Permit (124) CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2018-00008
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/05/2018
Parcel: 2S 106AD06500
Jurisdiction: Tigard
Site address: 12924 SW RIVER TERRACE BLVD
Subdivision: RIVER TERRACE EAST Lot: 172
Project: River Terrace East, Lot 172
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 Right 3 Detectors: Yes
Total: 1744 sf Value: $219,408.92 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 Storm Sewer 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0
Bckflw Prevntr: 0
Catch Basins: 0
Footing Drain: 0 Ice Maker: 1 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
Furn<100K: 1 Vents: 0 Woodstoves: 0
Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 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:
ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
BY FORSUM,MICHAEL 703 BROADWAY STREET,SUITE 510 1 Fire Rated Eaves both sides
7600 E DOUBLETREE RANCH RD VANCOUVER,WA 98660 2 Ersn Cntrl 503-639-4175
STE 1
SCOTTSDALE,AZ 85258
PHONE: 602-694-4031 PHONE: 360-695-7700
FAX:
Total Fees: $32,177.31
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 throir
u.• 'AR 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 By4 � Aar
Permittee Signature: /v , / -i-7e,-
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.
Bundling Permit Application Z-- 0 7--"
` esl<reaatia fr-
a
- FOR OFFICE I'SE O\L1'
City of Tigard T Receives
SEP 7 2017 Date/By: j iv li Permit No.A i rt/,rte
13125 SW Hall Blvd.,Tigard,OR 97223 i!/!s�(� [.T/U//f
DatPlaReview) J j It
Phone: 503.718.2439 Fax: 503.598.196 Other permit: Iffl�t��ljpy as
Inspection Line: 503.639.4175 '' L Date Re I�2 fo GCti�
TIG,,D , Date Ready/By: -�/ ` �f IuriS: H See Page 2 for
Internet: www.tigard-or.gov EU' ,- `t c r IUN Notifed/Method:.01 //� '��Y Supplemental Information
Cj Aid ,r`fzr t&-,--
Permit fees*are based on the value of the work performed.
®New construction ❑Demolition
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
� � work indicated on this application.
® 1-and 2-family dwelling ❑Commercial/industrial Valuation: $
CZ°
0 Accessory building 0 Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms: d��� 40
( 5 p ;kke t n.` • ' At Total number of floors: D-161
xr,. , .moi% �:., �$
Job site address:/1/2 il . SW River Terrace BLVD New dwelling area: I
7 square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: 2.32 square feet
4
Suite/bldg./apt.no.: I Project name:River Terrace East Covered porch area:6 3 44 square feet q3•9
Cross street/directions to job site: neckaraa: is square feetU O
�►atic GOVcIV
Other structure area: square feet
Subdivision:River Terrace East , Lot no.:f7 1Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
s �,-: ,, equipment,materials,labor,overhead,and the profit for the
3 I'= t t ' work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
0 €. ..., , , ., Z. Number of stories:
Name:ADVL Land Holdings,LLC Type of construction:
Address:7600 E Doubletree Ranch Road
Occupancy p y groups:
City/State/ZIP:Scottsdale,AZ 85258
Existing:
Phone:(602)694-4031 Fax:
_
New:
' V ,,. .a, '' ' a 1,2 , _tf , € �t 1 ,� - T
Business name:Polygon WLH,LLC l
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:
E-mail:Nichole.Thorpe@polygonhomes.com
Commercial and residential prescriptive installation of
. M - , '" I„I,,,P- R... 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:703 Broadway St Suite 510 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 lie.: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:Nichole Thorpe Date:8/23/2017 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(1 I/02/COM/WEB)
Alerb snit al er iib Apel ' _ '= t $
City of Tigard neeencei
A '_13125 SW Hall Btyd:,.Tigank QR 9722v,iR" y 2018 Uur+B,r, lh l w/f )/, T��UIII
Platt Review '
't z,:�h 1� Phone:
5 Line; 543.539 4175 3.5.93 i 960 t i'_. ,�a r:
DIN U l I,7atcIi t7lhor.i' inii:
hire~Ct: tvww.tigat kitiUY7111,.4(.7,.. ,/:). v .,,,,7.,a , '. R Zhnt edimetha • lana Ser bane 2 far
E i NOtiEiedlMrthod Supplementallafermattea
-t� �/ �y..� r
,N /�¢¢,�p{{ �Y Lai ��y� ;Q Q�/
' � t S .,`.-�'"� 'i-`tc#.r'•i' iM Y � '_�, 4 � k � : �'-i,4��1r�Il,� Y'" 'TLL\,{yy�.W .F���,+-4���:.:..
1 CN construction Q AddiLiOnl ltdratiC+llliCpliiCCIIIDiit. Mechanical permit tees*are based on the value of the work
performed.Indicate the value(founded to the nearest dollar)of alt
D Demolition 0 Other.
... ` ki
ma
materials.
ts equipment.labor.
overhead.
and
Profit
Value;S
fs,., 'CTE ?RXO,i._ i� yyR $ _ ... + rr prr ��o�rtovotigs o
:D t-and?-niti dwetling0 CminnercialrndusinaiD Acrybilding Rnrsprdal information use checklist®Mutfamily D lvtssFebuilder D 01het; 3crlpfpn Total
:., iO �TE. OJM JM4 E CM10t x r c',
Ai`
} Co itttrsiaiif i 46.75 •
ob site address:
j je L) cSw giveir- /enrac , !3►IO. t tit ,t>a 8 , ea 46.75
City/State/ZIP:TigardcOR 97224 . Furnace 100,00Or BM(duds nti1 54.91
Sttitedbtdg tajat no.: I lYtojesx ltasrie: m licit Ppm 6106.
�?.i VP-It le reac�. s-r- DuCt 2332
Cross street/directions to job site<
•
�Ifvdioltic hat water system 23 32
• Residential boiler(radiator or
. burin:Mk) 23.32
Vinithearers(fuel-t;=pe;not eleai•1t), •
in-wall.in-doet.susper dcd eft 46.75
W Finely*Par any of above , 2332
Subdin
ion;R•�V tt-"re s —. 1_Lot no. :11'2 Oither 23.32,
Tax map/parcel nu
Other het atiplhtneex •
W tei beater 27.32
.. �ztpnio r t.,'V1'ORi► {'_. h , Ona Cilarcellnsert Y33.39
fate view tear.water heater or' t
fireplace• : 2332.
Log tighter(gas) 23,32
Woodimdlet sir 3339
Wood fireplace/insert , 2332
vitineriflunlvent
A . 1'F1CT] i 32
.. DWPiER t 23
e 23.32
�: -y�1� fltli�;
?`atriz: �} Envirmunt lid exhaust and ventilation:
—✓ : Ran&hoodtotliarkhahen
Address:1 tQ W E -1) $�tf=i r flc („ •
rui cnt 33.39
CitylStatefLip 1�< - . Clothes dryerealtauat I • 33.39
`''�'���' . LTJ L5� Single-duet sxilseit itithreons,
I _ .tandexnnpailitleats,utility Mann). 23-32
liltolic 0°2—t y—'�t9( Fax ( )
Attidrerasrlspace fans
2332
erkliCa1t'2'... .s ,:: ,N�; 1 t.ONTA.C,T P R'SO]Y..:, :. Other: 23.32
Business name: ,A,i\V��1.� t \ �� 1 t� t 'tM Fuel tait»ue:
Contact name:A\V"r,n^�,n�1„1� i !�' 51;15 far that four;S4.03 far latch additional
fy(V1/4 t -�-�]
Address Furnace.etc,
'Si-0 (6rDelriAA)C1-9 . Sut.�e.�� - ;.. ... � ..
City/State/'LIP:Vancouver,WA 98660 Water
ditsrth heater
Water heater
Photo:(360)695.7709
Fra:::(360)69343 rirel►lare
•
S itis N len ile., t tik t o of
A
� . � . = l3atfiecrte
._. �, --: [(J.S1- 7, ,. rt
-- C`tMhc�s drevr(tom)
Businessname:Apex Air LLC. pd,p-
Address:18004?«7r"AveS
> A......AE,P$RhT. I ES!,,
•
Subtotal
Cts}=t'S"tateiGTP:Vancouver, 4'A 9868IS Tafinimout permit tee(590.00)
Phone:1369)34241419 j Fax:(360i 326-1760 Plan tcview $%.of permit fee)
CC15 Iia::203034
Smte smchslge(12%orptxmii:tee) :
TOTAL PERMIT FEE
'l'hia pariah application expires it o permit is nut obtained within t 8U
Attihori ed Si$riat mays attach tm barn acecpted as complete.
