Permit (57) CITY OF TIGARD MASTER PERMIT
711COMMUNITY DEVELOPMENT Permit#: MST2017-00003
T t C .r4 R L 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/07/2017
Parcel: 2S111DA20600
Jurisdiction: Tigard
Site address: 8600 SW SCHMIDT LOOP
Subdivision: HERITAGE CROSSING Lot: 25
Project: Heritage Crossing, Lot 25
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 936 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1361 sf Garage: 573 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right 5 Detectors: Yes
Total: 2297 sf Value: $286,428.12 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: 3 Garbage Disp: 1 Water Heaters: 1 Drains: 0
9Water Lines: 100 Catch Basins: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Bckflw Prevntr: 0
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 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: 4 201-400 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 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: $29,092.37
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 952-001-009 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: .,,,Z; P / termittee Signature: SrC l/Jew
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.
f 1Building Permit Applicationn 37)-L1 U
Residential
1-01? Oil ICI. 1 til OM 1'
City of Tigard ) Received
13125 SW Hall Blvd.,Tigard,OR 9743 '` ht Dau l3}: / `�7 Pernnt No: Lj7 O, 7'7_06003
Phone: 501718 2439 Fax 503,598,1960, Pan Rei lea
! ,1 Inspection Line. 503.639 d!�5 (late Ar: s'.)) - 1 Other Permit:§04.9.1)/7- 3/
llb1C Read)H. _ Jun, 0 Sec Page 2 for
Internet: www.tigard-or.gov Notified Method. /
i'3,-)s
�_,�, 5 S� f t Supplemental Information
c. cAi
TY'PL OF WORK REQUIRED DATA:I-AND 2-FAMILY DN ELLING
si New construction 0 Demolition Permit fees*are based on the value of the work performed.
0 Addition/alteration/replacementIndicate the value(rounded to the nearest dollar)of all
0 Other: equipment,materials.labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Q I-and 2-family dwellingValuation; f 14%).
LL 1
0 Commercial/industrial -
S a,BOJ T+
❑ Accessory building 0 Multi-family Number of bedrooms:
0 Master builder ._ 0 Other. Number of bathrooms: 3
JOB SITE INFORM ATION AND LOCATION Total number of floors: (. a.8 7#^
Job site address: b�DO `j A1,414-- t New dwelling arca: i vu v
P' `7 square feet
City/State/ZIP:Tigard, OR 97223 Garage carport area:�C7 uare feet
Suitebldg./apt.no.: Project name
1.- GAn irkCh-Dtji r\I Covered porch area: -1 square feet 1,3 6' I
Cross streetidirections to job site:
Deck area: square feet 936
Other structure area: square feet I
REQUIRED DATA:COMMERC IAL-USE CHECKLIST
Subdivision: [ Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor.overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
New SFR Valuation: S
Existing building area: square feet
New building area: square feet
it PROPERTY OWNER , 0 TENANT Number of stories:
Name: DR Horton Inc. Type of construction:
Address: 4380 SW Macadam Ave Suite 100
Occupancy groups:
City/State/ZIP Portland:OR 97239
Existing:
Phone:( 503) 222-4151 Fax:( )
New.
0 APPLICANT a CONTACT PERSON BUILDING PERMIT FEES'
Business name: DR Horton Inc. (Pfeaserefersoleesrbedaf�
Contact name:Emerald Weeks Structural plan review fee(or deposit):
Address: 4380 SW Macadam Ave Suite 100 FE S plan review. fee(if applicable):
OR 97239 Total fees due upon application:
City/State/ZIP:Portland,
Phone:(503 )222-4151 x1107 I Fax: :( ) Amount received:
PHOTOVOLTAl( SOLAR PANELS15TEM FEES°
E-mail: esweeks@drhorton.com
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name: DR Horton Inc. Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2011)Oregon
Aadress:43$0 SW Macadam Ave Suite 100
Solar instullallon Special(r Code checklist.
City/State/ZIP: Portland, OR 97239 Permit Fee(includes plan review
and administrative fees): 5180.00
Phone:(
503 )222-4151 I Fax:( )
CCB lic.: State surcharge(12%of permit fee): 521.60
130859
Total fee due upon application: $201.60
Authorized signature r This
t ; permit application expires ifs permit is not obtained
within 180 days after it has been accepted as complete.
I Print name: 1 i Date:2016 "Fee methodology set by Tri-County Building Industry
Service Board.
I:Building,Pcrmits BIJP-RESPcnnitApp.doe 0224 2011 440-4bl3T(i 1 02 COM'WEBI
S
EIectricaI Permit Application i t,,z 01 I « I t `,t ()NI 1
City of Tigard Date/By
Received
PermitNo.:NyT3C>t7-0oao3
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
�'1Phone: 503.718.2439 Fax: 503.598.1960 • may: Otter Pamir.
,, , i, Inspection Line: 503.639.4175 DateB See2 for
Internet: www.tigard-or.gov Notified/Method:Ready/By:od heti.: Page
. I Supplemental information
TYPE OF.WORD pLAN REVIEW
121 New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans wAtems checked below):
0 Service or feeder 400 amps or more 0 Building over three stories
❑Demolition 0 Other:
where the available fault current ❑Marinas and boatyards.
CATEGORY'OF CONST$T1CTION exceeds 10,000 amps at 150 volts or ❑Floating bondings.
❑ 1-and 2-family dwelling 0 CommerciaUindustrial" 0 Accessory building less 10 gC0und,or exceeds 14,000' ❑Co -use�' l
amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: D Fire pump. _ El]ental/anon of 75 KVA or
JOB SITE INFORMATION ANO LOCATION ❑A motor load of larger separately derived system.
A,'E","1-2","1-3",
Job no.: Job site address: - h ., ]00HPormore. occupancy.
( l ❑Six or more residential units. a Recreational vehicle prks.
City/State/ZIP: y�,._: ll 1 C ,)- C)i4eahh Dare facilities. 0
1 U G G 3Supply voltage for more than
/ �y r�� ❑Hazardous locations. 600 volts nominal.
Suite/bldg./aptno.: Project name: '0--tht. Oro, ❑Service orfader600amps ormore,
Cross street/directions to job site: FEE SCI>EDULE
���.�/JJ Dearman I Qty. I Fee. I Tent
New residential.single;or multi=family dwelling unit.
Includes attached garage.
Subdivision: Lot no.:1 < 1,000 sq.R.or less ( 168.54 4
Tax map/parcel no.: Ea add']500 sq.R.or portion33.92 1
DESCRIPTION OF WORK •
Limited thaovy,q.it) tial T5.00 2
(with above sq.R)
Limited energy,multi-family
residential(with above sq.R.) 78.00 1 2
Services or feeders instafadon,alteration,and/or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER• 0 TENANT 201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
Address: 60]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:( ) Fix:(. ) 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 i I 128.58 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps ]68.54 2
Owner si a Branch circuits-,new,alteration,or extension,per panel
gnatur Date: A.Fee for branch circuits with
❑ APPLICANT I 0 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,fust
Contact name: branch h
nch cit 56.18 2
Address: 4380 SW macadam Ave Each 'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
City/State/ZIP: Portland OR 97239 . Each manufactured or modular 67 a4 12
503 222-4151
dwelling,service and/or feeds
Phone:( ) Fax::( ) r Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
• CONTRACTOR i Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Business name: t742v panel,alteration,or extension. Page 2 12
/f r!_ Each additional inspection over allowable in any of the above
Address: 2 20 y tiE 6`s•- /J_ Additional inspection )
�- .Q„ (I hr thin 66.25/hr
City/State/ZIP: � /f� Investigation(1 In ruin) 66.25/hr
h C ti.k i/-e L'. V 1'7' 9:C C/ Industrial plant(l hr min) 78.18/hr
Phone:(33a .57,— ‘ .-...57.9 I Fax: ('p) 3 ,966't) Inspections for which no fee is
'�2r-- specifically listed(94 hr mut) 95.001 hr
CCB Lic.: ,6 f,p Electrical Lic.:.CZ 30 Suprv.Lic.:
/775 S ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: _�J j1 Subtotal:
^'v rJ Plan review(25%of permit fee):
Print name:C4 c sibrik , 2 l;it i Date: State 8 a(12%of
• permit fete
Authorized signature: TOTAL PERMIT bEi
Thio permit application expires ifs permit is lot obtained within 180
Print name: ' I Date: * days after it ban been accepted as complete.
-5/€80-1'.' _ Number of inspections allowed per permit.
I:1Buttding1PerorioAELC.PerraitApp
440.46151(1 r/O5 CQM/9VBB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Fee for all residential systems combined: $75.00 Deacriptiou Eden rn,p, •
Renosable electrical energy systems:
Check Type of Work Involved; 5 kva or Ics Ii,t,,U
T- I
5.U1 lu 15 kva 133.56 11
Audio and Stereo Systems* 15.01 to's kva
2u0.3-1
Wind _eneration systems in excess of 25 kva:
n Burglar Alarm
35.01 to 50 kva 11111 301.04 I 13
IN Garage Door Opener* SU.tit to 1ud kva 55_2.2b
>10( kva Mc in accordance
with(tAR 9l s-309-004U) 5S2.26
n Heating, Ventilation and Air Conditioning
I Solar generation systems in excess of 25 kva:
System*
(� tach additional kva:wcr-5 -2 3
Vacuum Systems* ICirkru-r;uadJitirnralchargc U.n z
Each additional ins.ection over allowable in any of the above:
Other: Each additional inspection is ■
char ed at an howly(I hr min) 66.35 hr I
Inspections liar which no lee is III -
—. —
s -citicall listed(`:hr '(LOU hr
miu)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Pagc I): I
(SEE OAR 918-309-0000) " Number of inspccI,on allowed per permit
Check Type of Work Involved:
n Audio and Stereo Systems
n Boiler Controls
• Clock Systems
E Data Telecommunication installation
n Fire Alarm Installation
n HVAC
Instrumentation
j Intercom and Paging Systems
n Landscape Irrigation Control*
n Medical
• Nurse Calls
n Outdoor Landscape Lighting*
n P• rotective Signaling
O• ther:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I.,Buiidin}•Pc ur,PLC Pa.nitAp*, LLR ERT dk; l v:':I'_015
.
Plumbing Permit Application,a ,
Building Fixtures I OR of I l(L (St. O.L1
City of Tigard `" ;,
III 13125 SW Hall Blvd.,Tigard,OR 97223
Date/By:may: Permit No:)101-(9'(700 )
I Phone: 503.718.2439 Fax: 503,598.1960 e/By: w Other Permit No.:
f!G.1-It it inspection Line: 503.639.41.73 R
Pre Reedy/By: ►ur6: RI See Pagel for
Intend: www.tigad-or.gov Notifiedimethod: T Surile,meetai tdermaMoa
. 4,• . TYPE OF WORK. . ' 0 tDitk. '4.
❑New construction 0 Demolition For spedat Information use eber?Usr.
❑Addition/alteration/replacement ❑Otter - Description r Qtz. I Ea I Total
New 1-2-family dwellings(includes 100 R for each utility connection)
CATEGORY OF COPiSlRtirfON SFR(I)bath ! 312.70 1
❑1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath V 500.32
❑Accessory building 0 Multi-family
J Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler(____sq.ft.) Page 2
JOB*OM N7ORMAV9N SAND LOCATION She utilities:
Job site address: 8-kuu 3 S i.✓ 1t1i" ). G Catch basin or area drain IIIII 18.76 1,
City/StattlLlP: �',..L� (�;7' 3 Drywell,leach line,or trench drain .
`'� ���,� Footing drain(no.linear ft.: _ ) Page 2
Suite/bldgJapt.no.: J Project name: V v "&Jti 1t" Manufactured home utilities 50.03
Cross street/directions to job site: UManholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_, Page 2
Storm sewer(no.linear ft.:,_.) Page 2
Water service(no.linear ft.:_,__) Page 2
Subdivision: ( Lot no.:?>�
Fixture or item; --i
Tax map/parcel no.: Backflow preventer 31.27
• DFSCRIfl1ON•OF WORK '• Backwater valve 12.51
Clothes washer 25.02
q�� n Dishwasher 25.02
V 1�.- Drinking fountain 25.02
Ejectors/sump 25.02
. Expansion tank 12.51
Q PROPERTY..OWNER • • ..F 0 TENANT
Name: ) �� \VV.C.. ►^ '
Fixture/sewer cap i 25.02
Address .k�6l j e�. \ \ �nD / -A- • Garbagelob drsoor sink/hub 25.02
�`'� disposal 25.02
City/State/Z1 P: V 6j1Z. ^
t Jv._. `•'(lani Hose bib 25.02
Phone:0)3 -J\t \ I Fax:( ) Ice maker 12.51
• ❑•APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name: )>Z, Vkl. -(fn k Medical gas(value:S ) Page 2
Primer 12.51
Contact name'. V-_-:\
� a �,, L 1 01 \} ,S Roof drain(commercial) 12.31
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: eCjvo-6065e, cAV VI CJS/ Wl . Cc 4/1 Urinal 25.02
•CONTRACTOR Water closet 25.02
Water heater 37.52
Business name:EDWARD MULLEN PLUMBING Water piping/DWV 56.29
Address:1601 SE RIVER ROAD Other: 25.02
City/State/ZIP:HILLSBORO,OREGON 97123 Subtotal
Phone:(S03)640.0113 Fax:(503)640-4483 Minimum permit fee: 572.50
•
CCB Lic.:94689 Plumbing Lic.no.:34-260PB Pim review (25%of permit fee)
'�_r State surcharge(12%of permit fee)
Authorized signature: ` ' _ TOTAL PERMIT FEE
Print name:RAY MULLEN / Date: TAB permit applieattoa expires ifs permit Is act obaleed within 1110 days
after it has bees accepted as eorpkte.
'Fee methodology set by Tri-County Building Industry Service Board.
I:inuI& rera,iUW.MU-Perwi,App.doc 1er6IA09 440.4616TI1019VCOMAVEB)
•
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qt'. Fee(ea) Total Square Footage: Permit Fee:
Footing drain- 1" IOU' 50.03 0 to 2,000 5121-90
Footing drain-each additional 100' 37,52 2.001 to 3,600 S169,69
3,001 to 7.200 5233.70
Sewer- 1st I u0' 02.54
7,201 and greater S327.54
_�.
Sewer-each additional 100' 37.52
Water Service- 1st lop' 62.54 Medical Gas Systems:
Water Service-each additional 100' 3752 Valuation: Permit Fee:
Storm&Rain Drain- 1st 100' 62.54
51.00 to$5,000.00 Minimum fee 572.50
Storm&Rain Drain-each additional 100' 37.52 55,0111.00 to 510.000.00 572.50 for the first 55,000.00 and 51.52 for
Other inspections or Fees Qty. Fee(ea) Total each additional SI 00.00 or fraction thereof,to
and including 510,000.00.
Inspection of existing plumbing or for S10.001.00 to 525,000.00 • S 148.50 tor the first S10010.00 and 51.54 for
which no fee is specifically indicated 90.00 hr each additional 510(1.00 or fraction thereof.to
(minimum charge—1/2 hour) and ins udin 525.000,01),
inspections outside of nonnal business 90.00-hr 525,001.00 to$5(1.(1110.00 3379.50 for the first 525,000.00 and SI.45 for
hours(minimum charge—2 hours) each additional S 100.00 or fraction thereof,III
Reinspection Fees 90tk)hr and includin• 550.000.00.
Additional plan review for revisions - 90.01y11r 350.001.0(1 and up 5742.011 for the first 550,000.00 and 51.20 for
(minimum charge—1:2 hour) J each additional 5100.00 or duction thereof:
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*.
Quantity by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Replace; 9
Plan review is required for any of the following.
Work Performed: Capped Added Relocate
Ba list Fonr Please check all that apply.
P r)',.
Bath Tub'Shower ❑ Any new commercial building with water service 2"and
JacuzziWhirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
Drive Thru 0 Ncw exterior plumbing site utilities for any complex structure
Cuspidor'Water Aspirator as defined in OAR91 K-730-0040.
Dishwasher -Commercial 0 Medical gas and vacuum systems for health care tircilitics.
-Domestic 0 Any multipurpose fire sprinkler system.
Drinking Fountain 0 Any complex structure as defined in OAR91 8-780-0040.
Eyc Wash
Floor Drain.'sink -2" Submit 2 sets of plans with any of the above.
4-Isometric or Riser Diagram
Car Wash Drain g
Garbage -Domestic—non-food 0 Isometric or riser diagram is required for new buildings
Disposal -Domestic—food related that meet the qualifications above.
-Commercial—food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Roc.Vehicle Dump Station
Shower -Gang
-Stall
Sink'Lav -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes
Water Extractor increase of sewer EDC s,a sewer permit will be issued and
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
G:`,Plans\Plats,Su mnit RidgciPcrtnit Docs\PLM F_PermitApp.doc 2
City of Tigard
lill ' COMMUNITY DEVELOPMENT DEPARTMENT
II
T I G A R D Building Permit Review — Residential
Building Permit #: H 6T,..90 17 -a Coo -3
Site Address: f S\Amv. t-
Project Name: Her iirme, avcc 6 Lot #: .2..E3(New dwelling bdivision name;A in
' n or Alteration=last name of owner)
Planning Review
Proposal: Neer
Verify site address/suite# exists and active in permit system.
River Terrace Neighborhood: "No CIYes,See River Terrace Review Addendum Attached
Site Plan Elements:
ree(3)copies of site plan `9": 'sting structures on site
Site plan must be on 8-1/2"x 11"or 11 x 17"paper ootprint of new structure(including decks)with finished
,Drawn to scale(standard architect or engineer scale) floor elevations
Xl\Torth arrow Utility locations (required for new,may apply for additions)
ite address,project or subdivision name and lot number I ocation of wells/septic systems
pplicant information(name and phone number) 14
1/ xisting trees to be retained with drip line,and tree
of dimensions and building setback dimensions protection measures
0 Lot area,building coverage area,percentage of coverage and &treet tree size,type and location
impervious 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)
gClean Water Services—Service Provider Letter (lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified Ig.No Received: ❑ Yes ❑ No
I. Public Facilities Improvement (PFI)Permit:
Required: ❑ Yes,applicant was notified tk. No Applied For: ❑ Yes ❑ No,stop intake
Land Use Case#: SU P.c i 5—06:1-)I 5
.1K Zoning: R--1 ( PO)
%Required Setbacks: Front Rear is Side .5 Street Side N i)Ik- Garage
Akt Landscape Requirement: •2L) %
Lot Coverage Maximum: L0
X.Building Height: Maximum Height Actual Height
.Visual Clearance
XEasements
Sensitive Lands: ❑ Yes XL No Type
Urban Forestry Plan
..t..,
Conditions "Met"prior to issuance of building permit
Notes: Qtv'cty "1 UY14S SI,11.1R 19-C YY1 * ,.Vr 1-i I-,su CtiV-lCC
Approved By Planning: -741-vim frit--t- Date: 12.1 ' 11
Revisions (after BuildingSubmittal only) Reviewer Date
te
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: 1P-/1 1/
Site Plans: # 3
Building Plans: # '3
Building Permit#: a-Enter building permit#above.
Workflow Routing: 8'Planning ❑'Engineering irmit Coordinator Building
Workflow Sign-off: 0 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
yriginal plan review routing form.
all Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: _ • / 40 4 / . Date: 2/4/1/_Z_______
Engineering Review
Slope at building pad: _,
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 I No
Assess Water Quantity Fee in-lieu: ❑ Yes No
LIDA Facility on lot: ❑ Yes No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: /4/1 2) Date: (-44-/ 7
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: ❑ N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: TrYes ❑ N/A
LOK to Issue Permit
Approved by Permit Coordinator: 1//// f Date: //9/1
I:\Building\Forms\BldgPermitRvw_RES_091216.docx
1741'41f
ie A4
• Ic3
Plumbing Permit AanbcaECTVEE)tity —
Building Fixtures AUG 8 2017
III
13ity o
CWBitIlf Tigard Reaciiod 7 4 125 Slilvt1,Tigard.ORC•732T2Y OF Tef.
IGARD thae/BY: i. /() )0. Pennit14"4 572- f7-06001
., Phut Revien
.'...,„ it- Phone:.'5°3•7182439 Fax: Ettilt.E4NG DIVISIOlm Datelt• ): .Ottici Penult No.:
Inspection Line: 503.639A175
t r .• ., pale RedYIRY: mill if See Nigel for
Internet; www,ftgard-or.gov NoutiediMethod: Supplemental Information
, . .. . ,
• '••! TYPE OF,WORK FEE* SCHERVI.E
. .
0 New construction 0 Demolition For spedel Worsnda is use checklist.
Description Qty. I Ea. I Total
0 AdditiontaltexatiOn/replaceMent 0 Other: Nor 1-2-Family dwellings(includes 100 ft:for each utility connection)
CATEGORY'DT coreriticnoti - sflt(1)bid 31230
,
. .
0 1-and 24family dwelling 0 Commercial/industrial SFR(2)bath 437.711
SFR(3)bath 500-32
0 ftcoessin bUilding 0 Muld-family ,
Each additional bathAtitchert 25.02
0 Master builder D Other: Fire Sprinkler( sq.ft.) ' Page 2
812E INFORMATION AND LOCATJON site utilltieit
lob site address '4'11 12 u L., bkj (‘---rAltAAJ-k--u)cv Catch basin or arca drain 111.76
Drywell.leach line,or trench drain 18.76
City/State/ZIP:
, . • Footing drain(no.linear 11.: ) Page 2
Suite/bldg./apt.no.: I Frojed mmHg - CVIA.1, 6/V1) :31 anufactured home utilities 50.03
Cross street/directions to job site: holes 1t76
'Td'n drain connector 1176
Sanitary sewer Mo.linear ft.:____) Page 2_
Storm sewer(no,linearft.:_) Page 2
V Waterservite(no.linear ft.:___) Page 2
Subdivision: 1 14 fl'. (-2 Fixtiux or item:
Tax map/parcel no.: Backflow preventer 31.27
• '•- ,- BakWater valve
• ' ' '. DESattrITON OF WORK - c 12.51
VAAC (A? --(RAV1 Dishwasher 25.02
25.02
Drinking fountain 25.02
Eit*cludsump 25.02
.•1..:3'''PS13 ,6 0**Ilt ' '.' t ::- •I:1 TENAr ExPansaat tank 12.51
Nan= ...)V_ kAlfy-k--(nn 'patine/sewer top . 25.02
Floortintin/floor sink/Itub 25.02
Address: -k'b 1 5Nk-), %\A6
City/State/ a'\L-C4.00.W jCif•-wel Carhop.disposal 23.02
4P: X OIL.. C'\- 1/.. Nose bib 25.02
Phone!V,5) ..-(41 C1‘. Fax ( ) Ice maker , 12,51
cutogrAct moo* : Interceptor/grease trap 25.02
Busincsn nen*: Medical gas(value:$ ) Pagel
Pruner 12.51
Contact name: E\PiAJZ Aal tr) VU'el. E'r. )
Roof dinin(commercial)
1251
Address: Sinlithasintlavatory 23.02
City/State/ZIP: Solar units(potable water) ... 62.54
Phone:( ) Fax :( ) Tub/Shower/shower pan 12.51
E-mail: Urinal 25.02
corcriactoR Water closet 25.02
Water heater 3/.52
Business name:Wolcott Plumbing Water piping/DWV 56.29
Address:1075 W.Blatant rolunibM River lIwy Other: 2502
City/State/ZIP:Troutdale Or.9068 . Subtotal
Phone:(S03)667-1781 Fax:(503)667-9891 Minimum permit fee:$72.30
Plan review (25%of permit fee)
CCB Lie,:112220Plumbing Lie.no.:26-824P8
State surcharge(12%of permit fee)
Authorized signsturt`-'Ok4-• )' A................ TOTAL PERMIT PIT
Print name:Mark.Buttons Date:2/17/17 1 This puma application e4pires HA permitn Milt obtained within ISO days
after It has,beett-accepted at complete.
'Tee methodology set by 1'6-County Building industry suryteu Bout
i
I kihi4d4Terraitai,MV-PetritAppim 10101/1/9 440400(I afatCOM,WER)
1
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8600 SW SCHMIDT LOOP, TIGARD, OR, 97224 December 27, 2017 at
1 :25:29 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00003
Inspection Type: Inspector:
299 Final inspection David Young
Result:
PASS - CofO
Comments:
No ac installed.
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.
Violation Summary:
Inspector Contractor