Permit (48) INrpt CITY OF TIGARD i6, ._ MASTER PERMIT
•
' COMMUNITY DEVELOPMENT Permit#: MST2016-00093
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/03/2016
Parcel: 2S1060002900
Jurisdiction: Tigard
Site address: 13751 SW 171ST AVE
Subdivision: WEST RIVER TERRACE Lot: Multiple
Project: Polygon at West River Terrace, Lot 40
Project Description: New SF. 12/20/2016: REPRINT to add NC.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 809 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 25 Bathrooms: 3 Second: 1049 sf Garage: 437 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 1858 sf Value: $232,139.51 Rear: 20
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel 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: 3 201-400 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:
OTR SF VB R-3 1858
Owner: Contractor:
ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
7600 EAST DOUBLETREE RANCH 109 E 13TH STREET 1 A Geotechnical report is
RD,STE VANCOUVER,WA 98660 required before the footing
SCOTTSDALE,AZ 85258 2 Ersn Cntrl 503-639-4175
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $30,666.50
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 •,- 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: '/70/e'€ %70 9 /
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.
Mechanical Permit ApplicationEri=IIIIIIIIIIEIMMIIIIIIM
prElv
,...... Received
City of Tigard ,, .....
Dtair. Ptvm°No ii,irr„,>reyb-evey3
111 _- 1305 SW Hall Blvd..Tigard.OR 97223
niC PIM REVICW
' z- Phone: 503.7[8.2439 F . 503 591t.1960 m AR 09 Zu iu rtuday. Other Permit-
' Inspection Line: 503.639,417S
,...gDare Ready/By: Avis- ill Sce Pare 2 tar
Internet: www.tigard-or.gov
cvry OF 1 KiAti Nalifiedthdethod. SottIllermatal laformarion
ILQING nIvisi 14
:f-,;::%;',:tc;fij,i.z,:A'i,A.,itwe:iarltet'VVA:,,ltf,e,zs?::',It;,-.4Zif;:"i'8-N.di5:;:N::,'' ';','4704**t*I :0::-,r'€ .
Mechanical permit fees*are based on the value of the work
21 New construction 0 Additionialterationkeplacement performd.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,_5uipment.labor.overhead.and profit.
r S
ri.-1: i' ' '''' ''"titUW%1VJuZeViii, -- ----- ----- !. .
rye, oiroi,,,,
I-and 24family dwelling 0 Comtnercialiindusirial 0 Accessory building , Ferspeciellefbrenalsar We oteetlisa
0 Multi-family 0 Master builder 0 Other: Description f Qty. I Es. r Total
Vifrad41.-ki., -I .. 1 ' !.'`-'''-'e.1'r Wol,Q4.tg.,41'4V,gi;P:Y 11"""ie"lhiz
--- ' ' '''' . ' ' ' ' 1?.''''''''''-'''''‘'.*11.''''''" ' Air conditioning / _46.75
Job site address: I-01-n 5 • 1---4-t _AN—) Furnace 100,000 BTU Mums/vents) 46.75
City/StateafF: 5-V../rU.,rap oa o R q'3-1\.-I 0 Furnace 100.000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suiteibldgiapt.no.: Project ‘0:1\ • 0,j__
nme.a .- osrl u.)0L71- *Duct work 23.32
Cross street/directions to job sire: ni...,,,,,...,0 itydronie hot water system 23.32
Residential boiler(radiator or
hydronk) ' 23.32
Unit heaters(fuel-type,not electric), . .
.. in-wall,in-duct,suspended.etc. 46.73
Fluelvent for any of above 2332
Other:
Subdivision:River Terrace Lot no.: 14(:).
Other reel appliances: 23.32
Tax map/parcel no.:
Water heater 23.32
-,-•'''-;,''..,,""tr .T.'42-V-zk:^2.`..::".`24fei2;. ..4,',.1't1=-11",!.37. 1-,;14.,:.:=44''..11m'''''!%1P;;Iif'''''''''''''4...44''''4 4';''' "rivePlacermscrt 33.39
—" Flue vent for toner heater or gas
HVAC det ‘S .", C,..--- ' _fireplace 23.32
Log lighter(gas) 23 32
- - Wood/petier stove '..II 33.39
Wood fireplaceinsert 23.32
Chinoteyilinerlfluervent 23.32
23.32
,,r4-1,,,,4.,,c ,
En," • "—TA— ",1",'"' ' ' ' " ' .,,, '• ' ''..*' '': "-''''1' ''''''' t.'" ' " Environmental calmest and ventilation:
Name:Polygon
Range hood/other kitchen
equipment 33.39
Address:109 E 136 St.Suite 200
Clothes dryer exhaust 33.39
City/StateZIP:Vancouver.WA 98660 Single-duct exhaust(bathrooms,
toilet comparttneMs,utility rooms) 23.32
Phone:(425)586-7700 Fax:( ) Attic/crawlspace fans 2332
,:74ed-„ta/:„.,..,,,,,,,..“-1.`-..-,',..: trP. “;, 7,1'..444 • =-,1,..t.x..4tar4 °ther: 23.32
Fuel piping:
Business name:Apes Air LLC
514.15 1w-first roar:54.03 tor each additional
Contact name:Stied Hay Furnace.etc. 1
Address:2210 W.Main St.Suite 107-272 Gas heat pump
Waltisuspended/unit heater
,
City/State/ZIP:Battk Ground,WA 98604
Water heater
' Plicate:(360)3424109 I Fax:::(360)326-1769 Fireplace
•-
Range
E-mail:staeih@apermirto.com
Barbecue
::47.*::"",,:;.IgiTi.:4::'-.::ki:,!..:'irt..7. ,,.$:,:. :',:':... .i-I.,;-;Xkl.It];'':,'";:"615ft:'''.1tti•,efii:ii.42-;-Ag:i Clothes dryer(4as)
Business name:Apes Air LLC OtherI
.. ',V'41'41** '' ^:'•'....',":-.' 'T,''':.:4',.:Y.,7, ,.. 7i,s;0
Address:220 W.Main St.Suite 107-272
Subtotat
,
City/State/2/P:Battle Ground,WA 98604 Minimum permit fee(390.00)
Plan review(25%of permit fee)
Phone:'360)3424109 Fax:(360)326-1769
State surcharge(I r4 of permit fee)
CCR lie.:203034 At ? - - - - TOTAL PERMIT FEE- - —
P5
This penult appiimU
utos expires s permit is net okayed within 180
4110/10 ' ' dais idler it has bens accepted an rook*.
Authorized signatur. r ,
- • Pee Met hodeiogy set by Tri-Coiney Building Wooly Service Board
..,
Prim name:Strict bay ' Date:in8n016
(\n,..1,6,„,"...emEc_eamitAw_6401 13;lac 4404617T(11,()`COMAVE8
�� CITY OF TIGARD
s MASTER PERMIT
' COMMUNITY DEVELOPMENT
Permit*: 6-00093
Date Issued: 08/03/2
TIGARD 13125 SW Hat Blvd.,Tigard OR 97223 503.718.2439 8/03/2 016
Parcel: 2S 1060002900
Site address: 13751 SW 171ST AVE Jurisdiction: Tigard
Subdivision: WEST RIVER TERRACE
Project: Polygon at West River Terrace, Lot 40 Lot: Multiple
Project Description: New SF
BUILDING
Floor Areas
Stories: 2 Bedrooms: 4
First: 809 sf Require d Setbacks Re��
Height: 25 Bathrooms: 3 Basement: 0 sf Left: 5 Parking Spaces: 0
Second: 1049 sf
Dwelling Units: 1 Garage: 437 sf Front: 15
Third: 0 sf Smoke
Total: 1858 sf Right: 5 Detectors: Yes
Value: $232,139.51 Rear 20
inks: 1 Water Closets: 3 PLUMBING
Washing Mach: 1 Laundry 100
Trays:
Lavatories: 4 Dishwashers: 1 0 Rain Drain: 1
Tubs/Showers: 3 Urinals: 0
Floor Drains: 0 Sewer Lines: 100
Garbage Disp: 1 Water Heaters: 1 SF Rain Storm Sewer:
Footing Drain: 0 Ice Maker: 1 Water Lines: 100 Drains: 0
Hose Bib: 2 Backwater Value: 1 Bckflw Prevntr: 0 Catch Basins: 0
Drywell-Trench Drain: 0
Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Tvmi Air Conditioning: N
Natural Gas Vent Fans: 5 Clothes Dryers: 1
Heat Pump: N
Furn<100K: 1 Hoods: 1 Other Units: 0
Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit
Service Feeder
1000idsf or less: 1 -- p TemSrvc/Feeders
0-200 amp: 0 Branch Circuits
Ea add'I 500 sf: 3 0-200 amp: 0 W/Svc or Fdr: 0
201-400 amp: 0 201-400 amp: p
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 W/O Svc/Fdr: 0
401-600 amp: p
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:
OTR SF Type of Constr: Occupancy Group:
VB Square Feet:
Owner: R-3 1858
ADLEAST
LAND HOLDINGS LLC Contractor:
DL EAST DO DINRANCH WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
RD,STE 109E 13TH STREET 1 A Geotechnical report is
RD, TSDALE,AZ 85258 VANCOUVER,WA 98660 required before the footing
SC2 Ersn Cntrl 503-639-4175
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $30,524.14
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
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
days. ATTENTION: Oregon law requires you to follow the rules adopted byOregon will
952-001-0010 throu•.-QAR 95 ••1-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. the 180
the Utility Notification Center. Those rules are set forth in OAR
Issued By:
Aar
Permittee Signature: i /t./ ,9-",e./�
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. 'i---,70
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.
Buiidlu Permit A lication 2 0 7 l 6
RECEIVED City of Tigard
Received FOR OF FIC r l sr e)\l.l
13125 SW Hall Blvd.,Tigard,OR 97223 pp Date/B : /� ei
Phone: 303.718.2439 Fax: 503.598.1960 M +7 7 Plan Itevie Q Permit No
Inspection Line: 503.639.4175 A �y DateB 2 7 _ i Other Perms �
Internet: wwwtigardorgov
CITY �Q```�Yi� � DotiSed/M thod
Y OMSK)
az e SeeP.whira �
e lteaay/By: �/
i Supplemental Wormatiou
New construction
0 Demolition
Permit fees*are based on the value of the work performed.
❑
Addition/alteration/replacementIndicate the value(rounded to the nearest dollar)of all
0Other
equipment,materials,laborli,overhead,
this and the profit for the
S� F
re I 111
® 1-and 2-family dwelling ' �
0 Commercial/industrial Valuation: $
❑Accessory building a��.
0 Multi-familyNumber of bedrooms: L
❑Master builder
pNi �S. ❑Other. Number of bathrooms:
(k ��"Z75 g 1 LL11 o�ttnn S:
Job site address: ` J"TWiri Total number"floors: 2 j �
1.-3-
City/Stat�IP:Sherwood,OR 97140 t New dwelling area: l� 1�, square feet
Suite/bldg./apt.no.: Project name:Polygon at West River Ter Garage/carport area: J� square feet
Covered porch are
Cross street/directions to job site: a
• i square feet/0 Li.S
Deck area:
square feet
Other structure area: fe square feet
Subdivision: 'ill a � ,z Ott
Lot no.: D
Tax
Subdivision:
no Permit fees*are based on the value of the work o �
ormed
Indicate the value(rounded to the nearest dollar)of all
' * ° i � : - equipment,materials,labor,i
-. � , r,m overhead,and the profit for the
New Single Family Detached Construction " work indicated n ''
�on.
Valuation: $
Existing building area:
_ , � �� � square feet
� �'>� ate" ro a Newbuildin
�, �� �t a � ,x g area:
ti � "a�-�` � � � �"" �� � �: �� sq�'e feet
iffam . _
N . .rt �^ Number of stories:
Address ee �V �' ` � /f✓(TS Type of construction:
City/State/ZIP. ��
v® Occupancy gaups:
Phone (360)695-}780.---
�k Fax (360)693 4442 Existing:
Business name:Polygon WLH,LLC
Contact name:Maggie Gordon
Structural plan review fee(or deposit):
Address:109E 13thStreet ■
City/State/ZIP:Vancouver,WA 98660 FLS plan review fee(if applicable): Min
Total fees due upon application: 111111111111
Phone:(360)695.7700
Fax :(360)693.4442
E-mail:maggie gordon of Amount received:
@p ygonhomes coin
c .1 Commercial and residential rinstallation
t ` tion'
stem.
Business name:Polygon WL13,LLC
roof-top mounted Photovoltaic Solar Panel Sl of
Address:109E 13m Street Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
City/State/ZIP:Vancouver,W 98660 Solar Installation S.-tial Code checklist
Phone:(360)695.7700 Permit Fee(includes plan review
Fax:(360)693.4442 and administrative fees : $180.00
CCB lie.:207247 State surcharge(12%of
Permit fee): $21.60
fro Total fee due upon application:
$201.60`Authorized signature: of
it name:Ma This permit application expires if a permit is not obtained
ggie Gordon within 180 days after it has been accepted as complete.
Date:17/11/15 *Fee methodology set by Tri-County.Building Industry
'nglPeimitslBUP-RESPermitApp.doc 02/24/2011 Service Board
440-4613T(i l/02/COM/WEB)
N .
" - )-01,,, tri r rt
ii o I >4� srae>ti�d .� 1
1,3125 SW Ha1!Slott,Tigard,OR 972234g A� 0 9 016 Petri �Y Pcrmfl j��/y
Pham 503 718.2439 Fait 503.598.19,
, . Dai 1
Related Permit ty rl r inspection n�503439.417$ ,.'`� -1'I, P' R=dy Datetny F
S pPate ForI Internet vwdg ; °"ri! il , eaSupplemental Iafo
rmallaa3 `T�P�" t'^ �i. p "
®NNewconstrutdton E1 Md tionJa ':tion/replacement p� Pal '� ,. '
d t}crnol ❑Other: tuck al flat nty'(ra6aa'stsets atplms_+�tyi tats
• ❑Service or reedgi4000mps or tears C.113enete aver arres,
a,, A O h r: lv4 N5"i2tif i?OR1 where theavaetable Imdtc ..1.
a< 1-`thrid"11'a dwelling cxteeds lof30D l�Mai'inac old boatY.rds,
nib g Q Commercial/industrial aaueee u0sousor L7ftoetmggetiat„gs
j' I�Mtiltlzuaty (''�y�• r, 0Aotxssorpbuilding Ietstopourrd,ora�cacdsldrtmt (�CvmiaueT�:uaa
1 �. L.{, trr$$ter Utlll4er saps coral(of ritutellations. t Uittq'dt
Ij Other: buildings.
.
SiTt3INX liktAn0r4AND L45G4TION 13FIrep;mp. lliacmlh6oaoflidtCyAor
St)Ik#: Jo1J Sttm ad<1rESS: Q&ncrpeacy 53'. m.. targeraeparately derived.
- ': LlAddition ormwtaotwToad of system .
City/State/ZIP:Sherwood t)lr 971411 1001{P mein Q a '8",'1-3**,"t•3.> t
❑Sec or ata*residential unit*; occupancy, I
Suite/bldg/apt . Elltoekh-oars raoiiides, Ll0S. eatropai vduete'perk
Frojet name; QBazatdwrs
Cross stteet/directonstojobSlee: -- llsenaor C7Supply�satmeet�rrw*aFaa
amps orator*. 6m)vales agmina{;
Mechanical Permit Application
II City of Tigard
ateitir Permit No/ttr-r,?evb e003
13125 SW Hall Blvd.,Tigard,OR 972-31:
Phone: 503318.2439 Fax: 503.598.1960 MAR 0 9 2016 113" Other Permit
Inspection Line: 503.639,4175
A ri Date Ready/Br
Internet: www.tigard-oreov
ciTy C)F Ittitedmethod: I surd See Plateat2ftolfr. stion
LDINC:3 1:11\11 ;1°1\'
Mechanical permit fees*are based on the value of the work
Esi New construction 0 AdditionialterationinTlacement
performed,Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment.labor,overhead:.and profit,
Value:S
':7<",
121 and 2-family dwelling 0 Commercial/industrial 0 Accessory building Far special Information use dreekliato ,
Multi-fami 0 Master bulkier 0 Other Description Qty. 1 Ea. Total
Heating/cooling:
Job site address: I"214 Air conditioning 46.75
Furnace 100,000 BTU(duetskents) 46.75
City/State/ZIP: bl-NgJrVJarDOCI, 0 q/-1\-1C) Furnace 100,000+BTU(duets/vents} 54.91
6 .06 1
Suitelblidgiapt.no.: Project name: peK t;),r) ID4ru ta PI Vuomr kP
2332
I Cross street/directions to job site:
liydronic hot water system 23.32
NC ((_P
Residential boiler(radiator or
hydronk)
Unit heaters(fuel-type,not electric)-
m-wa
' 11 in-duct,suspended,etc. 23.32
46,75,
Flue/vent for any of above 2132
Subdivision:River Terrace Lot no.: LA C) Other 23.32
Other fuel anitlisoetts:
Tax map/parcel no.:
Water heater 23.32
OF:441114--m-tt'Alt" Gas fireptacelnisert
: 3339
Flue vent for water heater or gas
HV.AC C
fireplace 23.32
Log lighter(gas) 2332
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
' Environmental exhaust and ventilation:
Name;Polygon Range hood/other kitchen
equipment 33.39
Address:109 E 130 St Suite 200
Clothes dryer exhaust 33.39
City/State/ZIP:Vancouver,WA 98660 Single-thiet exhaust thathmonts„
toilet compartments,Wilitv rooms) 23.32
Phone:(425)916-7700 Fax:( )
Attiricrawtspace fans 23.32
Other 2332
Fuel piping:
Business name:Apex Air LLC
St4,15 for first fear;S4,113 for each additional
Contact name:Stacl Bay Furnace,etc.
Gas heat pump
Address:2210 W.Main St.Suite 107-272
Wallisuspendedfunit heater
City/State/ZIP:Battle Ground,WA 98604
Water heater
Phone:(360)3424109 Fax:;(360)326-1769 Fireplace
Range
E-mail:stacib*apexairto.com
Barbecue
14 es Clothes dryer(gas)
Other
Business name:Apex Air 1.1.,C
Address:220W.Main St.Suite 107-272
Subtotal
City/State/ZIP:Battle Ground,WA 98604 ' Minimum permit fee(590-00)
Flan review(25%of permit fee)
Phone:(360)3424109 Fax:0360)326-1769
State surcharge(12%of permit fee)
lic,:203034 if - - TOTALPERMIT FEE
CCBThis permit application expires if a petal it is not obtained within tin
days after it has been accepted as coon**.
Authorizedsignatur4! Fee methodology set by Tri-eounty Building Industry service Bond
Print name:Stull bay I)ate: 1/28/2016
4tintisnotnenswitc gerreirAuefient 13 atx 440-46i7T liarCOMMEB)
Plumbing Permit Application
Building Fixtures I ED{{
® � alb Received
City of Tigard Pmnit No C
et 13125 SW Hall Blvd.,Tigard,OR 97223 p �� ��''eat)j
>g
1,4
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
�q $ Otho 1 nnnit No.:
1 t t=41 €� inspection.Line: 503.633.4175" 1 O 1 tislot4 paw Ready�By: auris: Bl See Page 2 for
Internet wwW tigard or goy Noattcd titethod Supplemental Information
r. n ew„ r :c...34141,,', 4^ y "' i-" �" ''^fie , z+z. ..yam , , ,r...:'"
0'1Vew construction Demolition For special information use check.
Description I Qty. I Ea. I Total _
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
P s;: „, `, ,„,, "" SFR(1)bath 312.70
""�-'� �.. ._.e.,ate tx;, ,_-
ill 1-and 2-family dwelling II Commercial/industrial SFR(2}bath 437.78
SFR(3)bath 500.32
❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02
0 master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
s ; i s ":',.4,-,-2"'÷1
4 ole ,g s CatchStiaties:
Job site address: '� 1 /€ basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: hQ r )1,)0 D A OR Ctl-k L�`�(9 Footing drain(no.linear R `
: ) Page 2
Suite/bldg./apt.no.: Project name: Val l (� - \kl t. Manufactured home utilities 50,03
Cross street/directions to job site: „fe "` . 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: ( Lot no.: - `° Fixture or item:
Backflow preventer 31.27
Tax map/parcel no.:
_ '...iiBackwater valve 12,5!
t. ',:°0`0°1, , ! . u _ - .--., _ . ' -
�� �� � »�� �� � `� � Clothes washer 23.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
N P� g- tvw % Expansion tank 12.51
Name: PD r i � Fixtur sewer cap 25.02
/� 9 '� f� (�, Floor drain/floor sink/hub 2102
Address: t`�U Y� : '✓ J- Garbage disposal 25.02
City/StatciZlP: „..,i q Hose bib 25.02
Phone (ND 6`1 _ .0 Fax: 0 o� `D ci \ /, Ice maker12.51
4,44 i '" , . -•",Jat, :� interceptor/grease trap 25.02
Business name: Medical (value:$ ) Page 2
V-,..,..t r":.. _r.y)43.,x. ) 1 L.�,A'1-NVNI V-%l..it ,, Primer 12.51
Contact name: IV) vi+,,v-i,..t ) Roof drain(commercial) 12.51
Address: ; l:y.4. 01-7'�a
Sink/basin/lavatory 25.02
City/State/ZIP: /. i s li.-} Solar units(potable water) 62.54
c t Tub/shower/showe pan 12.51
Phone:Ali ) 1p t l T3 Fax::( ) 25.02
E-mail' }} Urinal
yrs
" Water doses 25.02
� < � Water heater 37.52
Business name: .1~ -h f'.il r.,p, ,,rN P(1-t ,. ci t 'L, Water piping/DWV 56.29
Address: C GD-1.. 13-i Other. 25.02
City/State/ZIP: ,y.'C,, 1'")LI.-M i i. ' Subtotal
Phone:(C" 1) g. .'43113 Fax:( ) Minimum permit fee: $72.50
CCB Lie.: it7 .4-, 2. h......._Plumbing Lie.do Plan review (25°/.ofpetmit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
This permit application expires tt a permit is ant obtained within 180 days
Print name: Ma j< , -:{ i /'�1 .1'j Dat4 G I j j after if has been accepted as complete
-
...Fee! i *Fee methodology set by Tri-County Building Industry.Service Board.
.t:\Bidding'Panins'PLMU.PemitApp.dvr 10/01m 440-4616T(10?021COM/WEB)
' lllIlIl
City of Tigard
• COMMUNITY DEVELOPMENT DEPARTMENT
■
T I c n tz n Building Permit Review — Residential
Building Permit #:
Site Address:
..gar `S'Z % 2.
Project Name:
• - -4 -0- kdr- /r .Y,,,„ �1, '' Lot #: �
'
(New d ng=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: A
ierify site address/suite#exists and active in
st
/ver Terrace Neighborhood: pernu�t sem.
❑ No l/d'Yes,See Raver Terrace Review Addendum Attached
Site lan
ee(3El) coements:pies of site plan
t e plan must be on 8-1/2"x 11"or 11 x 17"p p ;� ; sting structures on site
a er o r elevations t of new structure (including decks)with finished
wn to scale(standard architect or engineer scale)
Pith arrow ,fl or elevations
�l t�" ty locations (required for new,may apply for
address,project or subdivision name and lot number additions)
ri?licant information(name and phone number cation of wells/septic systems
iotYep rosion control(including drainage-way protection, silt fence
dimensions and building setback dimensions
area,building coverage area,percentage of coverage and
d w location of catch basin,etc.)
' pervious area(applicable if R-7,R-12,R-25&R-40) tet names
ropert5 corner elevations (2 foot contour lines if more Street tree size,type and location
foot differential than sting trees to be retained with drip line,and tree
LP .rotection measures
I.
lean Water Services—Service Provider Lette of platted prior to 9/10/1995):
equired: E Yes,applicant was notified
Public Facilitie mprovement F Perini No Received: ❑ Yes ❑ No
Required: m t
Yes,applicant was notified ❑ No
Applied For:
es E No,stop intake
v/and Use Case#: I /Q '' ' ''.-- Act
-► /
oning: Act _►- �"C---i4etbacks: Front Rear
andscape Requirement: Side Street Side � ' Garage //
Lot Coverage Maximum: &
0 uilding Height Maximum Height
isual Clearance Actual Height
asements
sensitive Lands: Yes
It' Urban Forestry Plan ❑ No Type 7 ?
0 Conditions "Met"prior to issuance of building permit
Notes: Q7
iii
Approved By Planning:
Revisions (after Building Submittal only) ~, `� //. Date:
Revision 1: 0 Approved 0 Not Approved Reviewer Date
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
1:\Building\Forms\BldgPennitRvw RES_012116.docx
Building Permit Submittal
. /�
Original Submittal Date: # -5Site Plans:
Building Plans: #
Building Permit#: 2--Enter building permit#above. [�'1'ermit Coordinator l tsuilding
�Plannin l� Engineering
Workflow Routing: g
Workflow Sign-off: Sign-off for Planning(include notes from planingreview)
Route Application Documents: Q'"Engineering: (1) copy of permit application,
plan, (1) building plan and
original plan review routing form.
ffrBuilding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: 41VDate:
Date:
By Permit Technician: /��/�
En eering Review
Slope at building pad:
Conditions "Met"prior to issuance of building permit
Easements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility: ❑ No
Assess Water Quality Fee in-lieu: ❑ Yes 0 No
Assess Water Quantity Fee in-lieu:'- 0 Yes
0 No
LIDA Facility on lot: 0 YesDate:
0 NOT Appro ed by Engineering:
JO'
s ,.Lee
Notes: ,-__ . _. �. -- _
/ Date:
a.
Approved by Engineering: Date
Revisions (after Building Submittal only)
Reviewer
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
Permit Coordinator Review
0 Conditions "Met"prior to issuance of building permit /
Date:
�pproved,NOT Released:
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: ►:"" es ❑ N/A
?62
Tigard Trans SDC: Yes 0 N/A
Parks SDC: Yes 0 N/A
pK to Issue Permit J
-- _i_____/ __
�� ,
Approved by Permit Coordinator: i , Date:
1:\Building\Forms\B1dgPennitRvw_RES_012116.docx
City of Tigard
N COMMUNITY DEVELOPMENT DEPARTMENT
II
T I G A a nIN
River Terrace Building Permit Review Addendum
Building Permit #: i J- /6 — 09-3
Site Address: 4.? S'7 S'4U ///S"2- /7i..e
Project Name: Ae7/ .�
(New d 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.
Porch min. 5 ft eep Balcony w/ access 2 Window Projection Vertical Wall Offset a
ft. deep mm. 2ft., 5,`ft.wide min. 2 ft., oft. wide Gabled dormer
_ft i aft
•
2. Eyes on the street: a minimum of 12% Bch street facing facade must include windows or entrance doors.
"
Percentage Shown: /,J+
3. E rances:At least one entrance must meet both of the follo g standards:
Max. 8 ft. setback from lone street- facingwall Parallel to street,angle no more than 45° from street,
g or open onto porch
Entrance opens to a porch: Yes ❑ No
If y ,all the following apply: VIZ sq.ft. min.
ne street facing entry ft. max. roof height above porch
g
5 ft. depth min. 30%min.porch roof coverage
4. DEtailed Design:All buildings shall include a min. of five of t following elements on all street-facing facades:
r�7"7/ vered porch min. 5 ft.wide x 5 ft. deep Recessed entry area min. 5 ft.wide x 2 ft. deep
all offset min. 16 inches ❑ D. er min. 4 ft.wide
Roof eave min. 12 inch projection i/ ' •of offset min. of 2 ft.
❑ Roof shingles either tile or wood rZ Gable,hip or gambrel roof design
tch
enpsidinlAmin. 40ented %of streetth min. O0 sq.facade ft.
❑ Hrizontal lap siding min. 3-7 ft.wide
2: gndow trim min. 2 /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:
Np closer to front or side lot line, than longest street-facing wall. es ❑ No. If No (Check one):
0ay extend up to 5 ft. if there is a covered front porch and garage does not extend beyond the front porch.
ay 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 -foot-wide garage door0%max. of street facade
max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: �m ./
. . _! Date: 3
�� . 0
1:\Building\Fonns\B1dgPennitRvw RES RT 012116.docx
Plumbing Permit Application `
Building Fixtures SEP 2 .0 2016 I OR OIII( I l Sl t)vI.1
City of Tigard Date/By:
y lQ 'KI K.. , PaJnitN i 5,7A+lc._60 el 73
■ 13125 SW Hall Blvd.,Tigard,OR 97$23 ' N,'plan Review
II 71 Phone: 503.7182439 Fax: 503.598.1960°" Date/By: Other Permit No.:
Inspection Line: 503.639.4175 Date Ready/By. Juris: El See Page 2 for
Internet: www.tiardor. ov
g g Notified/Method: Supplemental Information
►:i New construction ❑Demolition For special information use cheek/is'
Description f Qty. I Ea. I Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION" SFR(1)bath 312.70
®I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 1 500.32
❑Accessory building ❑Multi-family Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler(_sq.It) Page 2
- .JOB SITE INFORMATION AND LOCATION - Site utilities:
Lit �® ' Catch basin or area drain 18.76
Job site address 3 l-1 1 ! 1
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.: ) Page 2
Suite/bldgJapt.no.: I Project name:Polygon at West River Ter Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision:Polygon at West River Terrrace I Lot no.:40 Fixture or item: -
Tax map/parcel no.: Backflowpreventer 31.27
DESCRIPTION OF.WORK Backwater valve i 12.51
- • •
��-y� i Clothes washer 25.02
U/lt Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
2.PROPERTY OWNER _ • I. 0 TENANT Expansion tank 12.51
Name:ADVL Land Holdings,LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:7600 E Doubletree Ranch Road
Garbage disposal 25.02
City/State/ZIP:Scottsdale,AZ 85258 Hose bib 25.02
Phone:(602)694-0031 Fax:( ) Ice maker 12.51
®.APPLICANT
0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:William Lyon Homes,Inc Medical gas(value:$ ) 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 PlumbingLic.no.:34-276PB
State surcharge(12%of permit fee)
Authorized signature: C.. _,..... TOTAL PERMIT FEE
I Print name:Carolina Malmedal I Date:04/25/2016 I 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:1BuidingTennits\PLMU-PesmitApp.doe 10/01/09 440-4616T(IOIO2ICOM/WEB)
I
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
13751 SW 171ST AVE, SHERWOOD, OR, 97140
Record Type:
Residential - Master Permit
Inspection Type:
399 Plumbing final
Result:
PASS
Comments:
Violation Summary:
Inspector
Tel: 503.718.2439
Inspection Date:
January 10, 2017 at 11:56:33
AM
Record ID:
MST2016-00093
Inspector:
Aaron Cillo-Gobel
Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
13751 SW 171ST AVE, SHERWOOD, OR, 97140
Record Type:
Residential - Master Permit
Inspection Type:
699 Mechanical final
Result:
PASS
Comments:
Previous corrections have been completed
Violation Summary:
Tel: 503.718.2439
Inspection Date:
Record ID:
MST2016-00093
Inspector:
Chip Barnett
Inspector Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
13751 SW 171ST AVE, SHERWOOD, OR, 97140
Record Type:
Residential - Master Permit
Inspection Type:
299 Final inspection
Result:
PASS -CofO
Comments:
Hi efficiency lighting report received
Blower door test report received
Street tree certification report received
Moisture content report received
CWS approved final erosion
Violation Summary:
Tel: 503.718.2439
Inspection Date:
Record ID:
MST2016-00093
Inspector:
Chip Barnett
Inspector Contractor