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Permit (209) CITY OF TIGARDMASTER PERMIT '. ' COMMUNITY DEVELOPMENT . Permit#: MST2019-00240 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ��f Date Issued: 08/26/2019 T t�' L li 1) 9 Parcel: 2S112BD10700 V Jurisdiction: Tigard Site address: 14994 SW BELVOIR CT Subdivision: ELDERBERRY RIDGE Lot: 3 Project: Elderberry Ridge, Lot 3 Project Description: New SF. 9/4/19: REPRINT to convert loft into 5th bedroom and add(1)laundry tray. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 5 First: 1179 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 23 Bathrooms: 3 Second: 1447 sf Garage: 379 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors. Yes Total: 2626 sf Value: $329,165.90 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0 Bckflw Prevntr: 1 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add!500 sf: 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 2626 Owner: Contractor: RIVERSIDE HOMES LLC RIVERSIDE HOMES LLC Required Items and Reports(Conditions) 17933 NW EVERGREEN PL STE 17933 NW EVERGREEN PKWY 370 i Er9n Cntr1503-639=4175 370 BEAVERTON,OR 97006 BEAVERTON,OR 97006 PHONE: 503-645-0986 PHONE: 503-645-0986 FAX: 503-690-2942 Total Fees: $32,300.22 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Co,es 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 issu- ce, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notificatio Center.' Those rules are set forth in OAR 952-001-0010 through OAR 952-001-009., You may,,..ain a cop = the rules or direct questions to OUNC by calling 503.'32.1987 or 1.800.332.2344. Issued By: ',)� 7 Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspection da e. This permit card shall be kept in a conspicuous place on the job site until completion • e project. Approved plans are required on the job site at the time of each inspection. Building Permit Application Residential ccii FOR 01 1 1( 1: tSF 0\1.1" City of Tigard RE C E I V E ��� _ in 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review _ Phone: 503.718.2439 Fax: 503.598.1960 AUG 2 8 2 019DateB : Other Permit: I `I Inspection Line: 503.639.4175 Date Ready/By: Julie: ® See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARD NotifedMethod: Supplemental Information Bl)Il RING DIVISION TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING ❑✓ New construction ❑Demolition '"a r F l r 771 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: r.,g , 0, - equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ✓ 1-and 2-familydwellingValuation: $ ❑ ❑Commercial/industrial EIAccessory building ElMulti-familyNumber of bedrooms: 5 ❑Master builder 0 Other: Number of bathrooms: 3 JOB SITE INFORMATION AND LOCATION Total number of floors: 2 Job site address: 14994 SW Belvoir Ct. New dwelling area: 2626 square feet City/State/ZIP: Tigard, OR 97224 Garage/carport area: 379 square feet Suite/bldg./apt.no.: Project name: Elderberry Ridge Covered porch area: 33 square feet Cross street/directions to job site: SW Bonita Rd &SW 76th Ave Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Elderberry Ridge I Lot no.: 03 Permit fees*are based on the value of the work performed. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. Adding an additional bedroom for a total of 5 and laundry room Valuation: $ sink. Existing building area: square feet -c"X,Sly ,-ri/74--ien5779.011_00e;..i/ y New building area: square feet — Q PROPER OWNER Q TENANT 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: 0 APPLICANT ❑✓ CONTACT PERSON BUILDING PERMIT FEES* (Please refer se fee schedule) Business name: Riverside Homes, LLC Structural plan review fee(or deposit): Contact name: Amo Avgi FLS plan review fee(if applicable): Address: 17933 NW Evergreen PI., Ste 370 Total fees due upon application: City/State/ZIP: Beaverton, OR 97007 Amount received: Phone503)645- 986 Fax :( 1 E-mail: aavgi@riversidehome.com Commercial and residential prescriptive installation of CONTRACTOR 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 Pl., Ste 370 Solar Installation Specially 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 lic.: 189148 Total