Permit (151) CITY OF TIGARD MASTER PERMIT
. ' COMMUNITY DEVELOPMENT
Permit#: MST2019-00004
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/25/2019
T I ;ti l:.D9 Parcel: 2S112BD12600
Jurisdiction: Tigard
Site address: 14833 SW 76TH AVE
Subdivision: ELDERBERRY RIDGE Lot: 22
Project: Elderberry Ridge, Lot 22
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1063 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1290 sf Garage: 378 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors. Yes
Total: 2353 sf Value: $296,781.25 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 Rain Storm Sewer: 100
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: _ Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 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
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 2353
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: $31,432.75
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 O952-001-0090. Y/.0 may obtain a copy of the rules or direct questions to OUNC by calling 50 .232.1987 or 1.800.332.2344.
Issued By: ,Akiri/i I4L g,d /1.t` 'i.,.; 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.
LcD0 ( a.?--< Budding Permit Application
R«.e,vtd iz-Lo-fg
Residential RECEIVED
FOR OFFICE CSI;O\Ll'
City Of Tigard a� ReactByd
,` `l � Permit No. \xn
IN -owo L.1-
. 13125 SW Hall Blvd.,Tigard,OR 97223 DE72n wCl t Plan Review Q� Other Permit.
Phone: 501718.2439 Fax: 503.598.1960 Date/BY: r 11 t /9'A' Z�Zb�q-
T I c: ,1}:C)
Inspection Line: 503.639.4175 C Date Ready/B ]oris:
CITY OF i IGARrt Y. q s SeePage2for
Internet: www.tigard-or.gov N.'ied/Method:
B i l l 1 R S O !MI^'O rFr Supplemental Information
* e VF& ,,,.,..,..,,,,;‘,..:42...,.g..
5' a :;„,...„,,x,„ ;:.,....4.1... � s, ., G..,%vt, �ry a.;-14,4.,.--".
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.❑Newconsuco . „§ 6;;;•`m";;;;10:"'''''"-1/4.—*
Dem"o>t)onnK1/4k '--
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
` 'b t • , T`' _; work indicated on this application.q/
1-and 2-familydwellingValuation: $
❑ 0 Commercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms: 4
El builder 0 Other: Number of bathrooms: 3
• I
A, .:41:!';,4",-;: , 7::,7,'' 1 a i . Total number of floors: 2 a7 3 1
.fix;a�� 1 .�?.
Job site address: 14833 SW 76TH AVE New dwelling area: 2353 square feet i',10
City/State/ZIP: Tigard, OR 97224 Garage/carport area: 378 square feet ,b(r)er
Suite/bldg./apt.no.: Project name: Elderberry Ridge Covered porch area: ›gr.
square feet
Cross street/directions to job site: SW Bonita Rd & SW 76th Ave Deck area: square feet ,.r
Other structure area: square feet
¢@, . t1-,3 t '.5.#:t+� 3, -- e X', d
Subdivision: Elderberry Ridge Lot no.: 022 Permit fees*are based on the value of the work performed.
2S 1126 D00300 Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no
r1equipment,materials,labor,overhead,and the profit for the
'' t `i work indicated on this application.
x
Construction of SFR — 2773 C12., Valuation: $
Existing building area: square feet
New building area: square feet
` v ..° t Number of stories:
Name: Riverside Homes, LLC Type of construction:
Address: 17933 NW Evergreen Pl., Ste 370 Occupancy groups:
City/State/ZIP: Beaverton, OR 97007 Existing:
Phone:( Fax:
Business name: Homes LLC Fax:( ) New:
f•Riverside ; i .,.: p r, ;
° _., ....��'
Structural plan review fee(or deposit):
Contact name: Wes Boisvert
FLS plan review fee(if applicable):
Address: 17933 NW Evergreen Pl., Ste 370
City/State/ZIP: Beaverton, OR 97007 Total fees due upon application:
Phone:(503)645-0986 Fax::( ) Amount received:
E-mail: wboisvert@riversidehome.com .° . ', ,£ ; ,.;,
r- Commercial and residential prescriptive installation of
. F. ' , ' roof-top mounted Photo Voltaic Solar Panel System.
Submit two(2)sets of roof plan with connection details
Business name: Riverside Homes, LLC
and fire department access,along with the 2010 Oregon
Address: 17933 NW Evergreen Pl., 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.
*Fee methodology set by Tri-County Building Industry
Print name: Nikki Pruett Date: 12/18/18
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 ONLY
City of Tigard Received
INDate/By: No.A -'�
13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
I Phone: 503.718.2439 Fax: 503.598.1960
T I G A h D 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 1c No N/:k
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-fl.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)
Mechanical Permit Applicati ECEiVReceived rod orFlcF USE ONI.v
City Of 7'1gaIC(1 Date/By: Permit No. 0`i
111 "I13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 DEC 2 0 2018 DateBy: Other Permit:
I I(,A R I7 Inspection Line: 503.639.4175 Date Ready/By: Iuris: ® See Page 2 for
Internet: www.tigard-or.gov CITY OF i f( ARO Notified/Method: Supplemental Information
BUILDING DIVISIO
, . l''''''''''.4.14::; . t '6 $: . tZet r. ' ,',:,:::::;;74V'•` 1:144Z .�Y #Ii':,::...442'4::"'s '..1`,',.1,,`; o v a;
Mechanical permit fees*are based on the value of the work
✓❑New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
mechanical materials,equipment,labor,overhead,and profit.
0 Demolition ❑Other:
y 4I, E �Fr
Value:$
''. 3'` 2 x' �ty, � � t . Y. ;;� k..Y� L�� i 2W" ,J W" A
4 * s>l c s cl
❑✓ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total
4 xala . , . , , ' 0. Heating/cooling:
Air conditioning 1 46.75 46.75
Job site address: 14833 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.: 022 Other: 23.32
Other fuel appliances:
Tax map/parcel no.: 2S112BD00300 Water heater 1 23.32 _ 23.32
." w .:,,,.....r...w,E a�, r ,k"" "" Gas fireplace/insert 1 33.39 33.39
ry' 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
�a azOther: 23.32
...,"... s0r :4'
F � : 0 0 „ w;41..;41:014.1,,,‘;',4...:,:0,4-,,'.4-1-111-. r �,...f,.-e-
" ,
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) 5 23.32 ni1•40
Phone:(503 )645-0986 Fax:( ) Attic/crawlspace fans 23.32
r. Other: 23.32
r ie 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 pump
Wall/suspended/unit heater
City/State/ZIP: Beaverton, OR 97007 Water heater 1 14.15
Phone:(503 )645-0986 I Fax::( ) Fireplace 1 14.15
E-mail: wboisvert@riversidehome.com Ba be1 14.15
Barbecue
_ s
K z',° ;'a $#. ,h"` 17 _ �uf Clothes dryer(gas)
Other:
Business name: Pro Heating & Cooling
Address: 2095 NW Alocleck Rd.#1103 Subtotal
City/State/ZIP: Hillsboro, OR 97124 Minimum permit fee($90.00)
Phone:( 971) 205-4989 Fax:( ) Plan review(25%of permit fee)
State surcharge(12%of permit fee)
CCB lic.: 209001 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: * Fee methodology set by Tri-County Building Industry Service Board
Print name: Nikki Pruett Date: 12/18/18
I:\Building\Permits\MEC_PermitApp_040113.doc 440-46171(11/02/COM/WEB)
' Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Famil Fee Schedule:
y
$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 Applicatio'RECEIVE FOR OFFICE USE oyl.v
Received
City of Tigard ateB : Permit#. , _ a -0 1
't 13125 SW Hall Blvd.,Tigard,OR 97223 DEC 2 0 2 0 1 8 DPlan Review
0 Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#:
Inspection Line: 503.639.4175 CITYry Ready Date/By: 7uris: ® See Page 2 for OF (�bAR
T 1 G n R n Internet: www.tigard-or.gov BUILDING
LDINC Du
Notified/Method: Supplemental
upplement•
al Information
'. . ,I PT ,.k , ; J-'- �,�°',.i W' .g > 44k7: .. . 4 7,4 i . -,•-;:f; i4-':: ° ` s i ';',Xw1>
E lNew construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Demolition ❑Service or feeder 400 amps or more ❑Building over three stories.
❑Other: where the available fault current 0 Marinas and boatyards.
i r _"s> ; _ fexceeds 10,000 amps at 150 volts or
< �� .',�� §`-� 0 Floating buildings.
❑✓ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 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 :',),.i•-111.•:;
." 5,7:F-2,11.
z / „ '. xp �p 1� k s is, p p� I '�,�'r : 0 Emergency system. larger separately derived
Job#: Job100HPsite address: 14833 SW 76TH AVE ❑Addo of new motor load of system.
or more. ❑"A",`B","1-2","I-3",
❑Six or more residential units. occupancy.
City/State/ZIP: Tigard, OR 97224
0 Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: 1 Project name: Elderberry Ridge ❑Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: SW Bonita Rd & SW 76th Ave .:: ,; .-' i 1;: 5(s ' y 1w;
DescriptionQty. Each Totalka
New residential single-or multi-family dwelling unit.
Subdivision: Elderberry Ridge 1 Lot#: 022 Includes attached garage.
1,0Tax map/parcel#: 2S112 B D00300 Ea.a.a sq.ft.or less 168.54 4
add'l 500 sq.ft.or portion 33.92 1
c C.,217.:1::'. I!`z! .td. Y Limited energy,residential 75.00 2
Construction of SFR (with above sq.ft.)
Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
121...'11.0"77:-.1:7V. 4 ' • Renewable Energy 0 See Page 2
�'¢ .w,--..-,-,,,,,7,-,,,, ,:,,` _ Services or feeders installation,alteration,and/or relocation
Name: Riverside Homes, LLC 200 amps or less 100.70 2
Address: 17933 NW Evergreen PI., 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
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 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
~"- - am 7 - 1 Branch circuits-new,alteration,or extension,per panel
ix • *''tf ' -`4 0 t" t A.Fee for branch circuits with
Business name: Riverside Homes, LLC above service or feeder fee, 7.42 2
each branch circuit
Contact name: Wes Boisvert B.Fee for branch circuits without
service or feeder fee,first
Address: 17933 NW Evergreen PI., Ste 370 branehcircnit 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
�:.:. a"t 1;t ttcati; � '7,,..., <.,Y ., t�.. " �°"; Pump or irrigation circle 67.84 2
Business name: Sunlight Electric Inc Sign or outline lighting 67.84 2
Address: 2804 NE 65th Ave. St. D Signal circuit(s)or limited-energy ❑ See Page 2 2
panel,alteration,or extension.
City/State/ZIP: Vancouver, WA 98661 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(360) 518-7589 Fax:( ) Investigation(1 hr min) 90.00/hr
Email: /U Ilfif
Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: 172549 Electrical Lie.: C230 Suprv.Lic.1?'FS s.ecificall listed '/z hr mm 90.00/hr
Suprv.Electrician signature,required: /24,,, , .24____,1/' Subtotal:
Print name: Chester Garrett I Date: 12/18/18 0 Plan Review Required(25%of permit fee):
�r�/I�����
State surcharge(12%of permit fee):
Authorized signature: 4TOTAL 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:
' r ..., ot t.
65+'.1„4 t
Description Qty Each Total *
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 lova(fee in accordance
with OAR 918-309-0040) 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
❑ 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 mm)
Inspections for which no fee is 90.00/hr
s.ecificall listed '/2 hr min
', Ia -' ` 'moo +4i .s ` .GI .W
vv �
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
(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
1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015
Plumbing Permit Application
Building Fixtures RECEIVE.-
Folz OFFICE USE ONLY
Cl of Tigard Received
ill 1114 13125 SW HallllBlvd.,Tigard,OR 97223 DEC 2 0 2018 Plan Re Date/By:
Permit No.���- RC1 ��;C �
e Plan Review ', l 1
Phone: 503.718.2439 Fax: 503.598.1960^-rte >t ate/By: Other Permit No.:
T I G A R D Inspection Line: 503.639.4175 "�a ' OF f'�� ; ® See Page 2 for
Internet: www.
BUILDING DIVISI*I. Ready/By: 1uris:
fied/Method: Supplemental Information
's -i ;pry#
t
i " '' ,; i( If " a'' * t
•
r'ff2 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)
i 3 . , .<,r{ e.4 ' tt. t ' '''''''''''':'4'''''
, P .' '''r'* ' ..,4:!'",,. SFR(1)bath 312.70
12I 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 1 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other.
Fire sprinkler(_sq.ft.) Page 2
1 x;'.,
i » '« A i '*:'"* Site utilities:
.mak .W , . .
Job site address: 14833 SW 76TH AVE Catch basin or area drain 18.76
City/State/ZIP: Tigard, OR 97224 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: 1 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.: 022 Fixture or item:
Tax map/parcel no.: 2S 112BD00300 Backflow preventer no backflow for this home. 31.27
h <�# 1 €, ,k r* Backwater valve
12.51
Construction of SFR Clothes washer 1 25.02
Dishwasher 1 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
lts
- e .• -;-,,,,N.:44
Expansion tank 12.51s .4'Nl t . t , .... . "" ' e Fixture/sewer cap' �. '
25.02
Name: Riverside Homes, LLC
Floor drain/floor sink/hub 25.02
Address: 17933 NW Evergreen Pl., 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
xnP 11. •j J ' -inti a 4 " Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name: Riverside Homes, LLC
Primer 12.51
Contact name: Wes Boisvert
Roof drain(commercial) 12.51
Address: 17933 NW Evergreen Pl., Ste 370 Sink/basin/lavatory (.0 25.02
City/State/ZIP: Beaverton, OR 97007 Solar units(potable water) 62.54
Phone:(503)645-0986 Fax: :( ) Tub/shower/shower pan 12.51
Urinal 25.02
E-mail: wboisvert@Q riversidehome corn
i : Water closet 3 25.02
.. . • Water heaterit,P 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
CCB Lic.: 178122 Plumbing Lic.no.: PB414 Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: /26(///p/A- 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.
440-4616T(10/02/COM/WEB)
l•\Building\Permits\PLMU-PermitApp.doc 10/01/09
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Su•• s ression S stems:
m ,. zz,
Footing drain-1"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
Storm&Rain Drain-1st 100' 62.54
$1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Other in .a >ilo n w
£ each additional$100.00 or fraction thereof,to
s' 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 first$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.le-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*.
Op
�i � qt 4 g A
rWait ulPerforhf Added' 'RaftsPlan review is required for any of the following.
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"
‘4,4
Car Wash Drain , � 4
Garbage -Domestic-non-food 0 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 workunderthis 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:\Users\npruett\Downloads\PLMF_PermitApp.doc 2
City of Tigard
i
114 st COMMUNITY DEVELOPMENT DEPARTMENT
G A f:l•
Building Permit Review - Residential
Building Permit #: s--- kqt -
Site Address: ,.41 t s) 9-(e /9Y-e
Project Name: Egerr�_ &d Lot #:&;2
(New dwelling=gi�5i division naiKAddition or Alteration=last name of owner)
Planning Review
Proposal: I} ,PL
Verify site address/suite#exists and activejn permit system.
F! River Terrace Neighborhood: Lvt No ❑ Yes,See River Terrace Review Addendum Attached
Sits Plan Elements:
IDizoee(3)copies of site plan I1 S.:sig structures on site
e plan must be on 8-1/2"x 11"or 11 x 17"paper I. ootprint of new structure(including decks)with finished
JIawn to scale(standard architect or engineer scale) i.or elevations
rth arrow I JJtility locations&easements(required for new and additions)
Oliite address,project or subdivision name and lot number Sidewalk/driveway approach
iDi .pplicant information(name and phone number) 11i,. ation of wells/se tic systems
KLot dimensions and building setback dimensions kV' :sting op y
At'' •uare footage of buildings to be demolished �p tectitreesonng trees e
a Lot area,building coverage area,percentage of coverage and 1�2S eet tree size,type and location
judpervious area(applicable if R-7,R-12,R-25&R-40) IQStreet names
Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replace ? Yes 1:11e
4 foot differential) If yes,is a storm water duality facility shown?t.] ❑Yes E No
Clean Water Services—Service Provider Lettof platted prior to 9/10/1995):
equired: ❑ Yes,applicant was notified AA No Received:
❑ Yes 0 No
Public Facil • Improvement(PFI)Permit: P i.2o/ _
Required: Yes,applicant was notified 0 No Applied . a
�,/ For. V� Yes 0 No,stop intake
eIci d Use Case.#: -2 Q b,_ p co 9
ning: -
iL► •uired Setbacks: Front
1 Rear /,c— Side Street Side /D Garage -Q
1: ndscape Requirement: Q 0
i2it Coverage Maximum: 70-7 vo
uilding Height Maximum Height - 1 11
Actual Height Le
VA Visual Clearance
Fr° ,-nsitive Lands:
0 Yes No Type
1 Urban Forestry Plan
0 Conditions "M t"prior to issuanceisso building permit
Notes: oNbil S' <C ,a/1 mei- fJjr- A /711i7L' ia' j/a2,t'
4proved By Planning: 1
Date: / 6 J *
Revisions (after Building Submittal only) Reviewer
Revision 1: 0 Approved 0 Not Approved Date
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
I:\BuildineForms\BldgPermitRvw_RES_061417.docx
Building Permit Submittal
Original Submittal Date: t .`- k t'
Site Plans: #
Building Plans: # J.4----
Building Permit#: g,/Enter building permit#above.
Workflow Routing: [QC Planning Engineering ["Permit 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.
[Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: .....54+-&-A-1'— Date: t, It)t lC\
En ineering Review o
cope at building pad: 2`,
onditions"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: 0 Yes 0 No
Assess Water Quantity Fee in-lieu: 0 Yes 0 No
LIDA Facility on lot: 0 Yes 0 No
❑ Final Plat Recorded:
❑ NOT Approved iyEngineering: Date:
Notes:�
[PApproved by Engineering: /� Date: Z /`
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 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
V
Revision Notice 3: Date Sent to Applicant:DC Fees Entered: Wash Co Trans Dev Tax: Yes 0 N/A
Tigard Trans SDC: g Y 0 N/A
Parks SDC: Yes ,❑ N/A
LIDA 0 Yes I.�'N/A
OK to Issue Permit
Approved Permit Coordinator: 2/6/1 9
b y /Tr-Date:
I:\Building\Forms\BldgPermitRvw_RES 010118.docx
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
III _ Transmittal Letter
i c,,1 R n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: MLL/ son a rt q DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
4 2019
FROM: I 1�k I Pete-t4 CITY OF TIGARD
COMPANY: 14 velem de 14Ume S 3UILDING DIVISION
PHONE: S}3 &LIS 0°1 Ve° By: /lel-
RE: riA SI- .-3 /1" 'h & P'l.s r 20 t 1-a)C0"/
(Site Address) (Permit Number)
tcteb ee /2-idle
(Project name or subdivision name and lot number)
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. x Engineer's calculations.
Other(explain):
REMARKS: "Tr--ti SS 1.4A1 CO 5 4r)9 i P1,6o - Oe S c 01449 i I ene y
P1 a-encl
FOR OFFICE USE ONLY
Routed to Permit Tec i ' 'an: ate: Initials:
Fees Due: ❑Yes 1'NN Fee Description: Amount Due:
NU $ 7,-----°-$
Special
Instructions:
Reprint Permit(per PE): ❑Yes N ❑ Done
Applicant Notified: V.„a9--- Date: a.I 1( /Gj Initials:
I:\Building\Forms\TransmittalLetter-Revisions_061316.doc
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
14833 SW 76TH AVE, TIGARD, OR, 97224 June 4, 2019 at 12:18:31 PM
Record Type: Record ID:
Residential - Master Permit MST2019-00004
Inspection Type: Inspector:
299 Final inspection Aaron Cillo-Gobel
Result:
PASS - CofO
Comments:
Final erosion control passed
Moisture content form received
Moisture barrier acknowledgement form received
High efficiency lighting form received
Insulation certification verified
C of 0 left on counter.
Violation Summary:
Inspector Contractor