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City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT It= Request for Permit Action -97223 • 503-718-2439 •wvlrw.tigard-or.gov = 1 i. ; s<1, 13125 SW Hall Blvd. •Tigard,Oregon7„c, ,^� ,t r;�, t r I TO: CITY OF TIGARD '` 4,, 4 BuildingDivision "; ` �f4 P 13125 SWHall Blvd.,Tigard,OR 97223 Phone: 503-718-2439 Fax: 503-598-1960 1 igardBuildingPermits®tigard-or•gov ¢,,'x- ire a' ' ' Wry, Owner ❑ Applicant dContractor 0 City Staff �r , , FROM: 0 � i 4, ,4 3y (:l�al�.t'J)one t 1 REFUND OR Name: � �Er.« �r (Business or individual) lvvv / S}11e1 rPi, r INVOICE TO: : °.x'i`° ; , Mailing Address: �,-IY�1c St t5o l\• ' a„ k air clic cc � � r ,,,, E fir,�^ City/State/Zip: 4 f r� � tr Y V ' S-1 -1"I gv s ' .. Phone No.: i t rr PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓): i � 1 ,,'', :; �.' ,:',1:;!' ` -'fib, VOID PERMIT APPLICATION. '.- a..' ,,, 1,:,',''' REFUND ERMIT FEES (attach copy of original receipt and provide explanation below). z , dbelow). .y,r..fi _, ' FOR FEES DUE (attach case fee schedule and provide explanation Permit#: Ivlg T 711"2/0 0?.72/;-2 Site Address or Parcel #: 1L u V Sl. ) 1i)("VIN) (- . ����� � �zl 44�i�-iv t'c3+) Project Name: 1 J Subdivision Name: Lot #: EXPLANATION: 1-1v¢, jhc Ch/ 1(A..- tot tv 8,414 ,.../ 'Cv s, l ((D r. �p ,c 1` in l os c iiv 7L- ' r(Tr i L,4s `'hn) a(vca<I y �t �sve A-A-'- t'1 .,'ct11 Ir �,r pY', 5 C: t C:Zo� —(ldc'2-'1 �., th�firi �aw,P^"Y � Signature: Date: 'Zito/ °2,1 . — Print Name: 711n, . S ht-. — Refund Policy 1. The dty's Community Development Director,Building Official or City Engineer may authorize the refund of: • Any fee which was erroneously paid or collected. • Not more than 80'%„of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended. • Not more than 80%of the application or permit fcc for issued permits prior to any inspection requests. 2. All refunds will be returned to the original payer in the form of a check via US postal service. 3. Please allow 3-4 weeks for processing refund requests. FOR OVI:ICI I ',I Oil.1 Route to Sys Admire: Date By } Route to Records: Date 9 /o 2.-/ Ey e} Refund Processed: Date 9/4 � ,,C✓ Invoice Processed: mate By Permit Canceled: Date /(7 "` I3'(tQ() Parcel Tag Added: Date By 1:\Building',Forms\RegPcrmitAdion l2I I8 doe 1111 u1 TIGARD City of Tigard September 10,2021 Tim Austin LLC 37875 SE Kelso Rd Sandy, OR 97055 Re: Permit No. MST2020-00323 Dear Applicant: The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the following: Site Address: 9680 SW Riverwood Ln Project Name: McHugh Job No.: N/A Refund Method: ® Check#240522 in the amount of$52.36. ❑ Credit card "return"receipt in the amount of$ Note: Please allow 2-5 days for this refund transaction to be credited to your account by the company that issued your card. ❑ Trust account"deposit"receipt in the amount of$ Comment(s): Per applicant's request as mechanical equipment was permitted under MEC2021-00029. Refund 100% of permit fees paid. If you have any questions please contact me at 503.718.2430. Sincerely, Dianna Ornelas Building Division Services Supervisor Enc. 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171 TTY Relay: 503.684.2772 • www.tigard-or.gov 111 111 City of Tigard `�/7/7-/ T I G A R D Accela Refund Request This form is used for refund requests of land use, development engineering and building permit application fees. Receipts, documentation and the Request for Permit Action form (if applicable) must be attached to this request form. Refund requests are due to Accela System Administrator by each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts Payable will route refund checks to Accela System Administrator for distribution to applicant. PAYABLE TO: Tim Austin LLC DATE: 9/6/2021 37875 SE Kelso Rd Sandy, OR 97055 REQUESTED BY: Dianna Ornelas TRANSACTION INFORMATION: Receipt#: 432780 Case#: MST2020-00323 Date: 2/4/2021 Address/Parcel: 9680 SW Riverwood Ln Pay Method: CreditCard Project Name: McHugh EXPLANATION: Per applicant's request as mechanical equipment was permitted under MEC2021-00029. Refund 100%of permit fees paid. REFUND INFORMATION: Fee Description From Receipt Revenue Account No. Refund Example: Building Permit Fee Example: 2300000-43104 $Amount Mechanical Permit Fee 230-0000-43102 3526--"' n, 7s 12%State Surcharge 100-0000-24001 5.61 TOTAL REFUND: $52.36 APPROVALS: SIGNATURES/DATE: A 0 ' If under$5,000 Professional Staff If under$12,500 Division Manager 0Z rat- -4---" If under$25,000 Department Manager i If under$100,000 City Manager If over$50,000 Local Contract Review Board i d r# n tr'` •< .' ., «. , i:'' e' — <A fit: - `? Case Refund Processed: Date: 9//0 I By: AeZg O fj( I:\Building\Refunds\RefundRequest.doc x 09/01/2010 f CITY OF TIGARD RECEIPT •a .' 13125 SW Hall Blvd.,Tigard OR 97223 IN - 503.639.4171 TICC AT:I) Project Name: MCHUGH Site Address: 9680 SW RIVERWOOD LN /,/ Receipt Number: 436382 - 09/10/2021 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID MST2020-00323 $-52.36 Total: $-52.36 PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 240522 DHOWSE 09/10/2021 $-52.36 Payor: Tim Austin LLC Total Payments: $-52.36 Balance Due: $52.36 Page 1 of 1 CITY OF TIGARD RECEIPT $: 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TtGAI;L) Project Name: MCHUGH Site Address: 9680 SW RIVERWOOD LN ( 6-/A✓fL— Receipt Number: 432780 - 02/04/2021 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID MST2020-00323 Furnaces< 100K BTU 230-0000-43102 $46.75 4e- MST2020-00323 12%State Surcharge-Mechanical 100-0000-24001 $5.61 ¢- Total: $52.36 PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Credit Card 7327165 PUBLICUSERO 02/04/2021 $52.36 Payor: Total Payments: $52.36 Balance Due: $0.00 Page 1 of 1 Mechanical Permit Application RECEIV City of Tigard GV Da ." 2` Li,-Zl \)ti Permit No.: t ' 323. 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Rrvtew Phone: 503.718.2439 Fax: 503.598.)960 FEB 0 3 2021 niftily: Other Pernik: r R,.,,, 1-, Inspection Line: 503.639.4175 to ReadyBy: Jure: I 0 See Page 2 fur Internet: www.tigard-or.gov CITY OF TIGAFit tiflnVMeibee: Supplemental Information BUILDINGDIVISIbN _ -- I TYPE OF WORK COMMERCIAL I.AI. FEE* S( Ut 1.E- USE CHECKLIST T.___. _---- Mechanical permit tees"are based on the N.alue at the work ❑New Construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. �___ _ ._ Value:S CATEGORY OF CONSTREC.TIOIv' _ .__ .. _. RESIDENTIAL F()t`IPAIir4Tl SYSTEMS FEES' J ❑ 1-and 2-family dwelling ❑Comtnercialiindustrial ❑accessory building For vpecial information use checklist ^ Q Multi-family 0 Master builder 0 Clthr Description Qty, Ea. Total lleating/cooling: JOB SITE INFORMATION .AND LOCATION - Air conditioning 46.75 Job site address: ")6r(O 4t/ e t v 2 v wee( (,-v. Furnace 100,000 BTU(ducts/vents) ( 46.75 tlip 1S- City.'StateJL1P: %S,-,"k_ d _Furnace pump 61.0 / ',7 Heat ce 100,000- BTU(duets/vents) 54.91 ti Suite/bldg./apt.no.: Project name: r Duet 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 23.32 .- - Gas fireplace/insert 33.39 DLSf:RlrtioN OF WORK �_. P Flue vent for water heater or gas /ny . C /v(-' 'Li 2 .,(-) .- o ba Vo fireplace 23.32 Log lighter(gas) 23.32 1Z) 1S Vey C 3( �lt F Wood/pellet stove 33.39 JJ Wool fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other. 23.32 CI PROPERTY OWNER 0 TENANT 1 Environmental exhaust and ventilation: Name. ti Range hood/other kitchen ! equipment 33.39 Address: Clothes dryer exhaust 33.39 CityStaterl.IP: j Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phony ( ) Fax:( ) Attic/crawlspace fans 23.32 } 0 APPLICANT ca?`-TAc'r PF;RStilr Other 23.32 t Fuel piping: Business name. S14.15 for first four;$4.03 for each additional Contact name: c Nu Tl\& r Furnace,etc. (� �,, l Gas heat pump Address: �d 7 S � 4 t�-�{. Wall/suspended/unit heater City State/"LIP: �( C7 e. el•v f-s--- Water heater Phone:0,)c")"?- "7"? Fax::( ) Fireplace Range E-mail: S et C., ,el I r e• (.,pt 4-' el Barbecue CONTRACTOR Clothes dryer(gas) -- { Other: 1 Business name. le;t� 41, ;/-7,., !-'t-L.---- ME+C'H.4NIC 4L PERMIT FEES* Address. Subtotal 1-1Ip.1 s- City/State/Z1P. Minimum permit fee(890.00) Plan review(25%of permit fee) Phone:( ) Fax:( ) State surcharge(12%of permit fee) 5.(D 1 CCB lie.: I TOTAL PERMIT FEE 51.3(p I r This permit application expires if a permit is not obtained within 100 Miliif of iM _1.4` loo after a has been accepted as complete. Authorized signature: Fee methodology set by Tn-County Building Industry ti.r,cc board . „i , �� 2DLI I.\Buitding'.Prnnit,MFC PmmnApp_0401 13.doc 440-4617T(I I/02R'OM/WEn) _.. - ........,.. ---....._.._._--`-'-•---. . -- 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 Transmittal Letter 11111 r;i A it r) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: A,-s Ar FEB 1. 7 2021 COMPANY:I(ram Asfi y\ a/c., CITY OF TIG : ti1 3UIl_DING DIVISIO ,. PHONE: 7) — S 7'7 - '7 Slz EMAIL: Cevl flOci14126-Y / 1'Qt-9 i,,,, ( . C a1-►--N RE: 1(00 SW VcV (...tcl • PS T;2_62-0 —cx)� (Site Address) (Permit Number) (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s)of plans. Revisions: Cross section(s)and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. 2i Engineer's calculatio s; . Other(explain): p 5 S —( r p( -g Ui�'�` 'w 12.(U I ct. REMARKS: FOIE OF ICE USE ONLY Routed to Pe t Technician: Date: 23 Z) Initials: Fees Due: Yes ❑No Fee Descriptio : Amount Due: $ do 1f f i { JM, (X,PVI rtv $ 15,$ $ Special Instructions: Reprint Permit(per PE): E Yes No [ Done Applicant Notified: "TlM Date: 4/,Ay`, Initials: .eO/7 CITY OF TIGARD MASTER PERMIT IIIII1 ' COMMUNITY DEVELOPMENT Permit#: MST2020-00323 Date Issued: 01/04/2021 T I t I A R. r) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S114BD02300 Jurisdiction: Tigard Site address: 9680 SW RIVERWOOD LN Subdivision: COPPER CREEK STAGE 2 Lot: 36 Project: MCHUGH Project Description: 737 sq.ft.bonus room addition above garage. NO FINAL UNTIL WATER METER UPSIZED. BUILDING Floor Areas jteauired Setbacks Required Stories: 2 Bedrooms: 1 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 21.5 Bathrooms: 1 Second: 737 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: Yes Total: 737 sf Value: $90,253.02 Rear: 0 PLUMBING Sinks: 0 Water Closets: 1 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain 0 Storm Sewer: 0 Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 1 Water Lines: 0 Drains: Catch Basins: 0 Bckflw Prevntr. 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Other Fixtures: 1 Drywell-Trench Drain: 0 Other Fixture Units: DWV MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 1 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 0 Other Units: 1 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 1 0-200 amp: 0 WI Svc or Fdr: 8 Ea add'I 500 sf: 0 201-400 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: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ADD SF VB R-3 737 Owner: Contractor: MCHUGH,MARK R ORIENT ELECTRIC INC Required Items and Reports(Conditions) DEY,MARISSA C 30532 SE BLUFF RD 9680 SW RIVERWOOD LN GRESHAM,OR 97080 TIGARD,OR 97224 PHONE: PHONE: 503-663-5881 FAX: 503-663-3187 Total Fees: $4,492.81 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.L Issued By: [T��JL�r�n� VJWe�/L Permittee Signature: On QFP11LC11 \� (.Pall 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. Baliidini Permit Application V3- 11123 20 Residential FOR OFFICE USE ONLY City of Tigard RECEIVE® Efilli711 iio / Jcn P itNo.y ST2O20-00323 IllSW Hall Blvd.,Tigard,OR 97223 NOV 2 3 2020 Plan Review �'^� j Other Pit. Phone: 503.718.2439 Fax: 503.598.1960 Date/B : !Ngi 4 A. R 1, Inspection Line: 503.639.4175 r Date Ready/By: linil Easet Page 2 for Internet: www.dgard-or.gov CITY Ut +l(4MfD Notified/Method: , j tr jj # Supplemental Information (i%i'r^cvt '7-'1'1 TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING ❑New construction ❑Demolition Permit fees*arc 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 i to prrott r the CATEGORY OF CONSTRUCTION work indicated on this application. 2 J -and 2-family dwelling ❑Commercial/industrial Valuation: $ f� /❑Accessory building 0 Multi-family Number of bedrooms: v ❑Master builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: New dwelling area: square feet Q� �� Slry (?tUcv�b�-/�iw '��1 City/State/ZIP: -r-�ert--A 0 le...,,, �7 2 Garage/carport area: square feet Suite/bldg./apt.no.: Project name: /(4,6„, ti Covered porch area: square feet C ss street/directions to job site: (� Deck area: square feet CS ` � � Other structure area: square feet P t" REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Lot no.: 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,and the profit for the DESCRIPTION OF WORK work indicated on this application. .AtliL( Zt" ,c- I %1 b t r!2 Valuation: $ ALL S ��y� Existing building area: square feet New building area: square feet 1 ROPERTY OWNER ❑ TENANT Number of stories: Name: t.i,—. , ,,,i , . 6� Type of construction: Address: ✓ Occupancy groups: City/State/ZIP: Existing: Phone:( ) Fax:( ) New: APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* �� 1 i (Please refer to fee scheduk� Business name: -� Structural plan review fee(or deposit): i/2 a a Contact name: l t m (^h `( Address: �f( St f/e (go FLS plan review fee(if applicable): vv F-C Total fees due upon application: City/State/ZIP: ,1�r f r2e, "�cG Phone:1,9. ) -)f g Z..," Fax: :( ) Amount received: E-mail: Csn-yjt pti {7d,-,( n 4(Mpr1 .G�yv PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRA�ICTOR7 Commercial and residential prescriptive installation of roof-top mounted PhotoVoltaic Solar Panel System. Business name: �� ✓ ' A- F 1�� Submit two(2)sets of roof plan with connection details ( , and fire department access,along with the 2010 Oregon Address: 37,e--75" 5e 440, A-1 Solar Installation Specially Code checklist. City/State/ZIP:P: a V 6 5 Permit Fee(includes plan review S 180.00 and administrative fees): Phone:<`U ) c5 ? -7-2�,,-... Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lie.: /g /al 1�g I rxj / 4;. Total fee due upon application: $20 L.60 Authorized signature: A� This permit application expires if a permit is not obtained V`r Print name: y. within 18U after It has been accepted as complete. � ,, *Fee methodology set by Tri-County Building Industry /Id14:� Date: k yn/� Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) , Mechanical Permit Application FOR OFFICE USE ONLY City of Tigard Received Date/By Permit No.: ,ILIS ! 7 -00323 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review, S Phone: 503.718.2439 Dateigy: Other Permit: T I G A R D Inspector Line: 503.639.4175 Date Ready/By: ions: ® See Page 2 for Internet: www.tigard-or.gov Notitied/Method: ler Supplemental Information ''•' ,'. '. ', s.. TYPE OF WORK *. COMMERCIAL FEE SCHEDULE-USE CHECKLIST ❑ New construction igl Addition'alteration/replacement Mechanical permit fees*are based on the value of the work performed.indicate the value(rounded to the nearest dollar)of all 0 Demolition ❑ Other: mechanical materials,equipment,labor,overhead,and profit. CATEGORY OF CONSTRUCTION Value:$ 46 n,CO RESIDENTIAL EQUIPMENT i SYSTEMS FEES* 0 1-and 2-family dwelling ❑ Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total JOB SITE v INFORMATION AND LOCATION l }8 Heating/cooling: Job site address: 9 Co O SW 1 I veJC3 Ck31 �L Air conditioning 46.75 C, Fumace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: '"-'1 6 -C) OK 9-12.7_,LI Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apL no.: Project name: qbi3 i71( 1 4 • E Heat pump .{ 61.06 Ductwork 1, , 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 Subdivision: Lot no.: Other: 23.32 Tax map/parcel nn.: Other fuel appliances: u' ,yNY,,, Water heater I 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 Flue vent for water heater or gas /tbJ� U�1n16 s'r�dkCe r+ L� ekIS'e�/•r � f 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: Range hood/other kitchen Address: equipment 33.39 Clothes dryer exhaust I. 33.39 City/State/ZIP: Single-duct exhaust(bathrooms, Phone:( ) Fax:( ) toilet compartments,utility rooms) - 23.32 Attic/crawlspace fans 23.32 0 APPLICANT ❑ CONTACT PERSON Other 23.32 Business name: Fuel piping: $14.15 for first four;$4.03 for each additional Contact name: Furnace,etc. Address: Gas heat pump City/State/ZIP: Wall/suspended/unit heater Water heater Phone:( ) Fax: :( ) Fireplace E-mail: Range Barbecue �,�y-y Clothes dryer(gas) CONTRACTOR Business name: V ' I f)S i iA-) L(.(. Other: Address: ' —1 R16 'SE LSO RO MECHANICAL PERMIT FEES* OR 41066 Minimum permitSubtotal City/State/ZIP: fee($90.00) Phone:(503) 61 '7 f 9 Fax:( ) Plan review(25%of permit fee) �� State surcharge(12%of permit fee) CCB lic.: B TOTAL PERMIT FEE This permit application expires if a permit is not obtained within I Sa Authorized signature: 4 ,,/ecie days after It has been accepted as complete. /vV 1 ,At • Fee methodology set by Tri-County Building Industry Service Board Print name: "'t-i M ' 1�silk,...) Date: �I`I5 �tJ t:\BuildingTern itdMEC_PennitApp_082520.doc 440A617T(I I/02/COM/WES) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Submittal Requirements: • (2) sets of plans, drawn to scale. • (2) sets of equipment cut sheets. • (2) copies of site plan for ground and roof top equipment location and screening per Tigard development code. 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. I:Building\Permits\MEC_PermitApp_082520.doc 2 • , Electrical Permit Application FOR OFFICE USE (1NI N . City of Tigard o ; d � �/jJy�lir � 13125 S W Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit h: TIC'A i:11 Inspection Line: 503,639.4175 Ready Date/13y: EMIVI See Page 2 for Internet: w'ww.tigard-ar.gov Notified/Method: Supplemental information TYPE OF WORK PLAN REVIEW ❑New construction n-Addition/alteration/replacement Please check all that apply(submit 2 sets of plan,w/iten„checked): 0 Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition ❑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 ElCommercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agr;wltural amps for all other installations. buildings. ❑Multi-family ❑Master builder 0 Other: 0 Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived � _ ��(` 0 Addition of new motor load of system. ( Job#: Job site address: (r(Q O ) i4ue-C.9/OZ) LA) 100HP or more. ❑"A"."E" "l-2" "l-3" ^T' �-.� �I )1 o Six or more residential units. occupancy. City/State/ZIP: l G r 1"� v 12� t ❑Health-care facilities. ❑Recreational vehicle patios. Suite/bldg./apt.#: Project name: 1 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: FEE SCHEDULE Description I Qty. I Each I Total New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. I,000sq.ft.ortess 168.54 4 Tax map/parcel#: Ea.add'1500 aq,ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential f o I t l oN n- / - 6 6 (with above sq.ft.) 75.00 2 �(}� limited energy,multi-family 75.00 2 residential(with above sq.it.) 0 PROPERTY OWNER 0 TENANT Renewable Energy 0 See Page 2 Services or feeders installation,alteration,and/or relocation Name: 200 amps or less i 100.70 2 Address: 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: 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 snips 168.54 2 0 APPLICANT ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel ,,1 A.Fee for branch circuits with Business name: '\l v l ft5�/"t &cL above service or feeder fee, Q 7 42 2 t-� each branch circuit (� Contact name: 1 1(Y1 � n/V s' B.Fee for branch circuits without 3-7 SiS Cc- p_o service circuit fee,first 56.18 2 Address: c.7c, 166z....5.6 blanch circuit City/State/ZIP: Q pp_ 9-To 5S Each add'1 branch circuit 7.42 2 �-i Miscellaneous(service or feeder not included) Phone:( ) 617 --77 Z Fax::( ) Each manufactured or modular ,,c�- Mk,��.�� (}��q,, ('�jt� (',�/t� dwelling,service and/or feeder 67.84 2 Email: f.i 19u i�l()IC �1�( V 1/�� \7 r t , t (J� 1 Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: 2 'T e - .•-/( (✓ Sign or outline lighting 67.84 2 Signal circuits)or limited-energy 0 See Page 2 2 Address: c(.. 5 li3L-4) F e_i, panel,alteration,or extension. 5 l.y �y p ZJ Each additional inspection over allowable in any of the above City/State/ZIP: 1�/� )�t� —1 Additional inspection(1 hr min) 66.25/hr Phone:(50j ) ( ,( 3 -G88, Fax:(63) 3- 31 B-I Investigation(1 hr min) 90.00/hr Email: SoheM) zr Q 6(24. - e IC oyA Industrial plant(1 hr min) 78.I8/hr Inspections for which no fee is 90.00/hr CCB Lic.:Vg17,2,t,...1 Electrical Lie.: e_gCD Suprv. 'c.: 3)$ specifically listed('/,hr min) FI.FCTRICAL PERMIT FEES Suprv.Electricians azure,required: . Subtotal: Print name: ( ' k �F42.44 y Date: f�/q/�O ❑Plan Review Required(25%of permit fee): ( / State surcharge(12%ofperrnit fee): Authorized signature: TOTAL PERMIT FEE: � I7- 1 This permit application expires if a permit is not obtained within ISO Print name: Tl k V \ kt.,��(Iv Date:,1 /1 S/ 20 days after it has been accepted as complete. i * Number of inspections allowed per permit. I:\Building',Permits1ELC PermitApp_ELR_ERE.doc Rev 0(517/2015 440-4615T(11/05/COM/'EB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Description I Qty. I Fach Total -'- Fee for all residential systems combined: $75.00 Renewable electrical energy systems: Check Type of Work Involved: s kva or lean 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 ❑ Garage Door Opener* soul l00 kva 552.26 2 >100 kva(fee in accordance 552.26 2 with OAR 918-309-0040) ❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 El Vacuum Systems* >100 kva-no additional charge 0.0 3 Each additional inspection over allowable in any of the above: f Other: Each additional inspection is charged at an hourly(1 hr min) 66.25!hr inspections for which no fee is 90A0/hr specifically listed('I.hr min) COMMERCIAL WORK ONLY: 1,, ELECTRICAL PERMIT FEES Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 * Number et-inspections a awed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: El Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC El Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ 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:\Building\Permits\ELC PennitApp ELR ERE.doc Rev 06/17/2015 • •Piumbin2 Permit Application Building Fixtures lit]; t,i l it f 1 tit t)„ City H Tigard Received Da Permit No.: $s12O2o -ov 3z3 : 13125 SW Hall BIvJ.,Tigard,OR 97223 Plann Re Review ocher Pcrmtit No.: Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Inspection Line: 503.639.4175 w Date R eady:Br ® See Page 2 for (�h.,.�i�!' Internet: ww.tigard-or.gov _Notified/Method: ' Supplemental Information TYPE OR WORK FEZ*RC CI New construction ❑Demolition For special information ase checklist Description 1 Qty. I Ea. I Total Fi Addition/alterationireplacement 0 Other: New I-I-family dwellings(includes IUD ft for each utility connection) CA'IRGORY d,1R'+j'"ON51'Htli:tt[u+l SFR(I)bath 312.70 SFR(2)bath 437.7$ 1-and 2-family dwelling 0 CermmerciaVindustna) SFR(3)bath 500.32 ❑Accessory building ❑Multi-family Each additional bath/kitchen 25.02 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 Jos INFoRNA AND LOCATION Site utilities: (p Catch basin or area drain 18.76 Job site address: C >( . �7� yG (v f�+V u(J 11 Dryvoell,leach line,or trench drain 18.76 City/State/ZIP: - ( ( 6 0(2,, 4 7?'L Footing drain(no.linear ft.:____) Page 2 Suite/bldg./apt.no.: I Project name:PL j r"10Pf fi fi(1J?J tr Manufactured home utilities 50.03 Cross streeLJditectituvs 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: l Lot no.: Fixture or item: Hack fllow preventer 31.27 Tax map/parcel no.: Backwater valve 12.51 { ! € Glotita washer I 25.02 fOr7/yi Grp kg It l.`)17iti6 C5A1 C Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 Exprnsion tank 12.51 PRO>'> P1 'OWNER1 Fixture/sewer cap 25.02 Name: IM PYR, (,Vkv 6a t Floor drain/Floor sink/hub 25.02 Address: 4(,go s(r) R.1 v Yz WnrcA 1-N1 Garbage disposal 25.02 City/State/ZIP: \1 6F 0 2 C'l 22l"I Hose bib 25.02 i r -ax:( ) Ice maker 12.51 yit"Phone:�j�� ) � •- �APPLICAI�IC Q CO Acy �' Interceptor/grease trap 25.D2 Medical gas(value:$_____) Page 2 Business name: '1-1 lNl PCUL 5T7Psi (.L.(..- Pruner 12.51 Contact name: iv) !,u STk 4 Roof drain(commercial) 12.51 Address: 8'1 C-, s K-L-'0 ) Sink/basin/lavatory 25.02 . Solar units(potable water) 62.54 City'Statc/Z1P: E'jt�(f ♦ l2 1.ti Tub/shower/shower pan 1 12.51 Phone:O 5�7--]7Z Fax::( ) Urinal 25.02 E maituy4A[TOI+ {Cj/Jt7 6111/1 L.,C Water closet l 25.02 , 37.52 Business name: O W ro,C Water piping/DWV ( 56.29 Other. 25.02 Address: Subtotal Minimum permit fee: $72.50 Phone:( ) Fax:( ) Plan review (25%of permit fee) CCB Lie.: Plumbing Lie.no.: State surcharge(12%of-permit fee) Authorized signature: Mark McHugh TOTAL PERMIT FEE 'Ms permit application expires if a permit B net obtalaed within ISM days Print name: ���► Date: 11/19/20 l after it tux been accepted as complete. "Fee methodology set by Tri-Caumy Building Industry Service Board. t;IBuilai.hyU'n'mi1cTLMU-PernrirApp.Soc 10/0 1109 4404516n I e/02/COM/W ED) Plumbing Permit Application - City of Tigard Page 2 -Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee tea) Total Square Footage: Permit Fee: Footing drain-I" 1(10' 50.03 0 to 2,000 $12190 Footing drain-each additional 100' 37.32 2,001 to 3,600 $169.69 Scwcr-1st 100' 3,60t to 7,200 $233.20 62.54 Sewer-each additional 100' 37.52 7,2U7 and greater $327.54 37.'. Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.92 Storm&Rain Drain-1st 100' 62.54 Valuation: Permit Fee: t $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37,52 $5,001.00 to$10,00 .00 $72.50 for the first$5.000.00 and$1.52 for Other Inspections or Fees Qty. Fee tea) Total each additional$100.00 or fraction thereof;to and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first S 10,000.00 and S1.54 for which no fig is specifically indicated 90.00Por each additional$10000 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 - 90,00Por 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 traction 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 Quantal by Fixture Type Plan review is required for any of the following. Fixture Type for Repine Please check all that apply. Work Performed: Capped added Relocate PP y' 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. CICar Wash: -Each Stall New exterior plumbing site utilities for any complex structure D ve as defined in OAR918-780-0040. Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial 0 Any multipurpose fire sprinkler system. Domestic El Any complex structure as defined in OAR918-780-0040. Drinking Fountain rive Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" 3" Isometric or Riser Diagram -4" -Car Wash Drain 0 Isometric or riser diagram is required for new buildings Garbage -Domestic non-food MM. 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: -Lay/Bar non-food related-Bradley -ComJServ/Util food related Service *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EllJs,a sewer permit will he issued and Washer-Clothes Water Extractor fees assessed for the sewer increase must be paid before the Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Petmits\PLMF_PermitApp.doc 0S;-04/20I I 2 Branden Taggart From: Branden Taggart Sent: Thursday, December 31, 2020 9:33 AM To: contractorportland@gmail.com Subject: Permit for Mark McHugh: MST2020-00323 - 9680 SW Riverwood Ln. Attachments: Invoice.pdf Hello Tim, The Building permit for Mark McHugh is ready to issue now. The balance due is$4,068.81, and I have attached an invoice above for you to reference. The permit fees can be paid online through our website: https://aca.accela.com/tigard/Default.aspx. From there,click on the Building tab,enter the permit number (MST2020-00323) in the Record Number field, and click Search. Once paid, please notify us at TigardBuildingPermits@tigard-or.gov, and we will place this permit and the approved site copy set of plans in our open Permit Center conference room for you to pick up between the hours of 8:00 a.m. and 5:00 p.m., Monday through Thursday. We are closed on Fridays. No appointment is necessary to pick up. Please note that we were unable to verify your CCB license information. We suggest that you contact the state at your earliest convenience for more information. Also, we will need to receive your plumber's license information prior to issuing this permit. Once we have received the plumber's license information, and your CCB license matter has been resolved,we will be able to issue this permit. Lastly, please keep in mind that you will not be able to schedule the Final inspection until the %" water meter has been paid and installed. Thank you, Branden Taggart al City of Tigard • Senior Permit Technician Community Development I KAKI) 13125 SW Hall Blvd Tigard,OR 97223 (503)718-2449 brandent@tigard-or.gov 1 Lina Smith From: Lina Smith Sent: Wednesday, November 25, 2020 2:29 PM To: contractorportland@gmail.com Cc: #Building Permit Technicians Subject: McHugh 2nd story addition - 9680 SW Riverwood Lane Hi Tim, I signed off on this permit for Planning/Zoning and routed it to the Building Division for processing. Please obtain a service provider from Clean Water Services. Fill out this form and upload your site plan here: https://www.cleanwaterservices.orgLdocuments-forms/pre-screen-form/. When you receive a response from CWS, please e-mail it to tigardbuildingpermits@Tgard-or.gov. This won't delay Building's review of your plans, but they'll need the letter before they can issue the permit. Thank you, Lina Smith Assistant Planner City of Tigard I Community Development 13125 SW Hall Blvd.Tigard, OR 97223 E-mail: LinaCS@tgard-or.gov City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT III C T I G A R D Building Permit Review — Residential Building Permit #: MST 20 20"00323 Site Address: 9680 SW Riverwood Lane Project Name: McHugh Lot #: Planning Review Proposal: 2nd story addition to existing house; no change to building footprint or setbacks ElVerify address/suite #active in Accela. O In River Terrace: ❑ No ❑ Yes, River Terrace Review Addendum Site Plan Elements: _frosion Control 01 copies of site plan on 8-1/2"x 11"or 11 x 17"paper etained trees with drip line and tree protection measures 0 111 rawn to scale(standard architect or engineer scale) i.- ootprint of new structure (including decks)and FFE 0 orth arrow Jfhility locations&easements(required for new and additions) D.ite address,project or subdivision name and lot number sidewalk/driveway approach 0 applicant information(name and phone number) cation of wells/septic systems 0 . dimensions and building setback dimensions __ treet tree size,type and location IV. quare footage of buildings to be demolished r'it t names 0' ' .. g structures on site rner elevations (2'contours if more than 4'differential Its.t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? es o � I r impervious area (applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? es ° o ❑ Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995): Required: ❑r Yes,applicant was notified ❑ No Received: _Yes No ❑ Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs /f 7 Required: ❑r Yes,applicant was notified ❑ No Received: ° Yes ❑ No SDC Exemption for ADU applied for: ❑ Yes ❑r No Received: Yes ❑ No Public Facilities Improvement (PFI) Permit \" Required: El Yes,applicant was notified ❑r No Applied For: ❑Yes 11 No,stop intake 1_ Land Use Case #: ElZoning: R-4.5 Required Setbacks: Front: No change Rear: No change Side: No change Street Side: N/A Garage: No change Height: Max. Height: 30 Actual Height: 21.5 ji,i,„.3uilding ndscap- ' •a: % of Coverage ax: _"/o Entrance Li. et back no more than 8'from street-facing wall arallel to street or offset 45 degrees or less Windows 0 Minimum 12%of area of all street-facing facades Garage ■ s ••• door is behind widest street-facing wall 1' 0 No,one of the following is met: I Door ex - -, o more than 5' from wall and the - ' a covered porch extending beyond garage. 0 Door extends no mor- .-•• 5' from w. . . there is a 12 sq ft.window above garage on 2"s floor. ❑ Gara•e door width is 0 12'or >_ -4. 400 or less of facade 60%or less and includes 7 of following: I Covered porch N 'ecessed entrance i "•. . • set 1'Roof eave Roof offset IFires '.• -s N La. Siding ❑Roof itch II .. , •.. or gambrel roof Dormer ccent siding 0 'indow trim Window recess I Win.o • : •'ection ❑ Balcony ZL. isual Clearance \]�1 % ban Forestry Plan El S- sitive Lands: 0 Yes ❑ No Type: Vegetated corridor \ ki Conditions met prior to issuance of building permit otes: El Approved By Planning: ---= Date: 11/25/20 Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved 1:\Building\F orm s\BldgPe rm i tRvw_RES_122419.docx Building Permit Submittal Original Submittal Date: I` .$ 2.020 Site Plans: #1 Building Plans: # 4.3 Building Permit#: Enter building perrmit#above. � n A Workflow Routing: ©'Planning hy"Engineering R Permit Coordinator EkSuilding Workflow Sign-off: Sign-off for Planning(include notes from planning review) Route Application Documents: IA--Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. Er Building: original permit application, site plans,building plans,engineer and beam calculations an st details,if applicable,etc. Notes: By Permit Technician: Date: __ a 0 Engineering Review 13.. ope at building pad: 2% Et.onditions "Met"prior to issuance of building permit n/&- R'asements (encroachments) per engineering conditions of approval and plat n IA— Lr Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes I� o L7yN Assess Water Quantity Fee in-lieu: ❑ Yes No � LIDA Facility on lot: Ell Yes Et-No R rinal Plat Recorded: N/- ❑ NOT Approved by Engineering: Date: Notes: [Approved by Engineering: �y44-,/436H y Date: I211 I Z02o Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review ` ,, Conditions "Met"prior to issuance of building permit 0`ry'�\( Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: II SDC Exemption: ❑ Received Does not a II SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes /A Tigard Trans SDC: II YesA Parks SDC: ❑ Yes /A LIDA ❑ Yes N/A OK to Issue Permit Approved by Permit Coordinator: Date: /.2//) -D I:1Building\Forms\BldgPermitRvw_RES_122419.docx I . Water Meter Fixture Unit Worksheet for Additions/Remodels/ADUs £,-- `bA Y... .. ED Please complete the following information: u E C 07 2020 Customer Name: Mark McHugh Service Address: Street/Suite#9seo sw Riverwood Lane City:Tigard StateDregon Zip97224 Phone Number: 503-313-1102 Email: mark@markmchugh.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 x I = x 1 = Bidet x 1 = x 1 = Clothes washer 1 x 4 =4 x 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 I x 1 =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 1 x 2.5 = 2.5 Bathtub/whirlpool 1 x 4 =4 x 4 = Shower stall 1 x 2 =2 1 x 2 = 2 Bath/shower combo 1 x 4 =4 x 4 = Current Points: 31 Proposed Increase: 5.5 Current Points+Proposed Increase= 36.5 =New Total Points =Required Meter Size 314 Meter Sizes: 1 to 30 points=5/8" 30.5 to 37 points=%" 37.5 and over points= 1" New Meter Size Needed for New Total Points: 314 Cost: $$13,425.00 (see page 1) Current Meter Size per Utility Billing: 518 Cost: $$9,406.00 (see page 1) New Meter Size Cost minus Current Meter Size Cost= $$4019 (This is Your Cost to Increase Meter Size Due to Additional Fixture Units) *******************************************************************x***************** FOR OFFICE USE ONLY A.'v r&---. in"( .---"1- is g—rmai"'JG' ti1�if b'LY P tAzti.va a Wk.. F v'7 _c puo�. 1Airsr s u•v G- NtzJ 1+/��yt-/fin y EYE 0A✓ 2 -- FwMdt--, Current Meter Size Confirmed with UB ,S 6— rf ar9- B7 4-7 c_ /42-17/20 A9U , Signature of UB Representative Date I:/Building/Forms/WaterMeters_070119_Add.dOCX Page 2 Dianna Ornelas From: UB Online Sent: Monday, December 7, 2020 8:48 AM To: Contractor Portland Cc: #Building Permit Technicians Subject: RE: Revising our water worksheet. Need reapproval Attachments: 9680 SW Riverwood Ln 120720.pdf Categories: Dianna The meter at 9680 SW Riverwood Lane is currently a 5/8 inch. With the new fixtures being added,the meter will be required to upsize to a 3/4 inch. Kind Regards, Jill (she/her/hers) AAA WO;,, Ill 6,oloJ CANOE 4Hyp r� _ City of Tigard-Utility Bilking + o . Senior Accounting Asst (888)826-7211 Payments (503)718-2460 UB Main irtSstatAft jilibgitigard-orgov (503)718-2494 SE KIL' 13125 SW Hall Blvd. Tigard, OR 97223 From: Contractor Portland <contractorportland@gmail.com> Sent: Friday, December 4, 2020 3:04 PM To: UB Online <UBOnlinepay@tigard-or.gov> Subject: Revising our water worksheet. Need reapproval Caution!This message was sent from outside your organization. We had a mistake on our worksheet vs. our plans and need to get this reapproved. Thanks Tim 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." 1 RECEIVED NOV 2 " 7f19(1 CleanWater74-Services SENSITIVE AREA PRE-SCREENING SITE 745\SESSMENT ILL Clean Water Services File Number 20-003093 1. Jurisdiction: Tigard 2. Property Information(example: 1S234AB01400) 3. Owner Information Tax lot ID(s): 2S114Rf)093f10 Name: mark mchugh Company: Address: 9680 sw riverwood In OR Site Address: 9680 sw riverwood In City, State,Zip: tigard, or, 97224 City, State,Zip: tigard, or, 97224 Phone/fax: Nearest cross street: sw copper creek dr Email: mark@markmchugh.com 4. Development Activity(check all that apply) 4. Applicant Information © Addition to single family residence(rooms, deck, garage) Name: Tim Austin ❑ Lot line adjustment ❑ Minor land partition Company: ❑ Residential condominium ❑ Commercial condominium Address: 37875 SE KELSO RD ❑ Residential subdivision ❑ Commercial subdivision City, State,Zip: SANDY,or, 97055-6500 ❑ Single lot commercial 0 Multi lot commercial Phone/fax: 5035777782 Other Addition will be adding living space above garage Email: timaustinllc@gmail.com 6. Will the project involve any off-site work? ['Yes ❑ No 0 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 Tim Austin Print/type title Signature ONLINE SUBMITTAL Date 11/19/2020 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. O 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. O THIS SERVICE PROVIDER LETTER IS NOT VALID UNLESS CWS APPROVED SITE PLAN(S)ARE ATTACHED. X 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 PROVIDERp0VI LETTER IS REQUIRED. Reviewed by ��.1,. j � Date 11/25/2020 Once complete,email to: SPLReview@cleanwaterservices.org • Fax: (503) 681-4439 OR mail to: SPL Review, Clean Water Services, 2550 SW Hillsboro Highway, Hillsboro, Oregon 97123 Revised 2/2020 Main Office • 2550 SW Hillsboro Highway • Hillsboro, Oregon 97123 • p: 503.681.3600 f: 503.681.3603 • cleanwaterservices.org 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. iv City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Transmittal Letter r! ;A a 11 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov to TO: DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: �\ f f l Y� I� DEC 14 2020 COMPANY: ` -'‘I N A) c5{-1t CITY OF T GARD PHONE: 5c9)-- S 11 - 1-1 82 BUILDING C 1 6S1ON.* EMAIL: CLvc,—(-o`Z Pow(17/\0e, ff IC,(04 Y) RE: 1(080 5W Qv9 r LA-Nc fMS12Oz0`Cx5Z 3 (Site Address) (Permit Number) t4z f& illo La.J 1?—69-i2A-6E (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s)of plans. 3 Revisions: ` FiLL Si t PO9 'S Cross section(s) and details. Z Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. 2 Beam calculations. 2. Engineer's calculations. Other(explain): REMARKS: DUE eE1 N6 HP L) Ti) e9io (,) 6/^/66-7 /4-6 ,y-E R.E'Ptf&ir10- s o- a P(,4-7r-5 -wire emu- 2--f" 3&" SE'T, oX.6 5 GJ1 // "h / 7 ., FOR F�/'ICE USE ONLY Routed to Pe it Technician: Date: (?i�t 12o?Za Initials: l Fees Due: Yes ❑No Fee Description.. Amount e: f _ $ _uo $ $ Special Instructions: Reprint Permit(per PE): ❑ Yes ❑ No ❑ Done Applicant Notified: Date: 0131),,. Initials: R7. rtd:Y ' I:\Building\Forms\TransmittalLencr-R visions_073120.doc