Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Permit (107)
City of Tigard s COMMUNITY DEVELOPMENT DEPARTMENT = � Request for Permit Action TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • www.tigard-or.gov TO: CITY OF TIGARD Building Division 13125 SW Hall Blvd.,Tigard, OR 97223 Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPerrnits@tigard-or.gov FROM: ❑ Owner ❑ Applicant ❑ Contractor ❑ City Staff Check ✓ one REFUND OR Name: INVOICE TO: (Business or Individual) a)/L G/,q"/ /7:,,,,,,/ , /� / �'"7E-j /�� Mailing Address: 7& /�/2..t,'141' //'9 y S7 f _E- �/o City/State/Zip: �in/C t c 67& AJ,l ���o 6 c i Phone No.: -2/p Q - 6 �/,S- 7'7� PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): • A =--_ VOID PERMIT APPLICATION. o`r REFUND :ERMIT FEES (attach copy of original receipt and provide explanation below). 1111 1 v• CE FOR FEES DUE (attach case fee schedule and provide explanation below). ❑ REMOVE/REPLACE CONTRACTOR ON PERMIT(do not cancel permit). Permit#: /ijS f�/7 —01,?6 6 Site Address or Parcel#: 1�%°7 S� ,2/�0i C y 1-4 Project Name: /E'// 7& - 49e1C- S/ Subdivision Name: Lot#: y�. EXPLANATION: /�EM a V 2- �'.` �6-� _ Signature: _ Date: /�/�407 Print Name: _ tiNq Refund Policy I. The city's Community Development Director,Building Official or City Engineer may authorize the refund of: • Any fee which was erroneously paid or collected. • Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended. • Not more than 80%of the application or permit fee for issued permits prior to any inspection requests. 2. All refunds will be returned to the original payer in the form of a check via US postal service. 3. Please allow 3-4 weeks for processing refund requests. Route to Sys Admin: Date By Route to Records: Date Refund Processed: Date �' /� By — /Z�2��7 B Invoice Processed: Date By Permit Canceled: Date /(/1,4— By4 Parcel Tag Added: Date I:\Building\Forms\RegPermitAction_0 2314.doc By q TIGARD January 18, 2018 City of Tigard Polygon WLH,LLC Attn: Angela Grajewski 703 Broadway St, Suite 510 Vancouver,WA 98660 Re:Permit No. MST2017-00266 Dear Applicant: The City of Tigard has processed a refund for fees on the above referencedermit follows: p (s) as Site Address: 16904 SW Friendly Ln Project Name: River Terrace East,Lot 45 Job No.: N/A Refund: ® Check#227200 in the amount of$26.12. ❑ Credit card "return"receipt in the amount of$ Note: Please allow 2-5 days for this refund transaction to be 0 credited to your account by the company that issued your card. Trust account"deposit"receipt in the amount of$ Comments: Per applicant's request to remove 2°d water heater from permit. If you have any questions please contact me at 503.718.2430. Sincerely, Dianna Howse Building Division Services Supervisor Enc. 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171 TTY Relay: 503.684.2772 • www.tigard-or.gov IliIll City of Tigard TIGARD Accela Refund Request This form is used for refund requests of land use, development engineeringand b application fees. Receipts, documentation and the Request forPermitAction form if applicable) be attached to this re uest form, ��g permit q Refund requests are due to Accela System Admnistrato by t each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing' of refunds. Accounts Payable will route refund checks to Accela System Administrator for distribution to PAYABLE TO: pol on applicant. Yg WLH,LLC DATE: 703 Broadway St,Suite 510 12/28/2017 Vancouver, WA 98660 REQUESTED BY: Dianna Howse TRANSACTION INFORMATION: Receipt#: 413625 Date: 10/31/2017 Case#: MST2017-00266 Dy Method: 10/3k Address/Parcel: 16904 SW Friendly Ln PaProject Name: River Terrace East,Lot 45 EXPLANATION Per applicant's request to remove 92ndwater heater frompermit. 4.. Wsin�' Pt� B �i� ° 3 2 3 "' yfy` '"'a " � y°SrF i-;,..,' ., _ e .c � v �°,;,$e e s l;i'", 'r 's.- a ' , �aE`4 x 6 �, � �tzi,-, w � _.. 12%State Surchar• 230-0000-43102 Ellim illi 100-000024001 2.80 1111.111111.11111.11.......... M1 LI1101111111111111111........ 1 111111111111.1111111111111111111111111111 1111111111111111111111......... APPROVALS; TOTAL REFUND: $26.12 If under SIG 1.,,,_4, RES DATE: $5,000Professional Staff If under$12,500 Division Managert��� If under$25,500 Department Manager If under$50,000 City Manager If over$50,000 Local Contract Review Board f : , 1,,,FQIt.TIDE ' =SYSTEM ADMINISTRATION USE ONLY Case Refund Processed: Date: 111111111I© B : r+-� I.\Building\Refunds\RefundRequest.doc x 09/01/2010 TY OF TIGARD 111 13125CISW Hall Blvd.,Tigard OR 97223 RECEIPT 503.639.4171 TIGAIM Project Name: River Terrace East, Lot 45 Site Address: 16904 SW FRIENDLY LN AF—fix.A4,6 Receipt Number: 416589 - 04/06/2018 CASE NO FEE DESCRIPTION MST2017-00266 REVENUE ACCOUNT NUMBER PAID $-26.12 Total: $-26.12 PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID Check 227200 CASH RECEIPT DATE RECEIPT AMT Payor: Polygon WLH, LLC DROWSE 04/06/2018 $-26.12 Total Payments: $-26.12 Balance Due: $26.12 Page 1 of 1 CITY OF TIGARD IN S' 13125 SW Hall Blvd.,Tigard OR 97223 RECEIPT 503.639.4171 TIGARD Project Name: River Terrace East, Lot 45 Site Address: 16904 SW FRIENDLY LN Receipt Number: 413625 - 10/31/2017 NO. FEE DESCRIPTION CASE7-00266 REVENUE ACCOUNT NUMBER Building Permit-New Construction PAID MST2017-00266 Plan Review 230-0000-43104 MST2017-00266 12% 230-0000-43106 $1.952.54 State Surcharge-Building $751.34 MST2017-00266 Wash Co Trans Dev Tax-SF Detached 105-0000-24001 MST2017-00266 405-0000-43320 $236.70 Tigard Trans SDC Improvement-SF $8,278.00 Detached 415-000043300 $5,488.00 MST2017-00266 Tigard Trans SDC Reimbursement-SF Detached 415-000043301 $317.00 MST2017-00266 Tigard Trans SDC River Terrace-SF Detached 415-0000-43302 $2,684.00 MST2017-00266 Parks SDC Improvement-SF Dwelling (detached/attached) 425-0000-43300 $4,356.00 MST2017-00266 Parks SDC Reimbursement-SF Dwelling(detached/attached) 425-000043301 $1,207.00 MST2017-00266 Parks SDC River Terrace-SF Dwelling (detached/attached) 425-0000-43302 $2,003.00 MST2017-00266 Plan Review MST2017-00266 DC Provision Review,SF-Ping 230-0000-431 MST2017-00266 100-0000.43112 $530.81 Info Process/Archiving-Lg$2.00(over $90.00 11x17) 230-000043135 $36.00 MST2017-00266 Info Process/Archiving-Sm$0.50(up to 11x17) 230-000043135 MST2017-00266 Metro Const. Excise Tax $60.50 MST2017-00266 Beaverton School CET-Residential 230-0000-24101 MST2017-00266 230-0000-24101 $419.89 Permit Fee-Elect(per dwelling unit) $3,584.224 MST2017-00266 Limited Energy 220-000043103 MST2017-00266 12% 220-000043103 $$35.10 State Surcharge-Electrical $75.00 MST2017-00266 Air Conditioning 100-0000-24001 MST2017-00266 230-000043102 $46.75 Furnaces<100K BTU $46.75 MST2017-00266 Water Heater 230-0000-43102 MST2017-00266 230-000043102 $46.75 MST2017-00266 Gas Fireplaceyy op $43 Range Hood/Other Kitchen 230-0000431023102 $3$33.399 MST2017-00266 Clothes Dryer Exhaust 230-0000-43102 MST2017-00266 230-000043102 Single Duct Exhaust(Bathrooms, Toilet, $116.60. 9 MST2017-00266 Utility Rooms) 230-0000 43102 Fuel Piping MST2017-00266 12%State Surcharge-Mechanical 200-0000-24102 MST2017-00266 100-0000-24001 $14.15 MST2017-00266 SFR-Baths $44.532 Laundry Tray 230-0000431013101 MST2017-00266 12% 230-0000-43101 $500.32 State Surcharge-Plumbing $25.02 100-0000-24001 $63.04 Total: $33,481.69 /A2 • o , s ,x. CF) kip- i ns / ,�.�� Gcov& /°4 - Vic, Page 1 of 2 Plumbing Permit ADDlicalicCEIVED Building Fixtures NOV 2 2 2017 City of Tigard I tlu ul l lc r 1 ,,I ()Nl ‘ ,� 13!25 SW Hall Blvd.,Tigard, CITY'OF TIGARD to �' I Phone: 503.718.2439 Fax: �G DIVISION Plan Review S �„ PumitNo. ��di' � �r ,„t 1 Inspection Line: 503.639.4175 Duda: ther Pathic ' Internet �V W W.tlgard.or gOV DateReady/By: ::YMr �'y' "' n .-T EiQR,}yOgH.;<., NotiBedimetbod: fill :Is", PPase2for ®NewcornhucfiOnY ,„...-_.- ..-..-..„...,.::...,.::.;-,:i„.:,..;..,, ., :tea �tallafor,,,gg . QDemoliGon :.:�•..; .;:�• � ayCHED ..<-::� : _:"_a.:�;x• s;: �-==.iso: ❑Addition/al For ! ornwdoa use ckautllsC Addition/alteration/replacement ❑Other. Descri.tion • New 1-2-famil dwells,,; 0f� Total :.i;:;..-.1.; .- . ” -CATEGORY OF CONSTRICTION'. includes 100 8 foreach 2.7' cwrulecdon ®I-and 2 family dwelling SFR(1)bath 111111 312.70 0 COmmaciaUmdustrial SFR(2)bath ❑Accessory cces ry building 0 Multi-family SFR(3)bath 5�2 Master��� Each additional bath/kitt hen _ • ❑Other: 25.02 — .: ' .i -. , .-: ':• "JOB-SITE INFORMATION AND-LOCATION ®— Job site address: Site utYitiq: ■I ,t m a Catch basal or area drain _��— Jity/St addre:Tigard,OR 97224 Drywall,h leach ' or line, trench drain Emma Suite/bldg./apt./apt no.: Project name:'/ Footing drain(no.linear$.:_) Cross11111111111 street/directions to job site: `` Eas•• Manufactured home utilities _®_ 11=3111111111.111.1 KM Rain drain connector 1111103111111111_ Sanitary mer(no.linear R:,___) _ — Storm SCIVOT(no.linear 8:�) MINN VII S Lot no.: Fixture or Subdivision: Tax map/pamcel no.: item: Baddima DFSCRIPTION OF WO121. Backwater valve —t lothes washer _ �• i ./U W ' 25.02 ^ Dishwasher r„ I !4 Drinking — Drinking toumttain 2raggri Y 25.0211111111. l 0 PROPERTY OWNER Ejection/sump 111111 25.p2 — . 17 !Elwin • Name:ADVL Land Holdings,LLC _®— Address:7600E Doubletree Ranch Road 25.02 Floor drain/Boor shdc/hub 25.02 — elZlP:Scottsdale,AZ 85258 .11 25.02 City/Stat _ Phone:(602)694-0031 Hone bib MN 25.02 - ice maker 111111111111131:1111111111111 . . ._ ••:-. ®.ArP>.�cAtaT .-. 0 CONTACT PERSON. Business name William Lyon Homes,lac �8 setrap NM 25.02 NM mune: I/Cll i..- � =®_ Contact EI 112=1111111111211 City/Stale/ZIP:Vancouver,WA ': i 1111111111 < Sink/basin/lavatory v25.02 — Phone:(360)695.7700 Solar units(potable water) _ Fax::(360)693-4442 _U_ EIIMMIM �/ I/, il - � / rs !/ Urinal ' s ser __ 25.02 — Business name:Malmedal Enterprises[ere 25.02 — 11213111111.111 I Address:POBo=207 Waterpiping/DWV -_®- AddrCity/State/ZIP:Banka,OR 97106 �� MI 25.02 1111111111 f Phone:(503)324-0759 Fax:(503)324-OSSA M CCB Lie.:102535 own permit fee: $72.50 11111111Plumbing lac.no.:34-276113Plan review (25%of permit fee) 1 Authorized signature: State surcharge(12%ofpeen fee) dilli Print name:Carolina Malmedal TOTAL PERMIT FEE — Date:0425/2016 T permit application expires Ha permit h aobtained within ISO days s aver it m has been accepted as complete. I11uadiniTennilaWP1.MU-hnaltApp•doe 10/01/09 Fee methodologyset by Tri-County Building L spy ServiceBoard. 410-4616V1W02 OM/WEB) II . ., CITY OF TIGARD � MASTER PERMIT COMMUNITY DEVELOPMENT /y 7 Permit#: MST2017 00266 /' Date Issued: 11/03/2017 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S106DA04500 Jurisdiction: Tigard Site address: 16904 SW FRIENDLY LN Subdivision: RIVER TERRACE EAST Lot: 45 Project: River Terrace East, Lot 45 Project Description: New SF. 12/5/2017: REPRINT permit to remove 2nd water heater. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1248 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 30 Bathrooms: 3 Second: 1666 sf Garage: 464 sf Front: 12 Smoke Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes Total: 2914 sf Value: $349,907.86 Rear: 10 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 Rain0 Storm Sewer: 100 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: 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 addl 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 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 2914 Owner: Contractor: ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions) BY FORSUM,MICHAEL 703 BROADWAY STREET,SUITE 510 7600 E DOUBLETREE RANCH RD VANCOUVER,WA 98660 STE 1 SCOTTSDALE,AZ 85258 PHONE: 602-694-4031 PHONE: 360-695-7700 FAX: Total Fees: $33,481.69 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 throu , R 2-001-0090. 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: w "o Permittee Signature: Ai �'l�-'��, 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. D Plumbing Permit Applicatiio>G`'"EI y E Building Fixtures NOV 2 2 2017 City of Tigard CITY OF fIGARD Detei y: /' ./ * /2-6494 Permit No.:A11 1/2-de 66 a 13125one: 503.71824S50 Hall B4399 Fax:Tigard, *y 111 11 Phone: tra\IG DIVISION Plan eyvewDate/BOther PermitNo.: 1 1< A i t n Inspection Line: 503.639.4175 Date Ready/By curia: 0 See Page 2 for Internet www.tigard-or.gov Notified/Method: Supplemental Information ;. ';:::.:,, ,.::1-,.:.,...::...,:.,,.._:::,'::,.:,::.... ....... .. .. ,..... ..a.:.. __ • - _ Lt,.u:..-:; u ? TY,PE-{;'lT:WORIE•, - ` � . :FEE*SC!#ED[JI3�<' ®New construction ' 0 Demolition For spedal information use checklist Description I Qty. I Ea. I Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) .CATEGORY'OF CONSTRUCTION'• .' . . SFR(1)bath 312.70 ®I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory buildingSFR(3)bath 500.32 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler(__sq.ft.) Page 2 2OB_S1TE INFORMATION°AND LOCATION 1 - Site utilities: V C/to y Sw lt 1,� Catch basin drain 18.76 Job site address: e„taiDrywell,leachch line,or trench drain 18.76 City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.:_J Page 2 Suite/bldg./apt.no.: I Project name:!Ili &4f- TeXYate 601-- Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft:_) Page 2 Subdivision: !"-v"ir{NroC. Fe„s+- Lot no.:Li ) Fixture or item: Tax map/pareel no.: Backflow preventer 31.27 DESCRIPTION OF.WORK: : : - Backwater valve 12.51 • Clothes washer 25.02 P�^� 'r heater-DFf �'I�JJr`� / ��fiL J permit we Dishwasher 25.02 (/1/1/I Anil 13 134 IkSt ng 1 • Drinking fountain 25.02 M citing DbflA0 Ejectors/sump 25.02 ®.PROPERTY OWNER - . I. 171 TENANT Expansion tank 12.51 Name:ADVL Land Holdings,LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:7600 E Doubletree Ranch Road Garbage disposal 25.02 City/State/ZIP:Scottsdale,AZ 85258 Hose bib 25.02 Phone:(602)694-4031 Fax:( ) Ice maker 12.51 0 CONTACT PERSON. Interceptor/grease trap 25.02 Business name:William Lyon Homes,Inc Medical gas(value:$-) Page 2 Primer 12.51 Contact name: Afle.h _ (), 9e- Roof drain(commercial) 12.51 �r Address' / i 4 t 4- . _ i ., i 10 Sink/basin/lavatory 25.02 x i City/State/ZIP:Vancouver,WA 986•I Solar units(potable water) 62.54 Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51 Email:A/Iehole-Thor jiy02,11halltr.r.W t ' urinal 25.02 Water closet 25.02 , Water heater 37.52 Business name:Malmedal Enterprises Inc. Water piping/DWV 56.29 Address:PO Box 207 Other. 25.02 City/State/ZIP:Banks,OR 97106 Subtotal Phone:(503)324-0759 Fax:(503-)324-0580 Minimum permit fee: $72.50 ' CCB Lic.:102535 Plumbing Lic.no.:34-2767B Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: C.,....- l- TOTAL PERMIT FEE I Print name:Carolina Malmedal I Date:04/25/2016 This permit application expires if s permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building industry Service Board. 1:1Bwldn Permits U-?umitApp.doe 10/01/09 440-4616T(10/02/COM/WEB) CITY OF TIGARD MASTER PERMIT ° COMMUNITY DEVELOPMENTIII Permit#: MST2017-00266 Date Issued: 11/03/2017 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S106DA04500 Jurisdiction: Tigard Site address: 16904 SW FRIENDLY LN Subdivision: RIVER TERRACE EAST Lot: 45 Project: River Terrace East, Lot 45 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1248 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 30 Bathrooms: 3 Second: 1666 sf Garage: 464 sf Front: 12 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Total: 2914 sf Value: $349,907.86 Rear: 10 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 0 Drains: Storm Sewer: 100 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 2 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'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 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 2914 Owner: Contractor: ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions) BY FORSUM,MICHAEL 703 BROADWAY STREET,SUITE 510 7600 E DOUBLETREE RANCH RD VANCOUVER,WA 98660 STE 1 SCOTTSDALE,AZ 85258 PHONE: 602-694-4031 PHONE: 360-695-7700 FAX: Total Fees: $33,481.69 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 throug AR 95 -.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. / : d , Issued By • Permittee 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. I. • 1.11 I.III• I I IIIIIIIIIIIIIIII Building Permit Application 7A-0 °: iA a FOR OFFICE ISE ONLI REGFr Received > City of Tigard Date/By: Permit No. IN 13125 SW Hall Blvd.,Tigard,OR 97223 /� /� /I5 ��/ . Plan Review Phone: 503.718.2439 Fax: 503.598.196 U N �+ � 7 Date/By: 7 31 (i ' (, Other Permit: 0/ /•� /r Inspection Line: 503.639.4175 / Date Ready/By: Juris: H See Page 2 for •G�C Internet: www.tigard-or.gov ,;+ ( Cr+ { Noti6ed/Method: Supplemental Information BUIL D32 3 r � ."` ,.; s�. ...... �S '' '�'.��s �° { ..ac,... ,_a •�� -�%wr^T�cyr—c .� .*r`�#. 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 ❑Other equipment,materials,labor,overhead ' l 'e profit f the work indicated on this application. C7D ® 1-and 2-family dwellingValuation: $ ❑Commercial/industrial ❑Accessory building 0 Multi-family Number of bedrooms: ❑Master builder ❑Other: Number of bathrooms: 3 1g64.1,5,--41-47-0;-7,3:0104-2, �p �s .., * +� ; Total number of floors: Job site address: I W I Svc friend( Lane, New dwelling area: Z square feet City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet ` / Suite/bldgJapt_no.: I Project name:River Terrace East Covered porch area: I4 quare feet \ V Cross street/directions to job site: Deck area: square feet Other structure area: square feet Subdivision:River Terrace East I Lot no.: LIS 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 x `& s• ' work indicated on this application. Valuation: $ Existing building area: square feet New building area: square feet -� �� � � s Number of stones: 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: e e-; *�im '.;:;�t r� Iq a ,e� _ vl a Business name:Polygon WLH,LLC Structural plan review fee(or deposit): Contact name:Nichole Thorpe 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::( ) E-mail:Nichole Thorpe ,, zs � �� Commercial and residential prescriptive installation of w I • �� � �� " •�� , " _�-�, __�,� � `� _�,�°� � �. ,,,. m�,���„r � 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 lic.:207247 Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Nichole Thorpe Date:06/16/2017 *Fee methodology set by Tri-County Building Industry Service Board” I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) ---.. ,,,.,-.....,-."...n".: 1.''."...:•:'Am Mechanical Permit Anplicaiwk)'',-,'-'''"- :' :v----' I FF OR OILE I SE ON1.1 .., . . City of Tigard .,4., .Received -1,1ffle13y: /*mil 14fW.,(77,7"-C./ 7—0(.4,26‘,,. 114 , isi25 sw Half Eilvd,Tigard.Ott 97221.!)[1, ( t ?JP! Pian Re!"ieiv ' al Phe: $)3..11s2439:FO503.598,1960 .• . Dategiy: • Other Permit 1 1 6,a D Inspection Line: 503.639.4175 ,-,F,',1'''V r)7;•3.'1,,f' ,'k:k....'1 -tii R ' lurix Id sit ttige.11.0 Internal WwW.rigitid-otgov '`.''''' ''' ' -.•' NetilledNented; SupploPetttal hitoemotion I .,'gk'.!fzf.;il 0%ilii)4:14141.iffrAtiO3)00*04"4k:Og gKO4r,.,::.',1. ivlechanktal permit fees*are based on the value of the work . ! El 1 New cotistrUCtiDit 0 AactilionliheradOltirePlaCedhelll perforated.indicate the value(rounded trithe nearest dollar)of. . 0 DentolitiOrt 0 Other ritechanicalmmeriab.equipmentlabor.overhead.and profit. _ Vg:9-#X.PCPOISI0:040014kil:°7 :::: 14 .:'fri''''''''' '47'-.;.';'*i'''.;:':-'il ''''''''-'-''' ' '' ''''-' '''''''''''.i.''''' -' F.A.O.IP.r.44:4*.:,g6.4n*.174A1,-.S:4.1114M5!! . 24 *(likening 0 CoMmurcialiindustrial 0 Accessory building Po spedd brfonvtution use ritetilLst . ..._ ..... Mnitt-tarnpy. 0 Master tvil4e,r 0 Other: .Description' „,.Qty. I Ea, Total i • . - '.,.'•-':...;:•••7'.:,;:-,-,"*.it'_:••149,;Ni;').-k*Attkiit70#44iiit:40','IiOalliiiiii:!,Avijiiii.,::,i,-,:'; ',--:,.:i. ., .H:tRdnew'lingt . . . Air cenditioning : 46 75 JO site address. I 1/q D Li 5W FY1 tfla t.y L-0-A ... . Furnam 100.000 BTU idurnivents) City/StalefilP:Tigard,OR 97224- Furnace l00.000 BTU(duets/venni) 54.91 _ - • • " fic1.4Puntri . 61.06 Stilte.ilildgiapt no. PrOjeet nettle:piv..e.r- le_triitp, 6.0.s+ Duet work.., _. „ _ ., 23,32 Cross streetidirections to jab site: liychertle hot water system 23.32 ,. . . „ . • '- - "..." - Residential'boiler(radiator or tivdrottic 1 23.32 . .• . $ ._ Unit heaters(fuel-type,not electric), .• . - .. .. .. ..._ _ , . irt-wall.in-dud.intspended.etc, 46,75 . - RIM/vent foranv of above I 23.32 - ,Other: 23.52..._.,.. .ShbdiviSIPIt-/ 11/Mr tbrIC7A.rC-..6-__CAS f- 17---""&*"Li 5 . . . . _ Tax mapfparccl no,; Water heater2332 __.. ',:'---;";;_ .,"•.:;!;•'!.'•'',.i.;•- 4,q-:,•,.itq",:lt4:7.,j:'.i:,-.-,,r,. .;2.W,titjtEA:7i44Si:•zot.-,-,:*otocri„,,,y,,4:*.4E.;G;: ii . :i., . . Gag firePlacc(111.4cri,, ..__, .. - . Flue vent for water heater or gas 114 5a01/ -00710(11 firepiace , 23.32 Log lighter(gas) . 23,32 . • Wood/pellet stove 33.39 • Wood Greplacelinsert 2332 ChintneyAineritliteivent 23.32 • -.-.. Other: ,, 23,32. _, .i''':.'i.::':••••. tali.:110.4'ittONV,Ntli,:', .:',..!:::!:;;-.::.-..7.::-:::: . ;Yi4 ..•,-tIji4N.-.04*.i,, ,,::::ij,*it:,-,.?„-;A:iiL. . • , • — --.• -• Ettviran.ntental exhaust and ventilation: Name:' D V I-- t-O.,Kiert.ftp)C111161 5' JJ Range hoixliother kitchen . . I . " equipment 1 33.39 Address:. lton0.. 6 ODkiotc..1-0,e. giLbc._14 (Z4-oaClothes dryer exhaust t 3339 Ci.4.'iStaltiZ.IP: Surifscla ki Al, qs-Lsp, Single-duct exhaust(trathroonri, 14 ' toilet, cornea-weals,utilitv rooms) ' 23.32 Pining' I a 01 1 a6 i I 1 1 ,..- 4 kr1,,,___7,.._7. b3 1 ' Fax:( ) • Atrieicrawlanace fans ._.. 23.32 : ,,..,...•-•-•",;.•• k50,:'Arctic,.01174-,•::;-',...;,•: ...:t....•,. .i;i:.:: •-,,,,,,:,:::,,:e',13,,,;:-.0%.00.-f;.pkitsoy : gi,,•,,,•.: ..' • Other 2332 ,. Fuel pipluat ausitles!nan.le 'Lk)i 1 t ictim kx{Or tkni\r\e,S 11.( c, Fur 11rat four;54.03 for each ttelditional Contact itatriei i\oi okr10‘.••_,Ilirk1) Furnace..etc. ' Gas heat .±1.1-LrefLapiacaced.4%)• '' ,_,‘ Wallistupendedfunit heater City/State/ZIP.:11aneotrver,WA 98661i , Winer beater . „.._ ' . .. Phone:(360)695-7700 Fax::(360)693 4142 Fireplace . 1 . Range- 1 ! EIT141 k At• i. h ‘ Li, ?II - onhiyms tern Barbectie .'!,!•,'?!..'.?!! --!.:,!:''Fc;':',,,,q,,,2 :.-',,'::'1'.g.::!'!---Vi!...:;!.:3''''.45'i-;!'!-7::c.c/N, '.. --,I.'_.''.:.2-..,'.2-..-,,,-„,-.-!,.;:- .!.,!.--. :?.....2.,:',:)-1,0!..!7':...T,qt'..!!:::-.i:,:-.:Y„:,!:7,!;!!:::.:: :-... Clothes dryer(gas) 43usiness name:Alitx Air LLC Other ... , ...........-- ... ......, . . ....... ... . . , Ti. ;::..7' ,;!,9).-1E,PlIATSICALl'ERNIX-FEEST-:;:. !. :i ..., ...,..,,,,. ,.. -••,-•_ .r.. . . ..- . •.,.. ,...-. . , Address.:10004 NE 72 Ave Subtotal City/State/ZIP:Vancouver,WA 9$684 . Minimum permit fee t.$90,00) . ' Plan review(2 %,of permit 17Fe) Phone:(360)3424109 Fax:(360)326-1769 State surcharge(12%ofpennit fee) , • CCB iic.:203034 TOTAL PERMIT FEE - .. 'Ellis permit application expires it a permit is,net obtained within tan - days after it has been accepted as complete. Authorized signature: • I * Fee methedaleu rot by Tri.finuaty Buildiap lodosul•Servitelksid . . , . .Print name: i ek of , . BlisiitzttnOcitutatEr_PrraiiiApp_Ml LI dm 444-461,r(€1/0..glOAAVIUS 1 d Electrical PermitA�uI><catio•n : :' FOR OFFICE USE ONLY City of Tigard 1)C1 ?Oh' Received Permit# .-5/0/7-00.. ._,- , R 13125 SW Hall Blvd.,Tigard,OR 97223 Date/8 Phone: 503.7182439 Fax: 503.59 .1 , ��. Pian B 18`9 Inspection Lille: 503.639.4175 �' l " DatdB .111 Related Permit fk T1 GAM?, R r Internet. www.tigard-or.gov t I y d t 'g Ti'' * I ' Ready d/Date/By:iJude: S See Page2 for - K 1.S. ` 4...4',11%u, u."k 0 0.,,, i: Nohfied/Me Supplemental Information ...ser ,7fC +f. 1-.if ^- ft a�.2 t �t1 r�. � �.� .f�c'?i,- ��z`3�.�,;�.� '�-�..�I'�-�.' .."te ..�*'-f. w�3,,d*'�� ��.�.�9`�s'"�a ��n<`^tr ®New constructionis ed 0 Addition/alteration/replacement Please check all that apply(submits sots of plans w/ltmns checked): ID or feeder 400 amps or more 0 Building over three stdries. ❑Demolition ❑Other: - s sf �'Ta 4 ... L� :t4,s m y where the available fault current ❑Marinas and boatyards. ® I. 2 famil buildinge ,u .- exceeds 10 000 amps at 150 volts or Q Pleating buildings. Y dwellingAccessory 0 CommCommercial/iridustrial 0less to ground,or exceeds 14,000 Q Commercial-use agricultural ❑Multi family 0 Master builder 0 Other: for s0 other installations, braidings.. u x Ya� s � 6 ❑Pim putap. ❑installation of I50 KYA or Job#: 'Vt ;,. .+,r_� "_ D Emergency system. sepandely Job site address:(�/�by S Wi f 1' 0 Addition of new motor toad larger derived V"� I 11!1 11 ,�, of La.�(~ 100iiP or more. (]"A",system. e`�"1_2",-1_3•,, City/StateIZIP:Tigard,OR 97224 0 Six or more residential units. occupancy. Suitdbld /aP t,#: Q Health-care facilities. 0 Recreational vehicle parks. gf Project name:give*, T' ,vr e_e r+_,,., ❑Hay�ous locatons. 0 Supply voltage for more than Cross street/directions to job Site: `. Y rpt C�� ❑ ce or idea 600 amps or mora. 600 volts nominal � x bra -.mss �i��� ��`'• �� �.A:t"ait �laj�� `WL At;., n. • Ireacnpdon I Oty. I leach I Total New residential single-or multi-family dwelling unit.(7 / r Te{Tet(49- .Eas - 1 Lot#:4Includes attached garage. Tax map/parcel; : 1.000 sq.ft.or less 1 168.54 4 ' r I a I d�Ca A ,�r-4‘40-'4W.,7.45-47:4V:4-.1e"- 17,-,-4-1t, Ba add'I 500 sq.ft.or portion C� 3392 1 J 1 W��'To � . - Limited en residential energy, (with above sq.ft.) 75.00 2 Limited energy,multi-family i.5 ��-�,, residential(with above sq.ft) 75.00 2 "'2-;a3---, VS'k.'.17.=. .'. Will"\ 4= ''' z-E--11, 4E73:7'- '- ''4'JF.uES3 q 00t t..V+K`� ,:. -. rgy O 2 s,LLC ServicesRenewable or feeEneders installation, lteratioSeen,Page and/or relocation Name:ADVL Land Holding 200 amps or less 100.70 2 Address:7600 E Doubletree Ranch Road 201 amps to 400 amps 133.56 2 City/State/ZIP:Scottsdale,AZ 85258 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Phone:(602)694-4031 I Fax:( ) Over 1,000 amps or volts 552.26 2 Email: Temporary services or feeders Installation,alteration,and/or Owner Installation:This installation is beingmade on relocation0amps o p7OP�'h'tbat I own which is not 200 amps or Iess 59.36 I 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 1 1 125,08 2 Owner signature: Date: 401 amps to 599 amps 168.54 _ L < 7 �Fl �c - 'a , tv*. Branch circuits—new,alteration,orextension,per panel` c' --, ; .. }_ —,-- _ .., .,` ;� .� ' A.Fete fru breach circuit,with Business name:William Lyon Homes,Inc. above service or feeder fee, ?.42each branch circuit 2Contact name: N'ehoteTiIo pp B.Pee for branch circuits without_ ° Wfee,Address: 1 D3 17n) dove& Sy u StD branch circuit 56.18 2 service fust City/State/ZIP:Vancouver,WA 98660 Each add''branch circuit 7.42 2 Phone:(360)695-7700 • Fax;:(360)693-4442 Miscellaneous(service or feeder not included) /� Bach manufactured or modular Enlatl ' a �/ s AL idv 1 t r dwelling,service and/or feeder 67.84 2 •.,� r.,- ,,,w 7,..., •-:- :?"'� Tr: 3 ;WO�'7 F�f`,C�'r r2.' a T .` Furtm It or It only 67.84 2 Pump or irrigation circle 67.84 2 usiness name:Garner Electric Washington,LLC B a._. Sign or outline lighting 67.84 2 Address:t DZ ��j �( � c Signal circuit(s)or limited-energy 1 v"�4 04:A. , tW ) panel,alteration,or extension. ❑ See Page 2 2 City/State/UP:' ! J `"F' Each additional inspection over allowable in any of the above Phone:ate/Z(253)P: /777 1l4 p 1 W cte3 1 Additional inspection(I hr rain) 6625/hr I Fax:( ) Investigation(1 hr min) 90.00!hr Email:bdaniels@gwensa.com Industrie)plant(1 hr min} • 78.15/hr CCB Lie.: C1158 Electrical Lic.: 208174 Inspections for which no fee is I Suprv.Lica: 4496S ificelty listed hr min 90.00/hr ,.,t---....:: z 9 0- 'l St - u.l' ,: 1Suprv,Electrician signature,required: - y� ,� ubtotal: • Print name: Joan P Albert, Date: 4/26/2016 0 Plan Review Required(25%of permit fee): t _.. _ -- State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: Print mine: Bill Daniels Date 4/26/2016 TL's permit application expires if a permftis not obtained within 180 days after It has been accepted as complete. s•1:Inrdldia 1Permitslfi[C P - * Number of inspections allowedperpemut g a`ur +Pp> 1311Kdoe Rev 06/17/2015 400 g615T(11/OS/tX12rt/1v13g b I , • ;... v !f y•.ys„r� 4 g ' 4, :Plumbing Permit Applica>�A"',, ' ' Building Fixtures FOR (Ili 11 1 t tile. t)M1.1 City of Tigard Received r�isjrtr7- -1 Date/B Permit No 1,1 ■ 13125 SW Hall Blvd.,Tigard,OR st Cir 1r, ,V1", ' , �� ��� ' r -F Plan Review Phone: 503.7182439 Fax 503: 9I6'(i D Other Permit No.: Inspection Line: 503.639 4175 , l,r . 7\ i''',‘!t' 1', may' T i 4.;1 H D Y Date Ready/By; Jude: fa See Page2 for Internet: www.tigard-or•gov A._ Notified/Method: Supplemental Information 't :,T YPE:OP WORK ,,......'-' w .. t ?::-':fr;�;•*a . ®New construction ' fl Demolition For special information use checklist Description I Qty. I Ea. I Total _ 0 Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) .. CATEGORY OF CONSTRUCTION'' SFR(1)bath 312.70 ®1-and 2-family dwelling 0 Cornmercial/mdustrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 50D 3Y ❑Master builderEach additional bath/kitchen 25.02 : 0 y: Fire sprinkler( sq.ft.) Page 2 . JOB SITE INFORM:KTION'OD LOCATION Site utilities: Job site address: I IP {Dy S V i FY i tOA tA fin. Catch basin or area drain 18.76 City/State/ZIP:Tigard,OR 97224 `"t Drywelt,leach line,or trench drain 18.76 Footing drain(no.linear ft.:_J Page 2 Suite/bldg./apt.no.: Project name: 141 ver T1rraeeir - Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.Iinear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: fader 're ra c . fas4- I Lot no.:LIS- Fixture or item: Tax map/parcel nono.: Backflow preventer ( 31.27 1_(. i ION OF.WORK. 1 : Backwater valve 12.51 v"�� Clothes washer 25.02 Dishwasher 25.02 • Drinking fountain 25.02 Ejectors/sump 25.02 ®-i_ROPERTY OWNER . I ❑ TENANT Expansion tank 12.51 Name:ADVL Land Holdings,LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:7600 E Doubletree Ranch Road Garbage disposal 25.02 City/State/ZIP:Scottsdale,AZ 85258 Hose bib 25.02_ Phone:(602)694-4031 Fax:( ) Ice maker 12.51 : ®.APPLICANT . 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name:William Lyon Homes,Inc Medical gas(value:$ ) Page 2 Contact name:4\i rill 0 I 01190, Primer 12.51 �,•, r `" 1� Roof drain(commercial) 12.51 n Address: 1 U3 Dr- St SIAi*( S10 Sink/basin/lavatory 25.02 City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54 Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51 E-mail: `. '^ I �n © Urinal 25.02 �v I GY l O\�-' .I r `CONTRACTOR( e Polu\Orn "�1 Water closet 25.02 • - Water heater 37.52 Business name:Malmedal Enterprises Inc. Water piping/DWV 5629 Address:PO Box 207 Other. 25.02 City/State/ZIP:Banks,OR 97106 Subtotal Phone:(503)324-0759 Fax:(503-)3244580 Minimum permit fee: $72.50 CCB Lic.:102535 Plumbing Lic.no.:34-276P13Plan review (25%of permit fee) �� State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name:Carolina Malmedal Date:04/25/2016 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. "Fee methodology set by Tri-County Building Industry Service Board. 1:1Building\PennitsnPLMU•PermitApp.doc 10/0U04 440-4616T(10/02/COM/WEB) , .r City of Tigard .111 ' COMMUNITY DEVELOPMENT DEPARTMENT ■ T 1 c a R o Building Permit Review — Residential Building Permit #: e 7 ,J7 00,2c,6 Site Address: /gyp'7401/ ..5-14) lrr;�n d y �he Project Name: R;Viar. re",-rcc ... 54511 Lot #: (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: -Le] S ' erify site address/suite#exists and active in permits tem. VV ver Terrace Neighborhood: ❑ No 1�J Yes,See River Terrace Review Addendum Attached Site lan Elements: Three(3)copies of site plan ig stncctures on site Site plan must be on 8-1/2"x 11"or 11 x 17"paper 2 otprint of new structure(including decks)with finished drawn to scale(standard architect or engineer scale) floor elevations arrowty locations&easements(required for new and additions) Apitaddress,project or subdivision name and lot number ,dewalk/driveway approach plicant information(name and phone number) hoc Tian-of wells/septic systems Lot dimensions and building setback dimensionszusis trees to be retained with drip line,and tree ge of buildings to be demolished protection measures t area,building coverage area,percentage of coverage and �S-�tre--et tree size,type and location �� impervious area(applicable if R-7,R-12,R-25&R-40) .fJStreet names ,L Pr��operty corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? s El No 4 foot differential) If yes,is a storm water quality facility shown? ❑Yes. No .Q 0,/, Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): USt Required: E Yes,applicant was notified ZNo Received: ❑ Yes ❑ No ❑ Public Facilities Improvement(PFI) Permit:Pp/2 D16-- pSg Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake 2"*.Land Use Case#: p R 'O/6 ,.OZj49/ ,2"-Required g: l -7 CPD) D Required Setbacks: Front )�� Rear ,C) Side 3 Street Side Garage as ,Landscape Requirement: 2 v cyo L t Coverage Maximum: g 0 'W.-Building Height: Maximum Height ___-L' Actual Height ,isual Clearance Sensitive Lands: ❑ Yes 121'n.-o- Type Urban Forestry Plan ❑ Conditions "Met"prir to issuance of buil g permit /�O/)GYi7 Notes: //-`99 // J G.. i�d/1S 51911 he riled- ,pr �/' -71e):d0 /SSto-q.7G 1Z Approved By Planning: - ' Date: 6/a 8/f�' 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_061417.docx Building Permit Submittal Original Submittal Date: _____‘€7.1-..210 Site Plans: # _R Building Plans: # Building Permit#: kir nter building permit#above. - Workflow Routing: G' lanning engineering pi- lit Coordinatoruilding Workflow Sign-off: a Sign-off for Planning(include notes from planning review) // Route Application Documents: _2 Engineering: (1) copy of permit application, (1) site plan, (1) building plan and riginal plan review routing form. <u Building: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: / By Permit Technician: _ //7 /, , /.'Ad/.�.,_�.. Date: t 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 ,Et No LIDA Facility on lot: ❑ Yes --E No ❑ NOT Approved by Engineering: Date: Notes: lt)A-LT f lm- f-ti L-1 0 K- ` ° 1%,)6._ Approved by Engineering: 141tot-i'L l,J . Date: 7// 77 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 ���f/ ( ,g'Approved,NOT Released: Date: —/ -- /./7 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: ?gi 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 OK to Issue Permit Approved by Permit Coordinator: Date: 7iv fr I:\Building\Forms\BldgPermitRvw_RES_061417.docx City of Tigard n COMMUNITY DEVELOPMENT DEPARTMENT IN I TIGARD River Terrace Building Permit Review Addendum Building Permit #: Site Address: / 6, goil S.LO F,- oe)4 4c.x„+42 Project Name: R;ve.- re.PrQLee Eos71' Lot #: 11 J!" (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review of River Terrace Plan District Design Standards (18.660.070.1.): 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.An additional element required for lots with over 60 ft. of street frontage shall be provided every 30 ft. Porch min. 5 ft. deep Balcony w/access 2 Window Projection Vertical Wall Offset a ft. deep min. 2ft.,5 ft.wide min. 2 ft., Eft.wide Gabled dormer 0 El min. ❑ 2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors. Percentage Shown: `ea % 3. Entrances:At least one entrance must meet both of the follog standards: £' ax. 8 ft. setback from longest street facing wall 1 arallel to street,angle no more than 45° from street, or open onto porch Entrance opens to a porch: l7ces ❑ No If yes•,all the following apply: %5 sq.ft. min. Ze street facing entry Z12 ft.max.roof above floor of porch •J 5 ft. depth min. . 40%min.porch roof coverage 411etailed Design:All buildings shall include a min. of five of the following elements on all street-facing façades: vered porch min. 5 ft.wide x 5 ft. deep 0 Recessed entry area min. 5 ft.wide x 2 ft. deep all offset min. 16 inches ID Dormer min. 4 ft.wide Roof eave min. 12 inch projection )oof offset min. of 2 ft. . ❑ Roof shingles either tile or wood 4 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 façade 5. Garages and Carports:May face the front or side lot line on a corner lot. Setbacks: No closer to front or side lot line,than longest street-facing wall. 2 Yes ❑ No. If No (Check one): ❑ May extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch. 0 ❑ May extend up to 5 ft.where the garage is part of a two-story building and there is a window at the second story above the garage that faces the street with a min. area of 12 sq.ft. width: (Check one) ❑ 12-foot-wide garage door L/1 40%max. of street facade ❑ 50%max. of street façade with 7 detailed design elements Notes: Approved By Planning: .- -----;;• Date: 6 $ iAl ____ I:\Building\Forms\B1dgPermitRvw REs RT 062216.docx City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 16904 SW FRIENDLY LN, BEAVERTON, June 1 , 2018 at 9:37:15 AM OR, 97007 Record Type: Record ID: Residential - Master Permit MST2017-00266 Inspection Type: Inspector: 199 Electrical final Aaron Cillo-Gobel Result: PASS Comments: A/C installed Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 16904 SW FRIENDLY LN, BEAVERTON, June 1 , 2018 at 9:33:53 AM OR, 97007 Record Type: Record ID: Residential - Master Permit MST2017-00266 Inspection Type: Inspector: 699 Mechanical final Aaron Cillo-Gobel Result: PASS Comments: A/C installed Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 16904 SW FRIENDLY LN, BEAVERTON, OR, 97007 Record Type: Record ID: Residential - Master Permit MST2017-00266 Inspection Type: Inspector: 299 Final inspection Allyson Armstrong Result: PASS - CofO Comments: Correction complete Collected Moisture content acknowledgement form Moisture barrier acknowledgement form High efficiency lighting form Air leakage test report Left C of 0 on the counter Violation Summary: Inspector Contractor