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Permit (58) 71y„ CITY OF TIGARD MASTER PERMIT ' COMMUNITY DEVELOPMENT Permit#: MST2016 00417 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/27/2016 Parcel: 2S106DB08400 Jurisdiction: Tigard Site address: 17485 SW SABRINA AVE Subdivision: RIVER TERRACE NORTHWEST Lot: 84 Project: River Terrace Northwest, Lot 84 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 978 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1251 sf Garage: 380 sf Front: 8 Smoke Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes Total: 2229 sf Value: $271,716.73 Rear: 10 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 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: 0 Drywell-Trench Drain: 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'I 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-2 2229 Owner: Contractor: ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions) BY FORSUM,MICHAEL 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175 7600 E DOUBLETREE RANCH RD VANCOUVER,WA 98660 2 One Hour Fire Rated Eaves STE 1 Required SCOTTSDALE,AZ 85258 PHONE: PHONE: 360-695-7700 FAX: Total Fees: $32,124.24 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344..23474. Issued By: M7*/- #.2el--1-e-- ,AI � %Permittee Signature: , ',e ` c/ Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application 4, • . L.. O 7 ' a 1/ Residential RECEIVED FOR OFFICE ISE ONLY City of Tigard Received j /��� ,,�y lig " 13125 SW Hall Blvd.,Tigard,OR 97223 c_ Plan Review / 6� Permit N"'/�T �� ©�Qf�7 = Phone: 503.718.2439 Fax: 503.598.1960 S p 1 Z 016 Plan Review `"^vv Date/By: j 0 a0 )C --"}�'� Other PerC2Ne--ifaij Js' T 1 G A R[) Inspection Line: 503.639.4175 Date Read B /J 7uris: H See Page 2 for 7 Internet: www.ti ard-or. ov 'ITY #i t*�ttfi Ready/13y: �G1 g g E g Notified/Method: 4 1L�tlt �11*,�� # 6tt� t ` /�F' Supplemental Information E Ss 6 f$ �-' ��' CEr;S-Si.S�,°� '�.S ty f ,..aa r,;s..� ,814 e ,.,, & .a't.rt k a»,.- ` .....`t �l r�" llV(,7 .. Y. :ate .re, ..>.s:::� a �'<' � x. F' ,s"nr ae'b E �' .T i` � '. �7. '^ �+ M .., �a-k e.mat.,�,s. a;:>: ®New construction 0 Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all 0 Addition/alteration/replacement 0 Otherequipment,materials,labor,overhead,and the profit for the triitWVIV -� i W> Oii aQ� �_ 4"W ` 2 :t work indicated on this application. . .ivm.., "a,Y£„-4 , .n,,,•¢.. _,44'_. a% - `�.; 'nx..Wg `"tea Ems: ® 1-and 2-family dwelling 0 Commercial/industrial Valuation:a-2 iji it.$ 0 Accessory building ❑Multi-family Number of bedrooms: 4 0 Master builder 0 Other: Number of bathrooms: mtmt sst ;..: .._r ��. * '�-� ,. ,e d.s''#r" tt ; '.^-L Total number of floors: /� 0 9 Job site address: ii y9J5 SW S hr"�(vt t\' e New dwelling area: 2Z'' /square feet City/State/ZIP:Tigard,OR 97224 r J ' Garage/carport area: (6D square feet Suite/bldg./apt.no.: Project name:River Terrace Northwest Covered porch area: U' I 1 n I square feet)t,5 I Cross street/directions to job site: Deck area: square feet 9 7 g Other structure area: square feet Subdivision:River Terrace Northwest �"'`"�� --- I Lot no.: Oy 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 s equipment,materials,labor,overhead,and the profit for the �� > - .eiki4A `i`is x3' . ,l ge y a a x, '.' `� II 4.itgigit-. a , !' s" ROg work indicated on this application. Valuation: $ Existing building area: square feet New building area: square feet jr< Wu �* I - � Number of stories: Name:ADVL Land Holdings,LLC Type of construction: Address:7600 E Doubletree Ranch Road Occupancy p y groups: City/State/ZIP:Scottsdale,AZ 85258 Existing: Phone:(602)694-4031 Fax ( ) New: aa� x =r zyerFMAIN a a a:a�., Sys .MV4-orf Alii:.s #.,.IM r4si .H v ��. s.��. k .,e .., - ��,za-.a,:s' r�„.�s,;.-� `•.'�,°: 2 �� .� '. t l�I 4e' ��4 Mnr" ,r ��y Business name:Polygon WLH,LLC €_e ;, _f ., : Contact name:Angela Grajewski Structural plan review fee(or deposit): Address:109 East 13a'Street FLS plan review fee(if applicable): City/State/ZIP:Vancouver WA 98660 Total fees due upon application: Phone:(360)695-7700 I Fax::( ) Amount received: E-mail:Angela.Grajewski@polygonhomes.comN�!M , - 1YT R titkka ` k - ` A ;1/2, t 1 Commercial and residential prescriptive installation of x4, .: .7.x 1,k} "� -�"��� �' *"`� � .,.m ,�-�':0 - w ..,,4,::.�� .�` roof-top mounted Photovoltaic Solar Panel System. Business name:William Lyon Homes,Inc Submit two(2)sets of roof plan with connection details Address: 109 East 13th Street and fire department access,along with the 2010 Oregon Solar Installation Specialty Code checklist. City/State/ZIP:Vancouver WA 98660 Permit Fee(includes plan review and administrative fees): $180.00 Phone:(360)695-7700 I Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60 CCB lic.:207247 ��/�/',/ Total fee due upon application: $201.60 G��J"(A Authorized signature: `�►��, od This permit application expires if a permit is not obtained C within 180 days after it has been accepted as complete. Print name:Angela Grajewski I Date: 0.4ihr I *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Application- F [ FOR OFFICE FSE ONLY City of Tigard Received r/ Date/By: Permit No. -r f6 eW 1114 . a 7 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review gi Phone: 503.718.2439 Fax 503.598.1960 SEP 1 2010 Other Permit: Inspection Line: 503.639.4175 Date Re T 1 G A R D p Internet: www.ti and-or. ov 7 /..�. Date Ready/By: ru�is: H See Page 2 for g g CITY O F 6 �(.ir' H D Notified/Metbod: Supplemental Information BIJILDlN(:° Di\i,, /cN € 1 .;: Z `MM >t;de r r a Mechanical permit fees*are based on the value of the work ®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition 0 Other. mechanical materials,equipment,labor,overhead,and profit T , > Value:$ ,'., : �'ia�ri �� �a �. - -' • ' 32 :".''''%'.,:f`� 1 a Ems, E,;%� .` ; ® 1-and 2-family dwelling 0 Commercial/industrial special building For special information use checklist ❑Multi-family 0 Master builder 0 Other. Description I QtY IEa. I Total �, ''',"'t:•;'';','-:; -- - � ' .�� t �� � :�„ �� a � k : �` i: '" Heating/cooling: . 4'� ''; aY Pte, Air conditioning r 46.75 Job site address: 17ytc Svc S o,,bo e Ne Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP:Tigard,OR 97224 �1 Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt no.: I Project name:River Terrace Northwest Heat pump 61.06 Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above ‘ 23.32 Subdivision:River Terrace Northwest I Lot no.: V Other. 23.32 ! Other fuel appliances: Tax map/parcel no.: Water heater 23.32 4. `l ", r t Gas fireplace/insert I 33.39 Flue vent for water heater or gas New construction HVAC system fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other. 23.32 1 r.. ' is .E t ° t. Environmental exhaust and ventilation: Name:ADVL Land Holdings,LLC Range hood/other kitchen 1 equipment 33.39 Address:7600 E Doubletree Ranch Road Clothes dryer exhaust I 33.39 City/State/ZIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms, 4 I toilet compartments,utility rooms) 23.32 Phone:(602)694-4031 Fax:( ) Attic/crawlspace fans 23.32 '-.1'.,:: , l Other. � ' 23.32 Business name:William Lyon Homes,Inc Fuel piping: $14.15 for first four,$4.03 for each additional Contact name:Angela Grajewski Furnace,etc. I Address:109 East 13th Street Gas heat pump Wall/suspended/unit heater City/State/ZIP:Vancouver,WA 98660 Water heater Phone:(360)695-7700 I Fax::(360)693-4442 Fireplace Range E-mail:Angela.Grajewski@polygonhomes.com Barbecue a . - • �� 3� ��EEss :� ' Clothes dryer(g�) � 'j Eh.was Cwt Business name:Apex Air LLC Other: Address:18004 NE 72°d Ave Subtotal City/State/ZIP:Vancouver,WA 98686 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(360)342-8109 Fax:(360)326-1769 State surcharge(12%of permit fee) CCB lic.:203034 TOTAL PERMIT FEE //� ` This permit application expires if permit is not obtained within 180 ,`./_X/yl/,//�/r/pY(—J '�'///�/y days after it has been accepted as complete. Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board Print name:Angela Grajewski Date:8/22/16 I:\Building\Permits\MEC_PermitApp_040113.doc 440.4617T(11/02/COM/WEB) 1 Electrical Permit Applicat� _ __ IVSD FOR OFFICE USE ONLY City of Tigard Received Pemrit;M T..,2IiC-J -CV//J 7 IN . 13125 SW Hall Blvd.,Tigard,OR 9722 EP 1 2016 Date/B . Plan Review Phone: 503.71824399 Fax 503.598.1960 DaWB , Related Permit II: Inspection Line: 503.639.4175 CITY 0 F 1-1(3AR[) Ready Date/By: lurk: H See Page 2 for TIGARD + Intemet www.tigard-or gov € ea DING r t a Noti6ed/Method Supplemental Information � :.+� . - +v�dc... s -'.'c,�r�s, ._`x,s?]H-..`G` =� .. c.Y'z�.,._... -.1 .*:-.! d'z='�=^C?_�.',�+'�i�^::- -0`r r` .-.....i'��.o^'�m-:'`L,`�'� .-.fi ®New construction ❑Addition/alteration/replacement Please check all that apply(subrnit 2 sets of plans wTttems checked): ❑Service or feeder 400 amps or more ❑Building over three strides. ❑Demolition ❑Other_ where the available fault cement 0 Marinas and boatyards. =' •, *'C�Q ( ,, " ' exceeds 10,000 amps at 150 volts or ❑Floating buildings. ®1-and 2-family dwelling 0 Commercial/iridiistrial 0 Accessory building less to ground,or exceeds 14,000 ❑commercial-use agricultural amps for all other installations. buildings.• ❑Multi-family - 0 Master builder 0 Other ❑Fire pump. ❑Installation of 150KVAor WatiA,i0kbF�.' ._.: TT T __�� 1;T�I�t; - _ -��" 0 Emergency system. larger separately derived of load f system. Job#: Job site address:J� vs SvJ Soteel ) r, ❑lOOli Addition moewmotor oa o IOOi-IP or more. ❑`A",E".`I-2","1-3". City/State/ZIP:Tigard,OR 97224 0 Six or more residential units. occupancy. �� ❑Health-cele facilities. 0 Recreational vehicle parks. •Suite/bldgJapt.#: Project name:. /.�r ',e/1/644(46' �/�r Hazardous locations ❑supply voltage far more than :pi ❑Service or feeder 600 amps or mora- 600 volts nominal ` ✓ ': . Cross street/directions to job site �.. %�^�= :��' Description i Qty. I Earl, 1 Total 1 New residential single-or multi-family dwelling unit Subdivision: .ft r, -r-ete,e, /(/a/40/P(J Lot#:�L4 Includes attached garage. V L000 sq.R or less I 166.54 4 Tax map/parcel#: _� - • v__�5#„T, Fz add'1500 sq.R or portion 3 3392 1 �?��== � -X05a.:_� -.:.i -. ::' .... mss`--= '�' -ay;..