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Permit (2) Building Permit Application Residential m :, ,' „s ^ - FOR OFFICE USE ONLY City of Tigard p a Received • J'/ / r� L S f Date/By: / G L ,/�„ 9 -00.. 111 I 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review /�,�h,� Phone: 503.718.2439 Fax: 503.598.1 Date/By: 2 c- C !?r' r it: y , T I GAR D Inspection Line: 503.639.4175 � � p� m, Date Ready/By / tins: Ei See Page 2 for Internet: www.tigard-or.gov inl Ili 1 , ..I ied/Method: ,A41.511l Supplemental Information TYPE OF WORK REQUIRED DATA:L.-AND 2-FAMILY DWELLING ®New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ® 1-and 2-family dwelling J❑Commercial/industrial Valuation: 33 k Uoct CIAccessory building ❑Multi-family Number of bedrooms: 2 0 Master builder ❑Other: Number of bathrooms://�3 Total number of floors: 30 1 JOB SITE INFORMATION AND LOCATION '�?/ Job site address:11499 SW Gabriel St New dwelling area: 2437 square feet City/State/ZIP:Tigard,OR Garage/carport area: 574 square feet l 9 1 0 Suite/bldg./apt.no.: Project name:Willow Brook 7 Covered porch area: 2_4{ square feet Cross street/directions to job site: Deck area: "`` 0���//// square feet Other structure area: y" 19i-square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision:Willow Brook Lot no.:7 Permit fees*are based on the value of the work performed. Tax map/parcel no.:2S115AB06200 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. New SFR 40'x 67'2 bedrooms w/2.5 baths,2 car garage with 6'shop attached. Valuation: $ Covered entryway and covered patio. Existing building area: square feet New building area: square feet ® PROPERTY OWNER 0 TENANT Number of stories: Name: Pacific Lifestyle Homes Type of construction: Address:11815 NE 99'Street,Suite 1200 Occupancy groups: City/State/ZIP:Vancouver,WA 98682 Existing: Phone:(360)573-8081 Fax:(360)574-6401 New: ® APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES* Business name:Pacific Lifestyle Homes (Please refer to fee schedule) Structural plan review fee(or deposit): Contact name:Permit Coordinator FLS plan review fee(if applicable): Address:11815 NE 99th Street,Suite 1200 Total fees due upon application: City/State/ZIP:Vancouver,WA 98682 Amount received: Phone:(360)573-8081 Fax::(360)574-6401 E-mail:permits@buildplh.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System. Business name:Same Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:Same Solar Installation Specialty Code checklist. City/State/ZIP:Same Permit Fee(includes plan review $180.00 and administrative fees): Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.:173524 Total fee due upon application: $201.60 Authorized signature ,/ 1 (../e1_6( This permit application expires if a permit is not obtained (� f J �1/tom �l�` within 180 days after it has been accepted as complete. Print name:Summer Dowell Date:8/29/19 *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONLY d City of Tigard Received Permit No.: 13125 SW Hall Blvd.,Tigard,OR 97223 Associat Phone: 503.718.2439 Fax: 503.598.1960 Associated permits: - TIGARD 24-Hour Inspection Line: 503.639.4175 Electrical ❑ Plumbing ❑ Mechanical Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW l es No N%k 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑ 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity 0 0 ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ 0 ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control 0 plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ ❑ basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 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 ❑ ❑ ❑ there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 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 ❑ ❑ 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. ❑ ❑ ❑ 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 ❑ 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 ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ 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 ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. 0 0 ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 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 ❑ architect licensed in Ore•on and shall be shown to be ag.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". ❑ ❑ ❑ 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 0 ❑ ❑ 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ ❑ 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 ❑ ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ 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, ❑ ❑ ❑ 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 ApplicatiRE ,, E'.J FOR OFFICE USE ONLY City of;&'1g2019 and Received Date/By: Permit No.: IIII13d 2,S W Hall Blvd.,Tigard,OR 97223 S E P Phone: 503.718.2439 Fax: 503.598.1960 Plan Review R .`�1-s �`' Date/By: Other Permit: T I C A K D Inspection Line: 503.639.4175 GM/ O F 1 l GrAri ti e qa , Date Ready/By: Juris: 0 See Page 2 for 1 it Internet: www.tigard-or.gov 9)l k", —,�e 11.,t' Notified/Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees*are based on the value of the work ® New construction ❑ Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑ Demolition ❑ Other: mechanical materials,equipment,labor,overhead,and profit. Value:S CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ® 1-and 2-family dwelling ❑Commercial/industrial ❑ Accessory building For special information use checklist. ❑Multi-family 0 Master builder ❑ Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 1 46.75 Job site address:11499 SW Gabriel St Furnace 100,000 BTU(ducts/vents) 1 46.75 City/State/ZIP:Tigard,OR Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name:Willow Brook 7 Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision:Willow Brook Lot no.:7 Other: 23.32 Other fuel appliances: Tax map/parcel no.:2S115AB06200 Water heater 1 23.32 DESCRIPTION OF WORK Gas fireplace/insert 1 33.39 Flue vent for water heater or gas New SFR fireplace 1 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 ® PROPERTY OWNER ❑ TENANT Other: 23.32 Environmental exhaust and ventilation: Name:Same as applicant Range hood/other kitchen equipment 1 33.39 Address: Clothes dryer exhaust 1 33.39 City/State/ZIP: Single-duct exhaust(bathrooms, toilet compartments,utility moms) 5 23.32 Phone:( ) Fax:( ) Attic/crawlspace fans 23.32 ® APPLICANT ►Z/ CONTACT PERSON Other. 23.32 Fuel piping: Business name:Pacific Lifestyle Homes $14.15 for first four;$4.03 for each additional Contact name:Permit Coordinator Furnace,etc. 1 Address:11815 NE 99th Street,Suite 1200 Gas heat pump Wall/suspended/unit heater City/State/ZIP:Vancouver,WA 98682 Water heater 1 Phone:(360)573-8081 Fax::(360)574-6401 Fireplace 1 Range 1 E-mail:permits@buildplh.com Barbecue 1 CONTRACTOR Clothes dryer(gas) Business name:Area Heating+Cooling Other: MECHANICAL PERMIT FEES* Address:2721 NE 65th Ave Subtotal City/State/ZIP:Vancouver,WA Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(360)737-0811 Fax:(360)737-6946 State surcharge(12%of permit fee) CCB lic.:64801 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 / y days after it has been accepted as complete. Authorized signaturq/ - -��r 11 Y L L �L f� - * Fee methodology set by Tri-County Building Industry Service Board Print name:Summer Dowell Date:8/29/19 I:\Building\Permits\MEC_PermitApp_040113.doc 440.4617T(1 I/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi-Family Fee Schedule: Total Valuation: Permit Fee: $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 thief fl IIcali Pct°blit pici ie�l>f roil OFFICE USEcONL� � " ^FJ ,p •,--11-- +r�. int... ,1....,...,.,. .. .v i- it City Of Tigard 1 Permit# l r ,µj Date/13v. " 13125 SW Hall Blvd.,Tigard,OI 97 3 Plan Review - i 5 " Plume: 503.718.2439 Fax: 503.598.1r P �� Related Permit u: . � 9 20 Dale/By: -' r Inspection Line: 503.639.4 175 Ready Date/By: ruris j IZ1 See t'age 2 for (I(.` 7 rte" Notified/Method: J Supplemental-aMMO Intt,rnet' www tEgard-or.gov -.`� dwl�`" p'p�3'1 �) pl enrentA!Information TYPE O• 144(1W--7.;7;E, C_ , �._.._ PLAN REVIEW -- ® New construction ❑Addition/a1 anon/replacement Please check all that apply(submit 2 sets of phns w/items checked): ❑Service or feeder 400 amps or more 0 Building over three stories. ❑ Demolition ❑Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings, ® -and -lillllil dwellingCommercial/industrial less to ground,or exceeds 14,000 ❑Commercial-useagriculuAal ) ❑ ❑Accessory building amps for all other installations. httiklfitgs. ❑ Multi-t irnily ❑ Master builder ❑Other: ❑Fire pump. 0 Installation of ISO K VA or JOB SITE INFORMATION ANI) LOCATION 0 Emergency system. larger sepaiately derived Job 9: IOb site address: f L, = k - 0 Addition it new motor fond of system. II f_ I (�``'1 C� 51(i nO/21 7 f 1 St - I OO HP or more. ❑,:r), :,E„ ,l_Z„ ,13„ City/State/ZIP: ) ❑Six or more residential twits occupancy. j( j ❑Health-care facilities. ❑Recreational vehicle parks. Cr Suite/bldg,/apt.t/: 1 Project name: 0 Hazardous locations. ❑SuI)voltage c I'or more than ---------_-_ ----._._ 600 volts nominal. ©Service or feeder 600 amps or more. C7ross street/directions to job site: FEE SCHEDULE Description Qty. l F.. 1111___12,,._ - -� New residential single-or multi-family dwelling unit. Subdivision:['CI L.01,,0 R • Lot#: I/ Includes attached garage. - - 1,000 sq.R.or less i 168.54 4 1 ax map/parcel 4: -7,___c; I i C ' - >, 3 ° l 7. - ' Ea.add'!500 sq.R.