Permit ih L CITY OF TIGARD MASTER PERMIT
sCOMMUNITY DEVELOPMENT
Permit#: MST2017-00006
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/14/2017
j" Parcel: 2S106DB12300
Jurisdiction: Tigard
Site address: 17483 SW SHADOW TRAIL ST
Subdivision: RIVER TERRACE NORTHWEST Lot: 123
Project: River Terrace Northwest, Lot 123
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 978 sf Basement: 0 of Left: 3 Parking Spaces: 0
Height: 28 Bathrooms: 3 Second: 1251 sf Garage: 380 sf Front: 8 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
Total: 2229 sf Value: $271,136.41 Rear: 10
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 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 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 2 Fire Rated Eaves-Both
STE 1 Sides
SCOTTSDALE,AZ 85258
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $32,133.54
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: �_�. .. ,�/ �.t���� Permittee Signature: �i' (/�� C-G� k.
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.
7--
23
Building Permit Application !� /23
cam
® ,_ FOR OFFICE I SE ONL1
City of Tigard
Received / 9 /7 `01 Permit N9/9:5:27/ 0,00
1111 DatdBy
' 13125 SW Hall Blvd.,Tigard,OR 97223 " I Plan Revie�� -• 1 ly Other Perm ,,, /7-��L'1L�0
s Phone: 503.718.2439 Fax: 503.598.19ts., Date/By: Juris: 0 See Page 2 for
Inspection Line: 503.639.4175 ' ei Ready/By: / �7
"Y 7"I ';:R D t tified/Method /e // I Supplemental Information
464. Internet www.tigard-or.gov /
ret.
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Permit fees*are based on the value of the work performed
r- z -
New,construction 0 Demolition Indicate the value(rounded to the nearest dollar)of all
Additton/alteration/replacement 0 Other equipment,materials,labor,overhead,and the profit for the
❑ work indicated on this application.
�� <"'"� Valuation: 19 oi ' •.
® 1-and 2-family dwelling 0 Commercial industrial 4
Number of bedrooms:
❑Accessory building 0 Multi-family
Number of bathrooms:
o Master builder 0 Other
ia: Total number of floors: Z o C,
�axe ��C ,�r"` P gv.,4�61� �, f � Vi � � t 3 � ��� ��, '"C'`
readd a .:.. _u --- : 9
��"� �:�-��-�� - � '`� -` ' � New dwelling square feet
Job site address: 21,9 116 M _ 1
City/State/ZIP:Tigard,OR 97224 ��Jw��l square feet
Garage/carport area: ` ) q
` "`"'
�'. t ,` Covered porch area: 4 4(quare feet
Suite/bldg./apt.no.: Project name:T�� ..�� OW
Cross street/directions to job site:
Deck area: square feet
Other structure area: square feet
� i�- -T1 e €,Itea€ a
W Lot no.: Permit fees*are based on the value of the work performed.
Subdivision: v ' Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no equipment,materials,labor,overhead,and the profit for the
,� '� .7 ,, "2 work indicated on this application.
$
Valuation'
Existing building area: square feet
New building area: square feet
Number of stories:
Type of construction:
Name:ADVL Land Holdings,LLC
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 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::( ) w ar s
E-mail:Angela.Grajewski@polygonhomes.com Commercial and residential prescriptive installation of
„ ; :1::`:-L-:: � 1 : � roof-top mounted PhotoVoltaic Solar Panel System.
e:W il'am Lyo Submit two(2)sets of roof plan with connection details
Business name:William Lyon Homes,Inc 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 lic.:207247 Total fee due upon application:
This permit application expires if a permit is not obtained
Authorized signature: R I l(l5 n 1 {-v within 180 days after it has been accepted as complete.
l/1 l ✓ Wl 1 1 I *Fee methodology set by Tri-County Building Industry
IPrint name: I Date: Service Board.
I:\Building\Permits\BUP-RESPemritApp.doc 02/24/2011 440-4613T(1 l/02/COM/WEB)
• Mechanical Permit Application
'' '''' ''' " '''''' . IIIIIIIIIIBIIIIIIIIIIIIIIIIIIIIIIII
City of Tigard
13125 SW Hall Blvd..Tigard,OR 97223t,;\
MReview
il OPentair.
Phone: 503.718.2439 Fax 503.598.1960 Receive:6"' '
Darcifty.
au
Damer
Inspection Lt,
ine: 503.639.4175 . , ' , , .„ - ,Rcsdyloy,
Internet: www.tiprcl-or.gov Notifica,7„3com& Permit Nn.:
ther
Auk. I 121 See PAtge 2 far
Supplemental information
:r ;1- —:x --' ' ' :I - .' "'''-' ' " '''',4' J'er t ,.---E'r•-'.'''''
',N, '',,a.,In.",!:.,,,i,'-'r_A' ..1";,:et.4. 17;:•^•:14:-.144.)7,4z4.47.1,i1,:iyiZti,-;4.•:te-5.,,,,,'OZr`V-4.1;,,,A`;','''41'?`,i'VY-f- ra.)* :::'7'''''''''L'''':,'''''`i-f" .'''t-',5- '-'''''''''' '''' '=1.!-, ' •••';-'." 4, --...; -:'.4`
."..„,,` Mechanical permit fees*rue based on the value of the work
181 New construction U Additionialterationfreplaortnent performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other. mechanical materials.ettuirtmenk labor.overhead.and profit
: 'tr:,,,e'vv,ir,:1'..p.0.- ',fr,..."4:77-4-.11-g'y,15,"•,..47)-'"..4 i'",-:',;','4 n,i31-.• ,:-..,,,,,,i,z,,,,,,- 4,..,--•.. ;,,,,,..,-...v...,,),' ,.. •, :„........- . v,...61,-u4:1 , -- • - - ,
o 1-and 2-family&tiling 0 Coranterchdrindustrial 0 Accessory building For spedat in,formailort xi-echo:Vat
18)Multi-family 0 Master builder 0 Other: Description Qty. I Ea. f Total
',F,,, ,^1k,V.r,ff,.;--,,,',47.1:f. :/'',,5-V,•.:.t 3'4 r.S",!tl`$,:":''' -'.' .itir:f•V't.,'5'I',,:.1.'‘-4',1z-.4E.*.I.P.",V4." :"q%:,:.V.. HeatineAbLding: I 46.75
Job site address:, nq133 Sr s1rvdM !put sr Furnace JOD.000 RTUPhictetemS) 1 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100.000+BTU Iductsivenosi $4.91
Heat pump 61.05
Suiteibldgjapt.no.: Project name:kOr7iirrAte Alo1iqw6cf- Dud work 23.32
Cross street/directions to job site: Hydrook hot water vstem 23.32
•
Residential boiler(radiator or .
hydronici 23.32
Unit heaters(fuel-type,not electric),
in-wall.in-duct,suspended.elc-• 46.75
Flue/vent for Mir of above 1 23.32
- Other
Subdivision:Ihyprivoryic,243, yiltittk#.— 1 Lot T1O.:/2?
23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
,,,..,,7,51-...,:_.-c,,,,,17-,:i.,g',.-::-. ..:i-.fi"-,,-,:':.:in.T.:;1)".1 , 17-,,,r,q,-,•T'Di0-4-,:;fj.4-;; ,,As)::„Isl-,-;,1&:*•,.;,,I,,,, .., Gas fitimiticefinsert r 33.39
Flue vent for water hotter togas
firmliace 23.32
Loa lighter(PO23.32
Wood/pellet stove 33.39
Wood finaplaccilosert I 23.32.
...
Chlraneyfiintrilineivent 23.32
23,32
•
„.i.','!'-'-`1-,'7' 4.,.-`,1-/ 3.').- --,•_,c''''..:,`,-,1--, 1,--"-,''''' ;'.,"'..t<Z'r:L';7""'''''''''''''';'.'''.t'''''''''''' .'''''''''''''''''''''''$.''' '''t:7"; Environmental exhaust and ventilation:
Name;Polygon WLII,LLC Range hood/other kitchen I
equipment 33,39
Address: 1119 East 13iStreet Clothes dryer exhaust I
CityiStuletZIP:Vancouver,WA 98660 Single-duct exhaust(bathrooms.
