Permit CITY OF TIGARD MASTER PERMIT
a COMMUNITY DEVELOPMENT Permit#: MST2019-00159
T I[; \R t) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/14/2019
Parcel: 2S106DA09000
Jurisdiction: Tigard
Site address: 16816 SW SNOWDALE ST
Subdivision: RIVER TERRACE EAST Lot: 90
Project: SHIM
Project Description: (1)new bedroom and(1)new bathroom in basement.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 1 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0
Detectors: Yes
Total: 0 sf Value: $17,500.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0
Drains: 0
Tubs/Showers: 1 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
Drywell-Trench Drain: 0 Other Fixtures: 1
Other Fixture Units: Ejector/Sump
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 0
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'I 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
Ecompasing: N
Other: N Other Description:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB R-3 0
Owner: Contractor:
SHIM,EUNJUNG PACIFICSIDE HOMES&CONSTRUCTION I Required Items and Reports(Conditions)
KIM,JUNGRYUL 2045 LESLIES WAY
16816 SW SNOWDALE ST WEST LINN,OR 97068
BEAVERTON,OR 97007
PHONE: PHONE: 503-312-7471
FAX:
Total Fees: $714.62
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes a•• ether 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 issuan • k is suspended for more the 180
days. ATTENTION: Oregon law requir you to follow the rules adopted by the Oregon Utility Notification Cent_ 'ose rules are set forth in OAR
952-001-0010 throng AR 952-001-009 . ou may obtai copy of rules or direct questions to OUNC by calling 503.232.1 it
:00.332.2344.
r• ,
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.
Building Permit Application
Residential FOR OFFICE l SE O\Ll
City of Tigard Received
,�
DateB : ! s Permit No.: t
11111 11 13125 SW Hall Blvd.,Tigard,OR 97223 R E C E I V E _Plan Review �
a Phone: 503.718.2439 Fax: 503.598.1960 Y DateBy: Aoly., Other Permit:
T t_A R D Inspection Line: 503.639.4175 APR 3 p Date Ready/By: Juris: la See Page 2 for
Internet: www.tigard-or.gov 2019 No%r eth��: �rj 7 sa Supplemental Information
TYPE OF W°RUIIDING DIVISION REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑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 ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1-and 2-family dwelling ElCommercial/industrial Valuation: $17500
❑Accessory building 111Multi-familyNumber of bedrooms: 4
❑Master builder ❑Other: Number of bathrooms: 4
JOB SITE INFORMATION AND LOCATION Total number of floors: 3
Job site address:16816 SW Snowdale St New dwelling area: 0 square feet
City/State/ZIP:Tigard Oregon 97007 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Shim Residence Covered porch area: square feet
Cross street/directions to job site:Hwy 210 to River Terrace Blvd to Deck area: square feet
Snowdale Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Buillid out newBedroom and full bath to basement bonus room Valuation:
m $
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name:Eunjung Shim Type of construction:
Address:16816 SW Snowdale St Occupancy groups:
City/State/ZIP:Tigard Oregon 97007 Existing:
Phone:( ) Fax:( ) New:
0 APPLICANT 0 CONTACT PERSON BUDDING PERMIT FEES*
Business name:Same as below (Plaice rejertofeeschedule)
Structural plan review fee(or deposit):
Contact name:
FLS plan review fee(if applicable): ,
Address:
Total fees due upon application:X5*. -
City/State/ZIP:
Phone:( ) ) Amount received:
Fax: :(
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name:PacificSide Homes&Construction LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:PO Box 672 Solar Installation Specialty Code checklist.
City/State/ZIP:West Linn Oregon 97068 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503)312-7471 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: 154979 `f f.2- /2-/ Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name Brett Darrow Date:4/26/19 *Fee methodology set by Tri-County Building Industry
-Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Plumbing Permit Application
Building Fixtures FOR OFFICE USE ONLY
City of Tigard RECEIVE `,eceived jr `
Date/By: f Permit No.: Ct"
q 13125 SW Hall Blvd.,Tigard,OR 97223 / �� ° ��'f_J�.JIJ
APR 3 0 2019 Plan Review
I III Phone: 503.718.2439 Fax: 503.598.1960 Other Permit No.:
Date/By:
Inspection Line: 503.639.4175
TIGARD Date Ready/By nuns See Page 2 for
Internet www.tigard-or.gov f QJ TIGARD Notified/Method '
WoSupplemental Information
" ;, `-;. '`� - zk, zi , ' .. a s r .
El New construction El Demolition For special information use checklist.
Description I Qty. I Ea. I Total
®Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
t._r., A, , . Y 'li ,.. ,. & SFR(1)bath 312.70
®1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
CI Accessory buildingSFR(3)bath 500.32
0 Multi-family
Each additional bath/kitchen 25.02
El Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
rr , OE$A M4` -? , Site utilities:
Job site address: 16816 SW Snowdale St Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,Oregon
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name: Shim Residence Manufactured home utilities 50.03
Cross street/directions to job site:Hwy 210 to River Terrace Blvd 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: 1 Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
tIR 1 fFT Backwater valve 12.51
Clothes washer 25.02
Add basement floor bathroom,Shower,sink toilet,Sewer ejector
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 1 25.02
, 1 1 a . , -. 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
Interceptor/grease trap 25.02
Business name:PAcificSide Homes&Construction LLC Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Brett Darrow
Roof drain(commercial) 12.51
Address:PO Box 672 Sink/basin/lavatory 1 25.02
City/State/ZIP:West Linn,Oregon 97068 Solar units(potable water) 62.54
Phone:(503)312-7471 Fax::( ) Tub/shower/shower pan 1 12.51
E-mail: Urinal 25.02
0
i % Water closet 1 25.02
s
Water heater 37.52
Business name:Hill's Construction Contracting
Water piping/DWV 56.29
Address:PMB 423 Other: 25.02
City/State/ZIP:17675 SW Farmington Rd,Aloha,Oregon 97007 Subtotal
Phone:(971)246-3682 Fax:( ) 7///d0Minimum permit fee: $72.50
CCB Lic.:102201 71st Plumbing Lic.no.: 1738 Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name:Brian Hifi Date:4-30-19 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.
I:\Building\Pennits\PLMU-PermitApp.doc 10/01/09 440-4916T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2- Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site`Utilit es �_ t ) o cnnit
Footing drain- 15`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
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*.
*per _ Plan review is required for any of the following.
Baptistry Font Please check all that apply.
Bath Tub/Shower El 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 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"
4„ mer,fl gra
Car Wash Drain ❑ Isometric or riser g
diagramis required for new buildings
Garbage -Domestic-non-foodq
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/Lay -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 Firs•
Users/brettdatrow/Downloads/PLMF_PermitApp.doc 2
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
16816 SW SNOWDALE ST, BEAVERTON, June 17, 2019 at 9:53:44 AM
OR, 97007
Record Type: Record ID:
Residential - Master Permit MST2019-00159
Inspection Type: Inspector:
299 Final inspection Jeremy Burrows
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor