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Permit Support Document CITY OF TIGARD MASTER PERMIT i III _ COMMUNITY DEVELOPMENT Permit#: MST2021-00289 Date Issued: 02/09/2022 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S111BD00402 Jurisdiction: Tigard Site address: 9650 SW MURDOCK ST Subdivision: DARMEL NO.3 Lot: 25 Project: Emmi Project Description: 96sf demo/rebuild and add 105sf at rear of home. Areas of work=sunroom, bathroom and laundry room. Water meter not required to be upsized. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 0 First: 105 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 20 Smoke Dwelling Units: 0 Third: 0 sf Right: 5 Detectors: Total: 105 sf Value: $86,340.00 Rear: 15 PLUMBING Sinks: 0 Water Closets: 1 Washing Mach: 1 Laundry Trays: 1 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 Bcklw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Other Fixtures: 1 Drywall-Trench Drain: 0 Other Fixture Units: Water piping/DWV MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 1 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 0 Other Units: 2 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 1 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 WI Svc or Fdr: 0 Ea add!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 Opener:O N Garage N Vaccuum HVAC: N Security Alarm: System: gp Audio&Stereo: All N Other: N Other Description: Ecompasing: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ADD SF VB R-3 105 Owner: Contractor: EMMI,JOSEPH S& GREEN BRIDGE CONSTRUCTION Required Items and Reports(Conditions) SHIH-EMMI,YAMIN MONICA 1406 SW MAPLECREST DR 9650 SW MURDOCK ST PORTLAND,OR 97219 TIGARD,OR 97224 PHONE: PHONE: 503-703-2278 FAX: Total Fees: $3,403.65 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 re 'es you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR ::::;: n rhrn c. nAl_nv nhtaln rnm nr dinar'n, tinctoniINf'by Tllinn co7: Al ,' Permittee Signature: /{///�/1 ,Call 503.639.4175 by 7:l0 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. , DG/r7 2( , i Building Permit Applicati°- CCEtVEr` Residential 1"�C G• V FOR OFFICE USE ONLY JUN 17 2021 Received City of Tigard Date/By ZZ ' i Oa PemitMST-20 Ll-CO Ai?? 13125 SW Hall Blvd.,Tigard,OR 97223rr ITY OF TIGARD Plan Review /L/� Phone: 503.718.2439 Fax: 503598.194 DateBy: �i��(iiWWWW iherPermit: I tlrv\I:I) Inspection Line: 503.639.4175 BUILDING DIVISION D a�,/BY. t' Sr® Page 2for Internet www.hgard-or.gov tt ed/Method: / /,� Supplemental Information TYPE OF WORK REQUIRED DATA:1-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 Addition/alteration/replacemcnt ❑Other: equipment,materials,labor, ea , roftt for e CATEGORY OF CONSTRUCTION work indicated on this ap cation. '�I-and 2-family dwelling 0 Commercial/industrial Valuation: $ 11{*(� U ❑Accessory building Multi-family Number of bedrooms: ` V / ❑ / ' ❑Master builder ❑Other: Number of bathrooms: 3 �U JOB SITE INFORMATION AND LOCATION Total number of floors: I C \ Job site address: -1 6 5-V 4 ,„ Mo VI- New dwelling area: ;� t ��'quare feet i 6 5- City/State/ZIP: Po2rtI_A-Nr> Q n" 9 a�• Garage/carport area: square feet � t j Suite/bldg./apt.no.: Project name: .�t,,`��m Covered porch area: I I fr square feet _(A.IA �Crposs street/directions to job site: 5. rW q(6 �v 1 etAt , �y� Deck area: {,/ IAr square feet A' �M 4 ( G(. M (A/o I K S* E r le- ( _' Other structure arca:: V IA- square feet t 1 C.WS SOW( - e/t°cvrbep�. £ aZftS/- �.'_ r REQUIRED DATA:COMMERCIAL-USE CHECKLIST _ICtt� Subdivision: Cr IA t'.T Z V t,e Lot no.:RcO1,t{t/ Permit fees*are based on the value of the work performed .— Indicate alto ^ O�� 1 Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: O� 1 5 equipment,materials,labor,overhead,and the profit for the ,,✓� A �}� / DESCRIPTION OF WORK p�y- work indicated on this application. .ramAr 'I� 40 t N V 0 N 1 b� 5(1 �J e 1 0A Valuation: $ _ 3� Existing building area: square feet e ,� 13A-CK d4- 'The- 1�w 'Co in1 c�.2- b\\ ,r 5011 (�,acy��� , �'h c c i1 f t..c/'. tx i,toor New building area: square feet Vt ,tIPRAOPER Y 1O7WNNER `lV••, I�wO-tV���lufi/�',❑ari I NIAN'II r• l Number of stories: t Name: -" e' Lim I Type of construction: Address: q 6 5-6 5 f Myp po� 5, Occupancy groups: \(� City/State/ZIP: P�j e �,A- rb 1 •6 \ Esi1A?1.1 L Existing: Phone:(61 a6 1 7 ct I _ Fax:( ) New: \\\� KAPPLICANT 111- El CONTACT '''PEERSON BUILDING PERMIT FEES* i. Business name: vrcon CO ts&Iq - (m'c-f VO•frOvl tPG+as'n rofer le rden schedak� b tom^ Structural plan review fee(or deposit): j,5.5 ,. L` ' Contact name: MI t _ t4, 4-� IIV Et 1 55�''' l44d h S w Mx.lplcc L e col--; FLS plan review fee(if applicable): i Address: ,.I Total fees due upon application: City/State/ZIP: Po k u ..,t-O p 0� all _ Phone:($ 3) ',.a,�,,1 V I Fax::( ) Amount received: mho yi M r6 ,.awl PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: 1 Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. 'y h_�'1` r Submit two(2)sets of roof plan with connection details Business name: 6 � I �tns'Ii�1� G�JV 1 NO v`J 5r; eo -- - and fire (2)departmentts access,along with the Oregon I Address: 1 if d 6 s tJJ .004 ��' " D I?l Solar Installation Specially Code checklist. �'\?4T'tv•J Q� ��' Permit Fee(includes plan reviej $180.00 City/State/ZIP: d., and administrative fees , 4 Phone:(t '��I�'��g Fax: ) State surcharge(12%of permit fee): $21.60 CCB lie.: '�l/ [7 /0z (2-3 Total fee due upon application: $201.60 Authorized signature: j} This permit application expires if a permit is not obtained di within 180 days after it has been accepted as complete. `, t,/I ♦ / *Fee methodology set by Tri-County Building Industry �6 Print name: ft f�� ' N Dale: a l Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-0613T( 1/02/COM/WEB) r Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONLY City of Tigard RecDateived Permit No.: 13125 SW Hall Blvd.,Tigard,OR 97223 a '. Associated permits: ■ Phone: 503.718.2439 Fax: 503.598.1960 ❑ Electrical ❑ Plumbing ❑ Mechanical II G A�i U 24-Hour Inspection Tine: 503.639.4175 Internet: www.tigard-or.gov 0 Other THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 ❑ ❑ 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 ❑ 3 Verification of approved plat/lot. _ ❑ 0 0 4 Fire district approval required. Name of district: 0 0 ❑ 5 Septic system permit or authorization for remodel. Existing system capacity 0❑ ❑❑ • 6 Sewer permit. ❑ ❑ CI Water district approval. CI ❑ 0 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- ❑ ❑ 0 basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 0 ❑ 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 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 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 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 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- ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 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 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 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 0 0 architect licensed in Ore•on and shall be shown to be as plicable to the Iro'ect under review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 1 I 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. 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ 0 0 _ 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 ❑ 0 27 "Drawn to scale"indicates standard architect or engineer scale. 0 0 ❑ 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, 0 ❑ 0 and protection measures must be drawn to scale and must include the project arborist's signature of approval. CI 0 0 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:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(1l/02/COM/WEB) r `' CEhjE� ' Mechanical Permit Applic FOR OFFICE USE ONLY City Tigard JUL 21 2021 Received Perm a q v 13125 SW Hall Blvd.,Tigard,OR 97223 _ Plan Review CITY OF tGARD Date/ Other Permit: Phone: 503.718.2439 �t Y: Inspection Line: 503.639.4175 t 7,i r' r t l'l<l(l]\N Date Ready/By: Juris: ® See Page 2 for I lt�:ARll QU�L� Supplemental Information Internet: www.tigard-or.gov Notified/Method: PP TYPE OF WORK COMMERCIAL FEE*SCHEDULE-USE CHECKLIST 0 New construction '.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 0 Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. CATEGORY OF CONSTRUCTION Value:$ - - RESIDENTIAL EQUIPMENT/SYSTEMS FEES* `ita 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist. ❑ Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: p + I , Air conditioning 46.75 Ilob site address: IO S w J r�r�(�K sf. Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: T 04'' of 7 as Furnace 100,000+BTU(duets/vents) 54.91 ����IIIII G < 61.06 Suite/bldg./apt.no.: Project name: Lm61 1 Heat pump _ L /- Duct work ` 'CJY�' 23.32 L 1640 s 0 Cross street/directions to job site: 5 wdi6-nr► ex vc.... }Iydranic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), pq•_ in-wall,in-duct,suspended,etc. i ` 46.75 AV( Flue/vent for any of above �,(K`� 23.32 f'�ram[� Subdivision: V ` E. Lot no.: 3 Other: 23.32 I(Vpp Other fuel appliances: Tax map/parcel no.: aS '' F�oO'T Water heater ' 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 Flue vent for water heater or gas ` fireplace t 23.32Aa r" 1Y\ Y\ '� (p nn•� D, h2on1 I Log lighter(gas) 23.32 140+e' txt� oat V im` eA-t75 Wood/pellet stove 23.32 Vv �Rf-/•, V Wood fireplace/insert Chimney/liner/flue/vent 23.32 PROPERTY OWNER 0 TENANT Other: 23.32 a t Environmental exhaust and ventilation: Name: "'rip . E m.r 1l Range hood/other kitchen equipment 33.39 Address: {t'("c2 w iuc Cr� �, ` 33.39 33•11 `3 Clothes dryer exhaust t` City/State/ZIP: Tits-fit O� 11�ai� Single-duct exhaust(bathrooms, �j toilet compartments,utility rooms) 23.32 �;a3 //�� Fax Attic/crawlspace fans 23.32 PrtthPhoce:(�(� � —'-1�� ( ) f''' `APPLICANT 0 CONTACT PERSON 23.32 Other: Business name: Nw1 15rt COJnc�YJL*JCJ V\ Fuel piping: M` t" ./ ,©�4_ $14.15 for first four;$4.03 for each additional Contact name: NN-.-- •• ��xx Furnace,etc. Address: (tk©( S(A) On Gas heat pump n ,,,,,,qqq Wall/suspended/unit heater y�J.1 " k`" City/Stale/ZIP: 1OR'Ctj—N "� QC 67Jd1 Water heater ` flavb kk J Phone:(gp3 743 i a� Fax::( ) Fireplace ' E-mail: tM r,_h`J.��� 0 lye,60 vv.‘ Range r'Irr'� Barbecue CONTRACTOR Clothes dryer(gas) Business name: Green � pp9905,4-1,J 0✓I Other: r � 7 �Y (� MECHANICAL PERMIT FEES* Address: `�ov w �yyo� 'Yl ^V�I Subtotal a 1 6 City/State/ZIP: �j'OITT L-'r- t> Or( 9 ( �,9 Minimum permit fee($90.00) N ✓ Fax: Plan review(25%of permit fee) 5aa Phone:(: �I/ a. �aa ( ) 1C/r,/I' State surcharge(12%of permit fee) '�[',„0 CCB lie.: 'aft TOTAL PERMIT FEE This permit application expires if a permit is not obtain within 180 days after it has been accepted as complete. Authorized signature: * Fee methodology set by Tr "" ���� i-County Building Industry S ice oard Q / Print name: IAic,v a4 ( V0( Date:7/ l citki , -4 g Qt,63 F\Building\Pe/mits\MEC_PetmitApp 082520.doe 440 I7T(Il/0/COM/lEB) r RECEIVED ' Electrical Permit Application lUL 21 2021 FOR OFFICE USE ONLY /�prl Received IliCity SW Tigard ' 1 C 14.aARD Date/B : lellEMMIN - 13125 Hall Blvd.,Tigard,OR 972Y3�Y CJ t IIGARD Plan Review ' Phone: 503.718.2439 Fax: 503.5 $l960DING. DIVISION Date/B : Related Permit#: Inspection Line: 503.639.4175 Ready Datc/By: EMS; See Page 2 for I I( ,\Ii i) Internet: www.tigard-or.gov Nodfied/Method': Supplemental Information 'TYPE OF WORK �; PLAN REVIEW nddition/allerat acemen ion/re lt Please check all that apply(submit 2 sets of plans mumshts checked): . El New cOnsliuetiOn P ❑Service or feeder 400 amps or more 0 Building over three stories. U . Demolition ❑Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings. less to ground,or exceeds 14,000 0 Commercial-use 11A1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building amps for all other installations. buildings. ❑Multi-family D Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ['Emergency system. larger separately derived 0 Addition of new motor load of system. p Job#: Job site address: I o SQ C�) s 100HP or more. ❑"A","E",'l-2","1-3", b �� r M� ❑Six or more residential units. occupancy. ❑ City/State/ZIP:T(AyI,.�t•^� Q^ ❑Healthcare facilities. Recreational vehicle parks. Su1le Bldg./apt.#: Project name: tA'AL' 0 Hazardous locations. 0 Supply voltage for more than � ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: Sul ci(1,rt vr9 {l a._ FEE SCHEDULE Description f Qty. I Each i Total A New residential single-or multi-family dwelling unit. Subdivision: p/kS4,1--- Lot#: 3 Includes attached garage. [II Bop() sq.ft.or less 168.54 4 map /parcel ap,/parcel#: ��-iiiVVV E La.a.add'1500 sq. sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 (with above sq.ft.) ADD p L1q n d--dv k7t5 -to wnrca2vni R(L h r-Go vn Limited energy,multi-family 75.00 2 GiNitL „n T 1^ - f2_,..th r'.._ 7 residential(with above sq.ft.) -�(/{�� 1'✓1 TQ,•1 li/ IX/�1, W.1 Renewable Energy 0 See Page 2 -...0 {'ROPER OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name: .." 1C y 'sl 200 amps or less 100.70 2 L ( f'���q /�' 201 amps to 400 amps 133.56 2 Address: I V co Su) m,t),?, l( 401 amps to 600 amps 200.34 2 City/State/ZIP: A a as 601 amps to 1,000 amps 301.04 2 Phone:(,ib3) 4 i"d?q I Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation adto2 at I own which is not 200 amps less 59.36 intended for sale,lease,rery t 7, 9,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: `J Date: 401 amps to 599 amps 168.54 2'� CONTACT PERSON Branch circuits-new,alteration,or extension,eer panel KAPPLICANT II-: ❑ ;/..,f C - A.Fee for branch circuits with Business name: 6 er 13,6' � ,Eft 1 r C. ls'QI f above service or feeder fee, 7.42 2 �1'w• t /ylf,_A��d''tT1L each branch circuit Contact name: 1 A ZG ( D N 1't Y B.Fee for branch circuits without I4-- service or feeder fee,first r 56.18 56ig 2 Address: Lv branch circuit 1 '� rS �f �i Each add'I branch circuit �` 7.42 aC,l�j�2 City/State/ZIP:p�(Tlty'�J O -1�� Miscellaneous(service or feeder not included) Phone:(5)) 70 a Fax::( ) Each manufactured or modular 67.84 2 ,fp -,r/) dwelling,service and/or feeder Email: MA ..1-4 O M R�� �A t I Reconnect only 67.84 2 ` �G,R-re CONTRACTOR Pump or irrigation circle 67.84 2 Business name: --e3--�sT-/ Ci ,L�� Sign or outline lighting 67.84 2 r i Y Signal circuit(s)or limited-energy ❑ gee Page 2 2 Address: panel,alteration,or extension. Each additional inspection over allowable in any of the above City/State/ZIP: Additional inspection(I hr min) 66.25/hr Phone:( ) Fax:( ) Investigation(1 hr min) 90.00/hr 1 Industrial plant(1 hr min) 78.18/hr Email: Inspections for which no fez is 90.00/hr Electrical Lie.: Suprv.Lie.: SpeciIcally listed(1/2hr min) CCB Lic.: p ELECTRICAL.PERMIT FEES / Suprv.Electrician signature,required: Subtotal: 55 a g O Print name: Date: ❑Plan Review Required(25%of permit fee): a,I 1 1 State surcharge(12%of permit fee): 'O'3i7 TOTAL PERMIT FEE: I '.Oil 6 Authorized signature: w( This permit application expires If a permit is not filed thin 18 Print name: Date: days after it has been accepted as camp e. * Number of inspections allowed per permit. IalERuldmgtPermitstELC PcmutApp_ELR_ERE.doc Rcv 06/17/2015 440-46i5T(11/05/COM/WED RECEIVED • Electrical Permit Application JUL 21 2021 FOR OFFICE USE ONLY �/ ' it y City of Tigard • Recrie. Permit#:I IS 1-2-n .10 LA 9 STY OF I IGARD Da ' 13125 SW Hall Blvd.,Tigard,OR 97 Plan Review FEB 9 1U11 Related Permit#: Phone: 503.718.2439 Fax: 503.56MDING DIVISION Date/By; sG Inspection Line: 503.639.4175 Ready Date/By: _( r_ tuns: RI See Page 2 for I WARD.. Internet: www.tigard-or.gov Notifted/MetbahN Of IIVA" Supplemental Information TYPE OF WORK �,J`I,tLIDIN(T DIV151 r PLAN REVIEW ❑New construction $1Addition/alteration/replacement Please check allthat apply(submit 2 sets of plans wrtems checked): 0 Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition 0 Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ElFloating buildings. less to ground,or exceeds 14,000 0 Commercial-use agricultural 1$1.1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings. ❑Multi-family ❑Master builder 0 Other: ['Fire pump. 0 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:0161z0 w M� Ceti 10011P or more. ❑"A"•"E"•"1"2"•"l-3" vV /N1N1( ❑Six or more residential units. occupancy. City/State/ZIP: Tie- R q-i-all- r 0 Health-care facilities. ❑Recreational vehicle parks. a"_ ❑Hazardous locations. ❑Supply voltage for more than Sulte/hldg./apt.#: Project name: F ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: S W ci()ill owe__ FEE SCHEDULE Description I Qty. I Each I Total I • New residential single-or multi-family dwelling unit. Subdivision: 9 4101k, Lot#: 3 Includes attached garage. I I 1 Bo00 1,000 ! or less 168.54 4 Tax map/parcel#: asS Eaaa. dd'd'I 5 s 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 (with above sq.R.) ¢p p L1 h�S dd5 -� curl crvn 3u h ri�J i'Yi Limited energy,multi-family 75.00 2 "ocre I ,ram vvi (mot,* 'A TD a (� w,- residential(with above sq.ft.) (�C '!4^M�r, I •1 l IXNL n ram•'j Renewable Energy 0 See Page 2 ('ROPER OWNF,R 0 'TENANT ..., Services or feeders installation,alteration,and/or relocation Name: ' p J y Yj I. 200 amps or less 100.70 2 _ J - , 201 amps to 400 amps 133.56 2 Address: O (� MJ f 401 amps to 600 amps 200.34 2 City/State/ZIP: vt ap�, 601 amps to 1,000 amps 301.04 2 1 1 Fax: Over 1,000 amps or volts 552.26 2 Phone:(, ) 4 7a a /"1 ' ( ) Temporary services or feeders installation,alteration,and/or Email: / relocation 1' Owner installation:This• sta do is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease, ze e,actor itfig to ORS 447,449,%/id pi. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 K AP ANT I ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel A.A.Fee for branch circuits with Business name: LJ�'gf 11 WV5 t- V c+10- l above service or feeder fee, 7.42 2 �� " �� /� ` 1,� each branch circuit Contact name: j(/r yll0_' 1 Q N t. 1 B.Fee for branch circuits without '�O L v� (n,, I service or feeder fee,firsttg Address: 6 (� IC(�r'e5 - D Q branch circuit 56.18 �b I 2 I Each add'!branch circuit oc 7.42 R-116`�2 City/State/ZIP:P6VENaJ O e7d 6� Miscellaneous(service or feeder not included) Phone:(6-0. -70 _ail, Fax: :( ) Each manufactured or modular 67.84 2 M 0 3�� (� n only and/or feeder Email: ftjReconnectdwesonly 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name; 12C ' G t/ Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy ❑ See Page 2 2 Address: panel,alteration,or extension. Each additional inspection over allowable in any of the above City/State/ZIP:• Additional inspection(1 hr min) 66.25/hr Phone:( ) I Fax:( ) Investigation(1 hr min) 90.00/hr Industrial plant(1 he min) 78.18/hr Email: Inspections for which no fee is 90.00/hr CCB Lic.: I Electrical Lic.: I Suprv.Lie.: specifcaly listed('Yo hr min) ELECTRICAL.PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: Date: 0 Plan Review Required(25%of permit fee): �j� ` a111�} State surcharge(12%of permit fee): i V i'70 Authorized signature: TOTAL PERMIT FEE: 1 12 a This permit application expires if a permit is not I ed thin 1P6/ Print name: Date: days after it has been accepted as comp e. * Number of inspections allowed per permit. 13Building\Permas5ELC_PermitApp_ELR ERE.doc Rev 06/17/2015 440-4615T(11N5/COM/WEB Plumbing Permit Applicatio CEIVED Building Fixtures Ili! 91 2021 FOR um( F: I SF (tyl.) City of Tigard Received Permit No. 2.k7 • 13125 SW Hall Blvd.,Tigard,OR 97223 I IGARD Date/By: ST�ZI"'00 Phone: 503.718.2439 Fax: 503.598.1960 Plan Review ` =DIVISION DatellY: Other Permit No.: Inspection Line: 503.639.4175 Date Ready/By: tuns. I H See Pee 2 for T I G A R O Internet: www.ti and-or. ov Notified/Method: o B 8 g No[it3cd.M1tcthod: Supplemental Information 1 TYPE OF WORK FEE" SCHEDULE. , - *,* For special information use checklist. El New construction ❑Demolition N �R Description I Qty. I Ea. I Total pp Additionlalteration/replacement El Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) r CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building 0 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: 5- sW \V�(l'pc, S --• Catch basin or area drain 18.76 City/State/ZIP: ' .q 0 R Gr 1 Al Dryting drain (line,or trench drain 1 ge 2 -IiY� •` Footing drain(no.linear ft.: ) Page 2 Suite./bldg./apt.no.: I Project name: MM r Manufactured home utilities 50.03 Cross street/directions to job site: 5w (( lh CIA.e.- Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Pagc 2 Water service(no.linear ft.: ) Page 2 Subdivision: 0 € Lot no.: 3 Fixture or item: Tax map/parcel no.: .R..5C I ( , f2 0 0 0 4 N Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer ( 25.02 ADD S h�ufeC TO SeciYtct_ O % Dishwasher 25.02 ,4 U (rt -s al k ik4 14Lo J1, ,vil Drinking fountain 25.02 U (� Ejectors/sump 25.02 PROPERTY OWNER ❑ TENANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 5,0..., Ma n� c` Floor dr o sink/hub 25.02 Address: vr`�KU 11( l' OZ. 11�. GarbageHsedisposal 25.02 City/State/ZIP: 1 l/` (.}' Hose bib 25.02 Phone:(5 j) i A6'2._q7 cf 1 Fax:(l ) Ice maker 12.51 XAPPLICANT 7 0 CONTACT PERSON Interceptor/grease trap 25.02 Business names r�nn✓1 /��/1/-�. "�Q� Medical gas(value:$_) Page 2 ate• 1 43•'n r,7 l- Primer 12.51 Contact name: c� pr/' v�� ( - Roof drain(commercial) 12.51 , Address: t5.0 u`�-//�J D Sink/basin/lavatory �� 25.02 '36 6-i{ City/State/ZIP: 0 t..-fife 01 d.19f Solar units(potable water) 62.54 w✓ "Y Phone: J3,,') 'I703--ll�"�����//111.�� x:( ) Tub/shower/shower pan , 12.51 ,'a.C f E-mail:m,q ©A/ 4 doW) Urinal 25.D2 V 1 •• 11 •` ' Water closet l 25.02 CONTRACTOR Water heater 37.52 Business name: '/�\ �/���P/ Water piping/DWV , 56.29 Address: T� a' 1 Other: 25.02 City/State/ZIP: Subtotal Phone:( ) Fax:( ) Minimum permit fee: $72.50 72d4-0 CCB Lie.: Plumbing Lic.no.: Plan review (25%of permit fee) 1 i It 43 State surcharge(12%of permit fee) .may Authorized si titre: t/ 1407147V- 4 TOTAL PERMIT FEE (( Print name: "C D This permit application eapires if a permit Is not obtained within 16011ays after it has been accepted as complete. 'Fee methodology set by Tri-County Building Industry Service Boar{ lc `1 I.\Building\Permits\Pt.MU-PermilApp.doc 10/01/09 440.4616T(10/02/COM/WEB) t��}1 5 . RECEIVED • Plumbing Permit Annlicatii CE Building Fixtures JUL 21 2021 /^ 241 CI of Tigard ReceivedDat 1 Permit No.n 5T21�21 Ld 13i25 SW Hall Blvd.,Tigard,OR 97 31� OFi IGARD PlanRevte3'"'IL"DING mils ,,� - ■� ' Phone: 503.718.2439 Fax: 503.598OittiING DIVISION Date/By: Other Permit No.: 1 ti'.. Inspection Line: 503.639.4175 Date Ready/By: Reis ® 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, I Ea. I Total 'Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ❑Commercial/industrial SFR(2)bath 437.78 g.I-and..-family dwelling 500.32 SFR(3)bath ❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler(_sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: _ Sty , AtCatchbashch arelinedr n 18.76 Job site address: r/o 7 d Drywall,leach line,or trench drain 18.76 City/State/ZIP: 4450 ;CPC OR LI 7 as Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: 44 I Project name: 4.,M.4 I Manufactured home utilities 50.03 Cross street/directions to job site: 5 ew (9-th owe_ 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: 01„A tiU Lot no.: 3 Fixture or item: Tax map/parcel no.: I I 1 I3.D 0 0 j N Backflow preventer 31.27 Backwater valve 12.51 DESCRIPTION OF WORK Clothes washer I 25.02 ADD S heluter /To $rec cL ev- �/�-11 Dishwasher 25.02 _ A ID UTa(I�t Ice 1 4 1.Qi Wjr,I1'y- k i Yr I Drinking fountain 25.02 b` - " .4 Ejectors/sump 25.02 (PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Fixture/sewer cap 25.02 Name: ( Floor drain/floor sink/hub 25.02 Address: c 6 set S w M(f-do c 'r Garbage disposal 25.02 City/State/ZIP:T�t/"`c C k 17 Hose bib 25.02 Phone:So)) i16'2-C 7%J Fax:( ) Ice maker 12.51 IIAPPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 �A ' �r _ � Medical gas(value:$_) Page 2 Business name: ,w^ I 4-ru j 12.51 1_ Primer Contact name: •%'may • Roof drain(commercial) �• 12.51 Address: I `�) Cie 'y ^ Sink/basin/lavatory 7� 25.02 ,�Z�I l.� T JJ f 1 v+✓ City/State/ZIP: r Solar units(potable water) 62.54 Phone: ) Tub/shower/shower pan ` 12.51 1'd`t; v t Urinal 25.02 E-mail:mom` ax::( ) /(d Water closet t 25.02 .4 CONTRACTOR Water heater 37.52 Business name: Ojfrr- Water piping/DWV ` 56.29 Other: 25.02 Address: Subtotal PChone:ate/ZIP: //J 724W Minimum permit fee: $72.50 Phone:( ) �, Fax:( ) 1 Plan review (25%of permit fee) t,r Y3 CCB Lic.: Plumbing Lie.no.: State surcharge(12%of permit fee) k-1 Authorized signature: TOTAL PERMIT FEE (( T This permit application expires if a permit is not obtained within 180 ays Print name: J b �� S s pq l Date: Z/�rZG2Z after it has been accepted as completes 'Fee methodology set by Tri-County Building Industry Service Boar Cf 1 t.113ui1dinglPembaeLMl7-PerautApp.d°c 10/01/09 440-4616T(I0/03/COM/wEB) / City of Tigard 'I COMMUNITY DEVELOPMENT DEPARTMENT • TIGARD Building Permit Review — Residential Building Permit #: {l`1 S 120 2 i - CO 2J 9 Site Address: %j&CV StA) ri iQ ?xk S'r Project Name: WW1 ADQITIO(I Lot #: Planning Review Prop sal: A1)iricD rl T) %'• i-Fo WtC Verify address/suite# active in Accela. River Terrace: ❑ Yes,River Terrace Review Addendum Site an Elements: 1...1) Erosion Control C] pies of site plan on 8-1/2"x 11"or 11 x 17"paper •i R aed trees with drip line and tree protection measures Vest)wn to scale(standard architect or engineer scale) ("1 tL Foorctprint of new structure(including decks)and Frh ti .rth arrow C IJ...ty locations&easements (required for new and additions) !4 Site address,project or subdivision name and lot number !Sidewalk/driveway approach ❑ plicant information(name and phone number) I�Location of wells/septic systems Lot dimensions and building setback dimensions " I■ reet tree size,type and location Oft Ill are footage of buildings to be demolished Street names xisting structures on site N`* Corner elevations(2'contours if more than 4'differential) Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑Yes impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes LJNo L/J Clean Water Se ices—Service Provider Letter (lot platted prior to 9/10/1995): ,R equired: Yes,applicant was notified CI No Received: ID Yes ❑ No Water Meter F;txture Unit Worksheet—Additions,Remodels and ADUs Required: Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No O' SDC Exemption for ADU applied for: ❑ Yes ❑ No Received: ❑ Yes ❑ No Public Facilities Improvement (PFI) Permit: Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake kith' and Use Case#: n^ ❑ oning:� 'R 3 •S Required Setbacks: Front: 'W 1 Rear: f 5" Side: C5 Street Side: 14 Garage: to El Building Height: n � Max. Height: 30 if Actual Height: i* El Landscape Area: QJf % ❑ Lot Coverage Max: /(�.4 % trance ❑ Set back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less Windows urn 12%of area of all street-facing facades Garage ❑ Garage door. ' d widest street-facing wall ❑ Yes ❑ No,one owing is met: ❑ Door extends no more ' rom wall and there is a cover extending beyond garage. ❑ Door extends no more than 5'from w ' a 12 sq ft.window above garage on 2nd floor. ❑ Garage door width is El 12'or les 0%or less o ❑ 60%or less and includes 7 of following: ❑ Covered porch ecessed entrance ❑ Wall offset eave ❑ Roof offset ❑ Fir • es ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambre ❑ Dormer Accent siding ❑ Window trim ❑ Window recess ❑ Window projection cony isual Clearance ❑ Urban Forestry,PlanPl Sensitive Lands: CI Yes .2f No Type: ❑ Conditions met prior to issuance of building pe 't Not / Approved By Planning: Date: - 3/J/ Z I Revisions (after Building Submittal ly) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw_RES_122419.docx Building Permit Submittal Original Submittal Date: /I ]/-1 Site Plans: # 3 Building Plans: # � Building Permit#: Enter building permit# above. Workflow Routing. 0planning gineering hermit Coordinator &I—trading 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: �4�// /1-4,•4,��,✓ Date: 7/L? Z� Engineering Review / Slope at building pad: 2,d/o Ri Conditions "Met"prior to issuance of building permit 1114.1 Easements (encroachments) per engineering conditions of approval and plat n llko C"Water Quality/Quantity Facility: �/ Assess Water Quality Fee in-lieu: ❑ Yes LS No Assess Water Quantity Fee in-lieu: ❑ Yes C 'No LIDA Facility on lot: ❑ Yes V No Final Plat Recorded: n/" ❑ NOT Approved by Engineering: Date: Notes: LNJ Approved by Engineering: 7rr ari`Gk Date: 7 4/t Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review 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 it Does not apply SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes 7 N/A Tigard Trans SDC: ❑ Yes , N/A Parks SDC: ❑ Yes • N/A LIDA ❑ Yes gi N/A if OK to Issue Permit Approved by Permit Coordinator: jy�-�Q�i�l� Date: 1 121 [2424 1:1Building\Fonns\B1dgPermitRvw_RES_122419.docx 4 � RECEIVED CleanWater Services Service Provider Letter FEB 9 2022 otui is clear. CITY OF IIGARL +3tIU PIING pMs OF Submission Date: Feb 09,2022 Confirmation#: 0000 Applicant Name: GREEN BRIDGE CONSTRUCTION CWS File q: 22-000554 Contact Email: mahonmr@me.com Review Type: Partner City Plan Review Contact Phone: (503)703-2278 Ground Disturbance: 198 Primary Address: 9650 SW Murdock ST New Impervious Area: 198 Tigard, OR 97224 Primary Jurisdiction: Tigard Mod.Impervious Area: 0 Affected Tax Lots: 2S111BD00402 Development Activity: Deck Addition Project Description: FOR DISTRICT USE ONLY ❑ Based on review of the submitted materials and best available information Sensitive areas do not appear to exist on site or within 200' of the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order 19-5, Section 3.02.1, as amended by Resolution and Order 19-22. All required permits and approvals must be obtained and completed under applicable local,State,and federal law. ❑ Based on review of the submitted materials and best available information the above referenced project will not significantly impact the existing or potentially sensitive area(s) found near the site. This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect additional water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order 19-5, Section 3.02.1, as amended by Resolution and Order 19-22. All required permits and approvals must be obtained and completed under applicable local,state and federal law. ❑ This Service Provider Letter is not valid unless CWS approved site plan(s)are attached. ❑ The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2). NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. ❑ NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. Reviewed By:LDRToolReview Date: February 09,2022 The CWS Development Services group is here to review your project in the most effective and efficient way,while protecting the Tualatin River Watershed. Our partners include municipalities,environmental organizations,and developers large and small. Contact Us*2550 5W Hillsboro Highway*Hillsboro,Oregon 97123 phone:503-681-5100*email:splreview@cleanwaterservices.org*website:www.cleanwaterservices.org/permits-development CleanWater Services SENSITIVE AREA PRE-SCREENING SITE ASSESSMENT Clean Water Services File Number �a —000G-514 1. Jurisdiction: Tigard 2. Property Information(example: 15234AB01400) 3. Owner Information Tax lot ID(s): Name: Joe Emmi 2 S111 BD00402 Company: Address: 9650 SW Murdock St OR Site Address: 9650 SW Murdock St City,State,Zip: Tigard, Oregon,97219 City,State,Zip: Tigard,Oregon,97224 Phone/fax: (503)268-9791 Nearest cross street: SW 96th ave Email: mail 4 je@yahoo.com 4. Development Activity(check all that apply) 4. Applicant Information El Addition to single family residence(rooms,deck,garage) Name: Mike Mahonery D Lot line adjustment D Minor land partition Company: Green Bridge Construction ❑ Residential condominium ❑ Commercial condominium Address: 1406 SW Maplecrest Dr ❑ Residential subdivision D Commercial subdivision City,State,Zip: Portland, Oregon,97219 D Single lot commercial ❑ Multi lot commercial Phone/fax: 503-703-2278 Other Email: mahonmr@me.com 6. Will the project involve any off-site work? ❑yes 0 No 0 Unknown Location and description of off-site work: 7. Additional comments or information that may be needed to understand your project: This application does NOT replace Grading and Erosion Control Permits,Connection Permits, Building Permits,Site Development Permits, DEQ 1200-C Permit or other permits as issued by the Department of Environmental Quality, Department of State Lands and/or Department of the Army COE. All required permits and approvals must be obtained and completed under applicable local,state,and federal law. By signing this form,the Owner or Owner's authorized agent or representative, acknowledges and agrees that employees of Clean Water Services have authority to enter the project site at all reasonable times for the purpose of inspecting project site conditions and gathering information related to the project site. I certify that I am familiar with the information contained in this document,and to the best of my knowledge and belief,this information is true,complete,and accurate. Print/type name Mike Mahonery Print/type title Owner Signature ONLINE SUBMITTAL Date 2/9/2022 FOR DISTRICT USE ONLY Sensitive areas potentially exist on site or within 200'of the site.THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties,a Natural Resources Assessment Report may also be required. ❑ Based on review of the submitted materials and best available information sensitive areas do not appear to exist on site or within 200'of the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider Letter as required by Resolution and Order 19-5,Section 3.02.1,as amended by Resolution and Order 19-22.All required permits and approvals must be obtained and completed under applicable local,State and federal law. ❑ Based on review of the submitted materials and best available information the above referenced project will not significantly impact the existing or potentially sensitive area(s)found near the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect additional water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider Letter as required by Resolution and Order 19-5,Section 3.02.1,as amended by Resolution and Order 19-22.All required permits and approvals must be obtained and completed under applicable local,state and federal law. ❑ THIS SERVICE PR IDER LETTER IS NOT VALID UNLESS CWS APPROVED SITE PLAN(S)ARE ATTACHED. ❑ The proposed act does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2).NO SITE ASSESSMENT OR SERVICE ER R IS REQ rED. ���� Reviewed by %'1 Date �-a Once complete,emrdtf o:SPLReview@cleanwaterservices.org • Fax: (503)681-4439 OR mail to: SPL Review,Clean Water Services,2550 SW Hillsboro Highway,Hillsboro, Oregon 97123 Revised 22C20 Main Office • 2550 SW Hillsboro Highway • Hillsboro,Oregon 97123 • p:503.681.3600 f:503.681.3603 • cleanwaterservices.org FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT ' ■ ' Transmittal Letter i ,A,:,, 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 •www.tigard-or.gov DATE RECEIVED: TO: RECEIVED DEPT: BUILDING DIVISION FROM: Mike Mahoney AUC 4 202J COMPANY: Green Bridge Construction iTY OF TIGARD 3UILDING DIVISJOkLr• ` PHONE: 503-703-2278 EMAIL: mahonmr@me.com RE: 9650 SW MURDOCK ST,TIGARD,OR 97224 MST2021-00289 (Site Address) (Permit Number) Emmi (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: I Description: I Copies: I Description: Additional set(s) of plans. 3 Revisions: Cross section(s)and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: FOR F1E USE ONLY ,t/ Routed to Permit Tec i 'an: „Date: Initials: ®d io✓ Fee Descri tion: Amount Due: Fees Due: ❑Yes � $ N.....\\.....0 J — j 6/ $ ;/ Special tiPns: No � Don Reprint Permit(per PE): D Yes Applicant Notified: / Date: /�.3/ Initials: FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT _ " Transmittal Letter T I G A it D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Allison Armstrong DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: Brian Shaw AUG 2 4 2021 COMPANY: Shaw Building Designer CITY OF TIGARG BUILDING DIVISIOIgy: . PHONE: 971-212-3802 EMAIL: brian_d_shaw@msn.com RE: 9650 s.w. murdock st..Tigard MST2021-00289 • (Site Address) (Permit Number) Emmi Residence addition (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Cop1ies: = .Description z" T ,,.e, 1° a:4 ` °` s S ',.Copies" sDescription: X Additional set(s) of plans. 3 Revisions: AS REQUESTED X Cross section(s)and details. Wall bracing and/or lateral analysis. X Floor/roof framing. Basement and retaining walls. X Beam calculations. Engineer's calculations. Other(explain): REMARKS: / - ,- ' — ''. , --' FO F CE.USE ONLY , ii , Routed to P echnician: Date: � 71� Initials: t' No Fee Descri tion: Amount Due: Fees Due: � � � P $ Est lily 0PA. 1 l/ $ - Special �:..., Instructions: Reprint Permit(per PE : ❑ Yes ^ 3 ! J No ❑ Done Applicant Notified: �. Date: ` r�[ Initials: I:\Building\Forms\Transmittaliener-Revisions_073120.doc RECEWED JUL 26 2021 CITY OF TIGARD BUILDING DIVISION Water Meter Fixture Unit Worksheet for Additions/Remodels/ADUs Please complete the following information: Customer Name: )r Service Address: Street/Suite#: I ( Q 5'v.i 1.40& 1os<LS4r City: ( QrJ _ State: OK Zip: 97 aal.4 Phone Number: go) i D68_g7CC/Email: Please fill in the number of each fixture you currently have. Please fill in the number of fixtures you propose to add. Multiply the quantity by the point value to arrive at the current Multiply the quantity by the point value to arrive at total. the proposed total. Fixture Unit Current Point Current Proposed Point Proposed Quantity Value Total Addition Value Total Bar sink x 1 = x 1 — Bidet x 1 = x I - Clothes washer I x 4 = tk x 4 = Dishwasher I. x 1.5 = t t' x 1.5 = la Outside Water Spigot 6 x 2.5 = `Xr5 x 2.5 -- Water Spigot,each add'l 1 x 1 = ti x I Kitchen sink 1 x 1.5 = 1 is- x 1.5 = Laundry sink x 1.5 t x 1.5 Lavatory(bathroom sink) X 1 = 3 X 1 — Water closet,1.6 GPF(toilet) x 2.5 = 7 t ,S ---_ x 2.5 = Bathtub/whirlpool I x 4 = x 4 = Shower stall 1 x 2 — k i x 2 Bath/shower combo x 4 = x 4 = Current Points: 27 Proposed Increase: p. Current Points+Proposed Increase= l =New Total Points =Required Meter Size R I ,,�� Meter Sizes: 1 to 30 points=5/8" 30.5 to 37 points=%" 37.5 and over points= 1" New Meter Size Needed for New Total Points: 5/8 Cost: $_ (see page 1) Current Meter Size per Utility Billing: 5/$..,µ. Cost: $_ ._,_(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 Current Meter Size Does Not Need to be Increased J Current Meter Size Confirmed with UB Bentley 07/26/21 Signature of UB Representative Date I:/Building/Porms/WaterMeters 070120 Add.docc Page 2 Dianna Ornelas From: UB Online Sent: Monday, July 26, 2021 8:36 AM To: #Building Permit Technicians; Mike Mahoney Cc: Nikki Tuason Subject: RE: 9650 SW Murdock St. Attachments: 9650 SW Murdock St 072621.pdf Attached is the signed meter update sheet. The current meter will not require an upgrade in size due to the increased fixture units. Kind Regards, Jill (she/her/hers) IN A WORL['., Jill 6r,aRroCM UMBEAYy .r; . • City of Tigard -Utility Billing q11111 '11 " S —�000C Senior Accounting Asst Tic ARD MB)826-7211 Payments , ifia (503)718-2460 UB Main .1 ] jillb©tigard-or.gov c �( (503)718-2494 Q13125 �+` ■���6 Tigard,OR H Blvd.97223 From: #Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Sent:Thursday,July 22, 2021 10:58 AM To: Mike Mahoney<mahonmr@me.com> Cc: Nikki Tuason <nikkit@tigard-or.gov>; UB Online <UBOnlinepay@tigard-or.gov> Subject: RE: 9650 SW Murdock St. Hello Mike, Thank you for the applications. I have copied Utility Billing to review and approve of the attached water meter worksheet. This permit has been approved by planning and the plan review submittal fee due is$655.24 (see attached invoice). The fees can be paid online at https://aca-prod.accela.com/TIGARD/Welcome.aspx by searching for the permit record number MST2021-00289 under the Building tab. Once the fees are paid, the plans will be routed offsite for plan review. Please allow 4-6 weeks for processing. The permit technicians will contact you when the permit is ready to issue and with instructions to pay the remaining permit fees due at that time. Please note that we will need the licensed contractors identified for the plumbing application and the electrical application which will also require the electrical supervisor's signature prior to permit issuance. When you have that information, please forward to TigardBuildingPermits@tigard-or.gov. 1 Thank you. Dianna L. Ornelas Building Division Services Supervisor City of Tigard I Community Development 13125 SW Hall Blvd I Tigard, OR 97223 503-718-2430 Direct 1503-718-2439 Permits From: Mike Mahoney<mahonmr@me.com> Sent:Thursday,July 22, 2021 10:20 AM To: #Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Cc: Nikki Tuason <nikkit@tigard-or.gov> Subject: Re: 9650 SW Murdock St. Caution!This message was sent from outside your organization. Hi Dianna, Sorry I missed your call yesterday. I did get ahold of someone earlier this week and I got all the trades permits filled out and delivered them to the Tigard office. Let me know if there is anything else you need from me. Thank you Mike Mahoney Green Bridge Construction CCB 213892 On Jul 22, 2021, at 9:31 AM,#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> wrote: Dianna 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 / / ' J BUILDING DESIGNER AW 8/23/21 Allyson Armstrong City of Tigard Hello Allyson We have perused your list of items needed to complete the permit process; ✓-V2' We have shown the new foundation on the existing foundation ( Page 4.) Bird blocks will be installed every other rafter. (see pg 4) ✓�3 Crawl access is located in the new laundry. (page 3) V j Using engineers footing design (page 4) Using engineers footing design (page 4) ✓ V Added dimensions, sq.ft on floor plan title. (page 3) Please contact me if more information is needed. Brian Shaw, Building Designer 971-212-3802 QjTY o / (.,bI.)1 ( t (i wL_J t o s clA frot 0( 171- loto.-(\ y-,t_titt,(1,J ,c-.44.--, 1318 9th Street,Oregon City,OR 97045 • Office 503-557-0897 • Cell 971-212-3802 • m •• • Water Meter Fixture Unit Worksheet for Additions/Remodels/ADUsiV ED Please complete the following information: L 2 1 2021 '''T;'OF i IGARD Customer Name: -jp. yY)(` 'NG DIVISION Service Address: Street/Suite#: 1 65Q 5'(N 1"VJk l k+ City: -'(iQQ,ca_ State: 0p., Zip: q7 aaq Phone Number: ) 1 DIR—971_I Email: Please fill in the number of each fixture you currently have. Please fill in the number of fixtures you propose to add. Multiply the quantity by the point value to arrive at the current Multiply the quantity by the point value to arrive at total. the proposed total. Fixture Unit Current Point Current Proposed Point Proposed Quantity Value Total Addition Value Total Bar sink x 1 = x 1 = Bidet x 1 = x 1 = Clothes washer I x 4 = V( x 4 = Dishwasher ( x 1.5 = t l5 x 1.5 = 15t Outside Water Spigot r x 2.5 = -e,y5 x 2.5 = Water Spigot,each add'1 t x 1 = % x 1 = Kitchen sink I x 1.5 = l t 5 x 1.5 = Laundry sink x 1.5 = t x 1.5 = Lavatory(bathroom sink) X 1 = 3 X 1 = Water closet,1.6 GPF(toilet) x 2.5 = '7 r s- x 2.5 = Bathtub/whirlpool I x 4 = 4 x 4 = Shower stall t x 2 = a i x 2 = Bath/shower combo x 4 = x 4 = Current Points: a7 Proposed Increase: Current Points+Proposed Increase= a.CI =New Total Points —Required Meter Size 80 ' - Meter Sizes: 1 to 30 points=5/8" 30.5 to 37 points=3 " 37.5 and over points= 1" New Meter Size Needed for New Total Points: Cost: $ (see page 1) Current Meter Size per Utility Billing: Cost: $ (see page 1) New Meter Size Cost minus Current Meter Size Cost— $ (This is Your Cost to Increase Meter Size Due to Additional Fixture Units) ************************************************************************************* FOR OFFICE USE ONLY Current Meter Size Confirmed with UB Signature of UB Representative Date 1:/Building/Forms/WaterMeters_070120_Add.dOcx Page 2 Branden Taggart From: #Building Permit Technicians Sent: Tuesday, August 24, 2021 11:03 AM To: 'brian_d_shaw@msn.com. Subject: Transmittal Letter for Permit MST2021-00289 - 9650 SW Murdock St. Attachments: TransmittalLetter-Revisions_073120.pdf Hi Brian, Per our phone conversation, we will need you to complete the Transmittal Letter attached above for the revisions to MST2021-00289 at 9650 SW Murdock St. Once we receive the completed Transmittal Letter, I will forward the revised plans to our Plans Examiner, Allyson Armstrong, for review. Also,to give you a heads up, we have not been slip sheeting revisions. However,Allyson may choose to do this for you. She will be in contact you if this needs to be done. Thank you, Brantten Taggart City of Tigard I i1. Senior Permit Technician Community Development TIC;APD 13125 SW Mall Blvd Tigard, DR 97223 (503)718-2449 brandent@tigard-or.gov 1 Dianna Ornelas From: #Building Permit Technicians Sent: Thursday, July 22, 2021 10:58 AM To: 'Mike Mahoney' Cc: Nikki Tuason; UB Online Subject: RE: 9650 SW Murdock St. Attachments: SKM_284e21072210580.pdf; MST2021-00289.pdf Hello Mike, Thank you for the applications. I have copied Utility Billing to review and approve of the attached water meter worksheet. This permit has been approved by planning and the plan review submittal fee due is$655.24(see attached invoice). The fees can be paid online at https://aca-prod.accela.com/TIGARD/Welcome.aspx by searching for the permit record number MST2021-00289 under the Building tab. Once the fees are paid, the plans will be routed offsite for plan review. Please allow 4-6 weeks for processing. The permit technicians will contact you when the permit is ready to issue and with instructions to pay the remaining permit fees due at that time. Please note that we will need the licensed contractors identified for the plumbing application and the electrical application which will also require the electrical supervisor's signature prior to permit issuance. When you have that information, please forward to TigardBuildinePermits@tigard-or.gov. Thank you. Dianna L. Ornelas Building Division Services Supervisor City of Tigard I Community Development 13125 SW Hall Blvd I Tigard, OR 97223 503-718-2430 Direct 1503-718-2439 Permits From: Mike Mahoney<mahonmr@me.com> Sent:Thursday,July 22, 2021 10:20 AM To:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Cc: Nikki Tuason <nikkit@tigard-or.gov> Subject: Re: 9650 SW Murdock St. Caution!This message was sent from outside your organization. Hi Dianna, Sorry I missed your call yesterday. I did get ahold of someone earlier this week and I got all the trades permits filled out and delivered them to the Tigard office. Let me know if there is anything else you need from me. 1