Permit CITY OF TIGARD MASTER PERMIT
iliii11 . COMMUNITY DEVELOPMENT
Permit#: MST2021-00008
-TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/06/2021
Parcel: 2S109ACO2601
Jurisdiction: Tigard
Site address: 13064 SW FORAN HILLS CT
Subdivision: FORAN HILLS Lot:
Project: Foran Hills, Lot 10
Project Description: New detached dwelling. DEMO CREDITS FOR SDC FEES APPLIED FROM BUP2020-00115.
BUILDING
Floor Areas Reauired Setbacks Required
Stories: 2 Bedrooms: 5 First: 1070 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1680 sf Garage: 683 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2750 sf Value: $370,047.59 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr. 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Tvoes Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Fum<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Fum>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea addl 500 sf: 5 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2750
Owner: Contractor:
BULL MOUNTAIN LLC STONE BRIDGE HOMES NW LLC Required Items and Reports(Conditions)
3115 SW STEPHENSON ST 4230 GALEWOOD STREET#100 1 Ersn Cntrl 503-639-4175
PORTLAND,OR 97219 LAKE OSWEGO,OR 97035
PHONE: PHONE: 503-387-7577
FAX: 503-387-7615
Total Fees: $13,587.33
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through 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.
Hotly Vary OlvAppUcat'wwt
Issued By: Permittee Signature:
Call 503.639A175 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.
i.,i..,
300(0
Buiidini Permit Application /
Residential RECEIVE I rOF Ol ricE USE O&LY /y�Q
Received 01 n '/ Permit No:M ST2021^O0W O
City of Tigard natdey: 1 L H
n 13125 SW Hall Blvd.,Tigard,OR 97223 JAN 0 4 2021 Plan Review /t/l Othftpertn �R��- Gg- Phone: 503 7181439 Fax: 503.598.1960DateBy. Jfjl�Date Ready/By. 724
t� iwu: Ed See Page 2 for
TIGARD Inspection Line: 503.639.4I75 CITY OF TIGARD Not ad/Method 1 ,(� Supplemental f¢rarmelioa
Internet: www.tigard-or.gov BUILDING DIVISION 7 D&--ffLA11-- I
TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING
Permit fees*are based on the value of the work performed
law construction ❑Demolition Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ['Other: equipment,materials,labor,overhead,and profit or th.
CATEGORY OF CONSTRUCTION work indicated on this application.
S -r-/i 3� ' 7r
Valuation: r 1.
1/I 1-and 2-family dwelling 0 Commercial/industrial
Number of bedrooms: 'S
0 Accessory building ❑Multi-family
Number of bathrooms:3
❑Master builder 0 Other:
JOB SITE INFORMATION AND LOCATION Total number of floors: Z
New dwelling area: j1 square feet I(080
Job site address: 13(3(9i''q' �`J �(L/a1.1 H air c�'
City/State/ZIP: 110 dl a. Garage/carport area: l0‘73 square feet 1 670
Snite/bldgJapt.no.: Project name: Covered porch area: square feet r
Cross street/directions to job site: Deck area: square feet
Other structure area: spii< square feet PAllo
REQUIRED DATA:CO3 MERCIAI.`USE CHECKLIST
Subdivision: 411115 Lot no.:. 10 Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation:
t*1 /Sll`Ib1 * SitN Existing building area: square feet
New building area: square feet
i!j PROPERTY OWNER 0 TENANT Number of stories:
Name: ST S '&'^1i()j- k-toJ1 OLU,ti,1..L., Type of construction:
Address: E 23(D, 121 v1JOt)l) ST1 Cot -r It-k3 Occupancy groups:
Ciiy/Stoto//Z V-IP: LA— .CJSVcit.bbi CO,. 41 cc Existinge
Phone:(n )3erI-1511 Fax:(9531 32 h11,1)Ib New:
R.APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
7�+ {Please refer ro fee whale*
Business name: .S te}..(E. '(j Homes 1\m,L(.c. Structural plan review fee(or deposit): 7fg 3,/
Contact name: VE,j)2,11:42E -jMX r FLS plan review fee(if applicable):
Address: Total fees due upon application:
C
hone tate/ZIP: Amount received:
Phone: ) Fax::( )
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:'(73tz4T 1 TQ*{ S(2I{1U 41+ twhl 4bd). Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photovoltaic Solar Panel System.
Submit two(2)sets of roof plan with connection details
Business name: ST(� 5i-41)(aye ( [Ivies L +t$J:(l{._, and fire department access,along with the 2010 Oregon
Address: '-t-M) biki0k3ODD 'SIt S>3at- im Solar Installation Specially Code checklist.
PernutFee(includesplanreview $180.00
City/State/ZIP: ( tjj;�s UQ: IZti> tJ and administrativefees):
Phone:( '”t 11 Gil Fax:(,t ' c, --1 Z l.DI b State surcharge(12%of permit fee): $21.60
CCB tic.: 1-13- l', hj!(4 � Total fee due upon application: $201.60
---�. This permit application expires if a permit is not obtained
Authorized signature: within ISO days after it has been accepted as complete.
�9 a Pee methodology set by Tri-County Building Industry
Printname: 14^�i.'? T�.t-✓n+�,��� Date: �I-T� Service Board.
I:\Building\PemvtslBUP-RESPemiltApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
i'vlechanical p$I'fd#1O{)lICiddloREcEi� , C'E USE'ONLY
City of Tigard t a i. cd Permit`In PAST tx)oog
u 13125SW Hall Blvd,Ti Tigard, 97223 ilii
JAN4
l Ba 0 2021 Pisa O:ita tknni[
Phone: 503.718.2439 pax: 503.398.1960 J.,eti>y�
TIGARD, Inspection Line: 503.639.4175 t),te lieaty4iy: c 0 Lr Sec Page for
Internet: www.tigard-orgov CITY OF TIGARD Kotifieslitsiethod' Supplemental Information
BUILDING DIVISION --- t
__ TYPE OF WORK I COMMERCIAL FEE SCHEDULE—USECITECICLIST
Mechanical permit fees*are based on the value of the work
{{{I ®New construction ❑Addition/alteration/replacemeni perforated:indicate the value(iroutdedto the nearest dollar)ofall
I 0 Demolition ❑Other mechanical'materials.eouir,ment,labor.overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT l SYSTEMS FEES'
0 1-and 2-famil dwelling ❑ComtnerclaUiltdttsmal ID building j For special infonunrioa use clecktisr.
0 Multi-family 0 Master builder 0 Other: Description L Qty. Ea. 1 Total
Heating/cooling:
JOB STPE INFORMATION AND LOCATION - - j 46.75
Air conditioning__
lob sae address: 0014 SW ) -%1 }i11.i,,1' C.J(, Furnace 100.000 BTU(ttuctslemis) 1 46.75
City/Staie+ZIP:Tigard,OR Furnace I00.000's BTU Nor',re le) 54.91 , n.
I Heat pump 161.06
. . a ��. .. ® Project name: I _,...----, 1
_.._._..._ Mel work 23.32 I
Cross street/directions to job site:: 1 Hydrant':hot water system. L?3 32, I. t
�. .- ,_ —�.,.-.�.._.�w..,..�...... __._,...�____,,.-_,.—,.;:,^ , 1 Residential boiler 1
Indronic) . 23.32 j
.
Unit heaters(Pod-type,not electric), PM 1
__.___.._,—_,.—._._.._.� ._._.. in-wall in-duct.susoanAed.etc.. _
Flue,Yent for env of above , I.
rrn
Uther: 23.
. 32
Subdivision:t l 1111RS Lot no.:10 t-- -aneest ~"'
___..... . , Other fuel a fiances:
Tax map/parcel no.: �� Water healer 1. 23.32
_ DESCRIPTION OF WORK ,..® I_Oasfireplacdinsat . 33,39 }_
Floe vent for water heater or gas
new,single family residence fire lace 23.32
I.ogr lighter(gas) Mil 23.32
.-- --»-, - Wood/ .diet stove 33.39
Wood fireplace/insert __ . ,,,,..,_„2r3 32 1.. ,_
Chimoev'linerithl&vent ,..123 32
t PROPERTY OWNER 1 ❑ TENANT Other. { ?3 32
I Environmental exhaust and ventilation: _
Name:Stone Bridge hones Nit,LLC 1 Range hood/other kitchen
_•r....._.._. equipment 1 33.39 W.
