Permit CITY OF TIGARD MASTER PERMIT
2 : COMMUNITY DEVELOPMENT Permit#: MST2019-00306
Date Issued: 08/01/2019
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S134DB00600
Jurisdiction: Tigard
Site address: 11194 SW 114TH PL
Subdivision: BRIGHTWOOD SUBDIVISION Lot:
Project: Brightwood, Lot 8
Project Description: New SF Model Home. 7/31/19 DEMO CREDITS FROM BUP2019-00090 FOR
TRANSPORTATIONN AND PARKS SDCS APPLIED TOWARDS THIS PERMIT.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 6 First: 1142 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 23 Bathrooms: 3 Second: 1780 sf Garage: 741 sf Front: 20 Smoke Yes
Ri ht: 5 Detectors:
Dwelling Units: 1 Third: 0 sf g
Total: 2922 sf Value: $393,937.05 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs/Showers: 4 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 Other Fixtures: 0
Drywell-Trench Drain: 0 Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 6 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Y
Ecompasing:
Other: N Other Description:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF 2922
Owner: Contractor:
BRiME HOMES NW C Required Items and Reports(Conditions)
4230 SW GALEWOOD STE 100 4230 GALEWOOD STREET#100 1 Ersn Cntrl 503-639-4175
LAKE OSWEGO,OR 97035 LAKE OSWEGO,OR 97035
PHONE: 503-387-7577 PHONE: 503-387-7577
FAX: 503-387-7615
Total Fees: $10,094.88
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You ma obtain a cop i _estions to OUNC by calling 503.232.1987 or 1.800.332.2344
Issued By: X"------- ->- --%--, . -
Permittee Signature:
Ca . S 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 Applicatiaiit
Residential' FOR OFFICE USE ONLY
of
City of Tigard "t u�«i ca . . i t /f�i rParri' iii r
, II'' 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Rer�ew , ri- .41P / �.)� �
Phone: 501718.2439 Fax: 503.598.1960 Date/Bv: 7 as 1 rV
- k,
suis $t See Page 2 for
?t eidc 1,n Inspection Line: 503.639.4175 r, , _a, Date Ready/By. , Y
Internet: www.tigard-or.gov edMtet �� •#''l__ Strpptstrtental Information
TYPE OF WORK 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 t ne pr fit for the
pp n 3�-, 3—�
CATEGORY OF CONSTRUCTION work indicated on this application,
Valuation: $
® 1 and 2-family dwelling 0 Commercial/industrial
0 Accessory building ❑Multi-family
Number of bedrooms: Co
❑Master builder ❑Other: Number of bathrooms:
3
JOB SITE INFORMATION AND LOCATION Total number of floors: 2 33
Job site address: 1)191. Sik1 114 ► YL. New dwelling area: xltZ2 square feet 1'1 $C)
City/State/ZIP:Tigard,OR Garage/carport area: 74 t square feet L t Liz.
Suite/bldg./apt,no.: Project nmue: fi'ch
eap,•/ Covered porch area:, square feet
Cross street/directions to job site:SW North Dakota&SW 114ts Pl. Deck area: ^ square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:Brightwood Lot no.: $ Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
•
DESCRIPTION OF WORK work indicated on this application.
A Valuation: $
new,single family residence /'cJdZ / `/c•_
.hG Cc '73 _idtfLl.frtr1 '()(!)e)1 Existing building area: square fme
et
4.-/"../aL If p — T7-N,1^ L 79..•74`-..� /3:172.44.5., .�-.i ; New building area: square feet
►®:'PROPERTY OWNER 0 TENANT Number of stories:
Name:Stone Bridge Homes NW,LLC Type of construction:
Address:4230 Galewood St,Suite 100 Occupancy groups:
City/State/ZIP:I,ake Oswego,OR 97035 Existing:
Phone:(503)387.7577 Fax:(503)387.7615 New:
.. APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
fPtease refer to fee schedule)
Business name:Stone Bridge Homes NW,LLC
Structural plan review fee(or deposit):
Contact name:Deirdre Britt
FLS plan review fee(if applicable),
Address:same as above
Total fees due upon application:
City/State/ZIP:
Amount received:
E-mail:dbritt Jstonebtidgehontesmv,cam PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System,
Business name:Stone Bridge Homes NW,LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:4230 Galewood St,Suite 100 Solar Installation Specially Code checklist.
City/State•'ZIP: Lake Oswego,OR 97035 Permit Fee(includes plan review $180,00
and administrative fees):
Phone:(503)387.7577 Fax:(503)387.7615 State surcharge(12' of permit fee): $21,60
/
CCB lie,:173318 (41 6 / Total fee due upon application: $201.60
IIP'Authorized signature: I P pap lr yt
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Deirdre Britt Date: "Fee methodology set by Tri-County Building Lndustry
_�. 723/pl Service Board,
I:\Building\Permits\BUP-RESPertnitApp,doe 0224/2011 440.4613T(11,'02/C(DM/WEB)
. .
Mechanical Permit At)olicatiort . , ' , FOR OFFICE USE ONLY
City of Tigard . .; 11
Received
Permit\if,
•.- (.1 Date/By.
, *a 13125 SW Hall Blvd,Tigard,OR 97223 '-,L.,i-- .-, '-- ^-`-,'''' ,i,',,,,,,,,
; 2 ' Phone: 503.718.2439 Fax: 503.598,1960 Other Itemt.t
12.i.itti/flY
Inspection 1.iiiet 503,639 4175
TIGARD Date Ready/Bylims' El See Page 2 for
Internet: www.tigard-or.gov ...,„'.., Not itied'Rilethod Supplemental Information
1 . ,
copialititcjAL FEE. SCITEDDI4 7. DsR cliEc_RLIsT
Mechanical permit fees*are based on the value of the work
0 New construction P Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other. mechanical materials.euttipinent.labor,overhead,and profit,
Value:$
CATEGORY OF CONSTRUCTION
. RESIDENTIAL EQUIPMENT I SYSTEMS FEES"
El 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
0 Multi-family 0 Master builder E Other: Description Qty, Ea, Total
Heating/cooling;
: JOB SITE INFORMATION AND LOCATION Heatine
' - -
. ... . cotiditioriing
Job site address: 111141.1 w 114141 pi... Fun-lace 100,000 BTU(ductsivents) I 46.75
City/State/ZIP:Tigard,OR Furnace 100,0001 13TI,(ductsp,,eraNt. 54.91
Heat pump 61.06
SLI he/bldg./apt.no.: Project name:
23.32
Duct‘vork
Cross street/directions to job site:SW North Dakota&SW 114'P1 Hydroitic hot water system 23,32
......,
Residential boiler(radiator or
hydrottie) , 23.32
Unit heaters(hid-type,not electric),
in-wall,in-duct,suspended.etc. 46,75
Flue/vent for any of above 1 23.32 -. -
I Other: 23.32
Subdivision:Brightwood Lot no.: 12)
Other fuel appliances:
Tax map/parcel no.: Water heater 1 23.32 1
DESCRIPTION Op WORK Gas fireplace/insert 1 33.39
Flue vent for water heater or gas
new,single family residence fireplace 2 23,32
I,og lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
ItliTi PROPERTY OWNER 0 TENANT .
Environmental exhaust anti ventilation:
Name:Stone Bridge Homes NW,LLC Range hood/other kitchen
—
eguipmcnt I 33,39
Address:4230 Galewood St,Suite 100
Clothes dryer exhaust I 33.39
City/State/ZIP:Lake Oswego,OR 97035 Single-duct exhaust(bathrooms.
, toilet compartments,utility rooms) 7 23.32
Phone:(503)387.7577 Fax:(503)387.7615 Attic/crawlspace fans 23,32
APPLICANT 0 CONTACT PERSON , Other: tt 23.32
Fuel piping:
Business name:same as above
$14.15 for first four:54.03 for each additional
..
Contact name:Deirdre Britt Furnace,etc. 1
AddressGas heat pump
:-
- ..--- Wall/suspended/unit heater
City/Slate/ZIP: Water heater 1
( -)— - Fax. .( ) --*rrikelgaf4 i I
Range 1
E-mail:dbritt@stonebildgehomesnw.com
Barbecue
-----
CONTRACTOR Clothes dryer(gas)
Business name:Comfort Zone Other:
MECHANICAL PERMIT FEES"
Address:1032 NW Corporate Dr. Subtotal
City/State/ZIP:Troutdale,OR 97060 Minimum permit fee($90.00) .
Plan review(25%of permit feet
Phone:(503_)667.5595 Fax (503)491.8252
State surcharge(12%of i)crilait fee)
....- .,„„_,.... ._
CCB lie.:110091 TOl'AL.PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it lies been accepted as complete.
Authorized signatitte ‘, * Fee methodology set by Tri-Coerity Building intiustly Serince Board
Il'ritit riaine:David ileitIstab Date. 7/2.3/1 ,
I tRitilduigPeonesoNtr: Pritht,;pp C e 1,3 d;,., 1-10-loi)1.(,1,;,7 CC,t.1:51-,1,
Electrical Permit Application FOR OFFICE USE ONLY
Cityt7 Tigard and 1 j E 1{eLeiv'd
., Per
Date/P4, m:t it
I7,4
a 13125 SW Hall Blvd„Tigard,OR 97223 Plan Kry exp
I. Phone: 503.718,2439 Fax: 503.598.1960 ,te$) I.tr.c Permit 4:
T[GARD Inspection Ione: 503.639.4175 Ready D i c'By: s: H Seepage 2lot
,. Internet: ot
www,tigard-or. ov NrfieCiviethoci:
$ <.. , Supplemental Information
' PLAN.REVIEW ,
! TYPE OF WORK "' ,.,
®New constrttctloit ❑Addiiioit/alteratlonlIeplacelnent Please check all that apply(submit 2 sets of plans wntems checked`!
❑Demolition ❑Other: ❑Service or feeder 4(1 amps or more ❑Bu kI op over:tires stones,.
where the available taut current ❑mannas and boatyards..
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at:SO volts or 0 Floating suading,;
® I-and 2-family dwelling ❑Cial/inustr
dlal g l'"is gtaundexee
,or'''''''''`is14,1)(j0 on mere
0 ❑r al use agricultural
ommerc ❑Accessory bulldlllamps for all other instatlat:ensha:roto s.
❑Multi-family ❑Master builder ❑Other:
0 Fire pomp< ❑i n€rtl..€wr:of 14(i:CV.4 ur
JOB SITE INFORMATION AND LOCATION 0 Emergency system, larger separately derived
ad
Job#<
I Ct �#4'�'1 r L ❑Adr'ition cI rat,n•o..�r load cf sv tent
2,/�Z Job site address: t '`�'! J rN " • 1(sJ1IP o. Were. ❑ 4 ,,.)r•..,t.3'.••I.x•'.
City/State/ZIP:Tigard,OR
. ❑fix or mare r si:9ent�at r its. n�ctpaneq,
_ c_ ❑Itea(th-.,'t e tat.ilitii;. ❑Ke,.reat:erai o.t isle perks.. '
Suite/bldg./apt.#: Project name: ❑II';rardoa ccatiors, ❑s.,pp 7
✓otta e. r m,00 thor:
.:.. " ❑ .ervi�e s r tardy.60tt.imps u.men:
5u0voltsao ,nu:
Cross street/directions to job site:SW North Dakota&SW 114th PI
" FEE SCHEDULE
Description .:...: Qty. Each Total
New residential single-or multi family dwelling unit.
Subdivision:Brightwood Lot#:8 Includes attached garage.
1,000 sq.11.or less
lax ntap/parcel#: .2 j 168.54I. 4
Ea,add'1500 sq.ft.or portion 2. 33.92 1
DESCRIPTION OF WORK
Limited energy,residential
new,single family residence (with above sq.ft.) 7 ,00 2
Limited energy,multi-family 75.00 r
residential(with above sq.ft.)
Renewable Ener'y 0 See Page 2
El PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name:Stone Bridge Homes NW,LLC 200 amps or less 100.70 2
Address:4230 Gatewood St,Suite 100 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Lake Oswego,OR 97035 601 amps to 1,000 amps 301.04
Phone:(503)387.7577 Fax:(503)387.7615 Over 1,00t)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
Kg APPLICANT 0 CONTACT PERSON Branch circuits-new,alteration,or extension`Wer panel
A.Fee for branch circuits with
Business name:same as above above service or feeder fee, 7.42
each branch circuit
Contact name:Deirdre Britt B.Fee for branch circuits without —
Address: service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP: Each add'l branch circuit 7 4, 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax:
( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: dbritt ,stonebridgehomesnw.com Reconnect only 67.84 2
CONTRACTOR Punip or irrigation circle 67.84 2
Business name:City Electric Sign or outline lighting w 67„84 2
Address:5556E SW Schalteii siuTLn. panel.alteration,or extension. - 0 See Page 2 2
City/State/ZIP:Sherwood,OR 97140 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66,25/lir
Phone:(971)404.1714 Fax:(503)625.3052 Investigation(1 hr nun) 90.00.'hr
mail: Industrial plant(1 hr min) 78,18/hr
--- Inspections for which no fee is 9( t)0-lv
CCB Lie.. 42422 Electrical Lic.: 26-289C Suprv,Lie.: 35925 specifically hstcd(r i lu min)
ELECTRICAL PERMIT FEES
Suprv,Electrician signature,required: Subtotal:
Print name: Chuck Fiiesell Date: 773 el 0 Plan Review Required(25°u of permit lee):...
/� � State surcharge(12%ofpermit fee):
.•.,Authorized signature: `---•-_ e” ---' 1 Ol AL PERSIIT FEE. 1
'"""" """""'"'_"""w'""" '— -"------'--"-+ This permit application expires if a permit is not obtaitced within 180
[ Prltit name: Date' days after rt has been accepted as campfete.
!! ....._�-,�._-e______-d__
Electrical Permit Application— City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIALWORK ONLY: FEE SCHEDULE
`now.riptba I Q y. I' Each { Total l*
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: s "a or less 100"70
5.01 to 15 kva 133.56 2
❑ A• udio and Stereo Systems* 15.01 to 25 lcva 200.34
Wind generation systems in excess of 25 kva:
B• urglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
® Garage Door Opener*
>100 kva(fee in accordance
with OAR 918-309-0040) 55,26 2
® Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional k-va over 25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge a.0 3
Each additional inspection over allowable in any of the above:
Each additional inspection is
Other: charged at an hourly(1 hr mini, 66.25 hr
Inspections for which no fee is
specifically listed CA hr min) 90 hr
hr
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
Nu:nberuf inspe ;ons allowed lei ucrn,a_
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ A• udio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑; Fire Alarm Installation
H• VAC
❑ Instrumentation
El Intercom and Paging Systems
❑ Landscape Irrigation Control*
lel
❑ N• urse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
(l Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
L tadtda rI :•\.ei Pern:ain H as, P's';1.3 1'120
Plumbing Permit Application-
Building Fixtures FOR OFFICE USE ONLY
illCity of Tigard t ° ._.:` Recei
ztlu -na
d ,tt 13125 SW Hall Blvd.,Tigard;OR 97223 late 1Lnc;v
%' Phone: 503,718.2439 Fax: 503.598<1960Latei;Y ..?cher Perm it No•
T i G A R D Inspection Line: 503.639.4175 Date Ready/By. tons El See Page 2 for
Internet: www.tigard-or.gov Nabfied'Method Supplemental Information
TYPE OF WORK FEE* SCHEDULE
®New construction ❑Demolition For s,eciul in annul-on use checklist.
Desert ion tv.. =NI Total
❑Addition/alteration/replacement ❑Other:
P
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
® 1-and 2-family dwelling 1,❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 1 500,32
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 11�4 Sp/ !i41, f L� Catch basin or area drain 18,76
l Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name:
Manufactured home utilities 50.03
Cross street/directions to job site:SW North Dakota&SW 114th P1 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 IL:_) Page 2
Subdivision:Brightwood Lot no.; :„ Fixture et-lterrl:
Tax map/parcel no„: Backflow preventer t 31.27
- DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer I 25.02
new,single family residence
Dishwasher 1 25,02
Drinking fountain 25.02
Ejectors/sump 11111 25,02
121 PROPERTY OWNER 0 TENANT
Expansion tank
riiiii 25.02
Name:Stone Bridge Homes NW,LT.0 Fixture/sewer cap
' m Floor drain/floor sink/hub 25.02
Address:4230 Gatewood St,Suite 100
w.;._ Garbage disposal
City/State/ZIP:Lake Oswego,OR 97035 Hose bib 2. 25.02
Phone:(503)387.7577 Fax:(503)387.7615 Ice maker 12.51
07:t APPLICANT 0 CONTACT PERSON Interceptor/grease trap t
Page 2
Business name:same as above Medical gas(value:S )'
Primer 12.51
Contact name:Deirdre Britt
Roof drain(commercial) 12,51
Address: Sink-basitv'lavatory 725 02
City/State/ZIP: Solar units(potable water) 62.54
-- Tub/shower/shower.an �®
Urinal 25.02
E-mail:dbrittnstonebridgehomesnw.com
-- - Water closet 3 25,02
CONTRACTOR
Water heater I 37.52
Business name:Jardine Plumbing
Water piping D\\'V 56.29
Address:PO Box 186 Other: 25.02
City/State/ZIP: Estacada,OR 97023 Subtotal
Phone:(503)351.8532 Fax:(503)630.2882 Minimum permit He. 572,50
Plan review (25°o of permit fee)
CCB Lie,:108747 Plumbing Lie,no,: ((2,53 4;7--
State surcharge(12%ofp rnutfee)
Authorized signature: i'i 7 (ht) 3 -3-2•Ur t�!,/ TO"f AL PEItMI'I'FEE
Print name:Jay Jardine Date: ? ?j'3./' / This permit application expires if a permit is not obtained within 180 days
,m„_,,,.- „„_,,,, after it has been accepted as complete.
"Fee methodology set by 1n-County Rodding industry Service Board
I Isnit.: r t,rni ov n.,rar..iuAl t.doc ,0:;1:"9 4r10.161,5T;1::,02;' .A-:,1.:h
Plumbing Permit Aptlicatinn - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Tom 1 Square Footage: Permit Fee:
Footing drain-1'a 100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 3.7,92 2,001 to 3,600 $169.69
, 3,601 to 7,200 S233.20
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 -
I 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 $72050 for the first$5,000.00 and$1.52 for
Other Inspections or Fees' �p Fee(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 S50,000,00 and$1.20 for
(minimum charge—112 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,PlumbingInstallations;
Fixture Type for Replace/ Plan review is required for any of the following.
Work Performed: Capped Added Relocate 9 $•
Baptistry!Font Please check all that apply.
Bath Tuh-Shower ❑ Any new commercial building with water service 2"and
Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Then 0 New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040,
Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose lire sprinkler system.
Drinking Fountain 0 Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink 2" Submit 2 sets of plans with any of the above.
•
Isometric or Riser Diagram
Car Wash I)raut
Garbage Domestic-no„-foga
0 Isometric or riser diagram is required for new buildings
Disposal -Domestic—food related that meet the qualifications above.
-Commercial—food related
-Industrial-food related
'tCa=Ma R Drains v • a
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related <
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter
Washer-Clothes *Note: If the fixture work under this permit results in an
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
P:\City Permit Applications\Brightwood\B 4rV'PLMF_PermitApp-Jardine Pltttnhing.doc
I -
i21te2 �Vl -7tv�
Water Meter Fixture Unit Worksheet
Please complete the following information:
Contractor Name: �,Tp1�te$W me H omts NW/UC
Billing Address: Street/Suite#: 4230 GAIEW0DD CT, SOlTeIOO
City: (,per OSWtEO State: OR Zip: cl7035
Phone Number: Spa.39 VI517
New Meter Address: (I I�t4 SW 1144`1 FL,
Subdivision Name: 3t�4vNTWOOD Lot#: $
Building Permit#:
Please fill in the number of each fixture as detailed on the plans. Multiply the quantity by the point value
to arrive at the point total. Add all point totals together for total fixture unit points.
Fixture Unit Quantity Point Value Point Total
Bar sink x 1 =
Bidet x 1 =
Clothes washer I x 4 = s{"
Dishwasher I x 1.5 = I.5
Hose bib I x 2.5 = 2,S
Hose bib, each additional I x 1 = 1
Kitchen sink 1 x 1.5 =
Laundry sink ,,_'yam x 1.5 = _e. 0 : E
Lavatory x 1 = , j) J.in i-
Water closet, 1.6 GPF x 2.5 = . I N UPPER HA.
Bathtub/whirlpool I x 4 = 'BATH
Shower stall 2 x 2
Bath/shower combo i x 4 = '
Irrigation(#of heads in largest zone) 3 x 1 = 3 r
Total Fixture Unit Points: 3 tt J
Fixture Unit Points:
Up to 30=5/8" Over 37 = 1" -,---J=r—
pto37= 3g. 0
Meter Cost: ^1
Meter Size; -
****************************************************************** **** ***** <***
FOR OFFICE USE ONLY
Fixture Units Points verified with
Building(Master)Permit or Plumbing ❑Yes ❑No ❑ Other:
Meter#: Sale Date:
Receipt#: Meter Cost:
Employee Name:
I:/Building/Forms/WaterMeters_070119.dOCX Page 2
IF WATT-M6"Etz i tc t op-t I NSTaWEa Tx1N , VeVetop&ssT 4P
City of Tigard
IIIIq COMMUNITY DEVELOPMENT DEPARTMENT
T I c a RD Building Permit Review — Residential
Building Permit #: //l 57b)-0/1 - o g.o
Site Address: ///91 C9j) //41.m PI.
Project Name: n' /L7'L1jJaJ /74 D ,% Lot #:
(New we 'ng=subdivision name;Addition or Alteration=last name of owner)
Planning Review I / q /�
Pr posal: d1 1 t DC 7`t �� '� k 64'U-
1
4'C-
"--
MI Verify address/suite#active in Accela. i ► River Terrace. & No ❑ Yes,River Terrace Review Addendum
Sit,.Plan Elements: 4osion Control
03 copies of site plan on 8-1/2"x 11"or 11 x 17"paper V: -tained trees with drip line and tree protection measures
rawn to scale(standard architect or engineer scale) LrI ..otprint of new structure(including decks) and FFE
Orth arrow [4 U ' 'ty locations&easements (required for new and additions)
Vke address,project or subdivision name and lot number Sidewalk/driveway approach
Z .plicant information(name and phone number) SI'it ation of wells/septic systems
►MO.. dimensions and building setback dimensions t!_Peet tree size,type and location
II uare footage of buildings to be demolished LAS et names
I ;ftsting structures on site 11QComer elevations(2'contours if more than 4'diffee ntial)
tizi area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced LJ Yes ❑
impervious area(applicable if R-7,R-12,R-25&R-40) If es,is a storm water quality facility shown? n !ill Yes No
►, lean Water Services-Service Provider Lett (lot platted prior to 9/10/1995):
IiiPequired: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No
ublic Faciitigt Improvement(PFI) Permit:
—/Required: [Yes,applicant was notified ❑ No Applied For: Yes ❑ No,stop intake
i21;Land Use Case#: JEj '—O00() /Zoning: -
q 1-e utred Setbacks: Front: 0 Rear: Side: Street Side: /S Garage:e: 0
Building Height: Max. Height: - 0 Actual Height: r�1(p Ii
Landscapeiirea: % of Coverage M
Entrance 1V6et back no more than 8'from street-facing wall 01 Parallel to street or offset 45 degrees or less
Windows VAlinimum 12%of area of all street-facing facades
Garage ilOi Gara door is behind widest street-facing wall ❑ Yes J No,one of the following is met:
Door extends no more than 5'from wall and there is a covered porch extending beyond garage.
❑ Door extends no more than 5'from wa and there is a 12 sq ft.window above garage on 2nd floor.
Garage door width is ❑ 12'or less 50%or less of facade ❑ 60%or less and includes 7 of following:
❑ Covered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset
__ Ron€pitch 0 Gable,'flip,or gal surer roof ..fl Dormer
❑ Accent siding I. Window trim ❑ Window recess ❑ Window projection ❑ Balcony
Visual Clearance i► Urban Forestry an
Wensitive Lands: ❑ Yes Gg No Type:
❑ Conditions met nrinr to issuance of building permit
N s:
Approved By Planning: -//, ii Date: �a-1/1 V
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_RES_022819.docx
Building Permit Submittal
Original Submittal Date: 7/1711
Site Plans: #
Building Plans: #
Building Permit#: nter building permit#above.
Workflow Routing: Planningengineering "Permit Coordinator Building
Workflow Sign-off: Sign-off for lanning(include notes from planning review)
Route Application Documents: p>Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: , / Date:
En neering Review
IV Slope at building pad: Z;
❑ Conditions "Met"prior to issuance of building permit 1/1/4/ k!e4 e laic
❑ Easements (encroachments) per engineering conditions of approval and plat
LW'Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes VNo
Assess Water Quantity Fee in-lieu: ❑ Yes ["No
LIDA Facility on lot: ❑ Yes 'No
❑ Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: Date: -
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El Approved El Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance-ofbuilding permit
El Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
VSDC Fees Entered: Wash Co Trans Dev Tax: 1 "Ye ❑ N/A
Tigard Trans SDC: [i' es ❑ N/
Parks SDC: Yes ❑ /A
LIDA CI Yes N/A
OK to Issue Permit
/' /
, )1
Approved by Permit Coordinator: Date:
I:\Building\Forms\B1dgPermitRvw_RES 022819.docx