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Permit i1'� CITY OF TIGARD MASTER PERMIT v •tr . :;:g.1.! --t COMMUNITY DEVELOPMENT Permit#: MST2015-00233 TI I�CilARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/07/2015 Parcel: 2S102BC01102 Jurisdiction: Tigard Site address: 12758 SW KING CT Subdivision: GRACELAND Lot: 4 Project: Graceland, Lot 6 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First. 997 sf Basement: 0 sf Left: 5 Parking Spaces. 0 Height: 23 Bathrooms 3 Second. 1311 sf Garage 410 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2308 sf Value: $279,733.47 Rear. 15 PLUMBING Sinks: 1 Water Closets 3 Washing Mach: 1 Laundry Trays 0 Rain Drain 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines 100 SF Rain Storm Sewer 100 Tubs/Showers 2 Garbage Disp 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Catch Basins 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 4 Clothes Dryers: 1 Natural Gas Heat Pump. N Hoods 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 F u rn>=100 K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders- Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp 0 W/Svc or Fdr 0 Ea add'I 500 sf: 3 201-400 amp: 0 201-400 amp 0 W/O Svc/Fdr. 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other N Other Description Ecompasing Y BUILDING INFO Class of Work: Type of Use: Type of Constr.' Occupancy Group: Square Feet: NEW SF VB R-3 2308 Owner: Contractor: PACIFIC EVERGREEN HOMES LLC ALAN NATHANIEL GOFFMOORE Required Items and Reports(Conditions) 7410 SW OLESON RD#133 13950 SW BARLOW RD 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97223 BEAVERTON,OR 97008 2 Other Report(see note) PHONE 503-664-6423 PHONE: 503-664-6423 FAX: Total Fees: $22,391.50 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other <pp able la . 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 su-pended f"r more the 180 days. ATTENTION: Oregon law requires you to follow -- • = ;••pted by the Oregon Utility Notification Center. T '' -sales't forth in OAR 952-001-0010 through OAR 952-001-0090. You i- ••.in a c.•y of the rules•r direct questions to OUNC by calling 503.232.1987• :i; . '4. �' `,kIssued By: `� =, ,_—� Permittee Signature: V!� Carr'..4175 by 7:00 a.m.for the next available inspection date. ��- This permit card s all •e 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. ` t.: .;:� �.-ii.--,,,...1.,-,,,, ',!-Ti...-i-.38t ,4.T}i;�;�&tic,:n i, )-ocm' ///3e /S- iiii;' I ''''''''''N11/57-0201.5. .0#00,.3,:3 .___________ ______ ,.___ ___________ _ _ , . •.,„, ,:,_...,,, ,,-!,, Ti''ord,OR,972234 ' ...;,.,--,.....el.: .._7a:-por!(1,:00- 14 10 sq.,,,,, 1-,,,,- ' 1 " v ./u .cumxru� :/n , | ' ' — � -�� _____4 L�i� _n*_�_-�---- �--- - squaic !cell 9 -7' '----- -� � , ' ^x: mcuu�arca: ,9o:n |i'' ` ___ __ . -___ _' �__ --- _ / '` '� ' ' rcor��on^z`�wmn`ncxnxu`xsn/s/axq �_ __ __ _'__� ` � ___ ____ - ___ _ 7------. � SvuVm``"n coouoo � � ``/ �` �� �'r�'. .ic. "'':^�J^o�»�m�ocvr&�xvu}�r/.`oncu. . --' ---- --- --- -----� ~~----'-� `..;.-:..i`. `uv,:''c,,u'ux.`xc,u^n`tu^xu,`, ;di Fum^vrvnxo' `H,:;-,u/. :-`,,,c/,|•;.,/uuvw'x*a].and uvrnm ;r ir,, i nsSCu/rn0� ,,Tri �oo� � ., ,, :�, `����` �x'`a�����n_ ____ _ -_ ___ __-_-_�__��_- �_� _-_�-- .�. ` New n"", _��� ___- _ _ __ _ _��_ ------ ' .,,I'� n�.a`,�u�/ u|,um /*u . _---_��- wcxc ''u _ ------ - '� -__-_____-___ --__�--_' -_- ��-_- | 7 ruopun\ exNu: ___________ L] n�`^`` __ ��_�` ��� , N11:11,2 r,en, /:1,,or:ru` i/o,2e` �, ` `��,� ossvux`o ' Addles:, r-iw ":•;'o m""o Rd Suite i33 �'',rz`�� �,`cp� .__-__�___-� �____ -_---_'-_______-______--�� -___ __ _ __ __- ____ _ _ - ---------/ / , ' ^�v,� /x^ p",x:oo�ox�vr2z3 ____ _____ �___________________ ��^.`� _______ �� �-_'��-� /..,...1. /303�^4^4z3 / 'o ` ' N�, ,------' � / /�`xrni-----' --- r�WsoTh ` r____ --�----vnlLo/wnrxu`oTxcEs^ | �------ ~~ ''- ----�--�----� rle"pi *mfreschedule) | /-1o`1o,i-,s"ax" Sonic u�o°, --------- ' ! -- ---- �-------- -------'-------�-��---- `-..�z-':',-zz-|-r!amc`--u" ��-'w'upm'-). i c"°`u :mu: oox:"n\iv"n � ' ^� ,/u`�``o` ;��"/uprxc,m*• i Address- 1 --- -- /.'^i :' ,,,,'"rn,ovrx' 1x`o ! ci�,"��u'n, _______ _____�_ -_I— ,_ ________ ____ ___ __ xmv::»'�^a«: | ' rhm'- ' . ;`` --------�----�- --- - �'- `--'--'� ----------' ---� '-''^ -'------�---------- ----- 1'.:'�...»nnAu-wux-`or^NuT�*`srcxILLS' • !Huai: ��",,m/n,°",xn,"�"m°�"m _ ___-___-- __--- ------�----------------�----�-- '-- �.,'`"�.�h:��^�/i"*x/nusmvo.,m.m./u.^,"d � LnN Pnx.z:!y ` ''' " .`m�,� ph^wv^|w''S^|x,r,ma Sv/cm , ------'------- -'----' .----'-- --- '-- - '--� ` '�- � � ^�,..In,/,/*`".m'^ncc"u.,"`�/...l, xwoc,,^°� uxcx^n\|.m*'os«,u'� ,, , _ __� ___��— — �-' o� 'z /`'n�,p:* ,uca.a�S"/mme�xo�/v�^/ �- '_--____�_--_-_-__-_ _-- __� ^a|:,` 13950 *. x^*'n x: ` / ^� ` `u�'''."e c�c |m �--��.,--...'11 ri",2'111d;uc n|u'n'i^` 1 !/xom '.=N,v�'o ucx.v^^, ox.ynm� �nL�m�.o~u��,��/r , ^�-.�=---/a'a/6�w�z� -- ---^-------------- ------- ____'.,�`�~^s:�: ./rm^/pcon^uec S� Iw - - - ' P, h.: .x726" | • � , "nnx`ox w | 4 � _- � Fhis pt-_-,•niit application expires if a permit is not obtained `�1,`^:^.u^u,= AI, 46.4 Al� ^ui" ,,.00uw°after xhas been accepted ascomplete. `-- ^ a".nu�oum,* ^u»y�/�"'co=° a"ou..�/ouvu� p'Int xxmc w,o�vn‘/vvm � ozu• `,.,"�x,^u '----- __ -_ ___-_~___--___--_-_--- t , • Electrical Permit Application 3 +......-'$-;•-51.-.- -1,, iY�FQRoFI ►rtt1SE`°:�.1 VI:-'.,'• •`. . 1.:,.-0::,:.:,- City of Tigard I V U NOV 0 2015 015 Receive`( Permit ti/V,..,(702,40/5'..-0 0'233 .•. Date/By: ' 13125 SW Hall Blvd.,Tigard-OR 97223 Plmt Review Phone: 503.718.2439 Fax: 503.598.1960 s ;c;r,l:)t. )ate/BY: Related Permit 8: Inspection Line: 503.639.4175 c-rdy Date/By: turfs. ` RI See Page'2 for T_LGARDi Internet: www.tigard-or.gov 'UELD!" t ohlicd/Method: + Supplemental Information r, >.y.j. �:u.,e�-,�- _-tvr,. e�- _- .h,y�y 'e'e"ha-xr�: - - :,rte;- ,;�:.: .�N- „�=' -<.P,`tA TF.riSv Cyt Y F�.,.��:, - - % - :%ems'-j 7k:-;6.Z.::+ f5 ':�:. i�•.ha !a.!: - a� y ,._-+,.. :;: ':f:--� -z�,,.,.<IL'YPE�:,OF_.1iiOR1�J ,..,.._„-,£,`�� ..a,� a .- _.��:ar.��:t;Nd .,.- x..�.- ,,.1..-x `� ':'(:;, • ... ..... ._. . , .. . . . . _..yrs.? c3s>..,.`��;�. ,.<v"ai:,._. ,...,, .. 0 New construction . ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Dent°Iittotl 0 Other: whete the available fault current 0 Marinas and boatyards. r "°” - .—''.7.'''•'.'. •"'f eu:eeds 10,000 amps at 150 volts or 0 floating buildings. : -.EQTE;finR1;;:i)h� C(?NSTitI'JC;�InN ,:_`�,�,��„x'.�.:`•-�- =® '`' ”' -'- - Its to ground,or exceeds 14,000 0 Commercial-use agricultural I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building stops to,'all other i,tstauadous, buildings. ❑ Multi-family 0 Master builder ❑Other: I n-rite pump 0 Installation of 150 KVA or r . ,..-,:,.,,i.„,.r�,;, .. , OB -SfC>✓ N[ORMATiON':AN)'GOLRFICx'- -- - , zl Lmcr@cncysysem. largef cepatately derived I— -'---` I `— ----='- -- -'— I - ai,.. ...'.f.1.i ,h"pr 1 JJo of system. -Job#: I Job site address_ /'Z75g /_'.fL/, J I ibuFil'oi mote, -- - ' n Six or mole residential units. occupancy. City/Stale/ZIP: ❑tienith-cute f:cflities. 0 Recreational vehicle parks. --- ---- -------------------_-- --- -----------— _ for noir than Suite/bldg,/'t Jt.4: ''` — — — — ---- I I _I i-laz::r,: Ieeder 0 Supply voltage t I1 r ct r,,,1' _--- ----i 0 Semi,;.;or fz:`icr 600 amps or more. 600 volts nominal. Cross street/directions t0 job site: i t ,rt&tel.. ��•:.•t - .�"';zE_CnCiifErlitJCi '=:,;,a;n,r� _ ` 1 ne;crtptiun Qty I Each I Istat " - Z. .u,l4 , _^_--_ New residential single-or mold-family dwelling unit. Subdivision: eft J 4I - Iot 4: _ — Includes attached garage. 1,000 sq.It or less 1 168.54 4 Tax map/parcel 4: Ea add'l 500 sq.ft.or portion 33.92 1 < ..P.. . .-r;it .. . QF'SG.R1P .t tSjoPF' O.R.IC , . , •------------- . -. Limited energy,residential--- -- ---- -- (with aboveis ' 75.00 2 Limited enemy,,multilti -family 75.00 2 residential(with above sq.11) ; : '- r. ° Renewable Energy 0 See Page 2 0POPETS OWFR'T'' '''' u` iL :31;:'tiANL? ru: ` , --rex ureefders installation,alteration,and/or or reloc tion Name: Pacific Evergreen Homes 200;imps vii less 100.70 2 ----.------_ - - - 1 201 amps to 400 amps 133.56 2 Address:7410 SW Oleson Rd,Suite 133 I-- -- -------, 401 amps to 600 amps 2 City/StateiZlP: Portland,OR.97223 ' I i,;,; 200.34 a,nps t 000 amps ( 301.04 j 2 - 1 ,cr]nliti amps or voles I I 552.26 2 I Phone:(503)664-6423 f a:.: ) -__------__-_-- 1 -- --- - - -- t eniptn'ary services nr feeders installation,alteration,and/or {mail: 1 _ relocation Owner installation:This installation is being made on properIiia:l awn•solei is not i 1 200 roans or less - j I 59.36 1 intended for sale. Icase refit,or ey I::ii ,tecorcli;,t to i)„•, .;.17.-. 6:'0-:dt,';7(11. j I 201.:I`11,_I3 41st MTV,._- j 125.08 1 1 2 Owner signature: ---- ----.--___--- Date: ------____-- I 1 401 amps ua amps 168.54 12 - -� [3ranch circuits-new,alteration,or extension,per panel . ®I;` P3'Gie-ANT;,",,7 `` , - :; ,cCi�iri'�5`.:"L•'.L'.l✓RSOti -..1 --2-:.------"- ,,"":!:;s' .`-=r'. --_--�1___ ' -::.• --_.-_._•_•-•_ A.Fee for Manch circuits with -Business name:Same --`--- - I each service or(ceder fee, 7.42 2 each branch circuit Contact name:Alan GoffMoore I B.Fee for branch circuits without --' -'- service or feeder fee,first 56.18 2 • Address: blanch circuit _ Each add'I branch circuit 7.42 2 City/State/ZIP: -_-_._-__-- Miscellaneous(service or feeder not included) ('hone:( ) Fax: :( ) Each manufactured or modular 67 84 -- -- -'- dwelling.service and/or feeder Email:alangoffmoore@gmail.com Reconnect only 67.84 2 3 , ,i-, . - 7.v?_ a ^..-,,c 111)T•RAGTQ•R:= -• • ------,-T.... Pump or irrigation circle • 67.84 2 Business name:Sunlight Electric Inc -`-- ' _ - - S,n or outline lighting 67.84 1 2 — ---- { ,Signal circuit(s)sir limited-energy _0' j 0 See Page 2 12 1 Address:2804 NE 6� Ave.Sute U I i pane:trserauon,or extension. I Each additional inspection over allowable in any of the above City/State//..IP:Vancouver WA 98661A„d;uon;d inspection(1 hr min) 6.6.25/hr -----------_--------.--- --.__ Phone:(971)222-5758 I Fax:(360)326-9660 nvesuga i 'n\i hr man) 1. 90.00/hi . Int,<sut::inlant ll hr min) 78.18/hr I marl:sunlight.incl@comcast.net for which no t 1--- - -- - - --- - --- - ' ; Inspe:.:or,. ni fee is 90.00/hr 1 CCL) Lie.: 172549 I L•leclfic:, .,I,:, i 1608 15 ,,rn'. Lie. - ^r - 1 1 soe,..G,,,:.v I:_ei(S_hrman) I ' ' . . ! - iii�?: t ;%:5: -7 -I ____ _-E.I;GCT_gto, ,'- E~gt ti11:1'p'sFPti.g.a;s?:,:uf `, Suprv. Electrician siYnature-required:� ���.q�'�A� � .. i f p Subtotal: C L. - - I Print name: Chester Garrett j D::te: 1(/20.115 ' ❑Plan Review Required(25%ofpermit fee): I- - -- --- ------ 1 State surcharge(12%of permit fee): Authorized signature: i TOTAL PERMIT FEE: _ — 1 -Phis permit application expires if a permit is not obtained within 180 Print name: Peter Kuzarez days after it has been accepted as complete, �_ - I Date: 10/20!i 5 I--- ' Number`.f inspections allowed per permit. i'\Building\Permiiditi.C-PermaApp-Et-R EREdoc Rev 06117,2013 ,•:0-4t.I;',i.'1'.`'06i'WE;1 , ' i)%C( �r=o f r-c. Mechanical Permit Applhcatiod 11 .- -' wicv, Epit�ht t 1 ,� oNt ! ` 174' �� s 1 Cityof Tigard Received e eive Permit No f ��QO 'ysii. '" m, 131SW Flail Blvd.,Tigard,OR 97223 NOV 3 0 2015 [ -. _ � 33 '' Phone: 503 71.8.2439 Fax: 503 598.1960 Dat Review :'•,',!.1..4.. a �r-� r ,- .. �w Jata,'3y. Other Permit: �'- Inspection Line' 503 639.4175 Ulf lr i)'' .cis t42 r3 i',Date Ready/By: Auris: 8! See Page 2 for 1T1�Gii R L7" � p .<,:•!.'a Internet: www.tigard-or.gov BUID i•='r; ri1+ 't:.;(I)titnfied/Medtod: Supplemental Information �L' A [ COMMERCIAL FEES SCHEDULE- USE CHECKLIST -- TYPE OF W43ROs - - -1 ' Mechanical permit fees"are based on the value of the work El New construction 0 Addition/altcrationlreplacement i performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition Other: ' mechanical materials,e_atipment,labor,overhead,and profit. - Value:S CATEGORY OF CONSTRUCTION -- - _, - L. RESIDENTIAEQUiPMENTiSYSTEMSFEES' ►t I-and 2-family dwelling lCommercial/industrial ❑Accessory buildin --- For special injurmatianIlse checklist. 0 Multi-family G' Master builder El Other: Description _ Qty. l Ea. Total-1 JOB SITE INFORMATION AND LOCATION -Heating'cooling: 1 Air cor}diuonir l 46.75 -�_- Job site address -- :______.----_---r_-_---- 1 /Z 7L S t_ c,-_--- __. -' Furnace 100.000 BTU(ducts/vents) -1 46.75 City/State/ZIP: •7 j LFurnace 100,000+BTC(ducts/vents) I 54.91 Suite/bldg./apt.no.: - Project name: ----- i Heatpump _ 61.06 i 61.06 ! Duct work- - 23.32 Cross street/directions to job site: llytironie hot water system 23.32 ' ; Residential boiler(radiator or hydronicl23,32 1 Unit heaters(fuel-type,not electric), r .-_-___ ---------. --__-- � in-wall,induct,suspended,etc. -�_ 46.75 Flueivent for any of above I 23.32 Other j 23.32 Subdivision: Ln. �- --- - - j Lot no.: l,------- . Lf4!iL�4:/ ._.._____.__..-.__-___. I-..-_ I Otte! fuel appliances: Tax map/parcel no.: ' Wi err Ileat.cr I __ 23.32 DESCRIPTION OF WORK iFlec•Ga:tireplace'it ert _4--' 33.39 _-- _-_-_ --_ --- - J ! ewater heater nr gas Frenlace. - 1 23.32 __._-_------______ ------_______ I_ogigryg-a.'- lighter _--- -- _ 23.32 _ ` ood/m.1kt stove i 33.39 Wood fireplace/insert I l 23.32 _�i --------._._-.f i himney'Ilner.fue-vent---- ( 23.32 4- PROPERTY OWNER s 71 TENANT j Other: 1 Environmental exhaust and ventilation: 23.32 Name:Pacific Evergreen Homes - Range hoodiother kitchen -- - _ __.-_---------.__------_ --__.._.__ i e inmcn[ ! j 33.39 Address:7410 Sw Oleson Rd Suite 133 r-Clothes dryer exhaust :i 33.39 City/State/ZIP:Portland,OR.97223 I Single-duct exhaust(bathrooms, , -t_-_.___..._.-----_-._. .n_.__-.__.._..__-- I I toilet comparir:ents,_itiiity rooms I 1 23,32 i Phone:(503)664-6423 I Fax:( -- i Aniclerawisiacc fans I 23.32 .1 APPLICANT 1 �0 CONTACT PERSON I . Other ( 23.32 ; Fuel piping__ Business name:Same --^- T-`- 1 814.15 for first four;$4.03 for each additional Contact name:Alan GoflA400re i Furnace,etc. __- ------ _ - ______ --.__---_____ --------_-.-_-.._- Gas heal mum, -- Address: .__. i _ ----------.__--= Wall/susoeric1 d/unit heater d City/State/ZIP_--- Water heater rir Fireplace -- -- _ - -- - v.1. - E-mail:alae offmoore w mail.eons I , i g Lg _ - - F R"r" =i= ------f j CONTRACTOR. 1 Clothes dryer(gas: Business name: t ri-111__ ._! �1 11.1 } -`j t' i- MECHANICAL PERMIT FEES' Address: "' -.. � ..-- --------------_._--_...-.--_.___- _________.._._.-_ Subtotal ��O -)5c �,.._ i ------ City/State/L1P: (�� ,! f Minimum permit fee($90.00) `�`�t''1-- ' - 1 --- -- Plan review(2S°:o of permit fee) Phone:((JU ) j .,:(,v )r_(4A,.., pp (c� Tj- l.w„ --- --- } i b -_ State surcharge(12°1.o of permit fee) CCB lie.: TOTAL PERMIT FEE i t----- ------- -------;-----------" - '1 his permit application expires if a permit is not obtained within ISOys ed as signature >/' G/ " i ec .e,d-aaolrgy set by haTri-County Bupitditrg Industry Service Board rPrint name: lte0tjU Date: 70 r rK,2 I.:BuildingPermtOMEC-PeTmeAp,_ 003. dee 440-46177 t I i t)2!C OM,IVEB) . , Plumbing Permit Applicationffnfll\ • Building Fixtures4-1.L..._,, .„3, :1,.„, 4 , -;f::itIti$Ati4 C i ty of Tigard NOV 3 0 2015 I heeetved I ','; rap:trips: 1..)ate,it, het wit ly-py-c2‘,457...de A 3_gl illive.:,-. 1-;I 2S SW Hall ilk J.,;hoard OR 97223 . •,./. E:m .:........: :q. .i:`,.. P1101k: :10.2.i/L24.i9 Fax. 504 I-i‘A 1.06(cI') 3‘ir,ARO ! I;;;,,,,,;;B.,. Oilitt Penni:No.. I 1115pectim Line: 503,639,4 I-15, WE I! I 114 G'ARD) , • 1:-.. or rm.. rz, nr.flczirtm . ::,.,-,,!,..,„!:,p,,, , J.is 0 See Page 2 for interact: www,tigard-or.lacw t.....:%,,,-...I...01.\',... -4 i 4 is..04 m :;lettiotti I Supple:no:nal Information --- --- , TYPE OF \\(11-K1 "SCHEDULL. , ; ! I Z Nevi.construction ! 71 Demolition special information nse checklist. . . -4 , ; rpt -n ..,1 Qty. I La. I Fool_ E.A.,i,..iHKinialtatiowp,ph,,,-21,),.:Id , i :Oth,,T, ! i Ntt, i-2-fitniiti,tilt elli lids(includes 100 ft.for each utility tonneetiont I - cATEGoRv OF CONST RIX-110N ; 1 t ; ' Si-ti,;rt Melt t .312.70 I : . ! ; 1-- I TII-7f 1-and 2-1-dmily docilitg 1 ,1. omincrcii-nliindusiridi 'Iii-K i2.1 kith . ;____ - I ----, ; 437,78 ...._.. I 500.32 r- i ; 'Tt;',ibitill i , j Accessory building E \l -Canlii..> --i- _.1 ] [,,.,-1i:,6,iiiionill 1,,,th:kilcha, I 202 ; lel\1 dster bu i kio. E .1.11,,,,:1-: i.,i,...„;,,:;:;,10: -__ sq 111 I I NEE2t:2 1 . , ' • ,1014':§4TC INFORMATION AND LOCATION ; : II,Iit iitiliti-ki ._... _ I Joh.trite address: /2,7 5 0 g 1.- ,..._.- pu tb CI- . . Lat,l,basin or arta drain t ." 1./r,o'ell,!each liEtC,era.tnch drain I 18.70 Cuy,'StateiZIP: - „ ... . lootina dratn ow linear It: 1 I j Page 2 Suitelbldglapt.no.: i Protect name.: , Manuttictiotd nom,:EIN,sirs 50 03 I . I Cross streelidirections to job site: '; 0,1iiiiho _les • 18,76 ' i I .•• I I ti4/./11/4/ ; I iiii dram ci,r111C,I, 18 764 E , i I i ! 'mutt ry,tY.cr i HO.11111 1., •,_ 1 Pae 2 1 ; I r--Page 2 I I-- - vi„ito s,fri,itir i;;J; lira:-ti. ) I ' Pain 2 I I OtlIT or EfrItt: _....• I.--–— .......,... ....._........... . . v lc ..,,e 1 as mop/parcel no.", . p •. I I 317 __ 1,-..d..y..itt; 1',.. I 12'S i • , • ,Dr,SCRIPTION,OF Wt)10( ' 1-- — ... , , ,.Iothr,v.,,,licy I 25.02 . ' !,;•!;*.,;,.f;‘,. I 1 l'+. 2 I I iI ; 25.02 I 1 . koidond ioiliti,dri i --I i I ,r,IN-,,i-iii; 1 25.02 E..PROPER.TY:OWNCR s 2 If.: 'r r, ANT 1 I:Wt.:Yoh .TW`,t; I 1 1 .51 I i-- i -- i 25.32 i IName: Pacific Ever-green flumes . _I ..,_ 1 '., ...t dr-2nr sink-buts I I 25.02 I Address:7410 Sw (Meson Rd,Suite 133 E ----E Gartage disposn-ii i I 25 02 I CityStaterZ1P: POrtland.OR.97223 r -4 110,,e bib I 25.02 I I i Phone:15031663-6423 : Fa,:i ; ; ; lc::maker I 0, APPLICANT I C] LONIACTPERSON : ; ;; ,,,: :or;:.:ethe r , !h-III i 25.02 _ I ' Mk:slit-di s i‘...ita: S t i -r- i i Page 2 I I Rosiness name:Same - o ,num1 I 12,51 I , Contact name: i — --3 „ ------------____- i iIndoidiaiii simiriticiol) I I 12: 1 ; I Address: t‘, t 1)1-„,'..,int,I. ....„,-i, 02 . _ City/Stittei-ZIPit 1 i : , `s; i oink tolat i,i,,,,u2. 62.5 i . ; .- , ---+- I Phone,1 t Fir,:•i . , . ; i1-';i,kiy..d -;Iiiit.-„-r pail 1 12.51 I . ----- ; Liiiii,1 , I 212 [ 1`.-ITI:111' alatigolTmom-e'ii'gmaii.com . .___......... i 1 i – "– E-A mei,..:t. ..1 i I 25 02 i CONTRALTOR - 1 37 SII II r- RusiII"`"a"l'II EI/".'"4-1)811-LI EN l'IJ.‘1/11\if.; . ' vt.retr ithm, ,te. 56.29 I Adrire.t,st 1601 sit;RIVER 00,A II ' ' (;M.:- 1 25,02 I 1 t ' Subtotal I City/State/ZIP. HILLSBORO,OR 97123 : Home:(503)640-0113 ; Fax:(503)640-1483 : ______._ _ N'llninturn permit fee 5;72.50 t -- --- Plan reviev, 125%of permit feet I i (-CB Lie.:92689 I Numbing Lk-.no,-34-2611pB ,---- --- f ______ __ ________ , - !i.;tate stirchar ize(12°A,apt:milt fee) 1 _ Authorized signaturt i VI ..„......„07 ..././..se, , ... 1 ...,-. TOTAL PER N-11T FEE 1 I '-'4 ' , _ ert, i ,iiptiiitiddia e.Npires if a-perntil is not obtained within 180 days ! l'unt witylc; RAY 811LLEN I',,,t,„, 1,-.,, __ _• '---- — ---- _ ---- l''''.. - ,4;.'.-4- in it h3s iwt.n accepted It!.eit,tilliete. ,, siE.,,„2,,,,,.., ,,E..,.!E.E.,Th..Coatay PE,EiidiEttE itt(1115Ery SCE-Vita'13,,,Eird 1'HEEEIEEiEEVE,PrEuEll,Pi, It!EPEEEEEE-E,E.E.E,,E, EE!EEEE . • City of Tigard 114 I COMMUNITY DEVELOPMENT DEPARTMENT C ±� LTICA;aC Building Permit Review — Residential Building Permit #: /17S7-.2•0/...5=e)0 aZ 33 Site Address: /a'?" --A SU ) k_?__ Llr- Project Name: genre, ` ,--.&11,I<Myt Lot #: (New dwelling= subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: A) T-12_ i © Verify site address/suite # exists and active in permit sysyti. River Terrace Neighborhood: ❑ Yes V No SiPlan Elements: iPhrec(3) copies of site plan xisting structures on site ite plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure (including decks)with finished rawn to scale(standard architect or engineer scale) oor elevations r►'orth arrow Utility locations (required for new,may apply for additions) Elite address,project or subdivision name and lot number i11, ocation of wells/septic systems Vpplicant information (name and phone number) �IErosion control (including drainage-wap protection, silt fence ot dimensions and building setback dimensions esign,location of catch basin,etc.) "if St area,building coverage area,percentage of coverage and Alitreet names pervious area (applicable if R-7,R-12,R-25&R-40) reet tree size,type and location Property corner elevations (2 foot contour lines if more than Existing trees to be retained with drip line,and tree 4 foot differential) protection measures Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995): Required: E Yes,applicant was notified No Received: ❑ Yes 0 No e Public Facili . s Improvement (PFI) Permit: _J Required: Yes,( applicant was notified 0 No Applied For: AL1 Yes 0 No,stop intake i/Land Use Case #: P 2QC —O0a)/, 9.:46W0/171---(DOM i!Z Zoning: te—2/,8— IM Setbacks: Front -QO Rear /:c" Side S Street Side /5- Garage c:Q 0- Landscape Requirement: 0/0 PI of Coverage Maximum: Building Height: Maximum Height 30 Actual Height c23 V/Visual Clearance Pi Easements ensitive Lands:Vp ❑ Yes �No Type rban Forestry Plan Conditions "Met"prior to issuance of building permit Notes: Approved By Planning: , \''.------------- Date: / .,j Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved 0 Not Approved Revision 2: 0 Approved 0 Not Approved Revision 3: 0 Approved ❑ Not Approved I:ABuilding\Forms\BldgPennitRvw_RES_070915.docx Building Permit Submittal Original Submittal Date: ///7e/z5 . Site Plans: # 3 Building Plans: # '.3 Building Permit#: Enter building permit# above. Workflow Routing: ,, Planning Engineering ( ermit Coordinator Building Workflow Sign-off: IJ,sign-off for Planning(include notes from planning review) Route Application Documents: 2—Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. 2"-Building: original permit application, site plans,building plans, engineer and beam calculations and trust details,if applicable, etc. Notes: gilt By Permit Technician: ,,,�����" Date: // ,_ t / Engineering Review Slope at building pad: .27 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 ❑ No Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No LIDA Facility on lot: Yes ❑ No ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: AG _V Date: _12...7. -.1.5._--- Revisions (after Building Submittal only) Reviewer Date Revision 1: El Approved ❑ Not Approved Revision 2: ❑ Approved El 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: 0 DC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A Tigard Trans SDC: CI , N/A Parks SDC: i4 Yes ❑ N/A ❑ OK to Issue Permit Approved by Permit Coordinator: // / Date: -/35 I:\Building\Forms\BldgPennitRvw_RES_070915.docx 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 12758 SW KING CT, TIGARD, OR, 97223 Residential - Master Permit 699 Mechanical final PASS June 3, 2016 at 9:09:47 AM MST2015-00233 Chip Barnett No A/C 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 12758 SW KING CT, TIGARD, OR, 97223 Residential - Master Permit 199 Electrical final PASS June 3, 2016 at 9:09:15 AM MST2015-00233 Chip Barnett Previous corrections have been completed 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 12758 SW KING CT, TIGARD, OR, 97223 Residential - Master Permit 699 Mechanical final PASS June 3, 2016 at 9:09:47 AM MST2015-00233 Chip Barnett No A/C installed at this time Violation Summary: Inspector Contractor