Permit t CITY OF TIGARD MASTER PERMIT
;II 2.. . COMMUNITY DEVELOPMENT . _
Permit#: MST2016 00483
} ! Date Issued: 01/25/2017
-f-(GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 " Parcel: 2S111DA19700
i /��f`,
Jurisdiction: Tigard
Site address: 8537 SW SCHMIDT LOOP
Subdivision: HERITAGE CROSSING Lot: 16
Project: Heritage Crossing, Lot 16
Project Description: New SF.4/25/17 REPRINTED:to add A/C unit. Placement of NC unit must comply with
manufactures installation requirements.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 711 sf Basement: 0 sf Left: 4 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1109 sf Garage: 342 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 4
Detectors: Yes
Total: 1820 sf Value: $222,496.14 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 RainStorm 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: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temo Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 3 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description:
Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 1820
Owner: Contractor:
DR HORTON INC DR HORTON INC PORTLAND Required Items and Reports(Conditions)
4380 SW MACADAM AVE SUITE 4380 SW MACADAM AVE SUITE 100 1 Ersn Cntrl 503-639-4175
100 PORTLAND,OR 97239
PORTLAND,OR 97239
PHONE: 503-222-4151 PHONE: 503-222-4151
FAX: 503-222-1304
Total Fees: $28,113.18
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the
eerurulles or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
/44..Issued By: i i��G, A�/�` Permittee Signature: S'Z"r �7 �‘ f
lll��� Call 503.639.4176 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.
RECEIVE")
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114tCITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2016 00483
l E GAR 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/25/2017
Parcel: 2S 111 DA19700
Jurisdiction: Tigard
Site address: 8537 SW SCHMIDT LP
Subdivision: HERITAGE CROSSING Lot: 16
Project: Heritage Crossing, Lot 16
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 711 sf Basement: 0 sf Left 4 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1109 sf Garage: 342 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 4 Detectors: Yes
Total: 1820 sf Value: $222,496.14 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
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0
Bckflw Prevntr: 0 Catch Basins: 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'500 sf: 3 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC. N Security Alarm: N Vaccuum System: N Garage Opener N All
Other: N Other Description: Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group:Y Square Feet:
NEW SF
VB R_3
1820
Owner: Contractor:
DR HORTON INC DR HORTON INC PORTLAND Required Items and Reports(Conditions)
4380 SW MACADAM AVE SUITE 4380 SW MACADAM AVE SUITE 100 1 Ersn Cntrl 503-639-4175
100 PORTLAND,OR 97239
PORTLAND,OR 97239
PHONE: 503-222-4151 PHONE: 503-222-4151
FAX: 503-222-1304
Total Fees: $27,960.02
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 OA 952-001-0090. u may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: fzha:�%�/ �/,\
Permittee Signature: �/%��� 1 C.)11/
Call 603.639.4175 by 7:00 a.m.for the next available inspection date. /
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
• ---, - 1 lu, n 3710 6. -
-. • Building Permit Applicli171
&CE A 11/1.1 ' S 0 ,
Residential
tat'
... 1 0R-ovule 1'
I.' 3 : i
City of Tigard '. ' '' Oak /0/13 A. // 0 P.,,,t sx4.57,1.0/c.7)0,03
t .3(.25 SW Hall Blvd TigardiOlt,'921)1 Tyt' t.D).!
1111
Othkr.PernufSdk 140/6„-.6635?Ci
Phone-, .503 718 243'4' F .'505 5419 ' 't;`,,,K-',?.%Z f' DPI:lac RiTN1
Inspection Line 503.639 115irt rprn--_, ramrclot Daio Ifoo,,t,Hs 4 See Page 2 for
Internet: www tigard-orgrie'- i''x f It, /1 v Nolifled imeihod ii•-• 1U ' . T4:6— Supplemental Information
TYPE OF WORK
REQUIRED DATA: 1-AND 2-FAMILY DAN ELTING 1
New onstructio0 Demolition
Permit fees*are based on the t aloe of the work performed '
cn
--- Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement 0 Other:
equipmentmaterials,labor,nserhead,and the profit for the
CATEGORY OF CONSTRUCTIOIS
work indicated on this application.
....1
Valuation: $AAQ 14,43 c
1#i_and 2-family dwelling 0 Commercialustrial
0 mul,,,family Number of bedroons:
0 Accessory building
Number of bathrooms. , ,i s.1
0 Master budder 0.Other:
— -1
JOB SITE INFORMATION AND LOCATION Total number of floors.
Job site address: SS3-7 66, of{
,scith 4 /e,t,p New'dwelling area: I 'col° square feet
CIty'State/ZIP:Tigard, OR 97223 Garage carport area: 05 Cf . square feet
Stntebldg.fapt.no.: Project namt 1-ti- itikty, c„trobs,:ji rk 6,-A Cmered porch area: q square feet 1101:
Cross streetidireetions to job site: Deck area square feet 7)4 :
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHFC'KLIS I
Subdivision: I Lot no. 1(0 Permit fees*are based on the t alue oldie work performed
—
Tax map/parcel no.:
Indicate the salue(rounded to the nearest dollar)of all
equipment.materials,labor,o‘erlicad,and the profit for;he
DESCRIPTION OF WORK work indicated on this application,
Valuation: S
New SFR
Existing building areasquare feel
...
New building area' square feet
a PROPERTY OWNER 1 0 TENANT Number of stories:
I
Name: DR Horton Inc.
Type of construction
---i.
I Address:
Suite 100
4380 SW Macadam Ave Occupancy groups:
r-CityState,Z(P.Portland, OR 97239 Existing:
- — ---1
Phone:t 503) 222-4151 Fax:( ) Nett:
0 APPLICANT • CONTACT PERSON BUILDING PERMIT FEES'
(Please refer to fee u'heriulf)
Business name: DR Horton Inc. ,
Structural plan reviem, fee tor deposit):
Contact name:Emerald Weeks
1 1
Fl S plan ret let% fee(if applicable):
Address: 4380$W Macadam Ave Suite 100
J.
Total fees due upon application: ;
Cl(Y/Sta(eZIP: Portland, OR 97239
"
Phone:(503 )222-4151 x1107 I FaxAmount received'.t )
E-mail: esweeks@drhorton.corn
PHOTONOL f44( SOLAR PANEL S' STEM FEES' 1
Commercial and residential prescriptive installation of -1
CONTRACTOR
roof-top mounted PhotoVoltaic Solar Panel System.
Business name: DR Horton Inc. Submit two(2)sets of roof plan with connection details
and fire department access,along with the 20)0 Oregon
Address:4380 SW Macadam Ave Suite 100
i Solar Instal/won Specrody Code checklist. t
CitY/StateZIP: Portland,OR 97239 Permit Fee(includes plan7T-------s78,0 ut) 1
and administrative fees):
Phone:(503 )222-4151 I Fax ( I
State surcharge(12%of permit fee): S2 I.60
,
CCB lic.: 130859
1 Total fee due upon application: s2li1.oti 1
Authorized signature-
11iis permit application expires if a permit is not obtained
.,, ;
I Print name:
Is ithin 180 clays after it has been serepled as complete.
methadolog.s;set by 1 ri-County Building.Industrs.,„
I Service Board.
I.Building PennittcBUP-RESPermitApp.drx: 02 24 2011 .440.4o13Tt II 02 COM WEB i
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Electrical Permit Application '- - • 1 OR 014 l( E I SF ON,' 1
City of Tigard Received
____,L, / , DatelEty: Pennit No/i/(57),0/6-00 c/1)
13125 SW Hall Blvd.,Tigard OR 97223 ' Plan Review
'III---Of Phone: 503.718.2439" Fax: 503.598.1,960 Date/By: Other Permit
Inspection Line: 503.639.4175 t, 1 ".'''',' i,. :,!. ',...';',, :i, Date Rendy/BY: -kris; to See Page 2 for
Internet: www.tigard-or.gov Notified,Method: . Suppkatental Information . _
111
TYPE bit i,j0; Kis" i'l
, - -- ' ' PLAN REVIEW
0 New construction [3 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans wiitents checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
CATEGORY of. corisritiicvoN exceeds 10,000 amps at 150 volts or 0 Floating buildings.
,...,
less to ground,or exceeds 14,000- 0 Corianercial-use agricultural
U 1-and 2-family dwelling 0 Commercial/industrial' 0 Accessory building amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: OFire pump. 0 Installation of 75 EVA or
0 Emergency system, larger separately derived system
JOB SITE INFORMATION AND LOCATION 0 Addition of new motor load of
Job site address: 8-,..s'37 <_&' clihm2,1"-Lp 100HP or more. occupancy.
Job no.:
0 Six or more residential units. 0 Recreational vehicle parks
0 Health-care facilities. 0 Supply voltage fix more than
City/State/ZIP:
0 Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: \-0-VIT., C -0. 5VA0 0 Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: ....j Description I Qty. I Fre. I MA_ I •
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 6 1,000 sq.ft or less i 168,54 4
Ea.add'l 500 sq.ft or portion,/ 1,%,•-j)"' 33.92 1
Tax map/parcel no.:
Limited energy,residential
75.00 2
DESCRIPTION OF WORK • (witil above sq.ft)
Limited energy,muki-family
75.00 2
residential(with above sq.ft.)
Services or feeders installadon alteration,and/or relocation
200 amps or less 100.70 2
0 PROPERTY OWNER ' 0 TENANT
201 amps to 400 amps 133.56 2
401 amps to 600 amps 200,34 2
Name: „ ..
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation,alteration,and/or
relocation
Phone:( ) ( )Fax.
' 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 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701.
• Branch circuits-stew,alteration,or extension,per panel
Owner signature: Date: ______________ A.Fee for branch circuits with '
above service or feeder fee,
0 ArrucArcr i 0 CONTACT PERSON 7.42 2
each branch circuit
Business name: DR Horton Inc ' B.Fee for branch circuits without
service or feeder fee,first
Contact name: Emerald Weeks branch circuit 56.18 2
Each add'1 branch circuit 7.42 J 2
Address: 4380 SW macadam Ave
Miscellaneous(service or feeder not included) —-
City/State/ZIP: Portland OR 97239 , Each manufactured or modular i
i 67 84 2
dwelling,service and/or feeder
phonc:( 503) 222-4151
I Fax::( ) , Reconnect only 67.84 2
.. _ -. Pump or irrigation circle 67.84 2
E-mail:
Sign or outline lighting 67.84 I 2
CONTRACTOR ,
Signal circuit(s)or limited-energy
Business name: (7 / ,t7../... 2 t ,,41,.;c ris..a.„ panel, .alteration,or.extension.. Page 2 2
tiii Eacbadditional inspection.over allowable in any of the above
„.._.; _L.,
Address: 2go1l u t/E- 4„ ,5 7(.- ,74.i.....e, ---4:-. Additional inspection(I hr nun) 6625/hr 1
Investigation(1 hr min) 66.25/hr
City/State/ZIP: Va.ie7C ("*. WA. 31667 Industrial plant(I brim ) 78.18/hr
Phone:(3‘,a 5./f_ 7529 Fax:oca) sz6-....... 966 c:). Inspections for which no leers
90.00/hr
specifically listed(V5 hr min)
CCB Lic.: f- -2.6— ,.,9 Electrical Lic.:.CS 3 p Suprv.Lie.: /7 9,5 6
' ELEC'TRICAL PERMIT FEES
Subtotal:
Suprv.Electrician signature,required:1 'D. g__.4E
Plan review(25%,of permit fee):
...-
Print name:C4 Es4-4 (.) ,.. a rrf Date: State surcharge(12%of permit fee):
TOTAL PERMIT FEE:
Authorized signature:
This permit application expires ifs permit is not obtained within 180
Print name: .-Pee,asz• • Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
1.ABuildinecrraitsNELC-PainiaApti 440-46151511105/COMWEB
4
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SC HEDULE
nescri.fiD11 -------77071— f—TATI—F, --i 0111i •__1
Fee for all residential systems combined: $75.00 Renev.able electrical energy s.stems
Check Type of Work Involved:
5.61 tk, 151,A,
I I Audio and Stereo Systems* 15.ni R25k*
'11 ind generation systems in excess of 25 low. , I
I I Burglar Alann 1,(ii 1,..5() 301,, 1
1
{ . 1
.55 i'l 1,,1lXI
XI Garage Door Opener* 4 -I- --1
,;0-IN%J(1,..v.in a,cok1..inci:
v,itli(IAR',it-,-''19-01).1))
X Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kNa:
System* , — T 1
I ach additiona'k-',. ,\t r:5 i - 'ii'i . . i
r , 4
[ I Vacuum Systems* !,;,,k-,0-.to acklitIel
onalcharts , (i fi
Each additional ins i ection over allovotbic in any of the ahose:
. ,
I Other: Lach cidd it ion,t1 inspc,ition k
fi,,ii 2' lir 1 i 1
diarged al an houtly II Iiii nun)
Inspection,I rwhich n,Ice is 1111 — i 1
00 iiii hi ,
ticd112, fisted( hr miri) i L --.)
ELECTRIC AL PERMIT FEEN
COMMERCIAL WORK ONLY:
Fee for each commercial system:
$75.00 Subtotal(Entct on Pagc 1)
. Numbo or impecooll,All,,,,,_%1 per permit
(SEE OAR 918-309-0000)
Check Type of Work Involved:
[1 Audio and Stereo Systems
[ I Boiler Controls
[ I Clock Systems
____ Data Telecommunication Installation
Fire Alarm Installation
I I HVAC
1 I Instrumentation
Intercom and Paging Systems
I Landscape Irrigation Control*
1- Medical
I Nurse Calls
F Outdoor Landscape Lighting*
F Protective Signaling
—
Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
L a.,,:din,.NI-1n,I LC Pk-ma,srp i L.R FRI,),-, Its ,i' V 4,N
. .
,,A.,
Plumbing Permit AppneLatatin
Building Fixtures i 1 I 3 , i,', fOlt Oil I( : t SE ONL1
City of Tigard Reechoed
It 13125 SW Hall Blvd.,Tipritifq*10 .,,-'4k.. !. Date/By Permit N. OCA/6-60 tie
Phone: 503.718.2439 Nix; 03.5981,960 , Plan Review
Castriey: Other Permit No,
Inspection Line: 503.0440 T-',.',,',....,;,,D;.%7';',,,:.I.-V':
f 1 G A P.0 -, J., '.'t-11-“, ' ,C1,, pate Ready/By, Reis VI Set Page Z for
Internet: www.tigard-orgov Nortried/Method , Supplemental Informarioa
• TYPE OF WORK , FEE* $araoutt,-;
o New construction 0 Demolition For!pedal information use checklist.
Desctithon ,J Qty.,. I Ea. J Total
0 Addition/alteration/replacement 0 Other New 1-2-family dwellings(includes 100 11,for each utility connection)
CATEGORY OF corisrinirnori SFR(I)bath , 312,70
0 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath I 500.32
0 Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
0 Master builder 0 Other:
Fire sprinkler( sq.ft.) Pap 2
SOB;SITE,•11RFORYLATION*AND LOCATION Site utilities:
s-45-3 7 st,,./ ,.„11,4,, ., 41,0 Catch basin or area drain 18.76
lob site address: '
Drywell,leach line,or trench drain 18.76
City/State/ZIP:
Suite/bIdgJapt.no.: Footing drain(no.linear ft.: )
Project name: A -- - i" Manufactured ...
\-\6A Livto a home utilities Page 2
50.03
Cross street/directions to job site; Manholes 3876
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: Lot no.: /(0 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
-•. ^ • DESCRIPTION OF'WO , Backwater valve 12.51
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
.
0 ratirEirry OWNER1 Li TENANT . Expansion tank 12.51
Name: \)3._\-- :b-\,--\-- ot.C..., Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: ...- D..(St.., , --,,,,,,,) ,. ja. ot e Adyk -kl,A."" -
Garbage disposal 25.02
City/State/ZIP: N1110(1.t'Z.- De--- ona--...)6--) Those bib 25.02
Phone:0)31 AA,4, , ...\,...\.), it Fax:( ) lee maker 12.51
ID APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
• _
1 V‘.Ci
Business name: 32>Z„. \AUVAT1Y\i, 1 Medical gas(value:$_) Page 2
Primer 12.51
Contact name: \,---- 0 1 01 ' ' / .._,,,,,S -
Roof dram(commercial) 12.31
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: er-_,Aze, „5„ ,.. „ y VI Cv----c,y) _C CA/VA 'Urinal 25.02
Water closet 25.02
-CONTRACTOR
Water heater 37.52
Business name;EDWARD MULLEN PLUMBING Water piping/DWV 56.29
Address:1601 SE RIVER ROAD Other, 25.02
-1
Subtotal
City/State/ZIP:HILLSBORO,OREGON 97123
Minimum permit fee- 572.50
Phone:(503)640-0113 Fax:(503)640-4483 Plan review (25%of permit fee)
CCB Lie.:94689 - Plumbing Lie.no.:34-260P8 State surcharge(12%of permit fee)
,..--
Authorized signature: ...............milimor ileAllirimrs TOTAL PERMIT FEE
, This permit application expires ifs permit is not obtained within 180 days
I Print name:RAY MULLEN Date: after it has been accepted es complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I levildinskrermitAPLMS)-PeriaitApp due 10101109 440,4tierrioanrcomiwam
1
City of Tigard
.71 Il COMMUNITY DEVELOPMENT DEPARTMENT
■
T1cARo Building Permit Review - Residential
Building Permit #: A STPD l4.--00 el�3
Site Address: gS 32. S/L) ipal bcy9
Project Name: .n: W (7n)-c , . Lot #: 1(3
(New dwe =subdivision name;Ad u �n ar Alteration=last name of owner)
Planning Review /////
Proposal: /ti, \YF7e._
V(Verify site address/suite#exists and activ fm permit system.
OAliver Terrace Neighborhood: No ❑ Yes,See River Terrace Review Addendum Attached
Sine Plan Elements:
Three(3)copies of site plan .111 sting structures on site
iqn ite plan must be on 8-1/2"x 11"or 11 x 17"paper `I ootprint of new structure(including decks)with finished
vprawn to scale(standard architect or engineer scale) or elevations
C orth arrow iG Utility locations (required for new,may apply for additions)
Iite address,project or subdivision name and lot number I!Ia cation of wells/septic systems
iA
pplicant information(name and phone number) p► sting trees to be retained with drip line,and tree
VAot dimensions and building setback dimensions protection measures
( Lot area,building coverage area,percentage of coverage and eet tree size,type and location
pervious area(applicable if R-7,R-12,R-25&R-40) Street names
Property corner elevations(2 foot contour lines if more than
4 foot differential)
LI lean Water Services—Service Provider Lett (lot platted prior to 9/10/1995):
Pequired: ❑ Yes,applicant was notified VA No Received: ❑ Yes ❑ No
ublic Faciliti Improvement(PFI) Permit:
Lequired: [Yes,applicant was notified ❑ No Applied For: Yes ❑ No,stop intake
and Use Case#: - avcis
r, Zoning: 1,�
B Required Setbacks: Front /- Rear l c" Side 1/ Street Side 0/ Garage ?)
0(Landscape Requirement: .....9 0 %
of Coverage Maximum: —
0/Lot
Height: Maximum Height 3S-' Actual Height c iep I"
Ii ° isual Clearance
I►1 Easements
N1'%►ensitive Lands: ❑ Yes 1z(No Type
VA Urban Forestry Plan
❑ Conditions "Met"prior to
issuance of buildin permit
�
Notes:
0I7x7Sn_s / 2 1/ jP71 ,7nc 7 v � � iLT nC(._
Approved By Planning: T Date: o
,L3/14,a_
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
41
Revision 3: ❑ Approved ❑ Not Approved
i:\Building\Forms\BIdgPennitRvw_RESJ191216.docx
Building Permit Submittal
Original Submittal Date: /043//1
Site
``Site Plans: # 3
Building Plans:
Building Permit#: , ,/Enter building permit#above. _,
Workflow Routing: L7 lanning C�Engineering Ly'Permit Coordinator CBuilding
Workflow Sign-off: ['gn-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: / ,d- % Date: /7 /w
Engineering Review
Slope at building pad:
9%
la-Conditions "Met"prior to issuance of building permit
12"—Easements (encroachments)per engineering conditions of approval and plat
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes [ iNo
Assess Water Quantity Fee in-lieu: ❑ Yes [ -No
LIDA Facility on lot: ❑ Yes ErNo
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: , ( 1+ Date: l \-0S -1 k
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:
'' DC Fees Entered: Wash Co Trans Dev Tax: 'es ❑ N/A
Tigard Trans SDC: , Yes ❑ N/A
Parks SDC: ,Yes ❑ N/A
(In=0K to Issue Permit l /�
Approved by Permit Coordinator: Date: t l/ / `�
I:\Building\Forms\BldgPermitRvw_RES_091216.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8537 SW SCHMIDT LOOP, TIGARD, OR, 97224 May 24, 2017 at 7:35:08 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00483
Inspection Type: Inspector:
299 Final inspection David Young
Result:
FA I L
Comments:
Provide approved mechanical and plumbing final inspections prior to building final
inspection.
Violation Summary:
Inspector Contractor