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Permit
CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2022-00052 T[c;;1 j:n 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/10/2022 Parcel: 2S112CD17900 Jurisdiction: Tigard Site address: 15790 SW 76TH AVE Subdivision: DURHAM ACRES Lot: 9&PT 8 Project: Knauss Estates, Lot 5, Primary Project Description: New dwelling with (1)attached ADU. NO FINAL UNTIL DEFERRED SDC FEES ARE PAID. I 1 BUILDING Floor Areas Required Setbacks Required 1 Stories: 2 Bedrooms: 3 First: 649 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 25.5 Bathrooms: 3 Second: 1083 sf Garage: 402 sf Front: 15 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Total: 1732 sf Value: $246,779.12 Rear: 7.5 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: 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'500 sf: 3 201-400 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 1732 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: $15,510.79 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR oc9_f nl_nnlrl thrn,inh R QF9_f ni_nnon Vn,i may fain a nnmi of the nilcc nr dimwit nncctinnc to(ii WR by nallinn Sn1 919 10R7 n nn ZZ9 9144 Issued By: -1 ' 4A� "l,t � Permittee Signature: --" /�-'---- Call 503.639.4175 by 7:00 a.m.for the next available Inspection date. This permit card shall be kept in a conspicuous place on the job site until comple' n of the project. Approved plans are required on the job site at the time of each inspection. _ ernuiAe« :i .nv.vv. .vAr„»v uuu.AAa1 FAFaAva,ay. loa+�W evr .,.aara.... tA....,,.. DocuF?yn Envelope ID:B5D7256C-3AF5-48AC-A2A5-EEF4CD7E4F50 Building;Permit Application —Z I}`vZ Residential RECEIVE I FOR OFFICE USE ONLY City of Tigard rev L 13125 S W Ball Blvd.,Tigard OR 97223 FED 17 202.7 S 4 ra l Yv P0t9°ss�10:/ 5/70 L?•QQ0 s2 Plan Review • Q ~ Li ti j' j Q Other Permit:)VVr. ZZ'AtV Phone: 503.718.2439 Fax: 503.598.1960 DateB . ,`r, Y ' D Inspection Line:503.639.4175 O g i Of TI iARD Date Ready/By: +�+ B See Page 2 for T 1 Internet: Line gaad-or,$ov ammo ammo N ed/Method: u_ Supplements]Information TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING ©New construction ❑Demolition Permit fees•are based on the value of the work performed. IIIndicate the value(rounded to the nearest dollar)of all 0 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. (Z ���I1/9 Ell-and 2-family dwelling ElCommerciaUinduslrial Valuation: $ '., . ElAccessory building El Multi-familyNumber of bedrooms:3 ❑Master builder 0 Other: Number of bathrooms275-%3 JOB SITE INFORMATION AND LOCATION Total number of floors:2 3 Job site address: 15790 SW 76th Avenue; New dwelling area:1732 square feet 1 0 City/State/ZIP: Tigard,OR Garage/carport area:402 square feet Suite/bldg./apt.no.: Project name:Knauss Estates Lot 5 Covered porch area: square feet i Cro s street/directions to job site: East side of the block north of SW 76th Avenue and SW Boat Deck area: square feet 6% it w iY_..I , ) rS 144/44.7" �4(V /1&7 #6 Other structure area: square feet I ,Yi'kf i3/W 1. ®,"L f/°L°w•* jJ-t .it REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Knauss Estates h ' Lot no.: 5 Permit fees are based on the value of the work performed. I Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: WCTM 2S112CD,Tax Lot 00400 equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK ei ,/: work indicated on this application. Proposal to construct a primary residential structure and an attached accessory welling Valuation: $ unit. Each umtis 2 stories in height and will have a single car garage. Existing building area: square feet New building area: square feet �^ —GI PROPERTY OWNER 0 TENANT Number of stories: , Name: CBG SW 76th Avenue,LLC Type of construction: Address: 15110 SW Boones F Occupancy groups: Ferry Road,Suite 500 Occu an City/State/ZIP: Lake Oswego,OR 97035 Existing: Phone:(503 ) 956-9307 Fax:( ) New: ®APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* (Mow rerstofee Wasiak) Business name: CBG SW 76th Avenue,LLC Structural plan review fee(or deposit): Contact name: c.a� 7 N t .:u M. Contact FLS plan review fee(if applicable): 15110 SW Boones Ferry Road,Suite 500 —� - City/State/ZIP: Lake Oswego,OR 97035 To ees ue upon application: Amount received: Phone:(503 ) 956-9307 Fax::( PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-maiL' sean@canopypdx.com Commercial and residential prescriptive installation of CONTRACTOR 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 Specialn Code checklist. City/State/ZIP: Lake Oswego,OR 97035 Permit Fee(includes plan review $180.00 _.....__. and administrative fees): Phone:(503 ) 956-9307 Fax:( ) State surcharge(12%of permit fee): , $21.60 CCB lie.: CCBti232358 ta�yn.ary_ Total fee due upon application: $201.60 Audtottized slgnatu[e: L�U/l. iwit This permit application expires if a permit is not obtained Jwithin 180 days after it has been accepted as complete. Print name: Sean O'Neill 356D6C8B3F7D433-.. I 1 *Fee methodology set by Tri-County Building Industry Date: 02/11/2022 Service Board. I:\Building\Permits\BUP-RESPennitApp.doc 02/24/2011 440.4613T(11/02/COM/WEB) DocuSign Envelope ID:7AA377A6-4649-400E-BF5F-4FE6AD73FDDFF Mr,,,tapical Permit Applicatt a 1I D / /I� FOR OFFICE USE ONLYp �`�City of Tigard tr DateBy:' 1 2j [4 e I- PerrmtNo.: 1"511W(ijij- 5/, 13125 SW Hall Blvd.,Tigard,OR 97223 I I Plan Review W ph ,`,VI II �g Phone: 503.718.2439 �j 7 2>y7 Other Permit: J FED J, ��L4 DatcBy: Inspection Line: 503.639.4175 art Date ReReady/By: Juris: I Ef See Page 2 for TI G A R D Internet: www.tigard-or.gov OF TIGARD Notified/Method: Supplemental Information RUTS DING fllV!SION TYPE OF WORK COMMERCIAL FEE*SCHEDULE-USE CHECKLIST Mechanical permit fccs*arc based on the value of the work a New construction ❑ Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑ Demolition ❑ Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ® I-and 2-family dwelling ❑ 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: 15790 SW 76th Avenue Furnace 100,000 BTU(duets/vents) 1 46.75 46.75 City/State/ZIP: Tigard,OR 97224 Furnace 100,000+BTU(duets/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 WO' ' p,,,�r Gas fireplace/insert 1 33.39 33.39 Flue vent for water heater or gas Proposal to construct a primary residential structure and a .t.: -d 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 namizEl CBG SW 76th Avenue,LLC D $14.15 for first four;$4.03 for each additional Contact name: Sean O'Neill Furnace,etc. i( Address: 15110 SW Booties Ferry Road,Suite 500 Gas heat pump Wall/suspended/unit heater City/State/ZIP: Lake Oswego,OR 97035 Water heater Phone:(503 ) 9569307 Fireplace Fax: :( ) 1 Range E-mail: sean@canopypdx.com Barbecue CONTRACTOR Clothes dryer(gas) Other: Business name: ii 7 ,ef MECHANICAL PERMIT FEES* Address: l /" Subtotal Minimum permit fee($90.00) City/State/ZIP: Plan review(25%of permit fee) Phone:( ) Fax:( ) State surcharge(12%of permit fee) CCB lie.: TOTAL PERMIT FEE ,-mocuSigned by: �` . This permit application expires if a permit is not obtained within 180 /(� �` (l-t lK,1� Authorized signature: days after it has been accepted as complete. �.,� 56D6C853F70a33 * Fee methodology set by Tri-County Building Industry Service Board Print name: Sean O'Neii Date: 02/11/2022 I:\Building\Permits\MEC PemutApp_082520.doc 4404617T(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 $100.00 or fraction thereof. I:\Building\Permits\MEC_PermitApp_082520.doc 2 DocuSign Envelope ID: 7AA377A6-4649-400E-BF5F-4FE6AD73FDFF Mechanical Permit Applic j EIVEr ht)il OFhl( I I SE ONLY City of Tigard Received 71 Date/By: Permit No.: . 41 13125 SW Hall Blvd.,Tigard,OR 97223 APR 2 2022 Plan Review Phone: 503.718.2439 Other Permit: Line: 503.639.4175 Date/By: T I G A R D Inspection �,ITY OF T iGA�st� Date Ready/By: Juris: 0 See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information BUILDING DIVISIOI, TYPE OF WORK COMMERCIAL FEE*SCHEDULE-USE CHECKLIST New construction ❑ Addition'alterationlrchlacement Mechanical permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑ Demolition ❑ Other: mechanical materials,equipment, labor,overhead,and profit. CATEGORY OF CONSTRUCTION Value:$ RESIDENTIAL EQUIPMENT I SYSTEMS FEES* DI 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building ❑ Multi-family 0 Master builder ❑ Other: For special information use checklist. Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Job site address: 15790 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 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 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 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 toilet compartments,utility rooms) 23.32 Phone:(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%ofpermit fee) State surcharge (12%of permit fee) CCB lie.: 1441 TOTAL PERMIT FEE r D.,c.f'iyr,...1 Ly.--- t�rl`i :I/ This permit application expires if a permit is not obtained within 180 Authorized signature: days after it has been accepted as complete. Sean 049cd83F7Da33._ • Fee methodology set by Tri-County Building Industry Service Board Print name: Date:03/17/2022 I:\Building\Permits\MEC_PennitApp_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\Pennits\MEC_PermitApp_082520.doc 2 DocuSign Envelope ID:7AA377A6-4649-400E-BF5F-4FE6AD73FDFF Electrical Permit Application i•OR OFFICE USE ONLY City of Tigard flECE(VE •ate/Bey SR/ Z 10L2 Permit#: f T y7A -000 G5�, 111111 4 13125 SW Hall Blvd.,Tigard,OR 97223 p� Plan Review Phone: 503.718.2439 Fax: 503.598.1960 �L3 ,1 ¢ Date/By: I Related Permit#:St3d 120Lti-1 7 Ready Date/By:Ins Inspection Line: 503.639.4175 7uris: p CITY OF TIGARD Notified/Method: Supplementals Information Page 2 for T I G A R D Internet: www.tigard-or.gov r TIGARD i� TYPE OF WORidU!LOING motor- PLAN REVIEW ®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): 0 Demolition Other: ❑Service or feeder 400 amps or more Building over three stories. where the available fault current Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or Floating buildings. D 1-and 2-family dwelling Ej Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 Commercial-use agricultural Multi-familyMaster builder Other: amps for all other installations. buildings. n n n Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION Emergency system. larger separately derived Addition of new motor load of system. Job#: Job site address: 15790 SW 76th Avenue I00HP or more. 0"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 Qty, I Each I Total I * Subdivision: Knauss Subdivision New residential single-or multi-family dwelling unit. 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'l 500 sq.ft.or portion 2 33.92 67.84 l DESCRIPTION OF WORK Alfrfia6.---- Limited energy,residential 75.00 2 Proposal to construct a primary residential structure a n attached acce (with above sq.ft.) dwelling unit. Each unit will be be 2 stories Limited energy,multifamily residential with above sq.ft.) 75.00 2 X PROPERTY OWNER TENANT Renewable Lnergy II See Page 2 Services 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 Owner signature: Date: 401 amps to 599 amps 168.54 2 X APPLICANT CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business namD 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 branch circuit 56.18 2 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 dwelling,service and/or feeder 67.84 2 Email: sean@canopypdx.com Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 1 67.84 67.84 2 Business name: 5 u sz �7'-�1 Sign or outline lighting 67.84 2 _ a�'C Signal circuit(s)or limited-energy See Page 2 2 Address: panel,alteration,or extension. g Each additional inspection over twable in any of the above City/State/ZIP: tJ 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(VZ hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: r'1 Plan Review Required(25%ofpermit fee): Print name: Date: State surcharge(12%ofpermit fee): r Docusigned by: TOTAL PERMIT FEE: Authorized signature: J t_t��(,t i •(( This permit application expires rra permit is not obtained within IN(t( days after it has been accepted as complete. Print name: Sean O'Ne 356D6C8133F7D433 Date: 02/11/2022 * Number of inspections allowed per permit. I:\Building\Permits\ELC PennitApp ELR_ERE.doc Rev 06/17/2015 440-4615T(I1/05/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: Description FEE SCHEDULE Each l Total 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 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: (1 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) E 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 Other: charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed('h 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 nun31 of commercial systems: *No licenses firequired. Licenses are required for all other installationsl l:\Bu lding\Permits\ELtJ Pe io witApp_ELR_ERE.doc Rev 06/17/2015 DocuSign Envelope ID:6581141E-ABB8-4824-9AFD-F05062DFDF01 Electrical Permit Application � � FoR OFFICE 1 SE ON1.1 t Received City of Tigard Date/By: Permit#: • 13125 SW Hall Blvd.,Tigard,OR 97223 �y Plan Review •Phone: 503.718.2439 Fax: 503.598.1960 APR 2 10 1027 Date/By: Related Permit#: Inspection Line: 503.639.4175 L Ready Date/By: Juris: la See Page 2 for I IGALD Internet: www.tigard-or.gov ` OF ��� Notified/Method: Supplemental information TYPE OF W [{DING tPils)'<' ' PLAN REVIEW ®New 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 0 Other: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings. ® I-and 2-family dwelling ❑ Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural ngs. ❑ Multi-family ❑Master builder ❑Other: 0 FireF for all other installations. Inbustallation pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived Job#: Job site address: 15790 SW 76th Avenue ❑Add 100HP HP o of new or moremotor load of system. . ❑"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 5 0 Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: 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. Tax map/parcel#: WCTM 2S 112CD,Tax Lot 00400 1,000 sq.ft.or less 1 168.54 168.5 4 Ea.add'I 500 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 he he 2 stories residential(with above sq.ft.) Renewable Energy I I See Page 2 ®PROPERTY OWNER ❑ 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 [f APPLICANT ❑ 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'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:Jarmer Electric Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address:5105 SW 45th 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 CCB Lie.:6924 Electrical Lid 2'i 144C Suprv.Lie.:63655 specifically listed(%hr min) 90.00/hr r— cu tgned by:, ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: I6 Jt""'r'u Subtotal: Print name:Tim Jarmer `-472C61799C294A6... Date:3/17/2022 n Plan Review Required(25%of permit fee): o...uslyned b,. State surcharge(12%of permit fee): �p Authorized signature: S TOTAL PERMIT FEE: LAI.A. tTa , , 356D6C6B3F7D433 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. I:\Building\Permits\ELC_PermitApp_ELR ERE-doe Rev 06/17/2015 440-4615T(I1/05/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 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 ❑ Audio 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('/,hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 Subtotal(EnterPage I�: y * 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 n Fire Alarm Installation f HVAC ❑ 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 PP,mbing Permit Applicatio EfVE Site Utilities ,f FOR OFFICE USE ONLY City of Tigard FED 1 1" ON RDateByy:7Y V 7t/j/1 �L2 G Permit No.: a '�7,.VO 5-2/ • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review / 666 v _ Phone: 503.718.2439 Fax: 503.598.19 OF TIGAR[) Date/By: Other Permit No.:5,A,um 7J\ T 1 G A K D Inspection Line:503.639.4175 Date ReadyBy: Ions: a See Page 2 for Internet: www.tigard-or.gov BUILDING OIVISIOP Notified/Method: I Supplemental Information TYPE OF WORK FEE* SCHEDULE ®New construction ❑ Demolition For special information use checklist. Description I Qty. I Ea. I Total 0 Addition/alteration/replacement ❑ Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(I)bath 312.70 ® I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑ Accessory building 0 Multi-family SFR(3)bath I 500.32 500.32 La..h a id:,:o..al l,atilk:tkl.c.. 25.02 ❑ Master builder ❑ Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 15790 SW 76th Avenue 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 WOR /�' ! Backwater valve 12.51 / Clothes washer 25.02 Proposal to construct a primary residential structure�id an attached acce s Dishwasher 25.02 dwelling unit. Each unit will be be 2 stories Drinking fountain 25.02 Ejectors/sump 25.02 FC 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 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 Water closet 25.02 CONTRACTOR Water heater I 37.52 37.52 Business name: 7 iC1=fir c7emi, Waterpiping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal Phone:( ) Fax:( ) Minimum permit fee: $72.50 CCB Lie.: Plumbing Lic.no.: Plan review (25%of permit fee) (---DocuSigned by: State surcharge(12%ofpermit fee) Authorized signature: r TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days Print name: Sean errdeifl6D6C883F7D433 Date: 02/11/2022 after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Pemtiis\PLMU-PermitApp.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: o to 2,000 $121.90 Footing drain-1"100' 1 50.03 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 $I.00 to$5,000.00 Minimum fcc$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 futures?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/ Plan review is required for anyof the following. Performed: Capped Added Relocateq g. Baptistry/Font Aease check all that apply. Bath -Tub/Shower LJ 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 El 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 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 that meet the qualifications above. -Commercial-food related -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Rec.Vehicle Dump Station Comments regarding fixture work: Shower -Gang -Stall SinkiLav -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 ClosetWater -Toilet Urinalfees assessed for the sewer increase must be paid before the Urinal Other Fixtures: plumbing permit can be issued. L:\Building\Permits\PLMU_PermitApp.doc 2 UocuSign tnvelope IU: /AA;3/IA6-4649-4UUI--13I-b1--41-tbAUNI-UF1- Plumbing Permit ApplicationRECEIV , Site Utilities FOR OFFICE USE ONLY City of Tigard PR 2 A'7012 Received g Date/By: Permit No.. , a • 13125 SW Hall Blvd.,Tigard,OR 97223 OF 1-t(H�i� iryPlan Review illi Phone: 503.718.2439 Fax: 503.598.196o-01 Other Permit No.: Inspection Line:503.639.4175 r� ^ `! nb Date/By: T I C;A R D p j��,�-4J�N`�I D�V� �`' Date Ready/By: Juris El See Page 2 for Internet: www.tigard-or.gov Notified'Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE 0 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 ® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑ Accessory 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: Job site address: Catch basin or area drain 18.76 15790 S W 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.: 5 Fixture or item: Tax map/parcel no.: WCTM 2S112CD,Tax Lot 00400 Backflow preventer 1 31.27 31.27 I 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 I-?(PROPERTY OWNER n 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 City/State/ZIP: Lake Oswego,OR 97035 Garbage disposal 1 25.02 25.02 Hose bib 1 25.02 25.02 Phone:( 503 )9569307 Fax:( 1 Ice maker 1 12.51 12.51 pi APPLICANT (i 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: seanl canopypdx.com Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 1 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:( ) Ai, Lj Minimum permit fee: $72.50 CCB Lic.: 184601 Plumbing Lic.no.: Plan review (25%of permit fee) r-11..uSigneJ by. State surcharge(12%of permit fee) Authorized signature: �tA kill, TOTAL PERMIT FEE Print name: Sean b"-Nisrief8B3F7D433_ I Date: 03/17/2022 1 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 10/01/09 440-4616T(10/02/COM/WEB) UocuSign tnvelope IL): /AA3//Ali-4b49-4UUh-tirbr-41-tbAU/JI-o or , 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 additiona1100' 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.S 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 p 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 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: I:\Building\Permits\PLMU_PermitApp.doc 2 City of Tigard 71 itCOMMUNITY DEVELOPMENT DEPARTMENT : C T I G RD Building Permit Review — Residential ...�.. . .yam Building Permit #: 5 1 -Z--Zi-00051, Site Address: !S 1 '9O j r 9-Ci"^ Ave Project Name: 1OS csTr►(L Lot #: S. Planning Review paif.1 - I7 i/KEDs1re KAN Proyosal: NM) i Ckk-+rP DwRu._l1U10 rrr Verify address/suite #active in Accela. ` In River Terrace: Ik'No ❑ Yes,River Terrace Review Addendum Site Plan Elements: It rosion Control VI copies of site plan on 8-1/2"x 11" or 11 x 17"paper Letained trees with drip line and tree protection measures rawn to scale(standard architect or engineer scale) LJFootprint of new structure(including decks) and FFE LJNorth arrow , Jtility locations&easements (required for new and additions) Vite address,project or subdivision name and lot number L�1Sidewalk/driveway approach ,_,l{Applicant information(name and phone number) Location of wells/septic systems L�JLot dimensions and building setback dimensions C,�treet tree size,type and location 0' eSquare footage of buildings to be demolished [(Street names xisting structures on site L Corner elevations (2'contours if more than 4'differential) L/JLot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? CZ/Yes ❑No impervious area(applicable if R-7,R-12,R-25&R-40) If es,is a storm water .uali facili shown? ❑Yes L]< E Clean Water Services—Service Provider Letter jot platted prior to 9/10/1995): quired: ❑ Yes,applicant was notified Qiqo Received: ❑ Yes ❑ No P. Water Meters cnture Unit Worksheet—Additions,Remodels and ADUs equired: E Yes,applicant was notified ❑ No —/ Received: Yes ❑ No IV DC Exemption for ADU applied for: ❑ Yes Jd'No Received:` ❑ Yes ❑ No 9' Public Facilities Improvement (PFI) Permit: Required: ❑ Yes,applicant was notified L2 No Applied For: ❑ Yes ❑ No,stop intake ElLand Use Case #: SU 02018-0000/ cZoning: R"1' ❑ Required Setbacks: Front: /5-I Rear: 1-•S' Side: C' Street Side: /S ' Garage: 2 6 , ❑ Building Height: Max. Height:_3 - i Actual Height: • S Landscap�e Area: 1-.. % ��t Coverage Max: Y cyo Entrance IQ,/et back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less Windows Z Minimum 12%of area of all street-facing facades Garage ❑ Gara door is behind widest street-facing wall ❑ Yes 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. I 'Garage door width is ❑ 12'or less 2(50%or less of facade ❑ 60%or less and includes 7 of following: E Covered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset ❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer ❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony Visual Clearance Urban Forestry Plan Ail ensitive Lands: ❑ Yes No Type: Conditions met prior to issuance of building permit Notes: Approved By Planning: e Date: Z. 7J L� Revisions (after Building Submittal only) viewer Date Revision 1: 0 Approved ❑ Not Approved j �/(/j 3M/20 Z.2 Revision 2: ❑ Approved ❑ Not Approved I:\Building\Fonns\BldgPennitRvw RES_122419.docx Building Permit Submittal Original Submittal Date: q-1�?i1/ Site Plans: # ll Building Plans: # 3 Building Permit#: j7J Enter building permit#above. Workflow Routing: Planning r Engineering a. Permit Coordinator 14 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. gt Building: originalpermit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: Date: -5/1 be • Engineering Review [(Slope at building pad: te",4k. Q/Conditions "Met"prior to issuance of building permit g Easements (encroachments)per engineering conditions of approval and plat 49 Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes No Assess Water Quantity Fee in-lieu: ❑ Yes I'No _/ LIDA Facility on lot: Yes ❑ No Add Fee: El Yes ErYr\Io El Final Plat Recorded: Ca' NOT Approved by Engineering: 'j~ L"/4e-4/ Date: 3/Ylzrv: Notes: pf i.e sit„.., (/�eitle,./ 7i/l,' j/ T,/ /vA.» Zkc!.e%G ,f37.61st.,.19')71.5 /� PA 217 ,J, w,t�.�/ . SL,-.., 4«,/' A &- / scsci'A►.7 / e,. / ?j11'r I/ Approved by Engineering: 7 v 4— A eaibe4.1 Date: 31/c1 ,Z Revisions (after Building Submittal only) Reviewer Date Revision 1: Approved ❑ Not Approved '7 y /yr i- E v , „/ c.3)I ro/ 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: 31Ip1242 Z &I-- Revision Notice 2: Date Sent to Applicant: SDC Exemption: ❑ Received Does not apply SDC Fees Entered: Wash Co Trans Dev Tax: "Yes ❑ N/A Tigard Trans SDC: /Yes ❑ N/A TSDC iPa CDC Parks SDC: je Yes ❑ N/A . LIDA ❑ Yes W1/N/A OK to Issue Permit Approved by Permit Coordinator: Date: 3117 I Zv 2 z I:\Buildin¢Worms\BldgPennitRvw RES 1208021.docx DocuSign Envelope ID:1AFD6294-7700-4352-B318-E6E0707F151 C City of Tigard 111 I 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: 15788 SW 76th Ave (ADU) Project Knauss Lot 5 Land Use Case or MST2022-00053 Name: Building Permit#: Tax Lot Total Parks 2S112CD17900 $7,591.00 #: Amount*: 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 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. —DoeuSlgned by: SEAU, teAd 3/10/2022 Property Owner: `-3ssDecag3F'°°a3... Date: e—Docu8lpned by: St GUiI. O'(t,E,IU, 3/10/2022 Developer: Date: p �d00001.Ctl3Y I U403... Permit Coordinator: A5T'LL Date: 3/10/2022 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 = l Bidet x 1 = Clothes washer 2 x 4 = 8 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 to30=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: l:/Building/Forms/WaterMeters_070121_New.doCX Page 2 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 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. f:/Building/Forms/WaterMeters_070121_New.dOCX Page 1 FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT ~ Transmittal Letter T I c A R n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Agnes Lindor/Tina Escelera DATE RECEIVED: DEPT: BUILDING DIVISION �y FROM: Sean O'Neill RECEIVED COMPANY: CBG SW 76th Avenue, LLC MAR 141022 L;IIY OF 1l(.Atiti PHONE: 503 956 9307 3UILDING DIVISIQ ' EMAIL: sean@scotiawsh.com RE: 15790 SW 76th Avenue MST2022-00052 (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. FO O FICE USE ONLY Routed to Permit Technici , Date: 3 2?j 2-2- Initials: "A- Fees Due: ❑ Yes No Fee Descripti n: Amount Due: e- N- Special Instructions: Reprint Permit(per PE)• ❑ Yes No ❑ Done Applicant Notified: �_ Date: if /�( ,Z L Initials: • FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. illCity of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Transmittal Letter T I G A R I) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Allyson Armstrong DATE RECEIVED: DEPT: BUILDING DIVISIONRECE IV ED FROM: Samedy Kem MAR 2 4 2022 COMPANY: ;.:I rV OF 1 IGARL PHONE: 971.563.0552 WILDING DIVISIOn By:--- — EMAIL: RE: 15790 & 15788 SW 76th Ave MS12022-00052 & MST2022-00053 (Site Address) (Permit Number) Knauss Estates—Lot 5 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. 2 Revisions: Alot 2 Cross section(s) and details. 2 Wall bracing and/or lateral analysis. 2 Floor/roof framing. Basement and retaining walls. 2 Beam calculations. 2 Engineer's calculations. Other(explain): REMARKS: There was a lot of revision FO OFFICE USE ONLY Routed to Permit Technic : Da Pte: 5 31 2 -- Initials: tirr— Fees Due: n Yes n No Fee Descri tioh: Amount : f.SoPC ,____----- : Special Instructions: Reprint Permit(per PE): 0 Yes o v' ❑ Done Applicant Notified: Date: T k/ Ap), Initials: Branden Taggart From: Agnes Lindor Sent: Thursday, March 10, 2022 8:36 AM To: Sean O'Neill Cc: #Building Permit Technicians;Trent Brickey Subject: MST2022-00052/ MST2022-00053 Knauss Attachments: MST2022-00053 15788 SW 76th Ave ADU.pdf; MST2022-00052 15790 SW 76th Ave SFR.pdf Hi Sean- Attached are the deferral forms for your signature. In addition, revisions for both permits are being request by the engineering department: - Show vegetated filter strip on site plan. Include dimensions, plantings, and materials. - Show and label sanitary sewer line. Thanks! Agnes Lindor I Associate Planner City of Tigard ! Community Development 13125 SW Hall Boulevard Tigard, Oregon 97223 Phone: 503.718.2429 Email: AgnesL@tigard-or.gov DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained by the City of Tigard in compliance with the Oregon Administrative Rules"City General Records Retention Schedule." 1 Branden Taggart From: Agnes Lindor Sent: Thursday, March 10, 2022 8:36 AM To: Sean O'Neill Cc: #Building Permit Technicians;Trent Brickey Subject: MST2022-00052 / MST2022-00053 Knauss Attachments: MST2022-00053 15788 SW 76th Ave ADU.pdf; MST2022-00052 15790 SW 76th Ave SFR.pdf Hi Sean- Attached are the deferral forms for your signature. In addition, revisions for both permits are being request by the engineering department: - Show vegetated filter strip on site plan. Include dimensions, plantings, and materials. - Show and label sanitary sewer line. 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@tigard-or.gov DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained by the City of Tigard in compliance with the Oregon Administrative Rules "City General Records Retention Schedule." 1