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Permit
City of Tigard Deferral Until Occupancy Request • Washington County Transportation Development Tai: (TDT),Transportation and Parks System Development Charges (SDCs) This form is to be signed and submitted prior building permit issuance or,if no building permit is required,then upon land use approval(TMC 3.24, as amended by Ordinance No.21-09). Date: 11/212022 Site Address: 15659 SW Vanderwood Ave Project River Terrace Crossing Land Use Case or Name: (Stone Bridge) Building Permit#: MST2022-00432 Tax Lot 2S108DC01500 Total Parks $11,830.00 #: Lot 15 Amount*: TDT N/A Total TSDC Amount: Amount*: $12,004.00 *The total TSDC amount shown above is the sum of$7,760.00 for TSDC-Improvement,$448.00 for TSDC- Reimbursement,and$3,796.00 for TSDC-River Terrace,if applicable.. *The total Parks SDC amount shown above is the sum of$6,812.00 for Parks-Improvement,$1.887.00 for Parks- Reimbursement,and either$ NIA for Parks-Neighborhood or$_3J 31.00 for Parks-Neighborhood River Terrace. This constitutes my request to defer payment of the TDT, TSDC, and Parks SDCs, as provided above, to prior to final inspection. Payment of the TDT,TSDC, and Parks SDCs may be deferred until issuance of the occupancy permit. In requesting this option, I understand that any deferred TDT,TSDC,and Parks SDCs must be paid prior to final inspection. TDT may only be deferred if the TDT is greater than the amount for a single-family residence. I further understand that the amount of TDT due on deferred obligations shall be the amount in effect at the time of issuance of the building permit. For a deferral request to be accepted both the Property Owner and the Developer must sign this request. 4 ��c,, � Property Owner: """`7' �""Y Date: 12-12-2022 Developer: 8i�D Al M Date: 12/12/2022 Permit Coordinator: Date: 11/212022 ili CITY OF TIGARD MASTER PERMIT 8 '"- COMMUNITY DEVELOPMENT Permit#: MST2022-00432 Date Issued: 12/21/2022 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S108DC01500 Jurisdiction: Tigard Site address: 15659 SW VANDERWOOD AVE Subdivision: RIVER TERRACE CROSSING Lot: Project: River Terrace Crossing, Lot 15 Project Description: New detached dwelling. NO FINAL INSPECTION UNTIL DEFERRED SDC FEES HAVE BEEN PAID. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1596 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 24 Bathrooms: 4 Second: 1692 sf Garage: 627 sf Front: 12 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Total: 3288 sf Value: $536,001.37 Rear: 10 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 6 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100 Tubs/Showers: 4 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: 0 Other Fixtures: 0 Drywall-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 8 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=10OK: 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 addt 500 sf: 6 201-400 amp: 0 201-400 amp: 0 W/O SvdFdr: 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 V© R-3 3288 Owner: Contractor: CND-RIVER TERRACE LLC STONE BRIDGE HOMES NW LLC Required Items and Reports(Conditions) 1111 N POST OAK RD 4230 GALEWOOD STREET#100 1 Ersn Cntrl 503-639-4175 HOUSTON,TX 77055 LAKE OSWEGO,OR 97035 PHONE: PHONE: 503-387-7577 FAX: 503-387-7615 Total Fees: $28,097.80 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. os s are set forth in OAR q59-nn1_nnln thrn,inh(IAP o62nn1-nnon Vnii mm, i� of then ndee nr rlireH ell laefinne fn(111Mr.by n.11innn 9 1�r 1 senh'319 914A Issued By: if - Permittee Signature: . Call 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 the project. Approved plans are required on the job site at the time of each inspection. CITY OF TIGARD SEWER CONNECTION PERMIT l°1 p COMMUNITY DEVELOPMENT Permit#: SWR2022-00188 Date Issued: 12/21/2022 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S108DC01500 Jurisdiction: Tigard Site address: 15659 SW VANDERWOOD AVE Project: River Terrace Crossing, Lot 15 Subdivision: RIVER TERRACE CROSSING Lot: Project Description: Sewer connection for new detached dwelling. Contractor: Owner: CND-RIVER TERRACE LLC 1111 N POST OAK RD HOUSTON,TX 77055 PHONE: PHONE: FAX: FEES Description Date Amount Specifics: Sewer Connection Fee 12/21/2022 $6,625.00 Sewer Inspection-Residential 12/21/2022 $35.00 Type of Use: SF Class of Work: NEW Install Type: Line Tap and Building Sewer Fixture Units: Number of Dwelling Units: 1 Total $6,660.00 Required Items and Reports(Conditions) 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 952-001-0010 through OAR 952-001-0090. You may obtain a y of th rules Issued By: -- ---- Permittee Signature: 1-4461 ...., ./.0e,c. Ca .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 the project. i Approved plans are required on the job site at the time of each inspection. Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONLY City of Tigard Received Permit No.: Date/13y: .11 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits: M Phone: 503.718.2439 Fax: 503.598.1960 24-Hour Inspection Line: 503.639.4175 CI Electrical 0 Plumb ng 0 Mechan cat Internet. www.tigani-or.gov I i varier: I THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A 1 Land use actions completed. Sce jurisdiction criteria for concurrent reviews. ❑ 0 0 2 Zoning. Flood plain solar balance!mints seismic soils designation historic district etc. IT El El 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ 0 6 Sewer permit 0 0 ❑ 7 Water district approval. Li LJ U 8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 ❑ ❑ 9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 ❑ El basin protection,etc. 1t1 1 f'..a.flnfo oahc nr lanlhIa float Muni l.o Aro...n to poole. nkn.:,:nn nnncnrmonnn fry onrlinn1.lP lnnol onA nhntn n 1i 1 1 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 I copyright violations exist. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ® El ❑ there is more than a 4-It.elevation differential,plan must show contour lines at 2-It.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 halts any hold-downs and reinforeino pads connection details vent size, Ix1 El n and location. — — — 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater. x❑ 0 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- Q 0 ❑ Ilour,wail eousu uclion,roof consti uction. More than utte 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. CI ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- ® ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing X❑ El ❑ :oouiiuns. a::.,w mils-,...,::.ai,on. - . 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ 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 M ❑ ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. ® ❑ 0 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑X 0 ❑ for four or more appliances. 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall he stamped by an engineer or ❑X ❑ ❑ • iU la iiiwi iiGGiliGv tti iJl,wii il1iU:iliiiii P'd Juvvv Il iU'or,a:tnivuJry to LriG"iU Gla inrlrGl review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must he 8-1/2"x 11"or 11"x 17". • ■ ■ 24 Two(2)sets each are required for Items 16,19,20 and 22 above. ❑ ❑ ❑ - 'tc Budding_1........1...::_..a.._-....L-_d C...... .._, __ __.. ow,(.__..--J"build:_.__,.._.....AI_...L_......__a_.1 r—t r—i r-, <.o-u:..:::::r n v: :a - •x -::::s building---u::.. xv,:::....va.aw:. ss. 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document ❑ ❑ ❑ 27 "Drawn to scale"indicates standard architect or engineer scale. ❑ ❑ ❑ 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of'figard El ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 ❑ ❑ and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, ❑ 0 ❑ including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on-4 1ss. ,if-r.w_ss__P-vv-ss prim-to sap4__...1-__h-,Ia one . 11Building\Permits\BUP-RESPermitApp.doc 02/24/2011 410-4613T(11/02/COM/WEB) Plum bins Permit Application Building Fixtures FOR OFFICE use ONLY City of'Tigard Received Permit No.: 13125 SW Hall Blvd.,Tigard,OR 97223 ReviewPln ! Phone: 503.718.2439 Fax: 503.598.1960a Date/By: Other Permit No.: Inspection Line: 503.639.4175 Date Read B hors: I B1 See Page 2 for TIGARD Ready/By: Internet: www.tigard-orgov Notifred/Method: Suonlemental Information • TYPE OF WORK FEE* SCHEDULE Da New construction ❑Demolition For special information use checklist. Description I QtY. I Ea. I Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ❑X 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 1 500.32 ❑Accessory building 0 Multi-family _ Ranh add itinnal hath/kitnhen )5 09. ❑Master builder I ❑Other: Fire sprinkler(_sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 15659 SW Vanderwood Ave. Catch basin or area drain I 18.76 /]rvwnll leach line, or trench drain 1 R 76 City/State/ZIP: Tigard, OR 97224 Footing drain(no.linear ft.: ) Page 2 Suite/b1dg./apt.no.: Project name:River Terrace Crossing Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 • Rain drain connector :S.!b Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 I • uuvtlivisiuu. River Terrace Crossing 1 Lot nu.: 15 - - Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 Backwater valve 12.51 DESCRIPTION OF WORK Clothes washer 1 25.02 iVG1rv, :i8igfc family 3Iut;I i.i-. Dishwasher 1 25.02 . Drinking fountain 25.02 Ejectors/sump 25.02 f l PRf1PPRTV (oWNCR I I, TRN4a1T Exoansion tank 12.51 Fixture/sewer cap 25.02 Name: Stone Bridge Homes NW, LLC Floor drain!floor sink/hub 25.02 Address: 4230 Galewood St. Suite#100 Garbage disposal 1 25.02 City/State/ZIP: I nkn Clcwnnn (1R Q_71-Plc_ • __ Phone:(503)387-7577 Fax:( ) Ice maker 12.51 I I APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Medical gas(value:$_) Page 2 Business name: Stone Bridge Homes NW. LLC . . Primer 12.51 . Contact name: Permit Tech Roof drain(commercial) 12.51 Address: 4230 Galewood St. Suite#100 Sink/basin/lavatory 8 25.02 City/State/ZIP: Lake Oswego, OR 97035 Solar units(potable water) 62.54 Phone:(503 )387-7577 I Fax: :( ) Tub/shower/shower pan 4 12.51 E-mail: portlandpermitscstonebridgehomesnw.com Urinal 25.02 Water closet 3 25.02 CONTRACTOR tu . t .e t7 ar, Business name: Edward Mullen Plumbing Water piping/DWV 56.29 Address: S. E. River Road Other: 25.02 City/State/ZIP: Hillsboro,OR 97113 subtotal Phone:( 503)640-0113 Fax:( ) Muuulunl permit ice: $12.30 CCB Lie.:92689 Plumbing Lic.no.: 34-260PB Plan review (25%of pennit fee) State surcharge(12%of permit fee) Authorized signature:. TOTAL PERMIT FEE Print name: Jeremy Grace I Date: 10-27-2022 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 Tri-County Building Industry Service Board. 1:1Buildilg\Peanuts\PLMU-Pem,itApp.doc 10/01/09 440-4616C(10/011COM/WEB) Electrical Permit Application FOR OFFICE 1SE ONLY City of Tigard Received PeRnit#: :.;• 11t25 Cmrr Ha!!Riga Tino.',i OR O11M .ia„ _ _ c.._, - "pima Related Permit 0: • Phone: 503.718.2439 Fax: 503.598.1960 Date/Ely: Inspection Line: 503.639.4175 Ready r)atetny: Luis_ ® See Page 2 for TIC;A R 1 Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK I I PLAN REVIEW ❑X New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked). 0 Service or feeder 400 amps or more ❑Building over three stories. 0 Demolition ❑Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ti1 1-and 2-family dwelling El Commercial/industrial El Accessory building less s im aind,or exceeds 14,000 ❑Commercial-use agricultural ampsor r other nNidiid;iJru. Gliliuirig5. ❑Multi-family ❑Master builder ❑Other: ['Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system_ larger separately derived ❑Addition of new motor load of system. Job#:3244 Job site address: 15659 SW Vanderwood Ave. 1OOHP or more ❑"A","E","t-2","l-3", — _—_- - rl e:...,r.,..,.-r...:.Ln,:.,....:,^. occunancv. Ctty/State/ZIP: I igatYl, OR c i LZ4 0 He t -care a_iliti es_._. ❑Health-care facilities. 0 Recreational vehicle parks. ❑Hazardous locations. 0 Supply voltage for more than smite btdg./apt. #: Project name: River Terrace Crossing ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE n.o..a..«.... t ru., t Fora t hits, t * New residential single-or multi-family dwelling unit. Subdivision:River Terrace Crossing Lot#: 15 Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 3 168.54 I4 Ea.add'I 500 aq.ft orportian 1 33.92 l - DESCIxii Tivi: 'Jras CRii. Limited energy,reside ntial - ^ (with above sq.ft.) 75.00 2 New,single family residence Limited energy,mull-family 75.00 Z residential(with above sq.ft.) f l PROPERTY OWNER I n TENANT Renewable Energy ❑ See Page 2 • -- cc,;:aav:ftti.-.76 IzatalLitlim,-1_e; :iwi,ar.4:':. __k<it-_.. - Name: Stone Bridge Homes NW, LLC 200 amps or less 100.70 2 Address: 4230 Galewood St. Suite#100 201 amps to400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: Lake Oswego, OR 97035 601 wane to 1.000 am09 301.04 _ 2 Phone:( 503) 387-7577 Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: poltlandpermitscstonebridgehomesnw.com relocation Owner installation: This installation is being made on property that I own which is not 200 amps or leas 59.36 1 intended Ior sale,lease,rent,or exchange,according so ORS 447,449,670,and 70 i. 201 amps to 400 amps 125.08 2 • Owner signature: Date: 401 amps to 599 amps I I 168.54 12 lI APPLICANT 0 CONTACT PERSON Branch circuits—new,alteration,or extension, i•r panel A.Fee for branch circuits with Business name: Stone Bridge Homes NW. LLC above service or feeder fee, I I ,A3 each branch circuit Contact name: Permit Tech B.Fee for branch circuits without service or feeder fee,first 56.18 2 Address: 4230 Galewood St. Suite#100 branch circuit City/State/ZIP: Lake Oswego,OR 97035 Each add'l branch circuit 7.42 2 - Miscellaneous(service or feeder not included) Phone:( 503)387-7577 Fax: : ( ) Each manufactured ormodular 67.84 2 dwellEmail: orttand ermitS stonebrid ehomesnw.com ine,teand/or feeder P P Gm 9 Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: Garner Electric Sign or outline lighting I 67.84 2 Signal circuit(s)or limited-energy ❑ See Page 2 2 Address: 2840 SE Brookwood Ave.fserite-4 panel,alteration,or extension. Each additional inspection over allowable in any of the above City/State/ZIP: Hillsboro, OR 97123 _ Additional insneetinn(1 hr min) I I 6675/hr I I Phone:( 503)848-4552 I Fax: ( ) Investigation(1 hr min) 90.00/hr Industrial plant(1 hr min) 78.18/hr Email: chelsea4 arnerelectric.com Inspections for which no fee is 90.00/hr r ( 34 305C Suprv. 3707 5 specificallylisted(11lirmin) CCB Lic. �ri112..Ot1— Electrical Lie.:���� pp- Lie.: IILASCI iICAL PL1iiv11 r rice Suprv.Electrician signature,required: l_.ttA/rJ.ez, &cv44.ye c Subtotal: Print name: Charles Gamer Date: 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: , 'ccy/, . J,i,.-, I c iris.ri:v i;. aL I This permit application expires if a permit is not obtained within 180 Print name: liana Rudolf Date:10-27-2022 days after it has been accepted as complete. * Number of inspections allowed per permit. I:tBwldugy\Permits\ELC_PemutApp_ELR ERE.doc Rev 06/17/2015 440-46 t5T(11/05/COMAyER Electrical Permit Application —City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RFCII)FNTIAI.WORK ONI.V, I FEE SCHEDULE Description I Qtr. I Each I To J 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 U Audio and Stereo Systems* 15.01 to25 kva I I 200.34 ( 2 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 ( 2 r—. �r.,� 40 Al intful Irvin 4519A 9 IJ (`-""'"'be Door Opener* >100 kva(fee in accordance I 552.26 2 with OAR 918-309-0040) ❑x Heating, Ventilation and Air Conditioning S.>tar generation systems in excess of 25 kva: System* >9 , emllil...,ot k,.ev,:r 15 I1.A1I I z ❑ Vacuum Systems* >100 kva—no additional charge 0.0 ( 3 Each additional inspection over allowable in any of the above: n other: Each additional inspection is 66.25/hr I L h dt h charged u an hourly(1 hr min) _._ 1 lnspwtions Ibr which no fee is specifically listed 0,2 hrmin) 90.00Jhr COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 Subtotal(Enter on Page 1): y w Number of inspections allowed per oermn. (SEE OAR 918-3O9-000O) Check Type of Work Involved: 1--I U Allot()anti Stereo Systems ❑ Boiler Controls C.i_i L.:5J .a.a.y u law li ❑ Data Telecommunication Installation El Fire Alarm, Inofollatirsn ❑ HVAC 7 Instrumentation ❑ Intercom and Paging Systems n Landscape Irrigation Control* ❑ Medical n Nurse Calls U Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1:10tnlditg\Permits\ELC_PumitApp_ELR_ERE.doc Rev 06/17/2015 Mechanical Permit Application FOR OFF ICE 1 SF ONLY City of Tigard Received Permit No.: i•• 13125 SW Hall Blvd..'Hoard.OR 97223 Y Ian Review IliAikir: •Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: T I G A R O Inspection Line: 503.639.4175 Date Ready/By: hies. 6§ See Page 2 for Internet: www.tlgard-or.gov Notified/vfethod: Supplemental Information , _ __ TYPE OF WORK i;Vrviivi�.LCl.AAL rrii SC.t.J IIULL U— SL tr-IIE I.irt,i Mechanical permit fees*are based on the value of the work ❑X New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ i;TiGOF:i uT ia�:iafFcuc i:ui RESIDENTIAL EQUIPMENT/SYSTEMS FEES ❑X 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use cheekfis ❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total r/IR CITY INL`AOMATIAN ANTI r eld'ATIAN Heating/cooling: Air conditioning Job site address: 15659 SW Vanderwood Ave. (requires site plan showing placement) 1 46.75 d, OR 97224 ei h'/state/ZIP: Tigard, Furnace 100,000 BTU(ducts/vents) 1 46.75 g Furnace 100,000+BTU(ducts/vents) 54.91 an:.en.t.t,./,..,. „ u.,:�....,.-o. o:....,r..r•..,.., r...CC:.... Heat ounm (requires site plan showing placement) 61.06 Cross street/directions to job site: Duct work 23.32 Hydronic hot water system 23.32 Residential boiler(radiator or 1rydr:,:nie) 11.31 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Subdivision: River Terrace Crossing Lot no.: 15 Flue vent for any of above 1 23.32 Other: 23.32 tax magi pate ei no.; " Other fuel appliances: DESCRIPTION OF WORK Water heater 1 23.32 New, single family residence Gas l rep lace 1 33.39 Flue vent for water heater or gas 2 fireplace 23.32 log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 PROPERTY ,______ I r, ___-.___ Chimney/liner/flue/vent 23.32 _ 161 Yitiir ER ii CF-WNEii V iF,N.AN Other: - 23.32 Name: Stone Bridge Homes NW, LLC Environmental exhaust and ventilation: Address: 4230 Galewood St. Suite#100 Range hood/other kitchen I equipment 33.39 City/JtateiLtY: Lake Oswego, OR 97035 • Cioniea dryer-exhaust i ' 4.4.59 Phone: Fax: Single-duct exhaust(bathrooms, ( 503)387-7577 ( ) toilet compartments,utility rooms) 7 23.32 ® APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32 , a, Other: 23.32 • Business name: 3Lvile Blitigtll flOIlI ii,YY, LLC Fuel In PiP g: Contact name: Permit Tech $14.15 for first four;$4.03 for each additional Address: 4230 Galewood St. Suite#100 Furnace,etc. 1 Gas heat pump • CityiState/LIP: Lake Oswego, OR 97035 Wall/suspended/unit heater . Phone:(503)387-7577 Fax::( ) Water heater 1 E-mail: ortland rmits stonebrid ehomesnw.com Fireplace 1 P (� �. g Range 1 CONTRACTOR Barbecue • . Business name: Comfort Zone Clothes dryer(gas) Other: Address: 1032 NW Corportate Dr. MECHANICAL PERMIT FEES1 • City/State/ZIP: Troutdale, OR 97060 . • subtotat , • Minimum permit fee($90.00) Phone:( 503)667-5595 Fax:( ) Plan review(25%of permit fee) CCB lie.: 110091 Stale surcharge(12%of permit fee) Truer Inaba!NIT mm , pp i av:ai.r e.a::r:e s rr,r, i I Authorized signature: ,,i- °f1+ �, ,'f.'''CI-..„.-(}.. This permit application aalter it lmsres if a been accceptlt edis not obtained within 180 days Print name: David Heldstab Date: 10-27-2022 * Fee methodology set by Tri-County Building Industry Service Board I:\Buildug\Permia\MEC-PemetApp.doc 09/09/10 440-46I7T(I I/02iCOM/WEB) City of Tigard III ° COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Review - Residential TIGARD Building Permit #: MST 2027.-00432 �, Site Address: 'S WSa SW �al1�.Q,f WOOd Aire _p'Verified in Accela Project Name: czk\iker 1rt-+r'ace Cro5S►n Lot/Unit #: IS Proposal (include housing type): NeIA S!A Q ea sif. Zone: PtS —C Required Site Plan Elements:,,�(( �3 copies of site plan onkk>Ta1x17 p'6rawn to standard scale aired trees, drip line/ tree protection North arrow ,PrStreet and site trees shown / labeled /S,f ite address, project name, lot # El -attnlating tree canopy at maturity 8treet names (N/A for SFR) Applicant name and phone # -Eaartyard rectangle dimensioned (if applicable) 'Lot and setback dimensions 4ErVision clearance triangle -0-Existing-structures & square footage idUtility locations &easements Footprint of new structure and FFE )3 Property corner elevations if Sidewalk/driveway dimensioned el LIDA (>1,000 sf disturbance) of area and lot coverage percentage yrErosion control Required Elevation Plan Elements: (For SFR: calcs needed only on street-facing) Garage doors dimensioned Drawn to standard scale Summary table with calculations for: yr-Building height dimensioned sZf Total façade area 0Fasade dimensioned ,'Total window and door area 'Windows and doors dimensioned %Total garage area Required Floor Plan Elements: 0 Summary table that includes dEach story dimensioned 0 Total floor area ach story floor area calculated ❑ Floor area per story Planning Review The following standards have been met: Setbacks Front: UZ Rear: `) Side: 3 Min/Max Street Side: & / — Garage: i Height Max. Height: NA Proposed Height: P 1 %Yes ❑ N/A Landscape ❑ Yes.Z(N/A Screening (Quad only) 7-Yes ❑ N/A % Window Coverage fc.c77, .4 Ilo . 1,3 1, ".121'Yes ❑ N/A Garage (SFR Only) Parking (Other Res) iYes ❑ N/A Entrance (SFR, Rowhouse, Quad only) O YesJ2'N/A Other building design standards (Rowhouse only) ❑ Yes /A Accessory Structure Standards O Yes No Qualifying pre-exi 'ng unit exempt from standards (Cottage unit only) Additional standards for rtyard Units, Cottage Clusters, Rowhouses, and Quads: ❑ Y ❑ N/A Unit Co . 0 Yes ❑ Lot dth and Size O Yes ❑ N/A way Additional ndards Courtyard Units and Cottage Clusters only: ❑ Yes ❑ A Unit Area: ❑ Ye N/A Floor Area (per story) ❑ Y N/A Courtyard 0 Yes 0 N/A Fence ❑ Yes ❑ No ZN/A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995) ❑ Yes ❑ No N/A Public Facilities Improve ent (PFI) Permit: Y� Required: ❑ Yes No Applied For: ❑ Yes ❑No, stop intake � nsitive Lands: ❑ Yes £ Noo, , Land Use Case #:Q-2Ql,G-OcOk, k QQt-;+�8 -( ' 5 Conditions met prior permit issuance Approved By Planning: - - - Date: I ) ( ,2- Notes Revision 1: ❑ Approved ❑ Not Approved Date: Revision 2: ❑ Approved ❑ Not Approved Date: Building Permit Submittal f^ Original Submittal Date: JO/7 2 ,22 Site Plans #: Building Plans #: Building Permit #: ing permit # entered on age 1 Workflow Routing: nin Engineering 0-Ifermit Coordinator (ding Workflow Sign-off: S -off for Planning (include notes from planning review) Route Documents: Engineering: (1) copy of permit application, (1) site plan, (1) building plan an ginal plan review routing form. Building: original permit application, site plans, building plans, engineer and beam calculations and trust details, if applicable, etc. Permit Technician: Date: L0lz-Z`7.6ZQ- Notes• Engineering Review fialope at building pad: 3 /t//!t- VConditions met prior to issuance of permit &Easements (encroachments) per engineering conditions of approval and plat later Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes L AcIo Assess Water Quantity Fee in-lieu: ❑ Yes Quo LIDA Facility on lot: ❑ Yes BYNo Add Fee: ❑ Yes ❑ No E 1•Final Plat Recorded ❑ NOT Approved: Date: Notes: Approved By Engineering: Date: ll7z7ZZ Revision 1: ❑ Approved ❑ pproved Date: Revision 2: ❑ Approved Not Approved Date: Permit Coordinator Review J2'Conditions met prior to permit issuance ❑ Approved, NOT Released: _ Date notified applicant: ❑ ENG Revisions Required: Date notified applicant: „ffeSDC Exemption: ❑ Applied for ❑ Received gDoes not apply ZSDC Fees Entered: Wash Co Trans Dev Tax: ,Yes ❑ N/A Tigard Trans SDC: 'Yes ❑ N/A ZDeferred Parks SDC: Zes ❑ N/A Deferred LIDA ❑ Yes g N/A ,P(OK to Issue/Approved by Permit Coordinator: (JL Date: 1144202'/ Revision 1: ❑ Approved ❑ Not Approved U Date: Revision 2: 0 Approved 0 Not Approved Date: