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Permit CITY OF TIGARD MASTER PERMIT a ,_ COMMUNITY DEVELOPMENT Permit #: MST2012 00248 t G A.RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/14/2013 T Parcel: 2S114BA18000 Jurisdiction: TIGARD Site address: 9592 SW FERN HOLLOW CT Subdivision: FERN HOLLOW Lot: 6 Project: Fern Hollow, Lot 6 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First 972 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1218 sf Garage: 390 sf Front: 11 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2190 sf Value: $244,632.92 Rear: 2 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: 3 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 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 Srvc/Feeders Branch Circuits 1000 sf or less: 1 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add 1 500 sf: 4 201 -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 2190 Owner: Contractor: RIVERSIDE HOMES LLC RIVERSIDE HOMES LLC Required Items and Reports (Conditions) • 17933 NW EVERGREEN PKWY 17933 NW EVERGREEN PKWY 370 1 Ersn Cntrl 503- 639 -4175 SUITE 370 BEAVERTON, OR 97006 • BEAVERTON, OR 97034 PHONE: 503 - 645 -0986 PHONE: 503 -645 -0986 FAX: 503- 690 -2942 Total Fees: $18,606.60 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable w. 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 ' work is su ' end for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification C e Th• e / I=s e set forth in OAR 952- 001 -0010 through • • R ' 52-001-0!90. 90. You may obtain a copy of the rules or direct questions to OUNC by calling 503.23 7 or 1 r •. •: 3 . / / Issued By: � / J` , ..a. I . / / Permittee Signature: / Call 503.639.4175 by 7:00 a.m. for the next available inspection date. {-. • . This p =rmlt 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 Applicat Residential n FOR OFFICE USE ONLY City of Tigard 6� 6 nny�S Received a B ' ACP at IIRIM Permit No •floyAey?„ 0 9i: IN • 13125 SW Hall Blvd . Tigard. OR 97223 Plan Rc � e Phone. 5113 718 2439 Pas. 503 3y( (.,0F IG RD ir l� a Other PenniAa9 0.- 'I t C: .1 R D Inspection Line. 503.639, t ai) �e ryq �� , l Y('��� Date RenJwtly. /'� ,� h is 65 See Page 2 for Internet m,w tigard - goy ' BU S • ,�':.l �3.- 1 V il r No ficd Sictho � d / 3i� ( JIYJ Supplemental Information 1.�.. „ � d , . " .-o l 9 1e?-,(P . r► : TYPE ()F ( , WORK.. _, R£QUIREDDATA 1 `A 2- FAMILY DWELLING ;' X] New construction ❑ Demolition Permit fits* 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 ,= work indicated on this application. : CATEGORY OF' CONSTRU iiii17 =; =` kg 1- and 2-family dwelling ❑ Commercial /industrial Valuation. $ G 4-7632 ❑ Accessory building ❑ Multi - family Number of bedrooms: 4 ❑ Master builder ❑ Other: Number of bathrooms: 2.5 s;-1':-- '' Total number of floors: _ ]OB.;STI'E INFORMATION AND LOCATION ' 2 Job site address: 9592 SW Fern Hollow Ct New dwelling area: 2190 square feet City /State/ZIP: Tigard, OR 97224 Garage/carpon area: 390 square feet Suite/bldg. /apt. no.: Project name: Fern Hollow Covered porch area: 41 square feet ( Z (S Cross street/directions to job site: Deck area: NA square lift Ct 7'2. Other structure area '2-' so square feel - j.R£QI)IRED DATA :.COMMERCIAL -USE: CHECKLIST Subdivision: Fern Hollow I Lot no.: 6 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 wv r indicated on this application. Valuation: $ Existing building area: square feet New building area: square feet -- .' f l I'R ' - . 0 TENANT -' _ Number of stories: Name: Riverside Homes, LLC Type of construction: Address: 17933 NW Evergreen Pkwy, Suite 370 Occupancy groups: City/State/ZIP: Beaverton, OR 97006 Existing: Phone: ( 503)645 -0986 Fax: (503)690-2942 _ New . R : -APPLICANT. ,,• 0 CONTACT .PERS p(,TH.'D1NGPERiv1)i.T>FEES*;, - ;- Business name: Riverside Homes, LLC ( 1! leosere - k. _ ? Contact name: Lindsay Adams Structural plan review tee (or deposit): Address: 17933 NW Evergreen Pkwy, Suite 370 PLS plan review fee (if applicable): Total fees due upon application: City /State/ZIP: Beaverton, OR 97006 $79) ' en) Amount received: Phone: ( 503) 645 -0986 I Fax: : (503)690 -2942 ...... E- mail: LAdams @Riversidehome.com ,Pao?;9ya Mi9 §.QC R= f „TBtaT'BES >= Commercial and residential prescriptive installation of _ .. ,.:' ', ,._.1. :CO T AeTOR` ._'... - T i - .. ” roof -top mounted PhotoV oltaic Solar Panel System. Riverside Homes LLC S ubmit two (2) is:I'r plan with connection details Business name: P and fire depanme ccess, along with the 2010 Oregon Address: 17933 NW Evergreen Pkwy, Suite 370 Solar installation Specialty Codepbeekti5t4 City /State / P ermit Fee (inclu.:. an review City/State/ZIP: Beaverton, OR 97006 an.:. tinistrative fees): $180.00 Phone: ( 503)645 -0986 Fax: ( 503)690 -2942 States arge (12% of permit tee). $21.60 CCB he.: 189148 Total fee due upon application: $201.60 L"--) This permit application expires if a permit is not obtained �4T Authorized signatures \_ �r {� within 180 days atler days has been accepted as complete. Print name: L indsay Adams Date: 9 /25/2012 • fee methodology set h''fri- County Building Industry Service Board. 1. 1Building \PermuslBUP- RESPcrmitApp doc 02/24/2011 440- 4613T(I 1 /02 /COM /WEB) ■ Plumbing Permit OL Ann lic EIV � � { FOR l I(1 I � Building Fixtures NI: uNl = city of Tigard 2 6 2012 Da e/ey: ,9149 //� r Permit No.: "F rPeyert .itei 5‘•'1 i i� . ! a 13125 SW Hall Blvd., Tigard, OR 97223 ! Plan Review Pho ne: 503.718.2439 F�i(rIQ6oriGARD Date/By. btberPernit a �� �! Inspection Line: 503.639.41 5 ' ii I� Due Reed lair Al See Pap i Il,nrF y�r e 2 for Internet: www.tigard -0r, •. \Jp 19 / Q ,,; i ( Notified/Method: So • • iemenlal Information 3 s Z _s t s .p i -- ._3...._. _ t _ t-1 +) -{o) {E .- s - -, _ . -.<.,. _... . - _:"._,,.^...:f:- ; ,- 4 }et I(J .. lib New cOns truclion ❑ Demolition Forspeclal information use checklist Description I Qty. I Ea. I Total ❑ Addition/alteration/replacement ❑ Other: New 1.2.famll dwellings (includes 100 ft. for each utility connection) }- ;- " j e) r rZ_. Tii`i Y t fu 1r1< (1(a) >- - ---- SFR(1)bath 312.70 ) 1- and 2- family dwelling ❑ Commerciailindustrial SPR (2) bath 437.78 ❑ Accessory building ❑ Multi- family SPR(3)bath 500.32 Each additional bath/kitchen 25.02 o Master builder 0 Other: Fire rinkler( sq. IL Pa sP 9• ) e2 8 „r._ -°-- -- 'tu) )x7:4 i(ti) i ,x4111/ i4,' i4na e 4 -w r Siteutilltles: Job site address: 9592 SW Fern Hollow Ct Catch basin or area drain 18.76 Drywall, leach line, or trench dram 18.76 city /statenlP: Tigard, OR 97224 Footing drain (no. linear it: Paget Sulte/bldgJapt. no.: I Project name: Fern Hollow Manufactured home utilities 50.03 Cross street/dlrections to job site: Manholes 18.76 _Rein drain connector 18.76 Sanitary sewer (no. linear IL: _) Page 2 Storm sewer (no. linear ft.: _) Page 2 Water service (no. linear ft.: _) I Page 2 Subdivision: Fern Hollow I Lotno.: 6 Flitnreorllem: Tax map/parcel no.: Backflow preventer 31.27 _ e z Backwater valve 1251 T Jr) -1m il fVlt) t`t) , r)1 �, . - _ _ _ _ -_ _ _ Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectorslsump 25.02 c e ?- )fit) + � ta+ 1511 - , i 41 � F Expansion tank 12.51 Name: Riverside omes, LLC Fixture/sewer cap I 25.02 Address: 17933 NW Evergreen Pkwy, Suite 370 Floor drainJllo6rsinklFtub 25.02 Garbage City/State/ZIP: Beaverton, OR 97006 Hosse ebblb ib aposal 25.02 25.02 Phone: (503)645 -0986 Fax: (503)690 -2942 Ice maker 12.51 ` 1 j S� 1` Y Interceptor /grease trap 25.02 � �'( i rev � ='i F , r ) 1 Business name: Riverside Homes, LLC Medical gas (value: 5 Page2 Primer 12.51 Contact name: Lindsay Adams Evergreen Pkwy, Roof 12.51 Address: 17933 NW Ever g kwy, Suite 370 Sink/basin/lavatory 25.02 City/State/ZIP: Beaverton, OR 97006 Solar units (potable water) 62.54 Phone: (503)645 -0986 I Fax:: ( 503)690 -2942 Tub/shows/shower pan 12.51 E -mall: LAdams @Riversidehome.com Urinal 25.02 c E {' ..ii--1).'0';', , r s r Water Closet 25.02 ....;f.` __, ._- : _ -. ,-,. - . . .n`:- -k- .+.7< a <_. ' . Business name: H &H Mechanical Water Water pi heater 37.52 ping/DAN 56.29 Address: 5757 SW Willow Lane other: 25.02 City/State/ZIP: Millwaukie, OR 97267 Subtotal Phone: (503) 975 -9787 Fax: ( 503) 659 -2979 Minimum permit fee 572.50 CCB Lie.: 178122 Plumbing Lie. no.: PB414 Plan review (25%ofpennit fee) - State surcharge (12% of permit fee) . Authorized signature: -.LAO! 4 TOTAL PERMIT FEE I l Print n • / Date' This permit application expires if a permit b not obtained within 180 days �: / L ever It has been accepted as complete. Fee methodology set by Tel - County Building Indmlry Service Board. Li Buddmgt.PermRAPIMO•Pem:tAr,.deo 1001/09 440.4616T(IOONCOat'WEB) C FI�1 ° .l) • Mechanical Permit Ann'Ica ion r( >u Ol l lc I s1: 0 .1.1 City of Tigard - 26 2012 Dm Received . p4 # Pertnitho.. 13125 SW Hall Blvd., Tigard, OR 97223 y �r �� � �/ / � � � /� ��" n_ II I e Phone: 503.718.2439 Fax: 50 .5$6�� +-` ^ P� Review Other Prnnit :/ _do AD Inspection Line: 503.639.4175 1. 3 x I n'' i Date/By: 7 I G A R D y 1,� r �,7 i 4; i ON Date Ready/8)% Jurn ® See Page 2 for Internet: www.tigazd- or.gov D1JI U ,"; - , J , 1 Notified/Method: Supplemental Information D T YPE OwORK. EEk„ SCHEDI!LE 4:115:''E 4:115:''E CHECKLIST .... .. . :COMMERCIAL F . . 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 0 Demolition 0 Other: mechanical materials. equipment, labor. overhead. and profit. ' ' . ' '• CATEGORY OF CONSTRUCTION ' RESIDENTIAL EQUIPMENT /SPSTEMSEEES' ® I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special beformatlan we checiiitt. ❑ Multi - family 0 Master builder ❑ Other: Description I Qty. [ Ea. I Total T HeadnA/cool ^n);: JOB, SITE, INFORMATION . AND LOCATIO Air conditioning itioni g Job site address: 9592 SW Fern Hollow Ct 1 requires aim plan showing placement) 46.75 City/StatcrZIP: Tigard, OR 97224 Furnace 100.000 BTU (ducts/vents) I 46.75 Furnace 100.000+ BTU (ducts/vents) 54.91 Suite/bldg./apt. no.: I Project ruamc: Fern Hollow Heat pump (requires sits plan showing placement) 61.06 Cross suca.t/dircctions to job site: Duct work 23.32 Hydronic hot water system 2332 Residential boiler (radiator or hydronic) 23,32 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended. etc. 46.75 Subdivision: Fern Hollow I Lot no.: 6 Flue/vent for any of above 23.32 Other: _ 23.32 Tax map/parcel no.: Other fuel appliances: - - DESCRIFTIGN, WORK _ Water heater 1 23.32 Gas fireplacdinsen i 33.39 Flue vent for water heater or gas fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove 3339 Wood fireplace/insert 23.32 . -;,_',,.. , ; .,.._ ., _ f Chimney/liner/flue/vent 2 . , , • - Chi mney A • 3.32 .. , . ®-- �P,ROP.ERTX;OWNER � � -" Q T£1 : : : ,; ' Other. 23.32 Name: Riverside Homes, LLC Environmental exhaust and venllation: Address: 17933 NW Evergreen Pkwy, Suite 370 Range hood /other kitchen equipment 1 33.39 City/State/ztP: Beaverton, OR 97006 Clbthes dryer exhaust 1 33.39 Phone: ( 503)645 -0986 Fax: ( 503) 690 -2942 Single -duct exhaust (bathrooms. toilet compartments, utility rooms) 23.32 r APPLICANT _. Q COO ACT PERSON Attidcrawlspace fens 2132 Businessmume: Riverside Homes, LLC Other 23.32 Fuel pining: Contact name: S14.7S for first four: 54.03 for each additional Address: 17933 NW Pkwy, Suite 370 Furnace, etc- t Gas heat pump City/State/ZIP; Beaverton, OR 97006 Wallis scended/unit heater Phone: ( 503)645 -0986 1 Fax: : (503)690 -2942 Water heater 1 • Fireplace E -mail: LAdams ©Riversidehome.com Range . . -. . : CO0itii4 .0Bi. '. _ -, :' _ . ._ „:. Barbecue Business name: Andersen Heating, Inc Clothes dryer (Ras) :her. Address: 6463 Dawn Ave City/State/ZIP: Lake Oswego, OR 97035 Subtotal Minimum pamit fee (590.00) Phone: ( 503)841 -074 I Fax: ( 503)536 -6615 Ph„ review (25% of permit fee) CCB lie.: 168214 State surcharge (12% ofpermit fee) TOTAL PERMIT FEE Authorized signature: Thu peraltapplication n ifa permit t obtained within 180 days accepted as complete. I Prim name: Art Andersen 1 Date: �I 7 - 1 • Fee methodology set by Tri•Coulrty Building Industry Service Board I: fluidinptP iatitBC•PenoaAppdoe C8/07/12 t7r(t i/02/ OMIWEB) t Electrical Permit Applicati EC , . F 1•-;QIi O1,>= I 5i: QLti City of Tigard 2, 6 '30112 � 3i7 PemurNo. / �, , / -e-ri. e ° et 13125 SW Hall Blvd., Tigard, OR 97223 ' L Plan Review I Phone: 503.718.2439 Fax: 503 598.1960 p Other Permit: 404/ .0!a — p't(� s T I C A R D' inspection Line: 503.639.4175 CITY OF T1G �RD Date Read Jars ® See Page 2 for t a interact: ttww. tigard or.gov , iR niNG D 1 ''V IS IUIN Notificd/Method: Supplemental Information 3J it TYPE OF WORK PLAN REVIEW ® New construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 acts of plans wlaerrrs checked 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 El I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire Pump ❑ Installation of75 KVA or ❑ JOB SITE INFORMATION AND LOCATION wiry lmn' larger sep;uately droved system ❑ Addition of new motor load of ❑' "E", "I -a" "I-3 Job no.: Job site address: 9592 SW Fern Hollow Ct 100HP or 111Ofe- Occupancy. ❑ Six or more residential units. ❑ Recreational vehicle parks City /State/ZIP: Tigard, OR 97224 ❑ Health-care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Sui tc/bldgJapt no.: I Project name: Fern Hollow ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Daeriptim I Qtr. I Fee I Total I • New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Fern Hollow I Lot no.: 6 1,000 sq. 11. or less k 168.54 4 Ca. udd'I 500 sq. ft. or portion 33.92 1 Tax map/parcel no.: Limited energy, residential DESCRIPTION OF WORK (with above sq. R.) 75.00 2 Limited energy, multi - family 75.00 2 residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation 200 amps or less 100.70 r 2 l PROPERTY OWNER I 0 TENANT 201 amps to 400 amps 133.56 2 Name: Riverside Homes, LLC 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: 17933 NW Evergreen Pkwy, Suite 370 Over 1,000ampsorvolts 552.26 2 City/State/ZIP: Beaverton, OR 97006 Temporary services or feeders Installation, alteration, and /or relocation Phone: ( 503)645 -0986 Fax: ( 503)690 -2942 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 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670. and 701. 