Permit CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2021-00233
•
Ti i A I'.to 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/21/2021
Parcel: 2S110DA11100
Jurisdiction: Tigard
Site address: 15179 SW TIERRA TER
Subdivision: TRILLIUM HILL Lot: 11
Project: Trillium Hill, Lot 11
Project Description: New detached dwelling with 145sf covered deck
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 3 First 2424 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 19 Bathrooms: 3 Second: 0 sf Garage: 607 sf Front: 20 Smoke
Yes
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors:
Total: 2424 sf Value: $333,196.54 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 Drains: 0 Storm Sewer: 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Bckflw Prevntr: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 6 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Fum>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea adds 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
801-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio 8 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 Vs 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 Ersn Cntrl 503-639-4175
HOUSTON,TX 77055 BEAVERTON,OR 97006
•
•
PHONE: PHONE: 503-213-4415
•
FAX:
Total Fees: $38,461.49
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
oc,onl-nnln thrnunh flAR C59JIM-nnOn V"..mau"Main a n"nu of}ha n,Iae nr rlir eI nuae}inne In hl INr hu rnIlinn cnn 9Z9 1QA7 nr 1 Ann ZZ9 9Zd4
Issued By: �{O vQfV i7PWEC r Permittee Signature: OWflppLf C .tion
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 lob site at the time of each inspection.
"Building Permit Applicaticuci E® 13-0 15 -
. Residential FOR OFFICE USE ONLY /'/
City TigardJUN 15 2021 Date/By'�p/ �/ �j -y Permit No.:ms'r���-(JO2 3
of Zp
• 13125 SW Hall Blvd.,Tigard,OR 9 ._ Plan Review ((// /�/
i r' ,�' OF i�U�{Y`t� , v Other Penn 7n2 .W158
Phone: 503.718.2439 Far: 503. .� 1 Date.Re uJ
Inspection Line: 503.639A175 `., ING 1D1VITON Date ReadyiBy / Iter 0 gee Page 2for
TIGARU p e No - d/Method: l / Supplemental Information
Internet: www.tigard or Gov /y
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
® New construction ❑ Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alieration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the 54
CATEGORY OF CONSTRUCTION work indicated on this application. G� �j
Valuation: 35**U% 333 ( l `r1
ElI-and 2-fhmilydwelling ❑Commercial/industrial 9
0 Accessory building 0 Multi-family Number of bedrooms. 3
❑Master builder ❑Other: Number of bathrooms: 3
JOB SITE INFORMATION ION AND LOCATION Total number of Boors: 1 .a'
Job site address: 15179 TIERRA TERRACE New dwelling area: 2424 square feet 2,y2j..1
City/State/ZIP:Tigard/OR/97224 Garage/carport area: 607 square feet
Suite/bldg./apt.no.: Project name:Trillium Hill Covered porch area: square feet
Cross street/directions to job site:SW 10911'AVE AND SW Lady Marion Dr Deck area: 145 square feet
Other structur area: ( .S square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:Trillium hill Lot no.: 11 Permit fees* are based on the value or the work perfixmed.
Tax map/parcel no.:2S l IODAI 1400 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 Ilome to be built-2424 SQFI 3 Bedroom,3 bath with 630 SQ Valuation: $
FT 3 car garage with a 145 SQFT covered rear deck and 153 SQFT covered front Existing building area: square feet
porch. New building area: square feet
® 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: ( ) Now
❑ APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
(Please refer ra fee schedule)
Business name: David Weekley Homes
Structural plan review fee(or deposit): 751.34-
Contact name:Meghan Ticknor
FLS plan review fee(if applicable):
Address: 1905 NW 169"Place,Suite 102
Total fees due upon application:
City/State/ZIP:Beaverton/OR/97006
Amount received:
Phone:(503)213-4409 Fax::( )
E-mail: mticknora dwhomcs.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR root-top mounted Photovoltaic Solar Panel System.
Business name: David Weeklev Homes Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:1905 NW 169'Place,Suite 102 Solar Installation Specialty Code checklist.
City/State/ZIP:Beaverton/OR/97006 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503)213-4415 Fax:( ) State surcharge(12%ofpermit fee): S21.60
CCB lie.:213653 Total fee due upon application: $201.60
Authorized signature: 7447'
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Meghan Ticknor Date: C p 1111 I *Fee methodology set by'Fri-County Building Industry
V Service Board.
I:\Building\Permits\BUP-RESPemtitApp.doc 02/24/2011 440-1613T(I I/02/COM/WEB)
Building Permit Application Checklist
(hie- and Two-Family Dwelling FOR OFFICE USE ONLY
City of Tigard Received
-IIN Date/By:
Permit No.
• 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits.
Phone: 503.718.2439 Fax: 503.598.1960
TIGARD 24-Hour Inspection Line: 503.639.4175 El Electrical El Plumbing :� Mechanical
Internet: www.tigard-or.gov 0 Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW ties No N/A
I Land use actions completed. See jurisdiction criteria for concurrent reviews. ►41 ❑ ❑
2 Zoning. Flood plain,solar balance points,seismic soils designation.historic district.etc. E 0 0
3 Verification of approved plat/lot. E ❑ ❑
4 Fire district approval required. Name of district: . ❑ 0 ❑
5 Septic system permit or authorization for remodel. Existing system capacity . 0 0 ❑
6 Sewer permit. ❑ ❑ ❑
7 Water district approval. ❑ ❑ ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. E ❑ El
9 Erosion control ®plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- E ❑ El
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state E ❑ ❑
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.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if E ❑ 0
there is more than a 4-tl.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 E ❑ El
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, E ❑ 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. ® 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- E 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 E ❑ ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ /1
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 0 0
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. E ❑ 0
21 Energy Code compliance. Identity the prescriptive path or provide calculations. A gas-piping schematic is required !:/ ❑ 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 E 0 ❑
architect licensed in Ore*on and shall be shown to be a.*licable to the .ro'ect under review.
JURISDICTIONAL SPECIFICS
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". E 0 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 El 0
27 "Drawn to scale"indicates standard architect or engineer scale. E ❑ El
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard E 0 0
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations.driplimes, ❑ ❑ 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. ❑ El !I
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.
l:\Building\Permits\BlJP-RESPennitApp.doc 02/24/2011 440-46I3T(I 1/02/COM/WEB)
t'ilo,1
f Mechanical Permit ApplicaREC
FOR OFFICE USE ONLY
City of Tigard Received
Y Date/By: Permit No.:I- T�2I-00�,'5S
13125 SW Hall Blvd.,Tigard,OR 97223JUN ll 5 202� Plan Review
Date/By:114 Phone: 503.71$.2439 Fax: 503.598.19 0 Other Permit
T I GA a D Inspection Line: 503.639.4175 CITY OF..6 IGARD Date Ready/By kids: 0 See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION NoliliettMethod: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE C11ECK'LIST
Mechanical permit fees*are based on the value of the work
®New construction ❑ Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® I-and 2-family dwelling ❑Commercial industrial D Accessory building For special in(orntnaon use checklist.
❑ Multi-family ❑ Master builder ❑Other: Description Qty. Ea. Total
JOB SITE 1_NTORMATION AND LOCATION Heating/cooling:
Air conditioning 1 46.75 46.75
Job site address: 15179 TIERRA TERRACE Furnace 100,000 BTU(darts/vents) 1 46.75
City/State/ZIP:Tigard/ORl97223 Furnace 100,000+BTU(duets/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:Trillium Hill Duct work 2332
Cross street/directions to job site:SW 109'h Ave and SW Lady Marion Dr tlydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended.etc. 46.75
Flue/vent for any of above 23.32
Subdivision:Trillium Hill Lot no.:11 Other: 23.32
Other fuel appliances:
Tax map/parcel no.:2S 11 ODA 11400 Water heater I 23.32
DESCRIPTION OF WORK Gas fireplace/insert I 33.39
Flue vent for water heater or gas
New single family home to be built-2424 sqft,3 bedroom 3 bath home with fireplace 23.32
630 sqft 3 car garage and a 145 sq ft covered rear deck and 153 SOFT covered Log lighter(gas) 23.32
Wood/pellet stove 33.39
front porch. Wood fireplace/insert 23.32
Chimney/liner/flue/vent 2332
Other: 23.32
® PROPERTY OWNER El TENANT Environmental exhaust and ventilation:
Name: David YYceklev Itomes Range hood/other kitchen
equipment 1 33.39
Address:1905 NW 169"Place,Suite 102
Clothes dryer exhaust I 33.39
City/State/ZIP:Beaverton/OR/97006 Single-duct exhaust(bathrooms,
toilet compartments,utility moms) 4 23.32
Phone:(503)213-4415 Fax:( ) Attic'crawlspace fans 23.32
12 APPLICANT ® CONTACT PERSON Other: 23.32
Fuel piping:
Business no-one: David W'eeklcy Homes
$14.15 for first four;$4.03 for each additional
Contact name:Yleghan Ticknor Furnace,etc.
Address:1905 NW 169'h Place,Suite 102 Gas heat pump
Wall/suspended/ sit heater
City/State/ZIP:Beaverton/OR/97006 Water heater
Phone:(503)213-4409 Fax::( ) Fireplace
Range
E-mail: mticknor!a`dwhomes.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business names David YY'eckley Homes Other.
MECHANICAL PERMIT FEES"
Address: 1905 NW 169's Place Suite 102 Subtotal
City/State/ZIP:Beaverton/OR/97006 Minimum perm a fee($90.001
Plan review(25%of permit fee)
Phone:(503)213-4415 Fax:( ) State surcharge(12%of pennit 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 Slgnatun:: ' Fee rnethddologv set by Tri-County Building Industry Service Board
Print name:Ken P "man Date: 440
P.BuildingPerits NEC PemvihApp W0l 13 do: 440-4619T(I I/O2/COM/WEB)
aT
It'Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
Total Valuation: Permit Fee:
$0.0o to$500.00 Minimum fee$69.06
$500.01 to$5,000.00 $69.06 for the first$500.00 and
$3.07 for each additional $100.00 or
fraction thereof,to and including
$5,000.00.
$5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and
$2.81 for each additional$100.00 or
fraction thereof, to and including
$10,000.00.
$10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and
$2.54 for each additional$100.00 or
fraction thereof,to and including
$50,000.00.
$50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and
$2.49 for each additional$100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first$100,000.00 and
$2.92 for each additional $100.00 or
fraction thereof.
Note: MI new commercial buildings require 2 sets of plans.
1:1Building\Pemlits\MEC_PermitApp_040113.doc 2
' Electrical Permit Application ECE1VED FOR OFFICE ISF:ONLY
City o Ti and JUN 1 5 tIST2o.► -00233
Date Bv:
1 13125 SW Hall Blvd,Tigard,OR 97223 Plrv,Res.icw
I1' OF Related Pemtit tr:
�. Phone: 503.718 2439 Fax: 503.598.t QITy - Dale By:
pBUILDING t1�IU � � Juin
TI6ARD Inspection t. vv Line:s. SOo.-or gov75 110VI ION N sdvD41etho: ® SeePent l v
- Internet. bVWw_h"ard-trLgoc Noti6 ediT4efhod: Supplemental Information
TYPE OE WORK PLAN REVIEW
®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w,'itenis checked):
❑Service or feeder 400 amps or more ❑Building over three stories
❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at ISO volts or 0 Floating buildings.
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑commercial-rise agricultural
amps for all other installations. buildings.
❑Multi-family ❑ Master builder ❑Other: ❑Fire pump, 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system larger separately devised .
❑.Addition of new motor load of system.
Job#:68160011 .lob site address:15179 TIERRA TERRACE 100HPormore. ❑".a "E".'v 2","t-3",
City/State/ZIP:Ti ard/OR/97224 ❑Six or more El
mitts occupancy.
g _ 0 Health-care facilities. Recreational vehicle parks
Suite/bldg./apt.#: Project name:Trillium Hill 0 Hazardous locations. ❑Supply voltage for more than
0 Sets ice or feeder 600 snips 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 '
New residential single-or multi-family dwelling unit.
Subdivision:Trillium Hill Lot#: I I Includes attached garage.
1.000 sq.It or less I 168.54 168.54 4
Tax map/parcel#:2S1 I0D.A l 1400
_.._.___.,__ Ea.add'1500 sq ft.or portion 4 33.922 107.76 I
DESCRIPTION OF WORK Limited energy,residential
75.00
New single Famil)(tome to be built-2424 SQFT 3 Bedroom,3 bath with 630 SQFT (with above sq.lti
Limited enemy,multi-fussily 75 00 2
3 car garage with a 145 SQFT covered rear deck and 153 SQFT covered front porch. residential(with above sq.11.)
Renewable Energy 0 See Page 2
® PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name: David Weckley Homes 200 amps or less 10070 2
Address: 1905 NW 1691h Place Suite 102 201 amps to 400 amps 133. 6 3
401 amps to 600 amps 200.34 3
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
Branch circuits—new,alteration,or extension,per panel
® APPLICANT ID CONTACT PERSON A.Fee for branch circuits with
Business name:David Weekley Homes above service or feeder fee, 74, 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 56.18 2
branch circuit
City/State/ZIP:Beaverton/OR/97006 Each add''branch circuit 7 42 2
Miscellaneous(service or feeder not included)
Phone:(503)213-1409 Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service anchor feeder
Email: mticknora;dwhomes.com 2
- Reconnect only 67 84
CONTRACTOR Pump or irrigation circle 67.84 2
-
Business name:Garner Electric Sign or outline lighting 67.84 2
Address:2890 SE Brookwood Ave Signal circuit(s)or limited-energy 0 See Page 2 2
panel,alteration,or extension.
City/State/ZIP:Hillsboro,OR.97123 Each additional inspection over allowable in any of the above
Additional inspection 1 I hr min) 66.25/hr
Phone:(503)648-4552 Fax:( ) Investigation(I hr min) 90.00/hr
Industrial plant Qhrmin) 78.18;`nr
Email:permits@garnerelectric.com
7/43 Inspections for which no fee is 90.00/hr
CCR lie.:121159 Electrical Lie.: 4-305C Suprv.Lie.:3707S specthcant listed t hr min)
EIEC'TRICAI, PE dt`='` ' ES -.,.r);.
Suprv.Electrician signature,require Subtotal.
Print name:Charles Gamer —1 Date: ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: a4,. 5 TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within ISO
Print name:Brittany Burian I)Lite: 6/15/21 days after it has been accepted as complete.
* Nmnber of inspections allowed per permit.
I:Building(PerinitsiELC_PemitApp_ELR_ERE.doe Res.06/1T301 440-4615T(I I'OSCOM/WEB
•Electrical Permit Application —City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Description I Qty. Fach I Total I ^
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: >kva or less 00.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
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)
I Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 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:
❑ Other: Each additional inspection is
charged at an hourly(1 hr min) 66.25"hr 1
Inspections for which no fee is 90 00 hr
speci heal lv listed('=)hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Fluor on Pane 1)* Number of nspeee ons allowed per demur
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
Instrumentation
U Intercom and Paging Systems
n Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
F\nmldinatPeimits,ELC PennivApp FIR ORE doe Rev 06/I7/2015
r RECEIVED
Plumbing Permit Application UN 1 5 2021
Building Fixtures CITY OF 1IGARD 1 t1R OI l It I. 141 OAI)
BUILDING DIVISION
City of Tigard Received Permit No.: Try0j- s 3
i u 13125 SW hall Blvd.,Tigard.OR 97223 Plan Review �'
i. Phone: 503.718.2439 Fax: 503.598.1960 poWEy, Other Penult N
Inspection Line: 503.639.4175 pate Reedy/Ey.. tuns: 1 RI See Page 2 for
Internet: www.tigard-or,gov NellAaUNetheel Suppkmeolai Informaam
C 4'1 ] M .{ t ,N 'N].' !i 1 1 -Y fi f }}4' �(e yy+N r S! ".� +v r a yi Y . x r..y pl�j ,
�v�r, Piet . ,i{ $k�E ba 1 ' -''tR�'v hr`:arg/i `i r I43.5 i.1(,�"� 5A h �a1t ;. ie ! � :Htr'Q'wrIK R,F1. ;�A.:kT.:s
IF VW..- ,.S . «. ... h 0_ t. _. _ rtF Y � 1.0 9,,. ..A �J.+"' ..udY Sti � �i
El New construction ❑Demolition I Forsprdol htformation use checklist
Description I Qty. I Ea. I Total I
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 O.for each utility connection)
. l y f,Lt' l y X h^ �} F t ice' +HZir r�.
' .,5''°��.`_�^.�..`F. �''`�f�"'��..4 lt�..����"+"+,!��;,(,�y.,uu�t�%kLTI-�y$h rt'ke�-�,,,�3�yw�.ix SFR(1)both
312.70
El 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 3 500.32 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen I 25.02 25.02
0 Master builder 0 Other Fire sprinkler(W sin.IL) Page 2
gilgift. S.01.t.Wilillt0A0as E Ppi siviatorit Site ulilitiest
Jab site address:15179 TIERRA TERRACE Catch basin or area drain 18.76
City/State/ZIP:Tigard/OR/97224 Drywell,leach line,or trench drain I 18.76
•
Footing drain(no.linear ft.:lag) I Page 2 87.55
Suite/bldg./apt,no.: Project name:Trillium HIII Manufactured home utilities 50.03
Cross street/directions to job site:SW 10911`AVE AND SW Lady Marion Dr Manholes 18.76
Rain&tinconnector I 18.76
Sanitary sewer(no.linear II. _I I Page 2
Storm sewer(no.lineartt.:,__ I Paget
Water service(no.linear It.:_) I Page 2 I
Subdivision:Trillium Hill .Lot no.:11 I Future or item: I
Tax map/parcel no 251 I ODA(1400 Becktlow preventer I I 31.27 I 3127
iirrk r, uw v� ,114.. are F r r.r '.. »�,• Backwater valve 12.51
' %t �`�4?� '" Clothes washer 1 25.02 25.02
New single family home-2424 sqft,3 bedroom home with 630 sqft Dishwasher I I 25.02 I 25.02
3 car garage and a 145 sqft covered rear deck and 153 sqft covered Drinking fountain 25.02
front rch, .
Ejectors/sump 25.02 '
} 't-. ra'lI, t .. Expansion tank 12,51
c Fixttre/sewer cap 25.02
Name:David Weeldey Homes
Address:1905 NW 169*Place Suite t02 ( Floor draidtloar sink/hub 25.02
Garbage disposal 1 25,02 I 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 12,5)
.. Interceptor/grease trap I 25,02
Business name:David Weekley Homes Madicalgas(value;S ) Paget
Primer 1.251
Contact name:Megian Ticknor
Roof drain(commercial) 12.51
Address:1905 NW 16911'Place,Suite 102 ' Sink/basin/lavatory I 6 I 25.02 I 100,08
City/State/ZIP:Beaverton/OR/97006 Solar units(potable water) I 62.54 I I
Phone;(503)213-4409 I Fax::( ) Tub/shower/shower pan I 3 I 12,51 2502
E-mail:machiedler®dwhomes,eom Urinal 23,02
y a,. Watercloset ; 25.01 100.08
s ,'v.M' i � ' !F`.T '"+ . -. >>Irr r, _ w g - 1 37,52
Water beater 37 52
Business name:Mslmedal Plumbing Water pipirg/DWV 56.29 I
Address:PO Box207 Other: 25.02 I
City/State/ZIP:Banks/OR/97106 Subtotal
Phone:(503)324-0759 Fax:( ) Minimum permit fee: 372.50
CCB Lie.:102535 Plumbing Lic.no.;34-276PR Flan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: Carolina Malmedal tmria ------/a.-« TOTAL PERMIT FEE I '
Print name:Carolina Malmedal [ Date: 6/15/21 This permit app0eauop espirel if a permit la not obtained*IND lac dins
after it bits been accepted se complete.
•Fee inetitddoay sal by Trl-Coutey Ruddlag tduasy Service Board.
liaulldirteor Pi.MU•PemwApp.doe 1010109 4404616T(IOM:000M'WE6)
•
Plumbing Permit Application- City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Suppression Systems:
p
Residential
� tre u �ry[�%
Footing drain-I"100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37,52 2,001 to 3,600 $169,69
3,601 lc 7.200 $233.20
Sewer-1st 100' 62,54 _7,201 and grantor $32754
Sewer-each additional 100' 37.52
Water Service-1st 100' 62,54 Medical Gas Systems
Water Service-each additional 100' 37,52 , +r
e
Storm&Ruin Drain-1st 100' 62.54
$1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 35,001.00 to$10,000.00 $72.50 for Pre first$5,000.00 and 31.52 for
.a'. :..,.d�h w . .sa
s tkl. '>+ 1ISp�kf410ft�$,R4�' eeg,, ;r,�,° „,yy; 4 p each additional$1 0.0O or fraction thereof,to
and including$10,O0000.Inspection of existing plumbing or for $10,0111.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for _
which no tee is specifically indicated 90.00/hr each additional$100.00 or}Median thereof,to
(minimum charge-1t2 hours and including$25,000.00,
h,sptxtionsoutsideofnormalbusiness 90.00/hr $25,0OI.00to$50,000,00 $379.50 for the first$25,000.00 and$1.45for
hours(minimum charge-2 hours) each additional$'00.09 or fraction thereof,to
Reinspection Foes 90 00/hr and including$50,000.00.
Additional plan review for revisions 90.00/hr 350,001.00 nod up $742.00 for the first 350,000.00 and$1.20 for
(minimum charge-1/2 Incur) each additional$100.00 or faction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*.
tiii tl`yPe lvr':; - ' xs' �}.� ,(.t 181 t;1 , '"' lI,iIlP 13e��c�4 Al .lOn9+ ,C,y;Y
wos4PeMfonared a'` :f+pl>♦d,.., ",tJc+dgi,..` `l2elaa0e; Plan review is required for any of the following,
Baptistry/Font Please check all that apply.
Bath fuh/Shower 0 Any new commercial building with water service 2"and
-Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-DriveThru ❑ New exterior plumbing site utilities for any complex structure
Cuspldor/WaterAspirator as defined in OAR918-780-0040,
Dishwasher -Commercial 0 Medical gas and vacuum systems for health cure facilities:
-Domestic - ❑ Any multipurpose tire sprinkler system.
Drinking Fountain 0 Any complex structure as defined in 0AR91.8.780-0040,
Eve Wash
Floor Drain/sink 2" Submit 2 sets of plans with any of the above.
.3^
edie
Car Wash Drain s1hit „k3S lltey }t 'r1V ` ,�
Garbage -Domestic-non-food 0 Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
tee Mach/Refrlg.Denim
Oil Separator(Gas Sbuio) Comments regarding fixture work:
Rao.Vehicle Dump Station
Shower -Gang
-Stal I
Sink/Inv -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this
Washer-Clothes
permit results in an
Water 8xntiuwr Increase of sewer EDUs,R sewer permit will be issued and
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
C;\Usersl.Malmedul\AppDatalluoal1Microsoft\Windows\INeteache\Conte t.0utiook131I2CXR481PlumhingPermit.doe
City of Tigard
11111 I II
COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review — Residential
TIGARD
Building Permit #: m f2o21-bo 23 3
Site Address: /5/2-/ Op —Mira
Hill
,
Project Name: 7,'lliLlrn H ll Lot #: 11
Planning Review
Pr posal: 'Veup-
�
Verify address/suite#active in Accela. ❑ In River Terrr e: ❑ No ❑ Yes,River Terrace Review Addendum
Si Plan Elements: I1Er•don Control
copies of site plan on 8-1/2"x 11"or 11 x 17"paper ,�aained trees with drip line and tree protection measures
yawnnn to scale(standard architect or engineer scale) M Footprint of new structure(including decks) and FFE
oath 7, .tilt,locations&easements(required for new and additions)
e addressarrow,project or subdivision name and lot number ►i S+ -•alk/driveway approach
pplicant information(name and phone number) •'.• ation of wells/septic systems
IA Lot dimensions and building setback dimensions VA treet tree size,type and location
II Square footage of buildings to be demolished eet names
e-,‘ II Existing structures on site Comer elevations(2'contours if more than 4'diffe -ntial)
II Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? it Yes .I o
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? Ill .t s No
Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995):
Required: El Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No
Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ElYes,applicant was notified ❑ No Received: ❑ Yes ❑ No
DC Exemption for ADU applied for: ❑ Yes ❑ No Received: ❑ Yes ❑ No f
Public Facilit Improvement (PFI) Permit:
equired: ,� Yes,applicant was notified El No plied For: NYes ❑ No,stop intake
a/Land Use Case#: Qil1Z0! QJ —00002 Zoning: , "
equired Setbacks: Front:.2-i9 Rear: / Side: Street Side: 4.) Garage: .2 L
Building Height: Max. I leight: 30 Actual Height: /9
andscape Area: % of Coverage M :
Entrance V et back no more than 8'from street-facing wall Parallel to stre t or offset 45 degrees or less
Windows ' . um 12%of area of all street-facing facades
Garage Gar door is behind widest street-facing wall ❑ 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 w and there is a 12 sq ft.window above garage on 2nd floor.
Garage door width is ❑ 12'or less0%or less of facade ❑ 60%or less and includes 7 of following:
❑ Covered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset
❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof El Dormer
❑ Accent siding Window trim ❑ Window recess El Window projection ❑ Balcony
' `'isual Clearance Urban Forestryplan
i'\\ :ensitive Lands: CI Yes No Type:
C ditions met prior to issuance of building permit ��
No s: �n/
Approved By Planning: / Date: (-C' h 9" i
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:\Building\Fors\BldgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: ao ji 5/202 i
Site Plans: # 3
Building Plans: # 3
Building Permit#: e-Enter building permit#above.
Workflow Routing: Planning REngineering Permit Coordinator [1---Tuilding
Workflow Sign-off: [Sign-off for Planning(include notes from planning review)
Route Application Documents: 1:1--Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
C'Building: original permit application, site plans,building plans,engineer and
beam calculations and tru •-tails,if applicable,etc.
Notes:
By Permit Technician: y ii i,T . Date: O6/2//ZQV
Engineering Review
E"Slope at building pad: /f r;
a-Conditions "Met"prior to issuance of building permit
Easements (encroachments) per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes RNo
Assess Water Quantity Fee in-lieu: ❑ Yes 121--No
LIDA Facility on lot: ❑ Yes VNo
VFinal Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
kr-Approved by Engineering: 1Z, F S f}tit— Date: G-22,-zo2/
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
ermit Coordinator Review
�C nditions "Met"prior to issuance of building permit
pproved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
I, Al C Exemption: ❑ Received Does not apply
1:/ SDC Fees Entered: Wash Co Trans Dev Tax: VI Yes ❑ N/A
Tigard Trans SDC: ignfies ❑ N/A
Parks SDC :IV Yes ❑ /A
LIDA ❑ Yes LIr N/A
OK to Issue Permit
Approved by Permit Coordinator: Date: et/22121
I:\Building\Forms\BldgPermitRvw_RES_1224I 9.docx
IX, 4) 81,_(,),f6 prt.o......4.--4-4-(
Plan# 'T bi a �G
Floors ' Large
Bed rooms J Small -J D--
Wc 3
LAV
Tub Basement
Vent ( 1st Floor 1,./YY)-(
Water Heater \ 2nd Floor
AC �2� 3rd Floor �1
School "'( � R-3 Total a�-{ d-4
Garage Cp0-7
L.) e. i qs Total -6-E;;;
�..f�► . #for Elec
9 -oafIJ 004 is
J