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Permit (67) CITY OF TIGARD MASTER PERMIT 2: ':, COMMUNITY DEVELOPMENT .: ,. Permit#: MST2015-00285 it Date Issued: 11/07/2016 T f G., P D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 t 4 / Parcel: 2S112CB00500 Jurisdiction: TIGARD Site address: 8163 SW NORFOLK LN Subdivision: HOGGAN'S PARK Lot: 6 Project: Hoggans Park, Lot 6 Project Description: New SF. 3/20/2017: REPRINTED permit to include(1) utility sink. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1059 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1567 sf Garage: 676 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2626 sf Value: $330,180.76 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 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'l 500 sf: 5 201-400 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 2626 Owner: Contractor: WESTWOOD HOMES LLC WESTWOOD HOMES LLC Required Items and Reports(Conditions) 12700 NW CORNELL RD 12700 NW CORNELL RD 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97229 PORTLAND,OR 97229 2 A Geotechnical report is required before the footing PHONE: PHONE: 503-330-2215 FAX: 503-342-2403 Total Fees: $23,855.64 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. may obtain- Ep cf-tlie F or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. ` ' /,� �. Issued By: +% '- — Permittee Signature: ` Cr fJe/ C e •.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. Plumbing Permit Applicipa> 1,::, _' _ Building Fixtures _ FOR OFFICE USE ONLY i -'i'i Received City of Tigard , Permit No.: Ilh ■ 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: 3/h/(� - Sr/7Wi5-,....00,...,275- , Plan Review Phone: 503.718.2439 Fax: 5b3598.1960` Other Permit No.: Date/By: Inspection Line: 503.639.4175 TIGARD Date Read 8Y )aria: 0 See Page 2for Internet: www.tigard-or.gov Notified/Method• Supplemental Information TYPE OF WORK .., . , , ,EES SCtBEDt1LE ...,.,,. .. ®New construction 0 Demolitionet For special information use checklist 6,+�', Description 1 Qty. 1 Ea. 1 Total ❑Addition/alteration/replacement 0 Oth i New I-2-family dwellings(includes 100 ft for each utility connection) CATEGOIYY OF CONSTRU` ;,® SFR(1)bath 312.70 01-and 2-family dwelling 0 Co er ', •ustrial SFR(2)bath 437.78 buildingSFR(3)bath 500.32 0 Accessory 0 Multi-fancily Each additional bath/latchen 25.02 ❑Master builder 0 Other: .Firey2 sprinkler( s .ft.) Page JOB Srrg IN)rORMATl01 ,SND LOCATION Site utilities: . r ! Job site addre p / (' ia pte,, Catch basin or area drain 18.76 City/State/ZIP:Tigard,OR 97224 1?rywell.Ieach line,or trench drain 18.76 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt,no.: t Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18,76 /`�f Rain drain connector 18.76 /V Z.,--C)/S -. 0./ FS S Sanitary sewer(no.linear ft.:,) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision:Hoggans Park I Lot no.:4' Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 SItIPT1O1� F''WORD Backwater valve 12.51 a. ,., 0,V,..>1)EC... .. ..: it,,� . ., Clothes washer 25.02 4id, u j // • �•-�- , Dishwasher 25,02 1 / �/ f/ Drinking fountain 25.02 lJ Ejectors/sump 25.02 ` ,.L,r,x !`40:1 t' 7'WN7�R a,.,ai i,.h�t.;a +,.`,,. >£�, TNA 'a .` .s = Expansion tank 12.51 Name:Westwood Homes LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:12700 NW Cornell Rd Garbage disposal 25.02 City/State/ZIP:Portland,OR 97229 Hose bib 25.02 Phone:(971)678-5018 Fax:( ) Ice maker 12.51 'WgfrOra' AP `t NTiY tCdiMd. ; et,RS 1Nf Interceptor/grease trap 25.02 µ m?:2 w . v. Q®gt, , .,Aba0,.911a3AVaXkkh� t .M ,,N>. hSr;,,,u,i inq . Business name:Westwood Homes LLC Medical gas(value:$ ) Page 2 Contact name:Matt Fricke Primer 12.51 Roof drain(commercial) 12.51 Address:12700 NW Cornell Rd Sink/basin/lavatory l 25.02 j"-..:69- City/State/ZIP:Portland,OR 97229 Solar units(potable water) 62.54 Phone:(971)678-5018 Fax::( ) Tub/shower/shower pan 12,51 E-mail:Matt@westwoodhomesile.com Urinal 25.02 CON.,`CILACTtIWater closet et 25 02 ; O . , . : Water heater 37.52 Business name:H and H Mechanical Water piping/DWV 56.29 Address:5757 SE Willow Lane Other: 25.02 City/State/ZIP:Milwaukee,OR 97267 Subtotal Ac--:f}� Phone:(503)975-9787 Fax:(503)659-2979 Minimum permit fee: $72.50 - CCB Lie.:178122 Plumbing Lie,no.: Plan review (25%of permit fee) /--------/ State surcharge(12%of permit fee) `�Authorized signature L/ •1�4 111 /// TOTAL PERMIT FEE f 7, , �Print name: J ,/ 71/,),.t Imo " • Date: Jl// This permit application expires if a permit is not obtainedpwithi 80 days d f I l� / after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. ,` I:)Building\Permits\PLMU-PermitApp.doe 10/01/09 440-4616T(10/02/COM/WEB) -112L" CITY OF TIGARD MASTER PERMIT 1114 • COMMUNITY DEVELOPMENT Permit#: MST2015-00285 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/07/2016 T t[ A R ng Parcel: 2S112CB00500 Jurisdiction: TIGARD Site address: 8163 SW NORFOLK LN Subdivision: HOGGAN'S PARK Lot: 6 Project: Hoggans Park, Lot 6 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1059 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1567 sf Garage: 676 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2626 sf Value: $330,180.76 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 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!500 sf: 5 201-400 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 1 BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2626 Owner: Contractor: WESTWOOD HOMES LLC WESTWOOD HOMES LLC Required Items and Reports(Conditions) 12700 NW CORNELL RD 12700 NW CORNELL RD 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97229 PORTLAND,OR 97229 2 A Geotechnical report is required before the footing PHONE: PHONE: 503-330-2215 FAX: 503-342-2403 Total Fees: $23,782.62 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 the4180 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 952-001-0090.1- You may obtain a c theherules or direct questions to OUNC by calling 503.232.1987 1.800.332. 344. Issued By: /o..�.a`7/'�.-e,f�.. �r �/ Permittee Signature: /// "/ L .539.4175 by 7:00 a.m.for the next available inspeF' ate. 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 RECEIVED E® �--.5 �� .22 !S— FOR OFFICE IUSE ON EN� City of Tigard 2015 Received /D2/24/ /S DEC 2 Date/By: Permit N ��� � �/3 j�✓� 13125 SW Hall Blvd.,Tigard,OR 97223 IN Plan Review (� o I Phone: 503.718.2439 Fax: 503.598.1 Other Pe /�' � Inspection Line: 503.639.4175 III 4F TIGARD Date/By: I �j��/ . m it52:4 See ,2 TIGARD BUILDING DIVISION DateReady/By: �� J ® See SupplementalIor Internet: www.tigard-or.gov Notified/MeWod: //r �/� / I InformatSon m'i't /t9.9�T� . TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING ®New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ® 1-and 2-family dwelling 0 Commercial/industrial Valuation3 0 j 8 I $ ,z C7 - ❑Accessory building 0 Multi-family Number of bedooms: ❑Master builder 0 Other: Number of bathrooms: r s` JOB SITE INFORMATION AND LOCATION Total number of floors Job site address: F e.,„'v� 10/.��d/, ��pn„ New dwelling area 7(t'(' square feet 2 3 ±j� City/State/ZIP-`-' t r. -, / ,,"" Garage/carport area: square feet 1 / .,., � f l; / L/. / �"7F.:• Suite/bldg./apt.no.‘. Project name: #Q 6 6; t.- Aetfi-=- Covered porch area: square feet i„%"' C 7 Cross street/directions to job site: Deck area: square feet 1 9 Other structure area: — square feet fREQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: ,0 i ( 1-,i rir Lot no.: Permit fees*are based on the value of the work performed. Tax map/parcel no/.:" Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. New Single Family Construction Valuation: $ Existing building area: square feet New building area: square feet El PROPERTY OWNER El TENANT Number of stories: Name:Westwood Homes LLC Type of construction: Address:12700 NW Cornell Rd Occupancy groups: City/State/ZIP:Portland,OR 97229 Existing: Phone:(971)678-5018 Fax:( ) New: la APPLICANT CONTACT PERSON BUILDING PERMIT FEES* Business name:Westwood Homes LLC (Please refer to schedule) Contact name:Matt Fricke Structural plan review fee(or deposit): Address:12700 NW Cornell Rd FLS plan review fee(if applicable): City/State/ZIP:Portland,OR 97229 Total fees due upon application: Phone:(971)678-5018 Fax::( ) Amount received: E-mail:Matt@Westwoodhomesllc.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted Photo Voltaic Solar Panel System. Business name:Westwood Homes LLC Submit two(2)sets of roof plan with connection details Address:12700 NE Cornell Rd and fire department access,along with the 2010 Oregon Solar Installation Specialty Code checklist. City/State/ZIP:Portland,OR 97229 Permit Fee(includes plan review $180.00 and administrative fees): Phone:(971)678-5018 Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.:195597 /,'' . Total fee due upon application: $201.60 / ,,, –311 Authorized signature: ��� This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Matt ricke Date: l n� % Electrical Permit Application Foa 0FF1(T 1S ONLY City of Tigard Received �Tj IN Date/: : Permit#: !j lr;40/5.--»®0s" r 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review II Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#: Inspection Line: 503.639.4175 ReadyDate/By: Dans: 11 G A R DSee Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): El Demolition Other: ❑Service or feeder 400 amps or more 0 Building over three stories. where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ® 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 INFORMATION AND LOCATION ❑Emergency system. larger separately derived Job#: Job site address: Cj` ()IV J f- ❑Addition of new motor load of system. .�!( � L'�J:`'y', 100HP or more. ❑«A>, "E»"1-2" "1-3'> City/State/ZIP: ;- i ,� c)i 1 "(4.,t . i f ❑Six or more residential units. occupancy. t 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: 1 Project name: 0 Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Qty. l Each I Total I Po, New residential single-or multi-family dwelling unit. Subdivision: I'i,,/!` (/2(f Lot#: 4 Includes attached garage. Tax map/parcel#." [[ 1,000 sq.ft.or less i II 168.54 4 11 Ea.add'1500 sq.ft.or portion ,- 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 New SFR (with above sq.ft.) Limited energy,multi-family residential(with above sq.ft.) 75.00 2 kg PROPERTY OWNER TENANT Renewable Energy 0 See Page 2 Services or feeders installation,alteration,and/or relocation Name:Westwood Homes LLC 200 amps or less 100.70 2 Address:12700 NW Cornell Rd 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:Portland,OR 97229 601 amps to 1,000 amps 301.04 2 Phone:(971)678-5018 Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 1 59.36 1 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 2 181 APPLICANT 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel - A.Fee for branch circuits with Business name:Same as Owner above service or feeder fee, 7.42 2 each branch circuit Contact name: B.Fee for branch circuits without service or feeder fee,first Address: branch circuit 56.18 2 City/State/ZIP: Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Fax: :( ) Each manufactured or modular Email: dwelling,service and/or feeder 67.84 2 Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name:Ross Electric Inc Sign or outline lighting 67.84 2 Address:2870 SE 75th Ave#203 Signal circuit(s)or limited-energy ❑ See Page 2 2 panel,alteration,or extension. City/State/ZIP:Hillsboro,OR 97123 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(503)642-2800 Fax:( ) Investigation(1 hr min) 90.00/hr Email:RossElectric@comcast.net Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is CCB Lic.: 157891 Electrical Lic.: 34-436C Suprv.Lic.: 42325 specifically listed(Y:hr min) 90.00/hr ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: Stephen Ross Date: 0 Plan Review Required(25%of permit fee): 'i State surcharge(12%of permit fee): Authorized signature:;77 t�, TOTAL PERMIT FEE: j /i. / This permit application expires if a permit is not obtained within 180 Print name: uy Date: 7,- t._—, days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB Mechanical Permit Application FOR OFFICE USE ONLY Cityof Tigard Received v 13125SW Hall Blvd.,Tigard,OR 97223 Date/13y: Permit N S% g �)� Phone: 503.718.2439 Fax: 503.598.1960 Dan Review Pla - te/By: Other Permit: Dan T 1 G A RD Inspection Line: 503.639.4175 Date Ready/By: Juris: H See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE— USE CHECKLIST Mechanical permit fees*are based on the value of the work ®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ® 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: jj f Job site address: et Air conditioning 46.75 6 6-12 Sq,,,,,, It 9( r.l r /f`r r' Furnace 100,000 BTU(ducts/vents) ( 46.75 City/State/ZIP:Tigard OR Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: Project name: Heat pump 61.06 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: 1°,.-,.;. ,„ t e o Lot no.: / Other: 23.32 (,,I 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 :i PROPERTY OWNER 0 TENANT Environmental exhaust and ventilation: Name:Westwood Homes LLC Range hood/other kitchen / Address: 12700 NW Cornell Road equipment 33.39 Clothes dryer exhaust t 33.39 City/State/ZIP:Portland OR 97229 Single-duct exhaust(bathrooms, / ,z toilet compartments,utility rooms) ( 23.32 .� Phone: �!"Ci ;'Ofe. Fax:(503)342-2403 Attic/crawlspace fans 23.32 ►li APPLICANT 0 CONTACT PERSON Other: 23.32 `r Business name:Westwood Homes LLC Fuel piping: � �A $14.15 for first four;$4.03 for each additional Contact name: 1'► -f 1 tee, Furnace,etc. J Address: 12700 NW Cornell Road Gas heat pump j Wall/suspended/unit heater City/State/ZIP:Portland OR 97229 Water heater 1 Phone: IN-6 -60-/S Fax::(503-)342-2403 Fireplace Range E-mail:M/Wwestwoodhomesllc.com Barbecue i CONTRACTOR Clothes dryer(gas) Business name:Central Air Other: MECHANICAL PERMIT FEES* Address:PO Box 433 Subtotal City/State/ZIP:Clackamas,OR 97015 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(503)656-1908 Fax:(503)650-3898 _ State surcharge(12%of permit fee) CCB lie.: 178624 TOTAL PERMIT FEE r This permit application expires if a permit is not obtained within 180 t t days after it has been accepted as complete. Authorized signature: \._ * Fee methodology set by Tri-County Building Industry Service Board Print name:Jon Montgo Date: 1`_\Building\Permits\MEC_PermitApp_040113.doe 440-4617T(11/02/COM/WEB) r Plumbing Permit Application • Building Fixtures FOR OFFICE USE ONLY City of Tigard Permit No.: �%cL9fs�(Jy v 131Received SW Hall Blvd.,Tigard,OR 97223 Date/By: / S Phone: 503.718.2439 Fax: 503.598.1960 Plan Review Other Permit No.: Date/By: Inspection Line: 503.639.4175 T I G A R D Date Read/BY Jur s: I ® See Pagee 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ®New construction 0 Demolition For special information use checklist Description ( 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 ® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02 0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: ~. (1-6f-f,' r ff ; / rf Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard OR Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name: 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 ft.: ) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: 1-(07,!'/:),/ ,1 f,4f• 'Ii Lot no.: 6 Fixture or item: Tax map/parcel no.!r ( • Backflow preventer 1 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer ( 25.02 new SFR Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 El PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Name:Westwood Homes LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:12700 NW Cornell Road Garbage disposal ( 25.02 City/State/ZIP:Portland OR 97229 Hose bib 4 25.02 Phone: 17'1- 6}G"c'ul'l Fax:(503)342-2403 Ice maker 12.51 Ci APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: tAki (frt e) it( Medical gas(value:$ ) Page 2 LL Primer 12.51 Contact name:(11,1 FP:G kg_ Roof drain(commercial) 12.51 Address: j 4 �{,y a,1h," Sink/basin/lavatory C 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:691 )614_ 5/5 Fax::( ) Tub/shower/shower pan wf 12.51 E-mailf4liMwestwoodhomesllc.com Urinal 25.02 CONTRACTOR Water closet j 25.02 Water heater 37.52 Business name:H&H Mechanical WaterPin iP� g/D WV 56.29 Address:5757 SE Willow Lane Other: 25.02 City/State/ZIP:Milwaukie OR 97267 Subtotal Phone:(503)975-9787 Fax:(503)659-2979 Minimum permit fee: $72.50 CCB Lic.:178122 PlumbingLic.no.: Plan review (25%of permit fee) /' �e 9�1 State surcharge(12%of permit fee) Authorized signature: .47i _ / J �✓� TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days Print name:Dusti ague Date: after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT III T I G n R D Building Permit Review — Residential Building Permit #: /ys j;�2pg1S' - e"?()•e-f'• - Site Address: e/(, °3 ,,S'f_) A,la-/Zjl,L LI/1 Project Name: ` Psy .4"-k_ Lot #: 6-° (New dw g subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: Aie4.) ,sem` Verify site address/suite#exists and active in permit systt . ihtiver Terrace Neighborhood: ❑ Yes L✓I No Si Plan Elements: ree(3)copies of site plancalK • 14 k;A .sting structures on site e plan must be on 8-1/2"x 11"or 11 x 17"paper f/, ootprint of new structure(including decks)with finished iP Prawn to scale (standard architect or engineer scale) fl..r elevations V •rth arrow f, tility locations (required for new,may apply for additions) IFP e address,project or subdivision name and lot number I.cation of wells/septic systems EL) .plicant information (name and phone number) 7 Erosion control(including drainage-way protection, silt fence IR .t dimensions and building setback dimensions 1 d tgn,location of catch basin,etc.) iZ of area,building coverage area,percentage of coverage and �S eet names i pervious area(applicable if R-7,R-12,R-25&R-40) L(dStreet tree size,type and location t\ operty corner elevations(2 foot contour lines if more than Olkisting trees to be retained with drip line,and tree 4 foot differential) protection measures 0-Clean Water Services—Service Provider Lett (lot platted prior to 9/10/1995): equired: ❑ Yes,applicant was notified LIG No Received: ❑ Yes ❑ No LlG Public Facili�ti Improvement (PFI) Permit: �� 'equired: al Yes,applicant was notified ❑ No Applied For: I/es ❑ No,stop intake ,Pli and Use Case#: .. /�,3'QC>/y— 0000(1/ Gir-k3QaS- (loo %c) "oning: E etbacks: Front /5— Rear f/s Side Street Side Jv Garage t,26 andscape Requirement: • C) Ir Coverage Maximum: C °% Building Height: Maximum Height 3S / Actual Height or f'/ i lh I isual Clearance 1, Easements ensitive Lands: Urban ForestryPlan ❑ Yes 2No Type ❑ Conditions "Met"prior to issuance of building permit ,j Notes: :/C f/tV , rflu • - Z-c ifle-:71 ,j.� 1c /Z, • >IG/� 1 — /Q.,-1424ce , ,,,J Approved By Planning: �..._ .....„--_„_-_-3.--- � _ Date: Q /sg- Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Fonns\BldgPennitRvw_RES_070915.docx Building Permit Submittal Original Submittal Date: 3�'--S Site Plans: # j Building Plans: # _3 Building Permit#: a-Enter building permit#above. Workflow Routing: erEngineering Lermit Coordinator ©'"Building Workflow Sign-off: a-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: /° /- /45 Engineering Review Slope at building pad: /7 /conditions "Met"prior to issuance of building permit je 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: 1f4',,9) YIL Date: Revisions (after Building Submittal only) Reviewer Date Revision 1: E 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: t'liOSDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A Tigard Trans SDC: ❑ Yes jg,N/A Parks SDC: ([e Yes ❑ N/A , r 1 7( 4.€ OK to Issue Permit Approved by Permit Coordinator: I Date: I7-- , I:\Building\Fonns\BldgPennitRvw_RES_070915.docx City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 8163 SW NORFOLK LN, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2015-00285 Inspection Type: Inspector: 199 Electrical final Jeff Grove Result: PASS Comments: Violation Summary: Inspector Contractor