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Permit CITY OF TIGARD MASTER PERMIT ligj Permit#: MST2021-00336 COMMUNITY DEVELOPMENT T i i A R I) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/21/2021 Parcel: 2S110DA10600 Jurisdiction: Tigard Site address: 10804 SW LADY MARION DR Subdivision: TRILLIUM HILL Lot: 6 Project: Trillium Hill, Lot 6 Project Description: New detached dwelling BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 4 First: 2153 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 27 Bathrooms: 3 Second: 0 sf Garage: 380 sf Front: 20 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Total: 2153 sf Value: $309,281.46 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 Bckfiw Prevntr: 1 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 1 Other Fixture Units: Garage Utility Sink 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 WIG 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 l2-3 2153 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 2 Geo Tech Report Required Prior To Pour PHONE: PHONE: 503-213-4415 FAX: Total Fees: $38,724.76 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 peznit 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 y to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR QS2nn1-nnln thrni inh('AP OS') _won Vni o a nr dir, t iicctinnc to(11 mirk.,.ninn Snz 9z9 nr 1 Ann zz_9'9zdd /' rr Issued By: rmitt Signature: ` ` ` . .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 Application C3- S1 1 u!2-i Residential RECEIVED FOR OFFICE USE ONLY Received Og�la ry I�)r i I-4,T /17�,-QV�3/ City of Tigard AUG 1 u, �0�� Date/By: i+Vil �� Permit No.f 2.02 b i w 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 DareBy: Ca/zit �� 7i� Other CITY OF f IUARD kris 0 See Page 2 far Inspection Line: 503.639.4175 r Dare Re/dyBy: TIGARD Intemet: www.tigard-or.gov BUILDING DM SICnl otified/Meth -rii Supplemental Information TYPE OF WORK REQUIRED DATA:`I-AND 2-FAMILY DWELLING ® New construction ❑ Demolition Permit fees* are based on the value of the',cork pertirrrned - Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. i lki Valuation: 435"e0'3f1,7, ® I-and 2-family dwelling ElCommercial/industrial 1 , NA Iv{ 0 Accessory building 0 Multi-family Number of bedrooms: ❑Master builder ❑Other: Number of bathrooms: 3 JOB SITE LNFORMATION AND LOCATION Total number of floors: 1 a 533 Job site address: 10804 Lady Marion Drive New dwelling area: 2153 square feet-Z)S2, City/State/ZIP:Tigard/OR/97224 Garage/carport area: 380 square feet Suite/bldg./apt.no.: Project name:Trillium Hill Covered porch area: square feet Cross street/directions to job site:SW 10901'AVE AND SW Lady Marion Dr Deck area: 169 square feet rt tr p1'etc ( 49 square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision:Trillium hill I Lot no.:6 Permit tees*are based on the value of the work performed. Tax map/parcel no.:2S I 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 Ilomc to be built-2153 SQFT 3 Bedroom,3.bath,suite,a 380 Valuation $ SQFT 2 car garage with a 169 SOFT covered rear deck. Existing building area: square feet New building area: square feet ® PROPERTY OWNER ❑ TENANI Number of stories: Name: David Wceklev 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:( I Nes,,: ❑ APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES* (Please refer(*.fee schedule) Business name: David YYeekIey Homes Structural plan review fee(or deposit):767.9)4 Contact name:Meghan Ticknor Address:1905 NW'169'Place,Suite 102 FLS plan review fee(if applicable): City/State/ZIP:Beaverton/OR/97006 Total fees due upon application: Amount received: Phone:(503)213-4409 Fax::( ) F-mail: mticknora dwhomcs.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name: David Weekley Homes Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 1905 NW 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%of permit fee): S21.60 CCB lia: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. *Fee methodologyset byTri-County Building Industry I Print name: Meghan Ticknor Date:8/10/21 1 Service Board. l:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I I/02/COM/WEB) l_ j Building Permit Application Checklist - One- and Two-Family Dwelling FOR OFFICE USE ONLY City of Tigard Received permit No.: - • 13125 SW Hall Blvd.,Tigard.OR 97223 Associat _ Phone: 503.718.2439 Fax: 503.598.1960 Associated permits: 1 I(;A Itt) 24-Hour Inspection Line: 503.639.4175 ® Electrical ® Plumbing ® Mechanical Internet: www.ligard-or.eov 0 Other THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yeti No N/A I Land use actions completed. See,jurisdiction criteria for concurrent reviews. ® ❑ 0 2 Zoning, Flood plain,solar balance points,seismic soils designation,historic district,etc. El ❑ D 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 ❑ ❑ El 6 Sewer permit. 0 0 0 7 Water district approval. 0 ❑ 0 8 Soils report. Must carry original applicable stamp and signature on file or with application. ® ❑ 0 9 Erosion control El plan ❑permit required. Include drainage-way protection. silt fence design and location of catch- /1 ❑ 0 basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ® ❑ ❑ building codes. Lateral design details and connections must he incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. II Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ® 0 0 there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft. intervals);location of easements and driveway;footprint of structure(including decks):location of wells/septic systems;utility locations;direction indicator:lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Show dimensions.anchor bolts,any hold-downs and reinforcing pads. connection details,vent size ® 0 ❑ and location. 13 Floor plans. Show all dimensions,room identification,window size.location of smoke detectors,water heater, ® 0 ❑ furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- ® ❑ 0 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 Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- ® 0 ❑ 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 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 carrying a non-uniform load. 20 Manufactured floor/roof truss design details. ® ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ® 0 0 for four or more appliances. 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or ® 0 0 architect licensed in Ore•on and shall be shown to be applicable to the r roect 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". ® ❑ 0 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ® ❑ 0 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ►1 ❑ ❑ 26 "Reversed"building plans must meet criteria outlined in the Permit& System Development Fees document. El ❑ 0 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 ® 0 0 Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 ❑ CO 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 Sue Assessrnerd form is required for all building additions, ❑ ❑ 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:\Building\Permits\BLIP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Applicatl( CEIVED FOR OFFICE USE ONLY Dal Received st2021-0033 P . City of Tigard Permit No.: g Deceived 13125 SW Hall Blvd.,Tigard,OR 97223 AUG 11 2021 Plan Review ' Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: lurk: ® See Page 2 for Internet: www.tigard-orgov 3U;l O!NO f iv1QION Notified/Method: Supplemental Information TYPE OF WORK CO%IMIERCIAI- FEE* SCHEDULE USE CHECKLIST Mechanical permit fees*are based on the value of the work El Neoo construction ❑Addition%alteration/replac.meat performed.Indicate the value(rounded to the nearest dollar)of all ❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CUTEGORY' OF CONSTRUCTION _____ RESIDENTIAL F:QUIPNIENF/SYSTENISFEES* ® I-and 2-family dwelling ❑Commercial/industrial Accessory building For special injormatlon use checklist. ❑ Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total JOB SITE INFORATION AND LOCATION Heating/cooling: M Air conditioning I 46.75 Job site address: 10804 Lady Marion Drive Furnace 100,000 BTU(ducts/vents) 1 46.75 City/State/ZIP:Tigard/OR197223 Furnace 100,000',BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name:Trillium Hill Duct work 23.32 Cross street/directions to job site:SW 109'h 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 Hill Lot no.:6 Other: 23.32 Other fuel appliances: Tax map/parcel no.:2S110DA11400 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-21.53 sqft,3 bedroom 3 bath home with fireplace 23.32 169 sqft 2 car garage and a covered rear deck. Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 ® PROPERTY OWN ER ❑ TENANT Other: 23.32 Environmental exhaust and ventilation: Name: David Weekley Ilomes Range hood/other kitchen equipment I 33.39 Address: 1905 NW 169'h Place,Suite 102 Clothes dryer exhaust I , 33.39 City/State/ZIP:Beaverton/OR/97006 Single-duct exhaust(bathrooms. toilet compartments,utility rooms) 4 2332 Phone:(503)213-4415 I.a.x:( ) Attic/crawlspace fans , 23.32 APPLIf`.t1NT CI CONTACT PERSON Other: 23.32 Business name: David Weekley Homes Fuel piping: S14.15 for first four;S4.03 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)213-4408 Fax: :( ) Fireplace Range 1':-mail: mticknor4fdwhomes.com Barbecue CONTRACTOR Clothes dryer(gas) Other Business name:David Weckley Homes q .' ..._ r'iTPC'HAINICAt PERMIT FEES*' Address: 1905 NW 169'h Place Suite 102 Subtotal City/State/ZIP:Beaverton/OR/97006 Minimum permit fee($90.00) Plan review(25%ofpermit 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 190 days after it has been accepted as complete. Authorized signature: / iii — * Fee methodology set by Tti-County Building Industry Service Board Print name:Ken Puttman Date: tit O/Z L.Building\Permits1MEC PermilApp_04(lt 3 dm 440-4617T(I 002(COMM'EB) 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. I:\t3uilding\Permits\MEC_PermitApp_0401 I 3.doc 2 Electrical Permit Applicatio"iiiECEJ V ED FOR OFFICI. 1 SE ()AI. City ofTigard AU G 1 1. 2021 Received ST70�(e00 3 !,• g III �.ry,� Date'Bv: n a - 7.•,'S'.r '�I' �1.a�1�` N,1 Readicdn 131_5 SR Hall Blv ,Tigard,OR972,A3 7 Plan Review Related Permit 4. Phone: 503.718.2439 Fax: 503 598 t9 Bste'Bs. TIGARU Inspection Line: 503639.4175 „ „� t Ready Date/By. Jur7s B15ee Paget for ,. Internet: ws',w.tigard-or.gov - vlcthod: Supplemental Information „TY`PE OF WORK' PLAN REVIEW t El New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑Service or feeder 400 amps or store 0 Building over three stones. ❑ Demolition ❑Other: where the available bull current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ® I-and 2-family dwelling IDConnnercial/industrial El Accessory building less o ground or exceeds 14,000 0 Commercial-use agricultural amps for all other installations- buildings. 0 Multi-family ❑Master builder 0 Other: 0 Fite pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived ❑Addition of new motor load of system. Job#:68160006 Job site address:10804 Lady Marion Drive I00HPormore. ❑"A "l I-r l-r, C it'/State/ZIP:Ti and/OR/97224 ❑Six or more residential units- occupancy, y g ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: Project name:Trillium Hill ❑Hazardous locations. 0 Supply voltage for more than 0 Sen ice of feeder 600 amps or more 000 sulk nommnl. Cross street/directions to job site:SW 109w AVE AND SW Lady Marion dr FEE S(HEDLI E Description I Qty."'l Each I Total I * New residential single-or multi-family dwelling unit, Subdivision:Trillium Hill Lot#:6 Includes attached garage. 1,Tax map/parcel#:2S1 l 0DA11400 OOO sq.fl.or less 6854 68 5 4 Ea.add'I 500 sq.ft.or portion 4 33 9_ 107.76 1 DESCRIPTION OF WORK Limited energy,residential above sq.ht.) 75 00 2 New single family home to be build-2153 sqft,3 bedroom,3 bath home,suite,a 380 SQFT 2 car (with Limited energy.,multi-family 75.00 2 garage with a 169 SQFT covered rear deck. residential(with above sq.tt.) Renewable Eneresv 0 See Page 2 ® PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation Name:David Wcekley homes 200 amps or less 100.70 2 Address: 1905 NW 169th Place Suite 102 201 amps to 400 amps 13356 - '_ 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 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 El APPLICANT ® CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name:David Weekley Homes above service or feeder fee, 742 each branch circuit Contact name:Megh a n Ticknor B.Fee for branch circuits without Address: 1905 NW 169`h Place Suite 1112 service or feeder fee,first 56 18 2 branch circuit City/State/ZIP:Beaverton/OR/97006 Each add'l branch circuit 742 2 Miscellaneous(service or feeder not included) Phone:(503)213-4409 Fax: :( ) Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email: mticknoradwhmnes.com Reconnect only 67-84 2 CONTRACTOR Pump or irrigation circle 6784 2 Business name:Garner Electric Sign or outline lighting 67.84 2 - Signal circuit(s)or limited-energy ❑ See Page 2 Address:2890 SE Brookwood Ave panel,alteration,or extension. City/State/ZIP: Hillsboro,OR.97123 Each additional inspection over allowable in any of the above Additional inspection I I hr min) 66.25/hr Phone:(503)648-4552 Fax:( ) Investigation(I hr min) 9000/hr Email:permits@garnerelectric.com Industrial piam(t hr min) 781R nr Inspections for which no fee is 9000%hr CCB Tie.: 121159 Electrical Lic.• 4-305C Suprv. Fie.:3707S specil'eal l`listed f s5 lir min) ELECTRICAL PERMITWES Suprv.Electrician signature,require Subtotal Print name:Charles Gamer I Date: ❑Plan Review Required(25°iu of permit fee): �� �� State surcharge(12%of permit fee): Authorized signature: '4ez�- _ g a. TOTAL PERMIT FEE: ff//�l This permit application expires if a permit is not obtained within 180 Print name:Brittany Burian Date:8/10/21 days after it has been accepted as complete. * Number of inspections allowed per permit. ItBuilding?Peunits\ELC_PermitApp_ELR_ERE.doc Rev O0.'17.2015 440-1619Tt11iOJ"COR1/WEB • Electrical Permit Application—City of Tigard Page 2-Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCnf:ntilliE Description I rise!. I lolal Fee for all residential systems combined: $75.00 Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to15kva 133.56 2 n Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: n Burglar Alarm 25.01to50kva 301.04157 2 Garage Door Opener* 50.01 to 100 kva 552 26 2 >100 kva(fee in accordance 55226 3 with OAR 918-309-(X40) • 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 66.25'hr charged at an hourly(1 hr min) Inspections for which no fee is 90 00/hr specifically listed C;.hr mill) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Subtotal(Enter on Page 1 y Fee for each commercial system: $75.00 ,,ubtu of inspections allowed per pem,a (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems n Boiler Controls -1 Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation n HVAC I nstrumentation ❑ 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 L\Bielding'ernms,ELC_PermitApp_ELR_ERE.doe Rev 0 64 71201 5 RECEIVED . ., Plumbing Permit Application ,,G 1 1 202; Building Fixtures c'Pi OF 1-16Ar" ir,,,, ,,, , ,, ! City of Tigard EIS 13125 sw Holl Blvd.,Tigard, P.97223 0, 3/HLOINP, rIIV l'::' Rce4ivt4 Phone: 502718.2439 Fax: 503 51)8,1160 ' - ISIU DeNtwk,I*113.111444°: w Inspeolion Line: 503.639,4175 interact; www.tIgard-oegov Dabs Poodyn3y: teralnediMethed; :nuitiaot laiS120.21-6 4 3 Other honolI No.: hie 111 See bite 1 far Sieflesosatol Inforredon rirg*vrato,ttogso;tf,esojgitoailZVP.;*te MtVrgeali.,..1Kitm-kiMASSISIgt4 ISI New construction I CI Demolition Fer s&cial Istformagon use cliecAUst Description I Ott I E. I Total D Addition/Rite%stion/reploconent CI Other New 1.24amlly dwellings(includes 100 R thr cad)utility coo neotloo) gioWtSf,7.24,1t11A,4,PliiktWO ,.tectRAVAIMKUPA` mu',bath 312,70 el I-and 2-family dwelling 0 Commercial/industrial SFR(2)both 437.78 bath I 500,32 SOO 32 CI Accessory building 0 Multi-family - Each additioemi bath/cliches) 25.02 E)kiastotbuiidtr ii Other: , Fire sprinkler t ,sq (1.,) Page 2 ' - ) - I : _Re utillkac -.,- lab she Auto; 10804 Lady Marion Drive Catch basin or area chola 18,76 Drywall,lenehline,or von%drain 18,76 City/Stele/ZIP:Tigart1/01k97224 footing drain(cm,box it.:249) Page 2 $7 55 Sulteraldg.hipe,tx.i.: I Project name:Trillium R111 Manufactured hone utilitim 50.03 Cross streeththeollons to Job site:SW 109'1'AVE AND SW Lady M a Noe Dr Manholes 18.76 :Rain dish connector 18,76 Sanitary sewer(no,linear ft.;_.1 Page 2 Page 2 Woter service(no.linear It.:_„,) Pate 2 Subdivision Trillium$1111 I bzt no,:6 Mart or km Tax oiapiparcel no:2S110DA.11400 Baokflow preventer I 31,27 31.27 1"'"''''.'t 'z'-''''','. 27.t4047f7r#4"...t, fi'll5r-Ct'lr-iiir497'1 -...,.: 74'1.49;-.. Bookwaler valve 12,51 1 25.02 25.02 New single family home to be build-2153 sgft,3 bedroom,3 bath home,sute a 380 SOFT 2 car DitOrhISIgler I 25,02, 25,02 garage with a 160 SOFT covered rear deck Drinking fbuntain 25,02 EJectordsunth 25.02 - ExPamk'n hi/1k 1251 Fixture/sewer eap 2.1.02 Name:Dimid Weeklea,Roma Floor dralndloor sirkAmb 25,02 Address:1905 NW 1169111 Place Suite 102 Ourthige disposal 1 25,02 25.02 City/State/ZIP;Beaverton,OR 97006 llose bib 1 25.02 2s0" Phone:(503)213-4415 Fax;( ) lee maker 1 12.51 12.51 7; '7,7 417,TAIr.,41 interceptor/gm=imp 2502 Medical gas(value:$—/ Pep 2 Business name:David Woekley Roma Primer 12,51 Contact mune Meghaa Ticknor RooPdrain(commercial) , 12,51 Address:1905 NW 169*Piave,Solte 102 • Sink/basinflavatory -10 25.02 15neit City/Statc/ZIP:Beavertoo/OR/97006 Soler cants(potable water) 62.54 Phone;(503)213-4499 1 Pax::( ) Tuhishower/ohower pan 3 12,51 25.02 E th-mail; sehledlerigthrliomencom Urinal 25.02 .;;Far.,051.'45.7)4/11-t?-67-170:111$7:YerVi4c-', 7,-,-itow;l'onwirez.-.:,.,,", w"ck"gt 3 25.02 100.08 Busineas name:Malone:dal Numbing Wider plping/DWV 56.29 Addreas:YOB=207 ' Other. 25,02 City/ShgetZIP:Bankr/OPJ97106 • Sobtatal Phone;(503)3244759' I Faro:( ) Minimum permit fee: $72.50 ' Plan review(25°A of permit the) CC13 Lie;102535 . Plumbing(Jo..no.:34-276PB State surcharge(12%ofiasernit Re) Authorized signathre; Carolina Malowdal 40847-----)----- TOTAL PERMIT FEE Print ream Corolla*Wined)/ :1 pate:10/10/2021 This puree applied(/'mires If a parer Isnot reseed witen1/10 da,e . ete ft be been eteoprod as aesthete, 1 ogee Jetted/eta sol by Trhrrtutuy Wilde Industry Sere.Bore 1 tAlluIltibteMeeletAberobehdoe Itbottoe 440e1117(10,02KOMmrdO . Plumbing Permit Application.-City of Tigard Page 2-Supplemental Information Fee Schedule: yyCC �� Residential Fire Suppression S'et stems '�j ,iWi ll'J,lg `1'~+��, $itl.i: lei IO1,'^! � t �t ;i ai 36 'r"t � trfr1.. iumfo �`�' tie: .v va. 1.+}),.m 1 em.,;e� at�R'f 6'^ N.r,,ntI,t i.i d. 1 r I��a..��Y�k�; Footingdraln•14100' 50.03 0to2,000 $12,90 Footing drain•each additional 100' - 57,52 2,001 to 3,600 - $169.69 Sewer-tat 100' 62,54 -3 601 to 7,200 $233.20 7Ol and greater $327.54 Sewer•meta additional 100' 37,52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each addh)aG1100' 37.52 MilitlifeW , r Minimum er ._ '_,. Storm&Rein Drain-Id100' 62.54 fI,00to$S,00000 Mlnhnumtea fT50 StormhRain Drain-each additional 100' 37,52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1,52for fi 0.6+ i ` axii +t �c a% cacti additional$100.00 or filiation thereof,to and Including S1.0,000.00, inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the fast$10,000.00 and$1,54 fix which no fee Is specifically latioatod 90.00/lhr each additional$100.00 or fraction thereof,to (minimum ohttge-l/2 heat) and including$25,000,00. Inspections aaaide of normal business 90,00ahr $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 fraction thereof,to Relnapectlon Fees 90.0Orhr end Inalud!ng 550,000.00. Additional plan review for ovislana 90.00l1ur $50,001,00 and up -$742.00 for the first$50,000.00 taxi$1.20 for (mirnhntm oltarge-1/2 haul _ each additional$100.00 a fraction thereof. Sobtolalt Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees", L l,y,-LY �..^,r �}`f! r1� 1 % '.'.,'rt2rUtatt4ff�' .'...t•lN et Ji '� 1.�1I -. ��!�•4.����YYY.F} der' ' `� ` _ ,' ;x� f' Plan review is required fbr any of the following, k,igattlaefrairnfi -Ir :i.. . <7 .t',' o•„„•, ,Rob Please cheek all these apply, ea •TuhShower ClAny new commercial building with water eeevice 2"and Jec uz/Whirlpod greater,except systems designed and stamped by licensed Car Wash -Each Stall engineer. •DriveThru 0 New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918.780.0040, Diettwa er -Comm:rold 0 Medical gas and vacuum systems for health care facilities, -Domestic 0 Any muhipurpose fire sprinkler system. thinking Fountain 0 Any complex structure as defined in OAR918-7130-0040, Eye Wash Floor Drain/sink •2" Submit Z sab of plans with any of the above. •3" Car Wash Drain a srk � �• ,; ` , ,. .!!r$..�tt,. 'r Garbage •Domestic-nun•tbod isometric or riser diagram is required for new buildings Dlapueat -Domestic-food related that meet the qualifications above, -Commercial-tad related • -Industrhi-food related , toe Mach/treks.Drains Oil Separator(Gm Stance) . Comments regarding fixture work: Rea,Vehicle Dump Station Shower 'Gang -Stall Slnk/Lav -Non-food related •biadley -Commercial-food related -Service swimming Pool Filter "Note; if the fixture work under thin Washer-clothes permit results in an WafnExtmr Increase of newer 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;IUsera\MaimedallAppData\LoonlMiorosoft\Wlndows\INetCOcho\Contoot.Outlook\3tf2CXR4$\Plumbing Pennikdco City of Tigard 'PIr COMMUNITY DEVELOPMENT DEPARTMENT C T 1 G A K D Building Permit Review — Residential Building Permit #: 1-15T ZDZIt-CJ03 Site Address: 10804 SW Marion Drive Project Name: Trillium Hill Lot #: 6 Planning Review Proposal: New house E Verify address/suite#active in Accela. ® In River Terrace: J No ❑ Yes, River Terrace Review Addendum Site Plan Elements: X]Erosion Control M3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper OE Retained trees with drip line and tree protection measures ®Drawn to scale(standard architect or engineer scale) g]Footprint of new structure(including decks)and FFE ENorth arrow Utility locations&easements (required for new and additions) Site address,project or subdivision name and lot number JESidewalk/driveway approach $7Applicant information(name and phone number) ! ovation of wells/septic systems Lot dimensions and building setback dimensions $]Street tree size,type and location 1»Square footage of buildings to be demolished ®Street names Crl xisting structures on site g]Corner elevations (2'contours if more than 4'differential) ilLot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? Js ❑No impervious area (applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? EYes ❑No $E Clean Water Services-Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified Xl No Received: ❑ Yes ❑ No ® Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs Required: ❑ Yes,applicant was notified 1C] No Received: ❑ Yes ❑ No MI SDC Exemption for ADU applied for: ❑ Yes ❑ No Received: ❑ Yes ❑ No ] Public Facilities Improvement (PFI) Permit Required: ❑ Yes,applicant was notified E No Applied For: ❑ Yes ❑ No,stop intake © Land Use Case#: ZON2018-00002 t] Zoning R4.5 ® Required Setbacks: Front: 20 Rear: 15 Side: 5 Street Side: na Garage: 20 ® Building Height: Max.Height: 30 Actual Height: 27 0 Landscape Area: % ITI Lot Coverage Max: Entrance I] Set back no more than 8'from street-facing wall E Parallel to street or offset 45 degrees or less Windows ] Minimum 12%of area of all street-facing facades F: 13%/R:16% Garage ] Garage door is behind widest street-facing wall ❑ Yes f] 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 2°d floor. E Garage door width is ❑ 12'or less Y 50%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 ❑ Dormer ❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony ® Visual Clearance ® Urban Forestry Plan ® Sensitive Lands: ® Yes ❑ No Type: Significant Tree grove ® Conditions met prior to issuance of building permit Notes: f� _ , ` P Q,� ® Approved By Planning: to o .''�^�'v Date: 8/17/2021 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved 1:\13 ui I ding\Form s\BldgPermitRvw_RES_122419.docx Building Permit Submittal Original Submittal Date: OV .2OZ/ Site Plans: # Building Plans: # Building Permit #: NVEnter building permit#above. Workflow Routing: IiJ-"Planning Engineering P.-Permit Coordinator Building Workflow Sign-off: 1--"Sign-off for Planning(include notes from planning review) Route Application Documents: El.--Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. [ /Building: original permit application,site plans,building plans,engineer and beam calculations . • trust details,if applicable,etc. Notes: By Permit Technician: Date: Q��4,1LZ! Engineering Review 'Sl❑ ope at building pad: /77; conditions "Met"prior to issuance of building permit R.-Easements (encroachments) per engineering conditions of approval and plat Water Quality/Quantity Facility. Assess Water Quality Fee in-lieu: ❑ Yes CVo Assess Water Quantity Fee in-lieu: ❑ Yes �No LIDA Facility on lot: ❑ Yes No ❑ Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: 12'1pproved by Engineering: )4 , SO-e 2 Date: 8- 3,e20a. L Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved E Not Approved Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review 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 N Does not apply SDC Fees Entered: Wash Co Trans Dev Tax: 7/yes ❑ N/A Tigard Trans SDC: ,LEI Yes ❑ N/A Parks SDC: 71 Yes ❑ N/A LIDA ❑ Yes , N/A OK to Issue Permit Approved by Permit Coordinator: V5\,f,f Date: g lQ.Ltt Zj2{ I\Building\Forms\BldgPermitRvw_RES_122419.docx z6j2_,, 1,,z_c_i/._ ies„..7uir(L,.._ ( Plan# 6tufs g Floors t Large c (D �� Bed rooms 1 Small 5'7 WC 3LAV \ Tub Basement Y �' to Vent 5 1st Floor Z)cj Water Heater I 2nd Floor AC y.0--a / 3rd Floor School ` T'SGu s* R-3 Total ci.r,e_47 .c._ Garage 'J$D 4 SAS D Total 2533 b�LLc 1. 0 #for Elec 4 k -�J u-kl�}`1 5 r`i'llc-