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Permit CITY OF TIGARDMASTER PERMIT ` 4 , IS ri 7r”r.,7 n COMMUNITY DEVELOPMENT _.` .;'' Permit#: MST2016-00083 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 0 /2/7/4-- ' Date Issued: 04/28/2016 2S1080001506 Jurisdiction: Tigard Site address: 15335 SW MISSISSIPPI CT Subdivision: POLYGON AT BULL MOUNTAIN Lot: Multiple Project: Polygon at Bull Mountain, Lot 79 Project Description: New SF. 6/15/2016: REPRINT permit to reduce bathrooms from 4 to 3. 10/28/2016: Add NC and 2nd water heater. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1589 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 32 Bathrooms: 3 Second: 2148 sf Garage: 661 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3737 sf Value: $455,573.43 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: 2 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add.]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 3737 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: $35,400.04 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 0Allifiiii1-0090. 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: 1 L I / Permittee Signature: �� ��C L�''���f1 N 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. Aletthalyit,... ea E.,„ sot 1312) Nei Blvd Tinrd ot rz23 , . , . . . FOR(11-11(El SE(i\EI SE3710V2!6D : . . . . -Eitif of 11Pfard Re...,,,,,e4 - oproor/e/c;i7/0 < 4/— PctmlNYtetr.....c720/6-eo _3 Plan Review •- • Pon 56.3 711i 2439 Fax: SO-3 598 1960 illteiiiy: Other Permit. _ . . . . — - . . .... . — . . L639A 175 fISpliell itm. 303, „.., . ... Tr(ARE) IeeCITY OF TIGARD Date Readyrii).;. Twit' j. ,a See Poge 2 for . .4ntenicii www,tiatard-er.a.ov BUILDMIG DIVISION Netiaa'Nkthd: Supintitnentat intertnation - . ' , .. •f'"'' . • .' . .TYPE OF %OAK : ' .' ' .. .. -:- C°MMIRC141'r FEt*sOTEDYLE'•PsE.01E(ICLIST Mechanical permit fees";are bawd on the value of the work NeW cotiStruetio.o 0 Additiortfalterationimplattement • performed,Indicate the value(rounded to die omen dolled)anti El Demolition 0 Other, mechanical material&,0.11: twat,labor,overhead.and froth. Value:S ":',.. ' ".: '' " - . ''''• - CATEOORY•OF.CONSTRUCTION ':'..•.... -'''' • :-'. .. ‘• ' :: ,- ..;._- - -- -..... . -.- - '" • ' • - - •--,,- -: • - --', - I .:-,.......,:?::11t.;s1DENTIALEQIIIIIIENT..i SYSTEMS FEES* ; , -.- 0 1-and 2-family dwelling 0 Commereiallindualtini 0 A.CreSSOTY building I For spedal Information 145.e Meat& LO Multi-family 0 Mister builder 0 Other: I 1)=.riptientoy. 1 mt. 1 Total " '. JOB SITE INFORMATION'AM) LOCATION •• - • :ratta'ittlidb.:: .,_I . . . i .Aineseulitinnin' 75 III 6. J°"*8841::‘''s's.„ /535.-- 5Kfcei____ .- 000-0i, - 11111 ' Furnace Rift litattetskerta. 46;75 111111 City/StateRIP:Tigard,OR 97224 Furnace 109,090+Bid:doctithaintal: ' Heal pump MA 1 Suiteibidgiap(no.: Project.=net P4,1ygOtt at Roll Mountain DIM WO* 23,32 Cross atreettditectiorta milk shot (13,drouic hot water swan 2332 Residential tioilet(radinter or hydrainic) 2332 I - --, , Unit hettim(fael-tyne,not electric), * ini-wall,iniattnet suspended,eic. 4 4635 . ‘. Ffitekeill far dtv.., J t 2332 „ other Subdivision;Polygon at Bull'Mountain Lot no.: 23-32 Other litel noplisineas. Tax nutplpe(eel no.; Water ft-eater• 2132 .-•.; .• ....:. . , ..' :. oEscgotto* OF':.*oitk,.: • ..:-'. - . , (348 firePlvA'4°5°•4,.. . 3,3,39 Flue veal fot warei-heater nips i I It It I i Ati A..„ ' ti .-one 2337 I -IIIIIIIIIIIIIIIIIIIFIIIIMMIPIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII " Iklikr t'rm° 11111_,..1121111 IIIII 33 19 irtATFAIIIIiii. Wend' fi iiia lauctiosen 11111.. 23.32 Chimneydinintiluefvent 13.12 ' •..-. ,. 1 4 PROPERTY-OWNEIL: : ' •--,'.' . a TENANr - 1 z3:32 ,-.. .'. . - . . , ' - :-' Environmental exile ust and ventitation: - I Name;Polygon WL/1.LLC Range hoodionter kitchen ! equipment I . 33,39 Address;109 East le Street i Clothes diver exhaust 1 33.34 i • — CityiStattealie:'Vancouver,WA 9866•0 Sinate-cluct exhaust(bathmoms, I I 4340 eoniPannients,utility rooms) '1 23,32 I Phone:(360)695-7700 Fax( I Atticierawispace faits 2332 I -a--ii .._ . . . . .,,,_ 181:ArniCANT.;- :-,. ..-,:!: :::: :".: JJ.cO .T.:AcT.PERSON'.--::-. :,.,, "um : 23.19 . Fuel Pining: Business:nu:net Polygon W131,LLC iktr liot!Our:$4.91 lanae atittitional Contact name:Angria Gtajewski Furnace etc. 1 . : . . Addrom 109 East 13th Street Qua heat pump - Wellistispendeddinitheuter_ I _ City/State/4P;Vancouver.WA 98660 : Water heater ! : Milli Phone:(360)695-7700 Fax::(360)693.4442 • ; Fireplace I ... fl,mail:Angela„Grajewskrkpolmothomes.coin Bathecut :. . CONTRACTOR Clothes dryer teas) - - , r Other Otisiness name:Apex Air LLC , mmumeAs.,PERMIT FEES*' •- •• Address:18004 NE 72.4 Av:e 'Subtotal I ... City/StatetZIP:Vancouver,WA 98606 .... Mmum natant*($90.,(tm _ Plan review(2504.oromitree) I Phone:(360)342410 Fax:(360)326.4769 . Stateserchaign 02.114 of pootait fee) I CCB tic.:203034 TOTAL PERMITFEE, ' This laaaanitauptication expizad Ks Omit is nntnignincit within 010 dnys Itite,"it hts beta earpted as rimplete. Authorized signaut& ,, # tree methodology act lay id-CoitsV 1304440 lednairy Saraine Bawd IMT nunterr-7i.