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Permit (201) 7 CITY OF TIGARD , ` " x MASTER PERMIT 2 COMMUNITY DEVELOPMENT Permit#: MST2019-00228 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/22/2019 T �'' ` ' 9 Parcel: 2S 115AB06500 Jurisdiction: Tigard Site address: 11469 SW GABRIEL ST Subdivision: WILLOW BROOK SUBDIVISION Lot: 10 Project: Willow Brook, Lot 10 Project Description: New SF. 8/28/2019: REPRINT permit to add irrigation backflow. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 3 First: 1814 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 15 Bathrooms: 2 Second: 0 sf Garage: 433 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 1814 sf Value: $309,292.61 Rear: 15 PLUMBING Sinks: 1 Water Closets: 2 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 1 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 3 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 1814 Owner: Contractor: PACIFIC LIFESTYLE HOMES INC PACIFIC LIFESTYLE HOMES Required Items and Reports(Conditions) - 11513-Ple 99Tfi ST STC 12U 11515 Nf'SSTfi ST/P/2170 -- VANCOUVER,WA 98682 VANCOUVER,WA 98682 PHONE: PHONE: 360-213-0813 FAX: 360-574-6401 Total Fees: $30,892.16 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 0 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: d ��"�C'q ///O 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. CITY OF TIGARD MASTER PERMIT IN '' COMMUNITY DEVELOPMENT Permit#: MST2019 00228 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/22/2019 Parcel: 2S115AB06500 Jurisdiction: Tigard Site address: 11469 SW GABRIEL ST Subdivision: WILLOW BROOK SUBDIVISION Lot: 10 Project: Willow Brook, Lot 10 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 3 First: 1814 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 15 Bathrooms: 2 Second: 0 sf Garage: 433 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 1814 sf Value: $309,292.61 Rear: 15 PLUMBING Sinks: 1 Water Closets: 2 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 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: 4 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 add9 500 sf: 3 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 1814 Owner: Contractor: . TfACtrtt;ttrtstrtt tyvMtlroC PACIF+CtiFESTYt 1HOMEs - - _ _ _Required Items_and Reports_(CanditioW __ 11815 NE 99TH ST STE 1200 11815 NE 99TH ST#1200 1 Ersn Cntrl 503-639-4175 VANCOUVER,WA 98682 VANCOUVER,WA 98682 PHONE: PHONE: 360-213-0813 FAX: 360-574-6401 Total Fees: $30,857.14 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 i suance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow t dopted by the Oregon Utility Notifica on Center. Those rules are set forth in OAR 952-001-0010 through OA 952-001-0090. You ma a copy of the rules or)direct questions to OUNC by calling 'i3.232.1987 or 1.800.332.2344. Issued By: <, r-` . —'e• Permittee Signature: t, Cee. A c�f1 .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 Checklist . One- and Two-Family Dwelling FOR OFFICE LSE ONL\ City of Tigard Received Permit No.: Date/By: 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits: Phone: 503.718.2439 Fax: 503.598.1960 0 Electrical 0 Plumbing 0 Mechanical 24-Hour Inspection Line: 503.639.4175 ❑ Other: I 1 G A It D Internet: www.tigard-or.gov ' THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW les No N/A❑ 0 0 I Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 0 0 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0 3 Verification of approved plat/lot. 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 0 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. 0 ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. 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 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. 0 0 0 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 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. 0 0 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. 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. 0 0 0 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- prescriptive path analysis provide specifications and calculations to engineering standards. 0 0 0 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 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. 0 0 0 20 Manufactured_floor/roof truss desi.n details. 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ 0 for four or more appliances. 0 0 0 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or architect licensed in Ore.on and shall be shown to be a,.licable to the .ro'ect under review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". 0 0 0 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 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. 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. 0 0 0 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Application FOR OFFICE USE ONLY City of Tigard Received ' ' 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: Permit No4� f i•'7" Phone: 503.718.2439 Fax: 503.598.1960 Plan Review Date/By: Other Permit: TI G A R D Inspection Line: 503.639.4175 Internet: www.tigard-or.gov Date Ready/By: Jur s: WI See Page 2 for Notified/Method: Supplemental Information 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 0 Other: mechanical materials,equipment,labor,overhead,and profit. ' Value:$^ rwf1r�i ` r fi �r" 11b;ft !fli {:: r' ptrr;' iS`J�Iiaf { ' jf ,,,,, kt, ,,,,,,,,„,,..,,„7„,,,,,,,:,„,,,,,,„„ rs # ` ` fsa�. k`, .s ,g.2,2',''1 ,„-",. 44 # ✓r`` ID t t t 040,4® 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist. 0 Multi-family 0 Master builder ❑Other: Description I Qty. I Ea. I Total ,r yf,�Grr,, „�/F'f.u" r ;.. r ''%` '`' ,,-.a,r' „`frr'r f rr r�r mo r dT °p n IerKt�,r." 4,,• rst, la ,4 ire tx N a 4*/ 4.0x, Heating/cooling: it:rl .?;,"r ,r rf �1.,' „,A r..a,=�r,A.2*.,.4:2,,,., ,,,, . s, s .;:F,is r..,4,,.. "40441,4'/ 4,4 r'f44444'!frJ4„r.e. Job site address: )-1 y.4 r,� �n e j1 5 Air conditioning f 46.75 ��—:; fLL���...1��' t Furnace 100,000 BTU(ducts/vents) I 46.75 City/State/ZIP: l lw�� ' Furnace 100,000+BTU(ducts vents) 54.91 Suite/bldg./apt.no.: I Project name: 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 Subdivision: L,/1 1 I I 0\ 61r ,l-- I Lot no.: l Other: 23.32 ? Other fuel appliances: Tax map/parcel no.: ,✓ ' ,4%9��,�,,,Xf�1 �^ f u r: t�����-' t..� Water heater 23.32 15pe`'rr re r . xr�T r�� ) ',1 ' Hg',/41r5r r�rkkO r,.r '. tl%,.,C s 7, tl ,, 3 i` f or y k 1m`"f Gas fir lace/insert 33.39 ) Flue vent for water heater or gas N.. et-Ai fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 f"r"� ���$ d u 5a v�y r �� -0 r � r �, sk . r ylFOther: 23.32Kr « Environmental exhaust and ventilation: Name: Range hood/other kitchen I Address: equipment 33.39 Clothes dryer exhaust 1 33.39 City/State/ZIP: Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:( ) Fax ( ) r , . a" 4 Attic/crawlspace rawlspace fans 23.32frsf% Ay , f r' Pf ,f j' ✓ r I''', {#J?! . zx hT /r 1r ,v2 other: 23.32,r ., l�, ` Ltla 9 , VK44@i+ , ,; dirf!0f.; 1, � = 4m4' '4rA4,4,M -: �,� 1 ,,,,,, ta 29 Business name:Pacific Lifestyle Homes Fuel piping: $14.15 for first four;$4.03 for each additional Contact name:Permit Coordinator Furnace,etc. Address: 11815 NE 99th Street,Suite 1200 Gas heat pump Wall/suspended/unit heater City/State/ZIP:Vancouver,WA 98682 _ _ Waft ,-i ..... Phone:(360)573-8081 I Fax::(360)574-6401 Fireplace Range II E-mail:permits@buildplh.com Barbecue lp.` f G r'1f `;M', # f ;fixM ;;%r:r kdf W RfsO 7, lClothes d ryer(gas)lL ` s rXraF' IV /Slf i / ;fY� �% ` rer 'jer „ Business name:Area Heating+Cooling Other: f ` " r .•l n F� r ,,,,,,s4';'-',-am; 41,�,&i r ''Address:2721 NE 65th Ave Subtotal City/State/ZIP:Vancouver,WA Minimum permit fee($90.00) Phone:(360)737-0811 Fax:(360)737-6946 Plan review(25%of permit fee) State surcharge(12%of permit fee) CCB lic.:64801 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 ftyr, t- \ days after it has been accepted as complete. Authorized signature: �- r U(�l(1� 1 * Fee methodology set by Tri-County Building Industry Service Board Print name: p/� F1/1 n imor,ti Date: 5/ 1 J Cl I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(]1/02/COM/WEB) Mechanical Permit Application - City of Tigard .� Page 2 - Supplemental Information • Commercial& Multi-Famil Fee Schedule: $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 lk Electrical Pel�lniL� lic�atioI1 ��� • MCityo I'i and Received .64 �� Date/13v. Permit it ��� 13125 SW Hall Blvd.,Tigard,OR 97223 (� Plan Review Plume: 503 718 2419 Fax: 503.598.1960 �J Date/By: Related Permit r/: . Inspection Line: 503.639.4175 Ready Date/13y: auris. Vi See Page 2 for (IGARI) Internet' www.tigard-or.gov Notilied/Method: Supplemental Information TYPE OF WORK PLAN:REVIEW ® New construction 0 Addition/alteration/replacement Please check all that apply(submit 3 sets of plans w/items checked): Demolition 0 Service or feeder 400 amps or more 0 Building over three stories. 00 Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. -►I I-and 2-family dwelling ❑Commercial/industrial ❑Accessory,building tens to ground,or exceeds 14,000 ❑Cominerciud-use agricultural amps for all other installations. buildings. ❑ Multi-family ❑ Master builder 0 Other: 0 Fire pump.p 0 Installation of 150 K VA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived Job II: Job site address: 1 p ( 0 Addition of new motor load of system. ...... ---------- -- _ - 1449, l c J l /lcY/n c�\ �' 100 M'or more. ❑../,,. :.f., „1_2,,,:,1 3., City/State/Z,11111. ©Six ormore residential units. occupancy. 1 ❑Health-care facilities. [Ti Recreational vehicle parks. Suite/bldg./apt.#: `' J Project name: LLD_,iitrtt`� (0 ❑Hazardous tocalions. 0 Supply voltage 1•or more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: .. FEE SCHEDULE Description 1 Qty. I Encb I Total _]_"� - New residential single-or multi-family dwelling unit, Subtlivisi(tn;i t�( t�@u� MJ Lot#: 1 Includes attached garage. - _ 1,000 sq.ll.orless 168.54 4 IIOta Tax map/parcel#: �� �� ra.add'I 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK ' ' Limited energy, ` residential 75.00 2 _ i_ Q c - _y _ ( C (� (with above sq.ft.) t� I w r'`- a Limited energy,multi-family `� ,� residential(with above sq.fl.) 75.00 2 ' —"' Renewable Energy ❑ See Page 2 ® PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name: 200 amps or less 100.70 2 Address: V 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State%11P: 601 amps to 1,000 amps 301.04 2 Phone:( ) l Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Flynn!: relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I intended 'Or sale, lease,rent, or exchange, according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature:. ... _.__..__..._.... Date: 401 amps to 599 amps 168,54 2 ® APPLICANT F41 CONTACT PERSON Branch circuits--new,alteration,or extension,per panel A.Fee for branch circuits will Business name: Pacific Lifestyle Homes above service or feeder fee, 7.42 2 each branch circuit Contact name: Permit Coordinator B.Fee for branch circuits without servAddress: 11815 NE 99t5 Street,Suite 1200 branch t feeder fee,first 56.18 2 brunch circuit City/State/ZIP:Vancouver,WA 98682 Each add'l branch circuit 7.42 -- Each 2 Miscellaneous(service or feeder not included) Phone:(360)573-8081 Fax: :(360)574-6401 Each manufactured or modular 67.84 2 Email: permits@buildplh,cotn dwelling,service and/or feeder Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 --1- - Business name:Garner Electric Sign or outline lighting 67.84 2 Address: 2920 SE Brookwood Ave,Suite A Signal circuit(s)or limited-energy 0 See Page 2 2 panel,alteration,or extension. City/State/ZIP: Beaverton,OR 97006 Each additional inspection over allowable in any of the above - Additional inspection(I hr min) 66,25/hr Phone:(503)648-4552-- 1 Fax: (503)642-7925 Investigation(1 hr min) 90.00/hr Email,' mrnorato(r garnerelectric.corn Industrial plant(1 hr min) -- 78.18/hr Inspections for which no fee is CCB Lie.: 121159 Electrical L'•.; -305C Supry..Lie.:2,"1 i CJ specifically listed(%,hr min) 90.00/hr ELECTRICAL'PERMIT FEES Suprv. Flectrieian signature,require . Subtotal: Print name; Chuck Garner �, • -- Date:( v_f Gi..1 y 0 Plan Review Required(25%of permit fee): , ,`eters State surcharge(12%of permit fee): TOTAL PERMIT FEE: Authorized signature: f� This permit application expires if a permit is not obtained within 180 [Print name: C / / to l` I 1t��I Gni Date: (U .(q-1 days after it has been accepted as complete. * Number of inspections allowed per permit. i`•Itnitding'''i'ennii OF.t.C_IrermitApp at(tttI:doe Itev06/1'1/2015 440-4615T(11105/Co64,WEn Plumbing Permit Application Building Fixtures g FOR OFFICE USE oNLti City of Tigard Received ' Date/By: Permit No.: /)'i 1 1lk�..�4 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review / `c 1 ill Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.: Ti G A R D Inspection Line: 503.639.4175 Date Read/B Internet: www.tigard-or.gov Notified/Method:Ready/By: Juris: See Page 2 for Supplemental Information s 'x:3', u•tf�`.. " ; #sff 7 4 "" :r�w3:va X !, r% 0 New construction ❑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):: 'tP7WrP ' ` s b I#�dP � SFR(1)bath 312.70; f =ra ® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 CIAccessory building ❑Multi-family SFR(3)bath 500.32 El Master builderEach additional bath/kitchen 25.02 El Other: �r r r �� Fire sprinkler( sq.ft.) Page 2 4.4t�,ig 4e454, f ® .tY, B Rafr �t��b � 4,';`; }" I;r4350)1 t r:r.,'' ,.a./��mr;'1 Site •utilities: vz .�,f ,,r' �.%x.,„ff�r Job site address: .1_1 `-i cci h f17 els , Catch basin or area drain 18.76 City/State/ZIP: a/ / Drywell,leach line,or trench drain ■ 18.76 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:UO) Page 2 Storm sewer(no.linear ft.:(.1CV Page 2 l) )) �} � Water service(no.linear ft.:Ut Page 2 Subdivision: �k 1 � K/ Lot no.: �� Fixture or item: Tax map/parcel no.: (7-:..;114.5..4-' CO STA) Backflow preventer 31.27 ff , y 004 Z� "rg f2$, Si4 6 r '„ , r r ✓ /f,aBackwater valve 12.51il / rWf 'r `?'4! , „, , :' ° �s %"f.fa Clothes washer 25.02 Dishwasher25.02 Drinking fountain III 25.02 Ejectors/sump 25.02 it � F i A', k ` Expansion tank 12.514.0'1c tt(1 ,:g1141,-,.ry' !.1;:i.,,,, � 4 Name: rc c t 0, A e/S- & fv/l.,�e ;, Fixture/sewer cap 25.02 Address: I/g!C_ }• r ftt 4 e, i Floor drain/floor sink/hubEMI25,02 b J V Garbage disposal � 25.02 City/State/ZIP: C141 C f y- Is(.D r l'" i '�iv-L, Hose bib 25.02 Phone:(31(20 6 13 cdo Fax:( ) Ice maker I/I12.51 ' ` .j7a % 0( atr1.f J .. Interceptor/grease trap 25.02 0r :;.44'..� ; es Business name:Pacific Lifestyle Homes Medical gas(value:$ ) Page 2 Contact name:Permit Coordinator Primer 12.51 Roof drain(commercial) 12.51 Address:11815 NE 99'Street,Suite 1200 Sink/basin/lavatory .4 25.02 City/State/ZIP:Vancouver,WA 98682 Solar units(potable water) 62.54 - Mime: 360)573-8081 Fax: :(360)574-6401 Tub/shower/shower pan 12.51 E-mail:permits@buildplh.com Urinal ill25.02 ,,-;,,,,,,,,:a„44,,,,r„,,r r f" 4,r , ,, 7 ,, Water closet 25.02 tj, ;;,: 37.52 ITC) �� Water heater Business name: jet:btW . LI ITC l I �%►' � Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: ?/i Subtotal Phone:( ) AM Fax:( ) �y( /!(i` Minimum permit fee: $72.50 CCB Lie.: `Z/23 /`G r J h Plan review (25%of permit fee) �� [ ( / Plumbing Lic.no.:' ' t ' � �n State surcharge(12%of permit fee) Authorized signature: Y t,{ 00-' !/V Iu J TOTAL PERMIT FEE L I! 1 Print name: � �`l//'1J fl/ Date: ;26011,C1 I This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-PermitApp.dos 10/01/09 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard , , y Page 2 - Supplemental Information ' ' . Fee Schedule: Residential Fire Su I s ression S stems: Footing drain-151 100' 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 r""'r "�`'a ' %� "-7'. 4,,.',,,,.r'‘:,,,4`' � ,. ' ` `,, i 1r.,),,,4,„0„,,14.1,�` d % ,:er,,,,,6 i BQ' ,`ir` �` y e.,'®' 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 s AILJ r 7 t . a li f'A7,,,,(;:‘');':- ' 4; ,j•.. • >.... AAA 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 each additional$100.00 or fraction thereof. (minimum charge-1/2 hour) Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased� sewer fees* y' n s"'j4�1 ,1 , r � i ° ll tl , , ,. : Zl.,, f,! . vfi ',,i ?': : tet,. ., , .,', ,2044, f fiXtUfefar$ r tad Plan review is required for any of the following. or . .r,- Copped Agora i � ---F Please check all that apply. Baptistry/Font Bath -Tub/Shower 0 Any new commercial building with water service 2"and -Jacuzzi/Whirlpool 1pool greater,except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Drive Thru ❑ 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 ❑ Isometric or riser diagram is required for new buildings Garbage -Domestic-non-food 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 increase of sewer EDUs,a sewer permit will be issued and Water Extractor Water Closet-Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: P:Uob Folders\Oregon\Jurisdiction Docs\Tigard,City\Applications\PLB_PX-rmitApp.doc City of Tigard I a COMMUNITY DEVELOPMENT DEPARTMENT II T 1 c A Iz D Building Permit Review — Residential Building Permit #: "iS�okoig - 00)-014— Site 0)-- - Site Address: INig 9 ,,,,a) 90.,1),i,i:ei -71-.-- Project Name: A Moto 6004_ Lot #: /0 (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Pr• .osal: desk) JT a Verify address/suite# active in Accela. �� in River Terr e: lV_J No 0 Yes,River Terrace Review Addendum Sit Plan Elements: IL osion Control 1copies of site plan on 8-1/2"x 11"or 11 x 17"paper Vyeetained trees with drip line and tree protection measures fawn to scale(standard architect or engineer scale) YJ F otprint of new structure(including decks) and FFE orth arrow �tility locations&easements(required for new and additions) NJ S address,project or subdivision name and lot number O .ewalk/driveway approach •plicant information(name and phone number) el 4cation of wells/septic systems t,.t dimensions and building setback dimensions VA tree size,type and location kJ .re footage of buildings to be demolished Veet names • sting structures on site YJ Corner elevations(2'contours if more than 4'diffe ntial) 1U .t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced. V es ❑ im ervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? 1...) Yes lfQNo \h�@lean Water Services—Service Provider Lett (lot platted prior to 9/10/1995): e lured: > q 0Yes,applicant was notified No Received: 0 Yes 0 No IIV Public Faciliti74.Improvement(PFI) Permit: quired: 11 Yes,applicant gwaas notified 0 No Applied or: Yes 0 No,stop intake Ll/J and Use Case#: )1J&2Oi// ,�, 08 j V� : 2 /S-- 1-E' I g �^' / V) quired Setbacks: Front: ! Rear: /S Side: S Street Side: `"Garage: ..20 ding Height: ^� Max. Height: - Actual He. ht: J19e Landscape a: �V % rEi Lot Coverage Ma • 10/0 Entrance V t back no more than 8'from street-facing wall V Parallel to street or offset 45 degrees or less Windows ' um 12%of area of all street-facing facades / Garage V Garage door is behind widest street-facing wall 2 Yes 0 No,one of the following is met: O Door extends no more than 5'from wall and there is a covered porch extending beyond garage. 2/ 0 Door extends no more than 5'from w Wand there is a 12 sq ft.window above garage on 2nd floor. Garage door width is 0 12'or less L�50%or less of facade 0 60%or less and includes 7 of following: ❑ Covered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset ire s i es ' ❑ La Sidinoo itch Gable,hip,or gambrel roof ❑ Dormer 0 O Accent siding Window trim ❑ Window recess ❑ Window projection ❑ Balcony Ii'. isual Clearance Urban Forestry P n �1�r� ,-nsitive Lands: ❑ Yes lld No Type: 7 Co tions met prior to issuance of building permit No s: Approved ByPlanning: ` 9 i �j PP /' Date: / o// / Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPernutRvwREs 022819.docx Building Permit Submittal Original Submittal Date: �j —3 /7y Site Plans: # Building Plans: # J Building Permit#: Enter building permit#above. Workflow Routing: PlanningEngineering ermit Coordinator (,5i.-Building Workflow Sign-off: Sign-off for anning(include not s 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: 4 _ By Permit Technician: f / � �� Date: 'aO Engineering Review L I Slope at building pad: 3 12"-Conditions "Met"prior to issuance of building permit R'tasements (encroachments)per engineering conditions of approval and plat R Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes l2('-No Assess Water Quantity Fee in-lieu: ❑ Yes QKNo LIDA Facility on lot: ❑ Yes 0''‹o CIFinal Plat Recorded: Cl NOT Approved by Engineering: Date: Notes: C?pproved by Engineering: /4 y A S/4 Date: 6,---q-/ 9 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: CYSDC Fees Entered: Wash Co Trans Dev Tax: 12"-Yes ❑ N/A Tigard Trans SDC: Des ❑ N/A Parks SDC: Ihri Yes ❑ N/A LIDA ❑ Yes C /A OK to Issue Permit7‘.411))r Approved by Permit Coordinator: 466/Date: I:\Building\Forms\BldgPemlitRvw_RES 022819.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 i c;,\Em 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: DATE RECEIVED: DEPT: BUILDING DIVISION i FROM: / / � llJ!� - 2019 c / CI1YLit- 116AR COMPANY: cC c T (_., r ,g. / 1116 0 ��il !lta DIVISION �0 8/:t 4 I. PHONE: BY: RE: 1/Li& ( 5k) &, 4 �/ z/(.s7 ol - _ (Site Address) (Permit Number) La t -i 1 T) (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: x.,��, ..m.-macs '� r .. ,..:.m-e-.ra-r •- =an,-�.'. .-.�...s ,w.a l... . ,...P.,reh ..,.rte: a.----�.,�, ...,r*w+�+s ,m......- ..- .-.-r -h.- -.-,•..�. Copies: escr><'pffon: copies: �escr>it ii. ,/ Additional set(s) of plans. 2— Revisions: ��lS sib Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): 4 REMARKS: ,( ! , i LO (O VX-D \CA_ , '" fri& �--- C Fly, 1 . t . koutea to Fermi l'ec isan : e: p Initials: Fees Due: ❑Yes NcK Fee Descri'tion. Amount Due: ) ) 6NC $ )?:)/7 Special Instructions: Reprint Permit(per PE : ❑ Yes ►= Nd/ ❑ Done Applicant Notified: Date: (JO 77-' Initials: I:\Building\Forms\TransmittalLetter-Revisions 061316.doc