Permit (62) CITY OF TIGARD MASTER PERMIT
INCOMMUNITY DEVELOPMENT
Permit#: MST2017-00042
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/14/2017
T tt7 :Fd 9 Parcel: 2S106DB12200
Jurisdiction: Tigard
Site address: 17497 SW SHADOW TRAIL ST
Subdivision: RIVER TERRACE NORTHWEST Lot: 122
Project: River Terrace Northwest, Lot 122
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 948 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1130 sf Garage: 380 sf Front: 8 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
Total: 2078 sf Value: $252,028.18 Rear: 10
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 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 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!500 sf: 3 201-400 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 2078
Owner: Contractor:
ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
BY FORSUM,MICHAEL 109 E 13TH STREET 1 One Hour Fire Rated Eaves
7600 E DOUBLETREE RANCH RD VANCOUVER,WA 98660 Required
STE 1 2 Ersn Cntrl 503-639-4175
SCOTTSDALE,AZ 85258
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $31,740.25
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.
i
Issued By: 4# '' ii�/P) Permittee Signature: cr e jy /,c� ,,GL74-J i
.AZ
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. F//
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.
,
)3uifding Permit Application '.,t ''., ,, , ,, .1., 7-- /-41q--17 64-(-)
. &I FOR OFFICE 1 SE ONLN
City of Tigard 1r- r, '',), 0 2_016 B / 6 /7 - P—it No0:57;7-of7--61ev 1/47--
z Iii 13125 SVV Hall Blvd.,
I Tigard,OR 97223 ,..., , , I'lan It_evi w 1....1)._.)--, -74- Other PC
ermit—--'igo2C/7-eve3 7
Phone: 503.718.2439 Fax: 503.598.1960 s ' , . ;;DateiDate r_...1113.......2 /, -1.ø h.: et See Page 2 for .
,,, Inspection Line: 503.639.4175 ,,,, ,, , ' )1',4,911fi. ecVM''"Yethlc;d:c.VP/17 i4Crir . Supplemental Information
T'-'.'' . Internet www.tigard-or.gov
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1:1- ;.)e'm—cili,-;—io-n Permit fees*are based on the value of the work performed.10 New construction
Indicate the value(rounded to flie nearest dollar)of all
0 Addition/alteration/replacement 0 Other: 7equipment,materials,labor,overhead,and the profit for the
£ 7-£?:7-; ji7,•.,,,,,,-:."r work indicated on this application.
_ o " .. .3.a.y
pg 1-and 2-family dwelling 0 Commercialfmdustrial valuaionli17).7
Number of bedrooms: '3
El Accessory building 0 Multi-family
Number of bathrooms: 3
a Master builder
0 Other:, Total number of floors: 7....
Job site address: . k_ A • 111„ T i New dwelling areal...in 6 square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: 350 square feet
Suite/bIdgJapt.no.: Project name:Ri Pr' ' • (\hx) Covered porch area: et;ware feet ) )30
Cross street/directions to job site: Deck area: 4 4, square feet q Lig
Other structure area: square feet
Wi i210,,V00,11
Subdivision: I \i_eAr A .,,, , \)3 Lot no.: tat Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
'''''''" -' '--7z.'-'.17: :''' '''''r"l'i"-rm--",--;'''ll'''''tf-=',:vil ,•,',,,":- e 1-',.;;t.'1'`.",''',7,,,,,,,, .i",,,,,,!,47:::'' :2'7,"*P-,..-; work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
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 Far( ) New:
t74,r,7-----, 7----,',17:-Til5ii. .f---7775:77r-::::: %,-'17144.0--- -,10fl '''"'''f';'4)1i 7-'-''ll''''7-‘ '''''t ,''j'''''27-1,,:::,°7 -1-',T.:'.,,,#.74a.-:::47A 1.-,.<-4','-551•':=7.*Al 1:4`f,'A.,11E11,
Business name:Polygon WLH,LLC
Structural plan review fee(or deposit):
Contact name:Angela Grajewski
FLS plan review fee(if applicable):
Address:109 East 13th Street
Total fees due upon application:
City/State/ZIP:Vancouver WA 98660
Amount received:
-
Phone:(360)695-7700 Fax::( )
_,_ .:„„.„ ,-- >;-..; i',,-)•,..,.i, -4.).',1-,zr.' "iiffi--,-7111.. kt:
• --- •- -- - - - .„ -„_„-....,—...........„.........,„
E-mail:Angela.Grajewski@polygonhomes.com __ _, __ , , __ .4_,
1 .1,.1-'-`'''---' ',"' Commercial and residential prescriptive installation of
;„ - - - - --- •'- _ ' - c--;717-- ---71 i'l''•' ' ,: ' 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.
Permit Fee(includes plan review
City/State/ZIP:Vancouver WA 98660 and administrative fees): -;
Phone:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee):
I
CCB lie.:207247Total fee due upon application:
This permit application expires if a permit is not obtained
Authorized signature: uh as oltvl a
within 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry
Print name: - -. Date: Service Board.
I:\Building\Permits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
•
. . d(: `'� iii
iMechanical Permit Application 1 fm Ilii 1( I: 1 'Ni ()\1.1
11 City of Tigard l ,ni,n°
13125 SW Hall Blvd..rears OR, 97223 �! ? '{.f r>e,da,•: SSTa2p i 7—p0y
Ptah Review
Phone: 503.718.109 Ats: 501598196d rOtierPcruM.
,InsiectionLinc 503.639.4175 egg �;` t' '',k,
' ' te,,,Rte! Y 65 See Page 2for
Internet: www.tigard-or.gov ' l , Date /th : Aviv
Id°iifrod4wteti+od: � Snpplrmenmt lgforatatioo
131 n : wn 3a p1,; ; z y�? 1 .
' v r ,k 't' ^',cr`•,n..: :4 (. i✓' , ,.< a. ,y s b.,G t'`C..yt- r `. v s` '`-fi'cl,S,> �^° ai..:,.:7:',--:!.-1--37-:,..1,'..,-;_.,— S„ C. '4,--.4
Mechanical permit fees*are based on the value of the work
®Naw construction 0 Additiotvaltcration,replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials.equipment_labor.overhead.and profit.
r'� ifXi; f t ,.,'-" iltP."$ NSF ....t �) Rr V' ,r `7. - ,y -,:,�, }` i µ.--, ,,,,,,..„-,:„.,,,y--"F , Value 5
�t,,fi. '_::,..t..._n ..'�`,y...tv.,..t,,...r...,».w... .�.„ .T..o ......... ..�......�,.:�...A,:;::.. .. t:iry : ,A i'n,1 i r'� 3,f ill;::"i iy c.. ti;'r h�., x.. • '
� i
❑l-and 2-family dwelling ❑Commercialrndustrial 0 Accessory building Forspecraifrrformation oarcheek/ho
El Multi-family 0 Master builder 0 Other, Description
I Qty. 1 ea. i Total
')., :1,2�ac c.. , tr t e t e `i,' e r r 2 y r :i _ z" Hcatinaicoplin0:
.5 Eco__.._.,_.-,f...,,.. ... ..- .- +.� .._.+� _, a,., .
Alr coaditionina I 46.75
Job see address/7116n Svc s. / i j,rA ''s 5 Furnace 100.000 BTU(doetsNems) 1 46.75
City/State/ZIP:Tigard,OR 97224 Y w�4 Furnace 100.000+I3TU(duets/volts) 54,91
Suiteibidg.iapt.no.: J Project Iranne RAkr
...- Heal
tromp 61,06
1 F•j\4y•�enet'? f 1 orli loci f Heal work • 23.:12
Class streottdireetiong to job site: 4lydronic hot water system 23.32
Residential boiler(radiator or .
hydronie) 23.32
Unit heaters(fuel-type„notelectric),
in-wall.induct suspended.etc. 46.75
Flue/vent for any of above 1 2332
Subdivision:.�1/evTf i(IV t Lot no,:122. Other fuel app)ixnera:
1 ax trap/parcel no Water heater i 23.32
... E"f gt oti k r�$ Gas_ .. . ._ . .r. . ._! tt ,f�; � ^ ;. ',�,'. � "` +�. . fireplactaSnscrt c 33.39 ,
Rue vent for water healer or gas
fireplace 2332
Log BOW Buts) 23.32
Wood/pellet stove 33.39
Wood tlrcplaexrinscrt I 2332
Chinmeyilineriilurh eott 23.32
'41b.._L _.< r :Y t . ?t�.�...� ''_. ...IiE..,�....,..o-,.,;,.�.._t_;Y. „5'1".,�iP3.f<?„..: „tic..µ Other: 23.,33. ,
' Wim- Environmental exhaust and ventilation:
Name:Polygon Win,LLC Range hood/edier kitchen
Address: 109 East t3`M Street - equipment 33.39
Clothes dryer exhrui t I 33.39
City/State/ZIP:Vancouver,WA 98660 Single-duct.exhaust(bathrooms. (�
toiletiompartrncn1s.utility moms) 1•' 23.32
Phone:(360)695-7700 Pax:( ) Attielcrnwispacefans 23.32
1
un{y73 °l .- f t t''',''''1,-1-'1,'-f': ::-1t 3 'i . 1 wd1
,,, , �- fis�c �c'r °`t_ Other 23.32
Business name:Polygon W1-11,LLC Fuel Mainz
$14.13 Oar first four,$4.03 for sorb additional
Contact name:Angela Orajewski Fumes:v.cw. i {l
Address:109 East 13th Street Gas heat mono
Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98660 Waren heater
Phone:(360)695-7700 I Fax::(360)6934442 Fireplace 1
Range I
E.Inail:Angela.Grajevtski)polygonhorneLeom Barbecue
s-...__ • . 2 i r ) • c '..,;,,,,.-.1,_,:,',..' Clothes&far(Eos)
Business name:Apex Air LLC Lather
Address:18004 NE 72i4 Ave Subtotal >c
City/State/ZIP:Vancouver,WA 98666 klininwin permit.fee(590:00)
Plan review(25%of permit fee)
Phone:(360)342-8109 Fax:(360)3264769 State surcharge(12%of permit Ibe)
CCB lie:203034 TOTAL PERMIT PEE
This permit applicatinaexpires ife permit is not°budged within IOU
days atter it has been accepted as complete.
Authorized signature- Fee meibodolaw ret by Tri-County Building Industry Service t
Print peace_ to Y Date: 4.I I.!G. I
I ttuildiegt +inAnid'„t'an+itAis wai I3.des 4444eit?7'ir l.O/CO.UWl B)
Electrical Permit Application mon OFFICE.t,SE ON LA'
City of Tigard i''sv 1 # Pemtit g• .. .4fr 0) 01-
13125 SW Hall Blvd.,Tigard,OR 97223 pier,Review
Phone. 503.7182439 Fax: 503.59,8:1;9¢0•
Date!$
Inspection Line: 503.639.4175 _.. Ready Date/By- III= lel see Page 2 for
T it'k R DNooIfedFMethod: Supplemental Information
Internet: www.tlgffid orgov
r, _ ._ s ;,,,,�.ti..j..ifCi .Os iy;r'fS,3 ''''y: -4�"k y,-"6 _ :;4`4-42, �f,�, ��`,,w?'...To"* ?y 4) k*,Y;..l_. ?S"•i ,-;V,:s13: '>'''''�i:rx?4•;s
®New constrncl on 0 Addition/alteration/replacement Please check all that apply(suba,it2 sets of plans warms ducked):
❑Demolition 0 Other: Q Service or feeder 400 amps or more 0 Bullring over throe stokes.
where the available fault eurreot Q Marinas and bmtyards.
,::fir.4ti `'=.>_,`• ' w ':'f y 8 i=ti.41.V iV l f t? #t.'s qMisii.(21;', -'' .",_.- ,, ; '3,...... exceeds 10,000 amps at 150 volts or Q Flowing buildings.
®1-and 2-family dwelling 0 Commercia ruidtistrial 0 Accessory building lass to ground,or succeeds 14,000 Q Commercial-use agricultural
amps for ell other installations, buildings.-
❑Multi-family - ❑Master builder ❑Other. _ y Q ne purop. Q installation of 350 KVA or
1,°"'cE".:A3.-,".'":0-',11.1,01i; .r'.','Zr�"
. �1' GAr'v'Zlie ''''.e'"7.," t 4'v'Yr. A onk,a,' @�v ElEmergencysystem. larger separately derived
Job#: Job site adtirt Q Addition of dew motor load of system
1 1 t:!�-._ / ' 10011P ormore. 0"A","E","1-2","1.3",
Q Six or more residential units. occupancy.
City/State/ZIP:Tigard,OR 9727A Q Ranith-osze facilities. Q Recreational vehicle pmirs.
Suite/bldg./apt.li: Project name:(L f y ',�fyyxf j s.-QHazardous locations. O ,mita 1t ,cora than
❑Service or loader 600 amps or mole.
Cross street/dfreclions to job site: v,... T;•a�f 4• �� to�i ,w*'' ---'-
,nesctistfos Qty. Each Teal
New residential single-or multi-family dwelling unit
Subdivision:It j(yf T�AGL ((/oy1hw .j 1— I lot l:i22. Includes000 sqattached garage.
Tax map/parcel !- 1,000 sq.ft.or less 168.54 4
Ea.add'l 500 sq.R or portion i 33.92 1
u , ,., x, . r - :.ddr!Ut¢Aii:7,y(3f.,,-49 " ..1 d_t,< -: r ,. .0.r,'tiY' Limited energy,residential
(with above sq.ft.) 7$.00 2
Limited energy,molh-family 75.00 2
residential(with above sq.it.)
�. n.. 9 aPage 2
Renewable Energy Ste
',-, ,. 0:?,;4.�,{� tit, 1 . L t?F 4, jqc:..f :� �n�'"x -.... "> 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)694-4031 [Fax:( ) Over I,000 amps or volts 552,26 2
Temporary services or feeders installation,akeradon,and/or
Email: .. relocation
Owner installation:This installation is being made on property that I own which is not zoo amps or less I 59.361 t
intended for sale,lease,rent,or exchange,according to ORB 447,449,670,and 701. ' 201 amps to 400 amps 125.08 2
Owner signature: Date:
401 amps to 599 amps 168.54 J 2 i
k Branch elrettits--new,altehratie n,or teete"eime'per panel
�,� �t ,; _=4;t:'1,1,r���lig cj;r:�e,if'�:F, Y, ;�' �; --1�; €7� l�_�e„ a �:v,, �f.�,-•
';`�' A.Fee for branch dreuits with
i
name:Business Williamyonabove service or feeder fee. 7.42 2
each branch circuit
Contact „ B.Fee for branch circuits wfthotd
service or feeder fee,fust.Addres56.18 2
k e' t branch chant
ZIP:Vancottver,WA 3 Each add'lbranch circuit 7.42 2
Miscellaneous(service or feeder not included)
(360)695-7700 } Each maonfectured or modular
dwelling,service and/or feeder
67.64 2
„: .C,,, „ Recoronct only 67.84 2
ikc..:,.mv.. . ..nc�... ...tir s .�_Uf._ 6.!�. N''-''O 1 ;^J.<. ...o- . ; +._..:. ff'0. . .Zj-.G s. Pump or irrigation circle 67.84 2
Business name:Garner Electric Washington,LLC ' Signor outline lighting 67.84 2
Signal cirath(s)orlimited-clergy
Address:6101 NE St Johns Rd panel,alteration,or extension. 0 8u Page 2 2
Vancouver WA 98661 Each additional inspection over allowable in any of the above
City/State/ZIP:
Additional inspection(1 hr mitt) 6625/hr
Phone:(253)320-1657 Fax:( ) Investigation(1 hr min) 90.00/hr
Industrial plant(lhrmin) ' 78.18/hr
Emall:bdanielsegweusa.corn
Inspections for which no fee is 90.00/br
CCB Lie.: C1158 Electrical Lie.: 208174 J Suprv.Lim: 44968 s'. listed 'rft brmin)
•f. I•i? c? ?,4.5_., .l, _J .Sg•- ..> ,tS.LE..v.f r 3 __• • n
Suprv.Electrician signature,required: /,/ �J Subtotal:
Print name; Joan P Albert Date: 4/26/2016 . 0 Plan Review Required(25%of permit fee):
' State surcharge(12%of permit fee):
:7f•; _ — "=„� TOTAL PERMIT PEE:
Authorized signature: -
*s ` This permit application expires if a parade is sot obtained within 180
' Print name: Bill Daniels Date: 4/26/2016 days anter It Las bar accepted as complete.
st'?.,.iii • Number oflnepentionsallowed per permit I —
.4 '1t11/DS/WWWP.B
=i..?:^:LiaelidimtpekmesV,T.0 PeradtA}�Balt ffit8dot Rev 06117/20I5 44061S
Plumbing Permit Appliciaioi ` : � '`'
Building Fixtures 111111111111.1=11111111111111111111 .
City of Tigard F' ' 1 z may. Perron No.:// )7 -GgO 1 ...
u 13125 SW Hall Blvd.,Tigard,OR 97223
eview
Phone: 503.71$.2439 Fax 603.598.1960°- 4 p BR Other PermitNo.:
r n Inspection Line: 503.639.4175 p .... ..... Jurist El SeePane 2 for
Internet: www.tigard•or.gov /Me hod: Supplemental Information
El New construction . 0 Demolition For spadalWormalion=ether-kat
Description I Qty. I Ea I_ Total
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
. CATEGORY OF CONSTRICTION• SFR(1)bath 312.70
®1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 6 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
0 Master builder ❑Other. Fire sprinkler(-„__-sq.R) Page 2
. . : 'JOB SITE INFORMATION AND LOCATION . Site utilities:
Job site address: 111P17 SW ShOr iOvJ tt�IrQA 1 Sr D basin or area drabs 18.76
City/State/ZIP:Tigard,OR 97224 Drywall,leach lifts or trench drain 18.76 -
Footing drain(no.linear ft.:___) Page 2
Suite/bldg./apt.no.: 1 Project name: ✓ l Cryo t NI Tht ,t ' Manufactured home utilities 50.03 I
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear IL:_J Page 2
Storm sewer(no.linear It: ) Page 2
��.,� f ,r.hWater service(no.linear ft: ) Page 2
Subdivislon:�ll ' , mito_wrr-� Lotno.:1'� Fixture or item:
Tax map/parcel no.: err i�t Becicflc�v preventer 31.27
DESCRIPTION OF WORK Backwater valve i 12.51
Clothes washer 25.02
Dishwasher 25.02
Drinking formtain 25.02
Ejectors/sump 25.02
rif.pROPERT•5"•OWNER ' ' I O TENANT Expansion tank 12.51
Name:ADVL Land Holdings,LLC Fixturearsewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:7600 E Doubietree Ranch Road
Garbage disposal 25.02
City/State/ZIP:Scottsdale,AZ 85258 Hose bib 25.02
Phone:(602)694.4031 I Fax:( ) Ice maker 12.51
`
•
0 CONTACT PERSON. Interceptor/grease tap 25.02
Business name:William Lyon Homes,Inc Medical gas(value:$ _ ) Page 2
Primer 12.51
Contact name:Angela Grafewski Roof drain(commercial) 12.51
Address:109 East 13th Street Sink/basin/lavatory 25.02
City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54
Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan I251
E-mail:Angels.Grajewski@polygonhornes.com Urinal 25.02
•Water closet 25.02
• CONTRACTOR , Water beater 37.52
Business name:Malmedat Enterprises Inc. Water piping/DWV 56.29
Address:PO Box 207 Oilier: 25.02
City/StateJZIP:Banks,OR 97106 Subtotal
Phone:(503)3240759 Fax:(503-)324-0580 Minimum permit fee: $72.50
• CCB Lie,:102535 •Plumbing Lin.no.:34-276PB Plan review (25%of permit fi c)
State surcharge(12%of permit fee)
Authorized signature: C....----- TOTAL PERMIT FEE
Print name:Carolina Matmedat Date:04/25/2016This permit applkatioa expires If a penult is not obtained within 184 days
after it has been accepted as complete.
'Fee methodology set by Tri-Carry Building Industry Service Board.
t:lBugdirlPamitstPLMU.Pcrtnittepdoc 10/01/09 44046I6T(I0/02/COM/w66)
7
City of Tigard
1111111 N COMMUNITY DEVELOPMENT DEPARTMENT
r 1 c A li o Building Permit Review — Residential
�,t,".�as.�� a�::���s.�x=s_is.:�:�.� mow_ �..._. _, ._ ..wr w� ,._.•.,#:-:'r,r�+ �'�i3
Building Permit #: / j 2/7 — O
Site Address: /94/9,9- a) 2/4_0 )W --Thi/ ,c/
Name:ame:
i :selt/er —7--r%G.0 ,UelrAvc'S74' Lot #: /,g,
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: / t)
erify site address/suite#exists and active inP ermit s tem.
River Terrace Neighborhood: ❑ No (!d Yes,See River Terrace Review Addendum Attached
1 Si Plan Elements:
ree(3)copies of site plan '�' 'sting structures on site
plan must be on 8-1/2"x 11"or 11 x 17"paperi/
/ ootprint of new structure(including decks)with finished
awn to scale(standard architect or engineer scale) ►oor elevations
iffOrth arrow �i Utility locations(required for new,may apply for additions)
to address,project or subdivision name and lot number l P1 it cation of wells/septic systems
w,/ ..licant information(name and phone number) • ..sting trees to be retained with drip line,and tree
T. of dimensions and building setback dimensions protection measures
T4 Lot area,building coverage area,percentage of coverage and street tree size,type and location
pervious area(applicable if R-7,R-12,R-25&R-40) Street names
viroperty corner elevations (2 foot contour lines if more than
l 4 foot differential)
1\41ean Water Services—Service Provider Lett (lot platted prior to 9/10/1995):
equired: ❑ Yes,applicant was notified ltd No Received:
pP ❑ Yes ❑ No
Plai Public FacilitiImprovement(PFI)Permit:
equired: V Yes,applicant>was 4 J notified ❑ No Applied For: Yes ❑ No,stop intake
4aoning:
nd Use Case#: i ,� 's '-,5� &U )?c _(�k �,DuA
R-3 (pt
equired Setbacks: Front
do Rear /0 Side 3 Street Side E3Garage c,,20
Landscape Requirement: 0
0/0
ILJof Coverage Maximum: 00
0/0
Or uilding Height: Maximum Height 1147
Actual Height o2e
isual Clearance
rid
Easements
faensitive Lands: ❑ Yes IQ No Type
Urban Forestry Plan
❑ Conditions "Mee ,prior,o issuance of buildi • permit
Notes: 7 „�..lir .� .-� ,!_ f Kul--/L_' Qn1�
�L /S 5a2-fice_
Approved By Planning: << .( :L Date: cid c 1
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw REs 0912I6.docx
Building Permit Submittal
Original Submittal Date: /a/.2t/1Cv
Site Plans: # 3
Building Plans: #
Building Permit#: (5-Enter building permit#above.
Workflow Routing: [ Planning Engineering El-Permit Coordinator ilding
Workflow Sign-off: L'Sign-off for Planning(include notes from planning review)
Route Application Documents: [-Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
CI Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: AIM II.
By Permit Technician: MI.�..y z Date: /,,., .I 7
Engineering Review
Slope at building pad: / 71:Conditions "Met"prior to issuance ofing 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: ❑ Yes ❑ No
LIDA Facility on lot: ❑ Yes ❑ No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: 42. 7 Date: i--__1/--/7 IV
Revisions(after Building Submittal only) Reviewer Date
Revision 1: 0 Approved ❑ Not Approved
Revision 2: 0 Approved ❑ Not Approved
Revision 3: 0 Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions"Met"prior to issuance of building permit ?,�
'�1�pproved,NOT Released: f%�4Date: > 4//9---
Notes: >9---Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
SDC Fees Entered: Wash Co Trans Dev Tax: 1:1 N/A
Tigard Trans SDC: es ❑ N/A
Parks SDC: Yes ❑ N/A
OK to Issue Permit /�
pproved by Permit Coordinator: AWIS ./P//`77-
I:\Building\Forms\BldgPermitRvw_RES_091216.docx
b
•
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
g
T 1 c RD River Terrace Building Permit Review Addendum
1 _
Building Permit #: �o7p/7 epo%2_,
Site Address: /?1"/q - 10 %d ii ) f/ V/ 'f
Project Name: '/W.er 7rrcv 4_,t.7 dt., „2.7L Lot #: /.,?„,
(New dwelling=subdivision name;Aadition or Alteration=last name of owner)
Planning Review of River Terrace Plan Dist " t Design Standards (18.660.070.1.):
Is the project subject to the plan district design standards? VYes ❑ 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. ft. dee Balcony w/access 2 Window Projection Vertical Wall Offset a
p ft. deep min. 2ft.,5 ft.wide min. 2 ft., Eft.wide Gabled dormer
CI ❑ CI ❑
2. Eyes on the street: a minimum of 12%of eac eet facing f cade must include windows or entrance doors.
Percentage Shown: /1/7L, /v j/�
'C t'th
! o C.3. trances:At least one entrance must meet of the foll ' g standar s:a
Max. 8 ft. setback from ion st street- facing wall Parallel to street,angle no more than 45° from street,
or open onto porch
En nce opens to a porch: Yes ❑
p No
If e ,all the following apply: 25 sq.ft.min.
ne street facing entry /�2 ft.max. roof above floor of porch
5 ft. depth min. �j 30%min.porch roof coverage
4.x)etailed Design:All buildings shall include a tp. of five of/�he following elements on all street-facing facades:
/Covered porch min. 5 ft.wide x 5 ft. deep '�i4Q�Recessed entry area min. 5 ft.wide x 2 ft. deep/
VE all offset min. 16 inches ❑ Dormer min.4 ft.wide
Roof eave min. 12 inch projectionf.k El t .of offset min. of 2 ft.
❑ Roof shingles either tile or wood F? G able,hip or gambrel roof design f.4
❑ oof pitch oriented south min. 500 sq. ft. CF. orizontal lap siding min. 3 7 inches wide
Accent siding min.40%of street facade I Window trim min. 2 '/z"wide by 5/8"deepf�e
Window recess min. 3 inches for all street facing El 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:
N closer to front or side lot line,than longest street-facing wall. ❑ Yes F' 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)
❑ J/�foot-wide garage door ❑ 40%max. of street facade
50%max. of street facade with 7 detailed design elements
Notes:
1 - a% f i
Approved By Planning: __ (a t;�,..t
.Date: ! / p7'/ /r 7
/I:\Building\Forms\B1dgPermitRvw RES RT°62216.docx `