Permit (165) CITY OF TIGARD MASTER PERMIT
I: COMMUNITY DEVELOPMENT Permit#: MST2019-00015
T GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/10/2019
Parcel: 2S112BD13900
Jurisdiction: Tigard
Site address: 7611 SW CORNUTT ST
Subdivision: ELDERBERRY RIDGE Lot: 35
Project: Elderberry Ridge, Lot 35
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1063 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 25 Bathrooms: 3 Second: 1290 sf Garage: 378 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2353 sf Value: $296,781.25 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 4 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL•RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
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 2353
Owner: Contractor:
RIVERSIDE HOMES LLC RIVERSIDE HOMES LLC Required Items and Reports(Conditions)
17933 NW EVERGREEN PL STE 17933 NW EVERGREEN PKWY 370 1 Ersn Cntrl 503-639-4175
370 BEAVERTON,OR 97006
BEAVERTON,OR 97006
PHONE: 503-645-0986 PHONE: 503-645-0986
FAX: 503-690-2942
Total Fees: $31,477.25
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty ,odes a d 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 is uance, r if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notificati..n Cen-r. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. Yom. -'• - • thefules..cr_direct questions to OUNC by calling 50 .232.1-87 or 1.800.332.2344.
Issued By: -i a. Permittee Signature: �.
Jfe •.4175 by 7:00 a.m.for the next available inspection-.te.
This permit card shall be kept in a conspicuous place on the job site until completion • the project.
Approved plans are required on the job site at the time of each inspection.
Buiiiiin2 Permit Application l " - S-
`Residential FOR OFFICE 1 SE ONLY
City of Tigard +' +EG'NEIVEsI eceived 1 Perurit No
13125 SW Hall Blvd.,Tigard OR 97223 Date/By: \a S,\ { [- - �
g Plan Review r ^���/'; �j11 Phone: 503.718.2439 Fax: 503.598.1960 J Q N 2 9 2 019 DateBy: orf Other Permr ,�Ve"i ,�jt t.t
T I C'A R tD Inspection Line: 503.639.4175 Date ReadyBy. ! Juris: 0 See Page 2 for
Internet: www.tigard-or.gov CI F OE 1!GA 1Noti ',/Methe /, l� .r Cj J Supplemental Information
t�1,1 II
Q New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
'''t
r ,.. „,,.:,,,,::,-, 4,..::::-1•,,,.., work indicated on this application. (( f�
tti
1-and 2-familydwellingValuation: $
9 0 Commercial/industrial
1=1Accessory building 0 Multi-family Number of bedrooms: 4
El builder 0 Other: Number of bathrooms: 3
'' *” ` i �fi, ', 7-4:4k:::*::„.a Total number of floors: 2i t 21 3 l
Job site address: 7611 SW Cornua Lane New dwelling area: 2353 square feet 1.19LO
City/State/ZIP: Tigard, OR 97224 Garage/carport area: 378 square feet 1b( 2'
Suite/bldg./apt.no.: Project name: Elderberry Ridge Covered porcharea: square feet
Cross street/directions to job site: SW Bonita Rd &SW 76th Ave Deck area: ` square feet
Other structure area: square feet
Subdivision: Elderberry Ridge Lot no.: 035 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
it ., ,. �
equipment,materials,labor,overhead,and the profit for the
� 1.. , . ' work indicated on this application. _
Construction of SFR valuation: $
Existing building area: square feet
New building area: square feet
"' Number of stories:
Name: Riverside Homes, LLC .4"44Type of construction:
Address: 17933 NW Evergreen PI., Ste 370 Occupancy groups:
City/State/ZIP: Beaverton, OR 97007 Existing:
Phone:( 503)645-0986 Fax:( ) New:
Business name: Riverside Homes, LLC
Structural plan review fee(or deposit):
Contact name: Wes Boisvert
FLS plan review fee(if applicable):
Address: 17933 NW Evergreen PI., Ste 370
Total fees due upon application:
City/State/ZIP: Beaverton, OR 97007
Phone:(503)645-0986 I Fax::( ) Amount received:
E-mail: wboisvert@riversidehome.com
" i. t • ,: # Y E Commercial and residential prescriptive installation of
"� ) ,.
�. .,; ,,.., roof-top mounted Photovoltaic Solar Panel System.
Business name: Riverside Homes, LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 17933 NW Evergreen PI., Ste 370 Solar Installation Specialty Code checklist.
City/State/ZIP: Beaverton, OR 97007 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( 503)645-0986 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: 189148 Total fee due upon application: $201.60
/ ..
Authorized signature:, Gcc This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Nikki Pruett Date: 1/28/19 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Application rod o141cl: t sl.011.1
eceived
a City of Tigard �.",�` aF Y ate By: Permit No. j a.Geq_(1.-1C.)1
�
111 13125 SW Hall Blvd.,Tigard,OR 97223 ., ti E.'
I
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Other Permit:
Date/By:
T i c n x n Inspection Line: 503.639.4175 'AN 2 9 201'3 Date Ready/By: Turfs: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
0
._ s i-Z•7 ;')'1- -.4'
3 _ � .7".t4, LA-,.l tl _ _ IL �3 ,,.fix:„
Mechanical permit fees*are based on the value of the work
ElNew construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
mechanical materials,equipment,labor,overhead,and profit.
0 Demolition ❑Other:
Value:$rer :-:477:::),A1---`::-.!4.1.,,1?- s l
� �� t=7:!„7:7,777A-77,„,afyot ;a s � x��
❑✓ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total
1 lit " t 4 � I I }� , ("...g...„;4`., Heating/cooling:
Air conditioning 1 46.75 46.75
Job site address: 7611 SW Cornutt Lane Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75
City/State/ZIP: Tigard, OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: , Project name: Elderberry Ridge Duct work 23.32
Cross street/directions to job site: SW Bonita Rd & SW 76th Ave Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Other: 23.32
Subdivision: Elderberry Ridge 1 Lot no.: 035
Other fuel appliances:
Tax map/parcel no.: Water heater 1 23.32 23.32
, F ,. ; , )" sit' 2r*-,,,, . € f 0. . Gas fireplace/insert 1 33.39 33.39
Flue vent for water heater or gas
Construction of SFR fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
ot Other: 23.32
' - OP - x� - - ° • u + -. Environmental exhaust and ventilation:
Name: Riverside Homes, LLC Range hood/other kitchen
equipment 1 33.39 33.39
Address: 17933 NW Evergreen PI., Ste 370 Clothes dryer exhaust 1 33.39 33.39
City/State/ZIP: Beaverton, OR 97007 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 5 23.32 116.60
Phone:(503 )645-0986 Fax:( ) Attic/crawlspace fans 23.32
9' '- • , aA W
'� Other: 23.32
y.�.- ".K. ..razz .,,-g .: �.�s: ,x .. R{�...,_ .... .. F,+.%
Business name: Riverside Homes, LLC Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name: Wes Boisvert Furnace,etc. 1 14.15
Address: 17933 NW Evergreen PI.,
Ste 370 Gas heat pump
WalFsuspended/unit heater
City/State/ZIP: Beaverton, OR 97007 Water heater 1 14.15
Phone:(503 )645-0986 I Fax::( ) Fireplace 1 , 14.15
Range 1 14.15
E-mail: wboisvert@riversidehome.com Barbecue
,,,. .. ,.: ,: 0 1. .' ,' Clothes dryer(gas)
Other:
Business name: Pro Heating & Cooling .• • I b -7' , -* *** ( ,
Address: 2095 NW Alocleck Rd.#1103 Subtotal
City/State/ZIP: Hillsboro, OR 97124 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( 971)205-4989 Fax:( ) State surcharge(12%of permit fee)
CCB lic.: 209001 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
/ 17' / _,..,, days after it has been accepted as complete.
Authorized signature/'4{4 * Fee methodology set by Tri-County Building Industry Service Board
Print name: Nikki Pruett Date: 1/28/19
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard Ra iEr
/' Received
Date/B xpermit#�\ T �`�[ n
l
I -
'� 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 ,JAN 2 9 2019 DateB : Related Permit#:
T 1 GA i2 D Inspection Line: 503.639.4175 Ready Date/By: 7uris: ® See Page 2 for
Internet: www.tigard-or.gov i"l-ry oF
"1 ,7`r $D Notified/Method: Supplemental Information'6t : ',1 { 11f{f 1 ta; a.,. { t y.
ElNew construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
0 Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
+CA'1'l e",s J W s t N ;
'� *, r u..;; ��,�.z�� V .341,7:', .., exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑✓ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
0 Multi-family 0 Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
'` ro 'Siti tr " °2 'p t A i-): x ❑Emergency system. larger separately derived
Job#: Job site address: r ❑Addition of new motor load of system.
7611 SW Cornutt Lane 100HP or more. ❑°°A","E","l-2","l-3",
City/State/ZIP: Tigard, OR 97224 ❑Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: I Project name: Elderberry Ridge 0 Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: SW Bonita Rd & SW 76th Ave I4 .. l;t '; 7
Description .... . .��. ).:Qty. I Each I-Total
New residential single-or multi-family dwelling unit.
Subdivision: Elderberry Ridge 1 Lot#: 035 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#:
Ea.add'l500 sq.ft.or portion 33.92 1
.. :7. `° t/ 4 t 03. . .,? # a s Limited energy,residential 75.00 2
Construction of SFR (with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
;kizt _.127,47. "::.
#,4^ "9' W w13 ". V') `12
Renewable
r Eneedrgs installation,al❑ SteieonPaagend2/
or relocation
Name: Riverside Homes, LLC 200 amps or less 100.70 2
Address: 17933 NW Evergreen Pl., Ste 370 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: Beaverton, OR 97007 601 amps to 1,000 amps 301.04 2
Phone:(503)645-0986 I 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 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
A�PLte ;Lr rl i:: Br;71;
nch circuits—new,alteration,or extension,per panel
' '"" m A.Fee for branch circuits with
Business name: Riverside Homes, LLC above service or feeder fee, 7.42 2
each branch circuit
Contact name: Wes Boisvert B.Fee for branch circuits without
service or feeder fee,first
Address: 17933 NW Evergreen PI., Ste 370 branchcircuit 56.18 2
City/State/ZIP: Beaverton, OR 97007 Each add'l branch circuit 7.42 2
Phone:(503)645-0986 I Fax: : Miscellaneous(service or feeder not included)
( ) Each manufactured or modular 67.84 2
Email: wboisvert@riversidehome.com dwelling,service and/or feeder
Reconnect only 67.84 2
». :;. ,. .Ir`*:., !, . tlx. ..< ,. , ,/," r '. Pump or irrigation circle 67.84 2
Business name: Sunlight Electric Inc Sign or outline lighting 67.84 2
Address: Signal circuit(s)or limited-energy 0 See Page 2 2
2804 N E 65th Ave. St. D panel,alteration,or extension.
Each additional inspection over allowable in any of the above
City/State/ZIP: Vancouver, WA 98661
Additional inspection(1 hr min) 66.25/hr
Phone:(360) 51 8-7589 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:
Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lie.: 172549 Electrical Lic.: C230 Suprv.Lic.: specificall listed(Yz hr min) 90.00/hr
Suprv.Electrician signature,required: A � Subtotal:
Print name: Chester Garrett I Date: 1/28/19 ❑Plan Review Required(25%of permit fee):
/} State surcharge(12%of permit fee):
Authorized signature:�1C /-- -e.,,eTOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Nikki Pruett Date: 1/28/19 days after it has been accepted as complete.
* Number of inspections allowed per permit.
C\Building\Permits\ELC_PermitAppELR_ERE.doc Rev 06/17/2015 440-46151(11/05/COM/WEB
•
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
t �` Description Qty � *Each I 1 tTotal �y*
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
✓❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr mm)
Inspections for which no fee is 90.00/hr
s.ecificall listed '/2 hr min
s « .
Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00 * Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ 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
Plumbing Permit Application
Building Fixtures �, _ roiz oIIICE USE ONLY
Cityof Tigard �- Received
114 1,1 131SW Hall Blvd.,Tiard,OR 97223 Date/By: Permit Na c-V2IC\q-CC-US
Pl
I Phone: 503.718.2439 Fax: 503.598.19Dan Reviewate Other Permit No.:
R
Inspection Line: 503.639.4175 9 1 De
T I G A K D Date Ready/By Juns Ea See Page 2 for
Internet: www.tigard-or.gov t�ee :1-1,1'" Notified/Method: Supplemental Information
''.�v.5 ,..ra�,�v .. ....ru.ai :: :.. ‘ �'. ,.., . _ ,,..--,,1..s.. >tr .,�+W�'.:.. .f. .. - ,ass
2 New construction 0 Demolition For special information use checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
' OkTliGORis' e Y s e`` + SFR(1)bath 312.70
0 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
buildingSFR(3)bath 1 500.32
❑Accessory 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler(_sq.ft.) Page 2
:.!1:'.;"'f; B ;prirof1 t * ` t o '" Site utilities:
Job site address: 7611 SW Cornutt Lane Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: Tigard, OR 97224
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name: Elderberry Ridge Manufactured home utilities 50.03
Cross street/directions to job site: SW Bonita Rd & SW 76th Ave Manholes 18.76
Rain drain connector 1 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: Elderberry Ridge 1 Lot no.: 035 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
S.. - r, - ~ Backwater valve 12.51
411. ` ° -: ""' `l l' ",b -*-*1--'7):"-'-'-;-'0''''''-
Clothes washer 1 25.02
Construction of SFR
Dishwasher 1 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
tI ,1,,,,:-04,",i.,+ tr $, "" *': z Expansion tank 12.51
Fixture/sewer cap 25.02
Name: Riverside Homes, LLC
Floor drain/floor sink/hub 25.02
Address: 17933 NW Evergreen Pl., Ste 370 Garbage disposal 1 25.02
City/State/ZIP: Beaverton, OR 97007 Hose bib 2 25.02
Phone:(503)645-0986 Fax:( ) Ice maker 1 12.51
`" 4 .N. mi,t.'„;,,:;-,:-7. it, s Interceptor/grease trap 25.02
ram ,;•..:,.
Medical gas(value:$ ) Page 2
Business name: Riverside Homes, LLC
Contact name: Wes Boisvert Primer 12.51
Roof drain(commercial) 12.51
Address: 17933 NW Evergreen Pl., Ste 370 Sink/basin/lavatory 6 25.02
City/State/ZIP: Beaverton, OR 97007 Solar units(potable water) 62.54
Phone:(503)645-0986 Fax::( ) Tub/shower/shower pan 4 12.51
Urinal 25.02
E-mail: wboisvert@riversidehome.com
,...,....47:,, ,,, „ Water closet 3 25.02
Water heater 1 37.52
Business name: H & H Mecanical
Water piping/DWV 56.29
Address: 5757 SE Willow Ln Other: 25.02
City/State/ZIP: Milwaukie, OR 97267 Subtotal
Phone:( 503 975-9787 Fax:( ) Minimum permit fee: $72.50
CCB Lie.: 178122 Plumbing Lic.no.: PB414 Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: /),",e,"7t?' TOTAL PERMIT FEE
Print name: Nikki Pruett Date: 1/28/19 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.
C\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
. Pltlnlbing Permit Application - City of Tigard
.Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
';.
Site R t 9a, 6 M .. u.. . _.
Footing drain-l'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
$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
t $' each additional$100.00 or fraction thereof,to
a tlonta 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 char:e-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 char:e-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 char:e 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*.
Quantity by 1'ittre Type p •
iteiru*filesunibinir
Fixture Type for _4 3Replacei
Plan review is required for anyof the following.
Work Performed;: Capped Adie =Reioea"te, q
Baptistry/Font Please check all that apply.
Bath Tub/Shower
0 Any new commercial building with water service 2"and
Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru 0 New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities.
-Domestic 0 Any multipurpose fire sprinlder system.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
-3"
•
Car Wash Drain . '4 'd 4, ..ry•s...•44,;
Garbage Domestic-non-food ❑ Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
C:\Users\npruett\Downloads\PLMF_PermitApp.doc 2
City of Tigard
• 4 COMMUNITY DEVELOPMENT DEPARTMENT
III
E '.
TIGAR
D Building Permit Review — Residential
Building Permit #: +M --;- \c,- (-.
Site Address: 7 ( ( S w Co r rl u-h- L
Project Name: -CI der b er-c (Z ‘d y e Lot #: 3 5
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: NSW SG'R.
7 Verify site address/suite#exists and active in permit system.
River Terrace Neighborhood: pr No ❑ Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
Three(3)copies of site plan JExisting structures on site
C,7 Site plan must be on 8-1/2"x 11"or 11 x 17"paper
Drawn to scale(standard architect or engineer scale) Footprint of new structure(including decks)with finished
floor elevations
North arrow
71Utility locations&easements(required for new and additions)
IZISite address,project or subdivision name and lot number 'Sidewalk/driveway approach
pi/Applicant information(name and phone number) Location of wells/septic systems
Lot dimensions and building setback dimensions fiZExisting trees to be retained with drip line,and tree
❑Square footage of buildings to be demolished / protection measures
2Lot area,building coverage area,percentage of coverage and ,Street tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) Street names
2IProperty corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? 'es ❑No
4 foot differential) If yes,is a storm water quality facility shown? 0-Yes-❑No iV/z
9,.Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified g No Received: 0 Yes 0 No
7 Public Facilities Improvement(PFI)Permit: P FL W 11 00011
Required: 0 Yes,applicant was notified 0 No Applied For:
PP fd Yes 0 No,stop intake
C, Land Use Case#: PD22.oj — 00009 , SVQ2o1 (o — 000P-1
Zoning 2- 7
Required Setbacks: Front ( S Rear /5 Side f Street Side 0 e
�,( Garag ZO
Ji Landscape Requirement
FLot Coverage Maximum: eQ
RI Building Height Maximum Height 35 Actual Height 2-5
RI Visual Clearance
yi Sensitive Lands: 0 Yes A No Type
V'Urban Forestry Plan
0 Conditions "Met"prior to issuance of building permit
Notes:
yf Approved By Planning: Mme` e ,,.t8-zlL2,2A,� .- Date: 3/2.9//
Revisions (after Building Submittal only) Reviewer te
Revision 1: 0 Approved 0 Not Approved Date
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
I:\Building\Forms\BldgPermitRvw RES 061417.docx
Building Permit Submittal
Original Submittal Date: 11 •
Site Plans: #
,
Building Plans: #
Building Permit#: EiEnter building permit#above. �B
Workflow Routing: 1� Planning Engineering 1Y-Permit Coordinator g
Workflow Sign-off: 1E//Sign-off for Planning(include notes from planning review)
Route Application Documents: 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:
�_ �
By Permit Technician: �,;� Date: 1 -451 1 1 ch
Engineering Review
ope at building pad: 4
Conditions"Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes 0 No
Assess Water Quantity Fee in-lieu: 0 Yes 0 No
LIDA Facility on lot: 0 Yes 0 No
❑ Final Plat Recorded:
O NOT Approvedb Engineering: Date:
Y � �:
Notes:
lQ A rovedZ/�7/7
PP byEngineering: - Date:� ��
Revisions (after Building Submittal only)
Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved El Not Approved
Revision 3: 0 Approved 0 Not Approved
Permit Coordinator Review
❑ 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:
S C Fees Entered: Wash Co Trans Dev Tax: lyes 0 N/A
Tigard Trans SDC: 1;17 „Yes ❑ N/A
Parks SDC: 2' Yes 0 N/A
LIDA 0 Yes /A
OK to Issue Permit
Approved by Permit Coordinator: Date: Z i I
I:\Building\Forms\B1dgPermitRvw_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
Transmittal Letter
ansmi l tta
r E n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: ALLYSON ARMSTRONG DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
FEB 5 2019
FROM: NIKKI PRUETT CITY OF 1 IGARD
COMPANY: RIVERSIDE HOMES BUILDINGDIVISION
PHONE: 503-645-0986 - By: •T
RE: 7611 SW CORNUTT LN MST2019-00015
(Site Address) (Permit Number)
ELDERBERRY RIDGE LOT 35 • 235318 L
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
hr G =�': m y '; ,yg r '� � ^�v�' ''sx,t ' r ?,
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. 2 Engineer's calculations.
Other(explain):
REMARKS: ENERGY EFFICIENCY CHANGES TO TRUSSES
rarA.7.77
Routed to 'e s it Tec 'cian: Date: Cdi
Fees Due: ditiqr1• No Fee Descri.do : Amount Due:
:vt '7C4-
14; Q'
Special
Instructions:
' - .rint 'ermrt roitemi ❑ Yes i!1 No ❑ Done j
Alicant Notified: � Date: Ml7fj W%r
• /
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
7611 SW CORNUTT ST, TIGARD, OR, 97224 July 26, 2019 at 8:52:26 AM
Record Type: Record ID:
Residential - Master Permit MST2019-00015
Inspection Type: Inspector:
199 Electrical final Jeremy Burrows
Result:
PASS
Comments:
Note: no A/C
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
7611 SW CORNUTT ST, TIGARD, OR, 97224 July 26, 2019 at 8:53:22 AM
Record Type: Record ID:
Residential - Master Permit MST2019-00015
Inspection Type: Inspector:
299 Final inspection Jeremy Burrows
Result:
PASS - CofO
Comments:
Final erosion control approved.
Moisture content form received.
Moisture barrier form received.
High efficiency interior lighting form received.
Insulation certificate verified.
C of 0 left on kitchen counter.
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
7611 SW CORNUTT ST, TIGARD, OR, 97224 July 26, 2019 at 8:52:22 AM
Record Type: Record ID:
Residential - Master Permit MST2019-00015
Inspection Type: Inspector:
399 Plumbing final Jeremy Burrows
Result:
PASS
Comments:
Note: water pressure 60psi
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
7611 SW CORNUTT ST, TIGARD, OR, 97224 July 26, 2019 at 8:52:17 AM
Record Type: Record ID:
Residential - Master Permit MST2019-00015
Inspection Type: Inspector:
699 Mechanical final Jeremy Burrows
Result:
PASS
Comments:
Note: no A/C
Violation Summary:
Inspector Contractor