Loading...
Permit Support Document 4, REC V 97 ,LJ MAY 2 4 2020 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT ��'^^ II at Ci Y OF if GA Request for Permit Action 1 f r), i sio 1 i t;A It i u+' 13125 SW Hall Blvd. • Tigard,Oregon 97223 • 503-718-2439 •www.tigard-or.gov TO: CITY OF TIGARD Building Division 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov FROM: ❑ Owner [1 Applicant n Contractor ❑ City Staff Check(✓)one REFUND OR Name: INVOICE TO: (Business or Individual) kt vrtec'de [l01."-tts L GC, �.y Mailing Address: 11 53 A) I E r-eefrt p tcc'e.. -- ,�?: City/State/Zip: l?eCV v Ci— i G 121 77G' rr r Phone No.: S 2 J - C2(-{i5 O 1 4 PLEASE TAKE ACTION FOR THE ITEM(S)CHECKED (✓): ®, CANCEL/VOID PERMIT APPLICATION. ❑ REFUND PERMIT FEES (attach copy of original receipt and provide explanation below). 54, INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below). Permit#: 57Ci"3C Site Address or Parcel#: 15 civl S Lk) L r.t Project Name: E i dtv�j2a-E- jS! e_ Subdivision Name: E I plea-1 jQ,�'Y y l �l�✓ 1„- Lot#: 17 EXPLANATION: F est,7r1-i i)-1-)n q Gt ciA n'(- -f 1Gcr- ? It r.,-) Signature: i- 'J ' Date: 5 0 bi /,,C o?C Print Name: tJm/1ini -- t)c j Refund Policy 1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of: • Any fee which was erroneously paid or collected. • Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended. • Not more than 80%of the application or permit fee for issued permits prior to any inspection requests. 2. All refunds will be returned to the original payer in the form of a check via US postal service. 3. Please allow 3-4 weeks for processing refund requests. t ltIR tll'I ICI: L SILt)NI_! Route to Sys Admin: Date By Route to Records: Date 9 /5 21 By,S,� Refund Processed: Date N/4t By � Invoice Processed: Date By Permit Canceled: Date 67412.0 By�� lJ Parcel Tag Added: Date By I:\BuildingMoans\RegPertnitAction_I1 .doc Building Permit Ap licatto ECEIVED ' ' y ,GQ c) Residential FOlt U1 1 icE I NI O\l.l SEP 3 0 2019 Received City of Tigard DateB i0 _7 /� %e, Permit Nis-- 13125 SW Hall Blvd.,Tigard,OR 97 OF TrGARD y / 1 ��/ l�D, > g Plan Review i g il / ? ' Phone: 503.718.2439 Fax: 503.;: ti',I A'/'� Date/By: I , l y other Per Eby O/ �Q i f I G A It U Inspection Line: 503.639.4175 11V1a DIVISION Date Ready/By: cis: ® See Page 2 for Internet: www.tigard-or.gov 13[otified/Method: ,3 /1f Supplemental Information TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING ElNew construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the work indicated on this application. CATEGORY OF CONSTRUCTION Valuation: $ b Q El , 1-and 2-family dwelling Commercial/industrial ❑Accessory building ❑Multi-family Number of bedrooms: 5 0 Master builder ❑Other: Number of bathrooms: 4 JOB SITE INFORMATION AND LOCATION Total number of floors: 3 3510 Job site address: 7594 SW Hansen Ln New dwelling area: 3137 square feet \ t b City/State/ZIP: Tigard, OR 97224 Garage/carport area: 383 square feet 41h Suite/bldg./apt.no.: Project name: Elderberry Ridge Covered porch area: square feet 483 Cross street/directions to job site: SW Bonita Rd &SW 76th Ave Deck area: / ' .-.. square feet Other stru e a: /r7Z square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Elderberry Ridge I Lot no.: 17 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 ❑ PROPERTY OWNER ❑ 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 El CONTACT PERSON BUILDING PERMIT FEES* Business name: Riverside Homes, LLC (Please refer to fee schedule) Structural plan review fee(or deposit): Contact name: Nikki Pruett Address: 17933 NW Evergreen Pl., Ste 370 FLS plan review fee(if applicable): 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 Photo Voltaic 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 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: 9/30/19 *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB) Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONLY Received - City of Tigard Permit No.: III ■ 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: Phone: 503.718.2439 Fax: 503.598.1960 Associated permits: I l( ARD 24-Hour Inspection Line: 503.639.4175 0 Electrical El Plumbing El Mechanical Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW )e, No N/A 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 3 Verification of approved plat/lot. 0 0 0 4 Fire district approval required. Name of district: El El 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 ❑plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ❑ 0 0 basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ 0 0 building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ❑ 0 0 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. 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 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 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 ❑ ❑ 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ 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. 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, ❑ 0 ❑ 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-RESPemiitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) i .-- Mechanical Permit Applicant,*i • d ` FoR oii icl: usE()NIA City of Tigard Received Date/By: Permit No.t %.2j/?-OQ 1 111 "I 13125 SW Hall Blvd.,Tigard,OR 97223.F V $ 0 Z��yyU l9 / e Phone: 503.718.2439 Fax: 503.598.1960 Plan Review Date/By: Other Permit: T I G A R D Inspection Line: 503.639.4175 c+l(4 `U, ., A "'jki Date Ready/By: Eris: 0 See Page 2 for Internet: www.tigard-or.gov o` N i;'" Notified/Method: Supplemental Information TYPE OF WORK 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 ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* Q 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist. ❑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: 7594 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 Heat pump 1 61.06 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.: 17 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 ❑ PROPERTY OWNER ElTENANT Other: 23.32 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) 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 Gas heat pump 14.15 Address: 17933 NW Evergreen PI., Ste 370 WalUsuspended/unitheater 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) Phone: Fax: Plan review(25%of permit fee) ( 971)205-4989 ( ) State surcharge(12%of permit fee) CCB lie.: 209001 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 i-- • days after it has been accepted as complete. Authorized signature! il:'I*: * Fee methodology set by Tri-County Building Industry Service Board Print name: Nikki Pruett Date: 9/30/19 l:\Building\Permits\MEC PermitApp_040113.doc 440-4617T 0 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:\Building\Permits\MEC_PermitApp_040113.doc 2 Electrical Permit Applicatioi ECEIVE FOR OFFICE USE ONLY �+ p Received _.,n City of Tigard J�1 q ry 77 Date/B : Permit#.j*9 5%f (% V 6)...� � e 13125 SW Hall Blvd.,Tigard,OR 97223 ' 8 V L Plan Review °: I Phone: 503.718.2439 Fax: 503.59> 96a , Date : Related Permit#: Inspection Line: 503.639.4175 ' T OF +iGARD Ready Date/By: inns: ® See Page 2 for T I G A R D Internet: www.tigard-or.gov BUILDING MISION 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): O Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ❑✓ 1-and 2-family dwelling ❑Commercial/industrial El Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family 0 Master builder D Other: ❑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: 7594 SW Hansen Ln 100HP or more. ❑"A","E","1-2","1-3", City/State/ZIP: Tigard, OR 97224 0 Six or more residential units. occupancy. r ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: Elderberry Ridge 0 Hazardous locations. 0 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#: 17 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 Construction of SFR (with above sq.ft.) 75.00 2 Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 ✓❑ 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 I 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 a 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, 7.42 2 each branch circuit Contact name: Nikki Pruett B.Fee for branch circuits without serAddress: 17933 NW Evergreen PI., Ste 370 branch circuit fee,first 56.18 2 • g branch circuit City/State/ZIP: Beaverton, OR 97007 Each add'I 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 ❑ See Page 2 2 Address: 2804 NE 65th Ave. St. D panel,alteration,or extension. City/State/ZIP: Each additional inspection over allowable in any of the above y Vancouver, WA 98661 Additional inspection(1 hr min) 66.25/hr Phone:(360) 518-7589 Fax:( ) Investigation(I hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr I Cj/!/.2-L Inspections for which no fee is 90.00/hr 172549 C23Q Suprv. specifically listed('A hr nun) CCB Lic.: Electrical Lic.: Lic.:/ et 3 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: ,., A/ 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. 1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 4.40-4615T(II/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: 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 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* >100kva-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 s.ecificall listed %:hr min COMMERCIAL WORK ONLY: ir F 'total ; .r ,0 1 ,:r 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: ❑ 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 1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 Plumbing Permit Application RECIVD Building Fixtures l oiz oFFici: USE oNI.l City of Tigard S P $ 0 2019 Received Date/By: Permit No.: S e�� „?,. 3,cj lig 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review I Phone: 503.718.2439 Fax: 503.5e OF F GARD Date/By: Other Permit No.: I WARD� Inspection Line: 503.639.4175 BUILDING DIVISION Ready/By: ® See Page 2 for BUILDING L/ �7 Date Read/B luris: Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ©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 g I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 1 500.32 ❑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: 7594 SW Hansen Ln Catch basin or area drain I 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: 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 Lot no.: 17 Fixture or item: Tax map/parcel no.: Backflow preventer 3I.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 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 PI., 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 �✓ 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 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 Urinal 25.02 E-mail: npruett@riversidehome.com Water closet 4 25.02 CONTRACTOR Water heater 1 37.52 Business name: H & H Mecanical 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) r-� State surcharge(12%of permit fee) Authorized signature: ,.' '�G 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. 1:\Building\Permits\PLMU-PermitApp.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-I"100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Storm&Rain Drain-1st 100' 62.54 Valuation: Permit Fee: $1.00 to$5,000.00 Minimum fcc$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 ❑ 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" Isometric or Riser Diagram Car Wash Drain Garbage -Domestic-non-food ElIsometric or riser diagram is required for new buildings Disposal -Domestic-food related that meet the qualifications above. -Commercial-food related -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang -Stall Sink/Lay -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer-Clothes Water Extractor increase of sewer EDUs,a sewer permit will be issued and Water Closet-Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: C:\Users\npruett\Downloads\PLMF_PermitApp.doc 2 Plumbing Permit Application Building Fixtures 'RECEIVE 1 FOR OFFICE USE oNI.l City of Tigard Received Permit No q Qq II/ iii 13125 SW Hall Blvd.,Tigard,OR 97223 SEP 3 0 2019 Date/By: �7S%.�//(� a / Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Other Permit No.: Inspection Line: 503.639.4175 Date - I I G A R 1 m CITY OF TkiAfi L.l' Date Ready/By: luri, 163 See Page 2 for Internet: www.tigard-or.gov ^ `/ otified/Method: Supplemental Information WILDING TYPE OF WO iL ING rAVIS{ ' FEE* SCHEDULE ©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 EiI-and 2-family dwelling ❑Commercial/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: 7594 SW Hansen Ln Catch basin or area drain 18.76 Dryweu,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 Lot no.: 17 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 r0 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 ❑✓ 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 Urinal 25.02 E-mail: npruett@riversidehome.com 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 Plan review (25"/0 of permit fee) CCB Lie.: LCB#7962 Plumbing Lic.no.: / State surcharge(12%of permit fee) Authorized signature: kci./P'L 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(I0/02/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-1"100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Storm&Rain Drain-1st 100' 62.54 Valuation: Permit Fee: $1.00 to$5,000.00 Minimum toe$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 El Any new commercial building with water service 2"and Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Drive Thru ❑ 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" Isometric or Riser Diagram Car Wash Drain Garbage -Domestic-non-food ❑ Isometric or riser diagram is required for new buildings 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 NIq COMMUNITY DEVELOPMENT DEPARTMENT ■ . r 1 c A R o Building Permit Review — Residential Building Permit #: /1f 7 .Q/7 00_3,9 Site Address: " C-92 'l/C7rn �yn,� Project Name: 7 .he �/ /,` Lot #: (New dwelling=, ivision nanrril dition or Alteration=last name of owner) Planning Review ��� Pr osal: A/ t / Of Verify address/suite#active in Accela. 112kn River Terr e: IILI No ❑ Yes, River Terrace Review Addendum Sit7Plan Elements: A Er,sion Control opies of site plan on 8-1/2"x 11"or 11 x 17"paper .!A etained trees with drip line and tree protection measures Zl) awn to scale(standard architect or engineer scale) VA ootprint of new structure(including decks)and FFE l rth arrow V a 'ty locations&easements(required for new and additions)e address,project or subdivision name and lot number 7/Sid-walk/driveway approach 2tf information(name and phone number) N .cation of wells/septic systems et dimensions and building setback dimensions I/ eet tree size,type and location 11\ a are footage of buildings to be demolished yreet names 1 ,, 'sting structures on site '1 l Corner elevations(2'contours if more than 4'diffee ntial) M Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replace ? VJ Yes U o impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? Yes No WClean Water Services—Service Provider Lettttee of platted prior to 9/10/1995): equired: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No 12:J Public Faciliti Improvement(PFI) Permit: quired: tYYes,applicant was notified ❑ No Applied For: t" Yes No,stop intake Vri and Use Case#: ��� CVte —00e ! ing: Gt;—7 wequired Setbacks: Front: /C Rear: /c Side: Street Side: .'� Garage: ilding Height: Max. Height: Actual Hei ht: �( VLa ndscape Area: c2O % V Lot Coverage Max: �) 0/0 Entrance back no more than 8'from street-facing wall ❑ Parallel to street or of degrees or less Windows ❑ Minimum ° of area of all street-facing facades Garage ❑ Garage door is behin t street-facing wall ❑ ❑ No,one of the following is met: ❑ Door extends no more than wall an th ' a covered porch extending beyond garage. ❑ Door extends no more than 5'from ere is a 12 sq ft.window above garage on 2nd floor. ❑ Garage door width is ❑ 12' s ❑ 50%or less o ❑ 60%or less and includes 7 of following: ❑ Covered porch Recessed entrance ❑ Wall offset f eave ❑ Roof offset ❑ Fire es ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gam of ❑ Dormer Accent siding Window trim ❑ Window recess ❑ Window projection Balcony `,�i isual Clearance rban Forestry Plan VA Sensitive Lands: Yes ❑ No Type: — Ll S !.Q ❑ Conditips m tprior to issuance of b ding permi Carr/ T No : ( _021 i-7) i1 C /i'l/g - jr2J NJ t /1)7/7 1,<,Ct/0/1 ' Ia Approved By Planning: Date: -el C.) Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved l:\Building\Forms\BldgPermitRvw_RES_022819.docx Building Permit Submittal Original Submittal Date: / ?d `2� Site Plans: # Building Plans: # Building Permit#: Enter building permit#above. Workflow Routing: g Planning `2r Engineering [Permit Coordinator Building Workflow Sign-off: 7— 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: 2,3 ,_ Date: %b/3/. Enigineering Review Slope at building pad: j.,, Tl Conditions "Met"prior to issuance of building permit CAI Easements (encroachments) per engineering conditions of approval and plat Of Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes 3rNo Assess Water Quantity Fee in-lieu: ❑ Yes [ "No LIDA Facility on lot: ❑ Yes Ind No ❑ Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: (-------------7-- <pproved by Engineering: Date: `ti/j /7 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: SDC Fees Entered: Wash Co Trans Dev Tax: gr.Yes ❑ N/A Tigard Trans SDC: r' Yes ❑ N/A Parks SDC: Dies ❑ N/A LIDA ❑ Yes 127N/A OK to Issue Permit Approved by Permit Coordinator: Date: ,1)/ '/i I:\Building\Forms\BldgPermitRvw_RES_022819.docx TREE PLANTING NOTES (41111 1.NEW TREES THAT ARE PLANTED TO MEET THE EFFECTIVE CANOPY REQUIREMENTS SHALL CONFORM TO THE APPLICABLE STANDARDS IN THE TIGARD URBAN FORESTRY MANUAL.THEY SHALL BE PLANTED IN ACCORDANCE WITH THE AMERICAN NATIONAL STANDARDS INSTITUTE(ANSI)STANDARDS FOR TREE PLANTING(A300,PART 6)AND ADDITIONAL STANDARDS ADOPTED BY THE OREGON LANDSCAPE CONTRACTORS BOARD.NURSERY STOCK SHALL MEET THE REQUIREMENTS OF THE AMERICAN ASSOCIATION OF NURSERYMEN FOR NURSERY STOCK (ANSI 260.1)FOR GRADE NO.1 OR BETTER.DOUBLE STAKE TREES IF NEEDED FOR STABILITY DURING THE ESTABLISHMENT PERIOD. 2.ROOT BARRIERS SHALL BE INSTALLED ACCORDING TO THE MANUFACTURER'S SPECIFICATIONS WHEN A STREET TREE IS PLANTED WITHIN 5'OF ANY HARD SURFACE,PAVING,OR UTILITY BOX. 3.IF NEEDED,IRRIGATION TO BE DESIGN/BUILD BY THE LANDSCAPE CONTRACTOR. 0 1 0' 20' 4.IF NEEDED,SPECIES SUBSITUTIONS SHALL BE COORDINATED WITH THE PROJECT ARBORIST TO ENSURE EQUIVALENT CANOPY COVER IN ORDER TO AVOID MODIFICATION OF THE I I PREVIOUSLY APPROVED URBAN FORESTRY PLAN. The project arborist has reviewed this plan and certifies that the trees and tree protection are accurately represented in accordance with the previously approved Urban Forestry Plan. SCALE: 1"---20' Morgan Holen,ISA Board Certified Master Arborist(PN-6145B),ISA Tree Risk Assessor Qualified Date:Sept.25,2019 I Phone Number:971.409.9354 CITY OF TIGARD Approved Planning 11.77 f. ...4.„1„,.... Date: /30//9 Initials: k.210' PRIVATE WALL _ — --- — EASEMENT -- - - - [136 I 140 ._- 1. •�50.00' - - - -- y A15 r - - - - - • 4'-'N • . cigi, ,, CANTILEVER I; • .• I' FIREPLACE .' --•— _� _ 1. — — — - ,.\-. - 146BFE I 146 f • • SSI • •' UTILITY ••T• • •• •1 WO lEMENT I .- • 0T 18 . 148 - •5. 156FFE� •'••• I o LOT 1 6 I - - .�r.. ....i:i � I 1150 i ® � KATSURA/CEAdDVtYIWS 3APONKUM I 154GFE , LII ✓/ (DIAMETER SPREAD.07 j 5 ft Water Service Drainage --\yAir — • GARAGE I Erosion I zo Grade IV Lot Area: 4512 SF V—I , -1- c, Bldg Coverage: 2685 SF �IJf '-- ' I ---2. Total Impervious_, Z6.59_RF _ _ Z�j 6° MMM 7 \ \ Coverage: 38% / 43% Total — 1153 \\ F :.: . O. '154 .8P U E I Al s a / SW H AN SEN1 LANE 3 5 u DATE 08/15/2018 8 REVISION ELDERBERRY RIDGE WESTLAKE 2 DRAWN BY 1 TIGARD, OREGON CONSULTANTS Jxc. DAB 7594 SW HANSEN LN ENGINEERING • SURVEYING • PLANNING CHECKED BY JAB LOT SETBACKS PACIFIC CORPORATEQQ CENTER JOB NO. LOT 17, 4512 SF TIGARD, OREGONU 97224ARKWAY, SUITE 150 FAX((503))624 0B157 1306-006