Permit (86) CITY OF TIGARD MASTER PERMIT
. Permit#: MST2017-00422
COMMUNITY DEVELOPMENT Date Issued: 11/07/2017
Tt GAtp.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S106AD09700
Jurisdiction: Tigard
Site address: 16844 SW LEMONGRASS LN
Subdivision: RIVER TERRACE EAST Lot: 204
Project: River Terrace East, Lot 204
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 809 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1049 sf Garage: 437 sf Front: 8 Smoke No
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 1858 sf Value: $230,905.09 Rear: 0
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF RainStorm Sewer: 100
0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add]500 sf: 3 201-400 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 Y
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 1858
Owner: Contractor:
ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
BY FORSUM,MICHAEL 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175
7600 E DOUBLETREE RANCH RD VANCOUVER,WA 98660 2 Fire Rated Eave both sides
STE 1
SCOTTSDALE,AZ 85258
PHONE: 602-694-4031 PHONE: 360-695-7700
FAX:
Total Fees: $31,269.85
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 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling/ 4
503.232.1987 or 1.800.332.2344.
Issued By: `Y "',/"--17.- -.--.----7 / GPermittee Signature: 1Il -Al®ia
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 ' Z -0 PIC) V
` t1 JUN 142017
FOR OFFICE l SE ONE)
City of Tigard CITY Oh TIGARD Received / Permit S
IN13125 SW Hall Blvd.,Tigard,OR 9713I3)ILDING ION P>anReview O '� /7 / 1 `Z�
I Phone: 503.718.2439 Fax: 503.598.1960 /��I De/.y; j_ )/2 Ocher Permita`4/"�`�C/�)(/T/�Y l
Inspection Line: 503.639.4175 f \ Date Ready/By: ,,, ' Jam: H See Page 2 for
1"t C; „,I I> p Notified/Method:rr,.i Supplemental Information
Internet: www.tigard-or.gov / �� PP
(- li}ie, /11/e 47 e -
� ,�..�,Wn,��a��,�. �M�.;�� `� - ave. . „.,, . s,�� a�Wim `' .�"�,�� >�•°" �- � ���� "
®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
.:.- .,. ::°- 3° ' work Indicated o this application.
Valuatio • a.30J9 OS
® 1-and 2-family dwelling 0 Commerciallmdustrial +
❑Accessory building 0 Multi-family Number of b ooms:
❑Master builder 0 Other: Number of bathrooms: 3� � s �, ;,�.. i e� ,� a ; Total number of floors. L i96 Waaq
... ,.enw s ... _td,.. n a r..�, . .ec y5�-• ,..=r1.............,..,........-,,,...z. a.
Job site address: I to 1. 3 VJ ' t 11 y 1 IASS une.„ New dwelling area: i ' � square feet
/
City/State/ZIP:Tigard,OR 97224 Garage/carport area: 3� square feet
Suite/bldg./apt.no.: Project name: giV(r Tier raee may- Covered porch area.-irpla. square feet Iotiq
Cross street/directions to job site: «Peek ? i 6 square feet Q 0 9
p .Other structure area: square feet V
r ail- =),),,: �°' I�° :::° - �7°:m ��s-;1
Subdivision (l.I J it re,nracc,Ezt8 — Lot no.:' Ln( 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
� �I • x. g work indicated on this application.
a`m�„�.' ?,„�,., ,.. „ »tea.>,�<.F„��;»`�,.-,;u. uT,. ,u�”.�'e,�— � � � —. , , ,.. _ ,a°w �'. ..—. ry
Valuation: $
I Existing building area: square feet
New building area: square feet
,' .', a g, f:61,4,1 Number of stories:
�. ..., . �,:.. _.
Name:ADVL Land Holdings,LLC Type of construction:
Address:7600 E Doubletree Ranch Road Occupancy groups:
City/State/ZIP:Scottsdale,AZ 85258 Existing:
Phone:(602)694-4031 Fax:( ) New:
u '''' =' C.'-{� ° ��' ' ° .. tY f t,n„ ' 2' , 't Lis t,
?>..m..�.a �..,,� ` � i d �
Business name:Polygon WLH,LLC � ,,
- Structural plan review fee(or deposit):
fi
Contact name:N`*at
FLS plan review fee(if applicable):
Address:109 East 13th Street
City/State/ZIP:Vancouver WA 98660 Total fees due upon application:
Phone:(360)695-7700 I Fax::( ) Amount received:
Email N( O�* IA I I'.iN ►L� h 1 1 a1 1 is �-- -m.�,i,; -„:1,-_,-„,„!,,,,,_,,,,-,
� - i
yam4,, <- , r yqe jp . - ; - � Commercial and residential prescriptive installation of
� . 4,1a � -� � - roof-top mounted Photovoltaic Solar Panel System.
Business name:William.Lyon Homes,Inc Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 109 East 13th Street Solar Installation Specialty Code checklist.
City/State/ZIP:Vancouver WA 98660 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60
CCB lie.:207247 Total fee due upon application: $201.60
Authorized signature:7/1/1This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: i Jr Ch Uk / O�l Date:0 e •�7 4097'--- *Fee methodology set by Tri-County Building Industry
/" t7 lye//� Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) I
J
. .
Mechanical Peiiiiit Anniteattoil FOR 0 FEI('E I SE ONT.1
. ,.. ,
.dty.of-Tigard On
Ilatenr Pennit N°:14(57-elif 2-1(,)4/.2-Z-L.
Iqi--,- 13125 SW Hall:BlYft-,Tigarii,•qt 0.43., -, .. .: '". ' pian Review .. .. .. ..
Other.Partnitt
0 Moot 503,718.2439'FM 50.1,508.190,;:'.: :i .'.',' -- -' : Datair.•
;Inspection Linc..503.639417, '..-- - .. - -•. , ' Date ReadY•14: hum 21 See NO for., •
lulaniet iVsvii.tigarcf-mgov . - . . .- , - Notificamethot• . Strophannatat infernration*
. . . , „...:, .1.,,, .I.::. ..4,,,e,:i,-,:....• ...,,.fr,..Q.,,, ,..w.p.-., ,.z...4,,,-.-r-.- Wittiiiiiig)kfa.'*gtiisesitiStfikititf0.W:1 1
•.c,1,,,,I,v,,,;vz-,_*0,17,44..,i4ii3, - .g...,:f:Ivtiv,ok iirxto.i.-4.4.,;tiWk`ralgt,04,471:! ''''" -' ''.' - ''-'- - ---' ' ' -
'''':''zi:74'ff:e.5-014't"',06 .Y..:,'"':'''''Il':-'-'4r.r-""."..-'.''-'"' '''' . ' -r'-''--...''''''. ' 4•''-"'''-' '''''-- * Mechanied pertna fees*are based on the value of the work
ow onstruvtion 0 Addiannfilteratintitelliactnient- porformed.indicate the value frounded to the nearest dollar)of
El Denialitioli. 0 dtlfIc1": inoefornical materials.equipment.lahot overheadand profit. f
Value:S
!.''.t.g'-:;:iVt:NV'e:'r- :.*tlfitlkOt 0I43 ]Tilikts. :44g),Stalk007.044#4.1**AtEggC4
124
-and 24ait4 dWellfrig 0 Coitmettialtinciustrial 1:1 Xtvossoty building .-. Pot special kir/rotation use Oeckfist
.1
Multi- y. D.Mow 1,04-. 0(mier:- . Dec . Qty. 1 Ea. Total. •
'•:- ••••'.,7:'-(ap..**-4,:lx.,1;',liiiiiI0Ati4010‘1.01O*4.?0*CIPA1101i'liii.-.5-e:::;.E.,-.W.:,4);,v,1 , .. .. . •
7 1
JO s4 addir""; 1 1.0(341q C1 0.) Lerntmvvross Lo,irve Fceurna100,000 13TIRductskents) 46.73
.0034Slalcate::T.ightas.OR 0174. Furnace,100,00041.3Th 1411elsketa)
• Nes P(909 .
.-Siiitdbidg./ t.ilb,t Pritiegt iaine.:P Ater Te.Trafe _fas+ •buitwvk _ 23.3
L 61.06
ross street/directions bn JO din: ,flvdrente.hot water stIrlent 23.32
• Residential boiler(radiator or
kvdronic) — 2332 .
-
Unit heaters(firel-tyo,not oleenie),
in-wall.in-dtui.suspended:etc: 46.75
. . . . .
• Fintivent fist:aitv of thew. I 23.32 '
t.,,,..+ • • • Other: . . . 23.32.
SPbcli. 1 In:: Other fuel epistle/tees: — • - . . .
Tax tuatiptuncl ito..: . Water heater __ 23.32
-,::,;.=_;.-_:Q,'f.'.!,.;;.,z1.ffia.,.tkt.'-'.,,,,•;E:@''k:,;ir.ti,kg6tiiiiittiOlti*okief :qt-4-7. .4.•_ ::t,;..:f.2"...::.;:;:-M' - OffS erePtliteinSat. 1 3339
tffe43180C 23.32
Log tighter(gas) 2332
.•
Woodtnetlet stove 33.39
Wood fitenlaeotinstcrt 2333 .
• -
Chkrtneyilinertiktelvant 23.32. •
,
2332 ,
....; ,::•.!•-,:':.:i..40.00:0X.0O3- 40Q-1,..!;.: 1:: ......::•41.'Aiik!f$-P':.'ii--iti.. :''.e..747,'-';;‘i'-''':•7:1?"' . EttOrmnental eshaust toni ventilation:
Nang:'A-NR- equt-;61-ft 11D 4,(11 5 j L-LC-' , i .. • i Range htfodfother kitchen.ipment 1 3339
,
Mdress::.711,0 OD_ 6 r)Dud/fel-a', (2-rine-A 1.(- .. _ Clothes&vet'exhaust i Li 3339
City/Stateglf* pt7... ci ..2..svell Single-duct cxhansa(hathrooms,
toilet cempartillentS.till ilY rooms) 7 23.32 .
Phone if(fl (Pq.1-1 4.63 Fax ( ) Attlekrawlsoace fans 2332
'...!;.'"'•::''.4:: ..!i'..; 1,02.404.4..E:i*..i. J. •••PI.:4:::'•.:.;.;:::':• 44.0,t40gV;.::::::...••f . Other 23_32
dng,.
Busing luinnt '110 i i i.(1M t,1..{Of •tkONV,S I Div- SILTS fi3r orit Saw;SLO3 far each additional. .
C43111.aqt ilauli Ni rAtitle:11p t) . Furnace.etc. I
Addressr_____
WallistisnendeiSitait hcatea
City/Sate/ZIP:‘"aneowver,WA 90660 Wates.beater ,
Pbosw(360)695.7700. Fax:: 36O)693-4442 Finattlace 1 .
.. I
,7ir8,c;.,4„71:!1.1.i•1..:.1_.--41-1,13,,..m,!,::-„.,.._i.:,r,,oir.q,fr4.,p•P:.,1fr.x.::-,i'...-.ET,:!?*r-••Y•,.i-„„,l...,:•,o•,^,r1a
;".A.T.,:g: ._ i t,-'-'-.,x.•t'p.P.".dIZ,;,-',r,,;aF,,,:m7:":.?.:1-1.o',T.'''t,.---t.s1,,,_-4•
B4dl.r.6.7 ••
•
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Busntsinene:ApeAtC "
Mdrces 10004 NE 72' Av
14•1 -0t..iiti.r.*I_*Subtotal 44.4.:',,:;•,.,-1,.:.r...",•:;.:.-'
! .
Minimum penult fee(56,0,00)
atyateteiZIF.:Vascotroer,WA 94606
. Plan review(25%of penult feet
Pbone:-(360)3424109 Fax:(160)326-1769
Slte sufal409(12%of permit et)
CCB Lk.:203034 TOTAL PERMIT FEE
Thin' permit epode:Mien expires is permit is not obtained within tan
lay,saber it be bona accepted es complete.
Maks:hod signature- . Fee methodology int by Tei-tountyThildinp Indus*Sandoe'Beend
Print italiter . I Date 4, m?.tto.
i tnaintwpassaintafEc Pecattarep asoitides tan-ter:7 ti neIttnaMlnit
.. .
Electrical Permit Artplication '
, .. , FOR OFFICE USE ONLY
CI'
City of Tigard Received
Pennit VII 41.e4 ....r Ase
IIII 4 13125 SW Hall Blvd.,Tigard,OR 97223. " Dpial:RB,,,iew
1 Phone: 503.718.2439 Fax 503.598:1960 ' Date/B: Related Permit ii:
Inspection Line: 503.639.4175 . , Ready Date/By:
TIGARD Internet www.tlgard-or.gov - ' -* NotiSed/Method: IIIIIM Supplemental
Paegnetal2 trformation
--*'-•,-.L,--.7,'•-1:-.,•:?Z,--'--,:''-i.'..:--,5-`-t ,t,';'.4-77,:-4-101,5°.0:ff',4:911<:;--k- --4*,..9-i -c.-E,..F,A-14;c-'-ti.:--4.-----4.--:5g- 2,-;.. ,.:gi-S4WP,ri.%.,;:•-:z2*...44,40;4*:;,-t;
E]New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plansw/iterns checked):
0 Demolition D Other: ' 0 Service or feeder 400 amps or mons 0 Building over three shirks.
where the available fault current CJIVIerinas and boatyards.
ei.rtj,V,-;-..9-F,iWig.---:i;-9,<L,14:-Ogc:taity.,-..1-77;1:I;f4-43,7,-,y---V-41 exceeds 10,000 amps at 150 volts or 0 Floating buildings.
0 1-and 2-family dwelling 0 Commercial/hichistrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultoral
amps for ell other installations. . buildings.•
0 Multi-family -- 0 Master builder 0 Other. 0 Fire pump. 0 installation of 150 KVA or
- 0 Emergency system.
I:. ::" 74.' 'J'''-.6/11- al la.;''-i,°';11°'c.:IRL ''' ''It: :4 '' '. 0 Addition of new motor load of larger separately derived
system.
Job#: 1 Job site addressi bui-y SW LeMONsieVLS u„e 100111'or more.
(".3 Six or more residential units. occupancy.
City/State/ZIP:Tigard,OR 97224
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt#: •Project name: VeAr-- -reAtyme, Eo, - 0 Hazardous locations.
0 Service or feeder 600 amps or more. 0 S6WuPPvolYitsvnnitlgainft'ral•more than
Cross street/directions to job site:
De,cripdo. I Qty. I Each Total
New residential single-or multi-family dwelling unit.
Subdivision: 1(--- Ufr Te..rrette- .E0.3-1- I Lot#:2,43y Includes attached garage.
1,000 sq.it or less 168.54 4
Tax map/parcel#:
Ea.add'l 500 sq.R.or portion 33.92 1
'4filIK't:'-g.,----,t,%5:kt-•:•*-fe-,---,%--V4T1121: z I 41-0:ff'ZI'f41'34'70-110:a1-7-f7:1-.7714'.:';''21,?d*ViLimited energy,residential
(with above sq.R.) 75.00 2
Limited energy,multi-family
75.00 2
residential(with above sq.it)
Renewable Energy El See Page 2
-z'-;*.* :r'-'7---MVT±af-i--Y.-FP-1.i)-C*j-OI"-l-Cif'-'-•-;'i-',-?'-'b,-L'*'0,',"-,-;7-------a- i,',V'r-,TA-K.''',0k.'r”:7;'- '-'; '-'ti.'5E'---'11' Services or feeders installation,alteration,and/or relocation
Name:ADVL Land Holdings,LLC 200 amps or less 100.70 2
Address:7600 E Doubletree Ranch Road 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Scottsdale,AZ 85258 601 amps to 1,0050 amps 301.04 2
Phone:(602)694-4031 I Fax:( ) Over 1,000 amps or volts 55226 , 2
Temporary services or feeders installation,alteration,and/or
Email: -. relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. • 201 amps to 400 amps 125.08 2
Owner signature: Date: • 401 amps to 599 amps 168.54 2
Branch circuits-new,alteration,or extension,per panel
:,..fiefft,-7, ,,,.--',24'.11:,['',.'-.‘1.::?littzni.:10 *---re. .T?:::,17,..'..2';''''.1LiKIPur i?ikik-7.112V-:T.,:,,.i0, br • - •
-- - A.Fee for anch cuttuts welt
Business name:William Lyon Homes,Inc. above service or feeder fee,
7.42 2
each branch circuit
Contact name: hi i Ch Die;Th t)rpi B.Pee for branch circuits without
service or feeder fee,Brat
Address: 103 ( 111(i_oLbocui St Sii,LVt, ll) branch circuit 56.18 2
City/State/ZIP:Vancouver,WA 98660 Each adel branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(360)695-7700 • * ' Fax::(360)693-4442 tthenig,
nn*utvcitTelin or modular
67.84 2
Email:: I i 6. h 06, o 4 0 n 4 I P . Vs Reconnect only 67.84 -2,
:-*V'-'2L;!:7-*.:1;4?`-?.. -•,----:-':=LkM`,'.AM'iji-'''-' , CAP,'-:Ii*FF.$-*,.5.*-ZiP=.-- --,-1-V-T•T7r,r •-.,.::*e*'Pf.,'-'r ; Pump or irrigation circle 67.84 2
Business name:Garner Electric Washington,LLC ' Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy 0 see page 2
2
Address:1/4(.4 D•2_, \jaiktut Fsve...,‘„Ivs3 i s.k.,k;,\\*), kW) panel,alteration,or extenshm.
Each additional inspection over allowable in any of the above
City/State/ZIP:*p,t I fau,,i F; gesi 1
Additional inspection(1 hr min) 66.25/hr
Phone:(253)320-1657 1 Fax:( ) Investigation(1 br min) 90.00/hr
Industrial plant(1 hr min) • 78.18/hr
,
Email:bdaniels&wensa.com
Inspections for which no fee is
9000/hr
CCB Lie.: C1158 Electrical Lie.: 208174 Suprv.Lic.: 4496S .. '... listed %brmin
-•:ginglit47: irs
Suprv.Electrician signature,required:777a,117 Subtotal:
Print name: Joan P Albert •• Date: 4/26/2016 0 Plan Review Required(25%of permit fee):
(---, :c...______- ... State surcharge(12%of permit fee):
..,
orized signature: ___
• TOTAL PERMIT FEE:Auth
This permit application expires if a permit Is not obtained within 180
Print name: Bill Daniels Date: 4/26/2016 days after it has been accepted as complete.
..,., * Number of inspections allowed per petmit
',..3';:i,clIMPhfinglPermitslELC PennitApp_ELR BREAK Rev 06/17/2015 440-4615'IliiM/OOWWEB
k':i';'•
..
, ... . - .
Plumbing Permit Application.
12 . .
Building Fixtgre,$: 0 CT '2, 6, -
Cliyofligard
t •
Penn,twVit,STaLci/)-W.22
4, L3125 SW tia11/31vd;Tigard,Cilt Vh23. ' '' DatetBm„. .p...4..3'
i
; 1 Phone: 503.7182439' Fax103.598.1960: ' , . . '&7;5;7- Other PoonitIsto.:.
I 1 GARD
,
Inspection Line:.*503.639.4175' - -" DateRead. play:
3.1es: SI See_Pagel rot
.Internet Www.tigard-orsov NotitImithletbotb Soppioniental Information
11-#*C.1.---'114'2:**Zillgit.:"*XeiiiitirliWbf; f:tczt,',17 ,:tif.ik,• *53:41f.X:i''=",..1; , ,,...=".'-'14gtsAic*,_, TIVAN.---'"..,, ,,ra,,,,',"--------tr,,,..-----,N7ueeirtsti..;,-2.v.4,-4-;,,vr.••.1.-..,,,-,-,,1
•=tq'.-44ife.7%-EritaW-673 .?-,ftdii:A. ,,A..,t-'-,,,,, ,;,i`zW-47stg 3 -.,141;1<12?-'94.-;19.1AWAI:t -•,,, ,.....,::V5711.7;0441,4k454retrAigReRY3i1115,-itT.IW:71.ilr*d?"141'.gi:
1
0 Demolition For special information use chicktist.81 New construction.. .
Description .1 Qty. I Ea.- c Total
0 Ailditicin/alteratienheplacennent. . . 0 Other: New 1-2-famIly d*ellings cmcludes 100 ft for each utility connection)
*..'.. .,?&TIMAr'•--1-1614-ai0,,0'.--.0.55i10.655iliiiiiii'Aiiiii--.4LW4VO...ttPat SFR(1)bath 312.70
• SFR(2)bathi 437,78 S)le ard 2-ficnily dwelling 0 Conmeemial/industrial
. 1--, • SFR.(3)bath
' 1 500.32•
El Aceessery building I.J Mtilti...fatnly
Each additional bads/kitchen 25.02
0 Master builder 0.Other: . .Fut sprinkler( Sq,ft.) •
Page 2
:rob site addressi: (j)13 Led SW LeirsAorvArriss Lix_ne;• Catch basin or area drain 18.76 _
Drywell,lea*line,or bench dtsin 18.76
City/State/EP;Tigard,0107224 , Footing dmin.03o.linear it: ) Page 2
SuiteAtidgiaPt n0.; Project namiver[, rr -
Ens4 Manufactured home Utilities. 50.03
Cross set/directions to job site: Manholes 18.76
r---
Raw drain connector• ' 18.76
-:
• . Sanitary sewer(no.linear ft.:____) Fete 2
Storm sewer(no.linear ft.:____) ' Page 2
Water service(no.linear ft.: ) Page 2
Subdivisi9it 410( TOY-Otte.1E,, s.4-- f 144 n°.(1004 Fixture or Item:
Tax map/pareel no.: Backflow preventer -1 1.27 •
-..5..:7:;*-4.4-':V=A .***Vii.tieiiiiiiiiit-4.irroilie.434.'=-1?-.:'•%14:M.1. 44tV34'4Z4-'• BlkekviaterValve I 12.51
,t:‘.4.-4.,4-14:4,ta.,:-..fv,:::.i. r.-7:; .-.-....,,,,,....,-,,,,.;:--,:.:1,;..:--,,,,z....i,-',.:c.,,,r,e41,7-1.'2.tiAldlq•-';1:1-::-4,1'.1. clothes washer 25,02
Dishwasher 25.02
Drinkkg fountain 25.02
Ejectors/sump
tgreda9 AlrAila: : 4474 i 7,gM *g.:-; EXPanSiea12.51
Fixturelsewer cap 25.02
Name:MA%Land Holdings,Lik,
Floor drain/floor sink/hub 25.02
Address:1600 E Doubletree RancjiRnad•
Garbage disposal 25.02
City/State/EP:Scottsdale,AZ 85258 Hose bib. 25.02 •
' .
Phone:(602)694-031 Far(' ). Ice maker
. -
-tt4r0.4317:-.071lik-Uk;4:. :[7:.;g.. 141..IRM...:'::".44WiWaiirati:4, ilitercePi°rIgnme traP 25,02
- Idedioatgas(value:8 ) Page 2•
Business name:William Lyon Homes,be
Primer . 1231
Contact name: di ill o it Th pep&
Roof drain(commercial) 12.51
Addx‘V4' 103. groaf:1)(A)at,U) St alli-CW , Sinlobasbs/lavatory ' 25.02.• .
thy/State/EP:Vancouver,WA98660 4 Solar units(potable water) 62.54
Phone:(360)695-7700 Fax::(360)6934442 Tub/shower/shower pan 12.5.1
. 'Urinal 25.02
B41431' C1 0 . i I ' Fit ,IV . 1 ft . . .. IS
..,...,._.._..._ ,. Water closet 25.02 •
i':{,1 ,-..a.r.41-ip.-.2M42,?.:0-MtV:Stati'7,7°!r:.'•;15:A-_,T..--' -.1.LYiF;:.:45....kl.'.:2;'-k-,-t•.!i ts::'1'...'-1',!
ri.1.1•?-z:.,-,..eiol.i,.-t-tf.•:4.154._•,..,:.-o?!.;,,,,,vilv,-r-..,_=.4:. ,.........,,-.:.--. 1,...,•,,,-.1-,v,-;•1.7-y:.•-,-.-..-...--,-'..-,-:-•!,-!:,t-I,".:.:f water hater 37.52
Business nem=.t.!G4p4oAt , Water pipingOW 5629
Ahm= P .
Other 2542
City/State/EY?: 51,„ 9,94.#4 oi-e, c1'131 Subtotal. .
!tom(3b.3'Stst- 1411 Fax:101 V ye 14.1.-Ir JIA) Minimum ptumit fen: 872.50
Plan review(25%&pew&fee)
•CCB Lic.: to_ Plumbing Lic.no.ft Ott
' State surcharge(a%of permit fee)
Autbmized signature: ACrit 1-014.1.1 .... TOTAL .M1T FEE
.,.
Print nom=S÷f...ljt, Pi 1kg,44.,e_ Date:3-36-11, This pan*applicadon expires We prolific not obtained within I80:deys
Ater it Ma beets accepted u complete.
ItFra.matitodology-setby Tri-County Thultfing Jadedly SerriceBoard.
