Permit IN II 'p CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2015-00108
T[C;AR U) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/16/2015
Parcel: 2S110BA11600
Jurisdiction: TIGARD
Site address: 14236 SW 118TH CT
Subdivision: MEDALLION MEADOWS Lot: 9
Project: Medallion Meadows, Lot 9
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 4 First: 818 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 25.5 Bathrooms: 4 Second: 1289 sf Garage: 758 sf Front: 20 Smoke
Dwelling Units: 1 Third: 1404 sf Right: 5
Detectors: Yes
Total: 3511 sf Value: $437,589.71 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 6 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 4 Garbage Disp: 1 Water Healers: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 6 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 addl 500 sf: 7 201-400 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 3511
Owner: Contractor:
JT ROTH CONSTRUCTION INC J T ROTH CONSTRUCTION -Required Items and Reports(Conditions)
FOUR D CONSTRUCTION CO 12600 SW 72ND AVE#200 1 geo tech report required prior
12600 SW 72ND AVE#200 TIGARD,OR 97223 to footing inspection
TIGARD,OR 97223 2 Ersn Cntrl 503-639-4175
PHONE: 503-639-2639 PHONE: 503-639-2639
FAX: 503-624-0239
Total Fees: $25,399.39
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. Those rules are set forth in OAR
952-001-0010 throu AR 952-001-0090. You may obtain a co [he rules o • ct questions to OUNC by calling 50.. . •:7 or 1.800.3 .2344.
Issued By: . �� Permittee Signature:
I. ��/�
Cal by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of •roject.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Residential K IC IVEI P
City of Tigard Received
DateBy 5 /-1 Permit No.: i/ T x/66.'��O
• 13125 SW Hall Blvd.,Tigard,OR 97223 I 2 5 2015 Plan Review �� .-"/ �r
' a Phone: 503.718.2439 Fax: 503.598.1960 Date/By: t V" " ' I� L' ! Other Permit: S(✓ i 5∎__ (p
RI) Inspection Line: 503.639.4175 Date Ready/By: !� Juris ® See Page 2 for
Internet: www.tigard-or.gov CI V 0 1' t1ARR1► Notified/Method: Ito i e'7'- Supplemental Information
iiiii� it.).-1,-)0,',La.( ,i T�
TYPII BM DIVISION REQUIRED DATA:I-AND 2-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.
® I-and 2-family dwelling ❑Commercial/industrial Valuation.' 7j t7t. 3A9 1�1
❑Accessory building ❑Multi-family Number of bedrooms: 4
❑Master builder ❑Other: Number of bathrooms: 3.1
JOB SITE INFORMATION AND LOCATION Total number of floors: 3
Job site address: 14236 SW 1186 Court New dwelling area: 3511 square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: 758 square feet IA-CA
Suite/bldg./apt.no.: Project name:ineeketp,ikv G+ J Covered porch area: 90 square feet
Cross street/directions to job site:Gaarde Road to 1186 Court Deck area: 336 square feet 8te,,
Other structure area: 42(A_ re feet Z.�S•S
REQUIRED DATA: CHECKLIST
Subdivision:Medallion Meadows Lot no.:09 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.
Construction of new single family residence Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
•
Name:J.T.Roth Construction Inc. Type of construction:
Address: 12600 SW 72od Ave Occupancy groups:
City/State/ZIP:Tigard,OR 97223 Existing:
Phone:(503)639-2639 Fax:(503)624-0239 New:
L] APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES'
(Mews aearie tee
Business name:J.T.Roth Construction Inc.
Structural plan review fee(or deposit):
Contact name:David Jensen
FLS plan review fee(if applicable):
Address: 12600 SW 72 Ave.
Total fees due upon application:
City/State/ZIP:Tigard,OR 97223
Amount received: 75�
Phone:(503)806-0602 Fax::(503)624-0239
E-mail:david' trothinc.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
J @J
Commercial and residential prescriptive installation of
CONTRACTOR '. roof-top moun .1 PhotoVoltaic Solar Panel System.
Business name:J.T.Roth Construction Inc. Submit two(2)se : roof plan with connectio I • ails
and fire department acce .long with •- i 0 Oregon
Address: 12600 SW 7201 Ave. Solar Installation Special ecklist.
Permit Fee •.• •.es plan - 'ew $180.00
City/State/ZIP:Tigard,OR 97223 . d administrative f•- -
Phone:(503)639-2639 Fax:(503)624-0239 State surcharge(12%of permit fee): $21.60
CCB lic.:31700 Total fee due upon application: $201.60
This permit application expires if a permit is not obtained
Authorized sigma within 180 days after it has been accepted as complete.
/P�3. *Fee methodology set by Tri-County Building Industry
L Print name:David Jensen Date:06-24-2015 Service Board.
l:\Building\Permits\BUP-RESPerrnitA . oc 02/24/2011 440 4613T(]l/02/COM/WEB)
Electrical Permit Application 1.012 OFFI( 11 �l O'I 1
City of Tigard Received
'' 5 2015 Date/B : Permit#: V — /J '
IIIII
13125 SW Hall Blvd.,Tigard,OR 972232 Plan Review
I Phone: 503.718.2439 Fax: 503.598.1960 Related Permit#:
Date/B
Inspection Line: 503.639.4175 : . jARD,) Ready Date/By: Juris RI See Page 2 for
I 1 t' IZ f) Internet: www.ti ard or. Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition 0 Other:
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑Multi-family Master builder Other: amps for all other installations. buildings.
y ❑ ❑ ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
00HP
Job#: Job site address: 14236 SW 118th Court l
❑Addition of new motor load of system
00HP or more. ❑ A
City/State/ZIP:Tigard,OR 97223 ❑Six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name: ❑Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site:Gaarde Road to 118th Court FEE SCHEDULE
Description I Qty. I Each I Total i •
New residential single-or multi-family dwelling unit.
Subdivision:Medallion Meadows Lot#:09 Includes attached garage.
1,000 sq.ft.or less 1 168.54 4
Tax map/parcel#: Ea.add'I 500 sq.ft.or portion 7 33.92 1
DESCRIPTION OF WORK Limited energy,residential
(with above sq.ft.) I 75.00 2
Wiring of new single family residence Limited energy,multi-family
75.00 2
residential(with above sq.ft.)
Renewable Energy _ ❑ See Page 2 , ,
® PROPERLY OWNER (] TENANT Services or feeders installation,alteration,and/or relocation
Name:J.T.Roth Construction Inc. 200 amps or less 100.70 2
Address: 12600 SW 72nd Ave. 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Tigard,OR 997223 601 amps to 1,000 amps 301.04 2
Phone:(503)639-2639 Fax:(503)624-0239 Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:
relocation _
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
El APPLICANT 1 to CONTACT PERSON Branch circuits—new,alteration,or extension,Rer panel
A.Fee for branch circuits with
Business name:J.T.Roth Construction Inc. above service or feeder fee,
7.42 2
each branch circuit
Contact name:David Jensen B.Fee for branch circuits without
Address: 12600 SW 72°d Ave. branch circuit
City/State/ZIP:Tigard,OR 97223 Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included) _
Phone:(503)806-0602 Fax: :(503)624-0239 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:davidj @jtrothinc.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Dreamhouse Electric LLC Sign or outline lighting 67.84 2
Address: 13075 SW Canyon Road Signal circuit(s)or limited-energy ❑ Sec Page 2 2
Y panel,alteration,or extension.
City/State/ZIP:Beaverton,OR 97005 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)648-5144 Fax:(503)648-9723 Investigation(1 hr min) 90.00/hr
Email:dreamhouseelectric @gmail.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lie.: 196726 Electrical Lie.: C-848 Suprv.Lic.: 46105 specifically listed(14 hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name: Date: ❑Plan Review Required(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: Chris Mahoney Date: 06-24-2015 days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:Building'Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(II/05/COM/WEB
Mechanical Permit A licati EIVEl I0,, OI I I( I I .l (t\l ,
City of Tigard Received Permit No.:
13125 SW Hall Blvd.,Tigard,OR 9722 Plan Review
,_1 — • �V i
II Phone: 503.718.2439 Fax: 503.598.1941' 2 5 2015 Plan Review Other Permit:
Date/By:
T I t;n R I Inspection Line: 503.639.4175 (\ Date Ready/By: Juris 68 See Page 2 for
Internet: www.tigard-or.gov &.,1 i 1 OF FIGARD Notified/Method: Supplemental Information
P,1. --=I N ,1SJON -
TYPE OF WORK COMMERCIAL FEE' SCHEDULE—M CHECKLIST
Mechanical permit fees'are based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDE,gQUIPMENT/SYSFEMSFEW
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description 1 Qty. , Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address:14236 SW 118th Court Furnace 100,000 BTU(ducts/vents) 1 46.75
City/State/ZIP:Tigard,OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: Duct work 23.32
Cross street/directions to job site:Gaarde Road to 118t Court 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
Flue/vent for any of above 23.32
Subdivision:Medallion Meadows Lot no.:09 Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert I 33.39
Flue vent for water heater or gas
Wiring of new single family residence to include low voltage installation fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32 _
Chimney/liner/flue/vent 23.32
IS PROPERTY OWNER I ❑ TENANT Other: 23.32
Environmental exhaust and ventilation: _
Name:J.T.Roth Construction Inc. Range hood/other kitchen r
equipment ` _ 33.39
Address: 12600 SW 72"Ave. Clothes dryer exhaust ( 33.39
City/State/ZIP:Tigard,OR 97223 Single-duct exhaust(bathrooms, 6
toilet compartments,utility rooms) -- 23.32
Phone:(503)639-2639 Fax:(503)624-0239 Attic/crawlspace fans 23.32
❑ APPLICANT 0 CONTACT PERSON Other: _ 23.32 _
Fuel piping:
Business name:J.T.Roth Construction Inc.
$14.15 for first four,$4.03 for each additional
Contact name:David Jensen Furnace,etc.
Address: 12600 SW 72"Ave. Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Tigard,OR 97223 Water heater
Fireplace ll
Phone:(503)806-0602 Fax::(503)624-0239 Range
E-mail:davidj @jtrothinc.com Barbecue
CONTRACTOR Clothes dryer(gas)
Other:
Business name:All Time Heating LLC MECHANICAL PERMIT FEES*
Address:PO Box 1341 Subtotal
City/State/ZIP:Lake Oswego,OR 9+7035 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)208-2276 Fax:(503)208-2276 State surcharge(12%of permit fee)
CCB lic.:184575 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
1 / ./____c. days after it has been accepted as complete.
Authorized signature:
• Fee methodology set by Tri County Building Industry Service Board
Print name:Aaron Svobova Date:06-24-2015
I`_\Building\Peanits\MEC_PermitApp_040113 doc 440-4617T(I 1/02/COM/WEB)
Plumbing Permit Applicatiu
��,F1VEP
Building Fixtures 1 o oh I( I 1 ',I I)N11
City of Tigard 1 U N 2 5 2015 Received By: Permit No.: ri5r0/0 I 5-0`01
• 13125 SW Hall Blvd.,Tigard,OR 9n23 Plan Review
J
Plan Review
i Phone: 503.718.2439 Fax: 50 .598.19411 y Other Permit No.:
3 ri I'1�ARU Date/B :
Inspection Line: 503.639.4175-
1 I G A R D Date Ready/By: tuns See Page
2 for
Internet: www.ti ard or. v UIIII,DINn DIVISION_ Notified/Method: Supplemental information
ormation r
TYPE OF WORK FEE* SCHEDULE
®New construction ❑Demolition For special information use checklist
Description I Qty. I Ea. 1 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
® 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
❑Accessory building SFR(3)bath I 500.32
g ❑Multi-family
- Each additional bath/kitchen 1 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:14236 SW 118th Court Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97223 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: Manufactured home utilities 50.03
Cross street/directions to job site:Gaarde Road to 188th Court 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.: ) Page 2
Subdivision:Medallion Meadows I Lot no.:09 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Plumbing installation at new single family residence
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name:J.T.Roth Construction Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 12600 SW 72°4 Ave
Garbage disposal 25.02
City/State/ZIP:Tigard,OR 97223 Hose bib 25.02
Phone:(503)639-2639 Fax:(503)624-0239 Ice maker 12.51
❑ APPLICANT ® CONTACT PERSON Interceptor/grease trap 25.02
Business name:J.T.Roth Construction Inc. Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:David Jensen
Roof drain(commercial) 12.51
Address: 12600 SW 72e4 Ave. Sink/basin/lavatory 25.02
City/State/ZIP:Tigard,OR 97223 Solar units(potable water) 62.54
Phone:(503)806-0602 Fax::(503)624-0239 Tub/shower/shower pan 12.51
E-mail:davidj @jtrothinc.com Urinal 25.02
CONTRACTOR ,
Water closet 25.02
Water heater 37.52
Business name:ALL Plumbing Water piping/DWV 56.29
Address:9312 NW Skyline Blvd. Other: 25.02
City/State/ZIP:Portland,OR 97231 Subtotal
Phone:(503)520-0313 Fax:(503)469-1470 Minimum permit fee: $72.50
CCB Lic.:194089 Plumbing Lic.no.:PB1022 Plan review (25°/a of permit fee)
State surcharge(12%of permit fee)
Authorized signature: 3y��.......o'v TOTAL PERMIT FEE
Print name:Gary Luchs Date:06-23-2015 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
City of Tigard
'` COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review — Residential
Building Permit #: N' T 9cc 15— X4 0.2
Site Address: I y 23 6 SW 1 Wr-h C .
Project Name: M e2 ciJk on Me-fa/low S Lot #: 1
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: (1 SV
1 Verify site address/suite#exists and active in permit systt .
IYJ River Terrace Plan District: El Yes 6a No
Sit 'Plan Elements:
sree(3)copies of site plan -xisting structures on site
e plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished
Ub awn to scale(standard architect or engineer scale) or elevations
rth arrow Utility locations(required for new,may apply for additions)
e address,project or subdivision name and lot number r. ".cation of wells/septic systems
V/Applicant information(name and phone number) V Erosion control(including drainage-way protection,silt fence
L1dLot dimensions and building setback dimensions d• :gn,location of catch basin,etc.)
ro . area,building coverage area,percentage of coverage and 0 reet names
pervious area(applicable if R-7,R-12,R-25&R-40) II Street tree size,type and location
IT,Property comer elevations(2 foot contour lines if more than '$Existing trees to be retained with drip line,and tree
4,foot differential) protection measures
L✓—J/Clean Water Services—Service Provider Lett (lot platted prior to 9/10/1995):
equired: ❑ Yes,applicant was notified 5 No Received: ❑ Yes ❑ No
44 Public Faciliti#Improvement(PFI)Permit:
equired: N' Yes,applicant was notified ❑ No Applied For: /Yes ❑ No,stop intake
iff oiling:Use Case#: ,SL)B2O I �j—00006
oning: R—y ,S , 1
12 Setbacks: t t re c.\ (ac-�'u0,�) Front z0 (3e`,Rear i s'(2.L1') Side 5 (s') Street Side — Garage 20 C3q')
.ndscape R quirement:
a of Coverage Maximum:
�isuaI uilding Height: Maximum Height '30 r Actual Height ZS (j r,
l Clearance
NA/Visual
(�ensitive Lands: ❑ Yes M No Type
Urban Forestry Plan
4d Conditions "Met"prior to issuance of building permit
Notes: 1
Approved By Planning: IA '01 �i Date: 6 I2 S 1 c�
NW
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
1:\Building\Fonns\BldgPermitRvw_RES_031015.docx
A
4 .
Building Permit Submittal // (.9-5//`;Original Submittal Date: C.P
Site Plans: # 3
Building Plans: # 3
Building Permit#: 2-Enter building permit#above.
Workflow Routing: 8'Planning El-Engineering E Permit Coordinator B-Building
Workflow Sign-off: -Sign-off for Planning(include notes from planning review)
Route Application Documents: [} Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
[wilding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
C \
By Permit Technician: Date: (f/a 41/
Engineering Review y
lope at building pad: 2-0 �d i
/12'Conditions "Met"prior to issuance of building permit
Easements (encroachments) per engineering conditions of approval and plat
,Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes 0/No
Assess Water Quantity Fee in-lieu: ❑ Yes .0 No
LIDA Facility on lot: ❑ Yes No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: it 4.1 kit- w . Date: 4 Lc/�S-
Revisions (after Building Submittal only) Reviewer ( Date
Revision 1: LI Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
❑ OK to Issue Permit
Approved by Permit Coordinator: �„ Ccwnr---1 Date: C -a 4 -IC
I:1Buildingl Forms\BldgPermitRvw_RES_031015.docx
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
au
Transmittal Letter
r I G A It 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO:
DEPT: BUILDING DIVISION 11 II VV
al/JV l JUL 12015
FROM: CJpiI/,�IS CITY OF TIGARD
BUILDING DIVISION
COMPANY: C577) /?4.7
PHONE: v — • i `VIO Z By:
RE: ir3� /11' ` Gf /1st Z�J 00OK
(Site A dress) (Permit Number)
/�,
Project name or su division name an lot numi)er)
ATTACHED ARE THE FOLLOWING ITEMS:_
Copies: Description: Copies: Description:
Additional set(s) of plans. Revisions:
Cross section(s)and details. all bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
/j
REMARKS: /72‹)L/G��
FOR OFFIC USE ONLY
Routed to Permit Technicians Date: ( C- 1j r. J Initials: d ;
Fees Due: ❑ Yes Fee Description: Amount Due:
$
$
Special
Instructions:
Reprint Permit(per PE): El Yes El No ❑ Done
Applicant Notified: Date: Initials:
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
14236 SW 118TH CT, TIGARD, OR, 97224
Residential - Master Permit
399 Plumbing final
PASS
MST2015-00108
Jeff Grove
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
14236 SW 118TH CT, TIGARD, OR, 97224
Residential - Master Permit
199 Electrical final
PASS
MST2015-00108
Jeff Grove
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
14236 SW 118TH CT, TIGARD, OR, 97224
Residential - Master Permit
699 Mechanical final
PASS
MST2015-00108
Jeff Grove
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
14236 SW 118TH CT, TIGARD, OR, 97224
Residential - Master Permit
299 Final inspection
PASS - C of O
MST2015-00108
Jeff Grove
Street tree
Duct tightness
Lighting efficiency
Moisture content
Back flow
Insulation
All forms received
Violation Summary:
Inspector Contractor
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Transmittal Letter
I I 125 SW ` . Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: DATE NEW:F,)
DEPT: BUILDING DIVISION
_
AUG 242015
FROM: ( s�c!w , v� CITY OFT ' ' U
COMPA .
a 'l BUILD ► , I IVISION
/c 3' - 0‘a;2\ By:(�
PHONE: / ��
RE: uu �1P 4tt3 1 1 raT / —CO /C '
(Site ABass) (Permit Number)
'roject name or sue wision name an alot numser
ATTACHED ARE THE FOLLOWING E I _
Copies: Description: �\�'opies: escription:
Additional set(s)of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other ex. ain):
REMARKS: — t , e—v--- — ei\8,
( ztJ 6.
FOB USE ONLY -,
Routed to Permit Tec s. 'clan: l ate: (- Initials-� , v
Fees Due: ❑ Yes I! 1 o Fee Description: Amount Due:
Special
Instructions:
Reprint Permit (per PE): ❑ Yes I ❑No ❑ Done
Applicant Notified: 2,1 Date: V,/f/i S Initials:
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25t2012
•
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tic, /74:cT-,, ,),,--__ (-two
E l 1-1 z 3 c,.. 660 //Pi C7:`
HORN CONSULTING ENGINEERS LLC
Digitally signed by
Memo Dave Horn
DN:cn=Dave Horn,
l\ o=Horn Consulting
To: Mark Stewart
AO 11- Engineers,ou,
email=dave @hornce.c
Mark Stewart Home Design
om201
Datee::2015.10.28
From: David J. Horn 13:41:03 07'00'
Date: 10/28/2015
Re: Lot 9 Medallion Meadows Tigard, OR
We have reviewed the as-built framing at the above-mentioned new house and find the following conditions
acceptable:
• The low eyebrow roof framing at the back of the house was framed with the end / corner joist only
having a 1:1 back span vs. the 2:1 back span indicated on the plans. Since the second floor wall and
roof bears on top of this joist it is acceptable as framed with a 1:1 back span.
• See the attached revised details 10/L4 and 12/L4, which now indicate a 2x ledger in lieu of a 4x ledger.
#, --(A 1: --;INNAF
ter,.
s 1 E
iii
r oR, -,
4 12,A ,ti ;
iiie/ J. 1`'
9320 SW BARBER BLVD SUITE 135 • PORTLAND, OR • 97219
PHONE: 503.892.5782 • EMAIL: DAVE(OHORNCE.COM
WALL SHT'G
PER SCNED
2x STUD WALL
PER PLAN
EDGE NAIL'G
FLOOR SHT'G FLOOR 5NT'G
PER PLAN PER PLAN
CONC.TOPPG SLAB •
PER DESIGNER
U
n
FLR JSTS
/ PER DESIGNER
I n
REFER TO I /L4
P.T.JSTS PER PLAN FOR ITEMS NOT
w/1_51J NNGRS NOTED
P.T.2x12 LEDGER w/
3-SDS I/4"x41/2"
SCREWS 9 EA STUD 2x STUD WALL
WALL 51-MG PER PLAN
PER SCNED
0 SHEAR WALL e SUSPENDED GARAGE
SCALE: I I'-O"
�e�ED PRO,cs
G I N F�. Jio C HORN CONSULTING ENGINEERS LLC
PROJECT: Capital Plaza Suite 135 9320 SW Barbur Blvd
51 9PE y Portland,OR 97219
I I LOT 9 Phone: (503)892 5782
1 MEDALLION MEADOWS E Email: lave @hornce.com
OR ON
0 12 �0�� TIGARD, OR REVISED DETAIL: 10 / L4
400
DRAWN BT: DATE: SCALE: JOB NO:
Expires: 6-30-17 MTA 1028.15 I"•I'-O• M54-4D-15-OI