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Permit CITY OF TIGARD ; ;, ¢A ` MASTER PERMIT COMMUNITY DEVELOPMENT 9 /6 /- ,.- Permit#: MST2015-00317 TIG ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/27/2016 Parcel: 2S1060003000 Jurisdiction: TIGARD Site address: 13849 SW 175TH AVE Subdivision: RIVER TERRACE NORTHWEST Lot: 1 Project: Polygon at West River Terrace, Lot 97 Project Description: New SF. Model home. REPRINTED 7/18/2016 to add 260 sf patio cover; 8/4/2016 to add 2nd water heater; 9/14/16 to add a/c;9/16/2016 to correct address from 13835 to 13849. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1248 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 28 Bathrooms: 3 Second: 1666 sf Garage: 464 sf Front: 12 Smoke Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes Total: 2914 sf Value: $357,572.61 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 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: 2 Water Lines: 100 Drains: 0 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 Tvoes Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Fum<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temo 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: 5 201-400 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 2914 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 A geotechnical report is SCOTTSDALE,AZ 85258 reequired before the footing PHONE: PHONE: 360-695-7700 FAX: Total Fees: $33,499.18 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 95 -I'1-0090. 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: LdA) ,424 770h✓ 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. �,R CITY OF TIGARD MASTER PERMIT . .,, COMMUNITY DEVELOPMENT „`' Permit#: MST2015-00317 /S//, Date Issued: 01/27/2016 T[GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S1060003000 Jurisdiction: TIGARD Site address: 13835 SW 175TH AVE Subdivision: RIVER TERRACE NORTHWEST Lot: 1 Project: Polygon at West River Terrace, Lot 97 Project Description: New SF. Model home.7/18/2016: REPRINT permit to add 260 sf patio cover. 8/4/2016: REPRINT permit to add 2nd water heater. 9/14/16, REPRINTED to add a/c. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1248 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 28 Bathrooms: 3 Second: 1666 sf Garage: 464 sf Front: 12 Smoke Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes Total: 2914 sf Value: $357,572.61 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 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: 2 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: 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: 5 201-400 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 2914 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 A geotechnical report is SCOTTSDALE,AZ 85258 reequired before the footing PHONE: PHONE: 360-695-7700 FAX: Total Fees: $33,499.18 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 calling 503,232.1987 or 1.800.332.2344./� Issued B _ ' Permittee Signature: dpi 4.lrt..� . 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. -Mechanical Permit Application FOR OFFICE USE ONLY C1 Of Tigard and !Eew ED �m m H Iy!: PermitNo.: i13125 SW Hall BlvdTigardOl � ' 11 111Phone: 503.718.2439 Fax: 503.59 ( Date/By: Other Permit: TI G A R D Inspection Line: 503.639.4175 , U G 2 2 2 016 Date Ready/By: Innis: H See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information 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 ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value $ . _ ._ 7%9). :-C*:,CO] LC _N_ -- � . � IDIIITA1. i1PMEPTlrtS F�S = ® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist ❑Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. 1 Total -r - F : 13t 1C JOB IXQ11=_ 1IID�1i ,t,Ti )Y Heating/cooling: Air conditioning1 46.75 46.75 Job site address: --5e;(--5e;(3-� 3�1 l Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: I Project name:Polygon at West River Ter Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 • Residential boiler(radiator or • hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision:Polygon at West River Terrrace I Lot no.: 9 i Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 z 44z £""F.SPF O (1EWRif.' :.; fireplace/insert 3339 Gas a/insert . - - Flue vent for water heater or gas Add AC fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 ® u>CB5I—,_.1. ..._. Other23.32 __a _..i ,!'-*PR_ .: -_ __ . _ .TNAIT. .. _ _ `_.__ Environmental exhaust and ventilation: Name:ADVL Land Holdings,LLC Range hood/other kitchen equipment 33.39 Address:7600 E Doubletree Ranch Road Clothes dryer exhaust 33.39 City/State/ZIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:(602)694-4031 Fax ( ) Attic/crawlspace fans 23.32 ,tre . Other: 23.32 ,-7,;:',.- -'1?". ...._ : . ... # Business name:William Lyon Homes,Inc. Fuel piping: $14.15 for first four;$4.03 for each additional Contact name:Angela Grajewski Furnace,etc. Address:109 East 13th Street Gas heat pump Wall/suspended/unit heater City/State/ZIP:Vancouver,WA 98660 Water heater Phone:(360)695-7700 I Fax::(360)693-4442 Fireplace Range E-mail:Angela.Grajewski@polygonhomes.com _ Barbecue M � �� t g" "�-..- -u�*A ` . Clothes dryer(gas) Business name:Apex Air LLC Other: Address:18004 NE 72'd Ave Subtotal City/State/ZIP:Vancouver,WA 98686 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(360)342-8109 I Fax:(360)326-1769 State surcharge(12%of permit fee) CCB lic.:203034 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 r days after it has been accepted as complete. Authorized signature: �/ 4/9174A,J ll i, * Fee methodology set by Tri-County Building Industry Service Board Print name:Angela Grajewski I Date:8/22/16 I I:\Building\Permits\MEC PermitApp_04o113.doc 440-4617T(11/02/C0M/WEB) ,� CITY OF TIGARD /r/k I MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2015-00317 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/27/2016 Parcel: 2S 1060003000 Site address: 13835 SW 175TH AVE Jurisdiction: TIGARD Subdivision: RIVER TERRACE NORTHWEST Lot: 1 Project: Polygon at West River Terrace, Lot 97 Project Description: New SF. Model home. 7/18/2016: REPRINT permit to add 260 sf patio cover. 8/4/2016: .REPRINT permit to add 2nd water heater. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1248 sf Basement: 0 sf Left 3 Parking Spaces: 0 Height: 28 Bathrooms: 3 Second: 1666 sf Garage: 464 sf Front 12 Dwelling Units: 1 Smoke Third: 0 sf Right: 3 Detectors: Yes Total: 2914 sf Value: $357,572.61 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 LaundryTrays: 0 Y 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: 2 Water Lines: 100 Drains: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1Catch Basins: 0 Hose Bib: 2 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add!500 sf: 5 201-400 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 G NEW p yrou p: Square Feet: SF VB R-3 2914 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 A geotechnical report is SCOTTSDALE,AZ 85258 required before the footing PHONE: PHONE: 360-695-7700 FAX: Total Fees: $33,401.82 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 95 - 01-0090. 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: ell—C.__ Permittee Signature: ox) e -/4°4((•"it 770V 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. INCITY OF TIGARD Fri ! 4,4„ MASTER PERMIT ii -- COMMUNITY DEVELOPMENTPermit#: MST2015-00317 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/27/2016 Parcel: 2S1060003000 Jurisdiction: TIGARD Site address: 13835 SW 175TH AVE Subdivision: RIVER TERRACE NORTHWEST Lot: 1 Project: Polygon at West River Terrace, Lot 97 Project Description: New SF. Model home. 7/18/2016: REPRINT permit to add 260 sf patio cover. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1248 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 28 Bathrooms: 3 Second: 1666 sf Garage: 464 sf Front: 12 Smoke Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes Total: 2914 sf Value: $357,572.61 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 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: N Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'l 500 sf: 5 201-400 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 2914 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 A geotechnical report is SCOTTSDALE,AZ 85258 reequired before the footing PHONE: PHONE: 360-695-7700 FAX: Total Fees: $33,314.80 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 throug ;4AR• .•41-0090. 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: / / -Gr' 4 Permittee Signature: 647/1176:,°4•/e.,. --2-7e7,\ ' 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. Y 4 U 1 j City of Tigard i II COMMUNITY DEVELOPMENT DEPARTMENT i T 1 G A K D Building Permit Review — Residential Building Permit #: in ST,2,0(5---00 3, 7 Site Address: / g3'S" ..3/0 )9S7i9V-e._ Project Name: ;jpt;�/ i r / 4L , 'ver T,7yce_Lot #: 975' (New c ng=subdivision name;Addition or Alteration=last name of owner) Planning Review 1 µ1-Qf1� )\ Proposal: /&4 ) 7 ; ( MoG�,,,Q,t erify site address/suite#exists and action permit system. UG River Terrace Neighborhood: IJd Yes ❑ No Sit/Plan Elements: Ng ree(3)copies of site plan sting structures on site ' e plan must he on 8-1/2"x 11"or 11 x 17"paper ootprint of new structure(including decks)with finished rawn to scale(standard architect or engineer scale) 9 br elevations