Permit CITY OF TIGARD MASTER PERMIT
>� ® Permit#: MST2022-00375
COMMUNITY DEVELOPMENT
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/28l2022
Parcel: 2S114AC00500
Jurisdiction: Tigard
Site address: 9231 SW WAVERLY DR
Subdivision: EAGLE VIEW ESTATES Lot:
Project: Eagle View Estates, Lot 4-Primary
Project Description: New primary dwelling with(1)attached ADU. PER BO, NO FINAL UNTIL LOT NUMBER HAS
BEEN CONFIRMED AND APPROVED BY ADDRESSING DEPT.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 710 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1115 sf Garage: 388 sf Front: 19 Smoke
Yes
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors:
Total: 1825 sf Value: $298,784.59 Rear: 4
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: 2 Backwater Value: 1 Bckflw Prevntr: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Fum<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 2
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add"500 sf: 3 201-400 amp: 0 201-400 amp: 0 WIG Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System; N Garage Opener: N All Y
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 1825
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 Ersn Cntrl 503-639-4175
202 LAKE OSWEGO,OR 97035
LAKE GROVE,OR 97035
PHONE: PHONE: 541-600-5146
FAX:
Total Fees: $30,306.50
This permit is Issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work
will be done in accordance with approved plans. This permit will expire If work Is not started within 180 days of issuance, or if work is suspended for more
the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
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l
Issued By: e+si.._- & � Permittee Signature: � e _
�.4 503.639.4175 by 7:00 a.m.for the next available Inspectio4
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.
Kullding Permit Application
Residential RECEIVE. FOR OFFICE USE ONLY
City of Tigard O C T 5 2022 DateiDate/By:ved /f 0(� Permit No.: St�O�J��3 5
'. 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ! ! ` `_ '
ail
Phone: 503.718.2439 Fax: 503.598.1960CITY OF TIGARD Date/By: 1 /A 0-2. 2
TIGARD Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By: ��� Lam la See Page 2 for
Internet: www.tigard-or.gov Not'regMelhod y Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
®New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application. Zigi 7 gl`e 5i
❑x 1-and 2-family dwelling ❑Commercial/industrial Valuation: $ 390 9A6 99.
❑Accessory building ❑Multi-familyNumber of bedrooms: 3
Master builder D Other: Number of bathrooms: 3 7
JOB SITE INFORMATION AND LOCATION Total number of floors: 2 2Z6
Job site address: Lot 5 9231 SW WAVERLY DR New dwelling area: 1825 square feet 5
�� 111
City/State/ZIP: Tigard,OR Garage/carport area: 38g square feet `Z lb
Suite/bldg./apt.no.: Project name: Eagle View Estate Li i Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
\� p • Gf - _ REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Eagle View Lot no.: �` " I 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.: hea equipment,materials,labor,over
d and the profit for the
DESCRIPTION OF WORK work indicated on this application.
,9 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
Q PROPERTY OWNER ❑ TENANT Number of stories:
Name: CBG SW 76th Avenue,LLC Type of construction:
Address: 15110 SW Boones Ferry Road, Suite
Occupancy groups:
City/State/ZIP: 500 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): _r 1 j`i
Contact name: Sean O'Neill
FLS plan review fee(if applicable):
Address: 15110 SW Boones Ferry Road,Suite 500
Lake Oswe o,OR 97035 Total fees due upon application:
City/State/ZIP: g
Amount received:
Phone:(503 ) 956-9307 Fax: :( )
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: sean@canopypdx.com
CONTRACTOR Commercial and residential prescriptive installation of
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: 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 �/d !�
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: Sean O Neill Date: 08/09/2022 *Fcc methodology set by Tri-County Building Industry
Service Board.
l:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 r 440-4613T(l 1/02/COM/WEB)
— 1
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLY
Cityof Tigard Received
g Date/By: Permit No.:
■ 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 0 Electrical ❑ Plumbing El Mechanical
TIGARD Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes 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. ❑ ❑ ❑
3 Verification of approved plat/lot. ❑ ❑ ❑
4 Fire district approval required. Name of district: ❑ 0 0
5 Septic system permit or authorization for remodel. Existing system capacity _ ❑ ❑ ❑
6 Sewer permit. ❑ , 0 0
7 Water district approval. ❑ ❑ ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. [ ❑ ❑
9 Erosion control El plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ ❑
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ® 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 ® ❑ ❑
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 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,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. ® 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- ® ❑ 0
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 ❑
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
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 ® 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 ❑ ® ❑
architect licensed in Ore_on and shall be shown to be applicable to the .m'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". ❑ ❑ ❑
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 ❑
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ 0 0
27 "Drawn to scale"indicates standard architect or engineer scale. 0 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 ❑
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ ❑
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, ❑ ❑ ❑
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 r FOR OFFICE USE ONLY
City of Tigard F EE' tl E Received Permit No.:
Date/By:L
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
P 11! ill
Phone: 503.718.2439 CCT 2022 Date By: Other Permit:
T I G ARD Inspection Line: 503.639.4175 Date Ready/By: runs: El See Page 2 for
w Internet: ww.tigardor.gov f � { y o
CITY Y V 1 Il2P{HU Notified/Method! Supplemental Information
TYPE OF WORK COMMERCIAL FEE*SCHEDULE-USE CI I ECKI AST
la 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 ❑ Commercial/industrial ❑ Accessory building
For special information use checklist.
0 Multi-family ❑ Master builder ❑ Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Job site address: 9231 Waverly Drive Air conditioning 1 46.75 46.75
Furnace 100,000 BTU(duets/vents) I 46.75 46.75
City/State/ZIP: Tigard,OR 97224 Furnace 100,000+BTU (duets/vents) 54.91
Suite/bldg./apt.no.: Project name: Eagle View Estates Subdivision Lot 5 Heat pump c 61.06
Duct work 1 23.32 23.32
Cross street/directions to job site: SW 92nd and Waverly 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: Eagle View Estates Lot no.: Other 23.32
Other fuel appliances:
Tax map/parcel no.: WCTM 2S 112CD,Tax Lot 00400 Water heater 1 23.32 23.32
DESCRIPTION OF WORK Gas fireplace/insert %K. X 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 2 stories Log lighter(gas) 23.32
Wood/pellet stove 33.39
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: 15962 Boones Ferry Road,Suite 202 equipment I 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) 4 23.32
Phone:(503 ) 9569307 Fax:( ) Attic/crawlspace fans 23.32
❑ APPLICANT ❑ CONTACT PERSON Other: 23.32
Business name: CBG SW 76th Avenue,LLC Fuel piping:
S14.15 for first four;$4.03 for each additional
Contact name: Sean O'Neill Furnace,etc. I
Address: 15962 Boones Ferry Road,Suite 2020 Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
tY Lake Oswego,OR 97035 Water heater
Phone:(503 ) 9569307 Fax::( ) Fireplace "1.-I'.„,
E-mail:sean@canopypdx.com Range 1
Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Jacobs Heating and Cooling Other:
Address:4474 SE Milwaukie Ave- MECHANICAL PERMIT FEES*
Subtotal
City/State/Z1P:Portland,OR 97202 Minimum permit fee($90.00)
Phone:(503-413-9796 ) Fax:(N/A ) Plan review(25%ofpermit fee)
/ State surcharge(12%of permit fee)
CCB tic.: 1441 /�/1512 V TOTAL PERMIT FEE
th,ca3ig..wd by. f `
Sze- a t � This permit application expires if a permit is not obtained within 180
�7- days after it has been accepted as complete.
PrintAuthorizedname:
:Slgriean �,.,,E, , * Fee methodologyset Tri-Coon BuildingIndus Service Board
Sean Cr NCI 1 1 a'5""" S... by t al
Print name: Date:10/03/2022
I:\BuildingWemutatMEC_PermitApp_082520.doc 440-0617T(t 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
1:1Building\Permits\MEC_PermitApp_082520.doc 2
DocuSign Envelope ID:7AA377A6-4649-400E-BF5F-4FE6AD73FDFF
Electrical Permit Application RECEIVE FOR OFFICE USE ONLY
City of Tigard �J Daffy: Permit p:
I Mg • 13125 SW Hall Blvd.,Tigard,OR 97223 (t"r J 2022 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 J Date/By: Related Permit#:
Inspection Line: 503.639.4175 r r ?1f 7 - t. : Ready Date/By: runs H See Page 2 for
I]GARI). Internet: www.tigard-or.gov • Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
0 Demolition ID Other:
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
[tl-and 2-family dwelling ❑ Commercial/industrial ❑Accessorybuilding less m ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑ Multi-family ❑ Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: Job site address: 9231 WaverlyDrive ❑Addition of new motor load of system.
100HP or more. ❑"A" "E»"I-2""1-3"
City/State/ZIP: 0 Six or more residential units. occupancy.
ty Tigard,OR 97224 0 Health-care facilities. 0 Recreational vehicle parks.
Suite/ldg./apt.#: Project name: Eagle View Lot 5 Primary 0 Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal_
Cross streetdirections to job site: 92nd and Waverly FEE SCHEDULE
Description I Qty. I Each 1 Total 1
New residential Subdivision: -/ Includes attachedn gle- r multi-family dwelling unit.
Eagle View Estates Subdivision Lot#: ,� garage.
1,000 sq.ft.or less 1 168.54 168.5r 4
Tax map/parcel#: WCTM 2S112CD,Tax Lot 00400 Ea.add't 500 sq.ft.or portion 1 33.92 67.84 1
DESCRIPTION OF WORK Limited energy,residential
(with above sq.ft.) 75.00 2
Proposal to construct a primary residential structure and an attached accessory Limited energ
y,multi-family 75.00 2
dwelling unit. Each unit will be be 2 stories residential(with above sq.ft.)
Renewable Energy j 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 I 100.70 100.7( 2
Address: 201 amps to 400 amps 133.56 2
15962 Boones Ferry Road Suite 202 401 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@canopypcbc.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 I 59.36 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
Branch circuits-new,alteration,or extension,per panel
[f APPLICANT ❑ CONTACT PERSON A.Fee for branch circuits with
Business name: CBG SW 76th Avenue,LLC above service or feeder fee, 7.42 2
each branch circuit
Contact name: Sean O'Neill B.Fee for branch circuits without
service or feeder fee,first
Address: 15962 Boones Ferry Road Suite 202 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:tin@jarmer.com lab �i c Inspections for which no fee is
specificallylisted(1 hr min) 90.00/hr
CCB Lic.:6924 Electrical Lie.:26-144C Suprv.Lic.:6365S
ELECTRICAL PERMIT FEES
Supaev.Electrician signature,required: n Z..7`/G j�f s. Subtotal:
Print name:Tim farmer Date: n Plan Review Required(25%of permit fee):
o..caSIgnee by. State surcharge(12%of permit fee):
�1 r TOTAL PERMIT FEE:
Authorized signature:[ t.4t&, tit
3560608B3F70433... This permit application expires if a permit is not obtained within 180
Print name: Sean 0'Nei 11 Date: 10/03/2022 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\BuildinglPermits\ELC PermitApp ELR_ERE.doc Rev 06/17/2015 440-46157(11/05/COh4/WEB
_..m-_;-_.._,...-..In.-an n077ni.Cne 4nn .DCAC ACCRCrl77Cf1CC
DocuSign Envelope ID:AB207A5E-7CDF-4E1 E-9A58-50F92E4440C9
leci>Ical Yermlt Appucanon �t(1,F v I OR OFFICE 1:sE.ON I
City of Tigard - Received
Datugy. Pem,+t ff:
13125 SW Hall Blvd.,Tigard,OR 97223 fl"T ; 2022 Plan Review
' Phone: 503.718.2439 Fax 503.598.1960 Dated3y: Related Permit p:
Inspection Line: 503.639.4175 CITY OF 11(aHHLi Ready Day ludo, fa See Pagel far
r G A I;l; Internet www.tigard-or.gov .. _ ...
Notified/Method: Supplemental Information
TYPE OF WORK r . I PLAN REVIEW
®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/1t mess checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
El Demolition El Other: i where the available fault current 0 Mmines and boatyards.
CATEGORY OF CONSTRUCTiON exceeds 10,000 amps at 150 volts or 0 Floating buildings
® 1-and 2-family dwelling ElCommercial/industrial ❑Accessory building less to ground o exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑ Multi-family ❑Master builder ['Other: 0 Fire pump. 0 installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
-- ❑Addition of new motor load of system.
Job#: Job site address: 923I Waverly Drive I00HP ormore. ❑"A","E"."f-2","k-3".
❑Six or more residential units. occupancy.
City/State/ZIP: Tigarldx OR 97224 ❑Health-care feelings. ❑Recreational vehicle parka.
Suite/bldg./apt#: Project name: Eagle View Lot 5 Primary ❑Hazardous locations. ❑Supply voltage for more Chao
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: 92ad and Waverly FEE SCHEDULE
•.•. »meltQ[wa re,g. 1 Each i Told
New residential single-or multi-family dwelling unit.
Subdivision: Eagle View Estates Subdivision Lot#:a dil Includes attached garage.
Tax map/parcel#: WCTM 2S112CD,Tax Lot 00400 a.add.5 or sq.ft 1 133.52 6?fr85i 1
Fa.add'I 500 R.or portion I 3332 1
DESCRIPTION OF WORK Limited energy,residential
(with above sq.ft) 75.00 2
Proposal to construct a primary residential structure and an attached accessory
_. ... Limited energy,multi-faintly 75.00 2
dwelling unit Each unit will be be 2 stories residential(wit above au.ft.)
Renewable Energy 11 See Page 2
®PROPERTY OWNER I :1-"TKNANT' Services or feeders installation,alteration,and/or relocadoo
Name: CBG SW 76th Avenue,LLC 200 amps or less 1 100.70 100.7t 2
' 201 amps to 400 amps 133.56 2
Address:
15962 Boones Ferry Road Suite 202 401 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 I Pax:( ) Over 1,000 amps or volts 552.26 2
Email: seen@canOPYP .com Temporary
mrelo tl a services or feeders installation,alteration,and/or
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 to599 amps 168.54 2
-_ ---- "- Branch circuits—new,alteration,or extension,per panel
CI APPLICANT ❑ CONTACT PERSON A.Fee for branch circuits with
Business name: CBG SW 76th Avenue,LLC above service or feeder fee, 7.42 2
each branch circuit
Contact name: Sean O'Neill B.Fee for branch circuits without
ervAddress; 15962 Bermes Ferry Road Suite 202 bsra chcrfeedarfce,first rcuit 56.18 2
City/State/ZiP: Lake Oswego,OR 97035 Each add'!branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( 503 ) 9569307 Fax::( ) Each manufactured or modular 67,84 2
dwelling,service and/or feeder
Email: sean@canopypdx.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 1 67.84 67.84 2
Business name:Termer Electric Signor outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address:5105 SW 45th Avenue# 100 panel,alteration,or extension. 0 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) 6625/hr
Phone:(503 )246.5381 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:tim(c�jarmer,ctlm Industrial plant(I hr min) 78.18/hr
Kali, .S`� Inspections for which no fee is 90.06/br
CCB Lic.:6924 Electri i aea3(arH4(i Suprv.Lie.:6365S specifically listed(A hr min)
.�.c �.'A.� ELECTRICAL PERMIT FEES
•
Suprv.Electrician 5igne3are Ioyair..v I tM1 Jd'e"ttr _ Subtotal: _
Print name:TimJanner 472C61799C29446._ Date: 11/21/2022 Pion Review R ired(25%ofpermitfee):
t ..sw ,eon- l— -- State surcharge(12%of permit fee): C
. o..
Authorized signature:I S.LAVA, te 1 .lU TOTAL PERMIT FEE:
35666Caa3r T0455... This permit appliotlan expires ifs permit is not obtained within 180
Print name: Sean 0'Nei 11 Date: 10/03/2022 days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:tnuildne PenmiutELC PermilApp ELR_PRE.doc Rev96/17/2015 440-0615T(11/05/COM/WEB
DocuSign Envelope ID:7AA377A6-4649-400E-BF5F-4FE6AD73FDFF
• Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Description - -- Qty. I Each I Total (
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
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 552.26 2
with OAR 918-309-0040)
❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
n Vacuum Systems* >100 kva-no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 66.25/hr 1
charged at an hourly(I hr min)
Inspections for which no fee is 90.00/hr
specifically listed(Va hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Subtotal(Enter on Page 1):
Fee for each commercial system: S75.00 • Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
(1 Fire Alarm Installation
[� HVAC
(i 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
t:\BuildinglPermits1ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015
DocuSign Envelope ID: 7AA377A6-4649-400E-BF5F-4FE6AD73FDFF
Plumbing Permit Application
Site Utilities REC .-FIVE'. FOR OFFICE USE O\l.\
City of Tigard �nqq Received
Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 L..J J LL Plan Review
` Il Phone: 503.718.2439 Fax: 503.598.1960 deg Other PermitNo.:
•
Inspection Line:503.639.4175 f V ' )` ^`'`'(' y
I I t,\R 1) P Date Ready/By. Juns: 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental information
TYPE OF WORK FEE* SCHEDULE.
New construction ❑ Demolition For special information use checklist.
Description i Qty. I Ea. I Total
❑ Addition/alteration/replacement ❑ Other: New 1-2-family dwellings(includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
® 1-and 2-family dwelling ❑ Commercial/industrial SFR(2)bath 437.78
❑ Accessory building El Multi-family
SFR(3)bath 1 500.32 500.32
Each additional bath/kitchen 25.02
❑ Master builder El Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Catch basin or area drain 18.76
Job site address: 9231 Waverly Drive
City/State/ZIP: Tigard,OR 97224 Dtywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldgJapt.no.: Project name:Eagle View Estates 5 Manufactured home utilities 50.03
Cross street/directions to job site: SW 92nd and Waverly Manholes 18.76
Rain drain connector I 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: Eagle View Estates I Lot no.:i y Fixture or item:
Tax map/parcel no.: WCTM 2S 112CD.Tax Lot 00400 Backflow preventer 1 31.27 31.27
f•1 ;, Backwater valve 12.51
`;r/ ecr .>.,�,4>T4 DESCRIPTION OF WORK y j �$s
Clothes washer 25.02
Proposal to construct a primary residential structure and an attached accessory Dishwasher I I 25.02
dwelling unit.Each unit will be be 2 stories
Drinking fountain 25.02
Ejectors/sump 25.02
n{PROPERTY OWNER failol' , ❑ TENANT Expansion tank 12.51
Name: CBG SW 76th Avenue,LLC Fixture/sewer cap 25.02
Address: 15110 SW Boones Ferry Road,Suite 500 Floor drain/floor sink/hub I 25.02
Garbage disposal I 25.02 25.02
City/State/ZIP: Lake Oswego,OR 97035 Hose bib I 25.02 25.02
Phone:( 503)9569307 Fax:( ) Ice maker 1 12.51 12.51
n AYYLILANI n CON'I'ACl'.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: 15962 Boones Ferry Road,Suite 202 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
Urinal 25.02
E-mail: sean@canopypdx.cmn
CONTRACTOR , -, Water closet I I 25.02 I I
Water heater I 37.52 37.52
Business name:Alliance Plumbing Water P ip P m WV 56.29
Address:146 W Historic Columbia River Hwy. other: 25.02
City/State/ZIP:Troutdale,OR 97060 J Subtotal
Phone:((503)492-3490) Fax:( ) /If 5 /2 Minimum permit fee: $72.50
Plan review (25%of permit fee) I I
COI Lie.: 184601 Plumbing Lic.no.: 196752.
7 d�.aalsyned by. State surcharge(12%of permit fee)
Authorized signature: TOTAL(J t l�E iU TOTAL PERMIT FEE
Print name: Sean ` `4f 983P713433... I Date: 08/22/2022 I This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
°Fee methodology set by Tn-County Building Industry Service Board.
1\Building\Permits\PLMU-PemutApp.doe 10/01/09 440-4616T(10/02/COM/WEB)
DocuSign Envelope ID: 7AA377A6-4649-400E-BF5F-4FE6AD73FDFF
Plumbing Permit Application - City of Tigard
'Page 2 -Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee:
Footing drain-l' 100' 1 50.03 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 1 37.52 2,001 to 3,600 $169.69
37.52 3,601 to 7,200 $233.20
Sewer-1st 100' 1 62.54 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 1 62.54 62.5z Medical Gas Systems:
Water Service-each additional100' 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
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
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof,to
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:
I:\Building\Permits\PLMUPermitApp.doc 2
DocuSign Env@lope ID: 7AA377A6-4649-400E-BF5F-4FE6AD73FDFF
•
Site Utilities — Plumbing Permit Application
Plan Submittal Requirements
TIGARD
A plumbing permit for site utility plumbing work is required for sanitary sewer,storm sewer
and potable water systems on private property.
1. SITE PLAN and vicinity map showing the geographic location(fully dimensional,drawn
to scale) labeled with:
A. El map&tax lot# ❑ project name ❑ site address ❑ suite number
❑ zoning ❑ applicant name ❑ phone number
B. North arrow.
C. Scale(architectural or engineering only).
D. Street names.
E. Building pads with project location.
2. PLUMBING PLANS-Two (2) complete sets,civil only.
All details listed below shall be incorporated into the plumbing plans:
A. Storm drainage plan showing:
1) Finish elevations throughout the developed site.
2) Grade breaks determining area serving each catch basin.
3) Location of catch basins.
4) Pipe size.
5) Type of material.
6) Slope of piping.
7) Manholes and field drains.
8) Cleanouts provided for each 100 feet or fraction thereof.
9) Roof drain laterals specifying cleanouts at each upper terminal.
10) Location of existing or proposed connection to a public sewer line.
B. Utilities plan showing:
1) Sanitary sewer line location,pipe size,type of material, slope of piping,manholes
and cleanouts provided as required for storm.
2) Size and location of domestic water piping and drainage.
3) Proposed location of connection to a public water or sanitary sewer line.
I:\Building\Pemtits\PLMF-PermitApp.doc 12/30/05
City of Tigard
C ' COMMUNITY DEVELOPMENT DEPARTMENT
11111
TIGARD Building Permit Review - Residential
ry
Building Permit #: 'M57- -(2.°�- 00377 4'T ?-D D ` 00 3 7 5
Site Address: 923k SW Wa•Voiliy i,
Project Name: l`L V\e J fot S Lot #: „--55-----2-1
Proposal: i4e,V,J CQ.ed` (94/eUti (-1'0\) ytr v s)
Required Submittal Elements
1�3 copies of site plan '
�u Drawn to standard scaleootprint of new structure and FFE
,North arrow line / tree protection
.'Site address, project name, lot # d
,,'Street names jEtidewalk / driveway shown and dimensioned
.Z1Applicant name and phone # $Utility locations & easements (new / additions)
Lot and setback dimensions 0-Loc terns
es giot area and lot coverage percentage
,ef Erosion control porner elevations (2' contours if > 4' differential)
Vioion cicara ca t ate„_ 0-Ground slope at building pad calculated / shown
Planning Review
Verify address / suite # active in Accela.
