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Permit (46) CITY OF TIGARD 4 1xMASTER PERMIT #: MST2023-00074'` Perm I: COMMUNITY DEVELOPMENT j Date Issued: 04/19/2023 j j C, g,0 13125 SW Hall Blvd.,Tigard OR 97223 503.718.24 �ki Parcel: 1 S135DA02603 i Jurisdiction: Tigard Site address: 9095 SW NORTH DAKOTA ST Subdivision: GRAHAM ACRES Lot: 29 Project: ELMI Project Description: Adult foster care: Garage conversion for(2)new bedrooms and bathroom; (1)additional bedroom in dining area. MEC&ELC to be submitted separately. BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 3 First: 394 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 1 Second: 0 at Garage: 0 sf Front: 0 Smoke Yes Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: Total: 394 sf Value: $15,000.00 Rear: 0 PLUMBING Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 1 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 Bckflw 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: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 0 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=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/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 N Ecompasing: Other: N Other Description: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF VB R-3 394 Owner: Contractor: ELMI,SUAD OWNER Required Items and Reports(Conditions) 9095 SW NORTH DAKOTA ST TIGARD,OR 97223 PHONE: PHONE: FAX: Total Fees: $1,367.62 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 a F9_nn1_nnln fhrni ion()GP OF9_nM-noon vrn,mas,nht iq?Rnn, nri n]11nd>c nr rlirerf niiect,nnc fat ni IMrt h.,r.alJjprstA°^"'1 10R]nr 1 n'i49 91dd Issued By: - /_ _ Permittee Signature: `�. '�(� I 3.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept In a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Property Owner Statement RECEIVED Regarding Construction Responsibilities NOV 6 2023 Oregon Law requires residential construction permit applicants who are not licensed witlG0 OF TIGARD Construction Contractors Board to sign the following statement before a building permit3LAG DIVISION issued. (ORS 701.325 (2)) This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not submit this statement.This statement will be filed with the permit. Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or I will be performing work on property I own, a residence that I reside in, or a residence that I will reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. cYtnIr Print Name of Permit Applicant fr//17 / 3 Signature of Permit Applicant Date Permit#: _n /h;5% -3-�J(,4)? Address: �(D/s et-) /Yr�y� ,p�u1/4 �• , litUr of, Cik Issued by: .1 Date: !/rG/>l 14 This Copy for Permit Offices FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT __ " Transmittal Letter 1 I G A R l7 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: ALLYSON ARMSTRONG DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: MIKE MONTGOMERY COMPANY: SIMPL HOME DESIGNS MAR 13 2023 PHONE: 503-515-6495 BUILDING DIVIISIONBy EMAIL: mike@simplhomedesigns.com RE: 9095 SW North Dakota St. MST2023-00074 (Site Address) (Permit Number) W265122 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. 3 Revisions: D3.0 Cross section(s)and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: FOR O FIC USE ONLY Routed to Permit Technician: Date: Zj �i� -VS Initials: Fees Due: ❑ Yes ❑No Fee Description: tt Amount Due: 0 $ cz 0 , $ / Special Instructions: Reprint Permit(per PE): ❑ Yes {l No Lf Done Applicant Notified: Date: Initials: CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit MASTER MST2023-00074 Date Issued: 04/19/2023 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 1S135DA02603 Jurisdiction: Tigard Site address: 9095 SW NORTH DAKOTA ST Subdivision: GRAHAM ACRES Lot: 29 Project: ELMI Project Description: Adult foster care: Garage conversion for(2) new bedrooms and bathroom; (1)additional bedroom in dining area. MEC& ELC to be submitted separately. BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 3 First: 394 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 0 Smoke Yes Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: Total: 394 sf Value: $15,000.00 Rear: 0 PLUMBING Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 1 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 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Bckfiw Prevntr: 0 Drywall-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: •N Hoods: 0 Other Units: 0 Fum<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=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•I 500 sf: 0 201-400 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 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-3 394 Owner: Contractor: ELMI,SUAD BANEGAS CONSTRUCTION LLC Required Items and Reports(Conditions) 9095 SW NORTH DAKOTA ST 950 N 2ND ST TIGARD,OR 97223 WOODBURN,OR 97071 PHONE: PHONE: 971-444-0448 FAX: i Total Fees: $1,322.62 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 the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR QR9-nn1-M1n thrnnnh(1AP QR9_nni..nnQn Vror mar nhtain a 1110446 Jac nr r1irart nuactinna to Ol INC.h,r Tallinn Rill 949 1Q5:t7 nr 1 Rnn'1'39 9144 Issued By: ��. ,_ _ Permittee Signature: /i�/tP /6 1/„2 C_Ill_fS•.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the Job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application Residential C FOR OFFICE USE ONLY RECEIVE Received City of Tigard Date/Bv: 3 1 ,�. PemitNo.: �,Yr49- )-3-ell-;-2 tt • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review 1+ 0 Phone: 503.718.2439 Fax: 503.598.1960 MAR 7 2023 Date/By: 7/2�j a Peruar TIGARD Inspection Line: 503.639.4175 DateReady/By: f kris: See Page 4for Internet: www.tigard-or.gov Notified/Method: "/// 3/ 777....c, Eli - 77 Supplemental Information CITY OF TIGARD f ea H 'Loci ( I le TYPE OF WOREUILUING DIVISION 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 0 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. 0 I-and 2-family dwelling IDCommercial/industrial Valuation: $15,000.00 ❑Accessory building ❑Multi-family Number of bedrooms: 7j ❑Master builder 0 Other: Number of bathrooms: \ .)- t JOB SITE INFORMATION AND LOCATION Total number of floors: 1 y/ Job site address: 9095 SW NORTH DAKOTA ST. New dwelling area: 394 square feet 5 City/State/ZIP: TIGARD OR 97223 Garage/carport area: square feet Suite/bldg./apt.no.: Project name: SUAD ELMI Covered porch area: square feet Cross street/directions to job site: Deck area: square feet r► l'L i .yJefrN Other structure area: square feet 4 S� raj y,J REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: 9//'/l � 3 a'T qt ��,'}}}Liii///l7 e^ ot I L o.: Permit fees*are based on the value of the work performed. Tax map/parcel no.: % 1.t0�a rr"'e` ''�) �`MRI/ t..tr`s1' Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the 7 t ?B,..,DESCRIPTION O WORK ' work indicated on this application. N Valuation: $ ADRINfz7 NEW BEDRMS ANf RTH TO EXISTING fARAfE_ SPACE AND 1 NEW BED RM IN DINING A EA Existingbuitdingarea square feet •11 -4, I.{- 116 Care_ K6C -b C b et New building area: square feet ❑Q PROPERTY OWNER I ❑ TENANT 1 .4_4umber of stories: Name: SUAD ELMI Type of construction: Address:9095 SW NORTH DAKOTA ST. Occupancy groups: City/State/ZIP:TIGARD OR 97223 Existing: Phone:(503 )995-6476 Fax:( ) New: • APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* Business name:SIMPL HOME DESIGNS (Please refer tojeescheduk) Structural plan review fee(or deposit): Contact name:MIKE MONTGOMERY FLS plan review fee(if applicable): Address:4931 SW 76TH AVE, PMB 211 Total fees due upon application: City/State/ZIP:PORTLAND OR 97225 -- Amount received: Phone:603 )515-6495 I Fax: :603 )719-4825 PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail:mike@simplhomedesigns.com 1 Commercial and residential prescriptive installation of roof-top mounted PhotoVoltaic Solar Panel System. Business Warn Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: c (5)) A! I v. Solar Installation Specialty Code checklist. City/State/ZIP: Ai e.JY( kAilele J q 7 .D ! Permit Fee(includes plan review $180.00 and administrative fees): 6 Phone:(c71) il el_ O k s.t. I !Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lie.: '3 7 q jL , a3 Total fee due upon application: $201.60 Authorized signature: IT Nit,i This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. ,..!'�r r.,7aNrg8tn ' ( Dal -4F- 3 *Fee methodology set by Tri-County Building Industry Print name: / C / ( P s7 !r Service Board. 1 I:\Building\Permits\BUP-RESPerrnitApp.doc 01/25/2023 44 613T(11/02/COM/WEB) `Plumbing Permit Application Building Fixtures ," 1�(E FOR OFFICE I.SE ONLY City of Tigard ' � Aeccived Pe m t No.. Eril 13125 SW Hall Blvd.,Tigard,OR 97223 Y Date/By: ✓n�/ /v� �Q�7 1 PI��1 a �1,� Plan Review Other Permit No. Phone: 503.718.2439 Fax: 503.598.1960 I� '^ Date/By: TIGARD Inspection Line: 503.639.4175 .„r,pp r-Date Ready/By: lads El See Page 2 for Internet. wlvw.tigard-or.gov -ln' ( f'� Notified/Method: Supplemental Information i TYPE OF WORK FEE* SCHE r- ❑New construction ❑Demolition For special information use checklist. Description I Qty. 1 Ea. I Total ®Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF-CONSTRUCTION: �a�'.- SFR(1)bath 312.70 ® I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 ❑Accessory'buildingSFR(3)bath 500.32 ❑Multi-family Each additional bath/kitchen 25.02 E Master builder ❑Other: Fire sprinkler(_sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: Footing drain(no linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name: 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 *^° 'ai`l,i r Backwater valve 12.51 111 €�S41iIIf lw ,tRk Clothes washer 25.02 Adding bath room in remodeled garage space Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER ❑.TENANT:-. Expansion tank 12.51 Name:Suad Elmi Fixture/sewer cap 25.02 Floor drain/floor sink hub 25.02 Address:9095 SW North Dakota St Garbage disposal 25.02 City/State/ZIP: Tigard, Oregon 97223 Hose bib 25.02 Phone:(503 )995-6476 Fax'( ) Ice maker 12.51 m:'.7.-'-'''.7"0"7.;;;;;:;,5,1%Ir CONTACT PERSON Interceptor/grease trap 25.02 Business name: S Yvri ttdrv+e., r \/s/,S Medical gas(value:$_) Page 2 Primer 12.51 Contact name:Suad Elmi /I')t.CG hia,,,friteicirele,y Roof drain(commercial) 12.51 Address:9095 SW North Dakota St GI Cf 3 i 5w ,. 6 fin, 5 Sink basin/lavatory 1 25.02 City/State/ZIP: Tigard, Oregon 97223 /,,ns i,4 4.1 ry)}1-3 e'j t Solar units(potable water) 62.54 Phone:(503 )995-6476 Fax: : 525 ) Sly-.(oti,ys- Tub/shower/shower pan 1 12.51 E-mail: Urinal 25.02 CONTRACTOR Water closet 1 25.02 m• - Water heater 37.52 Business name.HOME OWNER Water PF� iP m DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal Fax: Minimum permit fee: $72.50 Phone:( ) ( ) Plan review (25%of permit fee) CCB Lic.: Plumbing Lic.no.: State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name: Date: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. �V'�'pt � '//{�/�� ('�� "Fee methodology set by Tri-County Building Industry Service Board. I:B 'APer as L - er .Aoc 100i�N9� 3IWpL 44V G1 COM/IVEB) 6143111/41t r S to to en'1� '1v 1 Se5"•r . 3/�t14/3 4'IV, 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 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 Sewer- 1st 100' 62.54 3,601 to 7,200 $233.20 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: pst $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 Inspection of existing plumbing or for and including$1 first$10,000.0000. which no fee is specifically indicated 90,00/hr $10,001.00 to$25,000.00 each a 0 for the and$1.54 for (minimum charge—1/2 hour) each additional$100.00 or fraction thereof,to Inspections outside of normal business 90,0pmr and including the first 0.00. hours(minimum charge—2 hours) $25,001.00 to$50,000.00 each a 0 for first$25,000.00 and thereof,for Reinspection Fees 90.00/ty each additional$100.00 or fraction to 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 Baptistry/Font IDAny