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Permit (182) CITY OF TIGARDL,"-zz:: MASTER PERMIT t: s'' - COMMUNITY DEVELOPMEN114 4 T `,; tc Permit#: MST2019-00175 ^�� Date Issued: 05/08/2019 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S108DB01000 Jurisdiction: Tigard Site address: 15075 SW DANUBE DR Subdivision: POLYGON AT BULL MOUNTAIN Lot: 8 Project: SOUSOU Project Description: Construction of a 16x33 ft in ground swimming pool with auto cover. 12/23/2019: REPRINT to add electrical: (5) branch circuits. — BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 5 Detectors: Total: 0 sf Value: $29,700.00 Rear: 5 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Electricity Heat Pump: N Hoods: 0 Other Units: 1 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 4 Ea add'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 01111. Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: OTR SF VB R-3 0 Owner: Contractor: SOUSOU,NATALY BLUE MOUNTAIN POOLS INC Required Items and Reports(Conditions) 15075 SW DANUBE DR 13121 S WARNOCK RD TIGARD,OR 97224 OREGON CITY,OR 97045 PHONE: PHONE: 503-760-4554 FAX: Total Fees: $1,311.08 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 pAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.;i c. 2.2344. Issued B i:Y 7__� C' Z r f� t; 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. Electrical Permit ApplicatCEIVED _ - FOIt 014 ICL 1 SI.ONE) IIICity of Tigardfl C 232019 Received / " • I— 'll 13125 SW Hall Blvd.,Tigard,OR 97 Date/By: d'13 �7 -<../f17% Permit#NJ S j �x� -�,�/ 75 Plan Review _ Phone: 503.718.2439 Fax: 503.59 . Related Permit#: V6?OF TIGARD Date/By: 1 I G A It 1> Inspection Line: 503.639.4175 BUILDING DIVISION Ready Date/By: Juris: la See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information - TYPJA.OF •, PLS REVIEW Please check all that apply(submit 2 sets of plans w/items checks.'): ❑New construction ■ Addition/alteration/replacement ❑Demolition IN Other: 0 Service or feeder 400 amps or more 0 Building over three stories. where the available fault current 0 Marinas and boatyards. CAA.. !*V OF p', 0' ; - 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 a icultural ❑Multi-family El Master builder amps for all other installations. buildings. ❑Other: ❑Fire pump. 0 Installation of 150 KVA or i $Fr , Bo i,. D I;rf CA, ! 0 Emergency system. larger separately derived Joh#: Job site address: 15015 SIA) NN V i3Q 0 Addition of new motor load of system. �.y.;^ �� 100I-IP or more. ❑"A","E","I-2","I-3", City/State/ZIP: ! t (o�-�� O it- 1 l Z,2-'•I� ❑Six or more residential units. occupancy. ❑Healthcare facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: 0 US 0 V 0 Hazardous locations. 0 Supply voltage for more than El Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHj 1 ULE 1 X111-1 DA%)tie e- DC Deacri tan I . Each Total New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 168.54 4 Ea.add'l 500 sq.ft.or portion 33.92 I �DE :" ,n , .` x= - ;- Limited energy,residential . 75.00 2C;1 a - o-C/ L_ 5‘n•ui(. .- Not 1tit.to_s_wei,__ with above s,.ft. 1. . , :,, , 75.00 2 Renewable Ene r).,u ,`�.i v ^','' 4 t•? l M .i,.;r't.,s, . tn:.. a -:iss ,,.M1 .zr 0 See ,a-n 2 . Services or feeders installation,alteration,and/or relocation Name: t YI<'("ci) G N k1Ril SOU SU O 200 amps or less 100.70 2 Address: I,507 5 ,{ Diu).;vi.se D L. 201 amps to 400 amps 133.56 2 City/State/ZIP: TO � d 14..._ 17 1-7-if601 amps to 600 am am 30 .04 2 601 amps to 1,000 amps 3011.04 2 Phone:(SIG) -7 81 ,41(85 I Fax:( ) Over 1,000 amps or volts 552.26 2 Email: Temporary services or feeders installation,alteration,and/or relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I 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 ,:',1.'1'10.:/:-..„1,,i; " ` , :: t s iEn fi ll �,,f ;,/'�V ,,, I;` Branch circuits-new,alteration,or extension,per panel A.Fee for branch circuits with Business name: I( atQ(0 0,J tAkk)5( °' 94 'l j- above service or feeder fee, � each branch circuit 7.42 2 Contact name: "j'p,,,y }>R.V�.1'e — B.Fee for branch circuits without Address: l 9 7e)5- 514j C(1>0(c- )2.0.4.70b / ranch or feeder fee,first branch circuit 56.18 2 City/State/ZIP: Slf 01441600 0,j_ 9`7 I 4D Each add'1 branch circuit 7.42 2 Phone:(r"03) 8 c�8 / I ( ) Miscellaneous(service or feeder not included) rax: ' Each manufactured or modular Email: 1-04/1 a(IOi . 01-3, dwelling,service and/or feeder 67.84 2 Reconnect only 67.84 2 T "''" '• r.` Pump or irrigation circle 111 67.84 2 Business name: 6le t „ / I00{ r Sign or outline lighting 67.84 -- 2 Address: } f t•7�(�t.?I .t Signal circuit(s)or limited-energy I ' g"- panel,alteration,or extension. 0 See Page 2 2 City/State/ZIP: /7'1 .&L(t Of i g C7 Each additional ins t ection over allowable in an of the above G� (� Additional inspection(1 hr min) 66.25/hr Phone•: )W/ 3 5�.. I Fax:( ) Investigation(1 hr min) 90.00/hr Email: �t ..C /etre-t'RJ t_ COrY7 Industrial plant(1 hr min) 78.18/hr `J(f ` (� V� �G.�' , _ Inspections for which no fee is CCB Lic.: Electrical Lic.: G` Sicit)ca11 listed h hr min 90.00/hr itiGg I Suprv.Lic.: J3 ' Suprv.Electrician signature,requir '' CAG I*: RI�IiT!,FEES — Subtotal: Print name: ki 0 r. Date: (25% � [(sL .. i9 0 Plan Review Required of permit fee):_ ) State surcharge(12%of permit fee): Authorized signature: LS 4Lt.r'7lod- TOTAL PERMIT FEE: Print name: jej ��e• This permit application expires if a permit is not obtained within 180 t I Date: �/f,ij�/ I days after it has been accepted as complete. I:�Buildin*V'errnits�ELC Permi[A fiLR ERE.duc Rev 06/79/2015 -"�J 1 * Number of inspections allowed per permit. Gp_ -" 440-4615'r(t 1/05/COM/WEB CITY OF TIGARD MASTER PERMIT µ!.i COMMUNITY DEVELOPMENT Permit#; MST2019 00175 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/08/2019 Parcel: 2S108DB01000 Jurisdiction: Tigard Site address: 15075 SW DANUBE DR Subdivision: POLYGON AT BULL MOUNTAIN Lot: 8 Project: SOUSOU Project Description: Construction of a 16x33 ft in ground swimming pool with auto cover. BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 5 Detectors: Total: 0 sf Value: $29,700.00 Rear: 5 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF RainStorm Sewer: 0 0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Electricity Heat Pump: N Hoods: 0 Other Units: 1 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add!500 sf: 0 201-400 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: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: OTR SF VB R-3 0 Owner: Contractor: SOUSOU,NATALY BLUE MOUNTAIN POOLS INC Required Items and Reports(Conditions) 15075 SW DANUBE DR 13121 S WARNOCK RD TIGARD,OR 97224 OREGON CITY,OR 97045 PHONE: PHONE: 503-760-4554 FAX: Total Fees: $1,214.92 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 f. h in OAR 952-001-0010 through OAR 95 - 1-0090. You ma •• •in a copy of I. .es or direct questions to OUNC by c- '•e • :87,,,f, 1 '.332.2344 Issued By: . �� Permittee Signature: �/ /j---.6 � Call 503.6 5 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 x `Residential .A "'' I O►2 tlrr►c1 L Sl ()NI 1 Received / /G, tl �v,/-7c City of Tigard n • P —vC/! `J g }i R,"''1 y .n, Date/B 11 13125 SW Hall Blvd.,Tigard,OR 97223 ") z `' LU' Plan Review I Phone: 503.718.2439 Fax: 503.598.1960 Date/By: 7/(P (� Other Permit: I t i) Inspection Line: 503.639.4175 r. { 3 Date Ready/By: � / Tuns: ® See Page 2 for 1 Internet: www.tigard-or.gov ul.i :,, +'� .. .,.,N otified/Me od:IF OL 7/ .i Supplemental Information TYPE OF WORK REQUI' ,DATA:1-AND 2-FAMILY DWELLING SNew 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 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. and 2-family dwelling ❑Commercial/indusMal Valuation: $ 7% '70 U Accessory building 0 Multi-family Number of bedrooms: 0 Master builder Other: L Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: /5075- . SAN t,(56 DR _ New dwelling area: square feet City/State/ZIP: T4,41'D r-Dg % 76:1,?ti Garage/carport area: square feet •...:-.1...1 Suite/bldg./apt.no.: Project name: y S�( ( Covered porch area: square feet Cross street/directions to job site: Deck area: ` � square feet Other structure area:t7 0 1 `}► square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: I Lot no.: Permit fees*are based on the value of the work performed. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. / 04 ev- r rQu/z - - ( Valuation: $ (,)/ /, t g7) C,'Nyam: / Existing building area: square feet / y `(-7 '. New building area: square feet ❑ PROPERTY 4 OWNthe.ERR / 0 TENANT Number of stories: Name: $ S aG( / ,1 . Type of construction: Address: / 7 C 54) 64 4 u 4 t Occupancy groups: City/State/ZIP: 7u/,..e '72.2_1 Existing: Phone:( ) Fax:( ) New: 0 A?P�PL�ICCANTe ❑ CONTACT PERSON BUILDING PERMIT FEES* (PkiisBusiness name: K lC: tat/ YCZLS viewerefrrtofeposit):rtel Contact name: ( � 7 /T 2.-76-7—Z— Structural plan review fee(or deposit): FLS plan review fee(if applicable): Address: Total fees due upon application: City/State/ZIP: Phone:r) 7�-x5-3 ,-/ Amount received: I Fax::( ) PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: (�1 P ��wf/ 5 aGIICW4 iOu►i , /Npczne.S - C.-CIA"( Commercial and residential prescriptive installation of roof-top mounted PhotoVoltaic Solar Panel System. Business name: . Q.6----- w--(--:- ��L S Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 13'6'( V t . )A fZ�QGK _ Solar Installation Specialty Code checklist. City/State/ZIP: /p 64( /� 9 Permit Fee(includes plan review �/•""1"-'/. 7�� and administrative fees): $180.00 Phone:( 23) -76,,,_ 0751( Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.: e _ Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained ��'i/ within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Print name: 1�� Date: Qwiry � Scrvicc 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 014I( E t s l: OM l.l City of Tigard Received/Pg Permit No.: 13125 SW Hall Blvd.,Tigard,OR 97223 AssoBy: 1 Phone: 503.718.2439 Fax: 503.598.1960 Associated permits: 24-Hour Inspection Line: 503.639.4175 ❑ Electrical 0 Plumbing 0 Mechanical TIGARD Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW ve No y/' 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 ❑ 0 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0 3 Verification of approved plat/lot. 0 0 0 4 Fire district approval required. Name of district: . 0 0 0 5 Septic system permit or authorization for remodel. Existing system capacity ❑ 0 0 6 Sewer permit. 0 A ❑ 7 Water district approval. ❑ 0 8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0 0 9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 0 0 basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 0 0 0 building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if 0 0 0 there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size 0 0 0 and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 0 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- 0 0 0 floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. 0 0 0 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- 0 0 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 0 0 0 locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 0 0 systems,see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists 0 0 0 over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof trusstlmign detsIils- 0 - 0r—� t 0___ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 0 0 for four or more appliances. 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or 0 0 0 architect licensed in Ore.on and shall be shown to be a I.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 ❑ 0 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 0 0 0 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 0 0 0 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 0 0 27 "Drawn to scale"indicates standard architect or engineer scale. 0 0 0 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 0 0 Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 0 0 and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, 0 0 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-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Applicaticr, FOR OFFICE I SE ONE) ,"-" City of Tigard :,v.,„, 4 , 1:Li, Received Permit No.: f 71 . 13125 SW Hall Blvd.,Tigard,OR 97223 , , A ,,.., Date/By: ,,,,,4 Plan Review ; I Phone: 503.718.2439 Fax: 503.598.1960 PA:A) V ',..) 2019 Date/By: Other Permit: Inspection Line: 503.639.4175 I I(..i A R D Date Ready/By: Juris: 0 See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYP E OF *Hire- COMMERCIAL FEE* SCAR DLitt -,I1SE—clittialsr Mechanical permit fees*are based on the value of the work pNew construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATAGORY„OP=CONSTRUCTION -.,. ', ... -',, RESIDENTIAL EQUIPMENT/SYsTEMS FEES* „ ...„ .. and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. 0 Multi-family 1:P 0 Master builder b Other: Z--- Description Qty. Ea. Total JOB SITE A '14 ; ' TON ANT) LOCATION Heating/cooling: Air conditioning 46.75 Job site address: /6-075- D9A/4/5LC r, Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: ---77gx 0,4'. 97e2F47 Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: Project name: Q,.. 7/5:y_el Heat pump 61.06 Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above ,/, 23.32 Other: ok.‘4-4,41.14 1 23.32 Subdivision: Lot no.: Other fuel appliances: Tax map/parcel no.: Water heater 23.32 _ DESCRIPTION OF WORK Gas' ' Gas fireplace/insert 33.39 Flue vent for water heater or gas f/(11/(V/47 ?r:e7 ert-e/ w-e-e.e- C7iz-ez.7c-cf) fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 23.32 '11AI).1R.Iillt OWNER -'"PIZ0"iiTA144 '', Other. - '. • ' --•--•--- -- Environmental exhaust and ventilation: Name: Range hood/other kitchen equipment 33.39 Address: Clothes dryer exhaust 33.39 City/State/ZIP: Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:( ) Fax:( ) Attic/crawlspace fans 23.32 0 APS4CANT -f.,:',1, 0 CONI*114ItittS !:,E,:,.;-..,: Other: 23.32 Fuel piping: Business name:s/az....,-; a,,-,--. 1, 5 $14.15 for first four;$4.03 for each additional Contact name: Cycji/R/TY I-,/6-:-/ Z- Furnace,etc. Gas heat pump Address: Wall/suspended/unit heater City/State/ZIP: Water heater Phone:s. 3) 7C,0-L-45.75--,-( Fax::( ) Fireplace Range E-mail:544pp 1,--721,tr I-Ts (/ z.t/6.„---koccbt,--1 14 4v ?2X5 . Cotex Barbecue '-';..... CONTRACTOR ''. Clothes dryer Other: i t(i-irrt- 1 Business name: (.406-, Par MECHANICALPERwr FEES* Address: / 3/,.2( ,c----, (A)4g4,7p44 I.-7 7. Subtotal City/State/Z1P:0/,?6,---6,c3,f_( 077', X., g 7e,C._.5 Minimum permit fee($90.00) utt.t.t46 Plan review(25%of permit fee) Phone:6(53) 7(()- /.45:5--z7 Fax:( ) State surcharge(12%of permit fee) CCB lie.: g 3 (5 ) /- TOTAL PERMIT FEE ...._ — This permit application expires if a permit is not obtained within 180 Authorized days after it has been accepted as complete. ..:,:.. --f-- ../ * Fee methodology set by Tri-County Building Industry Service Board Print name:_ Aelle/(OW . htn-N5a7(1 Date:4, 4r(/9Y ‘, /,L. 1:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information • Commercial& Multi-Family Fee Schedule: _Total Permit Fee: _ $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and $2.54 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I:\Building\Permits\MEC_PermitApp_040113.doc 2 City of Tigard 111111 COMMUNITY DEVELOPMENT DEPARTMENT I T I G A R D Building Permit Review — Residential Building Permit #: S/olo/ I —007-7A--- Site Address: 15D15 SW DAM,' 19e, Dri./e Project Name: cS D U SOU POD I Lot #: (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: IhlD14►0 c;Wi,1414K1Vti 10` Verify address/suite# active in Accela. '54-In River Terrace: ❑ No j1 Yes,River Terrace Review Addendum Site Plan Elements: Ti rosion Control -3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper rN' -tained trees with drip line and tree protection measures 'Drawn to scale(standard architect or engineer scale) NIF=tootprint of new structure(including decks)and FPI, E i orth arrow H Jtility locations&easements(required for new and additions) 'bite address,project or subdivision name and lot numberidewalk/driveway approach pplicant information(name and phone number) KkLocation of wells/septic systems Lot dimensions and building setback dimensions AiStreet tree size,type and location quare footage of buildings to be demolishedstreet names Existing structures on site , "Corner elevations (2'contours if more than 4'differential) of area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? 2 'ell No - - II impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? • es ❑No ig Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No Public Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified X No Applied For: ❑ Yes ❑ No,stop intake N Land Use Case#: N/ k tg Zoning: Q-I-1.0 Required Setbacks: Front: 14/Pr- Rear: g Side: G/ Street Side: /0/it—Garage: N/ I-Building Height: Max. Height: Actual Height: Landscape Area: % c Lot Coverage Max: Entrance le Set b. k no mor than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less Windows I► ' ' i um 12% area of all street-facing facades Garage III ara;,e door is ehind est street-facing wall ❑ Yes ❑ No,one of the following is met: II Door ext nds no , • e than 5'from wall and there is a covered porch extending beyond garage. ❑ Door ex ends no s10• - + an 5'from wall and there is a 12 sq ft.window above garage on 2nd floor. N Garage door 'dth is f IN 1•'or less ❑ 50%or less of facade ❑ 60%or less and includes 7 of following: ❑ Covere porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset ❑ Fire s ' gles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer ❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony Visual Clearance PliCkUrban Forestry Plan ,'Sensitive Lands: ❑ YesNo Type: -Conditions met prior to issuance of building permit Notes: ��} I ` l Approved By Planning: ty..,43 C l,� Dte: ,S1(o I EelRevisions (after Building Submittal oly) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw RES 022819.docx Building Permit Submittal Original Submittal Date: Site Plans: # Building Plans: # Building Permit#: qEnter building permit#above. Workflow Routing: -Planning C4 Engineering y-Permit Coordinator Building Workflow Sign-off: 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. 15 Building: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: ,1 fAAi� .4.A i Date: -16s Engineering Review /� /� ,Slope at building pad: , `� [27-"Conditions "Met"prior to issuance of building permit ,a-Easements (encroachments)per engineering conditions of approval and plat Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes kf' No Assess Water Quantity Fee in-lieu: ❑ Yes No LIDA Facility on lot: ❑ Yes j=1-No IFinal Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: Date: 5-.16// ` Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ 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: VVDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes N/A Tigard Trans SDC: ❑ Yes N/A Parks SDC: ❑ Yes 115 /A LIDA ❑ Yes v N/A OK to Issue Permit Approved by Permit Coordinator: A�' Late: 571-0/1I I:\Building\Forms\BldgPermitRvw_RES_022819.docx