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Permit
IPermCITY OF TIGARD MASTER PERMIT °7 I ' , COMMUNITY DEVELOPMENT it#: MST2020-00305 Date Issued: 12/10/2020 TIC A R 17 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S103BB08400 Jurisdiction: Tigard Site address: 12415 SW 122ND AVE Subdivision: LAKE TERRACE Lot: 11 Project: Smith Project Description: Add 160 sf master closet, remodel master bath, add 2nd lay&washer/dryer;add bar sink;add 236 sf deck cover, reconfigure deck stairs. NO FINAL INSP UNTIL WATER METER UPSIZED. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 0 First: 160 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 24 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: Total: 160 sf Value: $26,295.35 Rear: 0 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 2 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Drywall-Trench Drain: 0 Other Fixtures: 1 Other Fixture Units: bar sink MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 1 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 0 Other Units: 0 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Fum>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 4 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: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ADD SF VB R-3 160 Owner: Contractor: SMITH,TIMOTHY&MOLLY STRAIGHT LINE DESIGN&REMODELING LL Required Items and Reports(Conditions) 12415 SW 122ND AVE 4640 SW BEAVERTON HILLSDALE 1 Geo Tech Report Required TIGARD,OR 97223 HWY Prior To Pour PORTLAND,OR 97221 PHONE: PHONE: 503-244-5463 FAX: Total Fees: $1,672.65 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: ) WJ l ldC_XXJe Permittee Signature: l! V aPOC'a 1 6\Nr. Call 503.639.4175 by 7:00 a.m.for the next available Inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application_C FOR OFFICE I SE ONLY City of Tigard EC L��E ' Received Date/By: //Arid 4'26 Permit N/YSrZ{f 20-00 3OS NI • 13125 SW Hall Blvd.,Tigard,OR 97223 0 ■ Phone: 503.718.2439 Fax: 503.598.1960 NOV 0 3 L02GIMMIMIIIIIM Other Permit: 1 ; \;;l3 Inspection Line: 503.639.4175 Date Read B mrls: Internet: www.tigard-or.gov CITY OF TIGARD y y ® see Page2for RI Ill nlnJ(:. r`I1,!�Sil1 Notified/Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees*are based on the value of the work ❑New construction ® Addition/alteration/replace Ellperformed.Indicate the value(rounded to the nearest dollar)of all ❑ Demolition ❑ Other: e3 IC' 41 , mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ® 1-and 2-family dwelling 0 Commercial/industrial ❑ Accessory building For special information use checklist. 0 Multi-family ❑Master builder ❑ Other: Description Qty. Ea. Total (2q)5 JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 46.75 Job site address32. $W 122nd Ave Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP:Tigard, OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name:Master Closet Addition Duct work 1 23.32 23.32 Cross street/directions to job site: SW Walnut St. 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:Lake Terrace Lot no.:11 Other fuel appliances: Tax map/parcel no.:2S 103BB08400 Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 Flue vent for water heater or gas Extend heat air ducting to the new master closet. Remove and fireplace 23.32 replace bath exhaust fan. Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent _ 23.32 ® PROPERTY OWNER 0 TENANT Other: 23.32 Environmental exhaust and ventilation: Name:Tim and Molly Smith Range hood/other kitchen equipment 33.39 Address:12145 SW 122nd Ave Clothes dryer exhaust 1 33.39 33.39 City/State/ZIP:Tigard, OR 97223 Single-duct exhaust(bathrooms, l 23.32 toilet compartments,utility rooms) 23.32 Phone:( ) Fax:( ) Attic/crawlspace fans , 23.32 ® APPLICANT 0 CONTACT PERSON Other: 23.32 Fuel piping: Business name:Straight Line Design & Remodeling LLC $14.15 for first four;$4.03 for each additional Contact name:Steven Griffin Furnace,etc. Address:9645 SW Beaverton Hillsdale Hwy Gas heat pumpWall/suspended/unitheater City/State/ZIP:Beaverton, OR 97005 Water heater Phone:(971 )275-3261 Fax: :( ) Fireplace Range E-mail:steve@straig htl i ned r.corn Barbecue _ CONTRACTOR Clothes dryer(gas) Business name:Straight Line Design & Remodeling LLC Other: • MECHANICAL PERMIT FEES* Address:9645 SW Beaverton Hillsdale Hwy 11'1pk -r 3 Zei . Subtotal ..80,Q35.0,7( City/State/ZIP:Beaverton, OR 97005 Minimum permit fee($90.00) 90.00 Phone:( 275 3261 Fax:( ) Plan review(25%of permit fee) 22.50 State surcharge(12%of permit fee) 11.25 CCB lie.:195218 TOTAL PERMIT FEE $123.75 This permit application expires if a permit is not obtained within 180 7 days after it has been accepted as complete. Authorized signature:3&r.4„,k4z,CG,2 . . * Fee methodology set by Tri-County Building Industry Service Board Print name:Steven Griffin f/1 Date:10/19/20 I\BuildinglPermits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB) 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. $5,000.0 I 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$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I:\Building\Permits\MEC_PermitApp_040113.doc 2 Electrical Permit Application RECEIVE Received City of Tigard Date By: PeDnrtu:m$TZlJJZC7 Yit'J3o5 13125 SW Hall Blvd.,Tigard,OR 97223 19 Plan Review 11 Phone: 503.718.2439 Fax: 503.598.1960 OCT 10 Date/By: Related Permit 4: Inspection Line: 503.639.4175 Ready Date/By: Jute j' faSee Page 2 for I I l'ni,I) Internet: www.tigard-or.gov �CITY OF TIGARD Notified/Method: `to Supplemental Information p � TYPE OF WOIILDIPIC DIVISION PLAN REVIEW ❑New construction ®Addition/alteration/replacement Please check all that apply(submit 7/sets of plans w/items checked): 0 Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition 0 Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ® 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 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#:20016 Job site address:12415 SW 122nd Ave 100HP or more. ❑ 'A".'B"'"1-z',"I-3", City/State/ZIP:Ti ard, OR 97223 o Six or more residential units. occupancy. ❑ g 0 Health-care facilities.. Recreational vehicle parks. Suite/bldg./apt.#: Project name:Master Closet Addition 0 Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: SW Walnut St. FEE SCHEDULE Description I QiT. I Each I Total New residential single-or multi-family dwelling unit. Subdivision:Lake Terrace Lot#:1 1 Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#:2S103BB08400 -Ea add'1500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential (with above sq.ft.) 75.00 2 Add one circuit to the new closet addition and reconfigure existing Limited energy,multi-family adjacent bathroom circuits. residential(with above sq.ft.) 75.00 2 XPROPERTY OWNER 0 TENANT Renewable Energyto See Page 2 Services or feeedersders installation,alteration,and/or relocation Name:Smith, Tim & Molly 200 amps or less 100.70 2 Address:12415 SW 122nd Ave 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/state/ZIP:Tigard, OR 97223 601 amps to 1,000 amps 301.04 2 Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 - 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 ® APPLICANT 0 CONTACT PERSON Branch circuits-new,alteration,or extension,per panel A.Fee for branch circuits with Business name:Straight Line Design & Remodeling LLC above service or feeder fee, 7.42 2 each branch circuit Contact name:Steve Griffin B.Fee for branch circuits without Address: service or feeder fee,first 1 56.18 56.18 2 9645 SW Beaverton Hillsdale Hw y branch circuit city/State/ZIP:Beaverton, OR 97005 Each add'l branch circuit 3 7.42 22.26 2 Miscellaneous(service or feeder not included) Phone:(971 )275-3261 Fax::( ) Each manufactured or modular 67.84 2 dwellinEmail:steve strai htlinedr.com Reconne,tonlyeandorfeeder _ g Reconnect only 67.84 _ 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: Three Dog Electric Sign or outline lighting 67.84 _ 2 Signal circuit(s)or limited-energy ❑ See Page 2 2 Address:5250 SW Camaron Rd. panel,alteration,or extension. City/State/ZIP:Portland, OR 97221 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(503)421-4879 Fax:( ) Investigation(1 hr min) 90.00/hr Email: / Industrial plant(1 hr min) 78.18/hr / ,/ (1 1gt S � Inspections for which no fee is 90.00/hr CCB Lic.:138509 / Electrical L1Vc.:4613'i3" ! Supl' .1:› specifically listed('/z hr min) _ ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: IL �- Subtotal:_78.44 Print name: i� Daate:10/19/20 0 Plan Review Required(25%of permit fee): 19.61 State surcharge(12%of permit fee): 9.41 Authorized signature:S 4.z TOTAL PERMIT FEE: 107.46 This permit application expires if a permit is not obtained within 180 Print name:Steven Griffin Date:10/19/20 days after it has been accepted as complete, ' Number of inspections allowed per permit. t\8midmg\Peones\ELC_PormitApp_ELR_ERE.dee Rev 06/17/2015 440-4615T(11/05/COM,WEB I ' Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Fee for all residential systems combined: $75.00 on I o I Each I Tay I Renewable Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 2 ❑ 50.01 to 100 kva 552.26 2 Garage Door Opener* >100 kva(fee in accordance 552.26 2 with OAR 918-309-0040) ❑ H• eating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 LiVacuum Systems* >100 kva—no additional charge 0.0 3 Each additional inspection over allowable in any of the above: ❑ Other: Each additional inspection is 66.25/hr 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(1/2.hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 • Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ A• udio and Stereo Systems ❑ Boiler Controls ❑ C• lock Systems ❑ D• ata Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC El Instrumentation Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical —I Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: _ *No licenses are required. Licenses are required for all other installations 1:1131aldiig'Pen.ots\Flr PennitApp_EL;R_ERE.doc Rev 06/17/2015 Plumbing Permit Application • Building Fixtures RECEIVEIIIIIIIIIIIIUIIIIOIIIIIIIMIIIIIIII City of Tigard ceived Permit No. 111 ■ 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: ��30� ■ 0 C T 19 Plan Review Phone: 503.718.2439 Fax: 503.598.1960Other Permit No.: Date/By: i I i A Ii f Inspection Line: 503.639.4175 CITY OF TIGARD Dale Ready/By: 7,yL: BI See Page 2 for Internet: www.tigard-or.gov Notified/Method I Psi Supplemental Information BUILDING DIVISION TYPE OF WORK FEE* SCHEDULE ❑New construction 0 Demolition For special information use checklist Description Qt . Ea. I Total Ig Addition/alteration/replacement ❑Other: New I-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(I)bath 312.70 ® I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 ❑Accessory building ❑Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 ❑Master builder ❑Other: _ Fire sprinkler(-sq.It) Page 2 JOB SITE INFORMATION AM) LOCATION Site utilities: Job site address:12415 SW 122nd Ave Catch basin or area drain 18.76 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.: I Project name:Master Closet Addition Manufactured home utilities 50.03 Cross street/directions to job site: SW Walnut St. Manholes 18.76 pfol,,/CiUS se 2(/f Gt� A2.6-y/A6�.. LEIr72- •6 Rain drain connector 18.76 1/ fr./4i nb-'7- . j[idc/Zt Sanitary sewer(no.linear ft.: Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision:Lake Terrace I Lot no.:11 Fixture or item: Tax map/parcel no.:2S103BB08400 Backflow preventer 31.27 ( Backwater valve 12.51 / ,0C'rr Pe l rei- R ON *4 WORK 2-j - Clothes washer 1 25.02 25.02 Ate-shower stall. move sink and add 2nd sink. add clothes - Dishwasher 25.02 washer Fl r bs ( I) 1 s i KJ l� Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER ❑ TENANT Expansion tank 12.51 Name:Smith, Tim& Molly Fixture/sewercap - 25.02 Floor drain/floor sink/hub 25.02 Address:12415 SW 122nd Ave - Garbage disposal 25.02 City/State/ZIP:Tigard, OR 97223 Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name:Straight Line Design & Remodeling LLC Medical gas(gal e:$-> Page 2 Primer 12.51 Contact name:Steven Griffin Roof drain(commercial) 12.51 Address:9645 SW Beaverton Hillsdale Hwy Sink/basin/lav ry z, ,3 25.02 54.04 City/State/ZIP:Beaverton, OR 97005 Solar units(potable water) 62.54 Phone:(971)275-3261 Fax::( ) Tub/shower/shower pan 1 12.51 12.51 E-mail:steve@straightlinedr.com urinal 25.02 Water closet 25.02 CONTRACTOR - Water heater 37.52 Business name: Troy Elliot Plumbing Waterpiping/DWV 56.29 Address:PO BOX 1958 Other: 25.02 City/State/ZIP:North Plains OR 97133 Subtotal 91.57 Phone:(503 )309-5750 Fax:( ) �. Minimum permit fee: $72.50 / Plan review (25%of permit fee) 22.89 CCD Lie.:152130 ✓ Plumbing Lie.no.:34-402PB ✓ - State surcharge(12%of permit fee) 10.98 Authorized signature: TOTAL PERMIT FEE 125.44 Print name:Steven Griffin Date:10/19/20 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. "Fee methodology set by Tri-County Building Industry Service Board. I:'Building\Permits1PLMU•Perm@App.doc 10(01/09 440-4616T(I0/02/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 S121.90 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 each additional$100.00 or fraction thereof,to and including S10,000.00. Inspection 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 (minimum 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$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*. 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 Baptistry/Font ❑ Any new commercial building with water service 2"and Bath: Tub/Shower greater,except systems designed and stamped by licensed -Jacuzzi/Whirlpool engineer. Car Wash: Each Stall 0 New exterior plumbing site utilities for any complex structure D iv Each Thru as defined in OAR9]8-780-0040. Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities. Dishwasher -Commercial 0 Any multipurpose fire sprinkler system. Domestic 0 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 0 Isometric or riser diagram is required for new buildings -Car Wash Drain that meet the qualifications above. Garbage -Domestic non-food 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/Sere/Util food related -Service *Note: If the fixture work tinder 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 Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: 1:ABuilding\Permits\PLMF_PermitApp.doc 08/04/2011 2 City of Tigard C r COMMUNITY DEVELOPMENT DEPARTMENT UPI TIGARD Building Permit Review — Residential Building Permit #: M'ST'ZOZo-CC,3dS Site Address: 12416 SW I2-2-lioi Av-eProject Name: SOn t Lot #: Planning Review Proposal: AzitA 0'1(31%4. . QX. Verify address/suite#active in Accela. t.In River Terrace: IX. No ❑ Yes, River Terrace Reviem Addendum Site Plan Elements: 'Erosion Control X3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper (retained trees with drip line and tree protection measures ��(prawn to scale(standard architect or engineer scale) ll'Lootprint of new structure(including decks)and FFE ,25LNorth arrow Utility locations&easements (required for new and additions) Site address,project or subdivision name and lot number h 'dewalk/driveway approach Applicant information(name and phone number) ocation of wells/septic systems Lot dimensions and building setback dimensions treet tree size,type and location ware footage of buildings to be demolished txeet names ARI xisting structures on site `► omer elevations(2'contours if more than 4'differential) INABot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑Yes l:No impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes No yr Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995): Required: Yes,applicant was notified ❑ No Received: ❑ Yes . No VI Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs Required: ❑ Yes,applicant was notified NC No Received: ❑ Yes ❑ No X. SDC Exemption for ADU applied for: ❑ Yes No Received: ❑ Yes ❑ No ��,{ J� Public Facilities Improvement (PFI) Permit: Required: ❑ Yes,applicant was notified Xl No Applied For: ❑ Yes ❑ No,stop intake Land Use Case#: Zoning: R4.S Required Setbacks: Front: 20 Rear: 1-0 Side: 5 Street Side: Nl/ Garage: 20 21-Building Height: Max. Height: 3D Actual Height: }2.+ W-Landscape Area: % Lot Coverage Max: % Entrance C1 Set b, k no m re than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less Windows l i um 12° of area of all street-facing facades /� Garage II %. arati- door s b. , nd widest str �wand eXes ❑ No,one of the following is met: \t Poor xte . no more thaVW,Mewall a d re is o.erR u i 1�g beyond garage. ill Moor xte . o more than/1 fr� t s ` U Io waboove garage on 2"floor. l II Garage do r wi. i is ❑ 12'or e's or less of fa ca e ❑ 60%or less and includes 7 of following: ❑ Coy red ..rch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset ❑ Fir shing es ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer ❑ Ac nt siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony Khetcrisual Clearance rban Forestry Plan • tip (I oU tGtK"— Yes 0 No Type: V .W HO.'� (5c;tyli tSUrc�(�. Sensitive Lands: V Itn Conditions met prior to issuance of building permit of wa-U Notes: WAY not- proposed w[un we--fiC&or tAi r -Cws V63.Craimdo ilt J( UApproved By Planning: AA- -- Date: ID 2Z 110 Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved 0 Not Approved Revision 2: 0 Approved ❑ Not Approved L\Building\Fonns\B1dgPermitRvw_RES_122419.docx Building Permit Submittal Original Submittal Date: /0/19/202_0 Site Plans: # ,3 Building Plans: # 3 Building Permit#: [ Enter building permit#above. Workflow Routing: [ Planning 'Engineering Permit Coordinator L uilding Workflow Sign-off: [&Sign-off for Planning(include notes from planning review) Route Application Documents: [ —Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. [k--Building: original permit application, site plans,building plans, engineer and beam calculations and trus .etails,if applicable,etc. Notes: By Permit Technician: - iii/iI/r Date: /4/22/362 Engineering Review I 12" Slope at building pad: 2D`g) / �d( Gc, afoL e 'h ? U Conditions "Met"prior to issuance of building permit P4 is GEEasements (encroachments)per engineering conditions of approval and plat.t.h IR(Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes Ig/No Assess Water Quantity Fee in-lieu: D YesEl/No LIDA Facility on lot: ❑ Yes �No LYFina1 Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: C�Approved by Engineering: n.z-.f �V / Date: r0/2Z/Zo20 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: 0 Approved ❑ Not Approved Permit Coordinator Review Os-Conditions "Met"prior to issuance of building permit 0 Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: 54 SDC Exemption: 0 Received 't Does not apply SDC Fees Entered: Wash Co Trans Dev Tax: 0 Yes V N/A Tigard Trans SDC: 0 Yes ,�,{{ N/A Parks SDC: 0 Yes ��., N/A LIDA 0 Yes 1�.N/A OK to Issue Permit Approved by Permit Coordinator: Date: Pia,(700 L\Building\Forms\BldgPermitRvw_RES_122419.docx - oc� so RECEIVED NOV 2 4 2020 CTY OF TIG,ARO C1eanWate Services • SENSITIVE AREA PRE-SCREENING SITE ASS Ii ENT '�N Clean Water Services File Number 20-002778 1. Jurisdiction: Tigard 2. Property Information (example: 1S234AB01400) 3. Owner Information Tax lot ID(s): Name: Tim and Molly Smith 2S103BB08400 Company: Address: 12415 Sw 122nd Ave OR Site Address: 12415 Sw 122nd Ave City, State,Zip: Tigard, OR , 97223 City, State,Zip: Tigard, OR, 97223 Phone/fax: Nearest cross street: Walnut Email: 4. Development Activity(check all that apply) 4. Applicant Information © Addition to single family residence(rooms, deck, garage) Name: Steve Griffin ❑ Lot line adjustment 0 Minor land partition Company: Straight Line Design and Remodeling LLC. ❑ Residential condominium ❑ Commercial condominium Address: 9645 SW Beaverton Hillsdale Hwy ❑ Residential subdivision ❑ Commercial subdivision City,State,Zip: Beaverton, OR,97005 D Single lot commercial ❑ Multi lot commercial Phone/fax: 9712753261 Other Email: steve@straightlinedr.com 6. Will the project involve any off-site work? El Yes ❑ No ['Unknown Location and description of off-site work: 7. Additional comments or information that may be needed to understand your project: This application does NOT replace Grading and Erosion Control Permits,Connection Permits,Building Permits,Site Development Permits,DEQ 1200-C Permit or other permits as issued by the Department of Environmental Quality, Department of State Lands and/or Department of the Army COE. All required permits and approvals must be obtained and completed under applicable local,state,and federal law. By signing this form, the Owner or Owner's authorized agent or representative, acknowledges and agrees that employees of Clean Water Services have authority to enter the project site at all reasonable times for the purpose of inspecting project site conditions and gathering information related to the project site. I certify that I am familiar with the information contained in this document,and to the best of my knowledge and belief,this information is true,complete,and accurate. Print/type name Steve Griffin Print/type title designer Signature ONLINE SUBMITTAL Date 10/9/2020 FOR DISTRICT USE ONLY ❑ Sensitive areas potentially exist on site or within 200'of the site.THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties, a Natural Resources Assessment Report may also be required. ❑ Based on review of the submitted materials and best available information sensitive areas do not appear to exist on site or within 200'of the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider Letter as required by Resolution and Order 19-5, Section 3.02.1,as amended by Resolution and Order 19-22.All required permits and approvals must be obtained and completed under applicable �/local,State and federal law. LA Based on review of the submitted materials and best available information the above referenced project will not significantly impact the existing or potentially sensitive area(s)found near the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect additional water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider Letter as required by Resolution and Order 19-5,Section 3.02.1,as amended by Resolution and Order 19-22.All required permits and �/approvals must be obtained and completed under applicable local,state and federal law. NI THIS SERVICE PROVIDER LETTER IS NOT VALID UNLESS 1 CWS APPROVED SITE PLAN(S)ARE ATTACHED. ❑ The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2).NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. Reviewed by 6P1hur�ati� . Date 10/26/2020 Onc omplete,email to:SPLReview@cleanwaterservices.org • Fax: (503)681-4439 OR mail to: SPL Review,Clean Water Services, 2550 SW Hillsboro Highway, Hillsboro, Oregon 97123 2.0O20 Main Office • 2550 SW Hillsboro Highway • Hillsboro,Oregon 97123 • p: 503.681.3600 f: 503.681.3603 • cleanwa erservices.org s . /t'1 ST.-o -D -‘7030-s' A7//S, Water Meter Fixture Unit Worksheet for Additions/Remodels/A • — D Please complete the following information: NOV 2 4 2lL:IF 0 Customer Name: Steven Griffin CITY OF-1 i( .JILD!NGflVlpi� Service Address: Street/Suite #: 12415 SW 122nd Ave City: Tigard State: OR Zip: 97223 Phone Number: (971)275-3261 Email:steve@straightlinedr.com Please fill in the number of each fixture you currently have. Please fill in the number of fixtures you propose to add. Multiply the quantity by the point value to arrive at the current Multiply the quantity by the point value to arrive at total. the proposed total. Fixture Unit Current Point Current Proposed Point Proposed Quantity Value Total Addition Value Total Bar sink 2 x 1 = 2 x I = Bidet x 1 = x 1 = Clothes washer 1 x 4 = 4 1 x 4 = 4 Dishwasher 1 x 1.5 = 1.5 x 1.5 = Hose bib 1 x 2.5 = 2.5 x 2.5 = Hose bib, each x 1 = x 1 = Kitchen sink 1 x 1.5 = 1.5 x 1.5 = Laundry sink x 1.5 = x 1.5 -- Lavatory 3 x 1 = 3 1 x 1 = 1 Water closet, 1.6 GPF 3 x 2.5 = 7.5 x 2.5 = Bathtub/whirlpool x 4 = x 4 = Shower stall 1 x 2 = 2 x 2 = Bath/shower combo 1 x 4 = 4 x 4 = Current Points: 28 Proposed Increase: 5 Current Points+Proposed Increase= 33 =New Total Points =Required Meter Size 3/4" Meter Sizes: Ito 30 points=5/8" 30.5 to 37 points='A" 37.5 and over points= 1" New Meter Size Needed for New Total Points: 3/4 Cost: $13425.00 (see page 1) Current Meter Size per Utility Billing: 5/8 Cost: $9406.00 (see page 1) New Meter Size Cost minus Current Meter Size Cost $4019.00 (This is Your Cost to Increase Meter Size Due to Additional Fixture Units) FOR OFFICE USE ONLY Current Meter Size Confirmed with UB SEA LP"141 L rr;97 /5i'/ZO Signature of UB Representative Date 1:/Building/Forms/WaterMeters_070119_Add.dOCX Page 2 Risir . Dianna Ornelas From: UB Online Sent: Tuesday, November 24, 2020 3:58 PM To: Dianna Ornelas; #Building Permit Technicians Cc: Steve Griffin Subject: FW:Water meter fixture count revision for MST2020-00305 Attachments: WaterMeter Fixture count.pdf Dianna, With the changes in the Water Meter Fixture Unit Worksheet showing the bar sinks,the additional fixtures will require this meter to be upgraded from a 5/8 inch to a '/ inch. Please let me know if you have any questions. Kind Regards, Jill (she/her/hers) iiE A Willa Jill ( aii►Pi°""t1WCAMBFAN 1 - • City of Tigard -Utility Billing 140.0. 3 Senior Accounting Asst TICrARO (888)826-7211Payments (503)718-2460 UB Main jillb@tigard-or.gov (503)718-2494 BE KIH►, 13Tigard,25 OR RH97223all d From:Steve Griffin <steve@straightlinedr.com> Sent: Tuesday, November 24, 2020 10:07 AM To: UB Online <UBOnlinepay@tigard-or.gov> Subject:Water meter fixture count revision for MST2020-00305 Warning!This message was sent from outside your organization and we are unable to verify the sender. I'm submitting a revised water meter fixture count that shows the water meter to be upgraded to 3/4". In an effort to try to avoid the water meter upgrade charges we were going to remove the existing hose bib. However, after the fixture count revision the charges are unavoidable so we will keep the existing hose bib, therefore, the original plumbing application still stands. These changes are being submitted as per Dianna L. Ornelas request. Please email Dianna with any questions you might have and let me know if you need anything else. Thank you. Steve Griffin Straight Line Design & Remodeling LLC 971-275-3261 Steve@straightlinedr.com www.straightlinedr.com 1 Dianna Ornelas From: #Building Permit Technicians Sent: Tuesday, November 3, 2020 12:28 PM To: 'Steve Griffin' Cc: Allyson Armstrong; UB Online Subject: FW: Plan Review - 12415 SW 122nd Ave i'4.s i (' P - O€73 Attachments: SMITH.20016.Ceiling Insulation Revl.pdf; App.Mechanical.signed.Revl.pdf; SMITH.20016.energymeasuresRevl.pdf; Smith.Planning Revl.pdf; WaterMeters_070119 Add.pdf; TransmittalLetter-Revisions_073120.pdf Hello Steve, Thank you for submitting the revision documents. I have printed the documents and added a copy fee of$6.75 to the permit and routed them offsite for building plan review. Please note that if you have any revisions to submit in the future, please complete the attached transmittal letter that explains the revisions so that we can documents to the appropriate plan reviewers. After reviewing your attached check sheet response and the plumbing permit application, I understand that the plumbing scope of work is to relocate the existing shower stall, add a 2'd lay, and add a washer/dryer combo to the existing bathroom. Please confirm that this is correct. Because additional plumbing fixtures are being added to this residence, our Utility Billing (UB) division requires that you complete a water meter fixture unit worksheet (see attached) to determine if the current water meter needs to be 'upsized' to meet the additional plumbing fixtures. Please complete the worksheet and email to UBOnlinepay@tigard- or.gov for their review. UB will email their recommendations to you and they will copy the permit technicians so that we know how to process the building permit submitted for this project. Please note that if UB determines that the water meter needs to be upsized, the building permit will have a condition that requires the new water meter to be installed prior to final building inspection. Thank you and please let me know if you have any questions or contact UB if you have questions about the worksheet. Dianna L. Ornelas 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:Allyson Armstrong<AllysonA@tigard-or.gov> Sent:Tuesday, November 3, 2020 10:24 AM To:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Subject: FW: Plan Review- 12415 SW 122nd Ave Please print the attached revision in 3 copies for me. I forgot to ask him to fill out the Transmittal Form. Here is the info. To—Allyson MST2020-00305 1 J 12415 SW 122nd Ave. Revised Ceiling insulation, Adding dryer vent/ Mech app attached. Thank you, Allyson From: Steve Griffin <steve@straightlinedr.com> Sent:Tuesday, November 3, 2020 9:56 AM To:Allyson Armstrong<AllysonA@tigard-or.gov> Subject: Re: Plan Review- 12415 SW 122nd Ave Warning! This message was sent from outside your organization and we are unable to Allow sender I Block sender , verify the sender. Hello Allyson, I've attached a check sheet response, revised plan pages, and a revised mechanical application. Please let me know if you have any more questions. Thank you. On Mon, Nov 2, 2020 at 8:00 AM Allyson Armstrong<AllysonA@tigard-or.gov>wrote: Please see the attached plan review letter and let me know if you have any questions. Thank you, Allyson . Allyson Armstrong rr1-1 ' Ctty Of Tigard (503)716-2612 Work Mobile ltysonA@tigard-on gov 13125 SW Hall Boulevard Tigard, Oregon 97223 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." Steve Griffin Straight Line Design & Remodeling LLC 971-275-3261 2 Steve@straightlinedr.com www.straightlinedr.com 3 /t/-Si-2vc,7o — DO3cS Water Meter Fixture Unit Worksheet for Additions/Remodels/ADUs Please complete the following information: Customer Name: Steve Griffin Service Address: Street/Suite#: 12415 SW 122nd Ave rC D! ISIO J City: Tigard, OR 97223 State: OR Zip: 97223 Phone Number: (971)275-3261 Email: steve@straightlinedccom Please fill in the number of each fixture you currently have. Please fill in the number of fixtures you propose to add. Multiply the quantity by the point value to arrive at the current Multiply the quantity by the point value to arrive at total. the proposed total. Fixture Unit Current Point Current Proposed Point Proposed Quantity Value Total Addition Value Total Bar sink x 1 = x 1 = Bidet x 1 — x 1 = Clothes washer 1 x 4 = 4 1 x 4 = 4 Dishwasher 1 x 1.5 = 1.5 x 1.5 = Hose bib l x 2.5 = 2.5 x 2.5 = Hose bib,each x 1 = x 1 = Kitchen sink 1 x 1.5 = 1.5 x 1.5 = Laundry sink x 1.5 = x 1.5 = Lavatory 3 x 1 = 3 1 x 1 = 1 Water closet, 1.6 GPF 3 x 2.5 = 7.5 x 2.5 = Bathtub/whirlpool 1 0 x 4 = 4 0 x 4 = Shower stall 1 x 2 — 2 x 2 = Bath/shower combo 1 x 4 = 4 x 4 = Current Points: 23.5 26.0 Proposed Increase: 5 Current Points+Proposed Increase= 28.5 31. =New Total Points =Required Meter Size 5/8" 3/4 Meter Sizes: 1 to 30 points=5/8" 30.5 to 37 points='/d" 37.5 and over points= 1" New Meter Size Needed for New Total Points: 3/4 Cost: $ 13425.00 (see page 1) Current Meter Size per Utility Billing: 5/8 Cost: $ 9406.00 (see page 1) New Meter Size Cost minus Current Meter Size Cost= $ 4019.00 (This is Your Cost to Increase Meter Size Due to Additional Fixture Units) ************************************************************************************* FOR OFFICE USE ONLY Current Meter Size Confirmed with UB J. Bentley/UB 11/05/2020 Signature of UB Representative Date 1:/Building/Forms/WaterMeters_070119 Add.docx Page 2 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT • Water Meter Fixture Unit Worksheet For Additions /Remodels /ADUs 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov LOCATION: City of Tigard—City Hall WATER METER SALES: Utility Billing By Appointment Only: 503-718-2460 13125 SW Hall Blvd. Monday—Thursday, 9 a.m. to Noon Tigard, OR 97223 METER: SIZE: FEE: Pricing effective 7/1/2019 5/8" $9,406.00 Fee includes: 3/4" $13,425.00 water system development charge, 1" $24,645.00 water meter, and 1-1/2" $72,969.00 meter installation fee. 2" $118,163.00 DETERMINING METER SIZE FOR RESIDENTIAL CUSTOMERS City of Tigard Water Service Area uses the American Water Works Association Manual and the Oregon Plumbing Specialty Code to determine the size of meter needed to adequately serve buildings. Due to the variety of home sizes built in the Tigard area,we count the fixture units of all homes to determine the appropriate meter size. Use the worksheet on Page 2 to calculate the current number of fixture units compared to the proposed increased number of fixture units,which will determine whether an increased meter size will be required. Submit this signed worksheet with your building or plumbing permit application submittal. DOCUMENTATION Once you are ready to purchase the new meter,please provide the following items to the Utility Billing counter: • Completed water meter fixture unit worksheet for additions, remodels, ADUs, etc. (on back page). • Copy of building or plumbing permit application date-stamped by building division. • Copy of issued building or plumbing permit. Your fixture count will be verified and your request will be processed upon receipt of these documents. No exceptions. INSTALLATION TIME Once the upgraded meter size has been purchased,please contact Public Works for installation. Their number is 503-718-2591. Most meters are installed within 10-14 business days. 1:/Building/Forms/WaterMeters_070119 Add.dOCX Page 1 Dianna Ornelas From: UB Online Sent: Thursday, November 5, 2020 8:52 AM To: Steve Griffin Cc: #Building Permit Technicians Subject: RE: 12415 SW 122nd Ave Fixture worksheet Attachments: 12415 SW 122nd Ave.pdf Categories: Dianna Good Morning, Attached is the updated fixture unit worksheet. The home currently has a 5/8 inch meter. With the additional fixture counts, the property will be required to increase to a %inch meter. Kind Regards, Jill (she/her/hers) m A WD,,.. Jill gtl CAI(BEgHyT 1 s.'4SeniorAccounting Utility A Billing •40 TIGARD (888)826.7211Payments ti" (503)718-2460 UB Main jillb@tigard-or.gov l (503)718-2494 BE KIND Tigard,13125 SW H OR972all d 3 From: Steve Griffin <steve@straightlinedr.com> Sent:Wednesday, November 4, 2020 9:50 AM To: UB Online<UBOnlinepay@tigard-or.gov> Sbject: Re: 12415 SW 122nd Ave Fixture worksheet I— Warning!This message was sent from outside your organization and we are unable to verify the sender. Good Morning Jill, We are adding a clothes washer and a lavatory,that is correct. I called the home owner to confirm that the one bathtub IS a bath/shower combo. I also asked about hose bibs and they DO have one. Let me know if you have any other questions,thanks. On Wed, Nov 4, 2020 at 9:12 AM UB Online<UBOnlinepay@tigard-or.gov>wrote: Good Morning Steve, Thank you for your email. I have a few questions on the worksheet. 1 It looks as if you are only adding a clothes washer and a lavatory? Is that correct? Also, according to the worksheet the current house has one bathtub and one shower stall. Are either of these a bathtub/shower combo (which is what is normally in a bathroom except maybe the master bath)? Are there any hose bibs on the property? If so, how many? Once we receive that information, we'll be able to update and/or approve the worksheet. Thank you for your time. Kind Regards, Jill (she/her/hers) nr A WORL: Jill 0 CAN OEAA9. III " City of Tigard -Utility Billing SeniorAccountin9 Asst Tl(,AND MUD 826-7211 Payments (503)718-2460 LIS Hain jillb@tigard-or.gov (503)718-2494 BE KIND T 1gard,SW R 97 23d, From: Steve Griffin<steve@straightlinedr.com> Sent: Tuesday, November 3, 2020 4:03 PM To: UB Online<UBOnlinepay@tigard-or.gov> Subject: 12415 SW 122nd Ave Fixture worksheet Per Allyson Armstorng I'm sending you a water meter fixture worksheet for review. Please let me know if you have any questions. Thank you. 2 'teve Griffin • Straight Line Design & Remodeling LLC 971-275-3261 .. Steve@straightlinedr.com www.straightlinedr.com 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." Steve Griffin Straight Line Design & Remodeling LLC 971-275-3261 Steve@straightlinedr.com www.straightlinedr.com 3 Building Permit Application :- l0 l Al Residential Foit 01 11< r. I til. Ovl,l Cl of Tigard RECEIVED Received /22 V !,, Permit No.:MrST262O)3U5' 131251111‘ g Date/By: O Z • SW Hall Blvd.,Tigard,OR 97223 Plan Review ether Peraut: Phone: 503.718 2439 Fax: 503.598.1960 0 C T 1 9 arif Date/By: n t.t t Inspection Line: 503,639.4175 lc-may Date Ready/By: 7 { B See Page 2[or Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: 1[ Sapplemeatal Information RUILDING DIVISION TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING ❑New construction 0 Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ®Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ® 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ I 4�I 1 ID Accessory building 0 Multi-family Number of bedrooms: �J ❑Master builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION , Total number of floors: Job site address:12415 SW 122nd Ave New dwelling areal 60 square feet City/State/ZIP:Tigard, OR 97223 Garage/carport area: square feet Suite/bldg./apt.no.: Project name:Master Closet Addition Covered porch area: square feet Cross street/directions to job site: SW Walnut St. Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision:LAKE TERRACE Lot no.:11 Permit fees*are based on the value of the work performed. Tax map/parcel no.:2S1036608400 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. Build a 140sgft addition to the SE corner of the building creating a master Valuation: $ walk-in closet. Square off the SW corner of the house adding 20sqft. Existing building area: square feet Reconfigure the existing deck stairs to accommodate the addition. New building area: square feet 0 PROPERTY OWNER 0 TENANT Number of stories: Name:Tim and Molly Smith Type of construction: Address:12415 SW 122nd Ave Occupancy groups: City/State/ZIP:Tigard, OR 97223 Existing: Phone:( ) Fax:( ) New: 21 APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name:Straight Line Design & Remodeling LLC Structural plan review tee(or deposit): Contact name:Steven Griffin FLS plan review fee(if applicable): Address:9645 SW Beaverton Hillsdale Hwy City/State/ZIP:Beaverton, OR Total fees due upon application: Phone:(971 )275-3261 Fax: ( ) Amount received: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail:Steve@straightlinedr.com CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted PhotoVoltaic Solar Panel System. Business name:Straight Line Design & Remodeling LLC Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:9645 SW Beaverton Hillsdale Hwy Solar Installation Specialty Code checklist. City/State/ZIP:Beaverton, OR 97005 Permit Fee(includes plan review $180 00 and administrative fees): Phone:(503 )244-5463 Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lie.:195218 Total fee due upon application: $201.60 Authorized signature / — a This permit application expires if a permit is not obtained /' ``� within 180 days after it has been accepted as complete. Print name:Steven Griffin V Date:10/15/20 *Fee methodology set by Tri-County Building Industry Service Board. I.\Building\Permits\BUP-RESPermitApp.doe 02/24/2011 440-4613T(11/02/COM/WEB)