1:111olklinsifermittlithlU.Petteitem.dio
10/01/59 4404516100/02/COMVES)
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City of Tigard
III 'I COMMUNITY DEVELOPMENT DEPARTMENT
I
T1caRb Building Permit Review — Residential
e
Building Permit #: 7/7 s l 7.--09c0-2---
Site Address: 2//--f `s--k ) / _p ,,,,,,,, ra,c- 4
(2-,rl
Project Name:
1 ,e4V.2r- ��'r0C� E--- 71— Lot #: c02-71
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: ) ,c)F /0//7 xvAr Si%'a"A, J/#-7/ -ra
/Verify site address/suite# exists and active in permits tem.
NJ River Terrace Neighborhood: ❑ No M Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
Three(3)copies of site plan 0,I" 'sting structures on site
ViiAte plan must be on 8-1/2"x 11"or 11 x 17"paper ►Y Footprint of new structure(including decks)with finished
U9Orawn to scale(standard architect or engineer scale) oor elevations
orth arrow KJ .tility locations&easements(required for new and additions)
VJite address,project or subdivision name and lot number 11�'idewalk/driveway approach
pplicant information(name and phone number) H' •cation of wells/septic systems
ot dimensions and building setback dimensions Okixisting trees to be retained with drip line,and tree
; a uare footage of buildings to be demolished protection measures
L'Lot area,building coverage area,percentage of coverage and ' l treet tree size,type and location
pervious area(applicable if R-7,R-12,R-25&R-40) ®Street names
Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? LI Yes ❑► o
4 foot differential) If es,is a storm water quality facility shown? ❑Yes 11 No
il! Clean Water Services—Service Provider Lett (lot platted prior to 9/10/1995): 4 crizv9 t&) SW' u
/Required: ❑ Yes,applicant was notified No Received: E Yes El No
Public Facilitiyz Improvement(PFI) Permit: Pi-/ .Cil te
/Required: RJ -� ���
Yes,applicant was,��notified ❑ No Applied For: Yes ❑ No,stop intake j
V/Land Use Case#: /. .bP_ �.O/(e - '( 2d 1/ -06C-027Z) 71)e_QOil 'l �`C
,,_('Zoning: OC—.2 S )1)
o Required Setbacks: Front o 01 Rear 0 Side , Street Side \1 Garage 3
VLandscape Requirement: Q� ,/
Lot Coverage Maximum: X1(50/0
VABuilding Height: Maximum Height Oft Actual Height l`,
no Visual Clearance C
Oil e•ensitive Lands: 111Yes INo Type
Yl Urban Forestry Plan
❑ Conditions "Met"/�'rior to issuance o building permit
Notes: ��i7�f%7l7i)it-4 -,,c' 1 hle )11,7 f e)1 i, - 1SS'/. ?C,Q
Approved By Planning: ,�,, Date: /D Ce 1
Revisions (after Building Submittal only) Reviewer Date
Revision 1: (r Approved ❑ Not Approved A/1 .01,,,, VN.....=�. I I/ Ili 1
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw REs 061417.docx
,
Building Permit Submittal
Original Submittal Date: .ill
Site Plans: #
Building Plans: #
Building Permit#: p'Enter building permit#above.
Workflow Routing: Planning Engineering g Permit Coordinator Building
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: Y" Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
;%i;"Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes:
�
By Permit Technician: �4. moi;:i Date: / 0//7
6
//l
Engineering Review2/0 6
Slope at building pad:
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
p. Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes 7 No
Assess Water Quantity Fee in-lieu: ❑ Yes 0/No
LIDA Facility on lot: ❑ Yes j;i/No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: tk`i G..' • Date: /07,19l/7
Revisions (after Building Submittal only) Reviewerate
/
Revision 1: ,Approved ❑ Not Approved A. I k iv, � t 1/ t / 7
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: /o75/ I 4'
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 CI N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: Yes ❑ N/A
LIDA ❑ Yes /iri>N/A
OK to Issue Permit
Approved by Permit Coordinator: Alallt0 A (,, Date: II\1 (1
I:\Building\Forms\BldgPermitRvw_RES_061417.docx
City of Tigard
lign COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD River Terrace Building Permit Review Addendum
Building Permit #:
Site Address: /( h/ Rio 2_ ,e,27,,„_,, ,
-e___
Project Name: Etmr- �- g,cc 5n 2}- .J Lot #: ('
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan Dist . t Design Standards (18.660.070.1.):
Is the project subject to the plan district design standards?Vgi Yes ❑ No
1.Articulation: a minimum of 1 element per each street-facing facade that has 30-60 ft. of frontage.An additional
element required for lots with over 60 ft. of street frontage shall be provided every 30 ft.
Porch min. ft. deepBalcony w/ access 2 Window Projection Vertical Wall Offset a
ft. deep min. 2ft., 5 ft.wide min. 2 ft., 6ft.wide Gabled dormer
❑ ❑ ❑ ❑
2. Eyes on the street: a minimum of 2%f e ch street facing facade must include windows or entrance doors.
Percentage Shown:
3. ntrances:At least one entrance must meet both of the foll 'ng standards:
Max. 8 ft. setback from ion st street- facing wall Parallel to street,angle no more than 45° from street,
or open onto porch
Ij(2"Entrance opens to a porch: Yes
CI
If es,all the following apply:
5 f min.
ne street facing entry ) 2 ft.max.roof above floor of porch
5 ft. depth min. 30%min.porch roof coverage
I4. etailed Design:All buildings shall include a min. of five o 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 ❑ oof offset min. of 2 ft.
❑ Roof shingles either tile or wood Gable,hip or gambrel roof design
❑ Roof pitch oriented south min. 500 sq. ft. ❑ Horizontal lap siding min. 3-7 inches wide
❑ Accent siding min. 40%of street facade ❑ Window trim min. 2 1/2"wide by 5/8"deep
❑ Window recess min. 3 inches for all street facing ❑ Bay window min. 5 ft.wide by 2 ft. deep
❑ Balcony min. 5 ft.wide x 3 ft. deep with inside access ❑ Attached garage is 35%or less of street facade
. - . a:es and Carports: May face the front or side okline on a corner lot.
Setbacks: ��Xl
No closer to front or side o an longest street-facing wall. ❑ Yes ❑ ► :. f No (Check one):
❑ May extend up to 5 ft.if there is a covere. ..t .orch and .. • .oes not extend beyond the front porch.
❑ May extend up to 5 ft.where the garage is part o "o- .3- .uilding and there is a window at the second story
above the garage that faces the street wit. . n. area of 12 sq.ft.
Width: (Check one)
❑ 12-foot- '._ •.rage door ❑ 40%max. of street facade
■ _:'o max. of street facade with 7 detailed desi. elements
Notes:
Approved By Planning: ______ --- ��� Date: C cQ ,
I:\Building\Forms\B1dgPermitRvw_RES_RT_062216.docx
FOR OFFICE USE ONLY–SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
=.
Transmittal Letter
etter
T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Tom H. DAT ,�IV
DEPT: BUILDING DIVISION
EWED
NOV 1 2017
FROM: _N f rInDVe.,Tvof e. alar OF TtCiat D
BUILDING DIVISION
COMPANY: Polygon Northwest
PHONE: X100– C\� j L- -�� B
RE: —t\IV Te rode =p�S� \-1-'O ot-}�--
(?rte A dress) (Permit Number)
'rotect name or sue•ivision name ane of um•er
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
0 Additional set(s) of plans. 3 Revisions: Plot plan and Bulletin
0 Cross section(s) and details. 0 Wall bracing and/or lateral analysis.
0 Floor/roof framing. 0 Basement and retaining walls.
0 Beam calculations. 0 Engineer's calculations.
0 Other(explain):
REMARKS: ' - _ , ..-' •,. • -- • . IL/or /CS-ee
We have provided 3 Plot plans and 3 Bulletins stating that we bumping the fireplace in to be able to vent t
the outside
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: ) ) ) — � 7 Initials: '�"
Fees Due: El Yes JJ No Fee Description: Amount Dut:
Special
Instructions:
Reprint Permit(per PE): ❑ Yes No ❑ Done
Applicant Notified: Date: Initials:
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
FOR OFFICE USE ONLY-SITE ADDRESS:
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16844 SW LEMONGRASS LN, BEAVERTON, April 4, 2018 at 9:17:11 AM
OR, 97007
Record Type: Record ID:
Residential - Master Permit MST2017-00422
Inspection Type: Inspector:
299 Final inspection Aaron Cillo-Gobel
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