Permit (252) 4
City of Tigard
IIIIq COMMUNITY DEVELOPMENT DEPARTMENT
T I G A R D Building Permit Review — Residential
Building Permit #: fiSr /v - 00523"
Site Address: n3d3 sw AM-ctla s-r-.
Project Name: ¶2\ver Tel(cc cc Noi-l-ntAml-f- Lot #: 110
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: Nevi g 12-
erify site address/suite#exists and active in permit system. —N)Ot t' GtCCe L -
Rver Terrace Neighborhood: ❑ No k l Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
Three(3) copies of site plan 1 7i, xisting structures on site
Site plan must b:on 8-1/2"x 11" or 11 x 17"paper ootprint of new structure(induding decks)with finished
Drawn to scale(standard architect or engineer scale) - floor elevations
,ltNorth arrow Utility locations(required for new,may apply for additions)
Site address,project or subdivision name and lot number 1111 •cation of wells/septic systems
Applicant information(name and phone number) 1) xisting trees to be retained with drip line,and tree
lb
►= .t dimensions and building setback dimensions .rotection measures
it: ot 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) Street names
'roperty 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 y No Received: ❑ Yes ❑ No
Public Facilities Improvement(PH) Permit:
Required: ❑ Yes,applicant was notified No Applied For: ❑ Yes ❑ No,stop intake
Land Use Case#: P 2.015 —COCA.
1.57 zoning: (2--) CPD)
)8i, Required Setbacks: Front B Rear `O Side 3 Street Side Nip, Garage 2D
Landscape Requirement: 20
0/0
1Z ot Coverage Maximum: Q
a Building Height: Maximum Height N' a Actual Height' -C
.41 Visual Clearance t /Lar
Easements
,.1Si'Sensitive Lands: ❑ Yes No Type
Urban Forestry Plan
- Conditions "Met"prior to issuance of building permit
Notes: COfndthvfS SYYtt,' C Ya ---?o C per .m r. ISSual•cc- . .
Approved By Planning: jf AIL. Date: 2' !Le
Revisions (after Building Submittal of ly) viewer Da
Revision 1: leApproved ❑ Not Approved , 22/
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_RES_091216.docx
1.
Building Permit Submittal
Original Submittal Date: /OP re.'
Site Plans: # 3
Building Plans: # 5
Building Permit#: "Enter building permit#above.
Workflow Routing: Planning a-Engineering [ —P rmit Coordinator [ -Building
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: j '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: r Date: / V// ,
Engineering Review
Slope at building pad: 5
❑ 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: 0 Yes ,-No
Assess Water Quantity Fee in-lieu: 0 Yes fd' No
LIDA Facility on lot: ❑ Yes �'NO
❑ NOT Approved by Engineering: Date:
Notes: A`w-•
Approved by Engineering: /rWA.- Date: /2—///(
Revisions (after Building Submittal only) R er...27
Date
Revision 1: Approved ❑ Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 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:
4 DC Fees Entered: Wash Co Trans Dev Tax: Ito es 0 N/A
Tigard Trans SDC: : Yes 0 N/A
Parks SDC: Ur es ❑ N/A
OK to Issue Permit
Approved by Permit Coordinator: Date:/?
I:\Building\Forms\BldgPermitRvw_RES_091216.docx 4(// 3 7-.9
4
City of Tigard
a COMMUNITY DEVELOPMENT DEPARTMENT
T I G A RD River Terrace Building Permit Review Addendum
Building Permit #: /y. 7fie/6 — 00.5./._..<
Site Address: n -5 SvJ NM-c t Co% S'1y-ec-f-
Project Name: }2wer Tcrracc, NDr-thw'-est , Lot #: 11C)
(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 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
.c' ❑ ❑ ❑ ❑
2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: tcE, o
3. Entrances:At least one entrance must meet both of the following standards:
Max. 8 ft. setback from longest street- facing wall 4 , arallel to street,angle no more than 45° from street,
or open onto porch
Entrance opens to a porch: ❑ 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
. 5 ft. depth min. 30%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 .kecessed 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 !si oof offset min. of 2 ft.
El Roof shingles either tile or wood 'Gable,hip or gambrel roof design
El 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.XYes El No. If No (Check one):
El 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 171...40%max. of street facade
❑ 50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: �� - 2( - Date: j l l'). r/0
I:\Building\Fonns\BldgPcmitRvw_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
11/41 le
Transmittal s ttal Letter
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
FROM: Angela Grajewski
COMPANY: Polygon Northwest
PHONE: 971-212-2144 BA
RE: I73(D3 S\d ftrne,l. a St- M rp oak
(Site Address) (Permit Number)
River Terrace Northwest Lot j t 0
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies.. escri oIlto... �,,.. .., ....vm. =icopiek, )each l ion:
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
Routed to Permi echnician: Date: 3 z7 /-j Initials: '
Fees Due: Yes ❑No Fee Desc ption. .. .. i '0, Amount Due:
: J Y7 . k✓ pLovn, rt. .c c,.1 $ yS7=-
$
,v it
$
„. 2:c,. Y.,f• .. . 4W''',, $
Special
Instructions:
Reprint Permit(per PE): IZI4Yes n No 1413One y
Applicant Notified: ' Date: Initials: hriii
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
71CITY OF TIGARD MASTER PERMIT
t.
:, COMMUNITY DEVELOPMENT Permit#: MST2016-00515
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/05/2017
Parcel: 2S 106DB 11000
Jurisdiction: Tigard
Site address: 17363 SW AMELIA ST
Subdivision: RIVER TERRACE NORTHWEST Lot: 110
Project: River Terrace Northwest, Lot 110
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1248 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 26 Bathrooms: 3 Second: 1666 sf Garage: 464 sf Front: 8 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Yes
Total: 2914 sf Value: $349,907.86 Rear: 10
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0
Catch Basins: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Bckflw Prevntr: 0
Drywell-Trench Drain: 0 Other Fixtures: 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
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: Square Feet:
NEW SF VB R-3 2914
Owner: Contractor:
WILLIAM LYON HOMES INC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
109 E 13TH ST 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98660 VANCOUVER,WA 98660
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $33,818.51
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through O6R 95 -001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: t A, 2.-1-e - Permittee Signature: v (9w17)c`,C/1-->" 7' 1%
Call 503.639.4176 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
lBuilding Permit Application z_ or D
7-7:47; RECEIVE
� � t '� IOR OFf:ICE t O\Ll
City of Tigard D " ///Sv / Permit No
13125 SW Hall Blvd.,Tigard,OR 97223 0 C T 1 1 2016 ../ /�' f � Q �S
e Plan By: 1a.— - ) Other Perm_th—&� /�--efp
��11 Phone: 503.718.2439 Fax: 503.598.1960 _ Date/By:
t) Inspection Line: 503.639.4175 (✓1{ ()}- i'� � ,� Date Ready/By: �/. Juris: H See Page 2 for
Internet: www.tigard-or.gov 3 UI LO!( O oIVIS 10 Notifed/Method:/'/'f/ /CL Supplemental Information
IIs �. / Cif XIS
®New construction 0 Demolition Permit fees*are based on the value of the work performed.
❑Addition/alteration/replacement 0 Other equipment,
the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead, d e pr fit for the
� ?"`a� '�r.``�•„" � �° �'`: ttR'; u ` work indicated on this application.a q 4h 4 b 7 -/
m, :�„ r„.,�bn astmsv,,:�a�. .fi�s " . mts';a,
® 1-and 2-family dwelling ❑Commercial/mdustrial Valuationl$
Number of bedrooms:
Accessory building ❑Multi-family
V-3 ❑Master builder ❑Other. Number of bathrooms:
�' x & Total number of floors: Z
Job site address:/73(07 SW Amelia St New dwelling area: 11 l y square feet
City/State/ZIP:Tigard,OR97224 Garage/carport area: (J y square feet
Suite/bldg./apt.no.: I Project name:River Terrace Northwest Covered porch area: �_iIL.Z square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
Subdivision:River Terrace Northwest I Lot no.://fl 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
equipment,materials,labor,overhead,and the profit for the
�t a work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
� ` ' 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 "'" e,* , "'
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
Phone:(360)695-7700 I Fax::( )
Amount received:
P> t c { ! rE
E-mail:Angela.Grajewslsi@polygonhomes.com �� � , ,,�,„„�,,
�a � •, � ••• • Commercial and residential prescriptive installation of
• ����.SEs" E _ � a � rooftop mounted Photo Voltaic 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: $201.60
Authorized signature: J rV 1 This permit application expires if a permit is not obtained
�Lit.//// within 180 days after it has been accepted as complete.
Print name:Angela Grajewski Date: /10 q /_ *Fee ServimceethodologyBoard set by Tri-County Building Industry
-t��
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
VEDItti: t„ Ili1 tklct\l1
Mechanical Permit Apnlica _
ttccaved ,
71
City of Tigard �� 2 0 Dainty- Permit No.-
13125 SW Mall Blvd..Tigard,OR 97223 plan ketiew Other Permit:
i. Than: 503 tine:
3 39 Fax: 503.598.19.60_�, O F „l u AR t) �!•- 1.i. H Ste Psxe 2 tar
Inspection www. 503.639.4175 DI.#AIt Noti6ed.Rdethod: Supplementallalormatioa
Internet: www.tigard-or.gov goy � ,.. S���IS'
_-i u�i';i:I•i A rl,.4 ,,�o.;l +tit. .14110.0
-‘,44.;&,,,,: _e ""t.r � <". Yam " ,-�".,1'"'�' e' Meehameal permit fres*ate based on the value of the work
tom: N.ru'construction
u�
performed.indicate the setae(rounded to the nearest dollar)ata
ll
®Neu tlanonuclion 0 Other.
Addition/alteration/replacement mechanical materials.equipment labor,ore-timed.and profit.
❑Demolition 0 Othtx
Value:$
e
,,,,11-..-T:-.Z:2:;.-ii-_,2-4-1. .'; '4 s, . � 2TWIZ.YJ t S- - ,'t rIr a ;11 < e'v lP r; p, ;7 i (.' "'. 7-41,-,,,- ,'
,`'-'.-,
7 buildin RsrsproaTTajarn►atl6a�irdhse*Gst
❑ I and 2-family dwelling 0 Commcacia�ndustrial 0 Accessory iron • : Ea. ( Total
0 Master builder
®Multi-family Other: Descr_ l;eatiaPlctrolinl<:
• +3 ..' t '-' -1 1 ! g('''' - ¢:.t -r7•taC t IE.isx `s" .n= .rz.-.-:-�:4 Airco tioninit I , 46.75
r I E 3 7) S\} 1.\-1\41\9 VOL S` Furnace 100.000 BTU(duawvaus) 46.75 i
Job site tuidncss. ! 54.91
Furnace 100.000+BM(ducts/vents)Cit7tStata!LIP:Tigard,OR 9722 t ,�/y_ ' ` Beal pump 61.06
Project name 12—totvie ►civ .N�1 Ductwork 23.32
Suite/bldg./apt.no.:
i lydronic hot water system 23.32
Cross strccVdircclions to job site: Residential bailer(radiator or 2332
hydrank)
Unit heaters(fuel-type.not electric), 46 75
in-wall,in-duct,suspended.etc.
Flue/vent for any of above 2332 3
hOther:
23.32
Subdivision r \J0vA�--- t Other fuel appliances:Tax map/pnccl no.: Water heater
2332
�: , , _ c> a��r,Ztf-ra � � < sew7 '`x :'r - Rune vent for water
heater
at£ I 3339
fireplace 2332
Log lighter(pas) 23.32
Wood/pellet stove 33_39
Wood tlrePlacclinscrt23.32
ChhntteY/linedt]nePeent 23.32
23.32
.7-1-..iii)-Ll'..?`C..-i�` -w;� t .F�E.-d °rr o- ,>:-11., ,- .t?t°-s` �,'x1.a�, i� < FSRtfrannlentat exhaust'And l entilation:
blame.Polygon!� Rappfood/oihCt kitchen
LH,LLC equipment 33.39
`
Clothes dryer exhaust I 3339
Address:109 Bast 1.V4 Street Singer-duct oXhaust(bathroams,
CitylStatcfZlP:1'ancnuvcr,l4'1 98660 loilci mmpanmeats ability reams) 2332
Atticiemwlat fans 23.32
Phone:{36095-7700 Fax:( ) 2332 p
._,f ..
� . E -.I. :.;-' 4,r+. EVE L -v( t r•--'l fit z" !. Other 1
-r... t. e Fuel plpin
Business mune:Polygon WLH,1.I C 8t
$14:15 for rust fourl 54.03 for each additional r
la Gatjewski Furnace.etc. t
Contact name:Aage Gas heat pump
Address:109 East 13th StreetWalUSuSPeaded/unftbcater
Clty!State2ll' Yaticouver,WA 98660 Water heater
Fitm:ptaa
Phone:(360)695-7700 I Fax::(3 )693-4442 Range
E-mail Angela
ue e
t'atyt jewalt4polygonhomesto dryer(leas) t
-- e r;11.'1::cm . x..,�._
Clothes
Business nine.Apex A lr LLC = , `,s_.,i, r7 t_. . x `
SubtotalAddress:18004 NE 72"t Ave Minimum permit fee(590.00) c
Cjty/Stste2lF Vancouver,WA 986156 Pian review(25%of permit fee) G
Phone:(360)342-8109
Fax:(360)326-1769 State auosharge(12%of permit fee) '>
TOTAL PERMIT FEE _
' 'This permit application expires ifs permit Is out obtained within 180
CCB lie.:203034 as mindere.
1.
days a{(er it bars been accepted
Authorized signature'
• Fee methodologymethodologyset 17 Tri-County Building Industry Service Road
i
INita name. t, / I Date: 4.t t•ft•, 1 •
040113 dog 14-i617'r(tuti21Cn I
11ttw"hfio��!'em'M PCvttAPP_
I
Electrical Permit Applicati 9 t::.i OR OFFICE.ISE ON Ll
City of Tigard Received
N V Z Q 1 C� Permit ii:
13225 SW]lair Bivd,Tigard,OR 97223 n T7en Bcnow •
1'67 Phone: 503.7182439 Parc 503598.1960 IMM/By:. ttea.redPermit L
TIC,;1 Ic D Inspection Line: 503.639.4175 CITY OF fitiAliD Reedy Data/By: brieH See Paget for
Internet www.tIgard-or.gov V1 r} Notified/Method: Supplemental Information
a
- 7- -- a n 2 15?,a-_Atat. .:40--�-,li-i- -- L--, i' rr-_- - rte" -_ -.- 1.: . "Fr r °`Lj'� ,. i , Vii: ,-
®New construction 0 Addition/alteration/replacement Please ebeek on that apply(submit 2sets ofplans witteme ebeckcd):
❑Demolition ❑Other [Jeanie'or feeder 400 amps or mom ['Building over three stdries.
where the available fault current 0laminas mad boatyards.
1 7 _ .,.r.,4-„,•::4C4.1.Ft,a�;S*1.:c_ f a)a-c,5IF:..q tz7 ,--_� _-,-h =? 51 exceeds 10,000 amps at 150 volts or ❑Floating buildings.
®1-and 2-family dwelling 0 Commercianidtist ial 0 Accessory building lean to ground,or exceeds 14,000 0 Commercial-use agrioultarel
❑
amps for an otter installations.
❑Multi-family JD Master builder 0 Other: buildings..
FFitzpump. ❑Lrntallation of 150 KVA or
c7 _. ia, i '._Zro/.h.sti.it ;6102-p ?cAetaL ,0 ....ties 'F`s -,X" . ., 0 Emergency system. larger avant*derived
Job#: Job site address ``1 ► t [J Addition of new motor load of system.
i � sw a 10014Pormote. ❑"A;"E,"I-2',"]A
City/State/ZIP:Tigard,OR 97224 [J Six or mom residential units. occupancy.
❑Iieallfi-oer'facilities. 0 Reucetional vehicle parks.
Suite/bldgJapt#: Project name:RiV .—Terre te'N w) [J linmrdoas locations. 0 Supply voltage bur more than
0 Service es feeder 600 amps orator*. 600 volts nominal
Cross street/directions to job site: -4,„W---3-..y.2 "'r,e d J-. iia `V3 ,_
lhsedpdos Qtr. Rath Total
New residential single-or multi-family dwelling unit
Subdivision: r 6!` Lot#: , O Includes attached garage I
Tax map/parcel# 1.000 sq.R orless 1 I I68.54 1 4
Fa added 500 sq.ft or portion LI 33.92 1
• r -i M.tb i-1_'o.;E` ANN ILIA'- y ,; 1,.;_ ------;-'•.- Limited energy,residential
(with above sq.R) 75.00 2
Limited energy,mnhi-family
residential(withabove sq.ft) 75.00 2
• '-''''3'-'
Renewable Energy ❑SeePage2
' )� a - 1 : - ---r, ,ifp-,; se ;x ,ju 1o ,rc =- `- ^' ' h�3 'i , =
Services or feeders installation,alteration,and/or relocation
ame:ADVL Land Holdings,LLC 200 amps or less 100.70 2
Address:7600 E Doubletree Ranch Road 201 amps to 400 amps 133.56 2
City/StatcJZiP:Scottsdale,AZ 85258 401 amps to 600 amps 2'034 2
601 amps to 1,000 amps 32000104
2
'.one:(602)694-4031 +Fax:( ) Over 1,000 amps or volts 552.26 I 2
Temporary services or feeders installation,alteration,and/or
":l: relocation
e er installation:This installation is being made on property that I own which is not 200 amps or lass 5936 i
',..r.cd for sale,lease,tent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 1 I 125.08 i 2
8n
•wner signature: Date: 401 amps to 599 amps 168.54 1 2
__ ,-,r„ >+` . y :' rte° .,� hire,,o E.4 9 ;7-4 ,�- = Aran o branits-neits:iteration,or extension, r panel
Business name:William Lyon Homes,Inc. above service or feeder fee,
each branch circuit 7.42 2
Contact name:Angela Grajewski B.Fee for branch circuits without
service or feeder fee,first
Address:109 East 13th Street branch circuit 56.18
2
City/State/ZIP:Vancouver,WA 98660 Each add')branch rircssh 7.42 1 2
Miscellaneous(service or feeder not included)
Phone:(360)695-7700 • ••' , Fait::(360)693-4442 Each manufach ed ormodular 67.84 2
Email.Angela.Grajewsid®polygonhomescorca°d/°rfeeder
dwelling,service
Reconnect only 1 67.84 1 2
ci __ _. ..__._.-_ __ -.._•°�i •4 .r , r_...-.,--.z_7:::„,._- ,. __ Pump or irrigation circle 67.84 2
Business name:Garner Electric Washington,LLC • Signor outline lighting 67.84 2 ggi
Address:6101 NE St Johns Rd Signalel, oration(s)or wooden. 0 See Page 2 2 F
pans,alteratitm,or exfenslrm.
City/Stott/21P:Vancouver WA 98661 Each additional Inspection over allowable In any of the above
Additional inspection(1 hr min) 6625/lar
Phone:(253)320-1657 Fax:( ) Investigation(1 hr min) 90.00/br
Email:bdaniels(a�gweusa.com Indasttielplant(llnrmin) • 78.I8/br
Inspections for which no fee is
in listed t4 lir min) 90.00/hr
CCB Lia: C1158 Electrical Lia: 208174 Suprv.Lice: 44965 n i2: i t�s rr�3 z L a e•
Suprv.Electrician signature,required: �L D1 ..... u _._ subtotal:
Print name: Joan?Albert Date: 4/26/2016 0 Plan Review Required(25%of pemsit fee):
: I State surcharge(12%ofpetmit free): e
;; _ Authorized signature: '" ---nom TOTAL PERMIT FEE:
et,..!:: This permit application expires if a permit is not obtained within 181)
Print name: Bill Daniels Date: 4/26/2016 days after It hes been accepted as complete.
