Permit Support Document a CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT EVISED Permit MASTER
MST2022-00222
T I GAR 1) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 , Date Issued: 10/13/2022
Parcel: 1S135AC14100
Jurisdiction: Tigard
Site address: 10970 SW 95TH AVE
Subdivision: ASHBROOK VILLAS Lot: 6
Project: Ash Brooke Villas, Lot 8
Project Description: New attached dwelling. REPRINT: ELECTRICAL CONTRACTOR CHANGED.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 4 First: 73 sf Basement: 0 sf Left: 3
Parking Spaces: 0
Height: 32 Bathrooms: 3 Second: 860 sf Garage: 602
g sf Front: 10 Smoke
Dwelling Units: 1 Third: 835 sf Right: 3 Detectors: Yes
Total: 1768 sf Value: $264,453.84 Rear: 12
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100
SF Rain Drains: 0 Storm Sewer: 100
Tubs/Showers: 2 Garbage Disp: 0 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 Times Air Conditioning: Y Vent Fans: 3 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Fum<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3
Fum>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr. 0
Ea addl 500 sf: 3 201-400 amp: 0 201-400 amp: 0 W/O SvclFdr: 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 SFA VB R-3 1768
Owner: Contractor:
ABVOZBP21 LLC SAGE BUILT HOMES Required Items and Reports(Conditions)
1815 NW 169TH PL STE 1040 1815 NW 169TH PLACE,SUITE 1040 1 Ersn Cntrl 503-639-4175
BEAVERTON,OR 97006 BEAVERTON,OR 97006 2 Geo Tech Required-
Engineered Fill Present
PHONE: PHONE: 971-221-4597
FAX: 503-533-5164
Total Fees: $27,465.66
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
oc,nni_nn In thmunh flap Q59-nM.nnon Vnu met,nhtein n rnnv of the n,lea nr Airerl n ieelinne In rN INC by rollinn Sn- 719 10117 nr 1 Ann'T39t9'idd
Issued By: Permittee Signature: 4L'1° d1 ri, 1 1 c`LI_'v177
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.
Electrical Permit AAplicatio L , sly 1 t FOR OFFICE (-SE ONLI
City of Tigard Received
Date/By:
Permit it
UPI13I25 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.7182439 Fax: 503-598.1960 Date/By: Related Perri*q:
i
Z0ge2F
Co Z. ../
InspcaAion Line: 503.639.4175 r v , , . w„,: Needy ateiBo. r""'' Si sae Pent 2 ForTIGARD, Internet: wwwtigandor v Notified/MethodSupplementall
lafonnation
TYPE OF WORK PLAN REVIEW
®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans winces checked):
❑Service or feeder 400 amps ormore ❑Building over three storms
0 Demolition Cj Ocher:
'Were the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at ISO volts or 0 Floating buildings.
0 1-and 2-fancily dwelling 0 Commercialmdustrial ❑Accessory building less to ground.or exceeds 14,000 p Commneiat-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder
Other: 0 Fire pump. 0 Installation 01150 KVA or
JOB SITE INFORMATION AND LOCATION QEmergency system. larger separately derived
Job#: Job site address: 10110 SLID C1 ST+4 A u€w uE ❑Addition
o crow motor load of system
I(IO1tPwnnore. 0"A","E',"t-2",`I-3',
City/State/ZIP:Tigard, OR 97223 ❑Su or more residential mews. occupancy.
Suite/bldgJapt#: Project name:Ash Brook Villas O locations. 0 Recreational ppy age for more�pmts.
Cross street/directions to job site Q Service or f eder 600 snips or more 600 volts nominal.
FEE SCHEDULE
Derordpaoa I Vty. I Each 1 Total I •
New residential single.or multi-family dwelling unit
Subdivision:Ashbrook Villa's Lot#: Includes attached garage.
Tax neap/parcel►t: t ODR sq.& or less 168.54 4
DESCRIPTION OP WORK Ea-add'I sq.tl.or portion 33.92 1
Limited energy,residential 75.00 2
(with above sq.ft.)
Limited energy,multi-family
residential(with above sq.ft.) 75.011 2
0 PROPERTY OWNER 0 TENANT Renewable Energy ❑ See Page 2
Name:ABV PRO P LLC services or feeders installation,alteration,and/or relocation
200 amps or less 1 100.70 100.70 2
Addrvss:1815 NW 169TH PLACE, SUITE 1040 201 amps to 400 amps 133.56 2
City/State/ZIP:Beaverton,OR 9700E 401 amps io600amps 20034 2
601 amps to 1,000 amps 301.04 2
Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:katie@sagebuitthomeslic.eom
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 125.0E 2
Owner signature: Date: 401 snips to 599 amps 16854 2
Branch circuits—new,alteration,or extension,per panel
® APPLICANT ❑ CONTACT PERSON
Business name:ABVOZBP21 LLC A-Fee for branch circuits with
above service or feeder fee, 7.42 2
Contact nano:Katie Patterson each branch circuit
B.Fee for branch circuits without
service or Address:Same as above branch circ filaruit 56.18 2
City/State/Z1P: Each add'I branch circuit 7.42 ) 2 ',.
Mt+eetmoeoas(service or feeder not included)
Phone:003 6Q2S623 Fes.:
( ) Each manufactured or modalar 67.84 2
Email:katie@sagebuilthomesilc.com dwelling service and/or feeder
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84
Business name:Grizzly Electric Inc Sign2
-7 or outline lighting 67.84 2
Address: 2414 ►)Am sired- S`k- lag� )!/ page,alteaiio)oro limited-energy
extension.
r'! L panel,alteration,or exurosion. ❑ See Page 2 2
Each additional inspection over allowable in any of the above
City/Statr/z1P:Vsncouver, WA 98660
Phone:( Additional inspection(1 hr min) 66a5/hr
97/`5r10— fs /47/ Fax:( ) Investig
ation(1 hr rain) 90.00/hr
Email:grizzlyelectric@msn.com Industrial pleat(I hr min) 78 I8/hr
Inspections for whichno$e is 90.(10/h[
CCB Lie.:186218 Electrical Lic.: Supra,-Lie.:yf.-3'3 specifically listed(''hr min)
Su Electrician signature, ��// ELECTRICAL PERMIT FEES
lnv- required: .4�
�`-//-//�i/ Subtotal:
Print name: ��g44r� ate://2// /.z� 0 Nan Review Required(25%of permit fae)
` State surcharge(12%of permit fee): -
Autholized signature: Kpti.:¢,. PatteA4,t TOTAL PERMIT FEE:
Print Katie Patterson This permit application aspires if a permit is not obtained within 180
Date:12/1/22 days after it has been accepted as complete.
cViuiW. ' Number of inspections allowed per permit
mBWmainatC_PemitApp ELR EREdoe Rev06/172015 440461.5171 I IlORCOM/WES