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Permit (175) CITY OF TIGARD � ;;7; ' MASTER PERMIT I . COMMUNITY DEVELOPMENT //- Permit#: MST2019-00056 � Date Issued: 04/03/2019 T i G A R n 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 I. Parcel: 2S115AB05700 Jurisdiction: Tigard Site address: 11330 SW GABRIEL ST Subdivision: WILLOW BROOK SUBDIVISION Lot: 2 Project: Willow Brook, Lot 2 Project Description: New SF. 7/17/19: REPRINT to add(1)backflow preventer for landscape irrigation and(1) laundry tray. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 3 First: 1814 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 16 Bathrooms: 2 Second: 0 sf Garage: 553 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 1814 sf Value: $242,233.80 Rear: 15 PLUMBING Sinks: 1 Water Closets: 2 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0 Bckflw Prevntr: 1 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3 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: 3 201-400 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 Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 1814 Owner: Contractor: PACIFIC LIFESTYLE HOMES INC PACIFIC LIFESTYLE HOMES Required Items and Reports(Conditions) 11815 NE 99TH ST STE 1200 11815 NE 99TH ST#1200 1 Ersn Cntrt 503-639-4175 VANCOUVER,WA 98682 VANCOUVER,WA 98682 PHONE: 360-573-8081 PHONE: 360-213-0813 FAX: 360-574-6401 Total Fees: $30,454.63 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Ore•on 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 09:52-001-0=:.. Yo ay ob a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: - Permittee Signature: !.1. Call 503.639.4175 by 7:00 a.m.for the next available inspec n dat 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. Plumbing Permit Ap licatio r Building Fixtures {� City of Tigard J U L 1 s 2019 Received q 13125 SW Hall Blvd.,Tigard,OR 97223.. ) Date/By: a l�fi�� 7 "� �b��.- Plan Review ■ Phone: 503.718.2439 Fax: 503.598 4'6b,. Other Permit No.: • � � Date/By: 1 1 G A R D Inspection Line: 503.639.4175 Date Ready/By: Jur s: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information igi New construction ❑Demolition For special information use checklist. Description Qty. Ea. I Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OFN STRUCTION . SFR(1)bath ' 312.70 ritl 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 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: �...-.:: 9 Job site address: (133o 5(J-) 6Ab,Ez--e Cj- Catch basin or area drain 18.76 T Ann o 4 Drywell,leach line,or trench drain 18.76 City/State/ZIP: r"✓ f i Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I/ vProject name:("JILL"?( ) E,e.,j,Ve....,, Manufactured home utilities 50.03 Cross street/directions to job site: 56_, i 3 'N Ave 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: LA ;t�,p(A) g) 'l'- I Lot no.: (yam Fixture or item: Tax map/parcel no.: Backflow preventer I 31.27 DEgCRnotIOIiF ,'Q Backwater valve 12.51.<;�. /� � )}� Clothes washer 25.02 1./ v/`�✓/�y �f i Dishwasher 25.02 ,4CF2/ Lv� Pm e/� Drinking fountain 25.02 Ejectors/sump 25.02 pRopEwiryi r ,q,S Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 , A 4::: ;w i .-' '41, nook- i Interceptor/grease trap 25.02 Business name:$AGS t s-FccL Nb .5 Medical gas(value:$ ) Page 2 Pruner Contact name: -16pY g 1Ae Roofd 12.51 drain(commercial) 12.51 Address: It 615NE 19 TY S . S `CE c2ov ,, L Sink/basin/lavatory 1 I 25.02 City/State/ZIP: UAI3C6v (J()h 1 e6$? ' Solar units(potable water) 62.54 Phone:( )1,,l 3✓ 6067 Fax::( ) Tub/shower/shower pan 12.51 E-mail: 0 pV�i� �� Urinal 25.02 p z' Water closet 25.02 ' • 44E�� i-+-4,;,,,..,,,,,.. croft 1 .' � Water heater 37.52 Business name: (..-+-„I7 ols, Prwf'7izv Water piping/DWV 56.29 Address: fdk Other: 25.02 City/State/ZIP: 134Of.../ a O , f?6X07 Subtotal Phone:(5 .3) - r"' 66m Fax:( ) 7//!/}�/ Minimum permit fee: $72.50 CCB Lic.: g(.)(S 7 2,/ 1wt$lumbing Lic.no.:1/J6)�ll / Plan review (25%of permit fee) {{ State surcharge(12%of permit fee) Authorized signature==_ y2 TOTAL PERMIT FEE Print name3opl� �*j,� Date: 07/r7ii Of This permit application expires if a permit is not obtained within 180 days 66 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: Site Utilities Qty. 4Fee(ea) Total Square Footage: Permit Fee: Footing drain-1 a`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:.` 1 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) Tots :. each additional$100.00or fraction thereof,to and includinngg$$1010,,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 accuratelyreportfixtures could result in increased sewer fees*. f a ., fan R. � e r Pl0:a m Quantity by Future Type Plan review is required for any of the following. Fixture Type for a 1Replace/ Please check all that apply. Work Performed: upped Added` I Relocate Baptistry/Font 0 Any new commercial building with water service 2"and greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool 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" -' ,IseiveViC nr jiser. n ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain 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 - 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 MASTER PERMIT 1 COMMUNITY DEVELOPMENT Permit#: MST2019-00056 TIGAIR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/03/2019 Parcel: 2S115AB05700 Jurisdiction: Tigard Site address: 11330 SW GABRIEL ST Subdivision: WILLOW BROOK SUBDIVISION Lot: 2 Project: Willow Brook, Lot 2 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 3 First: 1814 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 16 Bathrooms: 2 Second: 0 sf Garage: 553 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 1814 sf Value: $242,233.80 Rear: 15 PLUMBING Sinks: 1 Water Closets: 2 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 2 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: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3 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: 3 201-400 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 Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 1814 Owner: Contractor: PACIFIC LIFESTYLE HOMES INC PACIFIC LIFESTYLE HOMES Required Items and Reports(Conditions) 11815 NE 99TH ST STE 1200 11815 NE 99TH ST#1200 1 Ersn Cntrl 503-639-4175 VANCOUVER,WA 98682 VANCOUVER,WA 98682 PHONE: 360-573-8081 PHONE: 360-213-0813 FAX: 360-574-6401 Total Fees: $30,189.98 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 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 5 .232.1987 or/1].80�0..3332.23/44 }�/ Issued By: 1 �, Permittee Signature: ,.� /l.�'(�- rC.i'`' '� 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 Residential FOR OFFICE LSE OM\ Received • City of Tigard Date/By: Permit No.. p RECEIVED ` q s3; �,�T oOk- L 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review �� _ Phone: 503.718.2439 Fax: 503.598.1960 Date/By: idol— . `I Other Permit\T , ,Cy_(1‘,.. -31,....‘—i.1 t G A R D Inspection Line: 503.639.4175 FEB 1 4 Q Date Ready/By:/ . Juris: ® See Page 2 for Internet: www.tigard-or.gov 219 Notified/Met //'//1/ Supplemental Information CITY OF T . . a ¢.,s f. r"f'rr! syslfl,,(f !""gfi%„ r1,.Yr,"r't :dire; •:1 {.,";v P .,, f f..,, :f f r7:4r! .4 C:n reN. ,"..XFS ..;s;, ,,'` a^`r)� , .`.x''r,v1 J, 1: �' :':s,k .*°ty_� aA�. r ,.y ',..6,.9/0;404,071,4, d.: rl,w .,,w'x ,,, �.:= ;f`: ;1�,+, �`- " 'a "r , 5,�s f '`1 ,, i ; . 11.g i!,i` B t a *" ,, .,; s„�%..'�FF%1r��'��rh�.r rf�F %�r�r,.C.�Fn�fi1 ,...,,,r�,n,°�` :�,."svF,�.�. „? "'' C�9r>#r�.�; "� f ? �` � _ �1^r �9s�`r i� '� I��r k� � Ist� ®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 ❑Other: equipment,materials,labor,overhead, an pOrrooi ft for the af,�# �' !0 ��fr�� i` a{ �.� d . [,.4 �,f�, �gi,H�� work indicated on this application. /i 5.3 ® 1-and 2-family dwelling 0 Commercial/industrial Valuation: $26t*eee 0 Accessory building 0 Multi-family Number of bedrooms: 3 ❑Master builder ❑Other: Number of bathrooms: 2 t .. , 3 `,.",',40 � ! 3(07 fr r/' ;0 ? !Fr !r :s0 ' r, r rf4r Total number of floors: 1 fr , rrf1fV� „% ,;;;',1;,,,,- !.4� . , � r , : fa,M 'f22aW1 Job site address:1133jlW Gabriel St New dwelling area: 1814 square feet it( 1 City/State/ZIP:Tigard,OR Garage/carport area: 553 square feet Suite/bldg./apt.no.: Project name:Willow Brook lot 2 Covered porch area: 39 square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet Zit ..z,a,„01,. .r. k rxr! lr...0 u.ti.r . t,,,,r,7-.77(i 7,rr,;.r+. Subdivision:willow brook Lot no.:2 Permit fees*are based on the value of the work performed. Tax map/parcel no.:2S115AB01400 Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the 0 rt*,; ti 4. ;: sy '17 t ' Y rf 4r4 r4er 2 workindicated on this application.47 1 ,4744ff" ,44: ,,s,1moi4r ,, 0ff40*4 "? s w44#, SFR 3 bedrooms and 2 baths with a covered patio and entryway. Valuation: $ Existing building area: square feet New building area: square feet r y `f ”' '' ir.w} .r t!>$ 'f`+� r� rs !!h rein,;f i f r ""N,',lfei,00'1+r .?` 2,;, ,t„ .r1. 0,-,t a,r .!-,'.,.��-'' .f;,,1, ,F %r.,` ",,, ,;. ,,, .,,,.rfis0,0. Er „'!r 0 n Number of stories: Name:Pacific Lifestyle Homes Type of construction: Address: 11815 NE 99t Street,Suite 1200 Occupancy groups: City/State/ZIP:Vancouver,WA 98682 Existing: Phone:(360)573-8081 Fax:(360)574-6401 New: rr 0 r.,,r.WW,.W"WF"`.r,+' ..3.,.r. ;,,,.,,/„`'.r` r ,':f.rce:?:'' ,'..� ,`,":.0 02 � �..�.,.;;;.r,.., ,� ,.,;.'4,�. uJ` , 0,r,rf r�` ,'ti`r'e S 11 :2 e„, a J1 gl� °''( `"yr t Business name:Pacific Lifestyle Homes ` `" .`a rfr ., ” / :,,: ,% .,,frr??,,,f,,,,,,,,,,, ,x „R ,a Structural plan review fee(or deposit): Contact name:Permit Coordinator FLS plan review fee(if applicable): Address: 11815 NE 99th Street,Suite 1200 Total fees due upon application: City/State/ZIP:Vancouver,WA 98682 Amount received: Phone:(360)573-8081 I Fax: :(360)574-6401 rivflfi s 4� "± 3 , :E-mail:permits@buildplh.com ,,Ak.6, rry ,,,,„, :,,,r . , ..uVr ._g. . .. ,,, .; " ! !, 4 F - fr f! ''% t ' ., „fsfrr* f 7 Commercial and residentialprescriptive installation of L74WARO,rsafgf �9�4), „�I;vE �, ,,A i0k,W ,,l , roof-top mounted Photovoltaic Solar Panel System. Business name:Same Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:Same Solar Installation Specialty Code checklist. City/State/ZIP:Same Permit Fee(includes plan review $180.00 and administrative fees): Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.:173524 Total fee due upon application: $201.60 Authorized signature: 7 This permit application expires if a permit is not obtained ( ,.<< III �.(_ C _ within 180 days after it has been accepted as complete. Print name:Summer Dowell Date:2/12/19 *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) Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE 1;SE OCL\ • City of Tigard Received Permit No.: a 13125 SW Hall Blvd.,Tigard,OR 97223 Associated Phone: 503.718.2439 Fax: 503.598.1960 Associatt ed permits: 24-Hour Inspection Line: 503.639.4175 El Electrical ❑ Plumbing El Mechanical I It,n R D Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW ties No N/A 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. 0 El ❑ 3 Verification of approved plat/lot. ❑ El El 4 Fire district approval required. Name of district: . El 0 0 5 Septic system permit or authorization for remodel. Existing system capacity . 0 0 0 6 Sewer permit. 0 ❑ El 7 Water district approval. 0 El El 8 Soils report. Must carry original applicable stamp and signature on file or with application. El ❑ ❑ 9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 0 0 1 basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ El El 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 ❑ El El 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. A 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size ❑ ❑ El and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 0 ❑ 0 furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- El 0 0 floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. 0 El El 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- El 0 ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing El ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered El ❑ 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 ❑ El ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured flow/.uof truss design details. 0 —D El 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 ❑ 0 for four or more appliances. 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Ore:on and shall be shown to be a..licable to the .ro'ect under review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". 0 ❑ ❑ 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. El El 0 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. El ❑ El 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 El ❑ 27 "Drawn to scale"indicates standard architect or engineer scale. ❑ ❑ 0 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard El El ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ El ❑ and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, 0 ❑ ❑ including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Application FOR OFFI('F CSF ONE) City of Tigard Received � � _ g Date/By: Permit No.yt\t�T 0 \ I_ - UST 13125 SW Hall Blvd.,Tigard,OR 972 r r C E'\/C® Plan Review Phone: 503.718.2439 Fax: 503.598.1':r C �/ G Other Permit: Date/By: T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Sufis: ® See Page 2 for Internet: www.tigard-or.gov FEB 14 2019 Notified/Method: Supplemental Information t .�,y ;..��'' r.F r r- rf i Fri �Jp"" '�,. ... n .' dF 4`,:e' ""7 ? ,..e.,;,..4.14,..1.eCri ' ';, $P'..# bi.., `, ,,,,fr, '_; ''''''''''''4'. '.trr.` ., '` 4 4744 y�' *$�9''t ,......'„:....,%, „,„,„,, .� ',,,, ,,,,,." .ams: Mechanical permit fees*are based on the value of the work ®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition D Other: mechanical materials,equipment,labor,overhead,and profit. s✓''�` � ,rr,�r�i`>,�"/r` ,ri;. rrr,�=;s: / � �;fi ,��;z"if g =y;cx r ,F .`2�?�' ,�',�,x ,'r` f Value:$ ." ,°..r`a fF.Y.i= f ,ff >a. tll #,i (t�w 'i) F!" j'"+r':'�'legAr,'�,O„ r,.f.1 r, a _ _:,.,,,,::. ;�rx ,r�. is '��.,lf.4 45460 y.,f�s�,,.�� ,:s ;4,4,. r=;' :„;,, ,,,f o J i �,''rr,= t 2 r, r` e ,r:,, ,.�.,• :� ,f..�,x ,r '.5�� :�.�pf'.,r,� �r. :,� ,�.�-.�r+"`.�s; '. $3 t) �,� :E1� �3°, i' ..^ ��. '�� `'�; �,,7,f'`r'r ® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. 0 Multi-family ❑Master builder 0 Other: Description I Qty. I Ea. I Total 5,' r'`'',,,%sr f� r Fs� / rrr rf ,�F f r, ,, k .4 3,:,' ,f f i 4404, s Attifi rtielW ,�, h ,, ,, ,...4.,,-.;......-...!",;.), ,,,v;. , „ !...-<�f ��f� ' ` ;r Air conditioning Air conditioning 1 46.75 Job site address:11'J .SW Gabriel St Furnace 100,000 BTU(ducts/vents) 1 46.75 City/State/ZIP:Tigard,OR Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 1 61.06 Suite/bldg./apt.no.: 1 Project name:Willow Brook Duct work 1 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 _ Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision:Willow Brook I Lot no.:2 Other: 23.32 Other fuel appliances: Tax map/parcel no.:2S115AB01400 Water heater 1 23.32 � . . r . '''''''''"''''''''Il'-'-'''' . % f ' r i, F Gas fireplace/insert' x# ,% � g ►l, i$ t a ri1 i rslx.y ! ? 1 33.39F4" a ,'4_ ; ra 14*'"*'i .r,r, s ;,,.u, .,, ,f;, _.,. "1:44"44'44'w/' '� F . "? � , Flue vent for water heater or gas SFR 3 bedroom 2 bath with a covered patio and entry way. fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 .n" ,, 23.32fsjT " , ,+r5 re , rrt & rrrfy y.;: " r ' '„ 'SOOther: /N1' l? � ,,, : t..-",2;: , " ' � .9 :-.-./..i,,;,&,/,..,,,,,, Environmental exhaust and ventilation: Name:Pacific Lifestyle Homes Range hood/other kitchen equipment 1 33.39 Address:Same as applicant Clothes dryer exhaust 1 33.39 City/State/ZIP: Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 4 23.32 Phone:( ) Fax:( ) Attic/crawlspace fans 23.32 ..:. � sr o 'fi rr; 4 4'i d .r r rr0 �� ._� „ t � � r Other: 23.320a�� , s „�, , ,,,. f ; „ r % J ! Sr@9, ,.,4 ,rr : � ✓„�� rr �Arr/,- Fuel piping: Business name:Pacific Lifestyle Homes $14.15 for first four;$4.03 for each additional Contact name:Permit Coordinator Furnace,etc. Address:11815 NE 99th Street,Suite 1200 Gas heat pump Wall/suspended/unit heater City/State/ZIP:Vancouver,WA 98682 Water heater Phone:(360)573-8081 I Fax::(360)574-6401 Fireplace 1 Range 1 E-mail:permits@buildplh.com Barbecue 1 0 f F y I l„!.:,,c/201, ,..r_„,,„,,,,744;;h7 ” ,s76,c0.4 "r' Pr''` Clothes dryer(gas) Business name:Area Heating+Cooling Other Address:2721 NE 65th Ave w rte Fr p; „„ „,:1„=, v _f .fi, o ,;,_a�,,r. rrt,; Subtotal City/State/ZIP:Vancouver,WA Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(360)737-0811 Fax:(360)737-6946 State surcharge(12%of permit fee) CCB lic.:64801 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 k., ,�j(C '/ �7�"\ _1 * Fee methodology set by Tri-County Building Industry Service Board Print name:Summer Dowell Date:2/12/19 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-Famil Fee Schedule: sf < aal; f,rf $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 4 Electrical Permit ApQIiTOR OFFICE USE ONLY A. City o fi arti Received ��t� ^],� (� ��(��, au/By: Pelmet X115\ c�V�C,k_,cpc :9\..?� 13125 SW Hall Blvd.,Tigard,OR 97223 (� \' P n Review Pril Phone: 503.718.2439 Pax: 503.598.196 EC E I tl E atC/13y: Refuted Permit a: TIGARD, Inspection Line; 503.639.4175 Ready Date/By: orris CJ See Page 2 for Internet: www.ligard-or.gov _ FEB 14 2019 Notified/Method: Supplemental Information J - _ TYPE OF WORK - PLAN REVIEW Please check all that apply(submit 2 sets of Mans whims checked ®New construction� ❑Addition/altcrationph • �I apply ! ) DemolitionB IUD 11 DIVISION ❑Service or feeder 400 amps or more 0 Building over three stories. _- ❑Other: _ where the available fault current 0 Marinas and boatyards CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Horning buildings. ® I-and 2-family dwelling ElCommercial/industrial ❑Accessory building less to ground,or exceeds 14,000 p Commercial-use agricultural amps for all other installations. buildings. ❑ Multi-family ❑ Master builder ❑Other: _ 0 Fire pump. 0 Installation of 150 K VA or JOB SITE INFORMATION AND LOCATION 0 Emergency system_ larger separately derived Job ll: Sob site address: 133 C7 ),�`- _ ( s..t- Addition of new motor load of system. --_,7: JY( 1 1001-11)or move. ❑,ai„ ,.F., ,.l_Z...13„ City/State/ZIP: ❑Six ormore residential units occupancy. -._ 1 I c c-tet ('_;I ,C"V- _ 0 Health-care facilities. 0 Recrealronal vehicle parks. Shite/bldg./apt.t/: - 1 Project name:1 �'1 V`` -'" t's7 ' J �_ 0 hazardous locations. 0 Supply voltage for more than ---------._.'_. 1. --Lf---- 7l'1.% f�� ----- -----_-- ----- ❑Service or feeder 600 amps or mare- 600 volts nominal. Cross street/directions lo job site: FEE SCHEDULE -- ___ Description _I Qty. I Each I notal ---- -- - Newresidential single-or multi-family dwelling unit. Subdivision: ( �,'l 11 DvL .\ "D C ' a Lot#: 2— Includes atlached garage. _ Tax map/parcel# -2—<-,-,i I j7*3 c`-Tu` — 1,000 sq.It or less f 16854 i(l�1� 4 _- Ea add'1 500 sq,ft,or portion ,2 1.3 33.92 i L.Let I DESCRIPTION OF WORK Limited energy,residential (with above s ft. 75.00 2 C Y �'7 ' �1tl� ) lx'i` Cr L`° (C'v'�.J c,• }7G. t-j 9 ) I _ Limited energy,nolo family • residential(with above sq.R.) 75.00 2 _. 4,4--d-lit b 1 l'L!4'��`' Renewable Energy I] See Page 2 ® PROPERTY 1r NL<'R ❑ TENANT Services or feeders installation,alteration,and/o•relocation Name:�� Cti(.( / �_s �._1- .1:s • I 1 �,•7 lti,, L 'Ti:�,('/( 200 amps or less 100.70 2 Addt'ess: l f ( 201 amps l0 400 amps 133.56 1"j Wit(' 2 > • Ci b b (� C 7 �1 (-0--t� 401 amps to 600 amps 200.34 2 City/State/Z1P: 601 amps to 1,000 amps 301.04 2 _ - Phone:( ) _I Fax:( ) Over 1,000 amps or volts 552.26 2 -- Temporary services or feeders installation,alteration,and/or F,mail: 1 -(,Y�n.,,t (C+'-[>i rt.x '� i J,C-�%) 's relocation Owner installation:This installation is beir{g made on property that I own which is not 200 amps or less 54.36 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: Pacific Lifestyle Homes above service or feeder fee, 7_42 2 — each branch circuit Contact name: Permit Coordinator B.Fee for branch circuits willtou/ Address: 11815 NE 9911'Street,Suite 1200 service or feeder lee,Inst 56.18 2 branch circuit C'ily/Slate/ZIP:Vancouver,WA 98682 Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(360)573-8081 Fax: :(360)574-6401 Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email:permits@buildplh,com Reconnect only 67.84 2 CONTRACTOR Pump ur irrigation circle 67.84 2 Business name:Garner Electric Sign or outline lighting 67-84 2 Address:2920 SE Brookwood Ave,Suite A Signal alteration, or limited-energyxensi Q See Page 2 2 _panel,alteration,or extension. City/State/I,1P: Beaverton,OR 97006 Each additional inspection over allowable in any of the above _—.__ • Additional inspection(1 hr min) 66,25/hr Phone:(503)648-4552 i Fax:(503)642-7925 Investigation(I hr nein) 90.001 hr Email:mmorato@garnerelectric.com Industrial plant(I hr rain) 78.18/hr -- -- Inspections for which no fee is 40.0(1/hr CCB L,ic.: 121159 Electrical I;•.: -3050 Supra,Lie,: '3"j b' ) 5 specifically listed(V1 hr min) -- - — ELECTRICAL PERMIT FEES - Suprv.Electrician signature,require Subtotal: Print name: Chuck Garner „IrDate: to i �-1 0 Plan Review Required(25%ofperniit fee): iI ge State surcharge(12%of permit fee): Authorized signature: I1 Ii' 1'O"1'Al,PERMIT FEE: /� J �, -- This permit application expires if a permit is not obtained within 180 Print name: f �/I R.15U\ r/,I f //'Gf e pate: (0 -(q j Y days after it has been accepted as complete. tom, .[' al I 1•� * Number of inspections allowed per permit. I Ituilding'PrrmitslEl.0 Permitapp its FRE doc Rev 06/17/2015 440-451 STII1l05/CUAVWPIs Electrical Permit Application--City of Tigard • Page 2---Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: • RESIDENTIAL WORK ONLY: FLEE SCHEDULE n��eripnnn (jry.�L~ Each 'total I " Fee for all residential systems combined: $75.00 Renewable electrical energy systems: Check Type of Work Involved: $kva or lessM 100 70 2 5.01 to 15 kva 133.56 2 11 A• udio and Stereo Systems* Sot to 25 lava 200.34 2 Wind generation systems in excess of 25 kva: 17 B• urglar Alarm 25.01 to 50 kva 301.04 2 5(1.01 to 100 kva 552.26 2 I Garage Door Opener* >100 kva(fee in accordance 552.26 2.. with OAR 918-309-0040) — - — 11 H• eating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System" Each additional kva over 25 7.42 3 I V• acuum Systems* >100kva—noadditional charge 0.0 3 Each additional inspection over allowable in any ol•the ahove: El O• ther: Each additional inspection is 66.25/hr charged at an hourly(1 hr inin) —,_ --.----._._. Inspections Ihr which no fee is 90-00/hr specifically listed(%a br min) COMMERCIAL WORK ONLY: ELECTRICAL PERWT FEES Subtotal(Enter on Page I): Fee for each commercial system: $75.00 • Number ol'uts'peclions allowed per permit (SEE OAR 918-309-0000) Check Type of Work Involved: I I Audio and Stereo Systems Boiler Controls I I Clock Systems I I Data Telecommunication Installation Fire Alarm Installation HVAC I Instrumentation I Intercom and Paging Systems I I Landscape Irrigation Control* Medical Nurse Calls Outdoor Landscape Lighting* Protective Signaling J Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I':nuitding\FermitsELC„Pei mit NILE LR_ERE doe Rev 05117''2015 Plumbing Permit Application Building Fixtures FOR OFFICI•. FSE oyl>v City of Tigard d Received g RECEIVEBy: Permit No.:MST i -` (yC 41 III 13125 SW Hall Blvd.,Tigard,OR 97223 tno/Revev iew IIP Phone: 503.718.2439 Fax: 503.598.196 Date/By. Other Permit No.: T 1 G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: H See Page 2 for Internet: www.tigard-or.gov FEB 14 2019 Notified/Method: Supplemental Information ;. OF WORK. CITY OF TIGARD FEE* SCHEDULE }New construction 0 DeNklit_IING DIVISION For special information use checklist Description Qty. I Ea. I Total 0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 1-and 2-familySFR(2)bath 437.78 4 j dwelling 0 Commercial/industrial T` 1 "(� buildingSFR(3)bath 500.32 ❑Accessory 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND 4 LOCATION Site utilities: !! � " Job site address: �,ir-isi, Catch basin or area drain 18.76 I Drywell,leach line,or trench drain 18.76 City/State/ZIP: 1 D Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: 1 Project name: OA\ _O 2, Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:C'�0y ) Page 2 Storm sewer(no.linear ft.: <i$) 1 Page 2 ,�,_ Water service(no.linear ft.:<Q3 r Page 2 Subdivision: b1/4...."II 0).A)t j()11 L Lot no.: 'L Fixture or item: Tax map/parcel no.: 2.S t 15A-Es cel el-ho Backflow preventer 31.27 ` 1 DESCRIPTION OF Backwater valve 12.51 ag ,) - ;.-. Clothes washer t 25.02 Dishwasher ' 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 i;`x PROPERTY OWNER k1 TENANT' ,; Expansion tank 12.51 �,N Fixture/sewer cap 25.02 Name: C^Ci66r �� ,.,. �y' „ Address: 11 / I c #,J , -�- 81-„,,,,c) Floor gedroor sink/hub 25.02 Garbage disposal 25.02 City/State/ZIP:VC(fr (0b,L;r �V. • 1,J A- q &L'g ),_ Hose bib 25.02 Phone: j ) 013 S, I Fax ( ) Ice maker 12.51 `�"* APPLICANI7 rC.CONTACT, ON Interceptor/grease trap 25.02 Medical gas(value:$ ) Pae 2 Business name: > g Contact name: Primer 12.51 Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 1g, 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax: :(_ar1,,�) Tub/shower/shower pan 12.51 E-mail:RV-Mt .(�✓ .. •p�` . k1 `- Urinal 25.02 CONTRACTOR Water closet 25.02 . , Water heater ' 37.52 Business name: ` ,/ / 1� 5„._ Water piping/DWV 56.29 Address: p/ Y6 i''Cj s Other: 25.02 City/State/ZIP: i,50Nri,ki rc- /AR 7°0? Minimum Subtotal Phone:(,7i)Yv`-t,. 76769(2_ C Fax:( ) v , Minimum permit fee: $72.50 CCB Lic.: 0 l S--- 7 Plumbing Lic.no.: 66`II/6. Plan review (25%of permit fee) // State surcharge(12%of permit fee) Authorized signature: / t)' TOTAL PERMIT FEE Print name: < .JiJ L 1,, If L .L( Datet �q// 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: Site Uti i ies Qty. Fee(es) _ Total Square 'outage: Perini t Fee: Footing drain-1s`100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Valuation: Permit F Storm&Rain Drain-1st 100' 62.54 t $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 T 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 fixtures could result in increased sewer fees*. Plan ,e' W for Plumhinfinstallatlins a,; Quantity by re Type Plan review is required for any of the following. Fixture Type forReplace/ Please check all that apply. Work Performed: Capped' Added f r Relocate Baptistry/Font ❑ Any new commercial building with water service 2"and greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool Stall 0 New exterior plumbing site utilities for any complex structure Car Wash: -Eachas defined in OAR918-780-0040. -DriveThru 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" 4>, 0 Isometric or riser diagram is required for new buildings -Car Wash Drain 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 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 IliCity of Tigard COMMUNITY DEVELOPMENT DEPARTMENT R Building Permit Review — Residential Building Permit #: 4 5' ' Site Address: / o a ) co,A,70., VName: )j//0k17:01' Lot #: (New elling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: 141- c-9P0 ❑ Verify site address/suite#exists and active in permit system. ❑ River Terrace Neighborhood: 0 No 0 Yes,See River Terrace Review Addendum Attached Sit- Plan Elements: . ee(3)copies of site plan �`. ting structures on site Jute plan must be on 8-1/2"x 11"or 11 x 17"paper Wawn to scale(standard architect or engineer sale) Footprint oor elevationss of w structure(including decks)with finished ► orth arrow S project tdity locations&easements(required for new and additions) 2 e address ro-ect or subdivision name and lot number Tr Sidewalk/driveway approach iplicant information(name and phone number) it ation of wells/septic systems Lot dimensions and building setback dimensions ill' :.ting trees to be retained with drip line,and tree I)►1 uare footage of buildings to be demolished otection measures r.Lot area,building coverage area,percentage of coverage and ri Meet tree size,type and location )thpervious area(applicable if R-7,R-12,R-25&R-40) Street names Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replac �dYes ❑ If yes,is a storm water quality facility shown?� _ Yes NJNo lean Water Services-Service Provider Lettttof platted prior to 9/10/1995): equired: 0 Y ,applicant was notified ltd No Received: Public Faciliti Improvement(PFI)Permit: ❑ Yes 0 No Required: Yes,applicant was notified 0 No Applied For. Yes 0 No,stop intake 1:64and Use Case#: -C-)f f,32Cj(0 -6-MN 6J Vi.fening. !J_ Vequired Setbacks: Front o/�- Rear ,5- Side c- Street Side .J 2 1 dscape Requirement _20 /0 ill-Garage Vifiof Coverage Maximum: r) ri Building Height Maximi Height S—! ! 1/ it Actual Height SCO � isual Clearance Ve itive Lands: 0 Yes 0 No Type z roan Forestry Plan1 C4?'1' /' _ 4'14+ cz Conditions "Met"prior to issuance of building permit Notes: proved By Planning: Date: vz____thiLT___ Revisions (after Building Submittal only) Revision 1: 0 Approved 0 Not Approved Reviewer Date Revision 2: 0 Approved 0 Not Approved Revision 3: 0 Approved 0 Not Approved I:\BuildingWorms\BldgPermitRvw_RES_061417.docx Building Permit Submittal Original Submittal Date: D.I l4 1Ct Site Plans: # Building Plans: # 3 Building Permit#: NVEnter building permit#above. Workflow Routing: EVPlanning E./Engineering C'Permit Coordinator E''Building Workflow Sign-off: a Sign-off for Planning(include notes from planning review) Route Application Documents: El Engineering: (1) copy of permit application, (1)site plan, (1)building plan and original plan review routing form. ["Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: ......;4---, -/"L-, ...-,, Date . 15(4 By Permit Technician: Engineering Review 31 Slope at building pad: 3 i ['� onditions"Met"prior to issuance of building permit [asements (encroachments)per engineering conditions of approval and plat Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: 0 Yes No Assess Water Quantity Fee in-lieu: 0 Yes No �,/ LIDA Facility on lot: 0 Yes No l Final Plat Recorded: Date: _ JT Approved by Engineering: Notes: ZE/Approved by Engineering: ti..PIN • Date: 2 . 2?"• 1/ Revisions(after Building Submittal only) Reviewer Date Revision 1: 0 Approved 0 Not Approved Revision 2: 0 Approved 0 Not Approved Revision 3: 0 Approved 0 Not Approved Permit Coordinator Review _El--Conditions"Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant Revision Notice 2: Date Sent to Applicant Revision� Notice 3: Date Sent to Applicant: ��/SDC Fees Entered: Wash Co Trans Dev Tax: 1 es 0 N/A Tigard Trans SDC: s 0 N/A Parks SDC: Yes ❑ NA LIDA 0 Yes /A OK to Issue Permit ...2-'/-211711 Approved by Permit Coordinator: Date: 1:\Building\Forms\BldgPermitRvw_RES 010118.docx FOR OFFICE USE ONLY—SITE ADDRESS: 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 IN _ Transmittal Letter i i(,\1;1, 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: DATA l €.> V D may DEPT: BUILDING DIVISION M.A.:? I 9 20i9 FROM: SUVIinaiL MA) eit' i. ,:= -- COMPANY: h Lt fCf if ��/�/i l ' 1 PHONE: 3 LW `51.j - O BY �� RE: /1.330 SCJ (mac 6(t D/ 101- /h5TatCf 7-c o S (Site Address) (Permit Number) �L) 1 IlO 0 rolect name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies Description: Additional set(s) of plans. X 6 Revisions: r&1L rtA,SS' (hSid 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: FOR FFI E USE ONLY Routed to Permi ec 'an Date: 3 'fes Initials: Mr- Fees Due: esfr u No Fee Desc ption: Amount Due: / $/___ pLac, CY...d\.,c---1-- $ r7 b 1 $ $ Special Instructions: Reprint Permit(per PE : ❑ Yes 0 o ❑ Do ;;e�II Applicant Notified: Date: 3 /A , Initial • I:\Building\Fonns\TransmittalLetter-Revisions 061316.doc City of Tigard Tel: 503.718.2439 Location: Inspection Date: 11330 SW GABRIEL ST, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2019-00056 Inspection Type: Inspector: 615 Mechanical rough-in David Young Result: PASS Comments: Correction complete. Violation Summary: Inspector Contractor City of Tigard Tel: 503.718.2439 Location: Inspection Date: 11330 SW GABRIEL ST, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2019-00056 Inspection Type: Inspector: 699 Mechanical final David Young Result: PASS Comments: Ac installed. Violation Summary: Inspector Contractor City of Tigard Tel: 503.718.2439 Location: Inspection Date: 11330 SW GABRIEL ST, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2019-00056 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS Comments: Ac installed. Violation Summary: Inspector Contractor City of Tigard Tel: 503.718.2439 Location: Inspection Date: 11330 SW GABRIEL ST, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2019-00056 Inspection Type: Inspector: 299 Final inspection David Young Result: FA I L Comments: Provide permit and approved inspection for landscape irrigation Backflow devise installed without permit. Fix landscape grade per code for slope away from structure right front. R401 .3 Add laundry tray to permit as noted on plumbing final inspection. Violation Summary: Inspector Contractor City of Tigard Tel: 503.718.2439 Location: Inspection Date: 11330 SW GABRIEL ST, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2019-00056 Inspection Type: Inspector: 399 Plumbing final David Young Result: PASS Comments: Corrections from previous inspection complete. 1 " febco model 850, serial # HE 81189. Violation Summary: Inspector Contractor City of Tigard Tel: 503.718.2439 Location: Inspection Date: 11330 SW GABRIEL ST, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2019-00056 Inspection Type: Inspector: 299 Final inspection David Young Result: PASS - CofO Comments: Corrections from previous inspection complete. Final erosion control approved. Moisture content form received. Moisture barrier form received. High efficiency lighting form received. Insulation certification checked. C of 0 left on site with approved plans. Violation Summary: Inspector Contractor