Permit (78) CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2017-00204
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/14/2017
T[GARg Parcel: 2S108DB02100
Jurisdiction: Tigard
Site address: 15220 SW HUDSON AVE
Subdivision: POLYGON AT BULL MOUNTAIN Lot: 19
Project: Polygon at Bull Mountain, Lot 19
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1248 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1666 sf Garage: 464 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2914 sf Value: $349,907.86 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
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 2 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: 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'l 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: Square Feet:
NEW SF VB R-3 2914
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: $33,910.11
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR, Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copyry of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. ,o
Issued By: (i�� /1'✓Y�`iPermittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
4 � 6
f Building Permit Application C//)
FOR OFFICE 1 SE 01L1
RECEIVED
City of Tigard Received / ,� Permit No u
Date/13 : /per 5 �-d�G
13125 SW Hall Blvd.,"Tigard,OR 97223(IAR 2 8 2017 Plan Review r Q(
i Phone: 503.718.2439 Fax: 503.598:19ib Date/By: G G•
j OtherPermit`sial.�r,0`Dol 01
T"1 c .R t Inspection Line: 503.639.4175 Date Read/B / ry Jun' H SeeY Page/2 for
Internet: www.tigard-or.gov CIN OF TIGARD Notified/Method:trs/�// �t� Supplemental Information
BUILDING DIVISION / ,,¢.4L , /
,
®New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
�x � sC ; work indicated
�)on this application.
� 'rt , Valuation: (/
9137$ ��' 'v ` '�
1-and 2-family dwelling 0 Commercial/industrial j
®Z
Number of bedrooms:
�L ❑Accessorybuilding ❑Multi-family
0 Master builder 0 Other: Number of bathrooms:
V ' a' l t o f t= floors:Total number of floo 3,3 7 g
Job site address:1 SZ�,O S lyl \� _ New dwelling area: 29 square feet
City/State/ZIP:Tigard,OR 97224 "� Garage/carport area: Lli/1q square feet
Suite/bldg./apt.no.: I Project name:Polygon at Bull Mountain Covered porch area: "(47 square feet )6 C‘
Cross street/directions to job site: Deck area: 1 square feet y
Other structure area: square feet
�--, .i ce .f,.„,,,,a,,,,,?„d�,.
Subdivision:Polygon at Bull Mountain I Lot no.:tq Permit fees*are based on the value of the work performed.
Tax map/parcel no.: ! Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
q�ti a work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
al a s tal 1 x •g 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:
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 I Fax::( )
,gin 7
E-mail:Angela.Grajewski@polygonhomes.comf t i �
- Commercial and residential prescriptive installation of
' f `� tv roof-top mounted Photovoltaic SolarPanel 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: $201.60
Authorized signature: VA, This permit application expires if a permit is not obtained
/Siv/
within 180 days after it has been accepted as complete.
Print name:Angela Grajewski Date:1/20/2017 *Fee methodology set by Tri-County Building Industry
Service Board.
I:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
t
Mechanical Permit Application l (ti.()i IR I.I ,l (?\l \
City of Tigard RReceivedReceived... ._..... i� � x��
,;k > � . (t. i�
13125 SW Hall Blvd.,Tivard.OR 97223 Flan Review CStiur Permit;
503.708.2439 Fax:503 591119611 ' Z .,'a natdtfv,
nspcction Linc: 503.639.4175 post Reardyrt)y: rimeid See Page 2 far
Internet: www.tlgard-or.govNotified?htethed: Supplemattat information
`. ^::•;-',r4...a'x-:C 'e t t r� •i rima �'v.4..,:',-,-:S• .Zs »' cis ri.Lj a Ysil_c .-iaj,,:....;...,14,,,,,1&,-read;oFF ,4;,,,, � `
4:4:--",670.7.,-,,,,,,i,47,-..-µ. .
. Y • P rMechanicei permit fees*are based on the v21nc of the wort:
0 New construction 0 Addition/alternlion replacement performed.indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,rquilm ent.labor.overhead,and profit.
Value:$
j , ,",-,,t-4,-_,-,,,',-,-�: .. .t-. C:�oe-(1""`-t r(�jl i.�.eer,s r , am -'7 *f. f ", 4 : ':r.''r,. 4 ` 7 *?1,,,.••.-1 - 'rj 41''''"-f..'"- ,• .
,.,,
,Flt. S1, ty.+a^� , e tiLk'4�iCi�.�n�'''';..tri. �-wryy ...j ..1c .1, FES i. r v4a1AA lt, r„„. �M
il! 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For spedalInformation rtyeekeetNtst
Multi-family 0 Master builder ❑Other: Description Qty. I Ga, I Total
a --s. • a , -.:i' N e „4 -< --,:,-1:,,.....,..„, ,.,„...,:-..,,,,,,,..,„,• �,,w, Hatiag/cuohog:
` �, 3.-- or, -'� � Air conditiotrittt' I 46.75
Job site address 1ST • • St)e) Furnace 100,000E TU(duaoyents) ! 46.75
City/State/ZIP;Tigard,OR 97224 Furnace 100,000+13TU tducts'venttl , 54.91.
Heat pump 61.06
Suite/bldg./apt.no.: 1 Project name:Polygon at Bull Mountain 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(1001-type,not eloctric),
in-Rall,in-duct;suspended.etc. 46,75
Flue/vent for any of above I 23.32
Other. 2332
Subdivision:Polygon at Bull Mountain I Lot no.:I elOther fuel appliances:
fax map/parcelno Water heater 23.32.
w> '1•11...:--,.'1--„..,,,,-.,,,,::,,,,,,,-, G. ,, ,- xr gasfiretla�nsext 33.39
t � i� l.,�_;4—i"1 -:.-M.....-'," -�.�-"'h_.,.: ,
-,,,-;-...i,..-_-_,„. - Foto veal for a�alex heater or gas
(i I lair,
fireplace 2332
J Log lighter(pas) 23.32
Wood/pedictstove 33.39
Wood tiircplacciinsert , 2332
Chimney/liner/flue/vent 23.32
tJther 23.32
`a r...�",:'-;-."—:::-1,,,.
_rr - .7'-=`,4*;.,..
_L�*,.<-: ..}{3''',-,..-,';"•.t.''';',t f u,,'v's .a-%''-':-.? �h tV ,'` °� ,:<r,-f
�
• Environmental exhaust and ventilation:
Name:Polygon WLB,LLC Range hood/olhet kitchen 1 3339
equipment
Address: 109 Fast 136 Street Clothes diver exhaust I 33.39
CityiState/ZlP:Vane ouver,WA 98660 Single-duct exhaust(txnhrOu ns,
toilet compartments.utility rooms) 4 2332
Phone:(360)595-7700 Fax:( ) Attieicrawlspact fans 33.32
''''..N41:-.3‘.;--..;:;',...z:. ...r.. iTl.,. 3'1-,. vx >.-" �' F3,, =-1i ...o._...M'F F Xr.•Lt-'. ' :e.:. OIe• _ 2332
• Fuel piping:
Business name:Polygon WLR,I,LCSl4.;S for fust four:$4.03 for each addiiuwal
A//Ch p .Furnace.etc. 1
Contact nttrn,G: t/r l+v
Gas heat pump ,
Address:109 East 13th Street'
a Wulf/susmttdcd/unit heater
City/State/ZIP:Vancouver,WA 98660 Water beater
Phone:(360)695-7700 I Fax::(360)693-4442 Fireplace }
Range I
1 'GL Ole Il44 1° i'1 r1i. IAL &.4
E-mail: e
Business name:
Apes Air LIG
Address:18004 NE 72i0 Ave Subtotal
City/State/71P:Vancouver,WA 98636 Minimum permit fee($90.00)
t Flan review(25%of permit fee)
Phone:(360)342.8109 Fax:(360)3264769 State surcharge(1296 of pcmtht fee)
CCS tic:203034 TOTAL PERMIT FEE.
This permit applicationexpires ifa permit is oat obtained within IAO
days afterit lois been accepted as complete.
Authorized signature' " Fee methodology NM by Tri-County Building lndustty Service mord
Lt_rint q Date: 4-i't—tt-
i:tUuilding'amirsl7EC_PenakA M[et i ddc AxW4t:f 0 tt,'Y�'CrtkJWP8l
i
,..
Electrical Permit Application , '' 1 (w()I 11( I 1 ',I (1\15
City of Tigard Received Puma kr7.57;20/7-'00)e
13125 SW Hall Blvd,.Tigard,OR 97223-
Phone: 501718.2439 Fax: 503.594960 ' 'Ilaiall111111111111111: .
Inspection Line: 503.639.4175 ._.' -- - - • Dam7Sy. '
littemet www.tiprd-or,gov HoOded/Mmhotl: hallillill •
•
1 : ..-:-',----- • 7::: ' ,.."7',...4c1'7,.' -'':-7.71-7:r 1 rj:.-c''':.:',r,';':;','''..';',:"' --''''',.='r 7,-'::-7-,-' -:-'.'-:7 :-'--' '": 1:--'., ,. - - ' :-, 1:77::.:77 :' -'-
C4 New construction 1:1 AdditiOn/alteratiOnTrephieement ileaseCheck alidmt m4,(Mbmit 2 sets• peas w/itarai ebeokedp
0 Service or feeder 400 amps or more CI Bonding ow:three nodes.
13 Demolition El Other: uhwe the available fault current a Marinas tad boatyards.
,: T:37, „.::-,-.,,, tweeds morn amps at 150 volts or 0 Floating buildiugs.
I-and 2-family dwelling 0—Commerciallindustrial (:)Accessory building ler.s to ground.or exceeds ions14,000 LI Comreacial.ust agricultural
amps for all(titer imitatbuildiags.
121 Multi-family CI Master builder El Other: ti Fire pump. 0 installation of 150 KVA or
0 Emogeuey system. larger separately tiesitrod
Additi
0 on of new motor load of system
Job site address: 0 II SW III in 4 100HP or more,
City/StaterZIP:Tigard,OR 97224 0 Six or tame residential units. occupancy.
0 lieshbarre facilities. 0 Recreational vehicle parks.
Suite/bldg./apt,0: Project namePpl”en ea-eu„,,,,,,,„4 '4.4 °Hazardous locations. 0 Suptiy voltitge for more than
r °Service or feeder 603 amps or more, 600"Its 000201.
Cross street/directions to job site: t'2- ;;:';;7-57-"i--7"...---.75`-';7,,,7..,-._,.,7:,f -.1-:A7`,...:',-•'z.f...:r•-;-..
cuswiMien
Qt'. Emit iaCei • .
New residential single-or multi-ramify dwelling unit.
Subdivis
ionpov,mok Nat metntun LotiO:ICI indndes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less I 16834 4
-- -...,„_'." -..7-,1.- , -.:::':i-71:i1: ..',,.:s'::-.e;C,,-Z ':E;:-..! Ea,add.'SOO sq•fl.or Poriton Liu 3392 I
Limited energy,residential 75.00 2
(with above sq.11.)
Limited energy,multi-family
75.00 2
' ..._ - __...-.....4.." 4,:''''-' -'-',,. :. :1,...1-...2.e....2.,..r..%:',',..,-.1,-.....-!,...,-.. LI--2..:.--,...,,`,.1'••,`,= - 1-,,.,.,,,,,--,i,'--7-..•-.
Name:ADVL Land Holdings,LLC Renewable Energy 0 See Page 2
Services or feeders installation.alteration,and/or relocation
Address:7600 E Doubletree Ranch Road
200 amps or less 100.70 2
City/State/Z1P:Scottsdale,.AZ 85258
201 amps to 400 mops 133,56 2
Phone:(602)694-4031 I Fax:( )
Email: 401 tot to 600 amps 200.34 2
Owner Installation:This installation is being made on property that I ownwhich is not 601 amps 101,000 amps 301.04 2
intended for sale,lease,rent,or exchange,according to on 447,449,670,and 701.
Over 1,000 amps or volts 552,26 2 '
Owner signature: :-.. .• Date:
' - - •.---' -••-•—— ------,•••-,•---------‘.-,T----v---r---,------,..-,•---•-•,---,--,--•-a-,-,---0,----‘,,A-• -,•, , 'Temporary services or feeders ostallation,alteration,and/or
.4-.....,,-1..-__, %I-21', i -.•Lt..,`-'2r:.5..t),P.J.,• ,,',"' P;.q.-;.,..--itj,'::,, relocation
Business name:William Lyon Homes,Inc. 200 amps or less 59.36 1
Contact narj. _itVtairote //Write 201 amps to 400 amps 125.08 2
Address:109 East 13th Street • 401 amps to 599 amps 16834 2
City/State/ZIP:Vancouver,WA 98660 Branch circuits-new.alteration,or extension,pr panel
Phone:(360)695-7790 Fax :(360)693-4442 A.Fee for branch circuits with
above service or feeder fee, 7.42 2
each branch circuit
Entail: , d At ie -# 140 , 1 Oi. ". 0 AI 1•014
0 :-,:-.--,----,-.--,• ...- ----....----. El.Fee for branch circuits without
.. ..-. .. . - _: _ -. „..- .-,....,..........,,,— ....21. , ._: ,.....' 1..j...'k......:1-:z... „service or feeder fee,first
56.18 2
Business name:slanted*electric branch circuit
Address:3415 ire 44th
,
Each add*,branch circuit 7.42 2
_..„
Miscellaneous(service or feeder not included)
City/Slate/ZIP:wane ibrvi/6te 2v/2- /4" 7.7—13 Each numufactured or modular
61.84 2
dwelling,service andior°seder
Phone:(503)3192192 I Fax:( ) - - --'
Reconnect only ,_ 67.84 ' I
Email:solatpdx@)ate.corn
Pump or irrigation circle 07.84
CCB Lic.: 199188 1 Electrical Lic,: c923 Suprv.Lic.: y$fr 7/5 . . ,
Sign or outline lighting D67,84
Suprv,Electrician signature,required: , ,. .
rint nanw: ki lc, ii,„:,,„,....<, ate: 5113//i terati n, extensi
paneSigntiajdretift(04"orlinlited-emnf.ott. 0 Ste Page 2 -
P
.Esell addidonal Inspection over allowable In anis!the itlx;r6' .
.,., ,.....
Additional Inspection('hr min)
Authorized.sign7u.,/ ---e:i :i.I Print nun: .,....",....„-..---.1 ---- Datesjza//4 j Investigation(1 hr min) ,, ..
90.017/lar
Vailf*treemimplaz_Paft ,EREdoe Rev 061170:115 <40-4615T/11/05/CCNAVS1
• .
. ,
P
Plumbing Permit Application
Building Fixtures ' '
City of Tigard Received
pesrlvq/`j /70..70y
13125 SW Hell Blvd.,Tigard OR 9722.1 , v pian Review Permit' Phone: 503.718.2439 Fax 503..59$1960 Demme:
Other- Inspection Line: 503.639.4175 ,` Dote Ready/By: Jul*. RI See Page 2 for
I 1 '-1: Internet ww't1 tigard-ot O Notified/method: Su Iemcatal Information
,op" u Aa■x is"` ins 3 2a r 7' n � rt 4- ,� iNM d N��-5, ry;T �" "''
- g•, �tt k. " .e ;a,rht.-tee.., 7a ::moi _" tecta,.._-,a ..t'4 h..1....Iw.
rya.. =�=`,� .����:r "'"."'"' �"��^-' For special information use checklist®New construction Demolition Description j Qty. I Ea. I Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
l' FR(1 bath 312.70
'x',.' '..',..t.--4.,,,,,,,-3.:.1y P� y>.�� ��t°�rE'-i, @f N4a 9��[.µ a�Fi°.�`P�s,�t Q�,✓' �.`a 1"�'• �r�'t,F"ce� � )
yr .u., '. SFR(2)bath 437.78
® I-and 2-family dwelling ❑Commercial/industrial SFR(3)bath j 500.32
0 Accessory building 0 Multi-family Each additional bath/kitchen 25.02
❑Master builder 0 Other:" Fire.sprinkler(__,_sq.ft.) Page 2
'-,7", ' A',is a.-1 . y^t':. 4 a 'r' lay ‘,.,-.tott>.<5-;i. r�ccs.,.' . . .. y ..' Site utilities:
I `S / COO
I . Catch basin.or arca drain 18.76
Job site address. Jr j "C,. Drywell,leach line,or trench drain 18.76 '
City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: j Project name:Polygon at Bull Mountain Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Bain drain connector 18.76
Sanitary sewer(no.linear ft.: f Page 2
Storm sewer(no.linear ft.. ) , Page 2
Water service(no.linear ft.:_) I Page 2
Subdivision:Polygon at Bull Mountain 1 Lot np.:/q Fixture or item:
Backflow preventer 1 3127
fax map/parr-el no.: t ,
�", , i�''. . :• , ,,...--61-..1-,A;,..' f t."4 1@ F '_ tj t2.51
1 zs -,5 yr r!;tm:nC.�.: z. .�k:y;.w =:� r aac::a ,,. ?�1ka:....ua Clotheswasher 25.02
(tshwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
,i -r. 3 &fi
� �s" ,q ..":1!..-",''''i'-- ', v tvi,r x Expansion lank 12.51
:1, _- ,...-:7z.v rteu - X.x..NIP_' 1'
Fixture/sewn cap 25.02
Name:Polygon'1'V1,11,LLC Floor drain/floor sink/hub 25.02
Address:109 East 130,Street Garbage disposal 25.02
City/State/ZIP:Vancouver,WA 98660 Rose bib25.02
Phone:(360)695-7700 Fax ( ) leo maker 12.51
.rr smaT (j +,tp �' �` �( TM3 ..0� M b'�
Interceptorgrease trap 25.02
,41..': �__-_.,;v7..`.:'..'" .�tia.,,...;:l;u.,.�..�:..... r� l ..-. ''..:_-e-'2,
Medico'gas(valueE ) Paga2
Business name:Polygon WLH,°LLC Primer • 12.51
Contact:name: 11/jthcie Th6 Roof drain(commercial) 12.51
Address:109 East 13th Street Sink/basin/lavatory [ rz,IALV` / 25.02
City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) / 62.54
Phone:(360)695-7700 1 Fax::(360)693-4442
TubIshower/shoWer pan 12.51
I
Urinal 25.02
E-mail: .1 IL If if, I t i•0 / / I/o _
yy 0 ,
Water closet 25.02
.k- 2- "' � 775r,17-4e .,:.;G 'Mu , rz3 . , x � . ^
X t% ,.T�,-3g. . ,k.bt.„'., ,
water heater ..
3742
Business name:BDL Plumbing LLe Water piping/DWV 56.29
Address:PO Box 85 Other. 25.02
Subtotal
City/StatelZiP:Corbett OR 97019 Minimum permit fee: $72.50
351-3903 Fax:( )
Phone:(S03) Plan review (25%of permit fee)
1 CCB LM.:180345 Plumbing 1.ic.no.:P01582 State surcharge(12%of permit tee)
Authorized signature: 0 w �,,.�,/'" TOTAL PERMIT FEE .
�['�""� This permit application expires if a permit is not obtained within ISO days
Print name:Brandon Lanter l Dale: after it hos been accepted as complete.
"Fee methodology set by Td-County Building Industry Service Board.
I.:foundingpeimtulPLMt:-Permlippdce 10/01109 440-16167(1e/01/COM/WE6)
N%
City of Tigard
11 . q COMMUNITY DEVELOPMENT DEPARTMENT
T 1 G A K D Building Permit Review — Residential
Building Permit #: / 57L /?-•,00 o'
Site Address: 15220 5D ( 1j3 ANNE
Project Name: ?oLcIri c-\-- Butt Addition or Alteration=last name of owner)
Planning Review
Proposal: 1/€
M Verify site address/suite# exists and active in permit/system.
River Terrace Neighborhood: ❑ No V Yes,See River Terrace Review Addendum Attached
Sit Plan Elements:
Ig ree(3)copies of site plan /114 xisting structures on site
Site plan must be on 8-1/2"x 11"or 11 x 17"paper [Footprint of new structure(including decks)with finished
Erprawn to scale(standard architect or engineer scale) fl or elevations
E'North arrow tility locations&easements(required for new and additions)
2/Site address,project or subdivision name and lot number Sidewalk/driveway approach
,,�//Applicant information(name and phone number) ocation of wells/septic systems
�LJLot dimensions and building setback dimensions xisting trees to be retained with drip line,and tree
Nquare footage of buildings to be demolished protection measures
NWET`of area,building coverage area,percentage of coverage and d reet tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) Street names
Property 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.
Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified r6 No Received: ❑ Yes ❑ No
E(Public Facilities Improvement(PFI) Permit: 1)F,2 -0001 —Required: ❑ Yes,applicant was notified CI /No Applied For: E Yes ❑ No,stop intake
_/ �2
IJLand Use Case#: 5UAQ15-0000
1 2
LJ Zoning: '\--'-j.,j
`t❑ Required Setbacks: Front 20 Rear I G1 Side LJ Street Side 1 .) Garage 20
Iw ' Landscape Requirement: N %
4k Lot Coverage Maximum:
Dt Building Height: Maximum Height .30 Actual Height 29
❑ Visual Clearance
I1G► Sensitive Lands: ❑ Yes ❑ No Type
A Urban Forestry Plan
Conditions "Met"prior to_Iissuance o building permit
k
Notes: 5ejosay cov\dtV-oviS eN Sk$2015-0000-2- ar-e- 5--1ti ouk-k-s-k-avid019
Approved By Planning: �jy�r�j V_ Date: W5 ( 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
F
Building Permit Submittal
Original Submittal Date: 3 1-410
Site Plans: #
Building Plans: #
Building Permit#: Enter building permit#above.
Workflow Routing: Planning (*Engineering i7Permit 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.
` -Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: or
_A, A( , A, Ad�/Ir���./- A Date:
Engineering Review
El Slope at building pad: l Id
El Conditions "Met"prior to issuance of building permit OUTSTA (N4, 00100171 dN S
❑ Easements (encroachments)per engineering conditions of approval and plat
El Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes IQ No
Assess Water Quantity Fee in-lieu: ❑ Yes No
LIDA Facility on lot: ❑ Yes No
El NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: Date: 6/th7
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved El 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
El 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:
I)C Fees Entered: Wash Co Trans Dev Tax: es ❑ N/A
Tigard Trans SDC: Pr..'Yes ❑ N/A
Parks SDC: ,Yes ❑ N/A
LIDA ❑ Yes /A
!iov:by Permit Coordinator: A3ate:
I:\Building\Forms\BldgPermitRvw_RES_051617.docx
I
City of Tigard
111111 1
p COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD River Terrace Building Permit Review Addendum
Building Permit #:
Site Address: 12-1-0 SW 1-lU1bSa) kjE
Project Name: ?,t ort 0.J- -8.01 Mcum-•ct,Y) Lot #: \q
(New ZIWelling=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 KNo
1.Articulation: a minimum of 1 element per each street-facing facade that has 30-60 ft. of frontage.An .:ditional
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 Gabled 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 facade must includ• , ' dows or entrance doors.
Percentage Shown:
3. Entrances:At least one entrance must meet bothgQb ei following sta .ards:
❑ Max. 8 ft. setback from longest street- facing ❑ Para to street,angle no more than 45° from street,
or o.= onto porch
Entrance opens to a porch: ❑ Yes ❑ Ni8C
If yes,all the following apply: IN25 sq.ft. min.
CI One street facing entry o�2J ❑ 12 ft.max.roof above floor of porch
❑ 5 ft. depth min. ❑ 30%min. porch roof coverage
NNd
4.Detailed Design:All buildings shall include : min. of five of the following elements on all street-facing façades:
❑ Covered porch min. 5 ft.wide x 5 ft. dee. ❑ 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 woo. ❑ Gable,hip or gambrel roof design
❑ Roof pitch oriented south . 500 sq. ft. ❑ Horizontal lap siding min. 3-7 inches wide
❑ Accent siding min. 40% •'street façade ❑ Window trim min. 2 1/2"wide by 5/8" deep
❑ Window recess min. 3:. ches for all street facing ❑ Bay window min. 5 ft.wide by 2 ft. deep
❑ Balcony min. 5 ft. 'de x 3 ft. deep with inside access ❑ Attached garage is 35%or less of street façade
5. Garages and ►arports:May face the front or side lot line on a corner lot.
Setbacks:
No closer t. front or side lot line,than longest street-facing wall. ❑ Yes ❑ No. If No (Check one):
❑ May -•tend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch.
❑ M. extend up to 5 ft.where the garage is part of a two-story building and there is a window at the second story
ab• e the garage that faces the street with a min. area of 12 sq.ft.
idth: (Check one)
❑ 12-foot-wide garage door ❑ 40%max. of street facade
❑ 50%max. of street façade with 7 detailed design elements
Notes:
Approved By Planning: Ates<Verh _ Date: (D/5 /17
I:\Building\Forms\BldgPermitRvw_RES_RT_062216.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15220 SW HUDSON AVE, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Master Permit MST2017-00204
Inspection Type: Inspector:
299 Final inspection Allyson Armstrong
Result:
PASS - CofO
Comments:
Per builder the Ground on left side below cantilever at fire place connected to area drain.
Collected
High efficiency lighting form
Moisture content acknowledgement form
Moisture barrier acknowledgement form
PTCS Air leakage test report
Left C of 0 on the counter
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15220 SW HUDSON AVE, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Master Permit MST2017-00204
Inspection Type: Inspector:
399 Plumbing final Allyson Armstrong
Result:
PASS
Comments:
Water pressure = 78psi.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15220 SW HUDSON AVE, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Master Permit MST2017-00204
Inspection Type: Inspector:
699 Mechanical final Allyson Armstrong
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15220 SW HUDSON AVE, TIGARD, OR, 97224 February 13, 2018 at
3:46:39 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00204
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
FA I L
Comments:
Provide access for inspection.
House cleaners mopping floors.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15220 SW HUDSON AVE, TIGARD, OR, 97224 February 13, 2018 at
3:47:04 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00204
Inspection Type: Inspector:
199 Electrical final David Young
Result:
FA I L
Comments:
No access to house, house cleaners mopping floors.
Re schedule with access.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15220 SW HUDSON AVE, TIGARD, OR, 97224 February 13, 2018 at
3:09:53 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00204
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
FA I L
Comments:
Hard cap un used rain drain stand pipe right rear.
Primer in mechanical room not in hub drain.
No access to house, cleaners mopping floors, no further inspection done.
Violation Summary:
Inspector Contractor