Permit (50) IN _ ol CITY OF TIGARD MASTER PERMIT
. COMMUNITY DEVELOPMENT Permit#: MST2016-00098
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/03/2016
TIGARD Parcel: 251060003000
Jurisdiction: Tigard
Site address: 17157 SW JEAN LOUISE RD
Subdivision: WEST RIVER TERRACE Lot: Multiple
Project: Polygon at West River Terrace, Lot 45
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 628 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 23 Bathrooms: 3 Second: 1017 sf Garage: 418 sf Front: 12 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 1645 sf Value: $206,541.67 Rear: 3.5
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 Rain0 Storm Sewer: 100
Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Tvpes Air Conditioning: N Vent Fans: 4 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: 2 201-400 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 1645
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: $30,018.44
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. ,, f
Issued By: Permittee Signature: �f �e'��1 jam" "
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.
to T. 4�- L S 3�b 1
Building Permit Application
RECEIVEDFOR OFFICE 1 SE 0\EN
Received sI / /� PamitNo -'
City of Tigard Dir �'
MAR " 20 6 Plan Revieve I5 «�
11,1 13125 SW Hail Blvd.,Tigard OR 97223 t�A J I OtherPermi• �/If_/4,- ay.?,
i Phone: 503.718.2439 Fax: 503.598.1960 _ p� Date/By:
CITY I G P Date Ready/By- Jur,: H See Page 2 for
7"I C; I I� Inspection Line: 503.639.4175 �� St t\ Notified/Method:�i"��/j Supplemental Information
Internet: www.tigard-or.gov BUILDING � ��, l dl L.-�
i.
_ yN __ ... _._ __._ _.._.• ._ --
®New construction 0 Demolition Permit fees*are based on the value of the work performed_
Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
0 Addition/alteration/replacement .- workindicated on s -
Other: d.
.. l 4 ` ''',:',-..-4
s.,21--' .. .,.Px.v ax�^w.+;r`'�.7`=,,,
this application
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® 1-and 2-family dwelling ❑Commercial/mdustrial
Number of bedrooms:
0 Accessory building 0 Multi-family
-13
Number of bathrooms:.::5
❑Master builder ❑Other
� - � l Total number of floors: 2
�,r„',1� �" ax _ ;2 ' ��C� 'B`3k� ,v�`J.�" t9 a�tl ��..'�a .:,'';';-: -�_
square fee
� ��--�__-�-.�- 1-/�,, ,,.�� ,�-�, Q p.�J 0-401, I New dwelling area: \. q �O2
Job site address: `� ,�� cC� , VL/� ,r - ,.—•
City/State/ZIP:Sherwood,OR 97140 Garage/carport area: (,)k' square feet
Suite/bldg./apt no.: I Project name:Polygon at West River Ter Covered porch area: l k--\L1/4 square feet j 017
Cross street directions to job site:
Deck area: 0 square feet ,Gag
Other structure area: •i square feet
Subdivision: I Lot no.: t.5 Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
*', zs work indicated on this application.
"R ;gam is �� 4� `, �.� , $
Valuation:
New Single Family Detached Construction
Existing building area: square feet
New building area: square feet
F4 7,7034411 ' :.. -"s'r,-t:L sem
A ,`: ^ ��72L�' '" , , 4 "f � Number of stories:
Name: a ,4 4 Lit uIII 1) Ile LAl/Vic$ C t C Type of construction:
Address. -- Occupancy groups:
City/Sta Existing:
Phon Fax(360)693.4442 New:
�"4 zs' x'., s v� . . i..*: M n- ' . l �lz ' ' ',,,Y.-:',7_ ;;. --. �..
gg�
� �sti 3 f ri�, `.k ' u"%5 .'�: t-r-'� r: r:�; rc "w!+ -;' s -z a:r d * 1,-;;',.;#7.-1A-r4 -.:-,6: -;--r.
Business name:Polygon WLH,LLC Structural plan review fee(or deposit):
Contact name:Maggie Gordon FLS plan review fee(if applicable):
Address:109E 13t1 Street Total fees due upon application:
City/State/Z1P:Vancouver,WA 98660 Amount received
Phone:(360)695.7700 I Fax::(360)693.4442 m
E-mail:maggie.gordon@polygonhomes.com
Commercial and residential prescnphvemstallation of
'2,2 . s- :A .. h 1 .,. :' roof-top mounted PhotoVoltaic Solar Panel System.
Submit two(2)sets of roof plan with connection details
Business name:Polygon WLH,LLC and fire department access,along with the 2010 Oregon
Address:109 E 13t"Street Solar Installation Specialty Code checklist.
Permit Fee(includes plan review $180.00
City/State/ZIP:Vancouver,WA 98660 and administrative fees):
Fax:(360)693.4442 $2160
Phone:(360)695.7700 State surcharge(120 of permit fee):
CCB lic.:207247 Total fee due upon application: $201.60- —
This permit application expires if a permit is not obtained
Authorize d signature: �iJ within 180 days after it has been accepted as complete.
' Date:12/11/15 *Fee methodology set by Tri-County_Building Industry
ne:Maggie Gordon Service Board.
lg\Pemiits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
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[}S wt`cedaXb00gapsorroom, 6578vale;6066114.
Cress sireetldirec##onsto job site:
B=0010°es 1 Qi I Fsr4 1 rata} J+
Nelyresideatlptside-oresutEi-7urallyd dive' mail
Subdivision:TtivTerrace Lot#:$�k incladzs`attatheilgacn
`I`aX map/parcel 1,000 sq.a.oxless i 164.54: 4
Ea odd J50#t sq>fG orpsrtt3Aa 33 � 1
--Erg 4l Seth'`rgant4or§v0:344 1timrSul ertcarizy° sldenti r .1 33 ?
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New Singlehatmlly {cath abovaatj.Tt l
Limited energy:molls-tmi#y 15.00 2 1
iesadentrai u9ttt stove a it)
",E71410)! f 1('" P. nYableE0tO r, C1 S'ee@aeo2 a
`1!Gr1ANY Sexvtcts or reedtrs instaltatlon,nitcratian,aadtor rtlaratloa laladtei a
Address:Mita lliogits 200segs alas 100.10 2
,
>E 13di,St 201 a to'0= 13156 2g.
401 amps 1461/0 amps 200.34 2i I
GirylSta,et$P:Yalictittvaar WA 98660
601111)1>s' to 1 lamps 301.41 2
Phone(3613)69S-7100 I Fax:( ) Ott(1,000 nrtgsarmt#s 552.26 "
Email: Temporary service or feeders installation,alteration,and ea
relocatlan
Owner instalfotiait:This installation is being made on property that I ocl2i swfiielr isnot 200 amps orlee 5936 1
Wadded for sale,toast,tent,or exchange,according to ORS 447,449,670,and 701., 201 ening to a00 maps 125.02 2
OxttersrgitatnrG Date: • 401amp814599amps 168,51
i FP1.It i - .$ranch Trcuitr-nett alteratlon,oreste lou e>pane)
1 0 cr. AiCV"PEI Its a
Business Liaise Garner Electric Wsshington LLC A..1,ee rorbrmtet,,eireuits urrh
r above service or feeder fee 743 2
Goner name Bill,Daniels each tuanch olrmrit
0,Pep forbraat:1ielmuitst rrhimt x
Aidress:610E NE St johns-Rd serviceii
drreeda fxe rtrsi 36.18
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GiryfStatefZIp Yat#cttsrverWA9$ti6l Ea r;cddlhortmItcirruit 7.42 2
Phone:(353)320-1657 I Fax::{ ) hiistellaneoua(service or fcedtr not#ndadeit?
Eadannn-uractareticrmpdiraur 67.84 2:
Email:bdait+ittiogweusa.cam •
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herd only 67,44 67 84 2
$iffiO1tilAAL 91 - Pian or Irrigation
r
1
P circle 2 t
iatss t Garner Electrick ashingtan,LLC sign or Dolts#ighung 67,84
Signet crrtulits}or tpaitgd egtugy
Address:6101 NE 5#Johns Rd A Sx Pige2 2 c
pane!altere3ioo,or;exten;tea, ,
Gi#ytStaleJZ1F' Vancouver VY A 9I66i Slab additional Iatpeerron overaltorraale to any of the above'' j
Phrute:{353)320=II657 {Fax: Additional inspection,
{t lrt.tnin} 66 25!"hr
I ( ) 3rtYcesti iibrr(l 1a lain) 9000/br• t
Email bdaa?le18 :4fensa.com IndastriO.Pianl(#fir OA.) 78-1 al,hr
_. laspE forts]tfahndtSe#a 90.001 le
G.CB Lis,: 01158 6 Electrical Lie.:208J14 l Suprv.Lie.: 4496$ 4IIy luted betmn} x
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Printname:Joan P A(bert Ant ;i l C7 Pran Rerleiv Regutidl{i3%lst ti ): i
Stale sntJtatga LI2€ofpdnitt Tee):
Authorizer!signature TOTAL PEI trFtp i
Print(101120:'
iart2e Blit Daniels late: 'Txrmrt■pion ccpi t,tra yermle&r oex ai tsi,Ka ti ttia Lao
x" (f1 says atter Tt bis Lean aeeepted as complete.
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Plumbing Permit ApplieatiO
Building Fixtures EC. EIVFE)
City of Tigard � �f�1
Q1� Received
PemtiYNo",y
13125 SW Hall Blvd.,Tigard,OR 97223 Daffy' ' 6 5 r. /6""oQo f 4'
a" r Plan Review
' Phone: 503.718.2439 Fax: 503.598 "y o - i!,.‘,...-,,,,,,,,,f Date/By: Otho Pcrs,lit o.:
r
i i i ;\1,D Inspection Line: 503.639.4175 I t }-- $„i t 4V ,C {
"e �Ready/By- auris:
Internet www tigard-ar goy BUILD, �" 1 SI See Pent 2 fnf
W 4: '���"° O ' -z, a Notified/Method: M Su !mental information
,,, . .a _ $ . �.-a E` v - , ; la ,„?.4 "T^^: ",tea- �r - ..
III
New construction ❑Demolition For special information use eheslHest
Description [ Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other" New 1-2-family dwellings(includes 100 ft.for each utility connection)
4'ai 4' a �tt ,exp SFR{l)bath 312.70
III ]-and 2-famil Y g dwel}in SFR(2)bath 437.78
Commercial/industrial
D SFR(3)bath 1500.32
Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
0 Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
• e3 .1 4 a ¢1 { ''c ° Pa' , Snell es.
Catch basin or area drain
Job Site address: G" C 18.76
��`� JT (��' J n 1,cu i5e •. . .:
City/State/ �] 1 /� Dryweli,leach lin;or trench drain 18.76
��Q r) O 1 `H / Footing drain(no.linear f.: ) Page 2
Suitefbldgiapt.no.: Project name: 9ntiI�5r) 1Ji- '{ Manufactured home utilities 50.03
Cross street/directions to job site: VManholes
J.:([ �/0144 18.76
Rein drain connector 18.7b
Sanitary sewer(no.linear ft: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no,linear ft: ) Page 2
Subdivision: ( Lot no.: Lk 5 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
>r; )' ' x'm' : 'g 0 -, q Backwater valve 12.51
j 0 44,A0 , . r .x *,.A clothes wasbez, 25.02
t t-e`.) \�-/IUD\ i Dishwasher 25.02
f Drinking fountain 25.02
. � . £ Ejectors/sump 25.02
a f 4 ,..t Expansion tank 12.51 iit
Name: PD1\1 a 0-1/AFbsture/sewer cap 25.02
Address: j n ``.'J} r C3Floor draiti/flaor sink boli 25.02
t V, ( n , 1 ,o�� t �} Q, , Garbage disposal 25.02
City/State/ZIP: V 1(n i J V e `0 i\ "I V`s(Q 0 Hose bib 25.02
Phone:(JlsiQ' (Ds - l]0 0 Fax: iD kD i( .
...
q� he maker 12.51
S 4 ..0interceptor/grease trap 25.02
$usiness name: Medical gas(value:$ ) Page 2
1,'"E-4 r i O.1 LA- kms# C
Contact name: Primer 12.51
e) V, ' Roof drain(commercial) 12.51
Address: ty4,.. 1,-)5-1
Sink/basin/lavatory 25.02
City/State/Z1P: G t'e c[ 1 Int ( Ci-)0-S-0 Solar units(potable water) 62.54
Phone: $ ) SCA" t t p Fax ( ) Tub/shower/shower pan
12.51
E-mail: f a. , .0 f Urinal25.02
Water
cloWater set
25.02
�1 �j . � 37.52
Business name: 1<, F- i f'V.i"rvlt.'! F" i1ttr')r9
-LC Waterpiping/DWV 56.29
Address: po, 12)D-i. r2OZ Other.
25.02
CitY/state121P;G t-.sh O . C`7 s�lsit►tal.
z
Phone:(9')/) f .,q/i 3 I Fax:( ) Minimum permit fee: $72.50
CCB Lie.: ( ... Plumbing Lie.noaat
f 2-- Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: :
TOTAL PERMIT FEE
L
Thisa is tion expires Ifs permit k not obtained within 180 days
Print tsarne' i..� �,�. ,�, et(, Dt {j
a_.91 itlr permitapplication ager 1E has been accepted as complete.
*Fee methodology set by Tri-Conmty Building Industry Service Board.
L\MekiMitre i imet.ML-Nenet4pp.eor .10,01x`09 440-4616TOWOICof.4MEB) _.
i n ,
Mechanical Permit Application 111111111111.1113=M11.1111111111
City of Ttgard � ` ived
Permit ret:,elS oic 1900 o
13125 SLY Hall Blvd.,Tigard,OR 9 •�
Phone: 503.718.2434 Fax: 503.598.1960 °EP DateBT
t1)areflatt y xe�L Other Permit:
i iz:t t.F) Inspection Line: 503.639.4175 n1 9-°1
t
Internet: www.fi and-or. ov H� Note Re/ e•'thy rutin Ste Page 2 for
g $ Notified/Method: 5opptemenott Information
i .lr
1. int i N OF ,Vk1$ , ' w
,. . _ _,a; .e ., �:':1� .max - .a � r _... , .. :' .. � '�+w e. ._ �. .,.. .
ivtechanNew construction 0 Addition/alteration/replacement tacement icaI permit fees*are based on the value of the work
P performed..Indicate the value(rounded to the nearest dollar)of all
Q Demolition 0 Other: mechanical materials.equipment.labor,overhead,and profit.
Value S�. K« ; " r,
..,-.......-,A,,,, , „ ,s .. .e , y ^ am t e,.„!, A, y 84Fg .,,, .'X l , :&a4 .a
® 1-and 2-family dwelling 0 Commerciai/industrial 0 Accessory building Far spedaI ieformt fart use t
Q Multi-family 0 Master builder 0 Other Description f Qty. Ea. I Total
' �' > tteatfngkoolla>~:
L �.. .�.. ... Airconditioning 46.75
Job site address: r 1-, 7 (5)319.0_(\r� t b(U1 _ [ Furnace 6X1,000 BTU tdueolventsi , 46.75
City/State/ZIP: , JTD 0d. 0 R "11--'\-1 0
, Furnace 100.000+BTU(ducts/vents) 54.91
61.06
1
Suiteibldgiapt.no.: Project name: pokk 'W Icor pump
Duct work 23.32
1 Cross street/directions to job site: ,3.1-437 (- 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:River Terrace Lot no.: i t Other: 23.32
`-1 Other feel appliances:
Tax map/parcel no,: Water heater 23,32
' , ,4air :1 � a is i I(y <a1rc.;; ii . .. ,: Gas fireplaatinsert . 3339s
Flue vent for Waler heater or gas .
HVAC t fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove : 33.39 J
Wood fireplaceinsert 2332
Chrrnney/linerffluedvent 23.32
wtk � � � A O 23.32
N ,,_. �",�. ,�. .�r.. � . � .>.*�� ` �� . ,,.� �,w �'
Environmental exhaust and veatilatirrn.
Name:Polygon Range hood/other kitchen
Address:109 E 13a`St.Suite 200 equipment 33.39
1 Clothes dryer exhaust 33.39
I City/State/21P:Vancouver,WA 98660 Single-duct exhaust(bathrooms.
toilet compartments,utility rooms) 23.32
( Phone:(425)586-7700 Fax:( ) Atticierawlspace fans 23.32
;w t, s 7 '..,"'-';',4 °fie, e R ..,.,,:c# i' Other. 2332
Fuel piping:
Business name:Apex Mr LLC
511.15 roe first tourSt.O3 for each additional
Contact name:Stasi Hay Furnace.etc.
Address:2210 W.Main St.Suite 107-272 Gas heat pump
all#suspendcdAmit healer •
City/State/ZIP:Battle Ground,WA 98604 Water heater
Phone:(360)342.8109 Fax::(360)326-1769 : Fireplace
Range
E-mail_stacih( apexaireo.com Barbecue
•
" q. �„� � 4 ,
mit ��, r x4> t a. ,, . . Coltcs dr( 1 _...
Other
business name:Apex Air LLC
•1*- a C e t ry t•o fr o
Address:220 W.Main St.Suite 107-272 Subtotal
City/State/ZIP:Battle Ground,WA 98604 Minimum permit fee($90.00)
Phone:(360)342-8109 Fax:(360)326-1769 •
Plan review(25%of permit fee) ,
F State surcharge(12%
of permit fee)
CCl3lic.:2f13034
. - - TOTAL PERMIT FEE _
` This permit application expires it a permit is not obtained within 180
" / days after it hex been accepted as complete
Authorized signatur,' T .- "1 f p Fre mcitrodotogy nes by Orr covert}Building Industry Service Board
I
1 Print name:Sta€i Tray Date: 1/28/2016
I 7iatfiiwd'cnxi"ersMEC_P itkpp,P40tt3 440-407Ti t r •'COM/Vr)
City of Tigard
~ COMMUNITY DEVELOPMENT DEPARTMENT
■
T I G A R D Building Permit Review — Residential
Building Permit #: "g--f7' _.
Site Address: f'Ac' . - 'k) \. -/2 icsP ,<e.
Project Name: )/ A >.„ . ( ./ iigi- 4T.ixoc e Lot #: c--`
(New ,'g= subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: /Vat) . ~%P
UQ
tem.
t1• River Terrace Neighborhood: ❑ No Yes, See River Terrace Review Addendum Attached
Site Plan Elements:
ee (3)copies of site plan J la:'.'A sting structures on site
i e plan must be on 8-1/2"x 11"or 11 x 17"paper A.'ootprint of new structure(including decks)with finished
I/ D awn to scale (standard architect or engineer scale) fl or elevations
r :rth arrow Jtility locations (required for new,may apply for additions)
7.S;te address,project or subdivision name and lot number
cation of wells/septic systems
plicant information(name and phone number) I 7 rosion control (including drainage-way protection, silt fence
dimensions and building setback dimensions sign,location of catch basin,etc.)
of area,building coverage area,percentage of coverage and 1Prt Greet names
i pervious 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 " 0 Si sting trees to be retained with drip line,and tree
4 foot differential) protection talklean Water Services—Service Provider Lette (lot platted prior to 9/10/1995):
'equired: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No
TiiPublic FacifitiImprovement (PFI) Permit:
Required: Yes,applicant was notified ❑ No Applied For: /Yes ❑ No,stop intake
and Use Case#: P. b c (,'J1�S - [.'. C: )i./ / 5vQr11�.�= l i--)i.t9 ?
on[124etbacing: ��'
ks: Front / Rear 0 Side ' Street Side AyiL2 Garage 3 ' //
V andscape Requirement: 0,
112 Lcyo
ot Coverage Maximum: a f�
�iuilding Height: Maximum Height
i . g Actual Height
tsual Clearance
l? Easements
G)j ensitive Lands: ❑ Yes 1P/No Type
P Urban Forestry Plan
❑ Conditions "Met"�,,� prior to issuance of buil •ng permit
Notes: a17 �'1; n21 /YILe&A fyl„e- ✓7C1t 'A J769s/W,i. ^{� 3-7/M/
3J
Approved By Planning: — � ' `' --- Date: 81/d//1!6,
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
1:\Building\Forms\BldgPennitRvw RES 012116.docx
c
•
Building Permit Submittal
Original Submittal Date: 3/41/43
Site Plans: #
Building Plans: # 3
Building Permit#: a-Enter building permit#above.
Workflow Routing: 1 J. Planning L`s r ngineering iermit Coordinator [wilding
Workflow Sign-off: 2—Sign-off for Planning(include notes from planning review)
Route Application Documents: Q—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:
07 Date: /// ,
Engineering Review
niti Slope at building pad: 4r%�
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
❑ NOT Approv•d 1 Engineering: Date:
Notes: ... _��• i.. .i► ./ i/ _ �s .r�i ' _►�.�►
Approved by Engineering: -- 7)' Date: 5.1
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
pproved,NOT Released: Date: 5 06
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:
7
DC Fees Entered: Wash Co Trans Dev Tax: r'i! es ❑ N/A
Tigard Trans SDC: ►Y es ❑ N/A
Parks SDC: Yes ❑ N/A
K to Issue Permit ,
Approved by Permit Coordinator: Date:
1:\Building\Fonns\BldgPennitRvw_RES_012116.docx
1,
City of Tigard
1111
a COMMUNITY DEVELOPMENT DEPARTMENT
T 1 G n iz n River Terrace Building Permit Review Addendum
Building Permit #: .04-7S7-2-0/6 s- Dap 21--
Site
&Site Address: /1, ) ` ?Dil I_ (:)u/ P Pc
Project Name: Prj� sn �---7' `Z e.5Q7L siv.pT i 7 ce_ Lot #: 41.S'
(Iw - ex
=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 f. dee Balcony w/ access 2 Window Projection Vertical Wall Offset a
p ft. deep min. 2ft., 5 ft.wide min. 2 ft., 64.wide Gabled dormer
. 1.,
1
2. Eyes on the street: a minimum of 12% of each street facing façade must include windows or entrance doors.
Percentage Shown: c=23. 4//A
3. Entrances:At least one entrance must meet both of the folio 'ng standards:
Max. 8 ft. setback from longe t street- facing wall Parallel to street,angle no more than 45° from street,
or open onto porch
Entrance opens to a porch: Yes ❑ No
Ies all the following apply: (.5 sq.ft. min.
Y5ne street facing entry ft.max. roof height above porch
ft. depth min. 30%min.porch roof coverage
4. tailed Design:All buildings shall include a min. of five of the following elements on all street-facing facades:
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 ❑ Dormer min. 4 ft.wide
oof eave min. 12 inch projection ❑ oof offset min. of 2 ft.
❑ Roof shingles either tile or wood able, 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 VrWindow 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.O&es pipi. If No (Check one):
11 1ay extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch.
IN ffay 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:i} (Check one)
0i-foot-wide garage door 101k6/0 max. of street facade
00/0 max. of street façade with 7 detailed design elements
Notes:
Approved By Planning: ' '-- "---'_� — '11,/- Date: 0 y
1:\Building\Fonns\BldgPermitRvwRES RT 012116.docx
Albert Shields
From: Albert Shields
Sent: Tuesday, March 15, 2016 6:21 PM
To: Maggie Gordon (Maggie.Gordon@polygonhomes.com)
Cc: Tom Hochstatter
Subject: MST2016-00097, -00098, &-00099, West RT
Maggie, FYI, because many conditions of approval are Not Met for Polygon at West River Terrace I have put these 3
applications on hold as Approved but Not Released. Albert.
1
Plumbing Permit Application: :7'_'I .A'
Building Fixtures ItrR (0111(1 t SI: ()NIti
S'P 2 '1 2016
City of Tigard Recefioft-f
d c
11111 `� g /(, )-2)- PtNo57i9■ 13125 SWHallBlvd.,Tigard,OR 973 t '', �'L /view
I Phone: 503.7182439 Fax: 503.598140 ;Date/By: Other Permit No.:
K n Inspection Line: 503.639.4175 Date Ready/By. runs: ®See Page 2 for
Internet www.tigard-or.gov Notified/Method: Supplemental Information
. . TI<`1!B<#aT-WORK,
:..:.:.....:
...
®New construction 0 Demolition For special informatlon use checklist
Description I Qty. I Ea I Total
0 Addition/alteration/replacement 0 Other: New I-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION' SFR(1)bath 312.70
®1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
❑Accessory buildingSFR(3)bath 1 500.32
❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other
Fire sprinkler(_sq.R) Page 2
10$SITE INFORMATION AND LOCATION _ Site utilities:
Job site address:/7157 3`j\.1 -jean t 4‘A.1 f ikvol Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain 18.76
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 R:_) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
i'
Subdivision:Polygon at West River Terrrace I Lot no.: `t 5- Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
_ DESCRIPTION OF.WORK Backwater valve 12.51
Clothes washer 25.02
&"'' r (ttJ1 Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
®.PROPERTY OWNER I . ❑ TENANT Expansion tank 1251
Name:ADVL Land holdings,LLC Fixture/sewer cap 25.02
Address:7600 E Doubletree Ranch Road Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP:Scottsdale,AZ 85258 Hose bib 25.02
Phone:(602)694-4031 Fax:( ) ]ce 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 Lie.:102535 Plumbing Lic.no.:34-276PB
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
I Print name:Carolina Malmedal I Date:04/25/2016 I This permit application expires if a permit isa not obtained within 180 days
after it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board.
I:1BuildinglPesmitstPLMU-PemtitApp.doe 10/01/09 440-4616T(10/02/COM/WEB)
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
17157 SW JEAN LOUISE RD, SHERWOOD, OR,
97140
Record Type:
Residential - Master Permit
Inspection Type:
699 Mechanical final
Result:
FA I L
Comments:
Tel: 503.718.2439
Inspection Date:
December 15, 2016 at 9:17:36
AM
Record ID:
MST2016-00098
Inspector:
David Young
Posted address numbers not correct, posted as 17175 not 17157.
Post correct address on site for inspections per code. R319.1
Violation Summary:
Inspector Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
17157 SW JEAN LOUISE RD, SHERWOOD, OR,
97140
Record Type:
Residential - Master Permit
Inspection Type:
199 Electrical final
Result:
FA I L
Comments:
Post correct address on site for inspections. R319.1
No inspection done at this time.
Violation Summary:
Tel: 503.718.2439
Inspection Date:
December 15, 2016 at 9:19:06
AM
Record ID:
MST2016-00098
Inspector:
David Young
Inspector Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
17157 SW JEAN LOUISE RD, SHERWOOD, OR,
97140
Record Type:
Residential - Master Permit
Inspection Type:
399 Plumbing final
Result:
FA I L
Comments:
Post correct address on site for inspections. R319.1
No inspection done at this time.
Violation Summary:
Tel: 503.718.2439
Inspection Date:
December 15, 2016 at 9:20:34
AM
Record ID:
MST2016-00098
Inspector:
David Young
Inspector Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
17157 SW JEAN LOUISE RD, SHERWOOD, OR,
97140
Record Type:
Residential - Master Permit
Inspection Type:
699 Mechanical final
Result:
PASS
Comments:
Violation Summary:
Inspector
Tel: 503.718.2439
Inspection Date:
December 20, 2016 at 8:55:55
AM
Record ID:
MST2016-00098
Inspector:
Jeff Grove
Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
17157 SW JEAN LOUISE RD, SHERWOOD, OR,
97140
Record Type:
Residential - Master Permit
Inspection Type:
299 Final inspection
Result:
PASS -CofO
Comments:
Contractor removing screen from dryer vent.
Final erosion control approved.
Street tree certification received.
Moisture content form received.
Vapor barrier form received.
High efficiency lighting form received.
Blower door test report received.
Insulation certification checked.
C of O left on site with contractor.
Violation Summary:
Tel: 503.718.2439
Inspection Date:
December 22, 2016 at 1:58:10
PM
Record ID:
MST2016-00098
Inspector:
David Young
Inspector Contractor