Permit (10) p77
CITY OF TIGARD , a '. MASTER PERMIT
III COMMUNITY DEVELOPMENT `� "�'/�/f I Permit#: MST2016-00227
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/15/2016
Parcel: 2S106DC01500
Jurisdiction: Tigard
Site address: 13740 SW SILENT FOX TER
Subdivision: POLYGON AT WEST RIVER TERRACE Lot: 15
Project: Polygon at West River Terrace, Lot 15
Project Description: New SFA. Building/unit 1.1. 1/3/2017: REPRINT permit to correct plumbing fixture count(1 hose
b
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 2 First: 101 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 31 Bathrooms: 3 Second: 646 sf Garage: 547 sf Front: 12 Smoke
Dwelling Units: 1 Third: 633 sf Right: 0 Detectors: Yes
Total: 1380 sf Value: $183,752.55 Rear: 10
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: 2 Garbage Disp: 1 Water Heaters: 1 Drains: 0
gWater Lines: 100 Catch Basins: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 1 Bckflw Prevntr: 0
Drywell-Trench Drain: 0 Other Fixtures: 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 add9 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 SFA VB
R-3 1380
Owner: Contractor:
WILLIAM LYON HOMES INC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
BY POLYGON WLH LLC 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175
109 E 13TH ST VANCOUVER,WA 98660
VANCOUVER,WA 98660
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $23,046.07
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OA 959-001-0000990. 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: 44.21-C___ Permittee Signature: eM.J .4/91°G./6 /27224.7
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.
Ammum
Water Meter Fixture Unit Worksheet
Please complete the following information:
Contractor Name:
Billing Address:
Phone Number:
New Meter Address:
Subdivision Name: Lot#:
Please fill in the number of each fixture as detailed on the plans. Multiply the quantity by the point value
to arrive at the point total. Add all point totals together for total fixture unit points.
Fixture Unit Quantity Point Value Point Total
Bar sink x 1 =
Bidet x 1 =
Clothes washer x 4 = 11-
Dishwasher ) x 1.5 = i
Hose bib J x 2.5 = ..s—
Hose
,SHose bib, each additional x 1 =
Kitchen sink J x 1.5 = ,s"
Laundry sink x 1.5 =
Lavatory
1÷ x 1 = Li,
Water closet, 1.6 GPF ,3 x 2.5 = 1
S
Bathtub/whirlpool x 4 =
Shower stall J x 2 =
Bath/shower combo I x 4 =
Irrigation(#of heads in largest zone) x 1 =
Total Fixture Unit Points: A 7
Fixture Unit Points:
Up to 30= 5/8" Over37= 1"
Up to 37= 3/4"
Meter Size: Meter Cost: $
*************************************************************************************
FOR OFFICE USE ONLY
Fixture Units Points verified with
Building(Master)Permit or Plumbing Permit: ❑ Yes ❑ No ❑ Other:
Meter#:
Receipt#:
Employee Name:
I:\Building\Forms\WaterMeters 070116.docx
14 CITY OF TIGARD MASTER PERMIT
4 ' COMMUNITY DEVELOPMENT Permit#: MST2016-00227
Date Issued: 08/15/2016
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S106DC01500
Jurisdiction: Tigard
Site address: 13740 SW SILENT FOX TER
Subdivision: POLYGON AT WEST RIVER TERRACE Lot: 15
Project: Polygon at West River Terrace, Lot 15
Project Description: New SFA. Building/unit 1.1
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 2 First: 101 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 31 Bathrooms: 3 Second: 646 sf Garage: 547 sf Front: 12 Smoke Yes
Dwelling Units: 1 Third: 633 sf Right: 0 Detectors:
Total: 1380 sf Value: $183,752.55 Rear: 10
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: 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 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 I
Other: N Other Description: Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SFA VB R-3 1380
Owner: Contractor:
WILLIAM LYON HOMES INC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
BY POLYGON WLH LLC 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175
109 E 13TH ST VANCOUVER,WA 98660
VANCOUVER,WA 98660
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $22,774.54
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 thro 0 -001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By. . Permittee Signature: 9/v , ioG/e$-770"/
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.
1 4'.
�4,�— F' sBuilding Permit Application i> ,' / b s z
il‘4441610 FOR OFFICE 1 SE O\Ll
MAY 2 ` 2)(1'�i- Received
City of TigardIV*
Date/By: W Permit N ..
1111 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Renew/ /
• Phone: 503.718.2439 Fax: 503.598./900 . P f Date/By: t., / l7 J j L ,` other Fermi /�E'�J/'
I,j c,A RI., Inspection Line: 503.639.4175 ,.,-. Date Ready/By: / Juds: H See Page 2 for
g
Internet: www.tigard-or.gov 3<t J , , _,,14.1 ,, 4s, Notified/Method. / ., Supplemental Information
:itiita _
ms €
4411-0;:log
®New construction 0 Demolition Permit fees*are based on the value of the work performed.
❑Addition/alteration/replacement 0 Other: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
1;',, rmots,„,5F,z.rwevmr t t nallanit work indicated on this application.
® 1-and 2-family dwelling Sf,4 ❑Commercial/industrial Valuation: 83,03 /
, a
0 Accessory building 0 Multi-family Number of bedrooms: 2
❑Master builder 0 Other: Number of bathrooms 3 4.
1 4-
i w s " t Total number of floors: 3 i 3° i 9 t
Job site address: 13�4,D SW Silent Fox Terrace New dwelling area: '394 square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: 544 7 square feet 6 3 3
Suite/bldg./apt.no.: I Project name:Polygon at West River Ter Covered porch area: t-^�l--*yS square feet 6;4 6
Cross street/directions to job site: Deck area: A �'9k spuare feet 1 0 I
%Other structure area:-J-0Jv-'-// /square feet
==
Subdivision:Polygon at West River Terrace Lot no.: I r) Permit fees*are based on the value of the work performed.
Tax map/parcel no.:
Indicate the value(rounded to the nearest dollar)of all
and
equipment,materials,labor,overhead, the profit for the
i, :t l' .k. work indicated on this application.
E6 6iAt I I.A fl 1T I.' Valuation: $
` Existing building area: square feet
New building area: square feet
pirlit-.ds. ; t - Number of stories:
Name:ADVL Land Holdings,LLC Type of construction:
Address:7600 E Doubletree Ranch Road Occupancy groups:
City/State/ZIP:Scottsdale,AZ 85258 Existing:
Phone:(602)694-4031 Fax:( ) New:
Business name:Polygon WLH,LLCji " 'y'` ' `
Structural plan review fee(or deposit):
Contact name:Angela Grajewski
FLS plan review fee(if applicable):
Address:109 East 13th Street
Total
City/State/ZIP:Vancouver WA 98660
.. application:
Phone:(360)695-7700 Fax::( ) ' '
IRITW E-mail:Angela.Grajewski@polygonhomes.com ,,,,,..?44N'' '.
%y Commercial and residential prescriptive installation of
: roof-top mounted PhotoVoltaic Solar Panel System.
Business name:William Lyon Homes,Inc Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 109 East 13th Street Solar Installation Specialty Code checklist.
City/State/ZIP:Vancouver WA 98660 Permit Fee(includes plan review $180.00
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
Authorized signature: t J (444,71 This permit application expires if a permit is not obtained
✓� Tom" -' within 180 days after it has been accepted as complete.
Print name:Angela Grajewski Date:5/20/16 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Anplicati4#1::<( 'i.,'f ,::,. --]-''; '',c' FOR 0H-i('y 1st:Om.'
City of Tigard Received
Date By Pemm No/1757;2 —pape„,7
Plan Review
!h,...._ 13125 SW Hall Blvd.,Tigard.OR 97223
Phone: 503.718.2439 Fax: 503,598.1960 MAY 2 5 2 0 IS Date/Os; Other Permit:
Inspection Line: 503.639,4175
, Date Ready By. Jan' FEl See Page 2 for
Internet: www.tigard-orgov
-,...,,I.:'": 1 :',•7;-: '',, ,. ,, Nonfied:Method Supplemental Information
TYPE OF illiiIkkdi“-a''''''11\''''''''`I''''' CONINIERCLAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
C.4 New construction 0 Addition/alteration/replacement
, performed,Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: 1 mechanical materials,equipment,labor,overhead,and profit.
Value:S
CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
0.4. 1-and 2-family dwelling 0 Commerciallindustrial 0 Accessory building ,
For special inftirmation use checklist , .
0 Multi-family 0 Master builder 0 Other: Description Qty. 1 Ea. 1 Total
ff JOB SITE INFORMATION AND LOCATION ileatingit°°1ing:
Air conditioning 46.75
Job site address: I 14O ‘,&.) SO.e_t- -)-• — 'OK Te crtt_c_k
Furnace 100,000 artJ(ducts vents) 1 , 46,75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BM iductsivenisi 54.91
Heat pump 61.06
Suite/bldg./apt.no,: 1 Project name:Polygon at West River Ter _
Duct work 23.32
Cross street/directions to job site:
Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric).
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Other: 23.32 ' 1
Subdivision:Polygon at%Vest River Terrrace Lot no.: ‘5
Other fuel appliances:
Tax map/parcel no.:
Water heater 23,32
. .
I DESCRIPTION OF wow,: Gas fireplace/insert 33,39
Flue vent for water heater or gas
Complete rough of HVAC
fireplace I 23.32 .,
g)ar )tlini . 1 t I r ' Log lighter(gas)
i 23.32
Wood/pellet stove
33.39
1 Wood fireplace/insert ' 23.32
i
Chimney/liner/flue/vent 23.32
Other:Range 1 23.32
' C.4 PROPERTY OWNER 1 0 TENANT
Environmental exhaust and ventilation:
Name:ADVT.,Land Holdings,LLC
Range hood/other kitchen
equipment I 33.39
Address:7600 E Doubletree Ranch Road
Clothes dryer exhaust 1 33.39
City/State/LIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms,
toilet compartments,utility'rooms) 3 23.32
Phone:(602)694-4031 Fax:( ) Attic/crawls ace fans 23,32
10 APPLICANT CI CONTACT PERSON Other. 23.32
Fuel piping:
Business name:William Lyon Homes,Inc,
S14.15 for first four 54.03 for each additional
Contact name:Angela Grajewski
1 1 Furnace,etc.
'
Address: 109 East 13th Street
Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98660
Water heater .
Phone:(360)695-7700 Fax::(360)693-4442 1 Fireplace
Range
E-mail:Angela.Grajewski(..it2polygonhotnes.com
Barbecue
CONTRACTOR I Clothes dryer(gas)
Other;
Business name:Andersen Heating,Inc
MECHANICAL PERMIT FEES*
Address:16285 SW 85th Ave ste 410
Subtotal
City/State/ZIP:Tigard,OR 97224 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone;(503)992-6664 Fax:(503)536-6615
State surcharge(12%of permit fee)
, . .
CCB lie.:168214
I TOTAL,PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signatur : '
* Fee methodology set by Tri-counry Building Industry Service Board
Print name: r Date:05/23/2016
13"BuildingTamits3MEC_PereretApp_3040113 doe 440-1617T(11'02..."COMAVE38)
'..P.r.;,i'. !I: ,41 7,I. :•,' i,,' 4.; f,,, , •
Clectrical Permit Applicatioti-' " — ' " -'• '
....... _ ..............._., _.,_.....__
City of Tigard
III Received
r, - Dinah,
13125 SW Hall Blvd..Tigard,OR 97223 'VI rA\1. ,.? 0.5. ii.Li,h plan at-wiew
Phone: 503,7182439 Fax!' 503.5981960 °near Pesintt 11-W-0/6,''"6)0412,02 7
Related Perron tt-
Inapection Linc°, 503.6394175 ,, , •,, Ready DatelEty. -Avis 0 See Page 2 for
Intetnet www.tiprd-or gov Supplemental bantnnanen
New construction 0 Additiomialteration/replacement il;;sedulaiiiit that apply(submit i,sem,,,Mans window cbushedt
0 Semite or feeder 400 amps or more 0 fluilding over three stones.
0 Demolition 13 Other whet the available fault cumin 0 Marinas and boatyards
• ;' ' '' - ' - ',.72,-;,,,..,::, ', '2:Ci.:.:,117,:;:sT'f.:7;:glit::7;127.7'. ,,illrikt;73::
eacceds 10,0001101Ps at 150 volts or Cl Muting hinkhuP
:1-4 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less at gram&or exceeds 14,000 0 Commereud-use agricultural
amps knell other installatioas buildings,
El Multi-family 0 Master builder 0 Other: 0 Fire PienP, 0 installnion of 150 KVA or
- -1,::";;;7-:44-3,C,i'i-777' ,:':"';,:, ''' 71":,';',:':..• ;;;. 717,7,t2;,i7,»,%t,r'7:',7177aiLIZE.:47.4.1 a EmerStscY 1°11`elvi- largo sonarstelY droved
Job H: tJoh site address: 1LE b Sk )1,I- ViraCe 10011P or more. 0"A", E,-i-r,-1-3",
i enk
.3 sw or more residential units occupancy.
City/State/ZIP:'Tigard,OR 97224 0 ltealdHaire facilities, 0 Recreational vehicle parks.
Suite/bldg./apt 0: Project name:Polygon at West River Ter 0 Hazardous locations. 0 Supply voltage for more than
0 Service or feeder 600 amps or more 600 vats nominal-
Cross street/directions to Job site: Fili:i2F4•71Z1772,:f.2;:.:;,. .' .'7-''.'1:''''...:7=titt?, :''''''' li.,;" 1
Deettiptite Qty. Ledo Taut • ,
New residential single-or multi-family dwelling unit
Subdivision:Polygon at West River Terrrace Lot H: IC Includes attached garage.
1,000 sq,ft,or less I 161.54 1 i tit-)51.[ 4
Tax map/parcel#:
::,j7'', 77:77.'i': =7',‘: -:,,a:::`S.7.17;0:;f 7::..,Z7,,,:::::::,1"7,2,;%•' '..::',. :7:,t;.----- r,:;.:71triiT Ea add"500 sq-R.°T.P°rti°n 4/ 33.92 35q2_, 1
to r9 ii,n if Limited energymodernist!
(with ,above sq.ft) 75.00 2
Limited energy,multi-family
7500 2
Name:ADVL Land Holdings,LLC Renewable Energy 0 See Page 2
Services or feeders installation,alteration,and/or relocation
Address:7600 E Doubletree Ranch Road
200 amps or less 100.70 2
City/State/ZIP:Scottsdale,AZ 85258
'
Phone:(602)694-4031 i Fax:( ) 201 amps to 400 amps 13336 2
Email:
401 amps to 600 amps 200.34 2
Owner installation:This installation is being made on property that I own which is not 601 amps to 1,000 amps 301.04 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. Over
1,000ps or volts 55126 2
Owner signature: Date:
Temporary services or feeders installation,alteration,and/or
', ',,,,,_„,f,:;,:„:::::,i7T..,',1::.-i,.,:".,..1.:,T.,•17,45if:'Y,:,i..,75,4!;t::::i2e,:-,g,44':•itl:II:2,,,r,,',,,,,,,..L.'';,ZEL..t.;;Xlattlt„ "location
Business name:William Lyon Homes,Inc. 200 amps or less 59.36 1
Contact name:Angela Grajewski 201 amps to 400 amps 125.08 2
Address:109 East 13th Street
401 arttps to 599 amps 168.54 2
City/State/ZIP:Vancouver,WA 98660
Branch circuits-new,alteration,or extension,ter panel
Phone:(360)695-7700 I Fax::(360)693-4442 A.Fee for branch circuits with
above service or feeder fee,
Email:Angela.Grajewski@polygon homes.com each branch circuit 7,42 2
•- - - B.Fee for branch circuits without
:„ :7;,,;;;,,::. ,',:::,,,,„„ .„., ,'II..77-7—:;':•;.7.5:17,7::•::•.;.):777:;',77-'!::7: 7,..:1:::":1::::::47:g27:7;, service.feeder fee,nrst 5618 2
Business name:alameda electric branch circuit
Address:3415 ne 44th Each addl branch circuit 7,42 2
Miscellaneous(service or feeder not included)
City/State/ZIP:11111114 1:b rvi 1v,?jo p ii / ' 2„,z,/3 Each manufactured or modular 67.84 2
dwelling,service aridlor feeder
Phone:(503)3192192 Fax:( )
Reconnect only 67.84 2
Email:solarpds@tne.com Pumporirrigation circle 67,84 2
CCB Lic.: 199188 Electrical Lic.: c923 Suprv.Lic.: yr7/5 -
Sign or outline lighting 67,84 2
Suprv.Electrician signature,required: signal ciretugs)Or limited-energy
„.., See Page 2 -
Print name: k j k /24,0‘,..,(.. I Date. /2. panel,alteration,or extension.
U
' r 3/4( Each additional inspection over allowable in any of the above
Authorized signature: Additional inspection(1 hr min) 66 25,'br •.
H-1"k -,-------•
Print name: i .,1
i vh.kiimort.i.oetc_ • ••isiffits.doc LW 06,1?MI 5
Date„6— ?„,,,3 /ff,,,i , Investigation(1 hr min) , 90 aot br
440-46151111/09COMAVE8 S(.119thtt.k 1 — •Ns-2- . ,
:2_,L, ,I-1 0
SLUrdIjtCle
, ___.....,
TL
, .
` Plumbine Permit Application ,
w) ,'
Building Fixtures , , 11111111111111111111111111111111111111.1
City of Tigard iteceisnd
Datertsy:
13125 SW Hall Blvd.,Tigard,OR 97223 ,,, ,„,, t., r, -1-11i' ph,Review
Mom 503.7182439 Fax: 503.598.1960V11-\ '4',' ''-); ,..t''(' Dawifir.
Inspection line: 503.639.4175
Internet: www.tigard-or.gov
11
, Dale Ready/By: Permit 14,117--C7- .0/6-fre22 71
, oth.rpernit No.:
Mris 121 See Page 2 for
Sapplementai Information
Pt.:,-,. .17:::77.47.7,74eirtfr'.7.11,714,:•!i"..' '..;.''''V fi'-''''''i.'i''-f.,. 1...a,.,4''''?'1,,i..,,,,,i7f0WW-t,ii., '.':.E.'"--4...S7,3-:..f;j1 i-p'20..F.3";", * "igtiizaiii/4, ',:7`., ,-
fl
','......-4i,i."'.•-..Tr;DI.:1.!01.-=P1-`,-t,t...,.#4,..v.,-,,,,,,,,..i _.,;..,: .,,,,:,,-....&,,„,,..„%*,..,,tt.v.s!:1,t A ''.,,c,..-lit P t.J.,,.,;tAr .- '- .s.ir.1.:%,,„*,-,-- „,, -, ,,,,•,$,,,,,,,d,-„,,.....„,,, _, .,-_ ,
124 New construction111 Dernolition For spedisi inforwrarion USE theckrat
Description i Qty. I Ea. 1 Toth!
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 10011 for each utility connection
SFR(I)bath 312.70
437.78 .
1$1 1-and 2-family dwelling 0 Commercial/industrial SFR(2)badi
SFR(3)bath t - 5°°32 .500.51_
•0 Accessory biniding 0 Multi-family I
Each additional bath/kitchen 25.02 '
0 Master builder El Other: Fire sprinkler(tVilisel•ft-) 1 Page 2 I la 1.410!
Site utilities:
Job site addrm 131 LI D sw 5 i 1eni ox. -1Crret VL catch baskn°`area drain 18.76 '
Dryviell,leach line,or trench drain 18.76
City/State:TIP:Tigard,OR 97224 Footing drain(no.linear 11:_j Page 2
Suite/bldg./apt.no.: I Project name:Polygon at West River Ter lvlanirfactured home utilities 50.03
Cross strect/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear It:_____) Page 2
Water service(no.linear ft.:_._) Page 2
Subdivision;Polygon at West River Terrrace Lot no.: 1 5 Fixture or item:
Tax map/parcel no.: Backflow preventer 3 ( Li .
,:,,,,,,,, '.. •,,,,,i,-. - :-.,,,,,..:',,,,..$-:,,l-,,r--,-,-7,4,-.;,y,-.,ri..i,-,---:-r-i-@, -,-.,---,54,-,t,,,,r,,‘-a,P,Aw4,,R Backwater valve . 12_571----tal-41
_4);',:‘,-.2,1',.e.,-,•,‘-. '''-;,.:-:',.',,..4,..','•4'.'',-4,,a' ,-;"-,14`,';',1'-..-7-'.../-,!', ..--0,--,„`-''..:::-.:-L1',2;Y:: :::", 1
"' aothes washer 23.02
& .1161S ualk-k- 1 \.1 , Dishwasher ' 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
, ..
4Fri..P:::;'%.::,;.'.',,' ''''...'•.'77:Z:..,ii 7711‘,P'1,4;11''',*.S':.:4;*'4'.'lAth*.M 2 4;41 T,..,,V.'r'-.2t., %AO Expansion tank 1231
Fixturesewer cap 25.02
Name:ADVL Land Holdings,LLC
floor drain/Boor sink/hubI 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
'''171,-7;7.•.:;":`, ..`;;;1„.--,,::f'11--;'f';',:-:Ii:t.4.1,1k1.'="411,1.&;411141FIT-fittf;1711---',1:kii.4';F;tlitg'11 intemePirffigrease traP 25.02
Medical gas(value:$ ) Page 2
Business name:William Lyon Houses,Inc
Primer 12.51
Contact name:Angela Grajewsld Roof drain(commercial) 12.51 ,
Address:109 East 13th Street
. Sinkftlasinflavatory , 25.02 , 1
City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54
Phone:(360)695-7700 Fax::(360)693-4442 nib/shower/shower pan 12.51
Urinal 25.02
E-mail:Angela:Grajewskigpolygonhonses.cons
4:7---';',e' 7,':".--,;.:-:::.--;7;i''',-,'i:,7t.i •,: i'';-,...'''';',"'" :,;;142.*-:-..,..;',;„'v;::7:--,r,,-;,- -r-4,:ir ,,g.;;;,:4;,,,, ; Waft'GicIset , 25.02
37.52
Business name:Alliance Plumbing LLC Water piping/DWV , 56.29
Address:146 W Historic Columbia River Hwy Other. , 25.02
City/State/ZIP:Troutdale,OR 97060 Subtotal (0(0(0.-1
Phone:(503)492-3490 Fax:(563)912-6438 Minimum permit fee: 572.50
- i Plan mvie (25%of permit fee)
w
CCB Lic.:184601 Plumbing Lk.no.:P8732
/ State surcharge(12%of permit fee) 7C
Authorized signature: TOTAL PERMIT FEE 1 li 5.6.1
Print name:Robert "DnIsman I Date:5/23/2016 This womb appfication expires Ns permit Is sot obtained within 180 days
after it has bees accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board
1•11iw1igoletPerrnittIPL4U-PermitApp.doe.10/0109 440-4616T(1010,-COMM28)
i
F ,
E - 7
City of Tigard
'I COMMUNITY DEVELOPMENT DEPARTMENT
III
T 1 c A R D Building Permit Review — Residential
�k.
Building Permit #: /ice j o20/ — k0 2 7
Site Address: j3740 S W Si Le.ni- Fox Te r
Project Name: Poi 109ori Ut- vWe.t amt Te tr c cq... Lot #: 15
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review nn
Proposal: N AA1 Ps1-1zi cilliA. 1Z-c w ho(YLQ_1
i
0 Verify site address/suite# exists and active in permit system.
0 River Terrace Neighborhood: ❑ No X Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
Three(3)copies of site plan ` fisting structures on site
1Z1Site plan must be on 8-1/2"x 11"or 11 x 17"paper ,Footprint of new structure(including decks)with finished
/Drawn to scale(standard architect or engineer scale) floor elevations
/North arrow Z�Utility locations (required for new,may apply for additions)
Site address,project or subdivision name and lot number ZiLocation of wells/septic systems
71Applicant information(name and phone number) ,Erosion control(including drainage-way protection,silt fence
Lot dimensions and building setback dimensions design,location of catch basin,etc.)
tot area,building coverage area,percentage of coverage and Street names
impervious area(applicable if R-7,R-12,R-25&R-40) cXtreet tree size,type and location
Property corner elevations(2 foot contour lines if more than meting 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 ❑ No Received: ❑ Yes ❑ No
Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake
71 Land Use Case#: 02 1S .. 00009, SV1 2015 - 00006, , SL►22011 -00(203
XZoning: (-- Z S
Setbacks: Front l Z Rear ( 0 Side 0 Street Side 3 Garage
Zi Landscape Requirement: V 0 %
Lot Coverage Maximum: 2...0 %
Building Height: Maximum Height 1 S Actual Height jI
O Visual Clearance
• Easements
Sensitive Lands: ❑ Yes ❑ No Type
JZ1 Urban Forestry Plan
ZConditions "Met"prior to issuance of building permit
Notes: eOhd)tivleJ til 6'0, Me+ Pr►or -tv isJvain ct 0L
✓►l&t1/1 v) 9-e/'m i fi .
Approved By Planning: /110 iii-2-e‘. /311 otd-titre Date: '3/ZS /1 6
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw REs 012116.docx
►
Building Permit Submittal
Original Submittal Date: SX2...S//,6
Site Plans: #
Building Plans: #
Building Permit#: .2 Enter building permit#above.
Workflow Routing: a Planning +Engineering .-'1 mit Coordinator Li—'Bading
Workflow Sign-off: .a"Sign-off for Planning(include notes from planning review)
Route Application Documents: „[].,Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
ALJ'Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: ���
Engineering Review
Slope at building pad:
❑ Conditions "Met"prior to issuance of building permit
E1 Easements (encroachments)per engineering conditions of approval and plat
41 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 El No
El NOT Appr�ovrd b Engineering: f� Date:
,�j
Notes: �(O't- c9,rr�,...9 44f+i�
Approved by Engineering: , 1/ Date: 6.-34- -/Z
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved El Not Approved
Permit Coordinator Review
El Conditions "Met"prior to issuance of building permit _
/� �--'1 Dated & (� /�S
. .Approved,NOT Released: G�t/� `
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:
C Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: 'Yes ❑ N/A
Parks SDC: 7"Yes ❑ N/A
=is K to Issue Permit
Approved by Permit Coordinator: .J Date:
I:\Building\Forms\BldgPermitRvw_RES 012116.docx
s '
aCity of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
I
TIGARD River Terrace Building Permit Review Addendum
Building Permit #: /1f7 alp/6 - 00 c2.27
Site Address: 137‘40 S w S i(P.vvfi Fo' Ter e
Project Name: F011 ypn G1+ tis, it (Z.oer Te+" Lot #: IS
(New dw'el1iing=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan District Design Standards (18.660.070.1.):
Is the project subject to the plan district design standards?,'Yes ❑ No
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. dee Balcony w/access 2 Window Projection Vertical Wall Offset a
p ft. deep min. 2ft.,5 ft.wide min.2 ft.,6ft.wide Gabled dormer
❑ ❑ ❑ yam"/ ❑
2. Eyes on the street: a minimumpf 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: I y . S
3. Entrances:At least one entrance must meet both of the following standards:
Max. 8 ft. setback from longest street- facing wall Parallel to street,angle no more than 45° from street,
or open onto porch
Entrance opens to a porch: , Yes ❑ No
If yes,all the following apply: %25 sq.ft. min.
One street facing entry C12 ft.max. roof above floor of porch
Vf75 ft. depth min. /30%min.porch roof coverage
4. Detailed Design:All buildings shall include a min.of five of the following elements on all street-facing facades:
Covered porch min. 5 ft.wide x 5 ft. deep ['Recessed entry area min. 5 ft.wide x 2 ft.deep
Wall offset min. 16 inches ❑ Dormer min. 4 ft.wide
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
AAccent siding min.40%of street facade ,Z Window trim min.2 1/2t 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.p4esfOrNo. 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)
Z12-foot-wide garage door ❑ 40%max. of street facade
.I50%max. of street facade with 7 detailed design elements
Notes: /I --
Approved By Planning: MD n�ZG. (3)1n dl,L4tAA Date: S, 2 c / ( !o
I:\Building\Fomu\BldgPermitRvwRES RT 031416.docx
c`
Plumbing Permit Applicat
4
Site Utilities ,k x,..` ' i
FOR OFFICE USE ONLY
City of Tigard Received
"i I H Date/By: Permit No.:
III
13125 SW Hall Blvd.,Tigard,OR 9732 .1, �� My12�jlo (��'�
S` Phone: 503.718.2439 Fax: 503.598 1960 Plan Review
T I G A R D Inspection Line: 503.639.4175 f
A, - Date/By: 1 Q,.(�.ap�04 Other Permit No.:
Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard-or.gov
111 'vifNotified/Method Supplemental Information
®New construction ❑Demolition For special information use checklist
Description Qty. Ea. Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
.' : .ck { RY 9,F 9yo vcnO _ 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 500.32
❑Master builder
Each additional bath/kitchen 25.02
0 Other sprinkler Fire s
S p ��.ft.) Page 2
., ;x ;9 I'T -R1 L 1Cr:T91 Site utilities: Ile° ti /
Job site address:13740 SW Silent Fox Terrace Catch basin or are 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:West River Terrace
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: I Lot no.: 15 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
Backwater valve 12.51
; ' 1 +C I' laN 9F• O ' Clothes washer
Multipurpose Fire Sprinkler System 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump
25.02
►� PR `rt oWN e° ' � � Expansion tank 12.51
Name:Polygon Northwest Fixture/sewer cap 25.02
Address: Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP:
Hose bib 25.02
Phone:( )
Fax ( ) Ice maker
-"Cil APPLICAN' " > 15.01
�I C9��C�'"P �gN _ Interceptor/grease trap 25.02
Business name:Alliance Plumbing,LLC Medical gas(value:$ ) Page 2
Contact name:Robert Dishman Primer 12.51
Roof drain(commercial) 12.51
Address: 146 W Historic Columbia River Hwy
Sink/basin/lavatory 25.02
City/State/ZIP:Troutdale,OR 97060 Solar units(potable water) 62.54
Phone:(503)492-3490 Fax::(503)912-6438 Tub/shower/shower pan 12.51
E-mail:robert.dishman@allianceplumbing.net Urinal 25.02
Water closet
,. , . . -, �tW14a)Z a 25.02
Business name:Alliance Plumbing,LLC Water heater 37.52
Water piping/DWV 56.29
Address: 146 W Historic Columbia River Hwy Other:
25.02
City/State/ZIP:Troutdale,OR 97060 Subtotal
Phone:(503)492-3490 Fax:(503)912-6438 Minimum permit fee: $72.50
CCB Lic.: 184601 Plumbing Lic.no.:PB732 Plan review (25%of permit fee)
/` �� / State surcharge(12%of permit fee)
Authorized signature: / v
TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180 days
Print name:Gavin Thornes Date:8/24/16
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
-Site Uti ittes :< - $qua 4 o e .. 61inifrte*
Footing drain 151 100' 50.03 0 to 2,000 $121.90
37.52 2,001 to 3,600 $169.69
Footing drain-each additional 100' 3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52 . o, Tie:�'
A
Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
blratniln*ar 'e
each and including or faction thereof,to
$110 000 00
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
each additional$100.00 or fraction thereof.
(minimum charge-1/2 hour)
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*. f5�
Quantity bZv Fixture Type .. J fl'' `�"'ii r'TIl „ lls
latiobs
Fixture TypeRapiacel-
for - Plan review is required for any of the following.
Work Perfo Capped Added IdekiF140
Please check all that apply.
Baptistry/Font _ 0 Any new commercial building with water service 2"and
Bath -Tub/Shower greater,except systems designed and stamped by licensed
-Jacuzzi/Whirlpool engineer.
Car Wash -Each Stall
-Drive 0 New exterior plumbing site utilities for any complex structure
Cas defined in OAR918-780-0040.
Dis
hwasher
s Coirator
-Commercial 0 Medical gas and vacuum systems for health care facilities.
-Domestic ® Any multipurpose fire sprinkler system.
Drinking Fountain 0 Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
4,> ;ksoItl&? > 1t�11 ": ra
Car Wash Drain 0 Isometric or riser diagram is required for new buildings
Garbage -Domestic-non-food
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes increase of sewer EDUs,a sewer permit will be issued and
Water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet
Urinal plumbing permit can be issued.
Other Fixtures:
\\up-dc2\home\gavin\My Documents\Fire Sprinklers\RT\City of Tigard Pelmit.doc
LI_ C /171)
Electrical Permit Applicatio .aE . ..a
FOR OFFICE USE ONLY
- 3125 W Tigard , 10 U 1 0 2 016Receivmoi,/ %,� u f1.i 1 �
13125 S W Hall Blvd.,Tigard,OR 972 Plan Revi
Phone: 503.7182439 Fax 503.598.1960 Date/$ Related Permit 5:
Inspection Line: 503.639.4175 OFTIGARD
T I G A R D Internet www.tigard-or.gov ' Neotifiedd/Methood: 7urir. Supplemental See Pent 2 for
_ i z T.
'" �', r. 7 reformation
®New construction `.a� = .�s: -.z ,;;_ * _----- K` 4 _ IV:
0 Addition/alteration/replacement Please check all that apply(submit 2 sets of lanswitemss cheeke
P d).
❑Deffiolition 0 Other ❑Service or feeder 400 amps or more ❑Building over three stories_
?� �.� it where the available fault current 0 Marinas and boatyards.
- -` � •- `' ' 14- fexceeds 10,000 amps at 150 volts or Q Floating buildings.
®1-and 2-family dwelling ❑Commercial/iridustrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
❑Multi-family ❑Master builder 0Otheramps for all other installations. buildings_
:.' ,n, - _ 0 Fire pump. 0 installation of 150 KVA or
i-i. e iSeat. ;1.,:_
a. �. :il ?61i1Y1LTFUN �<:a; -
�.,.: .,, ::r �.:.<:: �.-� vee/
l�t:;,;,��._,n.,:_:rs:.��>`--•; ❑Emergencysysteta larger separately Jeri
❑Addition of new motor load of
xl40SA Sit-en4-'fax Tex 100Hor
Pmore. system.E
Job#: lob site address:
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt,#:ityk i 1 Project name:Polygon at West River Ter 0 Hazardous locations. 0 supply voltage for more than
❑Service or Seeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: ss,„.
Description 1 Qty. I'. . th =_FaI Total _
New residential single-or multi-family dwelling unit.
Subdivision:Polygon at West River Terrrace Lot#:i 5' Includes attached garage.
Tax map/parcel#: L000 sq.R or less j 168.54 4
4— g, :tn. Ea.Limitedaddene500rgy,
sq.esftar tiaporl I 33.92 1
- `a energy,residential
ridi `- -- CV\/ ocr (with above sq.R) 75.00 2
v ”" Limited energf,mufti-family
residential(with above sq•R) 75.00 2
ba q .qs Wr .r_< s,�,,, , Renewable Energy ❑ See Page 2
-- Services or feeders installation,alteration,and/or relocation
Name:ADVL Land Holdings,LLC 200 amps or less 100.70 2
Address:7600 E Doubletree Ranch Road 201 amps to 400 amps 133.56 2 _
City/State/ZIP:Scottsdale,AZ 85258 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Phone:(602)694-4031 Fax:( ) Over I,000 amps or volts 552.26 2
Email: Temporary services or feeders installation,alteration,and/or
relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or Iess 5936 1 .
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. - 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
�4 � .
. _-a _ �s l g,® S� f Branch circuits-new,alteration,or extension,per panel
'_�"�yy. �`" '�'�' ""'``" � � A.Fee for branch-CZ:with
Business name:William Lyon homes,Inc. above service or feeder fee,
each branch circuit 7.42 2 i
Contact name:Angela Grajewski B.Fee for branch circuits without
s
Address:109 East 13th Street service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP:Vancouver,WA 98660 Each add'l branch circuit 7.42 2
Phone:(360)695-7700 Fax: (360)693-4442 Miscellaneous(service or feeder not included)
Each manufactured or modular
Email:Angela.Grajewski@polygonhomes.com dwelling service and/or feeder 67 2
3 z 5 Reconnect only 67.84 2
Y - t`Zg6 , 4. '.` ; cozy , i Pump or irrigation circle 67.84 2
Business name:Garner Electric Washington,LLC M1 Signor outline lighting 67.84 2
Address:6101 NE St Johns Rd Signal circuit(s)or limited energy ❑ See Page 2 2
panel,alteration,or extension.
City/Slate/Z1P:Vancouver WA 98661 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 6625/hr
Phone:(253)320-1657 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:bdaniels(a3gweusa,com
Jndustiial plant(1 hr min) 78.18/hr
inspections for which no fee is
CCB Lic.: C1158 Electrical Lic.: I r 90.00/hr
208174 Suprv.Lic.: 4496S specifically listed(f,hr mm)
Suprv.Electrician signature,required; .: ..- C .s �' bt � 4
Subtotal:
Print name: Joan P Albert • Date: 4/26/2016 0 Plan Review Required(25%of permit fee):
•
l State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Bill Daniels Date: 4/26/2016 days after It has been accepted as complete.
* Number of inspections allowed per permit
116ur7dirglPetairalELC PermitApp MR ERE.doc Rev 06/l7/1015 440.4515T(1]/05/COR%7,er
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13740 SW SILENT FOX TER, SHERWOOD, OR, April 28, 2017 at 9:52:13 AM
97140
Record Type: Record ID:
Residential - Master Permit MST2016-00227
Inspection Type: Inspector:
199 Electrical final David Young
Result:
FA I L
Comments:
Note: provide separate electrical and mechanical permit for AC installed without permit.
AC not part of this inspection.
Outlet in back of garage not made up.
Outlet in master taped over.
Missing outlet cover in upper level office.
Not ready for inspection, to many corrections.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13740 SW SILENT FOX TER, SHERWOOD, OR, May 4, 2017 at 11 :23:04 AM
97140
Record Type: Record ID:
Residential - Master Permit MST2016-00227
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS
Comments:
Previous corrections complete.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13740 SW SILENT FOX TER, SHERWOOD, OR, May 10, 2017 at 1 :40:51 PM
97140
Record Type: Record ID:
Residential - Master Permit MST2016-00227
Inspection Type: Inspector:
299 Final inspection David Young
Result:
FA I L
Comments:
Bottom step from entry to main level exceeds 8" max rise. 8 1/2"-9" as installed.
Provide fall prevention devise at windows less than 24" above finished floor and over 72"
to grade. Dining window.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13740 SW SILENT FOX TER, SHERWOOD, OR, May 10, 2017 at 1 :47:55 PM
97140
Record Type: Record ID:
Residential - Master Permit MST2016-00227
Inspection Type: Inspector:
299 Final inspection David Young
Result:
FA I L
Comments:
Step from entry to main level exceeds 8" max. R311 .7.4.1
Fall prevention devise required at dining window. R612.2
Violation Summary:
Inspector Contractor
FOR OFFICE USE ONLY-SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
g Transmittal
Letter
T i G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Tom H. DATE itffoi
DEPT: BUILDING DIVISION Jrf to
OCT 172016
FROM: Angela Grajewski CITY OF TI ARD
COMPANY: Polygon Northwest BUILDING DIVISION
PHONE: 971-212-2144 By_
RE: 13740, 13750, 13756,13760, 13768 SW Silent Fox MST2016--9 227, $ (.2 l,23.4
Terrace (Building 1)
Site Address) -""rte (Permit Number)
Polygon at West River Terrace Lots 15-19
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
0 Additional set(s) of plans. 0 Revisions:
0 Cross section(s)and details. 0 Wall bracing and/or lateral analysis.
0 Floor/roof framing. 0 Basement and retaining walls.
0 Beam calculations. 0 Engineer's calculations.
3 Other(explain): Spaced deck detail as requested by field inspector
REMARKS: Please pay fees owed with Trust Account. -� Cc�L �--E "/ fr)....fr.:2-0/6- 0,2,2 7
OFFICEiUSE 0 , ,
Routed to Permit Technician: Date: / 0--- I q 'j Initials.
Fees Due: ra Yes ❑No Fee Description: Amount Due:
j3 tS L /0LA/2!//x.3 $ '?c CTU
9
6
Special COct-EC-7— Fits CA) o'er/4 -670 02 02.7
Instructions:
Reprint Permit(per PE): ❑ Yes FINo ❑ Done
Applicant Notified: Date: j0//4. Initia��-
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
A