Permit IN CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2022-00272
Date Issued: 12/01/2022
T I t;A I-I Il 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S104CC06700
Jurisdiction: Tigard
Site address: 13657 SW ASCENSION DR
Subdivision: HILLSHIRE WOODS Lot: 11
Project: SW Grover LLC
Project Description: Crawl space conversion to habitable space and beams. Electrical permit obtained online.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 1 First: 0 sf Basement: 595 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 0 Smoke Yes
Dwelling Units: 0 Third: 0 sf Right: 0 Detectors:
Total: 595 sf Value: $89,767.65 Rear. 0
PLUMBING
Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 2 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Drains: 0 Storm Sewer: 0
Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 1 Water Lines: 0 Catch Basins: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Bckflw Prevntr: 0
Drywell-Trench Drain: 0 Other Fixtures: 1
Other Fixture Units: Ejector/Sump
MECHANICAL
Fuel Tvoes Air Conditioning: N Vent Fans: 1 Clothes Dryers: 0
Natural Gas Heat Pump: N Hoods: 0 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 2
Fum>=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'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
N
Other. N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VP R-3 595
Owner: Contractor:
SW GROVER LLC RED HAMMER CONSTRUCTION INC Required Items and Reports(Conditions)
3945 SW 98TH AVE 4148 SW 170TH AVE
PORTLAND,OR 97225 ALOHA,OR 97078
PHONE: PHONE: 971-226-9455
FAX:
Total Fees: $3,891.94
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. ATTENT ON: Oregon law requir ou to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
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Issued By: 1 Permittee Signature: de .
Call 503.639.4175 by 7:00 a. .for the next available inspection date.
This permit card shall be kept in a co uous place on the job site until completion of the project.
Approved plans are required on the lob site at the time of each inspection.
f
Building Permit Application
Residential FOR OFFICE USE ONLY
City of Tigard E� Received 7 l /fj�
Tigard,OR 97223 E I V E® Date/By: l7 /.2-2—j�l p ?„Z,- �?I
. 13125 SW Hall Blvd.,Ti
g Plan Review
_ Phone: 503.718.2439 Fax: 503.598.19 1UC 2 2 202? Date/By: t/5/I( 7iZ Other Permit:
l I G A R I7 Inspection Line: 503.639.4175 U Date Ready/By: ))) furls: 10 See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: fi t/r (�, 1/1d,6C Supplemental Information
TYPE OF WORK T G_Ma" , REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑ Demolition - J -1,p Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Addition/alteration/re lacement p El Other: l(134 IV j equipment,materials,labor,overhead,and the profit for tj�e�
CATEGORY OF CONSTRUCTION el,r, work indicated on this application. Z�11 7(07 (p
Ef1-and 2-family dwelling ❑Commercial/industrial aluation: $
ElAccessory building ❑Multi-family Number of bedrooms:
El Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors: 3
Job site address: } 1 (, S—7 n i,4 r V/a Of New dwelling area: S---square feet 59 s
City/State/ZIP: T iy. ) oyt, 9 ? z z -S Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: A s C<h s ,,",, Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
144:$ I 1< To e p r Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
4
Subdivision: I Lot no.: Permit fees*are based on the value of the work performed.
rIndicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK !/ work indicated on this application.
Re(4.- 51r 'C( '--r�v n•-. < ✓ i 1 o t3LA4„@ Valuation: $
f 1~ r,� ""Y
Existing building area: square feet
New building area: square feet
PROPERTY OWNER ❑ TENANT Number of stories:
Name: 12.µ, Iry c(.,`}a(. Z CF W 4;0„t ,l C t_r_> Type of construction:
Address: Sid I S i i ;./ 11:b)4 1.---.'"r L `' Occupancy groups:
City/State/ZIP: 06 r I I..i p CI ) Z 1 . ��ilt5
1 )� Existing:
Phone:( 5�) ) .*i y 1 , rt r,.t S- Fax:(\44)if e., :A Dr() New:
❑ APPLICANT ❑ CONTACT PERS BUILDING PERMIT FEES*
i, fee schedule.)name: tC t��ktnl � `t� t
(Please refer i
F\ �LLL��VYY��� Structural plan review fee(or deposit):
Contact name:
FLS plan review fee(if applicable):
Address:
Total fees due upon application:
City/State/ZIP:
Phone:( ) I Fax: :( ) Amount received:
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR \ roof-top mounted PhotoVoltaic Solar Panel System.
Business name: R c,5, `fc,,, , , [i ,, -r yc'L,,` �Q„� 1, 60„.\ Submit two(2)sets of roof plan with connection details
l!' d and fire department access,along with the 2010 Oregon
Address: i 1 L.' . 17 7 I R Solar Installation Specialty Code checklist.
City/State/ZIP: irk( I Permit Fee(includes plan review
` ' / and administrative fees): $180.00
Phone:('{7)► a a /__ 114Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: 7_0 0 .7 j ���--
Total fee due upon application: $201.60
Authorized signature: �_J This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Fee etholo
Print name: IL,.. A 1,,,`c(. / 1 r, -Date: f l I -Lk *Service Bodard.gy set by Tri-County Building Industry
I:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
7 NI
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLI •
City of Tigard111/ Received
Permit No.:
■ 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
e Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 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 0 ❑
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ 0 0
3 Verification of approved plat/lot. 0 0 0
4 Fire district approval required. Name of district: 0 0 0
5 Septic system permit or authorization for remodel. Existing system capacity 0 0 0
6 Sewer permit. 0 0 0
7 Water district approval.
❑ 0 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 ❑ 0
9 Erosion control ❑plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- 0 0 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 ❑ 0 0
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 0 ❑ 1 1
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 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 0 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 ❑ 0 0
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 0 0
systems,see item 22,"Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists 0 ❑ ❑
over 10 feet long and/or any beatn/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. ❑ 0 0
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ 0 D
for four or more appliances.
22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or 0 0 0
architect licensed in Oregon and shall be shown to be a p plicable 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 , ❑
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 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.
1:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(l 1/02/COM/WEB)
Mechanical Permit Application E V L FOR OFFICE USE ONLY
City of Tigard �� V G Deceivyd Permit No.:7,7579109
Date By: ...-0Jt7l
III • 13125 SW Hall Blvd.,Tigard,OR 97223 SEP 1 9 2022 plan Review
p Phone: 503.7182439 Fax: 503.598.1960 S C f � gy Other Permit
T I U k I) Inspection Line: 503.639.4175 Date Ready/By: axis: H See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
R1 In niNG DIV1SIO yr
TYPE OF WORK COMMERCIAL FEE* SCHEDULE- USE CHECKLIST
/ Mechanical permit fees*are based on the value of the work
�
D New construction c�Addition/alteration/replacement performed.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 I SYSTEMS FEES*
[al-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist.
❑ Multi-family 0 Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
' Furnace 100,000 BTU(ducts/vents) I 46.75 46.7t
Job site address: �3 C.S'�- 5 t,J �1 S c�e�5 ion ��
City/State/ZIP: ..f o q ad t r (Z, 4 7.Z .z 3 Furnace 100,000+BTU(duets/vents) 54.91
J li' Heat pump 61.06
Suite/bldg./apt.no.: Project name: Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above , 23.32
Other; 23.32
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater I 23.32 1).Ij 2
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
�/ Other; 23.32
PROPERTY OWNER ❑ TENANT Environmental exhaust and ventilation:
Name: , W �Z,,,,e.,. t_L L Range hood/other kitchen
equipment 33.39
Address: 17,G S-4 5 W A 5 t,tqi✓\t t`U✓. L)' Clothes dryer exhaust 33.39
Single-duct exhaust(bathrooms,
City/State/ZIP: f I`ql 1��� U Q. el, 2 2 toilet compartments,utility rooms) I 23.32 Z 1 ,3
Phone:( ) -7-4 15(--1 Fax:( ) Attic/crawlspace fans 23.32
❑ APPLICANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name: 514.15 for first four;$4.03 for each additional
Contact name: Furnace,etc. (
Gas heat pump
Address: Wall/suspendedhmit heater
City/State/ZIP: Water heater I 14,1 S
Phone:( ) Fax: :( ) Fireplace
Range
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
I r� Other:
Business name: ( , '- 1 YYYY1, q �I MECHANICAL PERMIT FEES*
Address: 21 — CC. Subtotal
City/State/ZIP: a , )or f, VA I G t/ CY\ C' 7 Minimum permit fee($90.00)
Vl�-� G Plan review(25%of permit fee)
Phone:( Cc y3L) -�jqi I .. ( ) Statesurcharge(12%of permit fee)
CCB lie.:Jr] 2 d 32i 2 rC,/a y TOTAL PERMIT FEE
JU This permit application expires If a permit is not obtained within 180
days after It has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name: L C iv.L/ t/(v Date: q ) (5 / 2r�L
1:03,adiogTerm \MEC_Pemitnpp 040113.doc 4404617T(t1ro2/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.
1:1BuildinglPermits\MEC_PermitApp_040113.doc 2
Plumbing Permit Application
Building Fixtures RECEIV FOR OFFICE USE ONLY
City of Tigard SEP 19 202 t PennkN° MST eon-)}
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
liki-i. Phone: 503.718.2439 Fax: 503.598.1960 CITY OF TIGARbteiBy Other Permit No..
T I G A R D Inspection Line: 503.639.4175 BUILDING n I /ICI ReadyBy: hen ® See Page t for
Interact wsvw.tigard-or 1 d/Method: Supplemental Information
TYPE OF WORK EEC SCHEDULE
0 construction ElDemolition For special information use checklist.
I Description I Qty. I Ea. I Total
tlei Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft for each utility connection)
„Q , /izY OF CatSIYtL asE„:: ._v SFR(1)bath 312.70
1-and 2-family dwelling ElCommercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Paget
JOB SITE I]\FORMA1 ION NI.. tC .€,� .§- Site utilities:
Catch basin or area drain 18.76
Job site address:
- - r %4,-^i. 5 if1✓1 (i2✓' Drywell,leach line,or trench drain 18.76
City/State/ZIP: fit LI to / a cc? - Z Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: - I Project name: Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
12.51
- - -- - Clothes washer 25.02
13.45a1-.ets ; Lo-v 5 ,cp.,. 660,sx(-I Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump I 25.02 .S u2
PROPER7 Y OWNER Expansion tank 12.51
Fixture/sewer cap 25.02
Name: 5 Li C1✓U�'e.r LA...,C-
_ Floor drain/floor sink/hub 25.02
Address: 13 (D 51. ,W /4S c .e/, 5,`i \ Pr- Garbage disposal 25.02
City/State/ZIP: 1.d W d t U g 7 2 Z -3 Hose bib 25.02
Phone:(CC.;) u 1 - o(ti Gi c Fax:( ) Ice maker 12.51
❑ APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name.
Primer 12.51
Contact name: r.: -
Roof dram(commercial) 12.51
Address: / t �" f Sink/basin/lavatory Z 25.02 10 t. }
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan I 12.51 I L,SI
Urinal 25.02
E-mail: x Water closet I 25.02 )S-0)
'. C.- . - y- , 1 kaxF''2114.is^ axr+."`r..', t
Water heater I 37.52 3 7 S
Business name: 4 C t:,,C„ ci 6 nQ� �� Water piping/DWV 56.29
Address: 73-. �L 1 al QA-e Other. 25.02
City/State/ZIP:
p Subtotal I S o,II
�j.Q�-%� Of._ 7�-� Minimum permit fee: $72.50
Phone:( �j 5 C'1 Fax:( )
Plan review (25%of permit fee)
CCB Lic.: citl 3-7 Plumbing Lic.no.: prsl I a °
State surcharge(12/a of permit fee)
Authorized signature: TOTAL PERMIT FEE
This permit application expires if a permit h not obtained within 180 days
Print name:,r0- kt c/,7 ii t,, Date: q t i tl/2,L7 after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:18uiIdinglPermiu\PLMU-PermitApp.doc 10/01/09 440.4616T(10/02/cOM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: •
Footing drain-I"100' 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 S stems:
Water Service-each additional 100' 37.52 ]Gt jgli_i ',ermlt Fee: ' '
Storm&Rain Drain-1st 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
Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
Other III ECtlonS or Fees and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to _
accurately report fixtures could result in increased sewer fees*. 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 Thru 0 Medical gas and vacuum systems for health care facilities.
Cuspidor/Water Aspirator
Dishwasher: -Commercial ❑ Any multipurpose fire sprinkler system.
❑ Any complex structure as defined in OAR918-780-0040.
