Permit IA CITY OF TIGARD MASTER PERMIT
it Permit#: MST2020-00191
COMMUNITY DEVELOPMENT _ Date Issued: MST220 -
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ``` itj
TIGARD 9 j � _ Parcel: 2S111BB00600
A lto t T •I i Jurisdiction: Tigard
Site address: 10114 SW COPPERLEAF LN
Subdivision: ERIKA SUBDIVISION Lot:
Project: Erika Court, Lot 4
Project Description: New detached dwelling. 10/5/20: REPRINTED permit to include NC. 11/4/20: REPRINTED
permit to add third car bay to garage, add shower in powder room, and move linen closet.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 1388 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height; 26 Bathrooms: 3 Second: 1717 sf Garage: 602 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 3105 sf Value: $409,573.76 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: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 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: 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 addl 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
IP 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 3105
Owner: Contractor:
CASCADE CIVIL DEVELOPMENT INC WEEKLEY HOMES Required Items and Reports(Conditions)
395 SHENANDOAH LANE NE 1905 NW 169TH PLACE SUITE 102 1 Ersn Cntrl 503-639-4175
WOODBURN,OR 97071 BEAVERTON,OR 97006 2 Geo Tech Required Prior To
Pour
PHONE: PHONE: 503-213-4415
FAX:
Total Fees: $39,630.74
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 throu h OAR 952-001-0090. You may obtai of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By (l'-'.----.- Permittee Signature: oeWLr �L�rn
all 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.
Buildini; Permit Application
Residential '.1ECE6VE I FOR OFFICE USE ONLY
Received ` ed.
., /15� /4/
City of Tigard JUri p q q Datei9vy: /f- Permit No.:
II! q 13125 SW Hall Blvd.,Tigard,OR 97223 9 2020 Plan Review ,� AV
Phone: 503.718.2439 Fax: 503.598. Dnte/Bv: /2.a/n /7 y}, Other Permit. � ')/a
TIGARD Inspection Line: 503.639.4175 rvl t T OF TIGARD DateReadylB leas: See r �
Internet: www.tigard-or.gov BUILDING i'1I\.I[vi!'Z(x�mifiedimethod: 77,.3 it �.0. fe Supplemental information
TYPE OF WORK 1t O lJ'V "_,REQUIRED DATA:1-AND 2-FAMILY DWELLING
Z New construction ❑ Demolition Permit fees*are based on the value of the work performed.
j°" Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ❑ Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY.OF CONSTRUCTION;FAS
II, work indicated on this application.
Z I-and2-famil dwellin 4I, , t� Valuation: $350,000
y g ❑Commercial/inl
❑ Accessory building ❑ Multi-family 1 .14 Number of bedrooms: 3
E Master builder L Other: Number f bathrooms: 2
7 floors:
number of
JOB SITE INFORMATION AND LOCATION Total37Q7 0/4.7t
Jeb site address: 10114 SW COPPERLEAF LANE New dwelling area: 2802 square feet
City/State/ZIP:Tigard/OR/97224 Garage/carport area: 607 square feet f 1 i7
Suite/bldg./apt.no.: Project name:RIDGECREST Covered porch area: 139 square feet i 38'8'
Cross street/directions to job site:SW I03R0 AVE AND COPPERLEAF LANE Deck area: square feet
Other structure area: 134 square feet
REQUIREDD TA:COMMERCIAL-USE CHECKLIST
Subdivision:ERIKA COURT I Lot no.:4 Permit fees*are based on the value of the work performed.
Tax map/parcel no.:25111 BII00600 indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
New Single Family Home to be built-2802 SQFT 3 Bedroom,2.5 bath with 399 SQ Valuation: $
FT 2 arage with a 139 SQFT covered rear porch Existing building area: square feet
3 co*rreow- New building area: square feet
Z PROPERTY OWNER ❑ TENANT Number of stories: !
Name:David Weekley Homes Type of construction:
Address: 1905 NW 169'Place Suite 102 Occupancy groups:
City/State/ZIP:Beaverton,OR 97006 Existing:
Phone:(503)213-4415 pax:( ) New:
CI APPLICANT Z.CONTACT.PERSON :BUILDING PERMIT FEES*
(Plea cc refer to fee sc/u dole)
Business name: David Weekley Homes
------ - Structural plan review fee(or deposit):
Contact name:Michele Sehiedler '..
FLS plan review fee(if applicable):
Address:1905 NW 169'Place,Suite 102
Total fees due upon application:
City/State/ZIP:Beaverton/OR/97006
Amount received:
Phone:(503)213-4415 Fax: :( )
E-mail:mschiedicr rdwhmnes.cnm 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'h Place,Suite 102 Solar Installation Specialty Code checklist.
City/State/ZIP:Beaverton/OR/97006 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503)213-4415 Fax:( ) State surcharge(12°/n of permit fee): $21.60
CCB lie.:213653 / Total fee due upon application: $20L60
Authorized signature: / This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Michele' er Date:5/26/20 *Fee methodology set by Tri-County Building industry
Service Board.
1:\Building'Permits\BUP-RESPennitApp.doc 02/24/2011 440.4613T(11/02/COM/WEB)
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard ReceivedDate By: Permit No.: �., )_46191
41 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
• Phone: 503.718.2439 Fax: 503.598.1960 Data/By, Other Permit:
T .i\H 0 Inspection Line: 503,639.4175 Date Ready/By: Jur6: ®' See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK Print name:MICHELE SCHIEDLER
®New construction 0 Addition/alteration/replacement COMMERCIAL FEE* SCHEDULE -USE CHECKLIST: ::;
❑Demolition ❑Other: Mechanical permit fees*are based on the value of the work
{ - performed.Indicate the value(rounded to the nearest dollar)of all
CATEGORY OF.CONSTRUCTION ,,.. 4;;„ ` mechanical materials,equipment,labor,overhead,and profit.
® 1-and 2-family dwelling ❑Commercial/industrialConercial/industrial 0 Accessory building Value:$
El Multi-family ❑Master builder ❑Other: iw,s'gir ;RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
For special Information use checklist
% F r A,y00)1(SITE INFORMATION AND LOCATION fa ' ''h Description Qty. Ea. Total
Job site address:10114 SW COPPERLEAF LANE Heating/cooling:
City/State/ZIP:Tigard/OR/97224 Air conditioning I 46.75 46.75
Furnace 100,000 BTU(ducts/vents) 1 46,75
Suite/bldg./apt.no.: Project name:RIDGECREST Furnace 100,000+BTU(ducts/vents) 54.91
Cross street/directions to job site:SW 103RD AVE and SW COPPERLEAF LANE Heat pump 61.06
Duct work 23.32
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
Subdivision:ERIKA COURT Lot no.:4 Flue/vent for any of above 23.32
Tax map/parcel no.:25111BB00600 Other: 23.32
l-t'q e r air 'DESCRIIY.1*,,OF WORK `'n � , 4 "r('rx� "ii�' Other fuel appliances:
_ tt" u.�se. "�, , St,) r•:. w*�, �=mt�a Water heater 1 23,32
New single family home to be built-2802 sqft,3 bedroom 2.5 bath home with Gas fireplace/insert 1 33,39
Flue vent for water heater or gas
399 sqft 2 car garage and a 139 sq ft covered rear porch fireplace 23,32
Log lighter(gas) 23,32
Wood/pellet stove 33.39
. ..'u -x a e,w bv+x a -w e, ,� ,, y.,y WOod fireplace/Insert 23.32
Ail. ' A'EItT .,,,ER ,t.,, ,z:c.,.,-,"," $0:1,,TEN44;NTO , Chimney/liner/flue/vent 23.32
Name:David Weeldey Homes Other. 23.32
Address: 1905 NW 169'a Place,Suite 102 Environmental exhaust and ventilation:
Range hood/other kitchen
City/State/ZIP:Beaverton/OR/97006 equipment I 33,39
Clothesdryerexhaust I 33.39
Phone:(503)213-4415 Fax:( ) Single-duct exhaust(bathrooms,
a 'w; ,� M - - os toilet compartments,utility rooms) 5 23.32
1 . U0; a"M,',.4,C ,T`; :444; ,.ii•6t ®4gilNTACT,PE', .
Attic/
crawlspace fans 23.32
Business name:David Weekley Homes Other; 23.32
Contact name:Michele Schiedler Fuel piping:
Address:1905 NW 169'h Place,Suite 102 Si4.1,5 for fiat four;54.03 for each additional
Furnace,eta.
City/State/ZJP:Beaverton/OR/97006 Gas heat pump
Phone:(503)213-4415 Fax: :( ) Wall/suspended/unithcater
Water heater
E-mail:mschiedler@dwhomes.com Fireplace
`,; GONTR4c!'4it, %`4 acnty, 03 a ys ;r Range
Barbecue
Business name:David Weekley Homes Clothes dryer(gas)
Address: 1905 NW 1691p Place Suite 102 Other:
City/State/ZIP:Beaverton/0:•' 7006
�,.f' T MEG .A�RMIT ,'' t39 s'4" ,,,h',
Subtotal
Phone:(503)213-4415 i Fax:( ) Minimum permit fee($90.00)
CCB lie,:213653
Plan review(25%of permit fee)
State surcharge(12%of permit tbe)
TOTAL PERMIT FEE
Authorized signature: i/ .•
This permit application expires if a permit is not obtained within 150
days after it has been accepted as complete,
1:1Buiiding1PermitAMEC_PermitApp 040113.doo 440-4617T(II/02/COM/WBBI
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard Received
Date/By: Permit# SST c le?1 J
114
I al 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
, 1Q Phone. 503.718.2439 Fax, 503.598.1960 Date/By: Related Permit#:
Inspection Line. 503.639.4175 Ready Date.B) suns: ® See Page 2 for
TIGARD Internet www.tigard-or.gov Notiticd'Mcthod. I Supplemental Information
TYPE OF WORK""? F111 1A TIIIM`:' Pa*:
®New construction ❑ Addition/alteration/replacement Please cheek 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 ❑ Other: __ where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRLCTION 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 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 AND LOCATION ❑Emergency system. larger separately derived
-- - -.- - - - - ❑Addition of new motor load of system.
Job#:68130004 Job site address: 10114 SW COPPERLEAF LANE IOOHP or more. ❑ A"."E","1-2","1-3",
City/State/ZIP:Ti ard/OR/97224 0 Six or more residential units. occupancy.
ty g 0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:RIDGECREAST ❑Ilazardous 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 103RD AVE AND COPPERLEAF LANE `, FEE SCHEDt) ,*--
Description I Qty. I Each Total I *
New residential single-or multi-family dwelling unit.
Subdivision:ERIKA COURT Lot#:4 Includes attached garage.
Tax map/parcel#:2S1I I BB00600 1,000 sq.ft or less I 168.54 168.54 4
Fa.add'l 500 sq ft.or portion C. " 33.92 135.68 1
DESCRIPTION.OF'.WORK Limited energy,residential
(with above sq.ft.) 75.00 2
New single family home to be build-2802 sqft,3 bedroom 2.5 bath home with
Limited energy,multi-family 75.00 2
399 sqft 2 car garage with a 139 covered rear porch residential(with above sq.ft.)
Renewable Energy 0 See Page 2
f-' PROPERTY OWNER ❑-TENANT Services or feeders installation,alteration,and/or relocation
Name:David Weekley[tomes 200 amps or less 100.70 2
-Address: 1905 NW 169'h 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
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 P1 f1 oN' - Branch circuits-ne ,alteration,or extension,per panel
—""�' '- A.Fee for branch circuitsw wNh
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
Address: 1905 NW 1691h Place Suite 102 service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP:Beaverton/OR/97006 Each add'I 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�dwhomes.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.
City/State/ZIP:Hillsboro, OR 97123 Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
Phone: 503-648-4552 Fax:( 503)642-7925 Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email:permits@garnerelectric.com Inspections for which no fee is 90.00/hr
CCB Lic.:121159 Electrica 4-3 C Suprv.Lie.:3707-S specifically listed('Az hr min),
ti a, rl$TIE4,ICAL PERMIT FEES "_ _
Suprv.Electrician signature,require : Subtotal:
Print name:Charles Garner Date:5/27/2020 0 Plan Review Required(25%of permit fee):
,t State surcharge(12%of permit fee):
Authorized signature: .1 f . � � TOTAL PERMIT FEE:
Uil This permit application expires if a permit is not obtained within 180
Print name:Brittany Burian Date:5/27/2020 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:1Euilding\Permits\ELC_PennitApp ELR_ERE.doe Rev 06/172015 440-4615T(I 1/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SC
Fee for all residential systems combined: $75.00 Description Qty. earn Total
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to25 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 552.26 2
with OAR 918-309-0040)
❑ 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 in any of the above:
❑ Other: Each additional inspection is 66.25/hr
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/fir
sxcificall fisted 1,8 hr min
COMMERCIAL WORK ONLY: I ' . ,w - .AL PERMIT FEES:-
Fee for each commercial system: $75.00 Subtotal(Enter on Page I):
y ` Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
n Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ 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\Budding\Permits\ELC_PermitApp_ELR_ERE.doc Rev O6/17/2015
Plumbing Permit Application
Building Fixtures FOR OFFICE USE ONLY
13 SW igard y Remit No.� � _44.�r �
Eril
3125 SW Hall Blvd.,Tigard,OR 97223 Date,B
Plan Review
Received
Phone: 503.718.2439 Fax: 503.598.1960 patsy, Other Permit No.:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for
Internet www-ttgard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK - FEE* SCHEDULE
Z New construction ❑Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑ 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
Z I-and 2-family dowelling ❑Commercial/industrial SFR(2)bath I' 437.78 437.78
- SFR(3)bath 500.32
0 Accessory building ❑ Multi-family
Each additional bath/kitchen 1 25.02 25.02
❑ Master builder ❑Other: Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 10114 SW COPPERLEAF LANE Catch basin or area drain 8.76
City/State/ZIP:Tigard/OR 97224 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear R.:230) Page 2 87.55
Suite/bldg./apt.no.: I Project name:RIDGECREST Manufactured home utilities 50.03
Cross street/directions to job site: SW 103RD AVE AND COPPERLEAF 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: ERIKA COURT Lot no.:4 Fixture or item:
Tax map/parcel no.: 2SI1IBB00600 Backflow preventer 1 31.27 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 1 25.02 25.02
New Single Family Home 2802 sgft 3 bedroom,2.5 bath with 399 sqft 2 car
Dishwasher 1 25.02 25.02
garage and with a 139 sq ft covered rear patio. Drinking fountain 25.02
Ejectors/sump 25.02
EPROPERTY-OWNER ❑ TENANT Expansion tank 12.51
Name: David Weekley Homes Fixturelsewercap 25.02
Floor drain/floor sink/hub 25.02
Address: 1905 NW 169°s 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 1 12.51 12.51
E APPLICANT E 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 169th Place,Suite 102 Sink/basin/lavatory 5 25.02 125.10
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
E-mail: mschiedlerradwhomes.com Urinal 25.02
I;
t Water closet 3 25.02 75.06
CONTRACTORCONTRACTOR ,;�° = ;::.<
,
t. Water heater 1 37,52 37.52
Business name: Malmedal Plumbing Water piping/DWV 56,29
Address:PO Box 207 Other: 25.02
City/State/ZIP:Banks/OR/97106 Subtotal
Phone:(503)324-0759 Fax:( ) Minimum permit fee: $72.50
CCB Lie.:102535 Plumbing Lic.no.:34-276PB Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: Carolina Malmedal -47,_,,, TOTAL PERMIT FEE
Print name:Carolina Malmedal Date:05/27/2020 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.
1,BuildingtPermits\PLMU-PermitApp.doe 10/01/09 440-4616T(10/02/COM/WEB)
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
14
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Transmittal Letter
T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: w- _ DATE RECEIVED:
DEPT: BUILDING DIVISION . t C.aa I yLi.)
OCT 1 / 2020
FROM: Michele Schiedler CiTY OF (;{ aD
COMPANY: David Weekley Homes BUILDING DIVISION
503-213-4415 By:
PHONE:
1111 RE: 10114 SW Copperleaf Lane,Tigard OR 97224 MST2020 00191
Permit Number
(Site Address) ( )
Erica Court, Lot 4
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
I Copies: Description: Copies: Description" ; „ , .r:. ,,,4-,
X Additional set(s) of plans. x Revisions:
x Cross section(s) and details. x Wall bracing and/or lateral analysis.
x Floor/roof framing. Basement and retaining walls.
X Beam calculations. x Engineer's calculations.
Other(explain):
REMARKS:. Plan revisions include adding a 3rd car bay to the garage,adding a shower in the powder room on the 1st
floor which required the HVAC closet to be relocated off the hallway on the 2nd floor.The linen closet was
also rel sated.All changes have been bubbled.
(.; Ve Yll /`0/ -:,) (i &Z s( -3- 1 f" k Q.AO `.5 )
�
/ FOR OFFICE USE ONLY i
Routed to Perml echnician: Datc: 11 q 2,0 Zt7 Initials: �j7o
Fees Due: Q i'es ❑ No Fee DesctiptfOn: Amount Due:
i $
Special /f/11/A,
Instructions: e7
Reprint Permit(per PE): es n No ❑ Done
Applicant Notified: y.a.a._ Date: /6i[$/O-o Initials: J?T? ,
I.\Building\Forms\TransnuttalLetter-Revisions.doc 05/25/2012
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
IIII
Building Permit Review — Residential
TIGAga
Building Permit #: /1,5 T 20 2-01 - 00 11
Site Address: 91 1 L. Svi Cop r Lee' ir,o(te.
Project Name: all VA r` '-i•- Lot #: 4
Planning-Review 4.1):5:: PLIAW QL Aap1JS 'RI ADD 721>CAE g�ecs. Jy ib
Proposal: New (/1Wrg M/`� TE1 = 4DD i IN potaveu M�Xgi CWSLrf
Cev7a¢dv.
Verify address/suite#active in Accela. fifi--In River Terrace: ,KI No ❑ Yes, River Terrace Review Addenda* d0
Site Plan Elements: Erosion Control '
N:;)copies of site plan on 8-1/2"x 11"or 11 x 17"paper KWetained trees with drip line and tree protection measures
Drawn to scale(standard architect or engineer scale) Wootprint 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 1�(Sidewalk/driveway approach
.Applicant information (name and phone number) t, Location of wells/septic systems
m% t dimensions and building setback dimensions "'4- ati,treet tree size,type and location It p,2_w419C. Ott
r .uare footage of buildings to be demolished Pt ' , Street names
ti,Wsisting structures on site (Corner elevations(2'contours if more than 4'differential)
N,l*ot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? qtyls,,101INo
impervious area (applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑ es No
A--Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified ' No Received: ❑ Yes ❑ No
171 Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
�/ Required: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No
R9. SDC Exemption for ADU applied for: ❑ Yes 124 No Received: ❑ Yes ❑ No
0 Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified N1.,No Applied For El Yes ❑ No, stop intake
U'Land Use Case #: r-,U S3 21)fl" Ct0003 N Zoning: 12'3• S-
v Required Setbacks: Front: 2-0 Rear: `.S Side: S Street Side: N/A" Garage: 2D
jil,Building Height: Max. Height: 3 D Actual Height: '�lP
l Landscape Area: % 114 'Lot Coverage Max: %
Entrance . Set back no more than 8' from street-facing wall k`?atallel to street or offset 45 degrees or less
Windows "Nr Minimum 12%of area of all street-facing facades I❑ io
Garage Garage door is behind widest street-facing wall ❑ Yes .3R'No,one of the following is met:
El 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's 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 eave ❑ Roof offset
❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer
❑ Accent siding ,❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony
( Visual Clearance �4 Urban Forestry Plan
- Sensitive Lands: ❑ Yes .. No Type:
(cConditions met prior to issuance of building permit
otes:
Approved By Planning: Ale&ft u, Date: (f o(?A
Revisions (after Building Submittal only) Reviewer 9 Date
Revision 1: Approved ❑ Not Approved i . - - h i I( WV/ft
Revision 2: El Approved ❑ Not Approved J n
1:1Building\Eons\B IdgPenn itRvw_R ES_I22419.docx
Building Permit Submittal
Original Submittal Date: 4/i/247
Site Plans: #
Building Plans: #
Building Permit#: D• nter building permit# above.
Workflow Routing: l Dlanning .0--E'tigineering ‘P- 15ermit Coordinator D—Building
Workflow Sign-off: E 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
00 final 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 e. 4e-.t-) Date: 41/b fZ-C3
mini m
En ineering Review
Slope at building pad: 0-0',1
Zr Conditions "Met" prior to issuance of building permit
isements (encroachments) per engineering conditions of approval and plat
7,4 atcr Quality/Quantity Facility. ,�/
Assess Water Quality Fee in-lieu: ❑ Yes l/ No
Assess Water Quantity Fee in-lieu: 0 Yes e-No
LIDA Facility on lot: ❑ Yes Ll No
'''Final Plat Recorded:
0 NOT Approved by Engineering: Date:
Notes: —
�_--
[ Approved by Engineering: Date: 6-' 4
Revisions (after�Bu ing Submittal only) le er Date
Revision 1: Ifd" Approved ❑ Not Approved /�/Q/2c.
Revision 2: 0 Approved ❑ Not Approved
Permit Coordinator Review
raConditions "Met"prior to issuance of building permit
0 Approved,NOT Released: O eP6t,ppu(swv" co/t4lZee —Al-- Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant: l ll1vl20
Revision Notice 2: Date Sent to Applicant:
c4 SDC Exemption: ❑ Received 'F-' Does not apply
—SDC Fees Entered: Wash Co Trans Dev Tax: sYsll Yes ❑ N/A
Tigard Trans SDC: ' Yes D N/A
Parks SDC: AK1 Yes 0 N/A
LIDA 0 Yes g N/A
t ;OK to Issue Permit
Approved by Permit Coordinator: 6/_— Date: bill 1'
I:\Building\Forms\B IdgPermitRvw_RES_1224I9.docx
Branden Taggart
From: Branden Taggart
Sent: Tuesday, November 17, 2020 2:37 PM
To: Schiedler, Michele
Cc: Dianna Ornelas
Subject: RE: MST2020-00191 Revisions
Importance: High
Hi Michele,
Evidently we have misplaced all of the applications for lot 4 of Erica Court. We have looked everywhere, and for some
reason we have not been able to locate the applications. With our Plans Examiner working off site, we think It's possible
that the applications could have been lost in transit somehow. Unfortunately, we need to request new completed
applications before we can issue this permit. We sincerely apologize for this inconvenience. I have already made all of
the revision adjustments in the system,and I can make this permit ready to issue as soon as we receive the new
applications. Again,we apologize for this inconvenience.
Thank you,
Branden Taggart
City of Tigard
a,- Senior Permit Technician
"ye; Community Development
13125 SW Hall Blvd'
Tigard, OR 97223
(503)718-2449
bra ndent@tig a rd-or,gov
From: Branden Taggart
Sent: Monday, November 16, 2020 3:34 PM
To: Schiedler, Michele<MSchiedler@dwhomes.com>
Subject: RE: MST2020-00191 Revisions
You are welcome, Michele.
Thanks,
Branden Taggart
la City of Tigard
9 Senior Permit Technician
fi 9 Community Development
13125 SW Hall Blvd
Tigard, OR 97223
(503)718-2449
brandent@tigard-or.gov
1
From:Schiedler, Michele <MSchiedler@dwhomes.com>
Sent: Monday, November 16, 2020 3:20 PM
To: Branden Taggart<brandent@tigard-or.gov>
Subject: RE: MST2020-00191 Revisions
Caution!This message was sent from outside your organization. Allow sender I Block sender
You are wonderful,thank you for your help!
Cheers!
Michele Schiedler I Division Coordinator I Portland
Oregon Principal Broker—Weekley Homes, LLC
Washington Managing Broker—David Weekley New Home Realty
D 503.213.4415 I M 503.349.0291 I mschiedler@dwhomes.com
1905 NW 169th PI,#102 I Beaverton,OR 97006
David Weeidey
Homes
From: Branden Taggart<brandent@tigard-or.gov>
Sent: Monday, November 16, 2020 3:19 PM
To: Schiedler, Michele<MSchiedler@dwhomes.com>
Subject: RE: MST2020-00191 Revisions
Hey Michele,
Thanks, same to you. We need to make some square footage adjustments,which can be complicated,so the permit
won't be ready to issue today. However, I will work on it today or tomorrow, and will let you know when this permit is
ready to issue.
Thanks,
Branden Taggart
o City of Tigard
a Senior Permit Technician
Community Development
TfCi, RD
13125 SW Hall Blvd
Tigard, DR 97223
(503)718-2449
brandent ntiBard-or.gov
From:Schiedler, Michele<MSchiedler@dwhomes.com>
Sent: Monday, November 16, 2020 10:30 AM
To: Branden Taggart<brandent@tigard-or.gov>
Subject: MST2020-00191 Revisions
Good morning Branden!
2
, • Happy Monday to you!
Wondering if this permit is on your plate - MST2020-00191?
If so, possible to pick up today? ...I know, I am so needy! Haha
Thank you!
Michele
Michele Schiedler I Division Coordinator I Portland
Oregon Principal Broker—Weekley Homes, LLC
Washington Managing Broker—David Weekley New Home Realty
D 503.213.4415 I M 503.349.0291 mschiedler@dwhomes.com
1905 NW 169th PI, #102 I Beaverton, OR 97006
DavidWeekley
Homes
DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail
may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained
by the City of Tigard in compliance with the Oregon Administrative Rules"City General Records Retention Schedule."
***This email originated from a non David Weekley Homes email address***
3
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
is
1,1 ,....
, - Transmittal Letter
T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Building Permit Technicians DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
FROM: Michele Schiedler JAN 1 9 2021
COMPANY: David Weekley Homes CITY OF TIGARD
BUILDING DIVTIBON��
PHONE: 503-213-4415
RE: 10114 SW Copperleaf Ln MST2020-00191
(Site Address) (Permit Number)
Erika Ct/Ridgecrest LOT 4
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. 3 Revisions: MAN DOOR TO GARAGE
Cross section(s)and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. 3 Engineer's calculations.
Other(explain):
REMARKS: ADDED MAN DOOR TO GARAGE. PLEASE SEE PLAN REVISIONS AND ENGINEER'S CALCS.
FOr 91FIICE USE ONLY
Routed to Penn echnician: _ Date: { ta, 0iA Initials:
Fees Due: Yes ❑ No Fee Descriptio Amount Due:
$ tYD
112 O \ r to $ 4s
Special
Instructions:
Reprint Permit (per PE): U Yes o n Done
Applicant Notified: Nl/(:lam Date: /2.o/z i Initials:
11Building\Forms1TransmittalLetter-Revisions.doc 05/25/2012
71 CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT
Permit#: MST2020-00191
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/01/2020
TIGARD Parcel: 2S111 BB00600
Jurisdiction: Tigard
Site address: 10114 SW COPPERLEAF LN
Subdivision: ERIKA SUBDIVISION Lot:
Project: Erika Court, Lot 4
Project Description: New detached dwelling.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 1388 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 26 Bathrooms: 3 Second: 1717 sf Garage: 399 sf Front: 20 Smoke
Yes
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors:
Total: 3105 sf Value: $399,681.57 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 0 Storm Sewer: 100
Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0
Bckflw Prevntr: 1
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywall-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
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp SrvcIFeeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea addl 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 3105
Owner: Contractor:
CASCADE CIVIL DEVELOPMENT INC WEEKLEY HOMES Required Items and Reports(Conditions)
395 SHENANDOAH LANE NE 1905 NW 169TH PLACE SUITE 102 1 Ersn Cntrl 503-639-4175
WOODBURN,OR 97071 BEAVERTON,OR 97006 2 Geo Tech Required Prior To
Pour
PHONE: PHONE: 503-213-4415
FAX:
Total Fees: $39,314.34
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 OAR� 952-001-0090.95 � You
1Amay obtain a copy of the rules or direct questions to OUNC by calling 5�03.r2�322.1987 or 1.800.332.2344. !y�-�
Issued By: L�ll,/I ] W�LJJ_.Y1 1� Permittee Signature: v` , �‘pp�� v` `
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 Checklist �eo
- One- and Two-Family Dwelling E v FOR OFFICE USE ONLY
City of Tigard JUN 01 21120 Date/By:
Permit No.:
e
Y
13125 SW Hall Blvd..Tigard,OR 97223 r Associated permits:
Phone: 503.718.2439 Fax: 503.598.1960 �+E OF-�Tip iJ ® Electrical El Plumbing
• 24-Hour Inspection Line: 503.639.4175 CITY�y t/ �`"A��� ® Mechanical
TIGARD Internet www.tigard-or.gov ����-l+��Vi CI Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A
I Land use actions completed. See jurisdiction criteria for concurrent reviews. ® ❑❑ ❑❑
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc.
3 Verification of approved plat/lot. ® El ❑
4 Fire district approval required. Name of district: • ❑ ❑ ❑
5 Septic system permit or authorization for remodel. Existing system capacity . ❑ El ❑
6 Sewer permit. ❑ El ❑
7 Water district approval. ❑ El 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. ® 0 0
9 Erosion control ® plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- ® ❑ 0
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ® ❑ 0
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ® ❑ ❑
there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements
and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction
indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and
surface drainage.
12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size /1 0 ❑
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 1 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. Z El 0
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. El ❑ El
prescriptiveWall 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. El El El
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 ❑ ❑
systems,see item 22,"Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ® 0 0
over 10 feet long and/or any beam/joist carrying a non-uniform load. El El ❑
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
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
architect licensed in Oregon and shall be shown to be applicable 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". ® O ❑❑
24 Two(2)sets each are required for Items 16, 19,20 and 22 above.
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ® ❑ El
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ® 0 ❑❑
27 "Drawn to scale"indicates standard architect or engineer scale.
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ® 0 ❑
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, El ❑
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.
l:\Building\Pennits\BUP-RESPermitApp.doc 02/24/2011 440-46131'(I1/02/COM/WEB)
r
Mechanical Permit Applicat►on FOR OFFICE USE ONLY
City of Tigard GENE. Received
`J g Date'By: Permit No.A,!+J�� �ro r 0 L,/
q 13125 SW Hall Blvd.,Tigard,OR 972231111 Plan Review I
_ Phone: 503.718.2439 Fax: 503.598.1960 J U N 01 202G Date By: Other Permit:
T I GA R D Inspection Line: 503.639.4175 r•, Date Ready/By: Luis: 0See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGAt Notified'Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
® New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
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 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address:10114 SW COPPERLEAF LANE Furnace 100,000 BTU(ducts/vents) 1 46.75
City/State/ZIP:Tigard/OR/97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: I Project name:RIDGECREST Duct work 23.32
Cross street/directions to job site:SW 103ao AVE and SW COPPERLEAF LANE Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not elecuic),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision:ERIKA COURT I Lot no.:4 Other: 23.32
Other fuel appliances:
Tax map/parcel no.:2S111BB00600 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-2802 sqft,3 bedroom 2.5 bath home with fireplace 23.32
399 sqft 2 car garage and a 139 sq ft covered rear porch Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent - 23.32
Other: 23.32
® PROPERTY OWNER El TENANT Environmental exhaust and ventilation:
Name:David Weekley Homes Range hood'other kitchen
equipment 1 33.39
Address: 1905 NW 169"Place,Suite 102 Clothes diyer exhaust 1 33.39
City/State/ZIP:Beaverton/OR/97006 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 5 23.32
Phone:(503)213-4415 Fax:( ) Attic/ctawlspace fans 23.32
® APPLICANT ® CONTACT PERSON Other: 23.32
Fuel piping:
Business name:David Weekley Homes
$14.15 for first four;$4.03 for each additional
Contact name:Michele Schiedler Furnace,etc.
Address: 1905 NW 169'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 diyer(gas)
Business name:David Weekley Homes Other:
MECHANICAL PERMIT FEES*
Address: 1905 NW 169"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: ..e," * Fee methodology set by Tri-County Building Industry Service Board '..
Print name:Ken Puttman Date:5/26/20
I.Building`.Permits\MEC_PermtApp_040113.doe 410.4617T(1 i/02/COMM'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 $1,363.71 for the first$50,000.00 and
$2.49 for each additional$100.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first$100,000.00 and
$2.92 for each additional$100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I:\Building\Permits\MEC_PermitApp_040113.doc 2
,
Electrical Permit Applic4COVED FOR OFFICE USE ONLY
City of Tigard II IN 0 1 2020 ReceivDate/Bed Penni( tts•/ LO'� ' tlO ,eg/
.1ZViv PlanR
III13125 SW Hall Blvd.,Tigard,OR 972 3 Plum Review
= Phone: 503.718.2439 Fax 503398 1960•?F TIGARD Date/By: Related Permit k:
Inspection Line: 503 639 4175 4` (-+ ! '+ f1. Ready Date By: Juris: ® See Page 2 for
TIGARD p C �'y��,fb��Q"� Notified/Method: Supplemental Information
- Internet:InternCY, wow-tigard-oi.go\ ', -� �+
TYPE OF WORK PLAN REVIEW
Please check all that apply(submit 2 sets of plans w/items checked):
[El New construction ❑Addition/alteration/replacement ❑Service or feeder 400 amps or more 0 Building over three stones.
0 Demolition 0 Other: where the available fault ctment 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or 0 Floating buildings.
less to ground,or exceeds 14,000 0 Commercial-use agricultural
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings.
❑ Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#:68130004 Job site address: 10114 SW COPPERLEAF LANE 100HP or more. ❑"'A"."E"."I-2","I-3",
❑Six or more residential tests.
occupancy.
City/State/ZIP:Tigard/OR/97224 ❑Health-care facilities. 0 Recreational vehicle parks.
0 Hazardous locations. ❑Supply voltage for more than
Suite/bldg./apt.#: Project name:RiDGECRE.AST 0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site:SW 10311°AVE AND COPPERLEAF LANE FEE SCHEDULE
Description I Qty. I Each I Total I "
New residential single-or multi-family dwelling unit.
Subdivision:ERIKA COURT Lot#:4 Includes attached garage.
1,000 sq.ft.or less I 168.54 16854 4
'fax map/parcel#:2S11111B00600 Ea.add]500 sq.ft.or portion 4 33.92 135.68 1
DESCRIPTION OF WORK Limited energy,residential 75.00 2
(with above sq.ft.)
New single family home to be build-2802 sqft,3 bedroom 2.5 bath home with Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
399 sqft 2 car garage with a 139 covered rear porch Renewable Energy 0 See Page 2
® PROPERTY,OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name:David Weekley Homes 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2 1
Address: 1905 NW 169'Place Suite 102 401 amps to 600 amps 2200.34 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 5522.26 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,per panel
ID APPLICANT ® CONTACT PERSON A.Fee for branch circuits with
Business name: David Weekley Homes above service or feeder fee, 7.42 2
each branch circuit
Contact name:Michele Sehiedler B.Fee for branch circuits without
service or feeder fee,first S6.18 2
Address:1905 NW 169'Place Suite 102 branch circuit
Each add'I branch circuit 7.42 2
City/State/ZIP:Beaverton/OR/97006 Miscellaneous(service or feeder not included)
Phone:(503)213-4415 Fax::( ) Each manufactured or modular 67.84 2
dwelling.service and/or feeder
Email:mschicdler@dwhomes.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 o
Address:2890 SE Brookwood Ave. panel,alteration,or extension. 0 See Page 2
Each additional inspection over allowable in any of the above
City/slate/ZIP:Hillsboro, OR 97123 Additional inspection(1 hr mini 66.25i hr
Phone:(503)523-9060 503-648-4552 Fax:( 503)642-7925 Investigation(1 hr min) 90.00/hr
Industrial plant(l hr min) 78.18/hr
Email:permits@garnereleetriaeom Inspections for which no fee is
90.001 IS/hr
CCB Lic.:121159 Electrical ' 4-3 C Suprv.Lic.:3707-S specifically listed(Y hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,require : Subtotal:
Print name:Charles Garner Date:5/27/2020 ❑Plan Review Required(25%of permit fee).
State surcharge(12%of permit fee):
r� TOTAL PERMIT FEE:
Authorized signature: g� v �� This permit application expires if a permit is not obtained within 180
Print name:BrittanyBurian Date:5/27/2020 days after it has been accepted as complete.
• Number of inspections allowed per permit.
19B11ildng\PermitskELC PernutAPp_ELR_ERE.doc Rev 06/17(2015 4404615T(I Ii05/COMIWEB
•
' Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Description l Qty. I Each I Total l
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less oo.70 2
5.01 to 15 kva 133.56 2
Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ 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
with OAR 918-309-0040) 552.26
® Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
I Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 66.25/hr I
charged at an hourly(Ihrmin)
Inspections for which no fee is 90.00'hr
specifically listed(b;hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Subtotal(Enter on Page I):
Fee for each commercial system: $75.00 Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
Boiler Controls
[f Clock Systems
Data Telecommunication Installation
• Fire Alarm Installation
n HVAC
U Instrumentation
7 Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
Nurse Calls
Outdoor Landscape Lighting*
n Protective Signaling
Other:
Total number of commercial systems: _
*No licenses are required. Licenses are required for all
other installations
IiBuilding'Pertnits\ELC_PemritApp ELR ERE.doc Rev 06/172015
e •Plumbing Permit Applicat' 1'�E
Building Fixtures t � 1! Z020 FOR OFFICE USE ONLY
City of Tigard JUN 0 Received
R DateBy: Permit No ' I r j i
i • 13125 SW Hall Blvd.,Tigard,OR 9'hn h TIGfti VI/
I Phone: 503.718.2439 Fax: 5(3' 99@t1.fF Plan Review
rr 11 DateiBy Other Permit No.:
Inspection Line: 503.639.417•��� t 1"t pt r Dhi l i0 Date Ready/By: ura: ® See Page 2 for
TIGARII Vl1 ( ,.-.i`s^�
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. I Ea. I Total
E 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 ❑Commercial/industrial SFR(2)bath I' 437.78 , 437.78
SFR(3)bath 50032
0 Accessory building ❑Multi-family
Each additional bath/kitchen I 25.02 25.02
❑Master builder ❑Other: Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION. Site utilities:
Job site address:10114 SW COPPERLEAF LANE Catch basin or area dra n 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard/ORl97224 Footing drain(no.linear ft.:230) Page 2 87.55
Suite/bldg./apt.no.: J Project name: RIDGECREST Manufactured home utilities 50.03
Cross streel/directions to job site:SW 103Ro AVE AND COPPERLEAF LANE Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear tt:_) Page 2
- Water service(no.linear ft.: ) Page 2
Subdivision:ERIKA COURT I Lot no.:4 Fixture or item:
Tax mapiparcel no.:2S1 I I BB00600 Backtlow preventer 1.27 31.27
DESCRIPTION OF WORK Backwater valve 12.51
---- Clothes washer I 25.02 25.02
New Single Family Home 2802 sgft 3 bedroom,2.5 bath with 399 sqft 2 car Dishwasher I 25.02 25.02
garage and with a 139 sy ft covered rear patio. Drinking fountain 25.02
Ejectors/sump 25.02
.. PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: David Weckley Homes Fixture/sewer cap 25.02
Floor drain/tloor sink/hub 25.02
Address: 1905 NW 1691h 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 169th Place,Suite 102 Sink/basin/lavatory 5 25.02 125.10
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
E-mail:mschiedler(idwhomes.com Urinal 25.02
Water closet 3 25.02 75.06
CONTRACTOR
Water heater 1 37.52 37 52
Business name: Malmedal Plumbing Water piping/DWV 56.29
Address:PO Box 207 Other 25.02
City/State/ZIP:Banks/OR/97106 Subtotal
Minimum permit fee: $72.50
Phone:(503)324-0759 Fax:( )
Plan review (25%of permit fee)
CCB Lic.: 102535 Plumbing Lic.no.:34-276PB
State surcharge(12%of permit fee)
Authorized signature: Carolina Malmedal TOTAL PERMIT FEE
Print Warne Carolina Malmedal Date:05/27l202D This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I tBuildingtrermitstPLMU-PermitApp.doc 10/01'09 440-46 l 6T(IO/02/COM'WEB)
'Plumbing Permit Application - City of Tigard
• Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qry. Fee(ea) 'rota! 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
Sewer- Is!100' 62.54 3,601 to 7,200 $233.20
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 Qtv. Fee(ea) 'Fetal 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 90.004u 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 foranyof the following.Work Performed: Capped Added Relocate q fllowi g•
Baptistry/FontPlease 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 0 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"
Isometric or Riser Diagram
Car Wash Drain ❑ Isometric or riser diagram is required for new buildings
Garbage -Domestic-non-food g q b
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 workunderthis 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\Malmedal\AppData\Local\Microsoft\Windows\Temporary Inters Files\Content.Outlook\6XKYAOWA\68130004 Plumbing Permit.doc
City of Tigard
IIICOMMUNITY DEVELOPMENT DEPARTMENT
T I G A R D Building Permit Review — Residential
Building Permit #: M,5 T ZD 'ZD _Do j 1 I
Site Address: 101 1 1 . 31nJ Coppl-leW Lcune.
Project Name: £r \Cti Cot '-I- Lot #: 4,
Planning Review
Proposal: NeW houf6
44 Verify address/suite# active in Accela. '®—In River Terrace: X No ❑ Yes,River Terrace Review Addendum
Site Plan Elements: Erosion ControlLN;
copies of site plan on 8-1/2"x 11"or 11 x 17"paper Netained trees with drip line and tree protection measures
,Drawn to scale(standard architect or engineer scale) ootprint of new structure(including decks)and FFE
.North arrow ,Utility locations&easements(required for new and additions)
e Site address,project or subdivision name and lot number .�/Sidewalk/driveway approach
AS Applicant information(name and phone number) taiLocation of wells/septic systems
.t dimensions and building setback dimensions e':'F (gtreet tree size,type and location* OP-Wh.),it .te_.
Ti..uare footage of buildings to be demolished wvti P .Street names
Mxisting structures on site Corner elevations (2'contours if more than 4'differential)
Ki*ot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? 4y$sNo
impervious area (applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? CI es No
1-Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No
71 Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: El Yes,applicant was notified 'L No Received: El Yes El No
5i SDC Exemption for ADU applied for: ❑ Yes No Received: El Yes ❑ No
Yr Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified .No Applied For. El Yes ❑ No, stop intake
V Land Use Case#: SU B 20 I-1— C0003 Zoning: a-3• `S
sr Required Setbacks: Front: 2C Rear: I S Side: S Street Side: i-1/Pv Garage: .2,-D
Building Height: Max. Height: 3 D Actual Height: 2 1 e
rLandscape Area: % AR--"Lot Coverage Max:
Entrance .-Set back no more than 8' from street-facing wall Parallel to street or offset 45 degrees or less
Windows Minimum 12%of area of all street-facing facades 1-7 7o
Garage L&—Garage door is behind widest street-facing wall ❑ Yes ,1'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"d floor.
,(Garage door width is ❑ 12'or less JR 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 El Dormer
❑ Accent siding ❑ Window trim El Window recess ❑ Window projection El Balcony
RPIVisual Clearance ��Urban Forestry Plan
-Sensitive Lands: ❑ Yes .k No Type:
Conditions met prior to issuance of building permit
otes:
Approved By Planning: AOh /u/J`- Date: (r,0(120
Revisions (after Building Submittal only) J Reviewer Date
Revision 1: 0 Approved ❑ Not Approved
Revision 2: 0 Approved ❑ Not Approved
I:\Building\Forms\B IdgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: �/�/2-c9
Site Plans: #
Building Plans: #
Building Permit#: -F,nter building permit#above.
Workflow Routing: .Manning ZI--Efigineering '8"-PermitCoordinator c❑-Building
Workflow Sign-off: 9"-"S-ign-off for Planning(include notes from planning review)
Route Application Documents: [`Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
o giinal plan review routing form.
-0-Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes: f,(.
By Permit Technician: (4tte-4,4.-) Date: 1p//2/7.-O
En ineering Review
Slope at building pad: yd./t
21 Conditions "Met"prior to issuance of building permit
kr E sements (encroachments) per engineering conditions of approval and plat
ater Quality/Quantity Facility: f
Assess Water Quality Fee in-lieu: ❑ Yes L7 No
Assess Water Quantity Fee in-lieu: ❑ Yes eNo
LIDA Facility on lot: ❑ Yes CJ No
LY Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: _ �_ Date: �l�26
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved 0 Not Approved
Revision 2: 0 Approved ❑ Not Approved
Permit Coordinator Review
Conditions "Met"prior to issuance of building permit
Ir
0 Approved,NOT Released: OVIVAW appu ut„,,,f- colto I2w Al.- Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
'S4 SDC Exemption: 0 Received 'F' Does not apply
CSDC Fees Entered: Wash Co Trans Dev Tax: V Yes 0 N/A
Tigard Trans SDC: II Yes 0 N/A
Parks SDC: Yes 0 N/A
LIDA ❑ Yes 1? N/A
OK to Issue Permit Approved by Permit Coordinator: °E q— Date: 6(11 I7,0
I:1Bui Iding\Forms\B IdgPermitRvw_RES_122419.docx