Permit V!i
Plumbing Permit Applic ' IVED
Building Fixtures
Cityof Tigard "" Received -t
g PermitNo.. el
13125 SW Hall Blvd.,Tigard,OR 97223 Date/By. I '� ��
TIGARD Plan Review
Phone: 503.718.2439 Fax: 503. 91;i1 6 8f bola) A6G, Other Permit No.:
Inspection Line: 503.639.4175 ` `/ /'�A Date By
716 ARI) pRL11� PIING DIVISION Date Ready/By qa 1 Sup a Page2 or
Internet www.ti ardor, ov OA'��� +U ''�`/-'� Supplemental Information
g g Notified/Method
TYPE'OF WORT( ( fJ--tL- z0/"7 r'I „--.FEE* SCHEDULE
❑■ New construction 0 Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement , 0 Other: New I-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
I-and 2-familydwellingSFR(2)bath 437.78
❑ ❑Commercial/industrial
ID Accessory buildingSFR(3)bath 500.32
❑Multi-family
Each additional bath/kitchen 25.02
0 Master builder 0 Other:
Fire sprinkler(1,asz sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:12973 SW Meadowbrook Ln Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: Tigard,OR Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: 1 Project name: River Terrace NE No. 2 Bldg 4 Manufactured 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 ft.:_) Page 2
Water service(no.linear 11 ) Page 2
Subdivision: I Lot no.:18 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF'WORK Backwater valve 12.51
Clothes washer 25.02
MULTIPURPOSE FIRE SPRINKLER SYSTEM Dishwasher 25.02
PERMIT# MST2021-00049 Drinking fountain 25.02
UNIT PLAN# D15 Ejectors/sump 25.02
iii,PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name: Taylor Morrison
Floor drain/floor sink/hub 25.02
Address: 703 Broadway Street Suite 710 Garbage disposal 25.02
City/State/ZIP: Vancouver,WA 98660 Hose bib 25.02
Phone:( 360)816-7788 Fax:( ) Ice maker 12.51
0 APPLICANT ® CONTACT PERSON Interceptor/grease trap 25.02
Business name: Alliance Plumbing, LLC Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: Gavin Thomes Roof drain(commercial) 12.51
Address: 146 W Historic Columbia River Hwy sink/basin/lavatory 25.02
City/State/ZIP: Troutdale,OR 97060 Solar units(potable water) 62.54
Phone:( 503) 577-6535 Fax::( ) Tub/shower/shower pan 12.51
E-mail: gavin@allianceplumbing.net Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name: Alliance Plumbing, LLC Water piping/DWV 56.29
Address:146 W Historic Columbia River Hwy Other: 25.02
City/State/ZIP: Troutdale,OR 97060 Subtotal
Phone:( 503)492-3490 Fax:( ) Minimum permit fee. $72.50
Plan review (25%of permit fee)
CCB Lic.:184601 Plumbing Tic.no.:PB732
State surcharge(12%of permit fee)
Authorized signature: / -----�� TOTAL PERMIT FEE /y4_s3
Print name:Gavin Thomes Date:6,14.2021 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 VBuilding1 Permits 1PLMU-PermitApp.doc 10/0I/09 440-4616T(I 0/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee:
Footing drain-1"100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52 Valuation: Permit Fee:
Storm&Rain Drain-I st 100' 62.54
$1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72 50 for the first$5,000.00 and$1.52 for
Other Inspections or Fees Qty.' Fee(ea) Total each additional$100.00 or fraction thereof,to
h and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*. Plan Review for Plumbing jestallatioes
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate PP Y•
Baptistry/Font ❑ Any new commercial building with water service 2"and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
-Jacuzzi/Whirlpool engineer.
❑
Car Wash: Each Stall New exterior plumbing site utilities for any complex structure
Drive Thru as defined in OAR918-780-0040.
CICuspidor/Water Aspirator Medical gas and vacuum systems for health care facilities.
Dishwasher Commercial ❑ Any multipurpose fire sprinkler system.
Domestic ❑ Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink -2"
Isometric or Riser Diagram
❑ Isometric or riser diagram is required for new buildings
-Car Wash Drain
Garbage Domestic non-food that meet the qualifications above.
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -Lay/Bar non-food related
-Bradley
-Com/Serv/Util food related
-Service *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and
Washer-Clothes fees assessed for the sewer increase must be paid before the
Water Extractor
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures.
I:1Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
rpq CITY OF TIGARD MASTER PERMIT
I' COMMUNITY DEVELOPMENT Permit#: MST2021-00049
Date Issued: 06/08/2021
T[GAR.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S106ACO2100
Jurisdiction: Tigard
Site address: 12973 SW MEADBROOK LN
Subdivision: RIVER TERRACE EAST 3 Lot: 262
Project: River Terrace Northeast No.2, Lot 18
Project Description: New attached dwelling
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 2 First: 284 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 36 Bathrooms: 4 Second: 594 sf Garage: 233 sf Front: 10 Smoke
Dwelling Units: 1 Third: 584 sf Right: 0
Detectors: Yes
Total: 1462 sf Value: $192,437.69 Rear: 5
PLUMBING
Sinks: 2 Water Closets: 4 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer. 100
Drains: 0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckfw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: 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: 2
Fum>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add,500 sf: 2 201-400 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 SFA VB R-3 1462
Owner: Contractor:
POLYGON WLH LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
703 BROADWAY ST STE 510 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98660 VANCOUVER,WA 98660
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $27,070.20
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.
Wray VLLM,V eA4)€�
Issued By: PermitteeSignature: o Ft/Appi cax'wvt
Call 503.839A175 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
f Residential - VEii D �/ 7 FOR OFFICE USE ONLY 7
City of Tigard 'LC) 1. L�2.! Date/By U Received An �Q f� (� PemutNo.MD 2(el'' 'aO99
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
J • Phone: 503.718.2439 Fax: 503.598.1960 iDateBy. '2�21 other Permit 38
c.Ty OF i !\iS!its
Inspection Line: 503.639.4175 r+ Date ReadyBy i t�tT�� ® See Page 2 for
1 c� \It 11 r,l���-'�j:1'(-' nil/i,"Ql�f\I •.otified/Method' ! / t �,C VI Supplementale 2 Information
Internet: www.tigard-or.gov
//L. ' . �derde, - i
TYPE OF WORK REQUIRED DAT .1-AND 2-FAMILY DWELLING
®New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $ 9 2*--t --1 t
® 1-and 2-family dwelling ❑Commercial/industrial
❑Accessory building El Multi-family
Number of bedrooms: 2.
❑Master builder ❑Other: Number of bathrooms: " Li
JOB SITE INFORMATION AND LOCATION Total number of floors: 3 " I. J2°t
Job site address: 12973 SW MEADBROOK LN New dwelling area: )j 62, square feet Say
City/State/ZIP:Sherwood, OR 97140 Garage/carport area: £33 square feet 51
Suite/bldg./apt.no.: Project name:River Terrace 1$/341\1014AFM' Covered porch area: square feet 2$
Cross street/directions to job site: Deck area: ' Z- square feet
othvontr_ecad (.42, square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:River Terrace BW�3.4/c, Z I Lot no. 18 Permit fees*arc based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Single Family Attached Building#4 lots 15-20 Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name:Polygon Homes WLH, LLC Type of construction:
Address:703 Broadway St., Ste 510 Occupancy groups:
City/State/ZIP:Vancouver, WA 98660 Existing:
Phone:(360 695-7700 Fax:(360)693-4442 New:
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Pleaserejerto{eescheduie)
Business name:Polygon Homes WLH, LLC
Structural plan review fee(or deposit):
Contact name:Omar Alami Abouhafs
FLS plan review fee(if applicable):
Address:703 Broadway St., Ste 510
Total fees due upon application:
City/State/ZIP:Vancouver, WA 98660
Amount received:
Phone:(360$95-7700 Fax: :( 360) 693-4442 PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:permitsubmittals@taylormorrison.com
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Polygon Homes WLH, LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:703 Broadway St., Ste 510 Solar Installation Specialty Code checklist.
City/State/ZIP:Varlcouver WA 98660 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(360-695-7700 Fax:(360 )693-4442 State surcharge(12%of permit fee): $21.60
CCB lic.: 207247 Total fee due upon application: $201.60
Authorized signature: Omar Alami Abouhafs This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Omar Alami Abouhafs Date: 02/10/21 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
rl
Mechanical Permit Applicati�}I{� qR/g}p�y w � �; FOR OFFICE USE ONLY UQ
® 1��LS� !P " ,GY.�` Received g5T+--IJ�.(..oUr/ t t
City of Tigard Date/By: Permit No.:
't 13125 SW Hall Blvd.,Tigard,OR 97223 FEB 1 .' Plan Review
• Phone: 503.718.2439 Fax: 503.598.1960 ® f Date/By. Other-Permit:
Y I ih: 1• Inspection Line: 503.639.4175 r Date Ready/By: ]ork: 0 See Page 2 for
Internet: www.ti and-or. ov CITY Or I i�x,y.:-
g g BU1 r/'N( Notified/Method: Supplemental Information
I 1 � fll\li,' ..-l=,
TYPE OF WORK COMMERCIAL FEE* SCHEDULE.- USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑ Other. mechanical materials,equipment,labor,overhead,and profit.
Value:S
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® I-and 2-family dwelling ❑Commercialindustrial ❑Accessory building For special information use checklist
j Multi-family ❑Master builder ❑ Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 1 46.75
Job site address: 12973 SW MEADBROOK LN Furnace 100,000 BTU(ducts/vents) 46.75
City/State/LIP:Tigard,OR 97224 Furnace 100,000+BTU(due s/ve¢ts) 54.91
Suite/bldg./apt.no.: Project name: River Terrace 1 B/3C Heat pump _ 61.06
Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended.etc. 46.75
Flue/vent for any of above 23.32 _
Subdivision: Lot no.: 18 Other. 23.32
Roshak Ridge Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
ElPROPERTY OWNER 0 TENANT Other: 23.32
• Environmental exhaust and ventilation:
Name:Polygon WLH,LLC Range hood/other kitchenI
equipment 33.39
Address:703 Broadway St.,Ste.510 Clothes dryer exhaust 33.39
City/State/ZIP:Vancouver,WA 98660 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(360)695-7700 Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name:Polygon WLH,LLC
S14.15 for first four;S4.03 for each additional
Contact name:Tonja Morris Furnace,etc.
Address:703 Broadway St,Ste 510 Gas beat pump
- W'all/suspended/unit heater
City/State/ZIP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 Fax::(360)693-4442 Fireplace
Ranee
E-mp i l:permitsubmittals(A LJO r❑orriso❑III)❑ Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Pro Heating&Cooling Other:
MECHANICAL PERMIT FEES*
Address: NW Alociek Dr,Ste.1104 Subtotal
City/State/ZIP:Hillsboro,OR Minunum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(360)270-1590 Fax:( ) State surcharge(12%of permit fee)
CCB lie.:209001 TOTAL PERMIT FEE
This permit applicatloo expires if a permit is not obtained within 188
A. a hUi days after it has been accepted as complete.
Authorized signature: W J ` Fee methodology ses by TO-County Building Industry Service Board
Print name:Elia Duran Date: O/3O/2O
Electrical Permit Applicat CF
I I �D Ft,II 01 TICE USE ONLY
City of Tigard R
20 L1 Re eived
13125 SW Hall Blvd.,Tigard,OR 972i3EB plan Review r
5 Phone: 503,718.2439 Fax: 503.598.19 R DateB : Related Permit#:
Inspection Line: 503.639 4175 t~I 1 1 OF TIS rtD Sarss.
p s r, (�R Ready Date/By: ® bee Page 2 for
I-I f;A RD. �r ,,; r-, nF'. {-'41,(i �,.16t Notified/Method: Supplemental Information
Internet: www.ligard-or.gov PP
TYPE OF WORK 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 snore 0 Building over three stories,
❑Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
® 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder El Other: ❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address:12973 SW MEADBROOK LN I00HP or more. ❑"A","E", 'l.2","1.3",
City/State/ZIP: Tigard OR 97224 ['Six or more residential wits. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: River Terrace 1 B/3C 0 Hazardous locations. 0 Supply voltage for more than
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Each I Total ) *
New residential single-or multi-family dwelling unit.
Subdivision: Roshak Ridge Lot#:18 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92
DESCRIPTION OF WORK Limited energy,residential
(with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
ID PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: Polygon Homes WLH, LLC 200 amps or less 100.70 2
Address: 703 Broadway St., Ste 510 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: Vancouver,WA 98660 601 amps to 1,000 amps 301.04 2
Phone:(360 )695-7700 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:permitsubmittals@taylormorrison.com relocation
Owner installation: This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
® APPLICANT ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: Polygon Homes WLH, LLC above service or feeder fee, 7.42 2
each branch circuit
Contact name: Omar Alami Abouhafs B.Fee for branch circuits without
service or feeder fee,first
Address: 56.18 2
703 Broadway St., Ste 510 branch circuit
City/StatelZlP: Vancouver WA 98660 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(360 )816-7800 Fax: :( ) Each manufactured or modular 67.84 2
Email: permitsubmittals@taylormorrison.com dwelling,service and/or feeder
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Portland Electric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy ❑ See Page 2 2
Address: 1915 E 5th St., Ste D panel,alteration,or extension.
City/State/ZIP: Vancouver, WA 98661 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:( 360)314-4915 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:paul@portlandelectric.biz Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lie.: 194066 Electrical Lie.: C760 Suprv.Lie.: 4920,gg specifically listed('V,hr min)
p- ELECTRICAL PERMIT FEES
n1.CC
Suprv.Electrician signature,required: 1C .x f,a Subtotal.
Print name: Alex Shalya D :10/30/20 ❑Plan Review Required(25o/a of permit fee):
� State surcharge(12%of permit fee):
Authorized signature: 'y I I�/� iAdu(JIL.f c4, TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Sergey Mishchuk Date:10/30/20 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I.\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06,17/2015 440-4615T(11/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Description I Q1y. I Each I Total •
Fee for all residential systems combined: $75.00 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 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 2
n Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* 1
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:
n Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(Yz hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
(SEE OAR 918-309-0000) Number of inspections allowed per permit.
Check Type of Work Involved:
n Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
n Fire Alarm Installation
n HVAC
nInstrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
n Nurse Calls
n Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
11DuildinglPermits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015
Plumbing Permit Application
,
Building Fixtures RECEIVED FOR OFFICE USE ONLY �J 1/ �(��y�,s�
Cityof Tigard Received T LOL I KN
' g 2021 Permit No.:
q 13125 SW Hall Blvd.,Tigard,OR 97223 FEB 1 0 Plana Rev
® Review
Phone: 503.718.2439 Fax: 503.598.1960 Other Permit No.:
Inspection Line: 503.639.4175 CITY OF TIGARD Date/By:
TIGARD Internet: www.tigard-or.gov ION Date Ready/By: kris: El See Page 2 for
Internet:
BUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
®New construction 0 Demolition For special information use checklist.
Description Qty, I Ea. I Total
0 Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 I
`
(�l-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building 4;1-Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder ❑Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 12973 SW M EADBROO K LN Catch basin or area drain 18.76
DCity/State/ZIP:Tigard,OR 97224 rywe ,leache,or trenchdrain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: River Terrace 1 B/3C Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear fi.: ) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: J Lot no.: 18
Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNERI. 0 TENANT Expansion tank 12.51
Name:Polygon WTH,LLC Fixture/sewer cap 25.02
Floor drain/floor sinkdhub 25.02
Address:703 Broadway St.,Ste 510 Garbage disposal 25.02
City/State/ZIP:Vancouver,WA 98660 Hose bib 25.02
Phone:(360)695-7700 Fax:( ) Ice maker 12.51
® APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:Polygon WLH,LLC Medical gas(value:$ ) Page 2
Contact name:Tonja Morris
Primer 12.51
Roof drain(commercial) 12.51
Address:703 Broadway St.,Ste 510 Sink/basin/lavatory 25.02
City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54
Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51
E-mail: permitsubmittals@taylormorrison.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:G&B Plumbing&Sons Inc Water piping DW V 56.29
Address:P.O.Box 92 Other: 25.02
City/State/ZIP:St.Paul,OR 97137 Subtotal
Phone:(503)868-1417 Fax:(971)727-8170 Minimum permit fee: S72.50
CCB Lie.:184372 Plumbing Lic.no.:pb634 Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name:Steve Fowler Date: 10/30/20 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.
t:1Buildioe1Permits1PLMU-PermitApp.doc 10/01/09 440-46 I6Tt 10,02/COM/WEB)
City of Tigard
4 COMMUNITY DEVELOPMENT DEPARTMENT
' C
T 1 G A R D Building Permit Review — Residential
Building Permit #: 1,4 STZOZI -000 q9
Site Address: /29?-3 SW Meadowbrook Lane
Project Name: River Terrace Northeast Lot #: /6
Planning Review
Proposal: New rowhome
0 Verify address/suite# active in Accela. 0 In River Terrace: ❑ No 0 Yes,River Terrace Review Addendum
Site Plan Elements: '' ion Control
111: copies of site plan on 8-1/2"x 11"or 11 x 17"paper tained trees with drip line and tree protection measures
0 P rawn to scale(standard architect or engineer scale) Footprint of new structure(including decks) and FFE
0 orth arrow • jJtility locations&easements(required for new and addition's)
rill.ite address,project or subdivision name and lot number "-i' -walk/driveway approach
CI pplicant information(name and phone number) ).$.cation of wells/septic systems
O .t dimensions and building setback dimensions ?treet tree size,type and location
Ii.quare footage of buildings to be demolished •Street names
ii :sting structures on site ,_,:orner elevations (2'contours if more than 4'differential
O it area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? jes o
impervious area (applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ( (i'es r o
0 Clean Water Services —Service Provider Letter (lot platted prior to 9/10/1995):
Required: ❑Yes,applicant was notified 0 No Received: ❑ Yes ❑° No
Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑ Yes,applicant was notified 0 No Received: ❑Yes Cl No
❑ SDC Exemption for ADU applied for: 0 Yes 0 No Received: ❑Yes 0 No
0 Public Facilities Improvement (PFI)Permit:
Required: 0 Yes,applicant was notified ❑No Applied For. 0 Yes 0 No,stop intake
0 Land Use Case #: PDR201 6-0001 3, MMD2020-00030 5 zoning: R-25
0 Required Setbacks: Front: 5/10 Rear: 5 Side: Street Side: A-in—Garage: 20
0 Building Height Max.Height: N/A Actual Height: 36 J
O Landsca e Area: 20 % 0 Lot Coverage Max: 80
0,4
Entrance ack no more than 8'from street-facing wall 0 Parallel to street o et 45 degrees or less
Windows Minimum ° of area of all street-facing facades
Garage Gara door is behin ' st street-facing wall \ s No,one of the following is met:
Door extends no more di ' om wall and 's a covered porch extending beyond garage.
Door extends no more than 5'from d there is a 12 sq ft.window above garage on 22d floor.
❑ Gara e door width is 12'o 50%or e acade 60%or less and includes 7 of following:
Covered porch ecessed entrance 0 Wall offset 1'Roof eave Roof offset
Fire s ' Lap Siding CIRoof itch 0 Gable,hi , brel roof Dormer
ccent siding Window trim U Window recess U Window pr ' n 0 Balcony
1 'Visual Clearance 0 Urban Forestrq Plan
k 4ensitive Lands: 0 Yes LI No Type:
\ -
C ditions met prior to issuance of building permit
No s•Outstanding conditions under PDR2016-00013; do not i
ssuQ until lr�-plat recorded under MMD202 -000 0
Approved By Planning: _ Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:1Buil ding\Forms\Bl dgPennitRvw_RES_122419.docx
Building Permit Submittal N.
Original Submittal Date: Q dQ 20z/
Site Plans: # ,7
Building Plans: Lvl � ,�
Building Permit#: Enter buildin ,�``pe�rmit#above. I� � nI- Building
Workflow Routing: �[Planning LW'Engineering L0._Permit Coordinator I Building
Workflow Sign-off: I. t 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.
L!1,Building. original permit application,site plans,building plans,engineer and
beam calculations an st details,if applicable,etc.
Notes:
By Permit Technician: Date:
En ineering Review
[S Slope at building pad: 2 Z.
❑ Conditions "Met"prior to issuance of building permit �7�
17"Easements (encroachments) per engineering conditions of approval and plat
V Water Quality/Quantity Facility: Er
Assess Water Quality Fee in-lieu: ❑ Yes LI�rI/No
Assess Water Quantity Fee in-lieu: ❑ Yes 1E 1Vo
�,� LIDA Facility on lot: ❑ Yes 1 1'No
LW Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
MJ Approved by Engineering: Date: 2 e/
Revisions(after Building Submittal only) Reviewer Date
Revision 1: 0 Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
E. Approved,NOT Released: Way j os., 01�- -ryy-t , Date: 2- J2 ?4
Notes:
Revisions(after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
ffSDC Exemption: ❑ Received Does not a ly
SDC Fees Entered: Wash Co Trans Dev Tax: Yes U N/A
Tigard Trans SDC: 1 Yes ❑ N/A
Parks SDC: Yes ❑ N/A
LIDA ❑ Yes ,®,N/A
ZOK to Issue Permit
Approved by Permit Coordinator: Date: (io' i
L\Building\Forms\Bl dgPermitRvw_RES_122419.docx
City of Tigard
•
r COMMUNITY DEVELOPMENT DEPARTMENT
C_
T[G A R D River Terrace Building Permit Review Addendum
Building Permit #: Pt STZQZ( -0604q
Site Address: 1.29 -3 SW Meadowbrook Lane
Project Name: River Terrace Northeast Lot #: /
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan District Design Standards (18.640 070.1.):
Is the project subject to the plan district design standards? 0 Yes ❑No
1.Articulation: a minimum of 1 element per each street-facing facade that has 30-60 ft. of frontage.An additional
element required for lots with over 60 ft. of street frontage shall be provided every 30 ft.
Porch rein. 5 ft. deepBalcony w/ access 2 Window Projection Vertical Wall Offset a
❑ ft. deep❑ min. 2ft.,5❑ft wide min. 2 ft.,6 .wide Gabled dormey�
gigE& PewT-*i2t /L
2. Eyes on the street: a minimu o#�%D f each street facing facade must include windows or entrance doors.
Percentage Shown: /
3. trances:At least one entrance must meet both of the folio mg standards:
Max. 8 ft. setback from long t street- facing wall Parallel to street,angle no more than 45° from street,
or op onto porch
En nce opens to a porch: Yes 0 No
If es all the following apply: """""",,,////��sq.ft.min.
e street facing entryBid
En
max. roof above floor of porch
5 ft. depth min. 30%min. porch roof coverage
4. Detailed Design:All buildings shall include a min. of five of the following elements on all street-facing facades:
overed porch min. 5 ft.wide x 5 ft. deepve
0 Recessed entry area min. 5 ft. wide x 2 ft. deep
all offset min. 16 inches ❑ ormer min. 4 ft.wide
VJ Roof eave min. 12 inch projection f,..)- � oof offset min. of 2 ft -
❑Roof shingles either tile or wood L✓J 'able,hip or gambrel roof design fi -is
ElRoof pitch oriented south min. 500 sq. ft. 3frlorizontal lap siding min. 3-7 inches wide'F'4"t
ElAccent siding min. 40% of street facade VWindow trim min. 21/z"wide by 5/8"deep'p'f.i
❑Window recess min. 3 inches for all street facing ❑Bay window min. 5 ft.wide by 2 ft. deep
❑Balcony min. 5 ft.wide x 3 ft. deep with inside access 0 Attached garage is 35%or less of street facade
5. Garages and Carports: May face the front or side lot line on a cor r lot.
Setbacks:
No closer to front or side lot line, than longest street-facing wall. Yes ❑No. If No (Check one):
ElMay extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch.
❑May extend up to 5 ft.where the garage is part of a two-story building and there is a window at the second story
above the garage that faces the street with a min. area of 12 sq.ft.
Wi : (Check one)
12-foot-wide garage door 0 40%max. of street facade
0 50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: — Date: --V ,2�
1'.\Bui ldingworms\hldgpermitRvw_RES_RT_121417.docz