Permit (111) CITY OF TIGARD MASTER PERMIT
a COMMUNITY DEVELOPMENT Permit#: MST2018-00039
T I C;A R.f) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/13/2018
Parcel: 2S106AD06900
Site address: 12955 SW RIVER TERRACE BLVD Jurisdiction: Tigard
Subdivision: RIVER TERRACE EAST Lot: 176
Project: River Terrace East, Lot 176
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 809 sf Basement: sf Left 3
Parking Spaces: 0
Height: 24.5 Bathrooms: 3
Second: 1049 sf Garage: 437 sf Front 8 Smoke
Dwelling Units: 1 Third: 0 sf Yes
Right 3 Detectors:
Total: 1858 sf Value: $233,402.43 Rear: 20
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 Storm Sewer 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Catch Basins: 0
Hose Bib: 1 Backwater Value: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Fum<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: 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
Other: N Other Description: Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr:
NEW Occupancy Group: Square Feet:
SF VB
R-3 1858
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 1 Hour Fire Rated Eaves
PHONE: 602-694-4031 PHONE: 360-695-7700
FAX:
Total Fees: $32,451.26
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 52-001-0090. 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: �, /L�/�/ �� � permittee Signature: k
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. L7/%I� l
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.
Bulling Permit Application 1-O 7— /
.kiiiiteential ,
FOR OFFICE l SE ON L1
City of Tigard "' Received /
1,1 . 13125 SW Hall Blvd.,Tigard,OR 97223 7 0+7
Date/By: �� ���/ PermitNo57t F LX�Wf
° Phone: 503.718.2439 Fax: 503.598 19 E P i U / Plan Review O
Inspection Line: 503.639.4175Fax: DateBy: 1 3 (— I i 4 0.• i .er Permit
T16AR1� P � lfor
Internet: www.tigard-or.govr ' � % Date ReadyBy: tee_ H gee age 2 for
NotiSed/Method: /�e I Supplementallnformation
®New construction ❑Demolition Permit fees*are based on the value of the work performed.
❑Addition/alteration/replacement 0 Other. Indicate the value(rounded to the nearest dollar)of all
� equipment,materials,labor,overhead,and the rofit for th
l: � ; E t a work indicated on this application. a 33i �a„ +
® 1-and 2-family dwelling 0 CommerciaUindustrial Valuation: $ �i�
❑Accessory building ❑Multi-family Number of bedrooms: I
❑Master builder
❑Other: Number of bathrooms:
(61.444‘4441,424yEglira.ill',Ni-� - 4070, Total number of floors:
Job site address:J Lq SW River Terrace BLVD New dwelling area: 18s 6 square feet l
1 `+
City/State/ZIP:Tigard,OR 97224 Gara e/c
g arport area: .I 31 square feet t bc4C;i
Suite/bldg./apt.no.: I Project name:River Terrace East
Covered porch area: Nig 5Clquare feet
Cross street/directions to job site: _. ck are :` � I�
iJbck areasquare feet
Other structure area: square feet
ice€ f- .
t
Subdivision:River Terrace East � � t . .: .�
I Lot no.:r, 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
N 6 s ` A work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
f yr i
raci
,..;• 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:
a . V 8r
Business name:Polygon WLH,LLC T
Contact name:Nichole Thorpe Structural plan review fee(or deposit):
Address:703 Broadway St Suite 510 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:
' ts ,E-mail:Nichole.Thora PofYgonhomes.com
" ,, Commercial and residential prescriptive installation of
roof-top mounted Photovoltaic Solar Panel System.
Submit two(2)sets of roof plan with connection details
Business name:William Lyon Homes,Inc
Address:703 Broadway St Suite 510 and fire department access,along with the 2010 Oregon
Solar Installation Specialty Code checklist.
City/State/ZIP:Vancouver WA 98660 Permit Fee(includes plan review
Phone:(360)695-7700 $180.00 and administrative fees): $180.00
I Fax:(360)693-4442
CCB lie.:207247
State surcharge(12%of permit fee): $21.60
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Nichole Thorpe I Date:8/23/2017 I *Fee methodology set by Tri-County Building Industry
Service Board.
I:1Building\Permits1BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
•
Mechanical Permit Anon ..!,o*.--i ir";::.t',,,, '.'--- ,‘. FOR OFFICE i SE ONLY
Q of Tigard •Reccivcd ,Keidt,1404/1/...C/-7,2/1/Of t,e,V,_;V:
DuetSy:
;111,1 1312.$$W Ha fiKTigit4.-OR 97223,,fo 1 1
' 1
Phone: 50 .7i&2439 Fai: 5.03.59g.1960-\" ' . L .. ,....., Date/fly:• OtherPerntit:
1 Ic,ARD lospeetion Line. 503439.4 17$
. .interim'Ivww.tigani4itinr f\VI\e \i r ',2','„:"*:,-,i.,,.,-"mt 140,lattumegi;d: . 'Supplemental Information'
"'" •,,,,,(.':;,'','`2;r0`7''''" „ . .
• 91;41-ail''''-' --
_
••••.':'-' 94.:;!,;40,22,:iMVE,:;. %!7!gtoiliti*i# ev,i7f3istamptiyg.gtgotelt°,'; 4,Koo-,.14*$og.4-0.o.c.s4f. 4.N.soottc*.itti.,:
Meehanteal permit fees*are based on the value a the work
.:1 New construction 0 Addition/alterationtrepi,*,emont
performed.Indicate the rattle(unaided to the nearest dollar)of all •
0 Da1161i11012 0 Other. Ovellanical materials.equipment,labor.overhead,and Profit.
. .0,.:.ie4t44e ., ,,...„„ ....,,.._, Y!lr,.. ....
