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Permit CITY OF TIGARD MASTER PERMIT III • ' COMMUNITY DEVELOPMENT Permit#: MST2021-00175 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/17/2021 T I GAh T7 9 Parcel: 2S103DA04400 Jurisdiction: Tigard Site address: 10630 SW PARK ST Subdivision: FANTASY HILL Lot: 3 Project: Noles Project Description: 40 sqft bathroom addition/remodel/Plumbing on separate permit. BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 0 First: 40 sf Basement: 0 sf Left: 5 Parkinf Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 20 Smoke Dwelling Units: 0 Third: 0 sf Right: 5 Detectors: No Total: 40 sf Value: $4,898.40 Rear: 15 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 1 Clothes Dryers: 0 Heat Pump: Y Hoods: 0 Other Units: 1 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 1 0-200 amp: 0 W/Svc or Fdr: 2 Ea add'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ADD SF VB R-3 40 Owner: Contractor: NOLES,DAVID R AND MCKENZIE REMODELING Required Items and Reports(Conditions) MARGARET L 7635 SW 161ST DRIVE 10630 SW PARK ST BEAVERTON,OR 97007 TIGARD,OR 97223 PHONE: PHONE: 503-407-4742 FAX: Total Fees: $1,091.12 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 of 1.800.332.2344. Issued By: Holly Vanv De.Weje Permittee Signature: (r)vt/Arp1Le t±irvi Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. filMIMIlliim..“ 1. C6 �'i ICI tWIA ( L Ina le- dPaK � n`� �s . cvwt Building Permit Application B_ 4 29 21 Residential n ii,/c(n� FOR OFFICE 1.SE U'\LI City of Tigard EC 1 V C 1.J Received as o4 � e� Permit No..������/7�Date/By: • 13125 SW Hall Blvd.,Tigard,OR 97223 o Plan Review Phone: 503.718.2439 Fax: 503.598.1960 APB ;° 7ry " ' i Other Permit: t), Date/By: TIGARD Inspection Line: 503.639.4175 Date Ready/By: / t 1�J��., H See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARD Noti6 ethod:��4 / i 7 r"�J Supplemental Information 3 ILDING DIVISION, , ',-- TYPE � OF WO QUI D DATA:I-AND 2-FAMILY DWELLING I ❑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, a ro for the CATEGORY OF CONSTRUCTION work indicated on this application. (td Valuation: $ •ay-��, ; f 1-and 2-family dwelling ❑Commercial/industrial / ❑Accessory building ❑Multi-family Number of bedrooms: ❑Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: I Job site address: 10 c,3l0 S W PA-)2 K s'r New dwelling area: Lf.D square feet City/State/ZIP: 71 6_)e() r I✓G-0 N q 7'Z7-3 Garage/carport area: square feet Suite/bldg./apt.no.: ioject name: Covered porch area: 0 square feet Cross street/directions to job site: W A[K( t\i'Cm Deck area: • square feet c r(/�G- /vvi 1 `2 Zti 8 �' `VC Other structure area: square feet 1��/,tt r /" Gt'ov htr i& p 1,rrr- v-,-,�/-°\ \ REQUIRED DATA:CO MERCIAL-USE CHECKLIST Subdivision: f 4li"i A 5 r [-I(L L. / Lot no.: 3 Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: Lt..4 DO equipment,materials,labor,overhead,and the profit for the rr? i `� {, DESCRIPTION OF WORK �, work indicated on this application. 13ArRkt.O�� Ri.ri6bL1.../ 11ry4It.bfr— Valuation: $ Existing building area: square feet VOA( l M�kriu.„) tl New building area: square feet ❑ PROPER OWNER 0 TENANT J Number of stories: Name: A ,at.0 i 0 tZ 10 0(_S Type of construction: Address: t 0 6.S n 5 u) pit_A 1L ST Occupancy groups: City/State/ZIP: i(6-,,,t p,v. D jL q 7 L23 Existing: Phone:(5 )3) .:j i t tt — Ci`Z 14 ( Fax:( - —)----- New: 0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* Business name: j k'e L;`_ IZ Lroi-,ct e 1 n (Pteose refer take schedule) Structural plan review fee(or deposit): Contact name: .4kr" im(Ar...e,ryZ,C.__ FLS plan review fee(if applicable): Address: ' 3 f3 S t`/ (Lp 1 Sk- c �J Total fees due upon application: City/State/ZIP: ,r,`.. ,...7COO / o ) COO Amount received: Phone:( -3) -7_q 7.i-Z.- Fax::( ) PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: c. iqr ! Commercial and residential prescriptive installation of CONTRACT roof-top mounted PhotoVoltaic Solar Panel System. Business name: MCI e.t12' 'c i7- �C.)(.k£ 1 j 4-1 C; Submit two(2)sets of roof plan with connection details J and fire department access,along with the 2010 Oregon Address: 76;3 5 SL�.J 1 cc).5 . .. p,� Solar Installation Specialty Code checklist. Permit Fee(includes plan review $180.00 City/State/ZIP: " v,t; ip,,.5 CI Phone:( '',.3) /le7_ tJ 7S/L_ Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lie.: 1 Ci) g+-/ /`Gll1-`j ) Total fee due upon application: $201.60 Authorized signatu 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: ( tvit�,,ti,,�` Date: 4; -may L7 Zt 1 Service Board. L:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(1 l/02/COM/WEB) Building Permit Application Checklist One— and Two—Family Dwelling FOR OFFICE i SE OyLA City of Tigard Received Permit No.: -w 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: Assoc _ Phone: 503.718.2439 Fax: 503.598.1960iated permits: r T 1 G A R D 24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical Internet: www.tigard-or.gov ❑ Other: THE FOLLO\\ I\G 11 1..-)1S .kRE RLQt IRI:D FOR Pl..A\ RI-.A 11..A\ ti« Ni, y ' 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑ Si 3 Verification of approved plat/lot. 0 0 L. 4 Fire district approval required. Name of district: ❑ CI ri 5 Septic system permit or authorization for remodel. Existing system capacity 0 0 ".4 6 Sewer permit. ❑ ❑ , 7 Water district approval. 0 0 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ 9 Erosion control ❑plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- El ❑ .. basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state El building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size [ sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 1 I Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if V ❑ ❑ there is more than a 4-ft_elevation differential,plan must show contour lines at 2-f1.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 g1 ❑ ❑ and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, % ❑ ❑ 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- g ❑ ❑ 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. ( El ❑ 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- g El ❑ 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 ] ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ 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 g El ❑ 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 ❑ ❑ 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 $ El ❑ architect licensed in Ore.on and shall be shown to be.r r licable to the r ro'ect under review. .It RISDI( 110\ 'I. SPECIFIC, 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 1T'. ❑ ❑ ❑ 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. El ❑ ❑ 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale"indicates standard architect or engineer scale. ❑ El ❑ 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ ❑ 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, ❑ ❑ ❑ 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:\Building\Permits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Co NTACT EvuAi L: ekoIesdpak@__ntsl0. co 01 Mechanical Permit Applica FOR OFFIC (�I.ON I.) City of Tigard Received FOR E Permit No.: III 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: ' 1 cS�`J�u �`�(j b APR 2 ?02a Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: r I G A R D Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: t I H See Page 2 for Internet: www.tigard-or.gov Notified/Method: Il Supplemental Information BUILDING DIVISION TYPE OF WORK COMMERCIAL FEE* SCHEDULE -USE CHECKLIST Mechanical permit fees*arc based on the value of the work ❑New construction KAddition/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* 01-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist ❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Job site address: ) tt 5 Air conditioning 46.75 1 D 6 3 0 . U. P T Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: j i ,4-Q Ot & (Lt 0 _E t1 q 7'2_Z 3 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump Z 61.06 1 2Z,1 2 Suite/bldg./apt.no.: Project name: Duct work 23.32 Cross street/directions to job site: (4)` 7 1 ioS Hydronic hot water system 23.32 f Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 1 Flue/vent for any of above 23.32 Subdivision: F A-.T4- (VtL L Lot no.: 3 Other. 23.32 Other fuel appliances: Tax map/parcel no.: L{-it DO Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 Flue vent for water heater or gas 1A) STI I-'i- 1R / N 1 5Pt (T t t (M,+ST-t 2 &&V fireplace 23.32 Ns TA-L.L- R A,1 5J ( �L-1 r I N ELF I L ( °7 Q D()Wl Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 a I 1 't(.i 4-- roar) 1'5 c 1�6Chimney/liner/flue/vent 23.32 0 PRO RTY OWNER 0 TENA Other. 23.32 Environmental exhaust and ventilation: Name: 6 L i b R to b LE-3 Range hood/other kitchen equipment 33.39 Address: l D 6 7 $W /',)c4. k S i Clothes dryer exhaust 33.39 City/State/ZIP: 'j'( 6-,--j) 0 Q ►4}0q 7 Z (bathrooms, Z3 Single-duct exhaust ( C( toilet compartments,utility rooms) i 23.32 Phone:503) 5 4 4- — q 24 I Fax:, —) Attic/crawlspace fans 23.32 0 APPLICANT ❑ CONTACT PERSON Other: 23.32 Business name: (0 LA) &)t 1).._ ( N S`T A � T 1 (}N Fuel piping: S14.15 for first four;$4.03 for each additional Contact name: ) . rIej A.� . - Furnace,etc. Address: t/C v( ,� -�C Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( ) Fax::( ) Fireplace Range E-mail: Barbecue CONTRACTOR Clothes dryer(gas) Other: Business name: 06ukkaPi7 MECHANICAL PERMIT FEES* Address: Subtotal 1 22 e.t Z City/State/ZIP: Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:( ) Fax:( ) State surcharge(12%of permit fee) 1 it•(0 CCB lie.: TOTAL PERMIT FEE 1 3 6,,-7-7 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board Print name: Date: C\Buitding\Permits\MEC_PermitApp_040113.doc 440..4617T(11l02/COM/WEB) c_o p 7:4 l Elm k I L-: ik d 1 e3 j per K e__ ;USN . Co run Electrical Permit Application F (1v I 1 EC E I�IE FOR OFFIC E c`, Received City of Tigard Date/By: Permit#: H3Y2021-t I7S -• 13125 SW Hall Blvd.,Tigard,OR 97223 4DR c� (a ��? Plan Review g Phone: 503.718.2439 Fax: 503.598.1960 (� d Date/By: Related Permit it: Inspection Line: 503.639.4175 Ready Date/By: Juts: l Id See Page 2 for TiGARD CITY OF TIGARD Internet: www.tigard-or.gov Notified/Method: Supplemental Information /+ TYPE OF w dILDiNG DIVISION- PLAN REVIEW I 0 New construction Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑Demolition ❑Other: 0 Service or feeder 400 amps or more 0 Building over three stories. where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps al 150 volts or 0 Floating buildings. 'l-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived Job#: Job site address: (� n C y r� 7- ❑Addition of new motor load of system. j 06 3 b ✓id. t4K( 31 J I00HP or more. ❑«A,. E„ «I 2..:<1_3.. City/State/ZIP: �. ��'`y� j Z ❑Six or more residential units_ occupancy. T i h , ( ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: Project name: ❑Hazardous locations. 0 Supply voltage for more than �a� ❑Service or feeder 600 amps or more. 600 volts nominal. W Cross street/directions to job site: A-r-K( CVS FEE SCHEDULE Description I Qty. 1 Each I Total I New residential single-or multi-family dwelling unit. Subdivision: 1- At) T.+_s ✓ Li I 1...(_ Lot#: 3 includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax trap/parcel#: 4.t{-00 Ea.add'1500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential _ 75.00 2 rr t` ) e L �- 3 7 i+ 121)0 1 (1 �_ j1 I) 0�'.L. (with above sq.ft.) ft S L IJ Q ^� l� Limited energy,multi-family /0,51-A-(-L 2 It1 (IV I ,51" L ( I S residential(with above sq.ft.) 75.00 2 Renewable Energy 0 See Page 2 0 PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name: p Al) I A p_ Iti 0 L Cs 200 amps or less I 100.70 (OOt7 L3 2 Address: < 201 amps to 400 amps 133.56 2 l "�{ IL J 401 amps to 600 amps 200.34 2 City/State/ZIP: i /6-A-/lb/ ft 1 Z 2,q 3 601 amps to 1,000 amps 301.04 2 Phone:(]- )I) 4 4— q. li-1 Faxe-(--'-1 Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: 0 b i es d gl (� YfS tv ._ at-)1/LI relocation Owner installation:itis installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,le e,rent,or exch ge,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: _ 1 _ t. • f-d - _ __ Date: Iraq/Z u"Z.( 401 amps to 599 amps 168.54 2 0 APPLICANT 0 CONTACT PERSON Branch circuits-new,alteration,or extension, .er panel A.Fee for branch circuits with Business name: above service or feeder fee, .- 7.42 p`( 2 each branch circuit 1 rC' 7 Contact name: B.Fee for branch circuits without Address: service or feeder fee,first 56.18 2 branch circuit City/State/ZIP: Each add't branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Fax::( ) Each manufactured or modular dwelling,service and/or feeder 67_84 2 Email: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy ❑ See Page 2 2 Address: panel,alteration,or extension. Each additional inspection over allowable in any of the above City/State/ZiP: 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 Lie.: Electrical Lie.: Suprv.Lie.: specifically listed(S4 hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: e/ 5.S ',f Print name: Date: ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): r 3 .p(U Authorized signature: TOTAL PERMIT FEE: i 2G1 140 This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. • Number of inspections allowed per permit. 1:\Building U'ermits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(1 t/05/COM/WEB City of Tigard v COMMUNITY DEVELOPMENT DEPARTMENT 111 ■ RD'` Building Permit Review — Residential TIGA .0) .,.F r . a ,.�: , bisN&AUtilibffstP,OallitilitatintitiV4PM4tiStP4190011M. Building Permit #: Kil ST 2OZ 1 Zit 75 Site Address: 10630 C(A) iP#4R - SNT. Project Name: N'(3t.- -- ( rrmw sy 1-t-tu:) ' Lot #: Planning Review Pro al: P j PL- -D't)t'--/i��(/\cl0J Verify address/suite#active in Accela. - ver errace: JQ No ❑ Yes, River Terrace Review Addendum Sitete Plan Elements: Erosion Control 1A3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper WA 1,0�1/Retained trees with drip line and tree protection measures gawn to scale (standard architect or engineer scale) IArootprint of new structure(including decks) and FFE ar.rth arrow [21f>dity locations&easements(required for new and additions) address,project or subdivision name and lot number (QSt ewalk/driveway approach Prlicant information(name and phone number) Ztocation of wells/septic systems Lot dimensions and building setback dimensions /A. [)I eet tree size,type and location tilt opS are footage of buildings to be demolished L,GJStreet names Axisting structures on site Corner elevations(2'contours if more than 4'differential) lLot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑Yes No Ofh iCervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑YesNo Clean Water Se ices—Service Provider Letter (lot platted prior to 9/10/1995): equired: ZYes,applicant was notified ❑ No Received: ❑ Yes El No Water Meter F. tore Unit Worksheet—Additions,Remodels and ADUs Required: Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No OIk l l SDC Exemption for ADU applied for: 'E I4c3 ❑ No- Received: ❑ Yes ❑ No ❑ Public Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified ❑ No App ied For: ❑ Yes ❑ No,stop intake Vand Use Case#: N/ Zoning: p 3•,S--- equired Setbacks: Front: 20 Rear: /S Side: ' Street Side: IS— Garage: 2 g Building Height: Max. Height: 3S / Actual Height: Landscape Area: J!� % C�] Lot Coverage Max: ��� 0/0 'l'N ntrance Set back no more than 8'from street-facmg wall ❑ Parallel to street or offset 45 de rees or less �" Windows Ill11 Minimum 12%of area of all street-facing facades Garage Garage door is behind widest street-facing wall ❑ Yes o,one of the following is met: ❑ t)o ends no more than 5'from wall and there i vexed porch extending beyond garage. ❑ Door extends no an 5'from there is a 12 sq ft.window above garage on 2"d floor. ❑ Garage door width is ❑ ' ess %or less of facade ❑ 60%or less and includes 7 of following: ❑ Cove rc ❑ Recessed entrance et ❑ 1'Roof eave ❑ Roof offset ire shingles ❑ Lap Siding ❑ Roof pitch ❑ Ga , • ambrel roof ❑ Dormer ❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window pro ❑ Balcony I\ Visual Clearance g))� Urban Forestry Plan Sensitive Lands: ❑ Yes Z No Type: Conditions met prior to issuance of building permit : Approved By Planning: Date: /3/V.I Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved 1:\Building\Forms\BldgPennitRvw RES_122419.docx rrll . Building Permit Submittal Original Submittal Date: O4/Zg/202J Site Plans: Building Plans: # Building Permit#: LJ Enter building permit#above. Workflow Routing: Er-Planning 'Engineering Ig'P ermit Coordinator DTuilding Workflow Sign-off: [Sign-off for Planning(include notes from planning review) Route Application Documents: [Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. [Building: original permit application, site plans,building plans,engineer and beam calculations and rust details,if applicable,etc. Notes: By Permit Technician: "":41r ! Date: 12/4/2024 Engin ring Review ?� Slope at building pad: [onditions"Met"prior to issuance of building permit f2'Easements (encroachments)per engineering conditions of approval and plat later Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes Er-No Assess Water Quantity Fee in-lieu: ❑ Yes ET-No LIDA Facility on lot: ❑ Yes C2ro Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: oved by Engineering: n K . Date: 6-- 'Zc'Z ) Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: El Approved El Not Approved Permit Coordinator Review KA_Conditions "Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: ,'SDC Exemption: ElReceived ji Does not apply SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes 12'N/A Tigard Trans SDC: ❑ Yes /N/A Parks SDC: ❑ Yes 7N/A LIDA ❑ Yes /N/A ,Zr OK to Issue Permit Approved by Permit Coordinator: / ' __ Date: 61Liit01.4 I:\Building\Forms\BldgPermitRvw_RES_122419.docx RECEIVED JUN 1 7 2021 CleanVvater Services RD SENSITIVE AREA PRE-SCREENING SITE S►i-1- �:�► I Ai yEERING Clean Water Services File Number 21-001516 1. Jurisdiction:Tigard 2. Property Information(example: 1S234AB01400) 3. Owner Information Tax lot ID(s): 2S103DA04400 Name: David R Noles 4400 Fantasy Hill lot 3 Company: Address: 10630 SW Park St OR Site Address: 10630 SW Park St City,State,Zip: Tigard,Oregon,97223 City,State,Zip:Tigard,Oregon,97223 Phone/fax: 5035449241 Nearest cross street: Watkins Email: nolesdpak©msn.com 4. Development Activity(check all that apply) 4. Applicant Information ® Addition to single family residence(rooms,deck,garage) Name: David R Noles ❑ Lot line adjustment 0 Minor land partition Company: ElResidential condominium 0 Commercial condominium Address: 10630 SW Park St ❑ Residential subdivision ❑ Commercial subdivision City,State,Zip: Tigard,Oregon,97223 ❑ Single lot commercial 0 Multi lot commercial Phone/fax: 5035449241 Other Email: nolesdpak@msn.com 6. Will the project involve any off-site work? ❑Yes 0 No ❑Unknown Location and description of off-site work: 7. Additional comments or information that may be needed to understand your project: Site plan was submitted with plans 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 David R Noles Print/type title Signature ONLINE SUBMITTAL Date 5/12/2021 FOR DISTRICT USE ONLY ❑ 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. ❑ 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. ❑ THIS SERVICE PROVIDER LETTER IS NOT VALID UNLESS 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 �. Date 6/17/21 p g • Fax: (503)681-4439 Once complete,email to:SPLReview���deanwaterservices.or OR mail to: SPL Review,Clean Water Services,2550 SW Hillsboro Highway,Hillsboro,Oregon 97123 fRerse 1 212 020 Main Office • 2550 SW Hillsboro Highway • Hillsboro,Oregon 97123 • p:503.681.3600 1:503.681.3603 • cleanwaterservices.org FOR OFFICE USE ONLY-SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. III City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT le ■ Transmittal Letter i t,,,I'. r) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Allyson Armstrong DATE REC IVED• DEPT: BUILDING DIVISION R G E)VE D FROM: Brynn Adkins JUN -3 2021 CITY OF TIGARD COMPANY: TM Rippey Consulting Engineers BUILDING DIVI fOF eri PHONE: (503)443-3900 By EMAIL: badkins@tmrippey.com RE: 10630 SW Park,Tigard,OR 97223 MST2021-00175 • (Site Address) (Permit Number) Noles Residence Addition (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Additional set(s)of plans. Revisions: 1 Cross section(s)and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. 1 Engineer's calculations. Other(explain): REMARKS: Header added for window opening,holdown added to meet wall bracing line requirements(end condition 5 from ORSC Figure R602.10.7,and exception 2 from ORSC R602.10.2.2.1) Routed to Pe echn ian: Date: lD /g I Initials: PrVer Fees Due: Yes No Fee Description: Amount Due: $ ou t�l rbi e.w $ LfA $ $ Special Instructions: Reprint Permit(per PE): ❑ Yes KNo ❑ Done jikr______ Applicant Notified: Cate: (/(d))--( 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 it 111 Tran mi l Le tter tta T 1 G AR t) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Ai (kiS(jJ A IrrItiTY11 DATE RECEIVED: DEPT: BUILDING DIVISION _ RECEIVED FROM: F COMPANY: CITY OF TIGARD PHONE: ( 3) 541. - 24 1 BUILDING DIVISIOtk'BY:1 EMAIL: RE: /Olv?d S vv Palms, S-" MST2oz1 _ Obr7 5 (Site Address) (Permit Number) (VOLES (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. 3 Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: FOp7/3.. O FICE USE ONLY Routed to Permit Technician: Ite` �Q / Initials:Fees Due: ElYes lNo , Fee Descnptn: Amount Due: 1\.) oP- $ 752/ Special Instructions: Reprint Permit (per PE): ❑ Yes NP® No ID Done Applicant Notified: f �-- Date: (pG 2/ Initials: 1:\Building\Forms\TransmittalLetter-Revisions_073120.doc k4 S►2oLf Water Meter Fixture Unit Worksheet for Additions/Remodels/ADUs Please complete the following information: RECEIVED Customer Name: DAV10 R- N 0 LE S NAY 2 0 2021 Service Address: Street/Suite#: l 0 6 3 O S V L K. S T CITY OF TIGARD City: Ti G-A-k State: D k. zip: BUILDING DIVISION Phone Number: .5'03 -s-u k- g 2,1+( Email: n o I es c p a I@ ms r 4 C O M 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 1 = Bidet x 1 = x 1 = Clothes washer J x 4 = 14. x 4 = Dishwasher I x 1.5 = J, �j x 1.5 = 1s`Outside Water Spigot I x 2.5 = 2,t,, x 2.5 = Water Spigot,each add'l J x 1 = I x 1 = Kitchen sink I x 1.5 = x 1.5 = Laundry sink x 1.5 = x 1.5 = Lavatory(bathroom sink) 3 x 1 = 3 I x 1 = Water closet,1.6 GPF(toilel) 3 x 2.5 = '7,rj x 2.5 = Bathtub/whirlpool x 4 = x 4 = Shower stall t x 2 = 2. x 2 = Bath/shower combo / x 4 = 14 x 4 = Current Points: 27.0 Proposed Increase: Current Points+Proposed Increase= Z 8 =New Total Points =Required Meter Size SA Meter Sizes: 1 to 30 points=5/8" 30.5 to 37 points=3/4" 37.5 and over points= 1" New Meter Size Needed for New Total Points: Cost: $ (see page 1) Current Meter Size per Utility Billing: Cost: $ (see page 1) New Meter Size Cost minus Current Meter Size Cost= $ 0.00 (This is Your Cost to Increase Meter Size Due to Additional Fixture Units) ************************************************************************************* FOR OFFICE USE ONLY Current Meter Size Confirmed with UB J Bentley-no meter upgrade required 05/12/2021 Signature of UB Representative Date 1:/Building/Forms/WaterMeters_070120_Add.dOCX Page 2 -- -. ........................................... ..,..........r..crr.«. ..aa.aa.aseaxaxxxwxaxewxxn.wH+.wu. Hxia.ua+iu fauiw.uuiut uuuuHiutH4NldHliHHM1Yi1N)ifu3uxNuiH. d HituHu HFixuuut bsF+iHtuLlt ffbuaxfiutaf cu Hati... Julie Drinkwater From: #Building Permit Technicians Sent: Thursday, May 20, 2021 3:19 PM To: Dave Noles Cc: Contractor - Jeff McKienzie Subject: FW: Noles water meter work sheet - MST2021-00175 - 10630 SW Park St Attachments: 10630 SW Park St 051221.pdf Hello Dave, We have received UB's approval that the water meter does not need to be upsized for the added plumbing fixture. We will print a copy of the attached file and put with your permit file. The permit is currently under review and the permit technicians will contact you when the permit is ready to issue. Thank you. Dianna L. Ornelas Building Division Services Supervisor City of Tigard I Community Development 13125 SW Hall Blvd I Tigard, OR 97223 503-718-2430 Direct 1503-718-2439 Permits From: UB Online<UBOnlinepay@tigard-or.gov> Sent: Wednesday, May 12, 2021 1:40 PM To: Dave Noles<nolesdpak@msn.com>; #Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Cc: Contractor-Jeff McKienzie <mckenzieremodel@gmail.com> Subject: RE: Noles water meter work sheet Dave, Attached is the approved worksheet showing that there is no requirement to increase the meter size. Kind Regards, Jill (she/her/hers) till A WO Jill AF gxYrk 6 �.-,w City of Tigard -Utility Billing Senior Accounting.Asst (888)826-7211 Payments M m (503)718-2460 UB Main jillb®tigard-or.gov (503)718-2494 (p y 13125 St.'Hall Blvd, Tigard,OR 97223 From: Dave Noles<nolesdpak@msn.com> Sent:Wednesday, May 12, 2021 1:20 PM To: UB Online<UBOnlinepay@tigard-or.gov> 1 Cc: Contractor-Jeff McKienzie<mckenzieremodel@gmail.com> Subject: Noles water meter work sheet Caution! This message was sent from outside your organization. Please find attach our water meter worksheet. A few things I would like to point out: 1)This is not adding a bathroom, we are adding to the existing bathroom. The only change is there will be 2 sinks instead of just one, which is the main reason for the remodel in the first place. 2) The water main coming from our meter to the house is currently 1-1/4". It was replaced in 2004 when we hooked up to the city sewer. I'm not sure what size the meter is but we have no issues with water pressure. If there are any questions or need for clarification, please email or call me. Thank you Dave Noles 10630 SW Park ST Tigard, OR 97223 503-544-9241 ri DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained by the City of Tigard in compliance with the Oregon Administrative Rules"City General Records Retention Schedule." a z�l lfj }:fJ t4 .e'. 2 l�s Nikki Tuason From: Nikki Tuason Sent: Monday, May 3, 2021 3:48 PM To: nolesdpak@msn.com Cc: #Building Permit Technicians;Agnes Lindor; Lina Smith Subject: 10630 SW Park St.Tigard, OR Hi David, I finished the planning/zoning check for the proposed master bathroom addition for 10630 SW Park St. in Tigard, OR. Please expect an email shortly from the building department with your new permit number and permit fees due. Additional items—these don't need to be submitted immediately, but the Building Division will need them before they can issue the permit.When you receive these items, please send them to tigardbuildingpermits@tigard-or.gov: • Service provider letter from Clean Water Services (CWS)—please fill out this form and upload your site plan here: https://www.cleanwaterservices.org/documents-forms/pre-screen-form/ o When you receive a response from CWS, please submit a copy to the Building Division • Water meter worksheet(since it looks like you're adding bathrooms): o Please fill out this worksheet: https://www.tigard- or.gov/document center/UtilityBilling/Water MeterWorksheet-Additions Remodels ADUs.pdf o Submit the completed worksheet to UBOnlinePay@tigard-or.gov o Utility Billing will then respond to let you know if the current water meter size is sufficient for additional plumbing fixtures to be added, or if the water meter size needs to be upsized o Submit Utility Billing's response to the Building Division Thank you, Nikki Nikki Tuason Assistant Planner City of Tigard I Community Development 13125 SW Hall Blvd. Tigard, OR 97223 nikkit(ciltigard-or.gov 1