Permit IIy , CITY OF TIGARD MASTER PERMIT
s COMMUNITY DEVELOPMENT Permit#: MST2021-00190
T I GAR f7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/29/2021
Parcel: 2S110DA11200
Jurisdiction: Tigard
Site address: 15149 SW TIERRA TER
Subdivision: TRILLIUM HILL Lot: 12
Project: Trillium Hill, Lot 12
Project Description: New detached dwelling with 298sf deck and 242sf deck cover.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 4 First: 2424 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 23 Bathrooms: 3 Second: 0 sf Garage: 589 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2424 sf Value: $338,385.98 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
Bckflw 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
Furn<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!500 sf: 5 201-400 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
Ecompasing: Y
Other: N Other Description:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2424
Owner: Contractor:
WEEKLEY HOMES LLC WEEKLEY HOMES Required Items and Reports(Conditions)
1111 NORTH POST OAK RD 1905 NW 169TH PLACE SUITE 102 1 Geo Tech Report Required
HOUSTON,TX 77055 BEAVERTON,OR 97006 Prior To Pour
2 Ersn Cntrl 503-639-4175
PHONE: PHONE: 503-213-4415
FAX:
Total Fees: $38,570.62
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 OA -001-0090. You obtain a c oft les or direct questions to OUNC by calling 5031P232.11987 or 1.800.332.2344.
�i!Issued By: Permittee Signature: 7 L 7titI° �G )
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 -Gilding Permit Application 8— 9't / j
c Residential RECEIVE a till:.oft It 1 1 •-' 11\1 1
Citynece yeti of Tigard D$4 ZO � Permit No.: 1�$T2_021'fbl�90
n n s [Y.ue/lhy;
+ 13125 SW Nall Blvd.,Tigard,OR '17223 ti �� Plan Review '� ,,_,.,„
1 6 Pbouc' 503.713.2439 Fax'. 103598.1900 Plan Re 5 as g 1 � 4 ttax Permits A 2J-co(Z
1 ,, ,,1;1, Inspection Line: 503.639.4175 CITY OF TIGARD Date •early/By: 0 See Page 2 for
Internet, .ww tigard o`.g°` BUILDING DIVISION' red/Method: ..aT / ,/ & Sappkinenfd Informal-km
.i'YYI, Oil- W011li - R}:QLIRED D%TA:l-AXD 2-FxMil.1"11WEI,LING
®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
t '\'CF:(:Otil OF CONS17(L'('I4Oti work indicated on this application. c„QZ
Valuation:o 2,(Q
El ]-and 2-family dwelling ❑Commercial/industrial
_ ___ ���j ✓17Si
❑Accessory building ❑Multi family Number of bedrooms: 4
0 Master builder 0 Other: Number of bathrooms: 3
31/B Slit INTORM,tTION 4.11).i.O(:A1loN Total number of floors: 1 3)1
Job site address: 15149 Tierra Terrace New dwelling area: 2424 square feet atta-y
City/State/ZIP:Tigard/OR/97224 Garage/carport area: 589 square feet
Suite/bldg./apt,no.: Project name:Trillium hill Covered porch area: square feet
Cross streclidireelions to job site;SW 109d'AVE ANT)SW Lady Marion Dr Deck area: square feet
oftstaturedepx9 to.square feet
RFOIF12.Gp DATA:COhl..V1FR(Y41.-i Si:t'llEt'Kl-iST
Subdivision:Trillium hill I.01.no.: 12 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,:25110DA11400 _ equipment,matetials,labor,overhead,and the profit for the
Yµ a r)I RIPT}ON OF HY)Rii work indicated on this application, _
New Single Family Home to be built-2424 SQ!-1.4 Bedroom,3 bath with 589 SQ Valuation: $
FT 3 car garage with a 278 SQir 'extended covered rear deck. Existing building area: square feet
New building area: square feet
ElPROPik:EITY (DINER ❑ FENAN•T Number of stories:
Name:David Weed:ley Homes Type of construction:
— �—-- '
Address: 1905 NW 169'h Place Suite 102 �Occupancy gawps:
City/State/ZIP:Beaverton,OR 97006 Existing:
Phone:(503)213-4415 Fax:( ) New:
0 .U'Pl=.LC'.tt:' l i3 ('O''it'I 1'kRk)t(;N -�J tti:ITID`ss,,1'L•'8'ri`] F''I F5..
Business name:David Weckley Homes
(Pieaseedertof shed«te)
Structural plan review tee(or deposit): 761.N
Contact name:Meehan Ticknor
Address:1.905 NW 169'h Place,Suite 102 ELS plan review fee(if applicable)
Total fees due upon application:
Cit !StatetZB': Beaverton/OR/97006
Amount received:
Phone:(503)213-4409 T-Fax::( ) ,
---- PfO1•OVOL`rA1( SOLAR P:1NLL S1 S UL11 f r,ES'
E-ntnil: mticknoridwhomes.com -
Commercial and residential prescriptive installation of
(Y)NT8:1,cr0R _ roof-top mounted PhotoVoltaic SolarPanel System,
Business name:David Weekley Homey Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:1905 NW 169th Place,Suite 102 .Solar TnstallationSpecialtt•Code checklist.
City/State/ZIP:Beaverton/OR/970116 Permit Fee(mclud plan review $180.00
_._ ___._..and adm_inistrative_fees)____.__..
Phone:(503)213-4415 _ Pak:( ) State surcharge(12%of permit fee): $21.60
C'CI--lie.:213653 Total tee due upon application: 9:201.60
Authorized signature: This permit application expires if a permit Ls not obtained
within ISO days after it has been accepted as complete.
Fee methodology sit by Tri-County Building industry
Prim name:illeghau Ticknor I Date:5/11R1 Semiee Hoard.
L lti ail ding'Permit,113U F.P-RSPermitApp.duc 02,2412011 440-4(13.111 L+O2/CONI/WEB)
Building Permit Application Checklist
One— and Two—Family Dwelling FOR OFFICE USE ONLY
City of Tigard Received
1 Date/13y: Permit No.:
�rn 13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
T IGARD
24-Hour Inspection Line: 503.639.4175 ® Electrical ® Plumbing El Mechanical
Internet: www.tigard-or.goy ❑ other.
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A.
1 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 . ❑ ❑ ❑
6 Sewer permit. ❑ ❑ ❑
7 Water district approval. ❑ ❑ ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. ® ❑ ❑
9 Erosion control ® plan ❑permit required. Include drainage-way protection. silt fence design and location of catch- ® El ❑
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.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions:property corner elevations(if ® ❑ ❑
there is more than a 4-ft.elevation differential,plan must show contour lines at 2-fl. intervals);location of casements
•
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, ® ❑ 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 ❑
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,rooting,roof slope,ceiling height,siding material,footings
and foundation,stairs,fireplace construction,thermal insulation,etc.
15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ® ❑ ❑
Exterior elevations must reflect the actual grade if the change in grade is 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- ® ❑ ❑
•
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 ® ❑ ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑
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 ® ❑ ❑
over 10 feet long and/or any beam-joist carix ing a non-uniform load.
•
• 20 Manufactured floor/roof truss design details. El El ❑
•
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ® 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 Z ❑ ❑
architect licensed in Oregon and shall be shown to he I licable to the ,ro ect under review.
.JURISDICTIONAL SPECIFICS
23 'three(3)site plans are required for Item 11 above. Site plans must he 8-1/2"x 11"or 11"x 17". ® ❑ El
24 Two(2)sets each are required for Items 16, 19,2t)and 22 above. ® ❑ ❑
25 Building plans shall not contain red lines or tape-ors. "Mirrored"building plans will not he accepted. ® El ❑
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ® ❑ 0
27 "Drawn to scale"indicates standard architect or engineer scale. ® El El
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. "free locations,driplines, El 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 ❑ ►1
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.
I LA Building V Permits\RUP-RFSPcrmitApp.doc 02/24/2011 440-46131'(11/02/COM/WEB)
t
Mechanical Permit Applicatl FOR OFFICE USE ONLY
�1 ������® Received ^�'��Yt /� 1
UPI
- City of Tigard Date/By. Pemtil No,: '..� 1 L-'tz�� too l�9 O
- I>125 SW Ilall Blvd.,Tigard,OR 97223 ? 2 q '
Phone: 503.718.2439 Fax: 503.598.1960 Y ��` Plan RovBS. Other Permit:
Date;B�.
inspection Line: 503.(39.4175 CITY OF TIGARD
TIGARD Date Ready/By: hail See Page 2 for
Internet: www.tigard-orgov Troliled/Method: Supplemental Information
BUILDING DIVISION .
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit tees°are based on the value of the work
® Ness 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
FION RESIDENTIAL EQUIPMENT/SYSTEMS FEES`
® l-and 2-family dwelling ❑Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi-family 0 Master builder ❑Other: Description Qty. La_ Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 1 46.75
Job site address: 15149 Tierra Terrace Furnace 100,000 BTU(duets/vents) 1 46.75
City/State/ZIP:Tigard/OR/97223 Furnace I00,000+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 Hvdronic hot water system 23.32
Residential boiler(radiator or
hy(ironic) 2332
Unit heaters(fuel-type,not electric),
in-wall.ill-duct.suspended.etc. 46.75
Flue/vent litr any of above 23.32
Subdivision:Trillium Hill Lot no.:12
Other 23.32
Other fuel appliances:
fa"map/parcel no.:2S110DA11400 Water heater 1 23.32
DESCRIPTION OF WORK Gas fireplace/insert 1 33.39
Flue vent for water healer or gas
Ness single family home to be built-2424 sgft,4 bedroom 3 bath home with fireplace 23.32
589 sgft 3 car garage and a 278 sqft extended covered rear deck. Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
® PROPERTY OWNER ❑ TENANT
Environmental exhaust and ventilation:
Name: David Weckley Homes Range hood/other kitchen
equipment I 33.39
Address: 1905 NAM'169th Place,Suite 102 Clothes dryer exhaust 1 - 33.39
City/State/ZIP:Beaverton/OR/97006 Single-duct exhaust(bathrooms. 4
toilet compartments,utility rooms) X 23.32
Phone:(503)213-4415 Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT ® CONTACT PERSON Other: 2332
Fuel piping:
Business name:David Weekley Homes
S14.171 for first four;S4.03 for tack additional
Contact name:Mleghan Ticknor Furnace,etc.
Address: 1905 NW 169`n Place,Suite 102 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Beaverton/OR/97006 Water heater
Phone:(503)213-4409 Fax::( ) Fireplace
Ranee \
F-mail: ntticknoriidwhomes.com Barbecue i
CONTRACTOR Clothes dryer(gas)
Business name:David Weekley Homes Other.
A1ECHANIC'AL PERMIT FEES*
Address: 190.5 NW 169'a Place Suite 102 Subtotal
City/State/ZIP: Beaverton/OR/97006 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(5(13)213-4415 Fax:( ) State surcharge(12%of permit fee)
CUB lie.:213653 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name:Ken Puttman Date:5/11/21
I auilJii I'amiK:AllC.1'elmitApp_0401l 3 doe 440-017T(II/0:/COM."WFOI
• Electrical Permit ApplicationRECEIVE I FOR OFFICE USE ONLYC co %]/�
Received MJT20A, l-/v
City of Tigard o oateB Permit.
1 3125 SW Hall Blvd Tigard,OR 9n23 r.,,iit 1 2 .—
g Plan Review
ill' Phone: 503 7'18.2439 Fax' 503.598.1960 I./we Bs. Related Permit#.
inspection Line: 503 639.4175 CITY OF TIGARD Ready Duie.By: Faris' See Paget for I
TIGARD Internet. wwwt tigard-orgov NottfedbAethod. Supplemental Information
BUILDING olvisinN
TYPE OF WORK PLAN REV If:14'
El Ness CII'is tru etioll ❑Addition.alteration'replacement PIet.c check all that apply(submit 2 sets of plant,w-items checked).
O Sen ice or fender 100 amps or more ❑Budding m cr three'Ponies.
❑ Demolition ❑Other: where the available litult current 0 Marinas and boatyards
CATEGORYOF CONSTRUCTION exceeds 10,000 amps at 150 soils or 0 Floating.buildings.
® I-soil 2-Family dwelling ❑Commercial/industrial ❑Accessory building less to grotmd,or exceeds 14,000 ❑Comnxretal-use agricultural
amps for all other installations. buildings.
❑Alttlti-famih ❑ Masterbuilder ❑Other: hire pump. ❑Installation of150Kv.aor
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
0 Addition of new motor load of system.
Job#:68160012 Job site address: 15149 Tierra Terrace I00HP or more. ❑`A ..e. 1- 'l's'.
Cit'/State/ZIP:TI ard/OR/97224 ❑Six or more res'identialmiits occupancy
y g ❑Health-care Facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Trillium II111 0 Hazardous locations. 0 Supply voltage liar more than
❑Seri ice or feeder 600 amps or store. 600 Cults nominal.
Cross street/directions to job site:SW 109th AVE AND SW Lady Marion dr FEE SCHEDLI F
DOA riplion I Q.v. I Each I I mai I '
NOV residential single-or multi-family dwelling unit.
Subdivision: Lot#:12 Includes attached garage.
1,000 sq.ft or less 1 16854 168.54 4
fax map%parcel r:2SI IODA11400 -
___.__ Ea.add'1500 sq.ft.or portion 33.92 107.76 I
DESCRIPTION OF WORK Limited energy,residential
7500
New Single Family Home to be built-2424 SQFT 4 Bedroom,3 bath with 589 SQ (with above sq_ft.1
Limited energy,multi-family 75.00 2
FT 3 car garage with a 278 SQFT extended covered rear deck. residential I with above sq.fr.l
Renewable Energy ❑ See Page 2
® PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name: David Weeldey Humes 200 amps or less 100.70
Address: 1905 NW 169'l'Place Suite 102 201 amps to 400 amps 3356
401 amps to 600 amps 20034 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 I
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
121
APPLICANT I 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 fet, 74' 2
each branch circuit
Contact name: Nieghan Ticknor B.Fee for branch circuits without
Address: 1905 NW 169t''Place Suite 102 service:or feeder fee,first 56)8 2
branch circuit
City/State/ZIP:Beaverton/OR/97006 Each add]branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)213-44(19 Fax: :( ) Each manufactured or modular 67.R4 2
dwelling,service and/or feeder
Email: mtieknora dw homes.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67 84 2
B usiness name:Garner Electric Sign or outline lighting 6784 2
Signal circuit(s)or limited-energy 0 See Page 2
Address:2890 SE Brookwood Ave panel,alteration,or extension_ 2
City/State/ZIP:Hillsboro,OR.97123 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)648-4552 Fax:( ) Investigation(I hr min) 90.00/hr
Email:permits Q@garne eIectriGCofT1 Industrial plant(1 h mine 78.18i hr
Inspections for trhich no fee is 9(100"hr
CCB Lie.:121159 Electrical Lie.' 4-305C Suprv.Lie.:3707S specifically listed P -Sr ctin)
ELECTRICAL. PERMIT FEES
Suprv.Electrician signature.require Subttal: __
Print name:Charles Garner Date: ❑Plan Review Required(25%of permit tee):
State surcharge(12%of permit fee):
Authorized signature: 154.s 9LULd,2Ili TOTAL PERMIT F'EE:
This permit application expires if a permit is not obtained within 180
Print name:Brittany Burlan Date: days after it has been accepted as complete.
* Number of inspections allowed per permit
IABuilding`PermitSELC_PerelitApp_ELR_ERE.doc Rev ON I?/2015 440-4615Tl I I:05:COhVWEB
•
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Description I OD' Each I llu.il
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less oft 7o 2
5.01 to 15 kva 13356 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 20034 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 5U kva 301.04 2
® Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance 55226 2
with OAR 918-309-0040)
® Heating, Ventilation and Air Conditioning solar generation systems in excess of25 kva:
System*
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
r—I Other: Each additional inspection is 6625:in
LJ charged at an hourly(I hr min)
Inspections for which no fee is 90A0 hr
specifically listed('4 hr mint
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 stint :doter on Page 1)_
Nanther of inspections allowed per permit
(SEC OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
n Clock Systems
❑ Data Telecommunication Installation
• Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
n Nurse Calls
❑ Outdoor Landscape Lighting*
n Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
IABuildingiPermii(ELC_Perrnicapp_ELR ERE.dee Res 0617/2015
,-
Plumbing Permit APPlicatio m
Building Fixtures riEGEI V .. roR orrlc is L sr oNt.)
