Permit iiii CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2019-00252
Date Issued: 01/13/2020
T'IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S112BD11100
Jurisdiction: Tigard
Site address: 14954 SW BELVOIR CT
Subdivision: ELDERBERRY RIDGE Lot: 7
Project: Elderberry Ridge, Lot 7
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: 22 Bathrooms: 4 Second: 1533 sf Garage: 491 sf Front: 20 Smoke
Yes
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors.
Total: 2885 sf Value: $365,198.05 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: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 DrCatch 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: 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 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: 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
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 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: $32,935.40
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 OAR 952-001-0090. You may•• - - ••. , the rules or direct questions to OUNC by calling 503.232.1987 br 1.800. 32.2344.
r \
Issued By: i -., �,f_ G - Permittee Signature:
503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application L 1
* Residential RECEIVED FOR OFFICE USE ONLY
Received _
City5 ofW Tigard C Permit No.
13125 SW Hall Blvd.,Tigard,OR 97223 l U N 13 2019 Plan Review ,(
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: ' 1 r Other Permt `Ct_ }S.
A K I) Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: 4f/ Juris: ® See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION N. ' d/Method: q I Supplemental Information
Ail ✓LLar.
i -
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
9 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.
Valuation: $ t 9 it
01-and 2-family dwelling El Commercial/industrial •.)i
IDAccessory building 0 Multi-family Number of bedrooms: 5
❑Master builder 0 Other: Number of bathrooms: 3.5,,L(
JOB SITE INFORMATION AND LOCATION Total number of floors: 2 -2j --7
Job site address: 14954 SW Belvoir Ct. New dwelling area: 2885 square feet IS 33
City/State/ZIP: Tigard, OR 97224 Garage/carport area: 491 square feet '"SSD__
Suite/bldg./apt.no.: Project name: Elderberry Ridge Covered porch area:'( 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: Elderberry Ridge I Lot no.: 07 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
Q PROPERTY 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 Q CONTACT PERSON BUILDING PERMIT FEES*
Business name: Riverside Homes, LLC (Please refer tofee schedule)
Structural plan review fee(or deposit):
Contact name: Amo Avg'
FLS plan review fee(if applicable):
Address: 17933 NW Evergreen Pl., Ste 370
Total fees due upon application:
City/State/ZIP: Beaverton, OR 97007
Phone:(503)645-0986 Fax: :( ) Amount received:_ _
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
aavgi@riversidehome.com
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): 521.60
CCB lie.: 189148 Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Nikki Pruett Date: 6/11/2019 *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)
Building Permit Application Checklist
` One- and Two-Family Dwelling RECEIVED FOR OFFICE CSE ONLY
JUN 1 3 2019 Received
City of Tigard Permit No.:
IIIU 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By:
Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
24-Hour Inspection Line: 503.639.4175 CITY OF TIGARD ❑ Electrical 0 Plumbing 0 Mechanical
lt"Al l� BUILDING DIVISION
Internet: www.tigard-or.gov 0 other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW v'es No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ 0 0
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0
3 Verification of approved plat/lot. ❑ ❑ 0
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 ❑ ❑
7 Water district approval. ❑ ❑ 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0 ❑
9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 ❑ ❑
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 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 ❑
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 ❑
and location.
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 ❑
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. ❑ ❑ ❑
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- ❑ ❑ ❑
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 ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ 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
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. ❑ 0 0
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ❑ ❑
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 ❑ ❑
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". ❑ ❑ ❑
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. ❑ ❑ ❑
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 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 ❑ ❑ ❑
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ 0
and protection measures must be drawn to scale and must include the project arborist's signature of approval.
30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, ❑ ❑ ❑
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 Ap lica yis2 ECEI\Eo Received FOR OFFICE USF,O\1.1
City of Tigard Date/F3Permit No :::,\F".13125 SW Hall Blvd.,Tigard,OR 97223 y 1 1
11111 I al ,° :::,\F".JUN 13 2 019 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
I I G A R t1 Inspection Line: 503.639.4175 Date Read /B orris:
e 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified Method: ®Slemeee ntalInformation
-.I !!! fl!NI(-', ll!V!!CI('�[ Supplemental
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 ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑.. 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist.
0 Multi-family ❑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: 14954 SW Belvoir Ct. Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75
City/State/Z1P: Tigard, OR 97224 Furnace 100,000+BTU(ducts/vents) , 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: Elderberry Ridge 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. 46.75
Flue/vent for any of above 23.32
Subdivision: Elderberry Ridge Lot no.: 07 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 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 ❑ TENANT Environmental exhaust and ventilation:
Name: Riverside Homes, LLC Range hood/other kitchen
equipment 1 33.39 33.39
Address: 17933 NW Evergreen Pl., 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
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: Amo Avgi Furnace,etc. 1 14.15
Address: 17933 NW Evergreen Pl., Ste 370 Gas heat pump
Walllsuspended/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:
aavgi@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) .
