Permit (61) t, CITY OF TIGARD MASTER PERMIT
2''-
COMMUNITY DEVELOPMENT Permit#: MST2016-00389
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/17/2016
Parcel: 2S106DB07800
Jurisdiction: Tigard
Site address: 13386 SW SATSUMA AVE
Subdivision: RIVER TERRACE NORTHWEST Lot: 78
Project: River Terrace Northwest, Lot 78
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 948 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 26 Bathrooms: 3 Second: 1130 sf Garage: 385 sf Front: 8 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes
Total: 2078 sf Value: $253,802.55 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: 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: Y Vent Fans: 4 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Fum>=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: 3 201-400 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 2078
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
ATTN GAST,FRED VANCOUVER,WA 98660
109 E 13TH ST
VANCOUVER,WA 98660
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $30,942.02
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: a_)---i-e___ Permittee Signature: Oic"/ / e-. /69-7-70A/
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
ermit Application La
Bu>'ding P ' .._
19 FOR OFFICE 1 Sl OOI A &J%� :=��! C Received i/.�.: > G '/K7-- , 7 TA
_ Tye�/ :� Perm�tNo
City of Tigard FEB 0 3 2016 Da y Ir/13125 SW Hall Blvd.,Tigard,OR 97223 Plan RevieiO s 10_ 16 Other Permit c I 03/116-eo
Date y ��//Aw Iuriz: H See Page 2 for
Phone: 503.718.2439 Fax: 503.598.1960 LII . , O F --1,
E Data ReadYBy:
Ins
tion Line: 503.639.4175 s 3 ayt`t 3 hfiedRvlethod�o /� /(� I Supplemental Information
1
1 c' ;f:I> lute n t: www.tigard-or.gov BUILDING t.�#.��.��a la
Permit fees*are based on the value of the work performed.
®New construction
❑Demolition Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
❑Addition/alteration/replacement ❑ er ,,z 1 g work indicated on this application. r
® 1-and 2-family g
Valuation: )j��'Y ja$ �,
dwelling ❑Commercial/industrial
of bedrooms:
❑Accessory building ❑Multi-family , Number Number of bathrooms:
❑Master builder 0 Other
. - Total number of floors: 2
ft
.,? ._- _. square
feet
. site, -14-e-� I New dwelling ares:
� j q
Job site address:/.;_ �Fj _1A) Jit71'4/'a"'G / " `` 0 ge/cazport area: square feet
City/State/ZIP:Sherwood,OR 97140 \ � +
Project nameg . �� ,) Covered porch area: ' C square feet ) / 'i�
Suite/bldg/apt no.: J
Deck area: square fe ^ )
Cross street/directions to job site:
Other structure area: f,
square feet q
Lot no.: 7 Permit fees*are based on the value of the work performed.
Subdivision: Indicate the value(rounded to the nearest dollar)of all
arcel no equipment,materials,labor,overhead,and the profit for the
Tax map/P :, ,,, work indicated on this application.
New Single Family Detached Construction Existing building area: square feet
New building area: square feet
� ` ,i, r A i r E, - Number of stories:
x
Type of construction:
Name:Polygon WLH,LLC
Address:109 E 13"Street Occupancy groups:
City/State/ZIP:Vancouver,WA 98660 Existing:
Phone:(360)695 7700 Fax(360)693.4442 New-
r a em - :',4--.,e,.: ''a - � '. t . s — '- :- - - s..' .n.„ �. '" a�4-. mo»
Business name:Polygon WLH,LLC Structural plan review fee(or deposit):
Contact name:Maggie Gordon FLS plan review fee(if applicable):
Address:109 E 136 Street Total fees due upon application:
City/State/ZIP:Vancouver,WA 98660 Amount received
IFax::(360)693.4442
Phone:(360)695.770(1 I �� s a���e _ a : ' �E-mail:magg►e gordon@polygonhomes com Commercial and residential prescriptive installation of
���x - , _,� -'- ,. sz _ roof-top mounted PhotoVoltaic Solar Panel System
' " -, . < -' g -- ,p.-- —- Submit two(2)sets of roof plan with connection details
Business name:� o on W/ -�r i�! �YCi- f and fire department access,along with the 2010 Oregon
Address:109 E 136 Street Solar Installation Specialty Code checklist.
Permit Fee(includes plan review $180.00
City/State/ZIP:Vancouver,WA 98660 and administrative fees):_
Phone:(360)695.7700 1
Fax:(360)693.4442 State surcharge(12%of permit fee): $21.60
CCB lic.:207247
Total fee due upon application: .$201.60
This permit application expires if a permit is not obtained
Authorized signature: V
within 180 days after it has been accepted as complete.
1 *Fee methodology set by Tri-County.J3uldmg Industry
Print name:Maggie Gordon
J Date:1S/11/15 Service Board.
440-4613T(11/02JCOM/WEB)
1:\Building�Permits\BUP RESPermitApp.doc 02/24/2011 r
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="lecuiegl rek.. m... FEB 03 2016 r on ICE 1 ""r t Yv[3' i
._(-7-.20/6- c
CitY of Togarfl 0,,, ,--1 0 i .0 ,,.,•-, t . * '
..... 13125 SW Ra11131vd,'I'lgagt,OR I45.1 "I' k -'1- t '-••''''' ''-'' 111%R/wit-AY •.
iterated Penult,,,z.
•' 67 Pirate:503.7102439 Fax: r:,
laspetton utie: 503.639.4175 i'...,k);...•,':,• - , " poady 0tepy, *Hi,: Eil
1111010%17 WAYAXtiaird`t)r•g" isnefitdrastrum: soppionnomi larennetree .:
21 New,,,ti.ts,•—tilletion 0 Adorihdrerationtreoacement 'Ilea.%4E0'1'4 notamOis(34mik-I'°f14"swift"i'cbcr"1"(r. 4
'
ElSerelmc or roadertoo amps or gnat 0 014Minooverttneeatenes.
0 OP111011800 0 Odlrr: , srham'emannierble auk.ent Ei kwiras ime boatyards- ,
...P18115,110(.N. exceeds ta,aon amps al 150 voila or 0 Floating loOldislos.
El 1-and 2-family dwelling 0 Commercialfludustrial ID Accessory building
seeps toren ether instefiettees. Mitrlap.
0 Mr1111-01MHY Ci Master builder Er Other: (Jae pomp. ij msamelion of 150 KVA Id
iSUZ 1NrOMAUON AND L4CATIO4 tne,....p.tely,urnfr.a..
IjAtIdttam of new motor:dad of $ya tern..
'1°11111 i 1(lb sit°address:\:'")?5 ,,,,n
0 Sic er more residential;mita ortopency. 1
CISY/StaletZIP:Shenvood •Olt 971410
rjr.ttroor,earo feedliks, Ontranatinnal oolitic parks. „
Suitribldeept is: Pretlea name: Ottezardeus lorotions. El Supply soilage for mare Illen ,
S8en wets miell.
1:1 ervice tw fee/term amps ar mem. sth
Cross sireer/directions to job site:
aduadpdats I 011.I oxen I Tato 1
New residential single.or muld-famtly dwelling wit
Subdivision:River.Terrace Lot#.... 1 s Inds:des attached garnge. 1
.i., a...a....._..,4 1.000 sq.S.or lcm J 160.54 4 1
''a'X'9'."1"°''''"`': Ea.addl 500 sq.it or portion . 33.22 1 r
I
DESCRIPTION OE WO4141c Untied enemy.residential(Wtht/ d%..it.) J
, 75.00 2 1 iabYe
New Slagle Family
limited anew.inolti-busty ,....,„„ 2
residential(Milt above sq.it)
,
, ....... Renartable Energy 0 SeePrige2
ft cr.„egotairly Giviatt 1 Li TENANT' . services or feeder&installation,Mtexation,and/or relocation
Name:Polygon Homes Mamma otters 100.70 2
Address:109 2tl=Pt to 40 ttans 13356 - r
t
401 amps to 600 amps 200,34 2
3 ,
City/State/ZIP:Vancouver WA 95660
601 amps 50 1000 Dells .01.04 2
none:.(360)695-7700 fax:( ) Over 1,000 amps or volts 552.26 2
e
Temporary services or(ceders insintlalinn,alteration,and/or
FArmil:
relocation "
r
Owner installation:This installation is being Lunde on property dint 1 own which is not 200 amps or less 50;56 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps so 400 amps 125,08 2
Owner signature: Date: . 401 amps to 597 amps 168.54 2
I r.
,
l'.3 ]CONTACT FEI8800Branob circuits--new,alteration,or ext-ension, r panel APOLICANT 1 A.p • • 1 h
ee forbranels=mats sr t
Business name:Garner Electric Washington,LLC aboveservies or feeder Fee, r
1 d 742,
Contact Barrie:Rill Daniels tach Manchrenit 2
0,Fie for branch circuits triarom
service rfte
Address:6101 blE St Johns Rd oeder fefirst` 56,18
branch cirmtil 2
City/ask/ZIP:Vancouver WA 90661 Each add'i bit 742 2ranch ci
,
Misteilantotis(service or feeder not included) r
t
Phone:(253)3204657 Fax::( ) atoll samitackarta or;nodular 81 84
.2 6
f
. ,
rivrelling,rsmvice and/or feeder -
Email:bdriniels@giveusa.cons
Iteconnect 01119 6754 2
ralun or Plintruirda 6724 2
Business name:Garner Electric Washington,LLC Sign or outline ligming , 67,84 2
Signr0 eirenit(s)or finnasdtmergy see pi 2
Address:6101 NE St Johns Rd 0 I
paneL alteration,or extension, gc. ,
:Each additional inspection over allowable in any or the above
City/StatetZIP:Vancouver WA 98661
' Addition/inspection(I hr ruin) 6625/It
Phone:(253)320-1657 I Fax:( ) Illuselgallon(I t,,-min/ 00.00/8s
78J8/IW
Industrial OlanI(1 lir rnir0
Smolt bdanielsggigwensa,con:
... illsiluutinnt kr which nu fee is
CC/3 LIC.: C1158 Electrical Lie.: 208174 Sum.Lic.:44968 s4eoia4allY listed(WM min) t
r-1 i_ i
story.Electrician smnature„required: k 40 r1 jae,,,c....L. subtotal: '
I
print name:Joan P Albert ' Data;aj jkt.r) CI Plan Review Required(2$16 o(permir fee): :
-- Slate sumbarge(12414 orPefetitifee): 4'
irr...
Authorized signature: / , •- . ToTALpERtIse
Print name:Bill Daniels i Thil PIThilt RPPlicittieW oreleY Ir 11 11%11,114(2*et°-ht4i6e(11441"lea
Date: It alt. 11S depi after frhes Veen iceipted as complete. '`'
I
'
, ' Norebe(of imptelientellessod per penniL
_
InananaguaneastaLn aensattro_ntA ElLa-der Rea Wet laot$ 4atae%151(11thile014/11.20
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Plumbing Permit Application
Building Fixtures 1 t,,,z,.. v rI
Roceiveil Permit NolliSre,20/6...1,0/e ci
City of Tigard FEB 0 3 2016 Data/BY:
31 ...a 0 13125 SW Hall Blvd.,Tigard,OR 97223 man Review
4 1i: Phone: 503.718.2439 Fax: 503.598.1160-i ,, • - ,•, -!.,. DY: rpay.
I FA sat
inspection Line: 503.639.4175 D Other Pezmit:tio.:
..,‘"F. s, -14: Isis: See Page 2 for
tietirmeoin.d, Sit..lententilinfoTni on
1 i i•1 P.D Internet •www.tIgard-or.gro: .... --.7“ t.
,,,..,,,., ,,,. -1,7.....;,- ,,,,,..,„-t" . ,,'-ie„'',:) ::, g.. ,,,'..",,,,1114.4*:it -..4,.74,2-4N-,? 5...P.t-'1A,,,,, 'VA,'- -.,.',144:,,:.. : • . .ecktist
For special Anformatzon use at
....I Demolition
IIII New construction Description I Total
I Qty. I EL
1111 Adon/alteration/replacerne.nt U Other' New 1-2-family dwellings(includes 100 It for each utility connection)
31230, • ...-- .•- • - s... gpR(1)bath
.,....: •.t. ' •,,i,,-g.1 '.^. ';',.,.,.;%I. '4'4547mir4.14r3n3q=s:*,1",* :',4
SFR(2)bath-.1..,..%:,,,z,..,IEW IN",:2,1,V.I...•`',..V-'7"''''''''' ' ''''' .'" ' 437.78
II 1-and 2-family dwelling Commercial/industrial
SFR(3)bath I 500.32
UAccessory building II Multi-family Each additional bath/kitchen 25.02
CI-Master builder
0 Other Fire sprinkler( sq.It) Page 2
Other
Site ut .
ilities.
; -,:-....,„-. ..0,....r..•oik.,4-h.',:fitts.."..t.:41.1-ita,,, .1,,..-.--4,1V, .... -,,,t-lty...11vz..,*--U,4+, ...,.---. - Catch basin or area drain
If.:`;.r.:k.",.--1•41:411,--°..":=‘,Y•/1i .Iii.fin'-'1„,.*`:•:. ";`'‘""o',....--',-^' '''''-;." ' , - p18.76
Job site address: 1 n)?3L0 8 'IliDnjwcll,leach line,or trench drain 18.76
` J 1
City/State/ZIP: -i\s2aki--r ,, e--4-23, OK (A -k0
1\
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name: a \,J-€..(f - froce ix)) rieufacti:ed home utilities 50.03
18.76
Cross street/directions to job site:
Rain drain connector 18.76
SanitarYsewer(n0(7lincat it:i--3Page
.linear
fl:--- Page2
Stormsewer2
Water service(no,linear ft:_) Page 2
•Lot o: g
-i- Future or item:
Subdivision:
Backflow preventer 3 L27
Tax map/garret no.: Backwater valve 12.51
- .,„•..-,.•-.-,-,,,,,,,4,..,..:,,v4--A•11,,,--:.---wAmli,ttfi
t:i.:'':;:Z-,ATY,II. ''',.111;:z'fIZ::g.r:-t.7'.7mz,•=111%''''7,:i4.211,1t,-- 7170,..,..1-'72::67,t.17;3141r"'::4*,11:::-4.4*:'*.5''.4tr445•4*/ **:.: Clothes washer 25.02
'Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25M
12.51
- -e k ;-k,-**,,-.4.4--.4., r-,..„., ,-:•,.,- ,.-,,,,,...m..:,,,,,,.24.0.4 Expansion tank
p...•,-:..... 4,-.7-tfie'r.:A...:-•0-''emzlati•;A*.t,11c-'41,',•,7.71.11._47Xtk.z.c*„.•-$7,,,It-;,141:,*-,ti„CA1,04.-e A--,--14
,..,,,,,•,..„....„...,tAri:_ ......-.4 r•,'S i-Z-.i,...'u j,:k.,z,,,,,,,,,,,,i,U.tr..i.e%"1"2^..- ......4,-i,m' . pbaumiccsvcr cap 25.02
Name: PC)\ VL-)1 .- Floor drain/floor sink/hub 25.02
Addres.s: , r ‘-»+*\ N- Garbage disposal
- 25_02
25.02
Ice maker
Phone: 0. •q - 1.19 Fax:( ) - - ' ,'' A-- hnerceptorigrcase map 15.02
Page 2
i'-' ,r7,1-,.7-,,. ..‘.---4-S.-Ir',4":::,,,!..'”,:,,,,s:...• ,r,: . „ .. ....., < ,
BinindSZ name: v.-L4 V...4-y-tt )i k..L....nr• Vi VA t) .•k„,...-C primer 12.51
Culnact name: NI(4 v1/ V.-Y-1,1c-X-4.Y-1 Roof drain(commercial) 12.51
Address: _it> 2)1,-.1_ 1`).ji C., Sink/basin/brvatorY 25.02
Slar uni (potable water) 62.5
cl--)os.D
CitYCity/State/ZIP: e-ci-e.s1-1,A-1.A ots 4
12.51
Tub/swer/shower an
F'hone:ell ) SCA, ' %I 5-3 Faxhop
( ) 25.02
- Urinal
E-mail: K.. . - .50 r cthil 4.00 94.4I . 25.02,IIt7)1.1-N...,...,••
• ,.- -,Pz.A,T, ,.., ,k.,,!.,-D.,-,r:‘''--4,-3:4:•.1':43** 5i;,i',•trfnZ-.754,-..V4'.Tilii.: ;.;',7i1:iT.:tZ-lir:-14t*A-ift:;41. wata hcata 3'1.52
:14.:•:'?if.".-5;iP•11-.4?-"*:':';47..:Jr;f:27::ty-e.,T..-*-.,..?...,,--,,,-4,,,,,...-,-,-- .
t-e.
Business name: 14.1-.1-4 r 11 A-y-4,-A." P(tA IY4A1 te) t, ._., Water piping/DWV 56.29
Address: 0 GD-1- 13-iz Other:
City/State/Ea al-c.,•sha..",) CPR_ 974:-ZO Subtotal
Phone:(911) VA., -4314-6 FaX:( ) Minimum permit fee: t72.50
Plan review (25%of permit fec)
CCB Lie.: IPlumbing Lie.no I 1.0.32-
D Co 4 . PeState surcharge(12%of permit fee)
' '
it..,2-,,,
,
Authorized signature: /
i This is avocation capicca tie permit
hitt 188 days
. _
I Print name: Ma_IX 143r-u cr ito1A-‘1, I Dt4i 'P-- 1 after'it has been accepted as complete.
*Fec methodology set by Tri-County Building Industry Service Board_
440-4416To inZCONINVEB)
1:1EtuailinecrmitesPLMU-PcmitAppAuc 10/0E/09
Mechanical Permit Application_ . , R i d l 0R t}1 I It 1: 1 • _(}\1-\
City of Tigard .h , . Recent/
- 13125 SW Hall Blvd.,Tigard,OR 97�.23 Ran Review Qther Permit:
Phone: 503.718.2439 Fax: 503.598 19611 c r pi ?016 �y'
huiv t Si See Page 2 for
« ) Inspection Line: 503.639.4175 Rate Rcady}f3y:
Internet: wxw.ti rd or.eov '-,'",-!',,'„`-'1•D Nwif ed'Methad: Supplemental Information
ga i' nt. F
,. its ` �}
a .v., x. .. _>. .. ... ,..,�,z.
..: Mechanical permit fees"are based on the value of the work
El New construction 0 Addttton/altetatton/R.•placement performed Indicate t€ie value(rounded to the nearest dol lar}of all
Other. mechanical materials_equipment.labor,overhead.d.and profit.
DemolitionValue:S
,kp . „t`e "X' .4-;a":V " 4` 1 ' �. s..�.; --
y��.�"'�� '3�l�C�t^���1 �H� � � il€ � � sa � �.�:�i r
;'`:?'a.vs'::wok
1,0 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For sped information use checklist
0 Master builder 0 Other: Description Qty, Ea. Total
[{Multi-family _
.. . .r ` :i" k i Heattagkwitug:
x 46.75
,rt „ n, ..��` .,t,... � . e: •�; �:.. Ait cxxtditioning
Job site address: 9 VI() 1�?(� iJry� Furnace 100.000 BTU(ducts/vents) .) 46.75
City/State/ZIP: 6s �` Oc L Furnace 100.000+BTU(duc stv nes) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:River Terrace f 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
Fluetvent for any of above 23.32
(( Other: 23.32
Subdivision:River Terrace . Lett no: �' Other tact appliances:
Tax map/parcel no.: Water heater 23.32
332
- ;` Gas ftreplacrJinscrt
u �;� :' �, )1§1,1,'' „ i”
. � ,• >«* � Flue vent for water heater or gas
HVAC I fireplace 2332
Log lighter(gas) 2332
Woodlpellet stove 33.
39 7
Wood fireplacelinsert 23.32
Chintne ilincrffluetvent 23.32
Other
$ �T c ,, r s .> Z � r.
s _, ,, ;. , ....,..'''''''''.44 , ` Environmental exhaust and ventilation: ,
Name:Polygon
Range hoodfothet kitchen
equipment 3339
Address:109 E I3o`St.Suite 200Clothes dryer exhaust 3339
.. . Single-duct exhaust(bathrooms.
Cit}€fStatefiZlP:Vancouver,WA 9856{1 toilet compartmcnt5,utility rooms) 23.32
1
I Phone
(42585-77v 00 Fax ( ) AA*tc/crawlspace fans 2332
•
2332
i
Fuel piplug:
Business name:Apex Air LLC .
SI4.i s for first four,$4.03 for each additional
Contact name:Stud"Hay Furnace.etc.
Gas heat pump
Address:2218 W.Main St.Suitt 107-272Wall/suspended/unit heater
City/State/ZIP:Battle Ground,WA 98604 Water heater
I Fax:':(360)326-1769 F"trcplae e
Phone:(3E0)34Z-81.09 _ Range
E-mail stacih®apexairca.cam Barbecue
�o- a . - ''''3,..4
3 clothes s
., ;atee � t. drper(gas)
fr
Business name Alun Air LLC pct i tay 'i � r ere „:; 4 ,, 3
Address:220 W.Main St.Suite 107-272 ; Subtotal
Iflittiitttrrtt permit fee(WAS)C
City/State/ZIP:Battle Ground,WA 98604 Plan review(25%of permit fee)
Phone:(.360)3424109 1 Fax::(360)326-1769 State surcharge(12%of permit fee)
- TOTAL PERMIT FE) .. --- -
CCB No:203t134
Thin permit apprication.expires if a permit is net obtained witioia 180
days after it has nem accepted as annotate.
Authorized sigtiatnr 1
a Foe methodology set by Tei-Camey Building industry Scrsiec Boatel
tom' E= t _ I Date:1128/2016 S t
Print name:Steel bayf
I+13n4efi4441/447etits Pamir 1pp 64a t 13 dos ....... 4-V4 4617 T(t tio:trOMM)WEn)
It,
City of Tigard
IN
N COMMUNITY DEVELOPMENT DEPARTMENT
: .
T I G A R D Building Permit Review — Residential
Building Permit #: #7.S.7;217/6_, — 00 3 g f
Site Address: 133 C., ,f_.>k,J So_-1-5 t.n i I.4. A-t,Z-
Project Name: v e.' -T (raw N&,-K.,w4.s 4- Lot #: 7a
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: Ne ,.„ d -4(CJttd Sr 2
,T Verify site address/suite# exists and active in permit system.
[ (River Terrace Neighborhood: ❑ No f k1'Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
, hree(3) copies of site plan ,Existing structures on site
1Vite plan must be on 8-1/2"x 11"or 11 x 17"paper ootprint of new structure(including decks)with finished
*Drawn to scale(standard architect or engineer scale) floor elevations
, North arrow Niltility locations(required for new,may apply for additions)
tte address,project or subdivision name and lot number
ation of wells/septic systems
sr pplicant information(name and phone number) ,xisting trees to be retained with drip line,and tree
. Lot dimensions and building setback dimensions protection measures
.ot area,building coverage area,percentage of coverage and ErStreet tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) [ftreet names
[
operty corner elevations (2 foot contour lines if more than
foot differential)
Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified ..V.-No Received: ❑ Yes ❑ No
.Public Facilities Improvement (PFI) Permit:
Required: El Yes,applicant was notified ❑ No Applied For: 'Yes ❑ No,stop intake
8rLand Use Case#: P D R c 6 — C i1G iS 1 5 P 2u k ms — UC? au
RI Zoning: —1 4- R l
Required Setbacks: Front >i '' Rear 1 0 Side .:3 Street Side Garage 3o
Landscape Requirement: C) %
G'Lot Coverage Maximum: 8 Ci %
Building Height: Maximum Height N/A Actual Height
Visual Clearance
Easements
'Sensitive Lands: ❑ Yes No Type
Urban Forestry Plan
❑ Conditions "Met"prior to issuance of building permit
otes: Co, t A, a il 5 ±±4c'1 .-4r 3 ) 511;, c,-, a s nu+ 1,/v2r-1- , lkk k hc rnt i.-
?ri of -iv per'rn1 k' 1 SSviuuiC .
Approved By Planning: ed t,� 6 e„..,..,...„ Date: 1 -/q -,1,,
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_091216.docx
Building Permit Submittal
Original Submittal Date: a/r(v
Site Plans: #
Building Plans: #
Building Permit#: Er-Enter building permit#above.
Workflow Routing: Er Planning Engineering B'Permit Coordinator Building
Workflow Sign-off: Er 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
riginal plan review routing form.
Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date:y�, i /�
Engineering Review
Slope at building pad:
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ❑ No
Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No
LIDA Facility on lot: ❑ Yes ❑ No
❑ NOT Approv Engineers : Date:
Notes: o�e19 �i yl/1 d Plot' 4
Approved by Engineering: /IL ,D Date: /,p_1l /
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
❑ Approved,NOT Released: Date:
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:
SDC Fees Entered: Wash Co Trans Dev Tax: ki Yes ❑ N/A
Tigard Trans SDC: Ni Yes ❑ N/A
Parks SDC: it Yes ❑ N/A
OK to Issue Permit p k `SS�� f- �,,.(-3.(-S (.0,4 —t
Approved by Permit Coordinator: (°„kes
QCa'` -,, Date: '4 (0 -1 - l lP
I:\Building\Forms\BldgPermitRvw_RES_091216.docx
S
City of Tigard
'I COMMUNITY DEVELOPMENT DEPARTMENT
r l G A R o River Terrace Building Permit Review Addendum
Building Permit #: /7,577 /6, - '3 cP j
Site Address: 3 3 &L.: S 1-->-,4L._
Project Name: r' Te n-ac.t c;Je s#- Lot #: 7 6
(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 façade that has 30-60 ft. of frontage.An additional
element required for lots with over 60 ft. of street frontage shall be provided every 30 ft.
Porch min. 5 ft. deep Balcony w/ access 2 Window Projection Vertical Wall Offset a Gabled dormer
ft. deep min. 2ft., 5 ft.wide min. 2 ft., 6ft.wide
[ ' ❑ El ❑
2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
cI
Percentage Shown: /3 /o
3. Entrances:At least one entrance must meet both of the following standards:
�y Parallel to street,angle no more than 45° from street,
LTJ Max. 8 ft. setback from longest street- facing wall
or open onto porch
Entrance opens to a porch: [VYes ❑ No
If yes,all the following apply: 01-25 sq.ft. min.
.kr One street facing entry E 12 ft.max.roof above floor of porch
,.1?"-5 ft. depth min. 11-30%min.porch roof coverage
4. Detailed Design:All buildings shall include a min. of five of the following elements on all street-facing façades:
R Covered porch min. 5 ft.wide x 5 ft. deep ❑ Recessed entry area min. 5 ft.wide x 2 ft. deep
lErWall 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 f Gable,hip or gambrel roof design
❑ Roof pitch oriented south min. 500 sq. ft. '."Horizontal lap siding min. 3-7 inches wide
❑ Accent siding min. 40%of street façade ❑ 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:
No closer to front or side lot line,than longest street-facing wall. EYes ❑ No. If No (Check one):
❑ May extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch.
❑ May extend up to 5 ft.where the garage is part of a two-story building and there is a window at the second story
above the garage that faces the street with a min. area of 12 sq.ft.
Width: (Check one)
❑ 12-foot-wide garage door "40%max. of street façade
❑ 50%max. of street façade with 7 detailed design elements
Notes:
Approved By Planning: N1 e (`a.f,, ;- Date: q - j 9 k,-)
I:\Building\Forms\BldgPermitRvw_RES_RT_o62216.docx
Plumbing Permit Applica Ci IV
Building Fixtures
City of Tigard NOV 3 2016ReceBy. I� T ifPermit 1444 S1 6th41,_Op3
•111
13125 SW Hall Blvd.,Tigard OR 97223 Plan Review '
eil
I Phone: 503.718.2439 Fax: 50v2'1ispeUFTIGARD Date/By: Other Permit No.:
Inspection Line: 503.639.4175��yy Date Ready/By: Judy. H See Page 2 for
I I c I:n R 1 NC DIVISION lady Y•
Internet www tlgard-0r.gov U.L I T13 NohfiedlMetbod Supplemental Information
TYPE-OF:Wt7 -i,.7.,:•-- - FEV BC NRDV 1
®New construction - 0 Demolition For special information use checklist
Description I Qty. I Ea. I Total
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION' SFR(I)bath 312.70
®I-and 2-family dwelling 0 Commerciallmdustrial SFR(2)bath 437.78
SFR(3)bath 1 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler(_sq.ft) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: / 338C00 )Vs SUM 1( {, 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/bldgJapt.no.: Project name. 1A1 7 erfZ1CG AAA Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear R:_) Page 2
Storm sewer(no.linear ft: ) Page 2
'v 7 value iJ�u)(,� 1 l) Water service(no.linear ft.: ) Page 2
T/
Subdivision:I / Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Cor vOL b `pYiO le- Dishwasher 25.02
1 Drinking fountain 25.02
Ejectors/sump 25.02
®.PROPERTY OWNER I 0 TEiVANT Expansion tank 12.51
Name:ADVL Land Holdings,LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:7600 E Doubletree Ranch Road
Garbage disposal 25.02
City/State/ZIP:Scottsdale,AZ 85258 Hose bib 25.02
Phone:(602)694-4031 Fax:( ) Ice maker 12.51
®.APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:William Lyon Homes,Inc Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Angela Grajewski
Roof drain(commercial) 12.51
Address:109 East 13th Street Sink/basin/lavatory 25.02
City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54
Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51
E-mail:Angela.Grajewski@polygonhomes.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:Malmedal Enterprises Inc. WaterP•PmP�t WV 56.29
Address:PO Box 207 Other. 25.02
City/State/ZIP:Banks,OR 97106 Subtotal
Phone:(503)324-0759 Fax:(503-)324-0580
Minimum permit fec: $72.50
CCB Lie.:102535 Plumbing Lic.no.:34-276FPlan review (25%of permit fee)
34-276F13
State surcharge(12%of permit fee)
Authorized signature: C____ c: ' TOTAL PERMIT FEE
Print name:Carolina Malmedal Date:04/25/2016 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:\BuildingtPemits\PLMU•PermitApp.doe 10/01/09 440-4616T(10Po2/COM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13386 SW SATSUMA AVE, BEAVERTON, OR,
97007
Record Type: Record ID:
Residential - Master Permit MST2016-00389
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
FA I L
Comments:
Remove screen from dryer vent. M1502.3
Seal floor in mechanical room chase. R302.5.3
Secure and level AC pad. M1401 .4
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13386 SW SATSUMA AVE, BEAVERTON, OR,
97007
Record Type: Record ID:
Residential - Master Permit MST2016-00389
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor