Loading...
Permit CITY OF TIGARD MASTER PERMIT 114 ' . COMMUNITY DEVELOPMENT Permit#: MST2022-00160 Date Issued: 02/20/2024 T f(.;,1 R.I) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S115AD03801 Jurisdiction: Tigard Site address: 10943 SW DOVER CT Subdivision: DOVER LANDING Lot: 19 Project: Wilhite Project Description: A new 884 sq.ft.garage.with 865 sf bonus room above. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: First: sf Basement: sf Left: 5 Parking Spaces: Height: 12 Bathrooms: Second: 865 sf Garage: sf Front: 30 Smoke Yes Dwelling Units: Third: sf Right: 5 Detectors: Total: 865 sf Value: $181,671.87 Rear: 25 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Drains: 0 Storm Sewer: 0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Bckflw Prevntr: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Electricity Heat Pump: Y Hoods: 0 Other Units: 0 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Fum>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 1 0-200 amp: 0 W/Svc or Fdr: 6 Ea add'l 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 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: ADD SF VB R-3 865 Owner: Contractor: WILHITE,MAURICE KELLY OWNER Required Items and Reports(Conditions) 10943 SW DOVER CT TIGARD,OR 97224 PHONE: PHONE: FAX: Total Fees: $4,291.50 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 QF9-M1-nMfl*erne C AP Qr.9_nni_nnQn Nine nhtain a rnnw of the re lec nr rlirert nuactinnc to(ll INC`hw rallin,-, cill 949 10117 nr 1 Ann'399 94dd .. y Issued By: Permiftee Signature: '" !' I Call 503.639 175 by 7:00 a.m.for the next available inspection date. This permit card shall be ept in a conspicuous place on the job site until completion oft project. Approved plans are required on the job site at the time of each inspection. Building Permit Application liesidential t: FOR OFFICE USE ONLY City of Tigard Received �,_,-/ III al g Date/By: ! 1✓ Permit No.: pets1-20;ti�,P3icoo 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review (pi `�' Phone: 503.718.2439 Fax: 503.598.1960E.` Date/By: t t I I S ,2 3 Other Permit: = .ga '(2)31( T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: t, U194)-3 ''^�1, Supplemental Information TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY.DWELLING ❑New construction 0 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 0 Other: equipment,materials,labor,overhead,and the profit for the,, CATEGORY OF"CONSTRUCTION work indicated on this application. y�j� t(1 e 1-and 2-familydwellingValuation: $ 0 0 Commercial/industrial 1 7�I 7 ElAccessory building ❑Multi-family Number of bedrooms: ElMaster builder ❑Other: Number of bathrooms: `Total number of floors: 1 1 ' iIOB SITE INFORMATION AND LOCATION Z Job site address: /Oct Lj. Sid boy E.--. GT New dwelling area: square feet City/State/ZIP: 7 /6AKD Gr. c ? LZL,i Garage/carport area: g3 square feet Suite/bldg./apt.no.: /Project name:vs/04 ri-E Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST. Subdivision: Lot no.: Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORT{ ;,` ;, work indicated on this application. A LQ J L./ r/A,6 A/ d s )A.2US COG/!4 i * Valuation: $ - - _ Existing building area: square feet New building area: square feet 0 PR(PERTY OWNER I V f,, 0 TENANT Number of stories: Name: MA U /C1C.. 7,E�..Lif W L,,f rri Type of construction: Address: ' 4 ? S j 1 v'.. cT J Occupancy groups: City/State/ZIP: T i6 Ali f 07, 7j7 9 7 3 Existing: Phone:(e-5) 5) / -7332 Fax:( ) New: 0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* Business name: �� n (Please refer to fee schedule) c (/,‘C CC Structural plan review fee(or deposit): Contact name: FLS plan review fee(if applicable): Address: Total fees due upon application: City/State/ZIP: Amount received: Phone:( ) Fax::( ) E-mail: .kw//h< v 5-A.,du PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System. Business name: r) �ell ,Soy+5 Submit two(2)sets of roof plan with connection details ` and fire department access,along with the 2010 Oregon Address: Solar Installation Specialty Code checklist. City/State/ZIP: Permit Fee(includes plan review $180.00 and administrative fees): Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.: [ t7 13 Total fee due upon application: $201.60 Authorized signature: /��. /6.„ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: /t('/C E `K/ 6-C �/�l/�r 7 Date: S/ZS1 y� *Fee methodology set by Tri-County Building Industry + `i 1 Y Y v ` Service Board. I:ABuilding'vPern its\BUP-RESPermitApp.doc 02 24/2011 440-4613T(11/02/COM/WEB) Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONLY .` i City of Tigard Received Permit No.: 13125 SW Hall Blvd.,Ti ard,OR 97223 Associated Associated permits: I Phone: 503.718.2439 Fax: 503.598.1960 24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical T I G A R D Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A I Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 ❑ 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 ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity 0 0 ❑ 6 Sewer permit. ❑ ❑ 0 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 ❑ ❑ 9 Erosion control ['plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ ❑ basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 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 0 ❑ ❑ 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- ❑ 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. ❑ ❑ ❑ 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 ❑ ❑ 0 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. ❑ 0 0 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 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 ❑ ❑ ❑ architect licensed in Ore.on and shall be shown to be applicable 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. 0 ❑ ❑ 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale"indicates standard architect or engineer scale. ❑ 0 0 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-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Application FOR OFFICE USE ONLY /�City of Tigard Date/Received Penryt"".y i .C.0 ( 0 74 13125 SW Hall Blvd.,Tigard,OR 97223 y �'��� Plan Review = Phone: 503.718.2439 # bate/B Other Permit: I-I v 41t l-� Inspection Line: 503.639.4175 " 8 k ! - . !a ate Ready/By: Juris: See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information New construction � � ��.: ' :.-`- �� w ,, b1Ulll't �.r x= *t ��yai11 i �..> � �'':'.. ❑ ruction 0 Addition/alteratioi relh(niiethent '' Mechanical permit fees*are based on the value of the work performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other mechanical materials,equipment,labor,overhead,and profit. t LL,. ,, , f i ... W z ,''"ii ,1 .,. Value:$ ❑ 1-and 2-family dwelling ❑Commercial/industrial .,rx- -a � _ .-I> : r❑Accessory building w . For special information use checklist. ❑Multi family 0 Master builder 0 Other: Description Qty. Ea. Total .. v S : f"....e.w,,u:hw"x i. a i„ :.''xy".... .554. iA =9"fin rG'� Y „,„f Heating/cooling: Job site address: l a,'q 3 5L✓ v6,.p (IT Air conditioning 46.75 �/ //j '7�2( t 1 Furnace 100,000 BTU(ducts/vents) City/State/ZIP: /� ! Furnace 100,000+BTU(ducts/vents) 46.7554.91 Suite/bldg./apt.no.: / Project name:wi -11/i er Heat pump j 61.06 `^r i C� Duct work 1 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: Lot no.: Other: 23.32 Tax map/parcel no.: Other fuel appliances: . ,, �' a 4 Water heater 23.32 " ", ... , . - .r=t . i. +• , a Gas fireplace/insert 33.39 �,/,pv /C ( Z �jp. 1 t )U r�L� r" Flue vent for water heater or gas 4 V�C,�(� ( //�� ,�/� Z}°/v ,��!''-f J fireplace 23.32 r�' -f�" '� / U " Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 0 ; � �$.. ' Other: 23.32 Name: ,t'V x,/,[�(A/c� �E4 L `,�Yv / Environmental exhaust and ventilation: r y Range hood/other kitchen Address: g)rl q3 . Dciviz5K n 7 equipment 33.39 Q 2-1-el dryer exhaust 33.39 City/State/ZIP: �,G-Af D 03 /72-1-el Single-duct exhaust(bathrooms, Phone 6103) _.c 7?j� . Fax ( ) toilet compartments,utility rooms) 23.32 v + s Attic/crawlspace fans 23.32 Other: 23.32 Business name: 5vvi, 45 A j✓, Fuel piping: Contact name: $14.15 for first four;$4.03 for each additional Furnace,etc. Address: Gas heat pump City/State/ZIP: Wall/suspended/unit heater Water heater Phone:( ) Fax::( ) Fireplace E-mail: Range tz, • ,, � �T � _ r• v •.„_� c Barbecue 2. , ,. Clothes Al dryer(gas) Business name: e y fy 5 �arm.„4Yw-p—y�a Other: Address: tr.':-> 11tA �*I Y* '' Subtotal City/State/ZIP: Minimum permit fee($90.00) Phone:( ) Fax:( ) Plan review(25%of permit fee) State surcharge(12%of permit fee) CCB lie.: t l DL O TOTAL PERMIT FEE / This permit application expires if a permit is not obtained within 180 Authorized signature: dcz, days after it has been accepted as complete. '.r * Fee methodology set by Tri-County Building Industry Service Board Print name:4. ,Au icy- 'LL )/ Whir �6 Date: S—�S,�Zjz.. 1:\ 1 P \M BuildingermitsEC P ermitApp_082520.doe 9 440-4617T(11/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Submittal Requirements: • (2) sets of plans, drawn to scale. • (2) sets of equipment cut sheets. • (2) copies of site plan for ground and roof top equipment location and screening per Tigard development code. Commercial& Multi-Famil Fee Schedule: r. "�' k44 . . �� 4 q. $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. I:\Building\Permits\MEC_PennitAPP_082520.doc 2 Electrical Permit Application FOR OFFICE USE ONLY City of Tigard Received /� Date/B Pe '! ao). `V 0 C Lb 13125 SW Hall Blvd.,Tigard,OR 97223 ,,Plan Review ' C Phone: 503.718.2439 (,,o '�t p ;Date/B : Related Permit#: tl g Email: TigardBuildingPennits@Tigard ov a ,. 'ReadyDate/By: TIGARD Juris: ® SeePage2for Inspection Line: 503.639.4175 Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK : �t`�t't� PLAN REVIEW ❑New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): r„ I 1 ::1() ❑Demolition ❑Other: El Service or feeder 400 amps or more ❑Building over three stories. where the available fault current ❑Marinas and boatyards. 'CATEGORY,OF CONSTRUCTION" ;" exceeds 10,000 amps at 150 volts or ❑Floating buildings. El 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or einstallationxceeds 14,000 ❑commercial-use agricultural amps for all other s. buildings. ❑Multi-family 0 Master builder 0 Other: ❑Fire pump. ❑Installation of 150 KVA or JOB SITE;;INFORMATION AND"LOCATION" 0 Emergency system, larger separately derived `Q / El Addition of new motor load of system. Job#: Job site address: I !c../ 3v c 100HP or more. ❑°°A",°E",°l-z",°°l-3", City/State/ZIP:T I�3A�,j1 �� Q �f�Z ['Six or more residential units. occupancy. (� L f ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: /I Project name: u )1 Lk 17-- 0 Hazardous locations. 0 Supply voltage for more than lJ� Service or feeder 600 amps or more. 600 volts nominal. El Cross street/directions to job site: ,. TEE SCHEDULE Description I Qty. I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 168.54 4 Ea.add'l 500 sq.ft or portion 33.92 1 DESCRIPTION OE.WORK Limited energy,residential /� (with above sq.ft.) 75.00 2 L(G" r/��T " / A'/"> c J 7 i ..y 7S Limited energy,multi-family OO �t YU E- r.'c �,t �`� gp b J se�f�tq residential(with above sq.ft.) 75.00 2 ✓v�1Ij Renewable Energy 0 See Page 2 0 PROPERTY OWNER i El TENANT " Services or feeders installation,alteration,and/or relocation Name: Ur\/c-E -/ (..f bo/ / amps or less 200 100.70 2 Address:/0 U SI- bd v/ 7" 201 amps to 400 amps 133.56 2 Cam/ 401 amps to 600 amps 200.34 2 City/State/ZIP: 7)6. b / cic 57t _ f 601 amps to 1,000 amps 301.04 2 Phone:(Spy) 5/9 _73 3 'Z Over 1,000 amps or volts 552.26 2 Email: 4T (N,/ P 7 /'�&-,D v c JI _16 Temporary services or feeders installation,alteration,and/or J/iy�" 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 'APPLICANT ❑",'CONTACT PERSON,. Branch circuits-new,alteration,or extension,per panel A.Fee for branch circuits with Business name: tl Cam �)€j __., above service or feeder fee, (J 7.42 2 c ���- each branch circuit "( Contact name: B.Fee for branch circuits without service or feeder fee,first Address: branch circuit 56.18 2 City/State/ZIP: Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Each manufactured or modular Email: dwelling,service and/or feeder 67.84 2 Reconnect only 67.84 2 rep CONTRACTOR Pump or irrigation circle 67.84 2 Business name: Sign or outline lighting 67.84 2 Address: 0 )A, Signal circuit(s)or limited-energy 'v panel,alteration,or extension. ❑ See Page 2 2 City/State/ZIP: Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:( ) hr min Investigation(1 g ) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is CCB Lic.: Electrical Lie.: Suprv.Lic.: specifically listed('Va hr min) 90.00/hr ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: Date: 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: - � 6 TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name:/,�� ( �� �„ �//�/l�j� Date: S ��G7 days after it has been accepted as complete. �"�' ` �� y' c�� * Number of inspections allowed per permit. 1:\Building\Permits\ELC PermitAppELR_ERE.doc Rev 10/26/2017 440-4615T(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: Each ta Description on Qty. sc ... To al Fee for all residential systems combined: $75.00 Renewable electrical energy systems: 5 kva or less 100.70 2 Check Type of Work Involved: 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: ❑ B• urglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 ❑ G• arage Door Opener* >100 kva(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 specifically listed '/z hr min Subtotal(Enter on Pagel): 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 ❑ F• ire Alarm Installation ❑ H• VAC ❑ 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 I:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 10/26/2017 vUlaitlhbing Permit Applicatioc Building Fixtures 1'[ CEIV FOR Orrl(`E I SE Oyvi,l City of Tigard NO V 15 2023 Received 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: Permit No.: V\S1A 0 1/1.00`I.0 C Phone: 503.718.2439 Fax: 503.598.1Q�p„, Plan Review 1/U V �N 1�1I Y TIGARD Other Permit No.: I I c;A R n Inspection Line: 503.639.4175 BUILDING Date Ready/By: Internet: www.tigard-or.gov y y: J°ris See Page 2 for DIVISION Notified/Method: Supplemental Information El New New construction 0 Demolition For special information use checklist. Addition/alteration/replacement 0 Other: Description Qty. Ea. Total New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF:coNs ufC`C'o SFR(1)bath 312.70 tg 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ElAccessory building 0 Multi-family SFR(3)bath 500.32 ❑Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB"Slh INFORMATION AND LOCATION : Site utilities: Job site address: i 0 ti 3 i to too v �. Catch basin or area drain 18.76 / Drywell,leach line,or trench drain 18.76 City/State/ZIP: ,�f 6A�p ©� 9? ZZ Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 p\/E Cr' # (0 b?f i Av6 Rain drain connector i18.76 142.74 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 Backwater valve 1DES R>EPrE to1V U1 WORK 12.51 �� j� (} Clothes washer 25.02 (' D ✓� R d aM A Ob,f/o p Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 Ilir PROPERTY owNER d TENANT Expansion tank 12.51 Name: t.L U/�t�/ t. Fixture/sewer cap 25.02 Address: I d 9 3 s, ,1 ,-\.,,, /� �, Floor drain/floor sink/hub 25.02 c IJ�J �,/CJ V Garbage disposal 25.02 City/State/ZIP: rl'6-AR Tl OR '7 7'-ZC} V Hose bib 25.02 Phone:(533) 5►g,,.7 /3 Z Fax:( ) Ice maker 12.51 a;`APII'ICiNT 'Cl CONTACT l'E*soN Interceptor/grease trap 25.02 Business name: U Medical gas(value:$ ) Page 2 Contact name: Primer 12.51 Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 Water closet 25.02 /1/A . , ,=r> " Water heater Business name: foe.,t e., �,e 37.52 / �5 ���`7 Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal Phone:( ) Fax:( ) Minimum permit fee: $72.50 CCB Lic.: ( / 7 d(3 Plumbing Lic.no.: Plan review (25%of permit fee) // I State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name: .,}� L /�/LH/7' Date://- S!-Z� 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:ABuildingAPermits\PLMU-PennitApp.doe 10/01/09 440-4616T(10/02/COM/WEB) ` RECEIVED Property Owner Statement FEB 2 0 2024 Regarding Construction Responsibilities CITY OF TIGARD PLANNINGIENGINEERING Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 (2)) This statement is required for residential building,electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants,exempt from licensing under ORS 701.010 (7), need not submit this statement. This statement will be filed with the permit. Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or I will be performing work on property I own, a residence that I reside in, or a residence that I will reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. 41Urfr-6- 4"(/ dij Print Name of ermitAppNca // r- nt /M,,,, ior,Viele4 Signature of licant PP Date Permit#: M c ° —00 [b 0 Address: ( a f L . ' Pe vw' ill' \111y1� 1 Issued by: Date: ?-(7-0 ( - This Copy for Permit Offices Plan# t Floors Large 1 Li Bed rooms Small 91 WC LAV Tub Basement Vent 1st Floor I , �3 Water Heater 2nd Floor �Ps S I �3� i! AC 3rd Floor School R-3 Total _ Garage �S� 3 - _== 1 S Total (---7`1pi 1 �, �v(�� �f� ��, - 51 . eSKgtays ' r133 - #for Elec 11 I.. acu-L,'-r-i ic-C- c-\.`4 vt_tAks c,-c----sL- 2-` Pow Cif ,n,A,„� was-sue- ( ' v�-✓-C c ' y tx=.`..t_ . 1,loL . \ CO . m"04-i . 5. 'T) v dC) o J J / `� P�n L ( VV\a-X\as- .SL b v r �jvaste_r" 7 Pr-Ov\GLe• pip �/`� �(,. �� ) Yam'L _'l �'"' rJ� �� O�1 1 (lti l R t�r 1 FOR OFFICE USE ONLY—SITE ADDRESS: to 6143 SW 'VpvIX C • 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 Tiga,, . rd • COMMUNITY DEVELOPMENT DEPARTMENT ii . Transmittal Letter 1 1 t A R n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: AN AEA pi PA DATE REC DEPT: BUILDING DIVISION REC DEC 0 6 2023 FROM: 4Li,Y \ '.)i I-H I r i COMPANY: CITY OF TIGARD BUILDING DIVISION PHONE: SD 3- S 1 7-7.33 Z By:11 p EMAIL: kW i 1 k► T 1C USA.N F. RE: I 6'1 g 5W Dovr c'rt NIS1'L42'C6I(00 (Site Ads) (Permit Number) T16A D ` 17 7-2-14 (Project name ortubdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Descriptions Copies: Deser>rptipn . 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. Other(explain): AR(9S 10,-) e_DniT L. Aivr S01 L SAA.POvAJD LDcATiCN REMARKS: I,(o i/fj dN 5/1"r Pi AO . rRov 1 O)zi) 3 /J#L ) s i Te- Pv4N co t°i t s FOR-O 4. GE USE ONLY. Routed to Permit Techni • : Date: I V/(l Initials: ,44 Fees Due: p Yes No Fee Descriptio : Amount Due: jj O < -...--. $$ p Special Instructions: Reprint Permit(per PE . 1::Yes No El Done Applicant Notified: V Date: t'i \i,I�,01, I(�(Ij(p(,( V,(,(,k,t, - Initials: - 49 � 3 � FOR OFFICE USE ONLY—SITE ADDRESS: 16413 SW1 v1 1-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. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT iliAl 1 " Transmittal Letter r ,,,E:. 1) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: DATE RECEIVED: DEPT: BUILDING DIVISION r FROM: 4.Ly �)LI'1/l 6 2 _. COMPANY: C .v.. PHONE: S 0.3 —S),-' 7 43 Z- E _ .. , _ A BY EMAIL: kvJl I T7/'h' V SA -A 6-7- RE: f O`343 5lAJ Df3V5R c7 A5 r ZD?2Z- oc I(0 (Site Address) (Permit Number) (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: 5 r-c FLM5kdditional 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. Other(explain): REMARKS: ,4D.D4 51'0 Al AKA/A e_ i- ,( A.<6/A T AAA vx(-1 7 4T J) c R 1 boer, ADD�nJ A 0 A) J4-I 4ALeA' /_.- ,4 Di 7"/oN FORO FICE USE ONLY Routed to Permit Technic' : Date: 6l 23 Initials: Fees Due: ❑ Yes LJ No Fee Description: Amount Due: b p E. $ Special Instructions: Reprint Permit(per PE): z ❑ Yes [ No ❑ Done Applicant Notified: V Date: i t t(1.,\.. , Initials: 39 I:\Building\Fonns\TransmittalLetter-Revisions_073120.doc City of Tigard •111 " COMMUNITY DEVELOPMENT DEPARTMENT C T I G A R D Building Permit Review — Residential Building Permit #: /1 r -a---4..)(; 4(,.j Site Address: (0(2.` $ S J D-oii'�-Q cc Project Name: i 3 It Lot #: Planning Review Proposal: 9S,e9c2 0-1 c?1 ❑ Verify address/suite#active in Accela. ❑ In River Terrace;�' ❑ No Li Yes,River Terrace Review Addendum Site Plan Elements: FErosion Control ® copies of site plan on 8-1/2"x 11"or 11 x 17"paper El pt�ned trees with drip line and tree protection measures yawn to scale(standard architect or engineer scale) �Fo tprint of new structure(including decks)and FFE Np❑ rth arrow tsl'Ukfty locations&easements (required for new and additions) S)ke address,project or subdivision name and lot number Sidewalk/driveway approach . Ap llicant information(name and phone number) Location of wells/septic systems of dimensions and building setback dimensions rGil S eet tree size,type and location 14" S 'are footage of buildings to be demolished Street names I existing structures on site di Corner elevations (2'contours if more than 4'differ ntial) os EVLot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? .'Yes ❑ impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes No lean Water Se ces—Service Provider Letter (lot platted prior to 9/10/1995): Required: Yes,applicant was notified 0 No Received: 0 Yes ❑ No 2/Water Meter Fixture Unit Worksheet—Add_/itio s,Remodels and ADUs ,yeequired: 0 Yes,applicant was notified I� No �� Received: 0 Yes 0 No Exemption for ADU applied for: ❑ Yes ,�T No Received: ❑ Yes ❑ No kr-Public Facilities Improvement(PFI) Permit: Required: 0 Yes,applicant was notified o Applied For: 0 Yes 0 No,stop intake O Land Use Case#: 0 Zoning: O Required Setbacks: Front: �i7 Rear: Gr Side: 'S Street Side: 2-0 Garage: ?D ❑ Building Height: Max.Height: 3C2 ' Actual Height: 1 2--' ❑ Landscape Area: 1.J k % ❑ Lot Coverage Max: Pt ntrance 0 Set back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less Windo Minimum 12%of area of all street-facing facades Garage ❑ Garage is behind widest street-facing wall ❑ Yes ❑ No,one of the following is met: ❑ Door exten ore than 5'from wall and there is a covered porch extending beyond garage. ❑ Door extends no more t a ' om wall and there is a 12 sq ft.window above garage on 2nd floor. ❑ Garage door width is ❑ 12'or less less of facade ❑ 60%or less and includes 7 of following: ❑ Covered porch ❑ Recessed entrance ❑ Wa 0 1'Roof eave ❑ Roof offset ❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gab e, ' or gambrel roof ❑ Dormer ❑ Accent siding ❑ Window trim ❑ Window recess ❑ Windo • ction ❑ Balcony ❑ Visual Clearance ❑ Urban Forestry Plan ❑ Sensitive Lands: ❑ Yes ❑ No Type: ❑ Condi • ns met prior to issuance of building per • Note ! Approved By Planning: Date: Sr Z Revisions (after B ilding Submittal only) Reviewer Date AMA PeSere"•i f R vision 1: Approved ❑ Not Approved 7/a7 0-3 tot,4 104 41"" Revision 2: Q/Approved ❑ Not Approved !/ ?y-✓ p \'a./ b/3.u'1�3 Loot sf Reloc,,,lek o i 1 P:[t.. a/I 'i;a IA41i .1 YLl c .,.. C' p �o J. 9 `}ice lti'v�7 � IV r��` I:\Building\Forms\BldgPennitRvw*RES 122X19.d cx , t���s8 �' �u :C�1 glji( (`�jis, t(S' Building Permit Submittal Original Submittal Date: 5/'"J) Site Plans: # Building Plans: # Building Permit#: �nt�r building permit#above. � Workflow Routing: -Planning �I neering .1 'ermit Coordinator [ —B ufding Workflow Sign-off: ES'gn-off for Planning(include notes from planning review) Route Application Documents: O'Engineering: (1) copy of permit application, (1) site plan, (1)building plan and on anal plan review routing form. -Building: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: gzuvj ,QYI Z. rouca 0A 1i 41 1 Z67,�� f.Ah By Permit Technician: g. ' _ Date: , (y� Engineering Review RI/Slope at building pad: 23�4, l' •nditions "Met"prior to issuance of building permit f/C.I J Easements (encroachments)per engineering conditions of approval and plat CGI Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes COY No Assess Water Quantity Fee in-lieu: ❑ Yes 3/No LIDA Facility on lot: ❑ Yes ["No V. Final Plat Recorded:VI I(N L/ NOT Approved by Engineering: j yv ,gh Date: (,f / 2 Z Notes: N I'm t vV jovS ex c e t cl5 /or/a f7 Z, 0/i71 'heed iv a j` 'yrn L4, /1i4it to t fah ¢'7, d ffivi ipips c A `-tyrarf to /Ce.eio SA-vc¢v:-C eV+ of ee`vh; L Approved byEngineering: Date: c�y_-t pp g� g� 5,+�plan. Revisions (after Building Submittal only) Reviewer Date Revision 1: E3/Approved ❑ Not Approved -rr a 4+ gh r1 si 2. /2,01,3 Revision 2: Approved ❑ Not Approved jy / id/!-, 12f 7/2i/23 Permit Coordinator Review 4 Conditions"Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: Notes: x. Myy\rinejle\-\" Revisions (after Buil 'ng Submittal only) Revision Notice 1: Date Sent to Applicant: (6•• CQ• St Jc Revision Notice 2: Date Sent to Applicant: r1 `- I2�Ii 10Z..3 `! SDC Exemption: ❑ Received Does not apply ���F SDC Fees Entered: Wash Co Trans Dev Tax: Yes N/A Tigard Trans SDC: ❑ Yes N/A Parks SDC: ❑ Yes N/A LIDA ❑ Yes ❑ N/A OK to Issue Permit Approved by Permit Coordinator: A6V,,,Oe.-- Date: 8 I ILI 12D23 I:\Building\Fonns\B1dgPermitRvw_RES_122419.docx