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Permit (66) A CITY OF TIGARD MASTER PERMIT Na IL` COMMUNITY DEVELOPMENT Permit#: MST2016-00172 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/08/2016 Parcel: 2S 106DC05900 Jurisdiction: Tigard Site address: 13765 SW 172ND AVE Subdivision: WEST RIVER TERRACE Lot: 59 Project: Polygon at West River Terrace, Lot 59 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 3 First: 805 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 23 Bathrooms: 3 Second: 939 sf Garage: 423 sf Front: 12 Smoke Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes Total: 1744 sf Value: $216,372.10 Rear: 0 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Drains: 0 gWater Lines: 100 Catch Basins: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Bckflw Prevntr: 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 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 SF VB R-3 1744 Owner: Contractor: ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions) 7600 EAST DOUBLETREE RANCH 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175 RD,STE VANCOUVER,WA 98660 SCOTTSDALE,AZ 85258 PHONE: PHONE: 360-695-7700 FAX: Total Fees: $30,224.48 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 OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. a Issued By: - r/ el-1--C- Permittee Signature: e/V ,-,70,--e.../e,9-7-70,v/ Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application : -, -- L',. +,G p 2 {�q FOR OFFICE l SE()NEN ADP! ) U{ Received /�/Z /� '� Permit N°.N.5-le/,‘`� / City of Tigard Date/By: 13125 SW Hall Blvd.,Tigard,OR 97223 _% Plan Review r' Other Penni J,r� j/_ � /_ Phone: 503.7182439 Fax 503.598.19gp t 1 ° Date/By (0/ / /6 It �/ K✓ Inspection Line: 503.639.4175 ,," ,,' '- ` 't N, Date Ready/By: ` rw s: H See Page 2 for T 1 Ce fi(� Notified/Method:( r' i Supplemental Information Internet: www.tigard-or.gov °f/t. ff'r✓6 / ®New construction_ .v -1 ' ❑Demolition F Permit fees*are based on the value of the work performed- Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement ❑Other equipment,materials,labor,overhead,and the profit for the -,-.--.,-,---z----- ,me , .. gwork indicated on this application. S � a ?r ifi 6 �€:1. f4, - r ., ,, -pro ® 1-and 2-family dwelling 0 Commerciallmdustrial ) • Number of bedrooms: 0 Accessory building ❑Multi-family ❑ Other Number of bathrooms�2.. Master builder 0 F — -4 Total number of floors: 2 ! 7 ��^,, ., ms _.: _. _ j�/')/gi Job site address: /)65 Sin/ /72, M en. eye I New dwelling area: \WAsquare feet City/State/ZIP:Sherwood,OR 97140 Garage/carport are`42D square feet Suite/bldgJapL no.: Project name:Polygon at West River Ter Covered porch area: •Str...\__7.3 square feet93 9 Cross street/directions to job site: Deck area: IA square feet 3 f . Other structure area: ', square feet J Subdivision: Lot no.:971 Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the s t w V ar , 1,, .i`j,t N-7 ` work indicated on this application. New Single Family Detached Construction Valuation: $ Existing building area: square feet New building area: square feet � " ",; Number of stories: Name: /1 �l�� tr, /y�/ . /m _ pea,",,r��� Type of construction: Address:/ OU L4 . VWO / f ' / / nal pe . Occupancy groups: City/State/ZIP: Sto�` 21 t Existing: Phone: — , P ._ Fax(360)693.4442 New: Business name:Polygon WLH,LLC Structural plan review fee(or deposit): Contact name:Maggie Gordon FLS plan review fee(if applicable): Address:109E 13"Street Total fees due upon application: City/State/ZIP:Vancouver,WA 98660 Phone:(360)695.7700 I Fax::(360)693.4442 Amount received E-mail:maggie.gordon@polygonhomes.com _ `:11,11)2121 -` � � r ` Commercial and residential prescriptive installation of 1 _ ,,,r.. _-t � � v , „-x ', -, :� ,-_ .', -,c , :. v=im' roof-top mounted PhotoVoltaic Solar Panel System- Business name:-8elyg ", 1.,),1.1"8,1 t �!/J �/ � /4,16._ Submit two(2)sets of roof plan with connection details y / and fire department access,along with the 2010 Oregon Address:109 E 136 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)693.4442State surcharge(12%of permit fee): $21.60 CCB lic.:207247 Total fee dueupon application: $201.60 �� PP� Authorized signature: V This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete._ Print name:Maggie Gordon Date:12/11/I5 *Fee methodology set by Tri-County_Buildm8 Indusay _ Service Board. I:\Building\Permits\BUP-RESPermitApp.doe 02/24/2011 440-4613T(11/02/COM/WEB) --- '-Z® Mechanical Permit Annlication t ext, ,...- " ' City of Ti andReceived Pamir No.-/€7_(>7:,2_0/6—00/7 - lh:;---. SPR 3 ZQ 1 u DaterAY, 13125 SW 11x11 Blvd.,Tigard,(Mt 972 3 Plan Review . Phone: 503.718.2439 Fax: 503.598.1960 Other Permit :,'ri t7 Inspection Line: 503.639.4175 ( r ' tete Readyl14y: SwEs: lil See Page/for Internet: www.tigard-or.gov k , :1i*a1xf€«i�?�lertsrxl; Sappkmeatoi toformatiou err , Ax � s' ' � Mechanical permit f are based on the value of the work t. New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all Demolition 0 Other: mechanical materials.equipment,labor.overhead.and profit. Value 5 El I-and 2-family dwelling 0 Commerciaifindustrial 0 Accessory building For special Information use rkrc*fIst, i CI Multi-family 0 Master builder 0 Other: Description i Cry. } Ea. Total Heatmgkoebng 4,.. � < �� Air c�ralitioning x€6.75 Job site address: /J 7� 3w 1?Z 6t Furnace 100,000 Efr i(duets/vents) j 46.75 City/State/ZIP: \--\.9._ir\,A.,r Q u( � Fussac100.0004-BM(ducts/vents) 54.91 — Uleat pomp 61,0 Suite/bldg./apt.no,: Project name:...P°K1.r c— u Duct work 2332 Cross street/directions to job site: tiNc. / ) Itydronic hot water system 23.32 1 4.1 c-C (/ Residential boiler(radiator or I hydron ) 23.32 Unit heaters(fuel-type,not electric), in-wall.in-duct,suspended.etc, 46.75 I Flue:vent for any of above 23.32 q Other- 23.32 Subdivision:River Terrace Lot no.: 1 Other fuel appliances Tax map/parcel no.: , Water heater 23,32 .0 � . ..,:;„;,z..,,,',-alb,:. .'t., ,r.V�` ', `r�k, ''«:a A vent 33.34 _. Gas i . Flue for Prater h or gas ..�. _ A. 23.32 I fireplace H AC Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 2332 y . ,..• < , „ , . . 1s,.: ".. V :,mss. :,.r: 1 Environmental exhaust and ventilation: 2 . )Marne. L V /4/J /..pkt iM > LIC //' Ratite hoodlotter kitchen (�((/I i. pp p� (�l�l. Road equi nt 33.39 Address:1 it 'K✓ `"'t Clothes diver exhaust 33.39 Single-duet ecliaust(bathr0Omg, I City.IStatefllP � � toilet compartments,utility rooms) 23.32 0� I Fax ( ) Auicterawlspace fans 23.32 Ptaortc 9 e� � � , t sa mom ,:,,...!':i2-,'•,--,''"3---,'-4'.',":1-- Other 2332 < ��, .... Fuel piping. Business name:Apes Mr LLC . lOr first four:54.03 for each additional Contact name:Staci Hap Furnace.etc. Gas heat pump I Address:2210 W. St.Suite 107-272Wall/suspended/unit heater City/State/ZIP:Battle Ground,WA 93604 Water heater Phone:(360)3424109 E Fax::(360)326-1769 • Fireplace Ranee E-mail:staeik®apexairco.com Barbecue 4 t • at . r ail Yi; ' it�IgV* `a; r * Clothesdryergas)'. 1 Business name:Apex Air LLC then < Address:220 W.Main St.Suite 107 272Subtotal I Minimum permit fee 1594.110} City/State/ZIP:Rattk Ground,WA 986114 Plan review(25%ofpermit fee) Phone:(360)3424109 1 Fax:(3 €l)326 1769 Stale surcharge(12%of permit fee) gg TOTALPERMIT FEE CCB lie.:203034 f I This permit application expires if a permit is got abtalaed wltirirf 180 } - ,.. days after it bete accepted as complete. Authorized signat y' r * Pee methodology ate by Tri-County Building Industry Service t curd I ay L Date:1/28/2016 I Print name:Staei bay I;Etxairderau:Prrmits tEC vi..14Apir.r4Ort3dem 440.4647144Sar•°Cb tti Es) ditivitt.... 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I - - -: : - , '•-ThieSeretriUrpiiiigiieliaiiiietx.i$04: .1.-1.W004er4e."Joeui40::au-erikeic iityeailbeiS ,44e4ersglyeacopoyee. . , • . , , I , I' Plumbing Permit Application , . : t ‘ n ., Building Fixtures ', F ived2 3 2oi,' IN /By:13125SWHailBlvd.,Tigard,OR 97223 Review C ' Phone: 503.718.2439 Fax: 503 598.19;60 ` ', Date/By: Other Permit No.: Inspection Line: 503.639 4175 s'1 ate Ready/By: Jut is: 8l See Page 2 for 1 f( \11. l) Internet. wwW ttgard-oY goy Nonned:'Method Su •lementai Information xt <�,�'+R '.. f a; ' '' `' -» -"F .ave° ,''* 14{ ' 0 Far special information use checklist. al Ea. 1 Total tiNew construction Descripon QtY• 0 Addition/alteration/replacement El Other: New 1-2-family dwellings(includes 100 ft for each utility connection) 4-i ! ,, „..<; SFR(1)bath 312.70 sa • '4nos x k .�.rA 4 ...,._ SFR(2)batlt 437.78 En 1-and 2-family dwelling l Commercial/industrial SFR(3)bath 50032 D Accessory building Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 ''� -site utilities: ''''L'-' - h A-< '`' •sr 'vs 4 . '' Catch basin or area drain 18.76 Job site address: (� Drywall,leach line,or trench drain 18.76 City/State/ZIP: 'h A N)0 C) C--)Ek CCi-"--� n Footing drain(no.linear ft.: ) Page 2 Suitefbldgfapt.no.: I Project name: '90\\1 ( 6Y\ (, t u.j-€ Manufactured home utilities 50.03 Cross street/directions to job site: r jute, �,,' {i 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: , Lot no.:soi Fixture or item: Backflow preventer 31.27 Tax map/parcel no.: ve - r . Backwater vol 12.51 . i st � § !"; I •f City of Tigard 71N COMMUNITY DEVELOPMENT DEPARTMENT s T 1 Gli 1, Building Permit Review — Residential Building Permit #: /757-.2e/6 — 067/ 7,P--- Site Address: l 37 6 5 SW 17 2 n a.1/4i', . Project Name: Po( 50,� 0-F we J+- (2v�u c, u T-errLot #: ,5. 1 (New dwelling= subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: IW_AU/ S P- `,, izr Verify site address/suite# exists and active in permit system. 21 River Terrace Neighborhood: ❑ No X Yes,See River Terrace Review Addendum Attached Site Plan Elements: /Three(3) copies of site plan structures on site /Site 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 /Utility locations (required for new,may apply for additions) /Site address,project or subdivision name and lot number ❑L,,catkm of wells/septic systems /Applicant information(name and phone number) :rosion control(including drainage-way protection, silt fence , Lot dimensions and building setback dimensions design,location of catch basin,etc.) /Lot area,building coverage area,percentage of coverage and /Street names impervious area(applicable if R-7,R-12,R-25&R-40) /Street tree size,type and location /Property corner elevations (2 foot contour lines if more than tirrg-trees-tt be retained with drip line,and tree 4 foot differential) protection measures 7 Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995): , Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No XJ Public Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified ❑ No Applied For: E Yes E No,stop intake i Land Use Case#: P vz20IJ 0 QQ(,� S\)'3 Zo t 3 _ 0 000 G .CJ Zoning: R-1 , Setbacks: Front 12, Rear 0 Side 3 Street Side 8 Garage Landscape Requirement: Lot Coverage Maximum: g Q % /� fol Building Height: Maximum Height N//I'1 Actual Height 30 Visual Clearance fA Easements 0 Sensitive Lands: ❑ Yes ❑ No Type Urban Forestry Plan 0 Conditions "Met"prior to issuance of building permit Notes: (i0(MTh 0 r11 'fib rn. .f pr ib( 'V I SS VO 0 ca e.I- 0 A a`'` by)) j/rvl i f^. Approved By Planning. /1/1/0 el 12--e"-- 611 d Date: 4/7- /1 So Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved 1:\Building\Fonns\B1dgPennitRvw REs 012116.docx 1li Building Permit Submittal Original Submittal Date: W2(0//(0 Site Plans: # 3 Building Plans: # _3 Building Permit#: la—Enter building permit#above. Workflow Routing: [}Planning 0---rmi�gineering B'1 ermit Coordinator Building Workflow Sign-off: lSign-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. LTJ'Building: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: <9 — Date: V2 4:7 Engineering Review ,zI Slope at building pad: ./d ©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 Approv d b Engineering: Date: Notes: � iz5 a 6 G: —17/ /'"'1I/ Approved by Engineering: t4Z.c_a Date: /b Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved El Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review 6 Conditions "Met"prior to issuance of building permit IApproved,NOT Released: C'� .c.c _ 0u cw�� Date: S Notes: F.--N1 G 60,,,L,' -(-i Un s bt ,,,e.A- • 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: ,1 SDC Fees Entered: Wash Co Trans Dev Tax: [- Yes ❑ N/A Tigard Trans SDC: [- Yes El N/A Parks SDC: 'Yes ❑ N/A OK to Issue Permit �j'��-.- Approved by Permit Coordinator: /1 ! Date: _4777:9717/c" I:\Building\Fonns\BldgPennitRvw_RES_012116.docx 1 I. . 11 City of Tigard ■ COMMUNITY DEVELOPMENT DEPARTMENT T l G n n River Terrace Building Permit Review Addendum Building Permit #: NS j 0/6 — 0 0/ 7-2-- Site -Site Address: 131 (0C S'W 12 "1-4 a v Project Name: 'PO l j90 rl cif We d- 12-(VX.r l ✓'r-- Lot #: 59 (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review River Terrace Plan District Design Standards (18.660.070.1): Is the project subject to the plan district design standards?Oyes ❑ 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. deep Balcony w/ access 2 Window Projection Vertical Wall Offset a Af ft. deep mm. 2ft., 5 ft.wide mm. 2 ft., 6ft. wide Gabled dormer ❑ CI ❑ 2. Eyes on the street: a minim m f 12% of each street facing facade must include windows or entrance doors. Percentage Shown: 4 /. 3. Entrances:At least one entrance must meet both of the foil wing standards: Max. 8 ft. setback from longest street facing wall N Parallel to street,angle no more than 45° from street, or open onto porch Entrance opens to a porch:/Yes ❑ No If es,all the following apply: gr25 sq.ft. min. One street facing entry X12 ft. max. roof above floor oforch 7'5 ft. depth min. 7itP 130%min. porch roof coverage 4. Detailed Design:All buildings shall include a min. of five of the following elements on all street-facing facades: )21 Covered porch min. 5 ft.wide x 5 ft. deep Recessed entry area min. 5 ft. wide x 2 ft. deep ,ZI 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 igf Gable,hip or gambrel roof design ❑ Roof pitch oriented south min. 500 sq. ft. ❑ Horizontal lap siding min. 3-7 ft. wide ❑ Accent siding min. 40%of street facade Window trim min. 2 1/2"wide by 5/8"deep ❑ Window recess min. 3 inches for all street facing ❑ Bay window min. 5 ft.wide by 2 ft. deep ❑ Balcony min. 5 ft. wide x 3 ft. deep with inside access ❑ Attached garage is 35% or less of street facade 5. Garages and Carports:May face the front or side lot line on a corner lot. Setbacks: 41o,, ,, . 0 C(4_1,_ n No close to front or side lot line, than longest street-facing wall. ❑ Yes ❑ No. If No (Check one): O(� ❑ May xtend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch. ❑ M extend up to 5 ft.where the garage is part of a two-story building and there is a window at the second story abo the garage that faces the street with a min. area of 12 sq.ft. W'dth: (Check one) 12-foot-wide garage door ❑ 40%max. of street facade ❑ 50%max. of street facade with 7 detailed design elements Notes: Approved By Planning: A i9 ti i2(#._ 43 do Date: // 2G/1fo 1:,Building`,Forms,BldgPeim dRm_RES RT 031416.docx Plumbing Permit Application Building Fixtures ts ___________________________________________________________ 714 City of Tigard SEP 1 b 2016 Date/By: /0 6 iG Permit No,: 01 A ``00 I Received i ms 6 -72. , . 13125 SW Hall Blvd.,Tigard,OR 97223 - Plan Review 8 Phone: 503.718.2439 Fax: 503.598.1,96(1--k.,- -,.- -,-.-- -----.,-- "i Date/I3 . Other Pemat No.: 11 T P,- ' ' 7'''‘'.''''' ) Y. Inspection Line: 503.639A175 L' - ' ' Date Read /B . 1 lt,Alti) June: 0 See Page 2 for Internet www.tigard-or.gov 31J1LDNG Dr'JIS;0 NIN'OtifiedijetiLi: Supplemental Information ':itllEiMlr3Mrirtr*rlri''iteM4'r'r'-e'''''W'Th'it''''i"'''atirVtgir4r'rf:41MrPN?45r3trPtclrttiz**trr'rtt' sVersMWil. 0PirliAllrOrat'''.".''''.-,k775..1'".7.'''',17.4.5.97sviplettiVityillil1kitilojtifiez., .tilS-------- 41-'"`""" '''''''j"'47'-'-:''-'a,-"'''3'''''''''''''''''' ''''''.3"•''''' L,..'"Per-q '''' gN.i.,''iaqta,V*'Mt'4ire-t3i:V.i8i,ffe:4.4 L,,,R1.:'41,1 4:;:1,* r "'-g.44M1.-MhF..t.M161L4SIElaiiiipiC-TRIRII,Eq, q.,-,d'4,0AigirriaggliAPiEf;OW^ '1141,Tiiid4iii,i' 19...:t..!::=16....445,-;:,-Igi,"iiiiiiATANNigivAiKAtipotamagligVirs4grwRI Th,P."V•-.PU5S,,,,,IM,,,,,,,,,,IT:IFFRiii, ' F, ..,-,-,'•,'-,,,.'..-.,,i,,,,,,,,-,-'21411r,R...,"VE:r'41-a=a2...,'''4,,,- For special information use checklist, New construction Demolition Description 1 Qty. I Ea. I Total 0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) 312.70 tingatOrt5.104tf 4:el'fitii4 ..e;•.::r..21'' t tinni:9-:rrt--.Me."-±;'liallaIONVANIZI11010 SFR(.I.)bath . CI 1-and 2-family dwelling al Commercial/industrial SFR(2)bath 437.78 500.32.., 0 Accessory building 0 Multi-family SFR(3)bath Each additional bath/kitchen 25.02 0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 igiiiliA17:134.1(.0.0133434m34..',.0) 'r.-,-. ,,-4 1...1'.:i''''4:', V ri..:r IN,-4 ,e,,,, i,,,-,-..kpA-Natord4,43,,,,,,t,,,,po Site utilities: ,e41.1......;n4 J.:7----,',-,r:kaglh-Til-glir;RPAVMi**:, Job site address: fl (05 5t.A..) ti 2,41, pkv-e_. Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.: ) Page 2 Suite/bIdglapt.no.: Project namerk*ge-st 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 ,r.-/ 4r 1 !tier Water service(no.linear ft.: ) Page 2 Subdivision:No ri' .:t River Terrrace I Lot no.: 59 Fixture or item: Backflow preventer 31.27 Tax map/parcel no.: 11"11,41SICILMV-11-1.,41"421''.it:71'-'47efrnri::71•Trrif,i4-233MIOPOPIfilkiritiftglia Backwater valve 12.51 'ZitifatiErgaitifiggiitighINZlikilfilt(2Clothes washer 25.02 - , Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ,-0431"4- e 4 '! , ..:111.44INIIA1(...ii,Iftitinifillig.a'in",fi:' g:• ,)6:1711:42 Expansion tank 12.51 .h.,-4-44.;..i--!.1.311.1.0`i-5111-MTEEirgla'7....;:".1.- ' ..:•:*..;.i.t:L--,•,,',-'...7.4.71,7:1111,40:: Fixture/sewer cap 25.02 Name:ADVL Land Holdings,LLC Floor drain/floor sink/hub 25.02 Address:7600 E Doubletree Ranch Road Garbage disposal 25.02 City/State/ZIP:Scottsdale,AZ 85258 Hose bib 25.02 Phone:(602)694-4031 Fax:( ) Ice maker ., 12.51 Intereeptor/grease trap 25.02 11-.1.1,--1.-440-4--wl,---IF-41-.7.t:3''''-%;:44'T-!;Er,!•-•7:4YrIthbRigilOtaiiirar,ailiaii„,,,,,.:41. ...4.,,''..L,'..,....i..7.,T.,...,.:0,,:..LarditgA, Medical gas(value:$ ) Page 2 Business name:William Lyon Homes,Inc Primer 12.51 Contact name:Angela Grajewski Roof drain(commercial) 12.51 Address:109 East 13th Street Sink/basin/lavatory 25.02 City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54 Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51 Urinal 25.02 E-mail:Angela.Grajewsld@polygonhomes.com , Water closet 25.02 1., ."-.-7.7."-o -i14.10,004710,-(11,,,,g-rigit:444.,.-&-.4,„sta-„,-„RIA.h.„ 1:-74.14.4111..t1IPTIIIIKKIRAIT/IIIIIMINIIIIimit",:`,.(.7/'7.---.---"4/-,-..-Al.-- -,.,`ARKUREIIIII041.41t14tHigiliIIRAIIMIINR4104.* Water heater 37.52 Business name: ,44 kviv,,,k1\x„c 'r5-0I afit- Water piping/DWV 56.29 Address: 9.0. is os, a(p., Other: 25.02 City/State/ZIP: 5y, e 4}0,A arc, ii 13/ Subtotal Minimum permit fee: $72.50 Phone:(4543*-*,$(4.-. ('Ui Fax:(eti v...-79,1-40,110 Plan review (25%of permit fee) CCB Lie.: 184 31aa..... Plumbing Lic,no.ft kali State surcharge(12%of permit fee) Authorized signature: 40 C111 ' 7,AAO.P.A"*"*'-- TOTAL PERMIT FEE Print name: ,j1' fAjf_ ,,,,,14e__ DateS-3b-it, This permit application expires Ifs permit is not obtained within ISO days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board IfeuildingTennits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02COWWEB) 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 13765 SW 172ND AVE, SHERWOOD, OR, 97140 Record Type: Residential - Master Permit Inspection Type: 399 Plumbing final Result: PASS Comments: Violation Summary: Inspector Tel: 503.718.2439 Inspection Date: Record ID: MST2016-00172 Inspector: Aaron Cillo-Gobel Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 13765 SW 172ND AVE, SHERWOOD, OR, 97140 Record Type: Residential - Master Permit Inspection Type: 299 Final inspection Result: PASS -CofO Comments: Final erosion control approved. Street tree certification received. Moisture content form received. Vapor barrier form received. High efficiency lighting form received. Blower door test report received. Insulation certification checked. C of O left on site with contractor. Underfloor insulation installed. No AC installed at this time. Violation Summary: Tel: 503.718.2439 Inspection Date: January 31, 2017 at 3:02:25 PM Record ID: MST2016-00172 Inspector: David Young Inspector Contractor