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 C W 4,-)1-.__-- _(with above sq.ft.) -_ _ Limited energy,multi-family residential(with above sq.ft.) 75.00 2 ------• Renewable Energy 0 See Page 2 ® PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/m•relocation Name: - 'U/U a. e cam -, 200 amps or less 100.70 2 Address: J ,pp 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: 601 amps to 1,000 amps 301.04 2 Phone:( ) 1 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 t intended lbr 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 Branch circuits-new,alteration,or extension,per panel ® APPLICANT ® CONTACT PERSON A.Pee for branch circuits with Business name: Pacific Lifestyle Homes above service or feeder fee, i h" 7 42 2 - each branch circuit I Contact name: Permit Coordinator B. Fee for branch circuits without service or feeder fee,lust Address: 11815 NE 99t1'Street,Suite 1200 branch circuit 56.18 2 -^ City/Stale/ZIP:Vancouver,WA 98682 Each add',branch circuit 7.42 — 2 Miscellaneous(service or feeder not inchided) Phone:(360)573-8081 Fax: : (360)574-6401 Each manufactured or modular 67.84 2 Email:perrnits(ir�buiklplh.com dwelling,service and/or feeder Reconnect only 67.84 2 - CONTRACTOR Pump or irrigation circle 67.84 2 Business name:Garner Electric Sign or outline lighting 67.84 2 Signal circ uit(s)or limited-energy ❑ Sec Page 2 2 Address:2920 SE Brookwood Ave,Suite A panel,alteration,or extension. City/State/ZIP: Beaverton,OR 97006 Each additional inspection over allowable in any of the above • Additional inspection(1 hr min) 66,25/hr Phone:(503)618-4552 Fax:(503)642-7925 Investigation(1 hr min) 90.00/hr Email: mmorato@garnerelectr•ic,com Industrial plant(I hr ruin) 78.18/hr Inspections for which no fee is 90.00/hr CCB l.,ic.: 121159 Electrical L. : -305C Supry.,Lie,:•1,1 DI S specifically listed('V,hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,require Subtotal: / /' ei 0 Plan Review Required(25%ofpermit 46, Print name: Chuck Garner ;re4- Date: iAiC °� 9fee): . 041 - State surcharge(12%of permit fee): Authorized signature: `A � � TOTAL,PERMIT FEE: ///��� - i "this permit application expires if a permit is not obtained within 180 Print name: t /s€� `/i llate: l i /, clays after it has been Accepted as complete, 11 iC P * Number of inspections allowed per permit. I',Iruiiding\Perm soF..LC t'etmitApp tiLR liRli doe Rev U6.117/2015 440-4615T(I tl05ICOM+wtil3 li:lectr•ical Permit Application --City of Tigard Page 2---Supplemental Information Limited Energy Permit Fees: Renewal)fe Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE.scH-IE.oULE • Description Fee for all residential systems combined; $75.00 Each Total i an �tY 3 y' Renewable electrical energy systems: Check Type of Work involved: s kva or fess — �— 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; ---- Ii Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to IOU kva 552.26 2 I Garage Door Opener* >100 kva(fee in accordance — —T 2- with OAR 918-309-0040) 552.26 -1 H• eating, Ventilation and Air Conditioning Solar generation systems in excess of25 kva: System* - Each additional kva over 25 7,42 3 I Vacuum Systems* >100 kva-no additional charge 0.0 3 Each additional inspection over allowable in any of the above: O• ther Each additional inspection is 66.25/hr --------- charged at an hourly(I hr min) —_.__ Inspections for which no Ice is 90,00/lir specifically listed(%7 hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: 575.0 Subtotal(Enter on Page I): * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: f 1 Audio and Stereo Systems Boiler Controls ❑ Clock Systems I I Data Telecommunication Installation I I Fire Alarm Installation I I HVAC Instrumentation Intercom and Paging Systems I I Landscape Irrigation Control* Medical r Nurse Calls Outdoor Landscape Lighting* ❑ Protective Signaling • O• ther: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I',Budding\Penniis'EL(',.PermilApp_ELR_ERE due Rev Ol/17.2011 Plumbing Permit Ap lication Building Fixtures \1 '` FOR OFFICE USE ONLY City of TigardSEP Q 2019 q Received 111 li U 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: Permit No.: Phone: 503.718.2439 Fax: 503.598.196t` �` P Plan Review y @ + r Date/By: Other Permit No.: T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: 63 See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ®New construction ❑Demolition For special information use checklist. Description Qty. I Ea. Total ❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ® 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 1 437.78 0 Accessory building IDMulti-familySFR(3)bath 500.32 ❑Master builder Each additional bath/kitchen .5 25.02 ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address:11499 SW Gabriel St Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard,OR Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name:Willow Brook 7 Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:<100) 1 Page 2 Storm sewer(no.linear ft.:<100) 1 Page 2 Water service(no.linear ft.:<100) 1 Page 2 Subdivision:Willow Brook 1 Lot no.:7 Fixture or item: Tax map/parcel no.:2S115AB06200 Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 1 25.02 New SFR Dishwasher 1 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER ❑ TENANT Expansion tank 12.51 Name:Same as applicant Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 1 25.02 City/State/ZIP: Hose bib 3 25.02 Phone:( ) Fax:( ) Ice maker 12.51 S. APPLICANT ® CONTACT PERSON Interceptor/grease trap 25.02 Business name:Pacific Lifestyle Homes Medical gas(value:$ ) Page 2 Contact name:Permit Coordinator Primer 12.51 Roof drain(commercial) 12.51 Address:11815 NE 99'Street,Suite 1200 Sink/basin/lavatory 5 25.02 City/State/ZIP:Vancouver,WA 98682 Solar units(potable water) 62.54 Phone:(360)573-8081 Fax::(360)574-6401 Tub/shower/shower pan 2 12.51 E-mail:permits@buildplh.com Urinal 25.02 CONTRACTOR ' Water closet 3 25.02 Water heater 1 37.52 Business name:Lippold plumbing and heating inc. Water piping/DWV 56.29 Address:PO Box 895 Other. 25.02 City/State/ZIP:Boring,OR Subtotal Phone:(971)404-7012 Fax;( ) Minimum permit fee: $72.50 Plan review25 CCB Lic.:201597 Plumbing Lic.no.:PB1416 review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: 1Cinir eik- 004).-e TOTAL PERMIT FEE Print name:Summer Dowell Date:8/29/19 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\Pemtits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) 1 Ell Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information • Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee tea) Total Square Footage: Permit Fee: 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 Valuation: Permit Fee: 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 Inspections or Fees Qty' Fee(ea) Total each additional$100.00 or fraction thereof,to p 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 Plan Review for Plumbing Installations Fixture Type for Replace/ Work Performed: Capped Added Relocate Plan review is required for any of the following. Baptistry/Font Please check all that apply. CIAny new commercial building with water service 2"and Bath -Tub/Shower Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Drive Thru ❑ New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918-780-0040. Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities. -Domestic ❑ Any multipurpose fire sprinkler system. Drinking Fountain ❑ 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" Isometric or Riser Diagram Car Wash Drain ❑ Isometric or riser diagram is required for new buildings Garbage -Domestic-non-food Disposal -Domestic-food related that meet the qualifications above. -Commercial-food related -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang -Stall Sink/Lav -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer-Clothes Water Extractor increase of sewer EDUs,a sewer permit will be issued and Water Closet-Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: P:\Job Folders\Oregon\Subdivisions\Willow Brook(113th Ave)\Lot 7\Pertitits and Inspections\PLB_PermitApp.doc Plumbing Permit Applic Building Fixtures &,Ake a s, FOR OFFICE USE ONLY City of Tigard Date/By: Permit No.: mi 11111 III 13125 SW Hall Blvd.,Tigard,OR23 Plan Review Phone: 503.718.2439 Fax: :598.1960 Date/By: Other Permit No.: Inspection Line: 503.639.4175. . TIGARD Internet: www.ti and-or. ov Date Ready/By: Juris: I3 See Page 2 for g g Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ®New construction ❑Demolition For special information use checklist. Description Qty. Ea. Total ❑Addition/alteration/replacement ❑ Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ® I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 111Accessory building 111Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 11499 SW Gabriel St Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard,OR Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: Project name:Willow Brook 7 Manufactured home utilities 50.03 Cross street/directions to job site: 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:Willow Brook Lot no.:7 Fixture or item: Tax map/parcel no.:2S115AB06200 Backflow preventer 1 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Back flow preventer for landscape irrigation Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER ❑ TENANT Expansion tank 12.51 Name:Same as applicant Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 ►� APPLICANT ® CONTACT PERSON Interceptor/grease trap 25.02 Business name:Pacific Lifestyle Homes Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:Permit Coordinator Roof drain(commercial) 12.51 Address:11815 NE 99th Street,Suite 1200 Sink/basin/lavatory 25.02 City/State/ZIP:Vancouver,WA 98682 Solar units(potable water) 62.54 Phone:(360)573-8081 Fax::(360)574-6401 Tub/shower/shower pan 12.51 E-mail:permits@buildplh.com Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name:Trademark Landscapes,INC WaterPP i m DWV 56.29 Address:PO Box 2410 Other: 25.02 City/State/ZIP:Oregon City,OR Subtotal Phone:(503)631-3893 Fax:(503)631-4737 Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lic.: Plumbing Lic.no.: State surcharge(12%of permit fee) Authorized signature:� �� -�Li) � � ` u r�Li,u,;�-�` TOTAL PERMIT FEE Print name:Summer Dowell Date:8/29/19 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(I0/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qtr• Fee(ea) Total Square Footage: Permit Fee: Footing drain-151 100' 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 Valuation: Permit Fee: 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 Inspections ections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to h 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 Plan Review for Plumbing Installations Fixture Type for Replace/ Plan review is required forof the following. Work Performed: Capped Added Relocate 4 any BaptistryFont Please check all that apply. Bath Tub/Shower ❑ 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 Thea ❑ New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918-780-0040. Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities. -Domestic ❑ Any multipurpose fire sprinkler system. Drinking Fountain ❑ 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" a" Isometric or Riser Diagram Car Wash Drain ❑ Isometric or riser diagram is required for new buildings Garbage -Domestic-non-food Disposal -Domestic-food related that meet the qualifications above. -Commercial-food related -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang -Stall Sink/Lav -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer-Clothes Water Extractor increase of sewer EDUs,a sewer permit will be issued and Water Closet-Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: P:\Job Folders\Oregon\Subdivisions\Willow Brook(113th Ave)\Lot 7\Periits and Inspections\Irrigation app for backflow preventer.doc 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 1.11111 im Transmittal Letter T I G A R i) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tipt_d-or.gov_ TO: DATE RECEIVED: DEPT: BUILDING DIVISION ECR FROM: , / e OCT 15 2019 ) CITY OFIIGARD COMPANY: �(( (� IP �L'1-� BUILDING DIVI PHONE: 3 1 V '6 7 , S00 ( By: RE: 1 1 ztq SO 66th h e.t' ., -t.- . //4 �j" ?'gJO. V (Site Address) ( umber) t 1I o7) F5 k-' 4i--) (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. _3 Revisions: tyl,ova-I 4,ryd,u1 dopy"vigaii Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: -3 CD 11,7)-2 S ' ino-yec wait env- /✓1 gahl-e_ . FO O FICE USE ONLY Routed to Pe it Tec • Ian: Date: L t to (41 Initials: API- Fees Due: Ye i' 0No Fee Desc .pti : Amount Due: /// ?WA itialL $ 4S- Special Instructions: Reprint Permit(per PE): ❑ Yes )4/ No ❑ Done pi., Applicant Notified: Date: `/� l l 7 Initials: I:\Building\Forms\TransmittalLetter-Revisions_061316.doc 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. MICity of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Transmittal Letter TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: DATE 12M5W3Allallf)8 DEPT: BUILDING DIVISION QEJVOIl dO ADO rr ) OZOZ p r8�3d u FROM: ?CALL 41 (f L�t.--is lX_- ) a ' 13 0 B H COMPANY: 4 5“-"ti -4 LQ4 e_--C PHONE: (!Z_ ,04 C6 I3 Q BB/ RE: i (("{ig SO rIIJ .) MST An _ J ` (Site Address) (Permit Number) (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOW ITE Copies: Description: \ Copies: Description: Additional set(s)of plans. \ /3 Revisions ,5 -I- Cross section(s) and details. A. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. \t, Engineer's calculations. Other(explain): REMARKS: stnic-e,lrl c)-v- r.D �( Lc0 cri4ze LZ JW'YR 1D -1 w FO OFFICE USE ONLY Routed to Pern • ec an: Date: a Za v� Initials: �' Fees Due: Y- I/ No Fee Desc pti n: Amount Due: $ C>0 \IZ- ?la,,v--- r.e__ARu^-) $ 9 s. $ $ Special Instructions: Reprint Permit(per PE): Yes ❑ No ❑ Done Applicant Notified: _ Date: a21e9. '-1/ -d Initials: 1:\Building\Forms\TransmittalLetter-Revisions 061316.doc