Permit (123) il
CITY OF TIGARD r
Mei' /i MASTER PERMIT
R COMMUNITY DEVELOPMENT Permit#: MST2016-00555
T 1GAR13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/06/2017
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Parcel: 2S 111 DA24100
Jurisdiction: Tigard
Site address: 8517 SW SCHMIDT LOOP
Subdivision: HERITAGE CROSSING Lot: 60
Project: Heritage Crossing, Lot 60
Project Description: New SF. 6/26/17 REPRINT: To add A/C unit. Placement of A/C unit must comply with
manufactures installation requirements.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 650 sf Basement: 0 sf Left: 4 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1021 sf Garage: 390 sf Front: 11.25 Smoke
Dwelling Units: 1 Third: 0 sf Right: 4
Detectors: Yes
Total: 1671 sf Value: $208,857.93 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
Drains: 0
Tubs/Showers: 2 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: 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'I 500 sf: 2 201-400 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 1671
Owner: Contractor:
DR HORTON INC. DR HORTON INC PORTLAND Required Items and Reports(Conditions)
4380 SW MACADAM AVE STE 100 4380 SW MACADAM AVE SUITE 100 1 Ersn Cntrl 503-639-4175
PORTLAND,OR 97239 PORTLAND,OR 97239
PHONE: 503-222-4151 PHONE: 503-222-4151
FAX: 503-222-1304
Total Fees: $27,704.69
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 2-001-0090.� Y.
V7i^ a1 obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: 6C.�it 4 Permittee Signature: CC 94 m0/>4��
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
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e=.
WARM
RECEIVED .
Mechanical Permit Apnlicabw 2 6 2017 1+,,_,E ,t: 11,, ;kv, ,
City of Tigard natGv iwO ,� / stir 6 e— ale 5 5
�Q P.61'''''.- ,:(25.Stt tlaulth1d.tir1nl,f3R 1' Pi.iftc'P.61''''' 5°.'''''" "v. 51 LANG DIVISt.I‘I "*'"t' Oricr Tertnit•
inspection Linc 503 639 41'5 nue Ready-14, w'* I astip r.1.16$
intcrnitt, into rt},.tr4 ot.gut tiutrertt.AiMhtd It MiRRte*trriw tdarm.nea
Xi i
Y \ E t
„ '` dzcJestftwtpctmrt[«»•tic kissed an the t s1uc of the coat
Ul New cemsitw f ion
0 i3emuliu+tn 0 hdditian.'altatat>fm'1C seCrtknt IIII minrroai,Indicate the value fr m:lad tunic neatest tl lIttn of nil
0 Other: i merhant.al materGh,cuoipmont labor.overhead,and profit.
Value.S
*1 and 2-tinnily dwelling 0 Cnmtrierctttlnndu.trim 0 Acce%tory building ! Fir sprtitttw rttmr;.w tstie1Jirt.
❑Mil Ili datn Iy 0 Matter builder 0 Other: Description l Qty.T iia. i Tx>:1
:: w A
hircwtdttianutg �_y„ I 46.73
Job site address: aJ II ����,{al- L^�� e Furnace 100440iii't,iAres'vemw} 46.75
e ir3 swtc. tP Ti_and OR Mtutswfer tQ(I,OIIQt am 1tWea?tentmt 54.91
p Heat pump 61.16
Srtitet1dg.'unt.MI.. 1 i'tuJrct mum': �I• 9 Q, Cr 55 I tl their work 23.32 �....
Cross d irtctions to job site: 1 t Nydrenic her water s3afetn 2132
Residential boiler(radiator or _
h'ttmn , 23.12
Unit homers fficI.t}pe.Writ cktxt'ic I.
_,___ in-nail,in tiucr.sasiendcd+etc_ sf..7S _r
/` /� flueF tit forel of above 32
Subdivision: r Lot 31a,: `/�i 1�� iktKM: 73.32
00...tufa untAulces,
Tax etar'ptueel no.: Water%rah i• 2332
.. ., ,,�;rv,' . •t .a rz„e' �� t., t+r�t?: .�`ti3.
: '.: t ibtPi cc.uttctt --- 3139
i1pC wM for water beater oe gm
New SFR fireplace 21:32
1 Log tighter(a' 7''.3.32 �,,
i , I r LWrrntf;prtta scout .. 13.39 .,.._...,..1
Wood frreptrre/irtsen � 233 ,_
C'hienney/lineadlaeivent 23.31
t �i7ther'
21.32
ci 3, s ,, • . ,; .'� , s xr •+ ..r° >- .sr.s.,,'4:£'."` P.atlroinn'ntalCahm00elidcca lIaBon:
Hank: 13R Horton Inc. surge hoadktthet kiwi"
e 4384 SW Macadam Ave Suite 100 �N` eywpmt rt 33,.;
Addr9
-- t C'hrdkes dt�t et rahaist 3J;:' _.
1'i1v'Statr.7lr: OR 97239 singlet-duct extsouv tbantraurtu,
... Portland, tmi«cutorkinmmm,maim founts) 23,32
rix+nc:1503 i 222-4151 TFact 1 Anitttxaa'kpaee tarts — _23.32�_
. e 4 'Nt, 3,Fc^a»r ,t, r'. CAhar. 23.37.
Bu * namc-DR Horton Inc.
ild�ek,
--- .. fee tint fear:SlA3 her etch additional _
COMnst rwnc: Emerald Weeks Fillmore.etc..
Gas pump
A 4380 SW Macadam Ave Suite 100 watlsertapa3dai'ttnithatrr ____.
City Stateflt[r,Portland,OR 97239 wow,.heater _•_ -
l'IN'” 1503 1222-4151 x1107 Fax::t 1 Fireplace —__ __�...__._.., ,
F-mall: esweeks@drhoIton.cam __ 4 mow,* W
t ei .,St :- t'iw ? . a ci-hcdewes-) ....,
Other:{3u,fInXCMriMr `
a 9w "; •
•
Adder 0t lr AiA1,r 76 j `h-7-,9_7 ., Subtotal
��1/41,.i)I, j}✓_ 4 tolirtirnunt ii fee 19(3:Ot?t
[:ivy Statr.�7.fr: pa'ft
Pion review(�Sa�of permit feel.
Phone: Fmx{*1j>�} .5.',40,I7 stem t urchatgr 112%af permit foul
CCI1 lie:: '?
[> /) Z,.41 iw'�f r it TOTAL PERMIT FEE
• Th prrmdtappite.Mas muerte It*pouts b.W ahtat>.ed wirhta-i%0
dry*eibu it brew accepted eat ew.pkfe.
,iSUlha1'I'1LdlSjgci Fw I t Fee nreevw6rUpy ret hD tri-ourgy t3uitdrag IMM n'S.i+n t34ara
Print n' 'Jar ___ r
i'n�,u 4s,e,. .1' 11.1011444,.: 3dp'Ot V I In
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CITY OF TIGARD MASTER PERMIT
71.r Permit#: MST2016-00555
2 COMMUNITY DEVELOPMENT
T)GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/06/2017
Parcel: 2S 111 DA24100
Jurisdiction: Tigard
Site address: 8517 SW SCHMIDT LP
Subdivision: HERITAGE CROSSING Lot: 60
Project: Heritage Crossing, Lot 60
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 650 sf Basement: 0 sf Left: 4 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1021 sf Garage: 390 sf Front: 11,25 Smoke
Dwelling Units: 1 Third: 0 sf Right: 4 Detectors:
Yes
Total: 1671 sf Value: $208,857.93 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
Drains: 0
Tubs/Showers: 2 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
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: 2 201-400 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 1671
Owner: Contractor:
DR HORTON INC. DR HORTON INC PORTLAND Required Items and Reports(Conditions)
4380 SW MACADAM AVE STE 100 4380 SW MACADAM AVE SUITE 100 1 Ersn Cntrl 503-639-4175
PORTLAND,OR 97239 PORTLAND,OR 97239
PHONE: 503-222-4151 PHONE: 503-222-4151
FAX: 503-222-1304
Total Fees: $27,652.33
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 th 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:� � Permittee Signature: C._ L.0—""----
Call
—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.
F
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Building Permit Applicata j CEIV s ,�
Residential f(>12 Oil III 1 ,I O\I V
114 City of Tigard ( f 14 5 2016 R� tied 572.CX� �5
M 13125 SW Hall Blvd.,Tigard,OR 97223 U+ce'D3- j°�I��/I�! `y feTmit Nc�jl —
Phone: 503.718 2439 Fax: 503.el b OF TI Plan Re'ica�—Lt.
t I•, • t.t Inspection Line. 503.639 41,5 BUILDING
�r1tii I��7tf/�DIVISION� ae Dr. 7 �Jt//L Other Permit, JQ Page fur,(�(1GG/
39VILLI?�G Date ed.Mat) not. /7 `�+: J/_ .lure S seelmenatt Information Internet: wuw.tigardimr.goc NrnifiedMetlaWt/�/ J^rYl•is VP
E- � � supplemental tntormatioa
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
a New construction 0 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 indicated on this application.
Q 1-and 2-family dwelling ❑Commercial/industrial Valuation: $ A.() v 7 -tr'
❑Accessory building 0 Multi-family Number of bedrooms: ---I
❑Master builder _ Other: Number of bathrooms.'
JOB SITE INFORMATION AND LOCATION��' Total number of floors; 're1 Q c 1 ,
Job site address: i 6 t ! �1v 1` LVu - New diecluing area: \
j '' I square feetf
City/State/ZiP:Tigard,OR 9 223 lJ Garage carport area: ' )i 0 square feet #
Suite no.: Project name ` vn til-e. Coveredporch area:
c-'Y t/ j h1 square feet 0
Cross street/directions to job site: .JI
Deck area: square feet CS
Other structure area: square feet I
REQUIRED DATA:COMMERC IAL-USE CHEC'KLIS i
Subdivision: [Lot no.: U.,) Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of ail
equipment.materials,labor.overhead,and the profit for the
DESCRIPTION OF WORE work indicated on this application.
New SFR Valuation: s
Existing building area: square feet
New building area: square feet
PROPERTY OWNER I 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:( )
Nee,
0 APPLICANT , CONTACT PERSON BUILDING PERMIT FEES*
Business name: DR Horton Inc. (Meese refer wire'Medoff)
Contact name:Emerald Weeks Structural plan revitmc fee tor deposit):
Address: 4380 SW Macadam Ave Suite I00 Ft S plan review fee(if applicable):
City/State/ZIP: Portland, OR 97239 Total fees due upon application:
Phone:(503 )222-4151 x1107 I Fax::( ) Amount received:
PHOTOVOL rAiC SOLAR PANEL Sl STEM FEES°
E-mail: esweeks@drhorton.com
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic 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 2010Oregon
Address:4380 SW Macadam Ave Suite 100
Solar lnstallalion Specialty Code checklist.
City/State/ZIP: Portland,OR 97239 Permit Fee(includes plan review
Phone:(503 )222-4151 I Fax:( )
and administrative fees): 5180.00
CCB lie.: I State surcharge(12%of permit fee): S21.60
130859
Total fee due upon application: 3201.60
Authorized signature: F j This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: /. _. I I .Fee methodologysety }Building Industry
r i .•; } t 4,.• t'{ Date:2016 b Tri-Count�
Service Board.
I:Building,Permits BUP-RESPcnnitApp.doc 62 242011 440-46131(11 02 COM'WEB I
, sC
Mechanical Permit ApplicaliEIVEP
Cit N Of Tigard .