h r 1 2 '1(i"., Received Permit No.: 1 021.-0 l RO
City SWof Hagard WV Dale/By:
• 13125 }}all Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.7182439 Fax: 503 598.1 �0�TIGARD Ool y: Other Permit No.:
T l t ti Inspection Line: 503.639.4175 Date Randy/By: lurk IS See Page 2 far
Internet: wwwtigard-or.gov BUILDING DIVISION Nolifed/Metlwl Supplemental Information
ggi't, C <s f(� r :tit I •. ,7.- z a y' MS ¢sr 1' �.cr�^ +�
k §�,.. . .... /y t'PE'GF WORka`: §.,x�.L ����., ,�.'I n�'sr�=:Z, `` �I��E ,'JwC,11ER L ��v �t ^t"1..,� l
El New construction ❑Demolition Forsnrciid information use checklist.
Description I Qty. i Ea. I Total I
❑Addition/alteration/replacement ❑Other: I New 1-2-family dwellings(includes 100 fl.for each utility connection)
CA'1 GDRY (3F,(ONS7R1)CT10N 1 "` r . .e SFR(1)bath 312.70
®I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath I 500.32 500.32
❑Accessory building 0 Multi-family
Each add Mona!bath/kitchen I 25.02 25.02
❑Master builder ❑Other. Fire sprinkler( set ft.) Page 2
,;4: *�-+`- .,: „r . .'' ., ,, s ;r, Site utilities:
lob site address:15149 Tierra Terrace Catch basin or area drain I 18.76
Drywell,leach line,or trench drain 18.76 I
City/State/7.IP: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 109t^AVE AND SW Lady Marion Dr Manholes 18.76
Rain drain connector I 18.76
Sanitary sewer(no.linear ft:_) I Page 2
Storm sewer(no.linear it.: 1 I Page 2 I
Water service(no.linear It.:_) I Page 2
Subdivision:Trillium Hill I Lot no.: 12 I Fixture or item:
Tax map/parcel no.:2S1L0DAL1400 Backtlowpreventer I . 31.27 3L27
i i :,. 1011 WU`i ,zie, 1 w - Backwater valve 12.51
"" Ciotheswasher I 25.02 25.02
New Single Family Home to be built-2424 SQFT 4 Bedroom,3 bath with 589 SQ Dishwasher I I ( 25.02 25.02
FT 3 car garage with a 278 SQFT extended covered rear deck. Drinking fountain 25.02 I',
Ejectors/sump 25.02
Wigattrip' ` >•; Expansion tank 12.51
Name:David Weekley Homes Fixture/sewer cap 25.02
Floor drain/floor sink/hub I 25.02
Address:1905 NW 1691s 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
t "" g� ': ( A.R
k() } Interceptor/grease trap 25.02 I
��I � �,�, y�.
Business name: David Weckley Homes Medical gas(value:$i) Page 2l
Primer I 12.51
Contact name: Megban Ticknor
Roof drain(commercial) 12.51
Address:1.905 NW 169d'Place,Suite 102 Sink/basin/lavatory 6 25.02 I
City/State/ZIP:Beaverton/OR/97006 Solar units(potable water) 62.54 I
Phone:(503)213-4409 I Fax::( ) Tub/shower/shower pan I 3 12.51 I 25,02
E-mail:mschiedler@dwhomes.com Urinal 25.02 I
,qY �r�i�' eM .,.j ,; ��yyyy�y t{t�[e ,(' ��f�,�; z. � WyF i. . Wider closet 3 25.02 100.08
fWA&�rW°"..:. :i.P# v ,^Ti ':A,e 41410 WA'"rIGNS u.q° '.4Fi Ssiz
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 I Fax:( ) Minimum permit the: $72.50
CCB Lie.:102535 Plumbing Lie.no.:34-276PB Plan review (25%of permit fee) I
State surcharge(12%of permit fee) I I
Authorized signature: Carolina Malmedal - TOTAL PERMIT FEE I
Print name:Carolina Malmedal I Date:65/115/2112 I This permit application expires If a permit Is not obtained within 1S0 days
after it has been accepted as complete.
"Fee methodology set by Ili-Comay Building Industry Service Board.
1:1Build'sg\Peneits1PLMt1-PemutApp.doe lOfOIN9 440-1G I GT(10A21COMVw[B)
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
■
T l C11RD Building Permit Review — Residential
Building Permit #: M N-2)221 - 00 Fcf C7
Site Address: 15149 SW Tierra Ter
Project Name: Trillium Hill Lot #: 12
Planning Review
Proposal: New house
® Verifyaddress suite# active in Accela. ® In River
/ Terrace: ❑ No 0 Yes, River Terrace Review Addendum
Site Plan Elements: $IErosion Control
]3 copies of site plan on 8-1/2"x 11" or 11 x 17"paper n®Retained trees with drip line and tree protection measures
lkDrawn to scale (standard architect or engineer scale) XI Footprint of new structure(including decks)and FFE
w North arrow XI Utility locations&easements(required for new and additions)
XISite address,project or subdivision name and lot number i1Sidewalk/driveway approach
®Applicant information(name and phone number) na Location of wells/septic systems
®Lot dimensions and building setback dimensions K1 Street tree size,type and location
ma Square footage of buildings to be demolished E Street names
r®Existing structures on site k( Corner elevations(2'contours if more than 4'differential)
naLot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? Elia ENo
impervious area (applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes ❑No
® 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
Required: ❑ Yes,applicant was notified ® No Received: ❑ Yes ❑ No
r� SDC Exemption for ADU applied for: El Yes ❑ No Received: El Yes ❑ No •
® Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified b IL No Applied For: ❑ Yes ❑ No,stop intake
® Land Use Case#: ZON2018-00002 i i Zoning: R-4.5
® Required Setbacks: Front: 20 Rear: 15 Side: 5 Street Side: na Garage: 20
® Building Height Max. Height: 30 Actual Height: 23
ra Landscape Area: % fia Lot Coverage Max:
Entrance ® Set back no more than 8'from street-facing wall Xi Parallel to street or offset 45 degrees or less
Windows ® Minimum 12%of area of all street-facing facades 12.5%
Garage Xl Garage door is behind widest street-facing wall N Yes ❑ No,one of the following is met:
❑ Door extends no more than 5'from wall and there is a covered porch extending beyond garage.
❑ Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2nd floor.
II Garage door width is ❑ 12'or less ® 50%or less of facade ❑ 60%or less and includes 7 of following:
❑ Covered porch ❑ Recessed entrance El Wall offset 0 1'Roof eave ❑ Roof offset
❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer
❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony
X Visual Clearance X Urban Forestry Plan
® Sensitive Lands: a Yes ❑ No Type: Sig. Tree grove
® Conditions met prior to issuance of building permit
Notes:EN Approved By Planning: G �tivlSk Date: 5/13/2021
Revisions (after BuildingSubmittal only) Reviewer Date
Revision 1: ❑ Approved 0 Not Approved
Revision 2: 0 Approved ❑ Not Approved
1:\Building\Forms\BldgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: 05-I2 2OZI
Site Plans: #
Building Plans: #,_�
Building Permit#: L0 rnter building permit#above.
Workflow Routing: LP1anning (C YEngineering ID-Permit Coordinator [uilding
Workflow Sign-off: [Sign-off for Planning(include notes from planning review)
Route Application Documents: j-Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
V. uilding: original permit application,site plans,building plans,engineer and
beam calculations and t details,if applicable,etc.
Notes:
By Permit Technician: _ 7/%7mf" Date: 05-113'2O2j
Engineering Review
Sloo e at building pad: )(2%D
Id<onditions "Met"prior to issuance of building permit
easements (encroachments)per engineering conditions of approval and plat
[er Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes le—No
Assess Water Quantity Fee in-lieu: ❑ Yes 13'No
LIDA Facility on lot ❑ Yes [ No
Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
E pproved by Engineering: . Date: 3-_- ./c5-2/
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: 0 Approved 0 Not Approved
Permit Coordinator Review
yJ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
SDC Exemption: ❑ Received / Does not apply
SDC Fees Entered: Wash Co Trans Dev Tax: .I Yes 0 N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: ,T Yes ❑ N/A
LIDA ❑ Yes „le N/A
OK to Issue Permit
Approved by Permit Coordinator: 7Arr
Date: `u{tQ (201/1
I:1B ui I d i ng\Fo rm s1B I dgPe rm i tRv w_RE S_122419.do cx