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Permit
CITY OF TIGARD BUILDING PERMIT `'' =. COMMUNITY DEVELOPMENT Permit#: MST2021-00127 Date Issued: 8/9/2021 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S136CA02500 Jurisdiction: Tigard Site address: 11065 SW 79TH AVE Project: Gathering Primary Dwelling Addition Subdivision: FRIENDLY ACRES Lot: 23 Project Description: Two-story addition to rear of existing single family residence and(1)ADU(see MST2021-00128 for ADU permit). Contractor: TGK CONSTRUCTION Owner: RESIDE, GRAHAM 4533 NE 17TH AVE OH, KLARISSA PORTLAND, OR 97211 1706 LILLIAN ST NASHVILLE, TN 37206 PHONE: 5013-505-0928 PHONE: FAX: Specifics: FEES Description Date Amount Type of Use: SF Class of Work: ADD Type of Const: VB DC Provision Review,SF-Ping 07/22/2021 $103.00 Occupancy Grp: R-3 Occupancy Load: Info Process/Archiving-Lg$2.00(over 07/22/2021 $46.00 Dwelling Units: 0 11x17) Info Process/Archiving-Sm$0.50(up to 07/22/2021 $9.00 Stories: 2 Height: 23.5 ft 11x17) Bedrooms: 3 Bathrooms: 2 Metro CET 07/22/2021 $228.12 Value: $190,098 Tig-Tual School CET-Residential 07/22/2021 $2,091.95 Tigard CET-Residential-Admin 07/22/2021 $76.04 Tigard CET-Residential-ODHCS 07/22/2021 $273.74 Floor Areas: Tigard CET-Residential-AH 07/22/2021 $1,551.20 Total Area: Branch Circuits wo/Purchase Service or 07/22/2021 $100.70 Accessory Struct: 0 Feeder Basement: 12%State Surcharge-Electrical 07/22/2021 $12.08 Carport: 0 Heat Pump 07/22/2021 $61.06 Covered Porch: 0 Duct Work 07/22/2021 $23.32 Water Heater 07/22/2021 $23.32 Deck: Wood/Pellet Stove 07/22/2021 $33.39 Chimney/Liner/FlueNent 07/22/2021 $23.32 Garage: Mezzanine: Total $8,085.97 Required: Required Items and Reports(Conditions) 1 Special Inspection-Bolts Fire Sprinkler: Parapet: installed in concrete Fire Alarm: Protected Corridors: 2 Ersn Cntrl 503-639-4175 Smoke Detectors: Manual Pull Stations: Accessible Parking: This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: (A0f4h:',4Permittee Signature: tsrr- 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. • -a14-rifei&-f-yki / 112 1 Mrs --z-717-74,--7-7-8---- Buildinp, Permit Application Residential RE( VE, s , , , ,- h...,..,}.i!SL ONLY City of Tigard IVA 0 1 2021 .1 .Rea.:,,,,B.,,,Il 1.1 s., ,202., Permit No..ti4Aleoti-obtrt l „.,. 13125 SW Hall Blvd.,Tigard,OR 97223 ' Plan Review4 I ' g 503.718 2439 Fax: 503 598 196t ; Duteift,„: I ' Other Pernut.610,01,4-..-60:765. Inspection Line: 503.639.4175 -v.:ITY OF TIGAR1..) __ auto Ready/By: Jut- 0 See Page 2 for I fill A ,1 Internet: www tigard-or.gov BUILDING DIVISION isi°' .almeth ' Supplemental information I TYPE OF WORK WWI D DATA;1-AND 2-FAMILY DWELLING ..-........—_ 0 New construction i 0 Demolition Permit fees*are based on the value of the work performed. 1 , Indicate the value(rounded to the nearest dollar)of all fri Addition/alteration/replaeement / 0Other: i„ equipment,materials,labor,overhead,and the pAt4the.,3.0 CATEGORY OF CONSTRUCTION ; work indicated on this application. 110 FNumber of bedrooms 3 Valuation: $. 4121;PC44°'P4 I-and 2-family dwelling m I 0 Comercial/industrial ._ . .... ! : El Accessory building 0 Multi-family t 0 Master builder er ; Number of bathrooms-. 2 SITE INFORMATION AND LOCATION Total number of floors: 2 lot site address. • ("L1/1*÷11-71.1 ADDITION; i 066 SW7'TH;-VE. - „ New dwelling arca: dip square feet —75- -. „„„._., ___„. City/State/ZIP: TIGARD;OR 97 , Garage/carport area: ,A square feet 7 • - Suite/bldg./apt,no.. rapt name. -7- 7:-6-*thc tiy - if-°22Iff 240 square feet )141(fik REQ°tDIciltlekra;:1t/Xert.alilitDu rAela'AletaC: ONIME—RCIALs-sUSEqquuffeareCHEtf:ecttC1KLIST ' Permit fees*arc based on the value of the work'Kills'med. Indicate the value(rounded to the nearest dollar)of all ( Subdivision FRIENDLY 1 _lb s I A CRsEws7gTH AVENUE40:/1WP:N.SW . ...,",,...":_0 . a SW IWUCE ST,,, ‘z-AfplAillitiae i - :„,,,d, A ir,-.-- ,- ,,..,-:,, , 4144 All ,,, Tax map/parcel no.: 1S13eCAO 2500 4 ,..... 141401,zerr-AO. for equipment,materials,labor,overhead,and the profit t the DESCRIPTION or WORK / work indicated on this application. _ " - . ' A NEW TWO STORY 1,505 SF ATTACHED ADDITION WILL BE ADDED TO":1 E MIST SIDE OE THE tIXISTING HOUSE. Valtiation: $ • tilE ADDITION WILL HAVE THREE BEDROOMS,TWO BATHROOMS,AND A LIVING ROOM tOOSEVVO3610.6F42446/14.) „ . Existing building area: square feet - ., - , u 'wWt , . - . ..irt•Fik.ScA-Muln..01 0-Au...Will tit . , -- Wi I AC New building area: square feet________• ;.,,, PROPERTY OWNER TIIIio' iiL Number of stories: Name- KLAR'SSA OH&GRAHAM RESIDE 1 ype of construction- Address- 1106b SW 79TH AVE. i.e:/4 Ett'5"r.,-, „ 411411 ,'''-- -'' '7,"i'' :f 7''ill Occupancs.groups. ('ily/State/ZIP: TIGARD,OR 97223 -i- V Existing: ithime ( ) F Fax:1 ) New: .' APPLICANT I tI: CONTACT PERSON ., BUILDING PERMIT FEES* , • (PkW."iff.wit!schedilk„, Business name: POLYPHON ARCHITECTURE&DESIGN,LLC , , Structural plan review fee(or deposit). 1 , , Contact name- SCHUYLER SMITH i r — 4 , ELS plan review fee fit'applicable). ; I — Address: 4103 NE TILLAMOOK STREET E - ' - -„- , . . ...--„ 1 Total fees due upon application: C ity/S tatc/Z1 P1 PORTLAND,OR 97212 II- . s , Amount received: Phone.( I 503.208.5678 I Pax:-( ) I. . , I PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* i-.mail: schayler@polyphon.com ,, Commercial and residential prescriptive installation of CONTRACTOR I roof-top mounted PhotoVoltaic Solar Panel System. .., - . Business name: TGK CONSTRUCTION.LLC Submit two i2)sets of roof plan with connection details . -1------------- --------------- and fire department access,along with the 2010 Oregon Address: 5433 ,NE 17TH AVE, Sake, Installation.5,-ecialtv Code checklist. ....._, ......_____ .,....... , ._..„. „. . .. „. _, .„ , .. , . , Permit Fee(includes plan review I PORTLAND,OR 97211 S180.00• , and administrative tees). Phone:( ) i ax i ) State surcharge(12%of permit fee): $21.60 ('Gil lic.: 216236 WiL?-si.,1 „. __I . --i- _ _ , Total fee due upon application. : $201.60 ! ) A It t hori zed signature- -i--- -,------ 'Otis pertuRaPplication expires if a permit is not riiitairsed . \ ; 1._ within 180 days after it has been accepted as complete. I .1•E..-tc methodology set by Tp-Couno Pudding Indust') Pratt name- SCHUYLER SMITH 1 Date I2 ,2 2:` J. I Service hoard. ; ;Fut IdingSPerm irtABt Tit-R ISPern JUAN.one 02124/26;1 140-461'5Tt 1 1/02/COMIWE PH i . , 11' ANINNOMMOuumeommesomm: Building Permit Application Che t'. z i t1 ,,. . One- and Two-Family Dwelling APR © 2021 Received 1o�z i)1 Flcl 1.SF: ()NIA City of Tigard Receive 1 Permit 10 �^�. _... 13125 SW Hall Blvd,Tigard,OR 97223 Girt(1(OF���A�© Associated permits i a Phone' 503-718 2439 Fax 503.598.1960 1 TIGARD 24-Flour Inspection tine. 503.639.4175 l��� �lVISION 0 Eleetr'cal , 0 Plumbing 0 Mechanical Internet: www.tigard-or,gov 0 Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN RE1 iEl% Nis No I A 1 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0+ ■ ■ ' 2 Zoning,. Flood plain,solar balance points,seismic soils designation,historic district,etc. '14 Ill M 3 Verification of approved plat/lot ►4 ❑ ❑ w 4 Fire district approval required Nar•ie of district ] 5 Septic system permit or authorization for remodel. Existing system capacity l 0 6 Sewer permit a 7 Water district approval "4 8 Soils report. Must c rr i one inal applicable stamp and signature cm file or with application. 4, ❑ i 9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch-'Jr 0 t basin protection,etc. Ill 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state • i-. ❑---- 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 _ I 1 I Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if .i there is more than a 4-11.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 ..4 and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, t .4 If 0 ❑ furnace,ventilation fans,plumbing fixtures. iand decks 30 inches above grade,etc. 14 Cross section(s)and details. Showll framing-member sizes and spacing such as floor beams,headers,joists,sub- r ii L j0 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,(hernial insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. mg— Exterior elevations must reflect the actual grade if the change in grade is greater than blur foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. t 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- ® 0 •• ❑ prescriptive path analysis provide secifications and calculations to engineeriiitz standards. 17 Floor/roof framing. Provide plans for all tloors/roof assemblies,indicating member sizing,spacing,and bearing i ® 0 locations. Show attic ventilation. _ 8 Basement and retainingwalls. Provide cross sections and details showingplacement ofrebar. Foren engineered ® iW 0 v ) 1g ❑ systems see item 22,:.Fn meet 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 tong and/or an'.beam/ioist earning a non unifonn load 20 Manufactured floor/roof truss design details. 0 ❑� 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ® 0 ❑ Mr lour or more apprlianccs. _ , b requiredprovided, _ _ 22 Engineer's calculations. When or (i.e.,shear wall,roof truss)shall be stamped by an engineer or ! i:+ ❑ architect licensed in Ore•on and shall be shown to be a i licable to the rolect under review. € JURISDICTIONAL SPECIFICS 23 Three(3Jsite plans are required for Item 11 above. Site plans must be 8-1/2 x 11 or 11 x 17 : 4 • ■■ 2,1 Two(2)sets each are required for items 16 19 20 and 22 above s<_ ❑ ■ "Mirrored"building 26 Reversed I'building l plans must meet�criteri outlined in the Permit&1i System n vell not be accepted.esdocument. _ El Development Fees document. 27 "Drawn to scale"indicates standard architect or engineer scale. i ❑ ' ■ '• 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of"f figard 0 i .Zi- Street Tree .,......_ .......__._.._.. ...m. ,__...-.... w,_ .....ist. 29 Site plan t Lnclude trees and treeprotection measures as required b•conditions o I a roval. Tree locations,do lines ❑ I...rl .k.._N P q y PP P � t and protection measures must be drawn to scaleand must include the ,roiect arbor t s si, ture of approval. —i 1:1tluilding'Penm its\t3UP-RESPermitApp doe 02/24/2011 440-4613T(I 1 l02/COM/W(1B) o / . 11' , L /I /2I NT' — -?f`' .' i vrt--- Mechanical Permit rApplicat;<.t t,-- _�_�� ._ 1fttt011II1.1`i f)'l1 L. City ofT4 Tigard } ReceivedN S"�26 M X t 6ot2'� Permit No * 131.2.5 SW Hall Blvd..Tigard,OR 97223 t 2021 .1 Dian Review n Phone: 503.718.2439 �Q� o OtherPe,tnit. W�20Z) Date;Ify: 13 lns cction Line: 503.639,4175 1 t t Aft 11 . hate Ready/Hy. 7 funs: Si See Page 2 for Internet: www.tigard-or.gov CITY T OF TIGARD Noiified'Nfethodi Supplemental information BUILDING DIVISION 1, -_____ _....�,...,. TYPEOF WORKGlSMERCfA,FEE*SCHEDULE_USE CHECKLIST ism . _ _�-. . . �._. .0 New construction 23 Addition/alteration/replacement -Mechanical permit tics are based on the value of the work performed.Indicate the value(rounded to the nearest dollar)of all Demolition `0 Other: mechanical materials ettaipment labor,overhead and t tutu CATEGORY OF CONSTRUCTION Value.$ El1-and 2-family dwelling 0 CommercialJindustrial ❑Accessory building RESIDENTIAL EQUIPMENT f SYSTEMS FEES*, For spacial information axe cbee*kst 0 MuIti fain ily ❑Master b er ` �. 0 Other. , g Description Qtr FA, Total • JOB SITE I MATIOT41 AND LOCATION� h. [ IleaRia cootitc Job site address: ADDITIO 11 SW 79TH AVE ADU 1 1 Air conditionui . 46.�4 .. ( �,� i Furnace 100,000 BTU(dc cts rents) 4b 75 Cily/State`GIP: TIGARD OR 97223 Furnace 100 t3t1t1+BTU duc sivcnts) 54.91 Sttitelbldgiapt.no.: P oject name , -fiaA'ff4ERII EDD1TlCI Heat one 61.06 . __. Cross street/directions wont to job st ihict walk i 3' l 79TH AVENUE BETWEEN SW I PFAFFLE ST AND SW SPRUCE ST. H dronic hot water m systit 23.32 Residential boiler(radiator or ( _. ..._ ._. .. h drontc 2:,.32 4 %Unit heaters(fuel-type,not electric), „ - ; i in watt.in-duct,suspended,etc, 46.75 --w _.,__ ..____-._,._ _ „ .�_�.. . .-� _ Fiuervent fvr ei of abov. 23.32 t. i Subdivision: FRIENDLY•ACRES Lot no 2500 IOther: 23.32 ...wM . . 'fax map/parcel no.: 1S136CAO2500 Other fuel a ,ttancas. - - Water treater,. _.. 23.32 • DESCRIPTION OF WO tIC Uaa firelaeefinsert 3139 • A NEW TWO STORY 1,50S SF ATTACHED ADDITION WILL BE ADDED TO THE EXISTING HOUSE.THE ADDITION WILL Flue vent for water heater or gas ,BE CONNECTED TO THE EXISTING HOUSE'S HVAC SYSTEM,AS WELL AS THE WATER HEATING SYSTEM.THE t + fireplace 23.32 ADDITION WILL HAVE A WOOD PELLET STOVE WI EXTERNAL COMBUSTION AIR AND THRU WALL DIRECT VENTING, i A NEW 350 SF ATTACHED STUDIO ADU WILL BE CREATED VIA CONVERSION OF THE EXISTING HOUSE WHERE TWO 1 s"1„,„h L"--"+,-as) t3 3� BEDROOMS AND A BATHROOM WERE PREVIOUSLY LOCATED. THE ADU WILL HAVE A NEW KITCHEN,AND THE 1 ;-Wood/peiiet stove .._t 33,39 EXISTING BATHROOM WILL BE CONVERTED TO THE ADO.THE ADO WILL HAVE A NEW WATER HEATER.AND ANEW ' • W"aod fir lacelinsert 23.32 WALL-MOUNTED ELECTRIC HEATER TO BE THERMOSTATICALLY CONTROLLED, _ Chtrnne)/1lnerflue/vent 2332, PROPERTY OWNER. 0 TENANT ,,, -1:1Other 23 32 Environmental exhaust and ventilation: _ .. Name: KLARISSA OH&GRAHAM RESIDE �� Range hoodlother kitchen Address; 11065 SW 79TH AVE. eqw ns nt 13.39 C aty.%State ZlP TIGARD,OR 97223 Llathe-s duct exhaust(bathrooms Phone: elletcomipartments utility morns) 23.32 I ( ) kiartssa ot1 mait.cgrtt Fax:( ) I Anicierawis tact trans 23.12 E3 APPLICANT 0 CONTACT PERSON I 3 .__ ..,..._ . .__.___� Other: 23.32 Business name, fly T ,', Ott 1) ; Fwel lrpin J, r t P Ste 15 for first Iour Sd U3 fur each additional Contact name ...,h + taS ! �� .Fumare otc , t ) i C.ta3 heat uni a Address: , I llt Y tU" a� � f, t t aty'StateIZIP I n I l �kallisus,Lended'''untt heater }'} 7 C. -,L,,.,t .,r...«, , 4. . ,, 7. 4 _ 7 Water r heater Phone t•2' ) L.I i it Fax ( ) Fire iaui_ ( `t _ �-Eaa7a i 1 0 4 M..;CDN >�,1 ) ,,,,.. ice.' t3ar ececue Y Clothes d= er t aas Business name: a) .. I` -C � k� ;"t # tither •� cc '4 MECHANICAL PERMIT FEES" .Address 2_...j_ N C. t" b a i 4 k k.' CT 1__ .�.�._ •�k,.-i� � -i, Subtotal.., sit.") . f aV$Idlc.t 1P. 1 {" , C ;, ._.. _..._ , i 1.... _I. -5 lr L � T Mmiinum permit fee $90 00 t r Phone:( I ) t a '� d Fax:( ) Plan review(25%of permu fee} Stan 4urc htuge l i 2%of permit fee) !'�-r a- CC'iflie.: ri I st'tL TOTAL AL PERMIT FEE 111'� ��� r'. ' ;<This permit appilcarion expires if perailt is not obtained within MU Authorized signature ,r days after It hat been accepted as complete. "'.. t ' Pee methodology an by i'ri-County Building Industry Service Hoard Litt name ) ,- 2 , , la 12c, lc, I.'•,f2u lid luePersnu NtiC_Penni:App ori2520.dac 4404611T t1)Kart O1WWM) :'ti RECEIVE' /.� -e- EleetricalllPermit Application 1 t,i,n1 I it: I.1 .Mr()'t 1 Art 01 2�21 y/S"/21 iur w1fT2t- OO(2.} Tigard "R" Permit#: 13125 SW Hall lvd,Tigard OR 97223(;o j}'OF'TIGARD Plan ReviewIt Rotated Permit#:SW Z I-�083 Phone: 503.718.2439 Fax: 503.598. gILDING DIVISION Daae/By: Inspection Line: 503.639.4175 Ready Date/Ely: I Jos: i 9I See Page 2 for t 1 LIr;1 ti L3 Internet: www.tigard-or.gov NotifedT dethod: q Bupplemcatnt Information TYPE OF WORK PLAN REVIEW ❑New construction Egi Addition/alteration/replacement Please check all that apply(submit a sets of plans whams checked): ❑Service or feeder 400 amps or more 0 Building over three stones. ❑Demolition 0 Other: where the evadable fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds t0,000 amps at 150 volts or 0 Floating buildings. igl I-and 2-frsmily dwelling 0 Commercial/industrial- CI-Accessory building less to ground,ar exceeds 14,000 0 Commercial-nee agricultural amps for all other installations. buildings. ❑Multi-family ❑Master builder 0 Other: p Fire pump. 0 Insudiation of I50 KVA or JOB S tNFoRMATI -i- VION fE ` 0 Emergency gem. larger separately derived Job#: Job site address: 065 SW 79TH AVE • 0 Addition of new motor toad of system. 20020 lOORP or more. City/State/ZIP: TIGARD,OR 9722,E ©Six or more residential units. occupitney. Q Health-carefacilities. ❑Recreational vehicle parka. Suite/bldg./apt.#: Project nilTe: t; t( ]ZI14Gittu TIOR l {ill a Hazardous locations. 0 Supply voltage for more than Q Service or feeder 600 amps or mom. 600 Volta nominal. Cross street/directions to job site: SW 79TH AVENUE BETWEEN SW FEE SCHEDULE PFAFFLE ST.AND SW SPRUCE ST. I cit. I mass I Total I • New retddendal single-or multi-family dwelling unit Subdivision: FRIENDLY ACRES 1 Lot#: 2500 includes attached garage. ' 1,000 sq.ft.or less I , usrt`-".-; ivy.54"'. ..:- Tax map/panel#: 1S136CA0 2500 Ea add't 500 sq.tL or portion ..,.., 33.93 , 3-}.f2 I DESCRIPTION OF WORK Limited energy,residential 75.00 2 A NEW TWO.STDRY 1.505 SF ATTACHED ADDMONW.L BEADtEO TO THE EXISTING NOUSE ANDCOtelECYEDTO THE EXISTING (with shove sq-ft) ELECTP5CA,...A350SFATTACHEDAOUWILLBECREATEDVIACONVERSIONOFTHEEXISI1NOHOUSEYMERETWOBDROOtMANDA ,,,, , .. , BATHROOM WERE PREVIOUSLY LOCATED.THE EXISTING BATtRoomTNIU.SE CONVERTED TO THE ADIJ,a ANEW KITCHEN WILL Limited energy,(With shove,i, 75.00 2 AI3itU THE ADUWALLBE HEATED BYAN ELECTRIC WAILMOUNTEDHEATER THE ADUVAILREQLVREANEWELECTRICALSUBPANEL : residemtiai(withaboves;l,ft. EZI PR�FERTY OWNER ❑ TENANT Renewable Eoet' _ 0 See.Page2 Services or feeders installation,alteration,and/or relocation Name: KLARISSA OH&GRAHAM RESIDE 200 amps or less 'fir. . 2 , 201 amps to 400 amps 133.56 2 Address: 11065 SW 79TH AVE. 401 amps to 600 amps 200.34 a ' 2 City/State/ZIP: TIGARD,OR 97223 :601 amps to 1,000 amps 301.04 - 2 Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 t 2 Temporary services or feeders installation,alteration,and/or Email: klarlssa.oh@gmall.com relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701, 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 0 APPLICANT ❑ CONTACT PERSON Branch thuds-new,alteration,or eatensiout per panel A.Fee for branch circuits with Business name: above service or feeder fee, 7.42 2 each branch circuit Contact name: 'a.Fee for branch circuits without , _ _ _ -- Address: service or feeder fee,first 56.18 2 branch circuit City(State/ZlP: Each add'l brunch circuit 7.42 2 Miscellaneous(service or feeder aot included) __ Phone:( ) I Fax::( ) Each manufactured or modular 67.84 2 Email: dwelling,sense and/or feeder Reconnect only 67.84 2 TRI-STAR ELECTRIC,INC. Pump or irrigation circle 67.84 2 Business name: CONTRACTOR Sign or outline lighting 67.84 2 Signal circuits)or limited-merry a See Page 2 2 Address: PO BOX 231175 i panel alteration,or extension. City/State/ZIP: TIGARD OR 97281 Each additional inspection over allowable to any of the above r Additional inspection(1 hr min) 66.25/hr Phone:(503 )860-3838 Fax:(503)590-2302 Investigation(1 hr min) 90 00/hr, Email: industrial plant it br min) 78.18/hr des s` �ahoo.com 7 Inspections for which no fee is 90.00/hr CCB Lic." _ Electrical Lit.: 34-620C i Suprv.Lic.: s vcifically listed i'4 hr min) 38325 1 ELECTRICAL PERMIT FEES Suety.Electrician signature,required: Subtotal: a 0 a.411 r Print name: RICH METZLER Date: 12/21/20 GI Plan Review Required(25%of permit fee): ,j. . State sunbelt(12%of permit fee) ,_. .2,t. ! Authorized signature: TOTAL PERMIT FEE. ---_- — - --- -1 This permit application aspires If a permit is not obtained,455bt 180 r Print name: Date: days after it bite been accepted as complete. .,.