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Permit (52) CITY OF TIGARD i' MASTER PERMIT iffli °F. 1 COMMUNITY DEVELOPMENT �� Permit#: MST2015-00253 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/28/2016 Parcel: 2S1080001506 Jurisdiction: TIGARD Site address: 15108 SW 154TH AVE Subdivision: POLYGON AT BULL MOUNTAIN Lot) Project: Polygon at Bull Mountain, Lot 62 Project Description: New SF. 6/2/2016: REPRINT permit to remove 4th bathroom. 7/14/2016: REPRINT permit to ADD 4th bathroom. 8/10/16, REPRINTED to add 2nd water heater. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1611 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 32 Bathrooms: 4 Second: 2171 sf Garage: 665 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3782 sf Value: $461,032.70 Rear: 15 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 2 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 6 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 7 201-400 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 3782 Owner: Contractor: POLYGON WLH LLC POLYGON WLH,LLC Required Items and Reports(Conditions) 109 E 13TH ST,STE 200 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175 VANCOUVER,WA 98660 VANCOUVER,WA 98660 PHONE: PHONE: 360-695-7700 FAX: 360-693-4442 Total Fees: $35,595.02 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. AT : Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-00 0010 through A -001-0090.-0You may obtain a copy of the rules or direct questions to OUNC by callin .232.1987 or 1.800.332.2344. • Issue By: LCX Permittee Signature: ! -�+'c� ✓ U 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. Plumbing Permit Application on Building !1 t"!II es FOR OFFICE US ONLY City tst Ii°€ �� )ece, d I ^a�tt�t4: 9 1dt'�SViIfallttI:d 1irru IIdI � �J�� n ts� Ms-T:20,5_00263 '�;'� Phone- 01?;i .tic) I tI\ '�O.;Oh 196!) Plan t�,e�.e, ;, D.0,-it, I r t� um , i ins)1 1 ;1 1 int 302. 54 417"i L ' 'RD Internet; ona,ti and of e'.ui _AUG 1 0 2016 N.,,,l ee ime i\t thr,,'. 1 ort see leme, 1 rte2to( 1 Etai tntormattere ' F-T---- - ' Typt ot, vaiitY OF 1 IGARD j LIE:, SsIIBtIIt s � hi IS�ecrrnstrtctot [ .__ I'ur spf crul in/ortnalirrrz r!se(^bee/aim'. l) eoiptton ()h i .a at,.ti -. I LII \dditttan tllurtiu)n replacement Li Other: 'Beat. 1 " family dnelliugs;includes 100.t i)n e tt1h uulm ct)tn eetion t C AI`Bh it OF ( )N RL£71-ION St11t 1ht11 12 70 i-and ]audile tlece11in1i bath I k 1 8 { [®](o oterci al ndustrial [J Acet soots building Multi-I nidi alt { I ash a(ladrtiemal bath l,nehen ,+i) j 1 [jj \tasterbuilder FIt)iller: i.- _._ �. _1 I lir sprinkler(„_ ,y,it' ' ' JOB SITE IMORNIA ZION . ND t AC kl ION date utilities: _ _�. ]tali sne address: I 6 105 svv ,731-4.4-',1 ic\ve., t;heli h to its tt;r drain IS h I ( ity'St it4/IP: 1 igard,OR 97224 1 ri ecell lead',Itne of trench(di int 1 - I C 1 I 1 oorttn train trio: linear line ti i I P i'e Suit crbldd alai,no Prods e^t name. t'ols you at Bull Mount iia 1 \h,11- ii cturead home uuhue_s n ttz 1 C toss trect'dircetions to job site: 1.1 inhuka 18 6 Naini drain conmector t 18,70 j `ilnit`rtrA '.con (iii linear Ii _ i ! Page 7 1 I `rt0i'ni eE(18i(oat ilntalt It __.......i 1 1 t ? r-- ter' or (1 Ins ai It ) ' i e 2 t t ciao 'oibdisisinn lrnitgon at Bull VIotintaita j I it ilei.: ' t- nem: tttaptptnctil no.: t(ac:Lilmc picccnter i I l^. i 1)PS(: IP1`1(W OF WORK - 1?tnchst:i1ui aches i \))alae tit]ober l a, 2 net --1- -F v CLt-e r , :�o s �. _ . ,_ ' Dishes t,her _._. I Uiiir ni'li,unt<tir {)7 I 1 I I I (ecru( ,somO i pi '� PRt0,14.41,, (rAj ;FR D l .NANT 1 Ivpansiirntank i 1'31 is tote: Polygon AA LII,IAC I- t i�ture W'�tier,,ap ;ri^, 1 1 .. :_ �._.. �.__ _. Floor drain'(lour sint.:huh i1? lcltlres 109 East 111i Street , , .. (?,aih i..n (hspu;al 23 t).' ('it} Staid/I1':A aticous ii to s 98660 }. __ a I ii Ilose. lath ? Phone:(360)695-7700 FUN:( ice maker 1 1 E._ _ l _�.. _..... 1 — 0 APPIIC AN-1- [0 CONI ( T' PERSON i loci(-(411011(1(3ins tra _.p I o ' I(nil l o name:Pots gun!A' .11,1.1,t I le rite ai^^a^,ra of ue I , I .c Primer 1 1 Comae; n tune:;Angela(a•ilei4skl 1 1_ R<of chain ' - . -.-- 1 I�,inui�c�cinli � • f`�1 lddress 109 Fast 13th Street -._ .. ( iic`State/ll : A 2tticou rr,A4 A 98((d) St 1 lar hues rpot able w nt°r) I Phoie 360)695-7700 II has '(360)693-4442 Toho^,h,cccr; . h,cccr pito � 12.51{ c« I I--mail:f'ingela C>raten'skioiputegunitomes.eoin l-r�ua1 t .. �. �. _�,. [\Natei Closet .. 1 25,0 I C O\`I R'.L (OR i r_ j _ 1�rttt t he^ test 1 �._ , s7 131 62_ 1 Business tonic (31)1 Plumbing I 1 a agate li)pin< 1)AVAI e. Address PO13ot85 1 1 (itbet 1 (Illy/Slate/11P;Corbett tt OR 9701*9 Subtotal visnunoni Perim(lei' V7:2:-:j10 Planate (505)351 X903 I I-as'( I { I I Plan iv i tin I)hrrt tlu rinall e - t(13 I ie.. 180345 PlPlumbing 1 it :uu PIP1315821 'i ;.. ... _ _.., `.__ __ .e_ _. e I'1 o permit'nate tints]n u.'^t 1 d e t tri.} ,Ait(horiit i trig pdittie' .w- _ _ . '"... • ii i d)11 PI ILMI i t I [ Print �_�-� I iia pc^rraii ;pplacatirm input it a permit innot oht,aured ii thin 151)day,. 1 I lii nuiie Brandon 1 anter I)aifE, ....�_.,._. __.. ._-. _-..._..... _._ _... _..._ atter it has been necepied a eoniptt tc. ',. :c nesh i ^,i,, 1,-,. Tr!-t ,mol iituldog.ludo,-n;Si' inn Board I I):rsninc Po S.111,Potr;trlt1 dou 1`-u1s}11 11 -I0-1(+1(.11,t,:'(l)',l till M CITY OF TIGARD VI liffi MASTER PERMIT i COMMUNITY DEVELOPMENT II Permit#: MST2015-00253 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/28/2016 Parcel: 251080001506 Jurisdiction: TIGARD Site address: 15108 SW 154TH AVE Subdivision: POLYGON AT BULL MOUNTAIN Lot: 68 Project: Polygon at Bull Mountain, Lot 62 Project Description: New SF. 6/2/2016: REPRINT permit to remove 4th bathroom. 7/14/2016: REPRINT permit to ADD 4th bathroom. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1611 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 32 Bathrooms: 4 Second: 2171 sf Garage: 665 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3782 sf Value: $461,032.70 Rear: 15 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 6 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add''500 sf: 7 201-400 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 3782 Owner: Contractor: POLYGON WLH LLC POLYGON WLH,LLC Required Items and Reports(Conditions) 109 E 13TH ST,STE 200 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175 VANCOUVER,WA 98660 VANCOUVER,WA 98660 PHONE: PHONE: 360-695-7700 FAX: 360-693-4442 Total Fees: $35,552.99 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through 0 52-001- 090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.19877o�r,11..800.332.2344. Issued By: ��'�� A /T�Permittee Signature: e .Pzie' %7C?-k,/ Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. CITY OF TIGARD MASTER PERMIT • COMMUNITY DEVELOPMENT Permit#: MST2015-00253 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/28/2016 T I G/t.R.D Parcel: 251080001506 Jurisdiction: TIGARD Site address: 15108 SW 154TH AVE Subdivision: POLYGON AT BULL MOUNTAIN Lot:_68— Project: Polygon at Bull Mountain, Lot 62 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1611 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 32 Bathrooms: 4 Second: 2171 sf Garage: 665 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3782 sf Value: $461,032.70 Rear: 15 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 6 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain0 Storm Sewer: 100 Tubs/Showers: 4 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 Times Air Conditioning: N Vent Fans: 6 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 7 201-400 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 3782 Owner: Contractor: POLYGON WLH LLC POLYGON WLH,LLC Required Items and Reports(Conditions) 109 E 13TH ST,STE 200 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175 VANCOUVER,WA 98660 VANCOUVER,WA 98660 PHONE: PHONE: 360-695-7700 FAX: 360-693-4442 Total Fees: $35,254.97 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 By: i 1 ar le--_- Permittee Signature: ilk Ad g/t/ ei /k-/ e7-7 d/1 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. 7 • Building Permit Application ■�/�'� y,,�■a entlia ��F City of TigardDEC 21 2015 Received Date/By: /per 200 S,' Permit No.,(A.5�1-J as S'3 IN " 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie J �//�� 7J I Phone: 503.718.2439 Fax: 503.598.Vili0�� OFTtGRRD Date/By: i6l�� OtherP �?0�� /e3 Inspection Line: 503.639.4175 ! Date Ready/By: Juris: ® Sce Page 2 for 1.lc, R p BUILDING DIVISION Internet: www.tigard-or.gov NotiSed/Method!f2f/4, Supplemental Information ...��rc :.. 7 �&" %a a ' s: "SL4E��E,.V a]f& e' ^� Via• <s .?.<�.c°-. 'is' �` t `'. • .., 'r ...P" �".{;FT= , .,,t:[ t:..} t�te�3 g,x •.k.sae ,..< ®New construction 0 Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the s a s t t r a '='� a as+-.a�u. f`1i a'cs'aEw z:" ;- '?s "" „ • work indicated on this application.'• ,,.s a a p .a 3 L-.‘" 5---2.77`;634+-...CIA---Pr ® 1-and 2-family dwelling 0 Commercial/industrial Valuation/o2,$ ❑Accessory building ❑Multi-family Number of bedrooms: 4 ❑Master builder 0 Other: Number of bathrooms: 1 -A• a E : -' Total number of floors: 2 Job site address:15108 SW./SY s.- ,9—(/E _ New dwelling area: `5) U v square feel 4 /-7 City/State/ZIP:Tigard,OR 97224 Garage/carport area: Lau, square feet Siuite/bldg./apt.no.: Project name:Polygon at Bull Mountain Covered porch area: V square feet 2.1 7 1 Cross street/directions to job site: Deck area:,2,9( 'I square feet 1 c 1 i Other structure area: 0 square feet �1. Subdivision: Lot no.:62 Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the . ',5,,-,„..., work indicated on this application. � ` New Single Family Detached Construction Valuation: $ Existing building area: square feet New building area: square feet x : x m �g -" ; . ,•;L', Number of stories: 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 13th Street Total fees due upon application: City/State/ZIP:Vancouver,WA 98660 Phone:(360)695.7700 l Fax::(360)693.4442 Amount received E-mail:maggie.gordon@polygonhomes.com „e ;; b` Commercial and residential prescriptive installation of ^" x' Y z 'r a.- ®, • .:�, r•"a,` fi��'a • �r ' "` roof-topmounted Photovoltaic Solar Panel System. Business name:Polygon WLH,LLC ' �� _ .;.. �< z� y Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:109 E 13th 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.:204238 Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Maggie Gordon Date: 12/11/15 *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) Electrical Permit Application RECEIVE 9 FOR OFFICE 11SE ONLI Received No/fr' of Ti and Permit Noj"� City g 1 2015 Uatclny. 13125 SW I fall Blvd.,Tigard,OR 97223 DEC 2 flan Revie., a Phone 503.718.2439 Fax: 503.598.1960 r� Dalefity: Other Permit mit Inspection Line: 503.639.4175 CITY O��F IGA1�R+ �D Dale Rcadylliy: Amis El See Page for Internet: w s'++ tigard or goy U{ � FFN G o v Sit) otifcd/Mcthnd Supplemental Information �. iC�a -�..r,,-^- s,s_t s,r..c 0. rye/' �(, i tiPW BEYIESY� cwK��3Fi..x*7h-ix�"�s..Y} •rr�F )••`; 1�?��* 'Fn{i<2(�IC... .i_�r Y . ::7 ..7.1..? ;. ?- .. ._ ,. ®New construction 0 Addition/alteration/replacement Please check all Ilial apply(submit 2 sets of plea++ilenn checked below) 0 Service or feeder 400 amps or more ❑Building oter three stories ❑Demolitionli� 0 Other: „here the available fault current 0 Marinas and boatyards ''-; n,atf. •+',,_... r u'•CA'( -40:10.4 F'„COJHSTJEt�'JCii? I r'.' exceeds 10.000 amps at 150 volts or 0 Flm fling budding!: ' _w..,a..+.,.z:'-.x , ,s_ .... .., u. _ k, - '.�. f . . less to ground.or exceeds 14.000 ❑Commercial-use agricultural ® I-and 2-family dwelling 0 Commercial/industrial 0 Accessory h Idill)! amps for all other installations buildings /5Y//� �--� Fire pmnp ❑Install:uion of 75 1.VA or 0 Multi-family ❑Master builder ❑Other �`_❑ .. Emergency system. ❑largo Sepal a1, I, estemm z 54, = � 9s „0,y. r . O ON _,.,• ❑Addition of new minor Inad of II ] 100111'or more. occupancy Job no.: Job site address: 1 •,t 411. r(�1 _i 1' 0 Six or more residential units 0 Recreational,chicle parks City/State/ZIP: *raw O R ❑I lcalth-care locations s ❑Supply.oltage lin murc than I�LJu "` ❑I lvardous lucalions 600,silts nunlimit Suite/hide./apt. no.: vrojeci name:120 (jry� lAM ooltAt ❑�rvccr ofeeder 600 im��ps or murc M Cross street/directions to job slit!: Description ( ow. I fee. j roof I` New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: Lot no.: U 1.cxxl sq n.or less ' 168 54 ~Ea.addi 500 sq.II or portion1 33 92 I Tax map/parcel nogg. Limited energy.residential d zs ''hi ..r. fi to 0 •-' . r s:".''''':- .:..1.:1-r.. : 00.. (wild ahnme sq.ft) ) 7' Limited energy.multi-family 75 nn ' New electrical service and wiring - residential(with above sq fi) - Services or feeders installation,alteration,and/or relocation 200 amps or less 101).7(1 � u r ,zcaF yx �'x" (1) )C; €. °' t ,. ,_, ' .ii i. 201 amps l0 400 amps 133.56 2 Name: Q„`t� 401 amps to 6W amps 2(10.34 2 `, 601 amps to 1,1)00 amps 301.04 2 Address: , b C` 1,o't • 54 Over 1.000 amps or volts 552 26 t oe ' q n q t) r Temporary services or feeders installation,alteration.and/or City/State/ZIP: v `/ W / V� J �7 relocation Phone: ) to (x 5 -Mb ND) I n(15 ' q/ / 200 amps or less 59 36 I � Fax vc_►vim i`��111��""LLL VV 201 amps to 400 amps 125 08 '- Owner installation: This installation is being made on property that I own which is not 2 intended for sale,lease-rent,or exchange-,according to ORS 447,449.670.and 701. 401 amps to 599 amps 168 54 Branch circuits-new,alteration,or extension,per panel Owner signature: Date: A.Fee for branch circuits with . above service or feeder lee.vz�i r ::..05° 3:"*S m i each branch circuit - Business name: 00 / ! B.Fee for branch circuits without service or feeder fee.first 46 1 7 Contact name: m f 1 o Ve, (—)o1. branch circuit !�/ Each•addl branch circuit 7 42 '- Address:" i r1 _ Miscellaneous(service or feeder not included) City/State/ZIP: Ctri r le• Each dwelling.service and/or feednufactured or er 67 84 i ' Phone:( ) Fax: :( ) Reconnect only 67 84 { 2 1 t ��^ /_ "5 - Pump or irrigation circle 67 84 — h E-mail: 1 e. r Qj � l,v • Sign or outline lighting 67 84 ' :. !,,f t _.;.�' 4" t t -G9� ... .•. . . - Signal circuit(s)or limited-energy. Business name:Simply Electric panel.alteration.or extension Page 2 . - Each additional inspection over allowable in any of the above Address: PO Box 822408 Additional inspection(I hr min) 66 25/hr City/State/ZIP:Vancouver,WA.98682 Investigation(I hr min) 66.25/hr Industrial plant(I hr min) 78 I8/hr Phone:(503)849-8202 Fax:(360)314-4945 Inspections for which no fee is 90.00/I specifically listed(%:hr min) CCB Lic-: 204615 ( Electrical I.ic.: . 067 Suprv. I.ic.: 4394S ' EC'ECPRICP1tL PERM tr. ..r S ' / .--- T Subtotal' Suprv. Electrician signature, required: 1--e..(4_, f- ," • I Ian review(25%of permit Ice) Print name: Victor 7arzhitsky Date: 11 17/2015 State surcharge(12%01 permit Ice)_ TOTAL PERMIT F1'. E. Authorized signature: This permit application expires if a permit is not obtained within I%0 days after it has been accepted as complete. Print name: Date: • Number sir inspcctimns aitiiwed per permil I Buddme+Pcrmih<gil.r-Pym it,\pp doc 07,0010 4411"11.1Sri I I,OC•(•0 i/WI O • , Mechanical kermit:Aupli { rc" Y 1E !}•r l lilt O I ICI:. L.sig(_)7s(_)7sLl Clay of Tigard P � , Ylvp/S-OOo? 3 _.. I. IN . 13125&VV Hail Bivd,Timid,:Ole 97223 Pl>m xevitw .._._.. .. - phos .: o31lt243 Fax .501& 8-Pt 9 EC 21 2015 n_dsx t t In�tion Liam•503:634A175 . Date RmdYBY )ix: si 13 see Pae,,for • srmplemmt�tiar6tmatiea: �� ge� CIT�f U4- f�C� �� ai ----'-•-',-------''''''''''"--,-‘—',--777-, 'y a E e,..H-t-",—`•Ed i Y s:9- ,77r ! F 77 64`1 ,:1 ; , - Mechanical permit fres :are bid an.lite value of the walk- -n] alk- liew cinshvetioa ❑Addltimffaltcaito arcPlaccxncnY performed.lndeaG the value{rou nded to the nearest dntler)o all J m 0 naxLameamate talc labor. profit Valise:.$ e '7 7rAr "_ �l1 R- .� iir .. psF € e'7'1'�;t3 •t'4q75. ®i ••nd2-itithily awenw$ 0 Comthercialtm&Otrial 0 ABY Wilding •F� n► n,rse Oe idist = ❑awl- +iluiy p Master buildertimer 45V•46-' ) ( Ea. l Total u s ti i a) t.:�: _� Jur coadt6oatns 46.75 / A tel♦ Furnace 300.00013111{durk(+s�) 1 46.33 :C.'Kyl$hlte� I elyAri .fie 100.006+$:TU( *s) `3491 1 •I, • [.- Beat6].06 t`I lb .itiit tth.: Prbject.nainm Ir$ �/ • I mkt vPork X32 ss /die ions to job site: IP Hydtoaic hot water system - 32 Residendial boiler(radlaaor or hylic iicY 2332 1410,10g..0(f d,�39Yrz elead 4 isi4.1iftic 46.75 Fliidvi t.fdr adY-of abon 2332 ._.... 1316e.e.. 2332 I,otno.: IiiIiiilisitT f0medm siiii*iler - l4' applianexly _ - ^ 3339 faep]ect 2332 II* t.4.4 ) .2332 _ _ - . W orliti t•, 33.39 ovodd fii a rl t. _ , _ 1.332 peat 2332 2332 , " t , maul=Mint ad ventilates*: •Nio»C as Aior6xlve!t $ettr000d/cihe r . .: 1 33.39 leg x.x_t r i3t •t 1 .3339 gui lsdr Indiana . �`7dr oiivcr,Rid 5tS661 • .rooms) . . 4 23.32. lsliooe;r r340)81 78110• Pico't ) 2332 -':--.--v-- 1==.77'7-1----.7 abet 2332 .�...,..�.....�.... _....:� ,.N..:.. _.e .�- '� Baal pi Bttattitii P+o -ltiortM►est • 514.13 first(oar;SiAS Ear esdi additional &Maoo.eta 1 AildrraaM 19li S 1 St gjrilhusocodedh ) - ITIPeoare r,SI'A98661 Witerdtiati,s - , tiaeollled .(360)816.7809 Farl( ) . •. , a r st'1: Barboane• Ciatesa9as) Iitollnissa riiatic•AnderseeHnirams,Inc t> r a dre•c 1G W tive Sic:810 totbbital ..... iAinnmim permit he(S913A0) CAWS_ 11100 ►cart224 • __ Plea rc;,ew(2374 ofpei al> - p 9664 Fate 03)S36-6615. - : Staie iiithatit 02%ofpeiritit ke) 1.30 lu.:Y<48:ZiiTOTAL PERNOTFEE.. thispernd*Noc=dau'el**it><*mitts'not obtained within 130 days drier.Itits-bums been •s entwine. Atimorimed •: rte.mabodolocy mai,/?d-Coney talking iadasuy Service Board Tr -- utte�trt lipiddr►ene,. Datc 17130V2013 r iMEd iAp 4ol834ac MwdintIVt=tCOWWEa) PlumbinPer g mit Application � rolz 1.1._1C_� �;F c��L� Building FixturesRECEIVEDReceived Permit No.!l\7:,20/s-004233 City of Tigard Y 13125 SW Hall Blvd,Tigard,OR 9722394E C 2 1 2015 MID Review Other Permit No: Phone: 503.7182439 Fax 503.598.1 l Y Inspectionrads lel See Pare 2 for Line: 503.639 4175 CITY ;- ��h D Ready Supplemental Information - lnterneR www.tigmd-of.gov . a 1 "'�- ° b• N ,•max"- F Supplemental F' iflh " ,z` _'---c --"------"'-'----='...-- -'' -- r --"' 2:: _ `Z"-ice • " L-- c 'k Y For specud uiformarf'n chl I Total New on ❑Demolition • Description ��ll��" New 1-2-family dwellings(includes 100 ft.for each utility connection) Otho Addtwdalta�onlrcplacanent ti� — ----F" 7 SFR(1)bath 31270 a� rT-_& �{E 5 ` T": it r ."'-�� 312_78 -s- - {r -� —.2. __, SFR(2)bash 1-and 2-family dwelling 0 CoolmacialfindustnalANL SFR(3)bath I 50032 `5 3i9 ❑Accessory builcimg • 0 Multi-family Each additional bath/kitshen 25.02 - 0 Master builder El Otter: E- Fire sprinkler(_sq.ft) Page 2 • _ Site uhi bee: r -------,•'_,---•-.-77-77,...-7L,---.:...-":"; rr;, t .>,...n A - ..a Odd,basic area drain 18.76 ' Job site address 1 10 V ' '' -� i'� .. � Drywdi,leach line,or trench drain 18.76 c Page 2CrtY/StadrlLlP, � Footin8 drain(no.linear R:_, . 9 ,.. )O}1 � Manufactured home utilities 50.03 SuitdbldgJapt-�: .Project name:Cross strxt/direcliorrs to job site: Manholes 18.7618.76 Rain drain connector Sanitary sewer(no.linear ft:_j Page 2 Storm sewer(n0/linear _)car ft: • Page 2 • Page 2 - LorL. service(no.linear-ft:_) . i of n° It raters� ,ents ( 3127 N,1-1' Subdivision 1227 1"2•�J Tax map/parcel no.: r Badnvata valve 2-51 I'2_.5\ `, _ - _. Cfothcs washy1°2 --�� ` - x - - City of Tigard 1,1111 ~ COMMUNITY DEVELOPMENT DEPARTMENT T I G A R D Building Permit Review — Residential Building Permit #: /7_5.7- 20/._S-- L51...2._s-L3 rdr- Site Address: 're «,��_yr(;�• AL . ��F�� Project Name: 0` &el Alan k Lot #: _ (New NAV= subdivision name;,Addition or,AIteration=last name of owner) Planning Review Proposal: A,/P4) ,9,C El erify site address/suite# exists and active • permit system. lld River Terrace Neighborhood: es ❑ No Sit Plan Elements: ree (3) copies of site plan /A sting structures on site plan must be on 8-1/2"x 11"or 11 x 17"paper IG ootprint of new structure (mcluding decks)with finished 7 b rawn to scale(standard architect or engineer scale) flyor elevations 4 ' Orth arrow 11Q Jtility locations (required for new,may apply for additions) L /fJ�to address,project or subdivision name and lot number • ation of wells/septic systems jl:pplicant information(name and phone number) rosion control(including drainage way protection, silt fence ot dimensions and building setback dimensions sign,location of catch basin,etc.) Nilat area,building coverage area,percentage of coverage andS II�Qeet names pervious area (applicable if R-7,R-12,R-25&R-40) Lid'Street tree size,type and location roperty corner elevations (2 foot contour lines if more than 94ftcisting trees to be retained with drip line,and tree 4 foot differential) protection measures fP lean Water Services—Service Provider Lett (lot platted prior to 9/10/1995): illtequired: ❑ Yes,applicant was notified No Received: E Yes ❑ No igie Public Faciliti Improvement (PFI) Permit: /Required: (It Yes,applicant was notified ❑ No Applied For: Yes ❑ No,stop intake and Use Case#: � [S^ ©(�, LIQ ��oning: P-41: tSetbacks: Front o Rear /S— Side s Street Side A"— Garage O?(3) Nis andscape Requirement: ill of Coverage Maximum: % 'Couilding Height: Maximum Height ,30' Actual Height a9C ' / /isual Clearance U� asements ensitive Lands: 9/Yes ❑ No Type __,ge '( 1 LL Urban Forestry Plan ❑ Conditions "Met"prior to issuance of building permit / / Notes: L�05/.�?.SZ iiVI-.4 , Al_a__ ` ?Jr-- '7(j .,(41 79 Qp,7Li,L /t'j4 2,7 P,( , �/ j _ Approved By Planning: �„�� a1- Date: 9-. Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: El Approved ❑ Not Approved 1:\Building\Forms\BldgPermitRvw_RES_0709I 5.docx Building Permit Submittal Original Submittal Date: 4.2-//7A_5- Site Plans: # 3 Building Plans: # _3 Building Permit#: 'Enter building permit#above. Workflow Routing: O'Planning g--l`ngineering a—Permit Coordinator E Building Workflow Sign-off: tr—Sign-off for Planning(include notes from planning review) Route Application Documents: +0"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: l'i*E-- Date: /22`2 /'-.S- Engineering 'SEngineering Review Slope at building pad: 5' ?D E 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 , No Assess Water Quantity Fee in-lieu: ❑ Yes 0No LIDA Facility on lot: ❑ Yes ,., No 1 ❑ NOT Approved by Engineering: Date: Notes: Pa' S 451-1-.. Avg. - Ai 1,4.T C .1#j'ut-ter pn-tdn- Te, i.,5/41 Approved by Engineering: Atik.c. iti Hi Date: 12 / 2 /ir Revisions (after Building Submittal only) Reviewer ( Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: E Approved ❑ Not Approved Permit Coordinator Review LI Conditions "Met"prior to issuance of building permit (... 7.,/ 1 NOT Released: ,G� , Date: / y5/Jipproved, otes: 7 ,Geir-G41 Co-A_elv Y t moi( . 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 1=1 N/A / Tigard Trans SDC: ›? Yes ❑ N/A Parks SDC: j8.'Yes ❑ N/A Ab K to Issue Permit Approved by Permit Coordinator: 1/��' "ate: Z-'51 /4=' 1:\Building\Fonns\B1dgPennitRvw_RES_070915.docx Albert Shields From: Albert Shields Sent: Wednesday, December 30, 2015 4:48 PM To: Maggie Gordon (Maggie.Gordon@polygonhomes.com) Cc: Cheryl Caines; Susan Shanks; Mike White Subject: Permit Applications, Bull Mountain Area 7-MST2015-00250, -00251, -00252, -00253, Attachments: Conditions- 12-30-2015.pdf Maggie, in reviewing the permit applications for MST2015-00250, -00251, -00252, and -00253 we find that there are two issues with the applications that must be resolved before we can release them for plan review, let alone issuance: 1. Each of these applications calls for an address on "Rio Grande Terrace" but we find no such street on the draft final plat that we have received. Instead, we find that the street on which those lots are located is"154`h Ave." If your intention is to establish "Rio Grande Terrace" as the street name please submit to us a plat that is revised accordingly. Please let me know which way you want to go. 2. Multiple Conditions of Approval under the governing Land Use Case,SUB2015-00002 that are required to be met before final plat approval and/or issuance of building permits remain Not Met. I've attached a printout of the Conditions on which I have highlighted those that must be met before we can continue to process these permit applications. We will put these applications on "Hold" until the requisite Conditions have been met. Please let me know if you have any questions. Albert Shields 1 Building Permit Application 1_,1 A, xy.. Resint R 1' dential FOR OFFICE USE ONLY City of Tigard• �J=L r�i Z015 Date/By:Rec //.Z yjs .�— Permit No./as+'^ �D�S3 '• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review �1�L('/L -�'D�� Other Perm • S Phone: 503.7182439 Fax: 503.598.Y j -y i DateBy: � -3 • OF � loris: ® See Page 2 for TIGARD Inspection Line: 503.639.4175 i jI `dam NilSliC1 DateReady/By �_ Internet: www.tigard-or.gov � `�'° Notified/Method: / Supplemental Information i n - a ,, a. v n "k " ° , ; r �3; M a =; z � VF-, i 3 ,. ; . . i' $0 7—,,24RC ,,f.r? F x: �}3y� _aT % iI a sai4J- ,„:_ ® New construction 0 Demolition Permit fees*are based on the value of the work performed. - Indicate the value(rounded to the nearest dollar)of all 0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CG .4FC7>t 1E1XT . � . £ work indicated on this application. a141.W,.„,. ,„,. 1 � . q - - Valuation: $ y % 5-cil ® 1-and 2-family dwelling 0 Commerciallindustrial ❑Accessory building ❑Multi-family Number of bedrooms: 4 CI builder ❑Other: Number of bathrooms: 2.5 -�M } iia 1 Total number of floors: 2 rs- + .,._x.b�,�. e�0 11lE�g ,il'1.: 1,s 8.E 6tg t1 .'3M-4 Job site address: 15108 SW ,! ,,, --- /54/ �% 4k I/&'. New dwelling area: ?'"A--S1, square feet City/State/ZIP:Tigard,OR 97224 Garage/carport area: Uits square feet Suite/bldg./apt.no.: Project name:Polygon at Bull Mountain Covered porch area: C U square feet Cross street/directions to job site: Deck area: i] square feet - Other structure area: 49 square feet i wobi,1 iA'rjaiT, - .it mE62,- > _ Subdivision: Lot no.:62 Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the ` t° t- ' €f _ t-, work indicated on this application. �FSG1i�QF Wf1I fit , t 3, W PP s . _ v� New Single Family Detached Construction Valuation: $ Existing building area: square feet New building area: square feet ® $tl '>I C1 1�I1 . z ” - t jr ^ Number of stories: 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: el- , g a s , 1- : , �"� D CON C ' ifat.t1N R 11 4 �rr.13 "u's'esr , , '� .;,,, ,v,t--xr- , i ,,,. _,l Jin 4.r>, ,,,..,.,u. v ;, .,,.mow , ,,,, _-._,.,,-.,,x- ,., a, .-a: s v 7 £ Business name:Polygon WLH,LLC Structural plan review fee(or deposit): Contact name:Maggie Gordon FLS plan review fee(if applicable): Address: 109 E 13th Street Total fees due upon application: City/State/ZIP:Vancouver,WA 98660 Amount received: Phone:(360)695.7700 Fax: :(360)693.4442 � �a 1G'H(kF111 � jk1 E-mail:maggie.gordon@polvgonhomes corn ,.. .*.- ..x. 1 ..tea . ,,,,4 - Commercial and residential prescriptive installation of � ..,. '- ,, �,< ' s �..._' ( .. .. ._. I .gam..,., `..." . ...,.. �t roof-top mounted Photo Voltaic 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 13th Street Solar Installation Specially 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.:204238 Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Print name:Maggie Gordon Date: 12/11/15 Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Albert Shields From: Albert Shields Sent: Wednesday, December 30, 2015 4:48 PM To: Maggie Gordon (Maggie.Gordon@polygonhomes.com) Cc: Cheryl Caines; Susan Shanks; Mike White Subject: Permit Applications, Bull Mountain Area 7 -MST2015-00250, -00251, -00252, -00253, Attachments: Conditions - 12-30-2015.pdf Maggie, in reviewing the permit applications for MST2015-00250, -00251, -00252, and -00253 we find that there are two issues with the applications that must be resolved before we can release them for plan review, let alone issuance: 1. Each of these applications calls for an address on "Rio Grande Terrace" but we find no such street on the draft final plat that we have received. Instead, we find that the street on which those lots are located is "154`h Ave." If your intention is to establish "Rio Grande Terrace" as the street name please submit to us a plat that is revised accordingly. Please let me know which way you want to go. 2. Multiple Conditions of Approval under the governing Land Use Case, SUB2015-00002 that are required to be met before final plat approval and/or issuance of building permits remain Not Met. I've attached a printout of the Conditions on which I have highlighted those that must be met before we can continue to process these permit applications. We will put these applications on "Hold" until the requisite Conditions have been met. Please let me know if you have any questions. Albert Shields 1 ... . . . . 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.1t pmes aild rey isions. • This form and the information it provides helps the review process and ses' to tb yqur prqject... .. ••• • City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT IN Transmittal Letter • ••• • • 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.7182434:wyww.Cigitrtt.dr.gov TO: ----ri---;Pt DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED JUL : 2016 FROM: C OF ; ;GARD COMPANY: 9:—PL- Lkrt— e.iltING 164i ON By: Lah PHONE: RE: 15[C 15y c off �� 0t5-0053 (Site Address) f (Permit Number) - (wok ,0—‘,011 P H+b , ; , .roJec or su.a ivision name an. of n •er 1 ATTACHED ARE THE FOLLOWIN Additional set(s) of f evis.. s: Cross section(s) . d detai W. bracing and/or lateral analysis. Floor/roof frail.'" g. :asement and retaining walls. Beam calcula 'ons. Engineer's calculations. Other(ex►1 :in): , REMARKS: is. As ,+, o 51� _A....-___ ....717....717` • ` — , . =.ice-.Ti;`' 1 a-- _ . ..L� .,. . d . • . LA/1/4.. Pi�t —TO-101,o_ } Routed to Pe n it Technician: Date: fraffillilitnetWgi Fees Due: a es • No Fee Descri stion: Amount Due: $ /moi $ "MI $ Special Instructions: Re•rint Permit .er PE : ❑ Yes .'rte ❑ Do - A. licant Notified: Date: ism ummirew• I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 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 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 •www.tigard-or.gov TO: on DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVE . JUL � 12016 FROM: t lel�Q}Q GUS CITY OF 1( COMPANY: )O ( Co,-071'1 (A)1,1-k. 1 W___ BUILDING DIVISION PHONE: - (5' liC0 By:1-----') t RE: \ )\ 08 W\ L1 -\--a6 t 5- 00 D--3 (Site Address) (Permit Number) 61 �f cam' � i \ c Loft D- �roj e or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: r ,s Additional set(s)of plans. ✓ Revisions: 1-+' d-h AME GL Cross section(s)and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: pn C U.St)m e tS ,01 1,_f2y3A Routed to 'ermit Technician: Date: ) - Tei Fees Due: $4 Yes • No Fee Descri stion: Amount Due: I I r • a rcV ; -cNi $ $ $ $ Special Instructions: Re'rint Permit •er PE : 1161211111.111.1 ❑No IN Done A 5 5 licant Notified:17N/6/ "Date: 7/moi �,,' Mill= nitials: orrioril I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 I Electrical Permit A licatiorlk i., 4 r} FOR OFFICE USE ONLY City of Tigard ¢ "rte." .:,,,JL- 1. ;?, s Received !c rs2/ KS 71 Date/B : / �ig Permit#: T20 i to 2 w 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review - Phone: 503.7182439 Fax: 503.598.19SC P 1 b 2016 Date/By: Related Permit 1/: Inspection Line: 503.639.4175 ReadyD y: li3 See Page 2 for TIGARD Date/By: luris .� Internet: www.tigard-or.gov c l• I0,t--_, 4 ;.:.:4,/,,k;:,--,),1:2 Notified/Method: Supplemental Information �._ t' TYPE O '`t 4.. " ` II .. " PLAN REVIEW ®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): 0 Demolition 0 Other:MO ❑Service or feeder 400 amps or more ❑Building over three stories. i where the available fault current Marinas and boatyards. ._, CATEGf)R%';OF CON,.$I'l.tfCTrON_, s exceeds 10,000 amps at 150 volts or Q Floating buildings. ® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural 0 Multi-family amps for all other installations. buildings. Y 0 Master builder ❑Other: ❑Fire pump. ❑Installation of I50 ICVA or JOB'SITE INFORMATION.AND LOCATION ❑Emergency system. larger separately derived Job#: I Job site address: 15 1 D Cs' S W l LL �y.❑Addition of new motor load of system. 5—i � �"v- 100HP or more. ©«A <.E„ <.l_z„ «1.3„ City/State/ZIP:Tigard,OR 97224 ❑Six or more resideantial units. occupancy. 0 Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt,#: 1 Project name:Polygon at T SL'Rhher-T-er StkAt ❑Hazardous locations. ❑Supply voltage for more than ❑Service or feeder 600 amps or mom. ore 600 volts nomunai Cross street/directions to job site: (f\f r-' } CREDULE ; 1 Description f Qty. I Each I Tota] New residential single-or multi-family dwelling unit. Subdivision:Polygon at Wes4 Bit ri---3w1 1 ()rm., 1 Lot#: ( '_ Includes attached garage. Tax map/parcel#: `� 1,000 sq.ft.or less 168.54 4 DESCRIPTION, )i WORD Ea.add'l 500 sq.ft.or portion 33.92 1 �"" �' OLimited energy,residential /�/'�l {r (with above sq.ft.) 75.00 2 Limited energy,multi-family 75.00 2 residential(with above sq,ft.) ewableesor En ers y ❑ g lig9 ERTlf M,:gl I -. ;_ f.... _, C].TtNAL�IT„° Renee Page 2 Servicfeedinstallation,alteration,and/or relocation Name:ADVL Lan i Holdin l• LC e 200 amps or less 100.70 2 c%,,w Address:7600 E Do t t l= •ee Ranch Road 201 amps to 400 amps _ 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:Scor,i le,AZ 85258 601 amps to 1,000 amps 301.04 2 Phone:(602)69' ,031 :( ) Over 1,000 amps or volts 552.26 2 Email: Temporary services or feeders installation,alteration,and/or relocation Owner installation:This installation' eing made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exc nge,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 ::.4 ZELrtArI`Lr I 0 CONTACT,PERSON Branch circuits—new,alteration,or extension,per panel `� `"" �•• A.Fee for branch circuits with Business name:Witttarribyerritiarrterftrer poiltj,I� W Ll,G above service or feeder fee, JJ o" 1 1 each branch circuit 7.42 2 Contact name:Angela Grajewski 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 Miscellaneous(service or feeder not included) Phone:(360)695-7700 Fax::(360)693-4442 Each manufactured or modular Email Angela Grajewskl@polygonhomes corn dwelling,service and/or feeder 67.$4 2 Reconnect only 67.84 2 ` „ TRACTORr, ... ,.,.. CONr Pump or irrigation circle 67.84 2 Business T' , a-� u name:Garner Electric Washington,LLC iv 0 Ce,*...e' Signor outline lighting 67.84 2 Address:6101 NE St Johns Rd Signal circuit(s)or limited-energy ❑ See Page 2 2 panel,alteration,or extension. City/State/ZIP:Vancouver WA 98661 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(253)320-165'7 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 Lie.: C1158 Electrical Lie.: 208174 15uprv.Lie.: 4496S specifically listed(%hr min) 90 00/hr �_ — - - EIGECTwe PERMIT, ES Suprv.Electrician signature,required: 'fit • L Subtotal: Print name: Joan P Albert Date: 4/26/2016 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): -- TOTAL PERMIT FEE: Authorized signature: '– - This permit application expires if a permit is not obtained within 180 Print name: Bill Daniels Date: 4/26/2016 days after it has been accepted as complete. " Number of mapectioas allowed per penuit- 1:1Building1PermitslELC PermitApp_BLR ERE-doc Rev 06/17/2015 440-4615T(I I/05/COM/WEB 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 15108 SW 154TH AVE, TIGARD, OR, 97224 Residential - Master Permit 699 Mechanical ﬁnal PASS MST2015-00253 David Young Note: no AC installed at time of ﬁnal inspection. Mechanical contractor to be changed on permit to reﬂect contractor that installed HVAC. Violation Summary: Inspector Contractor 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 15108 SW 154TH AVE, TIGARD, OR, 97224 Residential - Master Permit 299 Final inspection PASS - C of O MST2015-00253 David Young Final erosion control approved. Corrections from previous inspection complete. Street tree certiﬁcation received. Moisture content form received. High efﬁciency lighting form received. Insulation certiﬁcation checked. Blower door test results checked. C of O left on site with contractor. Violation Summary: Inspector Contractor 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 15108 SW 154TH AVE, TIGARD, OR, 97224 Residential - Master Permit 299 Final inspection FAIL MST2015-00253 David Young Remove construction debris from crawl space. Provide tempered window in upper level main bath at hazardous location by tub/shower. Remove washer knockout in laundry room. Remove landscaping covering AC line set. Provide correct mechanical contractor on permit. Violation Summary: Inspector Contractor