Permit CITY OF TIGARD MASTER PERMIT
xliki Permit#: MST2019-00359
COMMUNITY DEVELOPMENT
Date Issued: 12/16/2019
T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1 S 135C D 15600
Jurisdiction: Tigard
Site address: 9774 SW WINDSWEPT PL
Subdivision: CANYON COURT Lot: 3
Project: Canyon Court, Lot 3
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 680 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1138 sf Garage: 400 sf Front: 15 Smoke
Yes
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors:
Total: 1818 sf Value: $242,124.28 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 RainStorm Sewer: 100
0
Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 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: 3 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Y
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 1818
Owner: Contractor:
MAOZ LLC SAGE BUILT HOMES Required Items and Reports(Conditions)
1800 NW 167TH PL STE 150 1815 NW 168TH PLACE 1 Ersn Cntrl 503-639-4175
BEAVERTON,OR 97006 BEAVERTON,OR 97006
PHONE: PHONE: 971-221-4597
FAX: 503-533-5164
Total Fees: $31,975.12
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 o. -in a copy o : les or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: AlliglJr,..—,A•r-- ,t -- '•rmittee Signature: `
03.639.4175 by 7:00 a.m.for the next available inspection i
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
*,Building Permit Application
Residential FOR OFFICE USE ONLY
Received
Cityof TigardPermit No.:
q 13125 S W Hall Blvd.,Tigard,OR 97223RECEIVED
DateBy: l Y Orr" 0�2 6;- )3 `�
11 g Pl to/By: w �L A Other PermkS�� �'V V
Phone: 503.718.2439 Fax: 503.598.1960 DateBy:
TIGARD Inspection Line: 503.639.4175 SEP 5 2019 Date ReadyBy: I Juris: H See Page 2 for
Internet: www.tigard-or.gov ified/Method. O // e Supplemental Information
R�CIITY OF TIGARD , r
TYPE OF WOW-DING USN REQ RED 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 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $ /igii
111l-and 2-family dwelling ❑Commercial/industrial
❑Accessory building ®Multi-family Number of bedrooms: A--
❑Master builder ❑Other: Number of bathrooms: 13 9
JOB SITE INFORMATION AND LOCATION Total number of floors: 2 '7 C
Job site address:',�--\'i i SW Windsept Place New dwelling area: r. are feet 7 ( "30
City/State/ZIP:Tigard Ore on Garage/carport area: .--,41'11 uD square feet (p 1250
Suite/bldg./apt.no.: Project name:Canyon Court Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:Canyon Court 1 Lot no.: ' Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK ,,, work indicated on this application.
New Residential Construction Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 TENANT Number of stories:
Name:Sage Built Homes LLC Type of construction:
Address:1815 nw 1696 Place Suite 1040 Occupancy groups:
City/State/ZIP:Beaverton Oregon 97006 Existing:
Phone:(503)533-5167 Fax:(503)533-5164 New:
® APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:Sage Built Homes LLC
Structural plan review fee(or deposit):
Contact name:Alex Rodriguez
FLS plan review fee(if applicable):
Address:Same as above
Total fees due upon application:
City/State/ZIP:
Amount received:
Phone:(971)336-6911 Fax::( )
E-mail:planning@sagebuilthomesllc.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name:Same As Above Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:Same as Above Solar Installation Specialty Code checklist.
City/State/ZIP: Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.:189330
Total fee due upon application: $201.60
Authorized signatur . This permit application expires if a permit is not obtained
(1? within 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry
Print name:Alex Rodriguez Date: Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Buildin! Permit Application Checklist ' .0
One- and Two-Family Dwelling FOR OFFICE USE ONLY
City of TigardPReceived Permit No.:
Date/By.
13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
LI Phone: 503.718.2439 Fax: 503.598.1960
TIGARD 24-Hour Inspection Line: 503.639.4175
ID Electrical ❑ Plumbing ❑ Mechanical
Internet: www.tigard-or.gov 0 Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes \o N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ 0 0
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑ ❑
3 Verification of approved plat/lot. 0 ❑ 0
4 Fire district approval required. Name of district: • 0 ❑ ❑
5 Septic system permit or authorization for remodel. Existing system capacity ❑ 0 ❑
6 Sewer permit. ❑ 0 ❑
7 Water district approval. 0 0 ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑
9 Erosion control ❑plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- 0 ❑ ❑
basin protection,etc.
10 �i 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 mast be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ❑ 0 ❑
there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements
and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction
indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and
surface drainage.
12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size 0 0 ❑
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ ❑ 0
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- ❑ ❑ ❑
floor,wall construction,roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings
and foundation,stairs,fireplace construction,thermal insulation,etc.
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. ❑ ❑ ❑
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- 0 0 ❑
prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing 0 ❑ 0
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 ❑ ❑
systems,see item 22,"Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ 0 0
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. ❑ ❑ ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ❑ 0
for four or more appliances.
22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or ❑ ❑ ❑
architect licensed in Ore.on and shall be shown to be a..licable to the .ro'ect under review.
JURISDICTIONAL SPECIFIC'S
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". ❑ ❑ ❑
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 0 ❑ ❑
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ ❑ ❑
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ ❑
27 "Drawn to scale"indicates standard architect or engineer scale. ❑ ❑ ❑
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 ❑ ❑
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ ❑
and protection measures must be drawn to scale and must include the project arborist's signature of approval.
30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, ❑ 0 ❑
including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9, 1995.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received
Date/By: Permit No., ` , _ +y' o awl
1111 .- 'I 13125 SW Hall Blvd.,Tigard,OR 97 E'\ /E® Plan Review
`[
Phone: 503.718.2439 Fax: 503.598. E�j Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: Juris: a See Page 2 for
Internet: www.tigard-or.gov SEP 5 2019 Notified/Method: Supplemental Information
TYPE OF WOW 01- I llt ISDN COMMERCIAL FEE* SCHEDULE- USE CHECKLIST
�� DIV Mechanical permit fees*are based on the value of the work
®New construction ElAddition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling ❑Commercial/industrial E Accessory building For special information use checklist.
®Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 1 46.75 46.75
Job site address: L;V1-I . SW Windsept Plac Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75
City/State/ZIP:Tigard Oregon Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:Canyon Court
Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision:Canyon Court Lot no.:3 Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 1 23.32 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
New Residential Construction fireplace 5 23.32 \\ O,L2
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
'II PROPERTY OWNER 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name:Sage Built Homes LLC Range hood/other kitchen
equipment 1 33.39 33.39
Address:1815 nw 169th Place Suite 1040 Clothes dryer exhaust 1 33.39 33.39
City/State/ZIP:Beaverton Oregon 97006 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503)533-5167 Fax:(503)533-5164 Attic/crawlspace fans 1 23.32 23.32
k.,1 APPLICANT 0 CONTACT PERSON Other: 23.32
Business name:Sage Built Homes LLC Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:Alex Rodriguez Furnace,etc.
Address:Same as above Gas heat pump
WalUsuspended/unit heater
City/State/ZIP: Water heater
Phone:(971)336-6911 Fax::( ) Fireplace
Range
E-mail:planning@sagebuilthomesllc.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:All Time Heating&Cooling Other:
MECHANICAL PERMIT FEES*
Address:PO Box 1341 Subtotal
City/State/ZIP:Lake Oswego,OR 97035 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)208-2276 Fax:( ) State surcharge(12%of permit fee)
CCB lie.:18457510" 6`t�G i�7�/) e. TOTAL PERMIT FEE
0 V This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: C, / y�{� * Fee methodology set by Tri-County Building Industry Service Board
Print name:Alex Rodriguez t Date:C\t Z \\c\
I:\Buildingermits\MEC_PermitApp_0401 13.doc 440-4617T(I
\P1/02/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.
1`\Building\Permits\MEC_PermitApp_040113.doc 2
•. .,
Electrical Permit Application
CI O 71 SC(� EC�I V Received Permit ft' ti
`J b G Date/By 1 1 5 � aV
:14 i r 13125 SW Hall Blvd.,Tigard,OR 972 3 Plan Review Related Permit H:
iii Phone: 503.718.2439 Fax: 503.598.1960 C p PP ate/Bv:
Inspection Line: 503.639.4175 SEP f 5 2019 Ready Date/By: Juritr ® See Page 2 for
r 14 1 R f) Internet: www.tigard-or.gov Notified/Method: Supplemental Information
ITY OF TIGARn
TYPE OF WOR ILYINIG DIVISION PLAN REVIEW
Z New construction ❑Addition/alteratro rep acement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings
® 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations buildings.
0 Multi-family ❑Master builder ❑Other: ❑Fire pump 0 Installation of 150 KVA or
JOB STfE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address:('',. -114 ` J `3\;icet `, 100HP or more ❑occupancy
City/State/ZIP: Tigard Oregon 1 ❑Six or more residential units Recreation
0 Health-care facilities ❑Recreational vehicle parks.
'10 Supply voltage for more than
Suite/bldg./apt.#: 1 Project name:UA (�yA-- 0 Hazardous locations
`�V ❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. 1 Each 1 Total I '
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq ft or less 168.54 4
Tax map/parcel#:
Ea add'l 500 sq.ft or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
New Residential Construction
(with above sq.ft) 75 00 2
Limited energy,multi-family 7500 2
residential(with above sq ft.)
Renewable Energy 0 See Page 2 {
® PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: Sage Built Homes LLC 200 amps or less 1 1 100 70 7 100 70 1 2
Address: 1815 nw 169TH Place Suite 1040 201 amps to 400 amps I 133.56 1 2
M401 amps to 600 amps 200 34 2
City/State/ZIP:Beaverton Oregon 97006 601 amps to 1,000 amps 301.04 2
Phone:(971)221-4597 Fax:( ) Over 1,000 amps or volts 552.26 ' 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation: This installation is being made on property that I own which is not 200 amps or less 5936 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 j ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A Fee for branch circuits with I
Business name:Same As Above above service or feeder fee,
7.42 2
each branch circuit
Contact name: Alex Rodriguez B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address: branch circuit
City/State/ZIP: Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(971)336-6911 Fax: :( ) Each manufactured or modular 67 84 2
dwelling,service and/or feeder
Email:Planning@sagebuilthomesllc.comReconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Ross Electric Sign or outline lighting I I 67 84 I 12
Signal circuit(s)or limited-energy
Address:2870 SE 75th Ave 203 panel alteration or extension. 0 See Page 2 I 2
City/State/ZIP:Hillsboro Oregon 97123 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)642-2800 I Fax:( ) Investigation(1 hr min) 90.00/hr
Email: Industrial plant(l hr min) 78.18/hr
Lv ll/2-L Inspections for which no fee is
90.00/hr
CCB Lic.: 157891 Electrical Lic.: 34-436C Suprv.Lic.:Ki-32s specifically listed(v:hr min)
ELECTRICAL PERMIT FEES
Suprv. Electrician signature,required: ,Re: / // Subtotal:
Print name: Stephen Ross /-S j. 4c,‘ k'o $f Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
~1`, TOTAL PERMIT FEE:
Authorized signature
This permit application expires if a permit is not obtained within 180
Print name: Alex Rodriguez Date: 2/1/2018 days after it has been accepted as complete.
• Number of inspections allowed per permit.
i\Building\Permits\ELC_PennitApp_ELR ERE.duv Rev 06/17/2015 440-46157(:1/05/COM/WEB
Plun�lbin� Permit Application
Building Fixtures FOR OFFICE USE ONLY
t Received
City of Tigard C Etv C® Permit No.:t �� ejsa
G DateBy:-W J
IN • 13125 SW Hall Blvd.,Tigard,OR 99g Plan Review
_ Phone: 503.718.2439 Fax: 503.5 8. DateBy: Other Permit No.:
T I GARD Inspection Line: 503.639.4175 c EP 5 2019 Date Ready/By: Juris: El See Page 2 for
Internet: www.tigard-or.gov JC Notified/Method: Supplemental Information
TYPE OF WORICITY�1I®����IG�IVA1�U FEE* SCHEDULE
®New construction
L''��in6lYtio I Siohl For special information use checklist
Description I Qty. Ea. 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
❑ 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 /�
❑Accessory building ®Multi-family
SFR(3)bath 500.32 503 32-
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: t SW Windsept Place Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard Oregon
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name:Canyon Court ,
Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision:Canyon Court I Lot no.: Fixture or item:
Tax map/parcel no.: 1.--'2 32"27 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 1 25.02 25.02
New Residential Construction
Dishwasher 1 25.02 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Name:Sage Built Homes LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:1815 nw 169th Place Suite 1040
Garbage disposal 1 25.02 25.02
City/State/ZIP: Hose bib 2 25.02 50.04
Phone:(503)533-5167 Fax:(503)533-5164 Ice maker 12.51
0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:Sage Built Homes LLC Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Alex Rodriguez
Roof drain(commercial) 12.51
Address:Same as above Sink/basin/lavatory 7 25.02 '`25.,k0
City/State/ZIP: Solar units(potable water) 62.54
Phone:(971)336-6911 Fax: :( ) Tub/shower/shower pan 2 12.51 25-
E-mail:planning@sagebuilthomesllc.com Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 1 37.52 37.52
Business name:Edward Mullen Water piping/DWV 56.29
Address:1601A SE River Rd Other: 25.02
City/State/ZIP:Hillsboro Oregon 97123 Subtotal
Phone:(503)572-4586 Fax:( ) 1//01-
//j Minimum permit fee: $72.50
CCB Lic.:92689 Plumbing Lic.no.: Azi„0,06
! �6Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signatur TOTAL PERMIT FEE
Print name:Alex Rodriguez Date:9 V`5" ,/I This permit application expires if a permit is not obtained within 180 days
"I after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(1 0/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee:
Footing drain-1"100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52 Valuation: Permit Fee:
Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
each additional$100.00 or fraction thereof,to
Other Inspections or Fees Qty. Fee(ea) Total
and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
(minimum charge 1/2 hour) each additional$100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*.
Quantity by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Replace/ Plan review is required for anyof the following.
Work Performed: Capped Added Relocate 9
Baptistry/Font Please check all that apply.
Bath Tub/Shower ❑ Any new commercial building with water service 2"and
-Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
-3"
4„ Isometric or Riser Diagram
Car Wash Drain ❑ Isometric or riserdiagramisrequired for new buildings
Garbage -Domestic-non-food g
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lay -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
S:\Sage Built\Purchasing\Subdivisions\Canyon Court\Apps\Plumbing.doc2
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
q■
T 1 G ARD Building Permit Review — Residential
Building Permit #: i(pS—tom\CI_IK)j a
Site Address:
a,, ) AN i:ow � P/
Project Name: l� Lot #: ,j
(New 'ng=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Pr I .osal: klee 2W
4 Verify address/suite#active in Accela. In °n River Terr e: 4A No 0 Yes,River Terrace Review Addendum
Sit Plan Elements: VJ Er.sion Control
opies of site plan on 8-1/2"x 11"or 11 x 17"paper II -tained trees with drip line and tree protection measures
I dyawn to scale(standard architect or engineer scale) Footprint of new structure(including decks)and FFE
tz
Orth arrow . i ty locations&easements(required for new and additions)
?4-e address,project or subdivision name and lot number 1aSidewalk/driveway approach
plicant information(name and phone number) V:. cation of wells/septic systems
VLot s• ensions and building setback dimensions 7 eet tree size,type and location
l': are footage of buildings to be demolished eet names
� ,.,
• L;1 sting structures on site Corner elevations(2'contours if more than 4'differential)
Irt Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replace ? VIYes ❑ o
im.ervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? Yes No
11 lean Water Services—Service Provider Lett (lot platted prior to 9/10/1995):
Required: ❑ Y s,applicant was notified No Received: ❑ Yes CI No
' Public Facili . s Improvement(PFI) Permit:
lequired: Yes,applicant was notified ❑ No Appli For: Yes ❑ No,stop intake
�and Use Case#: l sPAQo1-"6oOf Zoning: ,K-/'2.
e aired Setbacks: Front: Rear: / Side: 5 Street Side: iL ,% Garage:g isg
•ding Height: Max. Height:_ Actual Heioi �3•
Landscape ea: o2^�, % •Lot Coverage Ma _ e
Entrance t back no more than 8'from street-facing wall ‘40 Parallel to street or offset 45 degrees or less
Windows ''n um 12%of area of all street-facing facades
Garage to Garapdoor is behind widest street-facing wall ❑ Yes YJ No,one of the following is met
V Door extends no more than 5'from wall and there is a covered porch extending beyond garage.
❑ Door extends no more than 5'from wall and there is a 12 sq ft. ow above garage on 2°d floor.
VGarajge door width is ❑ 12'or less ❑ 50%or 19st of facade 1)0%or less and includes 743,f following:
,vel'
raiovered porch ❑ ecessed entrance Wall offset/ 1'Roof eave Roof offset
Fire shingles I(Lap Siding ❑ Roof pitch VOi Gable,hip,or gambrel roof ❑ Dormer
❑ Accent siding I. Window trim ❑ Window recess El Window projection ❑ Balcony
11'b Visual Clearance A Urban Forestry Plan
ri'.ensitive Lands: CI Yes ki No Type:
P Conditions met prior to issuance of building permit
No
Approved By Planning: 4111111111111r7 Date: 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
r
Building Permit Submittal
Original Submittal Date: C �)1 rqt
Site Plans: #
Building Plans: #
Building Permit#: Enter building permit#above.
Workflow Routing: s/Planning R"Engineering "Permit Coordinator "Building
Workflow Sign-off: GYSign-off for Planning(include notes from planning review)
Route Application Documents: [Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
{9/Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: ` .:\\_. i„.._ _ Date: 1. 1t(---,
pgineering Review
f
dope at building pad: .24
Conditions "Met"prior to issuance of building permit
[basements (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 f"No
C' Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
Ud" Approved by Engineering: Date: ___FA(/_f_
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:
V/SDC Fees Entered: Wash Co Trans Dev Tax: 'Yes ❑ N/A
Tigard Trans SDC: Ili/yes ❑ N/A
Parks SDC: C✓f Yes ❑ N/A
LIDA CI Yes ) 1. --1\11AOK to Issue Permit
Approved by Permit Coordinator: Dat/17t —e:4// /11
I:\Building\Forms\BldgPermitRvw_RES 022819.docx
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
. ugTransmittal Letter
TI G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: et.e\t� v\ \i DATE RECEIVED:
DEPT: BUILDING DIVISION
FROM: W\\(1 �
COMPANY: SC9&r `ftY`CO \\L.
PHONE: , - - J G.1 By
RE: °1-1`21 L `k" �\ut..ef W O\9_ 00 ZSCI
(Site Address) (Permit Number)
OaKU 61A Q3301/411—
(Project naive or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s)of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS: }�(yo �'f t" b — vI r� �— (bvv(Z.
FOR F E USE ONLY {�*''"
Routed to Permit Techni Date: Z ( � Initials:
Fees Due: ❑Yes N`f Fee Desc ption: Amount Due:
Special
Instructions:
Reprint Permit(per PE): El Yes No ❑ Donere
Applicant Notified: '�P� Date: (r, // '-/ q Initials:
I.\BuildineForms\TransmittalLetter-Revisions 061316.doc