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Permit (88) CITY OF TIGARD MASTER PERMIT Iii.0_ q '- COMMUNITY DEVELOPMENT Permit#: MST2016-00496 T[ a t D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 '7 Ti''7' Date Issued: 04/06/2017 s Z. Parcel: 2S110BA11500 , /.7 -,4 lir, Jurisdiction: Tigard Site address: 14188 SW 118TH CT Subdivision: MEDALLION MEADOWS Lot: 8 Project: Medallion Meadows, Lot 8 Project Description: New SF. 12/11/17: REPRINTED to add irrigation backflow. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 5 First: 1514 sf Basement: 878 sf Left: 5 Parking Spaces: 0 Height: 28 Bathrooms: 5 Second: 1143 sf Garage: 606 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3535 sf Value: $436,758.33 Rear: 15 PLUMBING Sinks: 1 Water Closets: 5 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 7 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 0 Tubs/Showers: 5 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0 Bckflw Prevntr: 1 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: 7 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 1 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: 7 201-400 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 3535 Owner: Contractor: JT ROTH CONSTRUCTION INC J T ROTH CONSTRUCTION Required Items and Reports(Conditions) FOUR D CONSTRUCTION CO 12600 SW 72ND AVE#200 1 Ersn Cntrl 503-639-4175 12600 SW 72ND AVE#200 TIGARD,OR 97223 TIGARD,OR 97223 PHONE: 503-639-2639 PHONE: 503-639-2639 FAX: 503-624-0239 Total Fees: $32,498.03 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,js suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Th,se rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain- --i - the rules or direct questions to OUNC by calling 503.2 . ,87 I o r:332.2344. f�� %ff Issued By: / 11, — Permittee Signature: 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. Plumbing Permit Application Building Fixtures 1 it FOR OFFICE USE ONLI City of Tigard 1 Received 13125 SW Hall Blvd.,Tigard,OR 97223L�r i11 1 Date/By: ! ��///, ` Permit Ns/./8-7:20/6 _a`,4.49-6, IN Phone: 503.718.2439 Fax: 503.598.120 , Plan Review Inspection Line: 503.639.4175 l 1 Y 'a.6 °.6 z t, Date/By: Other Permit No.: TIC,/�R U : t x t ,o z•^Y I,� Date Ready/By: Juris: 0 See Internet: www.tigard-or.gov ,t ; ,4!,°/t ,, Page 2l nr " ���.,s; - Notified/Method: Supplemental Information TYPE OF WORK <<- A FEE* SCHEDULE tg:LNew construction 0 Demolition For special information use checklist Description ❑Addition/alteration/replacement 0 Other: P Qty. Ea. Total New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION.x SFR(1)bath 312.70 /n-`-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 ❑Master builder - Each additional bath/kitchen 25.02 0Other: Fire s rinkler s ft. � ' P • ( 9• ) Page 2 '` JOB`SITE`"INFORMATION AND' ; LOCATION. Site utilities: Job site address: 19 i' ti Su, > C/ Catch basin or area drain 18.76 City/State/ZIP: 1 0 Drywell,leach line,or trench drain 18.76 na_ i .iJ1 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name: !fit.. 111,o"� eh,�,� '�'z""', Manufactured home utilities 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: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer I 31.27 . DES I''T'IONi. RK ` Backwater valve 12.51 m,. CRI •-w.xu', W `1 '' a l' g ¢ i Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ``4 4 0""'ROPERTY;OWNER _ 5 " 1 TENANT 4 4;, . Expansion tank 12.51 Name: :IT ccr),i4, ,> Fixture/sewer cap 25.02 Address: Floor drain/floor sink/hub 25.02 Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax ( ) �, Ice maker 12.51 . 4 APPLICANT ❑ kZ �IC ONTPER )N Interceptor/grease trap 25.02 Business name: Medical gas(value:$ ) Page 2 Contact name: Primer 12.51 Address: Roof drain(commercial) 12.51 Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 , ,, ,� _ Water closet 25.02 CONTR CTOR Water heater 37.52 Business name: jt&w%'444 ick"--tS6u j I(C Water piping/DWV 56.29 Address: ftt) 13 oC 3c, (V Other: 25.02 City/State/ZIP: (.4:,--Lk. ,i�OI� f 7 1:5 Subtotal Phone:(03 ) 3&,.... 4V/8 Fax:( ) Minimum permit fee: $72.50 CCB Lic.: per. u: L Ca.ti lin. Plan review (25%of permit fee) Authorized signature: - ---r.....,.. oz_ State surcharge(12%of permit fee) . w._ TOTAL PERMIT FEE _?_57;02.,, Print name: 71ca.j C'S Date: /. This permit application expires if a permit is not obtained within 180 days / �I`� after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-permitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities - v Q'.` Fee ea) Total Square Footage: ; ;k Permit Peet A Footing drain-ls`100' 50.03 0 to 2,000 $121.90 37.52 2,001 to 3,600 $169.69 Footing drain-each additional 100' 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service each additional 100' 37.52Valuation: Perm*Fee: Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for each additional$100.00 or fraction thereof,to *0 01er I . ections or Pees - QtJ'• Fee Oa/F. To l and including$10,000.00. s - Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for each additional$100.00 or fraction thereof. (minimum charge-1/2 hour) Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Plan Review for<,Phuilh,ng I s llat n Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replacel Please check all that apply. Work Performed: Capped Added. Relocate ❑ Anynew commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool 0 New exterior plumbing site utilities for any complex structure Car Wash: -Each Stall as defined in OAR918-780-0040. -Drive Thru 0 Medical gas and vacuum systems for health care facilities. Cuspidor/Water Aspirator 0 Any multipurpose fire sprinkler system. Dishwasher: -Commercial 0 Any complex structure as defined in OAR918-780-0040. -Domestic Drinking Fountain Submit 2 sets of plans with any of the above. Eye Wash Floor Drain/sink: -2" 3„ Isometric or Riser Diagram 4" 0 Isometric or riser diagram is required for new buildings -Car Wash Drain that meet the qualifications above. Garbage -Domestic non-food Disposal: -Domestic food related -Commercial food related -Industrial food related Comments regarding fixture work: Ice Mach./Refrig.Drains Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -Lav/Bar non-food related -Bradley -Com/Serv/Util food related -Service *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and Washer-Clothes fees assessed for the sewer increase must be paid before the Water Extractor plumbing permit can be issued. Water Closet-Toilet Urinal Other Fixtures: I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2016-00496 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/06/2017 [ 11 f�' g Parcel: 2S110BA11500 Jurisdiction: Tigard Site address: 14188 SW 118TH CT Subdivision: MEDALLION MEADOWS Lot: 8 Project: Medallion Meadows, Lot 8 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 5 First: 1514 sf Basement: 878 sf Left: 5 Parking Spaces: 0 Height: 28 Bathrooms: 5 Second: 1143 sf Garage: 606 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3535 sf Value: $436,758.33 Rear: 15 PLUMBING Sinks: 1 Water Closets: 5 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 7 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 5 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: 7 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 1 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: 7 201-400 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 3535 Owner: Contractor: JT ROTH CONSTRUCTION INC J T ROTH CONSTRUCTION Required Items and Reports(Conditions) FOUR D CONSTRUCTION CO 12600 SW 72ND AVE#200 1 Ersn Cntrl 503-639-4175 12600 SW 72ND AVE#200 TIGARD,OR 97223 TIGARD,OR 97223 PHONE: 503-639-2639 PHONE: 503-639-2639 FAX: 503-624-0239 Total Fees: $32,463.01 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. A • Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-00 -0010 through*AR• '01-'••.0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issu.d By: A. /Or" Asaill _g1 Permittee Signature: ---C s� 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 completio - the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application ��� Residentialj P FOR OPPI( E I SI:()Nil City of Tigard Received ,I �/�, L� q Date/13y: l� Al �Y Ca Permit No.: /� ` QVO r 13125 SW Hall Blvd.,Tigard,O3.11 9% V 2 2 2 O 1 O plan Review Phone: 503.718.2439 Fax: 503.59'III8.1960 DateBy: )�' - ) Other Permit: e�/4-a_5 I l I 7 !C;AKD Inspection Line: 503.639.4175CFI-� F D Date Ready/By: �/ / � Juris: I BI See Page 2 for Internet www.ti and or_ ov � z- c 9 I 9a Notified/Method: -7 g g �,����5.���a�5;f t-€�j'��q( ,,�� � / �� Supplemental Information T YP 'WORK REQUIRED DA'l I-A#40,24-01Aftyilwpttiso' 0 New construction ❑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 ; ( 'op �0N, work indicated on this application. C � .1 1-and 2-family dwelling Valuation: $U@ gg�t�3 6 7S� ' g 0Commercial/industrial o Accessory building 0 Multi-family Number of bedrooms: 5 ❑Master builder 0 Other: Number of bathrooms:455 5 JOB SITE INFORMATION.ANDD LOCATION Total number of floors: 3 1+J (4 J Job site address:14188 SW 118th Court New dwelling area: 3535 square feet City/State/ZIP:Tigard,OR 97224 Garage/carport area: 606 square feet Suite/bldg./apt.no.: Project name: '' ,t 4./I,6,N 4/4,,,C7.1„23- L t Covered porch area:3 square feet 111+3 Cross street/directions to job site:Gaarde Road to 118th Court J Deck area: t 313.5 square feet 13 14 Other strucl-ure meal ) C G square feet 27 8 .900 D DATA:CO 1 i �1 T Subdivision:Medallion Meadows Lot no.:8 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 DIRWRIPTIO ,OF:WORK" work indicated on this application. F;: Construction of new single family residence Valuation: $ Existing building area: square feet New building area: square feet 14 :.PROPERT O ';I ���1 _ - Number of stories: Name:J.T.Roth Construction Inc. Type of construction: Address:12600 SW 72nd Ave Occupancy groups: City/State/ZIP:Tigard,OR 97223 Existing: Phone:(503)639-2639 Fax:(503)624-0239 A ANT :' li NT`A� N ,1,_ ew BL ( ,luiT 1l1iES* Business name:J.T.Roth Construction Inc. ',. (Pterreler4W.ee: Structural plan review fee(or deposit): Contact name:David Jensen Address:12600 SW 72°d Ave. FLS plan review fee(if applicable): City/State/ZIP:Tigard,OR 97223 Total fees due upon application: Phone:(503)806-0602 Fax::(503)624-0239 Amount received: 'c ) E-mail:davidj@jtrothinc.com PHOTOVOLTAICOLAR.PA EL SY rtM PUS* Commercial and residential prescriptive installation of CON ACTOK. , , , roof-top mounted Photo Voltaic Solar Panel System. Business name:J.T.Roth Construction Inc. Submit two(2)sets of roof plan with connection details oa and fire department access,along with the 2010 Oregon Address:12600 SW 72 Ave. Solar Installation Specialty Code checklist. City/State/ZIP:Tigard,OR 97223 Permit Fee(includes plan review $180.00 and administrative fees): Phone:(503)639-2639 Fax:(503 624-0239 State surcharge(12%of permit fee): $21.60 CCB lic.:31700 Total fee due upon application: $201.60 Authorized signal ' .� �� � - This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Print name:David Jensen Date:11/18/20106 Service Board. I:\Building\Permits\BUP-RESPaISrtitApp.doe 02/24/2011 440-4613T(11/02/COM/WEB) Plumbing Permit Application Building Fixtures R 1E FOR OFFICI: CSE O\Ll City of Tigard W= Received INa Date/By: Permit No.:� r�/4,-.004/x/ 13125 SW Hall Blvd.,Tigard,OR 9�7 b, tI 20162 ✓ fo a Phone: 503.718.2439 Fax: 503.5 jj 60rrPlan Review Other Permit No.: Inspection Line: 503.639.4175(W p Date/By: I l C;A RD g g f ut� g Date Ready/By: Juris: ® See Page 2 Internet: www tI ard-or o � • I 1 ff�� afor r!