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Permit
''1 � .t CITY OF TIGARD MASTER PERMIT 1 s COMMUNITY DEVELOPMENT Permit#: MST2022-00431 T t G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/12/2022 Parcel: 1 S133DC 19400 Jurisdiction: Tigard Site address: 13494 SW ORLIN CT Subdivision: DONNA PARK Lot: 6 Project: Donna Park, Lot 6 Project Description: New detached dwelling. BUILDING Floor Areas Reauired Setbacks Required Stories: 1 Bedrooms: 4 First: 2422 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 14.6 Bathrooms: 3 Second: 0 sf Garage: 523 Dwelling Units: 1 Third: 0 sf 9 sf Front: 10 Smoke Yes Right: 5 Detectors: Total: 2422 sf Value: $401,954.51 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100 Tubs/Showers: 3 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: 4 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'I 500 sf: 4 201-400 amp: 0 201-400 amp; 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Y Ewmpasing: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2422 Owner: Contractor: JT ROTH CONSTRUCTION INC J TROTH CONSTRUCTION Required Items and Reports(Conditions) 12600 SW 72ND AVE STE 200 12600 SW 72ND AVE#200 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97223 TIGARD,OR 97223 PHONE: PHONE: 503-639-2639 FAX: 503-624-0239 Total Fees: $43,271.51 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 OS9-nni_nnen thrni,nh OAR oc0.nM-nnon Vnn mast nhfa' nv of the miac nr rliront n„aerinnc/n Oh INC by raninn cn r. pnn 41' Issued By: Permittee Signature: /� 503.639.4175 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 project. Approved plans are required on the lob site at the time of each Inspection. Building Permit Application RECEIVED Residential OCT 2 7 2022 FOR OFFICE USE 0yIX City of Tigard Received Penn it No.: 111 13125 SW Hall Blvd.,Tigard,OR 97223 CITY OF TIGARD Datelp : (A . ►� - coQC 113 a Phone: 503.718.2439 Fax: 503.s98.i9 uILDINGDIVISION pate/BBev:IeW I(© 2 Other Permit: ' P. 20,....ta. 1 T 1 G A R I) Internet: Line: 503.639.4175 Date Ready/By: RI See Page 2 for Internet: www.tigard-or.gov Notified/Med ♦wd: , /a_ iii. Supplemental Information TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING ®New construction 0 Demolition Permit fees*are based on the value of the work performed. El Addition/alteration/replacement ❑Other Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead.,and the profit for]hers / CATEGORY OF CONSTRUCTION work indicated on this application. p 1/ ei� ® 1-and 2-family dwelling ElCommercial/industrial Valuation: sgg"gg;.gg—. Number of bedrooms: ElAccessory building ElMulti-family ❑Master builder D Other: Number of bathrooms;, JOB SITE INFORMATION AND LOCATION Total number of floors:1 79-/S Job site address:13494 SW Orlin Ct. New dwelling area: 2422 square feet 2tlu� City/State/ZIP:Tigard, OR 97223 Garage/carport area: 523 square feet l Suite/bldg./apt.no.: Project name:it9v 1/ova Aiiii 14-y yr Coovf red porch 42 square feet Cross street/directions to job site: W T r ea., 128 square feet SW 135th Ave. Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision:Donna Park Lot no.:4 Permit fees*are based on the value of the work performed. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. Construction of new single family home Valuation: $ Existing building area: square feet New building area: square feet 0 PROPERTY OWNER 0 TENANT Number of stories: Name:J.T. Roth Construction Inc. Type of construction: Address:12600 SW 72nd Ave, Tigard OR occupancy groups: City/State/ZIP: Existing: Phone:( 503-639-2639 Fax:( 503-624-0239 New: 0 APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES* Business name:J.T. Roth Construction Inc. (Please refer to fee scaedsdr) Structural plan review fee(or deposit): I.j'-' Contact name:David Jensen FLS plan review fee(if applicable): Address:12600 SW 72nd Ave, Tigard OR Total fees due upon application: City/State/ZIP: Phone:( Fax: ; 503- 24-0239 Amount received: 50$-806-0602 E-mail:david trOthlnD COn1 PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* 1lj CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted Photovoltaic Solar Panel System. Business name:J.T. Roth Construction Inc. Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:12600 SW 72nd Ave, Tigard OR Solar Installation Specialty Code checklist. City/State/ZIP: Permit Fee(includes plan review $180.00 and administrative fees): Phone:(503-639-2639 Fax:(503624-0239 State surcharge(12%of permit fee): $21.60 CCB lie.:31700 Total fee due upon application: $201.60 Authorized signature'f J This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Print name:David Jensen Date:08_18-2022 Service Board. L\Building\Pennits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB) Mechanical Permit Application FOR OH T I SI.(IvI 1 City of Tigard Received No.. 71 . - ■ 13125 SW Hall Blvd.,Tigard,OR 97223 s Phone: 503.718.2439 Fax: 503.598.1960 Plan Rev ew Date/By: Other Permit: TIGARD Inspection Line: 503.639.4175 Date Ready/By: tuns: BJ See Page 2 for Internet: www.tigard-or.gov Notified/Method. Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE-USE CHECKLIST Mechanical permit fees*are based on the value of the work is New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES` ® 1-and 2-family dwelling 0 Commercialindustrial 0 Accessory building For special information use checklist ❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. 1 Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 1 46.75 Job site address:13494 SW Orlin Ct. Furnace 100,000 BTU(ducts/vents) 1 46.75 City/State/ZIP:Tigard, OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/btdg./apt.no.: Project name: Duct work 23.32 Cross street/dtrections to job site: Hydronic hot water system 23.32 Residentialiboiler(radiator or SW 135th Ave. 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:Donna Park Lot no.:f Other' 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 1 23.32 DESCRIPTION OF WORK Gas fireplace/insert 1 33.39 Flue vent for water heater or gas HVAC installation new single family residence 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 . ® PROPERTY OWNER 0 TENANT 2332 Environmental exhaust and ventilation: Name:J.T. Roth Construction Inc. Rangehood/otherkitchen Address:12600 SW 72nd Ave, Tigard OR Cloequthes 1 33.39 g Clothes dryer exhaust 1 33.39 City/State/ZIP: Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 4 23.32 Phone:503-639-2639 Fax:503-624-0239 Attic/crawlspace fans 23.32 0 APPLICANT ® CONTACT PERSON Other: 23.32 Fuel piping: Business name:J.T. Roth Construction Inc. $1415 for first four;S4.03 for each additional Contact name:David Jensen Furnace,etc. Address:12800 SW 72nd Ave, Tigard OR Gas heat pump WalUsuspended/unit heater City/State/ZIP: Water heater Phone:503-806-0602 Fax::603-624-0239 Fireplace Range E-mail:davidj@jtrothinc.com Barbecue CONTRACTOR Clothes dryer(gas) Other Business name:Pro Heating and Cooling Inc. MECHANICAL PERMIT FEES* Address:2095 NW Alocleck Dr Subtotal City/State/ZIP:Hillsboro, OR Minimum permit fee(S90.00) Phone:(503-R70-1590 Fax:( ) Plan review(25%of permit fee) State surcharge(12%of permit fee) CCB lie.:209001 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within I80 days after it has been accepted as complete. Authorized signature: 0..............„.../ --- * Fee methodology set by Tri-County Building Industry Service Board Print name:Martin Perez Date:08-18 2022 1:tauddingtPermitstMEC Perm,tApp_040113.dec 440-4613T(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. L1Building\permits\MEC_PermitApp_040113.doc 2 Electrical Permit Application FOR OFFICE ISI ON ,Y City of Tigard 13125 SW Hall Blvd., Received p D Permit tt: Tigard,OR 97223 an Review a Phone: 503.718.2439 Fax: 503.598.1960 paPlng Related Permit N: Inspection Line: 503.639.4175 Ready Date/By: luris: H See Page 2 for 1 t,A RU 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 a sets of plans w/items checked): ❑Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition 0 Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural ❑Multi-family 0 Master builderamps forall otherinstallations. buildings. 0 Other: 0Fire pump, p. 0 Installation of 150 xva or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: Job site address:13494 SW Orlin Ct. 10011P or more. ❑ 'a", E".-1•r','1.3", City/State/ZIP:Tigard, OR 97223 ❑Six or more residential units. occupancy. 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name:Donna Park ❑Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE SW 135th Ave. Description I Qt,. I Each I Total i " New residential single-or multi-family dwelling unit, Subdivision:Donna Park Lot#:6 Includes attached garage. 1,000 sq.ft.or less 1 168.54 4 Tax map/parcel#: Ea.add•I 500 sq.ft.or portion 4 33.92 I DESCRIPTION OF WORK Limited energy,residential Electrical wiring of new single family residence (with above sq.ft.) 1 75.00 2Limited energy,multi-family 75.00 2 residential(with above sq.ft.) ® PROPERTY OWNER ❑ TENANT Renewable Energy 0 See Page 2 Services or feeders installation,alteration,and/or relocation Name:J.T. Roth Construction Inc. 200ampsorless 100.70 2 Address:12600 SW 72nd Ave, Tigard OR 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: 601 amps to 1,000 amps 301.04 2 Phone:( 503-639-2639 Fax:503-924-0239 Over 1,000 snips or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: davidj jtrothinc.com relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 0 APPLICANT ® CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name:J.T. Roth Construction Inc. above service or feeder fee, 742 2 each branch circuit Contact name:David Jensen B.Fee for branch circuits without service or feeder fee,first 56.18 2 Address:12600 SW 72nd Ave, Tigard OR branch circuit City/State/ZIP: Each add'l branch circuit 7.42 2 (50306-0602 (j Miscellaneous(service or feeder not included) Phone: Fax: : 03- 4-0239 Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: davidj a�j'trothinc.corn Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name:Dreamhouse Electric LLC Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy ❑ See Page 2 2 Address:13075 SW Canyon Rd panel,alteration,or extension. City/State/ZIP:Beaverton, OR Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:503-648-5144 Fax:( ) Investigation p hr min) 90.00/hr Industrial plant(1 hr min) 78.18/hr Email:dreamhouseeleetric@gmail.eom Inspections for which no fee is 90.00/hr CCB Lic.:196726 Electrical Lic.:C-848 Suprv.Lic.: specifically listed(%hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name:Chris Mahoney Date:08-18-2022 ❑Plan Review Required(25%of permit fee): /�j/ � � State surcharge(12%of permit fee): Authorized signature: c'---��/ r TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. • Number of inspections allowed per permit. 1:1BuildinglPermiu\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(I 1/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Description I Qty. l 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 E Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: n 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 2 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 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(.3 hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES • Fee for each commercial system: $75.00 Subtotal(Enter on Page 1): y ' Number of inspections allowed per permrl. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems 7 Data Telecommunication Installation n Fire Alarm Installation ❑ HVAC n Instrumentation ❑ Intercom and Paging Systems n Landscape Irrigation Control* ❑ Medical 7 Nurse Calls n Outdoor Landscape Lighting* ❑ Protective Signaling n Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:'0aildin5\PermiMLLC_PermitApp_ELR_ERE.doc Rev 06/17/2015 • • Plumbing Permit Application Building Fixtures FOR OFFICE t SE ()NIA' City of Tigard ReceivedDate/By: Permit No.: IIIi 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review • ' Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.: i GAR D Inspection Line: 503.639.4175 Date Ready/By: kris: B 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 ❑Additionialteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ® I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 ❑Accessory buildingSFR(3)bath 1 50032 0 Multi-family Farh additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address:13494 SW Orlin Court Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard, OR 97223 Footing drain(no.linear ft.:_J Page 2 Suite/bldg./apt no.: I Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 SW 135th Court 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:Donna Park I Lot no.:4 6 Fixture or item: Tax map/parcel no.: Backflow preventer 1 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Domestic plumbing of new single family residence Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER I 0 TENANT Expansion tank 12.51 , Fixture/sewer cap 25.02 Name:J.T. Roth Construction Inc. Floor drain/floor sink/hub 25.02 Address:12600 SW 72nd Ave, Tigard OR Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:603-6)39-2639 Fax:603-024-0239 Ice maker 12.51 0 APPLICANT la CONTACT PERSON Interceptor/grease trap 25.02 Business name:J.T. Roth Construction Inc. Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:David Jensen Roof drain(commercial) 12.51 Address:12600 SW 72nd Ave, Tigard OR Sink/besinnavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:603-806-0602 Fax::603-624-0239 Tub/shower/shower pan 12.51 E-mail:davidj@jtrothinc.com Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name:On Track Plumbing Water Pin iP g/D WV 56.29 Address:PO Box 506 Aumsmille, OR Other: 25.02 City/State/ZIP: Subtotal Phone:(541-2/33-8835 Fax:( ) Minimum permit fee: $72.50 CCB Lie.:219903 lumbing Lie.no.:10907 JP Plan review(25%of permit fee) State surcharge(12%of permit fee) __,,,, Authorized signature: TOTAL PERMIT FEE Print name:Spenser Stegman Date:/( l,iL '�i This permit application expires if a permit is not obtained within 180 days ZlfOJi7 after it has been accepted as complete. "Fee methodology set by Tri-County Building Industry Service Board. I:1Buildit8\PermastPLMU-PernutApp.do° 10/01/09 4404616T(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-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: Stone&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 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 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 Baptistry/Font 0 Any new commercial building with water service 2"and Bath: -Tub/Shower greater,except systems designed and stamped by licensed -Jacuzzi/Whirlpool engineer. • Car WashWash. Each Stall New exterior plumbing site utilities for any complex structure Drive as defined in OAR918-780-0040. Cuspidor/Water i ❑ Medical gas and vacuum systems for health care facilities. Aspirator Dishwasher Commercial 0 Any multipurpose fire sprinkler system. Domestic ❑ Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" 3" Isometric or Riser Diagram 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 Comments regarding fixture work: Ice Mach./Refrig.Drains g g 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 Water Extractor fees assessed for the sewer increase must be paid before the Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: C\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 • O Yes El No �N/A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995) ❑ Yes ❑ No 7N/A Public Facilities Improvement (PFI) Permit: Required: ❑ Yes ❑ No Applied For: ❑ Yes ❑ No, stop intake ❑ Sensitive Lands: ❑ Yes ❑ Nogyp ,Land Use Case #: Sllgq 2o� -WWI , A.212AI`1-O7O J „ErConditions met prior permit issuance Approved By Planning: Date: tO(21(�2 Notes Revision 1: 0 Approved 0 Not Approved Date: Revision 2: 0 Approved ❑ Not Approved Date: Building Permit Submittal Original Submittal Date: /O/27/2C22— Site Plans #: 3 Building Plans #: Building Permit #: Byilding perm' entered on page 1 Workflow Routing: ning ngineering ermit Coordinatorilding Workflow Sign-off: Si n-off for Planning (include notes from planning review) Route Documents: gineering: (1) copy of permit application, (1) site plan, (1) building plan and inal plan review routing form. wilding: original permit application, site plans, building plans, engineer and beam calculations and trust details, if applicable, etc. Permit Technician: Date: OM/? 'L Notes: Engineering Review Cd'Slope at building pad: 2'1 CIConditions met prior to issuance of permit C-Easements (encroachments) per engineering conditions of approval and plat Q.'ater Quality/Quantity Facility: Assess Water Quality Fee in-lieu: 0 Yes t iJo Assess Water Quantity Fee in-lieu: 0 Yes i iNo 1V� LIDA Facility on lot: 0 Yes Io Add Fee: 0 Yes ❑ No l Final Plat Recorded O NOT Approved: Date: Notes: Po har ✓vtk-Jt vafd Ci46.411b1..S hcve i+wer+ ,r,r-A (Aihc/ S, I.tt- Ori,E..Ge_ eferlj Approved By Engineering: 77-G+7i 1H44/47 Date: I'A/2422- Revision 1: ❑ Approved 0 Not Approved Date: Revision 2: ❑ Approved ❑ Not Approved Date: Permit Coordinator Review etonditions met prior to permit issuance .I IApproved, NOT Released: PGL. Date notified applicant: 1t I'1.I2,15Za' ❑ ENG Revisions Required: Date notified applicant: 'SDC Exemption: 0 Applied for ❑ Received Oboes not apply J2'SDC Fees Entered: Wash Co Trans Dev Tax: ,gfYes ❑ N/A Tigard Trans SDC: , Yes ❑ N/A ❑ Deferred Parks SDC: 0-Yes ❑ N/A ❑ Deferred LIDA ❑ Yes 0"-N/A 7OK to Issue/Approved by Permit Coordinator: Date: lltitQ Z02Z Revision 1: ❑ Approved 0 Not Approved Date: Revision 2: ❑ Approved 0 Not Approved Date: 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 r i t A It n 13125 SW Hall Blvd. • Tigard, Oregon 97223 . 503.718.2439 • www.tigard-or.gov TO: Allyson Armstrong DATE L 41,_,�./ D: DEPT: BUILDING DIVISION `� NC.' 3 2022 FROM: David Jensen CITY OF TIGARD COMPANY: J.T.Roth Const. Inc. BUILDING DIVISION PHONE: 503-606-0602 Bye-T. EMAIL: davidj@jtrothinc.com RE: 13422 SW Orlin Ct 7)-7,57 A4--(h) 3 . (Site Address) (Permit Number) Donna Park lot 6 (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. 3 Other(explain):Lateral engineering page REMARKS: Thanks for your help. FOR FFICE USE ONLY Routed to Permit Technici : Date: I(l ly{Z"L Initials: Alk Fees Due: ❑ Yes No Fee Description: Amount Due: i '0 e $$ (25 Special Instructions: Reprint Permit(per PE): D Yes No ❑Done Applicant Notified: Date: Initials: Agnes Lindor From: Agnes Lindor Sent: Wednesday, November 2, 2022 10:11 AM To: davidj@jtrothinc.com Cc: Hope Pollard;Trent Brickey Subject: Donna Park Permits Good morning- Your permits have been approved but cannot be released until the following condition is met: 31. Prior to final plat approval, the Applicant must submit to the Engineering Division the Final Sight Distance Certification indicating that sight distances are adequately provided at the intersection of the private street and 135th Ave. Thanks, Agnes Lindor I Senior Planner City of Tigard I Community Development 13125 SW Hall Boulevard Tigard, Oregon 97223 Phone: 503.718.2429 Email:AgnesL@tigard-or.gov 1