Permit Plumbing Permit Applicti,A 'VE®
Building Fixtures
Received h
City of Tigard ` "i b .� PennitNo.: � 1-
IIIIII . • 13125 SW Hall Blvd.,Tigard,OR///9 123 17GARD Date/By:
jt Plan Review
, Phone: 503.718.2439 Fax: 503. 8'.1.96 Date/By: g f/OAi 4c Other Permit No.:
Inspection Line: 503 639.4175 GUI! flING DIVISION
T I G A R D v Date Ready/By �1 J ® See Page 2 for
Internet: www.tigard-or got Notified/Method �( �/ ' Supplemental Information
TYPE OF WORK 6 /G--. 1 /'-7 ' FEE* SCHEDULE
p New construction ❑Demolition For special information use checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement ❑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 SFR(2)bath 437.78
❑ y g ❑Commercial/industrial
El Accessory buildingSFR(3)bath 500.32
❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler(2,069 sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Catch basin or area drain 18.76
Job site address:12991 SW Meadowbrook Ln
Drywell,leach line,or trench drain 18.76
City/State/ZIP: Tigard,OR Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name: 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 II.:_) Page 2
Subdivision: Lot no.:16 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# MST2021-00047 Drinking fountain 25.02
UNIT PLAN# D20 Ejectors/sump 25.02
n PROPERTY OWNER l 0 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 iii CONTACT PERSON Interceptor/grease trap 25.02
Business name: Alliance Plumbing, LLC Medical gas(value:$ ) Page 2
Primer 12.5 I
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 Lie.:184601 Plumbing Lie.no.:PB732
State surcharge(I 2%of permit fee)
Authorized signature: �����
TOTAL PERMIT FEE I�Gt'.q(4,
This permit application expires if a permit is not obtained within 180 days
Print name:Gavin Thomes Date:6.14.2021 after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I.ABuildingVPermitsVPLMU-PermitApp.doc I0/01/09 440-46 11/Tl 10/02/C'OM/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-I"100' 50 03 0 to 2,000 $121.90
Footing drain-each additional 100' 37 52 2,001 to 3,600 $]69.69
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 Inspect•ions or Fees QtY. Fee(ea) Total 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 90.00/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 Installations
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
❑ Any new commercial building with water service 2"and
Baptistry/Font greater.except systems designed and stamped by licensed
Bath: -Tub/Shower
engineer.
-Jacuzzi/Whirlpool
❑Stall New exterior plumbing site utilities for any complex structure
Car Wash: -Each
to as defined in OAR918-780-0040.
-DrivElCuspidor/Water Aspirator Medical gas and vacuum systems for health care facilities.
Dishwasher Commercial ❑ Any multipurpose fire sprinkler system.
Domestic El 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"
3" 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: -Lav/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
Water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
1:ABuilding\Permits\PLMF_PermitApp.doc 08/04/2011 2
1 _ CITY OF TIGARD MASTER PERMIT
11 -.- ' COMMUNITY DEVELOPMENT Permit#: MST2021-00047
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/08/2021
Parcel: 2S 106AC01900
Jurisdiction: Tigard
Site address: 12991 SW MEADBROOK LN
Subdivision: RIVER TERRACE EAST 3 Lot: 260
Project: River Terrace Northeast No.2, Lot 16
Project Description: New attached dwelling
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 3 First: 352 sf Basement: 0 sf Left 0 Parking Spaces: 0
Height: 36 Bathrooms: 4 Second: 684 sf Garage: 231 sf Front 10 Smoke
Dwelling Units: 1 Third: 1033 sf Right: 0
Detectors: Yes
Total: 2069 sf Value: $267,355.81 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
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0
Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Testes 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: 2
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't 500 sf: 3 201-400 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 V8 R-3 2069
Owner: Contractor:
POLYGON WLH LLC WLLIAM 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 98860 VANCOUVER,WA 98680
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $29,456.78
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 503.232.1987torr 1.800.332.2344.
Issued By: Rally Vary D Z W Permittee Signature:ege 0vvAp'l'CattaV
Call 503.039.4175 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
Residential RECEIVE p FOR OFFICE USE ONLY
Received permit No.'City of Tigard Date By O rzr '� sTZoZI-000�7
• e • 13125 SW Hall Blvd.,Tigard,OR 97223 FEB 1 0 2021 PlanReview3 A� tsilvif 7J2 .-oipy 3/Phone: 503.718.2439 Fax: 503.598.1960 Date/By: rl r` other Pe nv Wr VLr t CJ W
Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: /'t h+�+�„ ® See Page 2 for
I-WARD
No al/Method: 1 1{Q Supplemental Information
Internet: www.tigard-or.gov KM DING DDV'S!O;d ��
TYPE OF WORK REQUIRED DATA: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
work indicated on this application. y�
CATEGORY OF CONSTRUCTION r �I 3 56,
p�
Valuation: $ (p
® 1-and 2-family dwelling ❑Commercial/industrial
El Accessory building El Multi-familyNumber of bedrooms: 3
LI
❑Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors: )( 3 2
Job site address: 12991 SW MEADBROOK LN New dwelling area: Z9 square feet 10?3
City/State/ZIP:Sherwood, OR 97140 Garage/carport area: A 3 f square feet 14?,y
Suite/bldg./apt.no.: Project name:River Terrace 1.8/-3Enewci— Covered porch area: square feet 35a
Cross street/directions to job site: Deck area: 5141:2 square feet
Othtt9tiuttr gtlegvLc (e square feet
REQKBED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:River Terrace,Afea-3--. a I Lot no. 16 Permit fees"are 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/Z1P:Vancouver, WA 98660 Existing:
Phone:(360 695-7700 Fax:(360)693-4442 New:
® APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule_)
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
Phone: Fax: :( 360) 693-4442 Amount received:
(360 �95 7700 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:Vancouver WA 98660 Permit Fee(includes plan review $180.00
Y 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: $201.60
Authorized signature: Omar Alami Abouhafs This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Omar Alami Abouhafs Date: 02/10/21 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Application 9 FOR OFFICE USE ONLY
• b RECEIVE:• Permit Na. sT2O�.._600 ! f
Cl of Tigard eceived / I
ateBy:
" 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 DaleBy: Other Permit:
Y1Lia lili Inspection Line: 503.639.4175 FEB 10 2021 Dale Ready/By tuns:
r
Internet: www.tigard-or.gov Notified/Method: Supplemental See Page 2 Inf
CITY OF TIGAFRD Information
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE' SLHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead.and profit.
Value:$
CATEGORY.OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® I-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist
1 j Multi-family 0 Master builder ❑Other: Description I Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning ( 46.75
Job site address: 12991 SW MEADBROOK LN -
Furnace 100,000 BTU(duets/vents) 46.75
City/State/4 P:Tigard,OR 97224 Furnace 100,000 I BTU(ducts/vents) 54.91
pump
Suite/bldg./apt.no.: Project name: River Terrace 1 B/3C Heat
Duct work work 61.06
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
Other. 23.32
Subdivision: Roshak Ridge Lot no.: 16 Other fuel appliances:
Tax map/parcel no.: Water heater 23.32 1
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water beater 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
® PROPERTY OWNER ❑ TENANT Other. 23.32
- Environmental exhaust and ventilation:
Name:Polygon WLH,LLC Range hood/other kitchen
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 ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name:Polygon WLH,LLC 514.15 for first four;S4.03 for each additional
Contact name:Tonja Morris Furnace,etc.
Address:703 Broadway St.,Ste 510 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 Fax: :(360)693-4442 Fireplace
Ranee
E-mail:permitsubmittalset®®r❑orriso DEb❑ Barbecue
,I 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 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(360)270-1590 Fax:( ) State surcharge(12%of permit fee)
CCB lic.:209001 TOTAL PERMIT FEE
[" This permit application expires if a permit is not obtained within 180
GA: �u n days after it has been accepted as complete.
Authorized signature: W 'a'�' * Fee methodology set by Tri-County Building Industry Service Board
--.--..--- .
Print name:Elia Duran Date: 10/30/20
Electrical Permit Application FOR OFFICE l'SF:O\I,1
City of Tigard RECEIVE Received Penult#. S ' a''IIQ
U 13125 SW Hall Blvd.,Tigard,OR 97223. Date/By:: ��'-(.�m-!-ado 7
Phone: 503.718.2439 Fax: 503.598.1960 FEB 1 0 2021 Plan Review
Date/By: Related Permit n:
Inspection Line: 503.639.4175 _ Ready DateBy: funs: El See Page 2 for
I 11,1 R 1) Internet: Www.tlgard-OGgev STY E- I i F1r`)i.,l Notified/Method: Supplemental information
TYPE OF WORRt' :� v,," ' ' PLAN REVIEW
®New construction ❑ Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
O Service or feeder 400 amps or more ❑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 buildings.
® 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
❑Multi-family ❑Master builder amps for all other installations. buildings.
❑Other: ❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 1 ❑Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address:12991 SW MEADBROOK LN loot-IP or more. ❑"A","E "I-2","1-3",
City/State/ZIP: Tigard OR 97224 0 Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: River Terrace 1 B/3C ❑Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE;SCHIEDULE
Desolation I Qty. I Each I Total I *
New residential single-or multi-family dwelling unit.
Subdivision: Roshak Ridge Lot#:16 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
(with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
Cl 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
El 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
sAddress: 703 BroadwaySt., Ste 510 branch
it feederitfee,first 56.18 2
branch circuit
City/State/ZIP: Vancouver WA 98660 Each add'l branch circuit 7.42 2
Phone: 360 8167800 Miscellaneous(service or feeder not included)
( ) - Fax::( ) Each manufactured or modular
Email: permitsubmittals@taylormorrison.com
dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
,,,. �,l„ ' r P + ;: r"':",2,,; " ACTOR Pump or irrigation circle 67.84 2
Business name: Portland Electric Sign or outline lighting 67.84 2
Address: 1915 E 5th St., Ste D Signalnl,circuit(s)o or limited-energy
0 See Page 2 2
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/In
Industrial plant(1 hr min) 78.18/hr
Email:paul@portlandelectric.biz Inspections for which no fee is
CCB Lic.: 194066 Electrical Lic.: C760 Suprv.Lic.:
4920(61 speci fically listed('/,hr min 90.00/hr
Suprv.Electrician signature,required: ��] QA�� ELECTRICAL PERMIT FEES
l/1.c.eA., fIQ-_,G[ Q. Subtotal:
Print name: Alex Shalya Date:'I(�/30/20 0 Plan Review Required(25%of permit fee):
.l0� - 0 - 0 L State surcharge(12%of permit fee):
Authorized signature: ...k , �(A- TrtL�aNL.iJ/1.ul, TOTAL PERMIT FEE:
Thu permit application expires if a permit is not obtained within 180
Print name: Sergey Mishehuk Date:10/30/20 days after it has been accepted as complete.
• Number of inspections allowed per permit.
IaBuilding/Permits\ELC_PermitApp ELR_ERE.doe Rev 06/17/2015 440-4615T(Il/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
Fee for all residential systems combined: $75.00 Description I Qty. Each I Total I
y Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
n A• udio 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
❑ Garage Door Opener* 50.01 to too kva 552.26 2
>100 kva(fee in accordance 552.26 2
with OAR 918-309-0040)
n Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
❑ V• acuum 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 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed('fr hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Subtotal(Enter on Page l):
Fee for each commercial system: $75.00
' Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
n A• udio and Stereo Systems
n B• oiler Controls
El Clock Systems
❑ Data Telecommunication Installation
El Fire Alarm Installation
❑ HVAC
❑ Instrumentation
El 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
I'\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015
• Plumbing Permit Application
Building Fixtures `' FOR OFFICE USE ONLY
City of Tigard RECEIVE DareBy: Permit No.: STz021-cror)(i7
;, a 13125 SW Hall Blvd.,Tigard,OR 97223
s Phone: 503.718.2439 Fax: 503.598.1960FEBPlan Review
1 0 2021 Date By: Other Permit No.:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: Jrufs: H See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
TYPE OF woRKRUILDINU UIVISIUN FEE* SCHEDULE
®New construction ❑Demolition For special information use checklist
Description Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
XI-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
❑Accessory building %Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 12991 SW MEADBROOK LN Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97224 Drywall,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: ' 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 ft.:_) Page 2
Storm sewer(no.linear ft.: ) Page 2 1
Water service(no.linear ft.:_) Page 2 1
Subdivision: I Lot no.: 16 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 OWNER l ❑ TENANT Expansion tank 12.51
Name:Polygon WLH,LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 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:S ) 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/DWV 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 Lic.: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.
I:tBuBdincTemirs,PLMU.PermitA.pp.doc 10/01/09 44046I6T(10IO2/COMIWEB)
it City of Tigard
V COMMUNITY DEVELOPMENT DEPARTMENT
i
' Building Permit Review — Residential
IIGARI)
Building Permit #: 143Y2O21•Q 00 4 7
Site Address: /.2 9g/ SW Meadowbrook Lane
Project Name: River Terrace Northeast Lot #: J(to
Planning Review
Proposal: New rowhome
❑ Verify address/suite # active in Accela. ❑ In River Terrace: ❑ No ❑r Yes,River Terrace Review Addendum
Site Plan Elements: ° sion Control
�: copies of site plan on 8-1/2"x 11"or 11 x 17"paper �tained trees with drip line and tree protection measures
IS prawn to scale(standard architect or engineer scale) botprint of new structure(including decks)and FFE
IS orth arrow ./Jtility locations&easements(required for new and addition's)
:Lite address,project or subdivision name and lot number '''i ewalk/driveway approach
0 pplicant information(name and phone number) cation of wells/septic systems
el .t dimensions and building setback dimensions ,Street tree size,type and location
• t 1i.quare footage of buildings to be demolished street names
II xisting structures on site '"Comer elevations (2'contours if more than 4'differential
CI .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):
otRequired: ❑Yes,applicant was notified ❑r No Received: ❑ Yes ❑r No
Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑Yes,applicant was notified ❑r No Received: ❑ Yes ❑r No
❑ SDC Exemption for ADU applied for: ❑Yes ❑' No Received: ❑ Yes ❑r No
CIPublic Facilities Improvement(PFI)Permit:
Required: ❑Yes,applicant was notified ❑ No Applied For: 0 Yes ❑No,stop intake
CI Land Use Case#: PDR2016-00013, MMD2020-00030 zoning: R-25
❑� Required Setbacks: Front: 5/10 Rear: 5 Side: Street Side: Garage: 20
El Building Height: Max. Height: N/A Actual Height. 36
0 Landsca e Area: 20 % 0 Lot Coverage Max: 80
Entrance ' ack no more than 8'from street-facing wall ❑ Parallel to street o et 45 degrees or less
Windows Minimum ° of area of all street-facing facades
Garage Gam door is behin ' st street-facing wall 4( s No,one of the following is met:
Door extends no more th ' 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 2nd floor.
❑ Gala e door width is 12'o 50%or e acade 60%or less and includes 7 of following:
Covered porch ecessed entrance ❑ Wall offw 1'Roof eave Roof offset
Fire s ' Lap Siding ❑ Roof itch L Gable,hi , mbrel roof ❑ Dormer
- ccent siding Window trim UWmdow recess UWindow pr ' ' n 0 Balcony
!S isual Clearance 0 Urban Forestry Plan
\N't.ensitive Lands: ❑ Yes ° No Type:
• C. .itions met prior to issuance of building permit
No -s:Outstanding conditions under PDR2016-00013; do not is ry plat recorded under MM 02 -00030
S Approved By Planning: '— Date: -2 / ,2
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: 0 Approved 0 Not Approved
1:1B uil d ing1F o rms\Bl dgPerm i tRvw_RES_122419.do cx
.
Building Permit Submittal R
Original Submittal Date: 92/C%02/
Site Plans: # 3
Building Plans: # 3
Building Permit#: IEnter buildin}p�errmit# above.
Workflow Routing: 'Planning 1!�Engineering L'1 Permit Coordinator (n
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.
Building: original permit application,site plans,building plans,engineer and
beam calculations an. . st details,if applicable,etc.
Notes:
By Permit Technician: _.....r.1/4914 / Date: _ r!1 2J
Engineering Review
(�1 Slope at building pad: .�
r
❑ Conditions "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 El/No
Assess Water Quantity Fee in-lieu: ❑ Yes No
LIDA Facility on lot: ❑ Yes No
Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: Date: / Z/2J
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
pproved, NOT Released: WAllTYI/1 O n J k a - . 1\1— Date: "O?J3 ' 74
Notes: J /
Revisions(after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
2 SDC Exemption: 0 Received ig Does not a4ly
P: SDC Fees Entered: Wash Co Trans Dev Tax: Yes 1 N/A
Tigard Trans SDC: n Yes ❑ N/A
Parks SDC: 3 Yes 2 N/A
LIDA ❑ Yes N/A
glOK to Issue Permit
Approved by Permit Coordinator: 4k Date: 4l2.0 l?,O2
I:\Building\Forms\Bl dgPermitRvw_RES_122419.docx
City of Tigard
IIIp q COMMUNITY DEVELOPMENT DEPARTMENT
T 1 G ARD River Terrace Building Permit Review Addendum
Building Permit #: M srz4v-coo q7
Site Address: /2 qq SW Meadowbrook Lane
Project Name: River Terrace Northeast Lot #: 42
(New dwelling=subdivision name;Addition or Alteration_last name of owner)
Planning Review of River Terrace Plan District Design Standards (18.640.070.L):
Is the project subject to the plan district design standards? 0 Yes ❑No
1.Articulation: a minimum of 1 element per each street-facing façade 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.
Balcony w/ access 2 Window Projection Vertical Wall Offset a
Porch min. 5 ft. deep ft. deep min. 2ft., 5 ft.wide min. 2 ft.,6 .wide Gabled dormey
2. Eyes on the street: a minimu i of 12�o D f each street facing facade must include windows or entrance doors.
2GG
Percentage Shown: //..
3. ' trances:At least one entrance must meet both of the folio g standards:
Max. 8 ft. setback from longejt street- facing wall Parallel to street,angle no more than 45" from street,
m'/ or op onto porch
Entr nce opens to a porch: Yes ❑No
If es all the following apply: sq.ft. min.
e street facing entrylidl ft. 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 façades:
❑ te.
aovered porch min. 5 ft.wide x 5 ft. deep ❑Recessed entry area min. 5 ft.wide x 2 ft. deep
all offset min. 16 inchesQ. ❑ ormer min. 4 ft.wide
VJ Roof eave min. 12 inch projection i) oof offset min. of 2 ft
❑Roof shingles either tile or wood it able,hip or gambrel roof design -`
❑Roof pitch oriented south min. 500 sq. ft. Alorizontal lap siding min. 3-7 inches wide`Rfi
❑Accent siding min.40% of street facade OWindow trim min. 2'/2"wide by 5/8"deep>ort. 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 ❑Attached garage is 35%or less of street facade
5. Garages and Carports:May face the front or side lot line on a co r lot.
Setbacks:
No closer to front or side lot line,than longest street-facing wall. Yes 0 No. If No (Check one):
❑May 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 h: (Check one)
12-foot-wide garage door ❑40%max. of street façade
❑50%max. of street façade with 7 detailed design elements
Notes:
Approved By Planning: — — Date: 2
I:16"ilding\Fwrn s181dgPermitRvw_RES_RT_121417.docx