Print •
name: lA ffi°d ° i'7 T Baitdinfi lndu tt}Sit+•icc&aard
Date: ' '19•ft.
t.1t3w'taiine;PpmiteklEC_AaeuUpp NM 13 dev 446-4h17Tt11/.0CoMM:111
City ofrigard jAt,i 1 1 ?OA Received
Date/B : Penni(4"17,.-f /cfl''' •Afr
)11 'I 13125 SW Half Bivd..,Tigard,OR 97223 ' '' -
Plan Review
P , It , Phone: 503.718.2439 Fax 503.5909a, ",..- i A A -4.A.F ' Date/B .
lunsimilimmieffSfM111111111111
Inspection Line: 503.639.4175 i,,1 l 'I "-.'r . I,-i - Ready Date/Bv:
63 See Page 2 for
T1 CARD
t,_,-, rv;ki,-;”::.-f,,-",,e'N., - -
Internet: wsvw.tigard-or.gov 1.3 t,1,l L D 0),, -. Notified/Method:
MEMO Supplemental Information
M127,1T. 7;„8:140.1tiggikaata'as-Anf.,f;YAn.::rt: '•c::':';11T,::4-• en.1.i'ii.f44413,\IO,.firaii.5.::-.:5:E.;;;:5!?4*.KAil-4.VP.7.1'
10 New construction 0 Addition/alteration/replacement Please check all that apply(submit2 sets of plans w/itema obeelced):
. °Service or feeder 400 amps or store 0 Building over three stories.
0 Demolition 0 Other:
where the available fault current 0 Marinas and boatyards.
-YJI.I,C14-;1.S.ft'4:1,q.4.4:14114111 ...4011:*:$01.04::o g.i...!:.7rAVITA3 ..• exceeds 10 000 amps at 150 volts or El Floating buildings.
kT. 1-and 2-family dwelling 0 Commercialfindusbial 0 Accessory buildingtoss to ground,or exc,eeds 14,000 EIC0Inmeletar-use agricultural
maPs for all other installations. buildings.
0 Multi-family • 0 Master builder 0 Other:
Cf Fire pump, 0 Installation 01150 KVA or
X, 11•Pisell**Ce 1....2r.e.,#.10:-01 gtitkAil**1010;Z: '-'.:C.`S'1::.i :;,*',:.;.• CiEnterSerloY sYstelm larger aeparately derived
z.:
U ,44japr of new motor load of system.
Job#: Job site address ' ° A V. -41 00, ' ft ' 'more, El"A'Y'E' "1-2","1-3",
NI Six or more residential units. occupancy.
A-
CitY/SWegjP:Tigard,OR 97224
°Health-care facilities. °Recreational vehicle parlcs.
Suite/bldgiapt#: Project name: r•
°Hazardous locations. 0 Supply voltage for more than
I d i" ' 0 IS
°Service or feeder 600 amps or;core, 600 volts mminal•
Cross street/directions to job site:
VfA3-,•:' iftaili*:Wg;.4g4V:M
Dena-don
11102.111.21iii Total. El
New residential single-or multi-family dwelling unit.
Subdivision: V i . 1-- , N Lot#:0 Includes attached garage.
1,000 sq.ft.or less
...,1111..._11=1.1111111_1111:11
Tax map/parcel#:
WiiEa.add'I 500 sq.ft,or portion p-joimmilla
Limited ifiACWIPPAVIliftiAkiiIVS.b.gs:040.00101100 'ri :` energy,residential iman
rilabive' 'fr11111175.00
Limited energy,
7500
residential me
milie
NO
ar4-*I'Z'N'ISICKWiTIOIMENE1 StROfilattelOgibitig00.:'Ag itnresboi:feendeen installation,
aFterateo:a'new2orilliii.retoca non
ii Pi II di, I Services
I a # 200 amps or less 1111 10030 a
201 amps to 400 amps 111111EIE3111111111E1
Address:. i 1 1 ao • . - it- ..- [4111%Ml t_, , II.
E
401 amps to 600 amps II. 20034 ll
city/swamp:
601 amps to 1,000 amps 1.11 301.04 min
Phone: i 0 if - ill - r
Over,, IF'allailnIIIIIIIIIIIIIIII
Temporaservicesserv000 5UlS"iele;lotsr feeders 552.26installatiors, ltern
tion,and/or
Email: A, A tz .14 t III!' ril i10, s. li alas- ..Ai relocation
Owner installation:This installa..n is .e g ma•- .n property that own which is not 200 amps or less IIIIIEM le
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 1.11 125.08 min
Owner signature:
Date: 401 amps to 599 amps IIIIIIEZEIIIIIIIIEI
:1,4 , i. ,,,..,,, ,.„.,........7- : Branch circuits-now alteration or extension ,er,anel
OP . -..yv" .QA - A.Fee for branch(limits iP'th
service or feefsIs111 -
Business name: ii 1 a I li IA ROA%.. above dere, I N... A
each bands circuit
Contact name: ..,A I 0 I 4 iv;
B.Fee for branch circuits without
,
service or feeder fee,first
t
Address: il a AI i so-••• -A 11. ..J 1 - N, II branch circuit OE I
City/State/ZIP:Vancouver,WA 98660
Each addl branch circuit 1111111ECE11111111E1
Miscellaneous service or feeder not includ
Phone:(360)695-7700 Fax::(360)693-9442
Each manufactured or modular III 6724 MD
dwellik,service and/or feeder
Email: L' , • Ti.,vAk).- A Ike a a t.ii.: • 1 II Reconnect only IIIII 67114 IIIIIEEI
fis-E- -er,7-7.147,;P:vi7izo:-.4nxibs.r ' eAtAhNigfakegAgalikAA', Pump or hylgation circle all 6724 moo
Business name:Garner Electric Washington,LLC
Sign or outline lighting 1111111111M11111111118
Signal drunks)or limited-energy
Address:402'Valley Ave NW Ste 106
• .anel alteration or extension. ID See Page 2 low
Each additional Ins.tenon over allowable in an of the above
City/State/Z1P:Puyallup WA 98371
Additional inspection(1 hr min) in 662.5Thr
111
Phone:(253)872-6051 Fax (253)872-1801 Investigation(1 lir min) an 90.0W hr Mill
Industrial plant(1 br min) - 78.18/hr Min
Email:bdaniels@gweusa.com
Inspections for which no fee is
CCB Lic.: C1158 Electrical Lie.: 208174 Suprv.Lic.: 4496S ,--,'.04 listed(%hrmin 111 90.00/hr 1111111 ,
._-. .. .
igT;;;-'1 V,• ••InIkijli,,s,."J.,,,, ,,71 ci,7.:#615PWEI.IkS:W'
Suprv.Electrician signature,required: '44PMFIPAIRMW. - •
Subtotal: 1............_1111111111111
Print name: Jean P Albert ..
Da 0 Plan Review Required(25%of permit fee): =nom
„--
State surcharge(12%of permit fee): IIIIEIIIIIIII
Authorized signature: lifirr"./ifoi ---- -- TOTAL PI3R1.siT PEE: 111111111111
-------_____ This permit application expires Ira 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.
muildinglearaiitattic ParmItApp Etit intadoo Rev 06/17/2013
440-461ST(IVOSICOINWEB
Plumbing Permit Appikatign,
Building Futures Wri, ;r7, .0, r:-''''--
). , --- -- .. . .. .
.1L___ city 9fTigard, , ,A N 1 1 2 0 IS , Received
Dateillik: Peneloro/Z$7,e,,,-...aive :
4( L1125 SW 141.1Blvd.,Tigard,OR 9.72ii-\-'—
Phone: 501718.2439Fax: 50359;k44.0-1.i_ talti33416,,.."I Other Petaiit
,
Inspection Line: 503.639.4175 ki 1 1 T I-), .!„!:,':,„.„, .-•.,.!,,;., I. .
7!GARD # -kp....v:,-; 5,••!1.,,,;:` ;'''..0, '-' 1.,,TFIteaclYar leak I ES:See Page 2 for
• Internet Www,tigard7or.go* F31,!I L..i. 1; ,.,,.- &--' ' Notitied/Method: Soppleuitatal Information
litifficAtIMI- ifititati40,11(40:14.41,1ilittaaRa0:' 7.430-*=;re•OW4ir•OZ.4*eiaiiiiizatZalrtNI:Mintg,!1'jitt'AjW7.1 ''.
,ta .,.,..._,„,...,1 ,,,.New canstruction 0 beination . For special ixforiiirtion a:vizier:1;5st.
.• .Description j Qty. I Ea- J Total. . ...
FA.dditic'mialteration/repracement 7E3 Other:- New 1-2-falituy tisifellings(indudes 100 ft;for eickutiliey cionrieCtion)
A.4611244147.'610.01Y.-,:, 4*****7.-01:*.titaliMISV 'BF")bath 312.10
;•:'
SFR(2)bath• 437.78
. e 1-and 2,,family dwelling 0 Commerciallindustrial• .
' ri • SFR(3)bath . i 50042
0 Actessory holding: i....i Multi-family .
-'-
. 13eoh additi'omil batblkitcheit . 15.02
0 Master builder 0 Other;. .
„ . .Fht sPrinkler( Sq.it). Page 2
V03•04141140011:1*~4.7***W:71.04gentiltt Site trades:,
Catch Whirr area drain 18.76
Job site addle=121?11 W giVede Thrrabc.... 1311119
:Drywoocaab linc.or hooch drain 18.16
City/State/aP:Tigard,0R97224
... • Footing drain(no.linear it:____) Page 2
• Suite/bldg./apt,no,: Project name: ' Manufactured home utilities . 50.03
Cross street/direMions to job site: Manholes 18.76
.....
Rain drain connector 18.76
Sanitary sewer(no. 'linear ft _ ): Page 2
•
Storm sewer(no.linear ft.:._) . Page 2
Water service(no.linearft: ) Pagis 2
Su.bdivisier 12-Wer r(.lirtite reaSth— • I Lot no.:11) Fixture or hew
Taxnutp/paroel no:. ' Backflow preveuter 1 31.27
P:e. ,•..:•:.544..,'E'42-4E.:, ',V;iiiii'Z';!'•i••••"'iiiirkiii4olii&ZF,t--tiA5.4M%::,ALVIT.:*?Z•nr-;741•. Backwater valYc 1 12.51
..4.7504:14)..,4,,,w-,,,,,,,y;s:,:...-•:..v,Itvv-,.04....,..._;.,,,_-•.,,,,„,..,...,-,,,;.,4„-7.,,,,...,„,.:,L o.ty•-•-5,F;„2,•.3;:„7•towtr.:.%4;;I:;,,.-N.15.1.mi
Clothes washer. 25:02
Dishwasher 25.02
Drinking fountain' 25.02
Ejectors/sump 25.02
ExPansiw tank 12.51
Fixture/sewer cap 25.02
•
Name AD VL Land'Holdings,LLC
Floor drain/hoer sink/hub 15.02
Address:1600 E DOubletree Rauch Road
Garbage disposal .25.02
City/State/ZIP;Scottsdale AZ 85258
Hose bib 25;02 '
Phone:(602)694-404 Fax.( ). lee maker 12.51
. . , . •
-':•giffirirIttla*-1.1 ],ga,ilikignglA'hl'±;Ta:4'WiNitiiiiint,'.:li intercePtcrigraase._ trap 25,02 ..
Medical gas(value:$ ) •
Page 2 I •
• Business nameg William Lyon Homes,Inc
Primer 12.51
Contact name;IslichatabOrr-i Roof drain(commercial) 12.51
: Ad4resal 0 3BrnadikuA- s# SuLite.510 ...,Sink/basin/lavatory 25.02 . •
•
City/State/ZIP;Vancouver,WA 9864 Solar units{potable water) 62.54 .
Phone:(360)695-7700 Fax::(360)693-4442 . Tub/shower/shower pan 12:51
: Urinal
-E-Illa I, % I 1 ' • la 1,81.." (4 ,1 I a• frionn-Qon) . . Water closet 25.01 •
.T.r.S.21:11.04,_,tciAMVAVIN ,;,:;',-';',7,,,-,.''.• i''` :: "ri;r,4*.,,,q,l'A!-,7:f: i.:7-::Y.;
.-1t,g.•,,,f4.....,:i-SilifTi:',Y.;,:p.N .'41 water heater
37.52
Business name: GEt k)kort,i)‘ 1/4...cvit-sovvi Water piping/DWV 59.
•
Address: {),_().. 6..0K, of A J Other: 25;02
City/State/ZIP:- st, 9404 am, 40131 Subtotal
. .
Phone:0163'Stitt'1411 Fax;(efi t.•141-4)1,0 • Ivrinimuni perrait fee: $72.50
Plan review(25%of perthit fee)
CCH Lic4 181372_ Plumbing Lim no.it 63q .
State surcharge(12%of pertnit fee)
Authorize' dsignatum; olZCCIt.- t)1410"'•%-..... I . TOTAL PERMFF FEE.
IPrint wine: 647fAit, F,4,014.e, 1 mfts-36-I f I This permit application expires if&permit is not obtained witidn Ild:dsys
after it hat been accepted as complete,
*Fee methodology-why TriCotatty Bantling Industry Service Board.
tanundineboteatimm-Peeettapp.ilac manias 44s-istsnatmccuvwss)
N ; City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
■
Building Permit Review — Residential
TI GARD
Building Permit #: /fil SP-00—000,g—
Site Address: ON S Ls) ( w Trill( �l✓L1
Project Name: k;, ltrtki t cal" Lot #: I 7Z
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review • _
Proposal: C.nsk-M. " 0 ntu I`
4Verify site address/suite# exists and active in permit ystem.
I River Terrace Neighborhood: ❑ No L1 Yes,See River Terrace Review Addendum Attached
Sie Plan Elements:
1 ree(3)copies of site plan '11f xisting. structures on site
e plan must be on 8-1/2"x 11"or 11 x 17"paper L Footprint of new structure(including decks)with finished
yawn to scale(standard architect or engineer scale) oor elevations
Orth arrow ['utility locations&easements(required for new and additions)
Site address,project or subdivision name and lot number !' ewalk/driveway approach
Q/r.pplicant information(name and phone number) l! •cation of wells/septic systems
of dimensions and building setback dimensions Ili Existing trees to be retained with drip line,and tree
quare footage of buildings to be demolished protection measures
LUllot area,building coverage area,percentage of coverage and , )SStreet tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) [Street names
Eroperty corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? [es ❑No
4 oot differential) If es,is a storm water .uali facili shown? 1:1koisil0No
T Clean Water Services—Service Provider Lett (lot platted prior to 9/10/1995): L 46/A4 ,,..iii.,
Required: iTes,applicant was notified Wr No Received: ❑ Yes ❑ No L,.— ti k,
101 Public Facilities Improvement(PFI)Permit: /,
Required: 0 Yes,applicant was notified/� ❑ No Applied For: CI' Yes I=1 No,stop intake
Ed
Land Use Case#: P L)(2-O I!; li u 6 e F i Lo t( `oo q
Zoning: fv4 (
0//Required Setbacks: Front j LRear `j Side 3 Street Side ? Garage j 6
L andscape Requirement: 20 — %
L( Lot Coverage Maximum: ',� 7 %
a:uilding Height: Maximum Height 5 --' Actual Height LS'S
er Visual Clearance1Yes
L ensitive Lands: El No Type r'^.,.I vi h+ L;-.vti i, <;, ,_<,- �f;�,,? Fol, hz f
Ig Urban Forestry Plan
Conditions "Met"prior to issuance of building permit
Notes: DO NOT ISSUE UNTIL CONDITION #63 0`1/4 itj iYlr
_ SIGNED OFF BY PLANNING.
Approved By Planning: At,,,o ‘6,A,Lef r. "L Date: lig I 1
Revisions (after Building Submittal oty) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_RES_061417.docx
Building Permit Submittal
Original Submittal Date: ?77/0
Site Plans: # 3
Building Plans: # 3
Building Permit#: Enter building permit#above.
Workflow Routing: lanning -Engineering -Permit Coordinator 'Building
Workflow Sign-off: Sign-off for Planning(include notes from planning review) /
Route Application Documents: p`Engineering: (1) copy of permit application,(1) site plan, (1) building plan and
original plan review routing form.
1:2"Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
/ - vli_
By Permit Technician:
..t....,, A` 44.Z.Afr _ Date: ___V_LU
Engineering Review
O Slope at building pad: 7,
❑ 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 Zr No
Assess Water Quantity Fee in-lieu: Cl Yes Er No
LIDA Facility on lot: ❑ Yes Ze No
❑ Final Plat Recorded:
El NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: ,�'j„, jr,' ,13,.. Date: ! t o--/8
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 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
❑ 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: LT
Yes GI N/A
Tigard Trans SDC: I es ❑ N/A
Parks SDC: Yes ❑ N/A
LIDA ❑ Yes pe N/A
OK to Issue Permit
Approved by Permit Coordinator: Date:///0/P
I:\Building\Forms\BldgPermitRvw REs 111617.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12924 SW RIVER TERRACE BLVD, August 23, 2018 at
BEAVERTON, OR, 97007 9:25:58 AM
Record Type: Record ID:
Residential - Master Permit MST2018-00008
Inspection Type: Inspector:
199 Electrical final Jeremy Burrows
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:
12924 SW RIVER TERRACE BLVD, August 23, 2018 at
BEAVERTON, OR, 97007 4:34:32 PM
Record Type: Record ID:
Residential - Master Permit MST2018-00008
Inspection Type: Inspector:
699 Mechanical 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:
12924 SW RIVER TERRACE BLVD, August 23, 2018 at
BEAVERTON, OR, 97007 4:33:50 PM
Record Type: Record ID:
Residential - Master Permit MST2018-00008
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS
Comments:
Previous corrections completed.
Violation Summary:
Inspector Contractor