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Permit qCITY OF TIGARD MASTER PERMIT 1111 s COMMUNITY DEVELOPMENT Permit#: MST2015-00186 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/23/2015 Parcel: 251080001500 Jurisdiction: TIGARD Site address: 15111 SW DANUBE DR Subdivision: 1998-005 PARTITION PLAT Lot: 2 Project: Polygon at Bull Mountain, Lot 9 Project Description: New SF. 3/28/2016: REPRINT permit to correct number of tub/showers from 4 to 3. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1259 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1658 sf Garage: 464 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors. Yes Total: 2917 sf Value: $355,247.81 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 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 Drains: 0 100 Catch Basins: 0 Bckftw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: 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.'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 2917 Owner: Contractor: POLYGON WLH LLC POLYGON WLH,LLC Required Items and Reports(Conditions) 109 E 13TH ST,STE 200 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175 VANCOUVER,WA 98660 VANCOUVER,WA 98660 PHONE: PHONE 360-695-7700 FAX: 360-693-4442 Total Fees: $33,196.29 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 0'• 952-0f '090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued B /✓1��1�� 0/V ,7-7°/°1--/e'9 Y: _� ��� /i Permittee Signature: 770 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. CITY OF TIGARD MASTER PERMIT • .0 COMMUNITY DEVELOPMENT Permit#: MST2015-00186 TIG tRD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/23/2015 Parcel: 251080001500 Jurisdiction: TIGARD Site address: 15111 SW DANUBE DR Subdivision: 1998-005 PARTITION PLAT Lot: 2 Project: Polygon at Bull Mountain, Lot 9 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories. 2 Bedrooms: 4 First 1259 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1658 sf Garage: 464 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2917 sf Value: $355,247.81 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain. 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer 100 Drains: 0 Tubs/Showers: 4 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 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans. 5 Clothes Dryers. 1 Natural Gas Heat Pump. N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp- 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 4 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt. 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System N Garage Opener N All 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 2917 Owner: Contractor: POLYGON WLH LLC POLYGON WLH,LLC Required Items and Reports(Conditions) 109 E 13TH ST,STE 200 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175 VANCOUVER,WA 98660 VANCOUVER,WA 98660 PHONE: PHONE: 360-695-7700 FAX: 360-693-4442 Total Fees: $32,709.09 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 952-001-0 h OAR 952-001-0090 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1. 0.3322344.i Issu By: Permittee Signature: /CS19�'`�/ - - 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. Building Permit Application Res dential s -r' Y;FOR OFF IC E,USE7O".L' A 4 a � t "t l':t Received / r=. City W Tigard *.co\ieo Date/By: /v /l � PermitNo.:M )0/ / .L• 13125 SW Hall Blvd.,Tigard,OR 9 Plan Review, ! I of 1 I,r Phone: 503.718.2439 Fax: 503.598.1960 �� 8 V\� Date/By: `1 S 1 HS' 'i Other Permit:S'�2 t�o i S,,0/:30 TLGA P.D Inspection Line: 503.639.4175 0 Date Ready/By: ! Juris: ® See Page 2 for Internet: www.tigard-or.gov o ,Gro`O Notified/Method:go f� (i c. Supplemental Information N co F 1V1S ,�. rt• -�=iE D � y,s"_.., ,x "'�1U.::.C3.,3N�„�,fik,.r�=s,,,c 71133' ;„ 1Y'�.; z�,�;.c.,., „�, �.a«�. T�a. :9•i:,,".. �...;.,; .�;...xa�a>,-_ t s;;; °`°'° 6 r ` ' 4 'RE.,IIiREI}' l A:Tt1z'41 �•AIYD�2-FAMII I) Is7Va '., • �:zus;:gA. sF�h E„50F�gy,• ,_��__<:t"` �Y R � .�,�,,,,r. � x�, c'. ,�,�. v..��._.r,.��.,�. • -.�:5� ',��o°.:=�,tt l��,tta ��, � ..:�- � � ��.'�,�,.�,,..-,,.; r ,� <�-"-� �-et�ra�uv��, ', � ���s �r � ®New construction 9 Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all 0 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the ` ' * EG1O'RY QF CONR.UGON a ` zwork indicated on this application. 11.1 � % � . , 3xd:.,K; S-Tr -,..,,,,t104,..,,® 1-and2-familydwelling ❑Commercial/industrial Valuation:���)ail$ �� Number of bedrooms: � ❑Accessory building ❑Multi-family 9 Master builder ❑Other: Number of bathrooms: 3 0 SOB SITE'a ORMATIU A TD I�OCA"'LT 1 Total number of floors: 2 Job site address: l'01\ S u) \/and e_ New dwelling area: oQ I 7 square feet‹li i City/State/ZIP:Tigard,OR 97224 Garage/carport area: t.'1u square feet Suite/bldg./apt.no.: Project nam . Covered porch area: q2 square feet 1 6 J g Cross street/directions to job site: Deck area: ch square feet' a_S 9 Other structure area: square feet ..RE [1IR.Ei1 !.C o te_: c<:. - SEdH;.E-.u:J9,A Subdivi(ion:Polygon at Bull Mountain Lot no.: ”` Permit fees*are based on the value of the work performed. • indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the T. � 1` t� D pawn o,,,, t1 , , --4'URK work indicated on this application. !� s�” Valuation: $ /i/ Existing building area: square feet New building area: square feet fx ® i'RU ERTY OWNER 4 WRAF r Mi '! -:-':ill" Number of stories: .v Name:Polygon WLH,LLC Type of construction: Address:109 E 13th Street Occupancy groups: City/State/ZIP:Vancouver,CA 98660 Existing: Phone:(360)695.7700 Fax:(360)693.4442 New: `"�" 'I:,AP LIC`ANT '`t, I £Gf1NTACT1,006j1;447 ill ' ° _. �. .rig; �;,-;.< A ,� _,�"" UII<.IiING PE1tM1T`FEE � 170 -,.,5 .° ,,- _ :-.Y,.--:. >„�" ' h 9=kir lease ej k u1e Business name:Same l , Structural plan review fee(or deposit): Contact name: FLS plan review fee(if applicable): Address: Total fees due upon application: City/State/ZIP: Amount received: Phone:( ) Fax: :( ) : I"`r':t5;,>.:� .��:va�,E'^.'3s"�F°�'xii-�'-' �I% •^��l s3Y4��_>.�.' ,',�i PIILrI'iNdr AIc sU1.AR P I) S1 rW i E-mail:maggie.gordon@polygonhomes.com k,. 4 _W <NAVS'Ssrt•a ,t.,.:._:,.,,,..,,:...,_c §,,,;,,,• ;, tt ,•„mow,, ,;i:; Commercial and residential prescriptive installation of C , Y CONI CTOR ti :„ m a i j ;r -,4346-,-„ati-,4-1,,, _ x,, t; ,.. fit , _ „ig,„, ,,,INt..4041? roof-top mounted Photovoltaic Solar Panel System. Business name: �4 ?t. 2 Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 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.:204238 Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Date: *Fee methodology set by"Tri-County Building Industry Service Board. L\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Electrical Permit Application FOR OFFICE USE ONLY City of Tigard Received / M�� 7� g i Per nm No i III 13125 S\\ Hall Blvd..Tigard.OR 97223 'tan Review eview Plan R Phone 503.718.2439 Pax: 5(13.5911 196)1 )atony,. Atha Pei nut: 116 A R I) Inspection Line. 503.639.41 75 Date Ready/1)y: tuns 0 See Targe 2 for Internee www,tlgard-or goy Not lied/Method: Supplemental Information TYPE•'OF WORK . PLAN :REVIEW ®ISIew constructionPlease check all that apply(submit 2 sets of phots w/itent.s checked below) 0 Addition/alteration/replacement 0 Sen ice of (eedei 400 amps or mole ❑'bidding mei t Nice snnles 0 Demolition 0 Other: ,'hcnc the available fault current 0 Marinas and huatvmds CATEGORY OF CONSTRUCTION ., eseeeds 10.000:amps at 150 volts In 0 Fat 1,111hliii s • less to g,uuud,ut escceds 14-(1(10 ❑Cununeicirl-use:igneulnual ® I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps list all other installation.; buildings ❑ Multi-family ❑ Master builder ❑Other: ❑Jut:pump 0 Installation of 75 KV,\it .." . 'O' •, t . ❑F.nlct gcncy 5)stein bilge,separel,'dcn,cd system •- • •. •-'-J,OB.SITE,IINFORMATI'ON•AND LOCATION ' - . .- .. t 0 Addition of new motel load of ❑"t\'• "I?.. "I '.. "I 3.. Job no.: lob site address:ISM I SW Danube Dr 100111'or mote. occupancy ❑SIN 01 mole residential un11s 0 Recle;tnunal,Chicle parks City/State/ZIP: Tigard.OR ❑!health-care facilities 0 Supply,oltage IM mule than ❑I tivaiduus locations 600 silts nominal p ProjectService 600 amps tit 111010 Suite/bldg./a t. no.: name: 0•ervice or iccd . FEE -SC . HF.DIILE` Cross street/directions to job site: Description I tp,. I rce. I renal • New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: I,01 no.: 1.11110 sq.ft.or less ICS 54 4 Na.add'!500 sq.ft or portion I 33 02 I Tax map/parcel no.: limited energy.tesidennal 75 Oh) . , ._ - ,„ RI DESCRIPTION`OF WORK ' . - (with above sq n) — Limited energy,multi-family New electrical service and wiring residential(with above sq ft) 75 On Services or feeders installation,alteration,anti/or relocation 200 amps or less (—Ion 711 .'❑'PROPERTY OWNER ' _ . 0 TENANT • 201 amps to 400 amps 133 56 , 401 amp,to 600 amps 2O0 34 I ) Natne: 601 amps to4000 _ _ amps 301 04 , Address: Over 1.000 amps or volts iii 26 F2 City/Stale/ZAP: Temporary services or feeders installation.alteration,and/or relocation Phone:( ) Fax:( ) 200 amps or less 1 59 30 rI 201 amps to 400 amps I PI 25 03 Owner installation: This installation is being made on property that I own which is not — intended for sale, lease. rent,or exchange. according to ORS 447.449, 670.and 701. 401 snips to 599 amps I-,68 54 1— Branch circuits–new,alteration,or extension,Ler panel Owner signature: — ---- I)ate: A Fee for branch circuits myth --❑°APPLICANT• aho\'e service or feeder Ice. 0CONTACT PERSON 742 ii • each branch circuit _ Business name: 13 Pee fur branch circuits iruhr,u/ service Of(Cede, lee.lust 56 13 ' Contact name: branch circuit Fitch add•I branch circuit I 7 42 2 Address: Nlisccllancous(service or feeder not included) City/Stale/LII': Each manufactured or modular 67 84 dwelling,service and/or feeder— _ 'hone:( ) Pax: :( ) Reconnect on1) 67 84 ' F.-mail: Pump or Irrigation circle 67 54 I i Sign or outline lighting 67 s=l I I 2 coNTRACTOR • Signal circuit(s)or limited-cnerg) i Business name: Simply Electric panel,al(erauon,01 e\tension I Page 2 --- Each additional inspection over allowable in any of the abuse Address: PO Box 822408 Addition:it Inspection I I lir nun) 66 25/hi City/State/LIP: Vancouver,WA.98682 Investigation(1 hr min) 66 25/hr Industrial plant(I hr nun) 75 I5/hr Phone:(503)849-8202 I'ax: (360)314-4945 Inspections for,which no lee Is I io��/140I 90OWhr 1`1. specilicalh'listed(Y:hr min) I3I. CCie.: 204615 �S Electrical Lie.: fVII Suprv. l"ie.: 4394S "' -ELECTRICAL PERMIT FEES A r Subtotal Suprv. Electrician signature, required: / afar, •(S�_ Plan review(25%of permit Ice) Print name: Victor Lar•zhitsky Date: I 117/2015 State surcharge(I 2%of permit fee) Authorized signature: 'I.OT/\l..PE RN-Il'l'Fa. This permit application c\pires if a permit is 1101 obtained within ISO Print name: Date: after it has been accepted as complete. I)ale: • Number of inspections allowed pet pet uit IIauddrn_Nennnal?L('-I'cinntApp due 1)71(11/10 .WO.-t,(''li l thin/t'O\I/\vim 4.4 ,t `" i i �' !f" ' ��Mechanical Permit Application ,', '',-...,"1:01`OF: t- NI'(3NI; " _ ', i ': 'City of Tigard Rate/By: // 0�3 ' P.rin xa:: r ved .,zDate/By: /S r7 �l��o/S D1D 1, - � 13125"SW]ial!Bldd.,Tigard,OR 97223 Plan Review ` 9. 'Phone: 503,718.2439 Fax: 503398.196b ,Dal y.: Other Perini+:" "`= • Ins ction Line: 503.639.4175 :l i i.,/YR D Date Ready/By: runs. I ®See Page 2 for 5,• Internet www.tigard-or.gov Norihed,MeMod: Supplemental Information '-i'b-;v. -'"";2:;;;Z:,,:,,,;11.:. TYPE>OF,.::WORtC,: �-.�:' �w. ��`:; O1Vi:AEl2ClAt'7f'EE':°SCIiEtfLJi:E`'�x1JSE:Ci>�G7 —��.��w,_ �. .,, :..»w.� ' b � ��wr �a_r 'i���2� �`�-�`r� �,... � H, _. �T � Mechanical permit fees*are based on the value ofthe:work ®New construction 0 Addition/alteration/replacement performed.Indicate the valve(rounded to the nearest dollar)of all 0 Demolition 0 Other: mechanical materials.equipment.labor,overhead.and profit. .., . Value:$ „ tr - CTEGORYYOF.CO5IRUCTOA t FSID �' h1E i4T"I.sYSIE:+.iS;EEES''* ►.t I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information usecheckiisx ❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total `kp ,', _ Hearin coolin :. :A{;:,i " ., :grt4;t7$Sri f:i*FOR'►3ATIOh',AD.lOGAT[O$, " " R! g: -,.. .. .> _. Air canditiani»g 146"73 I{ Job site address:15]11 SW Danube Dr Furnace 100.000 BTU(ducts/vents) 1 46.75 I City/State/ZIP:Tigard,OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91 i Heat pump 61.06 Suite/bldg./apt.no.: ' Project name: Duct work 23.32 Cross'streetidirections to job site: Flydronic hot water system 23.32 _ Residential boiler(radiator or I hyvdranic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-dud,suspended.etc. 46.75 Flueivent for any of above 23.32 Subdivision: Lot no.: Other:: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 I "E; :: i, ;a „ ;.; , w '.DES �10 ', ; =r,"',; K�::'' Gas fire laceiinsert ��t��:-..,_::rte-- ;, ... ,,,.�'ya ,.,,.r,.C'R11'T„lti OB�1Y<3it1C_�"��.. ... ,..�.�;.';.--;;a41-1::''.1 = P 33.39 `' � Flue vent for water heater or gas. Complete Rough In fireplace 2332 Log lighter(gas) 2332 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 'UPERlT'A:Will' a 6nv23.32 �; 1Y ' .,'.;4''' ^i:.' i° ,� ICI. EIl31N;X';>`' �" s. _ ..rxr x ironmeotal exhaust and ventilation: Name:Polygon Northwest. Range hood/other kitchen Addressi-109 E 13th ST equipment 1 33.39 Clothes dryer exhaust 1 33.39 CityiState/ZIP:Vancouver,WA 98661 Single-duct exhaust(bathrooms, toilet compartments.utility moms) 4 23.32 Phone:(360)816-7800 Fax:( ) Attic/taawlspace fans 23.32 Or ,`c - P°',2 7.;;PP41. 111„!',/I ir gT;�I<:r-C. .4.� ' ... Other: 23.32 Business name:Polygon Northwest Fuel piping: S14.15 for first four:54.03 for each additional Contact name: Furnace,etc. I Address:109 E 13th St Gas heat pump Wall/suspended/unit heater City3State/ZIP:Vancouver,WA"98661 Water heater Phone:(360)816-7800 Fax::( ) Fireplace 1 Range 1 E-mail: , Barbecue ky °i K " I :Y:� ,w�i �C?N7;iA:044t„te,. ?i;.,-:�iYMS .__ Pky.F1ul :''_ai Clothes(hver (gas) Business name:Andersen Heating,Inc Address:16285 SW 85'"Ave Ste 410 ,. ICC $,-.E llf.:7„W1'ERM1T FEES '; ., `;'.:-''-:'.i,;I Subtotal City/State/ZIP:Tigard,OR 97224 Minimum permit fee($90.00) Phone:(503)992-6664 Fax:(503}rr;6-6615 Plan review(25%of permit fee) State surcharge(12%of permit fee) CCB lic.:168214 e/ fib TOTAL PERMIT FEE Tho permit application ibpiasbn aacpecermptedit isasn,ocot mobpaitned within ISO Authorized signature: .._. • Fee methodology set by Tri-County Building Industry mice Board,----- Print name:Art Andersen Date:11/20/2015 I:lnuildinglPermiu: .CPermit 04a713 doe 4eo..ia17r i 1 lia2Coi.ewEa) • FJC17/1VEP • Plumbing Permit Application IOR of rl(: 1.SF :o1L1- • Building Fixtures NOV 12 2015 Received '. _. ... PermitNofVST �J 'CJo/� City.of Tigard Y� Datersr ■ 13125 SW Hall Blvd.,Tigard,OR 1)/Iit' 1A9ta)11y Plan Review Other permitNo.: Phone: 503.7182439 Fax: 503.598:1960 Dat/By: Oths it O.:page x for �( gQDate Read B . inspection Line: 503.639.4175 BUILDING DIV S O Ready/By: 67 See Page 2lororma6on til,i:Ft•D. Internet www.tigard-or.gov Notified/Method: �r4,r, • !. c f.4.-1/..'nInformation• 'fir y z:,•-' rtes. }.:�t�£. l„ r.�.bVi-•t, --y.-F!, µc,^•2'.:' -' / Jy> ,•t t'3'117i 't' >.n...3 -,-.-t. s ', f 5� •-' .*?. ,;?'.Vc„.* :o-4' r-• �, -°r-• rift-zee "% .. - .--4..' ✓.-vs -4',a.c% ` ',.;','''......i.,43.4"" ..,". �� ;� '�"�- c=`� -' ""�- �''� For special Information use checklist. ew construction ❑Demolition Description 1 Qty. 1 Ea. I Total ❑Addition/alteration/replacement 0 Other: New 2-2-family dwellings(includes 100 ft.for each utility connection) ��1'�� : "!, oda•' SFR(1)bath 312,70 .?,- . t'''•":a'�` 65•`'207-404,_'9}!- F> 1.a-r.'r Tp-- ,..•. ,l �14..i„ . :33, _, .€�;:.-."H a._.a_'. ,..•�N;�. _ r bath 437.78 «, SFR(2) , 1-and 2-fatuity dwelling 0 Commereialrutdustrial SFR(3)bath ' 500.32 .rjOrU t.5(... 0 Accessory building ❑Multi-family Each additional bath/kitchen 25.02 , ❑Master builder 0 Other: Fire sprinkler(___sq.ft) . Page 2 rep :l �rxe l.l ,0*1.1a .. �� ��-;c '; Building Permit Submittal Original Submittal Date: MA/�' Site Plans: # 3 Building Plans: # 2 Building Permit#: enter building permit# above. Workflow Routing: 0-'11-fanning neering ermit Coordinator - 'Building Workflow Sign-off: CSign-off for Planning(include notes from planning review) Route Application Documents: fl Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. %O.-Building: original permit application, site plans, building plans, engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: ,4�jiAAir, Date: ld/��� En6gineering Review -/ q Slope at building pad: !b Conditions "Met"prior to issuance of building permit ❑ Easements (encroachments) per engineering conditions of approval and plat Water Quality/Quantity Facility: �/ Assess Water Quality Fee in-lieu: CI Yes SCJ No Assess Water Quantity Fee in-lieu: ❑ Yes ,CJ No LIDA Facility on lot: ❑ Yes , No ='NOT Approved by Engineering: Date: Notes: MP i) Pv`T /Uor R44(.- / 7►IJ4 e-a•1.i77-va.. 3 Approved by Engineering: /4..,.- . Date: /0(2-,4 c 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 VApproved, NOT Released: ,/•4 ;_ d Da e: Notes: _ ejJ2 4 3 7 / Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: XSDC Revision Notice 3: Date Sent to Applicant: Fees Entered: Wash Co Trans Dev Tax: X Yes ❑ N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: X Yes ❑ N/A XOK to Issue Permit - / Approved by Permit Coordinator: 1 • Ge/G� Date: SIA 1 S 1•\Building\Fonns\BldgPennitRvw_RES_070915.docx Eivgple.4 it oBVit` i'''1cmillUlt l'..11 4l•.ONLI 111 City o Tigard SEP 2 0 2016 �Vio '/ t itis _- �i 13125 Ste'Hail Blvd. Tigard,OR 97223 /- t� Phone: 503.718,2439 Fax 5 flan Retie U3 3 .i1 1 T ® f i GAR D 1341913r Related Benoit 0: Inspection Line: 303.639.4175 11^ ��++ Reidy mar til Set-Page 2 far - Internet: w tiggtrd*or.gov ouiLD \17 fl V!S O ' Notified/Method: sulrgtementalInformation _ Pg' or- ' - - � - F1- New construction � r = _ • " �' ;���� . �� F^y 0 Addition/alteration replacement Plesseeheck all that apply(submit 2 ac s of pians W items cheeked): i J Demolition 0 Service or feeder 400 amps or mote l0 Building CVT throe ponies. Other: ulnae the available:fault cwrent a Marinas and boatyards. ati'.TE( R `:OF;COI'LST> ILC1'IO l_ _ exceeds 10,000 amps at 150 volts or 0 Floating buildings" et 1-and 2-family dwelling 0 Commercial/industrial D Accessory building less to ground,or exceeds 14;000 0 co-atmercisl-use agricultural El l iulti fart111y amps for ail other installations, buildings. Master builder 0 Other: 0 Fire pump• ®histnllatiott of ISO KVA or P- _ IO ITE:IitfieLIOI AND LO TIOit: '_ DEmergeney system, lager :separately derived Job 4: 3 Job site address 1 SW t.1 t 1( ' rJ ®1001 f an mofore,new motor load of system J I I iJ[. l/r tV IA4HP.or more: City/State/ZIP:ity/State/ZIP:Tigard,OR 93224 L7Six or Mere residential Traits, oaupancy. 0 Health-tare facilities ©Recreational vehicle parks. Suite./"bttig/apt.#: Project name: f > �p �? 't3Harardoss locations. 0 suptsty voltage for tnom than -jk'1 i ted ( �il u. ,..v JrD i ��' u j. ., Ice or feeder amps or more; 600 volts aomitxA Cross street/directions to job site: I WX. Description 1 gm Exch f Tow r. New residential single-or multi-family dwelling unit: Subdivision:Palejon a i, lu0/ 4,inl '_I Lot 4: ` Includes attached garage. Tex rnap/parcel#: 1,000 sq,11.or less I i 6L 54 4 r _ - -' J)ESCRW 1t.ON'OF W O - add'1500 ft or portion 3 I �• ul• H 3 .92 O (Icjik. el a a Limited:nemg<tr,residential (with above sq.a.) 75.00 2 Limited energy,multi-family 0,141. ,-,., ,.! ,., ,.: residential(with ?5.00 2 . 3'�I1t1P�ik�'Y_d1 '4r' <-' _''l ,,. .�-`Ta£l"e'� ( 'tfi above sq.#I.) Nave;AD:YL Land Holdings,.LLC Renewable Energy 0 See Page 2 Address:7600 E Doubletree Ratich Road Services or feeders installation,alteration,and/or relocation 200 amps or less 100.70 2 ' City/State/ZIP:Scottsdale,AZ 85258 Phone:(602)694-4031 Fax.( ) 201 amps to 400 amps 133.56 2 Email: 401 amps to 600 amps 200.34 2 Owner installation:This installation is being made on property that I own which is not 601 amps to 1,000 amps 301.04 2 intended for sale,lease,rent,or exchange,according.to ORS 447,449,670,and-70I. Over 1,000 amps or volts 552.26 . 2 Owner signature: ...,.. Date: :; i.,riP3'I.7... .. Temporar services or feeders installation,alteration,and/or i.`,_ - f c13h`7`ACI 1'E3#soN::'.-. : relocation Business name:William"Lyon Homes,Inc.. 200 amps.or less 59"35 1 Contact name:Angela Grajewski 201 amps to 400 snips 125.08 Address:109 East 13th Street 401 amps to 599 amps 158,54 2 City/State/ZIP:Vancouver,WA 9$550 Branch circuits-new.alteration,or extension,per panel Phone:(360)695-7700 I Fax::(360)693-4442 A,:.Fee for branch circuits with above service or feeder fee, 7.42 2 Email:Angela.Grajewski®polygonhomes.com each branch circuit r B: Fee for branch circuits without >LillNa',> li service or feeder fee,first Business name;alaeda electric branch Circuit 56.18 2 Address:3415 tie 44th Each add'/branch circuit. 7;42 2 //y ser Miscellaneous(service or feeder not-inchtded) City/State/ZIP;$ Jf . �/Z `�f Each manufactured 57.84 or modular. dwelling service and/or feeder : 2 Phone:(503).3192193 Fax:( ) - Reconnect cob. 67.84 Email:solarpdx@tne.com Pump or irrigation circle 57,84 ' -- CCB Lie.: 199188 Electrical Lie,: c923 Suprv,Lie.: 'y ir7/j . 2 Signor outline lighting 57.84 . Suprv.Electrician signature,requires/: Signal circuit(s)or limited-cner ' Print name: 1 j f./ZJ tee pane,alteration,or extension Page 2. �G v Date: i Each additional inspection over alloWabie in aratiltof the abiiii Authorized si attire: Additional inspection(1 hr min) ' S6 25r hr .- g-1 Print name: / ^- e C;:,� Date 2 InvCsugatiori(l hrmin) 9fi3Op,lir t. taitgin'•mtiLkIEt,C_pmni .ELR£R ,doe Ravi:10741015 40-46131•i11WCCi?+£•'W.E . ..... Mechanical Permit AppliefliEnCEIVED Et/R tif-Ilt V I 's f 0\I N City of Tigard71 o4;11.%14,.. i 312$SW Hell Blvd,Tird , .....,- 1ra ,OR 97 22Q E P 2 0 2016 Plan Rectal& p 7 ' \ Phone: 503-71131439 Fax: $03.59/31 . Other Penna. tiamits 1 1(,,,it I) Inspection ez 501639.4175 CITY OF TIGAFiD Dalt i'3, Itlfk. SI See Pagel tor Internet: www.tigard-orgov a'14 Med Supplemental Information BUILDING flIvISION' L-Nus''w I i •Typt of %,,ottk. , COMMERCIAL FEE* SCHEDULE- USE CHECKLIST Mechanical permit fees*are based on the value of the oort. ... New construction 0 Addition/alteration/replacement peribmsed,Indicate the value(rounded to the nearest-dollar)O1&1 0 Demolition 0 Other ' mechanical materials.equipment.labor,overhead.and profit. Vaitm:$ CATEGORY OF CONSTRUCTION . - RESIDENTLAL EQ1.4PMENT/SISTEMS FEES' El I-and 2-family duelling 0 Commercial/industrial 0 Accessory building For special informutir mar civet:Alia 4 Muiti-latnity 0 Master builder 0 Other: i)escr Toon Rq Qt,, I (is. Tend 1 lleatingv,4143. JOB SITE INFORMATION AND LOCATION itoolingi 1 - ,1 n., Air ZOnditiMarig 4,07f:.0.1. I 46.75 Job site address: /S-7/ ' ' sw 061,niii9e vv . Furnace1941,0001371*(ducialvents) 1 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 10(1_000+137U iditashmust 54.91 Suiteibidgiapt.no.: Project name:Polygon at Bull Mountain Heat pump thief work 61,96 23.32 Cross street/directions to Joh site: Bydronk hot water system 2332_, Residentkd boiler(radiator or hydronic) 23 32 Unit heaters truel-type.not electric), in-waft,in-dam suspended.etc. , 46.75. Fe/vent for rint-of above % 23.32 Other: 23.32 Subdivision.Polygon at Bull Mountain Lot no,: q oth.,fad*polio neex Ian Imp/parcel no.: Water Matter 23.32 1 - DESCRIPTION OF'WORK Gas literRaedinsert 3339 Flue vent for water hewer or gas C 0 ntraCiThr Changt firt*Plav'e , 2332 Acid Lo'!Miner eas) 23,32 • , Woodipellet stove 33.39, I Wood fireplasetinsen 23.32 1 — Chiranevilinertflueivent ' 23_32 Other 2332 C.(•PROPERTY OWNER : a TENANT Environmental exhaust and ventilation: Name;Polygon WEB,LLC Ramie hood'other kitchen L. . _ 1 equipment I 33.39 AtItiress 109 East 13 Street 1 Clothes dryer exhaust I 33 39_ City/State/Z1P:Vancouver,WA 911660 Single-duct exhaust(bathrooms, toilet cortmannients.utility rooms) L-I 23 32 Phone:(360)695-7700 Fax:( 3 Altiecnialspace fans 2332 ---1 i:= APPLICANT El CONTACT PERSON Other 23 32 Fuel piping: Business name:Polygon WLII,EEC 91435 tor first faun$4.93 for each aidditintiak_ Contact name:Angela Grajewski Furnace.etc. ) I Address:109 East 13th Street Oas hem pump Wailisuspendediunit inater —...._ City/State/ZIP:Vancouver,WA 95660 , WaLT heater Phone:(360)6954700 Fax::1360)6134442 , bare Range P-mail;Angebt,Grajewskiiilolygonhomeccom Barbecue CONTRACTOR Clothes dryer(cosi . Other: 17 13usiness nave:Apex Air LLC - MECEL4NIC41,PERMIT FEES* Address:15004 XE 72'4 Ave Subtotal City/Stale:ZIP;Vancouver,WA 98656 Minimum permit fee(590,001 Plan review(259i of permit fee) Phone;(36013424199 Fax:1360)326-1769 State surcharge(12.%of penult fee) - _ CUB lie.:203034 1 TOTAL PERMIT FEE 1 - This permit application expires if*permit is not obtained n ithin 1310 days otter it has been*mewed as entoplete. Authorized signature: * Feetnelhodelou set*Tri-County Ruiltima Industry Service BMPII ...... ---- [Print nunte1- : 4" / Date: 4,/././4,.. r li.4.5d1,5 Pru•-11-alf 17_Pc,^tnitApp r401 CI(km 44046 il 1=:i'. City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15111 SW DANUBE DR, TIGARD, OR, 97224 August 10, 2018 at 1 :28:58 PM Record Type: Record ID: Residential - Master Permit MST2015-00186 Inspection Type: Inspector: 699 Mechanical final David Young Result: FA I L Comments: Seal line set penetration at foundation vent. Gas fireplace not working. No power to master bath fan. Not ready for final inspection. R109.3 Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15111 SW DANUBE DR, TIGARD, OR, 97224 August 10, 2018 at 1 :32:49 PM Record Type: Record ID: Residential - Master Permit MST2015-00186 Inspection Type: Inspector: 399 Plumbing final David Young Result: FA I L Comments: Secure and seal back of laundry tray to countertop. Provide permit and approved inspection for landscape irrigation Backflow devise. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15111 SW DANUBE DR, TIGARD, OR, 97224 August 10, 2018 at 1 :27:49 PM Record Type: Record ID: Residential - Master Permit MST2015-00186 Inspection Type: Inspector: 199 Electrical final David Young Result: FA I L Comments: Provide breaker lock for dishwasher. No power to master bath fan. Provide missing outlet covers in master. Secure loose outlet at den by entry. Not ready for final inspection. R109.3 Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15111 SW DANUBE DR, TIGARD, OR, 97224 August 14, 2018 at 10:26:13 AM Record Type: Record ID: Residential - Master Permit MST2015-00186 Inspection Type: Inspector: 199 Electrical final David Young Result: FA I L Comments: Correction for securing loose outlet in den as noted on previously failed inspection dated 8/10/18 not done. Outlet boxes in brick wall setback more than 1/4" per nec 314.20. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15111 SW DANUBE DR, TIGARD, OR, 97224 August 14, 2018 at 9:43:47 AM Record Type: Record ID: Residential - Master Permit MST2015-00186 Inspection Type: Inspector: 399 Plumbing final David Young Result: FA I L Comments: Provide permit and approved inspection for landscape irrigation Backflow devise installed without permit as noted on previous failed inspection. (1 ) Investigative fee for re inspection applied for plumbing correction not complete as noted on previous failed inspection and work done without permit. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15111 SW DANUBE DR, TIGARD, OR, 97224 August 14, 2018 at 9:43:47 AM Record Type: Record ID: Residential - Master Permit MST2015-00186 Inspection Type: Inspector: 399 Plumbing final David Young Result: FA I L Comments: Provide permit and approved inspection for landscape irrigation Backflow devise installed without permit as noted on previous failed inspection. (1 ) Investigative fee for re inspection applied for plumbing correction not complete as noted on previous failed inspection and work done without permit. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15111 SW DANUBE DR, TIGARD, OR, 97224 August 14, 2018 at 10:05:44 AM Record Type: Record ID: Residential - Master Permit MST2015-00186 Inspection Type: Inspector: 699 Mechanical final David Young Result: FA I L Comments: Correction for sealing line set penetration at foundation vent not done as noted on previous failed inspection dated 8/10/18. Gap at right side. R408.2 Provide locking tamper resistant access port caps at ac. M1411 .6 Fireplace not working as noted on previous failed inspection dated 8/10/18. Investigative fee applied for scheduling inspections prior to corrections being complete and ready for inspection. R109.3 Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15111 SW DANUBE DR, TIGARD, OR, 97224 August 23, 2018 at 10:33:25 AM Record Type: Record ID: Residential - Master Permit MST2015-00186 Inspection Type: Inspector: 399 Plumbing final Aaron Cillo-Gobel Result: PASS Comments: Permit for landscape irrigation issued. Inspection to follow. Note: permanent cap for sewer to removed sales trailer verified All other plumbing appears ok. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15111 SW DANUBE DR, TIGARD, OR, 97224 August 27, 2018 at 12:38:16 PM Record Type: Record ID: Residential - Master Permit MST2015-00186 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS Comments: Correction complete. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15111 SW DANUBE DR, TIGARD, OR, 97224 August 29, 2018 at 2:15:24 PM Record Type: Record ID: Residential - Master Permit MST2015-00186 Inspection Type: Inspector: 299 Final inspection David Young Result: PASS - CofO Comments: Final erosion control approved. Street trees installed per BUP requirements. Moisture content form received. Moisture barrier form received. High efficiency lighting form received. Blower door test report checked. Insulation certification checked. C of 0 left on kitchen counter. Note: contractor to switch tempered window from laundry to upper level main bath prior to occupancy. Violation Summary: Inspector Contractor