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Permit CITY OF TIGARD MASTER PERMIT 111 1- - °t 7' COMMUNITY DEVELOPMENT • -Permit#: MST2022-00270 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/03/2022 Parcel: 2S114AC00500 Jurisdiction: Tigard Site address: 9214 SW WAVERLY DR Subdivision: EAGLE VIEW ESTATES Lot: 2 • Project: Eagle View Estates, Lot 2 Primary Project Description: New primary dwelling with(1)attached ADU. Alternate Means and Method of fire separation reviewed and approved by building official. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 3 First: 871 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1431 sf Garage: 534 g sf • Front: 15 Smoke DwellingUnits: 1 Yes Third: 0 sf Right: 5 Detectors: Total: 2302 sf Value: $382,444.04 Rear. 15 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: 1 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 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: 4 Furry=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: 4 201-400 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 ye R-3 2302 Owner: Contractor: CBG SW 76TH AVENUE CANOPY BUILDING GROUP Required Items and Reports(Conditions) 15962 SW BOONES FERRY RD STE 15110 SW BOONES FERRY RD STE 500 1 Fire Rated Conditions 202 LAKE OSWEGO,OR 97035 2 Ersn Cntrl 503-639-4175 LAKE GROVE,OR 97035 PHONE: PHONE: 541-600-5146 FAX: Total Fees: $32,190.12 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. ATTENTIO • Oregon law requires you to follow the rules adopted by the Oregon Utility Notification er. Those rules are set fo in OAR oco_nnt_Mtn thrnnnh • _nMAnon Vr, may nhl-rnnv of tha ri Jae nr rlirart nu iaetinne+n rll INC by point,'"cnq 10A7 nr 1 Ann R39 9A44 Issued By: %r�./I� 4 Permittee Signature: Call 503.639.4175 by 7:00 = .for the next available inspection te. This permit card shall be kept in a consp cuous place on the job site until comp) ion of the project. Approved plans are required on the lob site at the time of each inspection. > j Building`Permit Application Residential RECEIVE FOR OFFICE USE ONLY City of Tigard AUG 17 20;'? Date/B : i4l�7i� �/ e ' - „_n 13125 S W Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503s98.1960 CITY OFTIGARD DateB : ra �i' .:�. J ##ht Inspection Line: 503.639.4175 q Date Ready/By: Juris: ® See Page 2 for TIGARD BUILDING DIVISION g Internet: www.tigard-or.gov Notified/Method: Supplemental Information 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 El Other: equipment,materials,labor,overhead,and the profit for theott CATEGORY OF CONSTRUCTION work indicated on this application. ? 7 ]tliLx, ❑x 1-and 2-family dwelling ❑Commercial/industrial Valuation: $ t300,090.00 I ❑Accessory building ❑Multi-family Number of bedrooms: 3 ❑Master builder ❑Other: Number of bathrooms: /q�. 3 4g 1 la JOB SITE INFORMATION AND LOCATION Total number of floors: 2" 2$N4 Job site a ess: Lot 2 SW WAVERLY DR New dwelling area: 2302 square feet 1431 City/State/ZIP: Tigard,OR _ Garage/carport area: 534 square feet s,I Suite/bldg./apt.no.: Project name: Eagle View Estate Lot 2 Covered porch area: 112 square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Eagle View Lot no.: 2 Permit fees*are based on the value of the work performed. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the j DESCRIPTION OF WORK1 work indicated on this application. r Proposal to construct a primary residential structure and an attached accessory dwelling Valuation: $ unit. Each unit is 2 stories in height. Existing building area: square feet New building area: square feet E PROPERTY OWNER 0 TENANT Number of stories: Name: CBG SW 76th Avenue,LLC Type of construction: Address: 15110 SW Boones Ferry Road, Suite Occupancy groups: i City/State/ZIP: 500 Lake Oswego,OR 97035 Existing: Phone:(503 ) 956-9307 Fax:( ) New: ® APPLICANT ❑ 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: Phone:(503 ) 956-9307 Fax: :( ) Amount received: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: sean@canopypdx.com - Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Submit two(2)sets of roof plan with connection details Business name: Canopy Building Group,LLC and fire department access,along with the 2010 Oregon Address: 15110 SW Boones Ferry Road,Suite 500 Solar Installation Specialty Code checklist. City/State/ZIP: Permit Fee(includes plan review $ Lake Oswego,OR 97035 and administrative fees): $180.00 Phone:( 503 ) 956-9307 Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lie.: CCB#232358 Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained , within 180 days after it has been accepted as complete. Print name: *Fee methodology set by Tri-County Building Industry Sean O'Neill Date: 08/09/2022 Service Board. I:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) . Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONLY Mil City of Tigard Receive: 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: No.: • Phone: 503.718.2439 Fax: 503.598.196D Associated permits: TIGARD 24-Hour Inspection Line: 503.639.4175 0 Electrical ❑ Plumbing ❑ Mechanical Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Ves No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 • ❑ 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0 3 Verification of approved plat/lot. 0 0 0 4 Fire district approval required. Name of district: ❑ 0 0 5 Septic system permit or authorization for remodel. Existing system capacity 0 0 0 6 Sewer permit. - 0 0 ❑ 7 Water district approval. ❑ ❑ 0 8 Soils report. Must carry original applicable stamp and signature on file or with application. ® 0 ❑ 9 Erosion control 0 plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ❑ 0 ❑ basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ® 0 0 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 ® ❑ ❑ 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 ® 0 0 and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ® 0 ❑ 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- ® ❑ 0 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,roofmg,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. ® 0 0 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 ® 0 0 locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 0 IZI 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 ® ❑ ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. ® ❑ 0 21 Energy Code compliance. identify the prescriptive path or provide calculations. A gas-piping schematic is required ® 0 0 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 N 0 architect licensed in Orc•on and shall be shown to be a .licable to the .ro'ect under review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". 0 0 0 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 0 0 0 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 0 0 0 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 0 0 27 "Drawn to scale"indicates standard architect or engineer scale. ❑ 0 0 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 0 0 Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ 0 ❑ 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 0 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\BOP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Applica, ECEIVED FOR OFFICE USE ONLY City of Tigard Received ? Date/By. Permit No.. 13125 SW Hall Blvd.,Tigard,OR 97223 A U G 7 ': ; Plan Review Phone: 503.718.2439 Date/By, Other Permit. TIGARU Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Juds ® See Page 2 for Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information TYPE OF WORK - M USE fiaq COMMERCIAI.FEE*SCHEDULE- CHECKLIST New construction ❑ Addition/alteration/replacement Mechanical permit fees*are based on the value of the work performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑ Other: mechanical materials,equipment,labor,overhead,and profit. Mill CATEGORY. OF CONSTRUCTION „-„ Value:$ 'c�' 1-and 2-familydwellingCommercial/industrial RESIDENTIAL EQUIPMENT/SYSTE1t1S FEES* 0 ❑ Accessory building For special information use checklist ❑ Multi-family ❑ Master builder ❑ Other: Description Ea Total JOB SITE 1NFORMMiON AND LOCATION °s i' h1 im-- Heating/cooling: Job site address: i. ` Air conditioning 46.75 r— Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: Furnace 1 OQ0110-BTU(ducts/vents) S4 91 Suite Bldg./apt.no.:� Project name:ricr. e U� Heat pump d i lJl, Ductwork -� 2i32 Cross street/directions to job site: C f ) i ' /51Allalz-i Wl,✓ 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: ��e-lP �) l - Lot no.: a Other: 23.32 Tax map/parcel no.: ✓ Other fuel appliances: Water heater 23.32 DESCRIPTION OF WORK -. - - Gas fireplace/insert 33.39 1i L� 1. '-� Flue vent for water heater or gas `--'' �' "�' �'� 1 fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33 39 Wood fireplace/insert 23 32 Chimney/liner/flue/vent 23.32 ii'PROPERTY OWNER ❑.TENANT Other - - 23.32 Name: rY r t� Environmental exhaust and ventilation: f�l ps 0 f` Range hood/other kitchen Address: equipment 33.39 Clothes dryer exhaust 33.39 City/State/ZIP: Single-duct exhaust(bathrooms, Phone:( -6 ) r r,� Fax ( ) toilet compartments,utility rooms) 23.32 t ---_, . Attic/zrawlspace fans 23.32 - PLIC.ANT 0 CONTACT PERSON Other 23 32 Business name: Fuel piping: Contact name: �,)__e_t ���I $14.15 for first four;$4.03 for each additional Furnace,etc. Address: Gas heat pump City/State/ZIP: Wall/suspended/unit heater - Water heater ' Phone:( ) Fax: :( ) Fireplace E-mail: Range 1 -` .. 1 ONTRACTOR t '="4' 'r� s� C + „2 - Clothes d 1 dryer(gas) Business name: Co 11 Other Address: I c>c{� 1\r' �{' MECHANICAL.PERMIT FEES* r� i p 1 Subtotal City/State/ZIP: D!� L t Y Minimum permit fee($90.00) Phone:(VI ) ) -- 911 Fax:( f a Plan review(25%of permit fee) CCB tic.: �1' 60 i UUU State surcharge(12%of permit fee) TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 Authorized signature: days after it has been accepted as complete. /`�s " Fee methodology set by Tri-County Building Industry Service Board Print name: Date: j014'0/l (i r i 1Building\PermitstMEC PermitApp 082520.doc 4411-4617T I4121C M/WEB) 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\M EC_PermitApp_082520.doc 2 Electrical Permit Application FOR OFFICE USE ONLY City of Tigard -i'E C E I V E11 Received Permit#: Dste/By: 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review : . Phone: 503.718.2439 Fax: 503.598.1960 AUG 1 II Date By: Related Permit ut 6 T I G A R D Inspection Line: 503.639.4175 Ready Date/By: huis: ® See Page 2 for Internet: www.tigard-or.gov CITY OF TIU/HL. Notified/Method: Supplemental Information TYPE OF weitlltILUING. DIVISION PLAN REVIEW roWew construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans is/items checked): Aolt 0 Service or feeder 400 amps or mare ❑Building over three stories. r 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. ig 1 and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-we agricultural Multi-family El Master builderampsirefor all otherinstallations. buildings. 0 Other: 0Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND L TION .e.) w 0 Emergency system. larger separately derived Job#: �� I Job site address: (� ) amp /��/ly ❑Addition ofore.new motorload of system. +y V' VVV"`"'"' 1 (/ e., IOOHPnr nee. ❑"A" ", City/State/Z 1P: A �-{ ❑Six or more residential units. occupancy. V' i---a / , ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: L4).-1-Project name: f 1 ❑]Ivardous locations. ❑Supply voltage for more than ', ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: �,-Of 1 FEE SCHEDULE / Description I Qty. I Each I Total I " New residential singk-or multi-family dwelling unit. Subdivision: Fererk. A�1F—'41g I Lot#: Includes attached garage. Tax map/parcel#: U_V 1,000 sq.fl.or less t 168.54 4 ��-J�{y/,, �� Ea.add'l 500 sq.ft.or portion t 33.92 I ` DES 1ekil1-f' l^v'/WORK Limited energy,residential J /]IVI (with ited above, ft.) 75.00 2 Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 'PR�OjPERTY OWNERI/1/ f�! ❑ TENANT Services or feeders installation,alteration,and/or relocation Name: l L t(' S /6' L _. ,tp 1. LL uG/� 200 amps or less i 100.70 2 Address: a ,)/mod' p (N DV 'l ;2--- //_. I r< r ' 201 amps to 400 amps401 133.56 2 y l.0[4 l_ d "'Tax: ( ' v L xT _ ,_-4 o1rJ 601 amps to 600 amps 200.341 2 City/State/ZIP: Z7(�� 1` amps to 1,000 amps 301.04 2 Phone:( , ! ) Fax:( ) /"t/ Over 1,000 amps or volts 552.26 2 r 0 Temporary services or feeders installation,alteration,and/or Email: I f ta' d _' cc' -L relocation Owner installation:This installation is being made on property that Imo which is not 200 amps or less 1 59.36 I intended for sale,leas ant,or ex hange,accord]ngSn.OR&49`,4'4Y,670,,Canol 7 201 amps to 400 amps 125.08 2 Owner signature: .12/� � Date: ` >7J � !f' 'i amps to 599 amps = 168.54 —e APPLICANT 0 CONTACT PERSON Branch branch-new,alteration,or extension,per panel ''��,,,,pp�� A.Fee for branch circuits with Business name: S74 r _ above service or feeder fee, yt each branch circuit 7.42 2 Contact name: P B.Fee for branch circuits without Address: service or feeder fee,first 56.18 2 branch circuit City/State/ZIP: Each add']branch circuit 7.42 2 Phone: Miscellaneous(service or feeder not included) ( ) Fax: :( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name C�tt, • Af`l 7 Sign or outline lighting 6 67.84 2 � `,� y 0 L Signal circuits)or limited-energy Address: /( O S� '-'1 l� {arnel,altemt on,or extension. 0 See Page 2 2 City/State/ZIP: d✓f-{-� ( �'��l Each additional inspection over allowable in an of the above ��'� 111l/ [�i CCCC 1t 1 Additional inspection(I hr min) 66.25/hr Phone:( enb %--�6 v( Fax ( �C/T' Investigation(1 hr min) 90.00/hr ✓ l/1 e r C /V Industrial plant(1 ihrs min) 78.18/hr Email: LP�j/� p / Inspections for which no fee is 90.00/hr CCB Lic.: (�5acf Electrical Lic.: �' C, Suprv.Lie.: l95soF✓ specifically listed('A=hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: Date: 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: do This permit application expires if a permit is not obtained within 180 Print name: )x ,' p Date: �t(�� cl days after it has been accepted as complete. U � ' Number of inspections allowed per permit. I.\BuildinglPermhs1ELC PermitApp ELR_ERE.doc Revy V l (06/17%2015 44o-461 T(l1/05 OM/WEB _, Plumbing Permit Application Site Utilities RECEIVED FOR OFFICE USE ONLY City of Tigard Received Permit No.: IIII • 13125 SW Hall Blvd.,Tigard,OR 97223 A U G l 7 2[? '' Plan Review 0 Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.: Ti G A R D Inspection Line: 503.639.4175 CITY OF TI G AR G Date Ready/By: .nuns: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method. Supplemental Information TYPE.OF WORK. - FEE'* SCHEDULE •ui'.- - _ .�..,, ems:. b, -.:<J,ft a .. .. .. �.u _ „_. ,. ,, Ei( New construction ❑Demolition For special information use checklist. Description I Qty. I Ea. I Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION Vim' <:,f SFR(1)bath 312.70 IV- and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 SFR(3)bath ' 500.32 sera. ❑Accessory building 0 Multi-family Each additional batb/ldtchen 25.02 O ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: l a/y ,vi ' Catch basin or area drain 18.76 v Drywell,leach line,or trench drain 18.76 City/State/ZIP: r � Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: ltProject name: / f: Manufactured home utilities 50.03 Cross street/directions to job s___ite: J N` i, f Manholes 18.76 Rain drain connector i 18.76 l d r?a, Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 �I � Watereerice(no.linear ft.:_) Page 2 Subdivision: �(�..�,.1_((�JJ„ 'i Q e_?( Lot no.: 3 Fixture o re or item: Tax map/parcel no.: Backflow preventer 31.27 , j , 5' n.'' .>'A Backwater valve 12.51 _ llESCRIPTTON OF WORK A ,/ L Clothes washer 25.02 2 5:d a I V RP I- 1 c r[,( 1('51-1 f) ��- - a 'Ate- Dishwasher 25.02 Q f c Drinking fountain 25.02 Ejectors/sump 25.02 El--PR�O1 PEATY O W NERL) t _ v ❑ TENANT, Expansion tank 12.51 Name: C �. S Ui 2 6�( r'/ t4 ( . Fixture/sewer cap 25.02 �_I Floor drain/floor sink/hub 25.02 .Address: /J 4o F ( 11 )C Garbage disposal ) 25.02 at.., _6'_ City/State/ZIP: ,(/() * ffff���J l� a. - Hose bib 25.02 5'f a. Phone:(51,31 3 d 0 / Fax:( ki j Ice maker 12.51 - 'PLICANT 1 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: S(M,tQ Medical gas(value:$_) Page 2 `�� �` Primer 12.51 Contact name: ) Qyt t 6,tiler Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( / ) Fax::( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 r, Water closet 25.02 CONTRACTORT Water heater 1 37.52 9D, - Business name: If I I a vlc c e ,`7)J�J /) � o f Waterpiping/DWV 56.29 Address: LJ (�( N (~Z✓ (�0 b (v �`t IfJI Q(/UIiJ / Other: 25.02 City/State/ZIP: ( � ( 4 472 O 6 0 Subtotal L/ aMinimum permit fee: $72.50 Phone:( ✓ 1 Y V - 3 C(' � Fax:( !" �--' Plan review (25%of permit fee) CCB Lie.: i g p�gro. Plumbing Lic.no.: State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE r This permit application expires if■permit is not obtained within ISO days Print name: 5 Q�I �f Q�y� Date: `�a� �]7�_/ og sit bar beenuntyBuil an Industry CJ��U f *Fee methodology set by Tri-County Building Industry Service Board. l:\Building\Permits'PlMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WES) City of Tigard 1114 4 COMMUNITY DEVELOPMENT DEPARTMENT TIGARD Small Form Residential Supplemental (Non-RT) Building Permit #: ticS7ur� Project Name: eAc0 4 € lcl Site Address: 61 Z f L 5w vjA✓tf2-/ c- l itc ( 4riyrlyd-) Lot #: Total Existing Units: 0 One ❑ Two ❑ Three New Configuration: F Single Detached 0 Duplex 0 Triplex p"+ADU Small Form Residential Standards >ifie_ �1�n 5h�u J , ;; I`� . > Setbacks 0 Front: iY Rear: I Side: Street Side: Ir Garage: Za Height ❑ Max. Height: 3Q Actual Height: 2-`P Landscape ❑ Landscape Area: ?A? % Lot Coverage Max: 8D 0/0 Entrance t back no more than 8' from street-facing wall Parallel to street or offset 45 degrees or less Windows f' 1inimum 12% of area of all street-facing facades Garage Garage door is behind widest street-facing wall ❑ YPs PA'No, and one of the following is met: O Door extends no more than 5' from wall and there is a covered porch ext ing beyond garage. oor extends no more than 5' from wall and there is a 12 sq ft. window above garage on 2nd floor. Garage door width is: ❑ 12' or less 1fill( % or less of facade 60% or less and includes 7 of following: ❑ Covered porch ❑ Recessed entrance Cif Wall offset p°i' Roof eave 0 Roof offset Fire shingles &Lap Siding 'Gable, hip, gambrel roof ❑ Dormer ❑ Roof pitch 0 Accent siding RI/Window trim ❑ Window recess ❑'Window projection ❑ Balcony ,- Approved By Planning: —/1' - Date: -- S /i 7/ZC I:1Building\Fom \RldgpermtRvw_SFR Supplemental 070722 .1 I City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT 111 T GAR® Building Permit Review - Residential Building Permit #: /I-GS7 2-2- (�IJZ 'I ) Site Address: 1 Z i y sw r,_,R +--,1 '7yz 1 VE Project Name: EA .t- Yl -I) Lot #: ,z- Proposal: Nezd SI'HALA_ Fiatvi 1Q)1I2a1nAL /Alir Land Use Case: Sur32ol9-o000Z- Zone: ets-g Required Submittal Elements copies of site plan if.- L Square footage of buildings to be demolished prawn to standard scale Footprint of new structure and FFE Ll rth arrow vIr li=l stained trees, drip line / tree protection e address, project name, lot # ® Street trees shown / labelled eet names Sidewalk / driveway shown and dimensioned Applicant name and phone # 12r Utility locations & easements (new / additions) ❑ Lot and setback dimensions k m J,ocation of wells / septic systems rite [� M E1isting structures on site Lot area and lot coverage percentage Erosion control IZrrorner elevations (2' contours if > 4' differential) IEP Vision clearance triangle shown ©`Ground slope at building pad calculated / shown Pi- nning Review F,. 0-'..Verify address / suite # active in Accela. 2(Clean Water Services - Service Provider etter (lot platted prior to 9/10/1995) Required: ❑ Yes No -' Received: ❑ Yes El No ,ElPublic Facilities Improvement (PFI) Permit: Required: ❑ Yes ErNo Applied For: ❑ Yes ❑,o, stop intake p'Sensitive Lands: ❑ Yes Er No Type: .0 Housing Supplemental Sheets Completed ❑ Cottage Cluster C&O (1 site, 1 per unit) 0 Quad ❑ Courtyard Units C&O (1 site, 1 per building) ❑ gowhouse ❑ Cottage Cluster Type II (1 per unit) f Small Form Residential / ADU ❑ Courtyard Units Type II (1 per building) ❑ River Terrace Addendum ❑ Conditions met prior to issuance of building permit L0\rd AP CQSQ._ - Approved By Planning: — Date• `3', 471Z2 Notes 'Po nSUF 6F' ()Mu- y,N,t<- PI-or APRiove.0 Revision 1: N Approved El Not Approved 1 Date: // //z Revision 2: ❑ Approved ❑ Not Approved Date: I9BuildinglFormsg31dgPermitRvw Res 070722,docx Buildi„g Permit Submittal Original Submittal Date: ? 72-2. Site Plans #: Building Plans #: 2 Building Permit #: '❑-Building permit # entered on page 1 Workflow Routing: lanningrAa'Engineering,.0 Permit Coordinator.0-Building Workflow Sign-off: Ai-Sign-off for Planning (include notes from planning review) Route Documents: - Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. /6 Building: original permit application, site plans, building plans, engineer and beam calculations and trust details, if applicable, etc.AZ Permit Technician: Date: /Ji�7 f1/2 L Notes Engineering Review Slope at building pad verified Slope: az J 'Conditions met prior to issuance of permit Gwo,rielt5 140 Isements (encroachments) per engineering conditions of approval and plat •Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes EAo Assess Water Quantity Fee in-lieu: ❑ Yes LIDA Facility on lot: ❑ Yes IlreNo Add Fee: 0 Yes 0 No Ai Final Plat Recorded ►.ivr tl 1 rrcc"-d..tot iv/Lf{4 - 1-19bNOT Approved Date: 8 'te'z9 f Notes DO fdm-r 145V1, I`-e,nst- et.4►a 9-a SHe�.� 5T IC.r+ SAu�rrAs. C wa�IfL 2.012. 5 A154, 4,4 -1-744 s ,.itr.a- Ai or Am 17 fiRr Nttd tiGGLz Approved By Engineering: Date: Revision 1: ❑ Approved ❑ Not Approved -7--emai- Date: <<1/2/2ilu- Revision 2: 0 Approved 0 Not Approved Date: Permit Coordinator Review Conditions met prior to issuance of permit u Approved, NOT Released: Date notified applicant: i ;ENG Revisions Required: kA\ckc i, Date notified applicant: er SDC Exemption: 0 Received 111. Does not apply II-SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes 0 N/A Tigard Trans SDC: ❑ Yes ❑ N/A Parks SDC: 0 Yes ❑ N/A LIDA ❑ Yes 7N/A Ell OK to Issue/Approved by Permit Coordinator: Date: Revision 1: Approved ❑ Not Approved ( 1 \ ��`�� Date: Revision 2: 0 Approved ❑ Not Approved Date: