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Permit CITY OF TIGARD MASTER PERMIT ~ 't COMMUNITY DEVELOPMENT Permit#: MST2015-00236 0 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/28/2015 Parcel: 2S102BC01102 Jurisdiction: Tigard Site address: 12764 SW KING CT Subdivision: GRACELAND Lot: 4 Project: Graceland, Lot 5 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 925 sf Basement: 0 sf Left. 5 Parking Spaces: 0 Height: 24 Bathrooms. 3 Second: 1311 sf Garage: 429 sf Front: 20 Smoke Dwelling Units 1 Third: 0 sf Right: 2 Detectors Yes Total 2236 sf Value: $271,774.17 Rear: 15 PLUMBING Sinks: 1 Water Closets 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 0 Tubs/Showers: 2 Garbage Disp' 1 Water Heaters. 1 Water Lines 100 Drains: 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 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 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 8 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 2236 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 Lot to be independently tested for soil stability/ PHONE: 503-664-6423 PHONE: 503-664-6423 FAX: Total Fees: $22,278.70 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. TION: n law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 1-0010 through OAR 9 2- 090 You may obtain a copy of the rules or direct questions to OUNC .1987 or 1.800.332.2344. 1Csued Permittee Signatu : Call 503.639.4175 by 7:00 a.m,for the next available inspection dat This permit card shall be kept in a conspicuous place on the job site until co otion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application t�Z ResidentialRECEIVED FOR OFFICE USE ONLY Received City of Tigard Date/By: A/R Permit No.: 13125 SW Hall Blvd.,Tigard,OR 97223pEC 2 2015 Plan Revie%r��/.v 'J �/ /��ls a Phone: 503.718.2439 Fax: 503.598.1960 Da /By. . C> Other Pennn. R Inspection Line: 503.639.4175 CITY OF TIGARD Dale Ready/Byco/2 ns: ® See Page 2 for Internet: www.tigard-or.gov BUILDING oiviSIOI�I Notified/Metho Supplemental Information TYPE OF WORK ` REQUIRED DATA:I-AND 2-FAMILY D�VELLINC 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 y_ work indicated on this application- CATEGORY OF CONSTRUCTION , — ''' � I-and 2-family dwelling El Commercial/industrial Valuation: $ i Number of bedrooms: Aiv I ❑Accessory building ❑ Multi-family F-1Master builder ❑Other: Number of bathrooms: 13 AW Total number of floors: (� -:,° JOBSITE INFORNIATLON AND/LOCATION; L a1 � ,lob site address: 5L4 ���� New dwelling area: (M6 square feet" l.. City,/State/ZIP: �i w( R q7123 Garage/carport area: ,�29 square feet Suite/bldg./apt.no.: Project name: Care 1 e�� Covered porch area: square feet i 3 Cross street/directions to job site: WN\'nfj} Deck area: square feet Other structure area: square feet REQUIRED DATA:"COMMERCIAL'LiSE?CHECKLISI' Subdivision: tot Lot no.: �j Permit Ices*arebasedon the value of the work performed. G e�� Indicate the value(rounded to the nearest dollar)of all I � fax map/parcel no.: equipment,materials,labor,overhead,and the profit for the work indicated on this application. �•, „, _ :;DESCRIPTION__OF WORK- pp Valuation: S Existing building area: square feet New building area: square tett PROPERN."OW,ER 61. ❑'>TENANT"' Number of stories: Name: KCk (L_ �Wu ;tLn prib Type of construction: Acidress: l� (� C p ��a SUt ( 13 Occupancy groups: ----{ City/State/LIP: p,�c FYI 11� Existing: Phone:(�p3 ) 4Z Fax:( ) New: -- -M APP,LICAiNT, f „-, ❑, CONTA T_PERSON BUILDING PERMIT FEES* . �C N Y 1D C� "Please refer to,&e schedule Business name: R(�4 bu l Structural plan review fee(or deposit): _1 Contact name: l-- — FLS plan review tee(if applicable): \ddress: Total fees due upon application: City/State7111: --- i�— ( ) Amount received: I hone:( ) Fax 1 PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* I�-mail: Commercial and residential prescriptive installation o; ONTRACTOR roof-top mounted Photovoltaic Solar Panel System. Rnsiness name: /1� Submit two(2)sets of roof plan with connection details ! oModem and fire department access,along with the 2010 Oregon i Address: Solar lnstallcuion S ecially Code checklist. QIC,.1.G/"v 12� 3 w � / 5 S 9 Permit Fee(includes plan review $180.00 I � Cit.%State/7_IP: mi t�/1'(,, ! and administrative fees): 1 I' Phone:(,0oI Fax:( ) State surcharge(12%of permit fee): 521.60 I CCB l!c.: "Total fee due upon application: $201.60 Authorized signature* This permit application expires if a permit is not obtained J within 180 days after it has been accepted as complete. Dale:/7-1 L / *Fee methodology set by Tri-Count} Building Industry j Print name: L 4Vr U� Service Board. 1:',!',,;it(tin2\Permits\BUP-RESPemiitApp.(loc 02/24/2011 440-4613•T(I I/02 COM/WEB) Electrical Permit Applicatiak- ' Received. � Permit N: Q/ City of Tigard Date/l3 : I >3- 5 ft9 n 13125 SW Hall Blvd.,Tigard,OR 972UCGC 2 2010 Plan Review Related Permit N: �t Qnl�p = Phone: 503.718.2439 Fax: 503.598. wDate/13 : CA inspection Line: 503.639.4175 Ready Date/By: turis: ® See Page 2 for Internet; www.tigard-or.gov CITY pF TIGARD Notified/Method: Sup plemental Information WOU ` .Please check all that apply(submit 2 sets of plans w/items checked):' ❑New construction ❑Addition/alteration/replacement ❑Service or feeder 400 amps or more ❑Building over three stories. ❑ Demolition ❑Other: where the available fault current ❑Marinas and boatyards. Fr'>.z." Ca :j�(' :' t 'ra b P`"' exceeds 10,000 an at 150 volts or ❑Floating buildings. less to ground,or exceeds 14,000 ❑Commercial-use agricultural ® I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations._ buildings. ❑ Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of I50 KVA or ,, ,,},,..; .,,,,F ,, r_••• r- -�}. system. s❑Emergency system. larger separately derived xl)yrpiia Ip SR M, _... K.- 1 ❑Addition of new motor load of Job#: Job site address: (2- 7 Lk \Yl I 1OOH P or more. ❑"A""F" `1-z" t-3" 3 El Six or more residential units. occupancy. City/State/ZIP: �( ❑Health-care facilities. ❑Recreational vehicle parks. ❑Hazardous locations. ❑Supply voltage for more than Suite/bldg./apt.#: Project name: It3 Bl10 ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: vsa\h\J\T 91 'Description f 1'. Ench Total New residential single-or multi-family dwelling unit. Subdivision: GCQ 1e10.Yn Lot#:5 Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'l 500 sq.tt.or portion 3 33.92 1 Limited energy,residential 75.00 2 (with above sq.tl.) Limited energy,multi-family 75.00 2 residential(with above s1.ft. Renewable Energy ❑ See Page 2 Services or feeders installation,alteration,and/or relocation Name: Pacific Evergreen Homes 200 amps or less 100.70 2 Address:7410 SW Oleson Rd,Suite 133 201 atnps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:Portland,OR.97223 601 amps to 1.000 amps 301.04 2 Phone:(503)664-6423 Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or k'mail: 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 Branch circuits—new,alteration,or extension,per panel 61LONIA;Ca i1(Er (f�yy. y, A.Fee for branch circuits with Business name:Same above service or feeder fee, 7.42 2 each branch circuit Contact name:Alan Gofflkloore B.Fee for branch circuits without service or feeder fee,first 56.18 2 Address: branch circuit Each add'I branch circuit 7.42 2 City/State/ZIP: Miscellaneous service or feeder not included) Phone:( ) Fax::( ) Each manufactured or modular 67.84 2 dwelling,service and/or feeder Ismail:alangoffmoore@gmail.com Reconnect only 67.84 2 , .,..x. ,• , ,, 67.84 2'Y' :.'^ Pump or irrigation circle Business name:Sunlight Electric Inc Sign or outline lighting 67.84 2 th Signal circuit(s)or limited-energy ❑ See Page 2 2 Address:2804 NE 65 Ave,Sute D panel,alteration,or extension. Each additional inspection over allowable in any of the above City/State/%[P:Vancouver WA 98661 Additional inspection(I hr min) 66.25/hr Phone:(971)222-5758 Fax:(360)326-9660 Investigation(I hr min) 90.00/hr Industrial plant(1 hr min) 78.18/hr Ismail:sunlight.inel@eomeast.net Inspections for which no fee is specifically listed(%:hr min) 90.00/hr CCB Lic.:. 172549 Electrical L,ic.:1LHOR t!.° Suprv.Lic.:1'79 3 S gqW Suprv.Electrician signature,required _ Subtotal: Print name: Chester Garrett Date: 10/20/15 ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): TOTAL PERMIT FEE: Authorized signature: This permit application expires if a permit isnot obtained within 180 Print name: Peter Kozarez Date: 10/20/15 days after it has been accepted as complete. * Number of inspections allowed per permit. I:\nuildin5\Permits\EI-C PermitApp_ELR_ERE.doc Rev 06/17/2015 440.401 Sr(I I/05/COM/WEE1 , Mechanical Permit ApplicMAJEWED Received Petmit No. City of Tigard �E� 2 2015 Uatc/By: � a /S �iT6b/5-Gba'- 0 13125 SW Nall Blvd.,Tigard,OR 9722 Plan Review _ p may. Other Permit: aA n^om�./ e"1 Phone: 503.718.2439 Fax: 503.59���iQ,OF TIGARO iG� S �7 Inspection Line: 503.639.4175 II �� f A Date ReadylBy: ISS B! 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• ® I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. I Total JOB SITE. INFORMATION AND LOCATION Heatin coolia : Air conditioning 46.75 Job site address: \ 7 1\h ( Furnace 100,000 BTU ducts/vents 46.75 City/State/ZIP: f R 1 2 Furnace 100,000+BTU ducis/vents 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: Gf'l6 Q4 Duct work 23.32 Cross street/directions to job site: H dronic hot waters stem 23.32 Residential boiler(radiator or h dronic) 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: C�fe,(t�AY� Lot no.:S Other: 23.32 Other fuel a lianees: Tax map/parcel no.: Water heater 23.32 DESCRIPTI N OF WORK Gas fire lacelinsert 1 33.39 Flue vent for water heater or gas fireplace 23.32 j Log lighter as 23.32 Wood/ ellet 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:Pacific Evergreen Homes Range hood/other kitchen equipment 33.39 Address:7410 Sw Oleson lid Suite 133 Clothes dryer exhaust 33.39 City/State/ZIP:Portland,OR.97223 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:(503)664-6423 Fax:( ) Attic/crawls ace fans 23.32 ® APPLICANT ❑ CONTACT PERSON Other: 23.32 Fuel i in : Business name:Same $14.15 for first four;$4.03 for each additional Contact name:Alan GoffMoore Furnace,etc. Address: Gas heat pump Wallisus ended/unit heater City/State/ZIP: Water heater Phone:( } Fax::( ) Fireplace j Range E-mail:alangoffmoore®gmail.com Barbecue CONTRACTOR Clothes dryer as Other: Business name: 'i"11 MECHANICAL PERMIT FEES" Address: Q-Q Subtotal City/State/ZIP: �� Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(S03 )Z(, _ 1 Z Fax:('�j�)Z(Q(,y 3t State surcharge(121/a of permit fee) CCB lic.: �D© TOTAL PERMIT FEE This permit application expires its 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: I:\Building\Permits\MEC_Permit Ap_0401 r].doc 440461 Tr(I 1/021COM/WEB) Plumbing Permit ApplicaIRE FIVE® Building Fixtures • • ONLY DEC 2 2015 Iteceixed 7 s Tats/�a� City of Tigard Permit No.:, v Pi 13125 SW Hall Blvd.j'igard,O L7aruHy F TIGARL� clan Rciieu ems /�p Phone: 503.718.2439 Fa) Other permit No. ��{{ p� UGC✓(3}: Inspection Line: 503.639.417. ILLJ� G DIVISION I Date Ready/By. mds ® See Pa ge 2 for Internet: www.tigard-or.gov Nonfled:•A e'thod: Supplemental Information TYPE OF.YORK', FES" SCHEDULE ®Neu construction Q Demolition I For special iuformariuruuse checklist. --•---------- - Description r fia. T l`otal 1 ❑Addition/alteration/replacement----- ❑Other: Scw I-2-family dwellings(includes 100 ft,for each utility connection) E CATEGORY OF CO\S'1`NlS(:PION SFR(I)bath 312.70 I® SFR(2 i hath 437.78 I-and 2-fru»ily duelling i ❑Conunercial!industrial SFR(3)bath 500.32 ❑Accessory building ❑Multi-fami1v _.._..._._.....__.__..,_....__ ..._......___._...____.__.___.__..........._.....__._- Lich additional bath/kitchen 25.02 ❑ Master builder Other: Fire sprinkler(_sq.tt.) . Page 2 - __...._.._............__.............._...._..._._...........--•--...__..._........ i .. JOB'.S]'CE INFORMAT.[ON AND LOCATION Site utilities: 1 Job site address: Ili L Catch basin.,r area drain 18.76 Dry,eell-leach line.or trench drain 18.76 City/Statc!Zill: Foutin�s drain irto.linear 1t,:_) Page- SuiteibldgJapt.no.: Project name: C, N1anufacttire d 110111e utilities _ i 50.03 Cross street/directions to job site: q�hu Manholes 18.76 Rain drain connector 18.76 I r Sanitary seiner(no.linear ft.:kl ) ! Page 2 Siorm sewer(no.linear ft.:_) Page 2 w—__...-._............_.._. _.... Water service(m,.linear fl.:_) Paye'_ j Subdivision: �j C �� --�— L„t no.: Future or item: -- _._—._.—........-- Tax map/parcel no.: Backflow preventer 31.27 -" :DESCRIPTION"F,F NVORK Backwater valve � 12.51 i �w Clothes washer 25.02 W ___.....__ Dishwasher 25.02 Drinkin_li,untain 25.02 —.`_._._......._..........--.._.. _..—. - —_.—_ . 1jeclorsi SUIn 2v 0p +}.2 ,.PROPER O'YN>g12. ❑ TENANT _ Expansion tank 12 51 — :. Name:Pacific Evergreen I'lomes ' Fixture%se:ver cap 25.02 --- -- Floor drani'lfoorsink!hub 25.02 Address:7410 Sw Oleson Rd,Suite 133 Garbage disposal j 25.02 Citpistate/ZIP: Portland,OR.97223 -- Hose bib -- 25.02 _ Phone:(503)664-6423 Fax:( ) Ice maker 12>1 ® API'LICANT, ❑.CONTACT Pt:RS'tJi\`h'r Inwfceptovgreasetrap 25.02 Business name:Same I Medical gas ivalue:S_) Page 2 ------ Primer 12.51 Contact name: Roof drain(annmcrciai) 1251 1 Address: _ Smk/basin/lavaton• 25.02 City:/State/ZIP: Solar units(potable water) 62.54 ; Phone:( ) Fax::( } TUW'Shotverishimer pan —12.51 E-mail:alang.offmoore a gmail.com Urinal ---- ——y Water closet 25,02 CONTRACTOR .. Water heater 3752 Business name: EDWARD WI.I.EN PLIANIBINC ---- I Water pipin&DWV 56.29 I ---- Address: 1601 SF RIVER ROAD ther: 25.02 ..._......... _. City/State/ZIP:IIILLSBORO,OR 97123Subtotal -. _ — ..— Phone:(503)640-0113 Fax:(503)640-4483 — 5lmimum permit tee: S72>(I -- Plan review (25%of permit fee) CCB Lic.:92689 Plumbing Lic.no.:34-260111 — -- -- -._. State surcharge(12%of permit fee) Authorized sienature: TOTAL PER'v11'r FFF 146`permit application expires if it permit is not obtained Within 180 days Print name: RAN"�'1 ll.l_h:\ Date: after it has been accepted as complete. °Fee metbadology set by Tri-Coumy Building Industry Service Hoard 11Duil6i:,g;PernutstF'LA7U-f'ermi..wpy uoi n}pl,i,q .4G-+GI$r(L�A'KUx1A5'FH} City of Tigard u '. COMMUNITY DEVELOF'ME,'NT DEPAZTMFN T C Building Permit Review — Residential W Building Permit #: 1"l-jr-�l 3< Site Address: Project Name: Lot #: (New dw,clling=subdivision manic;Addition or Alteration = last name of owner) Planning Review Proposal: Gjew SXR Verify site address/suite# exists and active in permit sVNo ill. PPRiver 1 errace Neighborhood: ❑ Ycs Si Plan Elements: Three(3)copies of site plan ] tsting structures on site ite plan must be on 8-1/2"x 11"or 11 x 17" paper L rootprint of nevv structure(including decks)with fitushed )rawn to scale(standard architect or engineer scale) oor elevations North arrow NJtilin7 locations(required for nevv,may apply for additions) ite address,project or subdivision name and lot number IJocation of wells/septic systems �18-app11---rosion L licant information (name and phone number) control(including drainage-way protection, silt fence LVJII(�or dimensions and building setback dimensions lesign,location of catch basin,etc.) tApot area,building coverage area,percentage of coverage and J treet names 4lpervious area (applicable if R-7,R-12,IZ-25&R-40) reeet tree size,type and location ,"I'operty corner elevations (2 foot contour lines if more than (existing trees to be retained with drip line,and tree =4 foot differentialprotection measures lean Water Services —Sen ice Provider Let er (lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified d No Received: ❑ Yes ❑ No Public Facili es Improvement(P171) Permit: Required: J Yes,applicant was notified ❑ No Applied For: 4yes ❑ No,stop intake Land Use Case#: Setbacks: Front Rear Side treet Side Garage scape Requirement: % D 1Lot Coverage Maximum: `yo 1'Building Height: Maxinnun Height Actual Height Visual Clearance Easements 0 "S.(�ensitive Lands: ❑ Yes WN o T)-pe WVUrban Forestry Plan Conditions "Met" prior o issuance of building permit Notes: �'Y•e'-P "CyL_ /! 77 7—) f it i i i S -S-e Approved By Planning: Date: 2 2- Revisions Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not approved Revision 3: ❑ Approved ❑ Not Approved 1:\Building\Forms\BldgPennitRvw_RES_070915.docx Building Permit Submittal / Original Submittal Date: I't(A/' 4- Site Plans: # Building Plans: # 5- Building Permit#: 2' Enter building permit#above. Workflow Routing: 21 Planning Engineering E;�-Permit Coordinator D—Building Workflow Sign-off: Er Sign-off for Planning(include notes from planning review) Route Application Documents: 0 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: By Permit Technician: Date: /.Z ak— Engineering Review Slope at building pad: Conditions "Met"prior to issuance of building peri-nit Easements (encroachments) per engineering conditions of approval and plat ❑ Water Quality/Quantity Facilit> Assess Water Quality Fee in-lieu: ❑ Yes ❑ No Assess Water Quantity-Fee in-lieu: ❑ Yes ❑ No LIDA facility on lot: Yes ElNo rx ❑ NOT Approved by ngineering: Date: Notes: Approved by Engineering: Date: 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 ❑ 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: SDC Fees Entered: Wash Co Trans Dev Tax: Yes ElN/A Tigard Trans SDC: ❑ Yes V N/A Parks SDC: ' Yes ❑ N/A 7?OK to Issue Permit Approved by Permit Coordinator: I:\Building\Forms\BldgPcrmitRvw_RES_070915.docz 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 12764 SW KING CT, TIGARD, OR, 97223 Residential - Master Permit 299 Final inspection PASS - C of O June 6, 2016 at 9:36:35 AM MST2015-00236 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 12764 SW KING CT, TIGARD, OR, 97223 Residential - Master Permit 699 Mechanical final PASS June 3, 2016 at 9:05:39 AM MST2015-00236 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 12764 SW KING CT, TIGARD, OR, 97223 Residential - Master Permit 299 Final inspection PASS - C of O June 6, 2016 at 9:36:35 AM MST2015-00236 Chip Barnett Violation Summary: Inspector Contractor 1 ,,-ii" Plumbing Permit Applicatiart4 V il 41.1 il 44'.f -- —. ''' . • . .....„..4 Building Fixtures FOR OFFICE USS ()NLA' City of Tigard , l':' - :i c..., Recaved '.',!,. ' 'k: 1 '''' `. 1>ateittyi Pcrinit No.in,5-71i 1 5-..._cu?...36, 111.. 13125:S5WH7a111B21v3)d(,,Tigard,ax5 0:1599782 123 p ,.. 038496a Plau Revicw Other Permit No inapcction LITIC: ;503.639.417n, ' '° ii()1'' )11:Ait':1 DateTY'd In TIGARD t„„„,a,L. ii, ' l'i ' li l' ' Date ea y y Avis 62 Soo Page 2 for Internet: www.tigard4r.gov Supplintrontal Information 1 Vi'.847J7f:4.1-":C=14- kt.:*l44.0',WWW1.:Oti:' ..... New construction 0 Demolition For special information use checklist. ---- _Description 1 Qty. I Ea I Total 0 Additionielteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft for each utility connection .1 04,441:9 ''.!!:"N:'''.-.; ':„ ',.. ,', 5E0(1)bath 312.70 fl I-and 2-family dwelling 0 Commercial/industrial , SFR(2)bath 437.78 SFR(3)bath 500.32 0 Accessory building 0 Multi-family Each additional bath/kitchen 25.02 0 Master builder 0 Other: Fire sprinkler( sq.IL) Page 2 O1LLIA.*LON-..'A`ND-LOCATION ' ..' 'i- Site utilities; Job site address: 111(p ci s„A) 1. :„4„,,c.„ ,,,,,4._ ._ Catch basin or area drain F- 18.76 ---- Dry well,leach line.or trench drain 18.76 City/State/ZIP: ---1,T-(7 s 0 ..........._ Footing drain(no.linear it: 1 Page 2 Suite/bldg./apt.no.: Project name: 6-'7(Like,L....4m.D\\\-t- Manufactured home utilities 50.03 . Cross street/directions to job site: lap Manholes ... 18,76 _ .6.1 i_r21/-NU--f. i 1\ Rain drain connector 18.76 -- Sanitary sever(no.linear ft.:_) Page 2 • - Storm sewer(no.linear ft.: I. Page 2 . , - ce)%i. Water servi (no,linear fl., ) _._ Page 2 Lot Subdivision: 6-7 14.4(..c.tArdb ct nt no.: 5 Fixture or item: thick flow preventer 31.27 I ax mapIpareel no.: .• ',,-. "`..i..t.if,,q'ki:t7ii:7,e,VD.;.'ii*.-. '031.1;f7tV , '''',.- i',4,..', ' -- , , - kwater valve 12.51 25.02 /4.1) 1--1100.01Z-LI Stl -- __ Dishwasher 25.07 ' 10 ?egAro-r-- - Drinking Muntain _25.02 Ejectors/sump 25.02 'IN *1io1.ERTyo8yNiif'4,:',',, - ,..,.. , 0 TENANT xpansion tnk 251 FixtUreisc'4cr cap 25.02 Name:Pacific Evergreen Homes _..., tour dramilloor sink/hub 25, I' 02 Address:7410 Sw Oleson Rd,Suite 133 -- Garbage disposal 25.02 City/Stater/3P:Portland,OR.97223 Hose bib 25.02 . _ Phone:(503)6644423 Fax:( ) lee maker — 12.51 o,4,-0,-o,:xd., .. a..,,6,-i.e_.,,- Intercepto...r/grease trap 25.02 Medical gas(value:5 ) Page 2 Business name:Same Primer 12.5'1 Contact name: Roof drain Nom mercial) 12,51 Address: _ Sink/basimlavatory 25.02 ..._— City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tubistioskerisintwer pan 12.51 Urinal 25,02 . E-mail:alangoffmoore@gr mailcom ^ Water closet 25,02 r.,, . ,,,, ,;.:,.' rcorop.AcIpv,..'sr,,,t,,,,,,,,.. -... .,. __ ,-.- ,;, , .... , ,.. walc.'r heater 37,52 Business name:EDWARD MULLEN PLUMBING Water piping/1)1LN 56.29 1 Address:1601 SE RIVER ROAD Other 25,02 Cit%/State/ZIP:HILLSBORO,OR 97123 Subtotal —... _ ,.. Minimum permit 4....c $72.50 : Phone:(503)640-0113 Fax:(503)(i40-4483 -- F---- Plan review (25%of permit fee) CCB Lie.:92489 Plumbing Lie.no.:34-260PB _ Authorized signature: t .."13, _ ennit surcharge1,1.a.i.c..4t.i0S:tiettxupircsir (12%of permit fee) ..1 , TOTAL PERMIT FEE1 7 ) p.,..i,t$rusk obtaintd within 180 days Print name:RAY NT ILLElsr Date:ICI--..7i '..----(•"" 'Fia.,inotliodol:tir7stii7;!ftrit.Fin7a7Vid.ii7'117dPi;:tryt':Scr.-ice Board I'130,1tiot,Oartt15LNIU,PemidAgY Jac ,0'01..0° d 10,40161,toM;11:0,1,wr t5., • .- anden Taggart From: Branden Taggart Sent: Thursday, May 12, 2016 5:18 PM To: 'alangoffmoore@gmail.com' Cc: #Building Permit Technicians Subject: RE: Graceland Laundry Tray Installations: MST2015-00223, 225, 224, 236 Attachments: Branden Taggart3.vcf; Graceland Revised Permits_Lots 1-3.pdf Hi Alan, I have attached the revised permit copies for lots 1-3 of Graceland. Once we receive payment for lot 5, I will send you the revised permit copy for that one as well. Thanks, Branden Taggart City of Tigard t+> Permit Technician Ffn 4 04; Community Development 13125 SW Hall Blvd Tigard,OR 97223 (503)718-2449 brandent©tigard-or,gov From: Branden Taggart Sent: Thursday, May 12, 2016 1:59 PM To: 'alangoffmoore@gmail.com' Cc: #Building Permit Technicians Subject: RE: Graceland Laundry Tray Installations: MST2015-00223, 225, 224, 236 Alan, It turns out that Graceland lot 5 has a laundry tray on it, but the fee was not collected for this fixture when the permit was paid for. I invoiced the fee for the laundry tray, and you can pay for it online now. The permit number is MST2015- 00236 and the balance due is$73.02. If you have any questions, please let me know. Thanks, 1 Branden Taggart 1City of Tigard II E ,4 r Permit Technician ,, Community Des'elopment ill 00 U 13125 SW Hall Blvd Tigard,.OR 97223 (503)718-2449 brandentitigard-orgov 1 From: Branden Taggart Sent: Tuesday, May 10, 2016 7:07 PM To: 'alangoffmoore@gmail.com' Cc: #Building Permit Technicians Subject: Graceland Laundry Tray Installations: MST2015-00223, 225, 224 Hello Alan, I have added laundry trays to (3) of the (4) permits for Graceland that you submitted to us yesterday. I noticed that MST2015-00236 (lot 5) already has a laundry tray on it. You can pay the permit fees online at https://aca.accela.com/tigard/or in person. If you pay online, I can always email the revised permit copies to you. MST2015-00223 (lot 1) MST2015-00225 (lot 2) MST2015-00224 (lot 3) Thanks, ' Branden Taggart N,4 City=of Tigard 1114 Permit Technician Community Development 13125 SW Hall Blvd Tigard, OR 97223 (503}718-2449 brandent©tigard-or.gov 2