Permit (50) CITY OF TIGARD MASTER PERMIT
f
11111 1 ' COMMUNITY DEVELOPMENT Permit#: MST2016-00222
TtGA.R 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/29/2016
Parcel: 2S104AD06700
Jurisdiction: Tigard
Site address: 12879 SW PARKDALE AVE
Subdivision: OLSON WOODS Lot: 3
Project: Olson Woods, Lot 3
Project Description: New SF. DEMO CREDITS APPLIED FROM BUP2015-00222.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 1513 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 23 Bathrooms: 3 Second: 1767 sf Garage: 657 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 3280 sf Value: $403,745.70 Rear: 20
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 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 add'I 500 sf: 6 201-400 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 3280
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: $10,371.35
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. OAR
952-001-0010 through OAR 952-001-0090. Yo ..- •btain a c of th s or direct questions to OUNC by calling 503.23-1987.'r 1.800.332.2344.
Issued By: , �r�,1_- Permittee Signature: A '. .�/11.�g y
C.,' #9.4175 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 kft 1i 1‘l
-,‘%-.,11)
,� Residential -1'1,, FOR OFFICE USE ONLY
N.
� ,
Cityof Tigard Received /
g Date/By: /"/ Jyo k n/ Permit No.: �yr�/4: ovp^Z
illl 't 13125 SW Hall Blvd.,Tigard,OR 97223 /�ti Plan Review
p ....Ft, Other Permit: ,• �/Q
' • Phone: 503.718.2439 Fax: 503.598.1960 \)� " DateBy: 17/J
f 16 /.4.),Q.4940/6;+-"CO/6 D
J Juris: EI See 2 for
Inspection Line: 503.639.4175 Date Read/B , Page
TIG RD www.tigard-or.gov C s gl - Notified/Method: ��� / /37,--
Internet: Supplemental Information
��4L-1 � C .k, "ht.t,
TYPE OF REQUIRED DATA:1-AND 2-FAMILY DWELLING
gNew 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 OFCOTSTRUC TION „ work indicated on this application.
Valuation: ' $ 11.0 3 7 116
,01-and 2-family dwelling 0 Commercial/industrial ?I
Number of bedrooms:
❑Accessory building 0 Multi-family .3
❑Master builder 0 Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION. Total number of floors: 2, 9 3 ..7
Job site address: /z 8 7 9 pfrk-g,04 , /9/ji' New dwelling area: „..W : square feet
City/State/ZIP: T n r4.,/�„l„,) r.``, 12 -"/'- ."'_.. .,) Garage/carport area: "'? square feet
Suite/bldg./apt.no.: Project name:
-2/-5-04.1 0d0- Covered porch area:a 6"7 square feet/7 c 7
Cross street/directions to job site: A//.* Z/7.11.4.T Deck area: b square feet t5 1 3
>�fir.' i:��s,iir:�lfli Other structure area: square feet
ii'`1�— �� REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: ,,.�"�')4 G, '. 't' od 22.c Lot no.: 3 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: ,Titi70 G�a J,Q CQJi S 7 „Z �^ Type of construction:
Address: /t C� 6(....._1 41d,e.T Al a, F f ,4 ,'"' , A' :f� - Occupancy groups:
City/State/ZIP: 41r.2e2,,2-31' Existing:
Phone ( -.-- 7. . __'/3 2. Fax:( /?) ST,/,0- f`6 a` New:
}rrAPPLICANT $- dNTACT PERSON BUILDING PERMIT FEES*
Business name: (Please refer to fee schedule)
�Y Structural plan review fee(or deposit):
Contact name: ✓ j % f `�//:
-,..r. 1 . (
FLS plan review fee(if applicable):
Address:
Total fees due upon application:
City/State/ZIP: / C C.)
Phone: �, ''� Fax: : Amount received: ��/7, /)'
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:
Commercial and residential prescriptive installation of
CONTRACTOR= roof-top mounted PhotoVoltaic Solar Panel System.
Business name: kj_T ry/,Gt.f 4Cf D (U 2✓.. ,,. ..,r,.)c- Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: S//l .- 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.: 6 c/ q Total fee due upon application: $201.60
Authorized signature: w,. "' This permit application expires if a permit is not obtained
} within 180 days after it has been accepted as complete.
Print name: 2; 7Date: /1'/ / _j *Fee methodology set by Tri-County Building Industry
r_ r t.,J c- / ''' ,`�`--' (� Service Board.
I:\Building\Permits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard .�� (Till` DateB a
Permit No.: ,
M5�6�oil� oaaaa
Ill, 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
I Phone: 503.718.2439 Fax: 503.598.1960 t, li ,f'11 t Date/By:
Other Permit:
Inspection Line: 503.639.4175 ,��)i4' `(' Sums: 0 See Page 2 for
Tic;Apm p Date Ready/By: g
Internet: www.tigard-or.gov s. led/Method: Supplemental Information
r I
Mechanical permit fees*are based on the value of the work
ew construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition Other:❑ mechanical materials,equipment,labor,overhead,and profit.
Value:$
1 i ,' I t' +,tia :f r1; k "
. ; ti, �, ,- STt3
)21---and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist.
o Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total
Heating/cooling:
' a Air conditioning 46.75
Job site address:all"� 7 ,444,6)44.,,-, � �/�� Furnace 100,000 BTU(ducts/vents) / 46.75
City/State/ZIP: �[� /2 4 O�Z--y -`7-2.2_-3 Furnace 100,000+BTU(ducts/vents) 54.91
7 Heat pump 61.06
Suite/bldg./apt.no.: Project name: f.J (--(..../ --'
j � Duct work 23.32
Cross street/directions to job site: tJ .,
f ' /1,-, Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit ty , c
in-wallheaters,in-duc(fuel-t,suspendedpenot,eleetc.tric), 46.75
Flue/vent for any of above 23.32
Subdivision: Other: 23.32
Lot no.:
(��, D/�1 �wf•-. 7)/:...).2; Other fuel appliances:
Tax map/parcel no. Water heater 23.32
:
a. 1, ", 4 ;, �. ,:" � `+ Gas fireplace/insert 33.39
Flue vent for water heater or gas
t J:• L) -4'i. fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
23.32
h{ , t ''''' ;'�; l - and ventilation:
Other:
Environmental exhaust
Name: iii ;,h,� Range hood/other kitchen
p equipment 33.39
Address: / � 3 r�� ;� ?, '. 1
/ •., - :`'4.;1 Clothes dryer exhaust 33.39
City/State/ZIP: j .2 Single-duct exhaust(bathrooms,
y 7--26/9.. A- J7:4 ' �"?'�--� ��/ toilet compartments,utility rooms) 23.32
Phone:(�,� ',) '� Fax:(5&3) o 76 OC Attic/crawlspace fans 23.32
.� .0,,,,....,:..,,,,4,,-A 4.ON Other:
23.32
: _
Fuel piping:
Business name: ..---
Business �,(�t' $14.15 for first four;$4.03 for each additional
Contact name: �� G - . - -e`ff/Yri.L)5 Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Fireplace
- Fax: :( )Phone:( ) Range
/u-� /j1 t � ` 041 Barbecue
E-mail:
mall � y1dwUU` ` " .'......:s•----.,
SC lc ( ( ,' Clothes dryer
(gas). f'.
Other:
Business name: m ,„,,,,,!1.,....,,..„,,,,,,,,,,,*,,,_ .
Address: Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee) i
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
CCB lic.: . -----0/9,6TOTAL 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:5:12e- ,f{ Date: ������
440-4617T(11/02/COM/WEB)
I:\Building\Permits\MEC PermitApp_040113.doe
•
Electrical Permit Application a'? FOR OFFICE USE ONLY'
City of Tigard ; Permit No.:Ml�Of o-06,9_2'
'PI • 13125 SW Hall Blvd..Tigard.OR 97223 �' ��
g ;�� PlanRevicw
S Phone: 503.718.2439 Fax: 503.598.)96d ci\ Date/By: Other Permit:
T I G A R D Inspection Line: 503.639.4175 , r-" Date Ready/By: loris: ® See Page 2 for
Internet: www.tigard-or.gov 1 t d/Method: Supplemental Information
x;."' .. . o9_sl+dI ;II, .w4F 0 7`d; 14%`, ...ei#o ....; t ` eN, ovo wa ,..
lew construction
❑Addition/alteration/re r Ce N3 .� : Please check all that apply(submit 2 sets of plans w/items checked below r
„je
( 0 Service or feeder 400 amps or more 0 Building over three stories
❑Demolition ❑Other: -' where the available fault current 0 Marinas and boatyards
»xs �* ` "' t ai t exceeds 10,000 amps at 150 volts or 0 Floating buildings.
�' G r.w. ' a'-..ins, x. t ' 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.
❑Multi family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or
_ s,• �: a ,y , ,, ,,,, ; w „ ❑Emergency system. larger separately derived system
dA01.AQg' QA. WR�
t � s t' :�'r' „4's�.';� :".' ,.>a Ed
of new motor load of ❑"A”"E""I-2""I-i"
Job no.: Job site address: 26 7 f �J /� /f'��y 100oP or o more. occupancy.
�/ �Cf /"s'[/7�//� ❑Six or more residential units. ❑Recreational vehicle parks
-- -- „9-,e.„0 ❑Health-care facilities. ❑Supply voltage for more than
City/State/ZIP: /-f �f&..i...--7- q •
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: t /� C/ ; f ❑Service or feeder 600 amps or SCHEDULE ..
Cross street/directions to job site: l0/4 a,7- Description I Qtr._I Fee. I Total 1 •
New residential single-or multi-family dwelling unit.
Includes attached garage. ,
Subdivision: Q Ache Gt.f CriLot no.: .3 1,000 sq.ft.or less i 168.54 4
Ea.add'1 500 sq.ft.or portion n 33.92 1
lI ax map/parcel no.: Limited energy,residential
&4 ` r ^`t . ' Lt '" ;s � EV ° with above s .ft.) ) 75.00 2
_ ° , ,bES RIP1I,Ql fl 1i) TGg �a .' ' ,x -:;: ( q
,r� Limited energy,multi-family 75.00 '
Y f�� $�g residential(with above sq.fl.) 2 i
Services or feeders installation,alteration,and/or relocation +I
200 amps or less 100,70 2 i
7
K � x 201 amps to 400 amps 133.56 2
•
401 amps to 600 amps '200.34 2
Name: Pi-Fi,O+,t/e,a4 GOi T 171( 601 amps to 1,000 amps 301.04 2
Address: /c2‘ 4.5r.,,_) Ala 17N iihtiviyi 6 9_ Over 1,000 amps or volts 552.26 1 2
E ,r� ,e� Temporary services or feeders installation,alteration,and/or I
I City/State/ZIP: „To'A ie-1i,J c3e q)9_, relocation
I
tee'- 200 amps or less 59.36 t
Phone:(......e.,73) -20 _G/33 Fax:(I3)�7 9a-7rfar?
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 ,'
ar, „x t$14Mpt .. ice wz ;r 447 ), v fiw above service or feeder tee, 7.42. •——, Y .• ,,,u- : each branch circuit
Business name: B.Fee for branch circuits without
� service or feeder fee,first
Contact name: / ' At?,7 branch circuit 56'18 2
cL/ Each add'I branch circuit 7.42 2
Address: Miscellaneous(service or feeder not included)
Cit'/State/ZIP: Each manufactured or modular
dwelling,service and/or feeder 67.84
Phone:( ) Fax::( ) Reconnect only 67.84 2
mp
E-mail: Irt•t T"),,, {.J ti-toCy� 1 �1 JA r sr t_;e r/ / v,-;E Si,n oroutline l gh1 nge 67.84 ',67 84
i +C(1Il -.14, 00-44A-,44r-Rig. ,. a' x; " a Signal circuit(s)or limited-energy
Business name: Dream House Electric,LLC panel,alteration,or extension. Page 2 2
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(1 hr min) 66.25/hr
Phone:(503) 519-6711 Fax:(503)648-9723
Industrial plant(1 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(%s hr min)
Suprv.Electrician signature,required: „w :ELECTtt{C'AL.-P:ERMl1'•'FE><5''
Subtotal:
Print name: Chris Mahon Date: o
Plan review(25%of permit fee):
Authorized signature: / State surcharge(12%of permit fee):
/ TOTAL PERMIT FEE:
Print name:eAris niak,,,441 Date: e/m// ,
I'.Building\Permiis\ELC•PeimitAppdoc 07/01/10 0 440-1615T(I1/OS/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
Fee for all residential systems combined: $75.00 DescriptionQty. Each Total *
Renewable j
3' 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
Garage Door Opener*
g p >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
V' 'acuum Systems* >100 kva-no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
n 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(V2 hr min)
ELECTRICAL PERMIT FEES
CO1VEl ERCIAL WORK ONLY:
Subtotal Enteron Page 1):
Fee for each commercial system: $75.00 * Number of inspections allowed per penntt.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
n Audio and Stereo Systems
n Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
n Medical
n Nurse Calls
❑ Outdoor Landscape Lighting*
E Protective Signaling
❑ 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 .ki. - Received
pate/By: Permit No.:ri ,,e,...00?-'2"2.----•
RI 13125 SW Hall Blvd.,Tigard,OR 97223
+,, '±,.I .. c'.1.11c•Plan Review
Iiii : Phone: 503.718.2439 Fax: 503.598.1960 1 7.,k ^ Date/By: Other Permit No.:
Inspection Line: 503.639.4175 ,i,
TIGARD ,,,,,,,,14.141F..eady/By: Juris. El See Page 2 for
Internet: www.tigard-or.gov i< ,vi, ?,t'k f414.11,10titred/Method- Supplemental Information
i A \'‘.,ki v ' t, ,(,-14 I •
TY-PE16FYO* AI..„ ' - FEk*,sdiEpuLIE'
11 s ,`i III '•-•Ii.\.....kf -
JOINIew construction 0 Demoloon .'° •'' For special information use checklist.
Description I Qty. I Ea. I Total
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
'-.1.-..-.:g'...,w-..,-,-,,,,,,,,..,--, '.n'•., .,`' CATEGORY OF-CONSTRUCTION' :,.--' '- - ' - SFR(1)bath 312.70
SFR(2)bath 437.78
A21-and 2-family dwelling 0 Commercial/industrial
SFR(3)bath oe,'" 500.32
0 Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
:.:,-;--'',:•:.,:',:-' ''''':''''',,•:2'•••.".',.::".4C.B,SITE INFORMATION AND LOCATION -- ' Site utilities
• •
,. ,,
. .. .
Job site address: /as? f ,e4,2-(13/7/22::,/ / 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.: Project name: ) A:,.//,,,t !.,1_, iz) Manufactured home utilities 50.03
Cross street/directions to job site: l',.; :f.1,' ,-*„.,...4 i 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: .--)..,: ,,..-J,,,,/ ::„.4„, , ) ,(i) c,-, I Lot no.: ....3 Fixture or item:
Backflow preventer 31.27
Tax map/parcel no.:
Backwatervalve 12.51
DESCRWTION OF WORK.
Clothes washer 25,02
j<7,2-_----(, ) 5F-E. Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
, > .
iROPERTYOER- - I .- - - El TENANT ' Expansion tank 12.51
Fixture/sewer cap 25.02
Name: -,Li.,r,.-.,1, 1,-,,),,0,-.}6 (/'-,),,):7 ..:,/f/C ,
Floor drain/floor sink/hub 25.02
Address: z,.. e;5 ,...5 ,5.- ,_) /,,,,,.,/I", 7'/....,.; ,,,) j,,,7-74 . -
Garbage disposal 25.02
City/State/ZIP: '''..,., ....; ,y2 ;-•"., 37, ,^.".„2 ,:,..7),...).2 .::l-,, Hose bib 25.02
Phone:(6-6.-5) ,..i/37.<7 Fax:(-.7.7.,,:j ) /.',,i .(;X:-. Ice maker 12.51
;„-, ,•,,,•.':`, ...jatpLICAINIT ' , 0 CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business :
name: ...c..x,?,-7).."-'''
Primer 12.51
Contact name: ::". ,),:.--') ' = ) ,, 1/ i r VIT
Roof drain(commercial) 12.51
Address: ,,,,
Sink/basin/lavatory 25.02
City/State/ZIP: ci Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
, Urinal 25.02
E-mail:;•,. ,/,.../iv j.,,. ./r/1 ,,I,,,(;,-! -7.,,...-,/y„,,-.i J.'? , ,,i.,-. ,,, ,„--/,)-1,
Water closet 25.02
CONTRACTOR V '
Water heater 37.52
Business name: "" i 0 ,, .,-,,:;/),-,-, 6- Water piping/DWV 56.29
Address: C''') (i) I:-, ",‘,,,, , -,- r-12 Other: 25.02
City/State/ZIP: j 1 :1",: i]. /•//) .,,-,e,.."?,./,- <•-;1-,i'.,::,7-'3// Subtotal
Phone:( ..,.::-.) 7...,,/4 ';.---- 5-'-i 2-z., Fax:( ) Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lic.: /-3 47,:,,6 Plumbing Lic.no.: / : .,.,;,„.-.).
State surcharge(12%of permit fee)
Authorized signature: / ' ' •///
'-' r` - / " -:-.1.-"-€----- TOTAL PERMIT FEE
Print name: f i,,. .- ,.,.„ ,-,,,,,,--,, i ,
Date: 77-- ., '
.„ 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.
I\Buildineermits\PLMU-PermitApp doc 10/01/09 440-4616T(I0/02/CONVWEB)
Building Permit Application ‘ft 110
-4,1-,I)
ReSldentialRySiti FOR OFFICE USE ONLY
••• �""
City of Ti and Received /� )
g Date/By: ( / k t'P Permit No.: �l f/j/�eZ 2,
11/1 " 13125 SW Hall Blvd.,Tigard,OR 97223 10 Plan Review v`
` I O Other Permit:
p
Phone: 503.718.2439 Fax: 503.598.19601,v 1`' Date/By:
Inspection Line: 503.639.4175 Date Ready/By: Inns' Ed See Page 2 for
TIG�lRD p O A�
Q.
Internet: www.tigard-or.gov Cr" �� Notified/Method: Supplemental Information
., t.I<7�` ISIO�
TYPE.OF-;, ' REQUIRED DATA:1-AND 2-FAMILY DWELLING,;1
KNew 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
awork indicated on this application.
` " V; CATEGORI' OF'�O�TSTRUCTIOI�i•;�
01-and 2-family dwelling ElCommerctal/industrial Valuation: $
ElAccessory building ElMulti-familyNumber of bedrooms: 3
El Master builder El Other: Number of bathrooms: 3
' JOB SITE INFORMATION`AND;LOCATION:"- Total number of floors: 2
Job site address: /Z S 7 pifP. 0 4- ,Li9,v New dwelling area: _`square feet
City/State/ZIP: T4.� ,4/Z.�,) (32. l -21 Garage/carport area: 4,6'9 square feet
Suite/bldg./apt.no.: Project name: LScvv t oG/O_ Covered porch area: square feet
Cross street/directions to job site: /it/. Z/2//x,T Deck area: square feet
.&yle,_ �s 6/ } Other structure area: square feet
s-�
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: t')/6-4,12/ eV CO,r .,S Lot no.: 3 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
' 3DESCRIPTION OF WORK work indicated on this application.
,ve-ki sp Valuation: $
Existing building area: square feet
New building area: square feet
) !i ROFERTY OWNER -nl >TENANT Number of stories:
Name: .TA,/A ev 0640 ()41st$7 f7U'f... Type of construction:
Address: /#6 ,, c-1'°"' 6 t,e,.7 4'd —Th' /9 ,ed '-, .57-7444-2,--7 Occupancy groups:
City/State/ZIP: 7 ijr,"-;;; 4.,47,.. /.3,2.6,2_„,, , Existing:
Phone:(.,'`"-- 7; o. f/3 2c-- Fax:(?j$) 20- -7a 01- New:
-AI'IjLlLIl1VT`. TTTr1CT.'PERSON BUIL DINGtofeeschedu
PERMIT;FEES*
Business name: (Pleaserejer, e)
_ Structural plan review fee(or deposit):
-.
Contact name: ) ,. 77 ---(-/ -1 -'. _.:;;;
' FLS plan review fee(if applicable):
Address:
City/State/ZIP: Total fees due upon application:
Phone: a per: : Amount received: 7�'
PHOTOVOLTAIC SOLAR.PANEL SYSTEM FEES*
Email //.,1//1 d ta.. c1 C/„7-f y'l.j/ie'' vti0-°` x/11 Ct / /, f U 4/ Commercial and residential prescriptive installation of
h-.;, - CON1 C` OT ,• roof-top mounted Photo Voltaic Solar Panel System.
Business name: 4J f/ f/JG�dd..D 1/0/:-/S.. C- Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: ,. .-. /))- 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.: 6`0/F q Total fee due upon application: $201.60
This permit application expires if a permit is not obtained
Authorized signature: --
within 180 days after it has been accepted as complete.
t ` *Fee methodology set by Tri-County Building Industry
Print name: "72,,,,4;;),,9,,z,2,---:
1 1-c /i6, /,( ,�'; Date: —
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
NI
COMMUNITY DEVELOPMENT DEPARTMENT
T 1 c A R D Building Permit Review — Residential
Building Permit #: N',r a-vl La—Co a-a'---
Site Address: 1 2 (6 701 Pi rk-d AU—. L.ri .
Project Name: 0 igo r) Wood 4 Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: N eikA/ S F 2
Verify site address/suite#exists and active in permit system.
ARiver Terrace Neighborhood: ;21' No ❑ Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
Three(3)copies of site plan -B-Existing structures 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 Utility 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) Existing trees to be retained with drip line,and tree
/6Lot dimensions and building setback dimensions protection measures
/Lot area,building coverage area,percentage of coverage and XrStreet tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) 12rStreet names
'Property corner elevations(2 foot contour lines if more than
4 foot differential)
;a Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No
0 Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake
yr Land Use Case#: S U 6 ` 019 _ 0 0 0 0 8
f a Zoning: R.- q . s
7 Setbacks: Front 7,0 Rear 1 S' Side .3 Street Side LS Garage 2, 0
VI Landscape Requirement:
Lot Coverage Maximum:
g.
Building Height: Maximum Height 3 0 Actual Height 1
0 Visual Clearance
ZEasements
ASensitive Lands: ❑ Yes ❑ No Type
Urban Forestry Plan
gConditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: 4/10 v11'j-e, .. f'311(9 Date: I ( // (i
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_RES_060116.docx
Building Permit Submittal
Original Submittal Date: o/ 40
Site Plans: # 3
Building Plans: # 3
Building Permit#: IEnter building permit#above.
Workflow Routing: 2-Planning EKEngineering E Permit Coordinator building
Workflow Sign-off: 11--Sign-off for Planning(include notes from planning review)
Route Application Documents: [7-Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
priginal plan review routing form.
Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: G.._
By Permit Technician: ). C C Date: 67/,76
Engineering Review
%Slope at building pad: ii/
n 'tions "Met"prior to issuance of buildingpermit
� Codt
Easements (encroachments) per engineering conditions of approval and plat
7
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: i2 D Date: 44— --Mk
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:
4DC Fees Entered: Wash Co Trans Dev Tax: 1 OITes ❑ N/A
Tigard Trans SDC: ( Yes ❑ N/A
Parks SDC: irFeYes ❑ N/A
VA K to Issue Permit /1217 .� /�
Approvedby Permit Coordinator: 4Date:
I:\Building\Forms\BldgPermitRvw_RES_060116.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12879 SW PARKDALE AVE, TIGARD, OR, 97223 March 3, 2017 at 8:52:06 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00222
Inspection Type: Inspector:
199 Electrical final David Young
Result:
FA I L
Comments:
No access for inspection. House locked. 8:51 am
Provide access for inspection. R109.1
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12879 SW PARKDALE AVE, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Master Permit MST2016-00222
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12879 SW PARKDALE AVE, TIGARD, OR, 97223 May 25, 2017 at 11 :28:06 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00222
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
FA I L
Comments:
Provide permit for AC unit installed without permit, investigative fee waived R108.6 for
work installed without permit. Separate Mechanical permit and inspection required prior
to building final inspection. Separate electrical permit or minor label required prior to
building final as electrical final has been completed and AC whip not installed at this
time.
Remove screen from dryer vent. M1502.3
Violation Summary:
Inspector Contractor