Permit Building Permit Application C.
Residential RECEIVED FOR OFFICE USE ONLI
Cl of Tigard K r,CE Received (, ; Permit No.:'.t<j� vi
' 13125 SW Hall Blvd.,Tigard,OR 97223 }W
DPI Review 'a Og �� jU ¢ 3
IN
Phone: 503.639.4171 Fax: 503.598.1960 t A AAY 1 2 20pB Date/By:
Other Prnnit:c u)Lpsg-41,7 3
TIGARD Inspection Line: 503.639.4175 lviH Date Ready/By: Jut ® See Page 2 for
Internet: www.tigard-or.gov I �F,r�GARD Notified/Method: Supplemental Information
TYPE OF WORIZII i' C- 1\1 �N
�1'� REQUIRED)ATA:1- 1ND2=FAMILY DWELLING
®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
CATEGORY OF CONSTRUCTION work indicated on this application.
El 1-and 2-family dwelling ❑Commercial/industrial
Valuation: $130,000
11 Accessory building ❑Multi-family Number of bedrooms: 2
El builder ❑Other: Number of bathrooms: 2.5
- JOB SITE INFORMATION AND LOCATION Total number of floors: 3
Job site address: 1101 C .1(A) ma 1 lam)ri-ZN Y New dwelling area: 1329 square feet
City/State/ZIP:Tigard,OR Garage/carport area: 556 square feet
Suite/bldg./apt.no.: Project name:Village at Summer Creek Covered porch area: 25 square feet
Cross street/directions to job site: Deck area: 128 square feet
Other structure area: square feet
--REQUIRED,DATA:-COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.:"""7' Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
El PROPERTY OWNER ❑ TENANT Number of stories:
Name:JLS Custom Homes Type of construction:
Address: 16280 NW Bethany ct Occupancy groups:
City/State/ZIP:Beaverton,OR 97006 Existing:
Phone:(503)533-4006 Fax:(503)533-4306 New:
IEI.M RLICANT '
❑ CONTACT PERSON NOTICE
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 ct jurisdiction in which work is being performed.If the
City/State/ZIP:Beaverton,OR 97006 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)533-4006 Fax::(503)533-4306
E-mail: nicole@jIscustomhomes.com
:CONTRACTOR
Business name:JLS Custom Homes :BUILDING:PERMIT FEES*
Address:16280 NW Bethany et (J'�easereferso,feeschedule)
City/State/ZIP:Beaverton,OR 97006 Structural plan review fee(or deposit):
Phone:(503)533-4006 Fax:(503)533-4306 FLS plan review fee(if applicable):
Total fees due upon application: "750 .CCB lic.:139970 '
Cr}
� Amount received: of 75).CV
Authorized signature: Airignriiim , This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Nicole Paulsen Date:
Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits\BUP-RES PermitApp.doc 11/6/07 440-4613T(11/02/COM/WEB)
Mechanical Permit Application I()1t OFFICE USE ONLY
City of Tigard 1KECEIVED Received _
•1111111 13125 SW Hall Blvd.,Tigard,OR 97223
Date/By: /a�Q: Permit No.: ,p11.4. . ���� 3
Q + 2 2008 Dan Review I
Phone: 503.639.4171 Fax: 503.598.1960 MAY 1 -(r Date/By: Other Permit: �L/�g-amyl
IVIH l �
Ti G A R U Inspection Line: 503.639.4175 Date Ready/By: ions: 0 See Page 2 for
Internet: www.tigard-or.gov OF TIGARD Notified/Method Supplemental information
CITY rI i ur
E 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.
