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Permit �t IN CITY OF TIGARD MASTER PERMIT ' a ; COMMUNITY DEVELOPMENT Permit#: MST2021-00101 Date Issued: 05/10/2021 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S134DC00500 Jurisdiction: Tigard Site address: 11476 SW TWIN PARK PL Subdivision: None Lot: None Project: KURAHARA Project Description: Conversion of attached garage into habitable space with (2) bedrooms, (1) bathroom and (1) laundry room. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 2 First: 576 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 0 Smoke Detectors: Yes Dwelling Units: 0 Third: 0 sf Right: 0 Total: 576 sf Value: $70,536:96 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: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 1 Clothes Dryers: 1 Heat Pump: N Hoods: 0 Other Units: 0 Fum<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 W/Svc or Fdr: 6 Ea add?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 N Other: N Other Description: Ecompasing: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF VB R-3 576 Owner: Contractor: KURAHARA,JORDAN DAIRY FACTORY Required Items and Reports(Conditions) 11476 SW TWIN PARK PL 847 NE 53RD AVE UNIT B PORTLAND,OR 97223 PORTLAND,OR 97213 PHONE: PHONE: 520-270-3319 FAX: Total Fees: $3,521.40 This permit is Issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of Issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Of- thal �tn� On c1 �U ;o.S Issued By: Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. DocuSign Envelope ID:044629A2-046D-4694-8EE4-AC0C257CO204 Building Permit Application '$-3/1712 i Residentil Intl,t)1 I it I. 1'�i "i 1 Tigard7 ECEIVED secetred 11 PemtitNo.: r' ��4�j/Vi Cityof DataBy: " Phone:SW Hall Blvd.,Tigard OR 9 Dan Rev ew 24 ^,� 1.1114 rT►Q Other Permit: 503.7182439 Fax: 503.598.1960 DataBy: Inspection Line: 503.639.4175 MAR 1 7 ZOZi Date R� r �J I Supplementallnformadoc Intnmet: www.tigard-or.gov CITY OF TIGARD TYPE of vvgDING DIVISION REQUIRED D TA:I-,AND 2-FAMILY DWELLING Demolition Permit fees*are based on the value of the work performed. ❑New construction Indicate the value(rounded to the nearest dollar)of all ®Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the work indicated on this application. �� CATEGORY OF CONSTRUCTION Valuation: $ `343 600 '1 01536 r ® 1-and 2-family dwelling 0 Commercial/industrial 0 Multi-family Number of bedrooms: 2 ❑Accessory building❑Master builder 0 ' Number of bathrooms Other: JOB SITE INFORMATION AND LOCATION Total number of floors Job site address:11476 SW Twin Park Place New dwelling area: 576 square feet City/State/ZIP:Tigard, OR 97223 Garage/carport area: 576 square feet Suite/bldgJapt.no.: I Project namq:4DBli`7'FACt ?y Kt 1rd NIGr✓A Covered porch area: 0 square feet �ross street/directions to job site: Deck area: 0 square feet 0 Other structure area: 0 square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST subdivision: I Lot no.: Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Fax map/parcel no.:R269907 equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. :onversion of attached two car garage into two bedrooms and a full Valuation: $ Existing building area: square feet aom and laundry room. Ayr,4„ytCal1 e-/2,-et- -i-e4// per/ rt a/4Y� X_ r _ ` New building area: square feet �J[�IN�6l ¢i°-�+•tsz G'l�,/� 1 rl�v INJ:Cm✓ ® PROPERTY OWNER I ❑ TENANT Number of stories: lame:Jordan Kurahara Type of construction: .ddress:11476 SW Twin Park Place Occupancy groups: ity/State/ZIP:Tigard, OR 97223 Existing: hone:( 5p3-334-9678 Fax:( ) New: ® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT ES` (Please refer lo feu scheduk) issues name:Black Rabbit Structural plan review fee(or deposit): ootact name:Sean Coster FLS plan review fee(if applicable): Dress:4936 N Oberlin St Total fees due upon application: ty/State/ZIP:Portland, OR 972D3 Amount received: one:( )(503) 593-1396 I Fax: ( ) PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* mail: cote-A/is p_ .., corn Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. tsiness name:Dal Factory -David Monaceili Submit two(2)sets of roof plan with connection details Dairy and fire department access,along with the 2010 Oregon 'dress: 847 NE 53rd Ave Unit B Solar Installation Specialty Code checklist. Permit Fee(includes plan review $180.00 y/State/Z1P: Portland, OR 97213 and administrative fees): one:( )(520) 270-3319 I Fax:( ) State surcharge(12%of permit fee): $21.60 B lic.: G 7 A ,-nocuaigned by: ,, Total fee due upon application: $201.60 6 ` S1 k . (ANGY This permit application expires ifs permit is not obtained thorized signature: '-W 1CBCCF6E94453.. within 180 days after it has been accepted as complete. Date:3/1/2021 *Fee methodology set by Tri-County Building Industry ( nt name:Sean Coster Service Board. 4 DocuSign Envelope ID:044629A2-046D-4694-8EE4-ACOC257CO204 Building Permit Application Checklist One- and Two-Family Dwelling i ult uii•lr l I,NI u11_, City of Tigard Received s.a 13I25 SW Hall Blvd.,Ti Dare/By: Pe mit No.: Bard OR 98.19 Associated marts a ' Phone: 503-718.2439 Fax: 503.598.1960 24-Hour Inspection Line: 503.639.4I75 ❑ Electrical T I G A R t� P ❑ Plumbing 0 Mechanical Internet: www.tigard-or.gov ❑ Other: THE FOLl.O\%FN(. ITEMS ARF Rft:QIIIRFE) Il)R PLAN RLVII %V 1L4 A,LI ;t 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. f Dit 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. - X 3 Verification of approved plat/lot. L 4 Fire district approval required. Name of district 0 ❑ LK 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ 6 Sewer permit. ❑ 0 0 7 Water district approval 0 0 8 Soils report. Must carry original applicable stamp and signature on file or with application. a1 9 Erosion control 0 plan El permit required. Include drainage-way protection,silt fence design and location of catch- basin protection,etc. 0 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state Egi 0 ❑ 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. 1 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);Iocation 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. 2 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size 0 ❑ [a' and location. 3 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ 0 ❑ furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 4 Cross section(,)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- ❑ ❑ 51 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. 5 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. D 0 a Exterior elevations must reflect the actual grade if the change hi grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. i Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- ❑ 0 prescriptive path analysis provide specifications and calculations to engineering standards. ' Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing El 0 0 locations, Show attic ventilation. Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 ❑ jR systems,see item 22,"Engineer's calculations." ' Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists 0 0 [? over 10 feet long and/or any beam/joist carrying a non-uniform load, Manufactured floor/roof truss design details. ❑ 0 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 ❑ ix for four or more appliances. Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or [] ❑ r architect licensed in Oreeon and shall be shown to be licable to the ro'ect under review. Thee(3)site plans are required for Item ii above, Site plans must be 8-1/2"x 11"or II"x 17". 0 O Two(2)sets each are required for Items 16, I9,20 and 22 above. 0 0 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. M. "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. - ❑ "Drawn to scale"indicates standard architect or engineer scale. 0 ❑ Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard [? ❑ Street Tree List. Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 51 ❑ ❑ and protection measures must be drawn to scale and must include the project arborist's signature of approval. A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, 0 0 EX 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. ding'.Penults\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) DocuSign Envelope ID:368C2441-A78A-4750-A621-A9042BF1F1EE Mechanical Permit Application FOR OFFICE 11Sl: O..la - — City of Tigard Received Datv FenoitNo.: 11�1 21-0OI0 e 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Other Permit: II I Phone: 503.718.2439 Date/By: inspection Line: 503.639.4175 Date Ready/By: tads: I H See Paget for G l'1A10 p Internet: www.iigard-or.gov Notified/Method: Supplemental Information -_ TYPE OF WORK COMMERCIAL.FEE-SCHEDULE-USE CHECKLIST O New construction ®Addition/alteration/replace[ttent Mechanical permit fees"are based on the value of the work 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* ® 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information asechecklist ❑Multi-family 0 Master builder ❑ Other: Description {Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling; Air conditioning 146.75 Job site aadress:11476 SW Twin Park Place I Furnace 100,000 BTU(ducts/vents) 146.75 City/State/ZIP:Tigard, OR 97223 Furnace 100,000-F BTU(ducts/vents)_ 54.91 Heat pumn 61.06 Suite/bldg./apt no.: i Project name:Dairy Factory Ductwork 23.32 Cross street/directions to job site: Hydronic hot water system _ 2332 Residential boiler(radiator or hydronic) i 23.32 Unit heaters(fuel-type,not electric), 1 in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above - 23.32 Subdivision: Lot no.: Other: 23.32 Other fuel appliances: Tax map/parcel no.:R269907 Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 vent for water heater or gas conversion of attached two car garage into two bedrooms and a full fireplace Flue 23.32 Loa lighter(gas) 23.32 oom and laundry room. Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimneylliner/flue/vent 23.32 f ® L.PROPERTY OWNER 0 TENANT Other: 23.32 Environmental exhaust and ventilation: Tame:Jordan Kurahara Range hood/other kitchen ecuipment 33.39 aaaress:11476 SW Twin Park Place Clothes dryer exhaust 1 33.39 33.39 3ity/State/ZlP:Tigard, OR 97223 Single-duct exhaust(bathrooms, 1 23.32 toilet compartments,utility rooms) 23.32 'hone:( )503-334-9678 I Fax:( ) Attic/crawlspace fans 2332 ® APPLICANT . . - 0 CONTACT PERSON • Other. Fuel piping:3usiness name:Black Rabbit 514.15 for that four;$4.03 for each additlooal ;ontact name:Sean Coster Furnace,etc. tddress:4936 N Oberlin St Gas heat pump WalVsuspended/unit heater My/State/ZIP:Portland, OR 97213 Water heater hone:( )(503) 593-1396 I Fax: :( ) Fireplace Range -mail:scan @seancoster.corn Barbecue I CONTRACTOR Clothes diver(gas) Home Right Now LLCBusiness name: Other: MECHANICAL PERMIT FEES" caress:847 NE 53rd Ave Unit B Subtotal 56.71 - ity/State/ZIP: Portland, OR 97213 Minimum permit fee($90.00) $90.00 Plan review(25%of permit fee) $22.50 lone ( 503-775-0880 1 Fax:( ) State surcharge(12%of permit fee) $10.8 CB Ire.: CCB 193608 5DocuStgned binTOTAL PERMIT FEE 18123.30 .,d. .. This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. athorized signature: B605DBaAD3BG484.- * Fee methodology set by Tri-County Building Industry Service Board . I DocuSign Envelope ID:368G2441-A78A-4750-A621-A9042BF1F1EE Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Submittal Requirements: • (2) sets of plans, drawn to scale. O (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. 5100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional$100.00 or fraction thereof. uilding\Permits\MEC PermitApp 082520.doc 2 DocuSign Envelope ID:2BF60D3E-A689-4A86-8B27-3F01A3072EAF Electrical Permit Application FOR OFFICE USE ONLY Received Permit a: City of Tigard Date/By: " 13125 SW HaII Blvd.,Tigard,OR 97223 Plan Review Related Permit#: f t Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Inspection Line: 503.639.4175 Ready Date/By: tar,, El See Paget for TI;:.q 't' Internet: www.tigard-or.gov Notified/Method: l Supplemental Information TYPE OF WORK PLAN REVIEW Please check all that apply(submit 2 sets of plans wrtems checked): ❑New construction Addition/alteration/replacement ❑Service or feeder400 amps or more 0 Building over three stories. ❑Demolition ❑Other: where the available fault current ['Marines and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. less to ground,a exceeds 14,000 0 Commercial-use agricultural ® 1-and 2-family dwelling ❑Commercial/industrial DI Accessory building amps for all other installations. buildings ❑Multi-family ❑Master builder D Other: ❑Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: Job site address:11476 SW Twin Park Place 100HPormore. ❑"A",'E","l-2",")•3 0 Six or more residential units. occupancy. City/State/ZIP:Tigard, OR 97223 ❑Health-care facilities. 0 Recreational vehicle parks. ❑Hazardous locations. 0 Supply voltage for more than Suitelbldg./apt.#: Projectnam�0r)/ ({�jGtl'CL o Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Qty. i Larb I Total l • New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.ft.or less 75.4 168.54 166.54 4 Tax map/parcel#:R269907 Ea.add'l 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 75.00 2 ;onversion of attached two car garage into two bedrooms and a full Limited above meti-family residential(with above sq.ft.) 75.00 2 corn and laundry room. Renewable Energy 0 See Page 2 ® PROPERTY OWNER I 0 TENANT Services or feeders installation,alteration,and/or relocation ',lame:Jordan Kurahara 200 amps or less 1 100.70 100.70 2 201 amps to 400 amps 133.56 2 kddress:11476 SW Twin Park Place 401 amps to600amps 200.34 2 :ity/State/ZIP:11476 SW Twin Park Place 601 amps to 1,000 amps 301.04 2 'hone:( ) 503-334-9678 Fax( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or ;mail: Jordan.Kurahara@caliberhomeloans.com relocation )wner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 itended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 )caner signature: Date: 401 amps to 599 amps 168.54 2 PERSON Branch circuits-new,alteration,or extension,per panel ® APPLICANT 0 CONTACT A.Fee for branch circuits with lusiness name:Black Rabbit above service or feeder fee, 4i 7.42 2 each branch circuit 'ontact name:Sean Coster B.Fee for branch circuits without service or feeder fee,first 56.18 2 .ddress:4936 N Oberlin St branch circuit Each add'l branch circuit 1 7.42 i 2 icy/State/ZIP:Portland, OR 97203 Miscellaneous(service or feeder not included) :tone:( )(503) 593-1396 Fax: :( ) Each manufactured or modular 67.84 2 dwelling,service and/or feeder mail:sean@seancoster.com Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Malkiiif?ficMf6 RIGHT NOW HOME SERVICES INC Sign or outline lighting 67.84 2_ ��� 12042 SE SUNNYSIDE RD PMB 701 Signale tati )orlextension. 0 See Paget 2 ddresS: B panel,alteration,or smite-en. CLACKAMAS, ORY4 "WF�'tff 213 Each additional inspection over allowable in any of the above tylStatelZlP: Additional inspection(1 hrmin) 66.25/hr 97015 Fax:( ) investigation(1 hrmin) 90.00/hr Industrial plant(1 hr min) 78.I8/hr cl i+E5 Inspections for which no fee is 90 00/hr trYi76§ I 1F?8f(ci specifically listed(i4hrmin) B Lic.: CCB 193608 Electrical Lic.: ^ Suprv.Lic.: e26�S ELECTRICAL PERMIT FEES J / pry.Electrician signature,required: Subtotal: $344.24 -ACK B�` 5/4/2021 ID Plan Review Required(25%of permit fee): nt name: I Date: .-1-.. Stazesurcharge(I2%of permit fee): $41.31 TOTAL PERMIT FEE: $385.55 thorized signature: his ex res if a ermit is cot obtained wltbia 180 n4OannWOanr/p4... 5/4/2021 permitapplicationPl P nt name: Jac k B rockway I Date: days after it has been accepted as complete. DocuSign Envelope ID:2BF50D3E-A689-4A86-8B27-3F01A3o72EAF Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Fee for all residential systems combined: $75.00 Description Q� r—Iaeb 7 Toter —77' 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 to25 kva 200.34 2 ❑ Burglar Alarm Wind generation systems In excess of25 kva: 25.01to50kva 301.04 2 r] Garage Door Opener* 50.01 to 100 kva 552.26 2 >100 kva(fee in accordance with OAF.918-309-0040) 552.26 2 n Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 ❑ Vacuum Systems* >100kva—no additional charge 0.0 3 ❑ Each additional inspection over allowable in any of the above: Other Each additional inspection is 66.25/hr i charged at an hourly(1 hr min) Inspections for which no fee is 90,00/hr specifically listed(35 hr min) -OMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Pee for each commercial system: $75.00 Subtotal(Enter on Page 1): (SEE OAR 918-309-0000) Number of inspections allowed per permit. :heck Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ L• andscape Irrigation Control* n M• edical n Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling n Other: Total number of commercial systems: o licenses are required. Licenses arc required for all ter installations DocuSign Envelope ID:B863C7F4-0699-44CE-91EB-A01E22D9D9BF Plumbing Permit Application Building Fixtures l t r+:. ' c A. u; t.°, Received Permit No: . City of Tigard Date/By. 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review = • Phone: 503.718.2439 Fax: 503.598.1960 Datr/8y: Other permit No.: , Inspection Line: 503.639.4175 Date Ready/By: Laic 65 See Page 2 for 'I'f iGAt'.I) Internet: www.tigard-or.gov Notified/Method: Supplemental information TYPE OF WORK F FEE- SCHEDULE For special Wormation use checklist 0 New construction 0 DemoIition Description I Qty. I Ea. I Total ®Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utilit1connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70437 78 SFR(2)bath 0 1-and 2-family dwelling 0 Commercia)findustrial SFR(3)bath 500.32 ❑Accessory building ❑Multi-family Each additional batWkitchen 25.02 2 Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Catch basin or area drain 18.76 'ob site address:11476 SW Twin Park Place Drywell,leach line,or trench drain 18.76 :ity/StateiZIP:Tigard, OR 97223 Footing drain(no.linear ft.:_) Page 2 ;trite/bldg./apt no.: Project name:Qat/- actory ra17(9rq Manufactured home utilities . 50.03 :ross 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 ubdivision: Lot no.: Fixture or item: Backflow preventer 31.27 'ax map/parcel no.:R269907 Backwater valve 12.51 DESCRIPTION OF WORK Clothes washer 1 25.02 onversion of attached two car garage into two bedrooms and a full Dishwasher 25.02 )om and laundry room. Drinldng fountain 25.02 Ejectors/stamp 25.02 TENANT 2) PROPERTY OWNER 0 Expansion tank 12.51 Fixture/sewer cap 25.02 ame:Jordan Kurahara Floor drain/floor sink/hub 25.02 ddress: 11476 SW Twin Park Place Garbage disposal 25.02 ity/State/ZIP:Tigard, OR 97223 Hose bib 25.02 tone:( )503-334-9678 Fax:( ) Ice maker 12.51 ® APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Medical gas(value:$_) Page 2 isiness name:Black Rabbit Primer 12.51 rntact name:Sean Coster Roof drain(commercial) 12.51 ldress:4936 N Oberlin St Sink/basin/lavatory 25.02 ty/State/ZIP:Portland, OR 97203 Solar units(potable water) 62.54 62.54 one:( )(503) 593-1396 I Fax::( ) Tub/shower/shower pan 1 12.51 12.51 Urinal 25.02 mail:seen@seancoster.com Water closet 1 25.02 25.02 CONTRACTOR Water heater I 37.52 Purdy Pacific Construction - Water piping/DWV 56.29 tsiness name:. address:847 NE 53rd Ave Unit B Other: 25.02 Subtotal $100.07 y/StaterZ>P: Portland, OR 97213 Minimum permit fee: $72.50 ue:( )(520) 270-3319 Fax:( ) Plan review (25%of permit fee) $25.02 f/0,� 'L�(,YI�'1 Plumbing Lic.no.: PB 2205 W[� /I/ �aq a. State surcharge(12%of permit fee) 12.01 thorized signature: �� POtV(1 TOTAL PERMIT FEE $137.10 EBOB6FBNBDDBOF.. 1/27/2021 This permit application expires If a permit is not obtained within 180 days it name: Keith Purdy I Date: I after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. DocuSign Envelope ID: B863C7F4-0699-44CE-91EB-A01E22D9D9BF Plumbing Permit Application - City of Tigard Page 2-Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: Footing drain-1'100' 50.03 0 to 2,000 Footing drain-each additional 100' 37.52 2,001 to 3,600 $16 .69 $169.69 Sewer-]st 100' 62.54 3,601 to 7,200 $233.20 Sewer-each additional 100' 7,201 and greater S327.54 37.52 Water Service-1st 100' 62.54 Water Service-each additional 100' 37.52 Medical Gas Systems: Storm&Rain Drain-1st 100' 62.54 Valuation: Permit Fee: Storm&Rain Drain-each additional 100' $1.00 to$5,000.00 Minimum fee$72.50 37.52 $5,001.00 to$10,000.00 S72.50 for the first$5,000.00 and$1.52 for Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof to Inspection of existing plumbing or for and including the 0.00. which no fee is specifically indicated 90.00/hr SiD,00L00 to 525,000.00 each a 0 for first$10,000.00orfraction and thereof for (minimum charge—1/2 hour) each additional S100.00 or fraction thereof to Inspections outside of normal business and including$25,000.00. 90.00/ly $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours um charge-2hours) each additional$100.00 or fraction thereof:to Reinspection Fees 90.00/hr Additional plan review for revisions and including$50,000.00, 90.00/hr S50,001.00 and up S742.00 for the fast$50,000.00 and$120 for (minimum charge—1/2 hour) each additional$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please Indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Plan Review for Plumbing Installations PlxNre type for Quantl by Fixture Type Plan review is required for any of the following. Rep10°r Please check all that I aPp Y• Work Performed: Capped Added Relocate Baptistry/Font ❑ Any new commercial building with water service 2"and Bath: Tub/Shower greater,except systems designed and stamped by licensed -Jacuzzi/Whirlpool engineer. ar Wash: Each Steil 0 New exterior plumbing site utilities for any complex structure Drive Thnt as defined in OAR918-780-0040. :uspidor/4Vater Aspirator 0 Medical gas and vacuum systems for health care facilities. 3ishwasher. Commercial 0 Any multipurpose fire sprinkler system. Domestic 0 Any complex structure as defined in OAR918-780-0040. kinking Fountain Eye Wash Submit 2 sets of plans with any of the above. loor Drain/sink: -2" 3 Isometric or Riser Diagram Car Wash Drain 0 Isometric or riser diagram is required for new buildings garbage Domestic non-food that meet the qualifications above. isposal: -Domestic food related -Commercial food related -Industrial food related eMachJRefiig.Drains Comments regarding fixture work: it Separator(Gas Station) x.Vehicle Dump Station tower -Gang -Stall nk: -Lav/Bar non-food related -Bradley -Corn/Serv/Util food related -Service rimming Pool Filter *Note: If the fixture work under this permit results in an ashen-Clothes increase of sewer EDUs,a sewer permit will be issued and ter Extractor fees assessed for the sewer increase must be paid before the ner Closet-Toilet plumbing permit can be issued. inal ter Fixtures: Water Meter Fixture Unit Worksheet for Additions/Remodels/ADUs Please complete the following information: RECEIVE Customer Name: Jordan Kurahara �^ Service Address: Street/Suite#: 11476 SW Twin Park Place MAR 1 7 2021 City: Tigard,OR 97223 State: Zip: vITY OF TIGARD BUILDING DIVISION Phone Number: (503)334-9678 Email: Jordan.Kurahara@caliberhomeloans.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 quantitybythe point value to arrive at the current Multiply the quantity by the point value to arrive at PY total. the proposed total. Fixture Unit Current Point Current Proposed Point Proposed Quantity Value Total Addition Value Total Bar sink x 1 = x 1 = Bidet x 1 = x 1 = Clothes washer 1 x 4 = 4 1 x 4 = 4 Dishwasher 1 x 1.5 = 1.5 x 1.5 = 1"Outside Water Spigot 1 x 2.5 — 2.5 x 2.5 = Water Spigot,each add'l 1 x 1 = 1 x 1 = Kitchen sink 1 x 1.5 = 1.5 x 1.5 = Laundry sink 1 x 1.5 = 1.5 x 1.5 = Lavatory(bathroom sink) 2 x 1 = 2 1 x 1 = 1 Water closet,1.6 GI'F(toilet) 2 x 2.5 = 5 1 x 2.5 — 2.5 Bathtub/whirlpool x 4 = x 4 --- Shower stall 2 x 2 =4 x 2 = Bath/shower combo x 4 = x 4 = 7.5 Current Points: 23 Proposed Increase: 7.5 Current Points+Proposed Increase= 30.5 =New Total Points =Required Meter Size 3/4" Meter Sizes: 1 to 30 points—5/8" 30.5 to 37 points=3/4" 37.5 and over points= 1" New Meter Size Needed for New Total Points: 3/4" Cost: $13,554.00 (see page 1) Current Meter Size per Utility Billing: 5/8" Cost: $9495.00 (see page 1) New Meter Size Cost minus Current Meter Size Cost= $4059.00 (This is Your Cost to Increase Meter Size Due to Additional Fixture Units) FOR OFFICE USE ONLY Current Meter Size Confirmed with UB Signature of UB Representative Date L/Building/Forms/WaterMeters 070120_Add.dOCX Page 2 • Branden Taggart From: Branden Taggart Sent: Tuesday, March 23, 2021 6:11 PM To: UB Online Subject: Water Meter Form for Garage Conversion - 11476 SW Twin Park PI. Attachments: Water Meter Form for Jordan Kurahara.pdf Hello, I have attached the Water Meter Fixture Unit Worksheet for Jordan Kurahara. Jordan is converting an existing attached garage into habitable space with a new bathroom. Thanks, Brander Taggart q City of Tigard a.' Senior Permit Technician Community Development 13125 SW Hall Blvd Tigard, OR 97223 (503)718-2449 brandent©tigard-or.gov 1 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 NI Transmittal Letter I I G A R n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: ANctin t Yl' stri r' DATE RECEIVED: DEPT: BUILDING DIVISION J ^CEI`RECEIVED �f,En CSC` FROM: A NI —' t(—OST APR '7 2021 COMPANY: CITY OF HHGAHL: PHONE: (5C55- D— 1-50)(n BUILDING DIVISIO, By: EMAIL: RE: 1141t0 TA Mt\ PPRK f-. . L S 2l-ObiO i (Site Address) (Permit Number) VORA1-,412 (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. Engineer's calculations. Other (explain): REMARKS: • FOR FF CE USE ONLY r Routed to Permit Techni ian: Date: 1(� 2f Initials: �a1 Fees Due: ❑ Yes eL/hee Description: Amount Due: 0 i ...),.. e._& $$$ Special Instructions: Z/ Reprint Permit(per PE): ❑ Yes o ❑ Done ioRi_ Ap 'cant Notified: te: Lf/, 2_ ( Initials: I.\Building\Forms\Transmittal Letter-Revisions_073120.doc