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Permit (51) CITY OF TIGARD MASTER PERMIT 11111 1 ` COMMUNITY DEVELOPMENT Permit#: MST2016-00234 TEGTIG.A.RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/29/2016 Parcel: 2S104AD06600 Jurisdiction: Tigard Site address: 12867 SW PARKDALE AVE Subdivision: OLSON WOODS Lot: 2 Project: Olson Woods, Lot 2 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 5 First: 1632 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 26 Bathrooms: 4 Second: 2008 sf Garage: 610 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3640 sf Value: $442,696.59 Rear: 20 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 6 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: 6 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,500 sf: 7 201-400 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 3640 Owner: Contractor: WINDWOOD CONSTRUCTION INC WINDWOOD CONSTRUCTION INC Required Items and Reports(Conditions) 12655 SW NORTH DAKOTA ST 12655 SW NORTH DAKOTA 1 Ersn Cntri 503-639-4175 PORTLAND,OR 97223 TIGARD,OR 97223 PHONE: 503-780-4375 PHONE: 503-625-6526 FAX: 590-7606 Total Fees: $32,007.44 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 es adopted by the Oregon Utility Notification Center. Those rules are set forth ' OAR 952-001-0010 through OAR 952-001-0090. Yo obtain a copy 19144 or direct questions to OUNC by calling 503.232/1987 0 .800.332.2344. Issued By."---7,-01C--bs.ogre-- Permittee Signature: K i„.... q, ... .•39.4175 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 Residential FOR OFFICE USE ONLY • City of Tigard �� Received ✓ ` Date/By: rJ 3 `(G^ Permit No.:�6f�1/l/rcoZ5 IN " 13125 SW Hall Blvd.,Tigard, Plan Review Phone: 503.718.2439 Fax: 503.598.1960 c� iU Plan Review/ t,J l� Other Permit: .02.„,96)/(.0+QQ T I CARD Inspection Line: 503.639.4175 JUN 1 e7 Z0 Date Ready/By: Juns: PJ See Page 2 for Internet: www.tigard-or.gov i^E Notified/Method: ��' ��(� Supplemental Information GIT`I OF` IGA i� 19 «( TYPEalt JG I'., �M C r REQUIRED DATA:1-AND 2-FAMILY DWELLING 0-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- workindicated app on this application. 11 '-and 2-family dwelling 0 Commercial/industrial Valuation: $ 1'-t'Number of bedrooms: /�C-I Ir Ci , ❑Accessory building 0 Multi-family '/ ❑Master builder 0 Other: Number of bathrooms: : =-j- /r' JOB SITE INFORMATION ANTI LOCATION" Total number of floors: � ��crT'0 --il' \c`� Job site address: J 2 gG -7 P�-e-gN 4 �f)///L� New dwelling area: -,.,/ ,242..... square feet City/State/ZIP: „�.6 ,4 A,,,..7,-) , „�j�y, _�;r f.).'2.- ?.., Garage/carport area:`�6'0 square feet Suite/bldg./apt.no.: Project name: _(-:- -2Z-5-041 Cid -- Covered porch area: '''' -'f., square fee ` O 0 g Cross street/directions to job site: c�✓ar' A•�' -� � �iCf/ l Deck'ai'ea: r .y square feet 'S Other structure area: square feet REQUIRED DATA:COMMERCIAL-USECHECKLIST Subdivision: F{''°"; '2/ •„) CYC„ Lot no.: Z Permit fees*are based on the value of the work performed. If e is 1014 AD OLD(100 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. J f lam. Valuation: $ Existing building area: square feet New building area: square feet •.:,PROPERTY OWNER, 0 TENANT Number of stories: Name: pi i pt i4 „/0 s� C t,f C - j-ta cm. Type of construction: Address: / S 4;-- S cc_,A 4/6147--,7 Al , cT o T;4 5,r;4:-",17:47Occupancy groups: City/State/ZIP: 7- A2 iii ‘5,,,,),,,,/.,.:- /.-„2.,„:2-.!` Existing: Phone:( ftp, E 2s-- Fax (.."'";...-.)..3) `, >, ” " New: 'APPLICANT,, RCbNTACT PERSON BUILDING PERMIT FEES* Business name: _® (Please refer to fee schedule. -' Y Structural plan review fee(or deposit): Contact name: '-;:;)/,-2,,,i/i/,../ 7?.2 ,( //,.x _ FLS plan review fee(if applicable): Address: City/State/ZIP: Total fees due upon application: % . Amount received: Phone: ^' ' ) /,} � f37/^' Fax (50 ) ,r' ,sj. !=",,,iC" PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: jt�fp:v/'- do;'11341(-7:a;:-,-/t " �i ‘.;/17(t f , ( ,;/,; , Commercial and residential prescriptive installation of CONTRACTOR roof-top ted Photo Voltaic Solar Panel S -m. Business name: j,,t f f i 1D(AJ c 7 L) /0 j,-' 7 ,r7„,/c. Submit two(2)se f roof plan with co.--ction details and fire department acc along .•. the 2010 Oregon Address: 7/7, Solar Installation Specialty C:.+e checklist. Permit Fee(incl .es plan re -w City/State/ZIP: and administrative fees): $180.00 Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.: 61/7 cf 1, 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. 1 *Fee methodology set by Tri-County Building Industry Print name: ,12,,,,,,,)/71,1,27:- f _/,- /4. A /:).:.... Date: f Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(i l/02/COM/WEB) Mechanical Permit Application FOR OFFICE USE ONLY City of Tigard Received Date/By: LP /2 /4" �s/ Permit No.: Sri/6....Citna3c/ • IN . ° 13125 SW Hall Blvd.,Tigard • CVNIED Plan Review G.' Phone: 503.718.2439 Fax: R . Date/By: Other Permit: Owi2_90/6_CX,,g, 1l GARD Inspection Line: 503.639.417 7-. $ �� Date Ready/By: Ju s: B See Page 2 for w Internet: ww.tigard-or.gov 1,N\ U Notified/Method: Supplemental Information TI'P `� ©yj1 COMMERCIAL FEE* SCJiEDULE USE C CKLIST ,, jt Mechanical permit fees*are based on the value of the work 4,12.5;w construction ❑Additt ation/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. CATEGORY OF CONSTRU ,,, Value:$ ' CTION ' � ` RESIDENTIAL EQUIPMENT!SYSTEMS FEES* ,e121=-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist ❑Multi-family 0 Master builder ❑Other: Description Qty. Ea Total JOB SITE JNFORMATION.,AND::LOCATIO . Heating/cooling: Air conditioning 46.75 Job site address: /. ?" i 3' . ,4L4' 1,4%/4 Fumace 100,000 BTU(ducts/vents) 1 46.75 City/State/ZIP: 72 1'1 7,2 7 a Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: ! % .:)�r,:,,.'' E 4.i: - Duct work 23.32 Cross street/directions to job site: ("4_,/f,:' .' 7' 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: /),_}..:-9,-:-.),/-) 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 --.. ) ,' f, 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 OPERTY OWNER -❑ TENANT ' Environmental exhaust and ventilation: Name: Z4,4 Jf1) (�,•t.. I f , 7 Range hood/other kitchen 9P Address: I. '" f e ui ment 33.39 Clothes dryer exhaust 33.39 City/State/ZIP: c,371-,? Single-duct exhaust(bathrooms, �-� �J� ✓ ' toilet compartments,utility rooms) 23.32 Phone:( 1 .:) 7 H...;,:.;,, E, ; `;� Fax:(�,_:8) . " 7-7 Attic/crawlspace fans 23.32 I . APPLICANT 0 CONTACT PERSON Other: 23.32 Fuel piping: Business name: .__)::•:i 4, $14.15 for first four;$4.03 for each additional Contact name: 9 /:1 ;'/<l,4 jj-.5" Furnace,etc. Address: Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( ) Fax::( ) Fireplace Range E-mail: �/Ai//`tiU`U �7zc:3/I"1.'---El✓c,..,,.±7.'„:1 :.�ft-` E , //,/0;F'? Barbecue CONTRACTOR. Clothes dryer(gas) Business name: ,•:„7:7 ,r1/ / r- Other: '�;) i%`'''j.--. KMAi` �C { C, j7�HC MECHANICAL PERMIT FEES* Address: Subtotal City/State/ZIP: Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:( ) Fax:( ) State surcharge(12%of permit fee) CCB lie.: ��I7t TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized sign * Fee methodology set by Tri-County Building Industry Service Board Print name: `✓%22 /ar( Date:3/ .//j4. I:\Building\Permits\MEC_PermitApp_040113.doc 4400-4617rT(11/02/COM/WEB) • Electrical Permit Applica ' t\I , FOR OFFICE USE ONLY Received ilh - City of Tigard 3 ��1� Permit No.:t-{g f9-e ib-D0a3S/ A' Date/By: 13125 SW Hall Blvd.,Tigard,OR 9722)01\k �p Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/By: 0 Date/By: Other Permit: Ti G A R D Inspection Line: 503.639.4175 j°`,'['Y 0� `tl�1® Date Ready/By: Juris H See Page 2 for Internet: www ugard or.gov v y ��' )IV Notified/Method: to Supplemental Information .. ..,a�° a P .M d .rgr a .,•,..‘;',,,,,, Y .#.. 3 .r "p'' g .l �aF-S Vis' 4.•:i' ,. "; 5 1*W !7 - - New construction ❑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 ❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards. t. � " " '1"" r�""` p f exceeds 10,000 amps at 150 volts or 0 Floating buildings.G __ _ t..,� .F''-'-'-"'-'1'-'''''' '"s; j less to ground,or exceeds 14,000 0 Commercial-use agricultural and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings. ❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or yti a ❑Emergency system. larger separately derived system l II .�;� ,,., ;o „w, *4, ❑Addition of new motor load of ❑"A""E""I-2""I-1" i I OOHP or moreoccupancy. i Job no.: Job site address:/2 64, /6/ Six or more residential units. 0 Recreational vehicle parks City/State/ZIP: -yr9'242.2,1 ❑Health-rare facilities. 0 Supply voltage for more than ❑Hazardous locations. 600 volts nominal. /e 0 Service or feeder 600 amps or more. Suite/bldg./apt.no.: Project name: -�: .y;��J,�� �„I'C��( J,� a ? *jyE'"StHE[?4i:>;'•' Cross street/directions to job site: /f1, x.4,1 4,7- Description I Qty. I Fee. I Total I • New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: /s j c/)t„> &,evas Lot no.: 5 1,000 sq.fl.or less 1 168.54 4 Ea alert 500 sq.ft.or portion 7 33.92 I Tax map/parcel no.: Limited energy,residential ? ' F5CRWr1ON,OP 9 1 G_ i . iw. . .c ..�... (with above sq.ft.) i 75.00 _ Limited energy,multi-family 75.00 ,914--Z-2,914--Z-2 "/ 2 residential(with above sq.ft.) - • Services or feeders installation,alteration,and/or relocation • 200 amps or less 100.70 i 1APER 49..Y4.4s t. w 1 ... ^` 201 amps to 400 amps 133.56 2 401 amps to 600 amps '200.34 2 Name: M j„F�(A,0�©� eO,2- jT _trite 601 amps to 1,000 amps 301.04 Address: /c2 s" S 4,_..) /mal 7/ / j ),4 /7/)1574„447 Over 1,000 amps or volts 552.26 1- 2 Temporary services or feeders installation,alteration,and/or City/State/ZIP: I -4.6,4 1k` L 47,-)e4:::: ))., relocation Phone:(5,-03) -20 -4../.32T— Fax:( 3)5-7-a 7 6 200 amps or less 59.36 1 201 amps to 400 amps 125.08 2 Owner installation:This installation is being made on property that I 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 i v r,�,.-1 4w• above service or feeder fee, 4'k"a; s �” r'6. "" ® , � - 7.42 2 ,., ,,. :" -g r g' 2 4 •,� - . each branch circuit Business name: "5-',/,- '- B.Fee for branch circuits without service or feeder fee,first 5618 Contact name: X 7. /. - /, 1 Z branch circuit . 2 Each add'I branch circuit 7.42 2 Address: Miscellaneous(service or feeder not included) Cil'/State/ZIP: Each manufactured or modular dwelling,service and/or feeder 67.84 Reconnect only 67.84 2 Phone:( ) Fax::( ) Pump or irrigation circle 67.84 2 j E-mail: l t t i '{ J ?%�fl {) r 1 Sign or outline lighting 67.84 .,. :} r4 ,;:ti:* 0•"° ,..4°1�''„„ M.:* Signal circuit(s)or limited-energy panel,alteration,or extension. Page 2 2 13ttsiness 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) 78.18/hr CCB Lic.: 196726 Electrical Lic.: C-848 Suprv.Lic.: 4560S Inspections for which no fee is 90.00/hr - specifically listed(%hr min) Suprv.Electrician signature,required: ; "ELEGfRtts L:"!.ERMIV:FEtS' Subtotal: : Print name: Chris Mahon Date: Plan review(25%of permit fee): Authorized signature: 1State surcharge(12%of permit fee): � 74040,..„, TOTAL PERMIT FEE: /i Print name:l�7r[S Date: e/i/a/� I'.BuildinglermitstELC-PermitApp doe 07/01/10 • 440-4615D11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE DescrI Fee for all residential systems Renstems combined: $75.00 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: ❑ Burglar Alarm 25.01 to 50 kva 301.04 2 111 Garage Door Opener* 50.01 to 100 kva 552.26 2 >100 kva(fee in accordance 552.26 2 with OAR 918-309-0040) n H• eating,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 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(%hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 Subtotal(Enter on Page 1): * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems n Boiler Controls n C• lock Systems ❑ Data Telecommunication Installation n Fire Alarm Installation HVAC ❑ Instrumentation ❑ Intercom and Paging Systems n Landscape Irrigation Control* n M• edical ❑ N• urse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling n Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_PermitApp_ELR_ERE-doc Rev 06/17/2015 Plumbing Permit Application Building Fixtures FOR OFFICE USE ONLY City of Tigard "" ` G Received Permit No.:H �`&'oO�3 . n 13125 SW Hall Blvd.,Tigard,OR 972 (%d, O Plan Re: C Plan Review Phone: 503.718.2439 Fax: 503.598.1 S. w Date/By: Other Permit No.: T I GAR D Inspection Line: 503.639.4175 ``\N . �'ate Ready/By: turis: H See Page 2 for Internet: www.tigard-or.gov )�? `G� lc', d/Method: Supplemental Information �.� TYPE OF WORK �-rt`��0�� FEE* SCHEDULE , New construction ❑Deroq�' Q For special information use checklist ��`"' Description Qty. Ea. Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) -,: CATEGORY OF"'CONSTRUCi✓ION SFR(1)bath 312.70 r"-' +-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 AccessorybuildingSFR(3)bath i� 500.32 ❑ 0 Multi-family Each additional bath/kitchen 1 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB:SITE INFORMATION AND LOCATION Site utilities: Job site address " Catch basin or area drain 18.76 - Drywell,leach line,or trench drain 18.76 City/State/ZIP: Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: J Project name: )/I.;//7/ (4,..-....);_-y.,(6)..('-.,_,. Manufactured home utilities 50.03 Cross street/directions to job site: ',IL 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: „. 7 : // ,4 1 ` Lot no.: ,,, l _ _ . r r .� Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK? Backwater valve 12.51 Clothes washer 25.02 /27,2_-------. $/T( Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ' ROPE'RTY OWNER- 1 0 TENANT Expansion tank 12.51 Name: �t/ / /I Fixture/sewer cap 25.02 ,- / l ,,,,„„,9�,I7..) i; � � t Floor drain/floor sink/hub 25.02 Address: r /7 / E !1:-' ,1..)1-11:'&l<''r Garbage disposal 25.02 City/State/ZIP: - , ..,-*:/2_ , ,,::2//,',-;-:,--:' c,F. _2.-. Hose bib 25.02 Phone:(-j _ ) "2,..562-,...i./3 2 •- Fax (-7'..-•_:),) ) `Z±` -,- Ice maker 12.51 �;,�.1PPLICANT ` 0 CONTACT'PERSON' Interceptor/grease trap 25.02 Business name: ,..,_-.7,7,9,-'/),„-;',..- - Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: .,--"'T<''- `- "'l ): Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 25.02 City/State/ZIP: t Solar units(potable water) 62.54 Phone:( ) Fax: :( ) Tub/shower/shower pan 12.51 E-mail ,+,. i �. 'F /I I,ii : :,,tF Urinal 25.02 Water closet 25.02 CONTRACTOR t"` /- Water heater 37.52 Business name: �f�li J �� + ',/fff1 G Water piping/DWV 56.29 Address: `") .2*: -`, Other: 25.02 City/State/ZIP: , /_ ,-.7/ //j , , ,. -)f" -- ,--..-,2, , -.-,/,l Subtotal Phone:( .. .) ',..,,/,,„; s .-,r Fax:( ) Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lic.: /3 ,,70 G Plumbing Lic.no.: ;'u State surcharge(12%of permit fee) Authorized signature: .,. r' j °:.-- e..,- TOTAL PERMIT FEE ' - This permit application expires if a permit is not obtained within 180 days Print name: / Date after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\PermitsWLMU-PermitApp.doe 10/01/09 440-4616T(10/02/COM/WEB) Building Permit Application ertesidential FOR OFFICE USE ONLY' City of Tigard ('� �v Date/By: (o /3 /(p & / Permit No.:�s�' �Z3 q 13125 SW Hall Blvd.,Tigard, + Plan Review _ Phone: 503.718.2439 Fax: 503.598.1960 r1 p$ Date/By: Other Permit: T I Cr A R D Inspection Line: 503.639.4175 301\113 6 Date Ready/By: luris: 0 See Page 2 for Internet: www.tigard-or.gov 011) Notified/Method: Supplemental Information n TYP G. REQUIRED DATA 1=AND 2-FAMILY DWELLING K 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 0 Other: equipment,materials,labor,overhead,and the profit for the ?` .CATEGORY-iii.,,-,ONSTRUCTION, work indicated on this application. 01-and 2-family dwelling 0 Commercial/industrial Valuation: $ ❑Accessory building ❑Multi-family Number of bedrooms: S ❑Master builder ❑,Other: Number of bathrooms: .5/ ;r = JOB SITE INFORMATION AND'T,OCATl<ON. ; . Total number of floors: Job site address: l gG 7 pf— ,glo g- /Z.-/i9/9 - New dwelling area: 3x17' square feet City/State/ZIP: T. /4 A?/3 6)8,- -/7 .'2 Garage/carport area: G square feet Suite/bldg./apt.no.: Project name: - Z..5-04.../ A./Q6/0-C Covered porch area: square feet Cross street/directions to job site: Z/2,/k T Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USECHECKLIST •Subdivision: < /Y i CCI 4 .. Lot no.: 2 Permit fees*are based on the value of the work performed. ZS 11� ���00 Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the 3 DESCRIPTION OF WORK work indicated on this application. Valuation: $ Existing building area: square feet New building area: square feet t,i`; PROPERTY OWNER ❑`TENANT Number of stories: Name: wpt/lo a,4-U G 60N$r _«(., Type of construction: Address: //c, ,,�f S-3--- s cc.a /1/6- , '/V /0/1/earn , /` -�':- Occupancy groups: City/State/ZIP: 7wa 40.' ' 4) ': ,,..2,2„,t,2-, Existing: Phone:(57 ,.4 796-///37c Fax:(;C ) .,<:;:-2(..,)- 7[- 0 L New: 'APPLICANT: ¢ )NTACT PERSON BUILDING PERMIT FEES* Business name: - )�= (Please refer to fee schedule) . Structural plan review fee(or deposit): Contact name: -D '•/ 7:,.."--,-,,,:.,?...; ,, FLS plan review fee(if applicable): Address: Total fees due upon application: City/State/ZIP: . Amount received: Phone:(S-v3) 7: a- / 3 � Fax (sem ) — a✓- ? ✓� / PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail. /f`- /ilCA,,/dc)c:=f/ :;17,-, »,c•AjL � /77Cre / (•c/4,1 Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System. Business name: 41-,i j/\J,(n1 Dd o /U f✓S7 „.P,,J Cf Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: /9/2) Solar Installation Specialty Code checklist. City/State/ZIP: Permit Fee(includes plan review $180.00 and administrative fees): Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.: 6U/ e/ 4- Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: /12/"9/7,4:„_::-) / 1 I• ,I �', 1 Date: i `Fee methodology set by Tri-County Building Industry i C . t.; r� Service Board. I:\Building\Permits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) City of Tigard 111 p COMMUNITY DEVELOPMENT DEPARTMENT T l G A R D Building Permit Review — Residential Building Permit #: -(j o 0.3 ci Site Address: isexpi F a,t.t Project Name: 01cyn V\10aitS Lot #: '2- (New(New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: n,AN C L Verify site address/suite#exists