Permit 7 q CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2021-00090
Date Issued: 04/08/2021
T I G A RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 15135CC06400
Jurisdiction: Tigard
Site address: 10444 SW LUCY CT
Subdivision: BURT'S LANDING Lot: 16
Project: Burt's Landing Lot 16
Project Description: New detached dwelling unit
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1170 sf Basement: 0 sf Left 5 Parking Spaces: 0
Height: 23 Bathrooms: 3 Second: 1611 sf Garage: 526 sf Front: 20 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors:
Total: 2781 sf Value: $366,193.24 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain 0 Storm Sewer: 100
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
Drywall-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 6 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Fum<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 5
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr 0
Ea add'I 500 sf: 5 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mid Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Y
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2781
Owner: Contractor:
WESTWOOD HOMES LLC WESTWOOD HOMES LLC Required Items and Reports(Conditions)
12700 NW CORNELL RD 12700 NW CORNELL RD 1 Ersn Cntrl 503-639-4175
PORTLAND,OR 97229 PORTLAND,OR 97229
PHONE: PHONE: 503-330-2215
FAX: 503-342-2403
Total Fees: $39,861.95
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. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
1-Eouy VcwtiVe-Nlege OwAppUcat'wn
Issued By: Permittee Signature:
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.
Electrical Permit Application \J FOR OFFICE USE ONLY
►City of Tigard .ECEI Y ED R ., d G
INI • 13125 SW Hall Blvd.,Tigard,OR 97223 �n Review
r r'—""
L Phone: 503.718.2439 Fax: 503.598.1960 MAR 8 2021 Da. : . Related Permit 4:
Inspection Line: 503.639.4175 Ready Date/13y: tuns: la See Page 2 for
I I CARD Internet: wwwtigardor.gov CITY OF TIGARD Notified/Method: Supplemental Information
TYPE OF woMILDING DIVISION PLAN REVIEW
®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition ❑Other:
where the available fault current El Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
El1-and 2-family dwelling ❑ Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installation. buildings.
❑Multi-family 0 Master builder ❑Other: 0 Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: Job site address: /`�(`y� e7 ❑Addition of new motor load of system.
Ice, JV )I 2 , r/__ "100HP or more. ❑••A»•'E„ 'l-2»••l_3„
City/State/ZIP: / i 4,a,r-01 Ole- '9 77Z ❑Six or more residential units. acWancy.
❑
❑Health-care facilities. Recreational vehicle parks.
Suite/bldg./apt.#: I Project name: it e*r (�� /19 0 Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: `4 Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential 75.00 2
New SFR (with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
® PROPERTY OWNER I ❑ TENANT Renewable Energy 0 See Page 2
Services or feeders installation,alteration,and/or relocation
Name:Westwood Homes LLC 200 amps or less 100.70 2
Address: 12700 NW Cornell Rd 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Portland,OR 97229 601 amps to 1,000 amps 301.04 2
Phone:(971)678-5018 I 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 I El CONTACT PERSON
Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:Same as Owner above service or feeder fee,
each branch circuit 7.42 2
Contact name: B.Fee for branch circuits without
Address: service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP: Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax: :( ) Each manufactured or modular 67.84 2
Email: dwelling,service and/or feeder
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Ross Electric Inc Sign or outline lighting 67.84 2
Address:2870 SE 75th Ave#203 Signal circuit(s)or limited-energy ❑ See Page 2 2
