Permit (55) ri
TY OF TIGARD MASTER PERMIT
47' r,
rt
CI
`
COMMUNITY DEVELOPMENT Permit#: MST2016-00053
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/03/2016
Parcel: 251060002900
Jurisdiction: Tigard
Site address: 13734 SW 172ND AVE
Subdivision: WEST RIVER TERRACE Lot: Multiple
Project: Polygon at West River Terrace, Lot 51
Project Description: New SF. 12/20/2016: REPRINT to add A/C.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 805 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 32 Bathrooms: 3 Second: 939 sf Garage: 423 sf Front: 20 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors:
Total: 1744 sf Value: $216,649.34 Rear: 15
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: 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!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 8.-Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: Y
BUILDING INFO
dIass 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 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: $30,445.47
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through AR
95 - 01-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: - Permittee Signature: A/ (9"/77ti'V/
9
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
..A
iviechanical Permit Applica mu 01 i It I 1 NI ()Ni
City of Tigard tiFPEC.JEIVED Received
barenIr Penn.°14°//--Cr. 20/6-110e)-C,S
lig_ 13 L25 SW Hall Blvd.,Tigard,OR 97223
• r Phone: 503.718.2439 Far: 503.598.1960 FEB 2 4 2016 1313"Review
rtmeiBy Other Permit
Inspection Line: 503.639.4175 Date RcadylBy: Julir in See Page 2 Ibr
Internet www.ligard-or.gov CITY OF rIciARE) tioarkatmehod, Supplement Information
BUILDING DIVISION
.''.',^:.',4';',''':i'''''tii1:4:3'4:;:152-1.6i,bo:-.n:...'4'.:"'ii'''r$,,,,"11 r-4,)°&:,''''ArteSiiii.43iPtet,'0,reP,,,,4,14i7-6"t'''..'4 `',. .-',•..1..,''s',..•2 t.,4'3,,, -.4,:.,,,q-,,..t,,,,,I-0 4^0:.t"ii 0.1,,..-
Mechanical permit fees*are based on the value of the work
10 New construction 0 Addition/alteration/replacement perftwined.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other mechanical materials,equipment,labor.maltead.and Profit
4 14 Value:S
'',.'''')':•:*.V-i.S1i5:0*.‘...t'. 1''''..!?*.;';-'4',?:tf;'',::,:t V‘:::'''..i.-`,:4!:,:::::.!.:;‘'!!1-S*401 .-;;;e:'"::-:'..": '- '''•-* — '- ' --'f -'-' -" ' ' ' ' '--' -- "
GEI I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building
Forspeckl&formation use cliecitast.
0 Multi-family 0 Master builder 0 Other: Description i Qty. j Es. I Total
:,,,!;,.••;`,:;',4.44:iCH;;,:t1-;:7,,:,:r1.;,,-.r:;',774,;171, ,i,;... :.. ,,,, „,.!,3`tr:,:•.0.-,r.`.1r'r; 1;•,441-, .F.--.416,-,N;.7../ Heatingic**Mar
,,, '
-....,,,u.......1,-
Air conditioning 46.75
Job site address: l' --4,-2.-)„,\ )1-2,, a,
Furnace 100.000 BTU(ducts/vents) 46.75
City/State/ZIP: iNslii-- ,,r-Oo OR 1-'1\--i C) Furnace 10(k00(}r•BTU Ones/vents) 54.91
1
Suiteibidgiapt.no.: Project name:,..p(r.)k t Cd-
Cross street/directions to job site: i4'(-6{(.1) Hydronic hot water system 23,32
Residential boiler(radiator or
hydsonic) 23.32
Unit heatas(fuel-type.not electric). I
in-wall,in-duct,suspended.etc. 46.75
Flue/vent for any of above 2332
:
Subdivision:River Terrace Lot no.: Other23.
5\ 32 . 1
Other fuel apedlasees:
Tax map/parcel no.: Water heater 2332 1
,...'''„ii:414:4i-r4,:4:-:IV'q,;.,44*k.,ki,;,,,,...;.-*1:.;:i.',';',1111:=•-1;',::('-,,,:,7,-,r.,..- ,t,::+r--,,-.--,4).:,,-,1:..,:";,..: i.:,,.......4-.t+7,,,‘,4:1:.4 Gas fireplaceinsert 3339
..-,v,,:..,..,.r...1.1..:....-.v.,- ...:,-,..-...z..:,.,s.,'.1^:r?"...i`...4,..^1,,•:,-;`,.1.-. 4.o..-ar.,-,v:4...t.r.:4 nue vent ter water heater et gas
HVAC 4,..2) ,9 c.-- fireplace 2332
Lag lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 2332 ,
Chitnnevitinestfluetvent 2332
•. ------"--` " , ''."‘ .--' _ ' ' .' -- ` "*.'" `- " Eaviroduteatal exhaust sad veatibition: 2332
Name:Polygon Range hood/other kitchen
.., •
equipment 3339
Address:109 E 134 St.Suite 200
Clothes dryer exhaust 33.39
City/State/ZIP:Vancouver,WA 98660 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 2332
Phone:(425)586-7700 Fax:,( ) Attiderawlsgace Fans 23.32
kil•Q". '''.iN",,'"75,7:7'.;'''''4'7'741:=-7:7''''''''t.'1,77:-IzTr'7,-ri,"-'r".-7,'M7.7,(FvZ,-Ti°',:t;1.:17':';',:inria."11iYi Other: 2132
BUSitkeSS name.Apex Air LLC Fuel MAIM- ,
S14.is for first roan 34.03 tor eft*additiona
Contact name:Steel littY Furnace.etc.
Address:2210 W.Main St.Suite 107-27'2 Gas heat punto
Widliduspaniediunit beater '
City/State/ZIP:Baffle Ground,WA 90604 ,
Water heater
Phone:(360)341409 Fax::(360)326-1769 Fireplace .
Range
E-mail:stacih/gupexalrto.com '
Barbecue .
,. .
,,,,,;",,v-i.' '`'":i„*.,,,' t-,--•':-:r..-:*.:7''. `'-'r.:1.4.›....,,..r ': ': :4..;.'7,`^4'r'kr',, 41:',4`t''' ''''",ire'-"ZA.'",17'"
".....,.'A w*,e.:',24:L.,...':,..:..,,',.."..' .,.,- 'i."I'l" ,s''.':' L7,1..:.,.'....,-'':,',. :•.1,,l'..":2_ 14";:tk:,..Ztg,',.:L:LA'-tii: V,14-$.,,,If. _ CI°Illes drYer(Os) , '
Business name:Apex Air LI.0 Other:
--,±... _. -,....-",e.,-,...z."--.V•..:4;tai- '0,
Address:220W.Main St.Suite 107-272 Subtinal
. ,
City/State/Z1P:Battle Ground,WA 93604Mininrunt permit fee($90.00) '
;
Plan review(23%of permit fee)
Phone:(360)3424109 Fax (360)326-1769 State surcharge(12%or permit fee)
CCB lic.:203034 TOTAL PERMIT FEE- ---•- --- ——
ilk , .
Authorized si . it' / ."4. Or
gnssuree.$
This permit appficadon expires it*peraritis not aboristed widths 1110
days alter it has bees accepted as msetPlete. i
• Poe methodology set by Tri-'County Building Industry Santa Board -
Print name:Sisal bay Date:1/28/2016
I VkalcfintAPerrnestMEC_AamitApp_0401 LI doc 44046177(I MX-014MM)
I
apiqy CITY OF TIGARD MASTER PERMIT
: ' COMMUNITY DEVELOPMENT Permit#: MST2016-00053
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/03/2016
Parcel: 2S1060002900
Jurisdiction: Tigard
Site address: 13734 SW 172ND AVE
Subdivision: WEST RIVER TERRACE Lot: Multiple
Project: Polygon at West River Terrace, Lot 51
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 805 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 32 Bathrooms: 3 Second: 939 sf Garage: 423 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 1744 sf Value: $216,649.34 Rear: 15
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
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 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: $30,202.31
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.'R 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. //
Issued By: t 41 Permittee Signature: 1/1.,/ �"� /74/ems-7C'`/
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.
Building Permit Application
_ FOR OFFICE l til:0®Ll t./J
Received fj r�/: Pecmit No/ /6 O
City of Tigard ,ro DatcJBy: c'`
74 13125 SW Hall Blvd.,Tigard,OR 97223 FEB °� 20`t IJ Plan Review % J 1 ot>ze<P��u ��_ ���
Phone: 503.718.2439 Fax: 503.598.1960 Dale/BY:
Date Reatr,Z: 0/ , 'oris: H See Page 2 for
T t Ci;i l> Inspection Line: 503.639.4175 CITY OF aflR Nn[ised/Meth ��� 4.fr Supplemental Information
Internet: www.tigard-or.gov
BUILDING N Y'EAi g/z... _G/ "
u_..., ___ _ ._ _.. Permit fees*are based on the value of the work performed.
®New construction ❑Demolition Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ❑Other
equipment,materials,labor,overhead,and the profit for the
1: ,' ', work indicated on this application.
w 41�'.,,..� , , ,? �{ ..,.. .. ,.„ �C _,.� ��/ LJ�! 1 _`
® 1-and 2-family dwelling 0 Commercial/industrial
Number of bedrooms:
❑Accessory building 0 Multi-family ?
Number of bathrooms: J
❑Master builder ❑Other:
�,, V e , € .V Total number of floors: 2
`J/� \ t-�v -,(1 - � New dwelling area: �� �'a square feet 04.1
Job site address: &...3 `.3 L A -- 1
City/State/ZIP:Sherwood,OR 97140 Garage/carport area: t v12 square feet
Suite/bldg./apt_no.: l Project name:Polygon at West River Ter Covered porch area: square feet 9 3q
Cross street/directions to job site:
Deck area: , ✓J square feet 0
Other structure area: ', square feet
sem .;, . a __..
Subdivision: I Lot no.: 3 \ 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
- te � work indicated on this application.
Valuation: $
New Single Family Detached Construction
Existing building area: square feet
New building area: square feet
- '4;.. l as
Nam ' p Number of stories:
- r /!464 V �� GA/�a- 4-CC Type of construction:
Address�0 3 feet f_ ...."-Kr Occupancy groups:
City/State/ZIP: ouver,WA 98660 Existing:
Phone:(360)695.7700 Fax (360)693 4442 New
Business name:Polygon WLH,LLC Structural plan review fee(or deposit):
Contact name:Maggie Gordon FLS plan review fee(if applicable):
Address:109E 13th Street Total fees due upon application:
City/State/ZIP:Vancouver,WA 98660 Amount received
Phone:(360)695.7700 Fax: :(360)693.4442
E-mail:maggie.gordon@polygonhomes.com
- y ,.:,,,,'r', Commercial and residential prescriptive installation of
�����, �Fu� � a � � .� ��,_ )�i�g '--0,4:F.,:4:;-',:i.'7'.s, w�� :,...1:'-:4::.=.�„ „ �. .: 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 13th Street Solar Installation Specialty Code checklist.
Permit Fee(includes plan review $180.00
City/State/ZIP:Vancouver,WA 98660 and administrative fees):
Phone:(360)695.7700 Fax:(360)693.4442 State surcharge(12%of permit fee): $21.60
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
Print name:Maggie Gordon Date:12/11/15 Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) -
r t '
IV.
tY 1 �I� rr rr t1�
I tat,,tl 1 iCf t°.l ,a�yt
.:_J ani
FEB 2 2016 �sr ,. W
I3I75 SW Hall Sfvd.Tigard OR 9 w a �ry_ Dile Pe�sirsr /�j- ,�
• Phone:5037102439 Farr: 503. ` ",E 1 Ld# i� p , i)z t�datdPd u2s:
�t u 1 z3 tnspcctron l hre "3439;4175
03 t3y 4175 p ' i r1 i i $ c:day ram" a�Baas area
• Internet wnv trggrd ai gev 4J I Lt fildintcdtua;
a1'f, -.r 1w.,�X WQ1"C ' I ° ,,,'`i,:',.:.: , ,..LE .�'I .ic y
al`l r�ccnsiructton Oridd#tion/altettinp/replacerirent l't: ca •au.",./6.1,12111113'.„("i141,, 7 s'arylear,°ram,e tsq>.
( Deraoltlon CI 0.0t,...4.1,.....,.>. []gym+«wrrasiaaararo,a CI,ariiagavutluagaxc.
,. ,, ,� ,:a,� ,s _ rhescUraavailalrlerau#t2saietst Q': rsad'iaatyzrr9s...
I
-�3 � `!�"'1 # ,at kik:.,' _. '( ti,s az #Q,UcWampssl lsllwkaor L. gag 1d gs.
*®I and2-faalitydweliing O'Coir1'iiie Ii:adiistrial ❑Accbssdrybuilding kcsw uundarri, r=]a,tstt4 Llcommn;nteueea i
eieys bra o inelausisen. neitQas g
Q l' idle mrnily Q 14aster bviider Q f)thar:
JO ''''i'-'''''.'-:''
"'u' - 'a013:41401111:#0
.i - � +4d ., oTnc El. t £euc1F19aKYAor'
Cltrom¢
Sl1Ut1rlh�iLQf§i At+IU i ikT1O1d [Ty, Larger sapatatety derived
Soil: rob site addr .. Fr snptor toad ar eyar
1.
t
oil CIe A."E"E'3 ;7 3, ,
City/StatetZIP:Sherwoodfife9714t► 13sec-or/nemresldeeiraiunits; &w!any.
C7lfcadh rat euilides LIA?sraaHan�t vsAicie pis
Suittibtdg./apt#: Project name: I3Hazaioeueinenteot. Cl sappy t aserininwu toot
I:1Sbnxavrreetleraooamps�,t ra. 6tt¢wlnsaaminat.
Grass streeddixectioas us job site:
noeulffea T o I red, I 'raid I
New ri dential sfagte.or'asulti-$ain#ty dwdhr "
u t siitn:Rivet Terrace Lot iasetades aftastaetf i p► !,
Tror m ptu eel# 100 R#sq . 1-4,$'!.''''' i 1°834 4
Ea.acid 1508sq: erpoidon Q 33.92 1
. i' PSC )*T11diV OPW31.--midnrestnai .ay. ..... energy, 75.00„ g2 Srugle,ttflnlly (sithnbavasq 11.) i
3.itn0ai_.„ ,"R1idH 5mily 75.40 2
. Lina iihabovesq.it) t
- Bari'
t].SeePage2 t
P 'iii t3WN.8i . '".t ' Li, V#t9C Services or kcderofdstaltatantatter°atlonrauitterrelocation i
Name:Po
fygori names 200 arupsm ides. I04?4
Andress 199 13''St 201 miliate4 eipys 133:36 2
401 amps to 600 iniiiu 20039 2
City/State/ZiP;Vancouver WA 98660 60I amps to 1,040 snips 341.01 2
PItooe,{3s9)69s-77OO Fax:( ) l,t#noi++psarvolts 552.26 2
Britoil:
•
Tiaiporary services or feeders iisraffat'eon,sltersifian,and for t
` relocation
Ouvner installation:This installation is being made on properly that I meat which is not 200 amps or less 52.20 1
intended for sale,lemic„rent or exchange,according to ORS 447,.449,670,and 701. 201 au jju w 900 amps 125.08` 2
Owner signatare Date: 401 10599 asap 16834 2,
Brarick sircaits-.new aztg9sian,per aml t
1..• ,iP ," t M t ,attention,or
#' [ t tirr�Acr p>ascta
'Buiaessnarne Lamer Sleets-in Washington,LW h.secresera a grfeede rMrh
Ar abovcs4xv7ca ocfaiufea
archbuatnchcireint 7• 2 t
Cprrtasd mm�t::Blfl Daniels B.Fat for branch cnitsu rlurat J,
.address:6101 NE St Jahns ltd anrt cs rattcdcx fa,first: Salt °'
terneheircult 2 ,4-
City/State/ZIP:Vancouver WA 98661 EadiailltIbrerielicircuit 742: 2
Phopetitseellan (aari4ceorfeedernotIIncluded) r
{353}3ZO-1657 FAX::( ) Each mazttitkch,'+4d rocbitar
Email beanie ugwensa.eom -: declline,sonrres,,undreufeeder' 6784 2'
1i ," „-c `, ,. ;t;()IiiIi scro1I Pwnp �inoncirck 67.84 2
SSl
Business Beene;Garner Electric Washington,LW gn or otnliocligtrring 62.84 ; 2
Address If101 NE Et 3trhns Rd 4.iBRdf c renins)oriimlted-energy Ia SeePage2 2
„� inat attecation,erriztoasion.
City/5tatn1Z1p. VitlieottYEr WA°8601 -Eath additio»a1 impaction over allowable in any or the alis r
Add2lnatlltt hon(humin) d¢.23Iha
Pilon {25))3,24-1457 Fart:( ) Tnvss€f atitlir{I hrialr!1 94.0o/Lr
sur4
Email;bdaniels®gwveusa,coln lirdtsls?a Omit('hr nln) ?B IS/hr
fnspectiaufarwhiahnafeen g440ihr
CCB/Lin CUSS Electrical Lie.:208174 Suprv.Lie.:4496$ = 6 h abed !-1''"114]
/�� � " Gt�1[ 1rCttrlC$8
Supra Electnpt n signatures required. h e..�C. 1 i
print Jeal P Albert - *rt:>!e, i i,
i3 � � L7?fan fiiwfeevltequlr�5d.{3,5'�uF
i<
Authorizedsigtiature: ''” _' To11Af:PT : 1
Print nali�.Bill Daniels j���^ - Tht,gerrnii apyilita oa aapiav iia 1 tang!obtained v,iihin too' f
tate: k act ljr day's a"tterir has tmenaeapled as complete.
' 14umherofirssixbilon Una. tpej penal!..
t saildcstaara na,mePFaaitaaa A kiinP dor ser#15177170$5 :44e,esisitiin 5Cor aWVaa
1.j
t
. j pp
Mechanical Permit Applica€'
( 'IVED IIIIIIIIIIIIIIE)NIIISIIIIIIIIIIIIN
• City of Tigard Received ,,; »o,y
.1111 13125 S Halt Blvd.,Tigard,OR 97223 Date By '`.5� ��'D�
t Platt Review
. s► Phone: 563.718.2439 Fax: 563.598.1960FEB ° r Farelay Other Permit
t,1 ,,,,,i,„ Inspection Line: 503.639.4175
DateReady?By: him- 93 Set Page 2 forlntesnct ww+.ti td E[.Rov CITYOs1aTLe
tdotiFea't+tetttacl: Supplementer Information
BU/LOIN( 1:*,IMSACINJ
Mechanical permit fees'are based on the value of the work
0 New construction 0 Addition/alteration/replacement performed.Indicate tic value(rounded to the nearest dollar)of all
Demolition 0 Other: _ mechanical materials,equipment,labor,overhead.and profit.
Value:S
`is,. w tr °';r:::',-,:11:7 Q f ill
r
123 I-and 2-family dwelling 0 Commercial/industrial ", l t mai ,e4::,,,,„ }
Accessory building For special Information use ekedttft
Q Multi-family 0 Master builder 0 Other: Description
� �Ta rr 4, ng- Ea. Total
lfeatiaptcoarli
Job site �. r..�, ,
Air sditicming 46.75
address: 1�� \ '1% Furnace 100,600 BTU(ductsfvents) . 46.75
City/State/ZIP: bu rZ`3O 0 IRiFurnace 1ot1.1lo BTI;(ducts/vents) 54.91
^� Heat pump 61.06 l
Suite/hldgiapt.no,: Project name:_poi\ L-� C � Duct work . 23.32
Cross street/directions to job site: ,,,p r ,,,f, }l
`may t�-1 y tlronic Inst water system 23.32 ,
Residential boiler(radiator or
[ ` hydropic) 23.32
Unit heaters(fuel-type.not electric),
Iin-wall,in-duct,suspended,etc._ 46.75
1 Flue/vent for any of above 23.32
I Other
Subdivision:River Terrace Lot no.:51 23.32
Other fuel appliances
Tax map/parcel no
;'-'4',"4.s:$7; ��,�. ��- � ;-.,� • ,n. s :. ...:,� �... ft2332
� � rsg s . ,, `£ t .- t, ! ' G 3339
Floe vent for water heater or
HVAC s fireplace - 23.32
I Log liehter(gas) 23.32
Wood/pellet stove' 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
: Other,,,, & � , ",..s v ay 3332
_
w . v r. t,, g- a-t,`,l � " ' l' .A ,M;
Environments'exhaust and ventilation:
Name:Polygon Range hood/other kitchen
Address:1139E 13u`St.Suite 200 equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP:Vancouver,WA 98660 Single-duct compartments,(bathrooms,
toilet utility rooms) 23.32
Phone;(425)5866-7700 Fax:( ) Attic/crawl
spaces films 23.32
. ..t-igs, r. aiflti t 'B .. .� i n o r ,4 e Ooh : 2332
Business name:Apes Air LLC Fuel liiiti '
514.15 for first faun:54.63 for each additional
Contact name:Stasi Ray Furnace.etc..
Address:2210 W,Main St.Suite 107-272 Gas heat pump
Walla
City/State/ZIP',Battle Ground,WA 98604 Water heaterstdexl/unitheater
Phone:(3611)3424109 Fax::(360)326-1769 Fireplace
E-mail:stiteil4apexairco.com Range
t •,,: ._ � ,. Barbecue
_ 4 - . » i +a��f 'S �� ;� � ty���sr ' f���`` glt�-" _';
Clothes dryer(gas)
lit mess name:Apes Air LLCOtt'
Address:220W.Main St.Suite 107-272
Subtotal
City/State/ZIP:Battle Ground,WA 98604 Minimum permit fee($90.60) ,
Phone:(360)3424109 Fax:.1360)326-1769 Plan review(25%of permit fee)
Stale surcharge(12%of permit fee) •
CCB 1rc.:203034Ilif
' TOTAL PERMITFEE
This permit implication expires if a permit is not obtained within ISO
days after it has been at-teased as complete.
Authorized signatur . '" ;.r ,/ 7)/: '; . ' '-.7.' x
Fee ttethodoi et byTri-Cowity BuildingIndustry Board
Print name:Stasi bay I / Date:1/28/2016
1 JtoitdtogiPermitsLMEc Ptrn+irApp_t34o t ti doe 440-4617T(1 t•':'CAttAVE8)
Plumbing Permit Applies
Building Fixtures
FEB 2 4 2015
Received
e �1Sri4Mnz�03
City of Tigard Date/Br
Permit No
NI. '4 13125 SW Hall Blvd.,Tigard,OR "� 01- `j t BAR Pian Review
Phone: 503.718.2439 Fax; 594 4.. , Q c s o Dario
y_ Ocher Penult 30.:
1`11 s t$ u,� g M See Pae 2 for
Inspection Line: 503.639 4175 , Dace Ready/By Jens 8
Su
1 t< 1).4 i Internet www hgard ar goy
Noun d Method lemental information
For special informationusechecklist.
New construction IN Demolition Description ( Qty. i Ea. I Total
[3Other New 1-2-family dwellings(includes 100 ft.for each utility connection)
❑Addition/alteration/replacementP: .... # SFR ! bath 312.70
5FR(2)bath 437.78
II 1 and 2-family dwelling ■ Commercial/industrial SFR(3)bath I 50032
D Accessory building [21Multi-family Each additional bath/kitchen 25.02
Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
x '' k• Site utilttles:
Job site address: I t - Catch basin or area drain l 8.76
�f1� Drywell,leach.line,or trench drain 18:76
City/State/ZIP: A K 0 C ek. `1�T��
Footing drain(no.linear IL:�) Page 2
Suite/bldg.(apt.no.: Project name: anti ()kir CLA-- V Manufactured home utilities 50.03
Cross street/directions to job site: Al,(( 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: f Lot no.3\ Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
- y Backwater valva 12 51
owI �s _ -. ,_ t_„ clothes washer 25.02
n-eu �J pku n Dishwasher 25.02 f
Drinking fountain 25.02
Ejectors/sump 25.02
.fa1251
:.. ,, Expanesrton
tank,
Y�� �\ ':�� "` a Fixtur scwes cap 25.02
Name: 1 �] i
n J Floor drain/floor sink/hub 25.02
Address: U( l J Garbage disposal 25.02
City/State/ZIP: J a "\ ' L , I0 Hose bib 25.02
Phone c'�1p C - 0 Fax: •' �D t0 I - Ice maker 12 51
t
- rccpt csc trap
lute '
Business name: Medical (value:$ ) Page 2
Ki„.—..,,,i L 'YY y ; t X't� 1 v ti k.. Primer 12.51
Contact name: NI 0yve VA,--1,4,‘,.• Roof drain(commercial) 12.51
Address: t. 1. "7 Sink/basin/lavatory 25.02
City/State/ZIP: f � _A,..Sit'! i( CI�}(} Solar units(potable water) 62.54
g1 3 Fax::( } Tub/shower;shave r pan
Phone: 12.51
") ) Urinal 25.02
E-mail: a * • ,r.t water closet 25.02
• ,v, ;3 1,-4II. Wates heater 37_52
Business name: ` Water piping//DW"V 56.29
Address: P' G DI- Other. 25.02
subtotal
City/S`tate/ZIP: ...,_.,,h, i 3 L Minimum permit fee: S72.50
Phone:(911) g- •q/13 Fax:( )
Plan review (25%of permit fee)
CCB Lie.: Plumbing Lic.no State surcharge(12%of permit fee)
Authorized signature: t,,,„. ,
TOTAL PERMIT FEE
MCA
�{ This permit appllc dun esplrea 1f a permit is not obtained within 180 days
Print Warne: i" I.Y c` „ -;f ` 't 1, D� 1 c 9 I i( accepted a``omptete
S t aftertt h+s been a
'Fee methodology set by Tri-County Building Industry S.:mice'Board-
44O46t6T(i01UiCO.MIwEB)
S:isuiid eg'Pumia5PtMdti-PcaritApp.doc lO,t/09
t ,
IIIinCity of Tigard
■
COMMUNITY DEVELOPMENT DEPARTMENT
T 1 Gn tR n Building Permit Review — Residential
Building Permit #: /iiST,20/6 — CO a S3
Site Address: i 7 3 4 S iio nay, a, pc _
Project Name: Po(,i ci ,,n af 1„J R; rye-- --fie ry-C&C.1.-- Lot #: 5 I
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: We 3 F g--
-Ibn-env✓ Io-\- 1 Ae4-&-Cheizi 1-wrne. I out(t1 iGaet l 16,-,-Me--
At-
,-,-Me
Verify site address/suite# exists and active in permit system.
►g River Terrace Neighborhood: ❑ No ,Z'Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
Three(3)copies of site plan ,Ztaisting structures on site
fNSite plan must be on 8-1/2"x 11"or 11 x 17"paper liFootprint of new structure (including decks)with finished
1 Drawn to scale (standard architect or engineer scale) floor elevations
kNorth arrow ®Utility locations (required for new,may apply for additions)
PiSite address,project or subdivision name and lot number ,ocation of wells/septic systems
AApplicant information(name and phone number) ,C Erosion control(including drainage-way protection,silt fence
kLot dimensions and building setback dimensions design,location of catch basin,etc.)
Lot area,building coverage area,percentage of coverage and Pe-Street names
impervious area (applicable if R-7,R-12,R-25&R-40)
AfStreet tree size,type and location
Property corner elevations (2 foot contour lines if more than ,Existing trees to be retained with drip line,and tree
4 foot differential) protection measures
Clean Water Services —Service Provider Letter (lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified X No Received: ❑ Yes ❑ No
K Public Facilities Improvement (PFI) Permit:
Required: f Yes,applicant was notified E No Applied For: ( Yes E No,stop intake
,® Land Use Case#: `>DRa0 15- O0,..,C.•'t S-J E A015--0000i'3
l Zoning: R_ '7 P P 1
e Setbacks: Front �(t p Rear p 4 Side .� Street Side ..--- Garage 4
Al Landscape Requirement: ao % ,f
le' Lot Coverage Maximum: 80 % _ PeiP°Je d 46;2% exAt t
YO
'Building Height: Maximum Height 35 Actual Height a 5 u `` `1
Visual Clearance
Easements
0 Sensitive Lands: ❑ Yes Z No Type
Urban Forestry Plan
❑ ConditionsMet"prior to issuance of building permit /
otes: COln ct -{i (WI s t�ri u✓ -Fo b (c(5 �o i ,vt�`l� rt u (�C r� mei.
Approved By Planning: a. C Date: -o2 q—/4o
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\B1dgPennitRvw_RES 012116.docx
ti
S
City of Tigard
1111
M COMMUNITY DEVELOPMENT DEPARTMENT
T I G A R D River Terrace Building Permit Review Addendum
Building Permit #: f$i .0,, (, -- .0p 0 3„3
Site Address: t3y?3u ,S i.,J 17.).,A .\vz .
Project Name: Pvi ti v -, f 1,3 R° �- Tee-Y CA— Lot #: 5'f
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review River Terrace Plan District Design Standards (18.660.070.1):
1.Articulation: a minimum of 1 element per each street-facing 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
ft. deep min. 2ft., 5 ft.wide min. 2 ft., 6ft.wide
.�` / CI CI C] CI
Whale e,b , '''- atlu°\ 7 1
2. Eyes on the street: a minimum of 12% of each street facing facade must include windows or entrance doors.
Percentage Shown: 47,3 to
3. Entrances:At least one entrance must meet both of the following standards:
i Max. 8 ft. setback from longest street- facing wall - 'Parallel to street,angle no more than 45° from street,
C. " ! or open onto porch
Entrance opens to a porch: XYes ❑ No
If yes, all the following apply: :i 25 sq.ft. min.
►N One street facing entry 12 ft. max. roof height above porch
A'5 ft. depth min. :`,i 30% min.porch roof coverage
. Detailed Design:All buildings shall include a min. of five of the following elements on all street-facing façades:
PP Covered porch min. 5 ft.wide x 5 ft. deep ❑ Recessed entry area min. 5 ft.wide x 2 ft. deep
►iWall offset min. 16 inches ❑ Dormer min. 4 ft.wide
i Roof eave min. 12 inch projection Roof offset min. of 2 ft.
❑ Roof shingles either tile or wood Gable,hip or gambrel roof design
❑ Roof pitch oriented south'min. 500 sq:ft. Horizontal lap siding min. 3-7 ft.wide
❑ Accent siding min. 40% of street facade Window trim min. 2 1/2"wide by 5/8"deep
❑ Window recess min. 3 inches for all street facing ❑ Bay window min. 5 ft.wide by 2 ft. deep
❑ Balcony min. 5 ft.wide x 3 ft. deep with inside access ❑ Attached garage is 35% or less of street facade
5. Garages and Carports:May face the front or side lot line on a corner lot. (j/ usqtj rcJ f A e ct
Setbacks: "� a.ray--
No closer to front or side lot line, than longest street-facing wall. CI Yes ❑ No. If No (Check one): d
❑ 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 façade with 7 detailed design elements
Notes:
Approved By Planning: � l,�. a. (� Date: a - d`f—1
I:\Building\Forms\BldgPennitRvw_RES_RT 012116.docx
0
Building Permit Submittal
Original Submittal Date: a/�V/‘,
Site Plans: # 3
Building Plans: # J
Building Permit#: CJ Enter building permit#above.
Workflow Routing: ['Planning D—Engineering Ca—Permit Coordinator ea-Building
Workflow Sign-off: [Sign-off for Planning(include notes from planning review)
Route Application Documents: [4—Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
uilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: - Date: 02/2-5-A
Engineering Review
f Slope at building pad: /%
0r 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 0 No
Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No I
LIDA Facility on lot: ❑ Yes ❑ No
❑ NOT iii ;
—
Notes: Condition remain unmet that are required prior to issuance of bldg. permits. —
Approved by Engineering: k _7 Date: ,,,deg.—_,/,
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
ir/r-
pApproved, NOT Released: Date: ,/r//C
Notes: /-GG l'il>P
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
SDC Fees Entered: Wash Co Trans Dev Tax: Yes El N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: Yes ❑ N/A
O--=:►OK to Issue Permit
f/
Approved by Permit Coordinator: Date:
I:\Building\Forms\BldgPermitRvw_RES_0121 1 6.docx
Albert Shields
From: Albert Shields
Sent: Monday, March 07, 2016 4:44 PM
To: Maggie Gordon (Maggie.Gordon@polygonhomes.com)
Cc: Tom Hochstatter
Subject: River Terrace Northwest, Multiple permits
Maggie, here are eleven more that are going on Hold as"Approved but Not Released" pending completion of required
conditions of approval. Albert.
MST2016-00051, -00053, -00054, -00055, -00056, -00057, -00059,-00060, -00063, -00064, &-00065.
1
1
Plumbing Permit Application
Building Fixtures
City of Tigard s E p 2 ;? 2 Q;vReceivedDate/ // !/' /p..4.._ Permit No.:
111 II • 13125 SW Hall Blvd-,Tigard,OR 97223
Plan RyzewO��`(e �� �1�-a��s3
Phone: 503.7182439 Fax: 503.59$1960 Dt/B : Other Permit No.:
1 i ; 11,n Inspection Line: 503.639.4175 - Date Ready/By: Jun, H See Page 2 for
Internet: www.tigard-or.gov _ Notified/Method: Supplemental Information
SEE'-!SC11iEiitll,7�
®New construction 0 Demolition For special information use checklist
Description 1 Qty. 1 Ea. t Total
❑Addition/alteration/replacement 0 Other. New 1-2-family dwellings(includes 100 ft for each utility connection)
CATEGORY OF CONSTRUCTION' SFR(1)bath 312.70
®1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building ❑Multi-family SFR(3)bath 1
500.32
❑Master builderEach additional bath/kitchen 25.02
0 Other: Fire sprinkler( sq.ft.) Page 2
. JOB STYE INFORMATION AND LOCATION _ Site utilities:
Job site address: `37 3 l Spj etilt_ Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: J Project name:Polygon at West River Ter Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft: ) Page 2
Subdivision:Polygon at West River Terrrace I Lot no.:S ' Fixture or item:
Tax map/parcel no.: Backflow preventer t 31.27
DESCRIPTION OF.WORK Backwater valve i 12.51
Clothes washer 25.02
(jeninicttr r,kruige Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
.'PROPERTY OWNER I ❑ TENANI ' Expansion tank 12.51
Name:ADVL Land Holdings,LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:7600 E Doubletree Ranch Road
Garbage disposal 25.02
City/State/ZIP:Scottsdale,AZ 85258 Hose bib 25.02
Phone:(602)694-4031 Fax:( ) Ice maker 12.51
®.APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:William Lyon Homes,Inc Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Angela Grajewski Roof drain(commercial) I2.5I
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
CCB Lie.:102535 Plumbing Lie.no.:34-276FB
Plan review (25%of permit fee)
C State surcharge(12%of permit fee)
Authorized signature: .� 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 Tei-County Building Industry Service Board.
I:\Building1PetmitstPLMU•PermitApp.doc 10/01/09 440-4616T(10/09/COM/WEB)
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
13734 SW 172ND AVE, SHERWOOD, OR, 97140
Record Type:
Residential - Master Permit
Inspection Type:
399 Plumbing final
Result:
PASS
Comments:
Corrections completed
Violation Summary:
Tel: 503.718.2439
Inspection Date:
January 20, 2017 at 9:29:23
AM
Record ID:
MST2016-00053
Inspector:
Aaron Cillo-Gobel
Inspector Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
13734 SW 172ND AVE, SHERWOOD, OR, 97140
Record Type:
Residential - Master Permit
Inspection Type:
699 Mechanical final
Result:
PASS
Comments:
Corrections from previous inspection complete.
Violation Summary:
Tel: 503.718.2439
Inspection Date:
January 23, 2017 at 1:08:47
PM
Record ID:
MST2016-00053
Inspector:
David Young
Inspector Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
13734 SW 172ND AVE, SHERWOOD, OR, 97140
Record Type:
Residential - Master Permit
Inspection Type:
199 Electrical final
Result:
PASS
Comments:
Tel: 503.718.2439
Inspection Date:
January 24, 2017 at 12:03:59
PM
Record ID:
MST2016-00053
Inspector:
David Young
This inspection passed previously, see inspection dated 1/20/17.
Violation Summary:
Inspector Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
13734 SW 172ND AVE, SHERWOOD, OR, 97140
Record Type:
Residential - Master Permit
Inspection Type:
299 Final inspection
Result:
FA I L
Comments:
Provide city required documents for final inspection.
Violation Summary:
Tel: 503.718.2439
Inspection Date:
January 24, 2017 at 12:04:37
PM
Record ID:
MST2016-00053
Inspector:
David Young
Inspector Contractor