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Permit Support Document CITY OF TIGARD MASTER PERMIT S Permit#: MST2022-00214 COMMUNITY DEVELOPMENT T I GA RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 • Date Issued: 10/10/2022 Parcel: 1 S135AC13900 Jurisdiction: Tigard Site address: 11018 SW 95TH AVE Subdivision: ASHBROOK VILLAS Lot: 4 Project: Ash Brooke Villas, Lot 4 Project Description: New attached dwelling. REPRINT: CHANGING ELECTRICAL CONTRACTOR BUILDING Floor Areas Required Setbacks Required Stones: 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 Yes Dwelling Units: 1 Third: 835 sf Right: 3 Detectors: Total: 1768 sf Value: $306,199.66 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: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 1 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: Y Vent Fans: 3 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<10OK: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3 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: 3 201-400 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 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: $30,025.89 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 45Ann1-nnln lhrnnnh nna o59-nn1-nnon Vn,mm,nhlain a prim,of*Fa'lilac nr Airant n„aefinne in ni thin by nallinn cnv 9Q9 10137 nr 1 Ann'1'19 9'344 Issued By: See 1 l o t ah Permittee Signature: 7 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 job site at the time of each inspection. Electrical Permit Application ; '/ '_ _ FOR OFFICE I.SI: ONLY City of Tigard Received D Permit tr: ° 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 v '{ ri io Da,-: ' ' it ST ! / ♦ I"�, Ili]A RD Inspection Line: 5133.639.4175 - Ready DatelBy: Leif RI See page 2 for Internet. www.tiganlorgov " '-' NotiSedlMe(hod: Supplemental laformafion TYPE OF WORK PLAN REVIEW ®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 has of plans wfeems checked): ❑Service or feeder 400 amps or more ❑Building over three stories. ©Demolition ❑Other: where the available fauk tureen CI Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ®1-and 2-family dwelling 0 Commercialindustrial ❑Accessory building >e�to ground or emeeds 14.000 p Commercial-use mean cal ❑Multi-family ❑Master builderamps for ail other installations. buildings. 0 Other: ❑Fire Puma- ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Energencysystem. larger separately derived Q /�, ❑Addition of new motor load of system- Job#: Job site address: 110 I U S(0 C 5 r 1 s. (Scv ri a 11 . l00HP or more. ❑`A",`E,`(-2",`I-3`, City/State/ZIP:Tigard, OR 97223 l I T1 l nl�y ❑Sic or more,es;dert al omit. ton pa toy. ❑Health-care farilirics. a Recreational vehicle parks. Suite/btdgJapt#: Project name:Ash Brook Villas ❑Hazardous locations. 0 Supply voltage for room than ❑Service or feeder 600 amps or more. 600`vas normal• Cross street/directions to job site: FEE SCHEDULE Deunipdaa I Qty. ) each I Tate/ I • New residential single-or multi-family dwelling unit Subdivision:Ashbrook Villa's Lot#: LI includes attached garage. 1,000 sq.R or less 168.54 4 Tax map/parcel#c Fa add•500 sq.fl.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential (with above sq.tt.) 75.00 2 Limited energy,multi-family residential(with above sq.ft.) 75.00 2 WI PROPERTY OWNER I Cl .TNANT Renewable Energy CI See Page 2 Services or feeders installation,alteration,and/or relocation Name:ABVOZBP21 LLC 200 amps orless 1 100.70 i100.10 2 Address:1815 NW 169TH PLACE, SUITE 1040 201 amps to400amps 133.56 2 401 amps to 600 maps 20034 2 City/Statel'cl P:Beaverton,OR 97006 601 amp,to 1,000 amps 301.04 2 i Phone:( ) Fax:( ) Over 1.000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email:katie@sagebuilthomeslic.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 ciretdts—new,alteration or extension,per panel® APPLICANT 0 CONTACT PERSON A Fee for branch circuits with Business name:ABVOZBP21 LLC above service or feeder fee. 7.42 2 each branch circuit Contact name:Katie Patterson B.Fee for branch circuits without Address:Same as above serv ice or feeder fee,itrrt 56.18 2 branch circuit City/Staie/ZIP: Each add'(branch circuit t 7.42 2 Miscellaneous(service or feeder not iadaded) Phone:503-5026623 Fax::( ) Each manufactured or modular dlling,service and/or feeder 67.84 2 we Email:katie@sagebuiithomesllc.com Reamed only 67.84 ' 2 CONTRACTOR Pump or irrigation circle 6744 2 Business name:Grizzly Electric Inc Sign or outline lighting 67.84 2 sired- �{,� �7 signal circuit(s)or limited-energy Address: 2Jt i'NJ 4) 'E ., is - 11/ 0 See Page 2 2 r,1panel,alteration,or extension. Each additional inspection over allowable in say of 16t above City/State/zIP:Vantouver, WA 98660 Additional inspection(1 Par min) 66251 Par Phone:( 971-5'74)— g/tt/ Fax:( ) Investigation(I Par min) 90.001 hr Email:grizzlyelectric@msn.com industkalplant(1)xmin) • 78.18/hr Inspections for which no fee is 90,00!hr CCB Lie.:186218 Electrical Lie.: Suprv.Lic.:yogi)"S specifically tined e 4 Par min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name:AruipyAct!.‘ 7 ate:/ ❑Plan Review Required(25%of permit fee): 7 G�z State surcharge 02%of permit fee): • Authorized signature: /.[44,./41,.. ,r—a 1649:01i TOTAL PERMIT FEE: This permit application expires Da permit is not obtained IOUs ISO Print name;Katie Patterson Date:12/1/22 days after it has been accepted as complete. ' !Comber of inspections allowed per permit. I:11mildwg\PermeMiLC_PemuApp ELR Esadoc Re'06/1712015 44046157(I1x15K:OMlwe8