Permit (63) CITY OF TIGARD MASTER PERMIT
*..:`- COMMUNITY DEVELOPMENT IIVAM Permit#: MST2017-00455
T E A RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/06/2017
Parcel: 2S109AC07800
Site address: 13322 SW MADDIE LN Jurisdiction: Tigard
Subdivision: MADELINE HEIGHTS Lot: 16
Project: Madeline Heights, Lot 16
Project Description: New SF. 4/5/2018: REPRINT permit to add(1)laundry tray.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1138 sf Basement: 0 sf
Left: 5 Parking Spaces: 0
Height 28 Bathrooms: 3 Second: 1694 sf Garage: 464 sf Front: 15
Dwelling Units: 1 Smoke
Third: 0 sf Right: 5 Detectors: Yes
Total: 2832 sf Value: $354,349.36 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 LaundryTrays: 1
Y Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100
SF Rain Storm Sewer 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Catch Basins: 0
Hose Bib: 2 Backwater Value: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders
Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 5 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr:
Occupancy Group: Square Feet:
NEW SF
VB R-3
2832
Owner: Contractor:
LENNAR NW INC. LENNAR NORTHWEST INC Required Items and Reports(Conditions)
11807 NE 99TH STREET#1170 11807 NE 99TH STREET SUITE 1170 1 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98682 VANCOUVER,WA 98682
PHONE: 360-258-7900 PHONE: 360-949-9128
FAX: 360-258-7901
Total Fees: $31,862.53
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 throug AR•-',1. •;.->p. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
fVAMP
Issued By: , / s S Permittee Signature: (, 47 fn/Z x •�%7(,JA)
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.
Plumbing Permit Application
Building Fixtures
City of Tigard Received �,�-•
4. 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: S �� /�>r y Permit N �� j`� vs"
I Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
l[Gum Inspection Line: 503.639.4175
Date/By: Other Permit No.:
Date Ready/By: Axis: Efl See Page 2 for
Internet: www.tigard-or.gov
Supplemental Supplemental Information
TYPE OF WORK FEE* SCHEDULE
0 New construction 0 Demolition For special information use checklist
Addition/alteration/replacementDescription Qty. Ea. Total
0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
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: 13322 SW Maddie Lane Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: Tigard, OR 97223
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name:
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.:_J Page 2
Subdivision: Madeline Heights I Lot no.:
9 16 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
add laundry tray to existing permit MST2017-00455 Dishwasher
25.02
Drinking fountain 25.02
Ejectors/sump 25.02
62(PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Name: Lennar NW Inc. Fixture/sewer cap 25.02
Address: 11807 NE 99th St.#1170 Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP: Vancouver, WA 98682
Hose bib 25.02
Phone:(360)258-7900 Fax:( 360) 258-7901 Ice maker
12.51
OG APPLICANT
Ea'CONTACT PERSON Interceptor/grease trap 25.02
Business name: SAME AS ABOVE Medical gas(value:$ ) Page 2
Contact name: Juls Call Primer 12.51
Address:
Roof drain(commercial) 12.51
Sink/basin/lavatory 1 25.02 .25-02
City/State/ZIP: Solar units(potable water) 62.54
Phone:(360)258-7906 Fax::( ) Tub/shower/shower pan 12.51
E-mail: Juls.call@lennar.com Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name: Development Northwest Inc., dba Wolcott Plumbing Water piping/DWV 56.29
Address: 1075 W Historic Columbia River Hwy Other:
25.02
City/State/ZIP: Troutdale, OR 97060 Subtotal
25.02
Phone:(503) 667-1781 Fax:(503)667-9891 Minimum permit fee: $72.50
CCB Lic.: 112220 y Plumbing Lic.no.: 26-824PB Plan review (25%of permit fee)
�/t�" '�"��9 `f State surcharge(12%of permit fee) 3,�r Z7
Authorized signature: G
TOTAL PERMIT FEE r20 +L?L,2
Date:10/19/17 This permit application expires if a permit is not obtained within 180 days
Print name: Dennis L. Dunning
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/WF.B)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule:'� w ResidentialFire Suppression Systems:
' R ti S ,' ,,r .Q `ee(eo) 7'o* y #07644101 �r s fti *. x
�, $121.90
Footing dram-1'100' 50.03 0 to 2,000
2,001 to 3,600 $169.69
Footing drain-each additional 100' 37.52 3,601 to 7,200 $23320
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52 s + * , ,
Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
each $100.00 or fraction thereof,toDth�i' lcltos fir s ,,;. t � rpt fi
tY and additionali $10.00 o
0.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
h
90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
Additional plan review forrevisions each additional$100.00 or fraction thereof.
(minimum charge-1/2 hour)
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*.
Quantityby FixtureType . *4104;
*l inblit,00$‘6 44S r .
Fixture Type for " Replace/ ' Plan review is required for any of the following.
Mork Performed: Capped Added Retotate
Please check all that apply.
Baptistry/Font 0 Any new commercial building with water service 2"and
Bath -Tub/Shower greater,except systems designed and stamped by licensed
-Jacuzzi/Whirlpool engineer.
Car Wash -Each Stall ❑ New exterior plumbing site utilities for any complex structure
-Drive or as defined in OAR918-780-0040.
Cuspidor/WateriwherCoirator
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic 0 Any multipurpose fire sprinkler system.
Drinking Fountain 0 Any complex structure as defined in OAR918-780-0040.
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink -2"
Car Wash Drain 0 Isometric or riser diagram is required for new buildings
Garbage -Domestic-non-food that meet the qualifications above.
Disposal -Domestic-food related
-Commercial-food related
-Industrial-food related
Ice Mach./Refiig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.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 Cincrease of sewer EDUs,a sewer permit will be issued and
Water Extractorfees assessed for the sewer increase must be paid before the
Water Clooseset-Toilet
Urinal plumbing permit can be issued.
Other Fixtures:
C:\Users\JuCall\Downloads\PLMF_PermitApp(1).doc 2
CITY OF TIGARD MASTER PERMIT
' COMMUNITY DEVELOPMENT Permit#: MST2017-00455
T[ A.R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/06/2017
S
Parcel: 2S 109AC07800
Jurisdiction: Tigard
Site address: 13322 SW MADDIE LN
Subdivision: MADELINE HEIGHTS Lot: 16
Project: Madeline Heights, Lot 16
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1138 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 28 Bathrooms: 3 Second: 1694 sf Garage: 464 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes
Total: 2832 sf Value: $354,349.36 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0
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: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea addl 500 sf: 5 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2832
Owner: Contractor:
LENNAR NW INC. LENNAR NORTHWEST INC Required Items and Reports(Conditions)
11807 NE 99TH STREET#1170 11807 NE 99TH STREET SUITE 1170 1 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98682 VANCOUVER,WA 98682
PHONE: 360-258-7900 PHONE: 360-949-9128
FAX: 360-258-7901
Total Fees: $31,789.51
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 rule ar- ,t forth in OAR
952-001-0010 through' R 952-0.`0090. Y u may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.33 •
Issued By: i .04, / ' " '/�`G` Permittee Signature: AL 7,—.1
7 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 .roject.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Residential
RECEIVED FOR OFFICE ESE ONLY
City of Tigard Received
r 13125 SW Hall Blvd.,Tigard,OR 97223 q 1 Date/By: If/ /7 Pernut
Phone: 503.718.2439 Fax: 503.598.1960 N O V 2 2 01 Plan Review a ST 7—��GY>
T i GAR D Inspection Line: 503.639.4175 Date/By: ) Li - 7 Other Permit:9,2g).00
Internet: www.tigard-or.gov
Notified/Method:
CITY f Date Ready/By: // / 7u is: See Page for
BU LD tiG OItd S O � uSedMethod
�z
l Supplementall Information
`V. -4� REQUIRED A.TA 1 AND 2 1MIL'Y FVEZ.IsII,to
New construction . "�"'`
❑Demolition Permit fees*are based on the;valueFofthe worJ;f
Indicate the value(rounded to the nearest dem)of all
ID Addition/alteration/replacement ID Other:
e
' _ ' _, , ui ment,materials,labor,overhead and
_ - ° �GOit I o,, CONSTRU Cf1W - _ ;
equipment, the profit for the
„ ,Tye,, , CTC � _, 2 work indicated on this application.
II
V1-and 2-family dwelling ❑Commercial/mdustrial Valuation: §"38-471-79A9 3 S
ElAccessory building i
0 Multi-family Number of be. ooms: 4
❑Master builder ❑Other: Number of bathrooms:
VONR�, .. SAN „ i O S1T,LF INFOR ATIo :LO; TIO `� ' ,
�` � Total number of floors: 2 3�q 6
Job site address: 13322 SW Maddie Lane
New dwelling area: 2832 square feet
City/state/ZIP: Tigard, OR 97223
Garage/carport area: 464 square feet
Suite/bldg./apt.no.: Project name:
Cross street/directions to job site: Covered porch area: , Ga.'1 square feet f T
L q L(
Deck area: 3 Q square feet `7 +
a, .,.. , j•
• er • cture are.. ) square feet
Subdivision: Madeline Heights
it . ' ea x?- ims. ,IST
Lot no.: 16 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
�14. � equipment,materials,labor,overhead,and the profit for the
«; - 3.g. work indicated on this application.
NSFR Valuation: $
Existing building area: square feet
New building area:
1-11,-1.45-V4)--`
-. '
• square are feet
ROPEnTyd ? , 5 I TENAi ?; .� ,�` Number of stories:' N a. St=A,::; ., e... sw, •c .1111 '-1' .. ' ,I=,,, _. , .Name: Lennar
NW Inc.
Address: Type of construction:
11807 NE 99th Street,#1170
City/State/ZIP: Occupancy groups:
Vancouver, WA 98682
Phone:(360)258-7900 Fax: Existing:
6, (360 ) 258 7901
;'1 CONTACT: RSON*'
New
Business name: -` BIfILDING PE.RMI) FEES* ' „y
Lennar NW Inc.
�(Please"'refe;ri"tojeesche$rile), ,,_,,, a_,_;:
Contact name: Juls Call Structural plan review fee(or deposit):
FLS plan review fee(if applicable):
Address: SAME AS ABOVE
City/State/ZIP: Total fees due upon application:
Phone:( 360)258-7906 I Fax::( )
Amount received:
E-mail: SUIS Call@lennar C0171 i ' 'PHOTO ? gE5i PA I 'STE ``ES
' �, `til de F.. r
,. _,; .1 ��! ,. Gl ` p 1 Commercial and residential prescriptive installation of
"° `' ''' '�r-- - roof-top mounted Photo Voltaic Solar Panel System.
Business name: SAME AS ABOVE
Submit two(2)sets of roof plan with connection details
Address: and fire department access,along with the 2010 Oregon
City/State/ZIP: Solar Installation Specialty Code checklist.
Permit Fee(includes plan review
Phone:( ) and administrative fees):
Fax:( )
CCB lic.: 195307 State surcharge(12%ofpermit fee):
Authorized signature:
Total fee due upon application:
This permit application expires if a permit is not obtained
Print name: within 180 days after it has been accepted as complete.
Juls Ca I C -X
Date: 11/17/17 *Fee methodology sot by Tri-County Building Industry
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 "Service8oard.
440-4613T(11/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLY
City of Tigard Received
® 13125 SW Hall Blvd.,Tigard,OR 97223
DateBy: Permit No.:
I` Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
TIGARD 24-Hour Inspection Line: 503.639.4175 0 Electrical ❑ Plumbing 0 Mechanical
Internet: www.tigard-or.gov 0 Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Ves No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. LI ❑ El
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑ ❑
3 Verification of approved plat/lot. 1 ❑ ❑
4 Fire district approval required. Name of district: ❑ ❑ ❑
5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑
6 Sewer permit. ❑ ❑ ❑
7 Water district approval. ❑ ❑ ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑
9 Erosion control Vplan ❑permit required. Include drainage-way protection,silt fence design and location of catch- E ' ❑ ❑
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state [a' ❑ ❑
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if E ' ❑ p
there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements
and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction
indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and
surface drainage.
12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size Eli ❑ ❑
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, Til ❑ ❑
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- [ ' ❑ ❑
floor,wall construction,roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings
and foundation,stairs,fireplace construction,thermal insulation,etc.
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. g ❑ ❑
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- I X ❑ ❑
prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing [/ ❑ ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑
systems,see item 22,"Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists g ❑ ❑
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. E ❑ ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ❑ ❑
for four or more appliances.
22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or [ ' ❑ ❑
architect licensed in Ore.on and shall be shown to be a..licable to the pro'ect under review.
JURISDICTIONAL SPECIFICS
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". ❑ . ❑ ❑
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ❑ ❑ ❑
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ ❑ ❑
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ ❑
27 "Drawn to scale"indicates standard architect or engineer scale. ❑ ❑ ❑
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ ❑
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ ❑
and protection measures must be drawn to scale and must include the project arborist's signature of approval.
30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, ❑ ❑ ❑
including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9,1995.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Applicat CFI
\ FOR OFFICE USE ONLY'
City of Tigard Received P
111
i 13125 SW Hall Blvd.,Tigard,OR 97223 N O V 2 1 2017
Date/By: enn t No•
1`- , .0.0
Plan Review
Phone: 503.718.2439 Fax:
503.598.196ADate/By:
Other Permit:
Inspection Line: 503.639.4175 i 1 Y OF 1IGDTIUARD Date Ready/By: Juris:
0 See Page 2 forInternet. www.tigard-or.gov BUILaN DiViSION Notified/Method: Supplemental
Information
;. ii ,..s - <.:,e. _T E OF+ WORK ; : .: ,COMMERCIAL FEE*,=,SCHEDULE�;I 7SE( ECKUST £_
Mechanical permit fees*are based on the value of the work
SZ New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
mechanical materials,equipment,labor,overhead,and profit.
EI Demolition ❑ Other:
Value:$
:-:.,.1.:::Z :4f41!:, CATEO44:P CONS R... Ii, ,':l .. EA..,11' . 4,-.1.F0;:.40-; '
=RESI1ElYTIALEQUIPMEI /SYSTEMS EE , ,n
[2/ 1-and 2-family dwelling Ill Commercial/industrial a'
❑Accessory building For special information use checklist
El Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
.. QB.SI E O TION1 AND LO T I}I .1 Heating/cooling:
...... ,E .,,. z :g. Air conditioning 1 46.75 46.75
Job site address: 13322 SW Maddie Lane Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: Tigard, OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: Duct work 23.32
Cross street/directions to job site: 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
Other: 23.32
Subdivision: Madeline Heights Lot no.: 16
Other fuel appliances:
Tax map/parcel no.: Water heater 1 23.32 23.32
`i " Gas fire lace/insert 1 33.39 23.32
. ,le-,` . ..kirria § SCII IONt,4F WQR _4i:, ... : .. = ... t p
Flue vent for water heater or gas
NSFR fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
N ° _
23.32 Oz,F * EF Other:
. �" i'OW�N"�ER ,_ '�� ❑:)1-!- .1;1,."i7- �' e�. .
Environmental exhaust and ventilation:
Name: Lennar NW Inc. Range hood/other kitchen
equipment 1 33.39 33.39
Address: 11807 NE 99th St.#1170 Clothes dryer exhaust 33.39
City/State/ZIP: Vnacouver,WA 98682 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 4 23.32 93.28
Phone:(360) 258-7900 Fax:(360) 258-7901 Attic/crawlspace fans 23.32
.;, I CONTA,:} PERSO `� s'. .. Other:
�..` �' .., ..TCANT ., 23.32
Fuel piping:
Business name: SAME AS ABOVE
$14.15 for first four;$4.03 for each additional
Contact name: Juls Call Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:(360)258-7906 Fax::( ) Fireplace
Range
E-mail: juls.call@lennar.com Barbecue
ry ,. ,: ., a ... W ;Yr CO _1tAU' ORil, -Z. FF`Y, ,K .4,,'V,,,1
.. E.` Clothes dryer(gas)
Other:
Business name:
Development Northwest Inc. dba Wolcott Plumbing1 t MECIIAvICALPEBMITFEES*
Address: 1075 W Historic Columbia River Hwy Subtotal $220.06
City/State/ZIP: Troutdale, OR 97060 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( 503) 667-1781 Ext. 3007 Fax:(503 ) 667-9891 State surcharge(12%of permit fee)
CCB lie.: 112220 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: ta(144(.17i2114(14/411 * Fee methodology set by Tri-County Building Industry Service Board
Print name: Dennis L. Dunning Date: 10/23/17
I:\Building\Permits\MEC_PermitApp_04o113.doc 440-4617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
otal Va ation Permit Tee, ,
$0.00 to$500.00 Minimum fee$69.06
$500.01 to$5,000.00 $69.06 for the first$500.00 and
$3.07 for each additional$100.00 or
fraction thereof,to and including
$5,000.00.
$5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and
$2.81 for each additional$100.00 or
fraction thereof,to and including
$10,000.00.
$10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and
$2.54 for each additional$100.00 or
fraction thereof,to and including
$50,000.00.
$50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and
$2.49 for each additional$100.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first$100,000.00 and
$2.92 for each additional$100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I:ABuilding\Permits\MEC PermitApp_040113.doc 2
Electrical Permit Applicatio ,;. FOR OFFICE USE ONLY
NOV2 1 2017 Received
City ofTigard DateB Permit#:L/ P -OI
lig a 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
X' Phone: 503.718.2439 Fax: 503.598.1 > DateB : Related Permit#:
A�f Gi=-t GARD
Inspection Line: 503.639.4175 Ready DateBy: Ja s: El See Page 2 for
TIGARD Internet: www.tigard-or.gov
BUILDING DIVISION Notified/Method: Supplemental Information
M
', .. .` al . .i TYPE OF WORK. ,...,_ ,: , . f?t, r 4. . . .,,,m,_,.. it,.„, „",°I
EafNew construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more ❑BuiIding over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
+-. .* ' � S 3'' ` � _; exceeds 10,000 amps at 150 volts or g g
, sig, ,,,.t �Ctl,�,EGQRT' O (31tTSTRUCTION�,,'� ;I�� . ,,,,� i ❑Floatin buildin s.
Ri1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
,.„ 'kit., ,,;`4OB IJ 1 ,i ORI ATIOINt,AND14170 A'pO... 'R' F ❑Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address: 13322 SW Maddie Lane 100HP or more. ❑"A","E","1-z","1-3",
City/State/ZIP: Tigard, OR 97223 ❑Six or more residential units. occupancy.
0 Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name: ❑Hazardous locations. 0 Supply voltage for more than
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: a I ; . R I n
Description 1 Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision: Madeline Heights Lot#: 16 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#:
Ea add'l 500 sq.ft.or portion 33.92 1
c, 1 .i l JtS IO1 g0 ORK .... :+ r,. .�a< icr, ' u' ... ' Limited energy,residential
NSFR (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
._.1,'
, � , y (��")aRR`fY, ��-.� �t�„ �, z 0'T ENAlstTa .. • {'; Services or feeders installation,alteration,and/or relocation
Name: Lennar NW Inc. 200 amps or less 100.70 2
Address: 11807 NE 99th St. #1170 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: Vancouver, WA 98682 601 amps to 1,000 amps 301.04 _ 2
Phone:( 360 )258-7900 Fax:(360) 258-7901 Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: 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
Branch circuits—new,alteration,or extension,per panel
a .n 1:#0:!:'L::::, ._�,a,;; . . F .CONTACT PERSol A.Fee for branch circuits with
Business name: Same as above above service or feeder fee, 7.42 2
each branch circuit
Contact name: J u Is Call B.Fee for branch circuits without
Address: service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP: Each add'1 branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax::( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: juls.call@lennar.com Reconnect only 67.84 2
llaCiAl< 5e' ,.,.$r*V. ...<.dll...., ... ,.4..a . it ..;t., .. VINZ Pump or irrigation circle 67.84 2
Business name: Lantil LLC dba Three Phase Electric Sign or outline lighting 67.84 2
Address: Sanellalterat osn,)oorr lextensioneL gy
❑ See Page 2 2
11490 SE Jennifer St. P
City/State/ZIP: Each additional inspection over allowable in any of the above
n Clackamas, OR 97015 Additional inspection(1 hr min) 66.25/hr
Phone:( 503) 908-8058 Fax:(503 )726-1823 Investigation(1 hr min) 90.00/hr
Email: Industrial plant(1 hr min) 78.18/hr
rlane@threephaseelectric.com Inspections for which no fee is 90.00/hr
CCB Lic.: 162368 Electrical Lic.: 3-332C Suprv.Lic.: 3398S specifically listed(''/z hr mm)
CTRICA.L,PERIVII - S ,, 'f'
Suprv.Electrician signature,required: c,e_.,,.,,rz, Z,tJ.e
Subtotal:
Print name: Dennis Welch Date: 10/23/17 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): _
Authorized signature: u-- TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Robert Lane Date: 10/23/17 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015 440-4615T(11/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
x sl NTrAL WORK 00 . a, . .,
Fee for all residential systems combined: $75.00 Description I Qty. I Each I Tuta1 *
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
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
❑ 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 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed('/z hr min)
SCO _ W OIL ICAPILEOLKCAL PERMIT"FEES
Subtotal
Fee for each commercial system: $75.00 (Enter on Page 1):
* Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
n Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
n Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
n Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I:\Building\Permits\ELC_PermitApp_ELRERE.doe Rev 06/17/2015
Plumbing Permit Application
a"
PD
Building Fixtures FOR OFFICE USE ONLY
NOV City of Tigard 0 V 2 1 2017 Received Y
/B 57 /)
ei 13125 SW Hall Blvd.,Tigard,OR 97 Date/By: Permit N _ GM'
�
T
14 2' Phone: 503.718.2439 Fax 503.5 3 p lis n:R D Plan Review
C { jL�� r a 1- Date/By: Other Permit No.:
T I G A R D Inspection Line: 503.639.4175 1 W i 1`4 t2Di Vi S I i N Date Read Y kris: I>3 See Page 2 for
Internet www.tigard-or.gov Notified/Method: Supplemental Information
. .� . g.... ii'fYPE O,,WC1RK .,. %- ., t Ili o ... .,.t , . n.> -, ,.,, . . i, ,,..,.
r� j
p�New construction ❑Demolition For special information use checklist
Description j Qty. I Ea. j Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
:A (il E....GORY OF CON'SIRUCTION£(`'"' ;% `, I ..£ SFR(1)bath 312.70
gr1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
IIIAccessory building ❑Multi-family SFR(3)bath 1 500.32 500.32
Ill Master builderEach additional bath/kitchen 25.02
❑Other: Fire sprinkler( sq.ft.) Page 2
11< moiJo t, ::ORT4E �, OCATs . , .4 Site utilities:
Job site address: Catch basin or area drain 18.76
13322 SW Maddie Lane
Drywell,leach line,or trench drain 18.76
City/State/ZIP: Tigard, OR 97223 _
Footing drain(no.Jinear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name: 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: Madeline Heights I Lot no.:16 Fixture or item:
Tax map/parcel no.: Backflow preventer 1 31.27 31.27
Backwater valve 12.51
` ,, 1E :*.yi4 ® . c4 ..,
, Clothes washer 1 25.02 25.02
NSFR
Dishwasher 1 25.02 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
Viit frR , 4 0TEIANT =trot.. Expansion tank 12.51
Name: Lennar NW Inc. Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 11807 NE 99th St.#1170
Garbage disposal 1 25.02 25.02
City/State/ZIP: Vancouver, WA 98682 Hose bib 2 25.02 50.04
Phone:(360 )258-7900 Fax:( 360) 258-7901 Ice maker 12.51
lihlt ' �CONT'AC PERSON Interceptor/greasetrap
_..E�APPf ICF ,:. 25.02
Business name: SAME AS ABOVE Medical gas(value:$ ) Page 2
Contact name: Primer 12.51
LUIS Call Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 5 25.02 125.10
City/State/ZIP: Solar units(potable water) 62.54
Phone:(360)258-7906 Fax::( ) Tub/shower/shower pan 2 12.51 25 02
E-mail: Juls.call@lennar.com Urinal 25.02
. t t Water closet
3 25.02 75.06' s #t Ok1 , TOI ' !. . # . 1 `
Water heater 1 37.52 37.52
Business name: Development Northwest Inc., dba Wolcott Plumbing Water piping/DWV 56.29
Address: 1075 W Historic Columbia River Hwy Other: 25.02
City/State/ZIP: Troutdale, OR 97060 Subtotal 919.39
Phone:(503) 667-1781 Fax:(503)667-9891 Minimum permit fee: $72.50
CCB Lic.: Plan review (25%of permit fee)
112220 Plumbing Lie.no.: 26-824P B
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name: Dennis L. Dunning Date: 10/19/17 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)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
a Tt
Site til> .es Q .. .. l re Footage Pe mz ee .. ;
Footing drain-151 100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52
Storm&Rain Drain-1st 100' 62.54
$1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
�� Fee(ea otal each additional$100.00 or fraction thereof,to
n peC_ rns or;Fees ....> and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
(minimum charge-1/2 hour) each additional$100.00 or fraction 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 444. btng;''Iistallati4nS` x[:_, „
Fixture Type for Replacel
Work Performed: :::.: Capped.:, , ;Added' Relocate.; Plan review is required for any of the following.
Baptistry/Font Please check all that apply.
Bath Tub/Shower 111 Any new commercial building with water service 2"and
Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
-3"
oinetrlcE or Risei Diag>t RICt . ;;
Car Wash Drain ❑ Isometric or riser diagram is required for new buildings
Garbage -Domestic-non-food
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:
Rec.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 EDUs,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:
C:\Users\JuCall\Downloads\PLMF_PermitApp(1).doc 2
1111111
City of Tigard
■ a COMMUNITY DEVELOPMENT DEPARTMENT
T I G A R D Building Permit Review — Residential
Building Permit #: J F� �X)61 --
Site Address: 13321_ S I,/ Maddit Lane-
Project Name: Madc l►'lt 1 ,'4 h/ Lot #: 1 6
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review l I
Proposal: �,a,,,if n r' o rqw S F'
Zyerify site address/suite# exists and act,�iv�e )`n permit system.
K2/RiverLTJ
River Terrace Neighborhood: ' No ❑ Yes,See River Terrace Review Addendum Attached
Sit lan Elements:
three(3)copies of site plan 1'i . sting structures on site
%Footprint of new structure(including decks)with finished
S'te plan must be on 8-1/2"x 11"or 11 x 17"paper
awn to scale(standard architect or engineer scale)
or elevations
North arrow Lt�9/a'ty locations&easements(required for new and additions)
I address,project or subdivision name and lot number LI�Sidewalk/driveway approach
Y/Applicant information(name and phone number) /it ocation of wells/septic systems
L✓JLot dimensions and building setback dimensions IN Existing trees to be retained with drip line,and tree
,_,Snare footage of buildings to be demolished ► otection measures
[ i of area,building coverage area,percentage of coverage and J reet tree size,type and location
pervious area(applicable if R-7,R-12,R-25&R-40) V
street names
roperty corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? [14 Yes No
/�44ffoot differential) If yes,is a storm water quality facility shown? ( el❑No
Clean Water Services—Service Provider Lette (lot platted prior to 9/10/1995): 1._y 4 L,[R
equired: ❑ Yes,applicant was notified 0 No Received: ❑ Yes ❑ No ` (N-
Z 1 Public Facilities Improvement(PFI) Permit:
.equired: 21-Yes,applicant was notified ❑ No Applied For: 2 Yes ❑ No,stop intake
LV L nd Use Case#: S U B LO 1 _ Q
I--,6 0 0 3 PF12016 -0016qEZoning: 1 .-7-
Z Required Setbacks: Front l ' Rear ( S Side Street Side0 Garage/ ZO
127 .andscape Requirement: Z0 %
QV/Lot Coverage Maximum: 80 %
:uilding Height: Maximum Height 35 Actual Height Z
7V isual Clearance
nsitive Lands: ❑ Yes El/No Type
Urban Forestry Plan
2'Conditions "Met"prior to issuance ofIbuilding permit
Notes: All Ca'\c(i ar,i c� ,•,.t1' Oh keit
Approved By Planning: C Date: It-11-11-
Revisions
t-Z1-1Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: Cl Approved El Not Approved
Revision 3: ❑ Approved El Not Approved
I:\Building\Forms\B1dgPermitRvw RES 061417.docx
Building Permit Submittal
Original Submittal Date: ///21 4 7
Site Plans: #
Building Plans: #
Building Permit#: Enter building permit#above.
Workflow Routing: Planning � Engineering Permit Coordinator Building
Workflow Sign-off: ign-off for Planning(include notes from planning review)
Route Application Documents: ley Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
1 original plan review routing form.
f-Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: /,
By Permit Technician: ,44: �/j.�'r�rl�2'�r -
Date: (//A1/77
(//7
Engineering Review
ErSIo e at building pad: 3'0
Conditions "Met"prior to issuance of building permit
2'Easements (encroachments)per engineering conditions of approval and plat
IBJ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes Zr-No
Assess Water Quantity Fee in-lieu: ❑ Yes I2/No
LIDA Facility on lot: ❑ Yes ErNo
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: gt.,..r-rt 541-z,2__ Date: (/-2-E. -17
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
la 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:
)2K SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: ,Yes ❑ N/A
Parks SDC: X Yes ❑ N/A
LIDA ❑ Yes N/A
OK to Issue Permit I
Approved by Permit Coordinator: r I' !/L Date: L[110
I:\Building\Forms\BldgPermitRvw_RES_061417.docx
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
1111 " Transmittal Letter
T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO:
OrVA DATE V> ,:
DEPT: BUILDING DIVISION
J A i0 2 3 ;TO
G,
FROM: Juls Call ii R9
COMPANY: Lennar NW Inc.
PHONE: 360-258-7906 By:
RE: 13322 SW Maddie Lane MS 017-00455 ( )
(Site Address) (P it Number)
Madeline Heights, #16
(Project name or subdivision name and lot number) Sai
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: . Description: ? 'i•.: Description:
Additional set(s) of plans. Revisions: pony wall height increased
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: The pony wall is increasing to 6' ubmitting new engineering. No changes to any other structures.
FOR OFFICE USE ONLY
Routed to Permit Technician. Date: J__ a„ ) g Initials:
Fees Due: Yes ❑ ►'o Fee Description: Amount Due:'
• S ) r p)ay rev v, $
$
$
$
Special
Instructio
Reprint 'ermit(per PE): ❑ Yes ®No ❑ Done
At. 'cant Notified: Date: t/7(!l d / , Initials:q7
I:\Building\Forms\TransmittalLetter-Revisions.doe 05/25/2012
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13322 SW MADDIE LN, TIGARD, OR, 97224 June 4, 2018 at 10:08:26 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00455
Inspection Type: Inspector:
699 Mechanical final Aaron Cillo-Gobel
Result:
PASS
Comments:
A/C installed
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13322 SW MADDIE LN, TIGARD, OR, 97224 June 12, 2018 at 10:34:55 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00455
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
FA I L
Comments:
Correction for cleanout cap at front of house not complete. 707.3
Other corrections appear to be complete.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13322 SW MADDIE LN, TIGARD, OR, 97224 June 18, 2018 at 10:50:20 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00455
Inspection Type: Inspector:
299 Final inspection David Young
Result:
FA I L
Comments:
Step from garage to house exceeds 8" maximum to top of threshold, approximately
9". R311 .7
Seal mechanical hood vent penetration at ceiling prior to cover. R302
All else appears ok.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13322 SW MADDIE LN, TIGARD, OR, 97224 June 19, 2018 at 12:14:48 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00455
Inspection Type: Inspector:
299 Final inspection David Young
Result:
PASS - CofO
Comments:
Corrections from previous inspection complete.
Final erosion control approved.
Street tree certification received.
Moisture content form received.
Moisture barrier form received.
Insulation certification checked.
C of 0 left on site with approved plans.
Violation Summary:
Inspector Contractor