Permit (222) CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENTill
Permit#: MST2019 00295
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/08/2019
I Parcel: 1 S 1348 D 12900
MJurisdiction: Tigard
Site address: 11954 SW SUMMERBROOK LN _,
Subdivision: SUMMERBROOK SUBDIVISION Lot: 12
Project: Summerbrook, Lot 12
Project Description: New SF. 8/29/19: REPRINT to Change separate tub and shower to large shower. 9/18/2019:
REPRINT to add backflow device. 10/21/19: REPRINTED to add A/C.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 5 First: 2421 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 17 Bathrooms: 3 Second: 0 sf Garage: 594 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2421 sf Value: $330,533.49 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: 3 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
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 2421
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: $33,925.51
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtai a eepy of the rules or direct questions to OUNC by callin 5 8.232.1987 or 1.800.332.2344.
Issued By :----"°77,-:-.,-*-"1-.---/ !'� �-- Permittee Signature: ,,( !V-' )`/zy/,//
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received y
Date/By: Permit No.:,Ki 57::...,-.4)-- J `f 7:6:;(9,)....-
11 13125 SW Hall Blvd.,Tigard,OR 97223 fi Plan Review
Phone: 503.718.2439 Fax: 503.598.196 ' Date/By: Other Permit:
TI G A R D Inspection Line: 503.639.4175
IVE Read/B
Internet: www.tigard-or.gov Ready
/By:
S Anis: See Page 2 for
I
OCTSupplemental Information
TYPE OF WO t r° Print name:Hannah Scharer
t )
®New construction 0 Addition/alteration/replaNG0 � � COMMERCIAL FEE* SCHEDULE -USE CHECKLIST
0 Demolition 0 Other: Mechanical permit fees*are based on the value of the work
performed.Indicate the value(rounded to the nearest dollar)of all
CATEGORY OF CONSTRUCT iw
, mechanical materials,equipment,labor,overhead,and profit.
OM
® 1-and 2-family dwelling ❑Commercial/industrial ggligif Value:$
0 Multi-family 0 Master builder • Other: RESIDENTIAL EQUIPMENT I SYSTEMS FEES*
For special information use checklist.
JOB SITE INFORMATION AND LOCATION
Description p Qty. Ea. Total
Job site address:11954 SW Summerbrook Ln Heating/cooling:
City/State/ZIP:Tigard/OR/97223 Air conditioning 1 46.75 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 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.:12 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-2421 sqft,4 bedroom 3 bath home with Gas fireplace/insert 33.39
594 sqft 3 car garage Flue vent for water heater or gas
AAAAAAfireplace 23.32
/(C Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
® PROPERTY OWNER 0 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 _ 33.39
Clothes dryer exhaust 33.39
Phone:(503)213-4415 Fax:( ) Single-duct exhaust(bathrooms,
® APPLICANT ® CONTACT PERSON toilet compartments,utility rooms) 23.32
Attic/crawlspace 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/ZIP:Beaverton/OR/97006 Gas heat pump
Phone:(503)213-4415 Fax::( ) Wall/suspended/unit heater
Water heater
E-mail:mschiedler@dwhomes.com Fireplace
CONTRACTOR' Range
Barbecue
Business name:David Weekley Homes
Clothes dryer(gas)
Address:1905 NW 169'Place Suite 102 Other:
City/State/ZIP:Beaverton/OR/97006 MECHANICAL PERMIT FEES*
Subtotal
Phone:(503)213-4415 Fax:( ) Minimum permit fee($90.00)
CCB lie.:213653 Plan review(25%of permit fee)
State surcharge(12%of permit fee)
AUt11
do
oi1Ze ` TOTAL PERMIT FEE '7,-,„ :�.:n,
�dS�tgy/n/attire: E� This permit application expires if a permit is not obtained within 180
1lar r 1 C days after it has been accepted as complete.
1 ail -,!reI
I:\Building\Permits\MEC_PermitApp_040113.do / /r 440-4617T(11/02/COM/WEB)
CITY OF TIGARD MASTER PERMIT
..„11.W1. ' COMMUNITY DEVELOPMENT , ''. Permit#: MST2019-00295
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ;. S Date Issued: 08/08/2019
T€ li O. \ Parcel: 1S134BD12900
Jurisdiction: Tigard
Site address: 11954 SW SUMMERBROOK LN
Subdivision: SUMMERBROOK SUBDIVISION Lot: 12
Project: Summerbrook, Lot 12
Project Description: New SF. 8/29/19: REPRINT to Change separate tub and shower to large shower. 9/18/2019:
REPRINT to add backflow device.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 5 First: 2421 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 17 Bathrooms: 3 Second: 0 sf Garage: 594 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2421 sf Value: $330,533.49 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: 3 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
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Y
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2421
Owner: Contractor:
WEEKLEY HOMES LLC WEEKLEY HOMES Required Items and Reports(Conditions)
tsps NW 1e9Tt-1 Pt.STE 102 WS NW MTI PLACE SUIT-E142 1 Ersn Cntrl 503-639-4175
BEAVERTON,OR 97006 BEAVERTON,OR 97006
PHONE: 503-213-4415 PHONE: 503-213-4415
FAX:
Total Fees: $33,772.35
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: _As._ Permittee Signature: cJ CI V\C- '
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
• , I
Plumbing Permit Application
Building Fixtures FOR OFFICE USE ONLY
, Received r-, /-, �y Ci.. y�� p�--
Clt) of Tigard o i E Date/By: ` v - 1` \ Permit No.c c\�� 1.�� V0a '1 C
1 111 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review J
• 3 Phone: 503.718.2439 Fax: 503.598.1960 Other Permit No.:
Date/By:
T 1 G A R D Inspection Line: 503.639.417$ Date Ready/By: pais: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK. FEE* SCHEDULE
®New construction
0 Demolition For special infantation use checklist.
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
"CATEGORY OF CONSTRUCTIONSFR(1)bath 312.70
ell y,F SFR(2)bath 437.78
® 1-and 2-family dwelling ❑Commercial/ ; ,- t ..: . ,
❑Accessory building 0 Multi-family G\\ThleP
'
\o, SFR(3)bath 500.32
%
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION . _ Site utilities:
Job site address: 11954 SW Summerbrook Lane Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97223 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name:Summerbrook Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
SW 1210 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 i Lot no.: 12 Fixture or item:
Tax map/parcel no.: Backflow preventer 1 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Irrigation and backflow for lot 12 landscaping
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
El PROPERTY OWNER 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 169"'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
0 APPLICANT r ® CONTACT PERSON Interceptor/grease trap 25.02
Business name: David Weekley Homes Medical gas(value:$ ) Paget
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
lone:. '718=x!'731 .�` __.. , _ ,:( 1 -- E _ -44-54--.. � _:
E-mail:hscharer@dwhomes.com Urinal 25.02
'. ,; CONTRsACTORWater closet 25.02
` N
'i Water heater 37.52
Business name:Gro Outdoor Living Water piping/DWV 56.29
Address:5800 NE 88'Street Other: 25.02
City/State/ZIP:Vancouver,WA Subtotal
Phone:(360)727-5974 Fax:( ) Scar Minimum permit fee: $72.50
�"�� Plan review (25%of permit fee)
CCB Lie.:193268 Plumbing Lie.no.: otsas,
State surcharge(12%of permit fee)
Authorized signature: ,� �,.�"' l l letTOTAL PERMIT FEE
�/
Print name: gr v Date:�Sgel 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'Pei mils\PLMU-PernotApp.doc Itl/01/09 440-4616T(I 0;02/CONI/WEB)
ti
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Sup ression Systems:
dj ' ,m•''ll'AMO'�R' >,st:KO r,�',r )01 gu • '-. '-le 9) " h.011'141 A " a.. `,4°"a s'n..e �,w tt hee a i'�lrc'
,o,,,,,,-SIEE tllib s .4+s. i i '1 , , •i;A ,,..A ,,.. ,t „ ,.° �, ql ,., M [ g,� �, s 4 off, a
tngd " " 0 to 2,000 $121,90
Footing drain- l 100' 50.03
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 n s}rt1 t e b�Tle1 s Of W i it rRO i6.';''".'44..
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
fitir, I t "' W r�Fee(ea)'`' ,Total each additional$100.00 or fraction thereof,to
t�llI I1 .pCtlSo)1�F# e�e � raa g ?P� and including$.1.0,000.00.
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 a 1diti,ivtl$100.00 or frartion 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
each additional$100.00 or fraction thereof.
(minimum charge-1/2 hour)
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
} e increased sewer fees* . c� w.4 �r_rra�t
accurately report fixtures could result in {�
t, , g i ri v Quantity by Fixture Type d p), n.0 0 170,, ,U111 1nstallabons., ' +
Fixtur Typnr� {s i ` r1 SPI"`�, Plan review is required for any of the following.
Work PTme torte Ueifoedi =. ,r, ;Capped Added Relocate
Please check all that apply.
Baptistry/Font ❑ Any new commercial building with water service 2"and
Bath -Tub/Shower greater,except systems designed and stamped by licensed
-Jacuzzi/Whirlpool engineer.
Car Wash -Each Stall
Ea he Ta ❑ro 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.
-3" f 4 b x4�, ,,,,,Mn•x 11� rito�r g'
4„ ,r, ,,r".i.: i,3",6¢,. ,�, £ ,,t._. . ?s,.i<,agra trtA h: , ;
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
F _y. =titch trtat- 'retated --_-
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 fees assessed for the sewer increase must be paid before the
Water Closet-Toilet
Urinalplumbing permit can be issued.
Other Fixtures:
C:\Users\hbrecken\Downloads\PLMF PermitApp(1).doc 2
CITY OF TIGARD ,c p MASTER PERMIT
1 ' ' ''Y�'� ��
COMMUNITY DEVELOPMENT ��IJ� Permit#: MST2019-00295
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/08/2019
T I c;+1 R.D9 Parcel: 1S134BD12900
Jurisdiction: Tigard
Site address: 11954 SW SUMMERBROOK LN
Subdivision: SUMMERBROOK SUBDIVISION Lot: 12
Project: Summerbrook, Lot 12
Project Description: New SF. 8/29/19: REPRINT to Change separate tub and shower to large shower.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 5 First: 2421 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 17 Bathrooms: 3 Second: 0 sf Garage: 594 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2421 sf Value: $330,533.49 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: 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
Drywell-Trench Drain: 0 Other Fixtures: 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
asin
Other: N Other Description: Ecom P g: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2421
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 Cntti 503-639-4175
BEAVERTON,OR 97006 BEAVERTON,OR 97006
PHONE: 503-213-4415 PHONE: 503-213-4415
FAX:
Total Fees: $33,737.33
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 9 -001-0090. You may obtain a copy of the rules o, •irect questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
' �Zt //
Issued By: ....!//Air /.� /.��i.�� l/ '� Permittee Signature: G�'��� Cl
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
1 . ' COMMUNITY DEVELOPMENT Permit#: MST2019-00295
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/08/2019
T!�-A!iI 9 Parcel: 1S134BD12900
Jurisdiction: Tigard
Site address: 11954 SW SUMMERBROOK LN
Subdivision: SUMMERBROOK SUBDIVISION Lot: 12
Project: Summerbrook, Lot 12
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 5 First: 2421 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 17 Bathrooms: 3 Second: 0 sf Garage: 594 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2421 sf Value: $330,533.49 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'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
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 2421
Owner: Contractor:
WEEKLEY HOMES LLC WEEKLEY HOMES Required Items and Reports(Conditions)
1905 NW 169TH PL STE 102 1905 NW 169TH PLACE SUITE 102 rsri
BEAVERTON,OR 97006 BEAVERTON,OR 97006
PHONE: 503-213-4415 PHONE: 503-213-4415
FAX:
Total Fees: $33,692.33
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 la requires you o follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 9 I' -0090. You m. obtain a co;�9 of the rul'r direct questions to OUNC by calling 503. 2.198 or 1.800.332.2344.
h / /y /yam
Issued By: i/o /4 / Permittee Signature: GG� 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.
Builcl�irlg Permit Application - : '. F
Residential JUL 1 6 2019 FOR OFFICE USE ONLY
Cityof Tigard �, Received
�� -)t., 1"•t,, Date/B7 y:
SW Hall Blvd.,Tigard,OR 97223 r 2,,,*."
a �'. l9 'er t 5 tA0/?—/y�� 2)G�
: = ;I (- '+5"".3,r}'y 0t lanReview ''7 2 A , t P C/ [ii�1►`'57
Phone: 50 3.718.24 39 Fax: 503.598.19431.,”L' r E i nate;'By: I �/b
T 1(,A R D Inspection Line: 503.639.4175 Date Ready/By: ., tons: la See Page 2 for
Internet: www.tigard-or.gov Notified/Metho : i Supplemental Information
.4111
TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING
.:. Fps ;,• _..�. .
®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 fohe
CATEGORY OF CONSTRUCTION �'�,�,�
work indicated on this application. �•�C2y T'•�
►/ 1-and 2-familydwellingCommercial/industrial
�avuu
0 Commercial/industrial
❑Accessory building ElMulti-familyNumber of bedrooms: \Ls
❑Master builder 0 Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors: 1 7j0 IS
Job site address:11954 SW Summerbrook Ln New dwelling area: 2421 square feet
City/State/ZIP:Tigard/OR/97223 Garage/carport area: 594 square feet
Suite/bldg./apt.no.: Project name:Summerbrook Covered porch area: 110 square feet
Cross street/directions to job site:SW 1210 Ave and SW Summerbrook Lane Deck area: square feet
Other structure area: 145 square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:Summerbrook 1 Lot no.:12 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
{... ` work indicated on this application.
OF WORK
$
New Single Family Home to be built-2421 SQFT 4 Bedroom,3 bath with 594 SQ Valuation:
FT 3 car garage, Existing building area: square feet
New building area: square feet
'4
® PROPERTY OWNER
❑.TENANT, 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:
❑ APPLICANT ;,ig CONTACT PERSOIq BUILDING'PERM qES*
Business name:David Weekley Homes (Pteaser¢lerm jeesrlle e
Structural plan review fee(or deposit):
Contact name:Michele Schiedler
FLS plan review fee(if applicable):
Address: 1905 NW 169"'Place,Suite 102
Total fees due upon application:
City/State/ZIP:Beaverton/OR/97006
_.. __...__ _.___---Auluunt leceivcd.--l - -.._.. __._.–.__
Phone:(503)213-4415 Fax::( )
' OTOVOLTAIC' OLAR P al TEM FEES*1
E-mail:mschiedler@dwhomes.com �
-r 44 . cf, Commercial and residential prescriptive installation of
- 4_: c ,T €R .4., ,,, ; . , ; ., :liz,: 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 16' ' 'lace,Suite 102 Solar Installation Specialty Code checklist.
Permit Fee(includes plan review
City/State/ZIP:Beave ton/I ' 97006 $180.00
and administrative fees):
Phone:(503)213-441, I Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:213653
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Michele S hiedle Date:7/16/19 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Pennits\BUP-• .-'ermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
BuildinoPermit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLY
City of Tigard Received
Permit No.:
Date B
II
SW Hall Blvd.,Tigard,OR 97223 Associated permits:
Phone: 503.718.24 39 Fax: 50 3.598.1960
24-Hour Inspection Line: 503.639.4175 El Electrical ® Plumbing ® Mechanical
TIGARD
Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes NO N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ® 0 0
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ® ❑ ❑
3 Verification of approved plat/lot. ® ❑ 0
4 Fire district approval required. Name of district: ❑ 0 ❑
5 Septic system permit or authorization for remodel. Existing system capacity . ❑ 0 ❑
6 Sewer permit. 0 ❑ 0
7 Water district approval. 0 ❑ 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. /1 ❑ ❑
9 Erosion control ®plan 0 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 ® ❑ ❑
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 Z ❑ 0
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 ® ❑ ❑
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- ►1 ❑ ❑
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. Z ❑ ❑
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 Z ❑ ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 ❑
El
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 Z ❑ ❑
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 ® ❑ ❑
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 ® ❑ ❑
architect licensed in Oreton and shall be shown to be a''licable to the .ro'ect unae -v'•
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. ® ❑ ❑
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ® p ❑
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. ® ❑ ❑
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard i1 ❑ p
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, ❑ ❑
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-RESPernitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Application FOR OFFICE USE ONLY
CityOf Tigard Received
ilil ill g Date,'B
Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 y
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 i U L 1 6 201 Date By: Other Permit:
T I G A R D Inspection Line: 50.3.639.4175 Date Ready By: Juris: I ® See Page 2 for
Internet: www.tigard-or.gov t 8i r'4 Notitied Method: Supplemental Information
TYPE OF WORK Print name:Ken Puttman
®New construction 0 Addition/alteration/replacement CO1t2MERCIAL FEE* SCIHEDLJL; -41'TTS CKLIST
❑ Demolition 0 Other: Mechanical permit fees*are based on the value of the work
pertbnned.Indicate the value(rounded to the nearest dollar)of all
CATEGORY OF CONSTRUCTION mechanical materials,equipment,labor,overhead,and profit.
►� I-and 2-family dwelling ❑Commercial/industrial ElAccessory building Value:$
❑Multi-family ❑ Master builder 0 Other: RESIDENTIAL EQUIPMENT i SYSTEMS FEES*
For special information use checklist.
JOB SITE INFORMATION AND LOCATION Description Qty. Ea. Total
l._..-
Job site address: 11954 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.:12 Flue/vent for any of above 23.32
Tax map/parcel no.:TBD Other: 23.32
DESCRIPTION OF WORK - Other fuel appliances:
Water heater I 23.32
New single family home to be built-2421 sqft,4 bedroom 3 bath home with Gas fireplace/insert 1 33.39
...........
594 sqft 3 car garage Flue vent for water heater or gas
fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
'® PROPERTY OWNER ❑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,
` ..AED-APPLICANT ',- ® OIS�TACT PERSON
toilet compartments,utility rooms) 3 23.32
Attic/crawlspace fans 23.32
Business name:David Weekley Homes Other: 23.32
Contact name:Michele Schiedler Fuel piping:
Address:1905 NW 169t1 Place,Suite 102 $14.15 for first four;$4.03 for each additional
Furnace,etc.
Wall/suspended/unit heater
Phone:(503)213-4415 Fax::( )
Water heater
E-mail:mschiedler@dwhomes.com Fireplace
,I:'„!'-' I ' CONTRACTOR', k Range
Barbecue
Business name:David Weekley Homes Clothes dryer(gas)
Address:1905 NW 169'Place Suite 102 Other:
City/State/ZIP:Beaverton/OR/97006 7,z, - 'MECHANIC r IiltMlTFL,
Subtotal
Phone:(503)213-4415 Fax:( ) Minimum permit fee($90.00)
CCB lie.: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.
I:1Building1PermitsWEC_PermitApp_040113.doc 440-4617T(11,02,COM/WEB)
4.
Electrical Permit ApplicationJUL ���9
FOR OFFICE USE ONLY.
City of Tigard Received
Date/By: Permit#
• 13125 SW Hall Blvd.,Tigard,OR 972 t 4 L)_ I t ti'-s Plan Review
Mil
Phone: 503.718.2439 Fax: 503.5 (:t t ? %�t s %j Date/By: Related Permit#:
Inspection Line: 503.639.4175 Ready Date/By: Juris: I li, See Page 2 for
TIGARD Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE'O1+ WORK . ... .': •? ; . PLAN^Rtvit,W .,
el New construction 0 Addition/alteration/replacement Please check all that apply(submit I sets of plans w/items checked):
['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.
® I-and 2-family dwelling 0 Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION'AND',1i:OCATION-,: . 0 Emergency system. larger separately derived
0 Addition of new motor load of system.
Job 4:68020012 1 Job site address: 11954 SW Summerbrook Lane l0oHP or more. ❑"A"."E", 'l-2", 1-3
❑Six or more residential units. occupancy.
City/State/ZIP:Tigard/OR/97223
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: ( Project name:Sum merbrook 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;SCIIEDULE
Description I Qty. f Each I Total I •
New residential single-or multi-family dwelling unit.
Subdivision:Summerbrook Lot 4: 12 Includes attached garage.
1,000 sq.ft.or less 1 168.54 168.54 4
Fax map/parcel#:TBD Ea.add'I 500 sq.ft.or portion 3 33.92 107.76 1
DESCRIPTION OF'WORK . Limited energy,residential
(with above sq.ft.) 75.00 2
New single family home to be build-2421 sqft,4 bedroom 3 bath home with
Limited energy,multi-family 75.00 2
594 sqft 3 car garage
residential(with above sq ft
.
)
Renewable Energy 0 See Page 2
® PROPERTY OWNER I a'.❑.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 I 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 I
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
® APPLICANTBranch circuits—new,alteration,or extension, ter panel
® CONTACT,PERSON A.Fee for 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
service or fu
Address: 1905 NW 169th Place Suite 102 branch circuit 56.18 2
fee,first
City/State/ZIP:Beaverton/OR/97006 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)213-4415 Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Entail:msehiedler@dwhomes.com Reconnect only 67.84 2
''CONTRACTOR:: , •;•,': Pump or irrigation circle 67.84 2
_ - . _l ►Sifie S frtg._CarogrElectric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy 0 See Page 2 2
Address:2920 SE Brookwood Ave. panel,alteration,or extension.
City/State/ZIP: Hillsboro,OR 97123 Each additional inspection over allowable in any of the above
Additional inspection(1 hr mm) 66.25/hr
Phone:(503)648-4552 Fax:(503)642-7925 Investigation(1 hr min) 90.00/hr
Email:permits@garnerelectric.com Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lie.: 121159 Electrical Lic.: 34-3 Sup• .Lie.: 3707S speci icaly listed(Y:hrmin)
'ELECTRICAL :PERIVIit*EES
Suprv.Electrician signature,required: / Subtotal:
Print name: Charles ,t
Authorized signatur i 0 yaP ate: 7/16/2019 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
.ip
,� _ TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Andrea ' 'hips Date: 7/16/2019 days after it has been accepted as complete.
Number of inspections allowed per permit.
1\Building\Permits\ELC_PermitApg_ELR_ERE doe Rev 06/17/2015 440'4615T(I I/05/COMM1VEB
PlumbinE Permit Application a`'"
Building Fixtures IOR 01 11( I• I S1. O\1.4
JUL 1 6 21ivedCiof Tigard
Permit No.:Datn,ly:
■ 13125 SW Hall Blvd.,Tigard,OR 97223
r r ;
J P
iae* evicv
III
Phone: 503.718.2439 Fax: 503.5981960., l . _�y Other Permit*o.:
Inspection Line: 503.639.4175 -'* EIJ 1, � t € i 'y� di3y: lwis: iid See
Page Z for il,\ItI)
Internet: www.tigard-or.gov Notified/method: Supplemental information
I _ .. . .. TYPE OF WORK I FEE* SCHEDULE. .
• ®New construction ❑Demolition I� For special information use checklist •
I Description I Qty. I Ea. I Total
0 Addition'alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
® 1-and 2-family dwelling ❑Commercial/industrial
SFR(2)bath 437.78
0 Accessory buildingSFR(3)bath 1 500.32 500.32
0 Multi-family
Each additional bath/kitchen i 25.02
O Master builder 0 Other: Fire sprinkler( ,sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:11954 SW Summerbrook Lane Catch basin or area drain 18.76
i
Drywell,leach line,or trench drain 18.76
City/State/ZiP:Tigard/OR/97223
Footing drain(no.linear ft.:230) Page 2 87.55
Suite/bldg./apt.no.: Project name:Summerbrook
Manufactured home utilities [ 50.03
Cross street/directions to job site:SW 12V'Ave and SW Summerbrook Lane Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: Page 2
Storm sewer(no.linear ft: 1 Page 2
Water service(no.linear ft.: ) Page 2
Subdivision:Summerbrook Lot no.:12 Fixture or item:
Tax map/parcel no.: Backflow preventer 1 31.27 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 1 25.02 25.02
New Single Family Home 2421 sqft 4 bedroom,3 bath with 594 sqft 3 car garage Dishwasher 1 25.02 25.02
Drinking fountain 25.02
1 Ejectors/sump 25.02
® PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name:Weekley Homes LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:1111 N Post Oak Road f Garbage disposal 1 25.02 25.02 I
City/State/ZIP:Houston TX 77055 Hose bib 2 25.02 50.04
Phone:(503)213-4415 Fax:( ) I Ice maker 1 12.51 12.51 I
® APPLICANT ll 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 I Sink/basin/lavatory 4 25.02 100.08
City/State/ZIP:Beaverton/OR/97006 I Solar units(potable water) 62.54
Phone:(503)213-4415 Fax::( ) ' Tub/showerishower pan 2 12.51 25.02
E-mail:mschiedler@dwhomes.com UrineT 33.62
CONTRACTOR Water closet 2 25.02 75.06
Water heater 1 37.52 37.52
Business name:Malmedal Plumbing Water piping/DWV 56.29
Address:PO Box 207I Other: 25.02
i
City/State/ZIP:Banks/OR/97106 Subtotal
Phone:(503)324-0759 I Fax:( )
Minimum permit fee: $72.50
CCB Lie.:102535 Plumbing Lie,no.:34-276PB
Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: C TOTAL PERMIT FF.E
Print name: Ca.f(I U�'7ci a. livetti Date: 411i, This permit application espires if a permit is not obtained withia 180 days
after it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board.
I'LBuilding'PermisaPLS3L'-PermitApp.doc JO/OJI09 410.4616T(10/02/COM/WEB)
City of Tigard
II ■ ~ COMMUNITY DEVELOPMENT DEPARTMENT
T 1 G R D Building Permit Review — Residential
Building Permit #: 44$7 .2Q/ _ OJ 'j,c—
Site Address: 1t'Si 51,,/ ,),,,.,,,-,6,-y3L L,.t
Project Name: �J� U r Lot #: I 2
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review r +
Proy6sal:� IVtt, SFS, , V 1 __�1" 7 g 12 A-
LP'Verify address/suite#active in Accela. Nd In River Terrace: No ❑ Yes,River Terrace Review Addendum
SityPlan Elements: VC'.n Control
3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper G • ained trees with drip line and tree protection measures
riawn to scale(standard architect or engineer scale) I�tprint of new structure(including decks)and FFE
Willyr arrow locations&easements(required for new and additions)
. address,project or subdivision name and lot number Lam`dewalk/driveway approach
[Cl( .plicant information(name and phone number) r .• ation of wells/septic systems
IF •t dimensions and building setback dimensions ayeet tree size,type and location
(Ware are footage of buildings to be demolished Zykret names
Existing structures on site L`Jtomer elevations(2'contours if more than 4'dif�fere al)
Vapt area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? L' es ❑No
imperviousmparea(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑ No
E 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
r./Public Facili�t�i mprovement(PFI)Permit:
equired: M Yes,applicant was notified ❑ No Applie For: ❑ Yes ❑ No,stop intake
nd Use Case#: Off n � 1)
W C My �1�O0 l LW Zoning. vis
�(
quired Setbacks: Front: W Rear: 1 Side: S Street Side: .c Garage: 2i
Lid" Building Height: Max. Height: 3 0 Actual Height: t,g
U Landsca e a: % -Lot CoverageM�ax�
Entrance pt OQ back no more than 8'from street-facing wall Parallel to street or offset 45 degrees or less
Windows [C i i mum 12%of area of all street-facing facades 177.
Garage [� Gara oor is behind widest street-facing wall ❑ Yeso,one of the following is met:
Door extends no more than 5'from wall and there is a covered porch extending beyond garage.doe-
---..,Door extends no more than 5'from wa nd there is a 12 sq ft.window above garage on 2nd floor.
[ Garagedooris12' 50% 0
width ❑ or less Ifd or less of facade ❑ 60/o or less and includes 7 of following:
❑ Covered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset
Fire shingles -❑ tap Siding 1 Ro iffdl -D—Gable,hip,or gam1rfrooT a Dormer
❑ Accent siding • Window trim ❑ Window recess ❑ Window projection ❑ Balcony
isual Clearance f1 Urban Forestry Plan
1! Sensitive Lands: MI Yes [ No Type:
fili0 Conditions met prior to issuance o buildin permit �y" 1.-63/4
y ( i, j } 6
of : Cne10 -S r r t tl- I rA-- fitly- s✓��-, 1 01,, 1L7 C1Y4 > 'RAJ- '1 t Tiu 3 1 k k
L�' Approved By Planning: �i Date: .7-)6- �9 ti- 64
Revisions (after Building Submittal only) Reviewer Date
GA,Revision 1: ❑ Approved ❑ Not Approved L'�
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPennitRvw_RES_022819.docx
Building Permit Submittal
Original Submittal Date: 7 7(? 7/,
Site Plans: #
Building Plans: #
Building Permit#: nter buildingermit#above.
Workflow Routing: lanning engineering >ermit Coordinator �/�Building
Workflow Sign-off: ign-off for Planning(include notesTrom planning review)
Route Application Documents: Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
C�'Building: original permit application, site plans,building plans,engineer and
f beam calculations and trust details,if applicable, etc.
Notes: /
/ _._ j
By Permit Technician: 44 Date: 7//) /7
1
/
Engineering Review
elope at building pad: �ig
Conditions"Met"prior to issuance of building permit
CI Easements (encroachments)per engineering conditions of approval and plat
2 Water Quality/Quantity Facility: fr/No
Water Quality Fee in-lieu: ❑ Yes I� No
Assess Water Quantity Fee in-lieu: CIYes [6.-.No
,�,/No
/ LIDA Facility on lot: ❑ Yes fes'lNo
t2/Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
----- --------
IYApproved by Engineering: Date: 3p /�`
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:
Revision Notice 3: Date Sent to Applicant:
SDC Fees Entered: Wash Co Trans Dev Tax: ' Yes 0 N/A
Tigard Trans SDC: V( Yes ❑ N/A
Parks SDC: IS Yes ❑ N/A
LIDA ❑ Yes C(N/A
.KOK to Issue Permit
Approved by Permit Coordinator: Q^ Date:
I:\Building\Forms\BldgPermitRvw_RES_022819.docx
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
11954 SW SUMMERBROOK LN, TIGARD, August 27, 2019 at
OR, 97223 9:38:16 AM
Record Type: Record ID:
Residential - Master Permit MST2019-00295
Inspection Type: Inspector:
215 Footing drain Aaron Cillo-Gobel
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor
h.
FOR OFFICE USE ONLY-SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting info r ation.
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 prole, .
114 City of Tigard • COMMUNITY DEVELOPMENT DEPARTME T
Transmittal Letter
I c;,,R n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.24 • • www.tigard-or.gov
TO: I 1 F
A DATE RECEIVED:
DEPT: BUILDING DIVISION
RECEIVED
FROM: �:.f-9 goinna(1 al/Pirie(` AUG 1 9 2019
�' ,�,A CITY OF TIGAR►
COMPANY: DaI/j V ( r i� BUILDING ivisi j),4
PHONE: -( )-7(t.— By:
RE: (Cl15H SVJ , . ' Lae iz(57)-0/,'-06,
(Site Address) (Permit Number)
(Project name or s *n ) d 1,t number)
ATTACHED ARE THE FOLL' th4+ •i `$ EMS: �___ _
Copies: Description: \ \ Copies: Description:
Additional set(s) of pl. s. 3 Revisions:
Cross section(s) and •etails. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculation Engineer's calculations.
Other(explain): //
REMARKS: ,.,y'�,� c; ,�1 � ` b an� 4naciA04 40
Icts_p_,___ --4X-11.6,04---
.' .
Routed to P- • it •.-• ian: Date: 2„DJ ''
a [ ' Initials: ,
Fees Due: 7A '- No Fee Desc ptio : Amount Due:
-014
1/Z ► .-�'� $ y5-"2.---'
$
Special
Instructions:
Reprint Permit(per PE): ❑Yeso ElDone
Applicant Notified: /f,-- 11�
Date: � P A Initials:
I:\Building\Forms\TransmittalLetter-Revisions_061316.doc