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Permit (35) CITY OF TIGARD MASTER PERMIT $ COMMUNITY DEVELOPMENT Permit#: MST2016 00078 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/05/2016 Parcel: 251080001506 Jurisdiction: Tigard Site address: 15243 SW SEINE DR Subdivision: POLYGON AT BULL MOUNTAIN Lot: Multiple Project: Polygon at Bull Mountain, Lot 75 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1591 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 32 Bathrooms: 3 Second: 1836 sf Garage: 682 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3427 sf Value: $416,816.13 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: 1 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 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: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 0 201-400 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: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 3427 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: $34,393.21 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: •regon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 thro •h O- - -0' 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: DSV �//� LCr9-77dlj Call 603.639.4175 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 —0 / 75- n 1{ta RECEIVE , FOR OFFICE I SE 0\1,1 City of Tigard MAR 8 2016 3 /- �Received „� �1JT_ /4 700/7, Date/13 //1' Permit N .. f 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ` Phone: 503.7182439 Fax: 503.598.1960 DateBy: 4 ,)4 ) G Other Pe` ia.k ( 'Q �_A0o J i„ ,,,„, Inspection Line: 503.639.4175 CITY OF'WARD a ReadyBy: l Juris: H See Page 2 for l/ Internet: www.tigard-or.gov BUILDING DIVISIOIttifed/Method: Supplemental Information ®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 ❑Other: equipment,materials,labor,overhead,and the profit for the work indicated on this application. T ik a _� ,� .ei ,. __ 8E .. _._, L < _ ,_ „ , .. Valuation: $ 4 4. ® 1-and 2-family dwelling ❑Commercial/industrial . • • 0 Accessory building ❑Multi-family Number of bedrooms: 4 ❑Master builder 0 Other: Number of bathrooms: 1.k3 Total number of floors: 2 4 • q �� . I QO2'-\- J., , _ Job site address: New dwelling area: ' square feet City/State/ZIP:Tigard,OR 97224 Garage/carport area: l!! $2 square feet Suite/bldg./apt.no.: I Project name:PO M( t f 01t)\\ min Covered porch area: 5L19squarefeet 123 6 Cross street/directions to job site: J Deck area: 1) square feet J 3ci , Other structure area: ) square feet Subdivision:Polygon at Bull Mountain ( Lot no.: - 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 _ y ' • $ work indicated on this .s rltcatton. ne.-V i.1-13\\L!^ onn\.\, e P - ' • Valuation: $ l•J{ Existing building area square feet New building area: square feet a r Number of stories: Name:Polygon WLH,LLC Type of construction: Address:109 E 13`h Street Occupancy groups: City/State/ZIP:Vancouver,CA 98660 Existing: Phone:(360)695.7700 Fax:(360)693.4442 New: Business name:Lpc)� _ ‘,OL I n.c • Structural plan review fee(or deposit): Contact name: 1_\ 0. • -e (orc\� FLS plan review fee(if applicable): Address: O Q I� Th (D-Ji- Total fees due upon application: City/State/ZIP: \()JThO J Or Wj C\U�1 1D 0� Amount received Phone:) �9 Q�` �00 I Fax::e)0e) .U 17.�� E-mail:maggie.gordon@polygonhomes.com _ a m Commercial and residential prescriptive installation of Wit:, < • " rooftop mounted PhotoVoltaic Solar Panel System. Business name: b k D-i1 ti.A n C. Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: \0 a L./Li '3 t Solar Installation S.ecial Code checklist. City J con/State/ZIP: �Cil t,e A Q Pj`Q(0 Permit Fee(includes plan review $180.00 and administrative fees : Phone:Oleg) t 015, C) Fax:ekD) 0Q 3 . 412. State surcharge(12%of permit fee): $21.60 ,,,KCCB lir.:204238 Total fee due upon application: $201.60 Authorized signature:- ,rte I This permit application expires if a permit is not obtained / a within 180 days after it has been accepted as complete. Print name: Date 1 :I LI,— _ ^ I *Fee methodology set by Tri-County Building Industry W Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) I v ttECEIVE i�ORi11U 10ELSEONLI lY>t�c�ani�ai Peranit,�:ppTicafi I.};,hared • 13125 SW Ha]f 81rd-,Tieani,bl�9TY?3 MAR 8 2D16 P 1 I .. i ' -1,2111 �, prune 503:718.2439 Fax' 5435984960 p 14.4— cm- -: ._ .. - Inspoet on tine 503:639.4175: CITY OF TI GAR Il Dale Re*:iPy funs H*e I'age s I*. . V �� u•pptemenYat�•nfarmahoa www.tiga41-or,.gov or�o� BUILDING OIVISI ` � �� .. _ = ' ;� _ r y. �, a -Cf�� Sf'r t 1'`t''i�i.u' r.4ISE-,....-.. ...- y. +aa a s ;TYPE,C) 'RY�CfRI ,� ... . Mechanical it feel Ace based on the value of$tc wotk. - Pin . Indicate the value rounded to the nearest dollar)of all ta 1*3etY.ci�nsttuciiUn ❑Addtttontaltrranon,s reptaccrzaeutif` mechanical.materials,equipment labor,overhead.and profit .. CJ17 ettlohll 0 Olha �� .1 . . r - `3tESiD > uut t WOM�'��r�,�x-CA'FEGDAVAI~-�IZ�iBI:ICI�i(QN-. . . ' _. lSYS7E*S • For a!inartitatfon use chedJi� ®1-:and 2�'staily dtv'eliing 0 CommerctaSliii4ustrtal 0 Accessory building •I:I MnIitly ❑ Master butidrz 0 OtherDesenpnon I Qty: I a. I Total Ileattngko ling. 44.-. 1.:-:'"': '.OS SITE.Ii�iFORiVLtl�[DNW, � Aircanditioamg 46.73 C', � Fiimace 100,606 MI{d i;�t5) 1 46.35 ^ �` G 2-Zu r 100:000+33( , ') `,o1 LitylSlaldLl!~ 'rt (,�cL�Gl .. ` Heat pump.. SiittrJbllfg/apt tto i `J I Ptb eel.[faille: Poly( } r (j" 'BOA l m)n Duct work I 23.32 • yr dromic hot water system 2332 ob.site: ('�Yas st{rtetlditections to.l Residential bottler(radiator or hydroiic) 2332 ot electric), Utuiib (fi�s1. eatas -ty�,:n..:..: _ in=x��sll; r+illutf;'susPendcd,etc. 46.75 FlOONeiit Air`ad:ea above 2332 .. -7 `Outer. ... 23.32 .$0:00.411.*:, - ___. .... .. Iuo.: T5Ulgsr dud Appltanccs T om' z� .,,.._..�. . ._ .._...�.,_.. ...�.. . . .. ... ..._.. V' beaki • 2332 .Gfieplaixfsert ' �:�. -� � m33.39 Fb? cr re o ... 1 '23.32 • Ltkiliii*e ) 2132 - Wt-odnielletsiuve' 3339 GirOCUI,fitep-laceltiisert , . 23.32 . • liininep/lineeflO vert 23:32. tf" cam_f� �__ 1f`EB . ; .�- 'E rouriitdtal exhaust and ventilaiiort: 23:32 v Nam .1164gott Northwest Iaangehopd/otheriatchen egntt" I 1 3339 Addess:,i09 E23a'St Clotlfrs-dtret,i xrieust I 3339 _. e�dtict euharttt(ba4noorns, 3 �'itnCviiver, i' 98661 SitSgltonal t amp ents.:ottlit9 rte) 4 2332. 2332 Ptioatc(36!!816,4»(16' Fax ( ) . hY81N .. " a id 2332 $uttn..i Poiygbn,$orthwest - s14_1s for rust tour 94.03 for each additional Fuatace t 1 Cautacttiame: C:as:beotpitadi.• AddipFs 1.09 E 134i St . . ..... . wailtsuspeodedianii heater C 1Stat&ZIP.Vancouver, !A.8661lidiprt ,:..: . . -.. fax::( ) WatrxhcaoCr Pini (340)816:7800I R;itigF -g-93411; Itaibeasc ',r. ' it els et a&r ,' _; ;� z: :, g '- _ deer: 3_ Other 'I tts!ffi5s risithe An rEGtt litC ,<* F...-L-i:S.'S:R-4 -0. .Wili 4.w`' Address 1618.5 SW 11 Ave.8te.410 Subtotal lifmiaudm permit fee(590.00) t1R:9721t _ . CiE}�St*ZIP T otic,._ Pian rewew(23°lo of permit fx) Pho®e"{S03)9924664 ( Fax:(503)536.6615 . ..- ;3ltsfe.suiidtargc(IZ'o ofpetmitfee). TOTAL PERMIT)�E it IIC;1ts$l14 This permit application exi5tsa 1f a permit is not obtained within Ian days after it has:been accepted as campkte.. ,42.z..',sigtrnurc: * >ec methodaloSY setby Id•Cai:ay Building Industry Service Bond Dale:11720/2015 I Priuttzanie;AtrtAar7eraeri j�� ' Y Electrical Permit Application RECEIVE I FOR OFFICE I'SI.: O`1-1 Received. ullT�O G o F City of Tigardper,,,,,n„ .. Date;n•: / 7 lig • 13125 SW I tall Blvd., Tigard,OR 97223 MAR 8 2016 Ilan Review Phone 503.71 8.2439 Fax: 503.598 1960 l)a,e;t3v: other Permit Inspection Line: 503.639.417> TIGAR�I pate Kead B loris I 1(...\r•11) CITY OF y Y r O .lice Page 2 for Internet WWW Beard or e.tw hhuf/Mctlaal w p ��/_ ILD�NG P.I.. �'' ti,---.mental Information i.��^'�,moi �7 4- ia.: i lis 71V _ - LL1ti•gtioFi New Please check all that apply(submit 2 sets of plan. ni wlites checked below) ®New construction ❑Addition/alteration/replacement 0 Service or feeder 400 amps or more 0 Building user three stones ❑Demolition 0 Other: where the available fault current ❑Marinas and boats aids ` 'l i 5 CA1ORY� B6OF`A101. TR11Cr1 N r Sexceeds 10.000 amps at 150 volts or 0 Floating Mulcting, ai:.,.a. -'� •.::h �: less toround.or exceeds 14.01)0 g ❑Commercial-use agricultural ® I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other Install:Mons buildings I 0 Multi-family ❑ Master builder ❑Other: 0 Fire pump 0 Installation of 75 KVA nr s'R.�"'2- s s,. n _ 0 Iunei gency system_ larger sepatal:ls loosed,t stem 3k.. :; ..r .;-t. 1? ,r A h .ON D LOCATibN: 0 Addition o(ncw motor luau u( ❑ •A.. "F' "1 '.. I ..t��,t-- 5� ` n c 100111'or more. sxcupancy Job no.: Job site address: "l SIC `{ ^ �j r ` ❑SIX or more rcsukmial amts ❑Recreational selnele parks City/State/ZIP: '�1 p` r�Y OR Ci XZLL\ ❑Health-care facilities 0 tiupply s oltage lig more than CCCiiilll 1 ❑I 1 rnrdou,locations 600 s ohs nominal Suite/bldg./apt. no.: Project name:U b .SYS 0._4,-- \ a-4 ❑kn ice or Coder 000 amps or more 9 - Es x . . . Cross street/directions to job size: Description I Qty. 1 Fee. I Total 1 • New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: Lot no.: '-ft .(km sy It.or Icss 168 54 4 miEa.add'I 500 sq.Il or portion 33 92 I Tax map/parcel no.: limited cnerey.residential )<: F654- Y 4 I)EVOliti ife4St V x (with above sq.It) 1 75 011 2 Limited energy.multi-family 75 00 New electrical service and wiring residential(with above sq It) Services or feeders installation,alteration.and/or relocation 200 amps or less 100 70 2 tlC ....4ii itigtiPFJ�l k ' h ER t: , :IiTENAJ`13'• 201 amps to 400 amps 133.5x, , Pd`� 401 amps to 600 amps 2(N)34 2 Name: 1 - 601 amps to 1.000 amps 301 04 , Address: t 0 a tO Over 1.000 amps or volts 552 26 - ` �, �p ' q (} CD Temporary services or feeders installation,alteration,and/or City/State%./_II: �J �(`f[,� �l `'� relocation Phone: D) [0 -? t(5D Fax:bD) .av "`""'iiii k���1LLL ✓✓C1 '� 2amps or less 59 36 I I C(5...,?-4-0D 201 amps to 4(10 amps 125 ON , 1 Owner installation: This installation is being made on property that I own which is not - ( intended for sale, lease,rent,or exchange.,according to ORS 447,449.670.and 701. 401 amps to 599 amps 168 54 Branch circuits-new,alteration,or extension.per panel Owner signature: Date: A.Fee for branch circuits with r v s above service or feeder lee. r : . ::: ::1�, ® 91�3'ACT .d14UN 7 42 , each branch circuit Business name: —g t,. 13.Fee for branch circuits without service or Iceder Ice.first 56 I8 ' Contact name: In • , a Ve., (")(Di branch circuit �. Mach add'I branch circuit 7 42 2 Address: A _ Miscellaneous(service or feeder not included) City/Slate/LIP: Q fl \ ' \... .-.) I P 2 i�. Each manufactured or modular 67 84 V" dwelling.service and/or feeder Phone: Reconnect onl) 67 84 , ( ) { _ - Fax:(,�:( ) E-mail: orf �N��61y,Stb 67144 - Pump or irrigation circle2 Sign or outline lighting 67 84 -.':;:.±.;',., :::',1: 1". n.'-,.:3:-',..,, . ' .,C© , .. . . - Siena)circuits)or limited-energy Business name:Simply Electric panel,alteration.or e‘tension Parc Each additional inspection over allowable in any of the above Address:PO Box 822408 Additional inspection(I hr min) 66 225/hr City/State/ZIP:Vancouver,WA.98682 Investigation(I hr min) 66 25/hr Industnal plant(I hr min) 78 18/hr Phone:(503)849-8202 Fax:(360)314-4945 Inspections for which no lee is 90_(1(1/hr specifically,listed(V.hr min) CCB Lie.: 204615 Electrical Lie.: 067 Suprv. Lie.: 4394S ,Y •ELECTRIC: I,RE'R1111T'FEES ' // Subtotal Suprv.Electrician signature. required: ,' flan review(25%ofpermit fee) _ Print name: Victor Zarzhitsky Date: 1 117/2015 State surcharge(12%ol'penrot Ice) TOTAL.PERMIT FEEAuthorized signature: This permit application expires if a permit is not obtained within 1811 Clays after it has been accepted as complete. Print name: Dail': • Number of inspections allowed per permit I )t:nldmipPcrrna01il.C-PcrmitApp Jac 07,01;10 4:111.-Ili l Sfll l oi' omAvEll Plumbing Permit Application RECE'` CD S Building Fixtures Y GLFOR OFFICE 1 SF o\l_\ 8 2016 D.R7,4ved PrlmitlJu_:/YSr��b 7,?�0�� City of Tigard MAR �a►dsy Pim 13125 SW Heli Blvd.,TiOR 9 OF TIGAR Review �'a P�"t No. Phone: 5 www_2439 Fax: 503.598.1 Dine- lurk ® See Page 2 for Inspection Line: 503.639.4175 DING D'V'S`' t M Supplemental Informative Internet www_tigard-0r gm' - - e r v4 r 1 s - 7— �,. -'-'�"'*"'-��" �¢,�".-a��-2�-�m�ir- �t-.. mss—. :e - _- sw t For special information use checklisL • ow ❑Demolition tion I Qty. I Ea. I Total 1 i New � Descnp ❑Addtroo/alteration/replacanent 0 Other New 1-2-family dwellings(includes 100 R for each utility connection) ;-, = rz-i- ^s-- SFR(1)bath 312.70 --:--- :,-*F"-;•=•,y': n'Ttl c-24t."-: " ':, SFR(2)bath 437.78 1-and 2-family dwelling 0 Co n nercialruxh strial SFR(3) 50032 50(9,-5 e_ 0 Accessory building 0 Multi-family Each additional bath/kitchen 25.02 . ❑Master builder ❑Othr _Fire sprinkler(__sq.ft) Page 2 • �� - ----7.—=':=,.,- Site uh'lities: }r ," J:.i ! l i l• - ----,-----...---.7s 18.76 --,;,, ,4-, ". �7`` ,, Catch basin or area drain 5 L"1� u �.0 • 18.76 " Job site address: OR G�/ln 4 Drywell,leach line,or trench drain City/State/ZIP: '� o _ l `0_1'1501\L V . - Footing drain(no.linear R: ) Page 2 Suite/bldgJapt.no.: .Project name: Poi t'ell 1 Manufactured home utilities 50.03 • . �� Cross street/directions to job site: Manholes 18.7618.76 Rain drain connector Sanitary sewer(no.linear ft:_j Page 2 • Storm sewer(no.linear ft.:_, Page 2 — Water service(no.linear It: ) Page 2 Subdivision I Lot no.: --3--C--) Fixture or item: _ Backflow prevent= I 3127 j)',2<" Tax map/parcel no.: _ �Ve 12.51 ‘.2.cj‘ y� I J = _ clothes washer 25.02 , 5,OZ - .__� - i Dishwasher I 25.02 c9S,0 2 . ►. +f��tfi ~b ' ' 1ftt3 Drinking fountain 25.02 Ejectors/sump 25.02 - Expansion tank 12.51 -_-' - --4 _ - _ FrxhrteJscwercaP 25.02 �Na®e: Q�`��] � G, Floor drain floor smk/hub 25.02 Address: t I v '1--r `J , ,n q Garbage disposal 25-02 2_ ,(:)?,City/State/ZIP: an 0 D\i r ' W/ 1 f a Hose bib I 25.02 7.j,Iptti Ice maker• 12.51 12 C3, PhD= r` e + Fax( ) ya -1nLeroeptor/grease trap 25.02 .1;,....,-,4-,&- - `: .-,z? hi__. � --�-• - -. �____-_ Medical gas(value:S ) Page 2 Business name: -6-1)1 --- ,t1.144, ( Primer 1251 Contact nom= )v:L)n �_•iet Roof drain(commercial) 1251 Address:r ,Q t�lag Sink/basin/lavatory 25.02 City/Stater P: co ci a. -76)9 Soler emits(potable water) 62.54 _ 12.51 �5•(��_ Fax: Tub/shower/shower pmt. Phone: ) l 3�b3 F :( ) 25.02 E-mail: ►/► A:I 'a IAA_ p} Urinal class 25.02 z x y r.' _- _ _ Wager heater 37.52 ?1•. � � LLL Weer piping/DW V 5629 .5/2.- Business ss name:�� P -s LL Other 25.02 E Cr1q` Subtotal City/Slate/ZIP: Address: /ZIP: '_F V 9 Minimum permit fee: S72S0 Phone:) .81-75 rte_ / 2b�i I Far ( ) Plan review (25%of permit fee) CCB Lia: t ,-t,3tJ If Plumbing Lie.r fZ State surcharge(12%of permit fee) TOTAL PERMIT FEE Aut}roriacd signatures / __ _ ! This permit application expire if a permit is not obtained within 18a days . Print name: i- 1 date: / / /S) atter it has been accepted as complete- .Fee•Fee methodology set by Tri-County Building industry Service Board. r:&nwtng1Pam+s\rL/.tu-PermitApp.doc 10ro1/09 4e0-4616r(tam'toMnvta) if City of Tigard 11111 COMMUNITY DEVELOPMENT DEPARTMENT T I G A R D Building Permit Review — Residential Building Permit #: i7ST'ap/6 —0007F Site Address: 1 S 2.1 3 SvV se i rik- Or. Project Name: PSI y y0'i r^i- gull Mout-)1T..10(Th Lot #: Ts (New dwelling= subdivision name;Addition or,Alteration=last name of owner) Planning Review Proposal: IV eMi S 1n Verify site address/suite# exists and active in permit system. I River Terrace Neighborhood: ❑ No "Yes,See River Terrace Review Addendum Attached Site Plan Elements: ,Three(3) copies of site plan feExisting structures on site Site plan must be on 8-1/2"x 11"or 11 x 17"paper /nFootprint of new structure(including decks)with finished Drawn to scale(standard architect or engineer scale) floor elevations North arrow ,Utility locations(required for new,may apply for additions) Site address,project or subdivision name and lot number — etation of wells/septic systems ,-Applicant information (name and phone number) jlErosion control(including drainage-way protection,silt fence Lot dimensions and building setback dimensions design,location of catch basin,etc.) --. et area,building coverage area,percentage of coverage and 'treet names impervious area (applicable if R-7,R-12,R-25&R-40) Street tree size,type and location roperty corner elevations (2 foot contour lines if more than existing trees to be retained with drip line,and tree 4 foot differential) protection measures Vi Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified ❑ No Received: E Yes ❑ No 0. Public Facilities Improvement (PFI) Permit: Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes E No,stop intake ,,iEr Land Use Case #: S UO2.0 IS— 00002. ,/Zoning: 24 , S Id Setbacks: Front Rear f S Side S" Street Side 1 S Garage Z._ti K, Landscape Requirement: % LJof Coverage Maximum: zL LTJ Building Height: Maximum I leight 3 0 Actual Height ?'U Er Visual Clearance Easements Sensitive Lands: ❑ Yes ❑ No Type ZUrban Forestry Plan 6 Conditions "Met"prior to issuance of building permit Notes: CIA nail hQni rYVvIf be ► f Primr i ) issLic,, hLL Oc- 2u,I dart Perm" i- Approved Approved By Planning: 4'7 Or)/-2,C.4._ e df o .-ems-� Date: g/ 8 / I Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved CI Not Approved I:\Building\Forms\BldgPennit Rvw_RES_012116.doc x a t Building Permit Submittal Original Submittal Date: ,3/d//*i Site Plans: # ,3 Building Plans: # j Building Permit#: Enter building permit#above. Workflow Routing: Ga'Planning engineering E Permit Coordinator wilding Workflow Sign-off: 12'Sign-off for Planning(include notes from planning review) Route Application Documents: jL"-Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. Building: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: (4P.41-7C1-1-12— Date: 3//`j0, Engineering Review Slope at building pad: V7 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: E Yes No LIDA Facility on lot: ❑ Yes ❑ No ❑ NOT Approved by Engineering: Date: Notes: Condition remain unmet that are required prior to issuance of bldg. permits. Approved by Engineering: /IL Date: 1-A22.—.1Zx 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: 370//4' Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: Revision Notice 3: Date Sent to Applicant: SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A ((( Tigard Trans SDC: Yes ❑ N/A Parks SDC: ;Yes ❑ N/A prOK to Issue Permit Approved by Permit Coordinator: CA `"'"7 ( , Date: s -`4- l k I:\Building\Fonns\BldgPennitRvw_RES_0121 16.docx J t City of Tigard 'PI r COMMUNITY DEVELOPMENT DEPARTMENT T I C;A R D River Terrace Building Permit Review Addendum Building Permit #: r1S7 i ,/6 —0457<e Site Address: is-2 4 2 ,Sy,/ S eoett_ 0 r. Project Name: Poi y 9 p n u t evil MCS Vl f e 1 Y Lot #: 7S (New dwelling=subdivision 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 façade 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 fl ❑ ❑ / ❑ 2. Eyes on the street: a minimAim of 12%of each street facing façade must include windows or entrance doors. Percentage Shown: i 61 . i 3. Entrances: At least one entrance must meet both of the following standards: / Max. 8 ft. setback from longest street facing wall Parallel to street,angle no more than 45° from street, or open onto porch Entrance opens to a porches ❑ No If yes,all the following app y: '25 sq.ft. min. XI One street facing entry ZI2 ft. max. roof height above porch Zr5 ft. depth min. fd 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: 'overed porch min. 5 ft.wide x 5 ft. deep e Recessed entry area min. 5 ft.wide x 2 ft. deep 0 Wall offset min. 16 inches ❑ Dormer min. 4 ft.wide gr Roof eave min. 12 inch projection Roof offset min. of 2 ft. ❑ Roof shingles either tile or wood jZ Gable,hip or gambrel roof design ❑ Roof pitch oriented south min. 500 sq. ft. /'JE?Horizontal lap siding min. 3-7 ft. wide ❑ Accent siding min. 40% of street facade A Window trim min. 2 1/2"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°a 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 V'No. If No (Check one): leMayxtend up to 5 ft. if there is a covered front porch and garage does not extend beyond the front porch. 7May 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) . 2 ," ❑ 12-foot-wide garage door p 40% max. of street facade ❑ 50°% max. of street facade with 7 detailed design elements Notes: n Approved By Planning: N1,)vl t /J i/UG Date: 3/Q 1 /19 I:\Building\Forms\BldgPennit R vw_RES_RT_0l 2116.docx FOR OFFICE USE ONLY—SITE ADDRESS: �' This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. Cityof Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Transmittal Letter T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 •www.tigard-or.gov TO: Tom H. DATE ' 0.c - 6,EIVVII DEPT: BUILDING DIVISION AUG 2 2016 FROM: Angela Grajewski tTiGARD COMPANY: Pol BUILDINGIVISIOP. ygon Northwest PHONE: 971-212-2144 I E 42 RE: l )2-1-13 Sw ,n (Site Address) - c-' MST20 (p—coo 78 (Permit Number) Polygon at Bull Mountain (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: � SSP ti>� � ;: • 0 Additional set(s) of plans. 3 Revisions: add garage man door 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: - _- .e •. ;- e - ; ; - "" . 4 : . s: Routed to Permit Technician: Date: 2 -3-- Fees Due: Yes ❑No Fee Description: Initials Amount Due: n ` wAkf * 3 $ A *' . k .we $ $ Special Instructions: I Reprint Permit(per PE): ❑ Yes 1 ` NoDone Applicant Notified: --/E ,J'�, -- Date: 4 7 4 , _ I 11 Initials: �— I:\Building\Forms\TransmittaiLetter-Revisions.doc 05/25/2012 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15243 SW SEINE DR, TIGARD, OR, 97224 April 20, 2017 at 11 :01 :15 AM Record Type: Record ID: Residential - Master Permit MST2016-00078 Inspection Type: Inspector: 199 Electrical final David Young Result: FA I L Comments: Not ready for electrical final inspection, exterior light at garage front not installed. Inspections to be scheduled when work is complete and ready for inspection. R109.3 No inspection done. Provide address on site for inspections. R319.1 Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15243 SW SEINE DR, TIGARD, OR, 97224 July 13, 2017 at 9:30:22 AM Record Type: Record ID: Residential - Master Permit MST2016-00078 Inspection Type: Inspector: 699 Mechanical final Aaron Cillo-Gobel Result: PASS Comments: No A/C installed at this time. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15243 SW SEINE DR, TIGARD, OR, 97224 July 18, 2017 at 12:20:47 PM Record Type: Record ID: Residential - Master Permit MST2016-00078 Inspection Type: Inspector: 399 Plumbing final David Young Result: FA I L Comments: Secure T&P piping on water heaters per manufacturer requirements. Correction For hard cap at rear un used raindrain stand pipe not done. Investigative fee for re inspection without correction being complete applied. 103.5.6 Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15243 SW SEINE DR, TIGARD, OR, 97224 July 18, 2017 at 12:24:56 PM Record Type: Record ID: Residential - Master Permit MST2016-00078 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS Comments: Correction from previous failed inspection complete. No AC installed at this time. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15243 SW SEINE DR, TIGARD, OR, 97224 July 18, 2017 at 12:26:26 PM Record Type: Record ID: Residential - Master Permit MST2016-00078 Inspection Type: Inspector: 699 Mechanical final David Young Result: CNCL Comments: This inspection passed previously, see inspection dated 7/13/17. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15243 SW SEINE DR, TIGARD, OR, 97224 July 26, 2017 at 10:00:44 AM Record Type: Record ID: Residential - Master Permit MST2016-00078 Inspection Type: Inspector: 299 Final inspection Aaron Cillo-Gobel Result: PASS - CofO Comments: Final erosion control passed Street tree certificate received Moisture content form received Moisture barrier acknowledgement form received High efficiency lighting form received Insulation certification verified Blower door and/or duct seal test certificate received C of 0 left on counter. Violation Summary: Inspector Contractor