Permit (23) . CITY OF TIGARD MASTER PERMIT
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COMMUNITY DEVELOPMENT �. Permit#: MST2016-00596
f- Ry 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 00 Date Issued: 04/12/2017
�' ' Parcel: 2S111DA24300
Jurisdiction: Tigard
Site address: 8559 SW SCHMIDT LOOP
Subdivision: HERITAGE CROSSING Lot: 62
Project: Heritage Crossing, Lot 62
Project Description: New SF. 9/18/17: REPRINT to add NC unit. Placement of NC 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: $207,541.05 Rear: 16
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1
Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain
0 Storm Sewer 100
Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains:
Bckflw Prevntr: 0 Catch Basins: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: 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: 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:Y 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: $27,695.22
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952- 1-0090. You .y obtain a copy of -rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: '' /i /� �
Permittee Signature: crc- Q l/tl:',ia 1--,
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
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CITY OF TIGARD
31i: � MASTER PERMIT
COMMUNITY DEVELOPMENT
TE aAR.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Permit#: MST2016-00596
Date Issued: 04/12/2017
Site address: 8559 SW SCHMIDT LP Parcel: 2S111DA24300
Jurisdiction: Tigard
Subdivision: HERITAGE CROSSING
Project: Heritage Crossing, Lot 62 Lot: 62
Project Description: New SF.
BUILDING
Stories: 2 Bedrooms: 3 Floor Areas
First: 650 sfRepuirer d—$ Re—o
Height 24 Bathrooms: 3 Basement 0 sf
Second: 1021 sf Left: 4 Parking Spaces: 0
Dwelling Units: 1 Garage: 390 sf
Third: 0 Front 11. 5 Smoke
sf 2
Total: 1671 sf Right 4 Detectors: Yes
Value: $207,541.05
Rear 16
Sinks: 1 Water Closets: 3 PLUMBING
Washing Mach: 1 Laundry Trays: 0
Rain Drain: 1
Tubs/Showers: 2 Floor Drains: 0 Sewer Lines: 100 Urinals: 0
Lavatories: 4 Dishwashers: 1
Garbage Disp: 1 Water Heaters: 1 SF Rain Storm Sewer: 100
Footing Drain: 0 Water Lines: 100 Drains: 0
Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Bckflw Prevntr: 0 Catch Basins: 0
Drywell-Trench Drain: 0
Other Fixtures: 0
Other Fixture Units:
_ e
Ful Tvpes MECHANICAL
—�_ Air Conditioning: N
Natural Gas Vent Fans: 5 Clothes Dryers: 1
Heat Pump: N
Furn<100K: 1 Hoods: 1 Other Units: 0
Vents: 0 Woodstoves: 0
Furn>=100K: 0 Gas Outlets: 4
Residential knit ELECTRICAL
Service Feeder
1000 sf or less: 1 TemSrvclFeeders p
0-200 amp: p Branch
Ea add'I 500 sf: 3 0-200 amp: 0 W/Svc or Fdr: 0
201-400 amp: 0
0
Mfd Home/Feeder/Svc: 0 201-400 amp: 0 W/O SvGFdr:
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
Class of Work: BUILDING INFO
Type of Use:
NEW
SF VB Type of Constr: Occupancy Group:
Square Feet:
Owner: R-3
DR HORTON INC. Contractor: 1671
4380 SW MACADAM AVE STE 100 DR HORTON INC PORTLAND Required Items and Reports(Conditions)
PORTLAND,OR 97239 PMACADAM AVE SUITE 100 1 Ersn Cntrl 503-639-4175
PORTLAND,
ND,OR 97239
PHONE: 503-2224151
PHONE: 503-2224151
FAX: 503-222-1304
Total Fees: $27,642.86
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable la
be done in accordance with approved plans. This
w. All
beys. ATTENTION: Oregon law requirespermit will expire if work is not started within 180 days of issuance, or if work is suspended for more thek 180l
da952-001-0010 through OAR 952-001-0090 ou may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
/ _ t
Issued By: �.`� I� �i `
_L.,J.4 Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. �� .C4-41
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.
PPe
Building Permit Application -j
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• Residential RECEIVED FOR On ICI. I SF OM N.
City of Tigard Reethed t ! /i
`5 b _/^�.fb I L'V ♦ Permit No44572. /6 -0
II y 13125 SW Hall Blvd.,Tigard,OR 97223 Novt`B�`
tJ V 2 Q 16 Dan Iter len l ' 3-! s>ta 7
Phone; 503.718 2439 Fax. 503.S9t3J9t>U � OtberPennit.
Date By. fff
1 t, t t Inspection Line. 503.639 41'(5 CITY O1 3 l A D !Yale Read)fly lurks 0 Sic Page 2 fur
Internet: www.tigard-w•.gov Orli �� Notified.Method. 7 Supplemental Information
),LDI i�". ') MS.. "s
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DN ELLING
(♦New construction 0 Demolition Permit fees"are based on the v alue of the work performed.
-- Indicate the value(rounded to the nearest dollar)of all
0 Addition/aiteration/replacement _ 0 Other: equipment,materials, labor,m erhead,and the profit for the
CATEGORY OF CONSTRUCTION indicated on this application.
it I-and 2-family dwelling ElCommercial/industrial Valuation: $ 4190 /,�'ll ) —V I
❑ Accessory building 1:1 Multi-family Number of bedrooms: T
❑Master builder _ 0 Other: Number of bathroos.o?t>: { 3 `` �.
JOB SITE INFORMATION AND LOCATION Total number of floors: 4. 401.c. b '
Job site address: 8 7 C - G 1-, � New dm ening area: `/ '7( square feet
City/Statee/Z :Tigard, OR 97223 Garage carport area : ?' square feet ,
Suitebld /a t.no.: Project nano ' *AILC��51 h Covered porch area: S-60' square feet)Q a
Cross streetidirections to job site: Deck area:
square feet 6 S
Other structure area: square feet •
REQUIRED DATA:COMMERC IAL-USE CHECKLIST
Subdivision: Lot no.:10a 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 WORE. work indicated on this application.
New SFR Valuation: S
Existing building area: square feet
New building area: square feet
e PROPERTY OWNER 0 TENANT Number of stories:
Name: DR Horton Inc. Type of construction:
Address: 4380 SW MacadamAve Suite 100 Occupancy groups:
City/State/ZIP: Portland, OR 97239 Existing:
Phone:( 503) 222-4151 Fax:( )
New
0 APPLICANT ,� CONTACT PERSON BUILDING PERMIT FEES'
Business name: DR Horton Inc. (Please refer wire schedule)
Structural plan review fee tor deposit):
Contact name:Emerald Weeks
Ft S plan review fee(if applicable):
Address: 4380 SW Macadam Ave Suite 100
Total fees due upon application:
City/StateZIP: Portland, OR 97239
Phone:(503 )222-4151 x1107 Fax: .( ) Amount received:
E-mail: esweeks@drhorton.com PHOTOVOL fAIC SOLAR PANEL S1 STEM FEES*
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 1 Solar Instailarton Specialty C'ode checklist.
City;State2IP: Portland, OR 97239 Permit Fee(includes plan review S180.00
and administrative fees):
Phone:(503 )222-4151 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.: 130859
I Total fee due upon application: S2t11.60
Authorized signature: - This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: F i 4 r Date:2016 .Fee methodology set by 7 ri-County Building industr
Service Board.
I:Building.PennitsBl'P-RESPennitApp.doc 02242011 440-4613T(I 102C'OM'WEBt
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(ity of Tigard ttEIVED
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I * PROPERTV OWNER 1 a TENANT " . . ' '
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1 il,---4..'040 SW Niac Adam :1 vc Stilic 100 .. .,
.‘"4.I"' Portland, OR 972.39
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Electrical Permit Applicata b l V E 1
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City of Tigard N 0 V 8 2016 Permit No.: ��j
13125 SW Hall Blvd.,Tigard,OR 97223 �5i1 �'
Phone: 503.7182439 Fax: 503.�g eBy Review Other Permit:
Inspection Line: 503.639.4175 Ci K 'bz i'.. Date
UReady/By: kris: a See2 for
Internet: www.tigard-or.gov 3 U$L.D i N( a1/i s"f i"`,l Notified/Method Page
Supplemental Information
TYPE OF WORT j ' - PLAN'REVIEW
®New construction 0 Addition/alteration/replacement Please check all that apply(submit2 sets of plans w/uems checked below):
❑Demolition ❑Other: 0 Service or feeder 400 amps or more 0 Building over three stories.
where the available fault current ❑Marinas and boatyards.
CATEGORY'OF CONSTRUCTION exceeds 10,000 amps at 150 volts or O Floating buiidioge.
❑ 1-and 2-family dwelling ❑CommerciaUindustrial 0 Accessory building less to ground,or exceeds 14,000' ❑Coramercial.usc agricultural
amps forum other installations. buildings.
❑Multi-family 0 Master builder
❑Other: 0 Fire pump. ❑Installation of 75 KVA or
JOB SIDE INFORMATION AND LOCATION O gd0.cy system. larger separately derived system.
G�-`G l L ❑Addition of new motor load of 0"A","F',"1-2","1-3",
OW -/ 45i^/ i RvM 1,T six of orere.
Job no.: Job site address: f occupancy.
City/State/ZIP: G 2 ( (]Six or more residential units.
0 Recreational vehicle parks.
ty �I vi (' J 7,001 J ❑11ahit cera facilities. ❑Supply voltage for more than
1 / J ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt no.: Project name: kie,,v1-Ky.. Ci o 1 ElService or fader 600 amps or more.
Cross street/directions to job site: a FEE SCHEDULE
Dercrlptiaa I Ser. 1 Fee. . I Total 1 •
New residential'single:or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: IOoZ 1,000 sq.R.or less ).„...., 168.54 4
Tax map/parcel no.: Es.add'i 500 sq.R.or portionI 33.92 1
Limited energy,residential J
DESCRIPTION OF WORK (with above sq.it) 75.00 2
Limited energy,multifamily 75.00 2
residential(with above sq.R.)
Services or feeders installation,alteration,and/or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 anis 133.56 2
Name: 401 amps to 600 amps 20034 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:( ) Fax:(. ) 200 amps or less 59.36 1
Owner installation:This installation is being made on property that I own which is not 201 amps to 400 apps 125,08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
Branch circuits--new,alteration,or extension,per panel
Owner signature: _ Date: A.Fee for branch circuits with
to
❑ APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee, 7.42 2
DR Horton Inc each branch circuit
Business name: B.Fee for branch circuits without
Emerald Weeks service or feeder fee,first
Contact name: branch circuit 56.18 2
Address: 4380 SW macadam Ave Each 7.42 2
Miscellaneous(service or feeder not included)
City/State/ZIP: Portland OR 97239 Each dwellmanufactured service anoro modular 67.84 l 2
Phone:(503) 222-4151 Fax::( ) . Reconnect only 67.84 2
E-mail: ... Pump or irrigation circle 67.84 2
CONTRACTOR i. Sign or outline lighting 67.84 2
Std
• Signal circuit(s)or limited-energy
Business name: �.7 td 14 it`� t7.4- g l err/14 c 1-12:e..... panel,alteration,or extension. Page 2 1 2
(// I up-
rt Each additional inspection over allowable in any of the above
Address: 2,(o 1/ %'E (' .� Additional inspection(I hr min) 6625/hr
City/State/ZIP: Ver,hc 0 lit V /i-. Vx 4, ,,9F b
Investigation(1 lir min) 66.25/hr
36a 5/f_ . ---.5-,..9
7j) Inspectiolplant(]hr which
o►) 78.18/hr
Phone:( ! Fax:QS� 3� 966'0 Inspections for which no fee is
r specifically listed(K br min) 90.00/hr
CCBLic.:/t2,7"I9 Electrical Lic.:•C230 Suprv.Lic.: 179j s ELECTRICAL PERMIT FEES
Suprv.Electrician signature,requiredei_ ID - ,,/,1 Subtotal:
( ,1 �'�� `--'-e"L Plan review(25%of permit fee):
Print name:Ch 4 Ste kJ t2�' Date:
�//`� ('tom``/�j Stene surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
This permit appnaatinn expires ifs permit is not obtained within 180
Print name: I Date: days after it has been accepted as complete.
.4fov * Number of inspections allowed per permit.
I:t$uildingtper aitthELC.-PermaApj, 440.61ST(I I/05/COM/WEB
, Electrical Permit Application–City of Tigar` I (
• Page 2—Supplemental Information L "'%
I1 E'.
Limited Energy Permit Fees: NOV 8 2016 Renewable Energy Permit Fees:
CITY OF IE, 'ND
RESIDENTIAL WORK ONLY: FEE SCHEDULE ,�
Fee for all residential systems combined: $75.00 `�r`t°" °"' F"h '°`°�
Renewable electrical energy systems:
Check Type of Work Involved: 5 k.a or lc's I(:.,u2
5.U1to151.ca 133.56
n Audio and Stereo Systems* 15.01 to 25 kra MI 200.34
Wind generation systems in excess of 25 kva:
n Burglar Alarm 25.01 t,,5o 1,.1 301.04 ! 2
5u.n1 to IVUk\a 552.26
X Garage Door Opener* >u1,;kva(fle in accordanceI
5 .
I LI
with(PAR 91h 52,r I
F Heating, Ventilation and Air Conditioning
Solar generation systems in excess of 25 kva:
System*
Pack additional kva,wcr 25 7.12
n Vacuum Systems* ,101 k\a uu additional charge U 0 3
Each additional ins'ection over allowable in any of the above:
I I Other: Each additions!inspection ■ 6h hr i I
char ed at an}lowly(I hr min) -
I
Inspections Iln which no Ice is
slisted 11111,0.00 hr
xcific,Il 1 hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
n Boiler Controls
n Clock Systems
❑ Data Telecommunication Installation
I Fire Alarm Installation
n HVAC
I- Instrumentation
U Intercom and Paging Systems
Landscape Irrigation Control*
n Medical
n Nurse Calls
L Outdoor Landscape Lighting*
✓ Protective Signaling
F. Other:
Total number of commercial systems: — f
*No licenses are required. Licenses are required for all
other installations
I..BuiidintPer enc,1'LC Pct.ni;.4pp_LLR ERF k. P,.,U' I"_l�I�
Plumbing Permit Application
Building Fixtures FOR 01,1•1(.I. 1.1s1-. ONL\
Cityof Tigard Received
g onmt No.:
13125 SW Hall Blvd..Tigard,OR 97223 llatc/By: �'P � 1(/j COr'�
1man Review-
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit so.:
Y i c i A I:I Inspection line: 503.639.4175 Date Ready/HY: kris El See Page 2 for
Internet: www.tigard-nr.gov Notifed.'Metbod: Supplemental Information
TYPE OF WORK FEE` SCHEDULE
❑New construction 0 Demolition Fur special information use checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ff for each utility connection)
CATEGORY OF CONS7'RUUCrION SFR(I)bath 312.70
o I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
0 Master builder ❑Other: Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Catch basin or area drain 18.76
Job site address:
acot SW -.{.1-\ro la-t- toocp
Drywell,leach line,or trench drain 18.76
City/State/7.1P: Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name: preAl tCk ('OS c J Manufactured home utilities 50,03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) s Page 2
Storm sewer(no.linear$1.:_) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: Lot nu.: j
%,:.,t (12 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK I Backwater valve 12.51
Clothes washer 25.02
. ,--
Dishwasher
Dishwasher 25.02
C t.,10t1 'it(-X(h' ,-.4'I Ck(ACie 'fro On AA t.A..j t l') Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER 0 TENANT Expansion lank 12.51
Name: Fixture/sewer cap 25.02
-Ho at)f"1 Floor drain/fan'sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/LIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name: I). a l-t-v t on
Medical gas(value:5_) Page 2
Primer 12.51
Contact name: w P t°K.
>r'� L'Y(� Roof drain(commercial) 12.51
Address: L1 3e S11'i KA(if ori CU1t Alike Sink/hasin/lavatory 25.02
City/State/ZIP: PD V (172-39 Solar units(potable water) 62.54
Phone:(g ) 2-2-7- Li i S i I Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
UJ4) S C el Y it61 ()t t• -- Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:Wolcott Plumbing Water piping/DWV 56.29
Address:1075 W.Historic Columbia River Ilwy Other: 25.02
City/StatefLlI':Troutdale Or.9060 Subtotal
Phone:(503)667-1781 Fax:(503)667-9891 Minimum permit fee: 572.50
C'C'13 Lic.: 112220 Plumbing Lie.no.:26-824PB Ylan review (25°i0 of penult fee)
State surcharge(12%of permit fix)
Authorized signator a- TOTAL.PERMIT FEE
Print This permit application expires if a permit is nut obtained sithin 181)days
1 rint name:Mark Baleme Date:2/17/17 ager it has been accepted as complete.
*Fee methodology set by Tri-County ty Building Industry Service Road.
I AluilthrgoPermii01.101,PtnnitAppMx inaitx>7 440-4t,It 11110021Co?.t'WEll)
City of Tigard
UPIq COMMUNITY DEVELOPMENT DEPARTMENT
i
T 1 c R D Building Permit Review — Residential
Building Permit #: /fjj S TL (G"C.nS—,
Site Address: es-s--c-7 sZd )c%hlk1/P- �6r.✓�
Project Name: �`>k`. Q e5 in Lot #: (pQ
(New dwellin0subdivision name;Addition eration=last name of owner)
Planning Review CCCCCJJJJJ
Proposal: t) 2Fi
Verify site address/suite# exists and activ to permit system.
iver Terrace Neighborhood: V No ❑ Yes,See River Terrace Review Addendum Attached
Sits Plan Elements:
��ree(3)copies of site plan 0 Asting structures on site
Clr S e plan must be on 8-1/2"x 11"or 11 x 17"paper 7 Footprint of new structure(including decks)with finished
i D awn to scale(standard architect or engineer scale) �or elevations
IX i rth arrow f1QUtility locations (required for new,may apply for additions)
e address,project or subdivision name and lot number \7�t ation of wells/septic systems
.,i;/ .licant information(name and phone number) :':0.sting trees to be retained with drip line,and tree
T. .t dimensions and building setback dimensions otection measures
1 .t area,building coverage area,percentage of coverage andeet tree size,type and location
pervious area(applicable if R-7,R-12,R-25&R-40) Street names
Property corner elevations(2 foot contour lines if more than
4 foot differential)
tdiklean Water Services—Service Provider Lett (lot platted prior to 9/10/1995):
Pequired: ❑ Yes,applicant was notified W No Received: 1:1 Yes El No
ublic Facili ' s Improvement(PFI) Permit:
equired: V Yes,applicant was notified ❑ No Applied For: yes ❑ No,stop intake
Land Use Case#: A) L�f�— :1L1�il> jU /� C '
zoning: ✓`—IQ
Vi/Required Setbacks: Front /QS—Rear / Side Z71 Street Side Garage 7
andscape Requirement:
...70 0/0
/ot Coverage Maximum:
0/Building Height: Maximum Height SS— Actual Height ,62
ViVisual Clearance
L4Q Easements
roi 0.ensitive Lands: ❑ Yes /No Type
lit Urban Forestry Plan
❑ Conditions "Met">1prior to issuance of building permit
Notes: r:i/ Ic)y�9 'c'a 1/ Llic,. r' 4 ani i c tkwree._
Approved By Planning: 40110-- — Date: hJ
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
Site Plans: #
Building Plans: #
Building Permit#: Enter building permit#above.
Workflow Routing: Planning 'Engineering 'Permit Coordinator )2—Building
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
J> Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
ByPermit Technician: Date: 1
.c.d., iJ .�.-._„ /�/ .#, /lam
Engineering Review
Slope at building pad: .lc�
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: /17, 12_ Date: /�
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
DC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: Yes ❑ N/A
K to Issue Permit
Approved by Permit Coordinator: /
/ Date: i d�
I:\Building\Forms\BldgPermitRvw_RES_091216.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8559 SW SCHMIDT LOOP, TIGARD, OR, 97224 September 22, 2017 at
9:57:38 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00596
Inspection Type: Inspector:
699 Mechanical final Aaron Cillo-Gobel
Result:
PASS
Comments:
Corrections completed.
Note: master bathroom exhaust fan cover to be installed at time of building final.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8559 SW SCHMIDT LOOP, TIGARD, OR, 97224 September 22, 2017 at
10:13:09 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00596
Inspection Type: Inspector:
199 Electrical final Aaron Cillo-Gobel
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8559 SW SCHMIDT LOOP, TIGARD, OR, 97224 September 27, 2017 at
12:17:36 PM
Record Type: Record ID:
Residential - Master Permit MST2016-00596
Inspection Type: Inspector:
299 Final inspection Aaron Cillo-Gobel
Result:
PASS - CofO
Comments:
Final erosion control passed
Street tree certificate received
Moisture content form received
High efficiency lighting form received
Insulation certification verified
Blower door and/or duct seal test certificate received
C of 0 left on counter.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8559 SW SCHMIDT LOOP, TIGARD, OR, 97224 September 27, 2017 at
12:05:22 PM
Record Type: Record ID:
Residential - Master Permit MST2016-00596
Inspection Type: Inspector:
699 Mechanical final Aaron Cillo-Gobel
Result:
PASS
Comments:
A/C installed using minor label ELS596175
Violation Summary:
Inspector Contractor