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Permit (150) CITY OF TIGARD MASTER PERMIT MI1.' COMMUNITY DEVELOPMENT Permit#: MST2019-00358 !, Date Issued: 09/18/2019 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 i , ������ ��� Parcel: 1S134BD12000 rilr'�IIlMrf�iPW1 Jurisdiction: Tigard Site address: 11997 SW SUMMERBROOK LN Subdivision: SUMMERBROOK SUBDIVISION Lot: 3 Project: Summerbrook, Lot 3 Project Description: New SF. Backflow preventer included. 10/21/19: REPRINTED permit to add A/C. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 3 First: 2102 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 16 Bathrooms: 3 Second: 0 sf Garage: 577 sf Front: 20 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 5 Detectors. Total: 2102 sf Value: $286,990.33 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 DrCatch Basins: 0 Bckflw Prevntr: 1 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: 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 Ecompasing: Y Other: N Other Description: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2102 Owner: Contractor: WEEKLEY HOMES LLC WEEKLEY HOMES Required Items and Reports(Conditions) 1905 NW 169TH PL STE 102 1905 NW 169TH PLACE SUITE 102 1 Ersn Cntrl 503-639-4175 BEAVERTON,OR 97006 BEAVERTON,OR 97006 PHONE: 503-213-4415 PHONE: 503-213-4415 FAX: Total Fees: $32,877.11 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a c oftdag rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: 7i,`-- _ '-z--- `'� Permittee Signature: . .. I ;3.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application FOR OFFICE USE ONLY Cl of Tigard Received `J Date/Ry i L),.�,g .�-i ,, Permit No.: r. e` ` . , TA 111 1111 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review I Phone: 503.718.2439 Fax: 503.598.1960Date/By. Other Permit: TI G R D Inspection Line: 503.639.4175r tG Ready/By: Iuris: ® See Page 2 for Internet: www.tigard-or.gov EcEqd i _. ,ti)ied/Method: Supplemental Information TYPE OF WORK Ott; . ` Print name:Hannah Scharer ®New construction ❑Addition/alteration/repla COMMERCIAL FEE* SCHEDULE — USE CHECKLIST CI Demolition ❑Other. 4-,_ �r�� t t3 �yy�u Mechanical permit fees*are based on the value of the work 1LDIL� 11[ �V 1°, performed.Indicate the value(rounded to the nearest dollar)of all CATEGORY OF CONSTRUCTION ,0mechanical materials,equipment,labor,overhead,and profit. ® 1-and 2-family dwelling ❑Commercial/industrial 0 A,e c sr Iii > l r,: Value:$ El Multi-family 0 Master builder ❑O RESIDENTIAL EQUIPMENT/SYSTEMS FEES* lt.;) I lam. 6 J For special information use checklist. JOB SITE INFORMATION AND LOCAT : Descri• ption Qty. Ea. Total Job site address:11997 SW SUMMERBROOK LANE Heating/cooling: City/State/ZIP:Tigard/OR/97223 Air conditioning 1 46.75 Furnace 100,000 BTU(ducts/vents) 46.75 Suite/bldg./apt.no.: Project name:Summerbrook Furnace 100,000+BTU(ducts/vents) 54.91 Cross street/directions to job site:SW 121'Ave and Summerbrook Lane Heat pump 61.06 Duct work 23.32 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 Subdivision:Summerbrook Lot no.:03 Flue/vent for any of above 23.32 Tax map/parcel no.:TBD Other: 23.32 DESCRIPTION OF WORK Other fuel appliances: Water heater _ 23.32 New single family home to be built-2102 sqft,3 bedroom 2.5 bath home with Gas fireplace/insert 33.39 577 sqft 3 car garage Flue vent for water heater or gas fireplace 23.32 Ad! ,/c: Log lighter(gas) 23.32 S Wood/pellet stove 33.39 Wood fireplace/insert 23.32 ►'i PROPERTY OWNER 0 TENANT Chimney/liner/flue/vent 23.32 Name:Weekley Homes LLC Other: 23.32 Environmental exhaust and ventilation: Address:1111 N Post Oak Road Range hood/other kitchen City/State/ZIP:Houston,TX 77055 equipment — 33.39 Clothes dryer exhaust 33.39 Phone:(503)213-4415 Fax:( ) Single-duct exhaust(bathrooms, ® APPLICANT ® CONTACT PERSON toilet compartments,utility rooms) 23.32 Attic/crawlspace fans 23.32 Business name:David Weekley Homes Other: 23.32 Contact name:Michele Schiedler Fuel piping: $14.15 for first four;$4.03 for each additional Address:1905 NW 169th Place,Suite 102 Furnace,etc. City/State/ZIP:Beaverton/OR/97006 Gas heat pump Phone:(503)213-4415 Fax: :( ) WalUsuspended/unitbeater Water heater E-mail:mschiedler@dwhomes.com Fireplace CONTRACTOR Range Barbecue Business name:David Weekley Homes Clothes dryer(gas) Address:1905 NW 169th Place Suite 102 Other: MECHANICAL PERMIT FEES* City/State/ZIP:Beaverton/OR/97006 Subtotal Phone:(503)213-4415 Fax:( ) Minimum permit fee($90.00) CCB lie.:213653 Plan review(25%of permit fee) State surcharge(12%of permit fee) 45/ TOTAL PERMIT FEE c. Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. I:\Building\Permits\MEC_PermitApp_040113.dochnrh WJW' r fr / t 440-46171(11/02/COM/WEB) CITY OF TIGARD MASTER PERMIT 111 I COMMUNITY DEVELOPMENT Permit#: MST2019-00358 T-I( r1 k.i] 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/18/2019 Parcel: 1S134BD12000 Jurisdiction: Tigard Site address: 11997 SW SUMMERBROOK LN Subdivision: SUMMERBROOK SUBDIVISION Lot: 3 Project: Summerbrook, Lot 3 Project Description: New SF. Backflow preventer included. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 3 First: 2102 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 16 Bathrooms: 3 Second: 0 sf Garage: 577 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2102 sf Value: $286,990.33 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 1 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: 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!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 2102 Owner: Contractor: WEEKLEY HOMES LLC WEEKLEY HOMES Required Items and Reports(Conditions) 1905-1999, TH PC'STE 102 1905 NW 1b9I H PLACE SUITE 102 f Ersi entf# -4t75 BEAVERTON,OR 97006 BEAVERTON,OR 97006 PHONE: 503-213-4415 PHONE: 503-213-4415 FAX: Total Fees: $32,824.75 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notificati Center. Those rules are set forth in OAR 952-001-0010 through R 952-0 -009, You may obta' a copy of the rules or direct questions to OUNC by calling 232.19 7 or 1.800.332.2,44. Issued By: 4 Permittee Signature: �� -4/1°''l�� Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. ' Buildinu Permit Application Residential is i .J -.. ,. v FOR OFFICE USE ONLY Cityof Tigard , Received b� l' Date/By: n� j 7. G a,1.--C ,� ill III I 13125 SW Hall Blvd.,Tigard,OR 972'L Plan Review q J �[/ Phone: 503.718.2439 Fax: 5031594;1.9010 1 I I � 5 e-P it: z 6 � Date By: TI G A R D Inspection Line: 503.639.4175 'j r°` r Date Ready.By: , / / /. , Jwis: ® See Page 2 for Internet: www.tigard-or.gov 3'� r;�_.°` Notifieda a `/ [/ y 1 Supplemental Information TYPE )P ARK REQUIRED DATA:1-AND 2-FAMILY DWELLING ®New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all 0 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. // 1-and 2-family dwelling 0 Commercial/industrial Valuation: 0,000 Z$(P19 O ❑Accessory building 0 Multi-family Number of bedrooms: 3 ❑Master builder 0 Other: Number of bathrooms: x.; JOB SITE INFORMATION AND LOCATION Total number of floors: 1 .2 (i7 Q( Job site address:11997 SW SUMMERBROOK LANE New dwelling area: 2102 •-----squt((are-fee City/State/ZIP:Tigard/OR/97223 Garage/carport area: 577 square feet Suite/bldg./apt.no.: Project name:Summerbrook Covered porch area: 60 square feet Cross street/directions to job site:SW 121' Ave and SW Summerbrook Lane Deck area: square feet Other structure area: X square feet REQUIRED DATA:CGMMERCIAL-USECHECKLIST Subdivision:Summerbrook Lot no.:03 Permit fees*are based on the value of the work performed. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. New Single Family Home to be built-2102 SQFT 3 Bedroom,2.5 bath with 577 SQ Valuation: $ FT 3 car garage, Existing building area: square feet New building area: square feet ® PROPERTY OWNER ❑ TENANT Number of stories: Name:Weekley Homes LLC Type of construction: Address:1111 N Post Oak Road Occupancy groups: City/State/ZIP:Houston,TX 77055 Existing: Phone:(503)213-4415 Fax:( ) New: 0 APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES* Business name:David Weekley Homes (Please refer to fee schedule) ./- Structural plan review fee(or deposit): Contact name:Michele Schiedler to FLS plan review fee(if applicable): Address: 1905 NW 169 Place,Suite 102 Total fees due upon application: City/State/ZIP:Beaverton/OR/97006 Phone:(503)21 -4415 -- Fax: :( ) ---11-- _ ._ 1t[mo[mFtea�ived. PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail:mschiedler@dwhomes.com fa, ;.. ,, Commercial and residential prescriptive installation of P -Ai* _ CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System. Business name:David Weekley Homes Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 1905 NW 169th Place,Suite 102 Solar Installation Specialty Code checklist. City/State/ZIP:Beaver R/97006 Permit Fee(includes plan review $180.00 and administrative fees): Phone:(503)213-441 Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.:213653 Total fee due upon application: $201.60 Authorized signature: (/✓ l This his permit application expires if a permit is not obtained /(((fff (!/r / within 180 days after it has been accepted as complete. Print name:Michele chiedier Date:9/4/19 *Fee methodology set by Tri-County Building Industry Service Board. 1:\Building\Pennits\BUP- ESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) ' Building1Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONLY City of Tigard Received City Date;By: Permit No.: 13125 SW Hall Blvd.,Tigard,OR 97223 Associatedermits: I Phone: 503.718.2439 Fax: 503.598.1960 P 24-Hour Inspection Line: 503.639.4175 ® Electrical ® Plumbing ® Mechanical I TiGARD Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAIN REVIEW Yes No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. Z ❑ ❑ 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ® ❑ 0 3 Verification of approved plat/lot. ® 0 0 4 Fire district approval required. Name of district: ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ ❑ 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- ® ❑ ❑ 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 ® ❑ ❑ 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, ® ❑ ❑ 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- Z ❑ ❑ 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. Z ❑ ❑ 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 ® ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ 2 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 Z ❑ ❑ 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 Z ❑ ❑ 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". Z ❑ ❑ 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ® ❑ ❑ 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ® ❑ ❑ 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. Z ❑ ❑ 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ® ❑ ❑ 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. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) • Mechanical Permit Application..; ` , ` : FOR OFFICE USE ONLY @ L. - Received City of Tigard Permit No.: Date/By: 13125 SW Hall Blvd.,Tigard,OR 97223 [_D iS Z�} Plan Review a Phone: 50 3.718.2439 Fax: 503.598.1960 `" Dae' Other Permit: Inspection Line: 503.639.4175TIGARDtDate Read/BY Ju isI See Page 2 for Internet: www.tigard-or.gov k 1 F s a p r (-,ti Notified/Method: Supplemental Information TYPE OF WORK ` Print name:Ken Puttman ►T.1 New construction 0 Addition/alteration/replacement COMMERCIAL F S DEILEtISE'CIIE@KLIST ❑Demolition 0 Other: Mechanical permit fees*are based on the value of the work performed.Indicate the value(rounded to the nearest dollar)of all CATEGORY OF CONSTRUCTION mechanical materials,equipment,labor,overhead,and profit. ►� 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building Value:$ ❑Multi-family 0 Master builder ❑Other: RESIDENTIAL EQUIPMENT/SYSTEMS FEES* For special information use checklist. JOB SITE INFORMATION AND LOCATION Description Qty. Ea. Total Job site address: 11997 SW SUMMERBROOK LANE Heating/cooling: City/State/ZIP:Tigard/OR/97223 Air conditioning 46.75 Furnace 100,000 BTU(ducts/vents) 1 46.75 Suite/bldg./apt.no.: Project name:Summerbrook Furnace 100,000+BTU(ducts vents) 549I Cross street/directions to job site:SW 121't Ave and Summerbrook Lane Heat pump 61.06 Duct work 23.32 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 Subdivision:Summerbrook Lot no.:03 Flue/vent for any of above 23.32 Tax map/parcel no.:TBD Other: 23.32 DESCRIPTION OF WORK Other fuel appliances: .. ... Water heater I 23.32 New single family home to be built-2102 sqft,3 bedroom 2.5 bath home with Gas fireplace/insert 1 33.39 577 sqft 3 car garage Flue vent for water heater or gas fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 PROPERTY OWNER 0 TENANT.i Chimney/liner/flue/vent 23.32 Name:Weekley Homes LLC Other: 23.32 Environmental exhaust and ventilation: Address: 1111 N Post Oak Road Range hood other kitchen City/State/ZIP:Houston,TX 77055 equipment 1 33.39 Clothes dryer exhaust 1 33.39 Phone:(503)213-4415 Fax:( ) Single-duct exhaust(bathrooms, Z APPLICANT CONTACT PERSON toilet compartments,utility rooms) 4 23.32 Attic/crawlspace fans 23.32 Business name:David Weekley Homes Other: 23.32 Contact name:Michele Schiedler Fuel piping: Address:1905 NW 169'"Place,Suite 102 $14.15 for first four;$4.03 for each additional Furnace,etc. City/Stater'' avert /QR1970Q4 Galleat_punw Wall/suspended/unit heater Phone:(503)213-4415 Fax::( ) Water heater E-mail:mschiedler(a@dwhomes.com Fireplace CONcTOR i Range Business name:David Weekley HomesBarbecue Clothes dryer(gas) Address: 1905 NW 169th Place Suite 102 Other: City/State/ZIP:Beaverton/OR/97006 EC-1: 4N104:::7*-[M1TFEES* Subtotal Phone:(503)213-4415 Fax:( ) Minimum permit fee($90.00) CCB lir.:213653 Plan review(25%of permit fee) State surcharge(12%of permit fee) TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. C\Budding tPermits MEC_PermitApp_04011 3.doe 440-4617T(1 1/02,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_PennitApp_040113.doc 3 C� Electrical Permit Application S-.F b 201 FOR 01Fl(F Fat:Oy1.1 Cityo Tigard i.-I ' ' .r ,s ' f g C ; a Permit#: lig • 13125 SW Hall Blvd.,Tigard,OR 9722311: " ° , r "`7 I g a �t � ''P � 'eview Phone: 503.718.2439 Fax: 503.598.1960"' Date/B : Related Permit#: �.1 A D Inspection Line: 503.639.4175 Ready Date/By: tuns: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information °'TYPE OF WORK t, .PLAN REVIEW ®New construction ❑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. ❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF:CONSTRUCTION , , •?, " , , A exceeds 10,000 amps at 150 volts or 0 Floating buildings. ® I-and 2-family dwelling 0 Commercial/industrial ❑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 ❑Other: ❑Fire pump. ❑Installation of 150 KVA or JOB:SITE INFORMATION.,Ar11)1oc r oNA. „ , w,Ak* ,., ['Emergency system. larger separately derived Addof Job#:68020003 Job site address: 11997 SW SUMMERBROOK ❑100H ooP or moew motor load of system. 00Hmore. ❑"A""E""I-2""I.3" City/State/ZIP:Tigard/OR/97223 ❑Six or more residential units. occupancy. ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: Project name:Summerbrook ['Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more 600 volts nominal Cross street/directions to job site:SW 121st Ave and Summerbrook Lane FEE'SCHEDULE Description I Qty. I Each I Total I • New residential single-or multi-family dwelling unit. Subdivision:Summerbrook Lot#:03 Includes attached garage. 1,000 sq.ft.or less 1 168.54 168.54 4 Fax map/parcel#:TBD Ea.add'1 500 sq.ft.or portion 3 33.92 107.76 1 DESCRIPTIO1Nri)P4PORIC -41:6WArgAtnAiNt Limited energy,residential New single family home to be built-2102 sqft,3 bedroom 2.5 bath home with (with above sq.ft.) 75.00 2 Limited energy,multi-family 75.00 2 577 sqft 3 car garage residential(with above sq.ft.) Renewable Enemy ❑ See Page 2 ra PROPERTY OWNER `+. . TENANT,. , _. ` ' Services or feeders installation,alteration,and/or relocation Name:WEEKLY HOMES LLC 200 amps or less 100.70 2 Address: 1111 N POST OAK ROAD 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:HOUSTON TX 77055 601 amps to 1,000 amps 301.04 2 Phone:(503)213-4415 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 APPLICANT> '-a CONTACF)P1tItSON, .,:,`,.. ;, Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuiu with Business name:David Weekley Homes above service or feeder fee, 742 2 each branch circuit Contact name:Michele Schiedler B.Fee for branch circuits without Address: 1905 NW 169th Place Suite 102 service or feeder fee,first 56.18 2 branch circuit City/State/ZIP:Beaverton/OR/97006 Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(503)213-4415 Fax::( ) Each manufactured or modular 67.84 2 dwelling,service and/or feeder - Email:mschiedler@dwhomes.com Reconnect only 67.84 2 ` ... CONTRACTOR " " " '` ^' � .zR Pump or irrigation circle 67.84 2 Business name:Garner Electric Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address:-2920 SE BROOKWOOD AVE STEA ,❑See P�e2 _ 2 _ City/State/ZIP:HILLSBORO,OR 97123 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(503)648-4552 Fax:(503)642-7925 Investigation(1 hr min) 90.00/hr Email:andreap@garnerelectric.com Industrial plant(I hr min) 78.18/hr Inspections for which no fee is CCB Lic.: 121159 Electrical Lic.: 34-31 �, p ic.: 3707S specifically listed CA hr min) �/hr /i ELECTRICAI.PERMIT FEES Suprv.Electrician signature,required: I i Subtotal: Print name: Charles Garner i Date: 9/5/2019 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: andiea" • , TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Andrea Phillips ate: 9/5/2019 days after it has been accepted as complete. • Number of inspections allowed per permit. i`Building';Permiis\ELC PermitApp_ELR ERE.doc Rev 06/17/2015 440.4615T(t 1/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: z.s ag It. li ;t,..Y. Fee for all residential systems combined: $75.00 Description Qty. l Each c I Total I • y Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to25kva 200.34 2 Wind generation systems in excess of 25 kva: ❑ Burglar 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) 552.26 2 ® Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 ❑ Vacuum Systems* >100kva-noadditionalcharge 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 90.00/hr specifically listed('h hr min) COMMERCIAL WORK ONLY: crRIC4L PERMCr"FEES%. . Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):• Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems O Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC O Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical _.�..._ ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: _ *No licenses are required. Licenses are required for all other installations I'.Building'Permits\ELC PermitApp ELR ERE.doc Rev 06/17/2015 • • ,. Pldmbin2 Permit Application,. ik ,. -a Y •• Building Fixtures 1OR 011 I( 1 1 ‘,1 0v1 1 City of Tigard SEP 2('10 Received .i Date/By: Permit No.: a 13125 SW Hall Blvd.,Tigard,OR 97223. B Phone: 503.718.2439 Fax: 503.598.1940 ' a t Da1gy eW Other Permit No.: 1 t(;,v 1;1 Inspection Line: 503.639.4175 n : ;a' } ',.,Date Ready/By. Juni ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information _.. .. .-... ..:......_.-.. ... .._..... op:Wc111Ric -... ... ._...... .. . ._. ........ . . . FEE . ®New construction ❑Demolition For special information use checklist Description I Qty. I Ea. I Total ❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 0 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 1 437.78 437.78 buildingSFR(3)bath 500.32 0 Accessory 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address:11997 SW SUMMERBROOK LANE Catch basin or area drain 18,76 City/State/ZIP:Tigard/OR/97223 Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.: Q) Page 2 87.55 Suite/bldg./apt.no.: I Project name:Summerbrook Manufactured home utilities 50.03 Cross street/directions to job site:SW 121°Ave and SW Summerbrook Lane Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision:Summerbrook I Lot no.:03 Fixture or item: Tax map/parcel no.: Backflow preventer 1 31.27 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 1 25.02 25.02 New Single Family Home 2102 sqft 3 bedroom,2.5 bath with 577 sqft 3 car garage Dishwasher 1 25.02 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 0 PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Name:Weekley Homes LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:1111 N Post Oak Road Garbage disposal 1 25.02 25.02 City/State/ZIP:Houston TX 77055 Hose bib 2 25.02 50.04 Phone:(503)213-4415 Fax:( ) Ice maker 1 12.51 12.51 0 APPLICANT 0 CONTACT PERSON interceptor/grease trap 25.02 Business name:David Weekley Homes Medical gas(value:$ ) Page 2 Contact name:Michele Schiedler Primer 12.51 Roof drain(commercial) 12.51 Address:1905 NW 169th Place,Suite 102 Sink/basin/lavatory 4 25.02 100.08 City/State/ZIP:Beaverton/OR/97006 Solar units(potable water) 62.54 Phone:(503)213-4415 Fax::( ) Tub/shower/shower pan 2 12.51 25.02 E-mail:mschiedler@dwhornes.com CONTRACTORWater closet 2 25.02 75.06 Water heater 1 37.52 37.52 Business name:Malmedal Plumbing Water piping/DWV 56.29 Address:PO Box 207 Other: 25.02 City/State/ZIP:Ban ks/OR/97106 Subtotal Phone:(503)324-0759 Fax:( ) Minimum permit fee: $72.50 CCB Lie.:102535 Plumbing Lic.no.:34-276PB Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: 1101111° TOTAL PERMIT FEE t� ^ This permit application expires if a permit is net obtained within 180 days Print name: CJI V t` i �) �j�(/, (t Date:t�l after it has been accepted as complete. `��"� i *Fee methodology set by Tri-County Building Industry Service Board. CtBuilding\Permits\PLMU-PermitApp.doe 10/01/09 440-4616T(10/02/COM/WEB) -, 4 ' Plumbing Permit Application Building Fixtures - ,-- . !` :-. ` FOR OFFICE USE ONLY City of Tigard Received Permit No 1 71 q 13125 SW HallllBlvd.,Tigard,OR 97223 t. (> _ Date/By: 1� ���"' \� ��-0.(1-1-1.§:7:-) Plan Review Phone: 503.718.2439 Fax: 50 3.598.1960, Data/By: Other Permit No.: TIGARD Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov Notitied/ivlethod: Supplemental Information TYPE OF WORK,... FEE* SCHEDULE ,,.M.., .,. I New construction 0 Demolition For special information use checklist. Description I Qty. I Ea. I Total ❑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 ❑Accessory buildingSFR(3)bath 500.32 0 Multi-family • Each additional bath/kitchen 25.02 0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION" Site utilities: Job site address: 11997 SW Summerbrook Lane Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard,OR 97223 Footing drain(no.linear fl.:_) Page 2 Suite/bldg./apt.no.: I Project name:Summerbrook Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 SW 121s'Avenue 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:Summerbrook I Lot no.:3 Fixture or item: Tax map/parcel no.: Backflow preventer 1 31.27 DESCRIPTION OF WORK Backwater valve 12.51 ' Clothes washer 25.02 Irrigation and backflow for lot 3 landscaping Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 t " Expansion tank 12,51 ® PROPERTY OWNER I ❑ TENANT P Name:Weekley Homes,LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 1905 NW 169a'Place,102 Garbage disposal 25.02 City/State/ZIP:Beaverton,OR 97006 Hose bib 25.02 Phone:(503)213-4415 Fax:( ) Ice maker 12.51 APPLICANT ® CONTACT PERSON interceptor/grease trap 25.02 Business name:David Weekley Homes Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:Hannah Scharer Roof drain(commercial) 12.51 Address:1905 NW 169th Place,102 Sink/basin/lavatory 25.02 City/State/ZIP:Beaverton,OR 97006 Solar units(potable water) 62.54 ' TiibTshowerls1iower pan _ 1'2.51 Phone:(503)7(8-4742 Fax: :( ) E-mail:hscharer@dwhomes.com Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name;Gro Outdoor Living Water piping/DWV 56.29 Address:5800 NE 88th Street Other: 25.02 City/State/ZIP:Vancouver,WA Subtotal Phone:(360)727-5974 Fax:( ) NI { Minimum permit fee: $72.50 CCB Lie.:193268 Plumbing Lic.no.: Plan review (25%of permit fee) i A.,,, State surcharge(12%of permit fee) Authorized signature: t3� �' TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days Print name: ,�,� Date:�9/idtq after it has been accepted as complete, *Fee methodology set by Tri-County Building Industry Service Board. I:`.Building'Permits0PLMl1-PennitApp.doc 10/01/09 440-4610T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Su•pression Systems: ! 1-9N*� <�h }}t pQ ,,,TA,,,v,��",i , y F p x-..r Q6,1, -,47:*,-„,, ,,,,., w'w'"' Y �' ' 'I/ .t`",(_N,}Pi�' z i a /to � , ay i 4 c ,''II IFlYSi>.i. ;,,'sn ;tr'.11',� A 4,i g *,,- , `,,'i� se`:....., ,re Footage % -, !1 `Feed w1r ' .,'�„ , Footing drain-1e 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 r -n ,.', i l .otic umtir�' 'iii t. t ' ;v � uahon a 'e n4 ee '._. I,: Storm&Ram 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 „t r s ed ,,d, ra a u �, .Vat each additional$100.00 or fraction thereof,to Q l �nspeetions orantleP ,3.-- , , 3i .. � , 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*. vw urn i ti Vii fufufe T n. a ,., r r + " , ht!a a .an i, W•.raw w Q pe . flan Renewttor lu` ing;Itita atidnr = �,4 ,r7-F,tl re Type for thi t',iis $r`aS`�' Fe ? Plan review is required for any of the following. Wai'k etbrmett: Capp , ced 0(!.1 .x ,., elocate •' 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 0 New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR91.8-780-0040. Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities. -Domestic 0 Any multipurpose fire sprinkler system. Drinking Fountain 0 Any complex structure as defined in OAR918-780-0040. Eye Wash Floor Drain/sink -2" Submit 2 sets of plans with any of the above. Car Wash Drain 0 .Isometric or riser diagram is required for new buildings Garbage -Domestic-non-food Disposal -Domestic-food related that meet the qualifications above. -Commercial-food related -'(ndusina1-Th d-re1iTed -- 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\hbrecken\Downloads\PLMF_PermitApp(1).doc 2 City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT IIII T I G A R D Building Permit Review — Residential Jf3.r. Building Permit #: 7 S�`�(JL j— /.-,c--? Site Address: I.!VI- .�t,/ 1:,A.N,I* C lc (__ani. Project Name: r,v-`;r' Lot #: 3 (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Pro osal: t'i i A PiO.A. 1 J Verify address/suite#active in Accela. �S In •River Terra : LDNo E Yes,River Terrace Review Addendum Site/Plan Elements: li osion Control Itl opies of site plan on 8-1/2"x 11"or 11 x 17"paper IIQR ed trees with drip line and tree protection measures wn to scale(standard architect or engineer scale) rint of new structure(including decks)and FFE rth arrow t ,9ty locations&easements (required for new and additions) e address,project or subdivision name and lot number •W'idewalk/driveway approach Ac plicant information(name and phone number) ation of wells/septic systems Lot dimensions and building setback dimensions 4.treet tree size,type and location Lfi�� are footage of buildings to be demolished 0S et names RExisting structures on siteorner elevations(2'contours if more than 4'differ tial) ;ot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? 'es CI No tm ervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑YNo EJ Clean Water Services-Service Provider Letter of platted prior to 9/10/1995): I-4,troj fie- quired: ❑ Yes,applicant was notified wJ No Received: 1=1 Yes ❑ No ( L' Public Facilities Improvement(PFI) Permit: '1` lca.-- V2 Required: ❑ Yes,applicant was2notified I2 No . Appliiee For: ❑ Yes ❑ No,stop intake L ' and Use Case#: Cvr i(i'i 1 -dd d/ Std'e`Gil-(jG d d`( LI Zoning: ��`.. L equired Setbacks: Front: 2.O Rear: l S Side: S Street Side: I5 Garage: 2i G' 2 Building Height: Max. Height: 3 d Actual Height: 16 t/Landscape % -Lot Coverage Max„: Entrance S back no more than 8'from street-facing wall ' LV Parallel to street or offset 45 degrees or less Windows ' ' um 12%of area of all street-facing facades 3 ci Garage Garay door is behind widest street-facing wall LI Yes lid 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 nd there is a 12 sq ft.window above garage on 2nd floor. Cit Garr-Eage 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 w- Q _ "` I nabTh1 ,_organibrefroof `"'cr Dormer ' �� ❑ Accent siding Window trim ❑ Window recess ❑ Window projection ❑ Balcony Lid V al Clearance Urban Forestry Plan Illgensitive Lands: ❑ Yes 'No Type: Conditiops met prior o ' suance of buildi g permit L-44+14-4.s: l. i � n t v- n�nlA. 'a�fr„ ,y Vo VApproved By Planning: `�G Date: q_S._1 el 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: q(‘717, �—]<�/, Site Plans: # Building Plans: # Building Permit#: Enter building permit#above. Workflow Routing: Planning gineering rmit Coordinator ❑ Building Workflow Sign-off: Sign-off for P anning(include not from planning review) Route Application Documents: Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. Building: original permit application, site plans,building plans, engineer and beam calculations and trust details,if applicable, etc. Notes: i By Permit Technician: 411tA , _ Date: Engineering Review LI'Slope at building pad: j J 0 a--Conditions "Met"prior to issuance of building permit Lasements (encroachments)per engineering conditions of approval and plat Later Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes [ "No Assess Water Quantity Fee in-lieu: ❑ Yes E No LIDA Facility on lot: ❑ Yes ErNo ❑ Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes:� � L?Approved by Engineering: j Date: s/ci/5 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: Revision Notice 3: Date Sent to Applicant: rG( SDC Fees Entered: Wash Co Trans Dev Tax: ees _,, ❑ N/A Tigard Trans SDC: IQ Y ❑ N/A Parks SDC: Yes ❑ /A LIDA ❑ Yes �N/A ixiv- K to Issue Permit / Il Approved by Permit Coordinator: Date: I:\Building\Forms\B1dgPermitRvw_RES_022819.docx