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Permit (46) CITY OF TIGARD MASTER PERMIT 2: COMMUNITY DEVELOPMENT Permit#: MST2016 00587 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/27/2017 T€ Parcel: 2S111DA24200 Jurisdiction: Tigard Site address: 8535 SW SCHMIDT LP Subdivision: HERITAGE CROSSING Lot: 61 Project: Heritage Crossing, Lot 61 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 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 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1 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: 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 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: $27,812.54 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 0 R 952-001-00'. 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: �,I G Permittee Signature: Se" ./p/./?Ctpc)2/ 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 S °2 6e— , / /,1 4,0 t Residential 1 City of Tigard �� Rcxciad .7„1. 4. 13125 SW Halt Blvd.,Tigard,OR 97323 V + 1 Date,[ty: (A/,1 7 1� • Pemdt N5.7- UC ��x� • Phone; 503.718 2439 Fax: 503.59 1 Plan Iteriea S t.. F. #g i ' ow By: I- I 9- 1 Other Permits - t7 t , t Inspection Line. 503.639 4175 S , b:,, int �� �r i. Date head)lir: toric Internet: www.ligard-or.gov 3L D! -j. 3'v(-ouI's. Notified Method: /347 7 -- I S Page2for _.__ 'ted// Sepplementallnformation et rry./ .x-- ..-.-4.-+_- TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DH'ELLING 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 work indicated on this application. Q 1-and 2-family dwelling 0 Commercial/industrialValuation: S �J 6 0 7 D Accessory building ElMulti-familyNumber of bedrooms; 3 V ,/ ❑ Master builder 0{hirer: Number of bathrooms 3 JOB SITE INFORM 4TION AND LOCATION Total number of floors; a a J 3 3_ Job site address: i.. Lop New duelling arca: 17t/ square feet City/State/ZIP;Tigard, OR 97223 �+ Garageicarport arca: JWU square feet Suitebldg.Japt.no.: Project name 1- - �p t ro Coveredporch area: fl"`" r/Y 1� �11 Ci loll square feet I 0 3 Cross street/directions to job site: J Deck area: square feet 7 0 Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Lot no.: (.0' 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: S Existing building area: square feet New building area: square feet in 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:( ) Ne15: _ ❑ APPLICANT r CONTACT PERSON BUILDING PERMIT FEES" Business name: DR Horton Inc. (Please refer rofee schedule) Contact name:Emerald Weeks Structural plan review fee(or deposit): Address: 4380 SW Macadam Ave Suite 100 as plan review fee(if applicable): City/State/ZIP: Portland, OR 97239 Total fees due upon application: Phone:(503 )222-4151 x1107 Fax: :( ) Amount received: PHOTo�oD.ralc SOLAR PANEL s�STEM FEES' E-mail: esweeks@drhorton.com CONTRACTOR Commercial and residential prescriptive installation of 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 2010 Oregon Address:4380 SW Macadam Ave Suite 100 — Solar Installation Specialty Coda checklist. City/State/ZIP: Portland, OR 97239 Permit Fee{includes plan review Phone:(503 )222-4151 Fax:( ) and administrative fees): S180.00 State surcharge(12%of permit fee): $21.60 1 CCB lie.: 130859 I Total fee due upon application: $201.60 Authorized signature: .. ' � This permitapplicationexpires i t 4 , ex if a permit is not()Maine/ within 180 days after it has been accepted as rumple. Print name; 11' ,f ! ''y'" Date:2016 "Fee methodology set b Tri-Count Building Industry t z t `: � � t r'',.( y Y g Service Board. I:Building,Pcr•mits`BUP-RESPermitApp,doc 02 24-2011 440-4uI3Tt l 1 02 COM'WEB' r , Building Permit Application Checklist T One- and Two-Family Dwelling hole oiFicl: 1 sig: oyl.V r r City of Tigard Recti h ca Pcnnil Nn.: nate lly: _ II 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits: • is Phone: 503.718.2439 Fax. 503.598.1960 24-Hour Inspection Line: 503.o39.4175 0 Ekctrical 0 Plumbing ❑ Meclunical r I c n I D Internet: www.tigard-or.gov 0 Other: t THE FOLLOWING ITEMS ARE REQUIRED FOR /'LAN REVIEW les No I Land use actions completed. See jurisdiction criteria for concurrent reviews. • ■ _ 2 Zoning. Flood plain,solar balance points.seismic soils desjgnation,historic district.etc. i 0 0 3 Verification of approved i lat/lot. II 0 0 4 Fire district approval required. Name of district: Tua atin Va ey 5 Septic system permit or authorization for remodel. Existing system capacity _,. 0 ❑ 6 Sewer permit.. II 0 D 7 Water district approval. ■ ❑ ~ E:3- 8 8 Soils report. Must carry original applicable stamp and signature on file or with application. • 0 0 9 Erosion control 0 plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- • ❑ ❑ basin protection.etc. 10 3 ,Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state m ❑ L-1" _ „ building codes. Lateral design details and connections must he incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot he completed if copyright violations grist. t 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if m ( ❑ ❑ there is more than a 441. elevation differential.plan must show contour lines at 2-ft.intervals); location of easements and driveway;footprint of structure(including decks); location of wells'septic systems;utility locations;direction indicator; lot area;building coverage area;percentage of coverage: impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads.connection details,vent size illE 0 ❑ and location. 13 Floor plans. Show all dimensions.room identification,window size,location of smoke detectors,water heater, 01 0 0 furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches abovegrade,etc. 14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- • 0 0 floor,wall construction.roof construction. More than one cross section may he required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction.thermal insulation,etc. _ 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. IQ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building em elope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- • ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and hearing I ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement ofrcbar. For engineered © T❑ ❑ systems,see item 22."Engineer's calculations.” 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists II ❑ ❑ over 10 feet long and(or any beam='joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. _ _ I gi 0 0 21 Energy Code compliance. identify the prescriptive path or provide calculations. A gas-piping schematic is required il ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided.(i.e.,shear wall,roof truss)shall he stamped by an engineer or • ❑ ❑ architect licensed in Ore.on and shall be shown to be a.•licable to the roject under review. .JURISDICTiON.AL SPECIFICS 23 Three(3)siteplans are required for Item 11 above. Site plans must be 8-1/2"x I I"or 11"x 17". !...4 ❑ ❑ 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 0 ❑ 25 Building plans shall not contain red lines or tape-ons. "Mirrored"buildingplans will not he accepted. 11 0 ❑ 26 "Reversed"buildingplans must meet criteria outlined in the Permit& System Development Fees document. IEl ❑ 27 "Drawn to scale"indicates standard architect or engineer scale. 1 ❑ ❑ 28 Site plan to include tree size,type and location per approved project street tree plan(if'applicable),and City of Tigard ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplincs, 4 0 0 and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services'Sensitive Area Pre-Screening Size Assessment form is required for all building additions, I ❑ ❑ including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995, 1 Building.Pennits,B1 P-RESPennitApp.doc 02/242011 440-4613T(1 1.02=COM-W FB) . . , RECEIVED , ... - . Mechanical Permit Application City of Tigard NOV 2 2016 Rms.-tyre ili:..'$SW liali Ilkd I quad.OR 47221 r IV 1 Rf•,^6'. -1/'2434 ig" 99 1911PY OF TiGARD twiner lion I me; 503 610 4J 75 r-s ....--- i-,.. 9 Srt Pnge 2 for MI si cen tifintd•ot Inn 'it PI-DING DIVI ,ION Z.*::74,,;it, ! Supplimasseat liatormatiors 1 —_— : rtil*-1).'WM( - , = 1 1. 01:004,34 Irrit*-IttI00014,--1,Itte Oticamarr 1 1 Mechanical penult Ices*arc haver on the satin-of the'son .Neva construction 0 Addition a Iteration.tts.placernoll I t tit-trianted Indicate the%Atte mounded to the IM0(4C.4 dollar 0 De/n0htion 0 tither / 1_nicetianical initenah,rquiptiictit,labor,oirobract,and "kahle,S • I--anti 2•family dwelling 0 iontirraciallindumnial 0 Acce,,or) tnashlint: i no spa%id hiformakm en,chentlio. 1 i 0 Multi-hand) 0%islet Natick; 0 Other I I)0,ctint ion 1Qq L 00 AM SiOiliMMT01014/40kloceiThx- . - i ilt464.0"111Z: —7- i --- 1 L Air condittonitie 31.41 1411:oithItt,'”: s-5155- , .._ . . .tfr 1 t,1-irrnate 100.000 till .4..........ser, r ( It, SIAC/IP: Tigard,OR 9,---'1/3 , i Furnace MOM. .. .• .,..„ , -- . , rical pomp _4_ni on t `..teilt`bide Apt.;4.; Pritoxi!wow 1—\C_VVIVAL — I tt.,sftwt din:root!,lo poll 4,,Iir i itrairom,40,i%Air;as:-.44:: ---------. -----------—1 ! Rs-ink-mist boil,/indoor„r I ; J : tootron0 i I — --- i.,.....___ 1 fir brairrx1furl typr,not rick 41, in nail.in 410 twartliket.Cit. --- --,-----_ --. _ 1, J r Flue van for am of astakrir _ 4„,:1 '1: Nob411‘inton 1 I 0 no 6,( 1 4 ntict L2:t, — — _ I.1(114.1p parcel no St f tort heater T- , ,. -DititattrnaNIty-Stist* , . _ i tws iii 1.,,,e'own ... ... , flue rtit rof 1121t1 hoer or cs, LI t New SFR A --- ----- - ......_ . „„ e, I 1 ------, 1 v;;kk,'vac:m.,;c- .t. 1:119 t umkt titcp4,:c lawn 21:,: —_----- -- _ 1 (bonne,Ititot thre t en; 1 21 1.2 f I . 41 I SKOrairt 014*** . - '-' ;11 Mira ..1 Other ____ ..,.. - .. Fat t;irernmental estrum sad seatitatioar_ ___ Norfic DR Horton Inc. i itunre hood tither iiticiwn 7.-- -1. ........ . -4, ,., Add,,,,-4380 SW Macadam Ave Suite ItX1 Clothe,diver olliatt,t , I . 'I i t il., SIAS':liP Portland,OR 97239 i 1 ,;;;Fic 4100 P14311:0 ti44714(4...4(.., ' 1 f .i 'i..,it,i}Cf x 011)1"kittintill...titattlt It'tottts t :."A 32 r-----f 11441: '503 ) 222-4151 t i I t 1 , titc.4.-rn.,nr,i,vr Ian . . C) Arri.s - . At conAcT MitiON I [..1,?.42.ti_ , _ • _ I tiv...0..piPinsi ... 1 fiwont--name DR Horton Inc. - — i_ __ ,„ S14„ 15 tat Ciro ittitt,$4.6.1 tar fittit additional 1'0111a,1 wan: Emerald Weeks T - ; 1 — %Mies, 4380 SW Macadam Ave Suite 100 , 1 te9t tie,n rum! i _ ._ ___-- --- - . i WA str,peritiO Jen be.irer 1 ; 4.tq SIAL-/IP l'ortland,OR 97239let lic41 1 .. • i I l'11111' 1503 222- 415) x1107 I fax 4 1 -I i, Lk.0 tp,' I '”"'i CS weeks@'drborton.com _.....;.__ ,.„_ , iiii,int,,mon, r:), A iiLl aMittAtC4 ,er" ft* i ;4_104!_tr--„Arlyt tice„1„3, I i i [ ' AP --- iv..,,g,..11)/0 kb/,,,,,...,),-.. „4.4.1.:ffJ: _ ) I c:.) 7.„)., 4 rho' I —_ M m 1 , t CHACM.01#2114tft Subliwatr— ..i i I ttl 'MAC/IP iilliiii,..tb/..244,,,,i -) jiiA (-7.8.4,tvi i , mmin ,,iii,..,Irc 4.144 too ---. , r______ - _ t ;_ __,.___ ., Nts: -Wt. 1,4 II. Pi ez, ,.., _ __ _ ... 101AI.Ptlialli ETU I . . _ ___... ......_ ......._.... ....... __ this ititrftitt ntrii i i town twine*ti*pri mit iti Pot.tittoihrtt ttithtti 11., tht.att.t it lit+has bill Wire*4 tbnIpirit lkilthOt eitj 1::tellittt4' 7 / I Niro n.4s1u....% - -T-1.),,,-- .. . - , „ . Electrical Permit A t•ic tgCFIVizn Ipi: mil( i_ t ,i w.1 , IN-- City of Tigard N O V .2 ?016 Received 13125 SW Hall Blvd,Tigard,OR 97223 DamIB Permit No.. PhonePhone: 503.718.2439 Fax /� 9: : e: 503.639.41 ` !i r-'t,'•°i,p • ' ` otherPsrmir. Internet: www.ligard.or gar (Jim!NI r i i,, z r'f ,i ayM sod: Mr. QI See Page 2 for • TYPE OF WORK. • Supplemental Information ®New construction 0 Addition/alteration/replacement Please check all thatREM* . , ❑Service or apply(submit J sets of plans white=s checked below): feeder 400 amps or mote O Building over three atones. ❑Demolition 0 Other: CATEGORY oil CONSTRUCTION wherry the available fault current ❑Marinas and boatyards. •. exceeds 10,000 amps at 150 volts or Q Floating buildings. D 1-and 2-family dwelling 0 Co cial/industrial- - or 14,000 0 Multi- : ❑Master builder 0 Accessory building less to ❑Co acral-ase apiculture! D Other: amps for all other installations. n JOB SITE ❑Ftte ❑Installation of 75 KVA or INFOR11fATION! LOCATION QEme system. ' Ser ately derived system. Job no.: Job site address 45-6-633-- r 100❑Addition anew motor load of ❑"A",•V',-1-2""1,8,, . ,n M 112'ormore. armee!' • ❑Six or more residential units. ❑Recreational vehicle parks. ❑Asalth-care facilities. ❑Supply voltage for more than ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt no.: Project name: 6 P • • ❑Service of fader 600 amps or more. Cross street/directions to job site: iE SCM/DMZ D_. T�New residentialsingia or multi-familyunit. 11. Subdivision: Includes attached gars_ Lot no.: 1,000 aq R.ar lessp SOp —� Tax map/parcel no.: Ea.add'1 so, "g 168.54®_© DESCRIPTION OF WORK Limited Y., R.or residentialdential portion with above a..ft III 75.°0 IIIM Limitedgy,multifamily residential with above .,ft. III 75.00 —© Services or feeders install*,, alteratio, and/or relocation 2❑ PROPERTY OWNER i ❑ amps or less 111100.70 _® Name: 201 amps to 400 amps IIIIII 133.56 131 401 amps to 600 turps 0034 © Address: 601 apps to 1,000 amps 1111301.04 El City/State/ZIP: Over 1,000 amps or volts -El Phomeon Temporary services or feeders installation,alteration,and/or ( ) F`ax:(: ) 200 Owner installation:This installation is beinga or less 11111112E111111111111 intended for sale,lease,rent,or made on property that I own which is not 201 amps to 400 amps 125.08 exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 _© Owner signature: • Branch circuits—sew alteration s..,, Date: A.Fee for et' and ❑APPLICANT brand circuits with [] CONTACT PERSON above service or feeder fee, .® Business name: DR Horton Inc • each branch circuit B.Fes for branch circuits without Contact name: Emera . Wee Sbranservice or feeder fee,Bust 1111161111111Address: 4380 SW macs•am Ave • �101" Each add'I branch circuit - 7.42 mo© city/stat%zip: Portland OR 97239 Miscellaneous Vice or feeder not included $ Hach'_ service d d/modular ®� Phone:( I } dwell' service and/or feeder E-mail: lalitnrReconnect only � 1 El • Pump or irrigation circle IIIIIMECII11111113 CONTRACTOR i' - Signor outline lighting 111111121111111111111E1 Business name: , Signal cimlit(s)or limited-energy —© Address: .1 , g(„. („- Ci x al,-:r, or.extension. ■ y Each additional' ,, ///- 6' e/t / over allowable in an of the above City/State/23P: A/ � � I Additional inspection(I hr min) 6625/tar 111.11111 s , ' U. WA, i` . bf Investigation(1 hr min) plant(lhrmin) 6625/hr _■- 78.18/hrrIII Phone:(3‘„a 409— �Sr.,( Pax: bQ) 32‘..... J/ /Q riMEEEEMI Inspections for which no fee is s +£ treated !4hrmin Electrical Lic... 90.OD/br 11111111��3/ Suprv.Lic.: /?•-i $ Suprv.Electrician signature,required: ET�.PERMIT FEES Print name: '=•:. ' Subtotal: b`/1 R I'l l Pian review(25%of. emit fee): 11.111111111111 Date: Authorized signature: ��� IIIIIIIIIIIIIIIIIState age(12%of permit feek MI TOTAL PERMIT l FH Print name: This permit appJcatien expires if a permit b not obtained within 180 ` - Date: days atter it has been accepted as compkte. I1Bulldi,AIpr,e;$ _C.P m;tppD Number of inspections allowed per permit. 440-4615111 I/OS/COMlw® h ❑ Electrical Permit Application—City of Tigard Page 2- Supplemental Information NOV06 Limited Energy Permit Fees; CITY Y i F T I G A t iI _ .Nis; ; Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: Fee for all residential systems combined: FEE SCHEDULE $75.00 Ren ,tion Renewable electrical energy systems: Each rept Check Type of Work Involved: s k,a or less - I00.70 2 5.01 to 15 kva 133.5 0 Audio and Stereo Systems* r 15.01 to 25 kva . 200.34 0 Burglar AlarmWind veneration systems in excess of 25 kva: 25.01 tet 50 kva 301.04 El 17 Garage Door Opener* k 0 to 1 50.0100kva IIIII ss?2h >lkva 0in accordance 12 Heating, Ventilation and Air Conditioningwith OAR 916-309-00t10) 1111 552.26 System* Solar generation systems in excess of 25 kva: 0 Bach additional kva iwer 25 .42 Vacuum Systems* _ 3 >100k,a,noadditional charge 0.0 3 0 Other: Each additional ins•ection over allowable in any of the above: Each additional inspection is ■ char ed a1 an hourly 1 hr min) 1 1 Inspections fix which no fee is ■ COMMERCIAL WORK ONLY :• xciscall listed(':hr min) Fee for each commercial system:• ELECTRICAL PERMIT FEES — (SEE OAR 918-309-0000) $75.00 Subtotal(Enter on Pale 1): + Number of inspections allowed per permit. Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls n Clock Systems O Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC O Instrumentation O Intercom and Paging Systems O Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations t:.Buiid4 PetmiT,ILC Pct:nitApp[LE EFT.&,. Itc'.0 r:;'U Plumbing Permit Application Building Fixtures FoR t)FFIC 1. 1, 1. ( NLN City of Tigard Received 13125 SW Hall Blvd..Tigard,OR 97223 17atc/By; Pe"n'I No.: ; �/ � 11,11 flan Review 3...,- to-C�OS � Phone: 503.718.2439 Fax: 303.598.1960 Other Ferran 1\n.: Inspection Line: 503.639.4175 Date/By:t I c;t,It i) Dale Ready/Hv: Jurk4 0 See Page 2 for Internet: www.tigard-or.govNotifed Mcyhod: Suppkmenta I Information TYPE OF WORK FEE' SCHEDULE For special is formation use checklist ❑New construction ❑Demolition Description I Qty. I La. I Total ❑Addition/alteration/replacement ❑Other. New I-2-family dwellings(includes 100 II for each utility connection) CATEGORY OF CONSTRUCTION SFR(I)bath 312.70 ❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessorybuilding SFR(3)bath 50032 ❑Multi-family ❑Master builderEach additional bath/kitchen 25.02 0Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: &J(.-..---2. c" s-v,i SG1'1LY�t it t 4(y) Catch basin or area drain 18.76 City/Stater/IP: Drywell,leach line.or trench drain 18,76 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name: }.k tyi -a ()(9S S(t1C� Manufactured home utilities J 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18,76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.; ) Page 2 Subdivision: lot nu,: (0 Fixture or item: Tax map/parcel no.: ' Backflow preventcr 31.27 DESCRIPTION OF WORK _ Backwater valve 12.51 Clothes washer 25.02 Dishwasher 25.02 Cr Y)T?-61..(...to (.h art,C . -6-0m p t ulA(G_6, Drinking fountain 25.02 l;jectors/sump 25.02 0 PROPERTY OWNER 1 0 TENANT Expansion tank 12.51 7 Name: -b .�o rtO rl Fixture/sewer cap 25.02 Address: Floor drain/floor sink/hub25A2 City/State/ZIP: Garbage disposal 25.02 - Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: V (Z {rCsl�f�iY1 Medical gas(value:$ ) _ Page 2 Contact name: rx.n Primer 12.51 e rci td V\J P f LS Roof drain(commercial) 12.51 Address: y,Cbr) v‘i t\A(11 d a �� Sink/basin/lavatory 25.02 City/State/IIP: L� I PD 61"7-2-�9 Solar traits(potable water) _ 62.54 Phone:( ) 2-2-7, L I S I I Fax::( ) Tub/shower/shower pan 12.51 E-mail: gl m,oP S (4eiY I)Dii-On•COM Urinal 25.02 CONTRACTOR Water closet 25,02 Business name:Wolcott Plumbing Water heater _ 37.52 Water piping/D W V 56.29 Address:1075 W.Historic Columbia River llwy Other: 25.02 City/StaterLJP:Troutdale Or.9060 Subtotal Phone:(503)667-1781 Fax:(503)667-9891 Minimum permit fee: $72.50 CCB Lia: 112220 Plumbing Lie.no.:26-824PB Plan review (25%of penult fee) p,` ( / /....,...,„........ State surcharge(12%of permit fix) Authorized signatures j(n lv•` TOTAL.PERMIT FEE This permit application expires a permit is not obtained Millin ISO Bats Print name:Mark Baleme Date:2/17/17 after it has been accepted as complete, "tee methodology act bvTri-Coumy Building Industry Service Hoard. I'$uildinK.Permitsip Sit LTSnrnnftpp doe 1001119 440.4515'x(1 o''e:i('osl'wI:H) INCity of Tigard v COMMUNITY DEVELOPMENT DEPARTMENT T 1 G A R D Building Permit Review — Residential Building Permit #: Ac7—aV)/Ce - Oac?.? Site Address: C5 S`1 ) gehmiLit/ 4667 Project Name: / /ems, s �7� , ,� C�. `, - Lot #: ��� (New dweal=subdivision name;Adion or Alteration=last name of owner) Planning Review Proposal: v 7. Verify site address/suite#exists and activ in permit system. 1P°1'.ver Terrace Neighborhood: No ❑ Yes,See River Terrace Review Addendum Attached Si,e Plan Elements: reel(3)copies of site plan S' e plan must be on 8-1/2"x 11"or 11 x 17"paper NA ` sting structures on site II Footprint of new structure(including decks)with finished awn to scale(standard architect or engineer scale) or elevations 6th arrow W ' 'tY locations(required for new,may apply for additions) Sy-e. address,project or subdivision name and lot number , 'cation of wells/septic systems P y plicant information(name and phone number) sng P y IG .t dimensions and building setback dimensions ,':rot coon measures trees to be retained with drip line,and tree It •t area,building coverage area,percentage of coverage and rI reet tree size,type and location pStreet nameservious area(applicable if R-7,R-12,R-25&R-40) operty corner elevations(2 foot contour lines if more than rn 4��foot differential) 1"�:lean Water Services—Service Provider Lett (lot platted prior to 9/10/1995): Peili qbliuireFacd: ❑tieyesIm,applicant wasrovement(PFI)notified Permit: No Received: ❑ Yes Cl Public p equired: Yes,applicant was notified CI Applied For: Yes ❑ No,stop intake Land Use Case �_� t Zoning: - . 4...._ = 06 - Al / " 0`�,� / Required Setbacks: Front // Rear )�� //• .2� / ie Side Street Side A� 4/1 Garage Landscape Requirement: sy `r'/T 'Lot Coverage Maximum: Building Height: Maximum Height /35— Actual Height +II1�� isual Clearance 7 Easements .ensitive Lands: ❑ Yes {�No Type 4 Urban Forestry Plan ❑ Conditions "Met"p�por to issuance of building permit 7? Notes: ed/750h/.Y cSlIki///� Le in 12.:7L /v ✓ Approved By Planning: ter.,,.. � 1 Date: / Revisions (after Building Submittal only) Reviewer Revision 1: ❑ Approved ❑ Not Approved Date Revision 2: El Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\B1dgpermitRvw RES 091216.docx Building Permit Submittal l`�� � Original Submittal Date: Site Plans: # 3 Building Plans: # 3 Building Permit#: /IR'Enter building permit#above. Workflow Routing: "Planning , -Engineering IA'1'ermit Coordinator Building Workflow Sign-off: 7 Sign-off for Planning(include notes from planning review) Route Application Documents: Z Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. ,ti4—Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: �, 1( / ' .4.. _ Date: 1, h_) //p• By Permit Technician: i'l.! Engineering Review Slope at building pad: _.,G, 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: El Yes ❑ No Assess Water Quantity Fee in-lieu: Cil ❑ o LIDA Facility on lot: CI Yes ❑ o ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: ,ice ,7 Date: f _,,,,;>-/A Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved El Not Approved Revision 3: El 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: ErPSDC Fees Entered: Wash Co Trans Dev Tax: Yes El N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: Yes ❑ N/A 7OK to Issue Permit /743'c , Date: ��� Approved by Permit Coordinator: I:\Building\Forms\BldgPermitRvw_RES_091216.docx