} r s OORrxOFllufi i9CiB1Gi1�� a Value:S
. _ . . __.. _ . *1,1 .- ,_ 'sue.. _�, , ---- .._. -,
❑ 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building
❑Multi-family ❑Master builder ❑Other: For special information use checklist,
Description Qty. Ea. Total
- _ �7 ��5:�. '�, H ea ti ngicooli ng
/1�O
(--1\ • Air conditioning or heat pump
Job site address: ` l yy •`_vg y 14.00
1 Y t�\ � (requires site plan showing placement)
City/State/ZIP:Tigard,OR Furnace 100,000 BTU(ducts/vents) I 1' 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 I 14.00
Residential boiler(radiator or
hydronic) 14.00
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 14.00
Subdivision: j Flue/vent for any of above 6.80
Lot no.: 7 f
Other: 10.00
Tax map/parcel no.: Other fuel appliances
-. "- ;lrc" w tfitgAseti Water heater 1 10.00
Gas fireplace I 10.00
Flue vent for water heater or gas
fireplace 1 10.00
Log lighter(gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
s :�a - Chimney/liner/flue/vent 10.00
��.. eL . 1Vt5R'���'
Name:JLS Custom Homes Environmental exhaust and ventilation
Range hood/other kitchen
Address:16280 NW Bethany ct equipment 10.00
City/State/ZIP:Beaverton,OR 97006 Clothes dryer exhaust 1 10.00
• Single-duct exhaust(bathrooms,
Phone:(503)533-4006 Fax:(503)533-4306 toilet compartments.utility rooms) 6.80
g^ry ':y ..) N. . Attic/crawlspacefans 10.00
Business name:JLS Custom HOmes
Other: 1 0.00 I
Fuel piping
Contact name:Nicole Paulsen S5.40 for first four;$1.00 for each additional
Address:16280 NW'Bethany et Furnace.etc.
Gas heat pump I i
City/State/ZIP:Beaverton,OR 97006 Wall/suspended/unit heater
Phone:(503)533-4006 ir Fax::(503)533-4306 Water heater
Fireplace
E-mail:nicole@jlscustomhomes.com Range
- 3 _ [ 2' it4a4 t L I Barbecue
Business name:TBD Clothes dryer(gas)
Other:
Address: 41 044.*WA13941 a . .. .
City/State/ZIP: Subtotal 1
Minimum permit fee($72.50)
Phone:( ) Fax:( ) Plan review(25%of permit fee) j
CCB Iie.: State surcharge(12%of permit fee)
TOTAL PERMIT FEE 1
Authorized signature: This permit application expires If a permit is not obtained within 180
days after it has heen accepted as complete.
Print name: I Date: • Fee methodology set by Tn-County Building Industry Service Board
1:V Building V'ermadMEC•PermitApp.doc 01/19/07 440-4617T(11/02/COM/WEa/
Plumbing Permit Application RECEIVED
Building Fixtures MAY 1 2 2008 FOR OFFICE USE °NL1
City f Tigard Received G�.YJ�
t3 rJ /} U f" I Permit No.:ifST��g.-
■ 13125 SW Hall Blvd.,Tigard,OR 97223,
Date/13y:
t C Phone: 503.639.4171 Fax: 503.598.196 1" 'OF TIGARD Plan Review Other permit No.:
Inspection Line: 503.639.4175 BUILDING DIVISION Date/By: Da�—e�?3
T'I G A RD Internet: www.ti atd-or. ov Date Ready/By: Juno: Supplemental See Page 2 for
g g Notified/Method: Supplemental Information
❑New construction ❑Demolition For special information use checklist
Description J Qty I Ea 1 Total -
❑ Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
-ark ,e;+ ,t* .;.. 6 19t3IQ°$ itit it A SFR(1)bath 24920
❑ 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
n _& n r.( Y%a.a t ,''ri�w,- :0 ?> A
Site utilities
Job site address: 1 f 0-7 C
Sli,3 \'V\C M-,k j 4,r Catch basin or area drain 16.60
City/State/ZIP:Tigard,OR Drywell,leach line,or trench drain 16.60
Suite/bldg./apt.no.: I 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.:_) I Page 2
Subdivision: Lot no.: 7, Water service(no.linear ft _) Page 2
Fixture or item
Tax map/parcel no
Absorption valve 16.60
: 2 � FV`' ' r Backflow preventer Page 2
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
r Drinking fountam 16.60
=� .. •rl ,r Y ®~d11ry,. ..,:r. w .a
Ejectors/sump 16.60
Name:JLS Custom Homes
Expansion tank 16.60
Address: 16280 NW Bethany et 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
` . ��F ' _•_ ... � � ,:�. _.v
Ice maker 16.60
Business name:JLS Custom Homes
Interceptor/grease trap 16.60
Contact name:Nicole Paulsen Medical gas(value:S ) 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
I E-mail:nicole@jlscustomhomes.com Urinal 16,60
ylr - F-"
4: - rT . r rt 5 , Water closet 16.60
Business name:TBD Water heater 16.60
Address: Other:
City/State/ZIP: Subtotal
Minimum permit fee: 572.50
Phone:( ) Fax:( ) Residential backflow minimum permit fee: 536.25
CCB Lic.: Plumbing Lic.no.:
Plan review (25%of permit fee)
Authorized signature: State surcharge(12%of permit fee)
TOTAL PERMIT FEE
Print name: 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.
1 U tuilmng`.I'crmns\PLMP-PermdApp.doe 12/27/06 440-4616T(I0/02/COM/WEB)
i3So
Electrical Permit Application RECEIVED_ roll orrice is oNt.i
lit City of Tigard Received -- Permit ve
' 13125 SW Hall Blvd.,Tigard,OR 97223 MAY 1 2 2008 Date/Bv .. /� a T �/aid08-ii ,
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 DateB Other Permit
v: „.. 2 41:9k-eve 7
T I t i n It n Inspection Line: 503.639.4175 CITY OF TIC D Date Keady/By. Juris. ® See Page 2 for
Internet www.tigard-or.gov ` Notified/Method Supplemental Information
_ a
®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/hems checked below):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
t4IW 14-64 11liZt j6iii il�' exceeds 10.000 amps at 150 volts or
>:.i';rat,.? � ---. �,�. �„�; P ❑Floating buildings
.
❑ 1-and 2-family dwelling Commercial/industrial less to ground,or exceeds 14,000 ❑Commercial-use agricultural
y g ❑ ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 75 KVA or
a; _ -_ ❑Emergency system larger separately derived system.
r ,,fi+r1 A `�' i .., t.,.I-_ _ ❑Addition of new motor load of
/�`7O it 4 t�, I00HP or Moro. occupancy.
Job no.: Job site address:Ht r `u3
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,
Cross street/directions to job site: VW' - t i.E. CaHEDUL1E�-_: t 4,
J Description I Otv. I Fee. I loin! I
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.:---1 1 1,000 sq.ft.or less J 145.155 4
Ea.add'1 500 sq.ft.or portion I 33.40 1
Tax map/parcel no.: Limited energy,residential
�5. _._ - ,...� 75.00 2
.'43°,' K:way � �.. ' s'»':- y'- r".'`. (with above sq.ft.)
Limited energy,multi-family 75.00 , 2
residential(with above sq.ft.)
Services or feeders installation,alteration.and/or relocation
200 amps or less j 80.30 I 2
',�fi,1 .-:�-*_' s _ ®, IIN „., :_ .t 201 amps to 400 amps I 106.85 2
Name:JLS Custom Homes 401 amps to 600 amps I 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 16280 NW Bethany et 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 r 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
-, C . ,,i5 4t0 1:I 93 RSON! above service or feeder fee, 6.65 2
rtBusiness name:JLS Custom Homes Feehorbrancirci c
B.Fee for branch circuits
without service or feeder fee,
Contact name:Nicole Paulsenq 46.85 2
first branch circuit
Address: 16280 NW Bethany ct Each add'!branch circuit 6.65 2
Miscellaneous(service or feeder not included)
City/State/ZIP:Beaverton,OR 97006 , Each manufactured or modular
dwelling.service and/or feeder 90.90 2
Phone:(503)533-4006 Fax: :(503)533-4306 Reconnect only 66.85 2
E-mail: nicole@jlscustomhomes.com Pump or irrigation circle 53.40 2
v" „r _;" =eoNa J1K!JR iiiirA"`r y ,4i 4*: Sign or outline lighting 53.40 2
Business name:TBD Signal circuits)or limited-
energy panel,alteration,or
Address: extension.Describe: Page 2 2
City/State/ZIP: Each additional inspection over allowable in any of the above
Phone:( ) Fax: Per inspection 62.50
( ) investigation per hour(I hr min) 62.50
CCB Lic.: Electrical Lie.: Suprv.Lic.: Industrial plant per hour 73.75
'� _4E1B( }RH Q FRM1TaIEES `.xA v
Suprv.Electrician signature,required:
Subtotal'
Print name: Date:
Plan review(25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Date:
days after it has been accepted a.complete.
" Number of inspections allowed per permit
C\Building\Permns\ELC-PermitApp.doc 05/23/06 440.461 ST(iI/OS/COM/WEB
111 _ " Building Division
One & Two-Family Dwelling
T I G A R D Fees Checklist
PERMIT INFORMATION:
Permit#: 1 ST 8. �(Q3 Plan #: 0 � rn sto Date: 6• 29 •Cie Site Address: I �5tk) AI\Q\\ow Tejrcccct, Parcel #:
Subdivision: V► 110 e o u M e r Cse..k Lot #: —1 I Zoning:
Jurisdiction: rick etbacks: Front: Rear: Left: Right:
Class of Work: Net) Stories: 3 First Floor: -7 y-` '
Type of Use: in Height: Second Floor: 4
Construction: 5 b Floor Load: Third Floor: (p 5 S it
Occupancy Group: '3 Dwelling Units: Bonus Room: 25
Valuation: Z 4 !Bedrooms: Oa- Total Floors: IS E,3r
Bathrooms: 3 Basement:
Decks: 1 2-18 Garage: 542
Porches: 20 Other:
FEES: Description: Fee.Amount: Amount Paid: Balance Due:
Plan Check: Building: (o 7 _ $ •00
Extra Set:
Permit: Building: Cj,en
Tax: ' 1 24.32
Metro CET: l 8 3 , G
School CET: ( 2 -,S
Mechanical 4o.
Tax: 10• 0W
Plumbing: 3 t . C)O
Tax: 47 .
Electrical: 2..1 \ '95
Tax: 25.43
Low Voltage: 25
Tax: 0
CDC: CDC Ping. Rev.: • OA
CDC LRP Fee: �, ,
SDC: Parks:
TIF Res.: 747410
TIF MT: en
Erosion Permit: is,
Erosion CWS: _ r ,
Erosion COT: • •. ?A
• Water Quality: ;QS
,Water Quantity: ���v'
SUB-TOTAL: _A" , 4 la,-13o. L l_
Sewer: Permit:
Inspection:
SUB-TOTAL:
TOTAL MST & SWR:
I:\Building\Forms\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 I Qty _ Fee(ea.) I Total
New 1-&2-family dwellings Heating/Cooling
(includes 100 ft.for each utility connection) Air conditioning or heat pump* 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) I 17.90
SFR(3l bath t 399.00 Gas heat pump 14.00
Each additional bath/kitchen 45.00 Duct work 10.00
Rain Drain,single family 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-l'100' 55.00 Water heater I 10.00
Footing drain-each additional 100' 46.40 Gas fireplace I 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' ` 55.00 Wood fireplace/insert 10.00
Chimney/liner/flue/vent 10.00
Sanitary sewer-each additional 100' 46.40 Other: 10.00
Storm sewer- 1' 100' 55.00
�-- Environmental Exhaust&Ventilation
Storm sewer-each additional 100' 46.40 Range hood/other kitchen equipment 1 10.00
Water service- 1S`100' 55.00
Water service-each additional 100' 46.40 Clothes dryer exhaust 10.00
Fixture or Item Single duct exhaust
Absorption valve 16.60 (bathrooms,toilet compartments, ti
Backflow preventer 27.55 utility rooms) 6.80
Backwater valve g 16.60 Attic/crawl space fans 10.00
Clothes washer 16.60 Other: 10.00
Dishwasher 1 16.60 Fuel Piping
Drinking fountain 16.60 **($5.40 for first 4,$1.00 each additional)
Furnace,etc. ' **
Ejectors/sump 16.60 Gas heat pump **
Expansion tank 16.60 Wall/suspended/unit heater **
Fixture/sewer cap 16.60 Water heater 1 **
Floor drain/floor sink/hub 16.60 Fireplace I **
Garbage disposal l 16.60 Range ) **
Hose bib `..) 16.60 BBQ **
Ice maker I 16.60 Clothes dryer(gas) **
Interceptor/grease trap 16.60 Other: *1
Primer 16.60 Total:
Roof drain(commercial) 16.60 Mechanical Permit Fees
Sink/basin/lavatory I/O /y S 16.60 Subtotal: $ 'p.%O
Tub/shower/shower pan 16.60 Minimum Permit Fee$72.50 $
Urinal 16.60 Plan Review Fee(25%of Permit Fee) $
Water closet 3 16.60 State Surcharge(12%of Permit Fee) $ I V.B(o
Water heater 1 16.60 TOTAL PERMIT FEE $
Other:
Other:
Plumbing Permit Fees ELECTRICAL FEES (residential single-or multi-family)
Subtotal $ 349,Q(j Description Qty. Fee Total Insp
Minimum Permit Fee$72.50 $ 1,000 sq.ft.or less I 145.15 4
Plan Review(25%of Permit Fee) $ Ea.add'l 500 sq.ft.or portion 33.40 1
State Surcharge(12%of Permit Fee) $ 41. R Limited energy,residential 75.00 2
T T Each manufactured or modular
O AL PERMIT FEE $ dwelling,service and/or feeder 90.90 2
Electrical Permit Fees
Subtotal: $ Q t _
Plan review(25%of permit fee) $ 2 S +
State surcharge(12%of permit fee) $
TOTAL PERMIT FEE $
I:\Building\Forms\ResPlanCheckFees.doc 01/19/07 Page 2
11111 CITY OF TIGARD FEE AND PAYMENT HISTORY
_ 13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
TIGARD
MST2008-00063 - 11070 SW MALLOW TER
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 5/13/08 Check 2720080000 $0.00
0000001630
[CDCPLN]CDC Pln Rev 100-0000-433060 $46.00 $46.00 $46.00
[LRPF]LR Planning Surcharge 100-0000-438050 $6.00 $6.00 $6.00
[BUPPLN] Pln Rv Balance 245-0000-433000 $673.38 $673.38 $673.38 6/19/08 Check 2720080000 $0.00
0000002166
[BUILD]Bldg Permit 245-0000-432000 $1,035.97 $1,035.97 $76.62 6/19/08 Check 2720080000 $959.35
0000002166
[TAX] Build 12% State Surchrge 100-0000-207020 $124.32 $124.32 $124.32
[METCET]Metro Const Excise Tx 245-0000-229202 $183.55 $183.55 $183.55
[BEACET] Beaverton School CET 245-0000-229204 $1,355.00 $1,355.00 $1,355.00
[MECH]MEC Permit 245-0000-431010 $90.50 $90.50 $90.50
[TAX] MEC 12% State Surcharge 100-0000-207020 $10.86 $10.86 $10.86
[PLUMB] PLM Prmt 3Bth 245-0000-431000 $399.00 $399.00 $399.00
[TAX]PLM 12%State Surcharge 100-0000-207020 $47.88 $47.88 $47.88
[ELPRMT] 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
[EROSNI Erosn Pln Rv COT 245-0000-433010 $20.80 $20.80 $20.80
Refund-[BUPPLN]Pln Rv Depos 245-0000-433000 $-750.00 $-750.00 $-750.00 6/19/08 Check Refund 2720080000 $0.00
0000002165
Totals for Fees $12,730.44 $12,730.44 $750.00 $11,980.44
7� . 0
Revenue Payment
Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt# Due
Receipt# Payment Method Check# Payor: Receipt Date Receipt Amount
27200800000000002165 Check Refund 06/19/2008 $-750.00
27200800000000002166 Check 912156 JLS CUSTOME 06/19/2008 $750.00
HOMES
27200800000000001630 Check 912156 05/13/2008 $750.00
Total Payments: $750.00
Balance Due: $11,980.44
7 4" STORMLINE. WATE" METER
VuIIa&e t 3ummer�f ee ..
0C ' ., ,, 2" Paper Birch Tree
12[�OO� 4" SANITARY SEWER. O'")
u1� n Plan: Ma D L-
J CO a�tv s,to. •
G 2. ' PUE
Zots 11 6 9 f 70 f 71, 7 Z Bv1LO11`� 4" SANITARY SEWER. / •. •< .,r/
73 4/ '`° 3 2" Paper Birch Tree
,� . Unit B ' ,.. ,.ii 4" SANITARY SEWE`: t^ ��
Q
I. � � Unit E >z,..7. ��' •��— 3 tr
1. PROVIDE A MINIMUM 8" DEEP GRAVEL BASE FOR ALL 4" SANITARY SEWER. P /�`'°'. / \� 2" Paper Birch Tree
DRIVEWAY AREAS. - CD
2. MAXIMUM DRIVEWAY SLOPE SHOULD BE VERIFIED WITH V 0 Unit E ,> �� ��1 `�
THE BUILDING DEPARTMENT PRIOR TO CONSTRUCTION. i� \, to
3. PROVIDE A MINIMUM 4" DEEP GRAVEL BASE FOR ALL ` / _° `, '
SIDEWALK AND PATIO AREAS. `,; •
�_ Unit E a V " LLIR.cr) !
4. PIPE ALL STORM DRAINAGE FROM THE BUILDING TO A 4" SANITARY SEWER. :, �'
DISPOSAL POINT APPROVED BY THE BUILDING `'` 2 Paper Birch Tree a
DEPARTMENT. " .>;.° �. \� p
4 STORMLINE. �� 1
5. PROVIDE AND MAINTAIN POSITIVE DRAINAGE AWAY `•` `� J �� �O.�' °'
- itp,FROM BUILDING ON ALL SIDES. 10" 3 , I v......4 0 i
10 Water line Unit B 6'9
6. NON-STABILIZED FILL MUST NOT EXCEED 2:1 SLOPE �i �.
/ i�� `� L'
Paper Birch Tree 1
`a �„ l� Q
7. NO CUTTING OR FILLING SHALL TAKE PLACE WITHIN
■ l 'e.e, / 25
THE DRIP LINE OF AN EXISTING TREE UNLESS THE ------ ----- _ > •
EXCEPTION IS APPROVED BY THE BUILDING DEPT. __ _____________ ______ � ��' . , CITY OF TIGARD-SITE PLAA}WiiPVIIEW �'
8. AFTER COMPLETION OF CONSTRUCTION, THE CONTRACTOR �� , �- __ _____ • / BUILDING PERMIT NO.: Nhi o?�O$ - (p'f
MUST EITHER LANDSCAPE THE SOILS, MULCH THE SOIL OR • '• . , -� a i P ' SWING DIVISION: PD SelbkcKr I<
SEED THE EXPOSED SOILS. - •. ,
.,,� [. . ,. , 4 eotiired Setbacks: l�i{ Approved[.. [ , pi Pp ❑ Not Approved
','de Street Side:
9. PROTECT STOCK PILES FROM OCTOBER 1st THRU
APRIL 30th PER THE EROSION CONTROL HANDBOOK. 2" Eastern Redbud ` ` r` € r:••s►i. Garage: Rear:
�w R l -- = `l ' +stmI + %::!ranee: 144A 0 Approved ❑ Not Approved
�SEMARY LANE :iaxH;;i:.• i3 nit�iing Height `f5 feet
5/' rde6�aGi{7er v ice Provider Letter Required: ❑ Yes ,� No
. CITY OF TIGARD-SITE PLAN REVIEW / ❑ Received
eU1LDING PERMIT NO: 1'(1jjgcD$- �� a C G,c n Date: 5 :2?—a8
" FI\l;a vt R1N ' D. EPA TMENT:
,, • Actual Sloe: % Approved
. Street Trees: p ppr ❑ Not Approved
Approved ❑ Not Approved t Site P n: Approved ❑ t A p v
Protected Trees: (0 Approved ' ❑ of A Moved .--.-.<-
Y u'd P Date. d-t v� S97EBy ' Date: �NORTH ,L�, 1" _ N ies ,�
28 d
DATE 4/8/08