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Permit (62)
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT RECEIVED . 4 lig Request for Permit Action / 0 1 flUL 0 2021 TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-24 • www.tigard-or. 4 Y OF TIGARD nit,V DIVISION 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: LZ Owner 0 Applicant Ej Contractor E City Staff Check(1)one REFUND OR Name: INVOICE TO: (Business or Individual) RCI" ) y OA c>(1 4-,„ (77 (..\ . Mailing Address: I 3S 5 5 ) ..5 tvif po'A d a 4/- ,..) 1— City/State/Zip: /,...5‘ ,-.---), ) R 7 q Phone No.: CSo—5) i 5 —670- 6, P ASE TAKE ACTION FOR THE ITEM(S) CHECKED (V): CANCEL/VOID PERMIT APPLICATION. REFUND PERMIT FEES (attach copy of original receipt and provide explanation below). INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below.. Permit #: M 5 7 Zoi 7 — Ooze/ Ce tefrkt6tr— elE. Site Address or Parcel #: I 0.5-9.0 5(..,,/ PedAAJ,,,-- tivi T.., J or2q7z-zi Project Name: 51 Subdivision Name: Lot#: '\\ j ) EXPLANATION: ____Tk.c_ 5;Ic tfr-as ail,--,,--c-i /9 o-r- we- _fr---tr-r-C, L-'61 --LIC--- 16t Lit a.."--- iti.,,t. 4‘.---e-. ) I/..kJ.-- tiJ L V i j) Ill.5 1-k 7Li---SIA•e el irr es e9-Al e,--4-14. itivia&,-7)._ /0.si„ . .c. 0 — 4.--Av,-t Ivo 7- 6f3-i 65rx.0-14,-7, Is erp. /y / . .4)e - Signature: .. 27, ,......9 z Date: 7/7 /7-z. / Print Name: rhr2,I.2 "71 62---;:-/d 6/—I Refund Policy 1. The cin''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 • Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended.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')/o of the application or permit fee for issued permits prior to any inspection requests. 2. All refunds will be returned to the original paver in the form of a check via US postal service. 3. Please allow 3-4 weeks for processing refund requests. 4s i g5712.1t1/'T i..SSIZE-b 9 // .2.4,c7 - cep-xi /2-0-1/,, FOR OFFICE USE ONLY Route to Sys Admin: Date By Route to Records: Date 9 ler 7./ By / Refund Processed: Date 49/0. 2../ By ili Invoice Processed: Date By Permit Canceled: Date , 6,/2_, B -tlej Parcel Tag Added: Date By 1:\Building\Forms\ReqermitAction_12 31 8.d'oc q CITY OF TIGARD /2 ,4,v MASTER PERMIT NFL COMMUNITY DEVELOPMENT 6' Permit#: MST2017-00298 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 t' Date Issued: 09/11/2017 TIGARD 9 /� G>;�/r-I/ Parcel: 2S102BC06000 "9-A7 4 Jurisdiction: Tigard Site address: 10540 SW PATHFINDER WAY Subdivision: YOLO ESTATES Lot: 9 Project: OLLISON Project Description: 529 sq.ft.detached garage with 271 sq.ft.of storage&92 sq.ft.deck. Not to be used for sleeping area. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 15 Bathrooms: 1 Second: 271 sf Garage: 529 sf Front: 20 Smoke No Dwelling Units: 0 Third: 0 sf Right: 5 Detectors: Total: 271 sf Value: $38,146.60 Rear: 5 PLUMBING Sinks: 1 Water Closets: 1 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100 Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 1 Backwater Value: 0 Bckflw Prevntr: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 2 Clothes Dryers: 1 Electricity Heat Pump: N Hoods: 0 Other Units: 0 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 1 0-200 amp: 0 W/Svc or Fdr: 7 Ea add'I 500 sf: 0 201-400 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: ACS SF VB R-3 271 Owner: Contractor: OLLISON,RANDY L&CINDY A CLASSIC RANCH LLC Required Items and Reports(Conditions) 3439 SW SCHOLLS FERRY RD 13895 SW BOXELDER ST 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97221 TIGARD,OR 97223 2 Geo Tech Report Approval Required Prior To Pour PHONE: PHONE: 503515-6706 FAX: Total Fees: $2,270.15 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 oc9-nn1-nnln thrni inh OAR oc9-nnl-neon Ynn may nhfnin n rnnv of the rnlec nr rlirert niiocffnnc fn rll imr•by Tallinn cnz 9'19 10R7 nr 1 Ann AZ9 9444 Issued By: 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. FOR OFFICE USE ONLY—SITE ADDRESS: SZ�� s This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 1111 Transmittal Letter 0 r% 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: // kit.t/ DAT IVtivED DEPT: BUILDIG DIVISION JUN 20 2018 FROM: igailayO/I rjcv./ CITY OF TIGARD 1 COMPANY: (r� ' BUILDING DIVISION PHONE: BY: ///4 7. RE: /0fS-`7/6 fit ) 6 7 i� Z /3717—00 r (Site Address) / (Permit Number) (Project name or subdivision name and lot number) ifet Mr-- ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: FOR FFI E USE ONLY _Routed to Perms a ician: Date: ?A (� Initials: Fees Due: MICK ❑No Fee Descri tion. Amount Due: $ Lis . $ Special Instructions: _Reprint Permit (per PE): ❑Yes No' ❑ Done Applicant Notified: � Date: L, /?1 Initials, 1:\Building\Fomis\TransmittalLetter-Revisions_061316.doc u eugene Office (541)345.0289 A Division of Carlson Testing,Inc. Salem Office (503)589.1252 minimen r= Phone:j503)601-8250 Tigard Office (503)684-3460 Fax:(503)601-8254 ":7 n Authorization to Proceed&Work Order Olt'r�r 1 - Or Please complete and return by fax or email to Carlson Geotechnical at 503-601-8254 or nmartes@carlsontesting.com. This document constitutes authorization for Carlson Geotechnical(CGT),a division of Carlson Testing,Inc.(CTI),to provide the services detailed below under the terms of CTI's General Conditions(copy enclosed)dated 3/2013 for the project listed below. EVE This Authorization must be completed,signed,and returned prior to CGT performing services. Thank yoRE C I) , Date: May 14,2018 CGT Proposal No.: GP8062 Project Name: Pathfinder Way ADU Structure J U r,ht I 2 0 2018 Project Type: Limited Geotechnical Investigation Report Project Address/Jurisdiction/State: 10540 SW Pathfinder Way,City of Tigard,Oregon CITY OF TIGARD Scopeof Services: BUILDING DIVISION I N • isit the site and delineate(stake)intended exploration locations for utility locating purposes. 1JS •Contact the Oregon Utilities Notification Center("one-catr)to mark all public utilities located within a 20-foot radius of the staked boring I itgir/ locations. Please note this proposal assumes our client or their representative will be responsible to mark the locations of all private 0 •o- utilities within the same radius. CGT will not be responsible for damage of underground utilities that are not clearly marked at the site. oAs an optional(line item)service,CGT can subcontract a private utility locating service to mark detectable private utilities at the site. c i, •Advance a minimum of 2 hand auger borings and 2 Wildcat Dynamic Cone Penetrometer tests at the site to depths of up to 10 feet below oground surface or practical refusal,whichever occurs first. The explorations will be performed using hand portable equipment provided a. and operated by CGT staff. Representative samples will be collected during advancement of the borings. Soils encountered will be classified in general accordance with ASTM D2488(visual-manual procedure).Upon completion,loosely backfill the borings with cuttings. •Observe and probe the footing subgrades exposed at the time of our field investigation to gauge surface consistency. •Bring the soil samples to our Tigard laboratory for miscellaneous(moisture content,plasticity index)testing. •Perform geotechnical engineering analyses to assess allowable soil bearing pressure and estimate settlements for proposed loads. •Prepare a limited geotechnical report to summarize our investigation,laboratory testing,and analyses. The report will include an opinion of the assumed allowable soil bearing pressure used in footings and recommendations for footing subgrade preparation. In the event soft,loose,or otherwise unsuitable soils are encountered,specific geotechnical recommendations for mitigation will be provided.The report will be considered"limited"as it will not include an evaluation of seismic hazards at the site or seismic design recommendations. Anticipated Schedule: •CGT will perform the field investigation within 1 week of receiving notice to proceed. The fieldwork is anticipated to take up to 1/2 day to complete at the site. The written report will be completed within 1.5 weeks after field investigation is complete. Preliminary findings and recommendations can be conveyed to the client and construction team over e-mail,upon request,to help expedite construction. Fees: •Base Scope of Work: For the scope of services described above,our services will be provided for a fixed fee of$2,190. Full payment of the fixed fee and fine item fee(if authorized)will be required prior to issuance of the written report.Services requested beyond the scope of work listed above will be provided on a time-and-expense basis in accordance with CGTs Schedule of Charges dated 32017. •Optional Line Item:Carlson subcontracts private utility locating service for a line item tee of$250.Authorization: I I client initial Please enter the following billing information: Purchase Order Number(if applicable): Company&Contact Randy 011ison,Classic Ranch LLC € Address: 3439 SW Scholls Ferry Road c m City/State/Zip: Portland,Oregon 97221 mPhone: Fax: Email: 503-515-6706 classicranch@gmaii.com Unless otherwise agreed in wilting,the ordering of work from CGT or use of any work product produced by CGT constitutes acceptance of the attached CTI General Conditions dated 3/2013 and agreement to be bound by the terms and conditions incorporated therein. I certify that I have the authority to sign and enter into this agree r4�r�agree to be bound its terms. Signature of Authorized Re esentative: , Printed Name: / lit' .4/c 1,f c Q„_, Date: , 2.0/ Company Name: Phone: 'Q .__,r/ I U Zr CLI,rS c ,I?/ - 1r- I/ LI • nrl "r a b t 1— Dc cr OFFICE COPY IIIII „: " City of Tigard r l n►z I) Accela Refund Request This form is used for refund requests of land use, development engineering and building permit application fees. Receipts, documentation and the Request for Permit Action form (if applicable) must be attached to this request form. Refund requests are due to Accela System Administrator by each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts Payable will route refund checks to Accela System Administrator for distribution to applicant. PAYABLE TO: Randy 011ison DATE: 9/6/2021 13895 SW Boxelder St Tigard, OR 97223 REQUESTED BY: Dianna Ornelas TRANSACTION INFORMATION: Receipt#: 412567 Case#: MST2017-00298 Date: 8/29/2017 Address/Parcel: 10540 SW Pathfinder Way Pay Method: Check Project Name: 011ison EXPLANATION: Per applicant's request void permit for new detached garage and resubmit for a new detached ADU under 10538 SW Pathfinder Way. Refund 80% of permit fees. ADU approval yet to be obtained. REFL?ND1NFORDiATiON: i ._.._._ _..._... ..._.__. .._..___.. r /4 Fee Description From 1-tt,�.eipi i Kk:VeilkJe. ccount No. Reiund i Example: Building Permit Fee i.,,...ti.ple: 2300000-43104 $Amount _Building permit fee 230-0000-43104 $441.58 Electrical permit fee 220-0000-43103 122.11 Mechanical permit fee 230-0000-43102 64.02 Plumbing permit fee 230-0000-43101 270.18 12% State Surcharge 100-0000-24001 113.15 TOTAL REFUND: $1,011.04 APPROVALS: SIGNATURES/DATE: If under$5,000 Professional Staff If under$12,500 Division Manager �� L iyz ' If under$25,000 Department Manager If under$100,000 City Manager If over$50,000 Local Contract Review Board FOR ACCELA SYSTEM ADMINISTRATION USE ON ` t ", . t ;°, Case Refund Processed: LY Date: Vj/p/zy By: / ' I:\Building\Refunds\RefundRequest.doc x 09/01/2010 71 CITY OF TIGARD RECEIPT it; `; 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 T[GAR D Project Name: OLLISON Site Address: 10540 SW PATHFINDER WAY P Receipt Number: 436378 - 09/10/2021 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID MST2017-00298 $-1,011.04 Total: $-1,011.04 PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 240501 DHOWSE 09/10/2021 $-1,011.04 Payor: Randy 011ison Total Payments: $-1,011.04 Balance Due: $1,056.04 Page 1 of 1 CITY OF TIGARD RECEIPT 0 13125 SW Hall Blvd.,Tigard OR 97223 � 503.639.4171 TI4 r_1AII0 Project Name: OLLISON Site Address: 10540 SW PATHFINDER WAY ,1-4+-1-77-1-S7-�A Receipt Number: 412567 - 08/29/2017 -e..c.J P® o CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID MST2017-00298 DC Provision Review, SF-Ping 100-0000-43112 $90.00 MST2017-00298 Info Process/Archiving-Lg $2.00(over 230-0000-43135 $20.00 11x17) MST2017-00298 Info Process/Archiving-Sm$0.50(up to 230-0000-43135 $7.50 11x17) MST2017-00298 Erosion Control w/Development 100-0000-43134 $107.60 MST2017-00298 Plan Review 230-0000-43106 $-232.79 MST2017-00298 Plan Review 230-0000-43106 $7.16 MST2017-00298 Building Permit-RES 230-0000-43104C rort. s, $608.23 MST2017-00298 12% State Surcharge-Building 100-0000-24001 ,S p-, 99 $72.99 e MST2017-00298 Electrical Permit 220-0000-43103 /-2.2 4/ $152.64 MST2017-00298 12% State Surcharge-Electrical 100-0000-24001 /% 40 $18.32 MST2017-00298 Mechanical Permit-RES 230-0000-43102 ‘t/,®pz, $80.03 MST2017-00298 12% State Surcharge-Mechanical 100-0000-24001 7. 69 $9.60 e MST2017-00298 Plumbing Permit 230-0000-43101 .270,/t $337.73 MST2017-00298 12% State Surcharge-Plumbing 100-0000-24001 .32. f,2r $40.53 6 5444.—Total: 1,319.54 771Z- f-E7� ; �f,is0 H PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 2943 JDRINKWATER 08/29/2017 $1,319.54 Payor: Randy 011ison/Classic Ranch, LLC Total Payments: $1,319.54) lir- Balance Due: $45.00 A. --A/ gfiriat) ® /2 04 Su.,z.Gl, � 7 f/ SF, 3? /4/.. G f® 7• k f r f nevi /$-u/La r.J L yF-t,,, .Se, 3 a .L/.1— ,7- zs — ys.00 star `�e //3 75 _ e� A yy/ , � A raj,i � i ° Jc' .5 3 /d 7,1.- / 9t,/tb '7•55 ,Z r A? . vs' ® / , if 4/ ✓ 7-47 4-4-- / e, 1.`4-s1.- fit` Page 1 of 1 CITY OF TIGARD RECEIPT j g 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD Project Name: OLLISON Site Address: 10540 SW PATHFINDER WAY 0/1--(C ,NlZ_ Receipt Number: 412567 - 08/29/2017 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID MST2017-00298 62,7 Building Permit-Additions,Alterations, 230-0000-43104 $608.23 t, Demolition MST2017-00298 12%State Surcharge-Building 100-0000-24001 $72.99 v MST2017-00298 DC Provision Review, SF-Ping 100-0000-43112 $90.00 MST2017-00298 Info Process/Archiving-Lg $2.00 (over 230-0000-43135 $20.00 — 11x17) MST2017-00298 Info Process/Archiving-Sm $0.50(up to 230-0000-43135 $7.50 11x17) MST2017-00298 r Services or Feeders-200 amps or less 220-0000-43103 l $100.70 v MST2017-00298 6 Branch Circuits w/Purchase Service or 220-0000-43103 /5 2 14 \` $51.94 ,, Feeder MST2017-00298 12%State Surcharge-Electrical 100-0000-24001 $18.32 v MS12017-00298 f Hose Bib 230-0000-43101 $25.02 s MST2017-00298 Je) Sink 230-0000-43101 $25.02 4-i MST2017-00298 P Lavatories 230-0000-43101 $25.02 o MST2017-00298 le Tub/Shower/Shower Pan 230-0000-43101 $12.51 MST2017-00298 f Water Closet 230-0000-43101 $25.02 V MST2017-00298 J° Water Heater 230-0000-43101 $37.52 ./ MST2017-00298 12%State Surcharge-Plumbing 100-0000-24001 $40.53 ✓ MST2017-00298 Erosion Control w/Development 100-0000-43134 $107.60 MST2017-00298 Plan Review 230-0000-43106 $-232.79 MST2017-00298 ') Clothes Dryer Exhaust 230-0000-43102 $33.39 MST2017-00298 M Single Duct Exhaust(Bathrooms, Toilet, 230-0000-43102 $46.64 Utility Rooms) MST2017-00298 12% State Surcharge-Mechanical 100-0000-24001 $9.60 ✓ MST2017-00298 /" Sanitary Sewer 230-0000-43101 $62.54 ✓ MST2017-00298 f Storm Sewer 230-0000-43101 $62.54 ✓ MST2017-00298 f Water Service 230-0000-43101 $62.54 ✓ MST2017-00298 Plan Review 230-0000-43106 $7.16 — Total: $1,319.54 PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 2943 JDRINKWATER 08/29/2017 $1,319.54 Payor: Randy 011ison/Classic Ranch, LLC Total Payments: $1,319.54 Balance Due: $45.00 E-CC-a2--r7—r mot-L /34- ,-r f i'l C /t4 hLMMiv,Cr.t-_ /A c7c, - /5•Q• 6V 3S1 73 Pa 03 iv/ . yY k ef'a ve i' ire 'Zc x eFe 41 7` CPO a) r f- c -� � // '3 . 1 S = S�1. 1?� %/ '� v"� 710 . /F � e 0 !` ef• •23 /0-C6 . 0 Page 1 of 1 �, CITY OF TIGARD MASTER PERMIT ' COMMUNITY DEVELOPMENT Permit#: MST2017-00298 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/11/2017 Parcel: 28102BC06000 Jurisdiction: Tigard Site address: 10540 SW PATHFINDER WAY Subdivision: YOLO ESTATES Lot: 9 Project: OLLISON Project Description: 529 sq.ft.detached garage with 271 sq.ft.of storage&92 sq. ft. Not to be used for sleeping area. BUILDING Floor Areas Required Setbacks Required . Stories: 2 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 15 Bathrooms: 1 Second: 271 sf Garage: 529 sf Front: 20 Smoke Dwelling Units: 0 Third: 0 sf Right: 5 Detectors: No Total: 271 sf Value: $38,146.60 Rear: 5 PLUMBING Sinks: 1 Water Closets: 1 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 1 Water Lines: 100 Drains: 0 Catch Basins: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 1 Backwater Value: 0 Bckflw Prevntr: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 2 Clothes Dryers: 1 Electricity Heat Pump: N Hoods: 0 Other Units: 0 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit . Service Feeder . Temp Srvc/Feeders . Branch Circuits . 1000 sf or less: 0 0-200 amp: 1 0-200 amp: 0 W/Svc or Fdr: 7 Ea add'l 500 sf: 0 201-400 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: ACS SF VB R-3 271 Owner: Contractor: OLLISON,RANDY L&CINDY A CLASSIC RANCH LLC Required Items and Reports(Conditions) 3439 SW SCHOLLS FERRY RD 13895 SW BOXELDER ST 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97221 TIGARD,OR 97223 PHONE: PHONE: 503515-6706 FAX: Total Fees: $2,173.31 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 Ce - ose rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling • 2 s87•- :00.332.2344. -- ,4c9;t5j/ sc.:::. .._._.___._.________ Issued By: Permittee Signature: i �. Call 503.639.4175 by 7:00 a.m.for the next available inspectio date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Applicatio c EIV ,:' ; , *Resi iential 1 R 01:11(1. t sl:0\1.1 City of Tigard a f Received ^� q 13125 SW Hall Blvd.,Tigard,OR 97223 ��� Date/By: 7 Permit No.: $7)4)/ !—CIC't71. C Phone: 503.718.2439 Fax: 503.598 Plan Revi p T I C A K D Inspection Line: 503.639.4175 � "' O TIGARD Date/By: 7 1 7 1a Other Permit: Date Ready/By: Ajp, kris: la See Page 2 for Internet: www.tigard-or.gov '.4DING ; 1S'O ; Notified/Method: }-3 /, Supplemental Information �,R i,- /0.,,,--7-1,4...„___ .2.07 TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING NI New construction 0 DemolitionRECEIVED Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all 0 Addition/alteration/replacement 0 Other: _ equipment,materials,labor,overhead and the profit for the CATEGORY OF CONSTRUCTION AUG }' work indicated on this application. 1 z7,...-"'-. ❑ 1-and 2-familydwellingValuation: �r/�; ^1 0 Commercial/industrial4=000s �i ._ pl Accessory building ]�CITY OF TIGARD Number of bedrooms: 3 t,_t q 7 ❑Multi-fami UILDING DIVISION ❑Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 1 0C� � ) Pat1rgN IP . Wpb New dwelling area: square feet City/State/ZIP: 1760.4/b / 9 4.ZZ 1 Garage/carport area: 5-2,4/ square feet Suite/bldg./apt.no.: Project name: ?A p `k y Covered porch area: square feet Cross street/directions to job site: Deck area: �v � 4 � '1Ci�ti4 c'1: CZ,.,, square feet (414 Pe rrt‘CA4W 684eAegf-0101040.01.04 .444148�� ` square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: I Lot no.: Permit fees*are based on the value of the work performed. Tax map/parcel no.: 2.tj 102 PGO to OO O 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. AM lotliD4415e Cfrt L// ow 41A0 WI. fIIRt44. Valuation: $ Existing building area: square feet of c 5h C gt'/ 1st[1;4 wo • New building area: square feet 14 PROPERTY OWNER 0 TENANT Number of stories: Namegas tu: oy Qcoll Type of construction: Address: Q,34 % 4tAu oLA9 p i Occupancy groups: City/State/ZIP: IVit:N(,1D op- q Y,...; fop./ �iZ-I Existing: Phone:(503) S►S - (p7G,_ Fax:( ) New: pa APPLICANT Q CONTACT PERSON BUILDING PERMIT FEES* Business name: pu f 5n)D,D Uf'i' ..tu (Please refer to ee schedule) Contact name: 7 Structural plan review fee(or deposit): VAN Vu Address: rte, E2A of; 1,41..k. 1440 FLS plan review fee(if applicable): City/State/ZIP: �atnA+0b e a., O1 fill 1 Total fees due upon application: � t9 Phone:(t4,t) 5441, lig 3 Fax::( ) Amount received: E-mail: 'rU PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* @ Pop0t-stvnlo. conk CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted Photo Voltaic Solar Panel System. Business name: (4p>51 G oft/cmwt✓ C L,4 is 1 c (2,4-A.14-1f- and two(2)sets of roof plan with connection details Address: 13 is- �L� and fire department access,along with the 2010 Oregon ® 5W tdx' llv>< s'. _ Solar Installation Specialty Code checklist. City/State/ZIP: 11040 / os-, e Permit Fee(includes plan review 1and administrative fees): $180.00 Phone:( o ) cis-- 6706 Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.: 16;`f"2_ `f" 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. I Print name: , YG Date: 6.71.,..C" *Fee methodology set by Tri-County Building Industry r 1� Service Board. I:\Building\Pennits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Building Permit Application Checklist One- and Two-Family Dwelling FOR OFI.ICF 1.SF 0\1,1 ,-, a• City of Tigard Received Permit No.: Date/By: ■ 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits: = Phone: 503.718.2439 Fax: 503.598.1960 0 Electrical 0 Plumbing 0 Mechanical 24-Hour Inspection Line: 503.639.4175 Q Other: T t c n u D Internet: www.tigard-or.gov THE FOLLOW ENG ITEMS ARE REQUIRED FOR PLAN REVIEW les 10 Ai:1 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 ❑ 0 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0 3 Verification of approved plat/lot. 4 „Fire district a proval required. Name of district: • 0 0 0 5 Septic system permit or authorization for remodel. Existing system capacity 0ElEl El 0 0 6, Sewer permit. 0 0 0 7 Water district approval. 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. ❑ ❑ 0 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 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. 13 El 0 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size and location. ❑ 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 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 ❑ ❑ 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. X. 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". ❑ El Two(2)sets each are required for Items 16,19,20 and 22 above. 25 Building nlans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 9 ❑ ❑ 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 0 Q 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 Street Tree List. 0 0 0 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, and protection measures must be drawn to scale and must include the project arborist's signature of approval. CI ❑ 0 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9,1995. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Application FOR OFFICE USE ONLY City of Tigard Received Ht I -7� a Date/By: Permit No.: 4 13125 SW Hall Blvd.,Tigard,OR 97223 ` Plan Review Phone: 503.718.2439 Fax: 503.598.19 ,., Date/By: Other Permit: TIGARD Inspection Line: 503.639.4175 Date Ready/By: tuns: Internet: www.tigard-or.gov ��\�( 61 See Page 2 for WG y Notified/Method: Supplemental Information . e - -TYPE OF WOR � '� COMMERCI iL FER*SCI EDULE :USI CHECKLIST �j rill Mechanical permit fees*are based on the value of the work ❑X New construction 0 Addition/alters r i. : .C ment� performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ Fl CATEGORY OF CONSTRUCTION e: :: . - n.. u I ESIDENTIAL,EQUIPIYIENT/SYSTEMS I ES* ❑ 1-and 2-family dwelling 0 Commercial/industrial ❑x Accessory building For special information use checklist. ❑Multi-family 0 Master builder 0 Other: Description P Qty. ` Ea. Total Heating/cooling: 4O13 Silk. tP,T9.. :19,11T' LOCATION g g Air conditioning 46.75 Job site address: 10540 SW PATHFINDER WAY Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: TIGARD/OR/97221 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: SW PATHFINDER ACCESSORY STRUCTURE Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 SW PATHFINDER WAY&SW 107TH CT. 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: Lot no.: Other: 23.32 Other fuel appliances: Tax map/parcel no.: 2S102BC06000 Water heater 23.32 = I?ESCRIp LON ®Fv woRK-; ,, . .. ,. . "` ` Gas fireplace/insert 33.39 Flue vent for water heater or gas AN DETTACHED GARAGE/GUESTHOUSE LOCATED ON THE NORTHEAST CORNER OF THE PROPERTY.THE fireplace 23.32 ACCFSSORY STRI ICTI IRF IS I nCATFD RFYONr THF RFOI IIRFIl 5'SFTRACK FROM THF PROPFRTY 1 INFS THF TOTAL FOOTPRINT OF THE STRUCTURE IS 518 SF<528 SF REQUIRED BY THE CITY OF TIGARD.THE Log lighter(gas) 23.32 CALCULATED HEIGHT OF THE STRUCTURE IS 15',THE MAXIMUM HEIGHT ALLOWED BY THE CITY OF TIGARD. Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 ' 12 PRQPERTY OWNER 4 . 0 4.: Other: 23.32 Environmental exhaust and ventilation: Name: RANDY OLLISON Range hood/other kitchen Address: 3439 SW SCHOLLS FERRY RD equipment 33.39 Clothes dryer exhaust 1 33.39 33.39 City/State/ZIP: PORTLAND,OR 97221 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) leo 23.32 Phone:( 503) 515-6706 Fax:( ) Attic/crawlspace fans 23.32 ❑1<4PPI ICAN'I` .E Rlirj CONTACT PERS N 0 ' " Other: 23.32 Business name: Fuel piping: CLASSIC RANCH LLC $14.15 for first four;$4.03 for each additional Contact name: RANDY OLLISON Furnace,etc. Address: 13875 SW BOXELDER ST. Gas heat pump Wall/suspended/unit heater City/State/ZIP: TIGARD/OR/97223 Water heater Phone:( 503)515-6706 Fax::( ) Fireplace Range E-mail: CLASSICRANCH@GMAIL.COM Barbecue `, ' „ CONTRACTOR xI k i„4 Clothes dryer(gas) Business name: CLASSIC RANCH LLC Other: MECITANICALPERMIT,FEES* Address: 138V5 SW BOXELDER ST. Subtotal 33.39 City/State/ZIP: TIGARD/OR/97223 Minimum permit fee($90.00) 90.00 Phone:( 503)515-6706 Fax:( ) Plan review(25%of permit fee) 22.50 State surcharge(12%of permit fee) 10.80 CCB lic.: 163402 s/q it / TOTAL PERMIT FEE 123.30 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized s a re: * Fee methodology set by Tri-County Building Industry Service Board Print name: kA'Ut2y Ow*AA1 Date: 64 eZ, / 1 L\Building\Permits\ .C_PermitApp_040!13.doc 440-4617T(I1/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information ' • Commercial & Multi Family Fee Schedule: Total` a nation Permit) e: , $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 Application FOR OFFICE USE ONLY . City of Tigard .per ' \lP Received permit#: 13125 SW Hall Blvd.,Tigard,OR 9 „ Date/B : /t 1"0v Plan Review Phone: 503.718.2439 Fax: 503.59 .196O9 101 Date/B : Related Permit#: T[G A R D Inspection Line: 503.639.4175 n Ucj 01 AIL Date/By: Buis: See Page 2 for Internet www.tigard-or.gov N �, \A Notified/Method: Supplemental upplemental Information 7. u.,. u -1.r-:n ,. ytx:DF.WOM `_ �. � .,� i c. .' t.; mak- in PLAN�REVIE . . 4- ❑X New construction 0 Addition/alter em nt Please check all that apply(submit 2 sets of plans w/items checked): ❑Service or feeder 400 amps or more ❑Building over three stories. 0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards. C T1'OO t `OF; '� , ;� . �; $TRITIQWNI„Su',.,,„,.,w--Zi- exceeds 10,000 amps at 150 volts or 0 Floating buildings. ❑ 1-and 2-family dwelling 0 Commercial/industrialx❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural El Multi-family 0amps for all other installations. buildings. Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or ,``JOB,SITS' ORMA SAND LO 4TION 0Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: Job site address: 10540 SW PATHFINDER WAY 100111P or more. ❑"A","E","t-2","1-3", City/State/ZIP: TIGARD/OR/97221 ❑Six or more residential units. occupancy. 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: SW PATHFINDER ACCESSORY STRUCTURE 0 Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal Cross street/directions to job site: 44 4 4 s. FEE sTiEDULE `,,. 4 7 SW PATHFINDER WAY&SW 107TH CT. Description Qty. Each TotalI * New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.ft.or less168.54 (G 4 Tax map/parcel#: 2S102BC06000 Ea.add'(500 sq.ft.or portion 33.92 1 `' DESCRIPTION OF.uWORK ,,.. 474 ,., Limited energy,residential 75.00 2 AN DETTACHED GARAGE/GUESTHOUSE LOCATED ON THE NORTHEAST CORNER OF THE PROPERTY.THE (with above sq.ft.) ACCESSORY STRUCTURE IS LOCATED BEYOND THE REQUIRED 5'SETBACK FROM THE PROPERTY LINES.THE Limited energy,multi-family TOTAL FOOTPRINT OF THE STRUCTURE IS 518 SF<528 SF REQUIRED BY THE CITY OF TIGARD.THE residential(with above sq.ft.) 75.00 2 CALCULATED HEIGHT OF THE STRUCTURE IS 15',THE MAXIMUM HEIGHT ALLOWED BY THE CITY OF TIGARD. Renewable Energy 0 See Page 2 4. ® PROPERTY OWNER - 0 TENANT; , ,}'. = e,Ri Services or feeders installation,alteration,and/or relocation Name: RANDY OLLISON 200 amps or less ( 100.70 SID. }p 2 Address:3439 SW SCHOLLS FERRY RD 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:PORTLAND, OR 97221 601 amps to 1,000 amps 301.04 2 Phone:( 503 )515-6706 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 less59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps lgir 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 "0-4„ Branch circuits—new,alteration,or extension,per panel ® APPLICANT..:;," «�.. . ,,., �❑�COI�TACT.PERSON, , � �r- A.Fee for branch circuits with Business name: CLASSIC RANCH LLC above service or feeder fee, `/ 7'42 2 Contact name: RANDY OLLISON Feeh orbrancirci c 1t B.Fee for branch circuits without Address: 13875 SW BOXELDER ST. service or feeder fee,first 56.18 2 branch circuit City/State/ZIP: TIGARD/OR/97223 Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( 503)515-6706 Fax::( ) Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email: CLASSICRANCH@GMAIL.COM Reconnect 41only67.84 2 ,4: t ` CON.TRACTOR � �i. >�, �'r Pump or irrigation circle 67.84 2 Business name: ROBERT'S ELECTRIC INC Sign or outline lighting 67.84 2 Address: 5170 SW DOVER LANESignal circuits)or limited-energy 0 See Page 2 2 panel,alteration,or extension. City/State/ZIP: PORTLAND/OR/97225 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:( 503)572-3230 Fax:( ) Investigation(1 hr min) 90.00/hr Email: Industrial plant(I hr min) 78.18/hr Inspections for which no fee is CCB Lic.: 9388 SI),Ii1 I l Electrical Lic.: 34-23C Suprv.Lic.: 38865specifically listed('Y hr min) 90.00/hr ,;a ELECTRICAL.PERMIT FEES Suprv.Electrician signature,required: Subtotal: Z 4 CI . 44 Print name: ROBERT MCQUAID Date:08/02/2017 0 Plan Review Required(25%of permit fee): G? $1 P/14 / 9State surcharge(12%of permit fee): 3Q 3I'Authorized signature: C�/(cn.., TOTAL PERMIT FEE: 368 .f5 G This permit application expires if a permit is not obtained within 180 Print name: ROBERT MCQUAID Date: 08/02/2017 days after it has been accepted as complete. * Number of inspections allowed per permit. C\Building\Permits\ELC_PernitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11 05/ 1 Electrical Permit Application—City of Tigard Page 2—Supplemental Information • Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORKxONLX : 1' ..AFEF SCHEDULE, it Description I Qty. I Each I Total I * 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 a dan withkvOAR(fee 918-309-0inaccor040)ce 552.26 2 ❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 El Vacuum Systems* >100 kva-no additional charge 0.0 3 Each additional inspection over allowable in any of the above: ❑ Other: Each additional inspection is 66.25/hr 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(A.hr min) ;ELECTRICAL PERMIT'FEES COMMERCIAL WORK ONLY: Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ 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 I:\Building\Permits\ELCPermitAppELR_ERE.doc Rev 06/17/2015 4 Plumbing Permit Application . Building Fixtures FOR OFFICE USE ONLY City of Tigard •ate/B d Permit No.: NSTott Z/W(/� e u 13125 SW Hall Blvd.,Tigard,OR 97223 t"'' �,j11 y' :1 = Plan Review ��111 Phone: 503.718.2439 Fax: 503.598.1960 Other Permit No.: Inspection Line: 503.639.4175 AU ii I) 2017 Date/By:t�U Date Ready/By: lwis: ® See Page 2 for Internet: www.tigard-or.gov tified/Method Supplemental Information TYPE O..WORK OF ,. FEE* e ; ._. _ ., ._ _;.. 4 .„. I 1 Ort 1..a ...< i ...,:_ - iILE .. . , ®New construction 0 De t` U 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) rCATEGORY OF ICON TRUCTION : - ,' SFR(1)bath 312.70 ❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ®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 O MATION Al OCATIONIN Ps Site utilities: Job site address: 10540 SW PATHFINDER WAY Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: TIGARD/OR/97221 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: 1 Project name: SW PATHFINDER ACCESSORY STRUCTURE Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 SW PATHFINDER WAY&SW 107TH CT. 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.: 2S102BC06000 Backflow preventer 31.27 PTION OO F RK ' £ Backwater valve 12.51 _'> ''' ' DES I .. :. : , . .s.. ,''''E _ 4AktClothes washer 1 25.02 25.02 AN DETTACHED GARAGE/GUESTHOUSE LOCATED ON THE NORTHEAST CORNER OF THE PROPERTY. Dishwasher 25.02 TI IC ACCCGTII COBY SUCTUIIC IS LOCATED BEYOND TI IC r1000IIICD 5'SETBACK MOM TI IC rrIOr EnTY LINES.THE TOTAL FOOTPRINT OF THE STRUCTURE IS 518 SF<528 SF REQUIRED BY THE CITY OF Drinkingfountain 25.02 TI(IARf THF('Al n111 ATFr1 HFI(;HT(IF THF STRI ICTI IRF IS 15'THF MAXIMI IM HFIGHT Al I(1WFfl RY THF CITY OF TIGARD. Ejectors/sump 25.02 ® ROPERTY,OWNER :� 1 0 TENANT �? Expansion tank 12.51 Fixture/sewer cap 25.02 Name: RANDY OLLISON Floor drain/floor sink/hub 25.02 Address: 3439 SW SCHOLLS FERRY RD Garbage disposal 25.02 City/State/ZIP: PORTLAND, OR 97221 Hose bib 1 25.02 25.02 Phone:( 503)515-6706 Fax:( ) Ice maker 12.51 � Interceptor/grease ® APPLI+�ANT !---t-'1",:*-- ❑,CONTACT PERSONtrap 25.02 Business name: CLASSIC RANCH LLC Medical gas(value:$ ) Page 2 Contact name: RANDY OLLISON Primer 12.51 Roof drain(commercial) 12.51 Address: 13875 SW BOXELDER ST. Sink/basin/lavatory 2 25.02 50.04 City/State/ZIP: TIGARD/OR/97223 Solar units(potable water) 62.54 Phone:( 503)515-6706 Fax::( ) Tub/shower/shower pan 1 12.51 12.51 E-mail: CLASSICRANCH@GMAIL.COM Urinal 25.02 V �CONTRACTOR I Water closet 1 25.02 25.02 �.. ti.� t Water heater 7 37.52 name: _ _ li 0 At,N Ll el6EWater piping/DW V 56.29 rtKiness ddress: 13 . ,0679-66- 0�:- /47/Ai6 Lie..., Other: 25.02 City/State/ZIP: T /O lOff. Iti 7y t?/266-v,,°` C', 0/2 Subtotal Phone:( x/5,7,e Fax:( ) 7115 Minimum permit fee: $72.50 137.61 CCB Lie.: 463461 Plumbing Lic.no.: 87 J P P `�[js Plan review (25%of permit fee) 34.05 State surcharge(12%of permit fee) 16.52 Authorized signature: ''Q TOTAL PERMIT FEE 188.18 e/--- This permit application expires if a permit is not obtained within 180 days Print name: ��a K © u Date: � ' !�2 after it has been accepted as complete. 1� f *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-PemsitApp.doc 10/01/09 440-4616T(I 0/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site;Uti`hhes y ` Fee:(ea) Thal 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: Peritllt 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 ,,,., zons ar Fees _ TOW each additional$100.00 or fraction thereof,to 'Other nspecti (` and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for (minimum charge 1/2 hour) each additional$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Quantity by Fixture Type Plan Review for,Plumbing Installations.. Fixture Type for Replace/ Plan review is required for any of the following. Work Performed: Capped Added Relocate Baptistry/Font Please check all that apply. Bath Tub/Shower 0 Any new commercial building with water service 2"and Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed Car Wash -Each Stall engineer. Drive Thru 0 New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918-780-0040. Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities. -Domestic 0 Any multipurpose fire sprinkler system. Drinking Fountain 0 Any complex structure as defined in OAR918-780-0040. Eye Wash Floor Drain/sink -2" Submit 2 sets of plans with any of the above. -3', Isometric or.Riser Diagram Car Wash Drain 0 Isometric or riser diagram is required for new buildings Garbage -Domestic-non-food Disposal -Domestic-food related that meet the qualifications above. -Commercial-food related -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang -Stall Sink/Lav -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter *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:\Program Files(x86)\PDF Tools AG\3-Heights(TM)Document Converter Service\Temp\Scde9cd2e1 a0b868e78c81b5ddbace03.doc Branden Taggart From: Tuan Vu <tuan@propelstudio.com> Sent: Wednesday, September 06, 2017 11:48 AM To: Branden Taggart; Randy&Cindy 011ison Cc: #Building Permit Technicians Subject: Re: MST2017-00298, 011ison, 10540 SW Pathfinder Way Hey Branden, Thank you. I will cc this info to our client/ GC of the project. Best, Tuan. Tuan Vu LEED BD+C Propel Studio I www.propelstudio.com I (541)579-1193 15229 NE MLK BLVD Ste 101,Portland,OR 97211 On Wed, Sep 6, 2017 at 10:52 AM, Branden Taggart<brandent(a,tigard-or.gov>wrote: Hello Tuan, I'm following up on the building permit for Randy 011ison located at 10540 SW Pathfinder Way. The fees have been paid, and we just need a licensed plumbing contractor to issue this permit. Once you have found a plumbing contractor with a valid plumbing license, I can issue this permit to you. Also, once issued,the plans will need to be picked up. If you have any questions, please let me know. Thanks, Branden Taggart ISk4 City of Tigard is ,. Permit Technician Community Development TIC'A RD 13125 SW Hall Blvd Tigard,OR 97223 (503)718-2449 brandent@tigard-or.gov 1 . , From:Tuan Vu [mailto:tuan@propelstudio.com] Sent: Wednesday, August 23, 2017 1:09 PM To: Debbie Adamski <DEBBIE@tigard-or.gov> Cc:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Subject: Re: MST2017-00298, 011ison, 10540 SW Pathfinder Way Hi Debbie, Thank you so much for the info. I will forward this to our client. Best, Tuan. On Aug 23, 2017 10:26 AM, "Debbie Adamski" <DEBBIE@tigard-or.gov>wrote: Tuan, This permit is ready to issue and the balance due is $1,319.54. You can pay the fees online at https://aca.accela.com/tigard/by searching for the permit number, or in person when you pick up the permit, Monday-Thursday, 8:00 am to 4:30 pm. We are closed on Fridays. z The listed contractor for the plumbing work is Classic Ranch LLC. They do not have a valid plumbing license and we cannot issue this permit with just a journeyman plumber's license. Prior to issuance of this master permit a valid plumbing company, with both a construction contractor's license and a plumbing license will need to be identified for this project. Please let us know if you have any questions on this. Debbie Adamski Senior Building Permit Technician City of Tigard I Community Development 2 ` .13l25SWHall Blvd., Tigard, OR 97223 503-718-2450 DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e- mail may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained by the City of Tigard in compliance with the Oregon Administrative Rules "City General Records Retention � � Schedule." Albert Shields From: Albert Shields Sent: Tuesday, August 15, 2017 9:48 AM To: 'tuan@propelstudio.com' Cc: Kenny Fisher Subject: RE: MST2017-00298, 10540 SW Pathfinder Way Tuan, your revised site plan shows the existing sewer, storm, and water lines but does not show the three sanitary sewer easements that are shown on the plat. Please revise your site plan to show those easements and resubmit. Please let me know if you have any questions. Albert Shields From:Albert Shields Sent: Monday,August 07, 2017 6:31 PM To: 'tun@propelstudio.com'<tun@propelstudio.com> Cc: Kenny Fisher<Kenny@tigard-or.gov> Subject: MST2017-00298, 10540 SW Pathfinder Way Tuan, upon reviewing the plans and site plan submitted with this permit, Engineering has noted that there are existing easements on the property that are not shown on the site plan. Please revise the site plan to show all easements including the 20' sanitary easement shown on the plat and re-submit. Plan Review will proceed but the permit will not be issued until a satisfactory site plan is submitted. Please let me know if you have any questions. Albert Shields 1 Albert Shields From: Albert Shields Sent: Monday,August 07, 2017 6:31 PM To: 'tun@propelstudio.com' Cc: Kenny Fisher Subject: MST2017-00298, 10540 SW Pathfinder Way Tuan, upon reviewing the plans and site plan submitted with this permit, Engineering has noted that there are existing easements on the property that are not shown on the site plan. Please revise the site plan to show all easements including the 20' sanitary easement shown on the plat and re-submit. Plan Review will proceed but the permit will not be issued until a satisfactory site plan is submitted. Please let me know if you have any questions. Albert Shields AL3 % E r4 Srz Wt rLITS .�S T D to, " 4- l7t.✓i--x. i cps., 4' 6u t l cs- \ N ` L F S Nit G kl-r jC, y s )41 o --At r_ s vin t:.rt T's c9 i-a +L£ t w t I f 'rgL 8tc)d FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 111 "' Transmittal Letter r c,n k n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov, TO: � DATE ' .VED DEPT: BUILDING DIVISION " SEP 2 7 2017 FROM: TUi i V CITY OF TIGARD COMPANY: r12ore Ar BUILDING DIVISION PHONE: q , - _ By: RE: �D�4o rArf FrNltz w. / I -p 9 2-o - Do.2e) ( ite Address) Permit Number) a� 91-221 tN t n4-Fe r sub-- f�"CCSTS ( roject name or subdivision 1:14.147-n)lot nu ATTACHED ARE THE FOLLOWING I " : Copies: Description: Rt Copies: Description: Additional set(s) of pl. s ' Revisions: �i paw Cross section(s) cle!,� /•• 1 Wall bracing and/or lateral analysis. Floor/roof framin . -I�)�j / Basement and retaining walls. Beam calculations �V Engineer's calculations. Other(explain): REMARKS: Mbvirvlo •' 5 r.tV (o/ C-L -.- -i E 4Pi\rn N/) 4t 5 � FOR OFFICE USE ONLY Routed to P• it Technician: Date: jn. 'Z_ J-7 Initials: -41 Fees Du-• ❑ Yes Dq No Fee Description: Amount Due: $ $ $ Special Instructions: Reprint Permit(per PE): ❑ Yes No ❑ Done Applicant Notified: Date: /r)/ `,— Initials: 371> 1:\Building\Forms\TransmittalLetter-Revisions_061316.doc City of Tigard 4 COMMUNITY DEVELOPMENT DEPARTMENT IN' II, TIGARD Building Permit Review — Residential Building Permit #: fel e,j d_/7- c;el? Site Address: 1OC7-716) /d ,p-�l"l'1.�h�er (0,.,y, Project Name: O//ii ori Lot #: (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review 1 / Proposal: ' 1 �C`6%S7 �''/-'IiC71/ _ LTJ Verify site address/suite# exists and active in ermit s stem. P Y ❑ River Terrace Neighborhood: ❑ No ❑ Yes,See River Terrace Review Addendum Attached Si Plan Elements: ree(3)copies of site plan 'sting structures on site plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure (including decks)g with finished r P.rawn to scale(standard architect or engineer scale) or elevations rth arrow 'ty locations&easements(required for new and additions) l5�/S. e address,project or subdivision name and lot number Sidewalk/driveway approach plicant information(name and phone number) l'" t cation of wells/septic systems OIn Lot dimensions and building setback dimensions v Existing trees to be retained with drip line,and tree A uare footage of buildings to be demolished .rotection measures 10 k area,building coverage area,percentage of coverage and 10.k-et tree size,type and location pervious area(applicable if R-7,R-12,R-25&R-40) /Street names Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? ❑Yes 4 foot differential) If yes,is a storm water a uality facility shown? .s=Yes o ❑ i lean Water rvices—Service Provider Letter(lot platted prior to 9/10/1995): •equired: Yes,applicant was notified ❑ No Received: Yes �Jd" No Wu N blic Facilities Improvement(PFI)Permit: iof /i 7 47: Required: ❑ Yes,applicant was notified No Applied For: ❑ Yes ❑ No, intake "(and Use Case#: oning: !?.—� Required Setbacks: Front ,..?e) Rear s Side 7 Street Side f/ -Garage 2 G Pl'andscape Requirement: % // 4Wot Coverage Maximum: 0/0 Building Height: Maximum Height l c Actual Height Jc--- Oisual Clearance OpTN�ensitive Lands: El Yes El No Type ,i{�Urban Forestry Plan �O onditions "Met"prior to issuance of building permit Notes: Approved By Planning: —� ,[.-- Date: I' Revisions (after Building Submittal only) Reviewer ate Revision 1: [1 Approved ElNot Approved Al0,‘,N , �1----�- °� Revision 2: ❑ Approved DI Not Approved C171 � •� �� �s 1 �i Revision 3: ,,1 Approved El Not Approved � _ —'--- r� /2_71 11 I:\Building\Forms\BldgPermitRvw RES 061417.docx Building Permit Submittal Original Submittal Date: #V( /7 Site Plans: Building Plans: # 3 Building Permit#: C -Enter building permit#above. Workflow Routing: Cg-Panning 0.-Eng _ineering I'ermtt Coordinator -&'13ing 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 original plan review routing form. "*, uilding: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. 114 Notes: / By Permit Technician: gic— r' 2.----- Date:Date: 3/,37,07 Engineering Review 9 [lope at building pad: 02% 2"-Conditions "Met"prior to issuance of building permit (§5% asements (encroachments)per engineering conditions of approval and plat al-Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes Ef'No Assess Water Quantity Fee in-lieu: ❑ Yes [? No LIDA Facility on lot: ❑ Yes ErNo 121"-NOT Approved by Engineering: R , 6 5)41 Date: e 14—1 -j Notes: .5 ii-ovu &Li- 5..^,,,, rr s /4 c J 1. „Ili/ �,44,Azt. ith �}Sc wI-i-1r- 41+0.0 A-t 0(../ 0 AT: Approved by Engineering: Date: Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑' Not Approved K. f1sr4ti.ie_. g -74_17 * Revision 2: 5z,Approved ❑ Not Approved g. ¢(g 1-1, 8 -i 1.-i-) Revision 3: Approved ❑ Not Approved . itj S R ti /U",2.1 - Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit v3 ❑ Approved,NOT Released: Date: 3 Notes: 7 Revisions (after Building Submittal only) -' Revision Notice 1: Date Sent to Applicant: ��F / Revision Notice 2: Date Sent to Applicant: q// /1/4.- Revision Notice 3: Date Sent to Applicant: 4010 C Fees Entered: Wash Co Trans Dev Tax: ❑ Yes N/A Tigard Trans SDC: El Yes N/A Parks SDC: ❑ Yes N/A LIDA ❑ Yes N/A /Q/4-/I /NOOK to Issue Permitp�pproved by Permit Coordinator: 0Date: ° 7(I9 l I:\Building\Forms\BldgPermitRvw_RES 061417.docx