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Permit (2)
3' MASTER PERMIT CITY OF TIGARD ME=�, COMMUNITY DEVELOPMENT Permit#: MST2018 00033 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/22/2018 TIGARD Parcel: 1S135BD01600 Jurisdiction: Tigard Site address: 9577 SW ANNA BELLE CT Subdivision: ASH CREEK VILLAGE Lot: 2 Project: Ash Creek Village, Lot 2 Project Description: New SF. 6/22/2018: REPRINT to remove A/C from permit. 7/10/18: REPRINT to add A/C. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 4 First: 574 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 28 Bathrooms: 4 Second: 900 sf Garage: 370 sf Front: 15 Smoke Yes Dwelling Units: 1 Third: 1009 sf Right: 3 Detectors: Total: 2483 sf Value: $299,372.85 Rear: 15 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: _ MECHANICAL Fuel Types / Air Conditioning: Y M, Vent Fans: 6 Clothes Dryers: 1 Natural Gas ` -14681 PliiiiiiNw 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 2483 Owner: Contractor: SAGE BUILT HOMES LLC SAGE BUILT HOMES Required Items and Reports(Conditions) 1815 NW 169TH PL STE 1040 1815 NW 168TH PLACE 1 Ersn Cntrl 503-639-4175 BEAVERTON,OR 97006 BEAVERTON,OR 97006 2 Fire Rated eaves both sides PHONE: 971-221-4597 PHONE: 971-221-4597 FAX: 503-533-5164 Total Fees: $30,986.81 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calline -:1.23 . '87 or 1.800.332.2344. 400, Issued By: �. Permittee Signature: , I0�` Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. P i. 6.- Mechanical Mechanical Permit Applicat' FUR OFFICE I SE 0yl.V Cityof Tigard RIVEE) Received �7 g Date/By: Z/ / -- 4„.1' Permit No.:,� ri �/ J' lig13125 SW Hall Blvd.,Tigard,OR 97223 y Plan Review 0 Phone: 503.718.2439 Fax 503.598.1960 J U L 10 2018 Date/By: Other Permit: r 1 G A R I) Inspection Line: 503.639.4175 Date Ready/By: loos H See Page 2 for Internet: www.tigard-or.gov CITY OF [ GARL) Notified/Method: Supplemental Information Bu ILDI\NG DIVISION. Type/op WORIr: ` ,k~t?1 h1ERCIAL`FIEF St"IIf DIJLE- USE CHECKLIST`-, Mechanical permit fees*are based on the value of the work ®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ . CATEGORY OP CONSTRUCTION " RE •SIDENTIAL QUIPMENTISYSTEMSFEES'r':' " Z 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist. 0 Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total JOB STTE"INFORMATION AND LOCATION Heating/cooling: • W, Air conditioning 1 46.75 44.75 Job site address:9577 SW Anna Belle Court Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP:Tigard,Oregon Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name:Ash Creek Village Duct work 23.32 Cross street/directions to job site:SW 95th Avenue Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision:Ash Creek Village Lot no.:2 Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 D}S itirriON'or WORK{ Gas fireplace/insert 33.39 Flue vent for water heater or gas New residential construction fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other: 23.32 .+-P)IFUPERTY OW1+NER ❑TENANT.' Environmental exhaust and ventilation: Name:Sage Built Homes,LLC. Range hood/other kitchen equipment _ 33.39 Address: 1815 NW 169th Place,Suite 1040 Clothes dryer exhaust 33.39 - City/State/ZIP:Beaverton,Oregon 97006 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) _ 23.32 Phone:(971)221-4597 Fax:( ) Attic/crawlspace fans 23.32 r®4..APPLICANT a',. CONTACT"P NI Other: 23.32 Business name:Sage Built Homes,LLC. Fuel piping: $14.15 for first four;$4.03 for each additional Contact name:Ben Cooper Furnace,etc. Address:Same as above Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:(971)258-6658 Fax::( ) Fireplace Range E-mail:planning@sagebuilthomesllc.com Barbecue CONTRACTOR, Clothes dryer(gas) Business name:All Time Heating&Cooling Other: MECHANICAL PERMIT FEES*S • Address:PO Box 1341 Subtotal y6 ,'7.5 City/State/ZIP:Lake Oswego,Oregon 97035 Miffiliturvt- ) Plan review(25%of permit fee) Phone:(503)208-2276 Fax:( ) State surcharge(12%of permit fee) _ .5" 6, CCB lie.:184575 TOTAL PERMIT FEE ..5--2;9 4, This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signature:gee." * Fee methodology set by Tri-County Building Industry Service Board Print name:Ben Cooper Date:7/10/2018 I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB) 1 Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi-Family Fee Schedule: Total Valuation: Permit Fee:. $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and $2.54 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I:\Building\Permits\MEC_PermitApp_040113.doc 2 RECEIVED Electrical Permit Application JUL 1 d 2018 �µ^���� City of Tigard te/B 49 i� permit �TAv/ccP'--40°0--?..3 13125 SW Hall Blvd.,Tigard,OR 9 eT6Y OF fIGARD Plan Re ew is, Phone: 503.718.2439 Fax: 503.11111 t.J6I..GhlNC- DIVISION DateBy: Related Permit#: Inspection Line: 503.639.4175 j t Ready Date/By: Jurii. 61 See Page 2 for T I G A R D Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): 0 Demolition El Other: El Service or feeder 400 amps or more [21 Building over three stones where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings, ® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural Multi-familyMaster builderamps for all other installations buildings ❑ 0 0 Other: 0 Fire pump. 0 Installation of 150 KYA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived \ ❑Addition of new motor load of system Job#: Job site address: 'q 511 u* M , 'l`c- C)- 100EIP or more. ❑"A","l","1-2","t-3", 'v" occupancy ❑Six or more residential units. City/State/ZIP: i�� ��� s p0 Recreational vehicle parks. I 0 Health-care facilities. Suite/bldg./apt.#: Project name: r'C� !� 0 Hazardous locations ❑Supply voltage for more than ❑Service or feeder 600 amps or more, 600 volts nominal. Cross street/directions to job site: 60 Cis DescriptionFEE SCHEDULE I Each I Tow I New residential single-or multi-family dwelling unit. Subdivision: 5V\I c, Lot#: lZ. Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add]500 sq.It or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75,00 2 NEW RESIDENTIAL CONSTRUCTION (with above sq.ft.) Limited energy,multi-family residential(with above sq.ft.) 75,00 2 Renewable 0. See ge 2 3 PROPERTY OWNER 1 0 TENANT Services or feeders installation,alteration,aand/or relocation Name:SAGE BUILT HOMES LLC 200 amps or less100.70 2 Address: 1815 NW 169TH PL.SUITE 1040 201 amps to 400 amps r 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:BEAVERTON,OR.97006 601 amps to 1,000 amps 301.04 2 Phone:(503)533-5167 Fax:(503)533-5167 Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is being made on property that 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 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A Fee for branch circuits with Business name:SAGE BUILT HOMES LLC above service or feeder fee, 7 42 2 t� / each branch circuit Contact name: by s,\ (: ,R: ( B.Fee for branch circuits without Address:SAME AS ABOVE J service or feeder fee,first l 56.18 2 branch circuit City/State/ZIP: Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Fax::( ) Each manufactured or modular 67,84 � `_ dwelling,service and/or feeder K g Email: , SAGEBUILTHOMESLLC.COM Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67,84 2 Business name:Ross Electric Sign or outline lighting y 67.84 2 Signal circuit(s)or limited-energy Address:2870 SE 75th Avenue,203 panel,alteration,or extension. ❑ See Page 2 2 City!StatetL.IP:1lillsboro,Oregon 97123 Each additional inspection over allowable in any of the above , Additional inspection(1 hr min) 66.25/hr Phone:(503)642-2800 Fax:(503)642-5815 Investigation(1 hr mm) 90.00/hr Email: Industrial plant(I hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lie.: 157891 Electrical Lie.' 34-436C Suprv.Lie.:�� specifically listed('/:hr min) K✓ ' ELECTRICAL PERMIT FErs V Suprv.Electrician signature,required: Subtotal: f L �,'(� Print name: Date: 0 Plan Review Required(25%of permit fee): v Q + ` State surcharge(12%of permit fee): ��, `'47 { /�� TOTAL PERMIT FEE: ` "x Authorized signature: �B/p'� , W t' YY 'this permit application expires if a permit is not obtained within iffll Print name: BQ$(\ ( - Date:'1 —10.-7 0 k days after it has been accepted as complete. - • Number of inspections allowed per permit. IAN ildinglPermitslEl.C_PermitApp_FLR_ERE.doc Rev 06/17/2015 440-46151111/05/COM/WEB CITY OF TIGARD MASTER PERMIT a . ' Permit#: MST2018-00033 a e COMMUNITY DEVELOPMENT c)/za hp , a 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/22/2018 T Ia t�3.u:[ Parcel: 1S135BD01600 Jurisdiction: Tigard Site address: 9577 SW ANNA BELLE CT Subdivision: ASH CREEK VILLAGE Lot: 2 Project: Ash Creek Village, Lot 2 Project Description: New SF. 6/22/2018: REPRINT to remove A/C from permit. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 4 First: 574 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 28 Bathrooms: 4 Second: 900 sf Garage: 370 sf Front: 15 Smoke Yes Dwelling Units: 1 Third: 1009 sf Right: 3 Detectors: Total: 2483 sf Value: $299,372.85 Rear: 15 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Tubs/Showers: 3 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: N Vent Fans: 6 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 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 2483 Owner: Contractor: SAGE BUILT HOMES LLC SAGE BUILT HOMES Required Items and Reports(Conditions) 1815 NW 169TH PL STE 1040 1815 NW 168TH PLACE 1 Ersn Cntrl 503-639-4175 BEAVERTON,OR 97006 BEAVERTON,OR 97006 2 Fire Rated eaves both sides PHONE: 971-221-4597 PHONE: 971-221-4597 FAX: 503-533-5164 Total Fees: $30,934.45 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 OA -001- 090. You may obtain a copy of the rules or direct questions to OUNC by calling _V 503.232.1987�or/i or 1.800.332.2344., , Issued By: '7--e....___ Permittee Signature: 1/107 4'f e 77C?, `/ Call 503.639.4176 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. Plumbing Permit Application g t Building Fixtures "` Foli ()Fumy 1 sf•: ONI.l JULCity of Tigard JUL p)p ReceivedB7/.4 c-1171,--Perm] s/6`�3/>/�6)003 t� ;� • 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: ' _ t ZO�C/t VC�iJ Plan Review Phone: 503.718.2439 Fax: 503.598.19g0 Date/By Other Permit No.: 1 i ‘ 1 t Inspection Line: 503.639.4175 �j:L ",. 1;y 1 L,(�� Xe* ,y. loris: 0 See Page 2 for Internet www.tigard or gov 1g,* .,d: Supplemental Information ' { )i • « . 14•11:44--; - t '- ' ®New construction ❑Demolition For special information use checklist. Description I Qty. I Ea. I Total 0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) TM:1 ,, ' ' EY f� . .., y `- SFR(1)bath 312.70 -77.7' ® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 buildingSFR(3)bath 500.32 0 Accessory 0 Multi-family Each additional bath/kitchen 25.02 0 Master builder 0 Other Fire sprinkler( sq.ft.) Page 2 1 $ - ,u 2 0 `,M r747:. , t. CAt'tt "?•,?` , Site utilities: Job site address:9577 SW Anna Belle Ct Catch basin or area drain 18.76 City/State/ZIP:Tigard,Oregon Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name:Ash Creek Village Manufactured home utilities 50.03 Cross street/directions to job site:SW 95th Avenue Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision:Ash Creek Village I Lot:2 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 Backwater valve 12.51 "'"`"" Clothes washer 25.02 New residential construction/Plumbing contractor revision Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 77,77'R',,,;,,-fir+'PROPERTY I ,f © 1 t V 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 25.02 City/State/ZIP:Beaverton,Oregon Hose bib 25.02 Phone:(971)221-4597 Fax:( ) Ice maker 12.51 _i „° . ci co ; p�RS(wwN a' Interceptor/grease trap 25.02 Business name:Sage Built Homes,LLC. Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:Ben Cooper Roof drain(commercial) 12.51 Address:Same as above Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:(971)258-6658 Fax::( ) Tub/shower/shower pan 12.51 E-mail:planning@sagebuilthomesllc.com Urinal 25.02 ,:'",. - „. Water closet 25.02 CO t CTOR r'"'"n' , -- ' ' - o-s '`''` Water heater 37.52 Business name:Max Plumbing Service Inc Water piping/DWV 56.29 Address:PO BOX 230674 97281 Other: 25.02 City/State/ZIP: Tigard,OR 97281 Subtotal Phone:(971)-275-0198 Fax:( ) Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lie.: 205392 Plumbing Lic.no.: State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name:Ben Cooper Date:7/23/2018 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Res><dential FireSuppression Systems: jou, '� �1 9 ';':11%.;;.--7, -71 :-.171,t)",;;,,,. 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 S stems: Water Service-each additional 100' 37.52 p ' r r Vali ` ...?.w, :.. '',, 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 t ` trlusp each additional$100.00 or fraction thereof,to ° and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum char:e-1/2 hour ■ and including$25,000.00. Inspections outside of normal business - 90.00/hr - $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours minimum char:e-2 hours each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions - 90.00/hr - $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for (minimum char•e 1/2 horn 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*. xn y Quantity by Fixture Type f lan R u « f um iu tions: Fixture Type for Replace! Plan review is required for any of the following. Work performed: Capped Added Relocate Baptistry/Font Please check all that apply. Bath Tub/Shower ID 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" sometIr Riser Diagram Car Wash Drain Garbage Domestic-non-food CI Isometric or riser diagram is required for new buildings Disposal -Domestic-food related that meet the qualifications above. -Commercial-food related -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang -Stall Sink/Lav -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer-Clothes Water Extractor increase of sewer EDUs,a sewer permit will be issued and Water Closet-Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: C:\Users\kylie\Downloads\PLMF PermitApp.doc 2 RECE1VEP City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT III MAY2 ;? 18 e:�M Request for Permit Action t i 2 , . T I G A it D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 •www.tigai lJI G [NIP I '': TO: CITY OF TIGARD Building Division 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov FROM: ❑ Owner ❑X Applicant ❑ Contractor ❑ City Staff Check(✓)one REFUND OR Name: INVOICE TO: (Business or Individual) Sage Built Home Mailing Address: 1815 NW 169th Place Suite#1040 City/State/Zip: Beaverton,OR 97006 Phone No.: 503-533-5167 PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): ❑ L/VOID PERMIT APPLICATION. REFUND IEERMIT FEES (attach copy of original receipt and provide explanation below). INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below). ❑ REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit). Permit#: MST2018-00033 Site Address or Parcel#: 9577 SW Anna Belle Ct Project Name: Ash Creek Village Subdivision Name: Ash Creek Lot#: 2 EXPLANATION: Requesting to remove A/C from permit and a refund Signature: 5p�y Cg��pQ2, Date: ,2/ Print Name: Ben Cooper !/ Refund Policy 1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of • Any fee which was erroneously paid or collected. • Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended. • Not more than 80%of the application or permit fee for issued permits prior to any inspection requests. 2. All refunds will be returned to the original payer in the form of a check via US postal service. 3. Please allow 3-4 weeks for processing refund requests. �+ 3f j'6, 7S - .2770 -- 7 s. 4, - moi; Y9 ' / FOR OFFICE USE ONLY Route to Sys Admin: Date By Route to Records: Date 3/29y/ By, fj' Refund Processed: Date p/2 /t' By AV Invoice Processed: Date By Permit Canceled: Date ,1/,4-- By : ' - Parcel Tag Added: Date By I:\Building\Forms\RegPermitAction_0923 4.doc : - V • � . 11111 TIGARD City of Tigard July 16, 2018 Sage Built Homes Attn: Ben Cooper 1815 NW 169th PI, Suite 1040 Beaverton, OR 97006 Re:Permit No. MST2018-00033 Dear Applicant: The City of Tigard has processed a refund for fees on the above referenced permit(s) as follows: Site Address: 9577 SW Anna Belle Ct Project Name: Ash Creek Village,Lot 2 Job No.: N/A Refund: ® Check#228969 in the amount of$41.89. ❑ Credit card "return"receipt in the amount of$ Note: Please allow 2-5 days for this refund transaction to be credited to your account by the company that issued your card. ❑ Trust account"deposit"receipt in the amount of$ Comments: Per applicant's request to remove A/C from issued permit;refund 80% of permit fees paid. If you have any questions please contact me at 503.718.2430. Sincerely, Ad23S(7/7Zie---- Dianna Howse Building Division Services Supervisor Enc. 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171 TTY Relay: 503.684.2772 • www.tigard-or.gov City of Tigard T l G A R D Accela Refund Request This form is used for refund requests of land use, development engineering and building permit application fees. Receipts, documentation and the Request for Permit Action form (if applicable)must be attached to this request form. Refund requests are due to Accela System Administrator by each Wednesday at 5:00 PM. Please allow upn to 3 weeks for processing of refunds. Accounts Payable will route refund checks to Accela System Administrator for distribution to applicant. PAYABLE TO: Sage Built Homes DATE: 6/22/2018 1815 NW 169th Pl, Suite 1040 Beaverton, OR 97006 REQUESTED BY: Dianna Howse TRANSACTION INFORMATION: Receipt#: 416271 Case#: MST2018 00033 Date: 3/22/2018 Address/Parcel: 9577 SW Anna Belle Ct Pay Method: CreditCard Project Name: Ash Creek Village,Lot 2 EXPLANATION: Remove A/C from issued permit;refund 80%of permit fees paid. >"y. p r: Mechanical Permit Fee 230-0000-43102 $37.40 12%State Surcharge 100 0000 24001 4.49 TOTAL REFUND: $41.89 APPROVALS: SIGNE /DATE: If under$5,000 Professional Staff _-- If under$12,500 Division Manager If under$25,500 Department Manager If under$50,000 City Manager If over$50,000 Local Contract Review Board F "TTI E I X 'f MT,I ' 2A IO1's U:y O1 ,Y Case Refund Processed: Date: 329/4'9' By. I:\Building\Refunds\RefundRequest.doc x 09/01/2010 CITY OF TIGARD MASTER PERMIT 4 COMMUNITY DEVELOPMENT Permit#: MST2018-00033 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/22/2018 Ti C.A i;T=7 g Parcel: 1 S135BD01600 Jurisdiction: Tigard Site address: 9577 SW ANNA BELLE CT Subdivision: ASH CREEK VILLAGE Lot: 2 Project: Ash Creek Village, Lot 2 Project Description: New SF. BUILDING ' Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 4 First: 574 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 28 Bathrooms: 4 Second: 900 sf Garage: 370 sf Front: 15 Smoke Dwelling Units: 1 Third: 1009 sf Right: 3 Detectors: Yes Total: 2483 sf Value: $299,372.85 Rear: 15 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 6 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. Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2483 Owner: Contractor: SAGE BUILT HOMES LLC SAGE BUILT HOMES Required Items and Reports(Conditions) 1815 NW 169TH PL STE 1040 1815 NW 168TH PLACE 1 Ersn Cntrl 503-639-4175 BEAVERTON,OR 97006 BEAVERTON,OR 97006 2 Fire Rated eaves both sides PHONE: 971-221-4597 PHONE: 971-221-4597 FAX: 503-533-5164 Total Fees: $30,788.65 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 copy of the rules or direct questions to OUNC by callin 23 87 or 1.800.332.2344. � . Issued By: �, Permittee Signature: ���"rrr���rrr Call 503.639.4175 by 7:00 am.for the next available inspection da e. N 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. ,. h Building Permit Application Resicv_ntia1 ' ' '3J 1 "' rtlli OFF I( l: I `l:()NI.) City of Tigard DReacteeBiveyd .2•2_1(1 PermitNo.�: 61 O`/.yer.--C(...af 13125 SW Hall Blvd.,Tigard,OR 97223 �s .1 Plan Review t ,��9 ,. �r� ■ Phone: 503.718.2439. Fax: 503.598.1969\N i u /.,),,, y /�a ) • Other Permit:4/4.��_rt//O Cl/[/�7 Date/By: T I G n R D Inspection Line: 503.639.4175 Date Ready/By: ql �f, / Juris: El See Page 2 for Internet: www.tigard-or.gov - R ' "'f" (J Notifie ethod: ✓ /��/ /i Supplemental Information ��s `�' ��{ � takt.tit � TTT III , ;TYPE OC7� JSi1g REQ IIRI DATA:I-AND 2- AMILY 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 for the CATEGORY=OF CONSTRUCTION work indicated on this application. ® 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ � l 3 7 0 Accessory building 0 Multi-family Number of bedrooms: 4 ❑Master builder ❑Other: Number of bathrooms JOB SITE INFORMATION AND LOCATION Total number of floors: 3 A Q&3 Job site address:9577 SW Anna Belle Court New dwelling area: 2483 square feet City/State/ZIP:Tigard,Oregon Garage/carport area: 370 square feet Jo Q 9 Suite/bldg./apt.no.: Project name:Ash Creek VillageCovered porch area: 100 square feet 0 Cross street/directions to job site:SW 95th Avenue -ag4S\ 1f5tMe . square feet 3"7 9.. Other e e a. square feet / REQUIRED DATA:COM14+1ERCIA USE CHECKLIST Subdivision:Ash Creek Village 1 Lot no.:2 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 +4 PROPERTY OWNER ❑ TENANT Number of stories: Name:Sage Built Homes,LLC Type of construction: Address:1815 NW 169th Place,Suite 1040 Occupancy groups: City/State/ZIP:Beaverton,Oregon Existing: Phone:(971)221-4597 Fax:( ) New: in APPLICANT , ii CONTACT PERSON BUILDING PERMIT FEES* Business name:Sage Built Homes,LLC. (P ereJerfofeesdredtde) Structural plan review fee(or deposit): Contact name:Kylie Hofenbredl FLS plan review fee(if applicable): Address:Same as above City/State/ZIP: Total fees due upon application: Amount received: Phone:(971)221-4597 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:Sage Built Homes,LLC Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:Same as above Solar Installation Specially Code checklist. Permit Fee(includes plan review City/State/ZIP: and administrative fees): $180.00 Phone:( ) Fax:( ) o State surcharge(12%of permit fee): $21.60 CCB lic.:189330 Total fee due upon application: $201.60 Authorized signature: /c"1,..e., �`1,2ja This permit application expires if a permit is not obtained ,"""' within 180 days after it has been accepted as complete. Print name:Kylie Hofendl Date:1/16/2018 *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) a I •,o Building Permit Application Checklist One- and Two-Family Dwelling roll orrice: 1 si ()Nil Received City of T1g81 tl Permit No.: Up/ Date/B r 13125 SW Hall Blvd.,Tigard,OR,97223 Associated permits: • Phone: 503.718.2439 Fax. 503.598.1960 24-Hour Inspection Line: 503.639.4175 ❑ Electrical 0 Plumbing 0 Mechanical TIGARD Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW les No A/t 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 0 0 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: . ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ ❑ .6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑plan 0 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 ❑ ❑ ❑ 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- ❑ ❑ ❑ floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ systems,see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ❑ ❑ 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 Ion and shall be shown to be as s licable to the .ro'ect under review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". ❑ ❑ ❑ 24 Two(2)sets each are required for Items 16,19,20 and 22 above. ❑ ❑ ❑ 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 ❑ ❑ ❑ 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) rt Mechanical Permit Application t 1.'4 FOR OFFI( I. I SF o\l.V City of Tigard Received 13125 SW Hall Blvd.,Tigard,OR 97223 Dat '� '' �.a Other Permit: t'/ A fi�p t 1.r view IIIII D Phone: 503.718.2439 Fax: 503.598.1960 Date/By: T t G A R D Inspection Line: 503.639.4175 Internet: www.tigard-or.gov `"s`�/ ''r+ y: auris: H See Page 2 for '` 4 od: Supplemental Information TYPE OF WORK s ,U•I° COMMERCIAL FEE*:SCHEDULE-USE(:i1r.CKE:IST Mechanical permit fees*are based on the value of the work ®New construction D Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ® 1-and 2-family dwelling ❑Commercial/industrial ❑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 44.75 Job site address:9577 SW Anna Belle Court Fumace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP:Tigard,Oregon Fumace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name:Ash Creek Village Duet work 23.32 Cross street/directions to job site:SW 95th Avenue Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision:Ash Creek Village Lot no.:2 Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 1 23.32 23.32 DESCRIPTION OF WORK Gas fireplace/insert 1 33.39 33.39 Flue vent for water heater or gas New residential construction fireplace 1 23.32 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 <, 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) 4 23.32 93.28 Phone:(971)221-4597 Fax:( ) Attic/crawlspace fans I 23.32 23.32 r4 APPLICANT "' 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:Kylie Hofenbredl Furnace,etc. I Address:Same as above Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater 1 Phone:(971)221-4597 Fax::( ) Fireplace 1 Range 1 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,Oregon 97035 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(503)208-2276 Fax:( ) State surcharge(12%of permit fee) CCB lic.711:1375 /P---1 c---7S- TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 • days after it has been accepted as complete. Authorized signature: /.--- ri7e7-(1-12.0te4-42.Gee * Fee methodology set by Tri-County Building Industry Service Board Print name:Kylie Hofenbredl Date:1/16/2018 I:\Building\Pemits\MIEC_PemtitApp_040113.doc 440-46171'(11/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial &Multi-Family Fee Schedule: Total Valuation: Permit Fee: $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and $2.54 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I:Bui1ding\Permits\MEC_PermitAPP_O4OI 13.doc 2 r Electrical Permit Application re Z, 9s Vie I I FOR OFFR : ISE ON►.l City Of Tigard Received 13125 SW Hall Blvd.,Tigard,OR 97223 Date/B : riff �' '1 s . Phone: 503.718.2439 Fax: 503.598.1960 )��N 115 1 7{(' Plan'Review Date/B Related Permit#: I 1 c i A It I> Inspection Line 503.639.4175 .,Read Date/By: Internet. www.tigard-or.gov `_ / $ 1 s r (" y Juns: Supplemental See Page 2 for ,. (, e ,:.,i g it;-, fonfied/Method: Supplemental Information '' TYPE OF'W(' Ij roc DIVISION FLAN REVIEW . ®New construction 0 Addition/alteratlott/replacement Please check all that apply(submit 2 sets of plans w/items checked): 0 Demolition Other: ❑Service or feeder 400 amps or more 0 Building over three stories. where the available fault current ❑Marinas and boatyards. ' CATEGORY OF'CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings. ® 1-and 2-family dwelling El Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. Other: ❑Fire pump. 0 Multi-family 0 Master builder 0 Installation of 150 KVA or JOB RITE,INFORMATION AND LOCATION 0 Emergency system. larger separately derived Job#: I Job site address:9577 SW Anna Belle Court ❑Addition of new motor load of system. 100HP or more. ❑"A","E","1-2","1-3", City/State/ZIP:Tigard,Oregon ❑Six or more residential units. occupancy. D Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: I Project name:Ash Creek Village 0 Hazardous locations. 0 Supply voltage for more than Cross street/directions to job site:S W 95th Avenue 0 Service or feeder 600 amps or more. 600 volts nominal. FEE SCHEDULE Description 1 Qty. 1 Each 1 Total New residential single-or multi-family dwelling unit. Subdivision:Ash Creek Village I Lot#:2 Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 168.54 4 DESCRIPTION OF WORK" Ea.add'I 500 sq.ft.or portion 33.92 1 Limited energy,residential New residential construction (with above sq.ft.) 75.00 2 Limited energy,multi-family residential(with above sq.ft.) 75.00 2 =!PROPERTY OWNER 1 0:;TENANT rgy 2 ServicesRenewable or feedersEneinstallation,alteration,❑ SeePage and/or relocation Name:Sage Built Homes,LLC. 200 amps or less P 1 100.70 100.70 2 Address:1815 NW 169th Place,Suite 1040 201 amps to 400 amps 133.56 2 City/State/ZIP:Beaverton,Oregon 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Phone:(971)221-4597 I Fax:( ) Over 1,000 amps or volts 552.26 2 Email: Temporary services or feeders installation,alteration,and/or 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 1 2 =4 APPLICANT I ® CONTACT PERSON Branch circuits-c new,alteration,or extension,per panel Business name:Sage Built Homes,LLC. A.Fee for branch circuits with above service or feeder fee, Contact name:Kylie Hofenbredl each branch circuit 7.42 2 B.Fee for branch circuits without Address:Same as above service or feeder fee,first branch circuit 56.18 2 City/State/ZIP: Each add'1 branch circuit 7,42 2 Phone:(971)221-4597 Fax: Miscellaneous(service or feeder not included) :( ) Each manufactured or modular dwelling,service and/or feeder Email:planning@sagebuilthomeslic.com 67.84 2 CONTRACTORReconnect only 67.84 2 ` Pump or irrigation circle 67.84 2 Business name:Ross Electric Sign or outline lighting 67.84 2 Address:2870 SE 75th Avenue,203 Signal circuit(s)or limited-energy El See Page 2 panel,alteration,or extension. g 2 City/State/ZIP:Hillsboro,Or 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: /U/f// Industrial plant(1 hr min) 78.18/}u Inspections for which no fee is CCB Lic.: 157891 Electrical Lic.: 34-436C J Suprv.Lic.: 442.32 Jn specifically listed('/hr min) 90.00/hr Suprv.Electrician signature,required: EI ECTRICAL PERMIT FEES Subtotal: Print name: Steven Ross I Date: 1/16/2018 ❑Plan Review Required(25%of permit fee): State surcharge(12% fee): Authorized signature: v1� Y1/,"lQyq TOTAL PERMIT FEE: Print name: Kylie Hofenbredl I This permit application expires if a permit is not obtained within 180 I Date: 1/16/2018 days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC_PemutApp_ELR_ERE.doe Rev 06/17/2015 440-4615T(11/05/COM/WEB . Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: FEE SCHEDULE RESIDENTIAL TIAL'.1!'7.VR'"3 t\L : Description I Qty. I Each I Total I " Fee for all residential systems combined: $75.00 Renewable electrical energy systems: 5 kva or less 100.70 2 Check Type of Work Involved: 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 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 552.26 2 with OAR 918-309-0040) ❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 >100 kva—no additional charge 0.0 3 El V• acuum Systems* Each additional inspection over allowable in any of the above: Each additional inspection is 66.25/hr 1 FlO• ther: charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed('A hr min) ELECTRICAL PERMIT FEES CO RCIA WORKONLY: Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ 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 C\Building\Pemtits\ELC_PennitApp_ELR_ERE.doe Rev 06/17/2015 ,r Plumbing Permit Application .. Building Fixtures .1 a � City of Tigard Received » 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: Permit No.: >s Phone: 503.718.2439 Fax: 503.598.1960" I t 1 1 Plan Review Other Permit No.: Inspection Line: 503.639.4175 ) Date/By: T 1 G A R ll p Date Read/B H See Internet: www.tigard-or.gov A , i; L Ready/By: 7u°s' Page 2 for l`p+ f d y 1 Notified/Method: Supplemental Information TYPE OF WOR 1 1<T x YAT FEE* SCHEDULE ®New construction T2drrfbrttfbn 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 ® 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 ❑Accessory building ❑Multi-family SFR(3)bath 1 500.32 500.32 0 Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION.AND LOCATION Site utilities: Job site address:9577 SW Anna Belle Court Catch basin or area drain 18.76 City/State/ZIP:Tigard,Oregon Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: ) Project name:Ash Creek Village Manufactured home utilities 50.03 Cross street/directions to job site:SW 95th Avenue Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision:Ash Creek Village I Lot no.:2 Fixture or item: Tax map/parcel no.: Backflow preventer 31 27 DESCRIPTION OF,WORK Backwater valve 12.51 -New residential construction Clothes washer 1 25.02 25.02 Dishwasher 1 25.02 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 .N PROPERTY OWNER 0 TENANT Expansion tank 12.51 Name:Sage Built Homes,LLC. Fixture/sewer cap 25.02 Address: 1815 NW 169th Place,Suite 1040 Floor drain/floor sink/hub 25.02 Garbage disposal 1 25.02 25.02 City/State/ZIP:Beaverton,Oregon Hose bib 2 25.02 50.40 Phone:(971)221-4597 Fax:( ) Ice maker 12.51 APPLICANT ►. CONTACT PERSON Interceptor/grease trap 25.02 Business name:Sage Built Homes,LLC. Medical gas(value:$ ) Page 2 Contact name:Kylie Hofenbredl Primer 12.51 Roof drain(commercial) 12.51 Address:Same as above Sink/basin/lavatory 5 25.02 125.10 City/State/ZIP: Solar units(potable water) 62.54 Phone:(971)221-4597 Fax: :( ) Tub/shower/shower pan 3 12.51 37.53 E-mail:planning@sagebuilthomeslIc.com Urinal 25.02 CONTRACTOR; Water closet 25.02 Business name:Ed Mullen Plumbing Water heater 1 37.52 37.52 Water piping/DWV 56.29 Address:1601A SE River Road Other: 25.02 City/State/ZIP:Hillsboro,Oregon Subtotal Phone:(503)720-2636 Fax:( ) Minimum permit fee: $72.50 CCB Lic.:92689 Plumbing Lic.no.:34-260PB Plan review (25%of permit fee) j i/ ,n State surcharge(12%of permit fee) Authorized signature: slyg l,,g i TOTAL PERMIT FEE Print name:Kylie Hofen edl Date: 1/16/2018 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1:\Building\Permits\PLMJ-PemutApp.doc 10/01/09 440-4616T(10/02/COM/WEB) u Plumbing Permit Application - City of Tigard Page 2 -Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities � ) Total Square Footage: Permit Feet Footing drain-1'100' 50.03 0 to 2,000 $121.90 37.52 2,001 to 3,600 $169.69 Footing drain-each additional 100' 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 Other Inspections or FeesFee teal . Total each additional$100.00 or fraction thereof,to r 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 each additional$100.00 or fraction thereof. (minimum charge-1/2 hour) 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 any of the following. Work Performed: Capped Added Relocate Please check all that apply. pP y. Baptistry/Font 0 Any new commercial building with water service 2"and Bath -Tub/Shower greater,except systems designed and stamped by licensed -Jacuzzi/Whirlpool engineer. Car Wash -EachDStall ❑ New exterior plumbing site utilities for any complex structure Cu -Drive orTas defined in OAR918-780-0040. Dishwasher her Coirator Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities. -Domestic 0 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" Isometric or Riser Diagram Car Wash Drain ❑ 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 -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang -Stall Sink/Lav -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer-Clothes increase of sewer EDUs,a sewer permit will be issued and Water Extractor fees assessed for the sewer increase must be paid before the Water Closet-Toilet Urinal plumbing permit can be issued. Other Fixtures: C:\Users\kylie\Downloads\PLMF_PerirtitApp.doc 2 Plumbing Permit Application Building Fixtures a_ , i ; _ ~ City of Tigard Received 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: Permit N rF t~f_',33 g I/4N li / 0 Vc�J )111 _ Phone: 503.718.2439 Fax: 503.598 1960 J / Plan Review Date/By: Other Permit No.: Inspection Line: 503.639.4175 T I G r1 k Il Pate Ready/By: Ions: d See Page 2 for Internet www.tigard-or.gov ,t 44otified/Method: Supplemental Information ,TYPE OF WORRUILDING DIVISION FEE*'SCHEDULE ®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'CONSTROCTTON SFR(1)bath 312.70 ® 1-and 2-family dwelling 1:1Commercial/industrial SFR(2)bath 437.78 ❑Accessory building ❑Multi-family SFR(3)bath 500.32 El Master builder Each additional bath/kitchen 25.02 ❑Other: Fire sprinkler( sq.ft.) Page 2 • 1013 SITE.INFORMATION AND LOCATION Site utilities: Job site address:9577 SW Anna Belle Court Catch basin or area drain 18.76 City/State/ZIP:Tigard,Oregon Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name:Ash Creek Village Manufactured home utilities 50.03 Cross street/directions to job site:SW 951i Avenue Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision:Ash Creek Village I Lot no.:2 Fixture or item: Tax map/parcel no.: Backflow preventer 1 31.27 31.27 • Backwater valve • DESCRIPTION OF WORK 12.51 Backflow Permit Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ae PROPERTY OWNER 1E3TENANT Expansion tank 12.51 Name:Sage Built Homes,LLC. Fixture/sewer cap 25.02 Address:1815 NW 169th Place,Suite 1040 Floor drain/floor sink/hub 25.02 Garbage disposal 25.02 City/State/ZIP:Beaverton,Oregon Hose bib 25.02 Phone:(971)221-4597 Fax:( ) Ice maker 12.51 APPLICANT . . CONTACT PERSON, Interceptor/grease trap 25.02 Business name:Sage Built Homes,LLC. Medical gas(value:$ ) Page 2 Contact name:Kylie Hofenbredl Primer 12.51 Roof drain(commercial) 12.51 Address:Same as above Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:(971)221-4597 Fax::( ) Tub/shower/shower pan 12.51 E-mail:planning@sagebuilthomesllc.com Urinal 25.02 CONTRAC OR , Water closet 25.02 Business name:Truscapes Water heater 37.52 Water piping/DWV 56.29 Address:1600 NW Amberwood Drive Other: 25.02 City/State/ZIP:Hillsboro,Oregon Subtotal Phone:(503)531-9216 Fax:( ) Minimum permit fee: $72.50 CCB Lic.:7962 7/31'1r f Plumbing Lic.no.: Plan review (25%of permit fee) dl �C% State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name.Kylie Hofe redl Date: 1/16/2018 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-permitApp.doc 10/01/09 440-4616T(10/02/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 37.52 2,001 to 3,600 $169.69 Footing drain-each additional 100' 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 all ntiotC '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 F.,, Taut each additional$100.00 or fraction thereof,to Othe •Inspe�p0$or Fees QtY. oe( .tand 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 each additional$100.00 or fraction thereof. (minimum charge-1/2 hour) 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 lace/ Plan review is required for any of the following. Work Performed: Capped Added Relocate Please check all that apply. pP y. Baptistry/Font ❑ Any new commercial building with water service 2"and Bath -Tub/Shower greater,except systems designed and stamped by licensed -Jacuzzi/Whirlpool engineer. Car Wash -Each Stall ❑ New exterior plumbing site utilities for any complex structure -DriveprorTas defined in OAR918-780-0040. Cuspidor/Water DishwasherCoirator -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» Isometric Or Riser Diagram Car Wash Drain ❑ 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 -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 increase of sewer EDUs,a sewer permit will be issued and Water Extractor fees assessed for the sewer increase must be paid before the Water Closet-Toilet Urinal plumbing permit can be issued. Other Fixtures: C:\Users\kylie\Downloads\PLMF_PermitApp.doc 2 City of Tigard III■ COMMUNITY DEVELOPMENT DEPARTMENT 1111 T 1 c A K D Building Permit Review — Residential Building Permit #: 5- L .a�y� _ Site Address: ci 5 1 -1 Svw A nth Petu c±r Project Name: kh 1kL v; t(09 e, Lot #: '2.--- (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: Ni titik) SC-C- 1 Verify site address/suite# exists and active in permit system. // River Terrace Neighborhood: X No E Yes,See River Terrace Review Addendum Attached Site Plan Elements: ?Three(3)copies of site plan C'ExlThng structures on site / Site plan must be on 8-1/2"x 11"or 11 x 17"paper tnFootprint of new structure (including decks)with finished ]Drawn to scale(standard architect or engineer scale) floor elevations /North arrow Utility locations&easements (required for new and additions) Site address,project or subdivision name and lot number 7idewalk/driveway approach /Applicant information(name and phone number) .2.1.4acaticln of wells/septic systems ZLot dimensions and building setback dimensions sting trees to be retained with drip line,and tree footage of buildings to be demolished protection measures Lot area,building coverage area,pert age of coverage and Street tree size,type and location impervious area(applicable if R-7, R-25&R-40) 1ZJStreet names /Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced?/Yes No 4 foot differential) If yes,is a storm water quality facility shown? ZYes ❑No 9it Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): / Required: ❑ Yes,applicant was notified / No Received: ❑ Yes ❑ No Public Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified ❑ No Applied For: Yes ❑ No,stop intake Land Use Case#: p 0 iZ iC(.S - 0 000 ( , .S(,,�(3 2.0% .~ C 0003 Zoning: g i ,Z Required Setbacks: Front 15 Rear IS Side Sy Street Side • )0 Garage 1,4,2 )6 Landscape Requirement: Lot Coverage Maximum: 60 % 7] Building Height: Maximum Height 3✓ Actual Height 30 Visual Clearance ZSensitive Lands: ❑ Yes ❑ No Type Urban Forestry Plan gi Conditions "Met"prior to issuance of building ermit F Notes: 30 ( (ton 2_7 i I+ e d A Y1 ❑ Approved By Planning: 4A' V�:� Date: Il j 8 I 1 f) Revisions (after Building Submittal only) Reviewer Revision 1: ❑ Approved ED Not Approved Date Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPennitRvw_RES 061417.docx Building Permit Submittal Original Submittal Date: J z , ir Site Plans: # 3 Building Plans: # J Building Permit#: nter building permit#above. Workflow Routing: Planning ) Engineering 9,-Permit Coordinator /P—Building Workflow Sign-off: Sign-off for Planning(include notesfromplanning review) Route Application Documents: Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. r.PBuilding: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: r By Permit Technician: .,. „1,, S,L rL%/,,,,,,p Date: 7-/---J4- En ineering Review Ker5lope at building pad: /6" IV Conditions "Met"prior to issuance of building permit 0asements (encroachments)per engineering conditions of approval and plat Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes 2'No Assess Water Quantity Fee in-lieu: ❑ Yes ErNo LIDA Facility on lot: ( ❑ Yes [2-"No LTJ' Final Plat Recorded: PAGtL Date: ❑ NOT Approved by Engineering: p Notes: 6,k ;10 at,-/ `v 1-t( C Pace r Lpproved by Engineering: V- -' rrsf4f.R— Date: j_ithis 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: 60' welt.`ff- /407 f(me. 1-" (J s 8, v, i "l -5J , 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: SDC Fees Entered: Wash Co Trans Dev Tax: , Yes ❑ N/A Tigard Trans SDC: , Yes ❑ N/A r Parks SDC: t ''Yes ❑ N/A LIDA ❑ Yes ig00 N/A N7OK to Issue Permit J 2., / — Approved by Permit Coordinator: /� � % Late: / 1:\Building\Forms\B1dgP ennitRvw_RES_010118.docx FOR OFFICE USE ONLY-SITE ADDRESS: 5.'7 7 7 c "1-74a4/4. -%/�- 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 4 111 II Transmittal Letter r 1 G A R I) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: '1/2/7 DATE DATE RECEIVED: DEPT: BUILDING DIVISION RFOrr TD FROM: /fir l' 416 ' ( •2__ FEB 2 7 2018 BUS.;' i`; ''.:1:L-1-2'N COMPANY: Sc-cr- - at( //1-17 "'i e C PHONE: 7 7 1 - 224 --C-(5 57 serf/ RE: C?7 S/� d lM t "A / e// e7e—AtSM-6/ `' f/. ?1(Site Address) (Permit Number) ( roject name or subdivision name and lot um ) 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: ✓u rI., ' Yen ,1,-s 4 . vct YG �� vr-s. - FOR OFFICE USE ONLY Routed to Permit Technician: /Date: 3 - )...-Z -- ) Initials: Fees Due: ❑Yes pi Nd7 Fee Description: Amount : ______ / // $ $ $ Special Instructions: Reprint Permit(per PE): ❑Yes Aj No ❑Done Applicant Notified: _ Date: X1'2 r!g- Initials: I:\Building\Forms\TransmittalLetter-Revisions 061316.doc 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 Transmittal Letter T i(,,r\R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www. rd-or.gov TO: 'TOM DAT • CEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: A\-l.k cAL - CITY OF TIGAR ) COMPANY: vN, ve C . BUILDING DIVISION PHONE: `" t \ 3SW Wc4.'` RE: rlyvn(Site Address) . ` 1 • ( t Number) ! Ci.c, cs\-- 2_ ('roject nadie or subdivisi.w . ��t num \�� ATTACHED ARE THE FOLLO ``i ti' ITEMS: Copies: Description: ® I p' i p ` [ Copies: j Description: Additional set(s) of p1., s. —7( Revisions: Cross section(s) an. d etails. Wall bracing and/or lateral analysis. Floor/roof framin.. Basement and retaining walls. Beam calculati. s. Engineer's calculations. Other(expla' : REMARKS: Pj it ra ird yr (1-e kyr f l s 51-171,e r / /)late S - -� ✓' cE5--e. i/`r`,5 FOR OFFICE USE ONLY Route. o Permit Technician: Date: �/ffr Initials: Fees sue: ❑Yes rII o Fee Description: Amount Due. } if iv'./ Gt.) 717-7v' $ "J" ,'cam-.-v...f 4457 7-1/t.-7 �o F-&-ES r $ Special $ Instructions: Reprint Permit(per PE): [] Yes ►1 No ❑ Done Applicant Notified: Date: Initials: I.\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 FOR OFFICE USE ONLY-SITE ADDRESS: :5--?7 S _ LI 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 ipil .1 i :. Transmittal Letter T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.t' ard-or.gov TO: TNN DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FPB27201 FROM: A\-ek V1 Ck<ierARD TY OF TIG COMPANY: 0p\fi - �� �c\ '3 �� �� ` BUILDING DIVISION PHONE: C\--\,\ �� W"1. 1, BY`--__ l'IY ►.. l� 0 B Qty® (Site Address) ( ermit umber) is,c- 2_ ( rP oject Warne or s-alsi.to, \io. ) of num �r ATTACHED ARE THE FOLLO `N ` ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. --74- Revisions: Cross section(s) and, etails. Wall bracing and/or lateral analysis. Floor/roof framing? Basement and retaining walls. Beam calculatiis. Engineer's calculations. Other(expla' REMARKS: p!/ ,(a7rrf C U? ,-(1-ef`S JD yr CSS J Gl/irW 51'4{1,(e.-71-7/t / // . - s -- 1/- cFs--e• 517''. FOR OFFICE USE ONLY Route o Permit Technician: Date: -0//9//e? Initials: Fees ue: Ill Fees Fee Description: Amount Due. e —grv6.'ES 64V t�f_ix .'ri / $ d kt AJ' ,a77 /Jj, - $ >r $ Special Instructions: Reprint Permit(per PE): ❑ Yes V No [' Done Applicant Notified: Date: Initials: I:\Building\Fonns\TransmittalLetter-Revisions.doc 05/25/2012 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9577 SW ANNA BELLE CT, TIGARD, OR, 97223 July 19, 2018 at 12:46:59 PM Record Type: Record ID: Residential - Master Permit MST2018-00033 Inspection Type: Inspector: 299 Final inspection David Young Result: FA I L Comments: Window at top of stairs not tempered in hazardous location. It appears tempered window was installed in other opening in stairway. All else appears ok, City required documents left on site. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9577 SW ANNA BELLE CT, TIGARD, OR, 97223 July 18, 2018 at 9:15:50 AM Record Type: Record ID: Residential - Master Permit MST2018-00033 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS Comments: Ac installed. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9577 SW ANNA BELLE CT, TIGARD, OR, 97223 July 18, 2018 at 7:30:28 AM Record Type: Record ID: Residential - Master Permit MST2018-00033 Inspection Type: Inspector: 299 Final inspection David Young Result: FA I L Comments: Provide approved final erosion control inspection prior to building final inspection. No inspection done at this time. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9577 SW ANNA BELLE CT, TIGARD, OR, 97223 July 17, 2018 at 2:17:53 PM Record Type: Record ID: Residential - Master Permit MST2018-00033 Inspection Type: Inspector: 299 Final inspection David Young Result: FA I L Comments: Provide approved electrical final inspection prior to building final inspection. No inspection done at this time. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9577 SW ANNA BELLE CT, TIGARD, OR, 97223 July 17, 2018 at 2:06:54 PM Record Type: Record ID: Residential - Master Permit MST2018-00033 Inspection Type: Inspector: 399 Plumbing final David Young Result: PASS Comments: Corrections from previous inspection complete. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9577 SW ANNA BELLE CT, TIGARD, OR, 97223 July 17, 2018 at 2:03:28 PM Record Type: Record ID: Residential - Master Permit MST2018-00033 Inspection Type: Inspector: 699 Mechanical final David Young Result: PASS Comments: Corrections complete from previous inspection. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9577 SW ANNA BELLE CT, TIGARD, OR, 97223 July 23, 2018 at 11 :57:23 AM Record Type: Record ID: Residential - Master Permit MST2018-00033 Inspection Type: Inspector: 299 Final inspection David Young Result: PASS - CofO Comments: Final erosion control approved. Tempered window installed at top of stairs. Street tree certification received. Moisture content form received. Moisture barrier form received. High efficiency lighting form received. Blower door test report checked. C of 0 issued. Note: change of plumbing contractor to be submitted for All houses prior to further C of O issuance. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9577 SW ANNA BELLE CT, TIGARD, OR, 97223 July 23, 2018 at 11 :57:23 AM Record Type: Record ID: Residential - Master Permit MST2018-00033 Inspection Type: Inspector: 299 Final inspection David Young Result: PASS - CofO Comments: Final erosion control approved. Tempered window installed at top of stairs. Street tree certification received. Moisture content form received. Moisture barrier form received. High efficiency lighting form received. Blower door test report checked. C of 0 issued. Note: change of plumbing contractor to be submitted for All houses prior to further C of O issuance. Violation Summary: Inspector Contractor