:, ';• oie -OCT 2 52016
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CITY OFTIGAR9 - ''''
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TYPE OF WORK
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COMMERCIAL FEE` SCHEDULE - ESE CIIECKLINI
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_ _ .. ; RismEsma.mtingam/si-si ems FEES*
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DESCRIPTKEI OF WORK ! 1,..
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PROPERTY' OWNER _T.-- 0 TENAN1 I •
-- 2 I n s ironmentil r‘houst and'6'10111114mi:
._{ r 1.)1( Horton Inc. , R'frip.ff..,1 off1,-1..11,.13,,'
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.......... _.... _....... ... , 114 15 fot tiro lour NJ ill tor k"..“1,4411411:MAI,
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t '''''l 5- /IP Portland,OK 97239 .,%,.,..-,,,,,..-
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222- 4151 x1107
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esv,ve10,0,drhorton.com
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RECEIVED
Electrical Permit Application • , t„;,,i l ,( I , ', v '1LlOf Tigard OCT 2 y 7016 Received
Date/By: pwmit No.:1
t S 7,--,„z.U( coS S1312S
SW Hall Blvd.,Tigard,OR 97223 Plan Review
Irr Phone: 503.718.2439 Fax: 503 RD fir;IN
Other Permit
i,, Inspection Line: 503.639.4I75 j ty,DING
f!��(ir�t���/� l dy/By: Jurir B See Page 2 for
Internet: www.tiga[d-otgov R ltd l,Dµ7.l i'D yyl St OP shod: suppleaeatal latoratation
TYPE OF WORKPIAN REVIEW
Please check all that apply(subntita sets ofplans vitae=checked below):
®New construction 0 Addition/alteration/replacement
❑Service or feeder 400 amps or more 13Building over three stories.
❑Demolition ❑Other:
where the available fault current ❑Marinas and boatyards.
CATEGORY.OF CO8STR`IICTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
less to ground,or exceeds 14,000• ❑Cotianeroial
❑ 1-and 2-family dwelling ❑Commercial/industrial' ❑Accessory building agricultural
❑Multi-family 0 Master builder810p all other installations. lwildinga
0 Other: ❑ PumP.system. ❑haalaUation of 75 KVA or
JOB SITE INFORMATION ANI) LOCATIONger separately derived system.
❑Addition of new motor load of a"A",");","1-2","1-3",
Job no.: Job site address:C,(G V1 L } ' \,, IixH more or residential
11w:r occupancy.
b�-'" aSix or more tesideatial units. ❑Rcaaa6onal vehiak parks.
City/State/ZIP: 0 0\ ❑Health-care fealties. ❑Supply voltage for more than
0 Hazardous locations. 600 volts nominal.
Suite/bldg./apt no.: Project name: kitN (,1u c�J O (7 service or feeder 60D cps or more.
Cross street/directions to job site: OyFEE SCHEDULE
neemed,' I Qtr- I Ree. 1 Taw I
New residential single=or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.:i at 1,000 sq.ft.or less 168.54 4
Tax map/parcel no.: Fa.add'i 500 sq.R,or portion 33.92 1
Limited energy,residential
DESCRIPTION OF WORK • (with above sq.ft) 75.00 2
- Limited energy,multi-family
i3 hilt) residential(with above sq.ft)
75.00 2 Services or feeders instailadontalteration,and/or relocation
200 amps or less 100.70 2
0 PROPERTY OWNER i 0 TENANT 201 amps to 400 amps 133.56 2
N 401 amps to 600 amps 200.34 2
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:( ) 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 1 125.08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168 ser 2
Owner signature: Date: • Branch cireuits-new,alteration,or extension,per panel
v A.Fee for brands circuits with
0 APPLICANT ! above service or feeder fee,
0 CONTACT PERSON each branch circuit 7.42 2
B.Fee for branch circuits without
name: DR Horton Inc
Contact name: Emerald Weeks serviceh or fuit fee,that
breach circuit 56.18 2
,dam: 4380 SW macadam Ave Eads 'Ih circuit 7.42 2
Miscellaneous(service or feeder not included)
City/State/ZIP: Portland OR 97239 , ' Each manufactured o/orfemodular (--
dwelling,service and/or feeder 67.84 2
Phone:(5U3) 222-4151 Fax::( ) i Reconneaotily 67.84 2
E-mail: - Pump or irrigation circle 67.84 2
• CONTRACTOR i signor outline lighting 67.84 2
Signal circuit(s)or limited-energy
Business name: %St/4 14.t - Sr l 4 'G "�'� panel,alteration,orexte cion. Paget 12
!/ v ..[.�� r! Each additional inspection over allowable is any of dee above -
Address: 2 go y/ //E 6 1 fL I/ !iv Additional inspection(1 hr min) 6625/hr
City/State/ZIP: \4 h c 0 t t ye U. W4, 9I6 C/
Investigation(1 hr mini 662 hr
Phone:(3 ✓ ' f_ 7-..51)., Inderal plant(1 hr min) 78.18/hr
Fax:OCa) SSC— 96'60 Inspections for which no fee is
CCB Lic.:I' 2.6— 9 Electrical Lic.:. Suprv.Lie.:
specifically listed(%hrmin)
90.00/hr
Z 3,7 �?43 $ ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:%; j) Subtotal:
Ie4 rPlan review(25%of permit fee):
Print name:C ` f Q Date: State surcharge(12%of
� Permit fee): _
Authorized signature: ���d "r TOTAL PERMIT FEE:
This permit application expires ifs permit is not obtained within 180
Print name: Date: days atter it has been accepted as cow
* Number of inspections allowed per Pena
L•ffiaaadiusTera itsWIC-Pe miaApp
440461 5r(1 I/05/COM7VVE8
RECEIVED
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information p C T 2 5 2016 ST.zv/ -00
Limited Energy Permit Fees: CITY OF TIG Renewable Energy Permit Fees:
. `'�nf'
RESIDENTIAL WORK ONLY: t1SIO'V
FEE SCHEDULE
Fee for all residential systems combined: $75.00 tion Renewae� QF.�h 7'mal
»able electrical energy systemm s:
Check Type of Work Involved: k a or les l l;,'0 ,
5.01tu15f,ra I33.56 _
❑ Audio and Stereo Systems*
15.01 to25 ksa 2i)i134
Wind generation systems in excess of 25 kva:
Fl Burglar Alarm
25.01 to 50 kta _
3fII.IW
Garage Door Opener*
50.(il In 1U0 kca 552.26
i
>100 kra(fcc i n a.cord-mu
with(tAR 9l a-309-0(14u) ._'r
' [X Heating, Ventilation and Air Conditioning
Solar generation systems in excess of 25 kva:
System*
rnch additional kva wcr_5 7,12 ;
n Vacuum Systems* >11ii)k0a-noadditional charge Ohl 3
Each additional inspection over allowable in any of the above:
Other: Each additional inspection iv
charged at an hourly(I hr min) 66.25 hr
Inspections for which nn fee is T_
specifically listed( hr mini 'kw() hr
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page I):•
Number of inspections allowed per pormil.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
H Boiler Controls
n Clock Systems
E Data Telecommunication Installation
H Fire Alarm Installation
I j HVAC
n Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control*
❑ Medical
E Nurse Calls
• Outdoor Landscape Lighting*
n P• rotective Signaling
n O• ther:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
Bui;dinf Fume,['LC PomilApp t:LR ERF.0-c Rr u`:1",•''I
Plumbing Permit AnnlicatioRECEIVEP
Building Fixtures t olz oft lc I. t St. OM t
City of Tigard 0 C T 2 52 016 Received ppm,t 5r2,�t�S3�
111111 0 13125 SW Hall Blvd.,Tigard,OR DawBx
I Phone: 503.7182439 Fax: 303.5 O d I Nan '�f w
g�L} ! Drasay: Other Perini:No.:
inspection Linc: 303.639.4175 rrlGnRu lulls: B Sae Paget forinterrut: www.tigard-or.gov BUILDING " �oified/Method:
%pe n man'tatorootios
,.. ,., TYPE OF WORK. REt' BCHRDUL ,` r
0 New construction 0 Demolition For spedallnformaioa ore checklist
Description r Qtt. I Ea. ( Total
0 Addition/alteration/replacement 0 Other New 1-2-family dwellings(includes 100 ft for each utility connection)
CATEGORY OF CONSIRUICPION SFR(1)bath 312.70
0 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
0 Accessory building 0 Multi-family
SFR(3)bath , 500.32'
Each additional bath/kitchen 25.02
0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOS'BRE,1NT°.RMAVO1Y',AND LOCAT'1ON Site utilities:
•lob site address:C,(1�\> LOA)
- " V y�V it A A t( Catch basin a aces drain 18.76
V Drywell,leach line,or trench drain 18.76
City/State/ZIP:
5uitelbldgdapt,no.: Project name: /�,�
Footing drain(no.linear ft.:-_� Page 2
1 AA? bbJ I Manufeaurcd home utilities 50.03
Cross stroWdirections 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: ( Lot no.: i2,(�j Fixture or item:
Tax Inap/parset no.: v Backflow preventer 31.27 1
Backwater valve 12.51
Di83CRQ71IQN OF:WORK .. Clothes washer 25.02
Dishwasher 25.02
V�_ Drinking fountain 25.02
Ejectors/sump 25.02
•0 PHOPFAIrf.,o $ER _ . •"I ' 0 roanExpansion tank 12.51
;
Name: �,>Z.V (An,, ,N„C.,
l - . J Fixhrcdsewer cap 25.02
Floo<( --) &O0lOta-t y ' '"�V�-/ Garbage drai oor ainklhub 25.02
Address: disposal 25.02
City/State/ZIP: ( ()L Ci -10_ Hose bib 25.02
Phone:0-13) t`a4
- \t \ Fax:( ) Ice maker 12.51
0 APPLICANT I Cl CONTACT PERSON lnterceptorigrease trap 25.02
Business name: � ,___ ktpArryl ,til iJ Medical gas(value:S ) Page 2
-Contactname: �-_\+�\ 101 ^UOCe. � Prima 12.51
Roof
Roof drain(cornmeal) 12.51
Address: Sink/basin/lavatory 25.02
City/StateIZlP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pen 12.51
E-mail: e -31k)-606 6�- Qk,V vi oV f W' .C CJtVl Urinal 23.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:EDWARD MULLEN PLUMBING Water piping/DW V 56.29
Address:1601 SE RIVER ROAD Other: 25.02_
City/StaterLIP:HILLSBORO,OREGON 97123 Sabtoal
Phone:(503)640-0113 Fax:(503)640-4483 Minimum permit fee572.30
CCB Lia:94689 Plumbing Lic.no.:34-260PB
Plan review ( of permit fee)
Sate surcharge(112%2%of permit fa)
Authorizedsignature: Add >/,440" TOTAL PERMIT FEE *----
Print
-^Print name:RAY MULLEN Date: This permit application expires ifa permit b set obtslaed within ISO days
after it has bees accepted as complete.
'Fee methodology sex by Tri•Counuy Building Industry Service Board.
I:+evddioa+►aaitsWLMU-MaitAOp.doc 10101/09 440.46161tlofovCOMM'Ea)
V
City of Tigard
IIIr COMMUNITY DEVELOPMENT DEPARTMENT
C
T 1 c A R D Building Permit Review — Residential
Building Permit #: /f457-,2. /6,j - 00 m.--
Site Address: i _Tch //
Project Name: .p,,n:• . i earn , /pop Lot #: --(CD—
(New
-,C LL(New dw• =subdivision name;/: :•. or Alteration=last name of owner)
Planning Review
Proposal: 41.x,)
12(Verify site address/suite# exists and actio in permit system.
giver Terrace Neighborhood: 1 No ❑ Yes,See River Terrace Review Addendum Attached
Sit Plan Elements: A
ree(3)copies of site plan ...
: •sting structures on site
�te plan must be on 8-1/2"x 11"or 11 x 17"paper V ootprint of new structure(including decks)with finished
rawn to scale(standard architect or engineer scale) or elevations
VIorth arrow Utility locations(required for new,may apply for additions)
to address,project or subdivision name and lot number a l'e cation of wells/septic systems
pplicant information(name and phone number) Mil:' sting trees to be retained'with drip line,and tree
1otecf dimensions and building setback dimensions
tion measures
t area,building coverage area,percentage of coverage andreet tree size,type and location
/impenrious area(applicable if R-7,R-12,R-25&R-40) Street names
OA Property corner elevations(2 foot contour lines if more than
114((ff�oot differential)
'\ lean Water Services-Service Provider Lett (lot platted prior to 9/10/1995):
Veequired: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No
ublic Faciliti Improvement(PFI)Permit:
equired: Yes,applicant was notified ❑ No Applied For: ® yes ❑ No,stop intake
Land Use Case#: »�)/S. 00610(€ 9/1/&20/
Zoning: D2_IQ
,,?
'Required Setbacks: Front A Rear / Side Street Side /�-1'/y (�
Garage
( QLandscape Requirement: V % III `C
of Coverage Maximum:
Building Height:viir
Maximum Height ' Actual Height t 1�It
isual Clearance
asements
11.,fr bensitive Lands: ❑ Yes ❑ No Type
FA Urban Forestry Plan
❑ Conditions " "prior to issuance f buildingermit
Notes: 1161/ 0 - ` L'22 ,Y /l )1t-ems✓ riL) 6!/201- I SC742/7
ifi
Approved By Planning: — m
a.-� Date: !j M
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved •
Revision 3: ❑ Approved ❑ Not Approved
1:\Building\Forms\BldgPermitRvw_RES_091216.docx
Building Permit Submittal
Original Submittal Date: /O 4Z ch C
Site Plans: # 3
Building Plans: # 3
Building Permit#: nter building permit#above.
Workflow Routing: lanning C Engineering -Permit Coordinator uilding
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: -,��, AO 1. ,d,4' .....e.',....,- Date:
_.� .... _ _. / __ , ,,.
Engineering Review
Slope at building pad: _ 4z
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 No
Assess Water Quantity Fee in-lieu: ❑ Yes No
LIDA Facility on lot: ❑ Yes No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: 4" TJ Date: st-/7
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: 0 Approved 0 Not Approved
Permit Coordinator Review
,i1 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:
CSYSDC Fees Entered: Wash Co Trans Dev Tax: Ilj Yes ❑ N/A
Tigard Trans SDC: ® Yes ❑ N/A
Parks SDC: 'Yes ❑ N/A
OK to Issue Permit
Approved by Permit Coordinator: (,0�./.00 Date: I a a 3 _(
I:\Building\Fonns\BldgPermitRvw_RES_091216.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8517 SW SCHMIDT LOOP, TIGARD, OR, 97224 July 24, 2017 at 8:49:31 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00555
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
CNCL
Comments:
Inspection cancelled by contractor.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8517 SW SCHMIDT LOOP, TIGARD, OR, 97224 July 24, 2017 at 11 :04:01 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00555
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8517 SW SCHMIDT LOOP, TIGARD, OR, 97224 July 24, 2017 at 11 :03:05 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00555
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8517 SW SCHMIDT LOOP, TIGARD, OR, 97224 July 26, 2017 at 8:23:25 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00555
Inspection Type: Inspector:
299 Final inspection David Young
Result:
PASS - CofO
Comments:
Correction from previous inspection complete.
Final erosion control approved.
Street tree certification received.
Moisture content form received.
High efficiency lighting form received.
Blower door test report received.
Insulation certification checked.
Violation Summary:
Inspector Contractor