Permit (170) CITY OF TIGARD MASTER PERMIT
■ ' COMMUNITY DEVELOPMENT Permit#: MST2017-00391
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/04/2017
I[ "�'" Parcel: 2S 106 DA05500
Jurisdiction: Tigard
Site address: 16791 SW LARKSPRING LN
Subdivision: RIVER TERRACE EAST Lot: 55
Project: River Terrace East, Lot 55
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: 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: $353,724.58 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 2 Water Lines: 100 Drains: Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 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
Other: N Other Description:
Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2914
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
STE 1
SCOTTSDALE,AZ 85258
PHONE: 602-694-4031 PHONE: 360-695-7700
FAX:
Total Fees: $33,945.99
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OA/52-001-0090. ,u may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ,J. /. . 4 4 A. Al ,&/ ,/ /Kg Permittee Signature: rr anhGCG/L GG7
Call 503.639.4175 by 7:0s a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
- S—S---
Building Permit ApplicationL- O7
a i FOR OFFICE ISE ONLI
City of Tigard J “ 2 2017 Received Ar
Date/By: [ 21 / Permit No. 6//i,(42 ct/ q)
ll 13125 SW Hall Blvd.,Tigard,OR 97223C 56.11,4)00-15134 i1
Phone: 503.718-2439 Fax: 503.598.1960 ' ( 1zr4f11"D t�BY�eW' 1 a �Permrt:
InspectionLine: 503.639.4175 BUILDING DIAS! hteReadyBy: > ^ 0 7uris: H See Page 2for
TIC a I:I? Notified/Method: I/ f 7 41 • Supplemental Information
Internet: www.tigard-or.gov
..� -1i` MC eeE-
y,; 91C; ,,,, :.a.,1°a irk €�' "",F .,pl a _ -.... t.2 71.X4 .NV,s s��,+ g SkEi',..
-i S,`45 � @S! * "g\*.` `I"�a^"u�` `w77'i O :$mss.' `,,,,J.,414,4;3'§R1F 4 -i ` . � -^�' A,E.Li
� a ❑Demolition Permit fees*are based on the value of the work performed.
®New construction Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ❑Other equipment,materials,labor,overheaanAtliA profit fgrthe /
�-.4 ' a 'r work indicated on this application.
-- T om , s `` �
Valuation: $
® 1-and 2-family dwelling ❑Commercial/industrial '
Number of bedrooms-
7"\0
edrooms-7"\❑Accessory building ❑Multi-family
❑Other: Number of bathrooms: 3
❑Master builderW': "' � = Total number of floors:
Ct Job site address: I il 1 Sw Lor�.$�(h/\ Li New dwelling area: 7 j 1 square feet
kcitoko
City/State/ZIP:Tigard,OR 97224 1" 1 , . Garage/carport area: (n square feet I �
SurtelbldgJap no.:t. Project name:River Terrace East Covered porch area:.a 1
(� square feet
J
Cross street/directions to job site: eck area: square feet
Other structure area: square feet
Subdivision:River Terrace East Lot no.: 5P3 Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
µ
- -, ' r, work indicated on this application.
t4-,..., 4 i' g 9
Valuation: $
Existing building area: square feet
New building area: square feet
t -'7". tri
Number of stories:
:amu � �v ---:=1,. ,.
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:
a :1%-3
Business name:Polygon WLH,LLC Structural plan review fee(or deposit):
Contact name:Nichole Thorpe FLS plan review fee(if applicable):
Address:109 East 13'Street
Total fees due upon application:
City/State/ZIP:Vancouver WA 98660
Amount received:
Phone:(360)695-7700 I Fax::( ) r"- .41.7 u6§Za ' w
,
l `� I b
E-mail:Nichole Thorpe . `�' x
Commercial and residential prescriptive installation of
F' R t �' "� : :_ 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.
Permit Fee(includes plan review $180.00
City/State/ZIP:Vancouver WA 98660 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.
*F
Date:06/16/2017 Fee methodology set by Tri-County Building Industry
Print name:Nichole Thorpe Service Board.
I:\Building\Permits\BUP-RESPermitApP.doc 02/24/2011 44046131(11/02/COM/WEB)
1
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Mechanical F.'ettiiit A . lirititit—'-'-''' -- ' 1,01t OFFICE L.SE ONLV
tity.of Tigard . • ., .:. -T - .
0.day:
16 ., - 13;14w Half Blyd,,Tipni,pit 972*C 42 6 71k-117
Man Review
C' l'ihasni 503,711i/439;Fax,•: 503.598,1903' , ,I. Datethy;• . Othar Permit;
.
T IC,Ail B 1,11M/eith311Lillts;'5O3:4354175
inorlio;'tifurbi.tiiii‘orvir t.. F. a ;; - ' _ __,, , 1 1,4c4trodimethed:. StIPPlernental havisaittitni
',2,5.,:i 1,..,•I.c.';.!;.:,,V.71 2-.";.,', -'-,-'- ' - - . .• _ - _ . . . ,. . . . . . .
'.;`•-='7:4'ineAlti,..;04,e';"Cri4Z-iitiiiiielitAiiitLIV.k;c1f:'41V.V.OVIIVRI",,S 04*-V2 re0iiii:4.4. 1ftktilickgtii#:**Wir.:41:000,07'..-:-:-.
..".,,,7.i,Wf,'-kr,44-.-3g.,1*.inTs:4:A15,1/4-,,,,Ici,: :,7:qat,-,:.i,,•:.. ••,--C ,,.-1,... ,...:24,.1:.::::i:•,:11,-..,%,,,g,,,,41.,•,..,,,f26 ,,,,,,,zt,,,,i. :4,„ jr) , • .
MechalliCal pan*tees*are based 011 ille Ville of the NI-vit.
'.J.New ecnistiuctical 0 AdditiZeilteratiutilleplecettidil: performed:indicate the value frounded to the nearest dollar)dell
0 Denialitiati. I:1 Other riterimical' materials.equipmentlabor.overhead.and Profit-
- • , . „, Value:S .
,.,-;:.7.;?,F,ilf,40.:Hvia.,,,,,, M„ .......g.,t,W, 2.,Arigwi-Wl....0j1F. ,L,..77,L7.6,1,,,,,,;itt., ..14,,;.,,r,,,,112,-iff..42.:;,:: ,?..„;,;,?.....,..,r,,..3..les,..--10..-.043,1a,-.r.,....-414v--thko,tigi..3TEms,•„-----. s,..A,,,,....„,.,....a•.....,.. ,
111--'and 2-fantill&tiling. 0 CoMmernialiinduttriai 0 Avassery building Fur special turohnution use elyralist.
Mtitti-ta4iy, 0 Ntia4er bldi*. 0(*Cr* Denestitintf 1.Czny. I ea i Total.
Air ionditioning 46.7d ...
/0*.addrFfs.: 11/161 1 Sq,) Lo.r14sretyl ; ,Laity.. Pima 10,000/MT fdietskentsl 46.73 •
OtY/Slale/44).::Thlarlls..OR 97224; Peruke 11:10,060+IBTP(dorssivenis) , 511.9.1.. .. ..
. .
fiesuptintp 1 61.06
7Sititeltildgpt.tio..' PtWe‘ftithi:Plar-Ttrrti(r.. ...&2.S.+ Nit'work -
2332
Oess slreetAlirectforts to Job site: lfrdthnio hat water wstem : 2332
- • Residential heifer(radiator or
Itydrunic) 23_32
• Unit beaters(titel-type.tan electric),
• - •.- • . . iii.:wall.itkluct Snanended,-eic: • 46.75
. .
nueivertl.fitrati;nr alianie• I 23.32 .
•
S 177 . Lei no.:55 ' Other: l •• • • 23.32-
.SP6divisiM 141 kif/If /-eflali•C:; C_Ci
Other furamtliaiteis: • ,
Tax.rnapipatcel ite.:' Water heater . ,.., .. . 2332
i'W3:731:4-Y-4-S414,-,',..0*.7.0.***0.0***WAM,7;2.-Vg- -'.f:!'";4Y-':. °Is firtPlavelfrised - 1 . 33'39
M ST10 I-1'.60)A i • ---:'----- Ma esnt fbr.water heater or ps
fireplace• 23.32
•
Lne IOW(la ) 23,32
• Wood/Pellet stove 33.39 •
. .. .
Wood rtreplacts6asert 2332
Chinuteyitinertfisterent 23.32
gilf0.101.#00:6*lit*••r:,::i.;;71•:-''. .;!'ili1 :tjfil*Tit1/4sief-4, ..,-..,;:a.::;,114'.:;: Other 23.32
-..._..,,,,,,,....,. ... ,...- 4....:L.- "..'.'. ',.'-4.'a.:.1'''''',. ''•;‘' '',, •'' "''."7.....:''.'":7'.'" Envirounteatal exhaust end ventilation:
Nanie:'Pt D Vs.- •t49...tild--OD Icl i oi 5 /.U-C-. Ranr Watt/other titolteat.
• • -
oraripment 1 33.39
Addrem:.7110 W. 6 0 Di ziotc.- e. g&hc,14 (e-oct-4. Clothes dryer came I
l4
' Single-duct exhaust*alveolus, i •
irri-- tenet cumparuncuts.utility rooms) %-r 23.32:
PhtinC*I)CI- (1)9 ( 3 ) For( ) AttlekravvIspace fans 23.32 e .
..,........;.''?:,..,.';', ig44*.i4PASir1.. ..;.'::7;.; 1• - -' ,; 1,(47.1-rOlier.Acr.i,!.f:41,f$0.$414.,7.::i.- (NM:
23.32 •
-
Business name 'W i 1 1 i.tam l.kior\ tiuyvs izinc_ SILTS for first fain;S4.03 tor cad additional.
C0/11m1001110i. Nlidc alf_d____Ticts>g<„, Furnace.etc. . , I
,Gas heat nem
Address: -1021.il
-, imailo t ..: it, 11.
WartistisPeudedruult heater
CityiStateZIP:Vancouver,WA 94664 ' , Water he i le e.
Phone(360)6954700,. Roc:-(364)6934442 Fireubtee 1
Range . 1 . .
E-ma i ' A a i I 1, 'Ali tt P41143045.44Ca---, Thuile:no .
•
•
A,V.!.:440.'•A•7.Z.."Vq,%...:',W•-.!:;•.,-;',ZV:C.431'i' ' - t Ito',11.:;:. •.••r,•,:c•.--4.:-,•-z-:.-1-7,::.:-...7..:7.-rp.:F.e.:k.,..;?.y.: Clotim*Ter(u9s) •
Businesiname:Apex Air 11,C 04= .
. , - ,t,ti•---Z:: : :49•2..V.i .,4•0*/.41-.1**. ..4.-r:ti•Vr,•,.:• :.F. :
Adclres. 38904 la 72-4 Ave Subtotal
- •
dtylStattiZIP:Vantouver,WA 94646 • Minimum permit fee('90.00) _
• Mao review(25%of permit feel
(360 342411)9 Fax:(364)326-1'769 . Sidle surablerge(12%uf permit fee) '
CC E3 lic20303,4 • TOTAL,mom FEE .
ure:
...I...4 .
Tido permit application eapiret tin permit is not obtained within 180
days.abseil bas been tempted as complete,
.Autbodzed signat
* Fen boyr4 by TekCinuity.Baliding Indusai Scrui(nalosid •
Print name: Lea. go( Odle: 4-tit.14.
.1 TduldukfsPediuMEC PaankArte 04011:1 dun •440-01,7 t 1 IMIC0410.7113)
Electrical Permit Application FOR OFFICE USE ONLY
d )1t97
City of Tigard 11 i i RI:cavedPermit a/V-57.7-0/7-00 3 1,
IN�a 13125 SW Hall Blvd.,Tigard,OR 97223 _ ° plan Review
,t Phone: 503.718.2439 Fax 503.5984960 . t ��6 y �' ; Dig Related Permit ii:
Inspection Line: 503.639.4175 '+, •-.dy Date/By: Jahr H See Page 2 for
TIGARD Internet: www.tigard-or.g,V t It' :.. `-.,e .- . ^ - Notified/Method: Supplemental Information
j r " z 3 z` AW4 r-:-.1v,1i!z#?t', t V- ;•,—k,, •f Y ,.?• P:.& i 4 .'",r4 yr• a:N S 3 7 K4"g v t 2 :eT. ti--; •
®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plena—v//items checked):
❑Demolition Other 13 Service or feeder 400 amps or more 0 Building over three stories.
where the available fault current ❑'Marinas end boatyards.
:,-,--*-3,-..i.': . 9 r �7 ,:. fl"`3514, I, 64 i s exceeds 10,000 amps at 150 volts or Ej Floating buildings.
®I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
❑Multi-family - 0 Master builder 0 Other: Fire for ell other installations, Installation
latio
❑Fire pump. ❑Installation of ISD KVA or
'-'s :2, - gn Lig, .s1; , --,cr.--9,--a a.y.- `ff„,,yae D .4•777-15.:,-4- ; •-?..� ' 0 Emergency system. larger separately:,:, aratc derived
Job#: Job site address:1 V1g 1 ' i 1.1 i .. ti � Ne ❑Addition of new motor load of system »
100iiP or more. ❑"A"",?,"I-2,"i-3,
City/State/ZIP:Tigard,OR 97224 0 Six or more residential units. occupancy.
❑Health-oma facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: I\irk,- �" D
" Hazardous locations. ID Supply voltage for more than
Y �� 0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: r A ,,. = -
Description I Qty. I lash Total •
New residential single-or multi-family dwelling unit.
Subdivision: L Lot#: Includes attached garage.
�}d�1' Te;`r 'r- CP_ � T 1,000 sq.8.or less i 168.54 4
Tax map/parcel#:
Ea.add'I500 sq.ft.or portion 9 33.92 1
',r '„ x---: ,Y',- it t,51 '-!" 0Kl.T��' A 4: 7.. Limited=IOC residential 75.E 2
C A STZZ
\i 3- O l/3 tqI (with above sq.R)
Limited energy,multi-family 75.00 2
residential(with above sq,R,) 1
r s e � --at-l� 4'" "` t tic Renewable Energy ❑ See Page 2
L It -2)z , -� --, '?^-E,a-L ''e" . '7', -5-x 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 1,000 amps 301.04 2
Phone:(602)694-4031 I Fax•( ) Over 1,000 amps or volts 55226 2
Ercall. 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 I 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
'.';,5,- -'-'117-21&/.‘r. �1 4;..Ns-:„h r4 1 f-• -c- Erna -' '.y_U�-'�+- " Branch circuits—new,alteration,or extension,per panel
-�'' �' �K� -•�1�' A.Fee for branch circuits writ
Business name:William Lyon Homes,Inc. above service or feeder fee,
each branch circuit 7.42 2
Contact name: N i ch Ok T OW, B.Fee for branch circuits without
Address: -HO k..lr61 $t �� S up service or feeder fee,first 56.18 2
branch circuit
City/State/ZR:Vancouver,WA 98660 Each add'l branch circuit 7,42 2
Phone:(360)695-7700 ' ' ' Fax::(360)693-4442 Miscellaneousctured mfmreder not include
//� dwelling,service andforfeeder
Email + 67.84 2
I f h P fe. Ii p 0 .r mP 4* Reconnect only 67.84 2
�-,z._-=- ._,-_ -5;._e a ,, .__c5- .-:�: .gc,:r�m , A-;-4- z:_ Y" Pump or irrigation circle 67.84 2
Business name:Garner Electric Washington,LLC ' Signor outline lighting 67.84 2
•r-•• Signal circuits)or limited—energy
Address:e,4 D? U a,�\Qil �b e\, \ S Lp_, \'T tip panel,alteration,or extension. 0 See Page 2 2
Cityress: /ZIP6 h 't`�1`° iQ� J�.J LOA,47_, Lam/ Each additional inspection over allowable in any of the above
r'(,l(al.(p j W L es I Additional inspection(I hr min) 6625/hr
Phone:(253)320-1657 `� �ax:( ) Investigation(1 hr min) 90.00/hr
Email:bdaniels@gweusa,com Indushialplant(1hrmin) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: C1158 Electrical Lic.: 208174 Suprv.Lica: 4496S listed 'h hr min)
Suprv.Electrician signature,required:)/1/ �` f 1-e •.••:::- Subtotal:
Print name: Joan P Albert Date: 4/26/2016 0 Plan Review Required(25%of permit fee): ,
State surcharge(12%of permit fee):
Authorized si TOTAL PERMIT t' :
gnatt2C8. £ — This permit application expires Um parasitic not obtained within I80
Print name: Bill Daniels Date: 4/26/2016 days after It has been accepted as complete.
* Number of inspections allowed per permit
•`•`4•SBtrildicePenaluNIR.0 PermltApp Ei.R,,ERErloc Rev 06/1712015 440.461$70n%os/COM/wEB
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Plumbing Permit Application
Building Fixtures ;I;1 _'6 ?All? 1 OR orrice. 1 sl ONl.1
City of Tigard ReceivedPermit No.JL757„0.7_04.739/
■ 13125 SW Hall Blvd.,Tigard,OR 91223 ; 4, '` --' plan Review
•• ■ Phone: 503.718.2439 Fax: 503 59$0960, •, ,Date/By: Other Permit No.:
1 An Inspection Line: 503.639.41755, It.. ••::} . ' 'Date Ready/Br Iuds: 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Metbod: Supplemental Information
;r,:d.=::4>.n eCr_, 'titpki;1lP-•.WOR :a:..-........,..... .... :i;:.•,.a;:::. -. •i. ••�.ai":0 iD -"a ::.-,;,c.r:; s:
El New construction fl Demolition For special information use checklist
Description I Qty. I Ea. I Total
0 Addition/alteration/replacement ❑OtherNew 1-2-family dwellings(includes 100 ft,for each utility connection)
• f,• •:.."; -•.• "•CATEGORY OF CONSTRUCTION'• . • SFR(1)bath 312.70
•
®1-and 2-family dwelling 0 Commercial/mdustrial SFR(2)bath 437.78
SFR(3)bath 1 500.32
❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02
❑Master builder , 0 Other Fire sprinkler( _sq.R.) Page 2
: : • .: .:•",iOB STTE INFORMATION'ji.11D LOCATION • ••••
• Site utilities:
Job site address: t 1/1 1,I S� Lax-v.:ti . (NCCI .o `� Catch basin or area drain I 8.76
City/State/ZIP:Tigard,OR 97224 `"`,1� Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:^.J Page 2
Suite/bldg./apt.no.: Project name: jai Ver T'eraLc- 4- 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.: I Page 2
Water service(no.linear It.: ) Page 2
Subdivision: (7 We r - ein%Ce. f a s-1- I Lot no.:ST- Fixture or Item:
Tax map/parcel no.: Backflow preventer ( 31.27
' . ' • DESCRIPTION OF.Wu/DC: . : • B valve 0 12.51
f Q Clothes washer 25.02
S UJ 11" 0 D3 I I Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
ELTROPERTF OWNER • . . I. • 0 TENANT . • Expansion tank 12.51
Fixture/sewer cap 25.02
Name:ADVL Land Holdings,
LLC
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 .•. Il . 0 CONTACT PERSON' Interceptor/grease trap 25.02
Business name:William Lyon Homes,Inc Medical gas(value:$ ) Page 2
�^ Primer 12.51
Contact name: c-I! ie, 0(/ i 'O Roof drain(commercial) 12.51
Address: 1Q'5 Dn j akijJ� t SUATC ClO Sink/basin/lavatory /, N 4/1/ / 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
,wUrinal 25.02
E-mail: j alp t�,��/1 O " e •Q o�u l�(`(1 P S.Q 1 �(1 Water closet 25.02
i. CONTRACTOR-C� • Water heater J" 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 Lie.:102535 'Plumbing Lic.no.:34-276PB Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: t_...,...- C TOTAL PERMIT FEE
Print name:Carolina Malmedal Date:04/25/2016 This pervert 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.
i:1BuildiagVermits\PLMU-PermikApp.doe 10/01/09 440-4616T(10/02/COM/WEB)
City of Tigard
aII I COMMUNITY DEVELOPMENT DEPARTMENT
T 1 c a Ro Building Permit Review — Residential
Building Permit #: STA0/7 —0637/
Site Address: I 7q I cvv rrkpr—A— L
Project Name: iZ IVV,r. PC-rrzzt &Ci S-I- Lot #: 5 S
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review _
Proposal: em/ Y I`I
Verify site address/suite#exists and active in permit system.
River Terrace Neighborhood: ❑ No iii Yes,See River Terrace Review Addendum Attached
Site Plan/Three(3)copies of site plan ng structures on site
/Site plan must be on 8-1/2"x 11"or 11 x 17"paper `Footprint of new structure(including decks)with finished
Drawn to scale(standard architect or engineer scale) floor elevations
North arrow .Utility locations&easements (required for new and additions)
Site address,project or subdivision name and lot number Sidewalk/driveway approach
Applicant information(name and phone number) Qboeatieno£zvells/septic systems
Lot dimensions and building setback dimensions +Q.E.xrsting-t eesxo be retained with drip line,and tree
/Square footage of buildings to be demolished protection measures
. tot area,building coverage area ercentage of coverage and Street tree size,type and location
impervious area(applicable i 7 R-12,R-25&R-40) treet names
CAProperty corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? ❑ es No/ i,y�
4 foot differential) If yes,is a storm water quality facility shown? e Noo V �"t
VClean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): WAA
Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No
Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified ❑ No Applied For: /2 Yes ❑ No,stop intake
Land Use Case#: PDr27iile" —00Op 1 SO 8 L.c i6 _ (Do 09
Zoning: (Z"1
Required Setbacks: Front 1`Z Rear 1,5 Side a Street Side � Garage 2.,0Landscape Requirement: Civ 0/0
Lot Coverage Maximum: t? (
Building Height: Maximum Height I"laA Actual Height 33
Visual Clearance
f:Sensitive Lands: ❑ Yes 7r*No Type
!`J Urban Forestry Plan
,J Conditions "Met"prior to issuance of building permit
otes:
Approved By Planning: lfr?0/171.--.... IC\ ----: -- Date: 10 / ) I / 17
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved El Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved El Not Approved
I:\Building\Forms\B1dgPermitRvw REs 061417.docx
a
Building Permit Submittal / '
Original Submittal Date: CP i��//2
Site Plans: # 3
Building Plans: # 1
Building Permit#: Enter building permit#above.
Workflow Routing: Planning ErIngineering 1.Permit Coordinator /"-Building
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: I,L, 1.1„4:4416,... ,// Date: /0 L
s
Engineering Review /A
,,E( Slope at building pad: 1
❑ 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 e No
Assess Water Quantity Fee in-lieu: ❑ Yes a No
LIDA Facility on lot: ❑ Yes pNo
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: PV1,/ (r( U-) I Date: /0 //7//7
i
Revisions (after Building Submittal only) Reviewer
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
'ill pproved,NOT Released: ', •ate: )o/X-3/i 2
1‘lotes:
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: 2fYes ❑ N/A
( Tigard Trans SDC: ` Yes ❑ N/A
Parks SDC: Yes ❑ N/A
LIDA ❑ Yes /A
Z OK to Issue Permit 44L1Approved by Permit Coordinator: Date: (t V{
I:\Building\Forms\BldgPermitRvw_RES_061417.docx
40.
City of Tigard
III 'I COMMUNITY DEVELOPMENT DEPARTMENT
1
T 1 c A R D River Terrace Building Permit Review Addendum
Building Permit #:
Site Address: ( b1 el 1 s of Lei r&( ri%- Lt,-).
Project Name: Pci lI eA,- Te-n---- ta. Ec4 S I- Lot #: SS
(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. deepBalcony w/access 2 Window Projection Vertical Wall Offset a
ft. deep min. 2ft., 5 ft.wide min. 2 ft., 6ft.wide Gabled dormer
e/
lti
Ai 0
2. Eyes on the street: a minimutpof 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: 1
3. Entrances:At least one entrance must meet both of the following standards:
Max. 8 ft. setback from longest street- facing wall Parallel to street,angle no more than 45° from street,
or open onto porch
Entrance opens to a porch,Yes ❑ No
Iffy/One
es,all the following apply: X25 sq.ft. min.
street facing entry MJ 12 ft. max. roof above floor of porch
75 ft. depth min. ?30%min. porch roof coverage
/4. Detailed Design:All buildings shall include a min. of five of 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 ❑ Roof 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
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. ❑ Yes Z'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.
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 '40%max. of street facade
❑ 50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: c'A.,-•_:::, c"." '`— Date: 101, I / 1 l
I:\Building\Forms\B1dgPermitRvw REs RT o62216.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
11111
Transmittal Letter
TI G A R C) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Tom H. DATE C ?
DEPT: BUILDING DIVISION CrE
18
FROM: Nichole Thorpe J A ��
° 11 OF TIGARD
COMPANY: Polygon Northwest
NUILDINC D.!VISION
PHONE: 360-989-4204 By
RE: 101 1 Sv4 LW(V-SViNIN3 Lie- M.S11.0\1-- 00-ijo►1
(Site Address) (Permit Number)
River Terrrace East Lot bS
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: I Copies: Description:
0 Additional set(s) of plans. 3 Revisions:
0 Cross sections) and details. �lanS aV1d plot pi�S
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: Please pay fees owed with Trust Account.
61(1,10,4 SCOMt ted aS E uMenn Ids a S�A4
C'W( ,or S (TE AVii,/ ,
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: j )
Fees Due: yeS Initials: -t
❑No Fee Description: Amount Due:
5- ill p) r,A-\ rev'••ev $ 1--);LS
Special
Instructions:
Reprint Permit(per PE): ❑ Yes I .6 No
Applicant Notified: of r �� Date: 0414.-- one
� Initial ,�--
e-7-1i I L—
I\Buildmaorms\TransmittalLetter-Revisions doc
—I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
1m
' City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
•
T I G A R D Building Permit Review — Residential
Building Permit #: 5T-A0/7—06 3 ,1
1 Site Address: kcici j Svv L&I rkt
Project Name: T'Cr'K-¢.. &C L+
(New dwelling=subdivision name;Addition or Alteration=last name of owner) Lot #:
Planning Review
Proposal: eAN -CFR- 1/04-'' Sit` lviii>=LJ
A/4 i re Chit/EN Pa9-770A/ t9A/ 41/2.(6-
Verify site address/suite#exists and active in permit system. —9".7E /541,`‘''' A
River Terrace Neighborhood: 0 No / Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
/Three(3)copies of site plan
� Stteplanstructures on site
di ? s2 bc on 8-1/2 x 11"or 11 x 17"paper AEIVootprint of new structure(including decks)with finished
PrDrawn to scale(standard architect or engineer scale) floor elevations
North arrow
ZiTtility locations&easements(required for new and additions)
f'Site address,project or subdivision name and lot number
ri
,gApplicant information(name and phone number) Q ewalk/Lsweway approach
ella
Lot dimensions and building setback dimensions /septic systems
Srotecti
quare footage of buildings to be demolished °be�rigiteas-ttain�wi
�drip line,and tree
on measures
2rLot area,building coverage are ercentage of coverageand
impervious area(applicable i ,treet tree size,type and location
(pp - 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? ❑ es N
rV
4 foot differential) � f/�
If yes,is a storm water quality fatality shown? a No
Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): A//A
ifRequired: 0 Yes,applicant was notified 0 No Received:
Public Facilities Improvement(PFI)Permit: ❑ Yes 0 No
Required: 0 Yes,applicant was notified 0 No Applied For:or. Yes 0 No,stop intake
Land Use Case#: 1'" D Z w go —00001 S062-0 i,
/"' Zoning 12.1 7
Required Setbacks: Front r 7. Rear 1 5 Side 3
Street Side Garage 2,0
Landscape Requirement: VO % 5---
7 Lot Coverage Maximum: g Q %
Building Height: Maximum Height N11 Actual Height 33
Visual Clearance
%Sensitive Lands: 0 Yes ,,,,eNo Type
XUrban Forestry Plan
AoConditions"Met"prior to issuance of building permit
tes:
Approved By Planning: ti IC -
Date: i0 / JI / + -1
Revisions (after Building Submittal only)
Reviewer �i><� �!J1�1{�!� Date.
Revision 1: .Approved 0 Not Approved nv�C G{
Revision 2: 0 Approved 0 Not Approved '.J clic/ �'���� l�S
Revision 3: 0 Approved 0 Not Approved
\Building\FormslBldgPemritRvw RES_061417.docx
F
i
Building Permit Submitta_111-2—.2-24/ I/7
Original Submittal Date: # 3
Site Plans:
Building Plans: #
Building Permit#: Enter building permit#above.
Workflow Routing. Planning
Engineering Permit Coordinator ,. Builg
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: Engineering. (1)copy of permit application,(1)site plan,(1)building plan and
original plan review routing form. engineer and
' Building original permit application,site plans,building plans, g
4
r beam
calculations and trust details,if applicable,etc.
Notes:
�' � Date: /� 2
By Permit Technician: JG�
..ZAMINIMMINI.*Air.. ���'�'`""'�
o
Engineering Review �f
Slope at building pad: l
❑ Conditions"Met"prior to issuance of building permit
❑ Easements(encroachments)per engineering conditions of approval and plat
a Water Quality/Quantity Facility: No
Assess Water Quality Fee in-lieu: 0 Yes
Assess Water Quantity Fee in-lieu: 0 Yes No
LIDA Facility on lot 0 Yes
Date:
❑ NOT Approved by Engineering:
Notes:
ky K tom— Date: Diff 1
Approved by Engineering: gteRevisions(afte4,,
wilding Submittal only) Reviewer I 1 8
Revision 1: Approved ❑ Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
0 Conditions"Met"prior to issuance of building permit i of-X:3/r
,��( �ate:
pproved,NOT Released:
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 0 N/A
Tigard Trans SDC: ` Yes 0 N/A
Parks SDC: (ITYes0 N/A
LIDA 0 Yes '6:1N/A
OK to Issue Permit -,
) q /V
Date:
Approved by Permit Coordinator. 4121Maik___________--4–
I:\Building\Forms\gldgpermitRvw_RES 061417.docx
i
Y
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
T► A R River Terrace Building Permit Review Addendum
Building Permit #:
Site Address:
07 Cl 1 S W LArk.S pr %'741 Z4-1.
Project Name: RI ler.r Te-r'rzi ti2 €G S P
(New dwelling=subdivision name;Addition or Alteration=last name of owner) Lot #: ;"S
Planning Review of River Terrace Plan District Design Standards (18.660.070.1.);
Is the project subject to the plan district design standards?/Yes 0 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.
Balcony w/access 2 Window Projection Vertical Wall Offset a
Porch min. 5 ft.deep
ft. deep min.2ft.,5 ft.wide min.2 ft.,6ft.wide Gabled dormer
0
/111 ❑
2.Eyes on the street:a minim of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: t loi
3.Entrances:At least one entrance must meet both of the following standards:
Max.8 ft.setback from longest street-facing wall /e Peel to street,angle no more than 45°from street,
Entrance opens to a porch:16 Yes 0 No or open onto porch
If es,all the following apply:
25 sq.ft.min.
One street facing entry 12 ft.max.roof above floor of porch
f5 ft.depth min. ,30%min.porch roof coverage
4.Detailed Design:All buildings shall include a min.of five of the following elements on all street-facing facades:
Covered porch min.5 ft.wide x 5 ft.deep 0 Recessed entry area min.5 ft.wide a 2 ft.deep
Wall offset nun. 16 inches 0 Dormer min.4 ft.wide
,Roof eave min. 12 inch projection 0 Roof offset min,of 2 ft.
❑ Roof shingles either tile or wood
ft. ,21'Gable,hip or gambrel roof design
❑ Roof pitch oriented south min. 500 sq.
0 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 0 Bay window min. 5 ft.wide by 2 ft.deep
❑Balcony min.5 ft.wide x 3 ft. deep with inside access 0 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:
No closer to front or side lot line,than longest street-facing wall. 0 Yes.'No. If No(Check one):
May extend up to 5 ft.if there is a covered frontporch and garage does not
orc
May extend up to 5 ft.where the garage is part of a two-story building and there is a window at the seeyond the frontpcon h
above the garage that faces the street with a min.area of 12 sq.ft. d story
Width: (Check one)
❑ 12-foot-wide garage door /2°.r40a/"max.of street facade
❑ 50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: ,/11 9—"\. t/-1"+_
,r Date: I 0/1 I /17
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Address 109 Fast 13th Street
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Scanned by CamScanner
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16791 SW LARKSPRING LN, BEAVERTON, June 20, 2018 at 9:45:54 AM
OR, 97007
Record Type: Record ID:
Residential - Master Permit MST2017-00391
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:
16791 SW LARKSPRING LN, BEAVERTON, June 20, 2018 at 9:44:37 AM
OR, 97007
Record Type: Record ID:
Residential - Master Permit MST2017-00391
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS
Comments:
Water pressure = 65 psi
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16791 SW LARKSPRING LN, BEAVERTON, June 20, 2018 at 9:45:11 AM
OR, 97007
Record Type: Record ID:
Residential - Master Permit MST2017-00391
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:
16791 SW LARKSPRING LN, BEAVERTON, June 26, 2018 at 10:15:30 AM
OR, 97007
Record Type: Record ID:
Residential - Master Permit MST2017-00391
Inspection Type: Inspector:
299 Final inspection Jeremy Burrows
Result:
PASS - CofO
Comments:
Final erosion control passed
Street tree certificate received
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