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Permit (2) CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT1,114 ---- Permit#: MST2019-00374 Date Issued: 10/21/2019 T I G A R[) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S112BD11900 Jurisdiction: Tigard Site address: 7644 SW HANSEN LN Subdivision: ELDERBERRY RIDGE Lot: 15 Project: Elderberry Ridge, Lot 15 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 5 First: 1352 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 23 Bathrooms: 4 Second: 1533 sf Garage: 491 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2885 sf Value: $378,320.18 Rear: 15 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 6 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains. 0 Tubs/Showers: 4 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: 6 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'l 500 sf: 5 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Y Other: N Other Description: Ecompasing: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2885 Owner: Contractor: RIVERSIDE HOMES LLC RIVERSIDE HOMES LLC Required Items and Reports(Conditions) 17933 NW EVERGREEN PL STE 17933 NW EVERGREEN PKWY 370 1 Ersn Cntrl 503-639-4175 370 BEAVERTON,OR 97006 BEAVERTON,OR 97006 PHONE: 503-645-0986 PHONE: 503-645-0986 FAX: 503-690-2942 Total Fees: $34,938.65 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and - of er applicable law. All work will be done in accordance with approved plans. This permit wil expire if work is not started within 180 days of issuance, or i wor is suspended for more the 180 days. ATTENTION: Oregon law requires y 4 to follow,the r es adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 9 -'01-0090. Yo ay obtain copy• the rules or direct questions taOUNC by calling 503.232.1987.r 1.-..0.332.2344. ' de By:Issued B �fr. Permittee Signature: v.. Call 503.639.4175 by 7:00 a.m.for the next available inspection date. �,r' 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 ►.OR OFFICE USE O\I.l SEP 19 2019 Received Q (� G� t<f,; f /? �-/��,L-/ City of Tigard DateBy: ` ! it O�.(� v(�+ II 13125 SW Hall Blvd.,Tigard OR 97223 Plan Review P t: WQ�� C Phone: 503.718.2439 Fax: 503.598.1960 Date/By: ���///��� to Ready/By: /�ACuris: ® See Page 2 for I I G A l:t) Inspection Line: 503.639.4175 Not Read et I Supplemental Information Internet: www.tigard-or.gov " TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING ElNew 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 work indicated on this application. CATEGORY OF CONSTRUCTION �� f'520Valuation: ❑✓ 1-and 2-family dwelling ❑Commercial/industrial $ / Number of bedrooms: 5 ❑Accessory building 0 Multi-family r ' 0 Other: Number of bathrooms: ❑Master builder JOB SITE INFORMATION AND LOCATION 2 "> Total number of floors: .2).2)-1(19 New dwelling area: 2885 square feet 1533 Job site address: 7644 SW Hansen City/State/ZIP: Tigard, OR 97224 Garage/carport area: 491 square feet l? p-/ Suite/bldg./apt.no.: Project name: Elderberry Ridge Covered porch area: 45 square feet Cross street/directions to job site: SW Bonita Rd &SW 76th Ave Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: ElderberryRidge I Lot no.: 15 Permit fees*are based on the value of the work performed. 9 Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. Valuation: $ Construction of SFR Existing building area: square feet New building area: square feet ✓❑ PROPERTY OWNER I 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: Q APPLICANT Q CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: 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 Total fees due upon application: City/State/ZIP: Beaverton, OR 97007 Amount received: Phone:(503)645-0986 Fax::( ) PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: npruett@riversidehome.com Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Submit two(2)sets of roof plan with connection details Business name: Riverside Homes, LLC and fire department access,along with the 2010 Oregon Address: 17933 NW Evergreen Pl., Ste 370 Solar Installation Specialty Code checklist. Permit Fee(includes plan review $180.00 City/State/ZIP: Beaverton, OR 97007 and administrative fees): Phone:( 503)645-0986 Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lie.: 189148 Total fee due upon application: $201.60 - zThis permit application expires if a permit is not obtained Authorized signature:` L /12� within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Print name: Nikki Pruett I Date: 9/18/19 I Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Building Permit Application Checkl .t r 3 Q One- and Two-Family Dwelling { FOR OFFICE USE ONLY Ci ' g of Tigard SEP 1 9 2019 Received PermitNo.: � DateBy: 71 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits: Phone: 503.718.2439 Fax: 503.598.1960 est , -) ❑ Electrical ❑ Plumbing ❑ Mechanical 24-Hour Inspection Line: 503.639.4175 I L��i t e, 1,f�, t'`� t� Internet: www.tigard-or.gov • 0 Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/.‘ I 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 0 6 Sewer permit. 0 0 0 7 Water district approval. 0 0 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. 