^ ri I Date: tUfgiiding',NmiWAIECINnhitApp.0401t.tdod 440 7i' •• - - - - jr;1,etrieal.Permit Application _ IV . . .... . .. „. , . RECEIVE • . . f tilt Of FR L : • . . ., .._ City of Tigard SEP 2 0 2016 ,R7113ved,, /6) At 4' fly -..itii/-ke-7-_ .7/c, ----p e)d__-3 13)25 SW Hall filvd„Tigard,OR 972'..13 Plan Review - Phone 503,7111.2439 Fax 503,598,1'Zi TY OF TIGARD.Daletr CP:44m1PaIlliP PP ItiSpention Line:-503,639,4175 BUILDING OIVISIO '-',04ar- I.6,. 0 &strata 2 for Internet www.tigard-or,gov ' i:ottlierkMethod: Supplemental informaillan . . • — -:. . i::,.._!.-..„:1‘;4c..t ,:,,, ,Ay,s3t.:iiii::;:-•fil:',..,,i;ki.1::81*-19 ,*:• 1kg-,:_.;..•:-;'•-;''.- ,i: ::iI -,';:.-1Z.:".;:,4-:::; :":3-','':' "', ,::!":: :-.;.:'7 .'.7':::,;:.:'.:r.FUN. gt.k.WtiVri-34'.;.i.:',7:;::f'.7.-'7-;-.'. tr'.'•.:1'.',:if-5' 0 New alnstruction 0 Addition/alteration/replacement Please chock all that apply{submit 2 sets of plans willems cheekke4 El Service or feeder 400 amps or more 0 Building over dues stories. 0 Demolition 0 Other: where the available:huh eurrent a Mariam and boatyards, -;:;',',.--i,--. .:‘::::-;•':i74,i:'-4-,•,:1::,- !-:---4f.ifg-.471.g0010.:9I%C(firtiStROCTIOCj...777exceeds 10,000 amp-at 150 volts or 0 ftmang buildings, :FT1 /-and 2-family dwelling 0 Commercial/industrial ED Accessory building tens to ground,Cr cxceeds)4,000 0 Oxmaitsminktst agricultural amps for all other instalintioas buildings. 0 Multi-Cattily 0 Master builder 0 Other: 0 Fire pump. c]instalomi of 1$0 KVA or .?";*---Ti-21'...- :";:al -f•'.::'-----T:,:"T.10/PSITrEsW01131.-ATION"-ANDLOCATION; ,.2`,;,--,':- ', ? .:,_-/'',:: 0Emergency System. larger•separately derived — • 0 Addition of new motor load of system, Job//: : Joh site,address p i i s ..•r,i#P. 1001IP ur more. . ©six or more residential units, occupancy. Cily/StateiZIP:Tigard,OR 97224 011ealth-case facilities 0 Recreational vehicle parks. 0 Supply voltage for mora than Suite/bldg./apt.#: Project name:!"4r)ift7: n e 11--b bi Mf-,,1.1 ,r, 'Eser,144—d,ce,:fl,atio.o.s•amps or mom, 600 volts nominal, _ . • ii, &,,ii j ' aei-..4L Cross street/directions to job site: 1::."-','- -:•':;":'---7.'•5- .F.,g$:,: Description 1 Qty. 1 Each I Tow 1 * New residential single-or millti-familj:dwelling unit Subdivision: ,ddr-bwuil lAa-- v.jat At Lot#: a Includes attached garage, Tax map/parcel#: 1,000 sq.fl,or less 1 168,54 4 ..''.'_,--.f.--'1'..,-,:14-•,Y(-.'.,'":-- 4'' ;" ''--".itiESCRIITION OF WORK: •:i-T:., :•':.'s,,I.:',..t . Es.add'l SOO sq:.ft or portion tap 33,92 11 21.i Ali ( A ilk iffrgiliglinrMIIIIIIIIIIIIIIIIIIIIIIII t A AL, IIIIIIIIIIIIIIIIIIIIII Limited energy.residential 750, (with above sq.ft.) Limited energy,maid-fatally75.00 2 icf,',..iyitiptittlittW-DwArit•-•,;,-:-;..,"77-7: --_,,.....-7,-r,- 4,„1:;.-. ..5.0:1-trii.w,!..*:-.,,.4-.,± ;,.--.-.-7:,!:.!::., residential(with above sq..11.) Natne:.ARVL Land Holdings,LLC Renewable Energy 0 See Page 2 Services or feeders installation,alteration,and/or relocation Address:7600 E Doubletree Ranch Road 200 amps or less 100.70 2 City/State/ZIP;Scottsdale,,AZ 85258. 201 amps to 400 amps 133_56 2 Phone:(602)694-4031 Fax:( ) Email: 401 amps to 600 amps 200.34 2 Owner installation:This installation is being made on property that t own which is not 601 amps to 1,000 amps 301.04 2 intended for sale,lease,rent,or exchange,according-to ORS 447,449,670,and 701. Over 1,000 amps or volts 552,26 2 Owner signature: -- • ...-- _ - Date: " 7 t. 13:,411740-4 , . AP*PariO.::,, Temporary services or feeders installation,alteration,and/or '.:e,•'_-, ',.:::'--r .-.,1.-::::::-:-'_.'.' S- 10:**.C. Business name:William Lyon Homes,Inc. . - ;on amps Or less 59.36 1 ' Contact name:Angela Grajewski 201 amps to 400 amps 125.08 1 .,.. Address:109 East 13th Street • 401 amps to 599 amps 168.54 2 City/State/ZIP:Vancouver,WA 98660 ••- - Breach circuits-new,alteration,or extension. er panel Phone:(360)695-7700 Fax::(360)693-4442 A;Fee for branch circuits with • above service or feeder fee, 7.42 Email:Angela.Grajewski@polygonhornes.com each branch circuit . 2 M7,••-••,;?, :?•.',.'Y',--.i','7,-*...i.:4",,,,• ii-ii:-.•lit';•':4;.,L:C.ii5,. ....'citiiiifRA-ittiiit:., 7--..' " :,..i:4;1:g,-ir' -:'-''i.'..';'.;!'" "':7'.:- :,,,..--, 13""Fee!br b121/61 circuits with°"1 -r.. service or feeder fee,first . rBusiness name:alameda electric ., branch circuit 56.18 2 Each add'lbranch circuit. 742 2 Address:.3415 tee 44th . " , ; Miscellaneous(service or feeder not included) City/State/ZIP; MM m j „/ ,9/2- 4, -.W.-/ •:.- Each manufactured or modular ”67.4 :. 2 dwelling serviceandior feeder Phone:(503)3192192 Fax:( ) . .:'..-,. . - , • Reconnect only 67,84 " -:- : 2- •.. Email:solairpdxghne.cont , Pump or irrigation circle • 67,84 ' '', :•2.'"2;.'"! .... CCB Lie.: 199188 Electrical Lie,: c923 Suprv.Lie.: /(7/5 . .. • . , •. •_ , ... , - . Sigwor outline lighting • . " - 0,84 - , • Suprv.Electrician signature,required: . , .,.... ,, . Signal circuit(s)or limited-energy " 0 StePage"2, . '.-"*". - 2,- Print name: t ik 2.0474,..,C Date: (-- 23 • /1,1 panel,alteration,or extension. Eicft additional inspection over allowable in nriv Of the aboVe,. Authorized signature: -.- Additional inspection('hr min) ' ,i 6.6,25,hi' *:-- ''...;•:. '-..' I . , . •",-. .-,.- ..Print Tiarne: AL - .. ....„...e ‘..-----.... DEtie.is-, 2.3 „1.74" Investigation(1hr min) i I 90,0(illit• ,'':, ,.. . ' ,,,,..„....-- • eauil.4intrenniu.NRLC_Porosktipp ELR ER.E.doc Rev 05.1 712011 440-461.51111/D.5.COM/WER . •' • .1...:, . , • - - IR '' Plumbing Permit Application, Building Fixtures Rate Date/By City of TigaTd Permit Na 13125 SW Hill Blvd.,Tigard,OR 97T23 /�' `�� �/�' e��� Plan Review Phone- 503.718.243:9 Fax: 503.591E i 60l7ater734: Other Permit No.: Inspection Line 503.639.4175 T I G A it D Date Ready 14: Tuns, fsee Page 2 for Internet: wuwtigard-or.gov Notified/Method: Supplementaa information 4 ®New construction Q Demolition For speciul information use checklist Description 1 Qty. 1 Ea. ( Total Q Addition/alteration/replacement 0 Other New 2i-2...family c 00 ft h utili GoR 'fi d . SFR(1) y - } it dwelCings(includes 1 €oreu , ty connection '- ��. .__. 1 ' ' �.,. � r bath 312.70 1 and 2-family dwelling ❑Commercial/industrial SFR(2)bath 43;�78 ❑Accessory building ❑Multi-family SFR(3)bath i 500.32 Each additional'bath/kitchen 25.02 0 Master builder ❑Other Firesprinkler x �7Y3 S R Site uhhties ( Page, ft,) 2 Job site address: S'w, t yj"r �t : Catch basin or area drain 18.76 ,, l t Drywelk leach line,or trench drain 18.76 City/State/Z1P:Tigard,OR 97224 Footing drain(no,linear ft,: } Page e 2 - Suite/bldg./apt.no.: Project name;Polygon at Bull Mountain Manufactured borne utilities 50.03 Cross street/directions to job Site: Manholes 18,76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page:2 Stonn sewer(no linear I1.: ) Page 2 • Water service(no,linear f.:. ) I Pagel Subdivision;Polygon at Bull Mountain Lot no.: 19 l isttire nr stern; Tax map/parcel no.: Backflow preventer 31.27 ` a e Backwater valve 12.51 /-7,--C-",-7-677--- f totlit s yvaSher 25.02 �1 r,' /- t "!�- -- Dishwasher 25.02 Drinking fountain 15.01 Ejectors/surrip 25,02 t a t' f18QT]" @41Y12 = Q TICK c` c Expansion tank 12.51 Name;Polygon'%Iii.:LLC Fixture/sewer cap- 25.02 Floordraintfloor sinkmliub 25.02 Address:109 East 136 Street Garbage disposal 25.02 City/State/ZIP Vancouver,WA 98660 ... Hose bib 25.02 Phone:(30)695-7700 Fax:.( ) lee maker 12.51 Interceptgr/gr ase trap 25.02 Business name;Polygon WEB,LLC Medieal'gas(value;$ ) Page Z Primer 12.51 Contact name:Angela.Grajewski Roof drain(commercial) 12.51 Address:109 East 13th Street Sinklbasin/lavatory 25.02 • City/State/ZIP:Vancouver,WA 98660 :Solar units(potable water) 62.54 Phone:( 60)695-7700 Pax :(36d1}693 t 42 Tiiblshoiser/shoyverpgn 12.51. E-mail:.Angela.Grajewski®palygonhomes.com [rinai 25:412 GVa closet 25.02 a4 ` " --^' r .iter heater ) X37.52 Business name:BOL Plumbing LLc. Water piping/MN, 56.29 Address:PO Box 85 Other: 25.02 City/State/ZIP:Corbett OR 97019 Subtotal Phone:(503)'351-3903 Fax:( ) Minimum permit fee; $72.50 CCB Lie.:1S0345 Plumbing Lie,no.::!'131582 Plan rectt,w (25%o€perrtiji fee) :State surcharge(12%of permit fee) Authorized signature: L /' TOTAL.PERMIT FEE Print name:.Brandon L anter' Phis permit application expires if a permit is not obtained within 180 days 1?ate 8 Jno�I co after it has been accepted as complete. *Fee methodology sot by Tri-County Building Industry Service Beard. isBuiidiny;PermitsPLMti-PemueApp.doc 101ti/ti 440.461er(10i02/(7QMWER) CITY OF TIGARD MASTER PERMIT 11114 �t Permit#: MST2016-00083 1 - COMMUNITY DEVELOPMENT 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/28/2016 TIGARD Parcel: 2S1080001506 Jurisdiction: Tigard Site address: 15335 SW MISSISSIPPI CT Subdivision: POLYGON AT BULL MOUNTAIN Lot: Multiple Project: Polygon at Bull Mountain, Lot 79 Project Description: New SF. 6/15/2016: REPRINT permit to reduce bathrooms from 4 to 3. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1589 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 32 Bathrooms: 3 Second: 2148 sf Garage: 661 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3737 sf Value: $455,573.43 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: Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 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 3737 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: $35,260.66 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 0 952-001-0090. 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: QA/ e","4./69770/1f 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. 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 IV 111141 Transmittal Letter T€(JA R t) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Tom H. DATE RIftEICTIV ED. DEPT: BUILDING DIVISION MAY 17 ?016 FROM: Angela Grajewski/Chris Walther CITY OFTIGARD COMPANY: Polygon Northwest BUILDING DTVI ION - PHONE: 503-312-6213 By: RE: 15335 SW Mississippi Ct MST2016-00083 /S 51-4-'6---3 (Site Address) (Permit Number) Polygon at Bull Mountain LOT 79 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copus Description: ' ' _ Copies:,..:.Description: =#' 0 Additional set(s) of plans. 3 Revisions: WIC/4th bath change 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: Removal of 4th Bedroom bathroom into Walk-in Closet --iti, FOR OFFICEUSE`ONLY Routed to Permit Technician: Date: b f a.j i 6 Initials: 4-J Fees Due":"-E1 Yes ❑No Fee Description: Amount Due: s'' ,\ I Or ploo" rtV'm,J $ 90 430$ ...< ? 4 $ Special (3) 00-.f77/7200 S CS i [MS)) ( 3) 174 6/Cie- zt.)E77.s j (i M-unizsgie Instructions: 7729 y (3 hq rz C i. c'SETS, ( .) (1, --iv7- , .i Reprint Permit(per PE):' — Yes ❑Noone Applicant Notified4 /r' Date: ( /5 /;�a 49"-/q-7/__ I�Initials: ,( I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 CITY OF TIGARD MASTER PERMIT II S COMMUNITY DEVELOPMENT Permit#: MST2016-00083 Date Issued: 04/28/2016 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S1080001506 Jurisdiction: Tigard Site address: 15335 SW MISSISSIPPI CT Subdivision: POLYGON AT BULL MOUNTAIN Lot: Multiple Project: Polygon at Bull Mountain, Lot 79 Project Description: New SF BUILDING Floor Areas Reauired Setbacks Required Stories: 2 Bedrooms: 4 First: 1589 sf Basement: 0 sf Left 5 Parking Spaces: 0 Height: 32 Bathrooms: 4 Second: 2148 sf Garage: 661 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3737 sf Value: $455,573.43 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 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 3737 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: $35,148.98 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 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling.. 98 5503.232.1987 or 1.800.332.2344. ,� /// Issued By: Permittee Signature: C,Ar `7 �ei e�nn'" Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the Job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application E;671miminimmifiiiiimiv: LS 3 l . k yafy,P'. , Via! RECEIVE City of Tigard A Q Received eiv / Perm�tNq S /6 Maj".3 13125 SW Hall Blvd.,Tigard,OR 97223 MAR 8 2016 Plan Review /� • S I Other Permit��ie ��77 Phone: 503.718.2439 Fax: 503.598.1960 DaWBy: � ��J f � /� �P79G0rpt'p Inspection Line: 503.639.4175 CITY'Jr TIGARD Date ReadyBy: Juris: See Page 2 for ' 1,1, g BUILDING DIVISICI�i Intemeti www.tigard-or. ov oti5ed/Method: Supplemental Information F s .. ,...w,.:u.._ _: :M.4....:: ,. -.n kn...t...,rs u .�..-€. au. _..aa .w......,,:w,. ...�z,..�a .RG,.wa.._L�s���':.a' k... .v,9 ®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. • B? d r..,'°.;:-.,:-.-,. .- C`> .., 1� _ n yn ® 1-and 2-family dwelling D Commercial/industrial Va]uationG l� 3 $ (� ❑Accessory building ❑Multi-family Number of belooms: 4 o Master builder ❑Other Number of bathrooms:"".17.5... 0 4 7 (r , g {,':to 4 & F`� Total number of floors: :Fr Job site address: I 5 t 5D \Y1,�� 1 New dwelling are. a`7 3 7^ square fe4 3 9 511 City/State/ZIP:Tigard,OR 97224 M 15515 S (1tp P 1 Garage/carport area: Lcko 1 square feet Suite/bldg./apt.no.: I Project name:Poll(3-on cA, i5,.)r\ n Covered porch area: ` square tt a 4 g Cross street/directions to job site: Deck area: fp square )s 8 9 _ Other structure area: 4 square feet } `est �� �� - Subdivision:Polygon at Bull Mountain I Lot no.: .31 1 Permit fees*are based on the value of the work performed. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the t.. = '- work indicated on this application. n 1�3 lu �N.A P a Valuation: $ Existing building area: square feet New building area: square feet t Number of stories: 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: r , :�.. .':.. T .._�_ � ._...-.:.�. _�.._....,..<.x.�a --�,.._.. _,...;i._._._�zei,..�.....,....d......f._mat_.,,.& ys„�.�.�. •, ". t � x k Business name: P 0 ,� Ll L n C Structural plan review fee(or deposit): 1.,,\Contact name: 1 \ a \_e. (Occ\0-1Th FLS plan review fee(if applicable): Address: I O Q F7-4-4Th - (� Total fees due upon application: City/State/ZIP: V 1 O i� \W elr f \ Cr f `,0 Phone:atpO) l9(k . 1---4-00I Fax::Nee) U -u222 Amount received E-mail:maggie.gordon@polygonhomes.com ' , '- i ,• _ ' =,`+" ` ' `ti .f roof ttoop mounted �� Solar P em.. ential prescriptive installation of • p PhotoVoltaic Solar Panel System. Business name: b ' , W i - 'n C Submit two(2)sets of roof plan with connection details � and fire department access,along with the 2010 Oregon Address: \0 q ri 13 �I-T, Solar Installation Specialty Code checklist. (lin V �CoU0CA A `(1 st0(0�J Permit Fee(includes plan review $180.00 and administrative fees): shone:61p0) b a 5`1;4-00 Fax:( D) LOQ3 ' '\222 State surcharge(12%of permit fee): $21.60 ``J' CCB lic.:204238 Total fee due upon application: $201.60 Authorized signature: , ( This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Print name: Date —2.1-Is, Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) • M schanical Per 1itAPOli 1.oRUt 1 lCE LSL-ONL1 • :- . CEIVED Rttaved Parc No. STa0i6-OOO 83 Cl!ty nf`Tlgar� liatG>3r 13125 sw Hall 81Vd.,Ttgardt,.O.97.2.3. 1.1y,4,.., ..... C Plan ltaVkW Puu,t Phone 5037183439° Fax 5035981 IAR 8 2016 taiei r : °tom .tm i.mc.• 503 639.4175: Da Ileiti BY ? id Scapaee y fur _ CITY OF TIGARD i i i. r t` 3votdiodit4ethod Supplementaiinfot eatioti. !Menet: www tigard-or eoV BUILDING DIV1$I0�i ,x '✓o; Rifiit J E scsJ`n SE C>“iSC. -Dula— . ;,re V,'.' .TYPE OF,vtnui, '` . al f ih v k ... bused on the'v ae o e u Mccttanttaltpesfees' . s value.(rounded to lite nearest dollar)of all 121 r3arr constritcuati 0 tiddlUontalteiauon, iaceittc[tf 0 inerlisnical.matcriais,equipment,labor,overhead,and profit .. - °° ❑Other' Yalttc 5 eft,IV f'.; '`-CA'YFGDA3.1P * i] if) *: AESTDE4 r. >dr�-I SYStEIIIS" Si. EQ building For speiial infarmotioa sse.tbecklis. ®1 attd 21'stritly dwelling 0Comtis�resal/in3tsstnaI 0 Accessnsy �� Qt.-Y. Ea. Total ElMulti'faintly 0 Master builder ❑Other. 1, 1leattnpJei tion. ,, 8 rLis r�u�f5 Il o1LM ox ?r;7A -3'3i-x _k._ ' :_. 46.75 Asr con.... . g Job•stfe I _Jb ,J1i0 r - -PPl Fiimaci loo ooil B`t`IJ lductsiir s) I 1 46.75' tY/stttr -rl Jr � G Z��.... Fursmace 100 000+:STU(dudsdventsl x:91 Beat gip: 63,06 ` t fto.i 1 Projeet.naute: Poly 3,511 ( 'BJ 11 M`c I T)uct*veil Sittatbldg:/ap 2332 liydronic.hot water system 2332 ob.site: i�ass-sttt�ldii'echgns to.J, Resideitiisl boder(ra8i�or or ti. 2.132 hydrowc) • ' 14trth4teri(file)41 fl eteettic/ isi-4alL i dart*,suspended.tic. • 46.75 Flielveptfbraiiyof abase 3332. .. .2332 ' St�bdlsysssaa: - ---•• -... .- Lot.no.t .O hsr fnei mppiamcei CV. rfiari�c 2331 Taz xtaplTiareel na - ''—lacelttsstrt' 39 -. -e2=-.- "._. ' igri' (itti 3!* 3'0_*='- r „�.^�- k;' . , .. . :for water he ictus gas furP33 2332 Logii (_ts0} .2132 ... Woi stove 3339 Wotstl:£o`eg-tacrltiiscrt. 2132 thivin y/liue3'Sudyent° 2332._ 23.32 � . _., d' � 4 '£nilroutiiepital exhanst and'ventilation: Flangehao i/ather3:itchea Hata P`.. iVarthwest equtptaeiit` t 3339 *chess.10 .1.., St .Glotbei&yeriexhaust t .3339 .__..._. ....... _ :Sist yklx-ict rill n<t(1304foonis., - tstty/&nie/ZTF ,S4' 98661 lotld:t sspa hatcnts,:uttlstyrooms) 4 1332. -Pliaiki:(360£464g00Fan.'( ) a :: AittiOritilepate tate e 2332 'Friel o-0.4w •SIMWOO .._. ` ... fies Polygon 1�Iortlnt - $14:I5 for fast four.$ forestal additional .Furnace,rias i Ciinlai 'aemc: • .•.._...... - Cas:l>csil tsinp-. ::.... : . :.14 E]3a' . .. wit111isttspendedhinitbeatef. Ctats '3fancouver,3YA:98661 Wrier hcacc[ ::,:: ; Fate:( ) Flieplace. Piiorie{369)816X808 ,.. lima@, l3acbecst• Other, ` • ins s t liiiie Andetsert lati,.inc .'i IIt l .. ,S._ .�«�'-d .�:: A 1_• $1**i*Ave Sita 419 . .. .. lvfmirmim•permit fee(590.00) GitAs?u+ '?"t;:ai-1,Dit:97224 .Platt ttiiiiew(25%of_peimit fez)- Pho�rie �� �. I Fax (503)536-56155. _ _ .Stale.surcharge(12'%ofpcniii fee). TOTAL PERMIT FEE lit : 4 'Cha pumd appticatian expirxv 11ie permit is aot.ebtained iriihln 180 days i attert ins..baeateeFtcd as eusnPletz Authorized4l ` Ftseth iars: pexeltoclolog• antySuiildinglndeatr3SecvixBoard saartte AirtAtali7te err . I bat=11M/2015 1 Pont'I'�f4uuSiaiiRa r ripv_Pwtis:a9q 4aoabsr'gmaxowvissl Electrical Permit Application FOR OFFICE ESE ()NEN Cityof Tigard "RECEIVED Recei,•ed �j( Bate/fay: Penin��/ /J r�//Moo8� • 13125 SW I hill Blvd.,Tigard,OR 97223 p ry ccly� VVV Tigard, p 2016 Plan Rcvie,r Other Permit. NI / Phone 503.718.2439 Fax: 503.598.1960 M/•iR g BatdBy: I I C,,\KI) Inspection Line: 503.639.4175 Bate Ready/By: Juris ID See Page 2 fur Internet: lsww tiaard of Lvov CITY OF TIGARD Notified Mei hod Supplemental Information Please check all Mai apply(submit 2 sets of plans w'iiems checked below) ®New construction ❑Addi[ion/alteration/replacement 0 Service or leeder 400 amps or more 0 Budding riser three stories ❑ Demolition 0 Other: wvhcre the available IMill current 0 Marinas and boat.aids rix? a CATEGORY OF;CONSTR JCT1 _ exceeds 1(1.000 amps:t ISO soils or 0 Floating buildings_.W_s. a t-...v a... ,,, ,• .._,a 1?'+N - i less toround.or exceeds 14.000 8 ❑Commercial-uu agricultural ® I-and 2-family dwelling ❑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 s.,,,,,,,,..,..,.,.,?:.,-;,.1,., • ❑ anergency system harper.epar alcl,den,ed. tem"kZf4 5 2 u ) ` kiifi �tof(Stt61 D WC- . .ty, , -r.. ,,. . f.„ .. - ofne motor load of 1 �%'�2 �-.(�.n�p� ���---yyy��� • ❑Addition � ❑..A.. ..1,-. ..1_,. _:'. Job no.: Job site address: 1 5 I r lNlC mo I 10(111P or more. occupancy. l /W ` ❑Six or more residential units 0 Recreational,chicle parks City/State/LIP: 1,Ciac � OR q��z� ❑t is ar-care facilities ❑Supply,nhace lin more than Jvvviii \/ _t ❑I I vrrdouti locations (OO,tilts nominal Suite/bldg./apt.no.: ] Project name:t,)b� V Q% 0A-- Bo1 m•1-r ❑Service or'Ceder 000 amps or more — Ftp>Sc IEEIJLE Cross street/directions to-job site: Description 1 Qtv. I Fee- 1 Total j • New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: Lot no.:.' I.(X)0 sq ft.or less —1--168 54 4 Ea.add')500 sq.II or pontos 33 92 L Tax map/parcel no.: Limited energy.residential }a ' t,+ 3.sx s• 1)ES'0:- .1ot`i' , 1 O JC •. (,villi above s It ' 75 00 limited energy.multi-family 75 00 , New electrical service and wiring residential(with above sq Il) - Services or feeders installation,alteration,and/or relocation 200 amps or less I(x)7(1 , ir4:6 ) r.�$ER ` Q TENAl`T 201 amps to 400 amps 133.56 , Name: PO\ ... 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301 04 , Address: k b Q 4 Over 1.000 amps or volts 552'6 City/State/ZIP: anoD�,G1.1�,� ' Dc q g{ of 1, Temporary services or feeders installation,alteration,and/or , r-w �I �/�L/�tC L-J/� relocation Phone: 0) 1„ q v-1� D I-aa:�(7„D) I _q _- It (I p /� :amps or less 59 36 1 CC������lttt{//// v �/ hon la` I `�}`�`c ( '01 amps to 4(X)amps 125 03 I , I Owner installation: This installation is being made on property that 1 own which is not intended for sale, lease.rent,or exchange.according to ORS 447,449.670.and 701. 401 amps to 599 amps 16 s 54 2 Branch circuits-new,alteration,or extension,per panel Owner signature: Date: A.Fee for branch circuits with ' above service or feeder lee. ,tr " �I4- r .�©„ X17* �$ - • each branch circuit 7 41 ' Business name: —, ' 13.Fee for branch circuits n•iNroru service or leeder first 56 18 , Contact name: m a 1 If Ve, (--)or branch circuit - Address: i • o Each add'I branch circuit 7 42 , Ii _ liscellaneous(service or feeder not included) City/State/ZIP: QXl COU ' l!`'' I P U.. Each manufactured or modular I dwelling.service and/or feeder 67 84 Phone:( ) Fax: :( ) Reconnect only 67 84 l - rn^ ^^,D .9br Pump or irngation circle 67 84 , E-Mail:' t K,lL1V-l�{Y�. (tel ` a ,b Sign or outline lighting 67 84 I , - O ,,_; CPO- Signal circuit(s)or limited-energy Business name:Simply Electric panel.alteration.or extension Page 2 j • 2 Each additional inspection over allowable in any of the above Address: PO Box 822408 Additional inspection(1 hr mm) 66 25/hr City/State/LIP:Vancouver,WA.98682 Investigation(I hr min) 66.25/hr Industrial plant(1 hr min) 78 I hi hr Phone:(503)849-8202 Fax:(360)314-4945 Inspections for which no fee ix 90.00/hr specifically listed(Y:hr min) CCB Lie.: 204615 Electrical Lic.: 067 Suprv. I.ic.: 4394S :"'?`!•:.'''.'•ELECPRICAL"P100I177.17E>y ' Sups'. Electrician signature. required: Q/ Subtotal �tfGxe, Plan review(25%of permit lee) j Print name: Victor Zarzhitsky Date: I 1 17/2015 State surcharge(12%ofpermit fee) Authorized signature: IOTA(.PERMIT I:til? I This permit applica ti nn expires if a permit is not obtained within 1811 days after it has been accepted as complete. Print name: Date: • Number of inspections allowed per permit I iieiidinel'crm,,S.i.C-Permit"ps doe 07,01/l a 44It-.761 S(11.0c'('OxIAFY-B e Plumbing Permit Application FOR OFFICE i SE otiLN Building Fixtures RECEIVED City of Tigard MAR 8 2016 Da>dsY Pcm;tNn_ ard0/6 ....00013. 13125 SW Hall Blvd,Tigard,OR 97223 Plan Review Other permit No.: Phone: Sn Line:2 3903. Fax 503.597 IIT OF TIGARD > Re hair 0 See Page 2 for Inspection Line: 503.634 4175 't Date Rea BY -11' It Internet www.tigard-ur av : DING DIVISIO Notified/Method Supplemental Information r : _ For special information rise checklist Dtxnolition I Qty. I Ea_ Total 1 l New construction Description 0 Addition/alteration/replacement ❑Other. New 1-2-family dwellings(includes 100 R for each utility connection) _�:2,4.14'77i. rs tW- =� ;-.- ,; -. SFR(1)bath 312.70 ''''''- '4t•-'Fj�s � -y.tr'C4Y >Igi;•..._ 1 n•F:- n ,:i 1 .r."'_,.. ',,' ,...z ct...... _ ... SFR(2)bath 437.78 71-and 2-family dwelling 0 C°mmereiaU>rdus>ria1 SFR(3)bath I 50032 5 713!,� 0\Accessory building • 0 Multi-family Each additional bath/kitchen 25.02 . 0 Master builder 0 Other. Fire sprinkler(__sq.ft) Page 2 �-..,� —.-- - .._. '7`-f �'-- ,.---,--..-.,7.-f,-_--,...._ Site utilities: .q fir ''Yip..:."j?.. i-2 f f�-=,-;P_-!a-,-,!-�;.. - "-�--»,.:,_;;.-s ....- -�� � LAN � Catch basin or area drain l 8.76 Job site address: t p r " ""'G"k v I" t Drywall,leach line,or trench drain 18.76 City/StatJLIP T 5�c� 1 \_ 1��lZ, ,4' ry —y Footing drain(no.linear ft:_.j Page 2 Suite/bldgJapt.no.: I Project name: YD\\\9 l cis l.lJ�\ '' '11 r Manufactured home utilities 50.03 D\\\ J Manholes 18.76 Cross street/directions to job site: 18.76 Rain drain connector Sanitary sewer(no.linear ft:_) Page 2 • Storm sewer(no.linear ft.:_) Page 2 • Water service(no.linear fL:__) Page 2 Subdivision: I Lot no.: -7'—1 Fixture or item: Backflow prevanta 31 27 N�'t Tax map/parcel no.: Backwater valve ( 12.51 \'Z.ej -., ,Y. �• -r ter' �. = , 5 . _., �_. - _ `,. _ Clothes washer I 25.02 05,02 Dishwasher I 25.02 a5,0 2 V 'i 1 f -con g E V;i5 Drinking fountain 25.02 Ejectors/sump 25.02 - _ •;.. __.,7---'-.' u _ Expansion tank 12.51 ~ Y — 2' Fxtrrch:wer cap 25.02 Bance: QoNill • Floor drain/floor sink/hub 25.02 Address: \--h‘ S `_ / Garbage disposal t 25-02 2c5,5'L City/State/ZI :\ 1(I Du f\W q V Hose bib I 25.02 7 ,011. Ice maker 1 1251 2. Phone: ,r �� + Ft=( )` / 25.02 w ,-.--.,--...„.„--.•______.„----,--„,„----_,,•-_--„-f-,... h}; s F _GInterceptor grease trap (`- C. -4 ,!, �-= m ,,,„ A ,2._,..,,,,„.„,,,,,,,_7_._.,,,,,,„:, Mesiical gtts(value:S ) 2 Business naurrc 3DL (,V�,b(1/�C �(,��JJt. Primer 1251 Contac nameylcibnan_-+'CJ` `Roof drain(commercial) 1251 Address -Sink/basin/lavatory 25.02 ' �r City/State/ZIP: CIO Vm, Ce . 1 b 1 12.5 4 Solar traits(potable water) 6254 Fax::( ) Tub/shower/shower pan. �- 25•Cj Phone:(553) l "-363rinal 25.02 v► = ► 1 '� ��,/� 13 E-mail:- • , ,� � �'�- y�,p... wider cord 2s D2 -, : _ _ • -fL ,_-,z7.-...--,,,,,,,-, • Water heater I • 37.52 ,f}.� LL__ 441 '� - - --,L. ILL Business nttme:73� ►7V1 LLL -Water piping/DW V • 5629Otha 25.02 Address:S ?�T Q ^ 17- "ticSubtotal City/Slate/ZIP: r�..- Fes' /� — _ Minimum permit fee: 57250 Phone:) :: I 3 l V� F ( ) Plan review (25%of permit fee) CCB Liar -: E fes Plumbing Lia,FD 1'-2_ State surcharge(12%of permit fee) TOTAL PERMIT FEE Authorized sigtrattuc I _ l o permit application aspires if a permit is not obtained w'ithie ltt6 days - Print Iran1C . i r' _ , Date:///1/5-1 Thatter it has been accepted as completes *Fee methodology set by Tri-County Building Industry Service Board. 1:l&nldingWenniuWLMt1-Penni1APP-doe 10/01x9 440-4616TOIlte COM/WID) r r City of Tigard IiiiCOMMUNITY DEVELOPMENT DEPARTMENT T l c n Building Permit Review — Residential Building Permit #: Sy----o20/e -- 00 0 F,.3 Site Address: &OAs,Vc5 ;,2pI O 71-- Project Name: 4i h )jam// RO1/,A,'i� Lot #: (New li y= subdivision name;.Addition or Alteration= last name of owner) Planning Review Proposal: Akzo ,RP-k 'Verify site address/suite#exists and active in permit s tem. River Terrace Neighborhood: ❑ No Yes,See River Terrace Review Addendum Attached SityPlan Elements: hree (3)copies of site plan structures on site !IFite plan must be on 8-1/2"x 11"or 11 x 17"paper 'Footprint of new structure (including decks)with finished awn to scale (standard architect or engineer scale) or elevations orth arrow Utilit}%locations (required for new,may apply for additions) S e address,project or subdivision name and lot number911 p!,cation of wells/septic systems licant information(name and phone number) I1 rosion control(including drainage-way protection, silt fence of dimensions and building setback dimensions sign,location of catch basin,etc.) 1 Oot area,building coverage area,percentage of coverage and S eet names rPervious area (applicable if R-7 R-12 R-25&R-40) ll+.tr-et tree size,type and location ro ' pert}'corner elevations (2 foot contour hues if more than 0 t`sung trees to be retained with drip line,and tree 4 foot differential) protection measures fAlean Water Services—Service Provider Lett (lot platted prior to 9/10/1995): ri equired: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No liPublic Facilitie Improvement (PFI) Permit: equired: VYes,applicant was notified ❑ No Applied For: 'es ❑ No,stop intake Iti;/Land Use Case#: 3)G'(620/S_ '� `7• oning: k_ , 5 L Setbacks: Front 020 Rear /5— Side 4-, Street Side NIA' Garage c.„,20 t kandscape Requirement: 0/0 at of Coverage Maximum: Pi Building Height: Maximum Height 30 Actual Height c g 0 P(isual Clearance asements ' / ensitive Lands: Yes ❑ No TypeLau- 1/�7/z� A.xiway• ,,.,,..200,7 Urban Forestry Plan ❑ Conditions "Met"prior to issuance of bui ding permit ` Notes: �.:G�a,k , i,,,,,,,/ i / jk_.,(V.c.a/e.e /,'27, 1)Zez/tim...4>'- Approved y Planning: Date: ____ LVE3)//b Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved 1:\Building\Fonns\BldgPennitRvw RES_0121 16.docx 4 Building Permit Submittal Original Submittal Date: / /ro Site Plans: # Building Plans: # 3 Building Permit#: H nter building permit#above. Workflow Routing: Planning Engineering alcrmit Coordinator ( 1--"Iiiiiilding Workflow Sign-off: It--Sign-off for Planning(include notes from planning review) Route Application Documents: .j'Engineering: (1) copy of permit application, (1) site plan, (1) building plan and ori nal plan review routing form. Building: original permit application, site plans,building plans, engineer and beam calculations and trust details,if applicable, etc. Notes: ice, 74-...111.7r. _ By Permit Technician: : ' -/ Date: .39//0 EnOeering Review Slope at building pad: 11 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 Q No ❑ NOT Approved by Engineering: Date: Notes: Condition remain unmet that are required prior to issuance of bldg. permits. — Approved by Engineering: AL D Date: /0--- Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit �/ Approved, NOT Released: Date: 31v//<p Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: . Revision Notice 3: Date Sent to Applicant: /115:2SDC Fees Entered: Wash Co Trans Dcv Tax: Yes ❑ N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: Yes ❑ N/A igt3 OK to Issue Permit / Approved by Permit Coordinator: Wile-----Date: b 1:\Building\Fonns\BldgPennitRvw_RES_0121 1 6.docx .v. r' City of Tigard III ■ r COMMUNITY DEVELOPMENT DEPARTMENT T 1 G n R D River Terrace Building Permit Review Addendum Building Permit #: A4-C7 20 (a — 0006P--3 Site Address: ./.573S---- cS'1() /N/i c ✓''7i ��u�7L Project Name: Pd1 - ,s-2-71 46 l Q �/� tt' Lot #: '9 (New d/ g=subdivision name;.Addition or Alteration=last name of owner) Planning Review River Terrace Plan District Design Standards (18.660.070.14: 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 mm. 5 . deep Gabled dormer ft. deep min. 2ft., 5 ft. wide min. 2 ft., 6ft. ide 1 II ❑ E ❑ 2. Eyes on the street: a minimum/o 12%of each street facing facade must include windows or entrance doors. / Percentage Shown: / 7 3 . trances: At least one entrance must meet both of the loll() 'ng standards: 7Max. 8 ft. setback from longe street- facing wall arallel to street,angle no more than 45° from street, or open onto porch Entrance opens to a porch: Yes ❑ No s, all the following apply: fv4 sq.ft. min. ne street facing entry ft. max. roof height above porch 5 ft. depth min. 0% min. porch roof coverage 4. etailed Design: All buildings shall include a min. of five of e following elements on all street-facing facades: Recessed entry area min. 5 ft.wide x 2 ft. deep overed porch min. 5 ft. wide x 5 ft. deep il (all offset min. 16 inches ❑ ormer min. 4 ft. wide Roof eave min. 12 inch projection of offset min. of 2 ft. ❑ Roof shingles either tile or wood Gable, hip or gambrel roof design ❑ Roof pitch oriented south min. 500 sq. ft. 0 orizontal lap siding min. 3-7 ft. wide ❑ Accent siding min. 40°%o of street facade Window trim min. 2 ' "wide by 5/8" deep ❑ Window recess min. 3 inches for all street facing ❑ B y 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 oser to front or side lot line, than longest street-facing wall. ❑ Yes No. If No (Check one): V y extend up to 5 ft. if there is a covered front porch and garage does not extend beyond the front porch. lay 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: ,,', � Date: • _ i / I:ABuilding\Fonns\BldgPennitRvw_RES_RT_012116.docx City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15335 SW MISSISSIPPI CT, TIGARD, OR, 97224 March 6, 2017 at 1 :41 :57 PM Record Type: Record ID: Residential - Master Permit MST2016-00083 Inspection Type: Inspector: 299 Final inspection David Young Result: PASS - CofO Comments: Correction from previous final inspection complete. Street tree certification received. Moisture content form received. Vapor barrier form received. High efficiency lighting form received. Insulation certification checked. Blower door test report received. C of 0 left on site at kitchen island. Violation Summary: Inspector Contractor