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Permit (175) CITY OF TIGARD MASTER PERMIT ' 1 • ' COMMUNITY DEVELOPMENT Permit#: MST2019-00017 r_i(A R.f? 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ►`; Date Issued: 04/25/2019 /\ Parcel: 2S112BD14400 " A : Jurisdiction: Tigard Site address: 7749 SW CORNUTT STi' ra- Subdivision: ELDERBERRY RIDGE �i' -0 Project: Elderberry Ridge, Lot 40 Project Description: New SF. 7/30/19: REPRINT to add(1)Laundry tray in garage. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 5 First: 1352 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 25 Bathrooms: 3 Second: 1533 sf Garage: 491 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2885 sf Value: $365,198.05 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 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 Other Fixtures: 0 Drywell-Trench Drain: 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: 5 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All 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 2885 Owner: Contractor: RIVERSIDE HOMES LLC RIVERSIDE HOMES LLC Required Items and Reports(Conditions) 1-7933NW€VERGREENPLST€ 370 PK9ffY370 1 ErenCntrtSOM3g4475 BEAVERTON,OR 97006 BEAVERTON,OR 97006 PHONE: 503-645-0986 PHONE: 503-645-0986 FAX: 503-690-2942 Total Fees: $32,950.78 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all o er =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 w. is suspended for more 'e 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. T ose rules are set fort OAR 952-001-0010 through OAR•52-001-0090may/ / -in a co.y of the rules or direct questions to OUNC by calling 503.232.1987 or 1 ;00.32.2344. / Issued By: moi— . ,`i . Permittee Signature: J Call 503.639. 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. Plumbing Permit Application °u3 Building Fixtures Foi OFTICE 1CI. LSI. oyLv City of Tigard :, Received ill13125 SW Hall Blvd.,Tigard,OR 97223" `'L- Phone: Permit No.: I Phone: 503.718.2439 Fax: 503.598.1960 Plan Review Inspection Line: 503.639.4175 ' Date/By: Other Permit No.: 1 I G A R D p Date Ready/By: Juris: H See Page 2 for Internet: www.tigard-or.gov Notified/Method:.` Supplemental Information r"..:,r, s +,yi:'�»: . ..,,,_ i.OF WORK . - .'''�.. '. :w f' ,__. .,--L. ,:Ts.Ram.tK:!JS,L)}k:-- -',--- L'.m...z^^' t,' ❑New construction 0 Demolition �,, rr For special information use checklist ddition/alteration/re lacement .�a`i,, A)az,'"on I . Ea. Total P 0 Other: ‘/!I1-2-family dwellings(includes 100 ft.for each utility connection) .::: , CATEGORY OF CONSTRUCTION FR(1)bath 312.70 ❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 ❑Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler( sq.ft.) Page 2 x. JOB SITE INFORMA''ION.ANI) LOCATION, Site utilities: Job site address: 7!�c7 S� f`�/, Catch basin or area drain 18.76 71:5,--A`� i-, c-/7. -2 leach line,or trench drain 18.76 City/State/ZIP: ca._ /� L Drywell, w Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name: ��(y '�° Manufactured home utilities `' 50.03 Cross street/directions to job site: l _ r/6 Manholes 18.76 r,,,,_ 2015- CkTc_)`"- 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: I Lot no.: LAD Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 ' 1-74 e Backwater valve 12.51 � Clothes washer 25.02 r)� :IA h" --D 50,a- Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 • *pF a. t 4 tg., ` ' Expansion tank �'�' 12.51 Name: ) Fixture/sewer ca \��,, 1 C__ cap 25.02 Address: Floor drain/floor sink/hub 25.02 1`7 9?,3 ,o4 f`�,7 k1v 0 3>0 i S Garbage disposal 25.02 City/State/ZIP: j--)e,_0.W ,}:�r-, �� 7>OU b Hose bib 25.02 Phone:( j ) 6y/S �, Fax ( ) Ice maker 12.51 0,*. V 1,O ? !A N t7, Interceptor/grease trap 25.02 Business name: Medical gas(value:$ ) Page 2 Contact name: Primer 12.51 Roof drain(commercial) 12.51 Address: Sink/basin/lavatory it 25.02 City/State/ZIP: Solar units(potable water) 62.54 Fax:: ( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 '',m CNTEA1t;► Water closet 25.02 Business name: Water heater 37.52 4- I-1 i£ L.kc. '(r.( 1/C. Water piping/DWV 56.29 Address: y / s-?. Si_ l.=>;)\0v L 1)-=., Other: 25.02 City/State/ZIP: 8/1 ‘1 (.L- m__ c� Z C-) Subtotal Minimum permit fee: $72.50 Phone:( ) Fax:( )! CCB Lic.: /7?i' L Plumbing Lic.no.: p,/3 vi Plan review (25%of permit fee) Authorized signs re: n State surcharge(12%of permit fee) TOTAL PERMIT FEE Print name: , 1 `(-) A Date: - ?:J / f This permit application expires if a permit is not obtained within 180 days Safter 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 tillties Qty , Fee(ea) Total Square Footage: Permit Fee: Footing drain-1s'100' 50.03 0 to 2,000 $121.90 2,001 to 3,600 $169.69 Footing drain-each additional 100' 37.52 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 Fee: Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Qty, Fee(ea) Total :„ each additional$100.00 or fraction thereof,to Other Inspections or;fees 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. $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for Additional plan review for revisions 90.00/hr each additional$100.00 or fraction thereof. (minimum charge-1/2 hour) Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. t '."PlaII"Re Dl l r., ' Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for, '' ' " ' * Please check all that apply. d Added Relocate Cappe Work Performed: 0 Any new commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool 0 New exterior plumbing site utilities for any complex structure Car Wash: -Each Stall as defined in OAR918-780-0040. -Drive Thru 0 Medical gas and vacuum systems for health care facilities. Cuspidor/Water Aspirator 0 Any multipurpose fire sprinkler system. Dishwasher: -Commercial 0 Any complex structure as defined in OAR918-780-0040. -Domestic Drinking Fountain Submit 2 sets of plans with any of the above. Eye Wash Floor Drain/sink: -2> "° -3" w s , c a1 Rise"'Diagram :m ; , 4" 0 Isometric or riser diagram is required for new buildings -Car Wash Drain that meet the qualifications above. Garbage -Domestic non-food Disposal: -Domestic food related -Commercial food related -Industrial food related Comments regarding fixture work: Ice Mach./Refrig.Drains 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 plumbing permit can be issued. Water Closet-Toilet Urinal Other Fixtures: I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2 CITY OF TIGARD1111 MASTER PERMIT • COMMUNITY DEVELOPMENT Permit' MST2019-00017 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/25/2019 F t G;1 R I-) 9 Parcel: 2S112BD14400 Jurisdiction: Tigard Site address: 7749 SW CORNUTT ST Subdivision: ELDERBERRY RIDGE Lot: 40 Project: Elderberry Ridge, Lot 40 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 5 First: 1352 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 25 Bathrooms: 3 Second: 1533 sf Garage: 491 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2885 sf Value: $365,198.05 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 Other Fixtures: 0 Drywell-Trench Drain: 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: 5 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All 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 2885 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 I PHONE: 503-645-0986 PHONE: 503-645-0986 f'. FAX: 503-690-2942 r Total Fees: $32,922.76 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes an, all er applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, o if w rk is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Cente hose rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. u may obtain a c py of the rules or direct questions to OUNC by calling 503.232.198 171.; • 32.2 , . "41 Issued By: Permittee Signature: ../ Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. /// Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application Folz OFFICE, USF.Oyl.v Received City of Tigard t l Date/By: Permit Non ,a� - , c,` . 1114 u 13125 SW Hall Blvd.,Tigard,OR 97223 l VE' -'` Plan Review I. Phone: 503.718.2439 Fax: 503.598.1960Other Permit: Date/By: �-I C R 1) Inspection Line: 503.639.4175 JAN2 9 2019 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information � slr ';': t*'''''''-" ' . ' " _."-'- cam ""° Mechanical permit fees*are based on the value of the work ❑✓ New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition D Other: mechanical materials,equipment,labor,overhead,and profit. '.'.. . . .d . ..;: Value: ,.$ ,. .. { s iEB trt '� . e.' a .' r': ' ' "S'1.1" f: tt t ,,. ,r: r, fi igi ❑✓ 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 e ,, II .. .r�' ll , t i Heating/cooling: FiB :.: _...... Air conditioning 1 46.75 46.75 Job site address: 7749 SW Cornutt Ln 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.: I 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 Subdivision: Elderberry Ridge I Lot no.: 040 Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 1 23.32 23.32 4 Gas fireplace/insert 1 33.39 33.39 6 1t t - ''"71 _ • " "' t .. '' " ` 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 *r Nom Other: 23.32 ' 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) 6 23.32 139.92 Phone:(503 )645-0986 Fax:( ) Attic/crawlspace fans 23.32 .." Other: t max,, ,c-�tr .. . . x r H 1 d} , 23.32 Fuel piping: Business name: Riverside Homes, LLC $14.15 for first four;$4.03 for each additional Contact name: Wes Boisvert Furnace,etc. 1 14.15 Gas heat pump Ste 370 Address: 17933 NW Evergreen PI., Wall/suspended/unit heater City/State/ZIP: Beaverton, OR 97007 Water heater 1 14.15 Phone:(503 B45-0986 I Fax::( ) Fireplace 1 14.15 Range 1 14.15 E-mail: wboisvert@riversidehome.com Barbecue $. 41i +`� x ax Clothes dryer(gas) Business name: Pro Heating & Cooling Other: 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 lie.: 209001 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 / ,:- ' 7 days after it has been accepted as complete. Authorized signature:L,rtvf.'ayG /.-:',/,‘-t.-c--" * Fee methodology set by Tri-County Building Industry Service Board Print name: Nikki Pruett Date: 1/29/2019 I:\Building\Permits\MEC PermitApp_040113.doc 4404617T(I 1/02/COM/WEB) Electrical Permit Application l"OR OFFICE l.:sl.°ON1.1 City of Tigard Received n Date/B : Permit /6, ` ,`q_, tcA.— '� 13125 SW Hall Blvd.,Tigard,OR 9722 Plan Review ' II Phone: 503.718.2439 Fax: 503.598.1` ,E1EIVE ,• DateB Related Permit#: Inspection Line: 503.639.4175 Ready Date/By: Iuris: 0 See Page 2 for TI G A R D Internet: www.tigard-or.gov 1 t+ 1 ry t )O 19pp G LNotified/Method: Supplemental 3• qz,Ga » _ ^" _ ^� yr � . a.�,we.�w '-'1.::'.1 -4t..--: ;-;�• „ :�r.-4u- .w...s�e a'..a� ... ;S�!''+ k` 't �”,�" �. • ❑✓ New construction 0 Addition/alterati s Ir:e i I en Please check all that apply(submit 2 sets of plans w/items checked): ❑Demolition 0 Other: BUILDING DIVISION 0 Service or feeder 400 amps or more 0 Building over three stories. where the available fault current 0 Marinas and boatyards. t .. v,,,Ate Y ":!„:),4, i t, t t' . }ma, , „ x. t ` 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 ❑Multi-family 0 Master builder 0 Other: 0 Firepmforuall other installations.p. 0 Insnstaltlnts. lation of 150 KVA or *r , ,f .JOnr* 5,P i P ,f „' ": i ', ,f.; ' . .""f 0 Emergency system. larger separately derived Job#: Job site address: ❑Addition of new motor load of system. 7749 SW Comutt Ln 100HP or more. ❑"A","E","1-2","1-3", City/State/ZIP: Tigard, OR 97224 ❑Six or more residential units. occupancy. 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: I Project name: ElderberryRidge ❑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 . Description I Qty I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision: Elderberry Ridge 1 Lot#: 040 Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1 ,- 10 t t �: 7:111:144,1,°041„,,,„,:t.N. • * 0 a 4° . .- 1. t • -,,,,,,,,4° „ Limited energy,residential 75.00 2 Construction of SFR (with above sq.ft.) Limited energy,multi-family residential(with above sq.ft.) 75.00 2 t ::k'1,,,,,1:,17,4, T Renewable Energy 0 See Page 2 ❑ • —' w ,.»: F .• 'r.? _, 1• • Services or feeders installation,alteration,and/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 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 - t ,`, , to , v, x: Branch circuits—new,alteration,or extension,per panel A1'PU a , ash' � - �� "( 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 sAddress: 17933 NW Evergreen PI., Ste 370 branch or feeder fee,first 56.18 2 g branch circuit City/State/ZIP: Beaverton, OR 97007 Each sdd'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(503)645-0986 I Fax: :( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: wboisvert@riversidehome.com Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 Business name: Sunlight Electric Inc Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address: 2804 NE 65th Ave. St. D panel,alteration,or extension. 0 See Page 2 2 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) 518-7589 Fax:( ) Investigation(1 hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: 172549 Electrical Lic.: C230 Suprv.Lic.: s ecificall listed '/z hr min Suprv.Electrician signature,required: (1..,46. , .„„1,e....--144 Subtotal: Print name: Chester Garrett I Date: 1/29/2019 0 Plan Review Required(25%of permit fee): / State surcharge(12%of permit fee): Authorized signature's jV6: , ' TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Nikki Pruett Date: 1/29/2019 days after it has been accepted as complete. * Number of inspections allowed per permit. C\Building\Permits\ELCPermitApp_ELR_ERE.doc Rev 06/17/2015 440-46151(11/05/COM/WEB Electrical Permit Application—City of Tigard Po —Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: «rte; t� �` � a �" 4> Description Qty. Each I Total I * 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.ecifically listed('/z hr min) ClAt. ° a .� +f41:ti` a: �, , r-t, ` t.`-. PE...4413 Subtotal(Enter on Page 1): $75*00 Fee for each commercial system: * 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_PemdtApp_ELR_ERE.doc Rev 06/17/2015 Plumbing Permit Application • Building Fixtures FOR OFFICE USE OMLY Cityof TigardRECtr Received permitNo�(� (`� < y� g Date/By: 1�T ,\q.,c JU\ IN .4 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ■ Phone: 503.718.2439 Fax: 503.598.1960)AN 2 9 ?...r319 Other Permit No.: Date/By: TICA�,.RDwxIn sp.maxection Line: 503.639.4175 �' Date Ready/By: funs. ® See Page 2 for Internet: www hgard or gov , iii, (o,e ! . Notified/Method: Supplemental Inf ormatlon 0 New construction 0 Demolition For special information use checklist. Description I Qty. .1 Ea. I Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) inv l"i Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Su s i ression S stems: Ate rPe-rmt• Footing drain-1"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 S stems: Water Service-each additional 100' 37.52 �rrr 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 ' E r ees each additional$100.00 or fraction thereof,to a0thet ,I ; e `If .. i _.. #==-x ftai ' 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*. 1:4 )�Y� a ` e As(4 ,.,:41t, 3 ire , "_� Future Type for N , Plan review is required for any of the following. Wet-'.T. rfo s . } ' Please check all that apply. Baptistry/Font pp y' 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 ❑ Any multipurpose fire sprinkler system. Drinking Fountain 0 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 ., .' Garbage Domestic-non-food 0 Isometric or riser diagram is required for new buildings Disposal -Domestic-food related that meet the •ualifications 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 underthis 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 .71,1 . COMMUNITY DEVELOPMENT DEPARTMENT TIGA R I3 Building Permit Review — Residential Building -....:r{. �.:..�:^Ya� � .. :CI 4-7:_ -_-,...:„:;:r7, ,77-.. ..�< . . . ��-. g Permit #: MSS �0� CS JtI- Site Address: 17 .1 9 S w Cor n v ti- LN Project Name: C Icier 10-erv\) reid.ce Lot #: 4 0 (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: n/.Qi1n/ S C(1~ Verify site address/suite#exists and active in permit system. op River Terrace Neighborhood: pc No 0 Yes,See River Terrace Review Addendum Attached Site Plan Elements: Three(3) copies of site plan Wiring structures on site Site plan must be on 8-1/2"x 11"or 11 x 17"paper )2rFootprint of new structure(including decks)with finished Drawn to scale(standard architect or engineer scale) floor elevations �JNorth arrow ,Utility locations&easements (required for new and additions) yl Site address,project or subdivision name and lot number ,Sidewalk/driveway approach 7Applicant information(name and phone number) tioa-e€-wells/septic systems ViLot dimensions and building setback dimensions $Earist a g es to be retained with drip line,and tree quare footage of buildings to be demolished protection measures )Lot 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 ViProperty corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? Yes ❑No 4 foot differential) If yes,is a storm water quality facility shown? D e5 4o5 U a 7 Clean Water Services-Service Provider Letter(lot platted prior to 9/10/1995): tv ��' Required: 0 Yes,applicant was notified /" No Received: 0 Yes ❑ No Public Facilities Improvement(PFI)Permit: pt. ,w 11 - 00 0 1 1 Required: 0 Yes,applicant was notified 0 No Applied For: p PP ,1�] Yes 0 No,stop intake Fr Land Use Case#: {" ORto1(p -- 0000cl f SUQIAD b — 00 007 FSZoning: R—1 /7Required Setbacks: Front i 5 Rear 1, 5 Side S Street Side $ (D Garage la l Landscape Requirement tO % g Lot Coverage Maximum: U 0 X Building Height Maximum Height > S Actual Height 2'S Visual Clearance 7 Sensitive Lands: 0 Yes grNo Type izr Urban Forestry Plan Conditions "Met"prior to issuance of building permit Notes: 7 Approved By Planning: VN..---.:__ Date: V/ 2-9/ 1'1 Revisions (after Building Submittal only) Reviewer Revision 1: 0 Approved 0 Not Approved Date Revision 2: 0 Approved 0 Not Approved Revision 3: 0 Approved 0 Not Approved I:\BuildineForms\BldgPermitRvw_RES_061417.docx Building Permit Submittal Original Submittal Date: \\ 1 \ 1 9 Site Plans: # Building Plans: # 3 Building Permit#: Nif Enter building permit#above. Workflow Routing: ErPlanning Er Engineering Er Permit Coordinator Er Building Workflow Sign-off: RiSSign-off for Planning(include notes from planning review) Route Application Documents: D7-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: \ \D \ct En ineering Review O rlope at building pad: 2 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: ❑ NOT Approvedb Engineering: Date: y � �� Notes: VAPProved Date: Z ` b y Engineering: 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 fC_onditions"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: E4 C Fees Entered: Wash Co Trans Dev Tax: E �i'es 0 N/A Tigard Trans SDC: C�9eY�es 0 N/A Parks SDC: [4s 0 N/A LIDA 0 Yes P7N/A K to Issue Permit /! Approved by Permit Coordinator: Date: I:\Building\Forms\BldgPermitRvw_RES 010118.docx City of Tigard Tel: 503.718.2439 Location: Inspection Date: 7749 SW CORNUTT ST, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2019-00017 Inspection Type: Inspector: 399 Plumbing final David Young Result: FA I L Comments: Provide permanent hard cap for un used rain drain stand pipe right side of house. Provide clean out cap to grade for what appears to be clean out with white dust cap left rear. Provide permit for laundry tray in garage installed without permit. Not ready for final inspection, work not complete. Violation Summary: Inspector Contractor City of Tigard Tel: 503.718.2439 Location: Inspection Date: 7749 SW CORNUTT ST, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2019-00017 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS Comments: Seal hole at microwave wire. Seal holes at edge of outlet face plates. Will check at building final. No ac installed at this time. Violation Summary: Inspector Contractor City of Tigard Tel: 503.718.2439 Location: Inspection Date: 7749 SW CORNUTT ST, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2019-00017 Inspection Type: Inspector: 699 Mechanical final David Young Result: PASS Comments: Seal penetrations at garage, will check at building final. No ac installed at this time. Violation Summary: Inspector Contractor City of Tigard Tel: 503.718.2439 Location: Inspection Date: 7749 SW CORNUTT ST, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2019-00017 Inspection Type: Inspector: 299 Final inspection David Young Result: PASS - CofO Comments: Final erosion control approved. Moisture barrier form received. Moisture content form received. High efficiency lighting form received. Insulation certification checked. Continuous operating fan in crawl for radon mitigation. C of 0 left on site with contractor. Note: no ac installed at this time, permit and inspection required at time of installation. Violation Summary: Inspector Contractor