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Permit (105) CITY OF TIGARD MASTER PERMIT 712." COMMUNITY DEVELOPMENT Permit#: MST2016 00509 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/01/2017 T[C� 9 Parcel: 2S111DA18600 Jurisdiction: Tigard Site address: 8739 SW SCHMIDT LP Subdivision: HERITAGE CROSSING Lot: 5 Project: Heritage Crossing, Lot 5 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 5 First: 1311 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 26 Bathrooms: 3 Second: 1639 sf Garage: 401 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2950 sf Value: $351,397.09 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: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 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'I 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 2950 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: $30,632.82 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 tofollow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090.Y btain. opy. e rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By. _ Permittee Signature: SI;3&::. 9J Vim' - a 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. Building Permit Application 3Z7 4e- Residential i-0-1 ,:1--ii - 1 =.w- 1012 on l('I 1 ‘,1 ()NI 1' City of Tigard RoaTc. ed (-& Penin N 13125 SW Hall BIVd.,Tigard,OR 97223 U .. 1 9 fit`to /Of(` `� / /"` � ��V��� Plan Rei iru )�/ Phone: 503.718 2439 Fax. 503.598.1960 Date Dy. `Q aQ ' 1 6 tither Permit c 74 2 c- Inspection Line. 503.639 4115 i ; } (� lGI/ ‘,. bale Read)By J r ♦a Set Pagt 2 for Internet: www.tigard-or.gov -- ; Notified Medmd: I,L/'?/it, Pr ...,;74g.._ Supplemental Information 4,FyyNA I 2c„tir- TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DM ELLING 311 New construction 0 Demolition Permit fees*arc based on the taiue of the work performed. Indicate the value(rounded to the nearest dollar)of all 0 Addition/alteration/replacement _ 0 Other equipment,materials.labor,overhead,and the profit for the CATEGORY OF CONSTRUCTIO)\ work indicated on this application. �-} Q 1-and 2-family dwelling 0 Commercial/industrial Valuation; $ Z .C. 3 7 J 1 ❑ Accessory building 0 Multi-family Number of bedrooms: / ❑Master builder 0 Other: Number of bathrooms:3 JOB SITE INFORM ATION AND LOCATION r Total number of floors:. 3 3 ) Job site address: b 7ba ,./ jcih+,, , t"���ref, New dwelling area:�CfcU square feet City/State/ZIP:Tigard,OR 97223 Garage:carport area: (,/v) square feet Suiterbldg./apt.no.: Project namt 1 - C U 1 Covered porch area:,f_5 square feet i 0 g Cross street/directions to job site: Deck area: square feet)3 1 1 Other structure area: square feet ) 11 REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Lot no.:ex— 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 SFR Valuation: Existing building area: square feet New building area: square feet 11 PROPERTY OWNER 0 TENANT Number of stories: Name: DR.Horton Inc. Type of construction: Address: 4380 SW Macadam Ave Suite 100 Occupancy groups: City/State/ZIP:Portland OR 97239 Existing: Phone:( 503) 222-4151 Fax:( ) New: 0 APPLICANT a CONTACT PERSON BUILDING PERMIT FEES* Business name: DR Horton Inc. (Meese refer to_fee ubedalJ Structural plan review fee or deposit): Contact name:Emerald Weeks FLS plan review fee(if applicable): Address: 4380 SW Macadam Ave Suite 100 Total fees due upon application: City/State/ZIP:Portland, OR 97239 Phone:(503 )222-4151 x1107 Fax::( ) Amount received: E-mail: esweeks@drhorton.com PHOTOVOLTAIC SOLAR PANEL SI STEM FEES. CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted PhotoVoftaic 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 2010 Oregon Address:4380 SW Macadam Ave Suite 100 Solar Installation Specialty Code checklist. (-4/Stale/ZIP: Portland, OR 97239 Permit Fee(includes plan review S180.00 and administrative fees): Phone:(503 )222-4151 Fax:( ) State surcharge(12°fie of permit fee): S21.60 CCB lie.: 130859 Total fee due upon application: 3201.60 Authorized signature: This permit application expires if a permit is not obtained I } {Date;2016 40.46137(1 lwithin 180 days after it has been accepted as complete P ii, ( "Fee methodology set by Tri-County Building Industry Print name. i� r t t _._ Service Board. 9uildingRemits BUP-RESPcnnitApp.doc 02 24.2011 4 :tl2 COM'WEB} NI echa nicat Permit App8 ��t�/,_ -' /"xn/n' / i `/ 0\9 '1 • ��LK _��_ r � ' .~ City wfU ,�°� , . ���� �. �� « ,«,�~� ,*ox»a i.�~u`'e,`-:��T 1 � r��� -F���'��------ --- ` "^""' ----- — � ,*°^ m. /"�~ /.. "^ ° ."~ ^ � ~ ^ *" _ ___ . Iti,pat‘holt� *^^=v-- ' . —' m m�"^ ^^~ ''p"^'^p^ �;KT� ~� ) /� ,� ` | `~`^``.^~ � | �r�"°~^'*~^~'~^ . ~ ^ ' ~ _• �! ____ _______� --..___. — — ---- xYoEmmWORK _' � ~------~- FEE* � ----- '� ------ ' --- `^x�"� i�°^xw- �'�°*.°"+.^~.'Ott:a`, ���*° amv^°'^m []xou^^w^wnw""�r ~n»"'' . ' r°`° . u^3 ^em°`a°'""~�/*«'="`°�^�' ~'| � `_ �� ` / . []0,o^�'�" ''/^v' • r � --� ==+^= 2`1 __ t _—__- � � , ---_ __-- ______- _ CATEGORY OpCmNSnR��� I'__ � __ __--------] LEQUIPMENT i lb / ^u ` | w x 0/"w.**tat°�° ,u' 0 \ �`—,` ~"w"4 . ��e�^r_ ._ _ , �����, __ JOB SITE INFORMATION AND LIX.ATION 1 __-_-----_'L��_ ` ! / ~ �~^�u��og _----_ l DESCHIMON OF WORK -, Vs,kt'"9pI., 11),i; ti i + ' '.z�;^ ,� . I ‘Jdfvss 4380 SW Niacadam Ave Suite 100 , ,��c�r-z / 4^ii�-TCc. ~`~“:.1,3 _- -_ . t=.= 4 , _ ^ ( . _ � , ,,~eo„ ue / / ` __L_ 7 � ! `-`~ ~ -- --�| ^ m.Al -------- -�r - """°=` | 1.N.- ' � _L^._�-__^___• -.��_~ ~+__'^~~~ . , ^__ _ _ ��� w_ , _-" ^^=.• . ^ ` 14 ~ ' L - �*��'�� . *",,~, _______ ' n'nt,�^�- �* . ,/ ^~ it m`~,, "''~ ^ , ~ • Electrical Permit Applicatle 'k- i (.i,r 2 i II( t_ t `,t i U v t 1 111111 , City of Tigard Received Datdlly Permit No.: L/ -/,• ie 13125 SW Nall Blvd.,Tigtud OR 972 ;T l 9 ?,�;,� Plan ReviewPhone: 503.718.2439 Fax 503.598.1960 Date/By: Other Permit ,) Inspection Line: 503.639.4175 ± #`i,, ` . late Ready/By: Sufis: 1 0 SSee Page 2 for Internet www.tigard-or.gov ti Notified/Method: Supplemental Information • TYPE OF.WORIiCi ®New construction 0 Addition/alteration/replacement nt Please check all that apply(submit sets of l ❑Demolition elow): °service or feeder 400amps or more plansw�checked hies. ❑Other: ❑Buildingover three stales. where the available fault current 0 Marinas and boatyards. CATEGORY-OF CONSTR/7crION exceeds 10,000 amps at 150 volts re °Floating bondings. lessCII-and 2-family dwelling 0 Conimercial/industrial- 0 Accessory building - rot or e><e t4,000 ❑eoritmeeiat-cess agricultural ❑Multi-family 0 Master builder =Infix all other installations. buildings. ' ❑Other: ❑Fire pump. ❑installation of 75 KVA or JOB SITE INFORMATION AN!) LOCATION 0 Emergencysystem. targe separately derived system. ❑Addition of new motor load of ❑"A","E","1-2,"1-3", Job no.: Job site address: 71i"1 �t� Lop , _ loollP ormore. occue racy. J °Siz or more m re: tial units. ❑Recreational vehicle parks. City/State/ZIP: -F;6,,,4- fu 2 9 -23,y3 ❑Hahh-care fealties. ❑Supply voltage for more than Suite/bldg./apt.no.: / Project name: ' - CA, ,,,...3 ❑Swviccedo r feeder 600 on more. 600 volts