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Permit (5) CITY OF TIGARD MASTER PERMIT II = COMMUNITY DEVELOPMENT Permit#: MST2019-00428 T I GA R.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/26/2019 Parcel: 2S115AB06900 Jurisdiction: Tigard Site address: 11425 SW GABRIEL ST Subdivision: WILLOW BROOK SUBDIVISION Lot: 14 Project: Willow Brook, Lot 14 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 3 First: 1854 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 22 Bathrooms: 2 Second: 0 sf Garage: 433 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 1854 sf Value: $249,091.36 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 Drains: 0 Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 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'I 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 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 1854 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: $32,051.71 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 la equires,.ru to folio, the rules adopted by the Oregon Utility Notificati•'P Center. Those rules are set forth in OAR 952-001-0010 through OAR• 2-001 :090:-Y6u may obtai :copy of the r. '°'or direct questions to OUNC by calling 50 .232.1987 or 1.800.3322.23344_.. (--/eiC Issued By: �''.►iI Permittee Signature: ��� %t%%�r�v j Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application - Residential EIVED FOR OFFICE LSE ONLY City of Tigard g 2 2019 Date/By:Received e ,, /X T Permit No.: jkf-yi t,— '193'III "I 13125 SW Hall Blvd.,Ti ard,OR 97223 O V Plan Review a Phone: 503.718.2439 Fax: 503.598.1960 Date/By: II Z? 11 Otherck,g20/1. .. G/ FIGARO Inspection Line: 503.639.4175 1( OF TIGARD Date Ready/By: // Juris: H See Page 2 for Internet: www.tigard-or.gov BUILDING DIVISION Notified/M od: A 77n i Supplemental Information ad TYPE OF WORK ,?4,,,,,,,,,„:„4,147, r�ll � 3 t . . :. fi ®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 t1 "' t e work indicated on this application CATEGORY OF CONSTRUCTION e Valuation: alPL ® I-and 2-family dwelling 0 Commercial/industrial J 0 Accessory building 0 Multi-family Number of bedrooms: 0 Master builder ❑Other: Number of bathrooms: 2.... r� --7 JOB SITE INFORMATION AND LOCATION Total number of floors: i ZZ p / ( 14-2_,c-- (-:}A-) ���yt New dwelling area: I�'��- square feet 1.9)s-t4 Job site address: 11. �� City/State/ZIP:Tigard,OR Garage/carport area: 42,3 square feet Suite/bldg./apt.no.: Project name: O.( `I M7-0)171)V...-2)41 ' Covered porch area: 1 square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST r Subdivision: ba 1,(�� u tLot no.: I 1 Permit fees*are based on the value of the work performed. LI 1 K ) 0(4,9�� Inicate the value(rounded to the nearest dollar)of ollf Tax map/parcel no.: ; equipment,materials,labor,overhead, p and the profit for the DESCRIPTION OF WORK work indicated on this application. Valuation: $ ,40M111 ( Existing building area: square feet /�2.10, / 2 c a�/,1 ' ,6f-e, �`'!/ New building area: square feet ® PROPERTY OWNER 0 TENANT Number of stories: Name:Pacific Lifestyle Homes Type of construction: Address:11815 NE 99th Street,Suite 1200 Occupancy groups: City/State/ZIP:Vancouver,WA 98682 Existing: Phone:(360)573-8081 Fax:(360)574-6401 New: ►1 APPLICANT ►,4 CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name:Pacific Lifestyle Homes 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 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 lic.:173524 Total fee due upon application: $201.60 Authorized signature 1 ,pn This permit application expires if a permit is not obtained yr l O within 180 days after it has been accepted as complete. Print name:Summer Dowell Date: i 1 *Fee methodology set by Tri-County Building IndustryService Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440 4 13T(Ji 1/02/COM/WEB) Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONLY ' f City of Tigard Received Date/By: Permit No.: 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits: Phone: 503.718.2439 Fax: 503.598.1960 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 1 es No `/,A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ 0 0 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ 0 0 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 0 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ 0 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ 0 0 9 Erosion control 0 plan 0 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 ❑ ❑ ❑ 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 ❑ 0 0 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- ❑ ❑ ❑ 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 ❑ 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 ❑ ❑ 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 0 0 ❑ for four or more appliances. 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or 0 0 ❑ architect licensed in Ore:on and shall be shown to be a..licable to the .ro'ect under review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". ❑ ❑ ❑ 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. ❑ 0 0 27 "Drawn to scale"indicates standard architect or engineer scale. ❑ ❑ 0 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ 0 0 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 ❑ ❑ 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 Application FOR OFFICE USE ONLY Cl Of Tl and Received Permit No.: Ty g Date/By: /L,'/ t ` lig 13125 SW Hall Blvd.,Tigard,OR 97223 �'\I�� Plan Review • Phone: 503.718.2439 Fax: 503.598.1960i EC V Date/By: Other Permit: T I G ARD Inspection Line: 503.639.4175 Date Ready/By: Juris: H See Page 2 for Internet: www.tigard-or.gov NOV 2 5 2019 Notified/Method: Supplemental Information >r ' TYPE OF WORK' ' I 1 COMMERCIAL FEE* SCHEDULE — USE CHECKLIST ,„ l� �1�81 �' ` m 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. s� ,- Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ® I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑ Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total TION Heating/cooling: JOB SITE INFORMATION AND LOCA i;. �7 Air conditioning 46.75 'J Job site address: r (�j`'(�j/ 'j _ Furnace 100,000 BTU(ducts/vents) / 46.75 ,13 City/State/ZI . r 0-12_, Furnace 100,000+BTU(ducts/vents) 54.91 l Heat pump 61.06 Suite/bldg./apt.no.: J Project name:t4�v)(i I o �.").1.30k.L____,14 Duct work i 23.32 .225,3 Cross street/directions to job site: " Hydropic 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 Other: 23.32 Subdivision: •� ) Lot no.: t� Q I/l J �LLf Other fuel appliances: Tax map/parcel no.: . 1 15 -/�,(,(Q(,Q 0 Water heater i 23.32 2,._.- ,3')----"" DESCRIPTION OF WORK Gas fireplace/insert 1\ 33.39 , 3.039 Flue vent for water heater or gas 2 fireplace 23.32 220,J2-- 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 PROPERTY OWNER ❑ TENANT r Environmental exhaust and ventilation: Name: .1 r (� ` .-, �. Range hood/other kitchen d LiLI�( 1 1 i, l i '� t/ �v i 1 C1 equipment 1 33.39 3.3� Address: I 1 / �'1,(.4. D-01) Clothes dryer exhaust ' 33.39 333.81 City/State/ZIP:ran(15-1,A707----,„ it- , 1.j 2- Single-duct exhaust(bathrooms, 9.70,2-5btoilet compartments,utility moms) 4- 23.32 Phone: ) to . .i`?'f Q IT 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. Address:11815 NE 99th Street,Suite 1200 Gas heat pump Wall/suspended/unit heater City/State/ZIP:Vancouver,WA 98682 Water heater Phone:(360)573-8081 Fax::(360)574-6401 Fireplace y, Range 1 E-mail:permits@buildplh.com Barbecue 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 days after it has been accepted as complete. Authorized signature: JO * Fee methodology set by Tri-County Building Industry Service Board Print name: t I 1 t' k' ►C1 w( or Date: I I './1/1 q I:\Building\Penults\MEC_PennitApp_040113.doc 440 617T( /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\Pernvts\MEC_PermitApp_040113.doc 2 ' Electrical Ical PeI°Iait �licz�ti®><� I-OR O1�HCE USE .... NLY .. ,.5� clued _&7 City O 1'I ilf't RECEIVE Pennitn: / 8 ale/By II . I v `t 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review r-- Phone 503.718.2439 Fax: 503.598.1960 NOV 2 5 2019 Dale/Bv: Related Permit 6: `t inspection Line: 503.639.4175 Ready Date/13y: Innis VI See Page 2 for rag 0. Notified/Md: Supplemental Information r1Internet: w'a'\t-ttgard-or.gov CITY OF TIGARD h — TYPE OF woRI�UILD►NG DIVISION PLAN REVIEW ®New construction ❑Addition/alteration/replacement Please check all that apply(submit awls of plans w/gems checked). ❑Service or feeder 400 amps or snore ❑Building over three stories ❑Demolition ❑Other: where the available fault current D Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings. ® I-and 2-lamily dwelling IDCommercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑C:ommereiirl•use agricultural amps for all other installations. buildings. ❑ Multi-family ❑Master builder ❑Other: 0 Fire pump. 0 Installation of 150 K VA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separate y derived r system. ❑Addition of new motor load Of Y� ' Job it: I lob site address: iI4 C 6Wt1,Q,�t�}": 100HPormore. ❑`A' `1: "I-2"'l-3" 1 0 Six or more residential trails. t_Il1'/Stall/Z1P: \d � 0�f 1 Jj 0 Recreational vehicle parks. I """---"""---}�t� ---fff n ❑l lcahh-care ftctlities. Stri ----.__j .l jail D IA) / b'V�/' ,1 0 Hazardous locations. ❑Supply voltage fisal.more than Suite/bldg,/apt.t/: Project name: �/ 600 volts nominal. ❑Service or feeder 600 amps or more. Cross street/directions to.job site: FEE SCHEDULE -- — -- _ Description I Qty. � EacL i 'I'otnl __--L_",_ New residential single-or multi-family dwelling unit, Su bd�v��s�on: r c 1R fD Lot#: J Includes attached garage. _ — — 1,000 sq.R.or less 16854 4' Tax_map/parcel#: .- I 1c' -,7"1—� 01091 D I a.add'{500 sq ft or portion 33 92 I DESCRIPTION OF WORK Limited energy,residential 75.00 2 (with above sq.It.) Limited energy,multi-family 75.00 2 residential(with above sq.ft.) ----- Renewable Energy ❑ See Page 2 1:i PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation Name: t'"�) V L_A J ) , 200 amps or less 109.70 2 ` , l /v , �, / ' .�, 201 sato to 400 amps 133.56 2 Address: ` V �Jt/'(� a .e.D ,__ ll 'n 401 amps to 6W amps 200.34 2 City/State/ZIP: LD k YV it 0 �L 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 1 own which is not 200 amps or less 5936 I intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125 08 2 Owner signature:,_ Date: 401 amps to 599 amps 168,54 2 Branch circuits—new,alteration,or extension,per panel ® APPLICANT ® CONTACT PERSON A.Fee for branch circuits with f d feeer fee,Business name: Pacific Lifestyle Homes above service or 7.42 2 — each branch circuit Contact name: Permit Coordinator B.Fee for branch circuits without service or feeder fee,first Address: 11815 NE 99111 Street,Suite 1200 branch circuit 56.18 2 City/State/ZIP:Vancouver,WA 98682 Each add'!branch circuit 7 42 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:perm its@buildplh,com 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 circuit(s)or limited-energy (3 See Page 2 2 Address:2920 SE Brookwood Ave,Suite A panel,alteration,or extension, te — —` Each additional inspection over allowable in any of the above City/State/ZIP: Beaverton,OR 97006 Additional inspection(I hr nim) 66.25/hr Phone:(503)648-4552 Fax:(503)642-7925 Investigation(I hr Iain) 90.00/hr Industrial plant(l hr min) 78.181 hr Emailn i norato{r garnerelectric.cotn —� —_ Inspections for which no fee is 90,0(1/hr CCB Lie.: 121159 Electrical 1:'.: -305C Suprv.,Lie.:3-10-1 5 specifically listed('Ye hr mm) - ,- ELECTRICAL PERMIT FEES Suprv.Electrician signature,require.. Subtotal: r i ,' t fl p•--(1.1(I ❑Plan Review Required(25%of permit fee): Print name: Chuck Garner �,�, r Date:✓t- ,' State surcharge(12%of permit fee): Authorized signature: j4 �4 F I O'I Al.,PERMIT FEE: [ —_-. --- This permit application expires if a permit is not obtained within 180 Print name: f•hRSC 5eJ al r/i G Date: I�1' t I.9 I x days after it has been accepted as complete. 1� i I r{ 1 Number of inspections allowed per permit. I 13u4dineermiis\EI.C.PermitApp EI.K ERE doe Rev.56.17/2015 440-4 IST(I I 5iCoa'vWE13 Electrical Permit Application--City of Tigard Page 2---Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE.SCHEDULE Fee for all residential systems combined: $75.00 �+ __ nab 1 otal 1= Renewtvabat le electrical energy systems: Check Type of Work Involved: 5 kva or less-��— 100.70 2 5.01 to 15 kva 133.56 2 ri A• udio and Stereo Systems* 1501 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: I Burglar Alarm 25.01 to 50 kva 301.04 2 Garage Door Opener* 50.01 to too kva 55226 2 >100 kva(fee in accordance 552.26 2 with OAR 918-309-0040) _ 11 H• eating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:System" Each additional kva over 25 7.42 3 Vacuum Systems* >100kva—noadditional charge 0.0 3 C Each additional inspection over allowable in any or the above: n O• ther: Each additional inspection is 66.25/hr — charged at an hourly(1 hr min) Inspections for which no lee is 90.00/hr specifically listed(%s hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES 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: U Audio and Stereo Systems ❑ Boiler Controls Clock Systems II Data"Telecommunication Installation Fire Alarm Installation HVAC Instrumentation Intercom and Paging Systems II Landscape Irrigation Control* Medical [] Nurse Calls Outdoor Landscape Lighting* U Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required, Licenses are required for all other installations I.13uildinglPennits'i.EL( PerutilApp-ELR_ERE doe Rev 06/1712015 Plumbing Permit Application Building Fixtures RECEIVED FOR OFFICE USE ONLY Cityof Tigard Received ". g Permit No.: 2 � 20�9 Date/By: /�5`�-�lta `t �-G1(r d IN w 13125 SW Hall Blvd.,Tigard,OR 97223 NOV f Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Other Permit No.: Inspection Line: 503.639.4175 CITY OF TIGARD Date/By: TIGARD p g g BUILDING DIVISION Date Ready/By: kris: El See Page 2 for Internet: www.tt and-or. ovNotified/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 437.78 42,1766 El Accessory buildingSFR(3)bath 500.32 ❑Multi-family Each additional bath/kitchen 25.02 ❑Master builder III Other: Fire sprinkler(_sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION f Site utilities: Job site address: O(4'2. �''t.e( S - 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.: I Project name: t'10L_Ii 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.:.412.1)CO I Page 2 I Water service(no.linear ft.:/i v O 1 Page 2 Subdivision:,l� 0 Lot no.: I lFixture or item: Tax map/parcel no.: 2-S I 1 -a(Q qD c Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 n �p `� Clothes washer i 25.02 r L`'� Dishwasher I 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER 0 TENANT Expansion tank 12.51 Fixture/sewer cap 25.02 Name: �Q�it�i i� �� 1 � `'� }_n ' Floor drain/floor sink/hub 25.02 Address: t�j 9j f ��<�� I I-CSI I I v v^ d�I Garbage disposal I 25.02 City/State/ZIP: an�L(,V4 q S( 2-_r ti Hose bib 25.02 Phone: 5-1✓ (bora I Fax:( `) t� 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 CONTRACTOR Water closet 2.. 25.02 Water heater I 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 CCB Lie.:201597 Plumbing Lic.no.:PB1416 Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signatur-• / / '/ / / -,../ TOTAL PERMIT FEE Print name: (Linn') l/ l )/J� JA]ere_ Date: i( IJ() This permit application expires if a permit is not obtained within 180 days C �V / 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-1St 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-I st 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 1 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 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 El Isometric or riser diagram is required for new buildings Garbage -Domestic-non-food g q g 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\Jurisdiction Docs\Tigard,City\Applications\PLB_P�rmitApp.doc Plumbing Permit Application it*/(4,12-C /r kri 6100(m '1(_, Building Fixtures FOR OFFICE USE ONLY City of Tigard R E E I r C " eceived �/ G sate/By: Permit No.: �1 C7-'_` Gt ��(i179 Ili NI 13125 SW Hall Blvd.,Tigard,OR 97223 /21527-01.6 5 t7`6 fY�j Plan Review S Phone: 503.718.2439 Fax: 503.598.1960Other Permit No.: T I GARD Inspection Line: 503.639.4175 N 0 V 2 5 2019 Date/By: Ready/By: Juris: H See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information ‘.42 2 t orTIGAFRD TYPE OF WORK BUILDING DIVISION ," FEE* SCHEDULE 0 New construction 0 Demolition For special information use checklist Description Qty. Ea. I Total 0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 0 Accessory building ❑Multi-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: 1 (Z\-2_,S oik ,,ri"ppCatch 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:1/) I I /4 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 1 Storm sewer(no.linear ft.:_) Page 2 lv; I MAD I Water service(no.linear ft.:_) Page 2 Subdivision: � i, I Lot ri0.: Flxtnr �, Tax map/parcel no.: Backflow preventer 1 31.27 DESCRIPTION OF WORK Backwater valve Clothes washer 25.02 Sl/'a ( rr i Lyci'l 6l& Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 0 PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Name: I?'�7� r , Fixture/sewer 25.02 • N1 Floor drain/floor sink/hub 25.02 Address: I! / ) 9` ' rarCID/� 'I ', t . �1 Garbage disposal 25.02 City/State/ZIP: t� l (�rr-1�1)/ ) Wf l O Y Z Hose bib 25.02 Phone:Nai 3 .Q' o Fax:( ) U 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 P �° Water heater 37.52 Business name: 2 Lar Kii hL' Waterpiping/DWV 56.29 Address:pp Box 1 I Other: 25.02 City/State/ZIP:'0 0 o i l t 1 t/ ' Subtotal Phone:1"� f Minimum permit fee: $72.50 _6i) (03 - Fax:( ) Plan review (25%of permit fee) CCB Lic.: (07`3 1 1&` Plumbing Lic.no. _ ` '� / State surcharge(12%of permit fee) � Authorized signature:4j/ / TOTAL PERMIT FEE Print name: ( Q Date: (pi permit application expires if a permit is not obtained within 180 days �l ii I after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. C\Building\Peanits\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 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/ 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 Thio El 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 CI 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\Jurisdiction Docs\Tigard,City\Applications\PLB_PnnitApp.doc City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT ill ■ TIG ARD Building Permit Review — Residential Building Permit #: //15-7,02- jt _ 0pt7' - r j Site Address: II /a5 . . G a.4,-,d5- , Project Name: w)lo /) glOek Lot #: (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: ii)71i1 6 Verify address/suite#active in Accela. L:J-`'In River Terrace: _a"-"No ❑ Yes,River Terrace Review Addendum Site Plan Elements: CI Erosion Control ,lc pies of site plan on 8-1/2"x 11"or 11 x 17"papertained trees with drip line and tree protection measures rawn to scale(standard architect or engineer scale) rint of new structure(including decks)and FFE 2orth arrow .2etility locations&easements(required for new and additions) i�t address,project or subdivision name and lot number walk/driveway approach .�l�Applicant information(name and phone number) „����a ono wells/septic systems of dimensions and building setback dimensions .l�street tree size,type and location 4:1Spaare-feetag8 of buildings to be demolished _eet names . • • ctures on site 2r6orner elevations(2'contours if more than 4'differential) t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑Yes ❑No impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes ❑No Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified ` 1.-N Received: ❑ Yes ❑ No —15Facilities Improvement(PFI) Permit: Required: es,applicant was notified ❑ No Applied For: J -Yes ❑ No,stop intake 1:g-Land Use Case#: cu B 2/ - a OD l 1 ❑ Zoning: -0” Required Setbacks: Front: 16 Rear: (S Side:- S Street Side: /6 Garage: 2t' ❑ Building Height: Max. Height: 35 Actual He' ht: 2r)- 2'1Landscape : a.O % 0.--rot Coverage Max: Y % Entrance 2. Set back no more than 8'from street-facing wall 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 walls ❑ 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 wall and there is a 12 sq ft.window above garage on 2nd floor. ❑ Garage door width is ❑ 12'or less -21'50%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 ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer ❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony _©-Tisual Clearance .B- tan Forestry Plan --fSensitive Lands: ❑ Yes --ErNo Type: .nditions m . r to issuance of building permit Notes: proved By Planni Date: I VD...51,A>.--"' Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPennitRvw RES 022819.docx Building Permit Submittal Original Submittal Date: ///, // Site Plans: # Building Plans: # Building Permit#: Z1...Eriter building permit above. Workflow Routing: banning ngineering 't Coordinator ZI—Btti ig Workflow Sign-off: [ i -off for Planning(include notes from planning review) Route Application Documents: engineering: (1) copy of permit application, (1) site plan, (1) building plan and orial plan review routing form. B-<ilding: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: Date: ///131, Engineering Review 2'1ope at building pad: Jtonditions "Met"prior to issuance of building permit Easements (encroachments)per engineering conditions of approval and plat B'Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: 0 Yes [2 No Assess Water Quantity Fee in-lieu: 0 Yes ErNo LIDA Facility on lot: 0 Yes Er No 2--Final Plat Recorded: 0 NOT Approved by Engineering: Date: Notes: Cr Approved by Engineering: . Date: 1- Z-7-11 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 0 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: C(DC Fees Entered: Wash Co Trans Dev Tax: ['Y s 0 N/A Tigard Trans SDC: s 0 N/A Parks SDC: Ld''Yes ❑❑1A LIDA 0 Yes LJ' N/A OK to Issue Permit // D Approved by Permit Coordinator: ate: /) /2.�// I:\Building\Forms\BldgPermitRvw_RES_0228 19.docx