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Permit (15) CITY OF TIGARD MASTER PERMIT 1114 II . COMMUNITY DEVELOPMENT Permit#: MST2019-00416 Date Issued: 11/13/2019 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S115AB06700 Jurisdiction: Site address: 11449 SW GABRIEL ST Subdivision: Lot: Project: Willow Brook, Lot 12 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 3 First: 1910 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 17 Bathrooms: 2 Second: 0 sf Garage: 454 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 1910 sf Value: $258,946.42 Rear: 15 PLUMBING Sinks: 1 Water Closets: 2 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 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: 4 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: 3 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Y Other: N Other Description: Ecompasing: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 1910 Owner: Contractor: PACIFIC LIFESTYLE HOMES INC PACIFIC LIFESTYLE HOMES Required Items and Reports(Conditions) 11815 NE 99TH ST STE 1200 11815 NE 99TH ST#1200 1 Ersn Cntrl 503-639-4175 VANCOUVER,WA 98682 VANCOUVER,WA 98682 PHONE: PHONE: 360-213-0813 FAX: 360-574-6401 Total Fees: $32,214.56 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notifi'.=tion Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calli . •03.232.1987 or 1.800.332.23 Issued By: _. Permittee Signature: y C 5 . 39.4175 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 FOR OFFICE ESE ONLY City of Tigard RECEIVED Received v 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: an R�irC/,0,7 Permit No.-'f�7 j,e?_e &,c = Phone: 503.718.2439 Fax: 503.598.1960 OCT 3 1 2019 tt 1°1 �A' Other PentAs. ?0/ �'L;*30/ Date/By: T t 1 I) Inspection Line: 503.639.4175 Date Ready/By: 7uris: 8 See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARD ifiedMethod: / �/ °I Supplemental Information BUILDING DIVISION TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING ®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 ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: $�$f!0 `Z5(g 14 P ® 1-and 2-family dwelling 0 Commercial/industrial �� 0 Accessory building 111Multi-familyNumber of bedrooms: 3 ❑Master builder ❑Other: Number of bathrooms: 2 JOB SITE INFORMATION AND LOCATION Total number of floors: 1 234L Job site address: 11449 SW Gabriel St New dwelling area: 1910 square feet City/State/ZIP:Tigard,OR Garage/carport area: 454 square feet Suite/bldg./apt.no.: Project name:Willow Brook 12 Covered porch area: 24 square feet Cross street/directions to job site: Deck area: square feet Other structure area: 96 square feet 1 REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision:Willow Brook Lot no.: 12 Permit fees*are based on the value of the work performed. Tax map/parcel no.:2S115AB06700 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 3 bedrooms,2 baths with a 2 car garage.Covered entryway Valuation: $ and covered patio. Existing building area: square feet New building area: square feet /1 PROPERTY OWNER El 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 — Phone:(360)573-8081 Fax::(360)574-6401 Amount received: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail:permits@buildplh.com 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 lie.:173524 ' Total fee due upon application: $201.60 Authorized signature: L r, ,/ ; I�! .^ ry/J ��� This permit application expires if a permit is not obtained (�� �1 CCJJ'CC within 180 days after it has been accepted as complete. Print name:Summer Dowell Date: 10/29/19 *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) Building Permit Application Checklist , One- and Two-Family Dwelling FOR OFFICE USE ONLY City of Tigard Received IP/ Permit No.: 13125 SW Hall Blvd.,Tigard,OR 97223 AssociatedDate/By a Phone: 503.718.2439 Fax: 503.598.1960 permits: TIGARD 24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing El Mechanical Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A 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: ❑ 111 5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. El ❑ El 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ 0 ❑ 9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 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 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 1. 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 ❑ ❑ 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 ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 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 over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ❑ ❑ 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 ❑ ❑ ❑ architect licensed in Ore:on and shall be shown to be a..licable to the .r&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. ❑ ❑ ❑ 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, ❑ ❑ ❑ 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(1 1/02/COM/WEB) .Mechanical Permit Application FOR OFFICE USE ONLY III ° Cl of Tigard v 13125 SW Hall Blvd.,Tigard,OR 97223 E `p eceived `Jsate/By: i rr L���j - Plan Review Phone: 503.718.2439 Fax: 503.598.1960 0 C T 31 2019 Date/By: Permit No/it-AraOther Permit: TIGARD Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information v Ili ,"?' f•-• r-lonc:in 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:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ® 1-and 2-family dwelling ❑ Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑ Master builder ❑Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 1 46.75 Job site address: 11449 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 12 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.:12 Other. 23.32 Other fuel appliances: Tax map/parcel no.:2S115AB06700 Water heater 1 23.32 r n, •. t Gas fireplace/insert 1 33.39 Flue vent for water heater or gas New SFR fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/litter/flue/vent 23.32 0 PROPERTY OWNER 0 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) 4 23.32 Phone:( ) Fax:( ) Attic/crawlspace fans 23.32 0 APPLICANT 0 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. Gas heat pump Address:11815 NE 99th Street,Suite 1200 Wall/suspended/unit heater City/State/ZIP:Vancouver,WA 98682 Water heater Phone:(360)573-8081 Fax::(360)574-6401 Fireplace I 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 lie.:64801 ^ TOTAL PERMIT FEE / / This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized sign4y3p. . .C-L/' / 9 Cej /12)Z'J " Fee methodology set by Tri-County Building Industry Service Board Print name:Summer Dowell Date: 10/29/19 I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/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$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. 1:\Building\Permits\MEC_PennitApp_040113.doc 2 Electrical Permit A 1 licationFtECEIVED roR 0141(:1::usE ONLY City offigardl OCT 3 1 2019 IteCCiVc41 Daw/Bv: Pel-inill'f(icre?(3/9"-0 0 V ct, , 4 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review . I , Home: 503.718.2439 His: 503.598.1QTY OF TIGARD Dowilly: Rotated Perron a: Inspection Line: 503.639.4175 BUILDING DIVISION Ready lloreffly hub fili See Page 2 for t "* 1A11, ) Internet: www.tigard-orgov Nor itied/Merhod Supplemental Information 1 TYPE OF WORK PLAN REVIEW Nrw construction 0 0 Demolition Addition/ m alteration/replaceent 0 Other: Please check all 11181 apply(sauna a sets°cairn's wiiicmhcilict1) 0 . Service or feeder 400 ampsot or me 0 Brrildella ovcrliffce,Ittric$ where the available Nat current 0 Mations and boaryards, I CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts tir 0 Flooring buildings, cm to ground,or exceeds 14,000 Ell Commercial-me agricultural EJ I"rind 2-family dwel ling 0 Commercial/industrial 0 Accessory building amps for oil oilier install:Mons. buddirms Ell Multi-family 0 Master builder 0 Other: 0 Fire pump 0 Insuillturon of ISO K VA ur JOB SITE INFORMATION AND LOCATION ' 0 Emergency sysient larger separately derived _ 0 Adria ion of new rumor load of system. Joh 4: Job site address: 1\ 24 z49 .,.1,....-..,61,4), 1.(,1 s---... 100HP or more. City/Stale/ZIP: k_c_jc0,ck i (4,,V..,, 0 Six or more residential mars occupancy. 0 Rtcreationol vehicle parks, 0 flealdr-earc facilities .... Suite/bldg./apt.8: -I Project Ilan:: 0Hazardous locations, 0 Supply voliam ge fur ore than Et Service or feeder 600 amps or more 60h°"66o mmi1611' Cross street/directions to job site'. FEE SCHEDULE qesap4loo r Qty.—I—tub I Tolnl IL New residential siugle-or multi-family dwelling unit. Subdivision: Li_.,‘\t 1 xo ..k.D v.:Yu 0 *. ) 1.01 4: 1')-- Includes mulched garage. --- I 000 sq.II.or less 4 168 54 4 t r...)(0-1 e,0 _ Fa.add'I 500 sq.tl.or portion , 33 92 1 DESCRIPTION OF WORK Limited energy,residential 75 00 2 L0 (with above sq.It.) Limited energy,multi-family , 75.00 2 residential(with above sq.11,) Renewable Energy 0 See Page 2 in PROPERTY OWNER __I 0 TENANT Services or feeders histallationolleration,and/or relocation Name: y( uyi o ... ,' . ( c, (-A.pp 11(a(i-(-.,. 200 amps or less 100,70 2 201 amps to 400 maps 133,56 2 Address: 401 amps to 600 amps 200.34 2 City/Slate/ZIP: 601 amps to 1000 amps 301.04 2 Phone:( I Fax;( ) Over 1,000 amps or volts 55276 2 Temporary services or feeders installation,alteration,and/or Email: relocation _ Owner installation!This installation is being made on properly that I own which is not 200 amps or less 59 36 I intended for slile,lease,real,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Dale: _401 amps(0599 amps 168,54 2 .. „ . e APPLICANT I El CONTACT PERSON Branch circuits-new,alteration,or extension,per panel A,Fee for branch circuits with Business name;Pacific Lifestyle flames above service or feeder fee, 1 ' PC4'/742 21 _ each branch circuit Contact name:Permit Coordinator B.Fee for branch circuits without service ur feeder fee,Mg Address: 11815 NE 99"'Street,Suite 1200 brunch circuit 56.18 2 City/State/ZIP:Vancouver,WA 98682 Each add'I brawl)circuit 742 2 Miscellaneous(service or feeder not included) Phone:(360)573-8081 Fax::(360)574-6401 Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email:perinits@buildplh.com Reconnect only 67.84 2 CONTRACTOR Pulp ur irrigation circle 67.84 2 _ _ . Business name:Garner Electric Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address:2920 SE Brookwood Ave,Suite A panel,alteration,or extension. 0 See Page 2 2 Each additional inspection over allowable in arty_of the above City/State/ZIP:Beaverton,OR 97006 _ _ Additional inspection(I hr mint 66.25/hr _ .__ Phone:(503)6413-4552 Fax:(503)642-7925 Investigation(I hr min) 90,00/lir Industrial plant(I hr min) 78.18/hr Email:mmorato@garnereledric.com - . . . Inspections for which no fee is 9001)/In CCB Lie.: 121159 Electrical 1:-.: -305C Suprv.Lie.:31075 specifically listed eh hr min) ..xELECTRICAL'PERMIT FEES Stiprv.Electrician signature,requir-Ar Subtotal: Print name: Chuck Canter 0 Plan Review Required(25%of permit fee): Dale:—1(57-2-(1/7C1 State surcharge(12%of permit fee): Authorized signature: i 4 Ail , TOTAL PERMIT FEE: 1 This permit application expires if a permit is not obtained within 180 I Print name: 0,1t,I 50 / . ri c / [Mle: i /CPA ii e7 ' I days after it has been accepted as complete. ' Number of inspections allowed per park, I 11141ing,,PcoriiWEI.0 1)1.,untApp 1114,IiKE doe acv OW I 7/101$ '*40-46*STI I 1,9S,'CUKVWEI{ Electrical Permit Application-•City ol'Tigard Page 2--•Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE _unrdpn.n , Enel, Mal Fee for all residential systems combined: $75.00 Renewable electrical energy systems: Check Type of Work involved: s k,aor less u170 2 5.0110 l5 loll 133,50 2 L_ A• udio and Stereo Systems* 1501 to 25 kw) 2(1.34 2 Wind-enerution s stems In excess 0125 kva: Burglar Alarm 2501 to 50 kva 1111 301 04 5(1.01 to 110 k552 26 2 I ( Garage Door Opener* -- ri —. _.._.___.. >100 kva(Ice in accordance 552.26 2 with OAR 918.309-0040 Heating, Ventilation and Air Conditioning Solar generation systema in excess of 25 kvn: System* — Each additional kva over 25 7A2 3 rl * >100 kva-no additional charge a 0,0 3 V• acuum Systems Each additional inspection over allowable In any of the nbote� ❑ t)ther: Each additional inspection is G6,25/hr —• charged at an hourly(I In mut) Inspections for which no fee is 90.110/hr specifically listed(Si hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES S Fee for each commercial system: $75.00 Subtotal(Enteron Page 1):r Namherorin5pedionsalluwedperpermiI (SEE OAR 918-309-0000) Cheek Type of Work Involved: Lf Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems I I Data Telecomn unication Installation ❑ Fire Alarm Installation ❑ H• VAC n Instrumentation ❑ Intercom and ('aging Systems n L• andscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling n Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations t:nnildm,;Wern,ii OM'Pea ieir,,pp-ELR-ERE do Revaai712DI1 • Plumbing Permit Application . Building FixturesRECIV ® FOR OFFICE USE: oNl.� City of Tigard Received Permit N /� IIII 13125 SW Hall Blvd.,Tigard,OR 972?�((`` 1 PlaDan ReviewY /sf�g/9 �®�/�i _ Phone: 503.718.2439 Fax: 503.598.'1 60' 1 209 Plan Date/By: Other Permit No.: Inspection Line: 503.639.4175 TIGARD viTY OF TIUARD Date Ready/By: Juris: H See Page 2 for Internet: www.tigard-or.gov Notified/Method: Su lementalInformation ;P DING r'�1VFlo N� pp 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 0 Commercial/industrial SFR(2)bath 1 437.78 SFR(3)bath 500.32 0 Accessory building ❑Multi-family 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:11449 SW Gabriel St Catch basin or area drain 18.76 City/State/ZIP:Tigard,OR Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: 1 Project name:Willow Brook 12 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.:12 Fixture or item: Tax map/parcel no.:2S115AB06700 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 0 PROPERTY OWNER , 0 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 2 25.02 Phone:( ) Fax:( ) Ice maker 12.51 ►1 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 4 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 2 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:( ) 7i/be Minimum permit fee: $72.50 CCB Lic.:201597 Plumbing Lic.no.:PB141.6' 7 Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature:-C-....t ��k, i_A, t, �(_ ( _ ( TOTAL PERMIT FEE Print name:Summer Dowell Date:10/29/19 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(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) 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 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 for anyof the following. Performed: Capped Added RelocateQ Baptistiy/Font 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 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 Garbage -Domestic-non-food ❑ Isometric or riser diagram is required for new buildings Disposal -Domestic-food related that meet the qualifications above. -Commercial-food related -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang -Stall Sink/Lav -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter *Note: If the fixture 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 12\Permits and Inspections\PLB_PermitApp.doc . • 'Plumbing Permit Application Building Fixtures RECEIVED FOR OFFICE USE ONLY City of Tigard [�['T 31 2 Received 019 Date/By: Permit)Cf-S-7:02,9 f J- )©97 13125 SW Hall Blvd.,Tigard,OR 97ZL3 Plan Review iew9 Phone: 503.718.2439 Fax: 503.SSR g��` Other Permit No.: Date/By: Inspection Line: 503.639.4175 DiTrUF TIGARD TIGARD "I DING DIVISION Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE g New construction ❑Demolition For special information use checklist. Description 1 Qty. Ea. I 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 Z 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 D Accessory building ❑Multi-family 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:11449 SW Gabriel St Catch basin or area drain 18.76 City/State/ZIP:Tigard,OR Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: 1 Project name:Willow Brook 12 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.:12 Fixture or item: Tax map/parcel no.:2S115AB06700 Backflow preventer 1 31.27 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Back flow device for irrigation system. Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER I 0 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 0 APPLICANT 0 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 CONTRACTOR Water closet 25.02 Water heater 37.52 Business name:Trademark Landscapes,INC. Water piping/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 CCB Lie.:6.774, ( 2/140 Plumbing Lice�.no.: Plan review (25%of permit fee) C,�Lt il/---""tom State surcharge(12%of permit fee) Authorized signatur;� / TOTAL PERMIT FEE Print name:Summer Dowell Date:10/31/19 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: Site Utilities Qty. Fee(ea) 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 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. 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 Thar ❑ 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 Garbage -Domestic-non-food ❑ Isometric or riser diagram is required for new buildings Disposal -Domestic-food related that meet the qualifications above. -Commercial-food related -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang -Stall Sink/Lav -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter *Note: If the fixture 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:AJob Folders\Oregon\Subdivisions\Willow Brook(113th Ave)\Lot 12\Pinits and Inspections\irrigation application.doc City of Tigard .14 COMMUNITY DEVELOPMENT DEPARTMENT ■ T1cARo Building Permit Review — Residential Building Permit #: /V-5-7 -0/ q — 00 V/ C,o Site Address: //9/9) -C2it) 6. 27.'d '-9-- Project -c LProject Name: //J,9 ) 61o04 Lot #: /Q (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Propsal: A•+ Q I _ M Verify address/suite#active in Accela. n River Terr e: No ❑ Yes,River Terrace Review Addendum Sit,,Plan Elements: Erosion Control 3 opies of site plan on 8-1/2"x 11"or 11 x 17"paper tamed trees with drip line and tree protection measures awn to scale(standard architect or engineer scale) Y FF °tprint of new structure(including decks)and FFE fi�rth arrow 14 'ty locations&easements(required for new and additions) ISS ee address,project or subdivision name and lot number Sidewalk/driveway approach 121/plicant information(name and phone number) Ms) .cation of wells/septic systems r Lot dimensions and building setback dimensions iS eet tree size,type and location R are footage of buildings to be demolished 'la S et names at :sting structures on site VCorner elevations(2'contours if more than 4'diffe ntial) %Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? Yes ❑ impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? )Yes ( No 1. V Clean Water Services—Service Provider Lettof platted prior to 9/10/1995): \ 1 /Required: Received: q ❑ Yes,applicant was notified No ❑ Yes ❑ No VJ Public Faciliti mprovement(PH)Permit: ' :.uired: V Yes,applicant was notified ❑ No Applied r: Yes ❑ No,stop intake 1%yand Use Case#: S(i, )/l --&OOP VZoning: R-7,- d rZequired Setbacks: Front: /S--- Rear: /c--- Side: Street )deC ding Height: Max.Height: � •3�' Actual Hei ht: /c.P, Landscape/rip: —00 % 'IQ Lot Coverage Ma % Entrance back no more than 8'from street-facing wall (Ef Parallel to street or offset 45 degrees or less Windowsum 12%of area of all street-facing facades Garage Garage door is behind widest street-facing wall Yes ❑ No,one of the following is met: ❑ Door extends no more than 5'from wall and there is a covered porch extending beyond garage. Door extends no more than 5'from wa and there is a 12 sq ft.window above garage on 2nd floor. Garage door width is ❑ 12'or less 50%or less of facade ❑ 60%or less and includes 7 of following: ❑ Covered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset ❑ Fire shingles ❑ ap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer ❑ Accent siding A Window trim ❑ Window recess ❑ Window projection ❑ Balcony \\' 1 isual Clearance a�rban Forestry Plan f Llri nsitive Lands: qQ Yes 0 No Type: at) Vo?/lke h /A� V Co.• tions met prior to issuance of building permit No s: T Approved By Planning: _ Date: Revisions (after Building Submittal only) Reviewer I ate Revision 1: ❑ Approved 0 Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved 1:\Building\Forms\B1dgPermitRvw_RES 022819.docx Building Permit Submittal Original Submittal Date: (0/3 i/(2 Site Plans: # 7 Building Plans: # ,Y Building Permit#: ©Enter building permit#above. Workflow Routing: 2—Planning L"1 engineering 1'7 ermit Coordinator I- 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. L7i13uilding: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: <9 - _e Date: f i l Engineering Review lope at building pad: `� C'Conditions "Met"prior to issuance of building permit g--Easements (encroachments)per engineering conditions of approval and plat [ Dater Quality/Quantity Facility: Assess Water Quality Fee in-lieu: 0 Yes a No Assess Water Quantity Fee in-lieu: ❑ Yes ❑"No LIDA Facility on lot: ❑ Yes 2' No Ca'Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: • CYApproved by Engineering: K r l 5*A2- Date: )1-Le-11 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ 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: Revision Notice 3: Date Sent to Applicant: 0/S<DC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A Tigard Trans SDC: [�Yys ❑ N/A Parks SDC: [9' Yes ❑ N/A LIDA ❑ Yes Er N/A OK to Issue Permit Approved by Permit Coordinator: di i r Date: />/Lo1fl I:\Building\Forms\BldgPennitRvw RES_022819.docx