---------5---.4:"4.''' ,IiiitibliA44.4.0.744.441-0470.0***.;$..-442, ,-
Ei i•and 2-flintily dorelling 0 Conurtercialtindustrial El.Attessigy.tittilding Foespedef infonstation use checklist , .
El Miiiii-taMily 0 Masir.i.builder 0 Other; . DeSetiPtine, Qty. I Ea, I Total,.
4o..AAtorootoo:.ioiox;*xii:'oo--oA*:oriiF*riti,iFw:;-:Ri_:aui.'.: nailakitm
4llnv .
' Air einiditinning. . I. 46.75 . • • .:
11)site address:1111515 S' ) F-44-e)r-re)tv-c, re,%\.\.)4 Funtitee100:000 RTLfiduiteveatS)- . . 46.7$
Cityl$tateraP:Tigard,.OR 97224;
Fornice.1.00,060f.BTU t'doetsiVerii) 4 91 . •
,
. .
Reg pinup 61,06
Sttheibldg./:t;t.Inn.: 1 P6Jearidfit:give.r-re reace,F.,cts-t Dail work . „ __ .
23.32 •
Cross streetidirections to job she:
Byttrortio ho water cistern. 23.32'
.
- Resiifential boiler(radiator
Itydronie) 23.32
. .
Volt heaters(fuel-type,not electric),
, . ... .
iroknll.in-chtei,suspended etc: 46.75.
Floe/pant for any of stunt ,,. I 2332 1 :
.Subdivisitnr.NNICr-reAtret.C1-.:EZIS+- I Lot no I 1 0 • (jib"!
Other Piet itapharrem . 2332
.. .. . .
Water-heater
Tax mapiparcal no.:
2132
.. ._. ... .
.
',IF,tk.-i$''.g.'1'.7,2..141i:;•it::.1.0i. *WiO01.0N.'4)F1,*,01402444;140.gN,;*':,:it,'...'4 :72' : OasturPlaceituert • • V 33-19
flue mit for:water heater or gas
tinplate- 23.32.
Log Oehler-( as) 23.32
Wood/peites stove 33.39 .„
Wood fireplace/insert 23.32
. Chinutevilinerillacivent 23.32Other
332
NER
Virki)PR!TY,•PlY.- -i.i.'4- .1.:'.4 .':'?.4:17:' 'XN::-AAN,4141frig;442 .' &wire lid exhatna and Venthation: 2
Name: AD/L. Lainci ik _ A ,
Range hood/off*kitchen
i
e., _ _. equipment 33.19
Address:1 tp 00 E..opu .. -- ie,zunch Rmacibetties dryer eXhaust 33.39
,
City/StatetZ1P: sczAksdadie... flf ct, -25.9.3
. i Single-duct exhaust(hathreown„
torlet eampartm— erns,utility' rooms' ) 4 23.32.
Phonc:I AO")a,t Atli I— IN I Far )
..!. - . AttleArawkautee fans 23_32
:;:':.:6Vfi;;;;::.'alOs..*: 0,4:04001,Ai.,:-.:-,:..7.. Other 23.32
Fuel tololary
Business name: tj\)‘‘,1‘rAxyl ‘ tteneS tiV)C- , - . . .
$1.4.1SIOr Brit tear:S4.113(preach dditional
Ccatact name: i, A • ki b. ,,
FtifiliSCe.etc. .1
mdress'1 t) IlrLYActi4a-)-1St- Solt S\1) Ga-s bgat ur,._______p__r______,_____.________
VielPansoendechunii heater
thy/StaterZIP4 Vancouver,WA 98660
Waft'beget,
Phone:(360)693-7700 Fax :(360)693-4442 FiteClace . 1
Ranee . 1 -
• 64"1:' IQ 1 ehoW, IA AlZ 19 01
Barbecue
CO ' i...r •''',',..:,:,.i.,•,7::.''•'!'i':':!. .-'n''''''.''';A'''.'4'..'''';::.'-k-- .'2V'''... 06thitS firVIX(PO
BItSitieSs.11attle:Apex Air LLC. Other ' • • .
. . ,.,„4:Z;,.,77.''P.:!.. ..:WHOS' 'fIgAi..',..ft01,4i1rY,F.4.W.-1,,4„-•.:. .;)--..„-,;',;.---.?T; :
Address:15004 NE 72'4 Ave
Subtutid .
. ...
eity/StaterZiP:Vancouver,WA 98606.
lsrmimum permit fee 090.00)
:.
. -
Pin review(25%ofpernnt fee)
Plume:060)342-$109 I c (360)326-1769
. Stmeaureharge, (12%of permit.fee)
•
CCR lie::203034
TOTAL rportur FEE
Anthorized Signature' -
Print name: .
4
1 Dile; di• days atter it bat;becn accepted*6 complete.
11:epe ettan:odcIPIP:s:b3".:Tx:Ouut3r"irs permit1ildiIn:tdular,6bla•5,..ined-rvirewitahlal'aridSO
tutoinsrdiootivatiErJkomutorp wo11 doe 44-4lr77otavails4Airan)
r
.wae..w„ ,aangra A�MhNaaeaauurru E'/,
S ._� r� r H�t= -.e s CL USE o�yi�Y_
�� City D�Tigard � Received -- _- --
" 13125 SW Hall Blvd.,Tigard,OR 97223 n n� I .1 u 13 Date/By:
Permit#:/'��"f� J�'� �'+r• y
IN
U' Phone: 503.718.2439 Fax: 503.598.1960 )H. Plan Review ���
Inspection Line: 503.639,4175 �' Date/By: Related Pcmdt II:
TIGAIZD Internet wWlKtigerdorgoV r 6 4 ' ` " ReadyDate/By: ,tach
r fi 6ed/&tetkod•
c�i ,, Nott Bee Pagel for
` s•t"i `f' ` ' r , s + ;1 a Supplemental L,formation
x.ax-i:?r .",•.�1P-g Tf(t1.,.;x' }h; ,�'fii s:� fµy+S.r ;iii:rte,—;.--r z_
®Newconstru <..:�2x. �+' ���,-���'; �:��•'%:,_ . .. �•�•,�, "�'���'.:�-•`�' --::..;{�,..., � -
❑Addition/alteration/replacement Please cheek all that apply(submit,/sets of pia w/iteme ohectred):
❑'Den101iflOn n �` 0 Other:
0 Service or feeder 400 amps or more ❑Building o stories.
p;.::...r,�.Demolition
7,"s, ;;;1 y�? r; �., where the available fault c overtime ds, es,
2:t:•:,`VOMI I.VIti g§Mlat:s. '' A• .'in r, •,g t it,P`•,^;.-::14.. arrest ❑Marin g build ng
.;Ff�..�'=`5'...;?cl•:•..:::3;:;:r: Yards,
a- rk ,;.;:M�•i:'v'r':x exceeds 10,000 amps at ISO volts or ❑Floating bindings.
®I-and 2-family dwelling 0Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commerolal-use agricultural
❑Multi-family ❑Master builder ❑Other am um all installations. buildings.
',F '`'[-' di.',.:' z e other
,.{ 'r.:;;.,:..:'•mss-±•.: ,•'c; ��.�-� ` O r.:�,:., ,. ,-,, ID Fire
• `)�'+,• .,,,r. ,•�,1'7,'.1s5jr; .' ( !r' •:::;t,:::. Olagersti a ofi50KVAce
'•s' i>.t :% :::t .; 0 Emtrgenoy system. larger separately derived
Job#: Job site address:t 2Shi {�,v ❑Addition of env motor load of 0 system.
City/State/ZIP:Tigard,OR 97224 C1�ix on ore residential units. occupancy. k
Suite/bldg./apt#: i Project name:iz OIealth-care facilities, l]Recreational vehicle parks.
i Vein Te rracp y asi ❑Hazardous locations. 0 Supply voltage for more than
Cross street/directions to job site; 0 Service or feeder 600 amps or more. 600 volts seminal
•\ s: 5, •q :~`:*{ u6L4Yd�� .n•^ ":r i .
Description
New residentialsfn I Qt' I Each I Total i *
Subdivision: single-or multi-family dwelling unit
�iVe/r Tehrace. ?xis+ , Lot#: 1 l tF' Includes attached garage.
Tax map/parcel#:
1,000 sq.it.or less 16854 4
:*:-'1 +s.�`. . :; '' ? b +10 `• t:::'.: Ea.addl 500 sq. on
`t gettefit, ,r+4. . z.Y!<Q r;":::'.. � : ::,; ";::::;.•,.:",: ft.residentiali Z 3392 1
�• `•-•:': Limited energy,
(with above sq.it,) 75.00 2
Limited energy,multi-family
x residential(with above sq.ft.) ?S.Op 2
=4�'-•' ,? K�Y aG. .:e�d?:I '=BMs' =ri€�a�li�•;`; y`,�"•�':.u: s- w:,;:r': •cam c.. Renewable Energy
a•. . .��,..;,;:.a .? il,)I 1i7'a ��. =+1:£: .;' Services of ❑ See prang/
Name: Air L �� �•+ feeders installation alteration and/or relocation
� /" `el L.L C, 200 amps or less 100 70 2
Address:.h UO E Doclble_-t •ei .enc h 20I amps to 400 amps 111
13356
city/State/ZIP:'S�� i✓ 11�21 ca52 401 amps to 6�amps 2
i� 20034 2
Phone:UCI-011-1 .t 1() ) Over 1,000 am601 amps to ps 301.04mps 6 2
`'t t/'J Fax:( 552.26
Email: �,hp1,e, , Temporary services or feeders installation,alteration,and/or
Owner Installation:This installation isei ig ma n prope ernes I own is not 200 sto relocation or less .
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 29.086 1
Owner signature: 201 amps to 400 amps 125.08 2
Date: 401
k�'� �a'�#�-."�.�i3•p°n't. .1i.,r�+,tR:�,,,sr��]t:t�r�4:t: ••x�,P i µ amps to 599 amps ]68.54 2
�'.: •b�;.i'1•: �5.i i.. ,.,:
•:�#• ,::,t it���:�::;s.:�;y;;r�,���Q�t�, � �'��: � °• s, Branch circuits—new alteration er Janet
, {•:,,;;: _ ,or extension +
Business name:'�(-'`'a� t� "� ` �� A Fee for brei cdt ri feeder
e meth
above service or feeder fee,
Contact name: ®'i+hntT^® each branch circuit 7.42 2
- 1 B.Fee for branch circuits without
r+(t i 1a.i e�/� service or feeder fee,first
Address:
03 13 "^" S+ S _ l V blanch circuit 56.18 2
City/State/ZTP:Vancouver,WA 98660 Each add'l branch circuit
7.42 2
Phone:(360)695-7700 I Fax.:'(360)693-4442 Miscellaneous(service or feeder not included)
Bach manufactured or modular
Email. t 1.111 A
t ?,16. .46.:.
�. .,,� deconn:,tonly and/or feeder
67.89 2
qs, .q� 1.1h!
'frtiihTt,� 'i..-�-o-rr:.�;'Y,�3>.;Y �•".�h+`p,(,•ti tAC 47,114.'" 0 f r' •t�`:�3�+,,x:o•.i,:ar�:.,'-+.a*:.:r,,•.,•.r; •. Reconnect only y 67.84
t4a.r. i�,.e- ...illn;��'x;�';,i�.5o1�:3��v`;, ;,, `ilf,�,�;�'•-��; 2
:i s. Pump or irrigation circle 67.84
Business name:Garner)l loctric Washington,LLC 2
Sign or orttlinallgh6ng 67.84 2
Address:402 Valley Ave NW Ste 106 Signal circuit(s)or limited-energy
- panel,alteration,or extension. 0 See page 2 2
City/State/ZIP:Puyallup WA 98371 Each additional Inspection over allowable in any of the above
Phone:(253)872-6051 Additional inspection(l hr min) 66.25/hr
I Fax:(253)872-1801 Investigation(1 hr min) 90.00/hr
Email:bdaniels®gweusa.colu Industrial plant(1 hr min) 78.18/Itr
CCB Lie.: C1158 Electrical Lic.: 208174 I ... pInspections far which no fee is
Suprv.Lic.: 44963 specifically listed(h hrntht 90.00/hr
Suprv.Electrician signature,required: Mit/
-ItY» Y' ;;'i`<.. +, , .•.:r•
' ""ted' d 4,Y / (JT jt.+ .. •
• ,• "h.,Yii::��.::1.i, ,nY.;?i
Print name: Joan P Albert Subtotal:
Date: E3 Plan Review Required(25%of permit fee):
..• State surcharge(12%of permit fee):
Authorized signature: 4111.1"-0,00'...."----
� -- — TOTAL PERMIT FEE:
Print name: Bill Daniels 17atC: This permit application expires if a permit is not obtained within 180
days after ithas been accepted as complete.
L1Eu0diag12ermkslHt C}orndtppP > goo Rev 06✓17/2015 • Number of inspections allowed per permit.
440-4615(iit05/Cotvt/Wga
Plumbing Permit Application
.. .
Building Fixturea ,, i 1 1 2018
J A IN i.
qty firpgard , ,, ,, Received
PennitNo.; /(2.10/,.e..-ei,i13y :
1111 4 131.25 SW Hall Blvd.,Tigard,OR 97223 C.i IN 0 , ..:rtinellittiew
4. Phone: 502.718.2439' Fax 503.598./0011 r);1,,:::1-, '':-;.,!`-''''';'', fiatts-y: Otlicr Permit Isio.:
Inspection Line: 503.639.4175
•Bate Iteedy/Byt Tudii I 121:See Page 2 ler -
T I G A R D uteniet 4rww.iiititrd7cir.goli
..:.,Nediticeltiviethod: ._, . .. .., , ., .._ ._ . Siippleniental Information
tttttVN•KRMtr.SS;V*=**OW,CP-Ngtafro,t*tti;b. qghtattX414-TROMIA-04.WiWiagi#VAMi:Wla".41",;•
EI New conshucticat. n Demolition -• For special inforniatiOn use checklist
. Description I Qty. I Ea- 4 Total. :
ITA;lonfititerationfrepIacement ----70 Other: New 1-2-family dwellings(includes 100 ft.for each utility donrieetion)
7M-31•41Warti--47-Wr-WW_:41-*SfaltiOnt:V SFR(I)bath I 312.70
;--,
SFR(2)bath 437,78
1E1 1-and 24amily dwelling 0 Commercialtmdustrial. .
. r--,
SFR(3)bath i 50032 i,--
El Acoessory building U Multnily .
Each additional bath/lcitchen 25.02
0 Master builder EI:other:.
. -Fireepriodeg :sq.it.): * Page 2
% R :.*ig:****.Acim:Atitgttffttiqttg.i; Site utilities'
Catch Benin Or wen dmin 18.76
Job site address'/2,f1 n. &Al atve,rTexrqre_ 811/0
;Dtrycli,leach line,or bench(Intl
City/State/ZIP:Tigard,pa.97224
• Feeling drain(no.linear it. ) Page 2
Suite/bldg./apt,no.; Pnaject mune; ' Mannheim*blame tanks
Cross streeedirections to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:' ): Page 2
Storm sewer(no.linear ft4.,___) Page 2
Water service(no.linear it.:; _D Page 2
Subdivision 12-Wee redhente PAM-- I Lot no.:/7 1 31.27 iro,_ Fixture or ltemz
Fome '
Tax (parcel no:: . Baekilow nter
.1t1,-3,,,,,...,,,,,-,„r„,r4,_,...„,,2„;,,,,,„„.„,,,, 04 i, i ,ciikAtottiRit.:::4•14',.1,4,,,..,:,14;11,V4Y,%.1,1,,,„;:t:,,,.\It i.,..t,e.,•-.7,-:. 1 12.51
,,.7:4:-.-AVii,121',.,::';44',,r44::;•;j,,:v.:,Alt1.-.,,,,,,,,,,,;,,..,,,,,,,v.:,.,,,,,,,,T.-..,2::....: :,,.r,'-'*:-:::T'Ai.4.:r-R,-.,t1‘..i.7.:iity,:'=:^V
- Clothes.washer 25.02
Dishvrasher 25.02
Drbdring fountain .25.02
Ejectors/sump 25.02
. E'qThaskia tank 12.51
Fixture/sewer cap 25.02
Name;ADVL Laud Holdings,Ltc;
Floor drahigtoor 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 Far( ) Tee maker 12.51
_
'.:•W :friiii:Wpr'i_lifig IldereePioegrewie traP 25.02
Medical gas(value:$ ) Page 2
Business name:William Lyon Homes,Inc
Pritner 1251
. Contact n e.__ II01/)01, 1:klorprant Roof drain(cominercial) 12.51
: Address 103 Brn.a., c# svatte.slo Sink/basin/lavatory 25.02 •
City/State/ZIP:Vancouver,WA 9864 Solar unite(potable water) 62.54
„
Phone:(360)695-7700 I Fax ;(360)693-4442 Tub/shower/shower pan. 1251
. Urinal 25.02 .
B*Insi•L I. ' AD ' . IA cal. 0 P Al I* 1(10(fr S.St j)rn
Water closet 25.-02
..N..1M'-v4.--=t444.AZO!,E!3!si-qi,; letf.g-; 'di'-'%.:-'' ,,riO -z.,,=•kii;4%!,";ZsIf7.V ...A.s:& .,.,:i:i
=ftle4gtg-t.',1.=',4-. 716:111'.e4...:?5;40,1,376,..,...,.... ..,,,==-.-•,,A=N,,....,:,•,--; i4 ,..-?J',-74--4.,.:.--N-i=i7f,.Y::;..-,•.,,,,7 ,,':.•‘: wat„,i,„te„
3752
Business nun= G.,14 k)ti,"/I:t k,Crt--50,...4, f21,41.4.-- Water piping/DWV 56.29 "
Address: p.(4,4. 6..et °IA
I Melt 25;02
City/State/ZIP: 5T, p44.A4 ore, ' 1(31
Subtotal
Phone:0.'63''''841- 1(40 Fax:(liv.--ni....?flO - Minimumpermit fee: $7250
— -
Flan review(25%of pandit fee)
CClit Lk.: /85 3-7a., Plumbing Lic.uo.P45 63q .
State surcharge(12%of permit fee)
Authorized signature:: .1kapts. 1751.0tPA''''',--..—__ I . TOTAL PERMIT FES
IPrint mune: , r vit., w14,2,-___ i Date:S--36—I 10 I rids permit application expires ff aver:nit is not obtained vdtbla Idddays
after Mies been accepted as complete.
!Fee Inabodolortscit by Tti-Cc testy Building Industry Service Board.
BacadicePennitstmatioacciiiiiipelec tel01/0, 440.4616/(10/020*WEB)
j
City of Tigard
I 'I COMMUNITY DEVELOPMENT DEPARTMENT
71
T 1 c A a n Building Permit Review — Residential
Building Permit #: , c Jai f=-a 31
Site Address: 12-1Sc =c q(,,„,-- Tim tiv.)
Project Name: Kw.,„- T trait_ Easy Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review�
Proposal: �.zNfj-1t 4* 440.i 3 rtZ
,� erify site address/suite# exists and active in permit s stem.
My River Terrace Neighborhood: CI No OYes,See River Terrace Review Addendum Attached
SityPlan Elements:
f ree(3)copies of site plan Fla 'sting structures on site
10,S` e plan must be on 8-1/2"x 11"or 11 x 17"paper t ootprint of new structure(including decks)with finished
EDbr awn to scale(standard architect or engineer scale) oor elevations
rth arrow L�I7 Uz ty locations&easements(required for new and additions)
L�ISite address,project or subdivision name and lot number LQ idewalk/drivewa approach
���/// Y pp
E6,pplicant information(name and phone number) 7:`• •cation of wells/septic systems
[tot dimensions and building setback dimensions P. xisting trees to be retained with drip line,and tree
uare footage of buildings to be demolished p otection measures
Dtot area,building coverage area,percentage of coverage and eet tree size,type and location
pervious area(applicable if R-7,R-12,R-25&R-40) DI Street names [2(
[U4 roperty corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? MJYes El No
4 foot differential) If yes,is a storm water quality facility shown? ❑ /❑No
IiiClean Water Services—Service Provider LetterttX (lot platted prior to 9/10/1995): pfo..J Li;VII
Required: E Yes,applicant was notified I1No Received: CI Yes CINoy
tun,; Ja2
Public Facilitis Improvement(PFI) Permit:
/—/Required: Yes,applicant was notified ❑ No Applied For: ❑ Yes 1:1 No,stop intake
/Land Use Case#: rOabl6'0000i 1.--yi^r12...04, 0UiPl
L'sd Zoning: R-2 s (f i
d 'equired Setbacks: Front ` Rear 20 Side 3 Street Side pA. Garage 20
E,_,f_�Landscape Requirement: Lo %
My",L,ot Coverage Maximum: SO
E Building Height: Maximum Height ///1- Actual Height 221,
0/Visual
`1,
/Visual Clearance
Lel ensitive Lands: Cl Yes 1/(No Type
Urban Forestry Plan
El Conditions "Met"prior to issuance of building permit
Notes: C,una rt V r Li" 111M) bJ'U-y fee-P4 i i '10t(Z
Approved By Planning: �� ( Date: 1—ZA".!b
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: El Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw REs 061417.docx
Building Permit Submittal
Original Submittal Date: ' f/'?[//7
Site Plans: #
Building Plans: #
Building Permit#: ra nter building permit#above.
Workflow Routing: lanning Engineering >Permit Coordinator wilding
Workflow Sign-off: 0'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.
l Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: /1'`, 4 <j�,..,-,,,,..-__Ar Date: 1
En ineering Review I 7t,
All Slope at building pad:
El Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
/1:2'Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes /eNo
Assess Water Quantity Fee in-lieu: ❑ Yes i'll1No
LIDA Facility on lot: ❑ Yes /rJ No
El NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: lg�, CO Z- Date: 72----7/g
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:
SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: Yes CI N/A
LIDA ❑ Yes ?N/A
OK to Issue Permit
Approved b Permit Coordinator: %4' Date: ç/W'ov y
I:\Building\Forms\BldgPermitRvw_RES_061417.docx
1
City of Tigard
■
a COMMUNITY DEVELOPMENT DEPARTMENT
III T I G A R D River Terrace Building Permit Review Addendum
Building Permit #:
Site Address: IZTSS , / ��v� Jar Ltd
Project Name: �'�lv�-- �zi�� E s;�
(New dwelling=subdivision name;Addition or Alteration=last name of owner) Lot #: ���
Planning Review of River Terrace Plan Dlstrfct Design Standards (18.640.070.1.);
Is the project subject to the plan district design standards? Q'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.
Porch min. 5 ft. deep Balcony w/access 2 Window Projection Vertical Wall Offset a
ft. deep min.2ft., 5 ft.wide min. 2 ft., 6ft.wide Gabled dormer
0 0 0
V
2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: ______ s2:Z________
3. Entrances:At least one entrance must meet both of the folio' g standards:
Max. 8 ft. setback from longest Street- facing wall
Parallel to street,angle no more than 45° from
or open onto porch street,
Entrance opens to a porch: Yes 0 No
Iff yJes,all the following apply:
L1l'Qne street facing entry sq.ft.min.
[�/ 12 ft.max. roof above floor of porch
5 ft. depth min.
EK
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:
L Covered porch min. 5 ft.wide x 5 ft. deep C✓7'Recessed entry area min. 5 ft.wide x 2 ft. deep
0 Wall offset min. 16 inches
0 Roof eave min. 12 inch projection 0 Dormer min. 4 ft.wide
❑ Roof shingles either tile or wood 0 Roof offset min. of 2 ft.
0 Roof pitch oriented south min. 500 sq. ft. /Gable,hip or gambrel roof design
0 Horizontal lap siding min. 3-7 inches wide
DrAccent siding min. 40%of street facade ❑ Window trim min. 2 1/2tt wide by 5/8"deep
❑ Window recess min. 3 inches for all street facing ❑ ay window min. 5 ft.wide by 2 ft. dee
❑ Balcony min. 5 ft.wide x 3 ft. deep with inside access l;Q Attached garage is 35% or less of street pfa ade
c
5. Garages and Carports:May face the front or side lot line on a corner lot.
WA' Setbacks:
PINo closer to front or side lot line, than longest street facing wall. ❑ Yes ❑ No. If No
(Check one):
0 May extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch.
Garkyt iS 0 May extend up to 5 ft.where the garage is part of a two-story building and there is a window at the second
above the garage that faces the street with a min. area of 12 sq.ft. story
4k Width: (Check one)
ft"( - 1 ❑ 12-foot-wide garage door
0 40%max. of street facade
t's�VA n 50%max. of street facade with 7 detailed desi• elements
Notes:
hYt
Approved By Planning:
Date: "I r
I:\Building\Forms\BldgPermitRvw_RES_RT_121417.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12955 SW RIVER TERRACE BLVD, August 27, 2018 at
BEAVERTON, OR, 97007 1 :40:09 PM
Record Type: Record ID:
Residential - Master Permit MST2018-00039
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:
12955 SW RIVER TERRACE BLVD, August 28, 2018 at
BEAVERTON, OR, 97007 12:33:38 PM
Record Type: Record ID:
Residential - Master Permit MST2018-00039
Inspection Type: Inspector:
199 Electrical final Aaron Cillo-Gobel
Result:
PASS
Comments:
Previous corrections completed.
A/C installed.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12955 SW RIVER TERRACE BLVD, August 28, 2018 at
BEAVERTON, OR, 97007 12:30:04 PM
Record Type: Record ID:
Residential - Master Permit MST2018-00039
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS
Comments:
Previous corrections completed.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12955 SW RIVER TERRACE BLVD, August 30, 2018 at
BEAVERTON, OR, 97007 1 :06:11 PM
Record Type: Record ID:
Residential - Master Permit MST2018-00039
Inspection Type: Inspector:
299 Final inspection Jeremy Burrows
Result:
PASS - CofO
Comments:
Correction complete
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
MSTa.b\ - 000 5 l MSS � ,- Oc ) .-1- ) MSY3-6\ ouzp,8 'a-0R- CX6
m S �'} - CXJ 5 S-r \Q- boo
CITY OF TIGARD y / SITE WORK PERMIT
II . rc\S-r a-0\� �1
, COMMUNITY DEVELOPMENT Permit#: SIT2018-00011
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/08/2018
Parcel: 2S106AD06600
Jurisdiction: Tigard
Site address: 12917 SW RIVER TERRACE BLVD
Project: River Terrace East Subdivision: RIVER TERRACE EAST Lot: 173
Project Description: Retaining wall in front of lots 173-179.
Contractor: WILLIAM LYON HOMES INC Owner: WILLIAM LYON HOMES INC
703 BROADWAY STREET, SUITE 510 109 E 13TH ST
VANCOUVER,WA 98660 VANCOUVER,WA 98660
PHONE: 360-695-7700 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-Site Work 05/08/2018 $674.92
Plan Review 05/08/2018 $438.70
Type of Use: SF 12%State Surcharge-Building 05/08/2018 $80.99
Class of Work: NEW Info Process/Archiving-Lg$2.00(over 05/08/2018 $6.00
11x17)
Project Valuation: $75,000.00 Info Process/Archiving-Sm$0.50(up to 05/08/2018 $75.00
11x17)
Erosion Control w/Development 05/08/2018 $161.40
Site Specifics:
Excavation Volume: 240 cu.yd.
Fill Volume: 84 cu.yd.
Impervious Surface: 980 sq.ft.
Engineered Fill: Yes Soil Report Required: Yes
Paving: No Grading: Yes
Landscaping: Yes Site Prep:
Storn Drains: Retaining Wall: Yes
Fire Underground: No Accessible Parking: No
Fence: No
Total $1,437.01
Required Items and Reports(Conditions)
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 folio,' - r -s adopted by the Oregon
Utility Notification Center. Those rules are set forth a• • -001-0010 through OAR 952-001-0090. " •u may .btain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.:00.332.2344.
AlIssued By: ittee 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.
1
Building Permit Application l,�C+n
Residential 517E a/O� ECEI V ED FOR OFFICE USE ONI.I
APR 3 0 2018 Received ♦ ringNS�" /(7/7
City of TigardPlan Ry: w , .Cl/�"—, WA~ ��� --(,G' ��
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598. OF TIGARD Date/By: S"+� Other Permit:
r j G A R II Inspection Line: 503.639.4175 Date Ready/By: JudH i: See Page 2 for
Internet: www.tigard-oi gov BUILDING DIVISION Notitied/Method�/"/r Supplemental Information
Ork .". ,x u ar rP y x,77%A' ( Y '• m4 ry 1 C y�3 4, / s F`", �''z
.� O j i gazA f-,7;.4,i2,';
i 2 # I �. f
i a "
a
.cr ._. a ,a� g�,... ya.. a���Vi �": Vis, u
ialeiL
❑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 ®Other:retain.wall equipment,materials,labor,overhead,and the profit for the
m t i OIk N Y ¢E? aii work indicated on this application.
Valuation: $
F. I-and 2-family dwelling Commercial/industrial
0 Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
f E'4?I *iit r ,ii. 14 0 ��9 Total number of floors:
Job site address:/,/9/7, /;A 535, /4-,15,v7 /2,5:5-, / 9L 7 62 / New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 /‘, 9 I 7 siv /2,1 76'L-`/arage/carport area: square feet
Suite/bldg./apt.no.: Project name:Polygon at East River Ter Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet .
Subdivision:Polygon at East River Terrace Lot no.: 113—/7 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
lglep -_ t " � work indicated on this application.
Rt..-mi./P./6 ((l is wir, 5.(-A-02 Valuation: $75000
Existing building area: square feet
New building area: square feet
fo<�� a : .; I z ® �s) WNumber of stories:
Name:ADVL Land Holdings,LLC Type of construction:
Address:7600 E Doubletree Ranch Road,Suite 700 Occupancy groups:
City/State/ZIP:Scottsdale,AZ 85258 • Existing:
Phone:(602)694-4031 Fax:( ) New:
Business name:Polygon WLII,LLC 441. 4:70';',,,',1'.:140., t 'I.
Structural plan review fee(or deposit):
� Contact name:Tom Dicianno
FLS plan review fee(if applicable):
Address: 109 East 13th Street
Total fees due upon application:
i City/State/ZIP:Vancouver WA 98660
Amount received:
I Phone.:(503)577-4160 Fax::( )
� iE-mail:tom.dicianno@polygonhomes.com ,k _ �' �� „ ,
I' , r 4, Commercial and residential prescriptive installation of j
,...-1. (1..";::':,..: , ,. •.f roof-top mounted Photo Voltaic Solar Panel System. I
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. I
City/State/ZIP:Vancouver WA 98660 Permit Fee(includes plan review
and administrative fees): $180.00
Phone:(360)695-7700 Fax:(360)6934142 State surcharge(12%of permit fee):
$21.60
CCB lie.:207247 i
Total fee due upon application: $201.6 !
Authorized signature. This permit application expires if a permit is not obtained
7 i ...�� l within 180 days after it has been accepted as complete.
" it!t name:Tom Dicianno Date: /3 p _ *Fee methodology set by Tri-County Building Industry
f Service Board.
:' uildin;\Permits\BUP-RESPemiitApp.doc 02/24/2011 440-4613T(Il/02/COMiWEB)
City of l'iigard: Site W'tirk Permit Citeekliat
Supplemental Information
Commercial,fit ulti-k entity and Oa - n. l'w , emit
No pernii,is ret„onreil u lilt i$1414 IiIITI'50 york4 IS 4ivnlp true*Itht,Iio or its..thou 3 feet&leo arid
not be 1,upprotine a a:torture. It a building se:I!he ortntinnied on the flu,..1 IMF?:he one in,,eted Mi. if
CH to en a Coot!pI,itti„atainapt ii,o,or%etlant tiv appli,mot roue apply for a ociai 10.f,444414-;$ICV,t$4
(SI.R
P4eaSC c1144Iittv ail stems lickew,orilesi otherwise no•ed
...—
'07 ritacuvaticen 37olurat: - ---- 1 - --- --IP-10 en Ntis '
Gradi rip.Volonte
V '
l,.{Soil,.repset required for 1-5,3XX)on.±) 36•45 • lb
LAI 1 -
,..„ -4—*
Fin V141441C'
(FA exceeding 12"in depth shrill be cerlIpaaa in 1
90%of maximum density"
v i
1._
Retaining atraclune Whorl,oriel — —
I
I NI'
' Cflf44°4444' rig .
,„, .I am:new imprnions si.iNi including ail holiiip,1-0134.14041-1-rEfA
ISO sg.ft.'t1°P21)41j4ftt'Ll.
V !Act%alks,and pareine: lAtteitd ?talt/4tr
— —
I ftiej fp" tSs"
Site I fillitk-s Plumbing Work:
CornpicIe the Plumbing Permit Applieir ion rot aite atilii*a plotnhiog Welk
- - -_ --
Plans Required: See"Silt,Work Pennit Application.Plan Submittal Requirements-attached !
The following rtoria Ackmnpany NI application:
* Site Plan with Vicinity Notap sNowing ADA 1 07+P„mktha(ink-314,1in;ADA)and Lighting'.
l,coilipt.tonee _ / ' Pion
1 tiradi rift Plan and detaili ,,,,, 1,,,,*land—sizapin7i Plan
" ttoalria i'matol.Plan ri.Wid Ilet.ufs I Smits Repld 4 if redi.,:redi —
1 .. Rielintim.p Structutt% _ 1 1 I
'Die,PV4 apply to Oier.:orbit To-o-faitat,ihaehenri
Plan Submittal: Permit Feet
,
TV?h,(W SUBNIITTAI. -. #of Nam ' rTtrattU' Ati •
_ ___ on. mit PerEr;
, — 1 -- —
(Nror,Alatsditlato or itt.quirvd at 1 lac,le, _
AllieraiktIRP Subsraittel
I m —
ri$I3-$0,4i
N.:tP4 4-4,i,,, 44$0144=4,9$1 44.,ci 1444.,K41
-
I
(:trtnrativ 41 3 i orneq.mi.d......indiats5,24.1mqc.
killiet:E.Ectili R.1 CS::-.cuploi: . - -,-
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-7',I.'„ ei iii,
to 4 4 lie
V
1 $10''''rl.rItt additte4444 NI MI 0°
faelit.ii...Mi II/alw...oehkukc
i..1.1 Pol 4X),
Oat'.6, I wo 1 antiFiy )wth.E 3 irii',^,:g1.4.`4,-,iSC.4,41.i.i, 1-137)$.$:t4c the.0.4 V,iice.ca anl
14 0$$..t.044k 4-44.-'io4A$t4,444 co,,4
— ,-- 1 4,4041i=tz theft,'',,,Atext 04144$C44
$4-ilifer$'Xi
H.4...,$I ta,'4•rIt I $$11)4":'hi It,';`, ,;iiii71 ...4
4,w 444.1.0 1,4140-i1,4404 Ott
i t.s,0.70f w Ortd IN/4,1,..t
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I '1.'"UN,Y"."'"."sir-oitaii.,,,,ove, iwW.
City of Tigard
IIIa COMMUNITY DEVELOPMENT DEPARTMENT
11
T I G A R D Building Permit Review — Residential
Building Permit #: --S/TACE/f—ago 11 5a) ,ei v& 7772/24- -7. L L ✓b
Site Address: /29, 7, /2933, 42-9V7, /2_9SS, /Z `9' !.7, /,99/ /02 '277
Project Name: RO i-e T trace -5:5;k l n E \NGo 11.c Lot #: 913- 1 1
ew dwelling=subdivision name;Addition or Alteran last name of owner)
Planning Review
Proposal: Zi-e.-+eli n i n6 wok Its
'''R Verify site address/suite# exists and active in permit system.
'River Terrace Neighborhood: El No jiiQ Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
ree (3) copies of site plan .Existing structures on site
M Site plan must be on 8-1/2"x 11" or 11 x 17"paper 1RFootprint 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 "71Sidewalk/driveway approach
NqApplicant information(name and phone number) ocation of wells/septic systems
tot dimensions and building setback dimensions NNExisting trees to be retained with drip line,and tree
rq/ quare footage of buildings to be demolished protection measures
:Sttot area,building coverage area,percentage of coverage and Ntreet tree size,type and location
impervious area (applicable if R-7,R-12,R-25&R-40) IqStreet names
roperty corner elevations (2 foot contour lines if more than >1,000 sf of impervious area created or replaced? ❑Yes ❑No
4 foot differential) If yes,is a storm water quality facility shown? ❑Yes ❑No
Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No
Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes,applicant was notified .kNo Applied For: ❑ Yes CINo,stop intake
Land Use Case#: .0 D 1220 tLp-q)O\
,;'Zoning: R':?S`LPP)
1,1;1Required Setbacks: Front 0 Rear NIA Side C, i Street Side Jv/- Garage N/A-
' [D1 Landscape Requirement: 20 %
44, Lot Coverage Maximum: SD %
X Building Height: Maximum Height N)/A-- Actual Height 0— 1 I 1
Visual Clearance
jg—Sensitive Lands: N"Yes ❑ No Type \,.(7, ) V t\ . '11/1,\>l-k -tk
Urban Forestry Plan
lg. Conditions "Met"prior to issuance of building permit
Notes:
,isa' Approved By Planning: ae,`,,,,Q Date: (([. / I
Revisions (after Building Submittal only Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved Cl Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPennitRvw_RES_0614I 7.docx
Building Permit Submittal
Original Submittal Date: if/3e/rol>"
Site Plans: # -
Building Plans: # c,-
Building Permit#: Enter building permit# above.
Workflow Routing: ErPlanning ®--Engineering '-15-ermit Coordinator L—wilding
Workflow Sign-off: D'Sign-off for Planning(include notes from planning review)
Route Application Documents: D-Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
Ef-Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: , c _ Date: y� c)/41"
Engineering Review ^� 7e'
,Slope at building pad:
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments) per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ' No
Assess Water Quantity Fee in-lieu: ❑ Yes - No
LIDA Facility on lot: ❑ Yes ):11'No
Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
_Z.-Approved by Engineering: A,t KR-- L✓ L Date: 4/36/1 6
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:
►\ thC Fees Entered: Wash Co Trans Dcv Tax: ❑ Yes i N/A
Tigard Trans SDC: ❑ Yes N/A
Parks SDC: ❑ Yes N/A
LIDA ❑ Yes N/A
P'P Y
OK to Issue Permit C
Approved roved b Permit Coordinator: Date: 57�/ �
d
I:\Building\Forms\BldgPermitRvw_RES 010118.docx