The URL can be used to link to this page

Permit (166) CITY OF TIGARD �x MASTER PERMIT COMMUNITY DEVELOPMENTPermit#: MST2018-00142 PP,/y /9 ,401 Date Issued: 04/11/2019 T tGAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S 135 BD02300 Jurisdiction: Tigard Site address: 9544 SW ANNA BELLE CT Subdivision: ASH CREEK VILLAGE Lot: 9 Project: Ash Creek Village, Lot 9 Project Description: New SF. 8/14/2019: REPRINT permit to add A/C. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 3 First 456 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 34 Bathrooms: 4 Second: 799 sf Garage: 350 sf Front: 15 Smoke Dwelling Units: 1 Third: 864 sf Right: 3 Detectors: Yes Total: 2119 sf Value: $257,570.85 Rear: 20 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer 100 Drains: 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 4 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: 3 201-400 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 2119 Owner: Contractor: SAGE BUILT HOMES LLC SAGE BUILT HOMES Required Items and Reports(Conditions) �-- T M ta 1e9Ti—STE1t34fS 1815 NW 168TH PLACE a�Ed S -- BEAVERTON,OR 97006 BEAVERTON,OR 97006 2 Ersn Cntrl 503-639-4175 PHONE: PHONE: 971-221-4597 FAX: 503-533-5164 Total Fees: $29,887.57 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR,ir•-.-001:0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued B Y: .. —� Permittee ()Ai-- �Z-1 e" 771 ttee Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Applic ECEI V ED I t)IZ()I:I I( t: I S1.O\I.1 City of Tigard Received 41'' 13125 SW Hall Blvd.,Tigard,OR 97223Q�G 12 2019 Date/By: � � � 4F- mutN 91/5 t� —00/9:-1--, Plan Review Phone: 503,718.2439 Fax: 503,598.1960 Other Permit: Ttt?ri It t) Inspection Line: 503 639 4175 CITY OF TIGARD Date/By BUILDING DIVISION Date Ready/By: ^Jona: I til See 2 for Internet: www.tigard-or gov NotiSed/Method: Supplemental Information OF'W-ft'K -Z,01'''''''' -hif t4 .11;6':.°'.01 1. ,.i :4CHEBTAgATSZCil, ._.. Mechanica] ermit fe est are based on the value of the work p ®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition ❑Other: mechanical materials,equipmen t labor,overhead,and profit ,.: t i,i , Value:$ CATEGORY OF,CON1STR ,toN ., *, �. i . 1,r to a"1A1C.1tQ f3Y0 ��,FEESa "!Eis"'° ❑x 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description 1 Qty.i_Ea, 1 Total . a:JOB srkB,:nvFvR*T7tr3N Aran," AT�aN � Heating/cooliag: :,:'4,','. Air conditioning i 46.75 46.75 Job site address: 9544 SW Anna Belle Ct Furnace 100,000 BTU(ducts/vents) 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 Duet work 23,32 Cross street/directions to job site: Hydronic hot water system 2332 Residential boiler(radiator or hydronic) 2332 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46,75 Flue/vent for any of above 23.32 Subdivision: Other: 23,32 Lot no.: 9 - Other fuel appliances: Tax map/parcel no.: Water heater i 23.32 !._ D>:SCRJP1TON jF=WOR]{ , -..-;:,,, ,'I''''''''''"-'`,. - Gfiace/insert Flueas venreplt for water heater or gas 33.39 Adding A/C TO existing Permit:MST2018-00142 fireplace 2332 Log lighter(gas) 23.32 Wood/pellet stove 33,39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23=32 • Other: 2132 PROPERTY O�R a�w.e 1"" ,M,,, -; 0`TENANT Environmental exhaust and ventilation: Name: Sage Built Homes Ile Range hood/other kitchen equipment 33.39 Address: 1815 SW 169th Place Suite 1040 Clothes dryer exhaust 33.39 City/State/ZIP: Beaverton Oregon 97124 Single-duct exhaust(bathrooms, toilet compartmepts,utility rooms) 23 32 Phone:( 971 )336-6911 Fax:( 503 )533-5164 Attic/crawlspace fans 23.32 ® APPLICANT' y °' ' ❑ C�QNTACT PPR ON . , iu�, � � '.Other. 2332 Fuel piping: Business name: Same As Above 51435 for first four;54.03 for each additional Contact name: Alex Rodriguez Furnace. etc. Address: Gas heat pump ®__, Wall/suspended/unit heater City/State/ZIP: Water heater Range E-mail: planningQsagebuilthomesllc=corn Barbecue ' '1 +CSO' TRACTOR u'' " � ,�,ate,-''. � a �,,— ' '� dater LP.as) ,,� � Clothes Business name; All Time Heating&Cooling Other . ,du.��hl' cUAIIC" ]iE[tMIT a r$ Address: PO Box 1341 Subtotal V4,7s City/State/ZIP:Lake Oswego OR 97035 Minimum permit fee($90.00) Plan review(25%ofpermit fee) Phone:( 503 )208-2278 Fax:( ) State surcharge(12%ofpermit fee) 5,.(0 f, CCB lie.: 1845757 TOTAL PERMIT FEE Ste. 3 iv - -- - - -- - This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signature: O A/ e, -/6?A_1'e-t 4" /5i-[Ca j`76, s "-- * Fee methodology set by Tri-County Building Industry Service Board Print name: Alex Rodriguez I Date; l;\Building\Pcrmils\MEC_PermitApp_040113.:doe 440-46171'(11/02/COM/WEB) Mechanical Permit Appiicatioln-City of Tigard Page 2-Supplemental Information Commercial&Multi-Famil Fee Schedule: $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. T\Building\Permits\MF(;_PermitApp_040113 doe 2 CITY OF TIGARD MASTER PERMIT `` 41 ''> COMMUNITY DEVELOPMENT Permit#: MST2018-00142 TEGA D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/11/2019 Parcel: 1 S 135BD02300 Jurisdiction: Tigard Site address: 9544 SW ANNA BELLE CT Subdivision: ASH CREEK VILLAGE Lot: 9 Project: Ash Creek Village, Lot 9 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 3 First: 456 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 34 Bathrooms: 4 Second: 799 sf Garage: 350 sf Front: 15 Smoke Dwelling Units: 1 Third: 864 sf Right: 3 Detectors: Yes Total: 2119 sf Value: $257,570.85 Rear: 20 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 4 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: 3 201-400 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 2119 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 Fire Rated Eaves BEAVERTON,OR 97006 BEAVERTON,OR 97006 2 Ersn Cntrl 503-639-4175 PHONE: PHONE: 971-221-4597 FAX: 503-533-5164 Total Fees: $29,835.21 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 y of the ru direct questions to OUNC by calling 503.232.1987 or ....:' 344. Issued B �.40Z �, E{ Permittee Signature: 40 1 JP° C 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. Building Permit Application Residential 4. Received City of Tigard _ [ 7// Permit No.: - 1111 . 13125 SW Hall Blvd.,Tigard,OR 97223/A"-EC plan Revi i'^ 1� ® Phone: 503.718.2439 Fax: 503.598.19 "" �� Date/By: j [a i � Other Permit4Ig 20/u 1 i 3 5 TIC;A a D Inspection Line: 503.639.4175 _ Date Ready/By: IIIIII UUU / 9 is: H See Paagee22 for IJ Internet: www.tigard-or.gov MAY 1 t! 2018 • led/Method: c �� (t/i/ �J Supplemental Information `LLL�� //t�." ee t '11- 1 ' ❑•� Permit fees*are based on the value of the work performed. ®New construction �emo t ton Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit CAT i€ f GONS IIE t I work indicated on this application. 1,V ® 1-and 2-family dwelling 111Commercial/industrial Valuation: $ 25-,57 D ❑Accessory building 0 Multi-family Number of bedrooms: 3 ❑Master builder El Other: Number of bathrooms: 4 Total number of floors: 3 L9 408 srrl�IIvroietATc+�I+I LOCATION 2 Job site address:9544 SW Anna Belle Court New dwelling area: 2119 square feet S(2(. City/State/ZIP:TIGARD,OR Garage/carport area: 350 square feet 7i Suite/bldg./apt.no.: Project name:Ash Creek Village Covered porch area: )(square feet LKIca Cross street/directions to job site: Deck area: 231 square feet Other structure area: square feet REQ1JI 11)DATA;cOM1 kCIALVS CI 1iL ST Subdivision:Ash Creek Village 1 Lot no.:9 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 it SC, ON y k �'% work indicated on this application. NEW RESIDENTIAL CONSTRUCTION Valuation: $ Existing building area: square feet New building area: square feet *< PROPERTY R in TENANT': Number of stories: Name:SAGE BUILT HOMES LLC Type of construction: Address:1815 NW 169TH PL.SUITE 1040 Occupancy groups: City/State/ZIP:BEAVERTON,OR 97006 Existing: Phone:(503)533-5167 Fax:(503)533-5164 New: s., APPLICANTACF PERSON AILD PERMIv S'`* refer*fee$0144100 Business name:SAGE BUILT HOMES LLC Structural plan review fee(or deposit): Contact name:Ben Cooper FLS plan review fee(if applicable): Address:SAME AS ABOVE City/State/ZIP: Total fees due upon application: ' Amount received: Phone:(971)258-6658 Fax: :( ) 41I E-mail:Ben@SAGEBUILTHOMESLLC.COM `OVOLT� ?L R PAI�SYSTE M.IMEES*; ; ,.. of CON" RACTO�t Commercial and residential prescriptive installation P ,, roof-top mounted Photovoltaic Solar Panel System. Business name:SAGE BUILT HOMES LLC Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:SAME AS ABOVE 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.:189330 _ Total fee due upon application: $201.60 Authorized signature: 1--)41.,..--- C� % Z- This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Ben Cooper Date:5/17/2018 *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 USE ONL1 City of Tigard Received illh - 13125 SW Hall Blvd.,Tigard,OR 97223 Associated Permit No.: Date/Byr Phone: 503.718.2439 Fax: 503.598.1960 Associated permits: T I G A K D 24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW les No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 ❑ ❑ 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ 0 4 Fire district approval required. Name of district: . 0 0 0 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ 0 6 Sewer permit. ❑ ❑ 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 ❑plan ❑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 ❑ ❑ ❑ 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 ❑ ❑ ❑ there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 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- ❑ 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. ❑ ❑ ❑ 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- ❑ ❑ ❑ 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 ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 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 joists ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roo rut ss design details. 0 0 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Ore.on and shall be shown to be a..licable to the .ro'ect under review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". ❑ ❑ ❑ 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ElEl ❑ 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ ❑ 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 ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ ❑ and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. 1:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) 1 Mechanical Permit Apppg[�IVE' licat' FOR OFF It l St.()NI.1 T • City of Tigard `� ReceivedIZIEIWI / NM . 13125 SW Hall Blvd.,Tigard,OR 97223 �A y �7 g DDate/By: f a Phone: 503.718.2439 Fax: 503.598.1960 M I v 1 9 2 U Plan Review Date/By: Other Permit: T i G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris. H See Page 2 for Internet: www.tigard-or.gov CITY OF TI ARD Notified/Method: Supplemental Information 6«DING OIVISK .' TYPE OF V`ORIc;, :, ` ' aCOMMED6AL VED' SOriEDIILE ='VSE C IECk U T Mechanical permit fees*are based on the value of the work Z New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all El Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value.$ CATEGORY OF C()t!IS'I7tITC"I'IOI„ RESIDENTIAL,EQUIPMENN T/,SYSTEMS FE * ;' - ® 1-and 2-family dwelling El Commercial/industrial El Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total JOB SrE INRtitATONND IOC`ATKrHeating/cooling:A . Air conditioning 1 46.75 44.75 Job site address:9544 SW Anna Belle Court Furnace 100,000 BTU(ducts/vents) 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 Village Duct work 23.32 Cross street/directions to job site:SW 95th Avenue 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 Village Lot no.: 9 Other fuel appliances: Tax map/parcel no.: Water heater 1 23.32 23.32 C ION OF`WORRK. ' Gas fireplace/insert 1 33.39 33.39 ` ' Flue vent for water heater or gas New residential construction fireplace 1 23.32 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 v+ :PROPERTY OWNER , TENANT Environmental exhaust and ventilation: Name:Sage Built Homes,LLC. Range hood/other kitchen equipment 1 33.39 33.39 Address:1815 NW 169th Place,Suite 1040 Clothes dryer exhaust 1 33.39 33.39 City/State/ZIP:Beaverton,Oregon 97006 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 4 23.32 93.28 Phone:(971)221-4597 Fax:( ) Attic/crawlspace fans 1 23.32 23.32 t.:1 APPLICANT " c,CUNTACr PERSON ' Other: 23.32 Business name:Sage Built Homes,LLC. Fuel piping: $14.15 for first four;$4.03 for each additional Contact name:Ben Cooper Furnace,etc. 1 Address:Same as above Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater I Phone:(971)258-6658 Fax::( ) Fireplace 1 Range 1 E-mail:planning@sagebuilthomesllc.com Barbecue CONTRACTOR Clothes dryer(gas) Business name:All Time Heating&Cooling Other: MECHANICAL PERM T FEES* .. Address:PO Box 1341 Subtotal City/State/ZIP:Lake Oswego,Oregon 97035 Minimum permit fee($90.00) Phone:(503)208-2276 Fax:( ) Plan review(25%of permit fee) State surcharge(12%of permit fee) CCB lic.:184575 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: ,O.l2- 60124, * Fee methodology set by Tri-County Building Industry Service Board Print name:Ben Cooper �/ Date:5/17/2018 I:\Building\Pertnits\MEC_PermitApp_040113.doe 440-4617T(11/02/COM/WEB) 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 ApplicationFoR 01.1-1( I. l SF:1)N1,1 ' n 0. I Received City of Tigard Date/B Permit#. • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revrew ii1 "UI�`L AAAY �y 18 i Phone: 503.718.2439 Fax: 503.598.1960"I u Plate/l3 : Related Permit#: Inspection Line: 503.639.4175 r� {_ Ready Date/By: Bl See Page 2 for T 1(A R D Internet: www.tigard-or.gov CITY t �1 I� f to Notified/Method: ® Supplemental Information TYPE OF IG DIVISION PLAN REVIEW ®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑Service or feeder 400 amps or more ❑Building over three stories. 0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards, CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings, ® 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations buildings. 0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency systemlarger separately derived Job site address: 1 e ( 0 Addition of new motor load of system Job 4: c l t..f IAIWA Bole, W +. 100HP or more. ❑..A„ ..E,>,.1_2„..l_j., City/State/ZIP:Tigard Oregon 97223 ❑Six or more residential units. occreanon. ' 0 Health-care facilities. 0 Recreational vehicle parks. Suitelbidg.tapt.4: Project name: ,jh �, � 1r 1 p`1(�s/,� 0 locations 0 Supply voltage for more than �� 17 l "�*J) ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: ,f50, q,tt` At.. FEE SCHEDULE Description I Q4. I Each I Total l •• , New residential single-or multi-family dwelling unit. Subdivision: AS\,\ Cfee K. Lot 4: 9 Includes attached garage. Tax map/parcel 4: 1,000 sq.ft,or less 168.54 4 Ea.add]500 sq.ft.or portion 3392 1 DESCRIPTION OF WORK Limited energy,residential NEW RESIDENTIAL CONSTRUCTION (with above sq.R) 75.00 2 Limited energy,multi-family 75.00 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 2 Address: 1815 NW 1691.11 PL.SUITE 1040 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/Z1P:BEAVERTON,OR.97006 601 amps to 1,000 amps 301.04 2 Phone:(503)533-5167 Fax:(503)533-5167 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 1 own which is not 200 amps or less 59.36 l 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 a CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name:SAGE BUILT HOMES LLC above service or feeder fee, 7.42 2 each branch circuit Contact name: B.Fee for branch circuits without Address:SAME AS ABOVE servicencircuit or feeder fee,first branch c56.t8 2 City/State/ZIP: Each add']branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Fax: :( ) Each manufactured or modular 67,84 2 dwelliEmail: 1y �a7,SAGEBUILTHOMESLLC.COM Reconnectnonservly and/or feeder only 67,84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name:Ross Electric Sign or outline lighting 67.84 2 Address:2870 SE 751b Avenue,203 Signal circuit(s)or limited-energy ID See Page 2 2 panel,alteration,or extension. 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:(503)642-5815 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 Lie.: 157891 Electrical Lie.: 34-436C Suprv.Lie.:y)3_(' specifically listed(/s hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: � ' £� Subtotal: Print name:Stephen Ross Date: 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: . ¢.0.1.- 6 TOTAL PERMIT FEE: v This permit application expires if a permit is not obtained within 180 Print name: !Sen C,ry�,�,, Date: 5/17/2018 days after it has been accepted as complete. �'T� • Number of inspections allowed per permit. 1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440.46151'(11/05/COM/WET Plumbing Permit Application Building Fixtures L Ftllz OFFICE t SE O'I.\ City of Tigard y Received Permit No.: j J fol at 13125 SW Hall Blvd.,Tigard,OR 97223 SAY 7 2Q q I� DateBy: r /�'f�( 7 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 9 Date/By: Other Permit No.: TICARD Inspection Line: 503.639.4175 CITY OF IGiRD Date Ready/By: Juris lifi See Page 2 for Internet: www.tigard-or.gov Nohfied/Method Supplemental Information UILUIN UIVISIO ,. TAPE OF W RK PEE* SCHEDULE ®New construction 0 Demolition For special information use checklist. Description I Qty. I Ea. I Total 0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath312.70 ® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath ( , 437.78 SFR(3)bath _1 OI 0 500.32 500.32 0 Accessory building ❑Multi-family Each additional bath/kitchen iii C=D 25.02 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address:9544 SW Anna Belle Court Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard,Oregon 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 Lot no.: 9 Fixture or item: _ Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 1 25.02 25.02 New residential construction Dishwasher 1 25.02 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 0.:4 PROPERTY OWNER 1. 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,Suite 1040 Garbage disposal 1 25.02 25.02 City/State/ZIP:Beaverton,Oregon Hose bib 2 25.02 50.40 I Phone:(971)221-4597 Fax:( ) Ice maker 12.51 .4 APPLICANT CONTACT PERSON 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 5 25.02 125.10 City/State/ZIP: Solar units(potable water) 62.54 Phone:(971)258-6658 Fax::( ) Tub/shower/shower pan 3 12.51 37.53 E-mail:planningCsagebuilthomesllc.com Urinal 25.02 - - Water closet 25.02 CONTRACTOR Water heater 1 37.52 37.52 Business name:Ed Mullen Plumbing Water piping/DWV 56.29 Address:1601A SE River Road r Othe. 25.02 City/State/ZIP:Hillsboro,Oregon Subtotal Phone:(503)720-2636 Fax:( ) Minimum permit fee: $72.50 -"'� Plan review (25%of permit fee) CCB Lic.:92689 Plumbing Lic.no.:34-260PB "` State State surcharge(12%of permit fee) Authorized signature. TOTAL PERMIT FEE Print name:Ben Cooper f Date:5/17/2018 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\Pemuts\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: Site Utilities Fee t Total Square Footage: 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' 37.52Inatiot: , : 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 or Fees Qt,. Fee{ TWO 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 Realsce Plan review is required for anyof the following. Work Performed: Capped Added Relocate q Baptistry/Font Please check all that apply. Bath Tub/Shower El 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 ❑ 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" Isometric or Riser Diagram Car Wash Drain ❑ Isometric or riserdiagram is required for new buildings s Garbage -Domestic-non-foodq g 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/Lay -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 City of Tigard 1,1 u COMMUNITY DEVELOPMENT DEPARTMENT C T l c A R>a Building Permit Review — Residential Building Permit #: /y1S 3 a,0J 1.-!)_ Site Address: --4/ (S7Z,0 /93 >g/� co --71- Project Name: , er.Q, Vi? Lot #: ✓ (New dwelling=subdivision name;Addi:a f r Alteration=last name of owner) Planning Review Proposal: A-/t)? X V, Verify site address/suite# exists and actio permit system. 0 •ver Terrace Neighborhood: No ❑ Yes,See River Terrace Review Addendum Attached Sit 'Plan Elements: IVree(3) copies of site plan J I,'�r sting structures on site )ite plan must be on 8-1/2"x 11"or 11 x 17"paper 17 Footprint of new structure(including decks)with finished V Ckawn to scale(standard architect or engineer scale) i.or elevations orth arrow I i tility locations&easements (required for new and additions) o address,project or subdivision name and lot number tr !1 Si walk/driveway approach 1 0- pplicant information(name and phone number) ►l cation of wells/septic systems r ,,,, dimensions and building setback dimensions 'sting trees to be retained with drip line,and tree J ..uare footage of buildings to be demolished ` , rotection measures ►1 Lot area,building coverage area,percentage of coverage andreet tree size,type and location pervious area(applicable if R-7,R-12,R-25&R-40) Street names Property corner elevations (2 foot contour lines if more than >1,000 sf of impervious area created or replaced? AJ Yes ❑No 4 foot differential) If es,is a storm water .uality facili shown? 'J,°'M Yes ❑No di lean Water Services—Service Provider Lett r(lot platted prior to 9/10/1995): uired: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No Public Facilitie mprovement (PFI)Permit: pF,42_0A---,9-0,74/9 Required: Yes,applicant was notified ❑ No Applied For: /Yes ❑ No,stop intake Vand Use Case#: p,��f�Le/S -( ) J, sgU 07 't� C! ' oning: E—)2 PI) ;Required Setbacks: Front 7._ Rear (: ).0 Side s Street Side Garage o2 �andscape Requirement: 6 0/0 w�ot Coverage Maximum: ° ilding Height: Maximum Height 5S Actual Height <� II. isual Clearance _� ensitive Lands: 17Yes ❑ No Type •,L( —vJu2 '� 4/e A'%7 Ifroan Forestry Plan C Conditions "Met"prior to issuance of building permit Notes: fReviEl Approved By Planning: — T— .Z Date: . ---1---A-5-:— Revisions sions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\B1dgPermitRvw_RES_061417.docx Building Permit Submittal Original Submittal Date: c7/ 7/l P Site Plans: # Building Plans: , ' #,_,,__,�� Building Permit#: �")~nter building��permit--#above. � Workflow Routing: arming L�YI-�'.ngitieering 1 1-13ermit Coordinator ullding Workflow Sign-off: ] t-off for Planning(include notes from planning review) Route Application Documents: [-�gineering: (1) copy of permit application, (1) site plan, (1) building plan and ori • Ian review routing form. original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: /ice Date: 51/ 7/�el,' Engineering Review II Slope at building pad: /� 1{I Conditions "Met"prior to issuance of building permit II Easements (encroachments)per engineering conditions of approval and plat i • Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes t No Assess Water Quantity Fee in-lieu: ❑ Yes No LIDA Facility on lot: ❑ Yes No ❑ Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes:/er �j Approved by Engineering: Z, <- l / Date: _03:71--/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: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: Rev' ' n Notice 3: Date Sent to Applicant: SDC Fees Entered: Wash Co Trans Dev Tax: es ❑ N/A Tigard Trans SDC: es ❑ N/A Parks SDC: t�Yes CI N/A LIDA ❑ Yes N/A OK to Issue Permit / V Approved by Permit Coordinator: Date/Zy I:\Building\Forms\BldgPermitRvw_RES_010118.docx • RECEIVED City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT MAY 2 2 Z018 G ' a Request for Permit Action cmi OF ri ,$ i. qm- T 1 G A r D 13125 SW Hall Blvd. •Tigard, Oregon 97223 • 503-718-2439 • www.tiga 111 v'° I 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 (✓): ❑ CANCEL/VOID PERMIT APPLICATION. ❑ REFUND PERMIT 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#: MST2018-00142 Site Address or Parcel#: 9544 SW Anna Belle Ct Project Name: Ash Creek Village Subdivision Name: Ash Creek Lot#: 9 EXPLANATION: Requesting to remove A/C from permit and a refund Signature: Date: --.512 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. /ve,! /.Sca c772 J A727C77/ /9/G= am' /2-27'f A/i/e//ce7-7 FOR OFFICE USE ONLY Route to Sys Admin: Date By Route to Records: Date By Refund Processed: Date✓I//r} By 42r41 Invoice Processed: Date By Permit Canceled: Date /IV/, Bygt. Parcel Tag Added: Date By I:\Building\Forms\RcgPermitAction_092314.doc City of Tigard Tel: 503.718.2439 Location: Inspection Date: 9544 SW ANNA BELLE CT, TIGARD, OR, 97223 Record Type: Record ID: Residential - Master Permit MST2018-00142 Inspection Type: Inspector: 199 Electrical final David Young Result: FA I L Comments: Provide address on site for inspections. R319 Investigative fee to be applied at next inspection without correction. No inspection done at this time Violation Summary: Inspector Contractor City of Tigard Tel: 503.718.2439 Location: Inspection Date: 9544 SW ANNA BELLE CT, TIGARD, OR, 97223 September 3, 2019 at 12:50:22 PM Record Type: Record ID: Residential - Master Permit MST2018-00142 Inspection Type: Inspector: 699 Mechanical final Chip Barnett Result: PASS Comments: Previous corrections have been completed Violation Summary: Inspector Contractor City of Tigard Tel: 503.718.2439 Location: Inspection Date: 9544 SW ANNA BELLE CT, TIGARD, OR, 97223 September 4, 2019 at 9:13:02 AM Record Type: Record ID: Residential - Master Permit MST2018-00142 Inspection Type: Inspector: 299 Final inspection Aaron Cillo-Gobel Result: PASS - CofO Comments: Final erosion control approved. Moisture content form received. Moisture barrier form received. High efficiency lighting form received. Insulation certification verified. Duct seal test report received/verified. C of 0 left on counter. Violation Summary: Inspector Contractor Plumbing Permit Application Building Fixtures ,. . FOR OFFICE ESE ONE) City of Tigard 114 ^,t?5 I:- Date/By:d 7/A c/7 fJzt Permit No�,�c��ry/�i/ Z/Z, III ll 13125 SW Hall Blvd.,Tigard,OR 97233v �. "° ' J' r�'t vti/ C Plan Review Phone: 503.718.2439 Fax: 503.598.1960 - Other Permit No.: Date/By: Inspection Line: 503.639.4175 C. 1,i? ; Date Ready/By,...' lir s: H See Page 2 for Internet: www.tigard-or.gov „ . . • - ' - ' Notified/Medici& Supplemental Information s ..r * r , - r- t - For special information use checklist ®New construction ❑Demolition Description r Qty. I Ea. I Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) ig.' 8 s. s. f t - :` SFR(1 )bath 312.70 ,trs ® 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 0 Accessory building 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: g� Fire sprinkler( sq.ft.) Page 2 ri° r e : ',74r1-1 ',„..to 5'tipn .•+ t t ;`t •. ¢� . Site utilities: :. Job site address:9544 SW Anna Belle Ct Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard,Oregon 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:9 Fixture or item: Tax map/parcel no.: ,., Backflow preventer 31.27 �{ z tBackwater valve 12.51 ' 'I''''''''''''4' to :'_ Clothes washer 25.02 New residential construction/Plumbing contractor revision Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 '+ .: a ty y .rte'. ❑ . ;_.. rExpansion tank 12.51 Name:Sage Built Homes,LLC. Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 1815 NW 1696 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 fitt PPLICA T 4.7..,...' '. . i.- CO 0, 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 CON,I,RACTOR: -73,:t.0..„'„,,,,...,,, , Water closet 25.02 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 Lic.: 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-PermitApp.doc 10/01/09 440-4616T(I0/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Su i s ression S stems: Footing drain-V'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 S stems: Water Service-each additional 100' 37.52 � trin:ti,inttU 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 ffi l.,:;;.- t 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 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 char•e-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*. Quantiy.by Fixture Type :nit Plan Fixture Type for Re `We Plan review is required for any of the following. Work Performed: Capped Allied 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 CI 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 El Any multipurpose fire sprinkler system. Drinking Fountain El 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. IsometricDiagmn Car Wash Drain Garbage Domestic-non-food El 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