-..... �" -=•---�..... ;s...._.'ntt Limited energy,residential (with above sq.ft.) j 75.00 2 Limited energy,multi-family f 75.00 2 residential(with above sq.ft.) _ ,_y Renewable Energy ❑-See Page 2 O E'' - ' - -� `' 04—' ` Services or feeders installation,alteration,and/or relocation Name:ADVL Land Holdings,LLC 200 amps or less 100.70 2 Address:7600 E Doubletree Ranch Road 201 amps to 400 amps 133.56 2 401 amps to 600 amps 20034 2 City/State/ZIP:Scottsdale,AZ 85258 601 amps to 1,000 amps 301.04 2 Phone:(602)694-4031 Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I 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 16854 2 _ � - s _ u.„.,,x -- Q -7 Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name:William Lyon Homes,Inc. above service or feeder fee, 7.42 2 each branch circuit l Contact name:Angela Grajewski B.Fee for branch circuits without service or Address:109 East 13th Street branch cuit feeder fee,fust 56.18 2 1 City/State/ZIP:Vancouver,WA 98660 Each add'1 branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(360)695-7700 . Fax::(360)693-4442 Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email:Angela.Grajewski@polygonhomes.com Reconnect only 67.84 2 _'. ti '� ..ii,r i' -:.4-7_,: ' _ 4,2 '".„ Ptnnp or irrigation circle 67.84 2 Raciness name:Garner Electric Washington,LLC Signor outline lighting 67.84 2 .r.,: Signal circuit(s)or limited-energy Address:6101 NE St Johns Rd panel,alteration,or extension. ❑ See Page 2 2 City/State/ZIP:Vancouver WA 98661 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 6625/hr Phone:(253)320-1657 Fax:( ) Investigation(1 hr min) 90.00/hr Email:bdauiels@gweusa.com Industrial plant(I hr min) • 78.18/hr Inspections for which no fee is 90.00/hr CCB Lie.: CI158 Electrical Lie.: 208174 Suprv.Lica: 4496S specifically listed('4 hr min) ,:r. 3 Suprv.Electrician signature,required: ' ;$gc:A _ ,if + i .•.:: Subtotal: Print name: Joan P Albert Date: 4/26/2016 ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: — �_ . TOTAL PERMIT F.ri: — This permit application expires if a permit is not obtained within 180 Print name: Bill Daniels Date: 4/26/2016 days after It has been accepted as complete. * Number of inspections allowed per permit - I:tRsnidin51PermitsIELC PermitApp ELK EREdoe Rev 06/17/2015 440-4615T(11/05/COINWF.a • , ' Plumbing Permit Application Building Fixtures RECEIVED , (,,, ,„ , ,( City of Tigard Received DatedBy. 13125 SW Hall Blvd.,Tigard,OR 972%p 1 2016 Plan Review Phone 503.7182439 Fax: 503_598.1 gi DateBy: Inspection Line: 503.639.4175 CITY rIt-_, 1-it..,,,,L,, -) Date Ready/By: Internet www-tiflard-0140v a-/'- ' '''''"-;-:: NotifiedIMethod: Penait N°04/857---tp2C/IC,--00(//71 Other Permit No.: lurix 0 See page 2 ter Sapplementat soforatarioo '7[I,7-7: 77.7513;174,;..7'')4T:t.;.....AF-.4L1,,P, r;0f.-',--torIVM.14,0*44:}-4;:7"1:,:::: , For spedal Wont:a:kw use checklist New construction 0 Demolition Description 1 QtY- 1 Ea. 1 Total o Addifion/altenitionireplacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) SFR(I)bath 31/70 182 I-and 2-family dwelling 0 Commercialimehstrial SFR(2)bath 437.78 SFR(3)bath i 500.32 0 Accessory building 1:1 Multi-family • Each additional bath/kite' .hen 25.02 0 Master builder 0°lb:17 Fut-sprinkler(____sq.ft.) Page2 • Site stank= J°b site a.ddrPss: /71/.5' ttJ Sabrina_ ' . Catch basin or area drain 18.76 Drywell,leach line,or trendi drain 18.76 City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear It:_____) Page 2 Suite/bidgiapt no.: Pmject name:-RilteArl-e,v-fosg 0 EWAYWIttS 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:thq.er-T.tyvaceH or-Ilituitst- Lot no.:6 LI Fixture or item: Tax map/parcel rio.: Backflow preventer 3127 valve I 12.51 4‘''''T-;,- "' , ..:-'.. ..;'...• '-',/..,:-,14. 414---:';'''''4',ii4--4`--,4? :4-1,<4i:t,:'"7:::'f';'':':',.';':'t1 ,-.',"'',-'' ,, '4:.' - " ' Clothes washer 25.02 Dishwasher 25:02 Drinking fountain 25.02 Ejectors/sump 25.02 Expansion tank 12.51 ADVL LandH'Win LLC Fixture/sewer cap - - - gs' 25.02 Floor drain/floor sink/hub 25.02 Address:7608 E Doubletree Ranch Road Garbage disposal 25.02 City/State/ZIP:Scottsdale,AZ 85258 Hose bib 25.02 I Phone:(602)694-4031 Fax:( ) Ic:e maker 12.51 ;$77----,---•-.•;;i ' ,,. ...--•-;<:..7.-.;-;:,,-,77-,..,;:-.7t,t7*,...t,5!.yr,07,,:rtri.,,,,rt-v-rolt.r.- .4ssca.ar. lntcreqstor/ ease trap 25.02 Medical gas(value:S ) Page 2, I Business name William Lyon Homes,Inc Printer 1231 Contact name:Angela Grajewalti Roof drain(commercial) 12.51 1 Address:109 East 13th Street , Sink/basinilavdory 25.02 1 City/StatelZ1P:Vancouver,WA 98660 Solar wits(potable water) 62.54 . Phone:(360)695-7700 Fax::(360)693-4442 Tub/sbowerfshower pan 12.51 E-mail:Angela-Grajewski@polygeabonies.cons Urinal 25.02 25.02 - . -1.:'. ' '_ 'Ac,-:- -"r‘.,,'-..,' ' --,.-r----,;7' ater hater j 37.52 Business nom=*Malice Plumbing LLC Water piping/DWV • 56.29 Address 146 WHistoric Columbia River Hwy Other 25.02 City/State/Z1P:Troutdak,OR 97060 Subtotal Mont(503)492-3490 Fax:(50.3)9124438 Minimum permit fee: $7230 , Plan review (25%of permit fee) CCB Lic.:184601 Plumbing tic.no.:P8732 State surdunge(12%of permit fee) Authorized signatiac: TOTAL PERMIT FEE Print nameRobert Dishman Date:5/23/2016 This permit application expires If a penult is nut sibtain" td within 180 days ... after it Isaa bees accepted as complete. ..,_ "Fee methocblogyset by Tri-County Building Iredusny Service Board IABuffertitePermktIPLINU-PennitApp,doe 1001/09 440-4616T(10/02/COM/WEE) • City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT II I r 1 c R D Building Permit Review — Residential Building Permit #: /7.5 7 D/Cc, — Old y/ 2 Site Address: /7-2/9 SS j1) -S7 c4.6a o 7'4 Project Name: dyer- -race 6E-A re,v4— Lot #: S (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: Aiet,) ,S'P',e erify site address/suite# exists and active in permit stem. TIV River Terrace Neighborhood: ❑ No La Yes,See River Terrace Review Addendum Attached Sit Plan Elements: tt ree(3)copies of site plan la:°:sting structures on site Wile plan must be on 8-1/2"x 11"or 11 x 17"paper 1/.Footprint of new structure(including decks)with finished rawn to scale(standard architect or engineer scale) or elevations Orth arrow [ Utility locations(required for new,may apply for additions) tV . o address,project or subdivision name and lot number cation of wells/septic systems Ill plicant information(name and phone number) ) fisting trees to be retained with drip line,and tree Via t dimensions and building setback dimensions yrotection measures Lot area,building coverage area,percentage of coverage and eet tree size,type and location pervious area(applicable if R-7,R-12,R-25&R-40) L1dStreet names 'roperty corner elevations(2 foot contour lines if more than 4 foot differential) I1` `.lean Water Services—Service Provider Lett (lot platted prior to 9/10/1995): Required: El Yes,applicant was notified UrAt No Received: ❑ Yes ❑ No Di Public Facili ' s Improvement(PFI) Permit: Required: V Yes,applicant was notified ❑ No Applied For: Yes E No,stop intake and Use Case#: AZmoo/ = 000K—. S4(6QOis= 61066e 7A/Zoning t- (Pb) hLl Required Setbacks: Front Rear /0 Side 3 Street Side 8 Garage lig/Landscape Requirement: QQC7 % laii,Lot Coverage Maximum: ) VA/Building Height: Maximum Height417 Actual Height 0& '/ 0 Visual Clearance Easements ensitive Lands: GI Yes ZNo Type uf,t Urban Forestry Plan ❑ Conditions "At"prior to issuance of building permit Notes: nr,67 7,s' _ski(/' /( be )71,2,7`"® 11()r . /mI- Atsz f n'c%c Approved By Planning: - Date:' /0/4 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\BldgPermitRvw RES 091216.docx • Building Permit Submittal Original Submittal Date: 9/I/,6 Site Plans: # Building Plans: # Building Permit#: g--Enter building eeynit#above. �B'. Workflow Routing: L Planning L7 CJ Engineering a--Permit Coordinator Building Workflow Sign-off: i Sign-off for Planning(include notes from planning review) Route Application Documents: 0 Engineering: (1) copy of permit application, (1) site plan, (1) building plan and / original plan review routing form. CJ ' Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: �' Date: /V/�46 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-d b Engineering: Date: Notes: - _ r... ' L _ + .Ow mi., --- -/.- Approved by Engineering: ,44zy Date: r2:)--p9` 4j 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: .7 SDC Fees Entered: Wash Co Trans Dev Tax: ',Ai es ❑ N/A Tigard Trans SDC: %1 Yes ❑ N/A Parks SDC: Yes ❑ N/A OK to Issue Permit pproved by Permit Coordinator: Date: 1 7/1 /i c I:\Building\Forms\BldgPermitRvw_RES_091216.docx s 4 City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT i TRiver Terrace Building Permit Review Addendum Building Permit #: /ff 779-076, PO el/2 Site Address: /94/6-3c SO Sb 2 i Project Name: V-er .'r ? 4.k) 1 '."- Lot #: ety (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review of River Terrace Plan Dist9f6t Design Standards (18.660.070.1.); Is the project subject to the plan district design standards? V 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 t. deep ft. deep min. 2ft., 5 ft.wide min. 2 ft.,6ft.wide Gabled dormer 444-ate- 2. Eyes on the street: a minimum of12% f each street facing acade must incl de windows or entrance doors. Percentage Shown: ,v,771-: 1 Q /0 / ;i:*' 4%, ntrances:At least one entrance must meet both of the follo g standards: 3. Max. 8 ft. setback from long t street- facing wall Parallel to street, angle no more than 45° from street, or open onto porch Entrance opens to a porch: Yes ❑ No 1f-yes,all the following apply: 5 sq.ft.min. V5ne street facing entry 12 ft.max.roof above floor of porch ft. depth min. 30%min.porch roof coverage 4. etailed Design:All buildings shall include a min. of five of e following elements on all street-facing facades: v,overed porch min. 5 ft.wide x 5 ft. deep Recessed entry area min. 5 ft.wide x 2 ft. deep vf8all offset min. 16 inche§,' ❑ ormer min. 4 ft.wide FOA Roof eave min. 12 inch projection` .of offset min. of 2 ft. /g ❑ Roof shingles either tile or wood 7. Gable,hip or gambrel roof design p'3 ❑ Roof pitch oriented south min. 500 sq. ft. ❑ orizontal lap siding min. 3-7 inches wide ❑ Accent siding min.40%of street facade Window trim min. 2'/z"wide by 5/8"deepf S ❑ 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: Nc,closer to front or side lot line, than longest street-facing wall. ❑ Yes No. If No (Check one): ay 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) ❑ 2-foot-wide garage door ❑ 40%max. of street facade V50%max. of street facade with 7 detailed design elements Notes: Approved By Planning: .� '! L Date: 0 I I:\Building\Forms\BldgPermitRvw_RES_RT_062216.docx Plumbing Permit ApplicatleCEIVED Building Fixtures City of Tigard NOV 3 2016 D 1l /G ,, Permit No.`MSaCtil,-00 Li 11 7413125 SW Ball Blvd.,Tigard,OR 97223 Plan Review ■ Phone: 503.7182439 Fax: 503 (W TIGARD D,tefgy: Other PemutNo: 1, Inspection Line: 503.639.4175 ‘-"LD,�R�y�gy mwis: B See Page 2 for Internet www.tigatd-or.gov oys UILDII�G D Sapp :.,. . ,�._,", ..._. ..":..:.... iThi .:.: :......... . . . ,_ .. ....� _ -" . FFA►sc�it3iG�•m N Supplemental Information ®New construction " 0 Demolition For spedaI informWion use checkfist Description I Qty. I Ea. J Total ❑Addition/alteration/replacement 0 Other. New 1-2-family dwellings(includes 100 ft.for each utility connection) . •CATEGORY OF CONSTRUCTION' SFR(1)bath 312.70 ®I-and 2-family dwelling 0 Commerciallmdustrial SFR(2)bath 437.78 SFR(3)bath ( 50032 0 Accessory building 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other. Fire sprinkler(__sq.R) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: /7 t f A- cj VIIIIf d n not A`„�' Catch basin or area drain 18.76 + / v Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard,OR 97224 1^r Footing drain(no.linear ft.: ) Page 2 Suit&bldgJapt.no.: project name: �1 kr T-'v'feta. NW Y Manufacnued 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 �/�� y \ Water service(no.linear ft: ) Page 2 Subdivision:'v/tjly 'VI i y L N ul `r/�� _ Lot no.:S� Fixture or item: Tax map/parcel no.: Backflow preventer I 31.27 . " DESCRIPTION OF WORK: - Backwater valve 1231 . . ���l i1� ' ' � Clothes washer 25.02 c\�L 1\IDishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 .®."PROPERTY OWNER - 1 o TEiwANT 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)6944031 I Fax:( ) Ice maker 12.51 ®.APPLICANT I! ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name:William Lyon Homes,Inc Medical gas(value:S ) 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) 6234 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. Wo PmPmP�WV 5629 � Address:PO Box 207 Other: 25.02 City/State/ZIP:Banks,OR 97106 Subtotal Phone:(503)324-0759Fax(503-)324-0580 Minimum permit fee: $72.50 " CCB Lic.:102535 I"PlumbingLic.no.:34-2761'B Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signatu e: 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 atter it has been accepted as complete. "Fee methodology set by Tri-County Building Industry Savin Board. 1:1BuiduglPeemits1PLMU•PamitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 17485 SW SABRINAAVE, BEAVERTON, OR, May 15, 2017 at 9:33:00 AM 97007 Record Type: Record ID: Residential - Master Permit MST2016-00417 Inspection Type: Inspector: 199 Electrical final David Young Result: FA I L Comments: Fix un secured outlet in garage by panel. Provide breakerlock for dishwasher, installed on washer or panel labeled incorrect. 422 Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 17485 SW SABRINAAVE, BEAVERTON, OR, May 24, 2017 at 10:44:36 AM 97007 Record Type: Record ID: Residential - Master Permit MST2016-00417 Inspection Type: Inspector: 299 Final inspection Aaron Cillo-Gobel Result: PASS - CofO Comments: Final erosion control passed Street tree certificate received Moisture content form received Moisture barrier acknowledgement form received High efficiency lighting form received Insulation certification verified Blower door and/or duct seal test certificate received C of 0 left on counter. Violation Summary: Inspector Contractor