,Zl Zone: �S _lb
8-Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995)
Required: ❑ Yes ZNo
Received: ❑ Yes ❑ No
gPublic Facilities Improvement (PFI) Permit:
Required: ❑ Yes 0 No
Applied For: ❑ Yes ❑ No, stop intake
p'Sensitive Lands: ❑ Yes 12'No
Type:
'Housing Supplemental Sheets Completed
O Cottage Cluster C&O (1 site, 1 per unit) ❑ Quad
❑ Courtyard Units C&O (1 site, 1 per building) ❑ Rowhouse
❑ Cottage Cluster Type II (1 per unit) .Small Form Residential / ADU
❑ Courtyard Units Type II (1 per building) ❑ River Terrace Addendum
tJ32022 -Wil' -
'Land Use Case #: SUKek - 0000'- %Conditions met prior permit issuance
Approved By Planning: Date: 1k-112-52- -
Notes
Revision 1: ❑ Approved 0 Not Approved Date:
Revision 2: El Approved 0 Not Approved Date:
I:\BuildinglFonns\BldgPermitRvw Res 08162022.doex i
Building Permit Submittal
Original Submittal Date: (91 5
Site Plans #: 3
Building Plans #: `77
Building Permit #: ,iNBuilding permit # entered on page 1
Workflow Routing: $(Planning 1XEngineering XI Permit Coordinator Building
Workflow Sign-off: 'Sign-off for Planning (include notes from planning review)
Route Documents: kr Engineering: (1) copy of permit application, (1) site plan,
(1) building plan and original plan review routing form.
.4 Building: original permit application, site plans, building
plans, engineer and beam calculations and trust details, if
applicable, etc.
Permit Technician: N, - ( Date: i o (S (a-'-
Notes
Engineering Review
0-Slope at building pad verified Slope:
U Conditions met prior to issuance of permit
0-Easements (encroachments) per engineering conditions of approval and plat
O'Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes 0-No
Assess Water Quantity Fee in-lieu: ❑ Yes B-No
LIDA Facility on lot: 0 Yes ®-fd"o Add Fee: ❑ Yes ❑ No
it final Plat Recorded
❑ NOT Approved: Date:
Notes
Approved By Engineering: i4 • I" I s i fz, Date: / l- /5--c2-Z
Revision 1: 0 Approved ❑ Not Approved Date:
Revision 2: ❑ Approved ❑ Not Approved Date:
Permit Coordinator Review
Conditions met prior to permit issuance
Approved, NOT Released: Date notified applicant:
❑ ENG Revisions Required: Date notified applicant:
DC Exemption: ❑ Applied for ❑ Received 17°Does not apply
Jig SDC Fees Entered: Wash Co Trans Dev Tax: Yes 0 N/A
Tigard Trans SDC: Yes ❑ N/A ❑ Deferred
Parks SDC: Yes ❑ N/A 0 Deferred
LIDA ❑ Yes EJ/A
OK to Issue/Approved by Permit Coordinator: L �� G2" Z Date: (,\''L�
Revision 1: 0 Approved ❑ Not Approved Date:
Revision 2: 0 Approved ❑ Not Approved Date:
%L. c (J
City of Tigard
III ■ COMMUNITY DEVELOPMENT DEPARTMENT
C
TIGARD Small Form Residential Supplemental (Non-RT)
Building Permit #: i4A raO?J - 60375 Project Name: Fi j14 Ulm)
Site Address: O p-$1 S�1 c9f. - V
Lot #: 5 Total Existing Units:
t
New Configuration: ❑ Single Detached Duplex 0 Triplex +ADU
Small Form Residential Standards
Setbacks Front: le Rear: 1 Side: 5 Street Side: 15 Garage:
Height Max. Height: Actual Height: .2-1
Landscape iKLandscape Area: / IPfw % Lot Coverage Max: NA
Entrance 1E et back no more than 8' from street-facing wall
ref Parallel to street or offset 45 degrees or less
Windows .:1--Minimum 12% of area of all street-facing facades H .5 1.
Garage Garage door is behind widest street-facing wall
)2 es
❑ No, and one of the following is met:
O 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:
❑ 12' or less
)2 50% or less of facade
❑ 60% or less and includes 7 of following:
❑ Covered porch 0 Recessed entrance ❑ Wall offset
O 1' Roof eave 0 Roof offset ❑ Fire shingles
❑ Lap Siding ❑ Gable, hip, gambrel roof ❑ Dormer
❑ Roof pitch ❑ Accent siding ❑ Window trim
❑ Window recess ❑ Window projection ❑ Balcony
Approved By Planning: Date: I (2'er ILZ_
1'.,Budding AFormsABldgPermllRvw SFR Supplemental 070722
C._o ). WQ> - 36 gt13-i
Q1 .5 K3 .5 z 4.4i0,25 \ O1N
5 lC l p s SO
U.14o‘0S
E 3 k 2b1 1- 15(a f 12 = L ci
1� . s �l
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: 541-600-5146 Email: James@canopypdx.com
New Meter Address: , 9231-9233 Waverly Drive Tigard OR
Subdivision Name: Eagle View Estates Lot#: 7 11
Building Permit#: MST2022- 00375
MST2022-00377
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 '--- 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 I =
Kitchen sink 2 x 1.5 = 3
Laundry sink x 1.5 =
Lavatory 8 x 1 = 8
Water closet, 1.6 GPF 6 x 2.5 = 15
Bathtub/whirlpool x 4 =
Shower stall 2 x 2 = 4
Bath/shower combo 2 x 4 = 8
Total Fixture Unit Points: 57
Fixture Unit Points:
1 to 30=5/8" 37.5 to 89 = 1"
30.5 to 37 = 3/4"
1„
Meter Size: Meter Cost: $ $26,487.00
*************************************************************************************
FOR OFFICE USE ONLY
Fixture Units Points verified with
Building (Master)Permit or Plumbing ❑Yes ❑ No ❑ Other:
Meter#: Sale Date:
Receipt#: Meter Cost:
Employee Name:
l:/Building/Forms/WaterMeters_070121_New.doCx Page 2
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
14 ■ Water Meter Fixture Unit WorksheFiV
For New Buildings
F fill 1. 7 2022
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439• www.tigard-or;' 01 Ti4AH!
:l111.1!!IG l)l�l c,ir
LOCATION: City of Tigard —City Hall WATER METER SALES:
Utility Billing By Email Only. Please contact
13125 SW Hall Blvd. ubonlinepay@tigard-or.gov
Tigard, OR 97223 to discuss sending documents and payment
METER: SIZE: FEE: Effective 07/01/2021
5/8" $10,095.00 Fee includes:
3/4" $14,418.00 water system development charge,
water meter,$26,487.00 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.
1:/Building/Forms/waterMeters_07o121_New.dOCx Page 1
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
. y111111 Transmittal Letter
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Allyson Armstrong DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
FROM: Samedy KernOCT 19 ZOZZ
CITY OF TIGARD
COMPANY: BUILDING DIVISION
PHONE: 971.563.0552 By: /5
EMAIL: samedy@kem-consultant.com
RE: 9321 &9233 SW Waverly Dr MST2022-00375&377
(Site Address) (Permit Number)
Eagle View Loth"ki
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. 3 Revisions: Roof Plan
Cross section(s) and details. Wall bracing and/or lateral analysis. j
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
1 Other(explain):Mechanical Permit
REMARKS:
ROF ICE USE ONLY
Routed to Permit Technici • ate: Lb/3`/2-2_ Initials: j J
Fees Due: ❑ Yes Fee Descnptio : Amount Due:
N..) b N--) 6 ____------------ ss gi ______
Special
Instructions: /
Reprint Permit (per PE): El Yes o �/ ❑ Done
Applicant Notified: ��� Date: Ir ( 2 �?__ Initials:
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