Permit CITY OF TIGARD MASTER PERMIT'IIa . COMMUNITY DEVELOPMENT Permit#: MST2023-00306
Date Issued: 11/20/2023
T I 6 A R 1) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S106DC20900
Jurisdiction: Tigard
Site address: 13904 SW 172ND AVE
Subdivision: RIVERSIDE AT SCHOLLS MEADOW Lot: 47
Project: Riverside at Scholls Meadow,Lot 47
Project Description: New detached dwelling.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 1006 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 23 Bathrooms: 3 Second: 1286 sf Garage: 390 sf Front: 8 Smoke
Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 2292 sf Value: $409,539.24 Rear: 10
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: 3 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: 0
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 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 2292
Owner: Contractor:
RIVERSIDE HOMES LLC RIVERSIDE HOMES LLC Required Items and Reports(Conditions)
15350 SW SEQUOIA PKWY STE 320 17933 NW EVERGREEN PKWY 370 1 (2)layers of 2x fire blocking
PORTLAND,OR 97224 BEAVERTON,OR 97006 at area indicated
2 Ersn Cntrl 503-639-4175
PHONE: PHONE: 503-645-0986
FAX: 503-690-2942
Total Fees: $49,793.63
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. ATTENT : Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
oc/_M1_nR1n thrni i flA QF9_nn1_nnon a,nhtain a rnnv of the n elec nr dirart nnactinnc to(N intr.by Tallinn'A'i 49,1/Q�,$7 nr/1 An 119 94dd /�/ n
Issued By: //J1,1r/ Permittee Signature: �?tt'""I /l (5��
Call 503.639.4175keptin by nsp a.m.for the next available inspection dat ` t r-el/C �/� ei y' L
This permit card shall be kept a conspicuous place on the job site until complet pro a (~—f' //
Approved plans are required on the job site at the time of each inspection.
• Building Permit Application
Residential FOR OFFICE USE ONLY
City Of Tigard Received DDate/By: 7 v W •'/1 tn�! �c`'43 Permit No.: �j ];�
_( 3.0 .
:14
\ 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review / /�
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: L Z� Other Permit:S���1;Q\ W i
I t c A I:I) Inspection Line: 503.639.4175 Date Ready/By: n )anrm: ® See Page 2 fa.Internet: www.tigard-or.gov Notified/Method:g 17,S 1'v •I1,. 11/4 Supplemental Information
g yEu • .A .l. • �. ' L1 i1 - 1A I
lY" 'tblita ;:, '"`,, t`' $ +-4,, 6 ,I't•e .3u.; .. �„s .r 1'. ►,'',ftj t,,. 1 r}M'I■$ r t,,'i�,ft :l Gas .
8 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
4 rs. '',,!J.,. a. Ord 1,.. om �
` .t � 4 r kiwi v rr�.v work indicated on this application.
,,„„,,qqaa,,,,
Valuation: $ a q
01-and 2-family dwelling El Commercial/industrial b- I I 1 '
ElAccessory building El Multi-familyNumber of bedrooms: 4
0 Master builder El Other: Number of bathrooms:,2.g�3
.xkt ; .0 •s -, m n .: � � Total number of floors: 2 (i�S i
Job site address: 13904 SW 172nd Ave New dwelling area: 2292 square feet 'Lgb
City/State/ZIP: Tigard/OR/97140 Garage/carport area: 390 square feet (66(e
Suite/bldg./apt.no.: Project name: Riverside at Scholls Meadow Covered porch area: square feet
Cross street/directions to job site: Roy Rogers&Jean Louise Rd Deck area: square feet
Other structure area: square feet
- 11 E F 70 b a a F,r' -., x
Subdivision: Riverside at Scholls Meadow Lot no.: 47 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: WCTM 2S106DC21000 Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
� r o�..* . x ` pp:5 work indicated on this application.
