Permit (4) CITY OF TIGARD MASTER PERMIT
1. " COMMUNITY DEVELOPMENT Permit#: MST2023-00258
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/05/2023
Parcel: 2S108DC32300
Jurisdiction: Tigard
Site address: 15402 SW EVERGLADE AVE
Subdivision: CROSSING AT BULL MOUNTAIN Lot:
Project: River Terrace Crossing, Lot 179
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: 28 Bathrooms: 3 Second: 1512 sf Garage: 440 sf Front: 12 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 2676 sf Value: $430,317.32 Rear: 15
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
Bckfiw 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 addl 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 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 267E
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
PHONE: PHONE: 503-430-7413
FAX:
Total Fees: $24,815.07
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
OR9-nnl-nnln fhrnnnh rlAIR QR9-nnl-nmon Vnil m skinn rnnu of fho n,ioc nr rlircrt n„<dinnc M flu Iklf:by rullinn Rill 917 10117 nr l Ron T19 914A
Issued By:So,-- Permlttee Signature:
all 503.639.4175 by 7:00 a.m.for the next available inspection date.
This p rmit 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
Residential P ' 97 r.! FOR MF1'I(:I; USE oNL\
City of Tigard Received I �� Nys Permit No.:MS I�VJ.06 WV
III Y 13125 SW Hall Blvd.,Tigard,OR 97223 8 2023 Date By: HFJ /� j C Plan Review /_ I„ y h, Other Penmt:S��w V3.o6110I
Phone: 503.718.2439 Fax: 5035981960 Plan Re ie t(v kff
Inspection Line: 503.639.4175 Date Rea B 7ans:
TIGARD
p (4 ��TiABD Ready/By Y See Page2for
Internet www.tigard-orgov !„ --.,1 Nootified//,Method:�I (11, •pp Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
II 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 ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
IDO
1-and 2-family dwelling ❑Commercial/industrial Valuation: $ (,I )31-!r
❑Accessory building ❑Multi-family Number of bedrooms: 4
El Master builder ❑Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors: 2 7I I CO
Job site address: 15402 SW EVERGLADE AVE New dwelling area: 2676 square feet 15 ,a.
City/State/ZIP: Tigard / OR / 97224 Garage/carport area: 440 square feet I1 (eLi
Suite/bldg./apt.no.: Project name:River Terrace Crossing Lot 179 Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: Pati square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Crossing At Bull Mountain I Lot no.: 179 Permitfees*are based on the value of the work performed.
Tax map/parcel no.: 25108 DC TL#179 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
111 PROPERTY OWNER ❑ 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*
(Please refer 7a fee schedule)
Business name: ICHIJO USA CO., LTD.
Structural plan review fee(or deposit):
Contact name: Naoki Yamaoka
FLS plan review fee(if applicable):
Address: 3800 SW Cedar Hills Blvd. Ste. 131
Total fees due upon application:
City/State/ZIP: Beaverton/OR/97005
Phone:(503)430-7413 Fax: :(503)430-7621 Amount received:
- - PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
F:mail: nao@ichijousa.com
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%of permit 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:1 Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling colt Quiet: f SE o'sl.,
City of Tigard ReceivedDate/By: Permit No..
11 't 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
3 Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 ElElectrical 0 Plumbing ❑ Mechanical
TIGARD Internet: www.tigard-or.gov ❑ Amer:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW 1es No N/.
1 Land use actions completed. Sce jurisdiction criteria for concurrent reviews. 0 0 ❑
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 ❑ ❑
3 Verification of approved plat/lot. 0 ❑ 0
4 Fire district approval required. Name of district: El 0 0
5 Septic system permit or authorization for remodel. Existing system capacity ❑ 0 El
6 Sewer permit. 0 0 0
7 Water district approval. 0 0 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- ❑ 0 ❑
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state • 0 ❑
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if M ❑ 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 IIII El ❑
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, • ❑ ❑
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- III El El
floor,wall construction,roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings
and foundation,stairs,fireplace construction,thermal insulation,etc.
15 Elevation views. Provide elevations ns for new construction;minimum of two elevations for additions and remodels. I ❑ ❑
o
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- • El ❑
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 • El ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered El El El
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 NI ❑ ❑
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. II ❑ . El
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required Q El ❑
for four or more appliances.
22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or • 0 0
architect licensed in Ore•on and shall be shown to be applicable to the ,ro'ect under review.
JURISDICTIONAL SPECIFICS
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". • ❑ El
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. • ❑ ❑
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ® 0 0
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. • ❑ ❑
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 1111 ❑ ❑
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, M ❑ ❑
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, El 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.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(l l/02/COM/WEB)
Mechanical Permit Applicati -C E IVE D FOR OFFICE I SE ONE)
City of Tigard Received
Date/By: Pt 4u • oo I1SZ
Permit No.:
1114 • 13125 SW Hall Blvd.,Tigard,OR 97223 J J N R 2023 y
Fib l Plan Review
s Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit.
T I GAUD Inspection Line: 503.639 4175 lT<� ,�.. i _ ,) Date ReadyBy: rmis: lil See Page 2 for
Internet WWW,tigard-or gov G� NotifiedMlethod: Supplemental information
7 VI• I
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
III New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
D Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
Ill 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heahn cooling:
-- - Air conditioning 46.75
Job site address: 15402 SW EVERGLADE AVE Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: Tigard / OR / 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 1 61.06
Suite/bldg./apt.no.: Project name: River Terrace Crossing Lot 179 Ductwork 1 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: Crossing At Bull Mountain Lot no.: 179 Other. 23.32
Other fuel appliances:
Tax map/parcel no.: 2S1O8DC TL#179 Water heater 1 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
-- ---- "" Flue vent for water heater or gas
Single Family Detached Dwelling fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
111 PROPERTY OWNER ❑ TENANT Environmental exhaust and ventilation:
Name: ICHIJO USA CO., LTD. Range hood/other kitchen
Address: 3800 SW Cedar Hills Blvd. Ste. 131 equipment
dryer exhaust 1 33.39
City/State/ZIP: Beaverton/OR/97005 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 5 23.32
Phone:(503) 430-7413 Fax:(503) 430-7621 Attic/crawlspace fans 23.32
111 APPLICANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name: ICHIJO USA CO., LTD. $14.15 for first four;$4.03 for each additional
Contact name: Naoki Yamaoka Furnace,etc.
Gas heat pump
Address:
3800 SW Cedar Hills Blvd Ste. 131 Wall/suspended/unitheater
City/State/ZIP: Beaverton / OR / 97005 Water heater 1
Fax: :(503)430-7621 Fireplace
Phone:(503)430 7413Range 1
E-mail: nao@ichijousa.com Barbecue 1
CONTRACTOR Clothes dryer(gas)
Business name: Supreme Heating and Cooling LLC Other:
MECHANICAL PERMIT FEES*
Address: 13009 NE 91ST Circle Subtotal
City/State/ZIP: Vancouver, WA 98682 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)333-3213 Fax:( ) State surcharge(12%of permit fee)
CCB lie.: 221270 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: ' Fee methodology set by Tri-County Building Industry Service Board
Print name: Naoki Yamaoka Date: 06/08/2023
1:1BuildingwermitsWIEC_PermitApp_040113.doc 440-4617r(I1/OLCOM/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\ME.C_PennitApp_040113.doc 2
,Electrical Permit Application RECEIVE FOR OFFICE USE ONLY
• City of Tigard JUN R 2023 Date/By:Received
Permit#: Mg`( VV�3` O0 VVJ
n 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 CITY 'k: ) Date/By: Related Permit#:
T[GARD Inspection Line: 503.639.4175 sUILDl: Ready Date/By: raris. 0 See Page 2for
,, Internet www.tigard-oagov
1 s'" I` t' i11 Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
III 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 ❑Other: where the available fault current ❑Marinas and boatyards.
1 CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
III I-and 2-family dwelling ❑Commercial/industrial IDAccessory building less to ground,or exceeds 14,000 0 Commercial-use agrtcu uml
amps for all other installations. buildings. 1
❑ Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or I
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
---- - — 0 Addition of new motor load of system.
Jlob#: Job site address: 15402 SW EVERGLADE AVE looHPormore. ❑"A". E","1-z"."1-3
❑Six or more residential units. occupancy.
City/State/ZIP: Tigard / OR / 97224 0 Health-ca a facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: River Terrace Crossing Lot 179 ❑Hazardous locations. ❑Supply voltage for more than
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Each I Total I '
New residential single-or multi-family dwelling unit.
Subdivision: Crossing At Bull Mountain Lot#: 179 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: 2S 108DC TL#179 Ea.add'1500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential 75.00 2
Single FamilyDetached Dwelling (vedenegy,multth above sq. )
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
PROPERTY OWNER _. 0 .TENANT Services or feeders installation,alteration,and/or relocation
Name: ICHIJO USA CO., LTD. 200ampsorless 100.70 2
Address: 3800 SW Cedar Hills Blvd. Ste. 131 201 amps to 400 amps 133.56 2
401 amps to 600 snips 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 I
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
0 CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
II APPLICANTA.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 ao ki Yam ao ka B.Fee for branch circuits wirhou(
service or feeder fee,first 56.I8 2
Address: 3800 SW Cedar Hills Blvd. Ste 131 branch circuit
City/State/ZIP: Beaverton / OR / 97005 Each add'I 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
Business name: WEST SIDE ELECTRIC COMPANY
Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy 0 See Page 2 2
Address: 1834 SE 8TH AVE panel,alteration,or extension.
City/State/ZIP: PORTLAND, OR 97214 Each additional inspection over allowable in any of the above
tY 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/hi-
CCB Lie.: 13306 Electrical Lic.: 26-135C Suprv.Lic.: 5698S specifically listed('/2 hr min)
ELECTRICAL tTgp/IT FEES
Suprv.Electrician signature,required: kt" .idw.A,,. Subtotal:
Print name: BRENT WALL 5698-SS Date: 06/08/2023 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permitfee):
Authorized signature: TOTAL
PERMIT
FEE:
This permit application expires if a permit is not obtained within 180
Print name: N a o ki Ya m a o ka Date: 06/08/2023 days after it has been accepted as complete.
* Number of inspections allowed per permit.
LlBuilding\Permits\ELC_PermitApp_ELR_ERE doc Rev 06/1720 L5 440-4615T(11/05/COM/WEB
•
Electrical Permit Application—City of Tigard a
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Fee for all residential systems combined: $75.00 Descr
Renewable electrical energy systems:
Check Type of Work Involved: s kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
El Garage Door Opener*
50.01 to 100 kva 552.26 2
>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 66.251 hr
charged at an hourly(I hr min)
Inspections for which no fee is 90.00/hr
speeifically listed(Y hr min)
COMMERCIAL WORK ONLY: r ELECTRICAL PERMIT FEES
3 Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00
Number of inspections allowed perrpermit
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
n Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
n Landscape Irrigation Control*
❑ Medical
U Nurse Calls
❑ Outdoor Landscape Lighting*
n Protective Signaling
❑ Other:
Total number of commercial systems: _
*No licenses are required. Licenses are required for all
other installations
I:IBuilding\ermits\ELC PermitApp_ELR_ERE_doe Rev 06/17/2015
j . Plumbing Permit ApplicatiE�VE®
Building Fixtures a. t„ - FOR OFFICE USE ONLY
City of Tigard n2 Received
, , ZI
• 13125 SW Hall Blvd.,Tigard,OR 9722� i �v 3 Date/By l ; rl� ��
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.:
Inspection Line: 503.639.4175 CITY OF TIGARD
F 1 G A R D Date Ready/By: hair Pl See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
New construction ['DemolitionFor special information use checklist
Description 1 Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF' CONSTRUCTION SFR(I)bath 312.70
1-and 2-famil y dwellin SFR(2)bath 437.78
g ❑Commercial/induslri al
El Accessory buildingSFR(3)bath 1 500.32
❑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: 15402 SW EVERGLADE 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 Lot 179 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: Crossing At Bull Mountain Lot no.: 179 Fixture or item:
Tax map/parcel no.: 2S108DC TL#179 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
MI PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Name: ICHIJO USA CO., LTD. Fixturelsewercap 25.02
Floor drain/floor sink/hub 25.02
Address: 3800 SW Cedar Hills Blvd. Ste. 131 Garbage 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
111 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: Naoki Yamaoka
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
Water closet 3 25.02
CONTRACTOR
----- ------- 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 penult fee: $72s0
CCB Lic.: 174351 Plumbing Lic.no.: P B297 Plan review (25%of permit fee)
•
State surcharge(12%of permit fee)
• Authorized signature: TOTAL PERMIT FEE
Naoki ok i ai a m 06/08/2023 This permit application expires if a permit is not obtained within 180 days
Print name: Date: after it has been accepted as complete.
•
'Tee methodology set by Tri-County Building Industry Service Board.
I:ABuildingA Permits APLMU-PermitApp.doc 10/01/09 440-4616T(i0102/COMJWBB)
Plumbing Permit Application - City of Tigard a
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
Sewer3,601 to 7,200 $233.20
-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 ec Ins tions or Fees Qty. Fcc(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
Ba fist r /Font ❑ Any new commercial building with water service 2"and
1 greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
engineer.
-Jacuzzi/Whirlpool
Car
lCar Wash: -Each Stall New exterior plumbing site utilities for any complex structure
Drive Thru as defined in OAR918-780-0040.
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial ❑ 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
Garbage Domestic non-food that meet the qualifications above.
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Maeh./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.doc 08/04/2011 2
(1.c.X} & Z)C b a c c
1 Buildin Division
One & Two-Family Dwelling
TIGARD Fees Checklist
PERMIT INFORMATION: Application Date - FEE VERSION 3 J' ( 7_622--
Permit #: r�p2� ZC>g
( Q� Plan #: -,,(J Floors: �
Valuation: 47,Di fJl1 he Covered Porch: �1� Basement
Bedrooms: Li
Deck: 1"Floor ) I / q
WC (toilets) 3 Deck Cover: - 2nd Floor i -
Lavatories 5 Patio Cover - 3rd Floor
Tub/shower 9 Accessory Struct. r R-3 Total '7(--7(P
_
Laundry Tray -- Water Heater ` as Elec Garage f C f ob `
Exhaust Vents 5 Gas Flue Vents ----- Total for Elec. 3 4
Backflow Prey. Furnace / eat P ump / AC # for Electrical 5
BBQ „ e Gas Fireplace = „___—_ #Fuel Lines 3
FEES: Description: Fee Ap : Fee Entered:
DC Prov Revw: Planning
Info Proc/Arch: Lg$2.00 (over 11x17) a
Info Proc/Arch: Sm$.50 (up to 11x17) 7�
Metro CET: Residential Use i
✓
School CET: District: t f
Tigard CET: Admin
Tigard CET: ODHCS
Tigard CET: AH
Electrical Permit: Permit Fee:
Limited Energy:
12% State Surcharge
Mech. Permit: Permit Fee: f
12% State Surcharge t'
Plumbing Permit: Permit Fee:
12% State Surcharge
Erosion Control: w/Permit-Ping
I:\Building\Norms\ResPlanCheckFees_Dec2022_AA.doc 12/21/22
Page 1
City of Tigard
:II " COMMUNITY DEVELOPMENT DEPARTMENT
,:
Building Permit Review - Residential
TIGARD
Building Permit #: 1S I W1A 'UIJ /Sii
Site Address: 15402 SW Everglade Ave m Verified in Accela
Project Name: RT Crossing Lot/Unit #: 179
Proposal: New SFR Zone: RES-B
Housing Type: VI SFR(PJ Single Detached ❑ Duplex❑Triplex❑ADU) ❑ Rowhouse❑Cottage Cluster❑ CYU ❑Quad ❑Other
Required Site Plan Elements:
m 3 copies of site plan on max 11x17"
m Drawn to standard scale ❑ R 1..:....J 1...._,, J.:,- I:.._/ L. ..,L ction
m North arrow m Street and site trees shown / labeled
m Site address, project name, lot # n T-"'^ ^-'—',Fi~g 1-~^^ ^"^^f v — "'- urity
Cz Street names (N/A for SFR)
m Applicant name and phone # EIRorepeoilipimielpireipso.i applicable)
m Lot and setback dimensions m Vision clearance triangle
❑ C^;.,1;,. ..L.�..1..,,,.. Q...,....,... f...-L-, , m Utility locations & easements
❑ Footprint of new structure and FFE m Property corner elevations
m Sidewalk/driveway dimensioned 1_, LT&, (-I,000 _,f JL,L,,,L,,..—.)
m Lot area and lot coverage percentage m Erosion control
Require' Plan Elements:
(For SFR: calcs neede o reet-facing) Summary table with calculations for:
❑ Drawn to standard scale ❑Total facade area
❑ Building height dimensioned 'ndow and door area
❑ Facade dimensioned
❑ Windows and doors dimensioned
❑ Garage doors dimensioned
Require n Elements:
(Not required for SFR) ❑ Summary table that includes
0 Each story dimensioned or area
❑ Each story floor area calculated ❑ Floor area per s
Planning Review
The following standards have been met:
Setbacks m Front: 12/8 Rear: 15/10 Side: 3 Min/Max Street Side: 8 / Garage: 20
Height fl Max. Height: NA Proposed Height: 28'
Yes ❑ N/A Landscape
❑ Y- ■ N/A Screening (Quad only)
❑ Yes ■ ' A % Window Coverage
❑ Yes ❑ N/• Garage (SFR Only) Parking (Other Res)
❑ Yes ❑ N/A '- rance (SFR, Rowhouse, Quad only)
0 Yes ❑ N/A Othe Building design standards (Rowhouse only)
❑ Yes ❑ N/A Accesso " tructure Standards
❑ Yes ❑ No Qualifying pr- -xisting unit exempt from standards (Cottage unit only)
Additional standards for Cou and Units, Cottage Clusters, Rowhouses, and Quads:
❑ Yes ❑ N/A Unit Count:
❑ Yes 0 N/A Lot Width and Size
❑ Yes ❑ N/A Pathway
Additional standards for Courtyard Units an• Cottage Clusters only:
❑ Yes ❑ N/A Unit Area:
❑ Yes ❑ N/A Floor Area (per story)
❑ Yes ❑ N/A Courtyard
0 Yes 0 N/A Fence
❑ Yes ❑ No ON/A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995)
❑ Yes ❑ No ❑N/A Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes ❑ No
Applied For: 0 Yes ❑ No, stop intake
fl Sensitive Lands: ❑ Yes 0 No
m Main Land Use Case #s: PDR2016-00016 , PDR2018-00005 ❑ Conditions met
> i Applicant notified of land use expiration da • 3/ 2/26
Approved By Planning: Date: 6/5/23 6 f '/)p�g
Notes Optional facade s an ar s o no a y I
Revision 1: ❑ Approved ❑ Not Ap ed Date:
Revision 2: ❑ Approved ❑ Not App oved Date:
Building Permit Submittal I
Original Submittal Date: lag IW0'V3
Site Plans #:
Building Plans #:
Building Permit #: 'Building permit # entered on page 1
Workflow Routing: 6i'Planning 'Engineering B"Permit Coordinator 'uilding
Workflow Sign-off: M'/Sign-off for Planning (include notes from planning review)
Route Documents: L9 Engineering: (1) copy of permit application, (1) site plan, (1) building plan
and original plan review routing form.
Building: original permit application, site plans, building plans, engineer and
J� I,be'am calculations and trust details, if applicable, etc. 4 n,
Permit Technician: -4k$ ,f L' ptiY Ji 1 Date: ( I o Y W
Notes:
Engineering Review
❑ PFI Permit:
,_,/ lope at building pad: X/�
Conditions met prior to issuance of permit
EYEasements (encroachments) per engineering conditions of approval and plat
(Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes No
Assess Water Quantity Fee in-lieu: ❑ Yes �No
LIDA Facility on lot: ❑ Yes KNo Add Fee: ❑ Yes ❑ No
final Plat Recorded
❑ NOT Approved: Date:
Notes:
Approved By Engineering: Date: 67. T4
Revision 1: 0 Approved ❑ of 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:
rp'SDC Exemption: ❑ Applied for ❑ Received "Does not apply
7'SDC Fees Entered: Wash Co Trans Dev Tax: /Yes El N/A
Tigard Trans SDC: Yes ❑ N/A /Deferred
Parks SDC: /Yes ❑ N/A /J Deferred
LIDA ❑ Yves ,11(N/A
i.OK to Issue/Approved by Permit Coordinator: Date: (0 ( 6 (�Z
Revision 1: 0 Approved ❑ Not Approved CJ Date:
Revision 2: ❑ Approved 0 Not Approved Date:
City of Tigard
71 Deferral Until Occupancy Request
T I G A R D Washington County Transportation Development Tax(1'DT),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: 15402 SW EVERGLADE AVE
Project River Terrace Crossing Land Use Case or MST2023-00258
Name: lchijo Building Permit#:
Tax Lot 2S108DC32300 Total Parks $11,830.00
#' Lot 179 Amount*:
TDT Total TSDC
Amount: NIA Amount*: $12,004.00
*The total TSDC amount shown above is the sum of$ 7.780.00 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$ 6,412 00_for Parks-Improvement,$ 1.887.00 _ for Parks-
Reimbursement,and either$ NIA 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: ,/7, 44-4 YQ/7 Date: 6/2/2023
•
Developer: Date: C— r-
Date: 6/15(2023
Permit Coordinator: 161W