Permit (11) 44 CITY OF TIGARD MASTER PERMIT
"I ' '. COMMUNITY DEVELOPMENT
Permit#: MST2023-00400
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/13/2023
Parcel: 1 S 136AD00700
Jurisdiction: Tigard
Site address: 10470 SW 67TH AVE
Subdivision: VILLA RIDGE NO.2 Lot: 6
Project: AQUILA
Project Description: Bedroom conversion into master bathroom and master closet. Framing in(2)hallway doors and
windows and installing(2)new windows. Mechanical permit to be pulled Separately.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0
Parking Spaces: 0
Height: 0 Bathrooms: 1 Second: 0
sf Garage: 0 sf Front 0 Smoke
Dwelling Units: 0 Third: 0 sf
Right: 0 Detectors:
Total: 0 sf Value: $35,000.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 1 Washing Mach: 0 LaundryTrays: 0
Y Rain Drain: 0 Urinals: 0
Lavatories: 2 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Drains:
Storm Sewer 0 0
Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Bckflw Prevntr: 0 Catch Basins: 0
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 0
Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N
Y Garage Opener N All N
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB
R-3 0
Owner: Contractor:
SIMMON,S PATRICK A& GARDEN HOME INTERIORS Required Items and Reports(Conditions)
AQUILA,AMY C 8409 SW 57TH AVE
10470 SW 67TH AVE PORTLAND,OR 97219
TIGARD,OR 97223
PHONE: PHONE: 503-780-4010
FAX:
Total Fees: $1,097.63
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 yo to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
Qri9-nrN-nnln fhrni,nh• •- *y9-nni_nnon vnii m m r•nnv of thn nd>c nr diroM nine/inns fn nl!Mr by rallinn q 39 qI OR
// ��,, r ann
Issued By: (-1/,/li Permittee Signature:
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 job site at the time of each inspection.
Building Permit Application
d46
FOR OFFICE I:s>;ONLY
City of Tigard RECEIV■ wea �.r �� t ` v �/•ate By: / ✓ Permit No.: k,
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review Q
P AUG 15 202; Datc/B : r/ 7/Z'1j3 Other Permit:
T I i;;A Ft D Inspection Line: 503.639.4175 Date Ready/By: aril See Page 4 for
Internet: www tigard-or.gov Notified/Method: •7►"
CITY OF TIGA` Supplemental Information
.;,> ,. :�..�r: ..7, ...��a �..;� s. <... .s� a t �."�, 8 ; P r.n.,�'Rst £ s .Ea
Permit fees*are based on the value of the work performed.
0 New construction ❑Demolition
❑■ Addition/alteration/replacementIndicate the value(rounded to the nearest dollar)of all
" E p 0 Other:N/A equipment,materials,labor,overhead,and the profit for the
iii7i ° "' work indicated on this application.
El 1-and 2-family dwelling 0 Commercial/industrial Valuation: $35,000
❑Accessory building El Multi-familyNumber of bedrooms: ..� '
El Master builder ❑Other: Number of bathrooms:,< 4-
n.i �;� '"°' �` s t r t -, 1 Total number of floors: Main and basement
Job site address:10470 SW 67th Ave. New dwelling area: N/A square feet
City/State/ZIP:Tigard, Ore 97223 Garage/carport area: N/A square feet
Suite/bldg./apt.no.: Project name:Aquila q Covered porch area: N/A square feet
Cross street/directions to job site: Deck area: N/A square feet
trt17 C- v- 1-L-1" 1,1, LI -c. L 5124 t)nre i Other structure area: N/A square feet
Subdivision: * F,1 / 1 Lotno.: es* s the. "°"s'
t,.t�/3 ;,,Jz,". ��y- Permit fees are based on value of the work performed.
Tax map/parcel no R Indicate the value(rounded to the nearest dollar)of all
)J? equipment,materials,labor,overhead,and the profit for the
` :' work indicated on this application.
Change spare bedroom next to master bedroom into master Valuation: $
bath and master closet. Take out and fill in two hallway doors Existing building area: square feet
I ake out two existing windows an• install 2 ne, windows New building area: square feet
RiNkilingtrilr
.., j s t . . H n „ �� A t i Number of stories:
Name: all/1 , I1A r1 —
U I Type of construction:
Address: 18410 SW I011 k
lJ V Mt Occupancy groups:
City/State/ZIP: I`4p d ,Og- (1.11//
Existing:
Phone:( ) 0
Fax ( )
New:
Business name:Garden Home Interiors e""����� �, ,,,w ,J
Contactname:Bill Fletcher
Structural plan review fee(or deposit):
Address:8409 SW 57th Ave FLS plan review fee(if applicable):
City/State/ZIP:Portland, Oregon 97219 Total fees due upon application:
Phone:603-760-4010 Fax::( ) Amount received:
s n'"
BIII@gardenhomelnterlors com
7 w 0 pres
' ••,, NE„i roof-top mounted Phand ot Vol aic Solari Panel System.of
ve
on
� �'�"��' p o oVoltaic System.
Business name:Garden Home Interiors Submit two(2)sets of roof plan with connection details
Address:8409 SW 57th AVe and fire department access,along with the 2010 Oregon
Solar Installation Specialty Code checklist.
City/State/ZIP:Portland, Oregon 97219 Permit Fee(includes plan review
and administrative fees): $180.00
Phone:(503-7)80-4010 I Fax:( )
State surcharge(12%of permit fee): $21.60
CCB lic.:162912 _
Total fee due upon application: $201.60
� -- , - : 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
Print name:%`l` \2\ihl!I I Date:
Service Board.
l:\Building\Permits\BUP-RESPermitApp.doc 01/25/2023 440-4613T(1 I/02/COM/WEB)
Plumbing Permit Application
Building Fixtures
City of Tigard RECEIVE ceived �r it�14. 60
. 13125 SW Hall Blvd.,Tigard,OR 97223
ate/By: Permit No.: \v OOA
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 AUG15 2023 Date/By: Other Permit No.:
Inspection Line: 503.639.4175y y. ® See Page 2 for
T I G A K D Date Read/B Juris:
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK CITY 01-TIGAH 1) FEE* SCHEDULE
❑New construction 0 DemolitionBUILDING DIVISION For specs!•information use checkli•st
Description Qty. I Ea. I Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: /0''72 �j . . t 7-f'i� !n Catch basin or area drain 18.76
6J /(.(J �,LJ� Drywell,leach line,or trench drain 18.76
City/State/ZIP: 7 Z Z-.5
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
ill
a Rain drain connector 18.76
S.- Sanitary sewer(no.linear ft.: ) Page 2
QStorm sewer(no.linear ft.: ) Page 2
c. Water service(no.linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
:11%/10 ^ �'� / 4-C ,A Clothes
shwa washerher 25.02
f �''--, y_ C/ Dishwasher 25.02
l 1-e?"L 4 /.. 2.fr- \-- Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER f 0 TENANT Expansion tank 12.51
K' Name: Fixture/sewer cap 25.02
v Address: ,
Floor drain/floor sink/hub 25.02
\) Garbage disposal 25.02
Q City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker
12.51
` 0 APPLICANT CONTACT PERSON Interceptor/grease trap 25.02
�j Business name: Medical gas(value:$ ) Page 2
r'�' Primer 12.51
;'\,, Contact name: C3
-a^ Roof drain(commercial) 12.51
pQ Address: /�
/VVV /11 ��� �' Sink/basin/lavatory „et 25.02
City/State/ZIP: LQi2 / 7,2 ! GJ Solar units(potable water) 62.54
Phone:()'t ) '7 , '1 ^ / Fax: : / �( Tub/shower/shower pan I 12.51
E-mail: J3 �NI.
( fJo y�Unal 25.02
t/rG.s-�` U �C�'�C�( 1"`^ G?,/ _ -k`i�`'.� ; ni�Nlater closet
25.02
CONTRACTOR
Business name: f Water heater 37.52
*�(�'11l� l-��q�� I-'tom Waterpiping/DWV 56.29
Address: Ax(,i �' �'� h ��� V Other: 25.02
City/State/ZIP: eon\ \\ekt,1 pg. Q16S\ Subtotal
Phone:( tIS) 3\1 ti3S1 4,1�ii 1 5 Fax:( ) Minimum permit fee: $72.50
I J i^1� Plan review (25%of permit fee)
CCB Lic.: t _g Z / % W V Plumbing Lic.no.: P Wig\
!A
y�-;G r 1 t r- State surcharge(12%of permit fee)
Authorized signature: ���L/G/1�// /_� t W TOTAL PERMIT FEE
Print name: ]? tj 1 �' %��-�j 11 p Y Date: ! l g This permit application expires if a permit is not obtained within 180 days
f/ I i C-_Y! l ,r1 7 after it has been accepted as complete.
JJ *Fee methodology set by Tri-County Building Industry Service Board.
(:\Building\Permits\PLMU-PermitApp.doc 10/01/09 4404616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total
Square Footage: Permit Fee:
Footing drain-Pt 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: Permit Fee:
Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
Other Inspections or Fees 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*. Plan Review for Plumbing Installations
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate
❑ 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 0 New exterior plumbing site utilities for any complex structure
Car Wash: -Each Stall as defined in OAR918-780-0040.
-Drive Thru
0 Medical gas and vacuum systems for health care facilities.
Cuspidor/Water Aspirator Dishwasher: -Commercial 0 Any multipurpose fire sprinkler system.
mer ❑ Any complex structure as defined in OAR918-780-0040.
-Domestic
Drinking Fountain Submit 2 sets of plans with any of the above.
Eye Wash
Floor Drain/sink: -2"
3" Isometric or Riser Diagram
4" 0 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: -LavBar non-food related
-Bradley
-Com/Serv/Util food related
-Service *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and
Washer-Clothes fees assessed for the sewer increase must be paid before the
Water Extractor plumbing permit can be issued.
Water Closet-Toilet
Urinal
Other Fixtures:
I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2
9/5/2023 Mail-Anna Pina-Outlook
Re: Plumber Information For MST2023-00400 - 10470 SW 67th Ave
bill gardenhomeinteriors.com <bill@gardenhomeinteriors.com>
Thu 8/31/2023 3:34 PM
To:Anna Pina <anna.pina@tigard-or.gov>
David Loggins plumber
PB660
JP4890
CCB 185629
Let me know if you need anything else, thanks Bil
From:Anna Pina <anna.pina@tigard-or.gov>
Sent:Thursday,August 31, 2023 10:42 AM
To: bill gardenhomeinteriors.com<bill@gardenhomeinteriors.com>
Subject: Plumber Information For MST2023-00400- 10470 SW 67th Ave
Good morning Bill,
I am working on the permit, MST2023-00400 for 10470 SW 67th Ave, and noticed that a plumber is not listed on
the plumbing application. Does Garden Home Interiors have a plumbing license?Will a plumber be subcontracted
for this work? If so, can you please provide the name and the license number? I will be able to make this permit
"ready to issue" as soon as this information is received.
Thank you!
Anna Pina, She/Her
City of Tigard
Bilingual Permit Tech. Asst. I Hablo Espanol
Email: anna.pina@tigard-or.gov
13125 SW Hall Boulevard
Tigard,OR 97223
DIVERSE
■INCLUSIVE
1111 WELCOMING
TiunRu SAFE SPACE
w FOR EVERYONE
DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-
mail may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are
retained by the City of Tigard in compliance with the Oregon Administrative Rules "City General Records Retention
Schedule."
https://outlook.office365.com/mail/inbox/id/AAQkAGJmYmRjNjJhLWNIOWMtNGFIOS1 hNDhiLTg1 MGl5ZjZmOTdmNAAQAPSBzNMraHxBi3vOfoHBpyk... 1/1
Water Meter Fixture Unit Worksheet for Additions/Remot4 f/,�D
Please complete the following information:
1 Ails 15 2023
.
Customer Name: t .,% � A , L
L f ?r
- r �. L ...
DINS DIV�S�i 1.1
Service Address: Street/Suite W. �"c� •1 ,f�.. �„�t... -...ter
_ - . State j:�4.,., Zip: yt 2.
Email: .. ir.
Phone Number: �--
Please fill in the number of each fixture you currently have. Please fill in the number ofr fixtures yyou prto pos e o e to add.
Multiply the quantity by the point value to arrive at the current Multiply the
tuts ti o
ty by point
total. the
Fixture Unit Current Point Current Proposed Point Proposed
Quantity Value Total Addition Value Total
= x 1 =
x 1
Bar sink
Bidet — — x 1 = x 1 =
-- _
� = r: x 4 =
Clothes washer x 4
_ —
Dishwasher 1 x 1.5 j.5 x 1.5 =
-
1'�Outside Water Spigot / x 2.5 = a.s x 1.
2.5 _
_..Water Spigot,each add'I / x 1 = 1 x I =
Kitchen sink / x 1.5 = ! ,,S - 1.5 =
Laundry sink x 1.5 = x
1 --
Lavatory(bathroom sink) x 1 — X 1 =
1
.— — �"
Water closet,1.6 GPF(toilet) / x 2.5 = 2-, x 2.5 = .1 1 x 4 =
Bathtub/whirlpool x 4 = _
� . x 2 -
/ =
Shower stall x 2 _ ____ x 24 =
Bath/shower combox 41,1__
Current Points: I g Proposed Increase: 5-3. -
Current Points+Proposed Increase= . .--3`› =New Total Points =Required Meter Size fr
Meter Sizes: 1 to 30 points=5/8" 30.5 to 37 points=3/a" 37.5 and over points= 1"
New Meter Size Needed for New Total Points: Cost: $ (see page 1)
Current Meter Size per Utility Billing: Cost: $__. —(see page 1)
New Meter Size Cost minus Current Meter Size Cost= $
(This is Your Cost to Increase Meter Size Due to Additional Fixture Units)
*************************************************************************************
FOR OFFICE USE ONLY DB 8/21/23
Current Meter Size Confirmed with UB
Signature of UB Representative Date
Page 2
1:/Buildtng/Forms/WaterMeters 070121_Add.docx