Permit 14 CITY OF TIGARD MASTER PERMIT
s COMMUNITY DEVELOPMENT Permit #: MST2013 -00003
T t G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 ' Date Issued: 01/28/2013
Parcel: 2S109DA14400
Jurisdiction: Tigard
Site address: 15211 SW GREENRIDGE PL
Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 63
Project: Arlington Heights, Lot 63
Project Description: New SF. 4/29/13, adding a /c. Placement of a/c must comply with manufacturer's clearance
requirements.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1088 sf Basement: 0 sf Left: 5 Parking Spaces 0
Height: 30 Bathrooms: 3 Second: 1754 sf Garage: 648 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2842 sf Value: $324,723.44 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer 100
Drains: 0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr. 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Drywell -Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Tvoes 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
Fum > =100K: 0
ELECTRICAL
Residential Unit Service Feeder Tema Srvc/Feeders Branch Circuits
1000 sf or less: 1 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0
Ea addl 500 sf: 5 201 -400 amp: 0 201 -400 amp: 0 W/O SvcJFdr: 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 2842
Owner: Contractor:
STONE BRIDGE HOMES NW STONE BRIDGE HOMES NW LLC Required Items and Reports (Conditions)
16869 SW 85TH AVE #505 16869 SW 65TH AVE # 505 1 Ersn Cntrl 503- 639 -4175
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035
PHONE: 503 - 387 -7577 PHONE: 503- 387 -7577
FAX: 503 -387 -7615
Total Fees: $20,649.10
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
dayTiA N: n law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
2- 001 -0010 through OAR 9 - 0. You may obtain a copy of the rules or direct questions to OUNC by , :,ii. 03.232.1987 orr1.800.332.2344.
sued By: Permittee Signe ^
Call 503.639.4175 by 7:00 a.m. for the next available inspection •
This permit card shall be kept in a conspicuous place on the job site until • pletion of the project
Approved plans are required on the job site at the time of each inspection.
. CITY OF TIGARD MASTER PERMIT
p q
1 II COMMUNITY DEVELOPMENT Permit #: MST2013 00003
T 1GARLD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/28/2013
Parcel: 2S109DA14400
Jurisdiction: Tigard
Site address: 15211 SW GREENRIDGE PL
Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 63
Project: Arlington Heights, Lot 63
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1088 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 30 Bathrooms: 3 Second: 1754 sf Garage: 648 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2842 sf Value: $324,723.44 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains. 0
Tubs /Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Drywell- Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
' MECHANICAL
Fuel 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 SrvclFeeders Branch Circuits
1000 sf or less: 1 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0
Ea add, 500 sf: 5 201 -400 amp: 0 201 -400 amp: 0 W/O Svc/Fdr: 0
Mfd Home /Feeder /Svc: 0 401 -600 amp: 0 401 -600 amp: 0
601 -1000 amp: 0 601 +amp- 1000v: 0
1000 +ampNolt: 0
ELECTRICAL - RESTRICTED ENERGY
SF Residential .
Audio & Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Ecompasing: Y
Other: N Other Description: P 9
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R -3 2842
Owner: Contractor:
STONE BRIDGE HOMES NW STONE BRIDGE HOMES NW LLC Required Items and Reports (Conditions)
16869 SW 85TH AVE #505 16869 SW 65TH AVE # 505 1 Ersn Cntrl 503 639 - 4175
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035
PHONE: 503- 387 -7577 PHONE: 503- 387 -7577
FAX: 503 - 387 -7615
Total Fees: $20,596.74
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. A ION: eon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -0 -0010 through OA 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Iss d By: Permittee Signature: y
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept In a conspicuous place on the job site until completion of the project.
Approved plans are required on the Job site at the time of each Inspection.
Building Permit Application
Residential RECEIVED FOR OFFICE USE ONLY
Received l
- City of Tigard JAN 10 2013 Date /By: ( 1 ( $ Permit No cv � 3 _c .
a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review's
Phone: 503.639.4171 Fax: 503.598.1960 �.�+ Date /By: �` l \ 2 J r3 Other Permit _. a 660
T I G A R D Ins Line: 503 c l 1 OF TIGARD Date R eady / By: c / 0 See Page 2 for
Internet: www.tigard - or.gov BUILDING DIVISION Notified/Method: (_ Ea ( u i Supplemental Information
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
® New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
❑ Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® I- and 2- family dwelling ❑ Commercial /industrial Valuation�j�3,4,�$ 2,179
❑ Accessory building ❑ Multi- family Number
of bedrooms: S
❑ Master builder ❑ Other: Number of bathrooms: 2.s
JOB SITE INFORMATION AND LOCATION Total number of floors: 2.
Job site address: 167.41 ' W £'i i.1 D(t PL. New dwelling area: 3,012 square feet
City /State /ZIP: Tigard, OR 97223 Garage /carport area: 040 square feet
Suite/bldg. /apt. no.: Project name: Arlington Heights Covered porch area: 1 square feet' wak
Cross street/directions to job site: Deck area: ----- square feet 1i3
Other structure area: Atk96 square feet
REQUIRED DATA: COMMERCIAL - USE CHECKLIST
Subdivision: Arlington Heights I Lot no.: (3 Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
New, Single Family Residential Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: Stone Bridge Homes Type of construction:
Address: 4230 Galewood St, Suite 100 Occupancy groups:
City /State /ZIP: Lake Oswego, OR 97035 Existing:
Phone: (503)387 -7577 Fax: (503)387 -7616
New: (V `/l
q2 <3
❑ APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: SEE ABOVE All contractors and subcontractors are required to be
Contact name: Deirdre Britt licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City /State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax:: ( )
E -mail: dbritt @stonebridgehomesnw.com
CONTRACTOR
Business name: SEE ABOVE BUILDING PERMIT FEES*
Address:
(Please refer to fee schedule)
City /State /ZIP: Structural plan review fee (or deposit):
Phone: ( ) Fax: ( ) FLS plan review fee (if applicable):
CCB tic.: 173318 Total fees due upon application:
Amount received:
Authorized signature O This permit application expires if a permit is not obtained
i � Q within 180 days after it has been accepted as complete.
Print name: f �� F3Rr[T Date: ! • 10.13 * Fee methodology set by Tri- County Building Industry
Service Board.
I: \Building \Permits \BUP -RES PermitApp.doc 10/01/09 440 - 4613T(I I /02 /COM /WEB)
Plumbing Permit Application REC
Building Fixtures OFFICE USE ONLY
, ,�
1 0 20 Received / u
City of Tigard Date/By: 1 I � t ) 1 3 ` Permit No.: 14� i ' .e0. -- 000(223
q 13125 SW Hall Blvd., Tigard, OR 97223 ern OF n� Plan Review
Phone: 503.639.4171 Fax: 503.598. 19t�(f�� n� Di teBy: Other Permit No (L � ( C 3
Inspection Line: 503.639.4175 '" `�� I V i Q to Ready/By: 1 s ®See Pe 2 for
TI G A R D and - or. ov / t;
g g Notified/Method: J Supplemental Information
Internet: www.ti
TYPE OF WORK FEE* SCHEDULE
® New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 312.70
® 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 437.78
building SFR (3) bath ‘ 500.32
❑ Accessory g ❑ Multi - family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: , 5 sW �It jVN ✓b vE p„ Catch basin or area drain 18.76
City/State /ZIP: Tigard, OR 97223 Drywell, leach line, or trench drain 18.76
Footing drain (no. linear ft.: _) Page 2
Suite/bldg. /apt. no.: I Project name: Arlington Heights Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Water service (no. linear ft.: _) Page 2
Subdivision: Arlington Heights I Lot no.: Co3 Fixture or item:
Tax map /parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
New, Single Family Residential Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: Stone Bridge Homes Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 4230 Galewood Street, Suite 100
Garbage disposal 25.02
City/State /ZIP: Lake Oswego, OR 97035 Hose bib 25.02
Phone: (503)387 - 7577 Fax: (503)387 - 7615 Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
Business name: SEE ABOVE Medical gas (value: $ ) Page 2
Primer 12.51
Contact name: Deirdre Britt Roof drain (commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State /ZIP: Solar units (potable water) 62.54
Phone: ( ) Fax: : ( ) Tub /shower /shower pan 12.51
E -mail: dbritt @stonebridgehomesnw.com Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name: Max Plumbing Water P� tP in g/D WV 56.29
Address: p0 Box 5597 Other: 25.02
City/State /ZIP: Beaverton, OR Subtotal
Phone: (971)275 -0198 Fax: ( ) Minimum permit fee: $72.50
CCB Lic.: 194644 Plumbing Lic. no.: PB1083 Plan review (25 % of permit fee)
State surcharge (12% of permit fee)
Authorized signature: t. r -7 c in---- 4 . / ,. "' ��,/L�* .. TOTAL PERMIT FEE
Print name: � Date: This permit application expires if a permit is not obtained within 180 days
Jason rner after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
(:\Building \ Permits \PLMU - PermitApp.doc 10 /01/09 440- 4616T(10/02 /COM/WEB)
Mechanical Permit Applicatio FOR OFFICE USE ONLY
City of Tigard � L Date/By: l (I) I t Permit No.: S i ( 3 -0000_3
V 13125 SW Hall Blvd., Tigard, OR 97223 1 g
Phone: 503.639.4171 Fax: 503.598.1960 JAN 1 0 2013 Plan Review
Pla R y. R Other Permi let 3 �caa)3
�(�
TI G A R D Inspection Line: 503.639.4175 Date Ready /By: Juris: Elf See Page 2 for
Internet: www.tigard- or.gov CITY OFTIGARD Notified/Method: -314 Supplemental Information
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
® Mechanical permit fees* are based on the value of the work
New construction ❑ Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
I S 2 1 SW 6m7 124p* R. Air conditioning
Job site address: L . W
(requires site plan showing placement) 46.75
City/State /ZIP: Tigard, OR Furnace 100,000 BTU (ducts/vents) 46.75
Furnace 100,000+ BTU ( ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: Arlington Heights Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Arlington Heights Lot no.: (p9 Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace 33.39
New, Single Family Residential 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 Chimney /liner /fue/vent 23.32
❑ TENANT Other: 23.32
Name: Stone Bridge Homes NW, LLC Environmental exhaust and ventilation
Address: 16869 SW 65 Avenue #505 Range hood/other kitchen
equipment 33.39
City/State /ZIP: Lake Oswego, OR 97035 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (503)387 -7577 Fax: (503)387 -7616 toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name: same as above
Fuel piping
Contact name: Deirdre Britt $14.15 for first four; $4.03 for each additional
Address: Furnace, etc.
Gas heat pump
City/State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace
E -mail: dbritt @stonebridgehomesnw.com Range
CONTRACTOR Barbecue
Business name: Comfort Zone Clothes dryer (gas)
Other:
Address: 1032 NW Corporate Drive MECHANICAL PERMIT FEES*
City/State /ZIP: Troutdale, OR 97060 Subtotal
Phone: (503) 667 -5595 Fax: (503) 491 -8252 Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: 110091 State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: David Heldstab I Date: * Fee methodology set by Tri- County Building Industry Service Board
1:\ Building\Permits\MEC- PermitApp.doc 10/01/09 440 -4617T (I I /02/COM/WEB)
e
Electrical Permit Application
City of Tigard JAN 10201 etelvd i
Date/By: i v 1 c-f' ?ermitNo.:Mg, r)0r vix,�3
-
. q 13175 SW Ball Blvd, Tigard,OR 97223 • an Review
Phone 503.718.2439 Fax: 503.598.196CITY of TIG . a j;r, ,•Bv: Other Piermit , , j 3 - a )3
T I G .1 D Inspection Line: 503.639.4175 Reely/By; No'
Intranet: www.tignrd•nr.gor BUILDING DNISI V I( i s op en o i ofcrwstinu
� TYPE OF WORK PLAN IRRVTRW • - .
E Kew constuetion ❑ Addition /alreratiumireplacement Please chemk all Oat apply (submit 3 sets eel= wfdemscbuckedbelow):
❑ Service or feeds 400 amps or mom ❑ Baldins ever three series.
❑ Demolition ❑ Other: -where de evafable toalt eumenl ❑ fames an boatyanln.
CA.TS.GORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Fleming bioldinp.
I. to pound, or exceeds 14,000 ❑ r •. mm "l - ust agtie utbual
1 - and 2- family dwelling ❑ Cotnmcrcinllindustriol ❑ Accessory building amp; for a0 other installations. boidinas.
❑ Multi - family ❑ Mester builder ❑ Other. MitE Paatp• ❑ lo_Rafaticnnof75 KVA Or
' ❑Emergency larger sensately derivedsysWm.
JOB SITE INFORMATION' AND LOCATION ❑Addition of new motor load Of ❑ "4" "F "1 - -13';
lob no.: J 4 Job she address: 15211 S W rMh O p E+ 1 lt or armem. oewpzxy.
❑bin ar mare residential ettics ❑ 11eaut:mu!vabidcpar?s.
Ciryi'Stato/ZIP: ❑Tenllh- core faeiltia . ❑Slippiy unhinge for more then
_ Mau:edam Imali e�
n u. 400 volts al
Suitt/bldg./apt. no: Afit Project name: l�tl�lb - To N - ❑ Service or ceeder amps or tore.
FEE SCHEDULE
Cross strtetldireclions to job site: ate ti n
�P � f Qer I fV e. Ts • .
New residential single- or multi - family dweuing twit.
Tubules attached garage.
Subdivision: Lot no.: US 1,000 sq. ft orless 1 168.54 4
a. Tax map/parcel no.: . no i d 1 500 sq. IL or portion .5 3352 I
Limited energ, rrmdcntistl 1 75.00 2
DESCRIPTION OF WORK (with above sq. IL)
Limited enetpy, multi -frrrly 75.00 2
residential (with above sq. It.l
Services or feedersiostallatiot alteration, andlorrelowltan
200 amps or less I 100.10 2
)a PROPERTY OWNER I ��/ 0 TENANT 701 amps to 400amps I 13156 2
` Name: S ioW C* flOM 4 1`eP ej Ic- 40! ampsta600 amps 200.31., .2
1 i 601
• �� 601 amps to 1,000 amps 301.00 2
i Address: 4 0 &AtE ODD Si JU Ile
t - 11 00 i Ovc 1,000 amps or volts , 55226 2
Temporary City/Statc1ZIP: Lg./e o�w t o) 012-91035 relocation services or feeders iostouatlot� alteration, and/or
Phone: (J i i X5-1-1 I Fax: ( ) 200 amps or lea 59.26 I I
j 201 empsto amps 12500
, 21
i Owner Installation: This installation is being made on property that I own Which is not ase, 401 amps to 599 turps 16854 • j 2
intended for sale, le rent, or exchange, according to ORS 447, 449, 670, and '101.
Branch circuits - new. alteraliea, or extension, per panel
Owner signature: Date A. Ter for branch circuits svfth
i ❑ APPLICANT I . ErcONTACT PERSO-V above service or fcede fee, 7.42 2
e each branch circuit
BuSineSs name: 7A „1e t 6 E. B. Fee for bran; h circuit; withoutt n attvlee or feeder fcc, lust 56.1 B 2
Contact name: Vel R. tp2,0
� cranch circuit
v E cltald'lbrancteirah 7.42 2
1 Address: Misccll'rneons (service or feeder aul included) •
Erchimmufactured City/Slate/ZIP: dwelling, smvim art i ar feudler 67.84 2
Phone: ( ) . Fax: : ( ) Reconnect only 67.14 2 1
E-mail: " :j3:.. L its 1( ;3',16._ ■ 0 1•j I -7 l ifil ♦ P ump or irrigation circle 67.&I 2
S outline lighting 67.84 2
CONTRACTOR Sigeml circuit(s) or limitd 0ergy
SttxiacSSname e- rend, alteration, or =tendon. I -
Pnt o2 2
�-y Cs�t 1 V� vf j �L Each additional inspecloo over allowable inaay
J Addrcss:16q 3 56 -3 1 v'lYL AdditiottI lrspiriiun(lhfmin) 66_25ibr
I City /State/ZiP'O4,GSc(,LS oft / 7O lavesb'atlln (i )lr min) 667.5/ ht•
industrial plant (1 hr min) 75.181 hr
Phone: 3�= f fV , Fax: ( ) vAf j Inspections rut which no Tx is
i epecifieally listed (Vuhetnia) SO.00iIu i
CCB Lic.eieli Z, electrical Lic L Suprv. l.ic ` jZ2i s ELECTRICAL PERMIT FEES
Shpts. Electrician signature, required: �i�./L_ Subtotal
reui c)
- 2'� Pion review ('1595 of permit fee):
Print name Date: State surcharge (12% of permit fear
TOTAL PERMIT FEE e
Authorized. signature This pmt ap plicatan expires An permit is ant obtained within 180
Print name I Date- a days after suns berm =tensed us complete.. Number of innxotiom allowed per panic
I:uicil&FeamlIHLCRcaaitApp.dac 0/lntin v9WSL"ICt Va:ltUtrliWPb
, . +
1 Building Division
Development Code Provision Review
T I G A R D Residential Projects
Building Permit No.: WI S I 1 3_ ( )O3
Site Address: 1 Sa 1 4-1-4 �ei/
L 1�GL� ILL
Project Name & Lot No.: l (y r D N l4VrS, C.dr 4k3
CWS Service Provider Letter
Required: Yes ❑ No I7'
Received: Yes ❑ No ❑
Routed Plans: /
Original Plan Submittal Date: / // if 3 sir-
1st Revision Submittal Date: If'; -1 i 3 c- ❑ Site Plan Only
2nd Revision Submittal Date: ❑ Site Plan Only
To the Applicant:
Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies to the
Building Division. Only checked (1) 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 i approved. YVb / 4 '� ��,�
Planning Review (contact Pl.�r at 503 -7182 7 7 b or — @tigard- or.gov)
Land Use Case No. 7ff/2,4D 4 r / ///
Zoning R —
13r Setbacks:
/Front f' t 7 Rear / t 7 Side 5 Street Side / 0 Garage 2d
CO Maximum Building Height: `� Actual Building Height
Cr Visual Clearance
Er Easements
❑ Sensitive Lands Type:
❑ Street Trees
Protected Trees
�� ,f� / (/0/ / / , n' Notes: / � /� i ,194/€ �` / �l-�.% / y Q- 7Z L41 G �7 (/ � / lid-)
Original Plan: Approved ❑ Not Approved Date: 1 1 (' /
Revision 1: Approved Not Approved ❑ Date: �r — /3 - 01
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @tigard - or.gov)
- E A Slope: I k
Notes:
Original Plan: Approved Not Approved ❑ Date: I l ' X-
Revision 1: Approved-a Not Approved ❑ Date: �C�i7 ..
Revision 2: Approved ❑ Not Approved ❑ Date:
Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert @tigard - or.gov)
❑ Conditions of Approval Prior to Issuance of Building Permit
Notes :
Original Plan: Date Sent to Applicant:
Revision 1: Date Sent to Applicant
Revision 2: Date Sent to Applicant
Okay to Issue Permit: Yes No r3 /// •`-///' /•`-///' "
Date Routed to Building:
/
Page 2 of 2
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
15211 SW GREENRIDGE PL, TIGARD, OR,
97224
Residential - Master Permit
275 Framing
03/18/2013 00:00
MST2013-00003
FAIL
Framing okay but need sprinkler Ruffin approval
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
15211 SW GREENRIDGE PL, TIGARD, OR,
97224
Residential - Master Permit
240 Exterior sheathing
03/06/2013 00:00
MST2013-00003
FAIL
Nailing on "D" walls need to be 2" on edge
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
15211 SW GREENRIDGE PL, TIGARD, OR,
97224
Residential - Master Permit
299 Final inspection
04/29/2013 00:00
MST2013-00003
PASS - C of O
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
15211 SW GREENRIDGE PL, TIGARD, OR,
97224
Residential - Master Permit
242 Interior shear walls
03/06/2013 00:00
MST2013-00003
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
15211 SW GREENRIDGE PL, TIGARD, OR,
97224
Residential - Master Permit
280 Insulation
03/18/2013 00:00
MST2013-00003
FAIL
Insulation okay but need framing and sprinkler Ruffin approval
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
15211 SW GREENRIDGE PL, TIGARD, OR,
97224
Residential - Master Permit
199 Electrical final
04/29/2013 00:00
MST2013-00003
PASS
Herb's corrections completed
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
15211 SW GREENRIDGE PL, TIGARD, OR,
97224
Residential - Master Permit
280 Insulation
03/18/2013 00:00
MST2013-00003
FAIL
Insulation okay but need framing and sprinkler Ruffin approval
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
15211 SW GREENRIDGE PL, TIGARD, OR,
97224
Residential - Master Permit
699 Mechanical final
04/29/2013 00:00
MST2013-00003
PASS
Violation Summary:
Inspector Contractor