Permit (43) CITY OF TIGARD MASTER PERMIT
II
IL > COMMUNITY DEVELOPMENT Permit#: MST2017-00154
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/16/2017
Parcel: 2S106DB13800
Jurisdiction: Tigard
Site address: 17492 SW FOREST HOLLOW ST
Subdivision: RIVER TERRACE NORTHWEST Lot: 138
Project: River Terrace Northwest, Lot 138
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 4 First: 978 sf Basement: 814 sf Left: 3 Parking Spaces: 0
Height: 32 Bathrooms: 3 Second: 1251 sf Garage: 978 sf Front: 8
Smoke
Dwelling Units: 1 Third: 0 sf Right 3 Detectors: Yes
Total: 3043 sf Value: $365,690.59 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
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Bckflw Prevntr: 0
Drywell-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]500 sf: 5 201-400 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:
NEWp y Square Feet:
SF VB
R-3 3043
Owner: Contractor:
ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
BY FORSUM,MICHAEL 109 E 13TH STREET 1 Fire Rated Eave
7600 E DOUBLETREE RANCH RD VANCOUVER,WA 98660 2 Ersn Cntrl 503-639-4175
STE 1
SCOTTSDALE,AZ 85258
PHONE: 602-694-4031 PHONE: 360-695-7700
FAX:
Total Fees: $34,125.62
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 952-001-00"0. 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: L✓' _.._ Permittee Signature: 'ril e/_'i C --/ 70011
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-_ 0 / c
w .,.
azai
R 1ECEIVE® FOR OFFICE I SE O\Ll
City of Tigard APR 2 0 2017 Received
P atarsy: G r7 Peimit No. DI
II '� 13125 S\5V0 .1;11181.321:1319
Hall Blvd.,Tigard,OR 97223 �� � �,S b01�y
■ Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 S, o )7 i Other Permit:Jo 1(4673/ '
CITY OF TIUARD Date/By:
("i G.•1 R ll Inspection Line: 503.639.4175 Date ReadyBy: f , J � See page 2 for
d Internet: www.tigard-or.gov
BUILDING DIVISION Notified/Method: �Z��7 ��'% Supplemental Information
, .- 1/ iJ
co ®New construction ❑Demolition Permit fees*are based on the value of the work performed.
a Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
f4 t work indicated on this application.
--- 7-r_ el46. Hi
® 1-and 2-family dwelling 0 Commercial/industrial Valuation:3 � t� I,. ( J
❑Accessory building ❑Multi-family Number of be ooms: " 3,14°
❑Master builder 0 Other: Number of bathrooms:
,:, N 1- t # t. Total number of floors: 3 4 1 1
Job siteaddress: -7-1-1—qZ JV V 1 re �I St. New dwelling area:39 square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: 8 square feet
Suite/bldg./apt.no.: I Project name:River Terrace Northwest Covered porch area: I;I square feet )a 3 J
Cross street/directions to job site: - Deck area: square feet q 7
Other structure area: )3• square feet `41,,)
of Ol tt efrf,4t t el ,
.-.,, ,,,, moi #a. h.=
Subdivision:River Terrace Northwest —1 Lot no.:13 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: VV Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
s 1'' t t,, t,,' •. work indicated on this application.
Valuation: $
_,. ------ -- -----_. ------- _ --I
Existing building area: square :,et
New building area: square feet
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:
Business name:Polygon WLH,LLC � r lA•✓
N t i Chi'n Structural plan review fee(or deposit):
Contact name:Iv �,/ K
FLSplan review fee(if applicable):
Address:109 East 13th Street PP )
City/State/ZIP:Vancouver WA 98660 Total fees due upon application:
Phone:(360)695-7700 I Fa:.:( ) Amount received:
E-mail:Nichole.Thorpegpolygonhomes.com t
Commercial and residential prescriptive installation of
gip" k 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.
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: $201.60
Authorized signature: '0 _ This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
*Fee methodology set by Tri County Building Industry
Print name:Nichole Thorpe Date:4/17/2017
Service Board.
luilding\Permits\BUP-RESPermitApp.doe 02/24/2011 440 4613T(11/02/COM/WEB)
t
Mechanical Permit AppliCaECEI Y LI«/ l oiz(Jl 1 It is I ,•1 ()\1
City of Tigard bMAY2017 "Recei � Postait�'W..STAI,17_artS`I
'13125 SW Hall Bltad.,Tigard,OR 97223
Plan Review
Phone: 503.718 2439 Fax: 503 5g1A9 OF TIGARD Odiet Permit,
-inspection lino: 303.639 1175 D.Readvtt3y: hen 0 See Pape«tor.' •
. lritoroct: www.tigard-or.gov BUILDING DIVISION Notifed/Mdhad: Suppiemeatalinformation
tcM
s ,+. x ii V•;'''':`5 f .: k'•3 ....s, ;4,,W.'` A''''''20:,.tv!da_c. s,y x',3';;Cs t s ry, :6, :•••t; �4,:q' :);:q
` Mechanical permit fees,aro based on the value of the wort:
®New construction 0 Addition/alteration/replacement performtid.Indicate the value(rounded to the nearest tk)lar)of all
❑Demolition 0 Other: mechanical materials.equipment labor,overhead.and protit.
Value:$
it. , ..�.:=-,4 P� Y`€�.Z�'EJ E.t V3:. 6 f ` 4.4,74 ` . '; t ir^at;i'15..
�r!?3kz� . :" .�'..�, � ,.r" ,,.s,� .����.�.1Q _x d�e�'^"..,� '>.� *n rvtt s at r i`�."' tx rr<�`"�+3•�"� ,<� ,�.�'.r ,
9ILI-and 2-family dwelling 0 Commercial/industrial 0 Accessory building Per speialInfonnatio r size checklist
1 Multi-family 0 Master builder 0 Other: Description I Qt'!'. 1 Ea. I Total
^s4.,. n + rA-_ i r t � tr 2y
- - 4.',a a'
lleatingeouline:
':,-.'-:";%.f.!--.,. � a � i ..«;„<t ti-�'rz:Im' t;.2c4. �Srz.s..s'r.yd .:,,,,Ea:-..fi- a:; Airconditlbatn$
46.75
obte : 1711612 Sint orts* 11D1ii) .&+ Furry 100.000 BM(dt fven>} 4675
City/State/ZIP:Tigard,OR 97224 Furnace 100.000+BTU(due fvcntst , 54.91
Heat pump 61.06
Suite/bldg./apt.no.: 1 Project name: gtritwoe.Ooh cf Duct work 2332 _
Cross streetldirrctions to job site: tiydronic hot water system 23.32
Residential boiler(radiator or
hydronicl 2332
• Unit heaters(fuel-type,not electric).
in-wall,in-duct.suspended,etc. 46.75
flue/vent for ant~of above 1 23.32
Sub divlsion: tde.i(1 Trace, N(r n uikc j Mt7[irnr 23 32
Other rntl appliances:
Tax map/parcel no.: Water treater 23.32
f • t y
' r iei a E;i•-•••>;,,,.--3',.%'; , 4.,`"'q.' .: Gas iimpacsanscrt S 3339 ,
.c.... .3 . 4_t_....r... 2Wc_ >. -,,,A.7;'''..".1.i' t.. .,.._ rhMa ,b .e ''i �,
flue vent far water heater or gas
fireplace 23.32
• Log liable,'(gas) 23.32
Wood/pellet stove
_
Wood iireplace;insert • 23,32
Cbimncflinert'iluelvcnt 2332
.1-;"<_,,.4::;,e.,,''",..„‘ .. (hher: 23,32
4,...7.1" --..:1-.2.7-3-.-4-� ) F fl tiff r ',- 1 s3;:zi._ i.«�'Y z:;.' h.iT.:1.1z,1
,:.;,,,,,.;%:-.1.,,.1,.. :.:__ � �__ _.,�.�.„.� �- +,-ft..mss,-, _:iFns'irnnmeatstexhaust and ventilation:
Name:Polygon%VLH;LLC Range hood'other kitchen 1
equipment 33.39
Address; 109 East 13'1.Street Clothes dryer exhaust ___1 33.39 . .�
City/State/ZIP:Vancouver,WA 98660 Single-duct exhaust(bathrooms,
toilet cumpanmenis,utility-moms) ;" 23.32
Phone:(360)6195-7700 Fax:( ) Atticicrawispacc fans 23.32
t"'yi:':::.;,('
5 ` b,r iEi t ;e r G � _ ;, du0r•Ta,,....yam ` z1s filer. 2332 t
Business name:Polygon W LMI,LLC
Fuel P1N$1
514.15 for Graf four;54.03 for tech additienal
Corne d nittne: `Vi s O Thotik., FURtace.cue. M
Address:109 Est 13th Street Gas heat pump
Wall/suspended/unit healer
City/State/ZIP:Vancouver,WA 98660 Water healer
Phone;(360)693-7700 I Fax::(36(1)6934442 Fireplace
lw-nail 11 A., 1. re ,,,..1 t, A A 1) 111 Barbecue
.,'• - r `s III:..IE.r:',:..'.x :Y k`s.......k'1:tt..r .f..-ixr.s_.,icrrz_ :. {.totheadrYer(PM
Business name:Apex Air LLC Other. a
Address:18004 NE 72ie Ave Subtotal
City/State/ZIP:Vancouver,WA 98686 Minimum permit fee(590.00) ,
Plan review(25%of permit fee)
Phone:(3601342-8109 Fax:(360)326.1769 State surcharge(12$'0 of permit fee)
CCB lie:203034 TOTAL PERMIT FEE
`�-- This permit application expires if a permit is not attained within 1110
days after it hex been accepted as complete.
Authorized signature" ' Fee methodology set by Tri-Conn•tlrtiiding industry Service Board
Print name. to .( Date; ei•M.at.Y W__
1 AisttidrrtgiaauuNiEC Perehapp(401 11 doe 440.1r'ul'e sutra :OM:wrlti
Electrical Permit A»plicati E R
r o on-ICE LSEON LA
City of Tigard MAY b 2017 RemvedI�
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
mR: Phone: 503.7182439 Pax: 5°3.s 9�OF TIGARD Li a
,.c;,'r r' IInternet 2 for
Wwwn • 50 g ,75 ReadyBUILDING DIVISIONn EMI
10 See entalInormation
_ ,i.',-,4,,,,7“::,. .;:l.t,„7:47.c.):7.Va aaaS.:. .'tv' _,'� ?.-.3-f`rf'1N :+-"g`? 5- r i. ver;. _ .1-.;51-, M•fta',41-51T,n,.ti 2 _.cw4 ..-.,-,t,-,7-'„,---:
®New construction 0 Addition/alteration/replacement Please check a0 that apply(submit 2 sets of plans wTeros checked):
Q Demolition ❑Other:
0 Service or feeder 400 amps or more ❑Building over Arco snhies.
where the available fault cumin ❑Moines and boatyards.
. ' �F__-1Z4:sE i i-; t) ,,9:S!,.i).uCE P-,,t;)s_Th;(11 050 _..-', r..:`"'`„_.>:-:._-` exceeds 10,000 amps at 150 volts or allotting buildings.
®1-and 2-family dwelling Q Commercial/isidlistrial 0 Accessory building lora to ground,or exceeds 14,000 ❑Commercial-use agricultural
Q Multi-family amps far all other installations. headings.
y Q Master builder 0 Other: CI Fire ❑laatethtion of 150 KVA or
'z1 ' %'4? i yA$ .tad 70.:t4r+"A,'d`'E`x gtr eirs,,,,,:-.6_500.A.4it,,`4 1 / .t� *{ '7 % ❑Bmergeneyryatem- larger sepaeatrlyderived
Job#: Job site address:1 R CM f'flrC - t771`'Q� St ❑Addition of new motor load of system,
1 I a' 1'1e, 100111'or mom. ❑"A",E,"l-2'."1-3",
Clty/State/Z1P:Tigard,OR 97224 ❑six or more residential units. occupancy.
❑Reaits•oare facilities. 0 Recreational velrioleparhs.
Suite/bldg./apt#: I Project name:Q.Zvi rTt row Apti/I ve S4" CI Hazardous locations. ❑supply voltage ibr more than
❑Service or feeder 600 • or mote. 600 valla n ininal.
Cross street/directions to job site: :-.:,,i r .•«eiw 7 ,r / dr-:al_ !is ti: '" ;!Z:=:::'.;.':-'-!-::::Decription Ott. I�Bach Total
New residential single-or multi-family dwelling stmt
Subdivision:glue- [Watt N f.> Wes�F- Lot#: t#3?) Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel# Ba.add'l S00 sq R.or
- ;:
portion o 33.92 I
i-' "..;-':,:•-,---. o rJZC''i ait fJ '',',f1St el 'sz s_
Limited energy,residential
(with above ni.tt) 75.00 2
Limited energy,multifamily 75.E 2
residential(with above sq.ft.)
r4:'"- --:-'1"..-' 1%'''''':"::
Renewable Energy , 0 See Page 2
1, '1'..7 .4-')::;1151-:2-T'27•'•:'`s ,f•.; ",� t T.F s r v 5`.-13- 'Zr -<� , ,' Services or feeders instal tatlontalteratiott,and/or reiocatlon
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/ZlP:Scottsdale,AZ 85258 601 snips to 1,000 amps 301.04 2
Phone:(602)694-4031 ,.. 1 Fax:( ) .. Over 1,000 amps or volts 352.26 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 70I. 201 amps to 400 amps 125.08 2
Owner signature: Date: • 401 amps to 599 amps 168.54 2
r b .,Ktr-,;y ,,,5 c v ,_ ;;4 ,,, ;0 6 k .r -0-4.,,,,v 0 .„, Branch circuits-new,alteration,or extension, r panel
A.Fee for branch cirwite with '
Business name:William Lyon Homes,Inc- above service or feeder fee,
s
tel. each branch circuit 7.42 2 I
Contact name. lin t(Y/Ylf, B.Fee for branch circuits withal('
Address:109 ast 13th Streett •,Ve r s service it feeder foe,fust 56.18 2
Watch circuit
_
Bach�
City/State/ZIP:Vancouver,WA 98660 ')branchcircuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(360)695-7700 ' ' ' I Fax::(360)693-4442 Bach manufactured or modular ,
dwelling.service and/or feeder 67.84 2
Emil. ®, 1 1 ) G i t l E 1 ^ ► "i ;( 4 iii s J.J. Reconnectonly 67.84 2
r ,. , -_� cTaE;_ _ Glx_ _'..--i . r ,..,=i. ta'-- Pimp orirrigationcarle 67.84 2
Business name:Garner Electric Washington,LLC Signor outline lighting 67.84 2
z..,c Signal circuit(s)or limited-energy
Address:6101 NE St johns Rd react,alteration,or limy ❑ See rage 2 2
City/Stete/ZlP Vancouver WA 98661 Each additional Inspection over allowable in any of the above
Additional inspection(1 hr min) 6615/hr
Phone:(253)3204657 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:bdaniels®gweusa,com Industrial plant(I brinks) • 78.181 hr
Inspections for which no fee is 00/hr i
CCB Lie.: C1158 Electrical Lie.: 208174 J Suprv.Lica: 44968 $s;ee, listed br mm)
`
A _ y 1� re ,dar:.:4aatsyt4i.'.)121,47,17,:.,-7: :°-- 3,Z.,'
Suprv.Electrician signature,required ' - T bM. t-' Subtotal.
Print same Joan P Albert JDDate: 4/26/2016 ❑Plan Review Required(25%of permit fee):
?'.;. ,— . __ State surcharge(12%ofpt:unitfee):
Authorized signature: _• �� TOTAL PERMIT FEE:
•61,•'...., t"--r
Thispermit application expires if a
`:.�..' pp pu'm permltls sot obtained within 180
Print name: Bill Daniels DIF-7e-:.-7-1/26/7016 Idays after It bas been accepted es complete. _
t
* Number of inspections allowed per permit
'Sy`
h t- 4140ersitsVELC..t'ermhApp tit Ite.doc Rev memo's a-46tsl n/05/1%rM/ E6
i r.~i Vit;::. _
Plumbing Permit ADDlicatiFIECEIVED
Building Fixtures
:. Cfty of Tigard MAY 2017 Raxived• Perm•it No.
a 13125 SW Hal!Bivd.,Tigard,OR •- Y' S%r /2 /_S7
PI I Phone: 503.7182439 Fax: 50 ` ~' ®��fG��D Oder Permit No.:
� Inspection Line: 503.639.4175 D SING D l v i S n�r ip aY: . > s: a See Pagel For
Internet www.tigardor.gov Notified/Method: by,
_ ppkmmtat Informstiott
_
®New construction ' 0 Demolition For apecial leformet ionn reae checialat
.
NI Ea, I Total
0 Addition/alteration/replacement 0 Other:
Newew 1 1--2-family dwellings(includes 100on I tfR,for each utility connection)
•.::>.`':•" • • •. '•CATEGORY'OF CONbT.It[1Ci<'ION' • ' • SFR(1)bath 31270
• •
®1-arid 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 •
0 Accessory building 0 Multi-family SFR(3)bath 1 500.32
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler(_^sq.fl.) Page 2
: 'JOB SITE Ifl ORMAT1ON',AND LOCATION Site utilities:
•Job site address�7 Svc The les$ 1/01014)S " Catch basin or area drain l8.Tb .
Drywall,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224 Footing drain(ao.linear I :.J Page 2
SuiteibldgJapt no.: I Pmject natne:PI*r Tenet mit Manufactured home utilidies 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(rr0.linear IL:
^) Page 2
Subdivision: Lot �
,( I no,. Fhtture or Item:
U �rY1ef't��� '�
Tax maplpar�cel no.: • Backflow prevent= 3127
DESCRIPTION OF WORK Backwater valve i 12.51
C1aHus washer 25.02
..._.__._...__ .._ _ -- Dishwashex 25 02 .
Drinking fountain 25.02
Ejectors/sump 25.02
•®•#!ROPERT2'OWNER . • j 0 TENANT Expansion tank 12.51
Name:A.DVL Land Holdings,LLC Fixture/sewer cap 25.02
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)6944032 Fax:( ) Ice maker _ 12.51
,.•. ®.APPi ICANT . 0 cofj1ACT mum Interceptor/grease trap 25.02
Business name:William Lyon Homes,Inc Medical gas(value 5 } Page 2
i 1� k y
Primer 12.51
Contact name:141
h�. �l,hi Roof drain(commercial) 12.51 '
Address:109 East 13*Street I 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
E mail o' I t l Urinal 25.02
/ a A lilt 1.61 Water closet 25.02
Water heater 37.52
Business name:Malmedal Enterprises Inc. Water piping/DWV 56.29
Address:PO Box 207 Other 25.02
City/State/ZIP:Banks,OR 97106 Subtotal
Phone:(503)324-0759 I Fax:(503-)3240580 Minimum permit fee: 572.50
Plan review (25%of permit fee)
' CCB Lie.:102535 'Plumbing Lic.no.:34-276PB State surcharge(12%of permit fee)
Authorized signature: -..-.__ TOTAL PERMIT FEE
Print name:Carolina Malmedal Date:04/25/2016 1 This peraslt application expires if a permit it am obtained within 130 days
atter it los been accepted es complete.
"Fee methodology set by Tri-County Building Industry Service Board. _
i:IBu pamhnle[MU-PamltAppdoc lOJ01b09 440-46167(10N1/COM/WEB)
Ilk I
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
r l c K n Building Permit Review — Residential
Building . ..,t
Permit #: P-0 - ;.
QQ 4-
Site
Site Address: -2-/
�� t Art► I, ) ice'
Project Name: '
Utt-T a -' �0 ' ' Lot #: /36
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: i ii:.fii/Vl
erify site address/suite#exists and active inermit
p stem.
River Terrace Neighborhood: ❑ No Yes,See River Terrace Review Addendum Attached
S Plan Elements:
ies of site pl /2an
Mil ,n sting structures on site
Pl'rerepelan(3)nci:spt be on 8-1 "x 11"or 11 x 17"paper t1,Footprint of new structure(including decks)with finished
b�,/ raven to scale(standard architect or engineer scale) 'oor elevations
orth arrow
e address,project or subdivision name and lot number
INIU� sty locations(required for new,may apply for additions)
�licant information(name and phone number) ation of wells/septic systems
7 .t dimensions and building setback dimensions N c ting trees to be retained with drip line,and tree
IF •t area,building coverage area,percentage of coverage and protection measures
pervious area(applicable if R-7,R-12,R-25&R-40) treet tree Street nameeine,type and location
Property corner elevations(2 foot contour lines if morethan s
4 foot differential
lia
lean Water Services—Service Provider Lett (lot platted prior to 9/10/1995):
Required: CI Yes,applicant was notified
u(Public Facilites Improvement(PFI) Permit: No Received: ❑ Yes ❑ No
/equlred:
al Yes,applicant was notified CI No
Applied For: /Yes ❑ No,stop intake
/Land Use Case#: A / a _ ,
Zoning: e- !I',
squired Setbacks: Front Soo? ear _ Side
ap0/Landscape Requirement: P3 Street Side Garage
of Coverage Maximum:
_`I?/l.
/wilding Height: Maximum Height �,n Ir
�f Visual Clearance g �� Actual Height cp,�
ad Easements
tII 0..ensitive Lands: ❑ Yes
No Type
', Urban Forestry Plan
0 Conditions "Met"p 'or to issuance of building permit
Notes: . o 'a >l
Approved By Planning: ......
ffliRevisions (after Building Submittal only) Date: _ ,
Revision 1: 0 A roved Reviewer Date
PP ❑ Not Approved
Revision 2: 0 Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Fonns\BldgPermitRvw RES_091216.docx
Building Permit Submittal ,
Original Submittal Date: iit),3,477_ "
Site Plans: # ____:3_,-
. —
Building Plans: # --_--
Building Permit#: Enter building permit#above.
Workflow Routing: Planning P—
En eerie Permit Coordinator Building
�(include notes from planning review)
Workflow Sign-off: ,• Sign-off for Planning
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:
/ _ � Date:
_ �.// ii i�,./ .
ByPermitTechnician:
Eng' eering Review
Slope at building pad: d / , �
onditions"Met"prior to issuance of building permit ��
■ Easements (encroachments)per engineering conditions of approval and plat
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ❑ No❑ No
Assess Water Quantity Fee in-lieu: 0 Yes 0 No
LIDA Facility on lot: 0 Yes
Date:
❑ NOT Approved by Engineering:
Notes:
Ar
., Date:
Approved by Engineering: Date
Revisions (after Building Submittal only)
Reviewer
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
Date:
0 Approved,NOT Released:
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:
/�
7SDC Fees Entered: Wash Co Trans Dev Tax: Yes 0 N/A
I Tigard Trans SDC: (( "Yes 0 N/A
Parks SDC: Yes 0 N/A
igli K to Issue Permit //�' ate: 6--4 /
Approved by Permit Coordinator: /y����f D
7-----
1:\Building\Forms\BldgPermitRv"'-ids-091216.docx
City of Tigard
p COMMUNITY DEVELOPMENT DEPARTMENT
11111 2
T I G A R D River Terrace Building Permit Review Addendum
Building Permit #: il
Site Address: /:
Project Name: / r
'la ) #S Lot #: S/_
(New dwelling=subdivision name;Addition 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? 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.
Porch min, ft. deep Balcony w/access 2 Window Projection Vertical Wall Offset a
ft. deep min. 2ft., 5 ft. we Gabled dormer
0
ft., Eft.wide
' 0 0
0
2. Eyes on the street: a minimum of 12% of each street facing facade must include windows or entrance doors.
Percentage Shown: Fa' /9_4 2 , c ,/
0
3. ntrances:At least one entrance must meet both of the foll ng standards:
Max. 8 ft. setback from lon t street- facingParallel to str
wall eet, angle no more than 45 from street,
Entr nce opens to a porch: Yes 0 No or o n onto porch
If s all the following apply:
ne street facing entry sq.ft.min.
5 ft. depth min, ft.max. roof above floor of porch
30%min.porch roof coverage
4. I etailed Design:All buildings shall include a . of five o the following elements on all street-facing facades:
Il overed porch min. 5 ft.wide x 5 ft. deep,��'
�I 4 all offset min. 16 inches Recessed entry area ruin. 5 ft.wide x 2 ft. deep f
❑ ormer min. 4 ft.wide
FA Roof eave min. 12 inch projectionOS
N Roof shingles either tile or wood oof offset min. of 2 ft.
0 Roof pitch oriented south min. 500 sq. ft. _/Gable,hip or gambrel roof design. f'
0 Accent siding min. 40%of street facade �°rizontal lap siding min. 3-7 inches wide
❑ Window recess min. 3 inches for all street facingWindow trim min.2 �/ztt wide by 5/8"deep��
0 Balcony min. 5 ft.wide x 3 ft. deep with inside access 0 Attached Bay window is 3f°widet. by 2 ft. deep
garage5/o or less of street facade
5. Garages and Carports:May face the front or side lot line on a corner lot.
Setbacks:
No loser to front or side lot line, than longest street-facing wall. 0 Yes t�-� No. If NoMay extend upto 5 ft.if (Check one
there is a covered front porch and garage does not extend beyond the front porch.
0 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. r3
Width: (Check one)
0 -foot-wide garage door
If 50%max. of street facade with 7 detailed desi: elements 0 40%max. of street facade
Notes:
Approved By Planning: - -��
I:\Building\Fomu\BldgPennitRvw RES RT o62216.docx �� Date: ��
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
17492 SW FOREST HOLLOW ST, BEAVERTON,
OR, 97007
Record Type: Record ID:
Residential - Master Permit MST2017-00154
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:
17492 SW FOREST HOLLOW ST, BEAVERTON, December 19, 2017 at
OR, 97007 1 :20:21 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00154
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS
Comments:
Corrections completed.
Water pressure = 45 psi
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
17492 SW FOREST HOLLOW ST, BEAVERTON, December 21 , 2017 at
OR, 97007 8:35:12 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00154
Inspection Type: Inspector:
299 Final inspection Aaron Cillo-Gobel
Result:
PASS - CofO
Comments:
Final erosion control passed
Street tree certificate received
Moisture content form received
Moisture barrier acknowledgement form received
High efficiency lighting form received
Insulation certification verified
Blower door and/or duct seal test certificate received
C of 0 left on counter.
Violation Summary:
Inspector Contractor