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Permit IN a CITY OF TIGARD MASTER PERMIT Is . COMMUNITY DEVELOPMENT Permit #: MST2012 00154 Date Issued: 02/14/2013 T[G 13125 SW Hall Blvd.. Tigard OR 97223 503.718.2439 Parcel: 1S136CA10400 Jurisdiction: TIGARD Site address: 11068 SW LEGACY OAK WAY Subdivision: WHITE OAK VILLAGE Lot: 25 Project: White Oak Village, Lot 25 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: 11.5 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 Tubs /Showers: 2 Garbage Disp: 1 Water Heaters' 1 Water Lines: 100 Drains: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib' 2 Backwater Value: 1 Other Fixtures: 0 Drywell- Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump. N Hoods: 1 Other Units: 0 Furn <100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add'I 500 sf: 3 201 -400 amp: 0 201 -400 amp: 0 W/O Svc/Fdr: 0 Mfd Home /Feeder /Svc: 0 401 -600 amp: 0 401 -600 amp: 0 601 -1000 amp: 0 601 +amp- 1000v: 0 1000 +amp /volt: 0 ELECTRICAL - RESTRICTED ENERGY SF Residential Audio & Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R -3 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: $17,645.81 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all of = - • • ' -ble 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 w• is suspe •ed for more the 180 1p days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notifica Center. T. •se rules - e set forth in OAR 952- 001 -0010 through OAR , t5 -001 -0 r 0. You may obtain a copy of the rules or direct questions to OUNC by calling i 00.332.234.. Issued By: AiLLt - , Permittee Signature: - .�a i Call 503.639.4175 by 7:00 a.m. for the next available inspectio d . • 6' This permit card shall be kept in a conspicuous place on the job site until co.. • etion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application Residential prn ope. FOR OFFICE USE ONLY p - _ 7 ' , t ` Received / gb . _ . City of Tigard 5� . w — e .. ' 1 � Date /By: Permit No.: °ai g 13125 SW Hall Blvd., Tigard, OR 97223 J� Plan Revie� Other Permit: � • Phone: 503.718.2439 Fax: 503.598.1960 N 2 8 2012 Date /By: / Ins ection Line: 503.639.4175 Date Ready /By: Juris: ® See Page 2 for TIGARD p /T' '^ Supplemental Information Internet: www.tigard or.gov di . w O . - ; - Notifie. Method: E I � t',; e' il 7� i /; i , to „9,7;. am L -al TYPE OF WORK ..r °II/0GN REQUIRED DATA: 1- AND 2- FAMILY DWELLING Demolition Permit fees* are based on the value of the work performed. Iew construction ❑ Demol Indicate the value (rounded to the nearest dollar) of all ❑ Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the work indicated on this application. CATEGORY OF CONSTRUCTION / „ J / Valuation: $ eoei .- A- []/ I- and 2= family dwelling ❑ Commercial /industrial Number of bedrooms: ❑ Accessory building ❑ Multi - family r) Number of bathrooms: C�` : tj ❑ Master builder ❑ Other: ^ JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: f pi y Q,dr. New dwelling area: ar 01 square feet City/State /ZIP: 176.04 &g. I ' 7 233 Garage /carport area: / square feet 473 Suite/bldg. /apt. no.: Project name: (// 1 /7 (f `//c G/�' '- Covered porch area: square feet ? ( 7 Cross street/directions to job site: Deck area: square feet % o Other structure area: 23v35 square feet REQUIRED DATA: COMMERCIAL - USE CHECKLIST Subdivision: /a f rr6 a. ' , 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.: /S / 3b cA/o yoz equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. -. 5 ()VI/ W All, Valuation: $ lo/lyi M- -.016-1 � — Existing building area: square feet r 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: Dig APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* (Please refer in fee schedule) Business name: % / 97 /, _Iil/)r/iT,a /E 5 (/tt. A Structural plan review fee (or deposit): Contact name: /20/5 i / .7//`7 J/ /� , e/�� I FLS plan review fee (if applicable): Address: /), 7 i 50 �j�j'-` Xir� ¼52' 1 Z n Total fees due upon application: City/State /ZIP: 61:1 , � 9 7 - Z3 ` / Amount received: Phone: (SD3 S7} -6-71/6 I Fax:: o3) 6 - 9,Oter y� PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E -mail: ` -✓ -/ ra6G a /� CONTRACTOR i con/ Commercial and residential prescriptive installation of C ( CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System. Business name: (WC 1, \t, ...V(.( ) 3)\/C- Submit two (2) sets of roof plan with connection details and fire department access, along with the 2010 Oregon Address: I 70 c &,e t4 Solar Installation Specialty Code checklist. CJ Permit Fee (includes plan review $180.00 City/State /ZIP�� t^ y� �77i7i and administrative fees): Phone: ) ,/ (� (99 I Fax: (� ' q _ State surcharge (12% of permit fee): $21.60 CCB lie Q Total fee due upon application: $201.60 -- Authorizes • _ - 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 -t nan ��, • ip /‘ (qi Date: . < Service Board. \J: \Building\Penni. \BUP-RESPerrnitApp.doc 02/24/201 I 440- 46I3T(I I /02 /COM /WEB) . • • w ii ,i;r Plu nibing Permit Application Building hixtures a"; FOR oFF•lCr USE ONLY i gr /O ' � Iteceived City of Tigard �'�. ; �.'"'� '� Z.,. F . 1 �� Lt s2� a- (,�j Permit No.: C: a Phone: 03.7 81h 9' Tigard ' U3s98 � 2 8 2012 a eR' Other Permit No. v eao/ i /jf Inspection Line: 503.639.4175 r %• , �1 _ g� rye 1 See Page a for T I G R D Internet www.tigard - gov a l . " J r-- F. ''1 r Natified/Method: Supplemental Iuformatian TYPE too W t • j t; .... . S i i >E ew construction ❑Demolition For special informed= 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) CATEGARII • 01?' .CO NSYRUCTION SFR (1) bath P 312.70 • 2- family dwelling 0 Commercial/Industrial SFR (2) bath 437.78 SFR (3) bath (I 500.32 ❑ Accessory building ❑ Multi-family Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler L_ sq. ft) Page 2 JOB SITE•• ][NFOI ITIO1�F. ANb LOCAT*f N . Site utilities: 10 f g r� ( � l Catch basin or area drain 18.76 Job site address b /toy Drywall, leach line, or trench drain 18.76 City/State/ZIP: i X E r q ,, } ~, ! p Footing drain (no. linear R: _, Page 2 Suite/bldg./apt no.: Project nam (N `/ ,4 ManufacUued home utilities 50.03 Cross street/diredions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer (no. linear ft: _) I Page 2 Storm sewer (no. linear ft: ___) r Page 2 Water service (no. linear ft.: 1 I Page 2 Subdivision: 11 40- i, , 1) / ' Lot no .: ( Fixture or item: Tax map /parcel no.: / / 71 C -' 0 -96_6 _ Backflo _ Backflow preventer 3127 Backwater valve 12.51 DESCRIPTION of WORK 1 Q� y' �f / Clothes washer J 25.02 a ka /^'�// ii )e-216 �G / ` Dishwasher I ( 25.02 Drinking fountain 25.02 . Ejectors/sump 25.02 ❑ PROPERTY OWNER I 0 TENANT Expansion tank 12.51 ... Fixture/sewer cap 25.02 Name: Floor drain/floor sink/hub 25.02 Address: Garbage disposal j 25.02 City/State/ZIP: Hose bib 2.--- 25.02 Phone: ( ) Fax: ( ) Ice maker I. 12.51 L1d4PPLICANT ❑ "CONTACT PERSON Interceptor /grease trap 25.02 Business name: � t r7 . ` ' .109.0.A.6"7 Mt Medical gas (value: $ ) Page 2 Primer 12.51 Contact name: ,W_,r, / �� � � ; 12.51 / Roof drain (commercial ) Address: i v Vi f ` r, Sink/basin/lavatory 25.02 City/State/ZIP: -7 ,-) D Q-7 Solar units (potable water) 62.54 Phone: ((IN -?gYI - n6 ,Zit, Fax:: ( , �'91g / Tub/shower /shower pan 12.51 /� Urinal 25.02 E-mail: - _ A, S 11 j , ( Water closet 25.02 CONTRACTOR Water heater I 37.52 �Ul/ / t� Business name: 1 e ) ( FY C. Water piping/DW V 56.29 Address: - p Other. 25.02 City/State/ZIP: ab 4/740 Subtotal Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Plan review (25% of permit fee) CCB Lic.: Pltmtbing Lic. no.: 7 - S State surcharge (12% of permit fee) Authorized signature: TOTAL PERMIT FEE • ,�` Q Print nam (-(,l un► f Date /. r �� v This permit application expires if a permit is not obtained within 180 days r - TM t . I IG after it has been accepted as complete. "Fee methodology set by Tri- County Building Industry Service Board. I:tBuilding1Pe mitslpl.MU- PennitApp.doc 10/01/09 440 -4616T(10 /02/COM/WEB) waV - Mtchanical Permit Application P '°"�,�•i FOR OFFICE USE ONLY Y _ � :� � c - wed City of Tigard - . t ,; ;y . , l`! Permit N°.: �l / /0/a 13125 SW Hall Blvd., Tigard, OR 97223 Review Other Permit: 1 ° s JUN O 2 k Jot, ' Phone: 503.718.2439 Fax: 503.598.1960 2 U Date/By: r. � T I G A R D . Inspection Line: 503.639 Date Ready/By: runs: El See Page 2 for Internet: wWw. tigard- or.gov t F sl 0C"76' �� Notified/Method: Supplemental Information TYPE OF WORK -• s tF"vh j COMMERCIAL FEE* SCHEDULE - I/SE'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* • land 2- family dwelling ❑ C ❑ 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: ` ^ • • Air conditioning Job site address: // g 54 & /_f 7 l t/ j 1 if/ (requires site plan showing placement) 46.75 ii�� f `r' `^'� Furnace 100,000 BTU ( ducts/vents) 46.75 City/State /ZIP: l l OA 1 L Furnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg. /apt. no.: Project name: Cl / 1 t((s� Heat pump v „ (requires site plan showing placement) 61.06 Cross street/directions to job site: j i. 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 A` Flue /vent for any of above 23.32 Subdivision: (/ V �j 66.y ( Lot no.: �- ( Other: 23.32 Tax map /parcel no.: I 5 i3(,, C A ( t i y Other fuel appliances: DESCRIPTION OF WORK Water heater ( 23.32 Gas fireplace i 33.39 ez /� - _ r gal f ti E Flue vent for water heater or gas fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace /insert 23.32 Chimney /liner /flue /vent 23.32 ❑ PROPERTY OWNER . ❑ TENANT 23.32 Other: Name: Environmental exhaust and ventilation: Address: Range hood/other kitchen equipment • 33.39 City/State /ZIP: Clothes dryer exhaust I 33.39 Single -duct exhaust (bathrooms, • Phone: ( ) Fax: ( ) toilet compartments, utility rooms) "T 23.32 APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans ((( 23.32 Other: 23.32 Business name: (, �[�� � i � , � • Fuel piping: '1 J� Ylt 1 1 1• "' Contact name)y I \� 1 � $14.15 for first four; $4.03 for each additional l Address: �r j lj; - i n - 1 D "_ � � b 41 c/_Ot Furnace, etc. Gas heat pump 3 r City/State /ZIP: 1 ( 9 Wall /suspended/unit heater Phone: )S19.-011 b 100 : ( r4 ST, • q()? ( Water heater I Fireplace I E -mail: • 0f j fl+ u (h - Ins A - , a o . M Range I CONTRACTOR Barbecue Business name: $ f Clothes dryer (gas) nn Other: Address: 1 • 6. 1 `7 7 11 MECHANICAL PERMIT FEES* City/State /ZIP: � / '?7 5 Subtotal �� mit fee Minimum permit ($90.00) Phone: ( ' ✓' S' '57( Fax: ( ) Plan review (25% of permit fee) CCB lic.: 1 ' i ,, 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: ' 1 n ( o (j ( I Date:'b') . ( * Fee methodology set by Tri -County Building Industry Service Board I:\ Building\ Permits\M . PermitApp.doc 09/09/10 440 -4617T (I 1 /02/COM/WEB) 0.Oi Zs '. Electrical Permit Applicaop ^',' :..".• FOR OFFICE USE ONLY g �� : q ' t.. Received C fig of Ti / PermitNo.: 1/512 /S`'S and - i -" ° 13125 SW Hall Blvd., Tigard, OR 9'J2, i q Plan Review Other Permit Qp 3V 1 Phone: 503.718.2439 Fax: 503.5 )602 S 2012 Date/By: ���� /�' T.I. GAR. Ll Ins Line: 503.639.4175 Date Ready/By: Jurix H See Page 2 for Internet www.tigard-or.gov > "#.- Notified/Method: Supplemental Information /f, r: y 9 P l • . • TYPE ' ; . PAN REVjEV{S.'.:: :., i. ; ` r, so )�t sets of w/items construction ❑ Addition/alteration/replace Please check feeder that apply ( below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION . • exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural and 2- family dwelling ❑ Commercialrmdusttial ❑ 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 AN1 LOCATION ❑Addition of new motor load of ❑ "A ", "E ", "1 - ", "1 - ", 10011P or mare. occupancy. Job no.: • Job site address:rabg ) L ea/ icy Ow ❑ six or more residential units. ❑ Recreational vehicle parka. City/ State/ZIP: r I J ❑ Health -care facilities. ❑ Supply voltage for more than I (1 �l ! i ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt no.: Project name: p (9,4, M 6 f ❑ Service or feeder 600 amps or more. FEE SCHDULE Cross street/directions to job site: Description I our. I Fee. I Total I • New residential single- or multi-family dwelling unit Includes attached garage. Subdivision: Wil-trc D,q Ui - Lot no.: a S 1,000 sq. ft or less i 168.54 4 Ea. add' l 500 sq. ft or portion ?j 33.92 1 Tax map /parcel no.: Limited energy, residential t 75.00 2 DESCRIPTION OF WORK (with above sq. ft) /} Ais Limited energy, multi - family 75.00 2 fJ / . 77, �G� �/ / 1/ 4 I 5 41 residential (with above sq. ft.) C l iw �i /� ! t� 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 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 br>mch circuits with J above service or feeder fee, 7.42 2 ,L�J APPLICANT I ❑CONTACT PERSON each branch circuit Business name: i/j “ 7 - C a �A/QU57`✓�/� 5 B Fee for branch circuits without service or feeder fee, first 56.18 2 Contact name: / o / 1N®E/40,.> /y,, pi branch circuit Each add'1 branch circuit 7.42 2 Address: 0 - 6 10 5e0 60_ 4-6 5a i 7�� Miscellaneous (service or feeder not included) Each manufactured or modular 67.84 2 City/State/ZIP: 40 / ©� 172,33 dwelling, service and/or feeder Phone: S7 I TL Fax: : ).5 _07 (4 ) 5? '- 10 g / Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E -mail: • Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited -energy • �c` panel, alteration, or extension. Page 2 2 Business name: GL g. /ce / ,t/A49(/J s Each additional inspection over allowable in any of the above Address: 6 g3 56. 23, // Additional inspection (1 hr min) 66.25/ hr Investigation (I hr min) 6625/ In City /State/ZIP: 0 C6/5 • ' 9 L 97c 1 Industrial plant (1 hr min) 78.18 / hr • Phone: 963) 35 - 6 ggee Fax: ('7'7) 1 i b- 0`18o Inspections for which no fee is 90.00 / hr specifically listed (16 hr min) CCB Lic.: 6 6i/ ( Electrical Lic.: .d..).. 497 Suprv. Lic.' j, ELECTRICAL PERMIT FEES Subtotal: Suprv. Electrician signature, required: Plan review (25% of permit fee): Print name: / ft, � �` Date: - . 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: • Number of inspections allowed per permit. I:\ BuildingWermi ,stELC- PermitApp.doc 07/01 /10 440- 4615T(11 /05 /COM/WEB eile_kT-46 Oet.A_ kil I IIIII e Building Division Development Code Provision Review T I G A R D Residential Projects Building Permit No: H 5 I (.9DI a - UD 1 5 CWS Service Provider Letter Received: Yes ❑ No ❑ N/A L Routed Plans: Original Plan Submittal Date: 6 a t '/.2 1st Revision Submittal Date: 7 t ' Y ❑ Site Plan Only 2nd Revision Submittal Date: ; Y )7rSite 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 ' »i � �`' at 503 - 718 - or Cc @ tigard- or.gov) Land Use Case No. ` ` ?C& - ° t. '/C Name 1j4-. C'4 V, i / il- .e Er Zoning IZ' 1 aD Setbacks: Front ie Rear 4 - 3 Side 2 Street Side Y Garage Z.e _ .0" Maximum Building Height ,}S Actual Building Height ?CI .,Er Visual Clearance .l Easements ❑ Sensitive Lands Type: 1' Notes: Original Plan: Approved" Not Approved ❑ Date: 7 - 2 51 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) -Pr Actual Slope: S Notes: Original Plan: Approved ,Er Not Approved ❑ Date: Z (2- C 1Z Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 1; 4 City borist Review (contact Todd Prager at 503 - 718 -2700 or todd @ tigard - or.gov) treet Trees Proteced Trees / Notes: '/r l it •spe » G—.5 /o lrh i rJ to ye cvfrs S h--?- L.,/ �c 4-p� dad Y:R.t pl., fir 1 ft, SA1/ ),n /20,9. 75 s / /Ala s �„,.� s � l • Original Plan: Approved Ct ❑ Not Approved / Date: - 7-2‘ . - /a. Revision 1: Approved 11�' Not Approved ❑ Date: 4 'S < 'l L 1 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 - ant Okay to Issue Permit: Ye o K /�7;;------ Date Routed to Building: r ' r 1 Page 2 of 2 l _ B uilding Division Development Code Provision Review TIGARD Residential Projects Building Permit No.: H67 1" a - De/ 5 T Site Address: 0 0 a U) Fes= , � - �- Project Name & Lot No.: Why r� : _ .fit 4 CWS Service Provider Letter Required: Yes ❑ No Received: Yes ❑ No / Routed Plans: 1 /J {6" Original Plan Submittal Date: 1st Revision Submittal Date: ❑ Site Plan Only 2nd Revision Submittal Date: ❑ Site Plan Only To the Applicant: Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies to the Building Division. Only checked (✓) items are approved. Items not approved and those listed in the notes must be revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed above each section. Staff: please check items along left only if approved. i Planning Review (contact �L�tL., at 503 -718- ; 3 or n @tigard- or.gov) Land Use Case No. 0 6 00O /a Y Zoning ' " IZ �►M Setbacks: 4 , r / i Front 1 t ' Rear 13 Sid Street Side Garae Lb .....13 Building Height: 3 S ' Actual Building Height 3/ _El Visual Clearance Easements J Sensitive Lands Type: f Street Trees Protected Trees Or Notes: Original Plan: Approved Not Approved ❑ Date: I - 7-13 Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) • Page 1 of 2 F Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @tigard - or.gov) j Actual Slope: Notes: Original Plan: Approved Not Approved ❑, Date: / / / t 3 Revision 1: Approved ❑ Not Approved .0 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 Appli nt Okay to Issue Permit: Yes No ❑ Date Routed to Building: /,. / 5 /, 5 Page 2 of 2 1' �/ C:I / ��t —�II °Tti/I —�It ��III M r �:�a, jNO 1 ill - / tl i , y a �[D {� I a A�AR.� ; 2 S � ,; OF rl F.U.E. 4 , r � F "" , oatxD;s t A E E. 0.0' ! c E.E. 0.0' 14 G Q1ViSIpb P.S.Q. - _ ��--' WATER _ 45' • , ' � \ ;� - - - - GABLE - -! �� i �. 3a, MU 9na AvE �xARACaE I Pcianra,o, OR 912 Si , 0,3 � � I �i 219 SGY FTi P CAS =- 1 X \ / _ — 1c» j O .9 (563) 625331, P 1. il CONC. i / \ 1 _ -- I� "� ' i I 1 i I - l aJ3) 313132 F = u w maticateuart ccm 1 2.P BAT p H C s ---- -- '- . - t �, BBD. RI. — i '' -a v - g I I U 2109 SCE. 1=T I'� ",n; `:�«:. =Q � 1 PLAN WI-11 T E OAK � : �' ` �V I '1-1 K - � r ' /ILLAC.E LOT *25 X v T < <:< CN, C.,...) .. f-----\ •■• t, ..R., k' i �\ 40' a r P 6 7_, 1 �`'' ∎ Lk I SIDE _ .=. 0.0' C _ I s r _ in _ k Hcre Pans CC _ 1 ! 0.0' i,;\ 9 _,41,__________t=.7---. T I I Stock. G::atom G�3iC�n Et t 5f. M rkstino Interior DsaiGn a C — 5hcs ISM 1 LOT INFOR IATION IMPERVIOUS IOUS 4RE S: — n,...,..,..aasr.,.� 0.....,, J •ate abet Sn =ex LOT AREA 2,111 SQ. FT. 153 5Q. FT. DRIVEWAY i�' IMPERVIOUS COVERAGE 1,433 SQ. FT. 32 50. FT. PORCH BUILDING COVERAGE 6 14 SQ. FT. WALK r BUILDING HEIGHT APPROX - 3D' -5' 1d SO. FT. PATIO i1__ et,w..owd..+a.e . a, tlr coats 't�.dA' at ail Rs any. 244 SQ FT. OVERHANG �NO Weal S bM e ra+d ,aa U.. pima rota a. aoa yr mm Ys . mama flea 914 SQ. FT. BUILDING COVERAGE a" ...e.,,�..a.d abs� of Parlar 1,433 TOTAL SQ. FT. IMPERVIOUS AREAS .7. of Rs LI 0 T .-7, 2 5 T dv evpeabmfy a< de Cab.tla is aa'ala6 Jha R — = WOODEN CURB RAMP ® = STREET STREET TREE >_ atrat , , tilos NO _� w �' a ma ri = CATCH BASIN PROTECTION r 2' PYRUS GALLERYA�tilA CAMBRIDGE 99 , -t- W'OR = G STAGING/ MATERIAL STORAGE SCALE: 1/8 - - 1/ WESTL4ND HOMES / 7 = CONSTRUCTION ENTRANCE ra � .� . a r: +;0_4K MACE L`� C� `COVERED STOCKPILES 14r, , 20i2 — = SEDIMENT FENCE JULY 2012 N = COVER ALL AREAS OF BAR. 301L UNTIL Ave PERMANENT LANDSCAPE IS IN PLACE S IT p I FOR OFFICE USE ONLY — SITE ADDRESS: . l 0662 o at-) 69 - 1 L-- Lir This form is recognized by most building departments in the Tri -County area for transmittin formation. 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. 1 14 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT a Transmittal Letter TI G A R D 13131 Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard- or.gov TO: DATE RECEIVED: DEPT: BUILDING DIVISION fIEC IP . JUL 242012 FROM: law• C✓ r17G41-10 COMPA .• , F 41 -4A- LP /-44.-COLC-4-11-02.4 pg!ti tior, i PHONE: Bc42 RE: Cd b (p � L I Per 2 -eo / t tte Address) L 4ti (Permit Number) 0 5 (roject name or subdivision name and Io um er) 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: t E -Ck ce..eQ FOR O FICF USE ONLY Routed to Permit Techn Date: /0 (le 11'Z Initials: C' Fees Due: 111 Yes L� No Fee Description: Amount D ue: $ $ $ Special Instructions: Reprint Permit (per PE): ❑ Yes ❑ No ❑ Done Applicant Notified: Date: Initials: 1:\ Building\ Forms \TransmittalLetter - Revisions.doc 05/25/2012 FOR OFFICE USE ONLY — SITE ADDRESS: l D g 6 / "; , � _ D - ' ,. This form is recognized by most building departments in the Tri- County area for tran °l formation. 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 IN Transmittal Letter T I G A R I) , Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard- or.gov TO DATE ' lri; 51 Uzi 1 — K---J-2 - A- DEPT: t. • DING DIVISION .�. JAN 0 7 2013 -�)� CITY OF TIG�RD ('FROM: - ,� ` � BUILDING DIVISION COMPANY( c� 1� �j� D2 t J (7 PHONE: Q) 2, . �O - ( B //064 �r� D � , a' CC 1 st (Site Address) 6 (Permit umber) (Project name or subdivision name an t dumber) 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: • _ / I : _., , L _ _ " _Irk ti,;,____., . FOR I FFI USE ONLY Routed to Pe ' echnician: Date: 2., I '3 / - Initials: pal _ Fees Due: M Yes ❑ No Fee Description: Amount Due: - _ ►) a/1 $eo, $ $ $ 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 11068 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 610 Gas Line 04/01/2013 00:00 MST2012-00154 PASS Standard pressure 30# for 15 minutes 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 11068 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 120 Electrical rough-in 04/10/2013 00:00 MST2012-00154 PASS Jeff Groves 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 11068 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 242 Interior shear walls 04/01/2013 00:00 MST2012-00154 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 11068 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 225 Post/beam structural 03/08/2013 00:00 MST2012-00154 FAIL 1. Install posts and beams near crawl access as circled and dated on stamped plans or provide engineering as installed RAIN DRAIN PASS CRAWL DRAIN PASS POST AND BEAM PLUMBING 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 11068 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 120 Electrical rough-in 04/05/2013 00:00 MST2012-00154 FAIL Recept needed at entry wall in upstairs bedroom 3 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 11068 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 322 Shower pan 04/01/2013 00:00 MST2012-00154 PASS George Heimos correction 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 11068 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 240 Exterior sheathing 04/01/2013 00:00 MST2012-00154 PASS George Heimos correction 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 11068 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 320 Plumbing rough-in 03/28/2013 00:00 MST2012-00154 FAIL 1. Attach front bath tub/shower stall vert flange to wall. All else ok 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 11068 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 235 Shear walls/anchors 04/01/2013 09:31 MST2012-00154 PASS George Heimos correction completed Violation Summary: Inspector Contractor /145T20/2- dz9/5 //e26,2 ski L et C:94 Form 640S Ali Completion Certification —Site Inspection New Homes Program—Single Family EnergyTrust of Oregon To be completed by Verifier Portland Energy Conservation, Inc. (PECI) Is a Program Management Contractor for Energy Trust of Oregon, Inc. Input tab should be completed first to auto - populate applicable fields, indicated by orange highlighted fields. First Inspection Information Second Inspection Information Date: 5I112013IVerifier Name: preston k Date: 6/14/20131 Verifier Name: preston k Incentive Payee Company Name: Builder or Company: westland industries Contact Name: Performance Testing Company: performance insulation Technician Name: Verifier Payee Company Name: Technician Name: pk Site Information Development lot 25 REM /Rate ISCO Project ID: Name & Lot # File #: (required from verifier it project is ENERGY STAR®) Site Address: 11068 sw legacy oak City: beaverton State: OR Zip: El Unattached ❑Attached I Number of Stories: 3 Total Conditioned Area: 2183 Sq. Ft. # of Bedrooms: 3 Basement Type: UNone Full Basement UHalf Basement ❑Crawlspace Water Heater Gas ❑Garage/basement combo ['Slab on grade ❑Other Fuel: Electric Provider: Portland General Gas Provider: JNW Natural Electric Meter Number (must be permanent meter number): Gas Meter Number (must be permanent meter number): 22237130 46202519 Additional Project Information (please mark all that apply) ❑ Code plus Best Practices (meets minimum Best Practice requirements with improvements above code) El Path 1 EPS– Best Practices ❑ Path 2 ENERGY STAR ['Envelope Upgrade ❑Equipment Upgrade ['Ducts & HVAC Equipment Inside ❑ Path 3 ENERGY STAR with ducts inside ❑ Path 4 Performance Plus with ducts Inside ❑ Path 5 Advanced Performance ❑ Zonal Electric Efficient ❑ Advanced Electric Resistance ❑ Live Net Zero home ['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 Dwelling ❑Yes IN No Is this home an ADU? Unit ❑Yes No Is the ADU separately metered? If so, provide meter numbers above Other Certifications ['Earth Advantage - Certification Level ❑LEED - - Certification Level: ['Other: Retum completed form to: Energy Trust New Homes - Single Family 100 SW 5th Ave, #700 Portland, OR 97201 -5542 1.877.283.0698 Fax 877.501.9629 Form 640S v08 DRAFT newhomes(dlenergytrust.org Page 1 of 3 Form 640S \►i Completion Certification —Site Inspection '4\ New Homes Program—Single Family EnergyTrust of Oregon Verification Type Actual Model 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: 0 Intermediate Above Grade Walls R- 23 Insulation Type: bib Below Grade Walls R- Insulation Type: ❑Advanced Framing Size: Floor Over Unheated Space R- 30 Insulation Type: bait Floor Over Garage R- 30 Insulation Type: batt Slab Floor (unheated) R- [Under ['Perimeter ['Full Slab (Perimeter and Under) Doors Door R- Door Material: Windows U- 30.00 Window Frame Material: Windows SHGC: 30.00 vinyl U- Skylights SHGC: Window Area (Glazing) % Total window area: Lighting # Fixtures: 37 Indoor and Outdoor 81 % # ENERGY STAR fixtures or CFLs: 30 Appliances ENERGY STAR Dishwasher (l Yes ❑No EF: Model #: Cooling Air Conditioning SEER: Btu /Hr: [Fireplace AFUE: 95 Brand: fraserjohnmston Primary Heat source El Gas Fumace HSPF: Model #: tg9s060 ['Electric ['Boiler SEER: Serial #: w1n2342269 ig Gas Heat Pumps COP: Btu/Hr: 60,000 ❑Air Source (ducted) Outdoor Unit (for heat pumps) ['Other: Mini Split ductless ❑ Sp (ductless) Location: Model #: ❑Ground Source cond space Serial #: ['Radiant Floor Heat ECM ['Yes El No Heat pump commissioning report attached or ❑mod Electronic Air Cleaner ❑Yes No confirmation for ground source heat pumps that manufacturer's start up procedure was performed. ❑Zonal Backup fuel ❑Electric Gas [Other ['Other I: Yes Notes on Primary Heating: Notes on Secondary Heating: Water Heater Type: Gallons: Brand: rinnai ❑Electric [Storage EF: 82 Model #: r175 El Gas El Tankless Location: Serial #: dh.ca 077031 cond space Btu/Hr: 180,000 Return completed form to: Energy Trust New Homes — Single Family 100 SW 5th Ave, #700 Portland, OR 97201 -5542 1.877.283.0698 Fax 877.501.9629 Form 640S v08 DRAFT newhomesaenergytrust.org Page 2 of 3 Form 640S \►." Completion Certification —Site Inspection 747 New Homes Program—Single Family EnergyTrust of Oregon Ventilation ['Exhaust Only Meets Energy Trust Mechanical Ventilation Requirements? S Energy Trust of Oregon's 0 Yes [No ❑SuPPIY °HY Mechanical Ventilation Requirement El Air Cyder HRV /ERV Model #: ❑HRV /ERV Ducts ❑Ducts Inside % ducts inside: Ducts in Conditioned Space If claiming incentive for ducts inside, check one of the following: El Ducts Tested ❑Visual Inspection per RTF Specs Duct Insulation R- 8 Duct Location: 50 crawl 50 cond space Ducts Sealing w/ Mastic El Yes ❑No Performance Testing - . Duct Leakage . ; . Duct Leakage Cubic Feet Per Minute (cfm) Duct Leakage Air Handler in El Yes Air Handler Installed During Ell Yes 95 @ 50 Pa El Pass ❑Fail Conditioned Space? No Test'? ❑No Fan Pressure ❑DG3 Fan Ring Size/Type 00 02 Leakage Test El Total Leakage Gauge El DG700 Pressure: 230 (check one) 01 11 Method ['Leakage to Outside Duct Blaster Location: ra Pressure Tap Location: bath 'Area Tested: 2183 Whole House Leakage , • . Whole House Air Changes per Hour (ACH) Envelope Tightness Cubic Feet Per Minute (cfm) Leakage House Volume: 18750 3 @ 50 Pa El Pass ❑Fail 965 @ 50 Pa Best Practices Requirements: (All. requirements must be met to receive an Energy Performance Score)_ • Thermal Enclosure Checklist complete is Pass ['Fail IThermal Enclosure Checklist attached? ['Yes • Insulation Quality Inspection Performed Ill Yes ❑No — (complete insulation verification section below) • Approved Mechanical Ventilation Installed 0 Yes ❑No __ (complete mechanical verification section below) • Zonal Pressure Relief - All zones comply El Yes ❑No If no, state reason for failure: • Combustion Appliance Zone Net CAZ Pressure: Pa If not applicable, please explain: Testing (required) Forced air system operation must not depressurize Combustion Appliance Zone (CAZ) by more than 3 Pascals (Pa.) . 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 reaton kuckuck Verifier Signature: p Name: proton kuckuck Date: 6/17/2013 Red Tag Inspection (if needed) - - - - - - - - _ _. Signature (Name (Date: Return completed form to: Energy Trust New Homes--Single Family 100 SW 5th Ave, #700 Portland, OR 97201 -5542 1.877.283.0698 Fax 877.501.9629 Form 640S v08 DRAFT newhomes ©energytrust.org Page 3 of 3 111 STREET TREE TIGARD CERTIFICATION I, dG .00f/15o,0 , owner/ agent for 4s7 2' ',4/s7 :s' , (PLEASE PRINT) (PERMIT HOLDER) do hereby certify that the following location meets City of Tigard land use and development standards for street tree installation and is consistent with the approved site plan. PERMIT NO.: / DO /5 SI'1 E ADDRESS: //( ) 164Cy (2 z2'Gy SUBDIVISION: It /7 1 LOT #: o SIGNATURE: ewer. DATE: --/ — /3 (OWNER/AGENT) RE CEIVED & VERIFIED BY DA1 E: (CITY OF TIGARD) ❑ Tree location verified per approved site plan. I:\ Building \Forms \StreetTreeCertificate 05/30/2012 Oregon Residential Specialty Code 8318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM I, Rx5 £/L5v/t/ , am the general contractor or the owner- builder at the following address: Site Address: 110646 C4) /i 014_ Mir( City: 77g 6 • Permit #: ms-r /a2 - oU /sY Subdivision/Lot # � � GL�t6� L7 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. 4 1 1 / 41 1 Signature: Date: ( 3 � r e al Contractor or Owner - Builder I:\Building\Form\RES- MoistureSensitiveWood.doc 09/25/08 Oregon Residential Specialty Code N1107.2 HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: A S - (900 t0/s9 Jurisdiction: 176i4.41, Site Address: I ey off. kikf Subdivision/Lot #: �j/1L o/4 g a „ .44.1,‘ `: and/or C/ 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: . f� Date: -1/1-1 Ow L General Contractor /Authorized Agent Print Name: RA AVL Dd/' ORSC Section NI 107.2. 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