Permit CITY OF TIGARD MASTER PERMIT
IN ,
2 COMMUNITY DEVELOPMENT Permit#: MST2023-00017
Date Issued: 05/30/2023
T i GAR.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S135AC15400
Jurisdiction: Tigard
Site address: 9372 SW LONGSTAFF ST
Subdivision: ASHBROOK VILLAS Lot: 21
Project: Ashbrook Villas, Lot 21
Project Description: New attached dwelling.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 2 First: 610 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 30 Bathrooms: 3 Second: 887 sf Garage: 213 sf Front: 15 Smoke Yes
Dwelling Units: 1 Third: 321 sf Right: 3 Detectors:
Total: 1818 sf Value: $289,320.77 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
Bckflw Prevntr: 1
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 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 1818
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: $29,650.43
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 Ceo - hose rules are set forth in OAR
::: ° - '
y: ermittee Signature: / jM/L
03.639.4175 by 7:00 a.m.for the next available inspecti• ,/ /
This permit card shall be kept in a conspicuous place on the Job site until ••mpl- • of the project.
Approved plans are required on the job site at the time of e. h ins•-ction.
Building Permit Application
Resl ltntial R ECE hl FOR OFFICE ['SE ONLY
City of Tigard Received
;, . 13125 SW Hall Blvd.,Tigard,OR 97223 NA� `" 2022Plan �� � ��
Plan Review � )
Phone: 503.718.2439 Fax: 503.598.1960ey l 5i6A r m : ^,.J UU
T I A R D Inspection Line: 503.639.4175 'e✓IT`' `)" �rll`;' Date Ready/By: Juris ®See Page 2 for ��
Internet: www.tigard-or.govBUILDING IVtw i'' Notified/Method: �� L Jmo
Supplemental Information
' o1F' WOR At4,t 1€ AN -FM41LV l ELL ::
®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 rofit for the
work indicated on this application. :77
® I-and 2-family dwelling ❑Commercial/industrial Valuation: -400000—
❑Accessory building ❑Multi-family Number of bedrooms:2
❑Master builder ❑Other: Number of bathrooms:.2!g'3
SiStiiiiaakainIg** ** W*4,Hiii.01.1'ajttlljttallNTotal number of floors:3 'l.O'
Job site address:9372 SW Longstaff Street New dwelling area: 'Citi
square feet37 1
City/State/ZIP:Tigard, OR 97223 Garage/carport area: square feet gcs7
Suite/bldg./apt.no.: Project name:Ashbrook Villa's Covered porch area:28 square feet Le(0
Cross street/directions to job site: Deck area:48 square feet
Greenberg Road and 95th Other structure area: square feet
Subdivision:Ashbrook Villas Lot no.: 21 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
.. W 5 P t 1 pp d
work indicated on this application.
CAA) (-1(7)\611-kjertOt 1 Valuation: $
r(4. a�fjy _r- 6_ ( „ef/ t-/// Existing building area: square feet
6��`�`�'� 6/� �ii New building area: square feet
j
�; ,' `�4 ,,,, .T,A ,. Number of stories:
orAW
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
JJff � � ( ) rr w p
Illaalr'....� ",7 �: 'x r#:_ I .`4� 'w,'fx ;c 4.1 f s New:
#�' ..y-s. :1
F `€
Business name:Same as above .....:F: t .,,. .: ....:. ` ...... z' ,,`....; t ...:
Structural plan review fee(or deposit):
Contact name:Katie Patterson
Address:
FLS plan review fee(if applicable):
City/State/ZIP: Total fees due upon application:
Phone:( ) Fax: :( ) Amount received:
iiIiir
E-mail:katie@sagebuilthomesllc.com a! � 14 '1 �
afigagethantallaat � � Commercial and residential prescri tive installation of
p
t Ph t V It ' Solar Panel r. ....... :.. ..v ... ... . ,.. ....., .., ,. . . .. .. , f,,. ., . v. roof top mountedo 0 o atc oar ane 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 lie.: 189930
Total fee due upon application: $201.60
Authorized signature: /< /63:aB.ii, 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.
L\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I I/02/COM/WEB)
Building Permit Application Checklist .
One- and Two-Family Dwelling FOR OFFICE USE ONLY
City of Tigard Received
Permit No.:
13125 SW Hall Blvd.,Ti ard,OR 97223
g Associated permits:
Z Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 El Electrical ❑ Plumbing El Mechanical
T I G:1 R D Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW \es No N/A
I 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: ❑ ❑ ❑
5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑
6 Sewer permit. ❑ ❑ ❑
7 Water district approval. 0 ❑ ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑
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 ❑ ❑ ❑
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. ❑ ❑ ❑
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- ❑ ❑ ❑
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 ❑ ❑ ❑
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. ❑ ❑ ❑
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 Oreton and shall be shown to be at plicable to the .ro'ect under review.
JURISDICTIONAL SPECIFICS
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". ❑ ❑ ❑
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. ❑ ❑ ❑
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 ❑ ❑ ❑
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:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard IR r l y.„ eceived Penr y�
13125 SW Hall Blvd.,Tigard,OR 97223 bate/By. %�,' j(�(�t"I�
_ Phone: 503.718.2439 Fax: 503.598.1960 iQN 2 201 Plan Review
'I Date/By: Other Permit:
T 1 G A R D Inspection Line: 503.639.4175 t ' Date Ready/By: orris: !a See Page 2 for
Internet: www.tigard-or.gov +� ;` IA
l NotifiedMIethod: Supplemental Information
JIMING DIVI,SI0f>
I'i 1 T ... ., l
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.
Value:
:<
® I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑ Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
! s ;
Heating/cooling:
Air conditioning 1 46.75 46.75
Job site address:9372 SW Longstaff Street Furnace 100,000 BTU(ducts/vents) 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.:
21 Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
l t p " < ` ' Gfireplace/insert 33.39
., ,,w g. . . 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
r M Other: 23.32
BV '''' ',,,ASOURANNOM Environmental exhaust and ventilation:
Name:ABVOZBP21 LLC Range hood/other kitchen
equipment 1 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:(503026623 Fax:( ) Attic/crawlspace fans 23.32
4 a,`'!i ( Other: 23.32
Business name:ABVOZBP21 LLC Fuel piping:
$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
t t Clothes dryer(gas)
Business name:All Time Heating Other:
�lI+l�
at(' f
Address:PO Box 1341 Subtotal
City/State/ZIP:Lake Oswego, OR 97035 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503 )20$-2276 Fax:( ) State surcharge(12%of permit fee)
CCB lie.:1845757 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
i. ie /)G��� days after it has been accepted as complete.
Authorized signature: u'�� � * Fee methodology set by Tri-County Building Industry Service Board
Print name:Katie Patterson Date:12/15/22
I.\Building\Permits\MEC_PermitApp_0401 13.doc 440-4617T(1 I/02/COM/WEB)
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.
1:\Building\Permits\MEC_PermitApp_040113.doc 2
•
Electrical Permit Anplica F c FIVE, ,z, _ i t l iz f l I I l .l_ i 1 {t.1y - - -
Clty of Tigard Received
Da11 v 13125 SW Hall Blvd.,Tigard,OR 9722 �O O i,7
> AN 2 2027 PISnR view
= Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#:
Inspection Line: 503.639.4175 n T ReadyDatc/By: taro:
T f(;A RI), �I' ) •'. ��.�.+ ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
_ TYPE 0 G DIVISION
PLAN REVIEW
®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans wlitems checked):
0 Demolition Other: ❑Service or feeder 400 amps or more ❑Building over three stories.
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
® 1-and 2-family dwelling 0 Commercial/industrial CIAccessory building less to ground,or exceeds 14,000 0 Commercial use agricultural
amps for all other installations. buildings.
CI Multi family 0 Master builder 0 Other: ❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address:9372 SW Longstaff Street 100HP or more ❑�A N�», I-2' t-3»
City/State/ZIP:Tigard,OR 97223 o Six or more residential units. occupancy.
❑Hcalth-cart facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Ash Brook Villas ❑Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more 600 volts nominal.
Cross strect/directions to job site: FEE SCHEDULE
commotion I Qty. i Eadt I Tatal 1 k .
New residential single-or multi-family dwelling unit.
Subdivision:Ashbrook Villa's Lot#:21 Includes attached garage.
1,000 sq.ft.or less ' 168.54 4
Tax map/parcel 4: Ea add'l 500 ft.or sq. portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
(with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq,ft.)
Renewable Energy ❑ See Page 2
® [] TENANT PROPERTY OWNER 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 to400 amps 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 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
Branch circuits—new,alteration,or extension,per panel la APPLICANT ❑ CONTACT PERSON
A.Fee for branch circuits with
Business name:ABVOZBP21 LLC above service or feeder fcc, 7.42 2
each branch circuit
Contact name:Katie Patterson B.Fee for branch circuits without '
Address:Same as above service or feeder fee,first 56 18 2
branch circuit
City/State/ZIP: Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:1503-5)26623 Fax::( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email:katie@sagebuilthomesllc.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 100117 Signal circuit(s)or limited-energy panel,alteration,or extension. 0 See Page 2 2
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:(503-70-1855 Fax: .
( ) Investigation(1 hr min) 90.00/hr
Industrial,Iaru(1 hr min) 78.18/hr
Email:
grizzlyelectric@msn.com
Inspections for which no fee is
CCB Lic.:186218 Electrical Lie.: Suprv.Lie.: SILf J 9 5' specifically listed(%hr min) 00/hr
�/ ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:
Subtotal:
Print name `�'�'�,.\.l 13 �,-�' ate:12/1/22 O Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: A.--at� ,Oa d,49) TOTAL PERMIT FEE:
Ilia permit application expires if a permit is not obtained within 180
Print name:Katie Patterson Date:12/1/22 days after it has been accepted as complete.
* Number of inspections allowed per permit.
1:111uildinaermus\ELC PrnaitAppELR ERE.doe Rev 06/17/2015 440.4615T111/05/COM/WEB
Plumbing Permit Application
BuirdingFixtures RECEI FOR OFFICE USE ONLY
City of Tigard Received
1Ir 13125 SW Hall Blvd.,Tigard,OR 97223 ,IAN 2 2022 Date/By: Permy ;1- ;, .-00 0 i 7
l Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
_t ° Date/By: Other Permit No.:
Inspection Line: 503.639.4175 t"'l. ) e.a it„ y
T I G A R D ry bate Ready/By: Juris Vi See Page 2 for
Internet: www.tigard-or.gov UILDING DIVISl �hlotified/Method: Supplemental Information
" I4i7'
' .; TVP ''''O WORK
®New construction ❑Demolition For special information use checklist.
Description Qty. Ea. Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
l l SFR(I)bath 312.70
® 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
ElAccessory building 0 Multi-family SFR(3)bath 1 500.32 500.32
ID Master builderEach additional bath/kitchen 25.02
0 Other: Fire sprinkler sq.ft.) 2
p ( Page
* 16 # �. Site utilities:
Job site address: 9372 SW Longstaff Street Catch basin or area drain 18.76
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:Ash brook 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.: 121 Fixture or item:
Tax map/parcel no.: Backflow preventer 1 31.27 31.27
I `' 1 01 f Backwater valve 12.51
Clothes washer 1 25.02 25.02
Dishwasher 1 25.02 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
t . 4 .,.,. `, " e x r ry , Expansion tank 12.51
Name:ABVOZBP21 LLC Fixture/sewer cap 25.02
Address:1815 NW 169TH PLACE, SUITE 1040 Floor drain/floor sink/hub 25.02
Garbage disposal 1 25.02 25.02
City/State/ZIP:Beaverton, OR 97006 Hose bib
25.02 50.04
Phone ( Fax 12.51
( ) Ice maker 112.51
:,:;:, 7; , i :v1, 1 ''fi Interceptor/grease trap 25.02
Business name:ABVOZBP21 LLC Medical gas(value:$ ) Page 2
Contact name:Katie Patterson
Primer 12.51
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
�a Water closet 75.06
1? ;
3 25 02
�,.,;.. , :.. . ,,... . ...Y :. Water heater 1 37.52 37.52
Business name:Ed Mullen Plumbing
Water piping/DWV 56.29
Address:1601A SE River Road Other 25.02
City/State/ZIP:Hillsboro, OR 97123 Subtotal
Phone:(503 )572-4586 Fax:( ) Minimum permit fee: $72.50
CCB Lie.:92689 Plumbing Lie.no.: Plan review (25%of permit fee)
�LZ�� e,-
State surcharge(12%of permit fee)
Authorized signature: 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:/BuildingVPermits/PLMU-PermitApp_doe 10/01/09 440-4616T(I 0/02/COM/WEB)
Plumbing Permit Application - City of Tigard ,
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
i i :;Fee'lea) .. .TOI*1 ar* to e ` Permit Pile: .
�� tlll#�1+ g
Footing drain-1 t 100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer- 1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service- 1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52 Valuation: P 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
fi each additional$100.00 or fraction thereof,to
T l:`ee lit `ota#. :;
" > > }` 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
each additional$100.00 or fraction thereof.
(minimum charge-1/2 hour)
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*. , ' if 1' 'a .I i t flS
Qaantt by if*ttire"l ype .: Plan review is required for any of the following.
... ' �ai
Please check all that apply.
w� *ea " ❑ Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower engineer.
-Jacuzzi/Whirlpool ❑ New exterior plumbing site utilities for any complex structure
Car Wash: -Each Stall as defined in OAR918-780-0040.
-Drive Thru
❑ Medical gas and vacuum systems for health care facilities.
Cuspidor/Water Aspirator
❑ Any multipurpose fire sprinkler system.
Dishwasher: -Commercial ❑ Any complex structure as defined in OAR918-780-0040.
-Domestic
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2"
lit-3" o 1.... .., 1 ;
e. I r. €€
❑ Isometric or riser diagram is required for new buildings
-Car Wash Drain that meet the qualifications above.
Garbage -Domestic non-food
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -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 fees assessed for the sewer increase must be paid before the
Water Extractor
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
L\Building\Permits\PLMF PermitApp.doc 08/04/2011 2
City of Tigard
INCOMMUNITY DEVELOPMENT DEPARTMENT
S
Building Permit Review - Residential
TIGARD
Building Permit #: Q
Site Address: L1%12 S 1' L OI) cSTO .11/erified in Accela
Project Name: A 0,0k— V t S Lot/Unit #: Z.1
Proposal (include housing type): OW) C,\ (7k 3� Zone: f2 9
Required Site Plan Elements:
i copies of site plan on max 11x17"
X.Drawn to standard scale c(cco'. -S- ed trees, drip line/ tree protection
North arrow %Street and site trees shown / labeled
Site address, project name, lot # R Tahl_�alculating tree canopy at maturity
pPStreet names (N/A for SFR)
.6 Applicant name and phone # rectangle dimensioned (if applicable)
19 Lot and setback dimensions Vision clearance triangle
Et-Existing structures &square footage .l 1Utility locations &easements
Footprint of new structure and FFE %Property corner elevations
1:4Sidewalk/driveway dimensioned (>1,000 sf disturbance)
%Lot area and lot coverage percentage %Erosion control
Required Elevation Plan Elements:
(For SFR: calcs needed only on street-facing) ,'Garage doors dimensioned
, -Drawn to standard scale Su ary table with calculations for:
,1 uilding height dimensioned ,Jmotal façade area
eFacade dimensioned Total window and door area
Windows and doors dimensioned Total area
garage
Required Floor Plan Elements: ,0'cummary table that includes
%ach story dimensioned %Total floor area
iVEach story floor area calculated Floor area per story
Planning Review
rte91/1&
The following standards have been met: /, 4
Setbacks `Front: 1S Rear: tS Side: 3 Min/Max Street Side: C / .t� Garage:
II
Height %Max. Height: J s Proposed Height: u 1 .2 S
%Yes ❑ N/A Landscape (0 /• flu: b04*y
❑ Yes J /A Screening (Quad only)
'Yes 0 N/A °A) Window Coverage 11_ 0.
'Yes 0 N/A Garage (SFR Only)
Parking(Other Res)
Yes 0 N/A Entrance (SFR, Rowhouse, Quad only)
'Yes ❑ N/A Other building design standards (Rowhouse only)
❑ Yes 1 "N/A Accessory Structure Standards
❑ Yes'No Qualifying pre-existing unit exempt from standards (Cottage unit only)
Additional standards for Courtyard Units, Cottage Clusters, Rowhouses, and Quads:
j 'Yes 0 N/A Unit Count: 3
'Yes 0 N/A Lot Width and Size 18 �lQ.lc s\01/)
, Yes 0 N/A Pathway
dditional standards for Courtyard Units and Cottage Clusters only:
❑ ❑ N/A nit Area:
❑ Yes Floor Area (per story)
❑ Ye N/ Courtyard
❑ Y s ❑ N/A Fence
❑Yes 0 No /A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995)
es ❑ No ON/A Public Facilities Improvement (PFI) Permit:
Required: 4/Yes ❑ No
Applied For: ❑ Yes 0 No, stop intake
Re
fa-"Sensitive Lands: 0 Yes (No
ViLand Use Case #: rpvd--lo- Doo0Z Zonditions met prior permit issuance
Approved By Planning: 1 Date: / / V f/ Z3
Notes
Revision 1: ipproved ❑ Not Approved Date: 31_ //L3
Revision 2: ❑ Approved 0 Not Approved Date:
Building Permit Submittal
Original Submittal Date: `4.Z11/dZ3
Site Plans #:
3
Building Plans #:
Building Permit #: .p-Building permit # entered on page 1
Workflow Routing: -Planning ❑�.agineering ermit Coordinater-1 Building
Workflow Sign-off: e-ErSign-off for Planning (include notes from planning review)
Route Documents: p-Engineering: (1) copy of permit application, (1) site plan, (1) building plan
and original plan review routing form.
uilding: original permit application, site plans, building plans, engineer and
beam calculations and trust details, if applicable, etc.
Permit Technician: _ Date: / .Llh
Notes:
Engineering Review
Elope at building pad: .02'Lt3
,1:4--Ciinditions met prior to issuance of permit
0�-.Eassements (encroachments) per engineering conditions of approval and plat
Id'Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes
Assess Water Quantity Fee in-lieu: ❑ Yes o
LIDA Facility on lot: 0 Yes 0'No Add Fee: ❑ Yes ❑ No
final Plat Recorded
O NOT Approved: Date:
Notes:
Approved By Engineering; 14• r 1 S P.,�It Date: (,--Z. -2.07 $
Revision 1: Approved 0 Not Approved K.f/1S lerx Date: 4-I3-207-3
Revision 2: ❑ Approved ❑ Not Approved Date:
Permit Coordinator Review
,e.Conditions met prior to permit issuance
❑ Approved, NOT Released: Date notified applicant:
❑ ENG Revisions Required: Date notified applicant:
SDC Exemption: ❑ Applied for 0 Received 7-Does not apply
OSDC Fees Entered: Wash Co Trans Dev Tax: ,PI-Yes ❑ N/A
Tigard Trans SDC: Yes 0 N/A 0 Deferred
Parks SDC: .a-Yes ❑ N/A 0 Deferred
LIDA ❑ Yes /A
XOK to Issue/Approved by Permit Coordinator: Date: 1 23
Revision 1: /Approved ❑ Not Approved Date: 3 20 _
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 Letter
I r t,n Ei I) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: DATE RECEIVED:
DEPT: BUILDING DIVISION
FROM: lfMv.3 TuEz. RECEIVED
COMPANY: cj 4 t �.T 44 MAR 0 8 2023
PHONE: qi!, 32C-Cf340 BUILDING IG SION By._
EMAIL: ka'h e® sag eloui I RI U.e.' can
RE: q372 ? ) 14116STIAPF S'1. TiefiRt , °ri123 01?5120Z3 —QDD I i
(Site Address) (Permit Number)
rtS/t Ikt)1k t.LFIS LOT 21
(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.
i.. Other(explain):Mg us-rev 61,04+C. 5a.pr1.e 44 5l're qJ
REMARKS:
FO OFF CE USE ONLY
Routed to Permit Technic' : Date: L ( Li Zj Initials:
Fees Due: ❑Yes No Fee Desc 'ption: Amount ue:
$$$$ 7-
Special 1/ 1\° s
Instructions:
Reprint Permit(per PE): ❑ Yes No ❑ Done
Applicant Notified: Date: 3/i 40-3 Initials: /.
I:\Building\Foims\TransmittalLetter-Revisions_073120.doc