'•rte:'`<Fil�� • Number ofmspeaicoaallowed per permit
5: � d6g1r«mm1L7..c PendrApp ffi.R_IDtBdx /l7/tW
Rev 06s 440-460701/05/COM/9/103 I
if4;;44 '.
i
I
Plumbing Permit ApplicaKECEI
VED
Building Fixtures I ilIt 01 I tt 1 1 `,1 t1\1 1
City of Tigard 72 n V 3 0 2016 Received
Declive: Permit No.:
13125 SW Hall Blvd.,Tigard,OR 9 Plan Review pier permit No.:
■ Phone: 503.7182439 Fax 50 ..5�BT16t Date/By:
Inspection Line: 503.639.4175 tat° ° °- a£ Date Reedy/13y: lurk 0 See Page 2 for
11'. I.I' Internet www.tigard-orgov 8LIIL DI'1t ' 4d1§C`1x")SaI Notifted/Metbod: Supplemmtellnforrasbon
, ..;..FEN..$ ' ;::.::::;`,;,-.4.4;1.4: .:
`` e '.3.' '
®New construcfion 0Demolition For spade!Wormadoll use checklisit
Description I Qty. I Ea. I Total
❑Addition/alterationheplacement 0 Other. New 1-2-family dwellings(includes 100 ft for each utility connection)
•CATEGORY OF CONSTRUCTION'• : SFR(1)bath 312.70
SFR(2)bath 437.78
0 I-and 2-family dwelling 0 Commercial/industrial 50032
SFR(3)bath
(]Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Men Fire sprinkler L .sq.ft.) Page 2
JOBV SITE INFORMATION AND LOCATION • .. - Site utilities:
: : /13103 c ` IN it , •_i-
`1 Catch basin or area drain 18.76
Job site address: W YVlw�1
Drywell,leach line or trench drain 18.76
City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.: 1 Page 2
Suite/bldgJapt.no.: Project name: V.4eAr- Y'G�C.-e...--00 Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76 €
Sanitary sewer(no.linear ft:__j Page 2 €
c
Storm sewer(no.linear ft:_� Page2
�� i Water service(ao.linear ft.: ) Page 2
Subdivision: ' (Arrau - l J W Lot no.: Fixture or item: 32.27 i
Bad�ow preventer r
Tax map/parcel no.: IZ Sl
Backwater valve I.
: .. ' DESCRIPTION OF.WORK : Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
®1710PER1]f OWNER 1 Expansion tank 12.51
. GI TENANT
Fixture/sewer cap 25.02
Name:ADVL 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)694-4031I Fax:( ) Ice maker 12.51
. 0 CONTACT PERSON.. Interceptor/grease trap 25.02
:" APPI:t[CANT Medical gas(value:S ). Page 2
Business name:William Lyon Reines,Inc Primer 12.51
Contact name:Angela Grajewski Roof drain(commercial) 12.51
Address:109 East 13th Street Sink/basinnavatory 25.02 g
City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54
Phone:(360)695-7700
Fax :(360)693-4442 Tuls/sbowerhbower pan 12.51
Urinal 25.02
E-mail:Angela.Grajewski®polygonhomes.comW closet25.02
CONTRACTOR Water heater 37.52
Business name:Malmedal Enterprises Tan. Water piping/DWV 5629
Address:PO Box 207 Other- 25.02
Subtotal
City/State/ZIP:Banks,OR 97106
Fax:(503-)324.0580 Minimum permit fee: S72.50
Phone:(503)3240759 Plan review (25%of permit fee) k
CCB Lie.:102535 Plumbing Lie.no.:34-276PB State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name:Carolina Malmedai Date:04/25/2016
This penult appHeailon expires N a permit is not obtained within 180 days 1
atter k has been accepted as complete
*Fee methodology set by Tri-County Building Industry Service Board. tj
Lt uiduuglparaltAE.b1U-PemdeApp.doe 1001109 440.4616T(1002/COM/WFB) ,
is
City of Tigard
M COMMUNITY DEVELOPMENT DEPARTMENT
11111 N
T1cARD Building Permit Review — Residential
Building Permit #: / 2yy 005-/LS-
Site
0S--/rSite Address: 1-13,3 Svc AM-eltq S*.
Project Name: C2kver 1e' ca.c( NoC-rnw,ei-t- Lot #: 1 10
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: NCy\J U12-
---, _
C [51. erify site address/suite#exists and active in permit system.—1\) 1h ACC.e(..—
River Terrace Neighborhood: ❑ No Jg1 Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
Three(3)copies of site plan xisting structures on site
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 /: 'cation of wells/septic systems
.Applicant information(name and phone number) 4A, xisting trees to be retained with drip line,and tree
►: .t dimensions and building setback dimensions .rotection measures
_ of area,building coverage area,percentage of coverage and XStreet tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) Street names
'roperty 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 y No Received: ❑ Yes ❑ No
V Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified 14l No Applied For: ❑ Yes ❑ No,stop intake
Land Use Case#: PoR:joc3 -cc:c (�
Zoning: (Z_-1 (p D)
. Required Setbacks: Front s Rear IQ Side 3 Street Side sl Ipr Garage zo
Landscape Requirement: l()
lz ot Coverage Maximum: 0
0/0
i Building Height: Maximum Height Ni' A Actual Height* -9
. Visual Clearance IqAr
sPKEasements
. f Sensitive Lands: ❑ Yes )R" No Type
Urban Forestry Plan
Conditions "Met"prior to issuance of building permit
Notes: COnd k ms cfl U ' Y'f1 "prlb`C 1v ern -j- ISSt,o,,,cc .
Approved By Planning: i f A! L' +W Date: 11 6 (LQ
Revisions (after Building Submittal f ly) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPennitRvw REs 091216.docx
Building Permit Submittal (- •
Original Submittal Date: //////,
Site Plans: # 3
Building Plans: # 3
Building Permit#: Li."Enter building permit#above.
Workflow Routing: i'Planning a -Engineering 11.—Permit Coordinator L—Building
Workflow Sign-off: 421'Sign-off for Planning(include notes from planning review)
Route Application Documents: j],"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: ' � I Date: /2/-7a /A
Engineering Review
Slope at building pad: 5
❑ 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 ;2' No
LIDA Facility on lot: ❑ Yes �No
❑ NOT Approved by Engineering: Date:
Notes: LL•-
Approved by Engineering: (zCt, i,c2 Date: /2—//(
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:
4 DC Fees Entered: Wash Co Trans Dev Tax: RI es ❑ N/A
Tigard Trans SDC: : Yes ❑ N/A
Parks SDC: /I/ es ❑ N/A
( irPOK to Issue Permit
/(411/'
Approved by Permit Coordinator: Date:/?
I:\Building\Forms\B1dgPermitRvw_RES 091216.docx
City of Tigard
a COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD River Terrace Building Permit Review Addendum
Building Permit #: /757-,2e/6 — 00_52_ '
Site Address: f 3(93 SV J PCMc t is Stre e-f-
Project Name: Pwer Tcxrace/ Na r-trw\i-eSt- . Lot #: 110
(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 El 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
El El El ❑
2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: I'7/e.)
3. Entrances:At least one entrance must meet both of the following standards:
(Max. 8 ft. setback from longest street- facing wallarallel to street,angle no more than 45° from street,
or open onto porch
Entrance opens to a porch: ❑ Yes ❑ No
If yes,all the following apply: 25 sq.ft.min.
One street facing entry 12 ft.max.roof above floor of porch
�5 ft. depth min. 30%min.porch roof coverage
4.Detailed Design:All buildings shall include a min. of five of the following elements on all street-facing façades:
,Covered porch min. 5 ft.wide x 5 ft. deep kRecessed entry area min. 5 ft.wide x 2 ft. deep
Wall offset min. 16 inches El Dormer min.4 ft.wide
Roof eave min. 12 inch projectionoof offset min. of 2 ft.
❑ Roof shingles either tile or wood 'Gable,hip or gambrel roof design
El Roof pitch oriented south min. 500 sq. ft. El Horizontal lap siding min. 3-7 inches wide
❑ Accent siding min. 40%of street façade ❑ 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
El Balcony min. 5 ft.wide x 3 ft. deep with inside access ❑ Attached garage is 35% or less of street façade
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 El 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)
El 12-foot-wide garage door 17(40%max. of street facade
❑ 50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: &dl kt 1��j 7 Date: '/I(o
I:\Building\Forms\BldgPermitRvw_RES_RT_062216.docx