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Permit (126) 111 CITY OF TIGARD :f; I,` �e :i. ; MASTER PERMIT 2 COMMUNITY DEVELOPMENTWE Permit#: MST2018-00075 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/19/2018 T I GB` 9 Parcel: 1S135BD01500 Jurisdiction: Tigard Site address: 9599 SW ANNA BELLE CT Subdivision: ASH CREEK VILLAGE Lot: 1 Project: Ash Creek Village, Lot 1 Project Description: New SF. 6/22/18: REPRINT to remove NC from permit. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 3 First: 434 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 28 Bathrooms: 4 Second: 804 sf Garage: 332 sf Front: 20 Smoke Dwelling Units: 1 Third: 860 sf Right: 3 Detectors: Yes Total: 2098 sf Value: $253,827.18 Rear: 15 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 3 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 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N 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 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Tema 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: 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 Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2098 Owner: Contractor: SAGE BUILT HOMES LLC SAGE BUILT HOMES Required Items and Reports(Conditions) 1815 NW 169TH PL STE 1040 1815 NW 168TH PLACE 1 Fire Rated Eave required BEAVERTON,OR 97006 BEAVERTON,OR 97006 2 Ersn Cntrl 503-639-4175 PHONE: 971-221-4597 PHONE: 971-221-4597 FAX: 503-533-5164 Total Fees: $29,914.91 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 952-001-0010 through 0 95 0090 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. / Issued By: � �' Permittee Signature: �� 6/��'�/�L2s�1! 9 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. CITY OF TIGARD MASTER PERMIT IN .1 ' COMMUNITY DEVELOPMENT Permit#: MST2018-00075 T f( A I::r) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/19/2018 Parcel: 1 S 135BD01500 Site address: 9599 SW ANNA BELLE CT Jurisdiction: Tigard Subdivision: ASH CREEK VILLAGE Lot: 1 Project: Ash Creek Village, Lot 1 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 3 First: 434 sf Basement: 0 sf Left 3 Parking Spaces: 0 Height: 28 Bathrooms: 4 Second: 804 sf Garage: 332 sf Front 20 Dwelling Units: 1Smoke Third: 860 sf Right 3 Detectors: Yes Total: 2098 sf Value: $253,827.18 Rear: 15 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 LaundryTrays:Y 0 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 0 Drains: Catch Basins: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Bckflw Prevntr: 0 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 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: 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 Other: N Other Description: Y Ecompasing: BUILDING INFO Class of Work: Type of Use: NEW TYPe of Constr: Occupancy Group: Square Feet: SF VB R-3 2098 Owner: Contractor: SAGE BUILT HOMES LLC SAGE BUILT HOMES Required Items and Reports(Conditions) 1815 NW 169TH PL STE 1040 1815 NW 168TH PLACE 1 Ersn Cntrl 503-639-4175 BEAVERTON,OR 97006 BEAVERTON,OR 97006 2 Fire Rated Eave required PHONE: 971-221-4597 PHONE: 971-221-4597 FAX: 503-533-5164 Total Fees: $29,869.91 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 • follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OA -001-0090. You ma •btain a copy of the rules ;or direct questions to OUNC by calli 03.:32.19: br .800.332.2344. Issued By: 4 �/' �l Permittee Signature: , .::. .a.A- • ,....."31 ::2) Call 603.639.4176 by 7.00 a.m.for the next available inspectionIM 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. 1 Building Permit Application Residential /. J FOR OFFICE USE 01 El City of Tigard FEB i 4 2018 ReceivedDateBy: // -'rmit Noll s-�j��/ � J7S� !PI44 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review / / / �p ��/ Phone: 503.718.2439 Fax: 503.598.1960—j of, Y Date/By: 9- 16- ) t Other Permit: 5l'��,6)c}GC "t/r/�oo 3 1 1G �.r) Inspection Line: 503.639.4175 I R s ►f t s& A s Date ReadyBy: y Juris: ® See Page 2 for Internet: www.tigard-or.gov ,�� •red/Method: it l r j 1 Supplemental Information BUILDING VISION' s TYPE OF W6RkQUIRED DATA: i 2-FAMILY DWELLIN ®New construction 0 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 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCT/ON work indicated on this application. ® 1-and 2-family dwelling ❑Commercial/industrial Valuation: $ as38.a.- J ❑Accessory building 0 Multi-family Number of bedrooms: 3 0 Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: 3 otiI+3 0 Job site address:9599 SW Anna Belle Ct New dwelling area: 2098 square feet City/State/ZIP:Tigard Oregon Garage/carport area: 332 square feet g c 0 Suite/bldg./apt.no.: Project name:Ash Creek Covered porch area: square feet .80 ti., Cross street/directions to job site: Deck area: 20 square feet Li 3 14 Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHL ST Subdivision:Ash Creek I Lot no.:1 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 / p �-! DESCRIPTION OF WORK work indicated on this application. New Residential Construction Valuation: $ Existing building area: square feet New building area: square feet ►, PROPERTY OWNER El TENANT ;,`" Number of stories: Name:Sage Built Homes Type of construction: Address: 1815 NW 169th Place Occupancy groups: City/State/ZIP:Beaverton Oregon 97006 Existing: Phone:(971)221-4597 Fax:( ) New: ®:®'APPLICANT;' ❑ CONTACT'PONFEES* 'BUILDING PERMIT ; • Business name:Same As Above (�` tCf�cte. " Structural plan review fee(or deposit): Contact name:Kylie Hofenbredl FLS plan review fee(if applicable): Address:Same As Above Total fees due upon application: City/State/ZIP: Amount received: Phone:(971)221-4597 Fax::( ) E-mail:Planning@sagebuilthomesilc.com PHOTOVOLT` IC SOLAR"PANEL SSY M'FEES *' ,.. T ' Commercial and residential prescriptive installation of , , v CON* OR� roof-top mounted Photovoltaic Solar Panel System. Business name: Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: Solar Installation Specialty Code checklist. City/State/ZIP: Permit Fee(includes plan review $180.00 and administrative fees): Phone:( ) Fax:( ) o State surcharge(12/o of permit fee): $21.60 CCB lic.:l F, 33 6 //),71 Total fee due upon application: $201.60 Authorized signaturers. ;2........... This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. LPrint name:Kylie Hofenbredl Date:1/8/2018 *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440 4613T(11/02/COM/WEB) t Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE LSE ONLv City of Tigard Received Permit No.: a 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503.718.2439 Fax: 503.598.1960 Dated Associatt ed permits: TIGARD 24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www.tigard-or.gov ❑ mei. THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW les 1 o N/.1 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 0 0 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0 3 Verification of approved plat/lot. 0 0 0 4 Fire district approval required. Name of district: . 0 0 0 5 Septic system permit or authorization for remodel. Existing system capacity . 0 0 0 6 Sewer permit. 0 ❑ 0 7 Water district approval. 0 0 0 8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0 0 9 Erosion control 0 plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- 0 0 0 basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 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. Plan review cannot be completed if copyright violations exist. ,11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if 0 ❑ ❑ there is more than a 4-fl.elevation differential,plan must show contour lines at 2-fl.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 0 0 ❑ and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ ❑ ❑ furnace,ventilation fans,plumbing 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- ❑ 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. 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- 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 0 ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ 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 ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. ❑ 0 ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ❑ ❑ 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 ❑ 0 ❑ architect licensed in Ore•on and shall be shown to be a..licable to the .ro'ect under review. JURISDICTIONAL SPECIFIC'S 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 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ ❑ 0 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale"indicates standard architect or engineer scale. ❑ ❑ 0 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ 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 ❑ 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 ❑ ❑ 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:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Applicatio FOR OFFI('F I:SE OyLI Cityof Tigard r4 Received �� - g Date/By: PermitNo.`L c0 / c ...6 lig . • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ✓ (ill Phone: 503.718.2439 Fax: 503.598.1960 -'' !I Other Permit: 2 2 Date/By: TI G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: H See Page 2 for Internet: www.tigard-or.gov q qy 3 f 'A '� Notified/Method: Supplemental Information FEE* DING Et DIVISION c ><sT' �E,.c>, o SII. ►111C.>E , 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 0 Other: mechanical materials,equipment,labor,overhead,and profit. CATEGORY OI COI iUCTION " - Value:$ RESIDENrlA.Ll%42T1IPMENTfSYS " hIS EE * ® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. 0 Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total JOB SITE IIa{IRA'IA,TION AND LOCATION Heating/cooling: Air conditioning 1 46.75 46.75 Job site address:9599 SW Anna Belle Ct Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75 City/State/ZIP:Tigard Oregon Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name:Ash Creek Duct work 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:Ash Creek Lot no.:1 Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 1 23.32 23.32 DESCRIPTION OF WORK;FGas fireplace/insert 1 33.39 33.39 Flue vent for water heater or gas New Residential Construction fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 =+ PROPERTY:OWNER t"3~'ENANT" Other: 23.32 Environmental exhaust and ventilation: Name:Sage Built Homes Range hood/other kitchen equipment 1 33.39 33.39 Address:1815 NW 169th Place Clothes dryer exhaust 1 33.39 33.39 City/State/ZIP:Beaverton Oregon 97006 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 5 23.32 116.60 Phone:(971)221-4597 Fax:( ) Attic/crawlspace fans 1 23.32 23.32 �, APPLICAAT Q CONTACT PERSON „ Other: 23.32 Fuel piping: Business name:Same As Above $14.15 for first four;$4.03 for each additional Contact name:Kylie Hofenbredl Furnace,etc. Address:Same As Above Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:(971)221-4597 Fax::( ) Fireplace Range E-mail:Planning@sagebuilthomesllc.com Barbecue ONTRa�R Clothes dryer(gas) Business name:All Time Heating&Cooling Other: CHICAL PRMITES* Address:PO Box 1341 Subtotal City/State/ZIP:Lake Oswego,OR 97035 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(503)208-2276 Fax:( ) State surcharge(12%of permit fee) CCB lic.:4845957 / S?J5^..75----- 7l TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signatur� * Fee methodology set by Tri-County Building Industry Service Board Print name:Kylie Hofenbredl Date:1/8/2018 ABuilding�Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi-Family Fee Schedule: ` rluatwit: et $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and $2.54 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I:\Building\Permits\MEC_PermitApp_040113.doc 2 Plumbing Permit Application or riv "" Ate" Building Fixtures Received City of Tigard t_ '8 1 4 7 01Permit No. ` - • 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By:nJT�G1 -�j,�7s Plan Review Phone: 503.718.2439 Fax: 503.598.1964Other Permit No.: T I G R D Inspection Line: 503.639.4175 ti i .� I � rt Date Ready/By: tuns: See Page 2 for Internet www.tigard-or.gov �i I � �� '� �hfied/Method Supplemental Information f E;./,,, ,.6„,, .. . 5 , `1XPE OF WO W*;S DVL , ®New construction 0 Demolition For special information use checklist Description Qty. Ea. Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) ,E., 'f TE.Go y 0# a► rsm OX SFR(1)bath 312.70 ® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath x 500.32 500.32 Each additional bath/kitchen 1 25.02 25.02 0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB„ k 1N ORM TION AND,LOCATION`" Site utilities: Job site address:9599 SW Anna Belle Ct Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard Oregon Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name:Ash Creek 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:Ash Creek I Lot no.:1 Fixture or item: Tax map/parcel no.: Backflow preventer 1 31.27 31.27 F NOF VI Backwater valve 12.51 Clothes washer 1 25.02 25.02 Dishwasher 1 25.02 25.02 New Residential Construction Drinking fountain 25.02 Ejectors/sump 25.02 € > PRoparrY to iEB " } TENAN Expansion tank 12.51 Name:Sage Built Homes LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:1815 NW 169th Place Garbage disposal 1 25.02 25.02 City/State/ZIP:Beaverton Oregon 97006 Hose bib 2 25.02 25.02 Phone:(971)221-4597 Fax:( ) Ice maker 12.51 + PLGAJJ =: 0,CONTACT AS Interceptor/grease rease trap25.02 . Business name:Same As Above Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:Kylie Hofenbred Roof drain(commercial) 12.51 Address:Same As Above Sink/basin/lavatory 6 25.02 150.12 City/State/ZIP: Solar units(potable water) 62.54 Phone:(971)221-4597 Fax::( ) Tub/shower/shower pan 3 12.51 37.53 E-mail:Planning@sagebuilthomesllc.com Urinal 25.02 Water closet 25.02 � 4fte1O Water heater 1 37.52 37.52 Business name:Edwards Mullen Plumbing WaterPip i in WV 56.29 Address:1601 A Se River Rd Other: 25.02 City/State/ZIP:Hillsboro Oregon 97123 Subtotal Phone:(503)628-3560 Fax:( ) th )10 Minimum permit fee: $72.50 K iU o Plan review (25%of permit fee) CCB Lic.:92689 PlumbingLic.no. State surcharge(12%of permit fee) Authorized signature TOTAL PERMIT FEE Print name:Kylie Hofenbredl Date: 1/8/2018 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:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) Plumbin! Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential „ Re > en`tial Fire Suppression Systems: - Si et �Ce .. . 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' 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 Storm&Rain Drain-1st 100' 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 ItiF11 each additional$100.00 or fraction thereof,to 4tler s eclo s oar ees � 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: 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*. Qaantiy by Fixture T rpe flaiiiteviewIorniuttbingl Fixture Type for Replace Plan review is required for any of the following. Work Perforated: Capped Added Relocate Baptistry/Font Please check all that apply. Bath Tub/Shower 0 Any new commercial building with water service 2"and Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed Car Wash -Each Stall engineer. Drive Thru 0 New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918-780-0040. Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities. -Domestic 0 Any multipurpose fire sprinkler system. Drinking Fountain 0 Any complex structure as defined in OAR918-780-0040. Eye Wash Floor Drain/sink -2" Submit 2 sets of plans with any of the above. Car Wash Drain 0 Isometric or riser diagram is required for new buildings Garbage -Domestic-non-food Disposal -Domestic-food related that meet the qualifications above. -Commercial-food related -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) . Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang -Stall Sink/Lav -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer-Clothes Water Extractor increase of sewer EDUs,a sewer permit will be issued and Water Closet-Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: S:\Sage Built\Purchasing&Planning\Subdivisions\Ash Creek\Plans\Lot 32 Sellwood\Applications\Plumbing.doc Albert Shields From: Albert Shields Sent: Tuesday, February 27, 2018 5:14 PM To: 'Planning@sagebuilthomesllc.com' Cc: Gary Pagenstecher Subject: RE:Ash Creek Village, SUB2015-00003, PDR2015-00001 Alex and Kylie, please note my email of 2/8/18 below. As I explained, you are required to arrange for a site inspection by the project planner before the 8th permit is issued. You have not done so and you have submitted 3 more permit applications for a total of 11. Because you have failed to comply with Condition of Approval No. 27 of PDR3025-00001 I am classifying these 3 new permit applications, MST2018-00073, -00074, &-00075 as "Approved for Plan Review but Not Released." Plan Review will proceed but the permits will be put on Hold until the required inspection is requested, performed, and approved. Similarly, I am putting MST2018-00033, representing the 8th permit, on Hold as "Approved but Not Released" until the required inspection is performed and approved. Please let me know if you have any questions. Albert Shields Permit Coordinator City of Tigard Albert(a�tigard-or.gov 503-718-2426 From:Albert Shields Sent:Thursday, February 08, 2018 2:42 PM To: 'Planning@sagebuilthomesllc.com'<Planning@sagebuilthomesllc.com> Cc: Gary Pagenstecher<Garyp@tigard-or.gov> Subject:Ash Creek Village,SUB2015-00003, PDR2015-00001 Alex or Kylie, please note that you have now submitted 8 building permit applications and that Condition of Approval No. 27 of PDR2015-00001 says: "27. Prior to issuance of the 8th building permit, or within 36 months from the date of this decision, the applicant shall schedule an inspection with the project planner to verify the installation of the community gardens, as detailed on the proposed plans, including an on-site water supply." Please contact your project planner, Gary Pagenstecher, 503-718-2434, at your earliest convenience to schedule the required inspection. Thanks for your cooperation. Albert Shields Permit Coordinator Electrical Permit Application 1 ol<01 I I( 1 1 SI 0vl.1 City of Tigard •N LQW B �.� Permit#11111 " 13125 SvTi ardOR 97223 f ~`i- a Phone: 5017I8.2439 Fax: 503.598.1960 Related Permit#: Inspection Line: 503.639.4175 Date/By: 1 It, N.It I) Internet: www,ti d-or. ov �j jr �dy dJMeth Date/By: huh' fid See Page 2 for Bar B 1 Et; i Nottthed/Method: Supplemental Information TYPE OP WORK ('j`�J -'WARD lPtrAN VIEW„ ®New construction 0 Addition/alteration/repCcI lC#lt I. 15� Please check all that apply(submit 2 sets of plans w/items checked): 0 Demolition 0 Other: t 11 I'N G DIVISION ❑Service or feeder 400 amps or more ❑Building over three stories. tJ ' 1,45 where the available fault current 0 Marinas and boatyards_ CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural ❑Multi-family ❑Master builder amps for all other installations buildings. 0 Other: 0 Fire pump, 0 Installation of 150 KVA or JOB SITE INFORMATION°AND LOCATION 0 Emergency system. larger separately derived Job#: Job site address:c1 �"�Anna Belle Ct ❑Addition of new motor load of system. T 1 r" 10OHP or more. ❑"A" "E""1-2""1-3„> City/State/ZIP:Tigard Oregon ['Six or more residential units. occupancy, ❑Health-care facilities, 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name:Ash Creek 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 neseription 1 Qtr. I Each I Total I New residential single-or multi-family dwelling unit Subdivision:Ash Creek Lot#: Includes attached garage. Tax map/parcel#; 1,000 sq,ft or less 168.54 4 Ea,add'1 500 sq.ft,or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential New Residential Construction (with above sq.&,) 75.00 2 Limited energy,multi-family residential(with above sq,ft.) 75.00 2 I PROPERTY OWNER 1 0 TENANT Renewable Energy ❑ See page 2 Services or feeders installationr,alteration,and/or relocation Name:Sage Built Homes LLC 200 amps or less 1 100.70 100,70 2 Address: 1815 nw 169TH Place Suite 1040 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200,34 2 City/State/ZIP:Beaverton Oregon 97006 601 amps to 1,000 amps 301.04 2 Phone:(971)221-4597 Fax:( ) Over 1,000 amps or volts 552.26 2 Email: Temporary services or feeders installation,alteration,and/or 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 ® APPLICANT 1 ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A Fee for branch circuits with Business name:Same As Above above service or feeder fee, each branch circuit 7,42 2 Contact name:Alex Rodriguez B.Fee for branch circuits without ' Address: service or feeder fee,first 56.18 2 branch circuit City/State/ZIP: Each add'I branch circuit 7,42 2 Phone: 971 Miscellaneous(service or feeder not Included) ( )336-6911 Fax: :( ) Each manufactured or modular Email:Planning@sagebuilthomesllc.com dwelling,service and/or feeder 67,84 2 Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name:Ross Electric Sign or outline lighting 67.84 2 Address:2870 SE 75th Ave 203 Signal circuit(s)or limited energy ❑ See Page 2 2 panel,alteration,or extension, City/State/ZIP:Hillsboro Oregon 97123 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(503)642-2800 Fax:( ) Investigation(1 hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr `U[ dig I Inspections for which no fee is 90,00/hr CCB Lic.: 157891 1 Electrical Lie.: 34-436C j Suprv.Lic.:��.3)61 specifically listed(Is hr min) Suprv.Electrician signature, /fi� ELECTRICAL PERMIT FEES required: rF✓ 4e'r_�a r-'-2 __ Subtotal: Print name: Stephen Ross $le„...4c, ►os1 Date: 0 Plan Review Required(25%of permit fee): _____D State surcharge(12%of permit fee): Authorized signature TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Alex Rodriguez Date: 2/1/2018 days after it has been accepted as complete. * Number of inspections allowed per permit. 1:1BuildinglPennitstELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(it/05/COM/WEB 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. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 1111 _ Transmittal Letter TI( A 1Z n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: ' 01(v\ DATE Rrk IXED: DEPT: BUILDING DIVISION FROM: C f'h' /t cri COMPANY: \3 \k 11 th r� S PHONE: 3— 7 J -- 51..b-1 By: RE: "l56t`l J\M\O k TCS\\t c, ' A 7fl\ O0C)1 -J (Site Address) (Permit Number) P\ C (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: escription: Copies: Description: Additional set(s) of plans. Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. , l Engineer's calculations. Other(explain): �/ REMARKS: FOR OFFICE USE ONLY Routed to Permit c cian: Date: ) Initials: 11 Fees Due: 1 es ❑No Fee Description: Amount Due. •3 j•-•) P) Ye,": t.. $ 4- $ $ $ Special Instructions: Reprint Permit(per PE): ❑ Yes No ❑ Done Applicant Notified: Date: - d/ ([ /7,//f Initials: v I:\Building\Forms\TransmittalLetter-Revisions 061316.doc 11111 City of Tigard w COMMUNITY DEVELOPMENT DEPARTMENT T l c D Building Permit Review — Residential Building Permit #: /zt 7-,;mfr— -7S u Site Address: cf5q9 SUI Annu Mt c Project Name: AW, C(ec1 V 1LLy5. Lot #: i (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review`` Proposal: (,:.�Trit , o• nc,,./ SF 1 erify site address/suite#exists and active ' permits stem. Y 74 River Terrace Neighborhood: No GI Yes,See River Terrace Review Addendum Attached S'te 'Ian Elements: �/ U . ree(3)copies of site plan LCIREsting structures on site le ' e plan must be on 8-1/2"x 11"or 11 x 17"paper LlE'Footpri tt of new structure(including decks)with finished R brawn to scale(standard architect or engineer scale) ,�°or elevations 11 orth arrow jL'J tility locations&easements(required for new and additions) Vie address,project or subdivision name and lot number Ll� idewalk/driveway approach 11Zplicant information(name and phone number) L •cation of wells/septic systems tvdt dimensions and building setback dimensions I.Existing trees to be retained with drip line,and tree §quare footage of buildings to be demolishedprotection measures [?Lot area,building coverage area,percentage of coverage and � et , tree sizetype and location pervious area(lappliticable iffR-7,R-12,R-25&R-40) [ 'Street names —/ roperty comer eevaons(2 oot contour lines if more than >1,000 sf of impervious area created or replaced? [ Yes ❑No 4 foot differential) If yes,is a storm water quality facility shown? [1 ElYcLikNo Ei/Clean Water Services—Service Provider Leat%(lot platted prior to 9/10/1995): (11, equtred: ❑ yes,applicant was notified L� No Received: �p `"i ❑ Yes El No + 4 Public Facilt'tie,�Itnprovement(PFI)Permit: t Required: [2'Yes,applicant was notified El No Applied For: Yes El No,stop intake [4and Use Case#: 902LOIS- 0°A000 4 eFL 2-Q IS-001/ lIC: oning: R-1/ (P D) equired Setbacks: Front Rear Side Street Side S� ® _ _ Garage 2_ 0 andscape Requirement: 10 Lot Coverage Maximum: S0 % i Building Height: Maximum Height 35 Actual Height 315 Il - Visual Clearance Ly,F>ensitive Lands: Yes 0 No Type S�� 61W Artay: G� + ho,�l,,,1 Goo 5 R/Urban Forestry Plan El Conditions "Met"prior to issuance of building permit Notes: LA414n 5 L, ,,,t1- fir-"'- 1,'I61ki.j elr" o$✓aic.1 II/Approved By Planning: ADate: Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved El Not Approved Revision 2: El Approved ❑ Not Approved Revision 3: El Approved Cl Not Approved I:\Building\Forms\BldgPermitRvw_RES_061417.docx Building Permit Submittal Original Submittal Date: g` (e-itfr- • Site Plans: # Building Plans: # Building Permit#: lir- nter building permit#above. Workflow Routing: lPlanning Engineering prPermit Coordinator Building Workflow Sign-off: .% Sign-off for Tanning(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. C17Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: �I�� By Permit Technician: /��//, ,, /ii„, I0 Date: Engineering Review 'Slope at building pad: 1,i;; ;if Conditions "Met"prior to issuance of building permit 7Easements (encroachments)per engineering conditions of approval and plat (4e Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: 0 Yes No Assess Water Quantity Fee in-lieu: ❑ Yes No LIDA Facility on lot: 0 Yes No ❑ Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: t Approved by Engineering: 4 p Date: aa3.-46 Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved 0 Not Approved Revision 2: ❑ Approved 0 Not Approved Revision 3: 0 Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions"Met"prior to issuance of building permit Approved,NOT Released: 4-4,444 --,jib'/ c e '`''`- Date: 2 I l e (Notes: U ` " id Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: Revision Notice 3: Date Sent to Applicant: ►4,II C Fees Entered: Wash Co Trans Dev Tax: es ❑ N/A Tigard Trans SDC: es ❑ N/A Parks SDC: Yes ❑ N/A LIDA ❑ Yes `�/A OK to'Issue Permit 3 l�9 1 Approved by Permit Coordinator: Date: / I:\Building\Forms\BldgPermitRvw_RES 010118.docx City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9599 SW ANNA BELLE CT, TIGARD, OR, 97223 August 2, 2018 at 9:38:22 AM Record Type: Record ID: Residential - Master Permit MST2018-00075 Inspection Type: Inspector: 199 Electrical final David Young Result: FA I L Comments: Lighting in main level bath not complete, lighting location in process of being moved. Electric fireplace not installed, exposed Romex not protected. Remove smoke detector dust covers for inspection. Not ready for Inspection, Work not complete. R109 No ac installed. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9599 SW ANNA BELLE CT, TIGARD, OR, 97223 August 9, 2018 at 9:08:11 AM Record Type: Record ID: Residential - Master Permit MST2018-00075 Inspection Type: Inspector: 399 Plumbing final David Young Result: PASS Comments: Water pressure 65 psi. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9599 SW ANNA BELLE CT, TIGARD, OR, 97223 August 9, 2018 at 9:07:15 AM Record Type: Record ID: Residential - Master Permit MST2018-00075 Inspection Type: Inspector: 699 Mechanical final David Young Result: PASS Comments: No ac installed. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9599 SW ANNA BELLE CT, TIGARD, OR, 97223 August 14, 2018 at 1 :26:50 PM Record Type: Record ID: Residential - Master Permit MST2018-00075 Inspection Type: Inspector: 299 Final inspection David Young Result: FA I L Comments: Provide blower door test report for final inspection. No inspection done at this time. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9599 SW ANNA BELLE CT, TIGARD, OR, 97223 August 16, 2018 at 12:09:20 PM Record Type: Record ID: Residential - Master Permit MST2018-00075 Inspection Type: Inspector: 299 Final inspection David Young Result: FA I L Comments: Remove landscape irrigation line which appears to be installed from community garden and across lot 6 without permit and Backflow test report with approved inspection. Remove any irrigation line on lot 6 that is not part of lot 6 landscape irrigation. Provide permit and inspection of waterlines and Backflow devise for the community garden installed without permit. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9599 SW ANNA BELLE CT, TIGARD, OR, 97223 August 24, 2018 at 9:22:43 AM Record Type: Record ID: Residential - Master Permit MST2018-00075 Inspection Type: Inspector: 299 Final inspection Aaron Cillo-Gobel Result: PASS - CofO Comments: Previous corrections completed. Final erosion control passed Street tree certificate received Moisture content form received High efficiency lighting form received Insulation certification verified Blower door and/or duct seal test certificate received C of 0 left on counter. Violation Summary: Inspector Contractor Plumbing Permit Applic a Building Fixtures JUL �{ FOR OFFICE I si. OyI.l J V 2 3 0 " Received ��/�/ ^y City of Tigard Date/By: 7 2 /j1 PermitNst,/fT-]/l jr( 00V lig II 11 13125 SW Hall Blvd.,Tigard,OR 9•7223 ' 'i /�`��J /ALJ//u 4Plan Review Phone: 503.718.2439 Fax 5Q3,598'./960 -. ., Boat Other Permit No.: r l k.,.111 t) Inspection Line: 503.639.4175 ''s`�' - ,,.�iz`' r- y/gy. loris: El See Page 2 for Internet www.tigard-or.gov rr i' ,ti r4Z'd; hod Supplemental Information w a:° s ,. { i ¢� e'' i f f 0 Off r, r a ' *.k.:';',. F, tp"6' „ y ® 1 New construction 0 Demolition P�� For special information use checklist. Description Qty. Ea. Total Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utilityconnection) 0 PY g p [t '•° .: t ,, o - 7 SFR(1)bath 312.70 Z 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 'Y.w -,-,,,, ,.,.,'2.:,:374,,,,-,.Bk i 1E'f . .a. , E ,; 1 I ) ,, ,,,. " ,,,,,,,A:::,4Site utilities: Job site address:9599 SW Anna Belle Ct Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard,Oregon Footing drain(nolinear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name:Ash Creek Village Manufactured home utilities 50.03 Cross street/directions to job site:SW 95th Avenue 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:Ash Creek Village I Lot: 1 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 Backwater valve 12.51 'i 'fir �E. s ir I:,7.:W ., "� Clothes washer 25.02 New residential construction/Plumbing contractor revision Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 :i14-,,,:k1'.,,;,' ,} t` O ffit- ',.. ,•. i TEIar. `re' i' , Expansion tank 12.51 Name:Sage Built Homes,LLC. Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:1815 NW 169th Place,Suite 1040 Garbage disposal 25.02 City/State/ZIP:Beaverton,Oregon Hose bib 25.02 Phone:(971)221-4597 Fax:( ) Ice maker 12.51 AP' . IT - 4ACT PERSON Interceptor/grease trap 25.02 .).r,tiik rv , , Business name:Sage Built Homes,LLC. Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:Ben Cooper Roof drain(commercial) 12.51 Address:Same as above Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:(971)258-6658 Fax: :( ) Tub/shower/shower pan 12.51 E-mail:planning@sagebuilthomesllc.com Urinal 25.02 '` Ct�AClI012 �•�, 17Water closet 25.02 . . Water heater 37.52 Business name:Max Plumbing Service Inc Water piping/DWV 56.29 Address:PO BOX 230674 97281 Other: 25.02 City/State/ZIP: Tigard,OR 97281 Subtotal Phone:(971)-275-0198 Fax:( ) Minimum permit fee: $72.50 CCB Lie.: 205392 Plumbing Lic.no.: Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name:Ben Cooper Date:7/23/2018 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. 1:\Building\Permits\PLMU-PermitApp.doe 10/01/09 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2- Supplemental Information Fee Schedule: Residential Fire Suppression S stems: ftn( i s $:, ;n, � . v. etr 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' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas S stems: Water Service-each additional 100' 37.52 a >. ' ' ,, Storm&Rain Drain-1st 100' 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 € f E +;' each additional$100.00 or fraction thereof,to �. Att 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 char_e-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 char:e-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 char:e 1/2 hour each additional$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Quantity by Fixture Type tan eyi4of,for Plum mg-ln$all r e) Fixture Type#'or Replace/ Work Ferforuied: Capped added Relocate Plan review is required for any of the following. Baptistry/Font Please check all that apply. Bath Tub/Shower El Any new commercial building with water service 2"and Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Drive Thru ❑ New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918-780-0040. Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities. -Domestic ❑ Any multipurpose fire sprinkler system. Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040. Eye Wash Floor Drain/sink -2" Submit 2 sets of plans with any of the above. 4>, - or Riser Ol gra"` a' x Car Wash Drain Garbage Domestic-non-food 0 Isometric or riser diagram is required for new buildings Disposal -Domestic-food related that meet the qualifications above. -Commercial-food related -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang -Stall Sink/Lay -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer-Clothes Water Extractor increase of sewer EDUs,a sewer permit will be issued and Water Closet-Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: C:\Users\kylie\Downloads\PLMF PermitApp.doc 2 r RECEIVED City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT MAY 2 2 II . U 2018 II Request for Permit Action CITY OF TIGARD TI t;A R I) 13125 SW Hall Blvd. •Tigard, Oregon 97223 • 503-718-2439 •www.tigard- }ygD1 1G DIVISION TO: CITY OF TIGARD Building Division 13125 SW Hall Blvd.,Tigard, OR 97223 Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov FROM: ❑ Owner ❑X Applicant ❑ Contractor ❑ City Staff Check(✓)one REFUND OR Name: INVOICE TO: (Business or Individual) Sage Built Home Mailing Address: 1815 NW 169th Place Suite#1040 City/State/Zip: Beaverton,OR 97006 Phone No.: 503-533-5167 PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): U _ANG /VOID PERMIT APPLICATION. �(' REFUN ERMIT FEES (attach copy of original receipt and provide explanation below). � E FOR FEES DUE (attach case fee schedule and provide explanation below). ❑ REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit). Permit#: MST2018-00075 Site Address or Parcel#: 9599 SW Anna Belle Ct Project Name: Ash Creek Village Subdivision Name: Ash Creek Lot#: 1 EXPLANATION: Requesting to remove A/C from permit and a refund Signature: g Date: 7A�/ ' Print Name: Ben Cooper !/ Refund Policy 1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of: • Any fee which was erroneously paid or collected. • Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended. • Not more than 80%of the application or permit fee for issued permits prior to any inspection requests. 2. All refunds will be returned to the original payer in the form of a check via US postal service. 3. Please allow 3-4 weeks for processing refund requests. 6, • 25- -- 77, ye? = 9. 35 stat -_ ' , yy A4�. 3 • .3.6 V7reP? 7e1' V7 FOR OFFICE USE ONLY Route to Sys Admin: Date By Route to Records: Date 3 Zc' 19 By 4'17 Refund Processed: Date 4/227/cF" B t3 Invoice Processed: Date By Permit Canceled: Date NM- By 1,7"' Parcel Tag Added: Date By I:\Building\Forms\RegPermitAction_092314.doc TIGARD City of Tigard July 16, 2018 Sage Built Homes Attn: Ben Cooper 1815 NW 169th Pl, Suite 1040 Beaverton, OR 97006 Re:Permit No. MST2018-00075 Dear Applicant: The City of Tigard has processed a refund for fees on the above referenced permit(s) as follows: Site Address: 9599 SW Anna Belle Ct Project Name: Ash Creek Village,Lot 1 Job No.: N/A Refund: ® Check#228969 in the amount of$41.89. ❑ Credit card "return"receipt in the amount of$ Note: Please allow 2-5 days for this refund transaction to be credited to your account by the company that issued your card. ❑ Trust account"deposit"receipt in the amount of$ Comments: Per applicant's request to remove A/C from issued permit;refund 80% of permit fees paid. If you have any questions please contact me at 503.718.2430. Sincerely, ,0d )(1176P-- — Dianna Howse Building Division Services Supervisor Enc. 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171 TTY Relay: 503.684.2772 • www.tigard-or.gov UPI " City of Tigard TIGARD Accela Refund Request This form is used for refund requests of land use, development engineering and building permit application fees. Receipts, documentation and the Request for Permit Action form (if applicable) must be attached to this request form. Refund requests are due to Accela System Administrator by each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts Payable will route refund checks to Accela System Administrator for distribution to applicant. PAYABLE TO: Sage Built Homes DATE: 6/22/2018 1815 NW 169th P1, Suite 1040 Beaverton, OR 97006 REQUESTED BY: Dianna Howse TRANSACTION INFORMATION: Receipt#: 416856 Case#: MST2018-00075 Date: 4/19/2018 Address/Parcel: 9599 SW Anna Belle Ct Pay Method: CreditCard Project Name: Ash Creek Village,Lot 1 EXPLANATION: Remove A/C from issued permit;refund 80% of permit fees paid. ,1 4 , r.:.r d7. �° �n.. 5 �re:0., gr p_q $:�<a� H Be 11 t,0ys ,tion From ecei f f r � ' s am$e pr . : °l` �" a q �' �' Eta i t T r ?z3 Lel 4,5/ .�# g i w 8 Q!H it jr Mechanical Permit Fee 230-0000-43102 $37.40 12%State Surcharge 100-0000-24001 4.49 TOTAL REFUND: $41.89 APPROVALS: SI -• u 'E /DATE: If under$5,000 Professional Staff "W If under$12,500 Division Manager If under$25,500 Department Manager If under$50,000 City Manager If over$50,000 Local Contract Review Board 'FO—It `IDEIVIA -SYSZEM All :1N' STW,I©Nt'SLr ONL' " tit t Case Refund Processed: Date: .3,,P�/jci By: , I:\Building\Refunds\RefundRequest.doc x 09/01/2010