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Permit • tl CITY OF TIGARD BUILDING PERMIT � Ilt COMMUNITY DEVELOPMENT• Permit#: BUP2021-00306 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 2/10/2022 Parcel: 2S110AD12200 Jurisdiction: Tigard Site address: 10893 SW ANNAND HILL CT Project: Annand Hill Partition, Lot 1, Primary Subdivision: ANNAND HILL CT PARTITION Lot: 1 Project Description: New multi-family dwelling with(2)attached ADUs. Trade permits to be obtained separately. NO FINAL INSP UNTIL WATER METER UPSIZED. Contractor: BLUE PALOUSE PROPERTIES Owner: BLUE PALOUSE PROPERTIES LLC 333 S STATE ST, SUITE V452 333 S STATE ST STE V452 LAKE OSWEGO, OR 97034 LAKE OSWEGO, OR 97034 PHONE: 503-936-3212 PHONE: FAX: Specifics: FEES Description Date Amount Type of Use: MF Class of Work: NEW Type of Const: VB Building Permit-New Construction 02/08/2022 $1,044.40 Occupancy Grp: R-2 Occupancy Load: 4 Plan Review 02/08/2022 $751.34 12%State Surcharge-Building 02/08/2022 $125.33 Dwelling Units: 1 Wash Co Trans Dev Tax- 02/08/2022 $5,756.00 Stories: 3 Height: 35 ft Condominium/Townhouse Bedrooms: 2 Bathrooms: 2 Tigard Trans SDC Improvement-Other 02/08/2022 $3,903.00 Value: $140,016 Residential Tigard Trans SDC Reimbursement- 02/08/2022 $225.00 Other Residential Floor Areas: Parks SDC Improvement-Other 02/08/2022 $4,727.00 Total Area: 1125 Residential Accessory Struct: 0 Parks SDC Reimbursement-Other 02/08/2022 $1,112.00 Basement: 0 Residential Carport: 0 Parks SDC Neighborhood-Other 02/08/2022 $1,752.00 Covered Porch: 125 Residential Plan Review-Fire Life Safety 02/08/2022 $417.76 Deck: 50 Info Process/Archiving-Lg$2.00(over 02/08/2022 $48.00 Garage: 0 11x17) Mezzanine: 0 Total $23,346.18 Required: Required Items and Reports(Conditions) 1 Special Inspection(see plans) Fire Sprinkler: Yes Parapet: No 2 Ersn Cntrl 503-639-4175 Fire Alarm: Yes Protected Corridors: No Smoke Detectors: Yes Manual Pull Stations: No Accessible Parking: 0 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR, Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344, Issued By: Edgarc(o-Mad.dos 4.c- Permittee Signature: ye e, 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. rrtar..rtr 'Building Permit Application _ iZ I Z Commercial RECEIVE i FOR OFFICE. USE Om ,), City of Tigard Received �� ZO Dateive /2 "o K/� Permit No. P Z�'Q�3d� 1413125 SW Hall Blvd.,Tigard,OR 97223 DEC O 2021 Plan Rcvicw rnt�WR2021-OO 32.0 8 Phone: 503-718-2439 Fax: 503-5960 "� ill' RclatcdPcIns ection Line: 503-639-4175 //'� T I G,h R D p CITY OF TIGARD Datc Ready/ y: lu 6! See Page 2 for Internet: www.tigard-or.gov BUILDING DIVISION N 'fied/Mc od: e Supplemental Information ,...,,. ': '� °� , P. x ., , �D PAT*k W F 7t'D"WE ������ ��� ���� � Permit fees*are based� 'New construction ❑Demolition 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,a d the rof for the + is O ma y' ,..feu o {�m,indicate' 7 S othis licatio IL icjit� 0 1-and 2-family dwelling 0 Commercial/industriala"a"�' $ 1�z+�,G"� ❑Accessory building J Multi-family Number of bedrooms: 2 ❑Master builder ❑Other: Number of bathrooms: Zi ,,. i .., i INFORMA L4i4 L Total number of floors: 2— Job site address: /O8`r3 i J ,/IL r New dwelling area: /HZ c square feet City/State/ZIP: 7-7t71--Q1 O, Garage/carport area: r square feet Suite/bldg./apt.#: Project name: Covered porch area: (2 5 square feet Cross street/directions to job site: Deck area: fa square feet A/lJ( -Lgtt 7" Other structure area: square feet Subdivision: / Lot#: r Permit fees*are based on the value of the work performed. Tax map/parcel# 2•,S ` fl 'j Z 2-�� Indicate the value(rounded to the nearest dollar)of all a i� �I equipment,materials,labor,overhead,and the profit for the ; �tR of ��R work indicated on this application.-ivoe sr w(TLf (2) iicoci Valuation: $ /7i7,�- 0°0 r-fiZnifet U t7 1_Y 'fk rot Sr/IGrei./> Existing building area: / square feet New building area: //Z S - square feet ; kk „ ,, 10 O i,: WN 0 TENANT Number of stories: Iy Name: BLUE PALoosE PI2-oP - leS Type of construction: �-�/ Address: / [P� it/33 3 S. � .v4.6.2_ Occupancy groups: 22-'1- City/State/ZIP: j,Dr-KC.L'% ea S V.1 0 cpQ '1O 34 IC Existing: Phone:(03) c '36 32. (Z._ Fax:( ) New: 0 eo r PERSON i V i i a2 x, . 5 Sa"o�E m ��_ �xi Business name: � . .' ,� �- ' � ' ` � =.. �,> > , . , Structural plan review fee(or deposit): ,3Y Contact name: I V:.M $ _UE-e,A-LOc C, Goavt '^`A_T�S FLS plan review fee(if applicable): Address: •' Y+r` — Total fees due upon application: City/State/Z1P: Phone:(D3) 5 6 s Z i 2_,. Fax: ( ) Amount received E-mail: C�v�l� �L V Al-O e OO�7 # ,TA SOL R PANEL +ST t*i� grIi -,,�M� r t �mm ii ; , Commercial and residential prescriptive installation of ^° �� ` la�w�R wa C . w• T.-,� , i r: ei , ,.,as „'IL ,....� roof-top mounted PhotoVoltaic Solar Panel System. Business name: f Ll- P1 e-D USc Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: SPINE- 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 tee): $21.60 CCB Lie.: l 7 04+ Total fee due upon application: $201.60 I Authorized signature: j:/J This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: ,f* et6 Date: /(-0?.Zi * Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP_COM_PermitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB) Mechanical Permit Applicatioq�ECEIVE 1, FOR OFFICE LSE O.NL1 Cityof Tigard RR Received 24�&) 5 I; Date/By: Permit No.: 130 13125 SW Hall Blvd.,Tigard,OR 97223IN DEC 01 2021 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Other Permit: Date/By: 1'I e:A R I) Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: luris ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information BUILDING DIVISIO ❑New ��j�� �� .. ..a. ---: Mechanical permit fees*are bsed on the value of the work 0 Addition/alteration/replacementperformed.Indicate the value(rounded to the nearest dollar)of all construction ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. i ORY „' Value:$ ❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. 0 Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total �1 it AND SAT`' ;,. Heating/cooling: � t r ' "" "`" ' Air conditioning 46.75 Job site address: ) 'q 3 N N D �( Rt., Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: Ti fr a !- Tar` JJ►1 ,/�(_ Furnace 100.000+BTU(duets/vents) 54.91 I`— 1 L��"( Heat pump ( 61.06 Suite/bldg./apt.no.: Project name: Duct work 1 23.32 Cross street/directions to job site: GdirN tyria,9 Hydronic hot water system 23.32 ' "�L Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. �j 46.75 Flue/vent for any of above 23.32 Subdivision: Other: 23.32 Lot no.: Other fuel appliances: Tax map/parcel no.: z ccJ t k 0 ) I 2.,2_03 Water heater 1,. 23.32 `ram r 4� »'r ^x\y'�x !fit Gas fireplace/insert 33.39 . tea �b"wW..x '1� '.�� , �y�- r` Flue vent for water heater or gas `--AV(_a S2 w7c7'J "OU.S fireplace ( 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 23.32 ' i "b, Al �� Ate Other: It `P �' ^ -i° .,. Environmental exhaust and ventilation: Name: -t j E Rest,00 s E P 12,0 PE1`y r f Range hood/other kitchen Address: �� 3 5. 5 -�--- 1s-7- t /�,{ 6- Clothes ( 33.39 J �V`t'�-�� Clothes dryer exhaust ` 33.39 City/State/ZIP: (,,A te_ OSu(ErrO D� 0�'?0 ,t Single-duct exhaust(bathrooms, `^'r JT toilet compartments,utility rooms) .3 23.32 Phone:(5b3) c 3C:, 3 Z(Z Fax:( ) Attic/crawlspace fans 23.32 CI Wit.: rTiti °] A t ON Other: 23.32 Fuel piping: Business name: /� $14.15 for first four;$4.03 for each additional (2 Contact name: _013, ""rum)S Furnace,etc. Address: Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( ) Q/ Fax: :( ) Fireplace E-mail: ROB VA C. Blue j-OUSE• cowl Barrbee Range , � cue ,. �$1+)A0, ,r... . - Clothes dryer(gas) Business name: j5Uf— A fa. Gaup► r Other Address: 20( (O �. Imo( iz...p Subtotal City/State/ZIP: 0g, q 11 1 C('' OR. (p'70� Minimumpermit fee($90.00) `��� Plan review(25%of permit fee) Phone:(y763) 4.07 Z44'g' Fax:( ) State surcharge(12%of permit fee) CCB lie.: lob 4 03 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 Authorized Signature. / days after it has been accepted as complete. * Fee methodology set by Tri-County Building Industry Service Board Print name: (/�_t- 1 Ntgc9_ v( Date: (1.e .,�7 1:`Building\Permits\MEC_`P'ennitApp_040113.doc -� 440-4617T(11/02/COM/WED) Electrical Permit Application RECEIVE I , NN'7/��7 ecei , G-ULi- 3 0 City o f Tigard Pemdt [� U 0 d l q , !HI' 1 1 I I 1�aiC/Bv: IN :. 1312.i SW Hall Blvd.,Tigard,OR 97223DEC i Plan Review s Phone: 503.718.2439 Fax: 503.598.1960 DC O LU2� I Date/B,: --- Related Pemel 4: - - • Inspection Line: 503.639.4175 I Ready Date/By: Juris: is See Paee::for 7,8 t_i A l'') CITY► OF TlGAR I hotiticd/Mcthrd: u Inner.tal[nfartnuion Internet: www agates of htv � pp ci .S r - :iii cc it INe 1 g f jhrd,>i I A ' ......'�a... .�. �n,::Cr :5:.,,.:,... .:�I:ti . °E �,;is s: t„n .l. :. $ rl:r.d:i•:reir iL` x-,.,* JF.: ' r.:.• r New construction 0 Addition/alteration/replacement Piro chi ck all that apply(submit2 sets pl ass wiiwnr,checker: ❑Serv;c,or feeder 400 amps or more ❑1:uildirg c'wr:tree stories. 0 Demolition ❑Other: wlere.he available fault cer,ent EJ 1 tar nos ant a:.;tya-da. '$ xd k$3 r �r� r 7 gg a 4. h�ltt '� l";#,� .4°a�.���`?'S?'Ml''��'' -.'°F�'. , (,:k:��t�..,e.t.i:� �_�' :m:ds 10.000 a ups a:If in dr.or l.7}iialins build nits. 1 and 2-family dwelling 0 Commercial/industrial ❑Accessory building less to ground,or exceeds 14.00(1 0 t oni ier:ir,:-use•agricultural sups tar all otter installations. t uildrngt,. ❑Multi-family 0 Master builder ❑Other: 0 Fite pimp. ❑1 tsudiation of 1501tibh or ___ ____4 , rrT�l*• € 1 �.ill'`.f, it t,�'�.s£:;. ElEcg.n settcy sys:a m I it r e itarateI n LAde c.r. ❑Additian of new motor load of >;, t n Job#: Job site address: /05 a/ �, Af t i l)FtP or more ❑'A L, ' .: 't-,'. City/State/ZIP: `/- J /OQ s:ornorcresxiontial units. ccctpancy. �� O� 9/ —e+ � ❑Si❑Tleal*.h•crefaeilit•es. ❑1.cerwouiutl4r:lie leparks Suite/bldg./apt.#: Project name: ❑Hann ous locations. 0 I apply vol'atge tbtman:char t ❑Se•v a:or feeder 600 amps or snore. (00 witt.nom ral Cross stree;'directions to job site: efr,vT-�� q 1�� ,C �//`L a1tt r i 5 e0.0 . rte� 1 `* ,7„T a I ai tray Trt r t h o New res-dentiai single-or rmilti-fa mil! d•wellint;unit. Subdivision: Lot#: / Includes attached garage. I"----- 1,GOt1 sq.ft.or less 168.53 r a Tax map/parcel# 2S V AO 2-2-0• --- 33.92 1 ^^^tt� � _ Ea.;Will S00 sq.ft.or portion 33.9_ t ' t 1 it 3 s,a t ' a 3 s`r' i y' 1.•; gy,residential - ---- x d �atf .:a....�,. z. .. ` r �r a „1 Limited tncr 75.00 2 b A�/J� (with above so.IL) _ rJQ�..- �rr `� �� Limited rtiergy,multi-family 75.00 reside,rual(with above so.ft.) - — �1 s. Renew aale Energy [3 Sae Page'! r 4 j . ;r.,;>�,,li s . ; i �l� r lC>iE Il 4:11Ke-,7e11,Id Services or feeders installation,alleraiion and)or relocation Name: Bt-t)e- PAtDffe "/Z-!/,0e-`77d 20)amx or less- ----- 100.70 I 2 Address: 3 3 3 S. s ii- sr: $U 17F- ogr 201 amp:to 400 amps — - 133.56 2 i 401 amn:to 600 amps 200.34 2 City/State/LIP: Got ,asrfiefe072_ 9,707¢—_--- 601 amp:to 1,005 amps ---301.01 Phone:(03) q'3,6 ;L/2., Fax:( ) Over 1,0n0 amps or volts 552.25- 2 • Temporary services or feeders ins^allation,alteration,and/or Email: P-0B,6(.(<G� B -ei OZAZ-e ,( _ relocation _ ___ _ _ Owner installation:This installation is being made on property that I own which is not 200 amp:or less 59.3.i i 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,aad 701. 201 amp: co 400 imps ---12(i.08 -_ Owner signature: Date: 40I amp:to 599 amps --- - _ I68.57 '_._._ ., 3 t, '• 1 Brandt Circuits-new,alteration. re ctensioo. t•r panel_ -s(a[f;r €l ? r frF attotall.,_ ...�_.. :. . . A.Fe c tranch circuits iritJt Business name: 31 -�-P' - above service.)r fader fcc, ,r 4.2 t' each l ranch circuit `_ Contact name: B.Fee'or Usenet circuits i[itkoed - - Address: -- _ scavic::or tcecer Icc,first >0.13 , : brtnel circuit 1 City%State/ZIP: ---- Each add'1 itranch circuit --- 7.42 • 2 1 - Miscellaneous(service or feeder not ivcindeel • 1 Phone:( ) Fax: :( ) Each manufactured or modular —'— --- dwellin..service and/or feeder h7•&3 ' Email: Rea re t only 67.84 ---- ,oit ,•t^ ? l +¢ `F i ,ii. �f � r to o tt, l.:r. t..s,r or -.-------- _.,,::t,.�,,._, :,.,.-.s,.. �i ,.., .., ,... ".:t.tra "al L;.,,. .1... Rncrtor trigation circle 67.S4 Business name: Sign or tline lighting 67.84 2 ' N�CT Level_ �Z+�C-T721«YL l-G.-U ea ---------- - Signal cii cuit(s)or limited-energy ❑ Sae Page 2 ' Address: " 775- �L�I& fit.) - -- ---- panel,alteration.or extension b - _ -_-- /� �/ � / q Each additional inspection over al owi,ble in tussof the above City/State/LIP: _-- V aNQ)�/A (� ( 7O6¢ Addition 11 inspection(1 hr min) 7-; 56.25%lit_,--. Phone:( ) Fax:( ) investiga:icn(1 I min) i )0.11(1/Its atria:plant(I hr min) r lndu Email: - --1 78.!8/lu• -- tnop uo is for which no fee is )0 00'hr CCBLic.: ZZh(?5— Electrical Lie Gf 4( Suprv.Lk.: /r d�gs sccr,ea fisted 'A ill' T_ _ z Suprv.Electrician signature,required: _ _ _ Si.bt,ital: _ _ Print name: Date: - --- ❑flan Review Required(25%of pent it lee): _L___ --- ` _-State surcharge(12%of pent it Ice): - - - Authorized signature: TOTAL PEFh4Tf FEE: - Tbls permit application expires It a pat out'is not tibialurd wIthln 1N0- Print name: [ate: I days after it has beet:acctpte 1 r:complete. e Numbs,r of inspections allowed p,r peg.nut. I:'BwldinNPcmeia.'ELC PcrniitApp ELR._EREdoe.Rcv OM 7/2015 441444;15T1I 1,05Y05.4/WEB GE.,4 te E sr--/W g Electrical Permit Application—City of Tigard j{) Page 2—Supplemental Information ( iv Limited Energy Permit Fees: -' Renewable Energy Pertnit Fees: ++ sal 1 -- '��r��'pfitl ' .L. �i.' .rs,s..ES F ,. � .x-•�� . DcFerhrtton �Qt� N.acL In131 Fee for all residential systems combined: $75.00 IRenewa31e electrical enerRysystems: —_ 5 ry 100.70 2 a or less .i Check Type of Work Involved: --- — S.iil to 15 kva 133.56 2 1- iC ` 15.01 to 25 kva --1 200.34 Audio and Stereo Systems* r Wind&Iteration systems in excess of 35 kva: I �'1 i 25.01 to 50 kva 301.0.1 -- 2 I I B• urglar Alarm 1 50.01 to ,00 kva 552.26 2. n Garage Door Opener" i 100 kva(fee in accordance 552.2h 2 L with OAR 911z-309-i)040) _I . ❑ H• eating,Ventilation and Air Conditioning i ; Solar generation systems it excess of 25kva: — System* I I Each additional kva over 25 I 7.42 1 h n >100 kva—no additional charge 0.0 _ s V• acuum Systems* I —� I Each additional inspection over allowable in any of theabove: , l ins is ❑ Other: r Each addona inspection 6ti 25 hr Y rs i ch a�,ed-t an hourly(1 hr mn:Z—_—_-- tnspecti for which no fee t> 9 I r10,hr a t cificall listed(i:hr min Pig t SAL` L"R,(E�IT 1H Fi4 .�1 a_ ':: _ st a i+`;o E#t r , .»4.v. . ?i I Subtotal,f trier of Page 11.j Fee for each commercial system: $75.00 • Number ofinspectiens allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems n Boiler Controls ❑ Clock Systems >' n Data Telecommunication Installation cil n F• ire Alarm Installation n H• VAC • n y Instrumentation k. ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ,k' ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* 1-1Protective Signaling { ❑ Other: :-,,I, _— i Total number of commercial systems: ____ i *No licenses are required: Licenses are required for all i1 other installations 1,1 ${ LABuiklinp\Pormia`.ELC_.PunutApp_ELR ERE.drt Rw 06/I'/2015 Plumbine Permit Application r Building Fixtures CC CC V l OR OFt 1(i. 1,F:t�.t i.• I Cityof Tigard Rxeived U 2021 g DEC 0 2021 Dare$1': Permit No. 3()p ;()Ce INI13125 SW Ball Blvd,.Tigard.OR 97223 Plan Review t' Phone: 503 718.2439 Fax: 503.598.196 OtherP rmi No.. • CITY OF TIGARD i?ateBy. Inspection Line: 503.639,4175 I't:,A:•:1.}: p Due Ready/By: )uris: El Se:Page 2 for Internet www.tigard-org0v BUILDING DIVISIONN edits otrfi ethod Supplemental Ldormanon v 12 11.t )e Ai"aP .- . "alt ae ira n Iea i i s r r a s e *ik 9( ,xTll ai a- ..,,. urr Af w. ,In , rrl^ r• At g . if#I-1rrar •ra- h a " r <'k•KNew construction ❑Demolition For special information use checklist.Description L . I Ea. I Total 0 Addition/alteration/replacement El Other: New 1-2-fatally dwellings(includes 130 ft.t3r each utility connection) r a it s^E ,' ,..- x e:s --g4•zx,n,,, r� P i at ri t�� s`. 1 ,.4r r., .n„1. ttA Eaal E: .J %ill SFR(i)bath i 31::70 rsr1-and 2-famil y dwellin r SFR(2)bath 437.731 5 6 ❑Commerc}al/industrial i SFR(3)bath 500.32 El Accesso:y building El Multi-family - - Each additional bath/kitchen 100 25.02 ❑Master udder ❑Other Fire sprinkler( sq.ft,) Page 2 a n n star i ra t11 „SserTAs-x -r c ,ga a a>ras a. _-•- I iil 1., . ,., ,r amilini; r� Site utilities: --- Job sate address: /O v ' Su) Avii/f/f/0 RILL, Catch basin of area drain -1 18.76 - } `� r y Drytc ell,teach line:o:trench drain 1 S.76 City/State/ZIP: / C('7 o 472- y70 �,lw) - ---I__----- Footing drain(no,linear ft.:_) 1?ai;r 2 Suite/bldg.iapt.no.: Project name. Manufactured home utilities 50.0 Cross street/directions tojob site: --/ I �/ --_ j C/ , �1 AvI�1 e/1i4t- Manholes ; IS.76 _ /DS73 , .�1 %d/J 47JD 14 f(4. Rain drain connector '-- tfi.7fi - Sanitary sewer(no.linear ft.: ) i Page 2 Storm sewer(no.linear ft-:_) 1 Page 2 Water service(no.linear ft.:_) ' Page 2 Subdivision: Lot no.: / Fixture or item: _� _ __ Tax map/parcel no.. 2-5 f(0 A•A 12 2,� Backflow preventer -__ I 31.27 _ .: ear _:*-14 1.R F pp t Backwater valve ' 12.51 , . r , , E a , ,sue - /._ ) n _ btAi in ., e clothes washer 25.0 ADV ` 2 ( Vr Pr•'�`" L5-1/ Z', Dishwasher ( 25.02 Drinking fountain i 25.02 Ejectorslsuntp T- 25.02 dt sirk b p. amc ? �a•ara F „M' Expansion tank 12.51 ar;ms} ,.• mmR ,.ho , o -w..,;,,..; ; ;s: .,.s iaggl Name. gLVE i4 - t - /' / f7 Fixture/sewer cap 25.02 ,/ Floor drain/floor sink'hub 25.02 Address: ;3? 5. J5 -Sfl a(J/TLc- v4-s-z- Garbage disposal i 25.0: City/State/ZIP: (,zt}4-- aidezo Oil 9703¢ Hose bib ( 25.0".. Phone:(03) c776 3Z(2_. Fax:( ) Tee maker ( 1 12.51 r e,. ea .cots r ,: ii au^, Lsta fi ,y� a ri a #. : Interceptor/grease trap 25.0.. Business name: l it ' Medical gas(value:S_) Page 2 Primer 12.51 Contact name: Roof drain(commercial) 12.51Address: _ Sink/basin/lavatory ?/_1 25.02 CityiState,'ZIP: Solar units(potable water) 62.54 • Phone:( i Fax: :( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 l r;SAII' > .: g iit1 Water closet 7j 25.02 a ��.t ' ral2:rrxv- . •',',': - -, �w z�-'..,M >ili '": x tpl.:. - - 6 ' ��� Water heater L. 37.5:: Business name. P,'t 5774./L Puinigy lcr Waterpiping/.DWV 56.29 Address: 6/3 g se- /j, /ze, Other: 25 02 - City/StateiZIP: p07277,,ef 9 - Subtotal Phone:(03) 17 7 - 5.7.4.0 Fax:( ) Minimum permit fee: S72.50 _ CCB Lic-: / !--76 7 Plumbing Lic.no.: P$370 Plan review (25'/0 of permit -- State surcharge(12°h ofpKmit`z) Authorized signature: TOTAL.Pa MIT FEE Print name: C6lLU Ga/4A- Date: This permit application expires if a permit is net obtained within 19a days after It bas been accepted as complete. *Fee methodolugy set by Tri-County Building Wiser).:le.icc Board. I:\Buildin Pcrmil,\PLMU-PcrmrtA .dnc 10/01:(19 's1 F\ P� 44(1-0M1IATI lllAl2:'Cf:\Q/WEB) Water Meter Fixture Unit Worksheet Please complete the following information: Contractor Name: $L UI= PA L-o u s Pl2OPEATt e-S Billing Address: Street/Suite#: 33 3 S. ' 7M 5r so at-- t 4.s- City: LA -E OCW -O State: Or Zip: c 7C34- Phone Number: 03 '��3(�3[� 32-i 2- New Meter Address: l0 8='r SW A-AJAJA Ut9 ma Gr Subdivision Name: — Lot#: Building Permit#: — Please fill in the number of each fixture as detailed on the plans. Multiply the quantity by the point value to arrive at the point total. Add all point totals together for total fixture unit points. Fixture Unit Quantity Point Value Point Total j Bar sink Q x 1 = 0 Bidet 0 x 1 = 0 Clothes washer 3 x 4 = l'i.,p it Dishwasher 3 x 1.5 = 4,5 Hose bib ,Z I x 2.5 = 2 ,c i Hose bib, each additional ( x 1 = i .0 Kitchen sink 3 x 1.5 = 4-.S Laundry sink 0 x 1.5 = RP Lavatory 5 x 1 = 5 Water closet, 1.6 GPF 5 x 2.5 = J Z, Bathtub/whirlpool It O x 4 = 0 Shower stall 0 x 2 = 0 a Bath/shower combo 5' x 4 = SO Irrigation(#of heads in largest zone) 0 x 1 = 0 1 Total Fixture Unit Points: Ca- j Fixture Unit Points: Upto30=5/8" Over 37= 1" 1 Up to37 =3/4" Meter Size: u Meter Cost: $ -24 co ************************************************************************************* FOR OFFICE USE ONLY Fixture Units Points verified with Building(Master)Permit or Plumbing ❑ Yes ❑ No ❑ Other: Meter#: Sale Date: Receipt#: . Meter Cost: Employee Name: l:/Building/Forms/WaterMeters_070119.doCx Page 2 City of Tigard IIIa COMMUNITY DEVELOPMENT DEPARTMENT TIGARD Building Permit Review — Residential Building Permit #: BB u,f2O11-O 0 3 6 't 3 Site Address: I O ��,,) A'I na ne( Hilt C ": Project Name: A-net ay. ii 41 1 COUV--.- Lot #: i Planning Review 101 d eI 5Proposal: ;�-i,Q,0 �1 (/�, 9 Verify address/suite#active in Accela. El In River Terrace: xo No ❑ Yes,River Terrace Review Addendum Site Plan Elements: Erosion Control r3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper ADR,..reinctl-trees a itl.chip 1111.,and 11,,IJ1vL a h1U11 111CaSUICJ Drawn to scale(standard architect or engineer scale) gIFootprint of new structure(including decks)and FEE North arrow iitUtility locations&easements(required for new and additions) Site address,project or subdivision name and lot number idewalk/driveway approach AApplicant information(name and phone number) Ei„ ttlio...si;,y.:ll / t ue `„+ itiot dimensions and building setback dimensions ,Street tree size,type and location Street names Corner elevations(2'contours if more than 4'differential) 0Lot area,building coverage area,percentage of coverage and 1,000 sf of impervious area created or replaced?or Yes ❑No impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes f .io cP Provid r Latter(lot platted priorlaaaaLl 99 Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No t��i'eriuheel '— ' s, el�:errd A][-Us Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No • ❑ Yes ❑ No Received: ❑ Yes ❑ No c it: Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake ✓ Land Use Case#: 5 /A[4' Q ZO"' OrODO Z.- 51 Zoning: Q.- 1 '7- [12 Required Setbacks: Front: I S t Rear: Le tI Side: 5 t Street Side: t O` Garage: 2.© L' Building Height: Max.Height: 3 Actual Height: .5 g Landscape Area: % Lot Coverage Max: Sr© % Entrance eV Set back no more than 8'from street-facing wall Parallel to street or offset 45 degrees or less Windows I1 Minimum 12%of area of all street-facing facades Garage e door is behind widest street-facing wall ❑ Yes ,one of the following is met: ❑ Door no more than 5'from wall and there is a c porch extending beyond garage. ❑ Door extends no mor 5'from wall and is a 12 sq ft.window above garage on 2nd floor. ❑ Garage door width is ❑ 12'or less ° less of facade ❑ 60%or less and includes 7 of following: ❑ Covered porch ❑ ssed entrance ❑ W o 1'Roof eave ❑ Roof offset ❑ Fire shin ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or roof ❑ Dormer ❑ nt siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony / Visual Clearance ❑ Urban Forestry Plan 1A Sensitive Lands: 1 Yes ❑ No Type: ❑ Conditions met prior to issuance of building permit Notes: 6 Approved By Planning: Date: ?- ZZ Revisions (after Building Submittal only) Reviewer Date sx Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved l t. I:\Building\Forms\B1dgPermitRvw_RES_122419.docx Building Permit Submittal Original Submittal Date: i 2/t 1/202_i Site Plans: # 3 Building Plans: # 3 Building Permit#: TkEnter building permit# above. Workflow Routing: 2' Planning CuEngineering N.—Permit Coordinator Building Workflow Sign-off: Q'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: Date: /2/09:/2c 74 En ineering Review 0 IV at building pad: Z2� ����////Conditions "Met"prior to issuance of building permit Lvl Easements (encroachments) per engineering conditions of approval and plat �/Water Quality/Quantity Facility: / Assess Water Quality Fee in-lieu: ❑ Yes LJ No Assess Water Quantity Fee in-lieu: ❑ Yes if No LIDA Facility on lot: ❑ Yes 1!d No Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: Date: /2//3/Z/ Revisions (after Building Submittal only) Reviewer `Date Revision 1: ❑ 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 Does not apply ❑ SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A Tigard Trans SDC: /Yes ❑ N/A Parks SDC: Yes ❑ N/A LIDA ❑ Yes ,N/A ..,L2'OK to Issue Permit Approved by Permit Coordinator: OWD/&- Date: l2 I 15 I2021 L\Building\Fonns\BldgPennitRvw_RES_122419.docx