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Permit CITY OF TIGARD MASTER PERMIT III • . COMMUNITY DEVELOPMENT Permit#: MST2021-00043 13125 SW Hall Blvd.,Ti Date Issued: 03/10/2021 TI(„IRp and OR 97223 503.718.2439 g Parcel: 2S114BB21200 Jurisdiction: Tigard Site address: 10226 SW KENT CT Subdivision: RIVERVIEW ESTATES NO.2 Lot: 56 Project: Dolan Kitchen Project Description: Kitchen remodel-Add 28 sf new dwelling BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 0 First: 28 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 15 Smoke Dwelling Units: 0 Third: 0 sf Right 5 Detectors: Total: 28 sf Value: $50,000.00 Rear: 15 PLUMBING Sinks: 1 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 0 Tubs/Showers: 0 Garbage Disp: 1 Water Heaters: 0 Water Lines: 0 Drains: Catch Basins: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Bckflw Prevntr: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<1o0K: 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: 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: 2 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: ALT SF VB R-3 28 Owner: Contractor: DOLAN JOINT TRUST MOUNTAINWOOD HOMES INC Required Items and Reports(Conditions) BY DOLAN,MATTHEW JOHN& PO BOX 2257 DOLAN,KEHLI KATHLEEN TRS BEAVERTON,OR 97075-2257 10226 SW KENT PL TIGARD,OR 97223 PHONE: PHONE: 503-746-7338 FAX: Total Fees: $2,162.74 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: `��w a/1«�1�.1 P Permittee Signature: �� 0\`�P` :LG r1 �-1 Call 503.639. 175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the Job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Plan# Floors Large Le ,____— Bed rooms Small S 6t�4 2.� g$ We r3 — IZZ X 2` ) LAV Tub Basement (. b \``�,� rt U-k \f�At_1P 'f\ Vent 1st Floor Zg '1V� E U V� �� Water Heater 2nd Floor p eD�A-c_c , AC 3rd Floor T 1 School / R-3 Total `(-J.-mS ` ;fn--V / Garage !!! ck fosc-t Total 7i6 \ a _ o>oa. CX�a s �s 1_ #for Elec v C, t 3_ -, , 1 Building Permit Application q Residential R CEIV D FOR OFFICE USE. ONLY Received ey + r�7,� City of Tigard C Date/By: .. V1�1 \AV Permit No.:MS\ LUZl—c otk3 lig • 13125 SW Hall Blvd.,Tigard,OR 97223 FEB 0 9 Le�� Plan Review ■ ^,• q/ n J�/ Other Permit: Phone: 503.718.2439 Fax: 503.598.1960 Date By: fie /ter {��� TIGARD Inspection Line: 503.639.4175 CITY OF TIGARFDA Date Ready/B : /Gr/ /J� fur=s ® See Page 2 for Internet: www.tigard-or.gov BUILDING DIviSION nfied/Method: ` / ,// TJ . Supplemental Information TYPE OF WORK REQUIR DATA:I-AND 2-FAMILY DWELLING 0 New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all tg Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. tgl I-and 2-family dwelling ElCommercial/industrial Valuation: $C 51) /9 .0 .3. 0 Accessory building 0 Multi-family Number of bedrooms: 0 Master builder El Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: /(7? 2C.' �'1- er New dwelling area: square feet City/State/ZIP: �qa-d , O� ?7 z/ Garage/carport area: square feet Suite/bldg./apt.no.: V Project name: 0 1 Covered porch area: square feet Cross street/directions to job site:C Deck area: square feet J . l L / Wi 7/ .2e�of SSi n,4- Su lv7.4L 6#Afeeher Other structure area: square feet /� ��II c yn� / /�/J �J- /SS14e /i P " 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. Valuation: $ 1"Ze tOde-1 VI t' I -elle4 Existing building area: square feet 5 r't6r Y)42 4 (-pr / r-' 1/tC-f-e-r f'-r(-( New building area: square feet A PROPERTY OWNER El TENANT Number of stories: Name: NA6,f ' u J e-k`i/ Do Type of construction: Address: /O?- f 'l�G I C-T- / Occupancy groups: City/State/ZIP: • j /e Cj 2 ? ?? -e-/ Existing: Phone:( 3)e9 X 6,760 Fax:( ) New: a APPLICANT ;X CONTACT PERSON BUILDING PERMIT FEES* Business name: o fC((ijo©d (Please re(ordfer to eeosit):schedule) Structural plan review fee(or deposit): Contact name: 1.1)ra,j 9 `'C�t Address: 83 a[/ j( e_ FLS plan review fee(if applicable): City/State/ZIP: Beeu/ .r totN / Q� .7 Total fees due upon application: Phone:(S53)703 C `93 Fax::( ) / Amount received: E-mail:(!(LG-Mom/ rn p0� i tit.r-ri-(hos t es a ��JV�') PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of tie) mounted PhotoVoltaic Solar Panel System. Business name: Moo eq Ta t pazood bib*L� Submit two(2)sets of roof plan with connection details a�3� �w I01 - z:N ` �� od fire t n Specialty p calty along wchecklist. the. Oregon Address: G4YltA 7 Solar Installation S ecial Code checklist. City/State/ZIP: a��/`it, ©� 7 Permit Fee(includes plan review $180.00 / and administrative fees): Phone:�)3 )74a, ?3 3 g Fax:( ) State ) it fee permit surcharge(12%of : $21.60 P CCB lic.: 8Y3l 7 Total fee due application:upon $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. yy Date: d *Fee methodology set by Tri-County Building Industry Print name: K r7 ��� Service Board. I:\Building\Permits iB / SPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) A Building Permit Application Checklist One- and Two-Family Dwellin i=L -IVED FOR OFFICE USE ONLY City of Tigard FEB 0 9 2"7.i DatReceived eBy: 2 1C. Z Permit No.:iVW?_(DL1-Wei III13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits: I Phone: 503.718.2439 Fax: 503.598.1960 CITY OF TIGARD 24-Hour Inspection Line: 503.639.4175 El Electrical El Plumbing 0 Mechanical TIGARD Internet: www.tigard-or.gov r3UIl_��NG DIVISION 0 Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ e 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑ d 3 Verification of approved plat/lot. ❑ ❑ a 4 Fire district approval required. Name of district: • ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ r// 6 Sewer permit. ❑ ❑ re 7 Water district approval. ❑ ❑ Z 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ Rtr 9 Erosion control El plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ E • basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state El ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. / 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ❑ ❑ ❑✓ there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size Q ❑ 0 and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, [/ 0 0 furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- [.. 0 0 floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. [a" 0 ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- [ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing [r ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 ❑ (2-- systems,see item 22,"Engineer's calculations." / 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists L�1' ❑ 0 over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. ❑ 0 Ef---.. 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 0 Er for four or more appliances. J❑ ❑ 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or L architect licensed in Ore on and shall be shown to be al.licable to the .ro'ect under review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". Ia" M 0 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 13 ❑ ❑ 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 0 ❑ ❑ 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 ❑ ❑ 27 "Drawn to scale"indicates standard architect or engineer scale. 0 ❑ 0 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 0 0 Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 0 ❑ and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, 0 ❑ ❑ including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(l 1/02/COM/WEB) Mechanical Permit Application / ^ FOR OFFICE USE ONLY' City of Tigard C E I V E V Received ` Permit No.:t(�T 13125 SW Hall Blvd.,Tigard,OR 972Y3°� 1••• VVVV Date/By: `�`z\ �� KA 2m_�13y3 = Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: TIGARD Inspection Line: 503.639.4175 FEB 0 9 2021 Date Ready/By: orris: Internet: www.ti rd-or. ov od I S See Page I Information ICIITY OF TIGARD TYPE OF . ' )nING Dil iblUN COMMERCIAL FEE* SCHEDULE -USE CHECKLIST Mechanical permit fees"are based on the value of the work 0 New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑ Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES" g1-and 2-family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑ Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: /^���6� w.. Air conditioning 46.75 Job site address: lO0" r C f4f C.-T` Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: 'T j� 8 ry1 v^ C 7 Furnace 100,000+BTU(ducts/vents) 54.91 �" f Heat pump 61.06 Suite/bldg./apt.no.: Project name: Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 _ Flue/vent for any of above 23.32 Other: 23.32 Subdivision: Lot no.: Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 Flue vent for water heater or gas fireplace 23.32 I . f�/ /. f I_ / Log lighter(gas) 23.32 GC l h �('�(�( Wood pellet stove 33.39 Wood fireplace/insert 23.32 Chiumey/liner/flue/vent 23.32 ['PROPERTY OWNER ❑ TENANT Other: 23.32 Environmental exhaust and ventilation: ^^ � Name: f t' d- Ke.61 I Do Law Range hood/other kitchen I,�A' equipment t 33.39 Address: l'^��r C.T Clothes dryer exhaust 33.39 City/State/ZIP: f / a t% t� 9 ?27 y Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:()3)6aej (0?so Fax:( ) Attic/crawlspace fans 23.32 jg APPLICANT j,g CONTACT PERSON Other: 23.32 Business name: l tc t 0 coot 1-cq‘YL4I UP t.t.c e- Fuel piping: 5 _ $14.15 for first four;$4.03 for each additional Contact name: Vtea.9 1-e-66. Furnace,etc. Address: E33,211 5- ) Ark ,j. gv - Gas heat pump Wall/suspended/unit heater City/State/ZIP: Ergot Jef7D1-4 ' Q� 920g Water heater Phone:( 23)7d_3 4A2 j Fax::( ) Fireplace / Range E-mail: t4tEiV4/7L✓ a `?�7ptJ/y74 I'I C.e �11�'i(; fG se 6,07 Barbecue �� CONTRACTOR Clothes dryer(gas) Business name: kibSoldf j _c_ti<,yt Other: h MECHANICAL PERMIT FEES* Address: 6,(q �C 7act _ Subtotal City/State/ZIP: 6,4.4.67 ` J Q Minimum permit fee($90.00) ova-- W 9 V Plan review(25%of permit fee) Phone:( ) 7�l ' Fax:( ) State surcharge(12%of permit fee) CCB lic.: 4y j&3_,_ TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 / days after it has been accepted as complete. Authorized Signa[�T¢: �� * Fee methodology set by Tri-Comity Building Industry Service Board Print name: ), L� / Date: M 1:\Building\Permits1EC_P_Pe`mutAp�13.doc 440-4617r(t 1/02/COM/WEB) Electrical Permit Applicati `C�" / FOR OFFICE USE ONLY Received City of Tigard FEB 0 9 2021 pest# ST • 13125 S W Hall Blvd.,Tigard,OR 97223 Plan R view w `� Z l M 20Z -deb f-1 ': 0 Phone: 503.718.2439 Fax: 503.598.10ThY OF TIGA IL) Date/B : Related Permit#: Inspection Line: 503.639.4175 pp//t�,f Ready Date/By: Juris: ® See Page 2 for T IGARD Internet: www.tigard-or.gov Obj>Jb fb 4'f Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑New construction 1g Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items 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}-b-and 2-family dwelling ElCommercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived A) ( ❑Additionm new motor load of system. Job#: Job site address: `Q `�,� Set) � toollP or more. ❑"A","E","I-2","1-3", City/State/ZIP: 'fl' a ❑Six or more residential units. occupancy. i L ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: ❑Hazardous locations. 0 Supply voltage for more than 0 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. 1,000 sq.tt.or less 168.54 4 Tax map/parcel#: Ea.add'1500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential /`� (' r /e. L (/ , 1 _/- _- . (with above sq.ft.) 75.00 2 L X-YJ Q `-1( f +� Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy ❑ See Page 2 PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name: L X liL77— d._ /4e. 'j t 1. 'f 200 amps or less 100.70 2 GD 3 60 t/_ _ ,' c7--- 201 amps to 400 amps 133.56 2 Address: �-fit:`F + 401 amps to 600 amps 200.34 2 City/State/ZIP: T`l ,. ( 02_ ? 7pZ(2.1/ 601 amps to 1,000 amps 301.04 2 Phone:5223 )(a a CO?gO 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 El APPLICANT 0 CONTACT PERSON ' Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name: above service or feeder fee, 7.42 2 each branch circuit Contact name: B.Fee for branch circuits without Address: service or feeder fee,first ' 1 56.18 2 branch circuit City/State/ZIP: Each add'l branch circuit 1 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Fax: :( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: + Sign or outline lighting 67.84 2 � S &1 (�r� , 'p Signal circuit(s)or limited-energy ❑ See Page 2 2 Address: 16 070 Gj � L W�� panel,alteration,or extension. g City/State/ZIP: O( op," �`1 e. 9 70Y S Each additional inspection over allowable in any of the above Alb y ( n Additional inspection(1 hr min) 66.25/hr Phone:�+Q, {y' 5539— Fax:( ) Investigation(I hr min) 90.00/hr Email: / all Industrial plant(1 hr min) 78.18/hr • ) p 7(/ 7�3 `t/`l Inspections for which no fee is CCB Lie.: G l�3 3(�� ri,�ls specifically listed(%hr min) 90.00!hr Gf Electrical Lic. Suprv.Lic.: V ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: _ Print name: Dine: El Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signs �f TOTAL PERMIT FEE: / This permit application expires if a permit is not obtained within IRO Print name: 1,4 ,.+ L 42 ael" Date: days after it has been accepted as complete. * Number of inspections allowed per permit. I:\BuildinglPormita\ELC_PermitApp_ELR_ERE.doe Rev 06/l7/2015 4404615T(11/OS/COM/WEB Plu bing Permit Application Building Fixtures `C IV r Received FOR OFFICE USE ONLY City of Tigard Date/By: Z�\��Z► Permit No.:PASTZOZI-abotA3 III • 13125 SW Hall Blvd.,Tigard,OR 97 9 q 777 m�aapp 2OL I Plan Review Phone: 503.718.2439 Fax: 503.598.19b0 Date/By: Other Permit No.: Inspection Line: 503.639.4175 y l Date Ready/By: °. : T l G It D Internet: www.[i d-or. ov CITY O F T,`-BARE1 See Page 2 for gar' 8 Notified/Method: Supplemental Information TYPE OF WVAPiNG Li. i:Jl1A FEE* SCHEDULE El New construction El Demolition For special information use checklist Description I Qty. I Ea. I Total Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building ❑Multi-family Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler p (_sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: �/0 ,7� � / 7- Catch basin or area drain 18.76 City/State/ZIP: Q ''�j�j Drywell,leach line,or trench drain 18.76 1 ! f� �"`7` Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 - Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 a//�� /� / ,/ y-.�/ _ Dishwasher 1 25.02 kt b 1 o r CJ L G4 / a--*e- 4 Drinking fountain 25.02 Ejectors/sump 25.02 X PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: `N,/(a l f F gG !( r 00 (0 N Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: /69v6, 5e,j t4 T Cl Garbage disposal , 25.02 City/State/ZIP: 77 clot feJ t p2 9 ? y Hose bib 25.02 �(/ Phone:63 3)G AO&7 ) Fax:( ) Ice maker 12.51 A APPLICANT ,,, CONTACT PERSON Interceptor/grease trap 25.02 Business name: o ore, 1 N wood [0 1 1 NL Medical gas(value:$_) Page 2 Primer 12.51 Contact name: / (.4409 Roof drain(commercial) 12.51 Address: 83„ .y C,c-) i 141,19 ci,-; ie_ Sink/basin/lavatory 25.02 City/State/ZIP:DeQ ti te.6,4 t c> 7C,..)053 Solar units(potable water) 62.54 Phone:( )..,) 70 3 9-..3.03 Fax: :( ) Tub/shower/shower pan 12.51 E-mail: �(,tM,4 noo ban iI-4WG0c161.tL�cJ, Urinal 25.02 / Water closet 25.02 CONTRACTOR ' Water heater 37.52 Business name: [ �7/ice-W O (� Pe-u-Ky bi l y Water piping/DWV 56.29 Address: 7 733 5 4„.1 F ' P / Other: 25.02 City/State/ZIP: J€-I""rpm( / a y' 2006 Subtotal (6V / a 7 l � Minimum permit fee: $72.50 Phone: � CO 41-!s/ ��9 O Fax:( ) �L Plan review (25%of permit fee) CCB Lic.: 7 966 ' P o l l�E'j State surcharge(12%of permit fee) Authorized signa[lue: TOTAL PERMIT FEE Print name: e�JY .-. C Date: This permit application expires if a permit is not obtained within 180 days /44 after it has been accepted as complete. t/ *Fee methodology set by Tri-County Building Industry Service Board. I:\Budding1Pemdts\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) C1eanWate\ Services SENSITIVE AREA PRE-SCREENING SITE ASSESSMENT Clean Water Services File Number 21-000511 1. Jurisdiction: Tigard 2. Property Information(example: 1 S234AB01400) 3. Owner Information Tax lot ID(s): Name: MATT DOLAN 2S114BB21200 Company: Address: 10226 SW KENT CT OR Site Address: 10226 SW KENT CT City, State,Zip: TIGARD, OR, 97224 City, State,Zip: TIGARD, OR, 97224 Phone/fax: 503.624.6780 Nearest cross street: Email: KEHIDOLAN@GMAIL.COM 4. Development Activity(check all that apply) 4. Applicant Information Ijj7 Addition to single family residence(rooms,deck,garage) Name: kraig leMay ❑ Lot line adjustment ElMinor land partition Company: Mountainwood Homes ❑ Residential condominium ❑ Commercial condominium Address: 8324 SW Nimbus LN ❑ Residential subdivision ❑ Commercial subdivision City, State,Zip: Beaverton, OR,97008 ❑ Single lot commercial ❑ Multi lot commercial Phone/fax: 5037039203 Other Email: klemay@mountainwoodhomes.com 6. Will the project involve any off-site work? ❑Yes 0 No 0 Unknown Location and description of off-site work: 7. Additional comments or information that may be needed to understand your project: CATILERVERING OVER EXISTING FOOTINGS TO ADD TO KITCHEN,NO GRADE TO BE DISTURBED ADDED FLOOR PLAN FOR SCOPE OF WORK 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 kraig leMay Print/type title CAD Operator Signature ONLINE SUBMITTAL Date 2/11/2021 FOR DISTRICT USE ONLY O 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. O 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. X 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. ❑ THIS SERVICE PROVIDER LETTER IS NOT VALID UNLESS 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/ DE LETTER IS REQUIRED. Reviewed by ��'K".rs� Date 2/25/21 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 %,,,,Lc 2/20.0 Main Office • 2550 SW Hillsboro Highway • Hillsboro,Oregon 97123 • p:503.681.3600 f:503.681.3603 • cleanwaterservices.org City of Tigard Z/lig( IIIC • COMMUNITY DEVELOPMENT DEPARTMENT T 1 G A RD Building Permit Review — Residential Building Permit #: MST 2O1.1— OOb'-(�j Site Address: 10226 SW Kent Ct Project Name: Dolan Lot #: Planning Review Proposal: Kitchen remodel ® Verify address/suite#active in Accela. ® In River Terrace: $l No 0 Yes, River Terrace Review Addendum Site Plan Elements: n®Erosion Control X.13 copies of site plan on 8-1/2"x 11" or 11 x 17"paper nERetained trees with drip line and tree protection measures ]Drawn to scale (standard architect or engineer scale) 1114Footprint of new structure(including decks)and FFE North arrow Utility locations&easements(required for new and additions) ESite address,project or subdivision name and lot number na Sidewalk/driveway approach EIApplicant information(name and phone number) naLocation of wells/septic systems ®Lot dimensions and building setback dimensions nso Street tree size,type and location Square footage of buildings to be demolished Street names kExisting structures on site naCorner elevations(2'contours if more than 4'differential) XLot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? [ jes No impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes ❑No ® Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ® Yes,applicant was notified ❑ No Received: ❑ Yes 0 No E Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs Required: XI Yes,applicant was notified 0 No Received: ❑ Yes ❑ No A SDC Exemption for ADU applied for: ❑ Yes No Received: ❑ Yes ❑ No IX Public Facilities � Improvement �'F Permit: Required: ❑ Yes,applicant was notified K1 No Applied For: ❑ Yes ❑ No,stop intake nC] Land Use Case#: E Zoning: R-7 ® Required Setbacks: Front: 15 Rear: 15 Side: 5 Street Side: 1`41A— Garage: 20 ® Building Height Max.Height: 35 Actual H ,ht: YIUGra�tr Cc Landscape Area: 20 % '4 Lot Coverage Max: 80 - ❑ Set back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 de Windows no • .. 12%of area of all street-facing facades Garage ❑ Garage door . .'dest street-facing wall ❑ o,one of the following is met: ❑ Door extends no mor- - ' 'Doe not overed porch extending beyond garage. ID Door extends no more than ' :Doe re is a 12 sq ft.window above garage on 2'd floor. •❑ Garage door wid 1 " 7 or les~ - .,. .r less ❑ 60%or less and includes 7 of following: ■ -. porch ❑ Recessed entrance ❑ Wall offset e ❑ Roof offset ❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gam r Dormer ❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection O Visual Clearance n® Urban Forestry Plan ® Sensitive Lands: ❑ Yes a No Type: 1I Conditions met prior to issuance of building permit Notes: l � �c7 Approved By Planning: iv,/ 1 G .frteb 1 Date: 2/11/2021 Revisions (after Building Submittal onl, Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved I:\Building\Fomis\B1dgPermitRvw_RES_122419.docx Building Permit Submittal Original Submittal Date: 2.1°1,2\ Site Plans: # Building Plans: # 3 Building Permit#: [" Enter building permit#above. Workflow Routing: Planning R' Engineering [:4'Permit Coordinator 2' Building Workflow Sign-off: [Y Sign-off for Planning(include notes from planning review) Route Application Documents: 7 Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. IA Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: ` k,3CA J Date: 7-A 2,\ Engineering Review ❑ Slope at building pad: ❑ Conditions "Met"prior to issuance of building permit /�/ ❑ Easements (encroachments) per engineering conditions of approval and plat / v ❑ Water Quality/Quantity Facility: 47 Assess Water Quality Fee in-lieu: 0 Yes ❑ No Assess Water Quantity Fee in-lieu: ❑ Yes 0 No LIDA Facility on lot 0 Yes 0 No ❑ Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: [Approved by Engineering: Date: z 2 Revisions (after Building Submittal only) Reviewer ate Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved 0 Not Approved Permit Coordinator Review 1 .Conditions "Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant Revision Notice 2: Date Sent to Applicant SDC Exemption: 0 Received X1 Does not apply SDC Fees Entered: Wash Co Trans Dev Tax: 0 Yes K. N/A Tigard Trans SDC: ElYes N/A Parks SDC: 0 Yes . N/A LIDA 0 Yes [gt N/A OK to Issue Permit Approved by Permit Coordinator: Date: 2 ZZ Lc2( I:�B ui!ding\Forms\B l dgPe nnitRvw_RE S_122419.docx Agnes Lindor From: Agnes Lindor Sent: Thursday, February 11, 2021 9:13 AM To: #Building Permit Technicians; Kraig LeMay Cc: Lina Smith Subject: 10226 SW Kent Court Hi Kraig- Planning has approved your site plan and the permit is being routed to building. Please provide the following prior to issuance of your permit: 1. CWS Service provider letter (choose the first option, pre-screening) 2. Fixture count worksheet. Thanks! Agnes Lindor I Associate Planner City of Tigard I Community Development 13125 SW Hall Boulevard Tigard, Oregon 97223 Phone: 503.718.2429 Email:AgnesL@tigard-or.gov 1 s RECEI` ED FEB 0 9 2E21 Oregon Residential Specialty Code N1107.2 CITY OF TIGARD BUILDING D1VION HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: Jurisdiction: Site Address: C0 1 t4 r cam/e-T- Subdivision/Lot#: ! and/or Map and Tax Lot#: By my signature below, I certify that all of the permanently installed lighting fixtures in the above mentioned building contain high-efficacy lamps. Screw-in compact fluorescent and LED lamps comply with this requirement. (Oregon Residential Specialty Code N1107.2)I Signature: Date: er/G orized Agent Print Name: ray te-L\l9 ORSC Section N1107.2. High-efficacy lamps. All permanently installed lighting fixtures shall contain high- efficacy lamps. Screw-in compact fluorescent and LED lamps comply with this requirement. The building official shall be notified in writing at the final inspection that the permanently installed lighting fixtures have met this requirement. Exception: Two permanently installed lighting fixtures are not required to have high-efficacy lamps. I:\Building\Fonns\RES-HighEfficiencyLightingAcknowledgement_022018