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Permit CITY OF TIGARD MASTER PERMIT II "I 8 '„ COMMUNITY DEVELOPMENT Permit#: MST2022-00324 T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/28/2022 Parcel: 1 S 135DB06600 Jurisdiction: Tigard Site address: 9430 SW NORTH DAKOTA ST Subdivision: O'NEEL ACRES Lot: 6 Project: Leniger Project Description: 306 sq ft addition to include (2) bedrooms, a bathroom, a dining nook, and deck. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 2 First: 306 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 16 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 15 Smoke Yes Dwelling Units: Third: 0 sf Right: 5 Detectors: Total: 306 sf Value: $49,488.22 Rear: 15 PLUMBING Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Drains: 0 Storm Sewer: 0 Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 1 Clothes Dryers: 0 Natural Gas 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: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add!500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 5 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-3 306 Owner: Contractor: LENIGER,CHRISTOPHER A&KIRSTEN DAR MAR HOMES INC Required Items and Reports(Conditions) 9430 SW NORTH DAKOTA ST PO BOX 391 TIGARD,OR 97223 GRESHAM,OR 97030 PHONE: PHONE: 503 762-1044 FAX: Total Fees: $2,006.60 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 oc9 nn911n1n fhrm,nh()AP q59-nn1-nnon vrei nhlain a_cant,of fhu nfec nr Nirert n,mclinne to(II INC by rollinn Sill 9 (Oa nr 1 Rnn'l49 9'3dd Issued By: !% � /G.� ` Permittee Signature: P11403.638.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept In a conspicuous place on the job site until completion of the pro . Approved plans are required on the job site at the time of each inspection. _ Bnilding Permit Application Residential RECEIVE a `� �' >. e � � t_•4 r-OR ohrrcr t,�r os�Y � °�.; City W tall Blvd l SEP 2 2022 Received `I Vat irii.a! -40 4' i eUat•its% 13125 SW Flail Blvd Tigard,{.VC 99223 PlanRell :. / i Phone sO.7182J39 foe. 3�)t.�98 i9R( �'��(� o111 r PLline _--J CITY OF TIGARD `' ''ts, TIGARD Invcction I inc. 5t 3 639417s Dare Heap:fir / 4r i H Sec Page 2 nrz Internet irz%i:.tipadd nr.t.ni BUILDING DIVISION `ktincdd hiuthrnt `// A, L i Supptemeutal fnforn on 1 — TYPE OF WORK --- (��REQUIRED DATA:I-AND 2-1•'AMII t'D\%FsI I I'\C j ❑Nov construction ❑ISunolnion Permit firs*are based on the value of the work pet-filmed d.--+ -- -- Indicate the value trounced to the nearest dollar)of all El Addition'altcrutiomieplaceutcm 0 Other: equipment.materials.tabor.overhead.and the! ail for the CATEGORY OF CoNstRuenoN �� I work indicated on this application. r t��i Valuation: StI I + �t 1-and 2-family dwelling 0 Commercial/industrial ❑Acecssor building ❑ Multi-Iamily - rooms: 1 o — Number of bedrotnns .Z >_?—Number2.-f bath - ❑Master builder (alter: l Total number of Boors: I JOB SITE INFORMATION AND LOCATION ____ lob site address: C14?)r. C;.,,j E,, p/skz-. ,4 (,1 New dwelling area: ?Gt square feet 3D City/State:/II'; -1'1C-M2-f) 6 ri-j'L'�-?3 ' (aaragi carp to arw: C)r square feel Suite/bldg./apt no.: i Project name: h � I!(i-j I Covered porch area: (, square feel Cross atraetidirections to job site: e-,tk, GILa' 1/1 ,A GC: Deek urea: i 7 Otti, square list Other structure area: ct ,quire feet -- T REQUIRED DATA:COMMERCIAL-USE CFIECICI.IS'F Subdivision: Lot no.: Permit fiats'arc based on the value of the work perfirnied. Indicate the value(rounded to the nearest dollars of all "Fax mapiparcel no.: R I ZLI 3 ce-z%t' 1 S 135 P 13 C Ci G_C.Cequipment,materials.labor.overhead,and the profit for the DESCRIF TION OF t%OR1t work indicated on this application. - Valnation: S AI.-cc ':C(.t" cLi- F I . A.t'.>D 2 F.x: 1-7(2 G-E4ISt Ik -- — 1 bi'1 1. Isisling building area: square feet ):::,,,A1 1-1 rz.�'L 6 t ) Nl- C.) A LA i`'i h��'<- Ker - New building area: square feet 12f PROPERTY OWNER I D TENANT Number of stories: Name___.._LI1 2ICE tot,I', k!t12 )‘• )‘--‘ i i 1- e';'t_i< typeofconstnition: Address ge1-2 i. 'A- 1`) l 2/-.k 7'1“ &:1' Occupancy groups: i C ity';Stat./IP: t ( . '`Z :� - - TIL';/al_ fj 1 G,b-.. 1 1 l - Existing: — Phone:t 1 Fax:I ) New: ®, APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES` (Phase rgfer to,,keschedule) Business name- 1z.t C ' 1't A a4z. f1 1117-L' 1 1 :( 'YZ fS > L-tom LSttvetura(plan review fee for deposit): 1 Contact name: Vt.,(-„,L Lf-, 1)1,,t4 h l', 1.__— it tS plan rcvr lee(if applicable): ! _�. lddress: '�(C N� t puv otJiT 1 --- 'Colal fees due upon application: (nt:Statc/IP: I-'Gl.„! It f t I', Gait Cle'l �d•i2— - Phone:(t .�2�t (2 C:•3 '4+ 04, --I.F.i'( 1 `—_ Amount received I I m nd: e,p c4 rot , e u � 0 ia�_ m , cornpiioroM1'Or I .tC SOLAR PANEL SYSi I,i E Ft.b Commercial and residential pcseripti.e install:anal of CONTRACTOR - rool-top mounted PhotoVoltaic Solar Panel S lCm 13dt.mess mum : � Il ( �? ✓ i Lt} ' Submit two l'_I set,of loot plan%vith connection details >t` s)1 MILL it 15.E ISE � _ and lire deptuttnent access,,bong oath the 2olt)Oregon Address: 3 ' ; ISC) m. -2f1.1 Solar In�tolutton Spo..why Code checklist Ci1}•Slute'21P: GP IA )``' {7)1 .1-?�'- I.-) PerntiI Fee fincludes plan re%ied% , s I Vi tin C-'�� and administrant tees): Phone:(i`V ) ,t c I'ax { ) 2O. __ 1 1 t , _ __�—___ Stine surcharge!I� o nl penult lce1: 521 6b j !'oral Ice due upon application: S iLro Authorised:mixture: f t, 1.-- j - -'• C a--r. r-(1)-1 ..'-j 'Ibis permit application expires if a permit i.nut obtained %.thin 180 days after it has been accepted as complete. Print name {�� _--- .", iL%i 2tt l a Fc.matlwdoloz; i%'t h}"In-(ountc lieu)It lnd:r.I L -- --- 141 T t V.A • I t-t_t' �Uete.( J Sdy%tee lion d I.Building Pennms'lit'I'.RI:SPerutit=lnpdot 02^4f2o)l 440-4013"I(114)2/Cttpt'W1.131 I Mechanical Permit Application Fol.! (OFF ICI I SE oNi.A CityIii }�of Tigard Received . gan Date/By. Permit No.: 13125 SW Hall Blvd.,Tigard,OR 9722.3 Plan s Phone: 503.718.2439 Fax 503.598.1960 BRy evr Other Permit. I Il,,,i:U Inspection Line: 503.639.4175 Date Ready/Hy: is. ® See Page 2for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE*SCHEDULE-USE CHECKLIST Mechanical permit fees"are based on the value of the work ❑New construction Addition/alteration/replacement pt.knitted Indicate the value(rounded to the nearest dollar)of all ❑Demolition Other: mechanical materials,equipment,labor,overhead,and profit Value:$ CATEGORY OF CONSTRUCTION _ -- RESIDENTIAL EQUIPMENT/SYSTEMS FEES" g1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For specialInp/ormation me ebeatlin Cl Multi-family ❑Master builder ❑Other: Description Qty. Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling: G °' Air conditioning 46.75 fr Job site address: T CJ� A..10 pr,.f ( t 4,4 y Srj-- Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: ^T'-dy ve ` o it (�? .z3�'( Furnace 100,0004-BTU(du ts/vema) 54.91 HeatSuite/bldg./apt.no.: 6 Project name: Duct workmp 61.06 Duct t 2332 Cross street/directions to job site: Hythonic hot water system 23.32 Res��� l n , t o ?cL#e_— hydionic)al boiler(radiator or �u� N may( 7 M1 drenic 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: b/ A Aziee5 Lot no.: / Other: 23.32 f� Other fuel appliances: Tax map/parcel no.: /$( 's`03 D 660a Water heater - 23.32 DESCRIPTION OF WORK (ins frreplacetinseit 33.39 �I GG Flue vent for water heater or gas 2 O p a .MYJPl Ex4-e LOl Sue 111 fireplace 23.32 firelighter(gas) 23.32 t)u-k +0 c2? l3 V' OI efri a add I Wood/pellet stove 33.39 ad41 ,YL Woodfireplacelmsert 2332 Chimney/liner/flue/vent 23.32 PROPERTY OWNER 0 TENANTOther: 23.32 ��"" Environmental exhaust and ventilation: Name: e.4i,v Its i 14-6ce64tel 4 1.441 ts� Range hood/other kitchen � equipment 33.39 Address: Ciefla G / .0�,4'� b 1 B! ! - Clothes dryer exhaust 33.39 City/State/ZIP:( � TQ'a 'V 0 4- p y 2z-2 Single-duct exhaust(bathrooms, 7 ! L s .7 toilet compartments,utility rooms) / 23.32 a32 Phone:( ) Fax:( ) Attickraw(space fans 23.32 ❑ APPLICANT /li .CONTACT PERSON Other: 23.32 Business name: Dam A4>.✓ 141.004e5Fuel piping. Ci $14.15 for first four,$4.03 for each additional Contact name: 3-41.4.�CI 1t.1 Pit GO'''. Furnace,etc. Address: Po fi0/� set Os heat pump City/State/ZIP: /� - Wall/suspended/unit heater l7 YtG4 kaYMrt, © 9e 7o R) Water heater r Fireplace Phone:(+9J� �e$ -bogs Fax::( ) Range E-mail: OtQ!' 4e-ti.004e. e. /it.9n r C.BY" Barbecue CONTRACTOR Clothes dryer(gas) Business name: ic5.jen kt ,ker 4 Cop( Other: MECHANICAL PERMIT FEES` i J Address: Po G0 y, 1244, Subtotal l;. - City/State/ZIP: ' Gatti e 0'4 A?D SS-- - Minimum permit fee($90.00) / Plan review(25%of permit fee) Phone:(4)31 rev ` Fax:( ) - S/ 6 O p State stucharge(12%of pemiit fee) CCB lic.: 21 at!' I l TOTAL PERMIT FEE This permit application expires if a permit is not obtained within ISO �) days after has been accepted a6 complete. Sa Authorized signature: i�Om1�„'e'�'i.-�.i. / " Fee methodology set by Tri-County Building Industry Servitx Roam Print name: .) uj L (3�'�"Pl' le: fp��8 fZa$Z L"Building1Permiu\MEC I'nntdApp 040't?.doc 440461 iT(11/02 COM/WEB) Mechanical Permit Application - City of Tigard Page 2-Supplemental Information 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$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. 1:Ouilding\Pannits\MEC PermitApp_040113.doc 2 1 1 Electrical Permit Application FOR OFFICE USE O\l.1 City of Tigard Received Permit a: ;74/a 13125 SW Ball Blvd.,Tigard,OR 97223 Dam Phone: 503.718.2439 Fax: 503.598.1960 Plan Review DatdB : Related Permit a: I i -F 11 Inspection Line: 503.639.4175 Ready Date/By. curia El See Page2 for 4 , Internet: www.tigard-or.gov Notificd/Metbod: Supplemental Information TYPE OF WORK PLAN REVIEW ❑Newconstruction Addition/alteration/replacement Please cheek all thatapply(submit gsetsof plans re/items checked): El Demolition r] ❑Service or feeder 400 amps or more ❑Building aver three stories. ❑Other: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. l-and 2-family dwelling 0 Commercial/industrial ❑Accessory building Multi-family 0 Master builderless to ground,or exceeds to o00 0 Commercial-use ti c mat amps for all other buildings. 0Other: ❑fin pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived Job#: deb site address: Ct� �I/ ❑Addition of new motor load of system. ,40 5?�Olv A D4 'I- 100HP or more. ❑••A"«E""1-2••"1-3" City/State/ZIP: "r Q 2 ❑Six or more residential units. �caParxY 7 ? 7a23 ❑Rcoreadansl vehicle par�. r ❑Health-care facilities. Suite/bldg./apt#: Project name: 0 Hazardous locations. 0 Supply voltage for mom than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: SC,i) Gr$•KbW q Qd /SW FEE SCHEDULE q5. t Arve- DCsairlIon 1 Qtr. 1 Each I Total I New residential single-or multi-family dwelling unit. Subdivision: O 1iti e.4( Lot#: 4 Includes attached garage. Tax map/parcel#: i sr 31'i,13 0 4,6 00 1,000 eq.ft,or Less 168.54 4 Ea.add'1500 sq.ft,or portion 33.92 1 I)ESCRJFTION OF WORK Limited energy,residential 30 ei 46 610(d.`rty'aH w7S`GiRtu 11 (with above sq.ft.) 75.00 2 Limited energy,multi-family 75.00 2 residential(with above sq.It) 0PROPERTY OWNER I 0 TENANT Renewable Energy ❑ See Page 2 Services or feeders Installation,alteration,and/or relocation Name: e , '4 I44✓ 461," (. .H`a k-- 200 amps or less 100.70 2 Address: tIecr 3o 9 LA) , r D L f)x �. 4- 201 amps to 400 amps 133.56 2 City/State/ZIP: -r-el, is' / /o.2YJN f 401 amps to amps 200.34 2 q?Z2 3 601 amps to 1,000 amps 301.04 2 Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2 11 Temporary services or feeders installation,alteration,and/or K Email: I arp UG ' Oi.$ a '701,41(. GBvi.. relocation Owner installation:This insta ation is being made on property that 1 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 El APPLICANT CONTACT PERSON Branch cUcuits-new,alteration,or extension, panel r ^��f /� A.Fee for branch circuits with Business name: t Jh4v .�„L •T above service or feeder fa,_/ T�� each branch circuit 7.42 2 Contact name: }i Vlot 44.A.ef el, ,- B.Fee for branch circuits without Address: 7 service or feeder fee,first Address: �O 1'n� 3` I branch circuit ( 56.18 2 City/State/ZIP: V/r i'a gC -• ( ©0_ ei ze) Each add'!branch circuit Li 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) 3(' - t€ Fax::( ) Each mannfacmrcd or modular Email: .4yCv Syr rr �,O a �544, GOt� _ Re dwelling,service and/or feeder 67.84 2 • coimect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: F.o U'ne- E(er. -net- r� Sign or outline lighting 67.84 2 Address: `1 ` _. / 7(2 Signal circuits)or limited-energy-energy5 o L kL7t •D"• panel,alteration,or extension. 0 See Page 2 2 City/State/ZIP: Each additional Inspection over allowable in any of the above ( reb k.a 41 04 9 7o i3o Additional inspection(1 hr min) 6625/hr Phone:(5,3) -it 3 _7k,y0 Fat:(�3) r 66— u$!(c Investigation(I hr min) 90.00/hr Email: #K� /� -- ++ 77 f0 D T 7 Industrial plant(1 hr min) 78.18/hr TM`O.4.4 it/1{r e.i e.. , t.psu1 Inspections for which no fee is CCB Lie.: (7 i Zef te Electrical Lic.: !96 Suprv.Lie.: 5za35 specifically listed(Si hr min) 9n.0o!hr !! •?4 .- ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: ,� ' Subtotal: Print name: ei.'1ij 1 1� Date: / /9 2,0l/d 0 Plan Review Required(25%of permit fee): �"�" State surcharge(12%of permit fee): Authorized signature: �� TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: 37 014 el _/ `✓, — Date: (O/`.p /70�� . days after it has been accepted as complete. -'—7 aPE7. ( Number of inspections allowed per permit t:\Raildiea\Permilslpr.0➢ermisAppPLR nRP,de4 Rev 06/17/2015 4404615T(11i05/CoM/5616 • Electrical Permit Application—City of Tigard Page 2-Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Fee for all residential systems combined: $75.00 n I Qty. I E.m I Total I yS Renewable electrical energy systems: 5 kva or less 100.70 2 Check Type of Work Involved: 5.01 to15kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: 0 Burglar Alarm 25.01 to50 kva 301.04 2 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 kva(fee in accordance with OAR 91g-309-0040) 55226 2 ❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of25 kva: System* Each additional kva over 25 7.42 3 0 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 chargedat an hour 1 br min inspections for which no fee is 90.00/hr specifically listed(Fr hr min) COMMERCIAL WORK ONLY: EIEC1 bCAi. PERMIT FEES Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 • Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: 0 Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: _ *No licenses are required. Licens s are required for all other installations I:1Ruading\Permiic\RC PamdsApp_RLR F.Ru.doe Rev 06/172015 • Plumbing Permit Application Building Fixtures FOit 1/Ill(1 1 ',I I/NI1 City of Tigard Received •t Date/By: Permit No.: II 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.: f I C A fi.I.) Inspection Line: 503.639.4175 Date Ready/By: 3' . RI Seep e 2 for Internet: www.tigard-or.gov Page Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE. 0 New construction ❑Demolition For special information use checklist addition/alteration/replacement ❑Other: Description I Qty. e Fa. 1 Total New 1-2-family dwellings(includes 100 R.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 a "1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION.AND.LOCATION Site utilities: Job site address: Ce 3O SCO a 1 04 D 41494 St' Catch basin or area drain 18.76 City/State/ZIP: .�^�j �V Drywcll,leach line,or trench drain 18.76 ty i i!414 c 0� el 7 �5 Footing drain(no.linear fl.: ) Page 2 Suite/bldg./apt.no.: l Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 6d d.64.br.I.✓�e .IV S� R f f-Q Rain drain cmmector 18.76 tJ ` f�( Sanitary sewer(no.linear R.:_) Page 2 _.. Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: taj it)ff( '". I Lot no.: 6, Fixture or item: Tax map/parcel no.: (.99 ( 7 O S-b B G GL op Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 �tt �� 77�� -�J/J 1 Clothes washer 25.02 "�ti'`'a °r I> itat Cee(rY5" Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 PROPERTY OWNER ❑ TENANT Expansion tank 12.51 Name: ie,. L-7 {. re.e.,,s-fivi / �etet G� Fixture/sewer cap 25.02 �r l�L Floor drain/floor sink/hub 25.02 Address: 9Y�30 $1.J i0A"CIA ©dt Garbage disposal 25.02 + City/State/ZIP: Irg4'd f 02 4?2-2? Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 ID APPLICANT CONTACT PERSON Interceptor/grease trap 25.02 Business name: - Medical gas(value:$_) Page 2 �et sr. /.ARte �� 7.0 Primer I2.51 Contact name: Tr•A4 K (A)C_kL✓ Roof drain(commercial) 12.51 Address: PO y Ra/- 91. Sink/basin/lavatory 1 25.02 75.402i City/State/ZIP: Gees es 4.Q.wt O/) 97D 3V Solar units(potable water) 62.54 Phone:(c713) +;f$ ...�9e8 rFax::( ) Tub/shower/shower pan l 12.51 ('js S( E-mail:J_ r" Urinal 25.02 •u-a.... et- Inset. �ytet CONTRACTOR Water closet I 25.02 2‘.p 2i Water heater 37.52 Business name: 37-004' tPiLA4.r`9MI 60 Water piping/DWV 56.29 t. Address: t c. s9+ r4,Q. " 4i e_ Other: 25.02 c;ty/State/ZIP: p� •.� -( is. vL V R? 23C Subtotal 17r...2,s., Phone:(50) 760 ...3S 77 Fax:( ) Minimum permit fee: $72.50 Zy� Plan review (25%of permit fcc) CCB Lie.: (?Z 7a 3 Plumbing Lie.no.: P J V V{�� TOTAL Stare surcharge L%of permit fee) Authorized signature: PERMIT FEE Print name: -Q'abLL!S / (it�,dt� � .ea^`, Date: �Q�� r� Tits permit applicatfoa eryires if a permit ii autobratoad within ISO dayn [� ► l eoz t/ after it has been aceepted ss oompiete. 'Fee methodology set by Tri.County Building Industry Service Board 7:11luidingtPermils\PLMU-PerrnliApp.doc I1101/09 440.16161(10102,CAMIWIM) 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-1' 100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Valuation: Permit Fee: Storm&Rain Drain-I at 100' 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 d additing al$10$10, .0 or fraction thereof,to inclInspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$I.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 thane-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*. Plan Review for Plumbing Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate ❑ Any new commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool 0 New exterior plumbing site utilities for any complex structure Car Wash: -Each Stall as defined in OAR918-780-0040. -Drive Thm Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. Dishwasher: p al 0 Any multipurpose fire sprinkler system. Commer ❑ Any complex structure as defined in 0AR918-780-0040. Drinking Fountain Eye Wash Submit j sets of plaits with any of the above. Floor Drain/sink: -2" -3" Isometric or Riser Diagram 4" ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain that meet the qualifications above. Garbage -Domestic non-food Disposal: -Domestic food related -Commercial food related -Industrial food related -Ice Mach.fRefrig.Drains Comments regarding fixture work: Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -J,av/Bar non-food related -Bradley -Com/Serv/Util food related -Service *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and Washer-Clothes fees assessed for the sewer increase must be paid before the Water Extractor Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: T:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 l City of Tigard p COMMUNITY DEVELOPMENT DEPARTMENT • TIGARD Building Permit Review - Residential Building Permit #: ,32 -1 Site Address: gg30 Cc...) iv • 774koTA Project Name: Lot #: Proposal: /a i Inc)nJ Required Submittal Elements 3 opies of site plan -of 1r'attd1nys lu be del red- awn to standard scale ootprint of new structure and FFE 4 orth arrow •ned--taffies, drip line /-tree protection fRte address, project name, lot # t trees shown / labeled vir-eet names Sewalk / driveway shown and dimensioned 'pplicant name and phone # zUtility locations & easements (new / additions) �t and setback dimensions Existing structures Lot area and lot coverage percentage -R-Eis;u1i wlftTbl n Ge i • ) • alculated sb wn Planning Review .erify address / suite # active in Accela. ne: 12c5-13 .i'_T Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995) Required: El No Received: eYes ❑ No blic Facilities Improvement (PFI) Permit: Required: ❑ Yes H"No Applied For: ❑ Yes ❑ No, stop intake Z(Sensitive Lands: ❑ Yes Type: -lousing Supplemental Sheets Completed ❑ Cottage Cluster C&O (1 site, 1 per unit) ❑ Quad ❑ Courtyard Units C&O (1 site, 1 per building) ❑ owhouse ❑ Cottage Cluster Type II (1 per unit) 2/Small Form Residential / ADU ❑ Courtyard Units Type II (1 per building) ❑ River Terrace Addendum .erLand Use Case #: / ❑ Conditions met prior permit issuance Approved By Planning: dL Date: ‘ ,X2-//2--2 Notes !� Revision 1: ❑ Approved ❑ Not Approved Date: Revision 2: 0 Approved ❑ Not Approved Date: I:\Building`.PonnsTIdgPermeR%w Res O8162022dee% Building Permit Submittal Original Submittal Date: //./2--2- Site Plans #: Building Plans #: Building Permit #: ,Building permit # entered on page 1 Workflow Routing: manning engineering ,„El-Permit Coordinator- ❑ Building Workflow Sign-off: , Sign-off for Planning (include notes from planning review) Route Documents: ,- €ngineering: (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 applica le, etc. / Permit Technician�#. - Date: ./•ILJ Notes Engineering Review El Slope at building pad verified Slope: f5y4 C] Conditions met prior to issuance of permit © Easements (encroachments) per engineering conditions of approval and plat O Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: 0 Yes I75. No Assess Water Quantity Fee in-lieu: 0 Yes EfNo LIDA Facility on lot: 0 Yes Ef/No Add Fee: ❑ Yes ❑ No ❑ Final Plat Recorded O NOT Approved: Date: Notes Approved By Engineering: �J,,,,,�.( 12, E-I c,Date: - OS- 2 a Revision 1: 0 Approved ❑ Not Approved Date: Revision 2: 0 Approved ❑ Not Approved Date: Permit Coordinator Review NIA-Conditions met prior to permit issuance ❑ Approved, NOT Released: Date notified applicant: ❑ ENG Revisions Required: Date notified applicant: ,eSDC Exemption: ❑ Applied for ❑ Received JZI Does not apply ,'SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes Al N/A Tigard Trans SDC: ❑ Yes ,'N/A ❑ Deferred Parks SDC: ❑ Yes ' N/A 0 Deferred LIDA ❑ Yes V N/A aC� ,B"OK to Issue/Approved by Permit Coordinator: D Date: 144142,2, Revision 1: ElApproved ❑ Not Approved Date: Revision 2: 0 Approved ❑ Not Approved Date: I♦ o 1114 • City of Tigard RI COMMUNITY DEVELOPMENT DEPARTMENT TIGARD Small Form Residential Supplemental (Non -RT) W E,,,WWN t. 1 1g-2m. ;4T5V41.N wd .0 3;&xt va.4, R;+-,A.it.e t:M c. ,V„.,,,m,m rAv o.,en. _: .z Building Permit #: Project Name: Lam' &pcu Site Address: `:)y3n Svu t(I - 17A{e-0T4 Cr. Lot #: Total Existing Units: .0 One ❑ Two ❑ Three New Configuration: ❑ Single Detached ❑ Duplex 0 Triplex ❑ +ADU Small Form Residential Standards Setbacks ❑ Front: IS Rear: 1 r Side: S---- Street Side: fS Garage: & Height ❑ Max. Height: (.5O Actual Height: /k Landscape ❑ Landscape Area: 7i0 % Lot Coverage Max: Entrance ❑ Set back no more than 8' from street-facing wall ❑ Parallel to street or offset 45 degrees or less ) ' • .ows ❑ Minimum 12% of area of all street-facing facades Garage . . .e door is behind widest street-facing wall ❑ No, an. : ile of the following is met: ❑ Door exte : no more than 5' from wall and there is a covered porch extending beyon. . • age. ❑ Door extends no mo - han 5' from wall and there is a 12 sq ft. window above garage on 2n. oor. Garage door width is: ❑ 12' or less ❑ 50% or less of facade ❑ 60% or less and includes 7 of following: ❑ Covered porch ❑ Recessed entrance ❑ Wa .ffset ❑ 1' Roof eave ❑ Roof offset ❑ Fire shi . -s ❑ Lap Siding ❑ Gable, hip, gambrel roof ❑ Dormer LI Roof pitch ❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony Approved By Planning: Date: C)7//17--OZZ 1.ABufldingA Fornu\BldgPer ndlR w SIR Supplemental 070722 RECEIVE SEP 12 2072 CITY OF TIGnWater`Services SENSITIVE AREA PRE-SCREENING SITE ASSESSIVItI E NGDIVISION Clean Water Services File Number 22-001589 1. Jurisdiction: Washington County 2. Property Information(example: 15234AB01400) 3. Owner Information Tax lot ID(s): Name: Chris and Kirsten Leniger 1S135DB06600 Company: Address: 9430 SW N Dakota St. OR Site Address: 9430 SW N Dakota St. City, State,Zip: Tigard,OR,97223 City, State,Zip: Tigard,OR,97223 Phone/fax: Nearest cross street: Email: idrivefds@gmail.com 4. Development Activity(check all that apply) 4. Applicant Information ❑x Addition to single family residence(rooms, deck,garage) Name: Kendra Duang ❑ Lot line adjustment 0 Minor land partition Company: Kendra C.Duong Architect ❑ Residential condominium ❑ Commercial condominium Address: 3415 NE Fremont St ❑ Residential subdivision 0 Commercial subdivision City, State,Zip: Portland,OR,97212 ❑ Single lot commercial ❑ Multi lot commercial Phone/fax: 5038532006 Other Email: kendra.duong@icloud.com 6. Will the project involve any off-site work? ❑Yes x❑ No 0 Unknown Location and description of off-site work: 7. Additional comments or information that may be needed to understand your project: This application does NOT replace Grading and Erosion Control Permits,Connection Permits, Building Permits,Site Development Permits,DEQ 1200-C Permit or other permits as issued by the Department of Environmental Quality, Department of State Lands and/or Department of the Army COE. All required permits and approvals must be obtained and completed under applicable local,state,and federal law. By