new commercial building with water service 2"and Bath; -Tub/Shower greater,except systems designed and stamped by licensed -Jacuzzi/Whirlpool engineer. Car 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 ❑ 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" iit— i Isometric or Riser Diagram Car Wash Drain 0 Isometric or riser diagram is required for new buildings 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: -Lav/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 Washer-clothes increase of sewer EDUs,a sewer permit will be issued and Water Extractor fees assessed for the sewer increase must be paid before the Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: 1:1BuildingWermits\PLMF_PermitApp.doc 08/04/2011 2 City of Tigard illII " COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Review - Residential TIGARD Building Permit #: /7157-d'tl.73—0007/ p Site Address: 1(PS 610 JN n V 7ta di. $erified in Accela Project Name: LV4I R-ei/►'� O , Lot/Unit #: Proposal: V )A0f fonrioaet , YvWYl goolve to (Ali spit, Zone: g£S—g Housing Type: )SFR(c'Single Detached ❑ Duplex❑Triplex 0 ADU)0 Rowhouse ❑Cottage Cluster❑CYU❑Quad ❑Other Req fired Site Plan Elements: copies of site plan on max 11x17" ifi-Drawn to standard scale /Retained trees, drip line/ tree protection North arrow P-Str t and site trees shown / labeled Site address, project name, lot # .1 --T-ebittrralculating tree canopy at maturity .-Street names (N/A for SFR) .'Applicant name and phone # 8-Gecrrtgard rectangle dimensioned (if applicable) of and setback dimensions CI Vision clearance triangle Existing structures &square footage e-dtitlty IDcations &easements 14,1 Footprint of new structure and FFE •E1-12r.ofierty corner elevations 0 ex,Conor\)p( Q....Sidewalk/driveway dimensioned ❑-HDA (>1,000 sf disturbance) . -Eatarea and lot coverage percentage ❑ Eresio„ control Required Elevation Plan Elements: (For SFR: calcs needed only on street-facing) Summary table with calculations for: 4Drawn to standard scale ,IEF Total facade area S-Beritding height dimensioned dE1 Total window and door area ,0,acade dimensioned r_ .i Windows and doors dimensioned `I t0 7' VA-Garage doors dimensioned Re 'red Floor Plan Elements: (Not req ' for SF ❑ Summary table that includes 0 Each s sioned El Total floor area ch story floor area c ed ❑ Floor area per story Planning Review The following standards have been met:Setbacks /Front: k� Rear: 1S Side: S Min/Max Street Side: l nS / Garage: --0 Height JZ'Max. Height: fa0 Proposed Height: _�h.o o t r N1 p,pcl ) tJ yes u rv/A Landscape (I J —Cries ❑ N/A Screening (Quad only) _'Yes ❑ N/A % Window Coverage ❑ Yes ❑ N/A Garage (SFR Only) Parking (Other Res) YlYes-D-N/A Entrance (SFR, Rowhouse, Quad only) er building design standards (Rowhouse only) ❑ -Y.es-e-ti Accessory Structure Standards .1=1 Yef, e-No Qualifying pre-existing unit exempt from standards (Cottage unit only) Additional standards for Courtyard Units, Cottage Clusters, Rowhouses, and Quads: ❑ Y ❑ N/A Unit Count: ❑ Yes ❑ Lot Width a " e 0 Yes ❑ N/A Additional ar s Courtyard Units and Cottage Clusters only: ❑ Yes /A Unit Area: es El N/A Floor Area (per story ❑ Yes 0 N/A Courtyard 0 Yes 0 N/A Fence ArCo ❑ Yes t'No ❑N/A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995) ❑ Yes ❑ No4N/A Public Facilities Improvement (PFI) Permit: Required: D Yes ❑ No Applied For: ❑ Yes ❑ No, stop intake ❑ Sensitive Lands: ❑ Yes ,g1Jo //41 Main Land Use Case #s: ❑ Conditions met ❑Applicant notified of land use expiration date: Approved By Planning: I • �� 1 Date: 1 /7/7- Notes 3 P)G�horlel -to ACr oolo�}P vesic�Pinhwt Care {txGt—tif� Revision 1: ❑ Approved ❑ Not Approved V Date: Revision 2: ❑ Approved 0 Not Approved Date: Building Permit Submittal Original Submittal Date: 3/7/73 Site Plans #: I,, Building Plans #: 3 Building Permit #: King permit # entered on pa e 1 Workflow Routing: orllanning l ineering riE-Pfrrnit Coordinator P-BtriTding Workflow Sign-off: Dn-off for Planning (include notes from planning review) Route Documents: l - ineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. ceding: original permit application, site plans, building plans, engineer and beam calculations and trust details, if applicable, etc. Permit Technician: Date: 3/103 Notes: k''' c.7 ',- �nS o/�A)-✓ �i-. ✓- -� Engineering Review I 'PFI Permit: Ale, g Slope at building pad: 1.'b 0/0 l 'Conditions met prior to issuance of permit h Ma l'Easements (encroachments) per engineering conditions of approval and plat "Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: 0 Yes IN/No Assess Water Quantity Fee in-lieu: ❑ Yes I31No LIDA Facility on lot: ❑ Yes l3'No Add Fee: ❑ Yes 0 No r"Final Plat Recorded hf&. ❑ NOT Approved: Date: Notes: ��J��I�"""�� Approved By Engineering: T by i Date: 1I4 I7/tro Revision 1: 0 Approved ❑ Not Approv Date: Revision 2: ❑ Approved ❑ Not Approved Date: Permit Coordinator Review p€onditions met prior to permit issuance ❑ Approved, NOT Released: Date notified applicant: ❑ ENG Revisions Required: Date notified applicant: ,PTSDC Exemption: ❑ Applied for 0 Received /Does not apply11104- c-r'��1� .(SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes /N/A as FA--Fr- TI Tigard Trans SDC: ❑ Yes AN/A ❑ Deferred S Parks SDC: ❑ Yes /N/A ❑ Deferred LIDA 0 Yes /N/A ,zrOK to Issue/Approved by Permit Coordinator: V Date: 31 2l 1Zi23 Revision 1: ❑ Approved ❑ Not Approved Date: Revision 2: 0 Approved 0 Not Approved Date: - t vc-kiiir\ vo.,1A ,-- -t-i--\---ts-- blt,•--c___)--es---i---' ' .1/4- ---/7-77/7'2 Water Meter Fixture Unit Worksheet for AdditionsAlagOENEa Please complete the following information: MAR 2023 Customer Name: SUAD ELMI CITY OF TIGARD BUILDING DIVISION Service Address: Street/Suite#: 9095 SW NORTH DAKOTA ST. City: TIGARD State: OR Zip: 97223 Phone Number: (503) 995-6476 Email: sucaad4@gmail.com 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 l = Bidet x 1 = x 1 = Clothes washer 1 x 4 = 4 x 4 = Dishwasher 1 x 1.5 = 1 x 1.5 = 1st Outside Water Spigot 1 x 2.5 = 2.5 x 2.5 = Water Spigot,each add'l 1 x 1 = 1 x 1 = Kitchen sink 1 x 1.5 = 1.5 x 1.5 = Laundry sink 1 x 1.5 = 1.5 x 1.5 = Lavatory(bathroom sink) 3 x 1 = 3 1 x 1 = 1 Water closet,1 6 GPF(toilet) 3 x 2.5 = 7.5 1 x 2.5 = 2.5 Bathtub/whirlpool x 4 = x 4 = Shower stall 2 x 2 = 4 I. x 2 = N2.,2— ____ _ Bath/shower combo 1 x 4 = 4 x 4 = Current Points: 30 Proposed Increase: 5 : Current Points+ Proposed Increase= 35.5 =New Total Points =Required Meter Size 3/4 Meter Sizes: 1 to 30 points=5/8" 30.5 to 37 points='/4" 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 Nfri- _ 'vim c Current Meter Size Confirmed with UB d-7.: Signature of UB Representative Date I:/Building/Forms/WaterMeters_070121 Add.dOCX Page 2 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 71 _ " Water Meter Fixture Unit Worksheet TIGARD 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. ubonlinepay(a�tigard-or.gov 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, I" $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.Add.dOCX Page 1 Allyson Armstrong From: Jill Bentley Sent: Monday, April 3, 2023 1:08 PM To: Allyson Armstrong Subject: RE: 9095 SW North Dakota St - WMFS Hi Allyson, 9095 SW North Dakota St received their water from Tualatin Valley Water District. Kind Regards, Jill (she/her/hers) A WW1,: ; Jill WPoviou CAN BE ANyTH�NG' e • City of Tigard-Utility Billing tSenior Accounting Asst TIGARO t888)826-7211Payments (503)718-2460 UB '.lain jillb@tigard-or.gov • (503)718-2494 .,.. 13125 SW Hall Blvd. K�6• Tigard,OR 97223 From:Allyson Armstrong<AllysonA@tigard-or.gov> Sent: Monday, March 27, 2023 9:37 AM To:Jill Bentley<JILLB@tigard-or.gov> Subject:9095 SW North Dakota St-WMFS Allyson Armstrong City Of Tigard I ltijlKU (503) 716-2612 Work l5031 718-8137 Mobile 13125 SW Hall Boulevard Tigard,Oregon 97223 DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained by the City of Tigard in compliance with the Oregon Administrative Rules "City General Records Retention Schedule." 1