Permit (2) CITY OF TIGARD MASTER PERMIT
114 8: '< COMMUNITY DEVELOPMENT Permit#: MST2016-00240
13125 SW Hall Blvd.,Ti Date Issued: 09/08/2016
T[t t.D and OR 97223 503.718.2439 9
Parcel: 2S106DC06600
Jurisdiction: Tigard
Site address: 13762 SW SABRINA AVE
Subdivision: POLYGON AT WEST RIVER TERRACE Lot: 66
Project: Polygon at West River Terrace, Lot 66
Project Description: New SF. 3/9/17, REPRINTED to add a/c
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 805 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 25 Bathrooms: 3 Second: 939 sf Garage: 423 sf Front: 12 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Yes
Total: 1744 sf Value: $241,312.89 Rear: 0
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
Drains: 0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 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: 2 201-400 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 1744
Owner: Contractor:
ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
7600 EAST DOUBLETREE RANCH 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175
RD,STE VANCOUVER,WA 98660 2 1 hour fire rated eaves are
SCOTTSDALE,AZ 85258 required at fire place
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $30,601.63
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR ,2-01.61090.„. -u may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Wd
Issued By: - 1 i - 2--j< Permittee Signature: 04/ 9/'r'G'C/C..7 77e'
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Apnticat a"" T',, _ ., „,.-,. I(]I.:q Hi I. 1 ,1 t!\I 1
City ofTigard , X1,111
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13125 SW Hall Blvd.,Tigard,Olt 97223 Pian Review Other Permit:
,Phonc: 503.718.2439 Fax: 503.598I960„ t?atelfi}^.
,)nspcction.Lint: 503.639.4175 ft t3ateRmdytar
IllilllifikEt2151 ,
Internet: www.tigard-or.gev .` ` ''.' Notified/Method:
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... •..- ., � Meehariieal permit foes are based on thcvalue of the wori:
®New construction 0 Additiontalteratiotttreplacement performed.Indicate the vmechanical materials, ol funded to nearest dol
t t)of all
0 Demolition 0 Other Value:$
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1211 I-and 2-family dwelling 0 Com nerciairadustrial 0 Accessory building For spedafinfarnsarton sic checklist
Mule family 0 Master builder ❑Other Description I Qty. I Ea. 1 Total
_ CL t Htatiagltaaling: 1
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13102. SW ,- +,Atm,An Airc:oaditi„in t 46.75
Job she address: s(Lbl f five_ Furnace 100,000 BTU(dude vents) 46,75
City/State/ZIP:Tigard,OR 97224 Furnace 100.000+11113(doel1Iverasl 54.91
Heat pump 61.06
Suite/bldg./opt.no.: I Project name:P141190n l*we.S- Te- Duct work. 23,32
Cross street/directions to job Site: ✓ J llydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(triad-type,not electric),
in-wall in-duet,suspended.etc. 46.7$
Flue/vent for any of above 23.32
Other; 2332
Subdivision POlLj on AA- likietl' IthltrT-,read, I Lottto: 'i' Other fuel appliances:
Tax map/parcel no.: " p Water heater 23.32
rr`" _ x } a , % 3 .yip C f c c t4 s , .' " e Gulf fltepiacaliasext 33.39
. w ' v ,. , �.� r _. Flue vent for u�aler heater or gas
Ado Ql �?�`' to/veil-0- e9-ce% e 23.32.
iii �'Cjsl /.7 C"�ry}�� ! Log lighter(gas) 23.32
!V{J(f.R1��-OCFL'/D_ WocuNprllct Aare 33.39
. of i �r
Wood fireplace/insert
Chimne /inerfliue/veat 23.32
23.32
2332
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E)ryirvameatal.txlraasta am vcuttheEiesr3:
Name:Polygon WL11,1,LC Range hoodfother kitchen };,}9
equipment
Address: 109 East 13"'Street i Ctothts doer exhaust 3339
City/Siate/ZIP:Vancouver,WA 98660
Single-duet exhaust(i>uthracm ,
toilet cumpantrnent5,utility rooms) 2332
Phots:(360 95-7700 Fax:( ) Atticiaawtspace farts 23.32
,✓ , ?;-.. i.. s x w n} a r+.�,^ 5 s af. <r ;y Other" 2332
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Business name:Polygon WLIM,LLC 614.15 far t roar,x4.03 Forted)additional
i liin 3
• Contact lamp:Angela Grsjewski J'utnacc.etc.
Gas heat pump ,
Address:109 East 136 Street Wall/auspendcdiuna heater
City/State/ZIP;Vancouver,WA 98660 Water heater
Phone:•(360)695-7700 ( Fax::(360)693-4442 Fireplace
Range
cE-trail Aagela.Grajevski@polygon,Qcbomt, eceom Barbecue
,e^� xM s - J U , ,2- ,e tc r. , i -r -::::: Clothes d
ryer(gas)
t
Oil=
c lousiness name:Apra Air LLC K t, ,
Address:18004 NE T2"d Aver Subtotal
IN City/State/ZIP:Vancouver,WA 98086 Minimum permit fed($90.00)
Plan review(25%of permit fee)
d� Phone:(3601342-8109 Fax:(360)326-1769 t State surcharge(12%of permit tee)
t CCB tic.:203034 TOTA1.PERMIT FEE
This permit application Empires if a permit is apt obtained within 1St
daysatftrit-bat tees acreptertaacowplete.
Authorized.signature '-" " Fee mdhodolotry sd by Tri-County Building indtrslw Servrce(bard
Print name: tri ( • Dater: 4.11.1(..
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