Permit (42) III CITY OF TIGARD MASTER PERMIT
s. - COMMUNITY DEVELOPMENT
Permit#: MST2022-00117
Date Issued: 09/19/2022
Ti GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S108DC06100
Jurisdiction: Tigard
Site address: 15574 SW PEACE AVE
Subdivision: RIVER TERRACE CROSSING Lot: 68
Project: River Terrace Crossing
Project Description: New detached dwelling. Model Home.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1164 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 27 Bathrooms: 3 Second: 1512 sf Garage: 440 sf Front: 12 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 2676 sf Value: $371,995.28 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 5 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
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: Y Hoods: 1 Other Units: 0
Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 3
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 addl 500 sf: 5 201-400 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 Y
Other: N Other Description:
Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2676
Owner: Contractor:
CND-RIVER TERRACE LLC Required Items and Reports(Conditions)
1111 N POST OAK RD 1 Ersn Cntrl 503-639-4175
HOUSTON,TX 77055
PHONE: PHONE:
FAX:
Total Fees: $23,144.23
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
0c9-nn1-nr19n thrro nh/AR oc2.nn1 Anon Vn i nhtain a rnrai of tha ndac nr rlirart nnactinne fn(111N(`by Tallinn 5n2 929 10S7 nr 1 Ann 229 9244
, 1 , 1 ir::\i j /17 ,/
Issued By: L• (--- A, :,i/A/ 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.
i
Building Permit Application
Residential RECEIVED FOR OFFICE USE ONLY
111 - " City of Tigard Received Date/Bye ZGl?2 � � Permit No sT20 -�° 117
1 13125 SW Hall Blvd.,Tigard,OR 97223 MAR 2 9 2022 plan Review / �j
Phone: 503.718.2439 Fax: 503.598.1960 Date/By'
G�Oj/!/?/ Other Perm�pW 5,3
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: l((�� Ju is: See Page 2l for "/
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: / / Supplemental Information
c\,) #i (s/ )\t ,-*-IYi 1t/ 'A .�i,`
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
•New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
1-and 2-famildwellingValuation: $ i II�jg51
❑Commercial/industrial :rL r I r
ElAccessory building 0 Multi-family Number of bedrooms: 4
❑Master builder ❑Other: Number of bathrooms: 3 JOB SITE INFORMATION AND LOCATION Total number of floors: 2 31 ((0
Job site address: Unknown(re-platting in process) 15674 sid PEKE Ave New dwelling area: 2,676 square feet 15'
City/State/ZIP: Tigard/O R/97224 Garage/carport area: 440 square feet 1 u it
Suite/bldg./apt.no.: Project name: River Terrace Crossing Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: River Terrace Crossing Lot no.: 68 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Unknown(re-platting in process) 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.
Single Family Detached Dwelling Valuation: $
MODEL ( VM(% Existing building area: square feet
e.„.....--,__— New building area: square feet
PROPERTY OWNER ❑ TENANT Number of stories:
Name: CND-RIVER TERRACE,LLC Type of construction:
Address: 111 North Post Oak Road Occupancy groups:
City/State/ZIP: Houston/Texas/77055 Existing:
Phone:(713)316-3128 Fax:( ) - New:
111 APPLICANT 0 CONTACT PERSON
BUILDING PERMIT FEES*
Business name: ICHIJO USA CO., LTD. (Please refer to fee schedule
Structural plan review fee(or deposit):
Contact name: Masaki Narita
FLSplanreviewfee(ifapplicable):
Address: 3800 SW Cedar Hills Blvd
City/State/ZIP: Beaverton/OR/97005 Total fees due upon application:
Phone:(503)430-7413 Fax: :(503)430-7621 Amount received:
E-mail: m-narita@ichijousa.com e495 J6-,5- W3''i, ) PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name: IC H I J O USA CO., LTD. Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 3800 SW Cedar Hills Blvd Solar Installation Specialty Code checklist.
City/State/ZIP: Beaverton/OR/97005 Permit Fee(includes plan review
and administrative fees): $180.00
Phone:(503)430-7413 I Fax:(503)430-7621 _ State surcharge(12%of permit fee): $21.60
CCB lie.: 215360
�� Total fee due upon application: $201.60
Authorized signature: '`Le vAic- This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Masaki Narita Date:3/28/2022 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLY
Cityof Tigard Received
iplg Date/By:
Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:® Phone: 503.718.2439 Fax: 503.598.1960 P
T IGARD
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
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. ❑ ❑ ❑
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 ❑
3 Verification of approved plat/lot. ❑ ❑ 0
4 Fire district approval required. Name of district: ❑ ❑ ❑
5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ ❑
6 Sewer permit. ❑ ❑ ❑
7 Water district approval. ❑ ❑ ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ 0 0
9 Erosion control ❑plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ ❑
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state • ❑ ❑
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if • ❑ ❑
there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements
and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction
indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and
surface drainage.
12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size I ❑ ❑
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, • 0 ❑
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- ■ ❑ ❑
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. • ❑ ❑
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 • ❑ El
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ NI
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 • ❑ ❑
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. • ❑ ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required • ❑ ❑
for four or more appliances.
22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or • ❑ ❑
architect licensed in Oregon and shall be shown to be applicable to the •ro'ect under review. 1
JURISDICTIONAL SPECIFICS
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". • ❑ ❑
24 Two(2)sets each are required for Items 16,19,20 and 22 above. • ❑ ❑
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. • ❑ ❑
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 Tigard • ❑ ❑
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, • ❑ ❑
and protection measures must be drawn to scale and must include the project arborist's signature of approval.
30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, ❑ ❑ U
including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9,1995.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Plumbing Permit Application._
Building Fixtures ECEIVE II FOR OFFICE USE ONLY
City of Tigard MAR 9 2022 Received
v 13125 SW Halt Blvd_,Tigard,OR 97223 Datc/BY: PetmitNo.: ST 2022-00(I 7
Phone: 503.718.2439 Fax: 503.598.I Phan Review /
TI G ARD Inspection Line: 503.639.4175
�:`1TY OF TIGARD DateBy' Other PermitNo.:
Internet: www,tigard-or.gov Date Rc/Metho kris: Supplemental See Page 2 for
UILDING DIVISION Notified/Method:
I formati n
TYPE OF WORK.. FEB* Cki i,l i,EII .
New construction ❑Demolition For special information use checklist.
-
ElAddition/alteration/repIacement El Other: Description I Qty. Ea. Total
New 1-2-family dwellings(includes 100 ft_for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
1-and 2-family dwelling IDCommercial/industrialSFR(2)bath 437.78
D Accessory building ❑Multi-family SFR(3)bath I 500.32
[�Master builder Each additional bath/kitchen 25.02
❑Other: Fire sprinkler( sq.ft.) Page 2
dOR SF INF°E3BAT10F9'Ash LOCATION
Site utilities:
Job site address: Unknown(re-platting in process) Catch basin or area drain 18.76
Drywen,leach line,or trench drain 18.76
City/State/ZIP: Tigard/OR/97224
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name: River Terrace Crossing 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: River Terrace Crossing I Lotno.: 68 Fixture or item:
Tax map/parcel no.: Unknown(re-platting in process) Backflowpreventer 31.27
DESCRIPTION OF WOE Backwater valve 12.51
Single Family Detached Dwelling Clothes washer i 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
•.PROPERTY OWNER. ❑ TENANT Expansion tank 12.51
Name: CND-RIVER TERRACE,LLC Fixture/sewer cap 25.02
Address, 111 North Post Oak Road Floor drain/floor sink/hub 25.02
City/State/ZIP: Houston/Texas/77055 Garbage disposal p 25.02
Hose bib 25.02
Phone:(713)31 6-3128 I Fax:( ) Ice maker f 12.51
a AFPurcAIsn . . La'corrrAcr PERSON Interceptor/grease trap 25.02
Business name: ICHIJO USA CO., LTD. Medical gas(value:$ ) Paget
Contact name: Primer 12.51
Masaki Narita Roof drain(commercial) 12.51
Address: 3800 SW Cedar Hills Blvd
Sink/basin/lavatory 6 25.02
City/State/ZIP: Beaverton/OR/97005 Solar units(potable water) 62.54
Phone:(503)430-7413 Fax::(503)430-7621 Tub/shower/shower pan K 12.51
E-mail: m-narita@ichijousa.corn Urinal 25.02
CONTRACTOR Water closet 25.02
Business name: `� 11 ` e q Water heater r 37.52
Pf/'"e .iT p(u Uf 01,/ Water piping/DWV 56.29
Address:
> - : e Other: 25.02
City/State/ZIP: 138001`4,7 . CI n, •' 7 9 p R Subtotal
Phone:(5 3), t c( elje.t77 Fax-:( 9 t -Oc9�s' Minimum permit fee: $72.50
CCB Lie.: "7' ! Plumb;._•Lie.no.: pG ,9 7 Plan review{25%of permit fee)
/ State surcharge(12%of permit fee)
Authorized signature: J`/ /
�L�7����.� TOTAL PERMIT FEE
Print name: ��ch�+ y�'j j/� I• Date: This permit application expires if a permit is not obtained within 180 days
f �'C" �q,�` after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:18uiidity\Permits'PC.M.U-Permitapp.doc 10/01/09 440-4616T(10/02/COM/WEB)
' Electrical Permit Application RECEIVE I FOR OFFICE USE ONLY
City of Tigard Received 7�7
aBy Permit#:MST 2022-0o i I.7
14 . 13125 SW Hall Blvd.,Tigard,OR 97223 MAR 2 9 2022 Plan Rev:iew
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Related Permit#:
TIGARD
Inspection Line: 503.639.4175 CITY OF TIGARD Ready Date/By: Juris: I ® See Page 2
.. Internet: www.tigard-or.gov BUILDING DIVISIO Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
l, CATEGORY OF CONSTRUCTION < t; i exceeds 10,000 amps at 150 volts or ❑Floating buildings.
11-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address: Unknown(re-platting in process) 100HP or more. ❑"A","E","I-2","1-3",
City/State/ZIP: Tigard/OR/97224 ❑Six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name: River Terrace Crossing ❑Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision: River Terrace Crossing Lot#: 68 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Unknown(re-platting in process)
Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential 75.00 2
Single Family Detached Dwelling (with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
II PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name: CND-RIVER TERRACE,LLC 200 amps or less 100.70 2
Address: 111 North Post Oak Road 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: Houston/Texas/77055 601 amps to 1,000 amps 301.04 2
Phone:(713)316-3128 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:
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
APPLICANT ❑ CONTACT PERSON Branch circuits-c new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: I C H I J O USA CO., LTD. above service orr feeder fee, 7.42 2
each branch circuit
Contact name: Masaki Narita B.Fee for branch circuits without 1
Address: 3800 SW Cedar Hills Blvd service or feeder fee,first
branch circuit 56.18 2
City/State/ZIP: Beaverton/OR/97005 Each add'!branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503 )430-7413 Fax::(503 )430-7621 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: m-narita@ichijousa.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: WEST SIDE ELECTRIC COMPANY Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address: 1834 SE 8TH AVE panel,alteration,or extension. ❑ See Page 2 2
Each additional inspection over allowable in any ofthe above
City/State/ZIP: PORTLAND, OR 97214
Additional inspection(1 hr min) 66.25/hr
Phone:(503)231-1548 Fax:( ) Investigation(1 hr min) 90.00/hr
Email: OFFICE@ W ESTSID EE LECTRIC.CO M Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 13306 Electrical Lic.: 26-135C Suprv.Lic.: 5698S specifically listed CA.hrmin)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required.'"-Ci _Wag—
Subtotal
Print name:BRENT WALL 5698-S Date: 3/18/22 0 Plan Review Required(25%of permit fee):
,J State surcharge(12%of permit fee):
Authorized signature: ✓ �/t '.— TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: tviar,ki k10. ,4 4 Date: / q/20 ii_ days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Buildiog\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/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
Fee for all residential systems combined: $75.00 Description Qty. Each Total
y Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
n O• ther: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(%hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00 • Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
n F• ire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
L Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
L Outdoor Landscape Lighting*
❑ Protective Signaling
n O• ther:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I:\BuildingtPermits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015
•
Mechanical Permit Applicatl° FOR OFFICE USE ONLY
Cityg of Tigard ECEIVE Received Date/By: ,�'2o22�Qo1/�
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Eril
Phone: 503.718.2439 Fax: 503.598.1960D MAR 2 9 2022 Date/By: Permit No.:M V
Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: saris: ® See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION '
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
• 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: Unknown(re-platting in process) Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: Tigard/OR/97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 1 61.06
Suite/bldg./apt.no.: Project name: River Terrace Crossing Ductwork 1 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
Subdivision: River Terrace Crossing Lot no.: 68
Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Unknown(re-platting in process) Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
Single Family Detached Dwelling fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
• PROPERTY OWNER ElTENANT Other: 23.32
Environmental exhaust and ventilation:
Name: CND-RIVER TERRACE,LLC Range hood/other kitchen
equipment 1 33.39
Address: 111 North Post Oak Road Clothes dryer exhaust 1 . 33.39
City/State/ZIP: Houston/Texas/77055 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 3 ' 23.32
Phone:(713) 316-3128 Fax:( ) Attic/crawlspace fans 23.32
• APPLICANT ❑ CONTACT PERSON Other: 23.32
Business name: ICHIJO USA CO., LTD. Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name: Masaki Narita Furnace,etc.
Address: 3800 SW Cedar Hills Blvd Gas heat pump
Wall/suspended/unit
d/unit heater
City/State/ZIP: Beaverton/OR/97005 Water heater 1
Phone:(503)430-7413 Fax: :(503)430-7621 Fireplace
Range 1
E-mail: m-narita@ichijousa.com Barbecue 1
CONTRACTOR . I Clothes dryer(gas)
Business name:
Supreme Heating and Cooling LLC other
MECHANICAL PERMIT FEES*
Address: 13009 NE 91 ST Circle Subtotal
City/State/ZIP: Vancouver, WA 98682 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( 503-333-3213 Fax:( ) State surcharge(12%of permit fee)
CCB lie.: 221270 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
�� days after it has been accepted as complete.
Authorized signature: ,�sl,_' "�jY.r * Fee methodology set by Tri-County Building Industry Service Board
Print name: m6Scsi,i I40,l-1{-a Date: 3-21-22
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(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.
I:\Building\Permits\MEC_PermitApp_040113.doc 2
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
Temporary Use Type I Application
PROPOSAL SUMMARY (Brief description) REQUIRED SUBMITTAL
Temporary use approval to allow: Single-family detached model home ELEMENTS
❑ Owner's signature/
Property address/location(s): Address Unknown written authorization
❑ Two(2)copies of the site/plot
Lot 68 at River Terrace Crossing subdivision plan indicating:
Tax map and tax lot #(s): Unknown(re-platting in process) 1. Location of the Temporary Use
2. Lot size
3. Square footage and location of
Site size: 3,923 sq.ft. existing buildings
4. Current uses of existing buildings
Start date: 3 / 21 / 22 End date: 7 / 29 / 22 5. Number of existing parking spaces
6. Square footage of any space to be
Please check one: used as additional parking
❑ Season/special event 7. Driveway locations
❑ Unforeseen/emergency situation ❑ Site/plot plan(reduced to 8.5"x11%2")
O Applicant's statement address criteria:
M Temporary sales office/model homes
18.440.050(2 copies)
❑ Temporary use in commercial and industrial zone
❑ Filing fee(unless exempt)
APPLICANT* FOR STAFF USE ONLY
Business name: Ichijo USA Co.,Ltd. I Case No.: �/t 1 P/iw�(J �� 000
Address: moo SW Cedar Hills Blvd.Ste 130 •
Beaverton,OR 97005 Related Case No.(s):
City/state: Zip. P134.-
Masaki NaritaApplication Fee:
Contact name:
Ph#: (503)430-7413m-narita@ichijousa.comApplication accepted:
Email: )vL
By: -�dUY—\�fl- Date: (/
Application determined complete:
PROPERTY OWNER/DEED HOLDER(S)*(Attach list if more than one) By: Date:
Name: CND-RIVER TERRACE,LLC I:\Community Devabpment\Land Use Applications\02 forms and
Templates\land Use Applications Rev.12/14/2017
Address: 1111 North Post Oak Road
City/state: Houston,TX Zip: 77055
Contact name: John Burchfield Ph# 713-316-3128
* When the owner and the applicant are different people,the applicant must be the purchaser of record or a lessee in possession
with written authorization from the owner or an agent of the owner.The owner(s)must sign this application in the space
provided on the back of this form or submit a written authorization with this application.
City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 • Page 1 of 2
APPLICANTS
To consider an application complete,you will need to submit ALL of the REQUIRED SUBMITTAL ELEMENTS
as described on the front of this application in the"Required Submittal Elements"box.
(Detailed Submittal Requitetnent Information sheets can be obtained,upon request,for all types of Land Use Applications.)
THE APPLICANT(S) SHALL CERTIFY THAT:
• The above request does not violate any deed restrictions that may be attached to or imposed upon the subject property.
• If the application is granted,the applicant will exercise the rights granted in accordance with the terms and subject to all the
conditions and limitations of the approval.
• All of the above statements and the statements in the plot plan,attachments,and exhibits transmitted herewith,are true;and
the applicants so acknowledge that any permit issued,based on this application,may be revoked if it is found that any such
statements are false.
• The applicant has read the entire contents of the application,including the policies and criteria,and understands the
requirements for approving or denying the application.
SIGNATURES of each owner of the subject property required.
Applicant's signature Print name Date
O" ' John Bvccp-Fi£1 ti 2-q--Zz
f
s sign. e Print name Date
Owner's signature Print name Date
Owner's signature Print name Date
TEMPORARY USE—TYPE I APPLICATION(TUP)
City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • wwwtigard-or.gov • 503-718-2421 • Page 2 of 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
I-) SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: A I\k cov" Arm 541-U DATE RECEIVED:
DEPT: BUILDING DIVISION tU b V CI
FROM: Mas&E MAY 1 2 2022
COMPANY: Lcii;jU ""USA CITY OFTIGARD
MSK
BUILDING DIVISIQN
PHONE: s-3-63�f I By
EMAIL: Wv_ jet avi p ic(+rjo0-c 'cowl
1 S 5- 1`f SVJ r-eea.c,4--
RE: I.Ac 1 2oZ2-00III
(Site Address) (Permit Number)
�L i vov re {-Yc.C2 C vocOis 1 6S
(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.
Other(explain):
REMARKS: ko6f fours taro6k1
FOROFFICE USE ONLY
Routed to Permit Technic' n: Date: 5 /(e/ZZ Initials:
Fees Due: ❑Yes No Fee Descriptidn: Amount Due:
Special
Instructions:
Reprint Permit(per PE): ❑ Yes No ❑Done
Applicant Notified: Date: Initials:
I:\Building\Forms\TransmittalLetter-Revisions_073120.doc
City of Tigard
NIr COMMUNITY DEVELOPMENT DEPARTMENT
C
T l c A R D Building Permit Review — Residential
Building Permit #: IST2022-00l 17
Site Address: ( SS ,714 5W P&t` .
Project Name: R`jv\P,r 1 i ffli r e (A cSiUI Lot #: 699
Planning Review /
Proposal: M Odd H 0 Kitt A--, ciies arP1
Verify address/suite#active in Accela. ❑ In River Terrace: ❑ No in Yes,River Terrace Review Addendum
Site Plan Elements: giErosion Control
i4h copies of site plan on 8-1/2"x 11"or 11 x 17"paper WRetained trees with drip line and tree protection measures
71 Drawn to scale(standard architect or engineer scale) Footprint of new structure(including decks)and FEE
►a orth arrow tility locations&easements(required for new and additions)
Site address,project or subdivision name and lot number dewalk/driveway approach
Si
Applicant information(name and phone number)
Lot dimensions and building setback dimensions Street tree size,type and location
Square footage of buildings to be demolished V&Street names
Corner elevations (2'contours if more than 4'differential)
PLot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? Wes ❑No
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? Yes No
57.) Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified A No Received: ❑ Yes ❑ No
0 Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑ Yes,applicant was notified , D No Received: ❑ Yes ❑ No
. o Received: ❑ Yes ❑ No
Public Facilities Improvement(PFI)Permit:
Required: ❑ Yes,applicant was notified ? No Applied For:
(,1❑ Yes ❑ No,stop intake
A Land Use Case#: `^(U?Za Z s Oa p Zoning: �S
( Required Setbacks: Front: IV` Rear: 1 7 Side: 3' Street Sid : � Garage: 'Z-e)'
in Building Height: � ,S Max.Height: 5 -,-7 Actual Height: ' 7,?
OD Landscape Area: vU % Ki Lot Coverage Max: '�d
Entrance al Set back no more than 8'from street-facing wall vo Parallel to street or offset 45 degrees or less
Windows lid Minimum 12%of area of all street-facing facades
Garage ? Garage door is behind widest street-facing wall ❑ Yes RCNo,one of the following is met:
`le Door extends no more than 5'from wall and there is a covered porch extending beyond garage.
❑ Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2nd floor.
Garage door width is ❑ 12'or less xo 50%or less of facade ❑ 60%or less and includes 7 of following:
❑ Covered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset
❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer
❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony
0.1 Visual Clearance ❑ Urban Forestry Plan
01 Sensitive Lands: ❑ Yes ial No Type:
'i, Conditions met prior to issuance of building permit
Notes:
21 Approved By Planning: Date: `/ ( 24/zc 2-2-
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPernutRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: 03 29 2022
Site Plans: #
Building Plans: # 3
Building Permit#: O.-Enter building permit#above.
Workflow Routing: Tr-Planning Engineering Er-Permit Coordinator lWBuilding
Workflow Sign-off: Cir Sign-off for Planning(include notes from planning review)
Route Application Documents: RrEngineering: (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 applicable,etc.
Notes:
By Permit Technician: Date: 65/03/2022_
Engineering Review
[Slope at building pad: 7 O
❑ Conditions "Met"prior to issuance of building permit
E Easements (encroachments)per engineering conditions of approval and plat
❑ Water Quality/Quantity Facility: ,,�1
Assess Water Quality Fee in-lieu: 0 Yes IJ No
Assess Water Quantity Fee in-lieu: 0 Yes [ 'No
LIDA Facility on lot: 0 Yes Ps No Add Fee: ❑ Yes ❑ No
WCll-❑ Final Plat Recorded:
❑ NOT Approved by Engineering:/ �_,( /' Date: ,/
Notes: IP �edie �i� ' C l e sr ' chae
Approved by Engineering: Date: v5:79/ZL
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Permit Coordinator Review
❑ onditions "Met"prior to issuance of building permit
►. Approved,NOT Released: ernalizeicvmvicurt -u 515 120 Z 2 Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
SDC Exemption: ❑ Received / Does not applyMAD IS DC tie zY`d
SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: /Yes 0 N/A CtC re-61.
Parks SDC: Yes ❑ N/A
LIDA ❑ Yes / N/A
/ OK to Issue Permit
Approved by Permit Coordinator: C Date: � I l$ ('2o2/2-
I:\Building\Forms'BldgPermitRvw_RES_1208021.docxt
Agnes Lindor
From: Agnes Lindor
Sent: Wednesday,June 15, 2022 1:53 PM
To: Jenny McGinnis; Boris Piatski;Jeremy Tamargo; m-narita@ichijousa.com
Cc: #Building Permit Technicians
Subject: MST2022-00117 lot 68
Attachments: PDR2018-00005 Conditions 6-15-2022.pdf; PDR2016-00016 Conditions 6-15-2022.pdf
Good afternoon-
Boris/Jeremy and Jenny- Can you please sign off all required conditions for both the PDRs attached or let me know
whether these conditions do not need to be met for the issuance of the following permits:
MST2022-00117- Model home and Sales Office(Lot 68)
Please let me know if or which COAs need to be met prior to issuance of these.
It is also my understanding that there will be parks credits available for this subdivision, so I need to know if you want to
defer the parks fees to final building inspection in order to be able to apply the credits. For future submittals,this needs
to be stated on the application form under description of work: "DEFER ALL PARKS FEES". Otherwise I will not know that
you want to defer fees.
Thanks,
Agnes Lindor I Associate Planner
City of Tigard I Community Development
13125 SW Hall Boulevard
Tigard, Oregon 97223
Phone: 503.718.2429
Email:AgnesL@tigard-or.gov
1
Agnes Lindor
From: Agnes Lindor
Sent: Thursday, May 5, 2022 12:01 PM
To: m-narita@ichijousa.com
Cc: #Building Permit Technicians; Boris Piatski
Subject: MST2022-00117 Lot 68
Good afternoon-
Your permit has been approved but cannot be released at this time. Per Engineering, all utilities must be in place before
this permit can be released. If you have any questions, please follow up with Boris (copied on this email).
Agnes Lindor I Associate Planner
City of Tigard I Community Development
13125 SW Hall Boulevard
Tigard, Oregon 97223
Phone: 503.718.2429
Email:AgnesLPtigard-or.gov
1
City of Tigard
Deferral Until Occupancy Request
T I G A RD Washington County Transportation Development Tax (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: 6/22/2022 Site Address: 15574 SW PEACE AVE
Project River Terrace Crossing Land Use Case or
Name: (Ichijo USA) Building Permit#: MST2022-00117
Tax Lot Total Parks
#: Lot 68 Amount*: $10,903.00
TDT N/A Total TSDC $10,348.00
Amount: Amount*:
*The total TSDC amount shown above is the sum of$6,690.00 for TSDC-Improvement,$ 386.00 for TSDC-
Reimbursement,and$3,272.00 for TSDC-River Terrace,if applicable..
*The total Parks SDC amount shown above is the sum of$6,278.00 for Parks-Improvement, $ 1,739.00 for Parks-
Reimbursement,and either$ N/A for Parks-Neighborhood or$2,886.00_ 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 a cepted both the Property Owner and the Developer must sign this request.
3 ' `'
Property Owner: Date: 6/7
g)i)191/
Developer: Date:
Permit Coordinator: 141V
_ `" Date: 6/22/2022