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Permit (16) q CITY OF TIGARD MASTER PERMIT li 1 COMMUNITY DEVELOPMENT Permit#: MST2016-00158 TiC�AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/12/2016 Parcel: 2S104AD06800 Jurisdiction: Tigard Site address: 12891 SW PARKDALE AVE Subdivision: OLSON WOODS Lot: 4 Project: Olson Woods, Lot 4 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 3 First: 2374 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 32 Bathrooms: 3 Second: 0 sf Garage: 670 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2374 sf Value: $303,483.28 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 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: 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: 4 201-400 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 2374 Owner: Contractor: WINDWOOD CONSTRUCTION INC WINDWOOD CONSTRUCTION INC Required Items and Reports(Conditions) 12655 SW NORTH DAKOTA ST 12655 SW NORTH DAKOTA 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97223 TIGARD,OR 97223 PHONE: 503-780-4375 PHONE: 503-625-6526 FAX: 590-7606 Total Fees: $28,901.09 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• •• :ii a cop.• - - - or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: F'-- a 5' .4175 by 7:00 a.m.for the next available inspection date. C/,/%` 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 Gibc mg Residential RECEIVES Received FOR OFFICE USE ONLY tel,' City of Tigard Date/By: _� /`e /4{ Permit No.: /piAep--LCJ/51. M 111 11 13125 SW Hall Blvd.,Tigard,OR 97223 ^ C Plan Review a Phone: 503.718.2439 Fax: 503.598.1901 R 2 b ZO U Date/By: S 101 I Other Permit: o�tc�Q 6.-CO �3 Inspection Line: 503.639.4175 Date ReadyBy: Jurrs: H See Page 2 for I IGARD s , Internet: www.tigard-or.gov ���0 Y t -. i '.�,s,Ag'+D Notified/Method:s �_ Supplemental Information i,JI c)°\'r:' C51\;(4'a'jN QpS®j wi TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING _New construction 0 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 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. J21-and 2-family dwelling 0 Commercial/industrial Valuation: $ 303. 183-11 0 Accessory building 0 Multi-family Number of bedrooms: 3 ❑Master builder 0 Other: Number of bathrooms^ \ �1 JOB SITE INFORMATION AND LOCATION Total number of floors: 301 Li. C,04-Job site address: /26'1/ pf2, , / � Ore) New dwelling area: 3?L/ square feet I City/State/ZIP: T-- 6 , /2:�..) 71?4` .-7:).'� Garage/carport area: 4 7 0 square feet Suite/bldg./apt.no.: Project name: .19ZSo'v l.1Od6S Covered porch area:3 a4 square feet Cross street/directions to job site: Zt,i/31 t//.f T Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: .t/ d r./ t‹.../ ©d,Q .5:, Lot no.: Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. Valuation: $ Existing building area: square feet New building area: square feet p!PROPERTY OWNER . 0 TENANT Number of stories: Name: jjtila Gv iUr) cams 7 f f)( Type of construction: Address: 4; G-tc— ,'c 1 /1/04 11/// /// `2774 ,5"7-4,„--.4-77- Occupancy groups: City/State/ZIP: ,- „ ., x°,,,; cf)/.•7 4 ,,7r,1,,2-. Existing: Phone:(-' .4 7 - >37c Fax:( ::i ) _i' ;6 ()`"' New: ':--ErAPPLICANT43"Ct/NTACT PERSON BUILDING PERMIT FEES* Business name: t ,'7: (Please refer to fee schedule) Structural plan review fee(or deposit): Contact name: f,['.,_ T' /7_,-,77--/;,,,-, • .�;;, FLS plan review fee(if applicable): Address: City/State/ZIP: Total fees due upon application: �( Phone:(� i Fax: : Amount received: �`/ '1�•�.X70 ?) i j:% — '� 3 -2 (jam ) :a y_/-- %,,�_,'� /4/(3/-( PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail ti ',/1w-�'dCJ- r`.