Permit (3) CITY OF TIGARD MASTER PERMIT
1: COMMUNITY DEVELOPMENT Permit#: MST2023-00019
T E G ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/30/2023
Parcel: 1S135AC15600
Jurisdiction: Tigard
Site address: 9354 SW LONGSTAFF ST
Subdivision: ASHBROOK VILLAS Lot: 23
Project: Ashbrook Villas, Lot 23
Project Description: New attached dwelling.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 3 First: 610 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 30 Bathrooms: 3 Second: 887 sf Garage: 215
g sf Front: 15 Smoke
Dwelling Units: 1 Third: 324 sf Right: 3 Detectors: Yes
Total: 1821 sf Value: $289,894.24 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100
Tubs/Showers: 2 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: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 2
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: 2 201-400 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 SFA VB R-3 1821
Owner: Contractor:
ABVOZBP21 LLC SAGE BUILT HOMES Required Items and Reports(Conditions)
1815 NW 169TH PL STE 1040 1815 NW 169TH PLACE,SUITE 1040 1 Ersn Cntrl 503-639-4175
BEAVERTON,OR 97006 BEAVERTON,OR 97006 2 Fire Rated Conditions
PHONE: PHONE: 971-221-4597
FAX: 503-533-5164
Total Fees: $29,696.23
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 Thos- rules are set forth in OAR
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i/��Issued By: Permittee Signature: wtiC[i� / /
Call 503.639.4175 by 7:00 a.m.for the next available inspection .ate
This permit card shall be kept in a conspicuous place on the job site until co pl> on of the project.
Approved plans are required on the job site at the time of each •• ection.
a 1
Building Permit Application
Residential ,i3_ FOR OFFICE USE ONLY
Cityof Tigard Received
i�. ,genet /�^�g to S Date/By: G 4 /!//<,rd_c,&_.ow)
a 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revi 2 �A
Phone: 503.718.2439 Fax: 503.598.196Q Date/By: e 013 - l5 -
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: kris: 0 See Page 2 for
Internet: www.tigard-or.gov y " ' Not' Method: Supplemental Information
Ofit Ith ,1t ;,„„I' � 1f
®New construction ❑Demolition Permit fees*are based on the value of the work performed.
❑Addition/alteration/replacement ❑Other theprofit for the
Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and
91t 9 6 work indicated on this application.
�. .., ,.,, OA980 - S�
® 1-and 2-family dwelling ❑Commercial/industrial Valuation: l� ( t
❑Accessory building ❑Multi-family Number of bedrooms:2
III Master builder ❑Other: Number of bathrootns3
all * � Total number of floors:3
Job site address:9354 SW Longstaff Street New dwelling area: 1821 square feet 3Zy
�
City/State/ZIP:Tigard, OR 97223 Garage/carport area: 62t`7/ square feet 66-7
Suite/bldg./apt.no.: Project name:Ashbrook Villa's Covered porch area:28 square feet Co I 0
Cross street/directions to job site: Deck area:48 square feet
Greenburg Road and 95th
Other structure area: square feet
Subdivision:Ashbrook Villa's Lot no.: 23 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
i l • •� r work indicated on this application.
,/t/ a Y / ��
� �j //sue Valuation: $
Existing building area: square feet
New building area: square feet
,0140 '..
M 4z, , Number of stories:
Name:ABVOZBP21 LLC Type of construction:
Address:1815 NW 169TH PLACE, SUITE 1040 Occupancy groups:
City/State/ZIP:Beaverton, OR 97006 Existing:
Phone:603-5026623 Fax:( )
Business name:Same as above
Structural plan review fee(or deposit):
Contact name:Katie Patterson
FLS plan review fee(if applicable):
Address:
Total fees due upon application:
City/State/ZIP:
Amount received:
Phone:( ) Fax::( )
E-mail:katie@sagebuilthomesllc.com W" '
wo.. Commercial and residential prescriptive installation of
, ,... r.,'1z, r :`.:. ..._._.,' a:`.f, roof-top mounted Photo Voltaic Solar Panel System.
Business name:Sage Built Homes LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:1815 NW 169TH PLACE, SUITE 1040 Solar Installation Specialty Code checklist.
City/State/ZIP:Beaverton, OR 97006 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( )503-5026623 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:189930 Total fee due upon application: $201.60
Authorized signature: �oto P 4tept, This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Katie Patterson Date:12/15/22 *Fee methodology set by Tri-County Building Industry
Service Board.
I:ABuilding\Pennits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(ll/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLI'
City of Tigard Received
Date/By: Permit No.:
11111 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
1 Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 El Electr cal 0 Plumbing 0 Mechanical
TIGARD
Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW 1'es No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑ ❑
3 Verification of approved plat/lot. ❑ ❑ ❑
4 Fire district approval required. Name of district: . 0 ❑ ❑
5 Septic system permit or authorization for remodel. Existing system capacity 0 0 ❑
6 Sewer permit. ❑ ❑ ❑
7 Water district approval. ❑ ❑ ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ 0 ❑
9 Erosion control 0 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 ❑ ❑ ❑
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 ❑ ❑ ❑
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- ❑ ❑ ❑
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 for new construction;minimum of two elevations for additions and remodels. ❑ 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 ❑
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 ❑ ❑ ❑
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 ❑ ❑ ❑
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. ❑ ❑ 0
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ❑ ❑
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 ❑ ❑ ❑
architect licensed in Ore:on and shall be shown to be applicable to the project under review.
JURISDICTIONAL SPECIFICS
23 Three(3)site plans are required for Item 11 above. Site plans must be 84/2"x 11"or 11"x 17". ❑ 0 0
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
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, ❑ ❑ ❑
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, ❑ ❑ ❑
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
h\Building\Pennits\BUP-RESPcrmitApp.doc 02/24/2011 440-4613T(I1/02/COM/WEB)
Mechanical Permit Application -„n' y ,.)N FOR OFFICE USE ONLY
City of Tigard Received
�:J Date/By: Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223
r Plan Review
1 Phone: 503.718.2439 Fax: 503.598.1960 t Date/By: Other Permit:
C I G 1 R D Inspection Line: 503.639.4175 Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard-or.gov `fig,,,, Notified/Method: Supplemental Information
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.
oukw. I ON$1'Rll)I tll : Value:
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
t
Heating/cooling:
Air conditioning 1 46.75 46.75
Job site address:9354 SW Longstaff Street Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75
City/State/ZIP:Tigard, OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:Ashbrook Villa's Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision:Ashbrook Villa's Lot no.: 23 Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
, I!UO$ �s ,,1 Gas fireplace/insert 33.39
... .. .,. ..... :::...v... Flue vent for water heater or gas
fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
`: isle ,? t,w 1�1 t w `per ._ r Other: 23.32
4 ,. :,:..., .,. ,. ''' ....: : ...... :, u ,..4Z. ",' `Aga
:...:.j Environmental exhaust and ventilation:
Name:ABVOZBP21 LLC Range equipment od/other kitchen 33.39 33.39
Address:1815 NW 169TH PLACE, SUITE 1040 Clothes dryer exhaust 1 33.39 33.39
City/State/ZIP:Beaverton, OR 97006 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 4 23.32 93.28
Phone:(5j03-5026623 Fax:( ) Attic/crawlspace fans 23.32
1 ly! � �* z'°* ti! ..,; ;'..y: Other: 23.32
Fuel piping:
Business name:ABVOZBP21 LLC
$14.15 for first four;$4.03 for each additional
Contact name:Katie Patterson Furnace,etc.
Address:Same as above
Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace
Range
E-mail:katie@sagebuilthomesllc.com Barbecue
1t # t„
a, ....:�f ... ,:. .... :.: ...... •.. ... . .. . .:... Clothes dryer(gas)
Businessname:All Time Heating
Other:
11211111,11M:0127'ill:C:,A,1111111111
Address:PO Box 1341
Subtotal
City/State/ZIP:Lake Oswego, OR 97035 Minimum permit fee($90.00)
Phone:(503 )208-2276 Fax:( ) Plan review(25%of permit fee)
State surcharge(12%of permit fee)
CCB lic.:4g4 --. 1 1 ( S 7 c' l t /,7 ( `/ TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
K-&.- PCL../. - _ _� days after it has been accepted as complete.
Authorized signature: GL(L� �.�/[�(! * Fee methodology set by Tri-County Building Industry Service Board
Print name:Katie Patterson Date:12/15/22
I:A Building A Permits\MEC_PermitApp_040113.doc 440-461 TT(II/02/COM/WEB)
Electrical Permit Ampficat' - FOR OFFICE rSe ON i.l — —
City of Tigard �' Received
I.
DateiBv: Permit#:
III at 13125 SW Hall Blvd.,Tigard,OR 97223 r 20` Plan Review
Phone: 503.718.2439 Fax: 503.598.196M" D,aefB : Related Permit N:
Inspection Line: 503.639.4175 Ready DatciBy: Jugs: 0 See Page 2 for
TIGARD iT 'r ' t:,A iR+l i;
z Internet: www.tigard-or_gov C1' Notified/Method: Supplemental Information
TYPE oF9kAIED1NG olvIslah, PLAN REVIEW
®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans wlitems checked):
0 Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: 0 lire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ['Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address:9354 SW Longstaff Street b oHP or more. ❑"rt,4r "t-2", t-3',
City/State/ZIP:Tigard, OR 97223 0 Six or snore residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
❑Hazardous locations. ❑Supply voltage for more than
Suite/bldg./apt.#: Project name:Ash Brook Villas 0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description i Qty. l Each I Total r R
New residential single-or multi-family dwelling unit.
Subdivision:Ashbrook Villa's Lot I/:23 Includes attached garage.
Tax map/parcel it:
1,000 sq.ft.or less 168.54 4
. Ea.add'!500 sq.ft.or portion 33.92 i
DESCRIPTION OF WORK Limited energy,residential 75.00 2
(with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.1
Renewable Energy El See Page 2
® PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name:ABVOZBP21 LLC 200 amps or less 1 100.70 100.70 2
Address:1815 NW 169TH PLACE, SUITE 1040 201 amps to400amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Beaverton,OR 97006 601 amps to 1,000 amps 301.04 2
Phone:( ) Fax:( ) Over 1,000 amps or volts 1 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:katie@sagebuilthomesllc.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
V APPLICANT -- ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:ABVOZBP21 LLC above service or feeder ft , 7 42 2
each branch circuit
Contact name:Katie Patterson B.Fee for branch circuits without
service or feeder fee,first Address:Same as above branch circuit 56.18 2
City/State/ZIP: Each add'/branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone: 03-5¢)26623 Fax::( ) Each manufactured or modular 67.84 2
dwelling,service ansi/or feeder
Email:katie@sagebuilthomesiic.com -
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Grizzly Electric Inc Sign or outline lighting 67.84 2
Address:3301 E 11th Street Suite 100-117 panel,gnal Iterationt(s)or limited-energyextension. ❑ See Page 2 2
panel,alteration,or 1
City/State/ZIP:Vancouver,WA 98661 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503-770-1855 Fax:( } Investigation(I hr min) 90.00/hr
g y @ 7 {,i�� Industrial plant(1 hr min) 78.18/he
Email: rizzl electric msn.com
Inspections for which no fee is 90 00!br
CCB Lie.:186218 Electrical Lic3>iy4,`t Suprv.Lic.:g5i7s specifically listed(14 hr ruin)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: P Subtotal:
Print name: .k A C f 1 „}�Ct Li, ; . D . 2/1/22 Cl Plan Review Required(25%&permit fee):
1 State surcharge(12%of permit fee):
Authorized signature: ,' .&. . PG'r g.2.4.err, TOTAL PERMIT FEE:
This permit application expires it a permit is not obtained within 180
Print name:Katie Patterson Date:12l1122 days after it has been accepted as complete.
* Number of inspections allowed per permit.
l/t3uildin5U'ennits\ELC_Pennit.gpp_F.L.R_HRE..doc Rev 06r172015 440-4615rrt uosiCOM,'wal
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
$0.00 to$500.00 Minimum fee$69.06
$500.01 to$5,000.00 $69.06 for the first$500.00 and
$3.07 for each additional$100.00 or
fraction thereof,to and including
$5,000.00.
$5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and
$2.81 for each additional$100.00 or
fraction thereof,to and including
$10,000.00.
$10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and
$2.54 for each additional$100.00 or
fraction thereof,to and including
$50,000.00.
$50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and
$2.49 for each additional$100.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first$100,000.00 and
$2.92 for each additional$100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I:\Building\Permits\MEC_PermitApp_0401 13.doc 2
Plumbing Permit Applici t o 1--_ v .'r:
Building Fixtures FOR OFFICE USE ONLI
Ci} of Tigard 't Received
. g Permit No.:
13125II J SW Hall Blvd.,Tigard,OR 97 3 q, Date/By:
Phone: 503.718.2439 Fax: 503.598"1960 Plan Review
Date/B Other Permit No.:
Inspection Line: 503.639.4175 ,' 1 "t `- r ' ! ' 't'` Y
T I G A R D Date Ready/By: funs: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
T E W r it 3 i®New construction ❑Demolition For special information use checklist.
Description I Qty. I Ea. I Total
0 Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
411! w .t' ': # 1 T4 SFR(1)bath 312.70
I-and 2-family y dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 1 500.32 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other Fire sprinkler( sq.ft.) Page 2
1111181111111*Crft7q,*iiitra7i11:3111101gritilli Site utilities:
Job site address: Catch basin or area drain 18.76
9354 SW Longstaff Street
-
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard, OR 97223 Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name:Ashbrook Villa's 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:Ashbrook Villa's I Lot no.:23 Fixture or item:
Tax map/parcel no.: Backflow preventer 1 31.27 31.27
, ,•p`' tifiyly ai 8 t t i Backwater valve 12.51
.c ,,.,. , ...,.. o... .: ,,, .: ,a c...,<.,. ,. ..< _;,.. . '.,.....-. Clothes washer 1 25.02 25.02
Dishwasher 1 25.02 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
a ', oo P .. $ > 5€ Expansion tank 12.51
Name:ABVOZBP21 LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:1815 NW 169TH PLACE, SUITE 1040 Garbage disposal 1 25.02 25.02
City/State/ZIP:Beaverton, OR 97006 Hose bib 2 25.02 50.04
Phone:( Fax ( ) Ice maker 1 12.51 12.51
1413..... , ,.,.a .. "r i or r... ,t� ,,,,,,--.:;,,,,Ai Interceptor/grease trap 25.02
Business name:ABVOZBP21 LLC Medical gas(value:$_) Page 2
Primer 12.51
Contact name:Katie Patterson
Roof drain(commercial) 12.51
Address:Same as above Sink/basin/lavatory 5 25.02 125.10
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 3 12.51 37.53
E-mail:katie@sagebuilthomesllc.com Urinal 25.02
Water closet 3 25.02 75.06
Water heater 1 37.52 37.52
Business name:Ed Mullen Plumbing Water Pm 1p S DWV 56.29
Address:1601A SE River Road Other: 25.02
City/State/ZIP:Hillsboro, OR 97123 Subtotal
Phone:(503 )572-4586 Fax:( ) 7/1/)- Minimum permit fee: $72.50
CCB Lie.:92689 Plumbing Lie.no.3L�
Plan review (25%of permit fee)
�u�C State surcharge(12%of permit fee)
Authorized signature: / atj. /6)al gam, TOTAL PERMIT FEE
Print name:Katie Patterson Date:12/1/22 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PennitApp.doc 10/01/09 440-4616T(I 0/02/COM/WEB)
i.
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
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
Sewer-1st 100' 3,601 to 7,200 $233.20
62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52
Storm&Rain Drain-1st 100' 62.54
$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
each additional$100.00 or fraction thereof,to
t t t 3 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*. wingt e t t 1 Ie tl rat t c
tr r Plan review is required for any of the following.
xtur 5t r that apply.Please check allpp y.
Baptistry/Font ElAny new commercial building with water service 2"and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
-Jacuzzi/Whirlpool engineer.
ElCar Wash: Each Stall New exterior plumbing site utilities for any complex structure
as defined in OAR918-780-0040.
-Drive Thru
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial El Any multipurpose fire sprinkler system.
Domestic D 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"
eg : . „ f ,
3 � � 1 1 t 1A
4' 0 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: -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 increase of sewer EDUs,a sewer permit will be issued and
Washer-Clothes
Water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2
City of Tigard
1111 COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
TIGARD
Building Permit #: /14 7C7„2, —07)0/
Site Address: 1.5511 Sw �r . Verified in Accela
Project Name: ()e b'V'O1'II- i I(OL5- Lot/Unit #: 2 J
Proposal (include housing type): A)& ) P C F Zone: Vir/5'1)
Required Site Plan Elements:
3 copies of site plan on max 11x17"
Drawn to standard scale B-IRetai+ncd trees, drip line/ tree protection
4 North arrow ,e-Street and site trees shown / labeled
p-Site address, project name, lot # ❑ Tebte elculating tree canopy at maturity
'In-Street names (N/A for SFR)
"Et Applicant name and phone # - tyard rectangle dimensioned (if applicable)
fd Lot and setback dimensions Vision clearance triangle
-Existing structures &square footage sl rUtility locations &easements
,17'Footprint of new structure and FFE grProperty corner elevations
)a'Sidewalk/driveway dimensioned = • >1,000 sf disturbance)
4-Lot area and lot coverage percentage n Erosion control
Required Elevation Plan Elements:
(For SFR: calcs needed only on street-facing) Garage doors dimensioned
,ErDrawn to standard scale Summary table with calculations for:
Xi-Building height dimensioned eff Total facade area
,i5 Facade dimensioned di'Total window and door area
i'Windows and doors dimensioned ?I-Total garage area
Required Floor Plan Elements: Pl'Summary table that includes
1crEach story dimensioned total floor area
Vach story floor area calculated Floor area per story
Planning Review
The following standards have been met:Setbacks l 'Front: IS n Rear: 15 Side: 7 Min/Max Street Side: (5 2-6
/ Garage: 2-0
Height 'Max. Height: ; J Proposed Height: 3o'4 Li)
/Yes CIN/A Landscape la Y
Yes,,11N/A Screening (Quad only)
'Yes ❑ N/A % Window Coverage i 4•1(PO'
gYes ❑ N/A Garage (SFR Only) ► e
Parking(Other Res) IZ mom Uo - ol'riJ 'y
Yes ❑ N/A Entrance (SFR, Rowhouse, Quad only)
"(Yes ❑ N/A Other building design standards (Rowhouse only)
❑ Yes?"N/A Accessory Structure Standards
El Yes A-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: 3
Yes ❑ N/A Lot Width and Size i,' )
J2t1Yes ❑ N/A Pathway
Additional standards for Courtyard Units and Cottage Clusters only:
es ❑ N/A Unit Area:
❑ Ye N/ Floor Area (per story)
❑ Yes and
0 Y 0 N/A Fence
❑ Yes ❑ No f'N A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995)
❑ Yes ❑ No E J/A Public Facilities Improvement (PFI) Permit:
Required: VYes ❑ No
Applied For: %Yes ❑ No, stop intake
%Sensitive Lands: ❑ Yes V No ,
Land Use Case #: '241/0 6,,,„
-OCOQ�7' p1 Conditions met prior permit issuance
Approved By Planning: Date: 1 (21 173
Notes
Revision 1: ierApproved ❑ Not Approved __rfDate: 3 f °7 /Z3
Revision 2: ❑ Approved ❑ Not Approved Date:
Building Permit Submittal /
Original Submittal Date: //01 /'2_
Site Plans #:
Building Plans #: 7
Building Permit #: --P-Building permit # entered on page 1
Workflow Routing: En5fanning,51-Effl-gineering ermit Coordinator.,..P-Bt tding
Workflow Sign-off: gn-off for Planning (include notes from planning review)
Route Documents: in--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
beam calculations and trust details, if applicable, etc. /
Permit Technician: _ Date: ( `e2-Gl/.Z3
Notes:
Engineering Review �g,/�
pe at building pad: G0 %
Conditions met prior to issuance of permit
Easements (encroachments) per engineering conditions of approval and plat
2' Vater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes �Vo
Assess Water Quantity Fee in-lieu: ❑ Yes
LIDA Facility on lot: ❑ Yes D'No Add Fee: ❑ Yes 0 No
-Final Plat Recorded
❑ NOT Approved: Date:
Notes:
Approved By Engineering: K. (` 5/f e/ — Date: ( -'U Z- ZJ3
Revision 1: 12tApproved ❑ Not Approved 14, AIttevl Date: 3-)5.2e2 )
Revision 2: ❑ 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:
I/SDC Exemption: ❑ Applied for ❑ Received )'Does not apply
/SDC Fees Entered: Wash Co Trans Dev Tax: 2f Yes ❑ N/A
Tigard Trans SDC: VYes ❑ N/A ❑ Deferred
Parks SDC: /Yes ❑ N/A ❑ Deferred
LIDA ❑ Yes R'N/A
/ OK to Issue/Approved by Permit Coordinator: Date: l l 3a 120 23
Revision 1: /Approved ❑ Not Approved Date: l i3 12.1.D23
Revision 2: 0 Approved 0 Not Approved Date:
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
a smittal Letter
T AA A F n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: DATE RECEIVED:
DEPT: BUILDING DIVISION
FROM: fti'4113 Ttl,OL RECEIVED
COMPANY: MAR 0 8 2023
PHONE: °I I• --62 S• $t (� BUILDING DIVISION B' 5Ri
EMAIL: k Ovii4 CsZ9 aouii4ina rnt451 .c• Coc
RE: q 3S q l6W,S '1.fi1 D°t 1T-z-3 f'n5T 2D23-GOD 17
(Site Address) (Permit Number)
st %Z15() VI &JIM L 23
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations. ,
d... A-
Other(explain): D VV £�ST 6ziwiA i C 4 .. rlE.P as s I! 1' per
REMARKS:
FOR FFI USE ONLY
Routed to Permit Technici : Date: 3 /5- ., 2� Initials: Piit
Fees Due: ❑ Yes No Fee Description: Amount Due:
N-ON) 6 $
$ Rz
Special
Instructions:
Reprint Permit(per PE): ❑ Yes Ej No ❑ Done
Applicant Notified: Date: 1-/&7,2-3 Initials:
I:\Building\Forms\TransmittalLetter-Revisions 073120.doc