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Permit „ CITY OF TIGARD MASTER PERMIT . 8' COMMUNITY DEVELOPMENT Permit #: MST2013 00126 T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/18/2013 Parcel: 1 S136CA08400 Jurisdiction: TIGARD Site address: 11048 SW LEGACY OAK WAY Subdivision: WHITE OAK VILLAGE Lot: 5 Project: White Oak Village, Lot 5 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 3 First: 596 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 27 Bathrooms: 3 Second: 884 sf Garage: 162 sf Front: 10 Smoke Dwelling Units: 1 Third: 538 sf Right: 3 Detectors: Yes Total: 2018 sf Value: $223,784.93 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 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: 3 201 -400 amp: 0 201 -400 amp: 0 W/O Svc/Fdr: 0 Mfd Home /Feeder /Svc: 0 401 -600 amp: 0 401 -600 amp: 0 601 -1000 amp: 0 601 +amp- 1000v: 0 1000 +amp /volt: 0 ELECTRICAL - RESTRICTED ENERGY SF Residential Audio & Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R -3 2018 Owner: Contractor: ANDERSON HOMES & CONSULTING LLONESTLAND INDUSTRIES Required Items and Reports (Conditions) 12670 SW 68TH AVE, SUTIE 400 12670 SW 68TH AVE STE #400 1 Ersn Cntrl 503 - 639 - 4175 PORTLAND, OR 97223 TIGARD, OR 97223 PHONE: 503 -572 -0746 PHONE: 503 - 245 -9715 FAX: 503 -598 -9081 Total Fees: $18,228.87 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. Thos- es are set forth in OAR 952- 001 -0010 OAR 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2 ; t ..32.23 4. Issued By: --t,(C-e--e`-e Permittee Signature: \ . Call 503.639.4175 by 7:00 a.m. for the next available Inspection da This permit card shall be kept in a conspicuous place on the Job site until comple on of the project. Approved plans are required on the job site at the time of each inspection. building Permit A licagi ECE El .� 4 , Residential MAY 29 9 2013 -' FO USE ONEY i. q City of Tigard ITY OF TIGA, eD Deceived W s� Permit No.: � ��f� / (j� 3 Q0 4:94 7 1 13125 SW Hall Blvd., Tigard, OR 97223 I e IIC��� , .� Internet: www.tigard- or.gov Plan Review p. r_ Other Permit: eA 3-00W `, 2 , Phone: 503.718.2439 Fax: 503.59:; ,: DI NG D V �3 Date/By: 44 ' IV ( 1 Inspection Line: 503.639.4175 Date Ready /By: )uric: El See Page 2 for T.1 "GARD Notified /Method: //A /3 Supplemental Information ._ _ _ � TYPE OF WORK REQUIRED DATA: 1- AND 2-FAMILY DWELLING / Pennit fees* are based on the value of the work performed. New construction ❑Demolition 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: $ 22"S "M 0 1 - and 2- family dwelling ❑ Commercial /industrial Number of bedrooms: ' El Accessory building ❑ Multi- family d ❑ Master builder 0 Other: Number of bathrooms: , C JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: f 4 91 / i or y ag. `,h New dwelling are La I e " square feet City /State/ZIP: 4 7 4), &,,72 � 72-5g 5 / Garage/carport area: 4 square feet j38 Suite/bldg. /apt. no.: & r s- Project name: /14 (� `/C /-/' Covered porch area: 53— square feet 604-- Cross street/directions to job site: Deck area: square feet �J16 Other structure area. s feet 27 REQUIRED DATA: COMMERCIAL - USE CHECKLIST Subdivision: /ay r ri, V 24.K._ U( ri Lot no.: S 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.: / 5• / 3, C i Ll p equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. Valuation: $ /0/�y 'LT ,&4' Sl t;1 .-- /!y 4� 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: 7 APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: ��G 9f ( ,L //) _ A f,/ D j7-72 j i 5 /At_ Structural plan review fee (or deposit): Contact name: 720/ /f /, /, % &scsAJ / JUy //),//L e � 71 FLS plan review fee (if applicable): Address: / »G 74 50 �2 �d� ) � Total fees due upon application: City / State/ZIP: �/qy?6 , aie ? 7_2_3 4) a /0 � / Amount received: ��� . Phone: (S�3) j 7 } -0 7�G Fax:: 6Qj ) S� r .. , J 0� f 6 4•F /G GG� } PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: ; (� �, Commercial and residential prescriptive installation of CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System. Business name: (4} lwr4_cs . Submit two (2) sets of roof plan with connection details and fire department access, along with the 2010 Oregon Address: �`� \ Solar Installation Specialty Code checklist. ty ` 1 Ci / State/ZIP.� t;lliz,b q 72.•7 Permit Fee (includes plan review and administrative fees): $180.00 2 Phone: 4 ) • ` ( Fax: (9 —qop I' State surcharge (12% of permit fee): $21.60 CCB lic.: ` U1a Total fee due upon application: $201.60 Authorized ' • arm" This permit application expires if a permit is not obtained �{� within 180 days after it has been accepted as complete. ' - Tin . _ _ ._ l ,-. c �VU r Date: *Fee methodology set by Tri-County Building Industry t Hatt / ` Service Board. "I I:\Buildinr\Penni. \BUP- RESPennitApp.doc 02/24/2011 440- 4613T(11/02/COM /WEB) Plumbing Permit Applic c \' ` C �� FD Building Fixtures MAY 2013 FOR OFFICE USE ONLY Received Permit No.: nI, City of Tigard Date/By: T/ / 9`�J / i 3 Sr r94, 3 -Dv I.2 , . , n 13125 SW Hall Blvd., Tigard,01j�7 n� V iGARD Plan Review 111 I,gg�§ Other Permit No.: C Phone: 503.718.2439 Fax: 50 9 p� DatelBy: c5/0/2401 3-ex:' i l TIGARD Inspection Line: 503.639.4175 BUILDING DIVISION Y DateReadyBy: Juris: 0 See Page2 for Internet: www.tigard- or.gov Notified/Method: Supplemental Information � • TYPE OF WORK . FEE* SCHEDULE . 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 312.70 nd 2- family dwelling ❑ Commercial/industrial SFR (2) bath 437.78 SFR (3) bath I 500.32 ❑ Accessory building ❑ Multi- family Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SIT INFORMATION AND LOCATION Site utilities: Job site address: / , 9 ° J n� s ` 1,� Catch basin or area drain 18.76 -jl (� 4/1111 / / Drywell, leach line, or trench drain 18.76 City/State /ZIP: �� r Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: I Project name: //0 CW iliklgriC 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.: ) t Page 2 Subdivision: 0 ! r " ---- Lot no.: Fixture or item: Tax map /pazcel no.: l l 3 c •A .c' Backflow preventer 31.27 :' . i Backwater valve 12.51 DESCRIPTION 0 ORK �j J ,, { p, f Clothes washer 25.02 6 6A15r /lie 4 7. '' 6/�IL2.C� ���G /& Dishwasher ( 25.02 Drinking fountain 25.02 . Ejectors /sump 25.02 ❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Fixture/sewer cap 25.02 Name: Floor drain/floor sinlc/hub 25.02 Address: Garbage disposal / 25.02 City/State /ZIP: Hose bib 7 25.02 Phone: ( ) Fax: ( ) Ice maker ( 12.51 I VAPPLICANT C ❑ CONTACT PER Interceptor /grease trap 25.02 Business name: r Alb /u�r�jf ��"i. Medical gas (value: $ ) Page 2 ,a \ / � Primer 12.51 Contact name: tt �� � �� 6F � A / � Roof drain (commercial) 12.51 Address: ( )4 076 ,c� 64 �' ' (/7 Sink/basin/lavatory S- 25.02 City/State /ZIP: 17( 2) et- .q7�2, '�K(vJJ Solar units (potable water) 62.54 Phone: (t � 062� Fax :: ( {/S -CMS / Tub /shower /shower pan 12.51 E -mail: 1'5 col- @ ..6 f Zo (u Urinal 25.02 ? r�r ° -" I ( Water closet 25.02 CONTRACTOR ' Water heater ? 37.52 Business name: / )01,40 ( � c_ Water piping/DWV 56.29 Address: /7 h / Other: 25.02 City/State/ZIP: 6-0t) / �j() .2/ b Subtotal Phone: ( ) Fax: ( ) Minimum permit fee: $72.50 �//�,, Plan review (25% of permit fee) CCB Lic.: 3 y(.„ Plumbing Lic. no.: 3 - A S kl- State surcharge (12% of permit fee) Authorized signature: 12( TOTAL PERMIT FEE e Da te: ' This permit application expires if a permit is not obtained within 180 days Print Warn J - n/ (� N / k J • . / after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. I:\ Building \Permits\PLMU- PermitApp.doc 10/01/09 4404616T(10/O2JCOM/WF-B) I Mechanical Permit Applicati 7 � � -� FOR OFFICE USE ONLY u ® Received P No.: �� J ? _ 1114 City of Tigard r L, \ \ � � r „ l Date/By: 7T �4 )-/ DD / [p ° 13125 SW Hall Blvd., Tigard,OR 97223 Plan Review TM Phone: 503.718.2439 Fax: 503.598.1960`���Y 2013 Date/By: Other Permit: ( 5j -c' //5i TI G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: El See Page 2 for Internet: www.tigard-or.gov CITY p OF TIGARD Notified/Method: Supplemental Information TYPE OF v ll.t.. ■ INC DIVISION COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees* are based on the value of the work 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. Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling: if ? SO Air conditioning Job site address: (requires site plan showing placement) 46.75 City/State/ZIP: 110/PAZ3) Furnace 100,000 BTU ( ducts/vents) 1 46.75 Ci ty © 617 7 l Fumace 100,000 +BTU (ducts/vents) 54.91 Suite/bldg. /apt. no.: Project name: ' ►C thig 0�. _ t l / ` t Heat pump V" * t• r ` C/7 "`� V `+�/' " " (requires site plan showing placement) 61.06 Cross street/directions to job site: urr c 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: 044,fifg. O - IA /, �j �l Lot no.: s Flue /vent for any of above 23.32 Itiq , ■ Other: 23.32 Tax map /parcel no.: Other fuel appliances: DESCRIPTION OF WORK Water heater 1 23.32 Gas fireplace/insert 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 1 _ 33.39 Single -duct exhaust (bathrooms, ) Phone: ( ) Fax: ( ) toilet compartments, utility rooms) '7 . 23.32 APPLICANT 0 CONTACT PERSON Attic /crawlspace fans 23.32 Other: 23.32 Business name: .4 C , Fuel i in � P P 8: Contact name: 3 t i n , � � $14.15 for first four; $4.03 for each additional 1 Address: ' \ tf/��} Furnace, etc. l ZtD� 0 '7 `�� 6 l V Gas heat pump City/State /ZIP: ' ! ( ") 0 0, (. 7z y � Wall /suspended/unit heater Phone: (03 7 to c ) b 2 [2 Fax:: I � , 4a Q ( Water heater v � a Fireplace I E -mail: Range 1 CONTRACTOR Barbecue Business name: ge (y ! t 1I �r (.Tfa L J..� eel) I A Clothes dryer (gas) kJ Other: Address: , 9 ()Q4 W811,- E5 A I� MECHANICAL PERMIT FEES* City/State /ZIP: ��'D ' &.� Q7b b S-C Subtotal �'f `� v Minimum permit fee ($90.00) Phone: ( ) Fax: ( ) Plan review (25% of permit fee) CCB lic.: ` Q 7 4 , State surcharge (12% of permit fee) TOTAL PERMIT FEE nature: i ' , l This permit appli cation expires if a permit is not obtained within 180 Authorized si g �/ � days after it has been accepted as complete. Print name: e ^ Z C�� Date: S .ZQ ("5 \ B * Fee methodology set by Tri- County Building Industry Service Board I:ui lding\Permit.AMEC- PermitApp.doc 03/07 /12 440- 46177T /02/COM/WEB) / LISL ONLY Electrical Permit Applicati ` �E \` ED FOR OFFICE Received Petmi No.. � i 3 -qG 114 q City of Tigard �p Date/By: 3� M i ° y 13125 SW Hall Blvd., Tigard,OR 9722MM 2, ;Y 2013 Plan Review Other Permit: �W 2. „g i ; - Oo //V Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Inspection 503.639.4175 G� i Y OF TIGAR Date Ready/By: furls: H See Page 2 for T(GARU p ection Line: 503. ® Notified/Method: Supplemental Information Internet: www.tigard- or.gov � R � n'� DIVISION TYPE OF V�� 6 077 . PLAN REVIEW_. New construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 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 build amps for all other installations. buildings. 71-1-, ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or ❑ Emergency system. larger separately derived system. JOB SITE INFORMATION ANI LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "1 - ", "1 - ", 1001W or more. occupancy. Job no.: Job site addressa . 4 ) t , £��t` 044 v � ❑ Six or more residential units. ❑ Recreational vehicle parks. / ❑ Health -care facilities. ❑ Supply voltage for more than City/State /ZIP: / �� U L(� l�� / ❑Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: �,,�,��•r—y (9/ U/�41.(r. ❑ 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: Al V Lot no ' 1,000 sq. ft. or less ( 168.54 4 /f �T� i 4-i4 ifi1-Z-4 Ea. add'l 500 sq. ft. or portion , 33.92 l Tax map /parcel no.: Limited energy, residential I 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) //II / / Limited energy, multi - family 75.00 2 6,,)SwG ,iV iiv 5r4 lkii residential (with above sq. ft.) 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 ❑ CONTACT PERSON above service or feeder fee, 7.42 2 each branch circuit Business name: B. g,7-2„, �� Fee for branch circuits without ✓ ,67`, /,, s service or feeder fee, first 56.18 2 Contact name: Z , Tje/ �/,�,� branch circuit r ` - 2 �N ���� J / Each add'l branch circuit 7.42 2 Address: id_ 6 /0 ; ea GpN' , 50 ire, ifO Miscellaneous (service or feeder not included) �1 3 Each manufactured or modular 67.84 2 City/State /ZIP: • 0 / QO ei / 2 dwelling, service and/or feeder �t Reconnect only 67.84 2 Phone: (5 )5'n �7Gf(,� F (c0 3 )G� 10 Pump or irrigation circle 67.84 2 E - mail: Signor outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited- energy .�' panel, alteration, or extension. Page 2 2 Business name: �G e f2 /C� 4, 0 0f4 vat/5 Each additional inspection over allowable in any of the above Address: `` 446 c /�/� Additional inspection (1 hr min) 66.25/ hr ri / � ✓ � � �" - r[/J� 66.25/ hr Investigation (1 hr min) City/State /ZIP: ,(? . . q _ G ' 5 : ' oz.,. 9 d ea f Industrial plant (1 hr min) 78.18 / hr • • Phone: () ) 35 •- C W,q Fax: (8 ) I+ b• - ln 60 Inspections for which no fee is 90.00 / hr specifically listed (/a hr min) CCB Lic.: 6 ( Y (� h. Electrical Lic.: �q�(,I Suprv. Lic.: )) S ELECTRICAL PERMIT FEES Subtotal: Suprv. Electrician signature, required: Plan review (25% of permit fee): Print name: i • ( tier5 Date: State surcharge (12% of permit fee): �/ TOTAL PERMIT FEE: Authorized sign uie: it This permit applica expires if a permit is not obtained within 180 A 6 days after it has been accepted as complete. Print name: Date: • .11") • 9 • Number of inspections allowed per permit. 1:\ Building \Permits\ELC- PermitApp.doc 07/01/10 440 4615T(11 /05 /COM/WEB C " Building Division Development Code Provision Review T I G A R D Residential Projects , Building Permit No.: H D l 3 - oo / Project /Subdivision Name: 1.,,...14- i Tt- OA V I necf / , Lot #: S Site Address: () DO olw Lt re, , -cy 6P . way CWS Service Provider Letter: Required: Yes ❑ No Received: Yes ❑ No Plans Routed: Original Plan Submittal Date: �i'/� 4JI 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 if approved. Planning Review (contact trIrN KCf f r at (503) 718-242-1 or arrTiZ.S [ =- @tigard- or.gov) Land Use Case No. S lP,7b -l..C 1 P.P2 2 —: I Zoning R -1 2 (P D ) 3 Setbacks: f yront 10 Rear I S Side �J Street Side NA Garage � Maximum Building Height: )✓ Actual Building Height t 2-1 ❑ Visual Clearance / 4-- Er 9.sements L SS nsitive Lands Type: I Q Street Trees ❑ Protected Trees Notes: Original Plan: Approved Not Approved ❑ Date: 131 �J 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) o r Actual Slope: Notes: - Original Plan: Approve Not Approved ❑ Date: / ' R 1: Approve 0 Not Approved ❑ , Date: i 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: i Revision 1: Date Sent to Applica Revision 2: Date Sent to App • ant Okay to Issue' Permit: Yes o ❑ Date Routed to Building: • • • • ti • i • ?‘ I' Page 2 of 2 I: \CURPLN \Masters \Development Code Provision Review \DCPR_RES.doc Rev. 01/16/13 l !EC EV E ) Y • SITE PLAN NOTES: 10' -1 1/2' MAY 2 9 2013 L ALL EXCESS GRADING MATERIAL TO BE EXPORTED TO AN APPROVED DISPOSAL IU CITY OF TIGARD LOCATION. FU.L 0 BUILDING DIVISION 2. ALL FILL ALAS I• UNDER GARAGE FLOORS, SIDEWALK& DRIVEWAYS, ETC_ TO BE COMPACTED GRANULAR FILL Q Ili 3. TFERE WILL OE A SLIGHT OVER EXCAVATION TO PROVIDE CONCRETE FARING ALL - N ARA D NEW STRUCTURE. 0 n Q� w O IL 4. MAIM CAJNTY/CTTY APPROVED SEDIMENT FENCING ARAM M EXCAVATED AREA 0 E 0 PRIOR TO EXCAVATION AND CONSTRUCTION. W i11) 111 i__.. S. PROVIDE CAUNTY/CITY APPROVED STABILIZED GRAVELED CONSTRUCTION ENTRANCE \ 111 1— u ~ NS9D29'04'W 69.48' W D PRIOR TO EXCAVATON AND CONSTRUCTION )1— C 6. STOCKPILES MUST OE COVERED WITH PI LCH OR PLASTIC SHEETING OET4EEN `x' Y / � . rIlii. OGTODER 1 AND APRIL 90. ' ` ' ` /‘ x x X� ` _ 1 �J -1 1 CONTRACTOR/ SUM- CONTRACTOR TO VERIFY LOCATION OP ALL UTILITIES PRIOR TO STO LINE / V l 'X` O E* DESIGN EXCAVATION AND CONSTRUCTION W a BOUNDARY' AND TOPOGRAPHY 00ORMATION HAS BEEN PROVIDED TO SKYLINE HOEE8 . . ! • AND DESIGN INC. SKYLINE HOPES AND DESIGN, INC , WILL NOT BE HELD LIABLE FOR THE SAN. SEWER LINE 9 Y _ ! - 0 ACCURACY OF THIS afOR1ATION, IT IS THE SOLE RESPONSIBILITY OF THE CONTRACTOR m VERIFY WE. _I - • . TIER TO VE ALL SITE CONDITIONS INCUJDN G FILL PLACED CN in . 4 N.8.. a 0 H ' 1 0 ` X Q , P S. TOPOGRAPHY ELEVATIONS SERE COLLECTED FROM ACTUAL SITE SURVEY. 4 4 P.Y.C. WATER MAIN 9 D 'Q { j 0 0_ X A o > . : . b ELEVATION N LEGLEGEND. O W i� mQ0p- EE. EXISTING A G GRADE ELEVATION r FE• . FINISHED FLOOR ELEVATION A 1 I Cl � 0 ICE \01 N.B. N Hi II II. PROVIDE A MN LL C1l1 GRAVEL DOSE UNDER A DRIVEWAY A REAS / 12. PROVIDE A 4' MINR1R1 GRAVEL BASE UNDER ALL SIDEWALK MD PATIO AIEA5 0 ..• Z ��O AG 13. PIPE ALL STORM DRAINAGE FROM THE BUILDING TO A CANTY/CITY DISPOSAL �/ 0 N I� ON I POINT/CONgGTION �. I ` / . - �� 2 Sa, FT. - ! — 0 14. MAX111JI1 SLOPE OP OUTS AND FILLS TO BE TWO (2) HORIZONTAL TO ONE N � U 0 I I j j 0 VERTICAL FOR BUILDINGS, STR IE JCTJS, FOIIIATIONS, Alm IETAMING WALLS. \ ' 1 q r1. 18'8• ! iia *•2- B. PROVIDE AND MAINTAIN FINISH GRADE 11.TH POSITIVE DRAINAGE AWAY FROM V . / A - - \ E 0-1 STRUCTURE CN ALL SIDES WITH A SLOPE OF 6' MI MI IN IRr -er. GAS LINE .. .. ��_ ` x ____x________ x x )(---- 0 (3 N IMPERVIOUS AREA'S: —1 N89D29'04'W 69.44' O ``�\ 134 SQ. FT. DRIVEWAYS D 0 q Q 54 SQ. FT. PORCH (� 0 J ..-I 03 Q iii IS SQ. FT. WALK VJ 100 PATIO al 20' 33' -0° 16' -5 9/32° L N N 132 SQ. FT. OVERHANGS - / / _/ 0 Q EUILDI 842 S FT. BUILDING COVERAGE ' I 1280 TOTAL SQ. FT. IMPERVIOUS AREA'S N LOT INFORMATION: li El LOT AREA: 1515 SQ. FT. PLAN Noy 3071 IMPERVIOUS COVERAGE: 438 SQ. FT. BUILDING COVERAGE: 439 A DR4WN: T.F. BUILDING HEIGHT: APPROX---- 33' -2' MIN. BUILDING SETBACKS: 119' FRONT, IS' REAR, 3' SIDES. DATEl 3 -02 -2013 SCALE: 1' = 10' -0' EROSION CONTROL PLAN El PLOT . "= PLAN •t R U ∎ COVERED STOCKPILES • J��X X SEDIMJ:NT FENCE i .... j CONSTRUCTION ENTRANCE SO IL UN TIL ALL AREAS OP PERMANENT L DSCAPE IS IN PLACE Irii El Q CATCH BASH PROTECTION LOT 5 WHITE OAK VILLAGE TIGARD, OR. Si M STREET TREE . .TIGARD CER TIFICA TION I, v AAIDS , owner/agent for las-m4A/4 , (PLEASE PRINT) (PERMIT HOLDER) do hereby certj 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.: lin`r;O/3 - 00/.0Z,6 SITE ADDRESS: /1 Ogg St& L,� Cy .41-/ SUBDIVISION: ithi ii e a, LOT#: SIGNATURE: i-' DAZE: (OWNER/AGENT) RECEIVED d� VERIFIED BY DALE,:E: jI?//9 ( F T IGARD)d- Tree location verified per approved site plan. I:\Building\Forms\StreetTreeCertificate 05/30/2012 Oregon Residential Specialty Code R318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM I, 2,3 �it,O fiece.0 , am the general contractor or the owner-builder at the following address: Site Address: HOW) Sa..) Gf C1/ City: WO-AR-6 Permit#: /7/57-090/3 000-6 Subdivision/Lot#: ate_ gi „ #� and/or �/U r Map and Tax Lot#: To conform with the 2008 Oregon Residential Specialty Code (ORSC), Section R318.2 and OAR 918-480-0140, I am notifying the building official that I am aware of the moisture content Requirement of ORSC Section R318.2 and have taken steps to meet this code requirement. [Section R318.2 is provided for reference]. R318.2 Moisture Content: Prior to the installation of interior finishes, the building official shall be notified in writing by the general contractor that all moisture-sensitive wood framing members used in construction have a moisture content of not more than 19 percent by dry weight of dry framing members. 4.41, Signature: Date: / fQ'-ral Contractor or Owner-Builder I:1Building\Form\RES-MoistureSensitiveWood.doc 09/25/08 Oregon Residential Specialty Code N1107.2 HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: /15-T`020//3 ,00/;_c Jurisdiction: Site Address: //t5 ca) Zf Ly &rt— ' >' SubdivisionlLot#: / /� 4 � hr 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)1 Signature: �011110446/���► Date: / -3 -/V /Genera Contractor/Authorized Agent Print Name: IZg /I,JOI/ iJ I ORSC Section N 1107.2.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\Forms\RES-HighEfficiencyLighting.doc 07/01/08 Form 640S Completion Certification—Site Inspection New Homes Program—Single Family EnergyTrust of Oregon To be completed by Verifier Portland Energy Conservation,Inc.(PECI)is a Program Management Contractor for Energy Trust of Oregon,Inc. Input tab should be completed first to auto-populate applicable fields, indi ed by orange iugnliyhted fields. First Inspection Information Second Inspection Information Date: 8/29/20131 Verifier Name: jesse fear Date: 12/1/2013 Verifier Name jesse fear Incentive Payee Company Name Builder or Company: westland industries Contact Name: Performance Testing Company performance insulation Technician Name: Verifier Payee Company Name: performance insulation Technician Name: Jesse Fear Site Information Development REM/Rate SCO Project ID: Name&Lot# white oak lot 5-west File#: (required from verifier if protect is ENERGY STAR®) Site Address: 0 City: portland State: OR Zip: Its Unattached ['Attached Number of Stories: 2 Total Conditioned Area: 0 Sq. Ft. #of Bedrooms: 0 ❑None ❑Full Basement ❑Half Basement LA 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): 32 033 090 46724925 Additional Project Information (please mark all that apply) El Code plus Best Practices(meets minimum Best Practice requirements with improvements above code) ❑ Path 1 EPS—Best Practices ❑ Path 2 ENERGY STAR`" ❑Envelope Upgrade ❑Equipment Upgrade ['Ducts&HVAC Equipment Inside ❑ Path 3 ENERGY STAR with ducts inside ❑ Path 4 Performance Plus with ducts inside ❑ Path 5 Advanced Performance ❑ Zonal Electric Efficient ❑ Advanced Electric Resistance ❑ Live Net Zero home ❑Solar Electric(PV) ❑Solar Water Heating(SWH) ❑Small Wind Renewable ❑Solar Ready Electric(SRPV) ❑Solar Ready Water Heating(SRWH) Energy ❑Qualifies for Solar Ready Incentive(must attach checklist) Solar Installer: Name: Company: Low Income ❑Yes •No Does this project qualify as Low Income?(must provide documentation from builder) Accessory Dwelling ❑Yes No Is this home an ADU? Unit ❑Yes •No Is the ADU separately metered?If so. provide meter numbers above Other Certifications 111 Earth Advantage-Certification Level ❑LEER-H-Certification Level: ❑Other: Return completed form to: Energy Trust New Homes--Single Family loo SW 5th Ave.#700 Portland,OR 97201-5542 1.877.283.0698 Fax 877.501.9629 Form 640S v08 DRAFT newhomes @energytrust.org Page 1 of 3 Soil-a)r✓ / Form 640S \I% Completion Certification—Site Inspection New Homes Program—Single Family EnergyTrust of Oregon Verification Category Type Actual Model Equipment Details&Notes Insulation Flat Ceiling R- 49 Insulation Type bib Framing Type: Vaulted Ceiling R- Insulation Type Standard Scissor Truss R- Insulation Type: El 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 batt Floor Over Garage R- 59 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: 40 Indoor and Outdoor 50 % #ENERGY STAR fixtures or CFLs 20 Appliances ENERGY STAR Dishwasher !Yes ❑No EF: Model#. Cooling Air Conditioning SEER: Btu/Hr ❑Fireplace AFUE 95.5 Brand fraser-johnstone Primary Heat Source Gas Furnace HSPF: Model# tg9s060a10mp11a ❑Electric ❑Boiler SEER: Serial#. IOGas Heat Pumps COP: Btu/Hr: 60k ❑Air Source(ducted) Outdoor Unit(for heat pumps) ❑Other: [1]Mini Split(ductless) Location: Model#: Ground Source cond space Serial#: Radiant Floor Heat ECM [j]Yes 0 No Heat pump commissioning report attached or ❑Cadets confirmation for ground source heat pumps that Electronic Air Cleaner ❑Yes Q No manufacturer's start up procedure was performed. ❑Zonal Backup fuel ❑Electric ❑Gas ❑Other ❑Other ❑Yes Notes on Primary Heating: Notes on Secondary Heating: Water Heater Type: Gallons Brand rinnai 0 Electric ID Storage EF: 0.82 Model#: rI75 ❑Gas ❑Tankless Location Serial#: cond space Btu/Hr: 180k 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 64OS Completion Certification—Site Inspection (457 '/3 ---6,V4g41 EnergyTrust l\ New Homes Program—Single Family of Oregon Ventilation ❑Exhaust Only Meets Energy Trust Mechanical Ventilation Requirements? System Energy Trust of Oregon's ❑Supply Only Yes ❑No Mechanical Ventilation Requirement ID Air Cycler HRV/ERV Model#: ❑HRV/ERV Ducts ID Ducts Inside %ducts inside 95 Ducts in Conditioned Space If claiming incentive for ducts inside,check one of the following ❑Ducts Tested EI Visual Inspection per RTF Specs Duct Insulation R- 8 Duct Location. 95 cond 5 attic 1Ducts Sealing w/Mastic Yes ❑No 100 attic-return Performance Testing Duct Leakage Duct Leakage Cubic Feet Per Minute(cfm) Duct Leakage Air Handler in ❑Yes Air Handler Installed During❑Yes @ 50 Pa ❑Pass ❑Fail Conditioned Space? ❑NO Test? ❑No Fan Pressure ❑DG3 Fan Ring Size/Type 0 2 Total Leakage Gauge g yP ❑ ❑ Leakage Test ❑ 9 ❑DG700 Pressure: (check one) ❑t ❑3 Method ❑Leakage to Outside Duct Blaster Location: Pressure Tap Location: 'Area Tested: Whole House Leakage Whole House Air Changes per Hour(ACH) Envelope Tightness Cubic Feet Per Minute(cfm) Leakage ❑ ❑Fail House Volume: @ 50 Pa Pass 1001 @ 50 Pa Best Practices Requirements (All requirements must be met to receive an Energy Performance Score) • Thermal Enclosure Checklist complete 111 Pass ❑Fail Thermal Enclosure Checklist attached? Likes • Insulation Quality Inspection Performed •Yes ❑No —* (complete insulation verification section below) • Approved Mechanical Ventilation Installed •Yes ❑No -> (complete mechanical verification section below) • Zonal Pressure Relief-All zones comply Q Yes No If no,state reason for failure: Combustion Appliance Zone Net CAZ Pressure: Pa If not applicable, please explain: all dv • Testing (required) Forced air system operation must not depressurize Combustion Appliance Zone(CAZ)by more than 3 Pascals(Pa.) Additional Notes: Signature By my signature, below, I certify that I have performed the tests as described,that the form is complete,and that all information on the form is accurate. Verifier Verifier Signature jesse fear Name jesse fear Date: 12/1/2013 Red Tag Inspection (if needed) Signature Name Date Return completed form to Energy Trust New Homes--Single Family no 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 Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 11048 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 699 Mechanical final 2013-12-17 00:00:00 MST2013-00126 PASS Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 11048 SW LEGACY OAK WAY, TIGARD, OR, 97223 Residential - Master Permit 199 Electrical final 2013-12-17 00:00:00 MST2013-00126 PASS Violation Summary: Inspector Contractor