Permit CITY OF TIGARD MASTER PERMIT
111 .
COMMUNITY DEVELOPMENT Permit#: MST2017-00011
T[GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/14/2017
Parcel: 2S106DB13200
Jurisdiction: Tigard
Site address: 17370 SW FOREST HOLLOW ST
Subdivision: RIVER TERRACE NORTHWEST Lot: 132
Project: River Terrace Northwest, Lot 132
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 4 First: 948 sf Basement: 799 sf Left 3 Parking Spaces: 0
Height: 32 Bathrooms: 3 Second: 1130 sf Garage: 368 sf Front: 12 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes
Total: 2877 sf Value: $347,504.05 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 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 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
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'I 500 sf: 5 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
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 2877
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: $33,758.79
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
�o`fftthe rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: „G1`c� t /
Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. L
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 Applicatio E 'Ej EI) 6.0-/- /302_, /z Z /
i FOR OFFICE t SE O\Ll
City of Tigard DEC •2 0 2 016 ria ,/" ,5 /7 J:' Per-t xyf y_S i 4/7—�1D0//_
II41 13125 SW Hall Blvd.,Tigard,OR 97223 ry flan Review �} Other Permuc5Gr� ,7 at9/[)
I Phone: 503.7182439 Fax: 503.5 $ �Ii '�I�t y I� DateBy. 1- 17" /7 //
TI� �;t Inspection Line: 503.639.4175 a Date ReadyBy: Juris. ® See Page 2 for
Internet www.tigard-or.gov BUILDING DIVI I®�1 xotified/Methodc //? Supplemental Information
��4' 'w {E
_ a j 31 s a f r` r imp` =-,''','''. ...w.,1,..a� 4- „€ ..az�' 4 si.,£ ;fi�..: ., '2
; �A..a� .o. ,.,......'—.. .� a -.,..._..�.... �usss.�.�....�.;�u . _.. .._,..._.......x...,. . _�.�-*qv...u�;
®New construction ❑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/repiacement 0 Other. equipment,materials,labor,overhead,and the profit for the
u, cl �' work indicated on this applicati��
i- ..�a,, ',. ,`.-7'e--'"'e ' E i L-0�;i. -�,,-,—,>, -,"` `:';,a aa' _v
valuation:
......3.1t-6-1
2ID $
�I I , Y✓11_/�
® 1-and 2-family dwelling 0 Commerciallmdustrial
4-3 0 Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
'' Total number of floors: 3 '7, 9-/17
3S...�.__.._3 _.,,. _ J.. :_ ...,.._..,...mc�°�3.. .�..,,._ ..,...e..e,�'.8a_.4...a... ..r...2�. e :w ? , Q
Job site address: i' \ 11� \�� New dwelling area: Z u� .4'vsquare feet
City/State/LIP:Tigard,OR 97224 Garage/carport area: (4. square feet
Suite/bldgJapt no.: Project name:R' ,er'^'.(, _ ow Covered porch area:;6 IItiare feet
Cross street/directions to job site: Deck area: 1 1i ii square feet
Other structure area:" square feet
Subdivision: / v ' W Lot no.: erm
Pit fees*are based on the value of the work performed.
1 Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
'i ,3„ { q` 11 .,x' - work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
r-x ` ' ' ;&t -' -'2 � �y "0 ,: 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:
4 € , f vt 7 rt. : s 7 i' ��.0.1' -• ::: cF ` " 3s�''Tfq-l'
E',�. '� ,t2 z '„
Business name:Polygon WLH,LLC
Structural plan review fee(or deposit):
Contact name:Angela Grajewski
FLS plan review fee(if applicable):
Address:109 East 13'Street
Total fees due upon application:
City/State/ZIP:Vancouver WA 98660
Amount received:
Phone:(360)695-7700 Fax::( )
E-mail:Angela.Gralewski@polygonhomes.com
Commercial and residential prescriptive installation of
6 .. ` , : 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
and administrative fees):
Phone:(360)695-7700 Fax:(360)6934442 State surcharge(12%of permit fee):
CCB lie.:207247 Total fee due application:
upon
P
Authorized signature: This permit application expires if a permit is not obtained
airi5 {vo within,180 days after it has been accepted as complete.
Date:
*Fee methodology set by Tri-County Building Industry
Print name:
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440 4613T(i l/02/COM/WEB)
CEIVE!)- 11111111111111111111111111111111111111111111
Mechanical Permit Application`
City of Tigard Received Permit hn.;
1312S SW IUD Blvd..Tigard.OR 97223 ,j2 017 t
Phone: 503_718.24n Fax: 503.598-1g9y60 Datear Plan Itevlrw other Natoli:
! Inspection Lino: 503.639.4175 CITY O TICARD DMe y'�y: r.,d6 ! 1I See Page 2for
Internet: anew tigard.or.gov Y 3 �T $ Notified/Method: Supplemental Information
UILOINi IVi SIGN
. . r,",,,' ,--. 0V . . ,:
omb,-,-.--: , MS..—.— t , ,,i,,: '-.44.::,,,,-,44:7,;,.. - a ezrFL .r ryn ,-
Mechanical permit fees*are lased on the value nfthe work
�1 New construction 0 Addlitioi 1alttnutianfreplacement performed,indicate the value(mended to the nearest dollar)of ail
❑Demolition 0 Other mechanical materials.-,ui, labor.cverbead,and tit.
Value:5
', e
pu'. i 044,•.„,:y0' . tl , .• "' gt , T �(�.04:z, ,,,,,,,,r *.t1' ±, ,,Y E ,:- F C' Lb aFv,, +4^f: y .'or -,*1370;11,1: —�D���. ,ZiY�.♦,.•
n 3
t
❑ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building Far special atton Rsec*ecJJs
®Multi-family 0 Master builder 0 Other: a.—-' ion Qtv. Ea. Total
—`'. ,.4rsat• 'r��1 1 'a rts,,:.:.'fv ` c �.c G , k4 • „ , . F tfN Henan coolie_!
r _,.. :;".:.Ci'f S-... 1t.$-,24',4-4,...•-,....4,` .a�, "-,,,,,,x ;•V WP, �Y",.
IIIIII
Job ane address: j 7370 � Yes"1 1()vJ 3t Air Furnace 104 00; v 46.75
100.40D BTU rincta+»ntx7 =' 46.75 _
City/State/ZIP:Tigard,OR 97224 Furnace 140.000•BTU doets+ventst 54.91 1111111111
.— ' . Heat 6I.o6 INN
Suite/bldg./opt
no.: ProjecT name'Mi r I-ne rte No�ltwruf Ductwork 11111111M111•1111111
Cross street/directions to job site: H drank hot waters'stem IIIIMIMIIIIIII
Residential boiler(radiator .®all
. dronic
Linin-wall.in'dtraci-1.- etc. -��
in-wall.in-d. 'SUS,- .ed.etc.
Flue vent for env of above 11111M11111111
Subdivision: , -TrAi c.e_ J'.J ,,5r Lot no.:1911
Otho: 1111111M11111111111111
Other fuel a,,lianas:
Tax map/parcel no.: Water heater IIIIIMIIIIIIIIII
iii:;`- e,24`, 1Tl.µ" UryCN}"AR el:S AFF >,F* �j 0. i; . I k.ttAc..^W,,,- art :" Gas fi..aejinsen `a .3.x.39 MIN
Flue vent for tvatcr beater or as allipilill
- Lo' li ter f_ 1111111M11111111111
Wood/. miaow IIIIIIITIIIIIIIIII
Wood . -,lacc/insert ME 23.32 1111111111
e«,' . flincdlluetvent IIII IIIIIII
Chher Illinal_
vi .til ,' ifs i L[ rLt'IZ ,y Sam 14-zi ,1�- 2I t � ✓( i;u't
>t..�,-.,d,_ a �'_....,s-�,_,..�m __... _,._.v.... f.�,x:.-..J i...._....a..Win,»,4.'E�a..fi..l..o,c t"•., E 'IfDnmentalexbisistandvenlilalloa:
Name:Fnlygott WLli,LLC Range hoodfot et kitchen 11111E11111Addr :10'1 East 136"Street ,ui mens
Clothes dryer exhaust i __
CityrStntu2dP:Yantouver,WA 98660 -due exhaust(bathrooms, "MN
toilet r„ , ems.unlit rooms
Phone.:(360)6954700 Fax:( Attic/mewls, fang IIIIII 23.32MIN
L S, 13 ®�
C ! i P.y- 4 ry 1 +�. r .y C C f i C rP i ' t� n` '
L....�:_;�.)_.,.�..,.�....',..",e.".,..!".. ......,. til. _,.. ..-r.�.,.:%L w�_....., u..............�,...,_. �_,il..z..:... � �L.....:u3
Fad :.. ..
Business name:Polygon MIX,f 514.15 Ibi-fiat four;54.03 for each add111ooat
Contact frame:Angela Grajewsld Furnace.etc. 11111111111Gas �
11111111
Address:109 East 13th Stmt heat'. ��
Wail/-..,-,dedfuni heater _—_
ChylStatef!_1P:Vancouver,WA 90660 Water heater IIIIIIIIIIIIIIIIIIII
Phone:(360)695-7700 1 Fax::(360)693-4442 F -.We IIIIIIIIIIIRon 11/1111111111_
E-mail;AaBela.Grrejewski ppulygoabsxnes.com o ue '_11111111
7::::,:::,..,2',- ap "S-""`^ i'.27:
+ F'^ fi Clothes er 4 111.1__
11111111111
Business name:Apex Air LLC F r.fi , ,;z r ' ' .'7 1 I. 1t
Address:1130041E 72w'Ave Subtotal IIIIIIIIIIII
CatytStatefLlP:lrancatn`er,WA 48686'
Minimum .. it fee($90,00) MIN
Plan review 25%al-permit fee) 111111111111
Phone:(360)342-5109 Pax(360)3X64769 Stale surcharge(12,6 sd ,- I fro MINIIIIIII
CCB lie.:203034 TOTAL PERMIT FEE
This permit application expires if a pennitis not obtained within M0
dayeafrerithas been accepted as complete.
Authorized signature: R Fee methodology set by Tr•J. so ty�Bonding Industry Service Board
Print name: i i.k . Date: 4 11.1..,' 1 -
IwtsmetmiaimEr_NaNtApp aures.a+c 445.441661tlrCOJCCO I
_ RECEIVED
Electrical Permit Application FOR orf ICE l ASF OM 1..)
N r "Z017 Recd.,
City of Tigard 1
let Phone:$0 37824 9 F 503.59 .: .
Inspection Line: 503.639.4175 y y{� Ready Data/gy: —See Page z for
ilei,i,D met WWNjigard•or,goY BUIL iN(,nnTicLIS t IOl'' (gifted/Method: Supplementalinformaion
_
t_ _ ts,� 14. , .,',� ;;2---1:6:14.0.7.r` �`', .' 't-rif.v",4'r,'4iY`" 3 *v
t` 's,si's•�,:ti .,i,,, kat,f.!`,0\c'oil Tfi-✓,, lii4:' �' ``..i
®New construction 0 Addition/alteration/replacement Phase check all that apply(subunit Z sets*flame wiitams checked:
D Sarviee or feeder 40D amps or More 0 Build ing over three stades,
❑Dem011tiom 0 Other:
wheals the available fault current ❑]Jfarinas and boatyards.
,y; t,T;:;:j,<. f;-,..1-i. t;iYy2.`i ?`;i.q Sh7 :,Csiii*115.6"+ OF:, st -a`'' %L,.: exceeds 10,000 amps at ISO volts or ❑Floating buildings.
®I-and 2-family dwelling 0 CommesriaUuidustnal 0 Accessory building test to ground,or exceeds 14,000 0 Commercial-nae agrinuhntal
•
❑Multi-family ❑Masterybuilder q 0 Other. Dne Pawn iosfaUstioos. ❑ n of 1501CVA or
;Y Y''r). ;,•2a Tcli.,'e..9,.. �.+°: AI I�.NY ..;`gi"e q, :i°' .d ❑Sm Ymem• larSeraapuatolydaived
Job : lob Site addre ❑Addition ofnew mnla load of system
�0 SW I' ' �� 100HP or mote. ❑A","S"."1-p.."1-3".
City/State/ZIP.Tigard,OR 97224 0 Sex or mon residential uaies. P Y•
❑Re realdonat vehicle
Suite/bldg./apt #: Project name:pity ; ".( #.-C7 o� 0 sappty voltage fix m
1"'^r LY' i is.-ix or Seeder 600 amps ormolu. MO yolksnominal•
Cross street/directions to job site: -._ .c,�" s':,-r.z a u, •1 i. t,, ,,"',,-,, " ., s 1a
Vic,..
_ •-eeipeton 1 Qty. I Rad Tow
New residential single-or mufti-family ft.or less 4 _dwelling unit.
SubdiVlsie41 Tia�, N0(•1,1 1 I Lot#:13) Includes attached garage.
1.000 Tax rl7ap/ptucel#: Ba.addadds l 500 sq.R.or portion 33.92] .54 4
/Y y __yam,, 392 1
£ ".,;.7„� ,1 r .ir� .+•'/'-ti, A..,.i .i!.L .n`.r.3,3.-�.t':C '` r c ' � Iu41Gucorny,residential
(with above sq.ft.) 75.00 2
Limia:d energy,multi-family 75.00 2
residential(wife above sq.ft.)
se c; s lteuewabie Eue ❑Sec Page 2
`�..., - . ';'''''''''''''':' :'''''''''-*Z''''1:9a -• Services or feeders installation,alteration,and/or relocation
Name:ADVL Land Holdings,LLC 200 amps or less 100.70 2
Address„7600 E Doubletree Ranch Road 201 amps to 400 amps 133.56 2 •
403 amps to 600 amps 200.34 2
City/State/ZiP:Scottsdale,AZ 85258 601 amps to 1,000 amps 301.04 2
Phone:(602)044031 I Fax:( ) Over 1,000 amps or volts 552.26 2
relocation
services or feeders installation,alteration,and/or
Email:
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. • 201 amps 10400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
't o a t 10 Mme,; 4� 5 Branch circuits-.new,alteration,or extension,t• panel
-�' ���;, -� L U ..�, .”Y 7� ,��� „:gni ��3'�C�3��_�.�'P�:{ � �'
N A.Tex for branch circuits with
Business name:William Lyon Homes,Inc. above service or feeder foe, 7.42 2
each branch circuit
Contact name:Angela Grajewstti B,Fee for branch circuits withord
Address:109 East 13th Street bervice or feeder fbe,fust 56.I8 2
ranch circuit
Each add'16sanch circuit 7.42 2
-
City/SUM/ZIP:Vancouver,WA 98660 Miscellaneous(service or feeder not Included)
Phone:(360)695-7700 ' ' ' I Fax::(360)693-4442 Each mamtfecurred or modular
dwelling,aarwlceand/orfet der 67.84 2
?moll.Angela-Grajewsld@polygonhomes.com Reconnectonly 67.84 2
? J~,_ ic ^bpi., ? ,, 7`C Pump or litigation circle 61.84 2
Business name:Garner Electric Washington,LLC Signor outline lighting 67.84 2
mited-energy
Address:6101 NE St Johns Rd panel,altaration,00rcsr extension.
0 See Page 2 2
City/State/ZIP:Vancouver WA 98661
Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66,25/br
Phone:(253)320-1657 Fax:( ) Investigation(1 Junin) 90.00/hr j
Emailbdaniels@gweusa.com laduatrialplant(Ihrm&e) • 78.18Jhr
Inspections far which no fee is 90.00/br
CCB Lie.: C1158 Electrical Lie: 208174 Suprv.Lie.: 4496S listed 54 hr rota} _ '
_a -
• �, " ,� -'art��, E,ic.�b_CIT �7-,;:�Ji E�tiit-:� ,� l,f� R 'Lu+'��
Suprv.Electrician signature,required. / /jos I1P `. Subtotal:
3;• Print name: Joan P Albert Date: 4/26/2016 0 Plan Review Required(25%of permit fee):
g , l— • State surcharge(12%of permit fee): r
ti,�i,`: -'
t.:; Authorized signature: ` ~' __ ~� TOTAL PERMIT'FEE:
tn• �:
�:=• ?'lain permit applienfion expires if a permit is not obtained within ISO
bile'.: Print name: Bill Daniels Date: 4/26/2016 days after It has been accepted as complete.
titN i?.. • l4umberofinspectionsallowed per parmlt:
1124..":4.1auitding PemitslEl.0 Penance II,R}+AE,.doc Rev WWJ17h015 4 4.46157'1 l/o5lc0WwEn j
RECEIVED .
Plumbing Permit Application
Building Fixtures AN 1 7 2017 l niz of Fl, I. 1.',+: OM )
City of Tigard p y Received p ermh No;
13125 SW Hall Blvd.,Tigard,OR 9'. O � I GA RD Plan Review
• Phone: 503.7181439 Fax 503.59:.1''.i ,. Other Pencil No.:
Inspection Line: 503.639.4175 LUILDINC DIViS1I; , ::-R.4741:1": y;•. .. : 0 Sea Page 2for
Internet
•a, wwwtigard-or.gov Notified/Method:
Supplemental Information
tion
r„,.:' :eie- • .T .:O. ,Wru .... .. . .. . ...._._. ., . ._ f' . �pEEsc0z:.u .,r .: }d
'..+ty5:4: ;
®New construction ' p Demoliion For spedal iq/arm tion ear
.
❑Addition/alteration/replacement 0 O Description I Qty. 1 Ea I Total
New 1-2-family dwellings(includes 100 R.for each utility connection)
„ 'CATEGORY'OF CONfiTRJCTION' SFR(1)bath 312.70
Eg 1-and 2-family dwelling p Commercial/filch/stria' SFR(2)bath 437.78
0 Accessory building 0 Multi-family
SFR(3)bath I 50032
❑Master builder Each additional bath/kitchen 25.02
0 Other. Fite sprinkler L_._.s9.R) Page 2
, , . ,1008 SITE IN ORMA•TION'AND LOCATUON . Site utilities:
Job site address: 11310 SW 0 r ja(�) �..}�• Catch basin or area dram 18.76
CitylStatelZiP:Tigard,OR 97224 '1+'� 1 - tll,leach line,or trench drain 18.76 `
Footing drain(no.linear ft:_� Page 2
Suite/bldg apt.no.: I Project name: �+wer -ear u... lois- Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
1 Rain drain connector 18.76
' Sanitary sewer(no.linear ft:_,__) Page 2
Storm sewer(no.linear ft.:,,_,) Page 2
/' Water service(no.linear ft: ) Page 2
Met,Subdivision 'g wi b Lot no.:r?J'� Fixture or item:
Tax.map/pacelno.: BaCklowprcvenfer ( 31.27•
•• • DESCRIPTION OF.WORK, • '. . Backwater valve ( 12 51
Clothes wader 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump I 25.02
•piiOPERTv OWNER - J p 'TENANT Expansion tank 12.51
Name:ADVL Laud Holdings,LLC Fixtuuefsewer cap 25.02
Address:7600 E Doubletree Ranch Road
Floor dtain/floor sink/hub 25.02
Garbage disposal 25.02
City/State/2P:Scottsdale,AZ 85258 Rose bib 25.02
Phone:(602)694-4031 Fax:( ) Ice maker 12.51
' •`: +; .®•APPLICANT 0 colyTAcr PERSON: Iaterccpha/grease tmP 25.02
Business name:William Lyon Homes,Inc 1.4edical g ( :$ ) Page 2
Contact name:Angela Grajewski 'ser 12.51 ,
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 TuWshower/shower Fan 12.51
E-mail:Angela.Grajewski@polygonhomea.com D 25.02
Water closet 25.02
• CONTRACTOR • .
: ' •
' • Water heater 37.52
Business name:Malmedal Enterprises Inc. Water piping/DWV 56.29
Address:PO Box 207 Other. 25.02
City/StatetZIP:Banks,OR 97106 Subtotal
Phone:(503)3240759 Fax:(503-)324-0580 Minimum permit fee: $72.50
CCB Lie,:102535 PlumbInglie.no.:34-276PB Plan review(25%ofpermit fee)
Authorized signature: C...-------,..{: , State surcharge T 2L0 PERMIT
EE
TOTAL PERMIT FF3:
Print name:Carolina Matmedaf ( Date:04/25/2016 I This permit appilrsdon expires if a permit is not obtained within 180 days
atter it hes been accepted as complete.
`Fee methodology set by Tri-County Building Industry Service Board.
Mituli .doh 10101/09 440.461sroatr2ttowviEB)
City of Tigard
111111
e
COMMUNITY DEVELOPMENT DEPARTMENT
T 1 G A R D Building Permit Review — Residential
Building Permit #: /75 j j/ 7 .-- Dev//
Site Address: 1.7.370 SvV Pcr,eS.i-- t-F-oi)o,,, ,„(-
Project Name: 12 iVL°,r T-er;t c Vora- wes I-- Lot #: 13 2_
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: N eM/ .S p
l Verify site address/suite# exists and active in permit system.
/ River Terrace Neighborhood: ❑ No zrYes,See River Terrace Review Addendum Attached
Site Plan Elements:
ree(3)copies of site plan ,. Existing structures on site
Site 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 0 tility 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) Existing 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 Ai Street tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) itStreet names
❑Property corner elevations(2 foot contour lines if more than
4 foot differential)
JOClean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified ❑ No Received:
❑ Yes ❑ No
y' Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake
r Land Use Case#: D(Z.DO I S -- 0 00o , S V (3 21 S-- 'cOoo
Zoning: Il-, p--1 2-
Required
Required Setbacks: Front 12- Rear 1 S' Side 3 Street Side ; Garage `Z.."0
Landscape Requirement: f
g
Lot Coverage Maximum: cy./.0
Building Height: Maximum Height iv/A Actual Height VC
,_..,/Visual Clearance
1 VJ Easements
Sensitive Lands: ❑ Yes ❑ No Type
Urban Forestry Plan
Conditions "Met"prior to issuance of building permit
otes: 0 U+1.1 Tjl r1 CIA 1, CC .c h 0✓1 , 40 be ICY `_i-- P/1`l s" h3
builaA'-j 7,-XM;ii4-
Approved By Planning: /l/I r\---.-_-___ Date: 1 7-) 2.4..)/1 !Ai
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved El Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: El Approved ❑ Not Approved
I:\Building\Forms\B1dgPermitRvw RES 091216.docx
0
BuPermit Submittal
Originalilding Submittal Date: �/o0 /
Site Plans: # _3 3
Building Plans: #
Building Permit#: Ea-Enter building permit#above.
Workflow Routing: Er Planning e"Engineering 8`Permit Coordinator [I -B"uilding
Workflow Sign-off: g-"Sign-off for Planning(include notes from planning review)
Route Application Documents: 0'Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
VBuilding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
ftir
By Permit Technician: .0'
Date: /�--5//7
Engineering Review
----a'Slope at building pad: /
()Conditions "Met"prior to issuance of building permit ev. ( ,. '' ZD
❑ 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: 42 P Date: (--Z--1 7
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
tK1Npproved,NOT Released: _ ate: ` / yi?
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 Taxes ❑ N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: Yes ❑ N/A ���
'�'OK to Issue Permit / /
40
Approved by Permit Coordinator: '�� % •te: _,4 —
I:\Building\Forms\B1dgPermitRvw_RES_091216.docx
a
4
City of Tigard
111 COMMUNITY DEVELOPMENT DEPARTMENT
2 111
T I G A RD River Terrace Building Permit Review Addendum
Building Permit #: /1.f- 32 0/7— O(?O//
Site Address: l '7 37 0 SW ire s t- . - f l a w - .-
Project Name: 12_tvex terse-mc .. t ( 1'1 We 14. Lot #: 13 Z,
(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.
Porch min. 5 ft. deep Balcony w/access 2 Window Projection Vertical Wall Offset a
ft.deep min. 2ft., 5 ft.wide min. 2 ft., 6ft.wide Gabled dormer
❑ 1% ❑
2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: 1.2.-
3. Entrances:At least one entrance must meet both of the following standards:
/Max. 8 ft. setback from longest street- facing wall Xr
Parallel 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 appy: :25 sq.ft. min.
/One street facing entry / 12 ft.max. roof above floor of porch
/i5 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 /Recessed entry area min. 5 ft.wide x 2 ft. deep
Wall offset min. 16 inches ElDormer min. 4 ft.wide
9gRoof eave min. 12 inch projection ,`Roof offset min. of 2 ft.
Roof shingles either tile or wood 41 Gable,hip or gambrel roof design
❑ Roof pitch oriented south min. 500 sq. ft. Horizontal lap siding min. 3-7 inches wide
❑ 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 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 7No. If No (Check one):
71 May extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch.
C '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 façade with 7 detailed design elements
Notes:
Approved By Planning: MIGA"---....- (� Date: 1'2/1-0 / / 4,
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:
17370 SW FOREST HOLLOW ST, BEAVERTON,
OR, 97007
Record Type: Record ID:
Residential - Master Permit MST2017-00011
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
17370 SW FOREST HOLLOW ST, BEAVERTON, December 7, 2017 at
OR, 97007 10:43:51 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00011
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS
Comments:
Corrections completed.
Water pressure = 45 psi
Violation Summary:
Inspector Contractor