panell,,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)642-2800 Fax: ( ) Investigation(1 hr min) 90.00/hr
Email:RossElectric@comcast.net Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lie.: 157891 I Electrical Lie.: 34-436C I Suprv.Lic.: 42328'S specifically listed(/3 hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:
Subtotal:
Print name: Stephen Ross Date: ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature:„.., / zzi50
TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Date:3/2/26Z1_1 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:'Buildmg\Permits'ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(I I/OS/COM/WEB
Plumbing Permit Application = Z1 _�
Building Fixtures RECEIVED EON OFt l( 1: I SE O1L1'
13125 W Hall
DatcaeftdBy: •mil 12)(Z(II • 13125 SW Hall Blvd.,Tigard,OR 97223 MAR 2021 Plan Rev ,L I'cmit No.: }7(h 1 �y�/jGb
Pla= Phone: 503.718.2439 Fax 503.598.1960eJBrnew Other Permit No.:Dat
w t i w v I
$
"I l�:n it[) Inspection Line: 503.639.4175 O(r( OF TIGARC
Internet: www.tigard-or.gov `R�YBY= see Page2for
.���` Ana
Information
TYPE OF WORK FEE* SCHEDULE
®New constriction ❑Demolition For special Worm:lion use checklist
Description
❑Addition/alteration/replacement CIOther. New i-2-familydwellings(includes 100 R.for each utility connecawl)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
® I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
0 Accessory building 0 Multi-family SFR(3)bath 1 50032
❑Master builderEach additional bathhitchen 25.02
0 Other: Fire sprinkler
(..._-sq.R.) Paget
JOB SITE INFORMATION AND LOCATION - Site utilities:
•Job site address: ;r 0�8 I C4 _" , r , .' Catch basin or area drain
18.76
City/State/ZIP:Tigard OR 2 72Z 3 �) a Drywall leach line m trench drain Page18.76
2
Suite/bldg✓apt.no.: j Project name: �(.4'4 �)?./ Footing Manufactureddrr h(nome
linear ft.: ) 5 . 3
home utilities 50.03
Cross street/directions to job site: Manholes
18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear It.:_) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: Lot no.:
Fixture or item:
Tax map/parcel no.: Backflow preventer I 31.27
DESCRIPTION OF WORK Backwater valve 12.51
.
r Y • Clothes washer 25.02
Dishwasher 1 25.02 I
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER ... . j] TENANT Expansion tank
12.51
Name:Westwood Homes LLC Fixture/sewer cep 25.02
Address:12700 NW Cornell Road Floor drain a sink/hub 25.02
Garbaggee d disposal ( 25.02
City/State/ZIP:Portland OR 97229 Hose bib
2. 25.02
Fax:(503)342-2403 Ice maker 1 12.51
® APPLfCAJ It . ; 0:CONTACT PERSON Imerceplor/grease trap 25.02
� R /
Business name: V 2 S 41Jt77 d r , l f v Medical gas(value:S ) Page 2
Contact name:J�[/ Li s- A'? // t Primer 12.51
J2_ /' /) //A � n / Roof drain(commercial) I2.51
Address: V V U(1 /ram�l�
Sink/basin/lavatory 5. 25.02
City/State/ZIP: lay' MX Q 722'11111111 Solar units(potable water) 62.54
Phone: C/ 17 ?j-� 62.,ax::(] ,�), Tub/shower/shower pan 3 12.51
E-mail % VI C(f-i � l'
Q5- V t-o�hcTh&s//c cc/ Urinal 25.02
CONTRACTOR Water closet 3 25.02
Business name:H&H Mechanical
' Water heater 37.52
Water piping/DW V 56.29
Address:5757 SE Willow Lane Other:
25.02
City/State/ZIP:Milwaulde OR 97267 Subtotal
Phone:(S03)975-9787 Fax:(503)659-2979 Minimum permit fee: $72.50
CCB Lic.: 178122 Plumbing Lic.no.: '&t/f 1Plan review (25%of permit fee)
1 State surcharge(12%dorm*&e)
Authorized signature: yT� / TOTAL PERMIT FEE
Print]lame:Des' ague Date. 'j _'.. } `i/ This permit appliaaoa expires if a permit is not obts,ii d within 190 days
r % after it au been accepted as complete
'Fee methodology set by Tri-County Building Industry Service Board.
illhi1diag1pnmgsTIMII-P itio,o doe 10/01/09 440-46t6rf0'e1/COM,wen)
m City of Tigard g)ZI
I �
d COMMUNITY DEVELOPMENT DEPARTMENT t
T I G A R D Building Permit Review — Residential
Building Permit #: Ms72021— 000 Cal.)
Site Address: 10444 SW Lucy Court
Project Name: Burt's Landing Lot #: 16
Planning Review
Proposal: New single detached house
ElVerify address/suite#active in Accela. O In River Terrace: ❑r No ❑ Yes, River Terrace Review Addendum
Site Plan Elements: ° ro n Control
El: copies of site plan on 8-1/2"x 11"or 11 x 17"paper ained trees with drip line and tree protection measures
129 fawn to scale(standard architect or engineer scale) ootprint of new structure(including decks)and FFE
Q; forth arrow _Jtility locations&easements (required for new and additions)
7tite address,project or subdivision name and lot number 'id walk/driveway approach
O\pplicant information(name and phone number) cation of wells/septic systems
el at dimensions and building setback dimensions •treet tree size,type and location
lI.quare footage of buildings to be demolished jtreet names II xisting structures on site °Corner elevations (2'contours if more than 4'differential
II .t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ° 'es o
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? 'es -o
❑ Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified ❑✓ No Received: ❑Yes ❑r No
Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑Yes,applicant was notified El No Received: ❑Yes El No
❑ SDC Exemption for ADU applied for: ❑Yes ❑' No Received: ❑Yes El No
0 Public Facilities Improvement(PFI) Permit:
Required: El Yes,applicant was notified ❑ No Applied For: ❑Yes ❑ No,stop intake
El Land Use Case#: SUB2016-00002 R
❑ Zoning: -4.5
ElRequired Setbacks: Front: 20 Rear: 15 Side: 5 Street Side: N/A Garage: 20
Q B 'ding Height: Max. Height: 30 Actual Height: �2.
Mandscape Area: % t Coverage Max:
um . Set back no more than 8'from street-YAcing wall ❑� Parallel to street or offset 45 degrees or less
Windows v Minimum 12%of area of all street-facing facades
Garage Gara e door is behind widest street-facing wall ❑Yes ❑ No,one of the following is met:
❑gDoor extends no more than 5' from wall and there is a covered porch extending beyond garage.
uuDoor extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2"d floor.
ElGana e door width is 12'or less ❑r 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 itch ❑ Gable,hi ,or gambrel roof ❑ Dormer
Accent siding Window trim Window recess Window projection ❑ Balcony
II Visual Clearance CI Urban Fores Plan
II Sensitive Lands: ❑ Yes 12 I No Type:
0 Co itions met prior to issuance of building permit
No s•
Approved By Planning: —�'— Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
T:\Building\Forms\BldgPermitRvw_RES 122419.do cx
Building Permit Submittal
Original Submittal Date: 318I 2(
Site Plans: # 3
Building Plans: # 3
Building Permit#: IN Enter buildingermit# above. �p
Workflow Routing: Planning Engineering e Permit Coordinator ca Building
Workflow Sign-off: ®, Sign-off for Planning(include notes from planning review)
Route Application Documents: ® Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
1 Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: �^_
By Permit Technician: elVe LDU �1 C.,DCA4 Date: J ll S12,1
Engin ering Review
Slo building pad: p
Co ditions "Met"prior to issuance of building permit
Easements (encroachments) per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ERNo
Assess Water Quantity Fee in-lieu: ❑ Yes L�f 1�10
�/ LIDA Facility on lot: Yes ❑ No
E renal Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:/
,
Approved by Engineering: I . A.si,} Date: 3•Z2 .-2y21
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 Does not a�ly
SDC Fees Entered: Wash Co Trans Dev Tax: Yes N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: r Yes 0 N/A
LIDA Yes ❑ N/A
El OK to Issue Permit
Approved by Permit Coordinator: Arr / Y ` Date: 3123IW2I
I:\Building\Fortes\BI dgPerm itRvw_RE S_122419.do cx
Plan# a-7Q I ►T �� & ` to-r' y(.e,1JL./u—T�S-
Floors a.. Large 1 :}'�
Bed rooms Small
(Le we + 2Lv
LAV 5 R3 - 17_2.yLex ai(8l =- 340iS'o •
Tub Basement I
Vent Le 1st Floor in U , y$ 73 x 5 , .25/ (4)3
Water Heater , 2nd Floor i U 1
AC 3rd Floor _ _ I 93
�
$ I
Garage ati
School 1 ,-sW—,� R-3 Total ,27 O I 44 I
S ^-s. c,5-k S
V Total 33D7
6 eA #for Elec S