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Permit (47) CITY OF TIGARD MASTER PERMIT ,1111, II.. ' COMMUNITY DEVELOPMENT r",P aPermit#: MST2017-00213 T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 .-. Date Issued: 07/06/2017 Parcel: 2S111AA12000 r' i/ , ✓Q ',ii Jurisdiction: Tigard Site address: 8933 SW INEZ ST Subdivision: GREENSWARD SOUTH Lot: 14 Project: Greensward South, Lot 14 Project Description: New SF. 9/25/17: REPRINTED to add an additional furnace and A/C. 12/11/17: REPRINTED to add irrigation backflow. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 5 First: 2148 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 2366 sf Garage: 652 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 4514 sf Value: $547,935.02 Rear: 15 PLUMBING Sinks: 1 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 0 Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 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: 2 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: 9 201-400 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 4514 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: $34,909.15 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. Yo--?u may ofla• the rules or direct questions to OUNC by calling 503.232.1987 or 1.8 .3.2344. / Issued By: ""d &fr �Q A Permittee Signature: ,) / Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Application Buildingi-iFixtures JL4, V C . h• FOR OFFICE LSE ONE) City of Tigarda C I Received / Permit N / 1111 NI 13125 SW Hall Blvd.,Tigard,OR 97223 i t Date/B�: L Air Y!_S% �%/-7��Q��� Plan Review C Phone: 503.718.2439 Fax: 503.598. T" ,. t 1 f'_s(.ir3"�a„* Date/By: Other PermitNo.: Inspection Line: 503.639.4175 t i � ;.-t z-. i ;i-, Date Read/B Noris: See Pae 2 for TIGARD 3 �� �`"�1N ( 5 4Ready/By: B Internet: www.tigard-or.gov ° si€ ' .f �'Notified/Method: Supplemental Information , TYPE OF WORK k'.. " FEE* SCHEDULE ❑New construction 0 Demolition For special information use checklist Description I Qty. Ea. Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) +)CATEGORY OF CONTitUCi'ION SFR(1)bath _ 312.70 ❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 El Accessory buildingSFR(3)bath 500.32 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE , ORMATION ANS"LOCATION Site •utilities: �j a Catch basin or area drain 18.76 Job site address: �7%�1 .s-u) - /Jt Z ''`u t - Drywell,leach line,or trench drain 18.76 City/State/ZIP: ij q3a-1+ Page drain(no.linear ft.:_) Pa e 2 Suite/bldg./apt.no.: I Project name:v t' t ' t fi( ccv1472-) 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: I Lot no.: (11 Fixture or item: Tax map/parcel no.: vv Backflow preventer I 31.27 #t - '''2 D,ESC $ fN r WORK 3 Backwater valve 12.51 / k Clothes washer 25.02 / 1� rC `-'9`%7t'- . C C L - Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ti [� #IPERTY 0`' 1"' 0 TEN" ' Expansion tank 12.51 „ axe_, Name: 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 #CANT,e 1]'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 vw Water closet 25.02 ,c,.,,;.„. Cb$ TRACTOR :.s.„. "i.,, Water heater 37.52 Business name: 5'i.4.YLt,,-1 /C, - u SG,-Gl_ /l _t Water piping/DWV 56.29 Address: p JZ,,))x % /0 W Other: 25.02 City/State/ZIP: j,.f.'tvv(�15bait) Ok '?7I 3 Subtotal Phone:( )z ) Minimum permit fee: $72.50 -36)6 QQ Fax:( )� Plan review (25%of permit fee) CCB Lic.: Phyitbingtic.rio•: i8* of. State surcharge(12%of permit fee) Authorized signaturei‘_____&? / TOTAL PERMIT FEE 3c,ox Print name: el-j ki.6 .- Date: O /i r /f This permit application expires if a permit is not obtained within 180 days ( ( after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Q Fee(ea) Total xa. SquareFootage: Permit Fee: Footing drain-ls`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 Fee(ea) Total M each additional$100.00 or fraction thereof,to Otho,Inspections or Fees ' 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*. Plaileview.for Plumbing,Insta'g , tats Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for t(teplace/ Please check all that apply. Work Performed: Capped Added Relocate 0 Any new commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool 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 ❑ 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 Diagram 4„ 0 Isometric or riser diagram is required for new buildings -Car Wash Drain that meet the qualifications above. Garbage -Domestic non-food 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 F .~•' COMMUNITY DEVELOPMENT 4.v r. ,°yR+" Permit#: MST2017-00213 Tr ■11 k.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.24391 �� Date Issued: 07/06/2017 a` Parcel: 2S 111 AA 12000 Jurisdiction: Tigard Site address: 8933 SW INEZ ST Subdivision: GREENSWARD SOUTH Lot: 14 Project: Greensward South, Lot 14 Project Description: New SF. 9/25/17: REPRINTED to add an additional furnace and A/C. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 5 First: 2148 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 2366 sf Garage: 652 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 4514 sf Value: $547,935.02 Rear: 15 PLUMBING Sinks: 1 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 Bckflw Prevntr: 0 Catch Basins: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 2 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: 9 201-400 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 4514 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: $34,874.13 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes a,. all oth- -.plicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, if work . .uspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Cen - Thos , les are set forth in OAR 952-001-0010 through OAR -001- 0. Y may o in a c py of the rules or direct questions to OUNC by calling 503.232.1•: •r 1.800.:3 .2344. e Issued By: Permittee Signature: / /q Call 503.639A175 by 7:00 a.m.for the next available inspection date. r - KJ This permit card shall be kept in a conspicuous place on the job site until completion of the .roject. , Approved plans are required on the job site at the time of each inspection. \ Mechanical Permit Application FOR OFFICE USE ONEv City of Tigard Date/BReceived Permit No.: ■ 13125 SW Hall Blvd.,Ti7223 OR 97223 y 1111 g Plan Review _ Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: TI G A R D Inspection Line: 503.639.4175 Date Ready/By: loris: EA See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees*are based on the value of the work "New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* IRS-and 2-family dwelling 0 Commercial/industrial 0 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 ( 46.75 Job site address: C"-/3`2j s t.A3 ,r,,,-G__ ,Sti..-• Furnace 100,000 BTU(ducts/vents) ( 46.75 City/State/ZIP: '-ii.' 1 (2 c-2(7 2 2 ( Furnace 100,000+BTU(ducts/vents) 54.91 �A Heat pump 61.06 Suite/bldg./apt.no.: Project name: wS�( v \v, Duct work 23.32 Cross street/directions to job site: 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 ei Other: 23.32 Subdivision: A � �, 4��j - Lot no.: t Other fuel appliances: Tax map/parcel no.: Water heater 23.32 ''DESCRIPTI OF WOR ,', `.0-Sn Gas fireplace/insert 33.39 a -' pp w ti Flue vent for water heater or gas re. 2- ' "--- w CJ A CY \\giL".(2 fireplace 23.32 ""_ f.,l/� l Log lighter(gas) 23.32 2 � `�� Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 PROP OWNER T ' b ,,-. ,Y ,, Other: 23.32 *' Environmental exhaust and ventilation: � � Name: C `� Range hood/other kitchen � equipment 33.39 Address: VI }vG(/(t.) ' 4,,._ Clothes dryer exhaust 33.39 Ci /State/ZIP: LAAJ,/-1 C)(1--- 6E7(--)6 e Single-duct exhaust(bathrooms, U toilet compartments,utility rooms) 23.32 Phone:g-i) `7 "C'`4:t(, L Fax:( ) Attic/crawlspace fans 23.32 r , 0 APPLIC' s A PERSON Other: 23.32 Fuel piping: Business name: � S $14.15 for first four;$4.03 for each additional Contact name: 4 ,, N Furnace,etc. f, Gas heat pump Address: Wall/suspended/unit heater City/State/ZIP: c Water heater Fireplace Phone:( ) Fax::( ) Range E-mail: Barbecue ,` 'fit; CONTRACTOR t ;' # ' Clothes dryer(gas) Other: Business name: % ', � ` �.Gi s 'iri`��r/ ,r` MECHANICAL.PE TFEES* w., Address:`75 L / .) '4' &DM v Subtotal 1C t, I CI i 6 b Minimum permit fee($90.00) City/State/ZIP: �/ s (JJ2�L E�j,V4,14)CI Z Plan review(25%of permit fee) Phone:( ) O .8q1.2,6,�I Fax:( ) State surcharge(12%of permit fee) 6 CCB Tic.%� � �' ii Z TOTAL PERMIT FEE ` e .7 �' �t�/ � This permit application expires if a permit is not obtained 'thin 18� ` ` days after it has been accepted as complete. Authorized signature: ` * Fee methodology set by Tri-County Building Industry Service Board Print name: ( ' (-k- N t6` ( Date: G(. - -17--_ I:\Building\Permits\MEC_PermitApp_040113.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 CITY OF TIGARD MASTER PERMIT 111 Permit#: MST2017-00213 COMMUNITY DEVELOPMENT Date Issued: 07/06/2017 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S111AA12000 Jurisdiction: Tigard Site address: 8933 SW INEZ ST Subdivision: GREENSWARD SOUTH Lot: 14 Project: Greensward South, Lot 14 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 5 First: 2148 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 2366 sf Garage: 652 sf Front: 20 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Total: 4514 sf Value: $547,935.02 Rear: 15 PLUMBING Sinks: 1 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. 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'500 sf: 9 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Y Other: N Other Description: Ecompasing: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 4514 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 1 PHONE: PHONE: 503-784-9198 FAX: Total Fees: $34,769.41 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR, Specialty Codes - all other X/ -ble 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., .r if work i' u.pended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification -n-r. Tho • r -s are set forth in OAR 952-001-0010 through OAR 952-001-0090. Y -in a copy of the rules or direct questions to OUNC by calling 503.2 '.1•:7 or 1.80' 3'344. 1 /! AlaIssued By: ttee Signature: . t� — ce.' 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 pro.: Approved plans are required on the job site at the time of each inspection. / Building Permit Application fi Residential RECEIVED 1� ro►z orrlc► ist, oNl., City of Tigard Received lA 1/7 J�-� '��� 14 13125 SW Hall Blvd.,Tigard,OR Date/By: * PermitNo.:i i r,Ty7 �13 ■ r of " 7 017 Plan Review Phone: 503.718.2439 Fax: 503. 60 _0^� Date/By: '"� " 1 7 Other Permit: 1 7 W /g7 1 1 G A u D Inspection Line: 503.639.4175-,lTY®F TI�aAR�) Date Ready/By: kris' [ Internet: www.ti and-or. ov t✓ I ® See Page 2 for g g Notified/Method: SupplementalInformation BUILDING DIVISION t /-7 TYPE OF WORK QU D DATA:1-AND 2-FAMILY DWELLING ,Eral New 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. ® 1-and 2-family dwellingr —t) ❑Commercial/industrial Valuation: $S9 7 G�3 ❑Accessory building Number of bedrooms: J I ❑Multi-family ❑Master builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION - Total number of floors: a . r /' C Job site address: ") J � '%� '5 • New dwelling area: -1. 511-/ square feet / les City/State/ZIP: 11 I-``l ,,+?-22'( Gara ge/c arport area: L►�Z square feet Suite/bldg./apt.no.: I Project name: Covered porch area: 4s uare feet Cross street/directions to job site: �'u0' )-- q �j66 Deck area: square feeta� i—;4 v.w y Other structure area: OH j'Tquare feet �- c_.'� REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: V (\. . ��O 5c„-...,; ,vc i i`= I Lot no.: e y Permit fees*are based on the value of the work performed. - Tax map/parcel no.: t lIndicate 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. $r'(� /Vest , Valuation: $ Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER I 0 TENANT Number of stories: Name: l `C lke -moi Type of construction: Address: ' ( 9-. ,A> 5\IN T DU-i Occupancy p y groups: City/State/ZIP: Vt,/ - CiLe�76v - q Existing: Phone:L 7 jb) -tl C(I e Fax:( ) 0 APPLICANT New: CONTACT PERSON BUILDING PERMIT FEES* Business name: (Please refer to fee scheduiee) Contact name: Structural plan review fee(or deposit): Address: FLS plan review fee(if applicable): City/State/ZIP: / Total fees due upon application: Phone:( ) I Fax::( ) Amount received: 0(7Z'' "4 E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of ` roof-top mounted Photo Voltaic Solar Panel System. Business name: 0%4 O V\LNW /‘ Submit two(2)sets of roof plan with connection details Address: and fire department access,along with the 2010 Oregon Solar Installation Specialty Code checklist. City/State/ZIP: 5 ' / Permit Fee(includes plan review Phone:O 7i � r ( ) - and administrative fees): $180.00 State surcharge(12%of permit fee): $21.60 CCB lic.: oCl q, b Total fee due upon application: $201.60 Authorized signature: f,, il/�►- This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: . 4 NI Date: 6 1 !i�,7— I *Fee methodology set by Tri-County Building Industry ` / Service Board. I:\Building\Pennits\BUP-RESPetmitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Building Permit Application Checklist F One- and Two-Family Dwelling 1.0R orri(e: 1 si: oil.) I, City of Tigard Received Permit No.: IN Date/By: 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits: C Phone: 503.718.2439 Fax: 503.598.1960 0 Electrical 0 Plumbing 0 Mechanical 24-Hour Inspection Line: 503.639.4175 1 l L A R Internet: www.tigard-or.gov ❑ Other: 'HIE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW hcs 10 A/‘ 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 0 0 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0 3 Verification of approved plat/lot. 0 0 0 4 Fire district approval required. Name of district: • 0 0 0 5 Septic system permit or authorization for remodel. Existing system capacity 6 Sewer permit. 0 0 0 0 0 ❑ 7 Water district approval. 0 0 0 0 8 Soils report. Must carry original applicable stamp and signature on file or with application. 9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 0 0 basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ 0 0 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. 0 0 0 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 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. 0 0 0 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. 0 0 0 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. 0 0 0 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing 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 over 10 feet long and/or any beam/joist carrying a non-uniform load. 0 0 0 20 Manufactured floor/roof truss design details. 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 0 0 for four or more appliances. 0 0 0 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or 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". 0 0 0 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. AA 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 Q 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 0 0 0 Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 0 0 and protection measures must be drawn to scale and must include the project arborist's signature of approval. 0 0 0 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. I:\Building\Permits\BUP-RESPermitAPp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit A lic EIVED FOR OFFICE USE()NEN City of Tigard Received Date/By: Permit No.: ��r� 13125 SW Hall Blvd.,Tigard,OR 97223 II II rq 7_,00,943 • C Phone: 503.718.2439 Fax: 503.598.1960-'N 62.017 Plan Review Date/By: Other Permit: TI G A R D Inspection Line: 503.639.4175 -�/ +/��j Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov CITY i OF DIVISION t(���@ BUILDING lf�41h7�ON Notified/Method: Supplemental Information TYPE OF WORK AI w7 4i�'6 COMMERCIAL FEE* SCHEDULE - USE CHECKLIST y New construction Mechanical permit fees*are based on the value of the work ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. CATEGORY<OF CONSTRUCTION Value:$ RESIDENTIAL EQUIPMENT/SYSTEMS FEES* 01and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist ❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Job site address: ? C (l- Air conditioning 1 46.75 J �. E Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: -----t 6-4',04) Q(L i7 2 LI _( Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: Project name: Heat pump 61.06 Duct work 23.32 Cross street/directions to job site: 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: ���5'w Lot no.: 1 Li Other: 23.32 � Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OJ WORK Gas fireplace/insert 33.39 ,,,y- 1 l _�� Flue vent for water heater or gas /��`�^3 /�j fireplace 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 0 TENANT Other: 23.32 Name: ` Environmental exhaust and ventilation: \k. w-ii. L- Range hood/other kitchen Address: \,q ` equipment 33.39 5,3 C .s\ • , Clothes dryer exhaust 33.39 City/State/ZIP: . ,, Ott.- Ot 70 Single-duct exhaust(bathrooms, Phone: St.))"] -- .- 1l - toilet compartments,utility rooms) 23.32 ` Fax:( )CONTACT PERSONAttic/crawlspace fans 23.32 APPLICANT <: O' Other: 23.32 Business name: Fuel piping: - $14.15 for first four;$4.03 for each additional / Contact name: Furnace,etc. Address: Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( ) Fax::( ) Fireplace E-mail: Range Barbecue CONTRACTOR Clothes dryer(gas) Business name: 1„..c,.. k. 'aM Other: Address: t._ MECHANICAL PERMIT FEES* 50-t"' —: Subtotal City/State/ZIP: Minimum permit fee($90.00) Phone:( ) Fax:( ) Plan review(25%of permit fee) c ' State surcharge(12%of permit fee) CCB lic.: jd: TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 40' 1Jl days after it has been accepted as complete. Authorized signature: 11 * Fee methodology set by Tri-County Building Industry Service Board Print name: 6.4K:)li ('' N4:3 Date: 1 tiik1I:\Building\Permits\MEC_PermitApp_040113.doc 440-461 (11/02/COM/WEB) City of Tigard Mechanical Permit Application - Page 2 - Supplemental Information Commercial&Multi-Family Fee Schedule: T©tal'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 additiona1,000c:$$00101 $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 From:Elite Electric Group Fax:(888)901-7914 To: Fax: (503)598-1960 Page 1 of 1 07/06/2017 4:26 PM v Electrical Permit Application rOIz uiTlt:r;Hal.:0\IN City of Tigard ` °Vi Received III • 13125 SW Hall Blvd.,Tigard,OR 9 Date/By: Permit K: Phone: 503.718.2439 Fax: 50an Review r�(Al Date/ET: Related Penni!H; T I G A I;1--).. Inspection Line 503.639.4175 b (o Roads patdgy: loris Internet: www.tigard-or.gov Notified/Method: i 1�See Page 2 for t, ^ l Supplemental Information TYPE OF WORD ` -�� 1\S ! PLAN REVIEW ❑New construction 0 Addition/alterati�aYk\rVri Please check all that apply(submit It sets of plans w/items checked): ❑Demolition 0 Other: ``1``1`�`��` 0 Service or feeder 400 amps or more 0 Building over three stories. CATEGORY OF COI hVCTION where the available fault c of (3Marinas and boatyards. exceeds 10,000 amps at I500 colts or 0 Floating buildings. ❑1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14.000 ❑Commcrcial.uso agricultural ❑Multi-family ❑Master builder a for all other installations. buildings. ❑Other: ❑Fire pump. ❑tmtallatian of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system largo-separately derived ❑Addition of new motor load of system. Job 4: I Job site address: 8933 SW Inez St I00HPormore. 13-A-."E".1-2-,1-3, City/State2l P: Tigard,OR 97220 OS ix or more residential units. occupancy. ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: I Project name: 0 Hazardous locations. 0 Supply voltage for more than Cross street/directions to job site: 13Service or feeder 600 amps or more. 600 volts nominal. . FEE SCHEDULE Description I Orr. 1 Ears I Total I • New residential single-or multifamily dwelling unit Subdivision: ' Lot#: Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 168.54 4 DESCRIPTION OF WORK Ea add'I 500ener sq.R.or portion 33.92 i Limited energy,residential (with above sq.ft.) 75.00 2 Add to iermit#MST2017-00213 Limited energy,multi-family residential(with above sq.It) 75.00 2 0 PROPERTY OWNER � .❑ TENANT Renewable Energy (] See Page 2 Name: Services or feeders installation,alteration,and/or relocation 200 amps or less 100.70 2 Address: 201 amps to 400 amps 133.56 2 City/State/ZIP: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2- rOver 1,000 amps or volts 552.26 2 Phone:( ) I Fax:( ) Email: Temporary services or feeders installation,alteration,and/or relocation Owner installation:This installation is being made on property that 1 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 21 ❑ APPLICANT I ❑ CON ACT PERSON Branch circuits-new,alteration,or extension,per panel Business name: A. bo for branch circuits wish aboveservice or r feeder fee, Contact name: each branch circuit - 7.42 B.Fee for branch circuits wirhour Address: service or feeder fee,first branch circuit 56.18 2 City/Slate/ZI P: Each add'I branch circuit 7.42 2 Phone:( ) I Fax::( ) Miscellaneous(service or feeder not included" Each manufactured or modular Email: dwelling,service and/or feeder 67.84 2 Reconnect only 67.84 2 CONTRACTOR Pumpirrigation or gorier cirek 67.84 2 Business name: Elite Electric Group, LLC Sign or outline lighting 67.84 2 Signal`ircuit(s)orlimited-energy Address: 6150 NE 92nd Dr.#104 panel,alteration,or extension. 0 See Page 2 2 Each additional inspection over allowable in any of the above City/State/ZIP: Portland,OR 97220 Additional inspection(1 hr min) 66.25/hr Phone:( 503 432-8845 I Fax:(888)901-7914 investigation it hr min) 90.00/hr Email: Off1Ce(d�eliteeleCtriCpdX,C0111 Industrial plant(I hr min) 78.18/hr Inspections for which no fee is 191274 I ElectricalLic.:C639 I Suprv.Lic.: 5762S specifically listed('/zhrmin) - hr CCB Lic.: Suprv.Electrician signature,required: ELECTRICAL PERMIT FEES Subtotal: Print name: .�� ..e e- -y - Date: 7/6/2017 0 Plan Review Required(25%of permit fee): ..../-3"---,-.77--:,..-<:-. r'" ( ---" State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: Print name: I I This permit application expires if a permit is not obtained within ISO Date: days after it has been accepted as complete. • Number of inspections allowed per permit. 1:1auildinglikrmitalELC_PerntirApp_EIR ERE.dx Rev 06/17/2015 440-4615T(I I/Os/COMAVED Plumbing Permit Application • Building Fixtures RECEIVEDFOR OFFICE USE ONLI' City of Tigard I NI.223 2017 Received 14 . 13125 SW Hall Blvd.,Tigard,a 97223 Date/By: Permit No.: s r 7_00,943 11 Phone: 503.718.2439 Fax: $ � g Plan Review �1 Ins ection Line: 503.639.401 Y ny ���R Date/By: Other Permit No.: TI G A R D p Date Ready/By: tuns: I la See Page 2 for Internet: www.tigard-or.I��'LD1,V�DIVISION V I Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE w construction ❑Demolition For special information use checklist ❑Addition/alteration/replacement ❑Other: Description Qty. Ea. Total 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 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 ❑Master builder Each additional bath/kitchen 25.02 ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: €13?) S c v. -. Catch basin or area drain 18.76 City/State/ZIP: 1 Drywell,leach line,or trench drain -1 18.76 I Footing drain(no.linear ft.: Suite/bldg./apt.no.: Project name: -) Page 2 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 Subdivision: e rr' s=.�t Us„.t. _ I 0 if Fixtureerice(no.linear ft.: ) I Page 2 \� Lot no.: Fixture or item: Tax map/parcel no Backflow preventer 31.27 .,pis P'tION 6t, woii , ,, Backwater valve 12.51 5 - N.e�� Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 RPER `y _ '�R ; - ' .. ,� t, � �. � *� NANT,, , ��„ �� Expansion tank 12.51 Fixture/sewer cap 25.02 Name: I* Address: .5Z-k. ( "� Floor drain/floor sink/hub 25.02 City/State/ZIP: , arbage disposal 25.02 �`4'\A E COC � y� / Hose bib 25.02 Phone: b j ) 7s -__-ct( O G✓ I Fax:( ) Ice maker 12.51 0x APPLIC l 1's'l) 1 +4: 1 0t 40g *"NTA P Interceptor/grease trap tm 25.02 Business name: Medical gas(value:$ ) Page 2 Contact name: Primer 12.51 Address: Roof drain(commercial) 12.51 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 ?; k 1,Y. . '- • _s" e C � � Water closet 25.02 Business name: : .'I‘ Water heater 37.52 " 'LJ r::-.:7144./4„."(/i'!r*/Ad/A/n. Water piping/DWV 56.29 Address: 1(x.1 f I Other: 25.02 City/State/ZIP: ,%/ h k)... el-71,L3 Subtotal Phone:(k).) V j�� Fax:( ) Minimum permit fee: $72.50 CCB Lic.:�(� co,, Plumbing Lic.no.: Plan review (25%of permit fee) �y ?I,. State surcharge(12%of permit fee) Authorized signature:f I I NI 401 TOTAL PERMIT FEE Print name: eO. S RR 41 Date: I 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\PLMO-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 Feer 0 to 2,000 $121.90 Footing drain-ls`100' 50.032,001 to 3,600 $169.69 Footing drain-each additional 100' 37.52 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 Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to Other Inspections or'Fees 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. $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for Additional plan review for revisions 90.00/hr each additional$100.00 or fraction thereof. (minimum charge-1/2 hour) 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 ,ojiewv fol'I lumbiug I>istallations- Quantity by Fixture Type Plan review is required for any of the following. Fixture Type forReplace/ Please check all that apply. Work Performed: ❑ Any 2" Capped' Added Relocate new commercial building with water service and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool 0 New exterior plumbing site utilities for any complex structure Car Wash: -Each Stall as defined in OAR918-780-0040. -Drive Thru 0 Medical gas and vacuum systems for health care facilities. Cuspidor/Water Aspirator 0 Any multipurpose fire sprinkler system. Dishwasher: -Commercial 0 Any complex structure as defined in OAR918-780-0040. -Domestic Drinking Fountain Submit 2 sets of plans with any of the above. Eye Wash Floor Drain/sink: -2" 3,> ; • o1 iC 4Or. ISeIDIagra 4', 3 4" 0 Isometric or riser diagram is required for new buildings -Car Wash Drain that meet the qualifications above. Garbage -Domestic non-food Disposal: -Domestic food related -Commercial food related -Industrial food related Comments regarding fixture work: Ice Mach./Refrig.Drains 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 plumbing permit can be issued. Water Closet-Toilet Urinal Other Fixtures: 1:\Building\Permits\PLMFPermitApp.doe 08/04/2011 2 City of Tigard a COMMUNITY DEVELOPMENT DEPARTMENT I T1caRD Building Permit Review - Residential Building Permit #: 1-t7--c9-eD 1 `l_ Ov a( 3 Site Address: 89 j %,_ pi Project Name: ---- (37p�ixgte (New dwelling � �u 7/-k, Lot #: j 1� =subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: ) S�--/e IV Verify site address/suite# exists and activ in permit system. II 1'' ver Terrace Neighborhood: No ❑ Yes,See River Terrace Review Addendum Attached Si E Plan Elements: ih ree(3)copies of site plan 0-.1V°4‘;sting structures on site pf e plan must be on 8-1/2"x 11"or 11 x 17"paper Vi Footprint of new structure /awn to scale(standard architect or engineer scale) or elevations (including decks)with finished rth arrow . • ty locations&easements(required for new and additions) ife address,project or subdivision name and lot number V Sidewalk/driveway approach plicant information(name and phone number) !' : .tion of wells/septic systems pdimensions and building setback dimensions Rgy: t ting trees to be retained with drip line,and tree are footage of buildings to be demolished .. •tection measures area,building coverage area,percentage of coverage and 7 feet tree size,type and location of pervious area(applicable if R-7,R-12,R-25&R-40) Street names IT roperty corner elevations(2 foot contour lines if more than Ok water quality facility required if>1,000 sf of 4 foot differential) impervious area is created or replaced. Olean Water Services–Service Provider Lett (lot platted prior to 9/10/1995): equired: ❑ y ,applicant was notified No Received: Public Faciliti Improvement(PFI) Permit:t)(11. ❑ Yes ❑ No e aired: q Yes,applicant was notified ❑ No Applied For: �' Yes ❑ No,stop intake f/ioning: and Use Case#: <1,Gt'�0M> J_ 060!D R- /�. `7 tO1Required Setbacks: Front 7 c) Rear /5" Side c— Street Side �,, Garage ^, andscape Requirement: % - � ` tecit Coverage Maximum: Building Height: Maximum Height 30 Actual Height a9– ti,isual Clearance I:-nsitive Lands: ❑ Yes No Type ,�/,, rban Forestry Plan Conditions "Met"prior to issuance of building permit Notes: Approved By Planning: ,, ,/ Date: oar' Revisions (after Building Submittal only) Reviewer Revision 1: ❑ Approved El Not Approved Date Revision 2: El Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw RES 051617.docx Building Permit Submittal Original Submittal Date: - 60/ill 7 Site Plans: # 3 Building Plans: # Building Permit#: 'Enter building permit#above. �� �Btuldin Workflow Routing: Planning [engineering Permit Coordinator g Workflow Sign-off: Sign-off for Planning(include notes from planning review) Route Application Documents: Er Engineering: (1) copy of permit application, (1) site plan, (1) building plan and riginal plan review routing form. Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: N n By Permit Technician: k „A Date: e_c) 7 Engineering Review Slope at building pad: i 7.; 4 Conditions"Met"prior to issuance of building permit 4 Easements (encroachments)per engineering conditions of approval and plat M Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes Arr No Assess Water Quantity Fee in-lieu: ❑ Yes No LIDA Facility on lot: ❑ Yes ,ZNo Date: CINOT Approved by Engineering: Notes: Approved by Engineering: 111.--40 Date: 6017 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 ❑ Yes ::1 N/A rOK to Issue Permit / Approved by Permit Coordinator: Date: I:13uildingTorms\BldgPermitRvw_RES_051617.docx City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 8933 SW INEZ ST, TIGARD, OR, 97224 December 18, 2017 at 10:45:52 AM Record Type: Record ID: Residential - Master Permit MST2017-00213 Inspection Type: Inspector: 199 Electrical final David Young Result: FA I L Comments: Not ready for inspection,work not complete. Ac whips not installed, lights in master bath not installed. no further inspection done. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 8933 SW INEZ ST, TIGARD, OR, 97224 December 18, 2017 at 10:43:47 AM Record Type: Record ID: Residential - Master Permit MST2017-00213 Inspection Type: Inspector: 399 Plumbing final David Young Result: PASS Comments: Previous corrections complete. Note: provide approved thread sealant on cleanout caps by final inspection. OPSC 707 Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 8933 SW INEZ ST, TIGARD, OR, 97224 December 15, 2017 at 12:27:10 PM Record Type: Record ID: Residential - Master Permit MST2017-00213 Inspection Type: Inspector: 399 Plumbing final David Young Result: FA I L Comments: Secure dishwasher to cabinet. Seal base of tub/shower upper level main bath. 407.2 Bring cleanouts to grade. OPSC 719 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: 8933 SW INEZ ST, TIGARD, OR, 97224 December 18, 2017 at 10:44:29 AM Record Type: Record ID: Residential - Master Permit MST2017-00213 Inspection Type: Inspector: 699 Mechanical final David Young Result: FA I L Comments: Ac units electrical not connected. Work not complete, not ready for inspection. No further inspection done. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 8933 SW INEZ ST, TIGARD, OR, 97224 December 19, 2017 at 2:08:27 PM Record Type: Record ID: Residential - Master Permit MST2017-00213 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS Comments: Ac's installed. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 8933 SW INEZ ST, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2017-00213 Inspection Type: Inspector: 699 Mechanical final David Young Result: PASS Comments: Ac's installed. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 8933 SW INEZ ST, TIGARD, OR, 97224 December 21 , 2017 at 7:38:28 AM Record Type: Record ID: Residential - Master Permit MST2017-00213 Inspection Type: Inspector: 299 Final inspection David Young Result: PASS - CofO Comments: Final erosion control approved. Street tree certification received. Moisture content form received. High efficiency lighting form received. Blower door test report received. Insulation certification checked. C of 0 left on site at kitchen counter. Inspection complete 12/20/17. Note: drainage swale with drain installed left side of house. Violation Summary: Inspector Contractor