rth arrow I,%_Uttlity locations(required for new,may apply for additions) address,project or subdivision name and lot number anon of wells/septic systems , plicant information(name and phone number) rosion control(including drainage-way protection,silt fence iel,dimensions and building setback dimensions d ign,location of catch basin,etc.) Lot area,building coverage area,percentage of coverage and eet names 'yipervious area(applicable if R-7,R-12,R-25&R-40) Street tree size,type and location roperty corner elevations(2 foot contour lines if more than p�isting trees to be retained with drip line,and tree 4 foot differential) protection measures 00 Clean Water Services–Service Provider LetteAlot platted prior to 9/10/1995): equired: ❑ Yes,applicant was notified No Received: E Yes ❑ No ir Public Facilitie Improvement (PFI) Permit: Required: Yes,applicant was notified ❑ No Applied For: Yes 0 No,stop intake and Use Case#: AbPO2O , _ q O , 5'Ll•B /S= GZX c7 oning•. k---9- (P , 1Vietbacks: Front Rear /$" Side 3 Street Side e Garage V andscape Requirement: ( of Coverage Maximum: Itit Building Height: Maximum Height ��/ Actual Height l I) 11 b► isual Clearance 'Easements nsitive Lands: ILQ Yes E No Type Lan ' 4'1 r 1,_,; s. 2 ..- Tr I(G Urban Forestry Plan ❑ Conditions"Met"prior to issuance of building permit Notes: ile6 67r. C /17/4c'/ .he /�2t7: Gi;' 'OA,11/7'. 1 &f-6t?/7GQ Approved By Planning: c:::: ` Date: iS2 �.3 1/4S-- Revisions Revisions(after Building Submittal only) Reviewer / L 1 Date 4-ton Revision 1: Approved ❑ Not Approved ' -t O�Z /L6, ell0 ete4.�... 7/1 I 1' Revision 2: Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved l:\Building\Forms\BldgPennitRvw_RES_0709I 5.docx Building Permit Submittal , Original Submittal Date: /,z./3(?/15-- Site Plans: # 3 Building Plans: # 3 Building Permit#: El—trier building permit#above. Workflow Routing: arming [ -iineering ermit Coordinatorto ding Workflow Sign-off: Sign-off for Planning(include notes from planning review) Route Application Documents: 13-"Engineering: (1) copy of permit application,(1) site plan, (1) building plan and original plan review routing form. Er Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: - e Date: 4,1/4i/1s-- Engineering Review r,; -Er Slope at building pad: 7j ❑ Conditions "Met"prior to issuance of building permit ❑ Easements (encroachments)per engineering conditions of approval and plat ./ti Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes No Assess Water Quantity Fee in-lieu: ❑ Yes .0' No LIDA Facility on lot: ❑ Yes ;'No ❑ NOT Approved by Engineering: Date: Notes: 4 Ob 1;' ... M 64K, Approved by Engineering: kit.)I4� kJH f7'ry Date: (ih.A.6 Revisions (after B ilding Submittal only) Rei' er.17 Date ,�� Revision 1: Approved I: Not Approved 7 Revision 2: 0 Approved ❑ Not Approved Revision 3: 0 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: FtPSDC Fees Entered: Wash Co Trans Dev Tax: jYes ❑ N/A Tigard Trans SDC: es ❑ N/A Parks SDC: $ Yes ❑ N/A I 'OK to Issue Permit � p ed by Permit Coordinator: Alam Date: /17/0 I\Building\Fonns\BldgPennitRvw_RES_070915.docx FOR OFFICE USE ONLY–SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Transmittal Letter etter T i G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Tom H. DAT EIVED.: DEPT: BUILDING DIVISION lUt1j2010 FROM: Angela Grajewski COMPANY: Polygon Northwest PHONE: 971-212-2144 RE: 03 g 35 S W —I gill Ave- H - /5--ac_23 / 7 (Site Address) (Permit Number) Q Polygon at West River Terrace -17 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: (Copies eseri la. r op es I escrip %n o Additional set(s) of plans. 3 Revisions: add roof over patio 0 Cross section(s) and details. 0 Wall bracing and/or lateral analysis. 0 Floor/roof framing. 0 Basement and retaining walls. 0 Beam calculations. 0 Engineer's calculations. 0 Other(explain): REMARKS: home owner selected optional covered patio a 0 O OF XEI 1 .... . % , 1 Routed to Permit Technician: Date: 7- 13 -.) 6 Initials: –ft' Fees Due: Yes ❑No Fee Description: Amount Due: 1 }-fir PI c-v, rev;C‘„ $ – 4 Special Instructions: Reprint Permit(per PE): jYes ❑ NoDone Applicant Notified: ,g/V6--7 C" Date: '7 ///Ic. Er/i9-1c. I nitials�` L\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2015-00317 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/27/2016 Parcel: 2S1060003000 Jurisdiction: TIGARD Site address: 13835 SW 175TH AVE Subdivision: RIVER TERRACE NORTHWEST Lot: 1 Project: Polygon at West River Terrace, Lot 97 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1248 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 28 Bathrooms: 3 Second: 1666 sf Garage: 464 sf Front: 12 Smoke Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes Total: 2914 sf Value: $351,769.41 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 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 0 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: 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: 5 201-400 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 2914 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 A geotechnical report is SCOTTSDALE,AZ 85258 reequired before the footing PHONE: PHONE: 360-695-7700 FAX: Total Fees: $33,032.06 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 t OAR 952-001-0090. 5522-00 0011-0 1.090.•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 �`"c-Lec�-9��J Permittee Signature: C-�-- 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 ' ;,7 3 US— FOR _.r_ ential City of Tigard Received �7 DateB }` j Permit No.: r S 17 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review. Phone: 503.718.2439 Fax: 503.59 9 t 4 x Date/B : Other Permit: / 1 e Inspection Line: 503.639.4175 » ° Date Ready/By: Juns: 0 See Page 2 for Internet: www.tigard-or.gov Notified/Method: 11"i j Supplemental Information r � J 4, ®New construction on Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement ❑` er: equipment,materials,labor,overhead,and the profit for the work indicated on this application ® 1-and 2-family dwelling ❑Commercial/industrial Valuation:3:- $ ❑Accessory building ❑Multi-family Number of bedrooms: ❑Master builder ❑Other: Number of bathrooms: 'm Total number of floors: 2 Job site address ve � Us New dwelling area: Z,q 1 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 Cross street/directions to job site: Deck area: square feet Other structure area: square feet Subdivision: Lot no.:97 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 stones: Name:Polygon WLH,LLC Type of construction: Address:109 E 13th Street Occupancy groups: City/State/ZIP:Vancouver,WA 98660 Existing: Phone:(360)695.7700 Fax:(360)693.4442 New: Business name:Polygon WLH,LLC Structural plan review fee(or deposit): Contact name:Maggie Gordon FLS plan review fee(if applicable): Address:109 E 13`h Street City/State/ZIP:Vancouver,WA 98660 Total fees due upon application: Phone:(360)695.7700 Fax::(360)693.4442 Amount received: E-mail:maggie.gordon@polygonhomes.com Commercial and residential prescriptive installation of WEEMAREM roof-top mounted PhotoVoltaic Solar Panel System. Business name:Polygon WLH,LLC Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:109 E 13`h Street Solar Installation Specialty Code checklist. City/State/ZIP:Vancouver,WA 98660 Permit Fee(includes plan review $180.00 and administrative fees): Phone:(360)695.7700 Fax:(360)693.4442 State surcharge(12%of permit fee): $21.60 CCB lic.:207247 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. PrinService Board. t name:Maggie Gordon Date:12/11/15 Fee methodology set by Tri-County Building Industry I:\Building\Pemtits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) electrical Permit Application City of Tigard 'g• i � Kcccircd o Uatc;n•: Permit No e� tt 13125 SW 1 fall Blvd., Tigard,OR 97223 � g � � !'tau Review f Phone: 503.718.2439 Pax: 503.598 T911i">„ ate." Date fly: (Aber Pcnun Inspection Line: 503,639.417> t«° 1\• Dale Ready/liy: Jwis 0 See I'aKc 2 Gtr Internet: www.tigard-or._L'oV r r. f'a Motificd:Mclhntl: Supplemental Information ,..,x.-rt�_�xr�-;c�'• {a-s .�, _�i' t ��". '�}It rki'. .t�` -s t <�dl�:�S�lEfi�_ ®lac\4'construction ❑Addition/alteratJOR/J'E:�7�L L'bl Please check alf that apply(submit 2 sets of plans w/items checked helnw) 55,, ❑Servicc or feeder 400 amps or more ❑n nklmy,•oter Ihrcc stories. ❑Demolition ❑Other: v,here lhe:nailahle fedi current ❑Marinasand Ixiat,ards exceeds 10.000 amps at 150 volts or ❑Floating buildings less to ground.or exceeds Moro ❑Coni mere ial-usc aeric dl ural ® I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building snips for a0 other installations hnildiogS i ❑Multi-family ❑Master builder ❑Other: ❑Fire piiml) ❑Installation of 75 K VA or k:4. i 'rr?r)< / r r - ❑Emergency system. larger sepataielr domed Neem A ? N t�r1 ❑Arkfition ohiew motor load of ❑'q.. ..1,... ..l ,.. . l_:'. 100111'or more. ucngiancy Job no.: lob site address: Recreational chicle ark ❑ Six or more rcsidnuial amts ❑ park, ' City/ te/Zllt: vv l O ❑I-lcahh-cnrc facilities ❑Supply voltage lir nnre Ihan v�- ❑Ila ardous Icealions 600,olts nonunal - )1c/hldg./apt.no.: Project name: VC` ❑Service or feeder 600 unit.or more z Cross street/directions to job site: neseriBonk 1 21v. - Fee. ental l� New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: Lot no.:(q�q_ 1.(xx)sq ft.or less 16854 4 Iia.add'I 500 sq.It or portion 3392 1 Tax map/parcel no Limited energy.residential _ s� .. r ,; with above sq.ft z � + a . sc�IPT<QV�ctc L ( Kl i t 7�00 � a . ._.. ._M�, d.. ., _.. .imitc energy.mutt-amily New electrical service and wiring residential(with above s ft) 7'On - i Services or feeders installation,alteration,and/or relocation 3� 200 amps or less 100.70 2 e x y."°"a..Al� � yl(Se+R f ->.J C ;.-"•r , -,;"j`)(', 201 amps to 400amps 133.i6 Name: 40 amps to 600 amps 2(x).34 _' 601 amps to I,O(H)amps +01-04 Address: ' b a 't ` Over 1.000 amps or volts 55226 _ q Temporary services or feeders installation.alteration,and/or Cit)/State/7_If': �� W relocation Phone: ) 200 amps or less 59 36 1 Ig a C7 Fax: U ) � 1 201 amps to 400 amps 1250M 2 Owner installation:This installation is being made on property that I oven which isnot intended for sale,lease.rent,or exchange.,according to ORS 447,449.670.and 701. 401 amps to 599 amps 1 168 54 2 Branch circuits—new,alteration,or extension,per panel Owncr signature: Date: A.Fee for branch circuit,with 7. shove Service or lecdcr lee. 742 2 each branch circuit Business name: li.Fee for branch cirQ1iLS Withnrd service or feeder Ice.first 56 19 2 Contact name: ! I ' branch circuit Each add'I branch circuit 1 742 2 Address: Miscellaneous(service or feeder not included) Cit;lStale/71P: Each manufactured or modular 67 84 _ IJU t VL dwelling.service and/or feeder Phone:( ) I ax::( ) Reconnect only 6784 2 �. Pump or irrigation circle 6794 ! _' F:-mai I: Sign or outline Iightine 67 84 _ Signal circuit(s)or limited-energy Rusinets name:Simply Electric panel.alteration.or extension Pag Each additional inspection over allowable in any of the above Address:PO Boa 822408 Additional Inslxwtion(I hr min) 66 25/hr j —1 City/State/71P:Vancouver,WA.98682 Investigation(I hr min) 66.25/hr Industrial plant(1 hr min) 78 18/hr Phone:(503)849-8202 Pax:(360)314-0945 Inspections for which no fee is 90.00/hr Specifically listed(%,hr min) CCB Lic.: 204615 Electrical Lic.: 067 Supri. Lic.: 43945 ELECT'R1G ;R1�R1177T' F;S' Subtotal- Supr'.Electrician signature,required: fG 1 Ilan rcvlc%%(25%oI permil Ice). Print name: Victor Aarzhitsky a Date: 11,1117/20115 State surcharge(12%of permit Tec). TOTAL PE•RMTT I T.1i. Authorized Signature: 'this permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Prim name: Datc: Number of ins{xcliom al{ovvcd I>cr pe'mit I tt:eddmePermiicUil.('-PermitApp dnc 07/01110 44rt-.thl 51'111- -COMAVEll {g�o��mtr):ttisrow gyp';i tmu-�s!+� 7 pd�ey: Yaud: SI4 fTi amte0ft tl Pmog S a1$a!PL�B d�Oi7Pi�4ps�� '. % �datassrs�9'A'flal�� .. aa ,tcu c : c s�z1ras- s f tuas$c �- ;n2pww ji aria co jaggq -- [9956'1'Adc 1 tVA. gill 1:111,Pill OAO ism E B 0. T3 i» ,o N.-0-"i P! at!s gocm suorpa? /rn�s �► ZEEZ aa'xgid aar.Ida/ f?[gPv°5 - 6—Tc yruzi+oonoot - ,: ?rLra, _ ours O � Pink d rnpp Q mPt?M? i'u 1 ,. a,.. Sil > Pax PAO' felaar'I¢�ruegn!►! '' ttg3at�ilaa ?1AmpQpu—),7q-2I► sPat I ; ��uaa�sTg1�!3i'APd 8 i srtgslafl�W�Id�S . . SLitr6£4£OS �ar °aq�dsuT Og&1w6 -£45 w33 b£DoZ8TL£0 9d tea4J_`'PAIfl IlaF7;MS�iI£T . v".: .^��-�.?�. '.,. t '-art u�ena. •:.S� �, ;�' - ;�.i8�iy�0!*t�r� sur zaa� tgaa Plwifibing Permit Application Building Fixtures , City of Tigard �J, �� d a^ Mew ! t, / 3,V 15-"' ;,f'13125 SW Hall Blvd,Tigard OR Phone: 503.7182439 Fax 503.598.1 t�thrr['C1I[ii[No.: Inspcc ion Line: 503.639.4175 ��\ /By. s..lc 1 0 See Page 2 for lirttrncr www.tigard or.gov ""Meffiod_ Suppleamotal Information OREM— Ncw mon ❑pemol 4.4' For Wdaf hifornudon use checklist Desai tion I Qty, I Ea- I Total ❑AdE ihm/altcrabonImplacernent ❑Other. New 1-2-family dwcifings(includes 100 ft.for each utility comtcction) SFR(1)bath 312.70 l-and 2-fiamily dwelling [ICornmerciaUndush-ial SFR(2)bath 437.78 ❑Acressory building [I Multi-family SFR(3)bath 50032 `jil t3 Each additional bathJkitchen 25.02 ❑Master btu7der ❑Other Fire sprinkler(._s4 R) Page 2 _ Site ,46b,sift address ^� t `�- Catch basin or area drain 18.76 City/Stat,&T.- rJ" V� C)q\_ 'f�`"1\J Footing 1,leach ling or trench drain age 2 Footing drain(no.linear ft:,) Page 2 SuitrJbldglapt na Project name: ( aL Manufartued borne utilities50.03 Cross street/directions to job site: JJ Manholes 18.76 1-3 ,.-- Rain drain connector 18.76 Sanitary sewer(m linter ft:_� Page 2 Sto m sewer(no.linear fL: ) Page 2 Wafer service(no.linear IL:,) Pager 2 Subdivisiow Fatatre or item: Tax runpipareed no.: Bacidiow preventcr ( 3127 .2 Backwater valve 12-51 2.5 Clothes washer ( 25.02 a ,p Disbwashcr 25.02 D'� Drinking fountain 25.02 Ejectorslsnrnp 25.02 Expansion tank 1251 Name �0 b-1 Fnmudsewercap 25.02 n `— Floor drain/17ocr sink/hub 25.02 Adt3ress: L -�1 T Garbage disposal 25.02 CityrStetefop: Hose bib 25.02 Phm—_ 0 Fax( ) Ice maker 1251 ">> dg-M 1-P 25-02 Btainess asauG Medical gas(vahre:S ) Page 2 Prima 1231 Contact nems Roof drain(comercist) 12-51 Address - .01 Sb*AR%hAXvatory 25.02 Citymewup. Solar units(potable watrs) 6254 Phone:(23) Fay:( ) Tub/shmedshower pan. 12-51 `Z i7 E-=& V _ �p,.� I Wat25.02 Water CL] war clams 25.02 Water beater 37.52 . WaterpipinglDW V 5629 Address: Other 25.02 Subtotal Phone ), ; „r l _ �� Fax( ) Miuimuim Permit fee ST25O CCB Lit: t Phunbing Lie. � 'Z Plan review (250/of permit fm) State surcharge(12%of pezarit fee) Audmwirai sigoatum TOTAL PERMTr FEE This permit application expires if a permit is not obtained within 180 days Print IlBTnC. ��,� Date after it has been accepted as complete -Fee unailodology set by Tri-Comity Bwldmg Industry Servicer Board L• .doer IMOI/o9 440 4616T(INOJJCONWIM) City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT ■ Building Permit Review — Residential Building Permit #: STS 15-- )o 3, 7 Site Address: Project Name: ;' v 4, Lot #: �- (New c ng= subdivision name;Addition or Alteration=last name of owner) Planning Review / Proposal: t,7 U�Ierify site addZighbo s/suite# e'-sts and action permit system. ljd River Terrace rhood: Ud Yes ❑ No Sit Ian Elements: ree (3)copies of site plan sting structures on site e plan must be on 8-1/2"x 11"or 11 x 17"paper gootprint of new structure(including decks)with finished P pP rawn to scale(standard architect or engineer scale) r elevations 7 rth arrow Utility locations(required for new,may apply for additions) address,project or subdivision name and lot number ation of wells/septic systems plicant information(name and phone number) rosion control(including drainage-way protection, silt fence �L dimensions and building setback dimensions d ign,location of catch basin,etc.) of area,building coverage area,percentage of coverage and V eet names ervious area(applicable if R-7,R-12,R-25&R-40) VStreet tree size,type and location LAI roperty corner elevations (2 foot contour lines if more thanisting trees to be retained with drip line,and tree 4 foot differentialprotection measures Clean Water Services—Service Provider Lette (lot platted prior to 9/10/1995): egtiired: 11 Yes,applicant was notified No Received: [I Yes ❑ No Public FacilitieImprovement (PFI) Permit: ilkyes,applicant was notified ❑ No Applied For: /- Yes ❑ No,stop intake Vioning: land Use Case#: Zetbacks: FrontRear Side Street Side Garage VX"andscape Requirement: C>et] of Coverage Maximum: — 7 % uilding Height: Maximum Height j Actual Height l� tisual Clearance Zasements Vr nsitive Lands: /Yes ❑ No Type qd Urban Forestry Plan ❑ Conditions "Met"prior to issuance of building permit Notes: :: i Approved By Planning: Date: Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved 1:\Building\Forms\B1dgPennitRvw_RES_070915.doex Building Permit Submittal Original Submittal Date: f dl y Site Plans: # Building Plans: # _ Building Permit#: E}' anter building pperm��it--#above. Workflow Routing: anning [4-17ngineering ermit Coordinator 0—Tru—Ming Workflow Sign-off: Lj Sign-off for Planning(include notes from planning review) Route Application Documents: C�'Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. Building: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: Date: Engineering Review -$Slope at building pad: ❑ Conditions "Met"prior to issuance of building permit ❑ Easements (encroachments)per engineering conditions of approval and plat Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes ,Efr No Assess Water Quantity Fee in-lieu: ❑ Yes ,Er No LIDA Facility on lot: ❑ Yes _;;- No ❑ NOT Approved by Engineering: Date: Notes: Wl 0-l".)tic_.. H 6✓1-t Fs__. Approved by Engineering: k J KK, kJN n-f- Date: /16 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 El N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: Yes ElN/A I�OK to Issue Permit Approved by Permit Coordinator: Date: 1:\BuildingTonns\B1dgPennitRvw_RES_070915.doex Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 13849 SW 175TH AVE, SHERWOOD, OR, 97140 Residential - Master Permit 299 Final inspection PASS - C of O MST2015-00317 David Young Final erosion control approved. Street tree certiﬁcation received. Moisture content form received. Vapor barrier acknowledgement form received. High efﬁciency lighting form received. Blower door test results checked. Insulation certiﬁcation checked. C of O left on site with contractor. Violation Summary: Inspector Contractor Mechanical Permit ApplicatiRECEIVED City of Tigard 13125 SW 4411 %&1P&OR 97223 Phone: 503/1/32439 Fax: 503 598..1960 Inspection Line: 503.639.4175 Internet www.titand-or,gov Received / A 7c, rt..N°PigIO —1)03 oo.per.4 SEP 2 2 2016 // Pi.Revi z)i---- 1()— a CITY OF T 1 ci A A D Date--By- Notirtialit 'N4:31tYn'4- : tom ta See Pate 2 for Supplemental Information ' BUILDING DIVISION__ , '`.' A;r:1,,,,,,,.,4,-,,,),,,,/,',-fAi;:::, '':',f,7",.5,-, '; '';,'-'4'' i `1.'t 41'l'.',:‘•‘:,,,,'"li*,''d,',' '‘',/'1"':74/;•07''',.*:`' ----,4,0.. .4.,-,-- '-..-- 4.--- 4''- ' '''' - A"' ' ,- „,;7z-',',.',-m=-1, ''-`-'?4,.-;2' ,i'',,,::;'tw,./"-...,4 4<,4,4Argem,„,, -,....,-7,-.,/,••-,.w.-, ..;•.:',/---,%••. N....v, mechanical mien fees.are based on the value of,the work ,... New construction 0 Addition/alteration/replacement performed,Indicate the value(rounded to the nearest dollar i of all 0 Demolition 0 Other. mechanical inaterials.equipment,labor,overhead,.and pmfit. Value;S „, «,,iti"iiktiaex„,.4k460 ../O:‘,-;.r„„.,- 7:),--- , =--iP ',::::n' '„'„•,1....t.: ' .,ti',, -, !:'[t-- 'I', , U. o - .0 l and 2-family dwelling 0 Contmerciallindwarial 0 Accessory building For!pedal information use ritedlist i4 Multi-family 0 Master builder 0 Other peso-BP:Bon QB- I 1,--3.. I Total - - ', - ,, ,0i0--,'','- 0 ' '', '0', '",.'w -ir'401013Mo,-,, -;, ,0,o•t",;0Eri. ,-0v,,,,- ,i..„ri-m, Ilestingietsolirtg: ,-;'t -44.144,inrinait2.244/qrelalioning4o,' ',.."'""-,1.•'-'4 Job site address.: fa / „„ City/Stale/ZIP Tigard,OR 97224 I 7 A6ampimili. ' ' /— - ' eoriditioning 46-.5 IIMAglafilillill.11111111111111111111111111111111111111111111111111111111111111 Furnace 100010 BTU Itiactso ems) Furnace 100,0000i BTU(ductsoiimmt 54,91 s-...- - lleat pump 61.06 Suitelbldvapt.no.: Pmject name:'Pi .6 / . i I 'ii LL,L...i ,iLl Duct uork 23.32 Cross street/directions to job site; Ilydronic Inn water system , 23.32 Residential boiler(radiator or hYdrc'nic) 23 32 Unit heaters(fuel-type,not electric) in-wall in-daet,suspended.etc '. ' 46.75 ern for am of above 1 23.32 23.32 'r,I1IIIIMIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIItllIllIllMillIllj111a111,4,,,i42, OhertltUe''V I._4 4t,/ /4 ; I, 'i /. ,At ; , Critter fuel apcdiancesn fax rnagiparcel no. Water healer 23.32 g,-,, • ''' ''-e' ,.f:fA-,*' ','fa :; i;, -f;'''t °*s' /i*-jf:.";'':'",'''''''%.,,K11';i4,r':'-`,:': (34$firePlaCtlinSell 1 33 39 4 •''-,..,:;,,,- 0'',- `'':r" ',-r - -406 -"' flue vent for water heater or as 1111rfail ird AMVIMMI11111.1111111111111.111111111111111111111111/ fur/4"e . 2332 tog lighter(gas) 2332 Woodipetkt stove 3139 Wood ti$ firtitlaeenasert ' ' 23-32 ChernacNim"/fluelv" ; 2332' Other: 73,32 ,,-•-', - •i. ,,,,,i"- ,,%,,,U , ,,,, :41"T•, +'''''` A.-`,. ,'''',4' 7)7' , . ,",,i'1 .4"....'I'.aii.'v. '2. ...:/ .;', ''-‘-'4,' ‘ ' '-' Ens It-omen/al exhaust and ventilation: Name:Polygon Witt,LLC Range hood/other kitchen I 1 13'9 Address' 109 East 13th•Street Cloines dger exhaust i 3 CiiyiSmielZIP:Vancouver,WA 94660 Single-doct exhaust(bathrooms, 4 toile compartments,utility rooms) 23 32. Phone:(360)695-7700 11 Attie/emu s Ispace fan=1:1111111111111111111111111 23.32 , ' Other 23,32 Business name-Polygon W1,11.,Lie ptptng 514.15 for That four$4.03 for each additional Furnace-etc. I Address:109 East 13th Street Gas heat pump Wall/suspended/unit heater (lg./Stater/AP:Vancouver,WA 98660 water heater Phone.(360)695-7700 Fax: (360)693-4442 Fireplace 1 • Range E-mail;Angela.Grojewskizippolygurthomes.com • . - ,, ,- .... ....„, , .- , , , , "..-;--1,:,-;s.'„,/,....... mg: ..,,--;,..,,-....,.. .4.....,.......masus. .,, , , „ • • ,..... _,. , ,..., . . Business name:A a Air EEC Pe Address: 18004 NE 72 Ave CityeStatc/7.1P-,Vancouver,WA 956,86 . Other. ,.. ,-. ..---<, ',..,-.0('''"•"-TIP( '-,,i -.i'---,•''-':,.*.',' Subtotal Mtnstnum permit fee(590.00) Plan 1VVie%(25%of permit fret Phone:(3601342-8109 Fax:(360)326-1769 State surcharge(12%of permit fee) CCB lie;203034 TOTAL PERMIT FEE This permit application espires Kit permit is ant obtained within OM days atter it has been accepted as catapiele, Authorized signature: , . tee meffealoloey set by Tri-Conaty thindine huhrOry SCAttt Road Print name: i i ek, EZEIrallil 1 studttigoor.t*.mtr..ftlivorAmp4w 1 1(1,..v 44f,46 ri(I litrl,e0WWLS) RECEIVE Electrical Permit Application FOR OFFICE USF ONLY iiii - City of Tigard SEP 22 2016 Received 13125 SW Hall Blvd.,Tigard,OR 97223 _ _ Date/6 : i a' e Permit#. ,i W A -„ 0 Phone; 503.7182439 Fax: 503.598.1960CITY Oh TIGAPaanRevi ateBy: Related Permit#: TIGARD Inspection Line: 503.639.4175 BUILDING IVIS Internet: www tigard or gov otiBed/Method Turn _ _ 4 SupplementalS Information A- Y �'..--� m �� ,Fz"z _w _fir '�.� �_ '- � ._ `� �-�"'�^s- '� ^�-�-.X Page or ®New construction �._ PE2[ ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): 0 Service or feeder 400 amps or more 0 Building over three stories. El Demolition 0 Other: .`Aa ' i`�'"' litit where the available fault current 0 Marinas and boatyards. '�."�` •""'•-^-�r-;-- • :- �.,:.v� � ;�� exceeds 10,000 amps at 150 volts or CI Floating buildings. 0 1-and 2-family dwelling 0 Commercial/lnndtistrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural ❑Multi-family ❑Master builder 0 Otheramps for all other installations. buildings. 0 Fire pump. 0 Installation of 150 KVA or .;,.. „JO,t§.*-J1 IRl 0.lkk-'IA'1'ION'krq _P4tM_TtjI: O Emergency system- larger separately derived I06#: Job site address" U - ❑Addition of new motor load of system. / /9.U YV I /J L 10011P or more. ❑system City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy. ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt,#: Project name:Polygon at West River Ter 0 Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: Description I Qty. I Each I Total r•` • New residential single-or multi-family dwelling unit. Subdivision:Polygon at West River Terrrace Lot#: 91 Includes attached garage. V // Tax map/parcel#: 1,000 sq.ft or less I 168.54 4 ma =� DE3 -•+ :„ x Ea add'l 500 ft.orportion ( �IA,sf3E. r .v y33.92 1 �_' , _._,._ �_ �,..�_.,�, Limited energy,residential C O/wr-2.9-6_ C -� �' (with above sq.ft.) 75.00 2 ,A5Lfr Limited energy,multi-family 75.00 residential(with above sq.ft.) 2 'F = ''7 r^ Renewable Energy ❑ Pg2 Services or feeders installation,alteradeeon,aaned/or relocation Name:ADVL Land Holdings,LLC 200 amps or tens 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 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 a t .G. �:A g , k „i , Q r Branch circuits—new,alteration or extension,Ol A.Pee for branch cucuits with Per panel Business name:William Lyon Homes,Inc. above service or feeder fee, ! Contact name:Angela Grajewski each branch circuit 7.42 2 B.Fee for branch circuits without Address:109 East 13th Street service or feeder fee,first 56.18 2 branch circuit City/State/ZIP:Vancouver,WA 98660 Each add']branch circuit 7.42 2 Phone:(360)695-7700Miscellaneous(service or feeder not included) Fax::(360)693-4442 Each manufactured or modular Email Angela Grajewsla®polygonhomes coo dwelling,service and/or feeder 67.84 2 Reconnect only 67.84 2gyl: _ xeaC QW_ �,t : w = ` 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 circuit(s)or limited-energy ❑ See P e 2 panel,alteration,or extension. 2 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(1 hr min) 90.00/hr ' Email:bdaniels@gweusa.com Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is CCB Lic.: C1158 Electrical Lie.: 208174 l Suprv.Lic.: 4496S specifically listed CA hr min) 90.00/hr c Suprv.Electrician signature,required: -- 'g(4 /� I i Subtotal: Print name: Joan P Albert Date: 4/26/2016 0 Plan Review Required(25%of permit fee): e----- _-:-,.... _ __ --- State surcharge(12%of permit fee): Authorized signature: ___ --- -- TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 I Print name: Bill Daniels I Date: 4/26/2016 I days after it has been accepted as complete * Number of inspections allowed per permit :I:113uildinglPermitslELC PermitApp_ELR ERE.doc Rev 06/17/2015 440-46157111/05/COM/WEB Plumbing Permit Application BuildingFixtures _ FUR OrrR I l S►: O\1.1 EC ENE() Received II,A� Cityof Tigard Date/By: 2//Q �� ,-" M5T2D/5 Do31 ill g . Permit No.: lig13125 SW Hall Blvd.,Tigard,OR 972 n 1 !� 2Q16 Plan Review Phone: 503.718.2439 Fax: 503.598. b 1 Other Permit No.: Inspection Line: 503.639.4175 Date/By: I 1 c. R D e - byti 1 Date Ready/By. Juts: ® See Page 2 for Internet: www.tigard-or.gov CiTy y F 1 1 ,�1"tt°i� g ��} \k r'z r''t 11 f1 -1 �l Notified/Method: Supplemental Information TYPE OF Rl!�r`^ a FEE* SCHEDULE ®New construction 0 Demolition For special information use checklist Description 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 dwellingSFR(2)bath 437.78 0 CornmercialJindusMal ❑Accessory building 0 Multi-family SFR(3)bath 500.32 Masteri5uil er El Each additional bath/kitchen 25.02 Oth Fire sprinkler( sq.ft.) Page 2 g'y __I08 SITE INFORMATION AND LOCATION Site utilities: Job site address: S." W "1 ,„„e___ 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.: J 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.: 17 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 A% C, / Clothes washer 25.02 // 6/, Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER ( 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:Angela.Grajewski@polygonhomes.com Urinal 25.02 Water closet 25.02 CONTRACTOR 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 Plan review (25%of permit fee) CCB Lic.:102535 Plumbing Lic.no.:34-276FB . State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name:Carolina Malmedal Date:04/25/2016 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.doe 10/01/09 440-4616T(10/02/COM/WEB)