-
Phone:( 971) 205-4989 Fax:( ) Plan review(25%xof permit fee)
State surcharge(12%of permit fee)
CCB lie.: 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: , AeiG ;j. * Fee methodology set by Tri-County Building Industry Service Board
Print name: Nikki Pruett Date: 6/11/2019
I:\Building\Permits\MEC_PermitApp_0401 t3.doc 440-4617T(11/02/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:\Building\Permits\MEC_PermitApp_040113.doc 2
Electrical Permit Applications E VF fl rolz()Fr": USE ONLY
Received C W�-.
City of Tigard IIIIJ N N 1 3 2019 Received
: Permit#. ` .
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 50359819 '-y OF TIGARD Date/B Related Permit#:
T I G A It D Inspection Line: 503.639.4175 BUILDING DIVISION Ready Date/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
ElNew construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
['Demolition ❑Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or El Floating buildings.
❑✓ 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.
0 Multi-family ❑Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
0 Addition of new motor load of system.
Job#: Job site address: 14954 SW Belvoir Ct. 100HP or more. ❑`A","E",`t-2",`t-3",
City/State/ZIP: Tigard, OR 97224 0 Six or more residential units. occupancy.
0 Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name: ElderberryRidge0 Hazardous locations. CI Supply voltage for more than
0 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 I
New residential single-or multi-family dwelling unit.
Subdivision: Elderberry Ridge Lot#: 07 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#:
Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
(with above sq.ft.) 75.00 2
Construction of SFR •
Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
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
❑ APPLICANT 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: Riverside Homes, LLC above service or feeder fee, 7 A2 2
each branch circuit
Contact name: Amo Avgi B.Fee for branch circuits without
service or feeder fee,first 56.1 R 2
Address: 17933 NW Evergreen Pl., Ste 370 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: aavgi@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.
City/State/ZIP: Vancouver, WA 98661 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:( 360) 518-7589 Fax:( ) Investigation(1 hr min) 90.00/hr
/ /q Industrial plant(1 hr min) 78.18/hr
Email:
L U b`i Inspections for which no fee is
CCB Lic.: 1 72549 Electrical Lic.: 0230 Suprv.Lic 1 specifically listed('/2 hr mm) 90.00/hr
v — ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: 72 ,,, ...,24_____444Subtotal:
Print name: Chester Garrett Date: 6/11/2019 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature `'( z TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Nikki Pruett Date: 6/11/2019 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
Fee for all residential systems combined: $75.00 ion I Qty. I Each I Total
Renewable Renewwable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
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:
❑ 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
55226 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
sgectficallx listed 1/2 hr min?
COMMERCIAL WORK ONLY:
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
* Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
t:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015
Plumbing Permit Application
' Building Fixtures RECEIVE' roi orrice: USE oNL\
2 019 Received
City of Tigard JUN 1 3Permit No.
13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: �T5��-(
an
lig 1 Phone: 503.718.2439 Fax: so3s9a.19gpTY OF'TIGARD DDate/By:By: Other Permit No.:
T I G A It p Inspection Line: 503.639.4175 r;U I LD I N G DIVISION Date Rcady/By: luris: See Page 2 for
Internet: www.ti and-or. ov Notified/Method: Supplemental
Information
TYPE OF WORK FEE* SCHEDULE
E3 New construction 0 Demolition For special information use checklist
Description Qty. 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
L1 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
0 Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 14954 SW Belvoir Ct. 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 I Lot no.: 07 Fixture or item:
Tax map/parcel no.: Backflow preventer 1 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
Q✓ PROPERTY OWNER 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/Z1P: Beaverton, OR 97007 Hose bib 25.02
Phone:(503 )645-0986 Fax:( ) Ice maker 12.51
0 APPLICANT ❑✓ CONTACT PERSON Interceptor/grease trap 25.02
Business name: Riverside Homes, LLC Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: Amo Avgi
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
Urinal 25.02
E-mail: aavgi@riversidehome.com
Water closet 25.02
CONTRACTOR
Water heater 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: r ��ti� TOTAL PERMIT FEE
Print name: Nikki Pruett Date: 6/11/2019 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:ABuilding'PermitsVPLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB1
Plumbing Permit ApplicatioI E C E I V E D
Building Fixtures FOR OFFICE USE ONLY
City of Tigard JUN 1 3 2019 Dateived Permit No.l�'y\(,��,r\�G_ sC�
lig13125 SW Hall Blvd.,Tigard,OR 9722 ,
Date/By: ,` /+`3
3TY OF TIGARD Plan Review
Phone: 503.718.2439 Fax: 503.598 l) 1 Other Permit No.:
Inspection Line: 503.639.4175 DING DIVISION! DateBy:
T I G A R D Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
2 New construction ❑Demolition For special information use checklist
Description Qty. Ea. I Total
El Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
El 1-and 2-family dwelling 0 Cotmnercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑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: 14954 SW Belvoir Ct. Catch basin or area drain 18.76
City/State/ZIP: Drywell,leach line,or trench drain 18.76
y 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.: 07 Fixture or item:
Tax map/parcel no.: Backflow preventer 1 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
Q PROPERTY OWNER I ❑ 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
0 APPLICANT E✓ CONTACT PERSON Interceptor/grease trap 25.02
Business name: Riverside Homes, LLC Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: Ain Avg'
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: aavgi@riversidehome.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: TruScapes WaterPP�
tP m 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.: LOB#7962 Plumbing Lic.no.: Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: .,,G\ TOTAL PERMIT FEE
Print name: Nikki Pruett Date: 6/11/2019 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-PermilApp.doc 10.'01/09 440-4616T(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-1s'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
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/
Work Performed: Capped Added Relocate Plan review is required for any of the following.
Baptistry/Font Please check all that apply.
Bath Tub/Shower ❑ 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 ❑ 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 0 Any multipurpose fire sprinkler system.
Drinking Fountain 0 Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
4" Isometric or Riser Diagram
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
Washer-Clothes *Note: If the fixture work under this permit results in an
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
q.14 ■ COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review — Residential
Building Permit #: \ ,\q_W4S2.-
Site Address: rittt9 'lJ l m- (A.
Project Name: 8Utritpr, leif L Lot #: '-
(New dwelling=subdilhsion name;Addition or Alteration=last name of owner)
Planning Review
P�roosal: cTK.
LR Verify address/suite#active in Accela. ELK River Terrace: Ll No ❑ Yes,River Terrace Review Addendum
SitPlan Elements: I! .sion Control
[103/copies of site plan on 8-1/2"x 11"or 11 x 17"paper rE "yained trees with drip line and tree protection measures
L^i�b/rawn to scale(standard architect or engineer scale) [tif-•tprint of new structure(including decks)and FFE
G2f( arrow :1 ty locations&easements(required for new and additions)
IESte address,project or subdivision name and lot number •�.'dewalk/driveway approach
CIFIY4frplicant information(name and phone number) 'A • ation of wells/septic systems
['Lot dimensions and building setback dimensions IS -et tree size,type and location
Li axe footage of buildings to be demolished E eet names
PExisting structures on site ei orner elevations(2'contours if more than 4'difffer ntial)
'I of area,building coverage area,percentage of coverage and 1,000 sf of impervious area created or replaced? L7Yes E No
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? 047No
E Clean Water Services—Service Provider Letter of platted prior to 9/10/1995): "/rpn
uired: Received: II
q ❑ Yes,applicant was notified L(d No ❑ Yes ❑ No `
L1 Public Facili�tie Improvement(PFI)Permit: � 'CRA �'t
/Landequired: i Yes,applicant was notified ❑ No Ap_pli9d For: [a/Yes ❑ No,stop intake
Use Case#: fpY&'I6-00001 {B Zoning: g-i. (fii)
/Land
Setbacks: Front: 2.-0 Rear: IS Side: S Street Side: kA Garage: Zd
LfV Building Height: Max.Height: li 0 Actual Height: 72_
'Landscape Area: % 101-Lot Coverage Max: 0/0
�A Entrance ❑ Set back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less
�f J Windows ❑ Minimum 12%of area of all street-facing facades
f�` Garage CI Garage door is behind widest street-facing wall El Yes ❑ No,one of the following is met:
V 1� ❑ Door extends no more than 5'from wall and there is a covered porch extending beyond garage.
A.1 ❑ Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2"a floor.
❑ Garage door width is ❑ 12'or less ❑ 50%or less of facade ❑ 60%or less and includes 7 of following:
cfik ❑ 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 El Window recess ❑ Window projection ❑ Balcony
10-/Visual Clearance Lid rban Forestry Plan
Lid' Sensitive Lands: [ Yes ❑ No Type: \L1kL Gfrfil9r
c1Condjions1 met rilpr to issuance o`f buil�g permit
o s: L-041-11--d - l� h�r fries II 1d rr - Z(vaul
Ltd Approved ByPlanning: a'�'�X Date: C 1q
PP g ��`"
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\BldgPermitRvw_RES_022819.docx
Building Permit Submittal
Original Submittal Date: , 1'?. t I q
Site Plans: # ,)
Building Plans: # ;-�
Building Permit#: Enter building permit#above.
Workflow Routing: [Planning IVEngineering 12/Permit Coordinator D''guilding
Workflow Sign-off: R"Sign-off for Planning(include notes from planning review)
Route Application Documents: R'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: ' — Date: U.OrC I Ig
En neering Review
Slope at building pad: Xi;
kii Conditions "Met"prior to issuance of building permit
,_',, `EEa-sements (encroachments)per engineering conditions of approval and plat
LYWater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ["No
Assess Water Quantity Fee in-lieu: ❑ Yes UeNo
LIDA Facility on lot: ❑ Yes [No
❑ Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
LIJ/Approved by Engineering: Date: , S l
_
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:
E SDC Fees Entered: Wash Co Trans Dev Tax: ctd" es ❑ N/A
Tigard Trans SDC: Vy ❑ N/A
Parks SDC: Yes ❑ N/A
to Issue PermitLIDA ClYes [N/A
OK
M<ate:
, rApproved by Permit Coordinator: J
I:\Building\Forms\BldgPennitRvw_RES_022819.docx