Permit (105) CITY OF TIGARD MASTER PERMIT
I . COMMUNITY DEVELOPMENT Permit#: MST2019-00003
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/04/2019
T t[;r3 Et f7 9 Parcel: 2S111AA13400
Jurisdiction: Tigard
Site address: 8891 SW INEZ ST
Subdivision: IRMA DELL BUTTERFIELD Lot: 12
Project: Irma Dell Butterfield Park, Lot 12
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1912 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 23 Bathrooms: 4 Second: 1756 sf Garage: 733 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 3668 sf Value: $475,749.90 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 6 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: 7 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 5
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: 7 201-400 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 3668
Owner: Contractor:
LWD LLC SOLSTICE CUSTOM HOMES Required Items and Reports(Conditions)
FOUR D CONSTRUCTION CO 5740 SW ARROWWOOD LN
1 Ersn Cntrl 503-639-4175_. _ __ _
5740 SW ARROWWOOD LN PORTLAND,OR 97225
PORTLAND,OR 97225
PHONE: 503-709-2277 PHONE: 503-709-2277
FAX: 503-297-0104
Total Fees: $35,121.17
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. Thi •ermit will expire if work is not started within 180 days of issuan - or if rk is suspended for more the 180
days. ATTENTION: Oregon law requires you • folio he rules adopted by the Oregon Utility Notificatiq• Ce ter. hose rules arT set forth in OAR
952-001-0010 through OAR 95 :,.1-009'x'ou mi • = opy///the rules or direct questions to OUNC by calling 5' 32 98 1.800. • •
Issued By: .r/' L/ bit L/ 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 completio of the project.
Approved plans are required on the job site at the time of each inspection.
`Building Permit Application
•
Residential RI FOR OFFICE USE ONLY
City of Tigard eceived
Date/By: Permit No
1,,,
a 13125 SW Hall Blvd.,Tigard,OR 97223: 2 + ' �_ 11�'i �
Tigard, n Plan BR �
J N N Other PenniC-�'� acs:2)
Phone: 503.718.2439 Fax: 503.598.1960 ���y DateBy. 1 `&Vv - \C( _
�g
T 1 GAR D Inspection Line: 503.639.4175
CITY
//-� Date Ready/By:
Juris: ® See Page 2 for
Internet: www.tigard-or.gov V tt
I iUH p Notified ethod: (f ` A Supplemental Information
BUILDING • •, - fy
f, ,` ' , '. `' .' „'x,
TYPE O,F. OR � W �, z, r-; REQUIRED DATA: 1.1AND 2{FAMI ,YD,WELLING ;.`'
®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
0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
t 1 Crea F ®- fae nrwork indicated on this application.
Nafg 2 1 F ; ,, .O . .Ua
N,la:',s*frY'gVz 74'..
® 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ 00 7�
0 Accessory building 0 Multi-family Number of bedrooms: /'
0 Master builder 0 Other: Number of bathrooms: (� r�
,-''''', ..,M,1-, '-f.:''',1''
JOB SITE'1NFORMATIO-A-7. OCtAT10 1 Total number of floors: 2
Job site address:8891 SW Inez New dwelling area: S6 square feet 11 S(.o
City/State/ZIP:Tigard,OR 97224 Garage/carport area: X-733 square feet 19 1 z
Suite/bldg./apt.no.: Project name: Covered porch area: square feet
Cross street/directions to job site:Hall to Greensward Lane to 88th and Inez Deck area: Sip t )1( square feet
Other structure area: 0 _square feet
�F xs as, �. �� � �� �
REQUIRED;DATA COMMERCIAL USE CHECKLIST;
Subdivision:Irma Dell Butterfield Park Lot no.:12 Permit fees*are based on the value of the work performed.
Tax map/parcel no.:2S111AA 13400 Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
,DESCRIPTIO / O V4tORi work indicated on this application.
a r , .,.tt�.,�s,,..s° x.�v,'„�k,r r ,�,” .,a4�. ,.;.�„s,��'i"z �,w,,,;�....es, ,;
New detached single family residence Valuation: $
Existing building area: square feet
New building area: square feet
1 ® PROPERTY OWNER x -',1'47::::,
., � �: . ; ic-,: .,�=>r= Number of stories:
V.,.,- ,.,,,,.:'..17,,;,-.'.7.-,,,,,m, ,_.,. ,,s. . ate:-„b. :,� ,.,. m�y. .
Name:Solstice Custom Homes Type of construction:
Address:5740 SW Arrow Wood Lane Occupancy groups:
City/State/ZIP:Portland,OR 97225 Existing:
Phone:(503)709-2277 Fax:(503)297-0104 New:
,` ? r} 7 ®�ALms .P
t ; rl ®Y CO,„ ,.• 'P&te
O BT1L�G
g*
Aa: ,.gz_� �.P.PI�� a.4 't;t ., a x� 44 ; �-4 � , . ;; - _ '�0 „ �. � p 4iLP'ERMIT�tE
w
. ., t�.Y( teaerj�1tJesed�e) :�
..`
Business name:Same as Property Owner
Structural plan review fee(or deposit):
Contact name:Alan DeHarpport
FLS plan review fee(if applicable):
Address:
City/State/ZIP: _ Total fees due upon application:
`"� Amount received:
Phone:( ) Fax::( )
E-mail:adeharpport@gmail.com ,-.0.4.PQT®YO ISOIJ P ,, E „FEESM ;:
Commercial and residential prescriptive installation of
, t.;„A ' ;-,.. ,_�,° >, ,,_ Z�k,;r�r_ . tR, . -,;..,:3 „ , A.:10.4***,;•:,”,414-0 7 AV.-., roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Same as Applicant and Property Owner Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
City/State/ZIP: Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.:193633 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:Alan DeHarpport Date:1-3-19 Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Pennits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist
'One- and Two-Family Dwelling FOR OFFICE USE ONLY
Cityof Tigard Received
. 2ll Date/By:
Permit No.:
q 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
C Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
TIGARI3
Internet: www.tigard-or.gov 0 Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. N 0 0
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. N 0 0
3 Verification of approved plat/lot. N 0 0
4 Fire district approval required. Name of district: . 0 0 N
5 Septic system permit or authorization for remodel. Existing system capacity . 0 0 N
6 Sewer permit. N 0 0
7 Water district approval. 0 0 N
8 Soils report. Must carry original applicable stamp and signature on file or with application. N 0 0
9 Erosion control 0 plan N permit required. Include drainage-way protection,silt fence design and location of catch- N 0 0
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state N 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 N 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 N 0 0
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, N 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- N 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. N 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- N 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 N 0 0
locations. Show attic ventilation. .
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered N 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 N 0 0
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. N 0 0
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required N 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 N 0 0
-- , -•_..•_a -..-._Anti-CSI.• a--.-- _ ,-.- unohlo*,*hs ...-4 l..,-=-
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". N 0 0
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. N 0 0
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 0 0 N
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 0 N
27 "Drawn to scale"indicates standard architect or engineer scale. N 0 0
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard N 0 0
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, N 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 N
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-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Applicat ED FOR OFFICE USE ONLY
City of Tigard n Received Permit No.. nn CM
v JAN
Date/By: , �°I"
'* 13125 SW Hall Blvd.,Tigard,OR 97223 7 2 Q�� Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
T I GA RD Inspection Line: 503.639.4175 CITY (Jr- 'i mliit Date Ready/By: Juris: El See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
BUILDING DIVISION
x .1::,_4''
.
0y
lit value e 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.
u a
Value $.4. ,, � waerwr ATEGORYOFONSTRUCTIAmp E
S; sil „ te 6kC ., , .,,,v %.. r. .�ON a5 ? , ,*, , , SIDENALEQINT TEM,ES 4
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
'514 ', '� 0 JOBSITE INFORMAEOI DLQCATro " , , Heatin /coolie
g'
X m w� A P* ,, ' INf6ey
Air conditioning 1 46.75
Job site address:8891 SW Inez St Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: Duct work 23.32
Cross street/directions to job site:Hall Blvd to Greensward Lane to 88th 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:Irma Dell Butterfield Park Lot no.:12
Other: 23.32
Other fuel appliances:
Tax map/parcel no.:IS111AA 013400 Water heater 23.32
DESCRIPTION WORK. Gas fireplace/insert 33.39
"` � �' " "' '� Flue vent for water heater or gas
New detached single family home fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
0 ® I'ROPERTYAOWNER ' rif d`4:','''' ''',4,-,,j''':91'1''''` `TErtANT ' f Environmental exhaust and ventilation:
Name:Solstice Custom Homes Range hood/other kitchen
equipment 33.39
Address:5740 SW Arrow Wood Ln Clothes dryer exhaust 33.39
City/State/ZIP:Portland,OR 97225 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503)709-2277 Fax (503)297-0104 Attic/crawlspace fans 23.32
... ;;1,®I'AP,'PLIcANT ,�r,. , C:QNT €F R ,Q 1�� _" Other: 23.32
Fuel piping:
Business name:Same as Property Owner
$14.15 for first four;$4.03 for each additional
Contact name:Alan DeHarpport Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
• littakiZrP4_
Phone:( ) I Fax::( ) Fireplace
Range
E-mail:adeharpport@gmail.com Barbecue
� CONTRACTOR Clothes dryer(gas)
> .im, ....rr . W ' , r , sE
„ .,..,.:.
Other:
Business name:Central Air,Inc.
r , ,, ECO 1CALPJ1RMIT;I! ES ,r _'
E ' ., f
Address:PO Box 433 _
Subtotal
City/State/ZIP:Clackamas,OR 97015 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)656-1908 Fax:(503)650-3890 State surcharge(12%of permit fee)
CCB lic.:178624 TOTAL PERMIT FEE
4 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:Michael Kellar Date:1/3/19
I:\Building\Permits\MEC_PermitApp_040113.doc 440-46I7T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
f Total of tai- . ._f' e mij Fe� r `0 r, f£
$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 C I V FOR OFFICE USE ONLY
,-
City of Tigard Received j ��
L.
g DateB Permit#: .\---x \.�iR .:_e.
11/ '. 13125 SW Hall Blvd.,Tigard,OR 97223 JAN 7 2019 Plan Review Lv
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#:
TIGARD Inspection Line: 503.639.4175 CITY OF 'IMAR ReadyDateBy: Juris: H See Page 2 for
Internet www.tigard-or.gov { DING o�y ii �°y Notified/Method Supplemental InformationL71� lJ6�I.7 i II�1 ��J •
,r ` t ' .. TYPE O WORK i,,,, ;. . .,',..., 0 ,3 ,.. ,,.;,„,,.PLc ; I l ; ';_ -i '
®New construction IDAddition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Demolition ❑Other:
0 Service or feeder 400 amps or more 0 Building over three stories.
where the available fault cturent ❑Marinas and boat ards.
x i , r„, ;;;Of CATEG®y 'O O STR CTIO ` �z, exceeds 10,000 amps at 150 volts ors.
� ,�. �.w as,�,x. , „w w. 0Floating buildings.
® 1-and 2-family dwelling ❑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: ❑ um Fire
pump. 0 Installation of 150 KVA or
. f,iliei JOrSTE NO „' ( „AD,?1 O41I0212r0 Emergency larger separately derived
Job#: I Job site address:8891 SW Inez St ❑Addition of new motor load of system.
10011P or more. ❑"A","E","1-2","1-3",
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.4: I Project name: ❑Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or more 600 volts nominal
Cross street/directions to job site:Hall to Greensward Lane to 88th to Inez " j , iEE SCI DUI} ., -
Description I Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision:Irma Dell Butterfield Park 1 Lot#: 12 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#:2S111AA 13400
Ea.add'1500 sq.ft.or portion 33.92 I
x,.. i, }$- ,',.,-,7w1,,,,,,,,,,,,„:,...-1.,,„..-5 ... ,• 4r®»I A, „� . -' .., ,.._",. „ .. Limited energy,residential
New detached single family home (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
x ® PROPETY ONR_ . I ` . ❑4EAN1 „i Services oler fEeneedrfs installation,a❑raSteonP,aged/2o
r relocation
Name:Solstice Custom Homes 200 amps or less 100.70 2
Address:5740 SW Arrow Wood Lane 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Portland,OR 97225 601 amps to 1,000 amps 301.04 2
Phone:(503)709-2277 I Fax:(503)297-0104 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
0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
. � ., s1PPLCAI�JT „ 4 a Jrii ..:,,, A.Fee for branch circuits with
Business name:Same as Property Owner above service or feeder fee,
7A2 2
each branch circuit
Contact name:Alan DeHarpport B.Fee for branch circuits without
Address: service or feeder fee,first
branch circuit 56.18 2
City/State/ZIP: Each add'1 branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax: :( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email:adeharpport@gmail.com
Reconnect only67.84 2
''�'�,#t��. �� �����,��,,CO AOR ..,. *�? � ,�`., ". ,.,;� ��,� Pump or irrigation circle 67.84 2
1a` C^-------'7..
a� i
gn or outline ugn mg S'� `.}'t
Signal circuit(s)or limited-energy
Address:6150 NE 92nd Drive#104 panel,alteration,or extension. 0 See Page 2 2
City/State/ZIP:Portland,OR 97220 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)277-3788 Fax:(503)901-7914 Investigation(1 hr min) 90.00/hr
Email:chris@eliteelectric.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: 191274 Electrical Lic.: C639 Suprv.Lic.: 57625 specifically listed(%hr min) 90.00/hr
ilIalfirr:AttbiltnifftWklOW-PMAtiit
Suprv.Electrician signature,required: Subtotal:
Print name: Roberto Armendariz Date: 1/3/19 0 Plan Review Required(25%of permit fee):
CV47A State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Date: 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:
... e F f F E„SCHEbULE ' r
�
Description Qty. Each I Total I
ems combined:
Fee for all residential systems $75.00
3' Renewable electrical energy systems:
2
Check Type of Work Involved: 5 kva or less 100.70
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 kva(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 min)
Inspections for which no fee is 90.00/hr
specifically listed(%hr min)
COMMERCIAL WORK ONLY
t ;
�., . �E1JE;CaTRICAL"PER S`"�,
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
* Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015
• Plumbing Permit Application ,
Building Fixtures RECEIVE FOR OFFICE USE ONLY
City of Tigard Received
`J gPermit No.:
■ 13125 SW Hall Blvd.,Tigard,OR 97223 JAN2 DateBy: rG
Plan Review
Phone: 503.718.2439 Fax: 503.598.1�6�QTOther Permit No.:
VI P / OF Date/By:
Inspection Line: 503.639.4175 lig--''-"-)r, Date Read B Juris: See Page 2 for
TIGARD Internet: www.tigard-or.gov BUILDING DIVISI0r4.otified/Method: Supplemental Information
§.30,‘,.;M,..d,, e C 1,D, thus : fN tau.i: ::
®New construction 0 Demolition For special information use checklist
Description 1 Qty. 1 Ea. I Total
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
, „s C ESO 'f'e CO C O., ,� :',0� ,. ,, Z,r SFR(1)bath 312.70
® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
1
,V .,.: gr;Sgt g Sa1,1, OTOa( rD� ST �aI� ����,?r' Site utilities:
Job site address:8891 SW Inez St Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 972224 Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name: Manufactured home utilities 50.03
Cross street/directions to job site:Hall Blvd to Greensward Ln to 88th 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:Irma Dell Butterfield Park I Lot no.:12 Fixture or item:
Tax map/parcel no.:1S111AA 013400 Backflow preventer 31.27
4 ', f F DESR� OF URs ,g', q ,7', `
. Backwater valve 12.51e.t ,„ ,�fi ,�vx: ,. 4. , f. tQlt, SK
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
r hep r ,rij £/_ ..,...^,,,,,,,,,„,.,,v,.h -oikT Ex Expansion tank 12.51
;;;';a:®,tM RTY qr', -Iz':-,, ,,.y... ,x., , EfeW 4 P gin' P
Name:Solstice Custom Homes Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:5740 SW Arrow Wood Lane
Garbage disposal 25.02
City/State/ZIP:Portland,OR 97225 Hose bib 25.02
Phone:(503)709-2277 Fax:(503)297-0104 Ice maker 12.51
=� ,pip �I 1 `° * , �® r0N,TAC • p Atogw. Interceptor/grease trap 25.02
Business name:Same as Property Owner Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Alan DeHarpport
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
iPhone:( ) Fax::( ) u. s ower/shower pan 12.51
E-mail:adeharpport@gmail.com Urinal 25.02
': � �; Water closet 25.02
Water heater 37.52
Business name:The Mullen Company Water piping/DWV 56.29
Address:1601A River Road Other: 25.02
City/State/ZIP:Hillsboro,OR 97123 Subtotal
Phone:(503)640-0113 Fax:( ) Minimum permit fee: $72.50
CCB Lic.:92689 Plumbing Lic.no.:34-260PB Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature TOTAL PERMIT FEE
Print name:Jeremy Crace Date:1/3/19 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.
I:'.Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
• Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential
Fire Suppression Systems:ems:
om s, ` ' wt gsr 's'
}s r s' ie £ stts } �, 4F,01.0.1)-4V6)',.; riOtal. tasSquare e, r :luster pe
*s".,:a' A.x 'n ,.:
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 Systems:
Water Service-each additional 100' 37.52 � - ' # erml�e �
Storm&Rain Drain-1st 100' 62.54 U tion , >
$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
� p� t Vie'ea" � nfal each additional$100.00 or fraction thereof,to
„Ii spec,ti fij:! Fees ,_ Q r and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*.
Quantity by Fixture Type ;µ,y , ., r .
Fixtare¢Iyp�for �R"pYa€e/ = .an`Reyiew-fol P.,lu _= i
Plan review is required for anyof the following.
Work Performed: • Capped-• Added` Relocate, �l
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.
� �, e. 3t t
. som April,lag uam�ssori ;
Car Wash Drain _�
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-rood relate
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
D:\Documents\Butterfield Park\Lot 12\Lot 12BP Plumbing PermitApp.do2
City of Tigard
" COMMUNITY DEVELOPMENT DEPARTMENT
Iii g
r I c A R D Building Permit Review — Residential
Building Permit #: MS- lot _(,)=
Site Address: " ?/ Sw tviez 5-f
Project Name: IrYvh Dell 2t J. 0, -`i o(d Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner) i
Planning Review
Proposal: JV Ply() 5.TIZ
..®''Verify site address/suite# exists and active in permit system.
River Terrace Neighborhood: —o 0 Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
/Errrhree(3)copies of site plan • ❑Exist structures on site
,,,, rife plan must}fie on 8-1/2"x 11"or 11 x 17"paper ,..2Fo-otprint of new structure(including decks)with finished
AnTawn to scale(standard architect or engineer scale) floor elevations
In5"-rth arrow
„Pt/tufty locations&easements (required for new and additions)
,�. S..itte�eaddress,project or subdivision name and lot number idewalk/driveway approach
- .licant information(name and phone number) aff6n 3Twells/septic systems
-C.1Lot dimensions and building setback dimensions sting trees to be retained with drip line,and tree
-O-Squuic fodiJge of buildings to be demolished protection measures
area, wilding coverage area,percentage of coverage and daSrreet tree size,type and location
� impervious area(applicable if R-7,R-12,R-25&R-40) �txeet names
EJl'roperty corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? .2f"es ❑No
4 foot differential) If yes,is a storm water quality facility shown? ❑Yes gtcro r JfVP
„Zr—Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: 0 Yes,applicant was notified la-No Received: El Yes El No
2 Public Facilities Improvement(PFI) Permit:
Required: Jam-des,applicant was notified El No Applied For: El Yes 0 No,stop intake
.2'Land Use Case#: 5'0t3 06//' _dt,pI0
-Er Zoning: R_ (�7
Required Setbacks: Font _20 Rear iS Side 5' Street Side ' 5 Garage
Er Landscape Requirement: -----
..Z Lot Coverage Maximum: '� %
...1:4- Building Height: Maximum Height 3 ) Actual Height 93
Yisual Clear�n� __-- _...,
Sensitive Lands: 0 Yes 0 No Type
-Jrban Forestry Plan
.0 Conditions "Met"prior to issuance of building permit
Notes:
9--Approved By Planning:
�� Date: j/7/e,
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 ❑ Not Approved
I:\BuildingToms\BldgPermitRvw RES 061417.docx
Building Permit Submittal
Original Submittal Date: % b- 119
Site Plans: #
Building Plans: /7 3
Building Permit#: nter building permit#above.
Workflow Routing: El Planning Q -Engineering Permit Coordinator 2/Building
Workflow Sign-off: [ 'Sign-off for Planning(include notes from planning review)
Route Application Documents: Tr-Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
C"Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: 1t+1 lCk
Engineering Review m/ 0.0 Slope at building pad: .S,6 14
❑ 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: 0 Yes drNo
Assess Water Quantity Fee in-lieu: 0 Yes Ye/No
y/ LIDA Facility on lot: 0 Yes [ 'No
I Final Plat Recorded:
O NOT Approved by Engineering: Date:
Notes:
Ud
�/ J/""' Date: / 1 /`Approved by Engineering:
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_builpermit
O Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
SDC Fees Entered: Wash Co Trans Dev Tax: s 0 N/A
Tigard Trans SDC: 'Wiles 0 N/A
Parks SDC: 0 Yes 0 N
LIDA 0 Yes N/A
/417
OK to Issue Permit //g
Approved by Permit Coordinator: Date:
I:\Building\Forms\BldgPermitRvw_RES 010118.docx