Permit (8) CITY OF TIGARD MASTER PERMIT
111 4 'r1 COMMUNITY DEVELOPMENT Permit#: MST2023-00182
Date Issued: 07/17/2023
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S106DC16100
Jurisdiction: Tigard
Site address: 13885 SW 171ST AVE
Subdivision: RIVERSIDE AT SCHOLLS MEADOW Lot:
Project: Riverside at Scholls Meadows, Lot 52
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
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes
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
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Bckflw Prevntr. 0
Drywell-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
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 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 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: $47,662.82
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work
will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
g5Am1An1n thrnunh GR q59 Holm vm,man nhfain a nnmr of the ndac nr rlirart nimatinne in rll1Nr:Ks/callinn. 1 919/0137 nr nn aa9 9344.
Issued By: [ Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. i-,/
This permit card shall be kept in a conspicuous place on the job site until completion o the project.
Approved plans are required on the iob site at the time of each inspection.
Mechanical Permit Applicatio FOR OFFICE USE ONLY
Cityof Tigard `DECEIVE '-'eceived Q A n
u Date/By: Permit No.:if 11 I/t ,� ��6 �1"1
1111 13125 SW Hall Blvd.,Tigard,OR 97223 p/1 W f� V
Phone: 503.718.2439 Fax: 503.598.1960 MAY y 2023 Plan Review Date/By: Other Permit:
I 1, ;A 1,I) Date Ready/By: kris:Inspection Line: 503.639.4175 y y: ® See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
r I fl,,,;
TYPE OF WORK..i ~ COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
0 New construction ❑Addition/alteration/replacement
Mechanical permit fees*are based on the value of the work
performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
a I_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 1 46.75 46.75
Job site address: 13885 SW 171 ST Ave Furnace 100,000 BTU(duets/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 Ductwork 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.: 52 Other: 23.32
Other fuel appliances:
Tax map/parcel no.: WCTM 2S106DC16100 Water heater 1 23.32 23.32
DESCRIPTION OF WORK • tams 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
9PROPERTY OWNER 0 TENANT Other: 23.32
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
Fuel piping:
Business name: Riverside Homes $14.15 for first four;$4.03 for each additional
Contact name: Jennifer Doty Furnace,etc. 1
Address: 15350 SW Sequoia Pkwy, Suite 320 Gas heat pump
Wall/suspended/unit heater
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
City/State/ZIP: Hillsboro/OR//97124 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( 971)205-4989 Fax:( ) State surcharge(12%of permit fee)
CCB lie.: 209001 TOTAL PERMIT FEE
This permit application expires If a permit is not obtained within 180
t /�/7 days after it has been accepted as complete.
Authorized signature: ! * Fee methodology set by Tri-County Building Industry Service Board
Print name: Jennifer Doty Date: 2/6/23
I:\Budding\Permits1MEC_PermitApp_040113.doc 440.461 Tf(l i/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 -Supplemental Information
Commercial& Multi-Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to$500.00 Minimum fee$69.06
$500.01 to$5,000.00 $69.06 for the first$500.00 and
$3.07 for each additional$100.00 or
fraction thereof,to and including
$5,000.00.
$5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and
$2.81 for each additional$100.00 or
fraction thereof;to and including
$10,000.00.
$10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and
$2.54 for each additional$100.00 or
fraction thereof,to and including
$50,000.00.
$50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and
$2.49 for each additional$100.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first$100,000.00 and
$2.92 for each additional$100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I:\Building\Pernuts\MEC_PennitApp_040113.doc 2
Electrical Permit Application RECEIVE,! FOR OFFICE USE ONLY
City of Tigard Received
Date/By: Permit il: ��(?
tArk(1e., ./J0
Ill • 13125 SW Hall Blvd.,Tigard,OR 97223 MAY 4 2023 Plan Review M f �I OJ V
i Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Related Permit S:
Ins tion Line: 503.639.4175 Read Date/B Jaris: 1 See Page 2 for
TIGAR—, Internet: www.tigard-or.gov CITY OF TIGARD Notit-wd/Method: Supplemental Information
BUILDING pIVISiO '
TYPE OF WORK PLAN REVIEW
❑New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more 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
❑ 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 0 Master builder 0 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: 13885 SW 171ST Ave 1o0HP 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.
SuitePo ❑Hazardous locations. 0 Supply voltage for more thanldg./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 1
New residential single-or multi-family dwelling unit.
Subdivision: Riverside at Scholls Meadow Lot#: 52 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: WCTM 2S106DC16100 Ea.add'I500 sq.ft or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
Construction of single family detached residence (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
I] PROPERTY OWNER ❑ 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
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
Branch circuits—new,alteration,or extension,per panel
❑✓ APPLICANT El CONTACT PERSON
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
sAddress: 15350 SW Sequoia Pkwy, Suite 320 branihcce rfuederfee,first 56.18 2
q branch circuit
City/State/ZIP: Portland, OR 97224 Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(971 ) 371-1310 Fax: :( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
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 ❑ See Page 2 2
Address: 2804 NE 65th Ave, Ste. D panel,alteration,or extension.
City/State/ZIP: Each additional inspection over allowable in any of the above
ty Vancouver/WA/98661 Additional inspection(1 hr min) 66.25/hr
Phone:(360) 518-7589 Fax:( ) Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email: yegor@sunlightelectricinc.com Inspections for which no fee is 90.00/hr
CCB Lic.: 172549 Electrical Lic.: 230 Suprv. Lic.: 6652S specifically listed(1/2hr min)
.ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: /�� Exp 10/01/25 Subtotal:
Print name: Sunlight Electric ?/ � Date: 2/6/23 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
I TOTAL PERMIT FEE:
Authorized signature: .,, —.----
This permit application expires if a permit is not obtained within 180
Print name: Jenni er Doty Date: 2/6/23 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Pemsits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 4404615T(1 I/05/COM/WEB
1
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 Qty. J Each I Tole] J ,
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
❑ 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(I hr min)
Inspections for which no fee is 90.00/hr
specifically listed('/hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page I)
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
❑ 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
I:d3uitding1Permits'ELC_PemtitApp_EIR_ERE.doc Rev 06/17/2015
Plumbing Permit Application
Building Fixtures RECEIVE f()l1 Ol., It l I \I t>\I.N
Cityof Tigard ) (1 Received
2 g Y 2023ry DateBy: Permit No.:M //M� 1)1151,
13125SWHallBlvd.,Tigard,OR 97223 MAY •3 Plan Review ��
■ Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.:
q ` Inspection Line: 503.639.4175 CITY OF TIGA.RD Date Ready/By: Ions: El See Page 2 for
Internet: www.tigard-or.gov t e .„- .-, Notified/Methd Supplemental Information
TYPE OF WORK B.JI��.dds.� urv;v!v�- FEE* SCHEDULE
❑✓ New construction EIDemolition 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(1)bath 312.70
1-and 2-familydwellingSFR(2)bath 437.78
❑ ❑Commercial/industrial
El Accessory buildingSFR(3)bath 1 500.32 500.32
0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
v
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 13885 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.: 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 Lot no.: 52 Fixture or item:
Tax map/parcel no.: WCTM 25106DC16100 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
❑✓ PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name: Riverside Homes Fixture/sewer cap 25.02
Address: 15350 SW Sequoia Pkwy, Suite 320 Floor gedr oor sit k/hub 25.02
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 ❑ 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/showerpan 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 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 Lic.:178122 Plumbing Lic.no.: PB414 Plan review (25%of permit fee)
may; State surcharge(12%of permit fee)
Authorized signature: l_.�..L.__; ,__q„,,z__ 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.\Building1Permits\PLMU-PermitApp.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 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 I00' 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
P 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/ Plan review is an required for of the following.
Work Performed: Capped Added Relocate 9 y ow g'
Baptistry/Pont Please check all that apply.
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 Thru ❑ 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
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_PermitApp.doc 2
Plumbing Permit Application RECEIV Building Fixtures ■ Ft)li uFl,lt,r. l ,Cl. ()Nil
City of Tigard Dectre/Bed K Permit No.: '
PIN
• 13125 SW Hall Blvd.,Tigard,OR 97223 MAY 4 202 y� : j�+ 1,n1,� rjM'I�Z3- mill)
Plan Review 1A ,t�l ,is .7)'.t
Phone: 503.718.2439 Fax: 503.598.1960 Other Permit No.: sl w
OF TIGAR Date Ry:
Inspection Line: 503.639.4175 CITY fate Ready/By:I G A R D Saris: ® See Page 2 for
Internet: www.tigaid-oi.gov BU I k I 64,tified/Method: Supplcmentat Information
TYPE OF WORK ;.,_ y §_ FEE* SCHEDULE
B New construction [Demolition 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(1)bath 312.70
✓ 1-and 2-familydwellingSFR(2)bath 437.78
❑ El Commercial/industrial
El Accessory buildingSFR(3)bath 500.32
❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other. Fire sprinkler(_sq.ft.) _ Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 13885 SW 171ST Ave Catch basin or area drain 18.76
City/state/ZIP: Tigard/OR/97140 Drywell,leach line,or trench drain 18.76
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 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.: 52 Fixture or item:
Tax map/parcelno.: WCTM 2S106DC16100 Backflowpreventer 1 31.27 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Construction of single family detached residence clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
❑✓ 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 25.02
City/State/ZIP: Portland, OR 97224 Hose bib 25.02
Phone:(971 ) 371-1310 Fax:( ) Ice maker 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 25.02
City/State/ZIP: Portland, OR 97224 Solar units(potable water) 62.54
Phone:(971 ) 371-1310 Fax::( ) Tub/shower/shower pan 12.51
E-mail: jdoty@riversidehome.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: Truscapes Water Pm mp g/DWv 56.29
Address: 7800 NE Walker Road Other: 25.02
City/State/ZIP: Hillsboro/OR/97124 Subtotal
Phone:(503)531-9216 Fax:( ) Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lic.: Plumbing Lic.no.: LCB #7962 State surcharge(12%of permit fee)
Authorized signature: , ' :2.- -_.. 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.
I:Uiuildiag\srmhs\PLMU-PermitApp.doc 10/01/09 440-461oT(10/02/COM/WEB)
Plumbing Permit Application - City Tigard
Ti and
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 $I69.69
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
Storm&Rain Drain-1st 100' 62.54 Valuation: Permit Fee:
$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 Fee(ea) Total each additional$100.00 or fraction thereof,to
P and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to S25,000.00 $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.
Baptistry/Font Please check all that apply.
Bath -Tub/Shower ElAny 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 ❑ 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 ❑ Isometric or riser diagram is required for new buildings
Garbage -Domestic-non-food
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_PermitApp.doc 2
0 City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
Building Permit #: //I TA6 2-3 - 66172—
Site Address: _13885 SW 1715t Ave ® Verified in Accela
Project Name: _Riverside Homes at River Terrace Scholls Meadow Lot/Unit #: 52_..
Proposal: New Single Detached SFR Zone: RED;-E
Housing Type: ®SFR(® Single Detached ❑ Duplex❑Triplex❑ADU)❑ Rowhouse❑Cottage Cluster❑CYU ❑Quad ❑Other
Required Site Plan Elements:
181 3 copies of site plan on max 11x17"
l Drawn to standard scale U Retai ed Rees, drip line/ tree protArt' n
MI North arrow El Street and site trees shown / labeled
0 Site address, project name, lot # ❑Tablc calculating tree canopy at maturity
M Street names (N/A for SFR)
IE Applicant name and phone #
0 Lot and setback dimensions ® Vision clearance triangle
IN Utility locations & easements
lia Footprint of new structure and FFE M Property corner elevations
® Sidewalk/driveway dimensioned ® LIDA (>1,000 sf disturbance)
® Lot area and lot coverage percentage 0 Erosion control
Required Elevation Plan Elements:
(For SFR: calcs needed only on street-facing) Summary table with calculations for:
M Drawn to standard scale 54 Total facade area
IX Building height dimensioned ® Total window and door area
® Fagade dimensioned
0 Windows and doors dimensioned
®Garage doors dimensioned
Requ, 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 ® Front: 8 Rear: 10_ Side: _3_ Min/Max Street Side: 8 / Garage: _20_
Height 0 Max. Height: _35_ Proposed Height: 23 2 1/2"
IX Yes ❑ N/A Landscape 34% proposed 7 detailed design elements met, shown on Al. 59%
*Yes MI N/A Screening (Quad only) ier -garage width allowed for meeting these design
51 Yes ❑ N/A % Window Coverage 16% proposed elements.
® Yes ❑ N/A Garage (SFR Only) Parking (Other Res)
® Yes ❑ N/A Entrance (SFR, Rowhouse, Quad only)
❑ Yes (a N/A Other building design standards (Rowhouse only)
❑ Yes IXI 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 IX N/A Unit Count:
❑ Yes ® N/A Lot Width and Size
❑ Yes IX N/A Pathway
Additional standards for Courtyard Units and Cottage Clusters only:
❑ Yes 0 N/A Unit Area:
❑ Yes 0 N/A Floor Area (per story)
0 Yes IX N/A Courtyard
El Yes ® N/A Fence
El Yes 0 No XIN/A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995)
® Yes El No ❑N/A Public Facilities Improvement (PFI) Permit:
Required: IX Yes ❑ No
Applied For: IE Yes 0 No, stop intake N01 ??,fl—
fEJ Lands: 0 Yes ® No
® Main Land Use Case #s: PDR2021-00001 -Conditions m
❑ Applicant notified of lanc.�use pir e: `'"b"'d'f'= `'y�.=+s l; &/f?'o?'i . Z. o+ 0 ' S .2/a-oiI,
Approved By Planning: l 5/Li `�3 Date: 5/2/2023
Notes
Revision 1: 0 Ap•roved 0 Not Approved Date:
Revision 2: ❑ A.M.roved El Not Approved Date:
Building Permit Submittal �/
Original Submittal Date: 7 /`l/.23
Site Plans #: 3
Building Plans #: 3
Building Permit #: 0 Building permit # entered on page 1
Workflow Routing: ❑ Planning El Engineering 0 Permit Coordinator 0 Building
Workflow Sign-off: 0 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.
0 Building: original permit application, site plans, building plans, engineer and
beam calcul tions and trust details, if applicable, etc. /
Permit Technician: y�� Date: S f /�j
Notes:
Engineering Review
0 PFI Permit:
'lope at building pad: ?:6'. 0/0
474.p'Conditions met prior to issuance of permit
[B.Easements (encroachments) per engineering conditions of approval and plat
lf-SNater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: Cl Yes 'IClo
Assess Water Quantity Fee in-lieu: ❑ Yes trNo
LIDA Facility on lot: ❑ Yes eNo Add Fee: 0 Yes ❑ No
I"Final Plat Recorded
❑ NOT Approved: Date:
Notes:
Approved By Engineering: f� Date: - //‘`Z5
Revision 1: 0 Approved ❑'blot Approved Date:
Revision 2: 0 Approved El Not Approved Date:
Permit Coordinator Review
'`k onditions met prior to permit i suance re
)
_`Approved, NOT Released: (7b�11>!v Date notified applicant: i 73
• ENG Revisions Required: Date notified applicant:
p SDC Exemption: ❑ Applied for ❑ Received ?Does not apply
40 SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: Yes ❑ N/A ❑ Deferred
Parks SDC: Yes ❑ N/A CI Deferred
LIDA ❑ Pe;
rI N/A/
4 OK to Issue/Approved by Permit Coordinator: T1 `, € \!0.�! ?( Date: ' 'j "
Revision 1: El Approved 0 Not Approved Date:
Revision 2: 0 Approved ❑ Not Approved Date: