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Permit (53) CITY OF TIGARD �_ MASTER PERMIT 'lit' n'= COMMUNITY DEVELOPMENT Permit#: MST2016-00119 Date Issued: 08/03/2016 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S1060003000 Jurisdiction: Tigard Site address: 13764 SW 172ND AVE Subdivision: WEST RIVER TERRACE Lot: Multiple Project: Polygon at West River Terrace, Lot 49 Project Description: New SF. 12/22/2016: REPRINT to add A/C. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 3 First: 805 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 23 Bathrooms: 3 Second: 939 sf Garage: 423 sf Front: 12 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Total: 1744 sf Value: $219,579.26 Rear: 0 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: Catch Basins: 0 Bckflw Prevntr: 0 Footing grain: 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: 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 Clags of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 1744 Owner: Contractor: ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions) 7600 E DOUELETREE RANCH RD 109 E 13TH STREET 1 A Geotechnical report is #150 VANCOUVER,WA 98660 required before the footing SCOTTSDALE,AZ 85258 2 Ersn Cntrl 503-639-4175 PHONE: PHONE: 360-695-7700 FAX: Total Fees: $30,397.88 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 throughR 952- 01-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. r €r Permittee Signature: lit) ��e'l C` �0'J Issued By: 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. CITY OF TIGARD MASTER PERMIT iii ' COMMUNITY DEVELOPMENT Permit#: MST2016 00119 Date Issued: 08/03/2016 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 281060003000 Jurisdiction: Tigard Site address: 13764 SW 172ND AVE Subdivision: WEST RIVER TERRACE Lot: Multiple Project: Polygon at West River Terrace, Lot 49 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 3 First: 805 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 23 Bathrooms: 3 Second: 939 sf Garage: 423 sf Front: 12 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Total: 1744 sf Value: $219,579.26 Rear: 0 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: Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 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 1744 Owner: Contractor: ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions) 7600 E DOUBLETREE RANCH RD 109 E 13TH STREET 1 A Geotechnical report is #150 VANCOUVER,WA 98660 required before the footing SCOTTSDALE,AZ 85258 2 Ersn Cntrl 503-639-4175 PHONE: PHONE: 360-695-7700 FAX: Total Fees: $30,255.52 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 e-- 952-001-009'. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. 03 Issued By: 00.-0 • Permittee Signature: /x5g79,4)/;,-/ e 7e? 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. _ - " . . . r.._- c: L0 r /.17 Building Permit Application �.. I,(-)R OFFICF. l Sl:O>1 1 1J 1t�'; vJ Received �.S J� J? Permit Nj/ �� a ii j City of Tigard R r Dir' IN 13125 SW Hall Blvd.,Tigard,OR 97223 +�+�' 2 0 0 Plan Revie J,a t qua P �/1 ��� 00� Phone: 503.718.2439 Fax: 503.598.1960 Date/By: 1 1 It ' r ° 3 Date Ready/BY: �i 44/ iota emiH See Page 2 for f!Ci;I I� Inn'Line: and-o 501639.4175 l*a& } ar 1- N ed/Method.UJ /(er. Supplemental Information, Internet www.tigard-or.gov 1 ° ' a' •a�.' ' 77'/L-- 97J6/ u— •----,�--•r--- - -' `t ""'"'— "` "�_�� � Permit fees*are based on the value of the work performed. ®New construction 0 Demolition Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement ❑Other equipment,materials,labor,overhead,and the profit for the g, workinch cate on s d thi application is rte 6 F •-_, -..7 Sc � aR W � , a ' Valuahon:r�)C �7 $ k yap ......,111® 1-and 2-family dwelling ❑Commercial/industrial Number of bedrooms: 0 Accessory building ❑Multi-family Number of bathrooms: 4"/`.5..3 0 Master builder 0 Other a"r' Total number of floors: 2 51 D \I- I New dwelling area: square feet Job site address: W - Garage/carport area: t` \fZ3 square feet City/State/ZIP:Sherwood,OR 97140 l Suite/bldg./apt.no.: I Project name:Polygon at West River Ter Covered porch area \ square feet 9 3 9 Cross street/directions to job site: r Deck area: 7A square feet floc Other structure area: ♦i square feet Subdivision: I Lot no.:LA9 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 work indicated on this application. Valuation: New Single Family Detached Construction Existing building area: square feet New building area: square feet ' - 1 . Number of stories. N , . t s ar � � - Name:Pllyguu Vtl;l,LLC ,A4 Lrj'-�✓L ,/OLb//tJc.5 L i_C Type of construction: Occupancy groups: Address:-i6'9 3u eet ,ti"' - City/Stat Existing: Phone:(3611)545'7700 Fax (360)693 4442 New � 4,° t- ` a�k ��'^�" �1 s �5�.r-. 4� s„€T a`,`,s.• ,•� I 3��$�n��` .-,.,-,��.»..-.,,�-;',„:'.:,-_.'T°-.:',.a�n ,a., a:< 4 :���. �.: � ��� �-r,.. ,�,..K.rr ��.+dws:w�.�.,ssa.�, �``d."�.�.. F., Business name:Polygon WLH,LLC Structural plan review fee(or deposit): Contact name:Maggie Gordon FLS plan review fee(if applicable): Address:109E 13th 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.gordon@polygonhomes.com '" -: � ' - - Commercial and residential prescnptive installation of : x - ' ' � r , u=� F - -- r " roof-topmounted 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 136 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 $21.60 Phone:(360)695.7700 State surcharge(12%of peuLit fee): CCB lic.:207247 Total fee due upon application: $201.60 This permit application expires if a permit is not obtained Authorized signature: V within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County.Building Industry IPrint name:Maggie Gordon Date`.1Z/11/15 I Service Board. l:�Building�Permits�BUP-RESPermitApp.doc 02/24/2011 440 4613T(11/02/COM/WEB} a 1. E1 t rcR1 Permit Application nil( t 1-f.,i tl I 0 r� 201 c o.��'ilgOrf o pis iS.7 / —,r O/J cf 1312sOdialifINO,Tigard OP:97 �a l�V fkltttt 5(.718,2434 Fix 50595.1 ,k `, 3 3 neared remit i Uaspaetto Lina 103'639 4175 =s �g. 1:- }E CARL Internee wwrvngazd g y ruerx Ri,.....-,,,,,,..2,f.... s MC aF = P,,,,, ata,,, raaana l''''';'''''':'4''':'''''''''''' 't . 3 • 11014,1,11-,D010‘'-',,,,,,,:--:-'2„, ` 4N w4oastciictwwn E3Adttiacirilaiter""attmlrep)acement r £amt anit�,c ar# ,■�exa of tr ;`a ear 0.0p40,1494,,...- [ titer tioii9k.«fder4a0 amp�c"Ewer-. Satldra yvdF,taea$rarie n�rae a aatmta5la f#alr,=arnt t3 A4armar aad 6oapatds -' / - � +-7 '‘,14,m'' + Q}, :. :>- _; ' *' w�ls is as , q:at uo cults c4 [t -,{:1rta' lags, l'-'aril 2 family dwelling �'Comma ciatl>Aidtfst iil ©Pieccssory buiiding s ro grand arc • Ideon ,/,,,„_rsmscciet aye....,.....6,..../ • sari inra8aber ita€tarions, g [ ta1t11td quly [ 14�p5terbuiide QL)tli8r- 0puepun ❑ pfallamcut€IS0KYAor iOB BNtTi:•' 1ti,,,„TO14 AN D Ld TIQN ctmagrocysrstcm 161641"6416,0641Y derivw . 1 lob : Job she-eddtess: 'i €) LTAddilicn ofnewaotar Wad sf gaknl, " � LbpHPamoic. b"A,.a.,,, 13;"1-3', C2q>/StateJZ1P:SherwoodOt371Ait C7s*4t.mwems&tGatialt G'4+ �y .1.71�esii�-camctlhies, �Re+ana�tmtwty�it�(nparka. r. SudrlbidglapT. Pcojta tttattte l tflnea:, 10catsoaa £1stmAU'vnha Yerawraman i' astn7ccwf=ederG0 pr.cumora. 6P°valna�ctnnaat< 04066 stteeddirections to job site: t, r *,.,.: F arsrHpdaa l t.. to t j'. iclyd t:+� New residential MOW/a.ora rite fatatty dweltl wait. Subdivision*River Terrace Lot includes attached garage. Tax t)taprpattxl# t,orHlsq tt ru less J l6li 54 4 w. F Eq it4d(;51.001.fr.orpe,inn ....„41 33,92 a 0E5 71"'917 tLYY18TL Ltmipbd energy, .,r1.)Mini i t New Slagle Parody (+it#abovesq:R.t 5,{i0 2 t' -Limited-energy,Muhl-family 95.00 2 residential(with above sl-it.) t 1 Tt' itCTt-t9 Tt �, E1 L4NT Serviced oir iciiteYstnstallatien,atterafroa,aitil/or r tacsfian Name: olyggn Ho es 200 ,antis 10110 2 Adder 109 F Iia'3t 201 100P114*-0QQ amps 133,56 3 401 amps to 600 amps 2Q0:34 2 98698660 60, ainl$to 1; 10 Aalp9 30104 '' Phone.(360)6 7700 Fax:( ) aver”I000 min—. ervaiffi' 552 26 s Temporary services or Feeders habitation,altemillan,andteir Smrt: retoegihrrt t Owner lnsia8 tiarts This instatlat on is being made on proptaiy drat 1 awn 11ddclI is trot 300 mites arks 5936 1 intended forsale,lease,rank or exchange according m ORS 4 1,449>67t3.incl lt)i. 201 amxa ta40pamps 12105 2 Cwoe slgrtatu> Date; dol amps to 599 amps 16554 2 C r1PPL 1 CM4T" Branch circuits ue4r,akterdtian,or rite pian, erpanei 1 . , (. C N'aTACt`rotSi#NN A.Pec forinahrb circuits with Rosiness name:Garner Electric Washington,LI,e abaovaserv� arfeederfn• 7.42 2 i eocil.branehc1 . a Cottteofname:Rill Daniels B.Fee for branch drawbar/how Addle=6101 NE Si 3ahas td seariea orlixder fan,full 5618 2 branch ahead City1Stale21P Vancouver WA 98661 Emit add I blanch c neat 7.42 2 z btisteltadeoaa(servkc or feeder not irretaded) Phos (233)3201637 Fan:;( ) Bath manafacAuedee modular 67.84 Z p 7 bdaateis dtl�silbtg,ss epanillra feeder 1i ! Qgweasn.cam Recnnnectan 67.84 2 Ptnn1 orrrrigationcircle 67.64 2 k Business maim Garai"Electric W0'4110glon,,'LTC sign orm melba lighting 6714 2 ( Address 61011+11;StSohrts ltd Si8ttdl c tr a w Or r8Y C SecFzgex 2 panel,alt' City/State/ZIP:'Vancouver WA 98661 -136611 Additional inspec6on over allowable le any of above Addotning inspection 0 dm mini; 66.Slur r i Phan (253)32t11657 Fait( ) Tavesrfgatien(t lu dein} _ 91).901 Raul!:bdarliets glyeusa,etrm industrial plant((brmlu) 18.111 fir £ inspecdotisfor tvbiotirioIOU 50.0g,hr conk.: 01158 El triadic: 208174 ' Suprv.Lk:44965 speciftca►dytl61cd(Kitt rot') l� � ^ Ft T Ct R(l ptr$Bl� ,. , ' Su:- Slealrioiaa sigaahlr,regwtrod 'r� f / sidik41, Prmtname:loan P A►bort - • Date- f‘�v CI Plan Emden Required P514 otpr k feet state surcjtatga{F2lrc ofperatrt feed Authorized signature. 7 'RYTA[;PEittilITFEE: �l> ThiepmmltappT,ecrteiaeeptrrsifapermit#ip4Eabratut4wlrkiatso• D Print num:Bill Daniels Date: clays.rierit6asTeeda,:iii,discomp)te. ?^� number ofias*etloneallowed.petpcz it 666664666461E1,C aniktps Eta#REdx asv 4nn7Jnat5. 440460T{I0351CMIMB4 l r I 3; i . „ Mechanical Permit ? AnnhWeat -,,, , ,-.. ,, '',.../ --J-';,-''' ' r''''''' 11111111111.012111111111.11111111111 City of Tigard Received 13125 SW Hall Blvd..Tigard.OR 97223 1 i A..,) 9, -0, ?0 1 6 11 . '"' ' gi, Phone: 501718.2439 Fax: 503.598.1960 ''''' - " ' pawl:tr. Piall Review , &mealy: Other Permit: ,,.,.,,,,,,,., Inspection Line: 503.6394175 (..; Date ReadylBy; kos...' Ed See Page 2 for Internet: www.tigard-or.gov ' Supplemental Informadon ';. ' - - ' ' ' ::•-:', '',.. . t . ..,,,,-v•OtkIM.,..„-- Orm4i&v.w.pw9,4447r,,„,,,, Mechanical permit fees are based on the value of the work ta New construction 0 Additionialterationircplatement performed,Indicate the value(rounded to the nearest dollar)of all 0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. . Value;S ,,- DD I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For speck,inforroolloo use checklist 0 Multi-family 0 Master builder 0 Other: Description Q . Ea. Total ile.atinfjeaell": ' Air conditioning ' I 46.75 FinlaCC 1 Joh site address: (1)t-s "[A..1.-) --. r\---k1-1"- t00,000 BTU(dams/vans) 46.75 City/State/7.1P: 5-\.(1_/( ATI9 oa D. q-3-,\10 I Furnace 100,000+BTU iductsivenist 54.91 = —__.. Heat pump t 61.06 Suite/bldg./apt.no.: [project name: pok byi ck j-- 4 Duet work 23.32 Cross street/directions to job site: 3._4(\(74.cto Hydronk hot water system 2332 Residential boiler(radiator or hydronic) 2332 .. 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 i Subdivision:River Terrace Lot no.A...tk ti Other fuel applianets: Tax trap/parcel no,: Water heater 2332 , " ' ' '''' '''' 1 Flue vent for water heater or gas . 11 VACi fireplaee . 23.32 t Log lighter(gas) 23.32 , Wood/pellet stove 33.39 Wood fireplace/insert 2332 i Chinitterlincriftuelvent 23.32 ;.-'.1'..:4-lil8t7-!. .i .:,:.,;i:i...',,,:;;,iii;'4::,:;,;i1..; •044Ati,ipziot,i)ft;tle'',i'''''------:;4irdA,:tiVi•514,,,,c,,, • Environmental2332 exhaust and ventilation: Name;Polygon Range hood/other kitchen equipment 33,39 ' Address:109 E 13*Si,Sone 200 , Clothes dryer exhaust 33.39 I City/StatelL1P:Vancouver,WA 93660 Single-duct exhaust(bathrooms. toilet companments,utility rooms) 23.32 Phone:(425)586-7700 Fax:( ) AtticIcawlspace fans 23.32 Other 2332 Fuel piping: Business name:Apex Air LLC $14.15 for first four;S4.03 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/ZIP;Battle Ground,WA 98604 Water heater Phone:(360)3424109 Fax::(360)326-1769 Fireplace . _ Range E-mail:stacih6tapexairco.com Barbecue '.i„„r,iigit.f044:t clothes dryer(1_,u) Other: , Business name:Apex Air LLC 11-iTit,''rRPS5N.j'-.: ..!','J.;i„i','':.?i'[.;.: *l*gf'.P. •.'Zk.'4'' Address:220W.Main St.Suite 107-272 Silbtouti I City/State/ZIP:Battle Ground,WA 93604 Minimum permit fee($90.00) I Plan review(25%of permit fee) Phone:(360)3424109 Fax:(360)326-1769 State surcharge(12%of permit feel 1 CCB lie.;203034 - - - . TOTAL PERMIT FEE I This permit application expires its permit is not obtained-within 180 #/ iir ,' .- ,,,/ ,0-, 4101(' — ,,- Date: 1/28/2016 l' ' days after it has been accepted as complete. Author7ed signatur,„ r * Pee incthociology set by Tri-County Building Industry Service Board Print name:%lei hay .,,,Y i I i 1 414141dinw,Pcratits41.4EC_PcrmitAmp4a I li doe 440-46 7T 4 I OVCOMAVEB , . Plumbing Permit Application <' '. .r , ••O . Building Fixtures { °r 2 E1 2015 Received Permit No-f(�7 1/ �`Q 1/ City of Tigard l>amrsy: al 13125 SW Hall Blvd.,Tigard,OR 971.23 , r, ,, Plan Review Otho Permit No.: C' " Phone: 503.718.2439 Fax: 503.598=,1960 { patctBy. duns: y,� �Page 2 for inspection Line: 503634 4175 i ate Ready/By Su a e nage 2 Information rormattnn 1 16 11 Nodded Metho& Internet www agar d-or gov , ° - . �' ,.w-i 4 tt 3 ...- .. ab..„ +' , „.„,,,p,,..,4, .sem „,._ . ,,,_ * ,.,,.. ...."9 ,, . ., s._ - -. --- For special information use check D New construction Li Demolition Description I Qty. I Ea { Total 0 Additionlalteration/replacement El Other: New I-2-family dwellings(includes 100 ft.for each utility connection) � . -4=',,,:-,,,,,,4-,,4 f SFR(I)bath � 31230 t s t 437.78 III : ° -SFR(2)bath 1 and 2-family dwelling 11 Commercraltindttstria! SFR(3)bath 50032 D Accessory building Q Multi-family. Each additional bathkitchcn 25.02 0 Master builder 0 Other: ,,,, a sprinklerPage( sq.fl.) P e Z r _ _ Site utilities: it 8f.a y t s ® 1).', 1'7°1' ' --. Catch basin or area drain 18.76 Job site address:^ i 1` (� Drywell,leach line,or trench drain 18.76 City/State/ZIP �h Q !\f(2)C A 0 ']1 ``I L l Footing drain(no.linear fl.:_) Page 2 Project name: ,. Manufactured home utilities 50.03 Suite/bldg./apt.no.: Project cal� � W're {� . r e11(J/ /) Manholes 18.76 Cross street/directions to job site: 1'�ZJI� t"t�-� - 18.76 Rain drain connector Sanitary sewer(no.linear ft_:___) Page 2 Storm sewer(no.linear ft.:__) Page 2 Water service(no,linear ft.: ) Page 2 Subdivision: i Lot no.: `'l" \ Frstnre or item: Backflowpreventer 31.27 Tax maglparcel no tytBackwater valvc 12.5 I � r �� �t t � • s °� 25.02 - :. Clothes washer i-e-1 k lu,/1�-1V Dishwasher 25.02 f Drinking fountain 25.02 Ejectors/sump 25.02 „0: 4 Expansion tank 12.51 ° t -Al''' ,- Fixture/sewer cap 25.02 Names PD jrY> _ Floor drain/floor sink hub 25.02 k q n '� I�� �� Garbage disposal 25.02 Address: "(` �iA p��( q q Q� , j� V 1 1'c h) V `.)i A l l`-"(Ov Hose bib 25.02 CityJStatetZlP: J Phone:( p Q - Apo Fax: IP op V)! (L ce maker 12.51 l''''4.4' °t _ I_. interceptor/grease trap 02 to r k _ Pie2 a . .0, .-, ,,, Medical_ga (value:S ) Business name: /„.1;...z-4 f.k r ry1, I Lt.. \t:'it v t ,,,. Primer 12.51 Contact name: M 0 0/ kA,„_1r4 „ .:iY's° ...3- Roof drain(commercial) 12.51 Address: t - l Sink/basinllavatory 25.02 _ Solar units{potable water} 62.54 City/State/ZIP: { C; "1 Tub/sho�ver'shawer pan 12.51 Phone:POI ) %Di, t! Pax :( ) iUrinal 25.02 E-mail' t -' s P.0 4 1 Water closet 25.02 s _ , ° Water heater 37.52 �) Business name: V.-.1 t-i! V r‘,-,-..,4-1-\ 4 Zt t .Y Water pipingfDWV 56.29 �2� �,,tt Other. 25.02 Address: pp' Is .. 13-7z - Subtotal City/State/Z1P:L �y- 'xc� a>A' F c 'Minimum permit fee: 572.50 Phone:(q-n) I- „qi1 Fax:( ) Plan review (25%of petmit fee) CCB Lie.: tGr .- Plumbing Lie.no State surcharge(12%of permit fee) t*,,,.... TOTAL AL PERMIT FEE Authorized signature: Mia _ This permit appticatton a:pares if s permit is aot obtained within 180 days t Q 't l / Y 113a ' j ai'ter tt ties hexa scergteil u condustr. ! Print name: M }� 1(its 'Fee methodology set by Cr County Building Industry Se vu.e Board 440-4616T(i 0/01 CO.Mii'EB) t:iBuddint PamitstPLSn;-PcntiLAppdoc 1001109 i City of Tigard ■ COMMUNITY DEVELOPMENT DEPARTMENT T l c n a n Building Permit Review — Residential Building Permit #: /t -732p/6 -040//9' Site Address: (31(1-1 SW Il2.nd Ave . Project Name: Po on t. Wes+ River Terrace, Lot #: 1-19 (Ne wciting= subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: new SV E Verify site address/suite# exists and active in permit stem. River Terrace Neighborhood: E No permit See River Terrace Review Addendum Attached Site Plan Elements: MI ree(3)copies of site plan xisting structures on site ?to plan must be on 8-1/2"x 11"or 11 x 17"paper `KJ Footprint of new structure (including decks)with finished �raven to scale (standard architect or engineer scale) oor elevations torth arrow L'J Utility locations (required for new,may apply for Vite address,project or subdivision name and lot number ifs ~cation of wells/septic systems p additions) pplicant information(name and phone number) Y, rosion control(including drainage-way protection,silt fence of dimensions and building setback dimensions sign,location of catch basin,etc.) C/ILot area,building coverage area,percentage of coverage and �NJ/Street names impervious area(applicable if R-7,R-12,R-25&R-40) 1laStreet tree size,type and location CEJ Property corner elevations (2 foot contour lines if more than -E-Existing trees to be retained with dripline,and tree 4 foot differential) protection measures $Clean Water Services-Service Provider Letter (lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified Kri, No Received: ❑ Yes ❑ No Public Facilitiy<Improvement(PFI) Permit: Required: Yes,applicant was notified ❑ No Applied For: Yes ❑ No,stop intake id/Land Use Case#: pp�l 5`000O4 Zoning: R Setbacks: Front 12p Rear 0 Side 3 Street Side - DGarage3 ,� andscape Requirement: 2e� °/ p1oteh — 1Gof Coverage Maximum: cg b %o NJ Building Height: Maximum Height — Actual Height g 2y isual Clearance E Easements 7$' nsitive Lands: CD Yes No Type rban Forestry Plan Conditions "Met"prior to issuance of building permit Notes: 1(e Approved By Planning: Ti n1, ^ A r /n Date: 3122- 16 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\BldgpennitRvw RES 012116.docx .ar ilk Building Permit Submittal Original Submittal Date: 3/Z2/1c Site Plans: # 3 Building Plans: # -3 Building Permit#: E--Enter building permit# above. Workflow Routing: Planning Engineering 42-"Permit Coordinator f—Building Workflow Sign-off: -Sign-off for Planning(include notes from planning review) Route Application Documents: a-Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. C�Building: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: , Date: �2.�7/,o ngineering 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: Assess Water Quality Fee in lieu: ❑ ❑ No Assess Water Quantity Fee in-lieu: ❑ YYes m ❑ No LIDA Facility on lot: ❑ Yes ❑ No ❑ NOT Approv• s by ngineering: Date: Notes: f : _ r_ - _ 11, _ i - / APP by roved Engineering: _ WZ--12 Date: ; 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 permit3/ (1_1.--Approved,NOT Released: edel - Date: // Notes: CeW ` '-`''� 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: $2"Yes ❑ N/A Tigard Trans SDC: 9Yes ❑ N/A Parks SDC: Yes ❑ N/A XOK to Issue Permit i Approved by Permit Coordinator: /��� '0 Date: 94-6//6 I:\Building\Fonns\B1dgPennitRvw_RES_O 12116.docx City of Tigard INIM COMMUNITY DEVELOPMENT DEPARTMENT T I G n R D River Terrace Building Permit Review Addendum Building Permit #: ,t/f716, .—pO //? Site Address: (37614 SVJ ti21YA Ave. Project Name: Poi ,opri a+ We.. RNe(Terrat� Lot #: 149 (Nc4 clling=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. deep Balcony w/ access 2 Window Projection Vertical Wall Offset a Gabled dormer 197 ft. deep min. 2ft., 5 ft.wide min. 2 ft., 6ft.wide ❑ E ❑ ❑ 2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors. Percentage Shown: 267. 3. Entrances:At least one entrance must meet both of the follong standards: Max. 8 ft. setback from longest street facing wall u Parallel to street,angle no more than 45° from street, or open onto porch Entrance opens to a porch: iYes ❑ No If y ,all the following apply: V25 sq.ft. min. ne street facing entry V ft.max. roof height above porch Zr5 ft. depth min. %min. porch roof coverage 4. Detailed Design:All buildings shall include a min. of five of1he 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 }X�all offset min. 16 inches ❑ Dormer min. 4 ft.wide Roof eave min. 12 inch projection ❑ t •of offset min. of 2 ft. ❑ Roof shingles either tile or wood V. Gable,hip or gambrel roof design ❑ Roof pitch oriented south min. 500 sq. ft. ❑yorizontal lap siding min. 3-7 ft.wide 1=1 � Accent siding min. 40% of street facade L�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: M y face the front or side lot line on a corner lot. Setbacks: n pk, — alte'1_'()0, �hq No closer to front or side lot 'ne,than longestlstreet-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) ❑ 12-foot-wide garage door ❑ 40%max. of street facade ❑ 50%max. of street facade with 7 detailed design elements Notes: Approved By Planning: S Ili • r I/ .Al Date: 319-211 6 1:\Building\Fonns\BldgPennitRvw_RES_RT_012116.docx Plumbing Permit Application Building Fixtures Al.ity of Tigard Received G!�! /� safi-G /�'J r' �� _-, n r- L Permit NO ■ 13125 SW Hall Blvd.,Tigard,OR 97233= 2 L .:+� Plan Review • Phone: 503.718.2439 Fax: 503.598 1960DateBy: Other Permit No.: Inspection Line: 503.639.4175 ? Date Ready/By: rods: H See Page 2 for `' �t�n Internet: www.ti ardor. ov y y S g g Notified/Method: Supplemental Information ®New construction 0 Demolition For special information use checklist Description I Qty. I Ea. I Total ❑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 ®I-and 2-family dwelling 0 Commercial/industrialSFR(2)bath 437.78 ❑Accessory building y SFR(3)bath 500.32 ❑Multi-famil Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler(_sq.R) Page 2 ` JOB SITE INFORMATION AND LOCATION Site utilities: Job site address:f? J(„I 5,\A) I-(101 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/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 CI Subdivision:Polygon at West River Terrrace I Lot no.:4`"I Fixture or item: _ Tax map/parcel no.: Backflow preventer 31.27 • DESCRIPTION OF.WORK- Backwater valve i 12.51 Clothes washer 25.02 t t a is r ciryfocie. 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 ®.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(a3polygonhomes.com Urinal 25.02 CONTRACTOR Water closet 25.02 Water heater 37.52 Business name:Malmedal Enterprises Inc. WaterPtPing/D WV 56.29 Address:PO Box 207 Other 25.02 City/State/ZIP:Banks,OR 97106 Subtotal Minimum permit fee: $72.50 Phone:(503)324-0759 Fax:(503-)324-0580 Plan review (25%of permit fee) CCB Lie.:102535 Plumbing Lic.no.:34-276PB State surcharge(12%of permit fee) Authorized signature: C C ' TOTAL PERMIT FEE Print name:Carolina Malmedal 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. r:lBudding\Permits\PLMU-PemiltApp.doc 10/01/09 440-4616T(10/02/COM/WEB) 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 13764 SW 172ND AVE, SHERWOOD, OR, 97140 Record Type: Residential - Master Permit Inspection Type: 699 Mechanical final Result: PASS Comments: Tel: 503.718.2439 Inspection Date: December 21, 2016 at 2:08:04 PM Record ID: MST2016-00119 Inspector: David Young Note: no AC installed at this time, permit required at time of installation. Violation Summary: Inspector Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 13764 SW 172ND AVE, SHERWOOD, OR, 97140 Record Type: Residential - Master Permit Inspection Type: 199 Electrical final Result: PASS Comments: No AC installed at this time. Violation Summary: Tel: 503.718.2439 Inspection Date: December 21, 2016 at 2:09:06 PM Record ID: MST2016-00119 Inspector: David Young Inspector Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 13764 SW 172ND AVE, SHERWOOD, OR, 97140 Record Type: Residential - Master Permit Inspection Type: 199 Electrical final Result: PASS Comments: Electrical final for AC ok. Violation Summary: Tel: 503.718.2439 Inspection Date: December 23, 2016 at 1:11:45 PM Record ID: MST2016-00119 Inspector: David Young Inspector Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 13764 SW 172ND AVE, SHERWOOD, OR, 97140 Record Type: Residential - Master Permit Inspection Type: 699 Mechanical final Result: PASS Comments: Final for AC only. Violation Summary: Tel: 503.718.2439 Inspection Date: December 23, 2016 at 1:12:47 PM Record ID: MST2016-00119 Inspector: David Young Inspector Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 13764 SW 172ND AVE, SHERWOOD, OR, 97140 Record Type: Residential - Master Permit Inspection Type: 299 Final inspection Result: PASS -CofO Comments: Correction complete, AC added to permit. 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 23, 2016 at 1:15:30 PM Record ID: MST2016-00119 Inspector: David Young Inspector Contractor