and active in permit system. River Terrace Neighborhood: No El Yes,See River Terrace Review Addendum Attached Site Plan Elements: Khree(3)copies of site plan 0/Existing structures on site IR$ite plan must be on 8-1/2"x 11"or 11 x 17"paper .Footprint of new structure(including decks)with finished prawn to scale(standard architect or engineer scale) floor elevations Worth arrow Jtility locations(required for new,may apply for additions) Kgite address,project or subdivision name and lot number NA—Location of wells/septic systems Applicant information(name and phone number) Vlfxisting trees to be retained with drip line,and tree of dimensions and building setback dimensions protection measures +of area,building coverage area,percentage of coverage and .,Street tree size,type and location impervious area(applicable if R-7,R-12,R-25&R-40) treet names 'roperty corner elevations(2 foot contour lines if more than 4 foot differential) 'Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: E Yes,applicant was notified No Received: ❑ Yes XNo ,Public Facilities Improvement (PFI)Permit: Required: ❑ Yes,applicant was notified , No Applied For: ❑ Yes ❑ No,stop intake Land Use Case#: L 13201L I —0000 E XZoning: R-4.5" '"Setbacks: Front 7C) Rear t S/ Side S Street Side t4/0,... Garage 1 Landscape Requirement: N I p. % ,l; Building Permit Submittal Original Submittal Date: (o jl$'/(p Site Plans: # 3 Building Plans: # -3 Building Permit#: C-Enter building permit#above. Workflow Routing: 1- Planning a-Engineering [Permit Coordinator 2VBuilding 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 original plan review routing form. ❑ Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: Date: (Q /5 / Engineering Review Slope at building pad: /7; Conditions "Met"prior to issuance of building permit 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 LIDA Facility on lot: ❑ Yes No ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: iii--- Date: Z•god Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: Revision Notice 3: Date Sent to Applicant: , SDC Fees Entered: Wash Co Trans Dev Tax: 'yes ❑ N/A Tigard Trans SDC: 'Yes ❑ N/A Parks SDC: Imo'Yes ❑ N/A 2::Issue Permit y b Permit Coordinator: le Dat '/2- I:\Building\Forms\BldgPermitRvw_RES 060116.docx 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. IS Mr City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Transmittal Letter 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 •www.tigard-or.gov -it TO: 7�,YYI DATE R � TA. DEPT: BUILDING DIVISION JUL 6 28,16 FROM: 4 A-Chir, 4,, ;: COMPANY: r iv ei,i.-r,-,,/ A 44. 53 PHONE: 3 - 700 - y3 7 Byfr RE: ^7 Ski ,. 1r-b(, (4 L /moi- P /b--0&L?'( rte ress (Pe t umber) 'rolect name or sus.ivision n. e an' of number 1 ATTACHED ARE THE FOLLOWING ITEMS: I 4 ifi Additional set(s) of plans. kir Revisions: (,r,ex 7b cv Cross section(s)and details. G Wall bracing and/or lateral analys Floor/roofframing.framin . l A asement and retaining walls. Beam calculations. 1 ngineer's calculations. Other(explain): ( G9 REMARKS: ' Routed to Permit Technici. : Date: 7- - i C Initials: Fees Due: 1�/ Yes • o Fee Description: Amount Due: 1 r ,p1 c.,., reef► trw $ 9 0 qo $ $ $ Special Instructions: Reprint Permit(per PE): ❑ Yes A No ❑ Done Applicant Notified: A4„. Date: -7`�,/ r Initials: _ I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 12867 SW PARKDALE AVE, TIGARD, OR, 97223 Record Type: Residential - Master Permit Inspection Type: 199 Electrical final Result: PASS Comments: Violation Summary: Inspector Tel: 503.718.2439 Inspection Date: March 7, 2017 at 12:31:25 PM Record ID: MST2016-00234 Inspector: Jeff Grove Contractor