Permit (97) CITY OF TIGARD MASTER PERMIT
COMMUNITY DEIll
VELOPMENT ---'----------- ------Permit#: MST2018-00217
T"f c;A l L) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/18/2018
Parcel: 2S104AD07200
Site address: 12980 SW PARKDALE AVE Jurisdiction: Tigard
Subdivision: OLSON WOODS
Project: Olson Woods, Lot 8 Lot: 8
Project Description: New SF.
BUILDING
Stories: 2 Floor Areas Required Setbacks
Bedrooms: 4 First: 1789 sf Required
Height 27 Bathrooms: 3 Basement: 1202 sf Left 5
Second: 0 sf Parking Spaces: 0
Garage: 540 sf Front
Dwelling Units: 1 20
Third: 0 sf Smoke
Right 5 Detectors: Yes
Total: 2991 sf Value: $389,966.65
Rear 15
PLUMBING
inks: 1
Water Closets: 3 Washing Mach: 1
Laundry Trays: 1 Rain Drain: 1
Lavatories: 5
Dishwashers: 1 Floor Drains: 0 Urinals: 0
Tubs/Showers: 4 Sewer Lines: 100 SF Rain Storm Sewer
Garbage Disp: 1 Water Heaters: 1 0 100
Footing Drain: 0 Water Lines: 100 Drains:
Ice Maker: 1 Hose Bib: 2 Bckflw Prevntr: 0 Catch Basins: 0
Backwater Value: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N
Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N
Furn<100K: 1 Hoods: 1 Other Units: 0
Vents: 0 Woodstoves: 0
Furn>=100K: 0 Gas Outlets: 5
ELECTRICAL
Residential Unit
Service Feeder Temp Srvc/Fers
1000 sf or less: 1 eedBranch Circuits
0-200 amp: 0 0-200 amp: 0
Ea add'I 500 sf: 6 p W/Svc or Fdr: 0
201-400 amp: 0 201-400 am : 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 p W/O Svc/Fdr: 0
401-600 amp: 0
601-1000 amp: 0 601+am -
p 1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N
Security Alarm: N Vaccuum Stem: N
Other: N Other Description: y Garage Opener N All
Ecompasing: Y
Class of Work:
BUILDING INFO
Type of Use: Type of Constr:
Occupancy Group: Square Feet:
NEW SF VB
Owner: R_3 2991
Contractor:
WINDWOOD CONSTRUCTION INC WINDWOOD CONSTRUCTION INC Required Items and Reports(Conditions)
12655 SW NORTH DAKOTA ST 12655 SW NORTH DAKOTA 1 Geo Tech Required Prior to
PORTLAND,OR 97223 TIGARD,OR 97223
Pour
2 Ersn Cntrl 503-639-4175
PHONE: PHONE: 503-625-6526
FAX: 590-7606
Total Fees: $33,336.60
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 I- requires you • follow the rules ado. -d952-001-0010 through OAR 01.009 / by the Ons egonto OC Utility Notification Center.187Those rules2are set forth in OAR
'r 0
ou m-�btain a co.'of the rulerr direct a estions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: i L AI AAA ALI r
1 �/ Permittee Signature: '�'�}"'^'-•.—
Call 503.639.4175 by 7:00 a.m.for the next available inspection a e.
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 RE �
'^-d FOR OFFICE USE ONLY
Residential !t N�S ��f— t��.�
Received
Air
City of Tigard Ah1(a to 2.018 Date/By: 0 /� 0
a 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Q/� " Other Permr'�! f,�'��i���/s"
s 114
Phone: 503.718.2439 Fax: 503.598.l & t {_ [y DateBy: VI p See Page 2 for
1, O T ARD Date Ready/By: ` Juris
Inspection Line: 503.639.4175 Notify./Method: // Supplemental Information
IIGARD BUILDING IV!c10'.
Internet www.tigard-or.gov If ir�
x ��4�Y x FAY
=P': 'Pa.,r � Y� - � �
�, � � +P
Permit fees*are based on the value of the work performed.
New construction ❑Demolition Indicate the value(rounded to the nearest dollar)of all
El AddAddition/alteration/replacementOther equipment,materials,labor,overhead,kid gthe pro it or the
work indicated on this application. l
1 CI
� ' : ., . 2. . max'; , $ t }44 , 4 „ -re Valuation:
J211-and2-family dwelling ❑Commercial/industrial y
Number of bedrooms:
❑Accessory building 0 Multi-family 3
Number of bathrooms:
❑Master builder 0 Other:
�s . ,§ Total number of floors:
tri2,___ '. 53t—
' ' � �� _� �`' *� fig, � _ New dwelling area: � fill., square feet
Job site address: / 9 is pfrte,o,4'�" 1_19,9
_ �t Z Garage/carport area: d) square feet ! 7
City/State/ZIP: T� 17 l square feet
Project name: 41 S Covered porch area: ��`� q off-0
Suite/bldg./apt.no.: J �j�-5'O wdU'd J,� square feet
Cross street/directions to job site: `,(�,��/ /k
Deck area: ll
Pitt we ` om,4 /r� (-- l. -�• {?;-,-t If r� ,7`(/
4:- Other structure area qii square feetDU
Co
YTd/ l us t xs
pc2(04, P77 " ' I Lot no.: Permit fees*are based on the value of the work performed.
Subdivision: "l „t , } 00 h ,EIndicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
. work indicated on this application.
to ._ Valuation:
Existing building area: square feet
New building area: square feet
' , f k , kk , s = :r 0 4,0,-,., ,,,,,,, Number of stories:
t�� k ��"m= w 'x Type of construction:
Name: Gt,j1iv4 u1 ov,O Codi/7 .,l/",C...c 4-7 Occupancy groups:
City/State/ZIP: 7
Address: / rte. .5� S u-' , r'0, .T/t / &i p , 5„/' -',4-
� � ' Existing:
j.,„--,,,,,,,,,,t,,:',„„:) e),,,,,,,-2_,,z: r� �"fi"`""`t
Phone:(,, 4 7,16 /f3 2c--- Fax (`�" ) S 'f , " ;6.a L New
� r, � �' �
*cam Y" � "` ,' '� .. , . , ` J--
Business name: . 4 ' Structural plan review fee(or deposit):
"--- `�....::.) FLS plan review fee(if applicable):
Contact name: ""--- /IL./z: C�/ -'�
Address: Total fees due upon application:
City/State/ZIP: Amount received: .�
Phone: 7/5) 7,6a 75— I Fax::( ) 9,i- -A,„:„..)
OTO*
14 *,. $
E-mail: r.,://1 dU./c?0:17/Cy,'e" ✓ e ./11 r.t / / 4) y Commercial and residential prescriptive installation of
�',.t i t$` y ete ^'t „ i ' ' roof-top mounted PhotoVoltaic Solar Panel System.
Business name: k)_Tr/13(N OQL3
Submit two(2)sets of roof plan with connection details
/✓S and fire department access,along with the 2010 Oregon
Solar Installation Specialty Code checklist.
Address: L Permit Fee(includes plan review $180.00
City/State/ZIP: and administrative fees):
Phone:( ) I Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: 6a/ y 4. Total fee due upon application: $201.60
---- This permit application expires if a permit is not obtained
Authorized signature: ''"."---- within 180 days after it has been accepted as complete.
/ *Fee methodology set by Tri-County Building Industry
,pry / Date: �' d f yi Service Board.
Print name: /✓ /0/1 /2 / ';`4: p--- /
I:\Building\Permits\BUP-RESPermitApp.
doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLY
Received
City of Tigard Date/By: Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223
g Associated permits:
1 Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
T I G A R D Internet: www.tigard-or.gov
0 Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. Et ❑ 0
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. la 0 0
3 Verification of approved plat/lot. a 0 0
4 Fire district approval required. Name of district: Et ❑ 0
5 Septic system permit or authorization for remodel. Existing system capacity . 0 0 2
6 Sewer permit. 12 0 0
7 Water district approval. 21 0 ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ 0 2
9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- „0" ❑ 0
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state kr 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 2 0 0
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, Q' 0 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- J2 El 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
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- ET 0 ❑
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 2t" 0 0
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ 0'
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 j2" 0 0
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. 12 ❑ ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required Z1 0 0
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 E ❑ ❑
architect licensed in Oreton and shall be shown to be a••licable to the •roject 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. ❑ El
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ 0 0
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ I
27 "Drawn to scale"indicates standard architect or engineer scale. 2' ❑ ❑
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 12" ❑ ❑
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 8 ❑ ❑
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, ❑ ❑ 2'
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:ABuilding\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
1 4
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received
. il 13125 SW Hall Blvd.,Tigard,OR 97223
II Date/By: Permit No.:
I
Plan Review
I Phone: 503.718.2439 Fax: 503.598.1960Date/By: Other Permit:
Inspection Line: 503.639.4175
TIGARD Date Ready/By: Juris: El See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TTITE.'OF'WORK ' •' ,,' • - ' . '.•- 2' 0 COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
ew construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY oir'eoirsriiii-eTioli ----
-- ,- .-.. -'• ,. RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
)21-1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
0 Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOW-SITE.INFORIWATION'AND LOCATION, -, -
. ,,„--;,,-',. , . -: • :-,0,-, -0„, • ,-00.•-0 • 0 ' ' Heating/cooling:
Air conditioning 46,75
Job site address: //.14 t ' RA-14 4 Az,,,..- „Z.4.11/10*-/— Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 74L/2„6:) (9/e.Z---- (.?" Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: ^"'),,(::-.)-0,0..i ',,..„,,,, i 0 4..„/_.„
Duct work 23.32
Cross street/directions to job site: /A//I . /;:,,: 1- Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Other: 23.32
Subdivision: Lot‘;'' ! / :<:)(--37:-) S Lot no.:e
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32•
;,-•',T.,-`:r:','.:.:-,:':,"' ,-- ,,. .; , '-',-,,DESCIiIPTION OF WORK_ .• `0 ' Gas fireplace/insert 33.39
Flue vent for water heater or gas
/s . 1' ) '''''''' 1- '''`7 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
-;:..a', ,,, H1)iSERT11:OWNER. 0 - - 0 - 0--TENANT'
-- - ;..-- • - • ' ' Environmental exhaust and ventilation:
Name: Z/1/-2741 Si CA-Jj J/) ,-',/,4 _. ,-/ ..` ./ - Range hood/other kitchen
equipment 33.39
Address: /; .` ,..'-',--- '., / ; -1/ , ,' ,' ` ,'"/ Clothes dryer exhaust 33.39
City/State/ZIP: /:I-6/94:/___,) cjz-/z_:"..7 c?"--2,...,),3--.) Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:CI -7) -7,-,..]:„..2 - .:-._ `2) '-'2':',-- Fax:(5 ') .379o—,76(..) - Attic/crawlspace fans 23.32
'->lErATI•ptic'ANT ' - -- 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name: --) ,,,:;;41r-
$14.15 for first four;$4.03 for each additional
Contact name: /7/49;.Z ,,,,,/:-.: 72i1(<,,,/W /03 Furnace,etc.
Gas heat pump
Address:
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace
Range
E-mail: tot A ci,„06,t,i/i0A1,,---.E.,,,A..--,,, ,_-_,„"7",. (:,1141„,..,; , /0,7041 Barbecue
,-,CONTRACTOR.:. • . - - , Clothes dryer(gas)
Other:
Business name: ,t--", 44)„./.:-"--
MECHANICALPERMIT FEES*
Address: Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
----7j/ /6 TOTAL PERMIT FEE
CCB lie.:
This permit application expires if a permit is not obtained within 180
,.....-___ days after it has been accepted as complete.
Authorized sign
* Fee methodology set by Tri-County Building Industry Service Board
Printname:,27,---„../e-
' Date:IVA/Ai3
I\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(]1/02/COM/WEB)
•
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESID& AL Why '�� ONLY: FEE SCHEDULE
Fee for all residential systems combined: $75.00 DescriptionQty. Each Total
y 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
❑ Garage Door Opener*
>100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
Fl Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
7/Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(%2 hr min)
ELECTRICAL PERMIT FEES
COMMERCIAL'W(IRK ONLY: Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00 * Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ 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\ELCPermitApp_ELR_ERE.doc Rev 06/17/2015
•
Electrical Permit Application FOR OFFICE USE ONLY'
City of Tigard • ReceivedDate/By: Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
5 Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
TIC A R D Inspection Line: 503.639.4175 Date Ready/By: Juris ® See Page 2 for
Internet: www.tigard-or.govv. ..tp `.., Notified/Method:
Supplemental Information
, , ,. x � , ;:i® ": i f',1:',..1,;, ...'.,,!...', .' Za 6 .)"Mati# a � r1 .p�x ,�EW :
Please check all that apply(submit 2 sets of plans w/items checked below)construction ❑Addition/alteration/replacement fII
0 Service or feeder 400 amps or more 0 Building over three stories
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
"` "' t x4? r exceeds 10,000 amps at 150 volts or 0 Floating buildings.
`-N, less to ground,or exceeds 14,000 ❑Commercial-use agricultural
and 2-family dwelling 0 CommerciaUindustrial 0 Accessory building amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or
..: 4 :,„4„..,4,,,, ❑Emergency system. larger separately derived system
..40 o r Y Q ? a r ,6,4 , ❑Addition of new motor load of ❑"A","E","1-2' "1-3"
/�/ , I OOHP or more. occupancy.
Job no.: Job site address/460 � i4�, tJT�r/ ❑Six or more residential units. 0 Recreational vehicle parks
City/State/ZIP: t.,,,t-‘1100 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: " C'Jel G1 ❑Service or feeder 600 amps or more.
" 7a SCtl
EDLO,
Cross street/directions to job site: L{, &ifja,f Description I Qty. I Fee. I Total I •
New residential single-or multi-family dwelling unit.
Includes attached garage. ,
Subdivision: Q/.5d Gtr cc/as Lot no.:b 1,000 sq.ft.or less 4' 168.54 4
Ea.add'1 500 sq.ft.or portion 33.92 I
Tax map/parcel no.: Limited energy,residential
eta 5i' `g `'. yl „� (with above sq.ft.) 75.00
Limited energy,multi-family 75.00 '
ti../ !' residential(with above sq.ft.) -
Services or feeders installation,alteration,and/or relocation
200 amps or less 100.70 -i
$00, 09:W 'A "" P, 201 am s to 400 ams 133.56 ,
Name: ,O i„�p� COAST. �C 401 amps to 0 amps • 00.34 2
601 amps to 1,000 amps 301.04 2
Address: �i ‘ s pia i 7/1 /) A'#J6,074.4t:,-,,‘7 Over 1,000 amps or volts 552.26 2 ,
,Egr,4 . 0 ,,., 9 aTemporary services or feeders installation,alteration,and/or
City/State/ZIP: fig' relocation I
Phone:(53 -20a_L/32 Fax:(9/3)5`790-."7a6 200 amps or less 59.36 I
201 amps to 400 amps 125.08 2
Owner installation:This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701.
Branch circuits-new,alteration,or extension,per panel
Owner signature: Date: A.Fee for branch circuits with
, :a above service or feeder tee,
,',44,11".4g6;•,,, �-,,a:s s :. > ..I �-s�o .. .. �. ,tr ` each branch circuit 7.42 2 P'., x. .jet x+°,.
Business name: �!/r)C B.Fee for branch circuits without
service or feeder fee,first 56 18 ,
Contact name: Vn,4_ /2i-2/,' branch circuit
Each add'I branch circuit 7.42 2
Address: Miscellaneous(service or feeder not included)
Cil'/State/ZIP: Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Phone:( ) Fax::( )
Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E-mail: (.t✓n./.44,..r04y,O %)55'6'/.t °',/}o 4 / 31 3 2-
yy''��((��``qq•• /�'e� �'`'"" µ., ,�j� }, Sign or outline lighting 67.84 _ i
•^. ° .il•K(Y, x7.,�:J�,""� ig �.Crb 4"„"3"',1 Kr} ;:::X of T ;: 1
. .a. �..,a Signal circuit(s)or limited-energy
Business name: DreamHouse Electric,LLC panel,alteration,or extension. Page 2 {
Each additional inspection over allowable in any of the above
Address: 221 SW Moonridge Place Additional inspection(I hr min) 66.25/hr
City/State/ZIP: Portland,OR 97225 Investigation(I hr min) 66.25/hr
Phone:(503) 519-6711 Fax:(503)648-9723
Industrial plant(I hr min) 78.18/hr
CCB Lic.: 196726 Electrical Lic.: C-848 Suprv.Lic.: 4560S Inspections for which no fee is
specifically listed(Vs hr min) 90.00/hr,
Suprv.Electrician signature.required: :
' ' PlJumbing Permit Application
Building Fixtures FOR OFFICE USE ONLY
Received
i City of Tigard Date/By: Permit No.:
11 41 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By. Other Permit No.:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
.�. x t ' , WORK . >
Iew construction ❑Demolition For special information use checklist
Description Qty. Ea. Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
r h m' ',- _",x 7t`'; ..� %, SFR(1)bath 312.70
-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath v 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
t :1-11'
l "t t ri 1 ! ff� Site utilities:
Job site address: • Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
it f , 1,/'- c�,., 7L•) 7 ''
C" Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name:,,,,)/3//i ..,, Manufactured home utilities 50.03
Cross street/directions to job site: Ili f/;',,: if,'„,, ;, 7 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: /r, -"J,,,J ;21 ;,- ,.V X. `_ _ Lot no.:4) Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
.- �g ... Backwater valve 12.51
to ... 1 'e I' - iB es
,�'} ` �"� Clothes washer 25.02
71,,k7-6L) Ste-? Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
e � t .` s'< f.' ,; t,: "',❑77'7 777 Expansion tank 12.51
Fixture/sewer cap 25.02
Name: k/-LiU.. adJ3 (:::11:,„„- x orf/},'( Floor drain/floor sink/hub 25.02
Address: �/ 5 j .,S^Gv ,A..)0/''.7 A.> t.� ,, bs 11 " - ;.
Garbage disposal 25.02
City/State/ZIP: 7,_ ..,:;./1/2 :� L:9 1 =-'- 7,)..2.2-� Hose bib 25.02
Phone:( - ) 7e;a.--1/j7 Fax ("7,,,,',31,, ) �7�j-/1,,,, , Ice maker 12.51
¢ "�' t ` •i �� Interceptor/grease trap 25.02
Business name: Medical gas(value:$ ) Page 2
'`' r
12.51Primer
n !F " `� ' 'Contact name: r i `' ` , "
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
/ Urinal 25.02
Email:!, ,.,,�`fit d1 dl 1'' , ✓,."� '" :::,,,/,,,',,, 1` v�di'�
ra - ,, Water closet 25.02
F .: p1 y`7. sY
Water heater 37.52
Business name: iie,/ - d Water 1 m DWV 56.29
Pp
Address: j 0 `)j, 154, y' f 1� p Other: 25.02
Y/ 4�"w
City/State/ZIP: �sgg.�r,( j da ) rr( LI� Subtotal
( Fax:( ) Minimum permit fee: $72.50
Phone: % 3, r:
CCB Lie.: Caa 4"'/ �V/i „o,fad Plumbing Lic.no.36eZy196 Plan review (25%of permit fee)
/ / State surcharge(12%of permit fee)
Authorized signature: $'„It , ,,,/,,/ ?6i t 2 ) TOTAL PERMIT FEE
r,' This permit application expires if a permit is not obtained within 180 days
Print name: gr'C /-t 1."---571 Date: 9/0f i'6
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doe 10/01/09 440-4616T(10/02/COM/WEB)
City of Tigard
III N COMMUNITY DEVELOPMENT DEPARTMENT
C
T 1 A R o Building Permit Review — Residential
Building Permit #: A15 j / - ®Q 2/ 7
Site Address: \ i'CID SvJ Par c Le A-N,‹�
Project Name: D�sor V\f ryAS Lot #: 8
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: tJC f
"41 Verify site address/suite# exists and active in permit system.
.Ri River Terrace Neighborhood: J No Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
..k['hree(3)copies of site plan Existing structures on site
►Kite plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished
Si II rawn to scale(standard architect or engineer scale) floor elevations
North arrow ,Utility locations&easements (required for new and additions)
Site address,project or subdivision name and lot number *Sidewalk/driveway approach
►:r pplicant information(name and phone number) focation of wells/septic systems
R •t dimensions and building setback dimensions -A"Existing trees to be retained with drip line,and tree
Iquare footage of buildings to be demolished protection measures
►" of area,building coverage area,percentage of coverage and Street tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) .1>tiStreet names
roperty corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? 71No
foot differential) If yes,is a storm water quality facility shown? I No
Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified xi No Received: ❑ Yes ❑ No
'Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes,applicant was notified X.No Applied For: ❑ Yes ❑ No,stop intake
, Land Use Case#: a,)pj201Lf- 00060
V Zoning: -li.S
Required Setbacks: Front Rear IS Side ,S Street Side NO Garage 20
Landscape Requirement: 0/0
iV
.-� Lot Coverage Maximum: N
cyo
AS Building Height: Maximum Height ') Actual Height 2 7
rk Visual Clearance
Sensitive Lands: it Yes ❑ No Type L vJ rn re(-4- \t\U.C' 'wo -{-
O Urban Forestry Plan
W Conditions "Met"prior to issuance of building permit
Notes:
Alki Approved By Planning: Date: cl(p - , 0-
Revisions (after Building Submittal on1 Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPennitRvw_RES_061417.docx
Building Permit Submittal
Original Submittal Date: oe /,
Site Plans: #
Building Plans: # ,_,
Building Permit#: enter building permit#above.
Workflow Routing: [g-'Planning Engineering Cermit Coordinator wilding
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: +E Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: 1
By Permit Technician: L 1is�riirAa.....:__ Date: ce/V/cr---/
Engineering Review
0
KI Slope at building pad: , „S—
AConditions "Met"prior to issuance of building permit
'asements (encroachments) per engineering conditions of approval and plat
Water Quality/Quantity Facility: ,� �
Assess Water Quality Fee in-lieu: ❑ Yes LNo
Assess Water Quantity Fee in-lieu: ❑ Yes ,�
DA Facility on lot: ❑ Yes LSI'No
Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: rPrs Pt Q Date: 2/77/25
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:
C Fees Entered: Wash Co Trans Dev Taxes ❑ N/A
Tigard Trans SDC: IC, es ❑ N/A
Parks SDC: R Yes ❑ N/A
LIDA ❑ Yes N/A
K to Issue Permit /��J�/
Approved by Permit Coordinator: /�//l�O Date: /'7.--/ k
I:\Building\Forms\BldgPermitRvw_RES_010118.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
NI Transmittal Letter
u n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: /vh5,fo'1
DAtcrorer)
DEPT: BUILDING DIVISION
OCT 1 2018
FROM: CITY OF TIGARD
i WILDING DIVISION
COMPANY: 4)/1,`,�,�.cl69/(Q,;
PHONE: 3 7 By:4
RE: f) 9'if D Aa--/-4/t/® �f E' h/yt,7— /o - 6.0,217
(Site Address) '(Peermit Number)
( /-561.,1 Lir/Cil./1
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s)of plans. ��IFevisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS: _17, 60, wAr'7 '4'741 LSJch #C"3
2 - At7
i
FOR FFW .USE ONLY
Routed to Permit c clan: Date: t p ! S /'�i Jl4fr
Fees Due: e ❑No Fee Desc ' tion: ount Due:
$ Ot'�
C(Puil $ -
Special
Instructions:
Reprint Permit(per PE): E Yes / [] Done
Applicant Notified: Date: /l) l/.S—j Initials:
I:\Building\Forms\TransmittalLetter-Revisions_061316.doc