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Permit CITY OF TIGARD MASTER PERMIT IN Permit#: MST2016 00426 COMMUNITY DEVELOPMENT Date Issued: 11/03/2016 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S106DB09300 Jurisdiction: Tigard Site address: 17316 SW AMELIA ST Subdivision: RIVER TERRACE NORTHWEST Lot: 93 Project: River Terrace Northwest, Lot 93 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 3 First: 978 sf Basement: 814 sf Left: 3 Parking Spaces: 0 Height: 28 Bathrooms: 3 Second: 1251 sf Garage: 368 sf Front: 8 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Total: 3043 sf Value: $365,244.19 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 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 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: 5 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: 5 201-400 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 Y Other: N Other Description: Ecompasing: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 3043 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 STE 1 SCOTTSDALE,AZ 85258 PHONE PHONE: 360-695-7700 FAX: Total Fees: $34,112.20 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: ev f,,4)61./(1977e?'' Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. LCT ?3 Building Permit Application RECEIVED C Rt t,I1tia FOR OFFICE ISE O\1.1��j,, / /�� Received / 13 1 • ..•t N9r y -7 j� City of Tigard11 110 SEP 1 2 016 DateBy: jl `��i<, �� r 13125 SW Hall Blvd.,Tigard,OR 9722�! Other Permy L(l���/6 �03 Phone: 503.718.2439 Fax: 503.598.1t4TY+ ?F TIGARD DateBy a )1 - ) - ) j 51/ T 3 Ci LRD Inspection Line: 503.639.4175 8 U LD I Nf G DIVISION Date Ready/By: / =: Juris: El See Page 2 for Internet: www.tigard-or.gov Notified/Method: [//2i 4 Supplemental Information j Sit 17V61/E. rf X-� _ t . t t r - t ®New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the a .s t:, f t, t 4 i a 4 -.- x work indicated on this application.. ® 1-and 2-family dwelling 0 Commercial/industrial Valuation:3 t.$ V i Lab --)1 ❑Accessory building 0 Multi-family Number of bedrooms: 0 Master builder 0 Other: Number of bathrooms: 3 Total number of floors: 3 3 Li ) Job site address: New dwelling area: square feet X131�p SW �mel�r� S'r 3 oy' n� City/State/ZIP:Tigard,OR 97224 Garage/carport area: 3i W l� square feet Suite/bldg./apt.no.: I Project name:River Terrace Northwest Covered porch area: 12 square feet)a.S Cross street/directions to job site: Deck area: 1 (.4 ,5 square feet 9-7 Other structure area: square feet .g ) Li'` ikgazi Subdivision:River Terrace Northwest Lot no.: C� Permit fees*' pare basedt.E � tr on the value of the work performed. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all t _-., equipment,materials,labor,overhead,and the profit for the ,' <E t x , gi. work indicated on this application. Valuation: $ Existing building area: square feet New building area: square feet '' € a 4`: f �.r„ y Number of stories: Name:ADVL Land Holdings,LLC Type of construction: Address:7600 E Doubletree Ranch Road , Occupancy groups: City/State/ZIP:Scottsdale,AZ 85258 Existing: Phone:(602)694-4031 Fax:( ) New: Business name:Polygon WLH,LLC Structural plan review fee(or deposit): Contact name:Angela Grajewski - FLS plan review fee(if applicable): Address:109 East 13th Street City/State/ZIP:Vancouver WA 98660 Total fees due upon application: Phone:(360)695-7700 I Fax::( ) Amount received: E-mail:Angela.Grajewski@polygonhomes.com t t t 2pii Commercial and residential prescriptive installation of mitalgi � __,,r t t ° -y:. roof-top mounted Photovoltaic Solar Panel System. Business name:William Lyon Homes,Inc Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 109 East 13th Street Solar Installation Specialty Code checklist. City/State/ZIP:Vancouver WA 98660 Permit Fee(includes plan review $180.00 and administrative fees): Phone:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60 CCB lic.:207247 Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Angela Grajewski Date: jAra. I J *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 Applicata FOR OFFICE l SE oNL1 City of TigardNECEIVEr, Red �/�!— - Date/By: PermitNo� �v&�r�7�"`� Ill 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 SEP 1 2016 DateBy: Other Permit: TI G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: H See Page 2 for Internet: www.tigard-or.gov C TY OF TIG'ARD Notified/Method: Supplemental Information 3UILDING nIVIg1::tJ ,. ,, „'•.\:,4'-',€"2=',;°:;%1;;;;,;'0,,,-.,t,> ¢ _ :t- ,,. ,;._.. Mechanical permit fees*are based on the value of the work ®New construction ❑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: (� E.M, 0. !t t t ls> ® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist 0 Multi-family 0 Master builder ❑Other: Description IQty. I Ea. I Total " a � i1 :;'''*-4.1:1- t :3, €= >t - Heating/cooling: �� ` , Air conditioning 46.75 Job site address: / r t, Sw m a st Furnace 100,000 BTU(ducts/vents) 1 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: 1 Project name:River Terrace Northwest 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 I 23.32 Subdivision:River Terrace Northwest 1 Lot no.: ei3 Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 '''''""'-',-----"t..- ;4 .: 2. -, -'tet t 4.1 $ ” : ` Cz Gas fireplace/insert 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 a � � Other: 23.32 Environmental exhaust and ventilation: Name:ADVL Land Holdings,LLC Range hood/other kitchen i equipment 33.39 Address:7600 E Doubletree Ranch Road Clothes dryer exhaust 1 33.39 City/State/ZIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:(602)694-4031 Fax:( ) Attic/crawlspace fans 23.32 Other: 23.32 Fuel piping: Business name:William Lyon Homes,Inc. $14.15 for first four;$4.03 for each additional Contact name:Angela Grajewski Furnace,etc. 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 i Range 1 E-mail:Angela.Grajewski@polygonhomes.com Barbecue g .21i;EMClothes dryer(gas) Business name:Apex Air LLC other' tt, 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 lc This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized Signature: j .,(,, * Fee methodology set by Tri-County Building Industry Service Board Print name:Angela Grajewski Date:8/22/16 I:\Building\Permits\MEC_PennitApp_040113.doc 440-4617T(11/02/COM/WEB) Electrical Permit Ap licatio E lVED FOR OFFICE USE ONLY City of TigardDate/! Received Per'nit t5'�o2Cl/(—'©®442C,_ 13]25 SW Ball Bivd.,Tigard,oR 97223 S E P 1 2 016 Plan Review Related Permit a: Phone: 503.7182439 Fax: 503.598.1960 Date/13. Inspection Line: 503.639.4175ITYOReady Date/By: runt. 0 See Page 2 for TIGARD Internet wwcv_tigazd-or.gov ...3 - Gtal Noi.-rttiSed..��/M. ethod Supplemental Information �- - � � _� �:�� �i'6_;-,. ; "�= '�ti"'< = -=-�x i�ty 'lrP.. .�-_..., :_a''tt ;- r Please check all that apply(submit 2 sets of plans w/items checked): N NewDemolition construction 0 Other: Addition/alteration/replacement ❑Service or feeder 400 amps or more ❑Building over three staries. • ❑Demohitian 0 Othec where the available fault current 0 Marinas and boatyards. 015':;..;:i; `.`" exceeds 10,000 amps at 150 volts or Q Floating buildings. less to ground,or exceeds 14,000 0 Commercial-use agricultural et1-and 2-family dwelling 0 CommerciaUiridustrial 0 Accessory building amps for all other installations. buildings. ❑Multi-family - 0 Master builder 0 Other. 0 Fire pump. ❑Installation of 150 KVA or . _ — — Mr _- - _ _ 0 Emergency system_ larger separately derived ,.._�_.-sac=:�. ........,. ©..__� �. .._ . ; '��=•`;`>�t:-:i.�:i�'K �]Addition of new motor load of system. Job#: Job site address:I ,31 „SW' W T► et A,S ' Mdth or more. ❑"A"•"L"•`I-2=-I-sn, 0 Six or more residential units. occupancy. City/State/ZIP:Tigard,OR 97224 ❑Health-cera facilities. 0 Recreational vehicle parks. 0 Hazardous locations. ❑Supply voltage for mon than Suite/bldg./apt#: Project name:.14://or terrace,/ ( (t/ r ❑Service or feeder 600 amps or more. 600 volts nominal Cross street/directions to job site: `3`' 2 4Y -- tion I Qty. I Bath I Total �._.. New residential single-or multi-family dwelling unit Subdivision: .f{rT 4Ee j/ i (,{pf Lot#:qi 3 Includes attached garage. 1.000 sq.R or less 168.54 4 Tax map/parcel#: portion 33.92 1 t-7:-.. -1::-_:,-;.:,--;!;,-.- ---,7_*----- ----'--.,^ - C:: ti..lam: _ ~�.�--.--" .1- -. nergy,res tial 75.00 2 _ Ea_add'I or � Limited e (with above sq.ft.) Limited energy,multi-family 75.00 2 residential(with above sq.ft) , - Renewable Energy ❑ See Page 2 ,----. i R `-"`-r- `M= Services or feeders installation,alteration,and/or relocation Name:ADVL Land Holdings,LLC 200 amps or less 100.70 2 201 amps to 400 amps 133.56 2 - Address:7600 E Doubletree Ranch Road 401 amps to 600 amps 20034. 2 City/State/ZIP:Scottsdale,AZ 85258 601 amps to 1,000 amps 30I.04 2 Phone:(602)694-4031 Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or F.mnil: -. relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 ] intended for sale,lease,i nut,or exchange,according to ORS 447,449,670,and 701. • 201 amps to 400 amps 125.08 2 Date: 401 amps to 599 amps 16854 2 Owner signature: _ _ _ Branch circuits-new,alteration,or extension,per panel . T �_--,- f-v -' 0 ---� -' A.Fee for branch circuits with i Business name:William Lyon Homes,Inc. above service or feeder fee, - 2 each branch circuit Contact name:Angela Grajewski B.Fee for branch circuits without service or feeder fee,that 56.18 2 Address:109 East 13th Street branch circuit City/State/ZIP:Vancouver,WA 98660 Each add'l 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@polygoahomes.com Reconnect only 67.84 2 ra r - -. i �-- t ' { . . Pump or irrigation circle 67.84 2 Business name:Garner Electric Washington,LLC • Signor outline lighting 67.84 2 Signal circuit(s)or limited energy ❑ See Page 2 2 Address:6101 NE St Johns Rd panel,alteration,ore tension Each additional inspection over allowable in any of the above City/State/ZIP:Vancouver WA 98661 Additional inspection(I lir min) 6625/hr 3 Phone:(253)320-1657 Fax:( ) Investigation(1 hr min) 90.00/hr Industrial plant(1 hr min) 78.18/hr Email:bdaniels@gweusa.com Inspections for which no fee is 90.00/hr CCB Lie.: C1158 Electrical Lie.: 208174 Suprv.Lica: 4496S specifically listed(%hr min) Suprv.Electrician signature,required -1 t /'.r .i-if &... Subtotal: Print name: Joan P Albert •- Date: 4/26/2016 0 Plan Review Required(25%of permit fee): l State surcharge(12%of permit fee): — -�� TOTAL PERMIT Fl h: Authorized signature: 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:1Sueding{PermR+Us3.0 PernutApp RR ERE.doe Rev 06/17/2015 440-4615TQ7/05/tbM/WE9 _vis.`'..... ... _ i • • Plumbing Permit Application BRECEIVED Building Fixtures '"k "' I I( I I ',I ()\I ' City of Tigard cc Reccimd nal Bx a N°'://—C%�L►O(v dC� 13125 SW Hall Blvd.,Tigard,OR 972235 EP 1 2016 elan eeview other Permit No.: Pane 503 718.2439 Fax: 503.598.1960 Date/By. Die ltead9By: lura Et See Page 2 for [nspxtion Line: 503 639.4175 CITY OF TIGAR� laf rani.° Intemet wtvw.tigard or Sop , oafied,Mc hod SaP t rt.,' „ } , k , ' , .,, ,Fj, t o r : For ' information use checklist 0 DemolitionCciptiam Qty. Total New construction ©Add,tiodatteratron/Rpl�e1n ❑Other New 1-2-family dwellings(includes 100 L for each utility connection) -------74,—,—;e-----tigr Wr :, r, `'- SFR(1)bath 312.70 -.. y.. ' ''” ...'. - 437.78 -. �, SFR(Z)bath -and 2-familydwelling0 Commercial/industrial 500.32 ® SFR(3)bath' I 0 Accessory build ng 0 Muhl-family Each additional bsahlkitrltest 25.02 0 Master builder 0 Other Fittrsprinkler( s9.ft.) Page 2 � r'Sr -..ii eaxis; ar, s Sift atiiitres: i ''::-C.:1154-11"'-'4' ,•i_ tax' ' 18.76 ,�;��-,1- _ � k a =�� �r��� � . ��� � Catch basin or area drtrirt V sw V rn uipt S� Job site address I3 Drywdl,leach line,or trench drain 18.76 Crty/StattlLlP:Tigard,OR 97224 Footing drain(ilea)linear it: 2 ._... Suitee/bldgiapl no.: , Pmlect name: R.i U QirTeXf Cr.e 0 l/M*S :lured 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 R:_ iPage 2 Water service(no.linear ft.:_) Page 2 Subdivision:IN-[i1ION r C..0 , N lX 1 V6l�fj` I l of no.: Fixor item: t Y Backflow 3127 31.27 Tax maplpamel no.: Bacicwaterva valve' 12.51 �zt r_ �` ".. I' u�"_ �,,;.'"..,A,,,•__,,,"'",,;"--.'"',';.r- � oodles washer 2$.02 ' Dishwasher 25:02 Drinking fountain 25.02 _..._. E,lxtors/sump .... 25.02 . � � � Expansion:tank 12.51 � � ;,._ g• �� .,_r Fixture sewer cap 25-0 Name:ARYL 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:( ) Ick make 12.51 , , , . � : Interceptor/grease trap 25.02 Medical gas(value:S ) _ Page 2. Business William Lyon Homes,Inc :Firmer 1231 Contact name:Angela Grajcwski Roof diain(commercial) 12.51 . 1. Address:109 East 13th Street- • Ttnklbasin►7avatory 25.02 . 62.54 City/State/MP:Vsaebrrveq WA 98660 Solar taints(potable water) Phone:( Tublahowulshower pan 1231(360)��. Fax:.:(360j 693-4442 Urinal 25.02 E-mail Angela-Grajewsli gpo1yaashor> tom Water closet 25.02 s x, x -s m �> Water tl 37.52 Business nam=Alliance Plambing LLC Waterpip'tng/DWV ' ..56.29 Address:146 W Historic Columbia River Hwy Otlxr: ., City/State/ZIP:Troutdale,OR 97060 Subtotal Minimum permit fee: $7230 Phone:(503)492-3490 Fax:(503)9124438 Plan review (25°!of permit fix) CCB Lic�..184601 Plumbing Lice no.:PIi732' State surcharge(12%of per ilt fee) Authortzod_signattrce: 4(44/ - TOTAL PERMIT FEE Date:5/23/2016 Ibis Pah appileatson es piles If a permit a not obtained within 180 days Print mint Robert Dtsrmanatter it has been accepted as cawptet� *Fee methodology set by Tel-County Building:industry Service Board 1: 'Appdoe 101011/19 440•astertioa LCO ) Ii. City of Tigard IIIe COMMUNITY DEVELOPMENT DEPARTMENT T 1 c n x.D Building Permit Review — Residential Building Permit #: C-5 7:2_,0/ cc, — 00 V.240 Site Address: /7,Si a) /%1)2.4.2 S7 Project Name: _A/et- 17.63-face 4 e.d- Lot #: 93 (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: , 4> SPie erify site address/suite# exists and active in permits tem. cz(V River Terrace Neighborhood: ❑ No V Yes,See River Terrace Review Addendum Attached Si Plan Elements: we(3)copies of site plan /'sting structures on site pi e plan must be on 8-1/2"x 11"or 11 x 17"paper TA Footprint of new structure(including decks)with finished tip Prawn to scale(standard architect or engineer scale) oor elevations Pi orth arrow tility locations(required for new,may apply for additions) IV to address,project or subdivision name and lot number01 of wells/septic systems iiipplicant information(name and phone number) (I,'i 'sting trees to be retained with drip line,and tree V, of dimensions and building setback dimensions protection measures Lot area,building coverage area,percentage of coverage and treet tree size,type and location pervious area(applicable if R-7,R-12,R-25&R-40) Street names Property corner elevations(2 foot contour lines if more than n 4 foot differential) taiglean Water Services—Service Provider Lette of platted prior to 9/10/1995): Pequired: CI Yes,applicant was notified No Received: ❑ Yes ❑ No ublic Faciliti Improvement (PFI) Permit: Required: Yes,applicant was notified ❑ No Applied For: VJ Yes ❑ No,stop intake 4and Use Case#: PhP ("6111:67, --C1/6020/S7- 5 ��0 6 7111/Zoning: /Q-3- P ) 1 Required Setbacks: Front Rear /0 Side Street Side 0 Garage <)00 pi/Landscape Requirement: C 2 ) Lot Coverage Maximum: 00 ' uilding Height: Maximum Height N/ Actual Height cQii2/ ii Visual Clearance Vt Easements Piensitive Lands: ❑ Yes iNo Type rban ForestryPlan ❑ Conditions et" nor to issuance i:4 jbuilding permit (= Notes: G1�l .;'5(?r(.t--i' „, /2c,,‘?//' Ze /yie ,+ p - ` Approved By Planning: Date: 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\BldgPeimitRvw_RES_091216.docx 0 Building Permit Submittal Original Submittal Date: 9////k Site Plans: # 7 Building Plans: # ""3 Building Permit#: Er-Enter building permit#above. ,/ Workflow Routing: ID-Planning Engineering Permit Coordinator Imo"Building Workflow Sign-off: 2- Sign-off for Planning(include notes from planning review) Route Application Documents: .1;1-Engineering: (1) copy of permit application, (1) site plan, (1) building plan and � original plan review routing form. e Building: original permit application,site plans,building plans, engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: Date: /4//fV/,t Engineering Review Slope at building pad: e ❑ 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 by ngineering Date: ,�� y- Notes: � % /',GjSYyK r7 r' 4 1e+t+vr :'e. Approved by Engineering: 1.4.-27 Date:M k, 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: DC Fees Entered: Wash Co Trans Dev Tax: es ❑ N/A / Tigard Trans SDC: Yes CI N/A Parks SDC: Yes ❑ N/A OK to Issue Permit Approved by Permit Coordinator: Date: ! /9‘)/i I:\Building\Forms\BldgPennitRvw_RES_091216.docx 4 City of Tigard a COMMUNITY DEVELOPMENT DEPARTMENT T 1 c A R D River Terrace Building Permit Review Addendum Building Permit #: /If 7:320/ — 29 V 6, Site Address: /931(e so �a� fja� -s-4. Project Name: R Ver 7.-r/iO f ids- jic,t',S'f— Lot #: (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review of River Terrace Plan Dis ct Design Standards (18.660.070.1.): Is the project subject to the plan district design standardsqg 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 Gabled dormer ft. deep min. 2ft., 5 ft.wide min. 2 ft.,6ft.wide _L�. 1 ❑ ❑ 0 ❑ i'� 2. Eyes on the street: a minimum of 12%of each street f cing fa ade must include windows or entrance doors. 'jyf�, Percentage Shown: n %%cT, fc e: l .e°/v 3. trances:At least one entrance must meet both of the follo g standards: oy( Max. 8 ft. setback from longe street- facing wall Parallel to street,angle no more than 45°from street, or open onto porch Entrance opens to a porch: Yes ❑ No If)t s,all the following apply: 5 sq.ft.min. VI ne street facing entryft.max.roof above floor of porch 5 ft.depth min. 30%min.porch roof coverage 4petailed Design:All buildings shall include a min. of five of e following elements on all street-facing facades: vovered porch min. 5 ft.wide x 5 ft. deep f S Recessed entry area min. 5 ft.wide x 2 ft.deep f IWall offset min. 16 inches ❑ ormer min.4 ft.wide Roof cave min. 12 inch projection'�S Roof offset min.of 2 ft.fc 0 Roof shingles either tile or wood czrGable,hip or gambrel roof design ❑ Roof pitch oriented south min. 500 sq. ft. ❑ orizontal lap siding min.3-7 ft.wide 0 Accent siding min. 40%of street facade I Window trim min.2'/2"wide by 5/8"deepS 0 Window recess min. 3 inches for all street facing ❑ Bay window min. 5 ft.wide by 2 ft. deep 0 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: Nlc oser to front or side lot line,than longest street-facing wall. ❑ Yes No. If No (Check one): L�/ 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) 0502-foot-wide garage door ❑ 40%max. of street facade %max. of street facade with 7 detailed design elements Notes: Approved By Planning: ____ __77.._ r , Date: /O/i'c !i(. I:\Building\Fomes\BldgPermitRvw_RES_RT_031416.docx Plumbing Permit Application Building Fixtures RECEIVED City of Tigard PIisy: a /6;t....4Permit No. Sp�_O�z 1.• i • 13125 SW Hall Blvd-,Tigard,o(t,A7 Q 9016 / WIN • Phone: 503.7182439 Fax: 50(31 1960 D/BB`NOther Permit No.: - 1 Inspection Line: 503.639.4175 Date Ready/By: rads See Page 2 for Internet www.tigard or.govy� �I OF IG 1�RNotified/Method Supplemental Information '-:. -7 ' -- ... nt 1 6 DIVISION. .. 4 »Ek scReDtt ®New construction i Demolition For special inform ien use deer st ❑Addition/alteration/re lacementNew 1-ton Qty. I Ea. Total P 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION' SFR(1)bath 312.70 ®1-and 2-family dwelling 0 Commercial mdustrial SFR(2)bath 437.78 ❑Accessory buildingSFR(3)bath , 50032 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: ' lC r S Catch basin or area drain 18.76 Job site address: /-7 3'/0 l Alrl City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.: ) Page 2 Suite/bldgJapt.no.: Project name:Vow. '1 Vv1) N\r4 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 Stone sewer(no.linear ft.: ) Page 2 Water service(no.linear It: ) Page 2 Subdivision: I4 ✓'�Qiin('(AL,C, N0,i'rnA}t 4 -- Lot no.. Fixture or item: Tax map/parcel no.: Backflow preventer1 31.27 DESCRIPTION OF.WORK Backwater valve 12.51 Clothes washer 25.02 1)f CC Ckeint9t Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ®.PROPERTY OWNER ! 0 TENANT 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 1151 Contact name:Angela Grajewski Roof drain(commercial) 12.5I 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 Inn. Waterpiping/DWV 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 fee: $72.50 CCB Lic.:102535 Plumbing Lic.no.:34-276PB Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name:Carolina Malmedal Date:0425/2016 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:\BuildingtpermitstPLMU-PamitApp.doe 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: 17316 SW AMELIA ST, BEAVERTON, OR, 97007 May 9, 2017 at 10:52:25 AM Record Type: Record ID: Residential - Master Permit MST2016-00426 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS Comments: Corrections complete. No AC installed at this time. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 17316 SW AMELIA ST, BEAVERTON, OR, 97007 May 16, 2017 at 7:31 :12 AM Record Type: Record ID: Residential - Master Permit MST2016-00426 Inspection Type: Inspector: 299 Final inspection David Young Result: FA I L Comments: Provide approved final erosion control inspection prior to building final inspection. No inspection done at this time. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 17316 SW AMELIA ST, BEAVERTON, OR, 97007 May 16, 2017 at 1 :20:23 PM Record Type: Record ID: Residential - Master Permit MST2016-00426 Inspection Type: Inspector: 699 Mechanical final David Young Result: PASS Comments: Correction from previous inspection complete. No AC installed at time of building final inspection. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 17316 SW AMELIA ST, BEAVERTON, OR, 97007 May 4, 2017 at 10:02:56 AM Record Type: Record ID: Residential - Master Permit MST2016-00426 Inspection Type: Inspector: 399 Plumbing final David Young Result: FA I L Comments: Cut all cleanouts to grade, glue all adapter fittings and provide thread sealant. 719.3, 316.1 Not ready for plumbing final, no inspection done at this time. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 17316 SW AMELIA ST, BEAVERTON, OR, 97007 May 4, 2017 at 10:25:12 AM Record Type: Record ID: Residential - Master Permit MST2016-00426 Inspection Type: Inspector: 199 Electrical final David Young Result: FA I L Comments: Lower level outside gfci not resetting, all wet from pressure washer, no power at interior outlet at back side. No power at either outlet each side of lower level slider. No AC installed at this time. Remove debris in front of garage outlet for access. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 17316 SW AMELIA ST, BEAVERTON, OR, 97007 May 4, 2017 at 10:10:43 AM Record Type: Record ID: Residential - Master Permit MST2016-00426 Inspection Type: Inspector: 699 Mechanical final David Young Result: FA I L Comments: Provide impact protection for appliance in garage. M1307.3.1 FP glass not installed. Work not complete, not ready for inspection. No inspection done at this time. Violation Summary: Inspector Contractor