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Permit (85) I • CITY OF TIGARD MASTER PERMIT I2.''t COMMUNITY DEVELOPMENT Permit#: MST2017-00333 T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/19/2017 Parcel: 2S106DA00200 Jurisdiction: Tigard Site address: 13359 SW 169TH AVE Subdivision: RIVER TERRACE EAST Lot: 2 Project: River Terrace East, Lot 2 Project Description: New SFA. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 2 First: 97 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 32 Bathrooms: 3 Second: 562 sf Garage: 456 sf Front: 8 Smoke Dwelling Units: 1 Third: 562 sf Right: 0 Detectors: Yes Total: 1221 sf Value: $163,653.44 Rear: 5 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer 100 Drains: 0 Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add!500 sf: 2 201-400 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 p Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SFA VB R-3 1221 Owner: Contractor: ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions) BY FORSUM,MICHAEL 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175 7600 E DOUBLETREE RANCH RD VANCOUVER,WA 98660 STE 1 SCOTTSDALE,AZ 85258 PHONE: 602-694-4031 PHONE: 360-695-7700 FAX: Total Fees: $23,947.66 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 0 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: • Permittee Signature: SCS .4111// /lc y s Call 503.639.4175 by 7:00 a.m.for the next available inspection date. 4 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. Building Permit Application �'2.. • ResinS mai E r ?E. FOR OFFICE l"SE 0:\Ll City of Tigard 2 DRat;BY /, y/jj Permit No;��f7 Z33 13125 SW Hall Blvd.,Tigard,OR 97223 U G 2 2017 Plan Review 9•�' • 1 �. Other Permit:��//`+10p---ay22 111 1 41 Phone: 503.718.2439 Fax: 503.598.196 Date/By: / JAS. H See Pa e 2 for T 1c,„;R D Inspection Line: 503.639.4175 C3. - , A. Date Ready/By: t� g Internet: www.tigard-or.gov r311 c�if (r' F W ai r6s 4 F ^ Notified/Method:/2- // /7 �/V/. Supplemental Information L:F 5.1avS.,1i .� .✓141.3,.a1 6--.9/4. Al,Lj"'7rc LE ®New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all 0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the ' s; work indicated on this application. 1-and 2-family dwelling 0 Commercial/industrial Valuation: r^' J v f D� • J 0 Accessory building Multi-family Number of bedrooms: 2, 6 3� vc 3 0 Master builder 111 Other: Number of bathrooms: 7 s ,1 -, to i . t Total number of floors: Job site address: /3350) Sw i ip C tti f V New dwelling area: ! Z/ square feet City/State/ZIP:Tigard,OR 97224 Garage/carport area: 5/n square feet G Suite/bldg./apt.no.: I Project name:River Terrace East 43 7Covered porch area::square feet y 6 a. Cross street/directions to job site: Deck area: 7 Z square feet q 7 o J'. 4,v./ ther structure area: square feet • Subdivision:River Terrace East I Lot no.: 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 r3A.. mss._ ,, work indicated on this a ltcation. tl Igraill -x. .;s s ' ;6 pp Valuation: $ Existing building area: square feet New building area: square feet tiaktAtisit ,6 , . t ' '� � , Number of stories: Name:ADVL Land Holdings,LLC Type of construction: Address:7600 E Doubletree Ranch Road Occupancy groups: City/State/ZIP:Scottsdale,AZ 85258 Existing: Phone:(602)694-4031 Fax:( ) New: ter. 1 �, „ a� ,� . :• .` : i,.. ._. '", t l h+,,1 ;'i Business name:Polygon WLH,LLC ` Structural plan review fee(or deposit): Contact name:Nichole Thorpe SO FLS plan review fee(if applicable): Address: 7 03 ti ch J.�(JV1 S�- SU L-[L-e- S OJ Total fees due upon application: City/State/ZIP:Vancouver WA 9866 Amount received: Phone:(360)695-7700 I Fax::( ) E-mail:Nichole Thorpe f . --: ra,. .._ . . ;,- , Commercial and residential prescriptive installation of _ roof-top mounted Photo Voltaic Solar Panel System. Business name: pOillm imul Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 103 B,C clWO` ��- u�t.{, l(b Solar Installation Specialty Code checklist. City/State/ZIP:Vancouver WA 98660 Permit Fee(includes plan review $180.00 and administrative fees): Phone:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60 CCB lic.:207247 Total fee due upon application: $201.60 Authorized signature: .' _/ This permit application expires if a permit is not obtained / 1 • within 180 days after it has been accepted as complete. Print name:Nichole Thorpe Date:06/16/2017 *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) E -; Mechanical Permit Application No\,} 0 ' 2017 FOR OFhICE USE ONLY City of Tigard ,,, Received Ili 'a 13125 SW Hall Blvd.,Tigard,OR 97221 1 i i‘f ' .,_y Permit Nq s i nr} - Phone: 503.718.2439 Fax 503.598.1960ii i '`t -'y plan"eview Other Permit: TI GARD Inspection Line: 503.639.4175 Date Ready/By: Jude: a See Page 2 for Internet www.tigard-or.gov Notified/Method: Supplemental Information ::z�W€- -yy_-y,S,rr„k�3rT-- - saa6ar:�e. e: "b�-�•. „ r tr--..,- .:Y_'.• .� , �2. ,`.. _.'l _. Fp i:.- :4.•r,:;",ftp 1?CfMi4t F- 'SCID c.� _�.'• 's "_ �"�r•'::-�: �="'7'Y3'-,iG..L�F�=A4.0��'•_!� p" �,. �' `.�u�x_�-_:. ��::�bSE: ? 2.'' .�'+:r •-".H. ::u�- _:�'•..:_ - ._ :_;_`a�'�- � l-:;�Y�t'�r."�-_*���is+=t=ig'Yi�'tsr`.t-i7 ._,.;fit ®New construction 0 Addition/alteration/replacement Mec�i�p�fees*are based on the value of the work eP performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition 0 Other. mechanical materials,equipment,labor,overhead,and profit. ' ,- t. `A-4,:-..74;..,n,..---t 4 :E'-,..- DFtitUNSIRTJathi i : �;,., " _m.�; ';,-:;, Value:$ .i rs :.. . .._ _..-.. ..=n,_. :••7 _Tz: l.�t:•; ,°;.'t. +.1,. `""_I ie -N�.: r, fiery,auf, k.' ._3LESID„A' I I EQI7 ;_ts:UsISFEES = _--, 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For spedal Information use checklist. 'Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total �7�� /1,����Is4a y'.�•r.as ; �: _.-: _: 5 05Wa? `_ *'.�''f'F'� Heahngiewling: Air conditioning 1 46.75 46.75 Job site address: 'j�j S9 Sy '1 n G�'1 pot, Furnace 100,000 BTU(ducts/vents) _ 1 46.75 _ City/State/ZIP:Tigard,OR 97224 W 1� Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt no.: Project name:River Terrace East Duct work 2332 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 1 2332 Subdivision:River Terrace East Lot no.:2..... Other: 2332 _ Other fuel appliances: Tax map/parcel no.: Water heater 2332 ? t`a'�.. i�1 •,.�"-s''!.=r..:? g5,0It'3'ION`OF_,4':UR • >` -fit;4:0 _.r,iViY,: Gas fireplace/msert 1 3339 h .=: :T].r�':^'�; r. �".�,`�) : :. - ^_ ... . :•mss,.... .,= t•:i Flue vent for water heater or gas 4i c (. I 1 tV '!. w . fireplace 2332 Log lighter(gas) 2332 Wood/pellet stove 3339 • Wood fireplace/msert 23.32 Chimney/liner/flue/vent 23.32 .i£ik:7: �:.EOPFRTjA a{':1.' _ .0:14 =..; 3 . l> Ny:il Y;AG "ba _- Ohea: 2332 4-'*;` `1 Environmental exhaust and ventilation: Name:ADVL Land Holdings,LLC Range hood/other kitchen equipment 1 3339 Address:7600 E Doubletree Ranch Road Clothes dryer exhaust t 3339 City/State/ZIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) kk 2332 Phone:(602)694-4031 Fair:( ) Attic/crawlspace fans 2332 a.,.-.,>. ::1?2Z: rL 2332 {''h•;: 4r;,'',z-;•. 3•�'.T,,ry �?,;';;,�:-:i*.i,:'>- w«_. •%-�.(..��,y "�r.Im�t:�yalj:�yr^,-, Other. .?.*$i",. .{'T}'��:iTi.�.:dJZL �may. vi` . .�.t�.�—�'v .AiiJ�L1l7W� .. Fuel piping. Business name:William Lyon Homes,Inc $14.15 for first four,$4.03 for each additional Contact name:W{C Y I D ' • 'O Furnace,etc. 1 Address:1V) Vr vekokAA .S-\-- SW:A<-* Si O Gas heat pump Wall/suspendedhmit heater City/State/ZIP:Vancouver,WA 98660 Water heater _ Phone:(360)695-7700 -� Fax;:(360)693-4442 Fireplace 1 Range E-mail:AO{GkUlC. 7' TL-Q f4,+11(�/�',µ/y`', b�_ "J'4.l (•I es •CZY1 I Barbecue 1 !;:.-'I.uc •_--"�: E ISR 11�1k c o fA .:P�r .-/.:,i:- ...._ 1 �. r ,�u-r;= "- +•�4” b -'Vii`, : �,._ 1" Clothes dryer(8�) Business name: wyV Other: _ PV'D Irk( c a Coy"h �I 14'" .: .: _: EW ' NvJ . 10� �' l�v I l �r ." { : rJr~ tl; - ,=:r_ : r Address: Subtotal City/State/ZIP: SVJ D k)� '� Minim permit fee($90.00) _ ��� i2 �w u Plan review(25%of permit fee) Phone:903)".L 1_ J 0 Fax:613) O'`1 j- �'l s State surcharge(12%of permit fee) . CCB lic.:loci DDI ` TOTAL PERMIT FEE loci 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 Printname:M/ 4 t)/L 7l1 e Date: T4Th:SA4.1D.....iTM 11......i..111...... /1.117,....i.A_...flfttt A.... .n c.rnll• . • .Inn Iowa.rrn.... r . ' i ‘'.,.--i\„/ Q 9 ?o 7 - --.. ------ _ ._ Electrical Permit Application - FOR OFFICE USE ONLY City of Tigard 6.4,6%-i" '.t ' '- ' IRMIIIIIIIIIIIIIIexcoyll 13125 SW Hall Blvd,Tigard,OR N a Phone: 503.718.2439 Fax 503.598.1960 Dateia. Related Permit 11: inspection Line: 503.639.4175. Ready Date/By: Mc 121 See Page 2 for TIGARD batemet.www.tigara_otgav Itotifiedavlethod: Supplemental fxrformodon .f:;:4',--.:.---'..L. -•_•::W:'P:.--"2.:':---,'-,-7';'•-,A521-:'''',70'"--W-AtM,-----Zle:i1=- -- -i'-_;---'1Affer•-ik: ;""•->Liz.-:•,- -:):•-•eAf.•.-agSkEtf_SOTWi:i-_,-,,,4A*-,,74,--'_ ..751,. • 13,1 New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans Wile=checked): 0 Demolition 0 Other: . CI Service or Seeder 400 amps or more 0 Building over three Writs. where the available fault current 0 Warm'as and boatyards. exceeds 10,000 amps at 150 volts or I:3 Floating buildings. ,...-and 2-family dwelling 0 Commermal' Thidtistria' 1 0 Accessory building tees b3 ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. . buildings.• 4.14,4 Multi-family -- 0 Master builder 0 Other: 0 Fire pump. 0 Installation of ISO KVA.of '.'-,•'-'2,t--f.•.'s:',-;--..--'1,4'-a-t4.f:9101101':',14.V.-••-..ay., oRcvPb7-itm'c-vzfro -T•;;',,---2c.-:--A. --z ,','•--'•1-2- 0 Emergency system larger separately derived O Addition of new motor toad of system. Yob#: Job site addrelaWt3 kJJ kkertV1 pg ed 10,012 rumor*. 1:1"A",, ",“I-2; 1-3", 0 Six or mom residential units. Occupancy.Tigard,OR 97224 0 Bean-care facilities. 0 Recreational vehicle parks. Suift/bldgJapt.#: I D-Project name: . VeA,,,-MAArzt(...e Earri,_ °Hazardous locations. 0 Supply voltage for mere than 0 service orfeeder 600 amps or more. 600 volts nominaL Cross streeddirections to job site: Descriptios Qtz, lath Total I *_ • New residential single-or multi-family dwelling unit. Subdivision: VA:\te r -RATA ti'. -Eco+- I l'ot* _ Includes attached garage. I,000 sq.ft or less I 168.54 4 Tax map/parcel#: Ea.adel 500 5(1.ft or portion I 33.92. I Limited energy,residential . 0 5 (with above sq.ft.) 7 . 0 2 Limited energy,multi-family 75.00 2 residential(with above sq.it) Renewable Energy 0 See Page 2 '''''.::'-' L'2.q45..0-0-2.1Cc-1 .019-tkc:',.,-,-?-:.°•-' '1•1'--1::''' ''1--FI''Str.-i'`118°1.irrll'I-- -----1.--?---:5,5 " Services or feeders installation,alteration,and/or relocation _ Name:ADVL Land Holdings,LLC 200 amps or less 10020 2 Address:7600 E Doubletree Ranch Road , 201 amps to 400 amps 13336 2 401 amps to 600 amps 200.34 2 City/State/7/P:Scottsdale,AZ 85258 601 amps to 1,000 amps 301.04 _ 2 Phone:(602)694-4031 I Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Frnail• -. relocation Owner installation:This installation is being maids on property that I owe which is not 200 amps or Imo 59.36 I 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 '1:-.4---,?",-7:4_:,-_:,r',11k,'_Vo 1=5:„:(0.WeS.;,t'7,42A--,-1-i-...--,--_-':;3-:_;;",:7.8. 0.1-Xli.W7Tb,-Wiri2ft';•"-- -,-' A.731;netibrerannicht°-.111en witalteration,°I.extension,per panel Business name:William Lyon Homes,Inc. above service or feeder fee, 7.42 2 each branch circuit Contact name: hi I ch 0 tejlIn ret• B.Fee for branch circuits without service or feeder fee,first Address 103 e"rOacti/JaA St SkAA-t-, S D branch circuit 56.18 2 City/State/ZIP:Vancouver,WA 98660 Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included)_ Phone:(360)695-7700 • ' ' Fax::(360)693-4442 Each manufactured or modular 67.84 2 dwelling,service andfor feeder Fx"";I Ah(l 0 16.41 1,t,,, p0 ,,I i•A A Me_S . „ Reconnect onlY 67.84 2 Pump or Jute=circle 67.84_ 2 Business name:Garner Electric Washington,LW ' Signor outline lighting 67.84 2 .1- Signal circuit(s)or limited-energy Address:04n. va..x.1\kA i3vA9,k111.3 k1:A\-e \UP panel,alteraticm,or mdeasion. D See Page 2 Each additional Inspection over allowable in any of the above2 City/State/EP:'ptk u au 14 pi, VI_ Cte31 I Additional inspection(1 hr rein) 6625/hr Phone:(253)320-1657 1 Fax:( ) Investigation(1 br min) 90.00/hr Industrial plant(/hr min) ' 78.18/br Rrnail•bdaniels@gwensa.com Inspections for which no fee is CCB Lie.: C1.158 Electrical Lie.: 208174 Suprv.Lio.: 4496S specifically listed 4 hr min 90.00/hr , _.•-- . r, •••" Suprv.Electrician signature,required:Slititi ,P, A it a '• • - - • • Subtotal: Print name: Than P Albert •• ' Date: 4/26/2016 0 Plan Review Required(25%of permit fee): — State surcharge(12%of permit fee): ..... Authorizesignature: -----_-----•----.Nxie-- -----7 - TOTAL PERMIT FIES: ....:,,, d - This permit application expires ifs permits not obtained within ISO l•I Print name: Bill Daniels Date: 4/26/2016 daya after It has been accepted as complete. !it...!.. * Number of inspections allowed per permit tell?:?;:teindichrostassichig-C_Panakinso Eli BREdoc Rev 06117/2015 440461 5111 T/DSPITAPLInnt 4 Plumbing Permit Application 0 I 0 v 2017 _. - , Building Fixtures 3'O.51 01,111 E. 1',:;.F. t NLN City of Tigard �a �; . _ Pena"Nofl5 To2,,7-003.33' _, # 13125 SW Hall Blvd.,Tigard,OR 9Y Plan Phone: 503.7182439 Fax: 503.598.1960 may: OtherP rnit Mo.: Tic,Y R O Inspection line: 5°3.6394175 pane aeadylBy; huts: Ed See Page 2 for Intertest: www.tigard-or.gov Nom: Supplemental Inft oration ...- �_ �- " 115 :y.'a_n.,L - y.t. TM.v�.. .. .._ �]�,�,tE.'*'1=1.:tea-:.. .. ., -... .___ : .: ....._ .:`s= .:�"'._,. -.. .-•4f•'.!'�:_: .., �i}r.�:: y®New construction 0 Demolition For spedaf fnforrned nitre checklist. Description Qty. a Ea Toad Addition/alteration/replacenient 0 Other [ New t-2-family dwellings(includes 100 R for each utility connection) ' 4:•7tii.__ ,W-- _�.�: fEi�I�(?FG�S�" Iv)�$ :�•_•:,'•.�.:r;:f;:s� i:-'� : SFR(I)bath 3I2.70 ' _I-and 2-family thvelling 0 Cornnierciallindustrial SFR(2)bath 437.78 ' ❑Accessory building' $4Multi-faFnily SFR(3)bath 6 ' 500.32 . Each additional bah/kitchen 25.02 0 Master builder.' 0 Other Page2 ,s Fire sprinkle{issl.ft), :: ..• 't r*-1 i_i .ii+ i 0* ; 0"40.*= _ -_ Site utilities. lob site address: 133cg. SUS tip n .� Catch basin or area drain . • 18.76 18.76 City/State/ZIP:Tigard,OR 97224 Drywall,leash line,or mulch dealer • Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: i Project name: f.iV.r T'x m t ea Eos4- Manufactured home utilities 50.03 Cross street/directions too job site: Manholes 18.76; Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 3 ‘ Storm sewer(no.linear ft.: ) Page 2 .Water service(no.linear ft.: ) ' Pace 2• SubdivIsion: RAW "t"�ce l'S4- Lot no:. Z F xture.or item: Tax trap/parcel` no.: Backtiow prevent' 1 31.27 ' ' ---i • N _ Bad:vrater valve 1231 :.. ,.5!•4. .y:,.�•�-,.'o_ ''� �t�•�R�Q�.. _:� Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ; 14 .':1;`,$:4'. `:.i .f.:' :.'; s.el.hi2+6 Tt :;. Er pansian tank I2.51 Name:ADPL Land Holdings;LLC Fixnnx:'sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:7600 E Doubletree Ranch Road _ Garbage disposal 25.02 City/State/ZIP:Scottsdale,AZ 85258 Hose bib : 25.02 Phone:(602)694-4031 Fax ( ) Ice maker 12.51 :h :'=.' = _,4,--: - -f:1Y: r:,,.4 �� e� 25.02 Business name:William Lyon Homes,Inc Medical gas(value:S ) Page 2 Primer ; 12.51 . Contact name:it.`j Gh tD12 Address:'"163 2)11)040400C1-1-sk-�v(_1•-� - 0 ' 1 � '�y 2 12.51 02 City/State/ZIP:Vancouver,WA 9840 Solar units(potable water) 62.54 Phone:(360)695-7700 i Fax::(360)643.4442 Tub/shower/shower pen 12.51 Urinal 25.02 E-mail: i / \ ]l ♦ Ok r\V CO . ,.-u Ty_ •q;•;• 1-7..^err 81 r�! '"'.." fi t- 8':,: Bier closet } 25.02 . Water:heater 37.52 Business name:Alliance Plumbing LLC Wer plping/DWV 56.29 Address:146 W Historic Colombia River Hwy 'Other 25.02 City/State/ZIP:Troutdale,OR 97060 Subtotal ' Phones(503)492-3490 Fax:(503)912-6438 Minimum permit fee: $72.501 CCB Lic.:184601 Plumbing Lie no.:P8732 Plan review(25%of permit fee) AState surcharge(12%of permit fee) , Authorized signature: • TOTAL PERMIT FEE Print name Robert Dishonor ' Date 5/23l'016 T -pennititpprtcaliast=Pints iia parrot ht not obtained within ISO days after ithas been mewed asteaspkoe. *Fee methodology set'by Tri-County BuMiug industry Service Board. 1.1Bullan PamfalPL U.Pe nutAppdoe IUIWllw 440.4616T(10/621COM!wEB) City of Tigard : ~ COMMUNITY DEVELOPMENT DEPARTMENTI C T r A D` Building Permit Review — Residential Building Permit #: f/kt ST U/7—,0(�3' Site Address: / c6c) ) AeR-71,4_ i-e Project Name: / ' .e ,e . , , T Lot #: (New dwelling=sub. vision name;Addition or Alteration=last name of owner) Planning Review _Proposal: AJ t./ , le- 441_ j lL at (77),k )LiYl_IL ) �erify site address/suite# exists and active in permit stem. River Terrace Neighborhood: ❑ No qd Yes,See River Terrace Review Addendum Attached Sit/Plan Elements: Phree(3)copies of site plan 0 Asting structures on site e plan must be on 8-1/2"x 11"or 11 x 17"paper 7 Footprint of new structure(including decks)with finished OpKawn to scale(standard architect or engineer scale) oor elevations • orth arrowtility locations&easements(required for new and additions) • e address,project or subdivision name and lot number Sidewalk/driveway approach Pi plicant information(name and phone number) Oaation of wells/septic systems vep •t dimensions and building setback dimensions ,U!: sting trees to be retained with drip line,and tree 4 Pti are footage of buildings to be demolished . rotection measures A Lot area,building coverage area,percentage of coverage and J treet tree size,type and location yripervious area(applicable if R-7,R-12,R-25&R-40) Street names Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? Oa Yes 0Np 4 foot differential) If yes,is a storm water .uality facility sho ? , ❑Yes I f o / ��7 i1 can Water Services—Service Provider Lett (lot platted prior to 9/10/1995):4"rdbY`- ink '�T 6(�_ 'equired: ❑ Y ,applicant was notified No Received: ❑ Yes ❑ No ¶4 " Public Faciliti s Improvement(PFI)Permit: PF/ b - ,C�—Cyd / Required: Yes,applicant was notified ❑ No Applied For: UZI Yes ❑ No,stop intake Vnd Use Case#: P-Q—OieP—?Dot)ii �! 2 /NJLe ` `�)�, .Z�e_O/S' i)'-)�p oning: g— .QS (pi) _ C • Required Setbacks: Front Rear Side 0 � Street Side , Garage o2 0 �, andscape Requirement: ( ot Coverage Maximum: Re) Mii /Building Height: Maximum Height PP- Actual Height ;Visual Clearance 7 it ensitive Lands: ❑ Yes Lid No Type ffa Urban Forestry Plan ❑ Conditions "��M�, Jbs " rior to issuance of building permit Notes: a -S42^ /> d ./d'l.o l f�4 /4- / _c-G,l y1G(,, Approved By Planning: --- Date: g/ 1 / --- 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 i. Original Submittal Date: Vi //, Site Plans: # Building Plans: # Building Permit#: \, nter building permit#above. Workflow Routing: lir Planning Engineering Il.-Permit Coordinator Building Workflow Sign-off: I' Sign-off for arming(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. 17' Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: '441/;% Date: E2)--(-///� Engineering Review Elope at building pad: 7 ❑ 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 No Assess Water Quantity Fee in-lieu: ❑ Yes No LIDA Facility on lot: ❑ Yes —0- No ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: v L DO k Date: q s- 17 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved __ Revision 2: ❑ Approved ❑ Not Approved Revision 3: 0 Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit �� pproved,NOT Released: ��%,' "ate: /i 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: < DC Fees Entered: Wash Co Trans Dev Taxes 0 N/A Tigard Trans SDC: ?"'‘i( Yes ❑ N/A Parks SDC: Yes ❑ N/A LIDA ❑ Yes 1'/A 0 if,I K to Issue Permit pproved by Permit Coordinator: Date: J�,2) )7 1) I:\Building\Forms\BldgPennitRvw_RES 061417.docx City of Tigard IIICOMMUNITY DEVELOPMENT DEPARTMENT T AR River Terrace Building Permit Review Addendum Building Permit #: _ Site Address: , A) //L9 / /-e_ Project Name: /2/lies-- - '0C--e - g-Y--. Lot #: c (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review of River Terrace Plan Distri<t Design Standards (18.660.070.7.): Is the project subject to the plan district design standards? In Yes ❑ No 1.Articulation: a minimum of 1 element per each street-facing facade that has 30-60 ft. of frontage.An additional element required for lots with over 60 ft. of street frontage shall be provided every 30 ft. Balcony w/access 2 Window Projection Vertical Wall Offset a Porch min. 5 . deep ft. de- min. 2ft., 5 ft.wide min.2 ft.,6ft.wide Gabled dormer vilt yrilt 2. Eyes bn the street: a minimum�/off 12%of h street facing façade must include windows or entrance doors. Percentage Shown: —y7j29�-: /eao / }^. ar- /60 3. ntrances:At least one entrance must meet both of the folio ;ng standards: II Parallel to street,angle no more than 45° from street, Max. 8 ft. setback from longe street- facing wall or open onto porch Entrance opens to a porch: Yes ❑ No If yes,all the following apply: 2�tf sq.ft. min. ful ne street facing entry �/ ft.max.roof above floor of porch ft. depth min. 30%min.porch roof coverage 4. t etailed Design:All buildings shall include a min. of five of the following elements on all street-facing facades: tI Covered porch min. 5 ft.wide x 5 ft. deep- ❑ Recessed entry area min. 5 ft.wide x 2 ft. deep ❑ all offset min. 16 inches \,,� ❑ rmer min.4 ft.wide Roof eave min. 12 inch projection'��'" oof offset min. of 2 ft. ❑ Roof shingles either tile or wood it Gable,hip or gambrel roof design ❑ goof pitch oriented south min. 500 sq. ft. ❑ . .rizontal lap siding min. 3-7 inches wide Accent siding min.40%of street facade/ iIE Window trim min. 2'/2"wide by 5/8"deep ' ` ❑ Window recess min. 3 inches for all street facing ❑ Bay window min. 5 ft.wide by 2 ft. deep ❑ Balcony min. 5 ft.wide x 3 ft. deep with inside access ❑ Attached garage is 35% or less of street facade 5. Garages and Carports:May face the front or side lot line on a corner lot. Setbacks: No closer to front or side lot line,than longest street-facing wall. ❑ Yes No. If No (Check one): ❑ I�llay extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch. 4� ay extend up to 5 ft.where the garage is part of a two-story building and there is a window at the second story above the garage that faces the street with a min. area of 12 sq.ft. Wi. : (Check one) 12-foot-wide garage door ❑ 40%max. of street façade ❑ 50%max. of street facade with 7 detailed design elements Notes: Approved By Planning: = y c' 4,-;17, Date: 312. I:\Building\Forms\B1dgPermitRvw_RES_RT_062216.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 711 Transmittal Letter e T I ;A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Tom H. DATE RECEIVED: DEPT: BUILDING DIVISION FROM: Nichole Thorpe NU V 1 4 201? COMPANY: Polygon Northwest y1`Y u••. ! !?-:;-PWc, PHONE: 360-989-40204 By: RE: 13367 13359 13347,13341 SW 169TH (Site Ado-• 11 ermrt um er River Terrace East het-1-4 L c* Z M 5 7 2_0k1 00333 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: , Description: Copies: Description: 0 Additional set(s)of plans. 3 Revisions: Bulletin, Plan Sets 0 Cross section(s) and details. 0 Wall bracing and/or lateral analysis. 0 Floor/roof framing. 0 Basement and retaining walls. 0 Beam calculations. 0 Engineer's calculations. 0 Other(explain): REMARKS: Please pay fees owed with Trust Account. Adding 3rd Bathroom Option FOR OFFICE USE ONLY Routed to Permit Technician: Date: p.,— J `f — j77 Initials: Fees Due: 0 Yes ❑No Fee Description: ,Amount Due: 1 . )ir P).,, �',v; .,,� $90 v $ $ $ Special Instructions: Reprint Permit(per PE): ►4 Yes ❑No n Done Applicant Notified:/VEC ,c.c Date: /2 ty/j 7 Initials: I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13359 SW 169TH AVE, BEAVERTON, OR, 97007 October 24, 2018 at 11 :51 :35 AM Record Type: Record ID: Residential - Master Permit MST2017-00333 Inspection Type: Inspector: 199 Electrical final Jeremy Burrows Result: PASS Comments: Corrections completed Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13359 SW 169TH AVE, BEAVERTON, OR, 97007 October 24, 2018 at 3:14:38 PM Record Type: Record ID: Residential - Master Permit MST2017-00333 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 Plumbing Permit Applicatloltl ,,A, t ' 1 Building Fixtures FOR OFFICE USE ONLY 3 illCity of Tigard t3 6 't� Received 13125 SW Hall Blvd.,Tigard,OR 97iZ23. e Date/By: "Z 7 ��' 1 Permit N Ill Phone: 503.718.2439 Fax: 503.59k1960 Plan Review �1 ` TIGARD Inspection Line: 503.639.4175 Date/By: ry��ji /�LC,*7 Other Permit No Internet: Line gard-or..41 • I" '. ' ;`' Date Ready/By: Juris Notified/Method: TYPE OF I SuppleSSeemPageental2 Informationfor FEE* SCHEDULE ®New construction 0 Demolition For special information use checklist ❑Addition/alteration/replacement Description Qty. Ea ❑Other: . I Total New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 _® I and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 0 Accessory building ❑Multi-family SFR(3)bath 500.32 0 Master builder Each additional bath kitchen 25.02 0 Other: JOB SITE INFORMATION ANI) LOCATION,' Fire sprinkler(L221 sq.ft.) 6-1¢...--- Page 2 Site utilities: Job site address: 13359 SW 169T"Ave Catch basin or area drain 18.76 City/State/ZIP: Tigard,OR 97223 Drywell,leach line,or trench drain 18.76 Suite/bldg./apt.no.: I Project name:River Terrace East Footing drain(no.linear ft.: ) Page 2 Cross street/directions to job site: Manufactured home utilities 50.03 Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.:_) Page 2 Subdivision: Water service(no.linear ft.: ) Page 2 I Lot no.:2 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION Off'WO Backwater valve 12.51 Multipurpose Fire Sprinkler System Clothes washer 25.02 Permit# MST20l7- 00;S3 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 r4® PROI'E12TY OWNER " 'TENANT Expansion tank 12.51 Name:Polygon Northwest Fixture/sewer cap 25.02 Address:703 Broadway St.Suite 510 Floor drain/floor sink/hub 25.02 City/State%LIP:Vancouver,WA 98660 Garbage disposal 25.02 Phone:(360)695-7700 Hose bib 25.02 Fax:( ) Ice maker 21 APPLICANT 12.51 ©'CONTACT PERSON Interceptor/grease trap 25.02 ) Business name:Alliance Plumbing,LLC Medical gas(value:$ Page 2 Contact name:Gavin Thomes Primer 12.51 Address: 146 W Historic Columbia River Hwy Roof drain(commercial) 12.51 City/State/ZIP:Troutdale,OR 97060 Sink/basin/lavatory 25.02 Solar units(potable water) 62.54 Phone:(503)492-3490 I Fax::(503)912-6438 Tub/shower/shower pan E-mail:Gavin@AlliancePlumbing.net 12.51 Urinal 25.02 CONTRACTOR Water closet 25.02 Business name:Alliance Plumbing,LLC Water heater 37.52 Address: 146 W Historic Columbia River Hwy Water piping/DWV 56.29 Other: 25.02 City/State/ZIP:Troutdale,OR 97060 Phone:(503)492-3490Subtotal Fax:(503)912-6438 Minimum permit fee: $72.50 fee) CCB Lic.:184601 /1/4Plumbing Lic.no.:PB732 Plan review (25%of pe Authorized signature: / �y ���/ l State surcharge(12%of permit fee) ( Print name:Gavin Thomes i►"�� I TOTAL PERMIT FEE Date:2/5/2018 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Qty Fee(e$ 'Total Square= nota e: Permit Fee: Site Utilities oto 2,000 $121.90 Footing drain 15'100' 50.03 2,001 to 3,600 $169.69 Footing drain-each additional 100' 37.52 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 Valuation: Permit Feet 62.54 Minimum fee$72.50 Storm&Rain Drain-1st 100' $1.00 to$5,000.00 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 Fee(ea) 'Tota! Other Inspections off, ,ees Qty, 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 90.00/hr each additional$100.00 or fraction thereof,to which no fee is specifically indicated and including$25,000.00. (minimum chargeutsie 1/2fhour) 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 each additional$100.00 or fraction thereof,to Nouns(minimum charge 2 hours) 90.00/hr and including$50,000.00. Reinspection Fees 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 each additional$100.00 or fraction thereof. (minimum charge-1/2 hour) Subtotal: Other Fixtures: I I I 1 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 , Replace/ Plan Review for Plumbing Installations Fixture Type for capped Added Relocate Work Performed: Plan review is required for any of the following. Baptistry/Font Please check all that apply. Bath -Tub/Shower 0 Any new commercial building with water service 2"and -Jacuzzi/Whirlpool Car Wash -Each greater,except systems designed and stamped by licensed Stall engineer. -Drive o ❑ New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspiratorr ❑ as defined in OAR918 780-0040. Dishwasher -CommercialMedical 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. -4>' Car Wash Drain Isometric or Riser Diagram Garbage -Domestic-non-food ❑ Isometric or riser diagram is required for new buildings Disposal -Domestic-foodmeil-frelatedd related that meet the qualifications above. -Commercial-food -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 Washer-Clothes *Note: If the fixture work under this permit results in an Water Extractor Closet-Toilet increase of sewer EDUs,a sewer permit will be issued and Water fees assessed for the sewer increase must be paid before the Urinal https://allianceplumbing-my.sharepoint.com/personal/gavin_allianceplumlIng_net/Documents/Documents/Fire Sprinklers/RT/City of Tigard Permit.doc Electrical Permit Application a g. , ,-IIIIIIIIIIIIIIIIZMIIMIIIIIIIMI City of Tigard i-4 h t"o .17 i ' " aer ived �' ,,�/, 7 13125 SW Hall Blvd,Tigard,OR 97223 2 `$Y �!� //� PM 7'�'/lj�.Zr')I �l>J of Phone: 503.718.2439 Fax: 503.598.1960 J U L_ ri 2 018 Yg tew Related Permit 0: for i„.1��t 1 :? Inspection Line: 503.63 9,4175 Intranet Wwwtigard-or,gov 11 Lir a' fin' '; 7 n 2 Information r a , , Sappierree tak tnf 1. New constructionp�� 0111,111-- ° � w,t .,. �� : .. ;M[€Addition/alteration/replacetttentcheck all that apply(submit 2 sets of plans ve/items checked): ❑Demolition Other; ❑Service or feeder 400 amps or more 0 Building over three stories. ❑ 4. -. where the available fault current 0 Marinas and boatyards, ;.. ;eAYa j:< .s�' e `f—< ;), exceeds 10,000 ampsat 150 volts or i and 2-family dwelling 0 Commercial/industrialexceeds ❑Floating buildings. 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural Other amps for all other installations. buildings. 2QMulti-family 0 Master builder KVA or , gA s t 0 a , �t�', ' c ❑Fire pump. 0 largeinstaseparatelyation f I SO rived ❑Emergency system. larger derived Job#: 1 rob site address: i 3361 St.) 1 ❑Addition of new motor load of system. L i� I�V � IOOHP of more. 0"A'•"F'"1-2","1.3", City/State/ZIP: 3-4.poi- El Sir or more residential units. oc.upancy. ❑Health-care facilities. ❑Recreational vehicle parks.Suite/bldg./apt.# Prject name: ' r%-1- f7_V.evL^- ❑Haratdotas beim ns. 0 Supply voltage for more than Cross street/directions to job site: 1� _ , ❑Sets ice or feeder 6O0 amps or more. 600 volts nominal. �� Via' IDivI,_..Each rent (: Subdivision: New residential single-or multi-family dwelling unit. 'f< Qt#�;2 {1Lck�-,E 1 Lat#: 2, Includes attached garage. Tax map/parcel 9: 1,000 sq.R,or less 68.54 4 �� tae) �. r :.; v� Ea.add S00 sq.ft.or portion 133.92 1 C/� ''i.; . . • Limited a nergy,residential i d KI'rn./Af GK�sC.F (with above ui,t1.) 75.00 2 Limited energy,multi-family residential(with above sq.0.) 75.00 2 j ."71 z as s `" Renewable En _: 1. Sea Pae 2 s�';�$ Sei•vit�cs ar feeders installation,altertion,sudor relaxation Name: ADA(L LAr,.l,b 1-b LA i.i,C.s 1 LL C. 200 amps or less 100.70 1 2 Address: .71D C)Q f.—. " ie. E. IR—ES 12 „ A ' 201 amps to 400 amps 133.56 2 ' City/StatelZlP: Se—OTT—OTTS �7 _Vt K-u 401 amps to 600 amps 200.34 2 E) Z 2 8 660 601 temps to 1,000 amps 301.04 2 Phone;(402) ( q Lit..-4.403 1 I Fax:( ) Over 1,000 amps or volts 552.26 ' 2 Email: Temporary services or feeders installation,alteration,and/or 1 Owner installation:This installation is beingmade on propertyrelocation o that I own which is not 200 amps or less 59.36 J 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.. _.-, - o`i _ 'i 1r.°* 77-‘7, �. �, � a � � � BrFfocr ibrcanuicEhs—inws lter atlan.or extension,per panel Business name: .`u�� 141 64.e. J �,y�,, tL „e, above service orfexder fee, 7.42 2 branch circuit Contact ;J 1 CA At-J.1/4 Cli B.Fee for branch circuits without Address: J ct f4s T I Nnt Sr. branche circuit or feeder fee,first 56.18 2 brunch City/State/ZIP: Vih.le OL Vf1/L X 98 �O I _loC) Each add't brunch errant 7.42 2 Phone:(1503) 514 [� 1 ::( ) Miscellaneous(service or feeder not included) T Each manufactured or modular Email: dweliin service and/or feeder 67.84 2 "L»m ., ► iC can no •e • e% • .COiffl Reconnect only 67.84 2 ��1' 1`:41P-:.,r aa e iso Business name:Three Phase. Electric gip'air u'rigation circle 67,84 Sign or outline lighting 67.84 2 Address:11490 SE Jennifer St Signal circuu(s)or limited creep e 2 - 0 See P panel,alteration,or extension. 2 CirytStatelZlP:Clackamas,OR 97015 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(503)908-50558 I Fax:(503)762-1823 Investigation(1 hr min) 90.00/hr Email:permitsOthreephaseelectric.cpm Industrial plant(I tit min} 78.161 hr CCB Lie162368 1 Electrical Lie.: 3-332C I Supiv,Lic.: 3398S Inspections for which no fee is 99.00/hr spectficall hated i4 hr rain Suprv.Electrician signature,required: L,1,,, ,t, e' ';'-...40i, ti` '20.'4';- ,:•:11:.,i',.;t s tap 7� ” Subtotal: Print name: Dennis Welch I Date: 0 Plan Review Required(25%of permit fee): State surcharge(12%of pemut fee): Authorized signatu TOTAL PERMIT FEE; Print name: Gail Evans This permit applIcater expires if an r volts as complete * Number of inspections allowed per permit. l:iaritdir .Pacaits'ELEJcrautApp_ELS ERE.clot Rev oe 17,2015 446-46151111 ES,COMAVEB