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Permit (32) City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 11,1 Request for Permit Action T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • www.tigard-or.gov 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: El Owner 13 Applicant El Contractor El City Staff Check(✓)one REFUND OR Name: INVOICE TO: (Business or Individual) .--'66/5144. n1:71S Mailing Address: 1?O` ) I/iJ PACra i`Tf j /0,„? City/State/Zip: bat1ej* 4'), ooC Phone No.: ��(J3— �f l� `'( 7Cja PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): _.___C:AN€ 1 OID PERMIT APPLICATION. REFUND RMIT FEES (attach copy of original receipt and provide explanation below). E FOR FEES DUE (attach case fee schedule and provide explanation below). Permit#: N(S�'� � " °° 1 Site Address or Parcel #: I(?5q �1A.) 2,n�y�erbr La e Project Name: Surroierbaset Subdivision Name: 10)0101 1-Cei9k Lot #: EXPLANATION: /4�` Ao r . !J ��J ,� e=,d v %oh:4/j- r/t1/1, ,vv,/r a/r �,,s.�� ,) lam.5,5 S. a /y_ rm �i/ 1A P`""' GL.-e� tFfvr+..r741 `f .r. . `3•i Signature: Date: OVvg1 I q Print Name: nnat) ` fir 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 • Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended.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. s. U Q 3 . _v 3 • 7S Route to Sys Admin: Date /1 By , Route to Records: Date I71.) 7, , By,4- Refund Processed: Date/0 / B Invoice Processed: Date By Permit Canceled: Date A/,� By reel-Tag Added: Date By I:\Building\Forms\RegPermitAction_1 518.doc a p . TIGARD City of Tigard October 11, 2019 David Weekley Homes 1905 NW 169th Pl, Suite 102 Beaverton, OR 97006 Re: Permit No. MST2019-00294 Dear Applicant: The City of Tigard has processed a refund for fees on the above referenced permit(s) as follows: Site Address: 11959 SW Summerbrook Ln Project Name: Summerbrook,Lot 4 Job No.: N/A Refund: ® Check#233550 in the amount of$28.02. ❑ Credit card"return"receipt in the amount of$ 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 reduce (1) hose bib from permit. Refund 100% of permit fees. If you have any questions please contact me at 503.718.2430. Sincerely, 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 ■ City of Tigard T I G A u D 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: David Weekley Homes DATE: 10/4/2019 1905 NW 169th P1, Suite 102 Beaverton, OR 97006 REQUESTED BY: Dianna Howse TRANSACTION INFORMATION: Receipt#: 425056 Case#: MST2019-00294 Date: 8/1/2019 Address/Parcel: 11959 SW Summerbrook Ln Pay Method: Check Project Name: Summerbrook,Lot 4 EXPLANATION: Per applicant's request to reduce (1) hose bib from permit. Refund 100% of permit fees. REFUND INFORMATION: Fee Description From Receipt Revenue Account No. Refund Example: Building Permit Fee Example: 2300000-43104 $Amount Plumbing Permit Fee 230-0000-43101 $25.02 12%State Surcharge 100-0000-24001 3.00 TOTAL REFUND: $28.02 APPROVALS: SIGNATURES/DATE: If under$5,000 Professional Staff If under$12,500 Division Manager If under$25,000 Department Manager If under$100,000 City Manager If over$50,000 Local Contract Review Board FOR ACCELA SYSTEM ADMINISTRATION USE ONLY Case Refund Processed: Date: cfy.)7/.2._, By: 1' 4 I:\Building\Refunds\RefundRequest.doc x 09/01/2010 101 CITY OF TIGARD RECEIPT II 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 ItGARL3 Project Name: Summerbrook, Lot 4 Site Address: 11959 SW SUMMERBROOK LN Receipt Number: 436106 - 08/27/2021 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID MST2019-00294 $-28.02 Total: $-28.02 PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 233550 DHOWSE 08/27/2021 $-28.02 Payor: David Weekley Homes Total Payments: $-28.02 Balance Due: $28.02 Paae 1 of 1 CITY OF TIGARD RECEIPT ill-1. : 13125 SW Hall Blvd.,Tigard OR 97223 - 503.639.4171 Tfi„F) Project Name: Summerbrook, Lot 4 Site Address: 11959 SW SUMMERBROOK LN 4006-/AIR-C-- Receipt Number: 425056 - 08/01/2019 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID MST2019-00294 Building Permit-New Construction 230-0000-43104 $2,078.62 MST2019-00294 DC Provision Review,SF-Ping 100-0000-43112 $102.00 MST2019-00294 Info Process/Archiving-Lg$2.00(over 230-0000-43135 $48.00 11x17) MST2019-00294 Info Process/Archiving-Sm$0.50(up to 230-0000-43135 $47.50 11x17) MST2019-00294 Metro Const. Excise Tax 230-0000-24010 $448.09 MST2019-00294 Beaverton School CET-Residential 230-0000-24101 $3,754.35 MST2019-00294 Permit Fee-Elect(SF or 1st MF 220-0000-43103 $338.14 dwelling unit) MST2019-00294 Limited Energy 220-0000-43103 $75.00 MST2019-00294 12%State Surcharge-Electrical 100-0000-24001 $49.58 MST2019-00294 Furnaces< 100K BTU 230-0000-43102 $46.75 I MST2019-00294 Water Heater 230 0000 43102 $23.32 MST2019 00294 Gas Fireplace 230-0000-43102 $33.39 MST2019-00294 Range Hood/Other Kitchen 230-0000-43102 $33.39 MST2019-00294 Clothes Dryer Exhaust 230-0000-43102 $33.39 MST2019-00294 Single Duct Exhaust(Bathrooms, Toilet, 230-0000-43102 $116.60 Utility Rooms) MS12019-00294 Fuel Piping 230-0000-43102 $14.15 MST2019-00294 12%State Surcharge-Mechanical 100-0000-24001 $36.12 MST2019-00294 SFR-Baths 230-0000-43101 $500.32 MST2019-00294 Hose Bib 230-0000-43101 in W $25.02 *-- MST2019-00294 12%State Surcharge-Plumbing 100-0000-24001 3.CO $63.04 4- MST2019-00294 Erosion Control w/Development 640-0000-43134 $386.40 MST2019-00294 Wash Co Trans Dev Tax-SF Detached 405-0000-43320 $8,968.00 MST2019-00294 Tigard Trans SDC Improvement-SF 415-0000-43300 $6,335.00 Detached MST2019-00294 Tigard Trans SDC Reimbursement-SF 415-0000-43301 $365.00 Detached MST2019-00294 Parks SDC Improvement-SF Dwelling 425-0000-43300 $5,523.00 (detached/attached) MST2019-00294 Parks SDC Reimbursement-SF 425-0000-43301 $1,530.00 Dwelling(detached/attached) MST2019-00294 Parks SDC Neighborhood-SF Dwelling 425-0000-43300 $2,048.00 (detached/attached) MST2019-00294 12%State Surcharge-Building 100-0000-24001 $249.43 Total: $33,271.60 PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 2865319 BTAGGART 08/01/2019 $33,271.60 Payor: The Weekley Group of Companies Total Payments: $33,271.60 Balance Due: $0.00 Page 1 of 1 11141 CITY OF TIGARD MASTER PERMIT `, COMMUNITY DEVELOPMENT Permit#: MST2019-00294 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 t ` Date Issued: 08/01/2019 E. Parcel: 1S134BD12100 kr , /,..- 04 Jurisdiction: Tigard Site address: 11959 SW SUMMERBROOK LN Subdivision: SUMMERBROOK SUBDIVISION Lot: 4 Project: Summerbrook, Lot 4 Project Description: New SF. 8/29/19: REPRINTED permit to show reduction of hose bibs from (3)to (2). 9/18/2019: REPRINT to add backflow device. 10/21/19: REPRINTED permit to add A/C. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1469 sf Basement: 0 sf Left; 5 Parking Spaces: 0 Height: 22 Bathrooms: 3 Second: 1312 sf Garage: 674 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2781 sf Value: $373,405.28 Rear: 15 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 Storm Sewer: 100 Drains. 0 Tubs/Showers: 4 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 Other Fixtures: 0 Drywell-Trench Drain: 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: 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 Ecompasing: Y Other: N Other Description: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2781 Owner: Contractor: WEEKLEY HOMES LLC WEEKLEY HOMES Required Items and Reports(Conditions) 1905 NW 169TH PL STE 102 1905 NW 169TH PLACE SUITE 102 1 Ersn Cntrl 503-639-4175 BEAVERTON,OR 97006 BEAVERTON,OR 97006 PHONE: 503-213-4415 PHONE: 503-213-4415 FAX: Total Fees: $34,710.08 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: ---7--- --Tri-– - Y. Permittee Signature: . i.` .r 6aW5b3.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application FOR OFFICE USE ONLY City of Tigard Received „,..,./,,,,/,,,, i Permit No.: - rr . EI y: 117,..__ r b r, a% ',i.!rr'G• ,a 13125 SW Hall Blvd.,Tigard,OR 97223 ” k Plan Review :IN 1 Phone: 503.718.2439 Fax: 503.598.1 Other Permit: Date/By: T I(;n R D Inspection Line: 503.639.4175 Date Ready/By: Juris: I ® See Page 2 for OCTInternet: www.tigard-or.gov 12019 Notified/Method: Supplemental Information ,ery *TIGARD , Print name:Hannah Scharer TYPE OF WOR .s� "a 1:s ' t l ,I ®New construction ❑Addition/alteration/replacement COMMERCIAL FEE* SCHEDULE — USE CHECKLIST ❑Demolition ❑Other: Mechanical permit fees*are based on the value of the work performed.Indicate the value(rounded to the nearest dollar)of all CATEGORY OF CONSTRICTION /01i111. mechanical materials,equipment,labor,overhead,and profit. ® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building Value:$ ❑Multi-family 0 Master builder ❑Other: RESIDENTIAL EQUIPMENT/SYSTEMS FEES* For special information use checklist. JOB SITE INFORMATION AND LOCATION Description Qty. Ea. Total Job site address:11959 SW Summerbrook Ln Heating/cooling: City/State/ZIP:Tigard/OR/97223 Air conditioning 1 46.75 Furnace 100,000 BTU(ducts/vents) 46.75 Suite/bldg./apt.no.: Project name:Summerbrook Furnace 100,000+BTU(ducts/vents) 54.91 Cross street/directions to job site:SW 121't Ave and Summerbrook Lane Heat pump 61.06 Duct work 23.32 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 Subdivision:Summerbrook Lot no.:04 Flue/vent for any of above 23.32 Tax map/parcel no.:TBD Other: 23.32 DESCRIPTION OF WORK Other fuel appliances: Water heater 23.32 New single family home to be built-2781 sqft,4 bedroom 3 bath home with Gas fireplace/insert _ 33.39 674 sqft 3 car garage Flue vent for water heater or gas fireplace 23.32 (k,,i ,% CITY OF TIGARD MASTER PERMIT '' COMMUNITY DEVELOPMENT Permit#: MST2019-00294 IN 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ♦ • / Date Issued: 08/01/2019 TIGARD 9 t •rp\tiU- Parcel: 1S134BD12100 'v�,sty. _' Jurisdiction: Tigard Site address: 11959 SW SUMMERBROOK LN Subdivision: SUMMERBROOK SUBDIVISION Lot: 4 Project: Summerbrook, Lot 4 Project Description: New SF. 8/29/19: REPRINTED permit to show reduction of hose bibs from(3)to(2). 9/18/2019: REPRINT to add backflow device. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1469 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 22 Bathrooms: 3 Second: 1312 sf Garage: 674 sf Front: 20 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Total: 2781 sf Value: $373,405.28 Rear: 15 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 RainStorm Sewer: 100 0 Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0 Bckflw Prevntr: 1 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 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 10004-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 2781 Owner: Contractor: WEEKLEY HOMES LLC WEEKLEY HOMES Required Items and Reports(Conditions) 1903 NW tetTM fL STE 162 '1905 NW 169TH PLACE-SLATE 142 1 Ersn Cntrl 5Q3-639-4175 BEAVERTON,OR 97006 BEAVERTON,OR 97006 PHONE: 503-213-4415 PHONE: 503-213-4415 FAX: Total Fees: $34,657.72 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 R 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.198787ora1.800.332.2344. �^� Issued By: \. .01\_",......_ Permittee Signature: SCs C\\'' CA 1\C 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. Plumbing Permit Application Building Fixtures ,..A; - , , ' FOR OFFICE USE ONLY City of Tigard Received By: Ck\c \ ss)-r Permit No..MS- i( (�j� t\ v 13125 SW Hall Blvd..Tigard,OR 97223 t,, Date Rev �+�r f "r Plan Review NI . Phone: 503.718.24 39 Fax: 503.598.1960Date/By: Other Permit No.: Inspection Line: 503.639.4175 ' ` TIGARD Date Ready/By: loris: El See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OI WORK FEE* SCHEDULE ®New construction 0 Demolition For special information use checklist. Description I Qty. I Ea. I Total ❑Addition/alteration/replacement 0 Other: New I-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION , f` " m f.,„,..FR(1)bath 312.70 Z 1-and 2-family dwelling D Commercial/industt ;t rr : .iera R(2)bath 437.78 V. 0"`• eV. R(3)bath 500.32 0 Accessory building 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Pane 2 JOB SITE,INFORMATION AND LOCATION"- Site utilities: Job site address: 11959 SW Summerbrook Lane Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard,OR 97223 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: 1 Project name:Summerbrook Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 SW 12151 Avenue 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:Summerbrook , Lot no.:4 Fixture or item: Tax map/parcel no.: Backflow preventer I 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Irrigation and backflow for lot 4 landscaping Dishwasher 25.02 _..._..... Drinking-fountain - - - _-_.-.....2-5:0? .._._. Ejectors/sump 25.02 PROPERTY OWNER 1 , I 0 TENANT"_ Expansion tank 12.51 Name:Weekley Homes,LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 1905 NW 169111 Place,102 Garbage disposal 25.02 City/State/ZIP:Beaverton,OR 97006 Hose bib 25.02 Phone:(503)213-4415 Fax:( ) Ice maker 12.51 }APPLICANT ' ® CONTACT PERSON Interceptor/grease trap 25.02 Business name:David Weekley Homes Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:Hannah Scharer Roof drain(commercial) 12.51 Address: 1905 NW 169'Place,102 Sink/basin/lavatory 25.02 City/State/ZIP:Beaverton,OR 97006 Solar units(potable water) 62.54 Niue:50.1171$- `ax: :( 3 , _-TtblshowerMiuwci pair . 1-/31 5, � 2 E-mail:hscharer@dwhomes.com Urinal __-0 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name:Gro Outdoor Living Water piping/DWV 56.29 Address:5800 NE 88th Street Other: 25.02 City/State/ZIP:Vancouver,WA Subtotal Phone:(360)727-5974 Fax:( ) ` �� ,{� Minimum permit fee: $72.50 ""�ry��` `1"" Plan review (25%of permit fee) CCB Lic.: 193268 Plumbing Lic.no.: ~`Al State surcharge(12%of permit fee) Authorized sigmrature: / 13l '�jt TOTAL PERMIT FEE // /, This permit application expires if a permit is not obtained within 180 days Print name: Date:Q9r �'/fq after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. i:'.Building\Permits\PLMU-PermitApp.doc 10/01/09 440-46I6T(I 0/02/COM/WEB) r Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: a' s+f x �'n K - r�.rF -tl 01441-96,.),,V).1010; $tw, r �, n 4,3xt1`3� x ,e.'+ S" ` �t " G� 9 �' �sy z ka,a ,. ip.A t, NI ,s` r QIY,,,y_ 4 X14 �„�,.) g0;. l ` ::, ''ermit;Feet, a' .' t'. .45t „cit til e ,','*x:' Footing drain-1e 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' 37.52lip a�b t * es yuF1 r e 4.l . + ;Peree : , .4aA A, _..—,r l ., 4-kinf, ;. Stonn&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 t ave t i, lI, , ,Qty. ?'Fee(e`) °4441.4,14' each additional$100.00 or fraction thereof,to 4.. ;4 f�,nspe >Y.P. ,b .O. , ,t, ,;. ti,t f t; 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$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to xtures could-result-in-increased sewer fees*. accurately report fi �a C t t y Quantity by Fixture Type ,1 1t1t,t J e fOi Yumbmg"In$t aala 1 "..3 t Flxta'e Type for 'l'N '1; � ' a� . ReplaSd Plan review is required for any of the following, •Work'Perforr"toed r,,.'. Capped Added,a. Relocatew=r Baptistry/Font Please check all that apply. Bath Tub/Shower 0 Any new commercial building with water service 2"and -Jacuzzi/WhirlpoolTub/Sower 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. -4" 4 s Icd E.F w ss„ vin. ,rya ?A `, ,�1 ,,q,;‘,.:. , yp- , .�i.t,-I _.. 'nMRiser Diagr 4t . Z. , ,/, Cor Wash Drain Garbage -Domestic—non-food ❑ Isometric or riser diagram is required for new buildings Disposal -Domestic—food related that meet the qualifications above. -Conunercial—food related -.. -1ndusin'a-irfarolated 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 increase of sewer EDUs,a sewer permit will be issued and Water Extractor Water Closet-Toilet fees assessed for the sewer increase must be paid before the Urinalplumbing permit can be issued. Other Fixtures: C:\Uscrs\hbrecken\Downloads\PLMF PermitApp(1),doc 2 N. .e.„. „, CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT k Permit#: MST2019-00294 TfCARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/01/2019 Et7Lfr.illinilParcel: 1S134BD12100 Jurisdiction: Tigard Site address: 11959 SW SUMMERBROOK LN Subdivision: SUMMERBROOK SUBDIVISION Lot: 4 Project: Summerbrook, Lot 4 Project Description: New SF. 8/29/19: REPRINTED permit to show reduction of hose bibs from (3)to (2). BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1469 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 22 Bathrooms: 3 Second: 1312 sf Garage: 674 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2781 sf Value: $373,405.28 Rear: 15 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 Storm Sewer: 100 Drains: 0 Tubs/Showers: 4 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 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/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 2781 Owner: Contractor: EY#4 _ Required Items and Reports(Conditions) 1905 NW 169TH PL STE 102 1905 NW 169TH PLACE SUITE 102 1 Ersn Cntrl 503-639-4175 BEAVERTON,OR 97006 BEAVERTON,OR 97006 PHONE: 503-213-4415 PHONE: 503-213-4415 FAX: Total Fees: $34,622.70 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 952-001-0010 through 952-001-0090. You may obtain . •py of the ru- • direct questions to OUNC by calling 2.1987 r 1.800.332.2344. r Issued By: .,,,,�,,� � i•nature: �l�39.4175 by 7:00 a.m.for the next available I •: 'on 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 11111 COMMUNITY DEVELOPMENT Permit#: MST2019-00294 Date Issued: 08/01/2019 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S134BD12100 Jurisdiction: Tigard Site address: 11959 SW SUMMERBROOK LN Subdivision: SUMMERBROOK SUBDIVISION Lot: 4 Project: Summerbrook, Lot 4 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1469 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 22 Bathrooms: 3 Second: 1312 sf Garage: 674 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2781 sf Value: $373,405.28 Rear: 15 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 Storm Sewer: 100 0 Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 3 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 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/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Ecompasing: Y Other: N Other Description: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2781 Owner: Contractor: _ WEE KLEY IOMES-ILC ---- --- -- WEVI ---- --- --------- Required Items and Reports(Conditions) 1905 NW 169TH PL STE 102 1905 NW 169TH PLACE SUITE 102 1 Ersn Cntrl 503-639-4175 BEAVERTON,OR 97006 BEAVERTON,OR 97006 PHONE: 503-213-4415 PHONE: 503-213-4415 FAX: Total Fees: $34,622.70 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 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503. .1987 1.800.332.2344. Issued By: 0 s_� •er- -- ',nature: z./ ell �� -. 13.639.4175 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. Build ng Permit Application Residential 1 15, FOR OFFICE USE ONLY ri� City of Tigard Date/BY 7 /7 7, / / te47"�jpi_��S ■ 13125 SW Hall Blvd.,Tigard,OR 97223 n Pl �) --1/,?_s_ I Phone: 503.718.2439 Fax: 503.598.1960JUL Date/By: ► Seett_a_:).0/1......,06,,t......,06......,06,,t2.ti I I G A K D Inspection Line: 503.639.4175 i , , Date Ready/By: / oris: 0 See Page 2 for Internet: www.tigard-or.gov ell'I q.`C 1 it +r if I Noti d/Metliod: j �j'' Supplemental Information 131.J1LD NG 1 iV Sat S Ui �. ,{t '<<.. .' . ,, . ,. v ,tib-, ,. t.. ... --.*yr t,�•_ #,,;.�vt TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING ®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 0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION ' work indicated on this application. ® 1-and 2-family dwelling 0 Commercial/industrial Valuation: „$3S+A;8btJ 373/4 b f"" ❑Accessory building 0 Multi-family Number of bedrooms: 4 1 ❑Master builder 0 Other: Number of bathrooms: 3 ,�.;;. JOB SITE'INFORMATION AND LOCATIONy;, " Total number of floors: 1 34 Sc Job site address:11959 SW Summerbrook Ln New dwelling area: 2781 square feet `3 1. City/State/ZIP:Tigard/OR/97223 Garage/carport area: (g7l square feet‘14 l Suite/bldg./apt.no.: Project name:Summerbrook Covered porch area: >WC square feet Cross street/directions to job site:SW 121'Ave and SW Summerbrook Lane Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST , Subdivision:Summerbrook I Lot no.:04 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 Single Family Home to be built-2781 SQFT 4 Bedroom,3 bath with 674 SQ Valuation: $ FT 3 car garage, Existing building area: square feet New building area: square feet PROPERTY OWNER ❑.TENAN ,",., Number of stories: Name:Weekley Homes LLC Type of construction: Address: 1111 N Post Oak Road Occupancy groups: City/State/ZIP:Houston,TX 77055 Existing: Phone:(503)213-4415 Fax:( ) New: 1 ❑ APPLICANT -'.CONTACT PER$( E ``.." BUILDING PERMIT FEES* 4 Business name:David Weekley Homes `e . . (Please referto feeschedute) -_ . ', Structural plan review fee(or deposit): Contact name:Michele Schiedler Address: 1905 NW 169th Place,Suite 102 FLS plan review fee(if applicable): Total fees due upon application: City/State/ZIP:Beaverton/OR/97006 Phone:(503)213-4415 Fax::( ) LAS'- ,,FE -S E-mail:mschiedler@dwhomes.com OTOV0 QR P NET, . ,. - °y a , 4 ;�, , c - ,,--,Ave ; Commercial and residential prescriptive installation of it ,,, y4 7, CONTRA C OR + > V z �.. .. ret,.-.7,--; �:�� .,°� _ � �...r. lift;. .:, roof-top mounted Photovoltaic Solar Panel System. Business name:David Weekley Homes Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:1905 NW 169th Place,Suite 102 Solar Installation Specialty Code checklist. City/State/ZIP:Bea erto OR/97006 Permit Fee(includes plan review $180.00 and administrative fees): Phone:(503)213-4.15 Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.:213653 / Total fee due upon application: $201.60 Authorized signatu e: P0/ l_________) This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Michel, c d Date:7/16/19 *Fee methodology set by Tri-County Building Industry Service Board. 1:\Building\Permits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Building Permit Application Checklist One- and Two-Family Dwelling .,m 1 FOR OFFICE USE ONLY City of Tigard Received Date/By: Permit No.: III13125 SW Hall Blvd.,Tigard,OR 97223 �U L ?019 Phone: 503.718.24 39 Fax: 503.598.1960 Associated permits: 1.l t,n{t 1) 24-Hour Inspection Line: 503.639.4175 'G1 i E,a�"` 1 t+ a • ® Electrical ® Plumbing El Mechanical Internet: www.tigard-or.gov t l l!L;„`)iN( r iVI S1(;\i 0 Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW YeS No N/A I Land use actions completed. See jurisdiction criteria for concurrent reviews. ® ❑ ❑ 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ® 0 0 3 Verification of approved plat/lot. ® 0 El 4 Fire district approval required. Name of district: . ❑ ❑ 0 5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ El 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. ® El 0 9 Erosion control ®plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ® 0 0 basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state Z ❑ ❑ 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 ® El El there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.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 ® El p and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ® ❑ El 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- ® ❑ ❑ 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. ® El ❑ 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- ® p ❑ 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 /1 ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ p 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. ® ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required Z ❑ ❑ 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 ® El ❑ architect licensed in Ore.on and shall be shown to be a..licable to the .ro'ect under review. __ _� JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". ® ❑ ❑ 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ® ❑ El 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ® ❑ ❑ 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. /1 ❑ ❑ 27 "Drawn to scale"indicates standard architect or engineer scale. ® El ❑ 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ® El ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ 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, ❑ ❑ El 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 Applicatiev t-=a, i V �.. FOR OFFICE ESE ONLY City of Tigard + s.,? - Received Permit No.: Date By: 111 ill 13125 SW Hall Blvd.,Tigard,OR 97223 1 y E�+ PlaReview Phone: 503.718.2439 Fax: 503.598.1960 ,JUL 2 u 1 C Datue.'By: Other Permit: i c A I:t) Inspection Line: 503.639.4175 Date ReadyBy:` loris: Internet: www.tigard-or.gov al ti l See Page 2 for k Notitied/Method: Supplemental Information Print name:Ken Puttman ", TYPE OF,WORK c '` ®New construction 0 Addition/alteration/replacementY C`IAL"rrE"15t ttrLL11 L° 115E Ll , 0 Demolition 0 Other: Mechanical permit fees*are based on the value of the work performed.Indicate the value(rounded to the nearest dollar)of all CATEGORY OF CONSTRUCTION mechanical materials,equipment,labor,overhead,and profit. ® 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building Value:$ ❑Multi family ❑Master builder ❑Other: RESIDENTIAL EQUIPMENT t SYSTEMS FEES*. ;. For special information use checklist. ,JOB SITE ,'INFORMATION AND LOCATION Description p Qty. Ea. Total Job site address: 11959 SW Summerbrook Ln Heating/cooling: City/State/ZIP:Tigard/OR/97223 Air conditioning 46.75 Furnace 100,000 BTU(ducts/vents) 1 46.75 Suite/bldg./apt.no.: Project name:Summerbrook Furnace 100,000+BTU(ducts vents) 54.91 Cross street/directions to job site:SW 121st Ave and Summerbrook Lane Heat pump 61.06 Duct work 23.32 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 Subdivision:Summerbrook Lot no.:04 Flue/vent for any of above 23.32 Tax map/parcel no.:TBD Other: 23.32 DESCRIPTION OF WORK Other fuel appliances: Water heater 1 23.32 New single family home to be built-2781 sqft,4 bedroom 3 bath home with Gas fireplace/insert I 33.39 674 sqft 3 car garage Flue vent for water heater or gas fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 ® PRCIPERTI Wood fireplace/insert 23.32 ` _.� WNER ❑;TENANT , ", Chimney/liner/flue/vent 23.32 Name:Weekley Homes LLC Other: 23.32 Address: 1111 N Post Oak Road Environmental exhaust and ventilation: Range hood/other kitchen City/State/ZIP:Houston,TX 77055 equipment 1 33.39 Clothes dryer exhaust 1 33.39 Phone:(503)213-4415 Fax ( ) Single-duct exhaust(bathrooms, 5 x ®''APPIICANT ';�� toilet compartments,utility rooms) \ 23.32 :'CONTA I�'>R O+i ° Auic/crawispace fans 23.32 Business name:David Weekley Homes Other: 23.32 Contact name:Michele Schiedler Fuel piping: Address: 1905 NW 169th Place,Suite 102 $14.15 for first four;$4.03 for each additional Furnace,etc. City/State/Z1P:Beaverton/OR/97006 Gas heat puma Phone:(503)213-4415 Fax::( ) Walllsuspended/unitbeater Water heater E-mail:mschiedler@dwhomes.com Fireplace ' - :` TINA b n; !Al Ran e Barbecue Business name:David Weekley Homes Clothes dryer(gas) Address: 1905 NW 169th Place Suite 102 Other: City/State/ZIP:Beaverton/OR/97006AttSkt::' Subtotal Phone:(503)213-4415 Fax:( ) Minimum permit fee($90.00) CCB lic.:213653 Plan review(25%of permit fee) State surcharge(12%of permit fee) TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 1:Building'.PermitslMEC_Perm tApp_040113.doe 440-4617T(IL 02,COM/WEB) Electrical Permit Application . r-/ � t_' FOR OFFICE USE ONLY City of Ti and i. r. Received g I l i l_ l tZ ?Dig Date/13 : Permit#: 14 11 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503 598.mot Date•B Related Permit 6. ,,,,,, Inspection Line: 503.639.4175 -g t t tx Ready Date/By. Juris. Fa See Page 2 for Internet: www.tigard-or,gov '—ti,-....'!7.,_„,,,, ' ° Notified/Method: Supplemental Information ®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): 0 Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition 0 Other: where the available fault current • • 0 Marinas and boatyards. CATEGORY:OF CONSTRUCTION • exceeds 10,000 amps at 150 volts or 0 Floating buildings. .1 I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family 0 Master builder ❑Other: ❑Fireum . P P ❑Installation of 150 KVA or ' JOB SITE'''INFORMATION,AND'LOCATION.' ! 0 Emergency system. larger separately derived 0 Addition of new motor load of system. Job 4:6802004 Job site address: 11959 SW Summerbrook Lane I00HP or more. ❑"A","E "t-2","l-3", City/State/ZIP:Tigard/OR/97223 ❑Six or more residential units. occupancy. 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.4: Project name:Summerbrook 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:SW 121st Ave and Summerbrook Lane • FEE.SCHEDULE Description I Qty. I Each I Total I • New residential single-or multi-family dwelling unit. Subdivision:Summerbrook Lot 4:04 Includes attached garage. 1,000 sq.ft or less I 168.54 168,54 4 Tax map/parcel# TBD Ea.add'1500 sq.ft.or portion 3 33.92 107.76 I ' '. , ':liESCRIIrfjON OF WORK' , . Limited energy,residential New single family home to be build-2781 sqft,4 bedroom 3 bath home with (with above sq.ft.) 75.00 2 Limited energy,multi-family 75.00 674 sqft 4 car tandem garage residential(with above sq.ft.) 2 Renewable Energy 0 Sec Page 2 ® PROPERTY OWNER ', 0 TENANT' ' Services or feeders installation,alteration,and/or relocation Name:WEEKLY HOMES LLC 200 amps or less 100.70 2 Address: 1111 N POST OAK ROAD 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: HOUSTON TX 77055 601 amps to 1,000 amps 301.04 2 Phone:(503)213-4415 Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: 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 El APPLICANT •': ' CONTACT PERSON Branch circuits—new,alteration,or extension,per panel ' ; A Fee far branch circuits with Business name:David Weekley Homes above service or feeder fee, 7.42 2 each branch circuit Contact name: Michele Schiedler B.Fee for branch circuits without Address: 1905 NW 169th Place Suite 102 branch circuit City/State/ZIP:Beaverton/OR/97006 Each add']branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(503)213-4415 Fax: :( ) Each manufactured or modular 67.84 dwelling,service and/or feeder Email:mschiedler@dwhomes.com Reconnect only 67,84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name:Garner Electric Signor outline lighting 67.84 2 Address:2920 SE Brookwood Ave. panel,of a ationt(s)or limited-energyxeni0 See Page 2 2 panel,alteration,or extension. City/State/ZIP:Hillsboro,OR 97123 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(503)523-9060 Fax:(503)642-7925 Investigation(I hr min) 90.00/hr Email:andreap@garnerelectric.coro Industrial plant(I hr min) 78.18;hr Inspections for which no fee is 90.00/hr CCB Lie.: 121159 Electrical L. .. 3 05 Suprv,Lic.: 3707S specificaily,listed('h hr min) ' ,EI.ECTRICAI::•PCRMIT.,FEES . Suprv.Electrician signature,required: Subtotal: Print name: Charles Garner Date: 6/4/2019 0 Plan Review Required(25%of permit fee): o / I State surcharge(12%of permit fee): Authorized signature: /7(` i TOTAL PERMIT FEE: / Thisermit application app tcafion expires if a permit is not obtained within 180 Print name: Andrea Phillips Da : 6/4/2019 days after it has been accepted as complete. * Number of inspections allowed per permit. I`,Building\Permits1ELC Per.miApp OLE ERE.doe Rev 06/17/2015 440-46 IST(II/05/COM,WEB Plumbing Permit Applicat r •, � iy F Building Fixtures2019 I:0li 011I( e t !,l 0\1.1 City of Tigard U L Received ll 13125 S W Hall Blvd.,Tigard OR L‘11- l�f ��x ti v) Date/By Permit No.: : I Phone: 503.718.2439 Fax 50 § 1`{ ° Plan Review Other Penult No.: Inspection Line: 503.639.4175 1e,i ."i" ' ).` ` DatelBy: Y- 1 1 c;h.R D Date Ready/By: furls: Si See Page 2 for Internet: www.ttgard-or,gov Notified/Method: Supplemental Information . - TYPE OF WORK I FEE* SCHEDULE .4 New construction ❑Demolition For special information use checklist Description I Qty. 1 Ea. 1 Total 0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) I CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 j C 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 1 ❑Accessory building 0 Multi-family SFR(3)bath 1 500.32 500.32 ❑Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler( sq.ft.) 1 Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address:11959 SW Summerbrook Lane Catch basin or area drain 18.76 City/State/ZIP:Tigard/OR97223 Drytivell,leach line,or trench drain 18.76 Footing drain(no.linear ft.: Page 2 87.55 Suite/bldgfapt.no.: Project name:Summerbrook Manufactured home utilities 50.03 Cross street/directions to job site:SW 121"Ave and SW Summerbrook Lane Manholes 18.76 Rain drain connector 18.76 j Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision:Summerbrook Lot no.:04 Fixture or item: Tax map/parcel no.: Backflow preventer 1 31.27 31.27 I DESCRIPTION OF WORK Backwater valve 12.51 New Single Family Home 2781 sqft 4 bedroom,3 bath with 674 sqft 4 car garage Clothes washer 1 25.02 25.02 Dishwasher 1 25.02 25.02 Drinking fountain 25.02 Ejectors/sump 1 25.02 181 PROPERTY OWNER 0 TENANT Expansion tank 12.51 Name:Weekley Homes LLC Fixture/sewer cap 25.02 Address:1111 N.Post Oak Road Floor drain/floor sink/hub 25.02 Garbage disposal 1 25.02 25.02 City/State/ZIP:Houston TX 77055 Hose bib 2 25.02 50.04 Phone:(503)213.4415 ! Fax:( ) Ice maker 1 12.51 12.51 ® APPLICANT 121 CONTACT PERSON Interceptor/grease trap 25.02 Business name:David Weekley Homes Medical gas(value:$ ) Page 2 Contact name:Michele Schiedler Primer 12.51 Roof drain(commercial) 12.51 Address:1905 NW 169th Place,Suite 102 Sink/basin/lavatory 4 25.02 100.08 City/State/ZIP:Beaverton/OR/97006 Solar units(potable water) 62.54 Phone:(503)213-4415 I Fax::( ) Tub/shower/shower pan 2 I 12.51 25.02 _ -._ UnnaI ..-,. .___ .. . 25.02 E-mail:mschedkrgdwhoroes.com CONTRACTOR Water closet 2 25.02 75.06 Water heater 1 37,52 37.52 Business name:Malmedal Plumbing Water pipingDWV 56.29 Address:PO Box 207 Other: 25.02 City/State/ZIP:Banks/OR/97106 Subtotal Phone:(503)324-0759 Fax:( ) Minimum permit fee: $72.50 f •CCB Lic.:102535 /� --) I Plumbing Lic.no.:34-276PB Plan review (25%ofpermit fee) 1 State surcharge(12%of permit fee) Authorized signature: 1�.✓� TOTAL PERMIT FEE Print name:Cl. .bYil t<t� tk*--- M 6 Date: ty (� Thin permit application expiresif a pmit1a nottained withto ISO days 11 after it bas been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1:tBuilding\PertnitsiPLMU-PermitApp.doc 10/01109 940-4616T(10,1021Co.WWEB) City of Tigard a COMMUNITY DEVELOPMENT DEPARTMENT likig T l a lz o Building Permit Review — Residential Building Permit #: m S % p-0/ -- QD2`14 Site Address: i i q Sq S INf 6i1. e,r-bv--rs Lt _ Project Name: JrArvv br,k Lot #: (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review ( q �j Pr osal: U S�g. : e t J 78(9i lla Verify address/suite#active in Accela. V In River Terrace: No ❑ Yes,River Terrace Review Addendum Site lan Elements: [Gat sion Control copies of site plan on 8-1/2"x 11"or 11 x 17"paper L��, p aired trees with drip line and tree protection measures yawn to scale(standard architect or engineer scale) E 'F tprint of new structure(including decks)and FFE rth arrow 'ty locations&easements(required for new and additions) LAS address,project or subdivision name and lot number idewalk/driveway approach L plicant information(name and phone number) ation of wells/septic systems lot dimensions and building setback dimensions d.t -et tree size,type and location �are footage of buildings to be demolished reet names ',Lld,[E�xisting structures on site Ii orner elevations(2'contours if more than 4'diffe tial) I` of area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? lir es�ENo impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑4ANo Ly' Clean Water Services-Service Provider Letter of platted prior to 9/10/1995): R ed: ❑ Yes,applicant was notified L'7 No Received: ❑ Yes ❑ No Public Faciliti mprovement (PFI) Permit: Required: V Yes,applicant was notified ❑ Nod App_lie For: ❑ (Yes ❑ No,stop intake �LCA and Use Case#: �-l1'� 11-° lj "' �l -�� 1 �` Zoning: 1 "J equired Setbacks: Front: 2-0 Rear: 1.b Side: S Street Side: `S Garage: ZO Building Height: Max.Height: S 0 Actual Height: ?Z Wr Landscape A�r a: % tiNi Lot Coverage Max: Entrance [Vt back no more than 8'from street-facing wall lid" Parallel to street or offset 45 degrees or less Windows um 12%of area of all street-facing facades 11,5 4 1�/` Garage at Garage door is behind widest street-facing wall V Yes ❑ 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�wallind there is a 12 sq ft.window above garage on 2nd floor. [ Garage door width is ❑ 12'or less 50%or less of facade ❑ 60%or less and includes 7 of following: ❑ Covered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset LJ Fire shingles -®—Q ZapSc t�ng-17- oR�ol'p chi _Gaffe;dip;ok"gam rrre of Do r — iVisual ❑ Accent siding Window trim ❑ Window recess ❑ Window projection ❑ Balcony Clearance II Urban Forestry pan [Diansitive Lands: ❑ YesIJd No Type: LTJ'Conditions mel priorto issuance of builclin permit No s: �i +-..u� ,p y� ,.j 1 +s�SVO.tw L Approved By Planning: _ Date: 7-IC-(if Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw_RES_022819.docx Building Permit Submittal Original Submittal Date: 77(c 7(7 Site Plans: # Building Plans: # Building Permit#: \'- nter buildingermit#above. Workflow Routing: r�'lanning [ngineering Permit Coordinator Building Workflow Sign-off: Sign-off for Planning(include notes from planning review) Route Application Documents: Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. Building: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: / I By Permit Technician: _ Date: Engineering Review L Slope at building pad: 14 Conditions "Met"prior to issuance of building permit ❑ Easements (encroachments)per engineering conditions of approval and plat Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes No Assess Water Quantity Fee in-lieu: ❑ Yes [No �/ LIDA Facility on lot: CI Yes lfr o LJ Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: C Approved by Engineering: Date: &.5"-- Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: Re ' 'on Notice 3: Date Sent to Applicant: // C Fees Entered: Wash Co Trans Dev Tax: LYYes ❑ N/A Tigard Trans SDC: C�� CI N/A Parks SDC: IWYes ❑ N/A LIDA ❑ Yes 2'N/A I <OK to Issue Permit Approved by Permit Coordinator: %e Date: 2 V) I I:\Building\Forms\B1dgPermitRvw_RES_022819.docx