Permit Building Permit Application Ex F I R ED
Residential '( 2 Ol ic ii l Sl ( \1.1
City of Tigard RECEIVE 11. Received / � �y e
Permit No.:W 7: p W/
•lig 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
■ Phone: 503.639.4171 Fax: 503.598.1960 JUN 17 2008 DateBv: other Permit: ,e ��� �`
Inspection Line: 503.639.4175 Date Ready/13y: Juris: El See Page 2 for
TIGARD
Internet: www.tigard-or.gov CITY OF TIGARD pp
Notified/Method: Supplemental information
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®New construction ❑Demolition Permit fees*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
., .7,-, work indicated on this application.
�' ¥ >;f�RtI'�ilOF�t7�NSiI�Lt1C�01�T �x�,�a,
® 1-and 2-family dwelling ❑Commercial/industrial Valuation: 5140,000
❑Accessory building ❑Multi-family Number of bedrooms: 3
❑Master builder ❑Other: Number of bathrooms: 2.5
Total number of floors: 3
Job site address: (. O Sf t\l�V�{1�fY� S L�JL90~� ''" ..-\ New dwelling area: 1449 square feet
City/State/ZIP:Tigard,OR `J�J` ' W Garage/carport area: 541 square feet
Suite/bldg./apt.no.: Project name:Village at Summer Creek Covered porch area: 20 square feet
Cross street/directions to job site: Deck area: 160 square feet
Other structure area: square feet
5EtCOSI1[S���
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
.'.:4t. ��: ' � Z3RnaaoNNiOTAWtDRd 3.� a`J ? _ `" t p work indicated on this application.
NSFR 1 Valuation: S
Existing building area: square feet
New building area: square feet
: .1 tr v s ,W,-._.. Number of stories:
Name:JLS Custom Homes Type of construction:
Address: 16280 NW Bethany et Occupancy groups:
City/State/ZIP:Beaverton,OR 97006 Existing:
Phone:(503)533-4006 Fax:(503)533-4306 New:
'w u� i. �}��c r?4 i Ai-f im 'Sn `-] Rae `w ' ar.y,ksa s '"•"�-x r 0 r ` 4
Business name:JLS Custom Homes All contractors and subcontractors are required to be
Contact name:Nicole Paulsen licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:16280 NW Bethany et jurisdiction in which work is being performed.If the
City/State/Z]P:Beaverton,OR 97006 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)533-4006 Fax::(503)533-4306 ‹f-IS ht He9V ex e� D
E-mail nicole@jiscustomhomes.com S Q -, \ Jf J it rE
_ �-� ` d." " ` y F Q 74 ` - gam --+i I i"
Business name:JLS Custom Homes -? * 6i'1 ER 14.- S* . 4 ,
Address: 16280 NW Behthany ct *' ry -40` 1 i4-i,lo•feeschedale� . -
Structural plan review fee(or deposit): /t 7 T) • fl
City/State/ZIP:Beaverton,oR 97006
Phone:(503)533-4006 Fax:(503)533-4306 FLS plan review fee(if applicable): B—
Total fees due upon application: A 7) O°
CCB lic.:139970 -
7� Amount received: /7)
Authorized signature:0 Nam �6V' I This permit application expires if a permit i(s not obtained
���JJJ\\\ within 180 days after it has been accepted as complete.
Print name: Date: * Fee methodology set by Tri-County Building industry
Service Board.
1:\Building\Permits\BUP-RES PermitApp.doc 11/6/07 440-46131(11/02JCOM/WEB)
Mechanical Permit ApplicatRECEI V E I Folz OFFICE I1SI':ONL\
71 City of Tigard Date/By: /HO p Permit No.: �> gw00
- • 13125 SW Hall Blvd.,Tigard,OR 97223 JUN 17 2008 C
Phone: 503.639.4171 Fax: 503.598.1960 Plan Review Other Permit: 5� "oolU/
Date/By:
l G ARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: tuns: El See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISIO Notified/Method: Supplemental Information
HYPE`OF"WORK `" " i:s{ . ',(011311 ERCIAL,FEE*SCHEDULE--°USEwCHEGIUJ1ST
®New construction ❑Addition/alteration/replacement Mechanical permit fees*are based on the value of the work
performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. _
= ATEGORY-OF'CONSTRUCTION Value:$
s 4RESIDENTJAL EQUIPMENT/svSTEMVIS TEES*`
❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building
Multi-family Master builder For special information use checklist.
❑ y ❑ 0 Description Qty. Ea. Total
JOB SITG FORAUTION 1D `OCATION Heating/cooling
Job site address: C Air conditioning or heat pump
3 J3 D cl�,mckV A Y" (requires site plan showing placement) I 14.00
City/State/ZIP:Tigard,OR Furnace 100,000 BTU(ducts/vents) I 14.00
Furnace 100,000+BTU(ducts/vents) 17.90
Suite/bldg./apt.no.: Project name:Village at Summer Creek Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
Residential boiler(radiator or
hydronic) 14.00
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 14.00
Flue/vent for any of above 6.80
Subdivision: Lot no.: .3
Other: 10.00
Tax map/parcel no.: Other fuel appliances
MESCA21P`I`-IONI-OF vOB/C T..: k _ Water heater I 10.00
Gas fireplace I 10.00
Flue vent for water heater or gas
-fireplace 2., 10.00
Log lighter(gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
;�PPROP..ERTY OWNER Chimney/liner/flue/vent 10.00
•' - :❑-TENANT
Other: 10.00
Name:JLS Custom Homes Environmental exhaust and ventilation
Address: 16280 NW Bethany ct Range hood/other kitchen
equipment I 10.00
City/State/ZIP:Beaverton,OR 97006 Clothes dryer exhaust I 10.00
Phone: 503 533-4006 Fax: 503 533-4306 Single-duct exhaust(bathrooms, V f
( ) ( ) toilet compartments,utility rooms) � 6.80
ARP-7ac El feoNT_ACT VERSON Attic/crawlspace fans 10.00
Other: 10.00
Business name:JLS Custom HOmes
Fuel piping
Contact name:Nicole Paulsen $5.40 for first four;$1.00 for each additional
Address: 16280 NW Bethany ct Furnace,etc.
Gas heat pump
City/State/ZIP:Beaverton,OR 97006 Wall/suspended/unit heater
Phone:(503)533-4006 Fax::(503)533-4306 Water heater
Fireplace
E-mail:nicole@jlscustomhomes.com Range
CONTRACTOR Barbecue
Business name:TBD
Clothes dryer(gas)
Other:
Address: _ MECHANICAL/PERMTF FEES*
City/State/ZIP: Subtotal
Minimum permit fee($72.50)
one:( ) Fax:( ) Plan review(25%of permit fee)
CCB lic.: State surcharge(12%of permit fee)
I q TOTAL PERMIT FEE
Authorized signature:w f, ,J This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: * Fee methodology set by Tri-County Building Industry Service Board
1:\Building\Permits\MEC-PermitApp,doc 01/19/07 4404617T(11/02/COM/WEB)
Plumbing Permit Applicatio Building Fixtures BEIJtI'JED FOR OFFICE USE ONLY'Received
114 City of Tigard 11 1�1 1 20O$ Date/By: •%are ■ Permit No.: yr-,, G
- • 13125 SW Hall Blvd.,Tigard,ON972Z3
Or Plan Review Other Permit No.: •0i �
Phone: 503.639.4171 Fax: 503.598 Date/By: ..
TI G A RD
Inspection Line: 503.639.��Y Date Ready/By: Juris ® See Page 2 for
Internet: www.tigard-or.,or-_ a , D1V1�lo� Notified/Method: Supplemental Information
TYPE •F WORK =- :iTEE*;SCHEDULE ,
❑New construction ❑Demolition For special information use checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
_ A31EGORY-000NSTRUCTION SFR(l)bath 249.20
❑ 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 350.00
❑Accessory building ❑Multi-family SFR(3)bath 399.00
Each additional bath/kitchen 45.00
❑Master builder ❑Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND'LOCATION Site utilities
Job site address: I I 0 �3..D ' &_„LA t Catch basin or area drain 16.60
City/State/ZIP:Tigard,OR Drywell,leach line,or trench drain 16.60
Suite/bldg./apt.no.: Project name:Village at Summer Creek Footing drain(no.linear ft.:_) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Subdivision: Lot no.:%j Water service(no.linear ft.:_) Page 2
Fixture or item
Tax map/parcel no.:
Absorption valve 16.60
-DESCRIPTION OF WORK Backflow preventer Page 2
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
'(81 PROPER IOW1NER El TENANT` _
Ejectors/sump 16.60
Name:JLS Custom Homes Expansion tank 16.60
Address: 16280 NW Bethany ct Fixture/sewer cap 16.60
City/State/ZIP:Beaverton,OR 97006 Floor drain/floor sink/hub 16.60
Phone:(503)533-4006 Fax:(503)533-4306 Garbage disposal 16.60
Hose bib 16.60
ATTIROL 1T,.,, .n MONTACT 41.BRSON
` Ice maker 16.60
Business name:JLS Custom Homes
Interceptor/grease trap 16.60
Contact name:Nicole Paulsen Medical gas(value:$ ) Page 2
Address:16280 NW Bethany et Primer 16.60
City/State/ZIP:Beaverton,OR 97006 Roof drain(commercial) 16.60
Phone:(503)533-4006 Fax: :(503)533-4306 Sink/basin/lavatory 16.60
Tub/shower/shower pan 16.60
E-mail:nicolt®jlscustomhomes.com Urinal 16.60
CONTRACTOR Water closet 16.60
Business name:TBD Water heater 16.60
Address: Other:
City/State/ZIP: Subtotal
Minimum permit fee: $72.50
phone:( ) Fax:( ) Residential backflow minimum permit fee: $36.25
B Lic.: Plumbing Lic.no.:
Plan review (25%of permit fee)
■fig' Tr"r r State surcharge(12%of permit fee)
Authorized signature: �IB'�leg . TOTAL PERMIT FEE
Print name: ����aaaallll■ Date: This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:1Building\Permits\PLMF-PermitApp.doc 12/27/06 440-4616T(10/02/COM/WEB)
Electrical Permit Application FOR OFFICE USE ONLI
City of Tigard RECEIVE !P,. 6
�� •PermitNo.: �
-Wee 9c0
• - " 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review �/ �,���ry�/M
Phone: 503.639.4171 Fax: 503.598.1960 eg Other Permit: ""�v�
1GARD
Inspection Line: 503.639.4175 JUN 1 7 t UU0 Date ReadyBy: kris. ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental information
STY OF
TYPE OF p . = J _ - : TIA ,REVIEW :_:74--'1,-,:.7. 3.•:.,:-::-. --;'-'-
.�
-
-
Please check all that apply(submit 2 sets of plans w/items checked below):
®New construction ❑Addition/alteratto rep acemen
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
tL-ATEGOR''OF4°CONS'IIRUUIION 741 g exceeds 10,000 amps at 150 volts or ❑Floating buildings.
less to ground or exceeds 14,000 ❑Commercial-use agricultural
❑ 1-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
Y,, _ ❑Emergency system. larger separately derived system.
, .,JOB SITE INFORMATION AND= OCATION _ ❑Addition of new motor load of ❑°A" 'E""1-2" "1-3"
Job no.: Job site address: C ; �,��tt �, 100HP or more. occupancy.
l ./v ,� �S f�,Y4 ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:Tigard,OR ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name:Village at Summer Creek ❑Service or feeder 600 amps or more.
_" .SEE SCHEDULE-- ,
Cross street/directions to job site: Description I Qty. t Fee. I Total I •
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: '3 1,000 sq.ft.or less I 145.15 4
Ea.add'l 500 sq.ft.or portion ' 33.40 1
Tax map/parcel no.: Limited energy,residential
DESCRIPTION1OF 3WOR3C _ (with above sq.ft.) 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 80.30 2
r] PROP.ERTrP OWNER ]'TENANT . 201 amps to 400 amps 106.85 2
Name:JLS Custom Homes 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
idress: 16280 NW Bethany ct Over 1,000 amps or volts 454.65 2
City/State/ZIP:Beaverton,OR 97006 Temporary services or feeders installation,alteration,and/or
relocation
Phone: (503)533-4006 Fax:(503)533-4306 200 amps or less 66.85 1
Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 133.75 2
Branch circuits-new,alteration,or extension,per panel
Owner signature: Date: A.Fee for branch circuits with
IS_AP—R TCANT ,CONTACT PERSON:-;_ irk above service or feeder fee,
each branch circuit 6.65 2
Business name:JLS Custom Homes B.Fee for branch circuits
Contact name:Nicole Paulsenq frs first rrtcrvi or feeder fee, 46.85 2
rst t b brannch circuit
Address: 16280 NW Bethany ct Each add'l branch circuit 6.65 2
Miscellaneous(service or feeder not included)
City/State/ZIP:Beaverton,OR 97006 Each manufactured or modular 90.90 2
Phone: (503)533-4006 Fax: : (503)533-4306 Reconnect t only and/or feeder
Reconnect only 66.85 2
E-mail:nicole(a�jlscustomhomes.com Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name:TBD Signal circuit(s)or limited-
Business panel,alteration,or
Address: extension.Describe: Page 2 2
City/State/ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone:( ) Fax:( )
Investigation per hour(1 hr min) 62.50
CCB Lic.: Electrical Lic.: Suprv.Lic.: Industrial plant per hour 73.75
-XLSOPRICALVERMIT NE':LS -
iprv.Electrician signature,required: Subtotal:
Print name: Date:
Plan review(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: OTOTAL PERMIT FEE:
Print name: Date: This permi t application expires if a permit is not obtained within 180
days after it has been accepted as complete.
• Number of inspections allowed per permit.
1:\Building\PermitsELC-PermitApp.doc 05t23/06 440-4615T(11ro5/COnvWEB
•
i 1
III Building Division
One & Two-Family Dwelling
TIGARD
Fees Checklist
1100/0:04.#0*MATIOlq..i. • . ' . ! . :.-.', :-.•' .:. i : . . . • . : ,
Pertnit#: MI 2 008 . 00 0 s (0 Plan#: Date:
Site Address: : til
to I -... * tic ,..- .k Parcel#:
Subdivision: Vi v k„t o,e 0 1 A , if,„ry,er. i ti.eiK Lot#: Zoning:
Jurisdiction: tic,. Setbacks: Front: Rear: Left Right:
Class of Work: ''‘.) Aka) Stories: -3 First Floor: Co Type of Use: M f: Height: 3C Second Floor: t0-.S0
Construction: la, Floor Load: SO Third Floor: . —7 1 8
Occupancy Group: K3 Dwelling Units:
Bonus Room: ra
Valuation: tSli 933.23 Bedrooms:. 2 Total Floors: t3cilt,
Bathrooms: Basement: 0
Decks: 1 2,a Garage: 554
Porches: 2..- Other: 0
S*S:, . ',- ' Description : - ..f.:. : .::. Fee ::: :‘.','...., ':.:A*40/4 Pod;J., . .- Bki4i100...Piitel
Plan Check: Building: (0A-1 -0(49 7 o.00 - (c)2-etl--1--
Extra Set: 0'
Permit: Building: ■ .0
Tax: t - - 11 4
Metro CET:
School CET: °ILI .00
Mechanical
Tax:
Plumbing: Sclek- 00
Tax: t_la-S ig
Electrical: 2_ 1 • ci S
Tax: 2 4
Low Voltage: (25
Tax: e5.-
CDC: CDC Ping. Rev.: 46•CC,
CDC LRP Fee: (Q • 00
SDC: Parks:
TIF Res.: 251(oft •(1)
TIF MT: 'LW)• 0
Erosion Permit: tot- . 00
Erosion CWS: 20.80
Erosion COT: 2n sa
Water Quality:
Water Quantity:
XII'
SUB-TOTAL: i_l 8_ ias2l (47g
Sewer: Permit:
Inspection:
SUB-TOTAL:
TOTAL MST & SWR: r7
I:\Building\Forrns\ResPlanCheckFees.doc 01/19/07 Page 1
PLUMBING FEES (for special information use checklist) MECHANICAL FEES(residential equipment/systems)
Description I Qty. I Fee(ea.) I Total Description Qty I Fee(ea.) _ Total
New 1-&2-family dwellings Heating/Cooling
(includes 100 ft.for each utility connection] Air conditioning or heat pumps 1 14.00
SFR(1)bath 249.20 Furnace 100,000 BTU(ducts/vents) 14.00
SFR(2)bath 350.00 Furnace 100,000+BTU(ducts/vents) 1. 17.90
SFR(3)bath 1 399.00 Gas heat pump 14.00
Each additional bath/kitchen 45.00 Duct work 10.00
Rain Drain,single famil dwelling 65.25 Hydronic hot water system 14.00
Fire sprinkler-sq.ft. 0 to 2,000 115.00 Residential boiler
Fire sprinkler-sq.ft. 2,001 to 3,600 160.00 (for radiator or hydronic system) 14.00
Fire sprinkler-sq.ft. 3,601 to 7,200 220.00 Unit heaters(fuel,not electric)
Fire sprinkler-sq.ft. 7,200 and greater 309.00 (in wall,in-duct,suspended,etc.) 14.00
. Site Utilities .. . Flue/vent(for any of above) 6.80
Catch basin/area drain 16.60 Repair units 12.15
Drywell/leach line/trench drain 16.60 Other Fuel Appliances
Footing drain- 1"100' 55.00 Water heater I 10.00
Footing drain-each additional 100' 46.40 Gas fireplace 1 10.00
Manufactured home utilities 110.00 Flue vent(water heater/gas fireplace) 10.00
Manholes 16.60 Log lighter(gas) 10.00
Rain drain connector 16.60
Wood/Pellet stove 10.00
Sanitary sewer- 1"100' I ._ 55.00 Wood fireplace/insert 10.00
Chimney/liner/flue/vent 10.00
Sanitary sewer-each additional 100' 46.40 Other:
Storm sewer- 1" 100' I 55.00 Environmental Exhaust&Ventilation
0.00
Storm sewer-each additional 100' 46.40 Range hood/other kitchen equipment 1 10.00
Water service- ls`100' t S5.00 Clothes dryer exhaust i 10.00
Water service-each additional 100' 46.40
Fixture or Item Single duct exhaust
Absorption valve 16.60 (bathrooms,toilet compartments,
Backflow preventer 27.55 utility rooms) 6.80
Backwater valve 1 16.60 Attic/crawl space fans 10.00
Clothes washer I 16.60 Other: 10.00
Dishwasher 16.60 Fuel Piping
1 **($5.40 for first 4,$1.00 each additional)
Drinking fountain 16.60 Furnace,etc. 1 **
Ejectors/sump 16.60 Gas heat pump **
Expansion tank 16.60 Wall/suspended/unit heater **
Fixture/sewer cap 16.60 Water heater I **
Floor drain/floor sink/hub 16.60 Fireplace I **
Garbage disposal r 16.60 Range t **
Hose bib 16.60 BBQ **
Ice maker i 16.60 Clothes dryer(gas) **
Interceptor/grease trap 16.60 Other: **
Primer 16.60 Total:
Roof drain(commercial) 16.60 Mechanical Permit Fees
Sink/basin/lavatory I /C) l i. 1, 16.60 Subtotal: $ q_-7.30
Tub/shower/shower pan . 16.60 Minimum Permit Fee$72.50 $ -I
Urinal 16.60 Plan Review Fee(25%of Permit Fee) $
Water closet 3 16.60 State Surcharge(12%of Permit Fee) $ It,(p�`j
Water heater 1 16.60 TOTAL PERMIT FEE $
Other:
• Other:
•
Plumbing Permit Fees ELECTRICAL FEES (residential single-or multi-family)
Subtotal $ Description Qty. Fee Total Insp
Minimum Permit Fee$72.50 $ 1,000 sq.ft.or less , 145.15 4
Plan Review(25%of Permit Fee) $ Ea.add'l 500 sq.ft.or portion 33.40 I
State Surcharge(12%of Permit Fee) $ Limited energy,residential 75.00 2
TOTAL PERMIT FEE $ Each manufactured or modular
dwelling,service and/or feeder 90.90 2
•
Electrical Permit Fees
Subtotal: $ ? it . IS
Plan review(25%of permit fee) $
State surcharge(12%of permit fee) $ ZS,4 3
TOTAL PERMIT FEE $
I'\Building\Forms\ResPlanCheckFees.doc 01/19/07 Page 2
CITY OF TIGARD
1111 FEE AND PAYMENT HISTORY
1 13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
TIGARD
MST2008-00096 - 13580 SW ROSEMARY LN
Revenue Payment
Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt# Due
[BUPPLN] Pln Rv Deposit 245-0000-433000 $750.00 $750.00 $750.00 6/17/08 Check 2720080000 $0.00
0000002095
[CDCPLN]CDC Pin Rev 100-0000-433060 $46.00 $46.00 $46.00
[LRPF]LR Planning Surcharge 100-0000-438050 $6.00 $6.00 $6.00
[BUPPLN]Pin Rv Balance 245-0000-433000 $687.06 $687.06 $687.06
[BUILD] Bldg Permit 245-0000-432000 $1,057.02 $1,057.02 $1,057.02
[TAX] Build 12% State Surchrge 100-0000-207020 $126.84 $126.84 $126.84
[METCET]Metro Const Excise Tx 245-0000-229202 $188.92 $188.92 $188.92
[BEACET]Beaverton School CET 245-0000-229204 $1,396.00 $1,396.00 $1,396.00
[MECH]MEC Permit 245-0000-431010 $97.30 $97.30 $97.30
[TAX] MEC 12% State Surcharge 100-0000-207020 $11.68 $11.68 $11.68
[PLUMB] PLM Prmt 3Bth 245-000D-431000 $399.00 $399.00 $399.00
[TAX] PLM 12% State Surcharge 100-0000-207020 $47.88 $47.88 $47.88
[ERPRMT] ELC Permit 220-0000-431510 $211.95 $211.95 $211.95
[TAX] ELC 12% State Surcharge 100-0000-207020 $25.43 $25.43 $25.43
[PKSDC]SF Park SDC 270-0000-450000 $5,215.00 $5,215.00 $5,215.00
[TIF-R]TIF Resident 210-0000-448001 $2,960.00 $2,960.00 $2,960.00
[TIF-MT]TIF Mass Tr 210-0000-448005 $240.00 $240.00 $240.00
[ERPRMT] Erosion Control 100-0000-207307 $64.00 $64.00 $64.00
[ERPLN]Erosn Pln Rv CWS 100-0000-207308 $20.80 $20.80 $20.80
[EROSN] Erosn Pin Rv COT 245-0000-433010 $20.80 $20.80 $20.80
Totals for Fees $13,571.68 $13,571.68 $750.00 $12,821.68
Revenue Payment
Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt# Due
Receipt# Payment Method Check# Payor: Receipt Date Receipt Amount
27200800000000002095 Check 912179 06/17/2008 $750.00
Total Payments: $750.00
Balance Due: $12.821.68
I
CITY OF TIGARD•SITE PLAN REVIE __
Surnnureek BUILDING PERMIT NO.: ;CIP rjr '1-
r r 4' SANITARY SEWER. r PLANNING DIVISION: r v t/I e/ t 4 5 ITA Required Setbacks: Approved Not A o Approved
R EC
RY SEWER � L� ❑ PP
4' 5A ITARY SEWER Sire: 3 Street Side:
4' SANITARY SEWEA�ront. I L Garage: Rear: 1v
� C JUN 17 2008 \ ,Visual Clearance: Approved ❑ Not Approved
Li'1�G�1Yj Plan: V 12' STOi�t1LINE. %rat Maximum Building Height• `�`'� feet
CITY OFTIGARD CWS Service Provider Letter Required: ❑ Yes ❑ No
ILpING DIVISION
Bll . S W a�: IA-c a-T Dace: ,Received
ots : �� ,�y 3� , 12' WATER LINE R��SEIV�q �/ 4' ��DEPARTMENT:
.L ._—
4' SANITARY SEWER ! �_,. Actual Slope:. % Approved ❑ Not Approved
_ . "
uyjjts', k �l�� Site PI gApproved Not roved
.
Site Date: •
. i
Aa1-��:�
.��_, --( 1111111111111,_ � Notts: ay�n,�sv``1 i < ---,:,,- „.
` b I 2' Ea:tern Redbud el
.�
I. PROVIDE A MINIMUM 8" DEEP GRAVEL BASE FOR ALL ( ,,R Y \', r ��
DRIVEWAY AREAS. 2' Eastern Redbu=�� 1 1 O
�r.+ CO 6
2. MAXIMUM DRIVEWAY SLOPE SHOULD BE VERIFIED WITH a i ��� LU THE BUILDING DEPARTMENT PRIOR TO CONSTRUCTION. _ ao 3. PROVIDE A MINIMUM 4' DEEP GRAVEL BASE FOR ALL W SIDEWALK AND PATIO AREAS. (v V " I
Ct
4. PIPE ALL STORM DRAINAGE FROM THE BUILDING TO A .DISPOSAL POINT APPROVED BY THE BUILDING Q• L DEPARTMENT. Unit A �'— O0 V ' O :
5. PROVIDE AND MAINTAIN POSITIVE DRAINAGE AWAY � `� U FROM BUILDING ON ALL SIDES.
lit Unit A W
Z
e.'•r) z E
6. NON-STABILIZED FILL MUST NOT EXCEED 2:1 SLOPE Z
I. NO CUTTING OR FILLING SHALL RACT "B"
LL TAKE PLACE WITHIN c---,THE DRIP LINE OF AN EXISTING TREE UNLESS THE
EXCEPTION IS APPROVED BY THE BUILDING DEPT. <
1111
8. AFTER COMPLETION OF CONSTRUCTION, THE CONTRACTOR � i `+4 ■
` 11
SEED THE EXPOSED SOILS. �`_,_` , << L `v
��� K
CO
PROTECT STOCK PILES FROM OCTOBER 1st THRU "---c�_ _� `C TY OF TIGARD- E PLAN VIEW
APRIL 30th PER THE EROSION CONTROL HANDBOOK. U U TRACT "A"
' ` ,; BUILDI G PERMIT NO:
DUI— j
m Q Z �-_�-- Street Trees: Approved ❑ Not Approved
D Z Ill Protected 'u Approved ❑ N. Approved
Q • Date: . 3 a
CNotes:
CS CO W S97E 0 ��
Lii NORTH 1' = 201-0'
a
DATE
RECEIVED
Jeremy Krueger AU6 '2 8 2U'`
Jkru Design
8217 SW Seminole Tr CITY OF TIGARD
Tualatin, OR 97062 BUILDING DIVISION
(503)-577-8781
Loraine Sellers, Plans Examiner
loraine@tigard-or.gov
Phone: 503.718.2708
Fax: 503.624.3681
Ms. Sellers:
This letter is intended to address the issues in the recent plan check for JLS Custom
Homes Village at Summer Creek Lot 1, located at 13580 SW Rosemary Ln. Permit
number MST2008-00096 .
Item 1 - The elevation shows crickets of 5'. Details 1/8, 2/8, and the plan sheet 6 show a
cricket less than 30". Correct the discrepancy and provide two copies of revised plan
sheets.
Details 1/8 & 2/8 revised to show cricket greater than 30"tall.
Item 2- The mechanical permit applications show heat pumps are to be installed,please
clarify if they are exterior, in which case they need to be shown on the site plan also.
Not addressed by Jkru Design
Item 3-All general notes at the cover sheet reference codes not used, change all
references to the 2005 ORSC.
Notes updated to reflect current code usage.
Item 4 -No manufactured floor framing is provided with this submittal. Provide two
copies of manufactured floor framing showing the beams in the same locations as the
engineered design
Not addressed by Jkru Design
Sincerely,
Jeremy Krueger
RESIDENTIAL PERMIT APPLICATION REVIEW
Permit No.: MST2008 -00096
Site Address: 13580 SW Rosemary
Subdivision: Village @ Summer Creek
Lot No.: 3
Contact Name: Nicole Paulsen
Business: JLS Custom Homes
Street: 16280 NW Bethany Ct.
City: Beaverton State: OR Zip: 97006
As required by the 1999 Legislative action (Senate Bill 587), your residential permit application and
• plans have been reviewed to determine if it is complete and if the plans are deemed "simple" or
"complex" as defined in ORS 455.467 and 455.469.
F The application is complete.
❑ The application is incomplete for the following reason:
❑ The submitted plans will be reviewed; however, a permit cannot be issued until the above
information is reviewed and /or approved.
❑ The submitted plans cannot be reviewed until the above information has been submitted
and /or approved.
❑ The plans are deemed "simple ".
• The plans are deemed "complex ".
Signature: /U p g
Name: Brandon Shaw Date
Title: Plans Examiner
Phone: 503 - 718 -2425
E -Mail: BrandonS @tigard - or.gov
I: \ Building \ Forms \RES- I'crmitAppRev'v- Blank.doc 1/18/07
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.
;I ■ BUILDING DIVISION
TIGARD TRANSMITTAL LETTER
TO: LW-V.-0-WL3-- DATE
DEPT: BUILDING DIVISION D
AUG 2 8 20(
FROM: ). \_( CITY OF TIGARD
BUILDING DIVISION
COMPANY:-RS LOScz ek\--tV QS
PHONE: SOS • -\ 5 fib (-----By:Is
RE: ✓<.-\J i Ur)S .."4'1, -o y -( [
MJ
(Site Address) a'ernvt/se umber)
t �rn V Mme. 1�
ro dCt n or b vi on nam�t
J e and lot numl3er)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: 1 Copies: Description:
Additional set(s)of plans. Nin Revisions: 1r. U.QS
Cross section(s)and details. Wall bracing andifair later analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS:
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: Initials:
Fees Due: ❑ Yes ❑ No Fee Description: Amount Due:
$
$
$
$
$
Special
Instructions:
Reprint Permit(per PE): ❑ Yes ❑ No ❑ Done
Applicant Notified: Date: Initials:
I:\Building\Forms\TransmittalLetter-Revisions.doc 4/4/07