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Permit
CITY OF TIGARD MASTER PERMIT 11 «� COMMUNITY DEVELOPMENT Permit#: MST2021-00551 Date Issued: 01/11/2022 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S112BC05200 Jurisdiction: Tigard Site address: 14920 SW 83RD AVE Subdivision: LA MANCHA ESTATES Lot: 5 Project: ROONEY Project Description: Relocating the kitchen and non-bearing partition walls. Installing a new window, lighting,and new ductwork. 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: $20,000.00 Rear: 0 PLUMBING Sinks: 1 Water Closets: 0 Washing Mach: 0 Laundry Trays: 1 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 0 SF Rain Drains: 0 Storm Sewer: 0 Tubs/Showers: 0 Garbage Disp: 1 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 0 Backwater Value: 0 Other Fixtures: 1 Drywell-Trench Drain: 0 Other Fixture Units: DWV piping MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 0 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: 6 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: ROONEY,CONNOR OWNER Required Items and Reports(Conditions) 1592 WORTHINGTON ST LAKE OSWEGO,OR 97034 PHONE: PHONE: FAX: Total Fees: $1,066.81 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.nn1.nn1n thrn,inh flAP oc9.nni.nnon Wm 1 ma',nhtain a rnnw of tha ndoc nr dirart ni lactinne rn fli inin by Tallinn cn' 949 1 og7 nr 1 Ann 149 9l4dc, Issued By: 477.--Are4-00"4(4-7n ,...1.'---"") Permittee Signature: e. J.. Call 175 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. Bug Permit Application Y Residential FOR OFFICE USE ONLY City of Tigard Receivedj,Jr l�r Permit No.:/1C'7yroz," 45 j � r pate/By: / v/®v ✓J II q 13125 SW Hall Blvd.,Tigard,OR 97223 I j E LJian Review Phone: 503.718.2439 Fax: 503.598.1960 M Date/By: ._ ��31 Other Permit: T t G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: El See Page 2 for A9 4 / i Internet: www.tigard-or.gov [IL4 7791, Notified/Method: ! 4 , 49)..- Supplemental Information 09 P_Mwu.( !ekt/"e4.-1 TYPE OF WORK REQUIRED DATA: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 ®Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. 0 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ 2,d, 000 ❑Accessory building 0 Multi-family Number of bedrooms: -�' ❑Master builder 0 Other: Number of bathrooms: S. JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: r 9`1 to S \lJ g sr& NV e, New dwelling area: ,. square feet City/State/ZIP: (i q t 0t� , 9 1 7-VA ,�b,_,�f Garage/carport area: square feet Suite/bldg./apt.no.: �1 Project name: i�, vt' _____ �}4-0- Covered porch area: square feet Cross street/direct. ns to job site: Deck area: f square feet E(�„„l.�( tar / l.�iG -t z t4,8. Other structure area: / ,,/ square feet Pe. 1 --6ve ,W)`l �., /� pi„474-) REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision:9 Lot no.: Permit fees*are based on the value of the work performed. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. \)€.1 o (1f`�� f. --�vC "\lore k t'�c.�(x 6t--4' Valuation: $ 1r`S.}^\\a.'hoc 0k re...‘,., S+n l`- I EEC ,or G,.N..�.�w tr.i-A\\ eAl Sc Existing building area: square feet 1--:PA:r-cJ .1r,sVa,\\ / ((1--0,,- , UkxA" -1-, p�,,r--\jWi CKCx„".-0/ ern{, New building area: square feet figi PROPERTY OWNER 1 0 TENANT Number of stories: Name: Coy-vr.0 r f2,,p(\Q,y. Type of construction: Address: ,1 q z,c) S(,,,) ,'r3(t Ave. Occupancy groups: City/State/ZIP: c 1Arr)` (Az, a '1 7-7...)-k Existing: Phone:('co ) -S3(.y cj 20`t 0 Fax:( ) New: 0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: Structural plan review fee(or deposit): Contact name: FLS plan review fee(if applicable): Address: Total fees due upon application: 'piA ,4/ City/State/ZIP: 777 e Amount received: Phone:( ) Fax::( ) '�,�� PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: CCI�111 C_'1 Y- hkt�t.�/ "1''I € /'P i i ''(C �/ Commercial and residential prescriptive installation of CONT CTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name: Jam,,"./ 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 permit fee): $21.60 CCB lic.: Total fee due upon application: $201.60 Authorized signature: yyr , This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Cerv`O r Ito 0 Date: 12/12,/ Z4 i-i *Fee methodology set by Tri-County Buil ing Industry Service Board. I:ABuilding\Permits\BUP-RESPertnitApp.doc 02/24 011 440-4613T(11/02/COM/WEB) p-1,1 7 1 Building Permit Application Checklist 1 One- and Two-Family Dwelling FOR OFFICE USE ONLY City of Tigard Received Permit No.: ,11 . p 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: Phone: 503.718.2439 Fax: 503.598.1960 Associated permits: TIGARD 24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing El Mechanical Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A I Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ 0 ❑ 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑ 0 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: . ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ ❑ 6 Sewer permit. ❑ 0 ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control 0 plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ ❑ 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 ❑ ❑ ❑ 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 0 ❑ and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ ❑ ❑ furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- ❑ ❑ ❑ floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. 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 ❑ 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 ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 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. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ 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 ❑ ❑ ❑ architect licensed in Ore:.on and shall be shown to be applicable to the .ro'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". ❑ ❑ ❑ 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale"indicates standard architect or engineer scale. ❑ ❑ ❑ 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ ❑ and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. 1:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Application FOR OFFICE USE ONLY City Of Tigard Receiv114 Date/Bea Permit No.: .,... ..--- ` 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review �,1191 L[)'`'r f ~ Phone: 503.718.2439 Date/By: Other Permit: Inspection Line: 503.639.4175 T I G A is i l Ins P Date Ready/By: Juris: lil See Page 2 for Internet: www.tigard-or.gov Notified/Method Supplemental Information _ _ ,. L. COMMERCIAL F>E*SCHEDl1LE-USE TYPE OF WORK CHECKLIST ❑New construction [Addition/alteration/replacement Mechanical permit fees*are based on the value of the work performed.Indicate the value(rounded to the nearest dollar)of all ®Demolition ❑Other: mechanical materials e„luipment,labor,overhead,and Jirofit._ CATEGORY OF CONSTRUCTION Value:$ ^ RE(WENTIAL PQWPMFNT/SYSTEMS FEES*... I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description Qty. Ea Total JOB SITE INFORMATION AND LOCATION Heating cooling: Job site address:r-` �j� ' 3 r� }Air conditioning 46.75 i 11 � °~~ 1 Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: \ l ekr'C/�...1...01. �'.12z`t ,._._.. — g Furnace 100,000+BTU(ducts/ventsi ' 54.91 TM Suite/bldg./apt.no.: 1 Project name: \„qv-e.. p...,4\0,o,t;o r -149,20 . Heat burn{, 61.06 P " Duct work ,.... ( 23.32 I Cross street/directions to job site: _____ _._.._..-, ......�............ ,... Hvdronic hot water s}stem 23.32 Residential boiler(radiator or — ..._.—___ -- ,„„ hdronict 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 _„ — Flue/vent for any of above iyd 23.32 23.32 Subdivision: of no.: Other: 23.32 I Tax map/parcel no.: Other fuel appliances: ... ,_.. Water heater 23.32 DESCRIPTION OF WORK _ Gas fireplace/insert 33.39 . op Flue vent for water heater or gas . C.ro V ' !�v / Y""1 C t C?�..GWt- VC/l� 1"Q""__ ,t�f a�art firefllace 23.32 - `1 r. „,-C-' _A Vt")V �O f Loee lighter leas) _.__._.._ 23.32 t Wood/pellet stove 33.39 ..m.._... .,. _..... ........_ 1 Wood fueplace/insert 23.32 PROPERTY OH w Chimney/liner/flue/vent 23.32 WNER ❑ TENANT Other _ 1 23 32 Name: C�1 QN-- Cnr4 Environmental exhaust And ventilation: -„w �__ Range hood/other kitchen Address: ment 1 33.39 33.39 41zo s� 6-� hut. Clothes diver exhaust._. 33.39 City/State/ZIP: i ^ C o�I'L 1 72-7.-'4 Single duct exhaust(bathrooms, Phone:(y71:3) 13-6 1 ZO 0 Fax:( ) toilet compartments,utilirs rooms! 23.32 1 Attickrawl ace fans 23.32 105,APPLICANT i 0 CONTACT PERSON Other Business name: d(N.Pef-'e Fuel 'dui_ t. _ —. . $14 IS for first four;$4.03 for each additional Contact name: u -,.-._ t Furnace etc ., ,, Address: Gas heat tuns .�_ City/State/ZIP: Wall/stispended/unit heater a __.. —.- - Water heater t Phone:( ) Fax::( ) 1 Fire rlace 1 I Range E-mail. i CONTRACTOR — Barbecue t ' ,., Clothes dryer#gas) € Business name: c,w-v�.Qy/ Other f ._._..__ ,._..,,��,. e Address: ' . , .. MECHANICAL PTGRMIT Pk ES* '. .... „> . .� Subtotal 55.71 City/State/Z1P: Minimumpermitfee($90.00) 3/<<! Phone:( ) Fax:( ) Plan review(25%ofpermit fee) State surcharge(12%of permit fee) CCB lie.: TOTAL PERMIT FEE — This permit application_expires if a permit is not obtained within 180 Authorized signature: C.4. VP)- ` days after it has been accepted as complete. * Fee methodology set by Tri-County Building industry Service Board Print name: CO r�.pr Date: 1 IZ _1 01BuiidingJ'ennitsuMEC PerinitApp_082520.doc 440-4617T(II/02/COM/WEB) • Electrical Permit Application FOR OFFICE: USE ONLY City ofTi and Po:c qed < 'J g Datc lir Permit#: MV'T ?-4'l .rr/ ..' 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review 11 Phone: 503.718.2439 Dale/B+ Related Permit#: •' ---.., June: --- ® See Page 2 for Email: TigardBuildingPermits@Tigard-or.gov Ready Date/By: g 1 i ci.1 K D Inspection Line: 503.639.4175 Internet: www.tigard-or.gov Notified/Method Supplemental Information TYPE OF WORK PLAN REVIEW ❑New construction IN Addition/alteration/replacement Please check all that apply(submit/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. RI 1-and 2"-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 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 ❑Addition of now motor load of system. Job#: Job site address: 1 a 20 51/J g 3 114142, 100HP or more. ❑"A","E","1 2","1-3", • occupancy. ❑Six or more residential units. • City/State/ZIP. \ e s tJ�Z 224 ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bld ./a t #: IPro ect name: 1 1 C to 0 Hazardous locations. 0 Supply voltage for more than g P I J <�'�^ `.- �^ 600 volts nominal. „ „ „ ---- 0 Service or feeder 600 amps or more. Cross street/directions to job site: FEE SCHEDULE Descnr'tion in,.. Each 1 Total ' „, _„_ New residential single-or multi-family dwelling unit. Subdivision: I Lot#: includes attached garage. -- 1,000 sq.ft.or less 168.54 1 4 Tax map/parcel#: Ea.add'1500 sq.ft,or portion 33.92 1 DESCRIPTION OF WORK Limited energy, ,. . residential 75,00 2 with above s .ft.l 14c A:n r Cc. ..l ‘i '1�Ir x}wes arm. Sv�'�'ov-eb �° Limited energy,multi-family 75.00 2 ,,,�},� tpp �Fi residential(with above sq.ft.J It s _--r' -4__ ' �1 1 Renewable Enemy See Pa e 2 OPERTY OW ER ❑ TENANT -- ..:_»_ �. Services or feeders installation,alteration,and/or relocation Name: Certevs.12r P-4t,0 200 amps or less 100.70 2 Address: NI 2,0 s 1.,,.., s�3-A201 amps to 400 amps 133.56 2 ,u.mw - 401 amps to 600 amps 200.34 , 2 City/State/ZIP: t`, 0 Z I7 21,4 601 amps to 1,000 amps 301.04 2 Phone:(,503 )--g6(\ Over 1,000 amps or volts 552.26 u - — '"""" Temporary services or feeders installation,alteration,and/or Email: t;,oriirwf COv t'^"tit • C,or^ relocation Owner installation:This installati is being made on property that I own which is not i 200 amps or less ' 59.36 1 i 1 intended for sale,lease,rent,or exchan e,according to•ORS 447,449,670,and 701. ; 201 amps to 400 strips 125.08 - i 2 �" Owner signature: C�/a+ Date: (W,1z✓'zoz t 401 amps to 599 amps 168.54 1 1.2 [,APPLICANT t 0 CONTACT PERSON Branch circuits new alteration,or extension,per anel , , A.Fee for branch circuits with Business name: C91..Adr44` above service or feeder fee, 7.42 2 _ each branch circuit Contact name: B.Fee for branch circuits without I ' � °""ro'-'"' service or feeder fee,first 1 56.18 56.18 2 Address: branch circuit City/State/ZIP: Each add'I branch circuit 5 7.42 37.10 2 1 „,_... „_ -- Miscellaneous(service or feeder not included Phone:( ) Each manufactured or modular 67,84 1.111 dwelling,service and/or feeder Email: Reconnect only IIIIIMECIIIIIIIIEll CONTRACTOR Pump or irrigation circle 67.84 2 - Business name: vi /J‘Q,P.-- Sign or outline lighting 67.84 2 — Signal circuit(s)or limited-energy ❑ See Page 2 2 Address: , panel,alteration,or extension. ' - Each additional inspection over allowable in any of the above City/State/ZlP: Additional inspection(1 hr min) 1 66.25/hr - - „ _ • Phone:( ) `.. investigation(1 hr min) 90,00/hr Ill _. —" Industrial plant(1 hr min) 78.18/hr , i Email: Inspections for which no fee is— 90.00/hr ; d s ificall listed /a hr min) L. CCB Lie.: 1 Electrical Lic.: Suprv.Lic.: •-- l ��„ �_„ ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal 93.28 Print name. Date: ❑Plan Review Re aired(25%ofpermit fee _W_. „ .. , ,- State surcharge(12%of permit fee): Authorized signature: ''„ -.. TOTAL PERMIT FEE: •.._ _ - This permit application expires If a permit is not obtained within 180 Print name: 6. Date: days after it has been accepted as complete. n - - �p p � Z/�7i� , * Number of inspections allowed per pennit. t:\Building/Permits\ELC_PenuitApp ELR ERE.doc Rev 10/26/2017 440-4615T(l l/05/COM/WEB . Plumbing Permit Application Building Fixtures FOR OFFICE USE ONLY Received City of Tigard permit No.: 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: �S/��F]-(1Lx) / Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.: T 1 G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑ New construction Demolition For special information use checklist. Description I Qty. Ea. Total gAddition/alteration/replacement El Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 cg I-and 2-family dwelling IIICommercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 0 Accessory building ❑Multi-family Each additional bath/kitchen 25.02 ❑Master builder El Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: (iiclk ri...O jy,./ ,3ri" /oVQ-. Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: \ adl r0\ ©fL 1"i'y2y Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: 1 Project name: yt Qi -HIP 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: Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 DpM,O T‘vrbi-. A-0 fv./K +o mi.., ‘‘-')}L kJGct"y,vr1 Dishwasher 25.02 _r„s,+,,,I, 18,,,e4r. 51".\/- 'sue \ &_v' Xr'� rOPr", Drinking fountain 25.02 Ejectors/sump 25.02 Jj.,PROPERTY OWNER 0 TENANT Expansion tank 12.51 // Fixture/sewer cap 25.02 Name: Wrl\Of ?se'dre- Floor drain/floor sink/hub 25.02 Address: ‘'A DI 1..-D S Vs, g 3`A PVC", Garbage disposal 1 25.02 City/State/ZIP: l y Err / 01t 17 2;1- Hose bib 25.02 Phone:(01).- f561 -7.040 Fax:( ) Ice maker ( 12.51 X APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: 6 WleN.Q�/ Medical gas(value:$ ) Page 2 A Primer 12.51 Contact name: J Roof drain(commercial) _f 12.51 Address: / Sink/basin/lavatory `�`kil 25.02 L$,.tTZ City/State/ZIP: / Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 CONTRACTOR Water closet 25.02 Water heater 37.52 Business name: U "+"e► Water piping/DWV i 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal 7...5,en. Phone:( ) /7*Fax:( ) Minimum permit fee: $72.50 CCB Lic.: Plumbing Lic.no.: Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: �ytiwv✓V'- "k144�7f TOTAL PERMIT FEE Print name: //' Or" �6 Date: a Z 20 Zt This permit application expires if a permit is not obtained within 180 days L�l.',�^ after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-46 16T(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-P'100' 50.03 0 to 2,000 $I21.90 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 Valuation: Permit Fee: Storm&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 Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to and including$10,000.00. Inspection of existing plumbing or 161 $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 each additional$100.00 or fraction thereof. (minimum charge-1/2 hour) 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 Baptistry/Font ❑ Any new commercial building with water service 2"and greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool IDCar Wash: Each Stall New exterior plumbing site utilities for any complex structure Drive tTall as defined in OAR918-780-0040. Cuspidor/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 Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" 3" Isometric or Riser Diagram -Car Wash Drain ❑ Isometric or riser diagram is required for new buildings Garbage Domestic non-food that meet the qualifications above. Disposal: -Domestic food related -Commercial food related -Ind Ice Mach./Refrig.Drainsustrialfood related 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 08/04/20I1 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 ontractor is: wrvW Name CCB# Expiration Date 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. C-brrcy Ores. Print Name of Permit Applicant f Signature of Permit Applicant Date Permit#: _CJOS 4 / _- OF Address: 10 l �C ; a N c, 4 w Issued by: ,Q , Date: g • This Copy for Permit Offices Information Notice to Owners About �` ¶CE�VE® Vj`= Construction Res onsibilit �"'' L:C 1 4 2021 `=� (ORS 701.325 (3)) CITY OF TIGARD 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, go online to the Oregon Business Registry. For questions, call 503-945-8091. • 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 800-452-0288. • 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, go online to 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 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 9-2016 This Copy for Permit Water Meter Fixture Unit Worksheet for Additions/Remodels/ADU. '3 pm Please complete the following information: Li)i Y OF TIGARD BUILDING DIVISION Customer Name: CO n r,or '?-o o IN Service Address: Street/Suite#: j 44l 20 S W S3(k Av Ci 1-iaarrX State: © 6 r Zip: c -nii-11 Phone Number: JO 3 - 8" 6a 204.0 Email: CoYv^orr-flo, 7TA ®tr.", c-o w. Please fill in the number of each fixture you currently have. Please fill in the number of fixtures you propose to add. Multiply the quantity by the point value to arrive at the current Multiply the quantity by the point value to arrive at total, the proposed total. Fixture Unit Current Point Current Proposed Point Proposed Quantity Value Total Addition Value Total Bar sink 7 x 1 = 0 0 x 1 = 0 Bidet 0 x 1 = 0 p x 1 = Y_ 0 Clothes washer I x 4 = %-t Q.. x 4 = p Dishwasher ti x 1.5 = I •S 0 x 1.5 0 1st Outside Water Spigot i x 2.5 = 2-S O x 2,5 = 0 Water Spigot,each add'l t x 1 = t — 1 x 1 = --1 Kitchen sink 1 x 1.5 = 1.S © x 1.5 = 0 Laundry sink 0 x 1.5 = 0 1 x 1.5 = 1. S Lavatory(bathroom sink) 2- x 1 = 2 0 x 1 — 0 Water closet,1.6 OPF(toilet) z• x 2.5 = S 0 x 2.5 = d Bathtub/whirlpool ] x 4 = 0 0 x 4 = 0 Shower stall i x 2 = Z O x 2 = 0 Bath/shower combo 1 x 4 = 4 0 x 4 — 0 Current Points: 2.3•S Proposed Increase: 0 S Current Points+Proposed Increase= 2-9 =New Total Points =Required Meter Size /$' _ Meter Sizes: 1 to 30 points=5/8" 30.5 to 37 points=3/4" 37.5 and over points= 1" New Meter Size Needed for New Total Points: SJ "6 Cost: $ _(see page 1) Current Meter Size per Utility Billing: Vs" Cost: $ 'r (see page 1) New Meter Size Cost minus Current Meter Size Cost= $ (This is Your Cost to Increase Meter Size Due to Additional Fixture Units) ************************************************************************************* FOR OFFICE USE ONLY No increase in meter size is required. Current Meter Size Confirmed with UB Jill M Bentley 12/23/21 Signature of UB Representative Date I:/3uilding/Forms/WaterMeters_070121.Add,doCX Page 2 Branden Taggart From: #Building Permit Technicians Sent: Tuesday, December 14, 2021 6:07 PM To: connorrooney789@gmail.com Subject: Building Permit Submittal - 14920 SW 83rd Ave. Attachments: Applications.pdf Hello Connor, We received your Building permit submittal. However, the Mechanical and Electrical Permit Application fee schedules were incomplete. I have attached the applications above for you to complete and return to us. Once we receive them, we will route the permit for plan review. Thank you, Branden Taggart 114 4 City of Tigard ii Senior Permit Technician Community Development 13125 SW Hall Blvd Tigard, OR 97223 (503)718-2449 brandent@tigard-or.gov 1