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Permit CITY OF TIGARD MASTER PERMIT 14 IN 1 . . COMMUNITY DEVELOPMENT Permit#: MST2015-00247 • Date Issued: 01/12/2016 T f A R o 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 �� parcel: 2S102CA02200 Jurisdiction: TIGARD Site address: 13408 SW BARNUM DR Subdivision: ASHWOOD Lot: 9 Project: Ashwood Estates, Lot 9 Project Description: New SF. 3/10/2016: REPRINT permit to add 363 sf of non-habitable space above garage,adjust project valuation and permit fees. 5/10/16: REPRINTED permit to include A/C unit. Placement of BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1566 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 20 Bathrooms: 3 Second: 1742 sf Garage: 464 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3308 sf Value: $402,546.16 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 Drains: 0 Tubs/Showers: 4 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 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Tvoes Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: Y Hoods: 1 Other Units: 0 Furn<100K: 0 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,500 sf: 5 201-400 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 3308 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: $25,476.53 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You ma obtain a cop f the rules or direct questions to OUNC by calling 503.232.1 ?344. Issued By: _ Permittee Signature: Cal .4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the ect. Approved plans are required on the job site at the time of each inspection. Mechanical Permit ApplicatiGgECEIVEDp FOR OFFICE ESE ONLI ReceivedBl City of Tigard DaeV /� Permit No: r , r 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 MAY 1 0 2016ipli Other Permit: Date/By: I I t.,,1;1, Inspection Line: 503.639.4175 Date Ready/By: ® See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information BUILDING DIVISION WEI TYPE OF WORK COMMERCIAL FEE* SCHEDULE USE C.I.tit.CKLIST Mechanical permit fees*are based on the value of the work ❑New construction ®Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all El Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY VE CONST RUCTION RfsmENT/AL.EQUIPMENT I SYSTEMS FEES* ❑ 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total B'SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 1 46.75 46.75 Job site address:13408 SW Barnum Dr Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP:Tigard,OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump61.06 _ Suite/bldg./apt.no.: Project name:Ashwood Estates Duct work 23.32 Cross street/directions to job site:Frewing Street 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.:9 Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 Flue vent for water heater or gas Air Conditioning fireplace 23.32 liZl� t Log lighter(gas) 23.32 ,v , /S , ,-, _ ! - /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 33.39 Address:5285 Meadows Rd Ste 171 Clothes dryer exhaust 33.39 City/State/ZIP:Lake Oswego,OR 97035 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:(503)657-3402 Fax:( ) Attic/crawlspace fans 23.32 ® APPLICANT 0 CONTACT PERSON Other: 23.32 Business name:JTSC,LLC Fuel piping: $14.15 for first four;$4.03 for each additional Contact name:JERED OTEY Furnace,etc. Address:5285 Meadows Rd Ste 171 Gas heat pump Wall/suspended/unit heater City/State/ZIP:Lake Oswego,OR 97035 Water heater Phone:(503)890-0840 Fax::( ) Fireplace Range E-mail:JOTEY@JTSMITHCO.COM Barbecue CONTRACTOR Clothes dryer(gas) Business name:INTEGRITY AIR LLC Other: MECHANICAL PERMIT FEES* Address:7301 SW KABLE LN STE 500 Subtotal City/State/ZIP:PORTLAND,OR 97224 Minimum permit fee($90.00) Phone:(503)572-3594 Fax:( ) Plan review(25%of permit fee) State surcharge(12%of permit fee) _ CCB lic.:203869 TOTAL PERMIT FEE 1 (3 l This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 1 Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board Print name:Janelle 'ao Date:05/10/2016 I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB) CITY OF TIGARD I, MASTER PERMIT II 11 COMMUNITY DEVELOPMENT I� Permit#: MST2015-00247 Date Issued: 01/12/2016 T I t q n 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 yi 1 Parcel: 2S102CA02200 Jurisdiction: TIGARD Site address: 13408 SW BARNUM DR Subdivision: ASHWOOD Lot: 9 Project: Ashwood Estates, Lot 9 Project Description: New SF. 3/10/2016: REPRINT permit to add 363 sf of non-habitable space above garage, adjust project valuation and permit fees. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1566 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 20 Bathrooms: 3 Second: 1742 sf Garage: 464 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3308 sf Value: $402,546.16 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 Drains: 0 Tubs/Showers: 4 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 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: Y Hoods: 1 Other Units: 0 Fum<100K: 0 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'l 500 sf: 5 201-400 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: I NEW SF VB R-3 3308 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: $25,379.17 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 oug •AR 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 B A . ./_'/ice—411 Permittee Signature: 4-ft SA:44- ✓' Call 503.639.4175 by 7:00 a.m.for the next available inspection date. Q 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. q CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2015-00247 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/12/2016Parcel: 2S102CA02200 Jurisdiction: TIGARD Site address: 13408 SW BARNUM DR Subdivision: ASHWOOD Lot 9 Project: Ashwood Estates, Lot 9 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms'. 4 First: 1566 sf Basement. 0 sf Left. 5 Parking Spaces: 0 Height: 20 Bathrooms'. 3 Second 1379 sf Garage'. 464 sf Front. 20 Smoke Dwelling Units: 1 Third. 0 at Right. 5 Detectors: yes Total: 2945 of Value: $361.220.91 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 : TUCs'ShowDrains0 ers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevnlr 0 Footing Drain'. 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 DrywallTrenchDrain: 0 Other Fixtures: 0 Other Fixture Units'. MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: Y Hoods: 1 Other Units: 0 Fum-100K: 0 Vents'. 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvC/Feeders Branch Circuits 1000 at or less: 1 0-200 amp'. 0 0-200 amp'. 0 W/Svc or For 0 Ea addl 500 sf 5 201400 amp'. 0 201-400 amp: 0 W/O Svc/Fdr 0 Mid Home/Feeder/Svc 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp0 601+amp-1000v: 0 1000-amp/vol[ 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Aud a 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 2945 Owner: Contractor: LF 4 LLC JTSC LLC Required Items and Reports(Conditions) 9700 SW FREWING ST 5285 MEADOWS RD.SUITE 171 1 Ersn Chid 503-639-4175 TIGARD,OR 97223 LAKE OSWEGO.OR 97035 PHONE. PHONE 503-308-7324 FAX 503-684-0102 Total Fees: $24,800.95 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 through OAR 952-001-0090. You may obtain a cop/y =_^r direct questions to OUNC by calling 503.232. r 800 332 2344 Issued By \ SLe SIg ature: Ca46i by 7:00 a.m.for the next available inspection dale This permit card shall be kept in a conspicuous place on the job site until comp on of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application C Residential t 1�11F City of Tigard �J� 7 1 Permit No:13125 SW Hall Blvd.,Tigard,OR 97223 (''1 X111 lan ReviePhone: 503.718.2439 Fax: 503.59 ■ te/B 1 'Other PermitInspection Line: 503.639.4175 / ate Ready/By: mm. ® SeePage2forIn[¢met www.ligard-or.gov �� otified/Method:l Supplemenrel Informason TYPE OF WO REQUIRED DATA:1-AND 2-FAMELY DWELLING ®New construction ❑ `� Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/altemtion/replacement equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONAiUCTION work indicated on this application. Valuation3® $ 3 1-and 2-family dwelling Commercial/industrial 1 t ❑Accessory building ❑Multi-family Number of bedrooms: 4 ❑Master builder ❑Other: Number of bathrooms: 3 JOB SITE INFORMATION AND LOCATION Total number of Boors: 2 Job site address: 13408 SW Barnum or New dwelling area: 2945 square feet c, City/State/ZIP:Tigard,OR 97223 Garage/carport area: 464 square feet Suite/bldg./apt.no.: I Project name:Ashwood Estates Covered porch area: S square feet Cross street/directions tojob site:SW Garrett Street Deck area: tQ Z square feet Is- Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision:Ashwood Lot no.:9 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. r New single family residence Valuation: S ` 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 Ste 171 Occupancy groups: City/State/ZIP: Lake Oswego,OR 97035 Existing: Phone:(503)657-3402 Fax:( ) New: ❑ APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES* Business name:JT Smith Companies PJeam 1weerM areAamt Structural plan review fee(or deposit): Contact name:Jared Otey Address:5285 Meadows Rd Ste 171 FLS plan review fee(if applicable): City/State/ZIP:Lake Oswego,OR 97035 Total fees due upon application: Amount received: Phone:(503)890-0840 E-mail:jotey@jtsmithco.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES- Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System. Business name:JTSC,LLC Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:5285 Meadows Rd Ste 171 Solar Installation Specialty Code checklist. City/State/ZIP: Lake Oswego,OR 97035 Permit Fee(includes plan review $190.00 and administrative fees): Phone:(503)657-3402 Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.:200237 Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:John Wylan Date: 12/16/2015 `Fee methodology set by Tri-County Building Industry Service Board. [:\Building\PermitsiBU - ESPermitApp.doc 02/24/2011 4404613T(11/02/COM/WEB) Electrical Permit Applicaii2 *-'` City Of Tigard peceiv a 13125 SW Hell Blvd.,Tigard,OR 97227 Plan Review Related I'ntrdt N: 3 Phone: 503.718.2439 Fax: 503.598.1960 ,,.,;: ' �� DaMls : '.. Inspection Line: 503.639.4175 - Ready Date/By. !wts ® Bee Paget for Internet: wvnv.tigmd-or.gov �, '�t,3 t�� `fied/Method: Supplemental lnformedon TYPE:OF Wo.. qWb -.i PLAN REVIEW New construction ❑Addilion/elteraU ( Moore check all that apply(submit 2 acts of plans whtems checked): -ff ❑Service a feeder 400 amp or mom ❑Building over three stories. ❑Demolition ❑Other: where the available(buil clap«t ❑Marinas and boatyxds. " CATEGORY-OF CONSTRUCTION 11exceeds 10,000 amps at I50 volts or [I Meatus bulldhmga I-and 2-family dwelling ❑Commercial industrial ❑Accessory building less to amount,oraxeeed.14.000 pcanmadci.l-uac agricultural aomps for all other installations. buildings. ❑Multi-family ❑Muster builder El Other: I]Fire pump. ❑Imtelluion or 150 KVAon JOB:SITE INFORAM71014 AND-LOCATION: ❑F.mergencysyMens. larger separately derived 11100 Le� [I Addition of naw mots m load of syste 1 Job#: Job site address: 114 O SLo RN R IOOHP or mate. ❑"A","e,'1-2","Ia" ❑ Six ormom residential omits occupancy. City/State/ZIp: Tigard,OR 97223 ❑Haelth-tete facilittie.s.. ❑Recreational vehicle piths. SuitelbldgJept.#: Project name: Ashwood ❑Hazardem lc atiom. ❑Supply Waage for more than ❑Service on feeder 600 amps a mars. 600 volts nominal. Cross street/directions to job site: SW kAPAVETT ST 77� REE:SCHEDULE` Dosed saeI Qty, I Eseh ITotal New residential single-or multi-family dwelling unit. Subdivision: A S A W 00 D Lot#:9 includes attached garage. 1,000 sq.R.or leas 1 168.54 4 Tax map/parcel M Fa.add'I 500 sq.ft.or portion S 33.92 1 i DESCItIFT14N OF;WORK .. = - Limited cnagy,residential 75.00 2 Electric for new single family residencewith above sq.R Limited energy,multi-Gamily 75.00 2 pestilential with above sq.ft ;,PROPERTY 05VNER : ❑ TENANT Renewable Ener S«Pa e 2 Services or feeders installation alteration and/or relocation Name: LF 4 , LLC 200 amps or les I 1 100.70 1 2 Address: 5285 Meadows Rd Ste. 171 201 amps to 400 amps 133.56 2 401 amps to 600 amps 20034 2 city/StateMP: Lake Oswego, OR 97035 601 amps to 1,0oo amis 3o1.w z Over 1,000 amps Phone:( 503)657-3402 Fax:( ) or volts 552.26 2 Temporary services or feeders installation,alleration,and/or Email: talo«lion I Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.oa z Owner signature: Date: 401 amps to 599 ampsEf— 169.54 121 "`- ,APPLICANT r.:' - '-13CONTA— PERSON Branch clreuils-new alteration orextcersion,per panel A.Fee for branch circuits with Business name: JTSC,LLC above service or feeder fee, 7.42 2 each branch circuit Contact name: ZT'S0.E O'M y R.Fee for branch circuits without Address: 5285 Meadows Rd Ste 171 service �«ahtedertit,first 56.18 z City/State/ZIP: Lake Oswego,OR 97035 Each add'I branch circuit 7.42 2 Miscellaneous servke or feeder col included Phone:( 503) 89 0- ostq 0 Fax::( ) Each manufactured or modular 67X4 2 dwellin scrviceund/orfeeder Einai[:TbTlEy@jtsmithco.com Rccomect only 6784 2 CONTRACTOR-. - pump or implion circle 67.94 2 Business name: Sign or outline lighting 67.84 z n Signal chruit(s)or limited-energy 0 S«page 2 2 Address:2.6k-2-0 el alteration,aextensim. CilylSlale2iP: "l Each additional Inspection rover allownble In an of the above Additional inspection(I hr min) 66.25/hr Phone:(Q?j) _ Fax:G03)- ---j Zi— - Investigation(I Its min) 90.00/hr Email: r Industrial plant(I hr min) 78.18/hr Inspections for which no The is qp UU/hr CCB Lic.: Electrical Lia:' Sam D-1 1D- 1S s inall limed Shrmin :ELECTRICAL PERMIT.FEES Suprv.Electrician signature,required: Subtotal: Print name: ie ❑Pian Review Required(25%of pemtit fee): / State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: This portals application expires its permit is not obtained within 190 Print name:John Wyland Date: days after It has been accepted u complete e Numberofinepmtionsatlowcdperpamh Musi14ing1Pamaxtal.C_PeraaApp_Et. ana.doc Rev Wl7ML5 4MNlISf(tlPoa/COM/wE0 Mechanical Permit Application Received City of Tigard �� DateBy: Permit No.: • 13125 SW Hall Blvd.,Tigard,OR 97223 ¢ Plan Review E Phone: 503.718.2439 Fax: 503.598.196( 1 Other Permit: ��, Date/By. Inspection Line: 503.639.4175 Date Read B : Juds_ Internet: www.ti ardor. ov Ready[By ® See Page 2 for g g 1 1 �O Notified/Method: 8upplemmhl Information F� TYPE OF WORK COMMERCIAL FEE` SCHEDULE — USE CHECKLIST l ' Mechanical permit fees•are based on the value of the work E] New construction E]Addition/alteration/`' 'i - performed.Indicate the value(rounded to the nearest dollar)of all Demolition ❑Other: L 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. Total JOB SITE 114MRMATION AND LOCATION Heatin coolin : Air conditioning I 46.75 Job site address: 13408 SW Barnum Drive Furnace 100,000 BTU(ducts/vents) 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:Ashwood Estates Duct work 23.32 Cross street/directions to job site:SW Garrett St 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 my of above 23.32 Subdivision:Ashwood Lot no.:9 Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 Flue vent for water heater or gas Mechanical for new singler family residence fireplace 23.32 Log lighter as 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other: 23.32 ® PROPERTY OWNER TENANT Environmental exhaust and ventilation: Name:LF 4,LLC Range hood/other kitchen equipment ' 33.39 Address:5285 Meadows Rd Ste 171 Clothes dryer exhaust 33.39 City/SlatelZIP:Lake Oswego,OR 97035 Single-duct exhaust(bathrooms, toilet compartments,utilityrooms) 23.32 Phone:(503)657-3402 =Fax ) Attic/crawls ace fans 23.32 ❑ APPLICANT ® CONTACT PERSON Other: 23.32 Fuel piping: Business name:JT Smith Companies $14.15 for first tour;$4.03 for each additional Contact name:Jered Otey Furnace,etc. Address:5285 Meadows Rd Ste 171 Gas heat pump Wall/suspended/unit heater City/State/ZIP:Lake Oswego,OR 97035 Water heater / Phone:(503)890-0840 Fax::( ) Fireplace Range E-mail:jotey@jtsmithco.com Barbecue CONTRACTOR Clothes dryer(gas) Business name:Integrity Air Other: MECHANICAL PERMIT FEES' Address: 12042 SE Sunnyside Rd Ste 693 Subtotal City/State/ZIP:Clackamas,OR 97015 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(503)572-3594 Fax:( ) State surcharge(12%of permit fee) CCB lic.:203869 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:John Wyland Dale: 12/16/2015 I:\BuildmTermiu\MEC_PermltApp_0401 doc 440-46M(II/02/C0M 1ni) Plumbing Permit Application Site UtilitiesReceive City of Tigard 7DatefBy. Permit No.: • • 13125 SW Hall Blvd.,Tigard,OR 97223 �t Phone: 503.718.2439 Fax: 503.598.1960 1 �- Other Permit No: Inspection Line: 503.639.4175 � mds: ® See Page 2 for Inlemet www.[igardor.gov " Supplemental Information TYPE OF WORK • '.,Y Y ' FEE* SCHEDULE ®New construction ❑Demo liC For special information use checkfisit Description I Q Ea. 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 ❑Multi-family SFR(3)bath 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: 13408 SW Barnum Drive 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 8.:-i Page 2 Suite/bldg./apt.no.: Project name:Ashwood Estates Manufactured home utilities 50.03 Cross street/directions lojob site:SW Garrett St Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:jz!�) 1 Page 2 62.s1 Storm sewer(no.linear It.: )ryi) 1 Page 2 62..-54 Water service(no.linear ft.:_) Page 2 r.Z,§"4 Subdivision:Ashwood Lot no.:9 Fixture or item: Tax map/parcel no.: Backflow preventer ( 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Plumbing for new single family residence i Dishwasher 1 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 Address:5285 Meadows Rd Ste 171 Floor drain/floor sink/hub 25.02 Garbage disposal 25.02 City/State/ZIP:Lake Oswego,OR 97035 Hose bib 2 25.02 Phone:(503)657-3402 Fax:( ) Ice maker 12,51 ❑ APPLICANT ® CONTACT PERSON Interceptor/grease trap 25.02 Business name:JT Smith Companies Medical gas(value:$_) Page 2 Contact name:Jered Otey Primer 12.51 Roof drain(commercial) 12.51 Address:5285 Meadows Rd Ste 171 Sink/basin/lavatory 25.02 City/State/ZIP:Lake Oswego,OR 97035 Solar units(potable water) 62.54 Phone:(503)890-0840 Fax: :( ) Tub/shower/shower pan 12.51 E-mail:jotey@jtsmithco.com Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name:The Mullen Company dba.Edward Mullen Plumbing Water piping/DWV 56.29 Address: 1601 A 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.:34-260PB Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name:John Wyland Date: 12/16/2015 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 'Fee methodology set by Tn-County Building Industry Service Board. I iauildingTermitcPl-W-PermitApp doc 10/01/09 4104616T(10102/COAVWEB) City of Tigard � C<)1vfhIUNI1T llliA'FLOPivIFN"1'Dl?PAR'FbfEN'F Building Permit Review — Residential Building Permit #: /n Sr �lJ=U�k7 Site Address: C,r U p . Project Name: A S h won a( Sv a L p t ci Lot #: 9 (New dwelling= subdivision name;Addition or Altmaion=last name of owner) Planning Review Proposal: Nt2 vJ S F (� Verify site address/suite # gists and active in permit systcm. $River Terrace Neighborhood: ❑ Yes $No Site Plan Dements: Phree (3) copies of site planststing structures on site ite plan must be on 8-1/2"s 1 I" or 11 s 17"paper Footprint of neve structure (including decks)with finished 7Dra%vn to scale (standard architect or engineer scale) floor elevations ,North arrow Utility locations(required for new,ma) apply for additions) J;Xite address,project or subdivision name and lot number ation of yells/septic systems �.lpplicant information (name and phone number) IzFrosion control(including drainage-wap protection, silt fence ZI.ot dimensions and building setback dimensions design,location of catch basin,etc.) _.❑.1,ntarca,building coverage area,percentage of coverage andStreet names impervious area (applicable if R--,R-12,R-25 K R-411) Street tree size, type and location Aroperty corner elevations(2 foot contour lines if more than _Zsting trees to be retained with drip line,and tree 4 foot differentialprotection measures —2—Uean Water Services—Service Provider Letter (lot platted prior to 9/10/1995): Required: ❑ 1 es,applicant was notified ❑ No Received: ❑ Yes ❑ No Public Facilities Improvement (PFI) Permit: Required: ❑ Yes,applicant was notified ❑ No Applied For: / Yes ❑ No,stop intake Land Use Case #: YV3 2-0 l 9 - ww Zoning: 4._& Setbacks: Front PLO Rear 20 Side S Street Side Garagc ZOO Landscape Requirement: Lot Coverage Maximum: Building I Icight Masimum Height 30 Actual I leight TV -� isual Clearance ---e�t'ascments "'tl—Sensitive Lands: ❑ Yes ❑ No '1'vpe Urban ForestnPlan Conditions "Met" prior to issuance of building permit Notes: Approved By Planning: 410'11-01- Date: IV 171 `J Revisions (after Building Submittal only) Reviewer Date Revision l: ❑ Approved ❑ Not.Approvcd Revision 2: ❑ Approved ❑ Not .Approved Revision 3: ❑ .Approved ❑ Not :Approved 1:,Bui Iding.Fonns',BldgPennitRve_RES_070915_docx Building Permit Submittal Original Submittal Date: W Site Plans: # 13m1cling Plans: # -- Building Permit #: ilding peant # eve. \Workfow Routing: �1nnncing Coordinator ung Workflow Sign-off: �f for Planning(include notes from planning review) Route [Application Documents: Q-1-11gineering: (1) cope of permit application, (1) site plan, (1) building plan ant] ,_,�, ori��g nal plan review-routing form. Kd�Suilding: original permit application, site plans,building plans, engineer and beam calculauons and trust details,if applicable, etc. Notes: By Permit Technician: Date: Engineering Review Slope at building pad: f Conditions `,Met"prior to issuance of building permit eET 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 LID.A Facilm on lot. ❑ Yes ❑ No ❑ NOT Approved by Engineering: 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: ❑ _\pproved ❑ Not_Approved Permit Coordinator Review Conditions "Alet"prior to issuance of building pemut ❑ 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-. IkSDC Fees Entered: AV ash Co Trans Dev 'Iax: I Ycs ❑ N/A Tigard 'Frans SDC: ❑ Yes -e� N/A Parks SDC: r�'Yes ❑ N/A Z OK to Issue Permit Approved by Permit Coordinator: t Q . CGt-� Date: 1 a- -aa-LS I nBuildmgFomis.BldgPoinaRvw 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 13408 SW BARNUM DR, TIGARD, OR, 97223 Residential - Master Permit 199 Electrical ﬁnal PASS MST2015-00247 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 13408 SW BARNUM DR, TIGARD, OR, 97223 Residential - Master Permit 399 Plumbing ﬁnal PASS MST2015-00247 David Young Corrections complete from previous inspection. Shower door removed for 22" RO per code. 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 13408 SW BARNUM DR, TIGARD, OR, 97223 Residential - Master Permit 299 Final inspection PASS - C of O MST2015-00247 David Young Final erosion control approved. Street tree certiﬁcation received. Moisture content form received. High efﬁciency lighting form received. Insulation certiﬁcation checked. Duct seal test report checked. C of O left on site in kitchen. Note: bonus room above garage is unﬁnished at this time, permits and inspections required to convert to living space. No insulation, heat or wall cover at this time. Regulater and gas line shutoff installed in this attic space. Violation Summary: Inspector Contractor