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Permit CITY OF TIGARD BUILDING PERMIT • COMMUNITY DEVELOPMENT Permit#: BUP2021-00281 Date Issued: 2/10/2022 TIGARD 13125 SW Hall Blvd..Tigard OR 97223 503.718.2439 Parcel: 2S110AD12400 Jurisdiction: Tigard Site address: 10847 SW ANNAND HILL CT Project: Annand Hill Partition,Lot 3,(1 of 2)ADUs Subdivision: ANNAND HILL CT PARTITION Lot: 3 Project Description: A new multi-family dwelling on the lower level.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 02/07/2022 $755.29 Occupancy Grp: R-2 Occupancy Load: 3 Plan Review 11/25/2021 $751.34 12%State Surcharge-Building 02/07/2022 $90.63 Dwelling Units: 1 Wash Co Trans Dev Tax- 02/07/2022 $5,756.00 Stories: 3 Height: 0 ft Condominium/Townhouse Bedrooms: 1 Bathrooms: 1 Plan Review-Fire Life Safety 02/07/2022 $302.12 Value: $82,976 Tig-Tual School CET-Residential 02/07/2022 $953.16 DC Provision Review,SF-Ping 02/07/2022 $110.00 Plan Review 02/07/2022 $-256.34 Floor Areas: Plan Review 02/07/2022 $-8.12 Total Area: 676 Plan Review 02/07/2022 $4.06 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 60 Deck: 0 Garage: 0 Mezzanine: 0 Total $8,458.14 Required: Required Items and Reports(Conditions) 1 Special Inspection(see plans) Fire Sprinkler: Yes Parapet: No 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: Eckgawkt/vj Permittee Signature: Se 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. „r , BBuildinw Permit Application IR.esid4'ntiaa RECEIVE 0 I t , • , , t.11;4)f•11( E 1 c), Irl i i 1/141 ,. ' Received/a Z 2/ /,/� - c12! SWof Tigard OCT 21 2021 y ;,,, Perms' i1 / Plan R : 7 zo l rye I ra 1 12� Hall Blvd.,Tigard,OR 97223 Plan Review t ether Perni �``©0��1” V I jj Phone: 503.7182439 Fax: 503.598.1960 Datc/try: p�„_i / _ __ _- _ - InspectionLine: 503.639.4175 CITY OFTIGARD DateReady/3y: i1 'eef•at;;2far BUILDING DIVIS O ,. . I` Internet: www.ngardorgov t eli•d'btec� ' up?lunnrrntlnfornracrrn I :ii G ..^' z.C>sl it it 1 r z. !r F.,<„' f?_ .! #s' .� l„e h s j .,, ,#�„ I�. i r- ,-i- !, if t ec . . rx it p�.`i � ; � � �7 �: ,,, r iiiii E .l f,{ 9. ."� �1 _,, �;. I New construction ❑Demolition P .ini:fees*are based on the value at the wc:rk per:ferruled. (relic:ate the value(rounded c the ne:tires!cloth 1 of all ❑Addition'alteratsonir•eplacement El Other: equi)ment,materials,la.xtr•overheat d,and the xro: t • the tog? t g e x r n.. u I ;° I t,4r, _ dt dicatod on this applu:rtio=a------- -- Jr- --.. .� a &' a { t.: t- e 3 r5 h -z ' MAt.r I zi ipce ❑ I-and 2-family dwelling ❑Commercial/industrial �a'i $ 0 Accessory building ❑Multi-family Nwnber of bedrooms: r ❑Master builder ❑Other: Number of bathrooms: %1r'' ,rtl.'Mfd Si :11 to ; s t t g Oai 0tnit 44tRi TJtat number of floors: / Job site address: /0S4-7 ,Cd i/UA/V(i //L G _ -New dwelling area -- �7 --square_'eel ---_-__--_... ('it;y;State'z:EP: //y• �Q /I7 77 -Gasageecatport uea:_..__-____ __squu___c_d.___._-_ Suite/bldg./opt.no.: fir Projec=�tname M *( /i i4 h �, --Ca,,ered porch area: ,e square_ATI - Cross street'directions to job site: 4 AMWD t�_ Deli(area: 60/ yisquare,I et el r _---__.. ill// ___--___,_____ Otter structure area: / square:eti m01, as i to}{� . n;:,1 l`I Subdivision: Lot no.: 3 Peuti.fees*are based on the value 31':he work rerionned. P I2 5 j AO Z�b� lydicate the value(rounded to tie ne ar�sl dollar(of all Tax ma /parcel no. l 1 equipment,materials,labor ov rite:cl,and the;t ofit e,r the et shills ' I ii`t,ike fil s § I I E li#li iixit z I ` `. -work ndicated on this 2pltcatit eL----- - t tei �0 . ss1s .; t�',1d1 arlITT MIT ,,dA:t, s.ov-)Tt,RtsElis 3�.), .. , ' •-----_-7-- ----------- i Valua:iou: S D 1 C_1 -�j 012- v&i- �� - - - � -----------------__--_--____----------- ./� / /� /w� �'/fj'`/c�'� �� /�C -Eris .ng building area: - --square et1 ----- C/ I f/` /-� --New building area: -i- squar__eel -- �1: 1: * ,.' 11 I e t41:x 'ps 1 g ?; Nwnberofstories: �.; �€ � -" a re --- ------- - -- -- !! Name: 1_ ,, ,0.4)dS. ip�OP Tje:S Ty/le of construction: Address: '3 3 S. S 7fy 37 SU/ Y _ -_— -__ - ------- - --- City/State/i(P: ,4,74/c- G`U �� Ozrttpattcy mops:--- -- -Existing: --- - ----_ - - E Phone ( 9 g 36 32 rZ.. Fax ( ) New I - " G .t *4rem, -, e l 1 n -! �� 'l'i 1 .�a 1d '�-mT l , ` � f Y tr 4 .a., ll Lil •t .. . Business name: 7``!'70 4"5am /tei/ Struc.u.al plus review fee(an da!pcsit): Contact nurse: ------ -- - -_ - -- - - ---- EIS plan review fee(if appl cab,,el Address: ----- ------- --- -- - - City/State/ZIP:Z,:fP: -_ Total fees duo upon appl sari on _. _- -- Amour t re:eh eel' Phone:( I Fax: :( ) tfrt r E-mail: - --_�- ---- „ .4 r It � 1.1 'I I s t s 4� i z. ri '7 �a Commercial and residential-prescrip Live,installation of .l ,ar Vie', n rt:t c�:tt tt l t e In a� 111 r 3 l a 1 i at ,a'l, ;; 1 roof-tr. mounted Photo'Volute ialar Farrel Ins-tem. t m a gm:axr azr�. �._�.w. e .. ._,�ss.t4..�.. l�o. �a�t.z,.?..�o..},.� � pp Business name: Q " DA-/ Kf ff' 04 operEpes -_ -__ Subrrrt two(2)sets of roof plan witsconnxtton details and fire department access,alan t w tit the 21)10 Oregon I Address: 33 3 S• S7-�y G ST 7 4-S - Sv/ai rnstallvrioa Spec:taw Cod?cl, cidist• - 1 City,StateiZ1P: ( .ve- ostageti Og _ — --' Permit Fee(includes plan rev eu and administrativ.fe:s): a 3180.00 Phone:( ) 936 - ) Fax:t, ) Slate surcharge(12%of penult F:e):J 321.60 ( CCB ilea: -p-_ -._�--- -- --- -- --._-.. �f ��¢� 1' Total fee due upon aFpi cation 320i.60 11 Authorized r,ignatur,: �����r 'This permit application expire if t permit is not ub aitted - .-f /JlJ - -- within 18G clays after it has bren accepted as complete. • Print '� �/ •Fee methodology set by Tri-County 3ui]ding lndusery 1 rint name: r0:712 f I M e tt6t Date: la..7,0 Seivice Board. I:\Building\Permits'BUP-RESPermitApp.doc 02/24/2011 440.461.3T(11e02/COM/WEB) , to Mechanical Permit Applicati ECEIVE :C1Y, „ ,' , h �1:'t,i., . �I 'H( .r'. t , , Cityof Tigard "" Pert,rt Jo.: 1 iy Date/Bt,: L +;1 i 13125 SW Hall Blvd.,Tigard,OR 9;223 -=d S OCT 21 2021 P1uoRe ew OtherPenre: 77 I Phone: 503.718.2439 Fax: 503.598.1960 Dale/8��: _ -__ inspection Line: 503.639.4.175 .__._-_..--.- Jr,i - Page _fi1 St Pa e 2 for- ---. l'I C.iA El D Dale Read yIB y: 1 • Internet: eww.tigard-or.gov Naified/Netlutd Supp'ementsl trtferntatian BUILDING DIVISION__---___—_—___-- ----------------- j l .'` e k s f d . , 4* 4't t . t't it f t ttlFgii.1 `i l' , . li 1•1 i1 1 1 4 al �-, .; *Tf" ., "" "”.. -^ a," ig Ivlecnanrcal permit fees*are based cn the value of the work El New construction 0 Addition/alteration/replacement perfi,nhad.lndi:ate•the value{painted 13 tie nearest dollar`of all 0 Demolition 0 Ocher: InxItaaictl materials.equip-ten:,la tor,ov:Ek e:ea add profi:. 1 tt e �,f t r tt gt ? a( gg�g�� Value:$ __ s r t$ , ., tt -,E II r a..: a� . ex i ` I<Pkw0 L* �" 2 - ira .f£_- + s.<, r a,ll )p '�l'I!-t rr•-7- u=i trlll4 to El and 2-family dwelling 0 Commercial/industrial 0 Accessory b:ji(ding For special infonr,wioa as iecklisr. _ ❑ Multi-family 0 Master builder 0 Cthe;-: .Descdpt oil L?ty. IEa - Tot:{I t it ! 4 s t rs •m *�-r F. r TIF.[n^71 _IF-1q�'_01 Vic:_ —_� 1 lam..'t1.4 h i- ,.,, �'.t,— , 1112 ..c;1il:g".u.r.,,.z.r l;Iil — 46.75 ; -...,.mil�.....= ��;..y�C"j .,�/ "'` Alt :0[Id ltlOnln�._...—. fi. Job site address: �OS it7 Sw /ehrd ht/17 A iz. - -- ------- - - -� -Furnace - - - Furnace1G{i,00( BTU tuctus?ven! 4(i.7 5 City/State/ZIP: . `7 �0 04. -- --- Fun..i(tlow. : (ductsn:nts}--- 54_.91 -_ — -- - - Ili a:eo on. - (-• 6:.UG -- Suitabldg.'apt.no.: Project name: _-" -- _ Duct. 2.'.32 _ Cross street/directions to job site: 4--(/T�U�V .� �ivi� ilvdron hot w:ter system -- -- -,�.' '_;__._..-_ �' J' ' his, lilal boiler(radiator or _h tonic) _ __ ^;t;2 ------- - -- -- ---- nit hea:a s(fuel-typo not electric). -- _ _- --- ._-_ -_._ ______ in-wall,m-duct,suspended,etc. - 46.75 Flue/vent for any of above • 23.32 -, -._-�-- Other: 2211.2 Subdivision: lot etc.: - - -_. Other fi el appliances: Tax map/parcel no 2S //0 /-,p /2 00 _Wat r atater _ 1 2 ;2 P 4-r'-^ n a c to ,,,tg tt, rk x Gaslla-lacelin:ert 3=.29 tom, �t � -^'r t a r r1 �; rs3 0 t ' (''' ";,. t ' lir•yi',.ia T 'g' ': 1 ., 1 - -----..-- -- - -- -- xr.,,., s. r., Flue act,:for w:urr heater a•ga:: 0" / k OG'E2— ti �Z -- ----- fir.;lace _ - 23.32 l,o$liyh:eraas) - ---23.32 --- -- Wood//otIlut stove ---__-__-3=.59 _wood Isolacelinsert - 23,32 - - ----- ----- Churns/liner/flue/vent 23.22 �,�° y Ulher: 23 2 :tfii �.!o x�i 2/11 1st,° 4.A�wwy5t.3pp"```:£ . - ;� "6s`i'4 .°,.,_i• 1 _Ei_vironntental exhaust and ventilation: -- Name: gz.ve— L OUST' -44,0ez.T:J. Range Mimi/other kitchen -- - ----- -- _ I.iipureat - --- 1 33.29 Address: > 5, S i Clothes iIjver exhaust L 7.39 // / r Siilgle-d ict exhaust(bathrooms. l;ity'S1ate%?IP: -_, 4e- OS -" 1, el' - _________________ toilct colilartments,utilityroon-:s) ----- 3.32 ------ Phont (0�) 9.36 32(Z Fa ( ) At lc c_ac�a wlce fans -- -- e 2 . ; {k.ji �,'"'7"' 4 Y t "�Fi 't� }�$��i 4 r � � 'B�y � v �)t`11. l.I 3.J2 Fuel piping: -- ----------.__.___-.. Business name: <w•r — -- — ---- .-- i��y� SI4�I5 for first four_$-t.03 for�:ach ntiditinnal Contact name: Furnace,eta --- -__l* --__-_- _--- Address: - --- - ---- Gas heat E.ml ___------ - -i-- -----------------• Wall.'susaended'unit heater -_ 1 _ _-_- CitytState/ZIP: Water deafer -- (-I —�__,•----, Phone:t ) I Fax::( ) ---- ---- - - - Folic L mail € Elalilecu:__--- ---_-- --_.-- ------ 1'61 4 , e . L.,� zs' ''` �,. ,., ,. �`n t,# ? ?.1:, I L1 Clothe:dl�cr(gas) -_----T' f - --- Business name: / Other:tTTT, t}t '- ," ` rn- t�.�sva1� ��,� �onrP�ar — ----- lilt. i:ll : � :r!l� V _ _;Er LL,1 I Address:W I2Q, C. �,/n,� Subtotai i I. C.ity/State/L11': D '� G�/ 1 O� 1 (D -- ----- --- Nlinimum pormi:fee($90 he) 1 Plan review(254ro)T pn rctit fife) 1 I, Phone:( ' ) Fax:( ) --- State surcharge(I 2%ofp%irmit fee) -- - _____ --- TOTAL PERMIT FEE -- Cal lit;.: `•/0ii ;03 --- - This per.ttit application expires if a permit 1s not obtained wl[bin IRO 1 days.after it has been accepted Sr complete. Authorized signature --------- ` Fe,:ID thudolo35•:et by Tri•Cot ty Btoldir g iodu to Scrrice Board ____0(jzik.da [ Print name /W(Ft- z.‘04/ Date' to. 0•Z . f:'Beat3ingPerrin'MFC_PennitApp_040It3.doc 440.4617111I'02'COM/WEB1 A ki , . D Electrical Permit Application—City of Tigard \ ANti V Page 2—Supplemental Information Of 14 t 44 / t I Limited Energy Permit Fees: V Renewable Energy Permit r:mit Fees: s �f ,", ' 1Fi44:a'ts i tl t , , „r.;. t r i it o,y'iitill�. ;.ROW,}llt*I ?,L. -"�� ` , 3�., '�.... .- .�. � .,.'. a ,. l)Grem,.tlon �� I hr. � t':Lch.....u.t lulal 1 Fee for En residential systems combined: $75.00 l/�V 1Renewaole electrical energy sy sterns: Check Type of Work Involved• 5 kva or ie55 ux1.7o 2 1 3P 5.01 to 15 kva 133.56 ❑ Audio and Stereo Systems* 115.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: _ `! ❑ Burglar Alarm I. 25.01 to 50 kva 301_0,1 2 J 50.01 to .00 kva 552.2E. 2 EGarage Door Opener* 1 _.1 g i >10(1 kva(fee in accordance I 5 i2`� —-_ I_ with,1)AR 91/I-309-0040) 1— —_--- ❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of:5 lava: T System* rach additional kva over 25 i I 7.42 3 ❑ Vacuum Systems* >!0J kvsi—no additional charge 1 0.0 3 F.Each ac dilionai Inspection over allowable in any of the above: C Other Each additional inspection is 66.25;hr i I. a charged en hourly(1 In min) 1 Inspecnols for which no fee is 19,y.00i lit ti ecifica ly listed(ii hr mini ,,,, ; , .,:. _ l * t 411' nS;y d;l I �',...i 1 i S . .P.ti. E?iy ...+..yii 1 ..f!'� �� . ��� : .n"l[..Ilia° {�1,1;1�.��tG'�� f +�' �-la.b��. ��`+ � . Subtotal later cm Page 111 Fee for each commercial system: $75.00 • Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: n Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation n HVAC • n Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* n Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* n Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required: Licenses are required for all other installations I:\0uildinp/Porn,lid.ELC P4rr ilApp_ELR ERE.det Rev(M/17/20I3 !( I1 RECEI\/E t)lt t, �! I INN yI�I p Electrical Permit Application I'i '� # lig � 111i111111 1111C1i 1 City r g OCT 21 2021 Becomes o Tigard ate/Rv: - Permit+;: 64�J i-..ve ja 1 IN 13125 SW Hall Blvd.,Tigard,OR 97223 i Plan Review -- `+� S Phone: 503.718.2439 Fax: 503.598.1960 CITY OF 11GARU t Date/Bv' Related Perm t M: i ; Inspection Line: 503.6.39.4175 !Read}Date/By: Juts: IZI Sec Pate.:for it.;11"> Internet: www.tigard-or.gov BUILDING DIVISIOILNotified/Method: - -- upplecrertal Information I t aC wF naS'P F Rf AL � 1 y i r 3 Xu. �•`•""#' 1 F G'.'^}'• � k i.l a sat s-n ) ¢ r i �? # ; tC)# i, f 1: in T 6a i:il.0, lti i) P. ':I ti �'Srs 13 f New construction 0 Addition/alteration/replacement Plc e.e ehi ch all flan apply(submit 2 sins pl tea w:mnis c h eked.- ❑Serv.c-or feed sr 400 amps or more 0 I.udi,g pier hree stories. 0 Demoli:ion 0 Other: vstete lit nvaitmble fault current []T tacntts ant i lL(ya Au. t n i a e<:e:cs U.000 an s at 15t)rots or ,.4"., *4t t i t i '. t i ii 1:.. �,( 4!Nit '.r n:s. p' 0I l a at.loci Id ngs [ '1 and 2-family dwelling ❑Commercial/industrial El bu ldins; Ices to ground,or exceeds 14.000 [](' mer.uc-use agr,culbual asps f n•all other installations. eliding. . ❑Multi-family 0 Master builder 0 Other: 0 Fire ix nip I ssuaiatian of 150 Kv!,or r; s r ,t t I Emitcg;nc sys:ent tu,?or ictuu.ttety derived ! " , .. .. "•-""'- 0 Addition of nevi motor load o t y t.n Job#: Job site address: /P fgt.-7 %,/ j/4/fJ �(r(, . lnofip or more ❑"� 1 ." I- '. City/State/ZIP: (ccc Tarr ❑»ar note tesxl errs!t ns. # ) O� 91 i ❑lleahh-c re liciht es. []1 e reaumut v ii le pa.dis I ❑1ISZar(OILR locano. . g Suite/bldg./apt.#: Project name: ❑G upply vol t e for more tan ❑Service or feed• 600 amps or more (0(1 vein nc m sal. Cross street/direct GA-•ons to job site: r&--g(�./ 4r �jL/ i'aala m) t : a " Po lop jpal : 1 I I"' 'I . ,„..,,Aon Ti„..,.. l e h Tut �+- _ _ Neer res -entiai single-or multi-fa mil! dwelling Brit. 1 Subdivision: Inelu >attached garage. Lot#� ---- -- Tax map/parcel# 26 //D y l 0 Lon,sq.ft or lens it g y� � 4_I 1! +k E .add'!500 sq.ft.or portion: 33.9_ Fix „tr)3 rt f4a ,: itT ` � I ,o _, s 1 ? t i .;tii f:I:fa€ �� t� ,, h ..� _. ,.. _ smite('cnorgy,residential 2 _ Lo������--••/��� ' E FE� (with Above so.ft.) 75.00 ���� (�!±-1� Lv , Limited energy,multi-family 75.q) 1 I reside.itial(with above so.ft.) _ _ -__ -__ ,g ,( Renrita3le Energy � 0 S_e Pa ,Lq u;�'sgi.s l ,cut , 1 t s s k --- .I�..---•--- t.•=<_-• Services or feeders installation aNenu ion,and or rtlocntinn � �ram- tl,�.� d��s 2 �•-------^ )Name: Bc-V !"ems' e- rf�-!/ �� - -..-.__. -03 amp: or less 100.70) 1 __ I _ 201:amp:to 400 amps 133.50 •1.. Address: 3 yy cam- 'j t ;� _ _--3 S. S/7 _Y sv L �1. 401 amp: to 600 amps 200.34 - City/State/ZIP: i 601 amp:to l,(100 amps 3t)l.t}t 7 Phone:( �j) �3 ' ?L . Fax:( - - -- --- over 1,0t10 amps or volts -y--552.26 --- .". 1 �l� Temporary services or feeders installation,alteration,and/or-i { Email: C!J � � � � ,� relocation Owner installation:This installation is being made on property tha own which is not 200 amp: or less _ • _59.3 t- 1 intended for sale,lease,rent,or exchange,according to ORS 447,''9,670,and 701. 201 amp:to 400 stops -125.01 2 Owner signature: II ate: 401 amp:to 599 amps `-_- 1018.54 t` __-!1 t, tr t r e „ t Branch circuits-new,alterstili(Lira(tension, t:r anel i3 °r'n �`� '�ttmmi v `, x. i;:�'„I, va l' '' ' s ,, 1' t A.Fee,;a:•brand circuits frill, - - -P- -- - .,.tl a.��is... A Business name: !�f}yL+ - __ above service or feeder fee, 74t o I each branch circuit Contact name: B.Fee'o-tranch.circuits without — -- sovic.:or teeter tee.first 50 1$ • band} circuit _ ___ , Address: 1 City/State/ZIP: -- - - ---- Each add'I branch circuit _ 7.42 2 ^ - ---- Miscellaneous(service or feeder not itchtdeci 1 Phone:( ) F•: :( ) E:acii ma,uract red or modular 67.84 dweller service and,or feeder -_' - Email: Rea ene t only :iGt E FY. d "Jg,Va > �. - y . e ill t t,f, Y Aras:?' Pump or rrigati on circle 67.84 2 - 67.84 2 : A — Business name: //ej(j— L tent_ Sign or oatline lighting -- 61.&t�y-_ 2 G" ---- Signal cat cult(s)or limited-energy �� se Page Address: panel,all!ration,or extension. _ ' s�77S� LOB' /'/AJ��tU --_---_ - - - CitylState/TIP: , O Each additional inspection over falow:,hie in anLaf the above ,1 r ; -- Additional inspection(1 hr min) , 56.25./Iir Phone:( ) Fax:( ) inyestiga:ien(l br min) ')O.00/Itr i Email: -- lndustriai plant(1 hrmui) i 78.18/lir --- haspc.:tic is for which no fee is >O.UOr hr CCB Lic.: 2 (1S Electrical Lie.: Su rv.Lic.: snit-wail listed�/:hrinm) Zb Gl¢6/ —p--- .fix, WA.. 0 � �I� silt Suprv.Electrician signature,required: _ St.btntat: __ __ Print name: Date: ❑Plan Review Required(25%of petty it lee):i„,.._ ' --State surcharge(12%of peer it tee): __ - - j Authorized signature: 1 -_ TOTAL PERMIT FEE: _ __. This peanait application expires it a permit is not obtained within IN Print name: Date: /Q—22.2, days after it has beer:accepts tat complete. -- • is urub,r of inspections allowed per pa,ant. t:`Bwlding Pcrniil,'ELC PcrmiiApp ELR_ERE.dnr.Rcv 06/17/2015 44(461ST(1 1a05'COM/WEB 0GA-%-E ST l/efit/ Plumbing Permit Au licatio ECEIVE BuildingFixtures `I,,(lR ()FIR t l ;i stir ' ,, l,, OCT 21 2021 ' l i is ,I,; i . 'I p City of Tigard Received Permit r,,,.. 1 Date/By: _ =QQ-- i a 13125 SW Hall Blvd.,Tigard,OR 9722. TY OF i IGARD Plan Review Other F:xmi No. 0 , Phone: 503.718.2439 Fax: 503.598.•.s DatelB � Inspection Line:.503.639.4175 " LDING DIVISION Date Read/B hair El St:Pa a 2l'or t t r i Internet wwa tigard or gov j Notified/Method Sii ptemental Information �r tp t - s -- .,*7 ti"71 'Nail - t a s CS vv t 1`¢ tl �. ; 17.•scr 4'-':., ;;i tx i 1 A? t WOWA: .-t1,m.�i #,7::l`lit ix I s r 4f t i 1 .1i'(�I i s is, ' - t Ft,. 7p i I ,A. .i~ j ff(New construction 0 Demolition For special information use checklist. Description ..1 tv. ! Ea_1-Total ❑itAdditionlalteration/replacement 0 Other: New I-2-family dwellings(includes 100 ft.t each utility connection) > i4 i C '+.," 'R Sr, • rT t r ! x ii.t Tk4t �T SFR(1)bath J ----- - 311 70 I ---- iV;;Illgli ,111 15 `' `A2g .s,. ,. 4-, .4,,,,,.i.,.I. ,,AtNi 7.„A Sra4.s „- . 141,1..f -- —1 _ .—❑ 1-and 2 family dwelling 0 Commercial/industrial SFR(2)bath - 437.7i • -- SFR(3)bath I 500 3:11 ❑Accessu.ry building 0 Multi-family —_i---_- __. Each additional bath/kitchen ! 25.02 ❑Master builder 0 Other Fire sprinkler(_sq.ft. /P,�p_Pal;2 ! t(4li R E"' :'Ci 'a.i2 YKfi'Y 71 S A .fit. �!. I. tv _— _.--_.�—.._- t s it se t•r ; Site utilities: Job site at:icfress: !O 54-7 5'u/ 1}-/W/A-A,4Q Aiat Catch basin of area dr n -� l 7(i /_ ) ,�.l� �j-7 Drywcll,leach lin ,or trench drain 18 76 CityiState'ZIP: 7'�&7 - eft- 7 !7 -- -- - — - _-_ Footing drain r..,lim ar Yt.:_ ) :'age Suite/bldg./apt,no.: Project name: Manufacture home utilities i 50 0.; Cross street/directions to job site: Manholes 1 S.",b Rain dr in connector 1 18:.76 Sani•ry sewer(no.linear ft.:_,__) --_ J Pag.:---_-_—_ S ,tin sewer(no.linear ft.: ) Page 2 ' ater service(no.linear ft.: ) Page 2 Subdivision: �t�e Lot no.: 3 Fixture or item: —_-_____- __ Tax map/parcel no.: 25 ((Q AD /Z466 Backflow pre-enter 1 31.27:moon "'Ya 1 ( , .�i, a(tit a w ^a7 lax s ,, Backwater valve 12.5I it . :°mod - .pit a • i,- < ,ay. '0 1 r r�?1 t M&7. ,.k:i. f:' Clothes washer -- ( _1 2`.0: ----_ _A ` / (L �OK Yi LO(4 I'- ��G`) Dishwasher ( 25.02. — 1 _ Drinking fountain 25.0' Ejectors/sump ( 1 25.0:: --_-- ^sli°(i`._�� i:_ s rT +a t s k�s��e #hs 1 t#:j. Expansion tank 12.51 liiiJiiiili t . 1 .,..i,<t . x.:t7, i'y'RO;l, .,,. t<,4'stta"lays' --- - $G(r P Ousb- log rtES Fixture sewer cap 1 :5.02 Name: --- Floor drain/floor sink'hub _ 25 0, - Address: ?✓3 5. ✓r -s7" svi]p• V -I—-_—._.__._-._ _ Garbage disposal � 25.0:: City/State/ZIP: ( I C64 4roto 64 97, , - Hose bib ---_�25.0::�__- Phone:(03) Q36 32ll- Fax:( ) Tee maker —)-r 12 51 - -_.... l'''''l�a' ` s ,y sl b �a t r •• c t -' t Interceptor/grouse trap 25.0:: ter:x..: as'., ..,!: -.,<0: p < 44Ti,.a......,'," ., :, ,:41 Business name: ~ Medical gas(value:S_) --- Page 2 -_- - ✓ Primer 12.51 Contact name: Roof drain(commercial) 12 51 Address: Sink/basin/lavatory ( _725.02 -- City/State/ZIP: Solar units(potable water) ti2.54- --~ _..Phone:( ) I F. : :( ) _ Tub/shower/shower pan ( 1251 L mail: Urinal --_- 25.02�_-�_. s s s r T 14� Water closet ! 25.02. ;Iii' Ci.I; #rn'a€ I#lr R i t ik is �`'` ;83 e A 9 t 1 It r i b "is . 9sa. . m.... 7aa ,,,Mx.:; s.€' .t.r1x .,... �I"1ts'Ct<s s•l , • ;s. -- i r.:.(-. .,., j Water heater ( rj 37.52 Business name: P(L spitz_ PGvAismier. Water piping/DWV 5629 - Address: 6ii(3 Y 5 C /3 6 Other: -- -25.02 City/State/ZIP: PD x 02, Subtotal `- - Phone:(co? qq 7 --cv o Fax:( ) Minimum permit fee: S72.50 Plan review (25%ofpennit`ee) CCB Lie.: re r 76 7s� Plumbing Lie.no.: pg 370 -- ' ((/ State surcharge(12°A ofpernit r x Authorized signature: rOTAI.PiiR 41T FEE Print name: (,/` GUI Date: This permit application expires If a permit Is not obtained w`.thin ISO days after It has been accepted as complete. *Fee methodology set by Tri-County building Indusuy Seri ice Bond. F:\Buiiding\Pcrmitc\Pt_MU-PcrmitApp.doe IWO 1:09 44.46 I OTt I 0n02:<CONI//WE6) Plumbing Permit Application - City of Tigard ljj �o� , Page 2 - Supplemental Information cQ Fee Schedule: Residential Fire Su ►pression S teeny �y -,, a-nrrr-... E 4t ;ganr�+ a r 7� i g:�� s n a .'s��rt i���'t:l 6 r-( .: 1r it °e +� ,4 t&'r. . latteil 'i- . , - :: aik.L#:t,lV a 9N._i;)1P,'.ys1°�3 t :1i1 i. Foo :drain-1"'100' 50.03 0 to 2,000 ,_ Amy' -_ 37.52 2,001 to 3,600 � . 69.69 Footing in-each additional 100' 3,601 to 7.200 _ $233.20 Sewer-1st :t' 62.54 7,201 and eater $327.54 Sower-each ad.''oral 100' 37.52. Water Service-1st r0' 62.54 Medical Gas S 'stems: Water Service-each additional 100' 37.52 a'' $ f It i 4i, , ,.,4t it� life-II i III tii Storm&Rain Drain- I st 1 i t' 62.54 $1.00 to$5,000.00 Minimum fee$72.50 __ __ Storm&Rain Drain-each ad. :oral 100' 37.52 $5.001.00 to$I{I,000.0( $72.50 fur the first$5 000.00 and$1.52 for Nip 0 ?t, x;> 44 11/. , _, " _ 4 E each additional S100.(((it fraction thereof,to i:;: b ., t wn ;m;•. w,, a ,. . : >r• and includin $10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,030.00 and$1.54 ter which no fee is specifically indicated 90.00/hr each additional$100.00 of fraction thereof,to (minimum charge- 1/2 hour) and includin $25,000.00. Inspections outside of normal business \ 90.00/hr $25,001.00 to$50,000.00 $ 79.50 for the firs:$hi3O)0.00 and$I.45 for hours(minimum charge-2 hours) each additional$100.00 of fraction thereof,to Reinspcction Finn 00/hr and includin $50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$30,0)0.00 and$1.20 for each additional$100.00 in fraction thereof. _minimum charge_1/2 hour) -" -- Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", lease indicate work performed byfixture. Failure to 1, ac urately report fixtures could result in increased sewer fees'. ':'.`3 K , ; y i j d for anyof the following. ¢ t4 s r y>� [io Plan review is required Ql:{J SBr 4^�&Y�a3� s�'$ .P U � .�.'•'"- 1, S K .✓� '. gr1 y 4 f # € Please check all that apply. „ LL'' ; )_ , s :; i... ,?p :I . -t.` io" ,t' ❑ Any new commercial building with water service 2"and Baptistry 'ant greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool ❑ New exterior plumbing site utilities for any complex structure '4 Car Wash: -Each Stall rive Thru as defined in OAR918-780-0040. ! Cuspidor/ ❑ Medical gas and vacuum systems for health care facilities. r:ater As,irator Dishwasher: -Co menial -Dom tic ❑ Any multipurpose fire sprinkler system. i D ❑ Any complex structure as defined in OP.R918-780-0040. Drinking Fountain Submit 2 sets of plans with any of the above. Eye Wash ` di Floor Drain sink: -2" \ r(3] I r ii gr 1 ' 4" \\ _ Isometric or riser diagram is required for new buildings xl -Car Wash Diem I that meet the qualifications above. t Garbage -Domestic non-food \ Disposal: -Domestic food related \ ' -Commercial food related 41 11 -Industrial food related Comments regarding fixture work: 1lce Mach/Refrig.Drains "1 Oil Separator(Gas Station) -- - Rec.Vehicle Dump Station \ ��-___�_ Shower: Gang - -Stall \11, _ Sink: -lav/Bar non-food related \ -Bradley p -Com/Serv/Util food related ;`€ -Service \ *Note: If the fixture work under this permit results in an loy A Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and Washer-Clothes Water Extractor fees assessed for the sewer increase must be paid before the r Water CCloset-Toilet plumbing permit tan be issued. i Urinal \ a Other Fixtures:at Other T:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 ;I {1 City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT I I T 1 c A RD Building Permit Review — Residential 11 Building Permit #: ek/P I - Oo? "1 II Site Address: 10 0 ill-Svc' AM vq, �' 11 &-f-• Project Name: m -� `{ R r Awl. t�� �-� far f-'��'t�)� Lot #: 3 Planning Review ��,,�J /111,4/,-7'r.:r,n,lir dijje lJ►r/9 �tN la1,,Jc,r. fa+�l: Proposal: GP Verify address/suite#active in Accela. ❑ In River Terrace: [)No ❑ Yes,River Terrace Review Addendum l Site Plan Elements: ,AErosion Control 1, Iiir3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper Retained trees with drip line and tree protection measures [ .Drawn to scale(standard architect or engineer scale) iitiFootprint of new structure(including decks)and FFE ANorth arrow OUtility locations&easements (required for new and additions) 21.ite address,project or subdivision name and lot number Sidewalk/driveway approach [Applicant information(name and phone number) -[]Location of wasfsep ,-ys e-IM &Lot dimensions and building setback dimensions AStreet tree size,type and location R)Street names S 'Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? Yes ❑No impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes Colo yi Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified 21 No Received: ❑ Yes ❑ No i9 Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs Required: p Yes,applicant was notified ❑ No Received: Yes ❑ No ] SDC Exemption for ADU applied for: ❑ Yes IYI No Received: ❑ Yes Al No iii Public Facilities Improvement(PF1) Permit: Required: ❑ Yes,applicant was notified 89 No Applied For: ❑ Yes ❑ No,stop intake I Land Use Case#: A Z2,4"00623,M1,92O20.10V2- Ro Zoning: "" 1Z- 1 SP Required Setbacks: Front: 1,S' Rear: Side: t Y''Street Side: is 1 Garages ' 11) Building Height: Max. Height: 3 5 ` Actual Height: 2-5- 5 Q Landscape Area: P2.4j % ® Lot Coverage Max: eiC % Entrance i Set back no more than 8'from street-facing wall Parallel to street or offset 45 degrees or less Windows fa Minimum 12%of area of all street-facing facades Garage ❑ Ga door is behind widest street-facing wall ❑ Yes ❑ No,o e following is met: ❑ Door exte more than 5'from wall and there is a covered xtending beyond garage. ❑ Door extends no more an wall and there ' sq ft.window above garage on 2' floor. ❑ Garage door width is ❑ 12'or less o or cade ❑ 60%or less and includes 7 of following: ❑ Covered porch ❑ Re entrance ❑ Wall offset 'Roof eave ❑ Roof offset ❑ Fire shingles Lap Siding ❑ Roof pitch ❑ Gable,hip,or ga 1 roof ❑ Dormer ❑ A siding ❑ Window trim ❑ Window recess ❑ Window project( Balcony CL Jis 1-Clearance `. Urban Forestry Plan 4 Sensitive Lands: ❑ Yes eg No Type: Conditions met prior to issuance of building permit Notes: ,AkQV 2-02;0 ` Oa C V-27 ie Approved By Planning: A� � 1 �► A l4 Date: Z{ Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved I:\Building\Forms\B1dgPermitRvw_RES_122419.docx wilimiimmorimomiew I Building Permit Submittal Original Submittal Date: /0/21/202/ Site Plans: # Building Plans: # 3 Building Permit#: [f Enter building permit#above. Workflow Routing: J[�Planning ''Engineering K."-Permit Coordinator Tr-Building Workflow Sign-off: - Sign-off for Planning(include notes from planning review) Route Application Documents: [.'Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. [JYBuilding: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable, etc. Notes:04t241 I iA 23/ - irrceivav/71 , "TS VVrsees,,/ /` ,Q44 f!.c_ .r.s ... By Permit Technician: !� .� Date: /Q //Poi,/ 677: Engineering Review Slope at building pad: A71 RtV Conditions "Met"prior to issuance of building permit V Easements (encroachments) per engineering conditions of approval and plat Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes [/No Assess Water Quantity Fee in-lieu: ❑ Yes n LIDA Facility on lot: 1Yes % No M Final Plat Recorded: L'NOT Approved by Engineering: Date: /7/3/e/ Notes: / h 4 t, .,._ i VApproved by Engineering: �.�✓ Date: i 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: chp...r 4 Date: ilkV2,t3'4 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._-/ J.f c( jai SDC Fees Entered: Wash Co Trans Dev Tax: O' Yes ❑ N/A Tigard Trans SDC: X Yes ❑ N/A Parks SDC: 21 Yes ❑ N/A LIDA ❑ Yes % —N/A �W CM ,ErOK to Issue Permit Approved by Permit Coordinator: Afferl.....-t. Date: I 7ti 7/ 1:\Bui Iding\Fonns\B1dgPennitRvw_RES_122419.docx RECEIVED City ofTigard JAI 1 0 2022 : .IN a FINANCE DEPARTMENT CITY of TIGARU TlcAR Systems Development Charge (SDC) ExemAtiow it 11, r.,tion REQUEST FOR ACCESSORY DWELLING UNIT (ADU) SDC EXEMPTION (Allowed under TMC 3.24.100.F) Note:Refer to TMC 3.24.180 and the Systems Development Charge(SDC)Exemptions for AccessotyDwelling Units Guideline for eligibility requirements before completing application.City Transportation and Park SDCs exemption only. REQUIRED DOCUMENTS PROPERTY INFORMATION ❑ Recorded Deed with the legal Name of property owner(s): Blue Palouse Properties description of the Property ❑ Proof of Ownership/ Authorized Representative Address of ADU : 10847 SW Annand Hal Ct Tax map and tax lot numbers: 2s 110 ad 12400 Land Use Approval Case Number: MAP 2020-00002 ADU 2020-0021,0022,0023 Type of Unit Total Units Square footage of each unit Attached ADU 1 676 Detached ADU APPLICANT INFORMATION Name(s),as appears on title of property: Blue Palouse Properties Mailing address: 333 S State St Suite V452 City/State: or Zip: 97034 Phone: 503-936-3212 Email: robm@bluepalouse.com Applicant's representative (if not property owner): iPhone: Email: robm@bluepalouse.com THE PROPERTY OWNER ACKNOWLEDGES AND AGREES TO THE FOLLOWING: 1. I understand that acceptance of this application and required documents by the City does not constitute an approval of an exemption. Exemptions are not granted until after all required documentation is received, the property owner(s) sign, notarize and record with Washington County the restrictive covenants agreement. 2. I understand that if at any time during a period of 10 years from the time my final inspection is approved the Page I 1 Rev. 10/21 accessory dwelling unit for which an exemption is granted is rented or listed as a short-term rental (AirBrib, VRBO,etc.),the owner of the property at that time will be required to pay to the City the amount of the exempted system development charges,plus interest. I also understand that an advertisement of the accessory dwelling unit as a short-term rental is sufficient evidence for the city to assess the amount of the exempted SDCs. I understand that this restriction will bind the property even through transfers of ownership. 3. I understand that the City may verify any of the information contained in this application at any time. 4. I understand that the City, its agents,successors and assigns will rely on the information contained in this application and the information represented herein;if any information should change prior to obtaining a certificate of occupancy,I will notify the City. I certify that to the best of my knowledge,all the information provided in this application is true and accurate as of the date rovided opposite my signatures below. Rob Matthews 11/23/21 _ ITr rty owner signature Print Name Date Property owner signature Print Name Date APPLICANTS It is the responsibility of the applicant to ensure that the application for the SDC exemption is submitted and approved before the payment of all SDCs are due to the City.SDCs are calculated and due and payable pursuant to Tigard Municipal Code 3.24.080. In accordance with TMC 3.24.080.B,the City may not issue a building permit or allow connection to the City's systems until either all SDCs have been paid in full or an exemption has been granted. It is the applicant's sole responsibility to ensure an exemption application is submitted to the City in a timely manner in order to meet the timelines in TMC 3.24.080. Electronic submittal of this application and required documentation is preferred and can he sent to SDC(a7,tigard- ot.gov Hardcopy applications and required documentation can be mailed to: City of Tigard—SDC Administrator, 13125 SW Hall Blvd.,Tigard,OR 97223. Questions can be directed to Christine Moody,at christine@tigard-or.gov or 503-718-2415. STAFF USE 0v1.1 Date Received: 11/23/21 Approved by: Christine Baker 1/6/22 1)at": 11/23/21 Amount of SDCs Exempt $11,719.00 Park $7,591.00 Trancportaticm $4,128.00 Page 12 Rev. 10/21