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Permit (10) CITY OF TIGARD MASTER PERMIT r ° 2 :'. COMMUNITY DEVELOPMENT Permit#: MST2019-00378 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/12/2019 Parcel: 1S134DB00600 Jurisdiction: Tigard Site address: 11319 SW ELLSON LN Subdivision: BRIGHTWOOD SUBDIVISION Lot: Project: Brightwood, Lot 2 Project Description: New SF with 605 sf patio cover BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1788 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 23 Bathrooms: 3 Second: 854 sf Garage: 929 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2642 sf Value: $383,553.34 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 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0 Bckflw Prevntr: 1 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: 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 l 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 Ecom asin Y Other: N Other Description: p 9� BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2642 Owner: Contractor: VENTURE PROPERTIES INC STONE BRIDGE HOMES NW LLC 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: $34,528.45 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 ropy of the rules or direct questions to OUNC by calling�� ,c.°'-'-'-'-' "" 503.232.1987 or 1 800.332.2344. � P. ) /7 Issued By: � � �,o. 2� -. .-, ? '� �rrnittee Signature: f �G�' II 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. 4 21510 ` -Bui1d i n Permit Application Residentialf FOR OFFICE USE ONLY City of Tigard 3 Received r i �y� III13125 SW Hall Blvd.,Tigard,OR 97223 SEP 2 2019 Da,cBy 7 et t v// 1,-4037, ' Plan Review // Phone: 503.718.2439 Fax: 503.598.1960 (� • '''/ `q p72 Date/BY: 1 � 1� � • � � L I"1(iAld1) Inspection Line: 503.639A175 CITY OF TIGARD DateReadyBy Jura: 2f See Page 2for Internet: www.tigat•d-or,gov �I��fN ������®�_. Notified/Method. SupptementalInformation BTYPE OF WORK ' REQUIRED DATA l=AND 2 FAMILY-DWELLING ®New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement ❑Other equipment,materials,labor,overhead,and the profit the CATEGORY OF CONSTRUCTION € work indicated on this application. 3%63, S3 ® 1-and 2-family dwelling ❑Commercial/industrial Valuation: S ❑Accessory building EJMulti-familyNumber of bedrooms: +L? ❑Master builder El Other: Number of bathrooms: s JOB SITE INFORMATION AND LOCATION Total number of floors: Z 3 1 4 Job site address: 11319 SW- b4.6et4. (44• › I�s X44. New dwellingg are a: 2674Z' square feet City/State/ZIP:Tigard,OR Garage/carport area: 8241 square feet '-fag Suite/bldg./apt.no.: Project name: Covered porch area: square feet Cross street/directions to job site:SW North Dakota&SW 114'P1• Deck area: � square feet ttt (1706_ square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision:Brightwood Lot no.: Z Permit fees*are based on the value of the work performed. Tax map/parcel no.: equipment, 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 residence Valuation: $ Existing building areal square feet New building area: square feet ® PROPERTY OWNER ❑ TENANT Number of stories: Name:Stone Bridge Homes NW,LLC Type of construction Address:4230 Galewood St,Suite 100 Occupancy groups: City/State/ZIP:Lake Oswego,OR 97035 Existing: Phone:(503)387.7577 Fax:(503)387.7615 New: ® APPLICANT E;C'pNTACT PERSON BUILDING FEES* -...,-"'''-•' -__ __ _....... -... (Please 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 CitylState/ZIY: Total fees due upon application: Phone:( ) Fax::( ) Amount received: E-mail dbritt@stonebridgehomesnw.com , PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* . Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic 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 Gatewood St,Suite 100 Solar Installation Specially Code checklist. City/State/ZIP: Lake Oswego,OR 97035 Permit Fee(includes plan review $180.00 and administrative lees): Phone:(503)387.7577 Fax:(503)387.7615 State surcharge(12°i,of permit fee): $21.60 T CCB lie,:173318 Total fee due upon application: $201,60 Authorized signatur~ This permit application expires if a permit is not obtained within 180(lays after it has been accepted as complete. Print name: Deirdre Britt Date: Y 1,49119 *Fee methodology set by Tri-County Building Industry Service Board. 1:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) ' building Permit Application co One- and Two-Family Dwelling FOR OFFICE USE ONLY City of Tigard SEP 2 3 2010 -� +�t 13125 SW Hall Blvd.,Tigard,OR 97223 ^p r� Associated permits: t 11 Phone: 503.718,2439 Fax: 503.598.1960Ln 9 P OF TR MI1LJ 24-Hour Inspection Line: 503;639;417 C DING V l B IE DING IVISIO ❑ Electrical 0 Plumbing 0 Mechanical T I G A R D Internet: www,tigard-or.gov 0 Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes Nit N/A I Land use actions completed. See jurisdiction criteria for concurrent reviews. 2 Zoning. Flood,plain solar balance points,seismic soils designation,historic district,etc. 0 El 3 Verification of approved plat/lot. 0 0 0 4 Fire district approval required. Name of district ❑ 0 0 5 Septic system permit or authorization for remodel. Existing system capacity El 0 ❑ 6 Sewer permit. ❑ 0 0 7 Water district approval. ❑ ❑' 8 Soils report_ Must carry-original applicable stamp and signature on file or with application, ❑ 0LJ 9 Erosion control El plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 ❑ 0 basin protection,etc, 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 0 ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed Y. copyright violations exist. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if 0 0 ❑ there is more than a 4-1,elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size ® ❑ 0 and location, 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, g 0 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 0 floor,wall construction,roof constriction. 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. PA 0 ❑ Exterior elevations roust 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- El 00 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 El locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered El ❑` systems,see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ® 0 0 over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. /IS 0 0 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ® 0 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 A ❑ ❑ architect licensed in Or 'on and shall be shown to be a licableto the re.ect under review. 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17"; 0 0 0 24 Two(2)sets each are required for Items 16,19,20 and 22 above.. 0 0 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑" 0 0 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 0 0 27 "Drawn to scale"indicates standard architect or engineer scale. 0 0 0 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 0 El Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval, Tree locations,driplines, ❑ ❑ 0 and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, 0 0 0 including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9,1995. I:\Building\Permits\BUP-RESPerntitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB) • , Mechanical Permit APphiC FOR OFFICE USE ONLY City of Tigard Received Permit N +t 13125 SW Hall Blvd.,Tigard,OR 97223�C 1 2 3 2019 Plan Review II IS Phone: 503.718.2439 Fax: 503.598.196 C Other Permit, Date/By. TIGARD Inspection Line: 503.639.4175 h ® Date Ready/13y. huffs: 13 See Page 2 for Internet: www.tigard-of,gov CITY OF TIGAN Natified/Method' Supplemental Information Blit DING DIVISION TYl' bF' W I ' COMMERCIAL FEE* SCHEDULE--AfSECIWKIJST Mechanical permit fees*are based on the value of the work ® hNew construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Otlier: mechanical materials.equipment;labor,overhead,and profit, - CATEGORY'OF CONSTRUCTION V ue:$ al t,� RESIDENTIAL EQUIPMENT 1 SYSTEI43 tE,:ki i* iS , ® I-and 2-family dwelling ❑Commercial/industrialem..... 