�,),„,e,„(„0 �,/ri,"t / , l ,)4, Commercial . d residential prescriptive installation of CONTRACTOR roof-top moun.-d PhotoVoltaic Solar Panel System. j✓C- Submit two(2) '-ts of roof plan with connectio • .ils Business name: UJ 1� (,t1401� ��l' ;' and fire departme access,along wi • 110 Oregon Address: 5y /17 L Solar Installation ••daisy - c ecklist. City/State/ZIP: Permit Fee(in ':.es plan review $180.00 •.• admin ative fees): Phone:( ) Fax:( ) State surc_arge(12%of pe ' fee): $21.60 CCB lic.: 1” - G _� c.// � Total fee due upon application. $201.60 Authorized signature: _ This permit application expires if a permit not obtained within 180 days after it has been accepted as complete. /12,i;:„.)/),_-;-_- � *Fee methodology set by Tri-County Building Industry Print name: / - -_ 1 _ Date: ? r-r i / '�� �J ✓- ' v Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Electrical Permit Apple t `!" FOR OFFICE USE ONLY' City of Tigard Received Date/By: Permit No.:7/�f `L-0V/'�-cz 13125 SW Hall Blvd.,Tigard, r 22qq 6 In1E; Planiteview = Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: Inspection Line: 503.639.4l.75r vi, , i. r '. .11-?,1' Date Ready/By: Suns. 65 See Page 2 for T I G A R D Internet: www.tigard-or.govk-) ) `' ''4 t ` Notified/Method: Supplemental Information :. - -,,,,Y7.1::::ta"�. 71, -,`; c, ,+ t( .*. (�•y'` T"'�" x 4,r�. f�`� lew construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked below' 0 Service or feeder 400 amps or more 0 Building over three stories 0 Demolition ❑Other: where the available fault current 0 Marinas and boatyards +'?° .ii: "4 """py a.rg exceeds 10,000 amps at 150 volts or ❑Floating buildings. WO Q cifv i less to ground or exceeds 14,000 ❑Commercial-use agricultural and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings. 0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or ro. •,. 1 ,, ,r,,, ,,, , y i Emergency system. larger separately derived system _ +i4 -4' 9, 2,1 K ,:,; „ 4:44 ? { 0 Addition of new motor load of ❑"A» E I.2 »I-3 . Job no.: Job site address:a,64/ �'J�j /, /J/ IOOor or more. occupancy. -7-__,,-----_ ,9-,e...,0 � / x//T/c/iG�fjf`i' ❑Six or more residential units. ❑Recreational vehicle parks City/State/ZIP: /�// Q;�//''�� nn� "���� ❑Health-care facilities. 0 Supply voltage for more than �� // !V t�'U ❑Hazardous locations. 600 volts nominal. Su ite/bldg./apt.no.: Project name: ''''),<50/7.1/_�">C11/'.1 w�>J ❑Service or feeder 600 amps or more. FEE SCHEDULE : Cross street/directions to job site: Z,o, 1 'k.T Description I Qtr. 1 Fee. 1 Total 1 • New residential single-or multi-family dwelling unit. �” Includes attached garage. , Subdivision: Q Ad)t) k_CriaS Lot no.: 1,000 sq.fi.or less f 168.54 4 Fa add'I 500 sq.R.or portion 4 , 33.92 I fax map/parcel no.: Limited energy,residential t '} . . ? l.. .. cflf, u x ,' :. ems, (with above sq. , f/ 75.00 Limited energy,multi-family Y 75.00 >�2 5-sig (with above sq.n.) - i Services or feeders installation,alteration,and/or relocation Il 200 amps or less 100.70 _ t K° - , 201 amps to 400 amps 133.56 n x �-�t 401 amps to 600 amps '200.34 Name: f(),C}L/U j CQ/ ST, 1�+e 601 amps to 1,000 amps 301.04 1 Address: /Q J!-"r 6 W 11,01 71,1 /),4r7/) 6.7.&. ..7 Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or City/State/ZIP: s1 ,Ter/9- 13 c)c. 9' relocation Phone:( 3 j ; —E/37S Fax:(9'3)��0 -.7e)6200 amps or less 59.36 I 201 amps to 400 amps 125.08 2 Owner installation:This installation is being made on property that 1 own which is not 401 amps to 599 amps 168.54 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. - Branch circuits—new,alteration,or extension,Per panel Owner signature: Date: A.Fee for branch circuits with + *� „�„t above service or feeder fee, 7 yp ry'.Y xx M 7.4- - "•�� ��-- each branch circuit Business name: . ,r - 7� B.Fee for branch circuits without { _ service or feeder fee,first 56.18 Contact name: 7:)l9�4=/Z //i9 branch circuit Each add'I branch circuit 7.42 2 Address: Miscellaneous(service or feeder not included) Each manufactured or modular 67.84 City/State/ZIP: dwelling.service and/or feeder - Phone:( ) Fax::( ) Reconnect only 67.84 2 1 r `�r/ 1 Pump or irrigation circle 67.84 2 E-mail: 6✓ I 'g ,,'R Ja/� T .. „ r Sign or outline lighting 67.84 '_ ‘-....7.,,;:4-.:4-4, . QrI�R Qit/ . . �% rx -F,. signal circuit(s)or limited-energy panel,alteration,or extension. Page 2 '_ Business name: Dream House Electric,LLC Each additional inspection over allowable in any of the above Address: 221 SW Moonridge Place Additional inspection(I hr min) 66.25/hr City/State/ZIP: Portland,OR 97225 Investigation(I hr min) 66.25/hr Phone:(503) 519-6711 Fax:(503)648-9723 Industrial plant(I hr min) 78 I8/hr CCB Lic.: 196726 I f Electrical Lic.: C-848 Suprv.Lic.: 4560S Inspections for which no fix is p specifically listed(h hr min) 90.00/hr Suprv.Electrician signature,required: '.'ELE tCAL P..ERMI1':FEESr` Subtotal: Print name: Chris Mahon Date: Plan review(25%of permit fee): Authorized signature: / State surcharge(12%of permit fee): Print name: i3 may,„.„1 Date: e//0//d„. TOTAL PERMIT FEE: Cy. I\BuildinaWenniis‘ELC•Pen itApp doe 07/01t10 440-4615T(11/05/COM/WEB Mechanical Permit Applicati # T;`I ' , t n ' '4 FOR OFFICE USE ONL\' % '% t ! City of Tigard a Received ermit No.:��aDr fr—OQ(5 IN 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: Plan Review 2 Phone: 503.718.2439 Fax: 503.598.1960 4 p'> 2 sDate Other Permit: Inspection Line: 503.639.4175 T I G A R D Date Ready/By: luris: El See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information 111, .., .y' 'TYPE O ,. )�43iNt/11 tel LSI()\ COMMERCIAL FEE* SCHEDULE USE CHECKLIST Mechanical permit fees*are based on the value of the work 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* )21'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: Job site address: //_& -1 / p� ,4LF Yl Air conditioning / 46.75 11 �" �� �� Furnace 100,000 BTU(ducts/vents) P 46.75 City/State/ZIP: 7`4-: /912 OI L_- 7_2,2 ' Furnace 100,000+BTU(ducts/vents) 54.91 Heat 61.06 '}; Suite/bldg./apt.no.: Project name: - '` um;, ,� ( .i, ; pump '� / -' Duct work 23.32 Cross street/directions to job site: (:.A.),,:.:,,' ,? '1 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: Other: 23.32 _ S ,:,17,1,,, '!.- ; .'-- Lot no.: Other fuel appliances: Tax map/parcel no.: Water heater i23.32 DESCRIPTION OF WORK • Gas fireplace/insert 33.39 Flue vent for water heater or gas / '' 4, `.. fireplace 1 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 OPERTY OWNER ❑ TENANT, Environmental exhaust and ventilation: Name: .i ; ,,✓ G /. Range hood/other kitchen equipment 33.39 r Address: "" Clothes dryer exhaust 33.39 City/State/ZIP: 7-i .6.4,._' f a Single-duct exhaust(bathrooms, = ...1,-.),) ' toilet compartments,utility rooms) 23.32 Phone:(-; _'_) 7 jam, 2' Fax:(5,.; ) ��G-76'f� Attic/crawlspace fans 23.32 /APPLICANT ❑ CONTACT PERSON Other: 23.32 Fuel piping: Business name: _,` /J'r` $14.15 for first four;$4.03 for each additional Contact name: 7/9 _/ ' � /..!,2,../ --,-,w,..•_.'`,/:..)...-.,- Furnace,etc. ! Gas heat pump Address: Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( ) Fax: :( ) Fireplace I / Range / E-mail: GtJI A r,/w Uci:'-//104.1(--_-:;;AA,_, c.,"7 Ji .} . ` CONTRACTOR Clothes dryer(gas) Business name: `j 4/i) Other: MECHANICAL PERMIT FEES* Address: Subtotal City/State/ZIP: Minimum permit fee($90.00) Phone:( ) Fax:( ) Plan review(25%of permit fee) State surcharge(12%of permit fee) CCBlic.: -5--7.)/ l TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signer * Fee methodology set by Tri-County Building Industry Service Board Print name:,Ul` ,/(�- Date:3//,//4. I:\Buildirig\Perrsits\MEC_PermitApp_0401 t3.doc 440-4617T(I 1/02/COMfWEB) Plumbing Permit Application ' . r , a oF( , Buildin Fixtures FOR OFFICE USE ONLY City of Tigard Date/ReceivBy: X167 /4°_ J O I. Permit No.: ' l 111 13125 SW Hall Blvd.,Tigard,OR 97223 y g q1 Plan Review Phone: 503.718.2439 Fax: 503.SA?f 6ad u Il Date/By: Other Permit No.: Inspection Line: 503.639.4175 Date Ready/By: Juris- RI See Page 2 for TIGARD Internet: www.tigard or.gov9' '} Y i. ay gR ) Notified/Method: Supplemental Information ' - :. • TYPE 1 Nci ' FEE*OrSTew construction Demolition For special information use checklist Description I Qty. I Ea. I Total ', ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) =' \ CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 -and 2-family dwelling 0 CommerciaUindustrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building 0 Multi-family Each additional bathkitchen 25.02 ❑Master builder 0 Other: Fire sprinkler(_sq.ft.) Page 2 JOB SITE'INFORMATION AND LOCATION Site utilities: Catch basin or area drain 18.76 Job site address: /2b 4/ io/1 _' l`,J/Ji_=.-1,z://;,-,,,,- -.- Drywell,leach line,or trench drain 18.76 City/State/ZIP: • Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name: r ti/ J '1/';�;> � _ ,./..);, Manufactured home utilities 50.03 Cross street/directions to job site: - , :1 Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: 1 1 / ',•,i r 1 `. I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 Backwater valve 12.51 DESCRIPTION OF WORK G- Clothes washer 25.02 /�- 5/ �� Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 � �'''PxVPERTY OWNER I' 0 TENANTExpansion tank 12.51, Name: / r 1 ' ,i.`,/i: Fixture/sewer cap 25.02 /(/ l I _ '� J��.1 Floor drain/floor sink/hub 25.02 Address: `i `j ,L) /'•) `-' �' /, ,•j/4/ '] f , Garbage disposal 25.02 City/State/ZIP: ' - /2 _7r %•-J^2 L Hose bib 25.02 Phone:(6-e..-1.3",' ' .5K3 fit'- Fax: '':, if ,_ Ice maker 12.51 ' PPLICANT ' 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: ^,<T. Medical gas(value:$ ) Page 2 `'„) Primer 12.51 Contact name: /" t f i' "' - Roof drain(commercial) 12.51 Address: \, Sink/basin/lavatory 25.02 City/State/ZIP: < Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 12.51 E-mail ' ' A/S ,, r/_.,v,)-- - , 2-) ' --,/ 1 Urinal 25.02 Y Water closet 25.02 CONTRACTOR Water heater 37.52 Business name: .„/'-eA ff Water piping/DWV 56.29 Address: ) /- .'r Other: 25.02 City/State/ZIP: /0 ) i .. i - / Subtotal Minimum permit fee: $72.50 Phone:( _.) . 1 Fax:( ) �,". Plan review (25%of permit fee) CCB Lic.: /3 ;7;26 Plumbing Lic.no.: _} State surcharge(12%of permit fee) Authorized signature: t �' e--- TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days Print name: r / , Date: after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1\Building\Permits\PLMU-PermitApp doe 10/01/09 440-4616T(I0/OZ/COM/WEB) Building Permit Application Lib4 n► Residential RECEIVEDFOR OFFICE USE ONLY City of Tigard ReceiDateB Y �.✓i'�veyd y /4, (I_ Permit No.: /.! / ./ ��� " 13125 SW Hall Blvd.,Tigard,OR 97223 q ^ Plan Review I Phone: 503.718.2439 Fax: 503.598.190P R h b 2 16 Date/By: Other Permit: Inspection Line: 503-639.4175 5 Date Ready/By: Jur1s H See Page 2 for T I G,A RD Internet: www.tigard-or.gov �,,(l y f.. - I : J Notified/Method: Supplemental Information rr 31,tif..4.t1`li q" nl\((C()N TYPE. OF WORK: REQUIRED DATA:1-AND 27FAMILY DWELLING_ , , New construction" 0 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. Valuation: $ 01-and 2-family dwelling 0 Commercial/industrial ❑Accessory buildingNumber of bedrooms: 3 0 Multi-family ❑Master builder ❑Other: Number of bathrooms: 42/S JOB SITE INFORMATION AND LOCATION , Total number of floors: Job site address: /2e 6J/ Pff/C/O gii•- s A-441 .. O '1 " New dwelling area: r L/ square feet City/State/ZIP: T-6 ,4//J (2/2� �7;2 2 a Garage/carport area: 4 /^Ib square feet Suite/bldg./apt.no.: Project name: bLSoti lr&/oaO5 Covered porch area: square feet Cross street/directions to job site: A�lj G/?// T Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: ,/2 60,�'f .) 00,O s Lot no.: 1.1 Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: - equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. Valuation: $ Existing building area: square feet New building area: square feet PROPERTY,OWNER 0 TENANT Number of stories: Name: 14. -',1,/lp a,evao LoA's T j/„l C,, Type of construction: Address: /tc;,4 5-.s--- S't,- 04.1/1/ 44//t4/77.4 5/7 4,74-7 Occupancy groups: City/State/ZIP: 7",.,-„ii 4: Cj44 fi..7c2-..2-- Existing: Phone: f G f/37� Fax:( ..J3) /,J `/" New: ' -." •-�rAPPLICANT $'CiINTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: f); Structural plan review fee(or deposit): Contact name: '-' ;/C3z.'_' - r ' // FLS plan review fee(if applicable): Address: Total fees due upon application: City/State/ZIP: CO fAmount received: -7 5-7-, Phone:(s,`1) 75-✓- J -7 Fax: :(SE ) ice,/- );r.,L / i PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: p"`fil ,;w-,' o (,(A.:)./.,'r'-- ,(1✓c.1 ./12:/ / /, ( d 41 Commercial . d residential prescriptive installation of CONTRACTOR roof-top moun.-d Photo Voltaic Solar Panel System. Business name: kJ 1r,NW DO'.0 C0/✓S' .1 i'L Submit two(2) •-ts of roof plan with connectio •- ails and fire departme access,along wi •- 110 Oregon Address: 5 /11 L-- Solar Installation ••cialty •:- c ecklist. Permit Fee(in t:.-s plan review $180.00 City/State/ZIP: ... admin ative fees): Phone: ( ) Fax:( ) State surc_arge(12%of pe fee): $21.60 CCB lic.: 4.,y/ ,' Z. Total fee due upon application. $201.60 Authorized signature: This permit application expires if a permit not obtained within 180 days after it has been accepted as complete. �� /i *Fee methodology set by Tri-County Building Industry //r Print name: /i),"24),..:;-_-- �_1 Jf' //, -..14: f,%- Date: City of Tigard IIICO■ MMUNITY DEVELOPMENT DEPARTMENT T 1 G R D Building Permit Review — Residential Building Permit #: ►--(g-ra-of to_CO/5-ed Site Address: l 28q I sw p c,r k of �. a,A s Project Name: 0 1 SO n vvoc) d S Lot #: 4 (New dwelling= subdivision name;.Addition or:Aiteration=last name of owner) Planning Review Proposal: Ni J .S PZ. Verify site address/suite# exists and active in permit system. 7fRiver Terrace Neighborhood: ,'No ❑ Yes,See River Terrace Review Addendum Attached Site Plan Elements: Three (3) copies of site plan -g-gmistisares on site Site plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished Drawn to scale (standard architect or engineer scale) floor elevations 'orth arrow EUtility locations (required for new,may apply for additions) ite address,project or subdivision name and lot number ❑L.,.atiun of wcils/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.) rage area,percentage of coverage and ❑Street names impervious area (applicable if R-7,R-12,R-25&R-40) El Street tree size,type and location /Property corner elevations (2 foot contour lines if more than Existing trees it,be retained with drip line,and tree 4 foot differential) protection measures i Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995): l Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No 7 Public Facilities Improvement(PFI) Permit: /Land Required ❑ Yes,applicant was notified ❑ No Applied For: CIYes CINo,stop intake Use Case#: g.0 0) 2011- - OOo` 3 71 Zoning: R 4 . /Setbacks: Front 1-0 Rear 1 5 Side 5 Street Side \ S Garage 20 pLandscape Requirement: .„--• % gLot Coverage Maximum: ---- 7 Building Height: Maximum Height 30 Actual Height 11 /Visual Clearance p( Easements XSensitive Lands: ❑ Yes ❑ No Type /Urban Forestry Plan 4Conditions "Met"prior to issuance of building permit otes: f Approved By Planning: d VI IN-rA_ 6/106(L — Date: L/< 2 w ( Revisions (after Building Submittal only) Reviewer Date Revision 1: Cl Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved 1:\Building\Fonns\BldgPennit Rvw_RES_012116.docx Building Permit Submittal Original Submittal Date: `/ � /� Site Plans: # �j Building Plans: # Tj Building Permit#: ['Enter building permit# above. Workflow Routing: De Planning -Er-Engineering .1:1-"Permit Coordinator -E/B uildin g Workflow Sign-off: 2r Sign-off for Planning(include notes from planning review) Route Application Documents: EEngineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. .ErBuilding: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: /, , iL ,l _. Date: cz Engineering Review Slope at building pad: Ali f f i/l aD/ Conditions "Met"prior to issuance of building permit Easements (encroachments) per engineering conditions of approval and plat 2/Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes I�1' No Assess Water Quantity Fee in-lieu: ❑ Yes IJ No LIDA Facility on lot: ❑ Yes 8 No ❑ NOT Approved by Engineering: Date: Notes: GOal/d ons �nv64 6t 6144,2rior 71v Gon►Sirveit‘/on Approved by Engineering: GLl+ Date: Olik 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 a I onditions "Met"prior to issuance of building permit Li Approved,NOT Released: CAu )— ` �,,t,y�'`� Date: 0'•S -3 -1 l Notes: �v �t i ALLAIricl Con :4,-. ' "t r; o✓ -{-o B u i (ct; n5 r,-,n, (A IMLA_,5� rn e� 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: eSDC Fees Entered: Wash Co Trans Dev Tax: Ni Yes ❑ N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: J 'Yes ❑ N/A {OK to Issue Permit Approved by Permit Coordinator: C Date: C - II -16 1: Building\Forms\BldgPennitRvw_RES_012116.docx 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 12891 SW PARKDALE AVE, TIGARD, OR, 97224 Record Type: Residential - Master Permit Inspection Type: 199 Electrical final Result: PASS Comments: Violation Summary: Inspector Tel: 503.718.2439 Inspection Date: December 13, 2016 at 8:26:08 AM Record ID: MST2016-00158 Inspector: Jeff Grove Contractor