Permit (79) CITY OF TIGARD J 7 . `. MASTER PERMIT
COMMUNITY DEVELOPMENT {%�/7 %.'� Permit#: MST2017-00201
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Datelssued: 06/14/2017
Parcel: 2S108DB01800
Jurisdiction: Tigard
Site address: 15306 SW HUDSON AVE
Subdivision: POLYGON AT BULL MOUNTAIN Lot: 16
Project: Polygon at Bull Mountain, Lot 16
Project Description: New SF. 10/10/2017: REPRINT to add 4th bathroom.
BUILDING
Floor Areas Required Setbacks Required .
Stories: 2 Bedrooms: 4 First: 1547 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 4 Second: 2144 sf Garage: 735 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 3691 sf Value: $454,196.52 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 6 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 4 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: 6 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit . Service Feeder . Temp Srvc/Feeders . Branch Circuits .
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 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 3691
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: $36,230.77
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: egon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 thr gh O' 952-0'01-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
A
si
Issued By: '. Permittee Signature: �� /7/.04., f[1 4.77Gy
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
CITY OF TIGARD MASTER PERMIT
S. :j COMMUNITY DEVELOPMENT Permit#: MST2017-00201
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/14/2017
E['t�'�tTt 9 Parcel: 2S108DB01800
Jurisdiction: Tigard
Site address: 15306 SW HUDSON AVE
Subdivision: POLYGON AT BULL MOUNTAIN Lot: 16
Project: Polygon at Bull Mountain, Lot 16
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1547 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 2144 sf Garage: 735 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 3691 sf Value: $454,196.52 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
0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 2 Water Lines: 100 Drains: 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: 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 3691
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: $35,981.33
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.�L
Issued By: 004 �� Permittee Signature: < C �
� c„ . ?�
Call 503.639.4175 by7:00 a.m.for the next available inspection date.
P
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 7 / ( .
R ?n RECEIVE
City of Tigard MAR 2 $ 2017 ReceivedDateBg Permit No. l�1 l
UPIal 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review //� ����v`� C>O�"
■ Phone: 503.718.2439 Fax: 503.598.1960 CITY OF TIGARD Date/BY. 6' �'� ) 7 abet Permit: SGr ti.2W-06/7/
T 1 G n R t i Inspection Line: 503.639.4175 BUILDING DIVISI O,,Date ReadyBy: / f ,�. Jurs rEl See Page 2 for
Internet: www.tigard-or.gov �Jt�oti5ed/Method: /�� ♦ Supplemental Information
r— d,1/4/ /�
rte.. x
-
®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
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
, , work indicated on this application.
Valuationl.}�C1. JC)6 $ ' I
® 1-and 2-family dwelling 0 Commercial/industrial II 1
Number of bedrooms:
❑Accessory building 0 Multi-family
❑Master builder 0 Other: Number of bathrooms:
t P t t t t,, , t., Total number of floors: Z 3 6q) 'facJob site address: , / �� at 1%(f..
' Ah New dwelling square/Li
t
City/State/ZIP:Tigard,OR 97224 Garage/carport area: i 3 square feet
Suite/bldg./apt.no.: Project name:Polygon at Bull Mountain Covered porch area: r-3\ square feet a) 1.1i
Cross street/directions to job site: Deck(iQAZ'O: square feet', L}'
Other structure area: square feet
{i 1.1 - t°k2' t
Subdivision:Polygon at Bull Mountain Lot no.: / 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
s ' 1, [e f F work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
a t"a :1, 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:
E I It i
� t
Business name:Polygon WLH,LLC
Structural plan review fee(or deposit):
Contact name:Angela Grajewski
FLS plan review fee(if applicable):
Address:109 East 136 Street
Total fees due upon application:
1 City/State/ZIP:Vancouver WA 98660
Amount received:
Phone:(360)695-7700 Fax::( )
E-mail:Angela.Grajewski@polygonhomes.com
. Commercial and residential prescriptive installation of
` �'. ;, - f i . n roof-top mounted Photo Voltaic 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: AillaiyAn VA, This permit application expires if a permit is not obtained
vvvv within 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry
Print name:Angela Grajewski Date: 1/20/2017
Service Board.
I:\Building\Pennits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(1 l/02/COM/WEB)
Mechanical Permit.Application
i(al:(tf { Itl. l11 WO
;City of Tigard
.-c $3125 SW lull Blvd.,Tigard,OR 97223EFinilliiiIIIIIIIIII
boar ttir+air:
Phone: 503.71L2439 Fat: Sa3 598 14F10,
i3su 1tcodylf y, IIM El See Page 2 for
Inspection Line: 503.-or g 175 4 Notiiiedtl4adtod: Supplements!Information
`Entcrtrct: �E1a�r.tigard-crc.gav ., ..
-' , cr • '' `s t ,;y''Tt ^`i; ; - ++ : "F ',
a v . r . ., ., .''''''C'''''''' '' , .t, " C''' . •y " " .E
bleChariical permit fees*arc based on the value of the wnr1.
®New construction 0 Additiatllaltcraiionlreplaeement
pe 1'ortned,Indicate the value(rounded to the nearest dollar)of all
mechanical materials,couirenent.labor,overhead,and profit.
0 Dernoltttan 0 Other: Value:S
• .F•+il, ,.xtii y } tC t<f • Xy q,?•Ckrl..-7.A ."1" :1,.. _4J••,.;�,•,`, r,,,,..1. d; a.,. 'at tE'4,,,F_F i2 LSF e -f' '"1'.. cy.•,k!rc_!,,,a e:.�,`,fic
1! l-arid 24amily dwelling 0 Commercialtindustrial ❑Accessory building For special in/ernt flonxse c*e akl&st.
0 Ocher: Descriptors' I Qty. Ea. Total
Multi faintly i
Master buildercooU
lleatiap( n>»z
V Y 2-2,,,i...;14.1� t'£ 1 t}k . i11 f.,,-,raj_ •••'-`..)''''`" r ti',_:;'I: 46,75
�-� :�' fr.�' {�.^� " ,�.1. �`� /� .."'`I /141'conditioning
1 S c3DU �Sv lallTirr c L �L Furnace 100.000 BTU(dueay.erns) 46.75
Job site address SA,q;
Furnace 100.000*BTU(dusts/vents/ntsl
City.'StaceTL1P:Tigard,OR 97224 Heat Pump 61.06
Suite/bldg./apt.no.: I Project name:Polygon at Buil Mountain Duct word( 23.32
Hydronic hot water syste n 23.32
Cross street/direGtions to job Site: 5, idettlial boiler(radiator or
hydronic) 2332 ,
Unit heaters(Net-type,not etcdxic), 46.75
in-wall.in-duct,suspeuuded.etc.
Flue//vent for any of above I 23.32
Other. 23.32
Subdivision:Polygon at Bull Mountain i Lot no.:'AfOther fuel appliantxs:
faxmaplparel no a.{, tier.isr .; 4r � Water heater
e2- 23.32
x .�. � e m E z r ?ts,r, . t b, M Gas I 33.3$
a ...,a #lue vent for Etiuier hence Or gas
23.32 `
Log lighter(gas) 23.32
Wtlod/pellet stove 3339
Wood arclllet:a/insert 23.32
Chimney/Finer/flue/vent 23,32
-4, .. rr"
23.32
e ..t s `: ;�� �f • ir '_ r
x�� s ..._ ,,,:�e_,S .se ;.o „7s,, ,:;n„ ,,,, _-, _ a Environmental exhaust and vtntiletion
Name:Polygon Will,LLC tgtgC 1WOdi011totkitchen
ctuintnelt l .
3339
Address: I09 East 136 Surat
Clothes dryer exhaust il.. 33.39
StnelrYdau exhaust(bathrooms. 23.32
Cityt$IateZ1P:Vancouver,WA 98660 -toilet owmpartments.utility corms)
Phone (360)695,-7700 ' Fax (
.. . ) ., . . Attiehxuwlspace Gus, 23.32
-'E. e [ � � - 2332
lr x. . ?',°"1,v S'::4._L. avis Frr .,..u.,.._, .p...,,
Fuel Pitting:
Business name:Polygon��nqWLII,ILC Sitt5 for ant tour_54.03 for earls additional
Contact aarnp: m
AlIChvie Thorpe Fore etc. I
(las heat Pimp
Address:109 East 13th StreetPyalllstis ltdedlunitttemter
City/StateD.1P:Vancouver,WA 9$660 Water heater
I Fax::(360)693-4442 Fireplace i
Phone:(360)695-7700Range
E-ntailc,40e. [41/4. /II P!{ �, i� 4 0/ d. CB Aad.,dTce(gas)
Business name:Apra Air LL: , _ . , ., " "7 " 7
_ .Y _ .,.._ t ___ :_ �_....0,,. 1.,
..,>-..c
SttbisltA[
Address:18004 NE 72"c Aide Minimum permit fee(nba:0a)
City/State/ZIP:VauC4nYCr,WA 9$6116 Plan review(25%of permit fee)
Phone:(360)3424109 I Fax:(360)3264769 State surcharge(12%of permit fee)
TOTAL PERMIT FEE
CCS tic.:203034 Ipixpermit application.expires Ifa remit it not obtained within 180
dayenfeer it bas been accepted as complete.
' Fee metleedolo>OE'et(by Tri-Coemty Building ladustiy Service Barad
Authorized signature.
j Print name: tri Y 1 Date: 4.11.14
i>4aI ado: 4ad-wtrrolio2#Cte�41V'.`PBl
e:.Ik�tldierg9�3et'A�PeemlGll�„
Electrical Permit Application
i{nat)tii( i t ,I iJN.i.l
Received !lean n:r Ls�r /7-G1:%�4)
IIICity oJTigard Dere:
13125 SWHall Blvd..Tiprd,OR 97223, Related partbit n:
Phone:503.7182439 Fax 503.59!8.I960
Itapeetion Line: 503.634 17S . ;
Internet www.tigani-or.gov
s
n_4 New construction Q Addition/altemtioafreplacement Plane oberall (ateb
that apply mit a sen• pram• wl tem-s
0 -
Service or feeder amps or more 01luilitin over three series.
D Demolition D Other where the available fault motet 0 Marinas and boatyards.
ri _ -.67::-..--';'7...;7.-;c ; ;5:'-'-',7:7,'_..Y.• �__ .. eao
. ,.,. eods 10000 amps at 150 volts er 0 Floating buildings.
less to ground,or exceeds 14,000 O Comataeial•ux agricultural
.� !-and^2 family dwelling 0 Gommercial)inilusnial 0 Accessory building amps for all other installationsbuildings.
D Maltz famil D Master budder ❑Other lD Fire pump. O lastaltwoa of 150 KVA or
`4,,, ''.k.',` r r c --'--1,---7.- Ofinereeer wawa. tenet separately derived
:; - j s f _ .€ n r
.
as 0 Addition ofnewmotor load of.
Job#: Job site address: i I it .��. t i lir, . _ t 'canon. 0`A-.-E^.-1-2-.-1-3-.
0 Six or more residential writs. o gas'•
City/State;/ZIP:Tigard,OR 972240 Health-care facilities. 0 Recreational vehicle paries.
rL ;.}Hazardous locations. 0 Supply voltage for more than
Suittlbldg./apt.#: Project Elaine I 6 d1 a,4 r-_. , r!.I. O Sema or feeder 600 amps or more. 600 voter nonan)
Cross sweet/directions!directions i ".., "�..-` ''' .f71.-;177.--?..r'--i.ti
to job site: ren'
New residential single-or mufti-family dwelling unit.Lot#: Includes attached garage.
Subdivisiesn: � (,� M ht. :i C�A t 1 161.54 4
Tax maplp steel#:
as or less loco .�.
''.• -iiiiii.7.7-‘iiiiiiiiiiiiiiiiiiiimii,•;•.4.`
r t 4t,t z 'r, s. Ea.add'!$00 sq.ft or portion ( /) 3392 1
Limited energy,residential `�' 75.00 2
(wish above sq.ft.)
Limited encrej,multi famIy 75.00 2
wt
residential(with above sq.ft.
._.. . ._,. a 9 ' ' Renewable Energy D See Page 2
Nettle:AUVL Land Holdings,LLC
Services or feeders installation,alteration,nod/or relocation
Address:7600$•Doubletree Ranch Road 200 amps or less 100.70 2
City/State/ZIP:Scottsdale,AZ 85258201 arnm to 400 amps 13356 2
Phone:(602)694-4031 Fax:( ) 200.34 2
401 amps to 600 amps
Email:
Owner installation:This installation is being made on property that I own which is not 601 amps to 1,000 amps 301.04 2
intended for sale,lease,rent,or exchange,according.to ORS 447,449,670,and 701. over 1.000 amps or volts 552,26 2
Owner signature Date Temporary services or feeders installation,alteration,and/or
y pn A tion
..1:: '',.�� {k :21',..,: -:>,;-.. -::.-.:..':a mss' ur,,..,...22'14 e,,I.L relocation
Business name:William Lyon Bowes,,Inc. 200 amps or less 5936 I
Contact name: . e 0 201 amps to 400 amps 125.08 2
Address:109 East 13th Street 401 amps to 599 amps 168.54 2
City/State/ZIP:Vaecotrver,WA 98660 Branch circuits.-new,alteration,or extension,per panel
693-4442 A..Fe a for branch circuits with
Phone:(360)695-7700 Pax::(360) above service or feeder fee. 7.62 2
/J „! p each branch circuit
®� i/ _ u • ,V v /(/t a Met/T ✓ 4�8 B.Fee for branch circuits without .
___ : ,, 1 ,.serviaaor fuer fee,first
• 56.18 2
branch circuit
Business name:alameda electric
Each a4d1 b ranch circuit 7.42 1 2
Address:3415 tie 44th Miscellaneous(service or feeder not included}
Each manufactured or modular 67.64 2
dweliinJ service and4x feeder
Ph :(�13j 3192192 ��� Reconnect only 67.84 3:
•
Email:solarpdx@mt.eotn Pump or iaigation circle 67.84
a , Suprv.Lic.: y ov7/ Signor outline lighting 67.84 ri`
Suprv.Electrician signature,required: Signal cirtxitit(s)ar limited e _
oetgy 0$erPage •
2
,/ panel.alteration.or extension, ):
Ptiht name; i�� Zr70G`l. Date: Z,i',� Lich additional inspection over allowable In any of tilt aboire
• A'
Additional Inspection(1 hr min) 6615/hr. -, , :- .
Authorized signature: s jj Investigation(t hr min) 9U.00!ter Y
Print name: / air Dates" !
t�tc t tea«twur✓trrSOts ao sctsttnms/caratnwea .
Plumbins�Pe �plicatio �
1 t)H 011.1( F. 1 ti1��. i)\i,`�
Building Fixtures Received.
PermitNa./''f_5 7;2-0/7'-oal
City of Tigard 13atelBy
13125 SW Hail Blvd.,Tigard,OR 97123 ' Plan Review Other Permit No.:
.. , mie/13y:
Phone: 5n Line: 503,639.4175
3, Foe 543 598.1960 Date Ready/By: lurk, ®See Page 2 for
Inspection Line: 503 639 4 t 75 Suppiemeetat tarormetion
1111' i' Internet wwtr t Bard or gor a< Not fl d/M hod xP �yt 'i a 1 aIn on fi
wg5`.HIr€4' tp . b Y.. -r'• '!fine-.4:,
7 ,n,«. L � ^"` For special information ime checklist
Y
`l New 0 Demolition Description I Qty. I Ea. I Total
��New construction °n
0 AdAddition/alteration/replacementent
Other New I-2-famil dwelti.14(includes 100 ft.for each utility connection
FR.(1)bath 312.70
bath 437.78
,I Wa s` 4 ,..u „ :: ... a,:,,,.. , %•=-1,7.•.-74 :•-,,,
-�:. �.rs SFR(2) 504.32
' IL-•-•-•':.11- 1-..z,,, 44'
� � (]Commerciai/Industnal
®1-and 2-family dwelling SFR(3)bath 111111
❑Accessory building
0 Multi-farnily Each additional bath/kitchen 25.02
❑Hostel btulder 0 Other: --zr 74� g )
Fim spool ter(__.sq.ft
t x I . i'•s� ,-----.1-.1. 7,-.7-,,,,o,y v. ; s , ,,� , Site utilities:
t , `t"t •.1 a ''n''° I 1 a o ,t oI _ Catch basin.or area drain IM
18.76
Job site address: k�'/PL INIRM�t a r*�aA, , Drywall,leach line.or trenal drain
Footing drain(no.linear ft.:,__-J Page 2
City/State/ZIP:Tigard,01297224 50.03
!a t.no.: Project name:Polygon at Bull Mountain Manufactured hone utilities 111111111111Suite/bklg. g Manholes
Cross stre&dit actions to job site: Main drain connector NM 18.76
___.r--- Page 2
Sanitary sewer(no.linear ft.: )
Storm sower(no.linear R.:_..)
Page 2
Water service(no.linear IL:_,___)
111111111111221
Subdivision:Polygon at Bull Mountain Lot no.: Fixture dr item:
..
Backflow
' . ,
1111111111111361faX map/parcel no.: „-�-v "�` ':tib 3� '' `dh' hr � r " meW111111111171.a ,,-wC, • r�: , `e„�,. r,,.24ii�o A, ,,, 4'.-. ',ilL._ . 11
N . .. .� _ r _�� , 1�u - �k. i -4sclothes 1er
NM 25.02
Qswash;r am 25.02
UN 25.02
Drinking fountain
g3ectors/sutrf NM 25'02
I .. � �;, ' ,j 4 t tank
r ,�x� r"� �'�, Expans On
;s' 1.1 fs . ," 1 �''dW Z `spi v,•si.r..,erer :z� sewer cap
{� 25.02
n vxt ..�...iGe J� ..:b ,r«„.,:,_x -,_u:�..au.� FLY 11TC1
Na_ 2502
Name:Polygon LH,LLC .----- Floor drainitloor sink/hub
Garbage disposal 25.02
Address:109(Fast Lad`Street
111111
City/State/ZIP:Vancouver,WA 98660 Hose bib
1111112g,p2
Phone (360) 45-7700 Fax ( ) lee maker 12.51
' r s r ;?„ „�l� :A wt, ws �. �R� , � "�. Entcrceptorlgrcasctrap 25.0
ry - '-i.:.----,,,.. , g .:_? � ltc-e Medieilgas
(vatle:
$ ) �,,,�,®
Business name:Points*WL1}1,1.LC Primer -
` �. r Roof drain(commercial) ��
Address:109 1sLt ! ■ Q /i Sinklbasin/iavatorY a4145� 25.02
Address:109 East 13th Street Solar Units(potable water) 11111111111311
CitylStatelZlP:Vancouver,WA 986b0 Tub/shower/shower pan
111111111311
Phare:(360)695- Fax::(360)693 4442 Urinal - 25.02
// (/' 1 • s Water closet r 25.02
E-mail: �` I�7 1 �t / ��r y may.awe 4 ��
' c A t`y ',w ja4`. r?-.r : .. Water heater
�.�� r.,_ _ MI 56.29
Other
Business name:B111;.Plumbing LlWater piping/DWV III, 25.02
.
Addts:PO Box 85 Subtotal
City/State/LIP:Corbett OR 97019 Minimum permit fee: $72.50
Fax:( ) Plan review (25%of permit fee)
phone:(503)35139(13
CCB Lie.:180345 Plumbing 1.,ic,no.:PB1582 State surcharge(12%of Imit!be)
TOTAL PERMIT FEE
sig ature: Li, i�� 'Phis permit application expires if.a permit as complete. within 180 days
fie• atter it has been accepted
as industry Service Baud.Friof Warne:Brandon Larrter `Pee methodology set by Tri-County g
�o-as I srp aovrtxtt�svre)
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City of Tigard
IIM COMMUNITY DEVELOPMENT DEPARTMENT
■
Building Permit Review — Residential
TIGARD
Building Permit #: 44 57d..0/? -00.02,O/
Site Address: 15 Sap SW i- U (Sore *re-
Project Name: Pol.� l 0, P3UI 1tC 1f r.. . Lot #: ilP
(New dwellisig=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: t CV 1 S
Verify site address/suite# exists and active in permit system.
River Terrace Neighborhood: E No '1, Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
Three(3)copies of site plan 1 J 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
1NDrawn to scale(standard architect or engineer scale) floor elevations
North arrow Nytility locations&easements(required for new and additions)
Site address,project or subdivision name and lot number L�.S�idewalk/driveway approach
Applicant information(name and phone number) ICkT ocation of wells/septic systems
SLot dimensions and building setback dimensions existing trees to be retained with drip line,and tree
(`quare footage of buildings to be demolished protection measures
'tLot area,building coverage area,percentage of coverage and N.Street tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) '.Street names
\SZProperty corner elevations (2 foot contour lines if more than 1S§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 [x'No Received: ❑ Yes ❑ No
Jb3 Public Facilities Improvement (PFI)Permit:
Required: ❑ Yes,applicant was notified No Applied For: ❑ Yes ❑ No,stop intake
a—Land Use Case#: Si„�I32O1S ce-6c>Z
Zoning: Rt-k.S
j'Required Setbacks: Front 2D Rear IS Side 5 Street Side 15 Garage 2D
Landscape Requirement: N[A %
Ai Lot Coverage Maximum: fJ 1.N_ %
Building Height: Maximum Height D Actual Height±XI
Visual Clearance f\if `_.
'� Sensitive Lands: ' ❑ Yes No Type
Urban Forestry Plan
Condition "Met"p or to issuance of building permit
Notes: t �til("A (-NO 12t. MLA- prve i Lc5LI ,U1
Approved By Planning: /'3 Date: (0I l ii
Revisions (after Building Submittal Reviewer Date
only)
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Fonns\BldgPermitRvw_RES 051617.docx
rt
Aiding Permit Submittal
Original Submittal Date: O F7/7
B
SiteuildiPlnans:gPlans: # j
#
Building Permit#: Enter building permit#above.
Workflow Routing: Planning Engineering 5- 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.
Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: AZ; i Date: (WS-7Q
Engineering Review
Slope at building pad: 11
CO onditions "Met"prior to issuance of building permit...... r e
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: E Yes No
LIDA Facility on lot: ❑ Yes No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: 44 c22 Date: 46.-��7_
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ 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: "Yes ❑ N/A
Tigard Trans SDC: 4!1'Yes ❑ N/A
Parks SDC: ee5 Yes ❑ N/A
LIDA ❑ Yes N/A
p9OK to Issue Permit
Approved by Permit Coordinator: hi/ Date: G/I//
I:\Building\Forms\BldgPermitRvw RES 051617.docx
City of Tigard
C e COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD River Terrace Building Permit Review Addendum
Building Permit #:
Site Address: 15 p sA1 --} Spn 7€-
Project Name: PoiLia7(1 G a,dt Mpnl le ta,h Lot #: 1(0
(New d ling=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 facade that has 30-60 ft. of frontage.A dditional
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 .,
Porch min. 5 ft. deep ft. deep min. 2ft., 5 ft.wide min. 2 ft.,6ft.wi.: Gabled dormer
El ❑ ❑ ❑ ❑
2. Eyes on the street: a minimum of 12%of each street facing facade must inc e windows or entrance doors.
Percentage Shown:
3. Entrances:At least one entrance must meet both of the following .ndards:
CI Max. 8 ft. setback from longest street- facing wall
CI P. el to street,angle no more than 45° from street,
or .pen onto porch
Entrance opens to a porch: ❑ Yes ❑ No
If yes,all the following apply: ❑ 25 sq.ft.min.
❑ One street facing entry ❑ 12 ft.max. roof above floor of porch
El 5 ft. depth min. ❑ 30%min.porch roof coverage
4. Detailed Design:All buildings shall includ='a min. of five of the following elements on all street-facing facades:
❑ Covered porch min. 5 ft.wide x 5 ft. de-. ❑ 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%o treet facade ❑ Window trim min. 2 1/2"wide by 5/8" deep
❑ Window recess min. 3 - hes for all street facing ❑ Bay window min. 5 ft.wide by 2 ft. deep
El Balcony min. 5 ft.wi. x 3 ft. deep with inside access ❑ Attached garage is 35%or less of street façade
5. Garages and Ca r.orts: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. El Yes ❑ No. If No (Check one):
❑ May exten. up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch.
❑ May ext,nd up to 5 ft.where the garage is part of a two-story building and there is a window at the second story
above th- garage that faces the street with a min. area of 12 sq.ft.
Width. (Check one)
❑ 1 -foot-wide garage door ❑ 40%max. of street façade
❑ 0%max. of street façade with 7 detailed design elements
Notes: r
DpesN o pp nvi ot lIeln nid oteve(opm.eAvf.
Approved By Planning: /Ow/4OCti r/l. Date: (p 1 t I t'1
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:
15306 SW HUDSON AVE, TIGARD, OR, 97224 March 28, 2018 at
10:23:51 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00201
Inspection Type: Inspector:
199 Electrical final Aaron Cillo-Gobel
Result:
PASS
Comments:
No A/C installed at this time.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15306 SW HUDSON AVE, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Master Permit MST2017-00201
Inspection Type: Inspector:
399 Plumbing final Allyson Armstrong
Result:
PASS
Comments:
Water pressure =58psi.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15306 SW HUDSON AVE, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Master Permit MST2017-00201
Inspection Type: Inspector:
699 Mechanical final Allyson Armstrong
Result:
PASS
Comments:
Gas line to bbq correction complete. Shut off operational.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15306 SW HUDSON AVE, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Master Permit MST2017-00201
Inspection Type: Inspector:
299 Final inspection Allyson Armstrong
Result:
PASS - CofO
Comments:
Collected
Air leakage test report
Moisture content acknowledgement form
High efficiency lighting form
Moisture barrier acknowledgement form
Left C of 0 on the counter
Violation Summary:
Inspector Contractor