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Permit CITY OF TIGARD MASTER PERMIT 11111 I " COMMUNITY DEVELOPMENT Permit#: MST2021-00350 T f GAR 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 �► Date Issued: 09/28/2021 'o, / Parcel: 2S103CC15800 Jurisdiction: Tigard Site address: 12183 SW PLANTATION TER ` Subdivision: PLANTATION ESTATES Lot: 3 Project: Toews Project Description: Bathroom remodel including replace roof framing, add attic and replace bath fan, replace existing fixtures, and replace deck railing and surface. 6/7/22: REPRINT to add (3)branch circuits. BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: Total: 0 sf Value: $15,000.00 Rear: 0 PLUMBING Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Drains: 0 Storm Sewer: 0 Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Other Fixtures: 1 Drywell-Trench Drain: 0 Other Fixture Units: DWV MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 1 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 1 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 5 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 N Other: N Other Description: Ecompasing: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF 0 Owner: Contractor: TOEWS,JORDAN&MEGAN OWNER Required Items and Reports(Conditions) 12183 SW PLANTATION TER JORDAN&MEGAN TOEWS TIGARD,OR 97223 12183 SW PLANTATION TERRACE TIGARD,OR 97223 PHONE: PHONE: 360-510-9311 FAX: Total Fees: $909.83 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Ore on law require you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR oc ..nn1_nn1n thrnnnh nap a - 1-nnon n m htain n,of the n!lcac nr rliront ni$octinnc to flu INf:by nollinn c(11) 10A7 nr/1'ann 119 9'2a4 Issued By: Permittee Signature: �/(\yr — �/T -�6-I OletCii 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. Electrical Permit Application FOR OFFICE,: USE ONLY of �► ceiveyd /7/� iiiiCi SW Hall BlardTigard,OR 97223 RECEIVE l' to/By:�r/ ;, �� s�� S Plan Review Phone: 503.718.2439 qg Date/By: Related Permit#: Email: TigardBuildingPennits@Tigard-or.gov JUN 2OLL Ready Date/By: Juris: ® See Page 2 for T 1 G A R D Inspection Line: 503.639.4175 Internet: ww Notified/Method: Supplemental Information TYPE OF WORK tPLAN REVIEW a? Icemen DIVISIONI..se check all that apply❑ New construction ❑Addition/alteration/rep aeemen pp y(submit 2 sets of plans w/items checked): 1 - ice or feeder 400 amps or more ❑Building over three stories. ❑ Demolition ❑Other: r 10. . 4 ere the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION r JI1-aeeds 10,000 amps at 150 volts or ❑Floating buildings. ID I-and 2-family dwelling CI Commercial/industrial El Accessory buil less to ground,or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑ Multi-family ❑Master builder ❑Other: 0 Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived 'h1'I -rEr_ ❑Addition of new motor load of system. Job#: Job site address: i zg3 SW ID.N 100HP or more. ❑"A","E","1-2",°t-3", City/State/ZIP: r� /�y ❑Six or more residential units. occupancy. / (t!i r+64✓ / %T Zz 3 ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: 0 Hazardous locations. ❑Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Qty. I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'I 500 sq.ft.or portion 33.92 1 4,44 -2,4?p. (e,37,DESCRIPTION OF WORK Limited energy,residential 75.00 2 Aop-/� �,r� -cei-y�, A ADPIT?d-N�4L (with above sq.ft.) 0 L G ZD 1� �C✓'�-nL-T fi l`� Limited energy,multi-family ) �L,j'`" , + /-j i�G L j'5 residential(with above sq.ft.)0 75.00 2 igri / Renewable Energy 0 See Page 2 PROPERTY OWNER I 0 TENANT Services or feeders installation,alteration,and/or relocation Name: Jt:5 a D,4N "ri,610�' 200 amps or less 100.70 2 t 201 amps to 400 amps 133.56 2 Address: SA yvt E /45 �(1F�J(,-['j 401 amps to 600 amps 200.34 2 City/State/ZIP: 601 amps to 1,000 amps 301.04 2 Phone:(3 Ls) S70 ^9311 Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: (2.,'pApi& -7-0, -73e4,05.('.4124A 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 ent exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date:06-Dq-Zo2Z 401 amps to 599 amps 168.54 2 174101r.PLICANT 0 CONTACT PERSON Branch circuits-new,alteration,or extension,per panel A.Fee for branch circuits with Business name: 5d4 I5, Alg, 410J.f re above service or feeder fee, 7.42 2 each branch circuit Contact name: B.Fee for branch circuits without service or feeder fee,first 3 56.18 4( 2 Address: branch circuit [ [T City/State/ZIP: Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy See Page 2 2 Address: panel,alteration,or extension. City/State/ZIP: Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:( ) investigation(1 hr min) 90.00/hr Industrial plant(1 hr min) 78.18/hr Email: Inspections for which no fee is 90.00/hr CCB Lic.: Electrical Lie.: Suprv.Lie.: specifically listed(A hr min) ELECTRICAL PERMIT FEES Suprv. Electrician signature,required: Subtotal: Print name: Date: 0 Plan Review Required(25%of pennit fee): State surcharge(12%of permit fee): Authorized signature: _ l'...‘ TOTAL PERMIT FEE: i This permit application expires if a permit is not obtained within 180 cJ Print name: egs7A,1/41 --123p...05 Date: 06-p ZoZz days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 10/26/2017 440-4615T(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Description Qt • I Each I total Fee for all residential systems combined: $75.00 Renewable electrical energy systems: Check Type of Work Involved: s kva or less 100.70 2 5.01 to 15 kva 133.56 2 n Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 2 n Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 n Vacuum Systems* >100 kva-no additional charge 0.0 3 Each additional inspection over allowable in any of the above: n Other: Each additional inspection is 66.25/hr 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed('/hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 Subtotal(Enter on Page 1): * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems n Boiler Controls ❑ Clock Systems n D• ata Telecommunication Installation { Ti F• ire Alarm Installation ❑ HVAC n Instrumentation ❑ Intercom and Paging Systems x. ❑ Landscape Irrigation Control* 4 Ti M• edical n Nurse Calls ❑ Outdoor Landscape Lighting* Ti Protective Signaling n Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations t:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 10/26/2017 „IN CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2021-00350 Date Issued: 09/28/2021 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S103CC15800 Jurisdiction: Tigard Site address: 12183 SW PLANTATION TER Subdivision: PLANTATION ESTATES Lot: 3 Project: Toews Project Description: Bathroom remodel including replace roof framing,add attic and replace bath fan, replace existing fixtures,and replace deck railing and surface. BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: Total: 0 sf Value: $15,000.00 Rear: 0 PLUMBING Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Drains: 0 Storm Sewer: 0 Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Bckflw Prevntr: 0 Drywell-Trench Drain: 0 Other Fixtures: 1 Other Fixture Units: DWV MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 1 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 1 Fum<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Fum>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 2 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 N Other: N Other Description: Ecompasing: BUILDING INFO I Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF 0 r Owner: Contractor: TOEWS,JORDAN&MEGAN OWNER Required Items and Reports(Conditions) 12183 SW PLANTATION TER JORDAN&MEGAN TOEWS TIGARD,OR 97223 12183 SW PLANTATION TERRACE TIGARD,OR 97223 PHONE PHONE: 360-510-9311 FAX: Total Fees: $884.90 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 QF7-nM-nni n fhrn,inh(AP QF7-nni_nnQn Vnn ma,'"Main a rnmi of*ha"doe nr riirorf nnoefinne in rii INC by Tallinn AM 747 1QR7 nr 1 Arlo 13.19 714.1.1 Issued By: No{Lj Vaw De,We Permittee Signature: Otv Ap-pLL.,aA-Le-s'. Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the lob site at the time of each inspection. Building Permit Application Residential RECEIVE I I.OK OFFICE USE ONLv Cityof Tigard AUG 'Received 2021Permit No.: III13125 SW Hall Blvd.,Tigard,OR 97223 �� 1 �� Date/By: z l mS.ZZOZt-oa3so Plan Review q ry ' Phone: 503.718.2439 Fax: 503.598.1960 DateJBy: t ' f.1 Other Permit-. t f(;A R I) Inspection Line: 503.639.4175 CITY OF TIG�ARD Date Ready/By: ® See Page 2 Ior Internet: www.tigard-or.gov BUILDING DIVISIO ,Not' /Method. Supplemental Information TYPE OF WORK RE RED DATA: -AND 2-FAMILY DWELLING ❑New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all g Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ✓/ 10 1-and 2-family dwelling ❑Cotmnercial/industrial Valuation: $15 000 ElAccessory building ❑Multi-family Number of bedrooms ❑Master builder ❑Other: Number of bathrooms:14 JOB SITE INFORMATION AND LOCATION Total number of floors:)( Job site address: 12183 SW Plantation Terrace New dwelling area: 0 square feet t City/State/ZIP: Tigard, OR 97223 Garage/carport area: 0 square feet -1 Suite/bldg./apt.no.: Project name:Master Bath; Roof& Deck Repair Covered porch area: 0 square feet Cross street/directions to job site: Deck area:0 square feet xts SlityetLhis r - Ul //t r tt re—fr eel f perAsI'f C7y'A/. Other structure area: 0 square feet ' t y t f l f 2t/(. JCi'r`�f b sit iie-e• " REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision:Plahtation Estates Lot no.: 3 Permit fees*are based on the value of the work performed. 25103CC 15800 Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. Complete to studs bathroom remodel. Repair and replace upper Valuation: $ roof framing that is damaged and insufficient. Install attic fan in Existing building area: square feet gable end. Remove and replace damaged deck railing and surface. New building area: square feet iii PROPERTY OWNER 0 TENANT Number of stories: Name:Jordan & Megan Toews Type of construction: Address:12183 SW Plantation Terrace Occupancy groups: City/State/ZIP: Tigard, OR 97223 Existing: Phone:(360) 510-9311 Fax:( ) New: 5/APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: Same as Owner Structural plan review fee(or deposit): Contact name: FLS plan review fee(if applicable): Address: Total fees due upon application: City/State/ZIP: Amount received: Phone:( ) Fax: :( ) E-mail: ^ PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Orr)O�reas� m Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name:Same as Owner Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: Solar Installation Specialty Code checklist. City/State/ZIP: Permit Fee(includes plan review $180.00 and administrative fees): Phone:( ) Fax:( ) State surcharge(12%of pennit fee): $21.60 CCB lie.: Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained ` within 180 days after it has been accepted as complete. �l U 6- *Fee methodology set by Tri-County Building Industry Print name: JoADA �S Date: �423-Zoit Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Building Permit Application Checklist One- and Two-Family Dwelling FOR Of FICL t SE. ONLv City of Tigard Received I Permit No.: w 13125 SW Hall Blvd.,Tigard,OR 97223 Y g Associated permits: ■ Phone: 503.718.2439 Fax: 503.598.1960 24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical 'FIG A tt D Internet: www.tigard-or.gov 0 Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW N`~ .7.,° ya I Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 ■ 0 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0 3 Verification of approved plat/lot. ❑ 0 0 4 Fire district approval required. Name of district: ❑ 0 ❑ 5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ 0 6 Sewer permit. 0 0 ❑ 7 Water district approval. 0 0 0 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ 0 0 9 Erosion control ❑plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 0 0 basin protection,etc. . 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 0 ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if 0 0 0 there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size 0 ❑ ❑ and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ 0 ❑ furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- 0 0 0 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,rooting,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. 0 0 0 Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- 0 0 0 prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing 0 0 0 locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ 0 systems,see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists 0 0 0 over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. ❑ 0 0 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ 0 0 for four or more appliances. 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or ❑ ❑ 0 architect licensed in Ore:on and shall be shown to be a•s licable to the Iro'ect under review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". 0 ❑ ■ 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ❑ ❑ 0 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 0 ❑ ❑ 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 0 0 27 "Drawn to scale"indicates standard architect or engineer scale. 0 0 0 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 0 ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 0 0 and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9,1995. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Application FOR Ol hlcl: lest O:NL1 City of Ti and Received !- g DateBy: ' C.(o u Permit No.:�1(�"C�Z\_ " 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: H See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE-,USE CHECKLIST Mechanical permit fees*are based on the value of the work ❑New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all is Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSI'EMS FEES* ]s 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. 0 Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning Job site address: 12183 SW Plantation Terrace (requires site plan showing placement) 46.75 Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: Tigard, OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: Project name: Master Bath; Roof& Deck Repair Heat pump (requires site plan showing placement) 61.06 Cross street/directions to job site: Duct work 23.32 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 Subdivision:Plantation Estates Lot no.:3 Flue/vent for any of above 23.32 Other: 23.32 Tax map/parcel no.:25103CC 15800 Other fuel appliances: DESCRIPTION OF WORK Water heater 23.32 Install Attic Gable fan and Bathroom Vent fan. Gas fireplace 33.39 Flue vent for water heater or gas fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 l PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 23.32 Other: 23.32 Name:Jordan& Megan Toews Environmental exhaust and ventilation: Address:12183 SW Plantation Terrace Range hood/other kitchen equipment 33.39 City/State/ZIP:Tigard, OR 97223 Clothes dryer exhaust 33.39 Single-duct exhaust(bathrooms, Phone:(360) 510-9311 Fax:( ) toilet compartments,utility rooms) I 23.32 23.32 71 APPLICANT 0 CONTACT PERSON Attic/crawlspace fans 23.32 23.32 Same as Owner Other: 23.32 Business name: Fuel P i m P g: Contact name: $14.15 for first four;$4.03 for each additional Address: Furnace,etc. Gas heat pump City/State/ZIP: Wall/suspended/unit heater Phone:( ) Fax::( ) Water heater E-mail: Fireplace Range CONTRACTOR Barbecue Business name: Same as Owner Clothes dryer(gas) Other: Address: MECHANICAL PERMIT FEES* City/State/ZIP: Subtotal 46.64 Minimum permit fee($90.00) Phone:( ) Fax:( ) Plan review(25%of permit fee) CCB lie.: State surcharge(12%of permit fee) TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 Authorized signature: 1401111411.---. days after it has been accepted as complete. Print name: J.AD4N �e Date: OS-/S-2AZ./ * Fee methodology set by Tri-County Building Industry Service Board C\Building\Permits\MEC-PermitApp.doc 09/09/10 4404617T(11/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi-Family Fee Schedule: Total Valuation: Permit Fee: $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and $2.54 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I:\Building\Permits\MEC-PermitApp.doc 09/09/10 2 .. '. Electrical Permit Application I.OR OFF ICL t ML(.)yLv City of Tigard Received ,/� �^'h FhlDate/By: � � vo Permit#'f 15\ e UZ.�_�2 13125 SW Hail Blvd.,Tigard,OR 97223 Plan Review J = Phone: 503.718.2439 Fax: 503.598.1960Related Permit#: Date/By: Inspection Line: 503.639.4175 Ready Date/By: 1uris: ® See Page 2 for 11 L A R D Internet: www.tt and-or. ov Notified/Method: g g $ Supplemental Information TYPE OF WORK PLAN REVIEW 0 New construction ElAddition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition ❑Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. .1-and 2-family dwelling 0 Commercial/industrial El Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑ Multi-family 0 Master builder 0 Other: 0 Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: Job site address:12183 SW Plantation Terrace 100HP or more. ❑ `A','E',`1-2 , 1-3', City/State/ZIP:Tigard, OR 97223 ❑Six or more residential units. occupancy. 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name:Master Bath; Root& Deck Repair 0 Hazardous locations. 0 Supply voltage for more than 0 Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Qty. i Each I Total i New residential single-or multi-family dwelling unit. Subdivision:Plantation Estates Lot#: 3 Includes attached garage. 1,000 sq.fi.or less 168.54 4 Tax map/parcel#: 25103CC 1580Q Ea.add'1500 sq,ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential Install Attic Gable fan and new circuit to bathroom (with above sq.ft.) 75.00 2 Limited energy,multi-family 75.00 2 residential(with above sq.fi.) Renewable Energy 0 See Page 2 PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name:Jordan & Megan Toews 200 amps or less 100.70 2 Address: 12183 SW Plantation Terrace 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:Tigard, OR 97223 601 amps to 1,000 amps 301.04 2 Phone:(360) 510-9311 Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email:jm06rentals@gmail.com relocation Owner installation:This installation is being made on property that 1 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 APPLICANT 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name: Same as Owner above service or feeder fee, each branch circuit 7.42 2 Contact name: B.Fee for branch circuits without Address: service or feeder fee,first k 56.18 56.1 8 2 branch circuit City/State/ZIP: Each add'I branch circuit l 7.42 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Fax::( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Small: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name:Same as Owner Sign or outline lighting 67.84 2 Address: Signal circuit(s)or limited-energy ❑ See Page 2 2 panel,alteration,or extension. City/State/LIP: Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:( ) Fax:( ) Investigation(1 hr min) 90.00/hr Industrial plant(I hr min) 78.18/hr Email: Inspections for which no fee is 90.00/hr CCB Lie.: Electrical Lie.: Suprv.Lie.: specifically listed CA hr min) ELECTRICAL PERMIT FEES Suprv. Electrician signature,required: Subtotal: 63.60 Print name: Date: 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): .0%''.-4 ::••••••"011"v---- Authorized signature: ` TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: c) p 4K Otl WS Date: le_ig.Ze?Z f days after it has been accepted as complete. * Number of inspections allowed per permit. I:'Building`PermitsAELC_PermitApp_ELR_ERE.doc Rev06/17/2015 440-4 6I5T(11/05/COM/WEB • Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEL SCHEDULE Description I Qq'. I Each I Total Fee for all residential systems combined: $75.00 Renewable electrical energy systems: 5 kva or less 100.70 2 Check Type of Work Involved: 5.01 to 15 kva 133.56 2 • Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 n G• arage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 2 E Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 n V• acuum Systems* >100 kva—no additional charge 0.0 3 Each additional inspection over allowable in any of the above: riEach additional inspection is O• ther: charged at an hourly(1 hr min) 6625/hr 1 Inspections for which no fee is 90.00/hr specifically listed('/z hr min) ELECTRICAL PERMIT FEES COMMERCIAL WORK ONLY: Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: { ❑ Audio and Stereo Systems r. E Boiler Controls ❑ Clock Systems fi ❑ Data Telecommunication Installation f ft ❑ Fire Alarm Installation ❑ HVAC fi E Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ft ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* fi ❑ Protective Signaling ❑ Other: sa Total number of commercial systems: ij *No licenses are required. Licenses are required for all other installations I:\BuildingTermitslELC_Permi1App_ELR_ERE.doc Rev 06/17/2015 ,.i 'Plumbing Permit Application Building Fixtures FOR OFFICE LSE ONLY City of Tigard Received �p No:Permit ` w 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: �' lit `�! mSC�i�)-cxDa, V Plan Review ilhl I Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.: Inspection Line: 503.639.4175 T 1 G AR i� Internet: www.ti and-or. ov Date Ready/By: Iaris: ® See Page 2 for g g Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑New construction ❑Demolition For special information use checklist. Description Qty. I Ea. Total Addition/alteration/replacement D Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 Iii 1-and 2-family dwelling ❑Conunercial/industrial SFR(2)bath 437.78 El Accessory buildingSFR(3)bath 500.32 ❑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:12183 SW Plantation Terrace Catch basin or area drain 18.76 City/State/ZIP:Tigard, OR 97223 Drywe1L leach line,or trench drain 18.76 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt,no.: Project name:Master Bath; Roof& Deck Repair Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: Plantation Estates Lot no.: 3 Fixture or item: Tax map/parcel no.:25103CC 15800 Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Replace existing fresh water from basement and existing draing Dishwasher 25.02 from main stack. Replace (E) sinks, WC & shower. Drinking fountain 25.02 Ejectors/sump 25.02 PROPERTY OWNER 0 TENANT Expansion tank 12.51 Name: Jordan & Megan Toews Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:12183 SW Plantation Terrace Garbage disposal 25.02 City/State/ZIP:Tigard, OR 97223 Hose bib 25.02 Phone:(360) 510-9311 Fax:( ) Ice maker 12.51 tz APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name:Same as Owner Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Roof drain(commercial) 12.51 Address: Sink/basin/lavatory ' 25.02 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 12.51 12.51 E-mail: Urinal 25.02 Water closet t 25.02 25.02 CONTRACTOR Water heater 37.52 Business name:Same as Owner Water piping/DWV 56.29 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal 118.84 Fax: Minimum permit fee: $72.50 Phone:( ) ( ) Plan review (25%of permit fee) CCB Lie.: Plumbing Lic.no.: State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name: 30,4 �0�C�5 Date: This permit application expires if a permit is not obtained within 180 days ' .,�.?(ju after it has been accepted as complete. �i 'Fee methodology set by Tri-County Building Industry Service Board. I:1Building\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-Is`100' 50.03 0 to 2,000 $121.90 Footing dram-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Valuation: Permit Fee: Storrs&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Other Inspections or Fees ' ' < > Total each additional$100.00 or fraction thereof,to p 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 S25,001.00 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 following. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate ❑ Any new commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool Car Wash: -Each Stall ❑ New exterior plumbing site utilities for any complex structure as defined in OAR918-780-0040. -Drive Thru Wirator ❑ Medical gas and vacuum systems for health care facilities. Cuspidor/Water Asp ❑ Any multipurpose fire sprinkler system. Dishwasher: -Commercialirator Domestic El Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" 3" Isometric or Riser 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./Refrig.Drains Comments regarding fixture work: Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -LavBar 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: 1:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325(2)) This statement is required for residential building,electrical,mechanical,and plumbing permits. Licensed architect and engineer applicants,exempt from licensing under ORS 701.010(7),need not submit this statement.This statement will be filed with the permit. Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: ' Name CCB# Expiration Date i I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or I will be performing work on property I own, a residence that I reside in, or a residence that I will reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. JC14\( / O6[J S Print Name of Permit Applicant AAA 16, Z0z1 S re of Permit Applicant D.,;a Permit#: Address: ��'' r L. r` Issued by: Date: f 1 This Copy for Permit Offices RECEIVED 0'�' Information Notice to Owners About AUG 19 2Ual ``"' r4 Construction Responsibilities InoFTIGARD V (ORS 701.325 (3)) BUILDING DIVISION Homeowners acting as their own general contractors to construct a new home or make a substantial improvement to an existing structure, can prevent many problems by being aware of the following responsibilities: • Homeowners who use labor provided by workers not licensed by the Construction Contractors Board, may be considered an employer, and the workers who provide the labor may be considered employees. As an employer, you must comply with the following: • Oregon's Withholding Tax Law: Employers must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Department of Revenue at 503-378-4988. • Unemployment insurance Tax: Employers are required to pay a tax for unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Employment Department at 503-947-1488. • Oregon's Business identification Number(BIN): is a combined number for both Oregon Withholding and Unemployment insurance Tax. To file for a BIN, call 503-945-8091 or go to jittp://www.oregon.gov/DOR/BUS/docs/211-055.pdf for the appropriate forms. • Workers Compensation insurance: Employers are subject to the Oregon Workers Compensation Law, and must obtain Workers Compensation Insurance for their employees. If you fail to obtain Workers Compensation insurance, you could be subject to penalties and be liable for all claim costs if one of your workers is injured on the job. For more information, call the Workers Compensation Division at the Department of Consumer and Business Services at 503-947-7815. • Tax Withholding: Employers must withhold Social Security Tax and Federal Income Tax from employee wages. You may be liable for the tax payment, even if you didn't actually withhold the tax. For a Federal EIN number, call the IRS at 1-800-829-4933 or visit their website at www.irs.gov. Other Responsibilities of Homeowners: • Code Compliance:As the permit holder for a construction project, the homeowner is responsible for notifying building officials at the appropriate times, so that the required inspections can be performed. Homeowners are also responsible for resolving any failure to meet code requirements that may be found through inspections. • Property Damage and Liability insurance: Homeowners acting as their own contractors should contact their insurance agent to ensure adequate insurance coverage for accidents and omissions, such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be redone. Liability Insurance must be sufficient to cover injuries to persons on the job site who are not otherwise covered as employees by Workers Compensation Insurance. • Expertise: Homeowners should make sure they have the skills to act as their own general contractor, and the expertise required to coordinate the work of both rough-in and finish trades. CONSTRUCTION CONTRACTORS BOARD 700 Summer St NE, Suite 300,PO Box 14140,Salem,OR 97309-5052 Telephone:503-378-4621 -Fax:503-373-2007 Website Address:www.oregon.gov/ccb f/property_owner adopted 9-23-08 This Copy for Permit Applicant Holly Van De Wege From: Edgardo Maldonado Sent: Monday, August 23, 2021 12:48 PM To: Holly Van De Wege Subject: Fwd: 11x17 Site Plan for 12183 SW Plantation Terrace Attachments: 11x17 Site Plan - 12183 SW Plantation.pdf Hey Holly, Do you think you could print this out and add it to the submittal? Thanks, Eggie From:Tina Escalera <tinae@tigard-or.gov> Sent:Thursday,August 19, 2021 11:51 PM To: Edgardo Maldonado Subject: FW: 11x17 Site Plan for 12183 SW Plantation Terrace Eggie, Can you print (3) copies of these and put it with the submittal that is by my desk?Then you can place it in the planning inbox. This arrived 8/19/21 by (B) box. Thank you! Tina Escalera Permit Tech Assistant City of Tigard I Community Development 13125 SW Hall Blvd.Tigard, OR 97223 From:J & M Rentals<jm06rentals@gmail.com> Sent:Thursday,August 19, 2021 6:26 PM To:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Subject: 11x17 Site Plan for 12183 SW Plantation Terrace Caution!This message was sent from outside your organization. Hi, Attached is the 11X17 version of the site plan for this project. Let me know if there are any other items that are required. Thank you, Jordan 1 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