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Permit
FOR OFFICE USE ONLY—SITE ADDRESS: b//// -(I 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 TigardII • COMMUNITY DEVELOPMENT DEPARTMENT _ Transmittal Letter T I c A R n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Agnes Lindor /AI lysOvi Arrvi trDnO DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVE!, FROM: Michele Schiedler fl JUUNN 1 20 2 1 COMPANY: David Weekley Homes CITY OF TIGARL PHONE: (503)213-4415 BUILDING DIVISW 6-%) EMAIL: mschiedler@dwhomes.com RE: 15129 SW Tierra Terrace To Be Determined ! r/5rN-- iyo (Site Address) (Permit Number) TRILLIUM HILL LOT 13 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: 35MS 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): 1 REMARKS: C4. S 4,1 V pc,?[A (S FOROI+'I 10E USE ONLY Routed to Permi etcll ian: Date: � 14 f.-z_i Initials: /,4" Fees Due: es ❑No Fee Description. Amount Due: ••--IXD, / VI- Oivel rt,vo.e w I SIB $ H S . sly- $ Special / Instructions: v Reprint Permit(per PE): ❑ Yes No ❑Done o/ Applicant Notified: ��. Date: l> 7/C- „L( Initials: �! III CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2021-00180 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/24/2021 T.I ;1 1t L• g Parcel: 2S110DA11300 Jurisdiction: Tigard Site address: 15129 SW TIERRA TER Subdivision: TRILLIUM HILL Lot: 13 Project: Trillium Hill, Lot 13 Project Description: New detached dwelling with 329sf deck and 253sf deck cover. BUILDING Floor Areas Required Setbacks Required Stones: 1 Bedrooms: 3 First: 2081 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 17 Bathrooms: 3 Second: 0 sf Garage: 576 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2081 sf Value: $296,771.02 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 4 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 Bckfiw Prevntr: 1 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 Fum<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 5 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 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 Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2081 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 2 Geo Tech Report Required Prior To Pour PHONE: PHONE: 503-213-4415 FAX: Total Fees: $37,177.19 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 yo to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR -001-0090. You y obtain a co of the r les or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. ` /A- Issued By: Permittee Signature: � !� 1 �I l/i�l/V t 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. I. ' Building Permit Application — 122, a ' Residential RECEIVED FOR OFFICE USE ONLY City of Tigard Dashed 2 2./ IyST2021 Gbl6O g �OZ� Data By- �� Permit No.: 13125 SW Hall Blvd.,Tigard,OR 97223Er APR a Y Plan Review �I Phone: 503.718.2439 Fax: 503.598.1960 pate gv Z Other Pc (& O2-1 ^ b0/18 TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By. / � tuny�'{ See Page 2 for Internet: www.tigard-or.gov BUILDING DIVISION Notified/M- n:�// 7 �� Supplemental Inform ation TYPE OF WORK REQUIRED DATA: I-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/rcplacernent ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. 3' ® I-and 2-family dwelling ❑Commercial/industrial Valuation: " 11 P91o11 1 r 0 ❑Accessory building ❑Multi-family Numbe of bedrooms: 3 El Master builder ❑Other: Number of bathrooms:'JOB SITE LNFORM.ATION AND LOCATION Total number of floors: 1 Z(067 Job site address: 15129 TIERRA TERRACE New dwelling area: 2081 square feet 01201 City/State/LIP:Tigard/OR/97224 Garage/carport area: 52 square feet Z Suite/bldg./apt.no.: Project name:Trillium Hill square feet Cross street/directions to job site:SW 1091a AVE AND SW lady Marion Dr Deck area: '32.1 square feet Other structure area: <luare feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision:Trillium Hill lot no.: 13 Permit fees*are based on the value of the work performed. Tax map/parcel no.: 25110llA11400 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. Ness Single Family (tome to he built-2081 SQL'I 3 Bedroom,study,2.5 Bathroom Valuation: $ 576 SQFT 3 car gar.with a 278 SQFT covered rear deck&83 SQFT Covered F porch Existing building area: square feet New building area: square feel ® PROPERTY OWNER ❑ TENANT Number of stories: Name:David Weekley Ilomes Type of construction: Address: 1905 NW 1696 Place Suite 102 Occupancy groups: City/State/ZIP:Beaverton,OR 97006 Existing: Phone:(503)213-4415 Fax:( ) New: ❑ APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES* Business name:David Weekley Homes (Please refer ro fee schedule } Structural plan review fee(or deposit): 7.67416 Contact name: Meghan Ticknor Address: 1905 NW 169'h Place,Suite 102 FLS plan review fee(if applicable): Total lees due upon application: City/State/ZIP:Beaverton/OR/97006 Amount received: Phone (503)213-4409 Fax: :( ) -mail: mticknor d dwhomes.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of COS TRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name: David W'eeklev llomes Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:1905 NW 169t Place,Suite 102 Solar Installation Specialty Code checklist. City/State/ZIP:Beaverton/OR/97006 Permit Fee(includes plan review SISO 00 - and administrative tees): Phone:(503)2(3-4415 Fax:( ) State surcharge(12%of permit tee): S21.60 CUB lie.:213653 Total fee due upon application: S201.60 Authorized signature:Sf� y This permit application expires if permit is not obtained (� ._��� within OM days after it has been accepted as complete. Print name:Meghan Ticknor Date:4l21/21 *Fee methodology set by Tri-County Building Industry Service Board. L\Building\Permits VBUP-RESPermitApp.doc 02/24/2011 440-4613T(1 l/02/COM/WEB) Building Permit Application Checklist ' One- and Two-Family Dwelling FOR OFFICE USE ONLY City of Tigard Received Perini(No.: • 13125 SW Hall Blvd.,Tigard,OR 97223 M I ' Phone: 503.718.2439 Fax: 503.598.1960 By: socratedpenmts: TIGARU 24-Hour Inspection Line: 503.639.4175 ElElectricallaPlumbing ® Mechanical Internet: www.tigard-or.gov ❑ Other. THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/.k I Land use actions completed. See jurisdiction criteria for concurrent reviews. ® ❑ ❑ 2 Zoning. Flood plain.solar balance points,seismic soils designation.historic district.etc. ® ❑ ❑ 3 Verification of approved plat/lot. ® ❑ ❑ 4 Fire district approval required. Name of district: . ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity . 0 0 0 6 Sewer permit. 0 0 0 7 Water district approval. 0 0 0 8 Soils report Must carry original applicable stamp and signature on file or with application. ® ❑ ❑ 9 Erosion control N plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- ® ❑ 0 basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale.showing conformance to applicable local and state ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot he completed if copyright violations exist. I I Site/plot plan drawn to scale. The plan must show lot and building setback dimensions:property corner elevations(if ® 0 0 there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft. intervals);location of easements and driveway; footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area:percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size 1/ 0 0 and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ® ❑ 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- 0 ❑ 0 floor,wall construction,roof construction. More than one cross section may he required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation, stairs. fireplace construction,thermal insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. ® 0 0 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 are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- ® 0 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 ® 0 0 locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 0 systems,see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ® 0 0 over 10 feet long and/or any beam joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. ® 0 0 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 11 0 0 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 ® 0 0 architect licensed in Oregon and shall be shown to be applicable to the .roject under review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans arc required for Item I I above. Site plans must he 8-1/2"v 11"or 11"x 17". ® 0 ❑ 24 Two(2)sets each are required for Items 16, 19.20 and 22 above. ® 0 0 25 Building plans shall not contain red lines or tape-ors. "Mirrored"building plans will not be accepted. ® 0 0 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ® 0 0 27 "Drawn to scale"indicates standard architect or engineer scale. ® 0 0 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ® 0 0 Street Tree I,ist. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations.driplines. 0 0 El 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 0 El 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. LABuilding\Permits\BUP-RESPermitApp.doc 02/24/2011 440-t613T(11/02/COM/WEB) Mechanical Permit Applicatio FOR OFFICE USE ONLY rlECEIVE •� acuei, 1 City of Tigard Date,By: ,eriil"e.. M T2021,_001 41 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone. 5O3.718.2439 Fax: 503.598.1960 AFR a D �0ZI Dales By Other Permit: TIGARD Inspection Line: 503.639.4175 Date Readv/By: Siri> el See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARD Not Supplemental Information .3L 11LDING DIVISION TYPE OF WORK COMMERCIAL FEE* SCHEDULE USE CHECKLIST Mechanical permit fees*are based on the value ofthe work ® New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to'the nearest dollar)of all ❑ Demolition a Other: mechanical materials,equipment,labor.overhead,and profit_ Val net S CATEGORY" OF CONSTRUCTION RESIDENTIAL EQUIPMF:NI/SYSTEMS FEES" I-and2-tamily dwel hug ❑Commercial/industrial ❑ Accessory buildine For special information use checklist. a Multi-family 0 Master builder ❑Other: Description Qty. Fa. Total JOB SITE INFORMATION AND LOCATIONHeating/cooling; Air conditioning 1 46.75 46.75 .lob site address: 15129 TIERRA TERRACE Furnace 100,000 BTU(ducts/vents) I 46.75 46.75 City/State/ZIP:Tigarnl/OR/97223 Furnace 100,000+BTU(duets/veins) 5491 Heat pump 61.06 Suite/bldg./apt.no.: Project name:Trillium Hill Duct work 23.32 Cross street/directions to job site:SW 109th Ave and SW Lady Marion Dr Hvdronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 • Flue/vent for any of above 23.32 Other: 23.32 Subdivision:Trillium Hill Lot no.: 13 Other fuel appliances: 'Iax map/parcel no.:2SIIODAI1400 Water heater I 23.32 23.32 DESCRIPTION OF WORK Gas fireplace/insert I - 33.39 33.39 Flue vent for water heater or gas New single family home to he built-2081 sgft,3 bedroom 2.5 bath home with fireplace 23.32 576 still 3 ear garage,278 SOFT covered deck&83 SQFf front porch. Log lighter(gas) 23.32 - W oud/pellet stove 33.39 Wood fireplace/insert 23.32 C himnev%liner/(l ue/vent 23.32 Other: 23.32 ® PROPERTY OWNER ❑ TENANT Environmental exhaust and ventilation: Name: David Neckley Homes Range hood/other kitchen equipment l 33.39 33.39 Address: 1905 NW'169'h Place,Suite 102 Clothes dryer exhaust I 33.39 33.39 City/State/ZIP:Beaverton/OR/97006 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 3 23.32 Phony(503)213-4415 lax:( ) Attic/crawlspace fans 23.32 ® APPLICANT ® CONTACT PERSON Other: 23.32 Fuel piping: Business name: David Weeklcy Homes $14.15 for first four;$4.03 for each additional Contact name:M11eghan Ticknor Furnace,etc. Address:1905 NW 169'Place,Suite 102 Gas heat pump WalUsuspended/unit heater City/Slate/ZlP: Beakerton1OR/97006 Water heater Fireplace Phone:(503)213-4409 Fax::( ) Firep I Range I:-mail: mticknm;a:dwltomes.eom Barbecue CONTRACTOR Clothes dryer(gas) 1 Business name: David Weekley Homes Other: MECHANICAL.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)213-4415 Fax:( ) State surcharge(12%of permit fee) CCB lie.:213653 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within ISO days after it has been accepted as complete. Authorized signature:+ * Fee methodology set by Ili-County Building Industry Service Board Print name:Ken Putt .n Date:4/21/21 Buildi,,SPermitsAMEC PennitApp 0401 13.doe 440-4617T(I 1102/COM./wEB1 r " i Electrical Permit ApplicatioiRECEIVED FOR OFFICE USE ONLY City of Tigard APR 2 2 qDZs, Received Permit#: r•'ts-r2z1—0jt S© Date/By: u.� 114 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review I• Phone: 503.718.2439 Fax: 503.598.19tITY OF TIGARD Date/By: Related Permit it: Inspection Line: 503.639.4175 Ready Date/By: iarir: ® See Page 2 for TI GA RE.. Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW 1 New construction ❑Addition/alteration/replacement please check all that apply(submit 2 sets of plans w/items checked): 0 Demolition ❑Other: 0 Service or feeder 400 amps or more 0 Building over three stones. CATEGORY OF CONSTRUCTION where the available fault current 0 Marinas and boatyards. exceeds 10,000 amps at 150 volts or 0 Floating buildings. E 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural 0 Multi-family ❑Master builder 0 Other: amps for all other installations. buildings. JOB SITE INFORMATION AND LOCATION ❑Firepump. 0 Installation separatelypa o l5d KV or 0 Emergency system. larger derived Job#:68160013 Job site address: 15129 Tierra Terrace ❑Addition of new motor load of system. 100HP or more. ❑"A" "E" "1-2" `9-3" City/State/ZIP:Tigard/OR/97224 0 Six or more residential units. occupancy. ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: Project name:Trillium Hill 0 Hazardous locations. 0 Supply voltage for more than th ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site:SW 109 AVE AND SW Lady Marion dr -- FEE SCHEDULE Description I Qty. I Each I Total New residential single-or multi-family dwelling unit. Subdivision:Trillium Hill Lot#: 13 Includes attached garage. Tax map/parcel#:2S110DA11400 1,000 sq.ft.or less 1 168.54 4 DESCRIPTION OF WORK Ea.add'1500 sq.ft.or portion 3 33.92 1 Limited energy,residential 75.00 2 New single family home to be build-2081 sqft,3 bedroom 2.5 bath home with (with above sq.ft.) - 576 sqft 3 car garage with a 278 SQFT covered rear deck&83 SQFT Covered F Limited energy,multi-family 75.00 2 Po residential(with above sq.ft.) Renewable Energy El PROPERTY OWNER ❑ TENANT ❑ See Page 2 Services or feeders installation,alteration,and/or relocation Name:David Weekley Homes 200 amps or less 100.70 2 Address:1905 NW 169th 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 El 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. 7.42 2 each branch circuit - Contact name:Meghan Ticknor B.Fee for branch circuits without service or feeder fee,first Address:1905 NW 169th Place Suite 102 branch circuit 56.18 2 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 dwelling,service and/or feeder _ I Email:mticknor@dwhomes.com Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name:Garner Electric Sign or outline lighting 67.84 2 ---------- Signal circuit(s)or limited-energy Address:2890 SW Brookwood Ave panel,alteration,or extension. ❑ See Page 2 2 City/State/ZIP:Hillsboro,OR.97123 Each additional inspection over allowable in any of the above Additional inspection(I hr min) 66.25/hr _ Phone:(503)648-4552 Fax:( ) Investigation(1 hr min) 90.00/hr Email:permits@garnerelectric.com industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lie.: 121159 Electrical .' 4-3 C Suprv.Lic.: 3707S specifically listed(1/i hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,require Subtotal: Print name: Charles Garner Date: 4/21/2021 ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: '? 7-•ur14 TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Brittany Burian Date: 4/21/2021 days after it has been accepted as complete. l/Buildi 1g\PermiuU'LC_PermilApp ELR ERE.doc Rev 06/17/2015 440-4615T(1 l/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 newton Qty. I Each I Total I * Fee for all residential systems combined: $75.00 Renewable electrical energy systems: Check Type of Work Involved: s kva or less 100.70 2 5.01 to 15 kva 133.56 2 n Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: n 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 552.26 2 with OAR 918-309-0040) ® Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 n Vacuum Systems* >100 kva—no additional charge 0.0 3 Each additional inspection over allowable in anyof 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(%hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls n C• lock Systems n D• ata Telecommunication Installation n Fire Alarm Installation ❑ HVAC ❑ Instrumentation n Intercom and Paging Systems _ Landscape Irrigation Control* Medical I I Nurse Calls IT Outdoor Landscape Lighting* • Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Pemuts\E1.C_PemdlApp BLR ERE.doc Rat 06//72015 Plumbing Permit Applicatio E�CG�,V ED Building Fixtures FOR OFFICE USE ONLY p ne��; City of Tigard QLI ie 2 2 �7td Received PerrnitNo.:tkil ST204...co 6$d :�_ • l3ho 5 SW Hall Blvd.,Tigard,OR 97223 Plan Review ■ Phone: 503.7I8.2439 Fax: 503,598.19+ GF TIGARD Date/By: Other Permit No.: Inspection Line: 503.639.4175 SIN DateAead B luris: ® SeePage2for -ttl3AAD Internet: www.tigard-or.gav BUILDING DM. Y y Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ►IS New construction ❑Demolition Fur special information use checklist Description . Qty. I Ea. I Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(I)bath 312.70 N 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 2 437.78 SFR(3)bath 500.32 ❑Accessory building 0 Multi-family Each additional bath/kitchen 1 25.02 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 15129 TIERRA TERRACE Catch basin or area drain 18.76 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 109ts 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 ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision:Trillium Hill Lot no.:13 Fixture or item: Tax map/parcel no.:2S110DA11400 Back flow preventer 1 31.27 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 1 25.02 25.02 New Single Family Home 2081 sqft 3 bedroom,2.5 bath with 576 sqft 3 car Dishwasher 1 25.02 25.02 garage and with a 278 sq ft covered rear deck&83 sq ft front porch. Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER ❑a TENANT Expansion tank 12.51 Name:David Weekley Homes Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:1905 NW 169t6 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)213-4409 Fax:( ) Ice maker 1 12.51 12.51 ® APPLICANT ® CONTACT PERSON Interceptor/grease trap 25.02 Business name:David Weekley Homes Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:Meghan Ticknor Roof drain(commercial) 12.51 Address:1905 NW 16916 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)2134409 Fax::( ) Tub/shower/shower pan 3 12.51 25.02 E-mail:mticknor@dwhomes.com Urinal 25.02 Water closet 4 25.02 100.08 CONTRACTOR Water heater 1 37.52 37.52 Business name:Malmedal Plumbing Water piping/DWV 56.29 Address:PO Box 207 Other: 25.02 City/State/ZIP:Banks/OR/97106 Subtotal Phone:(503)324-0759 Fax:( ) Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lic.:102535 Plumbing Lic.no.:34-276PB State surcharge(12%of permit fee) Authorized signature: Carolina Malmedal „- - TOTAL PERMIT FEE Print name:Carolina Malmedal Date:04/21/2021 This permit appncatioa 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/BuildingPeraisPLMI PennitApp.doc 10/01/09 440.4616T(10/02/COM/WEB) City of Tigard a COMMUNITY DEVELOPMENT DEPARTMENT C T I G A RD Building Permit Review — Residential Building Permit #: g 02t'Mt f30 Site Address: 15129 SW Tierra Ter Project Name: Triullum Hill Lot #: t ?j noing Review Piposal: New single detached house Verify address/suite# active in Accela. iverr Terr ce: No ❑ Yes, River Terrace Review Addendum Situ Ian Elements: on Control opies of site plan on 8-1/2"x 11"or 11 x 17"paper ��d�ied trees with drip line and tree protection measures raven to scale(standard architect or engineer scale) otprint of new structure (including decks)and FFE orth arrow 4 .ty locations&easements(required for new and additions) teaddress,project or subdivision name and lot number al/driveway approach plicant information(name and phone number) ation of wells/septic systems t dimensions and building setback dimensions et tree size,type and location \ quare footage of buildings to be demolished treet names xisting structures on site omer elevations(2'contours if more than 4'diff ential mot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? es o impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? es o ❑ Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995): Required: ❑Yes,applicant was notified ❑ No Received: ❑Yes CI No w.* 0 Water Meter Fixture Unit Worksheet—Additions, Remodels and ADUs R uired: El Yes,applicant was notified El No Received: ❑Yes ❑ No ❑ DC Exemptio for ADU applied for: ❑ Yes ❑ No Received: 11 Ye [11 No blic Faciliti Improvement (PFI) Permit: Required: Yes,applicant was notified CINo pplied For: Yes CI No,stop intake and Use Case#: ZON2018-00002 Zoning: R-4.5 equired Setbacks: Front: 20 Rear: 15 Side: 5 Street Side: N/A Garage: 20 airing Hei••id Max. Height: 30 Actual eight: J. scape , ri. % of Coverage Ma Entrance LTA I. back no more than 8'from street-facing wall Parallel to stre or offset 45 degrees or less Windows Pt , ' 'm 12%of area of all street-facing facades Garage TA Gara,e door is behind widest street-facing wall ❑ Yes No,one of the following is met: 7 Door extends no more than 5'from wall d there is a covered porch extending beyond garage. I Door extends no more than 5'from w and there is a 12 sq ft.window above garage on 2nd floor. 7 Gara e door width is — 12'or less 50%or l facad Covered porch Recessed entrance LiWessallof offsete 60%or less and includes 7 of following: ❑ 1'Roof eave Roof offset Fire shingles Lap Siding ❑ Roof itch ❑ Gable,hi ,or gambrel roof ❑ Dormer Accent siding Window trim Window recess Window projection ❑ Balcony : (ill Visual Clearance p(J Urban Forest n v CI ,ensitive Lands: CI r No Type: C nditions met prior to issuance of building permit N es: Approved By Planning: - Date: Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved I:1Buil ding\Forms1BldgPerm itRvw_RES_122419.docx Building Permit Submittal Original Submittal Date: r /22/2cz> Site Plans: # 3 Building Plans: # .? Building Permit#: ETnter buildingyermit# above. � Workflow Routing: Planning LrJ Engineering [Permit Coordinator [ ,Building Workflow Sign-off: Ii 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 o ginal plan review routing form. LI Building: original permit application, site plans,building plans, engineer and beam calculations an.�. st details,if applicable,etc. Notes: By Permit Technician: = / Date: 0540/2(2J Engjneering Review , lope at building pad: 02�8 Z—S E ;onditions "Met"prior to issuance of building permit : agasements (encroachments) per engineering conditions of approval and plat Vater Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes ErNo Assess Water Quantity Fee in-lieu: ❑ Yes TN I o �/ LIDA Facility on lot: ❑ Yes L�J No 12 Final Plat Recorded: ❑ NOT Approved by Engineering: Date: ,N--o,tees�s: • U'Approved by Engineering: �, . Fi 5 tot Date: f/0-39.1 t Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review pit C. ditions "Met"prior to issuance of building permit W pproved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: R=vision Notice 2: Date Sent to Applicant: .DC Exemption: ❑ Received litoes not aptly ❑ SDC Fees Entered: Wash Co Trans Dev Tax: iril es Ll N/A Tigard Trans SDC: 7 es ❑ A Parks SDC: rI Yes ❑ /A LIDA ❑ Yes N/A OK to Issue Permit = Approved by Permit Coordinator: �� ______ Date: �iD/� I:\Building\Forms\BldgPermitRvw_RES_122419.docx