nominal. Cross street/directions to job site: F> SCHEDULE ' • Derei.des 1 Qtr. I Fee. . I Tectal I • New residential single:or multi-family dwelling unit. Includes attached garage' Subdivision: Lot no.: 3- 1,000 sq.R.or leas 1 168.54 4 Tax map/parcel no.: Ea add'I 500 sq.R.or portion "I 33.92 l DESCRIPTION OF WORK Limited energy,eeeidesatial 75.00 2 (with above sq.it) Limited energy,multi-family 76.00 residential(with above sq.Rt) 11 2 Services or feeders installation,alteration,and/or relocation ❑ PROPERTY OWNER t 200 amps or less 100.70 2 I 0 TENANT 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 amps 200.34 2 • Address: 601 amps to 1,000 amps 301.04 2 Over 1,000 amps or volts 552.26 2 City/State/ZIP: Tem services or feeders installation,alteration,and/or ocation Phone:( ) Fix:( ) 200 amps or less 59.36 I 1 Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps i 125.48 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 to 599 amps 168.54 2 Owner signature: • Branch circuits-new,alteration,or extension,per panel Date: v A.Fee for branch circuits ways 0 APPLICANT I 0 CONTACT PERSON above service or feeder fee, 7.42 2 Business name: DR Horton Inc • each branch ci cuit B.Fee for branch circuits without feeder Contact name: Emerald Weeksbranch or fee,first56.18 2 ,dam: 4380 SW macadam Ave • Each branch circuit 7.42 2 Miscellaneous(service or feeder not induced) City/State/ZIP: Portland OR 97239 Each manufacturedormodular 6784 1 2 5U3 2'l1-4191 dwelling,service and/or feeder Phone:( ) I Fax::( ) ✓ Reconnaxonly 6784 2 . A.._Y 2. E-mail: Pump or irrigation'circle 67.84 • • CONTRACTOR ;- Sign or outline lighting 67.84 2 Signal circuit(s)or extension. Business name: �'04 1;�_�� g/����G taadon,oreactensiaa. Page 2 2 Address: o /t'� d it. Each additional inspection over allowable in any of the above 2/�o A/E- tp� 1 ,/. t,,� _l_i ..'/ Additional inspection(i hr min) 66.25/hr City/State/ZIP: '4 V7 C t�t4 1/ U. V v4, ,f b ( Investigation anion(1 hr min) 66 25/hr Phone:(3� .�--` 9 Ef a) 3 9 Industrial plant(1 is mo) 78.18/hr ,...67/f— � Fax: b � �j�j G� Inspections for which no fee is specifically listed°I hr min) 90.00/hr CCB Lic.: Z�I"�9 Electrical Lia:•62s30 Lic.: /775 s ELECTRICAL PERMIT FEES Suprv.Electrician signature,required:ey�/ jl r� Subtotal: Plan review(25%of permit fee): Print name:Ch c Sti, 6 R 6� --11 : I Date: - State surcharge(12%of pawn fee): Authorized signature: • TOTAL PERMIT FEE: This permit application expires ifs permit is not obtained within 180 Print name: days alter it has been accepted as complete. V I Date: * Number oinspections allowed Per permit. IMuadiamPerteitruitopamltAnji 440.4615T(1 r/os/COe/w88 Electrical Permit Application-City of TigarcRi:::i-' Page 2-Supplemental Information OCT 1- f' Limited Energy Permit Fees: Renewable Energy Permit Fees: .„. RESIDENTIAL WORK ONLY: FEE SCHEDULE Ikuription Qtv. Fee for all residential systems combined: $75.00 Renewable electrical energy systems: 5 kva ors I o0,70 Check Type of Work Involved: les 2 5.01 to 15 iva 133,56 El Audio and Stereo Systems* 15.nito2siod ME 21)0.34 Wind generation systems in excess of 25 kva: E Burglar Alarm 25.01 lo 50 kva 301.04 5001 to IOU kva 552.20 I XI Garage Door Opener* >100 kva(fce in accordance 552.20 with(tAR41h-309-004U) lx Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* rach additional kva over 25 3 E Vacuum Systems* . 00 lo a-no additional charge Each additional inspection over allowable in an-y of the al;o—V:— [__ Other: Each additional inspection ic 66.25 hr charged al an hourly(1 hr min) Inspections for which no Ice 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 inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: Ej Audio and Stereo Systems D Boiler Controls 111 Clock Systems • Data Telecommunication Installation LI Fire Alarm Installation II HVAC E Instrumentation LI Intercom and Paging Systems n Landscape Irrigation Control* fl Medical E Nurse Calls Li Outdoor Landscape Lighting* E Protective Signaling Fl Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I.BuiIdm1 Pamirs I LC PotnitApp LLR ERILJo: Ito W.I- Plumbing Permit Applica .m. Building Fixtures City of Tigard . l 1,,,t Receis d Permit N III 13125 SW Hall Blvd.,Tigard � ' DatdBy' S Phone: 503.718.2439 Fax 2 ! Plat Review per Permit No.: I ection Line: 503.639.417 r € t',• ' �eRy T 1 G:1 k t) � Date Ready/By: Judi: R See Paas 2 for Internet: www.tigard-or gov Notified/Mahod: , Supplement'Informatics 'a,. TYPE OF WORK .Ill a $t'1 IDULZ • :_:1;. , , ❑New construction ❑Demolition For spedal Information use checklist Description I (It I Ea. I Total ❑Addkion/alterationtreplecement 0 Other New 1-2-family dwellings(includes 100 R.for each utility connection) CATEGORY OF COPtsi'RU( noN SFR(1)bath 1 312.70 ❑I-and 2-family dwelling 0 Commercial/industrial SFR(2)beth 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 50032 Each additional bathAdtehen 25.02 ❑Master builder 0 Other: Fire sprinkler sq.ft.) Page 2 JOB'$IFE aNIFOR14 :AND LOCATION She utilities: • lob site address: J 73C1 �w jejirlJwciAA' " Catch basin or area drain 18.76 City/State/Z1P: .3, oe 7a�3 Drywall teach tine,or french drain 18.76 I l r� y Footing drain(no.linear ft.: ) Page 2 Suite badgJept.to.: 1 Project name: bb1)1� Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_ J Page 2 Storm sewer(no.linear ft.:_,__) Page 2 Water service(no.linear ft.:__,_) Page 2 Subdivision: 1 Lot no.:if. Fixture or item: Tax map/parcel no.: Backflow prevents 31.27 OF DBSCR>!!'1'IONt :WORK - Backwater valve 12 51 - Clothes washer 25.02 Dishwasher 25.02 '' SV(2,__ Drinking fountain 25.02 Ejectors/sump 25.02 O , C01.1!IER • . -1 0 Expansion tank 12.51 i' ` Fixture/sewer cap 25.02 Name: �� trYcS \ 1��-- ,^ ' J25.02 Address: `.A./ C(: 3 %.A.9\_.0 DtLl "7C" Floor drain/floor e poral hub 25.02 City/State/ZIP: 6.iiz, O' ', -la Hose bib 25.02 Phone:' )) e] _\ X. Fax:( ) Ice maker 12.51 -.1 • 0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: --\>?___ \ i to Medical gas(value:S ) Page 2 �/ Primer 12.51 Contact name: \,ti�f�41 01 liljeQ ' Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 25.02 City/Stata/ZIP: Solar units(potable water) 62.54 Phi:( ) Fax::( ) Tub/shower/shower pan 12.51 E-mail: e 'c�w tx,16-5(9, ok,V VI DV t W) ,1....n oW1 Urinal 25.02 Water closet 25.02 . • =CON[RACTOR 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 72.50 Phone:(503)640.0113 Fax:(S03)640-4483 Plan Minimum permit fee:permitfee) review (25%of fee) CCB Lie:94689 Plumbing Licno.:34-260P8 - State surcharge(12%of permit fee) Authorizedsignature: /I /, Je, TOTAL PERMIT FEE fib peewit application expires if s permit b sot obtained widtlm ISO days Print name:RAY MULLEN Date: after it has bees accepted as complete. •Fac methodology set by Tri-County Building Industry Barrio Board. 1:15uddieaPaeit►VI.MU4eVMtApp.doe 10/01/09 440.4016T(I0/02KOMAWES) City of Tigard •71 q COMMUNITY DEVELOPMENT DEPARTMENT T l c RD Building Permit Review — Residential Building Permit #: 4/(577-0/C. — 009,9' Site Address: 97 3C1 ,S'w &Chni;ji.- Loo ( Project Name: .1 tri &c E_- C ru s 4; t-C1 Lot #: 5 (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: 1.,1 e de dA 48 SF L Verify site address/suite# exists and active in permit system. River Terrace Neighborhood: No CI Yes,See River Terrace Review Addendum Attached Site Plan Elements: fgThree(3)copies of site plan )2rExisting structures on site kSite plan must be on 8-1/2"x 11"or 11 x 17"paper [RFootprint of new structure(including decks)with finished [ Drawn to scale(standard architect or engineer scale) floor elevations North arrow Utility locations(required for new,may apply for additions) Site address,project or subdivision name and lot numbertocation of wells/septic systems 1?Applicant information(name and phone number) Existing trees to be retained with drip line,and tree ®Lot dimensions and building setback dimensions protection measures tia'Lot 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) I,street names OProperty corner elevations(2 foot contour lines if more than 4 foot differential) Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified k No Received: ❑ Yes ❑ No Public Facilities Improvement(PFI) Permit: Required: ,'Yes,applicant was notified ❑ No Applied For: ,l Yes ❑ No,stop intake ALand Use Case#: 51. 3 �-U LS — y (5 , ' Zoning: IL_ 7 Required Setbacks: Front 1 S Rear ! 5 Side S Street Side 1,0 Garage 'Zo pr Landscape Requirement: 20 0/0 g Lot Coverage Maximum: 160 % ,i Building Height: Maximum Height ?S P+ Actual Height 2 n jZ Visual Clearance Z Easements 71 Sensitive Lands: ❑ Yes ❑ No Type gf Urban Forestry Plan Cil Conditions "Met"prior to issuance of building permit Notes: Ens j re, (A fl 11 too r1 3 ,,,re, one p t'1 o r to .14 v rit,-1 u.- Approved By Planning: 1S.,,bra-c", Date: i°°f l q / 110 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\B1dgPermitRvw RES 091216.docx Building Permit Submittal Original Submittal Date: Site Plans: # 3 Building Plans: # J Building Permit#: 'Enter building permit#above. Workflow Routing: Zr Planning Engineering 'Permit Coordinator itr Building Workflow Sign-off: 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: �x,�SA( i, Date: //4,51-7/,c. yr:�,•: _�_ ,���� .� ��ss�_ �� ., ,� Engineering Review 07 lope at building pad: ❑ Conditions "Met"prior to issuance of building permit ❑ Easements (encroachments)per engineering conditions of approval and plat .Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes Af:rNo Assess Water Quantity Fee in-lieu: ❑ Yes 4fr No LIDA Facility on lot: ❑ Yes .ErNo ❑ NOT Approved by Engineering: Date: Notes: J Approved by Engineering: /f 1 K�— lr� Date: ( ( 2-`? / i Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: 0 Approved 0 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: r-'ir-%f C Fees Entered: Wash Co Trans Dev Tax: /130)(es ❑ N/A Tigard Trans SDC: WYes ❑ N/A Parks SDC: I Yes ❑ N/A OK to Issue Permit Approved by Permit Coordinator: fi Date: // /l4) 1:\Building\Forms\BldgPeI mitRvw_RES_0912 16.docx City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 8739 SW SCHMIDT LOOP, TIGARD, OR, 97224 June 23, 2017 at 10:00:33 AM Record Type: Record ID: Residential - Master Permit MST2016-00509 Inspection Type: Inspector: 299 Final inspection Aaron Cillo-Gobel Result: PASS - CofO Comments: Final erosion control passed Street tree certificate received Moisture content form received High efficiency lighting form received Insulation certification verified Blower door and/or duct seal test certificate received C of 0 left on counter. Violation Summary: Inspector Contractor