Permit r
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
.N _ `
Transmittal Letter
T l c,,i L n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 •www.tigard-or.gov
TO: Agnes Lindor DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
FROM: Meghan Ticknor
JUL 13 2021
COMPANY: David Weekley Homes
CITY OF TIGAR
PHONE: (503)213-4409 3UILDING DIVISI. I`
EMAIL: mticknor@dwhomes.com
RE: 10844 SW Lady Marion Drive MST2021-00184
(Site Address) (Permit Number)
Trillium Hill Lot 8
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. 3 Each Revisions: Eng./Joist Clacs.&Drawing Sheets
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: The home will have a change on the lower level from Concrete slab to a crawl space.
FO OI 'ICE USE ONLY
Routed toPeit Technician: Date: ����a-'1 Initials: Afj-
Fees Due: �J Yes ❑No Fee Description: Amount Due:
ll $ 40
l2 FlA fl,,-e� $ �c
Special
Instructions:
Reprint Permit(per PE): ❑ Yes No ❑ Done i
Applicant Notified:, c 6/try) Date: 7/j/, . / Initials: /_b O
7/9-r
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
' #1 " Transmittal Letter
i i ,„tt r, 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Agnes Lindor DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
FROM: Meghan Ticknor SEP 1 2D21
COMPANY: David Weekley Homes CITY OF TIGARD
PHONE: 503.213.4409 3UILDING DIVISIE —
EMAIL: mticknor@dwhomes.com
RE: 10844 SW Lady Marion Drive MST2021-00184
(Site Address) (Permit Number)
Trillium Hill 1,4 �!ry
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s)of plans. 3 Revisions: Access Point to Crawl Space
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: Revision made on plan-Added an access point to the crawl space.Please see the attached.
O ON' 'ICE USE ONLY
Routed to Permit Technic' n , safe: '9-3� I Initials:
Fees Due: (_j Yes N Fee Descriptio Amount Due:
ryt.--------- $$
1 ...\co I''
1 $
Special
Instructions:
Reprint Permit(per PE): ❑ Yes ❑No E Done
Applicant Notified: y
A__ Date: 7/ .L4 Initials: f
FOR OFFICE USE ONLY—SITE ADDRESS: 4/r(yl_3
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
_ II Transmittal Letter
T I EI A h n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Agnes Lindor /A«1,1641 At"Y1 :510/iJ� DATE RECEIVED:
DEPT: BUILDING DIVISION
FROM: Michele Schiedler JUN 1 2021
COMPANY: David Weekley Homes CITY OF TIGARL
BUILDING DIVISION a,; e7'
PHONE: (503)213-4415
EMAIL: mschiedler@dwhomes.com
RE: 10844 Lady Marion Drive MST2021-00184
(Site Address) (Permit Number)
TRILLIUM HILL LOT 8
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
J.s+ Additional set(s) of plans. 3 each Revisions: Plan Review Comments/Calculation Package
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:) ,C,1 — v / cQ7b ]R
FOR Oh' 'ICE USE ONLY
Routed to Perm echnician: Date: `p iZ�Z1 Initials: f
Fees Due: es ❑No Fee Description: Amount Due:
t/Z p A,1 aAAve $ LIS ,�
$
$
Special
Instructions:
Reprint Permit(per PE): ❑ Yes (No// ❑ Done y
Applicant Notified: `'� Date: ��// Initials:.,
CITY OF TIGARD MASTER PERMIT
• . ' COMMUNITY DEVELOPMENT Permit#: MST2021-00184
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/29/2021
f I i;is R.I'. g Parcel: 2S110DA10800
Jurisdiction: Tigard
Site address: 10844 SW LADY MARION DR
Subdivision: TRILLIUM HILL Lot: 8
Project: Trillium Hill, Lot 8
Project Description: New detached dwelling with 334sf deck and 98sf deck cover.