Construction of single family detached residence Valuation: $
Existing building area: square feet
New building area: square feet
✓ -" Number of stories:
Name: Riverside Homes Type of construction:
Address: 15350 SW Sequoia Pkwy, Suite 320 Occupancy
p y groups:
City/State/ZIP: Portland, OR 97224 Existing:
Phone:(971) 371-1310 Fax:( ) New:
' tzt'd�P,i : t :#,
Business name: Riverside Homes Structural plan review fee(or deposit):
Contact name: Jennifer Doty
FLS plan review fee(if applicable):
Address: 15350 SW Sequoia Pkwy, Suite 320
Total fees due upon application:
City/State/ZIP: Portland, OR 97224
Phone:(971 ) 371-1310 Fax::( ) Amount received:
E-mail: jdoty@riversidehome.com i 3,., .. 5 ,
,7 ";.; v p , Ffi, • Commercial and residential prescriptive installation of
L. -" ..$1 . .i ,.. .,.,.. ; 'Ar.". 01z. ,;„. ,, ,f :i:, roof-top mounted PhotoVoltaic Solar Panel System.
Business name: Riverside Homes Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 15350 SW Sequoia Pkwy, Suite 320 Solar Installation Specialty Code checklist.
City/State/ZIP: Portland, OR 97224 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(971) 371-1310 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.: 189148 Total fee due upon application: $201.60
Authorized signature: _ This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Jennifer Doty Date: 2/6/23 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPemiitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist
•
One- and Two-Family Dwelling FOR OFFICE I SF O\1.1"
City of Tigard Received711 Permit No.:
DateBy:
13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
C Phone: 503.718.2439 Fax:`503.598.1960
I13,.AkD
24-Hour Inspection Line: 503.639.4175 El Electrical 13 Plumbing 0 Mechanical
Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW l es No 1/.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. ® 0 0
3 Verification of approved plat/lot. El 0 0
4 Fire district approval required. Name of district: Tualtin Valley Fire&Rescue El 0
5 Septic system permit or authorization for remodel. Existing system capacity . 0 0 10
6 Sewer permit. ® 0 0
7 Water district approval. ® 0 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. ® 0 0
9 Erosion control El plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- ® 0 0
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ® 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 0
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ® 0 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- ® 0 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 IN 0 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. ® 0 0
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ® 0 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 El 0 0
architect licensed in Ore•on and shall be shown to be a.slicable 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
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ® 0 ❑
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. 0 ❑ /�
27 "Drawn to scale"indicates standard architect or engineer scale. ❑ 0 0
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard El ❑
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 ❑ ER
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
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)
Mechanical Permit Application FOR OFFI( F FSF O\I.\
City of Tigard Received
Date/By: Permit No.: ag ? - - '..�
ii 13125 SW Hall Blvd.,Tigard,OR 97221
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
T l G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
r f , A:''':'„:
. :r.. *1 av1 `;' _.
Mechanical permit fees*are based on the value of the work
✓❑New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition D Other: mechanical materials,equipment,labor,overhead,and profit.
x x r t Value
t":.r�`21 4 :+' .: �k.4t , ,-�- eM * '§ i ., a-•°'.' ' r . , ,':�; "
�p M�
El1-and 2-family dwelling ElCommercial/industrial X
❑Accessory building k ik For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
E.,%.,,a", q � %. a a f . ,- �'� Heating/cooling:
.. I, A '� .,� 0* �.' - Air conditioning 1 46.75 46.75
Job site address: 13904 SW 172nd Ave Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75
City/State/ZIP: Tigard/OR/97140 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: Riverside at Scholls Meadow Duct work 23.32
Cross street/directions to job site: Roy Rogers&Jean Louise Rd 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
Other: 23.32
Subdivision: Riverside at Scholls Meadow I Lot no.: 47
Other fuel appliances:
Tax map/parcel no.: WCTM 2S106DC21000 Water heater 1 23.32 23.32
a ,v; : `ti.` $t::`1*a < i '` Gas fireplace/insert 1 33.39 33.39
''` K ' "m' `''" ''`" `'' " '"" ''1' S'' Flue vent for water heater or gas
Construction of single family detached residence fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert _ 23.32
Chimney/liner/flue/vent 23.32
23.32
` Environmental exhaust and ventilation:
Name: Riverside Homes Range hood/other kitchen
15350 SW Sequoia Pkwy, Suite 320 equipmentd 1 33.39 33.39
Address: Clothes dryer exhaust 1 33.39 33.39
City/State/ZIP: Portland, OR 97224 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 5 23.32 116.6
Phone:(971 y)371-1310 Fax:( ) Attic/crawlspace fans 23.32
F •. Lt ` .r s. a'e `a s G : 1 Other: 23.32
Fuel piping:
Business name: Riverside Homes
$14.15 for first four;$4.03 for each additional
Contact name: Jennifer Doty Furnace,etc. 1
Address: 15350 SW Sequoia Pkwy, Suite 320 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Portland, OR 97224 Water heater 1
Phone:(971 )371-1310 Fax::( ) Fireplace 1
Range 1
E-mail: jdoty@riversidehome.com Barbecue
° ,IYf - ¢yp Clothes dryer(gas)
-_. a..`-. _,X,s,..v:�t ., _ e a,A. x4,aM' ..1;, ... ,. .44. ',
Business name: Proheating & Cooling Other
Address: 2123 NE Aloclek Dr, Suite 1209 Wiz.. Subtotal
City/State/ZIP: Hillsboro/OR//97124 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( 971)205-4989 Fax:( ) State surcharge(12%of permit fee)
CCB lie.: 209001 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: [%z{ � * Fee methodology set by Tri-County Building Industry Service Board
Print name: Jennifer Doty / Date: 2/6/23
I:\Building\Permits1MEC_PemutApp_040113.doc 440-461TT(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Famil 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_040113.doc 2
Electrical Permit Application FoR orrice.: usi:()NIA
City of Tigard Received
lig - q 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#:
Inspection Line: 503.639.4175 Ready Date/By: Awls: ® See Page 2 for
I I C,A R D Internet: www.ti and-or. ov Notified/Method:
S g Supplemental Information
3 t. '
0 New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition 0 Other: where the available fault current ❑Marinas and boatyards.
t 1,,,* ,y,; r f ' qi ` # Q 1I�' ri exceeds 1 Q000 amps at 150 volts or ❑Floating buildings.
1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building Less to ground,or exceeds la,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi family 0 Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
r
Job#: F Job site address:ii :., g ,s- 'i'-p+!* t a s _ ❑Emergency system. larger separately derived
13904 SW 172nd Ave ❑Addition of new motor load of system.
100HP or more. ❑"A","E","1-2","1-3",
❑Six or more residential units. occupancy.
City/State/ZIP: Tigard/OR/97140 0 Recreational vehicle parks.
❑Health-care facilities.
Suite/bldg./apt.#: I Project name: Riverside at Scholls Meadow ❑Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: Roy Rogers&Jean Louise Rd oi i tt -.
Description Qty. Each Total *
New residential single-or multi-family dwelling unit.
Subdivision: Riverside at Scholls Meadow Lot#: 47 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: WCTM 2S106DC21000
a Ea.add'l 500 sq.ft.or portion 33.92 1
.'' ..r t.. lr #a.,`iO. .i.; e'i.;bit ".'..,�,. u uwr v
1, o. , ,.as. Limited energy,residential 75.00 2
Construction of single family detached residence (with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
f u e„ , „. Renewable Energy El See Page 2
' ' 'P
✓ ' r.i �
' � %mot t r " 14' t h''' Services or feeders installation,alteration,and/or relocation
Name: Riverside Homes 200 amps or less 100.70 2
Address: 15350 SW Sequoia Pkwy, Suite 320 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: Portland, OR 97224 601 amps to 1,000 amps 301.04 2
Phone:(971 ) 371-1310 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:
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
{
.. _ % .,. '' �� 1 .,t .,.�. I'-t.,.r ;LJ :40! �t" _ A.Fee for branch circuits with
Business name: Riverside Homes above service or feeder fee, 7.42 2
each branch circuit
Contact name: Jennifer Doty B.Fee for branch circuits without
Address: 15350 SW Sequoia Pkwy, Suite 320 service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP: Portland, OR 97224 Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(971 ) 371-1310 Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: jdoty@riversidehome.com Reconnect only 67.84 2
C'O R y w ' t, = g . Pump or irrigation circle 67.84 2
Business name: Sunlight Electric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address: 2804 NE 65th Ave, Ste. D panel,alteration,or extension. ❑ See Page 2 2
City/State/ZIP: Each additional inspection over allowable in any of the above
y Vancouver/WA/9866I Additional inspection(1 hr min) 66.25/hr
Phone:(360) 518-7589 Fax:( ) Investigation(I hr min) 90.00/hr
Email: yegor@sunlightelectricinc.com Industrial plant(lhrmin) 78.18/hr
Inspections for which no fee is
specifically listed('h hr mm) 90.00/hr
CCB Lic.: 172549 Electrical Lic.: C230 Suprv.Lic.: 6652S F ,
10/01/25 °`-t t a'n.. —,RIC*. ',t)KE>rrS.
Suprv.Electrician signature,required: Exp Subtotal:
Print name: Sunlight Electric Date: 2/6/23 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
r
Authorized signature: -_.- -.- TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Jennifer Doty Date: 2/6/23 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(t 1/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
DescriptionEach Total
Fee for all residential systems combined: $75.00 I Qty.
�' 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
❑ Garage Door Opener* >100 v kv kva 552.26 2
a(fee in accordance 552.26 2
with OAR 918-309-0040)
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
❑ 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
wfically ltsted(%hr min t ! kY
,
nter
o
Fee for each commercial system: $75.00 Subtotal pe perm t. Page 1):
3' * 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
h\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015
Plumbing Permit Application
Building Fixtures Foiz oFFRI. t SE ONl.I
City of Tigard Received
Date/B Permit No.:
IIN 111 13125 SW Hall Blvd.,Tigard,OR 97223 y j
li Date/By:
Phone: 503.718.2439 Fax: 503.598.1960 an Review Other Permit No.:
D
T t C;A R D Inspection Line: 503.639.4175 Ju Date Ready/By: ris: 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
.,.+ F S "Air :'r1 _ ~" ~olF .,4 a �b�^t1.I.l, 1 "'..ca ,..' a ¢{- >Ir x i " K3f1 " $ y
x
✓ For special information use checklist CI construction Demolition P
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
w rT
SFR(1)bath
,'' f;t,+' ,s... -ix� aPa= . r..r=� sue f 437.78.70
✓ 1-and 2-familydwellingSFR(2)bath
❑ 0 Commercial/industrial
SFR(3)bath 1 500.32 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other:
Fire sprinkler( sq.ft.) Page 2
.. � w� x �... � � � �' � Site utilities:
Job site address: 13904 SW 172nd Ave Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: Tigard/OR/97140
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name: Riverside at Scholls Meadow Manufactured home utilities 50.03
Cross street/directions to job site: Roy Rogers&Jean Louise Rd Manholes 18.76
Rain drain connector 1 18.76 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: Riverside at Scholls Meadow I Lot no.: 47 Fixture or item:
Tax map/parcel no.: WCTM 2S 106DC21000 Backflow preventer 31.27
x 1,,e , q : Backwater valve 12.51
"' ' '" Clothes washer 1 25.02 25.02
Construction of single family detached residence
Dishwasher 1 25.02 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
' ✓ '*_ ., r t�` 4 � :1 r � � , Expansion tank 12.51
Fixture/sewer cap 25.02
Name: Riverside Homes
Floor drain/floor sink/hub 25.02
Address: 15350 SW Sequoia Pkwy, Suite 320 Garbage disposal 1 25.02 25.02
City/State/ZIP: Portland, OR 97224 Hose bib 2 25.02 50.04
Phone:(971 ) 371-1310 Fax:( ) Ice maker 1 ` 12.51 12.51
� :1 ^A i "Y s 'A't ] 1 x r Interceptor/grease trap 25.02
Business name: Riverside Homes Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: Jennifer Doty
Roof drain(commercial) 12.51
Address: 15350 SW Sequoia Pkwy, Suite 320 Sink/basin/lavatory 6 25.02 150.12
City/State/ZIP: Portland, OR 97224 Solar units(potable water) 62.54
Phone:(971 ) 371-1310 Fax::( ) Tub/shower/shower pan 3 12.51 37.53
E-mail: jdoty@riversidehome.com Urinal 25.02
r 7 Croy Water closet 3 • 25.02 75.06
Water heater 1 37.52 37.52
Business name: H & H Mechanical Water piping/DWV 56.29
Address: 5757 SE Willow Ln Other: 25.02
City/State/ZIP: Milwaukie/OR/97267 Subtotal
Phone:(503)975-9787 Fax:( ) Minimum permit fee: $72.50
CCB Lie.:178122 Plumbing Lie.no.: PB414 Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name: Jennifer Doty Date: 2/6/23 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 10/01/09 440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: tv Residential Fire Suppression S stems:
1 $e g r. v ,.f.mob !B d 0 b . x.. .` f ,pa d'„ x�.,S ,.�+"'.`
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
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 S stems:
Water Service-each additional 100' 37.52 w' ;
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
r } each additional$100.00 or fraction thereof,to
t . 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*.
• " fir.e ter,. + ,. ., a✓., y t`§r]q dk
Onanti y by Fi ture �
Fixture a for Plan review is required for any of the following.
Work
P
ram' "It‘ Added t Please check all that apply.
Baptistry/Font
Bath Tub/Shower El Any new commercial building with water service 2"and
-Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
-3"
its
Car Wash Drain „. .
ElGarbage Domestic-non-food Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lay -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet • fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
C:\Users\npruett\Downloads\PLMF_PermitApp.doc 2
Z /`"4 IaL k`"`v Building Division
G
z,fan, t One & Two-Family Dwelling
TIGARD
Fees Checklist
PERMIT INFORMATION: Application Date -FEE VERSION ill(d 2-02-a
(
Permit#: S T ezci23— '3aC0 Plan #: ZZQj Z Floors: a
Valuation: - , i ��� Covered Porch: ---.. Basement
Bedrooms: 3 Deck: 1st Floor I bb
WC (toilets) 3 Deck Cover: - - 2nd Floor I2O
Lavatories Patio Cover — - 3'Floor
Tub/shower Accessory Struct. - R-3 Total 7 9
Laundry Tray — Water Heater l Ga Elec Garage 39 O
Exhaust Vents S Gas Flue Vents - Total for Elec. 2(42 Z.
Backflow Prey. o ..1�i'� ilIP' Heat Pump dia0110 # for Electrical Li
BBQ Gas Fireplace \f c_ #Fuel Lines (.`
FEES: Description: Fee Appiie : ;. Fee Entered:
DC Prov Revw: Planning ,.
Info Proc/Aich: Lg$2.00 (over 11x17) I(4
Info Proc/Arch: Sm$.50 (up to 11x17) ( ' ,
Metro CET: Residentia Use
School CET: District: 1c ,--,--C?
Tigard CET: Admin L '
Tigard CET: ODHCS f
Tigard CET: AH
Electrical Permit: Permit Fee: L '
Limited Energy:
12% State Surcharge ✓
Mech. Permit: Permit Fee:
12% State Surcharge t.
Plumbing Permit: Permit Fee: t.
12%State Surcharge , /,
Erosion Control: w/Permit-Ping �� /
Notes:
•
I:\Building\Forms\ResPlanCheckFees_Dec2022_AA.doc 12/21/22
Page 1
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
TIGARD
Building Permit #: (►'157' ( 3 c,:.%3 Q(
Site Address: 13904 SW 172nd Ave Verified in Accela
Project Name: Riverside at Scholls Meadow Lot/Unit #: 47
Proposal: New Single Detached SFR Zone: RES-C/RES-E
Housing Type: I$[SFR(J81 Single Detached 0 Duplex❑Triplex 0 ADU)0 Rowhouse❑Cottage Cluster 0 CYU❑Quad❑Other
Required Site Plan Elements:
ig 3 copies of site plan on max 11x17"
181 Drawn to standard scale
Cii(North arrow Street and site trees shown/ labeled
I$(Site address, project name, lot #
N Street names (N/A for SFR)
14 Applicant name and phone # 0 Colas l,e.J
ISI Lot and setback dimensions
❑ ....t...—Q..,....., f.,,,l IS(Utility locations &easements
ji4 Footprint of new structure and FFE N Property corner elevations
M Sidewalk/driveway dimensioned ® LIDA (>1,000 sf disturbance)
Lot area and lot coverage percentage ® Erosion control
Required Elevation Plan Elements:
(For SFR: calcs needed only on street-facing) Summary table with calculations for:
14 Drawn to standard scale 0 Total façade area
1l Building height dimensioned 0 Total window and door area
O Façade dimensioned
O Windows and doors dimensioned
®Garage doors dimensioned
Requir Elements:
(Not required for SFR) 0 Summary table that includes
❑ Each story dimensioned oor area
❑ Each story floor area calculated ❑ Floor area pe
Planning Review
The following standards have been met:
Setbacks 0 Front: 8' Rear: 10' Side: 3' Min/Max Street Side: 8' / Garage: 20'
Height ® Max. Height: 35' Proposed Height: 22' 3"
®Yes 0 N/A Landscape 35% Proposed 7 detailed design elements met, shown on Al. 60%
❑Yes ® N/A Screening (Quad only) ogarage width allowed for meeting these design
®Yes 0 N/A % Window Coverage 16% Proposed lements; proposed width <60%.
la Yes 0 N/A Garage (SFR Only) Parking (Other Res)
® Yes 0 N/A Entrance (SFR, Rowhouse, Quad only)
❑ Yes 0 N/A Other building design standards (Rowhouse only)
❑ Yes ® N/A Accessory Structure Standards
❑ Yes ® No Qualifying pre-existing unit exempt from standards (Cottage unit only)
al standards for Courtyard Units, Cottage Clusters, Rowhouses, and Quads:
❑Yes ❑ N/A
❑ Yes 0 N/A Lot Width and i
❑ Yes 0 N/A Pathway
�Ad ional standards for Courtyard Units and Cottage Clusters only:
❑ Yes ❑ nit Area:
❑ Yes 0 N/A Floor er story)
❑ Yes ❑ N/A Courtyard
0 Yes 0 N/A Fence
❑ Yes 0 No XN/A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995)
®Yes 0 No ON/A Public Facilities Improvement (PFI) Permit:
Required: ®Yes ❑ No
Applied For: IR Yes 0 No, stop intake
[X Sensitive Lands: 0 Yes X No
El Main Land Use Case #s: PDR2021-00001 0 Conditions met
Ix Applicant notified of land use ex irationnte: sub it all ermits b 8/5/24 obtain c of o by 8/5/26
Approved By Planning: rt.---- .61 i Date: 6/27/23 7(3/013
Notes
Revision 1: ❑ Approved Not Approved Date:
Revision 2: 0 Approved 0 Not Approved Date:
Building Permit Submittal
Original Submittal Date: /1.61i
Site Plans #:
Building Plans #:
Building Permit #: aBuilding perpit # entered on page 1
Workflow Routing: 67/Planning 0"Engineering L"Permit Coordinator Building
Workflow Sign-off: te ign-off for Planning (include notes from planning review)
Route Documents: Y Engineering: (1) copy of permit application, (1) site plan, (1) building plan
and original plan review routing form.
LfBuilding: original permit application, site plans, building plans, engineer and
beam calculations and trust details, if applicable, etc.
I P vwp✓ Date: 1lk0 IV/3
Permit Technician:
Notes:
Engineering Review
Op,FI Permit:
Slope at building pad: lit,'Conditions met prior to issuance of permit
t'Easements (encroachments) per engineering conditions of approval and plat
t'Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes t 4lo
Assess Water Quantity Fee in-lieu: 0 Yes 111 No
LIDA Facility on lot: 0 Yes ZAo Add Fee: 0 Yes 0 No
final Plat Recorded
❑ NOT Approved: Date:
Notes:
Approved By Engineering: Date: 70 3
Revision 1: 0 Approved 0 No pproved Date:
Revision 2: 0 Approved 0 Not Approved Date:
`�� Pe, it Coordinator Review
i y 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 1=rtoes not apply
SDC Fees Entered: Wash Co Trans Dev Tax: D Yes 0 N/A
Tigard Trans SDC: 7 Yes ❑ N/A 0 Deferred
Parks SDC: D Yes 0 N/A 0 Deferred
LIDA ❑ Yes f nfd/A �-7
OK to Issue/Approved by Permit Coordinator: 1\ (R) \\\O d Date: 4 G v3
Revision 1: 0 Approved 0 Not Approved Date:
Revision 2: 0 Approved 0 Not Approved Date: