Permit CITY OF TIGARD MASTER PERMIT
• • COMMUNITY DEVELOPMENT Permit#: MST2015-00120
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/21/2015
Parcel: 2S 102CA00600
Jurisdiction: Tigard
Site address: 9712 SW ASHWOOD ST
Subdivision: FREWING'S ORCHARD TRACTS Lot:
Project: Ashwood Estates, Lot 6
Project Description: New SF
BUILDING
Floor Areas Reauired Setbacks Reauired
Stories: 2 Bedrooms: 5 First: 1053 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 23.5 Bathrooms: 3 Second 1470 sf Garage: 399 sf Front: 20 Smoke
Dwelling Units: 1 Third 0 sf Right: 5
Detectors: Yes
Total 2523 sf Value: $304,321.72 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
Drains: 0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 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: 5 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 addi 500 sf: 4 201-400 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 Sr VB R-3 2523
Owner: Contractor:
LF 4 LLC JTSC LLC Required Items and Reports(Conditions)
9700 SW FREWING ST 5285 MEADOWS RD,SUITE 171 1 Ersn Cntrl 503-639-4175
TIGARD,OR 97223 LAKE OSWEGO,OR 97035
PHONE: PHONE: 503-308-7324
FAX 503-684-0102
Total Fees: $22,782.39
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By. Permittee Signature: lei,
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
S
Building Permit ApplicationlUN 3 0 2015
Residential CITY OFTIGARD FOR OFFICE USE ONLY
City of Tigard QUILD[NC DIVISION A _ J Permit No `/ ��:'/5—oo I, •
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie�i-�'ts w
Eri
Phone: 503.718.2439 Fax: 503.598.1960
Date/B : i r♦1 Other Permit:6(;0 12,aQ/5--COO$i
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: runs: H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: p Supplemental Information
TYPE OF WORK REQUIRED DATA:1-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.
Valuation 321: 2.$ 49c)�--•yy�� , A Vistj
® 1-and 2-family dwelling ❑Commercial/industrial �
❑Accessory building ❑Multi-family Number'of'' ``bedr ooms: 5
❑Master builder ❑Other: Number of bathrooms: ], 5
JOB SITE INFORMATION AND LOCATION Total number of floors: z
Job site address: to"T i a- 5W AsN:u ST New dwelling area: 2 5 a 3 square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area!"CI a square feet
Suite/bldg./apt.no.: Project name:Ashwood E. \L l Covered porch area: t 7() square feet1-k'r)
Cross street/directions to job site: Deck area: square feet[653
Other structure area: 2$7'2-2-... square feet Z3.S.
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: zO 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
DESCRIPTION OF WORK work indicated on this application.
New single family residence Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name:LF 4,LLC Type of construction:
Address:5285 Meadows Rd Stel 171 Occupancy groups:
City/State/ZIP:Lake Oswego,OR 97035 Existing:
Phone:(503)657-3402 Fax:( ) New:
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:JTSC,LLC
Structural plan review fee(or deposit):
Contact name:JohnWyland
Address:5285 Meadows Rd Ste.171 FLS plan review fee(if applicable):
Total fees due upon application:
City/State/ZIP:Lake Oswego,OR 97035 75 ,a;
Phone:(503)209-7555 Fax::( )
Amount received:
E-mail:jwyland @jtsmithco.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and esidential prescriptive installEinn of
CONTRACTOR roof-top mounted 'hotoVoltaic Solar Panel System.
Business name:JTSC,LLC Submit two(2)sets . roof plan with connection details
and fire department ac • along with the 2010 / ._.
Address:5285 Meadows Rd.Ste 171 Solar Installation Specialty ,•• the •. .
Permit Fee(incl •-. . •1 revi-
City/State/ZIP:Lake Oswego,OR 97035 .r inistrative fees): $180.00
Phone:(503)657-3402 Fax:( )
_ State surcharge(12%of permit fee): $21.60
CCB lic.:200237 /
Total fee due upon application: . 01.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
1 Print name:John Wyland Date: 613,11.5" *Fee methodology set by Tri-County Building Industry
Service Board.
1:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613 I1/02/COM/WEB)
Electrical Permit Applicati E EIVEh t:�tfz t)11,1( ►. I,SI f)°,1 ,i.
City of Tigard Received" �� � Other Penntl i
Pemut No LLLL ^�.,
li, , 13125 SW Flail Blvd.,Tigard,OR 97213 N 3 0 2015 DaleB : I s py! Gt3�. 11
Phone: 503.718.2439 Fax: 503.598.1960 ��M 0
•1 I GA!i!3 Inspection Line: 503.639.4175 , Date Ready/By: 3uris. El See Page 2 for
Internet: www.tigard-or.gov t,1TY OF 11( ANU Notified/Method: Supplemental Information
ft,µ,� �'�b 1 }
"S,1'(y',�^�. . ...'jr*... F' ' ,,,,.��, ISIO u. l„ ... `g.Ztn, AN 1 4.�...S rS,�r�������7t��5,,, ...
'� w 3 N\7,* a. .all+�lx'A '£\1.1'
®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/iteins checked below):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition El Other: where the available fault current ❑Marinas and boatyards.
'`' OA,CF+ ' r , ON tt , exceeds 10,000 amps at 150 volts or ❑Floating buildings.
O ` ' less to ground,or exceeds 14,000 ❑Commercial-use agricultural
(21 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
k
„ 1 ,,, .....-.,...:c ❑Emergency system. larger separately derived d system.a ,, JB ST 1 Q vamoi A ( tl V ,' t, , ❑Addition of new motor load of ❑ 'A •E" •1-2" "1-3•
Job no.: Job site address: 91 1 a,,, 91-) AS1.\Wh S1' Six o1' oreres, Recreational J�� ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:Tigard,OR 97223 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name. AStH0010D -S-rA►T es ❑Service or feeder 600 amps or more
Cross street/directions to job site: Description I Qty. I Fee. 1 Total I
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: Y 1,000 sq.ft.or less ( 168.54 4
Tax map/parcel no.: Ea.add'I 500 sq.ft.or portion '�-ti' 33.92 1
Limited energy,residential , 75.00 2
';.DESCRIP'll7ON OFD WORK (with above sq.ft.)
Limited energy,multi-family 75.00 1
Electrical for new single family residence residential(with above sq.ft)
Renewabte'iEnergy , 0 See Page.2
Services or feeders installation,alteration,and/or relocation
® PRIQ ,x∎ OWNER ❑ 4ElYrtINT
200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name: ' L.c. 4 / LL C 401 amps to 600 amps 200.34 2
Address:5285 Meadows Road Suite 171 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP: Lake Oswego,OR 97035 Temporary services or feeders installation,alteration,and/or
Phone:(503)657-3402 Fax:( )
relocation
200 amps or less 59.36 I
Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits—new,alteration,or extension,per panel
)4 QB.L CANT I 4,', 1❑ C[)NT4.C°`PERSON A.Fee For branch circuits with
�^- above service or feeder fee,
Business name:JTSC,LLC each branch circuit 7.42 2
B.Fee for branch circuits without
Contact narn 1"b l\t• wyl.,A ND service or feeder fee,First 56.18 2
branch circuit
Address:5285 Meadows Road Suite 171 Each add'I branch circuit j 7.42 2
City/State/"LIP:Lake Oswego,OR 97035 Miscellaneous(service or feeder not included)
Each manufactured or modular
Phone:(503)o_Oq -7 5 n 5 Fax: :( ) dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
E-mail: ■ ,1.�y hind @,j +Stab' h C n • CO m Pump or irrigation circle 67.84 2
"?CONTRACTOR'' Sign or outline lighting 67.84 2■
Business name: 40 rr.�_� y� Signal circuit(s)or limited-energy See
�3 !` D �f //' panel,alteration,or extension. Page 2 2
Address: i/r/i 0 /yboiewoo�t/41/6 1 J.1---4 - Each additional inspection over allowable in any of the above
City/State/ZIP: 1.-h 1/5JJ�`Q v lip h�'7 ). Investigation oa inspection(I mi ) hr min) 66.25/hr
` Investigation(I hr min) 66.25/hr
Phone:( 3)Lin).4e✓J.Z— Fax:r L. t0�. 7q2 ,5-
2 , Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCI3 Lic.: / 2//5c1 Electrical Lie,: 2 pr .,r : ��6/7 5 s ccihcalty listed(1 hr min) �'
t 7 ^.e. .` ELECTRICAL t R.F[ ' EES., .-
Suprv. Electrician signature,required: r
Subtotal:
Print name: t �, ! + , ' r Da Plan review(25%of permit fee):
�i►�t�t� ' _ State surcharge(12%of permit fee):
Authorized signature: I.- _ TOTAL PERMIT FEE:
� / 'Phis permit application expires if a permit is not obtained within 180
Print name: L Date: days after it has been accepted as complete.
-- - Number of inspections allowed per permit.
I\nuilding'.Peonitc.EL.0 PerntitApp ELR ERE doe Rev 05/212013 * •t40-1615T1 I 1/OS./COtiSfWER
Mechanical Permit Application FOR OFFICE USE ONLY
City Tigard JUN 3 0 2 015 Received I�
Ci of Ti and Date/By: f� /S ii 0 Permit No.: g rialip 60l r
w 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review (��
•
I Phone: 503.718.2439 Fax: 503.5 ,OF TIGARD Date/By: Other Permit:��)249615-600R6
T I G A R I) Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE 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 RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. 1 Ea. Total
JOB SITE INFORMATIO T Heating/cooling:
P F Air conditioning 46.75
Job site address: Q"'l'io. SW AsHwN Furnace 100,000 BTU(ducts/vents) I 46.75
City/State/ZIP: 'T 1 6 map♦ 0 R ell X2.3 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:Ashwood Duct work ■ 23.32
Cross street/directions to job site: 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: Lot no. 10 Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 1 23.32 _
DESCRIPTION OF WORK Gas fireplace/insert I 33.39
Flue vent for water heater or gas
Mechanical for new single family residence fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
® PROPERTY OWNER ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name:LF 4,LLC Range hood/other kitchen
equipment I 33.39
Address:5285 Meadows Rd Ste 171 Clothes dryer exhaust I 33.39
City/State/ZIP:Lake Oswego,OR 97035 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 5 23.32
Phone:(503)657-3402 Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT ❑ CONTACT PERSON Other: 23.32
Business name:JTSC,LLC Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:JohnWyland Furnace,etc. f
Address:5285 Meadows Rd Ste.171 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Lake Oswego,OR 97035 Water heater 1
Phone:(503)209-7555 Fax::( ) Fireplace 1
Range I
E-mail:jwyland @jtsmithco.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Integrity Air,LLC Other:
MECHANICAL PERMIT FEES*
Address:7301 SW Kahle Ln Ste 500 Subtotal
City/State/ZIP:Portland,OR 97224 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)572-3594 Fax:( )
State surcharge(12%of permit fee)
CCB lie.:203869 TOTAL PERMIT FEE
/ This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: • Fee methodology set by Tri-County Building Industry Service Board
Print name:John Wyland Date: 6/30l/rj
M
I:\Building\Permits\ EC_PermitApp_040113.doc 440-4617T(1 I/022//COM/WEB)
• Pludibin2 Permit Application
(( ��//ECEI"E�
Building Fixtures OFFICE USE ONLY
Ci}�,of H eie b p ., /S 0: /coil S oo 4�
IN , City Tigard �11LI Permit No.:
• 13125 SW Hall Blvd.,Tigard,OR 973ZSi+N `� Q 2015 Plan Review
■ Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.6(Q' l S J gd
Inspection Line: 503.639.4175 CITY OF TIGARD
I l t;A I/1 t Date Ready/By: orris: H See Page 2 for
Internet: www.tigard-or.gov Notified/Method. Supplemental Information
TYPE OF 4411,DING DIVISION FEE* SCHEDULE
®New construction 0 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)
CATEGORY OtCONSTRUCTION SFR(1)bath 312.70
® 1-and 2-family dwelling El Commercial/industrial SFR(2)bath 437.78
ID Accessory building ❑Multi-family SFR(3)bath 1 500.32
Each additional bath/kitchen ` 25.02
❑Master builder ❑Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: a 1 ) 1 SW AS 1-11400 D Si 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:ASHWOOD P57 J Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: Zr ) ( Page 2
Storm sewer(no.linear ft.: T') 1 Page 2
Water service(no.linear ft.: 24-) f Page 2
Subdivision: I Lot no.: ( Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 1 25.02
Plumbing for new single famiy residence Dishwasher I 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Name:LF 4,LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:5285 Meadows Rd Ste 171
Garbage disposal I 25.02
City/State/ZIP:Lake Oswego,OR 97035 Hose bib Z 25.02
Phone:(503)657-3402 Fax:( ) Ice maker 12.51
® APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:JTSC,LLC Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:John Wyland
Roof drain(commercial) 12.51
Address:5285 Meadows Rd.Ste 171
Sink/basin/lavatory S 25.02
City/State/ZIP:Lake Oswego,OR 97035 Solar units(potable water) 62.54
Phone:(503)209-7555 Fax::( ) Tub/shower/shower pan 3 12.51
E-mail:jwyland @jtsmithco.com Urinal 25.02
Water closet 3 25.02
CONTRACTOR
Water heater I 37.52
Business name:The Mullen Co.dba Edward Mullen Plumbing Water Pg�
i p in WV 56.29
Address: 1601 SE River Rd Other: 25.02
City/State/ZIP:Hillsboro,OR 97123 Subtotal
Phone:(503)640-0113 Fax:( ) Minimum permit fee: $72.50
CCB Lic.:92689 Plumbing Lic.no.:
Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name:John Wyland Date:4: �I5 This permit application expires if a permit is not obtained within 180 days
t after it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board.
1-\Building\Permits\PLMU-PermitApp doe 10/01/09 440-4616T(10/02/COM/WEB)
City of Tigard
a COMMUNITY DEVELOPMENT DEPARTMENT
I
T 1 G A R D Building Permit Review — Residential
,F,
Building Permit #: H 6-7(g0) -CC /aC cl- . e i2-0003 sO
Site Address: ' - �Yt...) ..i 7a
Project Name: /5 k.700 i -CLs k S Lot #: (,;.
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review, `�
Proposal: / J& ) , )1 'ft// 7,"s'id;0!%�
� a
Verify site address/suite# exists and active in .ermit s ste
P Y
F4*iver Terrace Plan District: ❑ Yes Of No
Site Ian Elements:
►- r ree(3)copies of site plan A -sting structures on site
MS. e plan must be on 8-1/2"x 11"or 11 x 17"paper I Footprint of new structure(including decks)with finished
It • awn to scale(standard architect or engineer scale) or elevations
If, .rth arrow Utility locations(required for new,may apply for additions)
IP a address,project or subdivision name and lot number 7Q w cation of wells/septic systems
I plicant information(name and phone number) n Erosion control(including drainage-way protection,silt fence
I.
at dimensions and building setback dimensions sign,location of catch basin,etc.)
FP it area,building coverage area,percentage of coverage and b.reet names
pervious area (applicable if R-7,R-12,R-25&R-40) IIIZ,Syeet tree size,type and location
I[J Property corner elevations(2 foot contour lines if more than �2' xisting trees to be retained with drip line,and tree
4 foot differential) protection measures
i f lean Water Services—Service Provider Le,t�te (lot platted prior to 9/10/1995):
jkequired: ❑ Yes,applicant was notified 1,d No Received: 171 Yes 1:7 No
LE' Public Facili,�s Improvement (PFI) Permit:
rotiZ equired: NJ Yes,applicant was notified ❑ No Applied For: Yes ❑ No,stop intake
1141nd Use Case#: ∎5 , 0/41 c Ooo
oning: '-
V Setbacks: Front 0 Rear /s Side c Street Side /c Garage t'O
t / .. dscape Requirement: /jr/ %
71 i' •t Coverage Maximum: ,a ___ % j /
1r Building Height: �Maximmum Height 5C) Actual Height ..�3�,'
Visual Clearance
Ofrasements
Nif '.ensitive Lands: ❑ Yes 111' No Type
l► Urban Forestry Plan
❑ Conditions "Met"prior to issuance of buil • g permit
Notes: esi l??(..Y0( Ailt 2 -,,Z2
2 P.12 ,- /I o' r- X itIS'itC2/7C',"
6"/MCl/Y1 e r
Approved By Planning: -J F _.� -, �" Date: *
ate: �"
�S
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:1Bu i I d ing\Forms\B l dgPermitRvw_RES_031015.docx
Building Permit Submittal
Original Submittal Date: /
Site Plans: #
Building Plans: # J,
Building Permit#: aetnter building permit#above.
Workflow Routing: 21-"Planning 13--Engineering IB'Permit Coordinator a-B-Uilding
Workflow Sign-off: a-Sign-off for Planning(include notes from planning review)
Route Application Documents: E Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
,..._original plan review routing form.
Building. original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
6 By Permit Technician: OS 1" Lr1 ! - Date: 4//3"---
Engineering Review
E j ope at building pad:
[l1 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 Ci
Assess Water Quantity Fee in-lieu: ❑ Yes -
LIDA Facility on lot: ❑ Yes Or No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: ,1 0 Date: 7-4 -J5
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit /r7
281 Approved, NOT Released: (�4,1,..(7h te-- Date: i3
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:
zOK to Issue Permit -
Approved by Permit Coordinator: Date: i S
App y
I:\Building\Forms\BldgPermitRvw_RES_0310I 5.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.
Ph City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Transmittal a smittal Letter
, , i i, 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
r
TO: CI �-'/ 0 c Vt9 Q,, ,c1 DATE RECEIVED:
DEPT: BUILDING DIVISION
RFC
EIVEP
FRO1Vi1 _ ��NE- Ll.. ,G_U�.1A, v _ _., ICI► 2 � 2015
COMP/NM ( ( Y 01' f l( AtU
COMPANY: 7T s M i T H CS
.��03, � a BUILDING D VISION
PHONE:
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RE: q7 1 3- sw ASt-%WOO P ST TI GAR ;0 iz MST -O i 001 2.0
(Site Address) // -- (Permit Number)
&SNWOO O EivisrAie and loLnOu T (P
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: I Description: I Copies: Description:
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(explain):
REMARKS:
FOR 1 FFICE USE ONLY
Routed to Permit Technician: Date: !rm i , commiii
Fees Due: • Yes • l o Fee Descri stion: Amount Due:
r_frirrlrfIRTY:, e -- ;'4
$
$
a i'1,:r .�' Y $
s ..i . 41.••`r R 4 `.=a,; $
Special
Instructions:
Re.rint Permit s er PE : PARMIIIMII ❑No • Done
A. .licant Notified: Date: Initials:
I:\Buil ding\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
9712 SW ASHWOOD ST, TIGARD, OR, 97223
Residential - Master Permit
199 Electrical final
PASS
MST2015-00120
David Young
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
9712 SW ASHWOOD ST, TIGARD, OR, 97223
Residential - Master Permit
699 Mechanical final
FAIL
January 27, 2016 at 11:09:15
AM
MST2015-00120
David Young
Permanent Address to be posted on site for final inspections.
Ductwork in garage not insulated at ceiling location.
All else ok.
Recall when corrections complete.
No AC installed at this time.
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
9712 SW ASHWOOD ST, TIGARD, OR, 97223
Residential - Master Permit
699 Mechanical final
PASS
February 10, 2016 at 10:17:38
AM
MST2015-00120
Chip Barnett
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
9712 SW ASHWOOD ST, TIGARD, OR, 97223
Residential - Master Permit
399 Plumbing final
PASS
MST2015-00120
David Young
Correction complete.
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
9712 SW ASHWOOD ST, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
PASS - C of O
February 16, 2016 at 9:58:19
AM
MST2015-00120
Chip Barnett
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
9712 SW ASHWOOD ST, TIGARD, OR, 97223
Residential - Master Permit
699 Mechanical final
PASS
February 10, 2016 at 10:17:38
AM
MST2015-00120
Chip Barnett
Violation Summary:
Inspector Contractor