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Permit
New `-,44 4. I.t.�C I°L 1,1 - ' . - Existing BACKFLOW ASSEMBLY TEST REPORT Ell Removed - Replacement Property Dreambuilder Custom Homes, Inc Owner Mailing 16805 SW Gassner Ln. Lake Oswego, OR 97035 Address Phone: Assembly 9677 SW 74th Ave Tigard, OR 97223 Address R.P.B.A. ® D-C.V.A.El R.P.D.A. I= D.C.DA. I=1 P.V.B.A- ID S-V.B.A.M A.Y.B. ID AIR GAP SIZE: 1" MAKE: Febco MODEL: 850 Water Purveyor Tualatin Valley Serial # HG24894 Assembly Location: Next to water meter REDUCED PRESSURE ASSEMBLY DOUBLE CHECK P.V.BA. , S.V B.A. INITIAL TEST #1 CHECK CHECK INITIAL PRESS DROP (AI CHECK #1 AIR INLET PASSED Egi TEST RELIEF VALVE TIGHT ® 30 OPENED PRESS FAILED El DAT MIN2PSID (B) AT DROP RESULTS LEAKED 0 PSID DATE BUFFER PSDI PSDI 09/15 /22 A-B = CHECK #2 BYPASS MIN 3 PSI CHECK RELIEF VALVE TIGHT ra 2 DID NOT FAILED SYSTEM PSI L J OPEN PASS 0 FAIL 0 LEAKED PSID 0 1 75 COMMENTS REPAIRS AND/OR PARTS REDUCED PRESSURE ASSEMBLY D.C.V.A. P.V.B.A. I S V.B.A. AFTER TEST #1 CHECK CHECK #1 REPAIRS AFTER PRESS DROP (A) TIGHT PSID OPENED PRESS REPAIRS PNF 0 AT DROP DATE OPENED (B) MIN 2 PSID CHECK #2 PSDI PSDI BUFFER TIGHT PSID A-B - 0 PASSED El MIN 3 PSI IN COMPLETING AND SUBMITTING THIS TEST REPORT,THE TESTER CERTIFIES THAT THE ASSEMBLY HAS BEEN TESTED AND MAINTAINED IN ACCORDANCE WITH ALL APPLICABLE RULES AND REGULATIONS OF THE WATER SYSTEM.AND STATE REGULATIONS GAUGE CALIBRATION DATE 12-07-2021 DETECTOR METER READING OIV101#7' TESTERSIG0 •T 9 E Bonifacio Garcia 503-707-0213 State Testers TruScapes Certification #6693 7800 NE Walker Rd Hillsboro, OR 97124 Gauge# 12171807 REPORT RECEIVED BY El SERVICE RESTORED 0 FOUND OFF, LEFT OFF Oregon Nt a, ,,.i yt w_ Backtlow BACKFLOW .XISTING ri REMOVED PREVEVER REPORT NEW LI REPLACED /�� _ It EPAIRED n1.D WN: PROPERTY NAME " 1 isr vJ� , PHONE. CONTACT NAME Y PHONE. MAILING ADDRESS CITY STATE (,Q ZIP PREVENTER ADDRESS ,'- if 11 i 1'TM' q OO'�, J, 1 WATER SUPPLIER SERIAL I _ 117 3�3 LOCATION L uM/f it. 1it)f MAKE f 4 — MODEL�}, LP 011 V I q'r SIZE ( i, TYPE n RP RPDA RPDA-II K.i DC n DCDA [J DCDA-II n I'VE n SVB AVB AG HAZARD PROTECTED n PREMISES ISOLATION El IRRIGATION Li FIRE SYSTEM 0 BOILER 111 OTHER APPROVED: ASSEMBLY ® INSTALLATION RIORIENTATION Ei ADIGAP PIPE SIZE,..c1 la IIMARA rtreurAt ' hi REDUCED PRESSURE ASSEMBLY PI/RA/SERAINITIAIiT�.6T DOUBLE CHECK AIR INLET CHECK VALVE PASSED CHECK Al CHECK El TYPE II n OAT AFal DROP: DROP: PRAM TIGHT hi FAILED L , INITIAL MNsresu Z,.� TEST RELIEF VALVE -LEAKED n MINI Pan MIN I PSID MINI MD DATE 'O ,t% •L. RESULTS OPLNEO AT: OPENED MINT Pmn CHECK R FULLY n FAEI.ED SYSTEM PSI ivirriajv RELIEF VANE: TIGHT ( �•`! �❑ READING: I. � DETECTOR PASSPASSIM./ n J 11 FA II 1. .1 LEAKED n MN I P.7® NOTES REPAIRS PARTS REDUCED PRESSURE ASSEMBLY TEST PVBA/SVBA CHECK Al DOUBLE CHECK _ AFTER REPAIRS DROP. CHECK AI TYPED n AIRINLET CHECK VALVE REPAIR MIN s MD now El OPINED AT: PRcss DROP: RESULTS RELIEF VALVE DATE OPENED AI: CHECKER Mar I PIM MIN I PER)... m MINI Pa RRIJ FVALVZ MIN 2PMII TIGHT n L I PASSED El PAWED E FAMED n I N I T9m GAUGE SIN 11132042 MAKE/MODEL Midwest 845-5 CALIBRATION DATE 12-20-2021 In completing and submitting this test report,the teeter certifies that the anion,*was tested and maintained in accordance with all applicable rules,laws,codes and regulations of the state and water system u®qt approved testing equipment and approved testing procedures. INITIAL TEST TEST AFTER REPAIRS /V" 403645 TESTER SIGNATURE TESTER SIGNATURE TESTER CERT# Melissa Schmeer 503-491-9402 TESTER NAME D) TESTER NAME(PRINTED) PHONE# 15685 SW 11 th Ave#199 Tigard,OR 97224 deanna@obtlic.com TESTER ADDRESS TESTER ADDRESS EMAIL Oregon Backflow Testing, LLC IV1 COMPANY NAME. COMPANY NAME I n i WATER RESTORED? Q FOUND OFF,LEFT OFF REPORT RECEIVED RY(REPRLRENTATIVR OP OWNER) RRPORT RECRIVIR)RE(REPERIEtFATTVR OF OWNER) PERMIT NO. C1eanWater Services LOT EROSION CONTROL INSPECTION REPORT DATE INSPECTOR SUBDIVISION OWNER/PERMITEE SITE ADDRESS APPROVED FINAL INSPECTION THIS SITE MEETS THE POST-CONSTRUCTION EROSION CONTROL REQUIREMENTS SET FORTH IN CLEAN WATER SERVICES RESOLUTION AND ORDER NOTE: IF POST-CONSTRUCTION EROSION CONTROL MEASURES ARE STILL BEING EMPLOYED ON THIS SITE TO MEET CRITERIA FOR AN APPROVED FINAL INSPECTION, THE MEASURE(S) MUST REMAIN IN PLACE UNTIL LANDSCAPING IS COMPLETE OR PERMANENT GROUND COVER IS ESTABLISHED. A COPY OF THE FINAL EROSION CONTROL INSPECTION REPORT MUST BE FORWARDED TO THE NEW OWNER, AT WHICH TIME NEW OWNER ASSUMES THE RESPONSIBILITY FOR MAINTENANCE, REPAIR AND REMOVAL. OTHER THANK YOU FOR YOUR COOPERATION! 1'Pi�e INSPECTOR PHONE 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 Transmittal Letter T I G A R I) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Allyson Armstrong DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: Dan Williams FEB 10 2022 COMPANY: Faster Permits L ITY OF TIGARD PHONE: 503-819-7754 lUILDING DIVISION By: EMAIL: Dan@fasterpermits.com RE: 9677 SW 74th Ave MST 20Z 1-OQ 22l (Site Address) (Permit Number) (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. X Revisions: _See remarks 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: Revision to shear - This change Shortens the sheer requirements from 24 in to 18 in at the master tub wall. F R FFICE USE ONLY Routed to Pe echnician: Date: 2f(�{(Z'Ti Initials: Mk- Fees Due: r YesiNo Fee Description: Amount Due: PA,y(1. OA," rs.,,K Special Instructions: Reprint Permit (per PE): ❑ Yes �/ ❑ Done f Applicant Notified: Z,l_Date: Il s ? No) Initials: 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 1114 _: Transmittal Letter TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Building Plans Examiner-Allyson Armstrong DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: Dan Williams SEP 7 ZO2, COMPANY: Faster Permits tJ TY OF TIGARD 1UILDINGDIVISION I BY PHONE: 5603-819-7754 EMAIL: dan@fasterpermits.com RE: 9677 SW 74th Ave MST2021-00221 (Site Address) (Permit Number) Leet (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: I Description: I Copies: I Description: Additional set(s) of plans. 3 Revisions: See Remarks Below for Description 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: REVISION- Foundation wall detail changes and revised sections tags to coordinate changes along with additional calculations provided for the increased retaining wall height. See Revised sheets S1.1 & S2.0 FOR QFFICE USE ONLY /r`, �,, Routed to Per ech ian: Date: 1127/ Z !�► ( Initials: /k_ Fees Due: [YesLLNo Fee Description: f Amount Due: 1I9. t/ti>ll CEAP:Ll--) $ — $ $ Special I Instructions: I Reprint Permit (per PE): ❑ Yes JNo ❑ Donefr_ Applicant Notified: Date: Initials: 1114 CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit a: MST2021-00221 Date Issued: 07/15/2021 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S125DC00500 Jurisdiction: Tigard Site address: 9677 SW 74TH AVE Subdivision: BOULEVARD HEIGHTS Lot: 27 Project: Leet Project Description: New detached dwelling with 548 sf covered patio and additional 136sf of conditioned storage and 647sf pool equipment room. DEMO CREDITS FOR TRANSPORTATION, PARKS&SEWER BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 2946 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 25 Bathrooms: 4 Second: 1311 sf Garage: 1457 sf Front: 20 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Total: 4257 sf Value: $604,919.52 Rear: 15 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 8 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100 Tubs/Showers: 5 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 Drywell-Trench Drain: 0 Other Fixtures: 2 Other Fixture Units: Pantry sink and outdoor living sink MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 7 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 1 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 7 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 add'!500 sf: 10 201-400 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 Y Other: N Other Description: Ecompasing: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 4257 Owner: Contractor: LEET,BRIAN L&ANGELA K DREAMBUILDER CUSTOM HOMES INC Required Items and Reports(Conditions) 7498 SW CEDAR WAY 16805 SW GASSNER LANE 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97223 LAKE OSWEGO,OR 97035 PHONE: PHONE: 503-880-7132 FAX: 503-821-6462 Total Fees: $20,985.73 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR oc9-nnl-nnln HI rnunh nap,Qc9-nM-anon war ryes,amain a,am,of the mile,nr,irarl m.aetinne to n11NC hs,niijnn cna 9'19 1QR7 nr 1 Ann nn,914e Issued By: iOUy V6i49.De'We e Permittee Signature: OYJ74PP Cattoyn Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the Job site until completion of the project. Approved plans are required on the lob site at the time of each inspection. Building Permit Application .6-5 1 2 Residential FOR OFFICE USE ONLY r �7 City of Tigard RECEIVED Received 1 02/ rp/ryl Permit No0S/202/ (VZ2I - 13125 SW Hall Blvd.,Tigard,OR 97223 y 0 plan Review 'wtz,iCiWR232I^WJ f(df\Phone: 503.718.2439 Fax: 503.598.1960 'WC I io2Date/By: l� �/�S,Q`� Other Perm �(J TIGARD Inspection Line: 503 639.4175 n to Ready/By (//��(� teas WI See Page 2 for Internet: www.tigard-orgov CITY OF TIGARDnfied/Mctho 7/ L LJ/��'�,�� Supplemental Information . iiLRING DIVl�l9� 'TYPE OF WORK REQUIRED HATA:1-AND 2-FAMILY DWELLING E,/]New construction D Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,a I the ro for th CATEGORY OF CONSTRUCTION work indicated on this application. q"�$ Number ofbedrooms: ® 1-and 2-family dwelling ❑ ValuaticCommercial/industrial ! �4 ❑Accessory building ❑Multi-family 0 Master builder ❑Other: Number of bathrooms: )tC L 6.--7/y JOB SITE INFORMATION AND LOCATION Total number of floors: 2 J 57 Job site address: New dwellingar s re et 9677 SW 74th Ave y������ `��i� '�'�� City/State/ZIP: Portland OR 97223 Garage/carpdYt'ar?a: -fi64 Sliiii square feet 294 (47 Suite/bldg./apt.no.: Project name: Covered g: 2)square feet Cross street/directions to job site: Dec "Q square feet square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Lot no.: Permit fees*arc 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. New replacement dwelling Valuation: $ 6.744.0 ` 4.0 y_/y _/ -� 7a�5 7,��- �( Existing building area: square feet 5 (/,%t' , -L�f'L6/ 5• � 14/70(l (-J1/Y 14�+ - ,,. rota ,/A New building area: square feet © PROPERTY OWNER fiv! ❑ TENANT Number of stories: Name: Brian Leet Type of construction: Address: 9655 SW 74th Ave Occupancy groups: City/State/ZIP: Portland, OR 97223 Existing: Phone: ( ) Fax: ( ) New: El APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: Faster Permits Structural plan review fee(or deposit): 75j.3C1 Contact name: Dan Williams Address: 2000 SW 1st Ave, Suite 420 FLS plan review fee(if applicable): Total fees due upon application: City/State/ZIP: Portland, OR 97201 Phone:(503) 819-7754 Fax::( ) Amount received: E-mail: dan@fasterpermlts corn PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photovoltaic Solar Panel System. Business name: Dreambuilder Custom Homes Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 1 125 SW Borland Rd. Solar Installation Specialty Code checklist. City/State/ZIP: West Linn, OR 97068 Permit Fee(includes plan review $180.00 and administrative fees): Phone:(503? 880-7132 / Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lie.: 138321 471,2) f , • Total fee due upon application: $201.60 Authorized signature: 1 i�(/u �"�'► This permit application expires if a permit is not obtained [,l/�t within 180 days after it has been accepted as complete. Dan Williams5/12/21 x Fee methodology set by IT;-County Building Industry Print name: Date: Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I1/02/COM/WEB) Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONLY Erof Tigard ssoad y g Permit No.: 13125R SW Hall Blvd.,Tigard,OR 97223 Date/By: Phone: 503.718.2439 Fax: 503.598.1960 Associated permits: TIGARD 24-Hour Tnspection Line: 503.639.4175 0 Electrical ❑ Plumbing ❑ Mechanical Internet: www.tigard-or.gov ❑ Other. THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A I Land use actions completed. Sec jurisdiction criteria for concurrent reviews. ❑ 0 Ea 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ 0 VI 3 Verification of approved plat/lot. 0 0 0 4 Fire district approval required. Name of district: • ® 0 ❑ 5 Septic system permit or authorization for remodel. Existing system capacity _ _ ❑ 0 6 Sewer permit. /2 0 ❑ •7 Water district approval. ® 0 El 8 Soils report. Must carry original applicable stamp and signature on file or with application. in ❑ 6�7[ 9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- ® ❑ 0 basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state . ® ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ❑✓ 0 ❑ there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft. intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage; impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size 2 ❑ ❑ and location. 13 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. 14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- ® ❑ ❑ floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. 1 ❑ 0 Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- ® 0 ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing ® 0 0 locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ® 0 ❑ systems,see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ® 0 ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ® 0 0 for four or more appliances. 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or ® 0 ❑ architect licensed in Oregon and shall be shown to be a•.licable to the troject under review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item II above. Site plans must be 8-1/2"x 11"or 11"x 17". ® 0 0 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ❑ ❑ El 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. © ❑ 0 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ® ❑ 0 27 "Drawn to scale"indicates standard architect or engineer scale. 0 ❑ 0 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ 0 Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ® ❑ ❑ and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, 0 El ❑ 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. 1:\Building1Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I1/02/COM/WEB) Mechanical Permit Applicatiaua'RECEIVED Received FOR OFFICE USE ONLY • R CC City of Tigard r- /Date/By. Permit No.. M s 2021'`-W22I ., 13125 SW Hall Blvd.,Tigard,OR 97223 1 2 : Phone: 503.718.2439 Fax: 503.598.1960 l l i "I !1 7.02i DaReview atee/By: Other Permit:D TIGARD Inspection Line: 503.639.4175 T Date Ready/By. tuns: 2 Internet: www.tigard-or.gov CITY i OF TIGARD Notified/Method- ® See Page l for Supplemental Information BUII niNG flvlsmed TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees*are based on the value of the work ©New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* 7 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For.specialirejormation use checklist. ❑ Multi-family ❑Master builder ❑Other: Description P Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 46.75 Job site address: 9677 SW 74th Ave Furnace 100,000 BTU(ducts/vents) 1 46.75 City/State/ZIP: Portland, OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: Project name: Heat pump 61.06 Duct work 1 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 1 23.32 Subdivision: Lot no.: Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 1 23.32 ' " DESCRIPTION OF WORK Gas fireplace/insert 1 33.39 Flue vent for water heater or gas 2 Mechanical for new replacement dwelling fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 j PROPERTY OWNER Other: 23.32 ❑ .TENANT Environmental exhaust and ventilation: Name. Brian Leet Range hood/other kitchen Address: 9655 SW 74th Ave equipment 1 33.39 Clothes dryer exhaust 1 33.39 City/State/ZIP: Portland, OR 97223 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 7 23.32 Phone:( ) Fax: ( ) Attic/crawlspace fans 23.32 ® APPLICANT '0 CONTACT PERSON Other: 23.32 Business name: Faster Permits Fuel piping: $14.15 for first four;$4.03 for each additional Contact name: Dan Williams Furnace,etc. 1 Address: 2000 SW 1st Ave, Suite 420 X Gas heat pump Wall/suspended/unit heater City/State/ZIP: Portland, OR 97201 water heater 1 Phone:(503 819-7754 Fax::( ) ((( J��^ Fireplace 1 E-mail: dan@fasterpermits.com \7 Range 1 Barbecue CONTRACTOR r ` Clothes dryer(gas) i Business name: To Bid Other: C'] ..... s rt. t`t' red , ICAL PERMI FEES* Address: Subtotal City/State/ZIP: Minimum permit fee($90.00) Phone: Plan review(25%of permit fee) ( ) Fax:( ) State surcharge(12%of permit fee) CCB tic.: TOTAL PERMIT FEE / This permit application expires if a permit is not obtained within 180 / ,' w days after it has been accepted as complete. v( Authorized signature: � /� /l * Fee methodology set by Tn-County Building Industry Service Board Print name: Dan Williams Date: 5/14/21 1\Budding\Permits\MEC_PermiiApp_040113_doc 440-4617T(11/02/COM/WEB) Mechanical Permit Application FOR OFFICE I ,l ON 1 City of Tigard Received •,r g Dat ,esy: 1 Permit No.:M VZ.437,i_o'ZI III— 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/By. Other Permit. 11,A r I t Inspection Line: 503.639.4175 Date Ready/By: tuns. RI See Page 2 for Internet: www.tigard-or.gov Notified'Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE-USE CHECKLIST Mechanical permit fees*are based on the value of the work cw construction Demolition Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT ISYSIEMSFEES• IK1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist I D Multi-family ❑Master builder 0 Other: Description Qty Ea. Total 1 JOB SITE INFORMATION AND LOCATION Heating/cooling: -�y''''/````o Air conditioning 46.75 Job site address: Cl(DR-,..1-(DR-,..1- � /,/We, Furnace 100,000 BTU(ducts/vents) 1 46.75 CityiState/'ZIP: "7�fJa-j r/ 61 7 1' '2 ` Fumaee 100,000+BTU(ducts/vents) 54.91 rf^3 Heat pump 61.06 Suite/bldg./apt.no.: Project name: Lirri:-k„.- Duct work 1 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 .^ Residential boiler(radiator or �U d ")it r ;1 I a ii,..., hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 1 23.32 1 Subdivision: Lot no.: Other 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 1 23.32 DESCRIPTION OF WORK Gas fireplace/insert 1 33.39 ` `"'°t'' ! ` �-r, r i�( 6 Flue vent for water heater or gas A cI , i-tb0 V L1 •L T ' V & k fireplace 2 23.32 r Log lighter(gas) 23.32 Wood/pellet stove 33.39 __ Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 ❑ PROPERTI OWNER , ❑ TENANT Other: _ 23.32 Environmental exhaust and ventilation: Name Range hood/other kitchen equipment 1 33.39 Address: _ Clothes dryer exhaust 1 33.39 City/State/ZIP: Single-duct exhaust(bathrooms, toilet compartments,utility moms) , 7 23.32 Phone:( ) Fax:( ) Attic/crawlspace fans 23.32 AAPPLICANT 0 CONTACT PERSON Other: 23.32 Business name: '7 -C.r ���rn I•-' Fuel piping: $14.15 for first four,$4.03 for each additional Contact name: 'R.( Z) ,7 re Furnace,etc. 1 Address: �' ` Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater 1 Phone:( ) Fax::( ) Fireplace 9 Range 1 E-mail: r0t>p ,S t----, ,l rl- i�-S . �YY1 Barbecue 1 CONTRACTOR Clothes dryer(gas) L.Business name: fl()N ,� +Tory In C re,t L i Other r,.. 1 y �l Y t l MECHANICAL PERMIT FEES` Address: I ( 'RLo Subtotal City/State/ZIP: S'Y1 `T n+1 : -t,4- G7 B..`_�/ Minimum permit fee permit fee) Phone:(�5 qq �F qq Fax:( ) tfJVtO Plan review(25%of fee) � C1 State surcharge(12%of permit fee) CCB tic.: /1' g7-1 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within ISO days after it has been accepted as complete. Authorized signature: tea,.✓-- /2.o'zi * Fee methodology set by Tri-County Building Industry Service Board Print name:`o r Ni 2 n J\if Date: YY it/ BuilngPermus'MEC_PermitApp_44DI13.doe 44 b17T(11/ COM/WEB) Electrical Permit ApplicationR ECE IVE D FOR OFFICE USE ONLY Received l, Ar'T qq//ll 2-�// City of Tigard Permit#: ,"�IJ{ LVu.-- 22,1 Date/By: a 13125 SW Hall Blvd.,Tigard,OR 97223 t'A Plan Review 1 2 '` Phone: 503.718.2439 Fax: 503.598.1960 Date/By Related Permit#: TIGARD Inspection Line: 503.6394175 CITY OF TIGARDReady Date/By: luris- ® See Page 2 for m Internet www.tigaid-or.gov BUILDING Qi.VIJI01' Noti fied/Method. Supplemental Information TYPE OF WORK PLAN REVIEW ❑New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans whims checked): 0 Service or feeder 400 amps or more 0 Building over three stories. El Demolition ❑Other: where the available fault current ['Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. El I-and 2-family dwelling LI Commercial/industrial El Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑ Multi-family ❑Master builder ❑ Other: ❑Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION El Emergency system. larger separately derived � 0 Addition of new motor load of system. lob 4: Job site address: 9677 Syyp 74th Ave 1D0HPormore. ❑"A","E","I-2","l-3", City/State/ZIP: Portland, OR 97223 ❑Six or more residential units. occupancy. 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: 0 Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Qty. I Each I Total ( New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.ft.or less 1 168.54 4 Tax map/parcel 4: Ea.add'l 500 sq.ft.or portion 9 33.92 t DESCRIPTION OF WORK Limited energy,residential 1 (with above sq.ft.) 75.00 2 Electrical for new replacement dwelling Limited energy,multi-family 75.00 2 residential(with above sq.ft.) �. PROPERTY OWNER ❑ TENAN T IV'P.t Renewable Energy 0 See Page 2 Services or feeders installation,alteration,and/or relocation Name: Brian Leet 200 amps or less 100.70 2 Address: 9655 SW 74th Ave 201 amps to 400 amps 133.56 z 401 amps to 600 amps 200.34 ' 2 City/State/ZIP: Portland, OR 9723 601 amps to 1,000 amps 301.04 2 Phone:( ) I Fax:( ) Over 1,000 amps or volts 552.26 2 Text 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 t intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps I25 08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 APPLICANT ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel �'' A.Fee for branch circuits with Business name: Faster Permits above service or feeder fee, each branch circuit 742 2 Contact name: Dan Williams B.Fee for branch circuits without service or fee Address: 2000 SW 1 St Ave, Suite 420 branch c rcurtder fee,first 5618 2 City/State/ZIP: Portland, OR 97201 Each add'I branch circuit 742 2 Miscellaneous(service or feeder not included) Phone:(503) 819-7754 Fax: :( ) Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email: don@fasterpermits.com Reconnect only. 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: To Bid Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy ❑ See Page 2 2 Address: panel,alteration,or extension. g City/State/ZIP: Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66 25/hr Phone:( ) Fax:( ) Investigation(I hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: Electrical Lic.: Suprv.Lic.: specifically listed(ia hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: Date: ❑Plan Review Required(25%of permit fee): 1 t State surcharge(12%of permit fee): Authorized signature: l/ -��' TOTAL PERMIT FEE: Ct�� This permit application expires if a permit is not obtained within 180 Print name: Da illiams Date: 5/14/21 days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permils\ELC_PermiuApp ELR ERE.doe Rev 06/17/2015 440-46157(1 I/05JCOM/WEB Electrical Permit Application FOR OFFICE ilSE ON1.1 City of Tigard Recei„ra 13125 SW Hall 503.,39.41d,OR 97223Pr Date Br: 1 \�\z `'�,J Pnmit*In.)V---t../ l—C3SZ-'7` Phone: 503.718.2439 Fax: 503.598-1960 Pan Review J C�s1 Inspection Line: 503.639.4175 DatOBc� Related I'etmiro TIGARU Ready fied'M tho 0- huts I fa Set Supplemental for Internet: ww11.1igard-ofeov Notified'Method Supplemental Information TYPE OF.WOtt( PLAN REVIEW New construction ElAddition/alteration/replacement Please check all that a I submn PP y I 2 sets of plans„ em'its checked, 13em011110n Other: ❑Strict or feeder 400 amps or more 0 Building user three stones where the available fall!eurrenr 0 Marinas and ixtmyards. CATEGORY OF CONSTRUCTION extends 10.0(10 amps at 150 volts or 0 Flowing buildings 1-and 2-family dwelling 0 Commerciallindustriallasm wind or w,wx 0Aeceswrybuilding g ❑Commercial-useapncuitmal Other: amps for all other inmallseions. building 0 Multi-,amity ❑ Master builder JOB SITE INFORMATION AND LOCATION 0 Fire pump 0 Installation of 150 r v d or 0 Emergency syvem larger xparately tinned lob Job site address: 18 - 2Ll 0 Addition of new motor load of syalem. �te �7o) '3I l -1I e. IOOHP or mar, Q.,A^•.E.....I�.. .1-y.. Cily5181eiZlI': Ti �ir'(f G! q; 2'JS ❑Six or SUM residentialunitt ottupnncy Suile.bld /a t. ! e ❑Health-care facilities ❑Recreational%chicle parks • & P I Project name: Le C-k" ❑Hazardous kit-miens 0 Supply voltage for more than Cross street/directions to job site: 0 service or tactic+!,Uri pop,at nap,. 6etn stilts nominal. FEE SCHEDULE H `� r�Gctz1 a I1C Description ! Q17. 1 tern I Tau 1 • Subdivision: New residential single-or multi-family dwelling unit, I Lot p: Includes attached garage. Tax map/parcel 1.000 sq.ft.or less 168.54 4 Ea.add'I 500 sq ft or portion 9 33.92 1 .,, O ,�r't•Q� " :, -w�sf ,. Limited energy,residential 1�Yv C:,� "t�{',7� ---1.- (with shove sq.h.) 1 751)t7 y ' 1 Limited energy,mold-famih residential(with above sq ii I 75 W - Renewable Energy Q See Page 2 ❑ PROPERTY OWNER l ❑ TENANT Services or feeders installation,alteration,and/ur relocation Name:s: 2fD amps orless 100.70 2 201 amps to400 amps 133.56 s Addres City/State/ZIP: 401 amps lo600amps 20034 601 amps to 1,000 amps 301.04 2 Phone:( I I Fax:1 I Over 1,000 amps or volts 552 26 Temporary services or feeders installation.alteration,and/or Email: relocaon Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 intended for sale,lease,rent,or exchange,according to ORS 447,449,670.and 701. 201 ampsto 4(X)am I Owner signature: ps 168.54 2 t� Dale: _ -701 amps to 599 amps 168.54 tq APPLICANT i ❑ CONTACT PERSON Branch circuits-newt alteration,or extension,per panel i3usincss name: - - A.Fee Inn brunch circuits with -- h •>'i"U`.� l� -{"Ti"1 it= above service or!elder Ice, Contact name: •C�Ub - each branch circuit 742 2 i`�1� ,h `f B.Fee for branch circuits%Anna Address: service or feeder fee,first branch circuit 56.15 _ City/State/ZIP: Fachadd'Ibanchcucw 7. T 4- t IshO°e'( I I Fax::( ! 2 Miscellaneous(service or feeder not included) Each manufactured or modular Email: dwelling,service_nd•'or feeder 67.64 .00-, k k'y r -1>er tt . Reconnect only CONTRACTOR 678a 2 Pump or irrigation circle 6714 s • -� Business name: - �(�y Y _ -�GC_-i Zr--' Sign or outline lighting 67 84 Address: �. y�-�X �� Signal circuitts)or limitedenergv ';� e / panel.alteration.or extension. 0 Set Page 2 - r( ny/Slap.LI I. -L�Y��L1 r(.�f C t j� C� �-y r Each additional Inspection over allowable in any of the above Phony.I S(j_j I �.��, f--L/ Additional inspection l I hr mint 66 25.Der v 13 s-s-I Fax:( I lareshgation 1 I hr min 4n on: Enulil: Per p Der 1-( yy,0 et'.li (-tilt_ c c" -) Industrial plant l l Der min) 78.1&'Der Ct1 _ ! spec ii tons for which no far rs CCIiLie.:e2U I / r Electrical Liz: x ^Su n. l.ic.: Spruticallv limed t:.lv min) 90(d:hr Sups.Electrician signature.required: ELECTRICAL PERMIT FEES Stephen R S`lepher > Subtotal: Print name: Date: ! /f.--„ f 0 Plan Review Required(25%of permit Ira State surcharge(12e1..a of permit feel: Authorized signatu .. TOTAL PERMIT FEE:Prim name: Stephen Shepherd I Date: I Tots permit application aspires if■permit Is not°brained within ISO p p 1 ^f tt.a.) 1 days after It has been accepted as complete. ILdalll,Pans,,Ott I'mnun 1Vy ELK FRt doe an rIt I t^�.115 N°mlWr of inspeclmnn allowed per penult 44r,reitTI1 t.tr5.'Co1111'1-n • Plumbing Permit Application Building Fixtures RECEIVE • FOR OFFICE USE ONLY City of Tigard Received 22 1 i Date/By: Permit No. l./isr2 b21'b0 + 13125 SW Hall Blvd.,Tigard,OR 97223 0,a 1 a 202` Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/By Other Permit No.: TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By- Juris: ® See Page 2 for Internet www_tigard-or gov R�� Notified/MethodU _ Supplemental Information TYPE OF WORII�QI14Lt ��IIJISIOI� FEE* SCHEDULE ®New construction ❑ Demolition For special information use checklist. Description Qty. I Ea. I Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 WII-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 cro r3, eIr 500.32 ❑Accessory building ❑Multi-family Each additional bath/kitchen I 25.02 ❑ Master builder ❑Other: Fire sprinkler( sq.II.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 9677 SW 74th Ave Catch basin or area drain 18.76 y Portland OR 97223 Drywell,leach line,or trench drain 18.76 City/State/ZIP: Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 71Ie 18.76 Sanitary sewer(no.linear ft.1 QQ) X Page 2 Storm sewer(no.linear ft.'_QQ) X Page 2 Water service(no.linear ft.:t QQ X Page 2 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Plumbing for replacement dwelling Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 1 PROPERTY OWNER ❑ TENANT Expansion tank 12.51 Name: Brian Leet Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 9655 SW 74th Ave Garbage disposal 25.02 City/State/ZIP: Portland, OR 97223 Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 ® APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name: Faster Permits Medical gas(value:$ ) Page 2 Contact name: Primer 12.51 Roof drain(commercial) 12.51 Address: 2000 SW 1st Ave, Suite 420 Sink/basin/lavatory 25.02 City/State/ZIP: Portland, OR 97201 Solar units(potable water) 62.54 Phone:(503) 819-7754 Fax::( ) Tub/shower/shower pan 12.51 E-mail: dan@fasterpermits.com Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name: To Bid Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal Phone:( ) Fax:( ) Minimum permit fee: $72.50 CCB Lie.: r ,plumbing Lic.no.: Plan review (25%of permit fee) �� f t State surcharge(12%of permit fee) Authorized signature: I c /� bl1V-"� TOTAL PERMIT FEE Print name: Dan Williams Date: 5/14/21 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 Service Board. 19Buildinq\Permils1PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) Plumbing Permit Application Building Fixtures City of Tigard Date/B. & y:y: \c`Z% ` Permit No.:m TZ Y.I-uZZt _ 13125 SW Hall Blvd.,Tigard,OR 97223 pun Review ` Phone: 503.718.2439 Fax: 503.598.1960 Datdey: Other Permit No.: T I G A R D Inspection Line: 503.639.4175 Date Reedy/By: brie: 0 Sae Page 2 for Internet: www.tigard-or.gov Notified-Method: Iafarmetlae ®New construction ❑Demolition For special MIornation use checklist. Description ❑Addition/alteration/replacement ❑Other: New - Qw 1.2-family dwellings(includes 100 ft.. � Ea i Toth for each utility connection) SFR(1)bath 312.70 cij t-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath X 500.32 ❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other. Fire sprinkler( sq.ft.) Page 2 Site utilities: Job site address: 9677 SW 64th Ave Catch basin o area drain 18.76 Drywelt,leach line,or trench drain 18.76 City/State/ZIP: Portland OR 97223 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 4 18.76 Sanitary sewer(no.linear ft.100) X Page 2 Storm sewer(no.linear ft.WO) X Page 2 Water service(no.linear ft.:1QQ X Page 2 Subdivision: I Lot no.: Fixture or item: , Tax map/parcel no.: Backflow preventer 31.27 Backwater valve 12.51 Clothes washer 25.02 Plumbing for replacement dwelling Dishwasher 25.02 i Drinking fountain 25.02 1 Ejectors/sump 25.02 Expansion tank 12.51 Name: Brian Leet Fixture sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 9655 SW 74th Ave Garbage disposal 25.02 City/State/ZrP: Portland, OR 97223 Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 Interceptor/grease trap 25.02 Business name: Faster Permits Medical gas(value:F_) Page 2 Primer 12.51 Contact name: Roof drain(commercial) 12.51 Address: 2000 SW 1st Ave. Suite 420 Sink/basinnavatory 25.02 City/State/ZIP: Portland, OR 97201 Solar units(potable water) 62.54 Phone:(503) 819-7754 Fax::( ) Tub/shower/shower pan 12.51 E-mail: dan fasts rmits.com Urinal 25.02 Water closet 25.02 11 Water heater 37.52 c Business name: of i.4 Tfl Q h,1 -7 1 C , Let- L Water piping/DWV 56.29 Address: 5'l 5-1 5 (A). 1 1 B li.l I Y'n , Other: 25.02 City/StateiZIP: M t I w ln-tt 4,a. 012- a-6 -7 Subtotal Phone:Q53)9-15_ q-i Q--I Fax:623) W Si- 2,9--3�, Minimum permit fee: $72.50 CCB Lie.: (' R 1 g Plumbing Lic.no.: Pf3"f 1 to Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE e:/ Print nam '1 �/ Dat / a ' This permit application expires if a permit is not obtained within 180 days U )ieY 7f) ' L t after it has been accepted as complete. •Fce methodology xi by Tri{'ourey Building Industry Service Board. I:1311ilduigPmna$,PLMU-PwmitApp.doe tO of/09 440-4616T110,024(:01WWEB) City of Tigard e COMMUNITY DEVELOPMENT DEPARTMENT : C TIGARD Building Permit Review — Residential Building Permit #: MST 2021-00221 Site Address: 9677 SW 74th Ave Project Name: Leet Lot #: Planning Review Pr posal: New single detached house / Verify address/suite #active in Accela. \`jIn River Terr re: L� No ❑ Yes, River Terrace Review Addendum Sit/Plan Elements: �`""�,�' osion Control 7 copies of site plan on 8-1/2"x 11"or 11 x 17"paper wined trees with drip line and tree protection measures x n to scale(standard architect or engineer scale) tprint of new structure(including decks)and FFE rtharrow �,Jtility locations&easements (required for new and additions) address,project or subdivision name and lot number 'idewalk/driveway approach p licant information (name and phone number) , - ocation of wells/septic systems ..ot dimensions and building setback dimensions 1 _i�r et tree size,type and location quaxe footage of buildings to be demolished et names �xisting structures on site .omer elevations (2'contours if more than 4'diff e tial ._l,ot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? es o pervious area (a plicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? es o Clean Water ervices —Service Provider Letter (lot platted prior to 9/10/1995): Required: Yes,applicant was notified ❑ No Received: Yes ❑ No Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs Required: ❑Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No ko SDC Exemption for ADU applied for: El Yes ❑No Received: ❑ Yes ❑ No Public Facilities Improvement (PFI) Permit: quired: ❑Yes,applicant was notified ❑ No plied For: ❑ Yes ❑ No,stop intake L d Use Case #: SLR2020-00003 Zoning: R-4.5 uired Setbacks: Front: 20 Rear: 5 Side: 5 Street Side: N/A Garage: 20 B ding H-"ght: Max. Height: 30 Actual eight: _ �� dscape Area: % ,ot Coverage M . `_ `Entrance !l .et back no more than 8'from street-facing wall Parallel to street or offset 45 degrees or less Windows FI Minimum 12%of area of all street-facing facades Ili Garage lis - .rate door is behind widest street-facing wall \,�❑Yes El No,o.a ."t e following is met: II P.. -xtends no more than 5'from wall and ere is a covered .. -xtending beyond garage. Door extent, -• more than 5'from wall and there is a q ft.window above garage on 2nd floor. ❑ Gara e door width is ii -' . less ❑ 50°A a -ss of facade 60%or less and includes 7 of following: Covered porch I Recessed ice ❑ Wall offset B 1'Roof eave Roof offset Fire shingles iding .: .itch ❑ Gable,hi ,or gambrel roof ❑ Dormer Accent si.'•- III Window trim Wm.. recess Window projection ❑ Balcony ❑ Visual Clearanc- ❑ Urban Forestry Plan ❑ Sen - ands: ❑ Yes U No Type: 11 .nddtions met prior to issuance of building permit N. es: Approved By Planning: Date: -Z Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved 1:\Building\Forms\BI dgPenn itRvw_RES_122419.docx Building Permit Submittal Original Submittal Date: 1)5/1/99/2OZ) Site Plans: # 3 Building Plans: # Building Permit#: Enter buildingyIermit#above. n Workflow Routing. Planning La. ID'Permit'l ermit Coordinator Building Workflow Sign-off: ErSign-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. Building: original permit application, site plans,building plans,engineer and beam calculations . I trust details,if applicable,etc. Notes: By Permit Technician: j /— - Date: //5-72-02/ Engineering Review OSlope at building pad: "-A-2lk-Conditions "Met"prior to issuance of building permit u 1 easements (encroachments) per engineering conditions of approval and plat H/.•- Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes B o 61 5v ik CiAii c1 l I Assess Water Quantity Fee in-lieu: ❑�L�/Yes lJ No !h C/vck / LIDA Facility on lot: Yes 0 No ry LI Final Plat Recorded: h(o`- ❑ NOT Approved by Engineering: Date: Notes: 0 Approved by Engineering: /r7i.-,14 Sm..k.ey Date: b/(7/zaZ,/ Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Pe, it Coordinator Review el :nditions "Met"prior to issuance of building permit • pproved, NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: • =vision Notice 2: Date Sent to Applicant: ��127' DC Exemption: ❑ Received IJ Does not a7 1y Ly SDC Fees Entered: Wash Co Trans Dev Tax: noes N/A Tigard Trans SDC: in es ❑ N/A / Parks SDC: �l es ❑ N/A LIDA 7 Yes ❑ N/A OK to Issue Permit Approved by Permit Coordinator: Date: (to1/Z 1 21 1:\Building\Forms\BldgPermitRvw_RES_122419.docx RECEIVED •-s(C1canWateeServices CITY OF TIGARD Our commitment is deer. UILDIN Ir DIUJSI CWS File Number Service rrovi er Le ter 20-002022 This form and the attached conditions will serve as your Service Provider Letter in accordance with Clean Water Services Design and Construction Standards (R&O 19-5, as amended by R&O 19-22). Jurisdiction: City of Tigard Review Type: No Impact Site Address 9655 SW 74th AVE SPL Issue Date: August 19, 2020 /Location: Tigard, OR 97223 SPL Expiration Date: August 19, 2022 Applicant Information: Owner Information: Name BRIAN LEET Name MICHAEL JEFFS Company Company Address 7498 SW RED CEDAR WAY Address 116 CALAN CT TIGARD OR 97223 CLOVIS NM 88101 Phone/Fax 503-928-4103 Phone/Fax 575-268-1612 E-mail: brian@truluma.com E-mail: Tax lot ID Development Activity 1S125DC00500 Single Family Residence Pre-Development Site Conditions: Post Development Site Conditions: Sensitive Area Present: X On-Site X Off-Site Sensitive Area Present: C I On-Site X Off-Site Vegetated Corridor Width: 50 Vegetated Corridor Width: 50 Vegetated Corridor Condition: Marginal/Degraded Enhancement of Remaining Vegetated Corridor Required: X Square Footage to be enhanced: 26,147 Encroachments into Pre-Development Vegetated Corridor: Type and location of Encroachment: Square Footage: No Encroachment 0 Mitigation Requirements: Type/Location Sq. Ft./Ratio/Cost No Mitigation 0 X Conditions Attached X Development Figures Attached (2) X Planting Plan Attached Geotech Report Required This Service Provider Letter does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered on your property. Page 1 of 6 f y CWS File Number 20-002022 In order to comply with Clean Water Services water quality protection requirements the project must comply with the following conditions: 1. No structures, development, construction activities, gardens, lawns, application of chemicals, uncontained areas of hazardous materials as defined by Oregon Department of Environmental Quality, pet wastes, dumping of materials of any kind, or other activities shall be permitted within the sensitive area or Vegetated Corridor which may negatively impact water quality, except those allowed in R&O 19-5, Chapter 3, as amended by R&O 19-22. 2. Prior to any site clearing, grading or construction the Vegetated Corridor and water quality sensitive areas shall be surveyed, staked, and temporarily fenced per approved plan. During construction the Vegetated Corridor shall remain fenced and undisturbed except as allowed by R&O 19-5, Section 3.06.1, as amended by R&O 19-22 and per approved plans. 3. If there will be any activity within the sensitive area, the applicant shall gain authorization for the project from the Oregon Department of State Lands (DSL) and US Army Corps of Engineers (USACE). The applicant shall provide Clean Water Services or its designee (appropriate city)with copies of all DSL and USACE project authorization permits. No wetland impacts proposed for this project. 4. An approved Oregon Department of Forestry Notification is required for one or more trees harvested for sale, trade, or barter, on any non-federal lands within the State of Oregon. 5. Prior to ground disturbing activity an erosion control permit is required. Appropriate Best Management Practices (BMP's)for Erosion Control, in accordance with Clean Water Services' Erosion Prevention and Sediment Control Planning and Design Manual, shall be used prior to, during, and following earth disturbing activities. 6. Prior to construction, a Stormwater Connection Permit from Clean Water Services or its designee is required pursuant to Ordinance 27, Section 4.B. 7. Activities located within the 100-year floodplain shall comply with R&O 19-5, Section 5.10, as amended by R&O 19-22. 8. Removal of native, woody vegetation shall be limited to the greatest extent practicable. 9. The water quality swale and detention pond shall be planted with Clean Water Services approved native species, and designed to blend into the natural surroundings. 10. Should final development plans differ significantly from those submitted for review by Clean Water Services, the applicant shall provide updated drawings, and if necessary, obtain a revised Service Provider Letter. 11. The Vegetated Corridor width for sensitive areas within the project site shall be a minimum of 50 feet wide, as measured horizontally from the delineated boundary of the sensitive area. 12. For Vegetated Corridors up to 50 feet wide,the applicant shall enhance the entire Vegetated Corridor to meet or exceed good corridor condition as defined in R&O 19-5, Section 3.14.2, Table 3-3, as amended by R&0 19-22. 13. Removal of invasive non-native species by hand is required in all Vegetated Corridors rated "good." Replanting is required in any cleared areas larger than 25 square feet using low impact methods. The applicant shall calculate all cleared areas larger than 25 square feet prior to the preparation of the required Vegetated Corridor enhancementlrestoration plan. 14. Prior to any site clearing, grading or construction, the applicant shall provide Clean Water Services with a Vegetated Corridor enhancementlrestoration plan. Enhancement/restoration of the Vegetated Corridor shall be provided in accordance with R&O 19-5,Appendix A, as amended by R&O 19-22, and shall include planting specifications for all Vegetated Corridor, including any cleared areas larger than 25 square feet in Vegetated Corridor rated"good."" 15. Prior to installation of plant materials, all invasive vegetation within the Vegetated Corridor shall be removed per methods described in Clean Water Services' Integrated Vegetation and Animal Management Guidance, 2003. During removal of invasive vegetation care shall be taken to minimize impacts to existing native tree and shrub species. Page 2 of 6 CWS File Number 20-002022 16. Clean Water Services shall be notified 72 hours prior to the start and completion of enhancement/restoration activities. Enhancement/restoration activities shall comply with the guidelines provided in Planting Requirements (R&0 19-5, Appendix A, as amended by R&O 19- 22). 17. Maintenance and monitoring requirements shall comply with R&O 19-5, Section 2.12.2, as amended by R&O 19-22. If at any time during the warranty period the landscaping falls below the 80% survival level, the owner shall reinstall all deficient planting at the next appropriate planting opportunity and the two year maintenance period shall begin again from the date of replanting. 18. Performance assurances for the Vegetated Corridor shall comply with R&O 19-5, Section 2.07.2, Table 2-1 and Section 2.11, Table 2-2, as amended by R&O 19-22. 19. Clean Water Services will require an easement over the Vegetated Corridor conveying storm and surface water management to Clean Water Services or the City that would prevent the owner of the Vegetated Corridor from activities and uses inconsistent with the purpose of the corridor and any easements therein. 20. Final construction plans shall include landscape plans. In the details section of the plans, a description of the methods for removal and control of exotic species, location, distribution, condition and size of plantings, existing plants and trees to be preserved, and installation methods for plant materials is required. Plantings shall be tagged for dormant season identification and shall remain on plant material after planting for monitoring purposes. 21. A Maintenance Plan shall be included on final plans including methods, responsible party contact information, and dates (minimum two times per year, by June 1 and September 30). 22. Final construction plans shall clearly depict the location and dimensions of the sensitive area and the Vegetated Corridor(indicating good, marginal, or degraded condition). Sensitive area boundaries shall be marked in the field. 23. Protection of the Vegetated Corridors and associated sensitive areas shall be provided by the installation of permanent fencing and signage between the development and the outer limits of the Vegetated Corridors. Fencing and signage details to be included on final construction plans. This Service Provider Letter is not valid unless CWS-approved site plan is attached. Please call (503) 681-3667 with any questions. Stacy Benjamin Environmental Plan Review Attachments (3) Page 3 of 6 . - , _ 1_• TAX LOT 3900 MAP. 1S 1 25D8,• I --- _. CWS FILE NO. 20-002022 --__. Approved _Y Clean Water Services - _", FO ENVIRONMENTAL REVIEW _ _ — — r Byc (�Date8/19/2020 1 1 i SPL ATTACHMENT 1 OF 3 %' % SW BARBURA snrvc 1 - ____________________„ USE -... � , - - - -TAX tOT-500 MAP 15 1 25DC- -- DEGRADED4 1 �, 1 j 0%----- -------,----- l, , _A-g—1,,)✓ i / I VC-1 _ - - 1 • .fly A.,.,.; ,,,:. f�% i 50.0' ,i I TAX LOT 7400 y m PA2, �{ I,• MAP 15-1-25C v vN 17 ` ' M y WETLAND DP= ` j.•' . , Tr •M , ,/3, STREA MARGINAL: i /- — DEGRADED '50.0' ±5,426 SF ' ±17,804 SF �� }� --- 6 DP-4 '''.' TAX LOT 9200 , .�, -__ _ _._ 23% - - MAP 1S-1-25CD1 / WETLAND .� — — , -- ------------ { •- _.- --••SDP?" __ - T9.X'"L97,,11d0, � �,,; MAP ,'15=1=25DCi i� '- Vegetated Corridor: 26,147 SF Sensitive Area: 3,954 SF • VC Data Plot Photo Point Marginal: 8,343 SF • Wetland Data Plot Degraded: 1 7,804 SF 1' Contours Environmental Figure 4831NEFremontSt., Existing Conditions C gu re 3 Assessment, LLC suite 2B 9655 S W 74th Avenue A l Base Map Source: Portland,OR 97213 V Phone: 503.478.0424iiii 1"=40' Modified By: KR www.esapdx.com Tigard, Oregon iiiimi� Date: 6/20 Project No. 0 20 40 Rev: 00/00 20023' J /—' -J / Ii CWS FILE NO. 20-002022 `� A roved ��S$- 12'2.9"E / Clean Water Services — — _ F0 ENVIRONMENTAL REVIEW \ 3���,_ — _ BysVJ(�Date 8/19/2020 i\ zo o boo, 1 ,b SPL ATTACHMENT 2 OF 3 40'---1 _ — ' PROPOSED f :l- PROPOSER' DRIVEWAY '11 HOUSE-. \-i" i 2SL mil;--20'_H i dY(�J990 SF) _"" ` PROPOSED / i- v` 1 TAX- LOT 500 (aoo sF� �• I\\ .1'' \ MAP 1S 1-25DC \ � LEIS \ I \ N — 1-0 o)- �'_ DEGRAD - MAR�GINAL` VEGETATED ._1.-_, (,`�� � Vw//I CORRIDOR / L d' I �� L1 1 \ \\. .. �;r _ C / 1� �� / \ CORRIDOR N —_� _ /i �/ /�T� IZ (� 5TREA M �� m J w w v' 4' \ '\ '— ±1 7,804 SF I 50'VEGETATED / , / �, WF�TLAND,I, ,�, - _ _ �\ // 1�17 CORRIDOR i // MARGINAL / i JJ y _ //// �/ ±5,426 SFi 1 WETLAND 1 �- DEGRADED ' 50' ail / ,' 1(,/—fi-- i , / WETLAND 1 // I / . Vegetated Corridor: 26,147 SF Sensitive Area: 3,954 SF VC Enhancement: 26,147 SF 192 Trees & 1 ,016 Shrubs 1'Contours Environmental A Figure 4 Science& 4831 NE Fremont St., Site Plan Assessment, LLC Suite 28 9655 SW 74th AvenueBase Map Source: Portland,OR 97213 N Phone: 503.478.0424 1"=40' Modified By: KR www.esapdx.com Tigard, Oregon . Date: 6/20 Project No. 0 20 40 Rev: 00/00 20023 w 9655 SW 74th Avenue, Tigard, Oregon—CWS Site Assessment Table 1. Plant List for Enhancement Area Plant Plant Spacing Total Common Name Scientific Name Number of Form/Size (ft on center) plants Enhancement Area 26,147 SF Trees 207 Vine maple Acer circinatum 2 gal/24" 10 ft O.C. 45 Red alder Alnus rubra 2 ga1/36" 10 ft O.C. 40 Oregon Ash Fraxinus latifolia 2 ga1/36" 10 ft O.C. 40 Big leaf maple Acer macrophyllum 2 ga1/36" 10 ft O.C. 42 Western red cedar Thuja plicate 2 ga1/36" 10 ft O.C. 40 Shrubs 1,309 Red-osier dogwood Comus sericea Bare root/18" Clustered 2 ft 145 O.C. Twinberry Lonicera 1 ga1/18" 4-5 ft O.C. 145 involucrata Osoberry Oemleria 1 gal/18" 4-5 ft O.C. 145 cerasiformis Pacific ninebark Physocarpus 1 ga1/24" 4-5 ft O.C. 145 cariatus Serviceberry Amelanchier 1 gal/2' single 149 alnifolia Cascara Rhamnus 1 ga1/1.5' cluster 145 purshiana Baldhip rose Rosa gymnocarpa 1 gal/18" 4-5 ft O.C. 145 Tall Oregon grape Mahonia aquifolium 1 ga1/6" single 145 Snowberry Symphoricarpos 1 gal/18" 4-5 ft O.C. 145 a/bus TOTAL 1,516 NOTES: 'Substitutes for plant form(e.g.bare root)and species may be used based on availability.2 Individual species quantities to be determined during landscaping Table 2. Enhancement Area Seed Mix Common Name Scientific Name Percentage of Seed Mix Native Wildflower/Grass Mix Spike bentgrass Agrostis exarata 20 California brome Bromus carinatus 15 California oat grass Danthonia califomica 20 Blue wild rye Elymus glaucus 30 Meadow barley Hordeum brachyantherum 15 TOTAL 100 *Seeding rate of pure live seed(PLS),35 pounds per acre for hydroseed application. **Seed mix application quantity is to be calculated for VC planting area and is subject to availability and measure PLS. CWS FILE NO. 20-002022 Approved Clean Water Services FOR ENVIRONMENTAL REVIEW By SN ' Date 8/19/2020 SPL ATTACHMENT 3 OF 3 Environmental Science&Assessment, LLC Page 5 FOR OFFICE USE ONLY—SITE ADDRESS: G/sD/0Y 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 =. Transmittal Letter TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: ALLYSON ARMSTRONG DATE RECCEIVED:DEPT: BUILDING DIVISION RECEIVED FROM: DAN WILLIAMS JUN 3 0 2021 COMPANY: FASTER PERMITS CITY OF TIGARD BUILDING DIVISfON PHONE: 503-819-7754 I By: / ) . EMAIL: dan@fasterpermits.com RE: 9677 SW 74th AVe MST2021-00221 (Site Address) (Permit Number) (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. X Other(explain):Response to City Comments REMARKS: See attached narrative response and revised plans sheets to address City comments FORrF ICE USE ONLY Routed to Permit Technic' n: Date- (2 ( Initials: H Ii Fees Due: ❑ Yes ✓ NoovFee Descriptio : Amount Due: V $ Special Instructions: Reprint Permit(per PE): ❑ Yes No ❑ Done 7\ Applicant Notified: Date: 7/i L l) Initials:j \