Permit CITY OF TIGARD MASTER PERMIT
1 '® COMMUNITY DEVELOPMENT Permit#: MST2020-00092
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: Jul 16 2020 12:00AM
TIGARD Parcel: 2S103CA00310
Jurisdiction: Tigard
Site address: 13074 SW 121ST AVE
Subdivision: BIRCH MILL SUBDIVISION Lot:
Project: Birch Mill Estates, Lot 3
Project Description: New SF. DEFER SDC's TO OCCUPANCY.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1249 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 25 Bathrooms: 3 Second: 1187 sf Garage: 664 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2436 sf Value: $330,669.28 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
Tubs/Showers: 3 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
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 SrvclFeeders Branch Circuits
1000 st 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
Mid 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 2436
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: PHONE: 503-308-7324
FAX: 503-684-0102
Total Fees: $21,312.31
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through
OAR
9952-001-0,0,90. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
e`er Issued By: /L1/ 1 Permittee Signature: c5747P1. --,--70 N/7
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.
Building Permit Application
Residential FOR OFFICE USE ONLY
priCity of Tigard RECEIVE, Date/B Received d 3 -12-2-020 Permit No.MT) 2O O.�I Z
97223
Phone:S 03.W 718l B2439 TFax: 50igard, 3.598.1960 MAR 12 2020 PlanReview 5 2 Z 0 Af-'
DateB : I! L.�/�' Aft- Other Perr6W R 2Q21) 6
TIGARD Inspection Line: 503.639.4175 CITYOF TIGARD Date Ready/By: Juris. ® See Page 2 for
Internet www.tigard-or.gov r �1,j1 e,'�^ Notified/Methods 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 0 Other: equipment,materials,labor,overhead and the prqfit for the
CATEGORY OF CONSTRUCTION work indicated on this application. katCt
® 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ _
ElAccessory building El Multi-familyNumber of bedrooms: 4
❑Master builder ❑Other: Number of bathrooms: 3 `
JOB SITE INFORMATION AND LOCATION Total number of floors: 2 3/6v
Job site address: 13074 SW 121"Avenue,Tigard,OR New dwelling area: z,436 square feet [ (97
City/State/ZIP:Tigard,OR 97223 Garage/carport area: (pEA square feet lot 4 9
Suite/bldg./apt.no.: Project name:Birch Mill-Lot 3 Covered porch area: square feet I
Cross street/directions to job site:SW 121"Ave&SW James St. Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:Birch Mill Estates Lot no.: 3 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
-4 72— S4 C..S 77) 0 ('(ALL ,6 9--,(e C/ New building area: square feet
® PROPERTY OWNER 0 TEN4NT 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 m fee schedule)
Structural plan review fee(or deposit):
Contact name:John Wyland
FLS plan review fee(if applicable):
Address:5285 Meadows Rd Ste.171 —
City/State/ZIP:Lake Oswego,OR 97035 Total fees due upon application:
Phone:(503)209-7555 Fax: :( ) Amount received:
E-mail:jwyland*jtsmithco.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
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:La a Oswego,OR 9703 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503)209- 555 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:200237 Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:John Wyland / Date:3/10/2020 *Fee methodology set by Tri-County Building Industry
Service/B(4. (5- �/ r 1) /,
I:\Building\Permits\BUP-RE5Pcrmi �pp.doc 02/24/2011 440-4613T(Ll/021COM/WEB) �L/�(�//j, t/�C��J % t/ QcpW
Mechanical Permit Application
City of Tigard R ECEIVF Permit N° IUsr2020— 4/
13125 SW Hall Blvd,Tigard,OR 97223
an IlRevil I Phone: 503.718.2439 Fax: 503.598.1960 2 Data By " Other permit:
TIG,,i:.D Inspection Line: 503.639.4175 MAR 1 202( Date Ready/By: Pure 121 See Page Zfar
Internet: www.ligard-or.gov Notified/Method; Supplements)Information
CITY OF TIGARL
TYPE OF WORRIM.,D1.NG Drub!(." COMMERCIAL EBB*SEBEIIVLE-USE CHEMIST
®New construction Mechanical permit fees*are based on the value of the wont
❑Addition/alteration/replacement perforated.Indicate die value(rounded to the nearest dollar)of all
mechanical materials,equipment,labor,overhead,and profit.
❑Demolition ❑Other:
Value:$
CATEGORY QF CONSTRUCLION RESIDENTIAL.EQUIPMENT/SYsTEMsEUS* \�
10 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For a!1iftnnolIon use dieek/ta iV
❑Mhlti-family ❑Master builder 0 Other: Description I Qty. I Ea. Total
JOB Sag INFORMATION AND LOCATION Heating/cooling: �^'
/3 74 rs ' ier2/ � Air conditioning 46.75
Job site address: Q r✓T Furnace 100,000 BTU(ducts/vents) I 46.75
City/State/ZIP: / G�4' 7,22 3 Furnace 100,000+STU(duets/vents) 54.91 (i\
Suite/bldg./apt.no.: Project name: ?D.;r Gh I) �1' 3 Neat pump 61.06 ,
M! ✓ 1 Duct work 1 23.32
Cross street/directions to job site:S (,� la l E}A.spe At- S(13• ,c.e,1 2,. 5-I Hydronic hot water system 2332
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
OtherSubdivision. '�i-c,h tt .t r I t �r�4. 1 Tl es Lot no.: 45 23.32
1 � Other fuel appliances:
Tax map/parcel nu.: Water heater 1 _ 23.32
DESCRIPTION OF WORK Gas fueplacrlinsert 1 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&eplace insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
® PROPERTY OWNER ElNA
1ENt
Environmental exhaust and ventilation:
Name:. L F ICI! 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-dud exhaust(bathrooms,
toilet compartments,utility rooms) 5 23.32
Phone:(503)657-3402 Fax:( ) Attic%awlspace fans 23.32
Igl APPLICANT d CONTACT PERSON Other: 23.32
Business name:JTSC,LLC Fuel piping:
$14.15 far first four,54.03 for each additional
Contact name:John Wyland Furnace,etc. I
Address:5285 Meadows Rd Ste 171 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Lake Oswego,OR 97035 Water heater I
Phone:(503)209-7555 I Fax::( ) Fireplace 1
Range 1
E-mail:jwyland@jtsmitheo.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Integrity Air,LLC Other.
MEC WRCALPERMIT PEW
Address:16756 SW 72"d Ave Subtotal
City/State/ZIP:Portland,OR 97224 Minimum permit fee($90A0)
Phone:(503)572 3594 Plan review(25%of permit fee)
Fax:(503)548 8498 State surcharge(12%of permit fee)
CCB lie.:203869 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within ISO
�" days after it has been accepted as complete.
Authorized signature: • Fec methodology set by Tri-Comity Building Industry Service Beard
Print name:Kyle Birman Date: b//o/Zjj 7-0
t:tBuadinsu'erodal tac_eamitapa_oaot 13. 440-061 tr(I illaalI:COM/WEB)
Electrical Permit Application RECEIVE 'a FOR OFFICE USE ONLY
City of Tigard MAR 1 2 2020 Ra.41i"ed Psrmitx:MSTZQZO --�(p1
Pln Re
13125 S50 Nall Blvd.,Tigard,OR 97223 Plan Review D Related Permit a:Phone: 503.718.2439 Fax: 503.598.19fi0 teI y
t Inspection Lila 503.639.4175 CITY Oi=TIGARCI wady Oaw re lByr lame ®See Page 2 for
n fl;.h lil wand, www.ligaidv.gov BUILDING DIVISICf Itsiae Vt1ethoa: 1 Supplemental information
, fl / n+ �nt)ao'" altA;-31 �y . �v ,e t , i rsa t'Z W e1ti 4 r y*,.,.y.�, r's: l`t
.ryp.�.p ��yy(( y�.,))((��yy���� ( Y4y���� r ,�p �i F y'�$p�' �"1�t '"�i .I."��^3kF',r7r+�
,.R wh .'Yi �- �%..W'�.: AM.L�/Ey.'tIRtKA��4 a" �.,xL., .�(.p."r@I�&'i'�i'jW .tb�.�l"S.k.. ,w c� s....�., d
®New construction ❑Addition/alteration/replacement Please check all that apply(submit1 fps ofpiaw Whom checked):
❑DemO)ItlOn ID Other: 0 Service or feeder 400 amps or more 0 Building over three stories.
9 x'rak'�y Demolition
a ,s'o le+.. icy:, a �t*gx:l,n a 1 red; where the available fault current 0 Marinas and boatyards.
.s1'`:iii,a7c.Tgaa:u,0a, T,�t . nnle. ltiiipi.xr^git.tt..%i..:e, i ' I'Zt eacaeda 1o.00o ampsatl50vo4or ❑❑Florrin/1buitdintr.
1-and 2-fatr 11 •
dw thin Ieas to ground,or exceeds 14.000 Commercial-use agricultural® Y g ❑Commercial/industrial ❑Accessory building
❑Multi-family ❑Master builderamps for all other Installations. buildings.
0 Other: ❑Fire pump. ❑installation of 150 KVA or
°+.i3``0'' �L,v';'. 't e ' `ro�t'tbVtf v'y 4y�;y.'3t' ❑Eolvgene.system. larger separately derived
s 4A, y s + jA :ISIT 4t>ltl l S 1Y%Jk lk#X ....D.1 .r . ....'...`........ a.2
Job H I lob site address: /3/5`y c$'h' /itsfilwitia ❑AIOdditioOHPnor ofmore.new ❑"A""E motor load of sy,teru.
"' -°.••].)"
City/State/ZIP:Tigard,OR 97223 0Sia or more residential ants. occupancy ocevpa
❑Flea/di-care facilities. 0 Recreational vehicle perks.
Suite/bldg./apt#. I Project name'.112
?t e g4 1,411..... Ltrt 2'' ❑Hazardous location. ❑Supply 60 volu voltage lmmmaL more than
❑Service or feeder 600 amps or mom.
Cross tweet/directions to job site:$0.5 bits) A - c$14 Tangs Sat- g r'',..g','. (;� o '(1 `s f .>a=t -°��
oeeeipBna I �M a80.tact I Mel I •
�y' N� New residential single.or multi-family dwelling unit.
Subdivision kc„g t.ka &14-cx}e4 Lotq 3 Indndes attached garage.
✓✓�` a/ ` 1,000 R.*Mess _
Tax map/parcel/I yy Js�9 500 -f 168.54 , a
„V :i2,Y i lei^� SM f4j 4 t fi'S~.��yU _rf\C`A VE h A Ea.'del sq.R or p.7mon 9 33.92 /0 r 1
„7.'s:,, e?.> ;... .R, 7.:< Et**1.1,hID i/!k':'died►*6397,t a�i, k-;,...t..a...,a:7 :an,>.+ Limited energy,residential 75.00 2
New home construction With above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.fl.)
�RAIN r�, a�,a„..p 1,y • x . $ , : Renewabh Er deFy ❑See Page 2
� -t.�v rd 't� fr%r��.�� xs;'».,,w `�� ,:af'). t5:tw ,' wrtn2ll�.f,'�a�';,z ;�+%„ SerWCes o[feederb installation a(hntion,and%or relocation
Name: L F Ip'iI, LL-c 200 amps or less I 100.70 2
Address:5285 Meadows Rd Ste 171 201 amps 1o400 mops 133.56 2
401 amps t � tap' 2
City/State/ZIP:Lake Oswego,OR 97035 6301.04 01 amps too 1,000 mops 301.04 2
Phone:(503)657-3402 Fax:( ) Ova 1,000 amps or volts 552.26 2
Temporary servkes or feeders installation,alteration,and/orEmail:
relocation
Owner installation:This installation is being made on pteepedy that I own which is not 200 ampa or less 59.36 I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Dom; 401 amps to 599 amps {68.54 2
r `"'n'e""'' " t" atii:Vt,iltei 7{ q, °"o"' r'eanysl Branch circuits-sew,alteratnom or extension,per panel
..�.w��ax�-r,a.- ..,r... ��.�..,,,. 1 �` � ��',ic�. A tr t,<w�c A.Fa fir brmch;rut;
wide �
Business name:JTSC,LLC _ above service or fader in, 7.42
each branch circuit _
Contact name:John Wyland B.Fee for branch circuits without
Address:5285 Meadows Rd Ste 171 service or feeder fee,firer braids S6.1S 2
aids cimuh
City/State/ZIP:Lake Oswego,OR 97035 Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)209-7555 Fax::( ) Each manufactured or modular
Email:jwyWnd(a3jismithao.eom dwelling,service and/or feeds 67.64 2
n t;rx t"rs e?j F 5:j 4 "r u xis -n + <.ra^a 4' h c.,..s.: Reconnect only 67.84 2
..t,i.:3 .r r..,,t - Fte.v v,?tit�'�>zy Q 01 t :-?.rr.13 .:;yes `t`t,°y....sc t. fl; Pump or irrigation circle 67.84 2
Business name'.Garner Electric Sign or outline lighting 67.84 2
Address:2920 SW Brookwood Ave Ste A Signal ilcmt(s)or limited-energy ❑ see Page 2 2
wad,*hanks%or attrition.
Cify/SCatdZl P:Hillsboro,OR 97123 Each additional Inspection over allowable in any of the above
Additional inspection(1 far min) 66.25/hr
Phone:(503)448-4552 Fax:(503)642-7925 Investigation(1 hr min) 90.00/hr
Email:andreap@garnerefectrlc.com industrial plant(Ihrmin) 78.38Uhr
Inspections for which no fee is 90.gN far
CCB Lie.: 121159 Electrical Lic.: 34-30 S ic.: 3707S s ificallh listed('h far mm� r
Suprv,Electrician signature,required: /// ti y�lal 5r'il ` Subtotal.
„`" `k
J.y / / Subtotal:
Print name: Charles Garn Data a2 j 7 0 Plan Review Required(25%of permit fee):
a State surcharge(12%of permit feel:
Authorized signatur LYl 74 g/!, TOTAL PERMIT FEE:
M This permit application caplet.if*permit Is not obtained xi Min Ito
Print name: Andrea Phillips I Date: f// 2Q Zo days after It leas beta accepted as complete.
• Number of inspections allowed per permit.
I.BuildialP iw.ELC_Pera,hApp tLt ERE4ee Rev 06.17l20t5 440-4615T1 I I.OiCUU'WEH
Plumbine Permit Application RECEIVE
Building Fixtures FOR OFFICE USE ONES
MAR 1 2 202i.City of Tigard Received
Received permit No.: S 120 0-1 00(0I
13125 SW Hall Blvd.,Tigard,OR 97223 CIT(OF TIGAR[.wa.Review
ft Phone: 503.718.2439 Fax: 503.598.19��p Other Permit No.:
43UILDING DIVISI cDateroy:
T 1 G Alt D Inspection Line: 503.639.4175 pate Ready/By: Id".
® Sa Page 2 for
Internet: www tigard-ot gov Nodfied/Mdhod Suppllunaml Inlormatloa
r 1 `� �yx., r r:
..' T,r e
���''�� �i�rMrti:. a sS, � �,}�`.'[ I. .. . - %r?f �. .".
ID New construction 0 Demolition For spec1x11xjormailon usechecklist
Description I Qty. 1 Ea. I Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft for each util' connection)
` •i ?'; SFR(I)bath L.. 312.70j
la1-and 2-family dwelling 0 Commercial/industrial SFR(2)balls 437.78
❑Accessory buildingSFR(3)bath I 500.32
0 Multi family Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
« « t
ggiiii 7 �. �.r
Site utilities:
Job site address: /5 0 7 56✓ /.2/ ST Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97223 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldgJapt.no.: Project name:'Pp;r Gh M i 11- L04 Manufactured home utilities 50.03
Cross street/directions to job site:S id,'SJ' Ave * stk.) 3aWeis S;. Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: Idt)) I Page 2
Storm sewer(no.linear ft: Ina) 1 Page 2
Water service(no.linear ft.:1 pc)) 1 Page 2
Subdivision: -j-t,V &t)` G5-6,a-es Lot no.: 3 Flatureoritem: -
Tax map/parcel no.: Backtlow overeater i 31.27
12.51
Clothes washer 1 25.02
New home construction Dishwasher I 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
°'-�. r "'' -' ,7t;:�c y ' ro4 ir"k. Expansion
tank 12.51
Name:' r I l a. ` LL C Fixture/sewer cap 25.02
G.f 1 1 Floor drain/floor sink/hub 25.02
Address:5285 Meadows Rd Ste 171 Garbage disposal I 25.02
City/State/ZIP:Lake Oswego,OR 97035 Hose bib 1 25.02
Phone:(503)657-3402 Fax:( ) Ice maker 1 1231
'`/ j '' N s ,i ,'', ' *..;.( s )tjo,i .12, Interceptor/grease trap 25.02
Business name:JTSC.LLC Medical gas(value:S_._) Page 2
Contact name:John Wyland Primer 1251
Roof drain(commercial) 12.51
Address:5285 Meadows Rd Ste 171 Sink/basin/lavatory '5 25.02
City/State/ZIP:Lake Oswego,OR 97035 Solar units(potable water) 62.54
Phone:(503)209-7555 Fax::( ) Tub/shower/showerpan a 12.51
E-mail:jwyland(gljtsmithco.com Urinal 25.02
r.. ')� ''f04G+0 ;�` .A r '•"^wed, yr„ . .y);_ Water closet 3 25.02
'`)" "":' '"':"'. `�. , Water heater I 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: S72.50
CCB Lie.:92689 Plumbing Lic.no.:34-260PB Plan review (25°/.af permit fa)
�+l State surcharge(12%of permit fee)
Authorized sigrt re: /y-/1 TOTAL PERMIT FEE
Print name:Jeremy cc Date: 3`/%uj This permit application expires ifs permit is not obtained within 1eo days
after it has been accepted as complete.
'Fee methodology set by Tri-County Building Industry Saivism Board.
1:19°ilding\PawitAPMU•PamitApp.doc 10/0lA9 4404616T(Im01/COMM'E8)
Plumbing Permit Application
Building Fixtures 1 uw
FOR orrlcr cse ONLY
City of Tigard 3 0 LJZJ Dateivc 7/r dl z<.) 400 Pamir NoMS i 7d1' --ti'k1O7`.,
III • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review IIO her permit No.: �� y
Phone: 503.718.2439 Fax: 503.598.1960 Dale)By:
T I G A It D Inspection Line: 503 639.4175 Dale Ready/By luny @See Pear 2 roc
Internet: www tigard-or gov Notified/Method: fad Supplemental Information
o _ - r 'k' ° ii 'i ,_ i. arm ,_,. a� 0.. ,
r �;4�Y �F ' tw �.--i.'�'� + :.,. „ R ,.,w "T+.s'rr� i •; .
®New constriction 0 Demolition For special iafornmlioa use checklist
Description I Qty. ) Ea. [ Total
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
SFR(I)bath 312.70
SFR(2)bath 437.78
®I-and 2-family dwelling 0 Commercial/industrial SFR(3)bath 500.32
❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02
❑Master builder ❑Other Fire sprinkler( sq.ft.) Page 2
y� �- s4', �4, ,r Site utilities:
1 -� Catch basin or area drain 18.76
Job site address: .mot-- .l c i `-) .� ),�\ )'
Drywall,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97223 Footing drain(no.linear ft.: _ ) Page 2
Suite/bldg./apt.no.: I Project name: .12>,i i (\\ 11\.\ \ 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 fl.:_.j Page 2
Subdivision: (� 1`(.��i-„si °,)•i c Lot no.: . Fiature or item:
Tax map/parcel no: Backflow preventer 1 31.27
,r sire l,r 4, �,,,,c c, , Backwater valve 12.51_
� =t *. r .• Clothes washer 25.02
New home construction - 1`1(1f�- �'�(� - '1 1 t: -' Dishwasher 25.02
t )1'(' \I C 1`,)( y j l - �X- vA.-]i‘C 1 p( 1 1 1 A � Drinking fountain
25.02
:, 1 Ejectors/sump 25.02
,ry , e, Y.-K g,sts'r !:4k.mX ;i: . :7, 3t\,wi Expansion tank 12.51
,1 Fixture/sewer cap 25.02Name. � ,_ _ 1 �, 1 ,� Floordrain/floorsink/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:( ) Ice maker 12.51
4 41- Itl rtir h yc .-wt4 "t',+tt. '(- ` ,r _:`- Interceptor/grease trap 25.02
Medical gas(value:f ) Page 2
Business name:JTSC,LLC
Primer 12.51
Contact name:John Wyland Roof drain(commercial) 12.51
Address:5285 Meadows Rd Ste 171 Sink/basin/lavatory 25.02
City/State2IP: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:iwylaod@jtsmtheo.com
Water closet 25.02
�iltA i 31'> C t x A' 1 • - '• Water heater 37.52
Business name:Mullen Company Water piping/DWV 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: 572.50
Plan review (25%of permitfce)
CCB Lic.:92689 Plumbing Lic.no.:34 260PB State surcharge(l2%of permit fee)
Authorized sign re: TOTAL PERMIT FEE
...kc
Date: 1�F This
permit application eapirm If a permit is not obtained within ISO days
Print name:Jeremy e ( ..' , ( . after It has been accepted n complete.
*Fee methodology set by Id-County Building Industry Service Board.
I:iBuildinglrenoittiP1MU-PermitAtp.dec 10/01/09 4404616TO 501/COM/WEB)
,a//2..G� /wLL 1 L ® i 3
Dianna Ornelas Pc c _ i2 ev,E u/
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(&,jtsmithco.com
Visit us online at .t' `Smithco.com Facehook
From: Dianna Ornelas<Dianna(catigard-or.gov>
Sent: Wednesday, April 08, 2020 11:41 AM
To: Karina Bradshaw<karina@jtsmithco.com>
Cc:#Building Permit Technicians<TigardBuildingPermits@tgard-or.gov>
Subject: RE: AC Permits for Birch Mill - Lots 1, 4& 6
Importance: High
Hi Karina,
1
City of Tigard
I ' COMMUNITY DEVELOPMENT DEPARTMENT
■
T I G A R D Building Permit Review — Residential
Building Permit #: tut ST2020- 00097_
Site Address: I307y Sw IZt $t.
Project Name: 1:3 1 rGl M'. t% Lot #: 3
Planning Review
Proposal: New 4-ho ex....--
C2 Verify address/suite# active in Accela. yr In River Terrace: No ❑ Yes,River Terrace Review Addendum
/Site Plan Elements: gErosion Control
f 3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper Retained trees with drip line and tree protection measures
Drawn to scale(standard architect or engineer scale) pfootprint of new structure(including decks) and FFE
North arrow 7thility locations&easements(required for new and additions)
7.8-'Site address,project or subdivision name and lot number Sidewalk/driveway approach
,Applicant information(name and phone number) f ncatio -ef-wells/septic systems
J7rLot dimensions and building setback dimensions ZStreet tree size,type and location
Square footage of buildings to be demolished ,Z%Street names
i'txisting structures on site Comer elevations (2'contours if more than 4'differential)
7Lot a:ca, dhxg coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑Yes,No
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑res DNo N/A
gl Clean Water Services-Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified j2'No Received: ❑ Yes ❑ No
E r -Fixture Unit Worksheet-Additions,Remodels and ADUs
Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No
12-8-13C-ExccAption for ADU applied for: ❑ Yes 0 No Received: ❑ Yes ❑ No
g Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes,applicant was notified ❑ No Applied For: /f Yes ❑ No,stop intake
71 Land Use Case#: S U 8 20l S p o vo l wf Zoning: t. 4 S
Required Setbacks: Front: 7-0 Rear: 15 Side: 5 Street Side: NA Garage: 2-0
7 Building Height: Max.Height ..?'O Actual Height: 2 S
Landscape Area: N/A °/u /17r Lot Coverage Max: N/A %
Entrance jil
Set back no more than 8' from street-facing wall 71 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 ,zr Yes ❑ No,one of the following is met:
❑ Door extends no more than 5'from wall and there is a covered porch extending beyond garage.
❑ Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2°d floor.
Gara e door width is ❑ 12'or less ❑ 50%or less of facade f 2/ 60%or less and includes 7 of following:
Covered porch ❑ Recessed entrance � Wall offset !� 1'Roof eave Roof offset
/lX"( Fire shingles 'Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer
❑ Accent siding ❑ Window trim ❑ Wmdow recess ❑ Window projection ❑ Balcony
Visual Clearance Urban Forestry Plan
Sensitive Lands: ❑ Yes ,,,LI No Type:
/ Conditions met prior to issuance of Building permit
Notes: /1 l dl+1c9rls ln'l0' ME1' Prior fro 13SvgnLe--
❑ Approved By Planning: /1/1 I91r%---- "' - - - Date: 3/I z /'L-o
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved 0 Not Approved
Revision 2: ❑ Approved ❑ Not Approved
L\Building\Forms\BldgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: 03 l2 taw
Site Plans: # 3
Building Plans: # ,3
Building Permit#: ak Enter building permit#above.
Workflow Routing: Lk-Planning G - Engineering Er Permit Coordinator 'Building
Workflow Sign-off: [g"Sign-off for Planning(include notes from planning review)
Route Application Documents: LP—Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
1 Building: original permit application,site plans,building plans,engineer and
beam calculations and t details,if applicable,etc.
Notes:
By Permit Technician: 1 / Date: D3 -f ZOZO
Engineering Review
'Slope at building pad: 2
Er.conditions "Met"prior to issuance of building permit
R' Easements (encroachments)per engineering conditions of approval and plat
111/Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes [INo
Assess Water Quantity Fee in-lieu: El Yes [3'No
LIDA Facility on lot: Et-Yes ❑ No
Er-Final Plat Recorded:
0 NOT Approved by Engineering: Date:
Notes:
L Approved by Engineering: 7 - p Date: 3�/7/2u ZL
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El Approved ❑ Not Approved
Revision 2: ❑ 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:
L531 SDC Exemption: ❑ Received SC.Does not apply
SDC Fees Entered: Wash Co Trans Dev Tax: 4 Yes El N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: ®' Yes ❑ N/A
LIDA El Yes ® N/A
, OK to Issue Permit
Approved by Permit Coordinator: ArmenQ`2'L. Date: 3 f 113'20
I:\Building\Forms\BldgPermitRvw_RES_122419.docx