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Permit (43)
CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit*: MST2017-00318 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/14/2017 Parcel: 2S110AC00200 Jurisdiction: Tigard Site address: 10985 SW ANNAND CT Subdivision: ANNAND HILL SUBDIVISION Lot: Project: Annand Heights, Lot 11 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 3 First: 1649 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height 24 Bathrooms: 2 Second: 0 sf Garage: 400 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes Total: 1649 sf Value: $209,405.20 Rear: 15 PLUMBING Sinks: 1 Water Closets: 2 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 B 0 Catch Basins: 0 ckflw Prevntr: 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: N Vent Fans: 4 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: 3 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 1649 Owner: Contractor: ANNAND HILL LLC WINDWOOD CONSTRUCTION INC Required Items and Reports(Conditions) BY RICHARDS,M DALE 12655 SW NORTH DAKOTA 1 Ersn Cntrl 503-639-4175 12655 SW NORTH DAKOTA ST TIGARD,OR 97223 2 Fire Rated Eave both sides TIGARD,OR 97223 3 Geotechnical Inspection Required before foundation PHONE: 503-768-4375 PHONE: 503-625-6526 FAX: 590-7606 Total Fees: $28,622.89 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 OA; 95 -001-0090. 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: d �,0...0 Permittee Signature: = - Call 503.639.4175 by 7:00 a.m.for the next available inspec on 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. ` AReceri:)z— ,2L.Z75BuildingPermit Application � ���idtilUSECity of Tigard ived / III13125 SW Hall Blvd.,Tigard,OR 97224,1!r t Date/By. //G///`� 4,0 Permit N s7�j?_/yc t/d.— ■ s/ s /i z�cit� Phone: 503.718.2439 Fax: 503.598.1M' a1 0 L s 7 Plan Revie ..`` Other Date/By: V �, Permit:[_ i/)01?-4). 71 TIGARD Inspection Line: 503.639.4175 Date Read B // a I/ee Page for Internet: www.ti and-or. ov Ready/By. Juris Supplemental See 2 g g • Notified Method: Information TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING flNew construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Ji 1-and 2-family dwelling ❑Commercial/industrial ValuationL' �� S ❑Accessory building El Multi-family Number of bedrooms: 3 a 9,_9O El builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: / ao 91y Job site address::/lf `�� �( Newdwelling area: ( I 11/IiicenU (Ok�r'-0 /6 c/i square feet City/State/ZIP: .716 4-2 CA-LC 9 723 Garage/carport g arport area`r-�},fj[} �quare feet Suite/bldg./apt.no.: Project name: d 66 I A `�6'� ... /�,/I4�t C{`/y Covered porch area: square feet Cross street/directions to job site: 1(79 t-b Deck area: 9 q square feet 1 6l,j,q Other structure area: square feet I REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: n ��AQ -C/ A. IS I 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. it/ .„k) 571 y Valuation: $ Existing building area: square feet New building area: square feet ❑!PROPERTY OWNER 1 /'/ 7-0 TENANT Number of stories: g Name: I) 1,00,0 COJLSr/i J/.$ i Px-- Type of construction: Address: /014 5--5- 5&) /]p n /V d 1v/1 Da-k.1 tc. 6YTt -74 Occupancy groups: City/State/ZIP: 7CA�a f spa__ 2- Phone:('''03) 70Y Li37�'C r Fax:( 3) -7 Existing: l> U'6lv4 New: ❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* Business name: (Please refer to fee schedule) Contact name: Structural plan review fee(or deposit): Address: FLS plan review fee(if applicable): City/State/ZIP: Total fees due upon application: Phone:( ) I Fax: :( ) Amount received: E-mail: I�tJ 1n cituctoe d®/n�N[tom ®�nt at: j/,Cam PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted PhotoVoltaic Solar Panel System. Business name: ��,I l �, �5� C Submit two(2)sets of roof plan with connection detail, Address: 4R /_�5 5 (5' # fs /2�/_ ,� er l� and l rfine department Specialty accalCode checklist.the. Orel Zt�"� �/ V Solar Installation Code checklist. City/State/ZIP: 7, 2. 9?2- 3 Permit Fee(includes plan review G and administrative fees): Phone: 3) gd ` 75"" I Fax:( `3 �6)-zadG State surcharge(12%of permit fee): CCB lic.: 6.---0/96. Total fee due upon application: Authorized signature:' � _ ----1---,.: _. This permit application expires if a per / / within 180 days after it has been act Print name: — ✓/ a 2IS Date: bG l//� *Fee methodology set by Tri-County Bi Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB) Mechanical Permit Application FOR OFFICE USE ONLY City of Tigard p ,4 3 Received 1111 - Date/By: Permit No.Ll �Ol�Df�3y� Hall Blvd.,Tigard,OR 97223 l a 13125 SW H Phone: 503.718.2439 Fax: 503.598.19E� 2017Plan Review HUG 1 0 Date/By: Other Permit: TIGARD Inspection Line: 503.639.4175 Date ReadB mds y o H See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information ' ' TYPE OF WORD COMMERCIAL FEE* SCHEDULE- USE C1ftCKLIST Mechanical permit fees*are based on the value of the work ,,,, ew construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. CATEGORY'OF CONSTRUCTION •. .. Value:$ � ' ` RESIDNTL4LQL1IPMENr SYSTEMS FEES*;' 1'and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special � l use checklist. ❑Multi-family 0 Master builder 0 Other: Description P Qty. Ea. Total ` `,,JQB'SI:1'1;INFORMATION AND LOCATION Heating/cooling: Job site address: (J L� /A / / Air conditioning 46.75 �" U`c 5 �a a [(j pi- Furnace 100,000 BTU(ducts/vents) .®''. 46.75 City/State/ZIP: 7---,,,,a (I,r 972.2.3 Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: Project name:/n ;4/.'_% - Heat pump 61.06 P"-� 9 Duct work 23.32 Cross street/directions to job site: /Q, /..:441- V Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision: finne/ /!(,h/j Lot no.:`/ Other: 23.32 $ Other fuel appliances: Tax map/parcel no.: Water heater ,/ 23.32 , DESCRIPTION •OFWoi Gas fireplace/insert ...'"-- 33.39 Flue vent for water heater or gas /UJiA-r cc/ fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 ❑ TENANI, Other: ROPERTY-OWNER" , 23.32 Environmental exhaust and ventilation: Name: 64)riidit_oaci &.5,( rpc, Range hood/other kitchen equipment 33.39 4 5 /Vd4 'Il � 57cl Clohes dryer exhaust .."' 33.39 City/State/ZIP: 4 �� 22,3 Single-duct exhaust(bathrooms, r� a ' toilet compartments,utility rooms) ./ 23.32 Phone:( �e3 7 d 7� Fax: 76'06 �3) gyp Attic/crawlspace fans 23.32 -tTAPPLICANT ❑ CONTACT PERSON Other: 23.32 Business name: C� Fuel piping: -" m� $14.15 for first four;$4.03 for each additional Contact name: Furnace,etc. Address: Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( ) Fax: :( ) Fireplace E-mail: / /� '`WRange k.,/,/,/ (.Gu or meS is &9 C�/na-1 Ir (a1°► Barbecue CONRACTOR. ,. �// Clothes dryer(gas) Business name: -Ft rr/ 6,/1 Other: /� MECHANICAL PERMIT FEES* Address: /3, /57_,) //ac A n4.5 Auer, /)/,. Subtotal City/State/ZIP: / dk 6S D' do 4- V5—' Minimum permit fee($90.00) Phone: '(! J Plan review(25%of permit fee) ( ) Fax.( ) State surcharge(12%of permit fee) CCB lie.: `7.2.64,23 TOTAL PERMIT FF This permit application expires if a permit is nog days after it has been accepted as Authorized signature: * Fee methodology set by Tri-County Buildin, i c//Print name: F �r� / Date: U� / I:\Building\Permits\MEC_PermitApp_04�e 440-4617T(11/02/COM/WEB) - Electrical Permit Application FOR OFFICE USE ONLY City of Tigard RECEI / Received - a Date/By: Permit#: 13125 SW Hall Blvd.,Tigard,OR 97223 /k 5X4'0/?-(�'3l/ 0 2017 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 AUG 1 Date/By: Related Permit#: Inspection Line: 503.639.4175 ReadyDate/By: Juris 0 See Page 2 for TIGAAD , Y Internet: www.tigard-or.gov CI t r ,3( ,_ Notified/Method BUt �_,_) Supplemental Information TYPE.OF-WORK t� 'tv 'Gltl<-:I,,;i�;P PLAN REVIEW New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked) ❑Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition ❑Other: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTIONexceeds 10,000 amps at 150 volts or 0 Floating buildings. 0 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: 0 Fireum P P ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ,d ❑Emergency system. larger separately derived Job#: Job site address/Q /��A n Q� /' 0 Addition of new motor load of system. _ (�` (tJt(/�+/ I OOHP or more. ❑"A" "E" "1-2> "1-3„ City/State/ZIP: ,Card Q��� 0 Six or more residential units. occupancy. u0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: nA ivd fI,�t . j ❑Hazardous locations. ❑Supply voltage for more than r' y`z, 9 A ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: /j�l/;1Jl V FEE SCHEDULE V77 Description Qty. I Each I Total New residential single-or multi-family dwelling unit. Subdivision: AAA( ® /Ii ,1,15 Lot#: Includes attached garage. Tax map/parcel#: vCC V 1,000 sq.ft.or less / 168.54 4 Ea.add]500 sq.ftor portion 33.92 I DESCRIPTION OF WORK Limited energy,residential V 5 (with above sq.ft.) ® 75.00 2 �� Limited energy,multi-family residential(with above sq.ft.) 75.00 2 �'FIUOPERTY OWNER' Renewable Energy 0 See Page 2 - G 0 TENANT Services or feeders installation,alteration,and/or relocation Name: LClU w,ddc/ /„/t-5/TaG�m 200 amps or less 100.70 2 Address: p�SS^ Sw �/./ /y,- p dA. 51 201 amps to 400 amps 133.56 2 P �/ �y� 401 amps to 600 amps 200.34 2 City/State/ZIP: 70 � £-C (7223 601 amps to 1,000 amps 301.04 2 Phone:(3 • t• 7 3 7s-- Fax:45 3 ) 70 ?//'� Over 1,000 amps or volts 552.26 2 Email:turrwit ie-cftrl�`t o ps , / `Wj A. V% / `CcJ' Temporary services or feeders installation,alteration,and/or (� (/O ® relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 TICANT 0 CONTACT'PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name: 5a�, above service or feeder fee, each branch circuit 7.42 2 Contact name: B.Fee for branch circuits without Address: service or feeder fee,first branch circuit 56.18 2 City/State/ZIP: Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Fax: :( ) Each manufactured or modular Email: dwelling,service and/or feeder 67.84 2 Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 4,zair-A01.4-5c Business name: frieCiflc- Sign or outline lighting 67.84 2 Address: / Signal circuit(s)or limited-energy i , C4--s inQdn j'f( panel,alteration,or extension. 0 See Page 2 2 City/State/ZIP: � at kW g �� Each additional inspection over allowable in any of the above + ef,cAdditional inspection(1 hr min) 66.25/hr Phone: 3) S/f _6-2 1,1 Fax:45--(/ )34.� ^� 3 ��-97� Investigation(I hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is CCB Lic.:/16,2274. Electrical Lic.4—gf f Suprv.Lic.:15'OS specifically listed(1/2hr min) 90.00/hr Suprv.Electrician signature,required: ELECTRICAL PERMIT FEES Subtotal: Print name /r `5 hi 4 AD Date: �j �//2 0 Plan Review Required(25%of permit fee): _ State surcharge(12%of permit fee): Authorized signature: „ �—� — TOTAL PERMIT FEE: This permit application expires if a permit is not obtained Print name: C Arp%) m4 -Ae• Date: e ///, days after it has been accepted as complete. G * Number of inspections allowed per permit. I1Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/1 , 5 440-4615T(11/OS/COM/WEB Electrical Permit Application—City of Tiga Page 2—Supplemental Information , x a x Limited EnergyPermit Fees: AUG 1 0 2017 Renewable Energy Permit Fees: C41-/- BUIL 1 RESIDENTIAL WORK ONLY: FEE SCHEDULE Fee for all residential systems combined: $75.00 Description I Qty. I Each TotalI Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100 70 z 5.01 to 15 kva 133.56 2 n Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 2 T1 Garage Door Opener* 50.01 to 100 kva 552.26 2 >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 n Vacuum Systems* >100 kva—no additional charge 0 0 3 Each additional inspection over allowable in any of the above: [ Other: Each additional inspection is 66.25/hr charged at an hourly(1 hr min) Inspections for which no fee is specifically listed(%s hr min) 90.00/hr COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 Subtotal(Enter on Page 1): (SEE OAR 918-309-0000) * Number of inspections allowed per permit. Check Type of Work Involved: ❑ Audio and Stereo Systems n B• oiler Controls n C• lock Systems n D• ata Telecommunication Installation n F• ire Alarm Installation [ HVAC [ Instrumentation [ Intercom and Paging Systems n Landscape Irrigation Control* [ Medical Nurse Calls [ Outdoor Landscape Lighting* n Protective Signaling n Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I.\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 - Plumbing Permit Ap licatio :. i-i- Building Fixtures FOR OFFICE USE ONLY City of Tigard AUG 1 0 2017 Received IN Plan Re: Permit 13e�� ;/ a 13125 SW Hall Blvd.,Tigard,OR 972 �'[�T�� Plan Review Phone: 503.718.2439 Fax 503.59.$ bt}. g' Date/By: Other Permit No.: Inspection Line: 503.639.4175 t��r a _.r u, j� } Y TIGARD Date Ready/By: Juris: H See Page 2 for Internet: www.tigard-or.gov Notified/Method. Supplemental Information TYPE OF WORK FEE* SCHEDULE W.ew construction ❑Demolition For special information use checklist Description Qty. Ea. Total 0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 JI-and 2-family dwelling ❑Commercial/industrial SFR(2)bath V__, 437.78 ,,12- 0 Accessory building 0 Multi-family SFR(3)bath ^1 32 ❑Master builderEach additional bath/kitchen X5.02 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address:/ - �•7.2,2-.2-300 i 4, A n011 (tali Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 T&1-A-10 City/State/ZIP: O/L� ��3 l� // Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name:, /7/14/1a/l�/ , k i5 Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 10 9 4 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: /lad t/ee A,/5 Lot no.: // Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 -� Clothes washer 25.02 /w(/ 5f--72- Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 0 PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Name: k,in� -d 0re1 a s 71-P Fixture/sewer cap 25.02 /_ / ` Gy y Floor drain/floor sink/hub 25.02 Address: /v"�/ "s� / /WT/4-X)G //z J ]- Garbage disposal 25.02 City/State/ZIP: 77 i ape" Oz, (7"-2 3 -7 Hose bib 25.02 Phone:( -2 -‘-b i' 7S- Fax:(S>3 S`, -l .� Ice maker 12.51 0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: 5-am Medical gas(value:$ ) Page 2 Contact name: Primer 12.51 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 �/d! WVdd /1LtSN(,J r'0a! 4�G v Water closet 25.02 CONTRACTOR L por1A / P44..6 f� /� Water heater 37.52 Business name: JJ Water piping/DWV 56.29 Address: /,-, //'62 5 61( `J 740/ /'4/ Other: 25.02 City/State/ZIP: /y�0/E e- AO d4 r7t7 Subtotal (� Phone:(5'n) �7�..3 C Fax:(SL.3) -7-,a,j�(, Minimum permit fee: $72.50 CCB Lic.: j/‘.2l 3 9 Plumbing Lic.no.3. -sor�6 Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: M/J.() TOTAL PERMIT FEE Print name: S�®' it lt.). L71r- Date: 1//2� This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLM 1-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) INCity of Tigard ' COMMUNITY DEVELOPMENT DEPARTMENT T l G t1 R D Building Permit Review — Residential rrs� Building Permit #: 57 )_a-fir Site Address: ( /��� � SW Alt-mould l G� l.F'JU v-i` Project Name: V � Lot #: 1 I (New dwelling=subdivision n e;Addition or Alteration=last name of owner) Planning Review Proposal: A d ` t-eve c X 4'40e- 4 b[. . Verify site address/suite#exists and active in permit system. .NRiver Terrace Neighborhood: No . 0 Yes,See River Terrace Review Addendum Attached Site Plan Elements:J Three(3)copies of site plan xisting structures on site Site plan must be on 8-1/2"x 11"or 11 x 17"paper 3Stfootprint of new structure(including decks)with finished Drawn to scale(standard architect or engineer scale) floor elevations W North arrow 1Jtility locations&easements(required for new and additions) Site address,project or subdivision name and lot numberdSidewalk/driveway approach applicant information(name and phone number) MI ..cation of wells/septic systems :IiitLot dimensions and building setback dimensions \) xisting trees to be retained with drip line,and tree NI quare footage of buildings to be demolished p otection measures •t area,building coverage area,percentage of coverage andreet 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 >1,000 sf of impervious area created or replaced? Yes ❑No 4 foot differential) If yes,is a storm water quality facility shown? ❑Yes*N fk IClean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified 2K-No Received: ❑ Yes ❑ No P"ti Public Facilities Improvement(PFI)Pe t: Required: ❑ Yes,applicant was notified 2.11 No Applied For: ❑ Yes ❑ No,stop intake Land Use Case#: 'i?& PPIC2-2b15_ertri Zoning: ?--t1 (.PD) Required Setbacks: Front IS Rear 1.5 Side 3' Street Side N/ Garage 20 XfLandscape Requirement: % r I erLot Coverage Maximum: - ..,,go U 0 Building Height: Maximum Height S Actual Height Visual Clearance Sensitive Lands: Yes ❑ No Type GS1a2S Urban Forestry Plan ""�' Condi 'ons "Met"prior to issuance of buildin ermit Notes: tty�� � p Approved By Planning: A.,Via I_ _ Date: �1(O((7 Revisions (after Building Submittal onl�! Reviewer to --�- gA20l,�- Revision 1: Approved 0 Not Approved 1- - / Revision 2: Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\BuildingTonns\BldgPeimitRvw RES 061417.docx Building Permit Submittal Original Submittal Date: 77(0/ Site Plans: # Building Plans: # Building Permit#: Enter building permit#above. Workflow Routing: Planning ( "Engineering I 'Permit Coordinator Building Workflow Sign-off: Sign-off for Planning(include notes from planning review) Route Application Documents: p Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. 7 Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: / < By Permit Technician: Date: /y//7 Engineering Review Slope at building pad: t 70f ❑ Conditions"Met"prior to issuance of building permit ❑ Easements (encroachments)per engineering conditions of approval and plat ar-Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes Assess Water Quantity Fee in-lieu: ❑ Yes Zi"No LIDA Facility on lot: ❑ Yes ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: AlI 14-11-- Date: 8 t( (7 Revisions (after Building Submittal only) Reviewer ® ,to s Revision 1: .. Approved ❑ Not Approved . 1 7 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: ie DC Fees Entered: Wash Co Trans Dev Tax: es ❑ N/A Tigard Trans SDC: res ❑ N/A Parks SDC: t' Yes ❑ N/A 4 LIDA ❑ Yes 1 /A OK to Issue Permit / 1 Approved by Permit Coordinator: Dater g---/,,d,-,_— I:\Building\Forms\BldgPennitRvw_RES_061417.docx >iic,...?(p,r roL ---,51--se-m- &.K- E--zs. /7- --- ,)9e- --ls FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. 111111 I City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT r Transmittal Letter T ,A Ck n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: DAT ft ;llirE DEPT: BUILDING DIVISION 9- A.G/4 AUG 932017 FROM: -� // �-.-'►— CI`n 'OF TIGARD COMPANY: h /4_,,/ 'ill/( l/�/.,zc/ ,72- UILPI�TG DWVISH)N PHONE: 'j -.`7 ., 1' '2 c Bem RE: /0 9�-t S \--> Alli A al C AA (Site Address) (Perim a ) 3/1 (Permit WO/?-6(1 41/ivf9iv6 /7167 Gti"//'.3. Z-07—`` // (Project name or subdivision name and lot nuniber) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) ofplans. (3) Revisions: si7 PL�},v .��6es'AL,�,�� Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: � ,(�ic� S'/ L n 414/ .�,` /t7o7// /72E�Lf5z FOR OFFICE USE ONLY Routed to Permit Technician: Date: -8 -30– ) 7 Initials: Fees Due: (❑ Yes cst No Fee Description: Am unt Due: Special $ Instructions: Reprint Permit(per PE): ❑ Yes )4No ❑ Done Applicant Notified: Date: Initials: I:\Building\Forms\TransmittalLetter-Revisions 061316.doc CITY OF TIGARD ' ,,, 1p r MASTER PERMIT 1111 ' COMMUNITY DEVELOPMENT Permit#: MST2017-00318 T f R D13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/14/2017 Parcel: 2S 110AC00200 Jurisdiction: Tigard Site address: 10985 SW ANNAND HILL CT Subdivision: ANNAND HILL SUBDIVISION Lot: Project: Annand Heights, Lot 11 Project Description: New SF. 3/20/18: REPRINT to change address from Annand Ct.to Annand Hill Ct. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 3 First: 1649 sf Basement: 0 sf Left 3 Parking Spaces: 0 Height: 24 Bathrooms: 2 Second: 0 sf Garage: 400 sf Front 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes Total: 1649 sf Value: $209,405.20 Rear: 15 PLUMBING Sinks: 1 Water Closets: 2 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer 100 Tubs/Showers: 2 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: N Vent Fans: 4 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 3 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 1649 Owner: Contractor: ANNAND HILL LLC WINDWOOD CONSTRUCTION INC Required Items and Reports(Conditions) BY RICHARDS,M DALE 12655 SW NORTH DAKOTA 1 Ersn Cntrl 503-639-4175 12655 SW NORTH DAKOTA ST TIGARD,OR 97223 2 Fire Rated Eave both sides TIGARD,OR 97223 3 Geotechnical Inspection Required before foundation PHONE: 503-768-4375 PHONE: 503-625-6526 FAX: 590-7606 Total Fees: $28,712.89 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 the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: ''G • l(,� �� i � —Permittee Signature: fltp. /i-d4� ' 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. CITY OF TIGARD MASTER PERMIT 111 s COMMUNITY DEVELOPMENT Permit#: MST2017-00318 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/14/2017 Parcel: 2S 110AC00200 Site address: 10985 SW ANNAND CT Jurisdiction: Tigard Subdivision: ANNAND HILL SUBDIVISION Project: Annand Heights, Lot 11 Lot: Project Description: New SF. BUILDING Stories: 1 Floor Areas Required Setbacks Bedrooms: 3 First: 1649 sf Re-pair`. Height 24 Basement: 0 sf Left: 3 Parking Spaces: 0 9 Bathrooms: 2 Second: 0 sf Garage: 400 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right 3 Detectors: Yes Total: 1649 sf Value: $209,405.20 Rear: 15 inks: 1 PLUMBING Water losets: 2 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 SF Rain Storm Sewer 100 Water Lines: 100 Drains: 0 Wa 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: 4 Clothes Dryers: 1 Natural Gas Heat Pump: N Furn<100K: 1 Hoods: 1 Other Units: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder . Temp Srvc/Feeders 1000 sf or less: 1 0-200 Branch Circuits amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'l 500 sf: 3 201-400 amp: 0 201-400 amp: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 p W/O Svc/Fdr: 0 p 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 Other: N Other Description: All Ecompasing: Y BUILDING INFO Class of Work: Type of Use: NEW Type of Constr: Occupancy Group: SF VB SquareFeet: R-3 1649 Owner: Contractor: ANNAND HILL LLC WINDWOOD CONSTRUCTION INC Required Items and Reports(Conditions) BY RICHARDS,M DALE 12655 SW NORTH DAKOTA 1 Ersn Cntrl 503-639-4175 12655 SW NORTH DAKOTA ST TIGARD,OR 97223 TIGARD,OR 97223 2 Fire Rated Eave both sides 3 Geotechnical Inspection PHONE: 503-768-4375 PHONE: 503-625-6526 Required before foundation FAX: 590-7606 Total Fees: $28,622.89 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 OA;95 -001-0090. 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: � �.��- Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspec on 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. % BuIn Permit Application lJD Residential / L' / - City of Tigard _ '''''s 7 FOR OFFICE USE ONLY ~ 13125 S W Hall Blvd Received Tigard,OR 9722�;'' Date/By- G Phone: 503.718.2439II Fax: 503.598.19 �1 PlanRevie ?�t PermitN� TIGARD Inspection 503.639.4175 Goy �"� Internet: Line:io DateBy: iii bard-or.gov Date Read B Other Permit: 'L /1_' 4 Ready/By: Notified Method: ® See Page 2 for Supplemental Information TYPE OF WORK New construction 0 Demolition DATA:1-AND 2-FAMILY DWELLING Permit fees*are based on the value of the work erfo 0 Other: Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement red. CATEGORY OF CONSTRUCTION equipment,materials,labor,overhead,and the profit for the PI-1-and 2-family dwelling work indicated on this application. 0 Commercial/industrial Valuation o Accessory building arr.,- $ 0 Multi-family ��_. 1:�� ❑Master builder Number of bedrooms: 3 0 Other: I / • JOB SITE INFORMATIONNumber of bathrooms: AND LOCATION Job site address: Total number of floors: City/State/ZIP: r G d ��J4/"-i � ` 1 / a/�t2I OLL= New dwelling area: Suite/bldg./apt.no.: /��- - square feet Project name: 1 Garage/carport area. ) Cross street/directions to job site: 4/! `?'= `7�9ume feet �' t�J qtr Covered porch area: square feet Deck area: 9 . square feet Other structure area: ` Subdivision: /r square feet 1' ,' //, REQUII2ED DATA:CO Tax map/parcel no.: Lot no.: CHECKLIST Permit fees*are based on heMERe o the work perfo eSJE Indicate the value(rounded to the nearest dollar)of all DESCRIPTION OF WORK equipment,materials,labor,overhead,and the profit for the h work o indicated on this application. Valuation: $ Existing building area: 0 PROPERTY square feet OWNER New building area: Name: i ❑ TENANT square feet jp tueo a co/1z/ Number of stories: Address: QJ(� �� d Type of construction: City/State/ZIP: / ,a��d �'► t�� / , A'?/� v' �23 Occupancy groups: Phone: 3 7�7-� 7� 0 APPLICANT Business name: s hi 1-0 coNTACT PERSON BUILDING PERMIT FEES* Contact name: Please re er to eeschedule Address: Structural plan review fee(or deposit): City/State/ZIP: FLS plan review fee(if applicable):pplicable): Phone:( ) Total fees due upon ap11:1111111111111111111111111111111111plication: E-mail: Amount received: 1iV l!t %B,vUel . �O/It 45�tt Iv 0 Ai 11111111111111 ® l PHOTOVOLTAIC SOLAR PANEL ANEL SYSTEM FEES* Business name: Commercial and residential prescriptive installation of � ' 1"d d roof-top Address: C-- - mounted Photovoltaic Solar Panel System. Submit two(2)sets of roof plan with connection detail, City/State/ZIP: � �� �� and fire department P ment access,along with the 2010 Oreg / �- 972-2- Permit Installation S.ecial Phone: � ry Code checklist.Q - Permit Fee(includes plan review CCB lit.: 6--U� 7s Fax:( �� �9U-"z�d� and administrative fees): 9 State surcharge(12%of permit fee): Authorized signature: Total fee due upon application: Print name: This permit application expires if a per �% ��� within 180 days after it has been am I:1Buildin� Date: *Fee methodology by set by Tri-County Bi pp.doc 02/24/2011 Service Board. 440-4613 T(I I/02/COM/WEB) R . . Mechanical Permit Application FOR OFFICE USE ONLY' City of Tigard R t� Received Date/B„. Plan Re: Permit No,�� /2����� 13125 SW Hall Blvd.,Tigard,OR 97223 //��[C Phone: 503.718.2439 Fax: 503.598.19III 7 Plan Review TIGARD Inspection Line: 503.639.4175 `�U G l a L D�� Date/By: Other Permit: Internet: www.tigard-or.gov Notifieed/Med/Me Date y: Juris S See Page 2 for thod: Supplemental Information ;`. TYPE OF WORD' COMMERCIAL FEE*.SCHEDULE -- USE CHECKLIST r%l ew construction ❑Addition/alteration/replacement Mechanical permit fees*are based on the value of the work performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. �.. . . CATEGORI'`OF.CONSTRUCTION ; Value:$ and 2-familRESIDENTLALEQUIPMENT/SYSTEMSFEES* dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total jOlg SITE,NFORMATIaN AND LOCATION .� Heating/cooling: Job site address: �f - ' in /ak/"T AirFurnace conditioning0 ,046.75 / U`� �� ��nG 100,000 BTU(ducts/vents) ....'". 46.75 City/State/ZIP: 7�a./� l 9 23 Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: Project name: j� Heat pump 61.06 /' Duct work 23 32 Cross street/directions to job site: /off r.4 Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision: �,nn4/L 0 h Lot no.:// Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 x*' ,`, DESCRIPTIO.N)OF;WORK Gas fireplace/insert .e 33.39 ccp.� Flue vent for water heater or gas A/c fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 ROPER I'°=OWNER` [3 TENANT Other: 23.32 Environmental exhaust and ventilation: Name: ®(t/Ar� c/ ( ) 57 c Range hood/other kitchen Address: 1(/ 65-5- 5� /v„ ,-06A p_ / 5 1 Cleqothes dryer 33.39 �O Y� Clothes dexhaust .e.”' 33.39 City/State/ZIP: �', �� � a3 Single-duct exhaust(bathrooms, Phone:( �O3 ��6 _/../37%-- Fes:�i toilet compartments,utility rooms) 0 23.32 �,.� �i "3) qyc) -'74i OG Attic/crawlspace fans 23.32 - .1 ►PPLICANT ' ;0 CONTACT PERSON Other: 23.32 Business name: .e Fuel piping: 0 $14.15 for first four;$4.03 for each additional Contact name: Furnace,etc. Address: Gas heat pump City/State/ZIP: Wall/suspended/unit heater Water heater Phone:( ) Fax: :( ) Fireplace E mail L -• Range LtiO (,�uf'der Ft-C11.rSNw® �-f4-/Ir (an') Barbecue CONTRACTOR l/ Clothes dryer(gas) Business name: Fl r5Vp1 / -4// Other: Address: /3/5Z) �j/f MECHANICAL PERMIT FEES* Ge/R�LS 6Q,/,..e", Dr' Subtotal City/State/ZIP: / d,_ C:' G an " Y5-- Minimum permit fee($90.00) Phone:( ) -' pax:( ) Plan review(25%of permit fee) State surcharge(12%of permit fee) CCB lic.: `7.2.6,;,v3 TOTAL PERMIT FF This permit application expires if a permit is no* days after it has been accepted as Authorized signature: p1/1 * Fee methodology set by Tri-County Buildin' /tom �`i/i Print name: � Date: I:\Building\Permits\Je C_PermitApp_040 13.doe 440-4617T(11/02/COM/WEB) Erectric CI Permit A lica ti 0 : 13125 °.f�Tigard n Su'Hall TI GgRp"If Inspection 03.718.B2439' Ttoard,OR 97223 „, 1 1 ,f:.., _... Internet: wLine: ww ti 503.639 4]75 03.5981960 x :teelV F Ne gard_or.gov �G © 2 Plan Rev.e OR OFFICE USE ONLY construction c1 I Date B w uCt10n T l'pE OF g it 1'ennit#: 0bell1011t6On O) • Read Y DateB . �G/.1- ❑Addition/alteration/r . r 1 NOnSed!v[etl�d Related Permit#: 3l� t 0 1-and 2-family CATEGORY Other: ePlacelnent ”-' ' stru dwelling 0 Multi-family Cp a See Page 2 for EGo mmerc1 ONSTRrjcTION Please check PI 111 Supplemental Job '1°8 0 MasterIndustrial OService all that aPPly VIEW Information #: SbE 11VF pi,,T der O ACC@SSpr Where Cher feeder 400 ly submit 2 sets o f CI ate/ site O`V• TIO A 0 Other: y bulldlri exceeds 0p'lable fault Pwre more C Buildans W/items checked). City/State/ZIP' Job N g less to l0 c ZIP: address Q. L�CATIp� group O amps at]5104,701 ts �F anti ® ng over three stories. Suite/bldg./apt. Ulte/bl f / amPs for d,er exceeds r d / I allo to as and boatyards. g apt # 1 4.41 �/�Q^ Fire Pump, other installations. 0 ❑Corruner buildings. Cross street/directions treet/ N A f` oEmergenc n of Ise directions to PrOJect name: • `f'E{/�� c3 Addition y system. buildings, apiculture] Job site: ]00 morof e motor of oingellation of 150 gV j �,/(�� �or load lar Subdivision: �� 9 /��'S Health-are residential units. syysternsapazatelyderiv derived °r Tax �Lj �H facilitie "1- neap/Farce]#: —" i�i.� �Sa�ardous locationss occupancy. Service or feeder Recreational SuPPI vehicle Parks. 600 amps or more y voltage for more t n DESCRIP Lot#. �ettr;.non F EE SCID 600 volts nominal. ha TIp, OF WpRK �� Includes deacral single-or m ' t1LE attachedgarage. a ulti OpE E,a. 0a0 s9 ft.or less gar ge. family dwe nr�t. © RTy p�, ER Litnir d e e00 sq P orponlon ,� 168. � 54 Address: �' /� (with abo 'residential _v TEN ::::eadbe:etrgrv(nygYewe, s..ft. 33.92C1t3/State/ZIP• /ziip s�r3Ct LAI1 �1 Tdenalihulti-family 7500 _©Phone'( ' - i�L' /Vd�.�C /p �rSeY above sq.ft.) `ro`p� Services or r 75.00 O trail: '#'6) �72�3 (� OO amps or less d ers installation,a10 Seep e 2 .� ►+net mall (4_'6�� /� Fax:/,�,� O]amps to 400 erahon and/or ■ inter installation: r 3) 401 amps . rel- O intended for sale,lease,his Installations Nty �L�c^'C a 6 p amPs to 600 atn 100.70 -n Owner signature: rent,or exchange ac eing ma "°n Pro / Over,0 Oto 1,000 amps . 200 56 _© amps . 34 _© Business cording to ORS 44^that I own which relmPo�ar3 ervoc volts 301.am 04 ss n / h is not °cation . attirm name: - 449, 670,and 200 am 552.26 Contact Date: 701 amps or less es or f eeders installation,alt name: �. 201 cratio- Address: Cp�1ACT P 40 amps to 400 am and/or EON 1 amps to 599 a amps . S9 36 _ City/State/ZIP: B °cb circuits mps al 12559.-0386010,1111111 5.08 �© Fee for new, A Phone: each serve orfe ch circarts N ihration or extension 4 _© B.F h branch circuitederfee, 'er.ane/ WI Fee for branch ra hr rvice r feeder1rcuits 5555hour arc fee,frst h;1)0°1 rcBusiness Each u;trid 'lapAddre tne: /Aft CpNTCTORMisce/lanranch circuit 56.18 Ss: / Each m us(service City/State/ZIP: ity/State/ ��G / dwelli i eravietured ormodularal or eeder n 1�_ ZIP :Lieconnect onl aand/orfeeder ■ uded APhone.�3)• ��Dd Yn mpoo ori . 67.84 -niyi}: rnganoncircleS� Sn or°utli 2.6111111 6677.8844 7. _ 7 LC 4.6L,�� Signal clrcuitie lightin 84 CCB Lic.:/C',�� Fax:�G3)�y Each,altei(q oror e�Xt�ed-energy 6784 l! 97�� addirrntai(sto nal ins ( ns,on. Q See Page 2 MIN © Elects' ' Additio SUPrv.Electric' Electrical ec signat Lic. I ]nve nalpection tion°per apo Print n are,re stigatio (1 hr min wable in atne� / 9uired: 1 hr ) ani'of /�,�� Suprv.Lic.:�( Industrial plant min) . 66.25/hr th=ve Au e(` S Gtis Inspections for (1 hr min) - 90.00/ _� thotl2ed SI s.e ' which ■ gnature -7:-.;f4"=""' l/ ctficap listed , h no fee is _ Print na Date: ( hr ��� ELECTRICAL P 0 00/hr ■ I�uilding�permi[s ` -. E has been �Lc Pefinegaa_>:LR e �Plan Review Required o � Subtotal: (25i Subt REde�Rev o6/I .:1—'5/ Da State sure o ofPe Date: rmit fe) haTO(12 aE e This permit TOTAL Pertnit fee) g40_g615T(11/OS/CpM/4l Numb r days application expires fa permit is FEE: EB Nun-then of inspections allowed per pemtim d as cOrnPlete obtained Y Electrical Permit Application–City of Tiga�tt � ;, — Page 2—Supplemental Information Limited Energy Permit Fees: AUG 1 0 2017 Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: ' #` FEE SCHEDULE Fee for all residential systems combined: $75.00 Description Qty. Eacn torn, R Renewable electrical energy systems: Check Type of Work Involved: s kva or less 100.70 2 5.01 to 15 kva 133.56 2 E Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 nBurglar Alarm Wind generation systems in excess of 25 kva: 25.01 to 50 kva 301.04 2 n Garage Door Opener* 50.01 to 100 kva 552.26 2 >100 kva(fee in accordance with OAR 918-309-0040) 552.26 2 Heating, Ventilation and Air Conditioning System* Solar generation systems in excess of 25 kva: Each additional kva over 25 7.42 3 n Vacuum Systems* >100 kva—no additional charge 0,0 3 Each additional inspection over allowable in any of the above: pi Other: Each additional inspection is charged at an hourly(I hr min) 66.25/hr Inspections for which no fee is specifically listed(%z hr min) 90.00/hr COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 Subtotal(Enter on Page 1): (SEE OAR 918-309-0000) * Number of inspections allowed per permit. Check Type of Work Involved: n Audio and Stereo Systems n B• oiler Controls C Clock Systems F7 D• ata Telecommunication Installation ❑ Fire Alarm Installation n H• VAC n Instrumentation n Intercom and Paging Systems ❑ Landscape Irrigation Control* n Medical Nurse Calls C Outdoor Landscape Lighting* n Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015 - Plumbing Permit Application-r- -°+,a, r-.,- Building Fixtures �j FOR OFFICE USE ONLY Q f(; City of Tigard 1 0 L 017 Received - Date/By: Permit I � (� 1111 II 13125 SW Hall Blvd.,Tigard,OR 972 /s'c STT/?' ;�!' Z Plan Review Phone: 503.718.2439 Fax: 503.59$ 954. 1' Other Permit No: -.1 Date/By: TIGARD Inspection Line: 503.639.4175 =`i•`r i. Date Read /B Juris: El See Page 2 for Internet: www.tigard-or.gov Ready/By: Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE Prew construction D Demolition For special information use checklist Description Qty. 1 Ea. Total o Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 r -1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath �„ 437.78 0 Accessory building 0 Multi-family SFR(3)bath ^0.32 ❑Master builderEach additional bath/kitchen 2.5.02 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: fU Q 6- CU nif /�4, Catch basin or area drain 18.76 ` / Drywell,leach line,or trench drain 18.76 City/State/ZIP: "�- � O''•' .7'73-23 Y �/,/ A 15 Footing dra (nolinear ft.: ) 0 2 Suite/bldg./apt.no.: Project name: V /I/1Lf/? Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 /® 9 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.:_) Page 2 Subdivision: rod //i0/ts kits I // Water it (no.linear ft.:_) Page 2 fillLot no.: Fixturee or or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 N 5,�"''n R Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 0 PROPERTY OWNER 0 TENANT Expansion tank 12.51 Name: PI./IIZ(/t�ddel 47/t-5T 1 , Fixture/sewer cap 25.02 ` orf- / /� ` �� Floor drain/floor sink/hub 25.02 Address: s t�' (�yCf// Garbage disposal 25.02 City/State/ZIP: � Q� � 3 Hose bib 25.02 Phone:(s3 7 a i. 7s" Fax:(S >3 5`, -7G 2 Ice maker 12.51 . 0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: 0/n 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 �A./Q Groerd/to/1LtSNLa- _erna! ,/te CONTRACTOR v Water closet 25.02 / A r 0 M /� Water heater 37.52 Business name: p6 r !(t,{1 n(�`� Water piping/DWV 56.29 Address: i., //c) 6 it 1/1 , /2" Other: 25.02 City/State/ZIP: (� yid/( i Ort r2d Subtotal Phone:(5G3) `7g..3 --g�C Fax:(5 3) 7",„3 U,5�rMinimum permit fee: $72.50 e� CCB Lic.: �lv� 9 Plumbing Lic.no.3. -3ar�6 Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: 77/�/I.OJ TOTAL PERMIT FEE c -i !!!�L Print name: 4 4j /l/ /kt Date: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *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) a illCity of Tigard COMMUNITY DEVELOPMENT DEPARTMENT TIGARD Building Permit Review — Residential Building P ermit #: ii5/;:, -//3 / Site Address: O SW Id 11 I A Project Name: C i i Lot #: _ (New dwelling=subdivision n'<, e;Addition or Alteration=last name of owner) Planning Review Proposal: PA. JR-Verify site address/suite#exists and active in permit system. -River Terrace Neighborhood: X,No . 0 Yes,See River Terrace Review Addendum Attached SitePlanElements:) l&`hree(3)copies of site plan .Xite plan must be on 8-1/2"x 11"or 11 x 17"paper J�► �g structures on site I. Drawn to scale(standard architect or engineer scale) � tprtnt of structure(including decks)with finished floor elevatioNorth arrow ..�� ns �� Site address,project or subdivision name and lot number `2t�ultty locations&easements(required for new and additions) AppliA cant information(name and phone number) �idewalk/driveway approach Lot dimensions and building setback dimensions ��� �•cation of wells/septic systems frAI 'fisting. /Al quare footage of buildings to be demolished 'fisting trees to be retained with drip line,and tree =' •t area,building coverage area,percentage of coverage and °tection measures impervious area(applicable if R-7,R-12,R-25&R-40) treet tree eine,type and location �'roperty corner elevations(2 foot contour lines if more than >1`Street names 4 foot differential) ,000 sf of impervious area created or replaced?�'es ❑No If es,is a storm water quali facility shown? ❑yes , . A-- x-Clean Water Services-Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified K g Public Facilities Improvement(PFI) Perin No Received: 0 Yes 0 No Required: ❑ yes,applicant was notified No Applied For: 0 Yes 0 Land Use Case#: 1%%g P�iNo,stop intake Zoning. "I,>I_♦ v Z PD Required Setbacks: Front 6 Rear �_ Side Street Side 1�)Ld Garage Landscape Requirement: �/a '—,� , ,_ 20 kLot Coverage Maximum: 0 V % 0 Building Height: —'- Maximum Height -Visual ClearanceNitActual Height .,Sensitive Lands: Yes 0 No Urban Forestry Plan Type _c s�DQS Condi ions "Met"prior to issuance of building permit Notes: 111.4 ii:a S Approved By Planning: l�/,�1__1 .... /,_/ Date: m Revisions (after Building Submittal onl Revision 1: Approved Reviewer to PP ❑ Not Approved ___�-- --'� Revision 2: Approved 0 Not Approved ______•-________ i--C C l Revision 3: 0 Approved 0 Not Approved I:\Building\Forms\BldgPennitRvw REg_061417.docx Building Permit Submittal Original Submittal Date: Site Plans: ## Building Plans: Building Permit#: Enter building permit#above. Buildin g 2—Engineering Permit Coordinator Workflow Routing: Planning g Workflow Sign-off: Sign-off for Planning(include notes from planning review) Route Application Documents: Engineering. (1) copy of permit application, (1) site plan, (1)building plan and original plan review routing form. 7 Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: Date: By Permit Technician: �i=• <<_ _I/I— y/47_ ... Engineering Review �} �� Slope at building pad: ( l ❑ Conditions"Met"prior to issuance of building permit ❑ Easements (encroachments)per engineering conditions of approval and plat Water Quality/Quantity Facility: �No Assess Water Quality Fee in-lieu: 0 Yes oN , Assess Water Quantity Fee in-lieu: 0 Yes Z/ LIDA Facility on lot: 0 Yes o Date: ❑ NOT Approved by Engineering: Notes: I'k 1 � Date: 8 ! Approved by Engineering: ,to Revisions (after Building Submittal only) Reviewer 1 Revision 1: 'Approved 0 Not Approved 4„ kJ ' Revision 2: 0 Approved 0 Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions"Met"prior to issuance of building permit Date: ❑ Approved,NOT Released: 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: ►`le 6 C Fees Entered: Wash Co Trans Dev Tax: es 0 N/A Tigard Trans SDC: Yes 0 N/A Parks SDC: IE' Yes 0 N/A LIDA 0 Yes /A V41-17VOKIssue Permit �/ 1 to/ Date. ! . Approved by Permit Coordinator: /1 11..7--- I:\Building\Forms\BldgPermitRvw_RES-061417.docx * , L 9 / FOR OFFICE USE ONLY-SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT III Transmittal Letter . ,,„\R n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: DAT w ;1.wyEp DEPT: BUILDING DIVISION 9 Acitel AUG 9 3 2017 FROM: /',(l COMPANY: � an,OF TIGARD (Ai/ ot-cl ( g/ tiQ BUILDING DIVISION PHONE: v?J 3 7�-o ^ I/ 2 l B RE: /091 SZ - (7( (Site Address) (Pe S Oer) Jas 4���N /// (Permit umber (Project name or subdivision -‘,.4?-3- 3 n er) !/ ATTACHED ARE THE FOLLOWING ITEMS: I Copies: I Description: I Copies: 1 Description: Additional set(s) of plans. (3) Revisions: -Sii' /769-iv14t35 roc Cross section(s) and details. '�'�0--5 Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: &J Sr 4 rig • - % / , /'707/ /2&/c' SEs FOR OFFICE USE ONLY Routed to Permit Technician: Date: $ -,3c)_ ) 41 Fees Due: El Yes No Fee Description: Initials: Am unt Due: Special $ Instructions: I Reprint Permit(per PE): I 0 Yes 1 )]No Applicant Notified: l Date: /� ❑Done Initials: I:\BuildingWorms\Transmit[alLetter_Revisions 061316.doc FOR-OFFICE USE ONLY-SITE ADDRESS: i This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Transmittal Letter 111111 1,;C„1 l n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: TC. DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED D oci 6 7.017 FROM: P-1" Azlea-eif un 3tiil_) r;f DIVISION COMPANY: Oji it Gl lyd de/i C,.17 �- PHONE: 71'e— e/375— By/31/ RE: �1 /1/lG'/rL/1 Cc5 �l7 17 'O /� (Site Address) � 4#q, J4J 4 /-5 ( J Pro'�ct'name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s)of plans. Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. ngin 's calculations. • Other(explain): /L!'/lc�t►f etszGe ,�e, REMARKS: 4u4-74.,Or e h.// t411, //M / -f4 W <� / I,(, at, /fit r•tE •--� Otxr' �-�JLGIJ 1�' �-c1 f L.cn-r J -- 3 © (Sr r--- /int dc/' "Ors t 41ml/ls t) FOR OFFICE USE ONLY Routed to Permit Technician: Date: JO - - j Initials: Fees Due: I Yes ❑No Fee Description: Amount D ue: I )4,- re_✓ : ,w $ $ $ $ Special Instructions: Reprint Permit(per PE): ❑Yes J'J No ❑ Done Applicant Notified: Date: /.2fRl/7 Initials: ' I:\Building\Forms\TransmittalLetter-Revisions_061316.doc pzipn , � F, j �� '.. http accetacom,jets eed/porta P' ; Iiii d 1 '., Accela Automations s File Edit View Favorites Tools Help Tigard,OR-Official Webs.., ' CCB Contractor Search e Google Maps C3 Cities Digital,Inc.-Support G Google A 'm HOME it NAVIGATION ` CREATE NEW r• MAPS" rase 1 Case(My Nay) i My Tasks i Inspection i Mise £ Address/Parcel/Owner Contacts I Professionals I Reports , P r+ �, �j € t .' 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Menu Refine Search New Help My Filters`--Select-- v,Module Building Showing 1-11 of 11 I I Case# Number Street Name Suffix Unit# Task Status Case Stt t, 1 MST2017-00350 11917 ANNAND CT Lvfi 1,3 Ready to I MST2017-00318 10985 ANNAND CTIssued L.vfi ll ❑', M T2017-0031 10993 ANNAN CT Ready to P MST2O17 00320 - _I - MST2017-00296 11934 ANNAND CT i_01---- oZ) Ready to ,` H MST2017-00289 11914 ANNAND CT L.0 7--.2-2- Ready to p MST2017-00291 10994 ANNAND CT �U t-- -41"/ Issued P MST2017-00292 10982 ANNAND CT V-r- S-- Issued [1 MST2O17-00293 10974 ANNAND CT Lo / ,2.-‘0, Issued '` — MST2017-00259 10964 ANNAND CT G.07---.2-7 Issued '' Paae 11 I of 1 -F City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10985 SW ANNAND CT, TIGARD, OR, 97224 February 22, 2018 at 10:28:39 AM Record Type: Record ID: Residential - Master Permit MST2017-00318 Inspection Type: Inspector: 199 Electrical final David Young Result: FA I L Comments: Romex not protected above panel at less than 8'. 334.15 Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10985 SW ANNAND CT, TIGARD, OR, 97224 February 22, 2018 at 10:11 :38 AM Record Type: Record ID: Residential - Master Permit MST2017-00318 Inspection Type: Inspector: 399 Plumbing final David Young Result: FA I L Comments: Secure T&P piping per manufacturer requirements. Grouting at master shower window not complete. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10985 SW ANNAND CT, TIGARD, OR, 97224 February 27, 2018 at 9:53:14 AM Record Type: Record ID: Residential - Master Permit MST2017-00318 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: 10985 SW ANNAND CT, TIGARD, OR, 97224 March 5, 2018 at 10:02:16 AM Record Type: Record ID: Residential - Master Permit MST2017-00318 Inspection Type: Inspector: 699 Mechanical final David Young Result: FA I L Comments: Seal around gas line penetration at ceiling and floor. R302.5 Verify sealing around Line set sleeve penetration to underfloor, no access from garage. Note: no ac installed at time of mechanical final inspection. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10985 SW ANNAND CT, TIGARD, OR, 97224 March 8, 2018 at 1 :38:21 PM Record Type: Record ID: Residential - Master Permit MST2017-00318 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: 10985 SW ANNAND CT, TIGARD, OR, 97224 March 8, 2018 at 1 :40:21 PM Record Type: Record ID: Residential - Master Permit MST2017-00318 Inspection Type: Inspector: 699 Mechanical 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: 10985 SW ANNAND HILL CT, TIGARD, March 29, 2018 at 9:35:34 AM OR, 97224 Record Type: Record ID: Residential - Master Permit MST2017-00318 Inspection Type: Inspector: 299 Final inspection David Young Result: FA I L Comments: Setback adjustment for deck encroachment into setbacks applied for by contractor, not approved at this time. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10985 SW ANNAND HILL CT, TIGARD, March 29, 2018 at 9:35:34 AM OR, 97224 Record Type: Record ID: Residential - Master Permit MST2017-00318 Inspection Type: Inspector: 299 Final inspection David Young Result: FA I L Comments: Setback adjustment for deck encroachment into setbacks applied for by contractor, not approved at this time. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10985 SW ANNAND HILL CT, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2017-00318 Inspection Type: Inspector: 299 Final inspection Allyson Armstrong Result: PASS - CofO Comments: Set back variance revised and approved. Collected Air leakage test report Street tree certification and verified tree location Moisture content acknowledgement form High efficiency lighting form Left C of 0 on the counter Violation Summary: Inspector Contractor