Permit CITY OF TIGARDMASTER PERMIT
' COMMUNITY DEVELOPMENT Permit#: MST2016-00594
T t GA RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 , 0-1 ?' /ft" Date Issued: 05/16/2017
Parcel: 2S111DA21000
Jurisdiction: Tigard
Site address: 8690 SW SCHMIDT LOOP
Subdivision: HERITAGE CROSSING Lot: 29
Project: Heritage Crossing, Lot 29
Project Description: New SF. 11/14/17 REPRINTED: to add A/C unit. Placement of NC unit must meet
manufactures requirements.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1311 sf Basement: 0 sf Left 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1639 sf Garage: 401 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes
Total: 2950 sf Value: $351,397.09 Rear: 15
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
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0
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'500 sf: 5 201-400 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 2950
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: $30,782.98
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. You may.btain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
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Issued By: /I I" Permittee Signature: f�.G -1.---irr/!e"4:72 C„),,
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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Mechanical Permit. Applicata.,ta' ' .*:gl!,f,l4Vji,PrtiVltWiQf(laaia'4ii4-1?4a0ii,i%;iiitltiVAii,4:igaVa;Ml'Pl
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CATEGORY OF CONSTRUCTION _
. RESMENTME EQUIPMENT/MITENIS no- j
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JOE SITE INFORMATION AND TAXATION,
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fitl,f14,,44.4.4E;,: I) tutori nc
_._....., ., _...- R 11- --- - 1 - - _ 1 I su t 5 rt lint four 14,01 tui etvcti stidition."
1 k 0:11,40:WOW Emerald Weeks t! i 14.9.1.144.1s-r,.0; 1
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4.180 SNV Macadam Ave Suite 100
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1111 CITY OF TIGARD MASTER PERMIT
1e COMMUNITY DEVELOPMENT Permit#: MST2016-00594
13125 SW Hall Blvd.,Ti Date Issued: 05/16/2017
Tt,Ga2. and OR 97223 503.718.2439 9
Parcel: 2S 111 DA21000
Jurisdiction: Tigard
Site address: 8690 SW SCHMIDT LOOP
Subdivision: HERITAGE CROSSING Lot: 29
Project: Heritage Crossing, Lot 29
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1311 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1639 sf Garage: 401 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors:
Yes
Total: 2950 sf Value: $351,397.09 Rear: 15
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: 4 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
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add.'500 sf: 5 201-400 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 2950
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: $30,629.82
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 0 952-001-0090. ou may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800,332,2344.
Issued B ' �L C
Y � ��� �1 a�� — Permittee Signature: �C. I� 4,/,,,, ,,,,
,,,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.
Building Permit Application L.3717
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Residential '.-: ' °,,..„..,
tou on lc U. I NE OM li
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City of Tigard Received
Dai BS, a /2o/i I • P—tyktcraitcya,,-- c-/
41 13125 SW Hall Blvd.,Tigard,OR 97223
1114
Plan Re,.ieu .....i.••••,„, is) ,, j 7
* Phone: 503 718 2439 Fax 503.598.19o° '
Other Perntit,544/C2_ac'—COS—QV
Inspection Line. 503.639 4175, . .., i , r-il)a)atie rt)tady}32,
. lutIt Fa Sre Page 2 for
Internet: wwvv.tigard-or.gos "s. t -, ,, , . s ,-J.
Notified Method. /71 / 41 supptememai taratitaatioo
ra..f,:IL?, #1-//";•ce/;, .A:7 ,,..,
TYPE OF WORK
REQUIRED DATA:I-AND 2-FAMILY DM EC
111 New construction 0 Demolition Permit fees*are based on the N alue of the work peietiOnetf77
-...
- Indicate the value(rounded to the nearest dollar)oa ,
0 Addition/alteration/replacement 0 Other: ,
equipment,materials. labor,oserhead,and the pro
work indicated on this application. ..,
CATEGORY OF CONSTRt/CTION
valuation.: $3 13 6 3
I-and 2-family dwelling
0 Comniercialindustrial
5 0 Accessory building o Multi-family Number of bedrooms:
0 Master builder 0 Other. Number of bathrooms.3
JOB SITE INFORMATION AND LOCATION fond number of floors,
Job site address: S<(;,?u (51./../ („cdup Ness dsselling area:AS-0 square feet
City/State/ZIP:Tigard, OR 97223
Garage carport area: 110i square feet
—.
Sunebldglapt.no.: Project name 1 t Ai.' Cos ered porch area:‘13 square feet)
. .
Cross street/directions to job site:
,.,
Deck area. square feet,
..t.:7,
Other structure area: square feet
REQUIRED DATA:COMMER(IAL-USE ClrfEC*IS I
,-
Subdivision:
1 Lot no.: .f Permit fees*are based on the s Ate of the work pertained,
Indicate the salue(rounded to the nearest dollar)oft
Tax map/parcel no.:
.
equipment, materials,labor.as erhead,and the profit the
DESCRIPTION OF WORK work indicated on this application,
Valuation: $
New SFR
Existing building area: square feet
New building area: square feet
t PROPERTY OWNER
I 0 TENANT Number of stories'
...,
Name: DR Horton Inc.
Type of construction:
-—','•-4,-----..si'sALt
Address: 4380 SW Macadam Ave Suite 100 Occupancy groups:
City/State/ZIP: Portland,_OR 97239
Existing:
-
„.....,.- ._'
Phone:l. 503) 222-4151 Fax:( )
Ness:
0 APPLICANT • CONTACT PERSON
BUILDING PERMIT FEES* '''''''' ''
..)
(Please refer tojee schedul.ai
Business name: DR Horton Inc.
Structural plan reviess, fee tor deposit):
Contact name: Emerald Weeks
...,...:.:
— ELS plan testes". fee(if applicable):
Address: 4380 SW Macadam Ave Suite 100
77- ---°r
Total fees due upon application:
City/State/ZIP: Portland, OR 97239
-...... -
Phone:(503 )222-4151 x1107 I Fax .( ) Amount receised:
.-..-7-----7"
E-mail: esweeks@drhorton.corn
PHOTON'OLrAic SOLAR PANEL STEM
Commercial and residential prescriptive installation
CONTRACTOR
roof-top mounted Photo Voltaic Solar Panel System.
Business name: DR Horton Inc, Submit two(2)sets of roof plan lith connection det84
and fire department access,along with the 200)Orekta#
Address:4380 SW Macadam Ave Suite 100
I Solar Installation,5pecialty Crde checklist, ,
Permit Fee(includes plan reviess
I CitY/State:.21P: Portland, OR 97239
*41
and administrative fees): .4
I Phone:(503 )222-4151 I Fax.'( )
State surcharge t 12%of permit fee):
I CCB lic.: 130859
i
Total fee due upon application: 0.1 60"
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Authorized signature: ,, ' ' , , ; :f , , ' This permit application expires if a permit is not o.;'o'',ed
st ithin 180 days after it has been accepted as complete,
[Print name; 1 -. - i ,-1 ": y I. ''1,: r e. ' .....1':... Date-2016 .Fee inetluxfolegy set by Tri-County Building Indus*
Service Board.
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• Electrical Permit Application ' 1 OR U[l I( L I ',I ()NI N
City of Tigard
13125 SW Hall Blvd.,Tigard.OR 9722
Phone: 503.718.2439 Fax: 501598,1960
gli . Received
Date/13y,
Plan Review
Date/By; Othmit:
Inspection Line: 503,639.4175 Date Ready/By:
Internet: www.tigard-orgov . ' Notified/Method: , Permit Ni.ii,:kts7---d.oic.....-064--.Z_(/'
er Per
/uric I slauppgeleemNerta21 for .441
TYPE OF WORK .- -• ' PLAN REVIEW
[24 New construction 0 Addition/alteration/replacement Please check all that apply(submit a sets of plans wfitems checked
Q Service or feeder 400 amps or more C]Building over three soda.-
0 Demolition 0 Other:
where the available fault current El Marinas and boatyards.
•
cATEGoity OF coNsivenoN , exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less to ground,or exceeds 14,000' f]Corinnercial-use agriculk4
0 I-and 2-family dwelling 0 Commercial/industrial' 0 Accessory building amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 irmonation cr7s KVA clit '
0 Emergency system. larger separately derive
JOB SITE INFORMATION ANO LOCATION
..i 0 Addition of new motor load of
Job no.: Job site address: 1 (10 . 3,L4...,,,-(1,1 Lt 100. [IP or more: .. ,.
tr 0 Six or more residential units. occupancy.
°Recreational vehicle pad*
CI Health-care facilities. 0 Supply voltage for moreahria
City/State/ZIP:-7-10‘ 0/ - 1 7AVS
0 / 0 Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.. 1 Project name: El Service or feeder 600 amps or more.
..,......„0,-.
FEE SCHEDULE
Cross street/directions to job site:
Dtscription F Qty. I Ft*. 1 Tsui
New residential single-or multi family dwelling unit.
Includes attached garage.
Subdivision: ] Lot no.: 3.--q 1,000 sq.ft or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92
Tax map/parcel no.:
Limited energy,residential
' ...2.
DESCRIPTION OF WORK . (with above sq.ft.)
75.00
Limited energy,multi-family
75 00 . k...12
residential(with above sq.ft.)
Services or feeders installation,alteration,and/or reloca
200 amps or less 100.70
0 PROPERTY OWNER 1 i 0 TENANT 201 amps to 400 amps 133.56 _12
401 amps to 600 amps 200.34
Name:
ci. ,
601 mops to 1,000 amps 301.04 -‹'t
Address:
Over 1,000 amps or volts 552.26 .' 0
Temporary services or feeders installation,alteration,an
City/State/ZIP:
relocation '
Phone:( ) Fix :x ( )
J 200 amps or less 59.36 I
..1
Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125,08
,.,
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,pr panel
Owner signature: Date: __4.0.____, A.Fee for branch circuits with
CI AnucANT i I 0 CONTACT PEIISON above service or feeder fee,
7.42 :".•
each branch circuit
Business name: DR Horton Inc '
B.Fee for blanch circuits without
service or feeder fee,first
Contact name: Emerald Weeks
branch circuit
Each addl lnarich circuit f 56.18
7.42 ,
Address: 4380 SW macadam Ave
Miscellaneous(service or feeder not included
City/State/ZIP: Portland OR 97239 ° Each manufactured or modular
67.84
dwelling,service and/or feeder
Phone:(
503 222-4151 Fax: ( ) i
Reconnect only 67.84
) I :
E-mail: — Pump or irrigation circle 67.84
Sign or outline lighting 67.84 '. ...."
CONTRACTOR ; -
Signal circuit(s)or liinitxd-energy
Business name: „StA,L1/4174- gt,Q.,,,--7,,...„ a 2-1.ile....„ panel,alteration,or extension. Page 2 --4
iivit. Each additional inspection over allowable in any of the alto
Address:
.2.go ii v ti/E 6-rs-/z. ,,,ek„e. -_11_,, Additional inspection(1 hr min) 66.25/hr
Investigation(1 hr nun) 66.25/hr
City/State/ZIP: Vet-i'?CC)Gf ye.i..-. W-4,, ,9 frg Cf i .
ndustrial plant(1 hr min) 78.18/hr .-.111*
Phone:(3‘,a 5/9_ . --,5--sf 9 1 Fax:oca) 326-1.... 96'6 0 Inspections for which no fee is
90_00/hr
specifically listed(%hr min)
CCB Lic.:IW..„514',...9 Electrical Lie,: C.2.30 I Suprv.Lic.: it 7 7.5- S ' ELECTRICAL PERMIT FEES
Subtotal:
Suprv.Electrician signature,required:z/R b.4,,,4:___atz
Plan review(25%of permit fee):
XL
Print name:Ch cs.lb..-a. 4 a rrt j Date: State surcharge(12%of permit fee):
- . .
TOTAL PERMIT FEE:
Authorized signature:
,.. .
This permit application expires if a permit is not obtained within
Print name: ,
I Date: days after it has been accepted as complete.
- Number of inspections allowed per permit,
TABuildingTermits1ELC-PermitApi
4404615V l/05/COM/WE
. Electrical Permit Application—City of Tigard .
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE St IREDULE
flown.tion Q . Each T
Fee for all residential systems combined: $75.00 Renenable electrical energy ssterns:
5 10,.1 cr ks,
Check Type of Work Involved:
is 1..‘a 133
11 Audio and Stereo Systems*
'5 01 to 2:3 kva 21/0 34
Vs ind generation systems in excess of 25 ksa:
2
I- Burglar Alarm
Otto25. 50 lott
301 14
c1 to )52 26
IX Garage Door Opener* I i
ks.(fec in mC011iglet2 ,
'a lilt()AR 41S-1094140) I
X. Heating, Ventilation and Air Conditioning
Solar generation systems in excess of 25 kva:
System* T
I ach additiona kv.,kv.cr 25 12 .
fl Vacuum Systems* 1k 0 niche
0 0
Each additional ins tection over allowable inniTy of the, ,
I I Other: Each additionainspecuon
IIII 66 25 hr
charged at an hourly I brims)
Inspections for which no lee is
shr mm) ri0
COMMERCIAL WORK ONLY: ELECTRIC Al.. PERMIT FEEss
Fee for each commercial system: $75.00 Subtotal(Enter on Page I).
Number of mspectlem,allcmed per permit
(SEE OAR 918-309-0000)
Check Type of Work Involved:
D Audio and Stereo Systems
11 Boiler Controls
I I Clock Systems
E Data Telecommunication Installation
[ IFire Alarm Installation
HVAC
I Instrumentation
I I Intercom and Paging Systems
Landscape Irrigation Control*
1— Medical
1 I Nurse Calls
O• utdoor Landscape Lighting*
fl P• rotective Signaling
I11 O• ther:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I Build=Per snic,f LC Pal mit App I LR LRF k Tim tYr
. •
. -
Plumbing,Permit Application '
Building Fixtures [OR OH'1(1 [SE. OMLI
City of Tigard Roccived
IN
U 13125 SW Hall Blvd.,Tigard,OR 97223 Dere/By. Permit NSfPlan Review
' I Phone: 503.718.2439 Fax; 503.598.1960 - Nway, Other Permit No.,
Inspection Line: 503.639.4175 _
,Bete Ready/fly: kris iiii Se*rap 2 for
r 1( It°
.5 A Internet: www.tigand-ocgov ' NotiftecVMethed: Suppkesemal laferatanos
I, . c„ .: TYPE OF WORK . FEE. sansoutik
ED New construction 0 Demolition For spedal InfontiatIaft use cheeAllsit
Description J Qty. I Ea. I Total
0 Addition/alteration/replacement 0 Other: New I-2-family dwellings(includes 100 ft.for each utility connection/
CATEGORY OF corinstrnor4 SFR(1)bath 312.70
0 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 '.
SFR(3)bath 500.32
0 Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
0 Master builder 0 Other: 0......'
Fire sprinkler( ,sq.ft.) Page 2 _ *
JOB SITE VIWORKATION'AND LOCATION : Site utilities:
Catch basin or area drain 18,76
Job site address: 95(0(tO St,./ „..,. ./.-\-)4\t„,ciAt LciLo - -
s.
Drywell,leach line,or trench drain 18.76
City/State/ZIP: Tit,c.," De, q'23.-)..3 r , . .
dip / , Footing drain(no,linear ft.:____) Page 2
Suite/bldg./apt.no.. Project name: \At/V / AA 1 A,eA
:Lsr ". (..)ils,/' ' Manufactured home utilities 50.03
Cross street/dinxtions to job site: Manholes 18.76
sss
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.:A Fixture or item: ..--..
Tax map/parcel no.: Backflow preventer 31,27 '
Backwater valve 12.51
DESCRIPTION OP MORK ,-
. , . .
Clothes washer 25.02
Dishwasher 25.02
a - Drinking fountain 25.02
.. ,
Ejectors/sump 25.02
0 rtttinteKy OWNER - ' U TENANT Expulsion tank
Name: \,,,--7). \-kti-v-t-uvl, \v‘,c,„...., Fixture/sewer cap
. -
Floor drain/floor sink/hub 25.02 ,
Address: Lk-J.35st ccs,„ki , A...,617p 0 it -A-11,-,) Garbage disposal 25.02 ,
sr. ,
,
City/State/ZIP: 1C00 C.Y.,,X., 0(e...,_ (:)1.1a..,.. 9 Hose bib 25.02
Phone:0)) •,_)„._\4\C Fax:Fax:( ) Ice maker 12.51 s. .
0 APPLICANT 0 CONTACT PERSON lnterceptor/grease trap 25.02 ..,
Business name:
Medical gas(value:$ ) Page 2
Z., '‘. it 1/4„ek,C--) Primer 12.51
Contact name: \ \SLAA 1 ot \ ' f)
Roof drain(commercial) I12.51
Address: Sink/basin/lavatory 25,02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
E-mail: ecivyeiA66. .62vvi ' .covtfit
t Urinal
25.02
Water closet
$ .
25.02 . ...
' - $
CONTRACTOR
Water heater 37.52
Business name:EDWARD MULLEN PLUMBING Water piping/OW V 56.29
Address:1601 SE RIVER ROAD Other: 25.02 ..-..
City/State/Z1P:HILLSBORO,OREGON 97123 Subtotal ' ..i..,
Minimum permit fee $72.50
Phone:(503)640-0113 Fax:(503)640-4483 .,
Plan review (25%of permit fee)
CCB Lit.:94689 Plumbing Lie.no.:34-260PB -
State surcharge(12%of permit fee)
Authorized signature: Air 4d* gill,411 I I P TOTAL PERMIT FEE
Print name:RAY MULLEN I Dat
' .. -............._.-41881/
This permit appimatioa expires if a permit is not obtained widibi NO dos,*
e: ems it has beta accepted as complete.
*Fee methodology se by Tri-Courity Building industry Service Board.
1 Neu4dirittesmits1K.MU-PersitiApp dor 10101/09 4404616T(101021COMMEN
. ' `
City of Tigard
IN I
COMMUNITY DEVELOPMENT DEPARTMENT
T 1 c A R D Building Permit Review — Residential
Building Permit #: /M57?-0/69 -OO ��j AL/
Site Address: e&' Sial gelni/C .
Project Name: /7• a '9 Cji/ Lot #: (QC?
(New dw 46 g=subdivision name;Al a o •r Alteration=last name of owner)
Planning Review
Proposal: /U40 /t
I/Verify site address/suite# exists and activyin permit system.
OPItiver Terrace Neighborhood: V No E Yes,See River Terrace Review Addendum Attached
Sits Plan Elements:
/eltlei ree(3)copies of site plan 0:!''sting structures on site
o plan must be on 8-1/2"x 11"or 11 x 17"paper It ootprint of new structure(including decks)with finished
to scale(standard architect or engineer scale) or elevations
�orth arrow tility locations(required for new,may apply for additions)
to address,project or subdivision name and lot number : ation of wells/septic systems
information(name and phone number) C • ting trees to be retained with drip line,and tree
V t dimensions and building setback dimensions r otection measures
Lot •
area,building coverage area,percentage of coverage and IG eet tree size,type and location
jinpervious 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)
Ofklean Water Services—Service Provider Lett (lot platted prior to 9/10/1995):
Required: ❑ es,applicant was notified No Received: ❑ Yes ❑ No
Public Facili ' s Improvement (PFI) Permit:
equired: Yes,applicant was notified ❑ No Applied For: Yes ❑ No,stop intake
12 Land Use Case#: 2e)/W._61 ---o�
�'�/ �4/i(ie37C1<C- aX'av'c—
Zoning: _
Required Setbacks: Front /5— Rear JS— Side Street Side Alitk Garage ,C:i)
IV/Landscape Requirement:Hil vo_
Lot Coverage Maximum: %
IA Building Height: Maximum Height Actual Height Q S.--
II
H ► isual Clearance
f,' Easements
ill ensitive Lands: ❑ Yes No Type
rban Forestry Plan
Conditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: ,===. - '' Date: /Q / rl
Revisions (after Building Submittal only) Reviewer Date T
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRyw RES 091216.docx
Building Permit Submittal
Original Submittal Date: /A4 ' /&
Site Plans: #
Building Plans: # j
Building Permit#: ` nter buildingpermit#above.
Workflow Routing: 'C' Planning Engineering ermit Coordinator Building
Workflow Sign-off: rd" Sign-off for Planning(include notes from planning review)
Route Application Documents: i Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
-Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: ‘ -/S Date: r,j,,, A 17/4„
Engineering Review
Slope at building pad: -7f�
Conditions "Met"prior to issuance of building permit
1 (7
❑ asements (encroachments)per engineering conditions of approval and plat
❑ ater 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: /1/- LD Date: - —
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: El Approved ❑ Not Approved
Permit Coordinator Review
El 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 ICI N/A
Tigard Trans SDC: '�"es ❑ N/A
Parks SDC: (Yes ❑ N/A
T'OK to Issue Permit ,
rrby
Approved Permit Coordinator: Date: /24/i5�
I:\Building\Forms\BldgPermitRvw_RES_091216.docx
oP13:1111:::.,:d,.Plumbing
iaigLerCiprinLFats,:inelin0:::s6iton5:70pc3Iir,ilineegiii8,ts,:trB.i246:1503.1d3dt913:6.1,3vr139.igfc.i4maniaxile::52(sOtRF33ci.,:4:91007nry,XCE.10(1100:FIE:tiron8IIVG2 UAER;1111.:DIVISION .alliPplaRN,"ellte"l7*rmeavedY'ywiatiodr.s..FRI.R01(:217):41'2.11::1--y11iit:inw''pliAlriPeanr'dtuilh::'$.1:..lesiIrkInnt14:1000.71'16(01::pplanta.otoriNt:*::fTP:geol3:214E.31titt:r7/2.:".(77418:1:tio7Tetion7/
Q
otal
Nw
conne
o 1-and 2-unity dwelling 0 Commercial/industrial
bath
SFR(3)bath 500,32
JOE.SITE INPORMATION AND LOCATION Site utllltle;
flY . Footing drain(no.Linear It.: ) Page 2
drain connector IS 76
Sanitary sewer(no.linear ft.:..._j Page 2
Storm sewer(no.linear ft.:__) Page 2
Subdivision: Lot
FIxture Or Item:
Tax map/parcel no.; Backflow preventer 31.27
,
PEPBactwater valve .51
oili:n014 0F17,esic Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/Sump 25.02
PROPIIIRTV OW001,11 . ' ta TottAlikfr - Expansmniank 12.51
uk
Nk...\-0\t...vcr.\f-A Fixture(sewer cup 25-02
ame:
Floor drain/fleet sink/uh 25,02
Address: ..\""i3 1510L) kr3, (0."W )aV—GlIf IsPlisai
base d 2"2
City/State/Z1P: ),e, Of — 1 (1Hose bib 25.02
Prone ""LI I 5‘ FIX:( ) lee maker 12.51 '
_, C1 0/1,1-1,dikliq ...., - ..* ;-ilvoptrAtti no* inicrceptortgrease trap 25,02
medical gas'(value:5_) . Page 2
Businesa WIC:
Contact name: Ci''.\tf‘A.0 Aril. i(-) \UY-1't 'S Primer 12.51
Roof drain(ommercial)
12,51
Address: iiti5iTesin/lavatray .25.02
City/Shire/DP: Solar units(potable water) 62.54
Phonic:( ) Fax"( ) Tehtbowertshower pan 12.51
E-mail: Urinal 23.02
Water closet 25.02
C014111.4CPOR .
. ,...._........._ Water heater 37.52
Busineis name;%kelt Plumbing Water piping/DWV 56.29
Address!1075W.Historic Columbia River Hwy Other: 25 02
City/State/ZiP:Troutdak Or.9060 — Subtotal
Minimum permit fee: $72.50
Phone:NU)667.1781 Fax:(503)66/-9891
Plan review(25%of permit fee)
CCB Lic.:112220 Plumbing Lie.no,:264124PB
State surcharge(12%of permit fee)
Authorized signahlret—igk 4-- /(.......... _(1 r 1 lt)TAI.PERMIT FEL-my permit application empires it!permit is not obtained within 180 days
Print name:Mark Roden* Date:2117/17 atter it has bees Steepled at template.
*lee ineihodoky set by Tri-Cuunty Building lishistry Servicelloard.
I sitiiidineamittAW-Pernianpo.doc KNOliti9 440-400(1111102,('OMAVFM)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8690 SW SCHMIDT LOOP, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Master Permit MST2016-00594
Inspection Type: Inspector:
199 Electrical final David Young
Result:
FA I L
Comments:
Turn on all breakers for inspection.
No power at garage or room by entry.
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:
8690 SW SCHMIDT LOOP, TIGARD, OR, 97224 December 13, 2017 at
10:56:49 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00594
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
FA I L
Comments:
Provide impact protection right side of water heater. Figure M1307.1
All else appears ok.
Ac installed.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8690 SW SCHMIDT LOOP, TIGARD, OR, 97224 December 18, 2017 at
9:42:11 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00594
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.
Blower door test report received.
Insulation certification checked.
C of 0 left on site with contractor.
Note: contractor to install fall prevention devise on openable tub deck window in
master bedroom.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8690 SW SCHMIDT LOOP, TIGARD, OR, 97224 December 18, 2017 at
9:21 :40 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00594
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
PASS
Comments:
Correction from previous inspection complete.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8690 SW SCHMIDT LOOP, TIGARD, OR, 97224 December 15, 2017 at
9:52:39 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00594
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS
Comments:
Correction complete.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8690 SW SCHMIDT LOOP, TIGARD, OR, 97224 December 15, 2017 at
9:54:47 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00594
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS
Comments:
Correction complete.
Note: ac installed.
Violation Summary:
Inspector Contractor