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Permit
INCITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2019-00380 T I AR 0 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/21/2019 (J Parcel: 2S112BD12000 Jurisdiction: Tigard Site address: 7620 SW HANSEN LN Subdivision: ELDERBERRY RIDGE Lot: 16 Project: Elderberry Ridge, Lot 16 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 5 First: 1194 sf Basement: 835 sf Left 5 Parking Spaces: 0 Height: 22 Bathrooms: 4 Second: 1108 sf Garage: 383 sf Front 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3137 sf Value: $407,792.09 Rear: 15 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 6 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 5 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 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 6 Clothes Dryers: 1 Natural Gas Heat Pump: Y 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: 6 201-400 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 3137 Owner: Contractor: RIVERSIDE HOMES LLC RIVERSIDE HOMES LLC Required Items and Reports(Conditions) 17933 NW EVERGREEN PL STE 17933 NW EVERGREEN PKWY 370 1 Ersn Cntrl 503-639-4175 370 BEAVERTON,OR 97006 BEAVERTON,OR 97006 PHONE: PHONE: 503-645-0986 FAX: 503-690-2942 Total Fees: $35,659.44 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes a d all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, r if work is suspended for more the 180 days. ATTENTION: Oregon I-. requires you to follow the r es adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR• 001-0090. •.0 may ,; -in a copy /he rul-.or direct questions to OUNC by calling 503.232.1987 or X.800.332.2344. _ '>. --).Ye: Issued By: '�/� �/ Permittee Signature: h 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 theisdject. Approved plans are required on the job site at the time of each inspection. Building Permit Application 4 Residential OFFI('E I SE O\I 1 City of Tigard RECEIVE Received e/ pmt No.: >- IN ■ 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: - �3A1 / �) t , SEP 2 6 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 219 Date/By: �� �� A Other Permit.CA>'an,fo,��;„� ��,,�ry^1 l I G A k D Inspection Line: 503.639.4175 Date Ready/By. / 'Jyris: _ ® See Page �2for Internet: www.tigard-or.gov CITY OF TIGARD ified/Method: C�` Supplemental Information BUil DING DIVISION TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING 8 New 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. ✓ 1-and 2-familydwellingValuation: $ q ❑ 0 Commercial/industrial d� 1 1 T ❑Accessory building 0 Multi-family Number of bedrooms: 5 ❑Master builder 0 Other: Number of bathrooms: 4 JOB SITE INFORMATION AND LOCATION Total number of floors: 3 35 2-0 Job site address: 7620 SW Hansen Ln New dwelling area: 3137 square feet l I A City/State/ZIP: Tigard, OR 97224 Garage/carport area: 383 square feet \, elki Suite/bldg./apt.no.: Project name: Elderberry Ridge Covered porch area:) square feet 0 Cross street/directions to job site: SW Bonita Rd &SW 76th Ave Deck area: q,,� 1 p'Z square feet t0 her stru tare rea i L2._ square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Elderberry Ridge Lot no.: 16 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. Construction of SFR Valuation: $ Existing building area: square feet New building area: square feet ElPROPERTY OWNER 0 TENANT Number of stories: Name: Riverside Homes, LLC Type of construction: Address: 17933 NW Evergreen Pl., Ste 370 Occupancy groups: City/State/ZIP: Beaverton, OR 97007 Existing: Phone:( 503)645-0986 Fax:( ) New: 0 APPLICANT ❑✓ CONTACT PERSON BUILDING PERMIT FEES* Business name: (Please refer to fee schedule) Riverside Homes, LLC Structural plan review fee(or deposit): Contact name: Nikki Pruett FLS plan review fee(if applicable): Address: 17933 NW Evergreen Pl., Ste 370 City/State/ZIP: Beaverton, OR 97007 Total fees due upon application: Phone:(503)645-0986 Fax::( ) Amount received: E-mail: npruett@riversidehome.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name: Riverside Homes, LLC Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 17933 NW Evergreen Pl., Ste 370 Solar Installation Specialty Code checklist. City/State/ZIP: Beaverton, OR 97007 Permit Fee(includes plan review $180.00 and administrative fees): Phone:( 503)645-0986 Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.: 189148 Total fee due upon application: $201.60 Authorized signature: , This permit application expires if a permit is not obtained r r. within 180 days after it has been accepted as complete. Print name: Nikki Pruett Date: 9/30/19 *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Application Foiz of i i i; t si:oNi.l City of Tigard Received E C E I V E , DateBy: Permit No.:«�S` kar j, :"C 13125 SW Hall Blvd.,Tigard,OR 97223 C C Plan Review Phone: 503.718.2439 Fax: 503.598.19 Date/By: Other Permit: T I G A R n Inspection Line: 503.639.4175 SEP 2 6 2019 Date Ready/By: luris: 0 See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information CITY OF TIGARD TYPE OF WOWIII DING DIVISION COMMERCIAL FEE* SCHEDULE- USE CHECKLIST Mechanical permit fees*are based on the value of the work 0 New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition D Other: mechanical materials,equipment,labor,overhead,and profit. CATEGORY OF CONSTRUCTION Value:$ RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ✓❑ 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist. 0 Multi-family 0 Master builder 0 Other: Description P Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 1 46.75 46.75 Job site address: 7620 SW Hansen 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 Suite/bldg./apt.no.: Project name: Elderberry Ridge Heat pump 1 61.06 61.06 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. 2 46.75 Flue/vent for any of above 23.32 Subdivision: Elderberry Ridge Lot no.: 16 Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 1 23.32 23.32 DESCRIPTION OF WORK Gas fireplace/insert 1 33.39 33.39 Flue vent for water heater or gas Construction of SFR fireplace 1 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Q PROPERTY OWNER 0 TENANT Other: 23.32 Environmental exhaust and ventilation: Name: Riverside Homes, LLC Range hood/other kitchen Address: 17933 NW Evergreen Pl., Ste 370 equipment 1 33.39 33.39 Clothes dryer exhaust 1 33.39 33.39 City/State/ZIP: Beaverton, OR 97007 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 5 23.32 116.60 Phone:(503 )645-0986 Fax:( ) Attic/crawlspace fans 23.32 0 APPLICANT ❑✓ CONTACT PERSON Other: 23.32 Business name: Riverside Homes, LLC Fuel piping: $14.15 for first four;$4.03 for each additional Contact name: Nikki Pruett Furnace,etc. 1 14.15 Address: 17933 NW Evergreen Pl., Ste 370 Gas heat pump 14.15 WalUsuspended/unit heater City/State/ZIP: Beaverton, OR 97007 Water heater 1 14.15 Phone:(503 )645-0986 Fax::( ) Fireplace 1 14.15 Range 1 14.15 E-mail: npruett@riversidehome.com Barbecue CONTRACTOR Clothes dryer(gas) Business name: Pro Heating & Cooling Other: MECHANICAL PERMIT FEES* Address: 2095 NW Alocleck Rd.#1103 Subtotal City/State/ZIP: Hillsboro, OR 97124 Minimum permit fee($90.00) ( 971)205-4989 ( ) Plan review(25%of permit fee) Phone: Fax: State surcharge(12%of permit fee) CCB lic.: 209001 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signature: , ,r * Fee methodology set by Tri-County Building Industry Service Board Print name: Nikki Pruett Date: 9/30/19 1:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(I 1/02/COM/WEB) Electrical Permit Application ECEIVE� I OR OFFICE l`Sl ()NI.) City of Tigard Received . 61 13125 SW Hall Blvd.,Tigard,OR 97223 q 6 Date/B : EMMINIRSIMIrte. Phone: 503.718.2439 Fax: 503.598.1960 SEP 2 2019 Plan Review Date/B : Related Permit#: T 1 G A R D Inspection Line: 503.639.4175 Ready Date/By: lurkVI See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information dTYPE OF WILDING DIVISION PLAN REVIEW ❑✓ New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑Demolition Othe[: 0 Service or feeder 400 amps or more 0 Building over three stories. where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. 9 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑Master builder 0 Other: ❑Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived o Addition of new motor load of system. 7620 SW Hansen Ln Job#: Job site address: looHP or more. ❑"A","E","1-2","1-3", City/State/ZIP: Tigard, OR 97224 0 Six or more residential units. occupancy. ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: Elderberry Ridge 0 Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: SW Bonita Rd &SW 76th Ave FEE SCHEDULE Description I Qty. I Each I Total New residential single-or multi-family dwelling unit. Subdivision: Elderberry Ridge Lot#: 16 Includes attached garage. Tax map/parcel#: 1,000 sq.R.or less 168.54 4 Ea.add'I 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential with above s 75.00 2 Construction of SFR ( q.ft.) Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 9 PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name: Riverside Homes, LLC 200 amps or less 100.70 2 Address: 17933 NW Evergreen PI., Ste 370 201 ampsto400amps 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 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 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 Branch circuits—new,alteration,or extension,per panel 0 APPLICANT Q CONTACT PERSON A.Fee for branch circuits with Business name: Riverside Homes, LLC above service or feeder fee, 7.42 2 each branch circuit Contact name: Nikki Pruett B.Fee for branch circuits without servAddress: 17933 NW Evergreen PI., Ste 370 branche cirr cuit fee,first 56.18 2 branch circuit City/State/ZIP: Beaverton, OR 97007 Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(503)645-0986 Fax: :( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: npruett@riversidehome.com Reconnect only 67.84 2 CONTRACTOR 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 0 See Page 2 2 Address: 2804 NE 65th Ave. St. D panel,alteration,or extension. Each additional inspection over allowable in any of the above Cityistate/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 L O 2. �----• Inspections for which no fee is CCB Lic.: 172549 Electrical Lic.: C230 Suprv.Lic i q 7 S specifically listed(V2 hr min) 90.00/hr : ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: Chester Garrett Date: 9/30/19 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: ,, TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Nikki Pruett Date: 9/30/19 days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Fee for all residential systems combined: $75.00 DescriptionIQty. Each T°`al Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 n 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 ❑ Garage Door Opener* 50.01 to 100 kva 552.26 2 >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 n 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 charged at an hourly(1 hr min) Inspections for which no fee is specifically listed(%,hr min) 90.00/hr COMMERCIAL Wt1tRI °+�lLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 Subtotal(Enter on Page 1): (SEE OAR 918-309-0000) * Number of inspections allowed per permit. Check Type of Work Involved: n Audio and Stereo Systems n Boiler Controls ❑ Clock Systems n Data Telecommunication Installation ❑ Fire Alarm Installation n HVAC ❑ Instrumentation ❑ Intercom and Paging Systems n Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* n Protective Signaling n Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I.\Huilding\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 , Plumbing Permit Application Building Fixtures RECEIVE -, FOR OFFICE t sr ()Nil City of Tigard .eceived (� Date/By:II IIPermit No.:cscs � `_ Vl 13125 SW Hall Blvd.,Tigard,OR 97223 SEP 2 6 2019 Plan Review �`�* C Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.: 7.1 Ci A R O Inspection Line: 503.639.4175 :_;ITY OF TIGARD Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov -it inn nINrlDIVISION Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE IEI New construction 0 Demolition For special information use checklist Description I Qty. I Ea. I Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 l 11-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 1 500.32 Each additional bath/kitchen 1 25.02 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 7620 SW Hansen Ln Catch basin or area drain 18.76 City/State/ZIP: Drywell,leach line,or trench drain 18.76 ty Tigard, OR 97224 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name: Elderberry Ridge Manufactured home utilities 50.03 Cross street/directions to job site: SW Bonita Rd &SW 76th Ave Manholes 18.76 Rain drain connector 1 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: Elderberry Ridge I Lot no.: 16 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Construction of SFR Clothes washer 1 25.02 Dishwasher 1 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 9 PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Name: Riverside Homes, LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 17933 NW Evergreen Pl., Ste 370 Garbage disposal 1 25.02 City/State/ZIP: Beaverton, OR 97007 Hose bib 2 25.02 Phone:(503)645-0986 Fax:( ) Ice maker 1 12.51 0 APPLICANT a✓ CONTACT PERSON Interceptor/grease trap 25.02 Business name: Riverside Homes, LLC Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Nikki Pruett Roof drain(commercial) 12.51 Address: 17933 NW Evergreen Pl., Ste 370 Sink/basin/lavatory 7 25.02 City/State/ZIP: Beaverton, OR 97007 Solar units(potable water) 62.54 Phone:(503)645-0986 Fax::( ) Tub/shower/shower pan 5 12.51 E-mail: npruett@riversidehome.com Urinal 25.02 CONTRACTOR Water closet 4 25.02 Water heater 1 37.52 Business name: H & H Mecanical Waterpip 1 m g/DWV 56.29 Address: 5757 SE Willow Ln Other: 25.02 City/State/ZIP: Milwaukie, OR 97267 Subtotal Phone:( 503 975-9787 Fax:( ) Minimum permit fee: $72.50 CCB Lic.: 178122 Plumbing Lic.no.: PB414 Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: y, {' TOTAL PERMIT FEE Print name: Nikki Pruett Date: 9/30/19 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\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) . Plumbing Permit Application Building Fixtures RECEIVED rt►iz 0141( 1. ISI: 0\I.1 - City of Tigard Received III Date/By: Permit No.. \`r rr g 13125 SW Hall Blvd.,Tigard,OR 97223 SEP 2 6 2019 M`�T�U�t-V Phone: 503.718.2439 Fax: 503.598.1960 Plan Review Date DateBReay: Other Permit No.: TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD d/B I t y y• Juris: ® See Page 2 for Internet: www.tigard-or.gov ,. t_DING DI\/ISIOI: Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE 2 New construction 0 Demolition For special information use checklist Description I Qty. I Ea. I Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 0 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 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 7620 SW Hansen Ln Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: Tigard, OR 97224 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name: Elderberry Ridge Manufactured home utilities 50.03 Cross street/directions to job site: SW Bonita Rd &SW 76th Ave Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: Elderberry Ridge I Lot no.: 16 Fixture or item: Tax map/parcel no.: Backflow preventer 1 31.27 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Construction of SFR Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 E PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Name: Riverside Homes, LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 17933 NW Evergreen Pl., Ste 370 Garbage disposal 25.02 City/State/ZIP: Beaverton, OR 97007 Hose bib 25.02 Phone:(503)645-0986 Fax:( ) Ice maker 12.51 Q✓ APPLICANT Q✓ CONTACT PERSON Interceptor/grease trap 25.02 Business name: Riverside Homes, LLC Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Nikki Pruett Roof drain(commercial) 12.51 Address: 17933 NW Evergreen Pl., Ste 370 Sink/basin/lavatory 25.02 City/State/ZIP: Beaverton, OR 97007 Solar units(potable water) 62.54 Phone:(503)645-0986 Fax::( ) Tub/shower/shower pan 12.51 E-mail: npruett@riversidehome.com Urinal 25.02 CONTRACTOR Water closet 25.02 Water heater 37.52 Business name: TruScapes Water piping/DWV 56.29 Address: 21600 NW Amberwood Dr. Other: 25.02 City/State/ZIP: Hillsboro, OR 97124 Subtotal Phone:( 503 531-8216 Fax:( ) Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lie.: LCB#7962 &/ ) Plumbing Lic.no.: State surcharge(12%of permit fee) Authorized signature: / ,,/,_,,.:v/-',1 TOTAL PERMIT FEE Y Print name: Nikki Pruett Date: 9/30/19 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. 1.Building\Permits\PLMU-PermitApp.doc 10/01/09 440-616T(10/02/COM/WEB) City of Tigard II COMMUNITY DEVELOPMENT DEPARTMENT 1111 ■ T 1 c A R D Building Permit Review — Residential Building Permit #: 1`c\ -\--2\C--k_tir. ' ; Site Address: 762.0 5\.•/ —mg') 1,r Project Name: LlIQr r7- Kitt Lot #: 16 (New dwelling— ubdivisi name;Addition or Alteration=last name of owner) Planning Review'' Pro sal: N LW S fLi,„ 313+ _ LJ Verify address/suite#active in Accela. LG'In River Terrace: Lid' No ❑ Yes,River Terrace Review Addendum Site lan Elements: it •sion Control 3,opies of site plan on 8-1/2"x 11"or 11 x 17"paper L ': ained trees with drip line and tree protection measures Ath wn to scale(standard architect or engineer scale) 2' .. .rint of new structure(including decks)and FFE rth arrow U tility locations&easements(required for new and additions) �t e address,project or subdivision name and lot number tdewalk/driveway approach evteVA•plicant information(name and phone number) ..,l�ocation of wells/septic systems ,, PI ot dimensions and building setback dimensions ,'2 S et tree size,type and location CA,••are footage of buildings to be demolished ISS et names l!! :sting structures on site orner elevations(2'contours if more than 4'differ tial) L ot area,building coverage area,percentage of coverage and > ,000 sf of impervious area created or replaced? 4d Y eS ❑No ervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑ ❑No L"J Clean Water Services—Service Provider Lette of platted prior to 9/10/1995): equired: ❑ Yes,applicant was notified LI No Received: ❑ Yes ❑ No r V Public Facilities Improvement(PFI) Permit: taJ 01- Required: ❑ Yes,applicant was notified i No Applied For: ❑ Yes ❑ No,stop intake lt� nd Use Case#: ?Oral/W-00001 Romig: 1("1" �) equired Setbacks: Front: I S Rear: IS Side: S Street Side: Garage: 2 L�'X� d [ Building Height: Max. Height: 3.S Actual Height: 2,I,-C _ ` �� "landscape Area: 10 % ILot Coverage Max: to 0/0 µ1 ntrance ❑ Set back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less Windows ❑ Minimum 12%of area of all street-facing facades Atoya Garage ❑ Garage door is behind widest street-facing wall ❑ Yes ❑ No,one of the following is met: ❑ Door extends no more than 5'from wall and there is a covered porch extending beyond garage. ❑ Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2nd floor. 044' ❑ Garage door width is ❑ 12'or less ❑ 50%or less of facade ❑ 60%or less and includes 7 of following: ❑ Covered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset 014 I ❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer ; ,,Fj —/ ❑ Accent siding Window trim ❑ Window recess ❑ Window projection ❑ Balcony 1_16yisual ClearanceC� ban Forestry Plan r Ud" Sensitive Lands: [3 Yes 1=1 No Type: \/{�c f+A lwrrl0ldr- gi C ndi 'on et oto to issuance of buil g ermit No s: p �jc rw ern.- 14t.d.....rit �yptS(vL1tictApproved By Planni -11'-L • Date: Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Fonns\B1dgPennitRvw_RES_022819.docx Building Permit Submittal Original Submittal Date: 9 t1 1C Site Plans: # ,3 Building Plans: # .3 Building Permit#: [t Enter building permit#above. Workflow Routing: [/Planning [/Engineering ["Permit Coordinator 'Building Workflow Sign-off: 1 'Sign-off for Planning(include notes from planning review) Route Application Documents: Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. [/Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: �--2 Date: C\12its..1 tat Engineering Review ( '4Slope at building pad: ey% 2//Conditions"Met"prior to issuance of building permit [ EE sements (encroachments)per engineering conditions of approval and plat Lei Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes LJ No Assess Water Quantity Fee in-lieu: ❑ Yes Q'No LIDA Facility on lot: ❑ Yes 2'No • Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes:�� Lid'Approved by Engineering: /--1.4---01Z24 Date: 9/•7,1119 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: eSDC Fees Entered: Wash Co Trans Dev Tax: C!"Yes ❑ N/A Tigard Trans SDC: Eyes ❑ N/A Parks SDC: Yes ❑ /A VOK to Issue Permit LIDA ❑ Yes V N/A Approvedby Permit Coordinator: ate: g//2/- /, I:\Building\Forms\BldgPermitRvw_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 it III 11 Transmittal Letter T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tiga/cr TO: 217 1! f4 'DATE REIVED: DEPT: BUILDING rdGt:iVED NOV 14 2019 FROM: Y CITY OF IPC,-ARD 3UILDINGOIVISIOlv COMPANY: ��c (5_� \---\c... ....._,- �I• � PHONE: l7I ?v) > Z F71- RE: RE: ;Ps--A),,i �_Iy ic- /06 At S�rd//9i` -e-'3' (Site Address) (Permit Number) (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS Copies: Description: Copies: Description: Additional set(s) of plans. \� Revisions: / \- is.c, ie GAA-V-�.. Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. ' Basement and retaining walls. Beam calculations. 4 II4 Engineer's calculations. Other(explain): PI REMARKS: V I FOOFFICE USE ONLY Routed to Permit Tricia Date: If rg i aj Initials: Fees Due: lij E ► o Fee Desc 'pti n: Amount Due: V2- Lr.�v;' $ S $ $ Special Instructions: Reprint Permit(per PE): ❑ Yes 'No ❑ Done Applicant Notified: . Date: K/17/1 Initials>,.\ I:\Building\Forms\TransmittalLetter-Revisions_061316.doc