Permit (21) CITY OF TIGARD MASTER PERMIT
r/ " Permit#: MST2016-00600
COMMUNITY DEVELOPMENT
13125 SW Hall Blvd.,Ti and OR 97223 503.718.2439 ' Date Issued: 03/20/2017
T laps 9 , 4 - Parcel: 2S106DB00800
Jurisdiction: Tigard
Site address: 13575 SW CALABASH TER t
WWII r
Subdivision: RIVER TERRACE NORTHWEST Lot: 8
Project: River Terrace Northwest, Lot 8
Project Description: New SF. 5/4/2017: REPRINT permit to correct the number of lays to(4). 8/10/17: REPRINT
permit to replace patio with deck.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 809 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height 25 Bathrooms: 3 Second: 1049 sf Garage: 437 sf Front: 8 Smoke Yes
Dwelling Units: 1 Third: 0 sf
Right: 3 Detectors:
Total: 1858 sf Value: $232,913.89 Rear: 3
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: Catch Basins: 0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 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'I 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
Ecompasing: Y
Other: N Other Description:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
OTR SF VB R-3 1858
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: $31,475.35
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. Yo ay obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Azi.: or Permittee Signature: __, •
5CG Gly` `Gu/ `o`er/
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.
Paw- mt
11111 City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
T 1 G A R D Building Permit Review — Residential
Building Permit #: /tel_Ce /6 -H 0 D 6 e0
Site Address: /55-9-c- S'I') r/z ii j./:
Project Name: r jar ' irae . (k)or ity-ems - Lot #: g
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
��
Proposal: Olen) /-- 'L>' `C' -/./ -7 /, /0//`ffi - 6 0
17 erify site address/suite#exists and active in permits tem.
virT
River Terrace Neighborhood: ❑ NoI Yes,See River Terrace Review Addendum Attached
Sit Plan Elements:
ree(3)copies of site plan sting structures on site
Pto plan must 12g on 8-1/2"x 11"or 11 x 17"paper ootprint of new structure(including decks)with finished
rawn to scale(standard architect or engineer scale) or elevations
rth arrow Otility locations(required for new,may apply for additions))tfe address,project or subdivision name and lot number dation of wells/septic systems
plicant information(name and phone number) MII:0,sting trees to be retained with drip line,and tree
Ilt dimensions and building setback dimensions trotection measures
ItdLot area,building coverage area,percentage of coverage and V eet tree size,type and location
pervious area(applicable if R-7,R-12,R-25&R-40) Street names
Property comer elevations(2 foot contour lines if more than
4 foot differential)
gitlean Water Services—Service Provider Lette of platted prior to 9/10/1995):
/Required: Yes,applicant was notified 11Q No Received: CI Yes ❑ No
DI 1:1ublic Facili •es Improvement(PFI) Permit: `
equired: Yes,applicant was notified ❑ No Applied For:
1/Yes 1:1 No,stop intake
( and Use Case#: el).P.2 — - 1 i/C-' S S. 4. r -- I ae
r4 •.. A_:_—frt
ai
F. Required Setbacks: Front Rear J Side Street Side '.4 Garage
FA Landscape Requirement: (_
0] Lot Coverage Maximum: /U'
0/0
Vg Building Height: Maximum Height f/1- Actual Height ,-
isual Clearance
SLI Easements
VJ Sensitive Lands: I Yes ❑ No Type LOA)_ Valk L. j jo*
Urban Forestry Plan
❑ Conditions"Met"prior to issuance]]of building permit
Notes: eff hl),C'YI S' S/he I be .ei 1471?),c--
4^ _.'l- u Date:
Approved By Planning: �_ ^ .,
___L4d-2/(0--_
Revisions (afterSwing Submittal only) • wer Date.
Revision 1: ..CJ Approved ❑ Not Approved '07V/7
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
1:\Building\Forms\B ldgPernvtRvw_RES_091216.docx
Building Permit Submittal
Original Submittal Date: 9/,./
Site Plans: # 3
Building Plans: #
Building Permit#: �Enter building permit#above.
Workflow Routing. Er Planning 0-Engineering L-Permit Coordinator [building
Workflow Sign-off: U'Sign-off for Planning(include notes from planning review)
Route Application Documents: IL,Engineering. (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
Ev/Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: 441A Date: 4,2AVI,,,,
Engineering Review
Slope at building pad:
°Conditions "Met"prior to issuance of building permit A47----04-7 I
IX Easements (encroachments)per engineering conditions of approval and plat
AWater 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
O NOT Approvb Engineering: Date:
Notes: L �cesee--/---
Approved by Engineering: 41. ]J Date: a.fd-/ti
Revisions (after Building Submittal only) Reviewer Tate
Revision 1: Approved ❑ Not Approved Ait (4)4. ( 7
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
Permit Coordinator Review
0 Conditions "Met"prior to issuance of building permit
K3IApproved,NOT Released: ate: //0 Z
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:
7
SDC Fees Entered: Wash Co Trans Dev Tax: li'Yes ❑ N/A
Tigard Trans SDC: G- es ❑ N/A
Parks SDC: P. es ❑ N/A
/1.11rK to Issue Permit /,,
Approved by Permit Coordinator: D. -: 371 v J
I:\Building\Forms\BldgPermitRvw_RES_091216.docx
OF 8 4
City of Tigard
III 'I COMMUNITY DEVELOPMENT DEPARTMENT
T I G A R D River Terrace Building Permit Review Addendum
Building Permit #: /-7177:2-0/& •- Qe9 6 Oe
Site Address: / `~ ,S'Z<) caLAh... - "
Project Name: eilAer ,erQC.e._ /Uar trt's Lot #: e
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan Distrt 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.
Porch min. 5 deep Balcony w/ access 2 Window Projection Vertical Wall Offset a Gabled dormer
ft. deep min. 2ft.,5 ft.wide min. 2 ft.,6ft.wide
❑ ❑ 0 0
2. Eyes on the street: a minimum of 12%of each street acing facade must include windows or entrance doors.
Percentage Shown: T/1)1, S/c f Si h2.e/a
3. trances:At least one entrance must meet both of the follo ' g standards:
Max. 8 ft. setback from longe street- facing wall Parallel to street,angle no more than 45° from street,
or open onto porch
En nce opens to a porch: Yes ❑ No
If es all the following apply: sq.ft. min.
ne street facing entry
En
ft.max.roof above floor of porch
5 ft. depth min. ig 0%min.porch roof coverage
4. etailed Design:All buildings shall include a min. of five o4 e following elements on all street-facing facades:
overed porch min. 5 ft.wide x 5 ft. deepf, Recessed entry area min. 5 ft.wide x 2 ft. deep f -c
Rall offset min. 16 inches 0/Dormer min.4 ft.wide
oof eave min. 12 inch projection f)• 9 'oof offset min.of 2 ft.%4c
❑ Roof pitch oriented south min. 500 sq. ft. 0 rizontal lap siding min. 3-7 inches wide
❑ Accent siding min.40%of street facade Window trim min. 2 1/2"wide by 5/8" deepp7
❑ 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
. . ; _. •es and Carports:May face the front or side lot line on a corner lot.
Setbacks:
No closer to front or si.e . '•e than longest street-facing wall. 0 - a No. If No (Check one):
❑ May extend up to 5 ft.if there is a . - -d front porc • garage does not extend beyond the front porch.
❑ May extend up to 5 ft. where the garage is • • ; o-story building and there is a window at the second story
above the garage that faces the stree i a min. area of 12 s•. .
Width: (Check one)
❑ I 2-foo •e garage door ❑ 40%max. of street facade
!' 1%max. of street facade with 7 detailed design elements
Notes:
c...,_
': <Z. Date: 1QA4APProved ByPlanning: -- � �-�'
I:\Building\Forms\BldgPermitRvw_RES_RT_062216.docx
.. .,., ..
,q CITY OF TIGARD t . t . MASTER PERMIT
..
lir
,17/7 4542
COMMUNITY DEVELOPMENT Permit#: MST2016-00600
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/20/2017
Parcel: 2S106DB00800
Jurisdiction: Tigard
Site address: 13575 SW CALABASH TER
Subdivision: RIVER TERRACE NORTHWEST Lot: 8
Project: River Terrace Northwest, Lot 8
Project Description: New SF. 5/4/2017: REPRINT permit to correct the number of lays to(4).
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 809 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 25 Bathrooms: 3 Second: 1049 sf Garage: 437 sf Front: 8 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes
Total: 1858 sf Value: $232,913.89 Rear: 3
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
Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 1 Bckflw Prevntr: 0
Drywall-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: 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:
OTR SF VB R-3 1858
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: $31,284.55
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: ` /
/ Permittee Signature: 0� < ,Z-/C. -len/
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.
CITY OF TIGARD MASTER PERMIT
,iii COMMUNITY DEVELOPMENT Permit#: MST2016 00600
Date Issued: 03/20/2017
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S106DB00800
Jurisdiction: Tigard
Site address: 13575 SW CALABASH TER
Subdivision: RIVER TERRACE NORTHWEST Lot: 8
Project: River Terrace Northwest, Lot 8
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 809 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 25 Bathrooms: 3 Second: 1049 sf Garage: 437 sf Front: 8 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 1858 sf Value: $232,913.89 Rear: 3
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 3 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: 1 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'l 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
-_- -
Ott ICI. N _ O�hci DcSuipEbfl. Ecompasing j
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
OTR SF VB R-3 1858
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: $31,284.55
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 I A' 95 -I.1-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. j
I/ . r. prz � 1 jam'/-' i is>�•�+
Issued By: Permittee Signature:
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.
` Building Permit Application
_ L_OT SP-
_:_Residential RECEIVED FOR OFFICE LSE ONLY
City of Tigard Received ,
Date/By:/Z 2-41/40 y'► Permit NoffJ7,„24/74, .-e7600
_ ■ 13125 SW Hall Blvd.,Tigard,OR 97223 SEP 1 2016 Plan Review Other Perini1�'��e�a//
Phone: 503.718.2439 Fax: 503.598.1960 R Date/By: I r 9'1 6
T 1 G A R D Inspection Line: 503.639.4175 („i.�Y Of- !E ARD Date Ready/By: ✓� Juris: El See Page 2 for
Internet: www.tigard-or.gov 3U �..D1NG } iVlSI N Notifed/Methodl7/ri/7 ' Supplemental Information
.,9111 s.
TRE � 7 ri• 3:" 1, yz l,�_t. % -� -3° n :a^*:_*'drw`+ S 4t a �a-Ty g is , -1," hw'""�
�.�.."a,'��-, ..:-? ..... -�-,?-.,,r.-�:�Eu s� rx.»:_. �I�+'� F*'ti ��4..... .:.::.....:�<... ,. ._�' ,--_.S .. ... . • ���_ ,.��„ s ��'.. � m rt
®New construction ❑Demolition Permit fees*are based on the value of the work performed. ^
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
aiWA � � � 3�� n W. W work indicated on this application. ni -'
Valuation: $
® 1-and 2-family dwelling 0 Commercial/industrialf
0 Accessory building ❑Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms: 3
r � � tu } t ,, ' Total number of floors: 2 as(1sa �
Job site address: 17)51S— b W cokkhksh
'e r(ac7 New dwelling area: 1 650 square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: 4'n square feet
Suite/bldg./apt.no.: Project name:River Terrace Northwest Covered porch area: square feet 1 a 4y
Cross street/directions to job site: Deck area: 1 O 4 square feet 8o q
Other structure area: square feet
wizo1a l s '`If s CU IU rS
Subdivision:River Terrace Northwest Lot no.: (6 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
M NLEar t " I f - '0 Till* a£, �` i`' ' work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
'' ` g:~ s r - 11::LF r a +r10-` ) **11 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 O` " ,
afV �- 't '' ^ x"
iii 44# I ' a.1 c`:..: -L: i :r g f -.
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::( )
E-mail:Angela.Grajewski@polygonhomes.com �P $ X t .. I:00 = '
i 7 , , t q Commercial and residential prescriptive installation of
, _._ _.1_� ,..� .. a. `.,::,tt _,. ..._ ._, 4. .. . ._`" °,` ".,. roof-top mounted PhotoVoltarc 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: (........>44,744/eft/OThis permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Angela Grajewski Date: g' J II, .Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
r
Mechanical Permit Applications y FOR OFFICE 1 SE ONE)
City of Tigard RECEIVED Received
Permit NS2 ,4e6
III • 13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1 kA Plan Review
_ °E P 1 2 016 Other Permit:
Date/By:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: fa See Page 2 for
Internet: www.tigard-or.gov crr OF d f GARD Notified/Metbod: Supplemental Information
It 1'"'a c t 1
Mechanical permit fees*are based on the value of the work
®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit
❑ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist
®Multi-family 0 Master builder D Other: Description I Qty. I Ea. I Total
4 r ,c a 6r. z • .,, • - �"tt • .' .,•:.;7';'''''•''''',. e` Heating/cooling:
CF„Fh,.E � ��zR,.firF h� �° ,,. Air conditioning 46.75
Job site address: 135 �\.1 .\ DA.0006V)T v f 1.0C.� Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldgJapt.no.: I Project name:River Terrace Northwest Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 1 23.32
Subdivision:River Terrace Northwest I Lot no.: rp , Other. 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
.� rt:. 1. M : Gas fireplace/insert 1 33.39
Flue vent for water heater or gas
new home construction fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
- Other•. 23.32
. Environmental exhaust and ventilation:
Name:ADVL Land Holdings,LLC Range hood/other kitchen
equipment I 33.39
Address:7600 E Doubletree Ranch Road Clothes dryer exhaust I 33.39
City/State/ZIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(602)694-4031 Fax:( ) Attic/crawlspace fans -- 23 32
"1 & i. Other. 2332
Business name:William Lyon Homes,Inc. Fuel piping:
$14.15 for first four,$4.03 for each additional
Contact name:Angela Grajewski Furnace,etc. I
Address:109 East 13th Street Gas heat pump
WalUsuspended/unit heater
City/State/ZIP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 I Fax::(360)693-4442 Fireplace I ,
Range I
E-mail:Angela.Grajewski@polygonhomes.com Barbecue
� � ra p� Clothes er as
Other.
Business name:Andersen Mechanical,Inc.
Address:16285 SW 85th Ave Subtotal
City/State/ZIP:Tigard,OR 97224 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)992-6664 Fax:(503)536-6615State surcharge(12%of permit fee)
CCB lie.:168214 TOTAL PERMIT FEE
VA; This permit application expires if a permit is not obtained within 180
4 Authorized signature: 71,1A7 * Fee methodology set by Tri-County Building Industry Service Board
Print name:Angela Grajewski Date:8/22/16
IABuilding\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)
Electrical Permit Applicati ~°t FOR OFFICE USE ONLY
City of Tigard 1� ""� Received Permit S2 /6, -0 606
13125 SW Hall Blvd.,Tigard,OR 972230CC 0 Plan Review
Phone: 503.7182439 Fax: 503.598.190I>e r 1 2016 Date/3. Related Permit a:
Inspection Line: 503.639.4175 Ready Date/By: jerk ®See Page 2 for
TIGARD: Internet www.tigard-orgov CITY OF I iGAAD Notified/Method: Sapplemental Information
T `-"'� �� - .nom-:- - -7 Rig I l M-� x:k4 4.�.<.:..�'��'"`_ ��'x- -�=z- aa`::>';g 7:-.7:77-:< _ ��'� m �...r.a
®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three strides_
El Demolition ❑Other where the available fault current 0 Marinas and boatyards.
tr--* :;;_—=; "'r'7 -?*r. �''} exceeds 10,000 amps at 150 volts or ❑Floating buildings.
®I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations, buildings.'
0 Multi-family 0 Master builder 0 Other. ❑Fire pump. ❑Installation of 150 KVA or
_ ;- - g Y '- - _ •='__ _ _ :; ' ❑Emergency system- larger seperaicly derived
_�,;.�� :.�:- ��i�r" ��'� Moil�-_ - -- -
;� = .t._`a :oil _._._ - .-< .. _..
/��'�r """"�r'r:- ❑Addition of new motor load of system.
Job#: 1 Job site address: hTcrYra IOOidP ormore. 0"A",`B",`1-2T,"1-3",
ElSix or more residentialmec�
units. R ' non'
City/State/ZIP:Tigard,OR 97224
❑Heaitlth care facilities. ❑Recreational vehicle parks.
/ t.#: Project name:. ❑Ha>ardons locations. ❑supply voltage for more than
Suite/bldg./apt.
�f t/ /v�r �/' �� ❑Service or feeder 600 amps or more. 600 volts nominal
Cross street/directions to job site: 'x'''' _"S-g--',-; --' _ N M7`
.'Description I Qtr. I Each I TotalI
New residential single-or multi-family dwelling unit.
Subdivision:If r� ,, ivertouef- 1 Lot#: S Includes attached garage.
1,000 sq.R or less I 168.54 4
Tax map/parcel#: Ea add'l 500 sq.R.or portion 2 33.92 1
rte " ter" =;0FS 7. (1 �`' SI:_-1 - Limited energy,residential
2
(with above sq.R) 75'00
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
i �T - 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
401 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 1,000 amps or volts 55226 2
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 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. - 201 amps to 400 amps 125,08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
Fv''-, ., x� Branch circuits—new,alteration,or extension,per panel
at*Ma". vk l'OL:. . ': `0-- -Q : Wd_ A.Fee for branch circuits with
Business name:William Lyon Homes,Inc. above service or feeder fee,
742 2
each branch circuit
Contact name:Angela Grajewski B.Fee for branch circuits without
service or feeder fee,fust 56.18 2
Address:109 East 13th Street branch circuit
City/State/ZIP:Vancouver,WA 98660 -- --- -- - — ® Each add-t branch cui4ri _ —
Miscellaneous(service or feeder not included)
Phone:(360)695-7700 • ' ` ! Fax::(360)693-4442 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email•Angela.Grajewski®polygonhomes.com Reconnect only 67.84 2
-E„f:Y.
6O - = ?-_. ' `' Pump or irrigation circle 67.84 2
Business name:Garner Electric Washington,LLC ' Signor outline lighting 67.84 2
.r..,; Signal circuit(s)or limited-energy ❑ See Page 2 2
Address:6101 NE St Johns Rd panel,alteration,or extension.
City/State/ZIP:Vancouver WA 98661 Each additional inspection over allowable in any of the above ,
Additional inspection(I hr min) 6625/hr
Phone:(253)320-1657 Fax:( ) Investigation(1 hr min) 90.00/br
Email:bdaniels@gweusa corn Industrial plant(I hr min) • 78.18/br
Inspections for which no fee is 90.00/hr
CCB Lic.: C1158 Electrical Lic.: 208174 Suprv.Luc:: 44968 specifically listed(h hr min)
..
'^ Suprv.Electrician signature,required: - r J4 • ".'': . Subtotal:
uP gnr� �_ • ,_ I �� .
Print name: Joan P Albert •- Date: 4/26/2016 - 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
— -�
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Bill Daniels Date: 4/26/2016 days after it has been accepted as complete.
•
* Number of inspections allowed par permit
:'`
I:inuld"mgtPcrmd t6LC PermitApp_ELR EREdoc Rev 06117/2015 440-4615TO1/05/COM/WEB
Plumbing Permit Application
Building Fixtures RECEIVED
City of Tigard Received PermitN�,r`TS1 /�> �U nd
11 4 13125 SW Hall B1yd,Tigard,OR 972231 E P 12016 ThatelBr
■ Phone: 503.718.2439 Fax:503.598.1960 FIG
Plan Review Other Permit No.:
Inspection Line: 503.639.4175 (.. . . O F-' .f ._;A DateRr
1 1�,.t f, Date Ymy' Huts: la See Page 2 for
Internet www.tigard-or.gov i! $ mss n l\i " Notified/Method: Supplemental Information
0 New construction a Demolition
For special information use checklist
Description J Qty. I Ea I Total
0 Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 1.00 ft,for each utility connection)
312,70
SFR(2)bath 437.78
`�4 1-and 2-family dwelling 11 Commercial/industrial SFR(3)bath ` 500.32
LJ Accessory building' ❑Multi-family Each additional bath/kitchen 25.02
❑lti+faster builder 0 Other. Fire sprinkler( sq.ft.) I Page 2
�).•-,,i t €ts, s fry _tis, a �; 71 6. A '< Site utilities:
Catch basin or area drain 18.76
Job site address:
11 SW a , •Sh-Te mace
1,leach line,or trench drain 18.76
City/Stare/ZIP:Tigard,OR 97224
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name:Northwest River Terrace 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 ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision:Northwest River Terrrace , Lot no.: 5 iresture or item:
Tax map/parcel no.: Backflow preventer 31.27
4' � '= Backwater valva 12.51
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
". „ Expansion tank 12.51
•
Name;ADVL Land Holdings,LLC >xumJsewer cap- 25.02
Floor drauJfloor sink/hub 25.02
Address:1600 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
Interceptor/grass, trap 25.02
)4....i.....1 (,«s.,a..
Business name William;Lyon Homes,Inc ) �,
Primer 12.51
Contact name:Angela Grajewski Roof drain(commercial) 12.51
Address:109 East 13th Street Sink/basin/lavatory 25.02
City/State/LIP:Vancouver,WA 98660 Solar units(potable water) 62.54
Phone:(360)695-7700 I Fax::(360)693-4442 Tublshowerishower pan 12.51
Urinal 25.02
E-mail:Angela.Grajewski®pelygonhomes.com
Water closet 25.02
>. �--: � -. _ •. Water heater 31.52
Business „s name: t . ‘Nik.,ci4--601Nt Waterpiping/DWV 56.29
Address: p.6. ) " Q{ 1, Other. 25.02
'
City/State/ZIP:. 5T, e (tt. 11 t31 Subtotal
Minimum Permit fee:$72.50
Phone: #--E '" 1411 tt��Y11 Fax (G1 ..'*��,' r ,' Plan review(25%of permit fee)
CCB Lie.: ., Plumbing{{ ''Lie.tw: 11 -
State surcharge(12%of permit fee)
Authorized sig ue: TOTAL PERMIT FEE
Print name: 6+€rLJt po W ik,l-,,. Date:Ga_.3 6....1 lc, This permit application
h hea baes if a permpfitcd isu cnommt mbseinepkh.d within ISO days
arae✓ s bees aece
*Fee methodology set by In-County Building Industry Service Board.
t3Bu1ldmg em2its1PLMU-Pe tritApp.doc 10/01/09 440.46161(10/021cOWWEB)
City of Tigard
11111 1 COMMUNITY DEVELOPMENT DEPARTMENT
•
T l G A R D Building Permit Review — Residential
Building Permit #: QST 2/4 -- Q,0 d p
Site Address: /SSC- -fit) /a27,1:
Project Name: £/✓- - ' rrp it) ) 1C,-e.s1— Lot #: g
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: QlF72—
17i erify site address/suite#exists and active in permits tem.
M River Terrace Neighborhood: ❑ No 2 Yes,See River Terrace Review Addendum Attached
Sit Plan Elements:
ree(3)copies of site plan sting structures on site
'pto plan must be on 8-1/2"x 11"or 11 x 17"paper g ootprint of new structure(including decks)with finished
rawn to scale(standard architect or engineer scale) or elevations
rth arrow
�(t�ility locations(required for new,may apply for additions)•113
t•fe address,project or subdivision name and lot number ol1.G�ation of wells/septic systems
Vg/Applicant information(name and phone number) S:b.sting trees to be retained with drip line,and tree
E.,451 dimensions and building setback dimensions otection measures
ItdLot area,building coverage area,percentage of coverage and reet tree size,type and location
pervious 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)
klean Water Services—Service Provider Lette, of platted prior to 9/10/1995):
/Required: ❑ Yes,applicant was notified 1P No Received: 1=1 Yes E No
Public Facilites Improvement(PFI) Permit:
equired: Yes,applicant was notified ❑ No Applied For: Yes ❑ No,stop intake
and Use Case#: A6 2e(),/r"_C0000 ' SLi/s /S=0661D e
o r2.-/Q
Required Setbacks: Front Rear 5 Side '' Street Side Garage
Landscape Requirement: (_
0/0
Lot Coverage Maximum: e�
0/0
Building Height: Maximum Height MActual Height -
tsual Clearance
1 Easements
0 Sensitive Lands: Yes ❑ No Type Lac)_ U/Ll L hah i'A'�
DI Urban Forestry Plan
❑ Conditions "Met"prior to issuanceofbuilding,permit /
Notes: C7?ar+r_/i,cvl S' S/k)dbe ✓1�e'Tou- ' iSL,fa.4ex
Approved By Planning: L Date: /0/� ��
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\B1dgPennitRvw_RES_091216.docx
I
Building Permit Submittal
Original Submittal Date: //./
Site Plans: #
Building Plans: #
Building Permit#: Enter building permit#above.
Workflow Routing: a-Planning CD—Engineering Permit Coordinator D_ iilding
Workflow Sign-off: 0' Sign-off for Planning(include notes from planning review)
Route Application Documents: Efr Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
ET-Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: ,r = Date: 7.,2�a->Vjc.,
Engineering Review
Slope at building pad:
i)21/Slope
"Met"prior to issuance of building permit /L47 X,4*--f
Easements (encroachments)per engineering conditions of approval and plat
AWater 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 Approv br Engineering: Date:
Notes: ----- /-..v4.e.2„t)j- 74, /..0z -----
Approved by Engineering: 4L 23 Date: a yz}--/A
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: El Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
Apptes: 3//roved,NOT Released: ate: /
No
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: li'Yes El N/A
Tigard Trans SDC: G— es ❑ N/A
Parks SDC: 17 es ❑ N/A
K to Issue Permit
itt:-.C:j. _
Approved by Permit Coordinator: Date: 3/1 l?-----
I:\Building\Forms\BldgPermitRvw_RES_091216.docx
I:\Building\Forms\BldgPermitRvw_RES_091216.docx
4
4
City of Tigard
NI " COMMUNITY DEVELOPMENT DEPARTMENT
Q
TI c A R D River Terrace Building Permit Review Addendum
Building Permit #: //f77,20/6 =- Ce 6 rd
Site Address: /}$, „cZ CalcaA 4-1.-
Project Name: e/vercce tour` kt.LS Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan Distrrtt Design Standards (18.660.070.1.):
Is the project subject to the plan district design standards? V Yes 0 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 deep ft. deep min. 2ft.,5 ft.wide min. 2 ft., 6ft.wide Gabled dormer
0 0 0 ❑
2. Eyes on the street: a minimum of 12%of each streetacing facade must include windows or entrance doors.
Percentage Shown: /lT ; !-�j/C/O' � S; -9„ /a e"'”e
3. trances:At least one entrance must meet both of the follo • g standards:
Max. 8 ft. setback from longe street- facing wall Parallel to street,angle no more than 45° from street,
or open onto porch
Ennce opens to a porch: Yes 0 No
If es all the following apply: sq.ft. min.
ne street facing entry 2 ft.max.roof above floor of porch
5 ft. depth min. 0%min.porch roof coverage
4. etailed Design:All buildings shall include a min. of five oe following elements on all street-facing facades: „
overed porch min. 5 ft.wide X,5 ft. deep. ,-t7 Recessed entry area min. 5 ft.wide x 2 ft. deep x
RVall offset min. 16 inches 0/Dormer min. 4 ft.wide
oof eave min. 12 inch projection'4%k9 V .00f offset min. of 2 ft:
0 Roof shingles eithcr til or woodIld Cab1,,hip or gr*rbrrl roof design f 44,__—
❑ Roof pitch oriented south min. 500 sq. ft. 0 rizontal lap siding min. 3-7 inches wide
O Accent siding min.40%of street facade indow trim min. 2 1/2"wide by 5/8" deepip '
❑ 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
. . ; .. •es and Carports:May face the front or side lot line on a corner lot.
Setbacks:
No closer to front or si.e . '•e than longest street-facing wall. 0 - % No. If No (Check one):
❑ May extend up to 5 ft.if there is a c• - -d front porc - . garage does not extend beyond the front porch.
❑ May extend up to 5 ft.where the garage is • •. ; ..o-story building and there is a window at the second story
above the garage that faces the stree • a min. area of 12 s..
Width: (Check one)
❑ 12-foo -•.e garage door ❑ 40%max. of street facade
1%max. of street façade with 7 detailed design elements
Notes:
Approved By Planning: �--' _R ' Date: / �s/�
I:\Building\Fomes\BldgPermitRvw_RES_RT_062216.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13575 SW CALABASH TER, SHERWOOD, OR, September 15, 2017 at
97140 10:25:54 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00600
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
PASS
Comments:
Water pressure 60 psi.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13575 SW CALABASH TER, SHERWOOD, OR, September 15, 2017 at
97140 10:28:58 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00600
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
FA I L
Comments:
FP not set up and operational.
Not ready for final inspection.
Re schedule when work is complete and ready for inspection.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13575 SW CALABASH TER, SHERWOOD, OR, September 15, 2017 at
97140 10:11 :59 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00600
Inspection Type: Inspector:
199 Electrical final David Young
Result:
FA I L
Comments:
Remove debris pile in front of electrical panel and outlet for inspection.
No inspection done. R109.1
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13575 SW CALABASH TER, SHERWOOD, OR, September 19, 2017 at
97140 10:03:03 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00600
Inspection Type: Inspector:
199 Electrical final Aaron Cillo-Gobel
Result:
PASS
Comments:
No A/C installed
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13575 SW CALABASH TER, SHERWOOD, OR, September 20, 2017 at
97140 1 :32:28 PM
Record Type: Record ID:
Residential - Master Permit MST2016-00600
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS
Comments:
No ac installed at this time.
Permit and inspection required at time of installation.
Violation Summary:
Inspector Contractor