signing this form, the Owner or Owner's authorized agent or representative, acknowledges and agrees that employees of Clean Water Services have authority to enter the project site at all reasonable times for the purpose of inspecting project site conditions and gathering information related to the project site. I certify that I am familiar with the information contained in this document,and to the best of my knowledge and belief,this information is true,complete,and accurate. Print/type name Kendra Duong Print/type title architect Signature ONLINE SUBMI I lAL Date 5/27/2022 FOR DISTRICT USE ONLY O Sensitive areas potentially exist on site or within 200'of the site.THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties,a Natural Resources Assessment Report may also be required. ❑� Based on review of the submitted materials and best available information sensitive areas do not appear to exist on site or within 200'of the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider Letter as required by Resolution and Order 19-5,Section 3.02.1,as amended by Resolution and Order 19-22.All required permits and approvals must be obtained and completed under applicable local, State and federal law. ❑ Based on review of the submitted materials and best available information the above referenced project will not significantly impact the existing or potentially sensitive area(s)found near the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect additional water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider Letter as required by Resolution and Order 19-5,Section 3.02.1,as amended by Resolution and Order 19-22.All required permits and approvals must be obtained and completed under applicable local,state and federal law. O THIS SERVICE PROVIDER LETTER IS NOT VALID UNLESS CWS APPROVED SITE PLAN(S)ARE ATTACHED. 0 The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2). NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. Reviewed by C-A Date 5/27/2022 Once complete,email to:SPLReview@cleanwaterservices.org • Fax: (503)681-4439 OR mail to: SPL Review,Clean Water Services, 2550 SW Hillsboro Highway, Hillsboro, Oregon 97123 Main Office - 2550 SW Hillsboro Highway Hillsboro,Oregon 97123 • p:503.681.3600 f: 503.681.3603 cleanwaterservices.org _f 6'-7}1 12'-0" 32.-0' X / 6•-O / (5'MINI. / / (5'MIN. SIDE SIDE SETBACK) SW NORTH DAKOTA ST SETBACK (E)WATER METER 156.60" ls \ t o R a EXISTING CONC N r m I i s _ DRIVEWAY tel - - / .. hl (E)WOOD FENCE m - J (E)ELEC METER ' I-I (N)DECK 1 O P -, ( , 1 MAIN HOUSE s,r .. r--' V -�_ r�—�i o I(E)DECIK b I o +1 -1 O 1 1 ,.1 -I a o 0 D ' . ` ` N0 . " OA /' • s„ O I - ADDITION V 1 �' I )N)4'X 8'PATIO o n ,z - U m h ", - (EJCHAIN LINK _ i FENCE 56.60" / IB-T / 264 / I0*-0" / (Th SITE PLAN P\ AC / SCALE:I" 1O'-0" 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 1 _ Transmittal Letter T I G A R I) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Allyson Armstrong DATE RECEIVED: DEPT: BUILDING DIVISION FROM: Kendra Duong COMPANY: Kendra C Duong Architect PHONE: 503 853 2006 By. EMAIL: kendra.duong@icloud.com RE: 9430 SW N Dakota St MST2022-00324 (Site Address) (Permit Number) Addition (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s)of plans. Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. t Other(explain):plan review response, MEP permit applications,water fixture worksheet REMARKS: FOR FEICE USE ONLY Routed to Permit Technician. Date: �`� ('7 1/ 2-1— Initials: �)— Fees Due: ❑ Yes Io Fee Descri tion. Amount Due: 7- ) -)- V e $ $ Special Instructions: Reprint Permit (per PE): ❑ Yes [ o ❑ Done Applicant Notified: Date: Initials: