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Permit (14) �, CITY OF TIGARD �i � MASTER PERMIT 1111 1•° • COMMUNITY DEVELOPMENT Permit#: MST2016-00040 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/13/2016 Parcel: 2S1080001506 Jurisdiction: Tigard Site address: 15396 SW THAMES LN Subdivision: POLYGON AT BULL MOUNTAIN Lot: Multiple Project: Polygon at Bull Mountain, Lot 63 Project Description: New SF. 6/2/2016: REPRINT permit to correct number of tub/showers to(3)total. 6/13/2016: REPRINT permit to add 245 sq ft covered patio. 8/25/16 ADD 2nd water heater BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1259 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 32 Bathrooms: 3 Second: 1658 sf Garage: 464 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2917 sf Value: $355,071.85 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 2 Water Lines: 100 Drains: 0 Catch Basins: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Bckflw Prevntr: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Fu rn>=100 K: 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 Group: Square Feet: NEW SF VB R-3 2917 Owner: Contractor: POLYGON WLH LLC POLYGON WLH,LLC Required Items and Reports(Conditions) 109 E 13TH ST,STE 200 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175 VANCOUVER,WA 98660 VANCOUVER,WA 98660 PHONE: 360-695-7700 PHONE: 360-695-7700 FAX: 360-693-4442 Total Fees: $33,239.57 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-001 .OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 50 .232.1987 or 1.800.332.2344. )GS Issued B : � � a Permittee Signature: �� `� � Call 503.639.4175 by 7:00 a.m.for the next available inspection date. GC�2�d.d This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved Approved plans are required on the job site at the time of each inspection. Plumbing Permit Application Building Fixtures RECEIVED Ci of Tigard >tecei` a 171/ /& Penait Na.!M aO/6-000 go 11,1 City Da#e 73y; s 13125 SW Hall Blvd.,Tigard,OR i b' Pian Review tS. Phone: i0•�.718.2439 Fax: 5O3: .'6 2016 Mealy: OtherPerniitNo.: Inspection Line: 503.639.417f-Try N Date Ready/Dy. oris, Pi See Page 2 for T I G A R D R$ f ®F it ARE)(('t Supplemental Information Internet: 1,vww tigard-orgov C�}ILe Notified Method: pp '-','"!7' • i 1O `1-I}" • FEE* SCHEDULE *S New construction ❑Demolition - For special information use checklist 0. Description I Qty. I Ea. ( Total 0 Additionialterationireplacernent 0 Other:: New.1-2-family dwellings(includes 100'ft.for each utility connection) SFR(1)bath 312.70 4. . � .;' . GAT GOR4,QF ,:ois tar610 _ .:Z .. ..,?f , l-and 2-familydwelling ❑Commercialrindustrial r SFR(SFR 2)bath 437.78 ® _ w . 00:32 ❑Accessory building 0 Multi-lbmily Each additional'ba0itkitchen. 25:02 0 Master builder ❑Other Firc sprinkler( sq.I ) Page.2 7. JOE SCFE INFORMATION A19 LOCATION `., s Site utiiitiest � 1 Catch basin or area drain 1.8.76 Job site address: ] ,J I V V 1 ►►L 1 l or Alpe;or trench drain 18.76 City/Statea1P`.Tigard,OR 97224 Footing drain(no,linear ft:: ). Page 2: Suite/bldg:/apt,no.: Project name:Polygon at Bull Mountain 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 it.: ) Pane 2 • Water service(no.linear I1.; 1 I Page 2 Subdivision:Polygon at BulllMountain Lit no-; CO 3 Fixture or item: Tax map/parcel no.: Backflow preventer , 31,27 .M;:;',,.7.1;1 . .. 1} gBt f UP;1 0 ': /. pack-water valve 1.2.51 =. _ Clothes.washer 25.02 . Dishwasher 25.02 Drinking fountain 25.02 Ejectersisump 25.02 r k:-.PROPERTY OWNER ,`; „ G' ❑ 'TENANT`. Expansion tank1�s1 _.. .2._ ..._. Fixture/sewer cap 25.02 Name:Polygon%%L11,LLC Floor drain/floor sink/bub 25.02 [ i Address:109 East 13th Street Garbage disposal j 25,02 City/State/L'IP Vancouver,WA 98660 .. Bose bib 25.02 Phone:(360)695-7700 Fax:( ) lee rnaker 12.51 ❑ CONTACT"PERSON _ lnterceptor/grease trap 25.02 Medical gas-(value:$ ) Page 2 Business name:Polygon WLt-1,LLC Primer 12.51 Contact name:Angela Grajewski . Roof drain(commercial) 12.51 Address:109 East13th Street Sinkibasin/lavatt ry 25.02 City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54 Phone:(360)695-7704 Fax::(:360)693-1442 Tub/shower/shower pan, . 12.51. Urinal 25,0 E-mail:Angeia.Grajeyvki@paiygonhomes.com 25 02 �., ° " r � « 4.4-' , t - Water closet -.. K 1 CON'PR itioR •, .:* � " ri,' 37.52 „�.�� ; A . .Water heater I VT 52) Business name:BDL Plumbing LLc Water•piping/DWV 56.29 . Address:PO Box 85 Other. 25.02 City/State/Z1P:Corbett OR 97019 \, Subtotal; Minimum permit fee: $72.54_ Phone:(503).351-3943 Fax:( ) Plan review (25RD of permit fee) GCB Lie.'180345 :PIumbing Lir nO.;:P111582 State surcharge(12%of permit tee) i Authorized signature: rirr " 1 "` TOTAL PERMIT FEE .... This permit application expires if a permit is not obtained within 180 days Print name::Brandon Lanfer I}ate; lit, 110 after it has been accepted as complete, *Pee methadolayy set by Tri-Const}Building Industry Service Beard. 1,Bgiiding':Permitntrr,RT,.PermitApp.dee 10/01/s 440446i6f(IOJO2/CONftWF8) • MASTER PERMIT CITY OF TIGARD /� fry i✓®��D "I� Permit#: MST2016-00040 a . � COMMUNITY DEVELOPMENT TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/13/2016 Parcel: 2S1080001506 Jurisdiction: Tigard Site address: 15396 SW THAMES LN Subdivision: POLYGON AT BULL MOUNTAIN Lot: Multiple Project: Polygon at Bull Mountain, Lot 63 Project Description: New SF. 6/2/2016: REPRINT permit to correct number of tub/showers to(3)total. 6/13/2016: .REPRINT permit to add 245 sq ft covered patio. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1259 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 32 Bathrooms: 3 Second: 1658 sf Garage: 464 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2917 sf Value: $355,071.85 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 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 Tvoes 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 addl 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 Ecom asin Y Other: N Other Description: p g BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2917 Owner: Contractor: POLYGON WLH LLC POLYGON WLH,LLC Required Items and Reports(Conditions) 109 E 13TH ST,STE 200 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175 VANCOUVER,WA 98660 VANCOUVER,WA 98660 PHONE: 360-695-7700 PHONE: 360-695-7700 FAX: 360-693-4442 Total Fees: $33,152.55 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: Permittee Signature: ///✓ /317a/ L/e e' / Call 503.639.4176 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. NivilM CITY OF TIGARD MASTER PERMIT 111 1-''' COMMUNITY DEVELOPMENT Permit#: MST2016-00040 TIC.1 A IZ T7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/13/2016 Parcel: 251080001506 Jurisdiction: Tigard Site address: 15396 SW THAMES LN Subdivision: POLYGON AT BULL MOUNTAIN Lot: Multiple Project: Polygon at Bull Mountain, Lot 63 Project Description: New SF. 6/2/2016: REPRINT permit to correct number of tub/showers to(3)total. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1259 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 32 Bathrooms: 3 Second: 1658 sf Garage: 464 sf Front 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2917 sf Value: $349,762.70 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 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!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 2917 Owner: Contractor: POLYGON WLH LLC POLYGON WLH,LLC Required Items and Reports(Conditions) 109 E 13TH ST,STE 200 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175 VANCOUVER,WA 98660 VANCOUVER,WA 98660 PHONE: 360-695-7700 PHONE: 360-695-7700 FAX: 360-693-4442 Total Fees: $33,015.60 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 5 1-00 0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.19: -r 1.800.332.2344. Issued By: Permittee Signature: - - ✓�� Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. CITY OF TIGARD MASTER PERMIT $ o COMMUNITY DEVELOPMENT Permit#: MST2016 00040 Date Issued: 04/13/2016 1 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S1080001506 Jurisdiction: Tigard Site address: 15396 SW THAMES LN Subdivision: POLYGON AT BULL MOUNTAIN Lot: Multiple Project: Polygon at Bull Mountain, Lot 63 Project Description: New SF BUILDING Floor Areas Required Setbacks Reauired Stories: 2 Bedrooms: 4 First: 1259 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 32 Bathrooms: 3 Second: 1658 sf Garage: 464 sf Front: 20 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Total: 2917 sf Value: $349,762.70 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF 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 Tvoes 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 Tomo 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 2917 Owner: Contractor: POLYGON WLH LLC POLYGON WLH,LLC Required Items and Reports(Conditions) 109 E 13TH ST,STE 200 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175 VANCOUVER,WA 98660 VANCOUVER,WA 98660 PHONE: 360-695-7700 PHONE: 360-695-7700 FAX: 360-693-4442 Total Fees: $33,015.60 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 R -001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. / Issued By:` Permittee Signature: °Ai .97°�L /e'��O'" Call 603.639.4176 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. I' . /--5 ,5-')/ 6 3 _ __, .Building permit Application �� trj RECEIVE FOR OF FICE I SE ON I.v P City of Tigard Received oZ/o?.2/�0, erm .:,y�To��b—49090PitNo / g Daze/By: / 13125 SW Hall Blvd.,Tigard,OR 97223 FEB 1 8 2016 Plan Review /4, 5�/e�/k e��, Phone: 503.718.2439 Fax 503.598.1960 Date/BY ate/B �� /v/`� • erPemvt: I e � Inspection Line: 503.639.4175 CITY OF T GARD Notified/Method:ateey/By: runs. ®ppleSee Page 2l for Internet www.tigard-or.gov BUILDING DIVISIO 'tj ®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 work indicated on this application. r ® 1-and 2-family dwelling ID Commercial/industrial Valuation3 $ �`� IA ❑Accessory building ElMulti-familyNumber of bedrooms: 4 El Master builder 15 3 R c 'tither Number of bathrooms: Total number of floors g�f 2 - t < •S @ G .t �f€ �'f-.iq 3 `'iL��,', � ..al._.�.�.._._--:......-.....e_».2utt .i Job site address: -1 c-JL16.�L .� -'�- y�1! 1`� New dwelling area: q / square feet 8 a City/State/ZIP:Tigard,OR 97224 Garage/carport area: `ALB L square feet Suite/bldgiapt.no.: I Project name:PD\I(5'rjn (;, 00‘)A ►Y}�f Covered porch area: quare feet C C. = Cross street/directions to job site: J Deck area: l J square feet 9 Other structure area: le square feet ‘'',..,:3,:xiL&° a a...� a w e' I `?..,.—.•:1.---f i J- ��tt ''� _, Subdivision:Polygon at Bull Mountain I Lot no.: (jj'5 Permit fees*are based on the value of the work performed. Indicate the value Tax map/parcel no.: equipment,materials,labor,toverhead,nearest dollar) the profit for the $ t work indicated on this ...lication. p �.. Valuation: $ r12\13 �J Li—)3\Q . Gum\. - Existing building area: square feet New building area: square feet - ..: t¢ r ro.; '7- Number of stones Name:Polygon WLH,LLC Type of construction: Address:109 E 136 Street Occupancy groups: City/State/ZIP:Vancouver,CA 98660 Existing: Phone:(360)695.7700 Fax:(360)693.4442 New: , Business name: A/0 L 'n C Structural plan review fee(or deposit):'^ Contact name: a & \_e_ Ore\C-f-) FLS plan review fee(if applicable): Address: I 0 10{ 13 Total fees due upon application: City/State/ZIP: \I cur)0 Q or Witk c\SADO 6(20) ��' �0D I Fax:(��D) `1 J U222 Amount received E-mail:maggie.gordon@polygonhomes.com ` Commercial and residential prescriptive installation of ._ `- roof-top mounted PhotoVoltaic Solar Panel System. Business name: 1P n) ( l \n C Submit two(2)sets of roof plan with connection details on '' t :\ios ' and fire department access,along with the 2010 Oregon Address: \9 a i l?) ' 5 Solar Installation S.ecial Code checklist. I City/State/ZIP: J an CaUo� A Q�`p� Permit Fee(includes plan review $180.00 Phone:e\ °) I a 5%�40C) Fax:(3100) 0Q3 . '222 age(12% ffees State surcharge(12/o of permit fee): $21.60 CCB lie.:204238 Total fee due upon application: $201.60 I This permit application expires if a permit is not obtained Authorized signature:- e!. 0 within 180 days after it has been accepted as complete. \ Print name: Date• I —VI.71-U) *Fee methodology set by Tri-County Building Industry Service Board. I:'Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-46131(11/02/COM/WEB) • Electrical Permit Applicatio ECEIVED FOR OFFICE FSE ONE City of Tigard FEB 1 8 2016 Received Permit w,cro b 0I 9'O 13125 SW I tall Blvd..Tigard,OR 9722 TY OF TyGARD Dat Review 1 I/ Phone 503.718.2439 Fax 503.598.(9 Other Permit /'� Dale/11y: I I C,.\F U Inspection Line: 503.639.4175 BUILDING OI\llSIO I. Dale Readyniy: Anis RI See Page 2 for Internet: www.ti�eard-or.gov vv v Notified/Mclhod: Supplemental Information 1i4 r "` 4 8 4 =TYEE rA00 PLWRFSTIEIV➢ Please check all that apply(subunit 2 sets of plans otitcnms checked below)®New construction EI Addition/alteration/replacement ❑Service or Feeder 400 amps or more 0 Building user three stones 0 Demolition 0 Other: where the available I:udt current ❑Marinas and homy: ifs q &'t) + ;. c.c.'s 10,000 amps:t 150 volts or 0 Floating buildings� CA`I"E)6'©RY �F'CONSTI�i�CTII�N 'z, less to ground.or exceeds 14.000 0 Commercial-use age i cultural ® I-and 2-family dwelling 0 Commercial/industrial ❑Accessory building amps for all other installations buildings 0 Multi-family 0 Master builder 0 Other: 0 Fire pump 0 installation of 75 K VA or *tfi. b "t 1 .>• - • .,".a.:**4104.0;:!-#60104:::•''.1 i. _ ❑t.n eigency system. larger aep:uatch Jrnscd sago y 3tgg.z ci:,,, 1 SIIT�,,,IiVT•O)i MAT1ON Afi1D LOGA'T1ON,,"..1 j..3 p { ( _ ❑Addition of ncsv motor load o1 ❑"A•" "P"."1-2 ,.1 �j V: 5�-,,�1� ^ _ ,�\ - 100111'or more. occupancy Job no.: Job site address: J` 1 �� J �(/ l 1 /� ❑Six or marc rcsnlcmial units ❑Recreauunal telucle park, City/State/ZIP: ' r cyu o CII-W_ ❑Health-care facilities ❑Supply subage file more than C«illl I ❑I I vlydnuti location 600 colts nonoral Suite/bldg./apt. no.: Project name:(Jb\ 11 ]__n 0 Service or Feder 600 romps or more. - FEE' SC EDTJLE Cross street/directions to job size: Description I Qty. I Fee. 1 Total I New residential single-or multi-family dwelling unit. Includes attached garage. _ Subdivision: Lot no.:�', L(w0 Si ft.or less 168 54 ^Ia.add')500 sq.fi or portion — 33 92 I Tax map/parcel no.: ��3 4 " 1iw * ;': 1 Hired energy.residential 75 00 ? n cn '• y, M11F,8C�RJP'�'I(Q)`)' 1 RK t (with above sq.It) . ) New electrical service and ++trio Limit energy.multi-Iamlly f; residential(with above sg fi) 75 00 Services or feeders installation,alteration,and/or relocation 200 amps or less 100 70 2 ,..L10.4.ROPDl 'A4IER= i-;=:❑ TENANT• 201 amps to 400 amps 133 56 2 401 amps to 600 amps 200.34 2 Name: Pt)\ 1_4031r--\ - 601 amps to 1,000 amps 301 04 2 Address: ` b a `,.oOver I.00()amps or volts 552 26 t,, `( j CD /� q c) "rempnrary services or feeders installation,alteration,and/or City/Staler/JP:: v(� /� relocation Phone: -p) to '•'LS,7, D pax: D ) ti2"5„{`-'t`'L V2(10 amps or less 59 36 � I 201 amps to 400 amps 125 08 Owner installation: This installation is being made on property that 1 own which is not 401 ampsto 5amps 99 168 54 2 intended for sale, lease.rent,or exchange. according to()RS 447,449.670.and 701. Branch circuits—new,alteration,or extension,per panel Owner signature: Date: A.Fee for branch circuits with T service or feeder lee. -lam a �> I ®. .O1�TA4T P 1�iSON above secath branch circuit 7 42 , Business name: �� 13 Fee for branch circuits n,flow service or feeder Ice.first 56 18 2 Contact name: rn ° 1 li Ve, (--)Or0 branch circuit Address: rEach add'I branch circuit 7 42 ' • f 1 _ Miscellaneous(service or feeder not included) City/State/ZIP: QX1 CCU ' ` , ' 4 P f't •(¢ , Each manufactured or modular 67 to 1l” u( dwelling,service and/or feeder I > 2 I hone:( ) Fax: :( ) Reconnect only 67 84 Pump or irrigation circle 67 841=.-mall gbre co\-)0-y- , J / Cm/1 Sign or outline lighting 67 84 ! 2 " 'LO ' CTO Signal circuit(s)or limited-energy Business name: Simply Electric panel.alteration.or estenston Page 2 j . 2 Each additional inspection over allowable in any of time above Address: PO Box 822408 Additional inspection(I hr min) 66 25/hr Investigation(I hr min) 66 25/hr City/State/Z11:Vancouver,WA.98682 Industrial plant(I hr min) 78 181 hr Phone:(503)849-8202 Fax:(360)314-4945 Inspections for which no fee is 90 00/hr specifically listed(A hr min) CCB Lie.: 204615 Electrical Lic.: 067 Suprv. I_ic.: 4394S ttECTRiC "PE t11ttf:F $ OSubtotal Suprv.Electrician signature. required: �tfG4, � r S Plan reviess (25%of permit fee) Print name: Victor%arzhitsky Date: 1 117/2015 State surcharge(12%of permit fee) Authorized signature: "IOTA!.PERMIT H I:^ This permit application expires if a permit is not obtained within 181) days after it has been accepted as complete. Print name: Dale: • Nunlller or inspections allowed per)sarin I Budding t.Pcrmitc\dil.C"Permit App doc,17,01!I 0 -140.46 151'i l utc•('OSifS Elf RECEIVED Mechanical:PermitAuplication FEB 18 2016 l OR oil ICE I Si.ON LA • City.of Tigard n lar: l No& ,_,/6 /00 9-0 13125 SW:Hall:Blvd.,Tigard,OR 97 ITY OF TrGATIU Plan Review Phone: 503;718_2439 Fax sn3s9i LDING DIVISIO natelBr-_ csd>�°l can Inspection Line 503:639.4175: DateReady13y two: BSee?atelier Internet y116.w.tiptd-or.gov Notifi hod: Supplement tator aaIIe. ;31`. F..774-4').1-..t...,r n :60-.—t0-7.:,a"v,.art,0 tiiIE a y i e I oar':.- �a ' ' " d. a -.---01797k-r::-.4. u.' °F,7 ' '."s•+�"•" "..-•aM^2 1rICCha[IICaI permit fees*are based on the Value of the War .. la hie*befnsbvetion 0 Additionlaltci atiom+mrtpla Ct 1C1 t pelf Indicate the value(rounded to the nearest dollar)of all mechanical nical matoxis[s,equipment labor,overhead.and profit T. ... ... 0 a yam:S -7 . '�s..c+tcto`'rL'E r—, 4 5. . •- B':a" 1�i`'�'r ,,...,,;,.<v �s_a a k4aa. an i e-? r ,.x _r. z3„ `•* ®i-and 2-..fatuity dwelling 0 Coinmt rcial mdustrial 0 Accessory building For`specid InfonMmton ale diegtiI p 140i-family 15 3 y,C1 Master builder 0 Other Description Qty. Ea. Total '�%`- ai 'ei s � , '5:3 '� len s•� �= , rAarcondifianin : 46.75 may. ,LF R.. r, ) O. 4...0 Pumice 100,000 BTU(duttsf tints) I 46.75 uyt5tatee Ti CCLrios 0 • qI7 14 ... _ Furnace 100.000+$T13 obseisivems) 34,9I ,, p `- 1�pip. 51.06 Suite/bldg./apt.no .6.-.. ,.as . o\ 1 irr o I \\ m Duet want 23.32 {doss_stmifdiipcxions to.job site: Hydroaic hot water system 2332 12esidetiiril,bolter(radiator or hydrouic) 2332 • _ . . Unith s(fuel-type,lwt electric), in-tkail,iii-and.suspended.etc. 46.7$ Fluefveft for any of above 2332 .. r " 2332 Snbwt3�q�C .. Lome.: lJ . • • Odes'[eel tppliiinees: Tiur,map!15.nrcel no > titan msut 33 39 °„ m . _., - ._ 7, .�:s�3.. .�r.:.; u -:.�..».�..�,.� --� flrusasrt: water or gas faoplecc 23.32 L gWiner 0310 23.32 Woad strwe 3339 WOW sreplacernisert 23.32 etiinne Ilii cefwvent 2132 L � -:: a "�- � ' ��"��e -4.-7.........,.$,T,, 7332 [ ^ a; y . 'k : � r:: � l . � f .: .._.y � tskeismtatal exhaust and ventilation: Name Polygon Northwest Range boodfothcrkitchen 1 oqu 1 3339 Address 109 E'i3'a St Clothes dryer-exhaust I , 3339 Single-duet exhaust(bathrooms,+Cityy/3tatefLiP Kaacatvcr,WA 98661 toilet.coarpartme ns,utility rooms) 4 23.32 Phone:(360)0164800 Fax:( ) Ani as a fans 2132 . ....:1.. .«a^ s ek‘74P^€'sE- 1 ,: a, „'—,'" .,,, � 2332 :Paid Rags Bushiest arms Polygon Northwest 51435 for Borst icor;S4,03 far each additional Comaa'nemc. ........... ......._ .... .Furnace,etc 1 •Address:,109 E 136 St Gas i)esn p unp WaWsuspende limit heats amr C ty/Staterz V.ocwrxer,WA:98661 wooer he That=(369)816-7800 Fac:( ) F°t:pike I E-motel: Babe= -:-,V(' ''.,- .-34.1.Z":1 babes aver( other Business name Andersen'Hesting,lac :< x „ u;.J,, t t *'. Ey2e: f'(�Lt .� F,6 T� ,,, s ,-.-_..gym... .. ..� -»+..,..,« , A°ddresc.162$5 iSW:85'a Ave.*419 Subtohd Gityl5t0La+,1P Tlpsid,OR 97724 iafmi mem permit fix(590.00) Plan review(25%ofpermit See:) Flame:{5003)994664 Fax(503)536-6615 State Sut+:huge(12%ofpennit fee) COI lie.:168214 TOTAL PERMIT FEE This permit appticaticei expires' t a permit is not enabled within 180 days atter it his bait*misted as amm➢lete. Authorized signature * fee methodology set by Tai.Caooty Building Industry Service Board Print name Art Atdersen _.__ Date 11/20/2015 , 440.461 Tr(11/CC CO3VR'Ea? L'V�aild�waYamiilNEC�mnlhiV_a W l 1).doc Plumbing Permit Application %Snilding Fixtures RECEIVED roll OFFICE. 1 SE ONLN City of Tigard ,,,FEB 18 2016 > Y Pmnit blo//Mpel/e....x0 ye lir 13125 SW Hall Blvd_,Tigard,OR 9 Plan Review Otter Permit No.: Phone: 503.718.2439 Fax 503.59 . ` - r- rate Re Other 1 i Pole 2 for Inspection Line: 503.639.4175 Lii! T OF T e A R Li Ready/By: Supplemental 2 Information Internet www hgard or gov ; �� 1 i 1 Notified/method: -. ,a _ . "'t _t moi' s- ' ` d" " T,= ,cW--11131j _ 5 a` ' = 1 iL r - ` - For special information use checklist • ❑Demolition Description 1 Qty. Ea I Total ►i New construction ❑Addition/alteration/replacement El Otho New 1-2-family dwellings(includes 100 ft.for each utility connection) _ 312.70 "7 ,, -. _ _Atz9 ',Y " - 3`" SFR(1)barb Ti3 -} ,1 gie SFR(2)bath 437.78 rte. ��,�.�_:..�--: � �._.a� 1-and 2-family dwelling 0 Commercialfindustrial SFR(3)bath t 500.32 5�t?�i_ 1❑\Accessory building 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder /5.39' ❑oma: -Fire sprinkler(_sq.R) . Page 2 Site utilities: _,address: . 1 `^ Catch basin or area drain 18.76 " lob site addrrss: 11lJ �^n' ` Drywc11•leach tine,or trench drain 18.76 City/StatefllP: lxCo OR /'LU1 2 - Footing drain(no.linear R:_) Page 2 Suite/bldgJapLI.Project name: P©\\ n C) _-,0\ Manufactured home utilities 50.03 no.: Manholes 18.76 Cross str eet/directions to job site: 18.76 Rain drain connector Sanitary sewer(no.linear ft:_j Page 2 Storm sewer(no.linear ft_: ) Page 2 Water service(no.linear ft:__) Page 2 2�TaxSubdivision: I Lot no.: _ Fixture or item: Backflow preventer ( 31.27 ,21.- Tax map/parcel no.: ,--,--5.71,,,,:„.z., Backwata valve I 12.51 1.2.5 1 ,.-...-:_-_-,_s-,..7,-.--__,...-,,,.--...,,__ Clothes washer I 25.02 e-5,0Z ....._.---_-=-»_ � '" --__ _. Dishwasher l 25.02 aF5;02 e"Pk1 , l:blelSi►'i-c .t 1 V i K-s'r 3 eiiit43 Drinking fountain 25"02 Ejectors/surnp 25.02 ffE-tix-_ z :.: Y..i.„ s . f•-1:-:=`..1:7 :::.- _:f-�. .- n. Expansion tank . 12.51 Fixture/sewer cap 25.02 NamP01 05-r, " Floor drain/floor sink/hub 25.02 Address: tU 1 'Y► G Garbage disposal ( t. I 25.02 2_7,�L City/State/ZIP: ��n0` , '( Ik q j I Hou bib 25.02 ZGj,rt, Phone: r` Q di Fax( ) Ice makes• ` 12.51 a,C5 , c i e 3:-.--,'-:t'''-: s . lnterccptor/t r �P 25"02 t-TeAr�` :-;,-5--.',-...-,!'",-.7:2-!".'-:747---.",:-2:-:;s. = 2 �rff's'�'__,.�- ..-�.F �: . � Ate__�. _ _ ��`._. Medical gas(vaiuc:S ) � Brrsirtess narric 3 D L U,IM, v1S Primer _ 12.51 }VCO4C1.1:31 (c.JCantednemsRoof drain(commercial) 12.51 Address:t l!0 Sink/basin/lavatory 25.02 CiCity/State/ZIP: 6e7 ete CI !_ �f 6)q Solar units(potable water) 62.54 a 12.51 .25 2� 2._ Phone:�.[��QQ22�)JJ 3�d 3 Fax :( ) Tub/shower/shower- • Urinal 25.02 %lE-mail: !a" 144f0t 'avv vial=closet 25.02 ►� r Water heatu I 37.52 2)1-.52 Business name:'BZI's LLQ Water piping/DWV 56.29 r� Other. 25.02 Address: 1' T het h c 1OIc Subtotal City/State/ZIP: �j.� V � Minimtun permit fax: S7230 P6ove: �) .: ( � 3903 F ( ) Plan review (25%a of permit fee) CCB Lie.: E ab3 Plumbing Lic.Int 1582_, State surcharge(12%of permit fee) TOTAL PERMIT FEE Authorized sigaattat~ I Print name: i Date: This permit application expires if a permit is not obtained within 180 days (� _ • ' / 1.S) atter it has been accepted as complete- • : Fee methodology set by Tri.Cowiiy Building Industry Service Board_ LABuOdinglPomitstPL U-PcmitApp.doc Io#0t D9 440"4616T(10mR:OMIWFB) $ City of Tigard i IlI' COMMUNITY DEVELOPMENT DEPARTMENT i T I G A R D Building Permit Review — Residential Building Permit #: /1S71:20/6 _- 000 y0 Site Address: 6.31004j S4 c 4 s w c1 01-12-i t_ n Project Name: PO 0 0 c - 13 v it MOuel t--oi ky) Lot #: 03 (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: SFR ' 'Verify site address/suite# exists and active in permit system. yRiver Terrace Neighborhood: ❑ No ,Z Yes, See River Ten-ace Review Addendum Attached Site Plan Elements: /Three (3) copies of site plan Existing structures on site Site plan must be on 8-1/2"x 11"or 11 x 17"paper L2Footprint of new structure (including decks)with finished /Drawn to scale (standard architect or engineer scale) floor elevations �North arrow 2/Utility locations (required for new,may apply for additions) Site address,project or subdivision name and lot number Location of wells/septic systems c2Applicant information(name and phone number) /Erosion control (including drainage-way protection, silt fence IZLot dimensions and btAlding setback dimensions design,location of catch basin,etc.) ( Lot area,building covg4ea,percentage of coverage and Street names impervious area (applicable if R-7,R-12,R-25&R-40) Street tree size,type and location `Property corner elevations (2 foot contour lines if more than flExisting trees to be retained with drip line,and tree 4 foot differential) protection measures Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No �� Public Facilities Improvement (PFI) Permit: Required: ❑ Yes,applicant wasp notified ❑ No Applied For: ❑ Yes C] No,stop intake Land Use Case #: S U Q 201 S-00 0 t -Z Ef Zoning: (2 4 , S i Z -0 .-Landscape Front 2..<.) Rear ( S Side S Street Side i S Garage ' Landscape Requirement: 0/0 iLot Coverage Maximum: ,J uildinHeight: Maximum g Height ;0 Actual Height Z Visual Clearance i 2 Easements ©Sensitive Lands: ❑ Yes ❑ No Type Urban Forestry Plan 12'Conditions "Met"prior to issuance of building permit Notes: Approved By Planning: fir) 0 (1 r '* 13 i 1V CL G(,ch. Date: 2/) / t,(7 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\BldgPennitRvw RES 012116.docx Building Permit Submittal Original Submittal Date: 02/cP��P, Site Plans: # 3 Building Plans: # __ Building Permit#: Ea-tn ter building permit#above. Workflow Routing: Q"-Planning - igineering 2-15-ermit Coordinator C'uilding Workflow Sign-off: Sign-off for Planning(include notes from planning review) Route Application Documents: Er-Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. E*--Building: original permit application, site plans, building plans, engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: I >� / Date: Engineering Review Slope at building pad: 7; 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 ❑ No LIDA Facility on lot: ❑ Yes ❑ No El NOT Approved y gineering: Date: (-- Notes: 'Notes: .i. ,..0-_ Viliv _' sir ,str i' Approved by Engineering: Asi&22 Date: Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit Approved,NOT Released:7g12' // Date: Z l Notes: /LGC l�cG 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: 'es ❑ N/A Tigard Trans SDC: [;Q'Yes IDN/A Parks SDC: ❑ N/A ,[kr, OK to Issue Permit 7Yes Approved by Permit Coordinator: Date: 14 — ( 3 ` 11. 1:\Building\Fonns\BIdgPennitRvw_RES_012I I 6.docx City of Tigard a III COMMUNITY DEVELOPMENT DEPARTMENT i 71 ■ T I G n R o River Terrace Building Permit Review Addendum Building Permit #: /7_51.7;20V42 000 'O Site Address: ( SI S 2 SW 1- h 6 av,s L r) Project Name: Po9 qon cit- Boit MO Vr 1 ; 0--, Lot #: (0 (New dtCcllisubdivision name;.Addition or.Alteration=last name of owner) Planning Review River Terrace Plan District Design Standards (18.660.070.1): 1.Articulation: a minimum of 1 element per each street-facing facade that has 30-60 ft. of frontage. An additional element required for lots with over 60 ft. of street frontage shall be provided every 30 ft. Balcony w/ access 2 Window Projection Vertical Wall Offset a Porch min. 5 ft. deep ft. deep min. 2ft., 5 ft.wide min. 2 ft., 6ft. wide Gabled dormer /2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors. Percentage Shown: 1 €3' 3. Entrances:At least one entrance must meet both of the following standards: / Max. 8 ft. setback from longest street- facing wall arallel to street,angle no more than 45° from street, r open onto porch Entrance opens to a porch: / Yes ❑ No If -es, all the following apply: i V 25 sq.ft. min. One street facing entry /12 ft. max. roof height