Permit (257) ..r
r
4
City of Tigard
11111 v COMMUNITY DEVELOPMENT DEPARTMENT
■
T t G A R D Building Permit Review — Residential
Building Permit #: /157:20/6 - 605 3 (6,
Site Address: 1-11-‘7•1 Sv Amt'I lo. Stce -
Project Name: 42.\\Je Y 7-P.Y cac e. ND fill We.St Lot #: I 0-7
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: f tvJ S' V,
Verify site address/suite# exists and active in permit system.
,gr River Terrace Neighborhood: ❑ No ,i' Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
jl -1"hree(3)copies of site plan xisting structures on site
,l' ite plan must be on 8-1/2"x 11"or 11 x 17"paper AFootprint of new structure(including decks)with finished
,Drawn to scale(standard architect or engineer scale) floor elevations
Torch arrow VaUtility locations(required for new,may apply for additions)
Site address,project or subdivision name and lot number 1,)r/t Location of wells/septic systems
pplicant information(name and phone number) N r 'sting trees to be retained with drip line,and tree
.t dimensions and building setback dimensions protection measures
.t area,building coverage area,percentage of coverage andIStreet tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) 5treet names
,Property corner elevations(2 foot contour lines if more than 11
4 foot differential)
Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified ,' l No Received: ❑ Yes 1:1No
! "Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified No Applied For: ❑ Yes ❑ No,stop intake
,t Land Use Case#: PD 22Ot S --tDoorz:5
:ET Zoning: R-1 P D)
IX Required Setbacks: Front 8 Rear ID Side 3 Street Side N Garage 20
$. Landscape Requirement: 'ZD
0/0
XLot Coverage Maximum: eD
❑ Building Height: Maximum Height 1 )/A Actual Height t21
14-Visual Clearance
0 Easements
EL Sensitive Lands: ❑ Yes eliiq No Type
Urban Forestry Plan
Conditionslia � "Met"prior to issuance of building permit
Notes: COY`filo YDS cflit 11 YYbt4 i?n0i''1), tSSVUIYI(,C, •
Approved By Planning: Date: 11 11L-1
Revisions( Buildingafter Submittal o y) Reviewer Date
Revision 1: C�;Approved ❑ Not Approved 111` 771 li,�
Revision 2: ❑ Approved ❑ Not Approved `
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_RES_091216.docx
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4
Building Permit Submittal
Original Submittal Date: /C1/1V/A'
Site Plans: #
Building Plans: # 3_
Building Permit#: E Enter building permit#above.
Workflow Routing: 0–Planning B--Engineering e–Permit Coordinator [ wilding
Workflow Sign-off: a Sign-off for Planning(include notes from planning review)
Route Application Documents: Q–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:
4)By Permit Technician: Date: /,,,2../ 1(67
Engineering Review
....Er Slope at building pad: 2:
❑" . —
v��y/
onditions "Met"prior to issuance of building permit
El 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: 0 Yes 0 No
LIDA Facility on lot: ❑ Yes ❑ No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: /4Z, Date: / -LS"--/4(
Revisions (after Building Submittal only) Reviewer Date
Revision 1: it Approved ❑ Not Approved /eiG 3,, �7
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: Ole es ❑ N/A
Tigard Trans SDC: G►Yes ❑ N/A
Parks SDC: , Yes ❑ N/A
' ► 9 K to Issue Permit
/ 1-A.2--/)..(i
/6e
Approved byPermit Coordinator: , ` rte:'
PP
I:\Building\Forms\BldgPermitRvw_RES_091216.docx g/ft 3/2.-
i.
City of Tigard
114 W COMMUNITY DEVELOPMENT DEPARTMENT
■
T I G A R D River Terrace Building Permit Review Addendum
11141111Mak 1111111111111111111
Building Permit #: I fS mei /(La ---QQ5 2
Site Address: 1-11-12-4 SW f-elq Sir-Cel-
Project Name: "{ewer Terraa N or-tvr v4tsfi Lot #: 101
(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?lin 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 ft. deep Gabled dormer
ft. deep min. 2ft., 5 ft.wide min. 2 ft.,6ft.wide
❑ ❑ ❑ ❑
2.Eyes on the street: a minimum of 12% of each street facing facade must include windows or entrance doors.
Percentage Shown: 1 3, 5`°
n
3. Entrances:At least one entrance must meet both of the following standards:
lax. 8 ft. setback from longest street- facing wall Parallel to street,angle no more than 45° from street,
or open onto porch
Entrance opens to a porch: E Yes ❑ No
If yes,all the following apply: -25 sq.ft. min.
.iNk One street facing entry 12 ft.max. roof above floor of porch
IR'S ft. depth min. x10%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 Recessed entry area min. 5 ft.wide x 2 ft. deep
Wall offset min. 16 inches ❑ Dormer min. 4 ft.wide
oof eave min. 12 inch projection Whoof offset min. of 2 ft.
❑ Roof shingles either tile or wood Gable,hip or gambrel roof design
❑ Roof pitch oriented south min. 500 sq. ft. ❑ Horizontal lap siding min. 3-7 inches wide
O 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...Yes ❑ 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.
O 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 0 40%max. of street facade
,50% max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: -t\M6CklQ f /- Date: R 14 J
I:\Building\Forms\BldgPermrtRvw_RES_RT_062216.docx
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
Transmittal Letter
71
T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Tom H. DATE RECEIVED:
DEPT: BUILDING DIVISION i'"i t- i ,
FROM: Angela Grajewski
COMPANY: Polygon Northwest
PHONE: 971-212-2144 By: ii--,
RE: /7y2� SUAJ A11 e.Liq St MST�IIP' btS3lp
(Site Address) (Permit Number)
River Terrace Northwest Lot t t`)
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies Deserip.iori' , = , Copies: es ption: .
0 Additional set(s) of plans. 3 Revisions: deck
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.
add deck due to terrain
u, t; 0 2 -;:'OR,OFFI E IJSE ._ Y g..... x.
Routed to Permit Technician: Date: 3 a') - j 7 Initials: -41'
Fees Yes ❑ No Fee Description: 6 j_l_' i Amount Due:
\. cu..., ' I JV $ W
$
$
Special
Instructions:
Reprint Permit(per PE): Yes ❑No ylDone
Applicant Notified: Date: Initials:
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
CITY OF TIGARD MASTER PERMIT
rill
'`' COMMUNITY DEVELOPMENT Permit#. MST2016-00536
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/05/2017
Parcel: 2S106DB10700
Site address: 17421 SW AMELIA ST Jurisdiction: Tigard
Subdivision: RIVER TERRACE NORTHWEST Lot: 107
Project: River Terrace Northwest, Lot 107
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: 26 Bathrooms: 3 Second: 1251 sf
Garage: 380 sf Front: 8 Smoke
Dwelling Units. 1 Third: 0 Yes
sf Right: 3 Detectors:
Total: 2229 sf Value: $341,439.85 Rear: 10
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 LaundryTrays: 0
y 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: 0
Bckflw Prevntr: 0
Footing Drain. 0 Ice Maker: 1 Catch Basins: 0
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
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
P W/Svc or Fdr: 0
Ea add'I 500 sf: 4 201-400 amp: 0 201-400 amp: 0
P 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: Y
Ecompasing:
BUILDING INFO
Class of Work: Type of Use:
Type of Constr: Occupancy Group:P Y P� Square Feet:
NEW SF VB
R-3 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
STE 1 2 One Hour Fire Rated Eaves
SCOTTSDALE,AZ 85258 Required both sides
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $32,840.55
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: // J ze
Permittee Signature: fj =%/�,
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 L.0 07
RECEIVEDFOR OFFI( [ t sr ONL)
City of Tigard Received
13125 Hall Blvd.,Tigard,OR 9722 )Plan Rev
• tCT 11 2016 Plan Review
/a �/ •J/% Permit No �� j6t , :?k
■ Phone: 503.718.2439 Fax: 503.598.1960 r+ /1 �/ 9.
CITY
Date/BY: )e1.')4- J C OtherPermifi����i°/6..�//y7
T t c i F(> Internet�nwww tigard-or gov75 v i i FIGARD Notified/Method:/ //�� a juns la See
Page l for
BUILDING DIVISIONsupp►ementalWorma6on
®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 Other: equipment,materials,labor,overhead,ad,and the profit for the
��° t [,�!°,,,, � -,,'2' " �� - work indicated on this application.
® 1-and 2-family dwelling 0 Commercial mdustrial Valuation31 j 43 9 $ (.1 —11 1
0 Accessory building 0 Multi-family Number of bedrooms: L.'
M0 Master builder ❑Other: Number of bathrooms:
'£� � msZ
' f". .: sWi �,, 4 - Et Total number of floors:
Job site address:i7 Z( SW Amelia St New dwelling area: 2211 square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: 7J1Q„ square feet
Suite/bldg./apt.no.: I Project name:River Terrace Northwest Covered porch area: L(v u square feet
Cross street/directions to job site: Deck area:
square feet
Other structure area: square feet
Subdivision:River Terrace Northwestil, ��`4`�'�' = °'
J Lot no.:1 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
x equipment,materials,labor,overhead,and the profit for the
- work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
7 1 t ; , 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:
,:;;-_-",-;-7: L-: '' fie) f. i i
Business name:Polygon WLH,LLC
Contact name:Angela Grajewski Structural plan review fee(or deposit):
Address:109 East 13th 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.Grajewslu@polygonhomes.com �, : ,--- M-,-.'.7---
t-` ,'` y am, s Commercial and residential prescriptive installation of
''... 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 $180.00
Phone:(360)695-7700 and.dministrative fees):
Fax:(360)693442 State (12%surchargeof
permit fee): $21.60
CCB lic.:207247
Total fee due upon application: $201.60
Authorized signature:,_.„4 / kA This permit application expires if a permit is not obtained
1,, within 180 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)
CI' '-i--'
Mechanical Permit application 1 ,,K,,i , 1, I I ...., ,,,,,
v,L:.r:: i,' 8 2016 Recaral ' • • .
C' ity of Tigard Pabday; Permit No. 4757
lh -4-- - 13125 SW lied Blvd...Tigard,OR 97223 ,,„_ plas,R
6: ' Phonic 503.71E2439 Fax: 503.598.1940'
inspection Line: 503.639.4175 - - ' *. ., '. 'I- - ptate itellitH43S.: Iwil' I id Ste Pstel tor
• Internet: www.tigard.or.gov 37,I-7 ---%"' V 4.' ';'")'1 ,' .';';7 7.,"-'Pu,if,,,alt4„6,„,k Supplemental Ittrormaidan
.....A.,.., 1,....i7
Mechanical permit fees*are based on the value of the work
183
New construction 0 Addition/alteration/replacement petformet indicate the value(rounded to the nearest dollar)of all
0 Demolition El Other: mechanical materials.equipment.labor.overhead,and Mfg.
Value:S
•s,,,,tt-:.----..:,4,"il--:1:-',.',7-..:-,-qrsr. -'-','•''''-7,'',;, 14.,-5'; 6-''• ''',77:71..- IC 6,,':..-Lo..r-':-,-_''°,.4-',-..`R•ti.A.1-','{'..`"-'10.'" ^ . - ....a, -- ., a '-' .- --- — -
..'.!-4.1!--- 2•L'E-i'jln-t.U-':,.* :;,,LY-!i_.4-;',1-;-1,7,1.1 7,i-.1-!.!..-A-5.s...g.L'LT,'-',.!..kt,'4):4--',.:..:4.,•._*.',.'-.1....,-'':: .4.z-..i.: If:',..,.. .221...-. ,:c,,'-:' ,.],':..-`4:;%:,._)...,,ttilij.4.,:7, ,171',.1.Fri:,4.i.'10-..,,,,k.M,r,..A.i 4::;:,,,,.`li,;,
171.1.and 2-family dwelling 0 Commercial/industria. 1 0 Accessory building For special be/On:Wiwi use chectat
Muld-farrtily 0 Master builder 0 Other Description I Qty, I Ea. 1 Total
;.'c'eli7Z-fif:-Ce-k_t?..sli•';[,..Z.';i':.k.?;''''''..q.;,. ...i.::' , . -Hutill/11°1°114x:
7 '-'--- -"- -— Air conditioning 46.75
Job site address: 114i, ..\,N pattuo, %-t- Font=100,000 BTU(ducrevems) i 46.75
CityiState/ZIP:Tigard,OR 97224 Fumaom 100.000+BTU(ductVventst 54.91
Heat pturm 61.06
Suite/bldg./apt,no.: I Project narr Nev-Te.trinut_.Nonintver— Duet work 23.32
Crass street/directions to job site: ,Ilydranic hot'Mika system 23.32
Residential boiler(radiator or
hYdronic) 23.32
Unit heaters(fuelaype,not electric).
in-walLw-duck suspended.etc. 46.75
Fluckent for any of above I 23.32
Other: 23.32
Subdivisior pw t,r..rt nface WoerAtptedt 1 Lot no.: in
, Other fuel appItinr.cs:
Tax'map/parcel no.: Water heater 23.32
: Went for at
T','t:i.:.'.:,-.(E.4f5,fi'3--Vt'ij'•"F'A. '''.l :,:'..(. 41, - Gas fli5Aaccrinsett 1 3339
----- ---- --- - -' ' - • - --' Flue vwer heater or gas
fireplace 2332
Lod Helder( as) 23.32
Wood/pellet stave 33.39
Wood Sreplacelinsert 23.32
• chintracydinedfluetrent 23.32
,,,,;,.J.;:, ,„.-,.,,, .... r_.„,,.c..,..,,,..„,,,, ,,,,..„,,k...,„te-e,,,,,,,--,,!,,y.,,,,,_,; ,-,:,,,i...-P,•....iTi''';.*:-7:-"-'' '...;A'',.....1;;.le-,7,7-c...2. Olhoc _ 23,32
::-C, 4,:•:,..-IC-!-''." ;',`,.'-''-'-...i7.-6 f.'iL'ik.^.(-R.'._1::..'f!'...':: :: .%.k1.-:I;-"-Ial"". ...',74_,...:41..1"•.f.S45,h,.-flii-S.-•_.-75.!-.'I-1`,1.?..T.:.' Eliviro„„bil exhitost and r„WAWA:,
Nam:Polygon WI,11,1,I,C ittuise hood/other kitchen 1
equipment 33.39
Address:109 East IP Street Clothes dryer exhaust 1 33.39 _
City/State/ZIP:Vancouver,WA 90660Single-diet exhaust(bathrooms.
• 4
toilet Oompartmems.utility rooms) t 2332
•Phone:(3601695:7700 Fax:( ) Atticlerawlspme fans 23.32
';'"7:7;,7- ,,,-.;,:.,.4,-F_-‘7,7-7: ':774--,:;;F;i7-4-', 1.‘ ,'-` ','".--' l'' -i- Other' 23.32
rue)olvinv
Business near:Polygon Will,LLC 31435(or that loon$4.03 for reb additional
Contact name:Angela Grejevssld Furace.etc.
Oas heat pump
Address:109 East 13th Street — Wall/suspendedfunit heater -
City/State/21P:Vancouver,WA 98660 Water beater
Phone:(3601695-7700 I Fax::(360)693-4442 ,Fireplace 1 -
Ranee 1
E-nuol:Angela.GrajewskIttpolygonhonses.eons Barbecue ,,
7' -:;--r--;'-;";----.;.-iA;;t.,&•t-.7: 4.. -7'22,S5-.-2.7....'", - .'7.-:. :_`' Clighcsdtler Os)
Other
Business natigm Apex Mr LW
Address:10004 NEW'Ave Subtotal _
City/Stoic/VP:Vancouver,WA 98686Minimum permit the($90.00)
Pt=review(25%of pennit fee)
Phone:(360)3424109 Fax:(360)3264169 State sureharSc OM of Pmaillb*)
CCB lit:203034 TOTAL PERMIT PEE
Authorized signature'
f.,.......4 Tb4l,Permit Imprimis*eopins Ks woad is net obtained withts Ida
dors letter le has been accepted as cataptete.
* Fee methodology set by Tet-Coonty Building holostrY Seonee accid
Print name.. i t", / Date: 4,1/-/t...
tAdmikftWeretaaMe_Posirapp_esal 13 floe sse-astIT(ttadanSawatt
` 4,
Electrical Permit ApplicatAon FOR OF1ICI-LSI.ON1,1; •
y` t ," Q 9 016
waived
City of Tigard mars . oi`7S7 2c/ --tic 3
Ili' .
13125
SW Inst!Bivd.,Tigard,OR 9 2 t,3 Pim ltevir w
Pimae: 503.7!82439 Fax 503.58 P9 0 3 3hdalB
inspection Line: 503.639.4175 „ DeteFB
_!(,.'Iii) !;or ' rx ..:..t1r • _civ.'_; Nealy Y-
htemet wwry tidor -.. i Notiked/tdathafi
1®New construction 0 Addition/alteration/replacement Please ebedc all that apply(submit 2 sets of plana w/iteu$checked):
0 Service or feeder 400 amps or more 0 Building over three stades.
❑Demolition ❑Other: where the available fault cunnut 01;6arines and boatyards.
'"t .",ti • ^.=a - .-+C_4-,a h Sa I` -F'-233 A'V Tk�. = ` :...:....-? 7,.4,-„4,-,!-:_-..-:,, exceeds 10,000 amps at 150 volt or 0 F7oatiog bnilduiga•
•.4 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building lase to ground,or exceeds 14,000 0 Commercial-toe agricndtacat
amps for all other installations. buildings.•
0 Mufti-family p Master builder 0 Other: O Fire pump. O lauauuion of 150 KVA or
;.3.,1N. r,'F r`-li (oma a {. t'.,', rP.I7463- 'c� l;t.: ° '- ,r c6 'c.":*-1. `5 ORmcg ucy system. y derived
'� O Addition of new motor load of
Job#: Job site address:! 215 V F V ' (,3r 10010 or more. Cl"A ^F",-2-2 X14',
O six or more residential Holts, occupancy,
City/Stat/ZIP:Tigard,OR 97224 ❑Htmlth•otue facilities. ❑Retaetdioaet vehicle parks.
Suite/bldg./apt#: Project name: `+ CI Haserdoes locations. O s+grply volt fir mom than
lerTul oiee.Nt "••
OService orinedar600amps orMOM. 600voltseeemel.
Cross streetldirections to job site: ' .P. S'49 _ F a' rAi .-4 + : .f'
f aertoti �Rti. Ysrh Tofi1 "
f��v.� w .��,[ c t-- New residential single-or multi-family dwelling unit
Subdivision PAVa t +ace_t 111/1 WfA 1 Lot#:1 01 .Includes ched garage. 368.54 4
Tax map/parcel# Ea add'1 500 sq.ft or portion ' 33.92 1
+d._:. :coil., say .� ).1 , . r'd_ x,yt"1ala Liwrr_.i9a:ass fX>ai . o- 1 -,1"4 �iYlted ERCTgY.rrdentai 7500 2
(with above sq.a-)
Limited energy,multi-family 75.00 2
resident{ial(with above sq.S.)
❑ Ste Page
? N l ,a7g6VlJ ar c"?` Y'-' "; ' y1- ��3> Y�sl» h:. P{ .r-Xf
Services or feeders installation alteration,and/or relocation
Name:ADVL Land Holdings,LLC 200 amps or less 10030 2
201 amps to 400 amps 133.56 2
Address:7600 E Doubletree Ranch Road
401 amps to 600 amps 200.34 2
City/State/ZIP:Scottsdale,AZ 85258 603 amps to 1,000 nips 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
$marl: relocation _
Owner Installation:This installation is being made on property that I own which is not 200 amps or less5936 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.082
401 ampsto 599 amps 168.54 2
Owner Signature Date: Branch circuits—atw,alteration,or extension, r panel
-"' x r- 'a r S. 0-(est;° Oz tray is .i•<ka , `3 a e,g1t.1 e4101` ;F r ti.:t ,;. A.ree for braaclt cirw'r�with
I
Business name:William Lyon Homes,Inc. above service or feeder fee, 7.42 2
each branch circuit
Contact name:Angela Grajewskl B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address!109 East 13th Street brunch circuit
City/State/ZIP:Vancouver,WA 98660 Each add1 trench chant 7.42 2
Miscellaneous(service or feeder not included)
Phone:(360)695-7700 - I Fax::(360)693-4442 Earhmanufectured ormoduler 67.84 2
• dwelling,service and/or feeder
panail•Angela-Grajewski@polygonhomes.cam 'llecommet only 67.84 2
v
_ '� ir�.r�c?;?� ,,s.,��s ,� , _' , _..R ';� Pump orbtigzGloaoink 67.84 2
Business name:Garner Electric Washington,LLC Sign or onalitu lighting 67.84 2
z.«,:. Signal crtrutt(s)or limited—energy CI See Page 2 2
Address:6101 NE St Johns Rd petal,alteration,or extension
Each*Monet inspection over allowable in any of the above
City/State/ZIP:Vancouver WA 98661 Addidonal inspection(1 hr min) 66.2.51 br
Phone:(253)320-1657 Fax:( ) Investigation(I brmia) 90.00/br
3nduatrinl plant(1 hr ruin) • 78.38/hr
l?rslail.bdatrleisgigwensa eafnlospectices for which no fee is
listed Y.brtnla 90.00/hr
• CCB cc.: C1158 Electrical Lie.: 208174 Suprv.Lim: 4496S
Y - .v ; t 2 ce, 3 r e� t- :,ieL I '
._"•.1,"- --,:',:<'-7-,g: _.
::;.,..• Suprv.Electrician signature,required, :•t '
i til( .I ., ,•-,, • Subtotal:
`'` Print name: loan P Albert I Date: 4126/2016 O Plan Review Required(25%of pen:nit fee):
I-E State surcharge(12%ofpermit fee):
.I.*.:;',,y ! =- - ---^` - T TOTAL PERMIT FEE:
, Authorized signature: -
"4h'j;; This parent epprreatloa expires$a perntltis not obbdned nithln 180
a. o- Print name:Bill Daniels Date: 4/26/2016 " days after Blum been accepted as complete. __ Number of impactions allowed per purer
;;��i1i;'::y;:
21'a"•`•=°x'4'laeadi4Pemilli l.0 PeumitApp MR MEAD;Rev 06/17/2015 44046151211105/COMME0
4y'4!•' .. —
. •
1 , tv; ;,
‘..,,i' Vi a fr•
Plumbing Permit Applicatlen•-e-Li ‘-."
Building Fixtures
‘,‘, 8 2016
IN City of Tigard Received
' 13125 SW Hall Blvd.,Tigard,OR 9-124;.„„; --,, ,.- , , , 1.N., .,,,Da'n3,,„ .,.. 'end'•e .L_6,i..g_.J-3'
irf Phone: 503.7182439 Fax 5035931960 *1. : ',. _',' ',---7'- ,,OnscrPondt No.:
1 I,, ,1_, Inspection Lin= 503.639,4175 ,..,,-.,-,i- - i y/,-,'-ec ' ' .
'Wallet Www.tigard.or.gyy 3ii,,,,. 2,„..: „. ,, ,,,,,•,,,,, Deeftaymy: md. Si Soo Page 2 for
77-1, ' ,' '. ' 14°11fiamethi3d: -• tomato Taformation
,,.. .,.•,.',,-,..:,-,..,,,...- ._:;---,.'=. a,i,'-it-':,Crig*:.i.
CI lit:w constmation •fit Demolition - For Veda!Jail:emotion ase eiteekils4
..„ Descriptkin OW. I Ba. I Total
. [lather:
;..1-1... Addidmialtecativie,-7_,-.--2:••,-...--..i.-11"Placwen---'-',-•-/'-'1,-?-•---,7,x....,.......,"•,.:7„,.,-, ..A..e.,..,.,.. „, , . • Naw 1.24/11n4 dwertw(ur-bdat 100 ft.fol earl utility*conection)
''''',c.,,'"''''''''''' - '''..::":-"--zf'-'.'\-:'- ".-P---.:,,,-•:q''. 2.....‘.. :'..4."2L,,,`.!`.15_4-.V.-3',4,-,.2,--;f.1',-,., f, SFR(1)bath 31z7o
tek,i 1,and 2411arly dwelling CI Conraercialiindruattial •SER(2)bath 437.713
SFR(3)bath I 500.32,
latkccessory building 0 hiulti-fatnily Each additional batb/kitchen 25.02
El hi/aster builder 0 Other: Firespaliddte(___sq.ft.) Page 2
''''Art -'-'47..-i•=1°-.^''''':-.'',-','..;'4,67-'"I"'`,In4 is'-',,Z,..,,;.',' ''.)...e',5,-1'..,',';•P'''''''Y f(''','-'''':'j'''''`"''''''''..-'''`ii:,.:,,.. Site Ander
Job sibs address: iq 2,I SNNI k ?li rk st-- Catch basin or area drain 18.76
Drywall,leach Hoe,or trench drain 18.76
Cily/StaterM Tigard,OR 97224
, Footing drain(no.Sneer IL:_____) Page 2
gattengdeaPt•n0-: Paled navie'iRi'‘*r .tri(0 L I I lA)e. .hiandactuted home utilities' 50.03
_
Cross street/directions to job site: Jganholes 18.76
,
Rain&tin conziecter 11.76
, • , - . . , Sanitary sewer(no.Bazar ft.: ) Page 2
Snurn sewer(no.linear ft.:____) Palo 2
. ' , Water service(no.linear ft.:.___..) I Page 2 I
Subdivisiqr!Li*,Tery-„,, No,f i'Vt.tAlei I-- I Let no.: i 01 rixture"licca:
Tat mail/Parcel no.: BaokBow prevent/sr 71 1 31.27
•:-..,:;„':„,,,,Z,,,.,.. z,,..i, .;...;:1;,..,,:,,,,:,t;-St..--.(f.. -r;7,..j-,,.---;;,, fi--. .74-te"-e,4-s-4-:,,,_; I 12.51
, .,.,...„ ,:'-- ''',,,'N'...‘.;-`,4::ns,7%!'.`ns.,1,4,,....E "I' .,-,-4"..:-T-4,1'..::.45'•;71,2....,--;-;,, ,ri''--i,•;•,-.',,--7-., -
"' C101bet WaribeV 25,02
. .. . . .- Dishinuther 25.02
D4oking'fountain 25.02
- ' Ejoetess/suntp 25.02
-11,-,1'",;-..'"... -"-L,...,?"tt.)1:2 at'-e::-'2'),';1171-1'i-F41.--''"i'i''''''''.r,: r:.:5145.g,27_,T;.T.-.:;L.':"Z.:3-gi:_.::,'-'%:,--r:L•''...-;;-"'• EFPanula 141k 1241
Tiatcte:A.1YOttand Holdings,LIC Fixture/sewer eaR 25.02
Sac*(10in/floor sinldbub 25.02
AddrOss:7606)Doubletree Rana Road , Gartmgc disposal . 25.02
Citptate/i0:14cottsrlatel AZ,85258 Bose bib 25.02
f1Agne:.(6.°469446i
lax ( ) Ice realer, 12.51
-- ,--' ,1:-,::`',.:'•-,..--''-': %-,':". i''';',2T'.,--_',.!--,7:- -,:i.._;'. .,' la@OPWriVeasetraP 25,02
lvferileoltas.Oder _
I:tininess-name;Wiliktiff'4.011 itolneti,tat - - . Pallor 12-51
C008601302074T01144 Cd7tionikt Ittif drain(cortunercial) 12.51
Add#4F i9913th sfreet . . Sin'labaski/lavatory 25.02
,
bifyignegIZI.P:Vaiktouver,IIV,44.98660 taw upits Wahl*'wecer) 62.54
P1104;.ejr4 6954760 Fax:(360)693. 442 Tub/shower/shower pan 12.51
Urinal 25.02
B-ntalAttgela.Grajewski@polygonbonuts.conaWB1C1OSC 25.02
'f.--_:--_-,7"..._--,__:...4%.-....1-,:.1- ..-.;:,.:-.2..•:4`.:•2....F i):I',I.:::,;,..:,,'z,'...`,7:: ::2;.;742,..-T1,, ,..C,Ee-;1' WaerJeatII 37.52
Bdtiness llamet' t *.VV.\•cr5rOvNif giAe--- .aterPting/DWV 56.29
Afric"Si 4) el.I S'ON 01.0. Other: 25.02
avlskiteoP: ST, e4-4A art_ Subtotal
-
Phone(343.-5(tt-' t4Ll I Pax:(11 la r1.*4 n6 Wininnuo pariah fee: 17230
CCB Pez j '#31 -. ,1 i PluPOIng',' Lie.no Pb (3,1pi=reryiew (25%of ixtualt fee)
• state sur0.2210(12%424*calf fee)
Authorized sigbaPnn: :431filkliCrit bt.t.6 ...----.. TOTAL paaiar FEE
, ,
I Print:junto;gf ttilt. P W kg I Pa,ta -.-I 101 Ths-Pern*"PlicAlinterotres iropermilt4t=ed,ifted,whin,
*Fete mthlokgy sat by Id-Coady Sadists bdastySetvice Boar&
voisidavecottonstutlyaisApaoce IMMO'? 440461610M/COMPOEB)
v.
4
IN
City of Tigard
I v COMMUNITY DEVELOPMENT DEPARTMENT
T 1 cA R D Building Permit Review — Residential
Building Permit #: /7157:P0/6 - brC5
Site Address: I-1l\�1 SW -AMP,I lal SfireeA-
Project Name: P-...\ve r 7-C r face, N b fah we St Lot #: (D-j
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: New STv-
Verify site address/suite# exists and active in permit system.
,Rt-River Terrace Neighborhood: ❑ No ,i2Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
: hree(3)copies of site plan 'xisting structures on site
, ite plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint 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 J Location of wells/septic systems
>qpplicant information(name and phone number) pJ xisting trees to be retained with drip line,and tree
ot dimensions and building setback dimensions protection measures
ot area,building coverage area,percentage of coverage and1Street tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) treet 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 g No Received: ❑ Yes ❑ No
Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified IR No Applied For: ❑ Yes ❑ No,stop intake
Land Use Case#: PD122O15 —(DD C(06
:ff Zoning: Q_—1 ( D�
IX Required Setbacks: Front a Rear io Side 2 Street Side NA Garage 20
$. Landscape Requirement: 20
0/0
XLot Coverage Maximum: SD
❑ Building Height: Maximum Height {JPA Actual Height t21
Ik'Visual Clearance
Easements
al Sensitive Lands: ❑ Yes A No Type
XUrban Forestry Plan
Conditions "Met"prior to issuance of building permit
Notes: Cw AVAS Lc hntl Ocjytt4 6i-tD ISSMeice, •
Approved By Planning: ° Date: 11 N l I
Revisions (after Building Submittal o
Y) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: El Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw RES 091216.docx
4
Building Permit Submittal
Original Submittal Date: lG'3G'3/1//,'
Site Plans: # /�
Building Plans: # _
Building Permit#: ®'`Enter building permit#above.
Workflow Routing: 1;1—Planning Er-Engineering E''Permit Coordinator i - iilding
Workflow Sign-off: 2' Sign-off for Planning(include notes from planning review)
Route Application Documents: [2—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:
``\ r 0 Date: J ` /,, '
By Permit Technician: -
Engineering Review
Slope at building pad: 2.g.
50- r
❑ 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 Approved by Engineering: Date:
Notes:
Approved by Engineering: gZ. --. Date: /2.--/ --ji
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: r Yes ❑ N/A
Parks SDC: Yes ❑ N/A
a► 9 K to Issue Permit y7-1/ /61
Approved by Permit Coordinator:
Date:
I:\Building\Forms\BldgPermitRvw_RES_091216.docx
s.
City of Tigard
e COMMUNITY DEVELOPMENT DEPARTMENT
11114
T I GA R D River Terrace Building Permit Review Addendum
Building Permit #: /`fS°t`c, 7C) —005-3 c,
Site Address: \---p--124 svMPSI lei SAY `
Project Name: RWer Terrcta N O—tin v4tsfi Lot #: 101
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan District Design Standards (18.660.0701):
Is the project subject to the plan district design standards?0 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.
Porch min. 5 ft. deep Balcony w/ access 2 Window Projection Vertical Wall Offset a Gabled dormer
ft. deep min. 2ft., 5 ft.wide min. 2 ft.,6ft.wide
❑ ❑ ❑ ❑
2. Eyes on the street: a minimum of 12% of each street facing facade must include windows or entrance doors.
Percentage Shown: 13. 5"9/e)
3. Entrances:At least one entrance must meet both of the following standards:
... 1/4-Max. 8 ft. setback from longest street- facing wall Parallel to street,angle no more than 45° from street,
or open onto porch
Entrance opens to a porch: EI Yes El No
If yes,all the following apply: -25 sq.ft. min.
. One street facing entry 12 ft.max. roof above floor of porch
)S'S ft. depth min. 0%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 Recessed entry area min. 5 ft.wide x 2 ft. deep
Wall offset min. 16 inches ❑ Dormer min. 4 ft.wide
Roof eave min. 12 inch projection Enoof offset min. of 2 ft.
❑ Roof shingles either tile or wood ErGable,hip or gambrel roof design
❑ Roof pitch oriented south min. 500 sq. ft. ❑ Horizontal lap siding min. 3-7 inches wide
El Accent siding min.40%of street facade %Window trim min. 2 1/2"wide by 5/8"deep
❑ Window recess min. 3 inches for all street facing ❑ Bay window min. 5 ft.wide by 2 ft. deep
❑ Balcony min. 5 ft.wide x 3 ft. deep with inside access ❑ Attached garage is 35%or less of street facade
5. Garages and Carports:May face the front or side lot line on a corner lot.
Setbacks:
No closer to front or side lot line,than longest street-facing wall.-Yes ❑ 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.
El 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
50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: CVQki�174-- Date: It 1F i J
I:\Building\Forms\BldgPermitRvw_RES_RT_062216.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
17421 SW AMELIA ST, BEAVERTON, OR, 97007 June 29, 2017 at 11 :51 :55 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00536
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS
Comments:
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:
17421 SW AMELIA ST, BEAVERTON, OR, 97007 June 29, 2017 at 11 :50:45 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00536
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS
Comments:
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:
17421 SW AMELIA ST, BEAVERTON, OR, 97007 June 29, 2017 at 11 :51 :55 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00536
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS
Comments:
No AC installed at this time.
Violation Summary:
Inspector Contractor