Loading...
Permit Support Document City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT N _ . Request for Permit Action T I G A R n 13125 SW Hall Blvd. ••Tigard, Oregon 97223 •• 503-718-2439 ••www.tigard-or.gov RECEIVED TO: CITY OF TIGARD $Z�3 Building Division III/ 13125 SW Hall Blvd.,Tigard,OR 97223 CITY OF TIGARD Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@TDIVI$ION FROM: ❑ Owner (] Applicant ❑ Contractor . ❑ City Staff Check(✓)one \ REFUND OR Name: /— i0 �F��INVOICE TO: (Business or Individual) \ktt P VsAci.:) , ''\62,- \<"\(-)W Mailing Address: 1V,,N 4., (\111.1 . %\.),,AP W(\" City/State/Zip: ‘-• C, �`\`�D�� ; a Phone No.: \I2 . v PLASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓): NCANCEL/VOID PERMIT APPLICATION. REFUND PERMIT FEES (attach copy of original receipt and provide explanation below). El INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below). Permit#: N\C). ` W4 0 I Ni-' \Aq(s` -1W k l 6i Site Address or Parcel #: •4 AA- r/f ` Project Name: 1 q 1'tC Y(iC'V COSb 11\1( L-c)'t )15 �\ )1 Lot#: IIc. Subdivision Name: EXPLANATION: \ k.L VA,1 1..— it No, J ®l 0' ,- ,4 c<< .c`vr►1 i' — s/r/1p. 0,' i (MTV--J'w,e/4*_,,,,,,;YJ Signature: K$— Date: `5 � 0�- Print Name: �F LU E �A K 6�,f Refund Policy 1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of: • Any fee which was erroneously paid or collected. • Not more than S0%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended. • Not more than 80%of the application or permit fee for issued permits prior to any inspection requests. 2. All refunds will be returned to the original payer in the form of a check via US postal service. 3. Please allow 3-4 weeks for processing refund requests. FOR OFFICE USE ONLY Route to Sys Adnvn: Date By Route to Records: Date By Refund Processed: Date By Invoice Processed: Date By Permit Canceled: Date 57 '/?3 By 467,27 Parcel Tag Added: Date By I:\Building\Forms\RegPermitAction_] f doc Building Permit Application Lu. CriP-46 ``S Residential F City of Tigard RE ' FOR OFFICE USE ONLY 11 `"� Datewe Ip fio i/A Permit No.:e,grciiaa— �0 u 13125 SW Hall Blvd.,Tigard,OR 97223 plan Review to r I ' Phone: 503.718.2439 Fax: 503.598.1960 OL! \ 3 gy: Other Permit. i i 1,.�t,t> Inspection Line: 503.639.4175 �41 Date ReadyBy: Jua%: H See Page 2 for Internet: www.tigard-or.gov G`''TV Or. `Iuh`,` Nptified/Method;/�./).]�Z) .i Supplemental Information a NG DIME TYPE OF WORK REQUIRED DATA lu 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. 01 and 2-family dwelling ❑Commercial/industrial Valuation: r$398 d lr 33)teS51- 19" 0 Accessory building El Multi-family Number of bedrooms: 3 ❑ Master builder ❑Other: Number of bathrooms: (3 JOB SITE INFORMATION AND LOCATION Total number of floors: 2 `'l$ Job site address:15707 SW Vanderwood AVE _ New dwelling area: 2548 square feet 13 `f City/State/ZIP:Tigard,OR Garage/carport area: 580 square feet `a(,lLLL Suite/bldg./apt.no.: Project name: Covered porch area: 74 square feet Cross street/directions to job site: Deck area: a.t square feet !er fsu} Vihacrae a151: .,, f0- Ne square feet REQUIRED DATA:COMMERCIAL-USE CHECKLI Subdivision:River Terrace Lot no.: 115 Permit fees*are based on the value of the work performed. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. New SFR 2 stories,/� 3 bedrooms 2.5 baths plus a den with a 3 car garage Valuation: $ Jj2p /j c ,,,/et J�./J/y,/ $) /q-,>pb,4 4� Existing building area: square feet J v 1 t vt l � r `�i / I�C�C � New building area: square feet �i PROPERTY OWNER ❑ TENANT Number of stories: Name:Pacific Lifestyle Homes Type of construction: Address:11815 NE 99th Street,Suite 1200 Occupancy groups: City/State/ZIP:Vancouver,WA 98682 Existing: Phone:(360)573-8081 Fax.(360)574-6401 New: iiita: El. APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES* Business name: Pacific Lifestyle Homes (Please refer ra fee schedule) ,...__ .. Structural plan review fee(or deposit): r l 5r1. 3<f Contact name:Permit Coordinator FLS plan review fee(if applicable): Address:11815 NE 99th Street,Suite 1200 City/State/ZIP:Vancouver,WA 98682 Total fees due upon application: Phone:(360)573-8081 Fax::(360)574-6401 Amount received: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail:permits@buildplh.com CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted Photovoltaic Solar Panel System. Business name:Same Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:Same Solar Installation Specialty Code checklist. City/State/ZIP:Same Permit Fee(includes plan review $180.00 and administrative fees): Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.:173524 �� �� / }7 ��q Total fee due upon application: $201.60 Authorized signature: �r l�r l.// ek. �V iv This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Summer Dowell D :10/11/2022 *Fee methodology set by Tri-County Building Industry Service Board. Y 1:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) ar • 4t 1 t Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE 1 NIS City of Tigard Received Permit No.: • 13125 SW Hall Blvd.,Tigard,OR 97223 Aste/B Phone: 503.718.2439 Fax: 503.598.1960 Associated permits: I l(,AL.0 24-Hour Inspection Line: 503.639.4175 El Electrical ❑ Plumbing El 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. ❑ El ❑ 3 Verification of approved plat/lot. El ❑ LI 4 Fire district approval required. Name of district: • ❑ LI - ❑ 5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ ❑ 6 Sewer permit. ❑ El 0 7 Water district approval. 0 ❑ 0 8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 El ❑ 9 Erosion control ❑plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ❑ 0 0 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 ❑ 0 ❑ 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- 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. ❑ El El 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- ❑ ❑ El , prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing 0 0 0 locations. Show attic ventilation. 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 0 0 ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. ❑ El 0 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required El El ❑ for four or more appliances. 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or 0 ❑ El architect licensed in Ore_on and shall be shown to be applicable to the .ro'ect under review. It RISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". 0 0 ❑ 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ❑ 0 ❑ 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. El ❑ ❑ 27 "Drawn to scale"indicates standard architect or engineer scale. 0 0 0 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 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, El El ❑ 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\Perrnits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/W EB) Mechanical Permit Application FOR OFFICE I Si ONI.1 City of Tigard Received Date/By: Permit No.: • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: G n It l� Inspection Line: 503.639.4175 Date Ready/By: hais. P7 See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE*SCHEDULE - USE CHECKLIST .. .. Mechanical permit fees*are based on the value of the work ®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 RESIDENTIALIQUJIPMENT/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: 15707 SW Vanderwood AVE Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP:Tigard Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: Project name: Heat pump 1 61.06 Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision:River Terrace Lot no.:115 Other. 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert 2 33.39 Flue vent for water heater or gas New SFR fireplace 2 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:Pacific Lifestyle Homes Range hood/other kitchen equipment 1 33.39 Address: 11815 NE 99th St.Suite 1200 Clothes dryer exhaust 1 33.39 City/State/ZIP:Vancouver,WA Single-duct exhaust(bathrooms, toilet compartments,utility moms) 6 23.32 Phone:(360)573-8081 Fax:( ) Attic/crawlspace fans 23.32 et APPLICANT ® CONTACT PERSON Other: 23.32 Business name:Pacific Lifestyle Homes Fuel piping: $14.15 for first four;$4.03 for each additional Contact name: Permit Coordinator Furnace,etc. Address: 11815 NE 99th Street,Suite 1200 Gas heat pump Wall/suspended/unit heater City/State/ZIP:Vancouver,WA 98682 Water heater Phone:(360)573-8081 Fax::(360)574-6401 Fireplace 2 Range 1 E-mail: permits(a-buildplh.com Barbecue 1 CONTRACTOR Clothes dryer(gas) Business name:Wolcott Other" MECHANICAL PERMIT FEES* Address:1075 W Historic Columbia River HWY Subtotal City/State/ZIP:Troutdale,OR 97060 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:( ) Fax:( ) State surcharge(12%of permit fee) CCB lie.:11220 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 ,n � n ///�L7� days after it has been accepted as complete. Authorized signature: L)j e * Fee methodology set by Tri-County Building Industry Service Board Print name: Summer Dowell i Date:10/11/2022 1:113uildiag1Pttmits/MEC_PerrodApp_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: Sumo 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:1Building\Permits\MEC_PermitApp_040113.doc 2 Electrical Permit Application FOR OFFICE USE ONLY • City of Tigard ReceivedDate/By: Permit#: 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review 6 Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Related Permit#: T 1 G A RD Inspection Line: 503.639 4175 Ready Date/By: runs: I H See Page 2 for r. Internet: www.tigard-or.gov Notified Method: Supplemental Information TYPE OF WORK PLAN REVIEW ®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/ltenss checked): 0 Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition 0 Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family 0 Master builder ❑ Other: 0 Fire pump. 0 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:15707 SW Vanderwood AVE 100HP or more. ❑`..4'•."E","1-2","1-3", City/State/ZIP: ❑Six or more residential units. occupancy. 0 Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: Project name:River Terrace Crossing ❑Hazardous locations. 0 Supply voltage formore than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Qq, I Each I Total I New residential single-or multi-family dwelling unit. Subdivision:River Terrace Crossing Lot#:1 15 Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 1 168.54 4 Ea.add'l 500 sq.ft.or portion 5 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 (with above sq.ft.) • Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 ® PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name:Pacific Lifestyle Homes 200 amps or less 100.70 2 Address:11815 NE 99th St. Suite 1200 201 amps to 400 amps • 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:Vancouver, WA 98682 601 amps to 1,000 amps 301.04 2 Phone:( 360)573-8081 Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email:permits@buildplh.com relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 ® APPLICANT 0 CONTACT PERSON Branch circuits.-new,alteration,or extension, ler panel A.Fee for branch circuits with Business name:Pacific Lifestyle Homes above service or feeder fee, 7.42 2 each branch circuit Contact name:Summer Dowell B.Fee for branch circuits without service or feeder fee,first Address:Same as owner branch circuit 56.18 2 City/State/ZIP: Each add'l branch circuit 7.42 2 Phone: 36p 904 8130 Fax:: Miscellaneous(service or feeder not included) ( 9 ( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email:permits@buildplh.com Reconnect only . 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name:Garner Electric Signor outline lighting 67.84 2 • Address:2890 SE Brookwood Ave. Signalnl,alteration,cireutt(s)or extension. 0 See Page 2 2 panel, or extension. City/State/ZIP:Hillsboro,OR 97123 Each additional inspection over allowable in any of the above Additional inspection(I hr min) 66.25/hr Phone:(503)648-4552 Fax:(503)642-7925 Investigation(1 hr min) 90.00/hr Industrial plant(1 hr min) 78.18/hr Email:permits@garnerelectrie.com Inspections for which no fee is CCB Lic.: 121159 Electrical Lie.: 34-305C Suprv.Lic.: 3707-S specifically listed(%hr min) 90.00/hr ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: A. Subtotal: Print name: Charles Gamer Date:12/5/2022 ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: g ge TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Brittany Burin Date:12/5/2022 days after it has been accepted as complete. Number of inspections allowed per permit. 1[BuildingtPennits\ELC_PennilApp_ELR ERE.doc Rev Ofi/17/2015 440-4615T(11/05/COMJWEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE 1),n-tattoo I Qty. I Eaeu I Total Fee for all residential systems combined: $75.00 Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 ❑ 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 n Garage Door Opener* >100 kva(fee in accordance 552.26 2 with OAR 918-309-0040) ❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 ❑ Vacuum Systems* >100 kva—no additional charge 0.0 3 Each additional inspection over allowable in any of the above: ❑ Other: Each additional inspection is 66.25/hr 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(Ya hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 subtotal(Enter on Page 1): y * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC n Instrumentation ❑ Intercom and Paging Systems n Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls n Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1:1BuildinglPerm11s1ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 Plumbing Permit Application - Building Fixtures FOR OFFICE USE ONLY III - Dare/By: City of Tigard Received Permit No,: • 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By. Phone: 503.718.2439 Fax: 503.598.1960 an Review Other Permit No.: D T I G A RD Inspection Line: 503.639.4175 Date Ready/By. curls: H See Page 2 for Internet: www.tigard-or.gov NotifiediMetbod: Supplemental Information „ ,:. OF" WORK FEE*.; #1PDU u ,,,, ® New construction ❑ Demolition For special information use checklist --- - --- -- Description I Qty. I Ea. I Total ❑ Addition/alteration/replacement D Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ® 1-and 2-family dwelling ElCommercial/industrial SFR(2)bath 1 437.78 SFR(3)bath 500.32 ❑Accessory building 0 Multi-family Each additional bath/kitchen .5 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 e JOB SITE INFORMATION AND LOCATION Site utilities: Job site address:15707 SW Vanderwood AVE Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard,OR Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) I Page 2 Storm sewer(no.linear ft.: ) 1 Page 2 Water service(no.linear ft.: ) 1 Page 2 Subdivision:River Terrace I Lot no.: 115 Fixture or item: Tax map/parcel no.: Backflow preventer 1 31.27 DESCRIPTION OF WORK Backwater valve 1 12.51 Clothes washer 1 25.02 New SFR Dishwasher 1 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER ❑ TENANT Expansion tank 12.51 Name: Pacific Lifestyle Homes Fixture sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:11815 NE 99th St.Suite 1200 Garbage disposal 1 25.02 City/State/ZIP:Vancouver,WA 98682 Hose bib 2 25.02 Phone:(360)573-8081 Fax:( ) Ice maker 12.51 >'4 APPLICANT ® CONTACT PERSON Interceptor/grease trap 25.02 Business name:Pacific Lifestyle Homes Medical gas(value:$_) Page 2 Primer 12.51 Contact name:Permit Coordinator Roof drain(commercial) 12.51 Address: 11815 NE 99th Street,Suite 1200 Sink/basin/lavatory 5 25.02 City/State/ZIP:Vancouver,WA 98682 Solar units(potable water) 62.54 Phone:(360)573-8081 Fax::(360)574-6401 Tub/shower/shower pan 3 12.51 E-mail:permits@buildplh.com Urinal 25.02 " - Water closet 3 25.02 CONTRACTOR i Water heater 1 37.52 Business name:Wolcott Waterpiping/DWV 56.29 Address:1075 W.Historic Columbia River HWY Other. 25.02 City/State/ZIP:Troutdale,OR 97060 Subtotal Phone:( ) Fax:( ) / / Minimum permit fee: $72.50 CCB Lic.: 11220 Plumbing Lic.no.: / /(i`( Plan review (25%of permit fee) M n ' ' State surcharge(1T %L R fee) Authorized signature: _Al ii td�[ I(�(/]l�/_l/1/- TOTAL PERMIT FEE Print name:Summer Dowell Date: 10/11/2022 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. 193uilding1Permits\PLMU-PermitApp.doc 10/01/09 4404616T(10/02/C0M/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: Footing drain-l'100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Valuation`.,_, . , ..Permit Fee: Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Other Inspections or Fees Qty, Fee(ea) Total each additional$100.00 or fraction thereof,to and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 S148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions 90.00/1u- $50,001.00 and up S742.00 for the first$50,000.00 and$1.20 for (minimum charge-1/2 hour) each additional$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. 'tits by Fixture Type Plan Review for Plumbing Installations Fixture Type for Replace/ Plan review isany ow required for of the following. Work Performed: Capped Added Relocate Please check al that apply. Baptistry/Font Bath Tub/Shower El Any new commercial building with water service 2"and Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Drive Thm ❑ New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918-780-0040. Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities. -Domestic ❑ Any multipurpose fire sprinkler system. Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040. Eye Wash Floor Drain/sink 2" Submit 2 sets of plans with any of the above. -3" 4 Isometric or Riser Diagram Car Wash Drain 0 Isometric or riserdiagram is required for new buildings Garbage -Domestic-non-foodq g Disposal -Domestic-food related that meet the qualifications above. -Commercial-food related -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang -Stall Sink/Lav -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer-Clothes Water Extractor increase of sewer EDUs,a sewer permit will be issued and Water Closet-Toilet fees assessgd,ffr the sewer iirereage must be paid before the Urinal plumbing permit can be issued. Other Fixtures: P:Uob Folders\Oregon\Subdivisions\River Terrace\Lot 115\Permits and Irtnpections\PLB_PermitApp.doc City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT . TIGARD River Terrace South Single Detached Supplemental Building Permit #: NTht aa-ad1-Iot Project Name: TT Q iN.... Site Address: �S�D�" t�J VANIDe doO / /d y Lot #: !7J - Total Existing Units: 1d- une ❑ Two ❑ Three New Configuration: CYSingle Detached El Duplex ❑ Triplex ❑ +ADU Land Use Case: 1?or2--1L- Single Detached Standards Setbacks ❑ Front: 12 Porch: 8 ❑ Side: 3 Street Side (public): 8 Street Side (alley): 3 El Rear: 1,_ Rear (alley/private street): 0 Rear Covered Patio: 10 Garage (public street): 20 Garage (alley/private street): 3-5 Height ❑ Max. Height: • Actual Height: '4 Landscape .IK dscape Area: 20% O'Lot Coverage Max: 80% Entrance grS t back no more than 8' from street-facing wall ar'allel to street or offset 45 degrees or less Windows l2'Minimum 12% of area of all street-facing facades Garage Garage-door is behind widest street-facing wall D Yes ❑ No, and one of the following is met: ❑ 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 00% or less of facade ❑ 60% or less and includes 7 of following: ❑ Covered porch ❑ Recessed entrance ❑ Wall offset ❑ 1' Roof eave ❑ Roof offset El Fire shingles ❑ Lap Siding ❑ Gable, hip, gambrel roof El Dormer ❑ Roof pitch ❑ Accent siding 0 Window trim ❑ Window recess ❑ Window projection ❑ Balcony I:HuildinglFennsNldgVerniitRvu_ROW Suppleinenlnl 070722 a City of Tigard ,I e ill COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Review - Residential TIGARD Building Permit #: 4- aG .' OGl'IcJ t Site Address: 1sW-7- Ql/`j Vtil rtlIiX AVM ❑ Verified in Accela Project Name: 12.1-- (2,71SSlac, Lot/Unit #: /IS" Proposal (include housing type): tkieW a<J$ 7Z.tc_ N(o Zone: — C- Requi ed Site Plan Elements: 03 copies of site plan on min 11x17" 2-6 awn to standard scale5 a/tree proles>ian rth arrow Street and site trees shown / labeled dddd to address, project name, lot # ity Er§,treet names (N/A for SFR) r/Klicant name and phone # • • ble) and setback dimensions Vjsi n clearance triangle �' I IIJ Du u��Qres &-aquae c--rvv`t yc �U y locations & easements F o int of new structure and FFE roperty corner elevations ewalk/driveway dimensioned Lot area and lot coverage percentage Erosion control Required Elevation Plan Elements: (For S c Ics needed only on street-facing) to standard scale Garage doors dimensioned w Summary table with calculations for: Byrl"ding height dimensioned fd'T9tal facade area de dimensioned Z window and door area ndows and doors dimensioned otal garage area Requi d F or Plan Elements: Xl<mmary table that includes E story dimensioned 8 Tel floor area ❑ ach story floor area calculated a Floor area per story Planning Review The following standards have been met: p �!�^ Setbacks ❑ Front: i2 '3 Rear: (0 Side: Min/Max Street Side: 0 I /"" Garage: v Hei t ❑ Max. Height: NA Proposed Height: 2/ • r Yes ❑ Landscape ❑ YES%N/A Screening (Quad only) Y ❑ N/A % Window Coverage WY-es s ❑ N/A Garage (SFR Only) Parking (Other Res) es ❑ A Entrance (SFR, Rowhouse, Quad only) ❑ YesA Other building design standards (Rowhouse only) ❑ YesA Accessory Structure Standards ❑ Yes o Qualifying pre-existing unit exempt from standards (Cottage unit only) Additional standards for Courtyard Units, Cottage Clusters, Rowhouses, and Quads: ❑ Yes N/A Unit Count: ❑ Yes N/A Lot Width and Size ❑ Yes N/A Pathway Additional standards for Courtyard Units and Cottage Clusters only: ❑ Yes d N/A Unit Area: ❑ Yes ❑ N/A Floor Area (per story) ❑ Yes b N/A Courtyard ❑ Yes 0 N/A Fence y ❑ Yes ❑ No Vt Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995) ❑ Yes ❑ No R /A Public Facilities Improvement (PFI) Permit: Required: ❑ Yes ❑ No Applied For: ❑ Yes j❑��No, stop intake Sensitive Lands: ❑ Yes i1 g.L�nd Use Case #: flPiliol'— c 7t c ` 79(206-OUDIC, ❑ Conditions met prior permit issuance Approved By Planning: -- — Date: /0/13A? Notes Revision 1: ❑ Approved ❑ of Approved Date: Revision 2: ❑ Approved ❑ Not Approved Date: Building Permit Submittal Original Submittal Date: ia/f 314a Site Plans #: -3 Building Plans #: ,� Building Permit #: IZI ilding permit # entered on page 1 Workflow Routing: 2-Planning ID-Engineering El-Permit Coordinator l uilding Workflow Sign-off: O'Sign-off for Planning (include notes from planning review) Route Documents: engineering: (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 calculatio s n+l trust details, if applicable, etc. Permit Technician: 1 (Lt 71 cJ ,1 Date: )/31 12 Notes: Enineering Review (d'Slope at building pad: Zola % ICJ/ Conditions met prior to issuance of permit rd'Easements (encroachments) per engineering conditions of approval and plat ia/Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes WNo Assess Water Quantity Fee in-lieu: ❑ Yes L'No LIDA Facility on lot: ❑ Yes I'No Add Fee: ❑ Yes ❑ No ❑ Final Plat Recorded ❑ NOT Approved: Date: " '71 ` . ` ' Notes: Approved By Engineering: Date: //Mtj�. Revision 1: ❑ Approved ❑ No pproved Date: Revision 2: ❑ Approved ❑ Not Approved Date: Permit Coordinator Review onditions met prior to permit issuance Approved, NOT Released: Date notified applicant: ❑ ENG Revisions Required: Date notified applicant: \SDC Exemption: ❑ Applied for ❑ Received ❑ Does not apply [ SDC Fees Entered: Wash Co Trans Dev Tax: Yes 0 N/A 1 Tigard Trans SDC: Yes 0 N/A Deferred Parks SDC: Yes ❑ N/A Deferred LIDA ❑ Yes E N/A ;ak OK to Issue/Approved by Permit Coordinator: \-\ O d .. Date: ' 2--\- /LZ Revision 1: ❑ Approved ❑ Not Approved Date: Revision 2: 0 Approved 0 Not Approved Date: City of Tigard 111 ° Deferral Until Occupancy Request A h D 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: 11123/2022 Site Address: 15707 SW Vanderwood Project River Terrace Crossing Land Use Case or Name: (Pacific Lifestyle Homes) Building Permit#: MST2022-00401 Tax Lot 2S108DC10700 Total Parks $11,830.00 $p: Lot 115 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$ N/A for Parks-Neighborhood or$ 3,131.00 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. Teil Massie Dec 1,2022 Property Owner: Date: Developer: S r ID:AlMMC4M� Date: 11/28/2022 4C\--4 Permit Coordinator: Datc: 11/23/2022 Signature: �4 —�-- Email: TeilM@buildplh.com • MST2022-00401 Lot 115 • Final Audit Report 2022-12-01 Created: 2022-12-01 By: Summer Dowell(SummerD@buildplh.com) Status: Signed Transaction ID: CBJCHBCAABAAyiiVrKmBaYaaU92te50OBNyK7ZPWWBoM "MST2022-00401 Lot 115" History (S0 Document digitally presigned by Foxit Software Inc. (foxit-sign-certs@foxit.com) • 2022-11-29-1:25:02 AM GMT-IP address:50.39.202.90 t Document created by Summer Dowell (SummerD@buildplh.com) 2022-12-01 -4:58:03 PM GMT-IP address:50.39.202.90 El Document emailed to Tell Massie (TeilM@buildplh.com)for signature 2022-12-01 -4:58:25 PM GMT ,t Email viewed by Teil Massie (TeilM@buildplh.com) 2022-12-01 -5:00:19 PM GMT-IP address: 104.47.55.126 5j Document e-signed by Teil Massie (TeilM@buildplh.com) Signature Date:2022-12-01-5:06:33 PM GMT-Time Source:server-IP address:173.11.13.53 0 Agreement completed. 2022-12-01 -5:06:33 PM GMT Adobe Acrobat Sign 111315 DRAIVN SMM * Pacific Lifestyle ri GARRETTE VANCOUVER, ST SUITE 1200 VANC NE 139T ST 98882 DATED: tOM612022 P.(360)573.8081 F.(360)574.6401 SCALE: 1"=20' HOMES • CUSTOM HOMES vww.Pe LdestyleHomes.con, wwa.GarretteCustomHomes.tom RIVER TERRCE, LT 115 PLOT PLAN 15707 SW VANDERW00D AVE, TIGARD, OR 9 224 PARCEL# R 220 5862 GENERAL NOTES 1. TOPO LINES AND ELEVATIONS ARE s_^ _ APPROXIMATE. +l 8 Y r" r Gi-xi iki GRAPHIC KEY Approved by G'1:finning W WATER OR WELL CONNECTION 0 Date: f /3//7-1- 0 SEWER OR SEPTIC CONNECTION Initials: (� -- E ELECTRICAL CONNECTION _ �/� © POWER PEDESTAL (SW) STORMWATER CONNECTION AREAS LOT AREA 10834.79 S.F. BUILDING COVERAGE 2055.33 S.F. %OF COVERAGE 18.97% CS...1 IMPERVIOUS AREA 424.62 S.F. �w STREET EE PER STREET TREE / \vO�! PLANTING PLAN, SHEET L1.02,APPROVED ENGINEERING CONSTRUCTION PLANS 4 G l�l / O ' ' . ROOF DRAINS C NE4�, VV \ . TO STORM T'R J. 4 /00. 111114 C3LAT . .,L=3232' �y, 559W c.: 00' x\\' ,//7 , ,q.lfr 4 4 '� �� „ 07 ',5c, 43p. ® // g6 a, 0' ,.\ti ��C93 /�A. �,./ � �ti �401 ,►LOJ\ 1 °90. o < co� o Ati� �'4/FC.S. \`0 401' R q y /� ' 2527 4,,40,E 393.5j / \% // go I.. ° / o. / / / 7y, Qa, i v 14'x14' , COVERED _ DECK ' co w g CT N \ O O T N tv 4 cn Z a r- II EXISTING RETAINING BLOCK WALL O 4-- Jr•~���N89°55'S3'E 49.66 ®®��® %CO r �76' ° -,c'0 0,,N 6.00' SCALE: 1"=20' DRAWN BY: SMM j Pacific Lifestyle r\ GARRETTE VANCOUVER,WA ST 98682 1200 1815 NE ER, SUIT DATED: 10/06/2022 P.(360)573-8081 F.(360)574-6401 SCALE: ,=20• HOMES • CUSTOM HOMES www.PacificLifestyleHomea.com www.GarretteCustomHomes.com RIVER CE, LOT 115 EROSION CONTROL PLAN 15707 SW VANDERWOOD AVE, TIGARD, OR 97224, AR EL# R 2205862 EROSION NOTES GENERAL NOTES 1. INSTALL GRAVEL CONSTRUCTION ENTRANCE. 1. TOPO LINES AND ELEVATIONS ARE 2. INSTALL AND MAINTAIN SILT FENCE. APPROXIMATE. 3. COVER DENUDED SOILS AS REQUIRED. GRAPHIC KEY 4. MAINTAIN CLEAN AND ORDERLY JOBSITE. 5. ALL STORMWATER DRAINS SHALL BE ® WATER OR WELL CONNECTION PROTECTED BY FILTRATION BAGS(C220). 6. HANDLE AND DISPOSE OF ALL POLLUTANTS O SEWER OR SEPTIC CONNECTION PROPERLY AND PREVENT FROM ENTERING O STORMWATER DRAIN. ELECTRICAL CONNECTION 7. APPROVED EROSION CONTROL INSPECTOR © POWER PEDESTAL WILL BE ON SITE OR ON CALL 24 HOURS A DAY(C160). (SW) STORMWATER CONNECTION 8. IF NEEDED CONTROL DEWATERING ON SITE, AREAS ANY DIRTY OR CONTAMINATED WATER SHALL BE FILTERED(C203). LOT AREA 10834.79 S.F. BUILDING COVERAGE 2055.33 S.F. %OF COVERAGE 18.97% ALL DEBRIS TO BE KEPT ON SITE IN IMPERVIOUS AREA 424.62 S.F. DESIGNATED AREA AND SHALL BE ,(> COVERED AND CONCRETE TRUCKS TO BE CLEANED OUT IN APPROVED / DESIGNATED AREA. / ' .14/ C93 `�j �\ 53°25'59"W / //' 9 .:, CONS UCTION 0 / / / C \ V:, firt ENTRANCE Wo O O 0 i i iN‘%6 *. C93 e .0 • \I • / �1 4T 1;`�gYJTF O sae Rr Y 6� G 6. / DRAINAGE SWALES TO DIRECT RUNOFF AWAY \ i $ r • FROM FOUNDATION,TYP. S . . N * o w $ • � o cP SILT FENCE AS NEEDED TO ' KEEP RUNOFF ON PROPERTY. USE CHECK DAMS AS NEEDED TO PREVENT STORMWATER RUNOFF r Rq ilk 4.-- $ ItainiallOSIOISMINagna Mgr O c o N89°55'53 E 49.66' 6.00' , SCALE: 1"=20'