Permit (46) CITY OF TIGARD MASTER PERMIT
ii: COMMUNITY DEVELOPMENT Permit#: MST2018-00098
Date Issued: 04/23/2018
T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110AC04100
Jurisdiction: Tigard
Site address: 11088 SW ANNAND HILL CT
Subdivision: ANNAND HEIGHTS Lot: 18
Project: Annand Heights, Lot 18
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 998 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 25 Bathrooms: 3 Second: 1367 sf Garage: 496 sf Front: 15 Smoke
Yes
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors:
Total: 2365 sf Value: $293,311.14 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
0
Tubs/Showers: 3 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: 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: 4 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2365
Owner: Contractor:
ANNAND HILL LLC WINDWOOD CONSTRUCTION INC Required Items and Reports(Conditions)
BY RICHARDS,M DALE 12655 SW NORTH DAKOTA 1 Fire Rated Eaves
12655 SW NORTH DAKOTA ST TIGARD,OR 97223 2 Ersn Cntrl 503-639-4175
TIGARD,OR 97223
PHONE: PHONE: 503-625-6526
FAX: 590-7606
Total Fees: $30,492.77
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
1 . 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 obta'. - •• of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: 't!!/' -/ Permittee Signature: a �—
all 503.639.4175 by 7:00 a.m.for the next
available inspection date.te.
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.
1 •
Building Permit Application•
Residential ;KJ ��� r rI : w FOR OFFICE USE ONLY
5'. p 4 '..d t, Received _
: City of Tigard Date/By. I ��.�..� Pemit No: I 1 {
13125 SW Hall Blvd.,Tigard,OR 97223 `�L�fI' LYG/�
Plan Revie
Phone: 503.718.2439 Fax: 503.598.1960 ?018 Date/B : Other Permit: ,� 7
Inspection Line: 503.639.4175 �� � y r'" �.�i
T I GA R D pAR Date Ready/ y: / �� Juris: E l See Page 2 for
Internet: www.tigard-or.gov v :, . ,_ No ed/Method: , `/ - ,, Supplemental Information
�� Aid r
TYPE OF t. a .oN REQUIRED DATA:1-AND 2-FAMILY DWELLING
'New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the prgfit f e
CATEGORY OF- CONSTRUCTION work indicated on this application. 3 [ ( (�
e_ 2-familydwelling ❑Commercial/industrial and Valuation: $ ! \
0 Accessory building 0 Multi-family Number of bedrooms:
❑Master builder Number of bathrooms: sp� •
❑Other: /
JOB SITE INFORMATION'AND LOCATION Total number of floors: :�
Job site address: //6 b bc5k.) /4A Q d ¢�� %t 64 r1 New dwelling area:�2' .3 , square feet (
City/State/ZIP: 7 T 42/1 er, �q/''2 ---3 Garage/carport area: / square feet • .•
,13
Suite/bldg./apt.no.: Project name: nitn4nd j-lCV A5 Covered porch area: '7 quare feet
Cross street/directions to job site: /a 61_b Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: thInand ileo A Is I Lot no.:/J Permit fees*are based on the value of the work performed.
Tax map/parcel no.: V Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
6'P� Valuation: $
�" Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER 0 TENANT Number of stories:
Name: 1tq it J) cue)o4 CUAnS f //'IGT �A) ,q iL Type of construction:
Address: 4421'.4 5-5-- 5& /110,17-1t i3Oa kei , cd'1'r Occupancy groups:
City/State/ZIP: 77 a 2?� 10' Existing:
Phone:(s"'"03) 70LI3 7 Fax:(513) 5-90'���4
New:
0 APPLICANT 0 CONTACT PERSON
BUILDING PERMIT FEES* _
Business name: /1'ti� (P� erel��fee schedule)
Structural plan review fee(or deposit):
Contact name:
Address:
FLS plan review fee(if applicable):
City/State/ZIP: Total fees due upon application:
Phone:( ) Fax: :( ) Amount received:
E-mail: �iA lhuad��pines/t/ ®( 4.it a`./I Cum PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRA CTOR l! Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name: k� dt atsL 1)► Submit two(2)sets of roof plan with connection details
°` and fire department access,along with the 2010 Oregon
Address: A.-6 g"S (iCFA PC417-, (1/1ei- Solar Installation Specialty Code checklist.
City/State/ZIP: 7j5 e'29'72-.2-3 Permit Fee(includes plan review
�,��''J and administrative fees): $180.00
Phone:(,r 3) ga' _t- 75_ Fax:(6Z3, 6170-Zad G State surcharge(12%of permit fee): $21.60
CCB lic.: 5—'0/960.
Total fee due upon application: $201.60
Authorized signature: _ _-a This permit application expires if a permit is not obtained
r within 180 days after it has been accepted as complete.
Print name: „' , /.” i zuS Date: 3/),„thy *Fee methodology set by Tri-County Building Industry
' _, Service Board.
I:\Building\Permits\BUP-RESPermitApp.doe 02/24/2011 440-4613T(11/02/COM/WEB)
. .
Mechanical Permit Applicatiiill F . OFFICE USE ONLY
...‘ 1 , 4 1 :
City of Tigard .7, , 11....J ,,, ,, h ' " ived
ei•--,. ...A. ,•-',3 * ''' 6'.a& v. Permit No.:
III 13125 SW Hall Blvd.,Tigard,OR 97223 ' ' ' - ' ' ''''' IB"..
Plan Review
: g Phone: 503.7182439 Fax: 503.598.1960 Date/By. Other Permit:
Inspection Line: 503.639.4175
TIGARD MAR a 4) „?.(0 Date Ready/By: Juris 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
i',...i ..., 0.,3''' Y4-:.':1'.'0.,i!:
_ 1,--„,,,--,,,.:,•,:.: . '‘-' -.:--;',.---l'i-J,-,,:., 1,**ft OF woury7.-i-ti I, - ' , COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
permit. ... , Mechanical permifees*are based on the value of the work
construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY"OF CONSTIRIJCTION ____ __
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
01 Multi-family P Master builder 0 Other: Description Qty. Ea. Total
?464i ,g prE.,OITIOnMA4ION'ASTI LOCATION' ','-' '. - Heating/cooling:
. ,
Air conditioning 46.75
Job site address: /Jo gf 5,.5-to- a,,La/ /54 1/64 i..../
Furnace 100,000 BTU(ducts/vents) ..--'''''. 46.75
City/State/ZIP: 7--.. are,/ 0,.. 9' - 2.. 3 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:/4,,,w,, ,,A. 4A
0Duct work 23.32
Cross street/directions to job site: /6)1 .4.--0 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: /9--/in4 Ad Ile 0 ti/-5 Lot no.:1 6 Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater ....---- 23.32
- ... . - . ... .. . . . . ,
.0.'"... 33.39
;'J'-;,-!'ri.',*' -",:,.''..';' . ,.-,-1p0ciiWilt*,co.,,-Nvoit.K ....:, :. Gas fireplace/insert
Flue vent for water heater or gas
4/CAL-1
5S'/ it=- 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
..-... 13PERTv,pwisiiR--,. ..,, -,,, , El TENANT Environmental exhaust and ventilation:
Name: 6,01()iftriciwcd ‘L.571 rP/C- Range hood/other kitchen
,'''''''
equipment 33.39
Address: /0,4 s-s-- 56,,D Neirvq-, i:14.46/... 5.firC-7/ Clothes dryer exhaust ."'-k 33.39
City/State/ZIP: 7,,,,,,,,..d 0, q-2.2.2-3 Single-duct exhaust(bathrooms, ..,..2,
toilet compartments,utility rooms) ,-:/ 23.32
Phone:( 5-03 .26 d -Z./37c- Fax: ---0 3) 7c -:7‘06 Attic/crawlspace fans 23.32
PLICANT_. : -,,, _ ' CONTACT PERSON 23.32
Fuel piping:
Business name: 50 ft,.e
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Gas heat pump
Address:
Wall/suspended/unit heater
City/State/ZIP:
Water heater
Phone:( ) Fax: :( ) Fireplace
Range
E-mail: d u.l-Ocre/91-0"e*5 11161-)&9(911-Ctil t (7f11 Barbecue
CONTRACTOR t", - Clothes dryer(gas)
Business name: -Ft r5/ (.4_il/ Other:
MECHANICAL PERMIT FEES*
Address: /3/5V Zia./Atiftet3 gz1,..,„, Dt. Subtotal
City/State/ZIP: 7i3,E5e,k af 07a/I ‘9V5- Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( )
State surcharge(12%of permit fee)
CCB lie.: 7.2.60./.3 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Authorized signature: ---e_...
(„,.. days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry Service Board
Print name: ffircir c e/A(.7eA,..._) Date: Sy)4.10./t7
1\Ruildinu\Permits\MEC PercnitAno 040 13 doc 440-4617T(11/02/COM/WEB)
, .
Electrical Permit Applicatio. t .,,OFFICE USE ONLY
' ••-, i,, i, , ..--,
';. eactee/iBveydCity of Tigard : En al13125sWHa11B1vd.,Tigard,0R972231; , PIanReview,,..e: 5037182439Fax. 503598196Dt/BrIMIMIMIEM
Related Pennit#:
Inspection Line: 503.639.4175 Ready Date/By: Juris. 2 See Page 2 for
TIGARD
Internet: www.tigard-or.gov MAk .;-/C.:, '!;1`, Notified/Method: Supplemental Information
_,..„.. TYPE OF WOKilt vim;.7,',4-, ,,t,z•g•i PLAN REVIEW
JO-New construction 0 Addition/alterationfieplacerrient '. '' '' Please check all that apply(submit 2 sets of plans w/items checked):
ElDemolition 0 Other: 4,1•11 1-.0•1t,''' ' ',-..fC'•)ii,-, 0 Service or feeder 400 amps or more 0 Building over three stories.
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less to ground,or exceeds 14,000 0 Commercial-use agricultural
1:1 1-and 2-family dwelling 0 Commercial/industrial El Accessory building
amps for all other installations buildings
0 Multi-family El Master builder fil Other: 0 Fire pump. 0 Installation of 150 KVA or
' JOB SITE INFORMATION AND LOCATIONi 0 0 Addition of new motor load of system.Emergency system. larger separately derived
Job#: Job site address#010 6# An qAcid/94/,/ 4,4 1001-FP or more.
0 Six or more residential units. occupancy.
City/State/ZIP: Tj aid(9,t- 9-)20:3
0 Health-care facilities. 0 Recreational vehicle parks.
//A/1421,d hiekt,A# 0 Hazardous locations. 0 Supply voltage for more than
Suite/bldg./apt.#: Project name:
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: /no th FEE SCHEDULE
‘`#/ Description 1 Qty. I Each 1 Total 1 *
New residential single-or multi-family dwelling unit.
Subdivision: /q-Afoftel #{61/5 Lot#: iiis Includes attached garage.
1,000 sq.ft.or less
Tax map/parcel#:
i 168.54 4
Ea.addi 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
oe‘i 5'F (with above sq.ft.)
Limited energy,multi-family / 75.00 2
75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
,,,81711-OPERTY OWNER 0 TENANT
Services or feeders installation,alteration,and/or relocation
Name: tulltalweeicej ats/77.,thc,„-- JAL 200 amps or less 100.70 2
Address: p‘,5-5- SCO itfet.-V-41 Pct-idt 67 ilre-f--.1 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 76 4.40/ 6.-c_ f-72_23
601 amps to 1,000 amps 301.04 2
Phone:( ' 3 • 7bc)-.17/3 7S— Fax:45&3 )570 -7444 Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:ttjheatp,irfclikylveS ea.., (-• 6,16...1 I taml 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 10 599 amps 168.54 2
Branch circuits-new,alteration,or extension,per panel
,.....42-1EFIT—ICANT 0 CONTACT PERSON
A.Fee for branch circuits with
Business name: (5qAtoe above service or feeder fee,
7.42 2
each branch circuit
Contact name:
B.Fee for branch circuits without
service or feeder fee,first
Address:
branch circuit 56.18 2
City/State/ZIP: Each addl branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax: :( ) Each manufactured or modular
67.84 2
dwelling,service and/or feeder
Email:
Reconnect only 67.84 2
CONTRACTOR
Pump or irrigation circle 67.84 2
Business name: Orraii-Aou-5C fritC_jr/C.: Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address: . ca//r..7ct_Jwin evipi/l riely panel,alteration,or extension. 0 See Page 2 2
Each additional inspection over allowable in any of the above
City/State/ZIP: cp7),----• 1it (::,‹ '"r2.1-.3-5 Additional inspection(1 hr min) 66.25/hr
Phone: -.-v3) yil ....z,-?t1 Fax:(57/5) ‘yb_92:73 Investigation(1 hr min) 90.00/hr
Email: Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
90.00/hr
CCB Lic.://6,20,24 Electrical Lic... ..—Ne Suprv.Lic.:11ZOS specifically listed(Y hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:
Subtotal:
Print name -"l eJ)4 AD Date: 0 Plan Review Required(25%of permit fee):
,
State surcharge(12%of permit fee):
----',-,/ AIII.>----,--•
Authorized signature:/' -; ----,-;- ---- TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: c Art') 111,6 ,11-0-Ase Date: ,a7 vi,,,,Iti days after it has been accepted as complete.
* Number of inspections allowed per permit.
I\Building\Permits\ELC_PermitApp_ELR_ERE doe Rev 06/1 -,--5 440-4615TO 1/05/COM/WEB
Electrical Permit Application—City')Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Fee for all residential systems combined: $75.00 Description Qty. I Each I Total I *
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
n Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
7 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:
I i Other: Each additional inspection is 66.25/hr
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed('/z hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
* Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
n Audio and Stereo Systems
n Boiler Controls
7 C• lock Systems
n D• ata Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
n Instrumentation
[i Intercom and Paging Systems
❑ Landscape Irrigation Control*
n Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
n Protective Signaling
n Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I:Tuilding\Permits\ELC_PermitApp_ELR_ERE-doc Rev 06/17/2015
s ,
Plumbing Permit Applicati.
Building Fixtures Ct r(f sl > FOR OFFICE USE ONLY
Cityof Tigard Date/By:
. g PermitNo.: '�---` -
111111
a 13125 SW Hall Blvd.,Tigard,OR 97223 � t tT����� 7C1�
Phone: 503.718.2439 Fax: 503.598.1960 MAR ?G Plan Review
%t j Date/By: Other Permit No.:
Inspection Line: 503.639.4175
TIGARD Date Ready/By. Iu s' RI See Page 2for
Internet: www.tigard-or.gov l' -#; J'': Notified/Method: Supplemental Information
1." I <s a11ikl
TYPE OF WO r * FEE* SCHEDULE'
ew construction � �-'p 1 ' ,�'
DDemolition For special information use checklist
Description Qty. j Ea. Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
1:3 Accessory building ❑Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: //0 G ►b CU A nQA1 / //i4 Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: 777 O/L� `�7�-�.�.+
�� ''` Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name:gAilandigeD 1,15- Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
if® !f f-b 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: lilt d /46. kis j Lot no.:16 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
/v t4--) 5/:=I2- Dishwasher j 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER 0
TENANT Expansion tank 12.51
Name: ®yVt 4/-j a� 6a/us Fixture/sewer cap 25.02
Address: �f c / 54J /tc�-/2 7/z 3",41,-,/ Floor drain/floor sink/hub 25.02
Y v`Y� Garbage disposal 25.02
City/State/ZIP: A if a,/-d o2, e:7-73 Hose bib 25.02
Phone:(6.--e13 7 7,5" Fax:(S7i3 317-7 9,� Ice maker 12.51
0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name: 0//71 Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax: :( ) Tub/shower/shower pan 12.51
E-mail: .4, �0erc A0-",-es.,11 w-"t '/f` G� Urinal 25.02
�V! Q/ Water closet 25.02
CONTRACTOR
f U V� /U Water heater 37.52
Business name: jna� �(1�{4 t Water 1 mgDWV 56.29
Address: ioo 11� 5 4! //z/-&,./) P Other: 25.02
City/State/ZIP: �O/1 �/ Subtotal
Phone:(p3) -7,9.3 ^ie/ d/tFax:6e3) tio/ Minimum permit fee: $72.50
CCB Lie.: ��� /39 Plumbing Lic.no. 'c,50‘,/,/6
Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name: �t l Date: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-46t6T(10/02/COM/WEB)
CITY OF TIGARD RECEIPT
13125 SW Hall Blvd.,Tigard OR 97223
IN503.639.4171
TIGARD
Project Name: Annand Heights, Lot 18
Site Address: 11088 SW ANNAND HILL CT
Receipt Number: 416356 - 03/27/2018
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
MST2018-00098 Plan Review 230-0000-43106 $750.00
Total: $750.00
PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 5557 BTAGGART 03/27/2018 $750.00
Payor: Windwood Construction, Inc.
Total Payments: $750.00
Balance Due: $1.34
Page 1 of 1
City of Tigard
q
COMMUNITY DEVELOPMENT DEPARTMENT
■
T 1 G A R D Building Permit Review — Residential
Building Permit #: /ri e/r.)cti IT
Site
'-
Site Address: r i 0 Z . cw 4rIticvli AV a,
Project Name: poi.) a,ki /kill-6 Lot #: /0-
(New dwelling=subdivision/fiame;Addition or Alteration=last name of owner)
Planning Review
Proposal: .N04-0 PR
L2iTerify site address/suite#exists and active in_c_ermit system.
Dr-River Terrace Neighborhood: 0-31; ❑ Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
Three(3)copies of site plan ftg-Enriglirptructures on site
liSite plan must be on 8-1/2"x 11"or 11 x 17"paper „„12trootprint of new structure(including decks)with finished
Z1)rawn to scale(standard architect or engineer scale) floor elevations
l arrow fility locations&easements(required for new and additions)
Lite address,project or subdivision name and lot number t ewalk/driveway approach
_2 pplicant information(name and phone number) g ❑T ocatic of wells/septic systems
.2'zot dimensions and building setback dimensions l kt 1 g trees to be retained with drip line,and tree
ware oo age of buildings to be demolished protection measures
AlLot area,building coverage area,percentage of coverage and eet tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) C35-eet names
�operty corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? Lames El No °fie
ie
4 foot differential) If yes,is a storm water quality facility shown? ❑Yes L;liGo
--B.-Clean Water Services-Service Provider Letter(lot platted prior to 9/10/1995):
Required: E Yes,applicant was notified C -No Received: ❑ Yes E No
Public Facilities Improvement(PFI) Permit: -?F /C;-C.7 a<7.5c)
Required: ❑ Yes,applicant was notified l7"-No Applied For: ❑ Yes ❑ No,stop intake
Er Land Use Case#: PO f x[)15 OOo 7
.-0 Zoning: g-/a (pip)
Er Required Setbacks: Front 1 • Rear 15 Side Street Side$` Garage , f,_)Landscape Requirement: -R6 %
Z.-Lot Coverage Maximum: 76
0/0
,:i.-Building Height: Maximum Height '�! Actual Height j
p-Visual Clearance
CR'-Sensitive Lands: ❑ Yes ❑ No Type
ein Urban Forestry Plan
E onditions "Met"prior to issuance of building permit
Notes:
❑ Approved By Planning:
----'6'(-. --- Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw RES_061417.docx
Building Permit Submittal
Original Submittal Date: M3 /I g
/F
Site Plans: #
Building Plans: # '"
Building Permit#: r building permit above. ,/
Workflow Routing: [I �llaanning I 'Engineering I�dlermit Coordinator Ott ing
Workflow Sign-off: 1i�51 -off for Planning(include notes from planning review)
Route Application Documents: gineering: (1) copy of permit application, (1) site plan, (1) building plan and
coiginal plan review routing form.
fr Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes:
gi‘gv _" Date: � r�7"�
By Permit Technician: ,5 �
Engineering Review 1,6t
70
❑'Slope at building pad:
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ,--EiNo
Assess Water Quantity Fee in-lieu: ❑ Yes No
LIDA Facility on lot: ❑ Yes .0'No
Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: Mita- L(), Date: 4-- !e
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
SDC Fees Entered: Wash Co Trans Dev Tax: es ❑ N/A
Tigard Trans SDC: !Z.'Yes ❑ N/A
Parks SDC: Yes ❑ N/A
LIDA ❑ Yes N/A
OK to Issue Permit �/
Approved by Permit Coordinator: ' Date:'' R `0
I:\Building\Forms\BldgPermitRvw RES_010118.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11088 SW ANNAND HILL CT, TIGARD, October 8, 2018 at
OR, 97224 1 :13:57 PM
Record Type: Record ID:
Residential - Master Permit MST2018-00098
Inspection Type: Inspector:
199 Electrical final Aaron Cillo-Gobel
Result:
PASS
Comments:
No A/C installed.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11088 SW ANNAND HILL CT, TIGARD, October 16, 2018 at
OR, 97224 1 :06:05 PM
Record Type: Record ID:
Residential - Master Permit MST2018-00098
Inspection Type: Inspector:
299 Final inspection Aaron Cillo-Gobel
Result:
PASS - CofO
Comments:
Final erosion control passed
Street tree certificate received
Moisture content 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