-,„.3 Mamba of inspeMions allow ed per permit l:IBuildiog\Permt,ELC_PereneApe BLR ERE.dac Roy c6/17/2015 404615TI1 lAISICOrt/wan ti.i c);) Electrical Permit Application—city of Tigard AtR 0 1 2621 Page 2—Supplemental Information OF TIGARD Limited Energy Permit Fees: BUILDING DIVISION Renewable Energy Permit Fees: rRESIDENTIAL WORK ONLY:: ---7 ERR SCHEDULE Fee for all residential systems combined: $75.00 . Descrittion Each : Total I Renewable electrical energy systems:Q" 1 ..:r 5 kva or less 100 70 1 2 Check Type of Work Involved: ,._. Audio and Stereo Systems* 7 , r5,50.0:0,,,,525kNkvla 2 .. 1 210033 3564 Wind generation mstems in excess of 25 kva: 11 B• urglar Alarm 25 01 to 50 kva / 301 04 2 ,.._..„. , 50 01 to 100 kva 552 26 2 n G• arage Door Opener* h>T00 kva(fee in accordance 1 1 cc, . 2 1 with OAR 918-309.0040. El H• eating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 I 7.42 I 3 i El Vacuum Systems* I00,kva-no additional charge 1 0.0 1 3 [._Each additional inspection over allowable in ant of the above: 1 El Other: Each additional inspection is 1 7 66 25/hr 1 chaned at an hour1::(1 hr min) 1 --t ..„ „ ..„, Inspections for which no fee is I 90.00/hr V2 srecificall,listed hr min) 1 .......„ : COMMERCIAL WORK 0NLY I ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 . Number of inspections Subtotal(Enter per permit jPage 1)1 t on i (SEE OAR 918-309-0000) Check Type of Work Involved: I I Audio and Stereo Systems I I Boiler Controls Li Clock Systems ' I Data Telecommunication Installation 0 Fire Alarm Installation U HVAC ID Instrumentation • . ! 0 Intercom and Paging Systems 0 I,andscape Irrigation Control* Medical ri N• urse Calls ' 0 Outdoor Landscape Lighting* E1 Protective Signaling Li Other: ' Total number of commercial systems: . *No licenses are required. Licenses are required for all ----j other installations 1 I,BuildinakPerinas‘ELC_PermaApp_ELR_ERE,doc itev 0647/2015 , RFrE-I y /i/21 NT-- Pliiinbbino,Permit Application A' '-,' `" 1 202' is , Iluilding Fixtures CITY OF TIGAI- 1 t,u ul fit , 1 ,,t om , city of Tigard BUILDING DIVISI ,i,� �7 D,te.s>.. y /s �Z1 u-r- I PanmtNo.:MS'oZI_OOI2 1 T 13125 SW Hall Blvd_Tigard,OR 9722;. — 1 .III Phone: Krvicw ^t V i ( 503.718.2439 Pax: 503.548.1960 nllicr Perini No.S wILw(/ Inspection t.inc: 503,C>39 4175 Date Ready/13y. Jars Bl See Page 2 for T I t Ii n 'Internet www.tigarci-or.gov Supplemental Information TYPE OF WORK FEE'` SCHEDULE f i New construction 0 Demolition _ -1 Fart 'al in armation use checklist. Description Ow Ea. ! Total aj Addiiion/alteration/replacement 0 Other. New 1-2-faxelly dwellings(includes 100 R.for each utility connection) CA tEC,ESRY OF CONSTRU i![tN SFR(1)b6th 312.'/0 i ..^_ SFR 2)bath ®I-and 2-family dwelling ` 0 Conunercial/Mdustrial (2 -._ 4fipfrntr.-, + SFR(3)bath ! 50012 ` ❑Accessory building 0 Multi-family 1 ----+ i —; S Each additional bath/kitchen I 25.02 t Blaster builder - ©Other: Fire sprinkler( sq.ft.) __-. .. .._. ^ i Page 2 TOR srry ORMAT O LOCATION Site utilities: ^.^.. --. Catch basin or area dram 18.76 ' Job site ddress ADMTI -1065 SW 79TH AVE. ADO_ _ Drywell,leach line,or trench drain 18 76 ; City State/ill': 11GAR©,OR 97223 ! W Footing dram(no.linear ft.: ) 3 Page 2 Suite/bldg/apt no Pr ject name: Q 1- 1 ^^y ^ ^ w m Nfanufactnrul home utilities � 50.03 6 Crossstreet/directions to I b site: S H NUE BETWEEN SW ' ! Manholes — 1 18,7ti A AF ST.AND SW SPRUCE ST_ ___._ i Rain drain manta:tot i 18,76 ` Sanitary sewer(no linear ft_: ) Page 2 _..._ Storm sewer(no.linear R: ) Page 2 Watts service(no.li scar R.:�3 L ; Page 2 ` Subdivision: FRIENDLY ACRES Lot no.: 2500 Future or item Tax map/parcel no.: 1S136CA0 2500 Backflow preventer 31.27 ' Backwater valve 12.51 I ' DESCRIPTION OF WORK A NEW TWO STORY'1.515 SF ATTACHE'!A01111ON ALL SE A0E1E0 TO THE EXISTING 5356E AND CONNECTED TO THE ±—Llothes washer 1 05 02 ! R. E ADDITION Will, VE Z NEW BATHROOM STORFtWATER RUNOFF fROM 1HE ADDII ION Dishwasher 5 TH EXISTING ISTI E E1 SF WHEFE TWO SEOSUT TO PIASHBNTHA BATAR ON SF ATTACHED PREVIOUSLYEEDADO LOL CATED.ATEIS ill EED VIA NAOIA OFASION OF Drinking fountain 1 25.02 WILL BE CONVERiEOTOT11EA0u(NEW SHOWS AOOE0),aA NEW KITCHEN Wii.LB EACCIED.THEAOQWALLBECONNECTEO ^^^^ ^^^^< - ` TO THE EXISTING HOUSES WATER ANJ SEWER, Ejectors/sump 25.02 PROPERTY"OWNER 0 TENANT Expansion tank 1, 12 51 5 it 1 I.Name: KLARISSA OH&GRAHAM RESIDE Fixture/sewer cap e 25.02 11065 SW 79TH AVE, floor drauJfloor sink/hub 25.02 f i Addn.s'• Garbage disposal L 25.02 �. . _._ City/State/ZIP: TiGARD,OR 97223 Hose bib 5 25.02 '. Phone ( ) klarissa,ehegmail.eo n , Fax:( ) Ice maker 4 12.51 0 APPLICANT 0 CONTACT PERSON inumxplor/grease trap j 25.02 Business name: Medical gas(value:$__,_,) I Page 2 Primer 12 51 j 3 Contact name: j Roof drain( er - I) i 12.SI Andress y t __w_ Sinko•bas' Uavamee 2� ' 25 02 c!� i y City/State/ZIP: Solar units le water) I 62.54 Phone ( ) J Fax ( ) Tub/show�lsbo er pew a i IZ 51 r� �, Tj.p I _. 1 If-ma k �„ Urinal 25 02 _.; __— . _ 1 Water closet Z 25.02 1 S0 D CON1RAC.TOR L.- ... �, _ _ 1 6Vater heater 37 52 Business name:Y. , t_u/4ST R.u LT;e3 k i !� 1 t.G \Water i in rDWV �� 56.29 Address y 3-7 73,6 E~ i_:; eJ co ST Other: 1 25.02 City/State/ZIP: Y Ct c:1-L.A t�S R- , v`123' Subtotal i S i a 314. mvtnt feu572sD Phone:l? �) d• 0S "' ,. jFax (S'L3) 2"1 ,%.f Z m. C(H Lie.:: ,5 t G I Plumbing Lie..no IS. Plan review t25%of permit fee) ,...._._- State surcharge(12%of permit feel 1 3'iTe AuUtcnrcd ttttc: �ttw � 2,4 TOTAL PERMIT FEE I Pr is e:aF..teb LA mg.: 1 ) 12 ,) 0 t This p`��appllraUoa t bon s if a accepted is not co obtained within IXO days ,. _._.._..._ _,._. ._........... ..... ... ^..,-.^-.._.-....^..,...,......,.._._._._.w..�._�,..._.,....; alter it bon been accepted�s complete. 'Ece matioiolore sei to Tre-Court.v litnicieig Irdom.v Ser.lee Hoard. I Ulr;idulTer,IAPLLiir-PennnArn.Ane 1,3501M9 401-4615T(00112//COMWERj RECEIVED AK 0 1 2021 . Plum bin .Permit Application - City of Tigard Page 2-Supplemental Information CITY OF TIGARD BUILDING DIVI, !ON Fee Schedule: Residential Fire Su ression Systems: 1 Site Utilities Qty, Fee(ea) Total Square Footage: Permit fee: _ Footing drain-l';100' .0.0 L.2,001 to 3,600 $169 69 0 to 2,000 $121.90 "1 1 Footing drain-each additional 100' 3 .52 1 3 601 to 7,200 5233.20 Sewer-1st 1.00' 62.54 1 7,201 and'theater $327.54 , Sewer-each additional 100' 37.52 „0..._ Waier Service-1st 100' s. 62.54 , Medical Gas Systems: Water Service-each additional MO' 37.52 Valuation: ; Permit Fee: -7 Storm&Rain Dram-1st 100' . 62.54 $100 to$5,000.00 Minimum fee$72.50 • • 1 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 , 372.50 for the first$5,000.00 and 151.52 for 1 each additional$100.00 or fraction thereof,to Other Inspections or Fees Qty. Fee(ea) Total i ; and includim•$10,000.00. Insilco:ion of existing plumbing or for 110,001.00 to S2r,0011-00 ;114430 lot tiiiiinritio-arir sT.Tiiii;r— which no fee is specifically indicated 90.00/hr l each additional$100.00 or fraction thereof,to (minimum char,e- 1/2 hour• , ; and includini•$25,000 00. Inspections outside of normal business 90.00/hr i $21,001:tioTc150,000.00 ' $379.50 for the First$25,000.00 idirtil745 far hours,rilltarraitTI charge—2 hoots, 1 each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr ; and including$50 000.00. ___.• Additional plan review for revisions _ . 1 $50,001.00 and up ----7$742.00 for the first$50,000.00 and$1.20 for mminimum char...e 1/2 houri 90.00/hr ,.. i i i 1 each additional$100.00 refraction thereof. subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Plan Review for Plumbing Installations 1 umsnik 1"/,.Fixture Type 1 Plea review is required for any of the following. Fixture Type for Repine Please check ail that apply. Work Performed: Capped Added Rehwate 0 Any new commercial building with water service 2"and Baptist;•./Font , .... greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool Car Wash -Each Stall k 0 New exterior plumbing site utilities for any complex structure , as defined in OAR9 1 8-780-0040. ' -Drive Thru 0 Medical gas and vacuum systems for health care facilities. Cusnidor/Water Aspirator , -Commer D 0 Any multipurpose fire sprinkler system. was ist her:icial li-in—g Fountain4knistic 4.. 0 Any complex structure-as defined in OAR918-780-0040. Drin E•e Wash Submit a sets of plans with any of the above. Floor Dram/sink: -2" . , . , Isonietric or kis' er Diagram 4. , 0 Isometric or riser diagram is required for new buildings • -Car Wash Drain that meet the qualifications above. Garbage -Domestic non-food .. , Disposal: -Domestic food related -Commercial food related ; . -Industrial food related Ice Mach./Refriii Drains Comments regarding fixture work: Oil 8...T:dater'Gas Station: • Rec.Vehicle Dusts;'Station Shower: -Gang . -Stall Sink: -Lay/Flar non-food related -Bradley ,. -Corn/Serv/Util food related Service .... — *NOtC: If the fix,turc work under this permit results in an Swimming Pool Fitter 4 increase of sewer EDUs,a sewer permit will be issued and Washer-Clothes - Water Extractor , fees assessed for the sewer increase must be paid before the , Water Closet-Toilet plumbing permit can be issued. Urinal Other II/dam' • 1 , • „....._— ~ • —..I . 1:\Build ing 1 Perm itskPLNIF_Penn itApp.doe 08/04/201 1 2 Plumbing Permit Applicatiq CCC I"e D Building Fixtures !'�G C d C FOR OFFICE I SF OyI.V City of Tigard AUG 3 2021 Plan Review Received B Date/By:y: , " 2. /.00/.?7 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503.718.2439 Fax: 503.598.1yiV T TIC?A�1 Date/By: Other Permit No.: Inspection Line: 503.639.4175 Bu+t nl�u^_ Divi Date Read/B Juris ® See Page 2 for T I G A R[7 Internet: www.ti and-or. ov LLlnw y y g g g Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑New construction ❑Demolition For special information use checklist Description [ Qty. I Ea. 1 Total Er 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 t 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 0 Accessory building 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 11065 SW 79th St Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: Tigard, OR g Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name:1.17 a,<sta/k. Manufactured home utilities 50.03 Cross street/directions to job site: .444675 Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Rough in and trim out two new bathroom in the house addition. Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Fixture/sewer cap 25.02 Name: Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 2 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax: :( ) Tub/shower/shower pan 3 12.51 E-mail: Urinal 25.02 CONTRACTOR Water closet 2 25.02 Water heater 37.52 Business name: D &Sons Plumbing Water piping/DWV 56.29 Address: 16500 NE 199th St Other: 25.02 City/State/ZIP: Battle Ground, WA 98604 subtotal Phone:( 971) 201-6148 Fax:( ) Z Ii / 3 Minimum permit fee: $72.50 CCB Lie.: 199766 s-l�i f Plumbing Lic.no.: PB1342 Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days Print name: Daniil Akimenko Date: 7/30/2021 after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. t.\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: Footing drain-I" 100- 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service- 1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 yaluation: Permit Fee: Storm&Rain Drain-1st 100' 62.54 V $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for (minimum charge 1/2 hour) each additional$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Plan Review for Plumbing Installations Quantity by Fixture Type Plan review is required for any of the follow ino. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate Baptistry/Font ❑ Any new commercial building with water service 2"and greater,except systems designed and stamped by licensed Bath: -Tub/Shower -Jacuzzi/Whirlpool engineer. Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure Drive Thr as defined in OAR918-780-0040. IDCuspidor/Water Aspirator Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system. Domestic ❑ Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eve Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" 3" Isometric or Riser Diagram ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain Garbage Domestic non-food that meet the qualifications above. Disposal: -Domestic food related -Commercial food related -Industrial food related Ice Mach./Refrig.Drains Comments regarding fixture work: Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -Lay/Bar non-food related -Bradley -Com/Serv/Util food related -Service *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and Washer-Clothes fees assessed for the sewer increase must be paid before the Water Extractor Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 City of Tigard in COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Review — Residential T 1 G A R D Building Permit #: MSI-2c7Z\—WI2T Site Address: II 0(0- 51Ai --1-01 1-{'' AV tJ• Project Name: 6,A'-} - -ram- 0 Lot #: Planning Review Proposal:_op Q'7 (TN c 1, J ( pet r4/may) 1� Verify address/suite# active in Accela. ❑ In River Terrace: No ❑ Yes,River Terrace Review Addendum Site Plan Elements: LEI rosion Control ZS copies of site plan on 8-1/2"x 11"or 11 x 17"paper ,it., ft Retained trees with drip line and tree protection measures Drawn to scale(standard architect or engineer scale) i21 otprint of new structure(including decks)and FFE l_1North arrow E Utility locations&easements(required for new and additions) Site address,project or subdivision name and lot number BSidewalk/driveway approach C,__//Applicant information(name and phone number) • ho [1Location of wells/septic systems of dimensions and building setback dimensions �" Street tree size,type and location []Square footage of buildings to be demolished Street names Existing structures on site forner elevations(2'contours if more than 4'differential) [17Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑Yes ❑No impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes ❑No All Clean Water Sevices—Service Provider Letter (lot platted prior to 9/10/1995): equired: JQ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No ifi Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs 4eDqaired: 12Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No C Exemption for ADU applied for: ❑ Yes ❑ No Received: ❑ Yes ❑ No Public Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes El No,stop intake ElLand Use Case#:_ ❑ Zoning: a. y ' quired Setbacks: Front: e249 Rear: I S Side: 5— Street Side: I Garage: Z Building Height: Max. Height: 501 Actual Height: 2 3 •5- I$l Landscape Area: N(A% 4J Lot Coverage Max: U/A. % Entrance Set back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less Windows [Minimum 12%of area of all street-facing facades Garage r is behind widest street-facing wall ❑ Yes: ❑ No,one o owing is met: ❑ Door extends no n 5'from wall and there is a covered tending beyond garage. ❑ Door extends no more than 5'from there' sq ft.window above garage on 2nd floor. ❑ Garage door width is ❑ 12'or less o or less o ❑ 60%or less and includes 7 of following: ❑ Covered porch ❑ entrance ❑ Wall offset ❑ 1 ve ❑ Roof offset ❑ Fire shin 1 Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel ro ❑ Dormer ❑ ent siding ❑ Window trim ❑ Window recess ❑ Window projection ony `,f Visual Clearance ❑ Urban Forestry Plan i" Sensitive Lands: ❑ Yes ❑ No Type: Conditions met prior to issuance of building permit Note • Approved By Planning: Date: Li/S a I Revisions (after Building Submittal only) Reviewer Date , Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw_RES_122419.docx :t Building Permit Submittal t Original Submittal Date: N/1//21 Site Plans: # 3 Building Plans: Building Permit#: # E er building pe # above. Workflow Routing: Ining Engineering Permit Coordinator Building Workflow Sign-off: S, -off for Planning(include notes from planning review) Route Application Documents: Engineering: (1) copy of permit application, (1) site plan, (1) building plan and iginal plan review routing form. Building: original permit application, site plans,building plans, engineer and beam calculations and trust details,if applicable, etc. Notes: 5uf3NntfT617 CA,NM,J SNb-p.. a"Yt N /l — By Permit Technician: < — Date: q©Z./ Engineering Review 'iope at building pad: a.Z [ Conditions"Met"prior to issuance of building permit N fa.. R.-Easements (encroachments) per engineering conditions of approval and plat it t4 E Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes YNo 4 4 Assess Water Quantity Fee in-lieu: El [Yes No '„iM"1 LIDA Facility on lot: CI Yes l N o ,,�f a► ��p01'" Oki ❑ Final Plat Recorded: 1 ✓ NOT Approved by Engineering: - ,J dh e y Date: y ftZ/gaZI Notes: n i i pe-r-Vi r/i RYCft e XUGFals /000 4 Z , ,g/4 tiS piee,/ /v 1' aa,.i Lion I Approved by Engineering: 7 H4-- 1grl-kei Date: stfiri&1_,( Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review Kitt-Conditions "Met"prior to issuance of building permit V Approved, NOT Released: &IAA/ Li DA on S Q Lcvn, AI, 4 l 161 w24 Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: SDC Exemption: ❑ Received Ze Does not apply lt#,DC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ,{' N/A Tigard Trans SDC: El Yes YJ N/A Parks SDC: El N/A LIDA ❑ Yes N/A OK to Issue Permit Approved by Permit Coordinator: _/1// Date: ��S-�.2� 1:\Building\Fonns\B1dgPermitRvw_RES_122419.docx Julie Drinkwater From: Schuyler Smith <schuyler@polyphon.com> Sent: Wednesday,June 23, 2021 4:34 PM To: Julie Drinkwater Subject: Re: Oh Primary addition and ADU Follow Up Flag: Follow up Flag Status: Flagged Warning!This message was sent from outside your organization and we are unable to Allow sender Block sender verify the sender. Julie, For sure.The ADU will be a studio.The house will then have 4 total bedrooms after the addition is completed. So four total, unless you count the studio ADU as another bedroom. Hope that makes sense. Let me know if you need additional info. Thanks, Schuyler I Schuyler Smith, Principal i Polyphon Architecture & Design, LLC I polyphon.com office:503.327.8679 I direct:503.208.5678 4103 NE Tillamook St. Portland,OR 97212 On Wed,Jun 23, 2021 at 4:29 PM Julie Drinkwater<JulieD@tigard-or.gov>wrote: Hello Schuyler I am currently post reviewing the permits for the Oh project, located at 11065& 11067 SW 79th Avenue, consisting of an addition to the primary home and new ADU. In order to access the fees for the sewer permit, we will need to know the total number of bedrooms, for the primary home and the ADU combined, that will be on the property once construction has been completed. Thank and please let us know if you have any questions. Julie Drinkwater 1 Permit Technician City of Tigard I Building Department 13125 SW hall Blvd Tigard, OR 97223 503-718-2804 • Due to an increased demand for services, please expect longer wait times for responses to emails,voice messages and building inspections. Requests for permit status may not be responded to until the permit is ready to issue. Other requests deemed non- essential,such as fee estimates,may take longer to respond. In the meantime, please view this quick guide on how to submit common service requests. 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." 2 Dianna OrnelasRFC:PIVE From: #Building Permit Technicians AQp3 © 1 Z0L1 Sent: Thursday, January 14, 2021 7:12 PM CITY(� T(�a�tw�, To: 'klarissa.oh@gmail.com' BUILDING C?Il/t l Cc: Christine Moody; Lina Smith Subject: 11065 SW 79th Ave (Primary) & 11067 SW 79th Ave (ADU) Attachments: SKM_C65921011418341.pdf; SKM_C65921011418340.pdf Hello Klarissa, Thank you for contacting me today about your permit submittal. Per our discussion,your application for an addition to the primary dwelling at 11065 SW 79th Ave and the conversion of existing space for a 350 sf ADU at 11067 SW 79th Ave is still under application completion review. Based on the building division's intake review, I have listed the following items that require attention: • Regarding SDC exemption for ADU, please contact Christine Moody at christine@tigard-or.gov for a copy of the exemption application and instructions for processing. This document will need to be completed and approved by our contracts and purchasing division, and a copy of the recorded document must be provided to the building division at TigardBuildingPermits(c@tigard-or.gov prior to building permit issuance. • The water meter worksheet was located in the application submittal packet (see attached), however we also need an email from Tualatin Valley Water District confirming that the current water meter size is sufficient or needs to be upsized to accommodate the additional plumbing fixtures added for this project. Please send TVWD email to TigardBuildingPermits@tgard-or.gov. This can be sent to us anytime prior to permit issuance. • Regarding the permit applications, we require that each address be permitted separately therefore we require a separate set of building, mechanical, electrical and plumbing permit applications for each address; (1) set for the addition, and (1) set for the converted space for the ADU. The permit fees and SDCs are assessed differently for ADUs vs the primary dwelling and we cannot combine them under one permit. I have attached the original applications submitted. Since the applications have already been signed by the contractors, it is ok to just copy another set and revise the address and contents of the items by separating them out for each address. We will also need a separate project valuation on the building permit applications for each area scope of work. Please note that the plan sets are ok as submitted with both areas of work on one plan set, we just need separate permit applications to create separate permits by each address. The completed applications can be emailed to TigardBuildingPermits@tigard-or.gov or submitted to the drop box in the lobby of the Permit Center, Monday- Thursday, 8 am to 5 pm. We are closed on Fridays, and will be closed for the holiday on Monday,January 18th. No appointment is necessary for submittal. Once we have the 2 separate sets of applications for each address,the application materials and plans will be routed to the planner on duty for their review. Upon their approval,the permit technicians will create the permits and contact with instructions to pay the plan review submittal fee online and the plans will be routed offsite for plan review. Please allow 4-8 weeks for review and the permit technicians will contact you when the permit is ready to issue and with instructions to pay the remaining balance due. Thank you and please let me know if you have any questions. 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 1 RECEIN/ED APR 01 2021 CITY Y OF .j.IGA D CleanWttcr Services !!4 glair-+ n;lti f.i7sO 9 SENSITIVE AREA PRE-SCREENING SITE ASSESSM-ENT • Clean Water Services File Number 20-003045 1. Jurisdiction: Tigard 2. Property Information(example: 1 S234AB01400) 3. Owner Information Tax lot ID(s): Name: klarissa 1 S 136CA02500 Company: Address: 11065 Sw 79th Ave .OR Site Address: 11065 SW 79th Ave. City,State,Zip: Tigard, OR, 97223 City, State,Zip: Tigard, OR, 97223 Phone/fax: 5038901895 Nearest cross street: Pfaffle Email: klarissa.oh@gmail.com 4. Development Activity(check all that apply) 4. Applicant Information I I Addition to single family residence(rooms, deck,garage) Name: klarissa oh ❑ Lot line adjustment ❑ Minor land partition Company: ❑ Residential condominium ❑ Commercial condominium Address: 11065 Sw 79th Ave ❑ Residential subdivision ❑ Commercial subdivision City,State,Zip. Portland, OR, 97223 ❑ Single lot commercial ❑ Multi lot commercial Phone/fax: 5038901895 Other ADU Email: klarissa.oh@gmail.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: We are adding on to our home and shifting 350 square feet in our house into an ADU. Thank you for all of your help! 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 klarissa oh Print/type title Signature ONLINE SUBMITTAL Date 11/2/2020 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. 10 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. Er THIS SERVICE PROVIDER LETTER IS NOT VALID UNLESS_ CWS APPROVED SITE PLAN(S)ARE ATTACHED. ❑ The proposed activity does not meet tie 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 Led4t x �t4Qi117t.re:¢2 Date 11/19/2020 Onc�e((//complete,email to:SPLReview@cleanwaterservices.org • Fax: (503)681-4439 OR mail to: SPL Review, Clean Water Services, 2550 SW Hillsboro Highway, Hillsboro,Oregon 97123 l 3 S 3: i 23 5 i ,1 to�..). i,,r: �J.!� � t:}��1�:..s.,.�t: i"'�°'fray €3,iIS�)GP'C==.4iC£';�Ct? # �,03 J,a.�'3�, :Sl3iJ�� 503.681 .3603 __ . i Tualatin Valley Water District , 0 , : '1-�, , si9 g t �E ttelivertn the Best Water Service , Value IL., Sizing of Residential Water Meter Worksheet Date: I . 10 . „D:4.O //el 4.,"_ _ , . . � �_ Site Address: il 4 Zip Code: gt 117.3 Subdivision/Lot#: �/ Q �,ir _ Builder/Contact Person: Phone: so ► . et . I V 1[ , Number of X Fixture unit = Fixture 1. Kitchen fixtures fixture(s) equivalent count A. Dishwasher 1 X 1.50 = 1 . 5 B Sink y X 1.50 = 1 2. Utility room fixtures A Washer I X 4.00 = 44 B. Laundry tub , X 2.00 = 3,Bath fixtures A Toilet 44 X 2.50 = 10 B. 1,avatory sink 41 X 1.00 = 44 C Whirlpool bath or shower/bath Z X 4.00 = _____S___ r 'Shower only2. X 2.00 = 4. Miscellaneous fixtures A. Outside hose bibb (enter only one here) X 2.50 - a• B Additional hose bibb X 1.00 C. Bar sink X 1.00 = D. Bidet X 1,00 F. Irrigation (Largest zone only) Number of heads: X 1.00 — 5.Total fixture count(fixture units), Total of 1 through 4 J aTC Additional questions: tI I) Witt the property have any of the following features? (check all that apply) { 1 Yes ' 40 t=1 Auxiliary water source, i.e. well, pond, spring or creek O Decorative water features, i.e. pond, hot tub or swimming pool .` 0 Solar heating unit, boiler, or hydronic radiant floor heating © Taller than three stories with a basement OR four stories and taller '1 Underground irngat.ori system F I. Is this property going to have a fire sprinkler system? -__ re __ Yes { 1 Per., f.' f yes, check the meter size; �_.I 3/4" 1 1„ 1t "r' 7..yew?`� t`. A QPV QF THE BUILDING I�EFiMiT AND PAYMENT 1S REQUIRE©AT THE TIM 3t ' '$ . " x r ,i.0 T.°, 1ICIf,IkJf 11,i!, ir. C'tof,C:£crrarl glijr:1? // . sc, ., ,16.->co:; Tj 'a.`,(`I-!,,,,I,2,:iI3'r if, °h',"-V ,,„,rc f. Y .. k Dianna Ornelas //0 (d 7 Ste) ` 7 6 - M7 From: Klarissa Oh <klarissa.oh@gmail.com> Sent: Monday, February 1, 2021 8:58 PM To: #Building Permit Technicians Subject: Fwd:water meter question Attachments: IMG_8664.jpg Categories: Dianna Caution!This message was sent from outside your organization. Hello,there. My name is Klarissa Oh, and I live at 11065 SW 79th Ave,Tigard, OR 97223. We are attaching this letter from TVWD to our permit application to confirm that we do not need to upgrade our water meter. If you have any questions, please reach out to me. Thank you so much for the attention and work on our application. Warmly, Klarissa Oh 503.890.1895 Forwarded message From: Michelle Rosa<Michelle.Rosa@tvwd.org> Date: Mon, Nov 16, 2020 at 3:03 PM Subject: RE: water meter question To: Klarissa Oh<klarissa.ohPgmail.com> Cc: Sarah Alton<sarah.alton@tvwd.org> Hi Klarissa, Thank you for your email and I apologize for the delay in responding to you. Based on the information attached that you provided,this email confirms that the existing 5/8" will be sufficient for the existing and additional fixture units you plan to add to your ADU. Your meter does not need to upgrade to a 3 " meter. Please let me know if you have any further questions. 1 NOTICE: Due to the COVID-19 front office closure,all Development Services payments(Plan Reviews, Meter Sales,and Fireflow testing payments)will be processed on Wednesdays. Payments may be mailed to our office,Attn: Meter Sales for quickest processing. Credit card payments over the phone may also be made on Wednesdays. Thanks, Michelle Rosa Engineering Administrative Assistant 1850 SW 170th Ave, Beaverton,OR 97003 direct 503-848-3028//office 503-848-3000 michelle.rosa@tvwd.org www.tvwd.org Tualatin Valley Water District Delivering the Best Water•Service•Value From: Klarissa Oh<klarissa.oh@gmail.com> Sent:Thursday, November 12,2020 2:33 PM To: Michelle Rosa <Michelle.Rosa@tvwd.org> Subject: Re: water meter question Hi Michelle, Thank you so much for this document and for the phone call. The conversation was very helpful for us as we plan, and I am greatly appreciative of your time and your communication. I have attached our planning document. I'm hopeful that we can confirm the sufficiency of our existing water meter at your earliest convenience. With many thanks, 2 Klarissa Oh 503.890.1895 On Wed, Nov 4, 2020 at 2:04 PM Michelle Rosa <Michelle.Rosa@tvwd.org>wrote: Hi Klarissa, Ivy directed you to the correct person. Attached is our residential fixture worksheet. Please review, complete and send back so I can confirm if your existing water meter will be sufficient for the ADU you are planning to add to your home. In the worksheet, please include the existing and additional fixtures you will be adding to your home. Please let me know if you have any additional questions. Thank you. NOTICE: Due to the COVID-19 front office closure,all Development Services payments(Plan Reviews, Meter Sales, and Fireflow testing payments)will be processed on Wednesdays. Payments may be mailed to our office,Attn: Meter Sales for quickest processing. Credit card payments over the phone may also be made on Wednesdays. Thanks, Michelle Rosa Engineering Administrative Assistant 1850 SW 170th Ave,Beaverton,OR 97003 direct 503-848-3028//office 503-848-3000 michelle.rosa@tvwd.org www.tvwd.org Tualatin Valley Water District Delivering the Best Water•Service•Value 3 ' From: Klarissa Oh <klarissa.oh@gmail.com> Sent:Wednesday, November 4, 2020 1:54 PM To: Michelle Rosa<Michelle.Rosa@tvwd.org> Subject:water meter question CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. Hi Michelle, My name is Klarissa Oh, and I live at 11065 sw 79th Ave,Tigard,OR 97223. We are in the process of adding an AUD in our house, and in order to obtain a building permit, I must confirm that our water meter size is adequate and obtain an approved email from TVWD. I called TVWD and I spoke to Ivy,and she told me to contact you. Would you be able to help me or direct me to the person who can? Thank you for any consideration! My cell number is 503.890.1895. Thank you! Klarissa 4 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 1111 r = Transmittal Letter ,_,t;,,R Il 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: Klfi 1 s in JUN 2 2611 COMPANY: CITY OF TIGARD PHONE: S o /(56n BUILDING DIVISICN$y: . EMAIL: k.LI (21SSt6 . 0 3( E -Mf1 ! 1 RE: J J o (0 64— Sly) —7d')Th AV E. Q7223 M 1zoz1- Old 12.E (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. X Floor/roof framing. j 12USS Basement and retaining walls. Beam calculations. t11 Engineer's calculations. Other(explain): M151 MA REMARKS: FO OFFICE USE ONLY Routed to Permit Technician: , ate: �'/Z/ Initials: Fees Due: ❑ Yeso v Fee Desc ption:` Amount Due: - $ a J\isL v $ f. -----' Special Instructions: Reprint Permit (per PE): ❑ Yes y...1\,_10 El Initials' Applicant Notified: Date: ��- r�,��,l�� Initials: ;?� I:\Building\Fonns\TransmittalLetter-Revisions 073 120.doc 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 �71 _ " Transmittal Letter T i c;A It t) 13125 SW Hall Blvd.•Tigard, Oregon 97223 • 503.718.2439• www.tigard-or.gov TO: DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: V.I.kg,i 5 A u NAY 4 2021 COMPANY: CITY OF TI AnD PHONE: CJ b3 .�S D . I ti S BUILDING DIVISION EMAIL: 141A ti55A . oN lry CA IVV 1 L. C DYV 00127 RE: I I OtD, S li) -MA4 M . el/223 V '-2D21 too f 2 S( (S11 510 'VOA (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. 1 Floor/roof framing. Basement and retaining walls. Beam calculations. i Engineer's calculations. Other(explain): p,katir?u A "(IAA 1 M oft M i 11' REMARKS: , • FOR OFFICE USE ONLY Routed to Permit Technniic.an: Date: Le ?� Initials: Fees Due: ❑ Yes '�QNNlee Description: Amount Due: $ /fey ) O 0 „(,./___j, ,.......______ $ _ 1 $ Special Instructions: Reprint Permit(per PE)• 0 Yes ,:1 Nk7- ❑ Done ,do- Applicant Notified: ?. -.- Date: (j‘)-,/ '/ Initials: .