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Permit
CITY OF TIGARD MASTER PERMIT IN _ ' COMMUNITY DEVELOPMENT Permit#: MST2022-00053 T I C_ A li T 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/10/2022 Parcel: 2S112CD17900 Jurisdiction: Tigard Site address: 15788 SW 76TH AVE Subdivision: DURHAM ACRES Lot: 9&PT 8 Project: Knauss Estates Lot 5,ADU Project Description: New attached ADU. NO FINAL UNTIL DEFERRED SDC FEES ARE PAID. BUILDING Floor Areas Required Setbacks Required Stones: 2 Bedrooms: 2 First: 591 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 25.5 Bathrooms: 3 Second: 777 sf Garage: 220 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 1368 sf Value: $189,915.04 Rear: 7.5 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 3 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: 3 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 2 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'I 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 ADU VB R-3 1368 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 2 Fire Rated Conditions LAKE OSWEGO,OR 97035 PHONE: PHONE: 541-600-5146 FAX: Total Fees: $11,754.45 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR oc9-nn1-nni n thr�h n oc9-nn1_nngn nil au fain a rnn,,of the n Iliac nr`lircrt n,icetinnc to ni INC by raufnn sn4 949 10 Ann 449 9444 Issued By: Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspection dat 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. V.. DoroSign Envelope ID:B5D7256C-3AF5-48AC-A2A5-EEF4CD7E4F50 ' Building Permit Application S- 2/ i 7/ 2- . Residential RECEIVED FOR OFFICE USE ONLY 131 5 Sw Tigard l Tigard,oR 97223 FED17 01Z rya �� J z/Z 1� Z Pemilit No.: `� (�G(?53 Plan Review : g- Phone: 503.718.2439 Fax: 503.595.1 Date/B : , ' OtherPa "mir 4 io t, el 1.1 6F 1;l Inspection Line:503.639.4175 V l i D OF 1 lUI U 11 Date Ready/By: /, See Page 2 for Internet: www.tigard-or.gov BUILDING f MSIOR'a otified/Method: , �/ n ®. * Sappiementat lnfarmatioa L/ .41110:-t — TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING ®New construction 0 Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the work indicated on this application. CATEGORY OF CONSTRUCTION iCit _M....___ Valuation: $ L 1q i 15 , ©I-and 2-family dwelling El Commercial/industrial .... Number ofbedrooms:3 ❑Accessorybuilding Yi4 0 Multi-family ❑Master builder 0 Other: Number ofbathrooms; 3 JOB SITE INFORMATION AND LOCATION Total number of floors:2 )5 e > Job site address:,L5,79P"SW 76th Avenue; 4 A-3 SS New dwelling area: I Vat,square feet 7 77 City/State/ZIP: Tigard,OR Garage/carport area:220 square feet 54) I Suite/bldg./apt.no.: Project name:Knauss Estates Lot 5 Covered porch area: square feet Cross street/directions to job site: East side of the block north of SW 76th Avenue and SW Bont — Deck area: square feet their,/ cee,S te.,f l.cT Gr W //iitr47)) Other structure area , square feet kef/ j,cpt-j7) it REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Knauss Estates k{' .t1Yt*, Lot no.: 5 Permit fees*are based on the value of the work performed. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all p/p WCTM 2SI I2CD,Tax Lot 00400 equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK iY ioq work indicated on this application. Proposal to construct a primary residential structure and en attached accessory dwelling Valuation: $ unit. Each unit is 2 stories in height and will have a single car garage. Existing building area: square feet New building area: square feet ❑PROPERTY OWNER ( 0 TENANT Number of stories: Name: CBG SW 76th Avenue,LLC Type of construction: Adams. 15110 SW Boones Ferry Road,Suite 500 Occupancy groups: City/State/ZIP: Lake Oswego,OR 97035 _ Existing; Phone:(503 ) 956-9307 Fax:( ) New: I ®APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* mare Business name: CBG SW 76th Avenue,LLC refer a,jK� �)Structural plan review fee(or deposit): Contact name: Snarl r"YA.piit FLS plan review fee(if applicable): Address: 15110 S W Boones Ferry Road,Suite 500_ City/State/ZIP: Lake Oswego,OR 97035 Total fees due upon application: Phone:(503 ) 956-9307 Fes::( Amount received: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: Bean@canopypdx.com CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted Photo Voltaic Solar Panel System. Submit two(2)sets of roof plan with connection details Business name: Canopy Building Group,LLC and fire department access,along with the 2010 Oregon Address: 15110 SW Boones Ferry Road,Suite 500 Solar Installation Specialty Code checklist. City/State/ZIP: Permit Fee(includes plan review I Akn Oswego,OR 97035 and administrative fees): $180.00 Phone:(503 ) 956-9307 i Fal.(_w ) State surcharge(12%of permit fee): $21.60 CCB lie.: CCB#232358 Total fee due upon application: $201.60 Authorized signature: r tam i_ t L' ;tt This permit application expires 1f a permit is not obtained JJ t"�•l within 180 days after it has been accepted as complete. I Print name:Sean O'Ne i 356D6C663F7o433... Date: 02/I 1/2022 I *Fee methodology set by Tn-County Balding Industry I Service Board. I:\Building\Pennits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) ilti.Nfsi4Y!£8{H#48.ute3#d4n 43t4£6Nx11... .. DocuSign Envelope ID:7AA377A6-4649-400E-BF5F-4FE6AD73FDFF Mechdl'lical Permit Applicati ++ f�' F-OsRy OFFICE USE ONLY City of Tigard �� �l��® ReDaceived c r V ` ,492.�' PermitNo.:/45''r)i'�- 3 le 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review I ten ,1 + DateB Other Permit:5 f gull,-,-COO�( Phone: 503.718.2439 y; Inspection Line: 503.639.4175 CITY��T�VIl1Il® Date ReadyBy: Allis: El See Page 2 for ncnitn V Internet: www.tigard-or.gov e/By:Notified/Method: Supplemental Information PUILDING DIVISinnl TYPE OF WORK COMMERCIAL FEE*SCHEDULE-USE CHECKLIST Mechanical permit fees*are based on the value of the work [ New construction ❑ Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ® 1-and 2-family dwelling 0 Commercial/industrial ❑ Accessory building For special information use checklist. ❑ Multi-family ❑ Master builder ❑ Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 1 46.75 46.75 Job site address: J5 92SW 76th Avenue / 3-3-8 g 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 Heat pump 61.06 Suite/bldg./apt.no.: Project name: Knauss Subdivision Lot 5 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 Other: 23.32 Subdivision: Knauss Subdivision Lot no.: 5 Other fuel appliances: Tax map/parcel no.: WCTM 2S112CD,Tax Lot 00400 Water heater 1 23.32 23.32 DESCRIPTION OF WORK Gas fireplace/insert 1 33.39 33.39 Flue vent for water heater or gas Proposal to construct a primary residential structure and an attached accessory fireplace 23.32 Log lighter(gas) 23.32 dwelling unit. Each unit will be be 2 stories Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other: 23.32 X PROPERTY OWNER TENANT Environmental exhaust and ventilation: Name: UCBG SW 76th Avenue,LLC U Range hood/other kitchen equipment 1 33.39 33.39 Address: 15110 SW Boones Ferry Road,Suite 500 Clothes dryer exhaust 1 33.39 33.3 City/State/ZIP: Lake Oswego,OR 97035 Single-duct exhaust(bathrooms, 9 toilet compartments, utility rooms) 23.32 Phone:(503 ) 9569307 Fax:( ) Attic/crawlspace fans 23.32 APPLICANT CONTACT PERSON Other: 23.32 Fuel piping: Business namcp CBG SW 76th Avenue,LLC U $14.15 for first four;$4.03 for each additional Contact name: Sean O'Neill Furnace,etc. f Gas heat pump Address: 15110 SW Boones Ferry Road,Suite 500 Wall/suspended/unit heater City/State/ZIP: Lake Oswego,OR 97035 Water heater Fireplace Phone:(503 ) 9569307 Fax::( ) Range E-mail: sean@canopypdx.com Barbecue CONTRACTOR Clothes dryer(gas) (' Other: Business name: c7,_L �r 94-7Q 7 f^"C MECHANICAL PERMIT FEES* Address: .e Subtotal Minimum permit fee($90.00) City/State/ZIP: Plan review(25%of permit fee) Phone:( ) Fax:( ) State surcharge(12%of permit fee) TOTAL PERMIT FEE CCB lie.: -DocuSigned by: This permit application expires if a permit is not obtained within 180 St 11 L days after it has been accepted as complete. Authorized signature: J 5606C883F7D433 * Fec methodology set by Tri County Building Industry Service Board Print name: Sean O'Neil! Date: 02/11/2022 1:\Building\Permits\MEC_PermitApp_082520.doc 440 4617T(11/02/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$100.00 or fraction thereof. I:\Building\Permits\MEC PermitApp_082520.doc 2 DocuSign Envelope ID: 7AA377A6-4649-400E-BF5F-4FE6AD73FDFF Mechanical Permit Application FOR OFFICE USE ONLY City of Tigard Received g /i r Permit No.: 11111 13125 SW Hall Blvd.,Tigard,OR 9722E1V•�1� `` Date/By: Phone: 503.718.2439 Plan Review Other Permit: Date/By: T I GARD Inspection Line: 503.639.4175 7 �Lo27 Internet: www.ti and or. ov APR 2 Date Ready/By: kris: El See Page 2 for g g Notified/Method: Supplemental Information CITY OF 1 MikK TYPE OF WORK. COMMERCIAL FEE*SCHEDULE-USE CHECKLIST New construction ❑ Addition/alteration/replacement Mechanical permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑ Demolition 0 Other: mechanical materials,equipment, labor,overhead,and profit. CATEGORY OF CONSTRUCTION Value:$ RESIDENTIAL EQUIPMENT/SYSTEMS FEES* DI I-and 2-family dwelling 0 Commercial/industrial ❑ Accessory building For special information use checklist. ❑ Multi-family 0 Master builder ❑ Other: Description Qty. Ea. Total (S'2 k1 JOB SITE INFORMATION AND LOCATION Heating/cooling: Job site address: 45 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 Fumace 100,000+BTU (ducts/vents) 54.91 Suite/bldg./apt.no.: Project name: Knauss Subdivision Lot 5 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.: 5 Other: 23.32 Other fuel appliances: Tax map/parcel no.: WCTM 2S112CD, 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 Loglighter as j dwelling unit. Each unit will be be 2 stories gh (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 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:(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 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: Address:4474 SE Milwaukee Ave- MECHANICAL PERMIT FEES* Subtotal City/State/ZIP:Portland,OR 97202 Minimum permit fee (S90.00) 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 r D„cuS:gudby: �` �tl`4.1� This permit application expires if a permit is not obtained within 180 Authorized signature: days after it has been accepted as complete. Sean 0R4 gc893F7D433.. * Fee methodology set by Tri-County Building Industry Service Board Print name: Date: 03/17/202 2 I:\Building\Permits\MEC_PermitApp_082520.doc 440-4617T(I 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. I:\Building\Permits\MEC_PernvtApp_082520.doc 2 DocuSign Envelope ID:7AA377A6-4649-400E-BF5F-4FE6AD73FDFF Electrical Permit Application RECEIVE FOR OFFICE USE ONLY - Cl ofTigard 'eceived 5 �/y,0 J 1 � z7 3 g DateBy: YY (/LIr � Permit#: 13125 SW Hall Blvd.,Tigard,OR 97223IIIIIII13 ], Plan Review Related Permit#. u V L Z.I Phone: 503.718.2439 Fax: 503.598.1960 Date/By: 24 Inspection Line: 503.639.4175 CITY OF TIGARD Ready Date/By: Juris: I El See Page 2 for T 1 G A R D Internet: www.tigard-or.gov Notified/Method: Supplemental Information BUILDING©IVIS101' PLAN REVIEW TYPE OF WORK ®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): Other: El Service or feeder 400 amps or more Building over three stories. 0 Demolition ❑ where the available fault current Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or Floating buildings. 121 1-and 2-family dwelling ❑ Commercial/industrial ❑ Accessory building less to ground,or exceeds 14,000 Commercial-use agricultural amps for all other installations. buildings. n Multi-family n Master builder n Other: Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION Emergency system. larger separately derived Job#: Job site address: 1.57eITSW 76th Avenue /S Tge Addition of new motor load of system. 100HP or more. ❑"A» "E" "1-2""1-3" City/State/ZIP: Tigard,OR 97224 Six or more residential units. occupancy. Health-care facilities. Recreational vehicle parks. Suite/bldg./apt.#: Project name: Knauss Subdivision Lot 5 Hazardous locations. Supply voltage for more than Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: SW 76th and Durham FEE SCHEDULE Description I Qtr. I Each I Total I New residential single-or multi-family dwelling unit. Subdivision: Knauss Subdivision Lot#: 5 Includes attached garage. Tax map/parcel#: WCTM 2S 112CD,Tax Lot 00400 1,000 sq.ft.or less 1 168.54 168.5 4 Ea.add'1500 sq.ft.or portion 2 33.92 67.84 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 Proposal to construct a primary residential structure and an attached accessory (with above sq.ft.) Limited energy,multi-family 75.00 2 dwelling unit. Each unit will be be 2 stories residential(with above sq.ft.) X PROPERTY OWNER TENANT Renewable Energy I 1 gee Page 2 feeders or feeders installation,alteration,and/or relocation Name: U CBG SW 76th Avenue,LLC U 200 amps or less 1 100.70 100.70 2 Address: 15110 SW Boones Ferry Road,Suite 500 201 amps to 400 amps 133.56 2 401 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 Email: sean@canopypdx.com Temporary services or feeders installation,alteration,and/or 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 2 401 amps to 599 amps 168.54 2 Owner signature: Date: Branch circuits—new,alteration,or extension,per panel X APPLICANT CONTACT PERSON A.Fee for branch circuits with Business namEl 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 service or feeder fee,first Address: 15110 SW Boones Ferry Road,Suite 500 56.18 2 branch circuit City/State/ZIP: Lake Oswego,OR 97035 Each add'1 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: y r' she K Sign or outline lighting 67.84 2 /"'"!` Signal circuit(s)or limited-energy See Page 2 2 Address: panel,alteration,or extension. Each additional inspection over ailDwable in any of the above City/State/ZIP: Additional inspection(1 hr min) LJ 66.25/hr Phone:( ) Fax:( ) Investigation(1 hr min) 90.00/hr Industrial plant(I hr min) 78.18/hr Email: Inspections for which no fee is 90.00/hr CCB Lie.: Electrical Lic.: Suprv.Lic.: specifically listed(I/2hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: nPlan Review Required(25%of permit fee): Print name: Date: State surcharge(12%of permit fee): -DocuSigned by: TOTAL PERMIT FEE: Authorized signature: - tT/Art (K l(;1t 1 This permit application expires if a permit is not obtained within 180 I days after it has been accepted as complete. Print name: Sean O'Neill-356D6C8B3F7D433 Date: 02/11/2022 * Number of inspections allowed per permit. 1:\Building\Penmits\ELC PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(1l/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: 5 kva or less 100.70 2 Check Type of Work Involved: 5.01 to 15 kva 133.56 2 ri 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 >100 kva—no additional charge 0.0 3 • Vacuum Systems* Each additional inspection over allowable in any of the above: Each additional inspection is 66.25/hr 1 ❑ Other: charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed('/hr min) ELECTRICAL PERMIT FEES COMMERCIAL WORK ONLY: Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 + Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: Audio and Stereo Systems Boiler Controls Clock Systems Data Telecommunication Installation Fire Alarm Installation HVAC Instrumentation Intercom and Paging Systems Landscape Irrigation Control* Medical Nurse Calls Outdoor Landscape Lighting* Protective Signaling Other: Total numE of commercial systems: *No licenses grequired. Licenses are required for all other installations I:\Building\Permits\EL�Pe�itApp_ELR_ERE.doc Rev 06/17/2015 t DocuSign Envelope ID:6581141E-ABB8-4824-9AFD-F05062DFDF01 Electrical Permit Application 11 N ECEIV ) FOR OFFICE USE ONI.1 City of Tigard # Received Date/By: Permit#: II U 13125 SW Hall Blvd.,Tigard,OR 97223 APR 2 7 2022 Plan Review 3 Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Related Permit#: T I GAR D Inspection Line: 503.639.4175 s��/0 �IGPd-L� Ready Date/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov 1� Notified/Method: Supplemental Information t n EI3 D1`II{;;.f TYPE OF WOIFtj_.t F.i �.I PLAN REVIEW ® New construction ❑ Addition/alteration/replacement Please check all that apply(submit 2 sets of plans is items checked): O Service or feeder 400 amps or more IDBuilding 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. ® I-and 2-family dw el ling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 El commercial-use agricultural amps for all other installations. buildings. ❑ Multi-f ly ❑Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or fir ! 1`3 JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: Job site address:.1.5-7462.SW 76th Avenue 100HP or more. ❑"A", `E","1-z", 1-3", ❑Six or more residential units. occupancy. City/State/ZIP: Tigard,OR 97224 ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: Knauss Subdivision Lot 5 ❑Hazardous locations. 0 Supply voltage for more than ❑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 i New residential single-or multi-family dwelling unit. Subdivision: Knauss Subdivision Lot#: 5 Includes attached garage. 1,000 sq.ft.or less 1 168.54 168.54 4 Tax map/parcel#: WCTM 2S l l 2CD.Tax Lot 00400 Ea.add'1500 sq.ft.or portion 1 33.92 67.84 1 DESCRIPTION OF WORK Limited energy,residential Proposal to construct a primary residential structure and an attached accessory (with above sq.ft.) 75.00 2 Limited energy,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 ►1 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 500 401 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 Email: sewn@canopypdx.com Temporary services or feeders installation,alteration,and/or 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 Address: 15110 SW Boones Ferry Road,Suite 500 service or feeder fee,first 56.18 2 branch circuit City/State/ZIP: Lake Oswego,OR 97035 Each add'l 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 v 2 Business name:Jarmer Electric Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address:5105 SW 45'h Avenue# 100 panel,alteration,or extension. ❑ See Page 2 2 Each additional inspection over allowable in any of the above City/State/ZIP:Portland OR 97221 Additional inspection(1 hr min) 66.25/hr Phone:(503 )246-5381 Fax:( ) Investigation(1 hr min) 90.00/hr Industrial plant(1 hr min) 78.18/hr Email:tim@jarmer.com Inspections for which no fee is 90 00/hr CCB Lie.:6924 Electric oit 14 f Suprv.Lie.:6365S specifically listed(':i hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required_ fli 31"ur Subtotal: �472C61799C294A6... 3/17/2022 Plan Review Required(25%of permit fee): Print name:Tim Jarmer Date: Cl Deet.Signed b,. State surcharge(12%of permit fee): /p t TOTAL PERMIT FEE: Authorized signature:[ t4UA. lT r,IU, 356D6C883F70433.. This permit application expires if a permit is not obtained within 180 Print name: Sean O'Neill Date: 03/17/2022 days after it has been accepted as complete. " Number of inspections allowed per permit. 1:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Res 06/17/21115 440-4615T(11/05/COM/WEB DocuSign Envelope ID:65B1141E-ABB8-4824-9AFD-F05062DFDF01 • 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: 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: n B• urglar 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) n H• eating, 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 I charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(''/z hr min) ELECTRICAL PERMIT FEES COMMERCIAL WORK ONLY: Subtotal(Ginter on Page I): Fee for each commercial system: $75.00 Number or inspections aur,wea per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC n Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 DocuSign Envelope ID:7AA377A6-4649-400E-BF5F-4FE6AD73FDFF Plumbing Permit Application Site Utilities FOR OFFICE USE ONLY Received City of Tigard RECELVE Dee/By:7�� 2 .j Z Permit No.:M$f Zo j4'Z-(, , -7j 13125 SW Hall Blvd.,Tigard,OR 97223 /� : ! Plan Review �+� -�p Phone: 503.718.2439 Fax: 503.598.1960 I '- 1 ' '" Date/By: Other Permit No.: 2 47-owM Inspection Line:503.639.4175 CITY GA Date ReadyBy: ions: H See Page 2 for T 1 C;A R D Internet: www.tigard-or.gov tid�1 I OF�y��`r"'"'� Notified/Method: I Supplemental Information TYPE OF WORKcUILQING DIUISIOI` FEE* SCHEDULE 50 New construction 0 Demolition For special information use checklist. Description I Qty. I Ea. I Total ❑ Addition/alteration/replacement 0 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 I:: Commercial/industrial SFR(2)bath 437.78 ❑ Accessory building 0 Multi-family SFR(3)bath 1 500.32 500.32 DCA ackl:t:orral LatlJkiti..h,,a 25.02 ❑ Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 1S$9YSW 76th Avenue f j- Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: Tigard,OR 97224 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03 Cross street/directions to job site: 76th/Durham Manholes 18.76 Rain drain connector 1 18.76 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: Knauss Subdivision Lot no.: 5 Fixture or item: Tax map/parcel no.: WCTM 2S 112CD,Tax Lot 00400 Backflow preventer 1 31.27 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Proposal to construct a primary residential structure and an attached accessory Dishwasher 25.02 dwelling unit. Each unit will be be 2 stories Drinking fountain 25.02 Ejectors/sump 25.02 rlC PROPERTY OWNER ❑ TENANT Expansion tank 12.51 Name: CBG SW 76th Avenue,LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 15110 SW Boones Ferry Road,Suite 500 Garbage disposal 1 25.02 25.02 City/State/ZIP: Lake Oswego,OR 97035 Hose bib 1 25.02 25.02 Phone:( 503)9569307 Fax:( ) Ice maker 1 12.51 12.51 1-4 APPLICANT n CONTACT PERSON Interceptor/grease trap 25.02 Business name: CBG SW 76th Avenue,LLC Medical gas(value:$ ) 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: •-. 7 •e- ,.T Water piping/DWV 56.29 Address: 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) -Docusignea by: State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Sc,aln, ot'tat This permit application expires if a permit is not obtained within 180 days Print name: Sean Otte6D6C8B3F7D433 Date: 02/11/2022 after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. t:\Building\Penaits\PLMU-PermilApp.doc 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: 50.03 0 to 2,000 $121.90 Footing drain-I'100' 1 50.03 2,001 to 3,600 $169.69 Footing drain-each additional 100' 1 37.52 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 Valuation: Permit Fee: Storm&Rain Drain-1st 100' 1 62.54 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 - $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Qty. Fee(ea) Total each additional$100.00 or fraction thereof;to Other Inspections or Fees 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) d f Plan review is required any Performed: Capped Added Relocate q of the following. Baptistry/Font Please check all that apply. Bath -Tub/Shower Li 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 Medical gas and vacuum systems for health care facilities. -Domestic Drinking Fountain Any multipurpose fire sprinkler system. Eye Wash Any complex structure as defined in OAR918-780-0040. Floor Drain/sink -2" 3.. Submit 2 sets of plans with any of the above. -4" Car Wash Drain Isometric or Riser Diagram Garbage -Domestic-non-food U Isometric or riser diagram is required for new buildings Disposal -Domestic-food related -Commercial-food related that meet the qualifications above. -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Rec.Vehicle Dump Station Comments regarding fixture work: 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 Urinal fees assessed for the sewer increase must be paid before the Other Fixtures: plumbing permit can be issued. I:\Building\Permits\PLMU_PermitApp.doc 2 Docuslgn tnvelope IL): /AA:i//Ab-4b49-4UUr-ttr5r-41-tbAut:ll-UH- Plprnliing Permit Application Site Utilities &•°' ` a FOR OFFICE USE ONLY City of Tigard APR 2 7 IOU Received Permit No.: { w 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: II Phone: 503.718.2439 Fax: 503.598.19 OF 1161\8V Plan Review �jI I 1 Date/By: Other Permit No.: Inspection Line:503.639.4175 \ Snr II6AR13 t l?! ' R�1 �4��` Date Ready/By: Juris: 0 SeePage2for Internet: www.tigard-or.gov Notifed/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE l3J New construction ❑ Demolition For special information use checklist. Description I Qty. I Ea. I Total ❑ Addition/alteration/replacement ❑ Other: New 1-2-family dwellings(includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 l3 1-and 2-family dwelling ❑ Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 1 500.32 500.32 0 Accessory building 0 Multi-family Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler( sq.ft.) Page 2 II6-2p 1 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: .4Sy4 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.: 5 Fixture or item: Tax map/parcel no.: WCTM 2S112CD,Tax Lot 00400 Backflow preventer 1 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 ('#(PROPERTY OWNER f 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 pi APPLICAN I n 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 I 37.52 37.52 Business name:Alliance Plumbing Water piping/DWV 56.29 Address: 146 W Historic Columbia River Hwy. other: 25.02 City/State/ZIP:Troutdale,OR 97060 Subtotal Phone:((503)492-3490) Fax:( ) Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lic.: 184601 Plumbing Lic.no.: eo,.usiyned by. State surcharge(12%of permit fee) Authorized signature: .`M �r k`;'I /wlU. TOTAL PERMIT FEE Print name: Sean fg8F8B3F7D433_ I Date: 03/17/2022 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. l:\Building\Permits\PLMU-PermitApp.doc 10/01/09 44046I6T(10/02/COM/WEB) Docuslgn tnvelope IU: (AM!tAti-4b49-40Uf--lit-bF-4rttiAD/31-U1-h 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-1"100- 1 50.03 50.03 0 to 2,000 S121.90 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 Valuation: Permit Fee: Storm&Rain Drain-1st 100' 1 62.54 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to I� 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. Baptistiy'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 ❑ Medical gas and vacuum systems for health care facilities. -Domestic ❑ 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: I:\Building\Permits\PLMU_PermitApp.doc 2 {f I j City of Tigard 1 11 COMMUNITY DEVELOPMENT DEPARTMENT e T1GARD Building Permit Review — Residential e. ".,k,cu,.:?r'or>`7+''t'tt rr,, Irn,.. .s3.,..' -„ .. 3!,. .-f.,R 't&. „ - T I3titiitTt't'.tf a,. . ,t .. ,„. _ Building Permit #: MST Z 07;1%0006 Site Address: /r-/-$$ AVf Project Name: )GcA L-$ ; r-177.4-m-S Lot #: S Planning Review R'6t/I�bSCrE PI- 1.1 Pro sal: jiEI J 4TTA cif6T, ADO Verify address/suite#active in Accela. p In River Terrace: 12 No ❑ Yes,River Terrace Review Addendum Site Plan Elements: 2/Erosion Control '3 copies of site plan on 8-1/2"x 11" or 11 x 17"paper [ 'Retained trees with drip line and tree protection measures {, PD wn to scale(standard architect or engineer scale) ootprint of new structure(including decks)and FFh North arrow 25.Jtility locations&easements(required for new and additions) 1 2/ to address,project or subdivision name and lot number JSidewalk/driveway approach /Applicant information(name and phone number) 1" 11 cation of wells/septic systems j Zill Lot dimensions and building setback dimensions LJS eet tree size,type and location tk Square footage of buildings to be demolished eet names r � xisting structures on site Corner elevations (2'contours if more than 4'differential) Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? es ❑N im ervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes 2/No Clean Water Services —Service Provider Letter of platted prior to 9/10/1995): wired: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No Water Meter F' ture Unit Worksheet—Additions,Remodels and ADUs 4quired: 0 Yes,applicant was notified CI No CI❑ Yes No ld S C Exemption for ADU applied for: ❑ Yes LXNo Received: ❑ Yes ❑ No V.Public Facilities Improvement (PFI)Permit: equired: ❑ Yes,applicant was notified No Applied For: ❑ Yes ❑ No,stop intake Land Use Case#: AGE To22'67)00 S l Zoning: Z— '3- uired Setbacks: Front: I r 1 Rear: 7 - r' Side: s' Street Side: I S / Garage: 2° 1 ding Height: Max. Height: 35' Actual Height: L.. .S' Landscape Area: 2iO % ❑ Lot Coverage May $'O % Entrance back no more than 8'from street-facing wall �I Parallel to street or offset 45 degrees or less 1 Windows {Minimum 12%of area of all street-facing facades Garage Ga_raggee door is behind widest street-facing wall ❑ Yes 2'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 w and there is a 12 sq ft.window above garage on 2nd floor. Garage door width is ❑ 12'or less 50%or less of facade CI 60%or less and includes 7 of following: ❑ Covered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof cave ❑ Roof offset ❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer �/ ❑ Accent siding ❑ Window trim ❑ Window recess CI Window projection ❑ Balcony (Z isual Clearance Urban Forestry Plan L 3 Sensitive Lands: CI Yes ONo Type: ❑ Conditions met prior to issuance of building ermit Notes: Approved By Planning: Date: Revisions (after Building Submittal only) Reviewe Date Revision 1: ? Approved ❑ Not Approved 4 S/( /ZO�i2 Revision 2: ❑ Approved ❑ Not Approved ` I:\Building\Fonns\BldgPernutRvw RES_122419.docx Building Permit Submittal Original Submittal Date: 2/( ZQi/Z/ Site Plans: Building Plans: # • Building Permit#: 10 Enter building permit#above. Workflow Routing: ri Planning g) Engineering p Permit Coordinator , Building Workflow Sign-off: AP Sign-off for Planning(include notes from planning review) Route Application Documents: jl, Engineering: (1) copy of permit application, (1) site plan, (1) building plan and • l.'"' 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: )1Q‘litil Date: 7-(7„.st)(2027 Engineering Review El Slope at building pad: S% Z onditions "Met"prior to issuance of building permit Easements (encroachments)per engineering conditions of approval and plat Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes Ni/No Assess Water Quantity Fee in-lieu: CI Yes [ 4 o _/ LIDA Facility on lot: [Yes ❑ No Add Fee: ❑ Yes [ ' No d Final Plat Recorded: ["NOT Approved by Engineering: -fW,.,.a- , ,7-2 k-p-y Date: 3/214. Notes: l°/e4Se 3lisar Ve7 e7 t 4o/ 41ltu• J7') ", S%1 e pkh . x c4id e size, f°G, lys) IhR71, r A/, $hvs✓ *Raid/rr /44t/ S',%r•:A iy /tAt... / 3i1s Approved by Engineering: Date: Revisions (after Building Submittal only) Reviewer Date Revision 1: ErApproved ❑ Not Approved -✓.ttn i- ekfti{e,, s 3/102.01 . Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review Conditions "Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: 31 i°(?,o22 Revision Notice 2: Date Sent to Applicant: SDC Exemption: ❑ Received id. Does not apply p U- - TS1 c idSDC Fees Entered: Wash Co Trans Dev Tax: /Yes ❑ N/A PGA P L DYE Tigard Trans SDC: Yes ❑ N/A _ 4 • Parks SDC: N Yes ❑ N/A LIDA ❑ Yes J2c N/ I 'OK to Issue Permit Approved by Permit Coordinator: Date: -)J((1 (7,41ii, I:\Building\Fomis1BldgPernvtRvw_RES_1208021.docx DocuSign Envelope ID:1AFD6294-7700-4352-B318-E6E0707F151C City of Tigard III ," Deferral Until Occupancy Request TIGARD 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: 3/10/2022 Site Address: 15790 SW 76th Ave (SFR) Project Knauss Lot 5 Land Use Case or MST2022-00052 Name: Building Permit#: Tax Lot Total Parks #_ 2S112CD17900 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$1,752-00 for Parks-Neighborhood or$ 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 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 [DT 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: Sc,aun, t �1�4ALL Property Owner: —358D8c8B3F7D433... Date: 3/10/202 2 DocuSigned by: Cam, 1-tU,' 3/10/2022 Developer: Date: OOoww,133r I U443... Permit Coordinator: AJT1.M OetivLetrbDate: 3/10/2022 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 1111 II N Water Meter Fixture Unit Worksheet G'r'►zl' 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 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: 15788 SW 76th Avenue/15790 SW 76th Avenue Subdivision Name: Knauss Subdivision Lot#: 5 Building Permit#: Please fill in the number of each fixture as detailed on the plans. Multiply the quantity by the point value to arrive at the point total. Add all point totals together for total fixture unit points. Fixture Unit Quantity Point Value Point Total Bar sink 1 x 1 = 1 Bidet x 1 = Clothes washer 2 x 4 = 8 Dishwasher 2 x 1.5 = 3 Hose bib, lst 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: 1to30= 5/8" 37.5to89 = 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 E No n Other: Meter#: Sale Date: Receipt#: Meter Cost: Employee Name: l:/Building/Forms/WaterMeters_070121 New.dOCX Page 2 FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. 11111 City of Tigard 0 COMMUNITY DEVELOPMENT DEPARTMENT Transmittal Letter i i t J A it t) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Agnes Lindor/Tina Escelera DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: Sean O'Neill MAR 14 2022 COMPANY: CBG SW 76th Avenue, LLC CITY OF TIGARD PHONE: 503 956 9307 lUILDING DIVISIOI`iy: 15._ EMAIL: sean@scotiawsh.com RE: 15788 SW 76th Avenue MST2022-00053 (Site Address) (Permit Number) Knauss Subdivision Lot 5 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: PDF Additional set(s) of plans. Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other (explain): REMARKS: PDF of Site Plan for Lot 5 of Knauss Subdivision was submitted electronically. FOROFFICE USE ONLY Routed to Permit Techmca i Date: 3 2/ i71--- Initials: Fees Due: El Yes [ o Fee Des ripti n: Amount Due: 1.,__) (- N-) $ $ .5 (- Special Instructions: Reprint Permit(per PE): ❑ Yes No ❑ Done Applicant Notified: Date: Initials: