f. hr rain) CCB Lic.: 6 `f ( _ Electrical Lic.: 2&. AWL] Suprv. Lic. ::7 ' > t PERMIT FEES /'� Subtotal: Suprv. Electrician signature, required: Plan review (25% of permit fee): Print name: / • " D ate: State surcharge (12% of permit fee): �'"� ��f - 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: • Number of inspections allowed per permit I:\ Building 'PermitsuELC- PermitApp.doc 07/01/10 440- 46157(11/05 /COM/WEB l /0310 6 Er Building Division Development Code Provision Review TIGARD Residential Projects Building Permit No: 1 ) r & A ! (P 7 CWS Service Provider Letter Received: Yes ❑ No ❑ N/A `R Routed Plans: Original Plan Submittal Date: It 1st Revision Submittal Date: AST ❑ Site Plan Only 2 ^d Revision Submittal Date: ❑ Site Plan Only To the Applicant: Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies to the Building Division. Only checked (✓) items are approved. Items not approved and those listed in the notes must be revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed above each section. Staff: please check items along left only if ap s r Planning Review (contact at 503 -718- 2( It ( or a' @tigard - or.gov) Land Use Case No. 1W 2 eA U - P ( Name WHEIE Mk a Zoning R-1 Z ❑ Setbacks: t Front ft 7 Rear /5( }Side 3 Street Side ? Garage 20 ❑ Maximum Building Height 3S Actual Building Height 30 a Visual Clearance Et Easements ❑ Sensitive Lands Type: N Pr Notes: 1 l y 1 .0 f [) ittt� � S` St Tf3 *des. / 3' 5 ,r..� t � � Ci 77 t.- Original Plan: Approved ❑ Not Approved 2' Date: - -/ L Revision 1: Approved t< 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: 5 Notes: Original Plan: Approved -Er Not Approved ❑ Date: 12' Revision 1: Approved ❑ Not Approved ❑ Date: _ Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 City Arborist Review (contact Todd Prager at 503 - 718 -2700 or todd @tigard- or.gov) 0' Street Trees rotected Trees Notes: Original Plan: Approved ,0' Not Approved ❑ Date: 7'; I - !L- Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert @tigard - or.gov) ❑ Conditions of Approval Prior to Issuance of Building Permit Notes : Original Plan: Date Sent to Applicant: Revision 1: Date Sent to Applicant Revision 2: Date Sent to ' .plicant Okay to Issue Permit: Yes ►` o Y Y7/ Date Routed to Building. • • I 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 13125 SW 11 Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard- or.gov TO: DATE RECEIVED: DEPT: ING DIVISION itECEIVED AUG 07 2012 FROM: CITYOFTIGARD COMPANY: �_.�� BUILDINGDIVISI vs PHONE: By � RE: 4( ‘R 6&) f . ,lam O 11♦l J r . -� (67 dress U • cm `um u er 0 a. l oject name or subdivision name and lot mb ) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: I Copies: I 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: C ;L � .� c s.� � dz -.�.o ( 3 �d • — y L e�- ifLc¢.o I . ,1 -p FOR O F IC USE ONLY Routed to Permit Technician: Date: 0 ( 1 3 Initials:'' Fees Due: ❑ Yes 2io Fee Description: Amount Due: Special Instructions: Reprint Permit (per PE): ❑ Yes I ❑ No ❑ Done Applicant Notified: Date: Initials: 1:\ Building\Forms \TransmittalLetter- Revisions.doc 05/25/2012 III t RECE - SITE P ��1 LAN NOTES: ! AUG 07 ; L ALL EXCESS GRADING MATERIAL TO BE EXPORTED TO AN APPROVED DISPOSAL LOCATION. C Tf XOFTIGA 2. ALL FILL AREAS is UNDER GARAGE FLOORS, SIDEWALKS, DRIVEWAYS, ETC... TO BE 20'-0" 34'_8 15/32" / 15 -0" BUR!. i . -' COMPAC GRANULAR FILL. _ 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/ LLI PRIOR TO EXCAVATION AND CONSTRUCTION. 5. PROVIDE COUNTY/CITY APPROVED STABILIZED GRAVELED CONSTRUCTION ENTRANCE �\ X W/ FIRE RATED PLYWD. N89D 29'04 "W 69.63' m '� ^ Z PRIOR TO EXCAVATION AND CONSTRICTION. CONSTRICTION. EE. 0. m' X X X 6. STOCKPILES MUST BE COVERED WITH MULCH OR PLASTIC SHEETING BETWEEN el \ - OCTOBER I AND APRIL 30 • 18'4" 16 `'* T. CONTRACTOR/ SUB- CONTRACTOR TO VERIFY LOCATION OF ALL UTILITIES PRIOR TO V b ...< ..... EXCAVATION AND CONSTRUCTION. 3 1 CAR B S. BOUNDARY AND TOPOGRAPHY INFORMATION 14A5 BEEN PROVIDED TO SKYLINE HOMES iti AND DESIGN INC. SKYLINE HOMES AND DESIGN, RING, WILL NOT BE HELD LIABLE FOR THE LU L3 AL3E H 0 M ES .� ACCURACY CF 11415 INFORMATION, IT IS THE SOLE RESPONSIBILITY CF THE CONTRACTOR O \ PATIO X N /OWNER TO VERIFY ALL 917E CONDITIONS INCLUDING FILL PLACED ON SITE. Q FFE: = 3 Skyline Ho I , 5. TOPOGRAPHY ELEVATIONS WERE COLLECTED FROM ACTUAL SITE SURVEY. Q 6021 SE Milwaukie Ave. to. ELEVATION LEGEND: —'- [ 1 j ' 1 " 2160 SQ. F T. (N �' e Portland. OR 97202 EE• EXISTING GRADE ELEVATION 503.235,3910 FE. FINAL GRADE ELEVATION (3 = 2 J R� 1 3 BD RM. r FFE• FINISHED FLOOR ELEVATION P.Y.G. WATER MAIN U CI wW. neplans.corn MINIMUM PROVIDE A MINIM GRAVEL BASE UNDER ALL DRIVEWAY AREAS. ' 2. BATI -I 0 12. PROVIDE A 4' MINIMIn GRAVEL BASE UNDER ALL SIDEWALK AND PATIO AREAS. GAS S LINE I ,� Q FFE: 1. rJ N. � • 0 ■ 13. P PI O PE ALL c DRAINAGE FROM THE BUILDING TO A COUNTY/CITY DISPOSAL SAN. SEWER LINE ,I' _ A 2 CD 14. MAXIMUM SLOPE OF CUTS AND FILLS TO BE TWO (2) HORIZONTAL TO ONE (I) GAMBRIDC3E I - `— - a- \ N VERTICAL FOR BUILDINGS, STRUCTURES, FOINDATIaNS, AND RETAINING WALLS. 15. PROVIDE AND MAINTAIN FINISH GRADE WITH POSITIVE DRAINAGE AWAY FROM TREE R► X X X X 0 ' n! �-- STRUCTURE 0.1 ALL SIDES WItH A SLOPE OF 6' MINIMUM IN I0' -0'. I' OVERHANG W/ N89D 29'04 "W 69.63' 0 1 CZ EE. 0.0' W/ FIRE RATED PLYWD. EE. 0.0' -- IMPERVIOUS AREA'S: CD Q to -4 al 160 SQ. FT. DRIVEWAYS Z }' 19 SQ. FT. PORCH 8' -1 1/16" I 46' -0" / 15' -0 1/8" / (� O O 32 SQ. FT. WALK � "' 100 PATIO Z 3 150 SQ. FT. OVERHANGS ' 111 `n " 825 SQ. FT. BUILDING COVERAGE —1 N 1— 1-- 1,286 TOTAL SQ. FT. IMPERVIOUS AREAS CO � N LU LOT INFORMATION: LOT AREA 1,880 SQ. FT. M ■ IMPERVIOUS COVERAGE: 1,286 SQ. FT. BUILDING COVERAGE: 61 % PLAN No.: 3052 BUILDING HEIGHT: APPROX---- 3I' -0" EROSION CONTROL PLAN MN. BUILDING SETBACKS: 11.5' FRONT, 15' REAR 3' SIDES. DRAWN T.F. 0 DATE: 8 -6- 2012 COVERED STOCKPILES WOODEN CURB RAMP SCALE I ® II SEDIMENT FENCE Q H CATC BASIN PROTECTION P LAN P L OT , CONSTRUCTION ENTRANCE N.B.: COVER ALL AREAS OF BARE LOT 2 SOIL UNTIL PERMANENT LANDSCAPE IS IN PLACE WHITE OAK VILLAGE 46 7--, WORK STAGING/ MATERIAL STORAGE TIGARD, OR. 0 ?s • 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 11036 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 399 Plumbing final 04/30/2013 00:00 MST2012-00167 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 11036 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 699 Mechanical final 04/30/2013 00:00 MST2012-00167 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 11036 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 399 Plumbing final 04/30/2013 00:00 MST2012-00167 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 11036 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 120 Electrical rough-in 02/21/2013 00:00 MST2012-00167 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 11036 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 199 Electrical final 04/30/2013 00:00 MST2012-00167 PASS Violation Summary: Inspector Contractor Oregon Residential Specialty Code 8318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM I, gg 4/1/0fie0A/ , am the general contractor or the owner- builder at the following address: Site Address: // o34 Cte./ �; � C �/ Qom- i(//4- City: 776" 412 Permit #: /7457--e! — 000l4 7 Subdivision/Lot #: /� / / / �,� J /� 4 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. e Signature: Date: 1 1-'30 —/ 3 eral Contractor or Owner - Builder I:\Building\Forrn\RES- MoistureSensitiveWood.doc 09/25/08 Oregon Residential Specialty Code N1107.2 HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: 2 0 7 Jurisdiction: / ;,_A2 Site Address: 1/0 3,6 51t2 mcy K- (./7,11i Subdivision/Lot #: V /on /) /4 1.4_61 _ 64_, / r_ 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: % ' 3U — / 3 O er /General Contractor /Authorized Agent Print Name: � 4 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 j� 4 5 owner/ agent for /k57 /J o0s7n-tE S 5 (PLEASE PRINT) (PERMIT HOLDER) do hereby certi 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.: 2O /a — 00/67 SI "1 E ADDRESS: ll 03 L a c y 0 SUBDIVISION: 41 rt. 0,4-/L PE' ti---)4 & F LOT #: SIGNATURE: DA 1 E: 6 /-30 - / 3 (OWNER /AGENT) RE CEIVED VERIFIED BY DA'1 E: (CITY OF TIGARD) ❑ Tree location verified per approved site plan. I:\ Building \Forms \StreetTreeCertificate 05/30/2012 • Program Use Only \r; 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: 1/1/13 Verifier Name: preston kuckuck _ Date: 4/30/13 Verifier Name: preston kuckuck Incentive Payee Company Name: Builder or Company: Westland industries Contact Name: Performance Testing Company: Fireside Home Solution Technician Name: Pak Site Information Development Lot Number: REM /Rate SCO Project ID: Name: white oak Fi le #: (required from verifier if 2 project is ENERGY STAR') Site Address11036 legacy oak way City: igar. State OR Zip: Jnattached ❑ Attached Number of Stories: 3 Total Building Square Footage: Number of Bedrooms 3 218:, Basement ❑ None ❑ Full Basement ❑ Half Basement XXJ Crawlspace Type ❑ Garage/basement combo ❑ Slab on grade ❑ Other Electric Provider I] PGE ❑ PAC ❑ Other: Gas Provider j NWN ❑ CNG ❑ Other: Electric Meter Number: Gas Meter Number: 42413041 (must apply to permanent meter) 24323319 (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 ❑ 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 `X 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 \r. Form 640S . 1\ 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 2.1 T Actual Value Equipment Details & Notes . Category Insulation Flat Ceiling R- 49 Insulation Type: bib Framing Type: Vaulted Ceiling R- 38 Insulation Type: Batt - Standard Scissor Truss R- Insulation Type: Intermediate Above Grade Walls R- 1 Insulation Type: bib ❑ Advanced 2 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 Window Frame Material: vinyl SHGC: .30 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 N Yes ❑ No EF Cooling Air Conditioning SEER: No Btu /Hr: Primary Heat lJ Fireplace AFUE: 95.5 Brand: fraser johnston Outdoor Unit (for heat Source Gas Furnace pumps) ❑ Electric ❑Boiler HSPF: Model #: TG9S060A 1 OMP 11 A Model #: [Gas Heat Pumps: SEER: Serial #: W 1 n2352420 ❑ Other: ❑ Air Source (ducted) COP: Btu /Hr: 60,000 Serial #: ❑ Mini Split (ductless) ❑ Ground Source Location: ECM: ❑ Vest' No Heat ❑Radiant Floor Heat �C pump commissioning ❑ Cadets Electronic Air Cl ❑ Yes [No report attached or con 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: Rlnnal ❑ Electric xl Tankless )0 Gas EF: 82 Model #: R1751 Location: Serial #: DK.CA-094875 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 \r. Form 6405 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 l{Yes ❑ No ®}€xhaust & Supply Cycler ❑ Heat Recovery ERV /HRV Model #: Ducts ❑ Ducts Inside % ducts inside: Ducts in Conditioned Space if liming incentives for ducts inside, check one of the following: DIDiucts Tested ❑ Visual Inspection per RTF specs Duct Insulation }RR-- Duct Location U attic 50 cond space Duct Sealing w /Mastic Paste "u - 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. y. Duct Cubic Feet Per Minute Duct Leakage Air Handler In Yes Air Handler Present LJ Yes Leakage: (CFM) @ 50Pa: 97 INVass ❑ Fail Conditioned Space ❑ No During Test ❑ No Fan Pressure ❑ DG3 Fan -235 Ring Type ❑ 0 ❑ 2 Leakage Test Total Leakage _ J{D Gauge LG700 Pressure: (check one) ❑ 1 3 Method ❑ Leakage to Outside Duct Blaster Pressure Tap Location: Bath Area Tested: 2183 Location: Main return Whole House Air Changes per Hour Envelope Tightness Cubic Feet Per Minute Leakage: (ACH) @ 50Pa: 4.9 [Pass ❑ Fail (CFM) @ 50Pa: 1540 House Volume. 1 8750 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 lsj Yes ❑ No - (complete insulation verification section below) • Approved Mechanical Ventilation Installed Yes ❑ No 4 (complete mechanical ventilation section below) • Zonal Pressure Relief — All zones comply Pp 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: Preston Kuckuck Date: 4/30/1 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