Permit (196) CITY OF TIGARD BUILDING PERMIT
31
COMMUNITY DEVELOPMENT Permit#: BUP2017-00153
T t GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/13/2017
Parcel: 2S 108C 600200
Jurisdiction: Tigard
Site address: 15149 SW 161ST AVE
Project: River Terrace Park Subdivision: None Lot: None
Project Description: Demo(1)3,516 sf dwelling on septic and(1)2,349 sf accessory structure and(1) 105 sf accessory structure.
UPON FINAL INSPECTION,DEMO CREDITS FOR SDC FEES MAY APPLY.
Contractor: NORTHWEST EARTHMOVERS INC Owner: STANLEY,JEAN A TRUST
PO BOX 1609 BY STANLEY, JEAN A GAVIN D CO-TRS
SHERWOOD, OR 97140 15025 SW 161ST AVE
TIGARD, OR 97224
PHONE: 503-625-3100 PHONE:
FAX: 503-625-3108
Specifics: FEES
Description Date Amount
Type of Use: SF
Class of Work: DEM Type of Const: Permit Fee-Additions,Alterations, 07/13/2017 $464.97
Demolition
Occupancy Grp: Occupancy Load: Info Process/Archiving-Sm$0.50(up to 07/13/2017 $0.50
Dwelling Units: 1 11x17)
Stories: Height: ft Erosion Control w/Development 07/13/2017 $107.60
Bedrooms: Bathrooms:
Value: $25,350
Floor Areas:
Total Area:
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $573.07
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking:
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.
Issued By: /4/- ; Permittee Signature:
�O/
i/POZZ
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. _7
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.
1 Building Permit Application
Rved y — Permit No.:,6‘00....-.2-e/ �lS'S
City of Tigard 1 s� � ate/By: �,��//7 �wd�' 7C/
'• 13125 S W Fall Blvd.,Tigard,OR 97223 i U N a' 0 17 DeceiPlan Review Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 Date/By:
Inspection Line: 503.639.4175 C 1'f�i F . a G ARD Date Ready/By: Anis H See Page 2 for
t 7 G:a A D Supplemental Information
Internet: www.tigard-or.gov Nottfied/Method:
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Permit fees*are based on the value of the work performed.
0 New construction ®Demolition Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
. "' '� , r; k ...,� work indicated on this application.
, .-� '...h-r ..,#. `�F,,..%..441,,,,,,.„,.J.4_, ®,,::.„,114.„:::„:40..-2.i....:;,-,6 :'`" 7 xr--N). ,4*.i i" 1..-4 `�X X35
Valuation: $ �J
® 1-and 2-family dwelling 0 Commercial/industrial 1
Number of bedrooms:
❑Accessory building 0 Multi-family
❑Master builder 0 Other:
Number of bathrooms:
�,.. `'' r`" itd. "r,,u.' Total number of floors:
' a €�:''..?-•- 4$�F•.,-,- .ci aE6 � ,_,,v r a:-*,.---2=,=::'. ; ;-TM
Job site address:15149 SW 161"Avenue New dwelling area: square feet
City/State/ZIP:Tigard,Oregon,97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:River Terrace Park Covered porch area: square feet
Cross street/directions to job site:West of SW 16151 Ave and SW Finis Lane, Deck area: square feet
Other structure area: square feet
r 4,.,rr Vit_. T yam:' .�.s�fin"4 W"+xw,-gtgF:d ���'.
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.:2S1080003000 equipment,materials,labor,overhead,and the profit for the
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'
+ 41-tI ' acF� q.Ci .V' k73r '',,4SVV7N- 41.. work indicated on tis$ hcation
Valuation: $
Demoilisb existing structures and driveway
Existing building area: square feet
New building area: square feet
r i 9 @ fr L i C. �i i' `S—W 'r 'x ,,.r ", - i x:---5 ?.ry Number of stories:
Name:Polygon W1..H LLC Type of construction:
Address:109 E.13'h Street Occupancy groups:
City/State/ZIP:Vancouver,Washington 98660 Existing:
Phone:(360)695-7700. Fax:(360)693-4442
., ..sNew:
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Business name:Polygon WLH LLC. Structural plan review fee(or deposit):
Contact name:Angela Grajewski
FLS plan review fee(if applicable):
Address:109 E.13th Street
Total fees due upon application:
City/State/ZIP:Vancouver,Washington,98660
Amount received:
Phone:(503)695-7700 I Fax::(360)693-4442 t4 �� 4
b'fg;'&1:i 6'"1':, t=e a Vria,,i•G i ,;,r G Fk, C�ie4 '
E-mail angela.grajewski@polygonhomes.com "~
g t .., �. , . ..,f s : Commercial and residential prescriptive installation of
4,,l -� ' jot-4 1 Z 4s ,1y ., .,; T4s 7s roof-top mounted PhotoVoltaic Solar Panel System.
Business name: iftmF(„., l Ode Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: /'A4$;,00 (f(jl � /NOM Solar Installation • cial Code checklist.
City/State/ZIP: m /y [ Permit Fee(includes plan review $180.00
Y s ,fr(/(,a t J� �f 717 o and administrative fees):
Phone:(50 ) co as .- 3(0 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: (aa (p 1 - Total fee due upon application: $201.60
Authorized si store: This permit application expires if a permit is not obtained
y ) { within 180 days after it has been accepted as complete.
z Fee methodology set by Tri-County Building Industry
Print name: jf ,A,/ / ., _ Date: to fig' I Service Board.
1:\Building\Permits\BUP ' SPermitApp..•o 02/24/2011 440-4613T(11/02/COM/WEB)
V. 4-Z). t, ' 7
Albert Shields
From: Albert Shields
Sent: Monday,June 19, 2017 2:53 PM
To: Angela Grajewski (Angela.Grajewski@polygonhomes.com)
Cc: Monica Bilodeau
Subject: River Terrace Park demo, BUP2017-00153
Angela, in reviewing the application for a demo permit for River Terrace Park, BUP2017-00153, we noted that we do not
have on record an arborist's certification that required tree protection is in place. Accordingly, I will code this
application "Approved but Not Released." Plan review will continue but he permit will be held until we receive an
arborist's report.
Albert Shields
- 1
City of Tigard
IIIe COMMUNITY DEVELOPMENT DEPARTMENT
II
TIGARD Building Permit Review — Residential
o
Building Permit #: 4Gt'i°�C7/7_--ek,/_3
Site Address: k 514q 5w I 6 1 5T PATE
Project Name: Q.iN'er Te N'ct C. Pik Lot #: N pi.
(New dwelling=subdivision name; ddition or Alteration=last name of owner)
Planning Review n
.
Proposal: B Q c 1$ �rtc , .`�,k i1 is 2 q cCe$ (o1� cJ- QQ
M Verify site address/suite# exists andactivein permit ystem.
lig River Terrace Neighborhood: ❑ Noig Yes,
Site/Plan Elements:
NoAre,,S�
e(3)copies of site plan 1-. o 1 , } -xisting structures on site
11``ite plan must be on 8-1/2"x 11"or 11 x 17"paper 14botprint of new structure(including decks)with finished
U, 6rawn to scale(standard architect or engineer scale) floor elevations
r'J orth arrow CJ . .ty locations&easements(required for new and additions)
R Site address,project or subdivision name and lot number r Sidewalk/driveway approach
`'Applicant information(name and phone number) lt` 'cation of wells/septic systems
l`� /Lot dimensions and building setback dimensions 1P xisting trees to be retained with drip line,and tree
NJSquare footage of buildings to be demolished protection measures
tittkat area,building coverage area,percentage of coverage and I1 a reet tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) Ci Street names
Property corner elevations (2 foot contour lines if more than Storm 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 II No Received: ❑ Yes ❑ No
Public Facilities Improvement (PFI) Permit: /
� Required: CI Yes,applicant was notified CI No Applied For: /Yes CI No,stop intake
L`�1` Land Use Case#: R1 00W
g t(Q -OOU12
—1Zoning: � O�)
Required Setbacks:2
Front Rear Side Street Side Garage
Landscape Requirement:
0/0
g Lot Coverage Maximum:
14 Building Height: Maximum Height Actual Height
N,/Visual Clearance
LI Sensitive Lands: "Yes ❑ No Type 5 ivirVA tct 0 A- lig4j, -q-.
aUrban Forestry Plan
Conditions "Met"prior to issuance of building permit
otes: iv*e.42-Qri er-A,o►, 2 S-2-CIWh-exg- eovlA-rrt vkkois1iv€ c.ovic 0 �e, \ Ori)Cillet/
pno'( Aci 6Ve1410
Approved By Planning: %/Agdeep4a.,.., Date:
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
Building Permit Submittal
Original Submittal Date: /' 2,//7
Site Plans: # ,a
Building Plans: # A///9
-
Building Permit#: ,E Enter building permit#above.
Workflow Routing: )) Planning $ Engineering Permit Coordinator ❑ Building
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: p 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:
Z , , 2
By Permit Technician: rxc Date: 6/��2
Engineering Review
Slope at building pad:
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 No
❑ NOT Approved by Engineering: Date:
Notes:
i
Approved by Engineering: �� Date: G//0'
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
pproved,NOT Released:�� G'` � `K /%rif Date: C// 'J'1'7—
otes:
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: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
LIDA ❑ Yes ❑ N/A
kiri K to Issue Permit
Approved by Permit Coordinator: i Date: ,?"-///1) -
I:\Building\Fonns\BldgPennitRvw_RES_051617.docx
L
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15149 SW 161ST AVE, TIGARD, OR, 97224 December 27, 2018 at
12:07:46 PM
Record Type: Record ID:
Residential - Building BUP2017-00153
Inspection Type: Inspector:
299 Final inspection Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor