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Permit CITY OF TIGARD MASTER PERMIT 1,1, , i - COMMUNITY DEVELOPMENT Permit#: MST2018-00354 Date Issued: 02/25/2019 T r C;;,,,r 17 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S1126D12700 Jurisdiction: Tigard Site address: 14811 SW 76TH AVE Subdivision: ELDERBERRY RIDGE Lot: 23 Project: Elderberry Ridge, Lot 23 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 982 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 23 Bathrooms: 3 Second: 1190 sf Garage: 397 sf Front: 15 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Total: 2172 sf Value: $276,250.00 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF RainStorm Sewer: 100 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Tvnes Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add.]500 sf: 4 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Y Other: N Other Description: Ecompasing: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2172 Owner: Contractor: RIVERSIDE HOMES LLC RIVERSIDE HOMES LLC Required Items and Reports(Conditions) 17933 NW EVERGREEN PL STE 17933 NW EVERGREEN PKWY 370 1 Ersn Cntrl 503-639-4175 370 BEAVERTON,OR 97006 BEAVERTON,OR 97006 PHONE: 503-645-0986 PHONE: 503-645-0986 FAX: 503-690-2942 Total Fees: $31,012.35 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 952-001-0090. You may obtain a cop of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800. 32.2344. Issued By: /�- 4...-(�% Z��ZL'C Permittee Signature: 6 < Call 503.639.4175 by 7:00 a.m. or 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 LC._`-"\---. t � Residential RECEIVED FOR OFFICE 1 S1:ONLY ' City of Tigard DcByd ��'^. -V r Sj �S_ Permit No. 1 ��r�t m V � ill 't 13125 SW Hall Blvd.,Tigard,OR 97223C i) !Is 2 O 8 Plan Review U V ` Q . + Phone: 503.718.2439 Fax: 503.598.19600 EDate/By: (� oZt7 1 u IllyOther Perini ljt%—(��� 'j 1.i( 1 R n Inspection Line: 503.639.4175 p�y TIGARD /ti �y Date Ready/By: ////7/ 7uris: I (a See Page 2 for Internet: www.tigard-or.gov CITYiii' A IIJ��I/ N+,ified/Method: c��✓ _ Supplemental Information ,� „� ez`ck^s k , � �xb+GYM ���" a ' � �5. • , . r�.t}, tii Q New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the ,. , ��' 't" '" , pt . ^.,4, , t � ;'� ° work indicated on this application. '.a ,d' -''''.4.-'''''''' a-'''':- az.Thi''' Valuation: $ ❑✓ 1-and 2-family dwelling 0 Commercial/industrial 27(P/ �� ❑Accessory building ❑Multi-family Number of bedrooms: ❑Master builder 0 Other: Number of bathrooms: ul n ^�� k at" - ' Total number of floors: 2 2.'5 [ Job site address: 14811 SW 76TH AVE New dwelling area: 2172 square feet " /C City/State/ZIP: Tigard, OR 97224 Garage/carport area: 397 square feet Z Suite/bldg./apt.no.: I Project name: Elderberry Ridge Covered porch area: square feet Cross street/directions to job site: SW Bonita Rd &SW 76th Ave Deck area: square feet Other structure area: square feet fu Subdivision: Elderberry Ridge I Lot no.: 023 Permit fees*are based on the value of the work performed. Tax map/parcel no.: 2S 112BDO03OO Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the t ^ work indicated on this application. k:s Construction of SFR -2.172 B L Valuation: $ Existing building area: square feet New building area: square feet t t # Number of stories: Name: Riverside Homes, LLC Type of construction: Address: 17933 NW Evergreen PI., Ste 370 Occupancy groups: City/State/ZIP: Beaverton, OR 97007 Existing: Phone:( 503)645-0986 Fax:( ) New: . � ,' #s�. :* '+ •,4 i .,,,,•.? �'',€.y'�"dSS.� Business name: Riverside Homes, LLC Structural plan review fee(or deposit): Contact name: Wes Boisvert FLS plan review fee(if applicable): Address: 17933 NW Evergreen Pl., Ste 370 Total fees due upon application: City/State/ZIP: Beaverton, OR 97007 Phone:(503)645-0986 I Fax: :( ) Amount received: a .. E-mail: whoisvert@riversidehome.com Commercial and residential prescriptive installation of } r -; roof-top mounted Photovoltaic Solar Panel System. Business name: Riverside Homes, LLC Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 17933 NW Evergreen PI., Ste 370 Solar Installation Specialty Code checklist. City/State/ZIP: Beaverton, OR 97007 Permit Fee(includes plan review $180.00 and administrative fees): Phone:( 503)645-0986 Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lie.: 189148 ` •- _ • Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Nikki Pruett Date: 12/18/18 *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 t;SE ONLY City of Tigard Received ll Permit No.: Date/By: SW Hall Blvd.,Tigard,OR 97223 Associated permits: _ Phone: 503.718.2439 Fax: 503.598.1960 T1 G,1 f:F) 24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical Internet: www.tigard-or.gov 0 Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW v"es o N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 0 0 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0 3 Verification of approved plat/lot. 0 0 0 4 Fire district approval required. Name of district: . 0 0 0 5 Septic system permit or authorization for remodel. Existing system capacity . 0 0 0 6 Sewer permit. 0 0 0 7 Water district approval. _ 0 0 0 8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0 0 9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 0 0 basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 0 0 0 building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if 0 0 0 there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size 0 0 0 and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 0 0 0 furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- 0 0 0 floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. 0 0 0 Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- 0 0 0 prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing 0 0 0 locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 0 0 systems,see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists 0 0 0 over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. 0 0 0 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 0 0 for four or more appliances. 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or 0 0 0 architect licensed in Ore.on and shall be shown to be a.•licable to the .ro'ect under review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". _ 0 0 0 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 0 0 0 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 0 0 0 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 0 0 27 "Drawn to scale"indicates standard architect or engineer scale. 0 0 0 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 0 0 Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 0 0 and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, 0 0 0 including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) rlCMechanical Permit Applicati j j IV rod OF lCl: usi:Oyl.v City of Tigard ReceivedDate/By: Permit No.: 111 II 13125 SW Hall Blvd.,Tigard,OR 97223 _ 2 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 r� �� ® 28ther Permit � 1 Date/By:B �-�� T I(7 A R 17 Inspection Line: 503.639.4175 y �/ Date Ready/By: Avis' ® See Page 2 for Internet: www.tigard-or.gov CAl l Off+TICARD Notified/Method: Supplemental Information 1 LT 1 fl e' Mechanical permit fees*are based on the value of the work ✓❑New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. ' s . . _ wI .t Value:$ k ., .-' 0'• • P s ' .ar . n t , Y i i' i 1'h ,,,T:;,:,:, ❑✓ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building Ac For special information use checklist. ❑Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total r *- • • ,. Heating/cooling: • r:;,r4. ; ^; .,°5 i t •t t a Air conditioning 1 46.75 46.75 Job site address: 14811 SW 76TH AVE Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75 City/State/ZIP: Tigard, OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: I Project name: Elderberry Ridge Duct work 23.32 Cross street/directions to job site: SW Bonita Rd & SW 76th Ave Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision: Elderberry Ridge 1 Lot no.: 023 Other: 23.32 Other fuel appliances: Tax map/parcel no.: 2S112 B D00300 Water heater 1 23.32 23.32 , f Gas fireplace/insert 1 33.39 33.39 M .rr.: an„„s,'.' P`I is*a,rs ..b ra:;r�.... Flue vent for water heater or gas Construction of SFR fireplace 23.32 _ Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 23.32 Environmental exhaust and ventilation: Name: Riverside Homes, LLC Range hood/other kitchen equipment 1 33.39 33.39 Address: 17933 NW Evergreen PI., Ste 370 Clothes dryer exhaust 1 33.39 33.39 City/State/ZIP: Beaverton, OR 97007 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 4 23.32 93.28 Phone:(503 )645-0986 Fax:( ) Attic/crawlspace fans 23.32 SID; ., .tea Other: 23.32 Fuel piping: Business name: Riverside Homes, LLC $14.15 for first four;$4.03 for each additional Contact name: Wes Boisvert Furnace,etc. 1 14.15 _ Address: 17933 NW Evergreen Pl., Ste 370 Gas heat pumpWall/suspended/unitheater City/State/ZIP: Beaverton, OR 97007 Water heater 1 14.15 Phone:(503 )645-0986 I Fax::( ) Fireplace 1 14.15 Range 1 14.15 E-mail: wboisvert@riversidehome.com Barbecue '2 _ ! � a . e. Clothes dryer(gas) Business name: Other: Pro Heating & Cooling L ^gl; ��� ��= wM1� � y*�; s�g�rap c+�iewA �� ,;;;:a Address: 2095 NW Alocleck Rd.#1103 Subtotal City/State/ZIP: Hillsboro, OR 97124 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:( 971)205-4989 Fax:( ) State surcharge(12%of permit fee) CCB lic.: 209001 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 k..10,ilt days after it has been accepted as complete. Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board Print name: Nikki Pruett Date: 12/18/18 1\Building\Permits\MEC_PemiitApp_040113.doc 440-46I7T(I l/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_PennitApp_040113.doc 2 ECEIED Electrical Permit Applicatio R V FOR OFFICE USE()NIA' City of TigardDateBed Permit#: 't 13125 SW Hall Blvd.,Tigard,OR 9722311 F r 2 0 2 018 Plan Review 11 Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit t , Inspection Line: 503.639.4175 CITY OF TIGARD Ready Date/By: 7uris: ® See Page 2 for TIGARD Internet: www.tigard-or.gov Notified/Method: Supplemental Information E lNew construction 0 Addition/alteration/replacement 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 ❑Other: where the available fault current 0 Marinas and boatyards. i ' tx atiyr t ' t t ., ��? exceeds 10,000 amps at 150 volts or ❑Floating buildings. El1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or t ; :° `1 s ;4:'-! f,� ' :4':4'''4.1.74.' e^"p'' ' '. t :''''"17.--W?'::' " h . ❑Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: Job site address: 14811 SW 76TH AVE 100HP or more. ❑"A",``E","1-2","1-3", City/State/ZIP: Tigard, OR 97224 ❑Six or more residential units. occupancy. 0 Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: I Project name: Elderberry Ridge ❑Hazardous locations. 0 Supply voltage for more than 0 Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: SW Bonita Rd &SW 76th Ave `_b It I'YI 3 tk sr r� ���� r Description Qty. Each Total New residential single-or multi-family dwelling unit. Subdivision: Elderberry Ridge Lot#: 023 _Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: 2S112BD00300 Ea.add'l 500 sq.ft.or portion _ 33.92 1 '_ . ' .;4!;,-:".:,-:,,i)1,::: Limited energy,residential Construction of SFR (with above sq.ft.) 75.00 2 Limited energy,multi-family residential(with above sq.ft.) 75.00 2 0 t € ,t r ,.- Renewable Energy 0 See Page 2 0 dl 'y t .« T Services or feeders installation,alteration,and/or relocation Name: Riverside Homes, LLC 200 amps or less 100.70 2 Address: 17933 NW Evergreen Pl., Ste 370 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: Beaverton, OR 97007 601 amps to 1,000 amps 301.04 2 Phone:(503)645-0986 I Fax:( ) Over 1,000 amps or volts 552.26 2 Email: Temporary services or feeders installation,alteration,and/or relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps '125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 :i."7";'''''' ',`: Branch circuits—new,alteration,or extension,per panel r.' � �' � � 2‘1 t.. t' A.Fee for branch circuits with Business name: Riverside Homes, LLC above service or feeder fee, each branch circuit 7.42 2 Contact name: Wes Boisvert B.Fee for branch circuits without service or feeder fee,fust Address: 17933 NW Evergreen Pl., Ste 370 branch circuit 56.18 2 City/State/ZIP: Beaverton, OR 97007 Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(503)645-0986 I Fax: :( ) Each manufactured or modular 67.84 2 dwelling,service and or feeder Email: wboisvert@riversidehome.com Reconnect only 67.84 2 "F z . "# .s`ia a," <' ::"' t p Pump or imgation circle 67.84 2 Business name: Sunlight Electric Inc Sign or outline lighting 67.84 2 Address: Signal circuit(s)or limited-energy 0 See Page 2 2 2804 N E 65th Ave. St. D panel,alteration,or extension. Each additional inspection over allowable in any of the above City/State/ZIP: Vancouver, WA 98661 Additional inspection(1 hr min) 66.25/hr Phone:(360) 518-7589 Fax:( ) Investigation(1 hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr /011/(1 Inspections for which no fee is 90.00/hr CCB Lie.: 172549 Electrical Lic.: C230 Suprv.Lic.:(7 7s :eciflcall listed rh hr min Suprv.Electrician signature,required: .724 _ Subtotal: Print name: Chester Garrett I Date: 12/18/18 0 Plan Review Required(25%of permit fee): Authorized signature: (}Gliflf; P7A/(1(7t- -- State surcharge(12%of permit fee): TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Nikki Pruett Date: 12/18/18 days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB ' Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: 144,4 Fee for all residential systems combined: $75.00 Descn tion � 3' Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 _© 5.01 to 15 kva . 133.56 _© ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 _© Wind •eneration s stems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 _© 50.01 to 100 kva 552.26 _© ❑ Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040 ■ 552.26 —© ✓❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 _© ❑ Vacuum Systems* >100 kva—no additional charge 0.0 _© Each additional ins ection over allowable in an of the above: ❑ Other Each additional inspection is ■ 66.25/lir _II char l ed at an hourl 1 hr min Inspections for which no fee is ■ 90.00/lir _. �^r • s.ecificall listed '/:hr min °�.. �, Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 (SEE OAR 918-309-0000) " Number of inspections allowed per permit. Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Pernilts\ELCPertnitApp_ELR_ERE.doc Rev 06/17/2015 Plumbing Permit Applicatio jj CEIVEJ) Building Fixtures " Folz OFFICE ['SE ON 1,1 Cityof Tigard Received g �` 0 4, Permit No.: 114 q ���_C 2 0 tl I Date By: 13125 SW Hall Blvd.,Tigard,OR 97223 ' Plan Review : 1111 Phone: 503.718.2439 Fax: 503.59 OP TIGARD Date/By: Other Permit No. S;Zt'\� -(�1 I-S4, Inspection Line: 503.639.4175 Li I� Lf Si it i��,art+hir. Date Read/B Juris: ® See 2 for v Vv 'T TI G A K I) Internet: www.ti and-or. ov a Ready/By: Page g g I. T , ;i �,T i Notified/Method: Supplemental Information }} ih ix 2 New construction 0 Demolition For special information use checklist Description I Qty. I Ea. I Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) z:, ,,,. . .. : st .,.. a y.. : SFR(1)bath 312.70 21-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 1 500.32 0 Accessory building 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler(_sq.ft.) Page 2 t 1E s1 a 1 Site utilities: Job site address: 14811 SW 76TH AVE Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: Tigard, OR 97224 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name: Elderberry Ridge Manufactured home utilities 50.03 Cross street/directions to job site: SW Bonita Rd & SW 76th Ave Manholes 18.76 Rain drain connector 1 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: Elderberry Ridge I Lot no.: 023 Fixture or item: Tax map/parcel no.: 2S 112BD00300 Backflow preventer no backflow for this home. 31.27 Jar, ,, r„,"--,w--,0.- -- * - Backwater valve 12.51 , a . •: l'. °� , - x _ t Construction of SFR Clothes washer 1 25.02 Dishwasher 1 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 d gi ' s Expansion tank 12.51 Fixture/sewer cap 25.02 Name: Riverside Homes, LLC Floor drain/floor sink/hub 25.02 Address: 17933 NW Evergreen PI., Ste 370 Garbage disposal 1 25.02 City/State/ZIP: Beaverton, OR 97007 Hose bib 2 25.02 Phone:(503)645-0986 Fax:( ) Ice maker 1 12.51 r , 1 -::.:741,:*':- t ' 0 't 1 i i € Interceptor/grease trap 25.02 Business name: Riverside Homes, LLC Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Wes Boisvert Roof drain(commercial) 12.51 Address: 17933 NW Evergreen PI., Ste 370 Sink/basin/lavatory 6 25.02 City/State/ZIP: Beaverton, OR 97007 Solar units(potable water) 62.54 Phone:(503)645-0986 Fax: :( ) Tub/shower/shower pan 3 12.51 Urinal 25.02 E-mail: wboisvert@riversidehome.com ' ..,..„1,,, • h . x § , t . , -,4,,,zop.„-w1:41 Water closet 3 25.02 Water heater 1 37.52 Business name: H & H Mecanical Water piping/DWV 56.29 Address: 5757 SE Willow Ln Other: 25.02 City/State/ZIP: Milwaukie, OR 97267 Subtotal Phone:( 503 975-9787 Fax:( ) Minimum permit fee: $72.50 , Plan review (25%of permit fee) CCB Lic.: 178122 (../LIA/ j2:f:.,t;ø6*1 gLic.no.: PB414 State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name: Nikki Pruett Date: 12/18/18 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. 1.\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Sus I ression S stems: Footing drain-1'100' 50.03 0 to 2,000 $121.90 Footing dram-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 w Storm&Rain Drain-1st 100' 62.54 k =.`',tIrttk` ' "' '*�r" $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$1.52 for o f ' }$ <<� ;. . each additional$100.00 or fraction thereof,to and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr ■ each additional$100.00 or fraction thereof,to minimum char:e-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 fust$25,000.00 and$1.45 for hours minimum char'e-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 char!e-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*. b ' I RFixture ®f' �`•� .yyy � Fixture Ve for 4 !'°;;;,i1;°:: Work Performed x Added' Plan review is required for any of the following. "� ' 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 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„ -4" Car Wash Drain • = e i m i = s s Garbage Domestic-non-food 0 Isometric or riser diagram is required for new buildings Disposal -Domestic-food related that meet the •ualifications 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 Washer-Clothes *Note: If the fixture work under this permit results in an Water Extractor increase of sewer EDUs,a sewer permit will be issued and Water Closet-Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: C:\Users\npruett\Downloads\PLMF_PermitApp.doc 2 City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT INg Building Permit Review — Residential TIGARD Building Permit #: mS j two k%, Q j . Site Address: lig I SW �- 6+-`' A Project Name: �lL�br �*.161,1t,.)- it Lot #: 13 (New dwellin=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: tJtki SM - Z 14 L tL 126Verify site address/suite# exists and activel permit system. 1L3 River Terrace Neighborhood: 1p' No El Yes,See River Terrace Review Addendum Attached Sits/Plan Elements: E ' ree(3)copies of site plan• l ' 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 D/ wn to scale(standard architect or engineer scale) flfly r elevations [B rth arrow L�'Utility locations&easements(required for new and additions) address,project or subdivision name and lot number idewalk/driveway approach Tr0plicant information(name and phone number) Fle, cation of wells/septic systems Lot dimensions and building setback dimensions Li Existing trees to be retained with drip line,and tree Suare footage of buildings to be demolisheitad ptection measures Lo ' area,building coverage area,percentage of coverage and L�',1S et tree size,type and location pervious area(applicable if R-7,R-12,R-25&R-40) I.EStreet names �/ roperty corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? les ❑No ) 4foot differential) If yes,is a storm water quality facility shown? ❑ ;e4ElNo te Clean Water Services—Service Provider Lette platted p d prior to 9/10/1995): LrAlej '''')/{\ Required: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No I Ili Public Faciliti�mprovement(PFI) Permit: uk equired: p" Yes,applicant was notified ❑ No Applied For: [Zs ❑ No,stop intake and Use Case#: PR2016'000&q [Loning: R-1 f po LI Required Setbacks: Front 15 Rear IS Side 3 Street Side Ikmt. Garage id ,�, andscape Requirement: 1,t} % [ of Coverage Maximum: so % Building Height: Maximum Height S Actual Height Z ZZ J Pr/Visual Clearance �/ nsitive Lands: El Yes L' No Type [ Urban Forestry Plan Conditions(' "Met"prior totissuance of buil ' gLill; _permit ecoor te : GAO-ON ► + env- 11�l l; t r`„�l' tilva..0 Approved By Planning: Jr . Date: [ .-L - Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: 0 Approved ❑ Not Approved Revision 3: 0 Approved El Not Approved I:\Building\Forms\BldgPerraRvw RES 061417.docx Building Permit Submittal Original Submittal Date: \:•'4.Q)t \' Site Plans: # , Building Plans: # 2 Building Permit#: 2 Enter building permit#above. Workflow Routing RI/Planning Engineering Dr-Permit Coordinator Er-Building Workflow Sign-off: [ Sign-off for Planning(include notes from planning review) Route Application Documents: [2'Engineering (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. De-Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: ' i,_, Date: ‘ ` \\ Engineering Review ,Slope at building pad: �-� Conditions"Met"prior to issuance of building permit ❑ Easements (encroachments)per engineering conditions of approval and plat ❑ Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes ❑ No Assess Water Quantity Fee in-lieu: 0 Yes 0 No LIDA Facility on lot: 0 Yes 0 No ❑ Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: ❑ Approved by Engineering: Date: ___4471/5 Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved ❑ Not Approved Revision 2: ❑ Approved 0 Not Approved Revision 3: 0 Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions"Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: grevision Notice 3: Date Sent to Applicant: SDC Fees Entered: Wash Co Trans Dev Tax: Illa Yes ❑ N/A Tigard Trans SDC: Er Yes ❑ N/A Parks SDC: [ ' Yes ❑ /A LIDA ❑ Yes I!4 N/A OK to Issue Permit -'-'21 /1,/A Approved by Permit Coordinator: Date: I:\Building\Forms\BldgPermitRvw_RES 010118.docx City of Tigard Tel: 503.718.2439 Location: Inspection Date: 14811 SW 76TH AVE, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2018-00354 Inspection Type: Inspector: 699 Mechanical final David Young Result: PASS Comments: No ac installed at this time. Permit and approved inspections required at time of installation. Violation Summary: Inspector Contractor City of Tigard Tel: 503.718.2439 Location: Inspection Date: 14811 SW 76TH AVE, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2018-00354 Inspection Type: Inspector: 399 Plumbing final David Young Result: FA I L Comments: Not ready for inspection. No access to exterior hose bib. Dishwasher handle not installed to check securing. House cleaners inside cleaning. Re schedule with access for inspection. Violation Summary: Inspector Contractor City of Tigard Tel: 503.718.2439 Location: Inspection Date: 14811 SW 76TH AVE, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2018-00354 Inspection Type: Inspector: 299 Final inspection David Young Result: FA I L Comments: Not ready for inspection. Guard rail and hand rail at stairs not done. Provide approved plumbing final inspection. No ac installed. No further inspection done. Violation Summary: Inspector Contractor City of Tigard Tel: 503.718.2439 Location: Inspection Date: 14811 SW 76TH AVE, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2018-00354 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS Comments: No ac installed at this time. Violation Summary: Inspector Contractor City of Tigard Tel: 503.718.2439 Location: Inspection Date: 14811 SW 76TH AVE, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2018-00354 Inspection Type: Inspector: 399 Plumbing final David Young Result: PASS Comments: Water pressure 45 psi. Violation Summary: Inspector Contractor City of Tigard Tel: 503.718.2439 Location: Inspection Date: 14811 SW 76TH AVE, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2018-00354 Inspection Type: Inspector: 299 Final inspection David Young Result: FA I L Comments: Provide duct seal test report as noted on approved plans and ORSC AF 103.4.8 All else appears ok. Violation Summary: Inspector Contractor City of Tigard Tel: 503.718.2439 Location: Inspection Date: 14811 SW 76TH AVE, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2018-00354 Inspection Type: Inspector: 299 Final inspection David Young Result: PASS - CofO Comments: Final erosion control approved. Moisture barrier form received. Moisture content form received. High efficiency lighting form received. Insulation certification checked. Continuous fan installed in crawlspace for radon mitigation. Electrician to install minor label for just completed work. C of 0 left on site with contractor. Violation Summary: Inspector Contractor