fee due upon application: $201.60 Authorized signature:, / This permit application expires if a permit is not obtained '= u t within 180 days after it has been accepted as complete. Print name: Nikki Pruett Date: 8/27/2019 *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Plumbing Permit Application Building Fixtures 1 oR Oilit ! t 0y1.1 City of Tigard RECEIVE eceived DaeBy' Permit No./17.s Ai)H._dc.),3,4 111111 4q 13125 SW Hall Blvd.,Tigard,OR 97223 e AUG (. eview Phone: 503.718.2439 Fax: 503.598.1960 U2 8 ^' DatePlanBy:ROther Permit No.: Inspection Line: 503.639.4175 i I G A It D `IGS Date ReadyBy: loris: la See Page 2 for Internet: www.tigard-or.gov CITY OF tified/Method: Supplemental Information t:"",'-'r .w, ,.r , � Tar Y''S`t a1i &ia amn .s vo...tW...sai.�u..' ,1„ .. �....�,. Www«., . ..a«-o-.-�a .. : _• ,*, _ !.¢ 0 New construction 0 Demolition For special information use checklist Description I Qty. I Ea. I Total ❑Addition/alteration/replacement 0 Other: g,. s<,` ; it New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION ii { SFR(1)bath 312.70 RI 1-and 2-family dwelling 0 Commerci • 14 r' SFR(2)bath 437.78 0 Accessory building 0 Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 1 25.02 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 14994 SW Belvoir Ct. Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: Tigard, OR 97224 Footing dram(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 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.: 03 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK` Backwater valve 12.51 Adding an additional bedroom for a total of 5 and laundry room Clothes washer 25.02 Dishwasher 25.02 sink. Drinking fountain 25.02 -e)(1{ /%1 r'1' A c l'il -t)01;41,L Ejectors/sump 25.02 Q PROPERTY OR 1 ❑ TENANT Expansion tank 12.51 Name: Riverside Homes, LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 17933 NW Evergreen Pl., Ste 370 Garbage disposal 25.02 City/State/ZIP: Beaverton, OR 97007 Hose bib 25.02 Phone:(503)645-0986 Fax:( ) Ice maker 12.51 0 APPLICANT 9CONTACT PERSON Interceptor/grease trap 25.02 Business name: Riverside Homes, LLC Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Amo Avgi Roof drain(commercial) 12.51 Address: 17933 NW Evergreen Pl., Ste 370 Sink/basin/lavatory 1 25.02 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 'k - Urinar s_- 425.0' E-mail: aavgi@riversidehome.com CONTRACTOR Water closet 25.02 Water heater 37.52 Business name: H & H Mechanical Waterpiping/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 Lw.no.: PB414 Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature:, ,, ,. /ti t, t� TOTAL PERMIT FEE Print name: Nikki Pruett Date: 8/27/2019 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(IO/02/COM/WEB) City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT 1111 I T 1 c D Building Permit Review — Residential Building Permit #: 'MST alcACt- 0 Site Address: /1/?91/ ,k) i e Vain GL- Project Name: Odpr-,en- &ti Lot #: .' (New dwelling=subdi sion name;Ad ti or Alteration=last name of owner) Planning Review a9 j 9 9ro sal: �.�dt) ��e -�' lac._'G_rvtice/iw Jdf9- d, a Verify address/suite#active in Accela. � n River T e: No 0 Yes,River Terrace Review Addendum 1'14 Plan Elements: SsW sion Control V!.4 copies of site plan on 8-1/2"x 11"or 11 x 17"paper ,Il P.tained trees with drip line and tree protection measures �� ►raven to scale(standard architect or engineer scale) j.•otprint of new structure(including decks)and FEE .4 •rth arrow 'ty locations&easements(required for new and additions) c/►:ite address,project or subdivision name and lot number Mi Sid.. alk/driveway approach pplicant information(name and phone number) i1'i�cation of wells/septic systems Lot dimensions and building setback dimensions J eet tree size,type and location u. - footage of buildings to be demolished 4 S eet names I' *. ting structures on site Comer elevations(2'contours if more than 4'diff tial) tteqtrarea,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replac ? i1fJ s ❑ o impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown Yes d4 No Wean Water Services—Service Provider Lette�(lot platted