0 Accessory building For specinlinformation use checklist. ❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total 4—Oil-silt INIItOT tA4ON AND LOCATION ' Heating/cooling; t 1319 GA/ fivbttSo1 r w. Air ace 1 io 00• 46.75 Job site address: �`15®� Furnace 100,000 BTU(ducts/vents) 1 46.75 _ City/State/ZIP:Tigard,OR Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.; Project name: Duct work 23.32 Cross street/directions to job site:SW North Dakota&SW 1141tr Pl 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 1 23.32 w ois Subdivision:Brightwood Lot no,: Other 23.32 Other fuel appliances: Tax map/parcel nos; Water heater 1 23.32 T ''•'.' .Yt Gas fire lace/insert 1 33.39 I?JCR�A`�'ION OF WC?RK. ��� P, . Flue vent for water heater or gas new,single family residence fireplace 2 23,32 Lo,g l iihter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Cltinmev/liner/fltteivent 23.32 a� IhOPE fY OWNER ._., a„ ANT - Other: 23.32 -'"`" :; •° . Environmental exhaust and ventilation: Name:Stone Bridge Homes NW,LLC Range hood/other kitchen equipment 1 33,39 Address:4230 Galewood St,Suite 100 Clothes dryer exhaust 1 33.39 City/State/ZIP:Lake Oswego,OR 97035 ''Single-duct exhaust(bathrooms. toilet compartments,utility rooms) S 23.32 Phone:(503)387.7577 Fax:(503)387.7615 Attic/crawlspace fans 23.32 g'APPLICANT•; ©•eo ERS©N .,...-4,;.,‘,..- Other. 23;32 Fuel piping: Business name:same as above $14.15 for first four;$4.03 for each additional Contact name:Deirdre Britt Furnace,etc. 1 Address: Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater 1 Phone:( ) Fax: :( ) Fireplace 1 Range 1 E-mail:dbritt(r�stonebridgehomesnw.com Barbecue $;' CONTRACTOR• Clothes dryer(gas) Business name:Comfort Zone Other: t M MECIIACAL PERMIT FEES: Address:1032 NW Corporate Dr. Sohtotal City/State/ZIP:Troutdale,OR 97060 Minimum permit fee($90.00) .... ................... . Plan review(25°6 of permit fee) Phone:(503)667.5595 Fax:(503)491.8252 State surcharge(12%of permit fec) CCB lie.:110091 TOTAL PERMIT FEE -- - - - M This permit application expires if a permit is not obtained within 180 C s, days after it has been accepted as complete. Authorized signature: _- * g' Fee methodology set by Tri-County Building Industry Service Board Print name:David Hehlstab Date: 9 ,� il I:1Buildii Peimils\MEC_PenuiiApp_O101i3,dee 440-1617T(1 1/7 COM,wrB) • ' Electrical Permit Application' FOR OFFICE USE ONLY CityOf Ti and SEP 2 3 2019 Received ✓g Date/13' w 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revtett' • Phone: 503.718.2439 Fax: 503,598,1 Z71 TY OF TIGARD Date/Bv Related Permit F TIGARD Inspection Line: 503.639.4175zady Dateit3y: H Sec Page 2 for BUILDINGDIVISItElm , Internet: www';tigaid-of„gov ottfiedMlethod: Supplemental Inform ation TYP1 ©P uW+RI+ ”? v ." REVIEW r °€ ®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,.El Demolition Demolition ❑Other: where the available fault current ❑Marinas and boatyards„ ,, -CATEGORY OF cONSTRIIcONi,, ���,'', ��G exceeds 10,000 amps at I so volts or 0 Floating buildings. ® 1-and 2-family dwelling ❑CommeIcial/industrial ❑Accessory building tens to ground,or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations: buildings; ❑Multi-family Master builder ❑Other: ❑Fire pump.. 0 Installation of ISO KVA or '. JOB SITE INFQ tilfaiTl0ls1 AND` TY , ^� „, �I,QCM,,tyI,,,< � ., � ❑Emergency system.. larger separately derived ❑Addition of new motor load of system, Job#: '2.151 Job site address: 11311 354) 1011414$04444* 10011P or more, 0"A","E","1-2","1-3", City/State/ZIP:Tigard,OR '" I 115 y ❑Six nr more facilities units- occupancy. � • ❑Health-care facilities;. ❑Recreational vehicle parks, Suite/bldg./apt.#: Project name: ❑Hazardous locations ❑Supply voltage for more than __-- _ - ❑Service or feeder 600 amps or more:.: 600 volts nominal,. Cross street/directions to job site:SW North Dakota&SW 114th p• J ;: FEE Description 1 Qiy.'1 Each l Total 1 New residential single-or multi-family dwelling unit. Subdivision:Brightwood Lot#: ,Z Includes attached garage "' 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'I 500 sq,ft,or portion 33.92 1 DESCRIPTION OF"WORK 4= Limited energy,residential new,single family residence (with above sq,ft.) 75.00 2 Litnited energy,multi-family 75.00 2 residential(with above sq.ft.) PROPERTY OWNER. CI,�,TENANT,'; Renewable Enert y _ 0 See Page 2 E,. Services or feeders histallationyalteration,and/or relocation Name:Stone Bridge Homes NW,LLC 200 amps or less 100.70 2 Address:4230 Galewood 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 97035601 amps to 1,000 amps 301.04 2 Phone:(503)387.7577 Fax:(503)387.7615 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 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701: 201 amps to 400 amps 125.08 2 401 amps to 599 amps signature: Date: 168.54 2 ><® APPLICANT Branch circuits—new,alteration,or extension,iter panel CONTACT PERSOhi,,,, "' ``�°� �� A.Fee for branch'circuitswith Business name:same as above above service or feeder fee, 7.42 2 each brands circuit Contact name:Deirdre Britt B.Fee for branch circuits wiihour Address: service or feeder fee,first 56.18 2 branch circuit City/State/ZIP: Each add'1 branch circuit 7,42 2 Miscellaneous(service of•feeder not included) Phone:( ) Fax::( ) Each manutnctured or modular 67.84 2 dwellings service and/or feeder Email: dbrittta),stonebridgehomesnw.coin Reconnect only 67.84 2 CONTRACTOR . 1.441 " .-';,,•„ Pump or irrigation circle 67.84 2 Business name: City Electric sign or outline lighting 67.84 2 SAddress:55568 SW SChaltettbrand Ln. panel,eircuiton,or cxlens-energy ❑ See Page 2 2 panel,alteration,or extension, r 2 City/State/ZIP:Sherwood,OR 97140 Each additional inspection over allowable in anv of the above Additional inspection(1 lar min) 66.25/hr Phone:(971)404.1714 Fax:(503)625.3052 Investigation(1 hr min) 90,00/hr Email; Industrial plant(1 hr min) 78,18/hr Inspections for which no fee is 90.00/hr CCB Lic,: 42422 Electrical Lic,: 26-289C Suprv.Lie.: 35925 specifically listed(/hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: Chuck Friesen Date; taptoleis Required❑Plan Review Re urged(25%of permit fee): State surcharge(12%of fee): Authorized signature: ea'-) TOTAL PERMIT FEE: ---- This permit application expires if a permit is not obtained within 180 Prmt name: Date: days•raer it pus been accepted as complete. -- - - - * Number of inspections allowed per permit.. ]'Building`d'zmtits'F:L(' PemritApp_FIR_ERE.des Rzv06R7/2015 J40-46f5T(1105COII:'WEB RECEIVED Electrical Permit Application—City of Tigard SEP 2 3 Z 019 Page 2—Supplemental Information CITY OF TICARD Limited Energy Permit Fees: BUILDING CIMISI . Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE 1 , DeScNDtlon ( 0,[y. � D'ach I Tofal Fee for all residential systems combined: $75.00 Renewable electrical energy systems: Check Type of Work Involved: S kva or less 100,70 2 5.01 to l5 kva 133.56 2 El Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm25,01 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 oris kva: System* Each additional kva over 25 742 3 ❑ Vacuum Systems* >100 kva-no additional charge 0,0 3 Each additional inspection over allowable in any.of the above: El 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 specilically listed('/hr min) COMMERCIAL WORK ONLY: KELECTRICAL PERMIT FEES - Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 Number ofinspectiensaltowedparpermit, (SEE OAR 918-309-0000) Check Type of Work Involved: El Audio and Stereo Systems ❑ Boiler Controls El Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation HVAC Instrumentation ❑ Intercom and Paging Systems O Landscape Irrigation Control* El Medical O Nurse Calls 111 Outdoor Landscape Lighting* Protective Signaling Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 16uiidieg\Pertnifsf LC_Pen 1App_ELR_:L?.EAoc Rev0U+17f2015 . • • Plumbing Permit Application EI VC', Building Fixtures FOR OFFICE USE ONLY City of Tigard SEP 23 201Received r h �?ate!Bp. Permit�.o,cill . •t 13125 SW Hall Blvd.,Tigard,OR 97223 E1� �l P1 ` !i� •1. Review 2 Phone: 503.718.2439 Fax: 503598.1 q tither Permit No, Inspection Line: 503,639.4175 �� �IVr 1V,# t eadyrBy: Iuris ID See Page 2 for TIGARD Internet: wwwtigard-or.gov Notifiedlslethod: Supplemental Information a TYPE OF WORK ,_,x ` 1:.-3,41V410-'1',, „ FEE* SCHEDULE ®New construction ❑Demolition For speeirrl inforrnarinu use checklist. Description I Qtv. j Ea. 1 Total ❑Addition/alteration/replacement ❑Other: New 1-2-fastilly dwellings(inclladcs 100 ft,for each utility connection) CATEGORY,OF CONSTRUCTION f ..N,,. SFR(1)bath 312.70 ® 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437,78 12 Accessory building 1=1 Multi-family SFR(3)bath ' >00,32 Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 Jf.IB SITE INFORMATION AND LOGATIONI Site utilities: �) �de4/' 1 i �f Catch basin or area drain 18,76 Job site address: "3�� DV �� l�^I �i'T. Ga��sQ� Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard,OR Footing drain(no.linear ft.: ) Page 2 Suite/bldgfapt,no.: I Project name: Manufactured home utilities 50.03 Cross street/directions to job site:SW North Dakota&SW 114th P) Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no„linear ft.: ) Page 2 Stone sewer(no.linear tl.: ) Page 2 Water service(no.linear ft,: ) Page 2 Subdivision:Brightwood I Lot no.:4g.ii Fixture or helot Tax map/parcel no,: Backflow preventer 1 31.27 DESCRIPTION OF WORK a Backwater valve 12.51 Clothes washer I 25.02 new,single family residence Dishwasher 1 25.02 Drinking fountain 25,02 Ejectors/sump 25.02 r 0 PROPERTY OWNERa- Expansion tank 12.51 e, Name:Stone Bridge Homes NW', LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:4230 Galewood St,Suite 100 , City/State/ZIP: Garbage disposal I 25.02 Cit) IP:Lake Oswego,OR 97035 Hose bib .2. 25,02 Phone:(503)387.7577 Fax:(503)387.7615 Ice maker 12.51 ® APPLICANT 0 CONTACT PERSON �, Interceptor/grease trap 25.02 Business name:same as above Medical gas(value:$ ) Page 2 Printer 12.51 Contact name:Deirdre Britt Roof drain(commercial) 12.51 Address: Sink/basin/lavatoryC 25..02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tubishower'show•er pan 3 12.51 E-mail:dbritt()stonebridgehomesnw.conr Urinal 25.02 Water closet a 25,02 CONTRACTOR • Water heater I 37.52 Business name:Jardine Plumbing Water piping/DW V 56.29 Address:PO Box 186 Other: 25.02 City/State/ZIP: Estacada,OR 97023 7//! ja Subtotal '`��'�tf Phone:(503)351.8532 Fax:(503)630.288233 L try Minimum permit tee: $72,50 CCB Lie,:108747 Plumbing Lic.no,: Plan review (25°0 of permit fee) r „ *;,/,,, State surcharge(12%of permit fee) Authorized signature: .w - ; e'" TOTAL,PERMIT FEE Print name:Jay Jardine Date:4,tb1ll 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. t:'iPnildingPennits'PLN1iJ-PernutApp-,doc 'MI. 440-1610T(10l02`CO5t N'EB) City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT 1111 TICA>zo Building Permit Review — Residential Building Permit #: . f/cs71Of -0... 71--- Site Address: 11319 15 • L I/sopa Lk/ • Project Name: 5, ,.A-�60c)(- 07 Lot #: 2 (New dwellin'subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: .4.)au.2 .1R Verify address/suite# active in Accela. ❑ In River Terrace: E2 No Li Yes,River Terrace Review Addendum Site Plan Elements: ��3T rosion Control • copies of site plan on 8-1/2"x 11"or 11 x 17"paper in.cetained trees with drip line and tree protection measures ..12Jrawn to scale(standard architect or engineer scale) $Footprint of new structure(including decks) and FFE �rth arrow qty locations&easements(required for new and additions) tte address,project or subdivision name and lot number idewalk/driveway approach p licant information(name and phone number) /septic systems ' Tot dimensions and building setback dimensions 36eet tree size,type and location B$quage of buildings to be demolished 05,eet names Wig-structures on site .IJ Comer elevations(2'contours if more than 4'differential) Clot area,btikling coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? 12YesenCI No /� tr impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes-0No 1491 / Clean Water Services-Service Provider Letter(lot platted prior to 9/10/1995): �Required: ❑ Yes,applicant was notified .2�No Received: ❑ Yes ❑ No -2 Public Facilities Improvement (PFI)Permit: Required: 2"-Yes,applicant was notified ❑ No l Applied For: fit'yes ❑ No,stop intake ,0-Land Use Case#: SU B OLeD -OOO2 L1 ❑ Zoning: ..Required Setbacks: Front: o�V Rear: 6 Side: 3 Street Side: — Garage: 1-Z5 .2 Building Height: Max. Height: 3 D Actual Height: r l-E e A a: % ❑ Lot Coverage Max: 0/0 EntranceSet back no more than 8'from street-facing wall -B"Parallel to street or offset 45 degrees or less Windowsimum 12%of area of all street-facing facades Garage 12 Garage door is behind widest street-facing wall ❑ Yes 4 No,one of the following is met: .2'Door extends no more than 5'from wall and there is a covered porch extending beyond garage. -1 Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2nd floor. E 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 ❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer ❑ Accent siding �❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony • isual Clearance -Ci rban Forestry Plan -21S nsitive Lands: SLI Yes ❑ No Type: -I - Conditions met prioi tpp issuance of b ' ding permit) Notes: 0,0 rimer s ,- zeki2 /Gv.:U,- -tom iSsvd; i -E Li-Approved By Planning: , Date: q/2 -5/I 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: 51A3 6G Site Plans: # Building Plans: # Building Permit#: 9nter building permit#above. Workflow Routing: Planning engineering Permit Coordinator Building Workflow Sign-off: ign-off for P nntng(include not s 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, e%---------tc. Notes: j. By Permit Technician: M Date: GI A 44 t Engineering Review ❑ Slope at building pad: ❑ Conditions "Met"prior to issuance of building permit ❑ Easements (encroachments) per engineering conditions of approval and plat ❑ Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes ❑ No Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No LIDA Facility on lot: ❑ Yes ❑ No ❑ Final Plat Recorded: LJ NOT Approved by Engineering: / gDate: q J2 ,)jq Notes: /4/a.71 /VI re' anleal Approved by Engineering: Date: i— 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: evisions (after : •ilding Submittal only) / ' - '. l otice 1: Date Sent to Applicant: , 4/ 17 ,414.5Pi�ai r Revision Notice 2: Date Sent to Applicant: !!! Rev' ion Notice 3: Date Sent to Applicant: SDC Fees Entered: Wash Co Trans Dev Tax: [ Yes ❑ N/A Tigard Trans SDC: C7'Yes ❑ N/A /7 Parks SDC: 2"-Yes ❑ N/A LIDA ❑ Yes N/A ' OK to Issue Permit ti Approved by Permit Coordinator: ate: (0/14 7 l:\Building\Fonns\BldgPennitRvw_RES_022819.docx