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Permit CITY OF TIGARD MASTER PERMIT II 5 ' COMMUNITY DEVELOPMENT Permit#: MST2021-00017 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/08/2021 i t I: „'yI? C' g Parcel: 2S111AB04500 Jurisdiction: Tigard Site address: 14405 SW 92ND AVE Subdivision: PENMAR TERRACE Lot: 12 Project: Stern Project Description: 1,070 sf addition for master bedroom and bath,and 342 sf covered patio. NO FINAL INSP UNTIL WATER METER UPSIZED. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 1 First: 1070 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 12 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 20 Smoke Dwelling Units: 0 Third: 0 sf Right: 5 Detectors: Yes Total: 1070 sf Value: $139,366.74 Rear: 15 PLUMBING Sinks: 0 Water Closets: 2 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 0 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Tubs/Showers: 3 Garbage Disp: 0 Water Heaters: 1 Water Lines: 0 Drains: 0 Catch Basins: 0 Bckllw Prevntr: 0 Footing Drain: 0 Ice Maker. 1 Hose Bib: 2 Backwater Value: 0 Drywell-Trench Drain: 0 Other Fixtures: 1 Other Fixture Units: Bidet MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 0 Other Units: 1 Furn<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: 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: 15 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 1070 Owner: Contractor: STERN,KAREN ROBIN ONEILL INTERNATIONAL INC Required Items and Reports(Conditions) 14405 SW 92ND AVE 16731 GREENBRIAR RD TIGARD,OR 97224 LAKE OSWEGO,OR 97034 PHONE: PHONE: 503-635-6181 FAX: Total Fees: $7,079.46 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OA 2-001-0090. You m y obtain a copy of e rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. r � Issued By: .4 Permittee Signature: /C i Call 503.639.4175 by 7:0 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application RECEIVE . 13- I2/23 20 Residential FOR OFFICE USE ONLY City of Tigard DEC 3 2020 Received Date/By: 112`! � , Permit NnJ>tiST20 Z I'-Dp0 [7 13125 SW Hall Blvd.,Tigard,OR 97223 CITY OF TIGARD Plan Review li RL7 3 I$ 21 Other Permit: Phone: 503.718.2439 Fax: 503.598.19 Date/By: Inspection Line: 503.639.4175 nUILDING DIVISION Date Ready/By: ) J ® See Paget for TIGARD g g /04L L( / 1.' f 1� pP Internet: www.ti and-or. ov fied/Method: Supplemental Information TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DWFI J INC ❑New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Addition/alteration/replacement ❑ Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. 1.44 yg 1-and 2-family dwelling ❑Commercial/industrial Valuation: $ " '� , I ❑Accessory building ❑Multi-family Number of bedrooms: ❑Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: ' Job site address: 1 4405 5v 9 2-ND ' -S SE' New dwelling area: I l carp square feet City/State/ZIP: 'n1t, Z 4) r c'l-Z244 Garage/ca ort area: square feet Suite/bld ./a t.no.: Project name: � a g p j ��� �',tttvjZyyL Covered area: 31.4 Z square feet Cross street/directions to job site::Sjt,t) C.D r - pF S� 92r,1D I )C Deck area: square feet 4. 5V) VtE1,J 1c.rTTtce Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST / Subdivision: MAW_ 'P.1Z,OkC ‘2....I Lot no.: � Permit fees*are based on the value of the work performed. "�tI ,¢J =��f' iJIndicate the value(rounded to the nearest dollar)of all b�'3 ,'1 n Gt 1 eg I 1 E-02--.L �_�- 'r'b. equipment,materials,labor,overhead,and the profit for the DESCRIPTIIONI OF WORK ..j -- I:.� '_V y'prk indicated on this application. L I D� ��. Pr• 1 (TIc� C+4ie �AP)t `--cktTe"r VVaalluation: $ 3�,Z S A- OD � Pao Existing building area: square feet 7tr tl��s Iti 1A["S i. - R�zz� p2( i)1L Td f L New building area: square feet RI PROPERTY OWNER ❑ TENANT ll�Sl� "Number of stories: ame: ` s -� Type of construction: Address: 14140 5 5.t,,)• 9 2-/-.ID Occupancy groups: City/State/ZIP: 11( k t of_ 1 q-2.2...1—[ Existing: Phone:(GJ03) 9 9v — 1SP-{ Fax:( ) New: la APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* (PleasBusiness name: DLSot4 G DP Prf .t•FTECTS viewerejertojeeosit): le Structural plan review fee(or deposit): {} 7 S. ci i Contact name: GUT &L.SotiL �^� / }� FLS plan review fee(if applicable): Address: l�-150 � E�u l`le5 •rCl"p`-7 Fi%.• City/State/ZIP: .��/v` DR- 9 c I Total fees due upon application: Phone:(9 3) (02-b -9 el-0 Fax: :( ) Amount received: E-mail: PFS I(A1 i ") CI.SDt`S�Q�t)P/ct'�'-t-I'1 t-TS. cpM PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name: O'tJElt� Irl i p4} }u, I I� Submit two(2)sets of roof plan with connection details 1 and fire department access,along with the 2010 Oregon Address: ,b.1.31 Ca &59.I pg. 1 . Solar Installation Specialty Code checklist. City/State/ZIP: (6,0{✓(;O �(1cJ3� Permit Fee(includes plan review $180.00 1 and administrative fees): Phone:(Gjp.j) 11,21 — '-ra64 Fax:(503) GS5- i321'1'5 State surcharge(12%of permit fee): $21.60 CCB lic.: ('L ?j eil /2/ Total fee due upon application: S201.60 Authorized signature: \2 , . 2 C) This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Print name: CL9 -T 01 f qJ Date: I Z l 2 p Service Board. 1:\Building\Permits\BUP-RESPerndtApp.doc 02/24/2011 4404613T(1 1/02/COM/WEB) l Mechanical Permit Applicati ECEIVED Ft)u OFFICE.: l'tiF.f)NI.1 Received City of Tigard )o (, ate By: Permit No. S 7 �lyc i 7 13125 SW Hall Blvd.,Tigard,OR 97223 3 z02n Phone; 503.718.2439 Fax: 503.598.196� Plan Review Other Permit: I..ITY OF TIGARD Dam Inspection Line: 503.639.4175 BUILDING woe Review y: orris 0 See Paget for ,y Internet:���ggq/www.tigard-or.gov G DIVISION F oiif+cdanethodt y�,, Supplemental information (_166 S g M3 7t ,..' * :113 rT r L'''-'.. `t1"..+ • o'�.An.)e 4 lir tTie �� }v t-Li .w4rv\ `. , } va VW'..ry . , r.ry ,^' `5 t' 4Y; i : its 0%!P; ,s•M _ I,0,4-4.L #'-. i ft i4r. '•+ - u4 .... Via' Mechanical permit fees*are based on the value of the work ❑ New construction XAddition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑ Demolition, li 0 Other: mechanical materials,equipment,labor,overhead,antiproftt. 4z:b" b fsw.''h+"..,. tt 5:t • q+.:_ K i; 'dY -- ,r .+; S-i r,5»1 r H Value:$ . ,, ._ g 4 r n fix" s� + t t t ry .w. ��t,� °' �� ��hN�'�'!,.' x1-and 2-family dwelling 0 Commercial/industrial ❑ Accessory building Far special information use checklist ❑ Multi-family ❑Master builder ❑ Other: Description I Qty. Ea. Total lt?afx VM <•' t a- 9 „MAT _ 7„atcs,4 3ll4t1 Heating/cooling: `" `� Air conditioning 1 46.75 Job site address: I lo5 5.0. c12. AD ASE. Furnace IOQO(10 RTL'(ductshents) I 46.75 City/State/ZIP: ^n G/) t p 17 z�� Furnace 100,006+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: Project name: SSTE"> �ti� D 23.32 �p1�(�lt Duuccttw wororkk i 23.32 Cross street/directions to job site: S,l.J , V tart) Hydronie but 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 Flueivent for any of above I, 23.32 Subdivision: pt lA mAi1 '12.2C.0 j Lot no.: I Z Other. 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 tl 4 �. r.s v x ties fireplace/insert 33.39 Flue vent for water heater or gas fireplace 23.32 Log tighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 t- A s r n,* y rF "7 a r.-y..s s aokik Other: 23.32 ,�,.•:r;�'+.3 _.,.' ..� .,-.,. ,..... '� ,., '4rr'"s�- zr �� ',..ft«fi + Environmental exhaust and ventilation: Name: (< j2. G-r-ize-1 Range hood/other kitchen DOS 5 _ Clothes dryer exhaust ` 33.39 City/State/ZIP: 1"((A 9 Z� Single-duct exhaust(bathrooms, toilet cumrattmenta,unlit rooms) 23.32 Phone:(50 1 910" Iria- 9 Fax:( ) Attic/crawlspace fans 23.32 y,g � yjF 75,;: �[Np�1•yy�'., Y,F S `�iC E Other: 23.32 SPTSX� 3i!9�1a•L£+Pi 6�`K F.tl%' 3 {yfj�' Fuel piping: Business name: (•p..lnw; r V `J��� - $14.15 for first four;$4.03 for each additional Contact name: {b ;l .. It.� Furnace,etc. Address: YYa 9 �� co X cT Gas heat pump ��ff Wallisuspendedlunit heater City/State/ZIP: f7O(-//c ..d 15 e p 77ZZO pu Water heater Phone:(soy) 7$G . `l$Z?. Fax:::(SO f) /y O1-J /sZ Fireplace6 E-mail: ver,„„..,1.‘.,2, yiarvtf/ Barbecue 4 wantfsr:sGaLtvave a a4smx' tt . ,. . .as z,' fig.'`3 t scr y ra Clothes d er as Business name: -FyrtaKad /ii sefb/i Other may '9 t� Address: 1701 Am.: CoI,x Subtotal City/State/ZIP: T1 -/�OG f J Qg q7 Minimum permit fee($90.00) Phone:( ) Fax:( ) Plan review(25%of permit fee) s� 7 g6 "9s Z.Z5( l gt 3 y 3 2 State surcharge 02%of permit fee) CCH lie.: s(/Q �/ g/vl(d-3 TOTAL PERMIT FEE I,l O 'this permit appUcadan eapires It•a permit h not obtained within 780 days after it has been accepted as complete. Authorized signature.ue: \ • Fcc methodology Net by'Fri-County Building Industry Service Board Print name: I e p is -rams k Date: 12 -ti-zoo 1..''Butiing'Pcm+its\MEC PcmdhApp_040113.doc 440-4 6 1 77 I I I.02COWP/EB) • RECEIVEDElectrical Permit Applicatio FOR OFFICE USE ONLY City of Tigard DEC 2 3 2020 Received 1]a,e/B Permit II: /'1.5r7421-000/7 III v 13125 SW Hall Blvd.,Tigard,OR 97223,T Plan Review 10 Phone: 503.718.2439 Fax: 503.598.}9401'OF TIGARD pate/3 : Related Permit It: InspeclionLine: 503.639,4175 BUILDING DIVISION ReadyPate/By: lads: PI See Page 2for 'FIGAllI) internet: www.ligard-or.gov Notified/Melhod: Supplemental Information TYPE OF WOR1C PI:A1V REVIEW: :< ❑New construction Addition/alteration/replacement Please check all that apply(submit a sets of plansw/items checked): 0 Service or feeder 400 amps or more ❑Building over three stories. ©Demolition El Other: where the available fault current ❑Marinas and boatyards. CATEGORY OPT•CONSTRUCTION -„ exceeds 10,000 amps at 150 volts or ❑Floating buildings. [RI-and 2-family dwelling ❑Commercial/industrial LI Accessory building less to ground,or exceeds 14,00a ❑Conunercial-uecagricultural amps for all other installations. buildings, ❑Multi-family ❑Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or :.WOOB'SITE INFORMATION-aND<LOCAT,Oi!1F _ , .> -. , 0 Emergency system. larger separately derived ❑Addition of new motor load of system. Job if: Job Site address: 1L1--105 5-W• 412..ro AVE . 100HP or more. ❑•'A"„E •1.2,,,••1_3,,, City/State/ZIP: (4rAll paD t Ot� 91 �Q ❑Six or more residential units. occupancy. ❑Health-care facilities ❑Recreational vehicle parks. SuiteJbldgfapt.#• Project name: ❑Hazardous locations. ❑Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Crossstreet/directions to job site: S•W• VIEW 1 -1 -- -' ., x -. - 'F.E)K'SCIIEDUX Deserlmloo I QV. I Each I ..7oal I •. New residential single-or multi-family dwelling unit. Subdivision: PENI1IJI ... E(Z?3ptC Lot#: (2, Includes attached garage, 1,000 sq.ft.or less . 168.54 4 Tax map/parcel#: Ea.add•J 500 sq.ft.or portion 33.92 1 DoCR1iPTIQ1vPl?vURIi;,... .:< ,..:- <. .: -,.r Limited energy,residential (with above sq.ft.) 75.00 2 Limited energy,multi-family 75.00 2 residential(with above sq.IL) Renewable Energy ❑Sae Page 2 3'P,ROPE1,11K.'UWNLB ©NgMAlit Services or feeders installation,alteration,and/or relocation Name: fE I ST Egi4 200 amps or less 100.70 2 Address: Il{406 S,VJ. Cjt-t'MC• 201 amps to 400 amps 133.56 2 �}, 401 amps to 600 amps 200.34 2 City/State/ZIP: 11 t*Af—P 1 C,,)R ci T22- 601 amps to 1,000 amps 301.04 2 Phone:(Ejo3) 9 1•O - 15 gy 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 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 0 APPLICANT ..f Branch circuits—new,alteration,or extension,per panel 1 I '�] CON�O„CT;PERSON A.Fee for branch oircuits wirJr Business name:On Electric above service or feeder fee, each branch circuit 7.42 2 Contact name:Vanessa Diostlado B,Fee for branch circuits without service or feeder fee,first 1 56.18 2 Address:9720 SW Hillman Ct.Ste 815 branch circuit City/StateZIP:Wilsonville,OR 97070 Each add•I branch circuit 1 c4 7A2 2 Miscellaneous(service or feeder not included) Phone:(503)654-2030 Fax::(503)654-2020 Each manufactured or modular 67.84 2 dwelling, Email:PermitsQOn-electric.com Reconnect serviceand/or feeder Reconnect only 67.84 2 rtx b 4 ... -. ,. .._`„C,ONTRAOT.LIR .V_ . ' ..--f.RRa s`w % Pump or irrigation circle 67,84 2 Business name:On Electric Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy El See Pflgc 2 2 Address:9720 SW Hillman Ct.Ste 815 panel,alteration,or extension. City/State/DP:Wilsonville,OR 97070 Ench additional Inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(503)654-2030 Fax:(503)654-2020 Investigation(1 hr min) 90.00/hr Industrial plant(1 hr min) 78.18/hr Email:Permits@On-electrlc,com th/�,s Inspectiars for vhich no fee is CCBLio,: 205100h / Electri C10 Suprv.Lic.:.� .5�s spectficallylisted(ghrmrn) 900o/hr, g,IELECTLUCAD P,ERMIT FEES k,.'. ,. Suprv,Electrician signature,required: aaL Subtotal: Print name: ke;,ri 1)e.-Y0B Date: ❑Plan Review Required(25%of permit fee) State surcharge(12%of permit fee): Authorized signature TOTAL PERMIT FEE; v \ •J This permit application expires if a permit is not obtained within 180 Print name: Levi Fletcher Date: days offer It has been accepted as complete. + Number of inspections allowed per permit. 1:113eltdIngPem,ttstFLC PemftApp_ELR_BRB.doe Rev 0611712015 440-4615T(11/057COWWEn Plumbing Permit Applicatii► ECEIVED Building Fixtures DEC 31 2020 FoR OVER I; 1 NT 0v1.1 City of Tigard Received• 13125 SW Hall Blvd..Tigard.OR 972jTY OF 1 IGARD Date/By: Permit No MS T7e</-.CYO ) 7 °� 7 Phone: 503.718.2439 Fax: 503-5WittDING DIVISION PDatlane Review/By: Other Permit No.: T I G A RD Inspection Line: 5(13.639.4175 Date Ready/By: orris: Fa See Page 2 for Internet: www.tigard-or.gov Notified/Method: Suppkmental Information TYPE OF WORK FEE* SCHEDULE ❑New construction ❑Demolition For special information use checklist Description I Qty. [ Ea. 1 Total Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 Ti.1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 0 Accessory building .❑Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler(_sq.It.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: , � Sj� Catch basin or area drain 18.76 AILVCitylStalelZlP: -IN�Qt �` O� ��� �� � Doting leach(ri ne,or trench drain 1 ge 2 }�^' Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: (J r Project name: Si j rl '�) 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 1- 1 25.02 ,il�Z y'1 1'YJt\Q� f\GU-P Dishwasher 1 ` 25.02 u7,_ Drinking fountain 25.02 Ejectors/sump 25.02 0 PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 11 Z. 25.02 C-0,134 Phone:( ) Fax:( ) Ice maker \ X 12.51 11.5` 1 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name:ki(MS pk nM'hi l,1 \f\Q Medical gas(value:$_) Page 2 VVV��, �V r r `zl t Primer 1251 Contact name: p(\4rQ n` y,, .V1i �O Roof drain(commercial) 12.51 Address: /'fit i t, (\►n O') I�.WYC1 Ic'1 f..7 )�,L4I 1 OI Sink/basin/lavatory 1 { 5 25.02 I It, City/Stattet/ZIP:T Jr t ° 171_3 Solar units(potable water) 62.54 Phone:try ids_ (�j`•�j Fax: :( ) Tub/shower/shower pan \\1 3 12,51 E-mail: �+✓ tOOS ,rn L\mbyvirC corn Urinal h�-� 25.02 C4 CONT CrOR corn Water closet h1 a,�' �j '� 25.02 �, Water heater \ , 37.52 -2,-1,S2 Business name:, t 11(1 frk 1�tnn t �s Water piping/DWV 56.29 K+ur � 1 . y�1` Address:QkV ft c'1� IV -�y , )�l t t jr /6/ Other 25.02 City/Stat tee/ZIP:, jaz_ (Y/1,�2 s r µ^ Subtotal ;5 Phone:t--y yy. ! ' £ (o Fax:( ) Minimum permit fee: $72.50 _ i_ •CUB Lie.: aL, 1 `�' Plumbing Lie.no.; z l.2q pED Plan review (25%of permit Fee) ,,,, - vv State surcharge(12/0 of permit fee) A,$l Authorized signature: it,' ' S 0 it 1 TOTAL PERMIT FEE j C1.4g, Print Ilalne�.\ Y�� t(1�� t 'ikei Date: �f/� This permit application expires if a permit is not obtained within ISO days W`-" ��f�I LLJ after it has been accepted as complete. ,ij.' •Fee methodology set by Tri-County Building Industry Service Board. I.Budding:Pennos/PLMU-PenniIApp.doe I Nu l lug 4Ab4/d6Tt IIIn12(04UWER) 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 $121.90 Footing dram-each additional 100' 37.52 2.001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer- 1st 100' 62.54 7.201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-Ist 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Valuation: Permit Fee: Stone&Rain Drain-1st 100' 62.54 $1.00 to$5.000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5.001.00 to$10.000.00 $72.50 for the first$5,000.00 and$1.52 for each additional$100.00 or fraction thereof,to Other Inspections or Fees (NY. Fee(ea) Total and including$10,000.00. Inspection of existing plumbing or for $10.001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25.001.00 to$50.000.00 $379.50 for the fast$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof to Reinspect ion Fees 90.00/hr and including$50,000.00. Additional plan review for revisions 90.00/hr $50.001.00 and up $742.00 for the first$50.000.00 and$1.20 for (minimum charge-1/2 hour) each additional$100.00 or 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 • Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate Baptistry/Font ❑ Any new commercial building with water service 2"and greater,except systems designed and stamped by licensed Oath Tub Shower -Jacuzzi/Whirlpool hirlpool engineer. Elcar wash Each Stall New exterior plumbing site utilities for any complex structure Drive Thru as defined in OAR918-780-0040. ElCuspidor/Water Aspirator Medical gas and vacuum systems for health care facilities. Dishwasher: -Commercial 0 Any multipurpose fire sprinkler system. -Domestic X ❑ Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eve Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: 2" -3" Isometric or Riser Diagram ❑ isometric or riser diagram is required for new buildings -Car Wash Drain that meet the qualifications above. Garbage -Domestic non-food Disposal: -Domestic food related -Commercial food related -Industrial food related Ice Mach./Refrig. Drains • Comments regarding fixture work: Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: AEafgli :O 1 -Stall Sink: •L.av/Bar non-food related -Bradley -Com/Serv/Util food related 1 -Service 1 *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and Washer-Clothes Water Extractor fees assessed for the sewer increase must be paid before the Water Closet-Toilet _ plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF_PemtitApp.doc 08/04/201 I 2 Cit'PIy of Tigard " COMMUNITY DEVELOPMENT DEPARTMENT ■ ,. TICARD Building Permit Review — Residential Building Permit #: M$T2c 21 " DO D ( '7 Site Address: 14405 SW 92nd Ave Project Name: Stern Addition Lot #: Planning Review 3///zi /2.sV/ram - r /'cA� Proposal: Addition on existing home and new patio coverF-071 E.-i /54r ElVerify address/suite# active in Accela. ❑o In River Terrace: ❑r No ❑ Yes, River Terrace Review Addendum Site Plan Elements: erosion Control ! Di copies of site plan on 8-1/2"x 11"or 11 x 17"paper , tetained trees with drip line and tree protection measures I 11prawn to scale(standard architect or engineer scale) `ootprint of new structure(including decks)and FFE O orth arrow JJtility locations&easements(required for new and additions) I.ite address,project or subdivision name and lot number :,;,Sidewalk/driveway approach II-kpplicant information(name and phone number) ,ocation of wells/septic systems I • dimensions and building setback dimensions street tree size,type and location la uare footage of buildings to be demolished •treet names O ' ting structures on site °Corner elevations (2'contours if more than 4'differential IN).•t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? • es o impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? L JYes ° o ❑ Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995): Required: Q Yes,applicant was notified ❑ No Received: 0 Yes ❑ No ❑ Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs Required: Q Yes,applicant was notified ❑ No Received: ❑Yes ❑o No II SDC Exemption for ADU applied for: ❑Yes ❑s No Received: ❑ yes ❑r No i� dl Public Facilities Improvement (PFI) Permit: Required: ❑ Yes,applicant was notified ElNo Applied For: ❑ Yes ❑ No,stop intake II Land Use Case#: El Zoning: R-4.5 III Required Setbacks: Front: 20 Rear: 15 Side: 5 Street Side: 15 Garage: 20 ❑r . ilding Height: Max. Height: 30 Actual Height: 12 `4Landscaie ' -a: % Lot Coverage 1 : % Entrance U. et back no more than 8'from street-facing wall it' arallel to street or offset .egrees or less Windows 0 Minimum 12%of area of all street-facing facades Garage so _ .:.e door is behind widest street-facing wall ❑ Yes E o,one of the following is met: Door - :-.s no more than 5' from wall and there is a c• ed porch extending beyond garage. IDoor extends no mo _.. 5'from wall and ._ - is a 12 sq ft.window above garage on 2"a floor. ❑ Gara e door width is 12'or less %.i or less of facade 60%or less and includes 7 of following: Covered porch Rece -. entrance \ : •ffset ❑ 1'Roof eave Roof offset Fire shingles ap Siding ❑ Roof itch .'S or gambrel roof Dormer Accent Accent g Window trim Window recess Win.o•• : •'ection ❑ Balcony ❑ Visual Clearan ❑ Urban Foresta Plan ❑ Sens. ' ands: ❑ Yes I_'I No Type: onditions met prior to issuance of building permit Notes: El Approved By Planning: Date: 12/23/20 Revisions (after Building Submittal only) Reviewer Date Revision 1: HApproved ❑ Not Approved th, 3I c[17.021 Revision 2: ❑ Approved ❑ Not Approved 1:\Building\Forms\BIdgPermitRvw_RES_122419.docx Building Permit Submittal Original Submittal Date: i2.123 )O z Site Plans: # 3 Building Plans: # 3 Building Permit#: Enter building erm�it#above. Workflow Routing: "Planning ;ngineering lTt'ermit Coordinator g'Suilding Workflow Sign-off: S�ign-off for Planning(include notes from planning review) Route Application Documents: �yrngineering: (1) copy of permit application, (1) site plan, (1) building plan and ori}pri ial plan review routing form. aiding: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: ei'2 ,� Date: //2 y/ZI Engineering Review l ' lope at building pad: Z% aConditions "Met"prior to issuance of building permit ki/"- Easements (encroachments) per engineering conditions of approval and plat n/41. ❑ Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes ❑ No Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No LIDA Facility on lot: ❑ Yes ❑ No Er Final Plat Recorded:% /— �NOT Approved by Engineering: %ram,¢ /4h ei_i, Date: 2 -2- Zb21 Notes: N'&e.c( 7b SA0,, G /D19 j , J 'i./ Ifni T✓Yr 7 vs e;cc,e eon f /OGrD A./ USC Crt/.S Stirm Wai t' g4/ iee-7/ Sterh S ❑ Approved by Engineering: Date: Revisions (after Building Submittal only) jteviewer Date LI Revision 1: Approved El7 Not Approved #7.714lh ./t..,,7 43/0/ Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review *Conditions "Met"prior to issuance of building permit ❑ Approved,NOT Released: c✓1,A l t_Qd typo + -kL,'Ll24 7.I Date: Notes: I Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant:13,gC Exemption: ElReceived -I�y �Does not apply SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes �{�� N/A .{ Tigard Trans SDC: 0 Yes -'CI�F+N/A Parks SDC: ❑ es �I N/A LIDA �/ Yes N/A OK to Issue Permit Approved by Permit Coordinator: Date: .2 f2/ 1:\Building\Forms\BldgPermitRvw_RES_122419.docx Water Meter Fixture Unit Worksheet for Additions/Remodels/AD i CEIVED Please complete the following information: DEC 2 9 ir Customer Nan 2020 N� • BUILDING DINNG DIVISfON Service Address: Street/Suite#: � ‘j S.�J• TI Q12 �r City f {) State: bp- Zip: 9/27y Phone Number: CD-2 l O — 158.4 Email: S'/. —�(STeJy.I e (,r-1Mi_. cnt.4 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 1 = x I = Bidet x I = l x I = 1 Clothes washer l x 4 = Lk x 4 = Dishwasher i x 1.5 = 1.6 x 1.5 = Hose bib l x 2.5 = Z,S x 2.5 = Hose bib,each I x I = 1 x 1 = Kitchen sink I x 1.5 = I,5 x 1.5 = Laundry sink I x 1.5 = I,5 x 1.5 = Lavatory Z x I = Z• 2- x I = 2- Water closet, 1.6 GPF 2- x 2.5 = 5 j x 2.5 = 2..5 Bathtub/whirlpool x 4 = I x 4 = t} Shower stall I x 2 = 2- I x 2 = 2- Bath/shower combo j x 4 = I-{ x 4 = Current Points: 2_5 Proposed Increase: I. .5 Current Points+Proposed Increase= �O.5 =New Total Points =Required Meter Size 3f-1 t Meter Sizes: Ito 30 points= 5/8" 30.5 to 37 points=%" 37.5 and over points= 1" New Meter Size Needed for New Total Points: 3/_,Ii Cost: $ 1-27 t"TI ZS (see page I) Current Meter Size per Utility Billing: 57t ii Cost: $ �41 t ,"i� (see page I) j New Meter Size Cost minus Current Meter Size Cost= $ 1 I 0 t C�1 (This is Your Cost to Increase Meter Size Due to Additional Fixture Units) FOR OFFICE USE ONLY / Current Meter Size Confirmed with UB 10 V `f- 1 d �C �4aQ.�Q Sig ature of U�Re resentative Date I I:/auilding/Farms/WaterMeters 070119 Add.ducX Page 2 RECEIVED DI,5 VIS Z�2IO1 N CITY OF TIGARO C1eanWater`\\ Services "I IILDING SENSITIVE AREA PRE-SCREENING SITE ASSESSMENT Clean Water Services File Number 21-000020 1. Jurisdiction: Tigard 2. Property Information(example: 1 S234AB01400) 3. Owner Information Tax lot ID(s): Name: Karen Stern Company: Address: 14405 S.W.92nd AVE. OR Site Address: 14405 S.W. 92nd AVE. City, State,Zip: TIGARD, OR, 97224 City,State,Zip: TIGARD, OR, 97224 Phone/fax: Nearest cross street: S.W.VIEW TERRACE Email: 4. Applicant Information 4. Development Activity(check all that apply) © Addition to single family residence(rooms,deck,garage) Name: Ryan Maas IDLot line adjustment ElMinor land partition Company: Olson Group Architects ❑ Residential condominium 0 Commercial condominium Address: 14405 S.W.92nd AVE. D Residential subdivision 0 Commercial subdivision City,State,Zip: TIGARD, OR, 97224 O Single lot commercial ❑ Multi lot commercial Phone/fax: 503-620-9870 Other Email: ryan@olsongrouparchitects.com 6. Will the project involve any off-site work? ❑Yes ❑ No 0 Unknown Location and description of off-site work: 7. Additional comments or information that may be needed to understand your project: This application does NOT replace Grading and Erosion Control Permits,Connection Permits,Building Permits,Site Development Permits,DEQ 1200-C Permit or other permits as issued by the Department of Environmental Quality, Department of State Lands and/or Department of the Army COE. All required permits and approvals must be obtained and completed under applicable local,state,and federal law. By signing this form, the Owner or Owner's authorized agent or representative, acknowledges and agrees that employees of Clean Water Services have authority to enter the project site at all reasonable times for the purpose of inspecting project site conditions and gathering information related to the project site. I certify that I am familiar with the information contained in this document, and to the best of my knowledge and belief,this information is true,complete,and accurate. Print/type name Ryan Maas Print/type title Designer Signature ONLINE SUBMITTAL Date 12/18/2020 FOR DISTRICT USE ONLY 0 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. X 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. ❑ 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. E(THIS SERVICE PROVIDER LETTER IS NOT VALID UNLESS 1 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 LETTER IS REQUIRED. Reviewed by • O6 Al Date 01/04/2021 Onceizeimplete,email to:SPLReview@cleanwaterservices.org • Fax: (503) 681-4439 OR mail to: SPL Review,Clean Water Services,2550 SW Hillsboro Highway, Hillsboro, Oregon 97123 Reaswl 22020 Main Office • 2550 SW Hillsboro Highway • Hillsboro,Oregon 97123 • p: 503.661.3600 f: 503.681.3603 • cleanwaterservices.org OLSON GROUP r -- tiRED AR ARO4fl ecrs AlA /'< • w .OLSON yA-1 _ ``�;/ 1 ~�-`-' '- _ _�� - DU HAM. . 1 w =` \ ^`__ `- .y OREGON cp —_.4I,.,,-_-,--_-:_,-.._ - -__=_..,..e,...\..,',p..v__- OFO "e-,-F....,. 1 i -~-- _� ,_ , `_-/�� ill dal \ ___-__7_ - -_-- -__- l:c_ t w Y --- \ - - y .�. 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N!FT.TO TLLEST RCG! I / /% pl�.Nn..N t /°y''•t I-• — 'i I NO INCREASE TO EXISTING WIGHT/ r - '/ T' j 1 1 LOTGOvERK# 1 PBy//..ppo j ttv�'t'+G \ \ ` !! ,\-1 CA ON I CODE ALLOWABLE ca2Rme. REVISED: �Ma �, C41'EFED PATIO — - 'X i 1 I NO MAXMII NI/(.rt-�`rya� s. E 1 I I ADDINCNAL NOTES IP I I •FOOTINGG TO BEAR ON RIV1,U DISTU eED NATIVE SOIL OR .1 w � -—. wi I 1 i I I I rRCPFlLT COMPACTED ENGINEERED FILL(954 PROCTOR) `\ I 1 I •v y Local-km CP ELECTRIC,CABLE T.V.TELEPHONE AND f{ qI S• I . 1 III I I I NATURAL GA!EERNCE ELM TO HAM.ALL BENNIC!TO B. '1, !1 !1 E"' 1 �--a-- I I ubER3ROND. WI y .R.�rRm I' T y III 1 I V++ 1 1 .tO Ey LCGGTIfs CP E]GfiTRG WRIER METER PRONDE SERVICE �`.1_ii..oewR.ea ___--_-________ [ p - ,, I -„ I -4 ; VE rE L.tCAt Br anERe.ProNDE tPRY.lrr FovDl S0 RAI. 'DATED I2A4/20 I !, I{ I :::'em---I 'DRAWN wM .wr•w. w PRO C : PO I' b$' Ep SITE dlN fe ICHECKED I 5ITE PLM I T TAX LOT 13 'PERWSE TERRACE' ECITY CPTIGARD,WITON COUNTY SEC.11 T 3S,R All.40M WANIRGTON CgNTT,oIffCLN