• w Notified/Method: Supplemental Information 11 New construction 0 Demolition For special information use checklist Description I Qty. I Ea. I Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGOII' OF CO1SIRIIC'I'IOPi SFR(1)bath 312.70 ® 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 ❑Accesso buildin - SFR(3)bath 1 500.32 13 g ❑Multi-family ❑Master builderEach additional bath/kitchen 2 25.02 0 Other Fire sprinkler( sq.ft.) Page 2 JOB,SITE INFO ' 'ION:AM)LOCATION Site utilities: Job site address:14188 SW 118th Court Catch basin or area drain 18.76 City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name: Manufactured home utilities 50.03 Cross street/directions to job site:Gaarde Road to 118th Court 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:Medallion Meadows I Lot no.:8 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 1)T II t IQN . rte Backwater valve 12.51 Plumbing of new single family residence Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 0 r'lifl"EI tv OW1 II A Expansion tank 12.51 Name:J.T.Roth Construction Inc. Fixture/sewer cap 25.02 Address:12600 SW 72°a Ave Floor drain/floor sink/hub 25.02 Garbage disposal 25.02 City/State/ZIP:Tigard,OR 97223 Hose bib 25.02 Phone:(503)639-2639 Fax:(503)624-0239 Ice maker 12.51 Q APPLICANT co CONTACT PER Interceptor/grease trap 25.02 Business name:J.T.Roth Construction Inc. Medical gas(value:$ ) Page 2 Contact name:David Jensen Primer 12.51 Roof drain(commercial) 12.51 Address:12600 SW 72"Ave Sink/basin/lavatory 25.02 City/State/ZIP:Tigard,OR 97223 Solar units(potable water) 62.54 Phone:(503)806-0602 Fax::(503)624-0239 Tub/shower/shower pan 12.51 E-mail:davidj@jtrothinc.com Urinal 25.02 h - Water closet 25.02 Water heater 37.52 Business name:ALL Plumbing LLC Water piping/DWV 56.29 Address:9312 NW Skyline Blvd. Other: 25.02 City/State/ZIP:Portland,OR 97231 Subtotal Phone:(503)520-0313 Fax:(503)469-1470 Minimum permit fee: $72.50 CCB Lic.:194089 Plumbing Lic.no.:PB-1022 Plan review (25%of permit fee) �/" State surcharge(12%of permit fee) Authorized signature: 2_,,10- TOTAL PERMIT FEE Print name:Aaron Luchs Date:11/18/2016 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) Mechanical Permit Application FOR Ol i R. I 1 Si Oyl,1 City of Tigard Received • = Date/By: Permit No.: (2 i f��/q 13125 SW Hall Blvd.,Tigard, ffi y 77 !l Phone: 503.718.2439 Fax: 50 . i d Plan Review . DateBy: Other Permit: "G A R D Inspection Line: 503.639.4175 Date Read B Juris Internet: www.tigard-or.gov NOV22016 Ready/By. Supplemental See Page 2 for 2 Notified/Method: Supplemental Information 1 IGS rE)i5lM.1tC"IAL Va* SCIUDIJI.E �� `Ki,l�4' ®New construction 'Urkt Mechanical permit fees*are based on the value of the work ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATS Y tilt ONS1RV 11ON K` 1I IAI 11T i S14$ * ® 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total jots.MT IN�I T o t Ana* Heating/cooling: Air conditioning x 46.75 Job site address:14188 SW 118th Court Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) x 54.91 Suite/bldg./apt.no.: Project name: Heat pump 61.06 Duct work 23.32 Cross street/directions to job site:Gaarde Road to 118th Court Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision:Medallion Meadows Lot no.:8 Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 D all RONWOW, Gas fireplace/insert 33.39 ` " Flue vent for water heater or gas HVAC installation at new single family residence fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 *2 PR�RT OW:$ER Other: 23.32 Environmental exhaust and ventilation: Name:J.T.Roth Construction Inc. Range hood/other kitchen Address:12600 SW 72°d Ave. equipment 33.39 Clothes dryer exhaust 33.39 City/State/ZIP:Tigard,OR 97223 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:(503)639-2639 Fax:(503)624-0239 Attic/crawlspace fans 23.32 Cl APPUI ANT . . ,. �! (OA ' PEl oN _. Other: 23.32 Business name:J.T.Roth Construction Inc. Fuel piping: $14.15 for first four;$4.03 for each additional Contact name:David Jensen Furnace,etc. Address:12600 SW 72°d Ave Gas heat pump Wall/suspended/unit heater City/State/ZIP:Tigard,OR 97223 Water heater Phone:(503)806-0602 Fax::(503)624-0239 Fireplace Range E-mail:davidj@jtrothinc.com Barbecue affir `)R Clothes dryer(gas) Business name:All Time Heating LLC Other: MECIUNICAL PZRMIT S* ':, Address:PO Box 1541 Subtotal City/State/ZIP:Lake Oswego,OR 97035 Minimum permit fee($90.00) Phone:(503)208-2276 Plan review(25%of permit fee) Fax:(503)208-2276 State surcharge(12%of permit fee) CCB lic.:184575 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 Authorized signature days after it has been accepted as complete. * Fee methodology set by Tri-County Building Industry Service Board Print name:Aaron Svoboda Date:11/18/2016 ,Building�PennitsW1EC PermitApp_040113.doc 440-4617T(11/02/COM/WEB) , Electrical Permit Application FOR OFFICE LSE ON1,1 City of Tigard r"" ;;rr 1 f DateBea Permit 4: ' 7�/ , J 419, 1,1 v 13125 SW Hall Blvd.,Tigard,OR 97232 `m'"° "� F lr Plan Review I: Phone: 503.718.2439 Fax: 503.598.1960DateB Related Permit it: T t G A R D Inspection Line: 503.639.4175 N O i j 2 2 2016 Ready Date/By: 1mi8: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information ®New construction 0 Addition/ tura' '/ Iabd i `I() Please check all that apply(submit 2 sets of plans w/items checked): ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition 0 Other: where the available fault current 0 Marinas and boatyards. C` T ';Q CN 'R C'k 2 , exceeds 10,000 amps at 150 volts or 0 Floating buildings. ® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural snips for all other installations. buildings. ❑Multi-family 0 Master builder 0 Other: ❑Fireum . P P 0 Installation of 150 KVA or It' TIO °�A' QN ❑Emergency system. larger separately derived Job#: Job site address:14188 SW 118th Court ❑Addition of naw motor load of system. 100HP or more. ❑"A","E","1-2","1-3", City/State/ZIP:Tigard,OR 97224 0 Six or more residential units. occupancy. 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: ❑Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site:Gaarde Road to 118th Court '_ ''FR Kilt-DM ', Description I Qty. 1 Each 1 Total New residential single-or multi-family dwelling unit. Subdivision:Medallion Meadows Lot#:8 Includes attached garage. 1,000 sq.ft.or less 1 168.54 168.54 4 Tax map/parcel#: 7 Ea.add'1500 sq.ft.or portion 33.92 169.6 1 IDE IPTION- WO: Limited energy,residential (with above sq.ft.) 1 75.00 75.00 2 Wiring of new single family residence Limited energy,multi-family 75.00 2 residential(with above sq.ft.) !I Renewable Energy 0 See Page 2 ' UT D x . `, .. Services or feeders installation,alteration,and/or relocation Name:J.T.Roth Construction Inc. 200 amps or less 100.70 2 Address: 12600 SW 72nd Ave 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:Tigard,OR 97223 601 amps to 1,000 amps 301.04 2 Phone:(503)639-2639 Fax:(503)624-0239 Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 ��� Branch circuits—new,alteration,or extension,per panel 4 ' . . .I , ''. U1!I'i'>!S;it `11 1 A.Fee for branch circuits with Business name:J.T.Roth Construction Inc. above service or feeder fee, 7.42 2 each branch circuit Contact name:David Jensen B.Fee for branch circuits without Address:12600 SW 72nd Ave. service or feeder fee,first 56.18 2 branch circuit City/State/ZIP:Tigard,OR 97223 Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(503)806-0602 Fax::(503)624-0239 Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email:davidj@jtrothinc.com Reconnect only 67.84 2 -- - - - � Pump or irrigation circle 67.84 2 Business name:Dreamhouse Electric LLC Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address: 13075 SW Canyon Road panel,alteration,or extension. 0 See Page 2 2 City/State/ZIP:Beaverton,OR 97005 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(503)648-5144 Fax:(503)648-9723 Investigation(1 hr min) 90.00/hr Email:dreamhouseelectric@gmail.com Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90,00/hr CCB Lic.: 196726 Electrical Lic.: C-848 Suprv.Lic.: its'--4t, specifically listed(Y2 hr min) Awl. RIICCL PERMIT ES Suprv.Electrician signature,required: Subtotal: Print name: Chris Mahoney Date: 11/18/2016 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: ae TOTAL PERMIT FEE: 4 This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC_PemtitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB a Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL.*:4041014,14*Oitteti*ViDescript Fee for all residential systems combined: $75.00_ I Qty. I Each Total l _ )' Renewable electrical energy systems: 10070 2 Check Type of Work Involved: 5 kva or less 133 56 2 5.01 to 15 kva 133.56 2 n Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 ►/ Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 2 ® Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 ® Vacuum Systems* >100 kva-no additional charge 0.0 3 Each additional inspection over allowable in any of the above: ® Other: Phone/TV Each additional inspection is 66.25/hr 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr �rspecifically listed(%2 hr min) Subtotal Enteron Page 1): Fee for each commercial system: $75.00 ya Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls • Clock Systems ❑ Data Telecommunication Installation [1 Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* • Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling n Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 City of Tigard 11111 N COMMUNITY DEVELOPMENT DEPARTMENT T 1 c A R D Building Permit Review — Residential Building Permit #: H 3 r'ICP-oo 4 Q Site Address: 14-H 83 S(,V )104"`` C- Project Name: Ike deacvl ("le c...d u .-L; Lot #: a (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: NP_ c{z-c- c.4,-e_d 'Verify site address/suite#exists and active in permit system. "River Terrace Neighborhood: CA No ❑ Yes,See River Terrace Review Addendum Attached Site Plan Elements: ( Three(3)copies of site plan Existing structures on site ffiSite plan must be on 8-1/2"x 11"or 11 x 17"paper [Footprint of new structure(including decks)with finished ❑Drawn to scale(standard architect or engineer scale) floor elevations 1 North arrow N ti ity locations(required for new,may apply for additions) tiO Site address,project or subdivision name and lot number ral lj,gcation of wells/septic systems l Applicant information(name and phone number) xisting trees to be retained with drip line,and tree 7'ot dimensions and building setback dimensions . otection measures JLot area,building coverage area,percentage of coverage and treet tree size,type and location J impervious area(applicable if R-7,R-12,R-25&R-40) ti, treet names l roperty corner elevations(2 foot contour lines if more than 4 foot differential) Fr Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified (No Received: ❑ Yes ❑ No Iii" Public Facilities Improvement(PFI) Permit: Required: t'Yes,applicant was notified ❑ No Applied For: CrYes ❑ No,stop intake iR Land Use Case#: Us. (3 U t OCUOQ, 2 Zoning: R- 4 . S 1 Required Setbacks: Front a V Rear 15 Side 5 Street Side -- Garage ',er Landscape Requirement: pi A. Zr 0/0 Lot Coverage Maximum: N/A 0/0 K. Building Height: Maximum Height 3 6 Actual Height ^ `a )2'Visual Clearance)✓'/A 1N' Easements Sensitive Lands: ❑ Yes E 'No Type li Urban Forestry Plan I'! Conditions "Met"prior to issuance of building permit r� `Notes: $V10„v t,..J'1ite A- 'I s c,a': �� c�, 't .•• p o LA-) -_ .s ', c-, Com,(0/ pl e r i4- Approved By Planning: ato j 6 . Op,- , ,,, Date: //_)d "1(o 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\BldgPermitRvw_RES_091216.docx Building Permit Submittal Original Submittal Date: /1 /oVit (p Site Plans: # ?j Building Plans: # 3 Building Permit#: Er-Enter building permit#above. Workflow Routing: 13'.-Planning engineering [ - Permit Coordinator J=Viuilding Workflow Sign-off: Er-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 Y'Bo ginal plan review routing form. uilding: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: - I 1 --.4 Date: /S,,,'�(o Engineering Review ©--g-lope at building pad: ,c)-Z ®"Conditions "Met"prior to issuance of building permit 2-Easements (encroachments)per engineering conditions of approval and plat Er-Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes 2-No Assess Water Quantity Fee in-lieu: ❑ Yes a No LIDA Facility on lot: ❑ Yes 2-No ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: 4L,.F15't+trz- Date: /Z-5.-/(e 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: SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A Tigard Trans SDC: Yes 111 N/A Parks SDC: es ❑ N/A K to Issue Permit / 7-6-7)452 A proved by Permit Coordinator:TDate: I:\Building\Forms\BldgPermitRvw_RES_091216.docx City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 14188 SW 118TH CT, TIGARD, OR, 97224 January 2, 2018 at 12:06:34 PM Record Type: Record ID: Residential - Master Permit MST2016-00496 Inspection Type: Inspector: 199 Electrical final David Young Result: FA I L Comments: Main house locked, no access for inspection. No message left with inspection request for access. No inspection done. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 14188 SW 118TH CT, TIGARD, OR, 97224 January 2, 2018 at 12:05:00 PM Record Type: Record ID: Residential - Master Permit MST2016-00496 Inspection Type: Inspector: 399 Plumbing final David Young Result: FA I L Comments: House locked, no access for inspection. No message left with inspection request. Front casita unlocked, no hot water. No further inspection done. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 14188 SW 118TH CT, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2016-00496 Inspection Type: Inspector: 199 Electrical final Jeff Grove Result: PASS Comments: Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 14188 SW 118TH CT, TIGARD, OR, 97224 January 4, 2018 at 11 :02:19 AM Record Type: Record ID: Residential - Master Permit MST2016-00496 Inspection Type: Inspector: 699 Mechanical final David Young Result: FA I L Comments: Seal Line set penetration at foundation vent. R408.2 Seal penetrations in garage at mechanical equipment. R302.5.3 Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 14188 SW 118TH CT, TIGARD, OR, 97224 January 4, 2018 at 11 :12:01 AM Record Type: Record ID: Residential - Master Permit MST2016-00496 Inspection Type: Inspector: 299 Final inspection David Young Result: FA I L Comments: Provide fall prevention devices on windows less than 24" finished floor and over 72" to grade. Dining window. Master windows at 24" above floor. R612 Bottom deck railing gap over 4" from deck at different locations. R312.2 Provide positive connections at posts to beams, covered deck. R502 Fix vapor barrier in crawl space. R406.3.2 Seal around interior rain drain penetrations. Street tree and rear yard tree not in locations approved by planning, provide revised street tree sight plan approved by planning. Provide slope away or approved drainage swale at front. R401 .3 Flooring for cantilevered fp at deck not pt or decay resistant. R317 Provide approved mechanical final inspection. Note: upper level front bedroom window not working correctly. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 14188 SW 118TH CT, TIGARD, OR, 97224 February 5, 2018 at 11 :54:54 AM Record Type: Record ID: Residential - Master Permit MST2016-00496 Inspection Type: Inspector: 299 Final inspection David Young Result: FA I L Comments: Schedule mechanical final inspection for approval (R109)with building final inspection. Corrections from previous mechanical final inspection complete. Plumbing correction not done for strainer tool in lower level bath, see plumbing final approved with corrections. Provide backflow test report for lawn irrigation. Provide blower door or duct seal test report for ductwork in the crawl. AF103 Provide insulation certification not posted on furnace or panel. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 14188 SW 118TH CT, TIGARD, OR, 97224 February 7, 2018 at 1 :35:19 PM Record Type: Record ID: Residential - Master Permit MST2016-00496 Inspection Type: Inspector: 699 Mechanical 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: 14188 SW 118TH CT, TIGARD, OR, 97224 February 7, 2018 at 1 :38:01 PM Record Type: Record ID: Residential - Master Permit MST2016-00496 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. Duct seal test report received. Insulation certification checked. Backflow test report received. C of 0 left on site with approved plans. Violation Summary: Inspector Contractor