Permit CITY OF TIGARD MASTER PERMIT
, _
COMMUNITY DEVELOPMENT Permit#: MST2017-00519
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/10/2018
T t(;;k l<' t� 9 Parcel: 2S106DA07300
Jurisdiction: Tigard
Site address: 16744 SW LARKSPRING LN
Subdivision: RIVER TERRACE EAST Lot: 73
Project: River Terrace East, Lot 73
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1254 sf Basement: 735 sf Left: 3 Parking Spaces: 0
Height: 0 Bathrooms: 3 Second: 1655 sf Garage: 464 sf Front: 8 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
Total: 3644 sf Value: $443,165.01 Rear: 10
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 2 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add.]500 sf: 6 201-400 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 3644
Owner: Contractor:
ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
BY FORSUM,MICHAEL 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175
7600 E DOUBLETREE RANCH RD VANCOUVER,WA 98660 2 Geo Tech Required Prior to
STE 1 Pour
SCOTTSDALE,AZ 85258
PHONE: 602-694-4031 PHONE: 360-695-7700
FAX:
Total Fees: $37,025.62
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: �G ry c: !<<"Gt‘
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
-
4 _ _ 1,, 0 -7 S
Building Permit Application °''
Residential I '""` FOR OFFICE USE ONLY
Cityof Tigard g Received /`�
® Date/By: f ?/// i Permit No `. ic l/2
g Iv�:l v 7 2017lr/�/
1 ill 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review 2 r ,
' Phone: 503.718.2439 Fax: 503.598.1q���yy ` t w, y 7 1$ Other Permit `(f4/ r,�.y. . �s 1
1sl�� („�� �!�. �L,t Date/
By:
I G A R D Inspection Line: 503.639.4175 •a h`h Date ReadyBy: Juris: la See age 2 for
Internet: www.tigard-or.gov Notified/Method: S ilr r Supplemental Information
-/&:-.1,7 /L 47>G/167G
TYPE OF WORK :REQUIRED DATA 1 AND 2 FAMILYDWELLINGj
®New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement 0 Other:
equipment,materials,labor,overhead,and thep�fi_ t f�
CATEGORY•OF CONSTRUCTION ;j work indicated on this application. �3
® 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ -rT
❑Accessory building 0 Multi-famil Number of bedrooms:
H Y
0 Master builder 0 Other Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors: 4 16'6
p
3
Job site address: til l4st-i> -SW LAY'�c+'rwv L��� `
New dwelling area: 3 square feet 1 �� If
City/State/ZIP:Tigard,OR 97224 Garage/carport area: Li..L0L1
square feet 1.-1_51..t I
Suite/bldg./apt.no.: Project name:River Terrace East Covered porch area:tip—)square feet 138 13
Cross street/directions to job site: Deck area: square feet
Other structure area:: square feet
REQUIRED DATA:COMMERCIAL-USE;CHECKLIST
Subdivision:River Terrace East Lot no.:1 3 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
DESCRIPTION OF WORK : ", '
work indicated on this application.
C5p Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 TENANT- 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:
E{ APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:Polygon WLH,LLC (Please refer So fee schedule)
Structural plan review fee(or deposit):
Contact name:Nichole Thorpe
FLS plan review fee(if applicable):
Address:109 East 13th Street
Total fees due upon application:
City/State/ZIP:Vancouver WA 98660
Amount received:
Phone:(360)695-7700 Fax::( )
E-mail:Nichole Thorpe PHOTOVOLTAIC SOLAR PANELSYSTEM FEES*_"
Commercial and residential prescriptive installation of
CONTRACTOR" 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
/�g7� Total fee due upon application: $201.60
Authorized signature:/G j���t� /j This permit application expires if a permit is not obtained
1. within 180 days after it has been accepted as complete.
Print name:Nichole Thorpe Date:06/16/2017 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
= Mechanical Permit ApplicatiottlEc‘JE‘\IECIIIIIIIIIIIIIMMIMIMI111111.1
City of Tigard RCfis:Ikqtd
PeriMit..N4`o ,5.72.,012_„,),duct"?
4 13125 SW Hall Blvd.,Tigard.00. 97223 \I 0 1 2- \t
Plume: 503.718/434 Fax 503,598.1960 \\I0 ' -
71 Dewily.
Pimi Review
„..., ,,DomIllk• Other Permit.
Insfectiort Lite: 503.639.4175 e-‘v,..- "'V tOPM-1,Yr2q.e Roado3).," tom 51 Soe Pam 2.for
TIGARD
Internet: www.tigard-er.aov CITIf k-.1‘‘ ill'g'4•ra.s4 h^ort
1%i ,.. . ) i) . et . 5)3unit-taxers!information
f';t 111-DING r-il‘/I
—
,
, ',• " ' , - .' Tylt*E oy wot/14. '-'' ` " •- - -- - ,-,..' 'COMMERCIAL rEt.scan:wax:-USE CHECKLIST
, .
Mechanical permit fees*are based on the value of the work
reg Nen cOn.struction 0 Additiorralleration'replacemen1 performed,Indicate the value(rounded le the nearest dollar)of all
0 Demolition 0 Other: triechanteal materials,equipment,labor.overhead,and profit,
Value:S
,
CATEGORY OF CONSTRU-CTION •.-
-•• - RESIDENTIAL EQIJIPMEIT i SI'SITAIS FEES*
. . . .
i-and 2-family dwelling 0 Commerciallindustrial 0 Accessory building Far vertu/Informournt mu,checkina
i Mufti-family 0 Master buililer 0 Other. Description I Qty, Fa. J Total
' - - Pleatingletoolin •
JOS SITE INFORMATION AND LOCATION • : g'
.„ , . ,
Air conditioning : I 46.75
lob site address:t(15144 S\NI Lails14-Siri(NCI LA irle,- Furnace 100.000 BTU(dints)rias) I 46.75 ,
CityStater2117:Tigard,OR 97224 Fitroace 100.000+BTU(thictsiverm) , 54.91
!teat pump 61.06
Sattethldg,lapt.no..:
Project name: r-v--1\ltr -rt./TY-ace_ecx..91- Duct work 23.32
Cross streetidireetions to job site: Ilvdronic hot water system 73,37
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall in-duct,suspended,etc. 46 75
Flueivent for any of above , 1 23.32
Subdivision: RW - Tonrace.-go,sA- .1_1-°1 nerl Other
Oilier furl appliances: 73.31
Tax rnap'pareel no.: Water healer 2.._ 23.32 I
DESCRIPTION OE NVOIDC • - - , , ., Gas einsert 1
Flue vent for water heater or gas
fireplace 23.32
Ima lighter teas l 23 32
Wood.'pellet stove 33.39
Wood fireplace.fitmen 23,32
Chirrtrievliner/fliteivent ' 23.32
Other: 2332
PROPERTY OWNER " 0 TENANT
Environmental exhaust and sentillitiort: _
n in9 I
Narne: ADIV I,- La d ii0 H _Ss 1.1.1--- Ranee hood/other kitchen
equipment ( 33,39
Address -1 li 00 E -1)0u.191,e,tr -e, 2-WY...V-1 V)i)CLCI I Clothes dryer exhaust -
1 p39 .
City/SuractZIP: C •a, - a, . sirleic-duct exhaust(bathrooms.
toilet evirtipartments,utility rooms) 1--1- 23,32
Phone:s 1p02 1661,4-4 o3li Fax'( ) Aftiecran!space fans 23.32
• *.7.• APPLICANT • , ' 0 CONTACT PERSON • 1 1
°ther: 23.32
Business mune: W i ili Inn Ly Of\ I-tonnes ITiAc_
S14.15 fur first four 54,03 for each additional
Contact name: 0‘c‘n Ole,-1"\f")0(-\)-e_ Furnace,etc. I I
. , ,
Gas hem pump
Addrms:rio-- - 1.-eck..a.14,400),1 s_k_ skkik.c slo
Wall'suspended`unit heater
City/State/ZIP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 I Fax:.(360)693-1442 Fireplace I.
Range , '1
Egna''It 1 i-//Vile ---11AOD I •
rPe-.6„_p ' Barbecue I
•• - CONTRA - R. - - ' Clothes dryer)nus)
Business name'.Apex Air LLC Other
•, - •MECHANICAL PERMIT ELLS*
Address:18004 NE 72"Ave
Subtotal
City'Slate ZIP:Vancouver,WA 93686 Minimum permit fee(590 00)
• Plan review(25*t)of permit feet
Phone:(360)342-8109 I Fax:(360)326-1769 —
State surcharge t 12%of permit
I CC13 lie.:21)3034 TOTAL PERMIT FEE
I This permit application expires if a permit is not obtained n id:in int)
days after it has horn morpted as nomplete.
Authorized signature: * Per reete).(1100 set by Tri-Omnis I:holding Indottri Service Road
IPrint name. I te‘ .1 i Date: ei.11.it,
i a.Ae,na:..0:111-3.t,MI C 0c.fmr5rr T10,`i z Azse• 40,4.:7,, ,0,,f T-t‘i V.-:1 ii
EVi -
EnectIrncj➢ Perrmnt Api�nnca oini �� FO OI{,FJcc ESE gNti
City of Tigard �10�1 r
'r 13125 SSV Hall Blvd.,Tigard,OR 97223 1�� �t E- I t
i Phone: 503.718.2439 Fax: 503.598.1960 (MIN 0'- y•�' ;
Inspection Line: 503.639.4175 rt @ V ReadyDate/By: Juris
See Page 2 for
TIGAR1) Internet www.tigard-or.gov �� d 1
BUIL' Notified/Method: Supplemental Information g
TYPE OF—WO. L e
®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Demolition Other: ❑Service or feeder 400 arnps or more 0 Building over three stories.
::r.-_:.,,,;r,,.:., .:._: ..._:;-.:.: ,_..: where the available fault current 0 Marinas and boatyards.
.... A
>=:-::...:.:�:_;..:,:: GA Y_OF4::CONST33IJ T��
,:...._ ....___.._.�._..._.._.,_..:, :_.,.,. :..___O:,IOfl 'i>?:;j'. I ":,^:±.' :7;-' exceeds 10,000 amps 150 volts or
P 0 Floating buildings.
EI I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
. . amps for all other installations. buildings-o Multi-family • 0 Master builder 0Other: 0 Installation
Fire pump. of 150KVAa
I
v, JOB.:STEINF,QMTION AID LOCATON .>.' ."', . ❑Emergenc system. larger
derived
LI-1 ❑Addition of new motor load of system. i
Job#: Job site address
:(0 I-1 S\nI I kr I(Sp n nJ Lt( mow or more. ❑"A,"E","1-2,"1-3>,
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bidgJapt_#: Project name: --r"race_ E& ❑Hazardous locations ❑Supply voltage for more than
Jr-wV
❑Service or feeder 600 amps or more, 600 volts nominal.
Cross street/directions to job site:
Description :.::. .. :..._..........:_.I Qty. I .Each .I.. Total I a I
New residential single-or multi-family dwelling unit.
Subdivision:pJZr T-e,\eraCe. • -k--- Lot#:1 Includes attached garage.
Tax map/parcel#: 1,000 sq.ft,or less I 168.54 4
;.:...
- _ _ _ --- - - Fa,add'I 500 sq.R.or portion 33.92 1 t
- 1P.TION SOF::.
- _ 1Y•S W ItTf;
_ .: ..,:-.�_•........,�-.�..:-..:.:......:....:.............: :'...-.:::'....' i':;:-..:.:.::::'::<._..•:,:. ::: Limited energy residential
(with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
`• .: S .
enewa a Energy ❑ See Page
2K=-ID cpRQE`, �rVO� ..;::` TENAT;.: : » : ::.z:<:.
Services or feeders installation,alteration,and/or relocation
Name:, Pi-D /L. r\VA ■ a al � 200 amps or less 100.70 2
Address::14)00 bC'a1)1 / r ` 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:' �Ccce' PSZ ta5-2_SP) 601 amps to 1,000 amps 301.04 2
Phone:CO C?2— + Lib I Fax:( ) Over 1,000 amps or volts 552.26 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 1
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
® AEpBIGANT _ Brandt circuits-new,alteration,or extension,per panel
_:< ,.:,,. _ .,�;CONTACT.:1'�RSON'�':.:;,.• .:'::• A.Fee for branch circuits[pith
Business name: kik) tp -li Y ^ '�.,�M,, -r� above service or feeder fee, 7.42 2
V`r �� �r p 1 + `ter 1 1 +tom I 1 S l-1�nC each branch circuit
Contact name: Nil cv-loth o,,-vp B.Fee for branch circuits without
Address: X03 4,�� C, , ; i Q +1 service it feeder fee first 56.18 2
�\ J aAJSJPC. V branch circuit
City/State/ZIP:Vancouver,WA 98660 Each add>l branch circuit 7.42 2
Phone:(360)695-7700 Fax: (360) Miscellaneous(service or feeder not included)
693 4442 Each manufactured or modular 67.84 • 2
Email N 1 r,Inek,.1 nari- tt •' . Reconnect
o
dwelling,service and/or feeder
•i ,ft.: _:: _. . „x�_r::>. ,: .AGO o C Pump or only 67.84 2
Pump orirrigation circle 67.84 2
Business name:Garner Electric Washington,LLC Sign or outline lighting 67.84 2
Address:402 Valley Ave NW Ste 106 Signal circuit(s)or limited-energy
El See Page 2 2
- panel,alteration,or extension.
City/State/ZIP:Puyallup WA 9$311 Each additional inspection overallowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(253)872-6051 Fax:(253)872-1801 Investigation(1 hr min) 90.00/hr
Email:bdaniels@gweusa.com Industrial plant(1 lir min) 78.18/hr
Inspections for which no fee is
CCB Lie.: CUSS Electrical Lie.: 208174 Suprv.Lie.: 4496S specifically listed(4 lir min)
90.00/hr
-_ -._ ECCRICAL.f_ -i
1tMLlLS
Suprv.Electrician signature,required: / P1 4 i Subtotal:
Print name: Joan P Albert - Date: ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: I _ TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within ISO
Print name: Bill Daniels Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
LiBuildinalPermitalELC-PwmikApp_ELn BpEdoc Rev 06/17/2015 440-4615T(11/051C014/WEB !,
3
• RECEIVED
Plumbing Permit Application
jimii=onia
Building Fixtures N O V '1 (2017
City of Tigard CITY OF T1GAR Received
111 ' , ii �t � 1 Permit No..44<i , 2... y B.
13125 SW Hall Blvd.,Tigard,OR 97BUILD4Nt'2 tom+ VI C('°�P9= Y.
Plan ! "` J �w w�
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.:
T 1 u A�D Inspection Line: 503.639.4175 Date Ready/By: Auris: 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OP WORK .:. FSE'-SCIiEDI3i,Ts
®New construction " 0 Demolition For special information use checklist
Description I Qty. I Ea. I Total
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
®1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory buildingSFR(3)bath 1 50032
❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION _ Site utilities:
Job site address LiC 3t1Lotr�S171119 `/vnp Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224
Footing drain(no.linear ft.: ) Page 2
Suite/bldg,./apt.no.: Project name: p. V r l ,V 't r� F 1- 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 it:_) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: ��,f-ey- iuorrice__,'� -- I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF.WORK Backwater valve 1 12.51
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Name:ADVL Land Holdings,LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:7600 E Doubletree Ranch Road
Garbage disposal 25.02
City/State/ZIP:Scottsdale,AZ 85258 Hose bib 25.02
Phone:(602)694-4031 Fax:( ) Ice maker 12.51
® APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:William Lyon Homes,Inc Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: I C hO k TN D1/13-L drain(commercial)!!"" Roof 12.51
Address:.1.0D :_ar 4vj�7 t j ...1-- . 0 A 't Sink/basin/lavatory utttlp9 y / 25.02
City/State/ZIP:Vancouver,WA 98660"J Solar units(potable water) / 62.54
Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51
E-mail:.,1\i I C h Ole, i O(((NnQ1hOine S ,Cm1 Urinal 25.02
CO jjo0R,L
Fater closet 25.02
Water heater - 37.52
Business name:Malmedal Enterprises Inc. Water piping/DWV 56.29
Address:PO Box 207 Other 25.02
City/State/ZIP:Banks,OR 97106 Subtotal
Phone:(503)324-0759 Fax:(503-)324-0580 Minimum permit fee: $72.50
CCB Lic.:102535 Plumbing Lic.no.:34-276PB Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name:Carolina Malmedal Date:04/25/2016 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I.\Building\Permits\PLMU-PcrmitApp.doc 10/01/09 440-4616I(10/02/COM/WEB)
'' City of Tigard
II ■
1 COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review — Residential
TIGARD
Building Permit #: s--/75 � �
Site Address: R-Aziz- )
Project Name: �iJ1/.-c� 7-----e4-7-„, Lot #: 7-3
(New dwelling=subdivision name;Addition or Al eration=last name of owner)
Planning Review
Proposal: ✓� �
LI Verify site address/suite# exists and active in permit stem.V gevieavAddendum Attached
River Terrace Neighborhood: DI No Yes,See River Terrace
Sits Plan Elements:
Three(3)copies of site plan 1,r sting structures on site
L11 to plan must be on 8 1/2"x 11"or 11 x 17"paper t�Footprint of new structure(including decks)with finished
4orth
rawn to scale(standard architect or engineer scale)
or elevations
arrow119Iy.ttlity locations&easements(required for new and additions)
Xanon of wells/septic systems
to address,project or subdivision name and lot number VS dewalk/driveway approach
®, pplicant information(name and phone number)
X11 •t dimensions and building setback dimensions )sting trees to be retained with drip line,and tree
�A,uare footage of buildings to be demolished
rotection measures
R Lot area,building coverage area,percentage of coverage and reet tree size,type and location
Zpervious area(applicable if R-7,R-12,R-25&R-40) Street names
Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? Yes ❑ o
4 foot differential) If yes,is a storm water quality facility shown? ❑Yes No
t lean Water Services—Service Provider Let -r(lot platted prior to9Rece/10ed/1995 . CI Yes CI No
'equired: ❑ s,applicant was notified FA No
\A Public Facili � s Improvement(PFI)Permit: Pr1�o/e—woe g
Required: Yes,applicant was notified ❑ No
Applied For: V Yes ❑ No,stop intake
/land Use Case#: /-n��01 �—�Ot) 1
oning: K -� 7z).
) Garage g �0 Side Street Side g ,i)
MIA/Required Setbacks: Front � Rear
MJ/�andscape Requirement: 0
IL/1 of Coverage Maximum:
uildin Height: Maximum HeightN.)/Pr— Actual Height
g g
:A Visual Clearance
RI '`ensitive Lands: ❑ Yes No Type
I/ rban Forestry Plan
Conditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: _
�� = Date: ___A=14-(e/r ..._
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: /II?77,
Site Plans:
gP #
Building Plans: #
Building Permit#: Enter building permit#above.
Workflow Routing: Planning
Workflow Sign-off: g 4 ::1 Permit Coordinator .7.51-BuildingSign-off for p?—Engin' cerin Manning(include notes from planning review)
Route Application Documents: J� 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: `p
fetZ sq'
Date: /.Z4? /72
Engineering Review /^
/0- Slope at buildin pad: 7 f'
g
❑ 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: El Yes %No
Assess Water Quantity Fee in-lieu: ❑ Yes No
LIDA Facility on lot: ❑ Yes ,'No
El NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: I,, /Kg- I tJ
!�� Date: / Z//es
Revisions (after Building Submittal only)
Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: 0 Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
El 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:
SDC Fees Entered: Wash Co Trans Dev Tax: "I° es ❑ N/A
Tigard Trans SDC: �- es ❑ N/A
Parks SDC: Yes ❑ N/A
LIDA ❑ YesJe T/A
OK to Issue Permit /�"1`�
Approved by Permit Coordinator:
7412
*/713—a-te: /
I:\BuildingTonns\BldgPennitRvw RES 061417.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16744 SW LARKSPRING LN, BEAVERTON, June 20, 2018 at 10:22:22 AM
OR, 97007
Record Type: Record ID:
Residential - Master Permit MST2017-00519
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:
16744 SW LARKSPRING LN, BEAVERTON,
OR, 97007
Record Type: Record ID:
Residential - Master Permit MST2017-00519
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:
16744 SW LARKSPRING LN, BEAVERTON, June 22, 2018 at 11 :00:08 AM
OR, 97007
Record Type: Record ID:
Residential - Master Permit MST2017-00519
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS
Comments:
Previous corrections completed.
Water pressure = 70 psi
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16744 SW LARKSPRING LN, BEAVERTON, June 22, 2018 at 10:58:59 AM
OR, 97007
Record Type: Record ID:
Residential - Master Permit MST2017-00519
Inspection Type: Inspector:
699 Mechanical final Aaron Cillo-Gobel
Result:
PASS
Comments:
Previous corrections completed.
A/C installed
Violation Summary:
Inspector Contractor