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Permit FOR OFFICE USE ONLY—SITE ADDRESS: 421 _Q 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 )14 Transmittal Letter TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: James Aronoff DEC 1 6 2021 COMPANY:Canopy Building Group CITY OF TIGARD ►3I.JILDING DIVISIb y PHONE: 541-600-5146 EMAIL: James@Canopypdx.com RE: '-15754 SW 76th Ave MST2021-00352/ i53 ` ` (Site Address) (Permit Number) Knauss Estates (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. 1 Revisions: Interior Footing Detail 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: This revision will apply to all buildings on this site. So far only the permit for the retj This revision is to clarify where detail 8 on the structural plan correlats with the drawings. The previous plan did not make it clear to where detail 8 was used. FOR 9 FFIIE USE ONLY Routed to Permit Technici. : Pate: 1/, 3-7 a--) Initials: nil Fees Due: ❑ Yes IN Now Fee Descrip ion: Amount Due: l./ $ $ Special Instructions: Reprint Permit(per PE): 0 Yes 'NNo ❑ Done Applicant Notified: Date: /,2, /3d ),�/ Initials: �or CITY OF TIGARD MASTER PERMIT III 44 1 ' COMMUNITY DEVELOPMENT Permit#: MST2021-00353 Date Issued: 10/27/2021 T ft.;A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S 112CD00400 Jurisdiction: Tigard Site address: 15752 SW 76th AVE Subdivision: Knauss Estates Lot: 9& PT 8 Project: Knauss Estates Lot 3-ADU Project Description: New attached ADU. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 3 First: 775 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 25.5 Bathrooms: 3 Second: 914 sf Garage: 247 sf Front: 15 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Total: 1689 sf Value: $234,728.54 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100 Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 1 Bckflw Prevntr: 1 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 2 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Y Other: N Other Description: Ecompasing: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW ADU VB R-3 1689 Owner: Contractor: CBG SW 76TH AVENUE LLC CANOPY BUILDING GROUP Required Items and Reports(Conditions) 15110 SW BOONES FERRY RD STE 15110 SW BOONES FERRY RD STE 500 1 Ersn Cntrl 503-639-4175 500 LAKE OSWEGO,OR 97035 2 Fire Rated Conditions LAKE OSWEGO,OR 97035 PHONE: PHONE: 541-600-5146 FAX: Total Fees: $26,767.57 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR oc9-nnt_nnln thrm inh oc9_nn1_nno Vnn maxi tai n of rho rnloc nr rlirorf ni ioctinnc to nl Mir Mi Tallinn cn2 919 1QA7 nr 1 Ann 119 91d4 Issued By: itii Permittee Signature: Z- ly///:G �/� // 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. Building Permit Application - _- / ,12.j Residential R CEtV L FOR OFFICEUSE ONI.1 Cityof Tigard ReceiLLL��� Date/ y:ed /) / ?/ N� Permit No.: MJT2 tD 3,53 g Date;'Re 7 � 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review SW�2 �1 qA4k Other Permit: tun Phone: 503.718.2439 Fax: 503.598.1960 DateBy: (0 I% C� bZ� w(26 Inspection Line: 503.639.4175 !R,�1HLt Date Ready/By: r ® Sec Page 2 for TIGARD Internet: www.tigard-or.gov CITY OF Noti' Rvlcthod:/0 a ' / lit Supplemental Information BUILDING DIVISION TYPE OF WORK REQUIRED D•TA:1-AND 2-FAMILY DWELLING ©New construction 0 Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all 0 Additionialteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ,23`-j 7 2S,� Valuation: $ ❑x l-and 2-family dwelling 0 Commercial/industrial Number of bedrooms: 0 Accessory building 0 Multi-family ❑Master builder 0 Other: Number of bathrooms: 3 JOB SITE INFORMATION AND LOCATION Total number of floors: ' t 3( Job site address:15752 SW 76th Avenue; New dwelling area: 1(0V9 square feet C1 I-1 City/State/ZIP: Tigard,OR Garage/carport area: ay-7 square feet '7—75 Suite/bldg./apt.no.: Project name: Knauss Estates Covered porch area: square feet Cross street/directions to job site: East side of the block north of SW 76th Avenue and SW Bond Deck area: square feet Ay'4L 1 cL ' Other structure area: square feet ..Cos /WA, .f AinSLt/• 5( -• Yg i1 mot REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Knauss Estates i 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.: WCTM 2S112CD,Tax Lot 00400 equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. Proposal to construct a primary residential structure and an attached accessory dwelling Valuation: $ unit. Each unit is 2 stories in height and will have a single car garage. Existing building area: square feet A .61,0,--�,i„jw/6— New building area: square feet 51 PROPERTY OWNER 0 TENANT Number of stories: Name: CBG SW 76th Avenue,LLC Type of construction: Address: 1511.0 SW Boons-Ferry Road,Suite 500 Occupancy groups: City/State/ZIP: Lake Oswego,OR 97035 Existing: Phone:(503 ) 956-9307 Fax:( ) New: ® APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule Business name: CBG SW 76th Avenue,LLC Structural plan review fee(or deposit): Contact name: Sean O'Neill FLS plan review fee(if applicable): Address: 15110 SW Boones Ferry Road,Suite 500 g City/State/ZlP: Lake Oswego,OR 97035 Total fees due upon application: Amount received: Phone:(503 ) 956-9307 Fax::( ) PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: sean@canopypdx.com Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name: Canopy Building Group,LLC Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 15110 SW Boones Ferry Road,Suite 500 Solar Installation Specialty Code checklist. City/State/ZIP: Lake Oswego,OR 97035 Permit Fee(includes plan review $180.00 g and administrative fees): Phone:( 503 ) 956-9307 Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lie.: CCB#232358 Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained /c-----7' — within 180 days after it has been accepted as complete. Print name: Date: 06/07 2021 *Fee methodology set by Tri-County Building Industry Sean O'Neill Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) _.. D;3cuSign Envelope ID:7AA377A6-4649-400E-BF5F-4FE6AD7 F Mechanical Permit Applicatioi> ' , FOR OFFICE USE ONLY City of Tigard Date/By:Received Q� Pcrmit No 13125 SW Hall Blvd.,Tigard,OR 97223 ��� ,�1 00353 S. g Plan Review Other Permit: �Q /24 ��"11 Phone: 503.71 R.2439 /� p p Date/B F� 21'0 U Inspection Line: 503.639.4175 CITY OF TIGAR 1 Date Read /B luris. ® See Page 2 for 1 TIGARD Y Y g f Internet: www.tigard-or.gov E3UILp'N^DMC' 1StotifiedMethod: Supplemental Information TYPE OF WORK COMMERCIAL FEE*SCHEDULE-USE CHECKLIST CS New construction 0 Addition/alteration/replacement Mechanical permit fees*arc based on the value of the work performed.Indicate the value(rounded to the nearest dollar)of all a 0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. CATEGORY OF CONSTRUCTION Value:$ RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ® I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. ❑ Multi-family ❑ Master builder 0 Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: 1 Job site address: 15752 SW 76th Avenue Air conditioning 1 46.75 46.75 Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75 City/State/ZIP: Tigard,OR 97224 Furnace 100,000+BTU(ducts vents) 54.91 Suite/bldg./apt.no.: Project name: Knauss Subdivision Lot 3 Heat pump 61.06 li Duct work 1 23.32 23.32 Cross street/directions to job site: SW 76th and Durham Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision: Knauss Subdivision Lot no.: 3 Other: 23.32 Other fuel appliances: Tax map/parcel no.: WCTM 2S 112CD,Tax Lot 00400 Water heater 1 23.32 23.32 1 DESCRIPTION OF WORK Gas fireplace/insert 33.39 `- T` Proposal to construct a primary residential structure and an attached accessory Flue vent for water heater or gas fireplace 23.32 dwelling unit. Each unit will be be 2 stories Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 ® PROPERTY OWNER 0 TENANT Other: 23.32 Environmental exhaust and ventilation: Name: CBG SW 76th Avenue,LLC ! Range hood/other kitchen Address: 15110 SW Boones Fe Road,Suite 500 equipment 1 33.39 33.39 Clothes dryer exhaust 1 33.39 33.3 e City/State/ZIP: Lake Oswego,OR 97035 Single-duct exhaust(bathrooms, 9 Phone:(503 ) 9569307 Fax:( ) toilet compartments,utility rooms) 23.32 Attic/crawlspace fans 23.32 0 APPLICANT 0 CONTACT PERSON Other: 23.32 Business name: CBG SW 76th Avenue,LLC Fuel piping: i1 Contact name: Sean O'Neill $14.15 for first four;$4.03 for each additional Furnace,etc. I Address: 15110 SW Boones Ferry Road,Suite 500 Gas heat pump City/State/ZIP: Lake Oswego,OR 97035 Wall/suspended/unit heater Water heater Phone:(503 ) 9569307 Fax: :( ) Fireplace E-mail: sean@eanopypdx.com Range I Barbecue CONTRACTOR / ,u // Clothes dryer(gas) Business name: �u1,•Uhs Trans. t WdLI!/l�. Other: //'�'� MECHANICAL PERMIT FEES* i Address: li 7 LI SA) /1/iiIwau,la? ���' a .2 � Subtotal0 City/State/ZIP: Minimum permit fee($90.00) Phone:07,3)_3 60Cr-✓ 7.. Fax:( ) Plan review(25%of permit fee) l State surcharge(12%of pennit fee) CCB lie.: LfG1. -Docusigned by: TOTAL PERMIT FEE .( This t � This permit application expires if a permit is not obtained within 180 Or days after it has been accepted as complete. Authorized signature: 356D8C883F7D"33_. * Fee methodology set by Tri-County Building Industry Service Board Print name: Sean 0'Nei 11 Date: 8/17/2021 I ABuilding\Pennits\M EC_PermitApp_082520.doc 440-4617T(1 I/02/COM/W EB) • DocuSign Envelope ID:1AA377A6 4649 400E-BFSF1- ' \E r,J Electrical Permit Application I(Ill t)I I If I I tiI ()\1 1 City' of Tigard OCT 2 6 201� Received Permit Y • Date By. $-" 13125 SW Hall Blvd,Tigard,OR 97223ITY OF TIGAhi..' Plan Rat iaw 1 Phone' 503,718.2439 Fax 503.598.19 Related Parma;# Inspection Line: 503.639.4175BUILDING pp� o Ready D TIGARI) castor- RcadpDnteBy: Tura I @! SeePaQe2tor Internet wow tigard-or gob Notified Method. I Supplemental Information ; TYPE OF WORK PLAN REVIEW Q New construction 0 Addition!altcration'replacement Please check all that apply(submit j,sets of plans i items checked): ❑Demolition ❑Other: ❑Serice ur fender 400 amps or more ❑Building arm dote stones Ni bare the available fault current 0 4tannac and boatyards CATEGORY OF CONSTRUCTION exceeds 11 000 amps at ISO colts or 0 Floating buildings El 1-and 2-family dwelling ElCommerciaUindustrial El Accessory building less to ground.or exceeds 14.000 0 Commercial-use agricultural 0 Multi-famih Master builder ❑Other: amps tot all other installation, buildings 0 Fire pump. 0 insoillation of ISO KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system larger separately denved 0 Addition ofne+v motor load of- system. Job a: Job site address: 15752 SW 76th Avenue l000P or more. ❑"A","E","t-2"."1-3 ❑Six or inure residential units, occupancy. CityiState.r Z.I P: Tigard.OR 97224 0 Health-care facilities 0 Reel canons!vehicle parks Suitetbldv.,apt.n: Project name: Knauss Subdivision lot 3 0 Hazardous locations 0 Supply solutge for more than ❑Service or feeder 600 amps or more. 600 salts nominal- Cross street/directions to job site: SW 76th and Durham FEE SCHEDULE 'API Hun I Qt•. I Faeh I Total I • New residential single-or multi-family dwelling unit. Subdiv ision: Knauss Subdivision Lot a: 3 Includes attached garage. 1,000 sq ft or less I 168.54 4 P'p Tax ma . arcel a: W'CFM 2S 112CD.Tax Lot 0040!) 4 Fa add'1 500 sq it or portion 2 33 92 677 8 5 84 1 DESCRIPTION OF WORK Limited energy,residential 75 00 ' Proposal to construct a primary residential structure and an attached accesaoq with above sq.A) — Limited energy,multi-family 75.00 dwelling unit. Each unit will be be 2 stories residential(with above sq.ft) Renewable Energy Q See Page 2 El PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name: CBG SW 76th Avenue.LLC 200 amps or less i 100.70 100 70 2 Address: 151 10 SW Boones Ferry. Road Suite 500 201 amps to 400 amps 133.562 401 amps to 600 amps 200.34 City/State/ZIP: i.ake Oswego,OR 97035 601 amps to 1,000 amps 301 04 2 Phone:( 503 ) 9569307 Fax:( 1 Over 1,000 amps or volts 552 26 sean'n.Cano dx.Corn Temporary services or feeders installation,alteration,andror Email: PyP relocation On per installation:This installation is being made on property that I own which is not 200 amps or less 1 59.36 59 36 I intended for sale,lease.rent_or exchange,according to ORS 447,449.670,and 701, 201 amps to 400 amps 125 08 _ Owner signature: Date: 401 amps to 599 amps 168 54 2 CIIBranch circuits—new,alteration,or extension,per panel APPLICANT El C'ON I'A(7 PERSON A Fee for branch circuits with Business name: CBG SW 76th Avenue.LLC above service or feeder fee, each branch circuit 7.42 Contact name: Scan O'Neill B Fee for branch circuits suhoai Address: 15110 SW Boones Ferry Road.Suite 500 i service or feedet fee,first branch circuit 56 18 2 City./State'Z,iP: i.ake Oswego.OR 97035 Each a id'I branch circuit 7.42 -2 Miscellaneous(service or feeder not included) Phone:( 503 ) 9569307 Fax •( I : Each manufactured or modular 6' dwelling.service and'or feeder Email: sean;wcanopypdx.com Reconnect only 6781 CONTRACTOR Pump or irrigation circle 1 67.84 67 84 Business name: 'a/4.j j 4 / _ TJ Lt"C- C L f L! h Sign or outline lighting 67-84 1;,..)— 1 Signs)circuit(s)or limited-energv� L _5 l,,,/ /'ire_ l / 0(.i ,pane!.alteration,or extension 0 Sec Page 2 Address: 2 City/State 21P: r"'f V� C� --- 7 ? / Each additional Inspection over allowable in any of the above _ _ Additional inspection(i hr min) 66.25r hr Phone:( , 1 1 7 )L-� � /� 5 3 �, 7 ( Fax:( 1 1 0///2Z investigauuntl hr min) 40.00:'hr Email: --f•�-/yy� -� )e r 01 ('(' Y e G�yv / 3 IL,(1 Industrial plant I h hr mini 78 18'hr J 10 6,__‘;,-.6.- �S'�!�c`�� Inspections for which no tee is 90 0U ht CC13Lie.: f Z i, Electrical Lie.:Z,L `/°/C. Suprv.Lic.: �=' .6...- specifically listed(',%hrmin) ELECTRICAL PERMIT FEES Suprs.Electrician signature.required: Subtotal: Print name ;, y�t/ -` _ Date: /6k_s 0 Plan Review Required(25aro of permit fee) - -oocusignea by: ' - State surcharge(12%of permit feel Authorized signature: SI,ztjA. Yiktitt, ! TOTAL PERMIT FEE. This permit application expires if a permit t_o not obtained nithin 18(1 Print name: Sean 0 t 4l3ta-C4`8ti3";d33.. Date: 8/17/2021 days after it has been accepted as complete. s Number of Inspections allowed per perm!. I Builds, .Parmas,ELC Permn acpjiLn FRF d+.e Rev 06172015 440.461571I I,0,C0MWbE6 DocuSign Envelope ID:7AA377A6-4649-400E-BF5F-4FE6AD73FDFF Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Fee for all residential systems combined: $75.00 Renewable 14,,, I tags T,„„, i . electrical energy systems: Check Type of Work Involved: s kva or IC" I00.70 2 5.01toLkva 133.56 ❑ A• udio and Stereo Systems* 15 01 to 25 kva 200.34 Wind generation systems in excess of 25 log: E Burglar Alarm 25.01 to so kva Sul 01 2 50 01 to 100 kva 552 26 (l G• arage Door Opener* - >100 Iota(fee in accord,mce with OAR 918-309.0040) 552 26 ❑ Beating, Ventilation and Air Conditioning * Solar generation systems in excess of 25 ion: System Each additional kva over 25 7 42 3 Vacuum Systems* >100 kva—no additional charge C! 3 Each additional inspection over allowable in any of the above: ri O• ther: Lach additional inspection Is 66.25,hr I charged at an hourly 11 hr min) Inspections for which no fee is 90 00 hr specifically listed(5:hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 Subtotal(Enter on Page I Y (SEE OAR 918-309-0000) ' Number of inspections allow ed per permit Check Type of Work Involved: ❑ Audio and Stereo Systems (l B• oiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation C Fire Alarm Installation U IIVAC (l Instrumentation ❑ Intercom and Paging Systems Landscape Irrigation Control* Medical ❑ N• urse Calls n O• utdoor landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I n,.ildi g,Perma:lix_RermnApp Etit_ERE Roc Rev r611720t5 QocuSign Envelope ID:7AA377A6-4649-400E-BF5F-4FE6AD73FDFF Electrical Permit ApplicationR C !\I FOR OFFICE: 1 SE ONiA' City of Tigard oate/B : ' 1Ted Permit#: `YIS'�2oZ1-p03," .113125 SW Hall Blvd.,Tigard,OR 97223 Plan Review 11 Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Perm S(IJQ/lpit#: Zl-60 2 2r inspection Line: 503.639.4175 CITY OF CIGAR: Ready Date/By: tens ® See Page 2 for "I I i A it I) Internet: www.tigard-or.gov BUILDING'p� ;��/�+f Notified/Method: Supplemental Information TYPE OF WO ILDING DIVISION PLAN REVIEW ®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): O Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 El Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: ❑Fire pump. 0 Installation of 150 KVA or JOB SiTE INFORMATION AND LOCATION 0 Emergency system. larger separately derived ❑ Job#: Job site address: 15752 SW 76th Avenue 100Hoo of new motor load of system. 00HP or more. ❑„A•. •'E•. "1-2""1-3'. Ci /State/ZIP: 0 Six or more residential units. occupancy. IY Tigard,OR 97224 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: Knauss Subdivision Lot 3 0 Hazardous locations. 0 Supply voltage for more than O Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: SW 76th and Durham FEE SCHEDULE Description I Qty. I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision: Knauss Subdivision Lot#: 3 Includes attached garage. 1.000 sq.ft.or less 1 168.54 168.54 4 Tax map/parcel#: WCTM 2S 112CD,Tax Lot 00400 Ea.add'I 500 sq.ft.or portion 2 33.92 67.R4 1 DESCRIPTION OF WORK Limited energy,residential (with above sq.ft.) 75.00 2 Proposal to construct a primary residential structure and an attached accessory Limited energy,multi-family residential(with above sq.ft.) 75.00 2 dwelling unit. Each unit will be be 2 stories Renewable Energy El See Page 2 ® PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name: CBG SW 76th Avenue,LLC 200 amps or less 1 100.70 100.70 2 Address: 15110 SW Boones Ferry Road,Suite 500 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: Lake Oswego,OR 97035 601 amps to 1,000 amps 301.04 2 Phone:(503 ) 9569307 Fax:( ) Over 1,000 amps or volts 552.26 2 sean@canopypdx.com Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less I 59.36 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 APPLICANT 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name: CBG SW 76th Avenue,LLC above service or feeder fee, 7.42 2 each branch circuit Contact name: Sean O'Neill B.Fee for branch circuits without Address: 15110 SW Boones Ferry Road,Suite 500 service or feeder fee,first 56.18 2 branch circuit City/State/ZIP: Lake Oswego,OR 97035 Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( 503 ) 9569307 Fax: :( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: sean@canopypdx.com 7 Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 1 67.84 67.84 2 Business name: �v m e/ i/z'G(G. Sign or outline lighting 67.84 2 l Signal circuit(s)or limited-energy El See Page 2 2 Address: y 7A �,�( � Ve&I ( panel,alteration,or extension.City/State/ZIP: i 6 f` t/ Each additional inspection over allowable in any of the above � Additional inspection(1 hr min) 66.25/hr Phone:( ) /� /, �u V' F :( ) Investigation(1 hr min) 90.00/hr G.e' / Industrial plant(1 hr min) 78.18/hr Email: �i// lA,� �fV". Inspections for which no fee is 90.00/hr CCB Lic.: it I Electri 1 Lic.: Suprv.Lic.: specifically listed('t/hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: Date: 0 Plan Review Required(25%of permit fee): uocusigned by: State surcharge(12%of permit fee): TOTAL PERMIT FEE: Authorized signature: r a, .3SeD This permit application expires if a permit is not obtained within 180 Print name: Sean 0 r Nel 1 16C8B3F7D433_ Date: 8/17�2021 days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Res On/17/2015 4404615T(l I/05/COM/WEB c Wiiuiukiki.di UY'.iliia.NilalNi< }„llMi.1•4 iiHIUt.44.34 txi•if ikttal.4.4is.141xir.,,.. DocuSgn Envelope ID:7AA377A6-4649-400E-BF5F-4FE6AD73FDFF Plumbing Permit ApplicatioRECEV ED Site Utilities I; ) V3Z. Received �7 City of Tigard 1 ) 21 MM- PermitNo.: Ftk.S1'Z Z\-()D'3 ,7 a 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: t�\ 1Vt = Phone: 503.718.2439 Fax: 503.598.1491 I 1 OF TIGARD Plan Review DateBy: Other Permit No.:S'wQ/L�1_Ol�j2� Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By: Allis: ® See Page 2 for v F 1 Ci A K U Internet: www.ti*ard-or.rov y y g b b Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE [R]New construction ❑Demolition For special information use checklist. Description I Qty. I Ea. I Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ® I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 1 500.32 500.32 ❑Accessory building ❑Multi-family Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 15752 SW 76th Avenue Catch basin or area drain 18.76 City/State/ZIP: Tigard,OR 97224 Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03 Cross street/directions to job site: 76th/Durham Manholes 18.76 Rain drain connector 1 18.76 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: Knauss Subdivision Lot no.: 3 Fixture or item: Tax map/parcel no.: WCTM 2S112CD,Tax Lot 00400 Backflow preventer 1 31.27 11 27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Proposal to construct a primary residential structure and an attached accessory Dishwasher 25.02 dwelling unit. Each unit will be be 2 stories Drinking fountain 25.02 Ejectors/sump 25.02 D. PROPERTY OWNER 0 TENANT Expansion tank 12.51 Name: CBG SW 76th Avenue,LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 15110 SW Boones Ferry Road,Suite 500 Garbage disposal 1 25.02 25.02 City/State/ZIP: Lake Oswego,OR 97035 Hose bib 1 25.02 25.02 Phone:( 503 )9569307 Fax:( ) Ice maker 1 12.51 2 1�51 ►: APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: CBG SW 76th Avenue,LLC Medical gas(value.$ ) Page 2 Primer 12.51 Contact name: Sean O'Neill Roof drain(commercial) 12.51 Address: 15110 SW Boones Ferry Road,Suite 500 Sink/basin/lavatory 25.02 City/State/ZIP:Lake Oswego,OR 97035 Solar units(potable water) 62.54 Phone:( 503) 9569307 Fax: :( ) Tub/shower/shower pan 12.51 E-mail: sean@canopypdx.com Urinal 25.02 CONTRACTOR Water closet 25.02 Water heater 1 37.52 37.52 Business name: //iaut. _ //um4J/,�, / Waterpiping/DWV 56.29 Address: /Lib, Li)61 S G edam kA r iRV�C! Other: 25.02 City/State/ZIP: -Fievt�� --E v _ �7/)6�`1 O Subtotal V Phone: ( Minimum permit fee: $72.50 (r7j ) - 3- Fax ( ) ��s-- , CCB Lic.: t 2'(,f /s �(sf1-/L 1. Plumbing Lic.no.:pg7?2 Plan review (25u/0 of permit fee) D lI 'K! DoeuSipned by: o State surcharge(12%of permit fee) Authorized signature: S- I-'Mitt TOTAL PERMIT FEE Print name: Sean 7741#1fjP18B3F7D433_ Date: 8/17/2021 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. t:\Buiiding\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) City of Tigard a COMMUNITY DEVELOPMENT DEPARTMENT INI TIGARD Building Permit Review — Residential (5 Frin ,..t RIIW.4ra.,.9..e•1L 5p.aik.'t373Pdtr£47keE3334Lu;:;x1 E1011SfiltiBfFXIlailE:t3'ift littE S t£i'8 IM6lS£dtd#.t"Fa'i£3Ylk!§§£$8}t7P3d313d;#SCcf$Fkizk7PS;MLce.e .°.I:a£T fissa3sfa£'L+t#£A tt356?'3:&969tic£f3t£fiitli iidYZt7'Yt!«:': Building Permit #: MSTZOty DOSS; Site Address: ( ci-S2 S(A-) 1(o c- Project Name: (0Aa S 6-Z7 tE Lot #: 3 Planning Review 9//'�8-/ /4' //Si:D £ 7' 4'.4 " Proposal: Ma �,toy e&S 1 oC(1.0 Verify address/suite # active in Accela. [Ll In River Terrace: L/1 No ❑ Yes,River Terrace Review Addendum Sit lan Elements: Erosion Control S,copies of site plan on 8-1/2"x 11"or 11 x 17"paper [ ] tained trees with drip line and tree protection measures 'awn to scale(standard architect or engineer scale) F otprint of new structure(including decks) and FFE orth arrow .ty locations&easements(required for new and additions) e address,project or subdivision name and lot number LJ'if Sidewalk/driveway approach pplicant information(name and phone number) rcation of wells/septic systems LJ Lot dimensions and building setback dimensions I' feet tree size,type and location o' Square footage of buildings to be demolished et names 1� xisting structures on site Corner elevations (2'contours if more than 4'differi'al) Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ZYes No im rvious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes Clean Water Services—Service Provider Letter of platted prior to 9/10/1995): quired: ❑ Yes,applicant was notified IQ No Received: ❑ Yes ❑ No Water Meter F' re Unit Worksheet—Additions,Remodels and ADUs li&V-- euuired: JJ Yes,applicant was notified ❑ No �� Received: ❑ Yes ❑ No C Exemption for ADU applied for: ❑ Yes 1 No Received: ❑ Yes El No Public Facilities Improvement (PFI) Permit: quired: ❑ Yes,applicant was notified E N V plied For: ❑ Yes ❑ No,stop intakencl Use Case#: 1��V 2L�_ � ICJ Zoning: Q. I/ quired Setbacks: Front: I.S Rear: Is- Side: S Street Side: 10 Garage: T LgJ B 'ding Height: Max.Height: Actual Height: 2S •S— Landscape ea: i..E:2 % Lot Coverage Max: go Entrance L t back no more than 8'from street-facing wall Parallel to street or offset 45 degrees or less Windows ji um 12%of area of all street-facing facades � Garage Garage door is behind widest street-facing wall Jd'Yes ❑ No,one of the following is met: ❑ Door extends no more than 5'from wall and there is a covered porch extending beyond garage. Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2nd floor. Garage door width is ❑ 12'or less ❑ 50%or less of facade ❑ 60%or less and includes 7 of following: ❑ Covered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset ❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer ❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony isual Clearance Urban Forestry Plan a.tive Lands: ❑ Yes �No Type: Condions met prior to issuance of building permit of proved By Planning: � Date: Zy 2 Revisions (after B ' ding Submittal o y) Reviewer Date Revision 1: Approved ❑ Not Approved /1/44- `0C , Revision 2: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw_RES_122419.docx Building Permit Submittal Original Submittal Date: 7/ /Z Site Plans: # 3 Building Plans: # 3 Building Permit#: ❑ Enter building permit#above. Workflow Routing: ❑ Planning ❑ Engineering ❑ Permit Coordinator ❑ Building 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 trust details,if applicable,etc. • Notes: By Permit Technician: ///1C-4-/ Date: y//�Z/ Engineering Review ❑ Slope at building pad: ❑ Conditions "Met"prior to issuance of building permit ❑ Easements (encroachments)per engineering conditions of approval and plat ❑ Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes ❑ No Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No LIDA Facility on lot: ❑ Yes ❑ No ❑ Final Plat Recorded: C 'NOT Approved by Engineering: 7-1,,,A1/1 Ari(,k l Date: Notes: Peed S iww veq l�,/yd fr'/fk' ' Sip S t4;t. (S 1arw►, Svewe.rj ❑ Approved by Engineering: Date: Revisions (after Building Submittal only) Reviewer pate Revision 1: C?Approved ❑ Not Approved %.thl JnI'41= f 9 libiZi724 Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review ,Zi Conditions "Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: SDC Exemption: ❑ Received j2r Does not apply SDC Fees Entered: Wash Co Trans Dev Tax: J Yes ❑ N/A Tigard Trans SDC: 7 Yes ❑ N/A Parks SDC: ,Z Yes ❑ N/A LIDA ❑ Yes f2 N/A C� OK to Issue Permit /Approved by Permit Coordinator: Date: oi 1 2 12,yu I:\Building\Forms\BldgPermitRvw_RES_122419.docx Water Meter Fixture Unit Worksheet For New Buildings Please complete the following information: Contractor Name: Canopy Building Group, LLC Billing Address: Street/Suite#: 15110 SW Boones Ferry Road Suite 500 City: Lake Oswego State: OR Zip: 97035 Phone Number: 503-956-9307 Email: sean@canopypdx.com New Meter Address: 15752 SW 76th Avenue, Tigard OR d - _A ,l/ 41 Knauss Subdivision 3 Subdivision Name: Lot#: Building Permit#: Please fill in the number of each fixture as detailed on the plans. Multiply the quantity by the point value to arrive at the point total. Add all point totals together for total fixture unit points. Fixture Unit Quantity Point Value Point Total Bar sink 1 x 1 = 1 / Bidet x 1 = Clothes washer 1 x 4 = 4 Dishwasher 1 x 1.5 = 15 Hose bib, 1"one 1 x 2.5 = 2.5 Hose bib, each additional x 1 = Kitchen sink 1 x 1.5 = 1.5 Laundry sink x 1.5 = Lavatory x 1 = Water closet, 1.6 GPF 3 x 2.5 = 7.5 Bathtub/whirlpool x 4 = Shower stall 1 x 2 = 2 Bath/shower combo 1 x 4 = 4 Total Fixture Unit Points: r Fixture Unit Points: 1 to 30= 5/8" 37.5 to 89= 1" 30.5 to 37=3/4" 30 Meter Size: Meter Cost: $ ************************************************************************************* FOR OFFICE USE ONLY Fixture Units Points verified with Building (Master) Permit or Plumbing ❑ Yes ❑ No ❑ Other: Meter#: Sale Date: Receipt#: Meter Cost: Employee Name: l:/Building/Forms/WaterMeters_070121 New.dOCX Page 2 RECEIVED Water Meter Fixture Unit Worksheet For New Buildings AUG 1 i 2021 Please complete the following information: CITY OF TIGARD BUILDING DIVISION Contractor Name: Canopy Building Group, LLC Billing Address: Street/Suite#: 15110 SW Boones Ferry Road Suite 500 City: Lake Oswego State: OR Zip: 97035 Phone Number: 503-956-9307 Email: sean@canopypdx.com New Meter Address: 15752 SW 76th Avenue, Tigard OR 1i Knauss Subdivision / 3 Subdivision Name: Lot#: Building Permit#: Please fill in the number of each fixture as detailed on the plans. Multiply the quantity by the point value to arrive at the point total. Add all point totals together for total fixture unit points. Fixture Unit Quantity Point Value Point Total Bar sink 1 x 1 = 1 Bidet x 1 = Clothes washer 1 x 4 = 4 Dishwasher 1 x 1.5 = 15 Hose bib, 1st one 1 x 2.5 = 2.5 Hose bib, each additional x 1 = Kitchen sink 1 x 1.5 = 1.5 Laundry sink 4 x 1.5 = 6 Lavatory x 1 = Water closet, 1.6 GPF 3 x 2.5 = 7.5 Bathtub/whirlpool x 4 = Shower stall 1 x 2 = 2 Bath/shower combo 1 x 4 = 4 Total Fixture Unit Points: 30 Fixture Unit Points: 1to30= 5/8" 37.5to89 = 1" 30.5 to 37 = 3/4" 30 Meter Size: Meter Cost: $ ************************************************************************************* FOR OFFICE USE ONLY Fixture Units Points verified with Building(Master) Permit or Plumbing n Yes ❑ No ❑ Other: Meter#: Sale Date: Receipt#: Meter Cost: Employee Name: l:/Building/Forms/WaterMeters_070121_New.dOCX Page 2