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Permit (34) CITY OF TIGARD MASTER PERMIT 11 2 ry'3 COMMUNITY DEVELOPMENT IY '_ `�' Permit#: MST2017-00227 T[G ;r 8 D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 V�/7 Date Issued: 07/05/2017 Parcel: 2S104AD07300 Jurisdiction: Tigard Site address: 12976 SW PARKDALE AVE Subdivision: OLSON WOODS Lot: 9 Project: Olson Woods, Lot 9 Project Description: New SF. 9/12/2017: REPRINT permit to change covered patio to a covered deck of 184 sf. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 5 First: 1632 sf Basement: 0 sf Left 5 Parking Spaces: 0 Height: 26 Bathrooms: 4 Second: 2008 sf Garage: 610 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3640 sf Value: $448,162.46 Rear: 15 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 6 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: 6 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 5 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: 7 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC. N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: NOther Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 3640 Owner: Contractor: WINDWOOD CONSTRUCTION INC WINDWOOD CONSTRUCTION INC Required Items and Reports(Conditions) 12655 SW NORTH DAKOTA ST 12655 SW NORTH DAKOTA 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97223 TIGARD,OR 97223 2 Geotechnical Inspection Required before foundation PHONE: 503-780-4375 PHONE: 503-625-6526 FAX: 590-7606 Total Fees: $32,801.20 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 th1 • R•52-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.234 �/ •• Issued :y:� / Permittee Signature. Call 503.639.4175 by 7:00 a.m.for the next availab e 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. CITY71 OF TIGARD MASTER PERMIT I' COMMUNITY DEVELOPMENT Permit#: MST2017 00227 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/05/2017 T j ��` 9 Parcel: 2S 104AD07300 Jurisdiction: Tigard Site address: 12976 SW PARKDALE AVE Subdivision: OLSON WOODS Lot: 9 Project: Olson Woods, Lot 9 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 5 First: 1632 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 26 Bathrooms: 4 Second: 2008 sf Garage: 610 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3640 sf Value: $444,055.58 Rear: 15 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 6 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 6 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 5 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 addl 500 sf: 7 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 3640 Owner: Contractor: WINDWOOD CONSTRUCTION INC WINDWOOD CONSTRUCTION INC Required Items and Reports(Conditions) 12655 SW NORTH DAKOTA ST 12655 SW NORTH DAKOTA 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97223 TIGARD,OR 97223 2 Geotechnical Inspection Required before foundation PHONE: 503-780-4375 PHONE: 503-625-6526 FAX: 590-7606 Total Fees: $32,724.91 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 obtain a copy of thelyles or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. l Issued By: 4� --e!-a'" i- ._ �S '2—._-Rermittee Signature: --►�' Call 50S'6Z&4175 by 7:00 a.m.for the next available inspection. This permit card shall be kept in a conspicuous place on the job site until-.letion of the project. Approved plans are required on the job site at the time of each inspection. $uilding Permit Application Residential WV CAN- FOR OFFICE USE ONLY City Of Tigard �A Ee ' PeritNo.114 SWHl Blvd.,Tigard,OR 9 3 7 �v if77Phone: 503.718.2439 Fax: 503.598.1960 w p U L' 21 7-Q DateBy: �'" �5-'" 17 Other Permit i l X3 2 —O s TI GARD Inspection Line: 503.639.4175 1 Date Ready By: tuTs See P Internet: www.ti ard-or. ov �, � , g�q'� / D Page l for g g Iri ' q�`J Notified/Method:�j�/ ry r 1 k' .. « �(lr /� i' I, a Supplemental Information TYPE OF W j1N,St l REQUIRED DATA:1-AND 2-FAMILY DWELLING - New construction olition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ID Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. 1211-and 2-family dwellingValuation: os,c 0 ,„,., --i Commercial/industrial $ 9 C+� Q 0 Accessory building 0 Multi-family Number of bedrooms: Tv 0 Master builder 0 Other: Number of bathrooms: L. JOB SITE INFORMATION AND LOCATION Total number of floors: _TDCS'0 Job site address: "t� x(,7 ,+'1,4 f' //9f/' New dwelling area: -34 °squarefeet �7 City/State/ZIP: T .4/'/ �> J -' 11 Garage/carport �Q '0 area:""6-rstpt square feet Suite/bldg./apt.no.: Project name: (-::://.3-0,4,1 a2V5 Covered porch area: / O square feetc100 8 Cross street/directions to job site: q f, �' f'4,/:', a 7 „Deck ..t a area: 16 square feet Other structure area: 29.14 square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: ,/,',7-04// 00 ,(r f Lot no.: q Permit fees*are based on the value of the work performed. Tax map/parcel no.: Indicate the value(rounded to the nearest dpllar)of all equipment,materials,label overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. ~ Valuation: $ • Existing building area: square feet New building area: square feet PROPERTY OWNER ' I 0 TENANT Number of stories: Name: k(,/-.T, ,/,0 ajo ,o (' �1 : �`., / Type of construction: Address: /gip• 5-e)--eg ,S c,,,,,,i /2/(;)4 77./!�f /: ` .,),,,r.---,4 :7:-�.'.' Occupancy groups: City/State/ZIP: 7. ,/7 ; y ( Existing: Phone rl ,. ,7;�� ;�..a��j Fax:(�, '-5 ) � , ,..�.- � r �/..» New: --B'APPLICANT 8"CbNTACT PERSON BUILDING PERMIT FEES* Business name: (Please refer to fee schedule) Contact name: Structural plan review fee(or deposit): -/-„:,, ._ -/, 2.: Address: FLS plan review fee(if applicable): City/State/ZIP: Total fees due upon application: Phone:(- �) �� - Fax: :(- ` ) Amount received: E-mail � f 4 f PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted PhotoVoltaic Solar Panel System. Business name: /4)If:,/,:),X.1, 1671) /`(:),/..--'; 7 _.[-/_i Submit two(2)sets of roof plan with connection details Address: r and fire department access,along with the 2010 Oregon / Solar Installation Specialty Code checklist. City/State/ZIP: Permit Fee(includes plan review Phone:( ) Fax:( ) and administrative fees): $180.00 CCB lic.: f:, f 6p State surcharge(12%of permit fee): $21.60 Total fee due upon application: $201.60 Authorized signature: '-'-"-- This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: /,4) /,- := F ' , Date: 1 ", Fee methodology set by Tri-County Building Industry p.--- Service_ , . Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanic j ermi' al t A i 4. a ,C2ty of Tigard lica tion 7i TI hone. 5 all Blvd .x 5-41-F GARD InteInsprnet: Line8.243g' Ftp d OOR 87223 " C t rnet: 503.639.417 3 598.19 :um 4— Di: -- www.ti orgov5 60 �eceeBivedFORbard- atc y OFFIC t D Byview E USE ONLY e� construction to t1CtiOn wow v `+ti g a u a 1{ t Ready/Ey: Putt No: bet-no/it/on OF •i r Q Addltion/alte ` -' ser:, -4 died/Method. Other Pe _ a,. rtnit: C Other: ration/r 1. „1\ 1' her• " eme 8 C nt See �lu1t lamtly dwelling�TEO�RY OF CoNS7�ir Mechanical e hani,C R ,` FEE» Supplemental upplem seepage Information Y CpmmerCial/• CTi©N „ performed. erformed�Pe itLfees* SSD n Job e address: J � E z4NFOaster b e7r dustr a] cessorY b n7ephanicaJ materials be value f ounare based d d o va value o f CEEEc ST b sttOB wild 0 Ac ty/State r1 .' / 1Ip � Other: ullding SIDE v�ue nt labor overhead, vthe ea nearest dollar)the o Ci K y 2IP: Suite/bldg./apt. LOCATIONQ $ d and'rofit. f all Cross�ldg/apt no.: ����,:kl �� i. �► �.�-" Heat'nDescriPL°n FnrsPeci�lnfUIpMENT anon seySrEFEES* street/directions tre t/dire Project cook checkli � �� � Air n.' s[ cttons to job site: feCt name' - � conditions Qty. �1�� = i Furnace n' 0 Total r Fu 1p�000 BTU 4 k'-':--; __. mace 100>OOpfBTUtductwnts 46.75 Duct work (ducts/vents) 46.75 IIPP/I! 7 h dronic)�boiler(radiator mor _® `��_ c Unit heaters Lot 'n wall,heaters (fuel-type not11111111111 DES no.: Flue/ve s.epde electric), 1 ONION OF WORK Other: nt for any of above etc. 0111 Other 46.75 her fuel a -® !lances: F�fre.Jace/rose rt N ® OpER fire lace ue t for water heater organ _ 3® .39 itimaritilli .. > , Wood/. (-as � Address t� 7-; . od/.elletsto e TEN1111111,I 1111 Wood fir lace/rose PCO/State/ZIPT Chimney/liner/ rt NSW 33 Phone:( 9 other: flue/vent rNISI ��,. Environ Mentalhood/other exhaust _ Range ch Business name. PLIC ,7 . Fax:(�- ,,..„--•'.2_,..),..) / e4ui.rnent d/Other kitchen and ventilation: � ,., �`U) s---,?;,,,.._--....,,,, Clothes dryerTr— Contact exhaust jaw.01VtAeT P toilet corn exhaust(bathrooms, ba 33.39 Address: / thro �w f <_ j� ETON OtherAttic/crawls•a e fsutility rooms) 33.39 C Phone:( Fuel ii'in:: �� Email: ) $14.1s '® � �� r-tr . for first four'5,4.03 for each CIC--/ additional Wall/sus. Business name. CO /C�c.._� -�; us.ended/u nit heater �_ Address: '' : NTRA CTO ' '. City/State/ZIP: r Barbecue �.ar_ Phone.( Clothes dryer CCB lic.: -c--7_). � Other. (.as �_ �/moi Authorized sign -- NLECRANICar,PE _ FP-ES* Print Warne: it Minimum Subtotal ?�u;td;ng�pe - m Permit fee Ota/ nntr:U,gC p��r .-.0. State 1�reVieH,(25% ($90.00) nnitAPP_040713doc surcharge(12% of permit fee) Date This permitapPlication TOTAL pO�f�pemtitfee) �� ► * Fee methodology after it hashes if a permit EjmIT FEE 440-46777,(71/02/C014/WEE) /0/C o1OgY set by Tri-Co en accepted as co obtained Wit �M Ee) Tri-County Building Industry Service ice Boa d 80 Electrical Permit Application _ u FOR OFFICE USE ONLY City of Tigard Ped �a � • DDate/B Permit No.: 13125 S W Hall Blvd.,Tigard.OR 97 " III ' Plan Review Phone: 503.718.2439 Fax: 503.598.1960 \} "t y f\\\ Date/By: Other Permit: TIGARD Inspection Line: 503.639.4175 �a`� ,j t DateReadyBy: Juris ® See Page 2for Internet: www.tigard-or.govotified/Method: Supplemental Information •::''':.''':;: '7,.;:q-44,-ft"-4_,,,,-'""7,,:.; so ,+ a1N4 ..w 4. "S ew construction ❑Addition/alteration( lC' It t' ' Please check all that apply(submit 2 sets of plans w/items checked below 1 -g�Ii t 1.a*.,' 0 Service or feeder 400 amps or more 0 Building over three stories 0 Demolition ❑Other: ill'-' the available fault current 0 Marinas and boatyards. rs ' , 1 .*' t *kms z exceeds 10,000 amps at 150 volts or 0 Floating buildings. less to ground,or exceeds 14,000 0 Commercial-use agricultural 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 Installation of 75 K VA or a w asfi- ❑Emergency system. larger separately derived system j01 -nS � Q � �.1 ltl /Q( ..: "�" (,r'P - 1a' :. 0 Addition of new motor load of ❑"A- „E","I-2","1-3" Job no.: Job site addresaddress/.2OOHP or more. occupancy. 9,60 � � , ir✓�' Six or more residential units. 0 Recreational vehicle parks. City/State/ZIP: �} ,r•�/ ❑Health-care facilities. 0 Supply voltage for more than f(- ,j 1V (/ ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: Project name: -'"; '", ;7/,,J' J ❑Service or feeder 600 amps or more. . ` FEE-SCHEAUIE Cross street/directions to job site: Z.6,117-,Z,../ 7- Description I Qty. I Fee. I Total I • New residential single-or multi-family dwelling unit. Includes attached garage. . Subdivision: /5 dit- c4L/ercii2 Lot no.:? 1,000 sq.ft.or less / 168.54 4 Ea.add'1 500 sq.ft.or portion itta 33.92 I Tax map/parcel no.: Limited energy,residential ' 75.00 ") g-0l;" i~$~RPIO0WO� sl6, t _ . ' (with abovesq.f Limited energy,multi-family 75.00 ' ,� L^t _ 5.72 residential(with above sq.ft.) - • t� t J Services or feeders installation,alteration,and/or relocation 200 amps or less 100.70 2 i • w 201 amps to 400 amps 133.56 ' 401 amps to 600 amps '200.34 ` 2 Name: pi ,)G14::,0,O e0,4,..vT, .171( 601 amps to 1,000 amps 301.04 I �' �! , �r} �t 7` Over 1,000 amps or volts 552.26 I} 2 Address: �02 64.5"--s--- e...7t (�'"� Nal d��� f JA"fe�`l ��r�"� ��``if.' Temporary services or feeders installation,alteration,and/or City/State/ZIP: 11 4,0-rt ii`;:_moi Cc,, ,),„ . relocation Phone:( F�, 2 ..4/375-- - 4 Fax; 200 amps or less 59.36 1 ) �`� 201 amps to 400 amps 125.08 2 Owner installation:This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. - Branch circuits-new,alteration,or extension,per panel Owner signature: Date: A.Fee for branch circuits with m p 4 An," N1, -, wf rt1, above service or feeder fee, 7.42 � w . « � ; . each branch circuit Business name: ,,- _..,n� B.Fee for branch circuits without service or feeder fee,first 56.18 2 I Contact name: /9 '/2_,42././1„0,110...cbranch circuit Each add'1 branch circuit 7.42 2 Address: Miscellaneous(service or feeder not included) Each manufactured or modular 67.84 City/State/ZIP: dwelling,service and/or feeder Phone:( ) ( ) Reconnect only 67.84 2 Fax:: Pump or irrigation circle 67.84 2 E-mail: / f 1.,...,:,,L• • Sign or outline lighting 67.84 :'. . .GO)`1TRAG 'Q$,.r; , Y`.'� s:` ' °.,.; Signal circuit(s)or limited-energy panel,alteration,or extension. Page 2 Business name: Dream House Electric,LLC Each additional inspection over allowable in any of the above Address: 221 SW Moonridge Place Additional inspection(1 hr min) 66.25/hr City/State/ZIP: Portland,OR 97225 Investigation(1 hr min) 66.25/hr Phone:(503) 519-6711 Fax:(503)648-9723 Industrial plant(/ hr min) 78.18/hr CCB Lic.: 196726 Electrical Lie.: C-848 Suprv.Lic.: 4560S Inspections for which no fee is specifically listed CAhr min) 90.00/hr Suprv.Electrician signature,required: , . . 'ELECTR-CAL:'EERM1T SEES: Subtotal: Print name: Chris Mahon / Date: Plan review(25%of permit fee): Authorized signature: State surcharge(12%of permit fee): i TOTAL PERMIT FEE: Print name:�7r[S �p�jU,�, Date: vv �/ 1\ttuilding\Permits\ELC PermitApp doe 07/01/10 (/{ 1440-0-4"6155T(I 1/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Description I Qty. [ Each j Total Fee for all residential systems combined: $75.00 Renewable electrical energy systems: 5 kva or less 100.70 2 Check Type of Work Involved: 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: re-jA<Trglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 2 ❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 Vacuum Systems* >100 kva-no additional charge 0.0 3 Each additional inspection over allowable in any of the above: n Other: Each additional inspection is 66.25/hr 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed('h hr min) ELECTRICAL PERMIT FEES COMMERCIAL WORK ONLY: Subtotal(Enter on Page I): Fee for each commercial system: $75.00 * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ B• oiler Controls n C• lock Systems n D• ata Telecommunication Installation n Fire Alarm Installation n HVAC n Instrumentation n Intercom and Paging Systems n Landscape Irrigation Control* n Medical n N• urse Calls n Outdoor Landscape Lighting* n Protective Signaling n Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 Plumbing Permit Application Building Fixtures FOR OFFICE USE ONLY 9 Received City of Tigard , 7 Permit No.: ' 13125 SW Hall Blvd.,Tigard,OR 97 ' r,`"r i` '),.1:. Dan Re Tigard, � t°1-.- Plan Review ' Phone: 503.718.2439 Fax: 503.598"1�"b0-."' DateBy: Other Permit No.: Inspection Line: 503.639.4175 Date Ready/By: Juris 0 See Page 2 for TIGARD � 11i{ Notified Method. Supplemental Information Internet: www.tigard-or.gov t4 TYPE OF WORK 9 FEE* SCHEDULE J2'New construction ❑ii)ai#ilrtron * For special information use checklist �.,_ 17 �y lDescription Qty. 1 Ea. Total ❑Addition/alteration/replacement [ tt:l*•'11 New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 -and 2-family dwelling ElCommercial/industrial SFR(2)bath 437.78 SFR(3)bath /" 500.32 ❑Accessory building 0 Multi-family Each additional bath/kitchen • 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: Catch basin or area drain 18.76 / 2el�� /` , ' `',. /, :' ,:�'` - Drywell,leach line,or trench drain 18.76 City/State/ZIP: �; ` -~ Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name: .,L �, Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: L. ;,'.' ' I Lot no.: ef Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF,WORK` Backwater valve 12.51 Clothes washer 25.02 .. / ,4/-F!k_ �-.) 5/. f=:„..7) Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 >- ROPER,-- OWNER I 0 TENANT Expansion tank 12.51 Name: 1 / Fixture/sewer cap 25.02 iy x l. A :.-`.�_) r-' , Floor drain/floor sink/hub 25.02 Address: /: (43 f,.- /' •-y',,_... Garbage disposal 25.02 City/State/ZIP: /2 , ;"� /_ Hose bib 25.02 Phone:(-fr....1'') -2.:,:;,:„.,---7/1-!:,'/''''''7 Fax:(';' ) r Ice maker 12.51 PPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: t Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Roof drain(commercial) 12.51 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: Urinal 25.02 1 CONTRACTOR t' Water closet 25.02 Water heater 37.52 Business name: -"''}/1�. /`,. ,4 ./1 Water piping/DWV 56.29 Address: r /- = Other: 25.02 City/State/ZIP: /...;'l !' „ , " Subtotal Phone:( �;) Fax:( ) Minimum permit fee: $72.50 CCB Lic.: �� PlumbingLic.no.: Plan review (25%of permit fee) / ' L' _1/� r,.:.a) State surcharge(12%of permit fee) Authorized signature: t TOTAL PERMIT FEE J r: ' , This permit application expires if a permit is not obtained within 180 days Print name: / Date:/__ / after it has been accepted as complete. ` f Y *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-PermitApp doc 10/01/09 440-4616T(10/02/COM/WEB) City of Tigard IIIIII COMMUNITY DEVELOPMENT DEPARTMENT Q T I GARD Building Permit Review — Residential Building Permit #: A57-w)/7-,co ,a,7 Site Address: 12 c11 Vorbc o)€, Project Name: O1se7A W OLot #: 9 (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: (� S '4;?... Verify site address/suite# exists and active in permit system. Lel River Terrace Neighborhood: [ No ❑ Yes,See River Terrace Review Addendum Attached Sit Plan Elements: y� Dripiree(3)copies of site plan r�OEisting structures on site 1MSttt plan must be on 8-1/2"x 11"or 11 x 17"paper [ 'Footprint of new structure(including decks)with finished N.Zrawn to scale(standard architect or engineer scale) fl or elevations EJ11/19rth arrow tility locations&easements(required for new and additions) [Wite address,project or subdivision name and lot number Sidewalk/driveway approach Cipplicant information(name and phone number) Location of wells/septic systems ❑Lot dimensions and building setback dimensions No4cisting trees to be retained with drip line,and tree pSquare footage of buildings to be demolished protection measures .ot area,building coverage area,percentage of coverage and C,�r Street tree size,type and location ji? pervious area(applicable if R-7,R-12,R-25&R-40) IJStreet names [ roperty corner elevations(2 foot contour lines if more than AAStorm water quality facility required if>1,000 sf of 4 foot differential) impervious area is created or replaced. * Clean Water Services-Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified 154 No Received: ❑ Yes ❑ No Public Facilities Improvement(PFI) Permit: // Required: El - Yes,applicant was notified ❑ No Applied For: /Yes ❑ No,stop intake KLand Use Case#: �1, Z61 y—00008 V Zoning: g-TS ,l d Required Setbacks: Front Rear 15 Side C) Street Side \5 Garage -zo 1IEt Landscape Requirement: rlot Coverage Maximum: Ri Building Height: Maximum Height dv Actual Height 25 11Visual Clearance )ensitive Lands: C71Yes ❑ No Type 5, l+�lri l'C:,GCab\� Okt. qs er Urban Forestry Plan J [onditionsl"M t"prior to issuance of buildingdpermit _,,] 1 Notes: OtAS Y164k3 �OYI0'ti4- cvlS ift•-'- r'e.c 0Vl[y . O4 4c, 155"ke Approved By Planning: Ago e...„ 9"A‘ef Date: ((Z 7 Revisions (after Building ubmittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\B1dgPer mitRvw_RES_051617.docx Building Permit Submittal Original Submittal Date: 6/4/ 7 Site Plans: # 3 Building Plans: # Building Permit#: nter building permit# bove. Workflow Routing: [ Ta Hing ngineering El-14eimtt Coordinator ut nig Workflow Sign-off: KkSign-off for Planning(include notes from planning review) Route Application Documents: [ ngineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. Lei cling: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: i,r Date: 6/ii,/,..7 4 Engineering Review D—Slope at building pad: !O [ ' onditions "Met"prior to issuance of building permit El—Easements (encroachments)per engineering conditions of approval and plat ['Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yesclo Assess Water Quantity Fee in-lieu: ❑ Yes l3"--No LIDA Facility on lot: ❑ Yes L7 No ❑ NOT Approved by Engineering: Date: Notes: ti fiicsti l-$' 4 f E d 5 /v,c% tlye, I;.4 —lc, Av+ /i.4.•S p--j wq-`L Approved by Engineering: g--e Ks'yam_ Date: ,Z ,32, -/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: C Fees Entered: Wash Co Trans Dev Tax: Yes CI N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: 6 Yes ❑ N/A LIDA ❑ Yes /A \r .OK to Issue Permit / /2-1 "---- Approved by Permit Coordinator: WMLat / I:\Building\Forms\BldgPermitRvw_RES_051617.docx City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 12976 SW PARKDALE AVE, TIGARD, OR, 97223 January 16, 2018 at 12:45:55 PM Record Type: Record ID: Residential - Master Permit MST2017-00227 Inspection Type: Inspector: 199 Electrical final Chip Barnett Result: PASS Comments: Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 12976 SW PARKDALE AVE, TIGARD, OR, 97223 January 16, 2018 at 12:46:28 PM Record Type: Record ID: Residential - Master Permit MST2017-00227 Inspection Type: Inspector: 699 Mechanical final Chip Barnett Result: PASS Comments: Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 12976 SW PARKDALE AVE, TIGARD, OR, 97223 January 18, 2018 at 3:15:56 PM Record Type: Record ID: Residential - Master Permit MST2017-00227 Inspection Type: Inspector: 299 Final inspection Chip Barnett Result: PASS - CofO Comments: Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 12976 SW PARKDALE AVE, TIGARD, OR, 97223 Record Type: Record ID: Residential - Master Permit MST2017-00227 Inspection Type: Inspector: 399 Plumbing final Chip Barnett Result: PASS Comments: Violation Summary: Inspector Contractor