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Permit
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. Iii City of Tigard • 'COMMUNITY DEVELOPMENT DEPARTMENT Transmittal Letter c~,. i 11 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: DATE RECEIVED: c n DEPT: BUILDING DIVISION RECEIVED FROM: Nestor Ngo $Ep 8 2021 COMPANY: Harmony Decor LLC CITY OF TIGARD BUILDING D1V4tOI\ , PHONE: 503-943-9744 EMAIL: project@harmonydecor.org RE: 13665 SW Liden Dr,Tigard,OR 97223 MST2020-00266 (Site Address) (Permit Number) Mark Luu Addition (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: ' iii on: .. .,,.: Copies:. Description;, Additional set(s)of plans. 3 Revisions: Bathroom Layout 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: Bathroom Layout , r , fl 'F1c E USE ONLY Routed to Pe echnician: Date: GI laj Initials: Alk- Fees Due: Yes ❑No Fee Desc iptio : Amount Due: 2 _ ( .0.^) $ `�S. p $ $ Special Instructions: Reprint Permit(per PE): ❑ Yes ❑No _ ❑ Done Applicant Notified: Date: 7/ly/,L/ Initials: I:\Building\Forms\TransmittalLetter-Revisions_073120.doc CITY OF TIGARD MASTER PERMIT IN s COMMUNITY DEVELOPMENT Permit#: MST2020-00266 TEGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/20/2021 Parcel: 2S104BA10600 Jurisdiction: Tigard Site address: 13665 SW LIDEN DR Subdivision: CASTLE HILL NO.3 Lot: 136 Project: Luu Project Description: 51 sf addition to convert den to bedroom and add bathroom. Mechanical and Electrical permits to be obtained separately. NO FINAL UNTIL WATER METER UPSIZED. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 1 First: 51 st Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 15 Smoke Dwelling Units: 0 Third: 0 sf Right: 5 Detectors: Yes Total: 51 sf Value: $6,245.46 Rear: 15 PLUMBING Sinks: 1 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain 0 Storm Sewer: 0 Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 1 Backwater Value: 0 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 0 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: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea addl 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 51 Owner: Contractor: LUU&CHAU REVOCABLE TRUST JOSE GARCIA CONSTRUCTION LLC Required Items and Reports(Conditions) BY LUU,MARK& PO BOX 571 CHAU,TU TRS AURORA,OR 97002 13665 SW LIDEN DR PORTLAND,OR 97223 PHONE: PHONE: 971-216-9372 FAX: Total Fees: $636.99 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: .`1' " i .l) Permittee Signature: C.::% -- '4",: -.' 1503.639.4175 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. • Plumbing Permit Application Building Fixtures < IECCIV ,-.. City of Tigard 6 2021 Received 2Datrl Ili • 13125 SW Hall Blvd.,Tigard OR 97223 ey. Permit No.: { 13� _axle, • o Phone: 503.718.2439 Fax: 503.598.196,0 Plan Rev aw Dar°/By; Other Permit Na.: 1lc,ntcD Inspection Line: SD3.639.4175 ,lrY OF TIGARL. DateRrdY/By: laic 0 See Page 2tar Internet: www,tigard-or.gov IC, 1 Notified/Method: Supplemental Warmed-Ion ❑t New construction ❑Demolition For special information use cheria Addition/alteration/replacement ❑Other Description I Qty. I a I Total i_+i New i-2 family dwellings(includes 100 ft for each utility connection) j CATEGORY.OF Or`.SrR fctzoN SFR(I)bath 312.70 © 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500 32 w Each additional bathlkitchen 25.02 0 Master builder 0 O $ µ P Fire sprinkler( _sq.R) Page 2 - :i0 Si'1'&t(1-l3P, IC)'ONA h>LF166,TiON r`1' ,:i:2h4 Site utilities: Job site address: 1 Catch basin or area drain 18.76 ti3COCcb sUJ upEt3 (Ng.. City/state/ZIP: r��� Drywall,leach line,or trench drain 18.76 TIG, s'�, f cyik la7 273 Footing drain(no.linear R: 1 Page 2 Suite/bldg./apt no.: Project name: rfl sav LIIO whb%n Manufactured home utilities 50.03 Cross stceet/dire ctions to job site: "11� Manholes 18.76 Rain drain connector 111.76 E Sanitary sewer(no.linear ft.:,_) Page 2 Storm sewer(no.linear ft.:,_) Page 2 Water service(no.linear It: ) Page 2 Subdivision: , Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 ' DEScR�IrTION'0F,WORK Bachwatervalve 12.51 It) Clothes washer 25.02 NEIJJ > �t t) EXSSilt.1Cr .1SC Dishwasher 25-02 4)IV, A Itt#t C)(r) 4*3likOW #1iltr..r.. j Drinking fountain 25.02 .A I )C. at A a k1J-C►oe f Ejectors/sump 25.02 ,HI PROPERTY OW', ER ". ❑ TENANT Expansion tank 12.51 Name: �•Y'►R _ Fixture/sewer cap 25.02 Address: �y Floor drain/floor sink/hub 25.02 ''`aC5 SW bR Garbage disposal 25.02 City/State/ZIP: •T•i G1A,RI, , OK. -r 223 Hose bib 1. 25.02 ZS .CY Phone:( E �) �� .�� ��( ) Ice maker 12.51 ml., U APP`LIC P :'tj],Ct7 y"CAGT PERSON Interceptor/grease trap 25.02 Business name: Medical gas(value:S ) Page 2 Contact name: i'f g. ._ wn Primer 12.51 Roof drain(commercial) 12.51 Address: 1364)5 'st..) L i DF NI i L Sink/basir✓Iavatory ja 25.02 �g 2c.JZ City/State/ZIP: G` � r 1[tii bars Solar units(potable water) 62.54 Phone:(6)3) . 84e1 „ Si sfe I Faxv::( ) Tub/shower/shower pan j 12.51 6�,*)-I E-mail. or1 Jt,,,,,� ��ak1 Urinal 25.02 ill' t __"G..,- l Water closet 25.02 ,C.90.4* .CFQR i > :4.. 1� Water healer 37.52 Business name: ()iw)i\�>r q bo 'IAA r jot:kr Water PiPiog/I3WV 56.29 Address; Other 25.02 City/Stale/LIP: Subtotal 7, 7 Phone:( ) Fax:( ) Minimum permit fee: $72.50 Plan review (25°h of permit fee) CCB Lie.: Plumbing Lic.no.: Mark, State surcharge(12%of permit fee) iC i /Y t Authorized signature: [ rk Lu.GL TOTAL PERMIT FEE I?',,`'3. Paint name: l a 1 WO Date. 05•Z.CD• L, Thb permit application expires If a permit is not obtained within 1110 days after it has been accepted as complete. 'Fee methodology set by Tri-County Building Industry Servire Beard. z melatiegwenoiMPiMtfPwmWpa dee'wires 440-4616T(10/071COMn EB) City of Tigard III i COMMUNITY DEVELOPMENT DEPARTMENT TICARo Building Permit Review — Residential Building Permit #: M5T22ZO -OOZ(o , Site Address: 13665 SW Liden Dr Project Name: Luu Addition Lot #: Planning Review Proposal: Adding onto side of existing home ❑r Verify address/suite#active in Accela. ❑r In River Terrace: ❑' No ❑ Yes, River Terrace Review Addendum Site Plan Elements: erosion Control Ot copies of site plan on 8-1/2"x 11"or 11 x 17"paper \ f2etained trees with drip line and tree protection measures 0 Prawn to scale(standard architect or engineer scale) /ootprint of new structure(including decks)and FFE 12 orth arrow _.Itility locations&easements(required for new and additions) rite address,project or subdivision name and lot number • Sidewalk/driveway approach 0 applicant information(name and phone number) \p[_►ocation of wells/septic systems A . dimensions and building setback dimensions street tree size,type and location 1,► .uate footage of buildings to be demolished ' 'peet names 12 xisting structures on site ver elevations (2'contours if more than 4'differential .t area,building coverage area,percentage of coverage and 1,000 sf of impervious area created or replaced? j es o 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: ❑s Yes,applicant was notified ❑ No Receive• ,{es El No ❑ Water Meter Fixture Unit Worksheet-Additions,Remodels and ADUs Required: ❑r Yes,applicant was notified ❑ No Received `P el No SDC Exemption for ADU applied for: ❑ Yes ❑' No Received: es ❑' No Applied For: El Yes ❑ No,stop intake \ \'''1! Public Facilities Improvement(PFI)Permit: \-` Required: 11 Yes,applicant was notified ❑e No Land Use Case#: ❑e Zoning: R-25 ❑r Required Setbacks: Front: 15 Rear: 15 Side: 5 Street Side: N/A Garage: N/A ❑> Building Height: Max.Height: 35 Actual Height: <35 ❑. Landsca.e Area: 20 % ElLot Coverage Max: 80 % Entrance Ill - back no more than 8'from street-facing wall ❑ Parallel to s - or offset 45 degrees or less Windows Minim i 2%of area of all street-facing facades Garage Gara e door is .:.'nd widest street-facing wall N e es ❑No,one of the following is met: gDoor extends no c e than 5' from wall and • e is a covered porch extending beyond garage. ❑❑Door extends no more tha ' from . . and there is a 12 sq ft.window above garage on 2nd floor. ❑ Gara e door width is I 12'or 1-- 11 50%or less of facade 60%or less and includes 7 of following: Covered porch I ' -cessed entrance 1 Wall offset 1'Roof eave Roof offset Fire shingles I Lap Siding ❑ Roof itc ❑ Gable,h or gambrel roof Dormer Acc-• iding Window trim Window re Window projection ❑ Balcony ❑ Visual Clears.• ❑ Urban Forestry Plan ❑ Senn ' - ands: ❑ Yes El No Type: P onditions met prior to issuance of building permit Notes: Q Approved By Planning: Date: 9/9/20 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw_RF,S_122419.docx Building Permit Submittal Original Submittal Date: O'aF 20.23 Site Plans: # J Building Plans: # 3 Building Permit#: REnter buildin permit#above. Workflow Routing: Planning L✓1 Engineering aPermit Coordinator abuilding Workflow Sign-off: Et Sign-off for Planning(include notes from planning review) Route Application Documents: Engineering: (1) copy of permit application, (1) site plan, (1)building plan and original plan review routing form. EtBuilding: original permit application, site plans,building plans,engineer and beam calculations an. trust details,if applicable,etc. Notes: 1 By Permit Technician: -! " 477 / Date: /22 251C1Z0 Engineering Review lope at building pad: 9 v/ M-Conditions "Met"prior to issuance of building permit I)l C7 Easements (encroachments)per engineering conditions of approval and plat Yl 10- IVater Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes No Assess Water Quantity Fee in-lieu: ❑ Yes r_ig .o LIDA Facility on lot: ❑ Yes L'7 No Final Plat Recorded: ii Pt- 0 NOT Approved by Engineering: Date: Notes: Approved by Engineering: Tom!' Qn` e-y Date: 9/28thaI 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 ❑ 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: ❑ Received 1.Does not a ly ..Er-SDC Fees Entered: Wash Co Trans Dev Tax: Yes N/A Tigard Trans SDC: ❑ Yes N/A Parks SDC: 0 Yes N/A LIDA ❑ Yes N/A 8OK to Issue Permit Approved by Permit Coordinator: ltr I Date: /?fi/20 I:\Bu ilding\Fors\BldgPennitRvw_RF.S_122419.docx • /ys ,—moo moo --g'o iz 66 Water Meter Fixture Unit Worksheet for Additions/Remodels/AD fECEIVED Please complete the following information: SEP 23 2020 CITY OF TIGARD Customer Name: {'t1ro.FZ1� LV V BUILUIIVG DIVISION Service Address: Street/Suite #: I GI•665 'Si..) unrna I City: TtG-NEtb State: OK �� ,, zip: 912P Phone Number: (�5) 943 - 9144 Email: pr .c �i,"A,�,""e �,"rlckii r. c. 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 I = x I = Clothes washer . x 4 = q x 4 = x 1.5 Dishwasher f x 1.5 I.5 x 2.5 Hose bib I _ x 2.5 = 2 Hose bib,each t x 1 = I.0 x 1 Kitchen sink I x 1.5 = I .5 _ x 1.5 = Laundry sink i x 1.5 = L_5 x 1.5 = Lavatory X I = 4 t x 1 — I Water closet, 1.6 GPF 3 x 2.5 = 7,5 t x 2.5 = 2 .5 Bathtub/whirlpool _ x 4 = x 4 Shower stall t x 2 = 2. A x 2 = a Bath/shower combo I x 4 = 4 x 4 _ Current Points: _� Proposed Increase: 5-5 Current Points +Proposed Increase= ell 5_ =New Total Points = Required Meter Size 34 Meter Sizes: 1 to 30 points=5/8" 30.5 to 37 points='/a" 37.5 and over points= l" New Meter Size Needed for New Total Points: a' ,. $ Cost: S `A r 4 OCo (see page I) Current Meter Size per Utility Billing: 141 Cost: $ lb , 42 5. (see page 1) New Meter Size Cost minus Current Meter Size Cost= $ 4 n I9 (This is Your Cost to Increase Meter Size Due to Additional Fixture Units) ************************************************************************************* FOR OFFICE USE ONLY Current Meter Size Confirmed with UB S C c ')7/ Cf/ --j fpf/2.CV'9 L fr2,e r7 C_Lg Signature of UB Representative Date Page 2 I:/Building/Forms/WatcrMeters_070119 Add.dOCx City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT " Water Meter Fixture Unit Worksheet TIGARD For Additions /Remodels /ADUs 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • N'y N't.ti<gard-or.aov LOCATION: City of Tigard—City Hall WATER METER SALES: Utility Billing By Appointment Only: 503-718-2460 13125 SW Hall Blvd. Monda) —Thursday. 9 a.m. to Noon Tigard. OR 97223 METER: SIZE: FEE: Pricing, effective 711/2019 5/8" $9,406.00 Fee includes: 3/4" $13,425.00 water system development charge, l" $24,645.00 water meter, and 1-1/2" $72,969.00 meter installation fee. 2" $118,163.00 DETERMINING METER SIZE FOR RESIDENTIAL CUSTOMERS City of Tigard Water Service Area uses the American Water Works Association Manual and the Oregon Plumbing Specialty Code to determine the size of meter needed to adequately serve buildings. Due to the variety of home sizes built in the Tigard area, we count the fixture units of all homes to determine the appropriate meter size. Use the worksheet on Page 2 to calculate the current number of fixture units compared to the proposed increased number of fixture units, which will determine whether an increased meter size will be required. Submit this signed worksheet with your building or plumbing permit application submittal. DOCUMENTATION Once you are ready to purchase the new meter, please provide the following items to the Utility Billing counter: • Completed water meter fixture unit worksheet for additions, remodels, ADUs, etc. (on back page). • Copy of building or plumbing permit application date-stamped by building division. • Copy of issued building or plumbing permit. Your fixture count will be verified and your request will be processed upon receipt of these documents. No exceptions. INSTALLATION TIME Once the upgraded meter size has been purchased, please contact Public Works for installation. Their number is 503-718-2591. Most meters are installed within 10-14 business days. L/Bmlding/Forms/WaterMeters_070119_Add.dOCx Page 1 RECEIVED SEP 1 0 2020 CITY OF TIGARD C1eanWatei Services SENSITIVE AREA PRE-SCREENING SITE ,4'sI§MKitt Clean Water Services File Number 1. Jurisdiction: City of Tigard 2. Property Information(example: 1S234AB01400) 3. Owner Information Tax lot ID(s): Name: Mark Luu Company: Address: 13665 SW Liden Dr OR Site Address: 13665 SW Liden Dr City, State,Zip: Tigard,OR 97223 City, State, Zip: Tigard,OR 97223 Phone/fax: 503-849-5156 Nearest cross street: Email: 4. Development Activity(check all that apply) 4. Applicant Information 0 Addition to single family residence(rooms, deck,garage) Name: Nestor Ngo ❑ Lot line adjustment ElMinor land partition Company: Harmony Decor LLC ❑ Residential condominium 0 Commercial condominium Address: 522 NW 23rd Ave ❑ Residential subdivision 0 Commercial subdivision City, State,Zip: Portland,OR 97210 ❑ Single lot commercial 0 Multi lot commercial Phone/fax: 503-943-9744 Other Email: project@harmonydecor.org 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: Propose new addition to existing house 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 NESTOR NGO Print/type title HARMONY DECOR LLC FOUNDER Signature Date 09.07.2020 n t FOR DISTRICT USE ONLY a ElSensitive 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. v1 ❑ 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. 4 ❑ 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. sz 0 THIS SERVICE PROVIDER LETTER IS NOT VALID UNLESS CWS APPROVED SITE PLAN(S)ARE ATTACHED. 0 The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2). NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. Reviewed by Date 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 Min Otter 2553 SW riiilst arc, Highway • Hillsboro;Oregon 97123 - p: 503 681.3600 f: 503 681.360'3 • cleanwaterservices.org