Permit .1111 CITY OF TIGARD MASTER PERMIT
I' ' COMMUNITY DEVELOPMENT Permit#: MST2021-005018
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/16/2021
Parcel: 2S 110DA10400
Jurisdiction: Tigard
Site address: 10771 SW LADY MARION DR
Subdivision: TRILLIUM HILL Lot: 4
Project: Trillium Hill, Lot 4
Project Description: New detached dwelling
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 454 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 20 Bathrooms: 3 Second: 1958 sf Garage: 603 sf Front: 20 Smoke
Yes
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors:
Total: 2412 sf Value: $351,880.56 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: 4 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
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
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add!500 sf: 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 2412
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: $39,947.01
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
oc9-MN_M1n thrnnnh(lAP oc9-nni-Mon VniI maxi nhtain a rnnw of tha/lilac nr rlirart nnactinnc to(I Inv-.by Tallinn Sn'2 719 10517 nr 1 grin 119 9144
` (7?--Al2" r
Issued By: Permittee Signature:
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.
' Building Permit Application //
Residential FOR OFFICE USE ONLY
Ci of Tigard RECEIVED t.eeeiy yeti �•i
`J r'� �(/� I Pemut
13125 SW Hall Blvd.,Tigard, 97223 NOV 8 '�0"1 Date By: OP ,ZQu'
o Plan Revicu „/ '
Phone: 503.718.2439 Fax: 503.593.1960 Date/By: l Z� �/� Other Perm8 �� '& -
lnspection Line: 503.639.4175 CITY OF TI'�:IAtiLi Date Ready.B) lutes
IIGARD / ® See Page 2for
Internet: www.tigard-or goy i Notifi /Method: ` l / Supplemental Information
a BUILDING DI1lI°',I(`��1 pI
- 'I1PE OF WORK REQUIRED DATA:1- %ND 2-FAMILY DWELLING
® New construction ❑ Demolition Permit lees* are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead„and the profit for the
CATEGORY' OF CONSTRUCTION work indicated on this application.
® I-and 2-family dweller ❑Connercial/indust.ri.�l Valuation: $ ;HN(� '���'
ElAccessory building ❑Multi-family Number of bedrooms: 4
❑ Master builder ❑Other: Number of bathrooms: 3
JOB SITE INFORMATION AND 1.0( ATION Total number of floors: 2 JO i
Job site address: 10771 SW Lads Marion Drive New dwelling area: 2412 square feet I 56
City/State/ZIP:Tigard/OR/97224 Garage/carport area: 603 square feet 5
Suite/bldg./apt.no.: Project name:Trillium Hill Covered porch area: square feet
Cross street/directions to job site:SW 109thi AVE AND SW Lady Marion Dr Deck area: I t1 square feet
D►_Vicictf ( 11l square feet
REQUIRED DATA:COMMERCIAL-I'SE CHECKLIST
Subdivision:Trillium hill Lot no.:4 Permit fees* are based on the salve of the work perlimrmcd.
Indicate the value(rounded to the nearest dollar)of all
'Fax mar.parcel no.: 251101)_dl 17011 equipment,materials,1 •P labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
New Single Family Home to be built-2412SQFT 4 Bedroom,3 bath with 603 SQ Valuation: S
FT 3 car garage with a 117SQFT covered balcony and a 108SQFT covered porch. Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 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:
0 APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name: David Weekley Homes
(Maw refer to,/ee sched,/e)
Structural plan review fee(or deposit): 75/$y
I Contact name:Meghan Ticknor
FLS plan review fee(if applicable):
Address:1905 NW 169fh Place,Suite 102 PP )•
Total fees due upon application:
City/State/ZIP:Beaverton/OR/97006
Phone:(503)213-44(19 I ,T t )
,Amount received:
F-mail: mticknora dwhomes.coro PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR
T OR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: David W.ecl.ley homes Submit two(2)sets of roof plan with connection details
— and fire department access,along with the 2010 Oregon
Address:1905 NW 1696 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 No::( 1 State surcharge(12%of permit fee): $21.60
CCB lie.:213653
Total fee due upon application: S201.60
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 Tic nor Date: 11/16/21 *Fee methodology set by Tri-County Building Industry
Service Board.
