Permit (3) FOR OFFICE USE ONLY—SITE ADDRESS: M kil\,) �✓
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
INI = r Transmittal Letter
T I G n R C) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Allyson Armstrong DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
FROM: Jennifer Doty !,'''Y I. 7 ZQ"L3
COMPANY: Riverside Homes CITY OF 110,
PHONE: 971-371-1310 BIJILDING DIVISION BY`42
EMAIL: jdoty@riversidehome.com
RE: 13915 SW 171st Ave MST-2023-00179
(Site Address) (Permit Number)
Riverside at Scholls Meadow
(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. 3 Engineer's calculations.
Other(explain):
REMARKS: Regarding item no. 1, submitting 3 copies of structural calcs. Regarding item no. 2, please
do not include the covered patio and porch in the plan review where not required.
FOROFFICE USE ONLY
Routed to Permit Technicia Date: - 22 �i?7 Initials:
Fees Due: ❑ Yes o Fee Descri ion: Amoun Due:
/v
Special
Instructions:
Reprint Permit(per PE • ❑ Yes ❑Done
Applicant Notified: V Date:b1AlA. i E,r( Ri1Li1 'W\XViii• Initials:40
CITY OF TIGARD MASTER PERMIT
N -i--
. COMMUNITY DEVELOPMENT Permit#: MST2023-00179
T t II A.Iz i3 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/31/2023
Parcel: 28106DC16100
Jurisdiction: Tigard
Site address: 13915 SW 171ST AVE
Subdivision: RIVERSIDE AT SCHOLLS MEADOW Lot:
Project: Riverside at Scholls Meadow,Lot 49
Project Description: New detached dwelling.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1105 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 21 Bathrooms: 3 Second: 1469 sf Garage: 371 sf Front: 8 Smoke
Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 2574 sf Value: $410,758.91 Rear: 10
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
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Bckflw Prevntr: 0
Drywall-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Fum<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Fum>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add?500 sf: 4 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All 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 2574
Owner: Contractor:
RIVERSIDE HOMES LLC RIVERSIDE HOMES LLC Required Items and Reports(Conditions)
15350 SW SEQUOIA PKWY STE 320 17933 NW EVERGREEN PKWY 370 1 (2)layers of 2x fire blocking
PORTLAND.OR 97224 BEAVERTON,OR 97006 at area indicated
2 Ersn Cntrl 503-639-4175
PHONE: PHONE: 503-645-0986
FAX: 503-690-2942
Total Fees: $48,141.87
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
ric%nn1-rtnln thr ,nh A c9-n nn met/nhtein a rune of the ndee nr dire,-t rn,ectinnc to(II Min hn rnllinn Sn'l 919 10R7 nr 1 Ann V19'Pidd
P •
Issued By: Permittee Signature: vd e o. i p i ` c. ,,1 `1 D0-7
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 lob site at the time of each Inspection.
Building Permit ApplicationRECEIVED h. 4 t ��
Residentil APR 2 7 2023 FORy� OFFICE USE ON 1.1
City g Datee/By: 411 I� s' T1 P MST�i3-00 ilq
of Tigard Permit No.:
,111 • 13125 SW Hall Blvd.,Tigard,OR 97223 CITY OF TIGARD
DIVISION Da&By: �2 3 / S1NQ.f t366161
Phone: 503.718.2439 Fax: 503.598.1BUILDINGDateBy: Z 1/ /S('' Other Permit q
'r I(i A it n Inspection Line: 503.639.4175 Date Ready/By: orris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method:��% '1-1 V Supplemental Information
en1\i'Q14aW tx. 01 'b Mil X
TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING
ElNew 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 0 Other: equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
CATEGORY OF CONSTRUCTIONof
Valuation:
❑✓ 1-and 2-family dwelling ElCommercial/industrial $ / 0/75S r
0 Accessory building 0 Multi-family Number of bedrooms: 5
❑Master builder ❑Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors: 2 Z L l{5---
Job site address: 13915 SW 171ST Ave New dwelling area: 2574 square feet 1 (Q
City/State/ZIP: Tigard/OR/97140 Garage/carport area: 371 square feet 1 D
Suite/bldg./apt.no.: Project name: Riverside at Scholls Meadow Covered porch area: square feet
Cross street/directions to job site: Roy Rogers&Jean Louise Rd Deck area: square feet
Other structure area' square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Riverside at Scholls Meadow I Lot no.: 49 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: WCTM 2S106DC16100 Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Construction of single family detached residence Valuation: $
Existing building area: square feet
New building area: square feet
Q PROPERTY OWNER ❑ TENANT Number of stories:
Name: Riverside Homes Type of construction:
Address: 15350 SW Sequoia Pkwy, Suite 320 Occupancy groups:
City/State/ZIP: Portland, OR 97224 Existing:
Phone:(971) 371-1310 Fax:( ) New:
❑✓ APPLICANT ❑ CONTACT PERSON ar" BUILDING PERMIT FEES*
Business name: Riverside Homes (Please refer to fee schedule)
Structural plan review fee(or deposit):
Contact name: Jennifer Doty
FLS plan review fee(if applicable):
Address: 15350 SW Sequoia Pkwy, Suite 320
Total fees due upon application:
City/State/ZIP: Portland, OR 97224
Phone:(971 ) 371-1310 Fax::( )
Amount received:
E-mail: jdoty@riversidehome.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: Riverside Homes Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 15350 SW Sequoia Pkwy, Suite 320 Solar Installation Specialty Code checklist.
City/State/ZIP: Portland, OR 97224 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(971) 371-1310 Fax:( )
State surcharge(12%of permit fee): $21.60
ecB lie.: 189148 Total fee due upon application: $201.60
Authorized signature: -_� __ This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Jennifer Doty Date: 2/g/23 *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
City of Tigard Receivednee n Permit No.:
■ 13125 SW Hall Blvd.,Tigard,OR 97223 Y
I Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
I I(. AItD
Internet: www.tigardor.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW ' 'so 'VA
I Land use actions completed. See jurisdiction criteria for concurrent reviews. N El El
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ® 0 ❑
3 Verification of approved plat/lot. N 0 0
4 Fire district approval required. Name of district: Tualtin Valley Fire&Rescue • N ❑ ❑
5 Septic system permit or authorization for remodel. Existing system capacity . ❑ 0 El
6 Sewer permit. ' El 0 0
7 Water district approval. N 0 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. N ❑ ❑
9 Erosion control NI plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- ® ❑ 0
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state N 0 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 ® ❑ ❑
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 N ❑ 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- N ❑ El
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. N 0 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- N 0 0
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 N 0 ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 ❑ IN
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. N ❑ 0
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required N ❑ ❑
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 ❑
architect licensed in Ore:on and shall be shown to be applicable to the .ro'ect 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". N 0 0
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ® 0 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. 0 El 0
27 "Drawn to scale"indicates standard architect or engineer scale. ❑ 0 0
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard N 0 ❑
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, ❑ ❑ N
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:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 4404613T(1 I/02/COM/WEB)
Mechanical Permit Application RECEIVE . F(Ik OFFI( l INF(1N1 \
City of Tigard API? 7 2023 Received
Date/By: Permit No.:1°1 W ' .,11C
11 .113125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
-
Phone: 503.718.2439 Fax: 503.598.1960 DateBy: Other Permit
T I G A R D Inspection Line: 503.639.4175 CITY OF TIGAR 1 a�t7Q�,ate Ready/By: turfs! RI See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISIIIf otited/Method: Supplemental information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
✓❑New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition ❑Other mechanical materials,equipment,labor,overhead,and profit.
Value:S
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
El 1-and 2-family dwelling ❑Commercialindustrial 0 Accessory building For special information use checklist.
D Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 1 46.75 46.75
Job site address: 13915 SW 171 ST Ave Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75
City/State/ZIP: Tigard/OR/97140 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: Riverside at Scholls Meadow
Duct work 23.32
Cross street/directions to job site: Roy Rogers&Jean Louise Rd 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: Riverside at Scholls Meadow Lot no.: 49 Other: 23.32
Other fuel appliances:
Tax map/parcel no.: WCTM 2S106DC16100 Water heater 1 23.32 23.32
DESCRIPTION OF WORK `e Gas fireplace/insert 1 33.39 33.39
Flue vent for water heater or gas
Construction of single family detached residence fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
,.".. .a r.6,ev,,.,;«,.'',�.v Other: 23.32
Q PRO , '" TENANT
Environmental exhaust and ventilation:
Name: Riverside Homes Range hood/other kitchen
equipment 1 33.39 33.39
Address: 15350 SW Sequoia Pkwy, Suite 320 Clothes dryer exhaust 1 33.39 33.39
City/State/ZIP: Portland, OR 97224 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 5 23.32 116.6
Phone:(971 ) 371-1310 Fax:( ) Attic/crawlspace fans 23.32
❑✓ APPLICANT ❑ CONTACT PERSON Other: 23.32
Business name: Riverside Homes Fuel piping:
$14.15 for first four;S4.03 for each additional
Contact name: Jennifer Doty Furnace,etc. 1
Address: 15350 SW Sequoia Pkwy, Suite 320 Gas heat pump
Wall/suspendended/unitheater
City/State/ZIP: Portland, OR 97224 Water heater 1
Phone:(971 )371-1310 Fax::( ) Fireplace 1
Range 1
E-mail: jdoty@riversidehome.com Barbecue
CONTRACTOR • Clothes dryer(gas)
Business name: Proheating &Cooling Other: MECHANICAL PERMIT FEES*
Address: 2123 NE Aloclek Dr, Suite 1209 Subtotal
cityisrate/zIP: Hillsboro/OR//97124 Minimum permit fee(S90.00)
Plan review(25%of permit fee)
Phone:( 971)205-4989 Fax:( ) State surcharge(12%of permit fee)
CCB lic.: 209001 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete.
Authorized signature: • Fee methodology fief byy Tri-County Building industry Service Board
Print name: Jennifer Doty Date: 2/6/23
1:\Building\Permits\MEC_Pem,itApp_040113.doc 440-4617T(I1/02/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:\BuildinglPermits\MEC_PemutApp_040113.doc 2
Electrical Permit Application RECEIVE'DFOR OFFICE USE ONLY
City of Tigard Received M.,'( 1�23 (�[1 q
Permit#:
• 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By:
7 an Review Related Permit#:
I Phone: 503.718.2439 Fax: 503.598.1960 JUN f 2023 Date/By:
Inspection Line: 503.639.4175 Ready Date/By: lam: ® See Page 2 for
TIGARD Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
TYPE OF WOWILDING'DIVISION PLAN REVIEW
0 New construction ❑ Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more ['Building over three stories.
❑Demolition ❑Other: where the available fault current ['Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
❑ 1-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: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address: 13915 SW 171ST Ave l00HP or more. ❑"A","E","l-2","l-3",
❑Six or more residential units. occupancy.
City/State/ZIP: TigardlOR/97140 El Health-care facilities. ❑Recreational vehicle parks.
0 Hazardous locations. 0 Supply voltage for more than
Suite/bldg./apt.#: Project name: Riverside at Scholls Meadow ❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: Roy Rogers & Jean Louise Rd FEE SCHEDULE
Description I Qty. I Each I Total I *
New residential single-or multi-family dwelling unit.
Subdivision: Riverside at Scholls Meadow Lot#: 49 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: WCTM 2S106DC16100 Ea.add'1500 sq.ft.or portion 33.92 I
DESCRIPTION OF WORK Limited energy,residential
(with above sq.ft.) 75.00 2
Construction of single family detached residence Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
❑✓ PROPERTY OWNER ❑ TENANT Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
Name: Riverside Homes 200 amps or less 100.70 2
Address: 15350 SW Sequoia Pkwy, Suite 320 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: Portland, OR 97224 601 amps to 1,000 amps 301.04 2
Phone:(971 ) 371-1310 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-new,alteration,or extension,per panel
❑ A.Fee for branch circuits with
Business name: Riverside Homes above service or feeder fee, 7.42 2
each branch circuit
Contact name: Jennifer Doty B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address: 15350 SW Sequoia Pkwy, Suite 320 branch circuit
OR 97224 Each add'I branch circuit 7.42 2
City/State/ZIP: Portland, Miscellaneous(service or feeder not included)
Phone:(971 ) 371-1310 Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: jdoty@riversidehome.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Sunlight Electric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy 0 See Page 2 2
Address: 2804 NE 65th Ave, Ste. D panel,alteration,or extension.
Each additional inspection over allowable in any of the above
City/State/ZIP: Vancouver/WA/98661 Additional inspection(1 hr min) 66.25/hr
Phone:(360) 518-7589 Fax:( ) Investigation(I hr min) 90.00/hr
Email: a or sunli htelectricinc.com Industrial plant(I hr ) 78.18/hr
y g g Inspections for whhichich no fee is 90.00/hr
CCB Lic.: 172549 Electrical Lic.: C 30 Suprv.Lie.: 6652S specifically listed(1/2hr min)
Exp 10/01/25 ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
r
Print name: Sunlight Electric Date: 2/6/23 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
TOTAL PERMIT FEE:
Authorized signature: y
This permit application expires if a permit is not obtained within 180
Print name: Jennifer DotyDate: 2/6/23 days after it has been accepted as complete.
* Number of inspections allowed per permit.
L/Build ng\Permits\ELC PerrniIApp_ELR ERE.doc Rev 06/17/2015 440-4615TO 1/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Description Qtv. I Each I Total I
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
El 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:
El Other: Each additional inspection is 66.25/hr
charged at an hourly(1 hr min)
Inspections for which no fee is 90A01 hr
specifically listed(44 hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
(SEE OAR 918-309-0000) ` Number of inspections allowed per permit.
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
El Clock Systems
❑ Data Telecommunication Installation
El Fire Alarm Installation
❑ HVAC
El Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
El Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
1:1BuildinglPermits'ELC_PcmatApp ELR_ERE.doc Rev 06/17/2015
Plumbing Permit Application
Building Fixtures RECEIV FOR OFFICE I bE OSI l
7 p7�Received
p,�eceiv d MS/(ZOZ3,b�11 G
_ City of Tigard a Permit No.:
11141 • 13125 SW Hall Blvd.,Tigard,OR 97223 APR 7 26CVafReview
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.:
T I G A R D Inspection Line: 503.639.4175 Internet: www.tigard-Or.gov CITY OF T Ready/B luris, ® See Page 2 for
hh+: r�to ified/Methy:od: Supplemental Information
DUiLbirNi6 ulVIx7 lON
TYPE OF WORK FEE* SCHEDULE
e New construction ODemolition For special information use checklist.
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
01-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 1 500.32 500.32
❑Accessory building El Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 13915 SW 171ST Ave Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/Z1P: Tigard/OR/97140
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name: Riverside at Scholls Meadow Manufactured home utilities 50.03
Cross street/directions to job site: Roy Rogers&Jean Louise Rd Manholes 18.76
Rain drain connector 1 18.76 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: Riverside at Scholls Meadow I Lot no.: 49 Fixture or item:
Tax map/parcelno.: WCTM 2S106DC16100 Backflowpreventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Construction of single family detached residence Clothes washer 1 25.02 25.02
Dishwasher 1 25.02 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
✓O PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name: Riverside Homes
Floor drain/floor sink/hub 25.02
Address: 15350 SW Sequoia Pkwy, Suite 320 Garbage disposal 1 25.02 25.02
City/State/ZIP: Portland, OR 97224 Hose bib 2 25.02 50.04
Phone:(971 ) 371-1310 Fax:( ) Ice maker 1 12.51 12.51
✓❑APPLICANT El CONTACT PERSON Interceptor/grease trap 25.02
Business name: Riverside Homes Medical gas(value:$_) Page 2
Primer 12.51
Contact name: Jennifer Doty
Roof drain(commercial) 12.51
Address: 15350 SW Sequoia Pkwy, Suite 320 Sink/basin/lavatory 6 25.02 150.12
City/State/ZIP: Portland, OR 97224 Solar units(potable water) 62.54
Phone:(971 ) 371-1310 Fax::( ) Tub/shower/shower pan 4 12.51 50.04
Urinal 25.02
E-mail: jdoty@riversidehome.com Water closet 3 25.02 75.06
CONTRACTOR Water heater 1 37.52 37.52
Business name: H & H Mechanical Water piping/DWV 56.29
Address: 5757 SE Willow Ln other: 25.02
City/State/ZIP: Milwaukie/OR/97267 Subtotal
Phone:(503)975-9787 Fax:( ) Minimum permit fee: $72.50
CCB Lie.: 178122 Plumbing Lic.no.: PB414 Plan review (25%of permit fee)
7 State surcharge(12%of permit fee)
Authorized signature: -o y,� „�_.. TOTAL PERMIT FEE
Print name: Jennifer Doty Date: 2/6/23 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:\Buildatg\Permits\PLMU-PerntitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total quare Footage: Permit Fee:
Footing drain-1"100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' 6254 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 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) _ each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*.
Quantity by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Replace/
Work Performed: capped Added Relocate Plan review is required for any of the following.
Please check all that apply,
Baptistry/Font
Bath Tub/Shower ❑ 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 Thru ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial 0 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
Garbage Domestic-non-food ❑ Isometric or riser diagram is required for new buildings
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 assessed for the sewer increase must be paid before the
Urinal _ plumbing permit can be issued.
Other Fixtures:
C:\Users\npruett\Downloads\PLMF_PemiitApp.doc 2
City of Tigard
" COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
TIGARD
Building Permit#: VISVICIA "G014
Site Address: SW 171s1 Ave ® Verified in Accela
Project Name: Riverside Homes at River Terrace Scholls Meadow Lot/Unit #: _49
Proposal: _New Single Detached SFR Zone: RES-E
Housing Type: Cil SFR(®Single Detached 0 Duplex 0 Triplex❑ADU)❑ Rowhouse❑Cottage Cluster❑CYU ❑Quad❑Other
Required Site Plan Elements:
0 3 copies of site plan on max 11x17"
IX Drawn to standard scale A Retainad trees, ._/+ ryrotectinn
North arrow MI Street and site trees shown / labeled
I& Site address, project name, lot # ❑Tablc calculating tree canopy at maturity
M Street names (N/A for SFR)
IX Applicant name and phone #
IX Lot and setback dimensions W Vision clearance triangle
-B-Existing structurc3 &cgua fieetage_ IN Utility locations &easements
M Footprint of new structure and FFE M Property corner elevations
NT 4/18/23 �Id(sidewalk/driveway dimensions ❑ LIDA (>1,000 sf disturbance)
Lo a a aTnf brrnvera percentage XErosion control
Required Elevation Plan Elements:
(For SFR: calcs needed only on street-facing) Summary table with calculations for:
M Drawn to standard scale IX Total facade area
IX Building height dimensioned IX Total window and door area
IX Facade dimensioned
IX Windows and doors dimensioned
Garage doors dimensioned
Requi Ian Elements:
(Not required for SFR ummary table that includes
0 Each story dimensi floor area
oor area calculated 0 Floor area per
Planning Review
The following standards have been met:
Setbacks ® Front: 8 Rear: _10 Side: _3 Min/Max Street Side: _8_/ Garage: _20_
Height IX Max. Height: _35_ Proposed Height: 21_
lX Yes 0 N/A Landscape 20%
❑ Yes IX N/A Screening (Quad only)
® Yes 0 N/A % Window Coverage 12%
® Yes ❑ N/A Garage (SFR Only) Parking (Other Res) same Or > distance than wall/ 12ft wide Or <50%
® Yes ❑ N/A Entrance (SFR, Rowhouse, Quad only) setback no further than 8 ft from widest street facing wall
❑ Yes ® N/A Other building design standards (Rowhouse only)
❑ Yes ® N/A Accessory Structure Standards
❑ Yes IN No Qualifying pre-existing unit exempt from standards (Cottage unit only)
Additional standards for Courtyard Units, Cottage Clusters, Rowhouses, and Quads:
❑ Yes IN N/A Unit Count:
❑ Yes MI N/A Lot Width and Size
❑ Yes IN N/A Pathway
Additional standards for Courtyard Units and Cottage Clusters only:
❑ Yes IX N/A Unit Area:
❑ Yes II1 N/A Floor Area (per story)
❑ Yes a) N/A Courtyard
❑ Yes RI N/A Fence
0 Yes ❑ No IN/A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995)
11 Yes ❑ No ON/A Public Facilities Improvement (PFI) Permit:
Required: ft Yes ❑ No
Applied For: 511Yes 0 No, stop intake
® Sensitive Lands: ❑Yes ® No
IE Main Land Use Case #s: PDR2021-00001 / ❑ Conditions met
o Applicant notified of land use expiration :
Approved By Planning: Date: 4/18/23
Notes
Revision 1: 0 Approved ❑ Not Approved Date:
Revision 2: 0 Approved 0 Not Approved Date:
Building Permit Submittal
Original Submittal Date: 4t, 1 11A13
Site Plans #:
Building Plans #:
Building Permit #: "Building permit # entered on page 1
Workflow Routing: i2Planning Engineering VPermit Coordinator Ertuilding
Workflow Sign-off: d ign-off for Planning (include notes from planning review)
Route Documents: EI Engineering: (1) copy of permit application, (1) site plan, (1) building plan
an original plan review routing form.
uilding: original permit application, site plans, building plans, engineer and
.- beam calculations and trust details, if applicable, etc.
•
Permit Technician: k,y'.m' 4- Date: 5 I� I 1-6ti3
Notes:
Engineering Review
❑ VI Permit:
Slope at building pad: 2 6�
VConditions met prior to issuance of permit
basements (encroachments) per engineering conditions of approval and plat
1-Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes 171,110
Assess Water Quantity Fee in-lieu: ❑ Yes gl-No
LIDA Facility on lot: 0 Yes Zl4 o Add Fee: ❑ Yes 0 No
final Plat Recorded
❑ NOT Approv d: Date:
Notes: �i�L/?��� >✓ �+�t- 1� PGA �1�� [�Ga e2Ce-e(6,
Approved By Engineering: Date:
Revision 1: ❑ Approved Not Approved Date:
Revision 2: 0 Approved ❑ Not Approved Date: 'rfl��93
P-rmit Coordinator Review
fis
onditions met prior to permit ittianH \ rr i ,
r Approved, NOT Released: C'\\1,'1``Vk IL
i Date notified applicant: -
• ENG Revisions Required: Date notified applicant:
*SDC Exemption: ❑ Applied for 0 Received ❑ Does not apply
51 SDC Fees Entered: Wash Co Trans Dev Tax: L Yes 0 N/A
( Tigard Trans SDC: Yes 0 N/A ❑ Deferred
Parks SDC: Yes 0 N/A 0 Deferred
LIDA ❑(Yes y1N/
❑ OK to Issue/Approved by Permit Coordinator: 'C� q
`I ya Date: C- a-3
Revision 1: 0 Approved 0 Not Approved Date:
Revision 2: ❑ Approved 0 Not Approved Date: