Permit (24) CITY OF TIGARDMASTER PERMIT
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PIN 2. COMMUNITY DEVELOPMENT Permit#: MST2017-00008
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/14/2017
T G �11.L 9 Parcel: 2S106DB12700
Jurisdiction: Tigard
Site address: 17407 SW SHADOW TRAIL ST
Subdivision: RIVER TERRACE NORTHWEST Lot: 127
Project: River Terrace Northwest, Lot 127
Project Description: New SF.4/12/17: REPRINT to add patio cover.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 978 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 24 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: $274,261.21 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
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
Fu rn>=100 K: 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: 4 201-400 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: $32,292.71
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. Y u 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: C�rr_- Qir/9l 'e-4741'al
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.
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
II Letter
Transmittal a e ter
T U G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Tom H. DATE RECEIVED:
DEPT: BUILDING DIVISION
RECEIVED
FROM: Angela Grajewski APR 3 2017
CITY OF TIGARD
COMPANY: Polygon Northwest BUILDING DIVISION /
/'
PHONE: 971-212-2144 By:
RE: 17407 SW Shadow Trails ST MST2017-00008
(Site Address) (Permit Number)
River Terrace Northwest Lot 127
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
ies
,,k copies:
X1`1
0 Additional set(s) of plans. 3 Revisions: /l
0 Cross section(s) and details. 0 Wall bracing and/or lateral analysis.
0 Floor/roof framing. 0 Basement and retaining walls.
0 Beam calculations. 0 Engineer's calculations.
0 Other(explain):
REMARKS: Please pay fees owed with Trust Account.
add due to terrain
fa-6P eerVtr"
... OR CE USE O ' ..;.
Routed to Pt Technician: Date: 6 / Initials: fi
Fees Due: [ es ❑No ee I)esc ption: t Due•
Special
Instructions:
Reprint Permit(per PE): Yes n No Done
Applicant Notified: IDate: '- / Initials: !S
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
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•
City of Tigard •
f 4 COMMUNITY DEVELOPMENT DEPARTMENT
l_ �,A n Building Permit Review — Residential
Reith ~..1: 4f.a0c.:i:tNt .++:iu4;,vi:.kiai,.rdo sWittsrb»iLt..1F" ...• 01,4Y cas' :,.. ictai&,;.,4' C..,mss,r.44, 76i.JR74S,,,,,
Building Permit #: /'I„ j / 7 — ee )Q e
Site Address: / I/ 9 SIO gkcii(94, 7i/ -7
Project Name: kkee - ` .cac._ A tueS- Lot#: /Q
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
_ ' p
Proposal: &J'a & not ) T 11' j�Cvff o (tour/ .
erify site address/suite#exists and active in permits tem. !
River Terrace Neighborhood 0 No Yes,See River Terrace Review Addendum Attached
Si Plan Elements:
ee(3)copies of site plan T. ': ting structures on site
to plan must k on 8-1/2"x 11"or 11 x 17"paper ! ootprint of new structure(including decks)with finished
:loge
to scale(standard architect or engineer scale) P•or elevations
Orth arrow ri Utility locations(required for new,may apply for additions)
eaddress,project or subdivision name and lot number P.1 L, .tion of wells/septic systems
.licant information(name and phone number) ■ :o. ting trees to be retained with drip line,and tree
, ,,t dimensions and building setback dimensions rotection measures
TA Lot area,building coverage area,percentage of coverage and et tree size,type and location
' pervious area(applicable if R-7,R-12,R-25&R-40) tet names
P"roperty corner elevations(2 foot contour lines if more than
4 foot differential)
lean Water Services—Service Provider Lett (lot platted prior to 9/10/1995):
vceilequired: 0 Yes,applicant was notified No Received: 0 Yes 0 No
Public FacilitiyiImprovement(PFI)Permit
utred: V Yes,applicant was notified 0 NoApplied For: Yes ❑ No,stop intake
d Use Case#: �ap — .S �� C^ +
OII oning. i2_- CP
equired Setbacks: Front Rear Jo Side Street Side OR Garage cQ(}
riadscape Requirement 0 %
•nt Coverage Maximum: 0_ % / / 1l
rd Building Height Maximum Height Actual Height <Q(Q Q
II e' isual Clearance
rA Easements
skive Lands: 0 Yes ltl No Type
Urban Forestry Plan
0 Conditions"Me ''priorr o issuance of buildi9g permit
Notes: ntir!4iE7ns e j�
L� pi7ir- pe is / .Slt c4._
Approved By Planning: c—�,,, '41111111,� // Date: .62 22-
Revisions
2Revisions(after Building Submittal only) Reviewer. r€.Gl Aai rDate
Revision 1: Approved 0 Not Approved AL. I"SCG+If lr te.S) 414 (n _
Revision 2: 0 Approved 0 Not Approved ,
Revision 3: 0 Approved 0 Not Approved
l:\Building\Fonns\BldgPermitRvw_RES 091216.docx
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Building Permit Submittal
Original Submittal Date: 4a ,IE:
Site Plans: # _
Building Plans: # ,..4
Building Permit#: 113-'Enter building permit#above. '
Workflow Routing. EL-Planning El--"Engineering 'Permit Coordinator --Building
Workflow Sign-off: Coign-off for Planning(include notes from planning review)
Route Application Documents: C-Engineering (1)copy of permit application,(1)site plan,(1)building plan and
original plan review routing form.
Er-Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
1 Notes: ,�
By Permit Technician: .. Date: VV/7
- .v_na-W-.1�L�i'.?f,sa7Fi•Yet4w.x'cS�;�fR'.S.ILYtX: ..
Engineering Review
...X-Slope at building pad: .,2j, ,r,
()Conditions"Met"prior to issuance of building permit J vO
f
❑ Easements (encroachments)per engineering conditions of approval and plat
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes 0 No
Assess Water Quantity Fee in-lieu: 0 Yes 0 No
LIDA Facility on lot 0 Yes 0 No
O NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: / 2 7 Date:
Revisions(after Building Submittal only) )12,Ter
�!Date _
Revision 1: Approved 0 Not Approved
Revision 2: Approved 0 Not Approved
Revision 3: 0 Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions"Met"prior to issuance of building permit
(15PApproved,NOT Released: Date: ///)//
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 EnteredWash Co Trans Dev Taxes 0 N/A
Tigard Trans SDC: Yes 0 N/A
Parks SDC: 0 N/A
i`B to Issue Permit ,Yes
-
i ----
Approved by Permit Coordinator: �/ 7���"'aie: / / r/ 9
I:\Building'arms\BldgPermitRvw_RES_0912I6.docx V
-7/`
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
17407 SW SHADOW TRAIL ST, BEAVERTON, October 10, 2017 at 10:27:14
OR, 97007 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00008
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS
Comments:
Water pressure = 50 psi
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
17407 SW SHADOW TRAIL ST, BEAVERTON, October 10, 2017 at 10:28:29
OR, 97007 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00008
Inspection Type: Inspector:
699 Mechanical final Aaron Cillo-Gobel
Result:
PASS
Comments:
Corrections completed.
A/C installed at this time.
Violation Summary:
Inspector Contractor