401 amps to 599 amps 168.54 2 Branch circuits— new, alteration, or extension, per panel _ Owner signature: Date: A. Fee for branch circuits with 50 APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7.42 2 each branch circuit Business name: Riverside Homes, LLC B. Fee for branch circuits without service or feeder fee, first 56.18 2 Contact name: Lindsay Adams • branch circuit Each add branch circuit 7.42 2 Address: 17933 NW Evergreen Pkwy, Suite 370 Miscellaneous (service or feeder not included) ry Beaverton, OR 97006 Each manufactured service or r feede Ci /St atclZlP: � dwelling, service ttrld/or fender 67.84 2 Photte: ( 503)645 -0986 Fax: : ( 503)690 -2942 Reconnect only 67.84 2 E- mail: LAdams @Rlversldehome.com Pump or irrigation circle 67.84 2 Sign or outline lighting 67.84 2 CONTRACTOR Signal eircuit(s) or limited-energy Business name: Western Cascade Electric panel, alteration, or extension. Page 2 2 Each additional inspection over allowable in any of the above Address: 8900 SW Burnham St. G18 Additional inspection(1 hr min) 66.25/hr City/State/ZIP: ligard, OR 97223 Investigation (1 ltrmin) 66.25/hr Industrial plant (I hr min) 78.18/ hr Phone: ( 503) 521 -0000 I Fax: (503)521-8876 Inspections for which no fee is i ^ specifically listed ('A hr min) 90.0(1/ hr CCI3 Lie.: 153415 I Electrical Lie.: 34 -616C Suprv. Lie-: 0 ..s s' .ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: Plan review (25% of permit fee): Print name: Jeff Evens Date: • � '�� / .. State surcharge (1 of permit fee): Authorized signature: y TOTAL PERMIT FEE. l This permit application ra expires if a permit is not obtained within 180 Print name: Jeff Evens / / ' / Date: �IKII days after it has been accepted as complete. • Number of inspections allowed per pernrit- I Ulm ki ietPermas\ELC- PernrlAep doe 07/01710 440 - r6 15f( 1 IN5/COMM'Ea ,, n r. C III I Building Division Development Code Provision Review T[ G A R D Residential Projects Building Permit No.• F1 I ,,, ( a- 2OO''t 4: Site Address: 9' S a t.w FcQtJ • • T' Project Name & Lot No.: .f.Q,. M-ot -w i ' Loft' CWS Service Provider Letter Required: Yes ❑ No 4 _ Received: Yes ❑ No Routed Plans: Original Plan Submittal Date: q/A6//2-049 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 - �) or 91 ) @tigard- or.gov) Land Use Case N9. _ .. O6 ODD! ( M zonin g - i o E " Setbacks. as FT /Front tear 1 " . ' 1 ' 2-r Side ICP" Street Sider'OF Garage — 20 Pr LT Maximum Building Height 7 j 5 Fr Actual Building Height 2.- Pr IIKVisual Clearance I i asements r� /� LW Sensitive Lands Type: hn g t(6 Notes: Original Plan: Approved Not Approved ❑ Date: Y - z 7 / Z Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Engineering Review (con act Mike White at 503 - 718 -2464 or MikeW @tigard- or.gov) --Er Actual Slope: Notes: Original Plan: Approved] Not Approved ❑ Date: 1 al t Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 9 City Arborist Review (co e er at 503 - 718 -2700 or todd @tigard - or.gov) ❑ Street Trees ❑ Protected Trees Notes: Original Plan: Approved Not Approved ❑ Date: 9 ' z I Z Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Permit Coordinator. Review (contact Albert Shields at 503 - 718 -2426 or albert @tigard- or:gov) ❑ Conditions of Approval Prior to Issuance of Building Permit Notes : Original Plan: Date Sent to Applicant: Revision 1: Date Sent to Applicant Revision 2: Date Sent to Ap 'cant Okay to Issue Permit: Yes • Date Routed to Building: • Page 2 of 2 Y • 9592 SW Fern Hollow Ct 2190 A Right RECEIVE 9/25/2012 ! V D STORM SANITARY i GIT YOF TIGARD (; ST Er7 LIGHT 86.66 BUILDING, n,n,' f ' . -' ; S W F ' N '' OLLOW COURT 0 c , ' o � R 73'31 f-� 114 —___ — k — -- ---t 9; -, - ,--"" - ' . 7 --- 2. w i ‘'" - .. .'./ Jr' C :-.,.‘- a Z V #.#' -) :41 1 1 1 A 11 I V : .. . . I . .ae: N7 ___N. 4 : _ x v- ,,,,......, .� PUBLIC STORM ,.___ 0 � -: EASEMENT � �� s 16.90' ' 7.> , •i ' 22.72' \ y � 20.0# 26' G 37 , o MIN. .� 331 6 . z. \ '�� ��� 59' r 17.38 , �� ^.t �� \ • 29.76 { (� T tii \ cr \ �.C�Z[C \ oo\ :3.8 ' 1 5.10 �$ \ \ 59.42 -2 5.00'\ �ry6 tk \ $ 20-39 y 0 i i 8.40' i i ■ .7 i i / 7 i i ■ ikl:X N MINIMUM FRONT YARD:10 FEET (N) 20' 10' 0 20' MINIMUM SIDE YARD:5 FEET (W) . MINIMUM SIDE YARD:16.90' MIN. (E) MINIMUM REAR YARD: VARIES (S) MINIMUM GARAGE: 20 FEET (N) SCALE: 1" = 20' P.U.E.: 10 FEET D L 0o7 FERN HOLLOW ! P»\ TIGARD, OREGON DESIGN GROUP INC. LOT 6 14025 SuAR RD Q. Project No. RVR001 Date: 05/17/12 I. BEAVERTON, OR 97005 6 of 6 (503) 644 -4628 DOsES 12.31-13 I Scale: 1' = 20' Drown By. KIW FOR OFFICE USE ONLY — SITE ADDRESS: This form is recognized by most building departments in the Tri- County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. Ilpg City Of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Transmittal Letter .TI G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard- or.gov TO: DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED OCT 25 2012 FROM: Lindsay Adams CITYOFTIGARD COMPANY: Riverside Homes, LLC BUILDINGDNISION PHONE: 503- 645 -0986 By. RE: 9592 SW Fern Hollow Ct MST2012 -0024g (Site Address) (Permit Number) Fern Hollow Lot 6 (Project name or subdivision name and lot number) 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. 2 Engineer's calculations. 2 Other (explain): S -pages of blueprint REMARKS: Changed the TJI joists to dimensional lumber FOR OFF CE USE ONLY Routed to Permit Technician: Date: (01''J�j (9__� Initials: IAA Fees Due: ❑ Yes iA o Fee Description: Amount Due: $ $ Special Instructions: Reprint Permit (per PE): ❑ Yes ❑ No ❑ Done Applicant Notified: Date: Initials: I: \Building\ Forms \TransmittalLcucr- Rcvisions.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 9592 SW FERN HOLLOW CT, TIGARD, OR, 97224 Residential - Master Permit 505 Sanitary sewer 03/25/2013 00:00 MST2012-00248 PASS Don S inspected on Friday the 24th 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 9592 SW FERN HOLLOW CT, TIGARD, OR, 97224 Residential - Master Permit 340 Storm drain 03/25/2013 00:00 MST2012-00248 PASS Don S inspected on Friday the 24th 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 9592 SW FERN HOLLOW CT, TIGARD, OR, 97224 Residential - Master Permit 235 Shear walls/anchors 04/11/2013 00:00 MST2012-00248 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 9592 SW FERN HOLLOW CT, TIGARD, OR, 97224 Residential - Master Permit 315 Post/beam plumbing 03/28/2013 00:00 MST2012-00248 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 9592 SW FERN HOLLOW CT, TIGARD, OR, 97224 Residential - Master Permit 275 Framing 04/26/2013 00:00 MST2012-00248 PASS Jeff Grove'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 9592 SW FERN HOLLOW CT, TIGARD, OR, 97224 Residential - Master Permit 115 Electrical service 04/22/2013 00:00 MST2012-00248 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 9592 SW FERN HOLLOW CT, TIGARD, OR, 97224 Residential - Master Permit 235 Shear walls/anchors 04/11/2013 00:00 MST2012-00248 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 9592 SW FERN HOLLOW CT, TIGARD, OR, 97224 Residential - Master Permit 120 Electrical rough-in 04/22/2013 00:00 MST2012-00248 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 9592 SW FERN HOLLOW CT, TIGARD, OR, 97224 Residential - Master Permit 120 Electrical rough-in 04/22/2013 00:00 MST2012-00248 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 9592 SW FERN HOLLOW CT, TIGARD, OR, 97224 Residential - Master Permit 610 Gas Line 04/25/2013 00:00 MST2012-00248 PASS 30 pounds 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 9592 SW FERN HOLLOW CT, TIGARD, OR, 97224 Residential - Master Permit 275 Framing 04/25/2013 00:00 MST2012-00248 FAIL Jeff Grove's corrections not completed at this time 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 9592 SW FERN HOLLOW CT, TIGARD, OR, 97224 Residential - Master Permit 320 Plumbing rough-in 04/17/2013 00:00 MST2012-00248 FAIL 1. Provide 1/4" per ft. Grade for master bath left trap arm. Table 10.1 2. Provide water service approval. 103.5.1 All else ok can pull test 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 9592 SW FERN HOLLOW CT, TIGARD, OR, 97224 Residential - Master Permit 275 Framing 04/22/2013 00:00 MST2012-00248 FAIL 1. Mechanical approval required 2. Gas line approval required 3. Provide adequate fire blocking above gas fireplace in corner 4. Not a code violation but not a good practice of nailing trusses down to interior wall top plates. Can cause Sheetrock problems. Violation Summary: Inspector Contractor 1 _ v CITY OF TIGARD MASTER PERMIT 1111- 2 - COMMUNITY DEVELOPMENT � ' Permit #: MST2012 -00248 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718 2439 /� "�'' -= = Date Issued: 03/14/2013 Parcel: 2S114BA18000 Jurisdiction: TIGARD Site address: 9592 SW FERN HOLLOW CT Subdivision: FERN HOLLOW Lot: 6 Project: Fern Hollow, Lot 6 Project Description: New SF 6/24/13, reprinted to add a /c. Placement if a/c unit must comply with manufacturer's clearance requirements BUILDING Floor Areas Required Setbacks Required Stories 2 Bedrooms 4 First 972 sf Basement 0 sf Left 5 Parking Spaces: 0 Height 24 Bathrooms 3 Second' 1218 sf Garage: 390 sf Front. 11 Smoke Dwelling Units 1 Third 0 sf Right 5 Detectors. Yes Total 2190 sf Value. $244,632 92 Rear 2 PLUMBING Sinks 1 Water Closets' 3 Washing Mach' 1 Laundry Trays: 0 Rain Drain. 1 Urinals 0 Lavatories. 4 Dishwashers 1 Floor Drains, 0 Sewer Lines' 100 SF Rain Storm Sewer 100 Drains' 0 Tubs /Showers: 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: Y 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 4 201 -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 2190 Owner: Contractor: RIVERSIDE HOMES LLC RIVERSIDE HOMES LLC Required Items and Reports (Conditions) 17933 NW EVERGREEN PKWY 17933 NW EVERGREEN PKWY 370 1 Ersn Cntrl 503 - 639 -4175 SUITE 370 BEAVERTON, OR 97006 BEAVERTON, OR 97034 PHONE 503 -645 -0986 PHONE 503 - 645 -0986 FAX 503 -690 -2942 Total Fees: $18,658 96 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 AT TION • :.on law requires you to follow the rules adopted by the Oregon Utility Notifica ^ renter. Those rules are set forth in OAR 952 -00 -0010 through OA 952- 1 0090 You may obtain a copy of the rules or direct questions to OUNC by calla ,: 503 232 or 1 800 332 2344 r - Issu d By: ' '/ Permittee Si gna t ure. ) W / d' ,.. ' G 1 __ _ Call 503.639.4175 by 7:00 a.m. for the next available Inspection • e. 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. STREET TREE TIGARD CERTIFICATION I u\- L� roUtS owner/ agent or ? o�5 �L p_oyne � a g f ( 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.: ST a1) 1L - Q7 7L q STl E ADDRESS: 9 1, SL , ) 1 CI - SUBDIVISION.• c-fr,,.\ I,,.,)) v LOT #: SIGNATURE: DATE: ( I (OIYiNER /AGEl\rI) l RE CEIVED d� VERIFIED BY DA'I E: (CT/ Y OF TIGARD) ❑ Tree location ven: ed per approved site plan. 1• \Building\ Forms \Strcctl'rccCcrtificatc 05 /30/2012 Oregon Residential Specialty Code N1107.2 HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: c5`t 0 It- b ITO lb Jurisdiction: 1 5 c ,,,` Site Address: c k el ti W Cron 40 i I OL-J CI' Subdivision/Lot #: v c..,,,,\ 4 i ` 0 ) �and /or l 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, o a lighting source that has a minimum efficacy of 40 lumens per input watt. (Oregon Residenti , . pecialty Code N1107.2) Signature: ,ijt B /, Date: M 17 �� er /Ge erl el ' ctor /Authorized Agent Print Name: 6 ,r C K 64 yp I / 4 ORSC Section N1107.2. High - efficiency interior lighting systems. A minimum of fifty (50) percent o the permanently installed lighting fixtures shall be installed with compact or linear fluorescent, or a lighting source that has a minimum efficacy of 40 lumens per input watt. Screw -in compact fluorescent lamps comply with this requirement. The building official shall be notified in writing at the final inspection that a minimum of fifty percent of the permanently installed lighting fixtures are compact or linear fluorescent, or a minimum efficacy of 40 lumens per input watt. I. \ Building \Fonns \R ES-High EfficiencyLighting.doc 07 /0I /08 Oregon Residential Specialty Code R318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM r I, t b W v6 , am the general contractor or the owner - builder at the following address: Site Address: " I Se, 7 , 5 W I_ /> c4- City: 1 h w-A Permit #: m Sr Z 1'L — C i-4 Subdivision/Lot #: ey )41, j / 9 U U` 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 d weight of dry framing members. Signature: ., �,� Date: le l Ge !:ra c V r Owner- Builder 1:\ Building\ Fonn \RES- MoistureSensitiveWood.doc 09/25/08 ® Pa � W4 LL Se mess.]b1- tor % pN Air & Duct Leakage Affidavit Permit P. House address or lot number. `46 re, 4. 1(o Gf City. 4 1 - i:g Zip: a 7 Z2if Cond. Floor Area (ft2): 2 I c l 0 Average Ceiling Height: 6 - h' Air Leakage test; Maximum Air Leakage: (EACH x V / 60) = it $ 61 CFM @50 Pa Measured Alr Leakage: I C10 CFM@50 Pa L/&c VI z if-, $ 7 Baseline: -- . 0 Pa Ring (circle one if applicable): Oper()2 3 Windy? Yes o Air Handler in conditioned space? y e s CI • Ir Handler present during tes ti no Circle Test Method Leakage to Outsi Total Leakage Maximum duct leakage: Post Construction, total duct leakage: (floor area x .08) = CFM@50 Pa Post Construction, leakage to outdoors: (floor area x .08) = 1 31 CFM @50 Pa Rough -In, total duct leakage with air handler installed: (floor area x .06) = CFM @50 Pa Rough -In, total duct leakage with air handler not installed: (floor area x .04) = CFM @50 Pa Test Result: (Zt- CFM @50Pa Ring (circle one if applicable): Open 1(7. 3 Duct Tester Location: Rev- it Pressure Tap Location: Lt Vt t45 (VOA 5 G ( y I certify that these air leakage rates are accurate and determined using standard ODOE protocol. Company Name: Westside Drywall : sulation Technician: K - Chase Technician Signature: ..40 ,/ Date: ) -t 7--V) - ho e Number: 503 -806 -1339