Permit 1111 CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2021-00483
T I G A R.Ll 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/30/2021
Parcel: 2S112BD01000
Jurisdiction: Tigard
Site address: 7819 SW MARA CT
Subdivision: Serenus Subdivision Lot:
Project: Serenus, Lot 5
Project Description: New detached dwelling
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 648 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height 20 Bathrooms: 3 Second: 896 sf Garage: 356 sf Front: 15 Smoke
Yes
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors:
Total: 1544 sf Value: $219,871.20 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100
Tubs/Showers: 2 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: 0
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3
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: 2 201-400 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 1544
Owner: Contractor:
BLUE PALOUSE PROPERTIES LLC DR HORTON INC PORTLAND Required Items and Reports(Conditions)
14630 SW 79TH AVE 4380 SW MACADAM AVE SUITE 100 1 Ersn Cntrl 503-639-4175
TIGARD,OR 97224 PORTLAND,OR 97239
PHONE: PHONE: 503-222-4151
FAX: 503-222-1304
Total Fees: $35,809.93
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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Issued By: HaLL i Vavv Pe, Wege Permittee Signature: Din'Ap�:'-�iza4-i-o-tA'
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 iob site at the time of each inspection.
Building Permit Application 'g-< </1 121
' Residential RECEIVED
City of TigardRate/By:// d9 Z02/ Msr2024„6D 3
NOV� � y ry(tZ1 PermitNo.:
1111 13125 SW Hall Blvd.,Tigard,OR 97223 1 tU ! Plan Review r
a Phone: 503.718.2439 Fax: 503.598.1960 Date/By: (,N b � Other Permit �l�j0��y
inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: { luris: ® See Page 2 for
TIGARD p BUILDING DIVISION otilied;Meth • hLiI/ I Supplemental Information
Internet: www.tigard-or.gov
TYPE OF WORK REQUIRED HATA: 1-AND 2-FAMILY DWELLING
[29 New construction ❑ Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: �'I(ems 29i(611
❑ 1-and 2-family dwelling 0 Commercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms:3
❑Master builder ❑Other: Number of bathrooms'?,
JOB SITE INFORMATION AND LOCATION Total number of floors:2 L 1 00
Job site address:7819 SW MARA CT New dwelling area: >lite(5C/1uare feet W
City/State/ZIP: Garage/carport area: 356 ssquare feet ' LE9,
Suite/bldg./apt.no.: Project name: Serenus Covered porch are? square feet �+'
Cross street/directions to job site: Deck area:0 square feet
Other structure area: 0 square feet Landing
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Serenus Lot no.:5 Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
NSFR Valuation: $
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER 0 TENANT Number of stories:2
Name:DR Horton Type of construction:
Address: 4380 SW Macadam Ave Ste 200 Occupancy groups:
City/State/ZIP: Portland OR 97239 Existing:
Phone:(503 ) 222-4151 Fax:( ) New:
' liM l " t lit 'PPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: DR 1 lorton
-- Structural plan review fee(or deposit): 73Y
Contact name: Emerald Weeks
FLS plan review fee(if applicable):
Address: 4380 SW Macadam Ave Ste 200
Total fees due upon application:
City/State/ZIP: Portland OR 97239
Phone:( 503 ) 222-4151 Fax::( ) Amount received:
E-mail: esweeksr/P,drhorton.com drhorion.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name: DR I lotion Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 4380 SW Macadam Ave Ste 200 Solar Installation Specialty Code checklist.
City/State/ZIP: Portland OR 97239 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( 503 ) 222-4151 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: 39— /3 eyVS'7 /J �Y� 't'(/L2- Total fee due upon application: $201.60
Authorized signature: CjryZ4trl.GTi l�i2 (/2 This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Emerald Weeks Date: 6/3/2021 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPennitApp.doc 02/24/201 I 440-4613T(1 1/02/COM/WEB)
Building Permit Application Checklist
' One- and Two-Family Dwelling roR orrlcl: usl•: o1i.v
City of Tigard Date/BReceived Permit No.:
is 13125 SW Hall Blvd.,Ti ard,OR 97223 y
g Associated permits:
■ Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 El Electrical 0 Plumbing 0 Mechanical
TIGARD Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW l es ° N/A
I Land use actions completed. See jurisdiction criteria for concurrent reviews. x ' ❑ • III
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. x❑ ❑ 0
3 Verification of approved plat/lot. x 0 0 0
4 Fire district approval required. Name of district: • _x 0 0 0
5 Septic system permit or authorization for remodel. Existing system capacity _. xD 6 Sewer permit. ,iD 0 0
7 Water district approval. xD 0 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. x❑ 0 0
9 Erosion control ❑plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- x❑ 0 0
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state x❑ 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 x❑ 0 0
there is more than a 4-tt.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 x❑ ❑ 0
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, x❑ 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- x 0 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. x❑ 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- x❑ 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 x❑ 0 ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered x❑ ❑ 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 x❑ 0 ❑
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. x❑ 0 0
21 Energy Code compliance. identify the prescriptive path or provide calculations. A gas-piping schematic is required x 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 x 0 0 0
architect licensed in Ore:on and shall be shown to be applicable to the roject 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 IT. 0 0 0
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 0 0 0
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 0 0 0
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 0 0
27 "Drawn to scale"indicates standard architect or engineer scale. 0 0 0
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 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 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:ABuilding\Permits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Applicati ECElVE®f''[ Received CT2ne� �O1 r Q.3
City of Tigard Received
Permit No.: J L.(J[E "r/a
13125 SW Hall Blvd.,Tigard,OR 97223 y
• g N 0 V 01 2021 Plan Review Other Permit:
Phone: 503.7]8.2439 Date/By;
i i t n l;I1 Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: luny 10 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE*SCHEDULE—USE CHECKLIST
®New construction ❑Addition/alteration/replacement Mechanical permit fees*are based on the value of the work
performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION Value:$
RESIDENTIAL EQUIPMENT I SYSTEMS FEES*
❑ 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building
For special information use checklist.
❑ Multi-family ❑ Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Job site address: 7819 SW MARA CT Air conditioning 46.75
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: Furnace 100,000+BTU(ducts/vents) I 54.91
Suite/bldg./apt.no.: Project name: Serenus Heat pump 61.06
Duct work i 23.32
I Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
i Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision: Serenus Lot no.:5 Other: 23.32
Other fuel appliances:
Tax map/parcel no.:
Water heater 23.32 ,
DESCRIPTION OF WORK Gas fireplace/insert 33.39
NSFR Flue vent for water heater or gas
fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
0 PROPERTY OWNER ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: DR Horton Range hood/other kitchen
Address: 4380 SW Macadam Ave Ste 200 equipment t 33.39
Clothes dryer exhaust 1 33.39
City/State/ZIP: Portland OR 97239 Single-duct exhaust(bathrooms, 4
Phone:( 503 ) 222-4151 Fax:( ) toilet compartments,utility rooms) 23.32
Attic/crawlspace fans 23.32
0 APPLICANT 0 CONTACT PERSON Other: 23.32
Business name: DR Horton
Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name: Emerald Weeks
Furnace,etc.
Address: 4380 SW Macadam Ave Ste 200 Gas heat pump
City/State/ZIP: Portland OR 97239 Wall/suspended/unit heater
Water heater 1
Phone:( 503 ) 222-4151 Fax: :( ) Fireplace
E-mail: esweeks@drhorton.com Range 1
Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: Development Northwest Inc.,dba Wolcott HVAC Other:
Address: 1075 W Historic Columbia River Hwy MECHANICAL PERMIT FEES*
Subtotal
City/State/ZIP: Troutdale,OR,97060 Minimum permit fee($90.00)
Phone:( 503 ) 667-1781 Fax:( 503 ) 667-9891 Plan review(25%of permit fee)
State surcharge(12%of permit fee)
CCB tic.: 112220 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: ff /
• Fee methodology set by Tri-County Building Industry Service Board
IPrint name: Andrew Darland Date: 10/21/21
li Building\Pennits\MEC_PenitApp_082520.doc 440-4617T(11/02/COMJWEB)
Electrical Permit Application RECEIVED l•OR OFFICE USE O(\1.1 n
Cl D T1 and Received iffrill Ji2.t/„L'-004r3
■ 13125 SW Hal Blvd.,Tigard,OR 97223 NOV 01 2021 Date/B :
g Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#:
Inspection Line: 503.639.4175 CITY OF TIGARD Ready Date/By: Juris: RI See Page 2 for
1 I G A R D Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information
,f1ff •.,, t :, :4 3 a
IN New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/it ems checke :
❑Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition ❑Other: y* where the available fault current 0 Marinas and boatyards.
CATEGORY OFO1)STR'4JCTIION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
0 1-and 2-family dwelling ❑ Commercial/industrial 0 Accessory building less to ground,or exceeds l4.000 ❑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 SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address:7819 SW MARA CT 100HP or more. ❑ `A","E", t-2", 1-3',
0 Six or more residential units. occupancy.
City/State/ZiP: ❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: Serenus 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: ^r ,.
De
scription - Qtv. Each Total •
New residential single-or multi-family dwelling unit.
Subdivision: Serenus Lot#:5 Includes attached garage.
1,000 sq.II.or less 1 168.54 4
Tax map/parcel#: Ea.add'I 500 sq.ft or portion 3 33.92 1
DESCRIPTION OF WORK Limited energy,residential
WIZ
(with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
0 PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: DR Horton 200 amps or less 100.70 2
Address: 4380 SW Macadam Ave Ste 200 201 amps to 400 stops 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZiP: Portland OR 97239 601 amps to 1,000 amps 301.04 2
Phone:(503 ) 222-4151 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: esweeksr drhorton.com relocation
Owner installation:This installation is being made on property that i own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
t, Branch circuits—new,alteration,or extension,per panel
.: :. , „" 4.,, ,<,0- .. ;, ":, ., -4 A.Fee for branch circuits with
Business name: DR Horton above service or feeder fee, 7.42 2
each branch circuit
Contact name:Emerald Weeks B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address: 4380 SW Macadam Ave Ste 200 branch circuit
City/State/ZIP: Portland OR 97239 Each add'I branch circuit 7.42 2
222-4151Miscellaneous(service or feeder not included)
Phone:( 503 ) I Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: esweeksndrhorton.com ,, �t Reconnect only 67.84 2
tl' it i'ice i ll . lY t`!,' .T:� gn s,ia s •`rl°
. � al.,i,ts ik i f};t.2zst.1}.n?fir;:. Pump or irrigation circle 67.84 2
Business name:Garner Electric Co Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy ❑ See Page 2 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(1 hr min) 66.25/hr
Phone:(503-648-4552 Fax:( ) Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email: permits@garnerelectric.com Inspections for which no fee is
90.00/hr
CCB Lie.: 121159 Electrical Lic.: —.15C Suprv.Lic.:3707-S sp cilicall listed C.hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: , _J .. Subtotal:
Print name: Charles Garner Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
��Authorized signature: W_.1u . _ TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Emerald Weeks Date: 6/3/2021 days after it has been accepted as complete.
* Number of inspections allowed per permit.
1:\Building\Permits,.ELC_PermitApp_ELR_ERE.doc Rev 06,17,2015 440-4615T(11,05'COM-WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
Descripl ion I Qh Each I Total
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
5 kva or less 100.70 2
Check Type of Work Involved:
5.01 to 15 kva 133.56 2
n A• udio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ B• urglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
n Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
E Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
E Other: Each additional inspection is 66.25/hr I
charged at an hourly(I hr min)
Inspections for which no fee is 90.00/hr
specifically listed('/z hr min)
COMMERCIAL WORK ONLY: q
Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00 • Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
El Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
El Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
n O• utdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
1`Building,Permits'.ELC_PennitApp_ELR_ERE.doc Rev 06/17'2015
Plumbing Permit Application
Building Fixtures RECEIVED FOR OFFICE USE ONLY
Cityof Tigard Received C r�,h9 t { (�Z
g NOV 0 1 2021 Date/By: Permit Na: Srazi.VO`Ii jj 0
13125 SW Hall Blvd.,Tigard,OR 97223 �V Plan Review
• Phone: 503.718.2439 Fax: 503.598.196D Date/By: Other Permit No.:
Inspection Line: 503.639.4175 UITY OF TIGARD 11(,Alt1) Date Ready/By:/B Juris ® See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
Q New construction 0 Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement E Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
ElI-and 2-family dwelling ElCommercial/industrial SFR(2)bath 437.78
SFR(3)bath 1 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:7819 SW MARA CT Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name: Serenus Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: Serenus I Lot no.:5 Fixture or item:
Tax map/parcel no.: Backllow preventer 31.27
Backwater valve 12.51
DESCRIPTION OF WORK
Clothes washer 1 25.02
NSI:R
Dishwasher 1 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name: DR Morton
4380 SW Macadam Ave Ste 200 Floor drain/floor sink/hub 25.02
Address: Garbage disposal 25.02
City/State/ZIP: Portland OR 97239 Hose bib 2 25.02
Phone:( 503 ) 222-4151 Fax:( ) Ice maker 12.51
❑ APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name: DR Horton Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: Emerald Weeks
Roof drain(commercial) 12.51
Address: 4380 SW Macadam Ave Ste 200 Sink/basin/lavatory 4 25.02
City/State/ZIP: Portland,OR 97239 Solar units(potable water) 62.54
Phone:( 503 ) 222-4151 Fax: :( ) Tub/shower/shower pan 2 12.51
Urinal 25.02
E-mail: esweeksGP,drhorton.com 3 25.02
Water closet
CONTRACTOR I 37.52
Water heater
Business name: Alliance Plumbing,LLC Water piping/DWV 56.29
Address: 146 W Historic Columbia River Hwy Other: 25.02
City/State/ZIP: Troutdale,OR 97060 Subtotal
Minimum permit fee: $72.50
Phone:( 503)492-3490 Fax:( 503 ) 912-6438
Plan review (25%of pennit fee)
CCB Lie.: 184601 Plumbing Lic.no.: PB732
State surcharge(12%of permit fee)
Authorized signature: I c?_ 7 t TOTAL PERMIT FEE
Print name: Gavin Moines Date: 7.01.2021 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:,Building\Permitsk.PLMU-PermilApp.doc 10'01,09 440-4616T(10,02:COM'WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty Fee(ea) Total Square Footage: Permit Fee:
Footing drain- I' 100. 50.03 0 to 2,000 $121.90
2,001 to 3,600 $169.69
Footing drain-each additional IOU. 37.52 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 Valuation: Permit Fee:
Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50
Slone&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
Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
Other Inspections or Feesand including$10,000.00.
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 fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $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
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 first$50,000.00 and$1.20 for
each additional$100.00 or fraction thereof.
(minimum charge-1/2 hour)
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*. Plan Review for Plumbing Installations
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate
❑ Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower engineer.
-Jacuzzi/Whirlpool ❑ New exterior plumbing site utilities for any complex structure
Car Wash: -Each Stall as defined in OAR918-780-0040.
-Drive Thru
0 Medical gas and vacuum systems for health care facilities.
Cuspidor/Water Aspirator
Dishwasher: -Commercial 0 Any multipurpose fire sprinkler system.
0 Any complex structure as defined in OAR918-780-0040.
_ -Domestic
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2"
3„ Isometric or Riser Diagram
4" ❑ Isometric or riser diagram is required for new buildings
-Car Wash Drain that meet the qualifications above.
Garbage -Domestic non-food
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -Lav/Bar non-food related
-Bradley
-Com/Serv/Util food related
-Service *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and
Washer-Clothes fees assessed for the sewer increase must be paid before the
Water Extractor
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
l:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
City of Tigard
III a COMMUNITY DEVELOPMENT DEPARTMENT
■
TI CARD Building Permit Review — Residential
Building Permit #: I Sr2oz ooLi S3
Site Address: 3 1.1°i Soo MA¢/4 Cr
Project Name: saw)is siiciN u(o oiu Lot #: -S---
Planning Review
Prop sal: Alva) C11Ut9(-1 Der461-E0 riomc-
Verify address/suite#active in Accela. In River Terrace: o ❑ Yes,River Terrace Review Addendum
E
Site lan Elements: rosion Control
33 opies of site plan on 8-1/2"x 11"or 11 x 17"paper Ret ed trees with drip line and tree protection measures
1 [ b}awn to scale(standard architect or engineer scale) oo rint of new structure(including decks)and FFE
2'&yrth arrow locations&easements(required for new and additions)
fLJSit address,project or subdivision name and lot number idewalk/driveway approach
IIVATplicant information(name and phone number) fr ocation of wells/septic systems
E✓1 of dimensions and building setback dimensions [lS eet tree size,type and location
Square footage of buildings to be demolished I��a,SSt/treet names
Lotsting structures on site Zf irner elevations(2'contours if more than 4'diffe tial)
area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? t 11 Yes ❑�Noo
impervious area(applicable if R-7,R-12,R-25&R-40). If yes,is a storm water quality facility shown? ❑Yes LiJNo
Ea
Clean Water Services—Service Provider Lette lot platted prior to 9/10/1995):
equired: ❑ Yes,applicant was notified ICJ No Received: E Yes ❑ No
Water Meter Fixture Unit Worksheet—Additio ,Remodels and ADUs
/Required: E Yes,applicant was notified Al No Received: ❑ Yes ❑ No
,L�1S C Exemption for ADU applied for: ❑ Yes C?o Received: ❑ Yes ❑ No
I & Public Facilities Improvement(PF1)Permit:
Required: ❑ Yes,applicant was notified 2 No Applied For: ❑ Yes ❑ No,stop intake
Land Use Case#: SU 20Z0 ' Gas 0 Zoning:
q
211.equired Setbacks: Front: `/S _ Rear: I r Side: S Street Side: /a Garage: ZO
ID B 'ding Height: Max. Height: 3S Actual Height: 1-Z)
Landscape ea: 2c' /oot Coverage Max: 8
Entrance al - back no more than 8'from street-facing wall O Parallel to street or offset 45 degrees or less
Windows nimum 12%of area of all street-facing facades ,� /
Garage Garage door is behind widest street-facing wall LY'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.win)w above garage on 2nd floor.
Gar door width is ❑ 12'or less ❑ 50%or le,of facade 60%or less and includes 7 of following:
Covered porch �R essed entrance all offset/ 1'Roof eave CI Roof offset
❑ fire shingles Lap Siding ❑ Roof pitch IQ Gable,hip,or gambrel roof ❑ Dormer
Accent siding ❑ Window trim CIWindow recess ❑ Window projection ❑ Balcony j
Ellyisual Clearance Cl Urban Forestry Plan
Sr—Sensitive Lands: ❑ Yes 0`No Type:
❑ Conditions met prior to issuance of building permit
Note
IQ Approved By Planning: Date: _±,Lialti
Revisions (after Building Submittal only) Reviewer Date
Revision 1: Cl Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: I t/Q( 2O2.(
Site Plans: #
Building Plans: #
Building Permit#: CVEnter building permit# above.
Workflow Routing: I 'Planning P"Engineering .Permit Coordinator Building
Workflow Sign-off: 121/Sign-off for Planning(include notes from planning review)
Route Application Documents: l'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 and trust details,if applicable, etc.
Notes:
By Permit Technician: Date: // ( ZOLI
Engineering Review
[lope at building pad: ":4
Q'Conditions "Met"prior to issuance of building permit
2"-Easements (encroachments) per engineering conditions of approval and plat
Et/Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes g No
Assess Water Quantity Fee in-lieu: ❑ Yes 2/No
LIDA Facility on lot: ❑ Yes R"No
VFinal Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
C 'Approved by Engineering: l y,Q�.�f to Date: tI 121-/"2-02.)
Revisions (after BuildingSubmittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Permit Coordinator Review
,e( Conditions "Met"prior to issuance of building permit
LI 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: Yes ❑ N/A
Parks SDC: / Yes ❑ N/A
LIDA ❑ Yes /f N/A
Af OK to Issue Permit
Approved by Permit Coordinator: Date: 11 l2ZIZ02(
C\Building\Fonns\BldgPennitRvw_RES_122419.docx