Permit (22) CITY OF TIGARD MASTER PERMIT
: s COMMUNITY DEVELOPMENT Permit#: MST2017-00509
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Date Issued: 05/29/2018
Parcel: 2S104AB00100
Jurisdiction: Tigard
Site address: 12014 SW REDBERRY CT
Subdivision: PROGRESS LANDING Lot:
Project: Progress Landing, Lot 8
Project Description: New SF. 5/29/2018: REPRINT to add irrigation backflow. 7/16/18: Reprint to add 120 sf deck
and cover. 8/15/18: REPRINT to add A/C unit.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1533 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 23 Bathrooms: 4 Second: 1352 sf Garage: 491 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2885 sf Value: $356,008.44 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 6 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 1
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 6 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add']500 sf: 5 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description:
Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2885
Owner: Contractor:
RIVERSIDE HOMES LLC RIVERSIDE HOMES LLC Required Items and Reports(Conditions)
17933 NW EVERGREEN PKWY STE 17933 NW EVERGREEN PKWY 370 1 Ersn Cntrl 503-639-4175
370 BEAVERTON,OR 97006
BEAVERTON,OR 97006
PHONE: 503-645-0986 PHONE: 503-645-0986
FAX: 503-690-2942
Total Fees: $32,188.91
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You y obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: -L( + '����Zi�' Permittee Signature: �t' GL/�A'n''/le.475.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. / "
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applicati I OR 01 11( I 1 SI:()NI l
CI of TI and ReceivedG 3 a 2.313
�Jg It l 1 Date/By: 0 /�, Permit No�/ go!^ 7Oi
Iiii 13125 SW Hall Blvd.,Tigard,OR 97223 ,u a x t i Plan Review
I Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
1 I c,,1 R u Inspection Line: 503.639.4175 Date Ready/By: tans: El See Page 2 for
Internet: www.tigard-or.gov ,-, Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE—USE CHECKLIST
Mechanical permit fees*are based on the value of the work
0 New construction ®Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 1 46.75 46.75
Job site address: 12014 SW Redberry Court 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: PROGRESS LANDING Duct work 23.32
Cross street/directions to job site: SW WALNUT ST. &SW 135 AVE 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: PROGRESS LANDING Lot no.: 08 Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
Add A/C to permit MST2017-00509 fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
JI PROPERTY OWNER 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Riverside Homes, LLC Range hood/other kitchen
equipment 33.39
Address: 17933 NW Evergreen Parkway, Suite 370 Clothes dryer exhaust 33.39
City/State/ZIP: Beaverton, OR 97006 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( 503) 645-0986 Fax:( ) Attic/crawlspace fans 23.32
gi APPLICANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name: Same as above
$14.15 for first four;$4.03 for each additional
Contact name: Wes Boisvert Furnace,etc.
Address: Gas heat pump
WalUsuspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax: :( ) Fireplace
Range
E-mail: wboisvert@riversidehome.com Barbecue
CONTRACTOR Clothes dryer(gas)
Other:
Business name: Pro Heating &Cooling MECHANICAL PERMIT FEES*
Address: 2095 NW Alocleck Rd.#1103 Subtotal
City/State/ZIP: Hillsboro OR 97124 Minimum permit fee($90.00)
' Plan review(25%of permit fee)
Phone:(971 )205-4989 Fax:( ) State surcharge(12%of permit fee)
CCB lie.: 209001 TOTAL PERMIT FEE 5—".g G
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name: Wes BoisvertditAA Date: 8/13/18
I:\Buildigg\Permits\MEC_PermitApp 040113.doc 440-4617T(11/02/COM/WEB)
CITY OF TIGARD MASTER PERMIT
114 11 COMMUNITY DEVELOPMENT /d /, �s•, Permit#: MST2017-00509
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/29/2018
T GARD g Parcel: 2S104AB00100
Jurisdiction: Tigard
Site address: 12014 SW REDBERRY CT
Subdivision: PROGRESS LANDING Lot:
Project: Progress Landing, Lot 8
Project Description: New SF. 5/29/2018: REPRINT to add irrigation backflow.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1533 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 23 Bathrooms: 4 Second: 1352 sf Garage: 491 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2885 sf Value: $350,596.44 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 6 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 1
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 6 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 2885
Owner: Contractor:
RIVERSIDE HOMES LLC RIVERSIDE HOMES LLC Required Items and Reports(Conditions)
17933 NW EVERGREEN PKWY STE 17933 NW EVERGREEN PKWY 370 1 Ersn Cntrl 503-639-4175
370 BEAVERTON,OR 97006
BEAVERTON,OR 97006
PHONE: 503-645-0986 PHONE: 503-645-0986
FAX: 503-690-2942
Total Fees: $31,937.32
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 throughgh/OA' •52-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987' or 1.800.332.2344.
Issued By: C- �� .- Permittee Signature: 4/t/ /G7(( -770,u/
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 Applicata r""'
BuildingFixtures
nnro FOR OFFICE LSF oNl.N
1`'11 0 0 I! i`� Received
City of Tigard M r,i' S a ,�
III - U 13125 SW Hall Blvd.,Tigard,OR 97223 P ate/By: ��' Permit - /� �0
T"' Plan Review
Phone: 503.718.2439 Fax: 503.598.960} Date/By: Other Permit No.:
Inspection Line: 503.639.4175 Esti i.
f[G A K I> �� Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
For special information use checklist
®New construction 0 Demolition
Description I Qty. I Ea. I Total
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
t t I t , SFR(1)bath 312.70
IX] 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
❑Master builder 0 OtherEach additional bath/kitchen 25.02
:
, Fire sprinkler( sq.ft.) Page 2
";;;:',:i.:-':..:::: t '71.214.4.,' / t tSite utilities:
Job site address: 12014 SW REDBERRY CT Catch basin or area drain 18.76
City/State/ZIP: TIGARD, OR 97223 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name: PROGRESS LANDING Manufactured home utilities 50.03
Cross street/directions to job site: SW WALNUT ST. &SW 135TH AVE. Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Stone sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: PROGRESS LANDING I Lot no.: 08 Fixture or item:
Tax map/parcel no.: Backflow preventer 1 31.27 31.27
s Backwater valve 12.51
m t- Clothes washer 25.02
Adding backflow preventer to lot for irrigation Dishwasher
25.02
Drinking fountain 25.02
Ejectors/sump 25.02
>.{ eJit ; "j : Expansion tank i. 12.51
Name: Riverside Homes, LLC Fixture/sewer cap 25.02
Address: 17933 NW Evergreen Parkway, Suite 370 Floor drain floor sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP: Beaverton, OR 97006 Hose bib 25.02
Phone:(503) 645-0986 Fax:( ) Ice maker 12.51
w ` q it a ie Interceptor/grease trap 25.02
Business name: Same as above Medical gas(value:$ ) Page 2
WES BOISVERT Primer
Contact name: 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: wboisvert@riversidehome.com Urinal 25.02
` Water closet 25.02
a i ,aR `
Water heater 37.52
Business name: TruScapes
Water piping/DWV 56.29
Address: 21600 SW Amberwood Dr. Other: 25.02
City/State/ZIP: Hillsboro, OR 97124 Subtotal 31.27
Phone:(503) 531-8216 Fax:( ) Minimum permit fee: $72.50
CCB Lic.: LCB#7962 Plumbing Lic.no.: Plan review (25%of permit fee)
State surcharge(12%of permit fee) 3.7,5'4
Authorized signature: TOTAL PERMIT FEE 35.0/3
Print name: Wes Boisvert C 1(/„/ /1 Date: 5/17/18 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 Sup!ression S stems:
A s of is
Footing drain-1'100' 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 S stems:
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
each additional$100.00 or fraction thereof,to., ! ! ! ! ! 416111111 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 char)e-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 chaz_e-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 char•e 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*.
ti b _ r 3� g .` z f • c .° • e �...1 ! r' r t ! ! t °
Fixture RePlac Plan review is required for anyof the following.
Work L ? wed Ad .Relocate �1
Baptistry/Font Please check all that apply.
Bath Tub/Shower
0 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 0 New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities.
-Domestic 0 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"
•
Car Wash Drain .. ri! )l .! .. . 1
Garbage Domestic non-food
0 Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
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 underthis 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\npruett\Downloads\PLMF PermitApp(1).doc 2
CITY OF TIGARD MASTER PERMIT
712: '> COMMUNITY DEVELOPMENT Permit#: MST2017-00509
T[ AID 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/29/2018
Parcel: 2S 104AB00100
Jurisdiction: Tigard
Site address: 12014 SW REDBERRY CT
Subdivision: PROGRESS LANDING Lot:
Project: Progress Landing, Lot 8
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1533 sf Basement: 0 sf Left 5 Parking Spaces: 0
Height: 23 Bathrooms: 4 Second: 1352 sf Garage: 491 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2885 sf Value: $350,596.44 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 6 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
0
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 6 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 2885
Owner: Contractor:
RIVERSIDE HOMES LLC RIVERSIDE HOMES LLC Required Items and Reports(Conditions)
17933 NW EVERGREEN PKWY STE 17933 NW EVERGREEN PKWY 370 1 Ersn Cntrl 503-639-4175
370 BEAVERTON,OR 97006
BEAVERTON,OR 97006
PHONE: 503-645-0986 PHONE: 503-645-0986
FAX: 503-690-2942
Total Fees: $31,902.29
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 3.232.1987 or 1.800.332.2344.
.... N. ,./},?.....52_.
..---
Issued By: i�-- ,1111 Permittee Signature:
(----01"
T -: .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.
$ui1din2 Permit Application /---D I F
Residential itE(d1t1-11 FOR OFFICE USE ONE\
City of Tigard DECg Receive( } f
DG 1 3 i tE" /B `"-1.2,4-i1/7 �� 'ermitNoA jil. ..f
13125 SW Hall Blvd.,Tigard,OR 97223 an ReviewIN _ Q
Phone: 503.718.2439 Fax: 503.598.1960 ,,,t , (U A Other Permit 1,
TIGARD
Inspection Line: 503.639.4175 a OFT `7. •?*,y/By: s �� ® See Page 2 for
Internet: www.tigard-or.gov �l�,(� a thod: / SupplementalInformation
�ip#1�iL7 ,0
e s, : ' a` TA:1ADDF a " tlx :
i , . - . ,
®New construction 0 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 rofit fs _1-
x - `RY e R
,-A e �� 8 .1 ," work indicated on this application. (p
w�.. , ea,, .�, � �_ �� ; Valuation:
® 1-and 2-family dwelling 0 Commercial/industrial $ '"'-somiATc _
ElAccessory building 1:1 Multi-family Number of bedrooms: 5
„„Ifor Li
❑Master builder 0 Other: Number of bathrooms:
1i e >. *1=4,w, ' Total number of floors: 2 --)
Job site address:12014 SW REDBERRY CT. New dwelling area: 2885 square feet i'K —
City/State/ZIP:TIGARD.OR Garage/carport area: 4'1 square feet 163%
Suite/bldg./apt.no.:97223 Project name:PROGRESS LANDING Covered porch area: .quare feet
Cross street/directions to job site:SW WALNUT ST.&SW 135"'AVE Deck area: 0 square feet
Other structure area: 0 square feet
° ',4.l a '
Subdivision:PROGRESS LANDING Lot no.:08 Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no
equipment,materials,labor,overhead,and the profit for the
" & t ' ION `f m - �t work indicated on this application.
Construction of SFR Home Valuation: $
4414 PLe:l� "�f ewh— �Tq1 Existing building area: square feet
�` New building area: square feet
iiiiWit
,.. . '
f .<. 4 e °. i _ • . . ,w .", , Number of stories:
Name:Riverside Homes,LLC Type of construction:
Address:17933 NW Evergreen Parkway,Suite 370 Occupancy groups:
City/State/ZIP:Beaverton,OR 97006 Existing:
Phone:( ,„„
503)645-0986 Fax:( ) New:
# zT ' +,,„„„ , ,` d CoN'rAr t
'.,..., :„....,,,, 4,,, _ ., , 0,, , , .
,,,, : ..
Business name:Same as Above
sereler ` schedule t '<
Structural plan review fee(or deposit):
Contact name:Brett Groves
FLS plan review fee(if applicable):
Address:
Total fees due upon application:
City/State/ZIP:
Phone:( ) Fax::( )
Amount received:
E-mail:bgroves@riversidehome.com P `COQ' 'AIC SOLAR-P EL SYSTEM
,. .., Commercial and residential prescriptive installation of
, .r . RACTOR b „ „ „ : F roof-top mounted Photo Voltaic Solar Panel System.
Business name:Riverside Homes,LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:17933 NW Evergreen Parkway,Suite 370 Solar Installation Specialty Code checklist.
City/State/ZIP:Beaverton,OR 97006 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503)645-0986 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.:189148 f\
Total fee due upon application: $201.60
Authorized signature: ('+ n This permit application expires if a permit is not obtained
i within 180 days after it has been accepted as complete.
Print name:Brett Groves Date:11/30/2017 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
B4uilding Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE LSF ON1.\'
City of Tigard Received
Date/By: Permit No.:
O 13125 SW Hall Blvd.,Tigard,OR 97223III
t,./61 6-Cd
Associated permits:
Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 ❑ Electrical 0 Plumbing 0 Mechanical
7 1 v A R D Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW les yo N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 0 0
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0
3 Verification of approved plat/lot. 0 0 0
4 Fire district approval required. Name of district: , 0 0 0
5 Septic system permit or authorization for remodel. Existing system capacity . 0 0 0
6 Sewer permit. ❑ ❑ ❑
7 Water district approval. 0 0 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0 0
9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 0 0
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ 0 0
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 ❑ 0 0
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 0 0 0
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ 0 ❑
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- 0 ❑ ❑
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. 0 0 0
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- ❑ ❑ ❑
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 ❑ ❑ ❑
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. 0 ❑ 0
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 .ro'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. ❑ ❑ 0
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, 0 ❑ ❑
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, ❑ 0 0
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)
RECEIVED
'Mechanical Permit Application Folz 01 F1( h: t SF OS I.\
Cityof Tigard 1 i 1-I 2(>'i 7 Received
g Date B Permit No.� , I) �)�t •
IN 4 13125 SW Hall Blvd.,Tigard,OR 97223 y t/C/
Phone: 503.718.2439 Fax: 503.598.1960 CITYOF'�' i' t, Other Permit:
Inspection Line: 503.639.4175 y y: ® see Page 2 for
[ i G A l:D /'� :ate Read 1B lir s:
Internet: www.tigard-or.gov BUILDING DIVISI I;
9J fied/Method: Supplemental Information
,�� ', ' Mechanical permit fees*are based on the value of the work
®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
mechanical materials,equipment,labor,overhead,and profit.
❑Demolition ❑Other:
Value:$
T
�;'- tA' 5.- ij 0g e, .,�spr t t' _1. "..Z - M ,, <.'' > v, •
® 1-and 2-family dwelling 0 Commercial/industrial
0Accessory buildingA. For special information use checklist
EIMulti-family 0 Master builder ❑Other: Description Qty. Ea. Total
P.
a 1' f o . ! i ! „ ' : Heating/cooling:
Air conditioning 46.75
Job site address: 12014 SW REDBERRY CT. 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.: I Project name: PROGRESS LANDING Duct work 23.32
Cross street/directions to job site: SW WALNUT ST. &SW 135 AVE 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: PROGRESS LANDING l Lot no.: 08 Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
:. ... � : .., t, !N4, "! ,�,..,, ': �, Gas fireplace/insert 33.39
Flue vent for water heater or gas
Construction of SFR fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
101)4 * * ""' -1 Environmental exhaust and ventilation:
Name: Riverside Homes, LLC Range hood other kitchen
equipment 33.39
Address: 17933 NW Evergreen Parkway, Suite 370 Clothes dryer exhaust 33.39
City/State/ZIP: Beaverton, OR 97006 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( 503) 645-0986 Fax:( ) Attic/crawlspace fans 23.32
; , ," 4°< t . Other: 23.32
Business name: Fuel piping:
Same as above $14.15 for first four;$4.03 for each additional
Contact name: BRETT GROVES Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:
Water heater
Phone:( ) Fax::( ) Fireplace
Range
E-mail: bgroves@riversidehome.comBarbecue
4` ICO CT -0QI Clothes dryer(gas)
Other:
Business name:
Pro Heating&Cooling -..c-7'.' ,31,:MECHANICAL;PERMIT PEI;
Address: 2095 NW Alocleck Rd.#1103 Subtotal
City/State/ZIP: Hillsboro, OR 97124 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(971 )205-4989 Fax:( ) State surcharge(12%of permit fee)
CCB lie.: 209001 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; Fee methodology set by Tri County Building Industry Service
( Board
Print name: Brett Groves t Date: 11/30/2017
440-46171(1 I/02/COM/WEB)
]:\Building\Permits\MEC_PermitApp_0401 13.doc
Mechanical Permit Application - City of Tigard
Page 2 -Supplemental Information
Commercial& Multi-Famil Fee Schedule:
PtaI, tion` i •
Rt
$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:\Building\Permits\MEC_PermitApp_040113.doc 2
RCEIViEC' 1V 1,
Electrical Permit Application 1( 1 out 1c I; I SI.OyI.I
City of Tigard1 q Received Permit# TX(//>
" 1 Date/By. /f/( 5 -Uc.)
ii 13125 SW Hall Blvd.,Tigard,OR 97223 DECPlan Review /
11 Phone: 503.718.2439 Fax: 503.598.1960 y q pp 1 e/g : Related Permit 4:
Inspection Line: 503.639.4175 TY el l F TIGA G ti 6 5 ady Date/ey: loris: ® See Page 2 for
I I C A R D Internet: www.ti and-or. ov : ethod:
$ $ r j Supplemental Information
►a 4 k �. 1 IF
X ,
►:I New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Demolition 0 Other:
0 Service or feeder 400 amps or more 0 Building over three stories.
�,.,t De r „„ where the available fault current 0 Marinas and boatyards.
r r
„, , C_ ,,1 :. _1t ... i. .- RI) ri :',01!--, exceeds 10,000 amps at 150 volts or 0 Floating buildings.
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory Y 'building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
k,. 4'.:s . 'S ` q °t RMATJ D Q ;'' JON. '' ''' ., .; ❑Emergency system. larger separately derived
Job#: Job site address: 12014 SW REDBERRY CT. ❑100H oo ofoew motor load of system.
100HP or more. ❑"A""E"••1-2" ,•1-3"
❑Six or more residential units. occupancy.
City/State/ZIP: Tigard, OR 97223 0 Recreational vehicle parks.
0 Health-care facilities.
Suite/bldg./apt.#: I Project name: PROGRESS LANDING 0 Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: SW WALNUT ST. &SW 135 AVE "` ` ""'
S;`� SC .� . � rs .
r y }'"
Description I Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision: PROGRESS LANDING 1 Lot#: 08 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcelap #:
Ea.add'I 500 sq.ft.or portion 33.92 1
2'.1 �;a,' MON 4 t�,• ;t
° Limited energy,residential
Construction of SFR (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
a Renewable Energy ❑ 2
�` h� ,-;,i,=;-*.. ( �""` � �� Services or feeders installation,alteration,SeePage and/or relocation
Name: Riverside Homes, LLC 200 amps or less 100.70 2
Address: 17933 NW Evergreen Parkway, Suite 370 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: Tigard, OR 97223 601 amps to 1,000 amps 301.04 2
Phone:( 503) 645-0986 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: bgroves@riversidehome.com 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
7,40;joriiv., 0 :, %., ,.„,.4.,,-, Rats1 Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: Same as above above service or feeder fee, 7.42 2
each branch circuit
Contact name: Brett Groves B.Fee for branch circuits without
service or feeder fee,first
Address: branch circuit 56.18 2
City/State/ZIP: Each add'1 branch circuit 7.42 2
Phone: Miscellaneous(service or feeder not included)
( ) Fax::( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: bgroves@riversidehome.com Reconnect only 67.84 2
i r• $'` ''w NTRAt7' 0' iv ;-' F Pump or irrigation circle 67.84 2
Business name: Garner Electric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy See Pa e 2
Address: 2920 SE Brookwood Ave#1 panel,alteration,or extension. 0 $ 2
City/State/ZIP: Hillsboro, OR 97123 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:( 503) 648-4552 Fax:( 503)642-7925 Investigation(1 hr min) 90.00/hr
jH''`s-( / ,/ 1 Industrial plant(1 hr min) 78.18/hr
Email: ge@gamerelectric.com w ` (/ Inspections for which no fee is
CCB Lic.: 121159 Electrical Lic.:r�$7j �Suprv.Lic.: 3?o?s specifically listed(Yu hr min) 90.001 hr
Suprv.Electrician signature,required: t/ ,„: ' KCAL PERMIT FEES ,,4,. r-
Subtotal:
Print name: Chuck Garner 1 Date: 11/30/2017 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: s n,^/ TOTAL PERMIT FEE:
/ This permit application expires if a permit is not obtained within 180
Print name: Brett Groves Date: 11/30/2017 days after it has been accepted as complete.
* Number of inspections allowed per permit.
1:\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:
bRICONN: •
I .inscription Qty. Each Total
Fee for all residential systems combined: $75.00 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 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50,01 to 100 kva 552.26 2
n Garage Door Opener* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
0 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 ins r ection over allowable in an of the above:
❑ Other: Each additional inspection is 66.25/hr 1
char ed at an hour] 1 hr mm)
Inspections for which no fee is
s r ecificall listed '/hr min 90.001 hr
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
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ 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
ii,‘ CE EIVED
Plumbing Permit Application
Building FixturesSEC 13 2011 FOIL 0141(1 l sl. ONl.l
City of Tigard , ived
III il 13125 SW Hall Blvd.,Tigard,OR 97223 Permit No.
Ic OFTINA` ,. .- y: /LiTh�/7-OUs7�5
U Phone: 503.718.2439 Fax: 503.598.1960` ,4y sl' "1Ij14q �1eW Other Permit No.:
1 �t. `1`1� Inspection Line: 503.639.4175 t� 1 tj Date Ready/By: luris: la See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
';'''.'.:;es''''''' ®lit * r
:/ New construction 0 Demolition For special information use checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
t RV 9,4:4,V,-`,-' U 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 1 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
", 1 1 L eV oN Site utilities:
Job site address: 12014 SW REDBERRY CT 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.: 1 Project name: PROGRESS LANDING Manufactured home utilities 50.03
Cross street/directions to job site: SW WALNUT ST. &SW 135TH AVE. 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: PROGRESS LANDING I Lot no.: 08 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
' Backwater valve 12.51
Clothes washer 25.02
Construction of SFR Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
.
a @ ® . s T, -. may,.. Expansion tank 12.51
Name: Riverside Homes, LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 17933 NW Evergreen Parkway, Suite 370
Garbage disposal 25.02
City/State/ZIP: Beaverton, OR 97006 Hose bib 25.02
Phone:(503) 645-0986 Fax:( ) Ice maker 12.51
4 '..,,s `0 N Interceptor/grease trap 25.02
Business name: Same as above Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: BRETT GROVES
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: bgroves@riversidehome.com Urinal 25.02
r,: cagliAcrotO �< Water closet 25.02
Water heater 37.52
Business name: H& H Mechanical Water piping/DWV 56.29
Address: 5757 SE Willow Ln Other: 25.02
City/State/ZIP: Milwaukie, OR 97267 Subtotal
Phone:(503) 975-9787 Fax:( ) Minimum permit fee: $72.50
P Plan review (25%of permit fee)
CCB Lic.: 178122 Plumbing Lic.no.: PB414
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name: Brett Gloves Date: 11/30/2017 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.
l:\Buildiag\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02ICOM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
F^
Footing drain-1"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 1t1a u
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 additional$100.00 or fraction thereof,to
t � � 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*.
QnanUty b'Fixture T,Pe lkt VI ,for• I r 1 a cgatailam
Fixture Plan review is re uired for anyof the followin
,Work Peciblined: Capped; Added Relocate q g•
Baptistry/Font Please check all that apply.
Bath Tub/Shower
0 Any new commercial building with water service 2"and
-Jacuzzi/Whiripool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thm 0 New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial 0 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
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
Car Wash Drain
Garbage -Domestic-non-food 0 Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
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\npruett\Downloads\PLMF_PermitApp(1).doc 2
Ammumn
City of Tigard
wIN COMMUNITY DEVELOPMENT DEPARTMENT
T 1 c A R o Building Permit Review — Residential
Building Permit #: M_57---().0/> - DD_ce).7. . . ... �,
Site Address: k. 0/27/ ,c)lit) &c/Lri2 Coo-4-
Project Name: ei. ,,mss c I . , f Lot #: e'
(New dwe 'yl subdivision name;Addi..n or Alteration=last name of owner)
Planning Review ��//
Proposal: AJett) iZ
F(17-1 erify site address/suite#exists and activkffi permit system.
tdil ver Terrace Neighborhood: [ No ❑ Yes,See River Terrace Review Addendum Attached
Si/e Plan Elements:
10 ree(3)copies of site plan • " sting structures on site
,_,(Site plan must be on 8-1/2"x 11"or 11 x 17"paper SVA Footprint of new structure(including decks)with finished
Tr raven to scale(standard architect or engineer scale) or elevations
01 North arrow
tility locations&easements(required for new and additions)
to address,project or subdivision name and lot number 14 Sidewalk/driveway approach
pplicant information(name and phone number) Il cation of wells/septic systems
11�Lot dimensions and building setback dimensions •Existing trees to be retained withri
ati'e,uare footage of buildings to be demolished otec on measures d p line,and tree
r� :
MMEMMEmmik
Building Permit Submittal
Original Submittal Date: /0Z /13//9
Site Plans: #
Building Plans: #
Building Permit#: l Enter building permit#above.
Workflow Routing: pi Planning lir Engineering 12'Permit Coordinator ,- Building
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.
tp. Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: / /`
By Permit Technician: / ,/ !�i/ Dater •, ' j
Engineering Review
Elf ope at building pad: 0,s•Conditions"Met"p rior to issuance of building permit
�,�-
lt�d"��:asements (encroachments)per engineering conditions of approval and plat
Ltd'Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes 0 No
Assess Water Quantity Fee in-lieu: ❑ Yes 0 No
LIDA Facility on lot: ❑ Yes 0 No
Ltd' )Final Plat Recorded:
LN' NOT Approved by Engineering: Date: j2./.2 v117
Notes: ,c..0 Co-"te ne G,...Ke sj 711.1iiile CoA Lottiveit PIAT kd T vtC n"'^'�+� .
Approved by Engineering: Date:
:l
Revisions (after B ' ing Submittal only) er Date
Revision 1: L� Approved 0 Not Approved 3/13/12-
Revision
/sa/12-
Revision 2: 0 Approved ❑ Not Approved
Revision 3: 0 Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions"Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
frit/visions (after Building Submittal only) ,
Revision Notice 1: Date Sent to Applicant: I a///
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
C SDC Fees Entered: Wash Co Trans Dev Taxes 0 N/A
(1' Tigard Trans SDC: Yes ❑ N/A
Parks SDC: Yes El N/A
LIDA 0 Yes XrN/A
O: ::::ornator:Is
Approved b
I:\Building\Foams\BldgPernvtRvw_RES_111617.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
:N : Transmittal Letter
tta
1 1(,A It D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: tc. DATE jls N' J'
ED
DEPT: BUILDING DIVISION
MAR 7 2018
FROM: W-L ('N ) "-'�('9 CITY oriG RD
COMPANY: BITTING DIVISION
PHONE: 5 02`f(> By:
RE: V7:0\`k tAJ'( ,v \-1 7,0 (4- - l?V G l
Site Address) (Permit Number)
\ l>
(Projecrhame 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.
‘K Floor/roof framing. Basement and retaining walls.
)C Beam calculations. Engineer's calculations.
Other(explain):
REMARKS:
FOR OFFICE USE ONLY
Routed to Permit ecbcian: Date: Initials:
Fees Due: &ges v u No Fee Description: Amount Due:
p*DNt C JZAK,.-i> COC $ 4,c-1'4) r/
o\v._ C./Apu
Special
Instructions: /
Reprint Permit(per PE): []Yes No ✓ ❑ Done
Applicant Notified: c�1 Date: 1� (fit Initials: /,'
tkefrirec q9-e.
I:\Building\Forms\TransmittalLetter-Revisions 061316.doc
FOR OFFICE USE ONLY—SITE ADDRESS: /07.0/el ,S/i(/This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting int irmation for plan review responses and revisions.
This form and the information it provides help. the review process and response to your project.
City of Tigard • CO MUNITY DEVELOPMENT DEPARTMENT
= Transmittal etter
T I G A\R D 13125 SW Hall Blvd. • Ti Lard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: T: e . _ ° lM DATE RECEIVED:
DEPT: BUILDING DIVISION
RECEIVED
JUN 2c2018
FROM: WES BOISVERT
CITY = GAD
COMPANY: RIVERSIDE HOMES BUILDING DIVISION
PHONE: 503-488-9602 By:
RE: 12014 SW REDBERR COURT MST2017-00509
(Site Address) . (Permit Number)
PROGRESS LANDIN - LOT 08
(Project name or subdivision na a and lot number) -
ATTACHED ARE THE FOLLOWIN TEMS:
Copies: Description: •pies: Descr ption:
3 Additional set(s) of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
3 Floor/roof framing. Basement and retaining walls.
Beam calculations. 3 Engineer's calculations.
3 Other(explain): SITE PLANS
REMARKS: ADDING 12' X 10' COVERED DECK. PLANS INCLUDE REAR/SIDE ELEVATIONS
SHOWING THE COVERED DECK. SHEET A4 SHOWS COVERED DECK ON THE FLOOR PLAN.
SHEET A9 SHOWS THE COVERED DECK OPTION AND DETAILS. TRUSS LAYOUT,
TRUSS ENGINEERING AND SITE PLAN FOR THE COVERED DECK.
FO OFFICE USE ONLY /
Routed to Pe it T ician: Date: () 2�J (') Initials:
Fees Due: ss U No Fee Desc do : Amount Due:
� P
))7,
$ LiD
O(
Special 4-4,1) ' I/�"L [ LCA_ C i ,/-
Instructions: /020 %
Reprint Permit(per PE): fol.;, es�� I :� �� ❑ Done
Applicant Notified: - Date: 7�� . �I7 /41L Initials:
�w TO Th-L-- AL 4We t
I:\Building\Forms\TransmittalL.etter-Revisions.doc 05/25/2012 /0,, _Ts , G��
City of Tigard
■ II COMMUNITY DEVELOPMENT DEPARTMENT
ritn \�� Building Permit Review — Residential
Building Permit#: ,e/ — .4I —
Site Address: AQ Oil/ g A/ ou,- --
Project Name: Po...elt . AL,, ' / Lot #: g
(New dw •, subdivision name;Ad.':., . Alteration=last name of owner)
Planning Review �• / �6(1•
Proposal: .tt)h � l - A'�� 42�� ( Com' v��P�
PACetify site address/suite#exists and acpermit system.
ever Terrace Neighborhood: at No
No ❑ Yes,See River Tema Review Addendum Attached
S. Plan Elements:
IA. • e(3)copies of site plan w °.sting structures on site •
FA ite plan must be on 8-1/2"x 11"or 11 x 17"paper r,Footprint of new structure(including decks)with finished .
rawn to scale(standard architect or engineer scale) o elevations
orth arrow K yt lity locations&easements(required for new and additions)
19fto address,project or subdivision name and lot number L0Sidewalk/driveway approach
yLopplicantinformation(name and phone number) I1 , ation of wells/septic systems
dimensions and building setback dimensions 'A Existing trees to be retained with drip line,and tree
I) ' uare footage of buildings to be demolished tection measures
�' area,building coverage area,percentage of coverage and t tree size,type and location
mpervious area(applicable if R-7,R-12,R-25&R-40) VStreet names ,
2lProperty corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? !]d x'es❑I j '
4 foot differential) If•es,is a storm water.uali • facili shown? 0 es o
t, can Water Services-Service Provider Le (lot platted prior to 9/10/1995): -.7,7,211<,". / -
.tired: 0 s,applicant was notified 4 No Received: 0 Yes 0 No
V Public Facdi ' Improvement(PFI)Permit 7 o�d 0i'�
"Reqwed: Yes,applicant was notified 0 No Applied For. Yes 0 PP/0-6R-
stop intake
d Use Case#: g u o21J 1,- 000049
oning: E- .X-
V Required Setbacks: Front Rear / Side S--- Street Side P)/l -Garage...20
sJ I .dscape Requirement:
� �► •t Coverage Maximum: % i, 11
'4 Building Height Maximum Height .30_ Actual Height .i .,'..Q (,P
Klillisual Clearance
•'1!.ensitiveLands: 0 Yes �No Type
VA Urban Forestry Plan
❑ Conditions"MI' •nor to iss .ce of b ding permi /
49
Notes: ö i /• I.. --..e4 �` alA:• i... 4 / a-,
' _ fr SSI . r• i, .- 's ..1
Approved By Planning: . 1••ill► 7 Date: DM
Revisions(after Byil'ding Submittal only) ewer Date
Revision 1: EApproved 0 Not Approved _ � �" - '-
Revision 2: Approved 0 Not Approved '_ _� (7
Revision 3: 0 Approved 0 Not Approved
PP PP
I:\BuildingWorms\BldgPenmitRvw_RES_061417.docz
Building Permit Submittal
Original Submittal Date: ) /11/0 _
Site Plans: #
Building Plans: #
Building Permit#: 1;rEnter building permit#above.
Workflow Routing Planning r Engineering lir Permit Coordinator Building
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: l Engineering. (1)copy of permit application,(1)site plan,(1)building plan and
i original plan review routing form.
t- Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: -‘14Date: td.4,/ ,,t 7
Engineering Review
Vope at building pad: D,i
/nditions"Met"prior to issuance of building permit 1
IGK.;sements(encroachments)per engineering conditions of approval and plat
Ltd'Water Quality/Quantity Facility ,
Assess Water Quality Fee in-lieu: 0 Yes 0 No
Assess Water Quantity Fee in-lieu: 0 Yes 0 No
/LIDA Facility on lot 0 Yes 0 No
[a/Final Plat Recorded:
L'SKNOT Approved by Engineering: WDate: l,L/2 vf&7
Notes: S 1 Cow[dol- l.• t' hide CoA i s ; Pim.; rdf ,,,,c...4.1. ,
Approved by Engineering: Date:
Revisions(after B ' Submittal only) . . Date
Revision 1: m/�pproved 0 Not Approved „i/� / - �
Revision 2: Ud Approved 0 Not Approved � � `�
Revision 3: 0 Approved 0 Not Approved
Permit Coordinator Review
0 Conditions"Met"prior to issuance of building permit
0 Approved,NOT Released Date:
Notes:
visions(after Building Submittal only) •
Revision Notice 1: Date Sent to Applicant p272
VI
Revision Notice 2: Date Sent to Applicant
Revision Notice 3: Date Sent to Applicant
SDC Fees Entered: Wash Co Trans Dev Tag: 4es 0 N/A
• 1// Tigard Trans SDC: ¶"Yes 0 N/A
Parks SDC: A7'Yes 0 N/A
LIDA 0 Yes ,N/A
OK W Issue Permit •'
Approved by Permit Coordinator: /ODate: �/`i/I(r-----
1:1Buildmg\Forms\BldgPamitRvw_RES_l 11617.docx
12V. \/ 6�— - 1 l (D1 if,
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12014 SW REDBERRY CT, TIGARD, OR, 97223 September 27, 2018 at
2:42:40 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00509
Inspection Type: Inspector:
299 Final inspection Jeremy Burrows
Result:
PASS - CofO
Comments:
Final erosion control passed
Street tree certificate received
Moisture content form received
Moisture barrier acknowledgement form received
High efficiency lighting form received
Insulation certification verified
Blower door and/or duct seal test certificate received
C of 0 left on counter.
Violation Summary:
Inspector Contractor
I ,* x,� i ,q ..1
Electrical Permit Application " roll oFFitu: I.SE()NEN
City of Tigard5 IE.P 12 ,''i Received p
Date/By: ! f; if AU/ e)e-r°9
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
I Phone: 503.718.2439 Fax: 503.598.1960 ( Date/By: Related Permit#:
Inspection Line: 503.639.4175 ,,. .,,JN i Ready Date/By: Suris: I ® See Page 2 for
I l('A R II Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE of-Worm m . ,, PLAN REVIEW
®New construction 0 Addition/alteration/replacementc ', m
e check all that apply(submit 2 sets of plans w/ites checked):
0 .. -rvice or feeder 400 amps or more
❑Demolition 0 Other: y mp ❑Building over three stories.
where •the available fault current 0 •Marinas and boatyards.
CATEGORY OF (O STRUC'TION " ,7 a, 0p, exceeds 10,000 amps at 150 volts or 0 Floating buildings.
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
JOR SITE INFORMATION ARV,LOCATION 0 Emergency system. larger separately derived
12014 SW REDBERRY CT. 0 Addition of new motor load of system.
Job#: Job site address: 100HP or more. ❑"A"."E". °t-2"."1-s",
❑Six or more residential units. occupancy.
City/State/ZIP: Tigard, OR 97223 ❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: PROGRESS LANDING 0 Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: SW WALNUT ST. &SW 135 AVE iC '[EE SCHEDULE ;
Description I Qty. f 1" Each I Total I *
New residential single-or multi-family dwelling unit.
Subdivision: PROGRESS LANDING I Lot#: 08 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
°',DESCRIPTIO(!1 OF WOI2 �*$��_t.hs.,=. ..., Limited energy,residential
(with above sq.ft.) 75.00 2
Construction of SFR
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
51 '
Renewable Energy 0 See Page 2
PROPER
o,.h... � w�'��T� �".> `t � �" y Services or feeders installation,alteration,and/or relocation
Name: Riverside Homes, LLC 200 amps or less 100.70 2
Address: 17933 NW Evergreen Parkway, Suite 370 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: Tigard, OR 97223 601 amps to 1,000 amps 301.04 2
Phone:( 503) 645-0986 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: wboisvert@riversidehome.com 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
ID APPLICrAN1`" 1 t .CONTACT e' SON Branch circuits—new,alteration,or extension,per panel
.x _ A.Fee for branch circuits with
Business name: Same as above above service or feeder fee,
each branch circuit 7.42 2
Contact name: Wes Boisvert 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:( ) I Fax: :( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: wboisvert@riversidehome.com Reconnect only 67.84 2
# RACT011t r" . ,_t.,;. ,; , . x Pump or irrigation circle 67.84 2
Business name: Sunlight Electric, Inc Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy 0 See Page 2 2
Address: 2804 NE 65th Ave. St. D panel,alteration,or extension.
City/State/ZIP: Vancouver,WA 98661 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:( 360)518-7589 Fax:( ) Investigation(1 hr min) 90.00/hr
�}. / b Industrial plant(1 hr min) 78.18/hr
Email:
6 4 c lo[i'G/ ''/yQ 7///20 tbl�45. Inspections for which no fee is
90.00/hr
CCB Lic.: 472541,5 Electrical Lic.: E2366Suprv.Lic.:s— 7.2S specifically listed('A hr min)
,AELECTRICAL PERMIT I:EES
Suprv.Electrician signature,required: ./2, �,- _„24.____.4 Subtotal:
Print name: Chester Garrett Date: 9/11/2018 0 Plan Review Required(25%of pennst fee):
State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Wes Boisvert Date: 9/11/2018 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(l 1/05/COM/WEB 1
I
A f bXV lam`/
City of Tigard ' COMMUNITY DEVELOPMENT DEPARTMENT
Request for Permit Action
TI t,,\R r`l 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 •www.tigard-or.gov{
Pa
TO: CITY OF TIGARD
Building Division SEP 1 -
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits Bard-or.gov
FROM: ❑ Owner ® Applicant ❑ Contractor C City Staff
Check(✓)one
REFUND OR Name:
INVOICE TO: (Business or Individual) Riverside Homes, LLC-Wes Boisvert
Mailing Address: 17933 NW Evergreen Place, Suite 370
City/State/Zip: Beaverton, OR 97006
Phone No.: 503-645-0986
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓):
❑ CANCEL/VOID PERMIT APPLICATION.
❑ REFUND PERMIT FEES (attach copy of original receipt and provide explanation below).
❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
❑X REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit).
Permit#: MST2017-00509
Site Address or Parcel#: 12014 SW REDBERRY COURT
Project Name: PROGRESS LANDING
Subdivision Name: PROGRESS LANDING Lot#: 08
EXPLANATION: CHANGED ELECTRICAL SUBCONTRACTOR-SEE ELECTRICAL PERMIT
Signature: Date: 9/11/18
Print Name: Wes Bo svert
Refund Policy
1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of:
• Any fee which was erroneously paid or collected.
• Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort
has been expended.
• Not more than 80%of the application or permit fee for issued permits prior to any inspection requests.
2. All refunds will be returned to the original payer in the form of a check via US postal service.
3. Please allow 3-4 weeks for processing refund requests.
FOR OFFICE USE ONLY
Route to Sys Admin: Date By Route to Records: Date By
Refund Processed: Date By Invoice Processed: Date , By
Permit Canceled: Date By Parcel Tag Added: Date By
I:\Building\Forms\RegPermitAction_092314.doc