Permit (29) i CITY OF TIGARD MASTER PERMIT
. ' COMMUNITY DEVELOPMENT : 7477 '7Permit#: MST2017-00180
Date Issued: 06/07/2017
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Its fs tr .a.P parcel: 2S111AA11100
Ot I! , 1., , Jurisdiction: Tigard
Site address: 9010 SW INEZ ST
Subdivision: GREENSWARD SOUTH Lot: 5
Project: Greensward South, Lot 5
Project Description: New SF. 12/11/17: REPRINTED to add irrigation backflow.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 2131 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1960 sf Garage: 580 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 4091 sf Value: $504,235.43 Rear: 15
PLUMBING
Sinks: 2 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 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: 5 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!500 sf: 8 201-400 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 4091
Owner: Contractor:
GP4 LLC H&H HOMES LLC Required Items and Reports(Conditions)
PO BOX 1577 19305 SUNCREST DR 1 Ersn Cntrl 503-639-4175
BEAVERTON,OR 97075 WEST LINN,OR 97068
PHONE: PHONE: 503-784-9198
FAX:
Total Fees: $33,994.19
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. hose rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain t7pp eCthe rules or direct questions to OUNC by calling 503.2 . •87 :00.332.2344.
/, 7V/v-2--
.
Issued By: .,-- '_....1p,...---•--------
���� Permittee Signature: . _
'Gait 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Applicat r ,
7 c5 a it
Building Fixtures = FOR OFFICE LSE ONLI'
City of Tigard
_
t t
Lit( I (..01/
l / Dateive
Date By:
/� /! //7 Permit N°�
1$:
v"x 7-17,//0 0
//Q
gi 13125 SW Hall Blvd.,Tigard,OR 97223 Plan PermitII Phone: 503.718.2439 Fax: 5( t $69s z'„,`- Other Permit No.:
Date/By:
Inspection Line: 503.639.417) . :“.....s.:','
' ( •TIGARD 1 g 4it 's,. i Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard-or.gov �. -,, n
Notified/Method: Supplemental Information
' gOF WORK: FEE* SCHEDULE
25Z,New construction 0 Demolition For special information use checklist
Description Qty. Ea. Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
!IKLI-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler(_sq.ft.) Page 2
"' JOB SITE INFORMATION AND LOCATION Site utilities:
pt / Catch basin or area drain 18.76
Job site address: -1 1pt.4� 5
/1-10,-6 (f Dtywell,leach line,or trench drain 18.76
City/State/ZIP:
1 �� ( Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name: (ante.- wa ld (...c)u"Al Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: 1 Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer I 31.27
4 I = Backwater valve 12.51
DESCRIP' ; 0E°,; e
,�r ," 7'" ' `° r, `" 1'° Clothes washer 25.02
// /64--,---76,A./ e�!l`94�Ci.f L C73
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
ROPER 'h OWNEII l TANT 1, Expansion tank 12.51
Name: �r41 14e.,AfiAI (L,44.,vc .5) Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
APPLICANT ':,,,,:x:',` 0 CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name:
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: S,A.,i+1n.WU* Lc„,,ASL,hz t I L •
Water piping/DWV 56.29
Address: 'PO ()4 ( 3610 Other: 25.02
City/State/ZIP: VVI k5b c<ytj ( &. 14 123 Subtotal
Phone:(S-O3) 3t.,jiJ-4(,Ic6 Fax:( )
Minimum permit fee: $72.50
ting (.641., 91 Plan review (25%of permit fee)
CCB Lic.:
Lia o.: Z
State surcharge(12%of permit fee)
Authorized signature: '' ..--7 TOTAL PERMIT FEE 33 3
Print name: 4-(0I,V J `i Date: I c)/, ',J�a- 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-PennitApp.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:
Fee(e*) Total Square.:_quare Footage: Perini
Footing drain-151 100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54
Medical Gas Systems:
Water Service-each additional 100' 37.52
Storm&Rain Drain-1st 100' 62.54 Valuation: Permit Fee:
$1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
each additional$100.00 or fraction thereof,to
Other Inspections or Fees ' Fee(ea) T°�`' 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*. an Review for Plumbing Ins ..rr riOs
Quantity by Fixture Type t Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate
Baptistry/Font
0 Any new commercial building with water service 2"and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
engineer.
-Jacuzzi/Whirlpool
Car Wash: -Each Stall ❑ New exterior plumbing site utilities for any complex structure
Drive Thras defined in OAR918-780-0040.
Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system.
Domestic 0 Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2"
-3" Isometric or Riser plagram
4>,
0 Isometric or riser diagram is required for new buildings
-Car Wash Drain
Garbage Domestic non-food that meet the qualifications above.
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -Lav/Bar non-food related
-Bradley
-Com/Serv/Util food related
-Service *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and
Washer-Clothes fees assessed for the sewer increase must be paid before the
Water Extractor
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2
CITY OF TIGARD MASTER PERMIT
P it. '- COMMUNITY DEVELOPMENT Permit#: MST2017-00180
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/07/2017
T[t�" 9 Parcel: 2S111AA11100
Jurisdiction: Tigard
Site address: 9010 SW INEZ ST
Subdivision: GREENSWARD SOUTH Lot: 5
Project: Greensward South, Lot 5
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 2131 sf Basement: 0 sf Left 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1960 sf Garage: 580 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 4091 sf Value: $504,235.43 Rear: 15
PLUMBING
Sinks: 2 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 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'I 500 sf: 8 201-400 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 4091
Owner: Contractor:
GP4 LLC H&H HOMES LLC Required Items and Reports(Conditions)
PO BOX 1577 19305 SUNCREST DR 1 Ersn Cntrl 503-639-4175
BEAVERTON,OR 97075 WEST LINN,OR 97068
PHONE: PHONE: 503-784-9198
FAX: ,
Total Fees: $33,959.16
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes - �l other-:.�..licable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuanc-, o if work i- s/spended for more the 180
days. A NTION: regon. law requires you to follow the rules adopted by the Oregon Utility Notification C nte'. Thoserfes are set forth in OAR
952-00 0010 through O'R••' -401-!'90. You may obtain a copy of the rules or direct questions to OUNC by calling 503.23 . t8 or 1.800.., '344.
IssuetI Bv:
14,... Ilr, �4 / _ Permittee Signature: ,� ...Ai-
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 projec
Approved plans are required on the job site at the time of each inspection.
Building Permit Application j
- Residential RECEIVE- colt(nil( LI.SI:O\1.1
UPICity of Tigardli �/ 2 2 2017 Date/Bea �jc i Ili Permit No.: / O/ 1- i/gO
13125 SW Hall Blvd.,Tigard,OR 911 Plan Review
■ Phone: 503.718.2439 Fax: 503.598.1960 tGARD Date/B : Other Permit:A-1LP°'7--6/9/6A
Ti G A R D Inspection Line: 503.639.4175 CITY or Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov BUILDING LAV 1%." Notified/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
tjtIsrew 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 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
and 2-family dwelling ElCommercial/industrial Valuation: $S.°14) aa
0 Accessory building ElMulti-familyNumber of bedrooms:
ID Master builder El Other:
Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors:a ILI
09
)/Li 67 !
Job site address: all.-/Q----1--31‘, New dwelling area: square feet
City/State/ZIP: 11 &kill) CA- 2_2- Garage/carport area: square feet c/3
Suite/bldg./apt.no.: Project name: `L'I'Z\\s,,,�+ y-�t Covered porch area �t square feet 1 1 Q 60
Cross street/directions to job site: 3�r.3 C h" Deck are 16 '—'4:j-5-19square fee 1 1
cO er structure atria: 3 s uare feet `e
+s j
REQUIRED DATA:COMMERCIAL- E ,,,e,....„,„.,)0 2 T
Subdivision: i,,1/4._:C:..,4,.1 Lot no.: 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.
Ni E,---4'3 S r 1 wlt= Valuation: $
Existing building area: square feet
New building area: / 07 Z square feet
❑ PROPERTY OWNER 0 TENANT Number of stories: A
I
Name: "t*--�^ t ( L LCC Type of construction:
Address: 'k. 3 oc S�lJ(�l�� Occupancy groups:
City/State/Z1P: 1/45-51- �r�i '70 6 Existing:
Phone:(J� -7: -Qi qS' Fax:( ) New:
0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name: (Please refer to fee schedule)
• Structural plan review fee(or deposit):
Contact name: 4 CiL
FLS plan review fee(if applicable):
Address:
Total fees due upon application:
City/State/ZIP: 00
Phone:( ) Fax: :( ) Amount received: 757J
E-mail: ��'t Gly o(av C;� �c ‘ ,t.?5� PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic Solar Panel System.
Business name: Submit two sets of roof plan with connection d:tails
4,N and fire departm, t access,along with •- I Oregon
Address: Solar Installation .'cial -- c ecklist.
Permit Fee i i `..8 es plan review
City/State/ZIP: $180.00
r i:nf. .8„ , ,;.tive fees):
Phone:( ) Fax:( ) Stat-surcharge(12%of perms : $21.60
CCB lic.: ?i,(3 Total fee due upon . . ion: $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: /��/� y n Date: *Fee methodology set by Tri-County Building Industry
C31� \l�K1. 1 Y 11 V ( Service Board.
I:\Building\Permits\BUP-RESPemiitApp.doc 02/24/2011 440-4 13T(1 f/02/COM/WEB) L
Building Permit Application Checklist
One- and Two-Family Dwelling 1.012 0111 i is t si: 0y1.1
City of Tigard d Received
g Date/By: Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
a Phone: 503.718.2439 Fax: 503.598.1960
T 1 G A K D 24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical
Internet: www.tigard-or.gov ❑ Other:
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 ❑
3 Verification of approved plat/lot. 0 0 ❑
4 Fire district approval required. Name of district: . ❑ 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 ❑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
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 ❑ ❑ ❑
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 ❑
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 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 ❑
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. 0 0 0
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 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
architect licensed in Ore on and shall be shown to be a licable to the ro'ect under review.
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. 0 0 ❑
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 0 0 ❑
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ 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 ❑
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 Application FOR OFFICE USE ONl.l
City of Tigard EIV E,® Date/By:d Permit No.: 145i /7 2O�
13125 SW Hall Blvd.,Tigard,OR 7
fe
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Other Permit:
Inspection Line: 503.639.4175 MAY 2 2 2017 Date/By:
T I G A R D Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard-or.gov OF TIG{qR{� Notified/Method: Supplemental Information
CITY
TYPE
NG DIVISION
COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: _mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
'r1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
0 Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning ' 46.75
Job site address: Sc.,,, -
�� sQL _ Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: .— ( tJL- C?22 y Furnace 100,000+BTU(ducts/vents) 54.91
y / Heat pump 61.06
Suite/bldg./apt.no.: Project name: Duct work 23.32
Cross street/directions to job site: 5 i c-, 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: (1) � 1 Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert I 33.39
Flue vent for water heater or gas
lvCL SF S fireplace 23.32
Log lighter(gas) 3.3
2 2
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
&PROPERTY;OWNER 0 TENANT Other: 23.32
Q 1S1 `pla t. ` . Rn hoodntal/oth exhaust and ventilation:
Name: W/- C--?Dr,
�`� Range hood/other kitchen
, �/' 2 nt 33.39
Address: r r Clothes dryer exhaust 33.39
City/State/ZIP: ec•{— C..t fj 09 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone: 7 g---(-- 96-
- Fax:( ) Attic/crawlspace fans 23.32
0 APPLICANT
0 CONTACT PERSON Other: 23.32
FuelPP t mg
Business name:
$14.15 for first four;$4.03 for each additional
Contact name: �. Furnace,etc.
Gas heat pump
Address: I;ljt
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace
GMLf /,_ _ Range
E-mail: (talk)0,,it:j`C:G4 Barbecue
CONTRACTOR` Clothes dryer(gas)
Business name: .—
Other:
MECHANICAL PERMIT FEES*
Address: Subtotal
City/State/ZIP: I\ Minimum permit fee($90.00)
Phone:( ) Fax:( ) Plan review(25%of permit fee)
State surcharge(12%of permit fee)
CCB lic.: / TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
- t — days after it has been accepted as complete.
Authorized signature: t r .., * Fee methodology set by Tri-County Building Industry Service Board
Print name: - • -1 / . v Date:,
1:\Building\Permits\MEC_PermitApp_0401 3.doc 44-4617T(1 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
•
Plumbing Permit App, t IVED
f Building Fixtures FOR OFFICE USE ONLY
CI of TI and MAY 2 2 2017 Received Ni Date/By: Permit No.: <' 1 S7�v 2_DDl 66
114 M 13125 SW Hall Blvd.,T
igar .�Q4 tt9 IG RD
Phone: 503.718.2439 Fa 151 .5V. 6 /!�� Plan Review
Date/By: Other Permit No.:
TI G ARD Inspection Line: 503.63 U�Q(NC�, DIVISION Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
New construction ❑Demolition For special information use checklist.
Description Qty. I Ea. 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
14'r-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath X 500.32
❑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: Catch basin or area drain 18.76
b Lia ��,, -�' • S r , Drywell,leach line,or trench drain 18.76
City/State/ZIP: -VI n CZ 722-'7
/ Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03
Cross street/directions to job site: 5-""' C 0t I" 1 t") 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: (Dir-. -J �Ca C':)-:341N Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
D IoN ,oRKzw Backwater valve 12.51
Clothes washer ( 25.02
tiv Si-- Et0
� Dishwasher 125.02
Drinking fountain 25.02
Ejectors/sump 25.02
.:.1:1 PROPEtTY _ R 0 4,A,NANT � r, Expansion tank 12.51
Name: ''t A-- 4,4:: :' tt Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: ['i.yj 0 Garbage disposal ( 25.02
City/State/ZIP:: ()es LE,
...i"-1" O -(206S Hose bib 2 25.02
Phone:6-. 3 7 _cit l Fax:( ) Ice maker 12.51
' C " r '141' Interceptor/grease 25.02
1❑ APPLIC 111 0 GO. 'f PERSO - trap
Medical gas(value:$ ) Page 2
Business name:
Primer 12.51
Contact name: ,
/ ttrf.-e,- Roof drain(commercial) 12.51
Address: J Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
� P ({-01W �il - ✓ ' Urinal 25.02
E-mail:
C�sL, �
. Water closet 25.02
:if C9 1,TRAC�ro> 'z M a Water heater ( 37.52
Business name: V` p r) VAA,LJLL fL...a477 i it Water piping/DWV 56.29
Address: . , . ii,,,t 1wei Other: 25.02
City/State/ZIP: ��1I- 1j„ g , `
23 Subtotal
Phone: 36,' ,d/L) ' Fax:( )
Minimum permit fee: $72.50
CCB Lie.: 6„ P mbing Lic.no.: 3�026,0, Plan review (25%0of permit fee)
_4 - State surcharge(12/o of permit fee)
Authorized signaturefgi / TOTAL PERMIT FEE
Print name:
Gipit:{L
Date; l iThis 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 - 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-151 100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52 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*. Plan Review for Plumbing Installatiions
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Workork Performed: Capped Added Relocate
try/Fo0 Any new commercial building with water service 2"and
Baptisgreater,except systems designed and stamped by licensed
Bath: -Tub/Shower
-Jacuzzi/Whirlpool engineer.
Car Wash: Each Stall
0 New exterior plumbing site utilities for any complex structure
as defined in OAR918-780-0040.
-Drive Thru
Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial
0 Any multipurpose fire sprinkler system.
Domestic 0 Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2"
3„
Isometric or Wiser Diagraipllf "," r `<
4
0 Isometric or riser diagram is required for new buildings
-Car Wash Drain
Garbage Domestic non-food that meet the qualifications above.
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -Lav/Bar non-food related
-Bradley
-Com/Serv/Util food related
-Service *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and
Washer-Clothes
Water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
IN City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
T 1 G A lz D Building Permit Review — Residential
Building Permit #: " ST---( 9-0 17-00 1 go
Site Address: 10 10 5t.i; cz �-
Project Name: �si%et 'c 5o(44-1,1
Lot #: 6
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: ifsit4.0 sn.
IgtVerify site address/suite#exists and active in permit system.
Eye River Terrace Neighborhood: tIK No ❑ Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
ree(3)copies of site plan xisting structures on site
L to plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structureg structure(including decks)with finished
Erbrawn to scale(standard architect or engineer scale) yy fl/oor elevations
orth arrow [ tility locations&easements (required for new and additions)
,,_,,//U
IL ite address,project or subdivision name and lot number LSidewalk/driveway approach
id Applicant information(name and phone number) iry 'cation of wells/septic systems
Lot dimensions and building setback dimensions N(. xisting trees to be retained with drip line,and tree
it.quare footage of buildings to be demolished protection measures
) Lot area,building coverage area,percentage of coverage and LLld'S,,,�__1,,S`treet tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) treet names
droperty corner elevations(2 foot contour lines if more than 7J Storm water quality facility required if>1,000 sf of
4 foot differential) impervious area is created or replaced.
1P' Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified I. No Received: ❑ Yes E No
❑ Public Facilities Improvement (PFI) Permit:
Required: E Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake
'Land Use Case#: i k4?,2c k T ^000(6
121/Zoning: f---4..9
IIS Required Setbacks: Front 2e Rear j 5 Side 5 Street Side V' Garage 26
11') Landscape Requirement: 0/0
No" Lot Coverage Maximum:
L Building Height: Maximum Height Actual Height 30
V isual Clearance
Nt*Sensitive Lands: ❑ Yes ❑ No Type
Er Urban Forestry Plan
❑ Conditions "Met"priof,to issuance of building permit
Notes: Locc`t60.0 eT feQuZyzec, -free nil V' 'C yorti• C Ot vIA Vial-c-11 -zoiy-OCOltj
b ui- Yli liM,be/" v 5 15 ArreCA-
Approved By Planning: 9, Date: 5 2YJ 17
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Fonns\BldgPermitRvw_RES_051617.docx
Building Permit Submittal
Original Submittal Date: 57R-Pl7
Site Plans: # 3
Building Plans: # 3
Building Permit#: Er nter building permit#above. �
Workflow Routing: 2 Planning engineering [l eeBuilding
Workflow Sign-off: '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
_.9...xiginal 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: ( ( J1A1 Date: 02/7
Engineering Review g�
Slope at building pad:
Conditions "Met"prior to issuance of building permit
Easements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes No
Assess Water Quantity Fee in-lieu: ❑ Yes No
LIDA Facility on lot: ❑ Yes No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: 4Z _0 Date: .5„, ,,7
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: Yes ❑ N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: Yes
❑ N/A
LIDA 11, ,s 7 N/A
OK to Issue Permit
�`�
,1'
Approved by Permit Coordinator: /�%'GDate:
I:\Building\Forms\BldgPermitRvw_RES_051617.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9010 SW INEZ ST, TIGARD, OR, 97224 January 30, 2018 at
3:45:30 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00180
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
FA I L
Comments:
Seal air intake pipe at drywall penetration for required fire separation at HVAC in
garage. R302
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9010 SW INEZ ST, TIGARD, OR, 97224 January 30, 2018 at
3:47:44 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00180
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
FA I L
Comments:
Fix or replace broken cleanout cap, storm by entry. Provide approved thread
sealant. 707.3
Remove white cap obstruction from main floor shower drain. 309
Lay stopper not working left side in master.
Remove white cap obstruction from upper level master shower.
Left side Lay stopper not working correctly upper main bath.
Not ready for inspection, work not complete. R109.3
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9010 SW INEZ ST, TIGARD, OR, 97224 January 30, 2018 at
3:47:06 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00180
Inspection Type: Inspector:
199 Electrical final David Young
Result:
FA I L
Comments:
Install missing outlet in garage covered by building material.
Fix gap around outlet upper level main bath. Nec 314
Multiple outlets blocked by staged furniture.
Re schedule inspection with access to electrical.
Work not complete, not ready for inspection. R109.3
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9010 SW INEZ ST, TIGARD, OR, 97224 February 15, 2018 at
10:32:38 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00180
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
PASS
Comments:
Corrections complete.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9010 SW INEZ ST, TIGARD, OR, 97224 February 15, 2018 at
10:33:49 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00180
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS
Comments:
Corrections complete.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9010 SW INEZ ST, TIGARD, OR, 97224 February 27, 2018 at
9:15:26 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00180
Inspection Type: Inspector:
299 Final inspection David Young
Result:
FA I L
Comments:
Master bedroom casement does not meet minimum egress width requirement, appears
to need egress hinges. Opening clear width approximately 18 in. Other window crank
handle disconnected.
Fall prevention devise on right side upper middle bedroom not working.
All else appears ok.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9010 SW INEZ ST, TIGARD, OR, 97224 March 5, 2018 at 9:27:41 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00180
Inspection Type: Inspector:
299 Final inspection David Young
Result:
PASS - CofO
Comments:
Corrections from previous inspection complete.
Final erosion control approved.
Street tree certification received.
Moisture content form received.
High efficiency lighting form received.
Backflow test report received.
Insulation certification checked.
Blower door test report received.
C of 0 left on site at kitchen island.
Violation Summary:
Inspector Contractor