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Permit (4) CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2023-00223 T I :aAR.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/28/2023 Parcel: 2S108DC31100 Jurisdiction: Tigard Site address: 15632 SW EVERGLADE AVE Subdivision: CROSSING AT BULL MOUNTAIN Lot: 166 Project: River Terrace Crossing, Lot 166 Project Description: New detached dwelling. NO FINAL INSPECTION UNTIL DEFERRED SDC FEES HAVE BEEN PAID. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 3 First: 1088 sf Basement: 518 sf Left: 3 Parking Spaces: 0 Height: 29 Bathrooms: 4 Second: 1470 sf Garage: 440 sf Front: 12 Smoke Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes Total: 3076 sf Value: $501,537.32 Rear: 15 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 6 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 Drywell-Trench Drain: 0 Other Fixtures: 1 Other Fixture Units: Sump pump MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 6 Clothes Dryers: 1 Natural Gas Heat Pump: Y Hoods: 1 Other Units: 0 Furn<100K: 0 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: 5 201-400 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 3076 Owner: Contractor: ICHIJO USA CO LTD ICHIJO USA CO LTD Required Items and Reports(Conditions) 3800 SW CEDAR HILLS BLVD STE 3800 SW CEDAR HILLS BLVD STE 130 1 Ersn Cntrl 503-639-4175 131 BEAVERTON,OR 97005 2 Geo Tech Required BEAVERTON,OR 97005 3 (2)layers of 2x fire blocking at area indicated PHONE: PHONE: (503)430-7413 FAX: Total Fees: $26,962.69 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 oc9_nn1_nnln thrniinh()Ai>aR9-nM_rinon Vnn ma, w.,wG n,of the+rnlac nr rliront ni icctinnc to(lu iiim by Tallinn Fn't 919 10R7 nr 1 Rnn 119 91dd Issued By: Permittee Signature: 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 roject. Approved plans are required on the job site at the time of each inspection. Building Permit Application 1 Residential i D FOR OFFICE USE ONLY City of Tigard Received > / 3 Date/By; Permit No.: af 2 — G III e 13125 SW Hall Blvd.,Tigard,OR 9722; 23 t ' �-O( J m Plan Review r/I� n{� Phone: 503.718.2439 Fax: 503.598.1960 DateBy: ,L`v� Othe -Oc f((,-/ Ins Inspection Line: 503.639.4175 'r'' `, t" . i ��r \to TIGARD p Ci 3 ,„+; 3', 1 DateReadyBy: ] /1. Inns: 6� SeePage2for Internet: www.tigard-or.gov B U't D `o! l UJ Z3• �, LLD jc ,; �y; IO� DateReadethod: 1/ ISupplemental ZI See Page2Information 1? TYPE OF WORK44Zi'l E_QU ED.DATA I; AND 2 RAMILY DWELLING 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 CATEGORY;OF CONSTRUCTION work indicated on this application. 2- 51/ S3`� 3 Valuation: $ � 1-and 2-family dwelling 0 Commercial/industrial � LI Accessory building El Multi-family Number of bedrooms: 3 ❑Master builder I:]Other: Number of bathrooms: 4 JOB SITEINFORMATION AND.LOCATION Total number of floors: 3 361 Job site address: 15632 SW EVERGLADE AVE New dwelling area: 3076 square feet 1. —1c0 City/State/ZIP: Tigard / OR / 97224 Garage/carport area: 440 square feet ( p Suite/bldg./apt.no.: Project name:River Terrace Crossing Lot 166 Covered porch area: square feet 5j1 9" Cross street/directions to job site: Deck area: ,, 18 square feet Other, 'i - .t0!" Patio 180 square feet REQUIRED$DATA COMMERCIAL USE CHECKLIST- Subdivision: Crossing At Bull Mountain Lot no.: 166 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.: 2 S 1 O S D C T L#16 6 materials,labor,overhead,and theprofit for the equipment, � ead r DESCRIPTION OF. WORK ' work indicated on this application. Single Family Detached Dwelling valuation: $ Existing building area: square feet Request the Transportation and Parks SDCs to be deferred to occupancy New building area: square feet • PROPERTY OWNER q TENANT Number of stories: Name: ICHIJO USA CO., LTD. Type of construction: Address: 3800 SW Cedar Hills Blvd. Ste. 131 Occupancy groups: City/State/ZIP: Beaverton/OR/97005 Existing: Phone:(503)430-7413 Fax:(503)430-7621 New: • APPLICANTy. In CONTACT PERSON BUILDING,PERMIT FEES* Business name: ICHIJO USA CO., LTD. �rteaserefertofeescheaure) : . Structural plan review fee(or deposit): Contact name: Naoki Yamaoka FLS plan review fee(if applicable): Address: 3800 SW Cedar Hills Blvd. Ste. 131 Total fees due upon application: City/State/ZIP: Beaverton/OR/97005 Phone:(503)430-7413 Fax: :(503)430-7621 Amount received: E-mail: nao@ichijousa.com PHOTOVOLTAICSOLARYANELSYSTEMFEES* CONTRACTOR Commercial and residential prescriptive installation of . R-.�Ar a „':1l . �>7r roof-top mounted Photo Voltaic Solar Panel System. Business name: ICHIJO USA CO., LTD. Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 3800 SW Cedar Hills Blvd. Ste. 131 Solar Installation Specialty Code checklist. City/State/ZIP: Beaverton/OR/97005 Permit Fee(includes plan review $180.00 and administrative fees): Phone:(503)430-7413 Fax:(503)430-7621 State surcharge(12%of permit fee): $21.60 CCB lie.: 215360 Total fee due upon application: $201.60 Authorized signature: 4Z.Air,z9/71--- This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Naoki Yamaoka Date: 5/18/2023 *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) R Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONLY City of Tigard Date/By:Received Permit No.: . MI 13125 SW Hall Blvd.,Ti ard,OR 97223 at g Associated permits: _ Phone: 503.718.2439 Fax: 503.598.1960 24-Hour Inspection Line: 503.639.4175 0 Electrical ❑ Plumbing ❑ Mechanical TIGARD Internet: www.tigard-or.gov 0 Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/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. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control 0 plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ 0 basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state . ❑ ❑ 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 III ❑ ❑ and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, • ❑ 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 ❑ 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. ll ❑ ❑ 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- III ❑ ❑ 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 II ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ 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 • ❑ ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. • ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required MI ❑ ❑ 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 U ❑ 0 architect licensed in Ore ton 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". li ❑ ❑ 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. IN ❑ ❑ 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. I ❑ ❑ 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. In ❑ ❑ 27 "Drawn to scale"indicates standard architect or engineer scale. Ili ❑ ❑ 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard II ❑ ❑ 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, ❑ ❑ 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 Applicatio> F FOR OFFICE LSE ONLY City of Tigard r w ),Received P•' i �4- , 0Q?- • 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: Phone: 503.718.2439 Fax: 503.598.1960 'i S r 1»nt Plan Review Other Permit: aJ .2,23 Date/By: T I GA R D Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov (ITV ( ,71,, r) Notified,Method: Supplemental Information tt COMMERCIAL FEE*a,SCHEDULE ,,15SF CHECKLIST TYPE OF W.O RK, .a ., , .. 1 Y ., '' .. ... '" � �` Mechanical permit fees*are based on the value of the work II New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value: CATE40RY OF CONSTRUCTION s oo-- m,; y i ' 1 RESIDENTIAL EQUIPMENT/SYSTEMS FEES*. • 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total _ Heating/cooling: _ JOB STfE`:A�IFORMATION AND I.00ATIO�T;. , - 3= 15632 SW EVERGLADE AVEAir conditioning 46.75 Job site address: Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: Tigard / OR / 97224 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 1 61.06 Suite/bldg./apt.no.: Project name: River Terrace Crossing Lot 166 Ductwork 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: Crossing At Bull Mountain Lot no.: 166 Other: 23.32 Other fuel appliances: Tax map/parcel no.: 2 S 10 8 D C T L#16 6 Water heater 1 23.32 e DESCRIPTION.OF',WORK'= Gas fireplace/insert 33.39 Flue vent for water heater or gas Single Family Detached Dwelling fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other: 23.32 :PROPERTY OWNER .; ❑ TENANT ';x - -• '� Environmental exhaust and ventilation: Name: I C H I J O USA CO., LTD. Range hood/other kitchen equipment 1 33.39 Address: ' 3800 SW Cedar Hills Blvd. Ste. 131 Clothes dryer exhaust 1 33.39 City/State/ZIP: Beaverton/OR/97005 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 6 23.32 Phone:(503) 430-7413 Fax:(503) 430-7621 Attie/crawlspace fans 23.32 ;.,E APPLICANT ❑ CONTACT PERSON Other: 23.32 Fuel piping: Business name: IC H I J O USA CO., LTD. $14.15 for first four;$4.03 for each additional Contact name: Naoki Yamaoka Furnace,etc. Gas heat pump Address: 3800 SW Cedar Hills Blvd Ste. 131 Wall/suspended/unitheater City/State/ZIP: Beaverton / OR / 97005 Water heater 1 Phone:(503)430-7413 Fax: :(503)430-7621 Fireplace Range 1 E-mail: nao@ichijousa.com Barbecue 2 x4 CONTRACTOR ,, r y Clothes dryer(gas) Business name: Supreme Heating and Cooling LLC Other i , f IIECHANI l PERMIlFFEES* 141 $ Address: 13009 NE 91 ST Circle Subtotal City/State/ZIP: Vancouver, WA 98682 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(503)333-3213 Fax:( ) State surcharge(12%of permit fee) CCB lie.: 221270 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: * Fee methodology set by Tri-County Building Industry Service Board Print name: Naoki Yamaoka Date: 5/18/2023 I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi-Family Fee Schedule: *' ',otal Valuation:4!. .,;ff F:PerPtitfee:',1.17.fi $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 r-v . . Electrical Permit Application BLit; �r ,, y FOR OFFICE l'sE ONLY Received City of Tigard Pe ..-‘ yy _ t� "J IIII v 13125 SW Hall Blvd.,Tigard,OR 97223 t. a/ Date/B � 1 J Ln23 plan Review _ ' Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#: T I GA RB Inspection Line: 503.639.4175 city{'+vA 1 Ready DateBy: Juris: See Page 2 for Internet www tigard or gov [*t y d° R < onfied/Method Supplemental Information K i 3li fov . .,t 1WIT,,,OF,WOT2 ,.` .1 t. , >... .. , PLAN. REVIEW ,�, In New construction ❑Addition/alteration/replacement a Please check all that apply(submit 2 sets of plans w/items checked): ❑Demolition 0 Other: ❑Service or feeder 400 amps or more ❑Building over three stories. where the available fault current ❑Marinas and boatyards. "',CATEGO X"OF CONSTRUCTIO(\ exceeds 10,000 amps at 150 volts or . ,^�. .t.. �- - ,.. =,•R �`:. .. ,� �.�. _ ,. s.Er .` P 0 Floating buildings. IN 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or 'OB SITE INFORMATION A,N,'D„LOCATION ,, ❑Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: Job site address: 15632 SW EVERGLADE AVE 100HPormore. ❑..A, ..E„ ..1.2>, .1.3„ City/State/ZIP: Tigard / 0 R / 97224 ❑Six or more residential units. occupancy. ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: Project name: River Terrace Crossing Lot 166 ❑Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more 600 volts nominal Cross street/directions to job site: , FEE SCHEDULE Description I Qty. 1 Each I :We: Total I * New residential single-or multi-family dwelling unit. Subdivision: Crossing At Bull Mountain Lot#: 166 Includes attached garage. 1,000 sq.ft.or less Tax map/parcel#: 2S108DC TL#166 168.54 4 Ea.add'l 500 sq.ft.or portion 33.92 1 1. DESCRIPTION AFC WORK;,. , '; .• Limited energy,residential 75.00 2 (with above sq.ft.) Single Family Detached Dwelling Limited energy,multi-family residential(with above sq.ft.) 75.00 2 Renewable Energy ❑ See Page 2 •`PROPER.TY�OWNER,,. ,=❑,TENANT :,y Services or feeders installation,alteration,and/or relocation Name: ICHIJO USA CO., LTD. 200 amps or less 100.70 2 Address: 3800 SW Cedar Hills Blvd. Ste. 131 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: Beaverton/OR/97005 601 amps to 1,000 amps 301.04 2 Phone:(503 )430-7413 Fax:(503) 430-7621 Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: info@ichijousa.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 APPLICANT :,. , ,.,> ❑„COST ACT PERSON,. A.Fee for branch circuits with Business name: IC H I J O USA CO., LTD. above service or feeder fee, 7.42 2 each branch circuit Contact name: N a o k i Yam a o ka B.Fee for branch circuits without 3800 SW Cedar Hills Blvd. Ste 131 branch or feeder fee,first Address: branch circuit 56.18 2 City/State/ZIP: Beaverton / OR / 97005 Eachadd'lbranchcircuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(503) 430-7413 Fax: :(503)430-7621 Each manufactured ormodnlar 67.84 2 dwelling,service and or feeder Email: nao@ichijousa.com Reconnect only 67.84 2 CONTRACTOR - ,fir=•. Pump or irrigation circle 67.84 2 Business name: WEST SIDE ELECTRIC COMPANY Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address: 1834 SE 8TH AVE panel,alteration,or extension. ❑ See Page 2 2 City/State/ZIP: PORTLAND, OR 97214 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(503 )231-1548 Fax:( ) Investigation(1 hr min) 90.00/hr Email: OFFICE@WESTSIDEELECTRIC.COM Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90 00/hr CCB Lic.: 13306 Electrical Lic.: 26-135C Suprv.Lic.: 5698S specifically listed('%hrmin) J' ,# r,` t , .,,., ,„ E FCTRICAI PERMIT FEES , ,.,. Suprv.Electrician signature,required:r ",rl . Subtotal: Print name: BRENT WALL 5698-S Date: 5/18/2023 0 Plan ReviewRequired(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Naoki Yamaoka Date: 5/18/2023 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: €r FEE SCHEDULE r: RESIDENTIAL WORK so Fee for all residential systems combined: $75.00 Description I rz�. I Each I Total I Renewable Renewwable electrical energy systems: Check Type of Work Involved: s 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 ❑ Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 2 ❑ 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('h hr min) COMMERCIAL WORK iosiv EL CTRICAL PERMIT FEES -, - Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 • Number of inspections allowed per pertnit. (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 I:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015 • - , Plumbing Permit Applicat' Building Fixtures 1 FOR OFFICE I:SE ONLY City of Tigard Received • 13125 SW Hall Blvd.,Tigard,OR 97223 .'1 t ;L' Date/By: P � � "©� s�- Phone: 503.718.2439 Fax: 503.598.1960IIIN Plan Review Date/By: Other Permit No.: Inspection Line: 503.639.4175 ('y 1 }s„ T I G A R D Date Ready/By: Juris: Pi See Page 2 for Internet www.tigard-or.gov r r .� .r '' _ Notified/Method: SupplementalInformation ott e thod 4. TYPEi.OF WORK ' FEE* SCIiEDULE ;. •New construction El Demolition For special information use checklist Description I Qty. I Ea. 1 Total _ ❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection).CATEGORY OF CQNSTRUCTION ' -: SFR(1)bath 312.70 MI 1-and 2-family dwelling D Commercial/industrial SFR(2)bath 437.78 ❑Accessory building ❑Multi-family SFR(3)bath 1 500.32 ❑Master builderEach additional bath/kitchen 1 25.02 0 Other: Fire sprinkler( sq.ft.) Page 2 TJOB SITE INFORMATIO AND LOCATION? Site utilities: Job site address: 15632 SW EVERG LADE AVE Catch basin or area drain 18.76 ri Tigard / 0 R / 97224 Drywell,leach line,or trench drain 18.76 City/State/ZIP: Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name: River Terrace Crossing Lot166 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: Crossing At Bull Mountain 1 Lotno.: 166 Fixture or item: Tax map/parcel no.: 2 S 108 D C T L#16 6 Backflow preventer 31.27 DESCRIPTION O::,..2.:,:_,,,,,,ORKS .- ;i Backwater valve 12.51 Clothes washer Single Family Detached Dwelling 1 25.02 Dishwasher 1 25.02 Drinking fountain 25.02 Ejectors/sump 1 25.02 PROPERTY OWNER I '❑ 'TENANT Expansion tank 12.51 Name: ICHIJO USA CO., LTD. Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 3800 SW Cedar Hills Blvd. Ste. 131 Garbage disposal 1 25.02 City/State/ZIP: Beaverton/OR/97005 Hose bib 2 25.02 Phone:(503)430-7413 Fax:(503)430-7621 Ice maker 1 12.51 'i APPLICANT ❑ CONTACT PERSON ^° Interceptor/grease trap 25.02 Business name: ICHIJO USA CO., LTD. Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Naoki Yamaoka Roof drain(commercial) 12.51 Address: 3800 SW Cedar Hills Blvd. Ste. 131 Sink/basin/lavatory 7 25.02 City/State/ZIP: Beaverton / OR / 97005 Solar units(potable water) 62.54 Phone:(503)430-7413 Fax: :(503)430-7621 Tub/shower/shower pan 3 12.51 E-mail: nao@ichijousa.com Urinal 25.02 . 'CANT ,TOR 1 Water closet 4 25.02 ,'. ., i, ., t ; . _ „ t = `. Water heater 1 37.52 Business name: Pipe It Plumbing LLC. Water Pm�1P DWV 56.29 Address: PO BOX 1389 Other: 25.02 City/State/ZIP: Boring / OR / 97009 subtotal Phone:(503) 544-0477 Fax:(503) 912-0045 Minimum permit fee: $72.50 CCB Lic.: P B297 Plan review (25%of permit fee) 174351 Plumbing Lic.no.: State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name: Naoki a m a o ka Date: 5/18/2 0 2 3 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: Residential Fire Suppression Systems: Q Fee ea) Total Square i otage _ `Permit Fee*o t> � ,� ,Sits Utdi>res � v mow. Footing drain-Is`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 r Val0a ion, 'ermut f ee ,.,,x;; 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 teal a Total each additional$100.00 or fraction thereof,to Other Inspections orFees { , _ ` :.to 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*. Phil Review for=„ lumbin,g Installa ions k,y, 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 ❑ New exterior plumbing site utilities for any complex structure Car Wash: -Each Stall as defined in OAR91 8-780-0040. -Drive Thru 0 Medical gas and vacuum systems for health care facilities. Cuspidor/Water Aspirator ❑ Any multipurpose fire sprinkler system. Dishwasher: -Commercial ❑ Any complex structure as defined in OAR918-780-0040. -Domestic Drinking Fountain Submit 2 sets of plans with any of the above. Eye Wash Floor Drain/sink: -2" .Isometric or Riser Diagram ❑ 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 Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 City of Tigard 11/4 " COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Review - Residential TIGARD Building Permit #: /T' ?-3,_ 00 Site Address: 15632 SW Everglade Ave 0 Verified in Accela Project Name: RT Crossing Lot/Unit #: 166 Proposal: New SFR Zone: RES-C Housing Type: 0 SFR(0 Single Detached ❑ Duplex❑Triplex❑ADU)❑ Rowhouse❑Cottage Cluster❑ CYU ❑Quad ❑Other Required Site Plan Elements: 0 3 copies of site plan on max 11x17" 0 Drawn to standard scale ❑ fl.lu;,,,.1 I.—, J,.t, I., / O North arrow 0 Street and site trees shown / labeled O Site address, project name, lot # 0 Street names (N/A for SFR) O Applicant name and phone # ❑ Call!tye,d r..ctungl., diwc,,s;on.,d (;f e,.,,rlicable) O Lot and setback dimensions 0 Vision clearance triangle ❑ Exioting otructurco &aquorc footagc 0 Utility locations &easements 0 Footprint of new structure and FFE 0 Property corner elevations O Sidewalk/driveway dimensioned 0 LIDA (>1,000 sf disturbance) 0 Lot area and lot coverage percentage 0 Erosion control Requ evation Plan Elements: (For SFR: calcs n only on street-facing) Summary table with calculations for: ❑ Drawn to standard sca ❑ Total façade area ❑ Building height dimensioned ❑ Total window and door area ❑ Façade dimensioned ❑ Windows and doors dimensioned ❑ Garage doors dimensioned Required Floo ments: (Not required for SFR) ❑ Summary table that includes ❑ Each story dimensioned floor area ❑ Each story floor area calculated ❑ Floor area pe Planning Review The following standards have been met: Setbacks 0 Front: 12/8 Rear: 15/10 Side: 3 Min/Max Street Side: 8 / Garage: 20 Height 0 Max. Height: NA Proposed Height: 28'7" • es ❑ N/A Landscape ❑ Ye ❑ N/A Screening (Quad only) ❑ Yes • /A % Window Coverage ❑ Yes ❑ N ° Garage (SFR Only) Parking (Other Res) ❑ Yes ❑ N/A ntrance (SFR, Rowhouse, Quad only) ❑ Yes ❑ N/A 0 •er building design standards (Rowhouse only) ❑ Yes ❑ N/A Acce .ry Structure Standards ❑ Yes 0 No Qualifyin: .re-existing unit exempt from standards (Cottage unit only) Additional standards for ourtyard Units, Cottage Clusters, Rowhouses, and Quads: ❑ Yes ❑ N/A Unit Count: ❑ Yes ❑ N/A Lot Width and Siz- ❑ Yes ❑ N/A Pathway Additional standards for Courtyard b •its and Cottage Clusters only: ❑ Yes ❑ N/A Unit Area: ❑ Yes ❑ N/A Floor Area (per story) ❑ Yes ❑ N/A Courtyard ❑ Yes ❑ N/A Fence ❑ Yes ❑ No ON/A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995) 0 Yes ❑ No ❑N/A Public Facilities Improvement (PFI) Permit: Required: 0 Yes ❑ No Applied For: 0 Yes 0 No, stop intake 0 Sensitive Lands: ❑ Yes ifNo 0 Main Land Use Case #s: PDR2016-00016, PDR�2018-00005 El Conditions met 0 Applicant notified of land use expiration dat : 3/22/ 6 Approved By Planning: Date: Notes Facade standards on app y o — Revision 1: El Approved ❑ Not Appr d Date: Revision 2: Cl Approved El Not App ed Date: Building Permit Submittal ` Original Submittal Date: (It 47.. Site Plans #: 7 Building Plans #: Building Permit #: kil Building permit # entered on page 1 Workflow Routing: 6Planning NEngineering ti.Permit Coordinator A.Building Workflow Sign-off: .Sign-off for Planning (include notes from planning review) Route Documents: l,.Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. C33.Building: original permit application, site plans, building plans, engineer and beam calculations and trust details, if applicable, etc. Permit Technician: ` % Date: S 4 D--4-- Notes: Engineering Review El PFI Permit: d LP/Slope at building pad: 2 '1;, wo AO IIY'Conditions met prior to issuance of permit Easements (encroachments) per engineering conditions of approval and plat ELAWater Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes t1No Assess Water Quantity Fee in-lieu: El Yes 'No LIDA Facility on lot: ❑ Yes kr No Add Fee: El Yes El No final Plat Recorded 0 NOT Approved: Date: Notes: Approved By Engineering: Date: S�y 3/2'3 Revision 1: 0 Approved Not Approved Date: Revision 2: 0 Approved El Not Approved Date: Permit Coordinator Review /Conditions met prior to permit issuance El Approved, NOT Released: Date notified applicant: CIENG Revisions Required:. Date notified applicant: l SDC Exemption: El Applied for ❑ Received I Does not apply SDC Fees Entered: Wash Co Trans Dev Tax: J 'Yes ❑ N/A Tigard Trans SDC: /Yes El N/A g1 Deferred Parks SDC: %Yes El N/A An Deferred LIDA ❑ Yes pIJ N/A Issue/Approved by Permit Coordinator: vim- Date:�131 1�i3 P OK to Revision 1: ❑ Approved ❑ Not Approved Date: Revision 2: El Approved El Not Approved Date: