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Permit CITY OF TIGARD MASTER PERMIT 1 7 a COMMUNITY DEVELOPMENT Permit#: MST2022-00199 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/03/2022 Parcel: 2S109DA04500 Jurisdiction: Tigard Site address: 15412 SW GREENFIELD DR Subdivision: SUMMIT RIDGE Lot: 22 Project: Butcher Project Description: Adding bathroom to attic space behind bonus room. BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 1 Second: 60 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: Total: 60 sf Value: $9,052.20 Rear: 0 PLUMBING Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Drains: 0 Storm Sewer: 0 Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Bckflw Prevntr: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 1 Clothes Dryers: 0 Natural Gas Heat Pump: N Hoods: 0 Other Units: 1 Furn<10OK: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add!500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 2 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All N Other: N Other Description: Ecompasing: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF VB R-3 60 Owner: Contractor: BUTCHER,BILL B&JOAN M LIVING TRLOLSON&JONES CONSTRUCTION INC Required Items and Reports(Conditions) 15412 SW GREENFIELD DR PO BOX 19563 TIGARD,OR 97224 TIGARD,OR 97280 PHONE: PHONE: 503-244-7467 FAX: 503-244-6791 Total Fees: $970.66 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 ::u: nnin tR oc9_nni_n n m h nnof tha nilec nr rtir::mL:s; ;:: rllin1n By: \ a 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. Building Permit Application Residential E C E! E D FOR OFFICE USE ONLY City of Tigard 2 7 2322 Received ,. ,/� (J Date/By: `r a 4a O Permit No.: I y t 5±d 0),:), _co)q I II a 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Q ' Phone: 503.718.2439 Fax: 503.598.1960'�1 1 OF TIGARD DateBy: e i i... Other Permit: TIGARD Inspection Line: 503.639.4175 31JILDING DIVISION DateReady/By: Juris: 0 SeePage2for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK' z` �' REQUIRED DATA:1-AND 2-FAMILYDWEI LI ., LiNew construction ElDemolition 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*t-----`=` GORY OF;CONSTR>ITT •v# work indicated on this application. 9 h 4*cl,2 b V 1-and 2-family dwelling ❑Commercial/industrial Valuation: /�? r � ElAccessory building ID Multi-family Number of bedrooms: 0 Master builder El Other: Number of bathrooms: 2_ 14 -3 �, �`4LOCATION Total number of floors: A :INFORMATION AND Job site address: i Ej 4)'L, �`N j GI(etvvc.,et& D6 J e, New dwelling area: D square feet 66 City/State/ZIP: 1 A 6.,--(, , ryk oil22L4 Garage/carport area: � ;quare feet Suite/bldg./apt.no.: Project name: J yk �� Covered porch area: / square feet Cross street/directions to job site: ��""" Deck area: 1�`1 square feet Other structure area:(��� square feet CHEC Subdivision: Lot no.: 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 ,t r work indicated on this application. h Nh 1 � Valuation: $ 1 fl,va,. roovn Existing building area: square feet New building area: square feet rl---"/ ❑ PROPERTY OWNER - Number of stories: Name: Si5l',\ fir, 1 .u (Ix Type of construction: Address: l5 Li I 7... 5 0'✓ (3\!"Q.�CL�j(I,c[.\Q.1�A D\., Occupancy p y groups: City/State/ZIP: ; �,y Or '12.2 LI Existing: p Phone:(5 . ) 81 Fax:( ) New: n _ 0 APPLICAN liVizgl 3 t. BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: 1 i _ �a Cfl,n^( i C a C 5 ( I Structural plan review fee(or deposit): Contact name: FLS plan review fee(if applicable): Address: Total fees due upon application: City/State/ZIP: Phone:( ) Fax: :( ) Amount received: E-mail: PHOTOVOLTAIC SOLA' ' STEM FEES* •::_ Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photovoltaic Solar Panel System. Business name: 'Sj� raGS (onS4v ,��h ��C. Submit two(2)sets of roof plan with connection details I / and fire department access,along with the 2010 Oregon Address: .� VO�� Solar Installation Specialty Code checklist. City/State/ZIP: %i oRenv,c10 ¶1� Permit Fee(includes plan review $180.00 ��11 1 q L� and administrative fees): Phone:(56'2,) ��—1 1 k 1 '12—" Fax:( 3) Z' / .i 711 State surcharge(12%of permit fee): $21.60 CCB lie.: 5 ©(p fj (). ^; ,( � ,i S G.,'} cj A c ``O`✓10- Total fee due upon application: $201.60 Authorized signature: �J` ` 'vC�� This permit application expires if a permit is not obtained � ,. �C within 180 days after it has been accepted as complete. Print name: �� Date: 6/2 7/ *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-46 13 T(1 1/02/COM/WEB) i Building Permit Application Checklist 'One- and Two-Family Dwelling FOR OFFICE USE ONLY Cityof Ti and Received - ll Date/By: Permit No.: j.r/ ..i t y v 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits: Phone: 503.718.2439 Fax: 503.598.1960 24-Hour Inspection Line: 503.639.4175 ❑ Electrical 0 Plumbing El Mechanical TIGARD Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ G/ 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ 0 _� 3 Verification of approved plat/lot. ❑ ❑ 4 Fire district approval required. Name of district: 0 0 [� 5 Septic system permit or authorization for remodel. Existing system capacity 0 0 6 Sewer permit. 0 0 7 Water district approval. 0 ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0 Qf 9 Erosion control ❑plan El permit required. Include drainage-way protection,silt fence design and location of catch- ❑ 0 [i basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state EY ❑ 0 building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if [r ❑ 0 there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. �❑ 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size ©/ and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, [ 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- 0 0 floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. [❑ 0 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- [] ''''❑ Er 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 Ll ❑ 0 locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered IV❑ ❑ 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 [r ❑ ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. /❑ 2„/„.." 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 project under review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". G ❑ ❑ 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. 0 0 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. fk 0 Er- 27 `Drawn to scale"indicates standard architect or engineer scale. ❑ ❑ f 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 0 [ 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, 0 0 including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) , . Mechanical Permit Application IIIIEIIESOZIIEIIISIIIIIIIIIIIII City of Tigard Received Permit No.:1vli1 2022..CO 1,CirCi 1,11 'I 13125 SW Hall Blvd.,Tigard,OR 97223 I P Review Phone: 503.718.2439 Fax: 503.598.1960 Date/By: lan Date/By: Other Permit: Inspection Line: 503.639.4175 T I G A P.D Date Ready/By: hair Id See Page 2 for Internet: www.tigard-orgov Notified/Method: Supplemental Information .. . ......, .:- ,,.-..:- ..:;.1 ....;.::.:1014141i40.*:,..;:,....,, _.: 1.'-?7:1:-'•,;7,:.:.' . :=?VglitY.4.0-1SiAttP4.0.:1*04.4.:Pig....0-tgle.447 - Mechanical permit fees*arc based on the value of the work 0 New construction 44 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of ail 0 Demolition EI Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ :..Y...-9A.1DOWPt-coNgAM:19rg I-and 2-family dwelling El Commercial/industrial 0 Accessory building For special Information use checklist. EI Multi-family D Master builder CI Other: Description I Qty. I Ea. I Total ip*Oriii44141:00N.Alb:0:0dAiiiim,2...f,., i, :::::,17:-.. ..:. Heating/cooling: _ I Air conditioning 46.75 Job site address:ro54//2...„. 613 VQS.1,14 wi, A D\r- Furnace 100,000 BTU(ducts/vents) 46.75 , City/State/ZIP: '1.0\CA kra ( V 17 2 Zi- Furnace 100,000+BTU(duets/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: "') 1 Project name: 't cLaAir-- Duct work 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,induct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Other: 23.32 Subdivision: Lot no.: Other fuel appliances: _ Tax map/parcel no.: Water heater 23.32 ' ..-''''''':. ''.'•:.:3':;: -,-.17.-.... l.,:*****:;.9}k 1,4010c":':::'..‘:.,:::::::. :',..';‘: :: ,.; .sik; Gas fireplace/Insert 33.39 _ ' , k \ Flue vent for water heater or gas p\j cA;_v tt-) 0, \D0,1"-V\ fireplace 23.32 t Log lighter(gas) 23.32 a`V\CS, \Ida\OM Q., cx\rk, Q.--f 154 i\,", Wood/pellet stove q tr n 0.\\\/- \1afo\, 40.,..),- Al) A uo/yroJea 12- Wood ftreplace/insen 23.32 wotrkt. k)(Lvik v)alki bo4k c'aktri Chimney/liner/flue/vent 23.32 4,...y. rii. Other: 23.32 :•i.'..:•i•A;:1;1419Y.4,114*.1*.N...-P41-:"::. .,"'''':i .:' .•7,.. -1--j,i•FlY'r-'' :-. '--• Environmental exhaust and ventilation: Name:t5)1 Range hood/other kitchen 1 r equipment 33.39 Address: to yiz , 1')b,j1 Gyrzavl (4,1c: 1.-)y- Clothes dryer exhaust 33.39 City/StaterLIP: T1C eArd 1 31R q72v4 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:(6.-6 ) 6 -5/S 7 Fax:( ) Attie/cmwIspace fans 23.32 k4Rty:•:".;.V:"•„....,!;•:- :•;;;ET:65147:40f,.00* , :: Other: 23.32 Fuel piping: Business name: 3(A.c..0 cps I-I-e..e.,_44 f'`..12 4-444 C^ $14.15 for first four;34.03 for each additional Contact name: Kam k oi. Furnace.etc. Gas heat pump Address: (--IL4 1 (-I < c t•-11.1 u jaz," GA:at., cirlo-,-- Wall/suspended/unit heater City/State/ZIP: R y-„VA et...v.\.64 0 (2_. 91 2_0.2_ Water heater Phone:6f)b) 2,.,3(-1-- -1 53 I Fax::(601) .toct. -ct 101 Fireplace Range E-mail: 140a•-1,‘0.-k eD io-r-do5 t-%.e.a0E-ir‘ai...i-ce,nel Barbecue : ;;•;.,4.;:: ::.`Z:;,..t.;.;:::;;;;i:q-1-il':::13i::'.;.';:t&Ittit-41.0t::,''.g.,.."\-e-1.‘;::7''',..1..):;,:.;::..'...'..:.:,-.:.'.- ::kv:'; ...:i.:;., Clothes dry"(gas) _ Business name: -3. '0,e_c,(os H-c.e...._A-i.,, _ +- y:= . Other:: ;.:1.:4413.0.14.01:044*.AttittE_Ot-L, ..i:•-•::,.:::::.:. ..._..... Address: 4 I-1 7 1-111/4-4;11-iiet_tfla.-c, i4A-A-12- Subtotal „3 Minimum permit fee(S90.00) 1.--j`5,..4--e City/State/ZIP: qt, .{,04.4„Ncl gee-- 9-) Plan review(25%ofpermit fee) Phone: 5O, I '2,3(-4.- J I Fax:6: 9 25bc6- 9 1 Clq State surcharge(12%of permit fee) CCB lie.:/ q CI i TOTAL PERMIT FEE This permit application expires If a permit is not obtained within 150 days after It has been accepted as complete. _..." Authorized signature: /A * Fee methodology set by Tri-Counly Building Industry Service Board Print name: 0444 la_ _ Date: .7./2_ic leo 23_ 1:1BuildinecnnititMEC railltApp 040113.doe 440-46177(11/02/e0MAVED) Electrical Permit Application IOI2 OFFICE USG ONLY 7 Received a��+ -'OR,^^ City of Tigard Date/By: Permit#:r`{�` V 17'�S'� rt 13125 SW Hall Blvd.,Tigard,OR 97223 g Plan Rcvicw _ >S Phone; 503,718.2439 Fax: 503.598.1960 DatelBy. Related Pencil 6: Inspection Line: 503.639.4I75 Ready Date/By: saris: I &f See Page 2 for TIGARD Internet: www.tigard-or.gov Notified/Method: Sutryrlemeninl information i,.. _TYPE'OT WORK ;; .: : PLA1 : tEV,IE•;1'.r._. . ❑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 0 Building over three stories. ❑Demolition El Other: where the a�nilable fatdt enrrrenr ❑Marinas and boatyards. .,t ATEGOR ' OT'CONSTRUCT'IOIR -, ., . -_..., exceeds 10,000 amps at 150 volts or 0 Floating building. ® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to grmrnd,orcxeecas 14 00o p Comrnerciat-use agricultural amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: 0 Fire pump. ❑Installation of 150 KVA or ,__._."r s7QI3-,SITE INFORMATIO1!'-,AND 1 ocATIOn;:, - ;M- • ❑Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: Job site address:1 5412 SW Greenfield DR iO0HPor more . ❑"A',"E",°'1-z",'1-3', City/State/ZIP:Tigard, OR 97224 ❑ ealth-are residensal units. Recreational 9 ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: Project name:Butcher ❑Hazardous locations, 0 Supply voltage for more than ❑Service or feeder 600 amps or snore. 600 volts nomnal. Cross street/directions to job site: * C StI-IglouivL : Description 1 Qty. I Each I Twat TI New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.fl.or less 168.54 4 Tay map/parcel I/: _ Ea.add'1 S00 sq.ft.or portion 33.92 1 . _ DESCRIPTION.:OF lYORIC Limited energy,residential 75.00 2 Bathh remodel. Install new bath fan & circuit for GFCI (with above sq.fl.) Limited energy,multi-family 75.00 2 residential(ttitht above sq.ft.) _ { Renewable Energy ❑ See Page 2 ' ,❑ P OPERTY_OWNER I. , . ©. ' T>lNAINT>: ` ` Services or feeders inStallatio11,Alteration,and/or relocation Name: Dill�,),port 6„... C\rvr. 200 amps or less 100.70 2 Address: 5r1(k. 201 amps to 400 amps 133.56 2 �51 401 amps to 600 amps 200.34 2 City/State/ZIP: 601 amps to 1,000 amps 301.04 2 Phone:( ) 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 l 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 Branch circuits—new,alteration,or extension,per panel ® APPLTCAhT _ - ,. ,. .�❑;.CONTACt P$I;50N .. A.Fee for branch circuits t+vith Business name:Multiphase Electric, LLC above service or feeder fee, 7 42 2 each branch circuit Contact name:Dave Gackle B.Fee for branch circuits without service or feeder fee,first Address:PO Box 1416 branch circuit 1 56.18 56.18 2 City/State/ZIP:Oregon City, OR 97045 Each add'i branch circuit 1 7.42 7.42 2 • Miscellaneous(service or feeder not included) Phone:( 5034908-1593 Fax::( ) Each manufactured or lmodular dwelling,service and/or feeder 67.84 2 Email:info@multiphaseelectfic.com Reconnect only 67.84 2 _.._._a. cO1TRA O ,: -_.._ Pump or irrigation circle 67.84 2 Business name:Multiphase Electric, LLC Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy V ❑ ge See Pa 2 2 Address:PO Box 1416 panel,alteration,or extension. City/State/ZIP:Oregon City, OR 97045 Each additional inspection over allowable in any of the above Additional inspection(I hr min) 66.25/hr Phone:( 503)-908-1593 Fax:( ) Investigation(1 hr min) 90.00/hr @ p j Industrial plant{I hr min) 78.18/hr Email:info multl haseeleCtriC.cOm /( /G. Inspections for which no fee is 90.00/lir 162827 Suprv.Lie.:51225 spect(ical listed(4Its min) CCB Lic.: Elect Li X1*CI'R1CAL PERMIT I�.EES'_ {�Sttprv.Electrician signature,required: DQQ,ya,,,az. Subtotal: 63.60 _ Print name:Dave Gackle Date:07/01/2022 ❑Plan Review Required(25%of permit fee): State surcharge{12%of permit fee): 7.63 Authorized signature: TOTAL PERMIT FEE: 71.23 This permit application expires if permit is not obtained within 1110 Print name:Dave Gackle Date:07/01/2022 days niter it has been accepter!as complete. ' Numberofinspectionsallowedperperntit. 1:Muitdia5iPemtiislELC_PennitApp_ELR ERE.dec Rev06/17/2015 440-46157(11/05/COMAVEII i Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESID1NTIAJ WORK ONI Y. TEE.SCIf EAui i . Desusptiva I Q, I Each l Total I Fee for all residential systems combined: $75.00 Renewable electrical energy systems: Check Type of Work Involved: 5 kva orless 100.70 2 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to25 kva 200.34 2 Wind generation systems in excess of 25 kva: n B• urglar Alarm 25.01to50kva 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 boa: System* Each additional kva over 25 7.42 3 ❑ V• acuum 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(I hr min) Inspections for which no fee is 90.00/hr <specifically � RIC�tL PERMIT TEES '..... ct tca X listedMtn min) COMMERCIAL WORK.ONLY ELECT Fee for each commercial system: $75.00 Subtotal(Enter on Paget): • Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ A• udio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems n Data Telecommunication Installation ❑ Fire Alarm Installation ❑ I-• IVAC ❑ Instrumentation ❑ Intercom and Paging Systems n L• andscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 193uildingO'vrmilsOELC_PermilApp_ELR ERG.doe Rev 06/17120E5 Plumbing Permit A>n)licntion Site Utilities q/��yr� �y� city or Hall gacti'Melly Pa mII No:t 1ZD22-•CD1. ■ 13125 SW Halt Blvd Tigard,OR 97223 briefly. • Phone: 503.7t8.2i39 Fay 503,598,1960 Ilia keHew Other Permit No.: nasally: In_gxN'tion Unc:503.b39.4175 1"tGARt) Internet:44�4u,t at4t�Y- �4 tale Readyttly: twit RI Ste Patel for > NNi0aV6tsttad: Su IemeMOlnfermanaa �. " .,a.: .,.. � �. ' � -- ate`' 4°��- .z--.$;tt,.,. ❑Newconstructi.n ❑Dcolotitial Pot sped alln/urnrorlona etherAllrb Ikscriptlon I Qly. I Ea I Total l Additiontalterahonheplacexnent ❑Other: New 1.2.family dwellings(Includes 100 ft.for each utilil connection) 312.70 tikt.and 2-family dwelling ❑Commet'ci alftndustrial SFR(2)bath 437.78 ❑Aox ry lwiidiag ❑Multi-family SFR(3)bath 500.32 ❑Master builder Each additional bath/kitchen 25.02 ❑Other Fire sprinkfcr( sq.ft.) Page 2 x t (2 R•6`Il\'k attIATION At;(141 'tION.)3 :: Site utilities: Job site address: )54/f z 3 J o V t 4„ . Catch basin or arca drain 18.76 City/State/LIP: T c rc r C) , 4 Dry44ttl,leach line,or trench drain 18.76 Footing drain(no.linear ft.:r" ) Page 2 Suite/bldglapt.no.: , Project name:-g„) .-c\ri cly-" Manufactured home utilities 50.03 Cross strectldirections to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft,: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: I Lot no.: Fixture or stem: Tax map/parcel no.: Backfow preventer 31.27 -DESCRIPTIOPPOF WO y..,.., <. ...�> - Backwater valve 12.51 �i (�1 1� Clothes washer 25.02 c-t 4 u c'. C IOW k v'\1oa\ Dishwasher 25.02 k`t� q$\5 \h a%,et+t c 5Voi ca. Drinking fountain 25.02 Ejectors/sump 25.02 -„0 11ro-EItT},oWl±�a: 'a „L I 'd TENANT Expansion tank 12.51 Name: y�.11}p � + ,k-A , -- Fixturdsewcrcap 25.0.2 �) 1 �,)J �14� Floor drain/floorsinkThub 25,02 Address: S,!3\\,/Y1tL Garbagedisposal 25.02 City/State/Z1P: 564 V a„,. Hose bib 25.02 Phone:( ) /11 , Fax:( ) Pt Ice maker 12.51 ' :, = 1�ry ,4�' \ � f-1 „C0 .,, O r "- Interceptor/grease trap 25.02 V�,5 �` Mo \CLJ l o4h { h'iedical gas(value:5� ) Page 2 ^Busyness name: t "'�� �^ Primer l2.St Contact name:31,, C,\r`\Q. _ r / Roof drain(commercial) 12,51 Address: tr. ,` D , 01 ' i j f� Slnklbasirdlavaiary ( 25.02 26,2 City/St le/ZIP: y Dy., 112 Solar units(potable water) 62.54 Phone:(5(3) 2'i -•7h1L/ IFax::( . ) 299_679I Tub/shower/shower pan 1 12.51 (2, Email: 4 \,f•1GY 't'Arles:. .,,, �,0 1 Urinal 25,02 y _, ,, ,, Water closet f 25,02 )5,-, :Vet-- "a - :�� - Water heater 37•52 Business name; I..2if4:ss S �LI j j 114 '/(,�,€_, Water piping/DWV 56.29 Address: till,. 12,,•p,J,Gv- 6v-4 i 4Other: _ 25.02 City/State/LIP: C.2L ) 01 C.4� { C?�.-. et7t)'t Y. Subtotal Phone:( � C'~ 4-:: �.:, E. ,( ) Minimum permit fee:S72.50 ./ "- Plan review(13y ofpcmtti fee) Al CCtI Lic.: �Jy'� ' Plumbing(Ic.rw: j j State surcharge(12%ofpcmd!foe) iC),,,,,., Authorized signature: .f�•,_ P),, TOTAL PERhiITFEl3 0Ct Print name at,r50(�f/ /[ ,C.„ v 1 Dale:4, so +/1,s� This penult implicit flan alphas Ira penult is ant obtained,,l(dtn tea dap �'•f!v e fir r It Aa a beta accepted is complete. arse nutlu,d,togy set by Trl.cuunly Uuildine Industry Service hoard. r.11kuldiatrarmadan.MU.ParmiApp.doe Ie oI o 440-01670A0004tAYE.0) rgCan-}Scanner I ISN-zoLZ--00119 Water Meter Fixture Unit Worksheet for Additions/Remodels/AD Us Please complete the following information: Customer Name: Butcher Service Address: Street/Suite#: 15412 SW Greenfield Dr City: Tigard State: OR Zip: Phone Number: 503-679-5137 Email: bbut195@comcast.net Please fill in the number of each fixture you currently have. Please fill in the number of fixtures you propose to add. Multiply the quantity by the point value to arrive at the current Multiply the quantity by the point value to arrive at total. the proposed total. Fixture Unit Current Point Current Proposed Point Proposed Quantity Value Total Addition Value Total Bar sink x 1 = x 1 = Bidet x 1 = x 1 = Clothes washer 1 x 4 = 4 x 4 = Dishwasher 1 x 1.5 = 1.5 x 1.5 = 1"Outside Water Spigot 1 x 2.5 = 2.5 x 2.5 = Water Spigot,each add'l 1 x 1 = l x 1 = Kitchen sink 1 x 1.5 = 1.5 x 1.5 = Laundry sink 2 x 1.5 = 3 x 1.5 = Lavatory(bathroom sink) 3 x 1 1 x I = 1 3 Water closet,1.6 GPF(toilet) 2 x 2.5 = 5 1 x 2.5 = 2.5 Bathtub/whirlpool x 4 = x 4 = Shower stall 1 x 2 = 2 x 2 = Bath/shower combo 1 x 4 = 4 1 x 4 = 4 Current Points: 27.5 Proposed Increase: 7.5 Current Points+Proposed Increase= 35 =New Total Points =Required Meter Size 3/4 Meter Sizes: 1 to 30 points=5/8" 30.5 to 37 points=3/4" 37.5 and over points= 1" New Meter Size Needed for New Total Points: 3/4 Cost: $ 14,418.00 (see page 1) Current Meter Size per Utility Billing: 5/8 Cost: $ 10,095.00 (see page 1) New Meter Size Cost minus Current Meter Size Cost= $ 4,323.00 (This is Your Cost to Increase Meter Size Due to Additional Fixture Units) ************************************************************************************* FOR OFFICE USE ONLY Meter will need to be upsized to 3/4 inch. Current Meter Size Confirmed with UB J. Bentley 07/11/22 Signature of UB Representative Date I:/Building/Forms/WaterMeters_070121_Add.dOCX Page 2 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Water Meter Fixture Unit Worksheet TIGARD For Additions /Remodels /ADUs 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov LOCATION: City of Tigard—City Hall WATER METER SALES: Utility Billing By Email Only. Please contact 13125 SW Hall Blvd. ubonlinepay(atigard-or.gov Tigard, OR 97223 to discuss sending documents and payment METER: SIZE: FEE: Pricing effective 07/01/2021 5/8" $10,095.00 Fee includes: 3/4" $14,418.00 water system development charge, 1" $26,487.00 water meter, and 1-1/2" $78,488.00 meter installation fee. 2" $127,125.00 DETERMINING METER SIZE FOR RESIDENTIAL CUSTOMERS City of Tigard Water Service Area uses the American Water Works Association Manual and the Oregon Plumbing Specialty Code to determine the size of meter needed to adequately serve buildings. Due to the variety of home sizes built in the Tigard area, we count the fixture units of all homes to determine the appropriate meter size. Use the worksheet on Page 2 to calculate the current number of fixture units compared to the proposed increased number of fixture units, which will determine whether an increased meter size will be required. Submit this signed worksheet with your building or plumbing permit application submittal. DOCUMENTATION Once you are ready to purchase the new meter, please provide the following items to the Utility Billing counter: • Completed water meter fixture unit worksheet for additions, remodels, ADUs, etc. (on back page). • Copy of building or plumbing permit application date-stamped by building division. • Copy of issued building or plumbing permit. Your fixture count will be verified and your request will be processed upon receipt of these documents. No exceptions. INSTALLATION TIME Once the upgraded meter size has been purchased, most meters are installed within 10-14 business days. l:/Building/Forms/WaterMeters_070121_Add.dOCx Page 1