Permit j I MASTER PERMIT
IN u CITY OF TIGARD
COMMUNITY DEVELOPMENT �� Permit #: MST2012 00199
T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 .el-/C /-- Date Issued: 02/21/2013
Parcel: 2S 109 DA16700
Jurisdiction: Tigard
Site address: 15477 SW SUMMERVIEW DR
Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 96
Project: Arlington Heights No. 3, Lot 96
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 734 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 32 Bathrooms: 4 Second: 1220 sf Garage: 477 sf Front: 15 Smoke
Dwelling Units: 1 Third: 1632 sf Right: 5
Detectors: Yes
Total: 3586 sf Value: $398,490.32 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 6 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs /Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell- Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 6 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Fum <100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn > =100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc /Feeders Branch Circuits
1000 sf or less: 1 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0
Ea add! 500 sf: 7 201 -400 amp: 0 201 -400 amp: 0 W/O Svc/Fdr: 0
Mfd Home /Feeder /Svc: 0 401 -600 amp: 0 401 -600 amp: 0
601 -1000 amp: 0 601 +amp- 1000v: 0
1000 +amp /volt: 0
ELECTRICAL - RESTRICTED ENERGY
SF Residential
Audio 8 Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R -3 3586
Owner: Contractor:
STONE BRIDGE HOMES STONE BRIDGE HOMES NW LLC Required Items and Reports (Conditions)
4230 GALEWOOD ST, SUITE 100 16869 SW 65TH AVE # 505 1 Ersn Cntrl 503 - 639 -4175
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035 2 geo tech report prior to
footing inspection
PHONE: 503 - 387 -7577 PHONE: 503 - 387 -7577
FAX: 503- 387 -7615
Total Fees: $22,255.29
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. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR •1 -0.90. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
' ` `
I
2.--------
ssued By: ..4 ��` dedi: Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept In a conspicuous place on the Job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
FOR OFFICE USE ONLY — SITE ADDRESS: /�y 7. SJ Su /7/7e 7Z L/ /E&) .42 .
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
ip
Transmittal Letter
- r 1 QA ji I) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard- or.gov
TO: -/ DATE RECEIVED:
DEPT: BUILDING DIVISION " RECEIVED
MAR 4 2013
FROM: /74/67 ��0 QFTIGARD
COMPANY: GI
BUILDING DIVISION
S %�J/i/> /- �/�i B UILD
PHONE: 253 - (F/9.7 By'
RE: • /-S-r7 '7 £'�.J S�/vil L--7Z, // i S7 /a — 00792 ?
(Site Aess) (Permit Number)
,,,e,-/,v6 r ✓ 6 / 3 LOT 76.
(Project name or subdivision name and lot number) /
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. ✓ Revisions: / 49 --- C/S
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:
•
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: .3 /y,/ Initials:
Fees Due: yas El No Fee Description: Amount Due:
$ a .-5??,3cf'
. $
$
$
Special / 7' (nfr ,,/''/7 `r - 7L. , 4/77or✓ - i✓ -Cj
Instructions: 61 ri/[r r9A /77 oA4 c _. S ,pji:-L
Reprint Permit (per PE): es ❑ No ❑ Done
Applicant Notified: Date: _WV /3 4 /sytrt/6 y Initials: L-
1:\ Building\ Forms \TransmittalLetter - Revisions.doc 05/25/2012
p CITY OF TIGARD MASTER PERMIT
;' l '' COMMUNITY DEVELOPMENT Permit #: MST2012 -00199
T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/21/2013
Parcel: 2S109DA16700
Jurisdiction: Tigard
Site address: 15477 SW SUMMERVIEW DR
Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 96
Project: Arlington Heights No. 3, Lot 96
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stones: 2 Bedrooms: 3 First: 1220 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 32 Bathrooms: 2 Second: 1632 sf Garage: 477 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2852 sf Value: $321,582.00 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
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: 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 +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 ' 2852
Owner: Contractor:
STONE BRIDGE HOMES STONE BRIDGE HOMES NW LLC Required Items and Reports (Conditions)
4230 GALEWOOD ST, SUITE 100 16869 SW 65TH AVE # 505 1 Ersn Cntrl 503- 639 -4175
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035 2 geo tech report prior to
footing inspection
PHONE: 503- 387 -7577 PHONE: 503 -387 -7577
FAX: 503 - 387 -7615
Total Fees: $19,666.91
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 -ccor. - • -. 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. • TTENTION: Ore! n law = • uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-0°1-0010 through OAR • • i r 1 -0.90. may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1 7 or 0.332.2344.
Issued ,. : I �� / Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept In a conspicuous place on the Job site until completion of the project.
Approved plans are required on the Job site at the time of each inspection.
r:_.. _. I6 "?3
Building Permit Application _
Residential' ° • E ' 7 ° FOR O FFI C EUSE ONLY t � � .
City of Tigard qqq��� Received, Permit No f Q
li - Date /By: - 3/ . �i 11 re20�� Q / / E
g 13125 SW Hall Blvd., Tigard, OR 97223) 2012 Plan Rev
Phone: 503.639.4171 Fax: 503.598.1960 Ot Permit.
Date /By: � � I �j ( a1.( DD /7,z_,
TIGARD Inspection Line: 503.639 CITY OFTIGARD Date Rea, y/ ty: Juris: El See Page 2 for
Internet: www.tigard or.gov e No ed/Methgd:�/ _ ,,...01 I � ► i i Supplemental Information
BUILDING DIVISION No;
. _ / Xi / a • spoeL w bet,-
TYPE OF WORK REQUIRED DATA: I- AND 2- FAMILY DWELLING CC -
® New construction El Demolition Permit fees* are based on the value of the work performed.
Indicate the value (round-d to the nearest dollar) of all
❑ Addition /alteration/replacement ❑ Other: equipment, . - :r••• -,,y r `., , er ead, and the profit for the t, CATEGORY OF CONSTRUCTION work indicates o t;:!pr.Uon
Valuation: I
® I- and 2- family dwelling El Commercial/industrial
.
❑ Accessory building El Multi-family Number of bedrooms: 3
❑ Master builder ❑ Other: Number of bathrooms: Z
JOB SITE INFORMATION AND LOCATION Total number of floors: 2 e
Job site address: 1 5411 SW SUM M E .V I Ew V . New dwelling area: 2 42 ; e j 2,, square feet
City /State /ZIP: Tigard, OR 97223 Garage /carport area: 417 square feet
Suite/bldg. /apt. no.: Project name: Arlington Heights /J0 ,3 Covered porch area: 6,15 square feet 1 b �
Cross street/directions to job site: Deck area: 5� s q u are feet
2 IZZp
Other structure area: . 3321' square feet 3 Z
REQUIRED DATA: COMMERCIAL - USE CHECKLIST
Subdivision: Arlington Heights I Lot no.: Ro 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.
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:
❑ 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)
Structural plan review fee (or deposit):
City /State /ZIP:
Phone: ( ) Fax: ( ) FLS plan review fee (if applicable):
CCB tic.: 173318 Total fees due upon application:
fne� .../}� Amount received:
Authorized signature: �J„�/�t`�JfVI This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: I RpRe BwTt Date: 01.31.1z. . * 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)
• il l, M , i -
Plumbing Permit Application i � , ;
Building Fixtures t ' e,� .i jE • roll -OFFICE USE ONLY =
City of Tigard JUL 3 1 2012 Received
Date/By: Perm a.: Pit N
1 114
a 13125 SW Hall Blvd., Tigard, OR 97223 //57�/��0/9/4
_ Plan Review
C
Phone: 503.639.4171 Fax: 503.598.19 Other Permit No.:
� F t� � D Date/By:
T 1 G A
Inspection Line: 503.639.4175 d +b�a Date Ready/By: Juris: ® See Page 2 for
Ft D Internet: www.ti and - or. ov p - (t owls K I Notified/Method: 7 ' Supplemental Information
g g �I-6f� �•t;f�? 1�41�t i/ L [� PP
TYPE OF WORK FEE* SCHEDULE
® New construction El Demolition For special information use checklist.
Description I Qty. I Ea. I Total
El Addition/alteration/replacement El Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 312.70
® I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78
❑ Accessory building El Multi-family SFR (3) bath i 500.32
Each additional bath/kitchen 25.02
El Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 15411 SW SUM MERv I EM! D?, 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 1 Lot no.: 1 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
F.jectors/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: 16869 SW 65 Avenue #505
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
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: Jardine Plumbing Water piping/DWV 56.29
Address: PO Box 186 Other: 25.02
City/State /ZIP: Estacada, OR 97023 Subtotal
Phone: (503)351 -8532 Fax: (503) 6302882 Minimum permit fee: $72.50
CCB Lic.: 108747 Plumbing Lic. no.: 93- 1185347 Plan review (25% of permit fee)
State surcharge (12% of permit fee)
Authorized signature: _�/
V _ TOTAL PERMIT FEE
Print name:
Jay This permit application expires if a permit is not obtained within 180 days
Ja Jardine Date:
after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
I:\ Building \Permits\PLMU- PemritApp.doc 10/01/09 440- 4616T(10 /02/COM/WEB)
Mechanical Permit Applica J" n • . i ? FOR OFFICE USE ONLY
City of Tigard t ‘ Recei
II Date/By: Permit No.:
° 13125 SW Hall Blvd., Tigard, OR 97223 I 1 201
Phone: 503.639.4171 Fax: 503.598. I960J U L 3 1 Plan Review
Date /By: Other Permit:
T I G A R D Inspection Line: 503.639 Date Ready/By: ® See Page 2 for
Internet: www.tigard- or.gov CA! 7 r!..4; 1-1!9 Notified/Method: Supplemental Information
pi d; j . 5, '- l'i'st /ON
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
LI Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
® I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ Multi- family ❑ Master builder ❑ Other: For special information use checklist.
Description 1 Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: MT* e414 SVM M E1.V IE7ti DR- Air conditioning
(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
Flue /vent for any of above 23.32
Subdivision: Arlington Heights Lot no.: itp
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 1 23.32
Gas fireplace I 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 I Chimney /liner /flue /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 t to
P g
Contact name: Deirdre Britt $14.15 for first four; $4.03 for each additional
Address:
Furnace, etc. 1
Gas heat pump
City/State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace 1
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 lie.: 110091 State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Authorized signature: ,..-C-.--_ This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: David Heldstab Date: ` Fee methodology set by Tri- County Building Industry Service Board
I:1Building \Permits \MEC- PermitApp.doc 10/01/09 4404617T(II/02 /COM/WEB)
Electrical Permit Application '- . E ,, Foi. OFrICL.usF O NLY . .
9 ° ' R ved
•
III City of Tigard Date /By: Permit No.: "7ST�J /� aO /99
° 13125 SW Hall Blvd., Tigard, OR 97223 JUL 3 1 2012 PIan Review
' C ' Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Permit:
Inspection Line: 503.639.4175 (�{ I/` D ate R ead y /By: 1 J' w 10 See Page 2 for
TIGARD, CITY OF ft/� B
Internet: www.tigard- or.gov 4:,5otified/Method: Supplemental Information
BIM niMr r it!totTq:
TYPE OF WORK � ilv ` t ' ° „ ‚ I PLAN REVIEW
Please check all that apply (submit 2 sets of plans w /items checked below):
® New construction ❑ Addition/alteration/replacement
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition 0 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
® I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", " I -3 ",
Job no.: 14u-1 Job site address: 15417 S) MMEYIG / 100HP ormore. occupancy.
❑ Six or more residential units. 0 Recreational vehicle parks.
City/State /ZIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: Arlington Heights ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Arlington Heights Lot no.: q (g) 1,000 sq. ft. or less - - 1 168.54 4
Ea. add'I 500 sq. ft. or portion sj 33.92 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 7b ' 2
Limited energy, multi - family 67.84 2
residential (with above sq. ft.)
Services or feeders installation, a lteration, and /or relocation
200 amps or less 100.70 2
® PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2
Name: Stone Bridge Homes 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: 16869 SW 65th Avenue #505 Over 1,000 amps or volts 552.26 2
City/State /ZIP: Lake Oswego, OR 97035 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503)387 -7577 Fax: (503)387 -7615 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
A. Fee for branch circuits with
® APPLICANT ❑ CONTACT PERSON above service or feeder fee,
7.42 2
each branch circuit
Business name: SEE ABOVE B. Fee for branch circuits
Contact name: without service or feeder fee, 56.18 2
Deirdre Britt first branch circuit
Address: Each add'I branch circuit 7.42 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 67.84 2
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
E -mail: dbritt @stonebridgehomesnw.com Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: City Electric Signal circuit(s) or limited -
energy panel, alteration, or
Address: 55568 SW Schaltenbrand Lane extension. Describe: Page 2 2
City/State /ZIP: Sherwood, OR 97140 Each additional inspection over allowable in any of the above
Per
Phone: (971) 404 -1714 Fax: (503) 625 -3052 Investigation 66.25
t o on gation per hour (I hr min) 66.25
CCB Lic.: 42422 Electrical Lic.: 26 -289C Suprv. Lic.: 35925 Industrial plant per hour 78.18
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal:
Print name: Chuck Friesen Date:
Plan review (25% of permit fee):
State surcharge (12% of permit fee):
Authorized signature: j TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Date:
days after it has been accepted as complete.
• Number of inspections allowed per permit.
1:\ Building \ Permits \ELC- PermilApp.doc 10/01/09 440- 4615T(I I /05 /COM/WEB
•
1,11 Building Division
Development Code Provision Review
T[ G A R D Residential Projects
Building Permit No.: /VS/ 070/ — ja/ 9
Site Address: /S gm-) , j/ /, c) �Y .
Project Name & Lot No.: Ai2.t-/n/670/1/ h-76 ZS JVO. 3
CWS Service Provider Letter
Required: Yes ❑ No jZP
Received: Yes ❑ No ❑
Routed Plans:
Original Plan Submittal Date: 7/3V/ L
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.
Planning Review (contact _ _ _ at 503 -718. Y VC) or @tigard- or.gov)
Lad Use CaseNo.
�oning 2 —
L' Setbacks:
/Front / Lj Rear /6 Side � Street Side /G- 4. Garage z Q
Maximum Building Height '� '� Actual Building Height ' F`
l �'
Visual Clearance
E' Easements
9/Sensitive Lands Type:
Notes:
Original Plan: Approved EK Not Approved ❑ Date:
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @tigard- or.gov)
,Actual Slope: > q cyo
Notes:
Original Plan: Approved Er Not Approved ❑ Date: 5 /1/12 -
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
, • •
City orist Review (contact Todd Prager at 503 - 718 -2700 or todd @tigard - or.gov)
L �l Street Trees
❑ Protected Trees
Notes:
Original Plan: Approved V Not Approved ❑ Date: V''' 1— /c)--__ � PP PP
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 P rior 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 c p i / r/ No ❑ /
Date Routed to Building: . . / �/
r
f
7
1
1
t
1
Page 2 of 2
. • •
STONE BRIDGE RE py,:iiiED OBE: 146'7 . LOT: 96
`HOMES N W JUL 31 2012 DATE: 7/17/12
4230 GALEWOOD ST. SUITE ioo PROPERTY: ARLINGTON
LAKE OSWEGO, OR 97035 ` C fa ,.
1( HEIGHTS
(5 387 1 1 l - i : • , r, ...;.
� �'
°•" ► CITY: TIGARD
F .'‘.::' "" A i _ SCALE: 1 " =20'
PLAN No.: 279 —MOD
409 OPTION 3 ELEVATION
I f 4d-line/2- O' wilit b
p� .� 298
zo h \ 296 74
:' CO E, : ..
� \ 294 }
,'D- VEWA - 1' \-
\;. X292 ';'Y
hi . ti` w \
- i,� y 288 af 4 \-..,, 10AILL....r �* ,\ d � , 286
$ _ � `\\ ` ' \ 284 /
TA. 6 . w
,)v 2 13A4T14 \ \ 44252 ki1411Mo FFE 3013' ',Mg. \\\ \;
�� .' �W= v O 288 \ \\ \\ ` -- it
ti ionommiiii \ 215 ,
Viill. -41, III\ - -,. . a l4 ill 87 ii - •I�Z i�fl '
/5�' 4P-QiV /1/4eA ` OC� .74 T. 1 Mwt �z
S;(1 ' EL • trill
Z i vi, TRACT 1"I m„''
LOT COVERAGE LEGEND
LOT AREA: 6,0S2 SQ. FT.
BUILDING AREA: 2215 SQ. FT. — STREET TREES:
PERCENTAGE: 35.5% RAYWOOD ASH
- FRAXINUS OXYCARPA-
NOTES:
ALL GRADE AND PROPERTY LINES ARE ESTIMATES OF CURRENT LOCATIONS.
ALL DIMENSIONS AND SQUARE FOOTAGE ARE APPROXIMATE FIGURES.
ALL RETAINING UJALL HEIGHTS AND LOCATIONS ARE ESTIMATES.
THEY MAY VARY AND BE SUBJECT TO CHANGE. LOT 41 96
DRIVEWAY MAY DIFFER DUE TO LOCATION OF UTILITY BOXES, 6062 Sq. ft.
STREETLIGHTS, AND OTHER SITE CONDITIONS.
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
15477 SW SUMMERVIEW DR, TIGARD, OR,
97224
Residential - Master Permit
115 Electrical service
04/16/2013 00:00
MST2012-00199
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
15477 SW SUMMERVIEW DR, TIGARD, OR,
97224
Residential - Master Permit
399 Plumbing final
06/07/2013 00:00
MST2012-00199
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
15477 SW SUMMERVIEW DR, TIGARD, OR,
97224
Residential - Master Permit
205 Footing
03/07/2013 10:00
MST2012-00199
Scheduled
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
15477 SW SUMMERVIEW DR, TIGARD, OR,
97224
Residential - Master Permit
322 Shower pan
05/22/2013 00:00
MST2012-00199
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
15477 SW SUMMERVIEW DR, TIGARD, OR,
97224
Residential - Master Permit
699 Mechanical final
06/06/2013 00:00
MST2012-00199
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
15477 SW SUMMERVIEW DR, TIGARD, OR,
97224
Residential - Master Permit
699 Mechanical final
06/06/2013 00:00
MST2012-00199
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
15477 SW SUMMERVIEW DR, TIGARD, OR,
97224
Residential - Master Permit
135 Low voltage
04/16/2013 10:00
MST2012-00199
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
15477 SW SUMMERVIEW DR, TIGARD, OR,
97224
Residential - Master Permit
135 Low voltage
04/16/2013 00:00
MST2012-00199
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
15477 SW SUMMERVIEW DR, TIGARD, OR,
97224
Residential - Master Permit
225 Post/beam structural
03/21/2013 00:00
MST2012-00199
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
15477 SW SUMMERVIEW DR, TIGARD, OR,
97224
Residential - Master Permit
399 Plumbing final
06/05/2013 00:00
MST2012-00199
FAIL
1. Expose lawn irrigation piping, at street side of side walk, to verify depth of a minimum
of 24". Pipe is going to back flow device. 609.1
2. Extend rain drain risers above grade at front left side. 1110.0
3. Provide cleanout plug needs thread sealant at: storm and sanitary cleanout plugs.
316.1.1
4. Provide caulking, required on fixture(s) at: kitchen sink. 310.4/407.2
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
15477 SW SUMMERVIEW DR, TIGARD, OR,
97224
Residential - Master Permit
275 Framing
04/22/2013 00:00
MST2012-00199
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
15477 SW SUMMERVIEW DR, TIGARD, OR,
97224
Residential - Master Permit
699 Mechanical final
06/07/2013 00:00
MST2012-00199
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
15477 SW SUMMERVIEW DR, TIGARD, OR,
97224
Residential - Master Permit
399 Plumbing final
06/06/2013 00:00
MST2012-00199
FAIL
No corrections have been completed. Not ready for inspection. No inspection made
OPSC 103.5.1
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
15477 SW SUMMERVIEW DR, TIGARD, OR,
97224
Residential - Master Permit
120 Electrical rough-in
04/16/2013 00:00
MST2012-00199
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
15477 SW SUMMERVIEW DR, TIGARD, OR,
97224
Residential - Master Permit
340 Storm drain
03/12/2013 00:00
MST2012-00199
PASS
NOTE provide 4 band adapters to tie storm and sanitary piping to public laterals
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
15477 SW SUMMERVIEW DR, TIGARD, OR,
97224
Residential - Master Permit
205 Footing
03/07/2013 10:00
MST2012-00199
Scheduled
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
15477 SW SUMMERVIEW DR, TIGARD, OR,
97224
Residential - Master Permit
299 Final inspection
06/07/2013 00:00
MST2012-00199
PASS - C of O
*Erosion Control approval Passed
*Approach to Sidewalk Approval. Passed
*Street Tree Certification, checked for trees. Received
*High-Efficiency Interior Lighting Systems Doc Received
*Moisture Content Acknowledgement Form. Received
*Insulation Certification checked. Checked
*Carbon monoxide Detector checked.
*Garage Vehicle Barrier Installed. Checked
*Final Plumbing, Mechanical, Electrical approval (and Fire Sprinkler if required) Checked
*Lawn Irrigation final with Backflow test results. (if required) Contractor will call for final,
checked, all ok, except need backflow test results.
*Duct air leakage test documentation, (if ducts installed in crawl) in accordance with
ODOE Stds. and Sec. M1601.4.1
Violation Summary:
Inspector Contractor
i
I P STONE BRIDGE OBE: 146'7
RECEIVED � HOMES N W DATE: 2/25/13
4230 GALEWOOD ST. SUITE ioo FEB 2 5 2013 PROPERTY: ARLINGTON
LAKE OSWEGO, OR 97035 HEIGHTS
(5 3 CITY OF TIGARD CITY: TIGARD
BUILDING DIVISION SCALE: 1" =20'
PLAN No.: 279 —MOD
Orei 3 OPTION 3 ELEVATION
, �/ , W/ BASEMENT
� J2,i
X16 4 29b / OFFICE COPY
ti� '.. 296 }
3,' 294
D vEWAY.- �'� s /_
•
IMMO
4 0 ,. -. ; .-. , - ,::::„ . :!.. : ::: . 1 .,.. :.i i . - ,,, N290 ks
i,� , . J 288
�) �* P 286 46 S 8 '° \ 284 /
411 • _ -4 AihP $53?
AO ") -
� 3 BATH #252 Allitill Of
` _ PPE. 301.51 •� . \ \ \\ *av
ma : _ - .'-' ... -14111 111.F 6 0 4 ' � i . 2 , \ 21,5
- 3 ,
--------; '
4 h �
•278' --41.,
EL• zr
TRACT N '40111-
LOT COVERAGE LEGEND
LOT AREA: 6,0622 SQ. FT. iii
BUILDING AREA: 2,215 SQ. FT. — STREET TREES:
PERCENTAGE: 36.5% RAYWOOD ASH
NOTES: - FRAXINUS OXYCARPA
ALL GRADE AND PROPERTY LINES ARE ESTIMATES OF CURRENT LOCATIONS.
ALL DIMENSIONS AND SQUARE FOOTAGE ARE APPROXIMATE FIGURES.
ALL RETAINING WALL HEIGHTS AND LOCATIONS ARE ESTIMATES.
THEY MAY VARY AND BE SUBJECT TO CHANGE. LOT I'O►6
DRIVEWAY MAY DIFFER DUE TO LOCATION OF UTILITY BOXES, 6062 eq. ft.
STREETLIGHTS, AND OTHER SITE CONDITIONS.
. STREET TREE
TIGARD CERTIFICATION
I, l v-LE Aci„r , owner / agent for S b e. ' `-,c1c, gw
(PLEASE PRINT) (PERMIT HOLDER)
do hereby certij 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.: S TR 1 2 _ DOM
SITE ADDRESS: / S' VT? S Li
SUBDIVISION: w �,� (-4� 5 � � � LOT #:
SIGNATURE: DATE: - 4,/ 3
(OWNE AGENT)
RECEIVED &
VERIFIED BY: DATE: g-7__(3
ITY OF TIGARD)
Tree location verified per app ived site plan.
I: \Building \Forms \StreetfreeCertificate 05/30/2012
Oregon Residential Specialty Code N1107.2
HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: Jurisdiction:
1 12_ - oo ��� > ►i�t�,�u�
Site Address:
Subdivision/Lot #:
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: - 6 -
Owner /General Contractor /Authorized Agent
•
Print Name: 1 4- A9 19-T
ORSC Section N1107.2. High - efficiency interior lighting systems. A minimum of fifty (50) percent o the
permanently installed lighting fixtures shall be installed with compact or linear fluorescent, or a lighting source that
has a minimum efficacy of 40 lumens per input watt. Screw -in compact fluorescent lamps comply with this
•
requirement.
The building official shall be notified in writing at the final inspection that a minimum of fifty percent of the
permanently installed lighting fixtures are compact or linear fluorescent, or a minimum efficacy of 40 lumens per
input watt.
1:\Bnilding\ Forms\ RES- 1- lighEfficiencyLighting.doc 07/01/08
Oregon Residential Specialty Code R318.2
•
•
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, • • k.— ` — , am the general contractor or the owner - builder
at the following address:
Site Address:
164 l)j
City: (vA-(--r)
Permit #:
IZ — 001 qg
•
Subdivision/Lot #: l; N -O'cl � G S ix Lc A— Cl •
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.
Signature: Date: 1p - 4-1 3
General Contractor or Owner- Builder
1:\ Building\ Form \RES- MoistureSensitiveWood.doc 09/25/08
& earth Sustainable Building and Climate SONJUGr19 I eaAhadvantage org
ochcrilagein 808 SW 3rd Ave, Suite 800, Portland OR. 97204 1 503.968, 7160 •
Inspection Date: b6 ,06 . (�
Address: C5 ShJ SUti(atezi.zu( W PR '
City: Tta_k2D
(41 57 —coo fy
Blower Door Test Results _.
Maximum Allowed ACH: 5.0 (for Earth Advantage) /4.0 (for ENERGY STAR)
Actual CFM: 1 SSo _
ACH: 5 7 `
Verifier Signature AAAfil 0 2.