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Permit CITY OF TIGARDMASTER PERMIT 1114 11 .' COMMUNITY DEVELOPMENT II ` Permit#: MST2015-00123 T f G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.243 f'/l Date Issued: 01/25/2016 Parcel: 2S102CA00600 Jurisdiction: Tigard Site address: 13363 SW BARNUM DR Subdivision: FREWING'S ORCHARD TRACTS Lot: 18 Project: Ashwood Estates, Lot 11 Project Description: New SF. 6/9/16: REPRINTED permit to include A/C unit. Placement of A/C unit must comply with manufacturer's installation requirements. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 5 First: 1053 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1470 sf Garage: 663 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2523 sf Value: $315,739.17 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 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y 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&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 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: $23,018.99 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. Y• - .• -in a copy• -rue • •'rect questions to OUNC by calling 503.232.1987• . .2344. !.�Issued By: i/�'�...-- / Permittee Signature: Call ' 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 o project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application FOR OFFI( F. FSE O\L1 City of Tigard ' ' '.i`ed 4 j(p �� PennitNo.:� , r,a ' aate/By: :� s 13125 SW Hall Blvd.,Tigard,OR 97223 .) Plan Review — • Phone: 503.718.2439 Fax: 503.598.1960 r e/By: Other Permit 1 I( ,�l:I Inspection Line: 503.639.4175 ''� Read /B .orris: Internet: www.tigard-or.gov ) y o Supplemental See Page forn \\\t\\ �Notifi,�t(Idethod: Information i f,4 Pry;. ,.,,,: Ra ' ,. -. Pl�',i'b ++ORK f ,Alit r $ ( I,�.. j - i'•, ' t . t ,,t, `ate✓ �t ,';?;.r '` 4'4 t'" s. 'a" IC t Mechanical permit fees*are based on the value of the work 0 New construction 0 Addition/alteration/replaceme ! '• performed.Indicate the value(rounded to the nearest dollar)of all ❑ Demolition 0 Other: V. *3� mechanical materials,equipment,labor,overhead,and profit. ;. *rj �# v xd§ " J r y tr ma^,y V�all(u�ey $ ,, .-A-1,°1t 14LIY.,,- � U4 TJOIV ;5,' a� .t#4,t'oY�1 G, ,, i rte. .En''�:�`s". l�.y m.'�,ab 2�6 3� -_�aAo .t.,. � - 3.. .',,-- -:4'1'-',....'-'2"-'- r ,a ❑ 1-and 2-family dwelling 0 Commercial/industrial 0 Acce - !IP.. [ t For special information use checklist. ❑ Multi family 0 Master builder 0 Other: ♦ Description Qty. Ea. Total +° v Heating/cooling: Air conditioning / 46.75 44.."75— Job site address: /3 (41, ect„,,i,rr\ ‘k Furnace 100,000 BTU(ducts/vents) 46.75 - City/State/ZIP: -7)'-0,4 ✓ Furnace 100,000+BTU(ducts vents) 54.91 (_Jf- Heat pump 61.06 Suite/bldg./apt.no.: Project name: t.ky t A /,�1/ Duct work 23.32 td•tkCross street/directions to job site: �l K! 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 Other: 23.32 Subdivision: Lot no.: 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 4 -/c_ it, exa-hkv) et- l� �`�L�=(�4a fireplace 23.32 ,/ ft MLog lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other: 23.32 '.Q PROPERTY-;OWNER I TENANT - Environmental exhaust and ventilation: Name: L.-r 4 tic . Range hood/other kitchen equipment 33.39 Address: q?UL, S:wdi-- Clothes dryer exhaust 33.39 City/State/ZIP: Single-duct exhaust(bathrooms, �� ,Lire ?- 3 toilet compartments,utility rooms) 23.32 Phone:( ) Fax.( ) Attic/crawlspace fans 23.32 y a ,=0***', 0-CONTACT;I�ERSbN. Other: 23.32 Fuel piping: Business name: 0--'7 c // �iC� _ $14.15 for first four;$4.03 for each additional K/LC. Contact name: , ^ �® !i[, Furnace,etc. Address: Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( ) Fax::( ) Fireplace Range E-mail: Barbecue 7 a15 1 ' 4O 0R ., &s 4 Clothes dryer(gas) Business name:71-56.. 1-4-(...- Other Address: Subtotal !j(,, 75" City/State/ZIP: Minimum permit fee($90.00) > 'c, Phone:( ) Fax:( ) ) 5/i1 CCB lic.: 2j►,���- TOTAL PERMIT FEE �, yo _ `�� 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: j A N G(_,\ 'A, Date: Le / G I BuitdingPermitsMEC Permit App-040113.doc 440-46171(II 02 M-WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi-Family Fee Schedule: Total Valuations t�' ., , $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,004.00 and $2.81 for each additional$100.00 or 4 fraction thereof,to and in'Ciu, ing $10,000.00. $10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and"'~ � $2.54 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. 1:A Building Permits MEC PennitApp040113.doc 2 CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2015-00123 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/25/2016 Parcel: 2S102CA00600 Jurisdiction: Tigard Site address: 13363 SW BARNUM DR Subdivision: FREWING'S ORCHARD TRACTS Lot: 18 Project: Ashwood Estates, Lot 11 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 5 First: 1053 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1470 sf Garage: 663 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2523 sf Value: $315,739.17 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 0 Tubs/Showers: 3 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 Drywell-Trench Drain: 0 Other Fixtures: 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 addl 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 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: $22,921.63 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 copy of the rules or direct questions to OUNC by calling 503.232. 32.2344. f , i Issued By: mittee Signature: Call 503. 4175 by 7:00 a.m.for the next available inspection t 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. $uildin2 Permit Application Residential �EC�I�EP City of Tigard 1' IR ./B Receivea G> S' Permit No.: �7 2 � 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598 Date B : —) —) Other Permit �� ;f5—(1G�fQ Inspection Line: 503.639.4175 J Un 3 0 2 015 Date ReadyBy: loris: ® see Page 2 for Internet: www.tigard-or.gov Notified/Method: © l S Supplemental Information TYP 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. ® 1-and 2-family dwelling ❑Commercial/industrial Valuation: $ � '739 7 ❑Accessory building ❑Multi-family Number of bedrooms: 5 ❑Master builder ❑Other: Number of bathrooms�6 JOB SITE INFORMATION AND LOCATION Total number of floors: a2 Job site address: %-5+j 3 SW a New dwelling area: _ square feet3 City/State/ZIP:Tigard,OR 97223 Garage/carport area: G square feet Suite/bldg./apt.no.: Project name:Ashwood Covered porch area: '14Q, I Q� quare feet Cross street/directions to job site: Deck area: square feet" Q& Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Lot no.: I 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. 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* Business name:JTSC,LLC Pkase refer tofee sclYtduk Structural plan review fee(or deposit): Contact name:JohnWyland Address:5285 Meadows Rd Ste.171 FLS plan review fee(if applicable): City/State/ZIP:Lake Oswego,OR 97035 Total fees due upon application: ro Phone:(503)209-7555 Amount received: 750 ' E-mail:jwyland@jtsmithco.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted PhotoVoltaic Solar Panel M. Business name:JTSC,LLC Submit two( is of roof plan with co and fire departmen ess,along with a 2regon Address:5285 Meadows Rd.Ste 171 Solar Installation S ecia Code c cklist. City/State/ZIP:Lake Oswego,OR 97035 Permit Fee(includes p eview $180.00 and admin' tive Phone:(503)657-3402 Fax:( ) State surchar %of permit fee): $21.60 CCB lic.:200237 tal fee due upon application: No1.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 6 ` l� *Fee methodology set by Tri-County Building Industry Print name:John Wyland Date: �V Service Board. l:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 4404613T(l1/02/COM/WEB) Electrical Permit ApplicM* j COVE 32 Rccerved _ City of Tigard Date/ Permit No !! 13125 SW!-Tall Blvd.,'Tigard,OR 97223 Plan Review Phone: 503.718.2439 Pax: 503.598.( 3 O Z015 Other Permit ��/ -Ooog DateJB Inspection Line: 503.639.4175 Date Ready/t3y: loris: p See Page 2 for Internet: www.tigard-or.gov Noliftcd/Method: Supplemental Information T1 ')� PI�A7x�u �. ®New Construction Please check all that apply(submit 2 sets ofplans w/items checked below): ❑-Addition a teratlon/replacement - ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards. CAT1; 0Ra'Q Cp145Tft1aC 1•lIC7N exceeds 10,000 amps at 150 volts or ❑Floating buildings. less to ground,or exceeds 1.1,000 ❑Commercial-use agricultural ® 1-and 2-fancily dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings ❑Multi family ❑Master builder ❑Other ❑Fire pump. ❑Installation of 150 KVA or zEl Emergency system. larger separately derived system. dQB 51� nOpN�aty>� LQCATION ❑Addition of new motor load of El"A" "E" "1-2" •`1-3". Job no.: Job site address: (�3�3 SW ARKIAM R l or more, occupancy. ❑Six oor r more residential units. ❑Recreational vehicle parks. City/State/ZLI:Tigard,OR 97223 ❑Health-care facilities. ❑Supply voltage for more than ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt, no.: Project name' AStAW4XD 0- T El Service or feeder 600 amps or more � TE>; SQFIEDTJI.E. - Cross street/directions to Job Site: Description Qty. I Fee. I Total New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: Lot no.: f 1,000 sq.ft.or less 168.54 4 Tax map/parcel no.: Ea.add'I 500 sq.ft.or portion 33.92 I Limited energy,residential , 75.00 DE.SCRIIIC}N OI'WORK, ' (with above sq,ft.) Electrical for new single Limited energy,multi-family 75.00 2 g e family residence residential(with above sq.ft.) Renewable'.Errer yO`See Pa e 2 Services or feeders installation,alteration,and/or relocation ® P ItQPERTl QWN1rR TENANT 200 amps or less 100.70 2 �+ 201 amps to 400 amps 133.56 2 Name: ' LI— L( 1 L,L 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 1 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 163.54 2 Owner signature: Date: Branch circuits—new,alteration,or extension,pcr panel r1yQ LI A T ❑ CQlyTtyC P�RSUN � 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 narrr. Tri ka N WVL.A N D service or feeder fee,First 56.18 2 branch circuit Address:5285 Meadows Road Suite 171 Each add'I branch circuit 7.42 2 City/State/ZIP: Lake Oswego,OR 97035 Miscellaneous(service or feeder not included Each manufactured or modular Phone: 503 20q -7 dwelling,service and/or feeder 67.84 2 Reconnect only 67.84 2 t� hnd� +sm1 h m Email: Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name: ' Signal circuit(s)or limited-energy See panel,alteration,or extension. Pae 2 2 Address: o2 C_ �,Q ( ( ti4'r-1,6 Each additional inspection over allowable in any of the above City/state/zn : U °I �� Additional inspection(I hr min) 66.25/hr t�YU (;�, Investigation(I hr min) 66.25!hr Phone:( 3) (/ /�/r � P'ax: ,�-��� Industrial plant N hr min) 78.18/hr Inspections for which no tee Is CCBLic.: ��r<�5�/ ElectricalUc,: 3 pr J C: us cc,Ehcall listed(!6hrmin) 9000/hr :� EL>uCTTiTCAI. IS>4$14'�1'I',FEES'' Suprv. Electrician signature,required: Subtotal: Print name: f l I� Date: Plan review(25%of permit fee): __--state.surcharge(I2%of permit fee). �— Authorized signature: TOTAL PERMIT FEE: a , This permit application expires if a permit is not obtained within 180 ttt Print nae: �{ �/• �� Date: daysays after it has been accepted as complete. — �—-- Number of inspections allowed per permit. I'RuildinEapermitc.t7?�' 1'ermiiApp_ELR.ERE.doe R,o)V 11201? 440-3(+I STIII/LISX'O�t/l1Tti Mechanical Permit Appficafia& ReceiCity of Tigard CEIVED Date/By: ` Permit No.: ��} 13125 SW Hall Blvd.,Tigard,OR 97223 y �� �� (a Plan Review Phone: 503.718.2439 Fax: 503.598.1960DateBy: Other Permit: Inspection Line: 503.639.4175 JUN 3 0 2015 Date Ready/By: Juris: 0 See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information CITY OFT HARD TYPECOMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees*are based on the value of the work ®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ 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. Total JOB SITE INFORMATION AND LOCATION Heatin coolin : Air conditioning 46.75 Job site address: 3 (e3 SW SmLou M V t Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: T1 Q AILD I OR (:N_12-3-1 Furnace 100,000+BTU(ducts/vents) 54.91 Heat um 61.06 Suite/bldg./apt.no.: Project name:Ashwood 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 anyof above 23.32 Other: 23.32 Subdivision: Lot no.: Other fuel appliances: Tax map/parcel no.: Water heater 1 23.32 DESCRIPTION OF WORK Gas fireplace/insert 1 33.39 Flue vent for water heater or gas Mechanical for new single family residence fireplace 23.32 Log lighter as23.32 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 ( 33.39 Address:5285 Meadows Rd Ste 171 Clothes dryer exhaust 1 33.39 City/State/ZIP:Lake Oswego,OR 97035 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 4 23.32 Phone:(503)657-3402 Fax:( ) Attic/crawls ace 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. I Address:5285 Meadows Rd Ste.171 Gas heat pump Wall/suspended/unit heater City/State/ZIP:Lake Oswego,OR 97035 Water heater I Phone:(503)209-7555 Fax::( ) Fireplace Range I E-mail:jwyland@jtsmithco.com Barbecue CONTRACTOR Clothes dryer as 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 lic.: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: L-7 A Fee methodology set by Tri-County Building Industry Service Board Print name:John Wyland Date: 30 f lj 1:�Building\Permits\NEC_PermitApp_040113.doc 4404617T(I 1/02/COM/WEB) Plumbing Permit Applib"IVll Z4V3 Building Fixtures ! City of Tigard J U N U 2015 Received Permit No.: Date/By: / Gj - 1a 13125 SW Hall Blvd.,Tigard,OR 972 3 Plan Review Phone: 503.718.2439 Fes(, 1' Date/By: Other Permit N06.L Inspection Line: 503.639.41U91 i NIGARD Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or. Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE New construction For special information use checklist ® ❑Demolition Qty.- I- DescriptionEa. I 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 E]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: V11403 SLA SARNUM VR 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.: Project name:ASHWOOD Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear It.: L ) ( Page 2 Storm sewer(no.linear ft.:_11D I Page 2 Water service(no.linear ft.: Z�) I Page 2 Subdivision: Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Plumbing for new single famiy residence Clothes washer 25.02 Dishwasher 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 ( 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 Contact name:John Wyland Primer 12.51 Roof drain(commercial) 12.51 Address:5285 Meadows Rd.Ste 171 Sink/basin/lavatory 5 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 CONTRACTOR Water closet 25.02 Water heater 37.52 Business name:The Mullen Co.dba Edward Mullen Plumbing Water piping/DWV 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) 14 V Authorized signature: TOTAL PERMIT FEE Print name:John Wyland Dater 7 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. "Fee methodology set by Tri-County Building Industry Service Board. C\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(l0/02/COM/WEB) City of Tigard N COMMUNITY DEVELOPMENT DEPARTMENT i Building Permit Review — Residential Building Permit #: S- Site Address: 3(P 3 12 0 d— Project Name: Lot #: (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: A,44u � jy �` y V ; Verify site address/suite# exists and active in permit sy7No Apiver Terrace Plan District: El Yes Sit lan Elements: tee(3)copies of site plan , sting structures on site S e plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished awn to scale(standard architect or engineer scale) f}6or elevations rth arrow •glut hty locations(required for new,may apply for additions) V address,project or subdivision name and lot number P*,ation of wells/septic systems plicant information(name and phone number) Erosion control(including drainage-way protection,silt fence t dimensions and building setback dimensions sign,location of catch basin,etc.) area,building coverage area,percentage of coverage andeet names pervious area(applicable if R-7,R-12,R-25&R-40) Misting eet tree size,type and location 4rcperty corner elevations (2 foot contour lines if more than trees to be retained with drip line,and tree 4 foot differentialprotection measures Xi Glean Water Services—Service Provider Lett (lot platted prior to 9/10/1995): equired: ❑ Yes,applicant was notified 1,d No Received: ❑ Yes ❑ No 2 Public Facilis Improvement(PFI) Permit: equired: L Yes,applicant was notified ❑ No Applied For: V/yes ❑ No,stop intake nd Use Case #: .S �7 FSetbacks: Front Rear Side — Street Side Garage t' 't 1kAAy/,�� andscape Requirement: i � % of Coverage Maximum: Aja % Vvisual ilding Height: Maximum Height 4)�/ Actual Height �3 Clearance Avll*asements Psitive Lands: El Yes KNo Type Uran Forestry Plan ❑ Conditions "Met"prior to issuance of buil g permit Notes: 7 iS Approved By Planning: F Date: Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Build ing\Forms\B I dgPermitRvw_RES_031015.docx Building.Permit Submittal Original Submittal Date: CPQ Site Plans: # Building Plans: # Building Permit#: Enter building permit#above. Workflow Routing: ,Er?lanning Engineering C;-ilermit Coordinator B—uilding Workflow Sign-off: ET__Sign-off for Planning(include notes from planning review) Route Application Documents: Engineering: (1) copy of permit application, (1) site plan, (1) building plan and "r iginal 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: QJ�'�Z Date: Engineering Review �S�ope at building pad: onditions "Met"prior to issuance of building permit fkS Easements (encroachments) per engineering conditions of approval and plat Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes 2'110 Assess Water Quantity Fee in-lieu: ❑ Yes ^Q"�No LIDA Facility on lot: ❑ Yes ANO O 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: ❑ Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit Approved, NOT Released: 4r_.e, wy 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: yOK to Issue Permit Approved by Permit Coordinator: Date: 3 1:\B uilding\Forms\BldgPermitRvw_RES_031015.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 13363 SW BARNUM DR, TIGARD, OR, 97223 Residential - Master Permit 399 Plumbing final PASS MST2015-00123 David Young Correction from previous inspection 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 13363 SW BARNUM DR, TIGARD, OR, 97223 Residential - Master Permit 299 Final inspection FAIL MST2015-00123 David Young Seal ceiling assembly in garage below living space above at plumbing and HVAC penetration as noted with contractor on site at previous inspection. R302.5.3. Master WC water running, adjust to shut off correctly. 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 13363 SW BARNUM DR, TIGARD, OR, 97223 Residential - Master Permit 199 Electrical final PASS MST2015-00123 David Young Corrections 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 13363 SW BARNUM DR, TIGARD, OR, 97223 Residential - Master Permit 699 Mechanical final PASS MST2015-00123 David Young Correction from previous inspection 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 13363 SW BARNUM DR, TIGARD, OR, 97223 Residential - Master Permit 299 Final inspection PASS - No C of O MST2015-00123 David Young Final erosion control approved. Street tree certification received. High efficiency lighting form received. Moisture content form received. Duct seal test report checked. Insulation certification checked. C of O left with contractor on site. Violation Summary: Inspector Contractor FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Transmittal Letter 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: T( DATE RECEIVE DEPT: BUILDING DIVISION RUMP FRO1Vi1 �/aN�LL� _�l�,l f�. U JUL 2 2 2015 COMPANY: �'T S M (� !-� CJ !�t{�� N ( CS �;ITY OF TIGARD BUILDING DIV 0-"-- PHONE: X03, 0051 " 34 RE: 133(03 5W &AR1JgiA DK 71GAR D C)P- MGT DO 15- ©() (SiteAddress) (Permit Number) A:5 VA W o Q ES-rA-r E$ LOT 11 rolect name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: 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: Routed to Permit Technician: Date: Initials: Fees Due: Yes No Fee Description: Amount Due: $ $ Special Instructions: Reprint Permit r PE): =Yes No Done Applicant Notified: I Date: Initials: 1:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012