Solid compartments.utility moms) 1-1- 23.32
Phone:(360)695-7700 Fax:( ) Aniderawlspace fans 23.32
1Y5lic`TT,"•''',.: ::-.T•-''''-:'-''.:?.;:1:71:, i:J.2::::.fl ..*: .:',= ,-).;..-,i,::-."1,-Treq,..z;;r;,, , ,y-',:,,,w,c,-,4 :, Other 23.32 ,
Foci PIPIRM
Business mine:Polygon WLII,LLC . 314.15 for lirst four;$4,03 for earb additional
Contact IMMO:Angela Grajewski Furnace.de. i
Address:109 East 13th Street Oas heat Munn ,
Wail/suspended/unit heater
City/Statealp:Vaneotrver,WA 98660 Water heater
Phone:(360)695-7700 I far:(360)693-4442 Fireplace I
i Ranlie • I
E-mail:Angeht-Grajewskigpoinonluoines.eam Barbecue .
,Z--.:3:7S:: ',`•-''=:'.4:7•-,._'::,;:-;.,lc_4'..: ,,,-"',:,..7:4.:1,T,,-;-'1,1::::' ,•y'iSit;',.:',12,-f,-.L5:`c,,.;:,-,1=:;.1. :; .:,:::,;-%:::::41-:4_,,ii:sp-7;,;:, Clothes shyer(pas)
,Other .
BaSiTOSS rune:Apex Air LILIC , ;',`..,-,':,,,.,; :z.;;,*-,7,-1 i i,cfl'Elc F.1„,s•'1'1..-TS,;?,0-,':,;./141',,,, ,-.4,0,'%'k.';
Address:18004 PIE 72"Ave Subtotal
City/State/ZIP:Vancouver,WA 98686 Minimum permit,fee(390:00) .
Plan review(25%of pemtit fee)
Phone:(360)3424109 Fax:(360)3264169 State surcharge(12%of peranit tire)
CCB lin.:203034 . TOTAL PERMIT FEE
'Ms permit application aspires lie permit is not obtained ithin UM
days atter irlem beat accepted as complete.
Authorized signature' * Fee methodology to by I'd-County Bflung Industry Service Beard
Print name: 1 irk / Dale: 4-1'?.It..
1.14611411601:11401%4EC_PelEMArp_04111141410 1O-46E71'4f fArAirOWW118)
Electrical Permit Application 1•()R orrtci:tSE z)NLN'
City of Tigard
114 13125 SW Ball Blvd.,Tigard,OR 97223 Plan acviaw
Phone: 503.718.2439 Fax 503598.1960 Datura• Num ${Ste Page 2 for
Inspection Line: 503.639.4175 Ready DIy' Sep See
Page 2 rorn+atiou
T1c,;.ii1> inittrilgt www.tigard-or.gov O fMeth0�
Please check ell that apply(submit 2 sats ofplans w/items checked).
®New construction 0 Addition/alteration/replacement Cl Service or feeder 400 amps or more 0 Buncfmg over thee steres.
❑Denloltboa 0 Other: where the available fact current ❑1:farinas and boatyards.
15 .i',',,:,--t:-T--- --,Z., Ed1 '.��J e'er` c tice,4-(5.gs"..'s sr: x c,.4a'r t,*Lt h. exceeds 10,000 amps at 150 volts or Q Floating buildings.
- less to ground,or exceeds 14,000 ❑Commercial-use agricultural®1-and 2 family dwelling 0 Ct,@mercia3lttidlisprial 0 Accessory building amps for all other iesmuatioes. headings.•
[]Multi-family Master builder 0 Other: ❑Fm pump.
[]jn.tnnttion of 150 KVA or
° »-r l,. '-- 2 o S:a•a d'M ati .,7 ki-0111 r v 1!�: v.i s , s rw�> r Q .._0 ❑SttlY mem. l h'derived
s,,. a ?, ❑Addition of new motor load of systems.
Job#. Job site address fl t/83 5 v'J s �i2oj irlu+s sr 3001IP or more. ❑n~,-a",-s r,n...r,
0 Six or more msidentiel units. occupaOcy.
eityJStdte/ZIP:Tigard,OR 97224 „_, ❑Reaub-nice faaililies. 0 Rameational vehicle pada.
pp�� �f'p'�/``' y., iiazardo�locations. 0Sapp1Y���'more than
Suite/bldg./apt/apt #: Project name: Iwf�Y '("l7Y 31v1L: +��V11,( 11tJt l ice or feeder 600 amps or moan. 600 volts nominal.
V.`s' Se. ;r �. z n 4.4:561'^fit e/i X- fes...-' "`
Cross stsee/directions to job site: ` aro.. Rica, Tont •
Drsestoaen 1
New residential single-or multi-family dwelling unit.
Subdivision:d iV r�''' *may/_ Lot#:1 23 Includes attached garage.
!"llf{,� /tJ Ate. �il►7V/1� � ( 1,000sq.ft.arless 1 168.54 4
Tax maplparcel#: Ea add'1500 sq.ft.or porton .5 3392 1
,,,,' `r. :r` 'a ..r .k46:o t t l6),�fi;Jl r=id;�.�4.+:','.r :k,- t4-ta.:,-;:' xrrc
` ,; Limited energy,residential 75.00 2
_ (with abovesq.ft
Limited energy.multi-family 75.00 2
residential(with above sq.ft.)
Renewable Enrsi;Y 0 Seo Pale 2
'.-`' 0 tri 4zi _1?,J,,;4.— - ^7"x„ a ..:;1:.'P-11-z'1,4A'-:‘,?4'.'". -1,3- 14- Services or feeders installation,alteration,and/or relocation
Name:ADVT.,Land Holdings,LLC 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Address:7600 E Doubletree Ranch Road 401 ataps to 600 amps 20034 2
City/State/ZIP:Scottsdale,AZ 85258 601 amps to 1,000 amps 301.04 2
Fax:( ) Over 1,000 amps or volts 55226 2
Phone:(602)694-4031I Temporary services or feeders installation,alteration,and/or
Email: . . relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less f 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 70L 201 amps to 400 amps I}j 125.08 2
Date 401 amps to 599 amps 168.54 2 r
Owner signature: Branch circuits-new,alteration,or extension,per panel
�� �,�7� °�.+��;-�=�t•'L�'t..rM;;'�x�.ra�Y? ; ',:.,..,.��'�<:�t�•�• i1a�,ut k�s?�,�n�`S�•'%� `:, �A.Fee for branch circuits with
Business name:William Lyon Homes,Inc. above service or feeder fee. 7 42 2 5
each branch circuit
Contact name:Angela Grajewslri B.Pee for branch circuits without '
service or feeder fee,fust 56.18 2
Address:109 East 13th Street branch circuit
Each add'l branch circuit 7.42 2
City/Statti/7�P:Vancouver,WA 98660 cellaneous(service or feeder not included)
Phone:(360)6957700 • ' ' I Fax::(360)693-4442 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:Angela.Grajewsld@polygonhomes.com Reconnect only 67.84 2
•
.s _ y >a�el:. _w
ar gc _' 7 ? r F Pump or irrigation cirrdo 67.84
Business name:Garner Electric Washington,LLC • Signor online lighting 67.84 2
4�.. Signal ciratit(s)or limited-energy 0 see Page 2 2
Address:6101 NE St Johns Rd Panel,alteration,or extension.
Each additional inspection over allowable in any of the above
City/State/ZIP:Vancouver WA 98661 Additional inspection(1 hr mica) ( 6625/br
Phone;(253)320-1657 l Fax:( ) investigation(11s min) 90.00/hr
Indsut a'1 plant(1 hr rain) • 78.I8/hr
Email:bdanleis@gweusa.com Inspections for which no fee is 90.00,hr
Electrical Lit.: 208174 Suprv.Lia: 44965 listed '%brinia
CCB Lie.: C115B _ _ - �`, '.a t';.icrti 0.._., air'_ " 7-':'2c'-'- '''''
Supra.Electrician signature,required: '- ' ,f / , {�,,�, '.. - Subtotal:
Print name: Joan p Albert •• I Date: 4/26/2016 ❑Plan Review Required(25%of permit fee):
r _ ,. State surcharge(12%of permit' fray:
'••tytt,!: ' --- —=- -`-.•. TOTAL PERMIT FEE:
•;• Atrthoriad SIgDatlire This permit application expires ifs petunia not obtained within 180
tPrint name: Bill Daniels Date: 4/26/2016 days after it accepted as complete.
1,111W!:;,rSNumber of inspectionsPer permit
i`.illuB 5ParminVil.0 ermitApp_liLA SaB.doe Re'OM?QaaS 440-46157LlUC5KAM/VVf9
Plumbing Permit Application' ` •
Building Fixtures . 4 --,,-., 111111111111.111111=1111111111111111 :
City of Tigardley Permit No.:
III i 13125 SW Hall Blvd.,Tigard,Olj'.97223- 'pianReview
R ' Phone: 5017382439 Fax 5035981960 Datesr Other Permit No.:
Inspection Line: 503.639.4175 - DatsgeadylB}r_. .. ...-•. hair. f El SeePaCc2for •
r I' Internet wwW.tigaTd-or.gov ,. , Notified/Method: _ 1 Supplemental Information
.::.:4;.1.;,:;-,..;;;;;;;,,,,....„....:. ,OF•.tWY.ORKa...t:p,..... .. _ .: :i:'......: .:..7.. rS Rc , a.:t-.:,`•`'.w,4.<°:•`•:,i•t_:,',
New const action' ' C Demoliton For special Information Use checklist
® Description I Qty. I Ea. I Total
Q Addition/alteration/replacement 0 Other. New 1-2-family dwellings(includes 100 B.for each utility connection)
' •.CATEGORY OF colgrittiCfl N!i' SFR(1)bath 312.70
®1-and 2-family dwelling 0 Commercial/mdushial SFR(2)bath 437.78
SFR(3)bath I 500.32
0 Accessory build ng Q Muni-fmnily Each additional batbtkitchen 25.02
0 Master builder ❑Other. _Fire sprinkler(_sq.f1.) Page 2
.. • ` JOB SITE INFORMATION.,AVD'LOCATION Site utilities:
/t��6 s Shae10 -teal t sr Catch basin or area drain 18.76
Jab site dtddrrss: Drywall,leach lime,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.:,_,_„) Page 2
Suite/bldg./apt no.: I Project name:At/tor laract NiriluMd Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear it:_J Page 2
� �] Water service(no.linear ft.:_•__) Page 2
Subdivision /� ^�'.,�, / ••,�,�- Lot no.L ... Fixture or Item:
tF71��N�J3�.1!r pi /v[ wyA► Br owpreventer ( 31.27
Tax map/parcel no.:
Bdukwatcr Valve f 1251
• DESCRIPTION OF WORK• •
Clothes waster 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
®.T'ROPERTP OWNER 1. Q TENANT Expansion tank 12.51
_, 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)694-4031 Fax:( ) Ice maker 12.51
®•APPLICANT .- '.❑ CONTACP PERSON: Interceptor/grease trap 25.02
Medical gas(value:S, ,) Page 2
Business Warne;William Lyon Homes,Inc
Primer 12.51
Contact name:Angela Grajewski Roofdtaut(cornnttrciai) 12.5I
Add=109 East 13th Street Sink/basin/lavatory 25.02
City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54
Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51
Urinal 25.02
E-mail:Angela.Grajewaklgpolygoabomes.com
Water closet 25.02
CONTRACTOR .• - Water heater 37.52
Business name:Malmedal Enterprises Inc. Water piping/DW V 5629
Address:PO Box 207 Other: 25.02
City/State/ZIP:Banks,OR 97106 Subtotal
Phone:(503)3240759 Fax:(503-)324-0580 Minimum permit fee: 572.50
Plan review(25%of permit fee)
CCB 102535 'Plumbing Lim no.:34-276PB State surcharge(12%ofpermit fee)
Authorized signature: C,....., '-(2 " TOTAL PERMIT FEE
Print name:Carolina Malmedal Date;04/25/2016 This permit application expires if a permit is not obtained within 181)days
after it has been accepted as complete.
"Pee methodology set by?ri•County Building Induriry Service Board.
1:46allditglYennitrV'LA4U.Pe++uRnDF•dea 10/0159 40.461611I0/02ACOM/WEB)
%
City of Tigard
N COMMUNITY DEVELOPMENT DEPARTMENT
I
TIGARD Building Permit Review — Residential
Building Permit #: /71 7T.2c) 7— CSC) 0 6 C
Site Address: 1140 &'1A) ( 44J -P9411 . '"
Project Name: 1\ei( Tay NOITYINInt Lot #: 123
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: N(
12:'Verify site address/suite# exists and active in permit system.
'River Terrace Neighborhood: ❑ No ®;Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
1:4114ree(3)copies of site plan X14 -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)
ite address,project or subdivision name and lot number IA .cation of wells/septic systems
pplicant information(name and phone number) "A xisting trees to be retained with drip line,and tree
I, ot dimensions and building setback dimensions .rotection measures
►t' 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
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 notifiedNo Received: ❑ Yes E No
X. Public Facilities Improvement(PH) Permit
Required: ❑ Yes,applicant was notified No Applied For: ❑ Yes ❑ No,stop intake
Si Land Use Case#: PD'Z2 c*5—co'
-i Zoning: k-1(PD)
:a Required Setbacks: Front Es, Rear 'o Side 3 Street Side Garage ID
Landscape Requirement: D % I
ALot Coverage Maximum: eo
.aBuilding Height: Maximum Height f Pr Actual Height t2-C1
Visual Clearance
Easements
.,N, Sensitive Lands: ❑ Yes .$1 No Type
XUrban Forestry Plan
Conditions "Met"prior to`isssu�ance of building permit
Notes: C � "I til �Qe, mei prw- ID ‘ a .. (F of ,
Approved By Planning: :ir/All C; _L Date: i2 1143
Revisions (after Building Submittal o ) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw RES_091216.docx
i
Building Permit Submittal
Original Submittal Date: /o2/ -t//k,
Site Plans: # '3
Building Plans: # ` ,
Building Permit#: B--Enter building permit#above.
Workflow Routing: Planning 4]/Engineering —Permit Coordinator ®-d wilding
Workflow Sign-off: (E'Sign-off for Planning(include notes from planning review)
Route Application Documents: a-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: c- Date: f 7
Engineering Review
• Slope at building pad:
411,Conditions "Met"prior to issuance of building permit o f ijjj/
❑ 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: dt„ Date: `4j 77
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 �j�
"111.pproved,NOT Released: /71 Date:
1
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:
911r DC Fees Entered: Wash Co Trans Dev Tax: es ❑ N/A
Tigard Trans SDC: (Yes ❑ N/A
Parks SDC: yes ❑ N/A
OK to Issue Permit / ,/�
Approved by Permit Coordinator: 1'✓d ate: / 'J /9
f "
I:\Building\Forms\BldgPermitRvw RES 091216.docx
City of Tigard
w COMMUNITY DEVELOPMENT DEPARTMENT
T 1 GARD River Terrace Building Permit Review Addendum
Building Permit #: /'S 7. /67/1 7 — O c 7 C9c0 6
Site Address: ‘14( .3 svi WOW .j faiktb S- cth-
Project Name: \2-NL r Terrace. NoLot #: iTh
(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? I,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
❑ CI ❑ ❑
2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: (a-S-1)!0
3. Entrances:At least one entrance must meet both of the following standards:
l�
XMax. 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:)'Yes ❑ No
If yes,all the following apply: ..25 sq.ft.min.
..13:1.One street facing entry ..2 ft. max.roof above floor of porch
5 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
all offset min. 16 inches ❑ Dormer min.4 ft.wide
Roof eave min. 12 inch projection ,,'Roof 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
❑ Accent siding min. 40%of street facade \Vindow 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 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,No. If No (Check one):
❑ May extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch.
❑ May extend up to 5 ft.where the garage is part of a two-story building and there is a window at the second story
above the garage that faces the street with a min. area of 12 sq.ft.
Width: (Check one)
❑ 12-foot-wide garage door ❑ 40%max. of street facade
/150%max. of street façade with 7 detailed design elements
Notes:
Approved By Planning: •
0411A r ' a / Date: 142...24k_
I:\Building\Forms\B1dgPermitRvw_RES_RT_062216.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
17483 SW SHADOW TRAIL ST, BEAVERTON, August 29, 2017 at 9:37:07
OR, 97007 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00006
Inspection Type: Inspector:
199 Electrical final Aaron Cillo-Gobel
Result:
PASS
Comments:
Corrections completed.
No A/C 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:
17483 SW SHADOW TRAIL ST, BEAVERTON, August 29, 2017 at 9:37:55
OR, 97007 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00006
Inspection Type: Inspector:
699 Mechanical final Aaron Cillo-Gobel
Result:
PASS
Comments:
Corrections completed.
No A/C installed at this time
Violation Summary:
Inspector Contractor