Permit (137) CITY OF TIGARD 7> 9 a: MASTER PERMIT
Ili ' ...9:-1•/ Permit#: T8
COMMUNITY DEVELOPMENT ® '
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12MS/19/2018201 -00326
T[�' � 9 Parcel: 2S 115AB00500
Jurisdiction: Tigard
Site address: 11249 SW GABRIEL ST
Subdivision: WILLOW BROOK SUBDIVISION Lot:
Project: Willow Brook, Lot 22
Project Description: New SF. APPLY DEMO CREDITS FOR TRANSPORTATION&PARKS FROM BUP2017-00284.
2/22/2019: REPRINT permit to add 2nd stackable washer/dryer in master closet.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1578 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1015 sf Garage: 444 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2593 sf Value: $328,364.05 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 2 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 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 Tvpes Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 2
Natural Gas Heat Pump: N Hoods: 0 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc!Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 5 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Ecompasing: Y
Other: N Other Description:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2593
Owner: Contractor:
PACIFIC LIFESTYLE HOMES PACIFIC LIFESTYLE HOMES Required Items and Reports(Conditions)
11815 NE 99TH STREET,SUITE 11815 NE 99TH ST#1200 1 Ersn Cntrl 503-639-4175
1200 VANCOUVER,WA 98682
VANCOUVER,WA 98682
PHONE: 360-573-8081 PHONE: 360-213-0813
FAX: 360-574-6401
Total Fees: $9,153.92
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 0090., You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
� , �2 a
Issued By: � �
r-
Issued Signature: ft/ ,97 ��./C ;. 7G'1
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.
r
CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2018-00326
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/19/2018
T f C. 1<.Cr 9 Parcel: 2S115AB00500
Jurisdiction: Tigard
Site address: 11249 SW GABRIEL ST
Subdivision: WILLOW BROOK SUBDIVISION Lot:
Project: Willow Brook, Lot 22
Project Description: New SF. APPLY DEMO CREDITS FOR TRANSPORTATION AND PARKS FROM
BUP2017-00284.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1578 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1015 sf Garage: 444 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2593 sf Value: $328,364.05 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 0
Natural Gas Heat Pump: N Hoods: 0 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 5 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2593
Owner: Contractor:
PACIFIC LIFESTYLE HOMES Required Items and Reports(Conditions)
11815 NE 99TH ST#1200 1 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98682
PHONE: PHONE: 360-213-0813
FAX: 360-574-6401
Total Fees: $9,088.50
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-00 -0090. You ma obtain a copy of the rules or direct questions to OUNC by calling 5 .232.1987 or 1.800.332.2344.
/3 � �
Issued By: y, i, ♦ L, �i//Ii Permittee Signature: ter%
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
,Building Permit Application F
Residential -t . 1 ., (:'•
Residential
1 ,,, FOR OFFICE LSE ONLY
Cl of Tigard Received A /„
`J g %(�1 Date/By:/� �/�� Permit 1 �/ L' '��� �1�
114 13125 SW Hall Blvd.,Tigard,OR 9721 1, .�n �n _
Plan Review G,1,le, 7
Phone: 503.718.2439 Fax: 503.598.1960 1,7-ii(D ($ � Other Pe / c'a`L'
Date/By:
T/G A R D Inspection Line: 503.639.4175 Date Ready/By: t" / ® See Page 2 for
Internet: www.tigard-or.gov otified/Me od: 17( Li Supplemental Information
ca J n-a,44 a"1a '"." C,^ ,y`.sus eg ':F,a y a ¢' r:,` r J .', a
®New construction El Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
y r yf ,� work indicated on this application.
® 1-and 2-family dwelling ❑Commercial/industrial Valuation: $3 0 , ( 51404
ElAccessory building IDMulti-familyNumber of bedrooms: 4
El Master builder El Other: Number of bathrooms:" 3
l 1: Total number of floors: 2 3 0-S'7
Job site address:11249 SW Gabriel St New dwelling area: 2593 square feet ,b‘S"--
City/State/ZIP:Tigard,OR Garage/carport area: 444 square feet 15 7 8
Suite/bldg./apt.no.: Project name:Willow Brook lot 22 Covered porch area: square feet
Cross street/directions to job site: Deck._area: square feet
Other structure area: square feet
t I , i Edi lx 6 r
Subdivision:willow brook Lot no.:22 Permit fees*are based on the value of the work performed.
Tax map/parcel no.:TBD Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
V.";.C.,": -:',,, -P/„;',1,yi.,,,:S:,,,,A1 iI s t , `'t 'P work indicated on this application.
SFR 4 bedroom 2.5 bath 2 car garage with a covered patio and entryway. Valuation: $
Uct �`c� 'TP O �-, Existing building area: square feet
t:4',F? V New building area: square feet
P a „ fr ,s7''')..- „ , „`' '.. .i'e;?)'',/,,,l'i-P Number of stories:
Name:Pacific Lifestyle Homes Type of construction:
Address:11815 NE 99th Street,Suite 1200 Occupancy groups:
City/State/ZIP:Vancouver,WA 98682 Existing:
Phone:(360)573-8081 Fax:(360)574-6401 New:
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l i •d' 1. ti $ F P «. z ,,s; .,,,. .,.. 1„ Af .; ,y r�:,, E, '� , ,F ,r ,,,i ,R /' p A 9 > t (f.F
Business name:Pacific Lifestyle Homes 404) `}
Structural plan review fee(or deposit):
Contact name:Permit Coordinator
FLS plan review fee(if applicable):
Address:11815 NE 99th Street,Suite 1200
Total fees due upon application:
City/State/ZIP:Vancouver,WA 98682
Phone:(360)573-8081 Fax: :(360)574-6401 Amount received:
1 o t #) #E-mail:permits@buildplh.com ,,,
` ,f
Commercial and residential prescriptive installation of
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roof-top mounted Photovoltaic Solar Panel System.
Business name:Same Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:Same Solar Installation Specialty Code checklist.
City/State/ZIP:Same Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:173524
Total fee due upon application: $201.60
Authorized signature: a' ��/�/) /� This permit application expires if a permit is not obtained
,„)
L.,/ „„
!-�� within 180 days after it has been accepted as complete.
Print name:Summer Dowell Date: 12/3/18 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE oNI.\
City of Tigard Dat/Bed Permit No.:
14 13125 SW Hall Blvd.,Tigard,OR 97223 a
g Associated permits:
111 Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing 0 Mechanical
I I C A RD Internet: www.tigard-or.gov
0 Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW 1 es No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 ❑ ❑
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 ❑
3 Verification of approved plat/lot. ❑ ❑ 0
4 Fire district approval required. Name of district: El ❑ 0
5 Septic system permit or authorization for remodel. Existing system capacity ❑ 0 ❑
6 Sewer permit. El ❑ El
7 Water district approval. ❑ El ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0 ❑
9 Erosion control ❑plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ❑ El 0
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state [V ❑ ❑
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 ❑ ❑ El
there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements
and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction
indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and
surface drainage.
12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size ❑ ❑ ❑
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ El 0
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- 0 0 El
floor,wall construction,roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings
and foundation,stairs,fireplace construction,thermal insulation,etc.
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. El 0 0
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- El 0 ❑
prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing ❑ ❑ ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ 0 ❑
systems,see item 22,"Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ El 0
over 10 feet long and/or any beam/joist carrying a non-unifuon load. 1
20 Manufactured floor/roof truss design details. E ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required Er ❑ ❑
for four or more appliances. �,/
22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or LV ❑ ❑
architect licensed in Ore:on and shall be shown to be a.plicable to the .ro'ect under review.
JURISDICTIONAL SPECIFICS
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". El El 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. 0 ❑ El
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ El ❑
27 "Drawn to scale"indicates standard architect or engineer scale. 0 0 El
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ 0
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ 0 0
and protection measures must be drawn to scale and must include the project arborist's signature of approval.
30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, 0 ❑ El
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 I SE ONL\
•
City of Tigard Received
g Date/By: Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
g Phone: 503.718.2439 Fax: 503.598.1960
Date/By: Other Permit:
T 1 G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
y ,' x.:L n k s y u^
i'v;, tG 'ff ,syv;2 f �`; .� f:,:: �uy.,,;:s. r ,¢ Y, z:r -,�" `r r t. �„£;:�` ffr
f. .;rf' fx t: f{�,� ,...,'����' f �, �f ,.,:'',.�f #�.7 �{.`,�;� r �j�. f, N ;dt� �i r,
Mechanical permit fees*are based on the value of the work
Z New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:
€. ,„s ,ar,.,. , ,,. ;" .:.,? ., ec.�, ,�„r.,rf „n -e ,u ,,: ,�wf ,,.,, u , ,,„ "!Ht 1P v) it" l✓f4 - 8t} r" -
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
Heating/cooling:
1 46.75
Job site address:11249 SW Gabriel St Furnace 100,000 BTU(ducts/vents) 1 46.75
City/State/ZIP:Tigard,OR Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 1 61.06
Suite/bldg./apt.no.: Project name:Willow Brook 22 Duct work 1 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:Willow Brook Lot no.:22 Other: 23.32
Other fuel appliances:
Tax map/parcel no.:TBD Water heater 1 23.32
Gas fireplace/insert 1 33.39
�f ✓,. r . F �,. �, ,.�, , -s ! Flue vent for water heater or gas
SFR 4 bedroom 2.5 bath,2 car garage with covered patio and entryway. fireplace 1 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other:onmental exhaust and 23.32
1
Envirven i a ion:
Name:Pacific Lifestyle Homes Range hood/other kitchen
Address: 11815 NE 99th ST Suite 1200 equipment 1 33.39
Clothes dryer exhaust 1 33.39
City/State/ZIP:Vancouver,WA 98682 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 5 23.32
Phone:(360)573-8081 Fax:( ) Attic/crawlspace fans 23.32
„ f , ._ ��,:* ggr ;lgi �( X. Other:
23.32
Fuel piping:
Business name:Pacific Lifestyle Homes
$14.15 for first four;$4.03 for each additional
Contact name:Permit Coordinator Furnace,etc.
Address: 11815 NE 99th Street,Suite 1200 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98682 Water heater
Phone:(360)573-8081 Fax::(360)574-6401 Fireplace
Range t
E-mail:permits@buildplh.com Barbecue 1
P,� fi L st r' '�
' :4 ! ',,Nf C � fS ti' s I,f . ,. ,. f f Clothes dryer(gas)
Business name:Area Heating+Cooling Other:
f fiF ':/ / k l .r.
.v,1' zr�rSS.�.Eal .., :>, 1,.. 09yla,,C... � ,� ,u e,a W >>t
Address:2721 NE 65th Ave Subtotal
City/State/ZIP:Vancouver,WA Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(360)737-0811 Fax:(360)737-6946 State surcharge(12%of permit fee)
CCB lic.:64801 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature 191)1A-) {7�� * Fee methodology set by Tri-County Building Industry Service Board
Print name:Summer Dowell Date:12/3/18
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-Famil Fee Schedule:
$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 Aiillicatio FOR OFFICE USE ONLY
° City of Tigard Received Permit 4:Date/Bv:
13125 SW Hall Blvd.,Tigard,OR 97223 flan Review — — —
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Related Permit 4:
TIGAI2,D inspection Line: 503.639,4175 Ready Date/By: luras. U See Page 2 fur
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN:REVIEW- -
N
Alen'construction Please check all that apply(submit 2 sets of plans w/items checked):
❑Addition/alteratialh•eplacement
0 Service or feeder 400 amps or more ❑Building over three stories
❑ Demolition ❑ Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings,
less to ground,or exceeds 14,00(1 0 Commercial-use agricultural
® I-and 2-fatuity dwelling D Commercial/ifidustrial ❑Accessory building
amps Inc all other installations, buildings.
❑ Multi-family ❑ Master builder ❑Other: 0 Fire pump. 0 Installation of 150 K VA or
JOB SITE INFORMATION AND LOCATION • • 0 Gnrergency system. larger separately derived
0 Addition of new motor load of system.
Job 0: lob site address: ++ >
1 � C.�i�r ,�� ��' IOOHi or more. ❑.:F�„ :.F,., „t.2„ :,1"3„
t:Ily/s t.slLP: '—
0 Six or more residential units. occupancy.
v ❑1lealtli-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.4: Project name:
(t oo ❑Hazardous locations. ❑Supply voltage for more than
---_-._.. —_�5� �
0 Service or feeder 600 amps or more 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Each I Total 1„____
-- -. New residential single-or multi-family dwelling unit.
Subdivision: Lot if; Includes attached garage.
—"— 1,000 sq.It or less 168.54 4
Tax map/parcel#: -7-15D
l
a.add'1 500 sq,ft.or portion 4.01 33.92 1
DESCRIPTION OF WORK Limited energy,residential
4 ^/��/j_ ,L✓- '9 _(with above sq.It) 75.00 2
[ /' Crs[1 Vv li�C � Limitedenergy,multi-family 75.00 2
(-)1)et Cvvexe..t 0 sk , , residential(n�ith above sq.ft.)
� J Renewable Energy 0 See Page 2
® PI2OPERTI OWNER ❑ TENANT • Services or feeders installation,alteration,and/or relocation
Name: -V(_ L: r , aS r 200 amps or less 100.70 2
Address. , 0 201 amps to 400 amps i 133.56 2
1 Ij l_5 iJ 1S-�. t,l.�t� , 401 amps to 600 amps 200.34 2
City/State/ZIP: \jJ'\CalAYreit 1,,.)..A d1 (.0 K 2i 601 amps to 1,000 amps 301.04 2
Phone:( 6i3 -6)31 J Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended fir sale,lease, rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature:_, Date: 401 amps to 599 amps 168.54 2
® APPLICANT ® CONTACT' PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: Pacific Lifestyle Homes above service or feeder fee,
7.42 2
each branch circuit
Contact name: Permit Coordinator B.Fee for branch circuits without
service or feeder fee,first
Address: 11815 NE 99th Street,Suite 1200 branch circuit 56 i8 2
City/State/ZIP: Vancouver,WA 98682 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(360)573-8081 Fax: : (360)574-6401 Each manufiactured or modular 67.84 2
dwelling,service and/or feeder
Email; permits a buildplh,eom
Reconnect only 67.84 2
- CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Garner Electric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy ❑ Sec Page 2 2
Address: 2920 Six Brookwood Ave,Suite A panel,alteration,or extension.
City/State/ZIP: Beaverton,OR 97006 - Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
Phone:(503)648-4552 Fax:(503)642-7925 Investigation(I hr min) 90.00/hr
- - Industrial plant(I hr min) 78.18/hr
Entail: mmorato�r�garnerelectric.com -- --
Inspections for which no fee is 90,00/hr
CCB L.ic.: 121159 1 Electrical ': -305C Suprv'. Lie.:'3"7 n-} 5 specifically listed(%,hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,require Subtotal:
Print name. Chuck Garner 'i ,, Date: ( I!D 0 Plan Review Required(25%of permit fee):
5 { Stale surcharge(12%of permit fee):
Authorized signature: /A
Ai
l'O FAT,PERMIT FEE:
//�� J I - This permit application expires if tt permit is not obtained within 180
Print name: Ct/t l) I Se k 41,di Date I2 e,$ clays after it has been accepted as complete.
1/1�i6 ` * Number of inspections allowed per permit.
1 Duilding'l'enniis\Flf t'ermitApp tilts tiRI:dot Rev 06:17/2015 440-4615T1I 1/05JC:OA4t1VEn
Electrical Permit Application --City of Tigard
Page 2--•Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE --•
rre
Fee for all residential systems combined: $75.00 newaTidal t l vtr. l C,ct,ReewaEtle electrical energy systems:
Check Type of Work Involved: s kva or less_._.— — 100 70 2
5.01 to 15 kva 133.56 2
Audio and Stereo Systems* 1501 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:___.__---------
i I Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
Garage Door Opener*
>100 kva(tee in accordance 552.26 Tu _
with OAR 918-309-0040)
1 Heating, Ventilation and Air Conditioning solar generation systems in excess of 25 twa:
System"
Each additional kva over 25 7.42 3
Vacuum Systems* >100kva-noadditional charge 0.0 3
Each additional inspection over allowable in any of the above:
n Other•. Each additional inspection is 66.25/hr
charged at an hourly(1 hr min)
---_,--_-._--_-- Inspections for which no lee is 90.00/hr
specifically listed(%lir min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enteron Page I):
' Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
Audio and Stereo Systems
Boiler Controls
Clock Systems
I I Data"Telecommunication Installation
Fire Alarm installation
I HVAC
I Instrumentation
PI Intercom and Paging Systems
I I Landscape Irrigation Control*
Medical
L. Nurse Calls
(� Outdoor Landscape Lighting*
I Protective Signaling
Other:
Total number of commercial systems: ____
*No licenses are required. Licenses are required for all
other installations
I,.1311iklieg\PermilsTLC,.I'ermiIApp_ELR_RRE doe Rev 0o/I712015
Plumbing Permit Application
Building Fixtures FOR OFFICE 1 SF ONLv
Cityof Tigard Received
ganPermit No.:
1114 I IN 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By:
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.:
TI G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
!r, :-.%:r"i= .! ::: 'A,' "4. ':/r a. .- ! ,`f /r4 iS ! t;;,.'4' r t" ✓ ..C. _,c ....Y ,r r r1 !/., S:r n;
r, i ,�
,.�'' !� ..�,r�t f/.,',P°"''!'r�i,�. fz , ,.4,,,,N•.'::-;,:f.), a �. rlr� F�:a: i 't" r+ a" r!'>fw r,,�..� !J"r.ir^F� '�„f^'y`�r l..k:, � ".,<- S , �v'y�sr,�,! fie..'
/,?' // tiff . z7 <!".:J .,,,r. r i t;'r r r^' ri.. t' 1` :7' . r 1: ! %"`
,� ..h ��'.. ! �: ilv' ,1.,.>„ 1,,, , ,.. � �fi x ..,. tfi;.x,r . .',`v;:,. ,.. � .;,rcf,.t.� !r. „rr t,.,r4,�;,„?ti?
❑New construction ❑Demolition For special information use checklist
Description I Qty. I Ea. 1 Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
),'lrr`,.eoN,,, ,// rel. rr r rr
r, � , / , e� g+ s), _ lc e- SFR(1)bath 312.70
.. ..,. ,�� r'��,.u�/�1%!� rFa ._�,.r�,��.,,f ,�r�r,,, .d:r „ee.. ,�, ,,, �l...,2,.�. ' .,r/,..4.
® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 1 437.78
I=1 Accessory buildingSFR(3)bath 500.32
❑Multi-family
Each additional bath/kitchen .5 25.02
0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
ftl Site utilities:
Job site address:11249 SW Gabriel ST Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name:Willow Brook 22 Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:<100) Page 2
Storm sewer(no.linear ft.:<100) Page 2
Water service(no.linear ft.:<100) Page 2
Subdivision:Willow Brook I Lot no.:22 Fixture or item:
Tax map/parcel no.:TBD Backflow preventer 31.27
v.,; h ,.! jv . r /
Backwater valve 12.51
'a g of fttit om3a .A,,l _1. $ fClothes washer 1 25.02
SFR 4 bedroom 2.5 bath,2 car garage with a covered patio and entryway.
Dishwasher 1 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
�' Fr ta°r ' =., Expansion tank 12.51
�'�'JF d
f!.✓
Name:Pacific Lifestyle Homes Fixture/sewer cap 25.02
Floor drain/floor sink/hub 1 25.02
Address: 11815 NE 99th ST Suite 1200
Garbage disposal 1 25.02
City/State/ZIP:Vancouver,WA 98682 Hose bib 2 25.02
Phone:(360)573-8081 Fax:( ) Ice maker 12.51
! .1 r> t 44 /, . ts. y Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name:Pacific Lifestyle Homes
Primer 12.51
Contact name:Permit Coordinator
Roof drain(commercial) 12.51
Address:11815 NE 99th Street,Suite 1200 Sink/basin/lavatory 4 25.02
City/State/ZIP:Vancouver,WA 98682 Solar units(potable water) 62.54
Phone:(360)573-8081 Fax: :(360)574-6401 Tub/shower/shower pan 3 12.51
E-mail:permits@buildplh.com Urinal 25.02
= ra rA/rr / / z r / ': Water closet 3 25.02
Water heater 1 37.52
Business name:Lippold Plumbing and Heating INC Water piping/DWV 1 56.29
Address:PO BOX 895 Other: 25.02
City/State/ZIP:Boring,OR 97009 Subtotal
Phone:(971)404-7012 Fax:( ) Minimum permit fee: $72.50
CCB Lic.:201597 Plumbing Lic.no.:PB14101 7 Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: / v La „Je�� TOTAL PERMIT FEE
Print name:Summer Dowell �✓v� _ Date: 12/3/18 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 S stems:
, 4,' ..c,� '''� a�' .,.Y l,r c3 >:.;/^`{� .��7:� r� ,f;,� �.�'f',
Footing drain-1s`100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas S stems:
Water Service-each additional 100' 37.52 Atu
Storm&Rain Drain-1st 100' 62.54 . r,.,,,1�
$1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
each additional$100.00 or fraction thereof,to
�.`: . », Avg'``.,' 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*.
Quantiy by Fixture Type �% ° 4 .' _4,.�1 i E 8...t.‘111; d A ;, 110
Fixture Type for Plan review is required for any of the following.
Work Performed: Capped Added Relocate Please check all that apply.
Baptistry/Font
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 ❑ 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 ❑ Any multipurpose fire sprinkler system.
Drinking Fountain LI 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.
Car Wash Drain
Garbage Domestic-non-food 1=1 Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/lav -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
P:\Job Folders\Oregon\Subdivisions\Willow Brook(113th Ave)\Lot 22\Pc2mits and Inspections\PLB_PermitApp.doc
City of Tigard
p COMMUNITY DEVELOPMENT DEPARTMENT
a
T 1 c A K n Building Permit Review — Residential
Building Permit #: 7Si zal i{ 003,:,2. ...,
Site Address: 112_.9q S` I Gabs-+ 1 ,�,.
Project Name: ,114I re, Lot #: Z
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review I q�q
Proposal: t J rK bJ L. �.1� , gay t� (.rf i14:1-rt A,AA to �."
L_9i rift'site address/suite# exists and acttiivee) permit system.
MI River Terrace Neighborhood: L(1'No ❑ Yes,See River Terrace Review Addendum Attached
Sit Plan Elements:
Wree(3)copies of site plan �r •''sting structures on site
e plan must be on 8-1/2"x 11"or 11 x 17"paper [;%Footprint of new structure(including decks)with finished
[g yawn to scale(standard architect or engineer scale) or elevations
oro arrow [. ' 'ty locations&easements(required for new and additions)
te address,project or subdivision name and lot number idewalk/driveway approach
[pplicant information(name and phone number) 'RS 1 ocation of wells/septic systems
Lot dimensions and building setback dimensions L Existing trees to be retained with drip line,and PlAluare footage of buildings to be demolishedotection measures
Lot area,building coverage area,percentage of coverage and Street tree size,type and location
pervious area(applicable if R-7,R-12,R-25&R-40) Leet names
Property corner elevations (2 foot contour lines if more than >1,000 sf of impervious area created or replaced? lYes ❑No
4 foot differential) If yes,is a storm water quality facility shown? ❑' .ONo
Clean Water Services—Service Provider Lette;(lot platted prior to 9/10/1995): 1--, n I
quired: CI Yes,applicant was notified No Received: CI Yes ❑ No Et
[ 'Public Facilities-/Improvement(PFI)Permit: t
Required: " Yes,applicant was notified ❑ No Applied For: 'Yes CINo,stop intake
and Use Case#: SU3U16-MI rf.1-1 11-n0a
ILP 1 Zoning: -
/Required Setbacks: Front IC' Rear 1S Side S Street Side 1,4 Garage 2,0
[i dscape Requirement: 7.4
cyo
IW/Lot Coverage Maximum: g %
LTJ Building Height: Maximum Height 33 Actual Height 24S
kthr,t, ]Visual Clearance '/
IAV Sensitive Lands: CY Yes CI No Type &Q-ai S'; (4„J LOA
ee,1rban Forestry Plan
E Conditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: � �; ,,,,t,� Date: I L-1- y
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw RES_o61417.docx
Building Permit Submittal
Original Submittal Date: /'Z`�,/1--
Site Plans: # -�
Building Plans: # _ 3
Building Permit#: EkEnter building�pp,ermit#above.
Workflow Routing: Planning L-YEn��gineering 42'1'ermit Coordinator Building
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.
wilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: /. .�` Date: / ///
Engineering Review
Slope at building pad: 09,15
[Conditions "Met"prior to issuance of building permit
f "Easements (encroachments)per engineering conditions of approval and plat
ErWater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes No
Assess Water Quantity Fee in-lieu: ❑ Yes ', o
LIDA Facility on lot: ❑ Yes LQ No
[Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
[Approved by Engineering: Cly <S 14V Date: /2— /
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 oftgperrnit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Re ' ion Notice 3: Date Sent to Applicant:
SDC Fees Entered: Wash Co Trans Dev Tax: 1L Yes ❑ N/A
Tigard Trans SDC: V Yes ❑ N/A
Parks SDC: Yes 0 N/AN/
LIDA ❑ Yes g"-N---TA
OK to Issue Permit S'.--------Approved by Permit Coordinator: I ate: / 1// Y�
I:\Building\Forms\BldgPermitRvw_RES 010118.docx
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
11249 SW GABRIEL ST, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Master Permit MST2018-00326
Inspection Type: Inspector:
299 Final inspection David Young
Result:
FA I L
Comments:
Provide approved approach and sidewalk inspection prior to building final inspection.
City required documents received.
No ac installed at this time.
All else appears ok at this time.
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
11249 SW GABRIEL ST, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Master Permit MST2018-00326
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
PASS
Comments:
Water pressure 53 psi at back covered porch.
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
11249 SW GABRIEL ST, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Master Permit MST2018-00326
Inspection Type: Inspector:
299 Final inspection David Young
Result:
PASS - CofO
Comments:
Sidewalk and approach ok per engineering.
Final erosion control approved.
Moisture content form received.
Moisture barrier form received.
High efficiency lighting form received.
Insulation certification checked.
Duct seal test report checked.
No ac installed.
C of 0 issued, available next day.
Violation Summary:
Inspector Contractor