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Permit II CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2022-00141 Date Issued: 06/23/2022 T I C;A Tt 11) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S134DA10800 Jurisdiction: Tigard Site address: 10730 SW NORTH DAKOTA ST Subdivision: 1998-067 PARTITION PLAT Lot: 1 Project: Wu Project Description: Home addition with new garage and 64sf breezeway. Not approved as a separate dwelling. NO FINAL UNTIL WATER METER HAS BEEN UPSIZED TO 1". BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 2 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 0 Bathrooms: 3 Second: 936 sf Garage: 936 sf Front: 20 Smoke Yes Dwelling Units: 0 Third: 0 sf Right: 5 Detectors: Total: 936 sf Value: $173,502.88 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100 Tubs/Showers: 3 Garbage Disp: 0 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 2 Backwater Value: 0 Bckflw Prevntr: 0 Drywell-Trench Drain: 0 Other Fixtures: 1 Other Fixture Units: Garage utility sink g MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 4 Clothes Dryers: 1 Electricity Heat Pump: N Hoods: 0 Other Units: 1 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 1 0-200 amp: 0 W/Svc or Fdr: 20 Ea add!500 sf: 0 201-400 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 N Other: N Other Description: Ecompasing: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF VB R-3 936 1 Owner: Contractor: WU,MAE HILINE HOMES Required Items and Reports(Conditions) PO BOX 192 3935 HAGERS GROVE 1 Ersn Cntrl 503-639-4175 TUALATIN,OR 97062 SALEM,OR 97317 PHONE: PHONE: 503-399-1721 FAX: Total Fees: $7,512.10 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: regon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth irk OAR oc9Jin1 nnln thrnitnh fAP 9-nn1_nnon V m nhtainlM r-nrn,n rho n dorm nr riirorf ni ioefinnc fn nu iMR by naiiinn 6 C9 10327 nr 1 Ann 149 9Z44 Issued By: t 2 Permittee Signature:7 `1,-�41 — Call 503.639.4175 by 7:00 a.m.for the next available Inspect da e. 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. Building Permit Application r / Residential RECEIVED E FOR OFFICE USE()NIA. City of Tigard Received MAY 19 2012 DateiBve: S. 2_,v $I Odt2 UD/ // 13125 SW Hall Blvd.,Tigard,OR 97223 Plun Review S • Phone: 503.718.2439 Fax: 503.598.19. .r �Q 13 22 III Other Permit; CITY Uf l i(..,r� Dare/13y: TIGARD Inspection Line: 503.639.4175 ute Reody/Dy: / Ju ts: ® See Page 2 for Internet: www.ti Bard-or.gov tt b b t1Jj� fl1 � .i f,f\114 { )�''' utiticcbMed�od Supplemental Information TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING gNew construction 0 Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all /" Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for thied CATEGORY OF CONSTRUCTION work indicated on this application. ,�3/gdZ (y I-and 2-family dwelling ❑Commercial/industrial Valuation: t CIAccessory building ❑Multi-family Number of bedrooms: 2.. ❑Master builder 0 Other: Number of bathrooms: j JOB SITE INFORMATION AND LOCATION Total number of floors: Z. `Ca-a— Job site address: i(y 3'0 $W Ai t'%kpt k er New dwelling area: eta (:, square feet City/State/ZIP: 'q+ita ,J. Om all Zx 3 Garage/carport area: 13 6 square feet (� Suite/bldg./apt.no.: d Project name: Covered porch area: square feet (_`t\ Cross street/directions to job site: (AI Dec. area: square feet "� �Yt ftt� ` �L ti-9 square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: _ Lot no.: Permit fees*arc based on the value of the work performed. Tax map/parcel no.: indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTIONP OF WORK work indicated on this application. 1 iOM .<o(o(t +7d 11 \)eA-) ( � - k Mey,) Valuation: $ fr-�� (� •"� Existing building area: square feet ROPER V VL New building area: square feet ® PROPERTY OWNER 1 ❑ TENANT Number of stories: Name: tAtt,.t., kA)IA Type of construction: Address: P b f?o, tot?, Occupancy groups: City/State/ZIP: 'r et i at.tfv. Q N. et7 0 6z Existing: Phone:(SDI) 34t' 0144.3 Fax:( ) New: ❑ APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* Business name: (Please refer to fee schedule) Structural plan review fee(or deposit): Contact name. FLS plan review fee(if applicable): Address: — City/State/ZIP: Total fees due upon application: Phone:( ) Fax::( ) Amount received: E-mail: PHOTOVOLTAIC SOLAR PANEL.SYSTEM FEES° n44�L✓ldLtt)1heSaDtSrH�t�a eck,-/ Commercial and residential prescriptive installation of CONTRA¢TOR roof-top mounted PhotoVoltaic Solar Panel System. Business name: 4`L . t iv $ Submit two(2)sets of roof plan with connection details f� and fire department access,along with the 2010 Oregon Address: 3a 5- A4 trS Cfbtt ti ___Lt, 56 Solar Installation Specialty Code checklist. City/State/ZiP: Set ltt e ae 97 3r 7 Permit Fee(includes plan review $180.00 and administrative fees): Phone:(spy) 5 p( Kci Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lie.: SZ L/l ?�41 Total fee due upon application: $201.60 Authorized signature: sss This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: a501 /'t'SS Date: iiiI� )2Z *Fcc methodology act by Tri-County Building Industry j� // Service Board. 1:\Buitding\Permits\BLIP-RESPermitApp.doe 02/24/2011 440-4613T(1 l/02/COM/WEB) CEIVE( Mechanical Permit Applicat>r�o -- htlRCllrltl:Isi:flNl.l City of Tigard MAY 19 2022 Received . Date/By, Permit No.: r 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review m Phone: 503.718.2439 Fax: 503.598.196Q Other Permit: Inspection Line: 503.639.4175 Li OF I K.ItkilL Date Re Tic;A R D p Date Ready/By: lulls H See Page 2 for Internet: www.tigard-or.gov + UILDING DIVISIO" Notified/Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE- USE CHECKLIST Mechanical permit fees*are based on the value of the work iitNew construction Addition/alteration/replacement performed.indicate the value(rounded to the nearest dollar)of all 0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* gl-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special Information use checklist. ❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. 1 Total JOB SITE INFORMATION AND LOCATION Ileating/cooling: Air conditioning 46.75 Job site address: to "73 d Sw N DA kat0. ST Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: 1i ov d a II2.-z 3 Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: •! Project name: Heat pump 61.06 Duct work 23.32 Cross street/directions to job site: 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: Lot no.: Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater I 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 Flue vent for water heater or gas y�/�m ec Y , �� JGo �-1/_,L, fireplace NiN 23.32 t � � �4 , .e Log lighter(gas) 23.3 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other: 23.32 Og.PROPERTY OWNER 0 TENANT Environmental exhaust and ventilation: Name: a I' k.!H Range hood/other kitchen equipment 33.39 Address: '7g it bay' I et Z Clothes dryer exhaust 1 33.39 City/State/ZIP: q Single-duct exhaust(bathrooms, } T'44. �� t In- d Z toilet compartments,utility rooms) 23.32 Phone:(5iO3) 3*_il- 04143 Fax:( ) Attic/crawlspace fans .La.J 23.32 ❑ APPLICANT d CONTACT PERSON Other: WI ( 23.32 Business name: Fuel piping: $14.15 for first four;$4.03 for each additional Contact name: Furnace,etc. Address: Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( ) Fax: :( ) Fireplace Range E-mail: Barbecue CONTRACTOR Clothes dryer(gas) Business name: t use 0. t�t"�Aln yCp Other: + MECHANICAL PERMIT FEES* Address: ZtiC}$ 'g rV.c. Lcj s• l?'t TI^` Subtotal City/State/ZIP: Atlawrt 012, Q 7 J 2.-2- Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(t54i) QLS-- liiii,5 Fax:( ) State surcharge(12%of permit fee) CCB lie.: + 5 iii 4 6, TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signature: • Fee methodology set by Tri-County Building Industry Service Board Print name: 6eAuk,.y__ I„j a1. Date: 5f/cf 7-2-- t:\BuildungPPemut94MEC_PermitApp 0401 I3.doc 440.461 T1-(I1/02/COM/WEB) RECEElectrical Permit Applicati �VE! FOR OFFI( I.t SF ONI.I SAY 19 Reee City of Tigard ?i}qq Date/By:e $yd Permit 0: P ® 13i25 SW Hall Blvd.,Tigard,OR 97223 CULL DtB view a Phone: 503.718.2439 Fax: SQ3.598.1+ Date/By: Related Permit#: Inspection Line: 503.639.4175 LA I T OF 1 I(IL%I1L Ready Date/By: luris: F5 See Page 2 for TIGARI. Internet: www.tigard-or.gov tRUI DIN La G D!VISI(..t, Notified/Method: Supplemental Information TYPE OF WORK V PLAN REVIEW FiNew 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 Matins and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. i 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building lensto ground,or exceeds 14,000 0 Conunercial-use agricultural amps for all other installations. buildings. 0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived Job#: Job site address: }. ❑A of motor load of system. l e 73 0 s-,,,,, .W TA14o,4c I OOdditionHI'or more.new ❑..A., „E,..,l.r,.,1_t„ City/State/ZIP: y s� �} ❑six or more residential units. occupancy. y I MC,(41 V R— et?Z,2•J ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: rJ Project name: 0 Hazardous locations. 0 Supply voltage for more than 0 Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Qty. 1 Each 1 Total ( • . New residential single-or multi-family dwelling unit. Subdivision: Lot#: includes attached garage. `- 1,000 sq.ft.or less y,, 168.54 4 Tax map/parcel#: Ea.addl.500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential t } (with above sq.ft.) 75.00 2 l/t 'r�` ` `F��1� / f? �i Al Crj? Y Limited energy,multi-family l residential(with above sq.ft.) 75.00 2 4fiet.--r.oete, Renewable Energy ❑ See Page 2 PROPEWNER ❑ TENANT Services or feeders installation Iteration,and/or relocation Name: Moot tA,.th 200 amps or less I 100.70 2 201 amps to 400 amps 133.56 2 Address: Pb ( 10(* 401 amps to 600 amps 200.34 2 City/State/ZIP: "(^ikh i 4/vttn. e IL. ql Oil- 601 amps to 1,000 amps 301.04 2 Phone:(5 01) 371(- 0 L fL(3 Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 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 0 APPLICANT 0 CONTACT PERSON Branch circuits-new,alteration,or extension,per panel A.Fee for branch circuits with l Business name: above service or feeder fee, each branch circuit 7.42 2 Contact name: B.Fee for branch circuits without service or feeder fee,first 56 I8 2 Address: branch circuit City/State/ZIP: Each add'i branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Fax::( ) Each manufactured or modular 67.84 2 Entail: - dwelling,service and/or feeder Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: .r^ `�- s` Sign or outline lighting 67.84 2 L�rit rS �� �t!'� Signal circuit(s)or limited-energy OS� .2, p 0 See Page 2 2 Address: ,A -J 3_I11 panel,alteration,or extension. City/State/ZIP: Each additional inspection over allowable in any of the above �tl'1�+1 t�/L (4-7 3 0. ' Additional inspection(1 hr min) 66.25/lir Phone:(5 03 393 3 — ZZZ Fax:( ) Investigation(1 hr min) 90.00/hr Email:lid II'tir�ltiti'rrs�i' 4>1. ex.x t - (Osi !wl/. industrial t(1hrmin) 78.18/hr 1 1 Inspectionsons for which no fee is 90.00/hr CCB Lie.: I 1. ,,1 Electrical Lie.:Z/1-3�6 Suprv.Lie.:yE61 specifically listed(ii lu mini ELECTRICAL PERMIT FEES C.--> Suprv.Electrician signature,required:Print name: 4 Subtotal: i GvL- l rri.s Date: Y/��1 z�-- ❑Plan Review Required(25%of permit fee): State surcharge(12n/o of permit fee): — Authorized signature: - TOTAL PERMIT FEE: u This permit application expires if a permit is not obtained within 180 Print name: fZ ttv k Date: t / l 7-Z days after it has been accepted as complete. Number of inspections allowed per permit. I''Suiidiug\Permits:Ei.C_PermitApp_ELR_EREdoe Rev 06.+I7'2015 440-461ST/I1/e5/COM/WW_li Plumbing Permit Application Building Fixtures RECEIVE' OR QI'1 1(ar. USE OM\ City of Tigard MAY 1 9 Received g Date/By: Permit No.: 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review 1 Phone: 503.718.2439 Fax: 503.598.1,�9,(j(�, Date/By: Other Permit No.: Inspection Line: 503.639.4175 v1 1 1 C d�P ltii TIGARD ^ Date Ready/By: lens: Ed See Page 2 foe Internet: www.tigard-or.gov Z! i LIMO IIp,I i�/IS!, ,,,,�,;_f_J4d'���I � Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE F_New construction 0 Demolition For special information use checklist. Description I Qty. 1 Ea. 1 Total 0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 73 i-and 2-family dwelling ❑Commercial/industrialSFR(2)bath 437.78 0 Accessory building 0 Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SiTE INFORMATION AND LOCATION Site utilities: Job site address: 1 0 73 0 5 ,, jv D6,1,40 kk 5-r Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: Ti �./g v rt. R1 ,-.3. Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt,no.: l Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector i 18.76 Sanitary sewer(no.linear ft.:_) }, Page 2 Storm sewer(no.linear ft.:_) fl Page 2 Water service(no.linear ft.:_) ' Page 2 Subdivision: ( Lot no.: Fixture or item: Tax map/parcel no: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 per_ .•��- (�,� _w Clothes washer i 25.02 ('th/\�( 4 U C1 \ T,`=„``,e- Dishwasher j 25.02 (. k-RLv a1A4:k Drinking fountain 25.02 Q Ejectors/sump 25.02 ® PROPERTY OWNER 0 TENANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 mK 6w‘0‘... Floor drain/floor sink/hub 25.02 Address: Pb (.Ok- 1612. Garbage disposal 25.02 City/State/ZIP:-71,,,44 to -•i Y. 02_ 9-7 b Z Hose bib I. 25.02 Phone:(5n3) j tit- 0413 Fax:( ) Ice maker • 12.51 0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: Medical gas(value:$ ) Page 2 Contact name: �q�� Primer ��} 12.51 Roof drain(commercial) I�X J 12.51 Address, Sink/basin/lavatory 1\r`.,D' q 25.02 City/State/ZIP: Solar units(potable water) N. 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 5 12.51 E-mail: Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater i 37.52 Business name:\I Lt')n Ate,c lick&. aCt?s Water Pg/ tp ur DWV 56.29 Address: 2„1Z1 i ktt'r1 Av . Iva Other: 25.02 City/State/ZIP: Set IL_tnr.. 0a Q-7 3 61 Subtotal Phone:(5.03)5'• -Ct I 0 I Fax:( ) Minimum permit fee: $72.50 CCB Lie.: fii4 2.1 7 Plumbing Lic.no.: 2l{11 2(a e� Plan review (25n/n of permit fee) State surcharge(12%of permit fee) Authorized signature: 4erivv,`, 5istip„eirkel-i.-- TOTAL PERMIT FEE Print name: ei (3a"„eC�leo Date: c1// G.vz� This permit applicationrcomplete. expires if a permit is obtained within 180 days l7 t after It has been accepted as c *Fee methodology set by Tri•County Building Industry Service Board. I:Building\I'crmiisWLMU•I'crmitApp.doc 10/01/09 440.4616T(10/02ICOM*WEB) City of Tigard 71111 • COMMUNITY DEVELOPMENT DEPARTMENT a c � Building Permit Review — Residential 0 Building Permit #: 5 7- /LI/ Site Address: 10 f5ait k QaVjk sf Project Name: (A A 4-1 0(4 /P-omodzel Lot #: Planning Review A , /'�,� n ( �n ,, � Proposal: VOU (A. 1 I 1`t 9('1 `C 0/1 i Verify address/suite#active in Accela. ❑ In River Terrace: No ❑ Yes,River Terrace Review Addendum Site Plan Elements: J1 rnion-C.e E.P1 i3 copies of site plan on 8-1/2"x 11" or 11 x 17"paper brawn to scale(standard architect or engineer scale) tieDFootprint of new structure(including decks) and FFE North arrow niT"1 t 1 ti R entc(ran irarl f a aa'ti *Site address,project or subdivision name and lot number idewalk/driveway approach Applicant information(name and phone number) B�ecation of wells/septic systems T of dimensions and building setback dimensions , „are fnnrag.of b o s e I Street names egExisting structures on site 4C,nrn-s alev s-(9'contiauxs if more t an 4' if f « rial) Lage area,peiceniage of Loverage and >1,000 sf of impervious area created or replaced? ❑Yes*No , - , - - Im �'1es, st.caz z ter quality facility 1, inn? ElYes_DN.A. C� Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified p No Received: ❑ Yes ❑ No 7 Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs Required: Yes,applicant was notified ❑ No Received: Yes ❑ No HC-- ex t -€cam AD lied fir IT Yes 6�'No Received: ❑ Yes ❑ No Public Facilities Improvement (PFI) Permit: Required: ❑ Yes,applicant was notified No Applied For: ❑ Yes IT No,stop intake 0. d Tom. [ Zoning: k 3:S qu Required Setbacks: Front: c2,tor Rear: 15 t Side: t Street Side: C 5 t Garage: -74 I gi� TTBuild ing Height: Max. Height: 3 0' Actual Height: rt 0 CkQ1 yC L ''sr-arre-Area: % coverage 1lav Entianae set-back ua me.w th R'from street facing. 11 ❑ Pa,all l Au stieei Jr-arises 45-degrees or less 0 o area g a s re - 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 2na floor. Garage door width is ❑ 12'or less p6 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 ❑ Window recess ❑ Window projection ❑ Balcony 8—visual Clearance an ►4 Sensitive Lands: ❑ Yes rgb No Type: ❑ Conditi MO metp.ri,. r to issuance of building permit Notes: O 141 1Ll r`Q,V1 0 e Vt - tyl,C[udid ((n 1--e I/ kde 0' Approved By Planning: li 4'0 PI Date: cifi t2,Z Revisions (after Building Submittal only) Reviewer Date Revision 1: IT Approved ❑ Not Approved Revision 2: 0 Approved ❑ Not Approved I:\Building\Forms\BldgPennitRvw_RES_122419.docx Building Permit Submittal Original Submittal Date: l cJ A2 Site Plans: # Building Plans: # ?, Building Permit#: . Enter building permit#above. Workflow Routing: -Planning Engineering ,ermit Coordinator �-Building Workflow Sign-off: rSign-off for Planning(include notes from planning review) Route Application Documents: 'CI-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: A‘ Date: _ 5'1/7l Engineering Review Re lope at building pad: 4% Conditions "Met"prior to issuance of building permit nia, 2'Easements (encroachments)per engineering conditions of approval and plat N jw R'Water Quality/Quantity Facility: / Assess Water Quality Fee in-lieu: ❑ Yes Kt No Assess Water Quantity Fee in-lieu: ❑ Yes { 'No _/ LIDA Facility on lot: ❑ Yes L/ No Add Fee: ❑ Yes ❑ No L" Final Plat Recorded: N(g' ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: %r vi y Date: �Zf/?2 Revisions (after Building Submittal only) / Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review ` l 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: \1 DC 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 4;,...., LIDA ❑ Yes N/A OK to Issue Permit n / Approved by Permit Coordinator: b 1 \ Date: ,'�/e- 1/ I:\Building\Fonns\BldgPemutRvw RES_1208021.docx RECEIVE MAY 19 IOU CITY OF 1"lui-u.i. BLUILi' r ', '",If" Water Meter Fixture Unit Worksheet for Additions/Remodels/ADUs Please complete the following information: Customer Name: r'1 \A e W U Service Address: Street/Suite#: I O 13 O .5 il/0 N6Yetk t21c& rk. 37 City:--i-t a,y— State: © R Zip: Cis 1 22 3 Phone Number: 5 63 •-3 _O4c1 Email: YY\ ,LJ lit i'� owt e5 e M 4 ( t ii Please fill in the number of each fixture you currently have. Please fill in the number of fixtures you propose to add. Multiply the quantity by the point value to arrive at the current Multiply the quantity by the point value to arrive at total. the proposed total. Fixture Unit Current Point Current Proposed Point Proposed Quantity Value Total Addition Value Total Bar sink x 1 = x 1 = Bidet x 1 = x 1 = Clothes washer -- ./ x 4 = 4 f x 4 =4- Dishwasher / x 1.5 = I,,— 1 x 1.5 = I,5 1a Outside Water Spigot 1 x 2.5 =_2.S x 2.5 = Water Spigot,each add'I x 1 = x 1 = ,�•XiKitchen sink / x 1.5 = 1, x 1.5 = , t� sink ^— Y x 1.5 = x l.5 = r Lavatory(bathroom sink) 3 x I = 3 x 1 = 3 Water closet,I.6GPF(toilet) .)? x 2.5 = 7%5 ., x 2.5 = -7•, 5— Bathtub/whirlpool x 4 = x 4 = Shower stall / x 2 = 2 1 � x 2 = "s'7,. Bath/shower combo / x 4 = q_/ x 4 = Curr Points: �ltrr- Proposed Increase: ..'',�3,; re-- Current Points+Proposed Increase= =New Total Points =Required Meter Size 1� _ Meter Sizes: 1 to 30 points=5/8" 30.5 to 37 points='/," 37.5 and over points= I" rr �j New Meter Size Needed for New Total Points: Cost: $ 26i `rg7 .p 0 (see page 1) Current Meter Size per Utility Billing: u Cost: $_,1 Ux OdI 5•o° (see page 1) New Meter Size Cost minus Current Meter Size Cost= $_ 16,392.00 (This is Your Cost to Increase Meter Size Due to Additional Fixture Units) *************************************************a:*********************************** FOR OFFICE USE ONLY Meter will be required to upsize from 5/8" to 1" J Bentley 0519/22 Redline still requires 1" meter Current Meter Size Confi►7 ied with UB JBent 05/71/22 -- -. Signature of UB Representative Date ►:/Building/Forms/WaterMeters_070121 Add.dOCX Page 2