BUILDING
Floor Areas Required Setbacks Reauired
Stories: 1 Bedrooms: 3 First: 1684 sf Basement: 712 sf Left: 5 Parking Spaces: 0
Height: 15 Bathrooms: 3 Second: 0 sf Garage: 429 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2396 sf Value: $324,589.22 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain 0 Storm Sewer. 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0
Bckflw Prevntr: 1
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 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
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 5
Fum>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp SrvcfFeeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 4 201-400 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 Y
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2396
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: $38,241.17
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. Thi 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 t follow rut adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OA 2 1-009 ou m btain a of rules or direct questions to OUNC by calling 503.23 7 or 1.800.332.2344. ^
�
Issued By: Permittee Signature: L. `/ ---1
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
Residential RECEIVED FOR OFFICE USE ONLY
!PIReceived „ ��t ij�2 fr„^ Pei
City of Tigard• f V /� „„ QS D�joJ/ PermitNo.: J�<f/ (xJ/ g
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review q n _�ta�
11 Phone: 503.718.2439 Fax: 503.598.1960 DaterBv: �',(/ (/� Mill' Other Permi z07/-� 12�
T I G A R D Inspection Line: 503.639.4175 CITY OF TIGARD Date Readv By 7 Id See Page 2 for
Internet: www tigard-or.gov Votifie ethod: I Il Supplemental Information
BUILDING DIVISION � � �� � +"1 pp
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
®Nev(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.
CATEGORY OF CONSTRUCTION 9' ���
® 1-and 2-family dwelling ❑Commercial/industrial
Valuation:
AccessorybuildingNumber of bedrooms: 3
❑ ❑Multi-family
-,
❑ Master builder ❑Other: Number of bathrooms: 3 dr..,_?-:.
JOB SITE INFORMATION AND LOCATION Total number of floors:)( '
Job site address: 10844 SW Lady Marion Drive New dwelling area: )1K�e4,�lllquare feet (Q$1
•
City/State/ZIP:Tigard/OR197224 Garage/ arport area: P square feet 7 (a
Suite/bldg./apt.no.: Project name:Trillium Hill area: 98 square feet
Cross street'directions to job site:SW 109th AVE AND SW Lady Marion Dr Deck area: `334 square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:Trillium hill Lot no.:8 Permit fees*are based on the value of the work performed.
Tax map/parcel no.:251 IODA11400 Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
New single family home to he build-2895 sgft edr n b•th hom.with 9114.
J Valuation: $
429 sqft 2 car garage with a qft rear and 49 sqft front porch. Existing building area: square feet
Vljt New building area: square feet
01 PROPERTY OWNER ❑ TENANT Number of stories:
Name:David Weekley homes Type of construction:
Address: 1905 NW 169'Place Suite 102 Occupancy groups:
City/State/ZIP: Beaverton,OR 97006 Existing:
Phone:(503)213-4415 Fax:( ) New:
❑ APPLICANT ® CONTACT PERSON 'BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:David Weekley Homes
Structural plan review fee(or deposit): 75/•u
Contact name:Meghan Ticknor
FLS plan review fee(if applicable):
Address: 1905 NW 169"Place,Suite 102
City/State/ZIP:Beaverton/OR/97006 Total fees due upon application:
Phone:(503)213-4409 Fax: :( ) Amount received:
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:mticknor(a dwhomes.com
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: David Weekley Homes Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 1905 NW 169fh Place,Suite 102 Solar Installation Specialty Code checklist.
pl
an
Permit F
City/State/ZIP:Beay. ton/OR 97006 ee(includes review $180.00
and administrative fees):
Phone:(503)213-4 Fax:( ) State surcharge(I 2%of permit fee): $21.60
CCB tic.:213653 Total fee due upon application: $201.60
Authorized signatur: ,/ This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Meghan ' or, Date:515-I`A *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPemiitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
• Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLY
City of Tigard Received Permit No.:
NI • 13125 SW Hall Blvd.,Tigard,OR 97223 AssocDate/t y.
U ' Phone: 503.718.2439 Fax: 503.598.1900 Associated permits:
TIGARDD
24-Hour Inspection Line: 503.639.4175 Co Electrical ® Plumbing ® Mechanical
Internet: wwtiv.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No VA
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. E ❑ 0
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. E ❑ ❑
3 Verification of approved plat/lot. E ❑ 0
4 Fire district approval required. Name of district: . ❑ ❑ ❑
5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ ❑
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. E ❑ 0
9 Erosion control E plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- el ❑ 0
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state El ❑ 0
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
II Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if El ❑ ❑
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 El ❑ El
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, E 0 0
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- E El ❑
floor,wall construction,roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings
and foundation,stairs,fireplace construction,thermal insulation,etc. ,
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. E ❑ ❑
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing foundation elevations with cross references arc acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- E 0 ❑
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 E ❑ El
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ E
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 E ❑ ❑
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. ❑ . ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required E ❑ El
for four or more appliances.
22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or E El ❑
architect licensed in Ore:.on and shall be shown to be applicable to the aro'ect under review.
JURISDICTIONAL SPECIFICS
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x II"or 11"x 17". E ❑ 0
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. E ❑ ❑
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. E ❑ 0
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. E ❑ ❑
27 "Drawn to scale"indicates standard architect or engineer scale. E ❑ , ❑
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard El ❑ ❑
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ E
and protection measures must be drawn to scale and must include the project arborist's signature of approval.
30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, 0 ❑ E
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.
1:1Building\Pennits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
II- -
4.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard RECEIVE received permit No: �,1I�-�rr� ,�I �1
= Date/ y: I"IJ14Lu-Oaip.
13125 SW Hall Blvd.,Tigard,OR 97223 t t Plan Review
Phone: 503.7182439 Fax: 503.598.1960 v'"'� ���'' Other Penn:
Data/By:
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARC Date Ready/Fly kris: El See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
(41 Ill mi.; DI\11SI( At
TYPE OF WORK COMMERCIAL EKE* SCHEDULE — USE CHECKLIST.
Mechanical permit fees*are based on the value of the work
®New construction ❑ Addition alteration'replacement perfomied. Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑ Other: mechanical materials,equipment,labor,overhead,and profit.
Value:S
CATEGORY OF t'ONSTRL'CTI(?N RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® I-and 2-Ihmily dwelling ❑ Commercial/industrial ❑Accessory. building For special injormanon use checklist.
❑ Multi-family ❑ Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 1 46.75 46.75
Job site address: 10844 SW Lady Marion Drive Furnace 100,000 BTU(ducts/vents) 1 46.75
City/State/ZIP:Tigard/OR/97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:Trillium Hill Duct work 23.32
Cross street/directions to job site:SW 109"Ave and SW Lady Marion Dr Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(titer-type,not electric),
in-wall,in-duct,suspended,etc, 46.75
Flue/vent for any of above 23.32
Subdivision:Trillium Hill Lot no.:8 Other: 23.32
Other fuel appliances:
Tax map/parcel no.:2S110D:111400 Water heater l 23.32
DESCRIPTION OF WORK Gas fireplace/insert I 33.39
Flue vent for water heater or gas
New single family home to be build-2895 still,2 bedroom 2 bath home with t4/� fireplace 23.32
429 sqft 2 car garage with a 371 sqft rear balcony and 49 sgft front porch. Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
le PROPERTY OWNEROther: 23.32
0 'TENANT' Environmental exhaust and ventilation:
Name: David 1b'eekley Homes Range hood/other kitchen
equipment 1 33.39
Address: 1905 NW 169'h Place,Suite 102 Clothes dryer exhaust 1 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
® APPLICANT ® CONTACT PERSON Other 23.32
Fuel piping:
Business name:David Weekley(tomes
$11.15 for first four:$4.03 for each additional
Contact name: Meghan Ticknor Furnace.etc. I
Address: 1905 NW 1691h Place,Suite 102 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Beaverton/OR/97006 Water heater
Phone:(503)213-4409 Fax: :( ) Fireplace t
- Range
11-moil: mticknora'dwhomes.cum Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: David Weekley Homes Other.
MEC[IANICAI.PERMIT FEES'
Address: 1905 NW 169'h Place Suite 102 Subtotal
City/State/ZIP:Beaverton/OR/97006 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)Z13-4415 Fax:( ) Stale surcharge(12%ofpermit fee)
CCB lie.:213653 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has bees accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Indushy Service Board
Print name:Ken Puttman Date:
19Building.PeminAMEC_PermitA Pp 040113doe 440-4617T I l'02/COMiWEI31
..Electrical Permit ApplicationRECEl V E I FOROFFICF: I.SL ONLY
City of Tigard k:i'! 0 r- 9(i2- Received
Date/By: Perma#: rZdZ1-On
■ 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
0 • Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Related Permit#:
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Ready Date/13y: Jens: I PI See Page 2 for
Internet: www_tigard-or_gov n1 it n:t,•n '-,a r ,-t. Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
®New construction ❑ Addition/alteration/replacement Please check all that apply Isubmit 2 sets of plans elitems checked)
❑Service or feeder 400 amps or more ❑Building over three stories.
❑ Demolition ❑ Other: where the available fault current 0 Manilas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or 0 Floating buildings.
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,600 0 Cornrnertaal-use agricultural
amps for all other installations. buildings.
❑ Multi-family ❑ Master builder ['Other: 0 Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ['Emergency system_ larger separately derived
!/o 99DYI p Qt fy �a1! ( 1 Mp t.�U„� ❑I00H Addition of new motor load of system.
Job# Job site address: Six or or more. ❑`A" "e" `9d" "t-�,
City/State/ZIP:Tigard/OR/97224
0 Six or more residential units. occupancy.
n g ❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Trillium Hill ❑Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site:SW 109th AVE AND SW Lady Marion dr FEE SCHEDULE
Description I Qty. I Each I Total I `
_ v New residential single-or multi-family dwelling unit.
Subdivision: I 1 I1 wrn 1Iiu1 1 Lot#: 0 Includes attached garage.
•
'fax map/parcel#:2S110DA11400 1,000 sq.ft.or less I 168.54 168.54 4
Ea.add'1 500 sq.ft.or portion 4 33.92 107.76 1
DESCRIPTION OF WORK Limited energy,residential
75.00 2
(with above sq.f_I
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
i El PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name: David Weekley Homes 200 amps or less 100 70 2
Address: 1905 NW 169u'Place Suite 102 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Beaverton/OR/97006 601 amps to 1,000 amps 301.04 2
Phone:(503)213-4415 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:
relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
W. APPLICANT ® CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:David Weekley Homes above service or feeder fee, 742 2
each branch circuit _
Contact name:Meghan Ticknor B.Fee for branch circuits without
Address: 1905 NW'169rh Place Suite 102 branch brce cit feet o
tee,first56.18 2
t
City/State/ZIP: Beaverton/OR/97006 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)213-4409 Fax: :( ) Each manufactured or modular 67.84 2
Email: mticknord'dwhomes.com dwelling,servIce and/or feeder
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 0 See Page 2 2
Address:2890 SE Brookwood Ave panel,alteration,or extension,
City/State/ZIP:Hillsboro,OR.97123 Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66251 hr
Phone:(503)648-4552 Fax:( ) Investigation(I hr min) 90.001 hr
Industrial plant(1 hr min) 78.181 hr
Email:permits@garnerelectric.com Inspections for which no fee is
90.00"hr
CCB Lie.:121159 Electrical Lie.• 4-305C Suprv.Lie.:3707S specifically listed('�:hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,require Subtotal
Print name:Charles Garner Date: ❑Plan Review Required(25%of pennit fee):
,,,,,,.��' - State surcharge(12%of pennit fee):
Authorized signature: g2zerr/// L 5��� TOTAL PERMIT FEE:
aThis permit application expires if a permit is not obtained within 180
Print name:Brittany Burian Date: days after it has been accepted as complete.
• Number of inspections allowed per pennit.
laBuilding1Pennirs\ELC PemitApp_ELR_ERE.doe Rev U6;17/2015 440-461ST(t Ii05/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
ne,crlption 1 Qis. 1 Faen 1 tuts[ I .
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: s kva or 00 70
5.01 to 15 kva 13356
I I 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) 55336 2
® Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
I I Vacuum Systems* >100 kva-no additional charge 0.0 3
Each additional inspection over allowable in any,of the above:
❑ Other: Each additional inspection is 66.35/hr
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00i hr
specifically listed('/hr mini
COMMERCIAL WORK ONLY ELECTRICAL PERMIT FEES
� �i v; Subtotal(Enter on Page I)_
Fee for each commercial system: $75.00 lerofin pectionsallwedperpetn,it.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
Audio and Stereo Systems
Boiler Controls
❑ Clock Systems
I I Data Telecommunication Installation
❑ Fire Alarm Installation
n HVAC
I_I Instrumentation
n Intercom and Paging Systems
Landscape Irrigation Control*
❑ Medical
I I Nurse Calls
❑ Outdoor Landscape Lighting*
7 Protective Signaling
I I Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
11BuildingiPermirs`ELC_PermiL4pp_ELR_ERE.doc Rev 06/17i2015
,
Plumbing Permit ApplicationRECEIVE
Building Fixtures FOR OFFICE LSE ONLY
/yT
_ City of Tigard MAY r 9�g Received Permit No.'. MST762!-eV/84
• 13125 SW Hall Blvd.,Tigard,OR 97223 Date ey: 1
1 Plan Review
Phone: 503.718.2439 Fax: 503.598.196111
OI�OF TIGARD Date By: Other Permit No.:
TIGARD Inspection Line: 503.639.4175 BUILDING Date Ready/By: Jmais. to See Page 2 for
Internet: www.tigard-or.gov BUILDING IV`7 DIVISIONNotified/Rletlu/d' Supplemental Information
TYPE OF WORK FEE* SCHEDULE
®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 ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath I 500.32 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen I 25.02 25.02
❑ Master builder El Other: Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: f(7g41--1" C�.v J'"1 Al `/�s a�'jt,n�� Catch basin or area drain 18.76
Nv ur ' 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 109th AVE AND SW Lady Marion Dr Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear if:_) Page 2
Water service(no.linear ft-: ) Page 2
Subdivision:Trillium Hill Lot no.: Fixture or item:
Tax map/parcel no.:2S110DA11400 Backtlow preventer 1 31.27 31.27
•
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer I 25.02 25.02
?�1 s 6 043eav •-v 1 / 2-h -+�1 (4�St Dishwasher I 25.02 25.02
liCv+� W to% 311 Y v Drinking fountain 25.02
-4,I. Ejectors/sump 25.02
y'ii, ... 0PRO RTV OWNER I ❑ TENANT Expansion tank 12.51
Name: David Weekley Homes Fixturelsewercap 25.02
-- Floor drain/floor sink/hub 25.02
Address: 1905 NW 169'h 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 ® CONTACT PERSON Interceptor/grease trap 25.02
Rosiness 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 4 25.02 100.08
City/State/ZIP: Beaverton/OR/97006 Solar units(potable water) 62.54
Phone:(503)213-4409 Fax: :( ) Tub/shower/shower pan 3 12.51 25.02
F-mail: msehiedler@),dwhomes.com Urhtal 25.02
Water closet 4 25.02 100.08
CONTRACTOR
Water heater 1 37-52 37.52
Business name: Nlalmedal Plumbing Water piping/DWV 56.29
Address:PO Box 207 Other: 25.02
City/State/Z1P:Banks/OR/97106 Subtotal
Phone:(503)324-0759 Fax:( ) Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lie.: 102535 Plumbing Lic.no.:34-276PB
State surcharge(12%of peon it fee)
Authorized signature: Carolina Malmedal ni.,.-...- ----------- TOTAL PERMIT FEE
Print name:Carolina Malmedal Date:05/05/2021 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.
1.\BuildingTermits\PLMl1-PermitApp.doc 10/01/09 440-4616T110/02/COM/WEB)
City of Tigard
.lig COMMUNITY DEVELOPMENT DEPARTMENT
T1cARo Building Permit Review — Residential
Building Permit #: L3f.2o2I 00 184,
Site Address: 10844 SW Lady Marion Dr
Project Name: 7TjJijury1 711 Lot #: e
nning Review
Piposal: New single detached house
Verify address/suite#active in Accela. ri River Terre: No ❑ Yes, River Terrace Review Addendum
Si Plan Elements: 1Y Sion Control
opies of site plan on 8-1/2"x 11"or 11 x 17"paper c` ,�tained trees with drip line and tree protection measures
awn to scale(standard architect or engineer scale) lo,.tprint of new structure(including decks)and FFE
rth arrow 4 tility locations&easements(required for new and additions)
ite address,project or subdivision name and lot number -i.-walk/driveway approach
pplicant information(name and phone number) ,\�i.cation of wells/septic systems
t dimensions and building setback dimensions yet tree size,type and location
quare footage of buildings to be demolished �j r(eet names
ixisting structures on site LCorner elevations (2'contours if more than 4'cliff- ential
t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? 4 'es o
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown ► I es o
❑ Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995):
Required: ❑Yes,applicant was notified ❑ No Received: ❑Yes ❑ No
\ ` Water Meter Fixture Unit Worksheet-Additions,Remodels and ADUs
�� R quired: ❑Yes,applicant was notified CI No Received: ❑Yes ❑ No
❑ DC Exempti for ADU applied for: Yes 11No dReceived: El Y El No
Public FaciltImprovement(PR) Permit
equired: Yes,applicant was notified ❑ No pplied For: Yes ❑ No,stop intake
d Use Case#: ZON2018 00002 Zoning: R-4.5
.''equired Setbacks: Front: 20 Rear: 15 Side: 5 Street Side: 15 Garage: 20
AB ding H • t: Max. Height: 30 Actual Height:
an He*:
- rea: % of Coverage Mr
Entrance :et back no more than 8'from street-facing wall P allel to street or offset 45 degrees or less
Windows 1, ' ' urn 12%of area of all street-facing facades
Garage 7 Gar e door is behind widest street-facing wall Yes ❑ No,one of the following is met:
Doorto extends no more u ildithan ng 5'pfromer mit wall d there is a covered porch extending beyond garage.
Door extends no more than 5'from w and there is a 12 sq ft.window above garage on 2nd floor.
Gard door width is _ 12'or less 50°/u or less of facade 60%or less and includes 7 of following:
Covered porch — ❑Recessed entrance Wall offset 1'Roof cave Roof offset
Fire shingles _ Lap Siding ElRoof itch ❑ Gable,hi ,or gambrel roof Dormer
Accent siding 1_ Window trim Window recess Window projection El Balcony
F/ V ual Clearance � Urban Fores n
ensitive Lands: ❑iee
Yes No Type:
nddtions met
rior
s:
pproved By Planning: —�— Date: S-�O °-/
p
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:1Bui I ding\Forms\BldgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: .46-45-2d2/
Site Plans: # 3
Building Plans: # 3
Building Permit#: fn�Enter buildin ermit# above.
Workflow Routing +Planning engineering ErPermit Coordinator @ Building
Workflow Sign-off: Qn"S�i,gn-off for Planning(include notes from planning review)
Route Application Documents: Ltd-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 anu Ast details,if applicable,etc.
Notes:
By Permit Technician: �/ . / Date: 0$a r2024
Engineering Review
n�Slope at building pad: /7%
,.. nditions "Met"prior to issuance of building permit
�Ea-sements (encroachments) per engineering conditions of approval and plat
Ektater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes P°No
No
Assess Water Quantity Fee in-lieu: ❑ YesLIDA Facility on lot: ❑ Yes
Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
E Approved by Engineering: (,,,ys, _ Date: S 1 3• z oz 1
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Permit Coordinator Review
ZConditions "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:5
❑ Received Does not a ly
SDC Fees Entered: Wash Co Trans Dev Tax: jaYes 11 N/A
Tigard Trans SDC: 2'Yes ❑ N/A
Parks SDC: 4Yes ❑ N/A
LIDA Yes 21 N/A
OK to Issue Permit
Approved by Permit Coordinator: R61-- Date: 5I 1'3 I 2„021
I:\Building\Forms\BldgPennitRvw_RE S_122419.docx