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Permit Ili. BACKFLOW EXISTING REMOVED PREVENTER REPORT NEW REPLACED REPAIRED OLD MN: PROPERTY NAME DR Horton Serenus Lot 7 PHONE CONTACT NAME PHONE MAILING ADDRESS 14526 SW 78th Ave CITY Tigard STATE OR ZIP 97224 PREVENTER ADDRESS 14526 SW 78th Ave Tigard, OR 97224 WATER SUPPLIER City of Tigard, Oregon SERIAL# HF 56433 LOCATION SW corner driveway, lawn MAKE Febco MODEL 850 SIZE 3/4" TYPE n RP ❑ RPDA r] RPDA-II IX.1 L)C n DCDA u DCDA-II n PVB 1 , J SVB AVB n AG HAZARD PROTECTED ri PREMISES ISOLATION ® IRRIGATION Li� FIRE SYSTEM [.._.1 BOILER I� OTHER APPROVED: IX ASSEMBLY ® INSTALLATION f�1 ORIENTATION l l AIRGAP PIPE sag _in SE AT in 8aPAMTRIN REDUCED PRESSURE ASSEMBLY PVRA/SVBA INITIAL TEST DOUBLE CHECK AIR INLET CHECK VALVE PASSED X CHECK#1 CHECK NI TYPE II 1 OPENED AT: Puss DROP: PRESS TIGHT I^) FAILED l l DROP INITIAL MIN sPSID 2.2 TEST RELIEF VALVE LEAKED n MINI MID MIN I PSID MIN t PSID DATE 1 0-06-22 RESULTS OPENED AT: OPENED _ MIN2 PSID CHECK#2 FULLY r 1 FAILEDf � SYSTEM PSI 1 06 RELIEF VALVE: TIGHT Di DID NOT IA DETECTOR METER PASSED n FAILED n 1 .8 OPPIN I I READING: LEAKED ri BM I PSID NOTES REPAIRS PARTS REDUCED PRESSURE ASSEMBLY MBA/SA/HATEST CHECK#1 DOUBLE CHECK AFTER REPAIRS DROP:PRESS CHECK#1 TYPE III l AIR INLET CHECK VALVE REPAIR __.. MIN s PSID TIGHT [-1 OPENED AT: PRESS DROP: RESULTS RELIEF VALVE DATE OPENED AT: CHECK#2 MIN I PSrr/ MIN I PSID MIN I PAID RELIEFVALVn MEN 2PSID TIGHT n MIME I I PASSED E PASSED n FAN I I LED MINI Pam GAUGE SIN 04141250 MAKE/MODEL Mid-west Instruments 845 CALIBRATION DATE 11-12-2021 In completing and submitting this test report,the tester certifies that the assembly was tested and maintained in accordance with all applicable rules laws codes and regulations of the stale and water system using approved testing equipment and approved testing procedures INITIAL TEST TEST AFTER REPAIRS _ 'r>"--- 066108 TESTER SIGNATURE TESTER SIGNATURE TESTER.CERT# Jordan A 503-849-0237 TESTER NAME(PRINTED) TESTER NAME(PRINTED) PHONE# 2153 Molalla Rd Woodburn, OR 97071 jordan@ablandscapes.net TESTER ADDRESS TESTER ADDRESS EMAIL Ashland Brothers Backflow Testing, Repair&Install 71 WATER RESTORED? COMPANY NAME COMPANY NAME — FOUND OFF,LEFT OFF REPORT RECEIVED BY(REPRENIATIVE OP OWNER) REPORT REMORA) (REPRESENTATIVE OP OWNER} ES City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT . ARD Building Permit Review — Residential Building Permit #: 1 f 5T2OZ►-00 t. .t f Site Address: 14526 SW 78th Ave Project Name: Serenus Subdivision Lot #: 7 Planning Review 4127122— atitchw Al'Ppo rsossiSetA0 tS AtRPT. sin51-Ouib t A apicAT Proposal: New detached dwelling 61. Verify address/suite #active in Accela. ® In River Terrace: in No 0 Yes,River Terrace Review Addendum Site Plan Elements: Qrosion Control l3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper V:Itetained trees with drip line and tree protection measures [XDrawn to scale(standard architect or engineer scale) ►L.1 Footprint of new structure(including decks)and FFE Cg[North arrow DIUtility locations&easements(required for new and additions) Site address,project or subdivision name and lot number IRSidewalk/driveway approach (Applicant information(name and phone number) Cli acati.,., i� +Pms G--"— c--'-te "--- Mot dimensions and building setback dimensions Mtreet tree size,type and location iare Dotage o u " 'shed N1Street names NCorner elevations(2'contours if more than 4'differential) OilLot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? NYes ❑No impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes NINo ►4 Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified Di No Received: 0 Yes ❑ No ® Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs Required: ❑ Yes,applicant was notified IR No Received: ❑ Yes El No ® SDC Exemption for ADU applied for: ❑ Yes N1 No Received: 0 Yes ❑ No Jl Public Facilities Improvement (PFI)Permit: Required: 0 Yes,applicant was notified tl No Applied For: 0 Yes ❑ No,stop intake ►:� Land Use Case#: SUB2020-00001 a Zoning: R-12 IXI Required Setbacks: Front: 15 Rear: 15 Side: 5 Street Side: 10 Garage: 20 ® Building Height: Max. Height: 35' Actual Height: 20' ® Landscape Area: 20 0A, EX Lot Coverage Max: 80 Entrance al Set back no more than 8'from street-facing wall 0 Parallel to street or offset 45 degrees or less Windows CR Minimum 12%of area of all street-facing facades Garage ($ Garage door is behind widest street-facing wall IX 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 2"d floor. I Garage door width is 0 12'or less ❑ 50%or less of facade l$ 60%or less and includes 7 of following: EX Covered porch ❑ Recessed entrance El Wall offset ® 1'Roof cave ® Roof offset ❑ Fire shingles 1 Lap Siding 0 Roof pitch (X Gable,hip,or gambrel roof ❑ Dormer INl Accent siding 0 Window trim El Window recess ❑ Window projection El Balcony NI Visual Clearance ® Urban Forestry Plan 1il Sensitive Lands: ❑ Yes [A No Type: ® Conditions met prior to issuance of building permit Notes: �ry Approved By Planning: Date: __)517 mil._Revisions (after Building Submittal only) eviewer ate Revision 1: 4 Approved ❑ Not Approved ti 2 /2o 2 z_ Revision 2: Approved ❑ Not Approved / I:\Building\Fonms\BldgPermitRvw RES_122419.docx Building Permit Submittal Original Submittal Date: / 0 Zell Site Plans: # Building Plans: # Building Permit#: Q'tnter building permit#above. Workflow Routing: 52"Planning ®''Engineering lih"Permit Coordinator ti'uilding Workflow Sign-off: [T Sign-off for Planning(include notes from planning review) Route Application Documents: [Engineering: (1)copy of permit application,(1) site plan, (1) building plan and original plan review routing form. 'Building.: original pertri tapplication,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: Date: /// /z42/ Engineering Review Er/Slope at building pad: Z.% lid' Conditions"Met"prior to issuance of building permit 1"Easements (encroachments) per engineering conditions of approval and plat 2"Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes Di/No Assess Water Quantity Fee in-lieu: ❑ Yes C"No LIDA Facility on lot: ❑ Yes n/No C;i"Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: R''Approved by Engineering: f f,.pi:1 f 161/1-e;., '_1,7 Date: 11l2 12,4/2,i Revisions(after Building Submittal only) Reviewer ,` Date Revision 1: 'Approved 0 Not Approved �vtv,t /(1)--i .mac,..._, Tf27/Z022 Revision 2: 0 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: iscl. 41 27 I 2Z2_ Revision Notice 2: Date Sent to Applicant: (u SDC Exemption: ❑ Received eg Does not apply /— SDC Fees Entered: Wash Co Trans Dev Tax: Yes 0 N/A Tigard Trans SDC: 7 Yes 0 N/A Parks SDC: Yes ❑ N/A LIDA 0 Yes N/A OK to Issue Permit Approved by Permit Coordinator: OL-- Date: it VZ'b 2A I:\Building\Forms\BldgPermitRvw_RES_122419.docx I 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. l IIPI City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Transmittal Letter T i G A,l) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: Emerald Weeks APR 2 7 2022 COMPANY: DR Horton CITY OF TIGARD BUILDING DIVIS PHONE: 503-222-4151 C�fy' EMAIL: esweeks@drhorton.com RE: 14526 SW 78TH AVE MST2021-00484 (Site Address) (Permit Number) Serenus Lot 7 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: LDescription: Copies: , Description: Additional set(s) of plans. 3 Revisions: Site Plan 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: This home is a garage left but the site plan that was approved was a garage right,please review the attached site plan with a left„thank you FO OFF CE USE ONLY Routed to Permit Technicia. te: t--I 2-7(ZZ Initials: I\* Fees Due: ❑ Yes 'No " Fee Description: Amount Due: , < ,,''., ,,;,',,,,,--, - ..6 c„....---- __Fl(ze.„. „, 'i • : °A' ;`-'. ,.< /4 6 JJ Special Instructions: / Reprint Permit(per PE): ❑ Yes ..) No ❑ Done Applicant Notified: Date: `//� 2.-1_ Initials: utM#+..t4tro-4 ua?4uWiam.4iizifi4MCsr:16#0lmd.Nidksaac6#ate44NNa i{xP.us«w4Utt.*a.n. ...,w . v4u-Yg}yy}pyyfsim«,.>raW •...nmx3w'4•W•.4+�+w miwwxisua a.a.,..., . ,rn.n#l.. .xr#sux#a .+1ubx44r,.4n»as W4.+aliksa#a.4ae+aw.N.keauuav F4YaNtW£nek.w. zxxae#n.x.Miuue..,. CITY OF TIGARD MASTER PERMIT I COMMUNITY DEVELOPMENT Permit#: MST2021-00484 Date Issued: 01/13/2022 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S112BD01000 Jurisdiction: Tigard Site address: 14526 SW 78TH AVE Subdivision: Serenus Subdivision Lot: Project: Serenus, Lot 7 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: $220,486.56 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 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 4 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'I 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 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: $35,826.70 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 OF7-nnl-nn1n rhrni,nh r1GR OF7-M1-nn0n Vnii may nhfain a rnnv of the.ndoe nr r+ircrf ni,oeenn4:fn flu Itir by ra IIinn Fng') ' 1007 ,rr 1 M 11,',gild Ho-UAJ ValDWege A r Lca'hoy. Issued By: Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the iob site at the time of each inspection. Building Permit Application 15—l1 12I21 Residential RECEIVED FOR OFFICE USE ONLY City of Tigard ReceiveDate/Byd i// 262, �'' Permit No. 5rzo2/-/!tf 13125 SW Hall Blvd.,Tigard,OR 97223 NOV 02 2021 Plan Review t i 'Z Other Perrot RZO,/,00 Phone: 503.718.2439 Fax: 503.598.1960 Date/By: `�5 7if � �-+ �/`�V6 I I c;A I:a Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: / ® See Page 2 for Intenet www.tigard-or.gov BUILDING DIVISION tified/Method:// ? .XI J / Supplemental Information .:14,texezeo TYPE OF WORK REQUIRED/ DATA: I-AND 2-FAMILY DWELLING L 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 ❑Other: equipment,materials,labor,overhead,and the profit for the VAP �� CATEGORY OF CONSTRUCTION work indicated on this application. y Valuation: 5 O 22o 0 1-and 2-family dwelling ❑Commercial/industrial Number of bedrooms:3 ❑Accessory building ❑Multi-family ❑Master builder ❑Other: Number of bathrooms:›l l JOB SITE INFORMATION AND LOCATION Total number of floors:2 19 V D Job site address:14526 SW 78TH AVE New dwelling area:"�$Q,6•S Ltquare feet V Lt, City/State/ZIP: Garage/carport area: 356 square feet (14% Suite/bldg./apt.no.: Project name: Serenus Covered h area:NyC square feet Cross street/directions to job site: Deck ea:24 square feet Other s area:‘,IC., square feet Landing REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Serenus Lot no.:7 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. NSI'R Valuation: $ Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER ❑ 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: ❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) j Business name: DR I Lorton 37 Structural plan review fee(or deposit): Tor� 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 Amount received: Phone:( 503 ) 222-4151 Fax::( ) ;:PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: esweeks@drhorton.com drhorton.com Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name: DR Horton 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 Y and administrative fees): Phone:( 503 ) 222-4151 Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lie.: 13059 r / Cj�� Q6�W�/, l �((t /�2- Total fee due upon application: $201.60 Authorized signature: �L 4 r2,GGGGTi 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\Pennits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(I I/02/COM/WEB) kir Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONLY City of Tigard Received Permit No.: 13125 SW Hall Blvd.,Ti ard,OR 97223 y g Associated permits 1 Phone: 503.718.2439 Fax: 503.598.1960 24-Hour Inspection Line: 503.639.4175 CI Electrical ❑ Plumbing 0 Mechanical T I C;A IZ I? Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A I Land use actions completed. See jurisdiction criteria for concurrent reviews. x ' ❑ ❑ ❑ 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. x❑ 0 ❑ 3 Verification of approved plat/lot. x❑ ❑ 0 4 Fire district approval required. Name of district: . x 0 ❑ 0 5 Septic system permit or authorization for remodel. Existing system capacity x❑ 0 ❑ 6 Sewer permit. x0 0 0 7 Water district approval. x❑ 0 0 8 Soils report. Must carry original applicable stamp and signature on file or with application. x❑ ❑ 0 9 Erosion control D plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- x❑ ❑ 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. P/an review cannot be completed if copyright violations exist. 1 1 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-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 x❑ 0 ❑ and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, x❑ 0 0 furnace,ventilation fans,plumbin• 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 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❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. x❑ ❑ ❑ 21 Energy Code compliance. identify the prescriptive path or provide calculations. A gas-piping schematic is required x 0 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 a Ilicable to the ,ro'ect under review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17... 0 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-ens. "Mirrored"building plans will not be accepted. 0 ❑ 0 26 "Reversed"building plans must meet criteria outlined in the Permit&Svstem Development Fees document. ❑ 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(1I/021COM/WEB) Mechanical Permit Application volt()Fury I.si.:(m , City of Tigard RECEIVED DAeBy: Permit No.: gy202i-.cots gq) w 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Date/By: Phone: 503.718.2439 NOV �. 2021Other Permit: 1 I t i A k I) Inspection Line: 503.639.4175 Date Ready/By: H See Page 2 for Internet: www.tigard-or.gov CITY OF TIGHRD Notified Method: 'lur 1 e— 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 ❑Other: mechanical materials,equipment,labor,overhead,and profit. CATEGORY OF CONSTRUCTION Value:$ RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ❑ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. ❑ Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Job site address: 14526 SW 78TH AVE 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 Cross street/directions to job site: 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: Serenus Lot no.:7 Other: 23.32 Tax map/parcel no.: Other fuel appliances: 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 0 TENANT Other: 23.32 Environmental exhaust and ventilation: Name: DR Horton Range hood/other kitchen Address: 4380 SW Macadam Ave Ste 200 equipment I 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: I Contact name: Emerald Weeks S14.15 for first four;54.03 for each additional Furnace,etc. Address: 4380 SW Macadam Ave Ste 200 Gas heat pump City/State/ZIP: Portland OR 97239 Wall/suspended/unit heater Water heater I Phone:( 503 ) 222-4151 Fax: :( ) Fireplace E-mail: esweeks@drhorton.com Range I CONTRACTOR Barbecue Clothes dryer(gas) Business name: Development Northwest Inc.,dba Wolcott HVAC Other: MECHANICAL PERMIT FEES* Address: 1075 W Historic Columbia River Hwy 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 lie.: 112220 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 Authorized signature: 4.Z :2-1„.7e,�'� days after it has been accepted as complete. • Fee methodology set by Tri-County Building Industry Service Board Print name: Andrew Darland Date: 10/21/21 1-\Buiiding\Pennits\MEC_PermitApp 082520.doe 440-46)7T(I I/02/COM/WEB) Electrical Permit Application RECEIVED FOR OFFICE USE ONLY d ceive City of'Tigard Received Permit#: 5iy' 26 00 4 eive 13125 SW Hall Blvd.,Tigard,OR 97223 NOV 02 2021 DaPlan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Related Pennit#: Inspection Line: 503.639.4175 CITY OF TIGARD Ready Date/By: Juris: I El See Page 2 for i[G A R D Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW E New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. 0 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground.or exceeds 14.000 0 Commercial-use agricultural amps for all other installations. buildings. ❑ Multi-family 0 Master builder 0 Other: ❑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:14526 SW 78TH AVE I00HP or more. ❑"A ,"E "1-7`,-1-3 0 Six or more residential units. occupancy. City/State/ZiP: 0 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: FEE SCHEDULE Description I Qty. I Each i Total i New residential single-or multi-family dwelling unit. Subdivision: Serenus Lot#:7 Includes attached garage. 1,000 sq.fl.or less 1 168.54 4 Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 3 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 NSFR (with above sq.1i.) Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 ❑ 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 amps 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: esweeksndrhorton.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 Branch circuits—new,alteration,or extension,per panel ❑ APPLICANT 0 CONTACT PERSON 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 4380 SW Macadam Ave Ste 200 service or feeder fee,first 56.18 2 Address: branch circuit City/State/ZIP: Portland OR 97239 Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) 222-4151 Fax: : Each manufactured or modular Phone:( 503 ) ( ) 67.84 2 dwelling,service and/or feeder Email: esweeks c drhorton.com Reconnect only 67.84 2 CONTRACTOR 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. Each additional inspection over allowable in any of the above City/State/ZIP: Hillsboro, OR 97123 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@garnereleetrie.com Inspections for which no fee is CCB Lic.:121159 Electrical Lie.: 4- 05C Suprv. Lic.:3707-S specifically listed(1/2hr min) 90.00/hr ELECTRICAL PERMIT FEES Suprv. Electrician signature,required: Subtotal: Print name: Charles Garner Date: ❑Plan Review Required(25%of pennit fee): /J / /' l State surcharge(12%of permit fee): Authorized signature:�f�i�2J W 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. t::Building..Permits'ELC_PennitApp_ELR_ERE.doc Rev 06/17,2015 440-4615T(II'OS'COMAWEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Description QD. I Each 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: Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 kva(fee in accordance , with OAR 918-309-0040) 55_,_6 n Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 n Vacuum Systems* >100 kva—no additional charge 0.0 3 Each additional inspection over allowable in any of the above: n Other. Each additional inspection is 66.25/hr 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr speciticall listed('h hr min) COMMERCIAL WORK ONLY: Subtotal(Enter on Page I): Fee for each commercial system: $75.00 • Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: n Audio and Stereo Systems [] B• oiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation n Fire Alarm Installation n HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ri N• urse Calls n O• utdoor Landscape Lighting* ❑ P• rotective Signaling n Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations a Permits ELC_PermitApp_ELR_PRE.doc Rev06,17,2015 , ' • 'Piumbin2 Permit Application Building Fixtures RECEIVE I FOR OFFICE USE ONLY City of Tigard NOV 02 2021 Received Date/By: Permit No. T .dQ ,,Lt 114 II 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Other Permit No.: ■ Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Inspection Line: 503.639.4175 CI�OF i IGpR® 1uris: ® See Page 2 for rlcnan p BUILDING DIVISION rDateReadetBi,�a: Supplemental Internet: www.tigard-or.gov Su lemental Information TYPE OF WORK FEE* SCHEDULE New construction ❑Demolition For special information use checklist. Description Qty. Ea. Total ❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ❑ 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 1 500.32 0 Accessory building ❑Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address:14526 SW 78TH AVE 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.:7 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 Backwater valve 12.51 DESCRIPTION OF WORK Clothes washer 1 25.02 NSFR Dishwasher 1 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Name: DR Horton Fixture/sewer cap 25.02 Address: 4380 SW Macadam Ave Ste 200 Floor drain/floor sink/hub 25.02 Garbage disposal 25.02 City/State/ZiP: Portland OR 97239 Hose bib 2 25.02 Phone:( 503 ) 222-4151 Fax:( ) Ice maker 12.51 0 APPLICANT ❑ 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 E-mail: esweeks c drhorton.com Urinal 25.02 Water closet 3 25.02 CONTRACTOR - Water heater 1 37.52 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 Phone:( 503)492-3490 Fax:( 503 ) 912-6438 Minimum permit fee: $72.50 CCB Lic.: 184601Plumbing PB732 Plan review (25%ofpennit fee) Lic.no.: State surcharge(12%of permit fee) Authorized signature: rl-----7/---, TOTAL PERMIT FEE Print name: Gavin Thomes Date: This permit application expires if a permit is not obtained within 180 days 7.01.2021 after it has been accepted as complete. *Fee methodology set by Tri-County Building industry Service Board. t:Building•.Permits'PLMU-PermitApp.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-l'' 100' 50.03 0 to 2,000 $121.90 2,001 to 3,600 $169.69 Footing drain-each additional 100' 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 _9,1.00 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 Qty.` Fee(ea) Total each additional$100.00 or fraction thereof,to Other Inspections o1r'Fees and 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 ❑ Medical gas and vacuum systems for health care facilities. Cuspidor/Water Aspirator Dishwasher: -Commercial ❑ Any multipurpose fire sprinkler system. ❑ 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" xA 3" Isomt t ' c i RiserRiagram 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 COMMUNITY DEVELOPMENT DEPARTMENT T 1 G A li n Building Permit Review — Residential Building Permit #: 1"15t20Z1"00 L(C f Site Address: 14526 SW 78th Ave Project Name: Serenus Subdivision Lot #: 7 Planning Review Proposal: New detached dwelling EX Verify address/suite#active in Accela. IN In River Terrace: Ea No ❑ Yes,River Terrace Review Addendum Site Plan Elements: Qyrosion Control L 3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper rtetained trees with drip line and tree protection measures [Drawn to scale(standard architect or engineer scale) 1KFootprint of new structure(including decks)and FFE N[North arrow CSIUtility locations&easements(required for new and additions) Mite address,project or subdivision name and lot number aSidewalk/driveway approach aApplicant information(name and phone number) n�ocatir,n„fwill�/septic w_ ems [Lot dimensions and building setback dimensions IXStreet tree size,type and location are ootage o u 'shed N[Street names �E ist aet s on sitr—� Corner elevations(2'contours if more than 4'differential) NLot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? EYes ❑No impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes CSINo ® Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified 21 No Received: ❑ Yes ❑ No ® Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs Required: ❑ Yes,applicant was notified a No Received: ❑ Yes ❑ No • SDC Exemption for ADU applied for: ❑ Yes No Received: ❑ Yes ❑ No XI Public Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified N No Applied For: ❑ Yes ❑ No,stop intake ® Land Use Case#: SUB2020-00001 C Zoning: R-12 ® Required Setbacks: Front: 15 Rear: 15 Side: S Street Side: 10 Garage: 20 ® Building Height: Max.Height: 35' Actual Height: 20' ® Landscape Area: 20 % EX Lot Coverage Max: 80 Entrance IX Set back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less Windows (I Minimum 12%of area of all street-facing facades Garage [X Garage door is behind widest street-facing wall at 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 2"d floor. at Garage door width is ❑ 12'or less ❑ 50%or less of facade I$ 60%or less and includes 7 of following: DI Covered porch ❑ Recessed entrance ® Wall offset IX 1'Roof eave DI Roof offset ❑ Fire shingles M Lap Siding ❑ Roof pitch (X Gable,hip,or gambrel roof ❑ Dormer • Accent siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony • Visual Clearance ►,1 Urban Forestry Plan X] Sensitive Lands: ❑ Yes a No Type: ® Conditions met prior to issuance of building permit Notes: EL Approved By Planning: Date: Z Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw_RES_122419.docx Building Permit Submittal Original Submittal Date: ///Q Z0)-1 Site Plans: # Building Plans: # Building Permit#: enter building permit#above. Workflow Routing: [Planning Engineering [ Permit Coordinator L ' uilding Workflow Sign-off: [Sign-off for Planning(include notes from planning review) Route Application Documents: [Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. geBuilding: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: Date: ///O?/0021 Engineering Review L Slope at building pad: Z.°ia Lrd' Conditions"Met"prior to issuance of building permit RrEasements (encroachments)per engineering conditions of approval and plat 2/Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes a/No Assess Water Quantity Fee in-lieu: ❑ Yes a/No LIDA Facility on lot: ❑ Yes L*1' No CY Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: [Approved by Engineering: p f „�� Date: 11/2 2 110 2; Revisions (after Building Submittal 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 ❑ 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 e,12r 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 N/A } / OK to Issue Permit Approved by Permit Coordinator: Date: it t 2,21 13)V I:\Building\Forms\BldgPermitRvw_RES_122419.docx