Permit . • Plumbing Permit Application r� '` i\I(,- j )
•
Building Fixtures
City Drn Tigard
`'. 1202'0 Reeereed
III 13125 SW'HallBlvd.,Tigard,OR 972-27 ..1 rs A.r-,f . Detel3y: Jo/7fi f�([6 Permit Ntykal 57�zo,0 p 17 7
g Phone: 503.718.2439 Fax: 503.598 1960 'I 1 t 11 . Ptwe Review
17mte;B Other Permit No.:
Inspection Line: SD3.639 4175 ` '' Re
f 1 G,x f:h Internet: wwew.ligard-or taw NDoii ettAleih t��r�. Supplemental
See Pent 2 Inc
Nonficd'liahod: Supplemental Information
TYPE OF WORK FEE* SCIIEDIULE
0 New construction ❑ Demolition For special information use checklist
Description I Qtv. I Ea- I Total
❑Addition/alteration/replacement ❑Other New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
® I-and 2-I'mnily dwelling 0 Commercial/industrial SFR(2)bath 437.78
0 Accessory building 0 Multi-family SFR(3)bath I 500.32 500.32
Each additionalbatM.itehen 25.02
0 Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION e�w p.a..r' T Site utilities:
Job site address:12079 SW Summ erbrook Lane ii- , -V--- Catch basin or area 18.76
L.. Drywall,leach line,or trench drain 18.76
City/State/ZIP:Tigard/OR/97223
Suite/bldg./apt no.: I Project name:Sum merbrook AUG 05 2020 (rooting drain(no.linear R.:2 (i l) Paget 87.55
iGARD Manufactured home utilities 50.03
Cross street/directions to job site:SW 121t Ave and SW Summercriacame Manholes 18.76
BUILDING DIVISION Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear R.:_) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision:Sum merbrook I Lot no.; 1 Fixture or item: l
(3-1....
s
Tar map/parcel no.: Backflowpreventer 1 31.2727
DESCRIPTION OF WORK Backwater valve 12.5]
Clothes washer 1 25.02 25.02
New Single Family Ilume 3176 sqft 5 bedroom,3 bath with 664 sqft 4 ear
Dishwasher I 25.02 25.02
garage and with a 143 sq ft covered rear patio. Drinking fountain 25.02
Ejectors/sump 25.02
El PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Name:David Weekley Homes Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 1905 NW 1696 Place Suite 102
Garbage disposal I 25.02 25.02
City/State/ZIP:Beaverton,OR 97006 Hose bib 2 25.02 50.04
Phone:(503)2134415 Fax:( ) Ice maker 1 12.51 12.51
® APPLICANT ® CONTACT PERSON Interceptor/grease trap 25.02
Business name:David Weekley Homes Medical gas(value:$_) Page 2
Primer 12.51
Contact name:Michele Sehiedler
Roof drain(commercial) 12.51
Address: 1905 NW I69's Place,Suite 102 Sink/basiMavatory 4 25.02 100.08
City/State/ZIP: Beaverton/OR/97006 Solar units(potable water) 62.54
Phone:(503)213-4415 Fax::( 1 Tub/shower/shower pan 3 12.51 25.02
E-mail: mschiedler/uldwhomea.com Urinal 25.02
e t q ,-p , xu, yg tie, , W'ater closet 3 25.02 75 06
�' �" a`v Water heater I 37.52 37.52
Business name:Malmedal Plumbing Water piping/DWY 56.29
Address:PO Box 207 Other: 25.02
City/State/ZIP:Banks/OR/97106 Subtotal _St.27
Phone:(503)324-0759 Fax:( ) Minimum permit tee: $72.50
COI Tic.: 102535 Plumbing Lie.no.:34-276PB Plan review (25%of permit fee)
State surcharge(12%of permit fee) 1.75
Authorized signature:caro ov.0.1 em c.- ':...- TOTAL PERMIT FEE 35. ()2.-
Print name: Carolina Malmedal pale- 05/18/2020 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
"Fee methedolopy set by Tri-County Building hdusuy Service Board.
I1BuddinglPernutsPLMU-PenrdlAppdoc 10;01119 440-161671 t0.%02'COM-' EB)
•
CITY OF TIGARD MASTER PERMIT
IIIII47 COMMUNITY DEVELOPMENT . Permit#: MST2020-00177
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 piixtLii.k'''
AOC d)D J Date Issued: Jul 14 2020 12:00AM
TIC.,t fit T3 9 Parcel: 1S134BD11800
Jurisdiction: Tigard
Site address: 12079 SW SUMMERBROOK LN
Subdivision: SUMMERBROOK SUBDIVISION Lot: 1
Project: Summerbrook, Lot 1
Project Description: New SF. 8/15/2020: REPRINT to add irrigation backflow.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1472 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 27 Bathrooms: 3 Second: 1664 sf Garage: 665 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 3136 sf Value: $416,440.01 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100Catch 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: N Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Fum<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: 6 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
6D1-1000 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 3136
Owner: Contractor:
WEEKLEY HOMES LLC WEEKLEY HOMES Required Items and Reports(Conditions)
1111 N POST OAK RD 1905 NW 169TH PLACE SUITE 102 1 Ersn Cntrl 503-639-4175
HOUSTON,TX 77055 BEAVERTON,OR 97006
PHONE: PHONE: 503-213-4415
FAX:
Total Fees: $39,755.89
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through R 952-001- 090.
�Y�ou/m/,any obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. 1
Issued By: iC S/ fi uc—r' -- Permittee Signature: O ��LJ cy
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit AnnlicationR EC EIVE 1 FOR OFFICE USE ONLY'
City of Tigard Received
13125 SW Hall Blvd.,Tigard,OR 97223 A U G 31 2020 Dste/13y: 9 Z�/�� '1. '( Permit No s7"� Qa�7?
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
Date/By: Other Permit:
t i, 1c 1, Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: lain:Internet: www.tigard-or.gov BUILDING DIVISIOI I Notified/Method: ® Seeman 2l Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction ❑Addition/alteration/replacement
performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION Value:$
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® I-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist
❑Multi-family 0 Master builder
0 Other: Description I Qty. I Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Job site address:12079 SW Summerbrook Lane Air conditioning 1 46.75 46.75
Furnace 100.000 BTU(ducts/vents) 1 46.75
City/State/ZIP:Tigard/OR/97223 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: I Project name:Summerbrook Heat pump 61.06
Duct work 23.32
Cross street/directions to job site:SW 121"Ave and Summerbrook Lane 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:Summerbrook Lot no.:1 Other: 23.32
Other fuel appliances:
Tax map/parcel no.:TBD Water hearer
1 23.32
DESCRIPTION OF WORK Gas fireplace/insert 1 33.39
New single family home to be built-3176 sq ft,5 bedroom 3 bath home with Flue vent for water heater or gas
fireplace 23.32
664 sqft 4 car garage and a 143 sq ft covered rear patio. Log lighter(gas) 23.32
•i//
fy j� Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
M.PROPERTY OWNER 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name:David Weekley Homes Range hood/other kitchen
Address:1905 NW 1691°Place,Suite 102 equipment 1 33.39
Clothes dryer exhaust I 33.39
City/State/ZIP:Beaverton/OR/97006 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 3 23.32
Phone:(503)213-4415 Fax:( )
Attic/crawlspace fans 23.32
® APPLICANT ® CONTACT PERSON Other:
23.32
Business name:David Weekley Homes Fuelpipint
S14.15 for Brst four;S4.03 for each additional
Contact name:Michele Schiedler Furnace.etc.
Address:1905 NW 1691°Place,Suite 102 Gas heat pump
City/State/ZIP:Beaverton/OR/97006 Wall/suspended/unit heater
Water heater
Phone:(503)213-4415 Fax: :( ) Fireplace
E-mail:mschiedler@dwhomes.com Range
Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:David Weekley Homes Other:
Address:1905 NW 1691h Place Suite 102 MECHANICAL PERMIT FEES*
Subtotal VC,7s
City/State/ZIP:Beaverton/OR/97006 Minimum permit fee($90.00)
Phone:(503)213-4415 Fax:( ) Plan review(25%of permit fee)
State surcharge(12%of permit fee) S, (p f
CCA tic.:213653 TOTAL PERMIT FEE SZ 219
A�/ This permit applicationsert has b Ina accepted
is not obtained within ISO
!/`// days after it has been accepted as complete.
Authorized signature: * Fee methodology set by TO-County Building Industry Service Board
Print name:Ken Pu man I Date:5/20/20 J
1:1BuildingWennitstMEC_PermilApp_040 I I3.doc 440.4617T(I I/OJCOM/WEt)
CITY OF TIGARD MASTER PERMIT
1;h' COMMUNITY DEVELOPMENT Permit#: MST2020-00177
Date Issued: Jul 14 2020 12:00AM
T J GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 1S134BD11800
Jurisdiction: Tigard
Site address: 12079 SW SUMMERBROOK LN
Subdivision: SUMMERBROOK SUBDIVISION Lot: 1
Project: Summerbrook, Lot 1
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1472 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 27 Bathrooms: 3 Second: 1664 sf Garage: 665 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 3136 sf Value: $416,440.01 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
0
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add9 500 sf: 6 201-400 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 3136
Owner: Contractor:
WEEKLEY HOMES LLC WEEKLEY HOMES Required Items and Reports(Conditions)
1111 N POST OAK RD 1905 NW 169TH PLACE SUITE 102 1 Ersn Cntrl 503-639-4175
HOUSTON,TX 77055 BEAVERTON,OR 97006
PHONE: PHONE: 503-213-4415
FAX:
Total Fees: $39,720.87
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 160
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification 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 calling 503.232.1987 or 1.800.332.2344.
Issued By e r ermines Signature: d .�i.«
3.639.4175 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.
Buildin2 Permit Application a t.o C �r �,
Residential •��� `"` FOR OFFICE, t'SE ONLY
City of Tigard I11AY 21 21 " RDaelivvy:4, 3 20 <Qr Pen it➢'y5 v`C10t' 77
13125 SW Hall Blvd.,Tigard,OR 97223 Y.
r ,. Plan Review �T l
:11111 III Phone: 503.718.2439 Fax: 503 598 10411' V C f Date/By: k f I'D�!r AIR- Other Pe kig-2020 "00(I r
TIGARD Inspection Line: 503.639.4175 - Date Ready/By: Inds: See Page 2 for
Internet: www.tigard-or.gov - N5ednvt -/ �� Supplemental Information
d
TYPE OF WORK REQUIRED DATA:1-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 ❑Commercial/industrial Valuation: SSb9btT� i (�(�a
❑Accessory building 0 Multi-family Number of bedrooms: 5
❑Master builder 0 Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors: 2 3�b
Job site address: 12079 SW Summerbrook Lane New dwelling area: s13 to
quare feet(t.t
City/State/ZIP:Tigard/OR/97223 Garage/carport area: .663 square feet N 72-
Suite/bldg./apt.no.: Project name:Summerbrook Covered porch area: square feet
Cross street/directions to job site:SW 121'Ave and SW Summerbrook Lane Deck area: square feet
Other structure area: square feet
_ REQUIRED DATA:CQMD1ERCIALr,USECHECKLIST
Subdivision:Summerbrook J Lot no.: 1 Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for theiov
DESCRIPTION OF WORK work indicated on this application.
New Single Family Home to be built-3176 SQFT 5 Bedroom,3 bath with 664 SQ Valuation: $
FT 4 car garage with a 143 SQFT covered rear porch Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name:David Weekley Homes Type of construction:
Address:1905 NW 169"A Place Suite 102 Occupancy groups:
City/State/ZIP:Beaverton,OR 97006 Existing:
Phone:(503)213-4415 Fax:( ) New:
❑ APPLICANT ® CONTACT PERSON BUILDING PERNHT FEES*
Business name:David Weekley Homes (Please refer to fee schedule)
Structural plan review fee(or deposit):
Contact name:Michele Schiedler
FLSplan review fee(if applicable):
Address:1905 NW 169t"Place,Suite 102 )
Total fees due upon application:
City/State/ZIP:Beaverton/OR/97006
Amount received:
Phone:(503)213-4415 Fax::( )
E-mail:mschiedlerCd who mes.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:David Weekley Homes Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:1905 NW 169'Place,Suite 102 Solar Installation Specialty Code checklist.
City/State/ZIP: Beavert 1 1 OR/97006 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503)213-441 Fax: ) State surcharge(12%of permit fee): $21.60
CCB lie.:213653
Total fee due upon application: $201.60
Authorized signature: - This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Michele S s 1 iedl. Date:5/21/20 *Fee methodology set by Tri-County Building Industry
Service Board.
I.1Building1 Permits 1BUP-RESPermitApp.doc 02/24/2011 440-4613T(l 1/02/COM/WEB)
Mechanical Permit Applicoprnp g n FOR OFFICE USE ONLY
5 .O
Received ^,, ' n^ .Do 17 7
City of Tigard Permit N M. 4(J
" 13125 SW Hall Blvd.,Tigard,OR 97223' '? I 2020 Dan By.
Phone: 503.718.2439 Fax: 503.598.1960 Plan
atei Review Other Permit:
TIGARD Inspection Line: 503.639.4175 ( t •, ;, r'1`;Pi3[ to'? Date Ready/By: furls: Sec Page 2for
Internet: www.tigardorgov7. �
g t l 1,,,1 r,•t,.,,.,. Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST.
Mechanical permit fees*are based on the value of the work
El New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
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 46.75
Job site address:12079 SW Summerbrook Lane Furnace 100,000 BTU(duets/vents) I 46.75
City/State/ZIP:Tigard/OR/97223 Furnace 100,000+BTU(ductslvents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:Summerbrook Duct work 23.32
Cross street/directions to job site:SW 121st Ave and Summerbrook Lane 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:Summerbrook Lot no.:1
Other 23.32
Other fuel appliances:
Tax map/parcel no.:TBD Water heater 1 23.32
DESCRIPTION OF WORK Gas fireplace/insert 1 33.39
Flue vent for water heater or gas
New single family home to be built-3176 sqft,5 bedroom 3 bath home with fireplace 23.32
664 sqft 4 car garage and a 143 sq ft covered rear patio. 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:David Weekley Homes Range hood/other kitchen
equipment 1 33.39
Address:1905 NW 169th Place,Suite 102 Clothes dryer exhaust 1 33.39
City/State/ZIP:Beaverton/Oft/97006 Single-duct exhaust(bathrooms,
toilet compartments,utility moms) 3 23.32
Phone:(503)213-4415 Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT ® CONTACT PERSON Other: 23.32
Business name:David Weekley Homes Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:Michele Schiedler Furnace,etc.
Address:1905 NW 169th Place,Suite 102 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Beaverton/OR/97006 Water heater
Phone:(503)213-4415 Fax: :( ) Fireplace
Range
E-mail:mschiedler@dwhomes.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:David Weekley Homes Other:
MECHANICAL PERMIT FEES*
Address: 1905 NW 169th Place Suite 102 Subtotal
City/State/ZIP:Beaverton/OR/97006 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)213-4415 Fax:( ) State surcharge(12%of permit fee)
CCB lic.:213653 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: * Fee methodology set by Tri-County Building Industry Service Board
Print name:Ken Putt an Date:5/20/20
IdBuilding\Permits\MEC_PennitApp_0401 l3.doc 440-4617T(11,02iCOM/W EB)
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 $1,36331 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_PermitApp_040I 13.doc 2
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard o 20 Received
1 %(� Pennn= 7
• 13125 SW Hall Blvd.,Tigard,OR 97223 PlanDate/
/�S I ZQ'Zp '�Q 17
1 S Phone: 503.718.2439 Fax: 503.593.1960 - - Date/By: Related Permit#:
TIGARD Inspection Line: 503.639 4175 Ready DateBy: Juris: 16d See Page 2 for
Internet: www.tigard-orgov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
®New construction ❑ Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑Floating buildings.
® 1-and 2-family dwelling ❑ Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑ Master builder 0 Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION U Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#:68020001 Job site address: 12079 SW Summerbrook Lane 100HPormore. ❑"A"."E"."1-2","1-3",
occupancy.
City/State/ZIP:Tigard/OR/97223 ❑Six or more residential units- ❑Recreational vehicle arks.
❑Health-care facilities. P
Suite/bldg./apt.#: Project name:Summberbrook ❑Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or mom_ 600 volts nannnal.
Cross street/directions to job site:SW 121st Ave and Summerbrook Lane FEE SCHEDULE
s Description I Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision:Summerbrook Lot#: 1 Includes attached garage.
1,000 sq.ft.or less 1 168.54 168.54 4
Tax map/parcel#:1
Ea.add']500 sq.ft,or portion 4 33.92 107.76 1
DESCRIPTION OF WORK Limited energy,residential _
75.00 2
New single family home to be build-3176 sqft,5 bedroom 3 bath home with (vvi th above sq.ft.)
•
Limited energy,multi-family 75.00 2
664 sqft 4 car garage with a 143 sq ft covered rear patio. residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
®.PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: David Weekley Homes 200 amps or less 100.70 2
Address: 1905 NW 169th Place Suite 102 201 amps to 400 amps 33.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Beaverton/OR/97006 601 amps to 1,000 amps 301.04 2
Phone:(503)213-4415 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Entail: relocation
Owner installation:This installation is being made on property that 1 own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
® APPLICANT ® CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:David Weekley Homes above service or feeder fee, 742 2
each branch circuit
Contact name:Michele Schiedler B.Fee for branch circuits without
rvAddress: 1905 NW 169th Place Suite 102 b branch cit feet
fee,first 56.18 2
t
City/State/ZIP:Beaverton/OR/97006 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)213-4415 Fax::( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: mschiedler(didwhomes.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 ❑ See Page 2 2
Address:2890 SE Brookwood Ave. panel,alteration,or extension.
Each additional inspection over allowable in any of the above
City/State/ZIP: Hillsboro, OR 97123 Additional inspection 11 hr min) 66.25/h
Phone:(503)523-9060 Fax:( ) Investigation('1 hr min) 90.00/hr
Email: /, Industrial plant(I hr min) 7818/hr -
permits@garnerelectric.com t 1 r 5—/li Inspections for which no fee is
CCB Lic.: Electrical L' .: Suprv.Lic.. specifically listed('=:hr min) 90.00/hr
121159 4-30 P 3707-S ELECTRICAL PERMIT FEES ; ,
Suprv.Electrician signature,required: Subtotal:
Print name: Charles Garner Date: 5/18/2020 ❑Plan Review Required(25%of permit fee):
,c./ State surcharge(12%of permit fee):
Authorized signature: thit.ceze ,LG2LCL/L TOTAL PERMIT FEE:
UiT This permit application expires if a permit is not obtained within 180
Print name: Brittany Burian Date: 5/18/2020 days after it has been accepted as complete.
" Number of inspections allowed per permit.
1:1Building\PermitsELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-45UT(I I/05/COMIWEB
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 Description Q 1 Each l Toed
5' Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
ri Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
® Garage Door Opener* >100 kva(fee in accordance 55226 3
with OAR 918-309-0040)
® Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 I:va:
System*
Each additional kva over 25 7A2 3
❑ Vacuum Systems* >100 kva-no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 66.25/hr l
charged at an hourly(I hr min)
Inspections for which no fee is 90 001 hr
specifically listed('iz hr mini
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
SFee for each commercial system: $75.00 allowebto al(Enter on Page I):
(SEE OAR 918-309-0000) nua,nerorisPecnoasuowe herpes 1.
Check Type of Work Involved:
Audio and Stereo Systems
Boiler Controls
Clock Systems
7 Data Telecommunication Installation
Fire Alarm Installation
E HVAC
I I Instrumentation
❑ Intercom and Paging Systems
7 Landscape Irrigation Control*
7 Medical
E Nurse Calls
n Outdoor Landscape Lighting*
Protective Signaling
n Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
Clnuildin5PnrmitsLLC PemtitApp_ELR ERE.doc Rev 06/17/2015
- . Plumbing Permit Applicatic*v r`^r:-I :,I
Building Fixtures r FOR OFFICE USE ONLY
City of Tigard OL Received Permit N`,/,�t
13125 SW Hall Blvd.,Tigard,OR 97 3 Date,Rev f l5 72.0 t�'C.)0 i 1 7
;� . - Plwt Review Other Permit No.:
• Phone: 503.7182439 Fax: 503.598.t960 Date/By:
1.11. s u D Inspection Line: 503.639.4175 Date Ready/By: hms. 65 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 I Qty. 1 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
® I-and 2-lamily dwelling ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath I 500.32 500.32
❑Accessory building ❑Multi-fancily
Each additional bath/kitchen 25.02
0 Master builder ❑Other: Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 12079 SW Summerbrook Lane Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard/OR/97223
Footing drain(no.linear ft.: Page 2 87.55
Suite/bldg./apt.no.: l Project name:Summerbrook Manufactured home utilities 50.03
Cross street/directions to job site:SW 121'Ave and SW Summerbrook Lane 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:Summerbrook 11,ot no.:1 Fixture or item:
Tax map/parcel no.: Backflow preventer 1 31.27 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer I 25.02 25.02
New Single Family Home 3176 sqft 5 bedroom,3 bath with 664 sqft 4 car Dishwasher I 25.02 25.02
garage and with a 143 sq ft covered rear patio. Drinking fountain 25.02
Ejectors/sump 25.02
PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Name:David Weekley Homes Fixture/sewer cap 25.02
Floor drain/loersink/hub 25.02
Address:1905 NW 1696 Place Suite 102 Garbage disposal 1 25.02 25.02
City/State/ZIP:Beaverton,OR 97006 Hose bib 2 25.02 50.04
Phone:(503)213-4415 Fax:( ) Ice maker I 12.51 12.51
® APPLICANT ® CONTACT PERSON Interceptor/grease trap 25.02
Business name: David Weekley Homes Medical gas(value:$_) Page 2
Primer 12.51
Contact name:Michele Schiedler
Roof drain(commercial) 12.51
Address: 1905 NW'169t"Place,Suite 102 Sink/basin/lavatory 4 25.02 100.08
City/State/ZIP:Beaverton/OR/97006 Solar units(potable water) 62.54
Phone:(503)213-4415 Fax: :( ) Tub/shower/shower pan 3 12.51 25.02
F.-mail: mschiedlerndwhomes.com Urinal 25.02
Water closet 3 25.02 75.06
CONTRACTOR
Water heater I 37.52 37.52
Business name: Nlalmedal Plumbing Water piping/DWV 56.29
Address:PO Box 207 Other: 25.02
City/State/LIP: Banks/OR/97106 Subtotal
Phone:(503)324-0759 Fax:( ) Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lie.: 102535 Plumbing Lic.no.:34-276PB
State surcharge(12%of permit fee)
Authorized signature:carolinaMelmedeI ' -ye t;`:,:: '- TOTAL PERMIT FEE
Print name: Carolina Malmedal Date: 05/18l2020 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.
I9BondingiPermivaPLMU-PermitApp.doc 10/01/09 440-4616T(10.f02/coM/ATB)
•
• Plujnbing 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- I' 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-I st 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) Plan review is required forof the following.
Work Performed: Capped Added Relocate q any
Baptistry/Font Please check all that apply.
Bath Tub/Shower 0 Any new commercial building with water service 2"and
-Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru ❑ 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 0 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"
Isometric or Riser Diagram
Car Wash Drain
Garbage Domestic-non-food 0 Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lay -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:
C:\Users\MalmedallDesktop168020001 Plumbing Permit.doc 2
City of Tigard
1111111 N COMMUNITY DEVELOPMENT DEPARTMENT
C
TICARQ Building Permit Review — Residential
Building Permit #: M 5 f 2 o l p - LSO 1 7 ?
Site Address: 12019 SW Stl n i-brc o k, LeAnd
Project Name: Summer brtpk Lot #:
Planning Review
Proposal: t'J W hw -'
1}l.Verify address/suite#active in Accela. EikIn River Terrace: X No ❑ Yes, River Terrace Review Addendum
Site Plan Elements: (g)rosion Control
copies of site plan on 8-1/2"x 11"or 11 x 17"paper Retained trees with drip line and tree protection measures
Drawn to scale(standard architect or engineer scale) Footprint of new structure(including decks)and FFE
Ar\Iorth arrowtility locations&easements (required for new and additions)
Xite address,project or subdivision name and lot number Sidewalk/driveway approach
]Applicant information(name and phone number) I.E. .cation of wells/septic systems
.ot dimensions and building setback dimensions0:670.treet tree size,type and location
NiPtquare footage of buildings to be demolished ►_ treet names
!!' xisting structures on site %Corner elevations(2'contours if more than 4'differential)
='Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? No
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? es No
Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: E Yes,applicant was notified /4 No Received: ❑ Yes ❑ No
Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑ Yes,applicant was notified WI No Received: ❑ Yes ❑ No
1SDC Exemption for ADU applied for: ❑ Yes ,rat No Received: ❑ Yes ❑ No
,Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes,applicant was notified ,No Applied For: ❑ Yes ❑ No,stop intake
Land Use Case#: S)(3Z1:47-O OOP 51 Zoning: R'}-s
ET' Required Setbacks: Front: 2-0 Rear: 15 Side: 5 Street Side: 15 Garage: 2D
Building Height: Max. Height: 4 Actual Height: *277
lijkLandscape Area: % OkLot Coverage Max:
Entrance ' .Set back no more than 8'from street-facing wall X Parallel to street or offset 45 degrees or less
Windows yr Minimum 12%of area of all street-facing facades : l Sip /S: l 3°w
Garage sg Garage door is behind widest street-facing wall X 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 wall and there is a 12 sq ft.window above garage on 2^a floor.
.•Garage door width is ❑ 12'or less X 50%or less of facade ❑ 60%or less and includes 7 of following.
❑ Covered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof cave 0 Roof offset
❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer
❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony
1 Visual Clearance '. Urban Forestry Plan
.Sensitive Lands: ❑ Yes jg No Type:
gr Conditions met prior to issuance of building permit
Notes: ��jj
f�;Approved By Planning: V fed Date: 5I26!5I ZD
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: 0 Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: S At/20
Site Plans: # 3
Building Plans: # 3
Building Permit#: ErEnter building permit#above.
Workflow Routing: Eri'lanning s'Engineering g'1.ermit Coordinator * uilding
Workflow Sign-off: El"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
ogginal plan review routing form.
Building. original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: �; `=f Date: /.3`L0
Eljgineering Review
10 ope at building pad: 4j
Le Conditions "Met"prior to issuance of building permit
YL( asements (encroachments) per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes Tr No
Assess Water Quantity Fee in-lieu: 0 Yes [No
LIDA Facility on lot: 0 Yes 'No
CFinal Plat Recorded:
0 NOT Approved by Engineering: Date:
Notes:
IV Approved by Engineering: Date: 6'r4/Zo
Revisions (after Building Submittal only) Reviewer c Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: 0 Approved 0 Not Approved
Permit Coordinator Review
X. 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:
SDC Exemption: ❑ Received Does not apply
X—SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: Yes 0 N/A
Parks SDC: Yes ❑� N/A
Xi
LIDA 0 Yes N/A
$-OK to Issue Permit
Approved by Permit Coordinator: AryN--aA‘(- Date: Co(8(2f)
I:\Building\Forms\BldgPermitRvw_RES_122419.docx