-Domestic
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2"
-3" Isometric or Riser Diagram
4" 0 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./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -LavBar 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:
I:1Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
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
Transmittal Letter
TIGARD) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Q\1�i.\ DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
FROM: c-K SCA -1 SEP 19 2022
CITY OF TIGARD
COMPANY: - ) Caster BUILDING DIVISION
PHONE: 6111 - 1p_ q 4 5F) By:
EMAIL:
RE: � 5-A) Sc�/15►rC4 Or PAS(Uz2-C,b2?a-
(Site Addr (Permit Number)
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
.3 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.
Other(explain):REMARKS: C?m\c e q�fi c✓i Cc,fly 12.�P(�1� C.1Q -h�1 G LcymrK
wV�` � Cri
FOR OF ICE USE ONLY
Routed to Permit Technici : Date: L6�/12�- Initials:
Fees Due: ❑ Yes No Fee Description: Amount Due:
( 5-1) -13 E veS
Special
Instructions:
Reprint Permit(per PE): ❑ Yes o ❑ Done
Applicant Notified: Date: Initials:
l:\BuikiinglFomislTransmittalLetter-Revisions_073 I20.doc
Water Meter Fixture Unit Worksheet for Additions/Remodels/ADUs
Please complete the following information:
Customer Name:
Service Address: Street/Suite#: 19 C 5- 7 S p c.r y 14 t^ i)
Cit\: I ,�, State: 0►1. Zip: 5 ) 2 Zf
Phone Number: l >G) ) 7 it 71 , 5(4,S - Email: )1w iC k !`e r( M cr,,7H<<. R GJ` .
Please fill in the number of each fixture you currently have. Please fill in the number of fixtures you propose to add.
Multiply the quantity by the point value to arrive at the current Multiply the quantity by the point value to arrive at
total. the proposed total.
Fixture Unit Current Point Current Proposed Point Proposed
Quantity Value Total Addition Value Total
Bar sink x 1 = x 1 =
Bidet x I = x 1 =
Clothes washer 1 x 4 = 0, x 4 =
Dishwasher i x 1.5 = I, ( x 1.5 =
1"Outside Water Spigot I x 2.5 = 2 r x 2.5 =
Water Spigot,each add'1I x 1 = i x 1
Kitchen sink
Laundry sink 1 x 1.5 = I , 5 x 1.5 =
Lavatory(bathroom sink) li I I 1} S x I = S ( X 1 =
Water closet,1.6 GPF(toilet) I I ik- .(r 3 x 2.5 = ?.S` k x 2.5 = ,5
Bathtub/whirlpool it sr I x 4 = x 4 =
Shower stall 4 i x 2 — 2 I x 2 = 2..
Bath/shower combo x 4 = �1 x 4 =
Current Points: Proposed Increase:
Current Points+Proposed Increase= =New Total Points =Required Meter Size
Meter Sizes: Ito 30 points=5/8" 30.5 to 37 points='A" 37.5 and over points= 1"
1"
New Meter Size Needed for New Total Points: Cost: $ (see page 1)
1"
Current Meter Size per Utility Billing: Cost: $ (see page 1)
New Meter Size Cost minus Current Meter Size Cost= $ 000.00
(This is Your Cost to Increase Meter Size Due to Additional Fixture Units)
FOR OFFICE USE ONLY Meter size does not need to be increased.
Current Meter Size Confirmed with UB Bentley 09/26/2022
Signature of CB Representative Date
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City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
;: Water Meter Fixture Unit Worksheet
H U;A R D For Additions /Remodels /ADUs
13125 SW Hall Blvd. • Tigard,Oregon 97223 • 503.718.2439• www.tieard-or.gov
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: Pricing effective 07/01/2022
5/8" $11,258.00 - Fee includes:
3/4" $16.094.00 water system development charge,
1" $29,588.00 - water meter,and
1-1/2" $87,787.00 meter installation fee.
2" $142,227.00
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 buildings. Due to the
variety of home sizes built in the Tigard area,we count the fixture units of all homes to determine the
appropriate meter size.
Use the worksheet on Page 2 to calculate the current number of fixture units compared to the proposed
increased number of fixture units,which will determine whether an increased meter size will be required.
Submit this signed worksheet with your building or plumbing permit application submittal.
DOCUMENTATION
Once you are ready to purchase the new meter,please provide the following items to the Utility Billing
counter:
• Completed water meter fixture unit worksheet for additions,remodels,ADUs,etc.(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
Once the upgraded meter size has been purchased, most meters are installed within 10-14 business days.
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