prior to 9/10/1995): eequired: ❑ Yes,applicant was notified L( No Received: ❑ Yes ❑ No 1!J Public Faciliti mprovement(PFI)Permit: ccRequired: al Yes,applic t was notified 0 No Applie or: '!J Yes 0 o,st intake nd Use Case#: )1e1 Co/ep-•- � � s" ) , equired Setbacks: Front.o�D Rear: / Side: Streety Side: /C— Garage: ding Height: Max.Height: / Actual Height: •.a.2'dig ndscape Area: % t Coverage Max: Entrance r. et back no more than 8'from street-facing wall Parallel to street or offset 45 degre- • -ss Windows 0 Minim ,. %of area of all street-facing facades Garage ❑ Garage door is be-1. - ..dest street-facing wall Yes ■ -o,one of the following is met: ❑ Door extends no more i 'from wall and there is . : . red porch extending beyond garage. ❑ Door extends no more than 5'from • . i ere is a 12 sq ft.window above garage on 2ad floor. 0 Garage door width is 0 12' • - ■ 50%or •f facade 0 60%or less and includes 7 of following: 0 Covered •or . a Recessed entrance 0 Wall of s- ■ 1'Roof eave ❑ Roof offset _ "". mo — ■ wormer 0 Accent siding Window trim ❑ Window recess -1J v ,._. •' _ 10 Visual�leaiance rban Forestry Plan Sensitive Lands: Yes 0 NoType: U70-.t toe7k?d,r •/ 0 Conditiops.)mettprior to issuance of b ding permit/ !/ , ec�m or- N es: L Qilifrij'cnt S. A/7L Q 271i `-- /iii/71"l-'!Ia-/7C� Approved By Planning: "—�"—" Date: &b Revisions (afterBding Submittal only) , view r�— Date ANINNOW 2'Approved 0 Not Approved ""l / 8- Revision 2: 0 Approved 0 Not Approved A j Revision 3: 0 Approved 0 Not Approved I:\Buildin \Fortns\Bld g gPermitRvw_RES_022819.docx Building Permit Submittal Original Submittal Date: t 12,1 iq Site Plans: # Building Plans: # Building Permit#: LTJ Enter building permit#above. Workflow Routing. g"Planning E3"Engineering C Pff./Building Coordinator L'� 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: . � Date: lQt P-3I Pi EnRineerrng Review Slope at building pad: . � Conditions"Met"prior to issuance of building permit O Easements (encroachments)per engineering conditions of approval and plat ❑ Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: 0 Yes Ca/No Assess Water Quantity Fee in-lieu: ❑ Yes U2rNo LIDA Facility on lot: ❑ Yes IW Final Plat Recorded: ❑ NOT Approved by Engineering: Date: ,,N_,otees�s: li' 'Approved by Engineering: Date: Revisions (after B.u' ding Submittal only) viewer Date Approved ❑ Not Approved 9:75//y' Revision 2: 0 Approved 0 Not Approved Revision 3: ❑ Approved 0 Not Approved Permit Coordinator Review O Conditions"Met"prior to issuance of building permit O Approved,NOT Released: Date: Notes: Revisions(after Building Submittal only) � Date Sent to Applicant Revision Notice 2: Date Sent to Applicant: R vision Notice 3: Date Sent to Applicant: SDC Fees • ntered: Wash Co Trans Dev Tax: Ce Yes 0 N/A Tigard Trans SDC: 21 yes ❑ N/A Parks SDC: 1 Yes ❑ /A LIDA 0 Yes L✓S N/A 9/31 ■ OK to Issue Permit Approved by Permit Coordinator: Date: !� I:\Building\Forms\BldgPermitRvw_RES_022819.docx CITY OF TIGARD MASTER PERMIT IN, , ;.. .., COMMUNITY DEVELOPMENT Permit#: MST2019-00240 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/26/2019 Parcel: 2S112BD10700 Jurisdiction: Tigard Site address: 14994 SW BELVOIR CT Subdivision: ELDERBERRY RIDGE Lot: 3 Project: Elderberry Ridge, Lot 3 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1179 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 23 Bathrooms: 3 Second: 1447 sf Garage: 379 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2626 sf Value: $329,165.90 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: 0 Bckflw Prevntr: 1 Catch Basins: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 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 2626 Owner: Contractor: RIVERSIDE HOMES LLC RIVERSIDE HOMES LLC -_ _ __Required items and 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: $32,227.20 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes a . al 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, ',r if ork is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Ce -r. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. Yo/'u mayrQbtain a c•- - - -s or direct questions to OUNC by calling 503.232.1:87 0 1.800.332.2344. Issued By: "i__� ,,," _ —� ` • - '.nature: a c.JIL? -'9.4175 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 Residential I (ll 1 1( 1 I sl:O\1.1" City of Tigard RECEIVED Received /�� III 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: 13 t �;T Permit No.mcy; 1t_u 'I . Phone: 503.718.2439 Fax: 503.598.1960 J U N 13 7019 Date/By:Plaiew(P 1 41 other pmt ''•'�' ' i c ‘Et i 1 Inspection Line: 503.639.4175 e'� �� Date Ready/By: orris: ® See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARD ••itiied/Method•Le ; f' ', Supplemental Information BUILDING DIVISION i,> ,,, .fir E •F WOl - REQUIRED DATA:1-AND 2-FAMILY DWELLING 0 New construction 0 Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. G., ` a 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ 3 a l j 1+' / 'c ID Accessory building 0 Multi-family Number of bedrooms: 4 `� ❑Master builder 0 Other: Number of bathrooms: 3 JOB SITE INFORMATION AND LOCATION Total number of floors: 2 3COc Job site address: 14994 SW Belvoir Ct. New dwelling area: 2626 square feet 1 C.{Lt 7 City/State/ZIP: Tigard, OR 97224 Garage/carport area: 379 square feet l t 19 Suite/bldg./apt.no.: Project name: Elderberry Ridge Covered porch area›( square feet 1 Cross street/directions to job site: SW Bonita Rd & SW 76th Ave Deck area: J `� square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-ME CHECKLIST Subdivision: Elderberry Ridge I Lot no.: 03 Permit fees*are based on the value of the work performed. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. Construction of SFR Valuation: $ Existing building area: square feet New building area: square feet D PROPERTY OWNER 0 TENANT Number of stories: Name: Riverside Homes, LLC Type of construction: Address: 17933 NW Evergreen Pl., Ste 370 Occupancy p y groups: City/State/ZIP: Beaverton, OR 97007 Existing: Phone:( 503)645-0986 Fax:( ) -1 New: Q �U APPLICANT CONTACT PERSON BUILDING PERMIT FEES* Business name: Riverside Homes, LLC (lle+rerefer mfee siethtl e) Structural plan review fee(or deposit): Contact name: Amo Avgi Address: 17933 NW Evergreen Pl., Ste 370 FLS plan review fee(if applicable): City/State/ZIP: Beaverton, OR 97007 Total fees due upon application: - one ( 3)645-0986 Fax::( ) Amount received: E-mail: aavgi@riversidehome.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted Photo Voltaic 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 Pl., Ste 370 Solar Installation Specialty Code checklist. City/State/ZIP: Beaverton, OR 97007 Permit Fee(includes plan review $180.00 Phone:( 503)645-0986 Fax:( ) and administrative fees): State surcharge(12%of permit fee): $21.60 CCB Pic.: 189148 Total fee due upon application: $201.60 Authorized signature:, (' This permit application expires if a permit is not obtained x ` r �` within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Print name: Nikki Pruett Date: 6/11/19 Service Board. I:\Building\Permits\BUP-RESPernritApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Buildjn2 Permit Application Checklist One- and Two-Family Dwelling FoR OFFICE USE ONLY City of Tigard Received lig13125 SW Hall Blvd.,Tigard,OR 97223 DateBy: Permit No.: I Phone: 503.718.2439 Fax: 503.598.1960 Associated permits: 24-Hour Inspection Line: 503.639.4175 0 Electrical 1WARD p ❑ Plumbing ❑ Mechanical Internet: www.tigard-or.gov 0 Other: THE FOLLOWING ITEMS ARE REQUIRED FIR PLAN REVIEW )es No NiA 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 s ' rxanarkhr ariP,v, -. _ ._,a ,.,. - __T__. . 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". 0 0 0 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 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. ❑ ❑ ❑ 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\BOP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Application• C City of Tigard REEIVED Received 11 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By:Phone: 503.718.2439 Fax: 503.598.1960 JUN I .3 2 01 n 7 PlanReDate/B :e W Other Permit. r i G AR n Inspection Line: 503.639.4175 Date Read/B : loris: Internet: www.tigard-or.gov CITY OF I G AR Dy y see Pent nr BUILDING DIVISION Notified/Method:Notified/Method: Snppkmental Information R +i ! ' ", !) ,;..• ..,. 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 ❑Demolition 0 Other: mechanical materials, equipment,labor,overhead,and profit. CATEGORY OF CONSTRUCTION Value:$ RESIDENTIAL EQUIPMENT I SYSTEMS FEES* ISI 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi-family ❑Master builder 0 Other: DescriptionQtY• Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 1 46.75 46.75 Job site address: 14994 SW Belvoir Ct. 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 Suite/bldg./apt.no.: Project name: Heat pump 61.06 j 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 hypnic) 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 I Lot no.: 03 Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 1 23.32 23.32 DESCRIPTION OF WORK Gas fireplace/insert 1 33.39 33.39 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 0PROPERTY OWNER } 0 TENANT Other: 23.32 Environmental exhaust and ventilation: Name: Riverside Homes, LLC Range hood/other kitchen Address: 17933 NW Evergreen Pl., Ste 370 - equipment 1 33.39 33.39 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 I Fax:( ) Attic/crawlspace fans 23.32 0 APPLICANT i EJ CONTACT PERSON Other: 23.32 Business name: Riverside Homes, LLC Fuel piping: $14.15 for first four;$4.03 for each additional Contact name: Amo Avgi Furnace,etc. 1 1 1 14.15 Address: 17933 NW Evergreen Pl., Ste 370 Gas heat pump - Wall/suspended/unit heater r _C'ty/State/ZIP: Btaave ton,_OR 97007 T__ _ - 14.15 Phone:(503 )645-0986 Fax::( ) Fireplace 1 14.15 Range 1 14.15 E-mail: aavgi@riversidehome.com Barbecue CONTRACTOR Clothes dryer(gas) Business name: Pro Heating & Cooling Other: MECHANICAL PERMIT FEES* 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 of surcharge g (12% permit fee) CCB lie.: 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: LPi. i W(" '��'I * Fee methodology set by Tri-County Building Industry Service Board Print name: Nikki Pruett Date: 6/11/19 I:\Building\Pemtits\mC_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 Application_ 1,012 01 1( 1. t SI 0yI 't City of Tigard E C E 1 V E D Received ,III 13125 SW Hall Blvd.,Tigard,OR 97223 I DateB : Permit#.�,`�� C ,� Phone: 503.718.2439 Fax: 503.598.1966'U N 1 3 2 019 Plan Review Date/B : Related Permit#: l_1 G`\R t) Inspection Line: 503.639.4175 Ready Date/By: tuns: ® See Page 2 for Internet: www.figard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information B ILDING DIVISION TYPE OF WO IN New construction 0 Addition/alteration/replacement Please check all that apply(submit g seta of Oasis w/items checked): 0Service or feeder 400 amps or more 0Building over three stories. El Demolition 0 Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings. MI 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural Other: amps for all other installations. buildings. ❑Multi-family 0 Master builder 0 Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived Job#: Job site address: 14994 SW Belvoir Ct. ❑Addition of new motor load of system. 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. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: Elderberry Ridge 0 Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: SW Bonita Rd &SW 76th Ave FEE SCHEDULE Description I Qty. I Each I Total 1 New residential single-or multi-family dwelling unit. Subdivision: Elderberry Ridge I Lot#: 03 Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 168.54 4 Ea.add'l 500 sq.ft.or portion 33.92 1 „„,. ;, ,, ,, K, ,...,;�, E:.:_ `tj rst -i t• ,t •W,'',1"'° Limited energy,residential Construction of SFR (with above sq.ft.) 75 2 Limited energy,multi-family residential(with above sq.ft.) 75.00 2 d PROPERTY OWNER 1 0 TENANT Renewable 2 Services or feedersEnergy installation,alteration,❑ SeePage 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 City/State/ZIP: 401 amps to 600 amps 200.34 2 ty Beaverton, OR 97007 601 amps to 1,000 amps 301.04 2 Phone:(503)645-0986 I Fax:( ) Over 1,000 amps or voha 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 I 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 0 APPLICANT' I 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name: Riverside Homes, LLC above service or feeder fee, each branch circuit 7.42 2 Contact name: Amo Avgi B.Fee for branch circuits without Address: 17933 NW Evergreen Pl., Ste 370 service or feeder fee,first branch circuit 56.18 2 City/State/ZIP: Beaverton, OR 97007 Each add'l branch circuit 7.42 2 Phone:(503)645-0986 I Fax: :( ) Miscellaneous(service or feeder not Included) Each manufactured or modular Email: aavgi@riversidehome.com dwelling,service and/or feeder 67.84 2 Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 ooroutline twining1 67.84 . 2 Signal circuit(s)or limited-energy Address: 2804 NE 65th Ave. St. D 0 See Page 2 2 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(I hr min) 78.18/hr 10/F!44 Inspections for which no fee is 90.00/hr CCB Lic.: 172549 Electrical Lic.: C230 Suprv.Lic.:1 l��7 P specifically listed('V2 hr min) Suprv.Electrician signature,required: ..... 4____4(14l� ELECTRICAL PERMIT FEES Subtotal: Print name: Chester Garrett Date: 6/11/19 0 Plan Review Required(25%of permit fee): �'- State surcharge(12%of permit fee): Authorized signature:1, f c,.z f- ii(e, e til TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Nikki Pruett Date: 6/11/19 days after it has been accepted as rnmpkte. * Number of inspections allowed per permit. LABuddingTennits\ELC_PertnitApp_ELR_ERE.doe Rev 06/17/2015 440-46151(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: row Fee for all residential systems combined: $75.00 `"'`'°° v. zLiral ®®o Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less MI 100.70 _© 5.01 to 15 kva MI 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 _© ❑ Garage Door Opener* 50.01 to 100 kva 1111 552.26 _© >100 kva(fee in accordance ■ with OAR 918-309-0040 552.26 —© ✓❑ Heating,Ventilation and Air Conditioning System* Solar generation systems in excess of 25 kva: Each additional kva over 25 1111 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/hr —� char l ed at an hourl 1 hr min Inspections for which no fee is 9 fc %hr min 90.00/hr s.ecificall listed Fee for each commercial system: $75.00Subtotal(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 I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 Plumbing Permit Application Building Fixtures RECEIVED .,0►Z0, ► i( .. t ,I: City of Tigard Received y [�' �j� Sa J 71J19 y Permit No. 1`1��- V��'1'�,'u.� '1 11 111• 13125 SW Hall Blvd.,Tigard,OR 97223 JUN 1 DateB • Phone: 503.718.2439 Fax: 503.598.1960 Plan Review Date/By: Other Permit No.: Inspection Line: 503.639.4175 CITY OF TIGARDTia nitDate Ready/By: ]oris: See Page 2 for Internet: wwwtigard-or.gov BUILDING DIVISION Notified/Method: I ®Supplemental orm oa S1.....t.....-.....-.,•+i u6Y�@i+erMNC! w,Fm...T: ,.. ,.3E .t 'hi+• M ' ... __........,...,... -........vrw.riex%a � �.n+nmw'+NR wie+r.'lawN !M.w+s.w.an+wr:wwrwb.•..+.ewer. ,..:.."a- n...�.4 ..+R�9+rrwrv-wN+?..-v.w+-...rr++n.....o-�-*y...r.m 2 New construction ■ Demolition For special information use checklist Description I Qty. I Ea. I Total ■ ■ New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 2 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 ❑Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler P� sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 14994 SW Belvoir Ct. 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.: 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 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.: 03 Fixture or item: Tax map/parcel no.: Backflow preventer 1 31.27 DESCRIPTION OF.WORK Backwater valve 12.51 Construction of SFR Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 0 PROPERTY OWNER 1 0 TENANT Expansion tank 12.51 Name: Riverside Homes, LLC Fixture/sewer cap 25.02 Address: 17933 NW Evergreen Pl., Ste 370 Floor drain/floor sink/hub 25.02 Garbage disposal 25.02 City/State/ZIP: Beaverton, OR 97007 Hose bib 25.02 Phone:(503)645-0986 Fax:( ) Ice maker 12.51 ■ APPUCANT 0 CONTACT • Interceptor/grease trap 25.02 name:Business - •- Homes, Medical gas(value:$ ) Page 2 • • Primer 12.51 Roof drain(commercial) 12.51 Address: 17933 NW Evergreen Pl., Ste 370 Sink/basin/lavatory 25.02 Beaverton, • ' 97007 Solar units(potable water) 62.54 . 1 • 1•I• Tub/shower/shower pan 12.51 Urinal 25.02 • • - •- • - • • • , Water closet 25.02 Business _ Water heater 37.52 * chanical Water piping/DWV 56.29 WillowAddress: 5757 SE 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.: PB41 4 Plan review (25%of permit fee) / ) State surcharge(12%of permit fee) Authorized signature:; `;e r - `{�- TOTAL PERMIT FEE Print name: Nikki Pruett 9 Date: 6/11/19 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. L•\Building\Pennits\PLMU-PennitApp.doe 10/01/09 440.46167•(10/02/COM/WEB) Plumbing Permit Application Building Fixtures RECEIVE I l OR OFFI( F l S► City of Tigard Received • ;� q 13125 SW Hall Blvd.,Tigard,OR 97223 �U N 1 3 2019 Date/By: Permit No.(\/�C � ,G_tV; ] ;�t ■ Phone: 503.718.2439 Fax: 503.598.1960 PDateBy:lan iew Other Permit�No.: X 7`-1 T I G It D Inspection Line: 503.639.4175 CITY OF TI GAR D Date Bead e 2 for Internet: www.tigard-or.gov BUILDING DIVISION Ready/By:y: loris: ® See Pa= Notified/Met6od: Se,pkmeatal Information � ,A....a._, :;bs '.:' ";» ,S.wrkr.V0'..-' =+ -4'.3".1.,".:0:44,45^.. a., r.. �[bw. 2 New construction 0 Demolition For special information use checklist. _ Description I Qty. ( Ea. I Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 IFI 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accesso buildin SFR(3)bath 500.32 rY g ❑Multi-family ❑Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 14994 SW Belvoir Ct. 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 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.: 03 Fixture or item: Tax map/parcel no.: Backflow preventer 1 31.27 DESCRIPTION OF WORK< Backwater valve 12.51 Construction of SFR Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 0 PROPERTY OR 1 0 TENANT Expansion tank 12.51 Name: Riverside Homes, LLC Fixture/sewer cap 25.02 Address: 17933 NW Evergreen Pl., Ste 370 Floor drain/floor sink/hub 25.02 Garbage disposal 25.02 City/State/ZIP: Beaverton, OR 97007 Hose bib 25.02 Phone:(503)645-0986 Fax:( ) Ice maker 12.51 ■l APPLICANT. [3 CONTACT PERSONInterceptor/grease trap 25.02 Bus ' •- Homes, Medical gas(value:$ ) Page 2 Primer 12.51 ontact name: • Roof drain(commercial) 12.51 Address: 17933 NW Evergreen Pl., Ste 370 Sink/basin/lavatory 25.02 Beaverton, • ' 97007 Solar units(potable water) 62.54 . I 1 •, 1•i• Tub/shower/shower pan 12.51 Urinal 25.02 • • •- • • Water closet 25.02 CONTRACTOR Water heater 37.52 Business name: . •- Water piping/DWV 56.29 21600 Arnberwood Dr. Other: 25.02 City/State/ZIP: Hillsboro, OR 97124 Subtotal Phone:( 503 531-8216 Fax:( ) Minimum permit fee: $72.50 CCB Lic.: LCB#7962 Plumbing Lic.no.: Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: iiz TOTAL PERMIT FEE Print name: Nikki Pruett I Date: 6/11/19 I This permit application expires if a permit is not obtained within 189 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Pemuts\PLMU-PemutApp.doc 10/01/09 440-4616T00/02/COM/WEB) . Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: 0. Residential Fire Su 1 t ression S stems: 11: IttiLF1r11 -1-41i2A--r a�: 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 Sewer-1st 100' 62.54 3,601 to 7,200 $233.20 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' t : iP � 37.52 $1.00 to$5,000.00 Minimum fee$72.50 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 &Rain Drain-each additional 100' 37.52 2 for = .::!;.1a , s ;1 7 - each additional$100.00 or fraction thereof,to Inspection of existing plumbing or for and including$10,000.00. which no fee is specifically indicated ■ 90.00/hr ■ $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for minimum char_e-1/2 hour each additional$100.00 or fraction thereof,to Inspections outside of normal business - 90.00/hr and including50othe first 250. hours minimum char_e-2 hours $25,001.00 to$50,000.00 $379.50 for first$25,000.00 and$1.45 for Reinspection Fees 90.00/hr each additional$100.00 or fraction thereof,to _ 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*. rrx _. mow.-_ ;, VPe�prt1 �; 0 a , _ .,< Plan review is required for any of the following. Baptistry/Font Please check all that apply. Bath Tub/Shower O 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 O 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" Car Wash Drain a' '" e..t h Garbage Domestic-non-food O 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 Other Fixtures: P g permit can be issued. C:\Users\npruett\Downloads\PLMF_PermitApp.doc 2 City of Tigard q COMMUNITY DEVELOPMENT DEPARTMENT T 1 c A R D Building Permit Review — Residential Building Permit #: ' .-k-ao C\_ Com, d Site Address: /2/?ql ,, i0 £é/Vo,- 0+ Project Name: L/t er-Le '# t/, ' Lot #: (New dwelling=subdi cion name;Ad.'ti. or Alteration=last name of owner) Planning Review Pro sal: /U-PiL) .Fe.-- ile Verify address/suite# active in Accela. n River Terre: l✓J No ❑ Yes,River Terrace Review 4Addendum 1 Sit Plan Elements: 6� rosion Control copies of site plan on 8-1/2"x 11"or 11 x 17"paper �1 '� tained trees with drip line and tree protection measures to scale(standard architect or engineer scale) J ..otprint of new structure(including decks)and FFE /fawn rth arrow '1 ity locations&easements(required for new and additions) �ite address,project or subdivision name and lot number Side alk/driveway approach pplicant information(name and phone number) f1 ►�cation of wells/septic systems VJLot dimensions and building setback dimensions J eet tree size,type and location 0+•u.re footage of buildings to be demolished ,OS eet names 111 .*:sting structures on site ttlComer elevations(2'contours if more than 4'diff ential) *area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replace ? s ❑ o impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown. Yes No \ `U can Water Services—Service Provider Lette�(lot platted prior to 9/10/1995): equired: ❑ Yes,applicant was notified No Received: ❑ Yes CINo Public Faciliti mprovement(PFI) Permit: equired: 'Yes,applic4rit was notified ❑ No Applie or: Zes ❑ o,stow intake and Use Case#: Eat)Hp— 0000,c9 Zonin : f--q_c- PI).,) lot/Required Setbacks: Front:020 Rear: / Side: cc. Street Side: 1 Garage: IBJ Building Height: Max.Height: 0,,,i Actual Height: 22'131 0andscape Area: % of Coverage Max: % Entrance 2 et back no more than 8'from street-facing wall Parallel to street or offset 45 degree t -ss Windows ❑ Minim %of area of all street-facing facades Garage ❑ Garage door is be'ii 'dest street-facing wall Yes • '•o,one of the following is met ❑ Door extends no more i ,.• 'from wall and there is . :•-red porch extending beyond garage. ❑ Door extends no more than 5'from ... . i ere is a 12 sq ft.window above garage on 2nd floor. ❑ Garage door width is ❑ 12' . - • 50%or -. .f facade ❑ 60%or less and includes 7 of following: ❑ Covered por • a Recessed entrance ❑ Wall of se ❑ 1'Roof eave ❑ Roof offset —_. _ E .—.-. .;. — .i. 71-7— a m.ie1 roof 111 Dormer �� ❑ Accent siding I Window trim ❑ Window recess CIWindow p ..- tion ❑ Balcony Ind Visual Clearance J rban Forestry Plan � Sensitive Lands: Yes ❑ No Type: / ✓I„t 4'7cm,� /. ❑ Conditio�j_m�e�t prior to issuance of b ding permit kiei✓ (7eer''Cy 2 viz Approved By Planning: —� Date: 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\B1dgPermitRvw RES 022819.docx Building Permit Submittal Original Submittal Date: U 1 I2,1 lqj Site Plans: # Building Plans: # .. Building Permit#: 2`Enter building permit#above. Workflow Routing: [Planning ["Engineering Permit Coordinator Eri3uilding Workflow Sign-off: giSign-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: .\___As.A....it By Permit Technician: Date: LQ,1 I Pt En ineering 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 17/No Assess Water Quantity Fee in-lieu: ❑ Yes VrNo LIDA Facility lot: ❑ Yes ba leo al Plat Recordedon: El NOT Approved by Engineering: Date: ,,N__otees�s: 11 4pproved by Engineering: Date: c/� p Revisions (after Building Submittal only) Reviewer `l Date Revision 1: Cl Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: R vision Notice 3: Date Sent to Applicant: I.-vision Fees ntered: Wash Co Trans Dev Tax: p"Yes ❑ N/A Tigard Trans SDC: ® yes ❑ N/A Parks SDC: Yes ❑ /A LIDA ❑ Yes F N/A OK to Issue Permit //� /i VI PP Y A roved b Permit Coordinator: /G `2' ' Date: I:\Building\Forms\BldgPermitRvw_RES 022819.docx