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Permit (9) ,, CITY OF TIGARD MASTER PERMIT .Iii : '" COMMUNITY DEVELOPMENT Permit#: MST2018-00034 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 . t 'r : , ' Date Issued: 05/09/2018 T€" Parcel: 1S135BD01700 Jurisdiction: Tigard Site address: 9559 SW ANNA BELLE CT Subdivision: ASH CREEK VILLAGE Lot: 3 I Project: Ash Creek Village, Lot 3 Project Description: New SF. 6/22/2018: REPRINT to remove A/C from permit. 9/10/18: REPRINTED permit to include A/C. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 4 First: 900 sf Basement 574 sf Left: 3 Parking Spaces: 0 Height: 29.5 Bathrooms: 4 Second: 1009 sf Garage: 370 sf Front: 15 Smoke Dwelling Units: 1 Third: sf Right: 3 Detectors: Yes Total: 2483 sf Value: $30Z146.50 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 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 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: Y 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: 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 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 2483 Owner: Contractor: SAGE BUILT HOMES LLC SAGE BUILT HOMES Required Items and Reports(Conditions) 1815 NW 169TH PL STE 1040 1815 NW 168TH PLACE 1 Ersn Cntrl 503-639-4175 BEAVERTON,OR 97006 BEAVERTON,OR 97006 PHONE: 971-221-4597 PHONE: 971-221-4597 FAX: 503-533-5164 Total Fees: $31,183.56 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 r - adopted by the Oregon Utility Notifica'•• Center. Those rules are set forth in OAR 952-001-0010 throug •'R 952-001-0090. You m. •• •'i a copy o the rule-•r direct questions to OUNC by callir,ff03.23 . ;7•r 1.800.332.2344. Issued By:. —.../ a�t ",�rL'- - Permittee Signature: ls. 11r:1'39.4175 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. 11Techanical Permit Application I O R U 1 1 1( 1 I .l:O v 1 1 City of Tigard BEC; E1VEDReceived 11114 " I> y: �, , ,__ 13125 SW Hall Blvd.,Tigard, I Phone: 503.718.2439 Fax: 503.598, 9p► Plan Review Other Permit: I ctionLine: 503.639.4175 JAN 1 8 Z01SDate/By 7 f t �;P � Date Ready/By: Juris: 21 see Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information CITY OF TIGARD 7' - TAW S COMMERCIAL FEE'"SGTIEDIII. ;pSE EC S'I Mechanical permit fees*are based on the value of the work ®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all O Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:S • CATEGORY OF CONSTRUCTION ' RESIDENTIAL EQ�MENT/SYSIT.MS FEESa. ® 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For spedel Information use checklist ❑Multi-family ❑Master builder 0 Other: Description I Qty. 1 Ea 1 Total JOB SITE.INFORMATION AND LOLOCATIONHeating//cooling: Air conditioning 1 46.75 46.75 Job site address:9559 SW Anna Belle Ct Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75 City/State/ZIP:Tigard Oregon Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldgJapt.no.: I Project name:Ash Creek Heatpump 61.06t work Duct 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 Other: 23.32 Subdivision:Ash Creek I Lot no.:3 Other fuel appliances: Tax map/parcel no.: Water heater I 23.32 23.32 DESCRIPTION.OF WORK Gas fireplace/insert 1 33.39 33.39 Flue vent for water heater or gas New Residential Construction fireplace 23.32 /� 7 -A 4t/c- Log d/ligpell (gas) 23.32 [ C 'Yl lam+ re � �r noes/ Ilei stove • 33.39 �:161 -� les r r , ' b...,44 ��® e yn„'"1- Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 --_ { J- ff7/2,, ..1 .Sr 1v'2 e"c .� Other: 23.32 ® PROPERTY OWNER L.1TENANT _/IxL +",-,S Environmental exhaust and ventilation: Name:Sage Built Homes Range hood/other kitchen - equipment I 33.39 33.39 Address:1815 NW 169th Place Clothes dryer exhaust 1 33.39 33.39 City/State/ZIP:Beaverton Oregon 97006 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 6 23.32 139.92 Phone:(971)221-4597 Fax:( ) Attic/crawlspace fans 1 23.32 23.32 iiiii APPLICANT 0 CONTACT PERSON' Other: 23.32 Fuel piping: Business name:Same As Above $14.15 for first four;$4.03 for each additional Contact name:Kylie Hofenbredl Furnace,etc. Address:Same As Above Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:(971)221-4597 Fax::( ) Fireplace Range E-mail:Planning@sagebuilthomesllc.com Barbecue CONTRACTOR Clothes dryer(gas) Business name:All Time Heatin &Coolin Other: g g MECHANICAL,PERMIT EEZ5* Address:PO Box 1341 Subtotal City/State/ZIP:Lake Oswego,OR 97035 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(503)208-2276 Fax:( ) State surcharge(12%of permit fee) 7K S.7c �j7!!f TOTAL PERMIT FEE CCB lie.:-18A345'!^ D6 I/lI ` This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board Print name:Kylie Hofenbredl Date:1/8/2018 I:\BuildingWermiti\MEC_PamitApp_040113.doc 4404617r(I 1/02/COM/WEB) CITY OF TIGARD 1 MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2018-00034 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/09/2018 T[ 9 Parcel: 1 S135BD01700 Jurisdiction: Tigard Site address: 9559 SW ANNA BELLE CT Subdivision: ASH CREEK VILLAGE Lot: 3 Project: Ash Creek Village, Lot 3 Project Description: New SF. 6/22/2018: REPRINT to remove NC from permit. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 4 First: 900 sf Basement: 574 sf Left: 3 Parking Spaces: 0 Height: 29.5 Bathrooms: 4 Second: 1009 sf Garage: 370 sf Front: 15 Smoke Dwelling Units: 1 Third: sf Right: 3 Detectors: Yes Total: 2483 sf Value: $302,146.50 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 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 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 Tvoes 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: 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: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2483 Owner: Contractor: SAGE BUILT HOMES LLC SAGE BUILT HOMES Required Items and Reports(Conditions) 1815 NW 169TH PL STE 1040 1815 NW 168TH PLACE 1 Ersn Cntrl 503-639-4175 BEAVERTON,OR 97006 BEAVERTON,OR 97006 PHONE: 971-221-4597 PHONE: 971-221-4597 FAX: 503-533-5164 Total Fees: $30,981.96 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 OA' • 2-001-0090. 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: ' - Permittee Signature: C%1 -51-74/ e2-./e 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. ^, • ll! CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2018-00034 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/09/2018 T t r; R:f g Parcel: 1S 135BD01700 Jurisdiction: Tigard Site address: 9559 SW ANNA BELLE CT Subdivision: ASH CREEK VILLAGE Lot: 3 Project: Ash Creek Village, Lot 3 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 4 First: 900 sf Basement: 574 sf Left: 3 Parking Spaces: 0 Height: 29.5 Bathrooms: 4 Second: 1009 sf Garage: 370 sf Front: 15 Smoke Dwelling Units: 1 Third: sf Right: 3 Detectors: Yes Total: 2483 sf Value: $302,146.50 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 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 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: Y 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: 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: Square Feet: NEW SF VB R-3 2483 Owner: Contractor: SAGE BUILT HOMES LLC SAGE BUILT HOMES Required Items and Reports(Conditions) 1815 NW 169TH PL STE 1040 1815 NW 168TH PLACE 1 Ersn Cntrl 503-639-4175 BEAVERTON,OR 97006 BEAVERTON,OR 97006 PHONE: 971-221-4597 PHONE: 971-221-4597 FAX: 503-533-5164 Total Fees: $30,936.96 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: Ore on law requires !•u to foll w the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through 952-001- 090.i• %may obt a co of the rules or direct questions to OUNC by calling p37.19: 1.800.332.2344. Issued By: �/ Permittee Signature: ( , '` Call 503.639.4175 by 7:00 a.m.for the next available inspection dat . 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. t , ' . Building Permit Application Residential City of Tigard ,, :„.- . _ .e„ Rece eived Permit No' y / ,2-I /� s72.0/ a9oay 13125 SW Hall Blvd.,Tigard,OR 97223 i C� n%p Plan Review e) Phone: 503.718.2439 Fax: 503.598.1960 J At i 1 11 t U',d Date/By. �' �f / d ^ Other Permit`�C(„�`d K.7[(��[�a2 Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for r«,nh� ti Internet: www.tigard-or.gov r t f" ,,,_. N,,., ed/Method:� "/ Supplemental Information GivyTYPE OF WO REQUIRED DATA:1-AND 2-FAMILY DWELLING ®New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the pro or +- CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: $ 3toi i ( it 1, ® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building [11Multi-familyNumber of bedrooms: 4 ❑Master builder 0 Other: Number of bathrooms:X34 if ^,353 JOB SITE INFORMATION AND LOCATION Total number of floors: 3 -a Job site address:9559 SW Anna Belle Ct New dwelling area: 2483 square feet City/State/ZIP:Tigard Oregon Garage/carport area: 370 square feet, IV 0 9 Suite/bldg./apt.no.: Project name:Ash Creek Covered porch area:..,7s- square fee 00 '" Cross street/directions to job site: Deck area: 7 square feet 7 5 Ske..- 0-_s airc rr, et il-z, _ �`/4. -' Other structure area: square feet Cyril,p.� >ic,t�S ,r�by /3 S Lf l�q G 7 REQUIRED DATA:COMMERCIAL-USE CHECKLIST Ssion:Ash Creek Lot no.:3 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 0.. OWNER 0 TENANT Number of stories: 14ame:Sage Built Homes Type of construction: Address:1815 NW 169th Place Occupancy groups: City/State/ZIP:Beaverton Oregon 97006 Existing: Phone:(971)221-4597 Fax:( ) New: UI APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedul) Business name:Same As Above Structural plan review fee(or deposit): Contact name:Kylie Hofenbredl FLS plan review fee(if applicable): Address:Same As Above Total fees due upon application: City/State/ZIP: Phone:(971)221-4597 Fax::( ) Amount received: E-mail:Planning@sagebuilthomesllc.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System. Business name: Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: Solar Installation Specialty Code checklist. City/State/ZIP: Permit Fee(includes plan review $180.00 and administrative fees): Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.: 6 9 3 3 0 t/A,>ILO 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:Kylie Hofenbredl Date:1/8/2018 *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) `, 1 Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE ESE ONl. City g of Tigard Received IIIDate/By: PermitNo.: I r 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits: Phone: 503.718.2439 Fax: 503.598.1960 T I G A R D 24-Hour Inspection Line: 503.639.4175 ID Electrical ❑ Plumbing ❑ Mechanical Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW ties No N/k 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. 0 0 0 3 Verification of approved plat/lot. ❑ 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 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. ❑ ❑ ❑ ' 9 ' Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 ❑ ❑ basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ 0 ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if 0 ❑ 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 0 ❑ ❑ and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ ❑ 0 furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- ❑ ❑ ❑ floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. 0 ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- ❑ 0 ❑ k 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 locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 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 ❑ ❑ 0 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 ❑ 0 p architect licensed in Ore.on and shall be shown to be a..licable to the .ro'ect under review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". 0 ❑ 0 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 0 ❑ 0 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 ❑ ❑ 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 0 ❑ 0 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, 0 ❑ ❑ including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440 4613T(11/02/COM/WEB) 0. . 1 N echanical Permit Application FOR OFFICE t SF ONLI. Cl of Tigard r Received `J g y DateBy: Permit No.L' Ar / 3'r 13125 SW Hall Blvd.,Tigard,ba. , Plan Review Other Permit: Phone: 503.718.2439 Fax: 503.598, Date/By:960 yy T I G A R D Inspection Line: 503.639.4175 a 3 7 a Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov t p y Notified/Method: Supplemental Information CITY Y i�.((F i!':s;AR� ..I II OItK DIVISION COMMERCIAL FEE*.SCHEDULE - USE CHECKLIST Mechanical permit fees*are based on the value of the work ®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition D Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 1 46.75 46.75 Job site address:9559 SW Anna Belle Ct Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75 City/State/ZIP:Tigard Oregon Furnace 100,000+BTU(ducts/vents) _ 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name:Ash Creek Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. _ , 46.75 Flue/vent for any of above _ 23.32 Subdivision:Ash Creek Lot no.:3 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 Flue vent for water heater or gas New Residential Construction fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove - 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other: 23.32 PROPERTY OWNER 0 TENANT Environmental exhaust and ventilation: Name:Sage Built Homes Range hood/other kitchen equipment 1 33.39 33.39 Address:1815 NW 169th Place Clothes dryer exhaust 1 33.39 33.39 City/State/ZIP:Beaverton Oregon 97006 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 6 23.32 139.92 Phone:(971)221-4597 Fax:( ) Attic/crawlspace fans 1 23.32 23.32 • 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:Kylie Hofenbredl Furnace,etc. Address:Same As Above Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:(971)221-4597 Fax::( ) Fireplace Range E-mail:Planning@sagebuilthomesllc.com Barbecue CONTRACTOR Clothes dryer(gas) Business name:All Time Heating&Cooling Other: MECHANICAL PERMIT FEES* Address:PO Box 1341 Subtotal City/State/ZIP:Lake Oswego,OR 97035 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(503)208-2276 Fax:( ) State surcharge(12%of permit fee) CCB lic.:1845757 i 7 5-75-- Gt ioli f 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: * Fee methodology set by Tri-County Building Industry Service Board Print name:Kylie Hofenbredl Date:1/8/2018 I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB) 4. 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:\Building\Permits\MEC_PermitApp_040113.doc 2 -Electrical Permit Application ... 1 "'` Foi oilICI. t S1 O\l. l' .. «,,,/°'_., '`'' eceived City of Tigard Date/By: Permit#: AA C7-01‘..0/ff' J lig13125 SW Hall Blvd.,Tigard,OR 97223 p 201 Plan Review �'�[ Phone: 503.718.2439 Fax: 503.598.1960 I N 1 Date/By: Related Permit#: Inspection Line: 503.639.4175 1 ,k a y Date/By: Juris: ® See Page 2 for T I G A I:U Internet: www.tigard-or.gov r e t "A ,tified/Method: Supplemental Information TYPE of`W RK3UIL.DIISSG Diiiis t + ` ' PLAN REYllrwW ®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition 0 Other: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family 0 Master builder 0 Other: 0 Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: Job site address:9559 SW Anna Belle Ct 100HP or more. ❑"A "E","1-2","t-3", 0 Six or more residential units. occupancy. City/State/ZIP:Tigard Oregon ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name:Ash Creek 0 Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Qty. I Each I Total I • New residential single-or multi-family dwelling unit. Subdivision:Ash Creek Lot#:3 Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 I DESCRDFTION OF WORK Limited energy,residential (with above sq.ft.) 75.00 2 New Residential Construction Limited energy,multi-family 7500 2 residential(with above sq.ft.) '. PROPERTY OWNER ❑,TENANT Renewable Energy 0 See Page 2 Services or feeders installation,alteration,and/or relocation Name:Sage Built Homes LLC 200 amps or less 1 100.70 100.70 2 Address: 1815 nw 169TH Place Suite 1040 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:Beaverton Oregon 97006 601 amps to 1,000 amps 301.04 2 Phone:(971)221-4597 Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 1 APPLICANT 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name:Same As Above above service or feeder fee, 7.42 2 each branch circuit . Contact name: Kylie Hofenbredl B.Fee for branch circuits without service or feeder fee,first 56.18 2 Address: branch circuit City/State/ZIP: Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(971)221-4597 Fax: :( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email:Planning@sagebuilthomesllc.com Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 i Business name:Ross Electric Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address:2870 SE 75th Ave 203 panel,alteration,or extension. ❑ See Page 2 2 City/State/ZIP:Hillsboro Oregon 97123 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(503)642-2800 Fax:( ) Investigation(1 hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr / Inspections for which no fee is 90.00/hr CCB Lic.: 157891 Electrical Lic.: 34-436C I Suprv.Lic.: / J//CCj specifically listed(%z hr min) ` ELECTRI€AL PERMIT FEES Suprv.Electrician signature,required: £ n 2. .3Subtotal: Print name: Stephen Ross [ Date: 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Kylie Hofenbredl Date: days after it has been accepted as complete. * Number of inspections allowed per permit. IABuilding\Permits\E.C_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-46151(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RES I►ENTIAL WORK ONLY: tu. SCIIEDULE Fee for all residential systems combined: $75.00 Description ( 4a'• I Each I Total •` Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 ❑ A• udio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 2 ID G• arage Door Opener* 50.01 to 100 kva 552.26 2 >100 kva(fee in accordance 552.26 2 with OAR 918-309-0040) ❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 n Vacuum Systems* >100 kva-no additional charge 0 0 3 Each additional inspection over allowable in any of the above: ❑ Other: Each additional inspection is 66.25/hr 1 charged at an hourly(1 hr min) Inspections for which no fee is specifically listed(V2 hr mm) 90.00/hr coiretutoAL W©RIf ONLY: - ELECTRICAL PERMITFEES Fee for each commercial system: $75.00 IW Subtotal(Enter on Page 1): (SEE OAR 918-309-0000) • Number of inspections allowed per permit. Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls n Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC n Instrumentation ❑ Intercom and Paging Systems Li L• andscape Irrigation Control* n M• edical (—] N• urse Calls H Outdoor Landscape Lighting* ❑ Protective Signaling ❑ O• ther: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015 . „. . `Plumbing Permit Application Building Fixtures , , • ' to I vi ,--- FOR OFFICE ( SE ONL1 City of Tigard9 901?.$ Received ' '''' Date/By: Permit No.4..../ 5 7--i,o/ef-06.ejy $1 . 13125 SW Hall Blvd.,Tigard,OR 97223 . ,,\1,. :) Plan Review - Phone: 503 718 2439 Fax: 503 598 196n- . of- . • •• * • • CI Pi( 1 i A,,4,,,1,-;;..,h pate/By: Other Permit No.: Inspection Line: 503.639.4175 TIGARD bate Ready/By: Juris WI See Page 2 for Internet: www.tigard-orgov Bii,)11-L.'0' --'`' Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE El New construction 0 Demolition For special information use checklist Description Qty. Ea. Total 0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 Z 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath x 500.32 500.32 0 Accessory building 0 Multi-family Each additional bath/kitchen 1 25.02 25.02 0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Catch basin or area drain 18.76 Job site address:9559 SW Anna Belle Ct Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard Oregon Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: 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 Lot no.:3 Fixture or item: Tax map/parcel no.: Backflow preventer 1 31.27 31.27 Backwater valve 12.51 DESCRIPTION OF WORK Clothes washer 1 25.02 25.02 Dishwasher 1 25.02 25.02 New Residential Construction Drinking fountain 25.02 Ejectors/sump 25.02 F: PROPERTY OWNER 0 TENANT Expansion tank 12.51 Fixture/sewer cap 25.02 Name:Sage Built Homes LLC 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 A APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name:Same As Above Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:Kylie Hofenbred Roof drain(commercial) 12.51 Address:Same As Above Sink/basin/lavatory 6 25.02 150.12 City/State/ZIP: Solar units(potable water) 62.54 Phone:(971)221-4597 Fax::( ) Tub/shower/shower pan 4 12.51 50.04 Urinal 25.02 E-mail:Planning@sagebuilthomeslIc.com Water closet 25.02 CONTRACTOR 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:( ) ig if //1- Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lic.:92689 Plumbing Lic.no.i L-060 ili5 State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name:Kylie Hofenbredl Date:1/8/2018 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I\Building)Permits\PLMU-PemlitApp 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: Site Utilities Qty Fee(ea) Total Square Footage: Permit Fee: Footing drain-151 100' 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 Other Inspections yr Fees Pee(ea} Total each additional$100.00 or fraction thereof,to and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for (minimum charge 1/2 hour) each additional$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Quantity by Fixture Type Plan Review for Plumbing Installations Fixture Type for Replace/ Plan review is required for anyof the following. Performed: Capped Added Relocate 9 Baptistry/Font Please check all that apply. Bath Tub/Shower ❑ Any new commercial building with water service 2"and Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Drive Thru ❑ New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918-780-0040. Dishwasher -Commercial El Medical gas and vacuum systems for health care facilities. -Domestic ❑ Any multipurpose fire sprinkler system. Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040. Eye Wash Floor Drain/sink -2" Submit 2 sets of plans with any of the above. 4„ Isometric or Riser Diagram Car Wash Drain ❑ Isometric or riser diagram isbuildings required for new Garbage -Domestic-non-food Disposal -Domestic-food related that meet the qualifications above. -Commercial-food related -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang -Stall Sink/Lav -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer-Clothes Water Extractor increase of sewer EDUs,a sewer permit will be issued and Water Closet-Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: S:\Sage Built\Purchasing&Planning\Subdivisions\Ash Creek\Plans\Lot 32kpplications\Plumbing.doc .11 . City of Tigard II COMMUNITY DEVELOPMENT DEPARTMENT TICAR>, Building Permit Review — Residential ,v Building Permit #: G Site Address: °I 5 S CI ,S'W 44 nn CI (3 . C4 Project Name: Ash Creek V t t vl cj e Lot #: 3 (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: IV Vip c' 12 yr Verify site address/suite#exists and active in permit system. ZRiver Terrace Neighborhood: 4 No ❑ Yes,See River Terrace Review Addendum Attached Site Plan Elements: ,IlThree(3)copies of site plan ERi>!$ng structures on site .Zite plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished Drawn to scale(standard architect or engineer scale) floor elevations North arrow Utility locations&easements(required for new and additions) 'ite address,project or subdivision name and lot number Sidewalk/driveway approach ,)Z\pplicant information(name and phone number) 13on'of wells/septic systems Lot dimensions and building setback dimensions Eig trees to be retained with drip line,and tree {tare footage of buildings to be demolished protection measures .12<ot area,building coverage area,percentage of coverage and ieStreet tree size,type and location pervious area(applicable if R-7,'11 R-25&R-40) Street names roperty corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced?/les 0 N 4 foot differential) If yes,is a storm water •uality facility shown? Yes ❑No Clean Water Services-Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified t No Received: ❑ Yes ❑ No Public Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified ❑ No Applied For: / Yes ❑ No,stop intake X Land Use Case#: 1'D 9.. 2,0‘5 - 00 0 01 , SUB 2-0 IS - 000 03 0 Zoning: Q, I ie Required Setbacks: Front i 5 Rear f S Side "i/ ._ Street Side 1 0 Garage Z,) Landscape Requirement: zo % Lot Coverage Maximum: g® % 7 Building Height: Maximum Height 3s Actual Height Z *q i' -S Visual Clearance Vi Sensitive Lands: 1=1 Yes 7e No Type Urban Forestry Plan Conditions "Met"prior to issuance of building permit Q, Notes: �' .�Q,m 2 7 St-� I r e "rlC✓) ❑ Approved By Planning: (V1vim:.. ( - Date: I / IS I is Revisions (after Building Submittal only) R iewer Date Revision 1: A Approved C] Not Approved A,% (rift 116 Revision 2: El Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved 1:\Building\Forms\BldgPennitRvw_RES_061417.docx Building Permit Submittal Original Submittal Date: /X, ,' Site Plans: # l? Building Plans: # 3 Building Permit#: nter buildin permit#above. Workflow Routing: PlanningEngineering Permit Coordinator Building Workflow Sign-off: Sign-off for Planning(include notes from planning review) Route Application Documents: ja Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. ' p7'Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: IV / By Permit Technician: -Z-ii /- Date: L�, 4,--- Engineering Review lope at building pad: ,:277;:, I:1-"Conditions "Met"prior to issuance of building permit Easements (encroachments)per engineering conditions of approval and plat 2-"Vater Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes G3i'l\io Assess Water Quantity Fee in-lieu: ❑ Yes RNo LIDA Facility on lot: // ❑ Yes ErNo GY�'inal Plat Recorded: Q.t.(a<C t d LI NOT Approved by Engineering: Date: Notes: :, ' "-) a/.7 Si)CL atc ❑ Approved by Engineering: C4 . f St4tiL_ Date: /-z Y --I 6 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: ll...,,i 2 7 go lie." ) &.;-‘----' MST,% `4.A N -11 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: 7 SDC Fees Entered: Wash Co Trans Dev Tax: X111 N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: "`Yes ❑ N/A LIDA ❑ Yes Fl-A;41715K to Issue Permit Approved by Permit Coordinator: drill--Date: //17"4/1(r- l:\Building\Fonns\BldgPermitRvw_RES_010118.docx A FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 41 1,11 Transmittal Letter r 1(;n[i to 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: ---Tpin ----H DATE RECEIVED: DEPT: BUILDING DIVISION F FROM: /f-I—(7 . 14,111 ,/,(ZZ FEB 2 7 C018 COMPANY: E :L , PHONE: • By. RE: rnsta.o ) g - 0003 (Site Address) (Permit Number) (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. `7 Other(explain): REMARKS: S 776(C 7.7.r Vet I f C-it`C v(s- 5 Gt Gl `c .v,?-- 1/-a2 C4c/r-Se FOR OFFICE USE ONLY Routed to Permit Tec ian: Date: .a 2,9- ) Initials: i Fees Due: D]Yes V 0 No Fee Description: Amount Due: $ $ $ Special Instructions: Reprint Permit(per PE): ❑ Yes 9 No ❑ Done Applicant Notified: Y Date: /;271 g- Initials` I:\Building\Forms\TransmittalLetter-Revisions_061316.doc City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9559 SW ANNA BELLE CT, TIGARD, OR, 97223 Record Type: Record ID: Residential - Master Permit MST2018-00034 Inspection Type: Inspector: 115 Electrical service Jeff Grove Result: PASS Comments: Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9559 SW ANNA BELLE CT, TIGARD, OR, 97223 September 11 , 2018 at 9:33:16 AM Record Type: Record ID: Residential - Master Permit MST2018-00034 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS Comments: Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9559 SW ANNA BELLE CT, TIGARD, OR, 97223 September 11 , 2018 at 9:34:50 AM Record Type: Record ID: Residential - Master Permit MST2018-00034 Inspection Type: Inspector: 699 Mechanical final David Young Result: PASS Comments: Provide tamper resistant access port caps at ac. Heating contractor on site to make correction. Violation Summary: Inspector Contractor Plumbing Permit Applicat Building Fixtures JUL 23 017) FOR orFlt F: I S1: OyLI City g Received 77,2471/0 7 41 j , $c `I I '.-09f:1314- of T1 arty Date/By: 7Permit • 13125 SW Hall Blvd.,Tigard,OR 91223 Plan Review 1 Phone: 503.718.2439 Fax: 503 :)9 „ _ _,'�,) Date/By: Other PerniltNo.: I I ,,1,( � Inspection Line: 503.639.4175 Dage'Re 4( Jmis: H See Page 2 for Internet: www.tigard-or.gov , No:; � '‘..:71.14...;744t4144 Supplemental Information �K"C5 w. [ '""'" wit. ..;1: . F!f it .X: :=4'" .r '" 6 c.wxw ,..w.t...x� ®New construction 0 Demolition 1`%��•' For special information use checklist Description I Qty. I Ea. I Total El Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) r." '.", . R '+e 1,:x, 5 rrtp SFR(1)bath 312.70 ® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building El Multi-family Each additional bath/kitchen 25.02 ❑Master builder El Other: Fire sprinkler( sq.ft.) Page 2 A ,_ r .. ".t ; ' ' '6104R i10f AND 't r b2V , -:-%:,,,,',,,',:,..,,,, Site utilities: Job site address:9559 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 Village Manufactured home utilities 50.03 Cross street/directions to job site:SW 95th Avenue Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision:Ash Creek Village I Lot:3 Fixture or item: Backflow preventer 31.27 map/parcel no.: 12.51 w . ;' ,IBackwater valve I n ' UR �fi , t -`> Clothes washer 25.02 New residential construction/Plumbing contractor revision Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 �� 4 }WN:R n '?'.1414.4k4;4'52:411.1.'. 7 m o 3 .tK Expansion tank 12.51 Name:Sage Built Homes,LLC. Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 1815 NW 169th Place,Suite 1040 Garbage disposal 25.02 City/State/ZIP:Beaverton,Oregon Hose bib 25.02 Phone:(971)221-4597 Fax:( ) Ice maker 12.51 0 AP$ACANT 4 (l. i2+ CONTACT PER q.14' Interceptor/grease trap 25.02 Business name:Sage Built Homes,LLC. Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:Ben Cooper Roof drain(commercial) 12.51 Address:Same as above Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:(971)258-6658 Fax::( ) Tub/shower/shower pan 12.51 E-mail:planning@sagebuilthomesllc.com Urinal 25.02 ( I �;; . ,. Water closet 25.02 CQNTRA JPR _ ` Water heater 37.52 Business name:Max Plumbing Service Inc Water piping/DWV 56.29 Address:PO BOX 230674 97281 Other: 25.02 City/State/ZIP: Tigard,OR 97281 Subtotal Phone:(971)-275-0198 Fax:( ) Minimum permit fee: $72.50 CCB Lie.: 205392 Plumbing Lic.no.: Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name:Ben Cooper Date:7/23/2018 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-PermiiApp.doe 10/01/09 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression S stems: ,tip r�lea) al. a 'ioC tt # t Footing drain-131 100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Tool' each additional$100.00 or fraction thereof,to tS¢ ° wvvlti and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum char_e-1/2 hour ■ and including$25,000.00. Inspections outside of normal business - 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours minimum char:e-2 hours each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions - 90.00/hr - $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for (minimum chane 1/2 hour each additional$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Quantity by Fixture Type Review of . i Iln In tit ttonS ": Fixture Type for R`place! Plan review is required for any of the following. Work Performed: Capped Added Relocate Baptistry/Font Please check all that apply. Bath Tub/Shower 1=1 Any new commercial building with water service 2"and Jacuzzi/Whirlpool greater.except systems designed and stamped by licensed Car Wash -Each Stall engineer. Drive Thru 1=1 New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918-780-0040. Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities. -Domestic ❑ Any multipurpose fire sprinkler system. Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040. Eye Wash Floor Drain/sink -2" Submit 2 sets of plans with any of the above. -3" 4„ Isomet txlr Riser,Diagram Car Wash Drain Garbage Domestic-non-food CI Isometric or riser diagram is required for new buildings Disposal -Domestic-food related that meet the qualifications above. -Commercial-food related -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang -Stall Sink/Lav -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer-Clothes Water Extractor increase of sewer EDUs,a sewer permit will be issued and Water Closet-Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures. C:\Users\kylie\Downloads\PLMF_PermitApp.doc 2 • RECEIVED City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT x'4.41 2018 Request for Permit Action CITY OF TIGARD BUILDING DIVIRicw TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 •www.tigard-or.gov TO: CITY OF TIGARD Building Division 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov FROM: ❑ Owner ❑X Applicant ❑ Contractor ❑ City Staff Check(1)one REFUND OR Name: INVOICE TO: (Business or Individual) Sage Built Home Mailing Address: 1815 NW 169th Place Suite#1040 City/State/Zip: Beaverton,OR 97006 Phone No.: 503-533-5167 PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): ❑ CANCEL/VOID PERMIT APPLICATION. v REFU NtPERMIT FEES (attach copy of original receipt and provide explanation below). INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below). ❑ REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit). Permit#: MST2018-00034 Site Address or Parcel#: 9559 SW Anna Belle Ct Project Name: Ash Creek Village Subdivision Name: Ash Creek Lot#: 3 EXPLANATION: Requesting to remove A/C from permit and a refund Signature: appy C.49.g,�0.p4, Date: -„S/2 z/t P Print Name: Ben Cooper !!// Refund Policy 1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of: • Any fee which was erroneously paid or collected. • Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended. • Not more than 80%of the application or permit fee for issued permits prior to any inspection requests. 2. All refunds will be returned to the original payer in the form of a check via US postal service. 3. Please allow 3-4 weeks for processing refund requests. 7 f Is-=6, r 9 !`� /• / o y��,--g ,/e2, V 7 FOR OFFICE USE ONLY Route to Sys Admin: Date By Route to Records: Date 'j 2' /y By '471'1"— Refund Processed: _ Date 4/77. � By dgtig Invoice Processed: Date By Permit Canceled: Date 4/7 By r` T Parcel Tag Added: Date By I:\Building\Forms\RcgPcrmitAction_092oc . TIGARD City of Tigard July 16, 2018 Sage Built Homes Attn: Ben Cooper 1815 NW 169th P1, Suite 1040 Beaverton, OR 97006 Re: Permit No. MST2018-00034 Dear Applicant: The City of Tigard has processed a refund for fees on the above referenced permit(s) as follows: Site Address: 9559 SW Anna Belle Ct Project Name: Ash Creek Village,Lot 3 Job No.: N/A Refund: ® Check#228969 in the amount of$41.89. ❑ Credit card"return"receipt in the amount of$ Note: Please allow 2-5 days for this refund transaction to be credited to your account by the company that issued your card. ❑ Trust account"deposit"receipt in the amount of$ Comments: Per applicant's request to remove A/C from issued permit;refund 80% of permit fees paid. If you have any questions please contact me at 503.718.2430. Sincerely, Dianna Howse Building Division Services Supervisor Enc. 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171 TTY Relay: 503.684.2772 • www.tigard-or.gov - " City of Tigard TIGARD Accela Refund Request This form is used for refund requests of land use, development engineering and building permit application fees. Receipts, documentation and the Request for Permit Action form (if applicable) must be attached to this request form. Refund requests are due to Accela System Administrator by each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts Payable will route refund checks to Accela System Administrator for distribution to applicant. PAYABLE TO: Sage Built Homes DATE: 6/22/2018 1815 NW 169th Pl, Suite 1040 Beaverton, OR 97006 REQUESTED BY: Dianna Howse TRANSACTION INFORMATION: Receipt#: 417157 Case#: MST2018-00034 Date: 5/8/2018 Address/Parcel: 9559 SW Anna Belle Ct Pay Method: CreditCard Project Name: Ash Creek Village,Lot 3 EXPLANATION: XPLANATION: Remove emove A/C from a` issued permit; ermit;refund 80%of permit fees paid.aid. "4NDVkii dF t + f ", / ,4 l f mFA dYame. :4.:07.!-21,,,,,,,,, ,,,,t,7.:,.‘; FedesPj4o �w00tk L ".:";,4,,,',, E � .k A g # 4° 7 o` � s` ^ � ,4„-.i.:u R .fix 7� # *A ��� 'tet k:: BuigP.teie tFeC.t, ,., _# ,z r i - e ! , a2,0 to:,,,,,-V0,,,,,«„J1,J Mechanical Permit Fee 230-0000-43102 $37.40 12%State Surcharge 100-0000-24001 4.49 TOTAL REFUND: $41.89 APPROVALS: SIG A • ` .S DATE: If under$5,000 Professional Staff 4�14 ' j '" If under$12,500 Division Manager If under$25,500 Department Manager If under$50,000 City Manager If over$50,000 Local Contract Review Board QR'T111tii SYSTEM%1uAI?112ITO`1<'I3 ► L1 p7LY ,fit= , Case Refund Processed: Date: r30L4j`/j�'° By: 44P------ I:\Building\Refunds\RefundRequest doc '----I:\Building\Refunds\RefundRequest.doc x 09/01/2010 FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 1114 Transmittal Letter i. A►z n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: r OIM DATE CEIVED: DEPT: BUILDING DIVISION RECEIVED i FROM: A\eK / FFP 2 7 2018 COMPANY: 5(SI e_ But 1v 4--IvwvS CITY `)(yi ` BUILDING DIVISION PHONE: 7 71— 5 3 666l I / By: RE: x551 6w w\ peX\e_ c �so -- °°°S (Site Address) (remit u er) tOA ' (Project name or subdivisio \.. • +'number) 1110 ATTACHED ARE THE FOLLOW ''' TEMS: Copies: Description: Copies/: Description: Additional set(s)of plan . v Revisions: Cross section(s) and d; ails. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculation Engineer's calculations. Other(explain): REMARKS: ' fr 1/, ( Al/i /rte i/S 1 . r--6../-1, ---s / ' c.-/' 5D0,Win,( (///t i c FOR OFFICE USE ONLY Routed to -rmit Technician: Date: s.3 -) 9- I'6 Initials:.. Fees Du;. ❑ Yes A No Fee Description: Amount Du ckc",5eS i- awd Wv �`f�ev in $ -Qc p� (3y 7'c,m $ $ Special ' v ) ��'4s co u t $ Instructions: Reprint Permit(per PE): ❑ Yes No ❑Done Applicant Notified: Date: Initials: I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012