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Permit (5) CITY OF TIGARD MASTER PERMIT ' - i n COMMUNITY DEVELOPMENT Permit#: MST2023-00274 Date Issued: 07/17/2023 T t G AR T) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S103DC06100 Jurisdiction: Tigard Site address: 11205 SW FAIRHAVEN ST Subdivision: EXODUS Lot: 2 Project: KOSMALA Project Description: Master bathroom remodel and installation of(1)new window. Electrical trade permit to be pulled separately. BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: Total: 0 sf Value: $25.000.00 Rear: 0 PLUMBING Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 2 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Drains: 0 Storm Sewer: 0 Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Bckfw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 1 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 0 Fum<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Fum>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add,500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/0 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 N Other: N Other Description: Ecompasing: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF VB R-3 0 Owner: Contractor: KOSMALA,MICHAEL W&SUSAN S SQUARE DEAL REMODELING CO INC Required Items and Reports(Conditions) 11205 SW FAIRHAVEN ST 8603 SE STARK ST TIGARD,OR 97223 PORTLAND,OR 97216 PHONE: PHONE: 503-254-4156 FAX: 503-254-4206 Total Fees: $1,008.37 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 oc9lnnt-nn1 n thrn,o AP oc,001..nn Vn, rn htain a rnnv ni tha n tine nr rlirart nunefinne In Al INR by rallinn Fn1 919 10A7 nr 1 Ann 119 9144 Issued By: Permittee Signature: 4 C e 1 p 1 k Cc1,4-'12.(4 Call 503.63 175 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 job site at the time of each Inspection. Building Permit Application Residential FOR OFFICE CSE ONLI City of Tigard Recei"ea /}� �`�]- i ,.T *1.^� Permit No. / 7/u 23_ ,1� '. •J RecDateno /J S /u UV 13125 SW Hall Blvd.,Tigard,OR 97223 7, Plan Renew Phone: 503.718.2439 Fax: 503 J4JN 1 1 2023 DareBv- �l21(23A.A, Other Permit: Inspection Line: 503.639.4175 Date Ready/By: ins: El See Page 4 for TIGARD Internet: www.tigard-or.gov Notified/Method: ID II(fj - r pan I Supplemental Information CITY OF TIGARD11 /TA tM '4. i .. P x= REQUIRED DATA ;a,', a _Y 11't 1 ,G, ❑New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all El Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the s , s,. 1 a work indicated on this application. iBlir III 1-and 2-family dwelling ElCommercial/industrial Valuation: $25000 Number of bedrooms: ElAccessory building 0 Multi-family ❑Master builder ❑Other: Number of bathrooms: " it Total number of floors: JOB SI ISM: KNFORmATIOp( AND LOCATION ` Job site address:11205 SW Fairhaven St New dwelling area: 0 square feet NCity/State/ZIP:Tigard OR 97223 Garage/carport area: Ng square feet Suite/bldg./apt.no.: Project name:Kosmala Covered porch area: square feet Cross street/directions to✓job site: Deck area: square feet / � U �B,�/Yl i- ?�y'.x• Other structure area: square feet L.J KAt.-USE CHECKLIST Subdivision: Lot no.: Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK 1t , work indicated on this application. Uyy Valuation: $ Master bathroom remodel, new window Existing building area: square feet New building area: square feet al PROPERTY OWNER r = ❑ fFdYANT a oil;i Number of stories: Name:Michael Kosmala Type of construction: Address:11205 SW Fairhaven St Occupancy groups: City/State/ZIP:Tigard OR 97223 _ Existing: Phone:(503-M6-5574 Fax:( ) New: ® APniii, AINIT 0 CONTACT PERSON BUILDING PERMIT FEES* , (Please refer to,(eesebeduln) C Business name:Square Deal Remodeling Structural plan review lee(or deposit): Contact name:Chris Kreipe FLS plan review fee(if applicable): Address:8603 SE Stark St Total fees due upon application: City/State/ZIP:Portland OR 97216 Amount received. Phone:603-254-4156 Fax: :603-254-4206 E ail chrisk@squa red eaIre mode l.com PHc1TOVo1.TAlCsoLAIi SYS1FNtFEEs� Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name:Square Deal Remodeling Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:8603 SE Stark St Solar Installation Specialty Code checklist. City/State/ZIP:Portland OR 97216 Permit Fee(includes plan review $180.00 tY and administrative fees): Phone:(503-254-4156 Fax:(503-264-4206 State surcharge(12%of permit fee): $21.60 CCB lie.:79188 Total fee due upon application: $201.60 Authorized signature: N This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Date: / *Fee methodology set by Tri-County Building Industry Print name: is kcit t/)Q 6 C t�r� Z3 Service Board 1:1Building\Permits\BUP-RESPermitApdrdoc 01/25/2023 440-4613T(1l/02/COM/WEB) Mechanical Permit Application FOR OFFICE USE ONLY iyi '�'EIVED City of Tigard v �,111...... Date Received Fenno No" Tx,)3_� �, ,y 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review _- Phone: 503.718.2439 Fax: 503.598.1960Date/By: other Permit: I!IN 14 2023 Rev TIGARi} Inspection Line: 503.639.4175 Date Ready/By: Reis. I 0 See Page 2 far Internet: wwtigard-or.gov Notified/Method: Supplemental Information ill' }- TYPE OF WOi#It C -,— ,� ,.r... '- Mechanical permit fees*are based on the value of the work ❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. ,. E. Value:$ ( f (I'.. CATEGORY OF COLY" ... r' p rs RF "-�,.,�,_ �- , _ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist ❑Multi-family 0 Master builder ❑Other: Description Qty. Ea. Total SAND I,OCATIO Heating/cooling: L Air conditioning 46.75 Job site address: t\ S �G�Y v\e",V cly- , ) r Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: q-'d( O g ef T.?- Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: Ke,S'r+-at (I � Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision: I Lot no.: Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DES r)r�"t .,l:" Gas fireplace/insert 33.39 l"' Flue vent for water heater or gas Y 16- ((2.`f 7cz t %re WIO(' Q t vxe l✓ fireplace 23.32 I err^ �X /t"1 1— P . Log lighter(gas) 33.3 (� i Wood/pellet stove 33.399 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 b Other: 23.32 1 it i ' - MaltEnvironmental exhaust and ventilation: Name: �/ ' Range hood/other kitchen " ( C��GC OS �Y� G equipment 33.39 Address: t1Z©5 cyy ia.i-. -1 tNCZv-) C(' . Clothes dryer exhaust 33.39 City/State/ZIP: - Single-duct exhaust(bathrooms, 1 ©� Z�/� toilet compartments,utility rooms) I 23.32 Phone:go3 ) q5 , - SS f- Lt Fax:( ) Attic/crawlspace fans 23.32 ,; - '. e'Ali 0 CONTACT PERSON Other: 23.32 Fuel piping: Business name: } SDI,' `-L ( —`4'r>d4 C!( t'Yl�' $14.15 for first four;$4.03 for each additional Contact name: Lk r I s k tr e4 � Furnace,etc. Address: 676 0 3 S e S _,, � Gas heat pump Wall/suspended/unit heater City/State/ZIP: P��(ay,12.1 0 - 17 ZI g Water heater Phone:51,3) 'ZS y - y I S 6 I Fax: :( ) Fireplace Range E-mail: L. t ' G. . ea. ge e, .C• Barbecue ti t : Clothes drct(gas) y Other • (Jr) Business name: ,,,rv4;cr :2 ( JP ? wi O I L ( h^ MECUANICAL . , Address: 8603 �c_ Sf rk- Sr Subtotal J City/State/ZIP: O�� �P Z 6 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:( ' 6 ax:( ) o y� �i�y - t"'(S F State surcharge of permit fee) CCB he.: q g 8 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 f ., I ea- days after it has been accepted as complete. Authorized signature: tf ,` .� /�` . Fee methodology set by Tn-County Building Industry Service Board .r t Print name: c fox e C, Y r 1 C Date: 6 - ('L- Ze Z-3 C\Buildmg\PermitsVMEC_PermitApp 040113.doe 440-46172(I1/02/COM/WEB) Plumbing Permit Application Building Fixtures FOR OFFICE USE ONLY City of Tigard Received DatePermit No.: 97 11111 ■ 13125 SW Hall Blvd.,Tigard,OR 97223 PISS Re: /►i5' p r3-�/'1 • - Plan Review i Phone: 503.718.2439 Fax: 503.5983960 Other Permit No.: DaleBy: TIGARD Inspection Line: 503.639.4175 i Date Ready/By: ions: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method. Supplemental Information TYPE OF WORK JUN t 1 LU.Z3 FEE* SCHEDULE ❑New construction ❑Del olition _ For.special information use checklist. �,,_,( Description Qty. Ea. Total I[l Addition/alteration/replacement ❑t1 ier: New 1-2-family dwellings(includes 100 ft.for each utility connection) \/ CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 bQ 1-and 2-family dwelling ❑CommerciaUindustrial SFR(2)bath 437.78 �❑AccessorybuildingSFR(3)bath 500.32 0 Multi-family Each additional bath kitchen 25.02 El Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 1 ( 'zC)S S ci (a Or ( t/e ri SF Catch basin or area drain 18.76 / Drywell,leach line,or trench drain 18.76 City/State/ZIP: ci-f/ .� i' LZ Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name: p c j c (0_ Manufactured home utilities 50.03 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: I Lot no.: Fixture or item: Tax map/parcel no: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 ( ,.,�.J/ Clothes washer 25.02 .��C>1- v G �("- v-\ e c �% (( Dishwasher 25.02 ..1-. i^12..tJ S ti.-‘l.` v1sc,v9 1 (e - vi?•t.✓ L.C9c- Drinking fountain 25.02 ' j.'AOV C. cell - L . Ejectors/sump 25.02 0 PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/Stag;/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name: 1.12. ADZ&+ 12-......4.wgk! 1 I Medical gas(value:$_) Page 2 t�4111 Primer 12.51 Contact name: v t S k e Roof drain(commercial) 12.51 Address: 86O 3 S[ S(--�1-- Sf".- Sink/basin/lavatory 'Z 25.02 City/State/ZIP: c'ryv.-r((M C4 A D ( q Z(,6 Solar units(potable water) 62.54 Phone:(.m3) --� Li _ 11(5 ,6 Fax::( ) Tub/shower/shower pan l 12.51 E-mail: t If I Urinal 25.02 sr t S J�r� S VCtiv-e(J1Q(ti (rel4A 001 C(. C Oki Water closet 25.02 COItRACTOR ' ) Water heater 37.52 Business name: I� L, r S �� Water t m WV 56.29 1 PP FrJ Address: i(l . Z© 5 L-1 ell F.t,'c tt Other: 25.02 City/State/ZIP: ` -isq 0 1� 17- 7 7 ' Subtotal Phone:(�3 ) S(el - 66 LI C-( Fax:( ) Minimum permit fee: $72.50 CCB Lie.: ( �-7 7 ( 1-/ Plumbing Lic.no.: ii Plan review (25%of permit fee) ///��t ll / ,. ` q��,t�� State surcharge(12%of permit fee) Authorized signature: / i //�, -� i I ov, TOTAL PERMIT FEE e �/t/� /� Thu permit application expires if a permit is not obtained within 180 days Print name: (�(�r t ) k ,f.�;re- Date: 47 • (L( • 10 7,3 after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1:\Buildiaa\Permil°1PLMU-PermitApp.doe 10/01/09 44046161(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-I"100' 50.03 0 to 2,000 $121.90 1 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 S72.50 Storm&Rain Drain-each additional 100' 37.52 S5,001.00 to$10,000.00 S72.50 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$1.20 for (minimum charge-1/2 hour) each additional$I00.00 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 Baptistry/Font ElArty new commercial building with water service 2"and greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool Car Wash: -Each Stall El New exterior plumbing site utilities for any complex structure as defined in OAR918-780-0040. -Drive Thru _ Cuspidor Water Aspirator ElMedical gas and vacuum systems for health care facilities. Dishwasher: Commercial El Any multipurpose fire sprinkler system. Domestic ❑ 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 ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain Garbage Domestic non-food that meet the qualifications above. 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: -Iav/Bar 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.doc 08/04/2011 2 Water Meter Fixture Unit Worksheet for Additio,is/Remodels/ADUs I Please complete the following information:o JUfv i 1 [Ot: Customer Name: (/L V t 5 t`'r l�-e CITY OF TIGARD k"J'ti'_' r t� 1 to Service Address: Street/Suite#: ( 120,5 05 S'L J . !' a 1?lr) fi j � -7 City: ( tf t state: o Zip: q �r r[�c�-. Phone Number: S03 -4 zsw - -115 6 Email: (' y t s aire Cc.i e/ .C,ra4-+ Please fill in the number of each fixture you currently have. Please fill in the number of fixtures you propose to add. Multiply the quantity by the point value to arrive at the current Multiply the quantity by the point value to arrive at total, the proposed total. Fixture Unit Current Point Current Proposed Point Proposed Quantity Value Total Addition Value Total Bar sink x 1 = x 1 = Bidet x 1 = x 1 = Clothes washer L x 4 = 9 x 4 = Dishwasher I x 1.5 = I. S^ x 1.5 = I"Outside Water Spigot I try x 2.5 = 'y, S x 2.5 = Water Spigot,each add'l i x 1 = P x 1 = Kitchen sink ( x 1.5 = I,, S x 1.5 = Laundry sink ( x 1.5 = (, x 1.5 = Lavatory(bathroom sink) `.. X 1 = Z ( x I = i Water closet,1.6 GPF(toilet) Z. x 2.5 = :S7 x 2.5 = Bathtub/whirlpool x 4 = x 4 = Shower stall ( x 2 = Z x 2 = Bath/shower combo I x 4 = '-(f. x 4 = Current Points: 7,6 Proposed Increase: Current Points+Proposed Increase= Z-47—=New Total Points =Required Meter Size 54 Meter Sizes: 1 to 30 points=5/8" 30.5 to 37 points='/," 37.5 and over points= 1" New Meter Size Needed for New Total Points: Cost: $ (see page 1) Current Meter Size per Utility Billing: Cost: $ (see page 1) New Meter Size Cost minus Current Meter Size Cost= $ (This is Your Cost to Increase Meter Size Due to Additional Fixture Units) FOR OFFICE USE ONLY 71Q 06/20/23 Current Meter Size Confirmed with UB /{7 Signature of UB Representative Date 1:/Building/Forms/WaterMeters_070121 Add.doex Page 2 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT `. Water Meter Fixture Unit Worksheet TIGA to For Additions /Remodels /ADUs 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439• www.tigard-or.gov LOCATION: City of Tigard —City Hall WATER METER SALES: Utility Billing By Email Only. Please contact 13125 SW Hall Blvd. ubonlinepav@tigard-or.aov Tigard, OR 97223 to discuss sending documents and payment METER: SIZE: FEE: _ Pricing effective 07/01/2022 5/8" $11,258.00 Fee includes: 3/4" $16.094.00 water system development charge, 1" $29,588.00 - water meter, and 1-1/2" $87,787.00 meter installation fee. 2" $142,227.00 _ DETERMINING METER SIZE FOR RESIDENTIAL CUSTOMERS City of Tigard Water Service Area uses the American Water Works Association Manual and the Oregon Plumbing Specialty Code to determine the size of meter needed to adequately serve buildings. Due to the variety of home sizes built in the Tigard area,we count the fixture units of all homes to determine the appropriate meter size. Use the worksheet on Page 2 to calculate the current number of fixture units compared to the proposed increased number of fixture units,which will determine whether an increased meter size will be required. Submit this signed worksheet with your building or plumbing permit application submittal. DOCUMENTATION Once you are ready to purchase the new meter,please provide the following items to the Utility Billing counter: • Completed water meter fixture unit worksheet for additions, remodels,ADUs, etc.(on back page). • Copy of building or plumbing permit application date-stamped by building division. • Copy of issued building or plumbing permit. Your fixture count will be verified and your request will be processed upon receipt of these documents. No exceptions. INSTALLATION TIME Once the upgraded meter size has been purchased, most meters are installed within 10-14 business days, I:/Building/Forms/WaterMeters 070121_tdd.dOCX Page 1