Permit (64) lyi . CITY OF TIGARD MASTER PERMIT
1 ' COMMUNITY DEVELOPMENT Permit#: MST2019 00016
TIARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/25/2019
Parcel: 2S112BD14300
Jurisdiction: Tigard
Site address: 7727 SW CORNUTT ST
Subdivision: ELDERBERRY RIDGE Lot: 39
Project: Elderberry Ridge, Lot 39
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1179 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 25 Bathrooms: 3 Second: 1447 sf Garage: 379 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2626 sf Value: $329,165.90 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
0
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 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 2626
Owner: Contractor:
RIVERSIDE HOMES LLC RIVERSIDE HOMES LLC Required Items and Reports(Conditions)
17933 NW EVERGREEN PL STE 17933 NW EVERGREEN PKWY 370 1 Ersn Cntrl 503-639-4175
370 BEAVERTON,OR 97006
BEAVERTON,OR 97006
PHONE: 503-645-0986 PHONE: 503-645-0986
FAX: 503-690-2942
Total Fees: $32,244.68
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty C es and all •her .pplicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of iss nce, or if w• k is uspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rul-: .pted by the Oregon Utility Notificatio Ce er. T ose les are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy oft-. direct questions to OUNC by calling 50 .232.1 87--or 1.:00.33 .2344.
Issued By: ��c ✓,r_ __ - Permittee Signature:
t
Call 3�}75 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
' Building Permit Application L( T 3'
-0 --
Residential FOR OFFICE LSE O\LI
i Received _
City of Tigard .''<k Date/By: 1` -) ‘G S Permit No. r��'j' 1q_ (t
1,11 . 13125 SW Hall Blvd.,Tigard,OR 9 223 Plan Review V4
= Phone: 503.718.2439 Fax: 503.598.1960. Date/By: 12/7 Other Permi � `C,—CCC\Ca
Inspection 503.639.4175 IA,N 2 9 2019
T I G�1 R D p Date Ready/By. i/��/�j�' Juris: See Page 2 for
Internet: www.tigard-or.gov tl t. �I a,/ No led/Method: ( 7 1\ I Supplemental Information
il-Y OF
❑✓ New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
''F ' ,` °€' 3I k ' S.7,..,7,,..1",-„„: work indicated on this application.
Valuation: $ zJ Zi J❑1-and 2-familydwelling 0 Commercial/industrial I
ElAccessory building ❑Multi-family Number of bedrooms: 4
❑Master builder 0 Other: Number of bathrooms: 3
a s &0.,i x r a a? 1;7,4 R „' Total number of floors: 2 3.b.a\
Job site address: 7727 SW Cornutt Ln New dwelling area: 2626 square feet 144-7
City/State/ZIP: Tigard, OR 97224 Garage/carport area: 379 square feet(11 9
Suite/bldg./apt.no.: Project name: Elderberry Ridge Covered porch area square feet
Cross street/directions to job site: SW Bonita Rd & SW 76th Ave Deck area: square feet
Other structure area: square feet
7; DATACOMMERCIAL-USE CHECKLIST,•
Subdivision: Elderberry Ridge Lot no.: 039 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
C s �` .1 1 t "'2.,,A4,11:0" ••° work indicated on this application.
Construction of SFR Valuation: $
Existing building area: square feet
New building area: square feet
e4`1T %. ✓ Pit 1it, Number of stories:
Name: Riverside Homes, LLC Type of construction:
Address: 17933 NW Evergreen PI., Ste 370 Occupancy groups:
City/State/ZIP: Beaverton, OR 97007 Existing:
Phone:( 503)645-0986 Fax:( ) New:
it,
: �, fie. .w... •
.,. i. *a..0 ,.,7 , 14. .N1 q1 lat"r$ AA"arte�'$`ii Ik�y�• ! i
Business name: Riverside Homes, LLC
Structural plan review fee(or deposit):
Contact name: Wes Boisvert
FLS plan review fee(if applicable):
Address: 17933 NW Evergreen PI., Ste 370
Total fees due upon application:
City/State/ZIP: Beaverton, OR 97007
Phone:(503)645-0986 Fax::( )
Amount received:
t t S 'IT';`°':'A 4
E-mail: wboisvert@riversidehome.com �.• r, > .. - . ...
x ,• t t r -; ,,s Commercial and residential prescriptive installation of
x 4 roof-top mounted PhotoVoltaic Solar Panel System.
Business name: Riverside Homes, LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 17933 NW Evergreen PI., Ste 370 Solar Installation Specialty Code checklist.
City/State/Z1P: Beaverton, OR 97007 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( 503)645-0986 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: 189148 Total fee due upon application: $201.60
Authorized signature: .12 This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Nikki Pruett Date: 1/29/19 *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)
Mechanical Permit A licat' E FOR OFFICE uSF ONLY
* Received
City of Tigard Date By: 111111
, ill • 13125 SW Hall Blvd.,Tigard,OR 97223 ;3 Aki 2 9 201
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
f 1 G A k 1 Inspection Line: 503.639.4175 s'i t, Date Read/B Juris:
Internet: www.tigard-or.gov i„";I '.. 4'
t Ready/By: S See Pagel for
£� A S O iv
Notified/Method: Supplemental Information
3UILDit
,..;;;:1-'7,.., -
New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition D Other: mechanical materials,equipment,labor,overhead,and profit.
rr t :1„ 1, T-, Nc " Value $Y
'"a,��,.� wokds"stt
El1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
0 Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total
,;. r 4 < =l 777 ; , y° - 1- Q .1Heating/cooling:
�. _,- i ' Air conditioning 1 46.75 46.75
Job site address: 7727 SW Cornutt Ln Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75
City/State/ZIP: Tigard, OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: Elderberry Ridge Duct work 23.32
Cross street/directions to job site: SW Bonita Rd & SW 76th Ave Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision: Elderberry Ridge Lot no.: 039 Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 1 23.32 23.32
' , �)5S c,=t � o31 '.'' ' � ' V
S, Gas fireplace/insert 1 33.39 33.39
Flue vent for water heater or gas
Construction of SFR fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
' Q s,1 '` 'i. .rya • _ , Other: 23.32
.. '"°'` li$-` Environmental exhaust and ventilation:
Name: Riverside Homes, LLC Range hood/other kitchen
equipment 1 33.39 33.39
Address: 17933 NW Evergreen PI., Ste 370 Clothes dryer exhaust 1 33.39 33.39
City/State/ZIP: Beaverton, OR 97007 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 4 23.32 93.28
Phone:(503 )645-0986 Fax:( ) Attic/crawlspace fans 23.32
. aP � `;,. :,:---,,,,,,,-:-A Other: 23.32
Business name: Riverside Homes, LLC Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name: Wes Boisvert Furnace,etc. 1 14.15
Address: 17933 NW Evergreen PI., Ste 370 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Beaverton, OR 97007 Water heater 1 14.15
Phone:(503 )645-0986 Fax::( ) Fireplace 1 14.15
Range 1 14.15
E-mail: wboisvert@riversidehome.com Barbecue
`=f = :, ... f,,,i4:: k , ;:',,a. . z.,0- x. Clothes dryer(gas)
Business name: Pro Heating & Cooling Other: e i :. i
..,'- ,nom ,a,bt ,= .,,.,. ', ,.f „:0°.-,
Address: 2095 NW Alocleck Rd.#1103 Subtotal
City/State/ZIP: Hillsboro, OR 97124 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( 971) 205-4989 Fax:( ) State surcharge(12%of permit fee)
CCB lie.: 209001 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: L.,/// , ... / / * Fee methodology set by Tri-County Building Industry Service Board
Print name: Nikki Pruett Date: 1/29/19
t:\Building\Permits\MEC_PennitApp_040113.doc 440-4617T(11/02/COM/WEB)
'Electrical Permit Application �� FOR OFFICE USE ONLY
' City of Tigard v , ,, —..
Received
1,111 d` Date/B : Permit# �(` j
" 13125 SW Hall Blvd.,Tigard,OR 97223
' C Phone: 503.718.2439 Fax: 503.598.19600 • Plan Review
�(y� 2 9 �U 1 9 Date/B Related Permit#:
T I G A k D Inspection Line: 503.639.4175 Ready Date/By: Juris: 0 See Page 2 for
Internet: www.tigard-or.gov 0-n ., GAR", Notified/Method: Supplemental Information
�L. .M �4 ®y4 tr�. , p _ Please check all that 1 #s �2 sets ofplans w/items checked):
El New construction ❑Addition/alteration/replacementapply(submit
0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition 12 Other:
where the available fault current 0 Marinas and boatyards.
,.�ki, tu t ' 1 " t ti� '�
� , exceeds 10,000 amps at 150 volts or 0 Floating buildings.
El 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builderOther:
❑ 0 Fire pump. 0 Installation of 150 KVA or
µ J .:.:..4-4) i.....ci., . , ¢ 1t,i E r W t L 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: I Job site address: 7727 SW Cornutt Ln 1ooHP or more. ❑`°A","E","1-2",°°t-3",
occupancy.
City/State/ZIP: Tigard, OR 97224 0 Six or more residential units. 0 Recreational vehicle parks.
❑Health-care facilities.
Suite/bldg./apt.#: I Project name: Elderberry Ridge ❑Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: SW Bonita Rd & SW 76th Ave ,_ . ; '''''''''.,,,,,f12 . FEE SCHTD "` 1
Description Qty. 1 Each I Total
New residential single-or multi-family dwelling unit.
Subdivision: Elderberry Ridge I Lot#: 039 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: x Ea.add'l 500 sq.ft.or portion 33.92 1
p. fi:x` ' _t t .`l�f'� e x
__ . . u �„ Limited energy,residential 75.00 2
Construction of SFR (with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
toPl�iz t. a m
, Renewable Energy 0 See Page 2
❑M
,.. ..- • °° .,1- Services or feeders installation,alteration,and/or relocation
Name: Riverside Homes, LLC 200 amps or less 100.70 2
Address: 17933 NW Evergreen Pl., Ste 370 201 ampsto400amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: Beaverton, OR 97007 601 amps to 1,000 amps 301.04 2
Phone:(503)645-0986 I Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:
relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
1 2" ., P Isi .:tiff .1 Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: Riverside Homes, LLC above service or feeder fee,
7.42 2
each branch circuit
Contact name: Wes Boisvert B.Fee for branch circuits without
service or feeder fee,first
Address: 17933 NW Evergreen Pl., Ste 370 branch circuit 56.18 2
City/State/ZIP: Beaverton, OR 97007 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)645-0986 Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: wboisvert@riversidehome.com Reconnect only 67.84 2
�
RAG ",
.$v,=�(•�;t _� �� , � .. i _ . ... :+; 4 Pump or irrigation circle 67.84 2
Business name: Sunlight Electric Inc Sign or outline lighting 67.84 2
Address: Signal circuit(s)or limited-energy ❑ See Page 2 2
2804 N E 65th Ave. St. D panel,alteration,or extension.
Each additional inspection over allowable in any of the above
City/State/ZIP: Vancouver, WA 98661
Additional inspection(1 hr min) 66.25/hr
Phone:(360) 518-7589 Fax:( ) 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.: 172549 Electrical Lic.: C230 Suprv.Lic.: s.ecificall listed 'h hr min
Suprv.Electrician signature,required: �� , ..„„4,---_ Subtotal: �a
Print name: Chester Garrett I Date: 1/29/19 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: L' 7 ( TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Nikki Pruett Date: 1/29/19 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermiIApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
Electrical Permit Application—City of Tigard
' Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
R.ESII ?' ;4 A a' `. ,k FtE SCHEDULE
Description I Qty. I Each I Total 1 *
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ B• urglar 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
✓❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
elAL WORK c Y e (/ t.,. ,PE .,I� ti�a-S
s ect tst : m a�
�� 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
❑ B• oiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ F• ire 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_ELRERE.doc Rev 06/17/2015
Plumbing Permit Application
r
- -Building Fixtures
City of Tigard �E' `� I E r Received: Permit No. (t
14 13125 SW Hall Blvd.,Tigard,OR 97223 ��
® Phone: 503.718.2439 Fax: 503.598.1960 .J F� 1 Plan Review Other Permit No.:
Date/By:
T I(i n R D Inspection Line: 503 639 4175
Date Ready/By: Juris: H See Page 2 for
Internet www tigard of g��yryo tt Y}(��}}r!..."
I q Ai Nohfied/M7h.,:'
d: iy c Gy Supplemental Information
TyriiF ''y 4 8 `` + iii�F+� .3� f 14'L� i �✓fJ)rf
0 New construction ❑Demolition For special information use checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
" �.. - '€;A i ;*.J';'''''''''''::4';1.-::-.
$ tl ,t -4i':
Rr /I: • ... *' '- - SFR(1)bath 312.70
0 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 1 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fires sprinkler 2
p (_sq.ft.) Page
�'T i * t 9 : ", :*1 f4 Site utilities:
Job site address: 7727 SW Cornutt Ln Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: Tigard, OR 97224 Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name: Elderberry Ridge Manufactured home utilities 50.03
Cross street/directions to job site: SW Bonita Rd & SW 76th Ave Manholes 18.76
Rain drain connector 1 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: Elderberry Ridge Lot no.: 039 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
Backwater valve 12.51
Clothes washer 1 25.02
Construction of SFR
Dishwasher 1 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
i } 46,-:_ ``' :. Expansion tank 12.51
Fixture/sewer cap 25.02
Name: Riverside Homes, LLC
Floor drain/floor sink/hub 25.02
Address: 17933 NW Evergreen Pl., Ste 370
Garbage disposal 1 25.02
City/State/ZIP: Beaverton, OR 97007 Hose bib 2 25.02
Phone:(503)645-0986 Fax:( ) Ice maker 1 12.51
t'
i1V : t Interceptor/grease trap 25.02
Business name: Riverside Homes, LLC Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: Wes Boisvert
Roof drain(commercial) 12.51
Address: 17933 NW Evergreen Pl., Ste 370 Sink/basin/lavatory 6 25.02
City/State/ZIP: Beaverton, OR 97007 Solar units(potable water) 62.54
Phone:(503)645-0986 Fax: :( ) Tub/shower/shower pan 4 12.51
Urinal 25.02
E-mail: wboisvert@riversidehome com
Water closet 3 25.02
Water heater 1 37.52
Business name: H & H Mechanical Water piping/DWV 56.29
Address: 5757 SE Willow Ln Other: 25.02
City/State/ZIP: Milwaukie, OR 97267 Subtotal
Phone:( 503 975-9787 Fax:( ) Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lic.: 178122 Plumbing Lic.no.: PB414
/. p---) State surcharge(12%of permit fee)
Authorized signature: 4 _e_ TOTAL PERMIT FEE
Print name: Nikki Pruett Date: 1/29/19 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)
City of Tigard
s COMMUNITY DEVELOPMENT DEPARTMENT
a
- G f�71
Building Permit Review — Residential
icW.�.F . .._ «.
Building Permit #: m5-c- `ok- p ct,
Site Address: 1-7 2.-7 Sw rn V L n .
Project Name: - i de r b e rnj R ;d cj.e Lot #: 39
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: N eAni S F 2
9. Verify site address/suite#exists and active in permit system.
River Terrace Neighborhood: !- No 0 Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
ee(3)copies of site plan
DExisting-structures on site
)6ite plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished
110 rawn to scale(standard architect or engineer scale) floor elevations
North arrow
Jtility locations&easementsre uir
Site address,project or subdivision name and lot number ( q ed for new and additions)
Sidewalk/driveway approach
IZTApplicant information(name and phone number) s of wells/septic systems
1Lot dimensions and building setback dimensions -❑EXisiing trees to be retained with drip line,and tree
aSgnarefeotage of buildings to be demolished protection measures
jlLot area,building coverage area,percentage of coverageand
- a8 Street tree size,type and 1
impervious area(applicable if R-7,R-12,R-25&R-40) Street #cation
names
,Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? f Yes❑No
4 foot differential) If yes,is a storm water duality facility shown? DYes ❑No IV/}
p' Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: 0 Yes,applicant was notified
,in No Received: ❑ Yes ❑ No
Public Facilities Improvement(PFI)Permit:
Requited: 0 Yes,applicantwas notified 0 No Applied For: i Yes 1o, _ O O
pp ,LI 0 No,stop intake
Land Use Case#: P2zo ( co ~ p0OQ9 su62-o(i6 - 0000
77
/5 Zoning. t
Required Setbacks: Front I S Rear I S Side S Street Side 1 0 Garage
Landscape Requirement 2 0 % *--w
0 Lot Coverage Maximum: S 0
JZ Building Height: Maximum Height 3 5 Actual Height 2 s
Z Visual Clearance
/`'' Sensitive Lands: 0 Yes %No Type
7 Urban Forestry Plan
p' Conditions "Met"prior to issuance of building permit
Notes:
)71 Approved By Planning: Date: I` 2 G) I I Gj
Revisions (after Building Submittal only) Reviewer
Revision 1: 0 Approved 0 Not Approved Date
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
I:\Building\Forms\BldgPcrmitRvw RES_061417.docx
Building Permit Submittal
Original Submittal Date: # 1 \° \19_
Site Plans:
Building Plans: # S
Building Permit#: ErEnter building pet#above. �Bg
Workflow Routing: Planning [ Engineering 13/Permit Coordinator
Workflow Sign-off: E 35ign-off for Planning(include notes from planning review)
Route Application Documents: 161 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:
By Permit Technician: Date: 1 \\\ VC\
Engineering Review
❑ Slope at building pad: !gyp
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: 0 Yes 0 No
Assess Water Quantity Fee in-lieu: 0 Yes 0 No
LIDA Facility on lot: 0 Yes 0 No
❑ Final Plat Recorded:
❑ NOT Approved by Engineering:
Date:
Notes:
Approved by Engineering:
Date: 2/6//9
i Reviewer Date
Revisions(after Building Submittal only)
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 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:
El/SDC Fees Entered: Wash Co Trans Dev Tag: es 0 N/A
Tigard Trans SDC: �es 0 N/A
Parks SDC: IJ Yes ❑ /A
LIDA 0 Yes tr7 N/A
iZI/DK to Issue Permit �� ) �{
Approved by Permit Coordinator:
�YDate: 2/ti / � \
I:\Building\Forms\BldgPermitRvw_RES 010118.docx
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
7727 SW CORNUTT ST, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Master Permit MST2019-00016
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS
Comments:
Ac installed.
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
7727 SW CORNUTT ST, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Master Permit MST2019-00016
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS
Comments:
Ac installed.
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
7727 SW CORNUTT ST, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Master Permit MST2019-00016
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
PASS
Comments:
Water pressure 60 psi.
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
7727 SW CORNUTT ST, TIGARD, OR, 97224 July 3, 2019 at 11 :21 :56 AM
Record Type: Record ID:
Residential - Master Permit MST2019-00016
Inspection Type: Inspector:
299 Final inspection Aaron Cillo-Gobel
Result:
PASS - CofO
Comments:
Final erosion control approved.
Moisture content form received.
Moisture barrier form received.
High efficiency lighting form received.
Insulation certification verified.
Duct seal test report received/verified.
C of 0 left on counter.
Violation Summary:
Inspector Contractor