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Permit FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 11 Transmittal Letter TIGARD 13125 SW Hall Blvd. • Tigard,Oregon 97223 • 503.718.2439•www.tigard-or.nov TO: City of Tigard DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: Contractor JAN 2 8 2021 COMPANY:VP Custom Construction CITY OF TIGARD PHONE: 360-521-6494 BUILDING DIVISIONBY: EMAIL: p16467@yahoo.com ifi`.✓�.rc� RE: 12080 SV11 iew CT,Tigard, OR 97223 MST2019-00150 (Site Address) (Permit Number) Estates at Aspen ridge Lot 1 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: 4 Additional set(s)of plans. 9 2 Revisions: qtre, Sprinkler 1�Ia�1S Cross section(s)and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: Fire Sprinkler addition FOR OFFICE USE ONLY Routed to Permit Tech�nic,i�a�n• Date: Q - /— .Q J Initials: A.L6 Fees Due: ❑Yes L�'No Fee Description: Amount Due: V Special Instructions: Reprint Permit(per PE): ❑ Yes No ❑Done Applicant Notified: 1=641 nT R- Date: 4/1_/7 f Initials: 46 I:1 Building\Forms\TransmittalLetter-Revisions 073I20.doc 14 CITY OF TIGARD MASTER PERMIT I ' ' COMMUNITY DEVELOPMENT Permit#: MST2019-00150 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: Aug 19 2020 12:OOAM Tftia''\R.D g Parcel: 2S110BC12600 Jurisdiction: Tigard Site address: 12080 SW VIEWCREST CT Subdivision: ESTATES AT ASPEN RIDGE Lot: 1 Project: Estates at Aspen Ridge, Lot 1 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 5 First: 2289 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 26 Bathrooms: 4 Second: 1247 sf Garage: 816 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3536 sf Value: $470,745.55 Rear: 15 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: I Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 6 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: 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: 7 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Fum<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 5 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: 7 201-400 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 3536 Owner: Contractor: NEW CENTURY HOLDINGS LLC VP CUSTOM CONSTRUCTION LLC Required Items and Reports(Conditions) 13376 SW BENCHVIEW TERR 13376 SW BENCHVIEW TER 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97223 TIGARD,OR 97223 PHONE: 503-481-6781 PHONE: 360-521-6494 FAX: Total Fees: $35,250.41 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 throughgh OAR 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 ,%f" ) a ��.1—J Permittee Signature: 0-,A/ �70,6e..1 Ctr-T7U p/ / 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. Rllilding Permit Application Residential i (llt OI 1 it F I ,,I OVI., ��� Received City of Tigard' Datesy: ��rfiIf l Permit No./I1 aq_doi5-0 1111 C A. Bone SW Hall Blvd.,Tigard,OR 98.1 Plan Review �` i I q Other Perm 1 a 1',� Phone: 503.718.2439 Fax: 503.598.1960 DareBy: TIGARD Inspection Line: APR 1 S 2019 Date ReadyBy: fun., ® See Page 2 for Internet: Line: 503.639.4175.goV J.I�� g1, N ed/Method Supplemental Intorma[ioo wag REQUIRED J� 1 lJ G TYPE OF W�raa REQUIRED DATA:1-AND 2-FAMILY DWELLING ®New construction El 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 the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ® 1-and 2-family dwellingValuation: ..533 �,O,"�(� 0 Commercial/industrial 1 1 ElAccessory building ❑Multi-family Number of bedrooms: 5 ❑Master builder ❑Other: Number of bathrooms: 4 xikeri4?- ,la)./'TOB SITE INFORMATION AND LOCATION Total number of floors: 2 Job site address:SOOW�t//VIEWCREST CT New dwelling area: sa�e2�sguare feet l 'a(7 City/State/ZIP: Garage/ arport area: 8r6 square feet2-t�$CL Suite/bldg./apt.no.: Project name: g'�, *S 'A -"-' AW, Covere area: square feet Cross sheet/directions to job site:SW BULL MOUNTAIN RI)SOUTH TO ASPEN El 7D GE Deck area: 203 square feet DR.WEST ONTO SW VIEWCREST CT Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST P Subdivision:ASPEN RIDGE Lot no.:1 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,add the profit for the DESCRIPTION OF WORK work indicated on this application. NEW SFR GG6f ltRyi; LtGe f Ito✓%L✓!� Valuation: $ rJ/5 N/l�� 54-f4evift 3 O✓s Sj�Yt os YL A., Existing building area square feet Ilik.,„ Cfre-7,--1 rec/ rZ'r'I+zli` itp/iees7jk, New building area: square feet ® PROPERTY OWNER b TENANT Number of stories: 'Name:NEW CENTURY HOLDINGS G ,L Type of construction: jddress:13376 SW BENCHVIEW TERR Occupancy groups: —Aty/State/ZIP:TIGARD,OR 97223 Existing: Phoi-le:(503)481-6781 Fax:( ) New: 0 APPLICANT ❑ CONTA :T PERSON BUILDING PERMIT FEES* Business erne: _ (Please refer so fee schedule) ` u l' ziS Structural plan review fee(or deposit): Contact na : FLS plan review fee(if applicable): Address: City/State/ZI): S--a L -f-, Toth fees due upon application: Phone:( ', ) Fax::( ) Amount received: 4 PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: 4Ct.I 1161,'I`ci I e y a ke 0 . LC rt'\-- CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted PhotoVoltaic Solar Panel System. Business name:VP CUSTOM CONSTRUCTION LLC Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 13376 SW BENCHVIEW TERR Solar Installation Specialty Code checklist. City/State/ZIP:TIGARD,OR 97223 Permit Fee(includes plan review $180.00 and administrative fees): Phone:(360)521-6494 Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lie.: i l ei 33,c / /At Total fee due upon application: $201.60 Authorized signature: orr 0 This permit application expires If a permit is not obtained within 180 days after it has been accepted as complete. Print name:PAVEL KUTSAR Date:04-16-19 *Fee methodology set by Tri County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit A lira ' E VED FOR OFFICE USE ONLI I Cityof Tigard DateBed g Date/By: Permit No.:Mrs-r_l I!''_�0 C� • 13125 SW Hall Blvd.,Tigard,OR 97223 1 ( Plan Review / C7 t OU6 ' Phone: 503.718.2439 Fax: 503.598.1960\PR 18 2019 Date/By: Other Permit: 1.1,,\r i, Inspection Line: 503.639.4175 _ A�7(^p, Date Ready/By: .Fats: 65 See Page 2 for Internet: www.tigard-or.gov CITY OF T IGAR V Notified/Method: I Supplemental Information BUILDING DIVISION TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees*are based on the value of the work ❑New construction ❑ Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑ Demolition D Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* 0 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description Qty. Fa. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: O Air conditioning i . 46.75 Job site address: 1 '2 p 6 d S C L) v (e-r1.',e R. e_s f c_+ Furnace 100,000 BTU(ducts/vents) ( 46.75 Furnace 100,000+BTU(ducts/vents) 54.91 City/State/ZIP: 1�, (`� Heat pump 61.06 Suite/bldg./apt.no.: Project name: 0 ujDuct 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: Lot no.: Other fuel appliances: Tax map/parcel no.: Water heater I 23.32 DESCRIPTION OF WORK Gas fireplace/insert 1 33.39 Flue vent for water heater or gas t r"r, fireplace 23.32 J Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Oth 0 PROPERTY OWNER 0 TENANTS' 23.32 �r Environmental exhaust and ventilation: Name: N t tiJ ."F.i.it e� ,'-A( 4 ZS Range hood/other kitchen / equipment r 33.39 Address: ('.;3 '1 _tit) € 1`T t F rr ( t L,:J C.p p S (� �' - Clothes dryer exhaust 1 33.39 City/State/ZIP: et Single-duct exhaust(bathrooms, �" toilet compartments,utility rooms) 23.32 Phone:( ) Fax:( ) Attic/crawlspace fans 23.32 ❑ APPLICANT • El CONTACTPERSON Other: 23.32 Business name: 0 P e Li S 1-0 I t O AS-F R U of 100 L L '� Fuel piping: $14.15 for first four;$4.03 for^uh additional Contact name: p CA J fa L Furnace,etc. „/ I Address: 133 7 c. .c'w l e-N C.H V t'eL4J , e., M, Gas heat pump Wall/suspended/unit heater City/State/ZIP: .4- ( a a tt Water heater I Phone:( 6e9' '2 . ( y (: If Fax::( ) ,�/ FRange ireplace IE-mail: Pt (m/ce 6 //.!7 �t Y art r+E l . [' O Q f ` Barbecue �`. Y CONTRACTOR Clothes dryer(gas) Other: Business name: �4� •ys y„�f j� MECHANICAL PERMIT FEES* Address: /7 6/ ,50- �/'11-- 1r,/ Subtotal City/State/ZIP: /�� / /_ fJt q%�F�6J 7 Minimum permit fee($90.00) "dam/ / Plan review(25%of permit fee) Phone:(360 y j - "ferl," Fax:( ) State surcharge(12%of permit fee) CCB lie.: 02.0(�S (2./4/ TOTAL PERMIT FEE 11 /1 / � This permit application expires if a permit is not obtained within t90 _��1/ days after it has been accepted as complete. Authorized signature: ' r * Fee methodology set by Tri-County Building Industry Service Board Print name: pot t (_ Date: t:\Building:PermitsUEC_PermilApp_040 113.doc 440-4617T(11/02/COMN✓®) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial& Multi-Family Fee Schedule: Total Valuation: Permit Fee: $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$100,000.00 and $2.92 for each additional$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. 1:\Building\Permits\MEC_PermitApp 040113.doc 2 Electrical Permit Application RECEIVE ri)Iz(wvicr nst:oyI.,. City of Tigard Re A • 13125 SW Hall Blvd.,Tigard,OR 97223 JUL 3 2019 plan Review L • Phone: 503.718.2439 Fax: 503.598-1960 DatelB : Related Permit a: T I c;A It o Inspection Line: 503.639.4175 CITY OF TIGAR I' Ready Date/By: hies RI See Page 2 for Internet: www.tigard-or.gov Rt IILDING DIVISI II Ix`'nfieNMethod' Supplemental Information TYPE OF WORK PLAN REVIEW ❑New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑Service or(ceder 400 amps or more 0 Building over three stories. ❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or 0 Floating buildings. ❑ I-and 2-family dwelling 0 Commercial/industrial El Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: Job site address: 12080 SW View Crest Ct IOOHP or more. ❑"A","E","1-2"."1-3", - ❑Six or more residential units. occupancy. City/State/ZIP: Tigard, OR ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: ❑Hazardous locations. ❑Supply voltage for more titan ❑Service or(ceder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Oty. f Pad, I Tend I New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'1500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 New SE (with above sq.ft.) Limited energy,multi-family 75.00 2 residential(with above sq.ft.) , Renewable Energy 0 See Page 2 0 PROPERTY OWNER I 0 TENANT Services or feeders installation,alteration,and/or relocation Name: New Century Holdings 200 amps or less 100.70 2 2131 amps to 400 amps 133.56 2 Address: 13376 SW Benchview Terr 401 amps to 600 amps 200.34 2 City/State/ZIP: Tigard f1R 601 amps to 1,000 amps 301.04 2 Phone:( 360)521-6494 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 70 i. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 Branch circuits—new,alteration,or extension,per panel 0 APPLICANT ❑ CONTACT PERSON A.Fee for branch circuits with Business name: VP Custom Construction LLC above service Or feeder fee, 7.42 each branch circuit Contact name: Pavel B.Fee for branch circuits without J - Address: 13376 SW Benchview Terr service ra ch circuieed tr«,rest 56,18 2 City/Stale/ZIP: Tigard, OR Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(360 ) 521-6494 Fax::( ) Each manufactured or modular 67.84 • dwelling,service and/or feeder Email: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2_ Business name:m Elite�E!lectric nnGlroup,1`LLC Sign or outline lighting 67.84 2 Address: LA: � R\ ¶ lS.t1.S"'k\K. ,, Signall alteratios)n, orlixiension. 0 See Page 2 2 panel,alteration,or extension. Each additional inspection over allowable in anyf the above City/State/ZIP: Portland,OR:C19-30 Additional ins pection(I hr min) 66.25/hr Phone:( 503 432-8845 Fax:( 888)901-7914 Investigation(I hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr ofticeneliteelectriepdx.com Inspections for which no fee is specifically listed('/r hr min) 90.E hr CCB Lic.: 191274 Electrical Lic.:C639 Suprv.Lie.: 5762S ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: �. Print name: � Dater ', �Jk Q Plan Review Required(25%of permit fee): �' State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within ISO Print name: Date: days atter it has been accepted as complete. Number of inspections allowed per penult. 1:19aildingUkrmits\ELC PnnatApp_ELR_ERE.doc Rev 06/17/2015 440.4519T(1 I/05/COMM'EB Plumbing Permit Application Building Fixtures RECEIVE FOR OFFICE USE ONLY City of Tigard RECEIVE. Received Permit No.: ^ e 8 20�9 Date/By: : p,71PU -O)/5c) ;� 13125 SW Hall Blvd.,Tigard,OR 972�pp Plan Review • Phone: 503.718.2439 Fax: 503.59 . 6i1 Other Permit No.: Date/By: Inspection Line: 503.639.4175 a 1�A�� T I C i A R D 1- rI Date Ready/By: kris: ® See Page 2 for Internet: www.tigard-or.gov `' \t�.),i ®r i ON1 Notified/Method: Supplemental Information TYPE OF `,vG 4Jty FEE* SCHEDULE ❑New construction ❑Demolition For special information use checklist. Description I Qty. I Ea. I Total ❑Addition/alteration/replacement ❑Other. New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 El1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 El Accessory building Multi-family SFR(3)bath 500.32 ❑ Each additional bath/kitchen 25.02 ❑Master builder ❑ Other: Fire sprinkler p (_sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: t 2_ o g (bj ra} v I e. Li e e.Q S•{ C+ Catch basin or area drain 18.76 City/State/ZIP: + I de aA2 v Drywefl,leach line,or trench drain 18.76 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name: 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 ft.: ) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 / - Clothes washer 25.02 �t�7W " ---- -- Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: 6ti e.La) C -tN.+p'y }{a t- I R)G-S Fixture/sewer cap 25.02 Address: (33 7 6 L CA, ef- V ( e_ t c E o, Floor drain floor sink hub 25.02 b` Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name: V p l�t3 c}b A C., N S+'t' .. C. -I f` Medical gas(value:$ ) Page 2 Contact name: �(',e tj .e,L Primer 12.51 ,� J Q Roof drain(commercial) 12.51 Address: i 1 3 Z G _Be 4' e fi v t D + " Sink/basin/lavatory 25.02 City/State/ZIP: i, ( g_et f .0 Solar units(potable water) 62.54 Phone:(^b) ,S, 1.1 6$ tfel ti Fax::( ) Tub/shower/shower pan 12.51 E-mail: j� L. Cif 67 ep Yq Et©°. C. Urinal 25.02 L `` �� Water closet 25.02 CONTRACTOR Water heater 37.52 Business name: /1/2 �� !n�`!✓(/V12' 1�j Waterpiping/DWV 56.29 Address: //{ -A,• I7 J Other 25.02 City/State/ZIP: (ip fiteI,✓'e.,i/Lt rf✓ Sa Subtotal Phone: Fax:( ) Minimum permit fee: $72.50 (? ) 77)-- r/6r� Plan review (25%of permit fee) CCB Lie.: 2373 ,X/ Plumbing Lic.no.: j v V r/ ' State surcharge(12%of pemut fee) Authorized signature: �1- � TOTAL PERMIT FEE Print name: t f [, Date: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by TO-County Building Industry Service Board. l:/Buildwg\Permits`PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: Footing drain-1"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 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Valuation: Permit Fee: Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Other Inspections or Fees Qty. Fee(ea) Total eaacd m aiding$1tional$0,00.000r fraction thereof,to aInspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to Jminimum charge—1/2 hour) - and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge—2 hours) each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and 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$120 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*. Plan Review for Plumbing Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace! Please check all that apply. Work Performed: Capped Added Relocate ElAny new commercial building with water service 2"and Baptistry Font Bath: Tub/Shower greater,except systems designed and stamped by licensed Jacuzzi/Whirlpool engineer. ❑ New exterior plumbing site utilities for any complex structure Car Wash: -Each Stall as defined in OAR918-780-0040. -Dave Thor Cuspidor/Water Aspirator El Medical gas and vacuum systems for health care facilities. Dishwasher: -Commercial ElAny multipurpose fire sprinkler system. Domestic ❑ Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" 3" Isometric or Riser Diagram ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain Garbage Domestic non-food that meet the qualifications above. Disposal: -Domestic food related -Commercial food related -Industrial food related Ice Mach./Refrig.Drains Comments regarding fixture work: Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -Lav/Bar non-food related -Bradley -Com/Serv/Util food related -Service *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and Washer-Clothes fees assessed for the sewer increase must be paid before the Water Extractor plumbing permit can be issued. Water Closet-Toilet P g Urinal Other Fixtures: 1:1Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 City of Tigard 114 ■ e COMMUNITY DEVELOPMENT DEPARTMENT T 1 c n x D Building Permit Review — Residential Building Permit #: MC,T icl— C 1cO Site Address: 12_Q$D SW V'vwcrej 4- Project Name: LS a�' A C-41t. Lot #: I (New dwelling=subditision name,Addition or Alteration=last name of owner) Planning Review Proposal: pto Sr me Verify address/suite#active in Accela. lid' In River Terra -: Li' No ❑ Yes,River Terrace Review Addendum Sit lan Elements: ,t�e, r.sion Control • 3 .pies of site plan on 8-1/2"x 11"or 11 x 17"paper P. ' ained trees with drip line and tree protection measures C I .wn to scale(standard architect or engineer scale)°tprint of new structure(including decks)and FFE LJj .rth arrow LF1UJtty locations&easements (required for new and additions) WI . address,project or subdivision name and lot number tdewalk/driveway approach le .plicant information(name and phone number) Rs •cation of wells/septic systems CI .t dimensions and building setback dimensions toittr>-t tree size,type and location I= quare footage of buildings to be demolished `: •eet names lxisting structures on site V omer elevations(2'contours if more than 4'diffe tial) larLot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? LlY0S❑No tm rvious area(applicable if R-7,R-12,R-25&R-40)vIf yes,is a storm water quality facility shown? es ❑No Lvl Clean Water Services-Service Provider Lettttee of platted prior to 9/10/1995): uired: ❑ Yes,applicant was notified Lvf No Received: E Yes 0 No gr/143eullic Facilities Improvement(PFI) Permit: utred: 0 Yes,applicant was notified •LN 1 tt� 'l No Id Use Case #: s��,Ol c—000 l Appplieedoning.d For: (d Z ❑S Yes 0 No,stop intake W' quired Setbacks: Front: � Rear: I Side: S Street Side: 4 Garage: 2.4 lid' B 'ding Height: ^ Max. Height: Actual Height: 2 L- Landscape ea: % L5"Lot Coverage Max:,,��, 1- iQ % Entrance lr ^W t back no more than 8'from street-facing wall /l arallel to street or offset 45 degrees or less Windows jidininaum 12%of area of all street-facing facades 17,5/- Garage door is behind widest street-facing wall 0 Yes P 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�wnd there is a 12 sq ft.window above garage on 2nd floor. UG Garage door width is 0 12'or less Lld 50%or less of facade 0 60%or less and includes 7 of following: 0 Covered porch 0 Recessed entrance 0 Wall offset ❑ 1'Roof eave 0 Roof offset 0 Fire shingles 0 Lap Siding 0 Roof pitch 0 Gable,hip,or gambrel roof 0 Dormer ❑ Accent siding �2 Window trim 0 Window recess 0 Window projection ❑ Balcony isual Clearance Kd Urban Forestry n h Sensitive Lands: ❑ Yes 6d No Type: l'r Conditions ImFt prior o issuanyye of building permit Q o s: G ^dk t'lMi to (x. fret-Ci Ott.r�(i- f�WWI- Approved By Planning: f Date: —tp li Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved 0 Not Approved Revision 2: 0 Approved 0 Not Approved Revision 3: ❑ Approved 0 Not Approved I:\Building\Forms\BldgPemiltRvw_RES_022819.docx Building Permit Submittal Original Submittal Date: 1-‘1�k \Q Site Plans: # Building Plans: # Building Permit#: [/ Enter building permit#above. Workflow Routing: 2/Planning 2/Engineering LPermit Coordinator Er- Building Workflow Sign-off: S Sign-off for Planning(include notes from planning review) Route Application Documents: E' Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. Cif Building: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: Date: kks Engineering Review ❑ Slope at building pad: 2,iit ❑ Conditions "Met"prior to issuance of building permit ❑ Easements (encroachments)per engineering conditions of approval and plat 17,_ ❑ Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes ❑ No Assess Water Quantity Fee in-lieu: 0 es ❑ No LIDA Facility on lot: Yes ❑ No ►1 Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: dil Approved by Engineering: Date: c/y///9 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit ❑ Approved, NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: Revision Notice 3: Date Sent to Applicant: SDC Fees Entered: Wash Co Trans Dev Tax: 2/Yes ❑ N/A Tigard Trans SDC: 2/ s ❑ N/A Parks SDC: [ ❑ A LIDA Yes )i6 OK to Issue Permit t ex" per-Kko t e Approved by Permit Coordinator: Date: I:1Building\Forms\BldgPern itRvw_RES_022819.docx