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Permit
Cloy CY/ I ! / z0Z0 FOR OFFICE USE ONLY—SITE ADDRESS: b`1 A-Cc? This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT ■ Transmittal Letter I , I, t> 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Agnes Lindor DATE RECEWED: DEPT: BUILDING DIVISION RECEIVED APR 23 2020 FROM: Michele Schiedler CITY OF TIGARD COMPANY: David Weekley Homes BUILDING DIVISION PHONE: 503-349-0291 BY (L /0/9 RE: 10874 SW Teal Crest Place Tigard OR MST2020-00078 (Site Address) (Permit Number) Summerbrook Lot 8 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Wintlow sae cha�grn in Gininw Additional set(s) of plans. X Revisions: e�a�,,,ro wintfow in sway Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: Window size changed in dining room _ -and added two windows to study 71y �) h.- a� IN+i -aS To 1?� oe--7y, h FOR,OFFICE USE ONLY Routed to Pe t Technician: Date: 5- ce Zp20 Initials: Fees Due: Yes ❑No Fee Description: Amount Due: $ 1/2- �J l r.�/'v�-e-ci-3 $ 4S� $ $ Special Instructions: Reprint Permit(per PE): ❑ Yes r►I No ❑ Done Applicant Notified: y- --- Date: P ) Initials: 1:\Building\Fomis\TransmittalLetter-Revisions.doc 05/25/2012 Branden Taggart From: Branden Taggart Sent: Tuesday, October 25, 2022 11:54 AM To: Schiedler, Michele Subject: Summerbrook, Lot 8 Revisions Hi Michele, I hope all is well. I discovered today that we still had window revisions for lot 8 of Summerbrook,which were never picked up. This permit has been closed since 2020, but I was thinking the owner may want to receive these revisions. Please let me know if you would like to pick them up. Thanks, Branden Taggart City of Tigard It. Senior Permit Technician }p A '}F{ry Community Development TEMd a'Y..I Rn.: 13125 SW Hall Blvd Tigard, OR 97223 (5€73)718-2449 brandent@tigard-or.gov 1 City of Tigard III 'I' COMMUNITY DEVELOPMENT DEPARTMENT ■ l i G A K D Building Permit Review — Residential Building Permit #: /�il STO16)-(-- -c1%7/ Site Address: 10 7 y .-C24) l�a l ereg7L ,l Project Name: S t/AI rk }-__ Lot #: e Planning Review g-t-y Pro ,?Q sal: � /.j e-.4 i4i Gt1-- 14L/14-.,lv6e2 &-IL c. Y'erify address/suite# active in Accela. O— River Terra e: Ild No D Yes,River Terrace Review Addendum Sit lan Elements: aydosion Control Iopies of site plan on 8-1/2"x 11"or 11 x 17"paper IZi etained trees with drip line and tree protection measures awn to scale(standard architect or engineer scale) otprint of new structure(including decks)and FFE Pit›orth arrowty locations&easements(required for new and additions) VS,"address,project or subdivision name and lot number 0.1 Sidewalk/driveway approach hd .plicant information(name and phone number) 14' . ation of wells/septic systems Pi .t dimensions and building setback dimensions T eet tree size,type and location t1{••uare footage of buildings to be demolished 6�dS�t names 43' sting structures on site kd"Corner elevations(2'contours if more than 4'diffntial) .140i area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? YJYes ❑I o impervious area(applicable if R-7,R-12,R-25&R-40) If es,is a storm water .uali facili shown? ❑Yes No r IP lean Water Services—Service Provider Lette of platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified No Received: ❑ Yes 0 No \Vater Meter Fixture Unit Worksheet—Add�i s,Remodels and ADUs quired: ❑ Yes,applicant was notified EV1 No Received ❑ Yes ❑ No ^ DC Exemption for ADU applied for. ❑ Yes 6d No Received: ❑ Yes ❑ No Public Facih'ti$Improvement (PH) Permit: quired: Yes,applicant was notified 0 o peed For: p Yes 0 No,stop intake ��''nd Use Case#: CUPPUI9-— ( ("C) - 14 i — VZoning: de —�, ")equired Setbacks: Front: -2O Rear /s_ Street Side: (7/1 —• Garage: 2O l.Q Building Height: Max. Height: .(7 Actual Height t.,2z/, S— I andscape rea: % lArrOt Coverage �Maxx % Entrance $fit back no more than B'from street-facing wall I 1 Parallel to street or offset 45 degrees or less Windows �"/„gnimum 12%of area of all street-facing facades Garage V Garage door is behind widest street-facing wall 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 w and there is a 12 sq ft.window above garage on 2nd floor. Garage door width is 0 12'or less dd 50%or less of facade ❑ 60%or less and includes 7 of following: ❑ Covered porch 0 Recessed entrance ❑ Wall offset 0 1'Roof cave 0 Roof offset ❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof 0 Dormcr ❑ Accent siding Window trim ❑ Window recess 0 Window projection 0 Balcony \ isual Clearance 12 Urban Forestryan VI'e.ensitive Lands: El Yes Forestry No Type: Ti Co ditions met prior to issuance of building permit No s• 2 Approved By Planning: — _ Date: chi/Q- -2---1) Revisions (after Building Submittal only) ‘,/%14_75-ii..i.ct Reviewer �/Date^ v 1 Revision 1: 0 Approved 0 Not Approved (, v� � /1-L., � 2V Revision 2: 0 Approved ❑ Not Approved L•113uilding\fonns\BldgPennitRvw RFS 122419.docz Building Permit Submittal Original Submittal Date: 2 Site Plans: # Building Plans: # Building Permit#: -Er Enter building permit#above. �� Workflow Routing: Planning ,gineering E t'ermit Coordinator ,i71—Suilding Workflow Sign-off: Sign-off for Planning(include notes from planning review) Route Application Documents: AE-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: V W /3.77 By Permit Technician: jae:tA1(:&::4;;;1<s"-------- Date: Engineering Review a di/Slope at building pad: 24 Mr Easements "Met"prior to issuance of building permit M Easements (encroachments) per engineering conditions of approval and plat i,. Ild Water Quality/Quantity Facility f.,0 O A Assess Water Quality Fee in-lieu: ❑ Yes ltrNo Assess Water Quantity Fee in-lieu: ❑ Yes o n 11 �/ LIDA Facility on lot 1: Yes (�(}� (JI! Final Plat Recorded: 0 NOT Approved by Engineering: \� Date: Notes: �V�J Id Approved by Engineering: o Date: _ /2-\/zp Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approv /97 Revision 2: 0 Approved 0 Not Appr9iVed / Permit Coordinator Review r ❑ Conditions "Met"prior to issuance of b 'ding permit O Approved,NOT Released: Date: Notes: Revisions (after Building Sub ittal only) Revision Notice 1: ate Sent to Applicant: Revision Notice 2: , Date Sent to Applicant: 0 SDC Exemption: // 0 Received 0 Does not apply , DC Fees Enter: Wash Co Trans Dec Tax: yes 0 N/A Tigard Trans SDC: es 0 N/A Parks SDC: ]d` Yes ❑ /A LIDA 0 Yes /A Ei OK to Issue Permit Approved by Permit Coordinator. Date: cJ/3) I:\13uilding\Fortes\BidgPermitRvw_RES_I224I 9.docx ili • 44 CITY OF TIGARD b ,y. I MASTER PERMIT I ' COMMUNITY DEVELOPMENT P s 2`' Permit#: MST2020-00078 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: Mar 17 2020 12:00AM TIGARD Parcel: 1S134BD12500 Jurisdiction: Tigard Site address: 10874 SW TEAL CREST PL Subdivision: SUMMERBROOK SUBDIVISION Lot: 8 Project: Summerbrook, Lot 8 Project Description: New SF. 8/5/2020: REPRINT permit to add irrigation backflow. BUILDING Floor Areas Required Setbacks Required • Stories: 2 Bedrooms: 4 First: 1472 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 25 Bathrooms: 4 Second: 1556 sf Garage: 868 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3028 sf Value: $413,106.52 Rear: 15 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 5 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 1 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: 6 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: 6 201-400 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 1000-1-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 3028 Owner: Contractor: WEEKLEY HOMES LLC GARNER ELECTRIC Required Items and Reports(Conditions) 1111 N POST OAK RD 2920 SE BROOKWOOD AVE A 1 Ersn Cntrl 503-639-4175 HOUSTON,TX 77055 HILLSBORO,OR 97123 PHONE: PHONE: 503-648-4552 FAX: 503-642-7925 Total Fees: $39,637.92 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 952-0 090, 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: 4/"Q_lC a Permittee Signature: (,fr✓ 441‘1/3L 1�'�i y?ON/ 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 Applicatiolt�i-�ECE'VED Building Fixtures 1'� V t Ou ut l l( I I ,1 uv I l Cityof Tigard AUG 0 5 2020 Received 2-0 Date/By: �d PermitNo.:M.S77-07j.04007 III i Ia 131 SW Hall Blvd.,Tigard,OR 97223 ,,ITY OF TIGARD Plan Review, I Phone: 503.718.2439 Fax: 503.598.1g(�y�� Other Permit Na Inspection Line: 503.639.4175 id IL�ING DIVISION Data Re I I t:.A I.I 1 Date Ready/By: huffs: ® See Page 2 far Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE-OF WORK .... FEE*..SCHEDULE ®New construction ❑Demolition For special Information use checklist Description 1 Qty. I Ea. I Total ❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) I CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ® I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 1 500.32 500.32 ❑Accessory building ❑Multi-family Each additional bath/kitchen I 25.02 25.0- 1:1 Master builder 0 Other: Fire sprinkler( sq.ft.) ] Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address:10874 SW Teal Crest Place Catch basin or area drain 18,76 Drywell,leach line,or trench drain 18.76 City/State/ZIP;Tigard/ORN7223 Footing drain(no.linear ft.:21QQ) Page 2 87. 5 Suite/bldg./apt.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 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Subdivision:Summerbrook Lot no.:8e. Fixture or item:W ervice(nlrttrtear ft __Z Page 2 `� Tax map/parcel no.: --g ,rp &-CIS 77,vCto / yr Backflow preventer 1 31.27 31.27 DESCRIPTION OF WORK 12.51 Clothes washer 1 25.02 25.Q2 New Single Family Home 3028 sqft 4 bedroom,4 bath with 868 sqft 5 car Dishwasher 1 I 25.02 25. 2 garage. Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER ❑ TENANT Expansion tank 12.51 Name:David Weekley Homes Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:1905 NW 169'a Place Suite 102 Garbage disposal 1 25.02 21.02 City/State/ZIP:Beaverton,OR 97006 Hose bib 2 25.02 50.04 Phone:(503)213-4415 Fax:( ) ice maker 1 12.51 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:Michele Schiedler Roof drain(commercial) 12.51 Address:1905 NW 169th Place,Suite 102 Sink/basin/lavatory 4 25.02 I 08 City/State/ZIP:Beaverton/OR/97006 Solar units(potable water) 62.54 Phone:(503)213-4415 I Fax::( ) Tub/shower/shower pan 2 12.51 2 02 E-mail:mschiedler©dwhomes.com Urinal 25.02 Water closet 2 25.02 7 .06 CONTRACTOR Water heater 1 37.52 3 .52 Business name:Malmedal Plumbing 1 WaterpipinglDWV 56.29 Address:PO Box 207 Other: 25.02 City/State/ZIP:Banks/OR/97106 Subtotal 3/, a-7 Phone:(503)324-0759 Fax:( ) Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lie.:102535 Plumbing Lic.no.:34-276PB State surcharge(12%of permit fee) 3 75" Authorized signature: 11 TOTAL PERMIT FEE 351,o 2 t�-� Print name: f.0 I l/ I LIGLIined.. T G _f Date: I 11)26 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1:\Beilding\PmniteiPL Mli-PermitAPP.doc 10/01/09 440.4616T(10/O2/COMAVEB) . CITY OF TIGARD MASTER PERMIT ' '! Is °n COMMUNITY DEVELOPMENT Permit#: MST2020-00078 Date Issued: 03/17/2020 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S134BD12500 Jurisdiction: Tigard Site address: 10874 SW TEAL CREST PL Subdivision: SUMMERBROOK SUBDIVISION Lot: 8 Project: Summerbrook, Lot 8 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1472 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 25 Bathrooms: 4 Second: 1556 sf Garage: 866 sf Front: 20 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Total: 3028 sf Value: $413,106.52 Rear: 15 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain 0 Storm Sewer: 100 Tubs/Showers: 5 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: 6 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: 6 201-400 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 3028 Owner: Contractor: WEEKLEY HOMES LLC GARNER ELECTRIC Required Items and Reports(Conditions) 1111 N POST OAK RD 2920 SE BROOKWOOD AVE A 1 Ersn Cntrl 503-639-4175 HOUSTON,TX 77055 HILLSBORO,OR 97123 PHONE: PHONE: 503-648-4552 FAX: 503-642-7925 Total Fees: $39,557.90 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may of the rules or direct questions to OUNC by calling 50 32.1987 or 1.800.332.2344. Issued By: ��sy�.v� Pehe next Signature: le in all 503.639.4775 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application Residential RECEIVE � FOR OFFICE USE ONLY iRj eeeived 1 City of Tigard i Date By: 3/4,/ Pennit No.:/7 O Q.,-6.yt7� 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review l .���J�yy� ��������� (/' GtA' ' Phone: 503.718.2439 Fax: 503.598.1960 MAR 2 2020 Date/By: 3� MI jvtjp d 7 TIGARD Inspection Line: 503.639.4175 Date Ready.!By. l See Page 2 Tor Internet: www.tigard-or.gov CITY OF T' A DNotitied Method �L G Supplemental Information BUIW!NG DIVISION TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING M New construction ❑ Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all O Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. I El I-and 2-family dwelling ❑ Commercial/industrial Valuation: ,$;56 B0r y �, OCP ElAccessory building ❑Multi-family Number of bedrooms: 4 O Master builder 0 Other: Number of bathrooms: 4 JOB SITE INFORMATION AND LOCATION Total number of floors: 2 3%9G, Job site address:10874 SW Teal Crest Place New dwelling area: 3028 square feet I ( City/State/ZIP:Tigard/OR/97223 Garage/carport area: ,868 square feet I y 1`O� �Suite/bldg./apt.no.: Project name:Summerbrook Covered porch area: 1 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 Lot no.:8 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-3028 SQFT 4 Bedroom,4 bath with 868 SQ Valuation: $ I FT 5 car garage, Existing building area: square feet • New building area: square feet ® PROPERTY OWNER ❑ TENANT Number of stories: Name:David Weekley Homes Type of construction: Address:1905 NW 169`h Place Suite 102 Occupancy groups: City/State/ZIP:Beaverton,OR 97006 Existing: Phone:(503)213-4415 Fax:( ) New: ❑ APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES* Business name:David Weekley Homes (Neese refer ro fee srhednlef _ Structural plan review fee(or deposit): Contact name:Michele Schiedler Address:1905 NW 169a'Place,Suite 102 FLS plan review fee(if applicable): Total fees due upon application: City/State/ZIP:Beaverton/OR/97006 Amount received: Phone:(503)213-4415 Fax::( ) E-mail:mschiedlerCdwhomes.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR 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 169`h Place,Suite 102 Solar Installation Specialty Code checklist. City/State/ZIP:Beaverton/OR/97006 Permit Fee(includes plan review $180.00 and administrative fees): Phone:(503)213-441 Fast'( ) State surcharge(12%of permit fee): $21.60 CCB lic.:213653 • Total fee due upon application: $201.60 Authorized signatu/ill This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Michel Seh' d Date:2/27/20 *Fee methodology set by Tri-County Building Industry Service Board. I:ABuilding\Pennits\BUP-RESPennitApp.doc 02.24/2011 440-4613T(11/02/COMiWEB) Mechanical Permit Application FOR OFFICE USE()NIA' Cityof Tigard Received g EGE ED Date/By: Permit No.: 13125 SW Hall Blvd.,Tigard,OR 972 Plan Review Phone: 503.718.2439 Fax: 503.598.1 Date,By,`W/ Other Permit; TIGARD Inspection Line: 503.639.4175 Date Ready/By: Jeris: El See Page 2 for Internet: www.tigard-or.gov MAR AO i1 202o Notified/Method: Supplemental Information TYPE OF W -Y Uf Ll P© COMMERCIAL FEE* SCHEDULE -USE CHECKLIST El New construction ❑Addition(altAli�C1PfnentVISIO Mechanical permit fees"are based on the value of the work performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. CATEGORY OF CONSTRUCTION Value:$ RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ® 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi-family 0 Master builder ❑Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 46.75 Job site address: 10874 SW Teal Crest Place Furnace 100,000 BTU(ducts/vents) I 46.75 City/State/ZIP:Tigard/OR/97223 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name:Summerbrook Duct work 23.32 Cross street/directions to job site:SW 121'Ave and Summerbrook Lane Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision:Summerbrook Lot no.:8 Other: 23.32 Other fuel appliances: Tax map/parcel no.:TBD Water heater 1 23.32 DESCRIPTION OF WORK Gas fireplace/insert 1 33.39 Flue vent for water heater or gas New single fancily home to be built-3038 sqft,4 bedroom 4 bath home with fireplace 23.32 868 sqft 5 car garage Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 ® PROPERTY OWNER ❑ TENANT Other: 23.32 Environmental exhaust and ventilation: Name:David Weekley Homes Range hood/other kitchen equipment 1 33.39 Address: 1905 NW 169'h Place,Suite 102 Clothes dryer exhaust I 33.39 City/State/ZIP:Beaverton/OR/97006 Single-duct exhaust(bathrooms, toilet compartments,utility moms) �Q� 23.32 Phone:(503)213-4415 Fax:( ) Attic/crawlspace fans 23.32 114 APPLICANT ® CONTACT PERSON Other: 23.32 Business name:David Weekley Homes Fuel piping: $14.15 for first four;$4.03 for each additional Contact name:Michele Schiedler Furnace,etc. I Address: 1905 NW 169a'Place,Suite 102 Gas heat pump Wall/suspended/unit heater City/State/ZIP:Beaverton/OR/97006 Water heater t Phone:(503)213-4415 Fax: :( ) Fireplace Range E-mail:mschiedler@dwhomes.com Barbecue CONTRACTOR Clothes dryer(gas) Business name:David Weekley Homes Other: --------- MECHANICAL PERMIT FEES* Address: 1905 NW 169fh Place Suite 102 Subtotal City/State/ZIP:Beaverton/OR/97006 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(503)213-4415 Fax:( ) State surcharge(12%of permit fee) CCB lic.:213653 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signature: /71------. * Fee methodology set by Tri-County Building Industry Service Board Print name:Ken P ttman Date: /24 ( VO I:\Building'PennitsMEC PennitApp_040113.doe 410-4617T(l1/02/COMIWEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial& Multi-Family Fee Schedule: Total Valuation: Permit Fee: $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and $2.54 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I:\BuildingWeimits\MEC_PetmitApp_040I I3.doc 2 e s Electrical Permit Application yp�� {'ram FOR OWJCE USE ONLY 1 [ j I V "'ceived . City Oj Tigard Date/By: Permits: IIIq 13125 SW Hall Blvd.,Tigard,OR 97223 qq q qq • Plan Review Phone: 503.718.2439 Fax: 503.598.1960 MAR 2 402 Date/fly: Related Pemtit t: inspection Line: 503.639.4175 OF-t-�/'. a, ady Date1By: laris. Pi See Page 2 for TIGARD Internet: www.tigard-or.gov CITY OF 1 9iGt� uuGed,Method p� Supplemental Information - U NG-UiV f r 1� A, ;*Y.Ei1 ' 'i ,`sr;P 2 TYPE�OF.`R'Q ,., ❑ New construction ❑ Addition/alteration/replacement Please check all that apply(submit Z sets of plans w/itams checked): 0 Service or feeder 400 amps or more 0 Building over three stories. ❑ Demolition ❑Other: where the available fault current 0 Marinas and boatyards. .CATEGORY OF CONS TA 'lON g , x exceeds 10,000 amps at 150 volts or 0 Floating buildings. El1-and 2-Ianiily dwelling ❑Commercial/industrial ❑Accessory building less to ground.or exceeds 14,000 ❑Conunercial-use agricultural amps for all other installations. buildings. ❑ Multi-family ❑ Master builder ❑Other 0 Fire pump. 0 Installation of 150 KVA or JOB SITE=INFORMAT'IO$ I D LOCATItti4.4 ' d s- ` ❑Emergency system. larger separately derived 5 ❑Addition of new motor load of system. Job#: 68020008 Job site address: 10874 SW Teal Crest Place loOrlrormore. ❑"A'."E","I 2' 1-3". City/State/ZIP:TigardlOR/97223 0 Six or more residential units. occupancy. 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name:Summberbrook ❑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 *T L7,0F '0, ;;" 't= ', , : s_ Description � Oh. I Each I Total I " __....._ New residential single-or multi-family dwelling unit. Subdivision: Summerbrook Lot#:8 Includes attached garage. ----- 1,000 sq.ft.or less I 168.54 16854 4 Tax map/parcel#:TBD Ea.add'I 500 sq.ft.or portion 3 33.92 107.76 1 ll: 1$CRJ*T1O "OF".R'ORK Limited energy,residential 75.00 2 New single family home to be build-3028 sqft,4 bedroom 4 bath home with (with shove sq.fl.) Limited energy,multi-family 75.00 2 868 sqft 5 car garage residential(with above sq.11.) "`v .PROPERTY OWNER, NA Renewable Energy ❑ See Page 2 v . ,. Services or feeders installationtatteration,and/or relocation Name:David Weeklev Homes 200 amps or less 100.70 2 Address: 1905 NW 169th Place Suite 102 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: Beaverton/ORl97006 hot amps to 1,000 amps 301.04 2 Phone:(503)213-4415 Fax:( ) Over 1,000 mops 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 1 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 ti, °=t ate'^ s Branch circuits-new,alteration,or extension,per panel „ , y >t/4 APPLICANT'. - ® CONTAC'It':y„`�,-T+ABET1 f.n A.feu for branch circuits with Business name: David Weekley Homes above service or feeder fee, 740 2 each branch circuit Contact name: Michele Schiedler B.Fee for branch circuits without service or feeder fee,first Address: 1905 NW 169th Place Suite 102 branch circuit 56.18 City/State/ZIP:Beaverton/OR/97006 Each add'I 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(n.dwhomes.com Reconnect only 67.84 2 a rr,wW C)NT-RAf:-T'Pk: _ ?:<xx_,r e i .,°" . Pump or irrigation circle 67.84 2 Business name: Garner Electric Sign or outline lighting 67.84 2 n B 1 . Signal circuits)or limited-energy 0 See Page 2 2 AAddress: �V t>VG- 0 4AMJ1 panel,alteration,or extension. City/State/ZIP: .ry7,1. r /f 2:� Each additional inspection over allowable in any of the above u.� J v tee— Additional inspection(I hr min) 66.25 hr Phone:SQ"J Co42 — (45S7._ Fax:( ) Investigation(I hr min) 90.00/hr Email:per 6 �— @ 0�n Q X�eC �m Inspectionsdustrial for which min) 79 18/fir �'e Inspections!or which no fee is 90.00'fir specifically listed(/hr min) CCB Lie.: (2t lecirical Lic.: Suprv. Lie.: Ix'•_ < Aw�iFe�,�G�. 1`�" 1r�s +�� �s „>:�'�yr; Suprv. Electrician signature,required: Subtotal: Print name: : -'-lid—7.0 ❑Plan Review Required(25°r;,of permit fee): /L1 I �' ` .� 1 State surcharge(12%of permit fee): Authorized signature: f ) ,eu ze-zC�' `-' TOTAL PERMIT FEE: LJ r j� 7 This permit application expires if a permit is not obtained within ISO Print name: '� 1 O5.. t Date: 'Z '.2-.I 6 days alter it has been accepted as complete. L xC * Number of inspections allowed per permit. /:`.Building Pomits'lLC_1'emtitApp_I Ilt_Eld doe Rev U6'17..2515 4404615T0 1051COM WEB . , Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK C)NLS': Description .Renewable electrical enemy systems:Qt I E 1 n. Each !oral Fee for all residential systems combined: $75.00 Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: • El Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 55226 2 ® Garage Door Opener* >100 kva(tee in accordance with OAR 918-309-0040) 552.26 2 ® Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 (1 Vacuum Systems* >100 kva -no additional charge 0.0 3 Each additional inspection over allowable in am of the above: ❑ Other: Each additional inspection is 66.25/hr I charged at an hourly(I hr min) Inspections for which no fee is 90.00/hr specifically listed(' hr min) ELECTRICAI.%1PERI U`f FEES SubtoFee for each commercial system: $75.00 allowed al per pEnterermit on Page1): (SEE OAR 918-309-0000) ' Numtxrnfinspectionsalk,wedperpc:mit Check Type of Work Involved: C Audio and Stereo Systems ❑ B• oiler Controls • Clock Systems n D• ata Telecommunication Installation [l Fire Alarm Installation • HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* n M• edical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1::RuiidmC Pc 711115.ELC_PenuiiApp ELR E t5F doe Rev 06.1'2015 Plumbing Permit Application Building Fixtures jECElVED IOR OFF It 7: 1 SF: O\1.1 City of Tigard Received i III 3M 'R 2 2020 Date/By: Permit No.: • 13I25 SW Hnl1 Blvd.,Tigard,OR 47223 plan Review g Phase: 503.718.2439 Fax: SQ3.59S.1 Date/By: Other Permit No.: ii;,\i11,, Inspection Internet wwne:503.639.4175 CITY OFTIGARD DateReadyBy: tuns ® See Page 2tor 11'PE-OF WINO DIVISION NoriiI"DMethod Sapplementat lttfonuadon ..". ®New construction ❑Demolition I For special information use checklist Description 1 Qry. 1 Ea. I Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 II.for each utility connection) CATEGORY OF CONSTRUCTION 1 SFR(I)bath 312.70 I ® I-and 2-family dwelling 0 Commercial/industrial ( SFR(2)bath 437.78 I 0 Accessory building 0 Multi-family SFR(3)bath 1 500.32 500.32 Each additional bath/kitchen 1 25.02 25.02 0 Master builder 0 Other. Fire sprinkler( sq.ft.) j Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address:10874 SW Teal Crest Place 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.:I) Page 2 87.55 Suite/bldg./apt.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 . Sanitary sewer(no.linear ft.:_) I Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear it:_) Page 2 Subdivision:Summerbrook Lot no.:8 Fixture or item: Tax map/parcel no.: Backflow preventer I 31.27 31.27 DESCRIPTION OF WORK Backwater valve 12.51 • Clothes washer 1 25.02 25.02 New Single Family Home 3028 sgft 4 bedroom,4 bath with 868 sgft 5 car Dishwasher I 25.02 25.02 garage. Drinking fountain 25.02 Ejectors/sump 25.02 14 PROPERTY OWNER ❑ TENANT Expansion tank 12.51 Name:David Weekley Homes Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:1905 NW 169't'Place Suite 102 Garbage disposal 1 25.02 25.02 City/State/ZIP:Beaverton,OR 97006 Hose bib 3 2" 25.02 j 50.04 Phone:(503)2134415 Fax:( ) Ice maker I 12.51 12.51 la APPLICANT • ElCONTACT PERSON Interceptor/grease trap 25.02 Business name:David Weekky Homes Medical gas(value $_) Page 2 Primer 12.51 Contact name:Michele Sebiedler 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 Fax::( ) Tub/shower/shower pan 2 12.51 25.02 E-mail:msehiedler@dwhomes.com Urinal 25.02 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 207 Other. 25.02 City/State/ZIP:Banks/OR/97106 Subtotal Phone:(503)324-0739 Fax:( ) Minimum permit fee: $72,50 • CCB Lic.:102535 Plumbing Lie.no.:34-276PB 1 Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature; TOTAL PERMIT FEE Print name: FQ 1l ra ILtfapz-eG( L, Date: ' ^ This permit applicatioa expires if a permit is not obtained within ISO days after it has been accepted as complete. r 'Fee methodology set by To-County Building Industry Service Board. 1inui16rtgiPou i* PLMU-PomitApp,da 10r0109 410-4616T(1 OW✓COMMEB) City of Tigard ligCOMMUNITY DEVELOPMENT DEPARTMENT e Building Permit Review — Residential TIGARD Building Permit #: ST 2—C Z ?f Site Address: /. -?2/ g/o /,.. / CPg-L Pi Project Name: // s.-AWL Lot #: j Planning Review Pro► .sal: (/,�y ,,,n k.) gi ,E_ R Verify address/suite#active in Accela. Ofn River Terra e: /No ❑ Yes,River Terrace Review Addendum Sit lan Elements: irdlyosion Control ltopies of site plan on 8-1/2"x 11"or 11 x 17"paper 01. .etained trees with drip line and tree protection measures wn to scale(standard architect or engineer scale) ootprint of new structure(including decks) and FFE rth arrow �hflity locations&easements(required for new and additions) S address,project or subdivision name and lot number Sidewalk/driveway approach .plicant information(name and phone number) 11 .cation of wells/septic systems G .t dimensions and building setback dimensions Z. eet tree size,type and location llt.uare footage of buildings to be demolished 64dS�et names sting structures on site T,d"Corner elevations(2'contours if more than 4'diffiential) Nit.t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? al Yes DI o impervious area(applicable if R-7,R-12,R-25&R-40) If es,is a storm water .uali facili shown? EYes No Nib lean Water Services—Service Provider Lette of platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified LJ No Received: ❑ Yes ❑ No Water Meter Fixture Unit Worksheet—Ads,Remodels and ADUs quired: ❑ Yes,applicant was notified qi No Received: ❑ Yes CI No DC Exemption for ADU applied for: ❑ Yes hd No Received: CI Yes CI No Ed te Public Faciliti Improvement (PFI) Permit: quired: ger Yes,applicant was notified ❑ oplied For: Yes ❑ No,stop intake V and Use Case#: ewPWi99— a003- •M��®1 _ VJ Zoning. #J- c— equired Setbacks: Front: -20 Rear. /S Street Side: Gv }— Garage: 2O IG Building Height: Max. Height: 50 Actual Height: 2L/. andscape rea: % t Coverage M�axv Entrance $>st back no more than 8'from street-facing wall L� Parallel to street or offset 45 degrees or less Windows IV • um 12%of area of all street-facing facades Garage Garage door is behind widest street-facing wall Yes El No,one of the following is met El Door extends no more than 5'from wall and there is a covered porch extending beyond garage. Door extends no more than 5'from and there is a 12 sq ft.window above garage on 2"d floor. IQ Garage door width is ❑ 12'or less 50%or less of facade ❑ 60%or less and includes 7 of following: ❑ Covered porch ❑ Recessed entrance El Wall offset ❑ 1'Roof cave ❑ Roof offset 0111 ❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof DI Dormer ❑ Accent siding Window trim ❑ Window recess El Window projection ❑ Balcony \ isual Clearance lt] Urban Forestry an 1\\/i:ensitive Lands: 0 Yes hd No Type: T. Co ditions met prior to issuance of building permit No s• Approved By Planning: — Date: /2/2--- 7 Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved ❑ Not Approved Revision 2: 0 Approved ❑ Not Approved I:\Building\Fonos\BldgPennitRvw_RES_122419.docx Building Permit Submittal / Original Submittal Date: Site Plans: Building Plans: # Building Permit#: $Enter building permit#above. Workflow Routing: Planning Engineering irmit Coordinator Building Workflow Sign-off: ign-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: By Permit Technician: Date: Engineering Review Slope at building pad: 2/b I'Conditions "Met"prior to issuance of building permit /Easements (encroachments)per engineering conditions of approval and plat UQ Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes Ct'I"No Assess Water Quantity Fee in-lieu: 0 Yes No LIDA Facility on lot: ❑ Yes tr No CO Final Plat Recorded: 0 NOT Approved by Engineering: Date: Notes: Approved by Engineering: Date: ,3/YzO Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved ❑ Not Approved Revision 2: 0 Approved 0 Not Approved Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit O Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: O�,�S-DC Exemption: 0 Received CI Does not apply qG bDC Fees Entered: Wash Co Trans Dev Tax: VYes 0 N/A Tigard Trans SDC: W es ❑ N/A Parks SDC: IrE'Yes ❑ /A LIDA 0 Yes VN/A LiJ OK to Issue Permit 2 Approved by Permit Coordinator: Date: J/3)y(7 / h\Building Worms\B1dgPermitRvw_RES_122419.docx