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Permit (197) CITY OF TIGARDfer 3 MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2017-00212 13125 SW Hall Blvd.,Ti Date Issued: 07/20/2017 Tfti., Ft.{ and OR 97223 503.718.2439 9 Parcel: 1S134DA01800 Jurisdiction: Tigard Site address: 10757 SW NORTH DAKOTA ST Subdivision: None Lot: None Project: Tasto Project Description: Construct 791 sf garage addition. 5/30/2018: REPRINT to replace radiant heat at ceiling with a gas furnace. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 791 sf Front: 20 Smoke Dwelling Units: 0 Third: 0 sf Right: 5 Detectors: No Total: 0 sf Value: $35,302.33 Rear: 15 PLUMBING Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 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 Noes Air Conditioning: N Vent Fans: 2 Clothes Dryers: 0 Natural Gas Heat Pump: N Hoods: 0 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 1 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 7 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 Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ADD SF VB R-3 0 Owner: Contractor: TASTO,NICOLE&RUSSELL OWNER Required Items and Reports(Conditions) 10757 SW NORTH DAKOTA ST 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97223 PHONE: 503-317-3652 PHONE: FAX: Total Fees: $1,974.69 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 952-001-0010 through OA 52-001-0090. Y u may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. 41,71 Issued By: Permittee Signature: L Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Applicatio FOR OFFICE USE ONE\' City of Tigard Received _ Date/By: , If..., Permit No/../S7- 2.0./f _%2/2 7::a� IIII13125 SW Hall Blvd.,Tigard,OR 97223 • // �`(! ■ Phone: 503.718.2439 Fax: 503.598.1960 Plan Review j! ��1 Date/By: Other Permit: Inspection Line: 503.639.4175 r Ti G A R D p Date Ready/By: Juris: 10 See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information CITY OFTIGAR TYPE„OFiitzoiNG DIVISION .x OMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees*are based on the value of the work 0 New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. O.., .;: Value:, CATEGORY F CON RUCTION ,,RESIDENTIALEQUIPMENT/SYSTEMS=FEES'', Cti 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total v:k JOB SITE,;INFORMATION AM? LOCATION ' Heating/cool'ng: � rAir conditioning 46.75 Q-1 - Job site address: , 5 7 X �a 1'C 06e, 5,..6 Furnace 100,000 BTU(ducts/vents) r 46.75 City/State/ZIP: `-,%,,,,,.. l Q c . %1 Z Z 3 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: C 'ZSr . C4 Pi Duct work "�c` (a i23.32 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 Other: Subdivision: Lot no.: 23.32 Tax map/parcel no.: Other fuel appliances: Water heater 23.32 .7. t ” # itp; CRIPTIOI 'QIF o ". a <_, Gas fireplace/insert . 33.39 ,r ' Flue vent for water heater or gas /V----C77- /Sem('`"/Si 7-7/1/ , /"G -�// fireplace 23.32 Vp\q.c..:t., \Li`,Cl, YM`� �Fc .4, �, �-` Log lighter(gas) 23.32 i ' 'S Wood/pellet stove 33.39 VY V's\CWood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 OPIIiT �VIi u wa x Other: 23.32 5 1 N4NT ' � Environmental exhaust and ventilation: Name: R,v S SQ 1 --c;:::AS�Q Range hood/other kitchen Address: 1 Q7 b.-7 S W N , )mak,,, -51 equipment 33.39 vv C/, �j Clothes dryer exhaust 33.39 City/State/ZIP: Single-duct exhaust(bathrooms, ty �� d,rc� r0 � � 1ZZ. 3 g Phone:(,. Q� '�` 6 9 Fax:( ) toilet compartments,utility rooms) 23.32 Attic/crawlspace fans 23.32 2 .x= 44„K,40'",,' t .:..❑ CONTACT TERS N r . Other: 23.32 Business name: Fuel piping: $14.15 for first four;$4.03 for each additional Contact name: Furnace,etc. Address: Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( ) Fax::( ) Fireplace Range E-mail: Barbecue n1 - '17. Clothes dryer(gas) Business name: Other: Address: -44‘ ,' QWre.- ID. : ,NTCAL iE '.FEES''/ Subtotal City/State/ZIP: Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:( ) Fax:( ) State surcharge(12%of permit fee) CCB lic.: 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: S std\ -1--CAS Date:h( ()/, Q I:\Buildng\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: o Va uation F' mit F *1 tpt- ' + : $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 CITY OF TIGARD MASTER PERMIT 1111 '. COMMUNITY DEVELOPMENT Permit#: MST2017-00212 13125 SW Hall Blvd.,Ti Date Issued: 07/20/2017 T[ta' k�. and OR 97223 503.718.2439 9 Parcel: 1 S 134DA01800 Jurisdiction: Tigard Site address: 10757 SW NORTH DAKOTA ST Subdivision: None Lot: None Project: Tasto Project Description: Construct 791 sf garage addition. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 791 sf Front: 20 Smoke Dwelling Units: 0 Third: 0 sf Right: 5 Detectors: No Total: 0 sf Value: $35,302.33 Rear: 15 PLUMBING Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer 0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 2 Clothes Dryers: 0 Natural Gas Heat Pump: N Hoods: 0 Other Units: 0 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 1 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'l 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 7 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 Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ADD SF VB R-3 0 Owner: Contractor: TASTO,NICOLE&RUSSELL OWNER Required Items and Reports(Conditions) 10757 SW NORTH DAKOTA ST 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97223 PHONE: 503-317-3652 PHONE: FAX: Total Fees: $1,929.69 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..,,.ATTTNTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 9501-0010 through OAR 552-0 - 090. You may obtain a�copy yof the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: (s' '_y/' ( ' ---7i'-.yrs—�op�/ Permittee Signature: 'C �� Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application Residentia C�n i/ EI CCiivv M � " rolz orrlcl: t:sl:0\l.1 Cl _ ■� ` Received // / ;� 131.♦ W Blvd Ti . ,, a• 974g t ' .2017 Date/By: Le 7 /� 1 �j�/ ' Permit No.: kir,„27,, 7�� 2 ■ � _ Plan Review \\\ Phone: - - , f 03. '8.1961 Fl G A k D Insp c� 03•' - ��I ° GA p Date/Read/�� Other Permit: i��yf��}, OF GARD y y: 7 Juris: ® See Page 2 for "r�� • RBUI 1 ING D VISION otified/Method: l/� I Supplemental information IVIS/Q�\/ 1 �/� TYPE`UF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING 0 New construction 0 Demolition Permit fees*are based on the value of the work performed. Addition/alteration/replacementIndicate the value(rounded to the nearest dollar)of all 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application.� R 1-and 2-family dwellingValuation: $ � "3 0 Commercial/industrialS. 0 Accessory building 0 Multi-famil Number of bedrooms: y 3SJ NJ 0 Master builder 0 Other: Number of bathrooms: JOB SITE Ny INFORMATIONL `. AND LOCATION Total number of floors: \` Job site address: I 0 75 7 SU ,,,vs ,„,�q, ,SA, New dwelling area: square feet City/State/ZIP: TI ��d 1 -7 Z Z 3 Garage/carport area: 7 J + square feet Suite/bldg./apt.no.: Project name: G c„,r O. \J „` \®^ Covered porch area: square feet Cross street/directions to job site: T 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. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the \ DESCRIPTION OF WORK `` work indicated on this application. am`- Wit\ ,4 +Or% /tt S"XC-.•6 S i t�C_ CNP Valuation: $ C�Y�? Existing building area: square feet New building area: square feet ja PROPERTY OWNER 0 TENANT Number of stories: Name: nn .1 S SQ-`\ ^�— C� --1---,„,,s 1 ,„,,sl Type of construction: Address: 1075 7 S\J n\ 1'1 \,ol a1 V "c�,'�(J �� Occupancy groups: City/State/ZIP: l 0 ck. s-7 Z � � Existing: Phone:( 3tT G''Z Fax:( ) New: LI APPLICANT CONTACT PERSON BUILDING PERMIT FEES* Business name: (Please refer to fee schedule) Contact name: 5 q` Q Structural plan review fee(or deposit): Address: FLS plan review fee(if applicable): City/State/ZIP: Total fees due upon application: Amount received: Y V71-/ i1 Phone:( ) Fes::( ) E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted Photo Voltaic Solar Panel System. Business name: ,r r,.r1 cr m 2 Submit two(2)sets of roof plan with connection details Address: CJ lis �J and fire department access,along with the 2010 Oregon Solar Installation Specialty Code checklist. City/State/ZIP: Permit Fee(includes plan review Phone:( ) Fax:( ) and administrative fees): $180.00 State surcharge(12%of permit fee): $21.60 CCB lic.: Total fee due upon application: $201.60 Authorizedsignature: RV f st.\\ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. � Date: 1 *Fee methodology set by Tri-County Building Industry Print name: VI 1171 2 011 Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) (4/, 01-91- t 2-) Building Permit Application Checklist One- and Two-Family Dwelling roil OFFICE t Si. 0y1.1 City of Tigard Received Permit No.: lipg Date/By: r 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits: I Phone: 503.718.2439 Fax: 503.598.1960 0 Electrical 0 Plumbing 0 Mechanical T I G A}t i) 24-Hour Inspection Line: 503.639.4175 ❑ Internet: www.tigard-or.gov Other: /: THE FOLLOWles \o A kING ITEMS ARE REQUIRED FOR PLAN REVIEW • 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 0 0 • 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 'D 0 0 3 Verification of approved plat/lot. 4 Fire district approval required. Name of district: 0 0 0 5 Septic system permit or authorization for remodel. Existing system capacity 0 0 0 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. 0 ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. 9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 0 0 basin protection,etc. 0 0 0 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 0 0 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 0 0 0 and location. 0 0 0 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 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. 0 0 0 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. 0 0 0 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. 0 0 0 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 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 0 over 10 feet long and/or any beam/joist carrying a non-uniform load. 0 0 0 20 Manufactured floor/roof truss design details. 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 0 0 for four or more appliances. 0 0 0 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 a licable to the ro'ect under review. 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". 0 0 0 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 0 0 0 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 0 0 27 "Drawn to scale"indicates standard architect or engineer scale. 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 0 0 Street Tree List. 0 0 0 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. 0 0 0 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) Electrical Permit Applicatirwk EwVE 1 0k OFFICE FSE ON Ll City of Tigard Dat Bed Permit#: s i? '/7— ?-/Z Ili • 13125 SW Hall Blvd.,Tigard,OR 97223 H 17 2017 Plan Review I Phone: 503.718.2439 Fax: 503.598.19bkl N Date/B : Related Permit#: Inspection Line: 503.639.4175 ^ t p�t,s-y Ready Date/By: Juris: H See Page 2 for 1 I(;ARD CITY OF TIGARD Notified/Method: Supplemental Information Internet: www.tigard-or.gov 13� ING DIVISION TYPE O DIVISION PLAN REVIEW O New construction Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): 0 Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. PIless to ground,or exceeds 14,000 0 Commercial-use agricultural 1-and 2-family dwelling ❑Commercial/indusMal ❑Accessory building amps for all other installations. buildings. ❑Multi-family 0 Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived 1 O1-9 7 S c W r � k�„el 0 Addition of new motor load of system. Job#: Job site address: t,'`I` oklooHP or more. ❑"A">"E">"1-2">"1-s"> 0 Six or more residential units. occupancy. City/State/ZIP: c 1 3� 7. 0 Health-care facilities. 0 Recreational vehicle parks. 0 Hazardous locations. 0 Supply voltage for more than Suite/bldg./apt.#: Project name: ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Qty. 1 Each I Total I * New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'1500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 (with above sq.ft.) �' (c--6/ -6` t Z (�O\ `Y 9 ( , sQ1'a e CX ik.it \ Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 W PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name: cl.u S 5c\\ 7;,,,5 200 amps or less 100.70 2 201 amps to 400 amps 133.56 2 Address: ()-7i \\s‘ p t1,,Qj 401 amps to 600 amps 200.34 2 City/State/ZIP:—T1I C7 1 ® c1. 37 Z„Z 601 amps to 1,000 amps 301.04 2 Phone:(53)-311—n1/4& 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 1 intended for sale,lease,rent, c��to ORS 447,449,670,and 701. � 201 amps to 400 amps 125.08 2 Owner signature: Date: C, /zot 401 amps to 599 amps 168.54 2 tAPPLICANT ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel itA.Fee for branch circuits with Business name: above service or feeder fee, 41 7 42 2 each branch circuit Contact name: 5 11),yv,e. B.Fee for branch circuits without service or feeder fee,first I 56.18 2 Address: branch circuit City/State/ZIP: Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder hi included) Phone:( ) Fax::( ) Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: 0 knI r B Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy ❑ See Page 2 2 Address: panel,alteration,or extension. Each additional inspection over allowable in any of the above City/State/ZIP: Additional inspection(1 hr min) 66.25/hr Phone:( ) Fax:( ) Investigation(1 hr min) 90.00/hr Industrial plant(1 hr min) 78.18/hr Email: Inspections for which no fee is 90.00/hr CCB Lic.: Electrical Lic.: Suprv.Lic.: specifically listed('/z hr min) 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): TOTAL PERMIT FEE: Authorized signature: -1 N, This permit application expires if a permit is not obtained within 180 Print name: R 0, ,5,e\\ Toks Date: %p! I//7 ( zoo� 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: RESIDENTIAL W ONLY:w :'°FEE'sCHEDUL „ Fee for all residential systems combined: $75.00 nescewa I Qty. I Each I Total I * 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 n Garage Door Opener* 50.01 to 100 kva 552.26 2 >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 Rspecifically listed(%hr min) A' w tO M �I�L'�'DR�'01 ,Yi `�� EL> xt� rERMM:TEEs Fee for each commercial system: $75.00 subtotal(Enter on rage 1): * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems n Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 Mechanical Permit Application FOR OFFICE USE O!SLV' Received I 13125 SW Hall Blvd.,Tigard ! Permit No.: l�r�✓bl 7_Q�a1 City of Tigard Date/By: , !,3 Plan Review Other Permit: Phone: 503.718.2439 Fax: 3 t�� ED Date/By: Inspection Line: 503.639.4175 TIGARD Date Ready/By: Jurs ® See Page 2 for Internet: www.tigard-or.gov J * 201Notified/Method: Supplemental Information ormation 0 TIGARD �+ COMMERCIAL FEE* SCHEDULE — USE CHECKLIST T B �ell' ��V 1 �Q`� Mechanical permit fees*are based on the value of the work 0 New construction M Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all mechanical materials,equipment,labor,overhead,and profit. 0 Demolition ❑Other: Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* Cgt 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total Heating/cooling: JOB SITE INFORMATION AND LOCATION Air conditioning 46.75 Job site address: I 0 7 y c7 Svj N p‘ . ..c)ttk31, Furnace 100,000 BTU(ducts/vents) 46.75 Ci ty/State/ZIP: I, cal 0 �7 "Z.,? 3 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: "IA ( Project name: Duct work 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. 1 46.75 Flue/vent for any of above 23.32 Other: 23.32 Subdivision: Lot no.: Other fuel appliances: Tax map/parcel no.: Water heater 23.32 i . Gas fireplace/insert 33.39 ' k.�\DESR3'IPTIO,,-V #F VYOKY c6 � m ,,,Flue vent for water heater or gas ��^�� t 1'\ ' (),, `scz,, 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 -ROPERTY E "`" ft, ' . Q , z: Environmental exhaust and ventilation: Name: v S Stk�r ` c,,,, jzi Range hood/other kitchen y� cequipment 33.39 Address: 101 `� s vi \\\ V�j,�q JV Clothes dryer exhaust 33.39 Single-duct exhaust(bathrooms, City/State/ZIP: � t. 1 �� , toilet compartments,utility rooms) fi 23.32 Phone:(?c . ."—C 3) '5 Z Fax:( ) Attic/crawlspace fans f 23.32 .:: APPLICANT P. ,'. -," +1 Other: 23.32 ' ?� Nr: ,.�.. �'^ � � .PFuel piping: Business name: $14.15 for first four;$4.03 for each additional Contact name: C--,yin Furnace,etc. Gas heat pump Address: Wall/suspended/unit heater 1 City/State/ZIP: Water heater Fireplace Phone:( ) Fax: :( ) Range E-mail: Barbecue .",, ` CONTRACTOR f Clothes dryer(gas) Other: Business name: " IECrHA iIC LrPE',41 TEES*:', : Address: J Ok wt / 0 ,,t o Subtotal Minimum permit fee($90.00) City/State/ZIP: Plan review(25%of permit fee) Phone:( ) Fax:( ) State surcharge(12%of permit fee) TOTAL PERMIT FEE CCB lic.: —(j�\\ �.. This permit application expires if a permit is not obtained within 180 , .....N.71.\\./ .., \`V;;J V days after it has been accepted as complete. 4,--\„/N, , * Fee methodology set by Tri-County Building Industry Service Board Authorized signature: -y Print name: \,,f,.fs(,`i --r—‘2„,, ,c) Date: b/7 /Z Oi 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: Total Valuation: Permit Fee: $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 $$51,0,36030.07.010 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_PemrmitApp_040113.doc 2 - Plumbing Permit Application Building Fixtures FOR OFFICE USE ONLY 1 City of Tigard EI�A Received / Permit No.: /1/4,../ T�n Z Y E Date/By: �( � (7 ?~ � IIIl'I 13125 SW Hall Blvd.,Tigard,OR 97 Plan Review _ Phone: 503.718.2439 Fax: 503.598.1 tyDate/By: Other Permit No.: Inspection Line: 503.639.4175 i 2017 TIGARD Date Ready/By' Jars: 0 See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF ., il�. Y OF Y(QN�iD FEE* SCHEDULE 0 New construction 0 Demolition For special information use checklist Description Qty. Ea. Total Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 It 1-and 2-family dwellingSFR(2)bath 437.78 ❑Commercial/industrial SFR(3)bath 500.32 ❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION.AND LOCATION Site utilities: Job site address:1 07 57 s W 1m p a L Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: -T-` ��/ ( �� 2.1 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 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: Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer \,/ 31.27 k DESIPTIt<?1V pW(�RK Backwater valve /J6 tr. Ate �]C 12.51 u rl Clothes washer 25.02 7} Z b E , t^ t7.a''0. C1 (SA t t O is Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 PROPERTYu}� R - � s, $�* : Expansion tank 12.51 Fixture/sewer cap 25.02 Name: $ \\ 7-,,,,,,,k,, Floor drain/floor sink/hub 25.02 Address: i c,--i -7 5\,,,1 IA p c.,,\Ap Slt, Garbage disposal 25.02 City/State/ZIP: 1.,,a l 0 , ---/ z Z3 Hose bib 25.02 Phone:(5®"3\ 6,5 Z Fax:( ) Ice maker 12.51 3i A: ` Interceptor/grease trap 25.02 k` PLIC�iNT.�tt � P ' �r e 2 Medical gas(value:$ ) Page Business name: Primer 12.51 Contact name: ,S czN w,e Roof drain(commercial) 12.51 Address: Sink/basin/lavatory I 25.02 City/State/ZIP: Solar units(potable water) ) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 12.51 Urinal 25.02 E-mail: T, x ',4". tWater closet 25.02 • To - Water heater 37.52 Business name: Q,v /rtvA..) Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal Phone:( ) Fax:( ) Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lic.: Plumbing Lic.no.: o State surcharge(12%of permit fee) Authorized signature: �/"\ t;""' . /�Ir TOTAL PERMIT FEE Print name: C\v (� j f.\\ ---r S Q Date: 17)7/Z Z Q1 , This permit application expires if a permit is not obtained within 180 days 1 after it has been accepted as complete. 111 *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: Site Utilities Qty• Fee(ea) Total Square Footage: Permit Fee: Footing drain-151 100' 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 Storm&Rain Drain-1st 100' 62.54 Valuation: Permit Fee: $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 Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,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 (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 futures could result in increased sewer fees*. I r*R.o''vi sink.r Plumbing Inst t p 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 Baptistry/Font ❑ Any new commercial building with water service 2"and Bath: Tub/Shower greater,except systems designed and stamped by licensed -Jacuzzi/Whirlpool engineer. Car Wash: Each Stall 0 New exterior plumbing site utilities for any complex structure Drive tall as defined in OAR918-780-0040. Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities. Dishwasher: -Commercial 0 Any multipurpose fire sprinkler system. Domestic 0 Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" Isometric or Riser Diagraiti 4 0 Isometric or riser diagram is required for new buildings -Car Wash Drain g q g Garbage -Domestic non-food that meet the qualifications above. 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: -Lav/Bar 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 Water Extractor fees assessed for the sewer increase must be paid before the Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2 City of Tigard 111111 III v COMMUNITY DEVELOPMENT DEPARTMENT T 1 G A R D Building Permit Review — Residential Building Permit #: H 51-C90 7-oo a---1 2-- Site Address: 10/57 S w IV 0 c'►k o 1-z-n c4-• Project Name: 1-a S.1-0 C-1 (Arc/19e Act cti 'h Oil Lot #: (New dwelling=subdivision na e;Addition or Alteration=last name of owner) Planning Review Proposal: G 0 a,t: Pt 64 co.) r'1 ,z Verify site address/suite# exists and active in permit system. River Terrace Neighborhood: Af No ❑ Yes,See River Terrace Review Addendum Attached Site Plan Elements: Three(3)copies of site plan 0 Existing structures on site eSite plan must be on 8-1/2"x 11"or 11 x 17"paper /Footprint of new structure(including decks)with finished /Drawn to scale(standard architect or engineer scale) floor elevations /North arrow 411Jtility locations&easements(required for new and additions) Site address,project or subdivision name and lot numberidewalk/driveway approach /Applicant information(name and phone number) 'ratiei4-c£wells/septic systems ❑Lot dimensions and building setback dimensions L rK1's'M11,r-trees to be retained with drip line,and tree txme.€ootage of buildings to be demolished protection measures Dincrt-zrearbetileling coverage area,percentage of coverage and ❑Ehcct tie size,type and location impervious area(applicable if R-7,R-12,R-25&R-40) Street?lProperty corner elevations(2 foot contour lines if more than Storm water quality facility required if>1,000 sf of Nies- 4 1ie!.4 foot differential) impervious area is created or re.laced. Clean Wate ervices—Service Provider Letter(lot platted prior to 9/10/1995): Required: `" Yes,applicant was notified ❑ No Received: g YesNo Public Facilities Improvement(PFI)Permit: 77 Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake g-Curd Use Case#: Zoning: g 4. S Required Setbacks: Front t. Rear is Side S Street Side — Garage 7....,:, 7 Landscape Requirement: rV/A Lot Coverage Maximum: N Building Height: Maximum Height 3 0 Actual Height Z1 .7 \T+c.nal Clearance ensi ive Lands: ❑ Yes ❑ No Type °❑ Urban Forestry Plan ❑ Conditions "Met"prior to issuance of building permit Notes: Approved By Planning: O^ v-N.-''-- Date: G/ i I I 1 Revisions (after Bu' ding Submittal only) Rest.we Date Revision 1: , ,/ipproved ❑ Not Approved j7i' 4 / ,/', (Q (-20117 Revision 2: 2' Approved ❑ Not Approved cvi 0 pt., f,'v 7/ 121 17 Revision 3: ❑ Approved ❑ Not Approved I:\Building\Fonns\BldgPermitRvw RES_05 16 17.docx Building Permit Submittal Original Submittal Date: 6/7/17 Site Plans: # `j Building Plans: # 3 Building Permit#: [ 'Enter building permit#above. Workflow Routing: Planning ❑—Engineering a-ermit Coordinator Jd'Building Workflow Sign-off: [a] Sign-off for Planning(include notes from planning review) Route Application Documents: Z-Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. IC Building: original permit application, site plans,building plans,engineer and n beam calculations and trust details,if applicable,etc. Notes: I� �' .: W. . 6 kt G,-) _ l v L t�r1 `= ' t Date(Q/ _/17 ByPermit Technician: INIV Engineering Review 1+ ElSlope at building pad: ' la-Conditions "Met"prior to issuance of building permitekt V191'04 al - L.1 Cl4 rACj )41Gg N ❑ Easements (encroachments)per engineering conditions of approval and plat 1' Water Quality/Quantity Facility: ii t¢at l`T Assess Water Quality Fee in-lieu: ❑ Yes 2--No (iwYD ` 0A2)S1 j'140-Lv L .S Assess Water Quantity Fee in-lieu: ❑ Yes Er-No' LOA eAlg b pm Gµjb S 1.-2.14-1,9 LIDA Facility on lot: C Yes g"1K0 1%01%., A-1.,O S 1440 w W*1E,.O„k, 40 +4 NOTA roved byEngineering: �A« D e:4,v-1-FALL -Too. PP ng: 1414 6‘k4-1-it G� /2-l'7 Notes: `..,� s.f.c� l m /AM c4 r��a., A-1e. .1 IAA 4-t,. ('jw5 SUzis Approved by Engineering: Date: Revisions (after Building Submittal only) ,e. , Reviewer Date Revision 1: 0 Approved Revision 2: J.Approved le-Not Approved ' ��j S 4„Z 7 0Not Approved, I'M (, }1'�s S it- I -- I-1- (7 IRevision 3: 0 Approved ❑ Not Approved Permit Coordinator Review gt, 6 sue il.,t ❑ Conditions "Met"prior to issuance of building ❑ Approved,NOT Released: Q fat E 'r'S 0b4 Notes: c! _ C`AC-4.- l��t otrN b 14'h'Ve Revisions (after Building Submittal only) 1;,,,, 2tc04.at A 4A-T'' 'L Revision Notice 1: Date Sent to Applicai Revision Notice 2: Date Sent to Applicai Is.K. ►43t,A q C-� Ty, Revision Notice 3: Date Sent to Applicai V ►A'.DC Fees Entered: Wash Co Trans Dev'1 Tigard Trans SDC: Parh. SDC: LIDA 4 ►.4k OK to Issue Permit nt 44. V/?- Approved by Permit Coordinator: Date: , I:\Building\Forms\BldgPermitRvwREs 05 1617.docx Clean Water Services File Number CleanWater Services 17-002019 Sensitive Area Pre-Screening Site Assessment j ; I ` 1. Jurisdiction: Tigard k 2. Property Information(example 1S234AB01400) 3. Owner Information dry+ I Tax lot ID(s): 1S134DA01800 Name: HL) Company: BUILDING 'VISION Address: 10757 SIN North Dakota S Site Address: 10757 SN North Dakota s City,State,Zip: Tigard.Cregon,97223 City,State,Zip: Tigard,Oregon,97223 Phone/Fax: 503-317-3652 Nearest Cross Street: 106th E-mail: russelltasto@gmail.com 4. Development Activity(check all that apply) 5. Applicant Information 51 Addition to Single Family Residence(rooms,deck,garage) Name: Resell Tasto ❑ Lot Line Adjustment ❑ Minor Land Partition Company: U Residential Condominium ❑ Commercial Condominium Address: 10757`3N North Dakota R ❑ Residential Subdivision ❑ Commercial Subdivision IJSingle Lot Commercial CIMulti Lot Commercial City State,Zip: Tigard,Gregor,97223 Other Phone/Fax: 503-317-3652 E-Mail: rus ltasto@gmaii.00m 6. Will the project involve any off-site work? ❑Yes Ii No ❑Unknown Location and description of off-site work 7. Additional comments or information that may be needed to understand your project This application does NOT replace Grading and Erosion Control Permits,Connection Permits,Building Permits,Site Development Permits,DEQ 1200-C Permit or other permits as issued by the Department of Environmental Quality,Department of State Lands andlor Department of the Army COE. All required permits and approvals must be obtained and completed under applicable local,state,and federal law. By signing this form,the Owner or Owner's authorized agent or representative,acknowledges and agrees that employees of Clean Water Services have authority to enter the project site at all reasonable times for the purpose of inspecting project site conditions and gathering information related to the project site. I certify that I am familiar with the information contained in this document,and to the best of my knowledge and belief,this information is true,complete,and accurate. Print/Type Name Rassell Tasto Print/Type Title ONLINE SUBMITTAL Date FOR DISTRICT USE ONLY ❑ Sensitive areas potentially exist on site or within 200'of the site. THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties,a Natural Resources Assessment Report may also be required. ❑ Based on review of the submitted materials and best available information Sensitive areas do not appear to exist on site or within 200'of the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order 07-20, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local,State,and federal law. Based on review of the submitted materials and best available information the above referenced project will not significantly impact the existing or potentially sensitive area(s)found near the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect additional water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order 07-20,Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local,state and federal law. ❑This Service Provider Letter is not valid unless _CWS approved site plan(s)are attached. ❑The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2). NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER iS REQUIRED. Reviewed by Date 6/15/17 2550 Svv Hillsboro Highway • Hillsboro,Oregon 97'23 • Phone (503)681-5100 • Fax (503)681-4439 • www.cleanwaterserices oro I' q 1 .:; TIGARD City of Tigard Thursday, June 29, 2017 Russell Tasto 10757 SW North Dakota St. Tigard, OR 97223 RE Your building permit application MST2017-00212 Dear Mr. Tasto: On further review of your application for the garage addition Engineering has made the following comments. I believe you have already discussed most of them with our Engineering Technician, Kenny Fisher. Revision#1. LIDA facilities need to be brought up to CWS standards, show CWS LIDA calculations on CWS sizing form and show where both facilities outfall to. Need to acquire private water quality agreements on both facilities and have them recorded with Washington County. Thank you for your cooperation. If you have any questions please let me know or contact Mr. Fisher directly at 503-718-2602. Sincere „ Albert Shields Permit Coordinator 503-718-2426 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171 TTY Relay: 503.684.2772 • www.tigard-or.gov 1111 TIGARD` City of Tigard Monday, June 12, 2017 Russell Tasto 10757 SW North Dakota St. Tigard, OR 97223 RE Your building permit application MST2017-00212. Dear Mr. Tasto: On reviewing your application and plans for the garage addition Engineering has noted that the plans need to include what type of LIDA facility will be used along with the CWS sizing calculations. Also please show where the existing rain drain outfalls. Thank you for your cooperation. Please let me know if you have any questions. Sincerely, r,, Al.ert Shields Permit Coordinator 503-718-2426 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171 TTY Relay: 503.684.2772 • www.tigard-or.gov FOR OFFICE USE ONLY—SITE ADDRESS: /0? Lc-7 �c f aAkC7 ✓moi- - < 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 N . Transmittal Letter T i c,n h n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: 1\ s Q y DATE RECEIVED: DEPT: BUILDING DIVISION � IvFP FROM: R vs Sd\ 743-2o JAN 3 201$ COMPANY: CITY ,. , / ° : BUILOPAr) DIVISION' PHONE: 50_ --, \--7 _b h�'c i By: 47r RE: \9 I) 3\�.f pc,k,t � 3t t'i. � o17 Q0 .\ Z S-77-6/514 e^ddress ( ermit Number) (Pro ecname or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: I Copies: I Description: I Copies: I Description: 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. --a--- Engineer's calculations. Other(explain): REMARKS: FO OF ICE USE ONLY Routed to PermitTec • *an: Date: 1 3 ( % Initials: 9— Fees Due: e / 0 No Fee Descriptio : Amount Due: t/Z ?1,,,,- r - $ 4-f S-'2� $ $ $ Special Instructions: Reprint Permit(per PE): I ❑Yes ❑ Done Applicant Notified: l Date: //`///>r f Initials: ildr ._ I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10757 SW NORTH DAKOTA ST, TIGARD, July 3, 2018 at 11 :14:31 AM OR, 97223 Record Type: Record ID: Residential - Master Permit MST2017-00212 Inspection Type: Inspector: 699 Mechanical final David Young Result: PASS Comments: Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10757 SW NORTH DAKOTA ST, TIGARD, July 3, 2018 at 11 :13:36 AM OR, 97223 Record Type: Record ID: Residential - Master Permit MST2017-00212 Inspection Type: Inspector: 199 Electrical final David Young Result: FA I L Comments: Right side outlets not gfci protected. All else appears ok. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10757 SW NORTH DAKOTA ST, TIGARD, July 3, 2018 at 11 :11 :34 AM OR, 97223 Record Type: Record ID: Residential - Master Permit MST2017-00212 Inspection Type: Inspector: 399 Plumbing final David Young Result: PASS Comments: Caulk sink to wall, will check at building final. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10757 SW NORTH DAKOTA ST, TIGARD, July 5, 2018 at 12:27:32 PM OR, 97223 Record Type: Record ID: Residential - Master Permit MST2017-00212 Inspection Type: Inspector: 299 Final inspection David Young Result: PASS - NoCofO Comments: Final erosion control approved. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10757 SW NORTH DAKOTA ST, TIGARD, July 5, 2018 at 12:25:47 PM OR, 97223 Record Type: Record ID: Residential - Master Permit MST2017-00212 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS Comments: Correction complete. Violation Summary: Inspector Contractor