Permit (127) 1111ICITY OF TIGARD MASTER PERMIT
S COMMUNITY DEVELOPMENT Permit#: MST2018-00074
T r G A R f-) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/22/2018
Parcel: 1 S 135BD02000
Jurisdiction: Tigard
Site address: 9590 SW ANNA BELLE CT
Subdivision: ASH CREEK VILLAGE Lot: 6
Project: Ash Creek Village, Lot 6
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 4 First: 864 sf Basement: 197 sf Left: 3
Parking Spaces: 0
Height: 32 Bathrooms: 3 Second: 914 sf Garage: 742 sf Front: 20
Smoke
Dwelling Units: 1 Third: 0 sf Yes
Right: 3 Detectors:
Total: 1975 sf Value: $259,573.33 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1
Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain
0 Storm Sewer 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains:
Bckflw Prevntr: 0 Catch Basins: 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: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1
Other Units: 1
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: W/Svc or Fdr: 0
Ea add.'500 sf: 4 201-400 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:
ALTp y Square Feet:
SF VB
R-3 1975
Owner: Contractor:
SAGE BUILT HOMES LLC ROSS ELECTRIC INC Required Items and Reports(Conditions)
1815 NW 169TH PL STE 1040 2870 SE 75TH AVE#203 1 Ersn Cntrl 503-639-4175
BEAVERTON,OR 97006 HILLSBORO,OR 97123
PHONE: 971-221-4597 PHONE: 503-642-2800
FAX: 503-642-5815
Total Fees: $29,785.88
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 : 2. •87 or 1.800.332.2344.
Issued By: rotti6;. Permittee Signature: ,
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. _—".'wii
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.
A
1 Building Permit Application
Residential
FOR OFFICE 1SE 0N1,1
City of Tigard CEIVED Et4/" '1T , 2 (4e,P" Pla /412)--
„,� • 'O/Vl,o., p� _f_
r t G A R ) Inspection Line: 503.639.4175 FEB2018 Date Re f other Permit:5� �F/f 6�IX�L
Internet: www.tigard-or.gov GB 1 4 DateReady/By: Juris: SeePage2for
i �,t d yt� pp a Notified/Method:
CIT I VI, IIG a RD PP m 1 Information
(,� f f� I i
u e ena
t
DING DIVISION REQUIRED DATA: AND 2-FAMILY DWELLING
®New construction ❑Demolition Permit fees*are based on the value of the work performed.
❑Addition/alteration/replacement 0 Other: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
” CATEGORY OF CONSTRUCTION" work indicated on this application.
® 1-and 2-family dwelling ❑Commercial/industrial Valuation: $ r15G1, 57
❑Accessory building 9„.37 !(
❑Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms: ,y33
JOB.SITE INFORMATION.AND LOCATION Total number of floors: 3 eD 1 11
Job site address:9590 SW Anna Belle Ct New dwelling area: 1975 square feetlq
City/State/ZIP:Tigard Oregon 1
Garage/carport area: 742 square feet (AO
Suite/bldg./apt.no.: I Project name:Ash Creek
Covered porch area: square feet 117
Cross street/directions to job site:
Deck area: 9.e quare feet
Other structure area: square feet
Subdivision:Ash Creek , REQUIRED DATA:COMMERCIAL-USE CHECIKLIST
I Lot no.:6 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 Residential Construction Valuation:
Existing building area: square feet
New building area: square feet
PROPERTY OWNER [ 0 TENANT
tNumber of stories:
Name:Sage Built Homes
Address:1815 NW 169'Place Type of construction:
City/State/ZIP:Beaverton Oregon 97006 Occupancy groups:
Phone:(971)221-4597 Existing:
Fax:( )
New:
� APPLICANT
CONTACT PERSON BUILDING PERMIT FEES*
Business name:Same As Above
Contact name:Alex Rodriguez Structural plan review fee(or deposit):
Address:Same As Above FLS plan review fee(if applicable):
City/State/ZIP: Total fees due upon application:
Phone:(971)336-6911 I Fax::( ) Amount received:
E-mail:Planning@sagebuilthomesllc.com J PIIOTOVOLTAIC SOLAR PANEL SYSTEM,FEES*
CONTRACTOR Commercial and residential prescriptive installation of
Business name: roof-top mounted Photovoltaic Solar Panel System.
Submit two(2)sets of roof plan with connection details
Address: and fire department access,along with the 2010 Oregon
Solar Installation Specialty Code checklist.
City/State/ZIP: Permit Fee(includes plan review
Phone:( ) and administrative fees): $180.00
Fax:( )
CCB lic.: 330 /:".. /� State surcharge(12%of permit fee): $21.60
Total fee due upon application: $201.60
Authorized signator . This permit application expires if a permit is not obtained
* within 180 days after it has been accepted as complete.
Print name:Alex Rodriguez I Date:2/1/2018 I Fee methodology set by Tri-County Building Industry
Service Board.
I:\BuiidingTermits\BUP-RESPermitApp.doc 02/24/2011
440-4613T(11/02/COM/WEB)
l t
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE, I SE O\ .1
Received Permit No.:
City of Tigard
Received
e
IN - 4 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
Phone: 503.718.2439 Fax: 503.598.1960 0 Electrical 0 Plumbing 0 Mechanical
T 1 G A R D 24-Hour Inspection Line: 503.639.4175 ❑ Other:Internet: www.tigard-or.gov
les No ti/:1
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW 0 0 0
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 0 0
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0
3 Verification of approved plat/lot. 0• 0 0
4 Fire district approval required. Name of district: 0 0 0
5 Septic system permit or authorization for remodel. Existing system capacity 0 0 0
6 Sewer permit. ❑ ❑ 0
7 Water district approval. ❑ ❑ ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application.
9 Erosion control 0 plan.0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 0 0
basin protection,etc. ❑ 0 0
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 0 0
there is more than a 4-fl.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. ❑ 0 0
12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size
and location. ❑ 0 0
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater,
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- 0 0 0
floor,wall construction,roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings
and foundation,stairs,fireplace construction,thermal insulation,etc.
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. ❑ 0 0
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing foundation elevations with cross references are acceptable. 0 0 0
16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non-
prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing 0
0
0
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 0
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 joists0 0 0
over 10 feet long and/or any beam/joist carrying a non-uniform load.
0 0 0
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. ❑ 0 0
22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or
architect licensed in Ore on and shall be shown to be a licable to the ro'ect under review.
0 0 0
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". 0 0 0
24 Two(2)sets each are required for Items 16, 19,20 and 22 above.
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 0 0 ❑
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 00 0
277 "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 0 0 0
Street Tree List. ❑ 0 0
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. 0 0 0
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-RESPermitApp.doc 02/24/2011
440 4613T(11/02/COM/WEB)
,
Electrical Permit Application
RECEIVE
Pt1K 01 I( I.1 SI.().1.1
City of Tigard �I ece;vea
14 13125 SW Hall Blvd.,Tigard,OR 97223
Date/By: Permit#:
11 g Phone: 503,718.2439 Fax: 503.598.!960 FEBn Plan Review �c7 ?/ 7y
Inspection Line: 503.639.4175 r EB U Date/By: dated Penni(#:
1 I(, \R t) P Ready Date/By: Juris
Internet: www.tigard-or.gov CITY OF TIGAR E ( Supplemental See menet Inv
CITY i Notified/Method:
Information
.TYPE Old W ILDJN( fIVISKON
®New constructionPLAN surtW
0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked).
0 Demolition ❑OtheC
0 Service or feeder 400 amps or more 0 Building over three stories.
CATEGORY OF CONSTRUCTION where the available fault current 0 Marinas and boatyards.
® I-and 2-family dwellingexceeds 10,000 amps at 150 volts or 0 Floating buildings.
0 Commercial/industrial 0 Accessory buildingless to ground,or exceeds 14,000
❑Commercial-use agricultural
❑Multi-family 0 Master builder 0 Other: amps for all other installations. buildings.
.108 SITE INFORMATION AND LOt ATION 0Ftre pump,
0 Installation of 150 KVA or
❑Emergency system. larger separately derived
Job#: J Job site address: 'Anna Belle Ct ❑Addition of new motor load of system.
City/State/ZIP:Tigard Oregon
100ttP or more, ❑ t-3",
❑Six or more residential units, occupancy,
Suite/bldg./apt,#: ❑Health-care facilities. 0 Recreational vehicle parks,
Project name:Ash Creek 0 Hazardous locations. 0 Supply voltage for more than
Cross street/directions to job site: ❑Service or feeder 600 amps or more. 600 volts nominal,
FEE SCHEDULE
Dexriptton i Qty. I Each I Total 1 r
Subdivision:Ash Creek New residential single-or multi-family dwelling unit.
Lot#: (D Includes attached garage.
Tax map/parcel#: 1,000 sq,ft,or less 168,54
4
DESCRIPTION OF WORK Ea.add'l 500 sq.ft,or portion 33,92 1
New Residential Construction Limited energy,residential
(with above sq.ft.) 75,00 2
Limited energy,multi-family
residential(with above sq.ft,) 75.00 2
PROPERTY OWNER I ❑ T Renewable Energy 0 See Page 2
Name:Sage Built Homes LLC Services or feeders installation alteration,and/or relocation
200 amps or less 1 100,70 100.70 2
Address: 1815 nw 169TH Place Suite 1040 201 amps to 400 amps
133.56 2
City/State/ZIP:Beaverton Oregon 97006 401 amps to 600 amps 200 34 2
Phone:(971)221-4597 ( 601 amps to 1,000 amps 301.04 2
Fax:( ) Over 1,000 amps or volts 552.26
Email: 2
Temporary services or feeders installation,alteration,and/or _
relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 59.36 1
20 t amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps
® APPLICANT € 168,54 2
I ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
Business name:Same As Above A Fee for branch circuits with
above service or feeder fee,
Contact name:Alex Rodriguez each branch circuit 7.42 2
B.Fee for branch circuits without w
Address: service or feeder fee,first
City/State/ZIP:
branch circuit 56.18 2
Each add'I branch circuit 7.42 2
Phone:(971)336-6911 Fax::( ) Miscellaneous(service or feeder not Included)
Each manufactured or modular
Email:Plannirtg@sagebuilthome911C.com dwelling,service and/or feeder 67.84 2
CONTRACTOR Reconnect only 67.84 2
Business name:Ross Electric Pump or irrigation circle 67.84 2
Sign or outline lighting 67.84 2
Address:2870 SE 75th Ave 203 Signal circuit(s)or limited-energy
panel,alteration,or extension, See Page 2 2
City/State/ZIP:Hillsboro Oregon 97123 Each additional inspection over allowable in any of the above
Phone:(503)642-2800 Additional inspection(1 hr min) 66.25/hr
I Fax:( ) Investigation(1 hr min) 90.001 hr
Email: / Industrial plant(1 hr min)
Ion /0 78.18/hr
CCB Lie.: 157891 Electrical Lie.: 34-436C f Suprv.Lie.: 'i� / p Inspectionsclly for which r fee is
J specifically listed{%,hr min} 90.00/hr
Suprv.Electrician signature,required: e. f ELECTRICAL PERMIT FEES
Print name: Stephen Ross ( �j Subtotal:
✓ e e e1 K o j Date: o Plan Review Required(25%ofpermit fee):
State surcharge(12%ofpermit fee):
Authorized signator :
TOTAL PERMIT FEE:
Print name: Alex Rodriguez This permit application expires if a permit is not obtained within t80
Date: 2/1/2018 days after it has been accepted as complete.
I:\BuildioglPermitalEL(:_PernitApp_ELR_ERE doe Rev 06/17,2015 * Number of inspections allowed per permit.
440-4615T(1 I/05/COM/WEB
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received
III13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: Permit No.: �4 T- 74
Phone: 503.718.2439 Fax: 503.598.196a- Plan Review /vl t
T I G n R D Inspection Line: 503.639.4175 �.{ Date/By: Other Permit:
Internet: www.tigard-or.gov i Date Ready/By: Juris: ® See Page 2 for
Notified/Method: Supplemental Information
FR142018
TYPE OF wORI{ p COMMERCIAL FEE*SCHEDULE- IISEC CIOLIST
aor 1 n Mechanicalermit fees*are based on the value of the work
®New construction 0 Addition/altera ua til 6. ,. DIVISION p
''��IIJJ 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 0 Commercial/industrial
0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder
0 Other: Description
Qty. Ea. Total
.IOB SITE INFORMATIONAND LOCATION Heating/cooling:
Job site address:9590 SW Anna Belle Ct Air conditioning 1 46.75 46.75
Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75
City/State/ZIP:Tigard Oregon Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name:Ash Creek Heat pump 61.06
Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision:Ash Creek Lot no.:6 Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater
1 23.32 23.32
DESCRIPTION OF WORK' Gas fireplace/insert 1 33.39 33.39
New Residential Construction 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
Chimney/liner/flue/vent 23.32
or... PROPERTY OWNER Q TENANT Other: 23.32
Environmental exhaust and ventilation:
Name:Sage Built Homes Range hood/other kitchen
Address:1815 NW 169th Place equipment 1 33.39 33.39
Clothes dryer exhaust 1 33.39 33.39
City/State/ZIP:Beaverton Oregon 97006 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 5 23.32 116.60
Phone:(971)221-4597 Fax:( )
Attic/crawlspace fans 1 23.32 23.32
=i APPLICANT 0 CONTACT PERSON Other:
23.32
Business name:Same As Above Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:Alex Rodriguez Furnace,etc.
Address:Same As Above Gas heat pump
City/State/ZIP:
Wall/suspended/unit heater
Water heater
Phone:(971)336-6911 Fax::( ) Fireplace
E-mail:Planning@sagebuilthomesllc.com Range
Barbecue
CONTRACTOR` Clothes dryer(gas)
Business name:All Time Heating&Cooling Other:
Address:PO Box 1341 MECHANICAL PERMIT FEES*
Subtotal
City/State/ZIP:Lake Oswego,OR 97035 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)208-2276 Fax:( )
_ State surcharge(12%of permit fee)
CCB lic.:1345-757 ! 7ti 5 7 S if /17//3-- TOTAL PERMIT FEE
\! This permit application expires if a permit is not obtained within 180
1 days after it has been accepted as complete.
Authorized signature: J * Fee methodology set by Tri-County Building Industry Service Board
Print name:Alex Rodriguez Date:2/1/2018
I:\Building\Permits\MEC_PermitApp_040113.doc 440-46I7T(I 1/02/COM/WEB)
MPageechanical2S
Permitupplemental ApplicationInformati - City of Tigard
- on
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:\Building\Permits\MEC_PermitApp_040113.doc 2
Plumbing Permit Application
Building Fixtures FOR OFFI( E ISF. ()NEN
City of Tigard Received
: Date/By: Permit No i/A 7�/)/�- J7C.
1111 13125 SW Hall Blvd.,Tigard,OR 97
Phone: 503.718.2439 Fax: 503.5'.;'•+ E1Plan Review t477,00
V
Date/By: Other Permit No.:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris H See Page 2 for
Internet: www.tigard-or.govp18 Notified/Method: Supplemental Information
'TYPE OF WOIRK FEE* scHRDULa
®New construction [GI1 1 1GAID For special information use checklist
Description Qty. I Ea. Total
p� y� R p
❑Addition/alteration/replacementt)9f 1� DIVISION New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSI1WCTION SFR(1)bath 312.70
® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building ❑Multi-family SFR(3)bath x 500.32 500.32
❑Master builder Each additional bath/kitchen 25.02
❑Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:9590 SW Anna Belle Ct Catch basin or area drain 18.76
City/State/ZIP:Tigard Oregon Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name:Ash Creek Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision:Ash Creek I Lot no.:6 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
Dishwasher 1 25.02 25.02
New Residential Construction Drinking fountain 25.02
Ejectors/sump 25.02
�4 PROPERTY OWNER , " :0 TENANT Expansion tank 12.51
Name:Sage Built Homes LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 1815 NW 169th Place
Garbage disposal 1 25.02 25.02
City/State/ZIP:Beaverton Oregon 97006 Hose bib 2 25.02 25.02
Phone:(971)221-4597 Fax:( ) Ice maker 12.51
>'®-APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:Same As Above Medical gas(value:$ ) Page 2
Contact name:Alex Rodriguez
Primer 12.51
Roof drain(commercial) 12.51
Address:Same As Above Sink/basin/lavatory 6 25.02 150.12
City/State/ZIP: Solar units(potable water) 62.54
Phone:(971)336-6911 Fax::( ) Tub/shower/shower pan 3 12.51 37.53
E-mail:Planning@sagebuilthomesllc.com Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 1 37.52 37.52
Business name:Edwards Mullen Plumbing Water piping/DWV 56.29
Address: 1601 A Se River Rd Other: 25.02
City/State/ZIP:Hillsboro Oregon 97123 Subtotal
Phone:(503)628-3560 Fax:( ) 7 r!( 0 Minimum permit fee: $72.50
CCB Lic.:92689 Plumbing Lic.no.:J2� /161))46 Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name:Alex Rodriguez Date:2/1/2018 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Qtr: > ee } xota�
Site UtilitiesSquare `ota�fage: Permit Fee:
Footing drain-1°`100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52 Valuation:
Permit Fee:
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
Qty Fee,(ea) Total each additional$100.00 or fraction thereof,to
Other Inspections or Fees 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
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
accurately report fixtures could result in increased sewer fees*.
Quantiy by Fixture Type Plan Review for plumbing Installations
Fixture Type for Replace/ Plan review is required for any of the following.
Work Performed: Capped Added Relocate
Please check all that apply.
Baptistry/Font
Bath -Tub/Shower 0 Any new commercial building with water service 2"and
-Jacuzzi/Whirlpool
1pool 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 ❑ 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" Isometric or Riser Diagram
Car Wash Drain
0 Isometric or riser diagram is required for new buildings
Garbage -Domestic-non-food
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes 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
Urinal plumbing permit can be issued.
Other Fixtures:
C:\Users\alejandra\Desktop\Templates\City of Tigard\Plumbing.doc 2
Albert Shields
From: Albert Shields
Sent: Tuesday, February 27, 2018 5:14 PM
To: 'Planning@sagebuilthomesllc.com'
Cc: Gary Pagenstecher
Subject: RE:Ash Creek Village, SUB2015-00003, PDR2015-00001
Alex and Kylie, please note my email of 2/8/18 below. As I explained, you are required to arrange for a site inspection by
the project planner before the 8th permit is issued. You have not done so and you have submitted 3 more permit
applications for a total of 11.
Because you have failed to comply with Condition of Approval No. 27 of PDR3025-00001 I am classifying these 3 new
permit applications, MST2018-00073, -00074, &-00075 as "Approved for Plan Review but Not Released." Plan Review
will proceed but the permits will be put on Hold until the required inspection is requested, performed, and
approved. Similarly, I am putting MST2018-00033, representing the 8th permit, on Hold as "Approved but Not Released"
until the required inspection is performed and approved.
Please let me know if you have any questions.
Albert Shields
Permit Coordinator
City of Tigard
Albert(c�tigard-or.ov
503-718-2426
From:Albert Shields
Sent:Thursday, February 08, 2018 2:42 PM
To: 'Planning@sagebuilthomesllc.com'<Planning@sagebuilthomesllc.com>
Cc: Gary Pagenstecher<Garyp@tigard-or.gov>
Subject: Ash Creek Village, SUB2015-00003, PDR2015-00001
Alex or Kylie, please note that you have now submitted 8 building permit applications and that Condition of Approval
No. 27 of PDR2015-00001 says: "27. Prior to issuance of the 8th building permit, or within 36 months from the date of
this decision, the applicant shall schedule an inspection with the project planner to verify the installation of the
community gardens,as detailed on the proposed plans, including an on-site water supply."
Please contact your project planner, Gary Pagenstecher, 503-718-2434, at your earliest convenience to schedule the
required inspection.
Thanks for your cooperation.
Albert Shields
Permit Coordinator
I
1
City of Tigard
N COMMUNITY DEVELOPMENT DEPARTMENT
111 .
T 1 AD Building Permit Review — Residential
Building Permit #: /fjl�T,Z0/ r 007(1
Site Address: ('Sq° S\1/ AnnU �tIIL CL
Project Name: ;451 Cheek. vliar. Lot #: 6'
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: (,:..,I4'r✓t-11A o. nt,,,I ,�F 1
Ind erify site address/suite#exists and active)' permit system.
River Terrace Neighborhood: L�1 No ❑ Yes,See River Terrace Review Addendum Attached
S't= Plan Elements:
6 ree(3)copies of site plan l_ E sting structures on site
le ite plan must be on 8-1/2"x 11"or 11 x 17"paper [ footprint of new structure(including decks)with finished
I D awn to scale(standard architect or engineer scale)
rth arrow
or elevations
•
/or
locations&easements(required for new and additions)
e address,project or subdivision name and lot number L�Sidewalk/driveway approach
plicant information(name and phone number) int' cation of wells/septic systems
t dimensions and building setback dimensions ci Existing trees to be retained with drip line,and tree
f�: uare footage of buildings to be demolished p tection measures
P •t area,building coverage area,percentage of coverage and S eet tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) 2Street names —/
./Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? Lyes No
4 oot differential) If yes,is a storm water quality facility shown? ❑ No
Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): �^^_,,
1-7 Appoxi ,,k
/Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No 104 (^t
Public FacilitieiImprovement(PFI) Permit:
�
�R quired: L'Yes,applicant was notified ❑ No Applied For: Yes ❑ No,stop intake
l and Use Case#:
190)2. LOIS— 00001 I'-7 II`L 2OIS-Ool' q
EV/Zoning: R-1Z PV)
10/Required Setbacks: Front LQ Rear I Side 3 Street Side ' Garage e 0
Y andscape Requirement: ZV %
V/Lof Coverage Maximum: g o
t Building Height: Maximum Height 35 Actual Height ?L.
isual Clearance ( ( /
Iffl Sensitive Lands: E7Yes ❑ No Type '�r T6aI J J'i n '^uanY 1 "�:)1'1 Ar(ati —1,6",/ltd Urban Forestry Plan
❑ Conditions "Met"prior to issuance of building permit
Notes: 1.�Aiii 1-1)gl 4t4, P-c iv AA;rsi IJArreJ' T3,l4-1ct
❑ Approved By Planning: .072 -- Date: 2.-11-6
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\BuildingTomis\BldgPernutRvw RES 061417.docx
Building Permit Submittal
Original Submittal Date: 2//L//1
Site Plans: #
3
Building Plans: #
Building Permit#: ►: -= ter building permit#above.
Workflow Routing: i Planning gineering I Permit Coordinator Building
Workflow Sign-off: 5 Sign-off for Planning(include notes from planning review)
Route Application Documents: EEngineering: (1) copy of permit application, (1) site plan, (1)building plan and
original plan review routing form.
.iilding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: /
By Permit Technician: ;,it / d' ����
Date: _l
-
Engineering Review
,1 Slope at building pad: tIP
41 Conditions "Met"prior to issuance of building permit
Easements (encroachments)per engineering conditions of approval and plat
27 Water Quality/Quantity Facility:
` Assess Water Quality Fee in-lieu: 0 Yes t No
Assess Water Quantity Fee in-lieu: El Yes No
LIDA Facility on lot ❑ Yes No
❑ Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
XApproved by Engineering: , j) Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
Permit Coordinator Review
Conditions"Met"prior to issuance of building permit--
Approved,NOT Released: eo'► 4o 6A, �t Date: 4.- 6�
Notes: ve n/ id rolla�cd 1k1 -S
o ru (not irc ast-
Revisions (after Building Submittal only)
4r It 2.1
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
DC Fees Entered: Wash Co Trans Dev Tax: o� es 0 N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: rYes ❑ N/A
LIDA ❑ Yes N/A
OK to Issue Permit
Approved by Permit Coordinator: ADate: ?j J22_J I 1
I:\Building\Forms\BldgPermitRvw_RES_010118.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9590 SW ANNA BELLE CT, TIGARD, OR, 97223 June 25, 2018 at 11 :19:16 AM
Record Type: Record ID:
Residential - Master Permit MST2018-00074
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS
Comments:
Electrical contractor on site fixing dining rm light.
No ac installed.
Temp power pole to be removed prior to building final inspection.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9590 SW ANNA BELLE CT, TIGARD, OR, 97223 July 16, 2018 at 7:49:14 AM
Record Type: Record ID:
Residential - Master Permit MST2018-00074
Inspection Type: Inspector:
299 Final inspection David Young
Result:
FA I L
Comments:
Provide approved final erosion control inspection prior to building final.
No inspection done at this time.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9590 SW ANNA BELLE CT, TIGARD, OR, 97223 July 16, 2018 at 10:32:09 AM
Record Type: Record ID:
Residential - Master Permit MST2018-00074
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
FA I L
Comments:
Seal ceiling penetrations at HVAC ductwork in garage. R302
Protect copper line set tubing from galvanized clamp contact. M1309.2
Ac mechanical and electrical on separate permits, to have approved final inspections
prior to building final inspection.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9590 SW ANNA BELLE CT, TIGARD, OR, 97223 July 23, 2018 at 7:18:42 AM
Record Type: Record ID:
Residential - Master Permit MST2018-00074
Inspection Type: Inspector:
299 Final inspection David Young
Result:
FA I L
Comments:
Provide approved final erosion control inspection prior to building final inspection as
noted on approved plans.
No inspection done at this time.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9590 SW ANNA BELLE CT, TIGARD, OR, 97223 July 25, 2018 at 1 :15:16 PM
Record Type: Record ID:
Residential - Master Permit MST2018-00074
Inspection Type: Inspector:
299 Final inspection David Young
Result:
PASS - CofO
Comments:
Previous corrections complete.
Final erosion control approved.
Street tree certification received.
Moisture content form received.
High efficiency lighting form received.
Moisture barrier form received.
Insulation certification checked.
Blower door test report checked.
C of 0 left on site with contractor.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9590 SW ANNA BELLE CT, TIGARD, OR, 97223 July 24, 2018 at 10:51 :41 AM
Record Type: Record ID:
Residential - Master Permit MST2018-00074
Inspection Type: Inspector:
299 Final inspection David Young
Result:
FA I L
Comments:
Not ready for Inspection at this time, tempered glazing being changed at upper
level bath.
Provide slope away from structure under entry stairs.
Provide approved site plan for street tree verification.
Violation Summary:
Inspector Contractor