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Permit (8) CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2023-00257 Date issued: 07/05/2023 T 16a A R.1 D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S108DC27300 Jurisdiction: Tigard Site address: 15638 SW MISSOURI AVE Subdivision: CROSSING AT BULL MOUNTAIN Lot: 128 Project: River Terrace Crossing, Lot 128 Project Description: New detached dwelling. NO FINAL INSPECTION UNTIL DEFERRED SDC FEES HAVE BEEN PAID. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1164 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 23 Bathrooms: 3 Second: 1512 sf Garage: 440 sf Front: 8 Smoke DwellingUnits: 1 Yes Third: 0 sf Right: 3 Detectors: Total: 2676 sf Value: $433,941.32 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 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: Y Hoods: 1 Other Units: 0 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 3 Furn>=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'I 500 sf: 5 201-400 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 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 2676 Owner: Contractor: ICHIJO USA CO LTD ICHIJO USA CO LTD Required Items and Reports(Conditions) 3800 SW CEDAR HILLS BLVD STE 3800 SW CEDAR HILLS BLVD STE 130 1 Ersn Cntrl 503-639-4175 131 BEAVERTON,OR 97005 2 (2)layers of 2x fire blocking BEAVERTON,OR 97005 at area indicated 3 Geo Tech Required PHONE: PHONE: 503-430-7413 FAX: Total Fees: $24,864.13 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR QS9-nnl-nMn thrni inh r1AR Q59-nni-/Vion Yn jvv nhf.ia rnnv ni tka rWee nr rlirort nnactinne t,rN iMC by rollinn Rill 719 10R7 nr 1 Ann'119 914d Issued By: /��y� ," Permittee Signature: LLL //„®t; 03.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the pr ject. Approved plans are required on the lob site at the time of each inspection. I uildint; Permit Application Residential w r'-l ''7 0 FOR orrice ► SI.ON►.Y City of Tigard ReceivedDate/By: rg 3• R Permit No.:IASt1,�A.OGti5l 13125 SW Hall Blvd.,Tigard,OR 971;41+,I 2023$ Plan Review Phone: 503.718.2439 Fax: 503 598g'''1 j6 Date/By: tQ ,�OSilitOther Permit:5lia1,01/1.0U`ig/i TIGARD Inspection Line: 503.639.4175 ('-,ter !�r TI�.9nD Date Ready/By: A ttN lads: 0See Page 2 for lJ Internet: www.tigard-or.goy Notified/Method: Id' 1 1 1•rtp I Supplemental Information ma;GUel Nck--0 TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING •New construction ❑ Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this applicatsi. I ZZ Valuation: $ 1 ,q�Lt .1,ion • 1-and 2-family dwelling ❑Commercial/industrial 1 ❑Accessory building 0 Multi-family Number of bedrooms: 4 ❑Master builder 0 Other: Number of bathrooms: 3 JOB SITE INFORMATION AND LOCATION Total number of floors: 2 3 L l4 Job site address: 15638 SW M ISSOU RI AVE New dwelling area: 2676 square feet 15I9_„ City/State/ZIP: Tigard / OR / 97224 Garage/carportarea: 440 square feet Li Suite/bldg./apt.no.: Project name:River Terrace Crossing Lot 128 Covered porch area: square feet l Cross street/directions to job site: Deck area: 120 square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Crossing At Bull Mountain Lot no.: 128 Permit fees*are based on the value of the work performed. Tax map/parcel no.: 2 S 108 D C T L#128 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. Single Family Detached Dwelling Valuation: $ ' Existing building area: square feet Request the Transportation and Parks SDCs to be deferred to occupancy New building area: square feet • PROPERTY OWNER 0 TENANT Number of stories: Name: ICHIJO USA CO., LTD. Type of construction: Address: 3800 SW Cedar Hills Blvd. Ste. 131 occupancy groups: City/State/ZIP: Beaverton/OR/97005 Existing: Phone:(503)430-7413 Fax: (503)430-7621 New: • APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* Business name: ICHIJO USA CO., LTD. (Please refer to fee schedule) Structural plan review fee(or deposit): Contact name: Naoki Yamaoka Address: 3800 SW Cedar Hills Blvd. Ste. 131 FLS plan review fee(if applicable): Total fees due upon application: City/State/ZIP: Beaverton/OR/97005 Amount received: Phone:(503)430-7413 Fax::(503)430-7621 E-mail: nao@ichijousa.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name: ICHIJO USA CO., LTD. Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 3800 SW Cedar Hills Blvd. Ste. 131 Solar Installation Specialty Code checklist. City/State/ZIP: Beaverton/OR/97005 Permit Fee(includes plan review $180.00 and administrative fees): Phone:(503)430-7413 Fax:(503)430-7621 State surcharge(12%ofpermit fee): $21.60 CCB lie.: 215360 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: Naoki Yamaoka Date: 06/08/2023 *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 O\1.1' Cityof Tigard Date/By. Permit No.: el 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits: Phone: 503.718.2439 Fax: 503.598.1960 14 24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing ❑ Mechanical TIGARD Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW les NO v1 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 ■ ❑ 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. _ 0 0 ❑ 3 Verification of approved plat/lot. ❑ ❑ 0 4 Fire district approval required. Name of district: . 0 0 0 5 Septic system permit or authorization for remodel. Existing system capacity . _ 0 0 0 6 Sewer permit. _ _ 0 0 0 7 Water district approval. ❑ 0 ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ 0 0 9 Erosion control ❑plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ ❑ basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state • ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if 0 0 there is more than a 4-fl.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size • ❑ 0 and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, • 0 0 furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- • 0 0 floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings 1 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 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 I 0 0 locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ 0 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 ii ❑ ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. MI ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required IN ❑ ❑ 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 U 0 0 architect licensed in Oreton and shall be shown to be al plicable 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". • 0 0 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. I 0 ❑ 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. [I ❑ ❑ 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. • ❑ ❑ 27 "Drawn to scale"indicates standard architect or engineer scale. • ❑ ❑ 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard • ❑ 0 Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, In ❑ ❑ 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, ❑ ❑ ON 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\Perm its\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/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:1Building\Permits\MEC_PermitApp_040113.doc 2 Electrical Permit ApplicatiR I rT. ONLY OFFICE USE ON � City of Tigard "� Received D;' IIEM _ • 13125 SW Hall Blvd.,Tigard,OR 9722311 1 AI 8 2023 Phan Review 1 , �) • ' ,r Phone: 503.718.2439 Fax: 503.598 I DateB : Inspection Line: 503.639.4175 Ready Date/By: Suns: Id See Page 2 for T l l;'1 R I) Internet: www.tigard-or.gov q�f�1CITV OF TIn,rn Notified/Method: Supplemental Information TYPE OFBAcK ikIINU UIVI."Sililil PLAN REVIEW New construction 0 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. El 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. 1-and 2-familydwelling Commercial/industrialless to ground,or exceeds 14,000 0 Commercial-use agricultural g 0 0 Accessory building amps for all other installations. buildings. ❑Multi-family ❑Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE.INFORMATION AND LOCATION I 0 Emergency system. larger separately derived _--- 0 Addition of new motor load of system. Job#: I Job site address: 15638 SW MISSOURI AVE 100HPormore. ❑ A","e',"1-z", I-3", city/State/ZIP: Tigard / OR / 97224 o Six or more residential units. occupancy. 0 Health-care facilities. ❑Recreational vehicle parks. Supply voltage for more than Suite/bldg./apt.#: Project name: River Terrace Crossing Lot 128 ❑Hazardous locations. ❑600 volts nominal. Cross street/directions to job site: ❑Service or feeder 600 amps' more. FEE SCIIEllULE . Description I Qty. I Each I Total I „ New residential single-or multi-family dwelling unit. Subdivision: Crossing At Bull Mountain Lot#: 128 Includes attached garage. Tax map/parcel#: 2S 108 DC TL#128 1,000 sq.ft.or less 168.54 4 Ea.add'1500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 Single Family Detached Dwelling (with abovesq.ft.) Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy ❑ See Page 2 PROPERTY,OWNER,,, ,.. . . _.❑ TENANT, . Services or feeders installation,alteration,and/or relocation Name: ICH IJO USA CO., LTD. 200 amps or less 100.70 2 Address: 3800 SW Cedar Hills Blvd. Ste. 131 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: Beaverton/OR/97005 601 amps to 1,000 amps 301.04 2 Phone:(503 )430-7413 Fax:(503) 430-7621 Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: info©ichijousa.com relocation Owner installation: This installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 APPLICANT El CONTACT PERSON Branch circuits—new,alteration,or extension, l er panel --- A.Fee for branch circuits with Business name: ICHIJO USA CO., LTD. above service or feeder fee, 7.42 2 -- - each branch circuit Contact name: N a o k i Yamaoka B.Fee for branch circuits without service or f Address: 3800 SW Cedar Hills Blvd. Ste 131 branch circuuiitder fee,first 56.18 2 City/State/ZIP: Beaverton / OR / 97005 Eachadd'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(503) 430-7413 Fax; ; (503)430-7621 Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email: nao@ichijousa.com Reconnect only 67.84 2 ..... CONTRACTOR Pump or irrigation circle 67.84 2 B usiness name: WEST SIDE ELECTRIC COMPANY Sign or outline lighting 67.84 2 Address: 1834 SE 8TH AVE Signalel, i(s)or limited-energy 0 See Page 2 2 panel,alteration,or extension. City/State/ZIP: PORTLAND, OR 97214 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(503 )231-1548 Fax:( ) Investigation(1 hr min) 90.00/hr Email: OFFICE@WESTSIDEELECTRIC.COM Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lie.: 13306 Electrical Lie.: 26-135C Suprv.Lie.: 5698S specifically listed(/hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Walk. Subtotal: Print name: BRENT WALL 5698-S Date: 06/08/2023 ❑Plan Review Required(25%of permit fee): -- State surcharge(12%of fee): Authorized signature: TOTTALLPERMITRMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: N a o k i Yamaoka Date: 06/08/2023 days after it has been accepted as complete. ' Number of inspections allowed per pemtit. I:1Building\Permits\ELC_PermitApp ELR_ERE.doc Rev 06/17/2015 440-46157(I1/05/COM/WEB Electrical Permit Application—City of Tigard Page 2-Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: DescriptiFee for all residential systems combined: $75.00 Renewable"" each Total Y 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 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 n Vacuum Systems* >100 kva-no additional charge 0.0 3 Each additional inspection over allowable in any of the above: ❑ Other: Each additional inspection is 66.25/hr 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(t4 hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 Subtotal l(Enterpermit. Page t): �' + Number of inspections allowed per penmt. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation n Fire Alarm Installation ❑ HVAC n Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls El Outdoor Landscape Lighting* ❑ Protective Signaling n Other: Total number of commercial systems: _ *No licenses are required. Licenses are required for all other installations I/BuildingtPermits\ELC_PernitApp_ELR_ERE.doc Rev 06/17/2015 .Plumbing Permit Application BuildingFixtures p {%�e : � `' 1 g ki L.k,I 'V I,,,,, FOR OFFICE lISE ONLY' Cl Of TigardBlvd., Dace/By: ��(^ -1�.�� J ,�,�! ved Date/By: Pernut No.: 3',IV/0 V III • 13125 SW Hall Blvd.,Tigard,OR 972kN 8 2023• ' Phone: 503.718.2439 Fax: 503.598.1960 Dan By: Other Permit No.: Inspection Line: 503.639.4175 Date/By: TI(� 1!iU CITY OF TICARD Date Ready/By: Juris: ® See Page 2for Internet www.tigard-or.gov -., ram. „ -, ,,,,, .� ( , ! � Notified/Method: Supplemental Information 5�1.�....1+„i i�.�rs.ui� . TYPE OF WORK FEE* SCHEDULE I.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-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 1 500.32 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: 15638 SW MISSOURI AVE Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: Tigard / OR / 97224 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: Project name: River Terrace Crossing Lot12i; Manufactured home utilities 5003 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: Crossing At Bull Mountain Lot no.: 128 Fixture or item: Tax map/parcel no.: 2 S 108 D C T L#128 Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 1 25.02 Single Family Detached Dwelling Dishwasher 1 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 U PROPERTY OWNER ❑.TENANT Expansion tank 12.51 Name: ICHIJO USA CO., LTD. Fixture/sewer cap 25.02 FlooAddress: 3800 SW Cedar Hills Blvd. Ste. 131 Garbage gdispoorsinkhab 25.02 Gagee disposal 1 25.02 City/State/ZIP: Beaverton/OR/97005 Hose bib 2 25.02 _ Phone:(503)430-7413 Fax:(503)430-7621 Ice maker 1 12.51 al APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: ICHIJO USA CO., LTD. Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: N a o k i Yam a o ka Roof drain(commercial) 12.51 Address: 3800 SW Cedar Hills Blvd. Ste. 131 Sink/basin/lavatory 6 25.02 . City/State/ZIP: Beaverton / OR / 97005 Solar units(potable water) 62.54 Phone:(503)430-7413 Fax: :(503)430-7621 Tub/shower/shower pan 4 12.51 E-mail: nao@ichijousa.com Urinal 25.02 CONTRACTOR Water closet 3 25.02 --- . Water heater 1 37.52 Business name: Pipe It Plumbing LLC. Waterpiping/DWV 56.29 Address: PO BOX 1389 Other: 25.02 City/State/ZIP: Boring / OR / 97009 Subtotal Phone:(503) 544-0477 Fax:(503) 912-0045 Minimum permit fee: $72.50 174351Plumbing PB297 Plan review (25%of permit fee) CCB Lic.: Lie.no.: State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name: N a o k i am a o k a Date: 06/08/2023 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tel-County Building Industry Service Board. I:1Bullding\Permits\PLMU-PermitApp.dac 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 Q+y. Fee(ea) Total Square Footage: Permit Fee: Footing dram-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 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*. Plan Review for Plumbing Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate ❑ Any new commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower -Jacuzzi/Whirlpool New engineer. Car Wash: -Each Stall ❑ New exterior plumbing site utilities for any complex structure as defined in OAR918-780-0040. -Drive Thru W 0 Medical gas and vacuum systems for health care facilities. Cuspidor/Water Aspirator Dishwasher: -Commercialirator 0 Any multipurpose fire sprinkler system. -Domestic El Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" 3" Isometric or Riser Diagram 4" ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain that meet the qualifications above. Garbage -Domestic non-food Disposal: -Domestic food related -Commercial food related -Industrial food related Ice Mach./Refrig.Drains Comments regarding fixture work: Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -LavBar non-food related -Bradley -Com/Serv/Util food related -Service *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and Washer-Clothes fees assessed for the sewer increase must be paid before the Water Extractor Water Closet-Toilet plumbing permit can be issued. Urinal • Other Fixtures: I:\Building\Permits\PLMF_PermitApp.doe 08/04/2011 2 Building Division TIGARD One & Two-Family Dwelling Fees Checklist PERMIT INFORMATION: Application Date - FEE VERSION 1.)t 2022- Permit #: mic�7'n3_ O0 Zs`7 Plan #: z5-�j J GWi 7 � Floors: Valuation: Covered Porch: Basement Bedrooms: 1 Deck: I -�/lJ/) 1"Floor 1 L CP[ l I WC (toilets) 3 Deck Cover: ( 2°d Floor 1 5 11Z Lavatories 5 Patio Cover -- 3`d Floor Tub/shower H Accessory Struct. R-3 Total — / 7(A Laundry Tray Water Heater l /Elec Garage !L/ T _�0 Exhaust Vents S Gas Flue Vents Total for Elec. ---)01 C f L v Backflow Prey. ,_.� Furnace / Heat Pump / AC # for Electrical 6 BBQ I �g Gas Fireplace #Fuel Lines 3 FEES: Description: Fee Applies: Fee Entered: DC Prov Revw: Planning Info Proc/Arch: Lg $2.00 (over 11x17) a Info Proc/Arch: Sm $.50 (up to 11x17) LvI 9 Metro CET: Residential Use [ School CET: District: c ✓ Tigard CET: Admin Tigard CET: ODHCS Tigard CET: AH Electrical Permit: Permit Fee: ✓ Limited Energy: 12% State Surcharge t Mech. Permit: Permit Fee: 1 - 12% State Surcharge Plumbing Permit: Permit Fee: 12% State Surcharge /j Erosion Control: w/Permit-Ping �✓/ I:\Building\Forms\ResPlanCheckFees_Dec2022_M.doc 12/21/22 Page 1 City of Tigard 111111 C " COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Review - Residential TIGARD �1 Building Permit #: 1�A VS1011.0(j151 Site Address: 15638 SW Missouri Ave X Verified in Accela Project Name: River Terrace Crossing Lot/Unit #: 128 Proposal: New Single Detached SFR Zone: RES Housing Type: X SFR(X Single Detached ❑ Duplex El Triplex❑ ADU) ❑ Rowhouse❑Cottage Cluster❑ CYU EQuad ❑Other Required Site Plan Elements: X 3 copies of site plan on max 11x17" X Drawn to standard scale X North arrow X Street and site trees shown / labeled X Site address, project name, lot # El Tal I.. .Iating F.s, F mat....ity X Street names (N/A for SFR) DSI Applicant name and phone # ❑ Cuu.tre1 U ...,..tu„yh 61I, .1,.,;,�I I,.J (if u1,,,I able) X Lot and setback dimensions ❑ Vision clearance triangle ❑ C l y �L,u l Q , f t y X Utility locations &easements X Footprint of new structure and FFE N Property corner elevations X Sidewalk/driveway dimensioned 9 LiDAI (-1,66G of diFtpurbanse) X Lot area and lot coverage percentage X Erosion control Re levation Plan Elements: (For SFR: cases only on street-facing) Summary table with calculations for: ❑ Drawn to standard sc ❑Total facade area ❑ Building height dimensioned ❑ Total window and door area ❑ Facade dimensioned ❑ Windows and doors dimensioned ❑ Garage doors dimensioned Requir n Elements: (Not required for SFR) ❑ Summary table that includes ❑ Each story dimensioned oor area ❑ Each story floor area calculated ❑ Floor area pe Planning Review The following standards have been met: Setbacks Front: 8' Rear: 10' Side: 3' Min/Max Street Side: 8' / Garage: 20' Height 4 Max. Height: 35' Proposed Height: 23' El Yes ❑ N/A Landscape ❑ Yes ❑ N/A Screening (Quad only) 0 Yes ❑ N/A % Window Coverage ❑ Yes ❑ N/A Garage (SFR Only) Parking (Other Res) ❑ Yes ❑ N/A Entrance (SFR, Rowhouse, Quad only) ❑ Yes ❑ N/A Other building design standards (Rowhouse only) ❑ Yes ❑ 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 N/A Unit Count: ❑ Yes L[ N/A Lot Width and Size CI Yes N/A Pathway Additional standards for Courtyard Units and Cottage Clusters only: ❑ Yes N/A Unit Area: ❑ Yes N/A Floor Area (per story) ❑ Yes N/A Courtyard 0 Yes N/A Fence ❑ Yes ❑ No XN/A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995) ❑ Yes ❑ No XN/A Public Facilities Improvement (PFI) Permit: Required: ❑ Yes ❑ No Applied For: ❑ Yes ❑ No, stop intake X Sensitive Lands: ❑ Yes Xi No ❑ Main Land Use Case #s: PDR2016-00016/PDR2018-00005 ❑ Conditions met XiApplicant notified of land use expiration 3/22/26 Date: 6/7/23 Approved By Planning: Notes Revision 1: ❑ Approved ❑ Not Approved Date: Revision 2: ❑ Approved ❑ Not Approved Date: Building Permit Submittal Original Submittal Date: I' 11ati3 Site Plans #: Building Plans #: Building Permit #: SX Building permit # entered op page 1 Workflow Routing: 61Planning 6]/Engineering Ni Permit Coordinator C�Building Workflow Sign-off: I 'Sign-off for Planning (include notes from planning review) Route Documents: Engineering: (1) copy of permit application, (1) site plan, (1) building plan an� original plan review routing form. @'Building: original permit application, site plans, building plans, engineer and ,�beam calculations and trust details, if applicable, etc. 4 • Permit Technician: 7�� 1 � Date: 6It I16'l/3 Notes: Engineering Review ❑ PFI Permit: lope at building pad: 2d % Conditions met prior to issuance of permit Wt.-Easements (encroachments) per engineering conditions of approval and plat ga-Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes 6-No Assess Water Quantity Fee in-lieu: ❑ Yes a-No LIDA Facility on lot: ❑ Yes till() Add Fee: ❑ Yes ❑ No final Plat Recorded ❑ NOT Approved: Date: Notes: c Approved By Engineering: Date: -�/-V2 3 Revision 1: ❑ Approved Not Approved Date: Revision 2: 0 Approved ❑ Not Approved Date: Permit Coordinator Review Conditions met prior to permit issuance ❑ Approved, NOT Released: Date notified applicant: ❑ ENG Revisions Required: Date notified applicant: . SDC Exemption: 0 Applied for ❑ Received ?'Does not apply SDC Fees Entered: Wash Co Trans Dev Tax: /Yes ❑ N/A Tigard Trans SDC: t?'Yes ❑ N/A fiDeferred Parks SDC: fiYes ❑ N/A y Deferred LIDA ❑ Yes f l N/A K to Issue/Approved by Permit Coordinator: arb Date: COI tB(2o2 Revision 1: ❑ Approved 0 Not Approved / Date: Revision 2: 0 Approved 0 Not Approved Date: RECEIVED City of Tigard JUN 2023 Deferral Until Occupancy Request BUILDING DIVI� ®N T t G A R i3 Washington County Transportation Development Tax(TDT),Transportation and Parks System Development Charges (SDCs) This form is to be signed and submitted prior building permit issuance or,if no building permit is required,then upon land use approval(TMC 3.24,as amended by Ordinance No. 21-09). Date: 6/2/2023 Site Address: 15638 SW MISSOURI AVE Project River Terrace Crossing Land Use Case or Name: Ichijo Building Permit#: MST2023-00257 Tax Lot 2S108DC27300 Total Parks #: Amount*: $11,830.00 Lot 128 TDT N/A Total TSDC Amount: Amount*: $12,004.00 *The total TSDC amount shown above is the sum of$ 7,760.00 for TSDC-Improvement,$ 448.00 for TSDC- Reimbursement,and$ 3.796.00 for TSDC-River Terrace,if applicable.. *The total Parks SDC amount shown above is the sum of$ 6,812.00 for Parks-Improvement,$ 1,887.00 for Parks- Reimbursement,and either$�_ N/A for Parks-Neighborhood or$_3,131.00 for Parks-Neighborhood River Terrace. This constitutes my request to defer payment of the TDT,TSDC, and Parks SDCs,as provided above,to prior to final inspection. Payment of the TDT,TSDC,and Parks SDCs may be deferred until issuance of the occupancy permit. In requesting this option,I understand that any deferred TDT,TSDC,and Parks SDCs must be paid prior to final inspection. TDT may only be deferred if the TDT is greater than the amount for a single-family residence. I further understand that the amount of TDT due on deferred obligations shall be the amount in effect at the time of issuance of the building permit. For a deferral request to be accepted both the Property Owner and the Developer must sign this request. Property Owner: ,./�2 R Date: 6/2/2023 Developer: Date: h 6/15/2023 Permit Coordinator: Date: