Permit t ^v 7r" Tia'
CITY OF TIGARD . MASTER PERMIT
COMMUNITY DEVELOPMENT /0� MASTER
MST2016-00070
T FARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/03/2016
C
Parcel: 2S 109 DB08300
Jurisdiction: Tigard
Site address: 13149 SW BLACK WALNUT ST
Subdivision: SUMMIT RIDGE NO.5 Lot: 151
Project: Summit Ridge No. 5, Lot 151
Project Description: New SF. 8/16/16,fire sprinklers added
•
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 3 First: 919 sf Basement: 195 sf Left: 5 Parking Spaces: 0
Height: 32 Bathrooms: 3 Second: 997 sf Garage: 450 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2111 sf Value: $258,126.11 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: 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
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea 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 2111
Owner: Contractor:
DR HORTON INC DR HORTON INC PORTLAND Required Items and Reports(Conditions)
4380 SW MACADAM AVE SUITE 4380 SW MACADAM AVE SUITE 100 1 Ersn Cntrl 503-639-4175
100 PORTLAND,OR 97239 2 A geotechnical report is
PORTLAND,OR 97239 required before the footing
3 Fire Sprinklers Required
PHONE: 503-222-4151 PHONE: 503-222-4151 4 Special welding inspection
FAX: 503-222-1304 required before shear wall
Total Fees: $28,273.47
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law, All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-00OAR 952-0001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued Permittee Signature: / ls--1
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
FOR OFFICE USE ONLY-SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
II
111 2 Transmi
ttal Letter
Tit;,;\1?D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Li,iJ 11CC DAT '.:+r'lid V ' • x�i
It
DEPT: BUI1� ING DIVI'ON
AU50°F
O ?O1E
`, Jj
FROM: ��.�' /fYit ,. I`'21 � qt
COMPANY:
De 14r w d r � 1
PHONE: (✓---- e0 - 11/6-/ �! Byj
RE: /�'�l �ic( vi,✓ 8/,ALL �Jcti�n✓__ .% 4- ► r 6ictip-60070
.5
(Site Address) 41
i /) (Permit Number)
tii ,
1
(Project name or subdivisioonn('ame and lo num.-0
ATTACHED ARE THE FOLLOWINGS EMS:
s I^$+ L ba 1 `,� a `'z.".;;RI,
p—h 1 11 �a yhT"
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.
r/' Other(explain): r,,, ;fi r-;nktbe- f/cAe s
REMARKS:
`'�' - � � , + � !rt xg ' . rq� e�$ tla �ii�t"� i��f
_ ,„;! = ir'h �� ' �)�i , . a t ''.;11:1: Zi t '. �� ;•�` i. ,,,, 'm,'-i.---'-;
Routed to 'e it Technician: Date: _ Initials:
Fees Due: L Yes ❑ No Fee Description: Amount Due:
�� /fig. CP c
�,,, _� d 4kV, S $ , 26) . 35---
I:4,
P ,' rt ,, $
7 $ f$c/• 9s
Special
Instructions:
Reprint Permit (per PE): ❑ Yes / No Done
Applicant Notified: Date: i()-4 i(p if
itials:4 - .<)/
I:\Building\Forms\TransmittalLetter-Revisions 061316.doc
CITY OF TIGARD MASTER PERMIT
' I COMMUNITY DEVELOPMENT Permit#: MST2016-00070
T I G A ti D7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/03/2016
Parcel: 2S109DB08300
Jurisdiction: Tigard
Site address: 13149 SW BLACK WALNUT ST
Subdivision: SUMMIT RIDGE NO.5 Lot: 151
Project: Summit Ridge No. 5, Lot 151
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 3 First: 919 sf Basement: 195 sf Left: 5 Parking Spaces: 0
Height: 32 Bathrooms: 3 Second: 997 sf Garage: 450 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2111 sf Value: $258,126.11 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: 4 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 Noes Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp SrvclFeeders 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 2111
Owner: Contractor:
DR HORTON INC DR HORTON INC PORTLAND Required Items and Reports(Conditions)
4380 SW MACADAM AVE SUITE 4380 SW MACADAM AVE SUITE 100 1 Ersn Cntrl 503-639-4175
100 PORTLAND,OR 97239 2 A geotechnical report is
PORTLAND,OR 97239 required before the footing
3 Fire Sprinklers Required
PHONE: 503-222-4151 PHONE: 503-222-4151 4 Special welding inspection
FAX: 503-222-1304 required before shear wall
Total Fees: $28,083.52
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: C----)02-lD .yK_..o...J l Permittee Signature: e «.1--.ZJ
Call 503.639.4175 by 7:00 a.m.for the next available Inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
' Building Permit Application / h
`-11-0 6L..
Residential FOR (11 11( 1. 1 -l"OM
City of Tigard \1E Received Permit No.:
114 a 13125 SW Hall Blvd.,Tigard,OR 9 Plan Re 3 /��j� p� �
g Plan Reviews Other Permit
Phone: 503.718.2439 Fax: 503.598. 9 1 7-Z$ Date/By: /9 ic 5(-tfe_goi�—t> js�..
Inspection Line: 503.639.4175 ( Date Ready'B tv■5:
I l i ? F:t R y / fa See Page 2 for
Internet: www.tigard-or.gov MA ��) Notified/Method: Y We) Supplemental Information
TYPE OF WOQ ksOi REQUIRED DATA: 1-AND 2-FAMILY DWELLING
(1 New construction ❑`Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement 0 Other: equipment.materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Q I-and 2-family dwelling 0 Commercial/industrial Valuation: Q f� $ ""�`
0 Accessory building 0 Multi-family Number of bedroo
0 Master builder ❑Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors: .:DS"6 1
Job site address: l'I WA
A' i/in l�iV� °' cwt- , New dwelling area: 2A1 1 square feet
City/State/ZIP:Tigard, OR 97223 *^r.� wain4.
Garage/carport area:i...1•SD square feet
Suite/bldg./apt.no.: Project name:Summit Ridge Covered porch area: 3t square feet 9
Cress street/directions to job site: Deck area: square feet 9 1
Other structure area: square feet 19 s--
REQUIRED
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: I i Permit fees*are based on the value of the work performed.
1 Indicate the value(rounded to the nearest dollar)of all
Tax mapiparcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
New SFR Valuation: $
Existing building area: square feet
New building area: square feet
It PROPERTY OWNER 0 TENANT Number of stories:
Name: DR Horton Inc. Type of construction:
Address: 4380 SW MacadamAve Suite 100 Occupancy groups:
City/State/ZIP: Portland, OR 97239 Existing:
Phone:( 503) 222-4151 Fax:( ) New:
0 APPLICANT a CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: DR Horton Inc.
Structural plan review fee(or deposit):
Contact name: Emerald Weeks
FLS plan review fee(if applicable):
Address: 4380 SW Macadam Ave Suite 100
Total fees due upon application:
1 City/State/ZIP: Portland, OR 97239
Phone:(503 )222-4151 X1107 Fax: :( ) Amount received:
E-mail: esweeks@drhorton.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: DR Horton Inc. Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:4380 SW Macadam Ave Suite 100 Solar Installation Specially Code checklist.
' City/State/ZIP: Portland, OR 97239 Permit Fee(includes plan review $180 00
and administrative fees):
Phone:(503 )222-4151 Fax:( ) State surcharge(I2%of permit fee): $21.60
CCB lie.: 130859 Total fee due upon application: $201.60
1
Authorized signature: " Lei
1/ 1 9 J L jt �C G/l This permit application expires if a permit is not obtained
i C ( ( within 180 days after it has been accepted as complete.
Print name: (-17:41.{-'' f Date:2016 *Fee methodology set by Tri-County Building Industry
' �4 /`-j�U Service Board.
I:`,Building,PennitsvBUP-RESPennitApp.doc 02,24'201I 440-4613T(I1/02/COM/WEB)
Mechanical Permit Application _e ,, ' ) r(llz (HI l( 1 1 �1 ()NI 1
City of Tigard ' ,;t -.- Received
' 13125 SW Hall Blvd.,Tigard,OR 97223 A Plan/By: L L� ._• ,
Plan Review
Phone: 503.7111.2439 Fax: 503.59R.I960AA{ Date/By: Other Permit:
Fit,A R D Inspection Line: 503.639.4175 `v,M •/"x i� Date Ready/By: lurk ® See Page 2 for
Internet: www.tigard-or.gov 0-� Notified/Methud: Supplemental Information
GO
t‘,,t,_: VOA
TYPE OF COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
4110 New construction ❑Addition/alteration/replacement performed.indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
1110 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
1��_\� %W �� I J1tt o Airconditioning1 ,00 ( 46.75
Job site address: �• 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: Summit Ridge Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision:
Lot no.: ' 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
New SFR fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
PROPERTY OWNER 0 TENANT
Environmental exhaust and ventilation:
Name: DR Horton Inc. Range hood/other kitchen
equipment 33.39
Address:4380 SW Macadam Ave Suite 100 Clothes dryer exhaust 33.39
City/State/ZIP:Portland, OR 97239 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503 ) 222-4151 Fax:( ) Attic/crawlspace fans 23.32
0 APPLICANT $ CONTACT PERSON Other: 23.32
Fuel piping:
Business name: DR Horton Inc.
$14.15 for first four;$4.03 for each additional
Contact name: Emerald Weeks Furnace,etc.
Address: 4380 SW Macadam Ave Suite 100 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Portland, OR 97239 Water heater
Fireplace
Phone:(503 ) 222- 4151 x1107 Fax::( ) Range
E-mail: esweeks@drhorton.com Barbecue
CONTRACTOR Clothes dryer(gas)
Other:
Business name: Birchfield Heating&Air
MECHANICAL PERMIT FEES*
Address: O t3 ' S (,"Z Subtotal
City/State/ZIP: A )a A h ,,. C( 7 3 Z 1 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(5 j I ) CI z.(t,-- 13 4 Fax:(9-/) ) ¶ 2,(a-- 7 1 7 t'' State surcharge(12%of permit fee)
CCB lic.: T-W.CI S .rTOTAL PERMIT FEE
This permit application expires if a permit is not obtained within IRO
days after It has been accepted as complete.
Authorized signature: I35 eS, • Fee methodology set by Tri-County Building Industry Service Board
Print name: ,.j cLtc 4 13t'-r`�5,e I V Date: J
I.\Buildmg\PermaslM EC.Permit App_040113.do, 440-461 Tr i i I/02/COM/WEB)
, I
., -Electrical Permit Application 1.0R 01 Flet: I Sl.' ON i.
City of Tigard Received ,
\leo Date/B : `/ �'iD . r
13125 SW Hall Blvd.,Tigard,OR 9722 plan Review
'� s Phone: 503.718.2439 Fax: 503.5 DatdB : Related Permit#:
Inspection Line: 503.639.4175 rt
2 16 Ready Date/By: tures' &1 See Page 2 for
I I`'\I II Internet: www.tigard-or.gov Notified/Method; Supplemental Information
pOSk
go New construction 0 Addition/alteratiNa i 0 Please check all that apply(submit/sets of plans wlnems checked):
(3 Demolition ❑Other: D, 4 v 0 Service or feeder 400 amps or more 0 Building over three stories.
,� where the available fault current 0 Marinas and boatyards.
t' t v CATEGORY WI'CQ1 OrI „, -. 4:,14; f•` exceeds 10,000 amps at 150 volts or ❑Floating buildings.
4 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB.SITE INIORWL01ON AK0410,C'ATIOIet 0 Emergency system larger separately derived
'✓`h.N� a 0 Addition of new motor load of system.
Job#: I Job site address:t�1 LA 41v ❑ A. E l-r 1.3
100 or or mors.
CityiState/ZIP:Tigard, OR 97223 ❑Sixor more residential units. occupancy.
Recreational
❑Health-care facilities. 0 Rereatiovehicle parks.
Suite/bldg./apt.#: I Project name: Summit Ridge 0 Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 yobs nominal.
Cross street/directions to job site: ,,. '`'FES RCHEDULE
Descriptio. .1 Qts. I Eacb 1 Total 1 ,'
t
New residential single-or multi-family dwelling unit.
h
Subdivision: I Lot#: 1 51 Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 1 168.54 4
Ea.add'I 500 sq.R.or portion 33.92 I
' DESCRIIP'rlOX OF'WORK "'” , .0 „ R .; Limited energy,residential
New SFR (with above sq.R.) 1 75.00 2
Limited energy,multi-family
residential(with above sq.R.) 75.00
Renewable Energy 0 See Page 2
i PROIRTjt OWNER w"'` ,',t.. -'0*44AHtetNaPAA, Services or feeders installation,alteration,and/or relocation
Name: DR Horton Inc. 200 amps or less 1 100.70 2
201 amps to 400 amps 133.56 2
Address:
4380 SW Macadam Ave Suite 100 401 amps to 600 amps 200.34 2
City/State/ZIP: Portland, OR 97239 601 amps to 1,000 amps 301.04 2
Phone:(503 )222-4151 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: esweeks@drhorton.com relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 1 59.36 I
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, er panel
0''AYPGIcANT' (' °�� i" A.Fee for branch circuits with
Business name: DR Horton Inc. above service or feeder fee,
7.42 ,
each branch circuit
Contact name:Emerald Weeks B.Fee for branch circuits without
Address: 4380 SW Macadam Ave Suite 100 service or feeder fee,firs` 56.18 2
branch circuit _
City/State/ZIP:Portland, OR 97239 Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503 )222- 4151 x1107 I Fax: :( ) Each manufactured or modular
67.84 2
dwelling,service and/or feeder
Email:esweeks@drhorton.com Reconnect only 67.84
,, ICONTRACTOR` -..r. , . Pump or irrigation circle 67.84 2
Business name: Wright 1 Electric
Sign or outline lighting 67.84 2
Signal circuit(s)or limited-encrt ❑ See Pa e 2 2
Address: 11490 SE Jennifer St, panel,alteration,or extension. --
City/StatelZlP: Each additional inspection over allowable in any of the above
Clackamas,OR 97015 Additional inspection(1 hr min) 66.25/hr
Phone:(503)760-8522 I Fax:(C` 1:3) 11I1 -' M s.S Investigation(I hr min) 90.00/hr
Email: Industrial plant(1 hr min) 78.18/hr
rlane@wrightlelectri.com Inspections for which no fee is
CCB Lic.:162368 I Electrical Lic.:3-332c I Suprv.Lic.: �
specifically listed('h hr min) 90.00/hr
�
r`� ELECTRICAL YERMIZ';]SES
Supra.Electrician signature,required: J4, Zit Subtotal:
Print name� �te� W��lrJ, Date: 2016 ❑Pian Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized si tire: _
TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: 'r Date: 2016 days after it bas been accepted as complete.
• Number of inspections allowed per permit.
I.Building Permits ELC_PermaApp EIJt ERE.doc Rev 06 17 2015 44(446t51(11 05 COWW'WEB
l
t
Electrical Permit Application—City of Tigard
rage 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
. :4:1 i a$,' -717r .7v Ag,„vi f r ',Via; 11 , .._. ,.
r•
Fee for all residential systems combined: $75.00
Description Q� each I T°ral
y Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
n Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
n Garage Door Opener*
>100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
a Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 66.25/hr
charged at an hourly(1 hr mm)
Inspections for which no fee is 90.00/hr
s cifically listed('/:hr min)
n
Subtotal(Enter on Page I):
Fee for each commercial system: $75.00 * Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
n Boiler Controls
n Clock Systems
E Data Telecommunication Installation
n Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
n Landscape Irrigation Control*
n Medical
n Nurse Calls
n Outdoor Landscape Lighting*
n Protective Signaling
El Other:
Total number of commercial systems: _
*No licenses are required. Licenses are required for all
other installations
1\Building\Permits\ELC_PermitApp_ELRERE.doc Rev 06/17/2015
Plumbing Permit Applicl CEI V ECS i'7C( 2Z
Building Fixtures MAR 2 9 2016 I ()I; III 1 11 1 I .I (.\I 1
City of Tigardgl
13125 SW Hall Blvd.,Tigard,01( 7131/
Phone: 503.718.2439 Fax: ULaAVGbuontine: 503.639.417
Internet: www.tigard orgov OF TIGARD Received
Date/By:
Plan Review
DIVISIOn Dat
Due Rcadl
oNotifedMetbd Permit Nu.:J
f
(a
o�erPermit Nu
®Se Page=tor
Srppkwctal Information tioniii )I
Wit OF WORK FEE* B i16E
❑New construction 0 Demolition For special information nu checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacemcnt 0 Other: New 1-2-famIly dwelinga(includes 100 ft.for each utility connection)
. CATI.CORY OF CONSTRUCTION SFR(1)bath 312.70
❑1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath
❑Accessory building 0 Multi-family ' 525.02
❑Master builderEach additional bath/kitchen 25.02
0 `r: Fire sprinkler(lilt sq.ft.) ( Page 2
JON Silt iNPORIKATK N AND LOCATION ' Site utilities:
Job site address: 131 41 9. 5 W /14.4., WGI ilv't S 1' Catch basin or area dram 18.76
7 Drywell,leach line,or trench drain 18.76
City/State/ZIP: Ti • 01/ C7 Z
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt no.: ' Project name: Summit Ridge� Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear It: Page 2
Water service(no.linear ft.:_,) Page 2
Subdivision: I Lot no.: `
J r 1 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRTi'I7ON OF WORK Backwater valve 12.51
• ' Clothes washer 25.02
Dishwasher 25.02
NSFR Drinking fountain 25.02
Ejectors/sump 25.02
a PR1 R'i11C 0*MIER 1 Q TENANT Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor smk/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP:
Hose bib 25.02
Phone:( ) Fax:( ) Ice maker
12.51
a APlIf+[C.ANT • a CONTACT PIERSON Interceptor/grease trap 25.02
•
Business name: DR Horton Inc Medical gas(value:$ ) Page 2
Contact name: Emerald Weeks Primer 12.51
Roof drain(commercial) 12.51
Address: 4380 SW Macadam Ave Ste. 100 Sink/basin/lavatory 25.02
City/State/ZIP: Portland,OR 97239 Solar units(potable water) 62.54
Pbtmc:(503 ) 222-4151 ext 1107 Fax::( ) Tub/shower/shower pan 12.51
E-mail: esweeks@drhorton.com Urinal 25.02
CONTRACTOR, Water closet 25.02
t-'
Water heater 37.52
Business name:Gro-v/1,.k-( V 1 v.IM. )tlAA(In . Water piping/DWV 56.29
Address: VMS S. G ret,.,7s,---etJUtr Other:
/ J �n _ 25.02
City/State/ZIP: Or ahrr u-I-Li ,,b -- 1 OLE 5 Subtotal
Phone:(Sa3) LVID-CY-14a Fax:(CI7I ) LSO-3s a 2) Minimum permit fee: $72.50
CCB Lic.: 1'14505" s Plumbing Lic.no.: PP,(D ua 5 Plan review (25%of permit fee)
. n State surcharge(12%of permit fee)
Authorized signature: ,,1'--'___, TOTAL PERMIT FEE
Print name: 30 ex„ c& . t tnl�-Le Date:
This permit applicationbeen accepted Is not obtained within IN days
�t ep complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:1BuiWiugtP.rmiLAPLMU-1,n, App.doc 10/ti/ut 4404616T(I0/02/COM/WEB)
City of Tigard
r COMMUNITY DEVELOPMENT DEPARTMENT
■
TI G A R D Building Permit Review — Residential
Building Permit #: 7157 /(Q—000'70
Site Address: 1 31q1 S J Platt- Wed Lcfi S4-
Project Name: S up,r.r„ t R:cti e, N a . 5 Lot #: 151
(New dwelling= subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: w e_G,; SF.
Verify site address/suite# exists and active in permit system.
❑ River Terrace Neighborhood: ❑ No ❑ Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
krhree(3)copies of site plan Existing structures on site
IE ite plan must be on 8-1/2"x 11"or 11 x 17"paper XIFootprint of new structure (including decks)with finished
!i •yawn to scale (standard architect or engineer scale) floor elevations
worth arrow 'Si tv locations (required for new,may apply for additions)
'Site address,project or subdivision name and lot number Location of wells/septic systems
Applicant information(name and phone number) Erosion control (including drainage-way protection,silt fence
Lot dimensions and building setback dimensions design,location of catch basin,etc.)
KiLot area,building coverage area,percentage of coverage and 'Street names
impervious area(applicable if R-7,R-12,R-25&R-40) treet 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
,t?"-Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified ,irNo Received: ❑ Yes ❑ No
'Public Facilities Improvement(PFI) Permit:
Required: 'es,applicant was notified E No Applied For: X.Yes E No,stop intake
Land Use Case #: 5(4,6 a O )5 0000 71 S LR a d is 000(.4
TA"Zoning: R — 7
S,l Setbacks: Front 15 Rear (s Side 5' Street Side -- Garage az,
xr Landscape Requirement: -75 0/0
Lot Coverage Maximum: els
pgf Building Height: Maximum Height 35 Actual Height 3
IA Visual Clearance
1. Easements
1'4 Sensitive Lands: ❑ Yes L)No Type
Urban Forestry Plan
kr Conditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: aL p ,Q Date: 3 ---/ - (b
Revisions (after Building Submittal only �,�,� Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved E Not Approved
1:\Building\Forms\BldgPennit Rvw_R ES_012116.docx
Building Permit Submittal
Original Submittal Date: 3/7//fr
Site Plans: #
Building Plans: #
Building Permit#: nt uilding,��permm�it#---a�bove.
Workflow Routing: Tanning L'f�Engineering ermit Coordinator =Trig
Workflow Sign-off: E5ign-off for Planning(include notes from planning review)
Route Application Documents: -gineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
uilding: original permit application,site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: v,- Date: 34`/tp
En ' eering Review
'
Slime at building pad: -- .ome.,....t -0, oe.....(/
_
C/ndition "Met"prior to issuance of bung permit
as ents (encroachments) per engineerinildig conditions of approval and plat
ater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes II No
Assess Water Quantity Fee in-lieu: ❑ Yes 11 No
LIDA Facility on lot: ❑ Yes Il No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering:
44- v Date: ij'_..<
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:
7
SDC Fees Entered: Wash Co Trans Dev Tax: es ❑ N/A
Tigard Trans SDC: { Yes ❑ N/A
Parks SDC: ryes ❑ N/A
?C12OK to Issue Permit
Approved by Permit Coordinator: 1/5"----------Date: 3/y/1'
1:\Building\Fonns\BldgPennitRvw_RES_0121 16.docx
REcovo
Mechanical Permit Application
iiiCity of,,TigardfpaY SEP 2 1 2016
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4380 SW Macadam Ave Suite.100 .__ _..... L.1.14.111c,drwr cx14.4t:44.4 . ' 41 '4'4
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13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
13149 SW BLACK WALNUT ST, TIGARD, OR,
97224
Record Type:
Residential - Master Permit
Inspection Type:
199 Electrical final
Result:
PASS
Comments:
Note: no AC installed at this time.
Violation Summary:
Tel: 503.718.2439
Inspection Date:
December 27, 2016 at 9:27:38
AM
Record ID:
MST2016-00070
Inspector:
David Young
Inspector Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
13149 SW BLACK WALNUT ST, TIGARD, OR,
97224
Record Type:
Residential - Master Permit
Inspection Type:
699 Mechanical final
Result:
FA I L
Comments:
Provide access for inspection. R109.1
House locked 9:05 am
Violation Summary:
Tel: 503.718.2439
Inspection Date:
January 4, 2017 at 9:04:55 AM
Record ID:
MST2016-00070
Inspector:
David Young
Inspector Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
13149 SW BLACK WALNUT ST, TIGARD, OR,
97224
Record Type:
Residential - Master Permit
Inspection Type:
199 Electrical final
Result:
PASS
Comments:
Note: no AC installed at this time.
Violation Summary:
Tel: 503.718.2439
Inspection Date:
December 27, 2016 at 9:27:38
AM
Record ID:
MST2016-00070
Inspector:
David Young
Inspector Contractor
CITY OF TIGARD MASTER PERMIT
311.q' COMMUNITY DEVELOPMENT MII
Permit#: MST2016 00070
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/03/2016
T f ° Parcel: 2S109DB08300
Jurisdiction: Tigard
Site address: 13149 SW BLACK WALNUT ST
Subdivision: SUMMIT RIDGE NO.5 Lot: 151
Project: Summit Ridge No. 5, Lot 151
Project Description: New SF. 8/16/16, fire sprinklers added. 2/13/17: REPRINTED permit to include A/C unit.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 3 First: 919 sf Basement: 195 sf Left: 5 Parking Spaces: 0
Height: 32 Bathrooms: 3 Second: 997 sf Garage: 450 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2111 sf Value: $258,126.11 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: 4 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: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'l 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 2111
Owner: Contractor:
DR HORTON INC DR HORTON INC PORTLAND Required Items and Reports(Conditions)
4380 SW MACADAM AVE SUITE 4380 SW MACADAM AVE SUITE 100 1 Fire Sprinklers Required
100 PORTLAND,OR 97239 2 Ersn Cntrl 503-639-4175
PORTLAND,OR 97239 3 A geotechnical report is
required before the footing
PHONE: 503-222-4151 PHONE: 503-222-4151 4 Special welding inspection
FAX: 503-222-1304 required before shear wall
Total Fees: $28,415.83
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 m- •- - - op • - • -s or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: /1..,,,,rteir - ._— Permittee Signature:
•- r49.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
...„, „
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