Permit (138) r n CITY OF TIGARD MASTER PERMIT
't . Ilt'
COMMUNITY DEVELOPMENT Permit#: MST2017-00501
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/03/2018
Parcel: 2S 106AD09000
Jurisdiction: Tigard
Site address: 16944 SW LEMONGRASS LN
Subdivision: RIVER TERRACE EAST Lot: 197
Project: River Terrace East, Lot 197
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 805 sf Basement: 0 sf Left 3 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 939 sf Garage: 423 sf Front 12
Smoke
Dwelling Units: 1 Third: 0 sf Detectors: Yes
Right 3
Total: 1744 sf Value: $216,612.33 Rear: 0
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 LaundryTrays: 0
Y Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain
Tubs/Showers: 3 Storm Sewer 100
Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 1
Bckflw Prevntr: 0 Catch Basins: 0
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Tvpes Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add9 500 sf: 3 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener N All
Other: N Other Description: Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group:
NEWP Y Square Feet:
SF VB
R-3 1744
Owner: Contractor:
WILLIAM LYON HOMES INC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
109 E 13TH ST 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98660 VANCOUVER,WA 98660 2 Fire Rated Eaves-Both Sides
PHONE: 602-694-4031 PHONE: 360-695-7700
FAX:
Total Fees: $30,988.94
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••R 9
-'41
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: -r1<_—. ,e �
Permittee Signature:
G-r-
e"�`}-P9
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.
6 C.-0 'i--- /,
` Building Permit ApplicationRECEIVED
7
t I FOR OFFICE FSE O\t.\
City of Tigard JUN 14 REew
/ y11 lj;,//i ,Q2- Perm13125SWHall Blvd. TigardOR 97223 1:��/�F� (�V��/
2 ' Phone: 503.718.2439 Fax: 503.598.1960_('!�OF RD DateBy: 17��� )7 -- Other Permit: ����// q
Inspection Line: 503.639.4175 UILDING S1ON / / `kS��(,f - �`
f!t, `,R r, Date Ready/By: 4.• Juns: See Page 2 for
Internet: www.tigard-or.gov ) Notified/Method/�vz j/
�/ d Supplemental Information
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®New construction Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
. '17`t 1. :;-t•:"---,-4.7; 7 7' , work indicated on this application.
® 1-and 2-family dwelling 0 Commercial/mdustrial Valuation: '
❑Accessory building 0 Multi-family Number of bedrooms: of 6 f 61 '1
❑Master builder 0 Other: Number of bathrooms: o�
�.... � � t= Total number of floors. 2. 4j
67
Job site address: j�� v� , rn s 7 � New dwelling area: /7(JL/ square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: 4i 7 square feet
Suite/bldg./apt no.: Project name: gjV.Gr Terrace C.,,•l Covered porch area: square feet 39
Cross street/directions to job site: 13% c v� t square feetQOS-
POther structure area: 1 square feet
Subdivision RiV.f r Terrace, 54.8.1.-- Lot no.:191 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
Tam� �� equipment,materials,labor,overhead,and the profit for the
.' I ;i � s ; 1,r ?: work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
, 1�. 1, .-i'-',< - � ..' 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:
I �
Business name:Polygon WLH,LLC
` 5` >
k ^',�T Structural plan review fee(or deposit):
Contact name: l"1 Vd1 w
Address:109 East 13th Street FLS plan review fee(if applicable):
City/State/ZIP:Vancouver WA 98660 Total fees due upon application:
Phone:(360)695-7700 I Fax::( ) Amount received
E-mail: I\1( / r if, i,� y sa t " hl
!�� I1 C. It 11§ 1 1 1 ► ,. axe- �� ��
,#, , ! t Commercial and residential prescriptive installation of
` ° ``' , a,3 3a �� •• 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: $201.60
Authorized signature: �� This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: l J/Ci vk I/ 002 Date:�/7// ) *Fee methodology set by Tri-County Building Industry
/" �l '-f" r T Service Board.
I:\Building\Pennits\BUP-RESPermitApp.doe 02/24/2011 440-46131(11/02/COM/WEB)
Mechanical Permit Applieatfoli. FoR OFFICE t SE ONLV
'''' • •
city.of-Tigard 11 0 F.1 26 "?.0 1 7 .=;e4y, . Pea*140/7_..5;re;2•69/7'0 0-.56 it.. ''l 345 SW iiall'OlyA.,TigantOtt 9r43.. '
Plan Review . , ... .. . .
' II Phone i.S3,718.2439'Far,501598.110,30: i ''',;„1,:.:', ':"7 7,'';•1. :i, ;,..'') Diteilly:• ' Other Permit;
TIC A R D • p )1 [4C •10.1.63 ,/In
Dam Read:Fray: neiN. Et See Page2 fur.
. intinntit'titiviv:tigaiti;nr.goi• -"'•if-',:-.". ,'i '-''-'' - "''''. -1!''" :‘Pintilled&ledierk• Supplemental tritatimi
. ... . ..
''iT4',V-kaall'--,"ttnIk -j411*ItiitipiiretiliierglgVliii.??1,04tVC. Argir 'MATAMOPIAUf.r.ktSell..gr.a. P. Olt.V.X.41"V:"1.
,,..*,4•:•=', .'Sii4.4...w.si..•!stn;.2t.,...?-:•.:1,,4-4:,:,--f,2., .-,.. ..--..- •'%.
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Mechanical permit fees*are based on the value of the work
la Isliw Constiuction 0 AdditiortialicratiOlitepinvounit. performed.tadicate the value(rounded to•the nearest dollar)of alt
0 Dettiolition. 00d*r.: , Mechanical material&eclair:anent.labor.overhead.end profit.
..7‘.2.:.faii?4•Ar;7;54re. iii66...witivigiiittiolitc,,,a4iitl!1;•: *.'4ili:- ,,,,.....,4.,......„,...„.„.„.. .,,,...."`..r..a....1".,;...S., 3.
,-..-i.q.i.,:::;• 0•47,.., :i.-•!.%i3.,7,-....44.- ,.-, • . •••;::...,-;..:_ • -...,„.•,,,,,,;,,•..,i .r-,1• 7' .1t0y,ACSJCp :,.k...TAIX,p71:
-and 24aatilY&tithing. 0 Corturtettialtinciuttrial. ip Accessory building .
Far spedal Writ-motion use Otecklist.
muiti-timpy. 0 Masw byik)er. 0 cottr.. . DeseetPliatt— . , Q . I Ea. : Total
44:1:0-tklitilIcist,:0:1111.1,:mP;;.'4.0.5%719.$.-AK:1-*3.-4,0;1. 7,-,v7: -. ._......
Air conditioning 46.7 ,_.
JO 54.addr.esc VIRAL' Sky) Lexn6rnrasS 1..airve Furnace 101000 STU(dm-Willits} 46.73 ,
CllYiSlsicarkitarlitOR 97224- Pumice 100,064103T11?dams/mite}
. •
61.06
lie.al PlitinP
Sitit&bidginpt.itt):: Project Mune-, OF Ver , 01 0
A.,. btit:wqrk_ 21.32
(toss shtetf.4ections W.f.*siii.:. 147tittark hot,oteins*en. , 23.32_
.. .. . . •• ... -
Residential heifer(radiator or
livdronicl . 23.32
,.
Unit heaters(feel-type,not electric),
• • • • : ...,
61.:silli•ill-dq.ci.0ga:tided:ate: , 4635 ....
•
•
FluefeeMibraity_of Aire- 1 2132 '
. --1. • • - . . Other:
Sobitivision:. GI kr v—7, i sz .. Lot ntt: ci
— Other Stet appitaittim _
Tax multiplied!rto.:
Water beater . 1 23.32
,
';;;, ''';-',:e•kiVit-%:;4V-:!ttk.i.it'':;;j:thsKTfitki*54.14041.1AWV....4k,V;Vti;::!-.. .-';'•':' " Cla efmPiwelasert - 1 . 3139
Flue-tiont for water heater or gas
fireplaca- 2132
Let Winer(Sas) " 23.32
• Woodtmellet*re 33.39
. ..
Wood fireplaeolasert 23_32
.,
Chhuney/litmehicivent 2332 '
23.32
K•f:4-•400.0.tit_0**ii. "!,.:.1,t17:4:"":Z4M...Kg.0 .041n .;;,::k . Emir nig nimushisd miaow-
Nathe:s'Pt I)V L tzuevi fiD)ciioq 5 i LLL . . i flange hoed/other kltelice,
equipment 1 31.39
mithesc:.it,00. E. DoLuote..1144 .. (24,h e.k 11—Q.ccq.. Clothes diver mdtanat t •33.39
,
42 -kii AI- C.) .-2...se4p1 . Single-duct exhaust(bathrooms, L.
tact compartments.utility rooms) 23.32 ...
Ph4114' ilea- (1)9 H 463 ) Fax:( ) Attidcranispace fans 23.32
',."::.'''.-•••'::;:7.. . 440:40. .:•:-!"fil;ilr.4-:: ':i;:j '''' :if:littija*.44;01.:_•k:',.004. : ":f'•'. ' "their 23.32
l*Phial
Bilsine4 /utme AO i 1 ii.olvi Uinr\ tkn\rs ir-n - Fooc_. situ fin-Arai fair;S4.03 far each additiona
l i
C'ortga ilume. 1\ i rt1r101?,TV1 l>r`?‹. , Furnace.etc.
. I . .. .
anceicnciwo-4-1, s-r Skdt-e, 510 , waMan
husi.ddAngheetifg
_
City/State/ZIP:Vaucenrer.'WA 98660'
%fa beater' ,
1 .
Phone:(360)6 .98-7700. Fax :kW)693.44.12 Fireoliste .
E•mla:Wie,leto k. iTilaveFtepo Itiii g L._. Itarbenao .
aeriFtft-4::'..i:::cgdoiiik,:fPf_i4::::ii;:i.ori..-!;xtitf3,.' 344:.: cskot$4,s;ei(ies) . .
-Other.
13usinesinoutt kpex,Air LLC
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---7577.711.,-2 ::14L4**. . . iii*Ot.igtWili:;-rr,..-4.:".-
AddresIC 18004 NE Ave'72*4
Subtotal
City/Stale/ZIP;Volum-vet,WA 98686 Minimme permit fee(S9400)
Plan review(25%of permit fee)
Phalle:0601 3424109 Fa (360)326-1769
State surcharge(12%of pertpit feel '
•
CCB lie.:103034
TOTAL PERMIT FEE
This mead application espres it 9 permit is net obtained within ISO
days alter it ha been accepted as stornPlei*-
,
Alnitelefl-.,6.4'-
* Fee ineticeiclogy al by iii•Catintysending Indus*Scrviee'00*
IPrint name: i'01.. -I I 631= 4.
1 tikatiingsPenalitatEC_Nanitilip 0401D deo a4O-a,try(1 ts,..2co-Nowcar
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Electrical Permit Application
FOR OFFICE USE ONLY
City of Tigard �1 O ! Received
Date/BIii II 13125 SW Hall Blvd.,Tigard,OR 9 , , ,,-..,r Thin R . riSMIZIFEp
- Phone: 503.7182439 Fax: 503.59Q DateEe"097
Ins ectionLine: 503.639.4175 Deady : RetatedPetmitlE:
TIGIIRD p .1 V,,* �, "' adyDateBy: lade: ltd SeePage2fcr
Internet www ttgard-or gov T
e;'-'s1"": .
NoG&ed/Method, Supplemental Information
s y ; k � yTi13Visa 'r nx
®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Demolition 0()th
er" 0 Service or feeder 400 amps or more 0 Building over three stories.
£. (a, r '..V.1- � p y -_ r where the available fault current
u ..)_W_,D� a 'i, --. ❑Marinas and boatyards.
m _ -ti - exceeds 10,000 amps at 150 volts or Q Floating buildings.
®I-and 2-family dwelling 0 Commercial/isidustrtal 0 Accessory building km to ground,or exceeds 14,000 ❑commercial-use agricultural
0 Multi-family ❑Master builder 0 Other: amps for all other installations, buildings.•
"- ; *r r,:, ja f".‘-1:w�,:-7tl_( 'ate o t :,-o 1:3 Fire ❑lrgerstioaof150 KVA or
rived
! (171 �, sy 0 Emergency system. larger separately derived
Job#: Job site address: � SW1,j),mor�,. ❑Addition ofnew motor toad of system.
s�()LS�J\Q- 100E1,ormore. Cl"A",B',"1-2","1-3",
City/State/ZIP:Tigard,OR 97224 `r ❑Six or more residential units. occupancy,
Suite/bldg./apt#; } Project name: 1 vele- r E 1 ❑Hea$h-care facilities. 0 Recreational vehicle parks.
�C� El hazardous locations. 0 Supply voltage for more than
Cross street/directions to job site: ElService m•feeder 600 amps or more. 600 volts nominal
Descrlpdoa Qtr. Each I Total..
New residential single-or multi-family dwelling unit.
Subdivision: V--4'•17 kr
r i,4)- ECO-1—
^U+'c-E I Lot#:1C 1 Includes attached garage.
Tax map/parcel#: PIM(
L 1.000 sq.S,tiles I 168.54 4
y y �, t, � � Ea.add'I 500 sq.ft.or portion 'L 33.92 1
Z: -=a Limited energy,residential
(with above sq.R) 75.00 2
Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
- - Illi aa(0_' 1 'e ``- r)74 , " „ ,;?r yam- , RenewableEnergy
-- � ��F<s��,hs/ta� i�, °; �� � ❑ SeePage2
Name:ADVL Land Holdings,LLC •
Seo amps or feeders installation,alteration,and/or relocation
200 amps or less 100.70 2
Address:7600 E Doubletree Ranch Road 201 amps to 400 amps 133.56 2
City/State/El:Scottsdale,AZ 85258 401amps
m 600 amps 20034 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 being made on propertyrelocationm
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701,not• 200 amps toor I00ess 59.36 2
201 amps 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 16854 2
'gym ,,,wa,,r vh 7 c; :c,zk ,t3,,, g;Evto. j�e N� ,a, a Branch circuits-new,alteration,or extension,per panel
Business name:William Lyon Homes,Inc. A above serviceorfeeder fee,
Contact name:lel ich o►e,Th flr 7' osehbreachch7.42 2 -
B.Fee for branch circuits without
Address: -103 lU service or feeder fee,first
t t a4 J 1 Jt�C'�+ S lEs branch circuit 56.18 2
City/State/ZIP:Vancouver,WA 98660 Bach add'/branch circuit 7,42 2
Phone:(360)695-7700 Fax '(360)693-4442 Miscellaneous(service or feeder not included)
/ Each manufactured or modular
Email, ( D(� l ' �` i
dwelling,service and/or feeder 67.84 2
x_,..-,34„-__;,..• ,—-,..— -,..-1,,-,,,,„-3/4;,.._• 4�,o�c :-8-.-e,: o),,. ' � i ✓ Y, p Reconnect
irrigation circle 67.84 2
Business name:Garner Electric Washington,LLC Signor outline lighting67.84 2
. - 67.84 2
.r_.
Address;t j OZ ` 0✓l Signal circuit(s)or limited-energy
1 i l�,AA k s3 U k\— `' 1° panel,alteration,or extension. ❑ See Page 2 2
CrtylState/Zlp: J ``F' Each additional inspection over allowable in any of the above
Phone:(253)320-1657� 14 p, 9 3
Additional inspection(l hr min) 6625/hr
/ Fax:( ) Investigation(1 hr min) 90.00/hr
Email:bdanielsawensa.com Industrial plant(I hr min) 78,18/hr
CCB Lie.: C1158 Electrical l Lie,: 208174 Suprv.Lic: 44965
Inspections which= is
s,. S. ,
90.00/hr
Suprv,Electrician signature,required 1 ^:t/ I - t` (xiqeH D, �r r t
• '� •---• Subtotal:
Print name: Joan P Albert • Date: 4/26/2016 0 Plan Review Required(25%of permit fee):
•
Authorized signature: - " State surcharge(12%ofpem:nit fee): -
C .-- _ TOTAL PERMIT FEE:
Print name: Bill Daniels Date: 4/26/2016 This permit application expires if a permltis not obtained within 180
days after It has been accepted as complete.
',.:0Ala' a$ 'aitsua.0 i'e'mitApp > doe Rev 06/17/2015 * Number ofinspecdoas allowecipe permit
.s, 410-4615'limIlOSICOirf/WF.B
K
Plumbing Peintt AppIieation _:. 's- '-
Binding Fixtures:
OC'T 26 n17
City vO Tigard .Received
Iii ■ 13.125-SW HaU t31vd:,Tigard,OR bataiBs Peaaitxo.: -%o2Q f7�`t20 0
/
C Phone: 503.718.2439 Fax:503-598:194 ° `
Inspection Line:.503.639.4175 ,Date/Bv: Dd>crPcrmit?Jn.:.
T t c n R D ntranet www tigatd.c .gov rt. laic &1 Seat e 2 roe -
Notl6eduettbod
�� ' i.- a T +"s`` �,�� ^ s, ; � -fie "�rarXr < ( Sappicateatal ialtOrelatloa
®New CC1lStluCttCIl...^ see tf, 2 Faro r' i.. '. i 2 ".<i st A. €:At5;1•t v14. i b�j,-, _
Demolition For special information use chickam.
0
Add3#ion/alteration/riepIacement. p - Description . 1 Ea. i Total
.,„",,,..;.-.,,,,,;.L.:,.-e i e BF t_RO11�5 = New 1-SFR aY dwelRugs(molvtias 100 8 for each utility connection}_
pr .- ;4 , e_- ;Wet ; (1)� 332.70
®le.and 241124 dwelling ❑Commesaialr SFR( barb 43.7,78
mdustciai
SFR(3)bi 50052-
o fi
Achessary building MuitiAnnily
0 Master
q �, Each additional.barb/kitchen 25.02
,(,a�.i__,a �i',iO,Sr (] �/y t•t '••t. -T'F:2 R��!{. ^ Fire sprinkler( .�/{ f) P 2
'cT":X.]]+.n�'n"^',--P�'"3 ta.cF ti �i.l 10 _ice_ �iS.# �F:1F*5 Sit Wades'
Y2
lob site address:: I W t`I LI Svc tzVY1Or1C! 1....,a-ne, = Catchbasin or area drain. 18 76
City/State0P.:Tigard,0497124- J Drymcit,leach line,or trench drain 18.76
Suite/bld$,fapt 1104 I'rojectnamr« Footing dtain-(ho.linear ft.:.__) Paget
giVe rle,ley-ace.E4A ! Manufactured home utilities. 50,03
Cuss street/directions to job site: Manholes
1&76
Rain drabs connector• 18.76
Sanitary sewer(no.linear ft.: )• Page 2
Storm sewer(no.linear ft.:_J Page 2
T .�+ L Water service(no.linear it.: ) Page 2
Spbdivislan:
I Q ate. . S 7 1 Lot no.:fl`7. Fixture or Beni
Tax mamap/paredno.: Backflow prevented- --•�-�1, . 31.27'
(�F F ` c Backwater valve 12.52• a:_:rF, 41 ; : . : - *U11� .
Ckiltes was6ea 25,02
Dishwasher 25.02
Drtnkiag fountain 25.02
�p 25.02 b n
t Lr1J fw _ 17 ' 4 :1•
4,- .z:Yi
Epanston tank 2.2.51
Name:ADVL Land Holdings,LLC, FixiturJsewer cap 35.42
Address:7600 E D'aabletiee Ratacli Roa�tl• Floor drabrtpo a sink/hub 25A2
Chy/StateIZIP:Scottsdale,AZ 85258 age 25112
Hage bib• 25.02 •
Phone:(602)694-4031 Fax.( ) ice maker 1251 7
- t ..o !.,. iii-.I I -,s.k.,..i. r tikiCl Ifl �C '!P * . . Intercepter'/grease tap 25.02
Business name:Witham Lyon Homes,Inc Medical (value:$ ) Page 2•
Contact name: (J r h u lei i t` t(o Primer 1251 .
Roof tb .(connneroial) 12.51
Addie —103-Fro1 n �-S.1- : S 1 D Sink/basiMavatory 25.02
City/State/ZIP:Vancouver,WA'98660 L Solar twits(potable water) 62.54
Phone:(360)695-7700 1 Fax::(360)693-4442 Tubtsbower•/abowerpan 12.5.1
1 \ t Urinal 25.02 CIV . 1/ I p( je� C,O 25.02s -> _ - ,t 7 , iWfercioaet
d F T t e YC ::]..-..."-..,,,--t,.. .J ,
- �f WaterhPater 37.52Business nam: G"`c- W %I '4—S-�- Water
pip?nglDWY 5¢ 9
Address: p.Q. 6"0i ciOther: 25:0 _ _
cltyJStaxe7ZiP: 57. 9 414t4 art. 11(31 Sub
total
Anne:(e't3„3,�-1 `" 140 Fax:(t 1 p..-74.1.4 J: } Miriam Permit fry $7250
CCB Lir.: 154131,2_, P3dmburg Lie.no. Plan review(25%of permit
A� � She surcharge(12%of permit fee)
Authorized signature: e TOTAL Pte'!'me
Plum name:.ST t 5'W .. D :3—.36— K�#.3_ This Permit application expires.it•a permit is not obtained within 1SO:daya
Ci attar it has been accepted m complete.
*Pee asetbadoiogy sat-by Tri-County Building Industry Service Board.
1:1Ba rliiegVamitslPIAMPacruiiAppdoe MIA* 44a4a1s10/021COMMSl
s
•
11111 City of Tigard
v COMMUNITY DEVELOPMENT DEPARTMENT
T I G A R D Building Permit Review — Residential
Building Permit #: /*<72-0/7-/?^ 00 5-0/
Site Address: (6'f t Sw is,r�/�r�1S L .c
Project Name: 11- lima_ e'w)- Lot #: /19-
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review II ,,
Proposal: C vol4 4 NUJ S F k
I�/Verify site address/suite#exists and active in permit stem.
LTJ River Terrace Neighborhood: ❑ No Ly Yes,See River Terrace Review Addendum Attached
Sity Plan Elements:
D'Tree(3) copies of site planEsting structures on site
Lite plan must be on 8-1/2"x 11"or 11 x 17"paper [ footprint of new structure(including decks)with finished
E65Awn to scale(standard architect or engineer scale) or elevations
IILISO
rth arrow
?llity locations&easements(required for new and additions)
Bite address,project or subdivision name and lot number P Sidewalk/driveway approach
A plicant information(name and phone number) Location of wells/septic systems
[ Lot dimensions and building setback dimensions lki*xisting trees to be retained with drip line,and tree
taie95.quare footage of buildings to be demolished rotection measures
Lot area,building coverage area,percentage of coverage and g reet tree size,type and location
}mpervious area(applicable if R-7,R-12,R-25&R-40) L!IStreet names
Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? dYesNo
4 oot differential) eta(1of If yes,is a storm water quality facility shown? ❑WssA1No
Clean Water Services-Service Provider Lett platted prior to 9/10/1995): L-3 il
Required: _ Yes,applicant was notified j No Received: ❑ Yes ❑ No 4Per �rh
Public Facilities Improvement(PFI) Permit: t4.4 vSe
equired: 2 Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake
Lld Land Use Case#: POR2016 `0000
[: -oning: k-L5 �. � � pF120(6` 0001Pa)
`\ t equired Setbacks: Front 1/ Rear O Side 3 Street Side tJ'A Garage 3
A Landscape Requirement: Z.0
of Coverage Maximum: SQ
��,,,,.pp Building Height: Maximum Height PAActualHeight 26.5
�`r�I' isual Clearance
giSensitive Lands: ❑ Yes E`q No Type
Yl�
__/Urban Forestry Plan
[ Conditions "Met"prior to issuance of building permit
Notes: C14 1J-n,4 IN (C "el- tgitii- h ,;f- rsidaice.
Approved By Planning: Cid—r{ Date: /2/i
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\B1dgPermitRvw RES 061417.docx
.
Building Permit Submittal /
Original Submittal Date: fl Ll/7
Site Plans: #
Building Plans: #
Building Permit#: nter building permit#above.
Workflow Routing: Planning Engineering P.—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: i
By Permit Technician: w -41Date: /2//7//7
7
Engineering Review
ve at building pad: ,S,t
ditions "Met"prior to issuance of building permit
1ements (encroachments)per engineering cot;ditions of approval and plat
ater Quality/Quantity Facility: el'L"''
Assess Water Quality Fee in-lieu: ❑ Yes ❑ No
Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No
LIDA Facility on lot: ❑ Yes ❑ No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: Date: /a�1O 7
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
❑ Approved,NOT Released: Date:
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:
C Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: ii57Yes ❑ N/A
Parks SDC: (es ❑ N/A
LIDA ❑ Yes /A
OK to Issue Permit
Approved by Permit Coordinator:
Date: /27Z ii 4— ---
I:\Building\F'orms\BIdgPermitRvw_RES_061417.docx
— -- -I:\Building\Forms\BldgPermitRvw_RES_061417.docx
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
111111
T I G A R D River Terrace Building Permit Review Addendum
Building Permit #:
Site Address: [619( S G/ CLANAInii Lane.
Project Name: Ri -Myatt E - Lot #: 117
(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? ig 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 deep Balcony w/access 2 Window Projection Vertical Wall Offset a
ft. deep min. 2ft.,5 ft.wide min. 2 ft.,6ft.wide Gabled dormer
0 0 0 ❑
2.Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: , /.
3.E trances:At least one entrance must meet both of the follo,ing standards:
old Max. 8 ft. setback from longest street- facingwall u 1 arallel to street,angle no more than 45° from street,
or open onto porch
Entrance opens to a porch: dYes ❑ No /
If„�/yes,all the following apply: C� 5 sq.ft. mi .
Ly One street facing entry , 1 ft.max.roof above floor of porch
LJ”5 ft. depth min. Lid"30%min.porch roof coverage
4.Detailed Design:All buildings shall include a min. of five of e following elements on all street-facing facades:
LE'Covered porch min. 5 ft.wide x 5 ft. deep L5d"Recessed entry area min. 5 ft.wide x 2 ft. deep
❑ Wall offset min. 16 inches 0 Dormer min. 4 ft.wide
Eoof eave min. 12 inch projection 0 Roof offset min. of 2 ft.
❑ Roof shingles either tile or wood 0 Gable,hip or gambrel roof design
0Roof pitch oriented south min. 500 sq. ft. ❑ Horizontal lap siding min. 3-7 inches wide
12/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 �❑ By 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: PA- ` GQrayt -lief 4ittr
No closer to front or side lot line,than longest street-facing wall. ❑ Yesifill No. If No (Check one):
kiMay 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)
kilt . GQrait 6 4't1
❑ 112-foot-wide garage door �v ❑ 40%max. of street facade
❑ 50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: - j-�- s�„.../ i Date: /4/07
I:\Building�Fornss�BldgPermitRvw_RES_RT_062216.docx
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
F',� al
Transmittal Letter
T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Agnes or Monica. DATE RECEIVED:
DEPT: BUILDING DIVISION r s ! ,
FROM: Nichole Thorpe yy
0 , ! it r
COMPANY: Polygon Northwest f . '! a,,luz e :3 ; c ; ..
PHONE: 360-989-4204 BY:
RE: !19 d W U'.V�f1 ic0SS
( ite A dr ss) (Permit Number)
Zwwer k. c2
(Project name or su'division name nand lot numi5;11 `,
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
0 Additional set(s) of plans. 3 Revisions: pkm- p S caFi‘ite#D,ce.,(3u-wNA0 Cross section(s) and details. 0 Wall bracing and/or lateralalysis.
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.
fWed place. burnp.
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: Initials:
Fees Due: ❑ Yes ❑No Fee Description: Amount Due:
$
$
$
Special $
Instructions:
Reprint Permit(per PE): ❑ Yes ❑No ❑ Done
Applicant Notified: Date: Initials:
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16944 SW LEMONGRASS LN, BEAVERTON, August 14, 2018 at
OR, 97007 10:53:41 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00501
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS
Comments:
Water pressure = 75 psi
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16944 SW LEMONGRASS LN, BEAVERTON, August 14, 2018 at
OR, 97007 10:56:13 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00501
Inspection Type: Inspector:
199 Electrical final Aaron Cillo-Gobel
Result:
PASS
Comments:
No A/C installed.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16944 SW LEMONGRASS LN, BEAVERTON, August 21 , 2018 at
OR, 97007 12:23:29 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00501
Inspection Type: Inspector:
699 Mechanical final Jeremy Burrows
Result:
PASS
Comments:
Corrections complete
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16944 SW LEMONGRASS LN, BEAVERTON, August 21 , 2018 at
OR, 97007 12:24:52 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00501
Inspection Type: Inspector:
299 Final inspection Jeremy Burrows
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