Permit CITY OF TIGARD MASTER PERMIT
' 1 ' COMMUNITY DEVELOPMENT '• +, v Permit#: MST2021-00529
Date Issued: 05/25/2022
T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 1y )i0 >d Parcel: 2S108AB06800
Jurisdiction: Tigard
Site address: 15375 SW SILKWOOD CT
Subdivision: Lot: 8
Project: Bull Mountain Summit, Lot 8
Project Description: New detached dwelling.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1067 sf Basement: 0 sf Left: 5 Parking Spaces; 0
Height: 23 Bathrooms: 3 Second: 1459 sf Garage: 505 sf Front: 15 Smoke
Yes
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors:
Total: 2526 sf Value: $355,741.48 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Bcklw Prevntr: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Fum>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 5 201-400 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 2526
Owner: Contractor:
KEMMER RIDGE LLC CHAD E DAVIS CONSTRUCTION Required Items and Reports(Conditions)
12555 SW HALL BLVD 2808 19TH AVE 1 Ersn Cntri 503-639-4175
TIGARD,OR 97223 FOREST GROVE,OR 97116
PHONE: PHONE: 503-357-8587
FAX:
Total Fees: $40,194.70
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. ATTE ON: 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: (((((///// Permittee Signature: eTe ('r\) " .3 '
Call 503.639.4175 y 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.
CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2021-00529
Date Issued: 05/25/2022
T I i;;1 R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439
Parcel: 2S108AB01300
Jurisdiction: Tigard
Site address: 15375 SW SILKWOOD CT
Subdivision: BULL MOUNTAIN SUMMIT Lot:
Project: Bull Mountain Summit, Lot 9
Project Description: New detached dwelling.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1067 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 23 Bathrooms: 3 Second: 1459 sf Garage: 505 sf Front: 15 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors:
Total: 2526 sf Value: $355,741.48 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Bckflw Prevntr: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Fum>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea addl 500 sf: 5 201-400 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 2526
Owner: Contractor:
KEMMER RIDGE LLC CHAD E DAVIS CONSTRUCTION Required Items and Reports(Conditions)
12555 SW HALL BLVD 2808 19TH AVE 1 Ersn Cntrl 503-639-4175
TIGARD,OR 97223 FOREST GROVE,OR 97116
PHONE: PHONE: 503-357-8587
FAX:
Total Fees: $40,194.70
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
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Issued By: CP"' / Permittee Signature: l jG AV"4".\
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 lob site at the time of each inspection.
a
t
Building Permit Application
Residential FOR OFFICE USE ONLY
RECEIVED City of Tigard Dare ve g 03 ao.z' :fit Pemnt No. .Brn0,2r ✓052/
111 • 13125 SW Hall Blvd.,Tigard,OR 97223 %nn qq Plan Review 2/ r/ AA,
.• 41Q2'(0)313
Phone: 503.718.2439 Fax: 503.598.1960 NOV 15 2U2! Date/By: J/zZ- OrlrerPermr
Inspection Line: 503.639.4175 Date Ready/By. v' / lulls Bf See Page 2 for
T IIiARU
Internet: www.tigard-or.gov CITY OF TIGARD - ed/Meth,: ,plemental Information
_ /� -�
EN .1 k. . I \ ON -.it'll" /� �' �
TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING
®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
CATEGORY OF CONSTRUCTION �wiork indicated on this fapplication. Qi
® 1-and 2-family dwelling ❑Commercial/industrial J'� —- ) �r•3J $ i r
Number of bedrooms:4
ElAccessory building ❑Multi-family
D Master builder D Other: Number ofbathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors:2
I
&/Z s square feet
Job site address:15375 SW Silkwood Ct New dwelling area: `4 5
City/State/ZIP:Tigard, Oregon 97224 Garage/carport area: 50 square feet Ib(07
Suite/bldg./apt.no.: Project name:Bull Mountain Summit Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
. REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:Bull Mountain Summit Lot no.:9 Pennit 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.
New Construction - Single Family Residential Valuation: $
Plumbing Permit - 1 Backflow Device needed per lot Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 TENANT Number of stories:
Name:Chad E. Davis Construction LLC Type of construction:
Address:2808 19th Ave Occupancy groups:
City/State/ZIP:Forest Grove, Oregon 97116 Existing:
Phone:I )503-357-8587 Fax:( ) New:
® APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule) _ i, r:'.
Business name:Chad E. Davis Construction LLC
Structural plan review fee(or deposit):
Contact name:Matt Weatherdon
FLS plan review fee(if applicable):
Address:2808 19th Ave
Total fees due upon application:
City/State/ZIP:Forest Grove, Oregon 97116
Amount received:
Phone:( )503-357-8587 Fax::
E-mail:Valli@chadedavisconstruction.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Chad E Davis Construction LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:2808 19th Ave Solar Installation Specialty Code checklist.
City/State/ZIP:Forest Grove, Oregon 97116 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( )503-357-8587 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lia:154184 , This Total fee due upon application: $201.60
Authorized signature: e e/g (7DCcGvG2 permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry
Print name:Chad E. Davis Date:11.15.2021 Service Board
I:\Building\Permits\BUP-RESPermitApp.doe 02/24/2011 440-4613T(11/02/COM/WEB)
1
%
Mechanical Permit ApplicatiofRECElVE*. FOR OFFICE USE ONLY
City of Tigard Received r2O�/- �/9/_77
qDate/By: Pe m t No.: I 1 VV✓<
13125 SW Hall Blvd.,Tigard,OR 97223 NOV 5 ZD2! Plan Review •
• Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
r i G n It I) Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Jarisa H See Page 2 for
Internet www.tigard-or.gov BUILDING DIVISIOI' Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE- USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling El Commercial/industrial 0 Accessory building For special information use checklist.
El Multi-family ❑Master builder ❑ Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 1 46.75 46.75
Job site address:15375 SW Silkwood Ct Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75
City/State/ZIP:Tigard, Oregon 97224 Furnace 100,000+BUT(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:Bull Mountain Summit Ductwork 8 23.32 186.56
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
Other: 23.32
Subdivision:Bull Mountain Summit Lot no.:9
Other fuel appliances:
Tax map/parcel no.: Water heater 1 23.32 23.32
DESCRIPTION OF WORK
` Gas fireplace/insert 1 33.39 33.39
Flue vent for water heater or gas
New Construction - Single Family Residential fireplace 1 23.32 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Plumbing Permit - 1 Backflow Device needed per lot Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
® PROPERTY OWNER 0 TENANT
Environmental exhaust and ventilation:
Name:Chad E Davis Construction, LLC Range hood/other kitchen1 33.39
equipment 33.39
Address;2$08 19th Ave Clothes dryer exhaust 1 33.39 33.39
City/State/ZIP:Forest Grove, Oregon 97116 Single-duct exhaust(bathrooms, 3 69.96
toilet compartments,utility rooms) 23.32
Phone:( )503-357-8587 Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT 121 CONTACT PERSON Other: 23.32
Business name:
Chad E Davis Construction LLC Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:Matt Weatherdon Furnace,etc.
Address:2808 19th Ave Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Forest Grove, Oregon 97116 Water heater
Phone:( )503-357-8587 Fax::( ) Fireplace
Range
F-mail:ValH@chadedavisconstruction.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Pyramid Heating and Cooling other *
MECIIANICALPERMIT FEES ,
Address:9409 NE Colfax Street Subtotal
City/State/ZIP:Portland, Oregon 97220 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( )503-786-9522 Fax: ( ) State surcharge(12%of permit fee)
CCB lie.:59382 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
/ �7-� days after it has been accepted as complete.
Authorized signature: l �v ,e4Y * Fee methodology set by Tri-County Building Industry Service Board
Print name:Chad E. Davis Date:11.15.2021
I18uilduglPermits\MtsC_PermitApp_040113.doc 440-0617I(I I/OLCOM/WEB)
4 Elefirical Permit A licatio ECEI v`/
E,I FOR OFFICE USE ONLY
City of Tigard Received
13125 SW Hall Blvd.,Tigard.OR 97223 NOV 15 2021 oateBy: �'ST ��vaie-�
se Phone: 503.718.2439 Fax; 503598.1960 Plan Review
DateBy: Related Permit a:
S!c,n R n Inspection Line: 503.639.4175 CITY OF TIGARD Ready bate-By: torts: Fa See Page 2 for
Internet: wvvw.tigard-or.goe
BUILDING DIVISION NotiIlcd'M1fetlxrd:
_ ___J. Supplemental Information
:. TYPE OF WORK
0 New construction 0 Addition/alteration:r lacement Please cheek all that apply
C(7 pp y(submit 2 sett of w.items checked)
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition 0 Other:
where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION, exceeds 10,000 amps at 150 volts or 0 Floating buildings.
I.and 2-family dwelling ❑Cotninerciallindustrial 0 Accessory building less to ground.or exceeds 14.000 ❑Commercial-use agricultural
amps for all other installations. buildings
0❑Multi-family ❑ Master builder Other: 0fire pomp P 0 Installation of 150 KVA or
JOB SITE INFORMATION.AND LOCATION ❑Emergence system. larger separately derived
❑Addition of new motor load of system.
Johis. Job site address: 15375SWSilkwoodCt loourormore. ❑-A",•'E t_r.-i-3
City/State/ZIP: ❑Six or more residentialunhs occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suitebldg./apt.#: Project name:Bull Mountain Summit ❑Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or more. 600 voles nominal.
Cross street/directions to job site: FEE'SCBED[JLE
Dmripl- I prt. 1 Each 1 Taal 1 •
New residential single-or multi-family dwelling unit.
Subdivision:Bull Mountain Summit i Lot#;9 Includes attached garage.
Tax map,'parcel t 1,000 sq.ft.or less 1 168.54 /leg S'' 4
Ea.add'!500 sq.ft.or ponion 33.92 1
DESCRIPTION OF WORK • .^ ,.'i tc7.C6V
Limited energy,residential
New Construction - Single Family Residential (with above sq.R.) 7$•00
------ Limited energy.multi-family 75
residential(with above sq.n.)
' °INNER Renewable Energy ❑ See Page 2
,PROPERTY ` ❑ TENANT - Services or feeders installation,alteration,and/or relocation
Name:Chad E Davis Construction, LLC 200 amps or less 100.70
Address:2808 19th Ave --- 201 amps to400 amps 133.56
city/state/zip:Forest Grove, Oregon 97116 401 amps to 600 amps 200,34 2
601 maps to 1.000 amps 301.04 2
Phone:( )503-357-8587 I Fax:( 1 Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,andior
Email:VaIH@ChadedaViSCOnstruCtlon.COm
relocation
Owner installation:This installation is being made on property that 1 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
;� APPLICANT ®CONTACT PERSON ,..., Branch circuits-new,alteration,or extension, -r panel
- - - A.Fee for branch circuits with
Business name:Chad E Davis Construction, LLC above service or feeder tee,
each branch circuit 7.42 2
Contact name:Matt Weatherdon B.Fee for branch circuits oithnur
Address:2808 19th Ave service or feeder fee,first 56.18 2
branch circuit
City/State/Z[P:Forest Grove, Oregon 97116 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:
( 1503-357-8587 Fax::( 1 Each manufactured or modular I ? I
Email:ValH@chadedavisconstruction.com
dwelling,service and/or feeder 67.84
Reconnect only 67.84 2 i
t.Vfvfl4ACFOR,. , Pump or irrigation circle 67.84 2
Business name:Platinum Electric Inc Sign or outline fighting 67.84 2 j
Address:4676 Commercial Street SE#248 Signal nel.alte anont(s)or leniensi n. - 0 See Page 2 2
panel,alteration,or extension.
Each additional inspection over allowable in any of the above
City/State/ZIP:Salem, Oregon 97302
Additional inspection(1 fir min) 66.25'fir
Phone:( t)503-510-5173 Fax:( ) Investigation(I he min) 90.00i hr
Email: \" 1�+'4 /� ( tndustnsl plant(I fir min) 78.18'fir
(6\IAUI e C�-(`1 L � l..l G'P�C '(• T, jv t j-' Inspections for which no fee is
CCB Lie.:172027 1 Electrical Li LVt 3`)f_I specifically listed nun) 90',ONfir
uprv.Lic.: lk' S i
ELECTRICAL PERMIT FEES
i Suprv.Electrician signature.required: a'a.- Subtotal: 316,3e.
Print name: IJIA 0,,,'1vy.�A. Date: ' I—/V I ❑Plan Review Requited(25%of permit fee): !
/ ' State surcharge(12%of permit fee): ,4,3
Authorized signature: C (0.--T7t2G`/b TOTAL PERMIT FEE: a40(.1 y
This permit application expires if a permit Is not obtained within 180
Print name:Chad E. Davis Date: 11.15.2021 1 days after it has been accepted as complete.
4' t " Number of Inspections allowed per permit
lt8ui4lin5'Pe,mhs`ElC PcmulApp ELR EREdoc Rev 0617,2015 410.b6 VI(11,05:COSi:14Ea
k.
Plumbing Permit Application
Building Fixtures RECEIVE FOR OFFICE USE ONLY'
Received � /
- City agard NOV 15 2021 PeavtNn.'(f�20�(pUS�?
111 • 13125 SW Hall Blvd.,Tigard,OR 97223 DateBy: i
Plan Review
Phone: 503.718.2439 Fax: 503.598.I960Other Permit No.:
Inspection Line: 503.639.4175
CITY OF TIGARD Date/By:
TIGARCO 1 ;It r�lt�if=,n1UISIQI ate Ready,By: Tons� 6J See for
Internet. wtivw.tigard-Or.gov - NotifiedMtethod: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
®New construction ❑ Demolition For special information use checklist
Description I Qty. I Ea. I 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
® I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 2.5 1 437.78 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
181" I A i 11 0 ® i• ' ' li :Rs tienities
Job site address:15375 SW Silkwood Ct Catch basin or area drain 18.76
City/State/ZIP:Tigard, Oregon 97224 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name:Bull Mountain Summit 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:Bull Mountain Summit I Lot no.:9 Fixture or item:
Tax map/parcel no-: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
-- Clothes washer 25.02
New Construction -Single Family Residential Dishwasher 1 25.02 25.02
Drinking fountain 25.02
Plumbing Permit - 1 Backflow Device needed per lot Ejectors/sump 25.02
® PROPERTY OWNER l ❑ TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name.Chad E Davis Construction, LLC
Floor drain/floor sink/hub 25.02
Address 2808 19th Ave
Garbage disposal 1 25.02 25.02
City/State/ZIP:Forest Grove, Oregon 97116 Hose bib 2 25.02 50.04
Phone:( )503-357-8587 Fax ( ) Ice maker 1 12.51 12.51
® APPLICANT VI CONTACT PERSON Interceptor/grease trap 25.02
Business name:Chad E Davis Construction, LLC Medical gas(value:$_) Page 2
Primer 12.51
Contact name:Matt Weatherdon
Roof drain(commercial) 12.51
Address:2808 19th Ave Sink/basin/lavatory 3 25.02 75.06
City/State/ZIP:Forest Grove, Oregon 97116 Solar units(potable water) 62.54
Phone:( )503-357-8587 Fax::( ) Tub/shower/shower pan 2 12.51 25.02
E-mail:ValH@chadedavisconstruction.com Urinal 25.02
Water closet 3 25.02 75.06
CONTRACTOR
Water heater 37.52
Business name:The Mullen Company Water piping/DWV 56.29
Address:1601 A SE River Road Other: 25.02
City/State/ZIP:Hillsboro, Oregon 97123 subtotal
Phone:( )503-640-0113 I Fax:( ) /1/4L j Minimum permit fee: $72.50
3�aL4iD ✓�� Plan review (25%of permit fee)
CCB Lic.:92689 7-� Plumbing Lic.no.: State surcharge(12%of permit fee)
Authorized signature: C (T!/CLG`bt TOTAL PERMIT FEE
Print name:Chad E. Davis Date:11.15.2021 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.
ClBuilding'.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-1"100' 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' 1 62.54 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 1 62.54 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52
Valuation: Permit Fee:
Storm&Rain Drain-1st 100' 1 62.54 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
Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
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
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof
Subtotal: 3 187.62
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
Quanfi 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 -
Car Wash: -Each Stall ElNew exterior plumbing site utilities for any complex structure
Drive as defined in OAR918-780-0040.
ElCuspidor/Water Aspirator Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial El Any multipurpose fire sprinkler system.
Domestic El Any complex structure as defined in OAR918-780-0040.
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
Garbage Domestic non-food that meet the qualifications above.
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: -Lay/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:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
Plumbing Permit ApplicatiRECF VED
Building Fixtures Nov2021 FOR OFFICE USE ONLY'
Cityof Tigard Itlo V 1 Received q� )
111 • 131 SW Hall Blvd.,Tigard,OR 972 Y OF TIGARD Date/By: Permit N°.'/��Tj c��IW
a 8, Plan Review
Phone: 503.718.2439 Fax: 503.59 plOther Permit No.:
Inspection Line: 503.639.4175 DING DIVISIONDate By:
I I G A R D Internet: www ti and-or. ov Date Ready/By: revs: See Page 2 for
g g Notified/Method: S Supplemental Information
TYPE OF WORK FEE" SCHEDULE
®New construction ❑Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other: New I-2-family dwellings(includes 100 R.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
SFR 2 bath 437.78
® 1-and 2-family dwelling ❑Conunerciallinduatrial ( )
❑Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑ Master builder III Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:15375 SW Silkwood Ct Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard, Oregon 97224 Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name:Bull Mountain Summit 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:Bull Mountain Summit I Lot no.:9 Fixture or item:
Tax map/parcel no.: Backflowpreventer 1 31.27 31.27
DESCRIPTION OF WORK Backwater valve 1 12.51 12.51
---- Clothes washer 25.02
New Construction - Single Family Residential Dishwasher 25.02
Drinking fountain 25.02
Plumbing Permit - 1 Backflow Device needed per lot Ejectors/sump 25.02
® PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Name:Chad E Davis Construction, LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:2808 19th Ave
Garbage disposal 25.02
City/State/ZIP:Forest Grove, Oregon 97116 Hose bib 25.02
Phone:( )503-357-8587 Fax:( ) Ice maker 12.51
0 APPLICANT ® CONTACT PERSON Interceptor/grease trap 25.02
Business name:Chad E Davis Construction, LLC Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Matt Weatherdon
Roof drain(commercial) 12.51
Address:2808 19th Ave Sink/basin/lavatory 25.02
City/State/ZIP:Forest Grove, Oregon 97116 Solar units(potable water) 62.54
Phone:( )503-357-8587 Fax::( ) Tub/shower/shower pan 12.51
E-mail:ValH@chadedavisconstruction.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:The Mullen Company Water piping/DWV 56.29
Address:1601 A SE River Road Other: 25.02
City/State/ZIP:Hillsboro, Oregon 97123 Subtotal
Phone:( )503-640-0113 Fax:( ) Minimum permit fee: $72.50
CCB Lie.:92689 Plumbing Lic.no.:
Plan review (25%of permit fee)
�� J 7-� State surcharge(12%of permit fee)
^
Authorized signature: (?Pa4NQ TOTAL PERMIT FEE
Print name:Chad E. Davis Date:11.15.2021 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.
I:1Building\Permits\PLMU-PermitApp.doc l0/0I/09 440-4616T(10/02/COM/WEB)
City of Tigard
11111 C ill COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review — Residential
Building Permit #: r�Vo�t'CO r/!ec /
Site Address: I 3 , (� S 4!(SIX, CA-.Project Name: .IJ4` M0uVlci—eill.i ,v> vA 1+ Lot #: 1
Planning Review ,, 9
Proposal: l V v J\ d "" kL ku lutiteiltky
g Verify address/suite# active in Accela. ❑ In River Terrace: y2 No ❑ Yes,River Terrace Review Addendum
Site Plan Elements: Erosion Control
�3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper " t ioed i ' ' a
C rawn to scale(standard architect or engineer scale) XFootprint of new structure(including decks) and FFE
ONorth arrow $Jtility locations&easements (required for new and additions)
rite address,project or subdivision name and lot number ®Sidewalk/driveway approach
WApplicant information(name and phone number) ono we s sep
g,ot dimensions and building setback dimensions ' treet tree size,type and location
P�Street names
try.-- corner elevations(2'contours if more than 4'differential)
Q71.ot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? laYes ❑No
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes No
0
Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No
• 'x/.,+ Mster Fixture L-I.,it Werkshect .Arldiiiu ,,-Rcu,odels and ADU,-
Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No
applied for: ❑ Yes ❑ No Received: ❑ Yes ❑ No
Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes,applicant was notified ® No Applied For: ❑ Yes ❑ No,stop intake
112 Land Use Case#: S U 6 Cat/ - 0 I I9 Zoning:
, t t J t
® Required Setbacks: Front: ,( Rear: Side: j6j Street Si e: l Or Garage: 2-0 I
cii Building Height: Max. Height: 3 rJ Actual Height: 3
O Landscape Area: Z7 % N Lot Coverage Max: f3-O
Entrance Set back no more than 8' from street-facing wall Parallel to street or offset 45 degrees or less
Windows Minimum 12%of area of all street-facing facades
Garage ® Garage door is behind widest street-facing wall ❑ Yes 0 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 ❑ 12'or less Zia 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
Li V 1 CI "^ee ❑ Urban Forestry Plan
/0 Sensitive Lands: ❑ Yes . No Type:
a t
Notes:
1 [ 1 Approved By Planning: ! ' itA ` 00414 Date: Z �7Z
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPennitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: (t/i 55/2
Site Plans: # '�
Building Plans: # '3
Building Permit#: [ Enter building permit#above. /
Workflow Routing. [Er Planning 2/Engineering Engineering [ Permit Coordinator C�Building
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
ginal plan review routing form.
hr Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: Date: D3 u
Engineering Review
D"-Slope at building pad: 2 v
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering canditions of approval and plat
['Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes E`f".No
Assess Water Quantity Fee in-lieu: 0 Yes 0/No
LIDA Facility on lot: ❑ Yes E'f'No
❑ Final Plat Recorded:
❑ NOT Approved by Engineering: AA Date:
Notes: 70 fr,of- ye(ea Se 1-1-77 (ex,0.1 S R v,! s-' "F M {
Approved by Engineering: . lrsi S %ram eu✓x,_4T.l:r 44,6 4)ate: 3/z 67/2)._ _,
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Permit Coordinator Review
(Ii Conditions "Met"prior to issuance of building permit
1`-' Approved,NOT Released: Pawl ?IA/40(44 �, - Az. Date: 12415 (Z0�
Notes: 1
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
j!J_SDC Exemption: ❑ Received / Does not apply
//r�y'f SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: �Yes ❑ N/A
Parks SDC: ,'Yes ❑ N/A
LIDA ❑ Yes ;21/N/A
,ZOK to Issue Permit
Approved by Permit Coordinator: Ar)\ g' Date: 3Z� f'zovi-
1:\Building\Forms\BldgPennitRvw_RESJ22419.docx
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Floors Z Large I �/
Bed rooms Small Q W C (3 p k �A JU.!/"�
LAV 5-
Tub3 Basement �•�+� "r�%�='
Vent 5 1st Floor 10 le 7 �., ��
Water Heater 1 2nd Floor ILI
AC Y.�g 3rd Floor / Y�
Schools R-3 Total 7-4 7i1
Z - C .S fOrc., ta-c-� Garage '5 o�
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