Permit (12) r
CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2016-00013
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/02/2016
Parcel: 2S1070001302
Jurisdiction: Tigard
Site address: 16650 SW BULL MOUNTAIN RD
Project: Polygon at South River Terrace Subdivision: None Lot: None
Project Description: Demo existing 2,368 sq ft house&125 sq ft shed. On septic. Upon approved final inspection SDC credits
available for future construction.
Contractor: BULL MOUNTAIN RIDGE LLC Owner: ADLV LAND HOLDINGS LLC
109 E 13TH STREET BY FORSUM, MICHAEL
VANCOUVER,WA 98660 7600 E DOUBLETREE RANCH RD STE 1
SCOTTSDALE,AZ 85258
PHONE: 360-695-7700 PHONE:
FAX: 360-693-4442
Specifics: FEES
Description Date Amount
Type of Use: SF
Class of Work: DEM T Permit Fee-Additions,Alterations, 03/02/2016 $464.97
ype of Const: Demolition
Occupancy Grp: Occupancy Load: Info Process/Archiving-Sm$0.50(up to 03/02/2016 $1.50
Dwelling Units: 0 11x17)
Stories: 0 Height: 0 ft Erosion Control w/Development 03/02/2016 $107.60
Bedrooms: 0 Bathrooms: 0
Value: $25,526
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $574.07
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done --= - .ce with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
da ATTENTION: Ore..n law -quires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
•52-001-0010 through OAR 9 ;-001-00.0 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
0
Issued By: /ift Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
`tis-., _ FOR OFFICE
ReceivedqC1SEO\L1
REC F " q 2
City of Tigard "� Date/By. PermitNo.: /a0/lD- 13
1.11
13125 SW Ha11 Blvd.,Tigard,OR 97223 C Plan Review
Phone: 503.718.2439 Fax: 503.598.1960' L S e • f 6 Date/By; Other Permit:
( Ic ,hl)
Inspection Line: 503.639.4175G.+� Date ReadyBy: Juris: ® See Page 2 for
Internet www tigard-or gov BUI r� L , � Notified/ Method 7 Supplemental Information
a
i ,... ,...,t.,o,....„.., .... a„ xs>x.�$..,, ' �e .. -& &i,sE.«�.«., �'.x &�< �fr- 5..„
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❑New construction ®Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
94
work indicated on this application.
,
® 1-and 2-family dwelling 0 Commercial/industrial Valuation: $gpS f aS.S4,—
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
= a .;1" Total number of floors:
Job site address:16650 SW Bull Mountain Road New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:South River Terrace Covered porch area: square feet
Cross street/directions to job site:SW Bull Mountain Rd&SW Roy Rogers Rd Deck area: square feet
Other structure area: square feet
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.:2S17/TL 1302 Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
• ' -: work indicated on this application.
Valuation:
Demo existing structures on tax lot
$
Existing building area: square feet
New building area: square feet
77Y
i 3• 1<; 77737.'"X:7-'7:-rNa • y Number of stories:�,,._..._,z�..a:x�.e. .2. sz..ae .m*c -�....., rii`
Name:Polygon WLH LLC Type of construction:
Address:109 E.13th Street Occupancy goups:
City/State/ZIP:Vancouver,WA 98660 Existing:
Phone:(360)695-7700 Fax:(360)693-4442 New:
..w�. s '-- ,._..� w °'��t E+.ir.a. �a., », a.�C,�,�-'..,cA.-.;.�.,. ����� ,�.,,'�� •'�� '
Business name:Polygon WLH LLC
Structural plan review fee(or deposit):
Contact name:Chris Walther
FLS plan review fee(if applicable):
Address:109 E.13th Street
City/State/ZIP:Vancouver,WA 98660 Total fees due upon application:
Phone:(360)695-7700 1 Fax::(360)693-4442 Amount received miff
E-mail:chriswa..lther@P fygouhomes.co.-.m
t €
i • Commercialandresidentialprescriptive installation
.�of
• , roof-top mounted PhotoVoltaic Solar Panel System.m
Business name:Bull Mountain Ridge LLC Submit two(2)s roof plan with co ection details
and fire department ac s,alon. ... e 2010 Oregon
Address:109 E.13th Street Solar Installation S e • ode checklist.
City/State/ZIP:Vancouver,WA 98660 Permi mcludes review $180.00
and administraU a fees):
Phone:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of pe fee): $21.60
CCB lic.:203735
Total fee due upon applicat in: $201.60
Authorized signature. This permit application expires if a •ermit is not obtained
within 180 days after it has been accepted as complete.
Print name:Chris Walther Date: *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard - - " ` :. '�
',. - -4"'""
COMMUNITY DEVELOPMENT DEPARTMENT ' m,,, r _.,
4 ■
T I G n R D Building Permit Review — Residential '—�
Building Permit #: bu.0 O I ep —coo I B
Site Address: 16650 SW Q A \ NlouI*ctin Sid
Project Name: 3oj ever T earrae., Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name(if owner)
Planning Review
Proposal: demo e t4,,g ak-nAck-ure__,s
Verify site address/suite# exists and active ' permit system.
vLJ River Terrace Neighborhood: 6Q Yes ❑ No d'Q,ty}r only
Sit Plan Elements:
ree (3) copies of site plan 19 xisting structures on site
L1lfS e plan must be on 8-1/2"x 11"or 11 x 17"paper $'Footprint of new structure(including decks)with finished
rawn to scale(standard architect or engineer scale) floor elevations
'orth arrow Jtility locations (required for new,may apply for additions)
9/Site address,project or subdivision name and lot number ocation of wells/septic systems
applicant information(name and phone number) rosion control(including drainage-way protection,silt fence
-Bt.ot dimensions and building setback dimensionssign,location of catch basin,etc.)
"'Biot area,building coverage area,percentage of coverage and Street names
impervious area (applicable if R-7,R-12,R-25&R-40) eet tree size,type and location
$Property corner elevations (2 foot contour lines if more than xisting trees to be retained with drip line,an tree
4 foot differential) protection measures C� '}recti ?Ian
Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995): r '}recti ?
Required: El Yes,applicant was notified X No Received: r Yes ❑ No
Public Facilities Improvement(PFI) Permit: 7
Required: E Yes,applicant was notified El No Applied For: pd Yes E No,stop intake
dand Use Case #: PDR \ S — O0003
m Zoning: R----1
$Setbacks: Front Rear Side Street Side Garage
E Landscape Requirement: 0/0
"Lot Coverage Maximum:
E--Building Height: Maximum Height Actual Height
$Visual Clearance
$Easements
./Sensitive Lands: 111 Yes No Type
S Urban Forestry Plan
E Conditions "Met"prior to issuance of buildii permit TuS# COYIf i rm proi-ee*-io,n ;unci rg
Notes: A
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
I:\Building\Forms\BldgPermitRvw_RES_0709 1 5.docx
Building Permit Submittal
Original Submittal Date: 01- 4 lf(n
Site Plans: # 3
Building Plans: # -----
Building
Building Permit#: "nter building permit#above. [2"-
Workflow Routing: 'I
Tanning Rngineering 2-Permit Coordinator I�'13uilding
Workflow Sign-off: -CJ Sign-off for Planning(include notes from planning review)
Route Application Documents: 2 r.ngineering: (1) copy of permit application, (1) site plan, (1) building plan and
ori 'nal plan review routing form.
2- Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes: /
By Permit Technician: k� ��c Date: 0P14'No'
1
Engineering Review
zr
Slope at building pad: 1-1XX Conditions "Met"prior to issuance of building permit
asements (encroachments) per engineering conditions of approval and plat
Fater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ YesNo
Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No
LIDA Facility on lot: ❑ Yes ❑ No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: dzt-y Date: .2.140.,
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:
E 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:
I:`,Building\Fonns\BldgPennitRvw_RES_0709I5.docx
Albert Shields
From: Albert Shields
Sent: Thursday, February 11, 2016 12:46 PM
To: Chris Walther(Chris.Walther@polygonhomes.com)
Subject: BUP2016-00013, DEmo 16650 SW Bull Mt. Rd.
Chris, we need to receive confirmation from your project arborist that appropriate tree protection fencing has been
installed before we can release this permit. Accordingly, we are putting it on Hold, marked "Approved but Not
Released." Please have me copied on the arborist's confirmation when it is sent.
Thanks, Albert Shields.
1
* I
Albert Shields
From: Albert Shields
Sent: Thursday, February 11, 2016 7:07 PM
To: 'Chris Walther'
Cc: Morgan Holen; Debbie Adamski; #Building Permit Technicians
Subject: RE: BUP2016-00013, DEmo 16650 SW Bull Mt. Rd.
Thanks, Chris. It's a good thing that I decided to work late tonight or I wouldn't have seen this until Tuesday morning.
I'm glad you forwarded the report. I'm sure that Morgan sent it to us originally but since we didn't have a permit
application to connect it to at that time I expect it got filed with other arborist reports.
I've released the permit from hold and have left it for Debbie to get ready for issuance on Tuesday. But since City Hall is
closed tomorrow and Monday I recommend that you call first or wait for her call on Tuesday.
Have a good weekend. Albert.
From: Chris Walther [mailto:Chris.Walther(apolygonhomes.com]
Sent: Thursday, February 11, 2016 5:31 PM
To: Albert Shields
Cc: Morgan Holen
Subject: RE: BUP2016-00013, DEmo 16650 SW Bull Mt. Rd.
Albert,
Please see the attached tree protection report for the Demo permit# BUP2016-00013, let me know if you have any
issues with it. I plan on being in Tuesday morning to pick up the permit.
Thanks,
ekza 20catkeec
Poleex yKawayac
dead.walt/,oc p7 .Gsgoakomea.cost.
ea 503-312-6213
cocoa,. igloakuxea.earn
POLYGON=NORI
From:Albert Shields [mailto:albert@tigard-or.gov]
Sent:Thursday, February 11, 2016 12:46 PM
To: Chris Walther<Chris.Walther@polygonhomes.com>
Subject: BUP2016-00013, DEmo 16650 SW Bull Mt. Rd.
Chris, we need to receive confirmation from your project arborist that appropriate tree protection fencing has been
installed before we can release this permit. Accordingly, we are putting it on Hold, marked "Approved but Not
Released." Please have me copied on the arborist's confirmation when it is sent.
•
Thanks, Albert Shields.
DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail
may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained
by the City of Tigard in compliance with the Oregon Administrative Rules "City General Records Retention Schedule."
2
MHA15003 South River Terrace(Area 5)-Tree Protection Monitoring
Morgan Nolen 1/25/2016
—,7 —AJJOCIAThJ«< Page 1 of 1
Inspection On Site Recommendation for Resolution
Inspector Item Condition or Comment
Date Contact Corrective Action Date
1/25/2016 Morgan Brad (United Tree Protection measures satisfactorily in place and in None. N/A
Holen Excavators) Protection good repair at tree 70153 prior to demolition.
General Comments:
None.
R '"l /ED
F�3 . 1 2015
Cu Y ui- TIGARD
PI,ANNING/ENGINEERING
Morgan flolen & Associates, LLC
Consulting Arborists and Urban Forest Management
3 Monroe Parkway,Suite P220, Lake Oswego,OR 97035
morgan.holen@comcast.net 1971.409.9354
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16650 SW BULL MOUNTAIN RD, TIGARD, December 27, 2018 at
OR, 97224 12:08:46 PM
Record Type: Record ID:
Residential - Building BUP2016-00013
Inspection Type: Inspector:
299 Final inspection Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor