Permit CITY OF TIGARD MASTER PERMIT
>t.. ' COMMUNITY DEVELOPMENT , . ' Permit MST2021-00527
T IGAR.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 �� - ��, Date Issued: 05/25/2022
Parcel: 2S108AB07000
Jurisdiction: Tigard
Site address: 15323 SW SILKWOOD CT
Subdivision: Lot: 10
Project: Bull Mountain Summit, Lot 10
Project Description: New detached dwelling
BUILDING
Floor Areas Required Setbacks Required
Stones: 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
DwellingUnits: 1 Yes
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
Fum<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!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/volC 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 Cntrl 503-639-4175
TIGARD,OR 97224 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: i�%' �'%/A/ Permittee Signature: '� �' 4. o !i ry 1✓sr (
all 503.639. y 7:00 a.m.for the next available inspection date. J
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.
CITY OF TIGARD MASTER PERMIT
III ' Permit#: MST2021-00527
' COMMUNITY DEVELOPMENT
T I G AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/25/2022
Parcel: 2S108AB01400
Jurisdiction: Tigard
Site address: 15323 SW SILKWOOD CT
Subdivision: BULL MOUNTAIN SUMMIT Lot:
Project: Bull Mountain Summit, Lot 7
Project Description: New detached dwelling
BUILDING
Floor Areas Required Setbacks Required
Stones: 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
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes
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 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 Cntrl 503-639-4175
TIGARD,OR 97224 FOREST GROVE,OR 97116
PHONE: PHONE: 503-357-8587
FAX:
Total Fees: $40,194.70
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work
will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
oc9_rnn1_nnln rhrn,In AP oF9-nn1_nnon Vnu may nhlain a runs,of th>nilac nr r4irw-f ni inetinnc rn nu INr h.,-.air,,,cm 929 10 7,�n,.r4 Ann'IT)9Qdd
,r.Ul Issued By: ' Permittee Signature: c1l.,4 te_ 1 Cl
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. '1
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
•
Building Permit ApplicatiO �_ /,//,__/.I _ ;,
Residential �p�/ �� FOR OFFICE USE ONLY
NO _I LYL! Received t�
City of Tigard Date/By: p2J PermitNo. ZQ J-W S2-
go 13125 SW Hall Blvd.,Tigard,OR 97223P ., Plan Review /�
Phone: 503.718.2439 Fax. 503.598.19�0ITY OF 71UANL, Date/By. �� A:
Other Perm{�Z .1't 1 J
TIGARD Inspection Line: 503.639.4175 BUILDING DIVISION DateReadyBy. nms lil See Page 2 for
Internet: www.tigard-orgov - :fled/Method. 22 Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
®New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit fin the
CATEGORY OF.CONSTRUCTION work indicated own/this{application. -r�`�
® I-and 2-family dwelling ❑ComtnerciaUindustrial V � r/. L r$ 5 4Ttl�`�+._ ,
ElAccessory building 0 Multi-family Num6erofbedrooms:4
0 Other: Number of bathrooms)(3
El Master builder ��
JOB SITE INFORMATION AND LOCATION Total number of floors:2
Job site address:15323 SW Silkwood Ct New dwelling area: 2426—75..ss uare feet`IC)
City/State/ZIP:Tigard, Oregon 97224 Garage/carport area: j�b7 square feet ) 941
Suite/bldg./apt.no.: Project name:Bull Mountain Summit Covered porch areafc 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.:7 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
New 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 ❑ 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: ( )503-357-8587 Fax:( ) New:
® APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name:Chad E. Davis Construction LLC (Please refer rojeeschadute)
Structural plan review fee(or deposit):
Contact name:Matt Weatherdon
Address:2808 19th Ave FLS plan review fee(if applicable):
City/State/ZIP:Forest Grove, Oregon 97116 Total fees due upon application:
Amount received:
Phone:( )503-357-8587 Fax::( )
E-mail:ValH@chadedavisconstruction.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic 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 lie.:154184
Total fee due upon application: $201.60
Authorized signature: C/?..d �, This permit application expires if a permit is not obtained
l within 180 days after it has been accepted as complete.
Print name:Chad E. Davis Date:11.15.2021 *Fee methodology set by Tri-County Building Industry
Service Board.
I:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit ApplicR E I V E D FOR OFFICE USE ONLY City of Tigard Received
p,n�, Date/By: PermitNo.. ST2O2.twOf2.7
14 • 13125 SW Hall Blvd.,Tigard,OR 9722p��G l( 1 1 t.u2 i Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
I (.4 PO Inspection Line: 503.639.4175 CITY OF TIGAH� Date Ready/By. Juris: H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
Dl ILDING DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE- USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling ❑Commercial/industrial ❑ Accessory building For special information use checklist
❑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:15323 SW Silkwood Ct Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75
City/State/ZIP:Tigard, Oregon 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:Bull Mountain Summit Ductwork 8 23.32 166.56
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
Subdivision:Bull Mountain Summit Lot no.:7
Other: 23.32
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
® PROPERTY OWNER IDTENANT Other: 23.32
Environmental exhaust and ventilation:
Name:Chad E Davis Construction, LLC Rangehood/otherkitchen
equipment 1 33.39 33.39
Address:2808 19th Ave Clothes dryer exhaust 1 33.39 33.39
City/State/ZIP:Forest Grove, Oregon 97116 Single-duct exhaust(bathrooms, 69.96
toilet compartments,utility rooms) 3 23.32
Phone:( )503-357-8587 Fax:( ) Attic/crawlspace fans 23.32
,a,
' #
3i `", ,.� �
l�z k (:�,.4�'� v Other: 23.32
.* a,.,ta.. Fuel
Business name:Chad E Davis Construction LLC piping:
S14.15 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 .2*.
Range
E-mail:VaIH@chadedavisconstruction.com Barbecue
CONTRACTOR _Clothes dryer(gas)
Business name:Pyramid Heating and Cooling Other:
MECHANICAL PERMIT 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
• days after it has been accepted as complete.
Authorized signature: eitad("°:1� ro, * Fee methodology set by Tri-County Building Industry Service Board
Print name:Chad E. Davis Date:11.15.2021
I:1BuildinglPermits1MEC_PermitApp_040113.doc 440-1617r(I 1/07JCOM/WEB)
•
` Electrical Permit Applicati
Cityo Tigard ECEI V L-v c Received e�h�^Cb52`T
g Date/By: Permits: 12b V0 2 I
13125 SW Hall Blvd.,Tigard.OR 97223 �III ` 'r ngnt Plan Review
tl Phone: 503.718.2439 Fax: 503.598-196V3�Y 1 1 LUL l Date/By: Related Permit It.
T K;A A D m
Inspection Line: 503.639.4175 per, Ready Date By: rods. ®See Page 2 for
Internet' wuv.'.ligard-or.gov /xCITYOrr TIGAH� tioti(tedMth eod. Supplemental Information
S New construction 0 Addition:alteration.replacement Phase cheek all that apply(submit 2 sets ofpiars whtems chekedr.
0 Demolition 0 Other: ❑Service or feeder 400 amps or more ❑Building over three stories.
where the mailable fault current 0 Marinas and boatyards.
CATEGORY OF.CONSTRUCTION - exceeds 10.000 amps at 150 volts or 0 Mating buildings.
® 1-and 2-family dwelling 0 Comrnercial.'industrial ❑Accessory building tw.s to ground.or exceeds 14.000 ❑Commercial.asc agricultural
amps for all other installations, buildings.
0 Multi-family 0 Master builder El Other:
❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job-! Job siteaddress:15323 SW Sllkwood Cl ❑Addition of new motor load of system.
100HP or more.
City/State/ZIP: ❑Six or more residential units occupancy.
❑ticalth-care facilities. 0 Recreational vehicle parks
Suite/bldg.Japt.0: Project name:Bull Mountain Summit ❑Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross streeUdirections to job site: FEE SCHEDULE
thscriptian I Qn. I Etch I Total I '
New residential single-or multi-famil)dwelling unit.
Subdivision:Bull Mountain Summit Lot 0:7 Includes attached garage.
I.000 sq.R.or less I 168.54 1Gg,SI( 4
Tax map parcel
- i Ea.add•I 500 sq.ft. b'7 sA or portion X 33.92 I
. DESCRIPTION OF WORK Limited energy,residential 75.00 2
New Construction - Single Family Residential 1 (with above sq.0.1
Limited energy.multi-family 75.00
residential(with above sq.R.)
Renewable Energy ❑ See Page 2
-�r
t1LI PROPERTY-Oc ER n TENANT 2 Services or feeders installation,alteration,and/or relocation
Name:Chad E Davis Construction, LLC 200 amps or less 100.70 2
Address:2808 19th Ave 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
CityistateizIP:Forest Grove, Oregon 97116 601 amps to 1,000 amps 301.04 2
Phone:( )503-357-8587 Fax:t ) Over 1,000 amps or volts 552.26 2
Email:VaIH@chadedavisconstruction.com Temporary services or feeders installation,alteration.andior
relocation
Owner installation:Thjs installation is being made on property that I own which is not 200 amps or less 59_16 I
intended for sale,lease,rent.or exchange,according to ORS 447.449.670.and 701. 201 amps to 400 amps 125.0R 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
{a APPLICANT , ® CONTACT.PERSON Dn Branch circuits—new,alteration,or extension, .-r panel
A.Fee for branch circuits with
Business name:Chad E Davis Construction, LLC aboveseniceorfeedertee, 742 2
each
Con tact name:Matt Weatherdon branchcircuit
B.Fee
for branch circuits without
Address:2808 19th Ave sonfirst ice or feeder fee, 56.18
branch circuit
City/State/ZIP:Forest Grove, Oregon 97116 Each add'l branch circuit 742 2
Miscellaneous(service or feeder not included) i
Phone:( )503-357-8587 Fax: :I ) Each manufactured or modular
dwelling,service and'ur feeder 67.84
Entail:Valli@ehadedaviseonstruetion.eom Reconnect only 67.84 2
___ CONTRACTOR;, _ Purttp or irrigation circle 67.84 2
Business name:Platinum Electric Inc Sign or outlineIightine 67.84 2
Signal circuit(s)or limited-energy Address:4676 Commercial Street SE#248 panel,alteration,or extension. 0 See Page 2 2
Each additional Inspection over allowable in any of the above
city/staterzlP:Salem, Oregon 97302
Additional inspection(1 hr min) 66.25'hr
Phone:( )503-510-5173 Fax:( 1 Investigation(I hr mini 9000 hr
Email' 4� i t �\ } Industrial plant(I hr min) 78_18'hr
f ' `t 4\\A ll'�['\yt tS., h*' �LL'rl C`S T'. lv t r _ Inspections for which no fee is
�-t s ifiralh listed(%-hr mist 9t1 00 hr
CCB Lie.:172027 Electrical Li apes.Lie.: '�j"��, �`, ELECTRICAL PERMIT FEES
Suprv.Electrician signature-required: if.....,.
Subtotal ')._3(,.,,3$ I
Print name: �
IJ�J �(�,"\((���1� i Date: ' _r I V r� �1 ❑Plan Review Required(259.0 of permit tee): J____I1 I State surcharge(12%of permit fee): a-$, 3
Authorized signature: Clad' as_spa,yy TOTAL PERMIT FEE: �-(Oy,�y
This permit applkaitoa expires if a permit is not obtained within 180
Print name:Chad E. Davis Dale: 11.15.2021 days after it has been accepted as complete.
i - ' Humber of inspections allowed per permit.
I:''Buildinp rcrmiiv'ELC_PcrnulApp_ELR ERE.Joc Ito.Oc II 20I5 44444151(I 1,451"o.VWEti
Plumbing Permit Applicat[ -_CEIVED
Building Fixtures fi ,,, FOR OFFICE USE ONLY
0�
1 t `°�; Received I�STZOZIXJ��f
City of Tigard Date/By:
Date/By: Permit No.:
• 13125 SW Hall Blvd.,Tigard,OR caw OF TIGAR� Plan Review
Phone: 503.718.2439 Fax: 503598�1A6Q,G, 1, OtherPermit No.:
TIGARD Inspection Line: 503.639.4175 UPI NN Iyis'' � Date Ready/By: Ions: ® See Page 2 for
Internet: www.hgard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
XI New construction ❑Demolition For special information use checklist.
Description I Qty. I Ea. j 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
® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 2.5 I 437.78 437.78
buildingSFR(3)bath 500.32
❑Accessory 0 Multi-family
Each additional bath kitchen 25.02
•
❑Master builder 0 Other: Fire sprinkler P (-sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:15323 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.:7 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 0 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 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
Vl APPLICANT ® CONTACT PERSON Interceptor/grease trap 25.02
Business name:Chad E Davis Construction, LLC Medical gas(value:$ ) Page 2
Contact name:Matt Weatherdon Primer 12.51
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 Fax:( ) `/ic i - Minimum permit fee: $72.50
CCB Lie.:92689 Plumbing Lie.no3q) 4 Plan review (25%of permit fee)
/„ State surcharge(12%of permit fee) .
Authorized signature: `' z z (Z7f4.- 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:1Buildiag\Prrmils\PLMU-PermitApp.doc 10/01/09 440-46161(10/02/COM/WEB)
Plumbing Permit ECEIVED
Building Fixtures
NOV 1 1 LujJ
Received 12 n.7 e 7
City of Tigard Date/By: Permit No.: 5 2�'�SZ
Illq ■ 13125 SW Hall Blvd.,Tigard,OR 972�I�OF TIGARLi Plan Review
■ Phone: 503.718.2439 Fax: S03s9 0 ILDING DIVISION Date/By Other Permit No.:
TIGARD Inspection Line: 503.639.4175 Date Ready/By. Earls_ H See Paget for
Internet: www_tigard-ocgov Notified!Mcthod: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
® New construction ❑ Demolition _ For special information use checklist
Description I Qty. 1 Ea. I Total
0 Addition/alteration/replacement ❑Other: New I-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
building SFR(3)bath 500.32
❑Accessory g ❑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:15323 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 Lotno.:7 Fixture or item:
Tax map/parcel no.: Backflowpreventer 1 31.27 31.27
DESCRIPTION OF WORK
Clothes 1-'-T2i1 1�.5F- -
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
® 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
x x .S✓' �, ff r i I' O > A •'�}ri} ,F-:n`. :,. , xosr Water closet 25.02
2` to,-;-,,..,.” 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)
State surcharge(12%of permit fee)
Authorized signature: eicie ('Z76LWd- 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'PermitstPLMU-PermitApp,doc I0/0I/09 440-4616T(10/O2/COM/WEB)
• City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
C
TIcnD Building Permit Review — Residential
Building Permit #: 0SI 2C2l-00 527
Site Address: I Fj 9 23 5 (A) r3 f W ®4--
Project Name: g u I 1 A-4 d v///V /.1 u( i(/V( i4- Lot #: q
Planning Review
1ri ' ,
Proposal: Il-e, w A0 e� tt ut q )e I V 6 ti
El Verify address/suite#active in Accela. ❑ In River Terrace:! 0 No ❑ Yes,River Terrace Review Addendum
Site Plan Elements: rosion Control
x3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper R, measures
Drawn to scale(standard architect or engineer scale) Footprint of new structure (including decks)and FFE
North arrow Utility locations&easements(required for new and additions)
parte address,project or subdivision name and lot number Sidewalk/driveway approach
¢!]Applicant information(name and phone number) Ili cat c••,=n / rpt - .
1Lot dimensions and building setback dimensions 9 Street tree size,type and location
s toJaeelenieli,hea--- , !Street names
❑g.vi s to p Comer elevations(2'contours if more than 4'differential)
gtLot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced?,YlYes ❑No
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑YesRINo
S - to 9/10/1995):
Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No
—Additlons
Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No
. Yes ❑ No Received: ❑ Yes ❑ No
Public Facilities Improvement(PM) Permit:
Required: ❑ Yes,applicant was notified}Now Applied For: ❑ Yes ❑ No,stop intake
g Land Use Case#: 6(1 g 2() 2-0 C9a5E I [ II Zoning. K '"
• Required Setbacks: Front 1, ` Rear: 15 I Side: G l Street Side: 16 I Garage: 2-,C,t
i•' Building Height: Max. Height: 'G t Actual Height: 9,3'
• Landscape Area: '2.6 % p Lot Coverage Max: ffQ
Entrance JO Set back no more than 8'from street-facing wall 'W7 Parallel to street or offset 45 degrees or less
Windows g2 Minimum 12%of area of all street-facing facades
Garage F1) Garage door is behind widest street-facing wall ❑ Yes iLl No,one of the following is met:
Door extends no more than 5'from wall and there is a covered porch extending beyond garage.
❑ Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2nd floor.
0' Garage door width is ❑ 12'or less "123 50%or less of facade ❑ 60%or less and includes 7 of following:
❑ Coveted porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset
❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer
❑ Accent siding El Window trim ❑ Window recess ❑ Window projection ❑ Balcony
❑ Urban Forestry Plan
e0 Sensitive Lands: ❑ Yes ear)No Type:
H CVaalL11Va1,11.1cl pie'-r. -ssu nc of l)itil_ ding mit
Notes:
Approved By Planning: L/HDate:
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: (ill 5/2.0.2-/
Site Plans:
Building Plans: #
Building Permit#: Ei'Enter building permit#above.
Workflow Routing LYPlanning lLk Engineering Icl Permit Coordinator 0/Building
Workflow Sign-off: rik Sign-off for Planning(include notes from planning review)
Route Application Documents: I} Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
tt Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: "�• Date: f,g/Oj f�Q,2T
Engineering Review /`
Slope at building pad: 2-
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
Er Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes R'No
Assess Water Quantity Fee in-lieu: ❑ Yes VNo
LIDA Facility on lot: ❑ Yes QrNo
❑ Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes: A, r o/ re(."- -e s r- e- PA l re cvvd a?
O'Approved by Engineering: -7- f �;� ,mac. Date: l 2/r y te..aal
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Permit Coordinator Review
Conditions "Met"prior to issuance of building permit
Approved,NOT Released: 1fct lAt4 r,Ci —f'¢, Date: 12(ls f/4 t4
Notes: i
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
SDC Exemption: D Received „.12' Does not apply
SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: fd' Yes ❑ N/A
Parks SDC: )2 Yes ❑ N/A
LIDA ❑ Yes ,l N/A
eZr OK to Issue Permit
Approved by Permit Coordinator: 40\14Q —
Date: 31 (ZOz�
l:\Building\Forms\BldgPennitRvw_RES_122419.docx
41, ,41.)
'Y
04
Plan # - [J`I(c — N' ggif </ /4—�
Floors Z Large
Bed rooms Small
WC 3 t 0 � �
LAV G'� �/\
Tuba Basement
Vents 1st Floor ID L¢�]
Water Heater 2nd Floor 14 59
AC --'2-S 3rd Floor
Schoo R-3 Total 29 2A-60
— 64-s fc..r., )(Q,c..3,_g Garage S o 5--
Total -3
1 lcw � rG
b:LIS #for Elec 5
stk., vsktz-h -<.R-.6 - �o
W Lk '71-ardim -1 °61 (- N11bI • 6z) Pam` �p .
26z� e o Az.-':of e z, S e.e_ �. 6.n ti�d1 Ptt r. .
s7.) yvvaA,3 4; r14-
w � ,�� _