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Permit II a CITY OF TIGARD MASTER PERMIT s COMMUNITY DEVELOPMENT Permit #: MST2013 -00053 T [GA R O 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/02/2013 Parcel: 1S136CA10500 Jurisdiction: TIGARD Site address: 11067 SW LEGACY OAK WAY Subdivision: WHITE OAK VILLAGE Lot: 26 Project: White Oak Village, Lot 26 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 3 First: 640 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 31 Bathrooms: 3 Second: 962 sf Garage: 182 sf Front: 10 Smoke Dwelling Units: 1 Third: 594 sf Right: 3 Detectors: Yes Total: 2196 sf Value: $236,451.28 Rear: 15 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 Drywell -Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 4 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn <100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Fum > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/ Svc or Fdr: 0 Ea addl 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: v BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R -3 2196 Owner. Contractor: HAWTHORNE BLOCK LLC WESTLAND INDUSTRIES Required Items and Reports (Conditions) 621 SW ALDER ST, STE 605 12670 SW 68TH AVE STE #400 1 Ersn Cntrl 503 - 639 - 4175 PORTLAND, OR 97205 TIGARD, OR 97223 PHONE: PHONE: 503- 245 -9715 FAX: 503 - 598 -9081 Total Fees: $15,849.77 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 Notifica '. n Cen ho . es are set forth in OAR 952 - 001 -0010 through OAR 952- 01 -00 0. You may obtain a copy of the rules or direct questions to OUNC by callin • 32 '0.332. 344. // �n n / Issued By: 01-00 j /Le Permittee Signature: Af � /w/w�� Call 503.639.4175 by 7:00 a.m. for the next available inspecti: . This permit card shall be kept In a conspicuous place on the job site until c etion of the project. Approved plans are required on the Job site at the time of each spection. Building Permit Application Residential RECEIVE' FOR OFFICE USE ONLY Received f • Pennit No.: u f 3� Iii City S of W Tigard $ 2 013 Date/By: 3g I .5 r . ...1 • 13125 5W Hall Blvd., Tigard, OR 97223 FEB 2 Plan Review 2 I z ` j*t i Other Permit: k,Jr2gp( 1 Phone: 503.718.2439 Fax: 503.598.1960 N II 'n Date/By: Ins Inspection Line: 503.639.4175 CITY 1 GARD Date Ready /By: �/ / saris: H See Page 2 for TIGARD p Notified /Method: a 1 / 13 71 � Supplemental Informati Internet: www.tigard- or.gov BUILDING DIVISION on TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ D emolition Permit fees* are based on the value of the work performed. ▪ Tew construction 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 �! Valuation: $ 23(0 1. l e 0 1- and 2- family dwelling ❑ Commercial /industrial Number of bedrooms: El Accessory building ❑ Multi- family ❑ O ther: Number of bathrooms: El Master builder e JOB SITE INFORMATION AND LOCATION Total number of floors: 3 Job site address: New dwelling arer 1` 6 square feet " � � � � n � � � � U � � square feet � City/State/ZIP: -7776_1.9,4 &,,e._ � 7 Z5 7j Garage/carport area: '18� ` 4 --,1A._ / j ki /L / TZ �), `/76 4. Covered porch area: 5 square feet ��2 Suitelbldg. /apt. no.: Project name: , Cross street/directions to job site: Deck area: square feet TAO Other structure area: 7.378 pare feet 3) REQUIRED DATA: COMMERCIAL - USE CHECKLIST Subdivision: /9: ! / .' / � L Lot no.: Pennit fees* are based on the value of the work performed. v �� Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: s 'J C� 1 D 8 equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. 7-4-4/4-.7-- / '!J Valuation: $ 4,0* � y ,11/-e:4, 7 !�`�� /�( Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: Phone: ( ) / Fax: ( ) New: [r APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule Business name: i/ y 57 _,L, /7 " 772 5 //It Structural plan review fee (or deposit): Contact name: /20/3 Acoc es //ill 57711- /�� a ,l-- FLS plan review fee (if applicable): Address: 4,26 7 r 4/v /fh-_, Total fees due upon application: City/ State/ZIP: �6-71 , 0/e 9 7 Z 23 Amount received: Phone: (5 ) 572_ -0 7�6 Fax: : Q ) fv� 10er _ PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E -mail: • • j /W ei 6 -i /k /L r Cei`y Commercial and residential prescriptive installation of CONTRACTOR roof -top mounted Photo Voltaic Solar Panel System. 11 Submit two (2) sets of roof plan with connection details Business name: 1 �: ► '�[ q and fire department access, along with the 2010 Oregon Address: r� \ e' 4 Solar Installation Specialty Code checklist. I —�O I��' �� Permit Fee (includes plan review City/ State/ZIP LI A q 7 ��_ and administrative fees): $180.00 Phone: ) '� Fax: ( ? '(? —ca) _ State surcharge (12% of permit fee): $21.60 CCB lic.: s` a sh Total fee due upon application: $201.60 This permit application expires if a permit is not obtained Authorized -aru e� within 180 days after it has been accepted as complete. 41 * Fee methodology set by Ti -County Building Industry Tint nan► r ��r Date: '�I� Service Board. L >11aa�i Jr 1 I: \Building\Penni, \BUP- RESPennitApp.doc 02/24/2011 440- 4613T(11/02/COM /WEB) Plumbing Permit Application RECEIVE Building Fixtures FEB 2 8 2013 Ft>i, 111 FICE USE ONLY City of Tigard Received sir Permit Nc s� 3 a:0313 nC ppr� Date/By: a ;7)55/(3 l 13125 SW Hall Blvd., Tigard, OR 97223 CITY TIGARD Plan Review Phone: 503.7182439 Fax: 503.598. ef91LDING DIVISIO �/� Date/By: Other Permit L 4D /�j 00J7 Inspection Line: 503.639.4175 �/ ISIV Date Read /B �uj�y El See Page 2 for T I G A K L7 Ready /By: Internet: www.tigard or.gov Notified/Method: I ((0 Supplemental Information TYPE OF WORK . FEE* SCI3EDULE New construction ❑ Demolition For special information use checklist Description Qty. I Ea. I Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION' SFR (1) bath 31230 allrtth- family dwelling ❑ Commercial/mdustrial SFR (2) bath 437.78 SFR (3) bath k 500.32 ❑ Accessory building ❑ Multi- family additional bath/kitchen 25.02 Each ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SIT INFORMATION AND LOCATION Site utilities: � , s� Catch basin or area drain 18.76 Job site address: j, f � �. 1,04 Catch Drywell, leach line, or trench drain 18.76 City/ State/ZIP: 41 04 L Footing drain (no. linear ft.: _, P age 2 Suite/bldg./apt no.: Project name: , /At-IC Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer (no. linear ft.: _) t Page 2 Storm sewer (no. linear ft.: _) f Page 2 Water service (no. linear it.: _) / Page 2 Subdivision: Ault A ill `/ ' j Lot no.: p Fixture or item: Tax map /parcel no.: / / 3 i c '' 6 Backflow preventer 31.27 Backwater valve 12.51 DESCRIPTION OF WORK / Clothes washer 25.02 �� 5� f Dl DESCRIPTION ^e� } O ` AKiZ.C- `rib/4167 ' Dishwasher ( 25.02 Drinking fountain 25.02 . Ejectors /sump 25.02 ❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Floor drain/floor sidc/hub 25.02 Address: Garbage disposal / 25.02 City/State/ZIP: Hose bib 7.- 25.02 Phone: ( ) z . Fax: ( ) Ice maker I. 12.51 PM4PPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02 Business name: / i (,� 7 A Medical gas (value: $ ) Page 2 / Primer 12.51 Contact name: l =� �/ S ;At /46-- (commercial) 12.51 Roof drain commercial Address: ( )4076 669 �1 Z: 00 Sink/basin/lavatory C 25.02 City/ State/ZIP: 17t .7 64, Q77,--27 Solar units (potable water) 62.54 Phone: (din - 7 ,f` 'l - ntizb Fax:: ( -9� / Tub/shower /shower pan 12.51 E -mail: �� ii.) : 3 P e - �� O Urinal 25.02 1 �1 Water closet 25.02 CONTRACTOR Water heater .1 37.52 Business name: /g'610 t� _ Pu4 6 � I C- Water piping/DWV 56.29 Address: /7 � `�.,,/ ) 41.74i' Other: 25.02 City/ State/ZIP: t;1a, ) Subtotal Phone: ( ) Fax: ( ) Minimum permit fee: $72.50 Plan review (25% of permit fee) CCB Lic.: q Plumbing Lic. no.: - .3 q. - 7,t, SIC State surcharge (12% of permit fee) Authorized signature. TOTAL PERMIT FEE Print nom�� 8/ t" ' t D ate: 2 . A This permit application exp i f a permit is not obtained within 180 days V� ! ". after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. I: \ Building \Permits\PLMU- PermitApp doe 10/01/09 440- 4616T(10/02/COM/WEB) Mechanical Permit ApplicationRECElVE r FOR OFFICE USE ONLa Cl of Tigard R permit N . City g FE 2 8 201 eceived DateBy: ,2� f 3 157 , 3 - 6 (3 14 - v 13125 SW Hall Blvd., Tigard, OR 97223 n p pn Plan Review q � , Phone: 503.718.2439 Fax: 503.598.1960 CITY OF TIGARD Date/By: Other Penfit a JO/ 3 - 04)04{7 T tG A R D Inspection Line: 503.639 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: I/ Co Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees* are based on the value of the work f g(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* NI- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description Qty. I Ea. Total JOB SITE INFORMATION AND LOCATION Heatinp,/cooling: Air conditioning Job site address: t 1 4 (9? V" ' 1 / �i rr , (requires site plan showing placement) 46.75 (/ry Furnace 100,000 BTU ( ducts/vents) 46.75 City /State /ZIP: ly.)<PM) © /�7 �/ Furnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg. /apt. no.: Project name: I .� � ! Heat pump `� (requires site plan showing placement) 61.06 Cross street/directions to job site: Duct work 23.32 Hydronic hot water system 23.32 Residential boiler (radiator or hydronic) 23.32 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 46.75 , Subdivision: Oi "( Fi Oily, Y (/ , f js6- I Lot no.: Flue /vent for any of above 23.32 1�+I �'�� Other: 23.32 Tax map /parcel no.: Other fuel appliances: DESCRIPTION OF WORK Water heater f 23.32 Gas fireplace/insert I 33.39 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 ❑ TENANT Chimney/liner /flue /vent 23.32 Other: 23.32 Name: Environmental exhaust and ventilation: Address: Range hood/other kitchen equipment L 33.39 City/State /ZIP: Clothes dryer exhaust 4 33.39 Phone: Fax Single -duct exhaust (bathrooms, ( ) ( ) toilet compartments, utility rooms) 4 23.32 APPLI ❑ CONTACT PERSON Attic /crawlspace fans 23.32 Business name: j W �Y Other: 23.32 fi t'( �.."`, l Fuel piping: r � Contact name: 1 Q n $14.15 for first four; $4.03 for each additional Address: 1 r V G t, l (� b �� 13 t,�/�' a Furnace, etc. ' 2 �� / "`� �/ l v Gas heat pump City/State /ZIP: II (p4) 0 & q7Z -V27 Wall /suspended/unit heater Phone: ( I N C) 7 ! Fax: ` (4) 4 g ( Water heater 1 V l�ff� Fireplace 1 E -mail: Range ' CONTRACTOR Barbecue Business name: JZ Age l r l gra L l r /..y..7- Clothes dryer (gas) Address: kk I JJ 9 D �� , t W t6 I f I r • &- Other: Y MECHANICAL PERMIT FEES * City /State /ZIP: �I l oe6-&- (J s� Q7b cc Subtotal Phone: ( ) / Fax: ( ) Minimum permit fee ($90.00) Plan review (25% of permit fee) CCB lic.: I Q 7 4' 9 State surcharge (12% of permit fee) /, TOTAL PERMIT FEE T his permit application expires if a permit is not obtained within 180 Authorized signature: days after it has been accepted as complete. Print name: ' .---- 11 *MI PITT 7 Date: / * Fee methodology set by Tri -County Building Industry Service Board _ L-� ate: �i I:\ Building \Permits\.MEC- PermitApp.doc 03/07/ ' 440.4617T(11/02/ aM/wEB) I RECEIV I Electrical Permit Application l t,lt (II I It I l :l: (,Nl.l City of Tigard FEB 2 8 201 . Received / 3" Permit NrQS+ ,A0 ' O00 S'3 la • 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review � 2 (901 - 001 Other Per (�,`� 0 Phone: 503.718.2439 Fax: 503.598.1960 CITY OF TIG ' • I) Date/By: T I GAM) Inspection Line: 503 BUILDING DIVIS a ReadyBy: 7u i : ® See Page 2 for Internet: www.tigard- or.gov �) nfied/M et hod: Supplemental Information TYPE OF WORK PLAN REVIEW ,,TNew construction ❑ Addition/alteration/replacement Please check all that apply (submit i sets of plans w /items 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 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 ❑ Emergency system. larger separately derived system. JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "1 - ", 1 - ", ? 100HP or more. occupancy. Job no.: Job site address: J JJ ,S6 / els�if 04-e. 4 -y ❑ Six or more residential units. ❑ Recreational vehicle parks. �� / �( `' ❑ Health -care facilities. ❑ Supply voltage for more than City/State /ZIP: �(. (� r! / I � 7j ❑Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: PffiT-c. (9/ &-Z- 0 Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description I Qtv. I Fee. I Total I * New residential single- or multi- family dwelling unit. Includes attached garage. • Subdivision: A if /1- 0,,4 - 141-46.-E- Lot no.: ;1., 1,000 sq. ft or less .. 168.54 4 Ea. add'/ 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential DESCRIPTION OF WORK (with above sq. ft) 75.00 2 Limited energy, multi - family 75.00 2 ( / ! /W V N , r & - /4'/ , e 5 4 residential (with above sq. ft.) W Services or feeders installation, alteration, and/or relocation 200 amps or less 100.70 2 ❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 Name: 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation, alteration, and/or City/State/ZIP: relocation Phone: ( ) Fax: ( ) 200 amps or less 59.36 1 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - new, alteration, or extension, per panel Owner signature' Date: A. Fee for branch circuits with APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7 42 2 each branch circuit Business name: g§72,4106 �^/QU57',L /f_ S B. Fee for branch circuits without service or feeder fee, first 56.18 2 Contact name: /Zoe AA) Df/WA) /,3 cnet,e0/�/.e - e--- branch circuit Each add'I branch circuit 7.42 2 Address: 49 6.1O ; jt0 G.±' S i 40 Miscellaneous (service or feeder not included) ty � 6*A / t / - ( Z3 3 Each manufactured serve and/or or r modular 67.84 2 City/State/ZIP: dwelling, service and/or feeder Phone: (5 ) 5 ' 7 ' 7 / 6 Fax: : (4 )78 ...._io 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 e croe /�)/ panel, alteration, or extension. Page 2 2 Business name: G 7;4U / 9(/,4 Each additional inspection over allowable in any of the above Address: rte/ Z1' 3 5C Additional inspection (1 hr min) 66.25/ hr Investigation (1 hr min) 66.25/ hr City/State /ZIP: £5 l'n 5ee/ ' 4' 9 7L # In dustrial plant (I hr min) 78.18/ hr S : Phone: 5 ) 3, e) -- CE.3q Fax: (8 I1) /I e - 01.60 Inspections for which no fee is 90.00/ hr specifically listed (h hr min) `f ( .2...... CCB Lic.: 6 c Electrical Lie.: 26- rogq(� Suprv. Lic.:: J 7 ), S ELECTRICAL PERMIT FEES Subtotal: Suprv. Electrician signature, required: Plan review (25% of permit fee): ft. Print name: ( —' t., • (! 10YAI S Date2 /. (� State surcharge (12% of permit fee): TOTAL PERMIT FEE: Authorized signature: ' This permit application expires if a permit is not obtained within 180 Print name: Date Z p days after it has been accepted as complete. p �� • Number of inspections allowed per permit. I:1BuiidinglPermits\ELC- PermitApp.doc 07/01/10 440- 4615T(11/05/COMAVEB IN . " Building Division Development Code Provision Review T l G A R D Residential Projects Building Permit No.: J--i a013 D 0 7 ‘ 3 Project /Subdivision Name: 4) N 1 T5 DAV- U l (9 L --- , Lot #: _ Site Address: 1 104' std L ,y' 041<— WAY CWS Service Provider Letter: Required: Yes ❑ No Er Received: Yes ❑ No ❑ Plans Routed: Original Plan Submittal Date: ?/9 -d/ 3 Routed By: 1St Revision Submittal Date: ❑ Site Plan Only Routed By: 2n Revision Submittal Date: ❑ Site Plan Only Routed By: 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 'f approved. i Planning Review (contact at (503) 718 - or V or @tigard- or.gov) Land Use Case No V0 l)t —2)00/ D Zoning J - /7---- U Setbacks: Front l 19 Rear / Side 3 Street Side N4 Gage 0- [ ra Maximum Building Height: -7.5.-- Actual Building Height 3 ' r T M Visual Clearance C" asements lensitive Lands Type: IJ' Street Trees ❑ Protected Trees Notes: Original Plan: Approved Not Approved ❑ Date: 3/ 4/I / Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 I: \CURPLN \Masters \Development Code Provision Review \DCPR_RES.doc Rev. 01/16/13 Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @tigard - or.gov) Er Actual Slope: S c Notes: Original Plan: Approved .0' Not Approved ❑ Date: W4://3 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 o ❑ Date Routed to Building: 3 14 •• Page 2 of 2 I: \CURPLN \Masters \Development Code Provision Review \DCPR_RES.doc Rev. 01/16/13 RECEIVED FEB 2 8 2013 CITY OF TIGARD SITE PLAN NOTES: BUILDING DIVISION I. ALL EXCESS GRADNG MATERIAL TO DE EXPORTED TO AN APPROVED DISPOSAL LCCATTCFL FOWLER 2. ALL PILL AREAS If UNDER GARAGE FLOORS, SIDEWALKS, DTtlVELLWYS, ETC.. TO DE COMPACTED GRANULAR FILL 3. THERE WILL BE A SLIGHT CWIER EXCAVATION TO PROVDE CONCRETE PORING ALL HONE + DESIGN AROUND NEU STRUCTURE. 4. PROVIDE COUNTY rr r m � APPROVED mr-443 ARaNO ExcAVATED AREA i 1 / SW LEGACY OAK WAY e PROVIDE COUNTY/CITY APPROV STABILIZED GRAVELED CONSTRUCTION ENTRANCE PRIOR TO ExCAVATION AFC c ED 6 . • STOCKPILED GTOBER T WITH MULCH OR PLASTIC SHEETING MUM T 11 �© to " 1 CONTRACTOR/ Sue- caNT RAC OR TO r LOCATION OP All UTILIT ES PRIOR TO a - 2c ' • CV 4 EXCAVATION A CONSTRUCTION. & BCUDARTY AND TOPOGRAPHY INFORMATION 1446 EMI PROVIDED TO eKYLNE HOPIS „� � , �'u"'� .. le VI AFC DESIGN I. SKYLINE HOMES AND DESIGN. INC. WILL HOT DE HELD LIABLE FOR THE = cAre SE' PILL ACCURACY OP THI6 NPORMATICK IT 16 THE SOLE RESPONSIBILITY CP THE CC TRACTOR T 2' A roINER TO VE U1 BI RVY ATE ccFCTTIOFUe INCLUDING PL CLLDG ACCD ON arm R EE DIVE n TOPOGRAPHY ELEVATIONS MRS COLLECTED PROM ACTUAL BITE SURVEY. e I 9 b. ELEVATION LEGEND. 4411 EE• EXISTING GRADE ELEVATION .'R• JAR FE. PAN Ie GRADE ELEVATION X W N P. PNISHm FLOOR ELEVATION -, R PROVIDE A nNCL 1 GRAVEL BASE INDER ALL DRIVEWAY AREAS. (i 1 ii i al 12. PfeGVDE A 4' MNIII.P1 GRAVEL G4eE UDER ALL SIDEWALK AND PATIO AREA& .> m a o * W B PIPE P� . PE ALL STORM DRAINAGE PROM TI.D BUILDNG TO A CO$NT1',CITY DIEPOEAL " g 5 Q POMnTONNECT . Lf F LAkI M.! 1 SLOPE Q CUTS AND PILLS TO DE TWO f4U HORIZONTAL TO CM lU ` ,q 1 1 r'', VERTICAL FOR BUILDIFG6, STRUCTURES P UNDATUONS. AND RETAINING WALLA " 23 ATI BRIC'ND . PE AND MAMTAN 1NI644 GRADE IIATH PO6RIVE DRAI4 AWAY PROM 9 d SQ. ^ I STRUCTURE ON ALL SIDES WITH A SLOPE OP 6' 113161.61 N b'-C'. � � .6,i L 0 IMPERVIOUS AREA'S: 134 SQ. FT. DRIVEWAYS 54 SQ. FT. PORCH 16•416•40' 3 4 IS SQ. FT. WALK PATIO a n 100 PATIO T PLAN No.: 3069 132 SQ. FT. OVER-IAWGS it 962 SQ. FT. BUILDING COVERAGE L X \te 9�V r 60 p 02-11-2013 1,400 TOTAL SQ. FT. IMPERVIOUS AREA'S LOT 26 d 23'-0. •r r j WHITE OAK VILLAGE SCALD: 1'•20' -0' LOT INFORMATION: TIGARp, OR. - LOT AREA: 1,915 SQ. FT. ' PL O �T� IMPERVIOUS COVERAGE: 438 SQ. FT. PLA1 t BUILDING COVERAGE: 42 % BUILDING HEIGHT: APPROX---- 33' -2' MN. BUILDING SETBACKS: IL'S' FRONT, B' REAR 3' SIDES. 0 �� 4. __, 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 11067 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 275 Framing 06/05/2013 00:00 MST2013-00053 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 11067 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 320 Plumbing rough-in 05/29/2013 00:00 MST2013-00053 FAIL 1. Provide test on upstairs tub/shower valve. 609.4. 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 11067 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 115 Electrical service 05/31/2013 00:00 MST2013-00053 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 11067 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 615 Mechanical rough-in 05/31/2013 00:00 MST2013-00053 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 11067 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 610 Gas Line 06/03/2013 00:00 MST2013-00053 FAIL 1. provide minimum gas pressure of 10psi for 15minutes. (5psi) 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 11067 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 310 Crawl drain 04/12/2013 00:00 MST2013-00053 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 11067 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 240 Exterior sheathing 05/29/2013 00:00 MST2013-00053 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 11067 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 240 Exterior sheathing 05/23/2013 00:00 MST2013-00053 FAIL Work shall be installed in accordance with the approved construction documents per ORSC R106.4 Garage "D" walls to be 2" on edges and back of house "C" walls 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 11067 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 240 Exterior sheathing 05/29/2013 00:00 MST2013-00053 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 11067 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 120 Electrical rough-in 05/31/2013 00:00 MST2013-00053 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 11067 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 320 Plumbing rough-in 05/23/2013 00:00 MST2013-00053 FAIL 1. Provide test on hall bath tub/shower valve. 609.4 2. Strap 1 1/2" auto washer vent, ceiling 2nd floor ceiling at 4' Ok to pull DWV 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 11067 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 320 Plumbing rough-in 06/03/2013 00:00 MST2013-00053 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 11067 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 340 Storm drain 04/05/2013 00:00 MST2013-00053 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 11067 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 335 Rain drain 04/12/2013 00:00 MST2013-00053 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 11067 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 225 Post/beam structural 04/15/2013 00:00 MST2013-00053 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 11067 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 335 Rain drain 04/12/2013 00:00 MST2013-00053 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 11067 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 505 Sanitary sewer 04/05/2013 00:00 MST2013-00053 PASS Violation Summary: Inspector Contractor Oregon Residential Specialty Code N1107.2 • HIGH- EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: Jurisdiction: / Site Address: //06 7 510 Z,6r-ricy r� Subdivision/Lot #: O f/re A zAt c_ c___ e 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) 0 Signature: - �� Date: � / l 3 •Q'rr /General Contractor /Authorized Agent Print Name: 3 V LiA__Sd4.1 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:\Building\Forms\RES- HighEfficiencyLighting.doc 07/01/08 Oregon Residential Specialty Code 8318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM I, 46 /4g/e-z-4V , am the general contractor or the owner- builder at the following address: Site Address: / (9& 7 (► & A6:,fc4/ 04e-- a/ City: 767 Permit #: /I j 5 To10/ 3 , DO C 3 Subdivision/Lot #: %J,' / ( 4 j 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. 0 Signature: ``•.... - 41111. ■ Date: 6 "l -/3 Ge ,' Contractor or Owner- Builder I:\ BuildingWorm \RES- MoistureSensitiveWood.doc 09/25/08 STREET TREE TIGARD C ER TIFICA TION I _ � owner / a ent or A5 T wo aysrx/f� S' agent (PLEASE PRINT) (PERMIT HOLDER) do hereby certift 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.: rsi a-O /3 -od0 S3 SITE ADDRESS: //oh 7 $) ZE 6- 4C / a4I G (1 SUBDIVISION: re- LOT #: SIGNATURE: gP DATE: - / — 3 (0 ' /AGENT) RECEIVED & (-) VERIFIED BY f =' DALE: R - (CITY OF GARD) ❑ Tree location verified per app ived site plan. I: \Building \Forms \StreetTreeCertificate 05/30/2012 s 2d1 - ozro 53 / /oC, 7 Sb1/ Le, �_c i OA k Form 6405 \I Completion Certification —Site Inspection 'AN 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: 4129 /2013IVerifier Name: Jesse fear Date: 7 /29/2013IVerifier Name: Jesse fear Incentive Payee Company Name: Builder or Company: westland Industries Contact Name: Performance Testing Company: Technician Name: Verifier Payee Company Name: Technician Name: Jesse Fear Site Information Development white oak lot F l #• to I � Project n is ENERGY Name &Lot # File #: S TAR®) Site Address: 11067 sw legacy oak City: portland State: OR Zip: 12 Unattached ❑Attached Number of Stories: 2 Total Conditioned Area: 2109 Sq. Ft. I# of Bedrooms: .3 UNone [ Full Basement []Half Basement L]Crawlspace Water Heater Basement Type: Electric ❑Garage/basement combo ['Slab on grade ❑Other Fuel: Electric Provider. Portland General Gas Provider. INW Natural Electric Meter Number (must be permanent meter number): Gas Meter Number (must be permanent meter number): 25 331 252 46373506 Additional Project Information (please mark all that apply) " ❑ Code plus Best Practices (meets minimum Best Practice requirements with improvements above code) Ei Path 1 EPS° Best Practices ❑ Path 2 ENERGY STAR ❑Envelope Upgrade DE 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 EI No Does this project qualify as Low Income? (must provide documentation from builder) Accessory Dwelling ❑Yes El No Is this home an ADU? Unit ❑Yes El No Is the ADU separately metered? If so, provide meter numbers above Other Certifications ['Earth Advantage - Certification Level ❑LEED -H - 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 's \ New Homes Program — Single Family EnergyTrust of Oregon Verification Type Actual Model Equipment Details 8 Notes Category Insulation Flat Ceiling • R- 49 Insulation Type: bib Framing Type: Vaulted Ceiling R- Insulation Type: ❑Standard Scissor Truss R- Insulation Type: lel Intermediate Above Grade Walls R- 23 Insulation Type: bib ❑Advanced Below Grade Walls R- Insulation Type: Framing Size: Floor Over Unheated Space R- 30 Insulation Type: bait Floor. Over Garage R- 30 Insulation Type: bib Slab Floor (unheated) R- ['Under ❑Perimeter ❑Full Slab (Perimeter and Under) Doors Door R- Door Material: Windows U- 0.30 Window Frame Material: Windows SHGC: 0.30 vinyl U- Skylights SHGC: Window Area (Glazing) % Total window area: Lighting # Fixtures: 36 Indoor and Outdoor 52 % # ENERGY STAR fixtures or CFLs: 19 Appliances ENERGY STAR Dishwasher to Yes ❑No EF: Model #: Cooling Air Conditioning SEER: Btu/Hr: Fireplace AFUE: 95.5 Brand: Fraser Johnstone Primary Heat Source O Gas Furnace HSPF: Model #: tg9s060a10mp11 b ['Electric ['Boiler SEER: Serial #: w1d3668359 O Gas Heat Pumps COP: Btu/Hr: 60k ['Air Source (ducted) Outdoor Unit (for heat pumps) ['Other: Mini Split ductless ❑ P (ductless) Location: Model #: ['Ground Source cond space Serial #: ❑Radiant Floor Heat ECM Des is No Heat pump commissioning report attached or confirmation for ground source heat pumps that ❑Cadets Electronic Air Cleaner ❑Yes Ei No manufacturer's start up procedure was performed. ['Zonal Backup fuel ❑Electric ❑Gas ❑Other ❑ Yes ['Other Notes on Primary Heating: Notes on Secondary Heating: Water Heater Type: Gallons: Brand: firma' El Electric Storage EF: 0.82 Model #: r1751 ❑Gas ❑Tankless Location: Serial #: dk ca 099000 Btu/Hr: 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 2 of 3 Form 640S \li Completion Certification — Site Inspection Energy Trust New Homes Program — Single Family of Oregon Ventilation OgditibIOOnly Meets Energy Trust Mechanical Ventilation Requirements? S Energy Trust of Oregon's Is Yes ❑ No ['Supply Only Mechanical Ventilation Requirement O Air Cyder HRV /ERV Model #: ❑HRV /ERV Ducts EI Ducts Inside % ducts inside: 95 Ducts in Conditioned Space If claiming incentive for ducts inside, check one of the following: ❑Ducts Tested IC/Visual Inspection per RTF Specs Duct Insulation R- 8 Duct Location: Ducts Sealing w/ Mastic 0 Yes ❑No Performance Testing 4 • Duct Leakage Duct Leakage Cubic Feet Per Minute (dm) Duct Leakage Air Handler in El Yes Air Handler Installed During El Yes 105 @ 50 Pa 11 Pass ['Fail Conditioned Space? ❑No Test'? ❑No Fan Pressure ❑ DG3 Fan Ring Size/Type ❑o 02 Leakage Test El Total Leakage Gauge In DG700 Pressure: 271 (check one) ❑ 1 il 3 Method ['Leakage to Outside Duct Blaster Location: return Pressure Tap Location: supply !Area Tested: 2109 Whole House Leakage Whole House Air Changes per Hour (ACH) Envelope Tightness Cubic Feet Per Minute (cfm) Leakage House Volume: 17399 3.9 @ 50 Pa ICJ Pass ['Fail 1141 @ 50 Pa Best Practices Requirements (All requirements must be met to receive an Energy Performance Score) • Thermal Enclosure Checklist complete 0 Pass ❑Fail (Thermal Enclosure Checklist attached? ❑Yes • Insulation Quality Inspection Performed El Yes ❑No --- (complete insulation verification section below) • Approved Mechanical Ventilation Installed El Yes ❑No -+ (complete mechanical verification section below) • Zonal Pressure Relief - All zones comply Ei Yes ❑No If no, state reason for failure: • Combstion Appliance Zone 1 NetCAZ Pressure: Pa If not applicable, please explain: all dv Testing 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 Jesse fear Verifier Jesse fear Date: 7/29/2013 Signature: Name: Red Tag Inspection (f 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