above porch 5 ft. depth min. �30%min. porch roof coverage 4. Detailed Design: All buildings shall include a min. of five of the following elements on all street-facing facades: Covered porch min. 5 ft. wide x 5 ft. deep /Recessed entry area min. 5 ft. wide x 2 ft. deep /r Wall offset min. 16 inches ❑ Dormer min. 4 ft. wide V 'oof cave min. 12 inch projection Roof offset min. of 2 ft. IN Roof shingles either tile or wood Gable,hip or gambrel roof design ❑ Roof pitch oriented south min. 500 sq. ft. ❑ Horizontal lap siding min. 3-7 ft. wide ❑ Accent siding min. 40%of street facade /Window trim min. 2 %"wide by 5/8" deep ❑ Window recess min. 3 inches for all street facing ❑ Bay window min. 5 ft. wide by 2 ft. deep ❑ Balcony min. 5 ft.wide x 3 ft. deep with inside access ❑ Attached garage is 35% or less of street facade 5. Garages and Carports: May face the front or side lot line on a corner lot. Setbacks: No closer to front or side lot line,than longest street-facing wall. ❑ Yes No. If No (Check one): May extend up to 5 ft. if there is a covered front porch and garage does not extend beyond the front porch. /May extend up to 5 ft. where the garage is part of a two-story building and there is a window at the second story above the garage that faces the street with a min. area of 12 sq.ft. Width: (Check one) ❑ 12-foot-wide garage door / 40%max. of street facade ❑ 50% max. of street facade with 7 detailed design elements Notes: Approved By Planning: ✓1/ L21/) i7 l 1 Jo Date: '71/g l/;9 I:ABuilding\Fonns\BldgPennitRvw_RES_RT_012116.docx Albert Shields From: Albert Shields Sent: Wednesday, February 24, 2016 2:51 PM To: 'Maggie Gordon (Maggie.Gordon@polygonhomes.com)' Subject: RE: MST2016-00038, -00039, -00040, -00041 & -00042 Attachments: Conditions -02-24-2016.pdf Maggie,various of the Conditions of Approval under SUB2015-00002, highlighted on the attached conditions list, remain to be Met before we can release these 5 permit applications, meanwhile we will put them on Hold marked "Approved but Not Released." Please let me know when the conditions have been met. Thanks, Albert. 1 , • • • •'. FOR OFFICE USE ONLY—SITE ADDRESS: ••• • • • • • • This form is recognized by most building departments in the Tri-County area for transmitting i>lformation. Please complete this form when submitting information for plan review levernses.�iid�;visiof. I.. This form and the information it provides helps the review process an;rts0811se to•your rtojec� • •••• • • ••• .• 4.. • • City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 1111 Transmittal Letter • :... ...• ▪• - c;A RD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.'io18.2439• www.tigard or.gov TO: Tom H. DATE RECEIVE DEPT: BUILDING DIVISION RECEIV t MAY 2 4 2016 FROM: Angela Grajewski/Chris Walther CTY LDING OF TIGIV�s` 1 on Northwest ►BUID CN COMPANY: Po yg PHONE: 503-312-6213 By. RE: 15396 SW Thames Ln MST2016-00040 (Site Address) (Permit Number) Polygon at Bull Mountain LOT 63 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description:` Copies: Description: 0 Additional set(s) of plans. 3 Revisions: add covered 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 the covered patio option FOR OFFICE USE ONLY Routed to Permit Technician: Date: S.")o,C, I) 4 Initials: Fees Due: ® Yes ❑No Fee Description: Amount Due: 0 ,S ).-)r p)c.v, rc v c\,,/ $ tis $ +� �I4° v+� p o.'1" •d CoC. V e,1/ /9-i tf/Al F6 $ ys':et Special .4}-,6,6 ji) I/9ZtC4-770n/ (r9-6eCG 1-4-7d-i_ S Instructions: /e.E-e,.4ti C. /671-/l i T" Pre-5 , Reprint Permit(per PE): )Yes ❑No n Done Applicant Notified: ate: Initials: I:\Buiiding\Forms\TransmittalLetter-Revisions.doc 05/25/2012 _ J 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 15396 SW THAMES LN, TIGARD, OR, 97224 Residential - Master Permit 399 Plumbing ﬁnal PASS MST2016-00040 Chip Barnett 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 15396 SW THAMES LN, TIGARD, OR, 97224 Residential - Master Permit 199 Electrical ﬁnal FAIL MST2016-00040 Herb Stabenow Not ready Danger live wire out at meter base 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 15396 SW THAMES LN, TIGARD, OR, 97224 Residential - Master Permit 699 Mechanical ﬁnal FAIL MST2016-00040 David Young Seal all penetrations in mechanical room. Note: no AC installed at this time, permit and inspections required at time of installation. 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 15396 SW THAMES LN, TIGARD, OR, 97224 Residential - Master Permit 299 Final inspection PASS - C of O MST2016-00040 David Young Correction complete. Final erosion control approved. 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 with contractor on site. Violation Summary: Inspector Contractor lel' Electrical Permit A licat10 .,,_ FOR OFFICE USE ONLY City of Tigard q,.Y� a fes,-. Received CII %., '� 13125 SW Hall Blvd.,Tigard,OR 97223 Date/B : ! /f /� Permit°: A T" l / —I tag 0 ' Phone: 503.718.2439 Fax: 503.598.19605 EP I !� 2016 Date/B Plan view Inspection Line: 503.639.4175 Ready Date/By: 11111.111 El See Page 2 for TIGARD Internet: www.tigard-or.gov ��``1-''y O 11 z',3,'"\';-:.1"0, Notified/Method: Supplemental Information r..:t1 ! 4.,,'a . 1:1 . z 0... 'Y'YPE:OF `. 1 Is ki; t4i PIAN RTVIEW ®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): 0 Demolition ❑Other: ❑Service or feeder 400 amps or more ❑Building over three stories. where e available current 0 s ,,, CATEGORY" OF CONSTEITCTION",:„ exceeds 10,00 ampfault at150 volts or ❑Floating buildings. ® l-and 2-family dwelling ❑ Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family 0 Master builder 0 Other: ❑Fire pump. ❑Installation of 150 KVA or JOB'SITE INFORMA`1ION,.-AND LOCATION ❑Emergency system. larger separately derived Job#: Job site address: '5 f t �\"t�/]-maims�' Ln ❑loo pAddition of new motor load of system. 3 `� lZ v v +f • Md�v4t? 100ftP or more. ❑„A,,,<.8,,,•.L2,,,a1.3,,, City/State/ZIP:Tigard,OR 97224 ❑Six or[Wore residential units. occupancy. ❑Health-care facilities. ❑Recreational vehicle parks. ;Lr__t f__.or RS_ 1314 Hazardous locations. ❑Supply voltage for more than Suite/bldg./apt.#: Project name:Polygon at �icrrerser ff��JJ ❑site: ,(�� El Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to jobm FEE SCHEDULE _ ; Description ' Qty. I "Each "I Total 1 'New residential single-or multi-family dwelling unit. Subdivision:Polygon at 11 Lot#: (es Includes attached garage. Tax map/parcel#: `f' 1,000 sq.ft.or less 168.54 4 _ , DESCRIPTION,OF'=WORK n 33.92 1 Ea add'l 500 sq.ft.or portio Limited energy,residential {with above sq.fr.) 75.00 2 eYO ✓ Limited energy,multi-family 75.00 2 residential(with above sq,ft.) igh,g,) QPERT:Y OWNER. _. . '.., :::.. n" ENANT,' Senvweas oer fneedregrys installation,al❑eraSeonP,atd2/o r relocation Name:ADVL Lan i Holdings, $a ntt 200 amps or less 100.70 2 201 amps to 400 amps 133.56 2 Address:7600 E Do ,letr• •anch Road City/State/ZIP:Sco AZ 85258 401 amps to 600 amps _ 200.34 2 601 amps to 1,000 amps 301.04 2 Phone:(602)69' ,.031 Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is being ate on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange, ording 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 ®° 1LrcAPIT „' .. „ ❑ CONTACT,PERSON $ranch circuits—new,alteration,or extension,per panel ' `"'--°� �^' � ' '"• A.Fee for branch circuits with Business name: poi td on w L,'ti �._ above service or feeder fee, 7.42 2 J t each branch circuit 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'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(360)695-7700 • Fax::(360)693-4442 Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email:Angela Grajewski®polygonhomes coin Reconnect only 67,84 2 eilliktelifilitelittifigagg0,0AdciliblillaSalagekialifilliaga Pump or irrigation circle 67.84 2 Business name:Garner Electric Washington,LLC Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address:6101 NE St Johns Rd panel,alteration,or extension. 0 See Page 2 2 City/State/ZIP:Vancouver WA 98661 Each additional inspection over allowable in any of the above Additional inspection(1 hr lnin) 66.25/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 Lie.: C1158 Electrical Lie.: 208174 Suprv.Lie.: 4496S specifically listed('/2 hr min) 90 00/hr __--._ — ___.. ELECTRICAL PERMIT,FEES Suprv.Electrician signature,required: ":41p l — .� A. � ;�. ,. Subtotal. Print name: Joan P Albert • Date: 4/26/2016 El Plan Review Required(25%of pennit fee): —� State surcharge(12%of permit fee): TOTAL PERMIT FEE: Authorized signature: /: a-•- ' 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 inspections allowed per penult_ 1:\Building\Permits'aLC PermitApp_ELR ERE_doc Rev 06/17/2015 440-4615TQI/05/COM/IEB 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 15396 SW THAMES LN, TIGARD, OR, 97224 Residential - Master Permit 199 Electrical ﬁnal FAIL MST2016-00040 Herb Stabenow Not ready Danger live wire out at meter base 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 15396 SW THAMES LN, TIGARD, OR, 97224 Residential - Master Permit 299 Final inspection FAIL MST2016-00040 David Young Provide approved mechanical ﬁnal inspection. Provide chimney cap on ﬁreplace chase. All else ok. 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 15396 SW THAMES LN, TIGARD, OR, 97224 Residential - Master Permit 699 Mechanical ﬁnal PASS MST2016-00040 David Young Corrections complete. Violation Summary: Inspector Contractor