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Permit CITY OF TIGARD MASTER PERMIT s COMMUNITY DEVELOPMENT Permit#: MST2022-00078 T I(1;AP-.T) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/02/2022 Parcel: 2S112CD17800 Jurisdiction: Tigard Site address: 15766 SW 76TH AVE Subdivision: DURHAM ACRES Lot: 9&PT 8 Project: Knauss Estates, Lot 4, Primary Project Description: New primary dwelling with(1)attached ADU. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 3 First: 671 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 29.5 Bathrooms: 3 Second: 855 sf Garage: 220 sf Front: 15 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Total: 1526 sf Value: $210,546.68 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 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 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'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 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 1526 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: $26,115.93 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 enter. Those rules ar t forth in OAR QF9_M1_M1 A thrnnnh n OF9.fM-AAQA Vn,,rn ,,nhtain a rnnw of the n ileac nr riirant of iecfinne Tn(II IN(:by Tallinn Fn4 9 1 QA7 nr 1 Ann 119 931d Issued By: 7CV�/► �.�If /�� Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspectio ate. 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. DocuSign Envelope ID:BOCBDBCE-61 EF-4AAF-B57C-504855A269EC Building Permit Application g- 3 Zi/Z--z, Residential RECEIVE 'eceived rolz t)rrlt.l.:I's1..()NI.Y City of Tigard Date/By: rV20 JP PermitNo.: "0/7" N . 13125 SW Hall Blvd.,Tigard,OR 97223 MAR 2 1.7127 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 (��j Date/By: /1 �V Other Permit: SVI�Q'ZO�i2'Q1 I 3 'I I C;A li U Inspection Line:503.639.4175 CITYOF TIGAf7 j Date Ready/By: Juris: El See Page 2 for Internet: www.tigard-or.gov Notified Method: Tye Supplemental Information BUILDING DIVISION t M TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING New construction El 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 �/O ���' Valuation: $ ®1-and 2-family dwelling ❑ Commercial/industrial Number of bedrooms:3 ❑ Accessory building ❑ Multi-family ElMaster builder IDOther: Number of bathrooms: 2) JOB SITE INFORMATION AND LOCATION Total number of floors:2 n Job site address: 15766 SW 76th Avenue; New dwelling area 1 591, square feet if.j City/State/ZIP: Tigard,OR Garage/carport area:220 square feet Un I Suite/bldg./apt.no.: Project name:Knauss Estates Lot 4 Covered porch area: square feet Cross street/directions to job site:East side of the block north of SW 76th Avenue and SW Bond Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Knauss Estates Lot no.: 4 Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: WCTM 2S 1 12C D,Tax Lot 00400 equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK/` `/ work indicated on this application. Valuation: $ Proposal to construct a primary residential structure and an attached accessory(welling it_ unit. Each unit is 2 stories in height and willil have a single car garage. { �^`S Existing building area: square feet � 1r c tiz-yr,- /-/ /,k/h tG- / c)off,/,� �"V`�` New building area: square feet Vv 0 PROPERTY,v( OWNER J ❑ TENANT Number of stories: Name: CBG SW 76th Avenue,LLC Type of construction: Address: 15110 SW Boones Ferry Road,Suite 500 Occupancy groups: City/State/ZIP:Lake Oswego,OR 97035 Existing: Phone:(503 ) 956-9307 Fax:( ) New: E APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: CBG SW 76th Avenue,LLC Structural plan review fee(or deposit): Contact name: Sean O'Neill FLS plan review fee(if applicable): Address: 15110 SW Boones Ferry Road,Suite 500 City/State/ZIP: Lake Oswego,OR 97035 Total fees due 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 PhotoVoltaic Solar Panel System. Business name: Canopy Building Group,LLC Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 15110 SW Boones Ferry Road,Suite 500 Solar Installation Specialty 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.: CCB#232358 e•••••••rietruSignati by Total fee due upon application: $201.60 Authorized signature: SUVA, 02/41L This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 1/4-35ODof.6B4O7D4-33...Print name: Sean O'Neill Date: 03/16/2022 *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) DocuSign Envelope ID: 7AA377A6-4649-400E-BF5F-4FE6AD73FDFF Mechanical Permit ApplicatioRECEIVE , VV FOR OFFICE USE ONLY City of Tigard Received g Date/By: / PermitNo.: 13125 SW Hall Blvd.,Tigard,OR 97223 AR 2 4.?Q7 / (�LZ Spy- I�IS1'107iL_cools iew Phone: 503.718.2439 Plan te/By: Other Permit:SWiZZ-000 Li 5 i .,, ,_, Inspection Line: 503.639.4175 CITYOF TIGARL)p (�uflllV Date Ready/By: Juris: p See Page 2 for Internet: www.tigard-or.gov BUILDING DIViSIOP Notified/Method: I Supplemental Information I-7' TYPE OF WORK COMMERCIAL FEE*SCHEDULE-USE CHECKLIST Ui New construction 0 Addition/alteration/replacement Mechanical permit fees*are based on the value of the work performed.Indicate the value(rounded to the nearest dollar)of all ❑ Demolition ❑ Other: mechanical materials,equipment,labor,overhead,and profit. CATEGORY OF CONSTRUCTION Value:$ RESIDENTIAL EQUIPMENT/ SYSTEMS FEES* Et 1-and 2-family dwelling 0 Commercial/industrial ❑ Accessory building For special information use checklist ❑ Multi-family 0 Master builder ❑ Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Job site address: 15766 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 4 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.: 4 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 t Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 [?f PROPERTY OWNER ❑ 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 ❑ APPLICANT 0 CONTACT PERSON Other: 23.32 is Business name: CBG SW 76th Avenue,LLC Fuel piping: $14.15 for first four;$4.03 for each additional Contact name: Sean O'Neill Furnace,etc. Address: 15110 SW Boones Ferry Road,Suite 500 Gas heat pump City/State/ZIP: Lake Oswego,OR 97035 Wall/suspended/unit heater Wateerr heater Phone:(503 ) 9569307 Fax::( ) Fireplace E-mail: sean@canopypdx.com Range Barbecue CONTRACTOR Clothes dryer(gas) Business name:Jacobs Heating and Cooling Other: MECHANICAL PERMIT FEES* Address:4474 SE Milwaukie Ave- Subtotal City/State/ZIP:Portland,OR 97202 Minimum permit fee ($90.00) Phone:(503-413-9796 ) Fax:(N/A ) Plan review(25%of permit fee) State surcharge(12%of permit fee) CCB lie.: 1441 TOTAL PERMIT FEE e--Doci Slgnedby: Ste- (�tl�4,i11, This permit application expires if a permit is not obtained within 180 Authorized signature: days after it has been accepted as complete. , S2dt1 p l� Et�G6DSr1D43J. * Fee methodology set by Tri-County Building Industry Service Board Print name: Date:03/17/2022 I:\Building\Permits\MEC_PermitApp_082520.doc 440-4617T(I 1/02/COM/WEB) DocuSign Envelope ID: 7AA377A6-4649-400E-BF5F-4FE6AD73FDFF Mechanical Permit Application - City of Tigard Page 2- Supplemental Information Commercial Submittal Requirements: • (2) sets of plans, drawn to scale. • (2) sets of equipment cut sheets. • (2) copies of site plan for ground and roof top equipment location and screening per Tigard development code. Commercial&Multi-Family Fee Schedule: Total Valuation: Permit Fee: $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and $2.54 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional$100.00 or fraction thereof. 1:\Building\Permits\MEC_PermitApp_082520.doc 2 DocuSign Envelope ID:65B1141E-ABB8-4824-9AFDD{9FE EIVE c. Electrical Permit Applicatio {tV FOR OFFICE I.Sh,oNi.)- City of Tigard( ?i " Received DateBy: 3 /4 ZOZZ splr Permit#:Act."2022-do0?8 • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review C Phone: 503.718.2439 Fax: 503.598.1960 CITY GAN Date/By: Related Permit 8:S W R12 Zo2. Oj jq3 Inspection Line: 503.639.4175 OF��""•R� ReadyDate/By: mars: tIGARD P SeePage2for Internet: www.tigard-or.gov BUILDING DiVISIO Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ®New construction E Addition/alteration/replacement Please check all that apply(submit2 sets of plans w/items checked): ❑Service or feeder 400 amps or more ❑Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. DI 1-and 2-family dwelling ❑ Commercial/industrial E Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural Multi-familyMaster builderOther: amps for all other installations. buildings. ❑ 0 0 ❑Fire pump. El Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived Job#: Job site address: 15766 SW 76th Avenue ❑100H ion of new motor load of system. 00HPormore. ❑"A","E","1-2","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 4 ❑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 New residential single-or multi-family dwelling unit. Subdivision: Knauss Subdivision Lot#: 4 includes attached garage. 1,000 sq.ft.or less 1 168.54 168.5 4 Tax map/parcel#: WCTM 2S112CD,Tax Lot 00400 Ea.add'l 500 sq.ft.or portion 1 33.92 67.84 I 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 ®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 Fax: Over 1,000 amps or volts 552.26 2 Phone:(503 ) 9569307 ( ) Temporary services or feeders installation,alteration,and/or Email: sean rgcanopypdx.com 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 cc APPLICANT ❑ CONTACT PERSON A.Fee for branch circuits with Business name: CBG SW 76th Avenue,LLC above service or feeder fee, each branch circuit 7.42 2 Contact name: Sean O'Neill B.Fee for branch circuits without 15110 SW Boones FerryRoad,Suite 500 branchce it feederitfee,first Address: branch circuit 56.18 2 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 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: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 specifically listed(1/2hr min) 90.00/hr CCB Lic.:6924 Electrical Lic.:26-144C Suprv.Lic.:6365S ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Dr.....eNnarl by j 1/ LULL Print name:Tim Jarmer I-1.40"V State surcharge(12%of permit fee): Date: fl man Review xequtreu(L.37o us permit lee). � 472c,��ris� na... TOTAL PERMIT FEE: Authorized signature: S(.Abt. V- K l \-356060883F70433._. This permit application expires if a permit is not obtained within 180 Print name: Sean 0'Nei 11 Date: 03/17/2022 days after it has been accepted as complete. * Number of inspections allowed per permit. 1:\Building\Pemets\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(I 1/05/COM/W EB UOcuslgn tnvelope IL): IAA3 I fAti-4b49-4UUI--bhbt--4l-EbAU/3l-UFt- Plumbing Permit Application Site Utilities RECEIVEC FOR OFFICE USE ONLY Cityof Tigard Received � gan Date/By: 3I n(�'1Ione spy. Permit No.: S.fz022... . + . 2 III ■ 13125 SW Hall Blvd.,Tigard,OR 97223 Miili = : Plan Review ■ Phone: 503.718.2439 Fax: 503.598.196 7 A y Other Permit No.:sv. 22n� 1 10 A It l Inspection Line:503.639.4175 CI(y GF 1 IGAHb Date Ready/By: Suns: 0 See Page 2 for Internet: www.tigard-or.govUILDIPIG DIVISION Notified/Method: Supplemental Information TYPE OF WORKFEE* SCHEDULE U 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 © I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 E Accessory building D Multi-family SFR(3)bath 1 500.32 500.32 Each additional bath/kitchen 25.02 ❑ Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 15766 SW 76th Avenue Catch basin or area drain 18.76 City/State/ZIP: Tigard,OR 97224 DY well,leach line,or trench drain 18.76 Footing drain(no.linear ft.: ) Paget 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.: 4 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 F{PROPERTY OWNER n TENANT Expansion tank 12.51 Fixture/sewer cap 25.02 Name: CBG SW 76th Avenue, LLC 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 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: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:( ) //jC/LZ Minimum permit fee: $72.50 CCB Lic.: 184601 Plumbing Lic.no.: � ��� Plan review (25%of permit fee) DJEUSipn.a y. State surcharge(12%of permit fee) Authorized signature: ` 0-skill, PERMIT FEE Print name: Sean et 8B3F7D433._ I Date:03/17/2022 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:ABuildingAPennits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) uocuSign Envelope iu: /AA3 • /�Ad 4049-40Ur-lil br-4t tbAD/3rUt r 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-I"100' 1 50.03 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 1 37.52 37.52 3,,601 to 7,201 to 3, 00 $00 $233..269 0 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 h and including$10,000.00. Inspection of cvisting plumbing of I<,r $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 Thu ❑ 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 ❑ Any multipurpose fire sprinkler system. Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040. Eye Wash Floor Drain/sink -2" Submit 2 sets of plans with any of the above. -3" 4"Car Wash Drain Isometric or Riser Diagram - Garbage -Domestic-non-food ❑ Isometric or riser diagram is required for new buildings Disposal -Domestic-food related that meet the qualifications above. -Commercial-food related -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang -Stall Sink/Lay -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter Washer-Clothes *Note: If the fixture work under this permit results in an Water Extractor increase of sewer EDUs,a sewer permit will be issued and Water Closet-Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: I:\Building\Pennits\PLMU_PermitApp.doc 2 City of Tigard INIr COMMUNITY DEVELOPMENT DEPARTMENT C 1 GARD Building Permit Review — Residential TBuilding Permit #: AA 5-tZO2-1 BOO' Site Address: IS-6 G ail 764" Pcv , Project Name: Kv4VS5 4100 Lot #: 1 Planning Review Proposal: N a &ckJeJV V vp Verify address/suite #active in Accela. ❑ In River Terrace: No ❑ Yes,River Terrace RevieavAddendum Site Plan Elements: tgErosion Control ,43 copies of site plan on 8-1/2"x 11"or 11 x 17"paper Retained trees with drip line and tree protection measures xi Drawn to scale(standard architect or engineer scale) FFootprint of new structure(including decks) and FFE o'W, ,ki 'North arrow Utility locations&easements (required for new and additions) Site address,,project or subdivision name and lot number / Sidewalk/driveway approach )Applicant information(name and phone number) , _pT,,catien-of wells/septic systems.- , ,EI,ILot dimensions and building setback dimensions Nib treet tree size,type and location iii Street names (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? SoYes ❑No impervious area (applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? $YYes ❑No 123 Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified $ No Received: ❑ Yes ❑ No pi Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs Required: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No xemp o plied for: ❑ Yes /0 No Received: ❑ Yes );i No il Public Facilities Improvement (PFI) Permit: Required: ❑ Yes,applicant was notified pa No Applied For: ❑ Yes ❑ No,stop intake iti Land Use Case #: i'- Zoning: Required Setbacks: Front: i 5 Rear: LL t Side: 1 q �.7 Side: 5 Street �7 Garage:�.D o8 Building Height: Max. Height: 3 5 t Actual Height: 2,51. 5 Landscape Area: 20 % Lot Coverage Max: 0 nuance Set back no more than 8'from street facing wall Parallel to street or offset 45 degrees or less Windows Minimum 12%of area of all street-facing facades Garage Garage door is behind widest street-facing wall p 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 2nd floor. Garage door width is IA 12'or less ❑ 50%or less of facade ❑ 60%or less and includes 7 of following: i? ❑ 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 i0 Sensitive Lands: ligaievs p No Type: EConditions met prior to issuance of building permit Notes: 4-e€(44 Pd Approved By Planning: Date: 312-qlZ0 LZ. Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved I:\Building\Fonus\BIdgPennitRvw RES_122419.docx Building Permit Submittal Original Submittal Date: 2f V /7(2' 7i Site Plans: # Building Plans: # Building Permit#: p Enter building permit#above. Workflow Routing: 133 Planning 61, Engineering F3 Permit Coordinator A Building Workflow Sign-off: ,JX Sign-off for Planning(include notes from planning review) Route Application Documents: cg Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. Pio Building: original permit application, site plans,building plans, engineer and beam calculations and trust details,if applicable, etc. Notes: 4.ojji By Permit Technician: l f Date: 3( /2422 Engineering Review Er Slope at building pad: 0 Co d Conditions "Met"prior to issuance of building permit 2/Water (encroachments)per engineering conditions of approval and plat LJ Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes E/No Assess Water Quantity Fee in-lieu: ❑ Yes 2/No LIDA Facility on lot: VYes ❑ No Add Fee: ❑ Yes RVNo Fr Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: C"Approved by Engineering: 7 ►/ i-Zl-Q, Date: 3/2 q /20 n Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved "Revision 2: ❑ Approved ❑ Not Approved ,• Permit Coordinator Review. Fr Conditions "Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: SDC Exemption: El Does not apply SDC Fees Entered: Wash Co Trans Dev Tax: ,er Yes ❑ N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: Yes ❑ N/A LIDA ❑ Yes /`J N/A VOK to Issue Permit Approved by Permit Coordinator: Date: f 31 I 71)7 2- I:\Building\Forms\BldgPennitRvw RES_1208021.docx 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@canol ypdx.corn New Meter Address: 15766 SW 76th Avf nue/15768 SW 76th Avenue Subdivision Name: Knauss Subdivision Lot#: 4 Building Permit#: MST 2022-00078/MST2022-00079 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, 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 55 Total Fixture Unit Points: Fixture Unit Points: 1 to30= 5/8" 37.5to 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: e 1:/Building/Forms/WaterMeters_070121_New.docx Page 2 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 11111 Water Meter Fixture Unit Works EIVEA 1 '`",,' For New Buildings APR 2 71022 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigarc ,'.ro �fl0Al(L SUILDING DIVISION LOCATION: City of Tigard—City Hall WATER METER SALES: Utility Billing By Email Only.Please contact 13125 SW Hall Blvd. ubonlinepay@atigard-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 't'