Permit (172) - CITY OF TIGARD MASTER PERMIT
' '
COMMUNITY DEVELOPMENTIN
Permit#: MST2016 00468
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/17/2016
Parcel: 2S106DB 10000
Jurisdiction: Tigard
Site address: 17458 SW AMELIA ST
Subdivision: RIVER TERRACE NORTHWEST Lot: 100
Project: River Terrace Northwest, Lot 100
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 4 First: 978 sf Basement: 814 sf Left: 3 Parking Spaces: 0
Height: 26 Bathrooms: 3 Second: 1251 sf Garage: 368 sf Front: 8
Smoke
Dwelling Units: 1 Third: 0 sf Right 3 Detectors: Yes
Total: 3043 sf Value: $366,136.99 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
0 Storm Sewer 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains:
Bckflw Prevntr: 0 Catch Basins: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
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
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.'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
Other: N Other Description: Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group:Y Square Feet:
OTR 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: $34,096.97
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 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.
1
Issued By: l i�}��-- Permittee Signature: C � ,9—/:4-)e--/(3e9/1G?�
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.
L oT /D
Building Permit Application 0
Residential REGEIVED FOR OFFICE USE ONLY
City of Tigard Received
Date/By: /`/ -5,,i y Permit N ::9�`0/4,—0 . 0,6t7
III = '� Phone: 503.718.2439 Fax: 503.598.196„0_13125 SW Hall Blvd.,Tigard,OR 9722DPaSEP 1 2016 Plat Ren Reyview Th. ' c Other Permul o/Ey—Q0/iii-
1 "f-> Date Read/B J4 Juris: H See Page 2 for
TIG.4 R B Inspection Line: 503.639.4175GI r E , E Ready/By:
Notified/Method.#) `�y (07 Supplemental Information
Internet: www hgazd or gov Blip DIN!,—, n,,'„:,--,le-,"�q ! i
L
A "* i, 4k ' 4 IF�4'O -k. , `... x '51 5 M i iff, ) , Y`I1 EI.ai "ie
rtav
®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 ❑Other: equipment,materials,labor,overhead,and the profit for the
r Vii; , fi raywork indicated on this application.
Valuation. r, J �0 $ t,�` 3
44
® 1-and 2-family dwelling ElCommercial/industrialkj ts
ElAccessory building CIMulti-familyNumber of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
' . "" ,
„`
n a I13hiTi oTio Am iocATi 1 � Total number of floors:
k ' sa s
Job site address: `i H5-5 5\1\1 PTCI, 4 Q New dwelling area: jQL1 square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: 30 square feet
Suite/bldg./apt.no.: Project name:River Terrace Northwest Covered porch area: 109 square feet
Cross street/directions to job site: Deck area: I L4 ti square feet
Other structure area: square feet
Subdivision:River Terrace Northwest Lot no.:' 00 Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,laoverhead, r r, and theprofit for the
ag �. )wn gaiVi iy�y gP T F "0. work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
t i abli �� 1 g�I E Number of stories:
Name:ADVL Land Holdings,LLC Type of construction:
Address:7600 E Doubletree Ranch Row Occupancy groups:
City/State/ZIP:Scottsdale,AZ 85258 Existing:
Phone:(602)694-4031 Fax:( ) New:
5 bf 4 Sat k 4 f - ,.", '�. ,,. *,r�. y cs,t,
``- ., - P.I4I �f '� 'z' �i'QIW1 AVT. F rf4d £ � E 1:NG,�.r��'� e3 ate`
inaM
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
Total fees due upon application:
City/State/ZIP:Vancouver WA 98660
Amount received:
Phone:(360)695-7700 Fax: :( )
E-mail:Angela.Grajewski@polygonhomes.com F. .T "'=)
s g „rd;Wirx _ , ,, ,, y,, p M gt
Commercial and residential prescriptive installation of
y V1 � . < - aa � t ,,, t � � geg�, „_� `K-niW.
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 lie.:207247
Authorized signature: 44( Total fee due upon application: $201.60
' This permit application expires if a permit is not obtained
within days after it has been accepted as complete.
Print name:Angela Grajewski Date: *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit FOR OFFICE 1 SE O\l_\ 9 G
J.
City of Tigard Received Permit No��T0/6—OO6,f—
III
,
Date/By:
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 SEP 1 2016 DateBy: Other Permit:
TI G A R D Inspection Line: 503.639.4175Date Ready/By: Juni: fa See Page 2 for
Internet: www.tigard-or.gov Cn/1/ 0 ' a; /H Notified/Method: Supplemental Information
UiOINf? i -1y1,pak0r..o
Mechanical permit fees*are based on the value of the work
®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit
Value:$
., �. ... , s4° te', '" .`','''''';!:4:3 -..a , .' .,. s. ;4 ..._.:: 7 -. �r..�.._ .. ... ---' _.
® 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information usecltecklist
❑Multi-family 0 Master builder 0 Other: Description I Qty. I Ea- I Total
Heating/cooling:
• � z' ,, ,z•;.,:-.4
es. � 7 1 46.75
v Air conditioning
Job site address: /7 Svc 4 en' Ot
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/bldgJapt.no.: I 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 1 23.32
Other. 23.32
Subdivision:River Terrace Northwest I Lot no.:/
00 Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
,4"=:•;-r ' ,. i, e , , Gas fireplace/insert 33.39
6'
Flue vent for water heater or gas
New construction HVAC system fireplace 23.32
Log lighter(gas) 2332
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
14744:V�, � ,� „� � � �y Environmental exhaust and ventilation:
Name:ADVL Land Holdings,LLC Range hood/other kitchen
equipment 33.39
Address:7600 E Doubletree Ranch Road Clothes dryer exhaust 1 33.39
Single-duct exhaust(bathrooms,
City/State/ZIP:Scottsdale,AZ 85258
toilet compartments,utility rooms) 23.32
Phone:(602)694-4031 Fax:( ) Attic/crawlspace fans 23.32
w � ` Other 23.32
x�A t
Fuel piping:
Business name:William Lyon Homes,Inc. $14.15 for first four,$4.03 for each additional
Contact name:Angela Grajewski Furnace,etc. '
Gas heat pump
Address:109 East 13th Street Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 I Fax::(360)693-4442 Fireplace i
Range
E-mail:Angela.Grajewski@polygonhomes.com Barbecue
: ( ''''', •'V- xk ;, Clothes dryer(gas)
.
Other:
Business name:Apex Air LLC ; tam,v,,,,v,.;:-. 17:
Address:18004 NE 72.d Ave Subtotal
Minimum permit fee($90.00)
City/State/ZIP:Vancouver,WA 98686
Plan review(25%of permit fee)
Phone:(360)342-8109 Fax:(360)326-1769 State surcharge(12%of permit fee)
TOTAL
lic.:203034 PERMIT FEE
This permit application expires if a permit is not obtained within 180
frA,
7 days after it has been accepted as complete.
Authorized signature: t7dAteffP46 * Fee methodology set by Tri-County Building Industry Service Board
Print name:Angela Grajewski
Date:8/22/16
I:\Building\Permits\MEC_PemdtApp_040113.doc 440-4617T(11/02/COM/WEB)
Et, g FOR OFFICE USE ONLY
Electrical Permit Applicata
City of Tigard
Received
13125 SW Hall Blvd_,Tigard,OR 97223 S E n -tt1„✓ 2 016 Plan Review
ringrirffla
M
11 Phone: 503.718.2439 Fax: 503.598.1960 D Related Permit
Inspection Line: 503.639.4175 CITY OF i •" trl Rest'Date/BY:d ue H See Page Zfor r
TIGARD i5t NotrSed/MethoSapptenentalInformation
nernew . g5 . t , itpl,,e
ms � ter.__ �:Ye?` :w, :. ' „i 3�'• -
• ,,, ,--,....,-. .,,,,,,---,..k,,,,,,,..-- ,,,_x,, =w:'_,,,
”
®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans whims checked):
D Service or feeder 400 amps or more ❑Building over three stoics.
❑DemolItion 0 Other: where the available fault current ❑Marinas and boatyards.
i • ,;g xiTy - exceeds 10,000 amps at 150 volts or El Floating buildings.
'x-=,. 1,. ti� Ttr.� F• ""=� less to ground,w exceeds 14,000 ❑Commercial-use agricultural
®1-and 2-family dwelling 0 Commercial/iridlistrial 11 Accessory building amps for all other installations. buildings.•
❑Multi-family 0 Master builder 0 Other. :_ _ ❑Fire pump. tem ❑ separately ation of 0 KVA or
Malr.ftra (J Emergency sysderived
- '�°iI01�-•r�;" 4�'jl_"` '�f01�"�?�.=:_:..-_...." --- ,-_ system.
-;=: o _..- - -¢ ❑Addition of new motor load of
Job#: I Job site address:111,I� SW A s� 1001.1E or more. 0"A'."E".`1-2","1-3",
❑Six or more residentialoccupancy.units- �Recreational vehicle parks.
City/State/ZIP:Tigard,OR 97224 ❑Hoaith cure facilities. 0 Sly voltage for more than
r/ ❑Ilamrdans locations. 600 volts nominal
SuiteJbldg./apt #: ( Proj act name:/ �V /...6,-trace, 4✓P S r El Service or feeder 600 amps or more.
Cross street/directions to job site
Description 1 Qty I Bath I Total
New residential single-or multi-family dwelling unit.
��r p,� �.(� •� Lot#: Includes attached garage.
Subdivision: ,f yr �.v/�'" P✓ � v V GI�P'�•` a L000 sq.R or less 1 168.54 4
Tax map/parcel#: Ea.add'l 500 sq.ft or portion ' 33.92 1
� ��-"__: ::iYlS�_}_:;-.�: FS�, ' '3::i-_ - �-.�,� Limitedenergy,residential
75.00 2
with above s
( q•ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft)
Renewable Energy ❑ See Page 2
Pr-^""' .- -0-11 -x Services or feeders installation,alteration,and/or relocation
_�._�. - 100.70 2
Name:ADVL Land Holdings,LLC 200 amps or less
201 amps to 400 amps 133.56 2
Address:7600 E Doubletree Ranch Road401 amps to 600 amps 200.34 2
City/State/ZIP:Scottsdale,AZ 85258 601 amps to 1,000 amps 30I.04 2
Phone:(602)694-4031 I Fax:( )
Over 1,000 amps or volts 55226 2
Temporary services or feeders installation,alteration,and/or
E>al: relocation
59.36 1
Owner installation:This installation is being made on property that I own which is not 200 am ps or Iess 125.08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps ttoo 400 amps 599 s 168.54 2
•
Owner signature: Date: Branch circuits-new,alteration,or extension,per panel
MVP- ,�W 'eT 1W't . .,:,..� W-_ . A.Fee f th
- Sd for branch circuits
^'� '� -- "' above service or feeder fee,
VBusiness name:William Lyon Homes,Inc. 7'42 2
each branch circuit
Contact name:Angela Grajewski B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address:109 East 13th Street branch circuit
Each add')branch circuit 7.47 2
City/State/ZIP:Vancouver,WA 98660 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-Grajewsld(a3polygonhomes.com Reconnect only 67.84 2
_.� 67.84 2
% q t .M-s v -' Pump or irrigation circle$a _.: 67.84 2
Signor outline lighting
Business name:Garner Electric Washington,LLC •
Signal circuit(s)or limited-energy O See Page 2 2
Address:6101 NE St Johns Rd panel,alteration,or extension.
Each additional inspection over allowable in any of the above
City/State/ZIP:Vancouver WA 98661 Additional inspection(I hr min) 6625/hr
Fax:( ) Investigation(1 hr min) 90.00/hr
Phone:(253)320-1657 Industrial plant(1 hr min) • 78.18/hr
itmail:bdaniels@gweusa.com Inspections for which no fee is 90.00/hr
J Suprv.Lic.: 44965 specifically listed(A hr min)
C1158 Electrical Lic.: 208174 t1
CCB Lic.: —err .,:�" _ter:;: 5
4-4
aired: 1 Subtotal:.
Suprv.Electrician signature,req L .1/ R! . ..
Print name: Joan P Albert • Date: 4/26/2016 - 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
��- -_ _ TOTAL PERMIT FEE:
Authorized signature: This permit application expires if a permit is not obtained within 180
Date: 4/26/2016 I days after It has been accepted as complete.
Print name: Bill Daniels ! * Number of inspections allowed per permit
I:1&uld'mglPer,nsd..aLC PermitApp ETAERE-doe Rev 06/17/2015 410-4615Tt11/05/COWWEa
r
Plumbing Permit Annlicati . E
Building Fixtures I OR ()1 ri( 1 i •1 ivl ,
City of Tigard N O V 3 2016 Received Permit N°1s%
i /6 -L2()y6,
• n 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By
Phone: 503.718.2439 Fax: 503.4$ 'OF TI GA R D Plan
v Other Permit No.:
� .i � Inspection Line: 503.639.4175 Date Ready/By: rids: 62 See Page 2 for
Internet www.tigard-or.gov RIJILDING DIVISION_Notified/Metbod Supplemental Information
TYPE!OF WORLE FFA!
®New construction . 0 Demolition For special information use checklist
Description I Qty. I Ea. I 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
®1-and 2-family dwelling 0 Commerciallmdustrial SFR(2)bath 437.78
0 Accessory buildingSFR(3)bath 1 500.32
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: /7 Us-5 ,)YV I ot Q 4_ Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97224 J Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) ■ Page 2
Suite/bldgJapt.no.: Project name:I )\JW -r,e wN\rj 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 R.: ) Page 2
Subdivision:��\l ✓' P�n('Gur e, Nt),p i4\W{d Lot no.:t D� Fixture or item:
Tax map/parcel no.: 1 Backflow preventer 31.27
. - . DESCRIPTION OF.WORK Backwater valve 12.51
Clothes washer 25.02
OntraN W Cha t Dishwasher 25.02
/ Drinking fountain 25.02
Ejectors/sump 25.02
1:81.'PROPERTY OWNER I 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 12.51
Contact name:Angela Grajewslci
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.Grajewslri®polygonhomes.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:Malmedal Enterprises Inc. WaterP�P P�r in wry 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: 572.50
CCB Lie.:102535 Plumbing Lic.no.:34-276193Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: 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:\Building1Pennits1PLMU-PermitApp.doe 10/01/09 440-4616T(10/02/COMIWEB)
City of Tigard
a COMMUNITY DEVELOPMENT DEPARTMENT
TICARD Building Permit Review — Residential
Building Permit #: 71,2e O YC
Site Address: f19 5€ Svv We;IA Sr
Project Name: fWCAi TirYlace, I• (-hyhwt * Lot #: A00
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: stIC\%l ct9/
Verify site address/suite#exists and active in permit system.
River Terrace Neighborhood: ❑ No J"' Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
,Three(3)copies of site plan -*sting structures on site
Ii.Site 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 Utility locations (required for new,may apply for additions)
Site address,project or subdivision name and lot number Jocation of wells/septic systems
,Applicant information(name and phone number) NA.P.xisting trees to be retained with drip line,and tree
Lot dimensions and building setback dimensions protection measures
. Lot area,building coverage area,percentage of coverage and ,,�'Street tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) ,.ltreet names
Property corner elevations (2 foot contour lines if more than
4 foot differential)
Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified A No Received: ❑ Yes ❑ No
Public Facilities Improvement (PFI)Permit:
Required: ❑ Yes,applicant was notified No Applied For: ❑ Yes ❑ No,stop intake
1Z Land Use Case#: cD R2ok 5 _�c3
Zoning: R-1 CP )
'Sr Required Setbacks: Front1Z- Rear 10 Side Street Side not.., Garage 20X Landscape Requirement: 24-3) U
Lot Coverage Maximum: ec
0/0
Building Height: Maximum Height i%)/Pr Actual Height 't2e
Visual Clearance
Easements
,' Sensitive Lands: ❑ Yes L No Type
Urban Forestry Plan
Conditions "Met"prior to issuance of building permit
Notes: Ali CivOinovic ►l 3C rncc Rio( ( i.la.
Approved By Planning: '�/� ka-L4'- Date: \D i�Z, 1(4e7
Revisions (after Building Submittal .nly) 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: /4/Ark'
Ak'
Site Plans: #
Building Plans: # `3
Building Permit#: g'"Enter building permit#above.
Workflow Routing: Eg"Planning e' Engineering 'Permit Coordinator `Building
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: la-Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original 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: 4 / , , Date: //`/,
Engineering Review
lope at building pad: ./22e.
onditions "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 A.prov•d b Engineeri Date:
Notes:
�!► � y ' `` .� - jr
Approved by Engineering: �Z Date: /71/
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: Nies ❑ N/A
Tigard Trans SDC: L,21..Yes ❑ N/A
Parks SDC: Yes ❑ N/A
OK to Issue Permit
Approved by Permit Coordinator: I/Q l����'OQ Date: // 9//"f
I:\Building\Forms\B1dgPermitRvw_RES_091216.docx
6
City of Tigard
q COMMUNITY DEVELOPMENT DEPARTMENT
111
River Terrace Building Permit Review Addendum
TIGARD
Building Permit #: C-fic%�o�0/6, —Oe/
Site Address: 1-14-55 sv\l fctsASLi.k. Sr
Project Name: g\JC 'TO/Vac(' 4Q(Mwt S+ Lot #: ttO
(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.
Balcony w/ access 2 Window Projection Vertical Wall Offset a Gabled dormer
Porch min. 5 ft. deep ft.deep min. 2ft., 5 ft.wide min.2 ft.,6ft.wide
X- CI ❑ ❑ ❑
2. Eyes on the street: a minimum of 12%of each street facing façade must include windows or entrance doors.
Percentage Shown: 12--g-
3.Entrances:At least one entrance must meet both of the following standards:
,.XParallel to street,angle no more than 45° from street,
❑ Max. 8 ft. setback from longest street- facing wall or open onto porch
Entrance opens to a porch:.Yes ❑ No
If yes,all the following apply: 125 sq.ft.min.
NOne street facing entry A-12 ft.max.roof above floor of porch
3 5 ft.depth min. -LIY515%min.porch roof coverage
4.Detailed Design:All buildings shall include a min. of five of the following elements on all street-facing facades:
Covered porch min. 5 ft.wide x 5 ft.deep :1tecessed entry area min. 5 ft.wide x 2 ft.deep
.'Wall offset min. 16 inches ❑ Dormer min. 4 ft.wide
hoof eave min. 12 inch projection ,Roof offset min.of 2 ft.
❑ Roof shingles either tile or wood ,It'Gable,hip or gambrel roof design
O Roof pitch oriented south min. 500 sq. ft. ❑ Horizontal lap siding min. 3-7 ft.wide
❑ Accent siding min. 40%of street facade Window trim min. 2'/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.Y1Yes ❑ 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 facade
A50%max. of street façade with 7 detailed design elements
Notes: ff�Z•I i
Approved By Planning: !Il) _ 1_0 l_,; Date: \I�I i(Q
I:\Building\Forms\BldgPermitRvw_RES_RT_031416.docx V
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
17458 SW AMELIA ST, BEAVERTON, OR, 97007 July 20, 2017 at 11 :33:59 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00468
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS
Comments:
Corrections from previous inspection complete.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
17458 SW AMELIA ST, BEAVERTON, OR, 97007 July 24, 2017 at 9:53:21 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00468
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