Permit (4) CITY OF TIGARD MASTER PERMIT
2 COMMUNITY DEVELOPMENT Permit#: MST2023-00116
Date Issued: 05/23/2023
T[ ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S108DC23000
Jurisdiction: Tigard
Site address: 15094 SW FLATCREEK LN
Subdivision: RIVER TERRACE CROSSING Lot: 95
Project: River Terrace Crossing, Lot 95
Project Description: New detached dwelling w/covered rear deck and stairs. NO FINAL INSPECTION UNTIL
DEFERRED SDC FEES HAVE BEEN PAID.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1419 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 24.5 Bathrooms: 3 Second: 1597 sf Garage: 432 sf Front: 12 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 3016 sf Value: $494,023.28 Rear: 10
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning:
Y Vent Fans: 6 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Vents:Furn<100K:
1 0 Woodstoves: 0 Gas Outlets: 4
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: 4 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Y
Other: N Other Description:
Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 3016
Owner: Contractor:
STONE BRIDGE HOMES NW LLC STONE BRIDGE HOMES NW LLC Required Items and Reports(Conditions)
4230 GALEWOOD ST#100 4230 GALEWOOD STREET#100 1 Ersn Cntrl 503-639-4175
LAKE OSWEGO,OR 97035 LAKE OSWEGO,OR 97035
PHONE PHONE: 503-387-7577
FAX: 503-387-7615
Total Fees: $26,698.14
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
Qri9-nn1-nnin thrn,Inhr AR Qc9-nnl-nn n n rn ti nhtain a rnnu of tha r,dale nr rtirart ni laetinne to(ll INC by Tallinn WI 919 1Q317 nr'I 914.4.
IA
Issued By: 0,4/V\ Permittee Signature: --IA
Call 503.639.4175 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 lob site at the time of each inspection.
Building Permit Application
Residential FOR OFFICE: l'SE O\I.\
City of Tigard R w lam•WED Date/By:
11111 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review y
■ Phone: 503.718.2439 Fax: 503.598.1960 MAR 3 0 2023 Date/By: / 3 P rt023
�y
Inspection Line: 503.639.4175 Date Ready/By: ^ ^�j 9 Juris: H See Page 2 for
VI Ci A R[� p Notified/Method:5 I a, LO L J �T Supplemental Information
Internet: www.tigard-or.gov + PP
ClTYOFTIGARD tRAl1.ED, '(IWI�W
BUILDING ON
TYPE OF WORK REQUIRED DATA:I-AND' ISHL BELLING
®New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
CATEGORY OF CONSTRUCTION Z�
B
Valuation: $ Lit ,
X❑ 1-and 2-family dwelling ❑Commercial/industrial
❑Accessory building ❑Multi-family Number of bedrooms: 5
❑Master builder ❑Other:
Number of bathrooms:
JOB:sITE,fHPOH*10,00H=AHHLOCATION ''.0 Total number of floors:2
Job site address:15094 SW Flatcreek Ln. New dwelling area:3,016 square feet IS Ci7
City/State/ZIP: Tigard, OR 97224 Garage/carport area: 432 square feet 1 cf /
Suite/bldg./apt.no.: Project name: River Terrace Crossing Front Covered porch area:60 square feet It
Cross street/directions to job site: Deck area: 2( square feet
��� l tap square feet
RF IJIRED DiNTAt COMAILERCIALAUSEGOECRIAST
Subdivision: River Terrace Crossing Lot no.:95 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
DESCRIPTION OF.WORK work indicated on this application.
New, single family residence Valuation: $
Would like to request SCD deferral Existing building area: square feet
New building area: square feet
r I -PROPERTY`OWNER 0 T1EN T Number of stories:
Name: Stone Bridge Homes NW, LLC Type of construction:
Address: 423-Galewood St. Suite#100 Occupancy groups:
City/State/ZIP: Lake Oswego, OR 97035 Existing:
Phone:(503)387-7577 Fax:( ) New:
It APPLICANT. 0 CONTACT`PERSON, .`` BUII,OMNGPERMIT iE *
Business name: Stone Bridge Homes NW, LLC (nee ritQ fee irk et
Structural plan review fee(or deposit):
Contact name: Permit Tech
FLS plan review fee(if applicable):
Address: 4230 Galewood St. Suite#100
City/State/ZIP: Lake Oswego, OR 97035 Total fees due upon application:
Amount received:
Phone:( 503) 387-7577 Fax::( )
E-mail: portlandpermits@stonebridgehomesnw.com PHOTOVOLTAIC.<SOLAR PANEL SYSTEM ES*
Commercial and residential prescriptive installation of
`CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: Stone Bridge Homes NW, LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 4230 Galewood St. Suite#100 Solar Installation Specialty Code checklist.
City/State/ZIP: Lake Oswego, OR 97035 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503)387-7577 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: 173318 Total fee due upon application: $201.60
Authorized si ature: This permit application expires if a permit is not obtained
�ifr�?ter. % i� within 180 days after it has been accepted as complete.
Print name: Tiana Rudolf Date: 3-30-2023 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist
•
One- and Two-Family Dwelling FOR OFFICE l SE Oyl.l
City Of Tigard Received
Permit No.: A •b \\\I
III - . 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
I I t i A R D
Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW \es No N/.‘
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 ❑ ❑
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 ❑ 0
3 Verification of approved plat/lot. 0 ❑ 0
4 Fire district approval required. Name of district: 0 ❑ 0
5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑
6 Sewer permit. 0 ❑ ❑
7 Water district approval. 0 ❑ 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ 0
9 Erosion control ❑plan 0 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 ❑X 0 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 ® ❑ 0
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, x❑ ❑ 0
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- ❑X 0 ❑
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 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 E 0 ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ 0 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 0 ❑ 0
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. ❑X ❑ ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required El 0 ❑
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 ❑X 0 0
architect licensed in Ore•on and shall be shown to be as.licable 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". 0 0 0
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 0 0 0
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 0 0 0
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 0 ❑
27 "Drawn to scale"indicates standard architect or engineer scale. 0 0 0
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ 0 0
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 ❑ ❑
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, 0 0 0
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(11/02/COM/WEB)
Plumbing Permit Application
Building Fixtures FOR OFFICE I SF oNLv
City of Tigard
Received Permit No.: J v\sNitt L `jly%. (1''�[
13125 SW Hall Blvd.,Tigard,OR 9 C E I of ED Date/By:
I Phone: 503.718.2439 Fax: 503.5 8. •P1 Plan Review
Date/By: Other Permit No.:
T I c; K D Inspection Line: 503.639.4175 MAR 3 0 13� Date Ready/By: lur s: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
1:: '3' F f �., r Fr '`�vd .' ie, --N /. f grd;�:- r,rre r ;:r r'f rXf`r-,;r ;.,,.'r rrr t f f ,
.:,: r rv' v�,� s r; .'r �,f S x tit,.,.,, A.' ,,�' ,F`r'!..,. ,�,{..y/i�<r ;rz/ r, � � t�'""��'��,'��f ?%"�` ,�'^�
ir,', Ar��''... .,rh ... _. p hs;. :oi6' "i,.,-A<tq ., *.o A,....,.. .rr�r,,..::�''"`�i n, .c` . „�. r.OW44;k;r..,.rs, .m;,.r ,,/u.as v,
®New construction DE4tatittqG DiViSION
For special information use checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement El Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
- N , 1 1 fi - / r ,r j/ r f r r f r r/',:r,ns �/ +c „I
r, /-. x � `''14� , t4Wit� SFR(1)bath 312.70
u'� .,,,,,f .;s'"„�.,,r, ..... .,,., r�, ,.,E. ,; � ., ,,�, ..,�, o �,f,.,r.�,� �u.,,�r,^',� taW
E1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 1 500.32
0 Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
/ ` ,' rF,,.r i11Lr r .,.. 1'g1r{ � Yar ! Sttlt
/ d /g / vi.r .;„e, ,.,£ .4 :/ ,4.xam J,!L„ ,w; '✓ Fi✓l 1e uiiies:
Job site address:15094 SW Flatcreek Ln. Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: Tigard, OR 97224
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name:River Terrace Crossing • 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: River Terrace Crossing Lot no.:95 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
r //a W/frji%,rlr ry r Backwater valve 12.51
«,.,. Sfifty M, ,,,,. ,/ .r,, ., x.,,,:mitalailiteNlinafatI Clothes washer 1 25.02
New, single family residence Dishwasher 1 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
Fit £ w r .fn, r . /z r 'f', f 'r`"r a '". , 11% �' >i anion tank 12.51
•,?0,1,'fi , 41 4', • ; ,, .O.N00r t bP a '71099 4',r Expansion
Name: Stone Bridge Homes NW, LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 4230 Galewood St. Suite#100 Garbage disposal 1 25.02
City/State/ZIP: Lake Oswego, OR 97035 Hose bib 2 25.02
Phone:(503)387-7577 Fax:( ) Ice maker 12.51
,� r r f , ,4rr Interceptor/grease trap 25.02
,,,r, ,,,.17,1 ,`,.,,,,�°',. . ,,, ,r,.. ,,,, „,3: ,: rr & 4 'r,E.,,zF.csr`. ,. .u,. , ;`,:,,.,.rl<,.f
Business name: Stone Bridge Homes NW, LLC Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: Permit Tech
Roof drain(commercial) 12.51
Address: 4230 Galewood St. Suite#100 Sink/basin/lavatory 7 25.02
City/State/ZIP: Lake Oswego, OR 97035 Solar units(potable water) 62.54
Phone:(503 )387-7577 Fax::( ) Tub/shower/shower pan 3 12.51
E-mail: portlandpermits@stonebridgehomesnw.com Urinal 3 25.02
1l / i f�'` r'r rr/P r/ fir/ . r / S rf*: Water closet 25.02
r 1 .. . /„';�,.,y` .�. ;d :410, .,.,.. .,. r r„,,� f r , £.,` 10 ./x ,,, , at Water heater 1 37.52
Business name: Edward Mullen Plumbing Water piping/DWV 56.29
Address: S. E. River Road Other: 25.02
City/State/ZIP: Hillsboro, OR 97113 Subtotal
Phone:( 503) 640-0113 Fax:( ) Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lic.:92689 Plumbing Lic.no.: 34-260PB
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name: JeremyCrace Date: 3-30-2023 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-PermitApp.doc 10/01/09 440-46 16T(1 0/02/COM/WEB)
Electrical Permit Application FOR OFFICE I SE()NI.)•
RECEIVED City of Tigard Date/Bed Ellialiiraaffi
111 • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Related Permit#:
pp nn nn
Inspection Line: 503.639.4175 �%i 17 �U�3 Date/B Ready Date/By: Juris: ® See Page 2 for
T I G A R D Internet: www.tigard-or.gov Notified/Method: Supplemental Information
Tfi'PE OF wo t 1 OF Tl1G �iv , - ';, . P ? REVIEW
❑ ❑ �1 � "^"�" Please check all that apply(submit 2 sets ofplans w/items
X New construction Addition/alterat en pp y checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
El Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
CATEGORY.Or CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
X❑ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds la,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
400 SITE INFORMATION AND j,OcATIO ❑Emergency system. larger separately derived
Job#:3262 Job site address:15094 SW Flatcreek Ln ❑Additioo of oew motor load of system.
100HP or more. ❑"A","E","1 2","1-3",
City/State/ZIP: Tigard, OR 97224 ❑Six or more residential units. occupancy.
0 Health-care facilities. ❑Recreational vehicle parks.
❑Hazardous locations. 0 Supply voltage for more than
Suite/bldg./apt.#: Project name: River Terrace Crossing 600 volts nominal.
❑Service or feeder 600 amps or more.
Cross street/directions to job site:
.',.',FEE',SCDFDI;,E.. :.
Description I Qty• 1 Each I Total I *
New residential single-or multi-family dwelling unit.
Subdivision:River Terrace Crossing Lot#:95 Includes attached garage.
1,000 sq.ft.or less 3 168.54 4
Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 1 33.92 1
Og,SCRIPTION OF=WORK Limited energy,residential
New, single family residence (with above sq.ft.) 75.00 2
Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
f Renewable Energy 0 See Page 2
oirto OWNER : , ,t ,L.TiEN�.; ,T,. Services or feeders installation,alteration,and/or relocation
Name: Stone Bridge Homes NW, LLC 200 amps or less 100.70 2
Address: 4230 Galewood St. Suite#100 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: Lake Oswego, OR 97035 601 amps to 1,000 amps 301.04 2
Phone:( 503) 387-7577 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: portlandpermits@stonebridgehomesnw.com relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
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
�� P �T ;co�vT P4N A.Fee for branch circuits with
Business name: Stone Bridge Homes NW, LLC above service or feeder fee, 7.42 2
each branch circuit
Contact name: Permit Tech B.Fee for branch circuits without
Address: 4230 Galewood St. Suite#100 service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP: Lake Oswego, OR 97035 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( 503)387-7577 Fax: :( ) Each manufactured or modular
67.84 2
dwelling,service and/or feeder
Email: portlandpermits@stonebridgehomesnw.com Reconnect only 67.84 2
CONTRACTOR , , , Pump or irrigation circle 67.84 2
Business name: Garner Electric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy 0 See Page 2 2
Address: 2920 SE Brookwood Ave. Suite A panel,alteration,or extension.
City/State/ZIP: Hillsboro, OR 97123 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
cr Phone:( 503)648-4552 Fax:( ) Investigation(1 hr min) 90.00/hr
�.. Email: chelsea@garnerelectric.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 2822501 Electrical Lic.:34-305C Suprv.Lic.:.S1 Q",S specifically listed(Y:hr min)
/ p E ,ECTIIFCAL PERMIT FEES
�?l,Suprv.Electrician signature,required: Oivp ez, cvLne c Subtotal:
Print name: Charles Garner Date: 3-30-2023 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
/ TOTAL PERMIT FEE:
/
Authorized signature: . riGyi�� . jliti/,(
This permit application expires if a permit is not obtained within 180
Print name: Tiana Rudolf Date:3-30-2023 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
a 1' q t rF
A ll y , 4. r �tio-%;rFgfr ,v ,
Fee for all residential s stems combined: $75.00 De Qty. Each Total
3' Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
x❑ Garage Door Opener* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
❑x Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
El Vacuum Systems* >100 kva-no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed('/A hr mm)
fF y y , f' !/ ' r ,T f ,�
TVA! A S ONtr ,ire;,,� Y yr?'.a* „fir` i.
.t.<_ .....,5�,.; ... f �,.F ,!.v�.., .. ,;. ^��/e`^'yx'sr.�
Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00
* Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
L\Building\Permits\ELCPermitApp_ELR_ERE.doc Rev 06/17/2015
Mechanical Permit Application. FOR OFFICE USE ONLY
City of TigardRECEIVED Date/Received Permit No.: MS1 ti a I
IIIII 13125 SW Hall Blvd.,Tigard,OR 97223 y
= Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 MARDate/By: Other Permit:
Inspection Line: 503.639.4175 2�23
TIGARD
p Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
CITY OF TIGARD
k' r"r 1 * % ' — r ' 4h� kI.'Vj'1 , .41.
`k l r ' � ' r „ >' idam f 1
„
Mechanical permit fees*are based on the value of the work
X❑New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition CI Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
I . r r, M f '�, I#"b} �P 5 441 f,, /r,r rs r r✓
❑X 1-and 2-family dwelling ❑Commercial/industrial CI Accessory building For special information use checklist.
O Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. I Total
's r r , s r Z . f kf Heating/cooling:
, - i „� ,. ,„„„ r ,r= r� ,., ,,, ,,,.,„ , r, 4 r �,e4;,, ,. Air conditioning
Job site address:1 5094 SW Flatcreek Ln. (requires site plan showing placement) 46.75
City/State/ZIP: Tigard, OR 97224 Furnace 100,000 BTU(ducts/vents) 1 46.75
Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: 1 Project name: River Terrace Crossing Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
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 1 23.32
Subdivision: River Terrace Crossing i Lot no.:95
Other: 23.32
Tax map/parcel no.: Other fuel appliances:
`r 'r Vr, r r r 8a�*4 1 .; . i ,.�M'' ,„,`rI" Water heater 1 23.32
New, single family residence Gas fireplace 1 33.39
Flue vent for water heater or gas
2
fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
FP.4,.).4IIF'`)„" • r r, r , 3: r.' 'y ,,rr r f r ' ' Chimney/liner/flue/vent 23.32
,, t'r ,fir' '„„,„,z rr;yry
A ., ,a ,,. • , ..�,.,, wu ,,: �� ..tr.: ,r ,.. ,r Other: 23.32
Name: Stone Bridge Homes NW, LLC Environmental exhaust and ventilation:
Address: 4230 Galewood St. Suite#100 Range hood/other kitchen 1
equipment 33.39
City/State/ZIP: Lake Oswego, OR 97035 Clothes dryer exhaust 1 33.39
Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 6
Phone:( 387-7577 Fax:( ) 23.32
w
f` % �r%,�� 2 �`rt Attic/crawlspace fans 23.32
Business name: Stone Bridge Homes NW, LLC Other: 23.32
Fuel piping:
Contact name: Permit Tech $14.15 for first four;$4.03 for each additional
Address: 4230 Galewood St. Suite#100 Furnace,etc. 1
Gas heat pump
City/State/ZIP: Lake Oswego, OR 97035 Wall/suspended/unit heater
Phone:(503) 387-7577 Fax: :( ) Water heater 1
Fireplace 1
E-mail: portlandpermits@stonebridgehomesnw.com Range 1
'rr r a rk fy ' �..,, rI AI l ° ? I sI,` , 3
Barbecue' 4 44 . '' ,- ,r , 2 xr,r f, I
Business name: Comfort Zone Clothes dryer(gas)
Other:
Address: 1032 NW Corportate Dr. rf��r� fcso c; 1 1 yl s ,,%0' r r
City/State/ZIP: Troutdale, OR 97060 Subtotal
Minimum permit fee($90.00)
Phone:( 503)667-5595 Fax:( ) Plan review(25%of permit fee)
CCB lic.: 110091 State surcharge(12%of permit fee)
TOTAL PERMIT FEE
t, ``" = '' This permit application expires if a permit is not obtained within 180
Authorized signature:
days after it has been accepted as complete.
Print name: David Heldstab Date: 3-30-2023 * Fee methodology set by Tri-County Building Industry Service Board
I:\Building\Permits\MEC-PermitApp.doc 09/09/10 440-4617T(I1/02/COM/WEB)
^•w-ere reiGvAi cote
l�J�v�
City of Tigard 1IVl21
b ' COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
TIGARD L /
Building Permit #: `�1A 7-o -..3 J 6- 001 L ,
Site Address: 0.011ESIX 1,44 /Verifiieed in Accela
Project Name: ssirNq Lot/Unit #: /S
`4 cro
Proposal: ,v' J Zone: �J-G
Housing Type: Ringle Detached 0 Duplex 0 Triplex 0 ADU)0 Rowhouse❑Cottage Cluster 0 CYU OQuad 0 Other
Required Site Plan Elements:
pi/3 copies of site plan on max 11x17"
XJ Drawn to standard scale ained trees, drip line/tree protection
North arrow 4 Street and site trees shown/ labeled
Ili-Site address, project name, lot # -R-T-ati calculating tree canopy at maturity
•❑ Street names (N/A for SFR)
,P'Applicant name and phone # ectangle dimensioned (if applicable)
grLot and setback dimensions ,1Vision clearance triangle
.2-Existing structures &square footage Utility locations &easements
pf-Footprint of new structure and FFE Property corner elevations
v ; - jZf LIDA (>1,000 sf disturbance)
71-Lot area and lot coverage percentage /i Erosion control
Required Elevation Plan Elements:
(For : calcs needed only on street-facing) Summary table with calculations for:
❑ Dra to standard scale 0 Total façade area
❑ Building • ht dimensione 0 Total window and door area
❑ Façade dimens
❑ Win doors di •oned
arage doors dimensioned
Required Floor Plan Elements:
(Not re • ed for SFR) Summar le that includes
❑ Each stor d ❑ oor area
❑ Ea ory floor area calculated Floor a story
Planning Review
The following standards have been met:
20
Setbacks Front: Ot' Rear: I° Side: 3 Min/Max Street Side: / Garage:
Height %Max. Height: {Aik� Proposed Height: 21` 5.- S
rYes ❑ N/A Landscape 9-07
❑ Yes B N/A Screening (Quad only)
❑ Yes, N/A % Window Coverage COK4froi
❑ Yes 9-N/A Garage (SFR Only) Parking (Other Res)(IA
❑ Yes,11fN/A Entrance (SFR, Rowhouse, Quad only) rIA
❑ Yes 21 N/A Other building design standards (Rowhouse only)
❑ Yesl'N/A Accessory Structure Standards
❑ Yes 6 No Qualifying pre-existing unit exempt from standards (Cottage unit only)
dditional standards for Courtyard Units, Cottage Clusters, Rowhouses,and Quads:
❑ es 0 N/A Unit Count:
❑ Y-. 0 N/A Lot Width and Size
❑ Yes a N Pathway
Additio I standards for Courtyard Units and Cottage Clusters only:
❑ Yes g N Unit Area:
❑ Ye- 0 N/A Floor Area (per story)
❑ Y•s 0 N/A -ourtyard
❑ -s 0 N/A Fence
O Yes 0 No gN/A Clean Water Services - Service Provider Letter(lot platted prior to 9/10/1995)
0 Yes 0 No 2f1/A Public Facilities Improvement (PFI) Permit:
Required: 0 Yes 0 No
Applied For: 0 Yes 0 No, stop intake
El Sensitive Lands: 0 Yes 0 No
0 Main Land Use Case #s: t _j (p-DOO\ o , W 0 "000QS 0 Conditions met
Applicant notified of land use expiration date:
Approved By Planning: Op-v-%----,.... Date: 3 (SO (2.3
Notes
Revision 1: ,(Approved 0 Not Approved 47— Date: Y I l Z`�
Revision 2: 0 Approved 0 Not Approved (/ Date:
Building Permit Submittal
Original Submittal Date: 3/3U/.7--_3
Site Plans #: 3
Building Plans #: I
Building Permit #: .- 1Building permit # entered on page 1
Workflow Routing: Manning .ingineering .a-Permit CoordinatoriGBuilding
Workflow Sign-off: -Cr ign-off for Planning (include notes from planning review)
Route Documents: LTEngineering: (1) copy of permit application, (1) site plan, (1) building plan
aj_i_d original plan review routing form.
❑ Building: on inal permit application, site plans, building plans, engineer and
b am c ulati s and tr t details, if pplicable, etc.Permit Technician: Date: 43 /J!j
0/23
Notes:
Engineering Review
O PFI Permit:
Slope at building pad: 2, '$ wo
4 ' Q 'Conditions met prior to issuance of permit
0/Easements (encroachments) per engineering conditions of approval and plat
'Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes frNo
Assess Water Quantity Fee in-lieu: 0 Yes gl'No
LIDA Facility on lot: 0 Yes LYNo Add Fee: 0 Yes ❑ No
:Anal Plat Recorded �x �? I_et
NOT Approved:Ct
}' ate: 1 t` -b Z
otes•
l' S�
Approved By Engineering: Date: 7 2 3
❑ roved Revision-0 Appo pproved \� i Date: �i'� j _...--/-Z--4)/HP
Revision\.:‘ approved 0 Not Approved; Date:
Permit Coordinator Review
/r Conditions met prior to permit issuance
❑ Approved, NOT Released: Date notified applicant:
❑ ENG Revisions Required: Date notified applicant:
?SDC Exemption: 0 Applied for 0 Received /Does not apply
/SDC Fees Entered: Wash Co Trans Dev Tax: /Yes 0 N/A
Tigard Trans SDC: es ❑ N/A /Deferred
Parks SDC: es 0 N/A /Deferred
LIDA Ffes N/A d(
/OK to Issue/Approved by Permit Coordinator: £i.I AA Date: 91n,,20 3
Revision 1: 0 Approved f Vot Approved rimards Date: L3- \7 2
Revision 1 Vpproved 0 Not Approved ' 7U 1 0,-( Date: ' 1--7,fii3
FOR OFFICE USE ONLY-SITE ADDRESS: \ 3 - SW T.\a /y '.•n •
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. c2
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT "J�2
III
_ Transmittal Letter
l ,c,A R n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: 'Via/Amyl DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVE
FROM: 11na old IPE ?cz?.
COMPANY: SkOne, Ucky, Aims (V1 LLG C TY OF
TIGARD
Buall G L ION
PHONE: 1n''�q -I
VA) BY
EMAIL: 4 j 1av nc Illd norniS 1W.0 m
RE: P3CY I SW ?iatrxe . Lin. itiSticn3-comp
Site Address) (Permit Number)
IWY text CitegbfA R!
(Project name or subdivision name and lot nber)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description Copies: Description: _ _E -ran -ibeteestic
..
Additional set(s) of plans. 3 Revisions: •f tor, a, atAi i.ti
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: '4b, %,In ittf bttiontd or loV -to lot Us grim utrektim
rivit loonaans• 4 ThT 3 unt1 a% sacwaaK lr, 10e01 nt irtOW4 ib
ctfan e)(ifi rit\ Co dit onS-no plays 10 to411rva.•Winow -trim V135 b8G7
addRd on left P1emahotn -cannot `*au itut•.
FOR co FICE USE ONLY
Routed to P t Technician: Date: y/
II o Z3 Initials: l '
Fees Due: Yes No Fee Descrl ti n: Amount Due:
❑ p
$ - c
fkth"_ ar Cs 1. $ "c , �qQ
$
Special
Instructions:
Reprint Permit(per PE): ❑Yes 12 No ❑ Done
Applicant Notified: N/ Date: 511112n23•[! A tin 4 PMPI• Initials: N
I:\Building\Forms\TransmittalLetter-Revisions_073120.doc