Permit 114 ,� CITY OF TIGARD �� ER
1e . COMMUNITY DEVELOPMENT ; taws
Permit#:MAMST2016STER P00025MIT
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/13/2016
Parcel: 2S1080001504
Jurisdiction: Tigard
Site address: 15402 SW SEINE CT
Subdivision: POLYGON AT BULL MOUNTAIN Lot: Multiple
Project: Polygon at Bull Mountain, Lot 52
Project Description: New SF. 6/13/2016: REPRINT to reduce bathrooms from 4 to 3. 8/4/2016: ADD sump pump for
storm water. 8/25/16:Add heat pump. 10/11/16: REPRINT to add 4th bathroom.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 4 First: 1518 sf Basement: 826 sf Left: 5 Parking Spaces: 0
Height: 32 Bathrooms: 4 Second: 2144 sf Garage: 735 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 4488 sf Value: $548,864.77 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 6 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 1
Drywell-Trench Drain: 0
Other Fixture Units: Sump pump for storm water
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 6 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 8 201-400 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 4488
Owner: Contractor:
POLYGON WLH LLC POLYGON WLH,LLC Required Items and Reports(Conditions)
109 E 13TH ST,STE 200 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98660 VANCOUVER,WA 98660 2 A geotechnical repor is
required before the footing
PHONE: PHONE: 360-695-7700
FAX: 360-693-4442
Total Fees: $37,646.50
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OA- • -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.
g 0 / /°L/�f}-/�7L1
Issued By: ' � ' / Permittee Signature: N
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.
FOR OFFICE USE ONLY—SITE ADDRES : A)L&= hS ��`" f
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
Tran mit
s tal Letter
1 t to n It t� 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Tom H. DATE RECEIVED:
DEPT: BUILDING DIVISIONRFCPa
rrn
FROM: Angela Grajewski 0 C T 2016
COMPANY: Polygon Northwest 111 1; a.."w; ' :3 /
PHONE: 971-212-2144 Bl
RE: 15402 SW Seine Ct MST2016-00025
(Site Address) (Permit Number)
Polygon at Bull Mountain Lot 52
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
0 Additional set(s) of plans. 3 Revisions: ADD 4th Bathroom
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.
0 Other(explain):
REMARKS: Please pay fees owed with Trust Account.
Home owner upgrade.
FOR OFFICE USE ONLY
Routed to Permit Technician: Date:i — j j Initials:
Fees Due: F3 Yes El No Fee Description: Amount Du :
nS'L ,' / /A ) $ 90 , ere
/ 1� "lir✓ $ y,'. IU
/qr y $ Zs
t' FFR (
Special / '1e 34". sr
Instructions: 7-D7-h"-Z- o /P?, /r
Reprint Permit (per PE): Yes ❑No An Done
Applicant Notified: 47161 --- ate: /6/////6 ,l Initials:
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
- CITY OF TIGARD MASTER PERMIT
1111
COMMUNITY DEVELOPMENT4 Permit#: MST2016-00025
1p � Date Issued: 04/13/2016
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S1080001504
Jurisdiction: Tigard
Site address: 15402 SW SEINE CT
Subdivision: POLYGON AT BULL MOUNTAIN Lot: Multiple
Project: Polygon at Bull Mountain, Lot 52
Project Description: New SF. 6/13/2016: Reduce bathrooms from 4 to 3. 8/4/2016:Add storm water sump pump.
8/25/16:Add heat pump. 10/11/16:Add 4th bathroom. 10/21/2016:Add NC&2nd water heater.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 4 First: 1518 sf Basement: 826 sf Left: 5 Parking Spaces: 0
Height: 32 Bathrooms: 4 Second: 2144 sf Garage: 735 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 4488 sf Value: $548,864.77 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 6 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 2 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Drywell-Trench Drain: 0 Other Fixtures: 1
Other Fixture Units: Sump pump for storm water
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 6 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 add'I 500 sf: 8 201-400 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 4488
Owner: Contractor:
POLYGON WLH LLC POLYGON WLH,LLC Required Items and Reports(Conditions)
109 E 13TH ST,STE 200 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98660 VANCOUVER,WA 98660 2 A geotechnical repor is
required before the footing
PHONE: PHONE: 360-695-7700
FAX: 360-693-4442
Total Fees: $37,785.88
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 throu•h OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or
1.800.332.2344.
Issued B • `~A • Permittee Signature: d� �/ (?.49'770'v
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
'" IVIeehailical P rnit ApplicatiECEIVE , f()Rt}FFII [ t S.1, 11\1 `F
City f Tigard Received „1 ,a t3arr13y, /e i "P t'rttaaif.5isiv "T e/6 --P0401.5
131'2$SW Ilan Blvd„ SEP 2 0 2016 Plan Review
Phone: 503,718.2439 Fax, 503$9&t960a ab. Ofihc Permit:
I t ,A it l) lnspeopictn 1 rare. :,*t13.639. 175 CITY OF T IGARD
attF �.�� '13�: ham. Paz tyre
lriteruet. Yassw.tigardor,gov UIL(�IN(= niv��sr- NonfodIsic nd. S�i riementatInto matron
9 ._L_.
TYPE OF 1 (DR}i COMMERCIAL FEE SCHEI}ILE- USE CHECKLIST
Mechanical permit fees*are based on the aalue of the~nark
* New construction 0 Addttion/tlter t ntreplaeemeilt perforrne4,Indicate the value(rounded to the ueAreatdollar)itfall
Q I)erttoikiarn 0 Other meebattictal materials,ctpu ttmeni,labor,oierllead,and profit
Value:$
CATEGORY OF CONSTRUCTION
RESIDENTIAL E QUIPMENF/ YS EMS FEES*
Cl I-and 2-family dwelling 0 Commercial/industrial 0 Ac cessstry building ForYpecial anfnrmuriun uye ekerittax
MUiti-ranliiy 0 Master builder0 Other: t'3t�scrf iprion t . j La. Tvxtai
JOB SITE litiPO*MATIO1N AND LOCATION stip. iaiin_t
hitt site address ICDLDZ, 3w Sei k _
Air conditioning 46.75
�. Furn e 10000 l F3"1't i gai t„%vents) j ,, 46.75
City€State/ZIP:Tigard,OR 97224 Furnace ce 1tR3 ' BTU iducts,yerato 54,91
Heat pump 61.06
SuitCIbldgJ rL no.: Project name:Polygon et Bull Mountain
3 13uet Mark 23.32
Cross street/directions to job site; Hydronae hot Ismer"system 23.32
itesidential boiler(radiator or
hydronicl 23.32
tc fait heaters("ue(type,not electric),
lo-wall,in-duct,suspended.etc. 46.75
Flueivent for any of above 2332
Subdivision:Polygon at Bull;ltaanrftatn l.ot no..: S2 _ .. 11-.32
Other fuel appliances:,
Taex map/parcel no.: Water heater . . 233.'
DE.SC#RIPTIOi OF WORK Gas fiiepalacedusert 3339 _ _�
aril'
y_ �l�v1�,(, I rue vent for water heater or gas r. 1
a IU/ fireplace" 23 32
�c Log lighter
�teasp 23,32
Wood/pellet stove 33.39
Wood Omplaiselinsert 23.32
ChituneyilinertflueNent . 2132
"' PROPERTY OWNER Other23.3?
TENANT
tiA VT Ensirmtmi ntaI exhaust and ventilation: - 1
Range hood'other kitchen
Name:Polygon WIC,LLC equiprrncnr ... 33,39
Address,10East 13 Street
, Clothes dryer exhaust 1 33,39
City/State/Z1P:Vancouver,WA 9114 Single-ductexhaust(hathro€furs, ' I
toileta ompartments.utility rooms) `-1 23.32
Phone_(360)69S-7700 Pax:( 3 Attie`i ruialtpaace fans 23.32 •
t APPLICANT ' 0 CONTACT Puts(#'ii Other. 23.32
Business name:Polygon% LII,LLCFuel piping:,
514.1,bait nest pour;S4.63 for each additional
Contact name:Angela Grttjewski Furnace,etc.
Address:109 But 13th Street flits heat pump " 1111111
alp/stasta- del/unit beater
City/State=L1P:tianeotra er,WA 98660 Water heater
Phone (360)69S-7700 Fax: (360)693-4442 Pi
E-mail;Angela rajs ki';piilygorfitrr s•a.ttrrn
Barbecue
�
CONTRACTOR Clothes d er gas)
Business name:Apex Air LIC. Other
NIECILANICAL PERMIT FEES*
Address: 18004 NE 72'4 Asc.
Subtotal
City/ tate iP:Vancouver,WA 98666 Minimum permit f (890.00)
Plan review(25%of permit fit) 1
Phone:(360)3424109 Fax (360)3261749 State surcharge(2%*of permit lee)
CCB lie.:203034 TOTAL PERNIIT FEE
Lids permit application times if a.penult is list K utero titn
days sfterat tray here accepted asymptote.
Authorized signature. - Fie meth stmt
3`yta by Tri-Cotaitay Building Industry Senior karst
Prim name:'""" Date: 4>I°f•1t;�
s:t3'a.=r_.irr„i klf i 'woutApp 401114 .... 4t "T,:.:" d`f)tt TO`fi
picvtricitl rertntt Application :--,,,7.::-,,,---'...,,-- ‘-. F::::1-, I (MA)! I R I 1 sl ()NI 1
City of Tigard
13125 S%* Hall Blvd.,Tigard,
Phone 503 7181439 Fax 503,598.1060
vat
Data•
°R 97223 SEP 1 '..) 2016 Plan Review Ptimtl 4 ka.41( ,..0 0• 6 4 07,5
mien, Related Permit 0
llinispeclion Line' 503.,603r9;(1,Iv 75 c fry oi:.-. ,,,:4„,„,,,, :lead,'DateSy 'Mil See P:gett,21 Lair
II
p '': nr fis,„r.,; atifiedltiethod
l:CC.:1 ..:..-.11'T-alL2j:•:"- :14,11ti".,71.t. ..,.. ',:'."::;;,,:...:
S:4 New construction 0 Addition/alteration/replacement ' Please cheek all that apply(admit;sets 0'Plans aaeltas checked)
0 Service or feeder 400 amps or more 0 Makin*over ftet stones
0 Demolition 0 Other: where the available fault current 0 mwsuu and henrys*
i' I:7,7,:,'';.: ',1..,3.1,..i.7 f• '' '1'. . ..',! 7"... ..': . .,';-,','::::.;,:;7.-f•-•'''''.:4".i.,:771,':iregiganirst=7;;'1:':. exceeds 10,000 mugs at 150 volts or 0 Floalti8 buildings
0:4 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building iess to ground,or exceeds 14,000 0 Cianmercial-use agriculneal
amps for all other ineallaions buildings,
El Multi-family 0 Master builder 0 Other: 0 Fire pump 0Installation of 150 KVA or
8 Addition new of load of isystem
Job#: Job site address: 1 9402 d uu SG(ielc a 100HP CW'nIM 0"A","E"."1-2","1-3",
0 Six or more residential units occoPancY
City/State:2M Tigard,OR 97224
0 Health-care facilities 0 Recreational vehicle parks
Suite/bldg./apt#: Project name:Polygon at Weet4t.ilver—Tertaziw I I 0 Hazardous locations, 0 Supply of',. :e for more than
1 0 Service or feeder-600 amps or more 600 volts nominal
Drsrrlpdss Cross street/directions to job site: irair Fo.,,,,-.z4zgizoilv.r... ,',77-7,-,:'...'LlkingfliME7
(21.7. Each Total
New residential single-or multi-family dwelling unit.
Subdivision: Polygon at West fther-T-ermtv?")ult rain ,_ Lot#: 5 g... Includes attached garage.
Tax map/parcel#: 1,000 sq.ft or less 168,54 4
:.:272i.r,....:1 Th.:,,Tm177,,;: ',' ,' .,:••:i,...1.:.2...1:..4..11/ ' '..7r ,-.51...'...`7,L311'.4,:: :-.' :''S.,:::•• ;4:4:'.,C0'.-. Ea.addi 500 sq.ft.or portion 33.92 1
41 Ph d or . ftfcc Limited energy,residential
(with above sq.11.-) 75.00 2
Limited energy,multi-family
75.00 2
::,i,17-•..,;.:::::•-.7.•,",„., :,.-', •;:,,-,'i.7.2.t..79•4::.,,,.•, -;;;;E:Ez:,i,,..:::-. ...-...
Name:ADVL Lan. Holding LLC
Address:7600 E D ubkt Ranch Road Renewable Energy 0 See Page 2
1 Services or feeders installation,alteration,and/or relocation
‘Ir 200 amps or less
100.70 2
City/State/ZIP:Sea •. e,AZ 85258
201 amps to 400 amps 133.56 2
Phone:(602)694 . 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 of volts 55/26 2
Owner signature: Date:
,....,, ,„.-,,,.._ ,,,,-••••,...,,.„„,„...„.„....,,,,........„„„,.,..„,„„.„..„.„ Temporary services or feeders installation,alteration,antifor
_',„...::4„,.,_,,!-e.92'.-:.1..',. ' '1,,'''-'77 Z4.1";:t!:'.:17• ,s,, .......' ',.,...',!„,' •..;L..s;:...,!,:k.rlirt,,:sle relocation
Business name:VtiltbrivrbytripMenteorkbe.. 1=i) IA)Lki Lir_ 200 amps or less 59 36 1
I
Contact name:Angela Grajewski
201 amps to 400 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,T panel
Phone:(360)695-7700 Fax: :(360)693-4442 A Fee for branch circuits with
above service or feeder fee,
7
Email:Angela.Grajewski@polygonhomes.com each branch circuit 42 2
;,:J.:1,.:,-,-:!....:'!,-;',77:7: B F"f.:rizt:rt-Tsfir?'"
56 18 2
Business name:slanted*electric branch circuit
Each addl branch circuit 7.42 2
Address:3415 ne 44th
Miscellaneous(service or feeder not included)
City/State/ZIP:11MM Rar/JaiNX/oil /'!" 7.2- 13 Each manufactured or modular
67 84 2 .
dwelling,service ander feeder
Phone:(503)3192192 Fax:( ) „
Reconnect only 67 84 2
Email:solarpdx@me.com
Pump or irrigation circle 67 84 2
CCB Lie.: 199188 Electrical Lie.: c923 Suprv.Lie.: /f 7/.5 ,
Sign or outline lighting 67.84 2
Suprv.Electrician signature,required:
Print name: /C.,k /24,a‘,.."( j V/ ' paSitlil::::::„'Llien:::.0,17v ' 0 See Page 2 2
Date: .-CYZ3," IA° Each*additional inspection over allowable in any of the above
Authorized signature' Additional inspection(1 hr mm) 66 25:hr
g -
Ilrint name: ,' • -. -------. DateS-1.24/14 Investigation(I hr min) - 90 00;hr I
I 4supaetaineernevaILC,PerialtAsei.ELitEXE.doe Rev 06117/2015 440-4615V 11/05/CONVWEB
Plumbing Permit Application
i--,Cr:•-t;
Building Fixtures
City of Tigard ,..,.,..:L, 1 „,,, ,)DIE, ::....Recereed
Perini'No.::
, . . 13125 SW Hall Blvd.,Tigard,OR 97223 ''-'
71 i - t- ) pian::e,riew
: 0,., Phone: 503.718.2439 Fax: 503.5984960,, ,-,,,:, . ,„..:- ., rbieBv: Other perudfNc.:
Inspection 1.lne: 503 6394175 '''':'! ' " :' ' ' ' ' Dateieady/Bv-
TIGARD , him. fa See Page 2 for
Internet www.tigaro-orgov ..:::',"":. :,f: ,1,,'', '''- :: : : ',.,'. •, '''Notified/Method:: Supplemental Information
'
,::::.•.,,.-4,1; ;:.7*.gl?!!.,2%., ,.:;%.: 0",,..!-. ilisii4i-iiiik$1..; .. Vis4, vitfiukiczwitiiiigwP.wFt,-.?::f4,-.
....v.,,,,:...4.::-7,:.,:v,,,.:,,,4:iii:'•:w.--:::,4,,n.';;.:,.. ..,„,.,-;.!,v4:ii„••,„:,7-:.!-.„a ,'::•!:',11,P.:5%y.,:r: ?--.1,„i ,%,,,s,-; .:.il,',, •,'An :. :',, . ,,, ',",:-,;,'? :"'::/.3%,1•:'•
Ea New construction I El DertUdition For special information use checklist
Description I Qty. I Ea. I Total
0 Additiomalteration/replacement 0 Other:: New 1-2-family dwellings(includes 100 ft.for each utility connection)
'2,1,,:';.-1.6.,',•'.'•,;:kil':-,'•:':171'h',:"-,-,f,1" :;:all.:6611-VV:0,,,r , • • , 40,,,,,,,,•2,-,,,r/4 :•.,-•1•,•••••q:, SFR(1)bath 31/70
ED I-and 2-family dwelling El Commercial/industrial SFR(2)bath 437:78
.SFR(3)bath 500.32
o Accessary building 0:Multi-family
Each additional bath/kitchen 25.02
0 Masterbuilder 0 Other: Fire.sprinkler( sq.ft.) Page 2
•kM4:'-','':: :":::?I'' •:•'. 4Oif:SBOORiiikitkir*-i'Coie‘4tiOVF : r',1::'''''Z''''': Site iitillBes•
:' ge:,.,;••:,•,•:,,, ,,•••m,,,•;,..,, ,,.....,,-,,u.t,,, .,.--,••••..--,,,,,,,,z,(.:,:.,,,,,----,,q,,,...'•.,•-:14!):• ••.::i:;::'':-,-. -•••;,:--wJf
kb site address; i .. ..ip,..-Lsw ,serl,,,,, r A.,_ : Catch basin or areit drain 18,76
1 i IL' k-•?k " Drywall,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224
Footing drain(no.linear It; ) Page 2 ' 1
Suite/bldg./apt.no.: Project name:Polygon at BOB Mountain 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 11.: ) page 2
Water service(no.linear 11.: ) Page 2
Subdivision;Polygon at Bull Mountain Lot,no.: "7.._ Fixture or item:
Backflow prevent& 31,27
Tax map/parcel no,:
..„.......„1, ;-i
,...,. ..,.,,,,,,,.:ft,,,,a,,.. .14;ii.. .,,41,41,,bitier:x.:,i*?.7,141;! ,,,...4,1,,z,.. t, Backwater valve 12.51
;I:j'"ALI.-1,,,,,,'.•:, -,ti,;i:'' ,,'WS'-',4Agli";-'.3 ,41: ,,, .77-,. --t, '-' '''', "17-'•''' '''-- -4' '-':'"''' Clothes washer 25.02
k-A97 /4. /71E-7-725X--- Dishwasher 25.02-
Drinking'fountain 75.07
Ejectors/Sump 25.02
i.:0,-**i..ii--***-.,.,:g.,,, 3::!: *::.;,,:;,0:,F,.-4.qvis*4r,,•.,,,.;.,5-.):,:„.4.i Expansion tank .. 1151
• Fixture/sewer cap 25,02
Name:Polygon WI.41.,LLC —
• — Floor drain/floor sink/hub 25,02
Address;109 East 13th Street
.
Garbage disposal 25.02
City/State/ZIP;Vancouver,WA 98660 Hose bib 25.02
Phone:(360)695-7700 Fax:( ) ice Maker 12.51 I
i,t•-:•:,,:,!•::•itt:;•1.7'Y: ,14,0:•!,Fr-,;:„.,:,1!-;:&*:•.:';14:',74,••!4.e....1:1=1:.,-*.0,,kf$F.:$S0,-,:it.0;:`,r:f:'• interceptor/grease trap 25.02 -.
,.„„.......... ...„-, •„:,n..,..., ......, • .
Medical gas(value:$ ) Page 2
BuSinesS name:Polygon Will,LLC
Primer • 12.51
Contact name:Angela.Grajewski
Roof drain(commercial) 12.51
Address:109 East 13th Street Sinkibasin/la.vatorV 25.02.
_ .
City/Stat&ZIP:Vancouver,WA 98660 :Solar units(potable water): 62.54
Phone:(360)695-7700: Fax::(360)693-4442 ,Tub/shower/shower pan , 12.51
l
E-mail:Angebt.Grajewski@polygonbontes:cont Urina25.02
11TE. 1
""•4•.:',,,.'',1p, :,t, 11 .a'-ie:'.:4 ",..'k ..43
j'f-: ,',1>„.4;..''''.. 747.-.V.:::.,:,:.:;i%',',Cia -e
r
:,:- 7, 147tprcloset 25.02
;?.0...--:•;,:',4:-7Wi:''':%',. .,":',;:",,-4-;:i,', ,,:' .--• '::-=,',,,-",2-•::::-:,•'''ke''''Air'r''''''''•4 ;If.''''L'''"': Water heater I
Business name:BDL Plumbing lie • Waterpiping/DWV 56.29
Address:PO Box 85 Other: .25.02
City/State/ZIP:Corbett OR 97019 Subtotal
Phone:(503):351,3903 Fax:( ) Minimum permit fee: $72.50
Plan review (25%anemia fee)
CCB Lie.:180345 Plumbing Lip,no.::P111582
State surcharge(12%of permit fee)
Authorized Signature: 12...t....t...0...,, tiTees TOTAL PERMIT FEE ,
Print name:Brandoni„tioer OM& 811(0 II 6 1 This permit application expires if a pertnit is unt Obtained within 180 days
after it:has,begn accepted as totapiete,
*Fe methodology sot by Id-County Building Industry Service BOO&
I:‘BuildingTermitAPLNIU-PcnaitApp.dcc 10/01/09 440461,6r(I 0/02/CONMEB)
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
IN 5 Transmittal Letter
T-i c_, 1.1) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 •www.tigard-or.gov
TO: Tom H. DATE RECEIVED:
DEPT: BUILDING DIVISION
FROM: Angela Grajewski U u 2 2016
COMPANY: Polygon Northwest a ; s:
PHONE: 971-212-2144Qt1
RE: 1 .1-�,DZ `j'� �jl���'�' 6— I: N' / MST201 0 �-
(Site Address) P (Permit Number) 0`�2--
Polygon at Bull Mountain
(Project name or subdivision name and lot n iiii,Pir
le
ATTACHED ARE THE FOLLOWING ' `1►-:
0 Additional set(s) of pl. 1 0 Revisions: :; .1
0 Cross section(s) and de .its. f 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): Al ditio 2a deck details requested by inspector
REMARKS:
8
Rou to Permit Tec I 1'clan: Date: 1 -- - Initials:
Fees Duel Yes ❑No Fee Description:
�� p Amount Due•
�� 1� � S Pl`� r�v,�,✓ $ X1,5 �a
$
I
f �p
� $
err-s ,tee,, -r � $
Special
Instructions:
Reprint Permit(per PE): ❑ Yes I EA o
Applicant Notified: , Date:
I ❑ Done
Initials:
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
CITY OF TIGARD MASTER PERMIT
t GP/ /( tai0
COMMUNITY DEVELOPMENT Permit#: MST2016-00025
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/13/2016
Parcel: 2S1080001504
Jurisdiction: Tigard
Site address: 15402 SW SEINE CT
Subdivision: POLYGON AT BULL MOUNTAIN Lot: Multiple
Project: Polygon at Bull Mountain, Lot 52
Project Description: New SF. 6/13/2016: REPRINT permit to reduce bathrooms from 4 to 3. 8/4/2016: ADD sump
pump for storm water.
BUILDING
Floor Areas Reauired Setbacks Required
Stories: 3 Bedrooms: 4 First: 1518 sf Basement: 826 sf Left: 5 Parking Spaces: 0
Height: 32 Bathrooms: 3 Second: 2144 sf Garage: 735 sf Front: 20 Smoke
Third: 0 sf Detectors: Yes
DwellingUnits: 1 Right: 5
Total: 4488 sf Value: $548,864.77 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 1
Drywell-Trench Drain: 0
Other Fixture Units: Sump pump for storm water
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 8 201-400 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 4488
Owner: Contractor:
POLYGON WLH LLC POLYGON WLH,LLC Required Items and Reports(Conditions)
109 E 13TH ST,STE 200 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98660 VANCOUVER,WA 98660 2 A geotechnical repor is
required before the footing
PHONE: PHONE: 360-695-7700
FAX: 360-693-4442
Total Fees: $37,202.13
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.
c /
Issued By: < Permittee Signature: c� 1P/0"+LC19"�0-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.
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
irk
Transmittal Letter
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 •www.tigard-or.gov
TO: 1,__>)-1/1. ..• DATE 1: I-Al
DEPT: BUILDING DIVISION
JUL 1 1 2015
FROM: i / / /, Giret3tewSb
f
COMPANY: ��v��4.� P,� �� P � I a��.,� F��I� � e � �y.
PHONE: ?(Q0 --2 (0 0 - 10 3' 7700 I 7700 1 ri
RE: TOte A, -rn a+ .--- (AAA ('JU& Afl. Nsz-a6r(,-„aoa-s—
�. (Permit Number)
157/a ? N-'.- ..Q-4- c i— L67- 5
( rolect name or subdivision name and lot number) )
ATTACHED ARE THE FOLLOWING ITEMS:
bVz
iw
T
Additional set(s)of plans. Revisions:
Cross section(s)and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS: 1 A ____A__, A •1F. ,, __' VOA •ter 'rte.■
'
iii
• 7- - . .4 ii•1. b. .. 'rbc'
/ Ii /, ..i4.e-7-Lc.?n o-cv
Routed to Permit Technician: Date: Initials:
Fees Due: OF es ❑No Fee Description: Amount Due:
• •� , f
S u�/° r° 7° $ c,2,5 ., Oa-.,
7 C7 . 'irk/,y�'�/C'm .t-$ -9. O _
t-e
Special _—___?
Instructions: Carr” a„PO _ -;;;;;Tay.„
Re•rint Permit •er PE : ❑ Yes C No ❑ 1 , I-
Applicant Notified: ,. Date: 7 2P/ , Im ""rr4111P-
IABuilding\Forms\TransmittalLetter-Revisions.doc 05/25/2012 4/A '4
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
15402 SW SEINE CT, TIGARD, OR, 97224
Record Type:
Residential - Master Permit
Inspection Type:
199 Electrical final
Result:
FA I L
Comments:
Tel: 503.718.2439
Inspection Date:
December 6, 2016 at 12:40:00
PM
Record ID:
MST2016-00025
Inspector:
David Young
No power at GFCI left side of island.
Outlets not done or made up at counter space by office/den.
Secure tv outlet by fireplace.
Work not complete, not ready for inspection.
Violation Summary:
Inspector Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
15402 SW SEINE CT, TIGARD, OR, 97224
Record Type:
Residential - Master Permit
Inspection Type:
199 Electrical final
Result:
PASS
Comments:
No A/C installed at this time
Violation Summary:
Tel: 503.718.2439
Inspection Date:
Record ID:
MST2016-00025
Inspector:
Chip Barnett
Inspector Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
15402 SW SEINE CT, TIGARD, OR, 97224
Record Type:
Residential - Master Permit
Inspection Type:
699 Mechanical final
Result:
CNCL
Comments:
Tel: 503.718.2439
Inspection Date:
December 13, 2016 at 8:50:27
AM
Record ID:
MST2016-00025
Inspector:
David Young
Inspection cancelled by contractor, not ready for final inspection at this time.
Violation Summary:
Inspector Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
15402 SW SEINE CT, TIGARD, OR, 97224
Record Type:
Residential - Master Permit
Inspection Type:
699 Mechanical final
Result:
PASS
Comments:
Tel: 503.718.2439
Inspection Date:
December 14, 2016 at
12:51:18 PM
Record ID:
MST2016-00025
Inspector:
David Young
Seal condensate penetration in foundation vent at rear patio.
Note: no AC installed at this time.
Violation Summary:
Inspector Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
15402 SW SEINE CT, TIGARD, OR, 97224
Record Type:
Residential - Master Permit
Inspection Type:
299 Final inspection
Result:
PASS -CofO
Comments:
Tel: 503.718.2439
Inspection Date:
December 14, 2016 at
12:55:48 PM
Record ID:
MST2016-00025
Inspector:
David Young
Contractor raising handrail to permitted height. Installing vent wells at front of house.
Plumber re setting upper level WC at tile replacement.
Final erosion control approved.
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.
Violation Summary:
Inspector Contractor