Permit CITY OF TIGARD nilnki MASTER PERMIT
a: COMMUNITY DEVELOPMENT Permit#: MST2021-00285
Date Issued: 08/02/2021
T I(.;A it 1) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110DA10100
Jurisdiction: Tigard
Site address: 10893 SW LADY MARION DR
Subdivision: TRILLIUM HILL Lot: 1
Project: Trillium Hill, Lot 1
Project Description: New detached dwelling.2/17/22: REPRINTED to include(1)laundry sink
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 430 sf Basement
0 sf Left: 5 Parking Spaces: 0
Height: 27 Bathrooms: 3 Second: 1957 sf Garage: 603 sf Front: 20 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors:
Total: 2387 sf Value: $327,210.80 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
Bckflw Prevntr. 1
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 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: 4
Fum>=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: 4 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mid Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Y
Other: N Other Description:
Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2387
Owner: Contractor:
WEEKLEY HOMES LLC WEEKLEY HOMES Required Items and Reports(Conditions)
1111 N 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: $38,198.95
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
g89ftn1_nn1 n I1hrnnnh rtSR g52.nnt-nnQn Vn, may nhtain a e.nnv of th>mlac nr dirxt nunatinnc to(HINT:by Tallinn Fn7 979 1QA7 nr 1 Ann 779 9'1dG
Issued By: �1��� Permittee Signature: an Awl;Lahjvl
L 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 fob site at the time of each inspection.
N ' CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2021-00285
T r c;A R.[) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/02/2021
Parcel: 2S 110DA 10100
Jurisdiction: Tigard
Site address: 10893 SW LADY MARION DR
Subdivision: TRILLIUM HILL Lot: 1
Project: Trillium Hill, Lot 1
Project Description: New detached dwelling
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 430 sf Basement 0 sf Left: 5 Parking Spaces: 0
Height: 27 Bathrooms: 3 Second: 1957 sf Garage: 603 sf Front: 20 Smoke
Yes
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors:
Total: 2387 sf Value: $327,210.80 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 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: 4
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 Y
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2387
Owner: Contractor:
WEEKLEY HOMES LLC WEEKLEY HOMES Required Items and Reports(Conditions)
1111 N 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: $38,198.95
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
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IEouy Vow/ De/Wege Owf(pplt:c,Axt n
Issued By: Permittee Signature:
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.
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Building Permit Application
Residential RECEIVED FOR OFFICE USE ONLY
City of Tigard Received
eceiv a o7 #? 2021 -' Pennit No:Pig rzO,2/-Qo2►c
s 4 13125 SW Hall Blvd.,Tigard,OR 97223 JUN 2 202i plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: 7/a(, / Aty Other Perniit.5(.C/ 02/10O/1.4
'l i u t Inspection Line: 503.639.4175 CITY OF TIGARI� D e Ready/By: uric 0 see Page z for
Internet: wwwhigard-or.gov BUILDING DIVISION tified/Metho Supplemental Information
TYPF. OF WORK I REQUIRED DATA: I-AND 2-FAMILY DWFI.IINC
® New construction ❑ 1kn10i:ion Permit lees*are based on the value(tithe work performed.
Indicate the value(rounded to the nearest dollar)of all
El Addition/alteration repidcemenl ❑t)1It_r- equipment,materials,labor,overhead,and the profit for the
C_�"hF:GORV OF CONSTRUCTION work indicated on this application.
40
® I-and 2-family dwelling ❑Commercial/industrial
Valuation: ..'„�- ��� a 10
❑Accessory building ❑Multi-family Number of bedrooms: 4
El Master builder ❑Other: Number of bathrooms: 3
z JOB SITE INFORMATION AND LOCATION Total number of floors: 2 ill a
i Job site address:10893 Lady Marion Dr. New dwelling area: 2387 square feet 1 C/57
City/State/ZIP:Tigard/OR/97224 Garage/carport area: 603 square feet 113D
Suite/bldg./apt.no.: Project name:Trillium Hill Covered porch area: square feet
Cross street/directions to job site:SW 109th AYE AND SW Lady Marion 1)r Deck area: t -111( square feet
I
autner structure area: ,(q square feet
REQUIRED l)DA'LA:COM1IYlERC1Al;I SE CHECKLIST
Subdivision:Trillium Hill Lot no.:1 Permit fees' are hayed on lie :rluc of the\turl:performed.
I as n?ap:}rnrr!nu. 2�1 I OD-�I II110 Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
New Single Family Home to be built-2387 SQFT 4 Bedroom,3 bath with 603 SQ Valuation: $
FT 3 car garage with a 119 SQFT covered balcony,108 SOFT covered rear porch Existing building area: square feet
and a 33 SQFT covered front porch. New building area: Square feet
® PROM:wry I OWNER ❑ TENANT Number of stories:
Name:David Weekley Homes Type of construction:
Address:1905 NW 169th Place Suite 102 Occupancy groups:
City/State/ZIP:Beaverton,OR 97006 Existing:
Phone:(503)213-4415 Fax:( ) New:
CI APPLIt 1NT ® CONTACT PERSON BUILDING PERMIT FEES*
(Herts.('refer iv fee schedule)
Business name:David 1\ccIde:k I tomes
Structural plan review lee(or deposit): 75/ 3`f
Contact name:Meghan Ticknor
FLS plan review fee(if applicable):
Address:1905 NW 169'h Place,Suite 102
Total fees due upon application:
City/State/ZIP:Beaverton/OR/97006
\mount received:
Phone:(503)213-4409 Fax::( )
Email:mticknor@dwhomes.com PHOTOVOLTAIC SOLAR PANEL.SYSTEM FEES*
...,., .,.F ,.,.._ _.. ,.„,... Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name: David Weekley Homes Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:1905 NW 169'h Place,Suite 102 Solar Installation Specialty Code checklist.
Fe
e ee(includes plan review
City/State/ZIP:Beaverton/OR/97006 Permit $180.00
4 and administrative fees):
Phone:(503)213-4415 Fax:( ) State surcharge(12%of pernnit tee): $21.60
CCB lie.:213653
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
�+ within 180 days after it has been accepted as complete.
Print name:Meghan Ticknor •• r *Fee methodology set by Tri-County Building Industry
Date: II
U 1��'`"�// Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
i
J
iI
.Building Permit Application Checklist
I.
' One- and Two-Family Dwelling FOR OFFICE USE ONLY
City of Tigard Received
2 ll DateBy Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits.
S Phone: 503.718.2439 Fax: 503.598.1960 y Electrical ® Plumbing ® Mechanical
C 1 G A R U 24-Hour Inspection Line: 503.639.4175
Internet: www.tigard-or.gov 0 Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A
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 ❑ ❑ ❑
6 Sewer permit. ❑ ❑ ❑
7 Water district approval. ❑ ❑ ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. It ❑ ❑
9 Erosion control ®plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ® ❑ ❑
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 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 ® ❑ ❑
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 ® ❑ ❑
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater. Z ❑ ❑
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- CO 0 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,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. ® ❑ ❑
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 ❑ 0 El
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 to ❑ ❑
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. CO ❑ ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required El 0 ❑
for tour 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 ❑
architect licensed in Orec: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 I I above. Site plans must be 8-1/2' y I I or I I..y 17"'. ® ❑ ❑
24 Two(2)sets each are required for Items l6, 19,20 and 22 above. ® ❑ ❑
25 Building plans shall not contain red lines or tape-ons. "Mirrored'"building plans will not be accepted. ® 0 0
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development fees document. ® ❑ ❑
27 "Drawn to scale"indicates standard architect or engineer scale. ® ❑ ❑
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ® ❑ ❑
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 0
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
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.
It
t
t
I:\Building\Permits\BUP-RESPemtitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Application FOR OFFICE USE ONLY
IF
City of Tig PECEIVED
al'(� Received Permit No.:Date/By: MST202.k00185
13125 SW Hall Blvd.,Tigard,OR 972 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 N cy 4 �O2i Date/By: Other Permit:
Inspection Line: 503.639.4175 JU `�
I I G A R D Date Ready/By: Juris. El See Page 2 for
Internet: www.tigard-or.gov CITY
OF TIGARD Notified/Method: Supplemental Information
RI 1!1 1 NG noVIS4ONf
TYPE OF WORK COMMERCIAL FEE* SCtIEDLLE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction ❑Addition/alteration !cplacetnen perforated.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value.$
CATEGORY OF CO\S IRt("PION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling 0 Commercial/industrial ❑ Accessory hitildam Forsperiol in/urination usedice/Jist.
❑ Multi-family 0 Master builder ❑ Other: Description (sty. 1.a. Total
Heating/cooling:
JOB SITE IN FORMA 17ON AND LOCATION
Air conditioning 1 46.75 46.75
Job site address:10893 Lady Marion Dr' Furnace 100,000 B'I'lJ(ducts vents) 1 46.75
City/State/ZIP:Tigard/OR/97223 Furnace 100,000+BTU(ducts/vents) 54.9I
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 Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision:Trillium Hillot no.: 1 Other: 23.32
I
Other fuel appliances:
lax malt/parcel no. 25I 110)N 11400 Water heater 1 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-2387 sqft,4 bedroom 3 bath home with fireplace 23.32
603 sqft 3 car garage with a 119 sqft covered balcony,108 sqft covered rear Log lighter(gas) 23.32
Wood/pellet stove 33.39
porch and a 33 sqft covered front porch. _ Wood fireplace/insert 23,32
Chimney/liner/flue/vent 23.32
... . ......... .. Other: 23.32
E PROPIiRI'\ OWNER 0 "FEN ANT
Environmental exhaust and ventilation:
1 Name:David Weekley homes Range hood/other kitchen
equipment I 33.39
Address:1905 NW 169th Place,Suite 102 Clothes dryer exhaust 1 33.39
City/State/ZIP:Beaverton/OR/97006 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 3 23.32
Phone:(503)213-4415 I aa:t ) Alhc/crawlspace fans 23.32
APPLICANT ® CO\TACK PERSON other: 23.32
Business name: David NV'eckley Ilontes Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:Meghan Ticknor Furnace,etc.
Address: 1905 NW 169'h Place,Suite 102 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Beaverton/OR/97006 Water heater
Phone.(503)213-44(19 lax: :( 1 Fireplace
— Range
I:-maiI: mticknor u do homes.com Barbecue
CONTRA('FOR Clothes dryer(gas)
ftu,iness name. David NNecklev Ilomes Other:
MMECHANICAI.PERMIT FEES*
Address:1905 NW 169a Place Suite 102
Subtotal
City/State/ZIP:Beaverton/OR/97006 Minimum permit fee(S90.00)
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 t80
days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name:Ken Puttma /ld4sDate: 0 4 0 1
I:\Building\Pennits\MEC_PermitApp_040 113.doc 4A 0-4617T(11/02/COM/WEA)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 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: All new commercial buildings require 2 sets of plans.
1:\Building\Permits\MEC_PermitApp_040113.doc 2
Liectrical Permit ApplicationRECElVED FOR OFFICE USE ONLY'
Received
City of'Tigard i In' Date/B Permitx. Hs1zo2( -ooze S
13125 SW Hall Blvd.,Tigard,OR 97223 J 1 I`I 2 ��' .U 21 Plan Review
IIIIII
I Phone: 503.718.2439 Fax: l 96 Date/B : Related Permit/k
Inspection Line: 503.639..4175 UITY OF"T IGARD Ready Date/By: tuns See Page 2 for
1IGARI)
IInternet: wWw.tig and-or.gov Bun n!Nri msloN Notified/Method: Supplemental Information
TYPE OF WORK PLAN RLVIL1y
®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
O Service or feeder 400 amps or more 0 Building over three stories.
❑ I/enrol lion ❑tllher: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
® I-and 2-lantih dtvelline ❑Commercial/industrial IDAceessoi. building
less to ground,or exceeds 14,000 ❑Commercial-useagicultural
amps for all other installations. buildings.
❑Multi-fami is EI Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SUFF: INFORMATION AND LOCATION ❑Emergency system. larger separately derived
❑Addition of new motor load of system.
.(oh#:68160001 Job site address:10893 Lady Marion Dr 100HP or more. ❑"A","E",`°I-2", °1-3",
City/State/ZIP:Tigard/OR/97224 ❑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
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site:SW 109th AVE AND SW Lady Marion dr FEE SCHEDULE
Description I Oil. i Each I Total i
New residential single-or multi-family dwelling unit.
Subdivision:Trillium Hill I.ot tit:1 Includes attached garage.
1,000 sq.ft.or less 1 168.54 168.54 4
I:i' map/parcel f,:2S1101)1114(1(1
Ea.add'l 500 sq.ft or portion 4 33.92 107.76 I
DESCRIPTION OF WORK Limited energy,residential
(with above sq.ft.) 75.00 2
I Limited energy,multi-family 75.00
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
® PROPER F1 OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name: Da‘id NI eekley Domes 'oo amps or less 100.70 _
Address:1905 NW 169"'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
Phone:(503)213-4415 Fax:( ) Over 1,000 amps or volts 552.26 _
Temporary services or feeders installation.alteration,and/or
Entail: 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
Owner signature: Date: 401 amps to 599 amps 168.54 _
►Zi APPI.ICA:N'I' Branch circuits—new,alteration,or extension,per panel
® COT TAT A( I PERSON A.Fee for branch circuits with
Business name: Das id NV eekley I limes above service or feeder fee, 1
each branch circuit 7.42
Contact name:Meghan Ticknor B.Fee for branch circuits without
s
ranch circuit
Address: 1905 NW 169th Place Suite 102 branch
or feeder fee.first 56 18 2
bra
City/State/ZIP: Beaverton/OR/97006 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)213-4409 Lax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
(:mail: mticknort)dwhomes.com Reconnect only 67.84
CONTRACTOR Pump or irrigation circle 67.84
Business name:Garner Electric Sign or outline lighting 67.84 _
Signal circuitls)or limited-energy
Address:2890 SE Brookwood Ave panel,alteration,or extension. 0 See Page 2
City/State/ZIP:Hillsboro,OR.97123 Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 6625,'hr
Phone:(503)648-4552 Fax:( ) Investigation(1 hr min) 90.00:hr
Email:permits@garnerelectric.com Industrial plant(I hr min) 78.18/hr ,
inspections for which no tee is Oil Oti hr
CCI3 Lie.:121159 Electrical Lie.' 4-305C Suprv. Lie.:3707S slsceiiicaII listed('=hi mill)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature.require ;ubtotol
Print name:Charles Garner Date: 0 Plan Review Required(25"0 of permit lee)
State surcharge(12%of permit tee):
Authorized signature: thdea . 9e t a.y- TOTAL PERMIT FF I'
This permit application expires if a permit is not obtained within I80
Print name:Brittany Burian Date:6/24/21 days after it has been accepted as complete.
* Nmnber of inspections allowed per permit.
(:\Building\Permits\ELC_PemtitApp_ELR_ERE.doc Rev 06/17/2015 440.4615TO I/05/COM/WEB
' Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
� � t (`VW FEE SCIIEDI LL
OW�CY:T Drsrri rlmn
I v1,. I Rath I low! 1 .
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5kva°`less Ioo.�o '"
5.01 to 15 kva 133 56 2
❑ Audio and Stereo Systems* 15 0l to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
El Alarm zs.ol to 5o kva 301.04 2
50.01 to 100 kva 55226 2
® Garage Door Opener*
100 kva(fee in accordance
with OAR 918-309-0040) 552.^_6 2
Solar generation systems in excess of 25 kva:
EA Heating, Ventilation and Air Conditioning
System*
Each additional kva over 25 7 42 3
El Vacuum Systems* 100 kva-no additional charge 0 0 3
Each additional inspection over allowable in any of the above:
❑ i ach additional inspection is
Other: charged at an hourly(I hr min) 66.25/hr 1
Inspections for which no fee is 90 001 hr
specitical1 listedd hr minI @
C,C 4Aiiit kL WORK.4NLYf° , ,,, f J
Subtotal(Enter on Page I).
Fee for each commercial system: $75.00
(SEE OAR 918-309-0000) * Nw„ber of inspections alloy,-nd per permit.
Check Type of Work Involved:
❑ A• udio and Stereo Systems
B• oiler Controls
E Clock Systems
E Data Telecommunication Installation
E Fire Alarm Installation
1 E HVAC
• Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
E Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
C Protective Signaling
❑ Other:
Total number of commercial systems: _
*No licenses are required. Licenses are required for all
other installations
I-VRRuilding,Permits`.ELC PereWApp El R ERE.doc Rev 06/17/2015
4
Plumbing Permit AnnlieuRECEIVED
Building Fixtures t t)It ()I I H t I 1/41 OM N,
CityofTf and JUN 2 A 2021 Received
g NisiBy; Pemtit No.:1'1STZ oZ l'aQZ vS
lig13125 SW Hell Hlvd.,Tigard,OR 9 2 v Plan Review
Phone: 503.718.2439 Fax: 50 S p®� 1� A D Other Permit No.:
[)eta/DY
i Inspection Line: 503.639.4175 iLD DING DIV!S O") llateReady/[iy: Iurro: GI seePege2ror
Internet: www.tigard-or.gov Notified/yethod
„ ytt,d 7r}x Supplemental
nrYwrr.ntntinra mat lon
at7st 6s" h tl: l.Af ✓ 7i1Vc �II ti� g4 r� V NINf XV 3 °rigilI r �ft�� Hy6T(Lkd4. l �ir
4
x&`t��1 l� .,.,r. t .t r f i c,',..,~ i S,,..�; �.) �.lVr#}: t a a,..Vr a. ,2133:i ���rJ/lafy.•4°;v 51,: i.rsft.-. JIx - ."':; r ,:.Ltg;>?ikSr<i ;
®New causinlction 0 Demolition For special information use checklist
Description _I Qty. I Ea. I Total
0 Addition/alteration/replacement 0 Other: New I-2-family dwellings(includes 1(N)it for each utility connection)
,0, ``# 1 c i(M f i(j1 to S Rr P yY r,�
{{S SFR(1)bath 312.70
p; .'?.{NR,�l.'0111,.,i . .4.;.1c (t , lY,d'NIN 4 kb . YY® i-and 2-Tinnily dwelling ❑Commercial/industrial SFR(2)bath 437,78
SFR(3)bath i 500.32 500,32
❑Accessory building 0 Multi-family Each additional bath/kitchen 25A2 25.02
0 Master builder 0 Other:
Fire sprinkler( sq.it) Page 2
fik:�'� 7 r,4 Y'. ? f J7� th f�` s,, dcc M-y� 4 �lr lar . t(r F,?;i
y ' " (s av� F it fsr''' .lkiA,0134 v, ,#.`r,'�E 55 ii)h`y i site uttlities;
eki:Sf ;SLY , 3 n.t. r
Job site t)ddrees: 10893 Lady Marion Dr. Catch basin or area drain 18.76
Drywell,knelt line,or trench drain 18.76
City/Slate/ZIP:9'igard/OR/97224 Footing drain(no.linear It.: Page 2 87.55
Suite/bldg./apt.no.: J Project name:Trillium Hill Manufactured home utilities 50.03
Cross street/directions to job site:SW I09ii AVE AND SW Lady Marion Dr Manholes 18.76
Rain drain connector 18,76
Sanitary sewer(no.linear lt.._) Page 2
Storm newer(no,linear f.: ) _ Page 2
Water service(no.linear it: ) Page 2
Subdivision:Trillium Hill 1 Lot no.:I ' Fix tort or hem;
Tax map/parcel no.:25110DA11.400 Back flow preventer 1 31.27 3127
r rorn t wzry,°s fr .,4 =. nv: ,Y,�t :tzs r.r fww u -y x Backwater val ve 12.51
vOii- 1B(r2 a:`.t.te",t �' R. ., >22,;rW ,zRi. t )-00 'ri<a t. A , ..440 f
Now Single Family Home to be built,-2387sgf1 4 bedroom.3 bath with 803sgft 3 car garage with a 118sga Clothes washer I 25,02 25.02
Dishwasher 1 25.02_ 25.02
covered balcony.108sgft covered rear porch aria a 33 sgft covered front porch.
Drinking fountain 25.02
Ejectors/sump 25.02
a ' r2 r " S r C x nston tai0 itrtfkr> H sE-'�i f'l �t£ ayig>, re W 12,51
�, t.4.Ftoe.. x 3 h.,y e F �,-�tnv ,,,,,a'r.*!,4, :41=_,c 41'.. `A 6
Name:David Weekley flumes Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25,02
Address: 1905 NW 1694 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
alsoM iFi t.,t frs PxU w tt y
� �-`t ,viro grown ityt#p� Interceptor/grease trap 25.02
Nil �. R �S: >i ,&i V&,,,, �zVv,.,.;',d . Set k01 ( . i,.'
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 169'M Place,Suite 102 Sink/basin/lavatory 67 25.02 100.08
City/State/ZiP:Beaverton/OR/97006 Solar units(potable water) 62,54
Phone;(503)213-4409 Fax::( ) Tub/shower/shower pan S 12,51 25.02
E-mail: ntschledler(a@dwhomea,com Urinal 25.02
r Ka KKr w(r.z rr 1r i r Water closet 25.02 100,08
water heater I 37.52 37.52
Buslite s name:Mahn edul Plumbing Water p tpin DWV 5629
Address:PO Box 207 Other: 25.02
City/State/ZIP:Ban ks/OR/97 1 06 Subtotal
Phone:(503)324-0759 l Fax:( ) Minimum permit Ter: S72.50
CCB Lie.:102535 ( Plumbing[,lc.no,:34-276PB Plan review (25%of permit fee)
State surcharge(12%of permit tee)
Authorized signature: Carolina Malmedal TOTAL PERMIT FEE
Print name:Carolina M1tahnedai Date' (211[[ 1 Thispermitapplicationexpiresifapermitisnotobtainedwithin180days
s./� after it has been accepted wv complete,
°toe methodology sei by Tit-County[Wilding Industry Service Doard,
iU3uildinatPertuanPr.MU.ParnutApp.doe fcalnl9 4404GIeT(10/a2/COM/wftn)
Plumbing Permit Application - City of Tigard
Page 2-Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
ii tillkivs ,V ti: u , r , 4:0 titi 2$4410u 00filge,: r: y i
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
Sewer-1st 100' 62.54 ,3,601 to 7,200 $233.20
7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-tat 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52 77r / 3, k i
.1i� 1 f;: eRt f e In` e .alft�f lkr; ,t
Storm&Rai»Drain-1st 100' 62,54 $1,00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001,00 to$10,000,00 $72.50 for the first$5,000.00 and$1.52 for
{' `k' ` , k "" r ,r_ �` each additional$100,00 or fraction thereof,to
tit' 4We"ti t; 41 ' y t:AWC Q60 i and including$10000.00.
inspection of existing plumbing or for $10,001.00 to$25,000.00 $148,50 for the first$10,000.00 and$1.54 for
which no tee is specifically indicated 90.00/hr each additional$100,00 or fraction thereof,to
(minimum charge-1/2hour) and inf:luding$25,000.00,
inspections outside of normal business 90,00/hr $25,001,00 to$50,000.00 $379,50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100,00 or faction thereof,to
Reinspect ion Fees 90.00/hr and inc1uding_$50,000.00.Additional plan review for revisions 90.00/hr $50,001,00 and up $742.00 for the first$50,000.00 and$1.20 for _
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*.
• QNaa iy by N(xtirrt type :lei �OVIN-14'WirlMilti z 0001 1511' ;
$trre xypt for ti r u r 11+ice/ Plan review is required for anyof the following,
•wbrTtl'eiYoridred: r,..,. CyIrM�;, ��!!1 A�iaeak 4 g,
Etaplistry/Font Please check all that apply.
Beth Tub/Slnower 0 Any new commercial building with water service 2"and
Jactrazi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer,
-Drive Thrtt ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/WaterAspirator us defined in 0AR918.780-0040,
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities,
-Domestic 0 Any multipurpose fire sprinkler system,
Drinking Fountain 0 Any complex structure as defined in OAR918-780-0040,
Eye Wash
Floor Drain/sink -2" Submit 2,sets of plans with any of the above.
3"
Car Wash DrainWash Drain ZrawasaiWyetileinatailinittan
Garbage Domestic-non-food (� Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Roe.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lay -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes •
Water Extractor increase of sewer EDUs,a 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:\Users\Malmedal\AppDtita\LocaltMierosoft\Windows\INetCache\Conte t,Outlook13FI2cXR481plumbing Perniit.doa
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
■
TIGARD Building Permit Review — Residential
Building Permit #: 1S7202/- OO 2g S
Site Address: 10893 SW Lady Marion Drive
Project Name: Trillium Hill Lot #: 1
Planning Review
Proposal: New house
$7 Verify address/suite# active in Accela. ® In River Terrace: ❑ No g7 Yes, River Terrace Review Addendum
Site Plan Elements: ®Erosion Control
i 3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper natetained trees with drip line and tree protection measures
XlDrawn to scale(standard architect or engineer scale) lFootprint of new structure(including decks)and FFE
�j-I(North arrow NUtility locations&easements(required for new and additions)
kSite address,project or subdivision name and lot number ®Sidewalk/driveway approach
®Applicant information(name and phone number) IVaLocation of wells/septic systems
®Lot dimensions and building setback dimensions XStreet tree size,type and location
# IAquare footage of buildings to be demolished 7k]Street names
t
existing structures on site ]Corner elevations(2'contours if more than 4'differential)
6$.ot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? 7�fA0No
impervious area (applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? uYes ONO
r ® Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
rRequired: CIYes,applicant was notified GilNo Received: ❑ Yes CINo
i
] Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑ Yes,applicant was notified Xl No Received: ❑ Yes ❑ No
n SDC Exemption for ADU applied for: ❑ Yes ❑ No Received: ❑ Yes ❑ No
l Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes,applicant was notified ® No Applied For: ❑ Yes ❑ No,stop intake
® Land Use Case#: ZON2018-00001 bitl Zoning: R-4.5
® Required Setbacks: Front: 20 Rear: 15 Side: 5 Street Side: 15 Garage: 20
E Building Height: Max.Height: 30 Actual Height: 27
no Landscape Area: % ID Lot Coverage Max: 0/0
Entrance Xl Set back no more than 8'from street-facing wall IX Parallel to street or offset 45 degrees or less
Windows ❑ Minimum 12%of area of all street-facing facades Front: 16% / Side: t2.6Y
Garage X Garage door is behind widest street-facing wall ❑ Yes a 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.
lk Garage door width is El 12'or less ® 50%or less of facade ❑ 60%or less and includes 7 of following:
t El Covered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset
❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof Cl Dormer
❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony
f] Visual Clearance ® Urban Forestry Plan
® Sensitive Lands: ❑ Yes ® No Type:
® Conditions met prior to issuance of building permit
Notes:
® Approved By Planning: Date: S
1 Revisions (after Building Submittal only) Reviewer Date
Revision 1: CI ❑ Not Approved
Revision 2: ❑ Approved CINot Approved
1 I:\Building\Forms\BldgPermitRvw RES_122419.docx
Building Permit Submittal
Original Submittal Date: Dlr/24//•202-1
Site Plans: #
Building Plans: # 3
Building Permit#: R"Enter building permit# above.
Workflow Routing: 'Planning 8'Engineering 9- Permit Coordinator Building
Workflow Sign-off: F"-Sign-off for Planning(include notes from planning review)
Route Application Documents: I'Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
Iff Building: original permit application,site plans,building plans, engineer and
beam calculations and t v..t details,if applicable,etc.
Notes:
By Permit Technician: �,-//�;.ip,),, Date: 47/Q�Lo z/
Engineering Review
Slope at building pad: 77P
/Conditions"Met"prior to issuance of building permit
2 asements (encroachments) per engineering conditions of approval and plat
or Water Quality/Quantity Facility
Assess Water Quality Fee in-lieu: ❑ Yes Ci'No
Assess Water Quantity Fee in-lieu: ❑ Yes E"No
LIDA Facility on lot: E Yes C?No
Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
,Approved by Engineering: , A 5 144.L. Date: 7-2s -2 '
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Permit Coordinator Review
x 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:
yr SDC Exemption: ❑ Received Vi Does not apply
SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: j Yes ❑ N/A
Parks SDC: Yes ❑ N/A
LIDA ❑ Yes A N/A
! OK to Issue Permit
Approved by Permit Coordinator: At)/ Date: (W2)
I:\Building\Forms\BldgPermitRvw_RES_122419.docx