I:ABuilding\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I I/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLY
City of Tigard ReceivedPenuit No.
13125 SW Hall Blvd.,Tigard,OR 97223 Date'By:
Associated permits:
! Phone: 503.718.2439 Fax 503.598.1960 r
i1GARD 24-Hour Inspection Line: 503.639.4175 ® Electrical ® Plumbing ® Mechanical
Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW tine No ',`.a
I Land use actions completed. See jurisdiction criteria for concurrent reviews. Z ❑ ❑
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ® 0 0
3 Verification of approved plat/lot. El 0 ❑
4 Fire district approval required. Name of district: • ❑ 0 0
5 Septic system permit or authorization for remodel. Existing system capacity 0 0 0
6 Sewer permit. 0 0 0
7 Water district approval. ❑ ❑ 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ 0
9 Erosion control ®plan 0 permit required. Include drainage-way protection.silt fence design and'location of catch- ® 0 0
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ® 0 0
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 ® 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 ® ❑ ❑
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 0
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- ® 0 0
prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor/roof framing. Provide plans for all floors/roof assemblies, indicating member sizing,spacing,and bearing ® 0 0
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 0
systems,see item 22,"Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ® 0 0
11 over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. ® 0 0
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ® 0 ❑
for four or more appliances.
22 Engineer's calculations. When required or provided.(i.e.,shear wall,roof truss)shall be stamped by an engineer or ® 0 0
architect licensed in Oregon and shall he shown to be applicable to the ,ro'ect under review.
JURISDICTIONAL SPECIFICS
23 Three(3)site plans are required for Item 11 above. Site plans must he 8-1/2"x 1 1"or 11"x IT. ® 0 0
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ® 0 0
25 Building plans shall not contain red lines or tape-ons. `Mirrored"building plans will not be accepted. Z 0 0
26 "Reversed"building plans must meet criteria outlined in the Permit& System Development Fees document. ® 0 0
27 "Drawn to scale"indicates standard architect or engineer scale. ® 0 0
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard Z 0 0
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ El
and protection measures must be drawn to scale and must include the project arborist's signature of approval.
30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, 0 0
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\BUP-RESPerritApp.doc 02/24/2011 440-4613T(l l/02/COM/WEB)
,Mechanical Permit Application. a FOR OFFICE USE ONLY
City of Tigard E`(�EIV• E "" Received Pla Pr ..
111 " 13125 SW Hall Blvd.,Tigard,OR 97223 n Re ST��('1��jQ
Phone: '503.718.2439 Fax: 503.598.1960 NOV 2021 Plan Revie�+
Date/By: Other Permit:
TIGARD Inspection Line. 503.639.4175 TIGARDDate Ready.B ' Jurlr ® See Page 2 for
Internet: www.tigard-or.gov' U�LD NO Notified/Method g
BUILDING DIVISION Supplemental Information
TYPE OF WORK {.OIINIERCIAJ FEE" SOK:DLIT - USE CHECKLIST
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 REStDL:NTU\1.EQUIPMENT SYSTEMS FEES*
® 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building Forspeciu/to/ormatiun use chec&/isl.
❑ DescriptionQty. Ea. Total
❑ :Multi-Family ❑Master builder Other:
JOB SITE IN FORMATION AND LOCATION
Heating/cooling:
Air conditioning I 46.75 46.75
Job site address:10771 SW Lady Marion Drive Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75
City/State/ZIP:Tigard/OR/97223 Furnace 1.00,000+BTU(ducts/veins) 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 109th Ave and SW Lady Marion Dr Flydronic hot water system 23.32
Residential boiler(radiator or
hvdronic) 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 I of no.:4 Other: 23.32
Other fuel appliances:
Tax map/parcel no.:2S 110D\11400 Water heater 1 23.32 22.32
DESCRIPTION OF WORK Gas fireplace/insert 1 33.39 33.39
Flue vent.for water heater or gas
New single family home to be built-2412sqft,4 bedroom 3 bath home with fireplace 23.32
603sqft 3 car garage and a 117sgft covered balcony& 108sqft covered porch. Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/I iner/tl ue/vent 23.32
® PROPERTY OWNER Other: 23.32
❑ TENANT
Environinental exhaust and ventilation:
Name: David Weekley Homes Range hood/other kitchen
equipment 1 33.39 33.39
Address:1905 NW 169th Place,Suite 102 Clothes diyer exhaust 1 33.39 33.39
City/State/ZIP:Beaverton/OR/97006 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 3 23.32 69.96
Phone:(503)213-4415 I ax:( ) Attic/crawlspace fans 23.32
® APPLICANT rl CONTACT PERSON Other: 23.32
Fuel piping:
Business name: David \ycehley Homes
S14.15 for first four;$4.03 for each additional
Contact name:Yleghan Ticknor Furnace,etc.
Address: 1905 NW'169th Place,Suite 102 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Beaverton/OR/97006 Water heater
Phone:(503)213-4408 Pax::( ) Fireplace
Range
f:-mail mticknorii dwhomes.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: David Weeklev Homes Other:
Homes
\tECII;INIC,11..PERMIT FEES*
Address: 1905 NW 169th Place Suite 102 Subtotal
City/State/ZIP:Beaverton/OR/97006 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)213-4415 Fax:( ) State surcharge(12%of permit fee)
CCB lie.:213653 TOTAL PEEWITFEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: '" Fee methodology set by Tti-County Building Industry Service Board
iiiiPrint name:Ken P man Date: . .I
i Building\Permits\MEC_PermitApp_040113.doc 440-4617T(I I/02/COMIWEB)
Ali
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:\Building\Permits\MEC_PermitApp_040113.doc 2
'- Electrical Permit Applicatio
RECEIVED
City bReceived
"
ofTigard e " Penmt�:`d w-20u-ao9o2
13125 SW Hall Blvd.,Tigard,OR 97223 `I Dan Re
_ 1Plan Review
Phone: 503 718.2439 Fax: 503.598.19611' V �021 DateBv: Related Permit
Inspection Line: 503 639.4175 ry py� Ready D uuB turfs: Bt See Page 2 for
TIGARD CITY► OF IIG/1r1V Supplemental Information
m Internet: wwtiv.tigard,or.gov Notified v .,,hr:d
BUILDING DI1/nON
TYPE OF WORK PLAN REVi t
®New construction ❑ Addition/alteration/replacement Please.Ibeck all that apply(submit se
0 Service or feeder 400 amps or more ❑imitinnv n,er three,torie,
❑ I)emolitiun ❑Other: where the available fault current Marinas and boatyards.
CATEGORY OF CO\STRI:C T(()N exceeds 10,000 amps at 150 volts or ❑Floating buildings.
® I-and 2-family dwelling ❑Commercialiindustrial ID;Accessory building
less to ground,or exceeds 14.000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑ Multi-family 0 Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB 5111 INFORMATION AND LOCATION 0 Emergency system larger separately derived
Job#: 68160004 Job site address: 10771 SW LadyMarion Drive ❑Addition moref .motor load of system.
100HP or more. ❑ "."E" "1-�" "I-;
City/State/ZIP:Tigard/OR/97224 ❑Six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Trillium Bill ❑Hazardous locations. 0 Supply voltage for more than
0 Service or feeder 600 amps or more 600 volts nominal.
Cross street/directions to job site:SW 109th AVE AND SW Lady Marion dr III SCHEDULE
Description I Qty. I Each I total I ^
New residential single-or multi-family dwelling unit.
Subdivision: Lot 4 Includes attached garage.
1,000 sq.ft.or less I I68.54 168.54 4
lax map/parcel ': 25110DA11400
Ea.add'I 500 sq.tt.or portion 4 33.92 107.76 1
DESCRIPTION OF WORK Limited energy,residential
New Single Family to be built-2412SQFT 4 Bedroom,3hath with 603SQFT 3 car (with above sq.ft.) 75.00
Limited energy,multi-family 75.00
garage with a 117SQFT covered balcony and a 108SQFT covered porch. residential(with above sq.ft.) _
Renewable Energy 0 See Page 2
® PROPERTY OWNER ❑ TENANT
NSV'1' Services or feeders installation,alteration,and/or relocation
Name: Day id 1!'eel/ley I comes 200 amps or less 100.70 3
Address: 1905 NW 169th Place Suite 102 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: Beaverton/OR/97006 601 amps to 1,000 amps 301.04 3
Phone:(5(13)213-4415 Fax:( l Over 1,000 amps or volts 552.26 2
Email:m.schiedlen@cdwhomes.com
Temporary services or feeders installation,alteration,and/or
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 _
(honer signature: Date 401 amps to 599 amps 168.54 2
C APPLICANT Branch circuits—new,alteration,or extension,per panel
® CONTACT' PERSON
A.Fee for branch circuits with
Business name: Day id%5 eekley I I otn es above service or feeder fee. 7 4
each branch circuit
Contact name:Meghan Ticknor B.Fee for branch circuits without
Address: 1905 NW 169thPlace Suite 102 service or feeder fee,first 56 18
branch circuit
City/State/ZIP:Beaverton/OR/97006 Each add'1 branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)213-4409 Fax::( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
I nail: mticknora dwhomes.com Reconnect only 67.84
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Garner Electric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address:2890 SE Brookwood Ave ID See Page 2 2
panel,alteration,or extension.
City/State/ZIP: Hillsboro,OR.97123 Each additional inspection over allowable in any of the abet e
Additional inspection(1 hr min) 66.25%hr
Phone:(503)648-4552 Fax:( ) Investigation(1 hr mint 90.00/hr
Industrial plant(I hr mini 78.18/hr
Email:permits@garnerelectric.coo Inspections for which no fee is
CCB Lia:121159 Electrical Lie.. 4-305C Suprv.Lie.:3707S
specifically listed(l,)hr min) 90.00/hr
ELEC1'RICAI P1113-III FETES
Suprv.Electrician signature,require Subtotal:
Print name:Charles Gamer Date: 11.16.21 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
tat f. ,U/Lza01.- TOTAL PERMIT FEE:
Authorized signature:
This permit application expires if a permit is not obtained within 180
Print name:Brittany Bu rian Date: 11.16.21 days after it has been accepted as complete.
' Number of inspections allowed per permit.
t:\Building`Permirs H i I'rmitApp_ELR_ERE.doe Rev 06/17. 'I' 4404615T(I I/OS/COM/W'EB
AN
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE s( tEN>1LE
Description I Qty. I Bath I Total
Fee for all residential systems combined: S75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
n A• udio and Stereo Systems* 15.01 to 25 kva 200.34
Wind generation systems in excess of 25 kva:
Burglar Alarm 25.01 to 50 kva 301.04 z
50.01 to 100 kva 552 26 2
® Garage Door Opener* 100 kva(fee in accordance
ith OAR 918-309-0040) »'26
w
/1 Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7 42 3
ri V• acuum 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?5 hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
cpecificella listed('hr min)
COMMERCIAL WORK ONLY: ELEC 1RlC L PERAIEI PEES
Subtotal(Enter on Page 1):
Fee for each commercial system: S75.00 v Limber ot inspections<tut„veaper„e,,,,iL
(SEE OAR 918-309-0000)
Check Type of Work Involved:
U Audio and Stereo Systems
—1 Boiler Controls
—1 C• lock Systems
Data Telecommunication Installation
7 Fire Alarm Installation
n H• VAC
—1 Instrumentation
Intercom and Paging Systems
Landscape Irrigation Control*
U Medical
P1 N• urse Calls
ri O• utdoor Landscape Lighting*
—1 Protective Signaling
P1 O• ther:
Total number of commercial systems: _
*No licenses are required. Licenses are required for all
other installations
L'Btu lding:Pennits\ELC_PennitApp_ELR_ERE.doe Rev Oy t7/2011
Plumbing Permit Applicatio�ECEIVE r
Building Fixtures I(lll t)I ) It , I •l r)vI 1
City of Tigard NOV 18 2021 R0CG1 I,4ST2b21-o
Ph_
DgtG+tl: Permit Q
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718,2439 Fax: 503.598.1 UatalBy; Otita Pormit No.;
Inspection Line: 503.639.4175 ` i t ' o� I�HI�I
1 pgta Regdy/By bra, FI See Page 2 for
Internet: wwwtigardorgov BUILDING DIVISION Nntfed/Medwd 1supplentenmllnrorn,ation
9�}3'k .,t+a"t i)tM ur sr r�r"ha-3. I iVit•',I,i .o p fi�y yi tOl k f3 yi#, y eo itt ri f.y 3' } t 344Si..�..�' f+>iY,t'F!., ilia li f 5 L y ,
.t . :'`kO .,.•4, YN.. . Fd,s ll1' !`k/, 1'!•R A4a Y- sso 4,,,;k , ra�G4 !!�1 Q�,,,.. i�J ^V • a.
t.:� 66B""""""���"' Y :� - � . .:+,. .. �Ci' �syS:.,.,: t I...:..•;4H�-
®New construction Cl Demolition For special lnfor+nntion use checklist
Description L Qty. 1 Ea, j Total
❑Addition/alteration/replacement Q Other: New 1-2-fondly dwellings(includes 100 It for each utility connection)
•l�' + ��v+*R v tr-lx, ro +r .y� i.x so �.`�,, t ge i; P 4fi� rs`a ,�y�"i..
ett ,,�,H1,:...aVAi; ik . , :.;: � ? I aa" } t'r "t y ,"!*{ SFR(I)huh 312.70
El1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building ❑Multi-family SFR(3)bath 1 500.32 500.32
Each additional bath/kitchen 25.02
❑Master builder ❑Other: _
I p � u r r m� (fit ,z �v Fire sprinkler( sq.(l.) Page 2
.a r„0..10 , 4 ,irk r:,l'AN ni3OQ s 1 , 4,4:' Site ntuides:
Job site address: 10771 SW Lady Marion Drive Catch basin or area drain I8,76
lJrywell,leach line,or trench drain 18,76
City/State/ZIP:Tigard/OR/972'2d Footing drain(no,linear ft: 30) Page 2 87,55
Suite/bldg./apt,no.: I Project name:Trillium Hill Manufactured home utilities 50.03
Cross street/directions to job site:SW 109'h AVE AND SW Lady Marion Or Manholes 18.76
Rain drain connector 18.76
Sauitaty sewer(no.linear ft.:_„) Page 2
Storm sewer(no,linear IL; ) �_ Page 2
Water service(nu.linear ft.:_.,_,_) Page 2
Subdivision:Trillium Hill I Lot no.: 4 Fixture or item:
Tax map/parcel no.:2S110DAt1400 Backtlow preventer 1 31.27 31.27
a e i � *I t t ii ia nk x au" s �.,, Backwater Valve
12.51
Clothes washer I 25,02 25,02
New Single Family Home to be built - 2412SQFT 4 Bedroom, 3bath Dishwasher _ I 25.02 25 t}2
with 603SQFT 3 car garage with a 117SQFT covered balcony and a Drinking fountain 25.02
108SQFT covered porch.
g Ejectors/sump . 2S.02
"� O�F. iT.�°t -t` i r *s � liiti ,; Expansion talk 12,51
z d � a� b
Name:David Weekley Homes Fixturersewer cap 25,02
Floor drain/floor sink/hub 25,02
Address:1905 NW 1694[Mace Suite 102
Garbage disposal 1 25.02 23 02
City/State/ZIP:Beaverton,OR 97006 Hose bib 25.02
Phone:(503)213-4415 Far ( ) Ice maker 1 12.51 12.51
1044KiiiI*64k4".50101:644' ::iilg PtVSIW < r lnterceptodgrottse trap 25.02
Business name:David Weekley Homes Medical gas(value:$`) Page 2
Primer 12.51
Contact MUM:Meghan'Ticknor Roofdruln(commercial) 12.51
Address:1905 NW 160'Place,Suite 102
Sink/basin/lavatory 5 25M2 125.10
City/State/ZIP:Beaverton/OR/97006 Solar units(potable water) 62,54
Phone (503)213-4409 Fax ( ) Tub/shower/shower pan 1 4 12,51 50.04
E-mail;mschiedlert dwhameO eom Urinal _ 25.02
t,,#1, + ? t A1,i4 Water closet r 3 25.02 75.06
- ++ ;�,tle ^ � .' �'� � "� Water heaterI. I. 37.52 37.52
Business name:Maim edal Plumbing Wager piping/DWV 56.29
Address: PO Boa 207 Other: 25.02
City/State/ZIP:Banks/OR/97106 Subtotal
Phone:(503)324-0759 Fax:( ) Minimum permit fee; $73.50
CCB Lie,;102535 Plumbing Lie.no.:34-276PB Plan review (2S%of permit the)
State surcharge(12%of permit fee)
Authorized signature: Carolina Malmedal 'llaW.,7 TOTAL PERMIT FEE
Print name:Carolina Ma!medal Date:it l-16-21 This permit application expires irI perntli is not obtained within BSO days
otter it has been accepted as complete,
"Fee methodology sat by Id-County Building industry Service Boatn'.
I:Ultel ingWermitsV'4MU-Pe,mitApp,doc 10/O1/0 440.451GT'(IOrt)2/COM/WC13)
Plumbing Permit Application City of Tigard
Page 2 -Supplemental Information
Fee Schedule Residential Fire Suppression Systems:
1`t 4),i.i>dire'. / S, ill i r,
y �.�, .GIY: t �' {ZC k[ �v r ib,L , t t�;i1„� + ii '#a ��, .�,r+t . t
Footingdrain I�100., • >;, q `e+ rtRA@ �d!i .4l',.hirt°��'.r ?
50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233,20
Sewer 1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52 -
Water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52 j e .; ��y ks$1; r y J Rr mri
Storm&Rain 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
f -}- hi S','
r, f1L 'Its ti0 .r- Art k," A e" t .k r„` each additional$100,00 or fraction thereof,to
l >Pg,..-'E ,'" `°'t 0'1.V and including$10,000.00,
Inspection of existing plumbing or for S 10,401.00 to$25,000.00 $148.50 for the first$10,000,00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100,00 or 0-action thereof,to
(minimum charge-1/2 hour) and including$25,000,00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,040.00 $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
Reinspection Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the Must$50,000.00 and$1.20 for
(minimum char e-1/2 hour) each additional$100.00 or inaction 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*.
,� , p+, , :' 9uaatit�'bvFiiiireTVtte:, ��y�„��1�>�@'�1 ,, ��[^�P� 1��n1�� ii �
Thrlglt i.v,t4. i .f '' ' w` ' Ae►iuer(!', A .,.. .9 fi;
,a�l..l:l(�n
.11d'brk•tTX'ormed, .' `,ted�d,: `fgitneste:: Plan review is required for any of the following.
Baptistry/FontPlease check all that apply.
Bat Tuls'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,
-Drive Thru 0 New exterior'plumbing site utilities for any complex structure
Cuspidor/Water Asp irator as defined in OAR918-780-0040, ,
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities,
-Domestic 0 Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Arty complex structure as defined in OAR9 18-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
3"
�wv:� air 4 u, F;< s
Car Wash Drain , , ', '-t 3 : :ai-,'QC �Fi# '. k ak
Garbage Domestic-non-foal 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
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
Wah 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\Ma!menial\AppDuta\Local\Microsoft\Windows\1NetCache\Conte2t.Outlook\3F12cXR48lPlambing Pertnit,doe
INI City of Tigard
q COMMUNITY DEVELOPMENT DEPARTMENT
TcARD Building Permit Review — Residential
Building Permit #: ' t T202 j-0 08'
Site Address: 10771 SW Lady Marion Dr
Project Name: Trillium Hill Lot #: 4
Planning Review
Proposal: New detached dwelling
XI Verify address/suite# active in Accela. CX In River Terrace: $l No ❑ Yes, River Terrace Review Addendum
Site Plan Elements: XJErosion Control
X13 copies of site plan on 8-1/2"x 11"or 11 x 17"paper n3etained trees with drip line and tree protection measures
XDrawn to scale(standard architect or engineer scale) Xl(Footprint of new structure(including decks)and FFE
X]North arrow XUtility locations&easements(required for new and additions)
X Site address,project or subdivision name and lot number Xi Sidewalk/driveway approach
[XApplicant information(name and phone number) naocation of wells/septic systems
L Lot dimensions and building setback dimensions XStreet tree size,type and location
naluare footage of buildings to be demolished XStreet names
naxisting structures on site XCorner elevations(2'contours if more than 4'differential)
mot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? Lf ❑No
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? LJYes LJNo
XI Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified X No Received: ❑ Yes ❑ No
XI Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑ Yes,applicant was notified r No Received: ❑ Yes ❑ No
ralSDC Exemption for ADU applied for: ❑ Yes ❑ No Received: ❑ Yes ❑ No
® Public Facilities Improvement (PFI) Permit
Required: ❑ Yes,applicant was notified X No Applied For: Cl Yes ❑ No,stop intake
® Land Use Case#: ZO N2018-00001 X Zoning: R-4.5
IX Required Setbacks: I ront: 20 Rear: 15 Side: 5 Street Side: na Garage: 20
CX Building Height Max.Height: 30 Actual Height: 20
MaLandscape Area: % naLot Coverage Max: cyo
Entrance X Set back no more than 8'from street-facing wall 60 Parallel to street or offset 45 degrees or less
Windows Rj Minimum 12%of area of all street-facing facades 1 5%
Garage X Garage door is behind widest street-facing wall X Yes ❑ No,one of the following is met:
❑ Door extends no more than 5'from wall and there is a covered porch extending beyond garage.
❑ Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2nd floor.
XI Garage door width is ❑ 12'or less IX 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
Ck Visual Clearance ® Urban Forestry Plan
KI Sensitive Lands: ® Yes ❑ No Type: Significant Tree Groves
I Conditions met prior to issuance of building permit
Notes: L,
kl Approved By Planning: Iv: G ,�,► iJ Date: 11/22/2021
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_RES_122419.docx f
1,,
Building Permit Submittal
Original Submittal Date: /l//$/au
Site Plans: # 3
Building Plans: # 3
Building Permit#: Er Enter building permit# above.
Workflow Routing: P'Planning 11?-Engineering L./Permit Coordinator [ - Building
Workflow Sign-off: [a'Sign-off for Planning(include notes from planning review)
Route Application Documents: [2'Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
LY'Building: original permit application,site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes: /
By Permit Technician: `A'
Date: /i/2402-1
Engine ring Review
lope at building pad:
R'vConditions "Met"prior to issuance of building permit
�Eas ents (encroachments)per engineering conditions of approval and plat
ater Quality/Quantity Facility
Assess Water Quality Fee in-lieu: ❑ Yes [ ' To
Assess Water Quantity Fee in-lieu: ❑ Yes No
LIDA Facility on lot: ❑ Yes Z No
Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
Pr--Approved by Engineering: K, 1 ' S l--ea— Date: /i-a ,'Z-n Z(
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ 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 /Does not apply
'SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: 7 Yes ❑ N/A
Parks SDC: / Yes ❑ N/A
LIDA ❑ Yes /N/A
OK to Issue Permit
Approved by Permit Coordinator: Date: �I V)I 244
I:\Building\Forams\B1dgPermitRvw RES_1224I9.docx
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
114 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Transmittal Letter
T I t i A R rD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Allyson Armstrong DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
FROM: Meghan Ticknor DEC 1 Zer
COMPANY: David Weekley Homes LAITY OF TI(aAHU
BUILDING DIVISION By.
PHONE: 503.213.4409
EMAIL: mticknor@dwhomes.com
00 c,0,6
RE: 10771 SW Lady Marion Drive Iv /JI2(-
• (Site Address) (Permit Number)
Trillium Hill Lot 4
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. Revisions: Code Compliance
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS: Submitted set showed old Oregon Residential Specialty code. Revised sheets show adjustments.
FOR F ICE USE ONLY Al
Routed to Permit Technici : Date: (2 Z�( Initials: Al
Fees Due: ❑ Yes No ' Fee Descri do : Amount Due:
b ` - ss 04...„---v
Special
Instructions:
Reprint Permit(per PE : ❑ Yes No ❑ Done le__
Applicant Notified: Date: (� �,/ Initials: