Permit (32) A� ` : MASTER PERMIT
11 p CITY OF TIGARD � �, ; xr
' COMMUNITY DEVELOPMENT Permit#: MST2016-00054
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/28/2016
Parcel: 251060003000
Jurisdiction: Tigard
Site address: 13850 SW 175TH AVE
Subdivision: WEST RIVER TERRACE Lot: Multiple
Project: Polygon at West River Terrace, Lot 98
Project Description: New SF. 8/4/2016: REPRINT permit to add 2nd water heater. 9/14/16, REPRINTED to add a/c.
9/16/2016: REPRINT to correct address from 13840 to 13850.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1108 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 32 Bathrooms: 3 Second: 1396 sf Garage: 385 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2504 sf Value: $341,215.53 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 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
Drywell-Trench Drain: 0 Other Fixtures: 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: 4 201-400 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 2504
Owner: Contractor:
ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
7600 EAST DOUBLETREE RANCH 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175
RD,STE VANCOUVER,WA 98660 2 A Geotechnical report is
SCOTTSDALE,AZ 85258 required before the footing
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $32,552.43
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 9 -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: /2/(/ /f f�09Z.le 7007
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 k i;,7p ,
MASTER PERMIT
III li
I r.. COMMUNITY DEVELOPMENT �{7;:' Permit#: MST2016-00054
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
/5r// Date Issued: 04/28/2016
Parcel: 251060003000
Jurisdiction: Tigard
Site address: 13840 SW 175TH AVE
Subdivision: WEST RIVER TERRACE Lot: Multiple
Project: Polygon at West River Terrace, Lot 98
Project Description: New SF. 8/4/2016: REPRINT permit to add 2nd water heater. 9/14/16, REPRINTED to add a/c.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1108 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 32 Bathrooms: 3 Second: 1396 sf Garage: 385 sf Front: 20 Smoke
DwellingUnits: 1 Detectors: Yes
Third: 0 sf Right: 5
Total: 2504 sf Value: $341,215.53 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 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'I 500 sf: 4 201-400 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 2504
Owner: Contractor:
ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
7600 EAST DOUBLETREE RANCH 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175
RD,STE VANCOUVER,WA 98660 2 A Geotechnical report is
SCOTTSDALE,AZ 85258 required before the footing
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $32,552.43
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
952-001-00 h 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. t..--.04,d—.114Permittee Signature: 61-7/e l
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. V
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.
-Mechanical Permit AppJica IV FOR OFFICE t'SE ONLY
City Of Tigard Received
Date/By: 7 /4e A / Permit No.: c - ,
,1111 w 13125 SW Hall Blvd.,Tigard,OR 97223 A U G 2 2 2016
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
Date/By: Other Permit:
T[GARD Inspection Line: 503.639.4175 CITY OF TIGARD DateReady/By: 7uris: H See Page 2for
Internet: www.tigazd-or.gov
BUILDING D31 7ESiON Notified/Method: Supplemental Information
Mechanical permit fees*are based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value $
q +0 'IGOXOeoN nuL 1QN 4
-2g .._ . . � '7tE3DEVITAIi tiIP T!zs 'EMsvE-
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist
❑Multi-family ❑Master builderI
0Other: Description Qty. Ea. I Total
- r fot B Heating/cooling:
, �� Q11�.ABR 1(.�E',1!
7��q Air conditioning 1 46.75 46.75
Job site address: I J 1.t C) 3 t J J 11c I Y1 j
l s Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: J Project name:Polygon at West River Ter Heat pump 61.06
Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
•
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision:Polygon at West River Terrrace I Lot no.:clo Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
-- - " �1Gas firelace/insert 3339* f S fUNflEIII I " p: -.,-,--4--,,,--,--'-----,•-----'--••••'_
Flue vent for water heater or gas
Add AC fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
F1tD1p.FdtT1' Other: 23.32
_.. :.�._: ..._. ,,_...g
.._._` _.....:ti..,__ "1 NA1N1_ :: Environmental exhaust and ventilation:
Name:ADVL Land Holdings,LLC y Range hood/other kitchen
Address:7600 E Doubletree Ranch Road
equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(602)694-4031 Fax ( ) Attic/crawlspace fans 23.32
` 44 th
Cfl -tea Other2332,w. o-e _ °. - �.
Business name:William Lyon Homes,Inc. Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:Angela Grajewski Furnace,etc.
Address:109 East 13th Street Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 I Fax::(360)693-4442 Fireplace
Range
E-mail:Angela.Grajewski@polygonhomes.com Barbecue
.,. t ,� Clothes dryer(gas)
Business name:Apex Air LLC Other:
Address:18004 NE 72nd Aver 4
Subtotal
City/State/ZIP:Vancouver,WA 98686 Minimum permit fee($90.00)
Phone:(360)342-8109 Plan review(25%of permit fee)
Fax:(360)326-1769 State surcharge(12%of permit fee)
CCB lic.:203034 TOTAL PERMIT FEE
r R This permit application expires if a permit is not obtained within 180
1111/31Ciat
* days after it has been accepted as complete.
Authorized signature: ,Aiiii Fee methodology set by Tri-County Building Industry Service Board
Print name:Angela Grajewski I Date:8/22/16 I
I:\Building'Permits11V1EC_PernitA.pp 040113.doc 440-4617T(I1/02/COM/WES)
CITY OF TIGARD � �� MASTER PERMIT
1111111
COMMUNITY
DEVELOPMENT Permit#: MST2016-00054
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/28/2016
Parcel: 2S 1060003000
Site address: 13840 SW 175TH AVE Jurisdiction: Tigard
Subdivision: WEST RIVER TERRACE
Project: Polygon at West River Terrace, Lot 98 Lot: Multiple
Project Description: New SF. 8/4/2016: REPRINT permit to add 2nd water heater.
BUILDING
Floor Areas Required Setbacks
Stories: 2 Bedrooms: 4 First: 1108 sf Basement: Repaired
0 sf Left: 5
Height: 32 Bathrooms: 3 Second: 1396 sf Parking Spaces: 0
Dwelling Units: 1 Garage: 385 sf Front: 20 Smoke
Third: 0 sf Yes
Right: 5 Detectors:
Total: 2504 sf Value: $341,215.53
Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1
Laundry Trays: 0 Rain Drain: 1
Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0
TSewer Lines: 100 SF Rain
Garbage Disp: 1 Water Heaters: 2 0 Storm Sewer: 100
Tubs/Showers: 3
Water Lines: 100 Drains:
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Bckflw Prevntr: 0 Catch Basins: 0
Backwater Value: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 5
Natural Gas Clothes Dryers: 1
Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0
Furn>=100K: 0 Gas Outlets: 4
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders
1000 sf or less: 1 Branch Circuits
0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add!500 sf: 4 201-400 amp: 0 201-400 amp: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 p W/O Svc/Fdr: 0
P 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
Other: N Other Description: All
Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use:
NEW Type of Constr: Occupancy Group:
SF VB Square Feet:
R-3 2504
Owner: Contractor:
ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
7600 EAST DOUBLETREE RANCH 109 E 13TH STREET
RD,STE 1 A Geotechnical report is
VANCOUVER,WA 98660 required before the footing
SCOTTSDALE,AZ 85258
2 Ersn Cntrl 503-639-4175
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $32,455.07
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 O•r •52-0r '90. 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: CAI <9/ /e22.--/ j—/(��
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2016-00054
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/28/2016
Parcel: 251060003000
Jurisdiction: Tigard
Site address: 13840 SW 175TH AVE
Subdivision: WEST RIVER TERRACE Lot: Multiple
Project: Polygon at West River Terrace, Lot 98
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1108 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 32 Bathrooms: 3 Second: 1396 sf Garage: 385 sf Front: 20 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors:
Total: 2504 sf Value: $341,215.53 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 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
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: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'500 sf: 4 201-400 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
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 2504
Owner: Contractor:
ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
7600 EAST DOUBLETREE RANCH 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175
RD,STE VANCOUVER,WA 98660 2 A Geotechnical report is
SCOTTSDALE,AZ 85258 required before the footing
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $32,368.05
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:
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.
f •
I _ /
Building,Permit Application C—0 7--- ?., ..........., ....., ............_. ,_ _, 1.')
-1 r . RECEIVED Fc)la 01'1'1(_ 1: 1 �l:Obi 1 - CJ
Reuived a .2y rP Permit1404f " D/b-,vast'_
City of Tigard Dat�ay:
13125 SW Hall Blvd.,Tigard,OR 97223 FEB 2 a 2016 Plan Review ��P� l2o?p/6-00�939
Date/By: 3 9) '� _
J Phone: 503.718.2439 Fax: 503.598.1960 Dace ReadyBy� ru,is: I � See Page 2 for
Inspection Line: 503.639.4175 CITY OF TIGARD DateReadlethod Supplemental Information
. I(i:-.) Internet: www.tigard-or.gov BUILDING D11/iSEfl
:_ _ Permit fees*are based on the value of the work performed
®New construction ❑Demolition Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
❑Addition/alteration/replacement Other work indicated on this application.
Valuation:3 $ I
® 1-and 2-family dwelling 0 Commercial/industrial ga
Number of bedrooms:
❑Accessory building 0 Multi-family
Number of bathrooms:
0 Master builder 0 Other
_ _ p Total number of floors: 2
11YI New dwelling area square feet. S93
� e
site
Job site address: 1c.J 11-5x .
� � - ', _ " Garage/carport area square feet
City/State/ZIP:Sherwood,OR 97140 at West River Ter Covered porch area: -
square feet
55
Project name:Polygon 9' 139 •
Suite bldg./apt.no.: I 1G
Cross street/directions to job site: Deck area: 1 0 square feet , Q O
Other structure a1ea: ', square feet
,
Lot no.:q /J d Permit fees*are based on the value of the work performed.
Subdivision: Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
work indicated on this ...hcation.
=1..��.;�. �
ex . , .` � .. �.r ,r�w, �s.,w tet. ,., ..� . . „ . . Valuation: S
New Single Family Detached Construction
Existing building area: square feet
New building area: square feet
Number of stories:
Name: alygoa W LH Abt.v J 46 1-/-0 1..2s/A/6-S Type of construction:
Address-109 Filth street _ Occupancy groups:
City/State/ZIP:V Existing:
Phone:(360)695 7700 Fax(360)693.4442 New:
Business name:Polygon WLH,LLC Structural plan review fee(or deposit):
Contact name:Maggie Gordon FLS plan review fee(if applicable):
Address:109E 136 Street Total fees due upon application:
City/State/ZIP:Vancouver,WA 98660 Amount received:
Phone:(360)695.7700 I Fax::(360)693.4442 - -
E-mail:maggie Bordon@polygonhomes.com Commercial and residential prescriptive installation of
x:-7 - roof-top mounted PhotoVoltaic Solar Panel System.
' Submit two(2)sets of roof plan with connection details
Business nam .
c7ES //V C and fired department with the 2010 Oregon
4//CC/!�� L�0� � M ep access,along
Code checklist
' n
S.�tial C
r Installation S
Address: 109 E 136 Street
Sola
Permit Fee(includes plan review
$180.00
City/State/ZIP:Vancouver,WA 98660 and administrative fees :
Phone:(360)695.7700
Fax:(360)693.4442 State surcharge(120/0 of permit fee): 521.60
CCB lit.:207247
Total fee due upon application: $201.60-
This permit application expires if a permit is not obtained
Authorized signature: '4* within 180 days after it has been accepted as complete-
' *Fee methodology set by Tri-County.,Building Industry
Print name:Maggie Gordon I Date:12/11/15 Service Board.
I:\BuildingTermits\BUP-RESPermitApp.doc 02/242011
4404613T(11/02/COM/WEB)
, r
EEIE !
Electrical r�L+'6i!!I$.>�,�} ��i CatioYFi t v:14,,l 1 1 r I ,5, t,,\r 1
ts,�7[�gatid FEB 2 5 2016 D P«mttis,,%�15 ,.;�,> -e►i
x, 13125 V flea''Wyk Tisard,OR 9'1223
Phones 503 7182 39 :1 sou ass y �^. -� ! rufarw Permit
otianu 503.639.4175 �g !�''�t ,� i �St��1.
••_Tnteine5..tigatd.rgov 1.31.1I1.,VS\if Of'JiS;�Li SaP loiTnfmmal44e
2?ItOitilSittletiOn El Militiontalteietthilfreplacetiztit ll,4c1uekill.that*Ref c 144•ots ., ems ea3:
❑ ntP1lb -®��� n
CISer Ica ar ke er4Oaao s orator* D a,Od a4nror airce lea
so.....a.. A*4 Auk«meat 17 t4tnant out boely
r
,ter-�':�wmz' - ;,`,,u4` „` ��coo� s:4:' ,. , exp;S�Bampsw 13Divttsor QFtatlmSltw`binss.
®1-and 2-fanijly dwetiing 0J comauicia Tiiulus alai p Actxssoty building tris.0-amd or,;,..0,:„4,t4Aoo 17 conn ifoid:we sgtcuit.at
wpm 61rAiDelor tstatistoas: %N...
Q Multi family ❑master builder 0 Othar. Ofireporni. El losi.1 th oflsO KYA or
' 1t`R> $fA77Ol t ANA,LOW•1" Citoterseacy swum. ististsinviiely derived
Job#: i `. `�} ' 0 Addidec c4cwino#artoadaf
lob site address:k 3cg1Q4ftPormom *Mom.
-it","E",1
", 1.2'"1:3.:
CityiStatelZTP:3hsdctvacdOR�7IdB 0Skormatsresideatioloak. orOOPOry.
1311oalikoara(sedates, 17Rnstsiionstwhich pada.
Suitt/bldg./apt.#: Project name; CIHsantous!mations, ❑ Hiso
ClSnn4000rtwdsr600eterscraiora. 6aavobr12nan t
Cross streeddirections to job site FEE
'oycirdee : : 1 Qtr. 1'ace 1 'Tater I s.
!
$e* de 1sing1eoror mukt.hirillydwellisgems.
Subdivision:1Tiver Terrace Loth: Tocttsdes atttebedgaaage-
Tatrmap/patcel#: 1000 sg R or less ) 1685$ 4 ,
Ea.*1*Si.h mpotiloa 4 A 33.9.3 1
'' SEriatr11.311 tJT''WORK Umrti4mtesity;ms 0attia7
twit abovesq.it)
ySOD
3
i Single Family
Limited[ melti-latnity ?3.tm 2
t�l(With above sq.2)
'iP 1a 1?Y OWNER I El TENANT SeaBct4Or srrt Q tlesPaga2
" Servtieseir[eedersitas4dtatiat„alkratsn;aadJor relocation
Name:Polygon floss
y$ _ 200 sows or1&s 100_70 2
Address 1891 136 St 2of naps 44 0 U pI 13356 2
401 Iran to 600 tmyn 200,33 2
City/State/ZIP;Vancouver WA 98660 tit aatpe 101,000 snaps Sot A4 2 i
Photic:(360)6957700 Fax:( ) Oe 1,000 amps or volts 55226 2 [
Email: Temporary service.*or feeders intonation,alteration,and/or
relocation 9��
Owner installation:Thisinstallation is being made on property that I own which is not 200 amps or kis 59.36 I k
intended for sale,lease,reit,or exchange,according to ORS 447,449,670,and 701. 201,arils to 400 amps 125,08 2
Owner signatur Date: 401 ramps to
599 amps 168,54• 2
±iT!lft c4Nr - , 0 CON7CACr PJtRSOIY Branch I:kasha—Oaw,alteration,or extetuton, r panel
A.Pae forbJaMPf ciicsls s lrh
Business own=Garner Electric Washington,LW abonn service or reedar tom;
each branch circuit
7.42 2
Contact name;13111 Daniels PJ.Fee iorbnttch cik+dts Wawa!
Address:6101 NE Si Jahns ted: =rice aRedcr Tea.first 56.16 2
branch eiredd
City/Sta#c/ZI1':Vancouver W.A.98661 Eachaskilbtandtchrcuk 7.42 2
Misedlaaww{aervted or(ceder not included)
Phone:(1/5;3)324-1657 Fax::( ) Eac»:»lanthmucd or Modular 67.84 2
- dwelling.'opvaceand/oribeder
Bnaii bdatriels@gwsnsrt.coat Rccomectoidy 6784 2 l
,"11,i,„ '. t' ,tg7'tiACroit . ramp w jip)Oig1 circle- 67.84 2:.
Business name:Garth Electric Washing(on,LLC sign or otulinc ligiwog 67.84 2
Signal ei o afs)er timikt-energy.
Address:6101 NE 5t,loons Rd CJ See Paget, 2
Panel.alteration.or.esttensian, _
•Etch add5ifanaaltotyable in apl inspection over of lite above
City/State/ iP:Vancouver WA 98661 Y
All#0loosi intlwrinn(1 ter thin) 66;25/br I
Phenix(253)320-1657 Fax:( ) fns stlgation(l hrmin) 9000/hr
Serail:bdaniels tvetisa, lnriastsielPtant(1 Uritis) 78.18/hr
Ltspaotionsforv4ikhnofeels 50.Q0yhr
CCB Lie,; 01158 Eleatical Lia:208174 Supty.Lic.:44968 sPe a6catty lined t'ht,r mi)
Sum Electrician;Ignatius;required' 4 i] / pI A.JL Subtotal;
Print marts:Joan P Albert v ail I(tt ❑Plan Review Requited(25%of pendlt Ike):
State surcharge 02%ofPtrmit rem): I
Authorized signature:--a....____------ TOTAL PERh11TFEE:
'fhbPesaro err entInnrspirwrita;penultbnet•,oblaiueafield.180
Printnalne:Bill Daniels bate: l��'act 1U day:,SKttbubeta segotedeaeorap
• Make(ofiasiYidlodgallawwdperpermik
re .e.. lil n„ES£dce Rtr:Ord171:at$: 4464615T 11NSiCOMewEa 1
1
t
Plumbing Permit Application
Building Fixtures
Ct-� Received PermitNo.:"S7 /b"C)OO5"/
City of Tigard iEdlIllIllIllIllIlIllIll1.11111lMm
l� Date/BY:
13125 SW Hall Blvd.,Tigard,OR 97223 Pfau Review Other Permit lio.
Phone: 503.718.2439 Fax: 503.598.1960 FEB 2016 Daisy.
Inspection Line: 503.639.4175 Date RcadyBy furls. Si See Page 2 for
I s C5 ' � NoutrodlMethoei Su lementalinform n
Internet:
www ngard-0r gov 1- r► „ ,
..-; For special information usa checklist
III ®Demolition Description 1 �+: 1 Total
New construction
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
#.' �.. _ = l T° SFR(t)bath 312.70
*°r '''''':--4"': ' y.3�x b i t'-n k',sero i tis.�t� �`m S,(_j "5i y,r''''''''
*. 'n I
.�. ,�-''t- u� ,6 ,>. k._a, ��,»� u ' :41 437.78
SFR(2)bath
II 1-and 2-family dwelling 0 CommcrciaUindustrial SFR(3)bath 50032
Q Multi-family Each additional bath/kitchen 25.02
❑Accessory building
❑Master builder
0 Other: Fire sprinkler( sq.ft.) Page 2
, �'M ' "�' 3:1 ® 1 A Site, cs:
Catcb basin or area drain 18.76
Job site address: �` '1- -.)+N(J ], ' t�ywell,leach line,or trench drain 18.76
City/State/ZIP: �h Q r �'�0 C a 10 �Cl-1-I,��L� Footing drain(no.linear ft.: ) Page 2
Suitc/bldgiapt.no.: Project name: 9011 ory-1 at-
1 :k'
Wt W5`l/C� Manufactured home utilities 50.03
t f,ellt''i�/1 M 18.76
U 1; \ ,
Crass street/directions to job site: p� uQ,� Y .t - 18.76
Raioles
n anhdrain connector
Sanitary sewer(no.linear ft:_) Page 2
Storm sewer(no.linear ft.:_J Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: I Lot no.: Fixture or item:
Backflow preventer 3127
Tax map(parcel no.: Backwater valve
12.51
.. ' ---$:;7.4-4.44,44'.'57, 1, "- ,,,,,,,-.'sk5 a' x `x`�. 74. s. as2 »iclothes washer 25.02.t a § . ;a „,..?,.-42,..1._1{ -..
irk n i n l�m ,\..i Dishwasher 25.02
t t C t/ Drinking fountain 25.02
Ejectors/sump 25.02
@ra ., _Lxpansiontank
12.51
.a 25.02
„. . . .._ Fotturelsewa cap
Name: pp 5,,--y\ W l� 1' Floor drain/floor sink/hub 25.02
Address: i '- '-� , ` - Garbage disposal 25.02
1�� �i �' A q a (O1� Hose bib 25.02
City/State/ZIP: j a h,,
�) Ice maker 12.51
Phone:( D
i 0 Fax: 0 o0 -� L , 25.02
�Yinicrccptor,grease trap
`' ar r Page 2a :41.1 ._r. % x� �«,=.1.......-..,.....,.. sMedical gas(value:S )aB: usin-essssname1tt /r�rl'ric3` .jt_ xr�l�iv} 1.,
L C Primer 12.51
Contact name: M.ei A k,;}-1,4 .....k_.r#'v Roof drain(commercial) 12.51
Address: 2 D.4_ (' "j'
Sink/basin/lavatory
25.02
Solar units(potable water) 62.54
City/State./ZIP: ,7u E'�i ttv1 D~} l� - 12.51
Tub/shower/shower pan
PPhone:Al i ) gQ(A ' 'KN.-3 Fax :( ) Urinal 25.02
�� 25.02
E-mail: * b�, s •A• ../ ..+ Water closet
. , 3T'"�7':-.,-.;;-...,."Z,'21:,,,,,'?'0s 'a ..:..•.a. ^" " t a r ,,... 37.52
r w .�. cva�' '' -,..-c3 S'. k �' Water heater
� �.� �� ���tib.. �. � � � ��
Business name: t� ) t �3 ,1.,_, � Water pipin�DWV 56.29
K,i--vi T �1,..y.„64,^ T �lrt.klrltirr 25.02
Address: PD`1- 13?z -Other:
td 2
Subtotal
City/State/ZIP:�'jy-ctsha,An OR_ czo Minimum permit fee: S72.50
Phone:(911) I- 1'1433 Fax:( ) - Plan review (25%of permit fee)
2 Ft2
CCB Lie.: ,(��p Plumbing Lic.no State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
This
it application expires tf a permit is notampler_obtained within 188 days
I Print name: M a fr ilrte'MA J, I Date a-`9/t/r I after it has been accepted as comptete
l f 'Fee methodology ser by Tri County B uldmg Industry Service Board.
410-46r6T(VO,OZC0.ti1/WEH)
1:Building`Fu \miraPLMU-PamerApp.dx 10/01/09
1
4 , •
Mechanical Permit AnnlicalltECFrVED I .)1,1()1 1 1( 1
City of TigardReceived
Date/By Pmut Na.'
'"000--<7f
II --- 13125 SW Hall Blvd.,Tigard,OR 97223 FEB9, a 2_016 Plan Review
' 16 Phone: 503.718.2439 Fax: 503.598.1960 ' I--- " DareBy• Other Permit:
.., Inspection Line: 503.639.4175
tutu- RI See Pagel for
Internet: www.tigard-or.gov
r .- r i\Il !ON Noofiedqvitthed- Supplemental Information
11tPt*,:otorl-L-r°v'',..19;:::.':-.113:1A!:3::3-., :.-Da:77 71 - .,:cpmmxAcieti„, ,-:_FEE ':.. :sclo:Di:_ .(tz,-tRsg.lptitcla.ttn,
Mechanical permit fees*are basal on the value of the work
Egi New construction 0 Additionlalterationtreplacernent performed.Indicate the value(rounded to the nearest dollar)of alt
0 Demolition 0 Other: mechanical materials.ecaftiment.labor,overhead,and profit.
' '''' '''"-'''' •?:'''''-''''''':'::-470:*04341**.' „ -----=-=*;,„4- -, -..,4 -1---,, . ,.,_ „ , _„ Valu!:=S ,_...r.t......_=,........_,,, ..,._ ,,
, -- , , , , , ,-„„.„,. , „:„-„.—,...., =-,--, ... ==ze,-.-,-------n,-4-'2, , -t-'- ev--,-. .:,7k.,!:pirrz.;,4,...,r. i 1,r. , Ic,,i 7 ', " c: „MT, •.,,,a, ,,',-''''-N....:-' '
I-and 2-family dwelling 0 Commercial/industrial 0 Accessory.building For special Information sae ekerilim
0 Multi-family 0 Master builder 0 Other. Description _ Qty. Ea. I Total
, .„:, ,..',,,„ .:,,,,itit-,'', ',.-.'..,' ..-1‘.:;;e:'-4146,10cAtiott 7..„, ,_, , '.,,',•,,, '-'-'„ Heatinifeanlinet
. ...c....,A.4
Job site address-. 1/53.t..,k0 1 0 Air conditioning 46.75
Furnace 100,000 BTU(ducts/vans)
46.75
City/State/ZIP: ‘"'NS).,("sV,, ipocc. C) q- _\\-1 0 , Furnace 100.0004-BTU(ductstvents) , 54.91
, 61.06
Suite/bldg./apt.no.: Project mune:..pC)K t,,,,,-, cj_ t,J04- ,.Ileat pump
Duct work 23.32
Cross street/directions to job site: ç2LQfn.,a,cp 11ydronie hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type.not electric),
in-wall,in-duct,suspended.etc. 46.75
Flue/vent for any of above 23.32
Other: 23.32
Subdivision:River Terrace Lot no=:q (3'
Other fuel appliaoces:
Tax map/parcel no.: Water heater 23.32
Gas fireplaceinsat 3339
Flue vent for water heater or gas
HVAC fireplace 23.32
Log lighter(gas) 2332
Wood/pellet stove 33.39
Wood ftrepbcefinsert 23.32
Chimney/liner/floe/vent 23.32
' ' .1EtSibit4*le,1*---r';'=:7471'.',:r„. •,',Ig:::‘, -,!ITIN-i'.,,..:.--;,:,-5.:,..E-1;,-- - k=---6,-.„.. -tg,,g ,5;.4 Other: _and ventilation:
Environmental exhaust 2332
-" -:'," ----' • .t.'-`414 '-'4"• ' ''''''''' ''-'''''''' -'''''''',' ---: --"----'14'''''''-""''''''.," st
Name:Polygon Range hood/other kitchen
equipment 33.39
Address:109 E 13*St.Suite 200 -
Clothes dryer exhaust 33.39
City/State/ZIP:Vancouver,WA 98660 Single-duct exhaust(bathmoms,
toikt compartments,utility rooms) 23.32
Phone:(425)586-7700 Fax:( ) Attic/crawlvace fans 23.32
'',,-;f,.4::,0!'"Z44:::,.'-',,,,iii,:•iii,1::.,.,1-1;11;;;,girost'-",-*-,A41;-,4',",'‘-'i t-,Ct Z 4,,a t,,,i,e's:;*.s,„, ,i 4:t, n-'''')"..A.A Other: 2332
Fuel piping:
Business name:Apex Air LLC 514.15 for first four;$4413 for each additional
Contact name:Staci Hay Furnace.etc.
Gas heat pump
Address:2210 W.Main St.Suite 107-272
Wall/suspended/unit heater
City/State/Z1P:Battle Ground,WA 98604 Water heater
Phone:(360)3424109 Fax::(360)326-1769 Fireplace ,
Ranee
E-mail:staeib*apenaireo.com Barbecue
'''',2'f,:3--!:.` ,.-L'',..;',:i7.:::':i::::.:E•::,..4'',4''g '4.74',,,,k,:=4,',,'-V;"? ,' ,.'":.- .'4-7k4,k17,5i,t.:',..',-''''',•-..."':',4T:,'4.:-.',,it':1:- Clothes drYer(tas)
Other
Business name:Apex Air LLC
Address:220W.220 W.Main St.Suite 107-272 Subtotal
City/State/ZIP:Battle Ground,WA 98604 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(361))342-8109 Fax:(360)326-1769 State surdtarge(12%of permit fee)
CCB lie.:203034 - - - TOTAL PERMIT FEE
- This permit*optic:anon expires Oa permit is mit obtained within ISO
iffilt — days after it has bees accepted as eartplete.
Authorized signatur.. r r 0/ r` illir • Foe methodology set by Tri-coonty Building industry Service Board
- ...
- I
Print name:Staci bay Date: 1/2812016
t tfludtholiPernonAMEC_PcoreitApp.,040113 doc 440-1617i(11,117-cOMAKEB)
. . -,
IIIICity of Tigard
■
COMMUNITY DEVELOPMENT DEPARTMENT
T 1 c n lZ D Building Permit Review - Residential
Building Permit #: /11S7-ap/4 -- eve, Sy
Site Address: 13q.14 O SI l-154-1 Ave,
Project Name: Po\\)c n a+ \Nes- R`Ive v T e,Y a ce, Lot #: 9(3
(New clling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: n eN j Sc
Verify site address/suite# exists and active in permit/ystem.
gi River Terrace Neighborhood: ❑ No k Yes,See River Terrace Review Addendum Attached
Sit- Plan Elements:
h7 ' ree(3)copies of site plan sting structures on site
.7i Site plan must be on 8-1/2"x 11"or 11 x 17"paper ootprint of new structure (including decks)with finished
VA 'rawn to scale(standard architect or engineer scale) floor elevations
VA orth arrow 'Utility locations(required for new,may apply for additions)
44 to address,project or subdivision name and lot number of wells/septic systems
Ac? plicant information (name and phone number) MErosion control(including drainage-wap protection, silt fence
D'/,t dimensions and building setback dimensions ksign,location of catch basin,etc.)
! ot area,building coverage area,percentage of coverage andC�'I SS reet names
impervious area (applicable if R-7,R-12,R-25&R-40) p�Street tree size,type and location
,��
froperty corner elevations (2 foot contour lines if more than ¶'existing 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: E Yes,applicant was notified No Received: ❑ Yes ❑ No
L`�J Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified ❑ No 1 , Applied For: LYes ❑ No,stop intake
nd Use Case #: B2O1S— 6O(0u
�oning: 1
etbacks: Front Rear 1 5 Side 3 Street Side d Garage 7_4
$ot
Zit/Setbacks:
andscape Requirement: 2-0
Coverage Maximum: SO
Sit Building Height: Maximum Height 30i
Actual Height 16 1
--Visual Clearance
$ Easements
ensitive Lands: ❑ Yes ' No Type
Urban Forestry Plan
❑ Conditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: 41,0 - i )_ 6 ii 0 10 y_-L, Date: 2/0S / 00
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Fonns\BldgPennit Rvw_RES_012116.docx
Building Permit Submittal
Original Submittal Date: o?7o2s//�
Site Plans: # 3
Building Plans: # 5
Building Permit#: Enter building permit#above.
Workflow Routing: Planning - ngineering 0-Permit Coordinator C—uilding
Workflow Sign-off: 0-Sign-off for Planning(include notes from planning review)
Route Application Documents: engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
[ uilding: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: / / ,,i. Date: Q2 9 /
Engineering Review
Slope at building pad: f�
❑ 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
❑ N(
Notes: Condition remain unmet that are required prior to issuance of bldg. permits.
Approved by Engineering: /%l. j) Date: 27:„/"9•-/C.
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
igPApproved,NOT Released: der Date: %Ø'ç'
Notes: /yC .- e-An4114-,
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:
?g'SDC Fees Entered: Wash Co Trans Dev Tax: l'es ❑ N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: Yes ❑ N/A
yOOK to Issue Permit �j � /'
Approved by Permit Coordinator: ��e�%�� Date: / ` /
1:\Building\Fonns\B1dgPennitRvw_RES_0121 16.docx
1
z . -
111 li City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
■
T I G A R D River Terrace Building Permit Review Addendum
Building Permit #: /'/S7 z,j/&— 0005(
Site Address: i 3�L D SW 054-h Ave.. _
Project Name: Po\\)010(1 a-i- JJes* R►NIe.v \ef face. Lot #: 9S
(New fling= 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 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
in
Porch m . 5 ft. deepGabled dormer
ft. deep
min. 2ft., 5 ft.wide min. 2 ft., 6ft.wide
❑ ❑ ❑ ❑
2. Eyes on the street: a minimum of 12°o f each street facing facade must include windows or entrance doors.
Percentage Shown: IT 7 . .r
3. Ftrances: At least one entrance must meet both of the foll• ng standards:
Max. 8 ft. setback from longe t street- facing wall Y1 Parallel to street, angle no more than 45' from street,
or open onto porch
Entrance opens to a porch: Yes ❑ No —/
Iir,s, all the following apply: CSL 5 sq.ft. min.
ne street facing entry ,Vt 12 ft. max. roof height above porch
2 5 ft. depth min. �d 30%min. porch roof coverage
4. etailed Design: All buildings shall include a min. of five of he following elements on all street-facing facades:
overed porch min. 5 ft.wide x 5 ft. deep Recessed entry area min. 5 ft.wide x 2 ft. deep
AVall offset min. 16 inches ❑ Dormer min. 4 ft. wide
glA Roof eave min. 12 inch projection ❑yoof offset min. of 2 ft.
❑ Roof shingles either tile or woodable,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 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% 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)
0/12-foot-wide garage door ❑ 40%max. of street façade
V50% max. of street façade with 7 detailed design elements
Notes:
Apprdved By Planning: , ` I irn Le})ADO Date: 2 2Z 16
1:\Building\Fonns\B IdgPenni t R v w_R ES_RT_0121 16.doc x
Albert Shields
From: Albert Shields
Sent: Monday, March 07, 2016 4:44 PM
To: Maggie Gordon (Maggie.Gordon@polygonhomes.com)
Cc: Tom Hochstatter
Subject: River Terrace Northwest, Multiple permits
Maggie, here are eleven more that are going on Hold as"Approved but Not Released" pending completion of required
conditions of approval. Albert.
MST2016-00051, -00053, -00054, -00055, -00056, -00057, -00059, -00060, -00063, -00064, &-00065.
1
POLYGON /M NORTHWEST COMPANY
RE ..gee
April 27,2016
APR 27 ?016
art OP' 1NI
Mark VanDomelen (1r
Building Official BULL lN( y),I`?:Sft)i
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
Regarding: West River Terrace Building Permits
Dear Mark:
I am writing you in regards to the understanding of the agreement between the City of
Tigard&Polygon NW.
Polygon is fully aware that we are being issued full building permits on the below list of
30 lot and agree that we will put in foundation only until certain site development
conditions are met. We will not start framing on any lots in West River Terrace until the
city agrees that conditions have been met.
Lot 73 - 17307 SW Jean Louise Road
Lot 74-17331 SW Jean Louise Road
Lot 75 - 17349 SW Jean Louise Road
Lot 76- 17363 SW Jean Louise Road
Lot 77- 17387 SW Jean Louise Road
Lot 78 - 13726 SW 174th Loop
Lot 79- 13738 SW 174th Loop
Lot 80- 13752 SW 174th Loop
Lot 81 - 13758 SW 174th Loop
Lot 82 - 13766 SW 174th Loop
Lot 93 -13749 SW 175th Ave
Lot 94 - 13765 SW 175th Ave
Lot 95- 13793 SW 175th Ave
Lot 96- 13849 SW 175th Ave
Lot 97- 13835 SW 175th Ave
Lot 98- 13840 SW 175th Ave /MST ,/ — 000.5"Y
Lot 99- 13850 SW 175th Ave
Lot 100- 13790 SW 175th Ave
Lot 101 - 13776 SW 175th Ave
Lot 102- 13754 SW 175th Ave
Lot 109- 13751 SW 174th Loop
Lot 110- 13769 SW 174th Loop
109 East 13th Street,Vancouver,Washington 98660
(360)695-7700 • (503)221-1920 • Fax(360)693-4442
www.Polygon homes.com
CCB#166871
POLYGON /� NORTHWEST COMPANY
Lot 111 - 13787 SW 174th Loop
Lot 112- 13853 SW 174th Ave
Lot 113 - 13837 SW 174th Ave
Lot 114- 17372 SW Jean Louise Road
Lot 115 - 17368 SW Jean Louise Road
Lot 116 - 17344 SW Jean Louise Road
Lot 117- 17328 SW Jean Louise Road
Lot 118 - 17302 SW Jean Louise Road
with us in order toget this project
We greatlyappreciate the City of Tigard working
PP .
underway,we look forward to building this project along with many others within the
city of Tigard.
Sincerely,
Chris Walther
Project Manager
503-312-6213
109 East 13th Street,Vancouver,Washington 98660
(360)695-7700 • (503)221-1920 • Fax(360)6934442
www.Polygonhomes.com
CCB#166871
Plumbing Permit Application
Building Fixtures R -
Cityof Tigard Received
g L p 1 b 2016
Date/B I // Permit No.: r,�St ., Oo
lig U 13125 SW Hall Blvd.,Tigard,OR 9723 y" ��L /f '"4 ��� VV(1��
• Phone: 503.718.2439 Fax: 503.598.1960 r°,, Plan Review
_ Other Permit No.:
Inspection Line: 503.639.4175 CITY r i/tom t`� Date/By:
I I l Alt t) . /C.`1 Date Ready/By. Juris: ® See Page 2 for
Internet. www.tigard-or.gov F3 LD N.,`_ I f,o,_ �- Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
®New construction ❑Demolition For special information use checklist
Description I Qty. I Ea. I Total
0 Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory buildingSFR(3)bath 500.32
❑Multi-family
Each additional bath/kitchen 25.02
0 Mash . ' a er 0 Other:
Fire sprinkler( sq.ft.) Page 2
/3,95-O. JOB SITE INFORMATION AND LOCATION Site utilities:
Job sl a a., -ss: 6/1/1) /7 5417 4 KL Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name:Polygon at West River Ter 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 ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision:Polygon at West River Terrrace I Lot no.: iv Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
C4 flay c/ s'K t 7o ,` Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
E PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Name:ADVL Land Holdings,LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:7600 E Doubletree Ranch Road Garbage disposal 25.02
City/State/ZIP:Scottsdale,AZ 85258 Hose bib 25.02
Phone:(602)694-4031 Fax:( ) Ice maker 12.51
0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:William Lyon Homes,Inc Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Angela Grajewski
Roof drain(commercial) 12.51
Address:109 East 13th Street Sink/basin/lavatory 25.02
City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54
Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51
E-mail:Angela.Grajewski@polygonhomes.com Urinal 25.02
Water closet 25.02
CONTRACTOR Water heater 37.52
Business name:Malmedal Enterprises Inc. Water piping/DWV 56.29
Address:PO Box 207 Other: 25.02
City/State/ZIP:Banks,OR 97106 Subtotal
Phone:(503)324-0759 Fax:(503-)324-0580 Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lic.:102535 Plumbing Lic.no.:34-276PB State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name:Carolina Malmedal Date:04/25/2016 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 Service Board.
I.\Building\Permits\PLMU•PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
13850 SW 175TH AVE, SHERWOOD, OR, 97140
Residential - Master Permit
199 Electrical final
PASS
MST2016-00054
David Young
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
13850 SW 175TH AVE, SHERWOOD, OR, 97140
Residential - Master Permit
299 Final inspection
PASS - C of O
MST2016-00054
David Young
Final erosion control approved.
Street tree certification received.
Moisture content form received.
High efficiency lighting form received.
Vapor barrier form received.
Insulation certification checked.
Blower door test report checked.
C of O left on site with contractor.
Violation Summary:
Inspector Contractor