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Permit (40) CITY OF TIGARD `f , �� MASTER PERMIT . COMMUNITY DEVELOPMENT Permit#: MST2016-00499 13125 SW Hall Blvd.,Ti and OR 97223 503.718.2439 Date Issued: 01/25/2017 9 Parcel: 2S 111 DA23400 Jurisdiction: Site address: 15470 SW APPLEWOOD LN Subdivision: HERITAGE CROSSING Lot: 53 Project: Heritage Crossing, Lot 53 Project Description: New SF. 4/13/17: REPRINTED to add A/C unit. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 3 First: 709 sf Basement: 0 sf Left 4 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1034 sf Garage: 390 sf Front: 11.25 Smoke Dwelling Units: 1 Third: 0 sf Right: 4 Detectors: Yes Total: 1743 sf Value: $216,075.93 Rear: 16 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 0 Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: 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 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: Square Feet: NEW SF VB R-3 1743 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: $27,909.90 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 952-001-0010t OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling/503.232.1987 or 1.800.332.2344. Issued By: ,� _(!C Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspection dat . 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. .c..'flF,sxe B F S 9 A a ,.58 S `s= ri i r 4404,-,41V 4$42‘11„) Eft}„ q g t r 1101101 .f$1 , .. as ..„., ... -.. q,rT-1-I1 ;k €i1 f° t. u )11; V h. • y Q(V19\et"411 f\Ac (1 E aY i 1 (4,4.Vr "I Ifl ., %IfOr t"EaiR it '.a q=^.meq tl11 k i4 is. 111 1f?h ,1; 4 1S4) 1st )i iolcIttly) la44 7J BOG - ea r ;y � 'e 4S a vi�°ls � 71 3 CITY OF TIGARD MASTER PERMIT r p COMMUNITY DEVELOPMENT Permit#: MST2016 00499 TR ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/25/2017 Parcel: 2S 111 DA23400 Jurisdiction: Site address: 15470 SW APPLEWOOD LN Subdivision: HERITAGE CROSSING Lot: 53 Project: Heritage Crossing, Lot 53 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 3 First: 709 sf Basement: 0 sf Left 4 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1034 sf Garage: 390 sf Front: 11.25 Smoke Dwelling Units. 1 Third: 0 sf Detectors: Yes Right: 4 Total: 1743 sf Value: $216,075.93 Rear: 16 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 0 Storm Sewer 100 Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 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'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: NEW p y Square Feet: SF VB R-3 1743 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: $27,812.54 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 952-0001-00900. You may obtain a copy of the rules or direct questions to OUNC by calling 503.23`/2.1987 or 1.800.332.2344. Issued By: 144 / Permittee Signature: C i—_, /5.4//CL'471.--) Call 503.639.4175 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. Building Permit Application 41 1 1- &— Residential I OR Oil ICI I sr OM V City of Tigard l Rn�r.�t!PI 13125 S W Half Blvd.,Tigard,ORc, *-"" +c Ci G� �� Perm,+Nn Phone; 503.718 2439 Fax: 503.. '�� Plan Re%ica -�� � 1 ,,: t, Inspection Line. 503.639 4 t 15 1 � Dau f3 •. " ! ill (>tficr Permit: t x ':r Internet: www.tigard-or.gm C i CL �1 t41 5 'Page 2 fur „,,..v.,,,, a ME r a $`P ° ' ;. - /lt Supplemental Information TYPE OF W t REQUIRED DATA:1-AND 2-FAMILY DN ELLING 3 New construction tL°'Ai molition Permit fees are based on the taIue of the work performed. ❑Addition/alteration/replacement0Other: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the work indicated on this application. CATEGORY OF CONSTRUCTION Q I-and 2-family dwelling 0 Commercial/industrial Valuation: S ❑ Accessory building .. a. 0 Multi-family Number of bedrooms: 3 ❑ Master builder ❑Other; Number of bathrooms: JOB SITE INFORMATION AND LOCATION Tota6.40....l number of floors; v2 Job site address: _ or..,or.., _• tn./ �� � IIIIIIIIIIIIIIII New duelling area: 7 - City/State/ZIP:Tigard,OR 972233 square feet Garage:carport arca: '+ square feet Suite/bldg./apt.no.: Project name Cross street/directions to job site: � � A�h Covered porch area: G square feet 0 Deck area: square feet • 0 Other structure area: square feet i Subdivision: REQUIRED DATA:COMMERC IAL-USE CHECKLIST Lot no.:cr3 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 DESCRIPTION OF WORK equipment.materials,labor,overhead,and the profit for the work indicated on this a..lication. FR Valuation: S • Existing building area: square feet New building area: square feet it PROPERTY OWNER 0 TENANT Name: I • Number of stories: :orto Inc. Address: Type of construction: :I A v . . t . ,, ; . ' • it City/State/ZIP:Portland OR 97239 Occupancy groups: Phone:( 503) 222-4151 Fax:( ) Existing: 0 APPLICANT Nei: r♦ CONTACT PERSON BUILDING PERMIT FEES'' Business name: DR Horton Inc. Sc re er to ee schedule Contact name:Emerald Weeks Structural plan review fee(or deposit): 1 OO FLS plan review. fee(if applicable): Address: 4380 SW Macadam Ave Suite •_ City/State/ZIP:P.rtland Total fees due upon application: 97239 Phone:(503 )222-4151 x1107 Fax::( ) Amount received: E-mail: eSWeeICS drhorton.com PHOTOV'OLTAICSOLAR PANEL S1"STEM FEES° CONTRACTOR Commercial and residential prescriptive installation of Business name: roof-top mounted Photo Voltaic Solar Panel System. DR Horton Inc, Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:4380 SW Macadam Ave Suite 100 CitylState'Z1P: Solar Installation cialn•Code checklist. Portland, OR 97239 Permit Fee(includes plan review and administrative fees: 5180.00 Phone:(503 )222-4151 Fax:( CCB 1ic.:130$59 State surcharge(12%of permit fee): 521.60 Authorized signature: Total fee due upon application: 7 5 01.60 ( + •t .4. {� r t ( ;. This permit application expires if a permit is not obtained Print name: t t { within 180 days after it has been accepted as comm'- f _ M Date:2016 Fee methodology set by Tri-County Building Int' • "$UP RESPennitA L Building.Permits dac R2. Sen ice Board. PI'• 24,2011 440-4b13T(11.02 COM'WEB 1 1lechanical Permit Application t A tit,()I t It i I st “si s . ,. a (::II I,,,1 stI‘I*1-.11.,,Iii vt,rady,i,,,,r, ,_2„:, ,, ,,, ,,\IF.s.,1 SI: pif ta,r„,1,,,,t IOC if,i3 6'kg 34 1'''' t , ''-,1 . ,.... _ ... IMMO ^1 tt. flp...od,..1.,..-.‘,- - .-111$ .,, ^,0.1,r1„, 4.uppkm,Agyi 10. CA 19 1-'' . . .. ,.„,._ ,,,..„„_, _ ___. npr or wool( r.oc., ic..6,.., .R0,04_77_77_ ..__ 7 -_.) . 1, -E. won" Urs.,- t t WM/AL AL FE SO . .,.. - --QTrt --- sho Kra,.A1 ts,..-AAA,AA A,....-,4‘. 4-•9,:d,,,4 4,-., .1„, ,,,0.,,,., .\ON 4:11/1•411,..,414 II 0 Nittikt tort.thokt til,rrytts,rti,":- 4 , ik-k-tt,tttttck! tokho-kt Mk'tt.Ow trkqtt.,kI ki to 0 1)4:111111141,/l .0(Afi,,,3 'BUIL ' 1,4,113:!1,,,i,,,i,,,s,!1, tA/Eirty/it .1 ...-"' --- CATEGORY OF CONSTRIXTION S ti.ov S RESIDENTIAL EQUIPMENT/SYSTEMS EVES* i IN I .ind.1' tamilt. AIAs,:i1v1.g 0 Comftw,,,,,'hil indu‘R I 31 0 \,,c,st.11 t'q 0 1411,1_ / p.,„d,„1„,,,,,,,„„„se,h..,0.., , DNtuItt.141.t1tth D‘1,1,141 buiLlo C•I nii,.-• • I-tk,t,itptts,!= I [ JO ,---- .--_ B SITE INFORMATION AND LOCATION 1(.5-14 70a C.../tA../ telmAil, 111,,,- 4ri , 1...11 A,A. too(too- ft I i o.A.A. ,,,, . :4 4` • I ". ''141' ill'" Tillard, OR 97223 .___ 4 ' v AttA03L.CirOl. . , 4 ,,,.....AN:0,1,,,,,,,, ,,,t,,,,,r-.,,I,.... , , ,... ,,..,....,..,..L.,...,,,..,. R,,T,--,,,,,, ,,,ar.,,,,,., . ,,-.. ,- __ 1 . I „,,h,,,,,,,No,,,,,,,,.. „„.,,,,,,,,..„.... ......_ ...... .... _.._ „ _ „ ,.._ ._._ : p..11n."2 -1.,..,...,..,..L,1 ,. ' I kti: OA 44 -'• 44 4f4441-• _'..4.41•6413,.444441 i 1 4 t!.•413 ' r------- — 1. I 4,.Ina:*N1%0 11.. " 0, • ' '4 Dumf.:ion OF WORK i ('-'"I u'ri'" '"7- .--. .3 . ----- - -.1 I iitc.A.cnt tor A%.14,1 hl.,11,4 r•t. , ! 1 New SFR 1 s.,'Itablet i 41,3s.i f t• :1 ;.-.• ti , , f• t ‘A.......!t.,..v,.!„, ....4,1 . 2 •,' ! —....... ......._ „.._..... ................. ..„...... ' - ---- - I 44"•414:". bq..c.r tl,i,'I -' .-- .PROPERTY OWNS it 1 0 TENAN7 1 t -. j ' and voila:Km:. "31IIt' DR Horton Inc. ' it'ktv.:hoot!othor 4,,th,Ito, 1 i \d'it‘''''.4380 SW Macadam Ave Suite 100 4, 1,444-4,-.44-,-4,,,44.4.4.4 1 ( " 'slaw"i' Portland,OR 97239 , 1/44;,,A 4.4,4"4:a',,.1\111q,,,n. t ,,!•,- tol k ottkrofttsokt- 4144:4.•4,4""-•, 14 ...:'• : 503 ' 212-4151 ' t " " \''''-‘';' ''' ' .. ..., ...... _ -4- ---- - ., ' 4 '44,4 4 '• •' ' APPLICANT L 4 CONTACT PERSON j , l , rupipin ti : I„:liu`mc"rmine DR Horton Inc,. _ — . S14.15 fiar lird loin,44.411 for frith additional, 1 t "Inat I/WM' Lmerald NVeeks I A.:AAA i udfc,, 4380 SW 'Macadam Are Suite 100 , 44'tw41-1-'"‘"Ar- A 4 • , ..„.... .. v.441•,..,spemit.st.ityr 1:4..0 ; t ; • `0•11c/IP Portland.OR 97239 ‘k fl,1 I..-..t , Ph."'"503 .222- 4151 x1107 ! i at 1 - ; 53 „it,:aw,;;• ,, _:: 1 1 " ' CSWCek.SO'dr11011011.00111 I A.. , 1 ft,,,r.,,,,wok* /41,14 A 1 1,,,,,......., ti, C, •It hcx — ----. MECHANICAL PERMIT FEW‘slti' ` 2-:"/i la)((MI&!":77 '-'.**. 7 11 Z I i -77 )- - Nubtofist . t.! f , _ ....R SLitt'/IP pilli."1 L(11..,71 b.,it, '-', 4 difi '';',;(1,,(,) I MITItitiun,Knoll{VC IS4tt Mt • ! P4.-41, ii.,-' -' ,--'', 4- 'kk kt, ' -5 t i I., 1,,t4,- 4 k7: '>1. / ',/ 4'7; 4 - 44 li"it. -; ""')/ i-...)I.I. TOT kl PERSOT Ill ' -- - - - t ht,pc,not irpolo afoot t gate*dapainut n not nioaood'lb.,. 0.1 dab,Art in ha%hte II atirpitti a.tainpitit 4-,.....3‘44,411444,44,; P1114 11044.:_,--- batt--: '' (''''';'/ f'- , V...1,..,rf •••4 ,,, .; . .,•• . ,. ..-, Electrical Permit Application • I OK OI 11( 1 1 ,I O\I City of Tigard 'ry t . It......d , — 13125 SW Nail Blvd.,Tigard,OR 9 Datdsy: Permit No.: /TI 5 �� Uel q Phone: 503.718.2439 Fax 503.598.1960 F ' i0`9 1'�" r U Inspection Line: 503.639.4175 n T Q Date/By: Other Permit Internet: www.tigard-or.gov �, Date ed Methy Judi: B See Page 2 for NotisealNietaod � ` ", � Suppklaeatal information TYPE OF.WO1 �Le e t €.(•; t",z • ' ®New construction 0 Additieah/alte 9t a al / s 1 FLAN'REVIEW eAt Please check all that apply(submit2 sets ofp plans wltems checked below): ❑Demolition ❑Other: 0 Service or feeder 400 amps or more 0 Building over three stories. where the available fault current ❑Marinas and boatrards. CATEGORY'OF CONSTRUCTION .• exceeds 10,000 amps at 150 volts or ['Floating buildings. ❑ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000- 0 ream .u88 agricultural amps um au older installation. hsstaings• ❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 bsstallation of 75 KVA or JOB SITE INFORMATION ANIS LOCATION C7 agency system. larger separately derived system. 0 addition of new motor load of O"A;'1-^,"1-2","1-3", Job no.: I Job site address:�1"�irl�7( .5,1", A1. - s- ❑ or m ceeidential wtits. ❑occuReaancy. vehicle parks. r City/State/ZiP: T-‘44, G2 9 7d�3 ❑health-mane facilities. 0 Supply voltage for more than Suite/bldg.lapt no.: projectname: L�,o --t-41,1_, ❑Hazardous locations. 600 volts nominal. 1 �l, �����1 P 0 Service or feeder 600 amps Of more. • Cross street/directions to job site: FEE SCHEDULE tae 'a 1 ow. 1 1e . I Tett 1 . New residential single-or multi=family dwelling unit Includes attached garage. Subdivision: I Lot no.: f 1, R.or less V3 000 sq. l1 168.54 4 Tax map/parcel no.: Ba add'I 500 sq.R.or portiere 4 33.92 1 I DESCRIPTION OF WORK Limited ft) ial 75.00 (with above sq.R) 2 Limited energy,multi family residential(with above sq.ft.) 75.00 12 Services or feeders hastafadon alteration,and/or relocation 200 amps or less132 13 PROPERTY OWNER , i ❑ TENANT 201 amps to 400 amps3.50 133.56 2 Name: 401 amps to 600 amps 200 2 Address: 601 amps to 1,000 amps 301.04 2 Over 1,000 amps or volts 552.26 2 City/State/ZIP: Temporary services or feeders insh nation,alteration,and/or • relocation Phone:( ) I Fix:( ) 200 amps or less 59.36H I Owner installation:This installation is being made on property that 1 own which is trot 201 amps to 400 amps 125.08 22 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 to 599 amps 16s.54 • Owner signature: Date:• Branch circuits—new,alteration,or extension, panel 13 � � v A.Fee for branch circuits with ❑ CONTACT PERSON above service or feeder fa, each branch circuit7.42 2 Business name: DR Horton Inc B.Fee for Lunch circuits without Contact name: Emerald Weeks service or feeder fee,stat branch circuit 56.18 2 Address: 4380 SW macadam Ave Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) City/State/ZIP: Portland OR 97239 Each 503 222-4151 1it�,serviaanorfeeder 67 1 z phone:( ) I Fax::( ) r Reconnect only 67.84 E-mail Pump or irrigation circle• 67.84 122 COlyTltAt:'DOR i Sign or outline lighting 67.84 2 Business name: //t.tl x.1) Sigma chalks)or Nailbed-energy Business ' ,74' g6,,,,...4,,,,;a /-12:e., panel,siltation,or extension. Pam 2 2 Address: 2 goy U ,l 6reft # it Each additional ins(Ipection over allowable in any of the above / /t ,,fL.Q, --4:k-: Additional inspection ) 6625/In city/State/ZlP: VGI Y!C 0 6f1/4- [�t t/' (�'. /�74,r�/,^9t,?6`�'/ Industrial plant Investigation it br nun) 66 75/hr Phone:(3 3--/e_ 75 2 A 1 Fax:obp) 32c- 966'0 Inspections for(which no fee is 1 hr min) 78.18/hr CCB Lic.:f'72,5— ,9' Electrical Lic.:.1 Z3o ' (� specifically listed 04In-min) 9o.00/S TC�' Suprv.Lic.: /7 91 s ELECTRICAL PERMIT FEES Suprv.Electrician signature,required:/j.7Th 11 Subtotal: Print name: ' !� Plan review(25%of permit fee): C�t=s(h ik 6 �a rrf . j Date: Shue surcharge(12%of permit fee): Authorized signature: ,,,e.,‘,...,_..- "7, �� '" TOTAL PBti1vAP FEE This permit appiicatian expires if a permit is not obtained within 180 Print name: Date: days after it baa been accepted as complete. L1Htdtdi /P * Number of inspections allowed per permit. �pMa.4615T(I l/a5/CAaeIWBB Electrical Permit Application—City of Tigard Page 2—Supplemental Information • Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Description CON. FactFee for all residential systems combined: $75.00 Renewable electrical energy systems: 5 icia or less 100,70 2-1 Check Type of Work Involved: -- 5.01 to 15 kva 133.56 2 j O Audio and Stereo Systems* 15.01 to 25 loa 2U0.34 Wind generation systems in excess of 25 kva: n Burglar Alarm 25.01 lit 50 kva 301.04 2 50.01 to IOU kva 552.26 IN Garage Door Opener* ,iou lo a(fee in accordance 552.2t with OAK 91S-309-0040) n Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* T-3 i'ach additional k .Liver 25 7.42 D Vacuum Systems* -IOU to —no additional charge 0.0 Each additional inspection over allowable in any of the above: • Other: Each additional inspection is 66.25 hr 1 charged al an hourly(Lar min) Inspections!lir which no lee 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 I):Number of of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: O Audio and Stereo Systems • Boiler Controls • Clock Systems • Data Telecommunication Installation O Fire Alarm Installation E HVAC O Instrumentation Li Intercom and Paging Systems n Landscape Irrigation Control* ri Medical n Nurse Calls E Outdoor Landscape Lighting* ✓ Protective Signaling • Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I.Suilding Pei rtii:s 11.0 PomhApp ELF ERJ' k, Rc WI 17:015 Plumbing Permit Application + , . Building Fixtures1111111111111111111 _ City of Tigard " '`yam t\e " nawBii Permit /)?ST )llv'r)i7'If n 13125 SW Mall Blvd.,Tigard,OR _- t"''g Cf I Plane: 503.718.2439 Fax: 503. 98.1960 Other Permit No.: r I c,y R a Inspection Line: 503.639.4175 C�CI 19 ?Q1� Date/By:R�y: ' kris: res Sse Pose:for Internet: www.tigard-orgov ;r-) Notified/Method: .,, • v,. : TYPE OF� `�1": ' �, 1 pere �ppkwe■pl laGraatiea � )"� 1 4 iFEE• BCifitp ti ❑New construction 1 qiviiDQ114 For special Information use checklist Description ( Qty. I Ea. I Total ❑Addition/alteration/replacement I 0 Other New 1-2-family dwellings(includes 100 R for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ❑1-and 2-family dwelling 0 Commercial/industrial SFR(2)bait 437.78 ❑Accessory building ❑Multi-familSFR(3)bath ( 50032 Multi-family Each additional bathlkitehen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 • . JOB'OM a11YORA�(J1 bi:'AND LOCATION She utilities: Job site address: (5"17() cSLA✓ /f. t 14.41,.., Catch basin a area drain 18.76 City/StatelZiP: t ,. Drywell,leach tine,or trench drain 18.76 Footing drain(no.linear ft:__) Page 2 Suite/bldgJapt.no.: ` Project name: � / �ij 111 Manufactured home utilities 50.03 Cross street/directions to job site: vx Manholes 18.76 Main drain connector 18.76 Sanitary sewer(no.linear ft.:__) Page 2 Storm sewer(no.linea ft.:___) Page 2 Water service(no.linear ft.: Paget Subdivision: ( La no.:63 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 D&RCR1?1 LON OF:WORK Backwater valve 12.51 .. Clothes washer 25.02 �\ c y Dishwasher 25.02 (2_ Drinking fountain 25.02 Ejectors/sump 25.02 . •0 PROPEICI V.ofi!NIER . • 1 ' 0 TENANT .i Expansion tank _ 12.51 Name: VIVA-VW \\A,L., FixtureJsewer cap 25.02 - 'F poor sink/hub 25.02Address• L-kj mac) '�rD� . Garbage disposal t 1 , City/StsteZl P: 0\t- 110.- 11 Bose bib 25.02 _ 25.02 Phone:l � _k \C , ax:( ) Ice maker 12.51 , • El.APPLICANT Q CONTACT PERSON 1 Interceptor/grease trap 25.02 Business name: ) 2 \- , - ' ('J Medical gas(value:S ) Page 2 Contact name �-��� Primer 12.51 Roof drain(commercial) 12.31 Address: Sink/basin/levatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( )) { Fax::( ) Tub/shower/shower pan 12.51 E-mail: a ,,k j�l//j� c' v ki Cv C( ._Urinal 23.02 . •;CONTRACTOR• Water closet 25.02 Water heater 37.52 Business name:EDWARD MULLEN PLUMBING Water piping/DWV 56.29 Address:1601 SE RIVER ROAD Other: 25.02 • City/State/ZIP:HILLSBORO,OREGON 97123 Subtotal Phone:(S03)640-0113 Fax:(503)640-4483 Minwrwm permit fee: 572.50 CCB Lic.:94689 Plumbing Lic.no.:34-260PB 1Plan review (25%of permit fee) �� State surcharge(1"of permit fee) Authorized signature: ` '• _-� TOTAL PERMIT FEE Print name:RAY MULLEN / Date: This perish appatatexpires if a permit is set obtalsed within 1110 days atter h has bee*accepted as complete. 'Fey methodology set by Tri.Coumy Building Industry Service Board. l:laudeaaPermi4MtMU-Pcrmi.App.doe 10/01/09 4404616T(I0/02/COMAVEB) City of Tigard 114 q COMMUNITY DEVELOPMENT DEPARTMENT T 1 c A R D Building Permit Review — Residential Building Permit #: /77,57-1 0/6 —COy Gj Site Address: 19410 (SW Appc Woo6f Lade' Project Name: Cit SS1 Lot #: 63 (New dwelling=s ivision name;Additiomlot Alteration=last name of owner) Planning Review Proposal: WJ(, I S Verify site address/suite# exists and active in permit system. h.River Terrace Neighborhood: X No ❑ Yes,See River Terrace Review Addendum Attached Site Plan Elements: --fi�nn Three(3)copies of site plan 14tl�xisting structures on site Site plan must be on 8-1/2"x 11"or 11 x 17"paper krootprint of new structure(including decks)with finished )yawn to scale(standard architect or engineer scale) floor elevations 'forth arrow 11Jtility locations(required for new,may apply for additions) lik<te address,project or subdivision name and lot number N,ocation of wells/septic systems Applicant information(name and phone number) xisting trees to be retained with drip line,and tree lot dimensions and building setback dimensions rotection measures 'RLot 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) Street names Property corner elevations(2 foot contour lines if more than 4 foot differential) XClean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified 'Q No Received: ❑ Yes ❑ No jir Public Facilities Improvement(PFI)Permit: Required: ❑ Yes,applicant was notified 19 No Applied For: ❑ Yes ❑ No,stop intake Land Use Case#: W92015COCAS 14 Zoning: r242 'Q p nk.Required Setbacks: Front 11.2S4 Rear ‘ko Side li Street Side N l.A Garage '(P Landscape Requirement: 1 0,0 _. Lot Coverage Maximum: igr Building Height: Maximum Height Of j Actual Height ±2 . Visual Clearance 1g Easements Sensitive Lands: ❑ Yes No Type Urban Forestry Plan Conditions "Met"prior to issuance of building ermit Notes: SW "'VW ( 7 hi& 02-4/) prior r u 1ssua i ee Approved By Planning: Date: Alail_Q Revisions (after Building Submittal on ) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: El Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw_RES_091216.docx Building Permit Submittal Original Submittal Date: /1/A�(. Site Plans: # Building Plans: # -3 Building Permit#: g- i er building permit#above. Workflow Routing: Ring [r--£*tfg eering rrrrit Coordinator wig Workflow Sign-off: Si off for Planning(include notes from planning review) Route Application Documents: ngineering: (1) copy of permit application, (1) site plan, (1) building plan and oal plan review routing form. Building: original permit application, site plans,building plans, engineer and beam calculations and trust details,if applicable,etc. Notes: ByPermit Technician: 4 i� ��.�'�.--, �' � Date: 1/, Engineering Review Slope at building pad: 3 670 ❑ Conditions "Met"prior to issuance of building permit ❑ Easements (encroachments) per engineering conditions of approval and plat 0 Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: El Yes .0'No Assess Water Quantity Fee in-lieu: ❑ Yes -No LIDA Facility on lot: ❑ Yes -0'Slo ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: 114 I G( ti.) , Date: (/1/2.-/7/(z, 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: Yes CI N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: Yes ❑ N/A S©OK to Issue Permit /_ Approved by Permit Coordinator: ate: it/�/`5° I:\Building\Forms\B1dgPermitRvw_RES_091216.docx I , City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15470 SW APPLEWOOD LN, TIGARD, OR, May 22, 2017 at 9:20:38 AM 97224 Record Type: Record ID: Residential - Master Permit MST2016-00499 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS Comments: AC installed. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15470 SW APPLEWOOD LN, TIGARD, OR, May 19, 2017 at 8:04:38 AM 97224 Record Type: Record ID: Residential - Master Permit MST2016-00499 Inspection Type: Inspector: 199 Electrical final David Young Result: FA I L Comments: House not open for inspection, front door taped over for painters. Provide access for inspections. R109.1 Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15470 SW APPLEWOOD LN, TIGARD, OR, May 19, 2017 at 8:03:49 AM 97224 Record Type: Record ID: Residential - Master Permit MST2016-00499 Inspection Type: Inspector: 399 Plumbing final David Young Result: FA I L Comments: House not open for inspection, front door taped over for painters. Provide access for inspections. R109.1 Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15470 SW APPLEWOOD LN, TIGARD, OR, May 25, 2017 at 9:34:38 AM 97224 Record Type: Record ID: Residential - Master Permit MST2016-00499 Inspection Type: Inspector: 299 Final inspection David Young Result: PASS - CofO Comments: Final erosion control approved. Street tree certification received. Moisture content form received. High efficiency lighting form received. Insulation certification checked. Blower door test report received. C of 0 left on site with contractor. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15470 SW APPLEWOOD LN, TIGARD, OR, May 25, 2017 at 9:22:14 AM 97224 Record Type: Record ID: Residential - Master Permit MST2016-00499 Inspection Type: Inspector: 699 Mechanical final David Young Result: PASS Comments: Corrections complete. Violation Summary: Inspector Contractor