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Permit (80) CITY OF TIGARD air j MASTER PERMIT 111 11,` = COMMUNITY DEVELOPMENT Permit#: MST2016-00242 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/17/2016 Parcel: 2S106DC01000 Jurisdiction: Tigard Site address: 13690 SW SILENT FOX TER Subdivision: POLYGON AT WEST RIVER TERRACE Lot: 10 Project: Polygon at West River Terrace, Lot 10 Project Description: New SFA. Building/unit 3.1. 1/3/2017: REPRINT permit to correct plumbing fixture count(1 hose bib). BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 2 First: 115 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 35 Bathrooms: 3 Second: 646 sf Garage: 543 sf Front: 8 Smoke Yes Dwelling Units: 1 Third: 633 sf Right: 3 Detectors: Total: 1394 sf Value: $184,419.55 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: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 0 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.'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 1394 Owner: Contractor: ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions) 7600 EAST DOUBLETREE RANCH 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175 RD,STE VANCOUVER,WA 98660 SCOTTSDALE,AZ 85258 PHONE: PHONE: 360-695-7700 FAX: Total Fees: $23,041.07 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 throughR1952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or11.800.332.2344. Issued By: -- j' . &''Z' Permittee Signature: ''' / se'e=fL;'}7%Ct"•/ \' 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. Water Meter Fixture Unit Worksheet Please complete the following information: Contractor Name: Billing Address: Phone Number: New Meter Address: Subdivision Name: Lot#: 1 0 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 j x 4 = 14, Dishwasher J x 1.5 = Hose bib J x 2.5 = .1-1÷----', Hose bib, each additional x 1 = Kitchen sink J x 1.5 = ) , s---- Laundry Laundry sink _ x 1.5 = Lavatory _ 14 x 1 = Li-. Water closet, 1.6 GPF 3 x 2.5 = 7. ‘ Bathtub/whirlpool x 4 = Shower stall J x 2 = Z. Bath/shower combo j x 4 = y. Irrigation(#of heads in largest zone) x 1 = Total Fixture Unit Points: cV7 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 CITY OF TIGARD MASTER PERMIT `'- COMMUNITY DEVELOPMENTIII Permit#: MST2016-00242 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/17/2016 Parcel: 2S106DC01000 Jurisdiction: Tigard Site address: 13690 SW SILENT FOX TER Subdivision: POLYGON AT WEST RIVER TERRACE Lot: 10 Project: Polygon at West River Terrace, Lot 10 Project Description: New SFA. Building/unit 3.1 BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 2 First: 115 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 35 Bathrooms: 3 Second: 646 sf Garage: 543 sf Front: 8 Smoke Dwelling Units: 1 Third: 633 sf Right: 3 Detectors: Yes Total: 1394 sf Value: $184,419.55 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 0 Storm Sewer: 100 Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Bckflw Prevntr: 0 Catch Basins: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 0 Drywell-Trench Drain: 0 Other Fixtures: 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 Fum<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:Y Square Feet: NEW SFA VB R-3 1394 Owner: Contractor: ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions) 7600 EAST DOUBLETREE RANCH 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175 RD,STE VANCOUVER,WA 98660 SCOTTSDALE,AZ 85258 PHONE: PHONE: 360-695-7700 FAX: Total Fees: $22,724.54 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and ail 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 OAR 9106,41-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. 40.---Issued By: j / . Permittee Signature: r� �J/(1J 72./ -7-7e t/ 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. Z-07— / 9 Building Permit Application /, 4 1( RECEIVED FOR01=F1(' I: ISEO\Ll City of Tigard n "e (, /7 Permitilf. Sro20 14 13125 SW Hall Blvd.,Tigard,OR 97223 JUN 01 2016 Plan Review = Phone: 503.718.2439 Fax: 503.598.1960 Date/By: — j Other PetmiS;/,e0/6 -"eV/9 I islNDoattifiRed/Meadyethod:6P/161/for Inspection Line: 503.639.4175 JurisH See Page 2 for71c;A a Internet: www.tigard or.gov Dg TaoDoI Supplemental Info rmation 4. / - 1 lr ®New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement 0 Other. equipment,materials,labor,overhead,and the profit for the �� � �.�� �Fs •� . „� �, � � work indicated on this application. 1-and 2-family dwelling 0 Commercial/industrial Valuation: 3 "-r'1 ❑Accessory building ElMulti-familyNumber of bedrooms: 2 Number of bathrooms: 2 5 ❑Master builder 0 Other i t • :° Total number of floors: 3 ICI 3-7 Job site address: ti',I () SW Silent Fox Ten-ace New dwelling area: 1394 square feet City/State/ZIP:Tigard,OR 97224 Garage/carport area: 543 square feet 6.33 Suite/bldg./apt.no.: I Project name:Polygon at West River Ter Covered porch area: s8) square feet ,Li 4 Cross street/directions to job site: Deck area: 96 square feet r " Other structure area: square feet Subdivision:Polygon at West River Terrace I Lot no.: t b 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 equipment,materials,labor,overhead,and the profit for the a t t � work indicated on this application. L E6 l&q l n I 1 3 . I Valuation: $ Existing building area: square feet New building area: square feet �t °, tNumber of stories: Name:AD VL 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,LLC Structural plan review fee(or deposit): Contact name:Angela Grajewski FLS plan review fee(if applicable): Address:109 East 13th Street Total fees due upon application: City/State/ZIP:Vancouver WA 98660 Amount received: Phone:(360)695-7700 I Fax::( ) b E-mail:Angela.Grajewski@polygonhomes.com ... Commercial and residential prescriptive installation of -„N' ®n„d 1 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 d /J , _ Total fee due upon application: $201.60 Authorized signature: , `u �/!/.\ This permit application expires if a permit is not of” -a ��`-' within 180 days after it has been accepted as con *Fee methodology set by Tri-County Building Indust Print name:Angela Grajewski Date:5/20/16 Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Application City of Tigard RECEIVEReceives 111 4 13125 SW Hall Blvd.,Tigard,OR 97223 Date By: Pemtit No, s�" ��—00.72 �yr�r � Phone: 503,718.2439 Fax: 503.598.1960 Plan Review G/4� 7 1 1 c, ,It t 1 Inspection Line: 503.639.4175 „it.) �U N 1 2016 D 1 Date'B}; Other Permit: Internet: WLine:gard.ilr.,41 Date ReadYBy: Jam 1�See Page 2 for Notified`Method Supplemental information 1 TYPE OF WORK 1'vt`-` '"t'i,it'' .r, COMMERCIAL FEE* SCHEDULE-USE CHECKLIST ®New construction 0 Addition/alteration/replacement Mechanical permit fees*are based on the value of the work ❑Demolitionperformed.Indicate the value(rounded to the nearest dollar)of all 0 Other: mechanical materials,equipment,labor,overhead,and profit. I CATEGORYOF CONSTRUCTION Value:$ RESIDENTIAL EQUIPMENT/SYSTEMS FEES* r I-and 2-family dwelling 0 Commercial/industrialAccessory building For special information use checklist 0 ❑Multi-family 0 Master builder 0 Other. Description I Qty. ( Ea. ( Total ( JOB SITE INFORMATION AND LOCATION Heating/cooling: Job site address: 13(ago Sw so en fi --TOK 1 cr4� Air Furnace 1 ionin 46.75 1 100,000 BTU(ducts/vents) I 1 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ductsivents) 54.91 Suite/bldg./apt.'no.: I Project name:Polygon at West River Ter Heat pump 61 06 Duct work 23.32 Cross street/directions to job site: Hydropic hot water system 2332 • 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 I Subdivision:Polygon at West River Terrrace I Lot no.: I O Other: 23.32 Tax map/parcel no.: Other fuel appliances: Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 Complete rough of HVAC Flue vent for water heater or gas fireplace 1 23.32 g,I(j/ to l f n ' 3, Log lighter(gas) 23.32 �IV Wood/pellet stove 33.39 Wood fireplace/insert 1 23.32 Chimney/liner/nue/vent; 23.32 It PROPERTY OWNER i 0 TENANT Other:Range I 23.32 Name:ADVL Land Holdings,LLC Environmental exhaust and ventilation: Range hood/other kitchen I Address:7600)w lloubletree Ranch Road equipment 1 33.39 Ctalhes dryerexhaust 1 3 3.39 City/State/ZIP:Scottsdale,AZ 85258 Single-dud exhaust(bathrooms, toilet compartments,utility rooms) 3 23.32 Phone:(602)694.4031 Fax ( ) Attic/crawlspace fans 23.32 1-APPLICANT ❑ CONTACT PERSON Other: 23.32 Business name:William Lyon Homes,Inc. Fuel piping: Contact name:Angela Grajewski $14.15 for first four,$4.03 for each additional Furnace,etc. Address;109 East 13th Street Gas heat pump City/State/ZIP:Vancouver,WA 98660 Wall/suspended/unit heater Water heater Phone:(360)69S-7700 I Fax::(360)693-4442 Fireplace E-mail:Angela.Grajewski?�a,�polygonhomes.eom Range I Barbecue CONTRACTOR ' Clothes dryer(tg om) Business name:Andersen Heating,Inc Other: Address: 16285 SW 85th Ave ste 410 MECHANICA PERMIT FETES* Subtotal City/State/ZIP:Tigard,OR 97224 Minimum permit fee($90.00) Phone:(503)992-6664 I Fax:(503)536-6615 Plan review(25%of permit fee) State surcharge(12%of permit fee) CCB lie.:16821 t I TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 Authorized Signal days after it has been accepted as complete. * Fee methodology set by Tri-County Building Industry Service Board I Print name: Date:05/23/2016 I;tguildingTermitsNIEe PermhApp+x0113 doe I 440-45177(I 1!03.'COM:WEa) x * Electrical Permit AppIicatia . \ it ,,, i( ,I r. , City of Tigard JUN 01 2016 e � him"� J7 o/f -OO 2V. 13125 SW}tali Blvd.,Tigard,OR 97223 f. rnw Phone: 503.718.2439 Fax; 503.598.1960-, - ., Inspection Line: 503,639,4175 �.o i 8 V r'"'1!CARD ply per,, err wr Internetwww.tigard-or,gov 8 U. I L IRS 6OVJ S 1 O F :Netifiedt od: ,__ ;., ' ' , 0-4 New Construction 0 Addition/alteration(repl nted+ed all'bat IP*. �( it a sees• plans w fid): O Service or feeder 400 amps or more 0 Building over dace stones ❑Demolition CI Other where the available fault current ❑Marinas and honeyed' 2,, -..„, r , ... rR •,. , ,--'17” ` ; °'. - exceeds 10,000 amps at 150 volts or 0 Floating buildings, .< 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to tlround,or exceeds 14.000 0 Commercial-tae ppicol ant 0 Multi-family 0 Master builder 0 Other �for all oma imtdlaions. _ ❑Fire pampa ❑laAdluioa of]SO tiVA or ,.<;." ... ..._, _' 2....:1'1 .. . .: . , ` ❑E,..7:ty ws...- larger seMrady derived I3 -1) S r*f rhIY �Addro o ram,maorloadof Job N; lob Site address: IOOHP a more. 0"A","E"."1-1;"1-r, City/State/ZIP:Tigard,OR 97224 J six or mire reaid 'mien. may. °Healthcare facilities. 0 Reaestimal vehicle per. SuitelbldgJapt,8: J Project name:Polygon at West River Ter O Hazardous locations. O Supply voltage for more than O Service or feeds 500 amps or more 600 vats'lamina( Cross street/directions to job site: 7 ;x Dea d-pl a Q'. L.a Toil • • New residential single-or multi-family dwelling unit. Subdivision:Polygon at West River Terrrace Lot i:/ _ Iodides attached garage. Tax map/parcel ftsq .or lex 1 168.54 4 .ten .�" u '� y � e v i 000 .I ji )eG�EaaddIS00 Rerr � `� :� �..� _ ..�>. .��s„..�.�,, ,�� ,y��..��., . .�,�.�. sq. pwrtion � 33.92 �� 1 K! . 9 �1 n I-k Limited energy,residential 75.00 2 r✓ (with above sq.d.) Limited energy,multi-family 75.00 2 .y r residential(with atwve sq.ft) Name:ADVL Land Holdings,LLC Renewable Energy 0 See Page 2 Address:7600 E Doubletree Ranch Road Services or feeders installation,alteration,and/or relocation 200 amps or less 100.70 2 City/State/ZIP:Scottsdale,AZ 85258 . 201 amps to 400 amps 133.56 2 Phone:(602)694-4031 I Fax:( ) 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 1,000 amps or volts 552.26 2 Owner signature: Date: .. Temporary services or feeders installation,alteration,and/or : ,,..:b.' ,..' . ". , '- relocation Business name:William Lyon Homes,Inc. 200 amps or less 59.36 1 Contact name:Angela Grajewski 201400 anms to amps 125.08 2 Address:109 East 13th Street 401 amps to 599 amps 168.54 2 City/State/ZIP:Vancouver,WA 98660 Branch circuits-new,alteration,or extension,per panel Phone:(360)695-7700 I Fax::(360)693-4442 A.Fee for branch circuits with above service or feeder fee, 7.42 2 Email:Angels.Grajewski@polygonhornes.com each branch circuit B.Fee for branch circuits withoz . t Business F, service w feeder fee,fust Business name:*lamed*electric branch circuit 56.18 2 Address:3415 on 44th Each add'I branch circuit 7.42 1 2 City/State/ZiP•alma > /4 7.2.-/3 11i'uemanuf cruus edor(service or feeder rotiachded8 JLt OJZ Each manufactured o<modular 67.84 2 dwelling,service and/or feeder Phone:(503)3192192 Fax:( ) Reconnect only 67.84 Email:solarpdx@me.com Pump or imgation circle 67.84 ' 2'' CCB Lic.: 199188 Electrical Lic,: c923 Suprv.Lic.: /$7/S - Suprv.Electrician signature,required: Sign or outline lighting 67.84 2 Signal clicnil(s)err limited-enexgy , 0 "r See page 2 ,,':`" Prim name: k:1G /2400‘,..‹, Dale: r1/2r1/234//'wz3,� 1 > .alteration. extension g Each additional inspection over allowable in auuof the above AutllpriZed tagttatttre: ,per / Additional inspection(1 hr min) 66.25;he Print name: �-''�'" — Date/ 43//, Investigation24 (I hr min) J 90.00'hr i I t vegx*unsc_ ,ERE.doc Rev06W11713015 440-4615Tf1tiosrcci Ln1'EB i�/\V l`.\1_ 10)_..q(40 . Plumbing Permit Application Building Fixtures RECEIVED i „i. „„ ,, , , �, ,a•, 1 Ci of Tigard Rece�sad Permit Nom f X24/I�-'OC� e/' 13125 SW H�Blvd.,Tigard,OR 972231 UN 01 2016 t sr. Phone 503.718.2439 Fax 50359 .l Date/By. otherPennit No.: Inspection Line: 503.639.4175 ( I i.) Date Ready/By: runs H See Page 2 for Internet: www.tigard-or.gov Qui �� r: s r/l t( r Notified/Method: 5appkmeatal information j ®New construction ❑Demolition For special information arse checklist Description i Qty. ( Ea. I Total 1 0 Addition/alteration/replacement 1 0 Other: New 1-2-family dwellings(includes 100 IL for each utility connection) ,?*„ '_ ` �4;: � SFR(1)bath 312.70 ' r as ff j: ® I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 1 , 50033 Accessory building 0 Multi-family 500.5,/ Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler .ft.) I Page 2a I 75- ,: a .h t e a e w F E -r'5- r Site utilities: cry Pi/'E" /2/NGL t.,, Li9std.£•CIO: job site address: 13(0"I O SW 5 i l - t -I-Errol C.A. Catch basin or arca drain1 18.76 Dryweli,leach lime,or trench drain 18.76 City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear IL:_) Page 2 Suite/bldg./apt.no.: I Project name:Polygon at West River Ter Mmurfactured home utilities 50.03 Crass street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_, - Page 2 ' Storm sewer(no.linear R: ) Page 2 ; , Water service(no.linear fl: ) Page 2 Subdivision:Polygon at West River Terrrace Lot no.: t0 Fi:tare aritem: . Tax map/parcel no.: Backflow preventer _ `-fir -" � 3127 6i.21 1 , Backwatervahve ( aj 12.51 I I i y. :. , clothes washer 25.02 W -1 .�ilkA 13. i D she ashce 25.02 " Drinking fountain 25.02 Ejectors/sump 25.02 y F FilRutdsewer cap , 25.02 Name:ADVI: Land Holdings,LLC - Boor drain/Boor sink/hub 25.02 Address:7600 E Doubletree Ranch Road Garbage disposal 25.02 City/Stat:AP:Scottsdale,AZ 85258 Hose bib 25.02 Phone:(602)694-031 Fax:( ) Icemaker 12.51 gam _£ ��'' �'�, In / 25.02 �_ � o",.. ; itroeptgrgreasetraP . Business name:William Lyon Homes,Inc" Medical gas(value:S ) Page 2 Primer 12.51 Contact name:Angela Grajewski Roof drain(commercial) 12.51 i Address:109 East 13th Street 5'utkbasin/lavatory 25.02 > City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54 j Phone:(360)695-7700 Fax::(360)693-4442 Tub/showerlshower pan 12.51 E-mail:Angela.GrajenaklOpolygonhomes.com Urinal 25.02 . ms , Water rdoset 25:42 e ,. „s Water heater 37:52 Business name:Alliance Plumbing LLC Waterpiiping'DWV 56.29 Address:146 W Historic Columbia River Hwy Other: 25.02 City/State/ZiP:Troutdale,OR 97060 Subtotal (0(0(p Phots:(503)492-3490 I Fax:(503)912-6438 Minimum permit fee: $72.50 CCB Lic:184601 Plumbing Lic.no.:P1B732 441/AC* -- ' Plan review (25°/a:ofpermit fox) ' State surcharge(12°40 of permit fee) -- et. i Authorized signature: TOTAL PERMIT FEE 14 6, a. Print name:Robed Des6man I Date:5/23/2016 ibis pamltapp8caban expires If a,permit.is not obtained within 180 days after kb=been accepted es complete •Fee methodology set by Tri-Comity Building Industry Service Board 1lBuidina4Pesmes'W1.MU-P r eitAppdoe IO/OIA79 44O.4616T(107021COMMEB) City of Tigard 114 r COMMUNITY DEVELOPMENT DEPARTMENT T 1 c R n Building Permit Review — Residential Building Permit #: /7.57—' / ,2 y,2 Site Address: 136 (I c0 5w s`ier t- x Te_ Project Name: Po dC r, U•+- v.eJt- .4 ver t reza L .., Lot #: 1 (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: �'2/W S"G 12. ,ji Verify site address/suite# exists and active in permits stem. River Terrace Neighborhood: LI No Yes,See River Terrace Review Addendum Attached Site Plan Elements: Three(3)copies of site plan 'BLxisting structures on site catite plan must be on 8-1/2"x 11"or 11 x 17"paper ,00tprint of new structure(including decks)with finished Obrawn to scale(standard architect or engineer scale) floor elevations $North arrow 'Utility locations(required for new,may apply for additions) /Site address,project or subdivision name and lot number -CJL,,,ation of wells/septic systems "Applicant information(name and phone number) fisting trees to be retained with drip line,and tree ,,//Lot dimensions and building setback dimensions protection measures /Lot area,building coverage area,percentage of coverage and jgtreet tree size,type and location impervious area(applicable if R-7,R-12,R-25&R-40) Street names /Property corner elevations(2 foot contour lines if more than 4 foot differential) Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No APublic Facilities Improvement (PFI) Permit: Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake A Land Use Case#: ?D fL :i S 0000/) V 2O1'1 - C 0001, , S Z IS— 00003 J Zoning: P..- 2 g / Setbacks: Front e/j 2Rear 10 Side 0 Street Side 3 Garage ,S Landscape Requirement: g] Lot Coverage Maximum: 0i C) % Building Height: Maximum Height 5s Actual Height AOA Visual Clearance ;i'Easements Sensitive Lands: ❑ Yes ,I71 No Type Urban Forestry Plan Conditions "Met"prior to issuance ofbuilding permit Notes: COO�h' b r) fit he yr e-- pr t r tv DSS Y t32. Cl et.l�l win i i-. Approved Ay Planning: 410. ey, e,t o Date: (4:),/ y/ 1 (C Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved 1:\Building\Forms\BldgPennitRvw_RES_060116.docx f f Building Permit Submittal Original Submittal Date: 4P/i i c_, Site Plans: # 3 Building Plans: # .3 Building Permit#: 0"Enter building permit# above. Workflow Routing: O'Planning $ Engineering RPermit Coordinator C-'building Workflow Sign-off: Ifr 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. QrBuilding: 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: ...�G, ' El Conditions "Met"prior to issuance of building permit El Easements (encroachments)per engineering conditions of approval and plat ❑ Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes ❑ No Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No LIDA Facility on lot: ❑ Yes ❑ No ❑ NOT A'p`pr e y Engineering: ,�p Date: Notes:C� a / h r� rU► Approved by Engineering: fa Date: 6=-11-4 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit :�� pproved,NOT Released: - ate: 7-,-4/4"Notes: C r°'''--' 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 ❑ N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: 7f Yes ❑ N/A K to Issue Permit pproved by Permit Coordinator: ate: 71 /6/-6 I:\Building\Forms\BldgPemutRvw_RES_060116.docx • City of Tigard 111 v COMMUNITY DEVELOPMENT DEPARTMENT T I G A RD River Terrace Building Permit Review Addendum Building Permit #: /1-45.7,20/6, — OO 9;2- Site .-.Site Address: (3C2`)10 c 1A✓ S iE'rl t' x T--..cr. Project Name: f'viyyo n elf Wei r eiver r _rre,t..4._ Lot #: " (New dwelling=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. Balcony w/ access 2 Window Projection Vertical Wall Offset a Porch min. 5 ft. deep Gabled dormer ft.deep min. 2ft., 5 ft.wide min. 2 ft.,6ft.wide 71 2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors. Percentage Shown: 17 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: A 25 sq.ft. min. One street facing entry 12 ft.max.roof above floor of porch /— 5 ft. depth min. 730%min.porch roof coverage 4.Detailed Design:All buildings shall include a min. of five of the following elements on all street-facing facades: gCovered porch min. 5 ft.wide x 5 ft. deep "f Recessed entry area min. 5 ft.wide x 2 ft. deep /1Z Wall offset min. 16 inches pormer min.4 ft.wide Roof cave min. 12 inch projection Roof offset min.of 2 ft. ❑ Roof shingles either tile or wood C7'Gable,hip or gambrel roof design 1=1 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'/2"wide by 5/8"deep ❑ Window recess min. 3 inches for all street facing ❑ Bay window min. 5 ft.wide by 2 ft. deep ❑ Balcony min. 5 ft.wide x 3 ft. deep with inside access ❑ Attached garage is 35%or less of street facade 5. Garages and Carports:May face the front or side lot line on a corner lot. Setbacks: No closer to front or side lot line,than longest street-facing wall. ❑ Yes7No. If No (Check one): 71 May extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch. VMay 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 Cp/50%max.of street facade with 7 detailed design elements Notes: Approved By Planning: it n iZ� �j i) �M� Date: 6 // I:\Building\Forms\BldgPermitRvw_RES_RT_031416.docx Plumbing Permit Applica' ; lr' ' , Site Utilities FOR OFFICE USE ON L1/' P rrl�rr� City of Tigard J E t1,F1 Received ? Permit No.: DateB /,a4016.... ��W ��i ill 13125 SW Hall Blvd.,Tigard,OR 97223 y _ Phone: 503.718.2439 Fax 50; q1046:g 1; ' "a# Plan Review n Other Permit No.: ' a s Date/By: 1 V-�(1-e50tto 6J T 1 G A R D Inspection Line: 503.639.4175 t r w ff, r. r- €t. ' Date Read/B Internet: www.tigard-or.gov f3 1 ,k " t'" y x , "` Ready/By: Juris: H See Page 2 for Notified/Method: Supplemental Information :1 ®New construction ❑Demolition For special information use checklist Description ❑Addition/alteration/replacement 0 Other: p Qty. I Ea. Total New 1-2-family dwellings(includes 100 ft.for each utility connection) a CA .(tr lt' ; e foo 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 0 Master builder Each additional bath/kitchen 25.02 0 Other Fire sprinkler(1,388 s9'ft.) 3 Page 2 X010 SlT> IFRT)�Ol llll A1"[ I Site utilities: Job site address:13690 SW Silent Fox Terrace Catch basin or area drain 18.76 City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name: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.: 10 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 12.51* TtaBackwater valveEaRN ir. K Multipurpose Fire Sprinkler System Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 :'>.a-PROPkRTY owN `,, . . , . .} 12.51 . jS �;,, Expansion tank 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 12.51 02 APPLICA1 l ❑ Ol:ii.4: " 'l if 1V 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 'ttf T(3R Water closet 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) /`--, 7,7/ , State surcharge(12%of permit fee) Authorized signature: / c TOTAL PERMIT FEE Print name:Gavin Thomes Date:8/24/16 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I\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: ' e�* : arsefootage: „Permit; e Footing drain-151 100' 50.03 0 to 2,000 $121.90 2,001 to 3,600 $169.69 Footing drain-each additional 100' 37.52 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 * tt 1erlsrllit ee:rM ,, 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 each additional$100.00 or fraction thereof,to tither Iaa �ctlon or4Feos, -' .-,'` ec e, ntal and including$10,000.00. 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$100.00 or fraction thereof. (minimum charge-1/2 hour) Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. ,Quantity by Fixture Type ,. Pan$tevjeef:i1,r Plumbing Installations Fixture Type tor Replete/ Plan review is required for any of the following. WIkFecfcied,` Ctp `' Please check all that apply. Baptistry/Font D 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 Thru ❑ New exterior plumbing site utilities for any complex structure as defined in OAR918-780-0040. Dishwasher Cuspidor/Water Coirator -Commercial ❑ 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. Isometric etiliserViagratn 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 Water Closet Extractor increase of sewer EDUs,a sewer permit will be issued and Water -Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: \\up-dc2\home\gavin\My Documents\Fire Sprinklers\RT\City of Tigard Pgmit.doc JO E'i R Electrical Permit Application FOR OFFICE USE ONLY INCity of Tigard N 0 V 10 2016 'ee've: 11/11`,� ,, /7 '' Pena IkA elle—00Z.0 2_ ■ 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503,7182439 Fax 503.598.1 "+qy[ �• fir`Review I.1 S:x R D DaWBy. Related Permit it: g S:y Inspection Line: 503.639.4175 ReadyDate/By: 0 See Page 2 for TI G Ii R D kris: Internet: www.tigard orgov BUILDING DWISiClired/ fethod; I Supplemental Information M ,Y�9,JIl _ 1 �eI Y �j€ 1r 3---._'�iX' i �*- ' 0.au 1 .'kY> : .S'c >tiu+r+..,ur. ^3.':: �,,'^.,uxa ,1 •` si=• ^.k, ui�- a3^ -w ' ph.,.u' ^"� -c..,;C'�"^' �--""�:z'' �.c i _ _ j� l�.Ff ��,•xit ''r'uC ®New construction 0 Addition/alteration/e lacem nt Please check all that apply nfi er e _ �:x Addition/alteration/replacement PP Y(submit 2 sets of plans w/atoms checked): 0DCffiOlIt- 0 Service or feeder 400 amps or more 0 Building over three stdries. Other where the available fault current 0 Marinas and boatyards. r—city —" ;a6- X ri 3 }- ar exceeds 10,000 amps El buildings. '`' - at 150 volts or Floating ridings. ®1-and 2-family dwelling 0 Commercial/indtistrial ❑Accessory building less to ground,or exceeds 14,000 0 commercial-use agricultural ❑Multi-family ❑Master builderamps for all other installations. bnildings. -- 0; 0 Other: ❑Fire pump. 0 Installation of 150 KVA or ,�. ..,:.A�:c-�,•.��:�' tJl�s -'�TIt71��� - - -yin::' _�';�;;;, --- =- Emergency.s... �. ..... ---•. ..,,__ �,.., ''•.�+,��t17Td�'>:.,. :...w - ......_.;. .,..� 0 geucYsystem. larger separately derived Job#: Job site address:1)3 0 SA s i t"e l\}'f y(. re 0 1001 Addition of newremotor Load of system. 1 �. /" VI 100HP or more. [j"A••,'E","1_2^,"1-g". City/State/ZIP:Tigard,OR 97224 0 Six or more residential units. occupancy, 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: `-5 ,\ Project name:Polygon at West River Ter 0 Hazardous locations. 0 Supply voltage for more than Cross street/directions to job Site: r� 0 Service or feeder 600 amps or more. 600 volts nominal. Description •.ti:�-.: Total ?.a-. i • Qty. I Rath Total l New residential single-or multi-family dwelling unit. Subdivision:Polygon at West River Terrrace Lot# Includes attached garage. Tax map/parcel#: I.000 sq.ft.or less 1 168.54 4 Ea.add'1500 sq.ft.or portion 33.92 1 =11 ;ms �)ES aA*` X,771 "Irt:F`.` I �� p- x Limited energy residential ( (with above sq.R) 75.00 2 �J yrT Limited energy,multi-family 75.00 2 residential(with above sq.it) 'as Lr ©'_ :h 51 t.,,__ s Renewable Energy 13 See Page 2 > lz x' Wil-L -: 4�k Services or feeders installation,alteration,and/or relocation Name:ADVL Land Holdings,LLC 200 amps or less 100.70 2 Address:7600E Doubletree Ranch Road 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:Scottsdale,AZ 85258 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 less 59.36 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 0€. T k`^ s -gp : Branch circuits-new alteration or extension,per panel - ' x"' j "t'" .' § m •rn, t Fee for branch circuits wrtlt Business name:William Lyon Homes,Inc. above service or feeder fee, each branch circuit 7.42 2 Contact name:Angela Grajewski B.Fee for branch circuits without i Address:109 East 13th Street service or feeder fee,first 56.18 2 branch circuit City/State/ZIP:Vancouver,WA 98660 Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(360)695-7700 • " Fax::(360)693-4442 Each manufactured or modular Email: 84 Angela Grajewsla@polygonhomes.com dwelling.servceand/orfeeder 2 4.001 only 67.84 2 Reconnect Pump or irrigation circle 67. 4 2 Business name:FGarner Electric Washington,LLC Sign or outline lighting 67.84 2 Address:6101 NE St Johns Rd Signal circuit(s)or limited-energy panel,alteration,or extension. ❑ See Page 2 2 City/State/ZIP:Vancouver WA 98661 Each additional inspection over allowable in any of the above l Additional inspection(1 hr mire) 66.25/hr Phone:(253)320-1657 Fax:( ) Investigation(1 hr min) 90.00/hr Email:bdaniels®gweusa.com Indiutrielplant p hr min) • 78.18/hr Inspections for which no fee is 90.00/hr CCB Lie.: C1158 Electrical Lie.: 208174 I Suprv.Lie.: 4496S specifically listed(%:hr min) _ six 5 Suprv.Electrician signature,required: 1,�p�� - (c r� '`x ` .�"�+.—i'_, ,:o:, - �C(P/ I' c •f .,��` .t 'f' :... 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 sig Iiiire; 741:-______________...------....‘ 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 i * Number of inspections allowed per pemrit .I51Iw7diaggPekmitsVII.C-PermitApp_ELR gander Rev 06/17/2015 440-4615Tt1I/O5/COM/WEa 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 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 RtFtV,pi 7 DEPT: BUILDING DIVISION tap OCTED 17 2016 FROM: Angela Grajewski CITY OF TIGARD COMPANY: Polygon Northwest BUILDING DIVISION PHONE: 971-212-2144 By:� ----- ✓✓ ' RE: 13690, 13704, 13716,13724, 13736 SW Silent Fox MST201 00242 1 ? ; 44, Terrace (Building 3) ^Q-t-f r'7 L Co vv (Site Address) (Permit Number) Polygon at West River Terrace Lots 10-14 (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. / cs r L.LE- . 0i! 4 Routed to Permit Technician: Date: /O- ) 9 - / Initials: Fees Due: gYes No Fee Description: Amount I3ue: y $ Special (!c S OA; /`1ST / —00,2 Lz, Instructions: Reprint Permit(per PE): ❑ Yes lig No ❑ Done Applicant Notified: /6/C Date: %////00. Initials: I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 L • ttf C VW'F. ) , ,..:.,i 0,,,,,,gLA ,`,,-4 ' i Electrical Permit Application . . .. . . . FoR 01,11(E IHSE ONLY • City of Tigard FEB 8 2017 RW-1-1FMAIlaiZa alvillYla# Mi..47.11 . . ,_ 4 11125 SW Hill Blvd,Tigard,OR 97223 ,,,,,,. ,....„, ,Tit-a I)r piv„,-" ,,v.i;;, ° ezzzniglimii,— • '0 Phene: 503.71E2439 Fax 503-598.10T li Aj r ll 1 ki Am l''.tiatem ; . Inapefimiliet 503.639.4175 75. iyoai.ik. 0n;... ,c, .!yDaday: Sec Pag ;forr'' 'rInternet wwW.tigard-orgav N ; ,i., wfw.44.,. ,dhod: Supplaneetal Information: ot-411,,,,r 1:',7,..'!,..T..7'.';',...t.1...4titil7:j.4,:,:-''''.0:":;.•;,'.',:i. i I:i01"4.1.'ktfgar'A.Wil.;,;"'..,t.Mrirgl XlikLEPK„, ,..iii-r,,,,,,,-,,#$,.. .,,,4::;:,,,,iff.....;„ . .. rgi Netstconstruction 1:3 Additioniateratianirepiacothent Please.check AI that apply 6t!bmit Z sets of plaes iv/items chocked): 0 Servia or feeder 400 amps or more °Building overtime stories. 0 Demolition 0 Other:. „ wbore the available faulteutrunt 0 Maritsa*and boatyards. exceeds 10,000 amps at 150 volt;or °Floating buildings. 1-and-2-familydwelling 0 Conunerciallindustrial 0 Accessory'building Wm ground,or exceeds 14,000 0 Comaterciakne stpiculttua.1 . ,$Multi-fatally E3 Master builder 0 Other amps for.all olisorinstaliations. °Fire.pomp. buildings. 0 Installation of 150 KVA or • ..-- ''''.;' ".•""..- -.'1..'''.:,--,,-.:4''''-i''.5..."i.'i'4t''1';..'-'1;17i-,,...'''''.1 .'i'''.. "4.."3",---4.0.... -:.-.•-:-,i. .,,.:,-.1•.:: 0 Emergency system larger separately derived °Addition'anew motor load of system: . Job 11: Job site address:1.3ton SMsilf,nvFoiTto 100M'ormore. 0 W."E","1-2",-1-3', El Six°more residential emits. ocounaucy. eltY/SOW/ZIe1ligard,OR 97224- 01realth.care facilities. 0 Rocressional voltiele parks, $111t.0614./apt.4/.: . Project name Polygon at West River TerOttintraonsiacations: 0 Supply voltsge liir mem than • 0 Service or&oder or more. 6®volts nemieril Cross street/directions to job site: r'el-fhe7-- coArred,..e... 4-'2:-:7-77,. -.4.pAm...irbirrigi,-;;-:1.71'-ii`?'".j1RPF,f7'..7-_",-..2. DeacciPtiaa La ry: ( Each Total .1 3 Z 0 7 /0 ofeiver New residential Single-or maltmily dwelling unit . . . SttbdiVisi'On:Polygon at West River Terrrace Lot,:in Includes attached garage. 1,000 sq.11:or less .161154 4 Tax uMptinucel#: • 1 : " , .. .e Ea.add')SOO sq.4.or portion Limited metro.residential ... . . - .. 75,00 2 W 1 eiV)(1/1\4(J (with above sq.ft.) Linilaxl aim%ainiti-temily . 75.00 2 r ft:sideliner(with above sq.ft) • Renewable Energy 0 Sec Page 2 , .lAteallairgt*Ortgliff0-fi,LOJAMilat:t:4.411.;'.--.P...***24:110:41,' Servicei or feeders installadon,alteration,and/or reMeation : Name:*PVT;Land Holdings;LLC •. 200 amps alms • 100.70 2 201 amps to 400 amps 13354 2 Arklreae:7600 X tlosibletree Ranch Road .401 amps to 600 amps - 200.34 2 City/State/ZIP.:Scottsdale,A• Z&5288 601 amps to 1,000 amps , 301.04 2 Phone:(602)694-4031 ',. Fax:( ) • Over 1,000-amps Or-volts . 5.5226 2 • Temporary services or feeders installation,alteration;and/Or Email: - relotittion. . Owner Installation;-This installation ii being Made on property thatl own which is not 200aiPPs Qr/4436 1 intended forsale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 20t amps to 400 amps . 1-559.08 2 Owner signature:. .. . , .. . . Date: :40Lamps to.599 snps • 2 T C R eh dreads-new; ' alteratiOn or extension,. r panel ltagg.SV:ttlfAt#StaW4.SttgOrt:VN3W4tM*11:.4t.41t#CS.4 :A.- e for . circuitwith. . Bitainest ntinte:1Williata Lytor.Ronses,Inc: above seryiee or feeder fee, ... . .. ... 7A2 2 . • . each breath circa Contact name:Angela Grajewsld B.Fee for launch circuits vithord -seiviee or feeder fee,lirst Address:109 lest:136 Street. , 5418 2 Manch circuit City/StaterLIP Yantantver,W.A-98660 Each min branch donut • 742 2 •. bliSeellaneou.s(Serviee.or feeder not included) rh0i*.(360)49S-7700 • Fax :(360)693-4442 • ' 'Each manufactured or-modular 6714 2 • . disolik,service and/or iheder Emil':Augete:GrajewatdOpolygonhoates.com • gamma only 67.84 2 'z:Ss.g.:',',4,00 .1",.49,•-- .:;:,.qi.0.-i&.1.4.-;%;•V;;;N , ,-,'- `45.4;Pi-::;:Ti,i•f=WA';';;.:; i•l'i'..,::;-,;i' . .Pump orirrigstion circle 6714 2 Businesa mame;;Simply.Electric LW Sign oroutline lighting . 67.84 2 • 81PaleirePig4)er limbolcuargY 0 set rage 2 • .2 Address:PO Box 822408 . ea*alteration,or extension. Eiek addition&inspection over allowable&any of the above: .. .:... City/State/ZIP:Vancouver,WA 98682 Additienallospection(1 hr min) . .6625/lir . . . Phone:4503):849.1202 • Acc:(360)314-4945 s Owes**(1 br min) . 901/O/lu • • . Industrial.Planr(1..brm10) 78.18/fir Email:simplyelectriepdx@gmaitcont &Speedo&for Whieh no fee is 90.00/hr CM Lit..... 20- 46/5. Electrical Lie.: -C1067 r 3.7rtc Lic.: 4394S ,...,«,,.41isted lihrmin) . .tsage..-X"-..,....P,.i.s..A..,'4b s1.&c..:2 col ii.li".Y;IT's,*k..,,..qAjf., Suprv.EleetriCiall signature,required: L ' I -1 1417/8/20 -Subtotal.: Print name; Victor Zarzhits.ky I Date:. . 17 . CI Plan Review Rewired(2.5%of permit ice): -...., State surcharge(12%of permit ice): A • •othorieed signature: '•. ..,.... TOTAL pER/vE1T FEE: ,., This permit application expirealf a permit ie not obbiined within 180 .,_ PrintnaniC ,Ditnitrly Misbchtik Date: 2/8/2017 days after it bas been accepted as complete. • NUMber of inspectimil allowedper permit. rlituildeeptensitnEW PaashAap EtR ERE.doc-Rov0e17/2015 440.45n7olt0SiCOMAVE8 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13690 SW SILENT FOX TER, SHERWOOD, OR, 97140 Record Type: Record ID: Residential - Master Permit MST2016-00242 Inspection Type: Inspector: 199 Electrical final David Young Result: FA I L Comments: No power to kitchen, breakers off in panel. Soffit or protection needed at exposed Romex at garage ceiling by mechanical room. All else appears ok. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13690 SW SILENT FOX TER, SHERWOOD, OR, March 28, 2017 at 5:17:04 PM 97140 Record Type: Record ID: Residential - Master Permit MST2016-00242 Inspection Type: Inspector: 699 Mechanical final David Young Result: FA I L Comments: Seal all penetrations in mechanical room. All else appears ok. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13690 SW SILENT FOX TER, SHERWOOD, OR, March 29, 2017 at 11 :50:40 97140 AM Record Type: Record ID: Residential - Master Permit MST2016-00242 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS Comments: Corrections complete from previous inspection. Violation Summary: Inspector Contractor