Permit (71) 11111 CITY OF TIGARD MASTER PERMIT
2: '� COMMUNITY DEVELOPMENT
Permit#: MST2017-00208
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/14/2017
T Eft • Parcel: 2S108DB01400
Jurisdiction: Tigard
Site address: 15285 SW PEACE AVE
Subdivision: POLYGON AT BULL MOUNTAIN Lot: 12
Project: Polygon at Bull Mountain, Lot 12
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1591 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1836 sf Garage: 679 sf Front: 20 Smoke
Yes
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors.
Total: 3427 sf Value: $423,497.72 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
•
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 2 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: 5 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: 7 201-400 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 3427
Owner: Contractor:
POLYGON WLH LLC POLYGON WLH,LLC Required Items and Reports(Conditions)
109 E 13TH ST,STE 200 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98660 VANCOUVER,WA 98660
PHONE: 360-695-7700 PHONE: 360-695-7700
FAX: 360-693-4442
Total Fees: $35,393.44
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 1.800.332.2233444..{, w
Issued By: 4i/' Permittee Signature: fJL 7 vr� c/�/
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
�0T /2
.. , RECEIVE
� d91., FOR OFFICE CSE ON LI
City of Tigard MAR 2 8 2017 RateIRL b(4., el/4/ PermitNo.:/',� G/7]120 aVE
IIII13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review/"i— �'lc'', //�.^may `I V.
Phone: 503.718.2439 Fax: 503.598.1960 CITY OF TIGAR a Date/By: Cj Other Pe'm'tvW !/fJ W
TIC l.> Inspection Line: 503.639.4175 BUILDING DIVISIa ateReadyBy: /, Juris: H SeePage2for
Internet: www.tigard-or.gov
1%��� Supplemental Information
•i %L--
dd✓ %g
e n � f . k t, l -,, @ all ,€ i f
®New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
� � . work indicated oa this application.
Valuation: 1LJ iJ $
® ^�
1-and 2-family dwelling 0 Commercial/industrial `1 =
❑Accessory building 0 Multi-family Number of bedrooms:
o Master builder 0 Other: Number of bathrooms: 3
Total number of floors: - 1 .. T i 0 6
J7 New dwelling area: 3 square feet
izQ Job site address:lG'1,UC- SVDptace. f \+o
City/State/ZIP:Tigard,OR 97224 Garage/carport area: p�9 square feet
\` Suite/bldg./apt.no.: I Project name:Polygon at Bull Mountain Covered porch area: 1�Sti square feet 1 g 3C
Cross street/directions to job site: Deck area: ) 7 0 square feet j q j
P Govt/
Other structure area: square feet
Subdivision:Polygon at Bull Mountain I Lot no.a.i 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
. ` ,6"-.' > 4 a work indicated on this application.
A.
Valuation: S
Existing building area: square feet
New building area: square feet
. a ;,. Number of stories:
Name:Polygon WLH,LLC Type of construction:
Address:109 East 13th Street Occupancy groups:
City/State/ZIP:Vancouver WA 98660 Existing:
Phone:(360)695-7700 Fax:( ) New:
a 4 f•i0;tt •fit ' :
Business name:Polygon WLH,LLC
Structural plan review fee(or deposit):
Contact name:Angela Grajewski
FLS plan review fee(if applicable):
Address:109 East 13'Street
Total fees due upon application:
City/State/ZIP:Vancouver WA 98660
Phone:(360)695-7700 I Fax::( ) Amount received
' t
E mail:Angela.Grajewski@polygonhomes.com 1. � �
Commercial and residential prescriptive installation of
,.�� ,. r � ��� t, „;. ,11:;,,,,, � roof-top mounted Photovoltaic Solar Panel System.
Business name:Polygon WLH,LLC 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.:204238 Total fee due upon application: $201.60
Authorized signature: kr This permit application expires if a permit is not obtained
(.570/
within 180 days after it has been accepted as complete.
Print name:Angela Grajewski Date:1/20/2017 *Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
,
Mechanical Permit Application l OR 111-1 l( 1 t •ri (t\1 1
Recci
'City of Tigard t raved rcrm;i .o �.S% '!7 of0 SW Hall Blvd.,Tigard,(Mt.97223 Plan Raicw
� • 'Phone: 503.71L2439 Fax: 503.598.1.960- t781c7ia;
inspection Line: 503.639.4175 •,_.,... s ` `'? ttme Rredy'tty: IN 121 See Page 2 for
tiitema: K'urw.tigard•or.gov ,;'
>'.. Nwiliiedfhlethod: Supplemental latermation
•., . -:. ,�. ,, vi n TE .t . �,•i..cs
11,:;':.7":.� tt
,,''` y '* � .,. ; . s - dg Fqr '' " , 'wa •• 44,-ml -c-, : , . «
t,��� w, :-.'4-., ' . L..- --' ..s , - . � '' ••s'`.--` 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 ail
[�Other: mechanical materials..cue lomat labor,overhead,and profit.
0 Demolition Value:5
• rlT Z.> N'5 " j. ,:. . r.;..11 , 'v'4:, 4"': -V,p,.1-&y E; -*.„ t- ie . 4a� ,t.-.', ,,a .• �, 'tx K `,a -,t,f- 1! A..1t-rt.t t . V.. t .7•',,,,..^.s
h 1-and 2-family dwelling T]Commercial/industrial 0 Accessory building For vadat Information;de dreektiit ,
Multi-familyMolti-family 0 Master builder 0 Other Description J Qty. I Ea. Total
`.a 2...» y'e.F :ft7t � [ l G 11 ?-C $ f YL n � L.}r1 •g1
rte« .+ i��z, . �fz.`.krzlit..%:. >wY•-'.. .-i4_ r. .c.w4. ,3,:;' ,.1".-_-...-L. - : :154.. r
Air conditioning 46,73
Job site uddrass:/ c SUV V L. + c Furnace 100.000 BTU tduaskentsi i , 46.75
City/State/ZAP:Tigard,OR 97224 Fumaee 100.000+BTU(duersAventcl 54.91
i•leat pump 61.06
Suite/bldg./apt.no.: 1 Project name:Polygon at Bull Mountain Duct work 23.32
Cross street/directions to job site: fivcironie hot water xvstetn 23.32 .
Residential Moller(radiator or
hydropic) 23.32
Unit heaters(Biel-type,not electric),
in-wall in-duet;suspended.etc. 46.75
Flue/vent for any of abote - I 23.32
Other 23.32
Subdivision:Polygon at Bull Mountain "I Lot no.: Other fuel appliances:
Tag map/parcel no Water heater i 23.32
�" .i ' e ntr+Y it t } C �bi:,,,'`v1 t .1� ' ' Gas fttepiato/inscrt ♦ 33.39
.-,•-",:i•-• -. �.. - ,. 4-� Flue vent for tater heater or gas
j1 0 $ + 23.32
, , fireplace
Log lighter(gas) 23.32
Woodtrpellci stove 33.39
Wood firepiacc/inscrt 2332
Chimneyilinerltluetvertt 23.32
t r
23.32
x --1-"d
it x � .: ; ehker
1, ;' . ` ,if.,-.4. r .°+ ;' .w,, ,:.FA. i.,'A ,. fi,:.. "-._> '} Environmentalexhaust and ventilation:
Nine:Polygon WL/1.L1.0 Range hood/other kitchen I 33.39
equipment
Addrets: 109 East'13''Street Clothes dryer exhaust 1 33.39
Single-duct exhaust
City?StutciZiP:Vantouver,WA 98660 .(bathrooms,
toftetcon1 Wkncttts,utilityrooms) 23.32
Phone:(3609$-77(10 Fax ( ) Atdctcrawisp fans
23.32
l E r 6 f:.r.t c t,' t 'L " c Fs i:' C w z:� - �..i'- h .,3.» ':. (71 : 23.32
i.......... .: .. tti•s�. ><e.'1a4 ;,.,..•.1 .rwa..."..x,a ...12:-5P:7,-.?:Ii-
�,,. ._ �. tr �,. ;mr.�.' Fnel piping:
Business name:Polygon WLLI,,L,L�C $1415 for lin tt four S4.03 for each mimosa!
Cgntacf name:
AI(C l vk Thorpe orpe Furnace,etc. I
Ons heat Qlmp
Address:109 East 13th Street WalUsu'ipendcd/unit heater .
CityIStatei7'IP:Vancouver,WA 98660 Water heater ,
Phone:(360)695-7700 I Fax::(360y 693.4442 Firepinoe i
�, Range
E-mail: c,jari ,!, ,/ ,1 PI , I d attir: +�� Barbecue (�G� '
U f Y. i' 4 "1 i r a: Clothes�er t4")
�.� -' ° � t r s,�5 jrl�.h�. syr$.�/i _ .y �. - .��.V.. r r
Business neiiie:Apex Mr LLC L. # { .r 37..- ,,,s::
Address:18004 NE 72wf Ave S Subtotal
Minimum permit
City/State/ZIP;Vancouver,WA 98686 fee($90.00)
Flan review(25%orpermit fee)
Phone:(360)342-8109 Fax:(360)326-1769 Stale surcharge(.12%of permit fee)
TOTAL.PERMIT FEE
CCB lie.:203034 ' Thi permit application expires ita permit is not obtained within lad
days aftrelt lot leen accepted.as cemptete.
Authorized signature' ' Fee methodology set by'rn-Cotany Nmtding Industry Service Board
Print name. ' i _ •I Date: rat •11.t#r
l"JlaifdtagiN=11.0l4EC_Pe nliapp(;fel 13 dere. a.)-t6f IT(litireK;OM/Wltlt)
r'i
iT'
y ,
Electrical permit Application i .'r% 1 ( 1t(t1 I it 1 I `,1 ttvI.t
City of TigardIII
Receive
13125 SW Hall 81vd,,Tigard,OR 97 3 <.,4 ' u
Phone: 503.718.2439 Fax: 5O3.59 .10 ,., -,:,
inspection Line: 503.639A 175 ;� _ �. Notified/Method:
p
Internet: www.dgatd-or.gov i�rodiieNklemnetho
d:
►_4 New construction 0 Addition/alteration/replacement N..,v. pl�dmdt all mat apply(submit 2 sets. w0ems chocked):
❑Demolition d Other °Stevie*or feeder 400 amps or more CI Building over dee*stones.
where the available fault cornu CI Marina and boatyards.
kr c +i C1 j, � r c ` sP a_' i..,_ra,.. exceeds 10,000 naps as ISO volts or D Floalin$ba0diags.
'< I-and 2-family dwelLmg 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 D Commercial-use agricultural
amps for di other iosudiations. htdidinga.
❑Multi-family 0 Master builder 0 Other: DFire pump. D lasidlatioa of tui KVA or
a ; ie.' .4j, „' tlEcT:t`-.F"T ,A.,-xa.. ;55.:,: Er"trgpteY'sr"e'n, larger separately derived
Job*: Job site address: y / D Addition of new motor load of system.
_� loom,onroare, D"A","E'.9-2,"t 3",
City/Slate/MO:Tigard,OR 97224 D Six or more residential emits. occupancy.
D Health-cert facilities. D Recreational vehicle parka
Suite/bldg./apt.4: name / t D Hazardous locations, D Supply yentas*tlx more du,,
Projects�1 Q " 0- '-/.
D 5tevece or feeder 600 amps or mora 600 vola nominal.
Cross street/dtrcctions to job site: 4 • --
a�>.. .,Ti'.-.7::7K-7.,:-.-.7)-7,-..1rs. .�iw { i.:� �Y SSi•'.:w"7::M�.i:-52- x
Description QQ. Inds 7ti,td •
New residential single-or ninth-family dwelling unit.
Subdivision:
1 em_ - Bitit Kt ht.'.1 C.A 1 Lot#: PAM Includes*dashed garage.
Tax tnap/pamel I/ 1,000 sq.n,or tem 1611.54 4
. N .�n.,:i-X �4. T`f. .,« ;t r e_F:ia add'1500 sq.ft.or portion 3392 1
limited energy,residential
(with above sq.IL) 75.00 2
-,: , t x - ' '' -. , 3 `i ' :, ithabovesq tto75.00 2
i
.__.�._ . .... _., ,-,_,__,..w..•.ar..,.:ti__._c,.... �...._ _. � residential
Name:ADV1,Land Holdings,LLC Renewable Energy 0 See Page 2
Address:7600 Ir Doubletree Ranch Road Services or feeders installation,alteration,and/or relocation
200 amps or leas 100,70 2
City/State/DP:Seottadsle,.AZ 85258
Phone:(602)694-4031 201 amps to 400 amps 133.36 2
Email: 401 amps to 600 amps 200.34 2
Owner installation:This installation is being made on property that 1 own which is not 601 amps to 1,000 amps 301.04 2
intended for safe,lease,rent,or exchange,according to ORS 447,449,670,and 701. •
Over 1,000 amps or volts 552.26 2
Owner signature Date:
.kE
, ; .4 s4 .,-n
" : -,
"Temporary services or feeders iastaistiem,alteration,and/or
.:_. t„_. 7t.,s -:;:-;-.A.: _1_,sF_r.»?.vtfCi.m �X�: ,2�� et,.t; a.aF �niTs
relocation
Business name:William'Lyon Homes,Inc. 200 amps or less 59.36 1
.Contact name: i . 0 201 amps to 400 amps 125.08 2
Addre s:109 East 13th Street 401 amps to 594 amps 168,54 2
City/State/ZIP:Vancouver,WA 98660 . . Branch circuits-new,alteration,or extension,per panel
Phone:(360)698-7700 Fax::(360)693-4442 A.Fee farbranch circuits with
1223/, above service or feeder fee, 7.42 2
k id 0 / /a .-,i V P•L i 141, branch.
cirri
fi n B.Fee far branch eirtttits wfthoaa
_ :.c... ..._, __ti.,.. .,., ..—,....::.�,._w.._.,.._ ...77.. _ �,seniceofeederfee,fr� 56.18 2
Business name:slanted*electric branch circuit
Address:3415 ne 44th Each add'ibranch circuit 7.42 2
Miscellaneous(service or feeder not included)
LI •, t li fir Each manufactured or modular '
ul f. _dwellings service and/or feeder 67.84 2
Phone:(503)3192192 Fax:( ) Reconnect only 67.84
Email:solatpdsiginie coat
Pump or irrigation circle 67.g4 '
CCB Lic.: 199188• Electrical Lia: c923 Suprv.L"tc.: c f(7/5 ,.
Electrician signature, Stg t ex outline lighting 67.84
Su
� signature,t�'i Signal circuit(s)or limited-energy • ,
p ff panel,alteration,or extension, D See iPaga2 s d:
Print name: iik. 2. �/L Date: J Each additional inspection over allowable in any of the above.
•
Authorized sie- Additional inspection(t hr mite) 66.231 hr'.
Print name: !' DateS 7,3 ! t, 1t”ta'Sa°on(i hr min) 9ti.00!in
•
° ;
itis to vall ea me Res 0617D015 cros6tsrittmstiwtnv8s , , •
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,
Plumbing Permit Application ,
Building Fixtures 1 OR UI;1 1( 1. I SE 0\1,1
r'e Received. Permit Ne/11.57-a207.01,211
kit XL
City of Tigard ��.
13125 SW Hall Blvd.,Tigard,OR�7223 ?plaa Review Perna Other Permit No.:
Phone: 503.718.2439 Fax: 50 . 481960._.
--- sr Inspection Line: 503.639.4175 , .� y y -i. .,.. �...
,. Ed See
Page 2 for
Il I? Internet vaw ttgard-or•goV Notified/Method: Supplemental
� 0}7W� 1.W:41 -4,47
yt •1.ai� �u AY1'�J9 4�..� . t � f.* s' „iZ r„ tt,,a � �,Information.. . i
- �x
®New construction ❑Demolition For special M/ormaffon use checklist
Description
I Qty. I Ea. I Total
D Addition/alteration/replacement 0 Other: New.1-2-family dwellings(includes 100 ft for each utility connection)
„': • ,,:y*: _SFR(1)bath 312.70
" �` 'r r ''4 1-,4-'''
, ,'. a:4-`a �g%a, -2,t...--'„,----'''...6rc ,i,�,4•-,',/,$ .ek,. z .,,g 437.78
^ ° .. ,. i SFR(2)bath
�t 1 and 2-family dwelling 0 Commercial/industrial SFR(3)bath I 500.32
-❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02
Q Master builder ❑Other Fire.sprinkler(___sq.ff.) Page 2
.1.,,„.‘,.. } ,, z,.........1::,,,-,•-; 04--*,,,,,,,,.^�, ? r./i.',4‘,::' ! , @ -ii •,\•-•'-',--x•,,,-1,'"-- nr ` , Site atditicS: 18.76
,.� _. .;r„ S+. 4_ . Catch basin or arca drain
Job site address: f L6� (,�/ �-► /. J v6+ Drywell,leach tine.or trench drain 18.76 •
City/State ZIP:Tigard,OR 97224 Footing drain(no.linear ft.: _.) Page 2
Suite/bldg./apt.no.: 1 Project name: Manufactured at Bull MountaiManufactureded borne utilities 50.03 Manholes 18.76
Cross f/dirediima to jab site: Rain drain connector 18.76
Sanitary sewer(no,linear ft.: ) Page 2
Stonn sewer(no.linear ft.:_.1 1 Page 2
/ Water service(no.linear IL:__.,_) f Page 2
Subdivision Polygon at Bull Mountain 1 Lot no.: /2 Fixture or item: 1
ptickFlow preventer 31.27
fax map/parcel no.: Backwater valve t ) (2.51
, y „ ;It i - o•«=�mt T . y{ ,-_r ,:. 25.02
x= 51
x �d� � :.J,�...>� ":ts�.��.�E1�..�,,..ac�,a �e%.�s"...i�. _.A'._-. -. �Ciothesivaaher
Dishwasher 25.02
Drinking fountain 25.02
. Ejectors/sump 25.02
} ` r\ + yr r ' kL: , �c yc. Expansion tank (2.51
ts - f( yaa „ ; • '''y " x, V Fixture/sewer cap .
02
Name:Polygon w1.>`1,.LI.0 Floor drain/floor sink/hub 25.02
Address:109'East 131"Street •
Garbage disposal 25.02
CiLy/StatetZlP:Vancouver,l A 98660 Hose bib 25.02
- 12.51
Fax ( ) Ice maker
Phone {360)6195 7700 x:( „ 25.02
interceptor/grease trap
k - ;1a>z ' � :� - h � .: Medical'gas(value:$ ) Page
Business name:Polygon W1,11,LLC Primer • 12.51
Contact name: WI !!chat 'Plonk Roof drain(commercial) 12.51
k/basin / 25.02
n /iavatvty L4tVLn y
Address:109 Enrst'13tb Street Si / 62.54
Vancouver,WA 98660 Solar units(potable water)
City/State/ZIP: � Tub/shower/shower pan 12.51
Phone:(360)695-7700 _i Fax::(360)693-4442 25.02
Urinal
l�, /� 25-02
E-mail: fft l,�1 f/' 1i (.► a 1 ,Ii♦_ ill.,, Water closet
Al ;; - F-... :1:16C,,,,::::;,:-•r .fir : ,+ttr Sr, tT'c
,, .. T,, ..?� t 1-t °ti'0'-',4.,' b, ,+, ,L' .: ,.`-'1,-=''',.
Water heater 37 52
,� ;. , .. :.,. • , 56.29
Business name:BDL Plumbing Lie Water piping/DW1 .
Other: 25.02
Address:PO Box 85 Subtotal
City/StatefZIP:Corbett OR 97019 Minirretim permit feta:Subtotal
al
Phone:(503)31-3903 Fax:( ) Plan review (25%of permit fee)
1 CCB Lie.t 180345 Plumbing Lie.no.:PB1582 State surcharge(12%of permit fee)
TOTAL PERMIT FEE
Authorizedname:
e signature.:nare L7 _ I
ra"��,,."" This permit application expires if a permit it not oUtalned,xithin 1.80 days
Date: after it has been accepted as complete.
Print ttat7lC:Brandon Laster *Fee methodology set by Tri-Cnimtp Building Industry Service Beard.
tAaeiiaicsp,mit..tri..Mtt-eetmrv,rp.aco 10101109
440.4616T(1 W02'CO,W WEB)
R
City of Tigard
NI COMMUNITY DEVELOPMENT DEPARTMENT
S
T 1 c a u D Building Permit Review — Residential
Building Permit #: /vL 5 / - j0�,o
Site Address: 15 S Sly pe,-Ac. A\ G-
Project Name: pot o,,l ai- 15N1! Mamiew Lot #: o___
(New Welling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: T\ J)
II/
`Verify site address/suite# exists and active in permit system.
LW River Terrace Neighborhood: ,❑ No Er YesSee River Terrace Review Addendum Attached
SiSie Plan Elements:
Three(3)copies of site plan 0fExisting structures on site
i4te plan must be on 8-1/2"x 11"or 11 x 17"paper &Footprint of new structure(including decks)with finished
L1 brawn to scale(standard architect or engineer scale) oor elevations
riAorth arrow tility locations&easements (required for new and additions)
EVite address,project or subdivision name and lot number ®Sidewalk/driveway approach
tot
pplicant information(name and phone number) Ivocation of wells/septic systems
dimensions and building setback dimensionsExisting trees to be retained with drip line,and tree
MASquare footage of buildings to be demolished ��pp/rotection measures
J[ Lot area,building coverage area,percentage of coverage and VdStreet tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) Street names
[.P roperty corner elevations(2 foot contour lines if more than torm water quality facility required if>1,000 sf of
4 foot differential) impervious area is created or replaced.
Iti Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995):
equired: ❑ Yes,applicant was notified No Received: E Yes ❑ No
Public Facilities Improvement(PFI) Permit: 1...(:)l5— 00077
Required: E Yes,applicant was notified ❑ No Applied For: ["Yes E No,stop intake
'Land Use Case#: 5(&B20 G -00002
Zoning: V-'15
1 Required Setbacks: Front 20, Rear t cJ Side 5 Street Side \ L� Garage 20
tg,
Landscape Requirement:
Lot Coverage Maximum: \ %
❑ Building Height: Maximum Height .j 0 Actual Height (-28
Visual Clearance
0/Sensitive Lands: ❑ Yes ❑ No Type
al Urban Forestry Plan
CD Conditions "Met"prior to issuance of b ding permit
Notes: S. v'2 \ cov YYTtCVIS 5�.(j2Dlf/ -c)C1DOZ. oye.. 5'� I( ou 0►
Approved By Planning: f , Date: A5/17
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\BldgPermitRvw_RES_051617.docx
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0
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Building Permit Submittal
Original Submittal Date: ?/047/)
Site Plans: #
Building Plans: # IC
Building Permit#: , Enter building ermit#above.
Workflow Routing: , Planning ..7.- Permit Coordinator Building
Workflow Sign-off: , Sign-off for Planning(include notes from planning review)
Route Application Documents: , Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
/12 Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
6/ /0�By Permit Technician: AZ .�I i ,�i Date:
Engineering Review o�
lope at building pad: !1
E Conditions "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
Assess Water Quantity Fee in-lieu: ❑ Yes -No
LIDA Facility on lot: ❑ Yes .B 'No
❑ NOT Approved by Engineering: Date:
Notes: 4.14
Approved by Engineering: ‘1- 1itt"e Date: 4 /r7
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El Approved ❑ Not Approved
Revision 2: El Approved ❑ Not Approved
Revision 3: El Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
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:
SDC Fees Entered: Wash Co Trans Dev Tax: !o., Yes ❑ N/A
Tigard Trans SDC: r Yes El N/A
Parks SDC: Yes ❑ N/A
LIDA El Yes N/A
e Sent tby Permit Coordinator: Date: ‘1.11// .7------
I:\Building\Forms\BldgPermitRvw_RES_05 16 17.doc
--I:\Building\Forms\BldgPermitRvw_RES_051617.docx
City of Tigard
111 p COMMUNITY DEVELOPMENT DEPARTMENT
■
TIGARD River Terrace Building Permit Review Addendum
Building Permit #:
Site Address: 15285 tA) P&J C E
Project Name: VOInovk 13y‘\ 14\ciwtTetNv) Lot #: �Z
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan District Design Standards (18.660.070.I.):
Is the project subject to the plan district design standards? ❑ Yes No
1.Articulation: a minimum of 1 element per each street-facing façade that has 30-60 ft. of frontage.An a. tional
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 sled dormer
ft. deep min. 2ft., 5 ft.wide min. 2 ft., 6ft.wide
❑ ❑ ❑ ❑ ❑
2. Eyes on the street: a minimum of 12%of each street facing façade must include wins.ws or entrance doors.
Percentage Shown:
3. Entrances:At least one entrance must meet both of the following standards:
CI Max. 8 ft. setback from longest street- facing wall
CI Parallel to s. -et,angle no more than 45° from street,
or open onto s orch
Entrance opens to a porch: ❑ Yes ❑ No
If yes,all the following apply: ❑ 25 :q.ft. min.
❑ One street facing entry ❑ 2 ft.max.roof above floor of porch
❑ 5 ft. depth min. • 30%min.porch roof coverage
4.Detailed Design:All buildings shall include a min. 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
❑ Wall 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. 501 sq. ft. ❑ Horizontal lap siding min. 3-7 inches wide
❑ Accent siding min. 40%of stre' facade ❑ Window trim min. 2 1/2"wide by 5/8" deep
❑ Window recess min. 3 inch-: for all street facing ❑ Bay window min. 5 ft.wide by 2 ft. deep
❑ Balcony min. 5 ft.wide ft. deep with inside access ❑ Attached garage is 35% or less of street façade
5. Garages and Ca p .rts:May face the front or side lot line on a corner lot.
Setbacks:
No closer to fr. t or side lot line,than longest street-facing wall. ❑ Yes ❑ No. If No (Check one):
❑ May exte•d up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch.
❑ May e tend up to 5 ft.where the garage is part of a two-story building and there is a window at the second story
above o e garage that faces the street with a min. area of 12 sq.ft.
W' the (Check one)
• 12-foot-wide garage door ❑ 40%max. of street façade
❑ 50%max. of street facade with 7 detailed design elements
Notes: CC'e�1Qy1 S n 45 1101— Gf/\CG�/Lf c s S i Y\G"
Approved By Planning: Date: c"//j l (-2
I:\Building\Forms\BldgPermitRvw_RE S_RT_062216.do cx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15285 SW PEACE AVE, TIGARD, OR, 97224 June 19, 2018 at 11 :03:32 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00208
Inspection Type: Inspector:
699 Mechanical final Aaron Cillo-Gobel
Result:
PASS
Comments:
Previous corrections completed.
A/C installed
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15285 SW PEACE AVE, TIGARD, OR, 97224 June 19, 2018 at 11 :02:47 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00208
Inspection Type: Inspector:
199 Electrical final Aaron Cillo-Gobel
Result:
PASS
Comments:
Previous corrections completed.
A/C installed
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15285 SW PEACE AVE, TIGARD, OR, 97224 June 18, 2018 at 9:51 :40 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00208
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
FA I L
Comments:
No power to microwave, not plugged in to test fan above gas range.
Gas fireplace not lighting.
Ac installed.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15285 SW PEACE AVE, TIGARD, OR, 97224 June 18, 2018 at 9:50:44 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00208
Inspection Type: Inspector:
199 Electrical final David Young
Result:
FA I L
Comments:
Recessed lighting not done back covered porch.
All else appears ok.
Ac installed.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15285 SW PEACE AVE, TIGARD, OR, 97224 June 18, 2018 at 9:49:48 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00208
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
PASS
Comments:
Finish sealing cracked grout at main bath tub/shower base at floor.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15285 SW PEACE AVE, TIGARD, OR, 97224 June 21 , 2018 at 8:50:15 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00208
Inspection Type: Inspector:
299 Final inspection Jeremy Burrows
Result:
PASS - CofO
Comments:
Corrections completed.
Final erosion control passed
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