0 0 0 20 Manufactured floor/roof truss design details. 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',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. ❑ 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. 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 L FOR OFFICE USE ONLY City of Tigard SEP Received Permit No.: 1114 II 1 9 �.% 9 Date/By:• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: Inspection Line: 503.639.4175 Ot i t l IGARD Date Ready/By: Jur s: ® See Page 2 for I Internet: www.tigard-or.gov BURS:;:,:+,. Notified/Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees*are based on the value of the work ❑New construction ❑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:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ✓Q 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 1 46.75 46.75 Job site address: 7644 SW Hansen Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75 City/State/ZIP: Tigard, OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: Elderberry Ridge Ductwork 23.32 Cross street/directions to job site: SW Bonita Rd &SW 76th Ave Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Other: 23.32 Subdivision: ElderberryRidgeLot no.: 15 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 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other: 23.32 ✓❑ PROPERTY OWNER El TENANT Environmental exhaust and ventilation: Name: Riverside Homes, LLC Range hood/other kitchen equipment 1 33.39 33.39 Address: 17933 NW Evergreen PI., Ste 370 Clothes dryer exhaust 1 33.39 33.39 City/State/ZIP: Beaverton, OR 97007 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 6 23.32 139.92 Phone:(503)645-0986 Fax:( ) Attic/crawlspace fans 23.32 El APPLICANT El CONTACT PERSON Other: 23.32 Fuel piping: Business name: Riverside Homes, LLC $14.15 for first four;$4.03 for each additional Contact name: Nikki Pruett Furnace,etc. 1 14.15 Gas heat pump Address: 17933 NW Evergreen PI., Ste 370 Wall/suspended/unit heater City/State/ZIP: Beaverton, OR 97007 Water heater 1 14.15 Phone:(503 )645-0986 Fax::( ) Fireplace 1 14.15Range 1 14.15 E-mail: npruett©riversidehome.com Barbecue CONTRACTOR Clothes dryer(gas) Other: Business name: Pro Heating & Cooling MECHANICAL PERMIT FEES* Address: 2095 NW Alocleck Rd.#1103 Subtotal City/State/ZIP: OR 97124 Minimum permit fee($90.00) ty Hillsboro, Plan review(25%of permit fee) Phone:( 971)205-4989 Fax:( ) State surcharge(12%of permit fee) CCB lie.: 209001TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 - days after it has been accepted as complete. Authorized signature:L.y( - ..,Ctit< * Fee methodology set by Tri-County Building Industry Service Board Print name: Nikki Pruett Date: 9/18/19 I:\Building\Permits\MEC PermitApp_040113.doc 440-4617T(I I/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial& Multi-Family Fee Schedule: Total Valuation: 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:\Euilding\Permits\MEC PermitApp_040113.doc 2 Electrical Permit Application ` FOR OFFICE USE ONLY III n City of Tigard SEP " ReceivedDatePermit#: Plan R 13125 SW Hall Blvd.,Tigard,OR 9721,E__ - Plan Review Phone: 503.718.2439 Fax: 503.598. 960 Date/B : Related Permit#: Inspection Line: 503.639.4175 Ready Date/By: Saris: El See Page 2 for T l G A R DInternet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑✓ New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked) 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition ❑Other: where the available fault current 0 Marinas and boatyards. X :` CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ❑✓ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. 0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: Job site address: 7644 SW Hansen 100HP or more. ❑"A","E","t-2","1-3", ❑Six or more residential units. occupancy. City/State/ZIP: Tigard, OR 97224 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: Elderberry Ridge 0 Hazardous locations. 0 Supply voltage for more than 600 volts nominal. ❑Service or feeder 600 amps or more. 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#: 15 Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'1500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 Construction of SFR (with above sq.ft.) Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 ✓Q 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 Pl., Ste 370 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: Beaverton, OR 97007 601 amps to 1,000 amps 301.04 2 Phone:(503)645-0986 Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 71',:A3 ,; ✓ ,._, :::1'.' t_i 4'1Branch circuits-new,alteration,or extension,per panel "�,,r ;,, .b s. ,b. , � A.Fee fox branch circuits with Business name: Riverside Homes, LLC above service or feeder fee, 7A2 2 each branch circuit Contact name: Nikki Pruett B.Fee for branch circuits without service or feeder fee,first 56.1 R 2 Address: 17933 NW Evergreen Pl., Ste 370 branch circuit Ciry/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 67,84 2 dwelling,service and/or feeder 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 ❑ 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 City/State/ZIP: Vancouver, WA 98661 Additional inspection(1 hr min) 66.25/hr Phone:(360) 518-7589 Fax:( ) Investigation(1 hr min) 90.00/hr Industrial plant(1 hr min) 78.18/hr Email: /O/1/('7 Inspections for which no fee is l p specifically listed('/:hr min) 90.00/hr CCB Lic.: 172549 Electrical Lic.: C230 Suprv.Lic.:jx3 J // // •• ELECTRICAL PERMIT FEES �Suprv.Electrician signature,required: .. -_a" Subtotal: Print name: Chester Garrett I Date: 9/18/19 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): TOTAL PERMIT FEE: Authorized Signature;l'( ',,'L / This permit application expires if a permit is not obtained within 180 Print name: Nikki Pruett Date: 9/18/1 g days after it has been accepted as complete. * Number of inspections allowed per permit. 1:\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 Description I Qty. I Each I Total Fee for all residential systems combined: $75.00 Renewable electrical energy systems: 5 kva or less 100.70 2 Check Type of Work Involved: 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: Fl Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 kva(fee in accordance 552.26 2 with OAR 918-309-0040) ✓❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 ❑ Vacuum Systems* >100 kva-no additional charge 0.0 3 Each additional inspection over allowable in any of the above: ❑ Other: Each additional inspection is 66.25/hr 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(%z hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: n Audio and Stereo Systems ❑ Boiler Controls n Clock Systems n Data Telecommunication Installation ❑ Fire Alarm Installation n HVAC n Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* n Medical ❑ Nurse Calls n Outdoor Landscape Lighting* ❑ Protective Signaling n Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations ]:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 D Plumbing Permit Application R EC,a 1 E:' Building Fixtures SEP 19 2019 FOR Of FRI: ISI. O`I.Y City of Tigard Received Permit No.: 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.: T 1 G A R D Inspection Line: 503.639.4175 • Date Ready/By: Innis: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE O New construction ❑Demolition For special information use checklist. • Description I Qty. I Ea. I Total ❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 lI 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 1 500.32 500.32 ❑Accessory building ❑Multi-family Each additional bath/kitchen 1 25.02 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 7644 SW Hansen 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.: Project name: ElderberryRidge g 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 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.: 15 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 1 25.02 25.02 Construction of SFR Dishwasher 1 25.02 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 0 PROPERTY OWNER 0 TENANT Expansion tank 12.51 Fixture/sewer cap 25.02 Name: Riverside Homes, LLC Floor drain/floor sink/hub 25.02 Address: 17933 NW Evergreen Pl., Ste 370 Garbage disposal 1 25.02 25.02 City/State/ZIP: Beaverton, OR 97007 Hose bib 2 25.02 50.04 Phone:(503)645-0986 Fax:( ) Ice maker 1 12.51 12.51 QE APPLICANT E✓ 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 8 25.02 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 12.51 Urinal 25.02 E-mail: npruett@riversidehome.com CONTRACTOR Water closet 4 25.02 100.08 Water heater 1 37.52 37.52 Business name: H & H Mechanical Water piping/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: $72.50 CCB Lic.: 178122 Plumbing Lic.no.: PB414 Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: , TOTAL PERMIT FEE Print name: Nikki Pruett Date: 9/1$/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 t , -L MM L. Building Fixtures SEP 1 9 2019 FOR OFFICE, USE ONLY Received UPI - City of Tigard , Date/By: Permit No.: In 13125 SW Hall Blvd.,Tigard,OR 97223 C g Plan Review Phone: 503.718.2439 Fax: 503.598.196(1.:'.' .41 i ;\;;,..'-.,,,..,..IbateBy: Other Permit No.: T I G AR D Inspection Line: 503.639.4175 Date Ready/By: Juris: El See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE 0 New construction ❑Demolition For special information use checklist Description I Qty. I Ea. I Total ❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ll 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 0 Accessory building 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 7644 SW Hansen 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.: 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 Lot no.: 15 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 0 PROPERTY OWNER 0 TENANT Expansion tank 12.51 Fixture/sewer cap 25.02 Name: Riverside Homes, LLC Floor drain/floor sink/hub 25.02 Address: 17933 NW Evergreen Pi., 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 ✓❑ 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 Pi., 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 Water closet 25.02 CONTRACTOR 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 CCB Lic.: LCB#7962 Plumbing Lic.no.: Plan review (25%of permit fee) /26‘,A1 - State surcharge(12%of permit fee) Authorized signature:L./(ziez TOTAL PERMIT FEE Print name: Nikki Pruett Date: 9/18/1 g 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 10/01/09 440-46I6T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: Footing drain-151100' 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 Valuation: Permit Fee: Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Other Inspections or Fees Qty. Fee(ea) Total 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*. Quantity by Fixture Type Plan Review for Plumbing Installations Fixture Type for Replace/ Plan review is required for anyof the following. Work Performed: Capped Added Relocate q Baptistry/Font Please check all that apply. Bath Tub/Shower 111 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 ❑ Medical gas and vacuum systems for health care facilities. -Domestic ❑ Any multipurpose fire sprinkler system. Drinking Fountain ❑ 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" Isometric or Riser Diagram Car Wash Drain ❑ Isometric or riser diagram is required for new buildings Garbage -Domestic-non-food $� q g 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 Water Extractor increase of sewer EDUs,a sewer permit will be issued and Water Closet-Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: C:\Users\npruett\Downloads\PLMF_PermitApp.doc 2 City of Tigard ■ COMMUNITY DEVELOPMENT DEPARTMENT 11111 Building Permit Review — Residential TIGARD Building Permit #: c7;20/q .00374/ Site Address: Wig SV Ianc t' Project Name: 611,4R IS � Lot #: (New dwellin subdivi, on name;Addition or Alteration=last name of owner) Planning Review Prposal: S'PR.- f 4- 2-00 R Verify address/suite#active in Accela. I/ In River Terrace: LVJ No ❑ Yes,River Terrace Review Addendum Sit- lan Elements: 1 Sion Control E •.pies of site plan on 8-1/2"x 11"or 11 x 17"paper .. ed trees with drip line and tree protection measures 6. awn to scale(standard architect or engineer scale) /1 ..otprint of new structure(including decks)and FFE, i arrow IA J,&ity locations&easements(required for new and additions) F " e address,project or subdivision name and lot number Sidewalk/driveway approach v .l�A licant information(name and phone number) cation of wells/septic systems of dimensions and building setback dimensions G S.eet tree size,type and location quare footage of buildings to be demolished I■ eet names X11 sting structures on site 6 omer elevations(2'contours if more than 4'differ ntial) IiXLot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? �iies,�CINo • ..ervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑\? ElNo PE Clean Water Services—Service Provider Lette of platted prior to 9/10/1995): if*04 �J„ quired: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No I Iiiii Public Faciliti mprovement (PFI)Permit: `°"i`IA Required: igi Yes,applicant was notified ❑ No Applied For: p'Yes ❑ No,stop intake [ and Use Case#: r IX�16-0000i [ Zoning: T 1- �C', Rear: Side: S Street Side: Garage: ZO ���`equtred Setbacks: Front: �S �S $ I�' ' ding Height: Max. Height: Actual Height: 21.5 Landscape ea: `L� °/U Lot Coverage M�ax/:- 0O Entrance g back no more than 8'from street-facing wall 'Parallel to street or offset 45 degrees or less Windows [Minimum Lid12%of area of all street-facing facades LL -j/. Garage ❑ Gara oor is behind widest street-facing wall ❑ Yes VNo,one of the following is met Door extends no more than 5'from wall and there is a covered porch extending beyond garage. —/ CI Door extends no more than 5'from w�li and there is a 12 sq ft.window above garage on 2nd floor. 2 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 ❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer ❑ Accent siding Window trim ❑ Window recess ❑ Window projection ❑ Balcony isual Clearance [rban Forestry Plan r t ' L ' Sensitive Lands: I� Yes ❑ No Type: Ste LS Lct. ��S v i�'�(W� �+�- Conditions tuft prir o issuance of buil permit otee : ��,t`t I4 µIfn1'� 1' div LYApproved By Planning: Date: q-19-1 1 Revisions (after Building Submittal only) Reviewer Date Revision 1: El Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: El Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw_RES_022819.docx Building Permit Submittal Original Submittal Date: 7/` /2 Site Plans: # Building Plans: # Building Permit#: ! Thter building permit#above. Workflow Routing: i lanning Engineering rmit Coordinator ,-wilding Workflow Sign-off: E` Sign-off for P arming(include note from planning review) Route Application Documents: 6'► 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: / /'r` Ai;I� 47(e,/± By Permit Technician: _ _..4L Date: Enngjn' eering Review ).ope at building pad: Z1' onditions "Met"prior to issuance of building permit asements (encroachments)per engineering conditions of approval and plat ric Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes C/No Assess Water Quantity Fee in-lieu: ❑ Yes 02/No LIDA Facility on lot: ❑ Yes No Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: ill Approved by Engineering: / r Date: 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: Er SDC Fees Entered: Wash Co Trans Dev Tax: ii.i. Yes ❑ N/A Tigard Trans SDC: e'Yes ❑ N/A Parks SDC: [ Yes Cl N/A LIDA ❑ Yes L/A OK to Issue Permit Approved by Permit Coordinator: Olt Date 2-3A I I:\Building\Forms\BldgPermitRvw_RES_022819.docx