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Permit
II CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2022-00079 T t c;AIR i3 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/02/2022 Parcel: 2S 112CD 17800 Jurisdiction: Tigard Site address: 15768 SW 76TH AVE Subdivision: DURHAM ACRES Lot: 9&PT 8 Project: Knauss Estates, Lot 4,ADU Project Description: New attached ADU. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 3 First: 649 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 29.5 Bathrooms: 3 Second: 827 sf Garage: 220 sf Front: 15 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Total: 1476 sf Value: $204,017.68 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 Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 1 Bckflw Prevntr: 0 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 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 1476 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: $23,811.26 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 nter. Those rules are set forth in OAR oc9.nnl.nnln fhrnionh n Qc9.nn1- no vni mmi nhfain a rnnw of fha!lilac nr rlirant nnactinnc fn nl M(:hu Tallinn 61-11 9 R7 nr 1 Ann 119 7211d 1 Issued By: i Permittee Signature: / Call 503.639.4175 by 7:00 a.m.for the next available inspectio date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. DocuSign Envelope ID:BOCBDBCE-61EF-4AAF-B57C-504855A269EC Building Permit Application ) _ 3 21 22 Residential RECEIVE , FOR OFFICE USE ONLY t City of Tigard 1 Q 2 12022 DateBReceivedy: ' ' 1' Z012 J p, Permit No.:M51- 7i7---^QO© 11 • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review v 111 i Phone: 503.718.2439 Fax: 503.598.1960 CITYOFTIGARD Date/By: Gi-7, A' other Permit:SW�' 27-doy'3 Inspection Line:503.639.4175 Date Ready/By: // ® Sec Page 2 for 1 l t,n I.D Internet: www.tigard-or.gov BUitt!! i(f1'/tSIOt'' Notified/Method: ' I( Supplemental Information TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING [3 New construction ❑ 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 CATEGORY OF CONSTRUCTION work indicated on this application. 1I8 ©1-and 2-family dwellinValuation: $ b � O/7, g 0 Commercial/industrial —1 ❑ Accessory building El Multi-familyNumber of bedrooms:3 ❑ Master builder 0 Other: Numberofbathrooms' 3 JOB SITE INFORMATION AND LOCATION Total number of floors:2 NovJob site address: 15768 SW 76th Avenue; New dwelling area square feefeeeet -7 ly-�,e � City/State/ZIP: Tigard,OR Garage/carport area:220 square feet (si tm 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 112CD.Tax Lot 00400 equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK — L work indicated on this application. Proposal to construct a primary residential structure and an attached accessory dwellin Valuation: $ ii unit. Each unit is 2 stories in height and will have a single car garage. \ >- Existing building area: square feet t J'"t' o /, �, New building area: square feet Di PROPERTY OWNER 0 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: ®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 Specially 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 appl ication:by; upon Total fee due $201.60 Authorized signature: t This permit application expires if a permit is not obtained � ES 180 days after it has been accepted as complete. Print name: Sean O'Neill 356D6C8B3F7D433... I Date: 03/16/2022 I *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:BOCBDBCE-61EF-4AAF-B57C-504855A269EC Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONI.l City of Tigard Received Permit No.: 14 0 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: Associated permits: Phone: 503.718.2439 Fax: 503.598.1960 24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical T I G A R D Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW l'es N. N/A and use actions completed. See Jun .iction cntena or concurrent reviews. I-I ❑ 0 l zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. I i vermcanon of approvea piatnot. ❑ ❑ _ 4 Fire district approval required. Name of district: ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity 6 Sewer permit. ❑ ❑ 0 7 Water district approval. ❑ ❑ a sous report. must carry original appiicanie stamp ana signature on me or witn appucation. —I1 II ' I�, 9 Erosion control plan permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ u basin protection,t®. ❑ ❑ ❑ 10 3 Complete sets of legible plans.Must be drawn to scale,showing conformance to applicable local and state El ❑ ❑ building codes.Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details.Plan review cannot be completed if copyright violations exist. 11 Site/plot plan drawn to scale.The plan must show lot and building setback dimensions;property corner elevations(if 0 0 El there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size ❑ ❑ ❑ and location. 13 Floor plans.Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ ❑ ❑ furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details.Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- ❑ ❑ ❑ floor,wall construction,roof construction.More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. 15 Elevation views.Provide elevations for new construction;minimum of two elevations for additions and remodels. ❑ ❑ El Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for non- ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing.Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 0 ❑ systems,see item 22,"Engineer's calculations." 19 Beam calculations.Provide two sets of calculations using current code design values for all beams and multiple joists 0 0 0 over 10 feet long and/or any beam/joist carrying a non-uniform load. ❑ ❑ ❑ 20 Manufactured floor/roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance.Identify the prescriptive path or provide calculations.A gas-piping schematic is required for four or more appliances. 22 Engineer's calculations.When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or 0 0 0 architect licensed in Oregon and shall be shown to be applicable to the project under review. JURISDICTIONAL SPECIFICS ree si e pans are require. or em a.iv-. i e p ans mus .e :- x or x . 24 Two(2)sets each are required for Items 16,19,20 and 22 above. J—f 19 f 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. J� �J J� . 27 "Drawn to scale"indicates standard architect or engineer scale. I I l 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval.Tree locations,driplines, El ❑ El and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, 0 ❑ ❑ including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9,1995. 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 Application FOR OFFICE USE ONLY • ' City of Ti and RECEIVED Receivvd w / ,� / 5 ��Z _aoo79 ,� g Date/B l// I?i�a?j 0 PerntitNo.: �' 13125 SW Hall Blvd.,Tigard,OR 9722 Phone: 503.718.2439 Plan Review Other Permit: a � I� a)�•'.w Date/By: SW ,7aZ2 000.43 T I(;n R D Inspection Line: 503.639.4175 3�A.3 2 1 -_ Date Ready/By: kris: El See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information TYPE OF AIMING t1nifsl ,t COMMERCIAL FEE*SCHEDULE-USE CHECKLIST Mechanical permit fees*are based on the value of the work❑C New construction 0 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. CATEGORY OF CONSTRUCTION Value:$ RESIDENTIAL EQUIPMENT/ SYSTEMS FEES* Di 1-and 2-family dwelling ❑ Commercial/industrial 0 Accessory building For special information use checklist. ❑ Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Job site address: 15768 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 2Sl l2CD, 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 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 Ef 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 I 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 I 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) CCB lic.: 1441 State surcharge (12%of permit fee) r D.coSiyn by: TOTAL PERMIT FEE S'` MU, permit application expires if a permit is not obtained within 180 Authorized signature: days after it has been accepted as complete. Sean 04R49c883F9D4J9... * Fee methodology set by Tri-County Building Industry Service Board Print name: Date:03/17/2022 I:\Building\Permits\MEC_PermitApp_082520.doc 440-46I7T(I l/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_PennitApp_082520.doc 2 DocuSign Envelope ID:6581141E-ABB8-4824-9AFD-F05062DFDF01 Electrical Permit Application RECEIVE IOROIFI( I. I SE O\l,l CityOf Tigard enRe „H jfl 5 $f ✓ g Date/By: 14 / Permit#: (� �f,_ I`+ • 13125 SW Hall Blvd.,Tigard,OR 97223 �{� 20 Plan Review q �vA-7 /p� _ Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Related Permit O. tJtt- 7 ZZ' e " Inspection Line: 503.639.4175 CITY OF TIGARD Ready Date/By: Juris. ® See Page 2 for TiGARD Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORIPO()ILDi►tt��47��oo G 1 jliffq ` 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 0 Building over three stories. ❑ Demolition ❑Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. El 1-and 2-family dwelling ❑Commercial/industrial ❑Accessol� buildinglesstoground,orexceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑ Multi-family ❑ Master builder ❑Other: ❑Fire pump. 0 Installation of 150 KVA or JOB SiTE INFORMATION AND LOCATION O Emergency system. larger separately derived AddJob#: Job site address: 15768 SW 76th Avenue ❑100H P or moreon of new motor load of system. 00H . ❑"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 4 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#: 4 Includes attached garage. 1,000 sq.ft.or less 1 168.54 168.5z 4 Tax map/parcel#: WCTM 2S112CD,Tax Lot 00400 Ea.add]50o sq.ft.or portion 1 33.92 67.84 i 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.) Renewable Energy I I See Page 2 ®PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name: CBG SW 76th Avenue,LLC 200 amps or less 1 100.70 100.7( 2 Address: 201 amps to 400 amps 133.56 2 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: 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 Branch circuits—new,alteration,or extension,per panel II APPLICANT 0 CONTACT PERSON A.Fee for branch circuits with Business name: CBG SW 76th Avenue,LI.0 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 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@jarmeGCom Inspections for which no fee is CCB Lic.:6924 Electricc�Id8taiti d464C Suprv.Lic.:6365S specifically listed(1/4 hr min) 90.00/hr ELECTRICAL PERMIT FEES Suprv.Electrician signature,require(: pm ^_,'i. Subtotal: Lr Print name:Tim Jarmer .472C61799c294A6... Date: 3/17/2022 i'i Plan Review Required(25%of permit fee): D.,csI ned by. State surcharge(12%of permit fee): 1p t Authorized signature:L 17 h�� 356O TOTAL PERMIT FEE: 6C8B3f7D433... 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.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB DocuSign Envelope ID:6581141E-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 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 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: n Other: Each additional inspection is 66.25/hr charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(''A hr min) COMMERCIAL WORI(ONLY: gag** Fee for each commercial system: $75.00 Subtotal(Enter Page 1). �' Number of inspections alloweeddper 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 ❑ 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 l:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 DocuSign tnvelope IL): (AA3/(Ab-4b49-4UUF-b1 51--41-tbAUr;iru1-r Plumbing Permit Application no Site Utilities RECEIVE 1 FOR OFFICE USE ONLY Cityof Tigard l ' 4 Received2 j) n� (p C �,ry��/ g NC . Date/By: ✓! f W7Z i7 L v PermitNo.:A4>fjO 7,-00 f '7 ii 13125 SW Hall Blvd.,Tigard,OR 97223 ll/ i Plan Review Phone: 503.718.2439 Fax: 503.598.196illC'�OF TIGARD Date/By: Other Permit No.:5 ) 2 2-OO k j T I G A R D Inspection Line:503.639.4175 Date Ready/By: Juris: 0 See Page 2 for Internet: www.tigard-or.gov BUILDING DIVIS►nt Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE (i 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 ❑ Commercial/industrial SFR(2)bath 437.78 0 Accessory building ❑ 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: 15768 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.: 4 Fixture or item: Tax map/parcel no.: WCTM 2S112CD,Tax Lot 00400 Back flow 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 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 fl APPLICANT n CONIACI' 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 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:003)492-3490) Fax:( ) i/15-/2_, Minimum permit fee: $72.50 CCB Lic.: 184601 Plumbing Lic.no.f)132 Plan review (25%of permit fee) r-Du,.Sigma by. State surcharge(12%of permit fee) Authorized signature: LAi/l. et'A` :,/ TOTAL PERMIT FEE Print name: Sean a+-R 9eF8B3F7D433 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. 1:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-46 16T(10/02/COM/WEB) L)ocuslgn tnvelope IL): /AA3//Ab-4b49-40U1--1:irb1--4l-EbAUNI-DFh 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 2,001 to 3,600 $169.69 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 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 ❑ New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918-780-0040. Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities. -Domestic ❑ Any multipurpose fire sprinkler system. Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040. Eye Wash Floor Drain/sink -2" Submit 2 sets of plans with any of the above. -3„ 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: C\Building\Permits\PLMU_PermitApp.doc 2 City of Tigard r COMMUNITY DEVELOPMENT DEPARTMENT IN l Building Permit Review — Residential Building Permit #: +VL 1-ZeZ' ?el Site Address: IS-140115 5W 1 4kft• Project Name: 16/W4S ESdai-e-5 Lot #: y Planning Review 4\-vd Proposal: Ak6,10\it k CW Verify address/suite #active in Accela. E In River Terrace: A No ❑ Yes,River Terrace Review Addendum Site Plan Elements: ['Erosion Control iii33 copies of site plan on 8-1/2"x 11" or 11 x 17"paper l tetained trees with drip line and tree protection measures Irprawn to scale(standard architect or engineer scale) Footprint of new structure(including decks) and FFE V' orth arrow WUtility locations&easements(required for new and additions) r41.ite address,project or subdivision name and lot number (Sidewalk/driveway approach Applicant information(name and phone number) ❑ Lot dimensions and building setback dimensions OStreet tree size,type and location El h3Street names ❑ to fACorner 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? f 4Yes [No impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? jjYes ❑No 0 Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified ,e/ No Received: ❑ Yes ❑ No 10 Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs Required: ❑ Yes,applicant was notified ( No Received: ❑ Yes ❑ No iii SDC Exemption for ADU applied for: ❑ Yes &.11 No Received: ❑ Yes .E9 No V Public Facilities Improvement (PFI) Permit: Required: ❑ Yes,applicant was notifiedK,��0 No Applied For: ❑ Yes CI No,stop intake DA Land Use Case #: �17, Z�� d w la Zoning: g.,---4- gl Required Setbacks: Front: i y Rear: ?.5t Side: 9' Street Side: I t Garage: 1 j 1 */Building Height: n ,' Max.Height: "3 5 i Actual Height: 2-1, VJ l4 Landscape Area: 2/(/ % V/ Lot Coverage Max: Entrance Set back no more than 8'from street-facing wall p 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 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. yl Garage door width is A 12'or less El 50%or less of facade ❑ 60%or less and includes 7 of following: ❑ 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 El Window recess El Window projection ❑ Balcony (� Visual Clearance E Urban Forestry Plan 11Sensitive Lands: ❑ Yes f ) No Type: AConditions met prior to issuance of building permit ;ot;: d By Planning: /lA tA,11 Date: __Zp4/20212_, Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved I:\Building\Fonns\BldgPernutRvw_RES_122419.docx ,;ter Building Permit Submittal Original Submittal Date: 9/ 1/ # Site Plans: 'l Building Plans: # Building Permit#: Enter building permit#above. Workflow Routing: Planning Engineering -P Permit Coordinator ig Building Workflow Sign-off: CIP Sign-off for Planning(include notes from planning review) Route Application Documents: I Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. Building original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: 4e Date: 3/2 (7621-- Engineering Review ['Slope at building pad: (0d •[E Conditions "Met"prior to issuance of building permit VI/-- Q -Easements (encroachments)per engineering conditions of approval and plat Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes EfNo Assess Water Quantity Fee in-lieu: ❑ Yes I"No LIDA Facility on lot: E Yes ❑ No Add Fee: ❑ Yes ENo Er Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: 3 Approved by Engineering: Date: 2i/2o az Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review Conditions "Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: SDC Exemption: ❑ Received Does not apply SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A Tigard Trans SDC: /Yes ❑ N/A Parks SDC: Yes ❑ N/A LIDA ❑ Yes g N/A OK to Issue Permit Approved by Permit Coordinator: �� !/ Date: 3 13 f 2 2, I:1Building\Fomis\BldgPernutRvw RES_1208021.docx