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Permit NICITY OF TIGARD MASTER PERMIT 2 COMMUNITY DEVELOPMENT Permit#: MST2020-00091 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/15/2020 TIGARD / /S 2/ CQQ Parcel: 2S103CA00309 Jurisdiction: Tigard Site address: 13044 SW 121ST AVE Subdivision: BIRCH MILL SUBDIVISION Lot: Project: Birch Mill Estates, Lot 2 Project Description: New SF. NO FINAL INSP UNTIL FEES PAID FOR SDCs DEFERRED TO OCCUPANCY. 1/15/2021: REPRINT permit to add shower in powder room and laundry sink. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1223 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 28 Bathrooms: 3 Second: 1347 sf Garage: 456 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2570 sf Value: $348,297.17 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Catch Basins: 0 Bckflw Prevntr: 1 Footing Drain: 0 Ice Maker. 1 Hose Bib: 2 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Tvpes Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Fum<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 5 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2570 Owner: Contractor: LF121 LLC JTSC LLC Required Items and Reports(Conditions) 5285 MEADOWS RD,STE 171 5285 MEADOWS RD,SUITE 171 1 Ersn Cntrl 503-639-4175 LAKE OSWEGO,OR 97035 LAKE OSWEGO,OR 97035 PHONE: 503-657-3402 PHONE: 503-308-7324 FAX: 503-684-0102 Total Fees: $21,885.49 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 thro OAR 95 -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: -(Q/Jc-, Permittee Signature: !s A/ I517°,G-/ L-')I--7 7 d Al Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. CITY OF TIGARD MASTER PERMIT s '- COMMUNITY DEVELOPMENT Permit#: MST2020-00091 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: Jul 15 2020 12:00AM Parcel: 2S103CA00309 Jurisdiction: Tigard Site address: 13044 SW 121 ST AVE Subdivision: BIRCH MILL SUBDIVISION Lot: Project: Birch Mill Estates, Lot 2 Project Description: New SF. DEFER SDCs TO OCCUPANCY. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1223 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 28 Bathrooms: 3 Second: 1347 sf Garage: 689 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2570 sf Value: $348,297.17 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckfw Prevntr: 1 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Fum<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Fum>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add!500 sf: 5 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2570 Owner: Contractor: LF121 LLC JTSC LLC Required Items and Reports(Conditions) 5285 MEADOWS RD,STE 171 5285 MEADOWS RD,SUITE 171 1 Ersn Cntrl 503-639-4175 LAKE OSWEGO,OR 97035 LAKE OSWEGO,OR 97035 PHONE: 503-657-3402 PHONE: 503-308-7324 FAX: 503-684-0102 Total Fees: $21,812.47 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 through4.,,,,,-.).- OAR 952-001-009/0.�(Iou may obtainbt -a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: t 7 /✓l K" ,, Permittee Signature: 1967°/9L! C�-7741 Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each Inspection. • Build3n2 Permit Application Residential RECEIVED FOR OFFICE USE ONLY City of Tigard t A y Received 7�J g MAR 1 2 Z02� DateBy: 3 / % - d "v ( • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review �y / 'N . Phone: 503.718.2439 Fax: 503.598.1COTY OF TIGARD Date/By: 3 1 U I etol � e/ TIGARD Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By: '7 �� ® See Page2 for Internet: www.tigard-or.gov No' ed/M o// aC S f / 7—Supplemental Information TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING ®New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and Ow profit for the CATEGORY OF CONSTRUCTION work indicated on this application. t El1-and 2-family dwelling ❑Commercial/industrial Valuation: $ 1 Number of bedrooms: /71 ElAccessory building 0 Multi-family ❑Master builder El Other: Number of bathrooms: 3 JOB SITE INFORMATION AND LOCATION Total number of floors: 7� 32-S1 Job site address:13044 SW 121"Avenue,Tigard,OR New dwelling area: a570 square feet ' 311 City/State/ZIP:Tigard,OR 97223 is sfCS Garage/carport area: square feet 1 D.,a, Suite/bldg./apt.no.: Project name:Birch Mill-Lot 2 Covered porch area: />,T-. square feet Cross street/directions to job site:SW 121"Ave&SW James St. Deck area: y.:0" square feet Other structure area: square feet t REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision:Birch Mill Estates Lot no.: Permit fees*are based on the value of the work performed. Tax map/parcel no.:TBD Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. New home construction Valuation: $ Existing building area: square feet Z,�PI-PI -- S.6 C_ 76 1 e 6,6-{,t°, 7New building area: square feet ® PROPERTY OWNER ❑ TENANT Number of stories: Name:LF 121,LLC Type of construction: Address:5285 Meadows Rd Ste.171 Occupancy groups: City/State/ZIP:Lake Oswego,OR 97035 Existing: Phone:(503)657-3402 Fax:( ) New: ® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* Business name:JTSC,LLC (Please refer to fee schedule) Structural plan review fee(or deposit): Contact name:John Wyland FLS plan review fee(if applicable): Address:5285 Meadows Rd Ste.171 Total fees due upon application: City/State/ZIP:Lake Oswego,OR 97035 Amount received: Phone:(503)209-7555 Fax::( ) E-mail: ' land tsmithco.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* 1wy @l Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name:JTSC,LLC Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:5285 Meadows Rd Ste.171 Solar Installation Specialty Code checklist. City/State/ZIP:Lake Oswego,OR 97035 Permit Fee(includes plan review $180.00 and administrative fees): Phone:(503)209-7555 ?Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.:200237 Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained / within 180 days after it has been accepted as complete. Print name:John Wyland Date:3/10l2020 *Fee methodology set by Tri-County Building Industry Service/Board. I:\Building\Permits\BUP-RESPermitA.p.doc 02/24/2011 440-4613T(11/02 �/COM/WEB) A[p4,�� /5 7D aCCG5aa • ' Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONLY Received City of Tigard DateB : Pet No II • 13125 SW Hall Blvd.,Tigard' OR 97223 Associated pe mits. I Phone: 503.718.2439 Fax: 503.598.1960 I'1 GARD 24-Hour Inspection Line: 503.639.4175 ❑ Electrical El Plumbing El Mechanical Internet: www.tigard-otgov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No NIA 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ 0 0 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 ❑ 3 Verification of approved plat/lot. 0 0 0 4 Fire district approval required. Name of district: ❑ 0 0 5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ 0 6 Sewer permit. _ ❑ ❑ ❑ 7 Water district approval. 0 0 0 8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 ❑ ❑ 9 Erosion control ❑plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ ❑ basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 0 0 0 building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if 0 0 0 there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size 0 0 0 and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 0 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- ❑ 0 0 floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. 0 0 0 Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- 0 0 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 0 0 0 locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 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 ❑ 0 ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. ❑ 0 0 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 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 0 0 0 architect licensed in Ore:on and shall be shown to be applicable to the .ro'ect under review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". ❑ 0 0 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 0 0 0 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ 0 ❑ 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ 0 0 27 "Drawn to scale"indicates standard architect or engineer scale. ❑ 0 0 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ 0 0 Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 ❑ ❑ and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, 0 0 ❑ including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. I:\Building\Permits1BUP-RESPermitApp.doc 02/24/2011 440-4613T(1 I/02/COM/WEB) RECEIVED Electrical Permit Application MAR 1 2 2020 Cl ofTigard r[[[!!! Received Permit , ;- 13125rSW Hall Blvd.,Tigard,OR 9727jITY OF I' Ti C;iFtRD DataBy: iew • MIMIC 503.718.2439 Fax: 5o3.5�tk9Y1pDING DIVISION poesy Related Permit#: 1 I:;1 I: ) InspectionLine: 503.639.4175 Ready Elat 1By- lens' FASee Page 2 for Internet: wwwiigard-w.gov Notified/Method: Supplemental larormaton n a ,W a`a'' {4 tf "ri,•vn•.oi 'ry �. <�ra , it. A q�.N^J ,�..i..�,y �±, t .,.: �..Jet_¢rti;<"!"..�' '`"S�'.p��r:��.,,��+u=+ArRiRMsA 3 .:e',�,,. ._ .M.:.. n�`�H�.a�tii'w+wi .]�fd`a:`i.�..<. K��frK*5�� .a'�FlvFGn*��l�a�,' inrin: E New construction 0 Addition/alteration/replacement Plasm check all flat sppty(submit 1 sea of plans wrtems checked): Q Service or feeder 400 amps or mole Q auilding over three stores. ❑Demolition ❑Other: `1:sv may' where the available fault current ❑Maness and boatyards. h'gl a .,a s;' r" tOdW (t..' 'O,A7 (J OO'1 .i mK�+ �!`a+-s�.e f '9 tt I;, exceeds I0,0 0 en SiISO`ohs or �., +a,�>.. a..,..a,on^.: % QFlwting building- ID I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building leas to ground,or exceed,14.000 ❑Commercial-use amict lwrai ❑Multi family CI Master builderamps for all other installations. headings. 0 Other' Q Fire pump. ❑Installation of ISO KVA or a 1� t a£1, v ''. X ^} lee ❑Enwarocy system. larger separately derived TT ,.,zx ,yfir ..,,.�.rr..,a,.+.�.�srr,�r�-nn.�.b,_aa� _,..,, rT,,e ) °, .e.S.at �ia.ck:3 Y.'. 5 1... 'a*S�h.W.^a+Alh>1rAy1Y<f ,N� T*�I'�r ;�4.=Crot$.r a,Y.,�i.ti'o Job fl Job site address /3/,5.( sh/ /Z/ ,lv,izU 1 Q Addtfea of new motor load of sys4an. IOOHP anmrc. Q"A "E""1-2""1-3'• City/State/ZIP:Tigard,OR 97223 ❑Six or more residential units. occupancy. ❑Hphh.tlre facilities. 0 Recreational vehicle perks. SUite'bidg./apL ff Project name:! (tivi M f J'— t. t Z Q HaanWus locations. ❑S vol minimal Supply vdbafor more than 0 Service or feeder 600 amps or more. Cross street/directions to job asic Sto 11110 A-kit -4' $1.4 r -CitlitS Si-- �, , tilti p,( [�$�,'1+� �-(, V \�sertag .t[1 Ji ii_.i, ' F, t,ar'�' �f'�..aj�HAI iY• oeseehhgoa GA Taal..:1 e �` New residential*Ingle•or m Wt4famlly dwelling unit. Subdivision Q;r o\ pa u E4-1.cs4e,.5 Lot 8 Includes attached garage. r Tax map/parcel it 1,000 sq.tl.or less 1 fi8.54 / •Sl 4 rtv{,r r« a. .� �,a�'� `f ,.vI'9., „ S� Ea.edd'I SOO sq.il,or potion 5 33.92 / ,t r;"..s1-'. i rl T� a,,,,„ it +.{.: Di l rP,,..._pk'....'k ri 5 .,,,, *u?u,.e its..,, ,+ Emilia,maergy.residenliet New home construction (with above sq.ft.) 75.00 2 Limited energy,multi-family 75.00 2 �s,':�y�,, � residential(with above so,B.) P�):a�FyalliN1O 'f s sN � s1I ',f'. a fA FAY •0„5 Renewable EoergY []sea PaCe2 '`$ ^Y'y pis "-`�'r .y..l ; atvr J:a't' J^'j^� Serrl«say feeders ISu i onralfer *Io and/or relocation Name: (_F ''f J [Lc 200 amps or less 100.70 2 Address:5285 Meadows Rd Ste 171 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:Lake Oswego,OR 97035 601 amps to 1,000 amps 301,04 2 Phone:(503)657-3402 Fax:( ) Over 1,000 amps or volts 552.26 2 Email: Temporary sery ra kes or feeders installation,attention,and/or relocation Owner installation:This installation is being made on property that 1 own which is not 200 amps orless 59.36 I intended for sale,tease,rent,or exchange,according to ORS 447,449,670,and 701, 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 :7+.yu ..� .a fir', o`ry,, r;+ ,. " l v y . yra, it a w.,.nlw- Brgnch circuits—new,plieration,or extension,;er panel K M .-v�R^-- �, a A�J .�I . ^. �� .��tA \'?I��a. .J"Syr A.Fee Wr brnrtch tiraYria wide Business names J TSC,LLC Shove service or feeder fee, 7.42 a each branch circuit Contact name:John Wyland B.Fee for branch circuits widioar Address:5285 Meadows Rd Ste 171 service or feeder fa,first branch 2 brancA circuit City/State/ZIP:Lake Oswego,OR 97035 Each addf branch circuit 742 2 Miscellaaeons(service or feeder not included) Phony(503)209-7555 Fax::( ) Each manufactured or modular 67.84 2 -Email:jwyland�a jtsmitheo corn dwelling,service anrwrf«s/n Reconnect only 67.84 2 a'✓"+ 7 rTy xg !'"7re, tt"4 3 4'm'Y5^+irtx? ft *a t Win„:_'inSI-hl-:yi:iliu'9 # ...eP, Pump orirrigation circle 67.84 2 Business name:Garner Electric Sign or outline lighting 67.84 2 Address:2920 SW Brookwood Ave.Ste A SignalIterationt(s)or lim0asio . Q See Page 2 2 panel,alteration,or extension. City/State/ZIP:Hillsboro,OR 97123 Each additional inspection over allowable in any of the above Additional inspection(l hr min) 66.25/hr Phone:(503)648-4552 Fax:(503)642-7925 Investigation(I hr min) 90.00/hr Email:aadreapa®.garnerelectric.com Industrial plant(i hr min) 78.18/hr Inspections for which no fee is 90 00/hr CCH Lic.: 121159 Electrical Lie.; 34-30 S ic.: 3707S speclfrcany IiseM h hr min ,P.,.:, a .>'10441,T'> Ssv r_,.v,�+,W76, Suprv.Electricity signature,required: Subtotal: Print name: Charles Gaul Data // t t) Q Plan Review Required(25%of permit fee): 7 State surcharge(12%of permit feel: Authorized signatu • th,A ,a TOTAL PERMIT FEE: "'LL^^ / q�q This permit application expires Ira permit k not obtained edihie 180 Print name: Andrea Phillips J Date: ,1 j id ZQ I days alter it has been accepted as complete. ` Number of inspections allowed per permit. 1:,Build'ag`Pmhia'.Eld:_PemilApp_F]R EBE.doc Rev 06617r2019 440-16I571 11'OS(x0a4WEB RECE Mechanical Permit Application,. IIIIIIIIIIIEIIIIENIZIIIMIIIIMIII City of Tigard a i 2 2020 Received Permit No.: 13125 SW Ball Blvd.,Tigard,Olt 9 DateBy� i m 13125: W3.all Blvd. Fax: 503. OF TIGARD Km Review ~ ING DIVISION Date/By: �"'° Permit TI Ct,\.it0 Inspection Line: 503.639.4175 Date Ready/By: rurir ®See Page 2 for Internet: www.tigard-or.gov Notified/Method: Sappkmental Information , n,rE or Wow( •f3W.. .Rout, *SCHzDU E 1188 CANCKUSt Mechanical permit fees*are based on the value of the work ®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit Value:$ CATEGORY OF CONSTRIDCPION _.. RESWENTIA,LEQVWMMENT,SysTSM8lPBz$* ® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building Foe:peclalbeformatiun use checklist Si y tC 0 Milli-family ❑Master builder 0 Other: Description I Qty. Ea. Total JOB SITE INFOIOINntiN AND LOCATION Healing/codig: Sob site address: 3QI(l O� 02� / ��J�lp Air Furnace l inning j 46.75 r J5/(fit 00,000 BTU(ducm/vents) I 46.75 ,/ City/State/ZIP: f e 7� Furnace 100,000+BTU(ducts/vents) 54.91 IAA !\ Heat pump 61.06 Q U \� Suite/bldg./apt.no.: Project name: ► ;r Ch PI;11-te:4 2 Duct work 1 23.32 ,),, Cross street/directions to job site: W jai5*}1j * S, Ar 5A VMS. 5f Hydrnnic hot water system 2332 Residential boiler(radiator or hydronio) 23.32 Unit heaters(fuel-type,not electric), ' in-wall,induct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision. Irc.h IA;I( 6s4a4..s Lot an.: .0 23.32 Other fuel appliances: Tax map/parcel no.: Water heater I 23.32 DESCRIPTION OF VitORIC Gas fucPlecefinsert t 33.39 Flue vent for water heater or gas , New home construction fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/iner/flueivent 2332 ® PROPER"( OWNFat ElTF1vAIYt Other: 23.32 Eavironmeatal exhaust and ventilation: Name:. L F 1 a f a LLC Range hood/other kitchen Address:5285 Meadows Rd Ste 171 equipment 1 33.39 Clothes dryer exhaust 1 33.39 City/State/ZIP:Lake Oswego,OR 97035 Single-duct exhaust(bathroom% toilet compartments,utility moms) 5 23.32 Phone:(503)657-3402 Fax:( ) Attic/cxawlspace fans 23.32 E APPLICANT [i CONTACT PERSON Other: 23.32 Business name:JTSC,LLC Fuel piping: $14.15 for first tour,S4.03 for each additional Contact name:John Wyland Furnace,etc. 1 Address:5285 Meadows Rd Ste 171 Gas heat pump City/State/ZIP:Lake Oswego,OR 97035 Wat heater eshsaeedad/uait Water heater t Phone:(503)209-7555 Fax::( ) Fireplace I Range 1 E-mail:jwyland®jtsnitheo.com Barbecue CONTRAL I ant Clothes dryer(gas) Business name;Integrity Air,LLC Other: MECHANICAL PERMEC FEES* Address:16756 SW 72"d Ave Subtotal City/State/ZIP:Portland,OR 97224 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(503)572-3594 Fax:(503)598-8498 State surcharge(12%of permit fee) CCB lie.:203869 TOTAL PERMIT FEE S^ This permit application expires if a permit is not obtained within LSO r days after it has been accepted as complete. Authorized signature: " Fee methodology set by Tri-County Building Industry Service Board Print name:Kyle Dimon Date: :l fauildhaglPermitOMEC PermitApp 0i01I 3 do I/03/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 -Supplemental Information Commercial& Multi-Family Fee Schedule: Total Valuation Permit Fees $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and $2.54 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$t 00,000.00 and $2.92 for each additional$100.00 or fraction thereof. Note: AU new commercial buildings require 2 sets of plans. I:\Building\Permits\MEC_PermitApp_0401 I3.doe 2 Plumbing Permit Appli E1CFI\ Pr Building Fixtures [OR OFFICL USE ONLY MAR 1. 2 2020 Received City of Tigard �,wer Permit No.: 114 fa 13125 SW Hall Blvd.,Tigard,OR+97223;;_ 7 , r -; g Phone: 503.718.2439 Fax:$03c598.i ¢0 I' "-h} `'� Was Review Other Permit No.: Inspection Line: 503.639.4175 DiVI ! Date/By:Re 1!GARS.) sp�tW Date Ready/By: brit ®Ste Pagetfor Internet: www.tigard-or.gov Notified/Method Supplemaai Infurmatlon, + ,w w_ n E.off Q :a ar r 4 : 4 ti 11 r_ ';: o-: ®New construction El Demolition - For special Information use checklist Description I Oty. I Ea. 1 Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) :. W SFR(gbath L 312.70 I el1-and 2-family dwelling 0 Commercial/industrialSFR(2)bath 437.78 SFR(3)bath l 500.32 ❑Accessory building ❑Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other. Fire sprinkler( sq.11.) Page 2 A V-� ' ''a my x ie 4,11 f, ,... Site utilities: kb site address: �3 0 y 5/11 4 2 Catch basin or area drain 18.76 City/State/ZIP:Tigard,OR 97223 Drywall,leach line,or trench drain 18.76 Footing drain(no.linear EL: ) Page 2 Suite/bldg.apt.no.: Project name:P-)i r C.j1 M i 1I- Lo4 7" Manufactured home utilities 50.03 Cross street/directions to job site:S(z) icll 5t Ave * s(A) )1Y1rQg s$. Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: IOU) r Page 2 Storm sewer(no.linear ft.: itl�) I Page 2 i l Water service(no.linear ft.:i.L J 1 Page 2 ' Subdivision: j ' '\. �rrl N`\ G.j-*'1-t'.s Lot no.: ?/ Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 yt q�q � r�.�.p}/g Backwater valve 12.51 y Clothes washer i 25.02 New home construction Dishwasher f 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 "-47 '`^` ; 54'Ci ' .t �."„ r„[ '?FJ' n Expansion tank 12.51 Name:. I F- l a I C Fixture/sewer cap 25.02 t f i Floor drain/floor sink/hub 25.02 Address:5285 Meadows Rd Ste 171 Garbage disposal 1 25.02 City/State/ZWP:Lake Oswego,OR 97035 Hose bib 1- 25.02 Phone:(503)657-3402 Fax:( ) Ice maker t 12.51 mY " i a '. '�1t f0 'tw"r:':1 �` j'` jc Interceptor/grease trap 25.02 Business name:JTSC,LLC Medical gas(value:$_) Page 2 Contact name:John Wylaad Primer 12,51 Roof drain(commercial) 12.51 Address:5285 Meadows Rd Ste 171 Sinklbasin/avatory ' 5 25.02 City/State/ZIP:Lake Oswego,OR 97035 Solar units(potable water) 62.54 Phone:(503)209-7555 Fax::( ) Tub/shower/shower pan a.. 12.51 E-mail:jwylaad(a3jtamithco.com Urinal 25.02 , 0 R r :,, ''' water closet 3 25.02 t" X} a Water heater 1 37.52 Business name:Mullen Company Water piping/DW V 56.29 Address:1601 A SE River Road Other. 25.02 City/State/ZIP:Hillsboro,OR 97123 Subtotal Phone:(503)640-0113 Fax:( ) Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lie.:92689 Plumbing Lie.no.:34-260PB State surcharge(12%of permit foe) Authorized si re: TOTAL PERMIT FEE Print name:Jeremy cc Date: ,�//)/ This permit application expires ifs permit is not obtained within ISO days after It has been accepted as complete. 'Fee methodology set by Tri-County Building Industry Service Board. MuildinglPmdn1PLNU-PevnitApp.doc IMeuA9 44.4616T(10/07/COM/WER) • Plumbing Permit Application - City of Tigard Page 2 -Supplemental Information Fee Schedule: Residential Fire Suppression Systems: h 1'ri3 $ , . p r W g4c T >¶n(.l}' 9y: r*Y tb• ti " 04" t�,h M Footing drain-I"100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 S233.20 Sewer-1st 100' 62.54 7,201 and greater S327.54 Sewer-each additional 100' 37.52 Water Service-tat IN' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 - - rry,� r +'' ' 71 Storm&Rain Drain-1st 100' 62.54 Y�IXp I000. "' Minimum e$,G, "s'�, e. t .y't�."..,;. 51.00 to$5,000.00 Minimum fee S72.50 Storm&Rain Drain-each additional 100' 37.52 $5,00I.00 to S 10,000.00 S72.50 for the first S5,000.00 and$1.52 for t � v,:�., t0 . , icy W1 x a� ,;,f r atl\�' each additional SI00.00 of fraction[hereof;to i01114+'- and including S10,000.00. Inspection of existing plumbing or for SI0,001.00 to S25,000.00 5148.50 for the first 510,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including S25,000.00. Inspections outside of normal business 90.00/1hr $25,001.00 to 550,000.00 5379.50 for the first S25,000.00 and S1.45 for hours(minimum charge-2 hours) each additional S100.00 or fraction thereof,to Reinspection Fees 90.00/hr end including$50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for (minimum charge-1/2 hour) each additional$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. �, ,,r.�;- , .Quaatl by rixturc Type k ':e4:�Iah ' hind titi ."iArg i id ''' .. or*iirktypefdr, Re lace/ Worlii irtotmett lipped Added isOoeele Plan review is required for any of the following. Baptistry/Font Please check all that apply. Bath -Tub/Shower ❑ Any new commercial building with water service 2"and Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Drive Thru 0 New exterior plumbing site utilities for any complex structure Cuspidor/WaterAspirator as defined in OAR918-780-0040. Dishwasher -Commercial ❑ Medical 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. Eve Wash Floor Drain/sink -2" Submit 2 sets of plans with any of the above. -3" Car Wash Dram ,. x,r =^ '-r .' ; -,< WY[`:: Garbage -Domestic-non-food Cl Isometric or riser diagram is required for new buildings Disposal -Domestio-food related that meet the qualifications above. -Commercial-food related -Industrial-food related Ice MachJRefrig.Drains Oil Separator(Gas Station) Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang -Stall Sink/Lav -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter *Note: lithe fixture workunder this permit results in an Washer•Clothes Water Extractor increase of sewer EDUs,a sewer permit will be issued and water closet-Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: C:\Users\jererny\AppData\Local\Microsoft\WindowsUNetCache\Content.Qutlook\BTBRFoU6104 Plumbing Permit-Blank.doc Plumbing Permit Applicat F r " ' I ED Building Fixtures FOR OFFICE USE ONLY IYi a?i4 3 0 2020 Received 1 t t.' ) Pamil No. City of Tigard t)elN 5 f 2i.% /�'G /43 i 20 le'-'00091 • 13125 SW Hall Blvd,Tigard ORi t Ca,/1�F1 n Wan Review Other Penult No.: 2�/j yJ y ■ Phone: 503.718.2439 Fax: 503. Da isy: / hispe tion Line: 503.639.4175 J i s a L)I A S i 0;`J pate Ready/By: twee: 0 See Page 2 for TIG,11ip Internet www.tigard-or.gov Notified/Method: Sepplemeatal laformatioa -brv7: s•-x. v..r.Y-y ;F y ._ iIII!: 31' Ie .`c a T n .',.10-4 _6:l t 44.+'VE,.4i' t'a For spedallnformation use eheck/Lu ®New construction ❑Demolition Description J Qty. 1 Ea. 1 Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utili connection) =� t, SFR(1)balk ( I 437.78 I 01-and 2-family dwelling 0 Commercial/industrialSFR(2)bath 500.32 SFR(3)bath 0 Accessory building 0 Multi-family Each additional badt/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler(_sq.ft.) Page 2 ''.. ..r « '<.:...r s , , '6Att t site utilities , /�,� �� Catch basin or area dram 18.76 Job site address: l r - 1 t + . ,_- I ,� I i-�1`� Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard,OR 97223 Footing drain(no.linear ft.:,_) Page 2 Suite/bldg./apt.no.: l Project name: l j) (cGy\„, 1 r ;\,1}} Manufactured home utilities 50.03 Cross street/directions to job site: 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 R: ) Page 2 Subdivision: i f, ",1,\ „1A V), al"fi Lot no.: r� Fixture or item: Backflow preventer r 31.27 r 3j1.(9 Tax map/parcel no.: -a" i.. .,M a00 ,! 4 v Backwater valve 12.51 25.02 New home construction .- cA Clc\ --.,)f A C.Y.V Ar) Dishwasher 25.02 0(`{ vl(,lO(' I 7 'e'?cI •15m n r'. fsrrv-t-V__ Drinking fountain 25.02 Ejectors/sump 25.02 s , w Expansion tank 12.51 Fixlurelsewer cap 25.02 Name: L.� �� 1 .LC'. Floor drain/floor sink/hub 25.02 Address:5285 Meadows Rd Ste 171 Garbage disposal 25.02 City/State/ZIP:Lake Oswego,OR 97035 Hose bib 25.02 Phone:(503)657-3402 Fax:( ) lee maker 12.51 ,y 3h li ' -- , N, rs"' 1 rs '"N`, Interceptor/grease trap 25.02 Business name:JTSC,LLC Medical gas(value:S_) Page 2 Primer 12.51 Contact name:John Wyland Roof drain(commercial) 12.51 Address:5285 Meadows Rd Ste 171 Sink/basin/lavatory 25.02 City/State/LIP:Lake Oswego,OR 97035 Solar units(potable water) 62.54 Phone:(503)209-7555 Fax.:( ) Tub/shower/shower pan 12.51 Urinal 25.02 E-mail Jwyland@Jlsmitheo.eom e g •tv ,. water closet 2s.02 °,.. • ,- .. �. •s! '� ' .',.; . � Water heater 37.52 Business name:Mallen Company Water piping/DWV 56.29 Address:1601 A SE River Road Other: 25.02 City/State/ZIP:Hillsboro,OR 97123 Subtotal s' t.2,7 Phone:(503)640-0113 Fax:( ) Minimum permit fee: S72.50 Plan review (25%ofpermitfee) CCB Lic.:92689 Plumbing Lis no.:34260PB State surcharge(12%of permit fee) 3 7S .kre Authorized signJTOTAL PERMIT FEE 35.Q 2j P: Dater I)t � / - This permit appantioo spires If a permit is net obtained within 18a days Print name:Jeremy ce / after h has been accepted as complete. •Fee methodology set by Tri-County Building Industry Service Board. 1:tBui16ng1PermimPl.MU-PennitApp dm 70/OIA9 440.e616TO0/02ICIMUWEB) /1-1-'T - ()CC9/ Dianna Ornelas ° " M�L'� - L" From: Dianna Ornelas Sent: Friday, April 10, 2020 4:49 PM To: Karina Bradshaw Cc: #Building Permit Technicians; 'John Wyland' Subject: RE: Birch Mill Estates, Lots 2 & 5 Attachments: SKM_C65920041016150.pdf; SKM_C65920041016151.pdf Hello Karina, Please see attached for revised invoices for lots 2 and 5 where the Tigard transportation and parks SDC's have been removed from the invoice for deferral to occupancy. The current balance due for these lots is listed below and the fees can be paid online at https://aca.accela.com/TIGARD/Welcome.aspx by searching for the permit record number under the Building tab. After payment of the permit fees, please email the permit technicians at TigardBuildingPermits@tigard-or.gov to schedule an appointment to pick up the permit as our permit counter is closed at this time. Birch Mill Lot# Permit# Fees Due 2 M5T2020-00091 $ 21,027.45 2 SWR2020-00064 $ 5,835.00 5 MST2020-00089 $ 20,250.98 5 SWR2020-00060 $ 5,835.00 Total: $ 52,948.43 Please retain the original invoices that Julie emailed to you on March 25th as the amount owing for these SDCs is reflected on the original invoices and not on the revised invoices as the fees have been voided on the permit so that inspections can be scheduled. Just prior to scheduling final inspection, please pay the amount deferred in order to obtain final building inspection and certificate of occupancy. Thank you and please let me know if you have any questions. Have a great weekend! Dianna L. Ornelas (Howse) Building Division Services Supervisor City of Tigard I Community Development 13125 SW Hall Blvd I Tigard, OR 97223 503-718-2430 Direct 1503-718-2439 Permits From:Julie Drinkwater<JulieD@tigard-or.gov> Sent: Wednesday, March 25, 2020 1:23 PM To:jwyland@jtsmithco.com Cc:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Subject: Birch Mill Estates, Lots 2 & 5 Good morning John 1 The permits for Lots 2 & 5, of Birch Mill Estates, are now ready to be issued. The balance due is listed below. Attached is the invoice for your review. Birch Mill Estates Lot# Permit# Fees Due 2 MST2020-00091 $ 36,776.09 2 SWR2020-00064 $ 5,835.00 5 MST2020-00089 $ 36,051.98 5 SWR2020-00060 $ 5,835.00 Total: $ 84,498.07 To pay the fees online, you can go to our website: https://aca.accela.com/TIGARD/Default.aspx. From there, click on the Building tab, enter the permit number in the Record Number field, and click Search. Please notify us once the fee has been paid so that we can contact you with special instructions for pick up, as the permit center is currently closed to public access. Thank you and please let us know if you have any questions. Julie Drinkwater Permit Technician City of Tigard Building Department 13125 SW Hall Blvd Tigard, OR 97223 503-718-2804 Please note that the Permit Center counter is currently closed. Staff will work remotely by phone and online to complete permit, planning applications, and design reviews. Inspections will continue to be scheduled online. We are accepting permit submittals by mail, or if you prefer, you may place your submittal in the box marked building department, located through the first set of doors as you enter the permit center, between the hours of 8:00am and 3:00pm Monday through Thursday. DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained by the City of Tigard in compliance with the Oregon Administrative Rules "City General Records Retention Schedule." 2 �S �� - o 09 c�/ / Q//-c/ /t1/ -L, oT _ Dianna Ornelas /`�- y n" i.Ss« tz. From: Karina Bradshaw <karina@jtsmithco.com> Sent: Wednesday, April 8, 2020 12:29 PM To: Dianna Ornelas; #Building Permit Technicians Cc: John Wyland Subject: RE: AC Permits for Birch Mill - Lots 1, 4 & 6 Attachments: Mechanical Application - Lot 1 - revised to include AC.4.8.20.pdf; Mechanical Application - Lot 4 - revised to include AC.4.8.20.pdf; Mechanical Application - Lot 6 - revised to include AC.4.8.20.pdf Warning!This message was sent from outside your organization and we are unable to verify the sender. Hi Dianna, Thank you for the information and for your assistance! I have attached the revised applications to include A/C(1)for Birch Mill Lots 1, 4& 6 as instructed.Thank you for adding to the Mechanical applications for lots 2 & 3. It appears that we did include A/C(1)on the application for Birch Mill Lot 5, correct? Please confirm. Can you please confirm that for lots 2, 3 and 5, it is the intent of JT Smith Company that the Tigard transportation and parks SDCs shall be deferred to occupancy?YES, we do want to defer on all lots that have not already been paid! Thank you again, Karina Bradshaw Contract Specialist/Purchasing Assistant J.T. SMITH Companies, LLC 15285 Meadows Rd., Suite 171 I Lake Oswego, OR 97035 Office: 503.657.3402 I Mobile: 360.936.0372 I karina(i4itsmithco.com Visit us online at ,l "Srr ithco„com Facehook From: Dianna Ornelas<DiannaPtigard-or.gov> Sent: Wednesday, April 08, 2020 11:41 AM To: Karina Bradshaw<karinapitsmithco.com> Cc:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Subject: RE: AC Permits for Birch Mill - Lots 1, 4& 6 Importance: High Hi Karina, 1 City of Tigard ICOMMUNITY DEVELOPMENT DEPARTMENT I T I G A It D Building Permit Review — Residential Building Permit #: ,*57 C ?/. Site Address: 110414 S w 12► St Project Name: Birch Mill Lot #: "z- Planning Review Proposal: N2n4 ttv lri.t. Verify address/suite#active in Accela. /1 In River Terrace: 0 No 0 Yes,River Terrace Review Addendum Site Plan Elements: Erosion Control /03 copies of site plan on 8-1/2"x 11"or 11 x 17"paper Otetained trees with drip line and tree protection measures rawn to scale(standard architect or engineer scale)orth arrow f27 Footprint of new structure(including decks)and FFE XUtility locations&easements(required for new and additions) Site address,project or subdivision name and lot number , Sidewalk/driveway approach Applicant information (name and phone number) ❑Lvcativ..of wells/septic systems ?Lot dimensions and building setback dimensions Z.Street tree size,type and location Square footage of buildings to be demolished Street names xisting structures on site ]Corner elevations(2'contours if more than 4'differential) t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ZYes ❑No impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? 0Yoa DNo1'/4 I21 Clean Water Services-Service Provider Letter (lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified Z No Received: ❑ Yes 0 No l W.t r Meter Fixture Unit Worksheet-Additions,Remodels and ADUs Required: 0 Yes,applicant was notified 0 No Received: 0 Yes ❑ No ❑ SDC Exemption for ADU applied for: 0 Yes 0 No Received: ❑ Yes ❑ No 0 Public Facilities Improvement(PH)Permit: Required: ❑ Yes,applicant was notified ❑ No Applied For: /6 Yes 0 No,stop intake Land Use Case#: S U!� 2p l S - 0000 7 �r Zoning: 1 Z• q. S Required Setbacks: Front: 1A Rear: i S Side: S Street Side: '' A Garage: Za il Building Height: Max.Height: 70 Actual Height 7- Landscape Area: MR Lot Coverage Max: ��A 0/0 Entrance Set back no more than 8'from street-facing wall Parallel to street or offset 45 degrees or less Windows Minimum 12%of area of all street-facing facades Garage �Garage door is behind widest street-facing wall Yes 0 No,one of the following is met: ❑ Door extends no more than 5'from wall and there is a covered porch extending beyond garage. 0 Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2nd floor. Garage door width is El 12'or less 0 50%or less of facade I� 60%or less and includes 7 of following: 7 Covered porch ❑ Recessed entrance Wall offset /)2'1'Roof eave Roof offset Fire shingles � Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer �, ❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection 0 Balcony w(Visual Clearance % Urban Forestry Plan 7fSensitive Lands: ❑ Yes / No Type: Conditions met prior to issuance of building permit Notes: C cL-i'nbns moat- 'of pief P�'�°' �° ssuah� p Approved By Planning: ( B'ti^:- V\--L Date: 3/IL /"44° Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved 0 Not Approved Revision 2: ❑ Approved 0 Not Approved 1:\Building Worms\BldgPermitRvw_RES_I22419.docx Building Permit Submittal l Original Submittal Date: / / Site Plans: # Building Plans: Building Permit#: nter building permit# above. Workflow Routing: ILf Planning engineering Permit Coordinator ding Workflow Sign-off: 2—Sign-off for Planning(include notes from planning review) Route Application Documents: elEr 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: Q� By Permit Technician: vC/`JJ g Date: Engineering Review Q'Slope at building pad: 2A ❑' Conditions "Met"prior to issuance of building permit CEEasements (encroachments) per engineering conditions of approval and plat l -Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes Q No Assess Water Quantity Fee in-lieu: ❑ Yes D No LIDA Facility on lot: El^Yes ❑ No Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: ❑Approved by Engineering: G��~� Date: 3/1/7/Zax Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review R.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: SDC Exemption: ❑ Received &Does not apply SDC Fees Entered: Wash Co Trans Dev Tax: 121 Yes ❑ N/A Tigard Trans SDC: El Yes ❑ N/A Parks SDC: Yes ❑ N/A LIDA ❑ Yes Y1 N/A J21 OK to Issue Permit Approved by Permit Coordinator: . Date: 3 l i8 Izo I:\Building\Forms\BldgPermitRvw_RES_122419.docx City of Tigard lig " COMMUNITY DEVELOPMENT DEPARTMENT TIGARD Building Permit Review — Residential e ermit #: 5 � ��Building P Site Address: I3 0 q 4 S w 121 S t Project Name: gi rch Mill Lot #: '- Planning Review Proposal: Ne v,•' ttv I'ru.. / 2L7 t•e yru GYS Verify address/suite#active in Accela. In River Terrace: liZ NY❑ Yes,River Temwe Review Addendum Site Plan Elements: Erosion Control y13 copies of site plan on 8-1/2"x 11"or 11 x 17"paper lletained trees with drip line and tree protection measures 7 rawn to scale(standard architect or engineer scale)tf[7 Footprint of new structure(including decks)and FFE orth arrow Utility locations&casements(required for new and additions) Site address,project or subdivision name and lot number J21Sidewalk/driveway approach Applicant information(name and phone number) ❑I t ti a of wells/septic systems Lot dimensions and building setback dimensions ,Street tree size,type and location Square footage of buildings to be demolished Street names xisting structures on site lCorner elevations(2'contours if more than 4'differential) t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? . Yes 0 No impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑.Yes-❑NoIV/14 (Z1 Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: 0 Yes,applicant was notified 71 No Received: ❑ Yes ❑ No R-3xTater A4eter Fixture Unit Worksheet—Additions,Remodels and ADUs Required: 0 Yes,applicant was notified 0 No Received: 0 Yes ❑ No 0 SDC Exemption for ADU applied for: 0 Yes 0 No Received: 0 Yes 0 No jiti Public Facilities Improvement(PFI)Permit: Required: 0 Yes,applicant was notified ❑ No Applied For: Yes ❑ No,stop intake Land Use Case#: StJ32'018 - boo07 [Zoning: (Z• 9•S Required Setbacks: Front 2- Rear. IS Side: S Street Side: "'/A Garage: Za Building Height: Max.Height: fl Actual Height Zgi Landscape Area: NA % Lot Coverage Max: Nt h nuance Set back no more than 8'from street-facing wall t Parallel to street or offset 45 degrees or less Windows [d Minimum 12%of area of all street-facing facades (2- •iq/O Garage /pi Garage door is behind widest street-facing wall /Yes 0 No,one of the following is met: ❑ Door extends no more than 5'from wall and there is a covered porch extending beyond garage. O Door extends no more than 5'from and there is a 12 sq ft.window above garage on 2°d floor. L.' Jp Garage door width is 0 12'or less 50%or less of facade f G0%or less and includes 7 of following: , ' Covered porch ❑ Recessed entrance Wall offset /)1'Roof cave Roof offset XFire shingles Lap Siding ❑ Roof pitch 0 Gable,hip,or gambrel roof 0 Dormer 0 Accent siding ❑ Window trim ❑ Window recess ❑ Window projection C Balcony g r.Visual Clearance `-' Urban Forestry Plan /El Sensitive Lands: ❑ Yes 0 No Type: Conditions met prior to issuance of building permit Notes: GA el cL,i b b 4U ry i c t lot, rn a f- a vi.' i-o I s s tr a rl ce- fcz Approved By Planning: V\ 9'L - V\— - Date: 3/t 2 / z.c Revisions(after Bu• ng Submittal only) -ipsr> � to Revision 1: Approved ❑ Not Approved "" _'ram /.2� Revision 2: 0 Approved ❑ Not Approved U !!! t:\Building\Forms`91dgPerrnitRvw_RES_122419.docx Building Permit Submittal / Original Submittal Date: / —( Site Plans: # Building Plans: Building Permit #: nter building permit#above. Workflow Routing: 13 Planning J Engineering Pern it Coordinator ding Workflow Sign-off: 2—Sign-off for Planning(include notes from planning review) Route Application Documents: ta.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: "44 - By Permit Technician: Date: Engineering Review 9/30/ 12/Slope at building pad: j Z ®" Conditions"Met"prior to issuance of building permit E Easements (encroachments)per engineering conditions of approval and plat • Water Quality/Quantity Facility Assess Water Quality Fee in-lieu: ❑ Yes D No Assess Water Quantity Fee in-lieu: 0 Yes 0- No �/ LIDA Facility on lot El"Yes ❑ No [ Final Plat Recorded: O NOT Approved by Engineering: Date: Notes: ❑'Approved by Engineering: `4-4- Date: 31i> /2,;i - Revisions(after Building Submittal only) Reviewer Date Revision 1: ['Approved ❑ Not Approved /O/�/Z(i?CJ Revision 2: 0 Approved 0 Not Approved Permit Coordinator Review gConditions"Met"prior to issuance of building permit O Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: SDC Exemption: 0 Received Does not apply SDC Fees Entered: Wash Co Trans Dev Tax: 151 Yes 0 N/A Tigard Trans SDC: xi Yes 0 N/A Parks SDC: a.Yes ❑ N/A LIDA $-Yes •. N/A ,'OK to Issue Permit Approved by Permit Coordinator: , Date: 3 ( i_ Pit (2° 1.•1Building\Forms'BidgPennitRvw_RES_I22419.docx