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Permit
i-0.'+o gF CS,:rN, t ' f; ,� CITY OF TIGARD /2 ze 46 4z•, MASTER PERMIT 111 . _ COMMUNITY DEVELOPMENT Permit#: MST2015-00315 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/27/2016 Parcel: 2S1060002900 Jurisdiction: TIGARD Site address: 13712 SW 172ND AVE Subdivision: RIVER TERRACE NORTHWEST Lot: 1 Project: Polygon at West River Terrace, Lot 52 Project Description: New SF. Model home. 12/20/2016: REPRINT to add NC. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 809 sf Basement: 0 sf Left: 2 Parking Spaces: 0 Height: 27 Bathrooms: 3 Second: 1049 sf Garage: 437 sf Front: 12 Smoke DwellingUnits: 1 Detectors: Yes Third: 0 sf Right: 3 Total: 1858 sf Value: $230,900.36 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 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: 4 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: 3 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All 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 1858 Owner: Contractor: ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions) 7600 EAST DOUBLETREE RANCH 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175 RD,STE VANCOUVER,WA 98660 2 Geo-Tech report needed SCOTTSDALE,AZ 85258 before footing inspection PHONE: PHONE: 360-695-7700 FAX: Total Fees: $31,221.90 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••R 9_amy 0190. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: IT/Kir i ''` Permittee Signature: / ��/(P7 /7Cf✓ 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. (aawr ►t)7tlsrc►t gT Vta�k6i I S:IOvo in -��-„_j . 'N°P V 141' paogaaums. "Wise -Pi L 434 'i :dt t y VOW"irpitda»+t ung1A 'step ort veli!s i'i i =16 y takOliva, v t,IT89C_ U JdW'1d Taal C It :czta s 9 ff09) frock 055 t1mwa s naoiw t PZZh6ig'p4i' was - 00.-,S`4 ed.S d anti' ?H, •, r • . .P _ tartdiut4 ( ):alta OUSE:9i8 460 t?!14RWC ... _ •- L99liG•Yrlt`pdYOate . • • - r1 �,, - m Suo011,11,1cJoicows um,.WO Jot sm.", y '?neoamp=gj wow? - s lis mitt Ot'**tglii MU F> .p CdasS'L�,lt11 ZSEZ• tsigYvtitkitArt gig ioi q i J __fs ... - .. 5,1:91, • '033°PPPwaara: zx: '°1 :YSga»pidit6rt Welifttift .ta ... . UTZ (l Pit ,�- ��� ''sZ. / meR7? t»x ZEEZ cetera t PA P1000: H '� i M Q asao13*!1 , Ma. fra ` - ` ki'akp lP : - r 90'[9 + ��(� i� I,zolfothajp. $esr l t )(ua0gqo,,a�,,,g�,,o,,c,,,,�,,,� � a�:awc •!s [ w �eErr !! •g Op, Its .-.;:-::- .._.,...•, ,.....:. e_»: -'3 _._._ ..a..... -- `. .. _ tot •• P,,oi I lea j AO I gowl a :,bio.0. Pi?n4 MtgA❑ A Fti.kPtizt4b 0 $ V� lU> )0 ny+ipt rzp -t® _, il�t��l. caro{ a r•., �t ?.un. g¢rifa;.,:ca.+d a:_ ? ,=-,--•-•_,,,,-,-,—,-----,-:,---7-...` SIit,o‘ ,... - Ztaadpuff ti lazinsgithRsu!htmlu9tvr 'Y S ❑ n rd( op>s»?t wwa)aalasa P? J . Igiu9Ptppv❑ t tt la nons;a no.'p 90: ru Y4 • ..,a..y..?9.t 4 I,kms`..f.` ,l]sn_1._..gaF-.••,,f.01 hd w:K � aA -._ -,,,,,-...--,,,,,,,-,0:.t.•-.-, t_ 3f /�_•'_,i ,..._3__a�"4 t . . ?AiJWRI4tddaS _ PI t' darS 0 snnF Aiikiw$ SLIP ... W! C' ‘) ./lC , ()S ita riti'S -EOS 9d ds+�E)' • 4 qtr Sia'-t•Sits u�act ,,. 4.1,4.1,..0-C-1 1.111_10 710:1 IIO 3! ddyIla ttj • 51S7 00- &/9r ! / . CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2015-00315 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/27/2016 Parcel: 2S1060002900 Jurisdiction: TIGARD Site address: 13712 SW 172ND AVE Subdivision: RIVER TERRACE NORTHWEST Lot: 1 Project: Polygon at West River Terrace, Lot 52 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 809 sf Basement: 0 sf Left: 2 Parking Spaces: 0 Height: 27 Bathrooms: 3 Second: 1049 sf Garage: 437 sf Front: 12 Smoke Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes Total: 1858 sf Value: $230,900.36 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Bckflw Prevntr: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 4 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 Tema SrvclFeeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 3 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All 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 1858 Owner: Contractor: ADLV LAND HOLDINGS LLC POLYGON AT WEST RIVER TERRACE Required Items and Reports(Conditions) 7600 EAST DOUBLETREE RANCH 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175 RD,STE VANCOUVER,WA 98660 2 Geo-Tech report needed SCOTTSDALE,AZ 85258 before footing inspection PHONE: PHONE: 360-695-7700 FAX Total Fees: $30,474.74 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 thr OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. AL Iding Permit Application " +enta Received City of Tigard �, , > j l Permit No.: i57 13125 SW Hall Blvd.,Tigard,OR 97223 3, 1 G� p anR vie�� Phone: 503.718.2439 Fax: 503.598.196 0 01 Date/By: �. �� Other Permit: , - Inspection Line: 503.639.4175 % 3ate Ready/By: Juris: H See Page 2 for Internet: www.tigard-or.gov sl�R ed/Method: A 1, Supplemental Information ®New construction ❑Demdition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the work indicated on this applic n. It ® 1-and 2-family dwelling ElCommercial/industrial : Valuation !_� _.$ ❑Accessory building ❑Multi-family Number of bedrooms: ❑Master builder ❑Other: Number of bathrooms: Total number of floors: 2 Job site address New dwelling area: ` - square feet City/State/ZIP:Sherwood,OR 97140 Garage/carport area: square feet Suite/bldg./apt.no.: Project name:Polygon at West River Ter Covered porch area: ' square feet L' Cross street/directions to job site: Deck area: square feet r' C Other structure area: square feet _4 Subdivision: Lot no.:52 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 work indicated on this application. New Single Family Detached Construction Valuation: $ Existing building area: square feet New building area: square feet Number of stories: Name:Polygon WLH,LLC Type of construction: Address:109 E 13`h Street Occupancy groups: City/State/ZIP:Vancouver,WA 98660 Existing: Phone:(360)695.7700 Fax:(360)693.4442 New: AMMAN Business name:Polygon WLH,LLC � h Structural plan review fee(or deposit) Contact name:Maggie Gordon FLS plan review fee(if applicable): Address:109E 13`h Street Total fees due upon application: City/State/ZIP:Vancouver,WA 98660 Phone:(360)695.7700 Fax::(360)693.4442 Amount received: E-mail:maggie.gordon@polygonhomes.com Commercial and residential prescriptive installation of roof-top mounted PhotoVoltaic Solar Panel System. isiness name:Polygon WLH,LLC Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon dress:109 E 13th Street Solar Installation Specialty Code checklist. /State/ZIP:Vancouver,WA 98660 Permit Fee(includes plan review $180.00 and administrative fees): (360)695.7700 Fax:(360)693.4442 State surcharge(12%of permit fee): $21.60 ic.:207247 7 1,0/17 Total fee due upon application: $201.60 ped signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. e:Maggie Gordon Date:12/11/15 *Fee methodology set by Tri-County Building Industry Service Board. ig\Permits\BUP-RESPermitApp.doc 02/24/2011 4404613T(11/02/COM/WEB) Electrical Permit Application FOR Of,FICE I SE ON LN ClRceci,•etl _ lr of Tigard � P Uate;n Permit tin 13125 SW I lall Blvd.,Tigard,OR 97223 ��y� � !Ian Rcvic,,, Phonc: 503.718.2439 Fax: 503.598.1 Rate/By: (Aber Pcrnur Inspection tine: 503.639.4175 1` Dae Ready/ v: 0 See P•rKe2 for Internet: w'ww.ligard-or.gov cot NotilicdlMcibod: Supplemental Informatiun ®Net+ construction ❑Addition/alteration/ Cel Please check all Thal apply(submit 2 set,of plans rclitems checked belo,c). ._ ❑Service or[ceder 400 amps or more El nodding oter three,aorie. ❑ Demolition ❑Other: �� where ills available(toll current ❑Marinas and buat)nrds - _ cscccds ID.000 am x rl I50 colts or ❑Floating boldines ,1 CAS©�i '13F FONST ;Ci Y1� I,: v•_i, x.<. ,e _ -xr..-,K�,c .._ _ -..... = - less In ground.or cscccds 141100 ❑Commercial-use agricnlutral ®TMI-and 2-1•amity dwelling ❑Commercial/industrial ❑Accessory building amps for all ollici inslallaiions hnildings i ❑Multi-family ❑ Master builder ❑Other lire pump nsta latinn of i i K VA o =R $ ; 7iPIWLP ❑I:nrcr fwncv syst�m trg�r sepatale r Erna - �n ..s'A .7X# _t _ •-.,z{`•`Y+$•"'-- ,- •i ;p++vT- bN -i r new motor load of _ I . I r .� ❑ I: I• ds,a• t ❑Addition of - 4Gb v� 100111,or more. va:ntpanc,= Joh no.:� �% 1 o dress: ❑ . ` � � Sts or num residential unit. ❑Recreational,chicle parks City/State/7_11': �� t-}'��'�� t`u' ❑1Icallh-care racililics ❑Supply—1tage lir nmic than O 1 \ ❑Ila ardous hxalions 600,alts nonunal Suite/bldg./apt.n0.: Project name: ]PO` ❑Service or feeder 000 vnp,or inure. Cross strect/dirccllons to Job Slie•: Desert tion Iv. tee. 'I'nul New residential single-or multi-famiiv dwelling unit. Includes attached garage. Subdivision: Lot no.: 1-000 sq 0.or less ( 16854 4 Iia.add'I 500 sq.fl.or portion 3392 1 Tax map/parcel no Limited encrey-residcntial (with above s .fl) J. - :3� iRX91 D() l_imitctl energy.multi-family 7500 > New electrical service and wiring residential(with above .it _ t Services or feeders installation,alteration,and/or relocation 200 amps or less 100.70 >- 4 ' sa r x ilu c5rt 1 301 amps to 40D amps 133.56 2 Namc: d l 401 amps to 600 amps 2(0.34 >_ k� 601 amps to1,000m I, 0 aps 301.04 2 Address: t v Q Over 1.000 amps or volts 552 26 2 c iVC 'I•cmporary services or feeders installation,alleratinn,and/or City/State/ZIP: relocation Phone: ry 2(w amps or less 59 36 ) 1 "1 Fax: �) 701 amps to 400 amps 125 U3 Owner installation:This installation is being made on property that 1 own which is not intended for sale,lease.rent,or exchange-,according to ORS 447,449,670,and 701. 401 Braampnch to uit amps 16x n, 2 Branch circuits-new,alteration,or eztcnsion,per panel Owner signature. Dalt:: A.Fee for branch circuits with F r n��(�(�{� above service or feeder fee. wr.s Y3�- D777at1°AT.R... i R .�+ik S4 h'�"¢� 7.2 > each branch circuit Business name: 13.Fee for branch circuit-;tritho r service or feeder fee.first 56 14 m 2 Contac)name: branch circuit Each•rdd•l branch circuit 742 2 Address Miscellaneous(service or feeder not included) city/State/7111: Qxl� � (� I::ach manufactured or modular 67%4 > VL dwelling,service and/or feeder Phone:( ) Pax: :( ) Reconnect only 6784 2 -777777 D. Pump or irrigation circle 6794 i 2 E-mail: Yl. r _ s.. ... .. Signal circuit(s)or limited G7%4 > Business name:Simply Electric panel.alteration.or extension Pa=ge 2 i - Each additional inspection over allowable in anv or the above Address: PO Boa 822408 Additional Inspection(I hr min) 66 251 hr j Investigation(I hr min) 66.25/hr -1 City/State/ZIP:Vancouver,WA.98682 Industrial plant(I hr min) 78 18/hr Phone:(503)849-8202 Fax:(360)314-4945 Inspections for which no fce is 90.00/hr specifically listed(9,fir min) CCB Lic.: 204615 Electrical Lic-: , 067 Suprv. Lic.: 4394S Y, •EL:ZCT81C 1 '.r. IT FEES Subtotal- 5upn Electrician signature,required: fG flan review(25%n of permit Ice). Print name: Victor Zarrhitsky Date: 11 17/2015 State surcharge(12%ofpermit 1ec). Authorized signature: TOTAL PERMITFIT. -this permit application expires if a permit is not obtained within 181l Jays after it has been accepted as complete_ Print name: Date: ).umber or inspections allm,,ed per permit t)astlat��rerna<ua.r-rr n,it,t�r dM orntno 44u_aniSTI I1,0=c•oadAVEll 1Vl Glial ical I'erma :A20ica#ion Dai 13125 SW 11a1f BIFd,Tward:iS�97223 r PIffiitev�csv" - 1'6e $03.718 2439 Fac Ltspuhun3 uec 303 639_.175 0 y Anal H se*.YaEeiui laounet �txwilge<d,or.$av �, - g - . inE6rraetwt: _. - 34iccbaeical Peimu fas arc bpi on.t}ie value of the - " I4ow.tiisttvction [�Addihonfaltcaiaion, >.,, > t� ind;���.{mnnacd to the aruestdH flar)of AM []3)cttivlihnn ❑Otb— mcr3iaoical m labor..ovwbcad.and praft ._ .. ... 4'x:.5. ®i= 2 Saintly d,.mtlia,9 []GogkmuviaUmuustn;I ❑Aesso;s bwldin For ' gspe�#orin,�crmtrl3ax uie c6ackt3st p a�lnTfi: tify []MaSW builder E Odor IXsQ;p6i Qty. I Es Tota! : 46.75 top Job life addtax Fentace'.1001M ,mu diliftrws 1 4633 oo: oo+-MU i"%Mko 54.91 3 61.16 bliig It Projeat,nsit► Q DUA%O mk 2332 Shtei/dit ons to job:Site fb"ba is hot wala Mtzm 2332 Re;tdeitiial baler(radiator or 1 J;L � �� `� k 2332 __._ _. t7rlit3►tstfti. not ttic iri=waIj:in ilii ruc 46.75. fbwvii A.Wrayof abaft 2332 ., .__ 2332 T �_ l�+sb6itieatex 2332 s 'lacclaisere 33.39 - �1nc�ffEn':N�bcrfie�x or gas 2332 Y8 2332 W - . 33.39 VPaol; assert. 23.32 vcu( 23:32 Odin 2332 'Eusfitisriispititl utiansi au0 mstlhedoa: "Name hiortitww Lao (otha3atcl t 1 33.39 rlrldirss ID9 E J3"'St tatbatt�t 1 :3339 ttyl3l 'Ki�atvevtr,W�1:98�b1 - Ttai . rolonis 4 23.32. Plv�oc' 7$BD Fxrc i } {rtes 2:33..'' _ Gkbtt1 1 2332 8nstneaz a P•ahp "N-ortkweet -- :SjX33 Jnr first tour,$4.03 Eor.tub'aeid�al Goiodacf _.F .sm i - lie _;'apt+eoai et fi'198661 (3�)816-78m -- 1 Amu= cover: 1u Amm Ta m-- ft Heridor,iac Othm A .167 -SW$P�flvc.S�bt did ra�-J_�I�LIPsT3gan{,l�bt:97u4 Pian renew cn%of. "Eet} Photic�503��31't�b64 Fay�3)536-b6id: :S�fc i12°h ofpi�titA�� Yc.i 1t+821i! TOTAL PMOW, EE_ °ean&rnVipaudis. Aufmiiiiiiii " am�itt►.s tie�a at ieomplet� '1'rieE :r�i'tAtriieren Date I1I�0t2U13 rlumbing Permit Application Building Fixtures • of Tigard Permit NO- City 13125 SW Hall Blvd.,'1"tgard,OR 972 q 7, EY= Review 503.7182439 Fax: 503.5 R+, OthcrPanDtNo-. Inspection Iane: 503.639.4175 a ' r :,fi • hKk 0 Set Page 2 for InUmint www-tigerd-or S v' k'•.,' d SpPPlrmenfal Information New mon ❑ int ,' For at irrformrdrott use checkthl Description Qty. Ea. Total ❑Additronfahs atitionfreplaeernent ❑Odra . New 1-2-family dwellings(includes 100 R for each utility mrinection) SFR(1)hath 31270 1-and 2-funny d—Uing ❑Cammgrciailmdustrial SFR(2)bath 437.78 SFR(3)bath 50D32 5�t3 ❑Accessory building ❑Multi-fmnily Each additional bathfkitchen 25.02 ❑Masfa builder ❑Othrr. Fire sprinkler C_sq.ft) Page 2 Site amities: Job site addiG55: Catch basin or arca drain 18.76 _ �" City/Stah-mp: � �� 0 t \ q�► � Fo>�l,leach o.l ne trench drain age 2 ' Footing drain(no.linear R:_� Page 2 S,tL-_Wdg.Japt.no_: Projed name: �� L Manuf ictmrd home utilities 50.03 Crass strecVduedions to job site: 1-� Manholes 18.76 7` �� Bain drain camector 18.76 Sanitary sewer(no.linear fL_) Page 2 Storm sewer(no.linear R:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: Lot no_- Fmtam or itrm: Tax mapfptuerd no.-. Backflow pmvcnt cr ( 3127 r2 Backwater valve f 12.51 Clod=washer i 25.02 Q Dishwasher 25.02 -bylVL.L MISDrini ing frwrdaitr 25.02 Ejectord—W 25.02 Expansion tank 12-51 Rause 0 l Fnutre/sewer cap 25.02 ' 1"t ' Floor drain/floor shWhub 25.02 Addrass' � Garbage disposal 25.02 City/SIateZIP: Hose bib 25.02 Photic~Nn. QFait( ) Ice makes 12-51 MENNIMMONINEMEM intcrccptodgraase fiv 25.02 Brtsitless ntunc Medical gas(value:S ) Page 2 Prima 1251 Guaiac nam Roof drain(cammercisl) 125 1 Ad*=y SiommirtQ mItmy 25.02 Cityst>sYt zw. b Solar units(potablo water) 6254 phonm l(��) 2 b Fax::( ) TnWshowedshower pan. ' 1251 E-maikW� J ma� - �� Urinal 25-02 Water closet 25.02 I'LL Water heats 37.52 Btisiitess risme Lei_ Water piping/DW V 5629 Arldt= other: 25.02 Cdy p; 0 Subtotal ae Pbo : ) i _ ax b3 F ( ) Minimum permit fee: 57250 CCB Lw Plumbing Lie. , Z Plan review (25%of pwuzit fee) State surcharge(12%of permit fee) Authorized signature TOTAL PERMU FEE Print rharrrC . - This Permit application expires if a permit is not obtained within Igo days r - Date: after it has hem accepted as complete *Fee mdhodology set by Tri-Comity Building Industry Service Bow& L'\au .doc tommq 44G 4616T(1QWXP M/M) . City of Tigard r COMMUNITY DEVELOPMENT DEPARTMENT ■ Building Permit Review — Residential Building Permit #: Site Address: 13-11 Z SW 1 TZ av c Project Name: PO tJ 9()l1 ()- V ei-f- 62i VM r T cty- Lot #: 2 (New dwe 'ng=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: NPW _�; v-y-L- Verify site address/suite# exists and active in permit system. River Terrace Neighborhood: Yes ❑ No Site Plan Elements: Three (3)copies of site plan E51!ating structures on site Site plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished Drawn to scale(standard architect or engineer scale) floor elevations C�North arrow /Utility locations (required for new,may apply for additions) Site address,project or subdivision name and lot number Ht:o ation of wells/septic systems 7Applicant information(name and phone number) /Erosion control(including drainage-way protection,silt fence /Lot dimensions and building setback dimensions design,location of catch basin,etc.) Lot area,building coverage area,percentage of coverage and Street names impervious area(applicable if R-7,R-12,R-25&R-40) Street tree size,type and location /Property corner elevations (2 foot contour lines if more than —sting trees to be retained with drip line,and tree 4 foot differentialprotection measures ._lean 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#: I V X,11- 000dq /Soning: LL -, r etbacks: Front' i Rear Side _ Street Side 8 Garage -7;0 Landscape Requirement: % Lot Coverage Maximum: Z1 V % Building Height: Maximum Height 9S Actual Height 2'7. 6 Visual Clearance /Easements Sensitive Lands: Yes ❑ No Type Urban Forestry Plan onditions "Met"prior to issuance of building permit '11— otes: Go Y1 da'by 0-) TMC4 Approved By Planning: 60 0C 'WLI Date: Z� �,? o Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved 1:\Building\Fonns\B1dgPennitRvw_RES_070915.docx Building Permit Submittal Original Submittal Date: Site Plans: # _ Building Plans: !I4I-,ntTbuilding Building Permit#: pern! Bove. Workflow Routing: nning PEngineeringA5ermit Coordinator ut ing Workflow Sign-off- Z; ign-off for Planning(include notes from planning review) Route Application Documents: engineering: (1) copy of permit application, (1) site plan, (1) building plan and on 'nal plan review routing form. P Building: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: Date: &3,1(;-- LIC-1 Engineering Review fir- 0 Slope at building pad: 1 ❑ Conditions "Met"prior to issuance of building permit ❑ Easements (encroachments)per engineering conditions of approval and plat ,�ETWater Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes ZNo Assess Water Quantity Fee in-lieu: ❑ Yes ET No LIDA Facility on lot: ❑ Yes J;;�"No ❑ NOT Approved by Engineering: Date: Notes: h4 C-D C-(_.. 1" &4— Approved by Engineering: A Kr,- LL)H 11f Date: Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: Revision Notice 3: Date Sent to Applicant: SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A Tigard Trans SDC: > Yes ❑ N/A Parks SDC: Yes ❑ N/A OK to Issue Permit Approved by Permit Coordinator: Date: �� 1:\Building\Forms\BldgPennitRvw_RES_070915.doex Mechanical Permit ApplicaliR i(16-. 0i 1 it I 1 N,1 s:CEIVED e.d. . . City of Tigard "" 1 3115 SW Ita11 Blvii.Tigard,OR 97223 E Phone: 503.718,2439 Fax: 503.591I1960 Inspection Line: 503.639,4175 Internet: www,tigard-or.gev S E P 2 2 2016 Rine::!evy o9'72 ,,A,).a KIMONO,msrulis. _003 is--- ,.„ CITY OF TIGARD D3:0°4:ficd:.:'d'Y'1,4xthod1.3' , "ht‘Pli" r*por.s**Zrtalift:firrtaittion BUILDING DIVISION .., : , .. , .„. .,.„ ..... ,, .,-, ,•,..,,,,.: r; :, ,,„:„"Ljz,,,.. ?AiLV: i ,„...,.., ,,....41...„, .,..,. :,:,,t1--;*-r-a!,4'! .:i7,11,7:W-S-!:-5f;7:i:'•?;:17;;;:ij'ill-4,7,--;::'::''''-'-',- 7::::''tL'''''''''',-'''' - -/ ------ Mee.hanical permit fees*are based on the value of the work 1. New construction 0 Addition/alteration/replacement perfoaneti.Indicate the value(rounded to the nearest dollar)of all titined. hanical materials,equipment,labor,oserhead,and profit 0 Demolition 0 Other Value:S .;.Arai-ii:tir: kii ,'ht,:,.., :t'.1('-'1:1';',;:.:h'.1..."%(:"'.i;g&(-(;,,l,":"(f";:(-:',,,,,-:,-( -- - ', -;.(,'vemeilinte,24, ., ''' !-4'''''''' '''''''4''' ''''''t''''' '''' °'' ' ' '.3.'''''' t Fo'rverisf&fir'Ise cherAfixt 0 1-and 2-family dwelling 0 Commerciallindustrial 0 Accessory building r4 Multi-family 0 Master builder„, _ ,, 0 Other: , tiDe:stirniPiwio'reolin nt: J,OW: I Ea. 1 Total '''' ' ''.°.'tl' ,-,-,Alk.:47, „ ,: ''",',t',t*('t,'.5:: ! t,""..k:',.;,e;,$; ''','OW-*Vv'''' Air conditioning 1 46.75 100 thl0 Brit Maass onto 46,75 Joh site address: ti sv\I 1-11, ivt Furnace 54,91 Furnace 100.000+BIC(ducts,voust CirdState'ZIP:Tigard,OR 97224 u , fleet pump 61.06 Suiteibldglapa no.: Prqieci name:IP1)1A1111A Ctt Wut- It- 'krr Duet work 23,32 Cross streetidiremions to job site: I Iv-Mimic bet fattier St'sktit 23.32 Residential boiler(radiator or , hydronie) 23 32 . Unit heatets(Mot-type,eel electric), rin-lue,wai'velnitni-dottleant'v5ut;Pendatm:414.tic i 2463:3725 . . ,-) Other Subdivisitm- o / A ,I 'eSt ga . Itt?...... I jn no..' (”' (Mier fuel appliances: 23.32 -, Fax map/parcel no,. Water beater 21,1,-. ,„ ,w,,-,i,,, ,,,l,,,,,-,,,, •-,,,,,,,,-,--, , - ,, -„. •:-.4 -.--- ',,,,-„,,A4,4,,,,«„;,,4--.. ,,,:;-:,,,,;44,,;,..,;,04, (41$fireplavviinscrt 33 39 Flue vent for water heater or gas &Da radie &MAIL fireplace 23.32 toe lighter(gas) 23,32 _ Wood(, Oct stove 33.39 Wood fireplace/insert 23.32 chimneyilliteriflueiv tilt 2332 .,,,,;, ,,.4.„._,.,...., ' ..-s„. ,,,,,,x.... .04,0„,•,...„,:..,...,.::: ()ther, 23,32 ;,:1'...i: ‘- %:771A- t((,4;".Mr'I'l:','143,-- '-,:,'•,'';-:'',''';'' Easlroa* amoral extrasat and ventilation: Name:Polygon WL11,EL(' Range hood/other kitchen _..........._ equipment 31.39 Address109 East Igk Street Clothes diver exhaust 33.39 ME Single-duct exhaust Ofothrootris. il Cm,tState/7.IP:Vancouver,%%' 98660 , mild compartments,unlit)rooms) I 2,:i 32 Phone.(360)695-7700 Fax:( ) Atticicruwispaee fans 23 32 . -'''f2444,r,s2i, '!';'-''2',:;:ii -1',:l,.:-.t,-n,,-„:V-'; Other. fe'1:1,;: ,12-1«.1, a „.„ , , 2.332 B '-' moor usiness name',Polygon WIll,LEE Fuel $14 1 kir first faun$4.91 fared additional Contact name;Angela Grairwski ' Furnace.etc. , 1 ' Address: 109 East 13th Street Gas heat pump heater City/State/ZIP:Vancouver WA 98660 Water heater Fireplace i Phone:(360)695-7700 Fax.::(360)693-4442 c • 13-mail:Angela-43 ritiewskin4tolygonhonits.torn , , ,, „ Barbecue 0(%1hesher dryer(gas) '3/t.sz---'-'*,'..,-,-,'---.,,gi-4,*''''3)..*Tr0V-Z4* i;':',...11 : .12•' '-',1,,,.-:e,,, ,,,,4.-:,,,,,,,, h;:k":,' .-', a.- "'' '''',A - Business name:Apex Air Lit; F'.3:7`,3*tt, ,i,si.t.,i ',--. i,',.."i *,''''-',-'4iAie.'•,,- ,- -•• , ..,,..s.3,-:;:,::„.••.--e..:.....; 33,fsabte 0.tai mom Address: 18004 NE 72-4 Ave City/State/ZIP:Vancouver,WA 98686 Mminturn permit fee($90.00) Plan review t25 of permit fee) Phone'(360)342-8109 Fax:(360)326-1769 ' State surcharge(12%of permit fee) CUB lie,:24)3034 TOTAL PERMIT FEE 'Ills permit application minima ilir permit is not obtained within tan days after ii has horn accepted as complete, Authorized signature; - - * Fee methodology set by Tri-Ccsinty Haddam Industry Service lloarti Print natner-777 / Date. 4.14.11, I livikblIgINVIIIII;NtEr_refffttkpri,Wi LI d-SW 440-4t4n(41SiZA;YAIWElii Electrical Permit ApplicatiRECEIVED FOR OFFICE USE ONLY City of Tigard Received IN i 13125 SW Hall Blvd.,Tigard,OR 97223S EP 2 2 2016 �te� ����� u L Phone: 503.7182Da 439 Fax: 503.598.1960 n Rem _ Rete/33 : Related Permit 11: TIGARD Inspection Line: 503.639.4175 CITY OFT ICARD ReadyDate/By: loris: ®See Page 2for Internet. www tigard or gov Notified/Method tai Information 'i 3 Xr x ©�ut ING CIALI 7IO"" n en n ormation ®New construction , ` "� _ _;.: �,.�__w::r., �;:._ . :. ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑Demolition Other: ❑Service or feeder 400 amps or more El Building over three stories. F where the available fault current , ....ig: '.atr"MrMa, _. 11tCt rf Y "t „: .", ,. 0 Marinas anduboatyards. . .� �;��„�'- exceeds 10,000 amps at 150 volts or El floating buildings. ®1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural ❑Multi-family ❑Master builder 0 Other: amps for al other installations. tangs. Y ,�, � w 0Firepump.a att�p�gfet�OKVAor ..„ . -,.. J t.$TF3« I 10.K. .#0: :i TU 1;(1CA'F0. _ -_. ,:r' 0 Emergency system. ❑larger } derived Job#: Job site address: 2 I'] \i 1 ��NIL 0 Addition of new motor load of system. J✓� L S V V f�� 10011P or more. ©SySt City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy. ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: Project name:Polygon at West River Ter ❑Hazardous locations. 0 Supply voltage for more than 0 Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: f Description I Qty. I Each I Total I •- New residential single-or multi-family dwelling unit. Subdivision:Polygon at West River Terrrace Lot#: S2 Includes attached garage. Tax map/parcel#: 1,000 sq.It or fess 168.54 68,54 4 ' � �" Ea add'l 500 sq.ft.or portion 33.92 1 . ._ r.W _ Limited en (�tU U energy,residential 75.00 `(JAY/1, (with above sq.ft) 2 Limited energy,multi-family 75.00 residential(with above sq.ft.) 2 ' M�$ 22EIUM f V VMI Tl lWIR: :`: Renn �Y ❑ ee P2 Servicesewable or fEeederseinstallation,alteraStion,and/ageor relocation Name:ADVL Land Holdings,LLC 200 amps or less 100.70 2 Address:7600 E Doubletree Ranch Road 201 amps to 400 amps 133.56 2 City/State/ZIP:Scottsdale,AZ 85258 401 amps to 600 amps 200_34 2 601 amps to 1,000 amps 301.04 2 Phone:(602)694-4031 Fax:( ) Over 1,000 amps or volts i 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 5936 1 . intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. • 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 „i ,-' .i tiLT`,hk'C:_' , t t`I" �r t IQ E�yONTAC'l:' );R5r01 Branch circuits—new,alteration or extension,per panel • .. �`" �_x'"' �-` A.Pee for branch circuits with Business name:William Lyon Homes,Inc. above service or feeder fee, each branch circuit 7.42 2 I Contact name:Angela Grajewski B.Fee for branch circuits without I Address:109 East 13th Street service or feeder fee,first 56.18 2 i branch circuit City/State/ZIP:Vancouver,WA 98660 Each add'l branch circuit 7.42 2 Phone:(360)695-7700Miscellaneous(service or feeder not included) Fax::(360)693-4442 Each manufactured or modular Email:Angela.Grajewslti@polygonhomes.com dwelling,service and/or feeder 67.84 2 s .. Reconnect only 67.84 2 "` s• ° -"4` `. ' _ . e. ', E . " - ..--, ? Pump or irrigation circle 67.84 2 Business name:Garner Electric Washington,LLC - Sign or outline lighting 67.84 2 Address:6101 NE St Johns Rd Signal circuits)or limited energy ❑ See Page 2 2 panel,alteration,or extension. g City/State/ZIP:Vancouver WA 98661 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 6625/hr Phone:(253)320-1657 Fax:( ) Investigation(I hrnsin) 90.00/hr Email:bdaniels@gweusa.com Industrial plant(1 hr min) • 78.18/hr Inspections for which no fee is CCB Lie.: C1158 Electrical Lie.: 208174 I Suprv.Lic.: 4496S specifically listed(%:hr nun) 90.00/hr --- �. 5 ` Suprv.Electrician signature,required: ,t 9 / iintgrigitt `�aii mss -_i,.4 Subtotal: Print name: Joan P Albert Date: 4/26/2016 0 Plan Review Required(25%of permit fee): ---------.._._`� State surcharge(12%of permit fee): Authorized signature: _ TOTAL PERMIT FEE: Print name: Bill DanielsThis permit application expires if s permttis not obtained within 180 Date: 4/26/2016 days after it has been accepted as complete. 1 * Number of inspections allowed per permit. -:1:VHuildingTera itv\Et.0 PermitApp_Et,R ERE.doe Rev 06/17/2015 440-4615TO 1/0S/COM/WEB Plumbing Permit Application , Building Fixtures telt 011 I( I ISI ()NI 1 City of Tigard ; { ./.-L,f, e a 7//p ai Permit No.ili 'OC�3/S evieW ,� n 13125 SW Hall Blvd.,Tigard,OR 97223 '`"L, !Sit Y • Phone: 503.7182439 Fax: 503.598.1960.:: Plan Date/By: Other Permit No.: � i r,t Inspection Line: 503.639.4175 Date Ready/By: kris. El See Page 2 for Internet: www.tigard-or.gov _ Notified/Method: Supplemental Information TYPE•OF WORK... ,. FEE,►.SC14EDULiEE. ®New construction 0 Demolition For special information use checklist Description .1 Qty. I Ea. I Total ❑Addition/alteration/replacement 0 Other. New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION' SFR(1)bath 312.70 ®1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 ❑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: /7,1 12_ 5U V i 72(k Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name:Polygon at West River Ter Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision:Polygon at West River Terrrace I Lot no.:5z Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 1 12.51 {)0/10.(.-11 Clothes washer 25.02 'r r fj/��`&I 7 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 El.PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Name:ADVL Land Holdings,LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:7600 E Doubletree Ranch Road Garbage disposal 25.02 City/State/ZIP:Scottsdale,AZ 85258 Hose bib 25.02 Phone:(602)694-4031 Fax:( ) Ice maker 12.51 ® APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name:William Lyon Homes,Inc Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:Angela Grajewski Roof drain(commercial) 12.51 Address:109 East 13th Street Sink/basin/lavatory 25.02 City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54 Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51 E-mail:An elaGra'ewski Urinal 25.02 g � @polygonhomes.com CONTRACTOR Water closet 25.02 Water heater 37.52 Business name:Malmedal Enterprises Inc. Water piping/DWV 56.29 Address:PO Box 207 Other: 25.02 City/State/ZIP:Banks,OR 97106 Subtotal Phone:(503)324-0759 Fax:(503-)324-0580 Minimum permit fee: $72.50 CCB Lic.:102535 Plumbing Lic.no.:34-276PB Plan review (25%of permit fee) G State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name:Carolina Malmedal Date:04/25/2016 I Thu 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. 1:1Building1PemitstPLMU•PermitApp.doe 10/01/09 440.4616T(10/02/COM/WEB) 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 13712 SW 172ND AVE, SHERWOOD, OR, 97140 Record Type: Residential - Master Permit Inspection Type: 699 Mechanical final Result: FA I L Comments: No access to AC unit for inspection. House being painted at this time. Violation Summary: Tel: 503.718.2439 Inspection Date: January 23, 2017 at 1:01:40 PM Record ID: MST2015-00315 Inspector: David Young Inspector Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 13712 SW 172ND AVE, SHERWOOD, OR, 97140 Record Type: Residential - Master Permit Inspection Type: 399 Plumbing final Result: FA I L Comments: Tel: 503.718.2439 Inspection Date: January 24, 2017 at 12:03:26 PM Record ID: MST2015-00315 Inspector: David Young Raise rain drain stand pipe above grade by side man door to keep debris out of storm piping. 714.1 Violation Summary: Inspector Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 13712 SW 172ND AVE, SHERWOOD, OR, 97140 Record Type: Residential - Master Permit Inspection Type: 699 Mechanical final Result: PASS Comments: Violation Summary: Inspector Tel: 503.718.2439 Inspection Date: January 24, 2017 at 12:08:19 PM Record ID: MST2015-00315 Inspector: David Young Contractor