Permit (4) CITY OF TIGARD MASTER PERMIT
: _ . COMMUNITY DEVELOPMENT Permit#: MST2023-00180
Date Issued: 07/31/2023
T WA A P.T7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S106DC16100
Jurisdiction: Tigard
Site address: 13909 SW 171ST AVE
Subdivision: RIVERSIDE AT SCHOLLS MEADOW Lot:
Project: Riverside at Scholls Meadow, Lot 50
Project Description: New detached dwelling.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1016 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 23 Bathrooms: 3 Second: 1450 sf Garage: 390 sf Front: 8 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 2466 sf Value: $395,613.12 Rear: 10
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories; 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
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
Furn<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
801-1000 amp: 0 601+amp-1000v: 0
1000+amplvolt: 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 2466
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 Ersn Cntrl 503-639-4175
PORTLAND,OR 97224 BEAVERTON,OR 97006
PHONE: PHONE: 503-645-0986
FAX: 503-690-2942
Total Fees: $47,662.32
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
oc9.nn1-nnln thrn nap o<9.nn1- Vn,i mnv nhtnin n rnnv of tha n,i s nr rlirart n,,actinnc to ell INC!h"Tallinn cn7 997 10A7 nr 1 ann 449�r \ Y1dd
�.p
Issued By: Permittee Signature: ✓ � i I C) .6‘a y
all 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 Application RECEIVED H ",` ,- '`?/2.
Residential FOR OFFICE USE ONLY
City of Tigard APR 2 7 2023 ReOe'"� '
DffiC/B : Permit No.: 'l - j '
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review '
h Phone: 503.718.2439 Fax: 503.598.196'CITY OF TIGARD Date/By: 5j III 2.2 Other Permit:NtIA -OO M
TIGARD Inspection Line: 503.639.4175 BUILDING DIVISION Date Reddy/By: r�,`q y1 p� brit: ® See Page 2 for
Internet: www.tigard-or.gov Nofified/Method: '�) WU3't"tN Supplemental Information
tY1e.ILA( l o,fu- i*.r' 1PLM'I.fli,3-tx}1,ti1•
TYPE OF WORK REQUH D DATA:1-AND 2-FAMILY DWELLING Z
El New construction 0 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 -+e,.
CATEGORY OF CONSTRUCTION work indicated on this application. p
❑✓ 1-and 2-family dwelling ❑Commercial/industrial Valuation: $ S♦� 13 t
El Accessory building El Multi-familyNumber of bedrooms: 5 JJJ "`
❑Master builder 0 Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors: 2 2,SitS5
Job site address: 13909 SW 171 ST Ave New dwelling area: 2466 square feet` i3
City/State/ZIP: Tigard/OR/97140 Garage/carport area: 390 square feet/b 4
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 Lot no.: 50 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: WCTM 2S1 O6DC161 O0 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
❑✓ 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:
El APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer b /Ge schedule)
Business name: Riverside Homes
Structural plan review fee(or deposit):
Contact name: Jennifer Doty
Address: 15350 SW Sequoia Pkwy, Suite 320 FLS plan review fee(if applicable):
Total fees due upon application:
City/State/ZIP: Portland, OR 97224
Amount received:
Phone:(971 ) 371-1310 Fax::( )
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
CCB lie.: 189148 Total fee due upon application: $201.60
Authorized signature: .� , :x.-,� This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Jennifer DotyDate: 2/6/23 *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)
. A
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLY
Cityof Tigard Received
_ g Date/By:
Permit No.:
gi 13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
•
1 I ci A R I) 24-Hour Inspection Line: 503.639.4175 ❑ Electrical ID Plumbing 0 Mechanical
Internet: www.tigard-or.gov 0 Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/-k
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ® ❑ •
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ® ❑ 0
3 Verification of approved plat/lot. g 0 0
4 Fire district approval required. Name of district: Tualtin Valley Fire 8 Rescue . ® ❑ ❑
5 Septic system permit or authorization for remodel. Existing system capacity 0 0 g
6 Sewer permit. g 0 0
7 Water district approval. ® 0 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. ® 0 0
9 Erosion control ISJ plan ['permit required. Include drainage-way protection,silt fence design and location of catch- g ❑ ❑
basin protection,etc.
10 3 Complete sets of'legible plans. Must be drawn to scale,showing conformance to applicable local and state g ❑ ❑
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 ® ❑ 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 ® 0 0
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ® ❑ ❑
fumace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- ® ❑ ❑
floor,wall construction,roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings
and foundation,stairs,fireplace construction,thermal insulation,etc.
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. ® 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- ® 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 ® 0 0
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ rg
systems,see item 22,"Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ® ❑ ❑
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. ® 0 0
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ® 0 0
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 g 0 0
architect licensed in Ore on and shall be shown to be a licable to the ro'ect under review.
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. ® ❑ ' 0
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ® ❑ ❑
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 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 ® 0 0
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ 0 g
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 IN
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.
1:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial&Multi-Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to$500.00 Minimum fee$69.06
$500.01 to$5,000.00 $69.06 for the first$500.00 and
$3.07 for each additional$100.00 or
fraction thereof,to and including
$5,000.00.
$5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and
$2.81 for each additional$100.00 or
fraction thereof,to and including
$10,000.00.
$10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and
$2.54 for each additional$100.00 or
fraction thereof,to and including
$50,000.00.
$50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and
$2.49 for each additional$100.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first$100,000.00 and
$2.92 for each additional$100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
L\Building\Permits\MEC_PermitApp_040113.doc 2
Electrical Permit ApplicatiaECEI V FOR OFFICE USE ONLY
City of Tigard APR 2 7 2023 Date/By:Reeed MS uV U3 1101ico
Permit#:
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
' 0 Phone: 503.718.2439 Fax: 503.598LAY OF TIGARD Date/By: Related Permit#:
Inspection Line: 503.639.4175 p Ready Date/By: kids: I ® see Page 2 for
TIGARD Internet: www.ti ard-or, ov BUILDING DIVi,.;;('�,.t� Notified/Method: g
g gSupplemental Information
TYPE OF WORK 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 0 Building over three stories.
0 Demolition ❑Other:
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
1-and 2-familydwellingCommercial/industrial less to ground,or exceeds 14,000 0 Commercial-use agricultural
0amp❑ ❑Accessory building
❑Multi-family ❑Master builder Other: Fire form . other installations. butngs.
❑ 0Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: Job site address: 13909 SW 171ST Ave ❑Addition of new motor load of system.
]OOHP or more. ❑"A" "E" "I-2" •`l-3"
City/State/ZIP: Tigard/OR/97140 0 Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: Riverside at Scholls Meadow ❑Hazardous locations. 0 Supply voltage for more than
❑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. 1 Each I Total I .
New residential single-or multi-family dwelling unit.
Subdivision: Riverside at Scholls Meadow Lot#: 50 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: WC TM 2S 106DC 16100 Ea.add'I 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential 75.00 2
Construction of single family detached residence (with above sq.It)
Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
Renewable Energy 0 See Page 2
Q PROPERTY OWNER El TENANT
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
Ci /State/ZIP: 401 amps to 600 amps 200.34 2
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
ElAPPLICANT 0 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,
each branch circuit 7.42 2
Contact name: Jennifer Doty B.Fee for branch circuits without
Address: 15350 SW Sequoia Pkwy, Suite 320 serviceor feeder fee,first 56.18 2
t1 branchh circuit
City/State/ZIP: Portland, OR 97224 Each add'l branch circuit 7.42 2
Phone:(971 ) 371-131 O Fax: : Miscellaneous(service or feeder not included)
) Each manufactured ormodular 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 Address: 2804 NE 65th Ave, Ste. D panel,alteration,or extension. 0 See Page 2 2
Ci /State/ZIP: Each additional inspection over allowable in any of the above
ri Vancouver/WA/98661 Additional inspection(I hr min) 66.25/hr
Phone:(360) 518-7589 Fax: ( ) Investigation(I hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email: yegor@sunlightelectricine.eom Inspections for which no fee is
CCB Lic.: 172549 Electrical Lic.: C 30. Suprv.Lie.: 6652S
specifically listed(1/2hr min) 90.00/hr
Suprv.Electrician signature,required: Exp 10/01/25
ELECTRICAL PERMIT FEES
Subtotal:
Print name: Sunlight Electric Date: 2/6/23 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
l TOTAL PERMIT FEE:
Authorized signature: � �- --
This permit application expires if a permit is not obtained within 180
Print name: Jennifer Doty Date: 2/6/23 days after it has been accepted as complete.
* Number of inspections allowed per permit.
Ltaailding\Permits\ELC PernsitApp_ELR ERE.doc Rev 06/17/2015 440-4615T(1 l/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 I Ott,. I Each j 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
E 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 ]
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(%hr min)
COMMERCIAL WORK ONLY: ELECTRICAL Pnteron Page 1):
FEES
Fee for each commercial system: $75.00 Subtotal rperm
�' '� 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
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape 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
1:1Building\Perrnits\ELC_PennilApp_ELR ERE.doc Rcv 06/17/2015
Plumbing Permit Applicaa f �7U .
E C E i l"a ,�(ram
Building Fixtures p,P2 2 7 2023
City g FOR OFFICE USE ONLY
of Tigard fi ! Received mila�• 60 6
ReceBPermit No
N i U 13125 SW Hall Blvd.,Tigard,OR OF TIGARD Plan Review
Phone: 503.718.2439 Fax: 50 p Date/By: Other Permit No.:
Inspection Line: 503.639.4175 L II IG DIVISION
T I(,A R O. Datc Ready/By: Juris: ® Sec Page 2 for
Internet: www.tigard-or.gov Notified/Metbod: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑✓ New construction 0Demolition For special information use checklist.
Description 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(1)bath 312.70
El 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 1 500.32 500.32
Each additional bath/kitchen 25.02
❑Master builder El Other: Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 13909 SW 171ST Ave Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: Tigard/OR/97140
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: 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 Lot no.: 50 Fixture or item:
Tax map/parcel no.: WCTM 2S106DC16100 Backflow preventer 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
❑r PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name: Riverside Homes Fixture/sewer cap 25.02
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 0 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
E-mail: jdoty@riversidehome.com Urinal 25.02
Water closet 3 25.02 75.06
CONTRACTOR
Water heater 1 37.52 37.52
Business name: H & H Mechanical Water P �t P m WV 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 Lic.:178122 Plumbing Lic.no.: PB414 Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: ..Va 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.
ItEluildingWermits1PLICJ-PermitAppdor 10/01/09 440-4616T(10/02/COM/WEm)
a
•
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-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' 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
Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
Other Inspections or Fees 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 ReplflCe! Plan review is required for any of the following.
Work Performed: Capped Added Relocate
Baptistry/Font Please check all that apply.
Bath Tub/Shower El Any new commercial building with water service 2"and
Jacuzz Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru 0 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 0 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"
Isometric or Riser Diagram
Car Wash Drain
Garbage Domestic-non-food 0 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:1Users\npruett\Downloads\PLMF_PermitApp.doc 2
City of Tigard
" COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
TIGARD
Building Permit #: t"IS101/ 'GUr U6
Site Address: _13909 SW 171st Ave Z Verified In Accela
Project Name: _Riverside Homes at River Terrace Scholls Meadow Lot/Unit #: 50
Proposal: New Single Detached SFR Zone: _RES-E
Housing Type: NI SFR(®Single Detached ❑ Duplex❑Triplex 0 ADU) ❑ Rowhouse ElCottage Cluster❑ CYU ❑Quad❑Other
Required Site Plan Elements:
❑ 3 copies of site plan on max 11x17"
® Drawn to standard scale ElRetained treesrdrip line/ tree p o* ctinn
M North arrow 171 Street and site trees shown / labeled
M Site address, project name, lot # fl Table calculating trce canopy at maturity
M Street names (N/A for SFR)
IN Applicant name and phone # El C"urtyar ' "`angle dimension d (•F li hl )
Ii Lot and setback dimensions MI Vision clearance triangle
-o Cxist;ng structures &square footage ® Utility locations &easements
Ul Footprint of new structure and FFE M Property corner elevations
NT 4/18/23 1-1 l.ewalk/driveway dimensioned ❑,j.IDA (>1,000 sf disturbance)
® Lo a -• . . . .•- ..- percentage gj Erosion control
Required Elevation Plan Elements:
(For SFR: calcs needed only on street-facing) Summary table with calculations for:
M Drawn to standard scale ZI Total façade area
Building height dimensioned MI Total window and door area
Facade dimensioned
• Windows and doors dimensioned
®Garage doors dimensioned
Requi Ian Elements:
(Not required for SFR mmary table that includes
❑ Each story dimensi floor area
oor area calculated ❑ Floor area per
Planning Review
The following standards have been met:
Setbacks IX Front: _8 Rear: 10_ Side: _3_ Min/Max Street Side: _8_/ Garage: _20_
Height M Max. Height: _35_ Proposed Height: 23
(ffi Yes El N/A Landscape 20% If using the 7 detailed design elements per
❑ Yes g N/A Screening (Quad only) 118.290.040.C.3, please list them on the plans
M Yes ❑ N/A 0/0 Window Covers e u Applicant listed 7 design elements an Sheet C1.NT 4/18/23
NT 4/18/2 s /A Garage (SFR Only) Parking (Other Res) same or > distance than wall/ 12ft wide or zSQ�ai�
I& Yes ❑ N/A Entrance S F ow Ouse, ua on y her an rom widest street facing wall
❑ Yes IN N/A Other building design standards (Rowhouse only)
❑ Yes IX N/A Accessory Structure Standards
❑ Yes ® 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 IE N/A Lot Width and Size
❑ Yes IX N/A Pathway
Additional standards for Courtyard Units and Cottage Clusters only:
❑ Yes ® N/A Unit Area:
❑ Yes IX N/A Floor Area (per story)
❑ Yes IM N/A Courtyard
❑ Yes ® N/A Fence
❑ Yes ❑ No ®N/A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995)
DIC Yes ❑ No ❑N/A Public Facilities Improvement (PFI) Permit:
Required: EA Yes ❑ No
Applied For: El Yes ❑ No, stop intake
2) Sensitive Lands: ❑ Yes X No
® Main Land Use Case #s: PDR2021-00001 i ❑ Conditions met
❑Applicant notified of land use expiration ee
Approved By Planning: ...... Date: 4/18/23
Notes
Revision 1: 0 Approved ❑ Not Approved Date:
Revision 2: ❑ Approved ❑ Not Approved Date:
Building Permit Submittal
Original Submittal Date: 1I1.-1 IV413
Site Plans #:
Building Plans #:
Building Permit #: ('Building permit # entered on page 1
Workflow Routing: ly lanningEngineering Permit Coordinator &Building
Workflow Sign-off: B'Sign-off for Planning (include notes from planning review)
Route Documents: 6/Engineering: (1) copy of permit application, (1) site plan, (1) building plan
an91 original plan review routing form.
Building: original permit application, site plans, building plans, engineer and
n beam calculations and trust details, if applicable, etc.
I'
Permit Technician: L6" iPtt/Y�ti- Date: 5 13 1/01,5
Notes:
Engineering Review
❑ PFI Permit:
TA-lope at building pad: 24.
/A-Conditions met prior to issuance of permit
r Ip' sements (encroachments) per engineering conditions of approval and plat
it"Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes aflo
Assess Water Quantity Fee in-lieu: ❑ Yes l 1Vo
LIDA Facility on lot: ❑ Yes No Add Fee: ❑ Yes ❑ No
final Plat Recorded
D NOT Approved: Date:
Notes: .25112 14-p`741-cC//ete-3t- l/L pi"e- ii�f-?:7 -•i/ iY 4z�G�7c'r�
Approved By Engineering: Date: ! 2
Revision 1: 0 Approved Not Approved Date:
Revision 2: ❑ Approved ❑ Not Approved Date:
Permit Coordinator Review
( Conditions met prior to permit i suares 5
Approved, NOT Released: f U \(:Ad
Date notified applicant:
O ENG Revisions Required: Date notified applicant:
\ DC Exemption: ❑ Applied for ❑ Received ❑ Does not apply
SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes I: N/A
Tigard Trans SDC: CAI Yes ❑ N/A ❑ Deferred
Parks SDC: d Yes ❑ N/A ❑ Deferred
// LIDA Li Yes
( rN/A
`
'16 OK to Issue/Approved by Permit Coordinator: 1 ' 1 ) . O Date: 3( ' 025
Revision 1: ❑ Approved ❑ Not Approved Date:
Revision 2: ❑ Approved ❑ Not Approved Date: