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Permit (44) CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2016-00550 T t OAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/16/2017 Parcel: 2S 111 DA21200 Site address: 8730 SW SCHMIDT LOOP Jurisdiction: Tigard Subdivision: HERITAGE CROSSING Project: Heritage Crossing, Lot 31 Lot: 31 Project Description: New SF. BUILDING Floor Areas Required Setbacks Stories: 2 Bedrooms: 4 First: 936 sf Repaired Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1361 sf Dwelling Units: 1 Garage: 573 sf Front: 15 Smoke Third: 0 sf Right 5 Detectors: Yes Total: 2297 sf Value: $286,629.00 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Urinals: 0 Sewer Lines: 100 SF Rain Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 : 0 Storm Sewer 100 Water Lines: 100 Drains Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Bckflw Prevntr: 0 Catch Basins: 0 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 1000 sf or less: 1 Branch Circuits 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'l 500 sf: 4 201-400 amp: 0 201-400 amp: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 p W/O Svc/Fdr: 0 P 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 Other: N Other Description: All Ecompasing: Y BUILDING INFO Class of Work: Type of Use: NEW Type of Constr: Occupancy Group: Square Feet: SF VB R-3 2297 Owner: Contractor: DR HORTON INC-PORTLAND 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: PHONE: 503-222-4151 FAX: 503-222-1304 Total Fees: $29,147.47 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 952-001-0090. Y u may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: �' / ,b� /LK / /j .lit Permittee Signature: cT /P./ /�c Call 503.639.4175 by 7:00 a.m.for the next available inspection date. �7 . / 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 Fer it Anpiicatio.t ,3 7i0 +fie, (3,,) r =i-y,: Rcside>ntialti ctiv ... City of Tigard aetcived s!s 13125 SW Hall Blvd.,Tigard.OR 97223 Date, i�/j}/� — Permit No- Phone; 503.718 2439 Fax: 503.+,yg.l9 �1 Date,)).ru " '' Tyls`/`" 1/�:(11550 It f <<: ,E.t 5 Inspection Line. 503.6394Fa4175 (I F L• , (U D Date D. — 1 — ) Otho Permit:,. .1.//e- Interact: gard rn-.g4late ilea B.. �M� -:` d, CC41 �"� I } ftitied Method: S'f a Page 2i fur �;,� � �P � supplemental Information TYPE; OF woRl �i1.'.illn ,...`s _ �.�.�,_�, pg REQUIRED DATA.1-AND 2-FAMILY DN FEEING New construction 0 Demolition Permit fees*are based on the value of the work perforated. Indicate the value(rounded to the nearest dollar) equipment,materials,labor,overhead,and the profit ll (]Addition/alteration/replacement E3 Other: for the CATEGORY OF CONSTRUCTION work indicated on this application. Q I-and 2-family dwelling ' ❑Commercial/industrial Valuation; $ ❑ Accessory building _ - 0 Multi-family Number of bedrooms; LI ❑ Master builder 0 Other: Number of bathrooms -. 3 JOB SITE INFORMATION AND LOCATION Total number of floors; 4. • • Job site address: 57.3c , ,$ l Ile ? New da ening area: square feet city/Slate/Zip;Tigard, OR 97223 0, Garage.carport area:5-7 square feet Suite'bldg./apt,no.: ] Project name 1 Cross street/directions to job site: J i Covered porch area: 03 square feet Deck area: square feet e Other structure area: square feet • Subdivision: REQUIRED DATA:COMMERCIAL-USE CHECkLIS1 Lot no.: 1 Permit fees*are based on the value of the work performed. Tax map/parcel 1.--------"Z"----------' Indicate the value(rounded to the nearest dollar)of all DESCRIPTION OF WORK equipment.materials,labor.overhead,and the profit for the work indicated on this a..lication, New FR Valuation: $ Existing building area: square feet New building area: square feet e PROPERTY OWNER 1 0 TENANT Number of stories: Name: DR Horton Inc. Address: Type of construction: 4380 SW Macadam Ave Suite 100 Occupancy groups: City/State/ZIP: Portland, OR 97239 Phone:( 503) 222-4151 Fax:( ) Existing: 0 APPLICANT Netti': CONTACT PERSON Business name: DR Horton Inc. BUILDING PERMIT FEES* Please re et to se schedule Contact Warne: Emerald Weeks Structural plan review fee(or deposit): 111111111111111 IIIIIIIIIIII Adess: 4380 SW Macadam Ave Suite 100 FLS plan review fee(if applicable): dr Total fees due upon application: City/State/ZIP:Portland, OR 97239IIIIIIIIIII �, Phone:(503 )222-4151 x1107 Fax; :1 ) Amount received; E-maileswet:ks@drhorton.com PHOTOI'OLrAIC SOLAR PANEL SI STEM FEES° CONTRACTOR Commercial and residential prescriptive installation of Business name: roof-top mounted PhotoVoltaic Solar Panel System. DR Horton Inc. Submit two(2)sets of roof plan with connection details and fire department access,along with the 20lq OregonAddress:4380 SW Macadam Ave Suite 100 CityiState,'ZIP: Solar Installation eialty Corte checklist. Portland OR 97239 Permit Fee(includes plan review t Phone:(503 )222-4,151 Fax:( and administrative fees: CCB lie.: 130859 State surcharge(l 2%of permit fee); $21.60 t. Total fee due upon application: 111.31111(t '� c- ° i` / This Permit application expires if a permit is not obtained Authorized signature Print name: ; i i / within 180 days after it has been accepted as complete._ i) ' `,� j' ? , i . -,, , Date:2016 "Fee methodology set by Tri-County Building Industry Service Board.I Building.Permits BLP-RESPennitAPp die 02 24.2011 440-4613Tt 1102 COM'WEB' Mechanical l'erniikApplication flit m /uf '~/ om ` Kix, of Tigard - ' /v�n�wumo�u ^m=x ^w ~'zz` /��^��0im y*°���� , ph,,,,,,, *'"-/~t'.4 Pt /"` waHw 146// �4,^�~/!Inv NO,/H19,41'4 mx�� ""°m*�a.`�`` �x'°^/~^---^'-^s. --- __�- -_� l�� ^ _- -``~-'.` ,�`�p��" m �°,*� �. ` — ----- ' ---------- ORK VV14 IN ------ � ^ - ' ; -- - '.N,°mmunv "* LAt/6.1011M*:�zu,",�duw�"' / "^°,�",�=,."~,,�uv° ,w**° `^" [ V^" l/�v 0 4mw > • VAC' m/ - _' _ . �� fit.T .1= I � � ° = ^ _ ��mvJ°d/" [ ,�" �uun "wva �a.~*`~*� o* W '.� a~ ^ : r ttl) !vi ci ] "| on � * » om �u � . _ -______ - r�--�--- ~=�=°p� *�°������ ��OCATIm� _ i , - ' . `'. - ~--I `---- - ` '-^==� - ' — i ' ^�. /x� . / ' "^^"" t-`"°''n" ~`"=~~' ___� __ -__~_._ '__-____ - __ -� . / �`�����u��1��"` ^�. ".~m -'____---__�__-_��� ! 1 . ___ ________________ �-c___'_f /^`Map wman,` rw DR Flotion Inc. 1 t- I SUP/NI'/Ho.four,,4.4,41k 110,1 irktto i!tithtiotiall /IQ ill' Portland,OR 97239 ; 1 ,L;;;!:,:;-; — - ;. t ,t;t, eNweek,sca4,1thorton.com r ... ....._ ....._ „ ... _........_....._ .... .,... , . _. .. 1. ...4 . i , 41/11 43 m�° .u��o _�________ � ` --040,~ ,.- I =`��/v _) | °~�`— �� �~�~., '.� � _LT, :, , Electrical Permit Application k AAS roR 01 ricl. t ',i ()Ni1 1111 City of Tigard Received Phon5:S503.71sB439 Tigard, ,50033..59 1819960 0L L ' 2016 Review other No.: /1...67)21 rL. Z�11 i Inspection Line: 503.639.4175 Data/By: Other Permit. 1 i,, , ��� pec Ready/By: Internet: www.tigard-or.gov f ' .,9 i.a"-I`l '•,.method Jar"' s panel for NC , Supplemental Io[ot7sation TYPE OF wol � ' ` feint: !IAN'REVIEW ®New construction ❑Addition/alteration/replacement Please Bieck all that apply(submit 1 sets of plans wwtems checked below): ❑Service or feeder 400 amps or ❑Building over three stories. ❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards. CATEGORY'OF COIdSTR IC!'I( 11 exceeds 10,000 amps at 150 volts or ❑Floating buildings. ❑ I-and 2-family dwelling 0 Commercia/industrial 0 Accessory building less to ground,or exceeds 14,000- Cil Commercial-use agricultural ❑Multi- amps for all other installations. buil, iiy ❑Master builder 0 Other: ❑Fire pump. 0 Installation of 75 KVA or OB ST!E INFORMATION AND LOCATION ❑Emergency system. larger arately derived system. J ❑Addition renew motor load of ©"A","E","1-2","1-3", Job no.: I Job site address: 10011P or more. occupancy. ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP: ij � ' j ❑Health-care facilities. ❑Supply voltage for more than 0 Haws locations. 600 volts nominal/ •no.: Project name: 1 t . ly �A.-j`-�J c,_ ❑Service ce feeder 600 amps or more. Cross street/directions to job site: lJ�VFEE SCHEDULE Dera3oNw I Qty. I Fee. I Total I • New residential single-or multi=family dwelling unit. Includes attached garage. Subdivision: I Lot no.:c.S 1 1,000 sq.ft.or less 1 168.54 4 Tax map/parcel no.: Fa add'l 500 sq.it.or portion 3 33.92 1 DESCRIPTION OF WORK • Limited energy,sq.ft) al 75.00 (with above sq.ti) 2 Limited energy,muki-family residential(with above sq.it) 75.00 1 2 Services or feeders installedo alteration,and/or relocation 200 amps or less 0 PROPERTY OWNER I 1 ❑ TENANamps to 400 amps T 201 133.56 2 133.56 2 Name: 401 amps to 600 amps 200.34 2 Address: 601 amps to 1,000 amps 301.04 2 Over 1,000 amps or volts 552.26 2 City/State/ZIP: • Temporary services or feeders installation,alteration,and/or relocation Phone:( ) F"ax:(: ) 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 amps 125.08 22 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 • Branch circuits--new,alteration,or extension, er panel Owner signature: Dam: ____6.,______ A.Fee for branch circuits with 0 APPLICANT I ! ❑ CONTACT PERSON eabove service ach branch circuit feeder fGe' 7.42 2 Business name: DR Horton Inc B.Fee for blanch circuits without contact name: Emerald Weeks or feeder fee,first branch circuit56.18 2 Address: 4380 SW macadam Ave Each add't branch circuit 7.42 2 City/State/ZIP: Portland OR 97239 , Miscellaneous rcdrolarerr ernot includ�) ll1-4151 dwelling,servlceand/orfeisler 67.84 2 Phone:( 503) I Fax::( ) a Reconnect only 67.84 E-mail: 2 Pump or irrigation circle 67.84 2 CONTRACT i' Sign or outline lighting 67,84 2 Business name: 6-(ALI'1 LT Com.J )— G 1 Signal lteraiiont(s)orlimitedianergy Gr t '"T"(/�� �� panel,alteration,or extension. page 2 12 Address: 20 Li/ A� /-�(^ n, tt Each additional inspection over allowable in any of the above mfr t0 c? „, —9*.40 Additional inspection(1 hr min) 6625/hr City/State/ZIP: r/r.i,•? e'(i(�/ t 1 44 QC b / Investigation(1 hr min) 66.25/hr Phone:(3a 5/f_ 25J' ]Fax: �� (1[� Industrial plant(1 hr min) 78.18/hr GU" c7�(�j Inspections for which no fee is 90.00/hr CCB Lic.: Z /, Electrical Lia:• specifically listed(%hrmin) -7,.. CZ 3 0 I Suprv.Lie.: /7 9..i: S ELEC IRICAL PERMIT FEES Suprv.Electrician signature,required: ' Subtotal: Print name:/1 G Plan review(25%Of permit fee): l.4 c:,/b`, 6 , , a -j + Date: State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name: This permit application expires if a permit is not obtained within 180 Date: days after it bas been accepted as complete. Number of inspections allowed per pandit. 1:1Buildina1PermitalELGPermitppp 440-06157 01/05/CONVWEB Electrical Permit Application—City of Tigard r'(113. 1 Page 2—Supplemental Information i&'ti .a ;;,.i" Limited Energy Permit Fees: Renewable Energy Permit Fees: -T�, TIGA: RESIDENTIAL WORK ONLY: 1" ,;' FEE SCHEDULE Fee for all residential systems combined: $7�;+ i n G )r'r IS a'tw° S". Each lout Renewable electrical energy systems: Check Type of Work Involved: 5 kva or to 5.01 to 15 kva 133.5EEl _j 2 Audio and Stereo Systems* 15.n1 to 25 kNa 21/0.34 I Wind generation systems in excess of 25 kva: FI Burglar Alarm 25.01 to 50 kva 301.114 G• arage Door Opener* 50.01 to 100kNa 552.26 - >loo k%a(fix in accordance with OAR 91h-309-0040) 552.76 , n H• eating, Ventilation and Air Conditioning - t Solar generation systems in excess of 25 kva; System* — 1 ach additional kva«act 25 7 42 ; I r V• acuum Systems* -100 k%a-no additional charge {l tr i Each additional inspection over allowable in any of the above: Other: Each additional inspection is t charged at an hourly(I hr min) 66 25 hr Inspections for which no Ice is specificall) listed(-:hr min) 00.00 hr f COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 Subtotal(Enter on Page I). (SEE OAR 918-309-0000) • Number of inspections allowed per Per,n;,. Check Type of Work Involved: ❑ Audio and Stereo Systems n Boiler Controls n Clock Systems E Data Telecommunication Installation ❑ Fire Alarm Installation n H• VAC I Instrumentation I Intercom and Paging Systems n L• andscape Irrigation Control* n Medical L Nurse Calls n O• utdoor Landscape Lighting* • Protective Signaling El O• ther: Total number of commercial systems: T *No licenses are required. Licenses are required for all other installations I.,Bui'.duy Pcrnuss rL.0 Pn:nitApp LLR ERF Lk, I`:OF A 1 Fiumbing Permit Application • Building Fixtures ,--1 (`` City of Tigard Received li pt�y: Permit No.: `ti • 13125 SW Hall Blvd.,Tigard,OR 97223 �6/�iJll ---- :,,S-C) g Phone: 503.718.2439 Fax: 503.598.1960 1S E(, 1 ?Q i p Flee Review Other Permit No.: Inspection Line: 503.639.4175 Date/By: I't G,�R.a Internet www.tigard-or.gov }1t r / k r, Dm Reedy/By: tart. B See e 2 for h �i r 1 tho iledikled: Supplemental lefermatlea u,. TYPE OF ( PE1C• $f, J)1[ `:, fi ❑New construction ❑ mo Aro 1 " ) ' Fors seal in onrrtuloo use checklist. DescrittionI Fa Total( To ❑Addition/alteration/replacement ration/replacement ©Other: New 1-2-family dwellings(includes 100 R for each utility connection) CATEGORY 'ov CONSTRW TION SFR(1)bath 312.70 ❑1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)beth 50032, Each additional bath/kitchen 25.02 ❑Master builder 0 Other Fire sprinkler( sq.ft.) Page 2 JOB.'$IElE,IAlIPORMA ON:'AND L(ICATION Site utilities. Job site address: &7J Sc.*, f Catch balm or area drain 18.76 City/StatelZlP: Diywctl leach line,or trench drain 18.76 Footing drain(no.linear ft.: ) Page 2 Suite/bidgJapt.no.: Project name: (, h bbl ll Manufactured home utilities 50.03 Cross street/directions to job site: � ` , Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:__J Page 2 Storm sewer(no.linear ft.:.,_,) Page 2 Water service(no.linear ft.: ) 1 Page 2 Subdivision: 1 Lot no.:3 I Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 . .. DESCRO!TION'OF:WORK Backwater valve 12.51 .. Clothes washer _ 25.02 y�� Dishwasher 25.02 VF Drinking fountain 25.02 Ejectors/sump 25.02 1Expansion tank 12.51 ❑ PROEM, OW14ER • ..1 0 TENANT Name: ?.._Vt V v t \N,-L, ' Fixture/sewer cap 25.02 Flom Address: C� 1 \ n.o � j( Garbage oor sink/hub 25.02 c�"�-� �tl��' Garbage disposal 25.02 City/State/ZIP: O'L ` `�L- `11 Hose bib 25.02 Phone:l( )�) -A -4l 1 Fax:( ) Ice maker 12.51 ElAPPLICANT 0 CONTACT PERSONJ Interceptor/grease trap 25,02 Business name: ›Zr. t~� � k lel(, ) Medical gas(value:S-) Page 2 PriContest name: k.`";\FAQ / I et "1� Romer 12.51 of drain(commercial) 12.51 Address: . Sink/basin/lavatory 25.02 City/StatetZlP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 12.51 E-mail; e J\d TOom6m &v vt Ci ) .Co di Urinal 25.M Water corer 25.02 ,.' ;COACTOR Water heater 37.52 Business name:EDWARD MULLEN PLUMBING rWaterpiping/DWV 56.29 Address:1601 SE RIVER ROAD Other: 25.02 City/State/ZIP:HILLSBORO,OREGON 97123 Subtotal Phone:(503)640-0113 Fax:(503)6404483 Minimum permit fee: $72.50 •CCB Lie.:94689 Plumbing Lic.no.:34-260PS Plan review (12%25%of permit fee) )11. State surcharge(12%of permit fee) Authorized signature: ', _ Jr, TOTAL PERMIT FEE - Print name:RAY MULLEN / Date:` Thb permit application expires if a permit b ant obtained within ISO days after it has been accepted as complete. 'Fee methodology set by Tri-County Building Industry Ranee toad, 1:113u510aj PaaiitAPLMU-PerwbApp.doc 10/91/09 440.4616T(10/02/COMAVEB) City of Tigard ■ COMMUNITY DEVELOPMENT DEPARTMENT T l c D111111 Building Permit Review — Residential Building Permit r._i.;:: �,�xg �� 5t3 Site Address: 8:7-&- ,git) S ,p- 24.7z. 4.r Project Name: 0 • ? C17)S-ci/t # Lot #: 3 (New dwi.,g=subdivision name;Aifri.o .r Alteration=last name of owner) Planning Review Proposal: /LAO .2Fe (LI Verify site address/suite#exists and activ in permit system.fiver Terrace N hborhoody No 0 Yes,See River Terrace Review Addendum Attached Si Plan Elements: V ree(3)copies of site plan to plan must be on 8-1/2"x 11"or 11 x 17"paper `n ;sting structures on site raven to scale(standard architect or engineer scale) orelevations w structure(including decks)with finished � orth arrow tility locations(required for new,may apply for additions ) to address,project or subdivision name and lot number • ; � i pplicant information(name and phone number) , , ling trees to be ation of wells/septic systems 0 t dimensions and building setback dimensions , of non measures retained with drip line,and tree Lot area,building coverage area,percentage of coverage and [I, feet tree pervious area(applicable if R-7,R-12,R-25&R-40) treet names size,type and location tProperty corner elevations(2 foot contour lines if more than 4 foot differential) lean Water Services—Service Provider Lett (lot platted prior to 9/10/1995): Required: ❑ es applicant pp t was notified No Received: ❑ Y Public Facili • s Improvement F Permit: es ❑ No P (P 1) equired: Yes,applicant was notified ❑ No Applied For: Yes ❑ No,stop intake 0 Land Use Case#: a9 )/ -Oc,, Zoning: " , L✓1�> Ll'f �1.� Required Setbacks: Front LS Rearc Side Landscape Requirement: • Q % / �� Street Side j Garage Q0Lot Coverage Maximum: C �(J 0/0 Building Height: Maximum Height ActualI � � al , isual Clearance Height ol fri Easements i1d9 ensitive Lands: 0 Yes No Type cv rban Forestry Plan Conditions "Met"prior to issuance of building permit Notes: Approved By Planning: _ _ Date: _ �/ Revisions (after Building Submittal only) Revision 1: 0 Approved ❑ Not Approved Reviewer Date Revision 2: 0 Approved 0 Not Approved Revision 3: 0 Approved 0 Not Approved IABuilding\Forms\BldgPermitRvw RES_091216.docx Building Permit Submittal Original Submittal Date: C . Site Plans: # Building Plans: # . Building Permit#: offer building permit#above. eerie —Permit Coordinatoril�g Workflow Routing: arming g Workflow Sign-off: 'Sign-off for Planning(include notes from planning review) Route Application Documents: El--Ei gineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. Iuilding: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: �--� . .----_____„,C.--- `may Date. 41/6—A, By Permit Technician. � � 'f- a,,,4.1, ,,,W..7- iL, .td,att.4.12"&EIO ,I,Ji*Wilt4FES7Niat-,aiL Engineering Review Slope at building pad: ...71. 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: 0 Yes 0 No Assess Water Quantity Fee in-lieu: 0 Yes t No LIDA Facility on lot: 0 Yes 41 No Date: 0 NOT Approved by Engineering: Notes: WZ. `I) Date: LZ / --14 Approved by Engineering: Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved ❑ Not Approved Revision 2: 0 Approved 0 Not Approved Revision 3: 0 Approved 0 Not Approved Permit Coordinator Review Conditions"Met"prior to issuance of building permit 0 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: l Yes 0 N/A Tigard Trans SDC: E- Yes 0 N/A Parks SDC: [ /Yes 0 N/A Efi OK to Issue Permit Approved by Permit Coordinator: e e..,._ Date: I< . -I c'i " 1 Cc I:13uilding\Forms\BldgPernutRvw_RES_091216.docx Plumbing Permit Aaplicatili ' Building Fixtures � � � City of Tigard UG 2017 Q Received Permit Permit NQ 7oZD/� t7 n.,erey; -� 13125 SW Hall Blvd.,'I UR,9 PlanReviea Phone: 503.718?434 Fax /t 1)ato/8v: Otita Paxnit No.: Inspection Line. 303.639.417 t '�R[) I ;`S� Onto Ready/Hy lona 16 SeePage3 for Internet: w2vwtigard-or_gov s� VP�10 A I Nohfad/Methwl: SunkmentalInformation TYPE OF WORK FEE* SCHROLILE ❑New ooltamction ❑Demolition For special F ormah n use checkll,% Description 6a. I 'fetal ❑AdditioWalteration/replacement ❑Other: Ntrw 11-2-fatoily dwcllin (includes)00 A.foreaeh utility connection) CATEGORY OF (VNSTRUCTION SFR(1)hath 312.70 ❑I-and 2•iamily dwelling ❑CornmerciaVindustriat SFR(2)hash 437.78 ❑Accessory building Mufti-family SFR(3)bath 50032 ❑ teach additional bath/kitchen 2.5.02 ❑Master builder ❑Other: Fire sprinkler(_sq.R.) Pagg 2 JOB,ffirM PMORMATK?N AND LOCATION Site utilities. _ -- Job site address: -�j"� i- � � t_ � . 7 Catch basin w area drain 18.715 City/Statd7.IP: Dr)wei1,leach line,or trench drain 18.76 I-opting drain(no.lincarFL�) Page'2 Suite/bldg.lapt.no.: Project name, r anufactured htrroe utilities 50.03 Crm strcd/directions to job site: bola 18.76 N'n drain connector 18.76 Sanitary sewer(no,linear ft.:_) Page 2 Strum sewer(no.linear ft.:_) Page 2 Waterservice(no,linear ft.:_) Page 2 Subdivision: I.ot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 11ESCRiT ION of WORK Badcwuter valve 12.51 Onthes washer 25.02 _ y g Dishwasher 25.02 Drinking fountain 25.02 Bjeotors/sump 25.02 ❑ TAOP'CY OWNIR ❑ TIINANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Qty Floor drain/floor siitlJltub 25:02 Address: Garbage dispel 2,5.02 City/State/ZIP X _ Hose bib 25.02 Phone — I.-Ax:( ) Ice maker 12.51 ❑ APFUCAW ❑ CONTACT MMM Interceptor/grease trap 25,02 Businm narlle' Medical gas(value:S_) Page 2 Primer 12.51 Contact name: Roof drain(commercial) 12.51 Address: Si"Mosin/lavatory 25.02 — City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tubfshower/shower pan 12.51 E-mails urinal 25.02 Water closet 25.02 CONTRACTOR Water heater _ 37.52 Business name:Wolcott Plumbing WaterP�Prt "n€m W V 56.29 Address:1075 W.Historic Columbia Riser Hwy Other: 2502 City/State/1111:Troutdale Or.9060 Subtotal Phone:(503)667-1781 Fax:(503)667-"91 Minimum permit fee: $72.50 Pian review(25"/o of permit fee) CCB Lic.:112220 Plumbing Lic.no.:26-924PB --- - State surcharge(12°l0 of pertnit fee) Authorized signatur . TO'I'Al.PERN11T F(-.L Print garrlC:Mark Baleme fate:2117/17 Thin permit application expires if ti permit is nor obtained within 190 days after it has,been accepted as ceppi te. "fee medwology set by Tri-Count)Building Industry SnrvmL Board. iiauildiag\Pomib%MW-PwmitAppdm ImW09 44N461o11Ior0Z")A1.wF8) City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 8730 SW SCHMIDT LOOP, TIGARD, OR, 97224 November 29, 2017 at 10:41 :29 AM Record Type: Record ID: Residential - Master Permit MST2016-00550 Inspection Type: Inspector: 699 Mechanical final Aaron Cillo-Gobel Result: PASS Comments: No A/C installed Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 8730 SW SCHMIDT LOOP, TIGARD, OR, 97224 November 30, 2017 at 10:36:34 AM Record Type: Record ID: Residential - Master Permit MST2016-00550 Inspection Type: Inspector: 199 Electrical final Aaron Cillo-Gobel Result: PASS Comments: Corrections completed. No A/C installed Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 8730 SW SCHMIDT LOOP, TIGARD, OR, 97224 November 30, 2017 at 10:37:19 AM Record Type: Record ID: Residential - Master Permit MST2016-00550 Inspection Type: Inspector: 399 Plumbing final Aaron Cillo-Gobel Result: PASS Comments: Corrections completed Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 8730 SW SCHMIDT LOOP, TIGARD, OR, 97224 November 30, 2017 at 10:44:37 AM Record Type: Record ID: Residential - Master Permit MST2016-00550 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