Permit (119) CITY OF TIGARD MASTER PERMIT
II '" a Permit#: MST2016-00488
. COMMUNITY DEVELOPMENT Date Issued: 11/21/2017
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S106DB02200
Jurisdiction: Tigard
Site address: 13428 SW SABRINA AVE
Subdivision: RIVER TERRACE NORTHWEST Lot: 22
Project: River Terrace Northwest, Lot 22
Project Description: New SF. Model home. 5/18/17: REPRINT to add additional water heater.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1108 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 26 Bathrooms: 3 Second: 1396 sf Garage: 385 sf Front: 8 Smoke No
Dwelling Units: 1
Third: 0 sf Right: 3 Detectors:
Total: 2504 sf Value: $302,784.71 Rear: 10
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 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: 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!500 sf: 4 201-400 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 2504
Owner: Contractor:
ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
BY FORSUM,MICHAEL 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175
7600 E DOUBLETREE RANCH RD VANCOUVER,WA 98660
STE 1
SCOTTSDALE,AZ 85258
PHONE PHONE: 360-695-7700
FAX:
Total Fees: $32,902.56
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 OA- 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: 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.
p
Building Permit Application L_S
r„ t, 1,i 1 REC I./ c FOR OFFICE L SE O\L.1
1111 City of Tigard Received DaDate/By: // �� Permit Nos /
"INO13125 713125 SW Hall Blvd.,Tigard,OR 97223 12016 Plan Revie
i Phone: 503.718.2439 Fax: 503.598y y Plan Re
: j J`o�c� ' )6 -H other Per ,aJ� /�-.er903
R D Inspection Line: 503.639.4175 `✓a S �` s' s L;1 d Date ReadyBy: J>rris: ® See Page 2 for
Internet: www.ti and-or. ov q-�I;1 rr NotiSed/Method: /9 /7
g g B U 1 Lid f Supplemental Information
®New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
® 1-and 2-family dwelling 0 Commercial/industrial Valuation: --it-32442Z. 3 L,�6 , I s'4
❑Accessory building 0 Multi-family Number of bedrooms: 4 1 /
❑Master builder 0 Other: Number of bathrooms: 3
;�; R t > c Total number of floors: 2
•Job site address:13428 SW Sabrina Ave New dwelling area:
square $
City/State/ZIP:Tigard,OR 97224 Garage/carport area: 385 square feet
Suite/bldg./apt.no.: Project name:River Terrace Northwest Covered porch area'/�'�158Uk'square feet j 3 q
Cross street/directions to job site: Deck area: )S, $ ����square feet 009
Other structure area: square feet
Subdivision:River Terrace Northwest Lot no.:22, 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
work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
t •• 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:
Business name:Polygon WLH,LLC
Structural plan review fee(or deposit):
Contact name:Angela Grajewski
FLS plan review fee(if applicable):
Address:109 East 13th Street
Total fees due upon application:
City/State/ZIP:Vancouver WA 98660
Amount received:
Phone:(360)695-7700 Fax::( ) •
E-mail:Angela.Grajewski@polygonhomes.com
� 1 Commercial and residential prescriptive installation of
• �� x' t': f ' roof-top mounted Photo Voltaic 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 rame:Angela Grajewski Date: *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Pennits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
REcEIVED
Mechanical Permit Application 1111111111111MOIRE11111111111111R,
City of Tigard JAN 1 9 L(117
13125 SW Bali(MIL Tigard,Olt nateit2 r'crmlt 11n,:
ST�c�i( ArJ���
_ Phone: 503.718.2439 .Fax: 503.5 gq Plan Review
Inspection tine: 503.539.4175 �!�i�j Aatrtt3Y: #3thcrPennit
l !i,n R[t l g Dun,fi��D Date Readyi1Iy JuxiK
Internet: ww v.ti d-or. ov f3 U tg DMAc zOa i Norin'ked7Mcthad: 111 set PxCc2 for
7 Supplemental Information
EST`-` 4J �•aaa:.x�'i�.`°`"' tet
- ci .a..M. � :.,x:a.;.1 Le.xn.`x..t,tiro t t o t '' "•�` .u` :s+-..fi,a res ai -'` F r''j -`fir ;' ,L',,,� w�-^;7,..,.
s.s .�,.. :'y..:.'�{ .r x47.1 S:rs+e-n'f r..,-:,,..2 ,+r: rc- ?...—ax t•.=...'-�'itJ =tee..,- .
®New construction 0 Addition/alteration/replacementMechanicaliierntk'Rev'are based on the valueof the wort
performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other:
mechanical materials. meat.
labor r
overhead_and refit.
$n a# ` t'e ' = sa7 , y,`
F-.s .c i ', +sr FI `w^S�t r� 't � ^ 6e`� r�z- +1 �aiz-11 I-and 2fatnll?dwelliriS a Commerclallindustrial
0 Accessory building For ecialktferrroyonuse&a ilsi
Multi family 0 Master
builder ]Other:
Description
1 Q . 1 Ea.
f Total 3"' °fm1> ti;ryr „Yc+ 7f-::3 tti' s ,. Y .ra 4Aeationp�itw
tiolinattRi 1 4675Joh site address:i'y ibs Jtoy0e p3Je
Furnace 100.000 BTU(duetsn:erus) ` 46.75
City/State/ZIP:Tigard,OR 97224 Fornauc 100.000*BTU id rdseventst 54.91
Suitclbtdg,apt.no.: j Project aiame�f Meat pomp 61.06
Q ' Dl . erydre tJ ihw Duct work 23.32
Cress street/directions to job site:
13vdrvnie hot water system 23.32
Residential boiler(radiator or
hydronie) 23.32
Unit heaters(fuel-type.not electric).
in-wall,in-:duel:suspended,etc. 46,7$
Flue/ventfor any of above i 23.32
Subdivision:pie y, r'eY1/AGC, ivo we it- Lot no.:" Other 23.12
Tax map/parcel no.: Other fuel appliances:
� � � —, - _ Water.heater 23.32
,.. �vm'r,t`-sw . i' 3 3.,•. .E"EIr'.-.1:s1:::`{ I"c T r t
,.L',,.e,..e....�^.'ai:.s..,.:��`cu:-,,.�- ,s«F.-rw:�-cx..v.3..�`��Tas �� ...n r�rS• .;epa�4 .���lrCt)lae£�1nSCrt 3339
flue vem for water heater or gas
fireplace 23.32
Lag lighter(gas) 23.32
Wood/pellet stove 33.39
Wood firtmlaccFmsert 2332
Cbktnneyllrrrull)ttClkl nt 23,32
7' » ..:TFT: vrto r,..-W. - 3RrP; , F y, S rSt EEheriramentalexhaust and mina ion: 2332
•
Name:Polygon WL/1,LLC
Range hood/other kitchen
Address:109 East 1311"Sttett uip to 33,39
t:ity/StatctLlP:Vancouver,WA 98660 __. I +Clothesttryer exhaust t 33.39
Single duet exhaust(bathrooms.
Phone:(360)69$-7708 t ax:( toilet at»nparrments,u ility moms) 2332
ne ) Aificicrawlspuce fans t
=> ur .. ,� a gf`j ,rt er 2332
_. . . F':;..�r� Esr Oth23.32
Business ride:Polygon WEIL LLC Friel piping;
Confect aarriC:Ara St4.1S for first faun$4.113 for.etteb additional.
gels t*rajlewski Emmett.etc,.
Address:109 East 13th Street etas-heat pump
CityrState/ tP:Vancouver,WA 98660. Walt;suspertdedfuriitbeater
Water heater
Phone:(360)695-771)0 I Flu::(360)693-4442 Fireplace
E-mail:Angela.Grajewskritlpolygonhomes.toin Range
r Barbecue
js . ., ).11,f'tlk-_-;z, �P:I _'—:_ ..,>, Cinthesdtyer(€as)
Business name:Apex Air Lie Other:
t ty t,:.....2„%•:4•;•.;:,-1'Yi t Address:18004 NE 72' Ave
Subtotal
City/State/ZIP:Vancouver,WA 98686 Minimum permit fee($90,00)
Phone:(360)�3d2.8I09 Fax:(360)326-1769 Plan review(25%ofpermitfee)
CCB lie,;203034
State surcharge(12%of hermit fee)
TOTAL PERMIT FEE
1 htss permit appticmtlan raphes Ifo p>rmitb+eat obiained wtthin 180
Authorized signature' daysatter3rbae been acupted as tompltte
Print name. f ` 1 m mcthtdulbgr sot by Tn-l"cruatj 13tiildinit lndckttryr riervicc[3uatd
Date: 4.19.fc...
imiuminowanwer petwapp.poi 1346e 44046(7t<3 voiGtr},tAyr )
RECEIVE!)
Electrical Permit Application
JA
N t t ���j FOR OFFICE USE°NIA
City of Tigard it Received
13125 SW Halt Btvd.,Tigard,oR 97zFIG ,Permit g tiS 7;20/6 20 licPe
Phone: 503.7182439 Fax: 503.598.1 - Dates .
1 iGAR17 �Inspecetraon Line; .63944175 �y jj $ (� Tg g
Wwwtr dor. Y fl)UILD3)U D5�'IS1 adyAate/By: NM s SeePage2for
. -,',:v
otrBetUMathad: �pplwgeolalloformatioa
c ,,,- -,,,& ;_,.!-i t N "rte" -.m TA''r?:'ti.°r),,IL`..z:ka: �" -1 3,e.», r. , i, t y�
::s -..-.�z3 `:`:: -c� r Z`F'11,ti.�....w'w.,�,@ .Y '' 1�i +SJJ,7�^x5r w'
�r>
®New conduction 0 Addition/alteration/replacement Please check all that i
appy(submit 2 sets of plans w/doms checked):
Q Demolitirm 0 mer 0 Service or feeder 400 amps or more 0 Building over three stories.
1e £ where the available fault current Q Vaginas and boatyards.
. e:'�, ?fi.tl 0;, ca 'gra f63 31 mY
) - '� e J' x r ' a �s� exceeds 10,000 amps at 110 volts or
El 1-and 2-family dwelling 0 Commercial/hidustrial 0 Accessory building toss to ground,or exceeds 14,000 D Commereial_use agricultural
❑Mmlti-family ❑Master builder [)Offer amps for all other iauallatious. , buildings..
,yEl or
ti;r ;, ' `'..t'''*-,.-.',•' 3nIli4. P 4,- ' a i �..".�; Fire l DemolitJob system. larger separately derived
Job site addr-ess:f 341 )SW S lr ❑100H Addition of new motor foal of system.
y 1 y'Q,� IOOHP or more. 0^A",•E","I-2;"1 3"
City/State/Z1P:Tigard,OR 97224 ❑Six or more residenttai untie. occupancy.
StdteJbl / t #: 0Health-cue facilities. 13 Recreational vehicle perks.
•aP I Project name giver Ttrro N West ii 1lazardorrs locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal
Cross street/directions to job site:
DeCci4tion Qts. Each Toth I '
New residential single-or mufti.family dwelling unit:
Subdivision: Ro er ic. rase, Norti„ S}-- i Lot#: lneiudesattached garage.
Tax map/parcel#:
1.000 sq.ft.or less i 166.54 4
3.'.'I2i. " lfig7;a.!•& .,. !, ict: 5.�-01 ,AW- ..�;jis '�z Limited manaddl 500 ',resq.ft.resider ntial 75.00
33.92 1
energy,residential
(with above sq.11.1
75.00 2
limited energy,multi-family
residential(with above sq.ft.) 75.00 2
s� C' 141:SQ It A.7.6--4.6';k 'i {�s 3 , e• ,a1),:.)7« tis `, Z `. tv writer feeders installation,a1Q Peg d/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 tag 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 1 Fax:( ) Over 1,000 amps or volts 55226 2
Email: Temporary services or feeders installation,alteration,and/or
• relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 1
amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
_ , t* ?,,w s '- 04!ao2 aa� s 's Branch circuits-new,alteration,or extension, r panel
Business name;William Lyon Homes,inc. n. fesbrvice. itederfee,
above service or feeder fee,
!
each i>ranch circuft 7.42 2
Contact name:Angela Grajewski B.Pee for branch circuits without i
Address:109 East 13th Street service or feeder fee,fust 56.18 2
branch circuit
City/State/ZIP:Vancouver,WA 98660 Each add'l branch circuit 7.42 2
Phone:(360)695.7700 Fax: (360)693-4442 Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
a -• � y� dwelling service
and/orfhaderEmail:Angela.Grajewsid®polygonhomes.conReconnect only
67.84 2`)15:0-''.:`: as: .Q.. r5' kn,a6 h rIg e6- AsaKt ; ; J
Pump or irrigation circle 67.84 2
Business name:Garner Electric Washington,LLC2
Sign or outline lighting 67.84
Address:6101 NE 3t Johns Rd Signal clrcuit(s)or limited energy
panel,alteration,or extension. 0 See Page 2 2
City/State/21P:Vancouver WA 98661 Each additional Inspection over allowable In any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(253)320-1657 I Fax:( ) Investigation(I hr min) 90.001 hr
Email:bdanieis(ftweusa.com industrial plant(I hr min) 78.18/hr
CCB Lie.: 01158 IElectrical Lit.: 208174 Suprv.Lie: 4496S Inspections for which no fee is
-�;-�- ca listed '%.hr min
90.00./hr
Suprv.Electrician signature,Y -'t i,sn, '' �tJ�„V,)0{c3i -';t4 ')11.4:64'75'7`A`, :',4-.4');-:- y
equired: /-- 1-'r i� + .
• Subtotal:
Print name: Joan P Albert, • Date: 4/26/2016 ❑Plan Review Requited(25%of permit fee):
State surcharge(12/e of permit the)`
Authorized signature: - a
TOTAL PERMIT F,EE;
;:^:;: . Print panne Bill Daniels This permit application expires if a permit is not obtained within 180
r.l ;:: Date: 4/26/2016 days after it has been accepted as complete. —
{•;.;,:i5`�ygaitd * Number of inspections allowed per permit
g;0. ;:. 'emtitz�EL,C PwadtApp ELR 71t6.doc Rev 00174015 MO 461$ i1105ICx),4J g
<';iw
. .
ilEIVEP
Plumbing'Permit Applicatio. --EC'
Building Fixtures
AN 1 9 2017
City of Tigard Reitieiyod
Neat N°4/7IT,20/6 ---00.11-6Pe
N..... /Nu 13125 SWliElvd.,Tigard,OR 97)2T ' fl 'll'
'• g Phone: 501/18.2439 Fax: m33984,966 - - I- PI"`"ew
Y 0 ric AR!) 1)4"113' Yl.
Other Permit No;:
_. .
T 6 A R D Inspection We: 503.639.4175Dui 1 nf NG Dws
iri•, ;1 b.;, p ,10;„ h
d.. RI See Page 2 for
•.. hitdnet: www„tigand-or.gov 1-4 U 1 LIU.i- k 1,401ffiediMehod: Sc,'lernentra bitennation
, . .. ., .„, , .. .... . .... .
.-;'-,'.iiii•;:::1'..j.;;; -.414.qg-gtr...A.,'.....i•ia--;..r.f,s-gS4Q14,„....4..„!);V.',.6,,,4%,.... .;54,...isli,4,iff, :i,C.,--, ';',7•4•:.',i,%;;;;Tf..W4 ':''''''.'F,rj‘,.',. .q.t!..i,-,-*---•3,i4,.f..,'",t,' X'I''''!1-,'?44-!,k.1,!*?..:>/%4A"..V.1!-511.,r,4,44-4.;;-'1;-.,4::,.,:37,,.
, ,,i.--...,.... .._ ,.,.,. _. .. , ..... . . ,
Per speCial infortisation Ate checklist..
1.2 New construction I Demolition,
DescriPtion 1 Otv.- 1 Ea. Total
El Addition/Altarationli4 enlaternent, 0 Other' New 1-2-faxidly dwellings(includes 100 ft,forc.aair utility oanxieciion)
V:4-V•f'*#,Y4-1•1,6,.(114,t,a,ti.IiltitiTi.Mtfflli•ia4lif:S.4.;f•-:t144.7:n SM(I-)bath' 312.70
CI' 1..and 2- fly dwelling 111 Conunereialintdustrial 'SFR(2).bath. 437.78
. _
SFR(3)bith
500.32
El
Accessory building Q idulti-faraily
Each additional bath/Idtc.hen 25.02
El Muter bui. idol'. , . p Other:. .H .• .. . •fir9 Orinkl9r C-_,.sq.ft) Page 2
•;:ii'...•.',..f.,L;:'...ilii-:/,..4‘:,,,';k::".•.',-.':-I..'elft•-/A-I44-"rr'''"SV,V7r..i ..',--t<`•-.'''''.4%*:'••zte-",;:•-ii"'4•,. .7--.4„ ..i..,....-„---,-., sue utilities
• Catch basin or rear drain 18.76 '
1"14 si*address'1;414e:k SkK) SCU'YrinCk erkle.
Cit
Drywall,leach line,or trench drainy/State/W:ligairtli OR 97224
Footing drain(no.linear ft.:_____) Page 2
- 1.10:919.1d819Pt.no,: I Project name::P.,i‘le rTe,)(1,alite NV%) Manufactuned home utilities 50.03
Coss strootidiiectiOnso)ob site: Manholes 18.76
, .
RaLin drain connector 16.76
. . . . .. .. . ... ..
.. - •••-• - •
•.• SanitaW..se*er(no.lirrear ft: _) Pao 2
Stoma sewei(no..linear it..: . ) Page 2
. • - Water service(no.linear lt.: ) Page 2
SubdiviSit4E.R.(\te te re.nea(e.„. 1‘10tetth Laj.e_c..}-. 1 Loino.: -LIAtturt or item:
BackBosvproventer k 31.27
Tax nap/parcel no.:
...
Backwalcrvajyc
., . ,..,,,..,,,,.n :-,,...1.-:,,,,,--;,.3,,,i,!----,:c7-,?•.F,,•,--:t,r,' • •
1151- 1rTc ,
clothes wasbor
25.02
. • . • .--.-- • Dis-h*asher 25.02
Dr**tontittin. 25.02
1 .
Ejectorestinth „ . . ... 25.02
*.-:-A'::::,F;,.zv,eM.'•..,..;-.. .;:i.'.f.4.7-g;zi.r*;:‘r...,741,,,•i7.A.,:: 4:ii1iiE'4, ;..-,..: V,i'Fi'•:.'-F-- ,;:!•.,...A., 1 :-..k'' xP4n31011 lank 1251
.
,*...sv.•5v:e...:i,..,.4.,...?:4,D I:.4 Y.::r..:,,sr-,1;1 I.1!1-...::,..•:,z.,:ir....:!:5 r,,,,,,4.i..-=.i..-,.;.•..,:+--,,...,;F'.:•:4+"'1.,‘a r.eF.•::7:,,,,,',=•*-!:,•,;---*- .
, ... ....„.. i. xturetsewer cap 25.92
Nanue:IADVL Land Ilaidltiri;LI,C•
FlOor drairilfloor,sink/hirb. 25.02
Addi*ss;.7600 E.Enithlettee Ranch Road.
.Garbage'disposal 25.02
CiWiEtatc/ZIP:Scottsdale,AZ.85258
IFIOSe bib. 25.02
. .- .. .. . .
Phone (602)00474011. Fax ( ) .1ce maker. 1151
2502
Medical gas(value:$ ) Page 2:
13usiness name:WillianiLyou.Bornes,.7.nc.
Pinker 1251
... ...
C.0#40413.41t9.:.Ant*Graie*110
Atrordraitticotnniercial) 12,51
ArldteSai.109 1;nst..j3th..Sticet.
Sinldhaiin/lavatory 25.02 .
..„,... . •• . . - ...
• taw/State/Eat vancouveri*A 98660 Solar units(potable water) 62,54.
Phone (300)6790-7.700 1 3
6
Fax (30).69 -4442
Tab/shoWeriahowet part 1.2.51
1/tinal 25.02
.E.,tnail.;;Mialh#GrajetY' faciaidlygo' !lib:sines-pi* -
• - - , ' , ' '- .•• • . - Water closet 25.02
, : ; ,...;...;;.4V, ...',.14, .10,-;n0.?.4'2.. ,- ,..::.:1243:.!'...7•''':Iiir.•'-':?..?;4.-2:. • . -
- Water heater3752
El. Iiiilimli'llame:: Git...6 k)VAN)' %l151-4--SONr 241.6- Ii9atcr.pipin.. 8/DWV 56,29
Address •1/el) fr-.OK OtA„ • Other: 25.02
tity/State/E/Pi 5-r. .eA...4 6....t. ili3-1 . , Subtotsd.
PliP1W(503••'.1S.4S''''' 144. Fax
11 •• • • -
11 V'1*lag-4114) lviinisatuii phimit feet..372.50
Plan review (25%of pennit fee)
• CEi 1.4C: ISKI
31- o''.. Pitwibing 14p..3.2014,i 433q
... Slate surcharge(12%of permit fee)
Mit00074441RithiUre: kitiECA' . Z:ftOti --...--_-
TOTAL PERMIT FEB
.Ptiniliardh'4.:8-h f....41./.- .PO.111.)14..e...., ?hig:c,...„2.2k„, f i This permit application aspires if a permit is not obtained within 180 days
J436 ,>V •.1100 atter Whits heel accepted so complete.
*Fee methodology set by Tri-County Building Wintry Service Board,
leatitti.kg1Paluffi1tAIU.PerpirtApp.dot 10/01/09 440-41611401,07./C0/4/WEB)
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City of Tigard
' COMMUNITY DEVELOPMENT DEPARTMENT
!PI 1
T 1 G A R 1) Building Permit Review — Residential
Building Permit #: /157O/&--&2 '/d P'
Site Address: /s47e a) „ 47-7/7,.3
Project Name: Uaf. -rein?Ge iUvrf - Lot #: ,:Q.
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: 240 Model iWnt t.
erify site address/suite#exists and active inp ermit stem.
River Terrace Neighborhood: ❑ No Yes,See River Terrace Review Addendum Attached
Sits Plan Elements:
�xee(3) copies of site plan !! 110,sting structures on site
e plan must be on 8-1/2"x 11"or 11 x 17"paper IT,Footprint of new structure(including decks)with finished
raven to scale(standard architect or engineer scale) fl or elevations
viNorth arrow tility locations(required for new,may apply for additions)
pi to address,project or subdivision name and lot number elation of wells/septic systems
PI pplicant information(name and phone number) sting trees to be retained with drip line,and tree
of dimensions and building setback dimensions rotection measures
Vil Lot area,building coverage area,percentage of coverage and V reet 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
4 foot differential)
lean Water Services—Service Provider Lett (lot platted prior to 9/10/1995):
/Required: ❑ Yes,applicant was notified V No Received: ❑ Yes ❑ No
tei Public Faciliti mprovement(PFI) Permit:
/Required: Yes,applicant was notified ❑ No Applied For: I/Yes ❑ No,stop intake
and Use Case#: P-hle.20/6=0--.WC" !S= 2 ))O
tli/Zoning: ® /Q C Pb /
�^y
,Required Setbacks: Front Rear j(.J Side S Street Side YJ4 Garage ('#}
andscape Requirement: QC
wof Coverage Maximum: %
ilding Height: Maximum Height Actual Height 1(11
tsual Clearance
Easements /No
Tensitive Lands: ❑ Yes Type
rban Forestry Plan
❑ Conditions "Met"prior to issuance of building permit
Notes: L.-G?/1 rX%7io 50,.9 r' A ,L2P,7h/1 /.�S7.�E,ui( •�
�'DY mo' ALte CJ1�1/- / /
Approved By Planning: wi y, . 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\B1dgPermitRvwRES 091216.docx
I
I
Building Permit Submittal
Original Submittal Date: 1/://7//fc,
Site Plans: # '
Building Plans: # 3
Building Permit#: R.-Enter building permit#above.
Workflow Routing: Planning a-Engineering 'Permit Coordinator d Building
Workflow Sign-off: [a—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
originalor�% plan review routing form.
a 3uilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: i
By Permit Technician: ,`t-' / %—, ,' Date: /%�/Y/,(
Engineering Review
Z -Slope at building pad: (p %
❑ Conditions "Met"prior to issuance of building permit
D—Easements (encroachments)per engineering conditions of approval and plat
dater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes i' No
Assess Water Quantity Fee in-lieu: ❑ Yes 12l—No
LIDA Facility on lot: ❑ Yes 12--14-o
❑ NOT Approved by Engineering: Date:
Notes: WA-tT fz-- 141... K/1 (.M; 1/4at1S c/0--- •
Approved by Engineering: ( ,6.5.4 ze Date: // •Z—ii -/
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
El Conditions "Met"prior to issuance of building permit
Approved,NOT Released: X ate: /VW/4,
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: W'Yes ❑ N/A
// Tigard Trans SDC: 2Yes ❑ N/A
?6
Parks SDC: pYes CI N/A
OK to Issue Permit
Approved by Permit Coordinator: ate: /I/ 2''2-
I:\Building\Forms\BldgPermitRvw_RES_091216.docx
s
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
:11 .
TIGARD River Terrace Building Permit Review Addendum
Building Permit #: 1 7;20/6,-- 6 0 +'t?
Site Address: /31-1-?0j ) _` na -c' .
Project Name: ,%>>f-E9Yfre0.-e,{ )y-.7'1 g.y. Lot #: c:>R.;
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan Dist 'ct Design Standards (18.660.070.1.):
Is the project subject to the plan district design standards?V 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 t. deep Balcony w/ access 2 Window Projection Vertical Wall Offset a Gabled dormer
ft. deep min. 2ft., 5 ft.wide min. 2 ft., 6ft.wide
CIEl ❑ ❑
2. Eyes on the street: a minimum of 12% of each street facing facade must include windows or entrance doors.
Percentage Shown: o . iJ 7
d
3. E rances:At least one entrance must meet both of the follo g standards:
Max. 8 ft. setback from long street- facing wall Parallel to street,angle no more than 45° from street,
or open onto porch
Entrance opens to a porch: Yes CI No
If s all the following apply: i sq.ft.min.
ne street facing entry ft.max. roof above floor of porch
5 ft. depth min. 30%min.porch roof coverage
4. etailed Design:All buildings shall include a min. of five of r e following elements on all street-facing facades:
V$overed porch min. 5 ft.wide x 5 ft. deep /Recessed entry area min. 5 ft.wide x 2 ft. deep
all offset min. 16 inches CI Pi ormer min. 4 ft.wide
Roof eave min. 12 inch projection fr, ' .of offset min. of 2 ft.
❑ Roof shingles either tile or wood {/. able,hip or gambrel roof design
❑ Roof pitch oriented south min. 500 sq. ft. horizontal lap siding min. 3-7 inches wide
CI 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
5. Garages and Carports:May face the front or side lot line on a corner lot.
Setbacks:
closer to front or side lot line,than longest street-facing wall. ❑ Yes No. If No (Check one):
ay extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch.
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)
❑ 2-foot-wide garage door CI 40%max. of street facade
50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: �, Date: —thhi.(7—
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:
13428 SW SABRINAAVE, SHERWOOD, June 14, 2018 at 11 :37:19 AM
OR, 97140
Record Type: Record ID:
Residential - Master Permit MST2016-00488
Inspection Type: Inspector:
199 Electrical final Chip Barnett
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:
13428 SW SABRINAAVE, SHERWOOD, June 14, 2018 at 11 :36:42 AM
OR, 97140
Record Type: Record ID:
Residential - Master Permit MST2016-00488
Inspection Type: Inspector:
699 Mechanical final Chip Barnett
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:
13428 SW SABRINAAVE, SHERWOOD, June 22, 2018 at 9:41 :25 AM
OR, 97140
Record Type: Record ID:
Residential - Master Permit MST2016-00488
Inspection Type: Inspector:
299 Final inspection Aaron Cillo-Gobel
Result:
PASS - CofO
Comments:
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
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13428 SW SABRINAAVE, SHERWOOD, June 22, 2018 at 9:37:09 AM
OR, 97140
Record Type: Record ID:
Residential - Master Permit MST2016-00488
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS
Comments:
Previous corrections completed.
Violation Summary:
Inspector Contractor