Permit Electrical Permit Application R E C E I .4 FOR OFFICE USE ONLY
City of Tigard c n !I�.s AT / Puma#pyS 7Zo Zo 00/��
IIR • 13125 SW Hall Blvd.,Tigard,OR 97223 AUG 2 6 2 O 2 G ° � Related Permit#:
I Phone: 503.718.2439 Fax: 503.598.1960 Dar
Inspection Line: 503.639.4175 Ready Date/By: tuns El See Page 2 for
1 ('A i(t) Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
JILDING.DIVISIOiN
TYPE OF WORK PLAN REVIEW
' New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
❑ Demolition 0 Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Hosting buildings.
E I-and 2-family dwelling ❑Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations, buildings.
❑Multi-family ❑Master builder ❑ Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION ANI) LOCATION 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: '1,1100 Job site address:I6 IS j Sac! 1141141 PL. l0oHP or more. ❑"A","E"."I-2"."i-3".
City/State/ZIP:Tigard,OR ❑Six or more residential units. occupancy.
0 Health-care facilities. 0 Recreational vehicle parks.
SuitelbldgJapt#: Project name 0 Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site:SW North Dakota&SW 1141h PI. FEE SCHEDULE
Description I Oh'. I Once I Total i .
New residential single-or multi-family dwelling unit.
Subdivision:Brightwood Lot#: to Includes attached garage.
1,000 sq.ft.or less '� 168.54 4
Tax map/parcel#: Ea.add'I 500 sq.ft.or portion I 33.92 1
DESCRIPTION OF WORK Limited energy,residential
75.00 2
new,single family residence
(with above sq.ft)
Limited energy,multi-family 75.00 2
am.yg /yC/7 � residential(with above sq.ft.)T -d r Renewable Energy 0 See Page 2
PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name:Stone Bridge Homes NW,LLC 200 amps or less 100.70 2
Address:4230 Galewood St,Suite 100 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Lake Oswego,OR 97035 601 wraps to 1,000 amps 301.04 2
Phone:(503)387.7577 Fax:(503)387.7615 Over 1,000 amps or volts 55226 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 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:same as above above service or feeder fee, 7.42 2
— - __-_ --_— each branch cin:uit
Contact name:Deirdre Britt B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address: branch circuit
Each add'I brands circuit 7.42 2
CitylState/ZIIa: Miscellaneous(service or feeder not included)
Phone:( ) Fax::( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:dbritt@stonebridgehomesnw.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 circuits)or limited-energy ❑ gee Page 2 2
Address:2920 SE Brookwood Ave.Suite A panel,alteration,or extension.
City/State/ZIP:Hillsboro,OR 97123 Each additional inspection over allowable in any of the above
h' Additionalinspection(1hrmin) 66.25/hr
Phone:(503)648-4552 Fax:(503)642-7925 Investigation(1 hr min) 90.00/hr
Email:Chelsea rnerelteetrlc.com Industrial plant(1 hr min) 78.18/hr
fa Inspections for which no fee is 90.00/hr
CCB Lie.: 121159 Electrical Lie.: 34-305C Suprv.Lic.:,...414 4r specifically listed(SS hr men)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: 7/0//Z j 3707 S Subtotal:
Print name: Charles Garner Date: $.20.ZQ 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: . . TOTAL PERMIT FEE:
/ This permit application expires if a permit is not obtained within 180
Print name: . _ Date: days after it has been accepted as complete.
i * Number of inspections allowed per permit.
I:lnuildingtPermits\ELC_PermttApp_ _a'a .,.,;l/2015 440.46IST(11/e5/COM/WEB
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 DfC1w°° Qty. I Each Total i
Renewable electrical energy systems:
Check Type of Work Involved: s kva lean 100.70 2
5.01 to 15 kva 133.56 2
El Audio and Stereo Systems* 15.01 to 2s kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 Eva 301.04 2
EA Garage Door Opener* 50.01 to 100 Eva 55216 2
>100 kva(fee in accordance
with OAR 918-309-0040) 55226 2
® Heating,Ventilation and Air Conditioning
Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva-no additional charge 0.0 3
Each additional inspection over allowable is an_of the above:
❑ Other: Each additional inspection is
charged at an hourly(1 hr min) 66.25/hr ]
Inspections for which no fee is 90.00/hr
specifically listed(54 hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75,00 Subtotal(Enter on Page I):
(SEE OAR 918-309-0000) ' Number of inspections allowed per permit
Check Type of Work Involved:
El Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrtmtentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems: _
*No licenses are required. Licenses are required for all
other installations
t:lHuiidiag\PmdtatELQ_Pamiupp_ELR_ERE.doc Rev 06/17/2015
Dianna Ornelas
From: Deirdre Britt <dbritt@stonebridgehomesnw.com>
Sent: Wednesday, August 26, 2020 6:53 AM
To: #Building Permit Technicians
Cc: Andy Thomas
Subject: revised electrical permit
Attachments: 2760 elec permit.pdf
Caution!This message was sent from outside your organization.
Please see attached electrical permit application for Brightwood lot 6. We are changing the electrician on file. No work
has been done under the existing electrician
Thanks,
Deirdre Britt I Residential Design Manager
Stone Bridge Homes NW I www.StoneBridgeHomesNW.com
office. 503.387.7577 I fax. 503.387.7615
4230 Galewood St., Suite 100 I Lake Oswego, Oregon 97035
A Unique Homebuilder Delivering Quality and Value to Oregon Residents
CCB#173318
�` Ix
f8b2` + .:t
DISCLAIMER:This message is for the sole use of the intended recipient and may contain confidential or privileged
information. If you have received this e-mail in error, please notify the sender immediately. Do not further review, copy
or disseminate this e-mail unless you are the intended recipient.
1
CITY OF TIGARD MASTER PERMIT
• COMMUNITY DEVELOPMENT Permit#: MST2020-00183
Date Issued: Jul 29 2020 12:00AM
T I CARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 1S134DB13400
Jurisdiction: Tigard
Site address: 11154 SW 114TH PL
Subdivision: BRIGHTWOOD SUBDIVISION Lot: 6
Project: Brightwood, Lot 6
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1343 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 26 Bathrooms: 3 Second: 1732 sf Garage: 492 sf Front: 20 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors:
Total: 3075 sf Value: $412,602.81 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 Drains: 0 Storm Sewer: 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 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
Fum>=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: 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 Y
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Consir: Occupancy Group: Square Feet:
NEW SF VB R-3 3075
Owner: Contractor:
STONE BRIDGE HOMES NW,LLC STONE BRIDGE HOMES NW LLC Required Items and Reports(Conditions)
4230 GALEWOOD ST,SUITE 100 4230 GALEWOOD STREET#100 1 Ersn Cntrl 503-639-4175
LAKE OSWEGO,OR 97035 LAKE OSWEGO,OR 97035
PHONE: PHONE: 503-387-7577
FAX; 503-387-7615
Total Fees: $39,540.75
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
0c9_M1_nni n thrnnnh Og9J)n1 �lnon Vnu mom,nhtniin o rnn,of the mine nr direr)no netinne to fN INC h„rcllinn Sn't 9R9 10147 nrr1 Ann 119 9144. l /
Issued By: tJ/.�lte ��i� Perm ittee Signature: d� `�/,PG"J� 7d'v
// Call 503.639A175 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.
it-vice0
• Building Permit Application ,, .
Residential . "n ,i a 3 FOR OFFICE USE ONLY
City Of Tigard Date/Bvd
�0 Pe""''PtSTZozo -DOif3
il
13125 SW Hall Blvd.,Tigard,OR 97223 �J1AY 2 ty 202; plan Review
' ■'' Phone 503.718.2439 Fax: 503.598. I n r I1�.//y� Other Pe 1
}900. o .. -Tit Date Received
4 f 0/ (N!/lJ / Q (/V 1
T 1 G A II t} Inspection Line: 503.639.4175 f t'; '.Y i- 7 ; t 4 Date Ready/By.l Ulm Et See Page 2 for
Internet: www.ligard-or.gov .k( ifl i )U, ,_` im7i t'..'y t,.. `.1 Notified/Method. Sapptemental Information
TYPE OF WORK REQU RED DATA:1 AND 2-FAMILY:DWF.I,LING
Z New construction 0 Demolition Permit fees*are based on the value of the work perfonncd.
Indicate the value(rounded to the nearest dollar)of all
❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor,overhegd,and thy profit for the
CATEGORY OF CONSTRUCTION work indicated on this application. �, tr.,
��
I-and 2-family dwellin Valuation'
El I- ❑Commercnahindustrial $ `S,VJ/4
v`
❑Accessory building ❑Multi-family Number of bedrooms:
❑ Master builder 0 Other. Number of bathrooms: 3
JOB SITEINFORMATION INFORMATION AND ,c',�']ON _+. _ `' _ L. S `7
�-,.. Total number of floors:
-mow
Job site address; III64 &W II 41 T�1 i pi,. New dwelling area: 3015j square feet 1132.
City/State/ZIP:Tigard,OR Garage/carport area: 4412. square feet L3i.I3
Suite/bldg.lapi.no.: Project name: en j, gizA ) w �G/a!I—f Covered porch area: X square feet
Cross street/directions to job site:SW North Dakota&S 114th Pl. Deck area: square feet
_ -- Other structure area: ill square feel
-
REQUIRED DATA:COMMERCIAL-USE CRECICLIST
Subdivision:Brightwood Lot no; G Permit fees*are based on the value of the work performed.
Tax map/parcel no: Indicate the value(rounded to the nearest dollar)of all
�? equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK . 11.ATM 'ili( work indicated on this application.
new,single family residence Valuation: $
Existing building area: square feet
New building area: square feet
PROPERTY OWNER 0 TENANT Number of stories:
Name: Stone Bridge Humes NW, LLC Type of construction;
Address:4230 Galewood St,Suite 100 Occupancy groups:
City/State/ZIP: Lake Oswego,OR 97035 Existing:
Phone'(503)387.7577 Fax:(503)387.7615 New
® APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to feeschedule)
Business name:Stone Bridge Homes NW, LLC
Structural plan review fee(or deposit): 75 (, y e/
Contact name:Deirdre Britt -'
FLS plan review fee(if applicable)
Address:same as above --
Total fees due upon application:
City/State/ZIP: -
Phone:( ) Fax: :( ) Amount received:
E-mail:dbritpn stonrbridgchomesnvv.com . I PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Submit two(2)sets of roof plan with connection details
Business name: Stone Bridge Homes NW,LLC
• and fire department access,along with the 2010 Oregon
Address:4230 Galewood St,Suite 100 Solar Installation Specialty Code checklist.
City/State/ZIP: Lake Oswego,OR 97035 Permit Fcc(includes plan review $180 00
and administrative tees):
Phone:(503)387.7577 Fax:(503)387.7615 State surcharge(12%of permit fee): $21.60
CCB he.:173318 • Total fee due upon application: $201,60
.�� This permit application expires if a permit is not obtained
Authorized signature: 1 1 S/ '"
..1.�'..i C within 180 days after it has been accepted as complete.
Print name:Deirdre Britt Dale: 5.2�, "Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPerntitApp.doc 02/24/2011 440-4613T(l t/02ICOM/WEB)
Building.Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLY
City of Tigard Received
rate oy. Permit No
IN
M 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits.
fit Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical
TIGARD
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. ■ 0
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑ 0
3 Verification of approved plat/lot._ 0 0 0
4 Fire district approval required. Name of district: 0 0 ❑
5 Septic system permit or authorization for remodel. Existing system capacity El 0 ❑
6 Sewer permit. 0 0 ❑
7 Water district approval. ❑ LI 0
8 Soils report. Must carry original applicable stamp and stature on file or with application. ❑ ❑ El
9 Erosion control ❑ plan ❑ 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 121 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 e ❑ ❑
there is more than a 4-11.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 .M 1 0
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, El 0 El
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- 21 ❑ 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. 1r
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- /Z� 0 ❑
prescriptive path analysis provide specifications and calculations to engineering standards,
17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing N ❑ 0
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,"Fnginar'a calculations.'
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists El ❑ 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 ut, licable to the flied under review.
3uRISD[CI ZONAL,SPEC!FiCS
23 Three(3)site plans are required for Item I I above. Site plans must he 8-1/2"x 11"or 11"x 17". 0 0 ❑
24 Two(2)sets each are required for Items 16, 19,20 and 22 above.. ❑ 0 El
25 Building plans shall not contain red lines or tape-ons.. "Mirrored"building plans will not be accepted. _ ■ 0 0
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. ❑ - ❑ D
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ Li
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, 0 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.
1:`Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
Mechanical Permit Appltca4IQ FOR OFFICE USE ONLY
'+ r'°^� 4 .. t Received
IN City of Tigard Permit No G 7
13125 SW Hall Blvd,Tigard,OR 97223 DatclBy MSTZ02o "oo(p
't ,. MAY 2 8 Received
Review Other Permit,
Phone: 503.718.2439 Fax: 503.598,1960 2020 Da1e/ny.
TIGARD Inspection Line: 503.639.4175 _ ( Date Reedy/By. tuns: 0 See Page 2 for T
Internet: www.tigard-or-gov C i : ' + i r, r 1 Notified/Method: Supplemental Information
.
+.,
TYPE O' F WORE . :COMME[+kC1AL FED' SC7IF.DULESHryC{,Kf �
Mechanical permit fees*are based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑ Other mechanical materials,equipment,labor.overhead,and profit.
._ Value S
CATEGORY OF CONSTRUCTION
-- RESIDENTIAL EQUIPMENT/SYSTEMS FEES^
® l-and 2-family dwelling ❑ Commercial/industrial 0 Accessory building For special information use checklist.
0 Multi-family ❑ Master builder 0 Other: Description Qty. Ea I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
' '. Air conditioning 46.75
Job site address: 11154 SW 114 r Furnace 100,000 BTU(ductsrvents) 1 46.75
City/State/ZIP:Tigard,OR Furnace 100,0004 BTU(ducts/vents) '• 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: '
Duct work 23.32
Cross street/directions to job site:SW North Dakota&SW 1141a PI 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 1 23.32
Subdivision:Brightwood Lot no,: Other 23.32
- Other fuel appliances:
Tax map/parcel no.: Water heater 1 23.32
DESCRIPTION OF WORK Gas fireplace/insert 1 33.39 �
" Flue vent for water heater or gas
new,single family residence fireplace 2 23,32
Log lighter(gas) 23,32
_. _.. Wood/pellet stove 33.39
Wood fireplace/insert 23 32
Chimnev/liner/flue/vent 23.32
,-; Other: 23.32
® PROPERTY OWNER 0 TENANT
Environmental exhaust and ventilation:
Name:Stone Bridge Homes NW,LLC Range hood/other kitchen
'p' equipment 1 33,39
Address:4230 Galewood St,Suite 100 Clothes dryer exhaust I 33.39
City/State/ZIP: Lake Oswego,OR 97035 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 5 23,32
Phone (503)387.7577 Fax (503)387.7615 Attic/crawlspace fans 23.32
® APPLICANT 0 CONTACT PERSON' Other 23.32
Business name:same as above Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:Deirdre Britt Furnace,etc. 1
Address: Gas heat pump
_.. Wall/suspendcd/nnit heater
City/State/ZIP: Water heater 1
Phone:( ) Fax: :( ) Fireplace 1
Range 1
E-mail: dbrittCstonehridgehunicsnw.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: Comfort Zone Other:
. -MECHANICAL PERMIT FEES^
Address:1032 NW Corporate Dr. Subtotal
City/State/ZIP:Troutdale,OR 97060 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)667.5595 Fax:(503)491.8252 State surcharge(12%ofpennitfee)
CCB lie.: 110091 TOTAL PERMIT FEE
This permit application expires if n permit is not obtained Within 180
' Via.-�, days aver it has been accepted as complete.
Authorized signature: A -"- - p * Fee methodology set by"In-County Building Industry Service Board
Print name:David Heldstab Date: 6•24e 20
I:1Boilding:Pemriis\MEC_PeneitApp_040117 dee 440.4617T ft I/021COM/W@6i
•
Electrical.Permit Application-FI r' ► f y 1 d f._I, FOR OFFICE USE ONLY
pc Received
City ofTigard MAY 2 S 2029 P r it /`l Teo 20 •77fJ l 1
a 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Re
8 Plan Review
tqlPhone: 503.718,2439 Fax: 503.598.1960 i,..- "" -- Date/Hy: Related Permit a
TIGARD Inspection Line: 503.639.4175 Ready Dale/By . Ions: El See Page 2 for
0,, Internet: www.ligardor,goy Notified/Method: Supplemental Information
TYPE OF WORK '_.. r`-`..I'LAN'REVIEW=`
E New construction ❑ Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/iicns checked)'.
❑Service or feeder 400 amps or more 0 building over three stories,
❑ Demolition ❑ Other: where the available fault current 0 Marinas and boatyards,
CATEGORY OF CONST11UC.`1'ION exceeds 10,000 amps at 150 volts or 0 Floating buildings
less to Ell Commercial/industrial 2-family dwelling ❑ ConeIcial/industrial ❑Accessory building amps for allr groud.or exceeds 14,000 ❑ u b id,^gs,tal-ose agricultural
❑ Multi-family ❑Master builder ❑ Other 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑F,mergency system. larger separately derived
0 Addition of new motor load of system.
Job#; 27teC Job site address: I i l 'I ''t1 111141F'L.. I00HP or more. ❑'A , E 1-2 ,"1-3 ,
Clt /State/ZlP:Ti ard OR ❑Six or more residential units occupancy.
y - - g ' - - ❑Health-care facilities, 0 Recreational vehicle parks.
Suite/hldg./apt.#: Project name: ❑Hazardous locations, 0 Supply voltage for more than
0 Service or feeder 600 amps or more:. 600 volts nominal.
Cross street/directions to job site: SW North Dakota&SW I14rh PI. :',. 11 FEE SCHEDfILE `" :t7
Description j Qty. I r Each I Total I •
New residential single-or multi-tandly dwelling unit.
Subdivision:Brightwood Lot#: Includes attached garage.
1,000 sq.ftorless 3 168.54 4
I as snap/parcel 4: ...... T -- --
...,.,.W___.._.-_ Ea;add'I 500 sq.It orpodion I 33.92 1
DESCRIPTION OT WORK Limited energy,residential
75,00 2
(with above sq.ft.)
new,single family residence Limited energy,multi-family
75,00 2
residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
2 PROPERTY OWNER CI TENANT Services or feeders installation,alteration,and/or.relocation ,.
Name: Stone Bridge Homes NW,LLC 200 amps or less 100.70 2
Address:4230 Galewood St,Suite 100 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34. 2
City/State/ZIP: Lake Oswego,OR 97035 601 amps to 1,000 amps 301.04 - 2
Phone:(503)387.7577 I Fax:(503)387.7615 Over 1,000 amps or volts , 552 26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation: This installation is being made on property that I own which is not 200 amps or less 59,36 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
» Branch circuits new,alteration,or extension,firer panel
® APPLICANT D CONTACT PERSON ,
- - - A,Fee for branch circuits will
Business name: same as above above service or feeder fee, 7.42 2
each branch circuit
Contact name:Deirdre Britt B.Fee for branch circuits rvrthour
- -- service or feeder fee,first 56.18 2
Address:
branch circuit
City/State/Z1P: Each add'fbranch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax: :( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Entail: dbritt`b),stonebridgehmnesnw.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67,84 2
Business name: City Electric Sign or outline lighting 67,84 2
Address: 55568 SW Schaltenbrand Ln. Signal circuit(s)oraion or limited-energy ❑ See Page 2 2
panel.alteration;or extension.
Cit}'!State/ZIY:Sherwood,OR 97140 Each additional inspection over allowable in any of the above
- - Additional inspection(1 hr min) 66.25/hr
Phone:(971)404.1714 Fax:(503)625.3052 Investigation(1 hr min) 90.001 hr
Industrial plant(1 hr min) 78.18/hr
Email: - •-
Inspections for which no fee is 90.00/1u
CCB Lie.: 42422 41811i Electrical Lic.: 26-289C yin/suprv.Lic.: 35925 ' f i� specifically listed(;.In-min)
�✓i `-.ELECTRICAL FERMIT.FEES
Suprv.Electrician signature,required: Subtotal:
Print name: Chuck Friesen Date:. S.�IQ7,Vl1, 0 Plan Review Required(25%of permit fee):
- - 'L� ( State surcharge(12%of permit fee):
it r� 1 TOTAL PERMIT FEE.
Authorized signature: /.---"�
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
I-:Rtitduag\Penrlrs,EL(: Penr,ilApp EI.R ERE doc Rev Oo'17,2015 I4O-.16 15T(I I.05/COM/WEB
Electrical Permit Application— City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: ' FEE SCHEDULE
Dourlpnon Qtv. Each Total
Fee for all residential s stems combined: $75.00
y Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less l00,�0 2• .
5.01 to 15 kva 133.56 2
El Audio and Stereo Systems* 15.01 tons kva 200.34 2
Wind generation systems in excess of 25 kva:
Burglar Alarm 25.01 to 50 kva 301,04 2
50.0I to 100 kva 552.26 2
® Garage Door Opener* >100 kva(fee in accordance 552.26 2
__.withOAR918-309-0040)
® Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional Iva over 25 7.42 3
❑ Vacuum Systems* >100 ks'S-no additional charge 0,0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is - 66-25/hr 1
--- -- charged at an hourly(1 hr.min).
Inspections for which no fee is 90.00/hr
specifically listed(Y hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Linter on Papa 1):
SEE OAR 918-309-0000) * Number of inspections allowed per permit.
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
n Clock Systems
n Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
n Instrumentation
n Intercom and Paging Systems
Ej Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
t:'uailding\Pencils\HLC_PenniLlpy_ELR E.P.E.doe Rot-Ob%I'72015
•
•
Plumbing Permit Application rok, _ „ .. ,, }
Building Fixtures ,;w` %' ' s~ "°
FOR OFFICE USE ONLY
City of Tigard mAY 2 8 2020 Received �^
DateiBy: Perm:t N14,5 W -'"()O l D 2
1111 13125 SW Hall Blvd,Tigard,OR 97223 - W S 7
11 Phone: 503.718.2439 Fax: 503.598.1960 -".""" " :iy"") Plan Review
- - Other Permit No,:
Datetgy-,.
TIGARD Inspection Line: 502,639.4175 Date Ready%By 'rues 121 See Page 2(or
Internet: 1klvw.tigttrd-or.gov NAI t eu:?,?cthoit Supplemental la fo rm at ion
'1YPE OF WORK FEE' SCHEDULE
® New construction ❑ Demolition For tpeciel iuformaltion use checklist.
Description T Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other: New 1-2-familydwellings(includes 100 ft.for each utilityconneelign)
CATEGORY OF CONSTRUCTION SFR(l)bath 312.70
® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath I 500.32
❑Accessory building 0 Multi-family
-- _ Each additional bath/kitchen 25.02
❑ Master builder ❑ Other:
Fire sprinkler( sq..R) Page 2
`" ' JOB SITE INFORMATION AND LOCATION Site utilities: -- - -
Job site address: 11I541 ssw iI ipi )i. - - - Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR
_.. Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt. no.: Project name: Manufactured home.utilities 50.03
Cross street/directions to job site: SW North Dakota&SW 114th PI 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 Il:_) Page 2
Subdivision: Brightwood [Lot no.: (. Fixture ot hens:
Tax map/parcel no.: Backflow preventer I 31.27
DESCRIPTION OF WORK ' ' �1 Backwater valves 12.51
y'k Clothes washer I 25.02
new,single family residence
Dishwasher 1 25.02
^Drinking fountain 25.02
-Ejectors/sump - ---- 25.02
® PROPERTY OWNER ❑ TENANT Expansion tank 12,51
Name: Stone Bridge Homes NW, I I C Fixture/sewer cap 25.02
- - Floor drain/floor sinklhub 25,02
Address:4230 Galcwood St,Suite 100
Garbage disposal t 25.02
City/State/ZIP: Lake Oswego,OR 97035 Hose bib Z 25,02
Phone:(503)387.7577 Fax:(503)387.7615 Ice maker 12.51
® APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 -- - -
Business name.same as above bledicaligus.(valuz:$ ): Page 2
Primer 12.51
Contact name:Deirdre Britt
- - - - -- -- Roof drain(commercial) 12.51
Address:
- - Sinlvbasindavatory S 25,02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax: :( ) Tub/shower/shower pan 3 12.51
E-mail:dbrittnstonebridgehonicsnw.com Urinal 25.02.
Water closet 3 25,02
CONTRACTOR
- - - Water heater I 37.52
Business name:Jardine Plumbing _ -- Water piping/DW V 56.29
Address:PO Box 186 Other: 25.02
City/State/ZIP: Estacada,OR 97023 Subtotal
Phone:(503)351.8532 Fax:(503)630.2882 ')0 Pa Minimum permit fee: $72,50
Plan review (25°o of permit fee)
CC13 Lic,:108747 Plumbing Lie,no.:013-N 347
.�,-) . - State surcharge(12oro of permit fee).
Authorised signature: e ` >((> Y-... f 115 f].t
r 1 L VV TOTAL PERMIT FEE
;�Print name:Jay Jardine Date: 5.2t. 0 This permit application expires if a permit is riot obtained within 180 days
after it has been accepted as complete.
"Fee methodology set by Tri-Count`Building Industry Service Board
I.`.Bnarting'Permil=_IVLNU-PannilApp,doc 10;01.0P a.Pd616'r(IO102CONUWE87
City of Tigard
114 COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review — Residential
Building Permit #: M.S TZp 20 — Cep 1 8 3
Site Address: lI1S4 &rJ ll1-ktvl 1--
Project Name: 1:3110 ltWp( Lot #: (7
Planning Review
Proposal: Ne 1 h'1Dl,ZSC.-•
Verify address/suite# active in Accela. In River Terrace: r8.No ❑ Yes, River Terrace Review Addendum
Site Plan Elements: 40") rosion Control
` 3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper Col etained trees with drip line and tree protection measures
IDrawn to scale(standard architect or engineer scale) RFootprint of new structure(including decks) and FFE
North arrow . Utility locations&easements(required for new and additions)
,Site address,project or subdivision name and lot number Sidewalk/driveway approach
kpplicant information(name and phone number) ocation of wells/septic systems
.ot dimensions and building setback dimensions .Street tree size,type and location
MA'Square footage of buildings to be demolishedtreet names
1" Existing structures on site aCorner elevations(2'contours if more than 4'differential)
rtrArot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? e No
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? s No
XClean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified R No Received: ❑ Yes ❑ No
VC Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑ Yes,applicant was notified - No Received: ❑ Yes ❑ No
RI SDC Exemption for ADU applied for: El Yes X No Received: ❑ Yes ❑ No
Public Facilities Improvement (PF1) Permit:
Required: ❑ Yes,applicant was notified V No Applied For: ❑^Yes CI No,stop intake
. Land Use Case#: SO,2I$—OOGQ 4- X Zoning: (Z'q'•S
Required Setbacks: Front:20 Rear: 15 Side: 5 Street Side: N/ Pr Garage: 20
121. Building Height: Max. Height: 30 Actual Height: ±2(Q
a/A-Landscape Area: % (Lot Coverage Max:
Entrance ' .Set back no more than 8' from street-facing wall TA-Parallel to street or offset 45 degrees or less
Windows X Minimum 12%of area of all street-facing facades Vs v/r7
Garage 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.
0 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 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 El Gable,hip,or gambrel roof ❑ Dormer
El Accent siding ❑ Window trim ❑ Window recess ❑ Window projection El Balcony
AVisual Clearance lg:C Urban Forestry Plan
.a.Sensitive Lands: ❑ Yes ):E( No Type:
Conditions met prior to issuance of building permit
Notes:
Approved By Planning: Date: 43/20
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved •
t:\Building\Forms\BldgPennitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: S f 28/7-a
Sitc Plans: # 3
Building Plans: #
Building Permit#: 42'Enter building permit#above.
Workflow Routing: B"Planning [--Engineering Kl-1 ermit Coordinator ,4;1.-tuilding
Workflow Sign-off: g"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.
Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: F 5 &'2444Z' _-___ Date: W
Eneering Review Q'
t Slope at building pad: . /9
IVConditions "Met"prior to issuance of building permit
e.re asements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility: +
Assess Water Quality Fee in-lieu: ❑ Yes [J No
Assess Water Quantity Fee in-lieu: ❑ Yes t'No
LIDA Facility on lot: ❑ Yes VNo
Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: ,' Date: �� Z®
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ 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:
SDC Exemption: ❑ Received 14 Does not apply
N SDC Fees Entered: Wash Co Trans Dev Tax: ,� Yes ❑ N/A
Tigard Trans SDC: 4X..Yes ❑ N/A
Parks SDC: -4-Yes D N/A
LIDA ❑ Yes N/A
X-OK to Issue Permit
Approved by Permit Coordinator: tw) ie7(-- Date: COI Sl ip
I:\Building\Forms\B1dgPermitRvw_RES_I22419.docx