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Permit
INSULATION CERTIFICATE Building Number: Number and Street: 15 a ` - jt,3 `r(ot" IAv2- City: T q I�a r� Zip: l+ZL—t I Contractor: I IuSPlD �,_LC 1.ROOF Insulation Type: 1:3 low ,r' Brand Name: Q,-{ V 3 (.0(l 1 1✓L Thickness added(inches): I to Thermal resistance added(R-Value): Ill Total Thermal Resistance(R-Value): jN 9 Insulated area: 00 ft2 2.-€ffl Veer. Dense pack:❑ Loose fill:❑ SG- k,, r Insulation Type: Brand Name: Thickness added(inches): Thermal resistance added(R-Value): Total Thermal Resistance(R-Value): Insulated area: ft2 3.EXTERIOR WALL Cavity frame type: 2"x4"❑2"x6"Z Dense pack:❑Loose till:❑ Other: Insulation Type: IS G,tt Brand Name: _- 4S vd, n Thermal resistance added(R-Value): Z.2 I Total Thermal Resistance(R-Value): 7,1 Insulated area: Z R 6 t 7 ft2 4.FLOOR Insulation Type: -3<al- Brand Name: O ie Y1 5 r ri 1ri Thickness added(inches): Q `‘ Thermal resistance added(R-Value):Filk Total Thermal Resistance(R-Value):12_3 0 Insulated area: 3 O(. ft2 5.RIM JOIST(Perimeter) " Insulation Type: ��t I 1 Brand Name: au.)Q y, � t✓ur Thickness added(inches): C.D Thermal resistance added(R-Value): Z Total Thermal Resistance(R-Value): 12:2— I Insulated area: GJD ft2 6.FOUNDATION WALL rr Insulation Type: �i 6 1 1) t oak,vv.. Brand Name: O(�t ,n ) Cp r,n 1 yt Thickness added(inches): Thermal resistance added(R-Value): VS Total Thermal Resistance(R-Value): 1 S Insulated area: 2470 ft2 I, Sat Wl 2S A(6,r.aff CERTIFY THAT THE RESIDENCE IDENTIFIED ABOVE WAS INSULATED AS SPECIFIED ON THIS CERTIFICATE AND THE INSTALLATION WAS CONDUCTED IN CONFORMANCE TO APPLICABLE CODES,WEATHERIZATION STANDARDS AND PROGRAM REGULATIONS. _ I D,2)l2L Item#s Si azure Data / Installing Subcontractor or Wx Subgrantee Item#s Signature Date Installing Subcontractor or Wx Subgrantee Item#s Signature Date Installing Subcontractor or Wx Subgrantee III „ CITY OF TIGARD MASTER PERMIT # COMMUNITY DEVELOPMENT Permit#: MST2022-00009 T I t;A R i' 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/01/2022 Parcel: 2S112CD00400 Jurisdiction: Tigard Site address: 15726 SW 76TH AVE Subdivision: DURHAM ACRES Lot: 9& PT 8 Project: Knauss Estates Lot 1, Primary Project Description: New dwelling with (1)attached ADU.**Revisions required to be approved prior to Mechanical Rough in*"NO FINAL INSPECTION UNTIL WATER METER IS UPSIZED& DEFERRED SDC FEES ARE BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 3 First: 732 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 28 Bathrooms: 3 Second: 993 sf Garage: 244 sf Front: 15 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Total: 1725 sf Value: $239,019.18 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100 Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 1 Bckflw Prevntr: 1 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'500 sf: 2 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Y Other: N Other Description: Ecompasing: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 1725 Owner: Contractor: CBG SW 76TH AVENUE LLC CANOPY BUILDING GROUP Required Items and Reports(Conditions) 15110 SW BOONES FERRY RD STE 15110 SW BOONES FERRY RD STE 500 1 Ersn Cntrl 503-639-4175 500 LAKE OSWEGO,OR 97035 LAKE OSWEGO,OR 97035 PHONE: PHONE: 541-600-5146 FAX: Total Fees: $15,344.76 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 equires yo to fo w the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR ocd_nn1_nnln thrni will n c9_nn _nno nil n,m, ain a nrn,nl tha r,Jac nr ddirart ni lactinnc fn nl IN(`.by ra llinn c(11 9'19 1057 nr 1 Ann'3'29 914.4 Issued By: Permittee Signature: G,1°1'ticiQj l7 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. DccuSign Envelope ID: 12F1756C-E12C-4533-BD79-654DC54439FE Building Permit Application 13-i 01 24 Residential RECEIVED I OR DEFICI: 1..•1 0\1 \ City of Tigard Received i Permit N - Date/1 ('IT 1 &/ZZ o." ti12022-600061 lliil0 13125 SW Hall Blvd.,Tigard,OR 97223 DEC '.. Plan Review . ' Phone: 503.718.2439 Fax: 503.598.1960_RD _ Dateill.r .7//5- 2/ AA, i Other Pennit: Sip erit$27-toty3Z1 inspection Line: 503.639.4175 CITY OF TIUmi i, Date Ready/By: ...-1ultri ., El Sapplemental See Page 2 for 11(JAInformation Internet: www.tigard-or.gov BUILDING iNvIc foN N iedlMethod: 2._---- -- i 1 .......,.._ ,.......______ ..... TYPE OF WORK REQUE il DA'f A: 1-AND 2-FAMILII, WA ELLiNG i New construction I D Dernofition Permit fees*are based on the value of the work performed. 1 Indicate the value(rounded to the nearest dollar)of all I El Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the —. - s plication.ndicated on thi ap CATEGORY OF CONSTRUCTION work i il • Valuation: $ ( D t/ • 0 1-and 2-family dwellingED, Commerciat/industrial _ El Accessory building -- * , Ej multi-family I Number of bedrooms 3 rbMaster builder l___ El Other: ; Number of bathrooms: 3 --, I JOB.wry, ENFORM_4T1ON aND LOC;aft)", Total number of floors: 'L 1 109 1 dr-._ __ .. ...... .._____ ._________ ---- 1 Job site address: 15726 SW 76th Avenue; New dwelling area: 1-7261 square feet Ot5 .. City/State/ZIP: Tigard,OR Garage/carport area: 2,Li q square feet 7 312., __. Suite/bldgJapt.no.: Project name: Knauss Estates Lot I Covered porch area: square feet Cross stkeet/direajoa,to Job site: East side of the block north of SW 76th Avenue and SW Bon Deck area: ifoi square feet I job - 44 id er/VA.4%(_ 4fe._c //1&i, ite5,14kr- Other structure area: square feet ritta7 A? /3$14.01frt sh 6,2_,,If--- REQUIREII DATA:COMmERi-ft i.a—/ "ti i iff"11+1,tsi . Subdivision: Knauss Estates Lot no.: 1 L Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of ail Tax map/parcel no.: WC rIN4 2S1 12C1),Tax Lot 00400 DESCRIPTION OF WORK equipment,materials,labor,overhead,and the profit for the work indicated on this application. Proposal to construct a primary residential structure and an attached accessory dwelling Valuation: S i' Each unit is 2 stones in height and will have a single car garage._p / Existing building area: square feet iir,1_A) erkyt/er6)^ New building area: square feet Ej PROPERTY OWNER i_ 0 T E N A N T 4 ' Number of stories: Name: CMG SW 76th Avenue,LLC Type of construction: Address: Occupancy groups: —. _—..------- CitY/StatealiP: Lake Osvveini,OR 97035 7---- Existing: 1 , Phone:(503 ) 956-9307 , ----t Fax:( ) New: ig APPL.K.A.NT 1 0 CONTACT PERSON E I.,ILI)I -C,.W_RIWT TEEFTT.77:/'7';'..,1:1,;11,.•/ / I--. , ' B.”-mess name; co SW 76th Avenue,LLC Structural plan review fee(or deposit): Contact name: , - FLS plan review fee(if applicable): i Address: 15110 SW Boones Ferry Road,Suite 500 _ - — Total fees due upon application: 1 City/State/ZIP Lake Oswego.OR 97035 - / , - Amount received: 1 Phone:1 503 ) 956-9307 i Fax::( ) , , . PrIOTOVi)LTAIC SOLAR PANEL SA STEM EE Est E-mail: sean@canopypdx.coin — . I-C-Otrunenial and residential prescriptive installation of CONTRACTOR , - roof-top mounted PhotoVoltaic Solar Panel System. Business name: Canopy Building Group LLC Submit two(2)sets of roof plan with connection details , ------ and fire department access,along with the 2010 Oregon Address: 15110 SW Booms Ferry Road,Suite 500 Solar Installationecially Code checklist. / __... _— I trati Cplioneity/S:ta(te/5:31P: Lake:93w07ego,OR 97035 — , i Fax:( )___ Permit Fee(inctudm plan review and adminisve fees): Y. State surcharge(12%of9ermit fee): $180.00 $21.60 CCB lie.: CC13#232358 ,—DocuSigned by: Total fee due upon application: S201.60 . Authorized signature S 11"' 1 6 MIL _ This permit application expires if a permit is not obtained LAI& within 180 days after it has been accepted as complete. '•---356D6C8B3F7D433 1 *Fee methodology set by Tri-County Building Industry Print name: Sean O'Neill Date: 06107/2021 1 Service Board. ill 1:133oilding‘Perniits1BUP-RESPermitApp.doc 02r24/2011 4404613T(11/02/COMIWF,B) DocuSign Envelope ID:7AA377A6-4649-400E-BF5F-4FE6AD73FDFF Mechanical Permit Applicati FOR OFFICE USE ONLY71 City of Tigard �I , Received n permit No.: 4 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: (V �/ 6 Iv)Sr�OZZ�r�x+wV q1 Plan Review 22 Phone: 503.718.2439N Date/By: A' t Other Permit: Q . ($ 2 L f G:1 R t> Inspection Line: 503.639.4175 Date Ready/By: Juris 0 See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information BUILDING DIVISION TYPE OF WORK COMMERCIAL FEE*SCHEDULE-USE CHECKLIST a New construction 0 Addition/alteration/replacement Mechanical permit fees*are based on the value of the work performed.Indicate the value(rounded to the nearest dollar)of all ❑ Demolition ❑ Other: mechanical materials,equipment,labor,overhead,and profit. CATEGORY OF CONSTRUCTION Value:$ ® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building RESIDENTIAL EQUIPMENT/SYSTEMS FEES* For special information use checklist. ❑ Multi-family ❑ Master builder ❑ Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Job site address: 15726 SW 76th Avenue Air conditioning 1 46.75 46.75 Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75 City/State/ZIP: Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: Project name: Knauss Subdivision Lot 1 Heat pump 61.06 Duct work 1 23.32 23.32 Cross street/directions to job site: SW 76th and Durham Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision: Knauss Subdivision Lot no.: I Other: 23.32 Other fuel appliances: Tax map/parcel no.: WCTM 2S I I 2CD,Tax Lot 00400 Water heater 1 23.32 23.32 DESCRIPTION OF WORK Gas fireplace/insert 1 33.39 33.39 Proposal to construct a primary residential structure and an attached accessory flup vent for water heater or gas fireplace 23.32 dwelling unit. Each unit will be be 2 stories Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 ®PROPERTY OWNER 0 TENANT Other: 23.32 Environmental exhaust and ventilation: Name: CBG SW 76th Avenue,LLC Range hood/other kitchen Address: 15110 SW Boones Ferry Road,Suite 500 equipment I 33.39 33.39 Clothes dryer exhaust 1 33.39 33.3 City/State/ZIP: Lake Oswego,OR 97035 Single-duct exhaust(bathrooms, Y Phone:( 503 ) 9569307 Fax:( ) toilet compartments,utility rooms) 23.32 Attic/crawlspace fans 23.32 0 APPLICANT 0 CONTACT PERSON Other: 23.32 Business name: CBG SW 76th Avenue,LLC Fuel piping: $14.15 for first four;$4.03 for each additional Contact name: Sean O'Neill Furnace,etc. Address: 15110 SW Boones Ferry Road,Suite 500 Gas heat pump City/State/ZIP: Lake Oswego,OR 97035 Wall/suspended/unit Water heater s heater Phone:(503 ) 9569307 Fax: :( ) Fireplace F-mail: sean(i canopypdx.com Range Barbecue CONTRACTOR Clothes dryer(gas) Business name: S re_ i r -e-rpo/� Other �"� ' MECHANICAL PERMIT FEES* Address: Subtotal City/State/ZIP: Minimum permit fee($90.00) ' ( )Phone:( ) Fax: Plan review(25%of permit fee) State surcharge(12%of permit fee) CCB lie.: TOTAL PERMIT FEE p-Do,nqigmid by SG A rid - Authorized signature: This permit application expires if a permit is not obtained within 180 (3 days after it has been accepted as complete. . � Sean p'N����SB3F7Dd33.. * Fee methodology set by Tri-County Building Industry Service Board Print name: Date: 01/0 5/202 2 LBuilding\Permits\MEC_PermitApp_082520.doc 440-4617T(I1/02/COM/WEB) DocuSign Envelope ID:7AA377A6-4649-400E-BF5F-4FE6AD73FDFF Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Submittal Requirements: • (2) sets of plans, drawn to scale. • (2) sets of equipment cut sheets. • (2) copies of site plan for ground and roof top equipment location and screening per Tigard development code. Commercial & Multi-Family Fee Schedule: Total Valuation: Permit Fee: $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and $2.54 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional $100.00 or fraction thereof. 1:\Building\Permits\MEC_PermitApp_082520.doc 2 DocuSign Envelope ID:7AA377A6-4649-400E-BF5F-4FE6AD73FDFF Mechanical Permit Apnlicat' FOR OW( l I SE OyI.I ��f���"� City of Tigard Received Permit No.: Date/By: 13125 SW Hall Blvd.,Tigard,OR 97223 MAR 1 2022 Plan Review Phone: 503.718.2439 Other Permit: Date/By: TI t;A I:n Inspection Line. 503.639.4175 CITY OF TIGAHL Date Ready/By: loos: El See Page 2 for Internet: www.tigard-or.gov Notified/Method Supplemental Information BUILDING DIVISION TYPE OF WORK COMMERCIAL FEE*SCHEDULE-USE CHECKLIST la New construction 0 Addition/alteration/replacement Mechanical permit fees*are based on the value of the work performed.Indicate the value(rounded to the nearest dollar)of all ❑ Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. CATEGORY OF CONSTRUCTION Value:$ RESIDENTIAL EQUIPMENT/SYSTEMS FEES* I-and 2-family dwelling 0 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: Job site address: 15726 SW 76th Avenue Air conditioning 1 46.75 46.75 Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75 City/State/ZIP: Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: Project name: Knauss Subdivision Lot 1 Heat pump 61.06 Duct work 1 23.32 23.32 Cross street/directions to job site: SW 76th and Durham Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision: Knauss Subdivision Lot no.: 1 Other: 23.32 Other fuel appliances: Tax map/parcel no.: W(`I'M 2S 112CD,Tax Lot 00400 Water heater 1 23.32 23.32 DESCRIPTION OF WORK Gas fireplace/insert , 1 33.39 33.39 Proposal to construct a primary residential structure and an attached accessory Flue vent for water heater or gas fireplace 23.32 dwelling unit. Each unit will be be 2 stories Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 3 PROPERTY OWNER 0 TENANT Other: 23.32 Environmental exhaust and ventilation: Name: CBG SW 76th Avenue,LLC Range hood/other kitchen Address: 15110 SW Boones Ferry Road,Suite 500 equipment 1 33.39 33.39 Clothes dryer exhaust 1 33.39 ' 33.3 City/State/ZIP: Lake Oswego,OR 97035 Single-duct exhaust(bathrooms, 9 Phone: toilet compartments,utility rooms) 23.32 (503 ) 9569307 Fax:( ) Attic/crawlspace fans 23.32 0 APPLICANT 0 CONTACT PERSON Other: 23.32 Business name: CBG SW 76th Avenue,LLC Fuel piping: $14.15 for first four;$4.03 for each additional Contact name: Sean O'Neill Furnace,etc. Address: 15110 SW Boones Ferry Road,Suite 500 Gas heat pump Wall/suspended/unit heater City/State/ZIP: Lake Oswego,OR 97035 Water heater Phone:(503 ) 9569307 Fax::( ) Fireplace E-mail: sean@canopypdx.com Range Barbecue CONTRACTOR Clothes dryer(gas) Business name:Jacobs Heating and Cooling Other. MECHANICAL PERMIT FEES* Address:4474 SE Milwaukie Ave- Subtotal City/State/ZIP:Portland,OR 97202 Minimum permit fee($90.00) Phone:(503-413-9796 ) Fax:(N/A ) Plan review(25%of permit fee) State surcharge(12%of permit fee) CCB lie.: 1441 TOTAL PERMIT FEE c D-ou8igned by: - �` / �t � This permit application expires if a permit is not obtained within 180 Authorized signature: days after it has been accepted as complete. sean 04 �e>�eF!lB3F7DwJ3. * Fee methodology set by Tri-County Building Industry Service Board Print name: Date: 02/11/2022 I:\Building\Permits\MEC_PermitApp_082520.doe 440-4617T(t I/02/COM/WEB) DocuSign Envelope ID:7AA377A6-4649-400E-BF5F-4FE6AD73FDFF Mechanical Permit Application - City of Tigard Page 2- Supplemental Information Commercial Submittal Requirements: • (2) sets of plans, drawn to scale. • (2) sets of equipment cut sheets. • (2) copies of site plan for ground and roof top equipment location and screening per Tigard development code. Commercial & Multi-Family Fee Schedule: Total Valuation: Permit Fee: $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional $100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional $100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and $2.54 for each additional $100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional $100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional $100.00 or fraction thereof. 1:\Building\Permits\MEC_PermitApp_082520.doc 2 UocuSlgn Envelope IU: /AA3//A6-4649-4001-431-bl--41-t6AU/31-OH- ElectriGal Permit Application RECEIVEreceivedFOR OFFICE USE ONLY� .t INCity of Tigard Date/By: IT I 491 Pertmt#: M$ '7 2(.- , II13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review . DEC 2 1 1.e'■ Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Related Permit#: S Q,ZojZ-(5' a- Inspection Line: 503.639.4175 CITY OF TIGARD Ready Date/By: 1uris ® See Page 2 for I IUAKI) Internet: www.tigard-or.gov pptt��e+ Notified/Method: Supplemental Information TYPE OF WOR>R�UIIDING DIVISION PLAN REVIEW © Nov construction ❑ Addition/alteration/replacement Please check all that apply-(submit 2 sets of plans w/items checked): ❑Service or feeder 400 amps or more ❑Building over three stories. ❑ Demolition ❑ Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑ Multi-family ❑ Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived AddJob#: Job site address: 15726 SW 76th Avenue ❑IOOH ion of new motor load of system. 00HP or more. ❑"A" "E" "1-2" "1-3„ ❑Six or more residential units. occupancy. City/State/ZIP: Tigard,OR 97224 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: Knauss Subdivision Lot I 0 Hazardous locations. 0 Supply voltage for more than ----.- . El Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: SW 76th and Durham FEE SCHEDULE Description I Qty. I Each I Total New residential single-or multi-family dwelling unit. Subdivision: Knauss Subdivision Lot#: 1 Includes attached garage. 1,000 sq.ft.or less 1 168.54 168.54 4 Tax map/parcel#: WCTM 2S1 12CD,Tax Lot 00400 67.84 Ea.add]500 sq.ft.or portion 2 33.92 1 DESCRIPTION OF WORK Limited energy,residential (with above sq.ft.) 75.00 2 Proposal to construct a primary residential structure and an attached accessory Limited energ y,multi-family 75.00 2 dwelling unit. Each unit will be be 2 stories residential(with above sq.ft.) Renewable Energy i i See Page 2 ®PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name: CBG SW 76th Avenue. 1.,LC 200 amps or less 1 100.70 100.7( 2 201 amps to 400 amps 133.56 2 Address: 15110 SW Boones Ferry Road,Suite 500 401 amps to 600 amps 200.34 2 City/State/ZIP: Lake Oswego,OR 97035 601 amps to 1,000 amps 301.04 2 Phone:(503 ) 9569307 Fax:( ) Over 1,000 amps or volts 552.26 2 cano dx.com Temporary services or feeders installation,alteration,and/or Sean Email: @ PYP relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 1 59.36 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 Branch circuits—new,alteration,or extension,per panel [j APPLICANT 0 CONTACT PERSON A.Fee for branch circuits with Business name: CBG SW 76th Avenue.LLC above service or feeder fee, 7.42 2 each branch circuit ' Contact name: Sean O'Neill B.Fee for branch circuits without serAddress: 15110 SW Boones Ferry Road,Suite 500 branchce it feederitfee,first 56.18 2 branch circuit City/State/ZIP: Lake Oswego,OR 97035 Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( 503 ) 9569307 Fax: :( ) Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email: searnacanopypdx.com _ Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 1 67.84 67.84 2 Business name: 5 — 4 Lset � Sign or outline lighting 67.84 2 ��r�` Signal circuit(s)or limited-energy g Address: panel,alteration,or extension. 0 See Pa e 2 2 Each additional inspection over allowable in any of the above City/State/ZIP: Additional inspection(1 hr min) 66.25/hr Phone:( ) Fax:( ) Investigation(1 hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: Electrical Lic.: Suprv.Lic.: specifically listed(%hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: Date: ❑Plan Review Required(25%of permit fee): p-Docusigned by: State surcharge(12%of permit fee): S TOTAL PERMIT FEE: Authorized signature: 1, , 0-t�1, e, -- � This permit application expires if a permit is not obtained within 180 Print name: Sean 0'Ne1 g l5 tD6C8B3F7D433_ Date: 01/05/2022 days after it has been accepted as complete. " Number of inspections allowed per permit. 1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB DocuSign Envelope ID:7AA377A6-4649-400E-BF5F-4FE6AD73FDFF Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Description I Qty. I Each I Total I " Fee for all residential systems combined: $75.00 Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 kva(fee in accordance 552.26 2 with OAR 918-309-0040) ❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 ❑ V• acuum Systems* >100 kva—no additional charge 0.0 3 Each additional inspection over allowable in any of the above: ❑ Other: Each additional inspection is 66.25/hr 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(%:hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 Subtotal(Enter Page 1): y ' Number of inspections allowed perr permit.. (SEE OAR 918-309-0000) Check Type of Work Involved: n A• udio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation n Fire Alarm Installation ❑ HVAC n Instrumentation ❑ Intercom and Paging Systems n Landscape Irrigation Control* • Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* n P• rotective Signaling n Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I.\Building\Permits\ELCPermitApp_ELR_ERE.doe Rev 06/17/2015 DocuSign Envelope ID:03096C14-751D-4862-A7B.R e ' " ENE NE 'Electrical Permit Application 1.oit OrFIt h: l St.:Om.) City of Tigard MAR 1 2022 Received Permit#: 111 • 13125 SW Hall Blvd.,Tigard,OR 97223p. Plan Review = Phone: 503.718.2439 Fax: 503.598.196Wfry OF TIGA�[J Date/By: Related Permit#: T I G A R D Inspection Line: 503.639.4175 3UiLDING DIVISIOI Ready Date/By: tuns ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑ Demolition ❑Other: 0 Service or feeder 400 amps or more 0 Building over three stories. where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ® I-and 2-family dwelling ❑ Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived AddJob#: Job site address: 15724 SW 76th Avenue ❑100H ion of new motor load of system. 00HP or more. ❑"A" "E" "1-2""1-3" Clt Y Tigard,g ard OR 97224 ❑Six or more residential units. occupancy. ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: Knauss Subdivision Lot 1 0 Hazardous locations. ❑Supply voltage for more than 0 Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: SW 76th and Durham FEE SCHEDULE Description I Qty. 1 Each I Total I •,. New residential single-or multi-family dwelling unit. Subdivision: Knauss Subdivision Lot#: 1 Includes attached garage. 1,000 sq.ft or less 1 168.54 168,5, 4 Tax map/parcel#: WCTM 2S1 12CD,Tax i,ot 00400 _ Fa.add'l500 sq,ft.or portion 2 33.92 67.84 1 DESCRIPTION OF WORK Limited energy,residential (with above sq.ft.) 75.00 2 Proposal to construct a primary residential structure and an attached accessory Limited energy,multi-family dwelling unit. Each unit will he be 2 stories residential(with above sq.ft.) 75.00 2 Renewable Energy I I See Page 2 ®PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name: CBG SW 76th Avenue,LLC 200 amps or less 1 100.70 100.7( 2 201 amps to 400 amps 133.56 2 Address: 15110 SW Boones Ferry Road,Suite 500 r 401 amps to 600 amps 200.34 2 / City/State/ZIP: Lake Oswego,OR 97035 601 amps to 1,000 amps 301.04 2 / Fax: Over 1,000 amps or volts 552.26 2 Phone: ) 9569307 ( ) Temporary services or feeders installation,alteration,and/or Email: sean@canopypdx.com relocation Owner installation:This installation is being made on property that 1 own which is not 200 amps or less 1 59.36 59.36 1 riintended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 Branch circuits—new,alteration,or extension,per panel a APPLICANT 0 CONTACT PERSON A.Fee for branch circuits with 1 Business name: CBG SW 76th Avenue,LLC. above service or feeder fee, each branch circuit 7.42 2 Contact name: Sean O'Neill B.Fee for branch circuits without 't service or feeder fee,first Address: 15110 SW Boones Ferry Road,Suite 500 branch circuit 56.18 2 fr g City/State/ZIP: Lake Oswego,OR 97035 Each add'i branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( 503 ) 9569307 Fax::( ) Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email: Sean@canopypdx.com Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 1 67.84 67.84 2 Business name: 7 a rme r Electric, Inc. Sign or outline lighting 67.84 2 5105 SW 45th Ave, #100 Signal circuit(s)or limited-energy SeePage2 2 Address: panel,alteration,or extension. ❑ { City/State/ZIP: Port and, OR Each additional inspection over allowable in any of the above 97221 Additional inspection(1 hr min) 66.25/hr Phone:( 5034246.5381 Fax:( ) Investigation(1 hr min) 90.00/hr Email: ti m@'a rme r.co Industrial plant(1 hr min) 78.18/hr m Inspections for which no fee is 90.00/hr CCB Lic.: 6924 Electrical Lic.?6-144C Suprv.Lic.:63655 specifically listed('/,hr min) ct� oeusigned by ELECTRICAL PERMIT FEES Suprv.Electrician signature,required:.j,f�1. Subtotal: Print name:Tim 3arme r �472C617 4A6 Date3/1/2022 n Plan Review Required(25%of permit fee): ovc.raig..-61 br State surcharge(12%of permit fee): a r I I TOTAL PERMIT FEE: Authorized signature: St4J,k u MAW I 356D6c8B3F70433... This permit application expires if a permit is not obtained within 180 Print name: Sean O'Nei 11 Date: 8/17/2021 days after it has been accepted as complete. " Number of inspections allowed per permit. I.\Building\Permits\ELC_Perm5App_ELR_ERE.doe Rev 06/17/2015 440-4615T(11/05/COM/WEB .rk DocuSign Envelope ID:03096C14-751D-4862-A7BA-661B9A2448D2 Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Description I Qty. I Each I Total Fee for all residential systems combined: $75.00 Renewable electrical energy systems: Check Type of Work Involved: S kva orless 100.70 2 5.01to15kva 133.56 2 n A• udio and Stereo Systems* 15.01 to25 kva 200.34 2 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 2 ❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 ❑ Vacuum Systems* >100 kva-no additional charge 0.0 3 Each additional inspection over allowable in any of the above: ❑ Other: Each additional inspection is 66.25/hr 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed('/2 hr min) COMMERCIAL WORK ONLY: Et ECTRIC i."MOUT FtES . (EnterFee for each commercial system: $75.00Subtotal perpermi on rage 1) y * Number of inspections allowed permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ A• udio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ D• ata Telecommunication Installation ❑ Fire Alarm Installation ❑ H• VAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1:\Building\Remits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 DocuSign Envelope IL): /AA:i//Ab-4649-4001-431-5h-41-tbAUfJI-U1-1- Plumbing Permit Application Site Utilities RECEIVED FOR OFFICE USE ONLY Ill ■ City of Tigard Date/By: A{ - 1 t� Permit No.: o72-OzzDci 13125 SW Hall Blvd.,Tigard,OR 97223 4 Fs . '.I, Received - y. t" ' Plan Review Phone: 503.718.2439 Fax: 503.598.1960 (r�eeb Date/By: Permit No.: y: S(/J1�ZZ Z ' T 1 G A R D Inspection Line:503.639.4175 cfry OE 1 T'l�nRD n Date Reacts By: Juris ® See Page 2 for Internet: www.tigard-or.gov �� �� �u1 ,l1 Notified Method: Supplemental Information TYPE OF WOR 3 FEE* SCHEDULE ,W New construction El Demolition For special information use checklist Description 1 Qty. 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 1-and 2-family dwelling ❑ Commercial/industrial SFR(2)bath 437.78 ❑Accessory building El Multi-family SFR(3)bath I 500.32 500.32 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: 15726 SW 76th Avenue Catch basin or area drain 18.76 City/State/ZIP: Tigard,OR 97224 Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03 Cross street/directions to job site: 76th/Durham Manholes 18.76 Rain drain connector 1 18.76 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: Knauss Subdivision Lot no.: 1 Fixture or item: Tax map/parcel no.: WCTM 2S1 I2CD.Tax lot 00400 Backflow preventer n 31.27 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Proposal to construct a primary residential structure and an attached accessory Dishwasher 25.02 dwelling unit. Each unit will be be 2 stories Drinking fountain 25.02 Ejectors/sump 25.02 1 Ey PROPERTY OWNER ❑ TENANT Expansion tank 12.51 Name: CBG SW 76th Avenue,LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 15110 SW Boones Ferry Road,Suite 500 Garbage disposal 1 25.02 25.02 City/State/ZIP: Lake Oswego,OR 97035 Hose bib 1 25.02 25.02 Phone:( 503)9569307 Fax:( ) Ice maker 1 12.51 12.51 ®APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: CBG SW 76th Avenue,LLC Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Sean O'Neill Roof drain(commercial) 12.51 Address: 15110 SW Boones Ferry Road,Suite 500 Sink/basin/lavatory 25.02 City/State/ZIP:Lake Oswego,OR 97035 Solar units(potable water) 62.54 Phone:( 503) 9569307 Fax::( ) Tub/shower/shower pan 12.51 E-mail: sean cano dx.com Urinal 25.02 pYP CONTRACTOR Water closet 25.02 Water heater 1 37.52 37.52 Business name: Sec c Kt-��i Water piping/DWV 56.29 Address: J /"'`" Other: 25.02 City/State/ZIP: Subtotal Phone:( ) Fax:( ) Minimum permit fee: $72.50 CCB Lic.: Plumbing Lic.no.: Plan review (25%of permit fee) nocuSign ed by State surcharge(12%of permit fee) Authorized signature: Stave /A to t:11 TOTAL PERMIT FEE Print name: Sean 8B3F7°433..• Date: 01/05/2022 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-PermitApp.doe 10/01/09 440-4616T(10/02/COM/WEB) DocuSign Envelope ID:7AA377A6-4649-400E-BF5F-4FE6AD73FDFF Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: Footing drain- IOW 1 50.03 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 1 37.52 37.52 3,601 to 7,200 $233.20 3,601 to 7,200 $ 33.20 Sewer-1st 100' 1 62.54 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 1 62.54 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Storm&Rain Drain-1st 100' 1 62.54 62.54 Valuation: Permit Fee: $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10.000.00 $72.50 for the first$5,000.00 and$1.52 for Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to P and including$10,000.00. Inspection of eyisting plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no tee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for (minimum charge 1/2 hour) each additional$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures?If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Quantity by Fixture Type Plan Review for Plumbing Installations Fixture Type for Replace/ Work Performed: Capped Added Relocate Plan review is required for any of the following. Baptistry/Font Please check all that apply. Bath -Tub/Shower 0 Any new commercial building with water service 2"and -Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Drive Thru 0 New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918-780-0040. Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities. -Domestic 0 Any multipurpose fire sprinkler system. Drinking Fountain 0 Any complex structure as defined in OAR918-780-0040. Eye Wash Floor Drain/sink -2" Submit 2 sets of plans with any of the above. -3" 4" Isometric or Riser Diagram Car Wash Drain Garbage Domestic-non-food ❑ Isometric or riser diagram is required for new buildings Disposal -Domestic-food related that meet the qualifications above. -Commercial-food related -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang -Stall Sink/Lav -Non-food related -- -Bradley -Commercial-food related -Service Swimming Pool Filter Washer-Clothes *Note: If the fixture work under this permit results in an Water Extractor increase of sewer EDUs,a sewer permit will be issued and Water Closet-Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: 1:\Building\Permits\PLMU_PermitApp.doc 2 DocuSign Erwelope ID:7AA377A6-4649-400E-BF5F-4FE6AD73FDFF • Plumbing Permit Application Site Utilities RECEIVE_r FOR OFFICE USE ONE l City of Tigard MAR qq Received MAR 1 2022 Date/By: Permit No.: 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503.718.2439 Fax: 503.598.1960 an Review Date/By:OF TIGAkb Other Permit No.: I I C f.It I) Inspection Line:503.639.4175 /'� Date Ready/By: Juris: 0 See Page 2 for Internet: www.tigard-or.gov i3UILDING DIVISIOP Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE Q New construction ❑ Demolition For special information use checklist. Description 1 Qty. 1 Ea. 1 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 ® 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 ElAccessory building 0 Multi-family SFR(3)bath 1 500.32 500.32 Each additional bath/kitchen 25.02 ❑ Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Catch basin or area drain 18.76 Job site address: 15724 SW 76th Avenue City/State/ZIP: Tigard,OR 97224 Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03 Cross street/directions to job site: 76th/Durham Manholes 18.76 Rain drain connector 1 18.76 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: Knauss Subdivision Lot no.: I Fixture or item: Tax map/parcel no.: WCTM 2S112CD,Tax Lot 0040(1 Backflow preventer 1 31.27 31.27 DESCRIPTION OF WORK Backwater valve 12.51 1 Clothes washer 25.02 Proposal to construct a primary residential structure and an attached accessory Dishwasher 25.02 dwelling unit. Each unit will be be 2 stories Drinking fountain 25.02 Ejectors/sump 25.02 Q{PROPERTY OWNER 0 TENANT Expansion tank 12.51 Fixture/sewer cap 25.02 Name: CBG SW 76th Avenue,LI,C i Floor drain/floor sink/hub 25.02 Address: 15110 SW Boones Ferry Road,Suite 500 Garbage disposal 1 25.02 25.02 City/State/ZIP: Lake Oswego,OR 97035 ( Hose bib 1 25.02 25.02 Phone:( 503 )9569307 Fax:( ) Ice maker 1 12.51 12.51 ('7i APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name: CBG SW 76th Avenue,LLC Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Sean O'Neill Roof drain(commercial) 12.51 Address: 15110 SW Boones Ferry Road,Suite 500 Sink/basin/lavatory 25.02 City/State/ZIP:Lake Oswego,OR 97035 Solar units(potable water) 62.54 Phone:( 503)9569307 Fax::( ) Tub/shower/shower pan 12.51 E-mail: sean@canopypdx.com Urinal 25.02 CONTRACTOR Water closet 25.02 Water heater 1 37.52 37.52 Business name:Alliance Plumbing � Water piping/DWV 56.29 Address: 146 W Historic Columbia River Hwy. Address: 146 W Historic Address:Address: City/State/ZIP:Troutdale,OR 97060 City/State/ZIP:Troutdale,OR 97060 City/State/ZI Phone Phon Phone: Phone: Minimum permit fee: $72.50 > m Phone:((503) 492-3490) Plan review (25%ofpermit fee) CCB Lic.: 184601 Dooustgnedby: CCB Lic.: 184604 /�I% State surcharge(12%of permit fee) _ Authorized signature: sty tt /S/tatTOTAL PERMIT FEE Print name: Sean , e11883F70433-. I Date: 02/11/2022 I This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1.lBuilding\Permits\PLMU-PermitApp.doe 10/01/09 440-4616T(10/02/COM/WEB) j DocuSign Envelope ID:7AA377A6-4649-400E-BF5F-4FE6AD73FDFF Plumbing Permit Application - City of Tigard Page 2 -Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: Footing drain- 100. 1 50.03 50.03 0 to 2,000 $121.90 Footingdrain-each additional 100' 37.52 2,001 to 3,600 $169 69 1 37.52 3,601 to 7,200 $233 20 Sewer-1st 100' 1 62.54 62.54 7,201 and greater $327 54 Sewer-each additional 100' 37.52 Water Service-1st 100' 1 62.54 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Storm&Rain Drain-1st 100' 1 62.54 62.54 Valuation: Permit Fee: $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 3752 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for (minimum charge-1/2 hour) each additional$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures?If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Quantity by Fixture Type Plan Review for Plumbing Installations Fixture Type for Replace/ Work Performed: Capped Added Relocate Plan review is required for any of the following. Baptistry/Font Please check all that apply. Bath Tub/Shower ❑ Any new commercial building with water service 2"and Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Drive Thru ❑ New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918-780-0040. Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities. -Domestic ❑ Any multipurpose fire sprinkler system. Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040. Eye Wash Floor Drain/sink -2" Submit 2 sets of plans with any of the above. -3„ Isometric or Riser Diagram Car Wash Drain Garbage Domestic-non-food ❑ Isometric or riser diagram is required for new buildings Disposal -Domestic-food related that meet the qualifications above. -Commercial-food related -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang -Stall Sink/Lay -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter Washer-Clothes *Note: If the fixture work under this permit results in an Water Extractor increase of sewer EDUs,a sewer permit will be issued and Water Closet-Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: I:\Building\Permits\PLMU_PermitApp.doc 2 City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT 1/ T 1 c n a Building Permit Review — Residential Building Permit #: V 5-C'7 o'V - atibq rfi Site Address: 154i G sW -7-6 41t PoN_ ri Project Name: VVta,U j S c1L3 Lot #: Planning Review '' ^ � II 6eak1 '/ l Proposal: < i Vk �t. O tk,c t/I d i t j 6� U ` CJ v (i Verify address/suite #active in Accela. ❑ In River Terrace: ® No ❑ Yes,River Terrace Review Addendum Site Plan Elements: i Erosion Control ,3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper AiiRetained trees with drip line and tree protection measures 1 [ Drawn to scale(standard architect or engineer scale) Footprint of new structure(including decks)and FEE 014 Worth arrow Utility locations&easements(required for new and additions) Site address,project or subdivision name and lot number of!- Sidewalk/driveway approach 5n7Applicant information(name and phone number) r iion of wells/septii$- Lot dimensions and building setback dimensions Street tree size,type and location B'�frrnr-faot�►�f��_ ���*a_bed chaired— Street names Mb I sm fps t Comer elevations (2'contours if more than 4'differential) [ XI Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? AYes ❑No impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm watere quality facility shown? AYes ❑No f� C„ \XI t r c o o S e n-�n.� pie -(lot platted"prii r�6 9 f 5) I Required: ❑ Yes,applicant was notified fl No Received: ❑ Yes ❑ No �Ieter F' —A�d3a Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No Received: ❑ Yes ❑ No Li -PuLli,.-Fatilitie lire Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake c Land Use Case#: �J L1 P...0 1 8"Q(bd I ® Zoning: Ic- � ® Required Setbacks: Front: Rear: L 1 1 5 ' Side: 5 t Street Side: (101 Garage: ZQ Building Height: Max.Height: 3 Actual H,eeight: ig Landscape Area:_ 7'% IZ Lot Coverage Max: 0 Entrance N) Set back no more than 8'from street-facing wall X Parallel to street or offset 45 degrees or less Windows A Minimum 12%of area of all street-facing facades Garage ;RI Garage door is behind widest street-facing wall M Yes 1 No,one of the following is met: ❑ Door extends no more than 5'from wall and there is a covered porch extending beyond garage. / ❑ Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2*'d floor. Garage door width is ❑ 12'or less ❑ 50%or less of facade Z 60%or less and includes 7 of following: ❑ Covered porch EL Recessed entrance V Wall offset E 1'Roof eave ❑ Roof offset ❑ Fire shingles 124 Lap Siding ❑ Roof pitch Al Gable,hip,or gambrel roof ❑ Dormer ❑ Accent siding Iki Window trim ❑ Window recess ❑ Window projection (I Balcony lg Visual Clearance p Urban Forestry Plan &oat S ��' (r`� ff � Rol (( __ Sensitive Lands: ,I� Yes ❑ No Type: &oat Jr' V l i?'i Ca t4t' Rol b1 Td- pConditions met prior to issuance of building permit Notes: ® Approved By Planning: S Date: tt VDATI I 2t7-e/*0 Revisions (after Building Submittal only) Reviewer Date 1 Revision 1: DI Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved e 1 I:\Building\Forms\BldgPernutRvw RES_122419.docx Building Permit Submittal Original Submittal Date: Site Plans: # Building Plans: Building Permit#: ❑ Enter building permit#above. Workflow Routing: ❑ Planning ❑ Engineering ❑ Permit Coordinator ❑ 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. ❑ Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: Date: Engineering Review [VSlope at building pad: a 4 Er Conditions "Met"prior to issuance of building permit g•;Easements (encroachments)per engineering conditions of approval and plat Lid Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: El Yes El' No Assess Water Quantity Fee in-lieu: ❑ Yes 'No C I4 W(, r 1 ' LIDA Facility on lot: "Yes ❑ No Add Fee: ❑ Yes e/No @Final Plat Recorded: NOT Approved by Engineering: Date: r Notes: f4f-/ it `"-(vt ci---- — LDS Approved by Engineering: r-+c-A-=.-y Date: i /t z (L?? Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review ra Conditions "Met"prior to issuance of building permit f�1 Approved,NOT Released: /CL.. Date: Ili ISl ZZ Notes: M'1Ga plat- hOt recDra.ect je.vec Coo5. Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: NA SDC Exemption: ❑ Received 7 Does not apply SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A s toe -rciC Tigard.Trans SDC: /JZr Yes ❑ N/A Parks SDC: ! Yes ❑ N/A LIDA ❑ Yes / N/A OK to Issue Permit Approved by Permit Coordinator: Date: ` 2,D L262./2-- I:\BuildingWorms\BldgPermitRvw_RES_1208021.docx DocuSign Envelope ID:414650D3-DE3B-4811-A7CE-7FCA6DBFADDO City of Tigard Deferral Until Occupancy Request T 1 G A K lj Washington County Transportation Development Tax (TDT),Transportation and Parks System Development Charges (SDCs) This form is to be signed and submitted prior building permit issuance or,if no building permit is required,then upon land use approval(TMC 3.24, as amended by Ordinance No. 21-09). Date: 1/10/2022 Site Address: 15726 SW 76th Ave (Primary) Project Knauss Lot 1 Land Use Case or MST2022-00009 Name: Building Permit#: Tax Lot Total Parks #: 2S112CD00400 Amount*: $7,591.00 TDT N/A Total TSDC Amount: Amount*: $4,128.00 *The total TSDC amount shown above is the sum of$ 3,903.00 for TSDC-Improvement,$ 225.00 for TSDC- Reimbursement,and$ N/A for TSDC-River Terrace,if applicable.. *The total Parks SDC amount shown above is the sum of$4,727.00 for Parks-Improvement, $ 1,112.00 for Parks- Reimbursement,and either$1,75200 for Parks-Neighborhood or$ N/A for Parks-Neighborhood River Terrace. This constitutes my request to defer payment of the TDT,TSDC, and Parks SDCs, as provided above, until occupancy. Payment of the TDT,TSDC, and Parks SDCs may be deferred until issuance of the occupancy permit. In requesting this option, I understand that any deferred TDT,TSDC, and Parks SDCs must be paid prior to final 1 inspection or issuance of an occupancy permit. TDT may only be deferred if the TDT is greater than the amount for a single-family residence. I further understand that the amount of TDT due on deferred obligations shall be the amount in effect at the time of issuance of the building permit. For a deferral request to be accepted both the Property Owner and the Developer must sign this request. —DocuSigned by: c� IL 1/11/2022 Property Owner: `� Date: p ;•-JDOU6l.bC4r/U43.5 ,--DocuSigned by: fi St4UA, 1-IM.1U, 1/11/2022 Developer: ..---15,RDsrss3r7DAn Date: Permit Coordinator: ATO Oevittek Date: 1/10/2022 -.�..0 sers+svauste ..r.rx:e: ees.sw.H.re...auu;.ex ai:suNst. u+zu ws>senusUviassusasur. 3 1 Water Meter Fixture Unit Worksheet For New Buildings Please complete the following information: Contractor Name: Canopy Building Group, LLC Billing Address: Street/Suite#: 15962 Boones Ferry Road Suite 202 City: Lake Oswego State: OR Zip: 97035 Phone Number: 503 956 9307 Email: sean@canopypdx.com New Meter Address: 15726 SW 76th Avenue/15724 SW 76th Avenue Subdivision Name: Knauss Subdivision Lot#: 1 10 Building Permit#: MST 2022-00009/MST2022-00010 1 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. i Fixture Unit Quantity Point Value Point Total 1 d Bar sink 1 x 1 = 1 0 = Bidet x 1 = Clothes washer 2 x 4 = 8 0 Dishwasher 2 x 1.5 = 3 Hose bib, 1st one 2 x 2.5 = 5 Hose bib, each additional x 1 = Kitchen sink 2 x 1.5 = 3 Laundry sink x 1.5 = Lavatory 8 x 1 = 8 Water closet, 1.6 GPF 6 x 2.5 = 15 Bathtub/whirlpool x 4 = Shower stall 2 x 2 = 4 Bath/shower combo 2 x 4 = 8 Total Fixture Unit Points: 55 Fixture Unit Points: 1 to 30=5/8" 37.5 to 89= 1" 30.5 to 37=3/4" 1" Meter Size: Meter Cost: $ ************************************************************************************* 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: I:/Building/Forms/WaterMeters_070121_New.dOCx Page 2 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 114 _ Water Meter Fixture Unit Worksheet For New Buildings 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov LOCATION: City of Tigard—City Hall WATER METER SALES: Utility Billing By Email Only. Please contact 13125 SW Hall Blvd. ubonlinepay@tigard-or.gov Tigard, OR 97223 to discuss sending documents and payment METER: SIZE: FEE: Effective 07/01/2021 5/8" $10,095.00 Fee includes: 3/4" $14,418.00 water system development charge, 1" $26,487.00 water meter, and 1-1/2" $78,488.00 meter installation fee. 2" $127,125.00 Note: An additional charge will apply for water meters where an"existing water main"requires a new service line to be installed by the City to the property address and is paid by the property owner as follows: • Up to 1"=$3,815.00 • Over 1"=Cost+ 10% DETERMINING METER SIZE FOR RESIDENTIAL CUSTOMERS City of Tigard Water Service Area uses the American Water Works Association Manual and the Oregon Plumbing Specialty Code to determine the size of meter needed to adequately serve new buildings. In most cases,new residential buildings require a 3/4"meter,however, due to the size of homes built in the Tigard area,we now count the fixture units of all homes prior to selling a meter. Buildings with 37 or less fixture points can use a 3/4"meter. for those over 37, a 1"meter must be purchased. Use the worksheet on Page 2 to calculate the number of fixture units. DOCUMENTATION Please provide the following items to the Utility Billing counter to purchase your meter: • Completed water meter fixture unit worksheet(on back page). • Copy of building or plumbing permit application date-stamped by building division. • Copy of issued building or plumbing permit. Your fixture count will be verified and your request will be processed upon receipt of these documents. No exceptions. INSTALLATION TIME Most meters are installed within 10-14 business days. If your meter is not located within an existing subdivision we may need additional time in order to verify the location of other underground utilities. Please keep these time frames in mind when purchasing your water meter. I:/Building/Forms/WaterMeters_070121_New.dOCX Page 1 i N. , 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 itprovides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Ph Transmittal Letter T I c,A tt n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Allyson Armstrong DATE RECEIVED: DEPT: BUILDING 4ECEIV FROM: CBG SW 76th Avenue, LLC (Sean O'Neill) FEB 9 2022 COMPANY: CBG SW 76th Avenue, LLC vlTY OF TIGARD PHONE: 503-956-9307 ' IILDING DIVISION By: '�r- EMAIL: sean@canopypdx.com RE: 15724& 15726 SW 76th Ave MST2022-000 ft&00010 . (Site Address) (Permit Number) Knauss Subdivision Lot 1 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. 3 Revisions: See Remarks Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. 2 Engineer's calculations. Other(explain): RE1'IARKS: Updated slabedge detail and foundation sheet is attached. The Slabedge detail will meet the requirements of N1101.1(2)by installing R-15 insulation around the perimeter of the footiings as shown in Detail 1 on Sheet S1. The engineering calc packet is attached as well. As discussed on the phone,we are only requesting a foundation permit at this time. FOR FFICE USE ONLY _ Routed to Permit Technic : ,Date: 9. t .2---' Initials: Fees Due: Yes Not' Fee Desc ptio : Amount Due: L...,,--' ifo' Nj 0 . %.--) Ci $ Special __v Instructions: Reprint Permit(per P ): []Yes ❑No ❑ Done Applicant Notified. Date: ,.,2/2_)--/,2 Z--- Initials: Agnes Lindor MORI l VIII I I\ I From: Agnes Lindor Sent: Tuesday,January 18, 2022 1:27 PM To: Sean O'Neill Cc: Trent Brickey;#Building Permit Technicians Subject: Knauss MST2022-00006, 8, 9, and 10 Hi Sean- These permits have been approved but cannot be released until the final plat has been recorded with the County. Thanks, Agnes Lindor I Associate Planner City of Tigard I Community Development 13125 SW Hall Boulevard Tigard, Oregon 97223 Phone: 503.718.2429 Email:AgnesL@tgard-or.gov 1