Permit Support Document (2) CITY OF TIGARD � MASTER PERMIT
. Vie. 47
s COMMUNITY DEVELOPMENT Permit#: MST2019-00187
a20 Date Issued: 01/23/2020
T t l A f D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S106DA19100
Jurisdiction: Tigard
Site address: 13194 SW 165TH AVE
Subdivision: RIVER TERRACE EAST 2 Lot: 230
Project: River Terrace East No. 2, Lot 230
Project Description: New SF. HOLD C of 0 until approval of street trees by planning. 5/15/2020: REPRINT permit to
add mini-split system.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 3 First: 2594 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 2D Bathrooms: 3 Second: 0 sf Garage: 566 sf Front: 12 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
Total: 2594 sf Value: $342,201.10 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 5 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: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: Y Hoods: 1 Other Units: 0
Fum<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3
Fum>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temo 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 2594
Owner: Contractor:
WILLIAM LYON HOMES INC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
109 E 13TH ST 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98660 VANCOUVER,WA 98660
PHONE: 360-695-7700 PHONE: 360-695-7700
FAX:
Total Fees: $35,793.33
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through 0 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.Issued By: .1 ta /t Q --) Permittee Signature: 694✓ d76143 4,-f C 1?- h 770 //
Call 503.639.4175 by 7:00 a.m.for the next available Inspection date.
This permit card shall be kept in a conspicuous place on the Job site until completion of the project.
Approved plans are required on the Job site at the time of each inspection.
Mechanical Permit Applicat`i i r ° I'/E P I,oiz of hu't. usi:UNIX
City of Tigard Receives
Date/By: J�y/Zo �� Permit No: S/ — „( �QI
i .. ° 13125 SW Hall Blvd.,Tigard,OR 97223 MAY ] 1 2020 �J
Phone: 503.718.2439 Fax: 503.598.1960 Date/By:
Other Permit:
Inspection line: 503.639.4175 Date Re —
T I G A R n p " Y U Ir 1�`-�t�t' Date Ready/By: Iris: fa See Page 2 for
Internet: www.tigard-or.gov +'` ['�. Notified/Method.� ///
A! IIL9IN DIV�4 �..f/ .(�(� Supplemental Information
TYPE OF WORK COMMERCIAL FEE*SCHEDULE — USE CHECKLIST
Mechanical permit fees'are based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family 0 Master builder Cl Other: Description Qty. Ea, Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: 13194 SW 165th AveFurnace 100,000 BTU(duets/vents) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name:River Terrace East Heat pump 1 61.06
Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Other: 23.32
Subdivision:River Terrace East Lot no.: 230 Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
add mini-split to MST20I 9-00187 fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
® PROPERTY OWNER ❑ TENANT Other. 23.32
----- Environmental exhaust and ventilation:
Name:ADVL Land Holdings,LLC Range hood/other kitchen
Address:7600 E Doubletree Ranch Road equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms,
toilet compartments,utility moms) 23.32
Phone:(602)694-4031 Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name:William Lyon Homes,Inc. 514.15 for first four;$4.03 for each additional
Contact name:Tonja Morris Furnace,etc.
Address:703 Broadway St Suite 510 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 Fax::(360)693-4442 Fireplace
Range
E-mail:Permitsubmittals@taylOrmOrriSonl.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Performance Insulation&Energy Services Other:
_ MECHANICAL PERMIT FEES*
Address:13939 SW Tualatin-Sherwood Rd. Subtotal el,/, p,4,
City/State/ZIP:Sherwood,OR 97140 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)707-6078 Fax:( ) State surcharge(12%of permit fee) -2�,33
CCB lic.: 1 Cl Q 1{l48 rta TOTAL PERMIT FEE •3 9
This permit application expires if a permit Is not obtained within 180
days after it has been accepted as complete.
Authorized.signatur ' ' Fee methodology set by Tri-County Building Industry Service Board
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