Permit 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 ityrovides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
! ' Transmittal Letter
T I G A R[) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Allyson Armstrong DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
FROM: Meghan Ticknor MAY 2 7 2021
COMPANY: David Weekley Homes CITY OF TIGARD
BUILDING DIVISIQrs'
PHONE: (503)213-4409 By(
EMAIL: mticknor@dwhomes.com
RE: 15109 SW TIERRA TERRACE MST2021-00172
(Site Address) (Permit Number)
TRILLIUM HILL LOT 14
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. i 3 Revisions: Trillium Hill Lot 14 Plot Plan(PDF)
Cross section(s)and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS`' Home needed to be shifted 3'to the east due to a gas line being in the way.Please see attachment for revisions made by Pacific Community Design.
FO 0 FICE USE ONLY
Routed to Permit Technician: D e: L. 2,�ZI Initials:
Fees Due: Yes o ee Descn hdn: Amount Due:
❑ ‘7 L p
\:\, Di\-JY c___-- $
$
Special
Instructions:
Reprint Permit(per P : n Yes (No I,'" ❑ Done
/
Applicant Notified: i ! Date: , ? Initials: ,
_ CITY OF TIGARD MASTER PERMIT
I' ' COMMUNITY DEVELOPMENT Permit#: MST2021-00172
Date Issued: 05/13/2021
T t _; ' I'. I) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110DA11400
r Jurisdiction: Tigard
Site address: 15109 SW TIERRA TER
Subdivision: TRILLIUM HILL Lot: 14
Project: Trillium Hill, Lot 14
Project Description: New detached dwelling
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1392 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 28 Bathrooms: 3 Second: 1746 sf Garage: 412 sf Front: 20 Smoke
Yes
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors:
Total: 3138 sf Value: $391,391.02 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 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: 3 Backwater Value: 1
Other Fixtures: 1
Drywell-Trench Drain: 0
Other Fixture Units: Utility Sink-Garage
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Fum<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add!500 sf: 6 201400 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 3138
Owner: Contractor:
WEEKLEY HOMES LLC WEEKLEY HOMES Required Items and Reports(Conditions)
1111 NORTH POST OAK RD 1905 NW 169TH PLACE SUITE 102 1 Ersn Cntrl 503-639-4175
HOUSTON,TX 77055 BEAVERTON,OR 97006
PHONE: PHONE: 503-213-4415
FAX:
Total Fees: $40,592.39
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.
Issued By: HOW)/Vc De/ Vege Permittee Signature: 0 rt.AppU;cat1,ovt
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
One- and Two-Family Dwelling FOR OFFICE USE ONLY
City of Tigard
Received Permit No.:
Dateey,
• 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
I Phone: 503.7182439 Fax: 503.598.1960 ® Electrical ® Plumbing ® Mechanical
T I C;A RD 24-Hour Inspection Line: 503.639.4175 Other:
www.tigard-or.gov
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A
I Land use actions completed. Sec jurisdiction criteria for concurrent reviews. ® 0 0
2 Zoning. Flood plain,solar balance points,seismic soils designation.historic district,etc. ® 0 ❑
3 Verification of approved plat/lot. ® 0 0
4 Fire district approval required. Nance of district: ❑ 0
5 Septic system permit or authorization for remodel. Existing system capacity 0 ❑ ❑
6 Sewer permit. 0 ❑ 0
7 Water district approval. ❑ ❑ 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. ® 0 0
9 Erosion control 0 plan ['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 he drawn to scale. showing conformance to applicable local and state
• building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot he completed if
copyright violations exist.
II Site/plot plan drawn to scale. The plan must show lot and building setback dimensions:property corner elevations(if I, 0 0
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 ® ❑ ❑
and location. El 0 0
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors.water heater,
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 he required to clearly portray
construction. Show details of all wall and roof sheathing,roofing,roof slope.ceiling height.siding material, footings
and foundation,stairs. fireplace construction,thermal insulation,etc. ® ❑ ❑
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels.
Exterior elevations must reflect the actual grade if the change in grade is g eater than four foot at building envelope.
Full-size sheet addendums showing foundation elevations with cross references are acceptable. ® ❑ ❑
16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations; for non-
prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor/roof framing. Provide plans for all floors/roof assemblies, indicating member sizing,spacing.and bearing ® 0 0
locations. Show attic ventilation.
IR Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ 0
systems, see item 22,"Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ►1 0 0
over 10 feet long and/or any beam/joist carrying a non-uniform load. ® 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. 0 0
22 Engineer's calculations. When required or provided,(i.e., shear wall,roof truss)shall be stamped by an engineer or CA
architect licensed in Oregon and shall be shown to be a licable to the ,ro'ect under review.
JURISDICTIONAL SPECIFICS
23 three(3)site plans are required for Item I I above. Site plans must he 8-1/2"x I I"or 11"x 17". ® 0 U
24 Two 12)sets each are required for Items 16, 19,20 and 22 above.
0
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ® ❑ ❑
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ® U ❑❑
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 IT 0 ❑
Street Tree List. El El29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations.dripliness,
El
and protection measures must be drawn to scale and must include the project arhorist's signature of approval. ❑ 0
30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions,
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.
hlBuilding\PermitsABUP-RESPermit\pp.doc 02/24/2011 440-4613T(I1/02/COM/WEB)
4
Mechanical Permit ApplicatRECEIVED FOR OFFICE USE ONLY
City of Tigard Received
. .._ Peru it`�., ...
13125 SW'Hall Blvd.,Tigard,OR 97223 503.718.2439 Fax: 503.593.1960
jPR 2 2 202I Plan Review
DateiBy:
Other I'ermr.
Phone:
T I GA RD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/Fly. ur6 ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
3UILDING DIVISION
TYPE OF WORK (OMMERCIAI EKE* SCHEDULE USE CHECKLIST
Mechanical permit tens`are based on the value ofthe work
®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑ Other: mechanical materials,equipment,labor_overhead,and profit.
Demo Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling ❑ Commercial/industrial ❑Accessory building For special information usechecklivt.
0 Multi-family ❑ Master builder ❑Other: Description Qty. Ea. Total
Heating/cooling:
JOB SITE INFORMATION .AND LOCATION
Air conditioning I 46.75 46.75
.lob site address: 15109 Tierra Terrace Furnace 100,000 BTU(ducts/vents) 1 46.75
City/State/ZIP:Tigard/OR/97223 + w
7223 Furnace 100,000BTU tductsents) 54.91
I pump 61.06
Suite/bldg./apt.no.: Project name:Trillium Hill Duct work 23.32
Cross street/directions to job site:SW 109'h Ave and SW Lady Marion Dr Hvdronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric).
in-wall,in-duct,suspended.etc. 46.75
Flue/vent for any of above 23.32
Other: 23.32
Subdivision:Trillium Hill Lot no.:14
Other fuel appliances:
Tax map/parcel no.:2S 110DA11400 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 he built-3138 sgft,4 bedroom 2.5 bath home n ith fireplace 2332
Log lighter(gas) 23.32
412 sqft 2 car garage and a 121 sq ft covered deer:patio and 152 sq ft front po. Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
ry PROPERTY OWNER 0 TENANT Environmental exhaust and ventilation:
Name: David Weekley Homes Range hood/other kitchen
equipment I 33.39
Address:1905 NW 169ih Place,Suite 102 Clothes dryer exhaust I 33.39
City/State/ZIP:Beaverton/OR/97006 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 3 23.32
Phone:(503)213-4415 Fax:( ) Attic/crawlspace fans 23.32
® CONTACT PERSON Other: 2332
® APPLI('ANT Fuel i in
P P g:
Business name: David Weekley Homes S14.15 for first four;S4.03 for each additional
Contact name: Meghan Ticknor Furnace,etc.
Gas hear pump
Address: 1905 NW'169'h Place,Suite 102 W'all,'suspended/unitheater
City/State/ZIP: Beaverton/OR/97006 Water heater I
Phone:(503)213-440Fireplace I
�' Fax: :( ) Range (
E-mail: mticknor'u dwhomes.eom Barbecue
CONTRACTOR Clothes dryer(gas)
Other
Business name:David Weekley Homes iVIECHANICAI.PERMIT FEES*
Address:1905 NW 169°'Place Suite 102 Subtotal
Minimum penn it fee($90.00)
City/State/ZIP: Beaverton/ORl97006
Plan review(25%of permit fee)
Phone:(503)213-4415 Fax:( ) State surcharge(12%of permit fee)
TOTAL,PERMIT FEE
CCB lia:213653
This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete.
...............„/X....................„..-
Authorized signature: s Fee methodology set by Tn-County Building Industry Service Board
Print name:Ken Putt n Date:4/20/21
FBuildise,Pemtlts\MEC PemdtSpp 040113 doe 440-4617r(I 1/02/COM.'WEB)
r
•
'x Electrical Permit Application RECEIVE I FOR OFFICE. USE.ON1.'t
d e Rec
City of Tigard A ive Permit ft:
�p 2 2 'Ijai Receive
1111 ■ 13125 SW Hall Blvd.,Tigard.OR 97223 Plan Review Related Permit a
is. Phone: 503.7182439 Fax: 503.598.1960CITY OF TIGARD Date.'BY:
Inspection Line: 503.639.4175 Ready Date'Qy: tuns: 10 See Page 2 for
TIGARD Internet: www.ligard-or.gov BUILDING DIVISION? NoiiftedlMethod: Supplemental information
TYPE OF WORK PLAN REVIEW
Please cheek all that apply(submit I,sets of plans w;'items checked):
0 New construction ❑Addition%alteration/replacement ❑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 CONSTRUCTION exceeds 10.000 amps at 150 volts or 0 Floating bmiidiugs.
less to ground.or exceeds 14.60(1 0 Commercial-use agricultural
ElI-and 2-family dwelling 0 Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑ Multi-family 0 Master builder 0 Other: 0 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#:68160014 Job site address: 15109 Tierra Terrace IOOHP or more. ❑"A"."E"."I.2"."I-3".
0 Six or snore residential occupancy.units City/State/ZIP:Tigard/0R/97224 ❑Health-care facilities. 0 Recreational vehicle parks.
0 Hazardous localions. 0 Supply voltage for more than
Suitelbldg./apt.#: Project name:Trillium Hill ❑Sen ice or feeder MO mops or more 600 volts nominal.
Cross street/directions to job site:SW 109'h AVE AND SW Lady Marion dr FEE SCHEDULE
Doatption I Qt,, I Each I 'rural I '
New residential single-or multi-family dwelling unit.
Subdivision:Trillium Hill Lot 4: 14 Includes attached garage.
1,000 sq.ti.or less I 168.54 168.54 4
Tax mapiparcel#: 2S110DA11400 Ea.addT500 sq.ft.orportion 4 33.92 107.76 I
DESCRIPTION OF WORK Limited energy,residential 75.00 2
.._._ sq.ft.)
New single family home to be build-3138 snit,4 bedroom 2.5 bath home with Limited a ew(with above,multi-family 75.00 2
412 sqft 2 car garage with a 121 sq ft covered deck patio and 152 SQFT Front po. residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
181 PROPERTY OWNER I 0 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
Address: 1905 NW 169'h Place Suite 102 401 amps to 600 amps 200.34 2
City/State/ZIP:Beaverton/OR/97006 601 amps to 1,000 amps 301.04 '-
Phone:(503)213 4415 Fax:( )
Over 1,000 amps or volts 552.26 2
Temporary services or[ceders 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
® APPLICANT 01 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: Meghan Ticknor B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address: 1905 NW 169'h Place Suite 102 branch circuit
Each add'I branch circuit 7.42 --
City/State/ZIP:Beat'ertoa/0R/97006 Miscellaneous(service or feeder not included)
Phone:(503)213-440M Fax::( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: ntticknor@dwhontes.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Garner Electric
Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy ❑ See Page 2 2
Address:2890 SE Brookwood Ave panel,alteration.or extension.
Each additional inspection over allowable in any of the above
City/State/ZIP: Hillsboro,OR.97123 Additional inspection(I hr min) 66.25/hr
Phone:(503)648-4552 Fax:(503)642-7925 Investigation(I hr min) 90.00/hr
Industrial plant(I hr min) 78.18/hr
Email:permits@garnerelectric.com Inspections six which no fee is 90.00'hr
specifically listed CI hrnln)
CCB Lie: 121159 Electrical Lk SC Suprv.Lic.: 3707-S
ELECTRICAL PERMIT FEES
Suprv. Electrician signature,required: / / _ Subtotal:
Print name: Charles Gamer Date: 4/20/2021 0 Plan Review Required(25%of permit fee):
Stale surcharge(12%of permit fee):
( •
TOTAL PERMIT FEE:
Authorized signature: �' ), o�iA6�( This permit application expires If a permit is not obtained within ISO
Print name: Brittany Buri✓✓an Date: 4/20/2021 days after it has been accepted as complete.
' Number of inspections allowed per permit.
I;BuildingPamin.ELC PrmitApp ElR ERE.dee Rn'0617'2015 440-16157(11:05-COM WEB
,1 Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ti ~ t ° '. ` FEE SCHEDULE
E
Description tp. E.nch I
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
5kvaorless 100.70 2
Check Type of Work Involved:
s o i to 15 kva 133.56 2
n 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`,_6
® Heating, Ventilation and Air Conditioning solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
u Vacuum Systems* >100 kva-no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
Each additional inspection is 66:25/hr
n Other: charged at an hourly(I hr min)
Inspections for which no fee is 90,00/hr
specifically listed(S4 hr min
ELECTRICAL PERMIT FEES
COMMERCIAL WORK ONLY: subtotal(Enter on page 1):
Fee for each commercial system: S75.00 * Number of inspections allowed per permit_
(SEE OAR 918 309-0000)
Check Type of Work Involved:
n Audio and Stereo Systems
Boiler Controls
❑ Clock Systems
7 Data Telecommunication Installation
Ti Fire Alarm Installation
U HVAC
instrumentation
Intercom and Paging Systems
n Landscape Irrigation Control*
Medical
r Nurse Calls
L Outdoor Landscape Lighting*
E Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I\BwIdlnplPermits\ELC_PeimiuApp_ELR—ERE.Sec Rev OG;17/2015
Plumbing Permit ApplicatIO ECEIVE
Building Fixtures FOR OFFICE USE ONLY
City of Tigard � � 'T.' DDatee/Byy Permit No.:
• 13125 SW Ball Blvd.,Tigard,OR 97223 Plan Review
_ ' Phone: 503.718.2439 Fax: 503.598.19CITY OF TIGARD RecDateive Other Permit No.:
Inspection Line: 503.639.4175 Dam gay By. luris: See Page 2 for
f tCi11iD Internet: www.tigard-or.gov 3UILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
®New construction ❑Demolition For special information use checklist.
Description I Qty. I Ea. j Total I
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
® I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 1 437.78 437.78
SFR(3)bath 500.32
❑Accessory building 0 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:
Catch basin or area drain 18.76
Job site address:15109 Tierra Terrace
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard/OR/97224 Footing drain(no.linear ft.:230) Page 2 87.55
Suite/bldg./apt.no.: I Project name:Trillium Hill Manufactured home utilities 50.03
Cross street/directions to job site:SW 109`s AVE AND SW Lady Marion Dr Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: 1 Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision:Trillium Hill I Lot no.:14 Fixture or Item:
Tax map/parcel no.:2S110DA11400 Backflow preventer 1 31.27 31.27
Backwater valve 12.51
DESCRIPTION OF WORK
Clothes washer 1 25.02 25.02
New Single Family Home 3138 sqft 4 bedroom,2.5 bath with 412 sqft 2 car Dishwasher 1 25.02 25.02
garage and with a 121 sq ft covered deck patio and 152 sq ft front porch. Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name:David Weekley Homes Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:1905 NW 169t"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
® APPLICANT 2 CONTACT PERSON Interceptor/grease trap 25.02
Business name:David Weekley Homes Medical gas(value:$_) Page 2
Primer 12.51
Contact name:Meghan Ticknor Roof drain(commercial) 12.51
Address:1905 NW 169th Place,Suite 102 Sink/basin/lavatory 8 25.02
City/State/ZIP:Beaverton/OR/97006 Solar units(potable water) 62.54
Phone:(503)213-440$q Fax::( ) Tub/shower/shower pan 3 12.51 25.02
Urinal 25.02
E-mail:mscbiedler@dwhomes.com
Water closet 3 25.02
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
Phone:(503)324-0759 Fax:( ) Minimum permit fee: $72.50
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 name:Carolina Malmedal Date:04/19/2021 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:\Building\Permas\PLM11-PermhApp.doc 10/01/09 440-4516T(10/02/COM/WEB)
City of Tigard
I' COMMUNITY DEVELOPMENT DEPARTMENT
T 1 G A RD Building Permit Review — Residential
Building Permit #: M VTZQZI-00(7Z
Site Address: 15109 SW Tierra Terrace
Project Name: Trillium Hill Lot #: 14
Planning Review
Proposal: New house
kl Verify address/suite# active in Accela. ® In River Terrace: ® No ❑ Yes, River Terrace Review Addendum
Site Plan Elements: XErosion Control
®3 copies of site plan on 8-1/2"x 11" or 11 x 17"paper mit Retained trees with drip line and tree protection measures
®Drawn to scale(standard architect or engineer scale) ®Footprint of new structure(including decks)and FFE
®North arrow 4 Utility locations&easements(required for new and additions)
IKJSite address,project or subdivision name and lot number Sidewalk/driveway approach
®Applicant information(name and phone number) naLocation of wells/septic systems
®Lot dimensions and building setback dimensions R Street tree size,type and location
IaSquare footage of buildings to be demolished ®Street names
naxisting structures on site IN Corner elevations(2'contours if more than 4'differential)
Mot arca,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? WA
impervious area (applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? EYes ❑No
® Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified a No Received: ❑ Yes ❑ No
• Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑ Yes,applicant was notified b1:7 No Received: ❑ Yes ❑ No
® SDC Exemption for ADU applied for: ❑ Yes 1!L] No Received: ❑ Yes ❑ No
® Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes,applicant was notified X No Applied For: ❑ Yes ❑ No,stop intake
® Land Use Case#: ZON2018-00002 ® Zoning: R-4.5
® Required Setbacks: Front: 20 Rear: 15 Side: 5 Street Side: na Garage: 20
f7 Building Height. Max.Height: 30 Actual Height: 28
KI Landscape Area: 20 % Lot Coverage Max: 80
Entrance ®aSe o more than 8' from street-facing wall Il Parallel to street or offset 45 ess
Windows ma Minimum of all street-fac r '
Does not have a street
Garage BP Garage door is behind wi o,one of the following is met:
acing facade; Does not
❑ Door extends no more than 5'f: t extending beyond garage.
❑ Door extends no more than 5'£a I 'P� _... ___ • ow above garage on 2"d floor.
rya Garage door width is ❑ ■ 50%or less of facade less and includes 7 of following:
❑ Covered .. - Recessed entrance ❑ Wall offset ❑ 1'Roo e ❑ Roof offset
• mgles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof
• Accent siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcon
® Visual Clearance ® Urban Forestry Plan
® Sensitive Lands: ❑ Yes ❑ No Type:
® Conditions met prior to issuance of building permit
Notes: 1l,,
l: Approved By Planning: PIVIL6 Q Date: 4/27/2021
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:\Building\Forms\BI dgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: 04j22�202!
Site Plans: # 3
Building Plans: #
Building Permit#: [}'Enter building permit#above. ,-.,,/
Workflow Routing: (Planning V L Engineering Y Permit Coordinator - uilding
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.
R.-Building: original permit application,site plans,building plans, engineer and
beam calculations ay trust details,if applicable,etc.
Notes:
By Permit Technician: jG�i 7v, Date: Qli/, /aLf
Enginering Review
Slope at building pad: /2,
(conditions "Met"prior to issuance of building permit
2'Easements (encroachments)per engineering conditions of approval and plat
2- Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes C No
Assess Water Quantity Fee in-lieu: ❑ Yes Er-No
LIDA Facility on lot: ❑ Yes e'‹o
L/1 Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
2"Approved by Engineering: K $ Date: t/ zel z4"2/
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Permit Coordinator Review
XConditions "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 ,0 Does not apply
yr SDC Fees Entered: Wash Co Trans Dev Tax: yes ❑ N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: /Yes ❑ N/A
LIDA ❑ Yes /N/A
OK to Issue Permit
Approved by Permit Coordinator: 7 Date: 5(3/fr?
I:\Building\Forms\B1dgPermitRvw_RES_I22419.docx