Address:.1230 Catewaod Si,Suite 100 Clothes dryer exhaust
—
{ City/StatcZlP:Lake Oswego.DR 97035 Single-duct exhaust(bathrooms.
— _ wastis. m uA++ tam'facets) Ell
Phone:(503)387.75?7 1 Pax (St)i)387.7675 3ltiutcrawlsaecethus — 23.32
El APPLICANT }} 0 CONTACT PERSON Other: 23.32..
Fuel 'nine:.
Business name:same as above
___________,,,___ ..._,-_„a,.,- i S14.15 for Ord four:S:t.033 for each additional
Contact amine:Deirdre Britt Furnace,era. _
Address: Gas heat um
Wall/utiapendedletnit treater v ,_
City/State/ZIP: �� i Water heater 1 _
Phone:( ) _.._ _I Fax. :( ).____ Pirznlac.. ,,,_ I. -
flange £ .___..I__._..,-..�I
E-mail:dht•itif'rstonehridgehnmesnw.com Barbz ue tea I µ t� [
¢, CONTRACTOR Oththes dryer s) I I ..._.._
Business name:Comfort Zone T Other: I I ,____`
` MECHANCICAL PERMIT FEES`
Address:1032 MV Corporate Dr. ( Subtotal
City/State/ZIP:Troutdale,OR 97060 Minimum permit foe($90.00)
Plan review(25°0 of permit fee)
Phone:(503)667.5595 .»._.___.____._ —Fax (503)-091.8252 w -_M State surcharge(12'ta of permit fee) ...._.
CCB Its.:110091 I __ TOTAL PERMIT FEE ;��_�
I.—,—Y•_„__„_,,,A.._,_._ ,__.__._ ,._._.________________ .-----_-..---5 -thh permit application expires if permit is emf obtained within 1Sa
---yam.,➢ days after it has been accepted as complete.
Authorized signature. '( ' Feemethodolo�-set by'Fri-County Building Industry seretec Bond
Pout name:David Heldstab I Date: 1 141 7...
t-,anadino'Pomdt<.Arr.0 Pamdgnn aims 1 Jac Uu-:gl St:IIII'C.Cut.VES,
1
RECEIVE �� ONLY Electrical Permit Application �� IoH OFFICE LSF �i
City of TigardReceived
Permit#:tt/i s i-20 Li- 017(iv K
• I3125 SW Hall Blvd.,Tigard,OR 97223 J A N 04 2021 Play,Review
Related Permit S:
"- Phone: 503.718.2439 Fax 503598.1960 Dare/13 r.
TnspectionLine 503.639.4175 CITY OF TIGARD Ready D'Ile/ty: ,ens Hi SeePage2 for
1'IGARD, Internet www.tigard-or.gov BUILDING DIVISIO Notified/Method: Supplementalinformatioo
TYPE OF WORK - PLAN REVIEW
New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sett of plans wiiitena checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
El Demolition ❑Other: where the available ihuh current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 snaps at 150 volts or 0 floating buildings.
less to g ouad or exceeds 14,000 0 Commercial-ass
and 2-family dwelling ❑Commercial/industrial 0 Accessory building agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB Suit.INFORMATION AND LOCATION ❑Emergency system. larger separately derived
{+ ❑Addition of new motor load of system.
Job#: 30041 yob site address:(30(04 JVJ j 1pg-A� H t A S G7. 100HP or more.
0 Six or more residential units. occupancy.
City/State/ZIP: it 0 Al2.0a'j ',.. 0 Healthcare facilities. 0 Recreational vehicle parks.
Suite/bld t.#: Project name: 0 Hazardous locations. 0 Supply voltage for more than
g' 1 0 Service or feeder 600 ampsor more. 600 volts nominaL
Cross street/directions to job site: 1 EE SCHEDULE
Description I Oty. I Each i Total I •
New residential single-or multi-family dwelling unit.
Subdivision: FOTZ_r1ti4 H 1 tic Lot#: it, Includes attached garage.
1,000 sq.ft.or less '2- 16854 4
Tax map/parcel#: Ea,add'l 500 sq.it.or portion `L 33.92 1
DESCRIPTION OF WORK Limited energy,residential 75.00 2
4 i. lPkP_4 Y t M i y�--t\�/E (with above sq.ft.)
'r /Vi' vVG j. t't tvt yti IJIt.-t,LG Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
to PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relucadon
Name: S- fijail(31:.6 H DME-S k-k Vi tic, 200 amps or lam 100.70 2
,l -y s 201 amps to 400 amps 13356 2
Address: 472Db Sir �UiTlu 1
�f ,��p 401 amps to 600 amps 200.34 2
City/State/ZIP: 1 W W"�V i OP. 1103E 601 amps to 1,000 amps 301.04 2
Phone:( 3cio—i1 Fax:(I:703)39511 W l Over l/100 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 I
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
ITtt APPLICANT 1 ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,er panel
A.Fee for branch circuits with
Business name: above service or feeder fee,
S'(flt� �h�ll� i=1l I �s ii4LJ;tS > Wchbran*,circuit 7.42 2
Contact name:' 24 T'g' B.Fee for branch circuits without
service or feederfee,first 56.18 2
Address: branch circuit
City/State/ZIP: Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax::( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: 959417 e GTOt•ti5?-(pl c NtaME&tNaW,C ✓t Reconneetonly 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: E-1.61.,7C(124C/A4-. i NW(J4,}e4TIC9ttil$ Sign or outline lighting I 67.84 2
Signal circut(s)or limited-energy 0 See Page 2 2
Address: I{yo�j'`63 SG 2,-52-No 1,a_. panel,alteration,or extension.
City/State/ZIP: C�9� Each additional inspection over allowable in any of the above
ty • 17 rp.,SC. S', (7�- Additional inspection(1 hr min) 6625/hr
Phone:( )3r>90(09 ei Fax:( ) investigation(I hr min) 90.00/hr
Infitsldal plant(1hr min) 78.18/hr
Email: l.0 7//)2,) Inspections for which no fee is 90,00/hr
CCB Lie.: 420412, Electrical Lie.: Ifhltgqql, Supru.Lic..2,./ C s-pecifically listed('h hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: ,.-yv ` — Subtotal: 1
Print name: vsizixi -ct.lotvi As I Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
TOTAL PERMIT FEE:
Authorized signature:
This permit application expires If a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
` Number of impactions allowed per permit.
i?noildinglPermitslp.LC Permi5App_ELR_uRhi.doc Rev 06/172015 4'9 4615T(Ir1onaCOMJsma
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Description 1 Qty.l Each 1 Total
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
5 kva or less 100.70 2
Check Type of Work Involved:
5.01 to 15 kva 133.56 2
0 Audio and Stereo Systems* 15.01 to25 kva 200.34 2
Wind generation systems in excess of 25 kva:
n Burglar Alarm 25.01 to30kva 301.04 _2
1P Garage Door Opener* 50.01 too x 552.26 2
>7�0 kva(fee in accordance 552.26 2
with OAR 91S-309-0040)
Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in an;of the above:
D Other. Each additional inspection is 66.25/hr
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(4 hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00anhtp(EntertoPage 1):
Number of inspections allowed per permit
(SEE OAR 918-309-0000)
Check Type of Work Involved:
Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
n D• ata Telecommunication Installation
n F• ire Alarm Installation
❑ HVAC
❑ Instrumentation
n Intercom and Paging Systems
❑ L• andscape Irrigation Control*
❑ Medical
❑ N• urse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
t.\rruiitling\PennitsWiC PermitApp_tLR_TREAoc Rev 06/172015
Plumbing Permit ApplicatioRECEIVE
Building Fixtures I,oR urn CF 1 SF oNl v
CityaLT' and Receivtd PcrmitNe.:
AiIST2O2I'OOUo
• 13125 SWAali Blvd.,Tigard,OR 97223 JANO4 2021pae/3y:an cw;• Phone: 503.7182439 Fax: 503.598.1 Dgtdgy. Other Permit No.:
Inspection Line: 503.639.4175 ` t TY OF TIGARD Date Ready/B Jmir: RI See Page 2for
.T GARI7. Internet ,rti�rd-or_gov BUILDING DIVISION r ficdlMdhod: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
V 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) I
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
®'1-and 2-family dwelling 0 Commercial/industrial
SFR(2)bath 437.78
SFR(3)bath j 50032
❑Accessory building 0 Multi-family Each additional batbtkit hrn 25.02
❑Master builder ❑Other: Fire sprinkler( sq.R) Page 2
JOB MIX INFORMATION AND LOCATION Site utilities:
130(p 4 CO/ fOR� H t u CT Catcd;basin or area drain 18.76
Job site address: J f
Ikytvell,leach line,or trench drain. 18.7fi
City/StatelZlP: --nopcini
i{. Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt..no.: I Project name: Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76 .
Sanitary sewer(no.linear IL: ) Page 2
Storm sewer(no.linear ft.: I Page 2
Water service(no.linear It.:. .) Page 2
Subdivision: I2 1 I LU' Lot no.:iL) Fixture or item:
Tax map/parcel no.: Backllow preventer 31.27
Backwater valve 12.51
DESCRIPTION OF WORK
�^�` Clothes washer i 25.02
}.A , S i ?PrM p -S.1� OS Dishwasher I 25,02
Drinking fountain 25.02
Ejectors/sump 25.02
+.4' PROPERTY OWNER 0 TENANT Expansiuntank 12.51
C ,n,t _ Fixture/sewer cap 25.02
Name: +.}Tut5 11Dt* Ft i‘ild%i i,(,£� Floor drain/floor sink/hub 25.02
Address: 42,3 (2maivow CI, St)iiL lw Garbage disposal 1 25.02
Citp/Staio121P- L 4E..E OS /JAL L), ()D. Gil irs� Rom.bib __..-- .1- 25.02
Phone:(3)3) 51-11511 Fax:0° )-`'je)-1-1(p IS Ice maker 12.51
APPLICANT ❑.CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value_$_) Page 2
Business name:-Sr 01.4S'$94tx:,E 1-4GN1,` Ntv,)/ (lc Primer 12.51
Contact name: i7, ( �'jgt!`i' Roof drain(commercial) 1251
Address: Sink/basin/lavatory '7 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 'I' 12.51
E-mail: . t�`2(r�e s-$OHad-l6l2tc.:.,`G(-ions iF�.t+t1p,1.{'C'M Urinal 25.02
Water closet 3 25.02
CONTRACTOR Water beater i 37.52
Business name: L,V"'+tw' iVie iet,6/P! TV)i^ii i'r+11(..4 Water piping/DWV 56.29
Address: e i7Jt , Other: 25.02
City/State/ZIP: 1.11 S D v i 02_(47 12.5 Subtotal
Phone:(91) )1.0400l(3 Fax:( ) f I /23 Minimum pemut fee: $72.50
Plan review (25%of permit fee)
CCB Lie.: ea.(0'61 __ , Plumbiug Lie no.:S.4- 0p State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Date' This permit application expires if a permit is not obtained within 180 days
Print name: ,�.rr t r; : after it has been accepted as complete.
s�i�.- "-- 1 - P mP
"Fee melhodoloy„v set by"fri-Coanry Ruildiug Industry Service Boord.
1.V)vilding\PermeaMLMJ.Permunop.doc 10,O1/09 440-1616T(I 0i02'CAM/0.T.R)
-ijy/z/
City of Tigard
i COMMUNITY DEVELOPMENT DEPARTMENT
Ti G A l2 D Building Permit Review — Residential
Building Permit #: Ill ST2.021-Q OZ3
Site Address: 13164 SW Foran Hills Ct
Project Name: Foran Hills Lot #: 10
Planning Review
Proposal: New House
] Verify address/suite# active in Accela. ® In River Terrace: C] No ❑ Yes, River Terrace Review Addendum
Site Plan Elements: %]Er ion Control
R]3 copies of site plan on 8-1/2"x 11" or 11 x 17"paper taned trees with drip line and tree protection measures
®Drawn to scale (standard architect or engineer scale) X Footprint of new structure (including decks)and FEE
®North arrow ®Utility locations&easements(required for new and additions)
XlSite address,project or subdivision name and lot number ®Sidewalk/driveway approach
®Applicant information(name and phone number) 1!: .cation of wells/septic systems
ClLot dimensions and building setback dimensions Ira Street tree size,type and location
riquare footage of buildings to be demolished ®Street names
ntaExisting structures on site ®Corner elevations(2'contours if more than 4'differential)
E]Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? X1Yes ❑No
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? QYes ❑No
El Clean Water Services—Service Provider Lett (lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No
® Water Meter Fixture Unit Worksheet—Addi..ns,Remodels and ADUs
Required: El Yes,applicant was notified Iva No Received: ❑ Yes ❑ No
® SDC Exemption for ADU applied for: ❑ Yes PC] No Received: El Yes El No
® Public Facilities Improvement (PFI) Permit:
Required: El Yes,applicant was notified ® No Applied For: ❑ Yes ❑ No,stop intake
® Land Use Case#: SUB2017-00005 Q Zoning: R-7
® Required Setbacks: Front: 15 Rear: 15 Side: 5 Street Side: 15 Garage: 20
] Building Height Max. Height: 35 Actual Height: 24
PSI Landscape Area: 20 % E Lot Coverage Max: 80
Entrance 11] Set back no more than 8'from street-facing wall E Parallel to street or offset 45 degrees or less
Windows ® Minimum 12%of area of all street-facing facades 20%
Garage $] Garage door is behind widest street-facing wall ® Yes El No,one of the following is met:
El Door extends no more than 5'from wall and there is a covered porch extending beyond garage.
❑ Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2'" floor.
® Garage door width is ❑ 12'or less R] 50%or less of facade El 60%or less and includes 7 of following:
❑ Covered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset
❑ Fire shingles ❑ Lap Siding El Roof pitch El Gable,hip,or gambrel roof ❑ Dormer
❑ Accent siding El Window trim ❑ Window recess ❑ Window projection ❑ Balcony
] Visual Clearance ❑ Urban Forestry Plan
® Sensitive Lands: ❑ Yes K No Type:
] C ditions met prior to issuance of building permit
No s:
VLI Approved By Planning: Date: i 9-
Revisions (after Building Submittal only) Reviewer Date
iiiiiisiort4:, .. Approved ❑ Not Approved K\-- 1 I l y[2\
Revision 2: ❑ Approved ❑ Not Approved
C\Building\Fonns\BldgPermitRvw_RES_1224I9.docx
Building Permit Submittal
Original Submittal Date: Pi^d 24z.1
Site Plans: # 13
Building Plans: # 3
Building Permit#: [ Enter building permit#above.
Workflow Routing: [Planning C1.-"Engineering 111'Permit Coordinator l Building
Workflow Sign-off: Eg'Sign-off for Planning(include notes from planning review)
Route Application Documents: a Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
2-Building. original permit application,site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: / / 20
Engineering Review
I21-S1-ope at building pad: ‘,72-
2 fonditions "Met"prior to issuance of building permit
Il�l asements (encroachments)per engineering conditions of approval and plat
2.' ater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes IQ No
Assess Water Quantity Fee in-lieu: ❑ Yes 2-No
LIDA Facility on lot: Yes 1 No
Id'Final Plat Recorded:
• NOT Approved byEngineering: sta.. Date: /-/ 3 ?��l
Notes: 4/30 ( ta,AL. .1 01,4 S a. 1 I a,rr St`wt M.. (.n rrcm a 1
❑ Approved by Engineering: Date:
Revisions (after Building Submittal only) Reviewer Date
Avis~18. Approved ❑ Not Approved • 20
Revision 2: ❑ Approved ❑ Not Approved
Permit Coordinator Review
Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
RevitiotilVotiee 1': Date Sent to Applicant: J/ /2
Revision Notice 2: Date Sent to Applicant:
able DC Exemption: ❑ Received �oes not apply
1•I SDC Fees Entered: Wash Co Trans Dev Tax: es ❑ N/A
Tigard Trans SDC: Aes ❑ N/A
Parks SDC: Jfes ❑ N/A
LIDA '��, Yes g N/A
OK to Issue Permit
Approved by Permit Coordinator: 71/70v---) Date: 12.012/1
I:\B u i Id ing\Forms\Bl dgPenn i tRv w_RE S_1224 19.d o cx