Permit (55) CITY OF TIGARD MASTER PERMIT
111 ---. - COMMUNITY DEVELOPMENT Permit#: MST2018-00086
Tit A i'f) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/03/2018
Parcel: 2S 106DA 10200
Site address: 16919 SW BIRDSONG ST Jurisdiction: Tigard
Subdivision: RIVER TERRACE EAST Lot: 102
Project: River Terrace East, Lot 102
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1248 sf Basement: 0 sf Left 3
Parking Spaces: 0
Height: 24 Bathrooms: 3
Second: 1666 sf Garage: 464 sf Front 8 Smoke
Dwelling Units: 1 Third: 0 sf Yes
Right: 3 Detectors:
Total: 2914 sf Value: $352,680.66 Rear: 10
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 LaundryTrays: 1
Y Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100
SF Rain Storm Sewer: 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 2 Drains: 0
Water Lines: 100 Catch Basins: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Bckflw Prevntr: 0
Drywell-Trench Drain: 0 Other Fixtures: 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: 5 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N
Y Garage Opener N All
Other: N Other Description: Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr:
Occupancy Group: Square Feet:
NEW SF
VB R-3
2914
Owner: Contractor:
ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
BY FORSUM,MICHAEL 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175
7600 E DOUBLETREE RANCH RD VANCOUVER,WA 98660
STE 1
SCOTTSDALE,AZ 85258
PHONE: 602-694-4031 PHONE: 360-695-7700
FAX:
Total Fees: $35,120.34
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.-001Y/(oouuu may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: '�i��` /"�xj Zk‘e-42 — Permittee Signature: l"..
Z-e7p4 kz.,:yc .:-.,,
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.
t
Building Permit Application
R�si+deptial - (:),;,&,
m'i'd"'" FOR OFFICE LSE O\L\
City of Tigard AUG 8 2 o 17 Received D__./1. "-1---
IN g 13125 SW Hall Blvd.,Tigard,OR 97223PlaL / Dan RevPermit No. �y�',
a Phone: 501718.2439 Fax: 503.598.1960C:-'," •, r,r Date/BY:view ?
p,D DateBy: .3-�J ,l, Other Permit:
TIG.a RI) Inspection Line: 503.639.4175 t✓v L w.3ii i C , Date Ready/By: s_ SCt.(.Q�QIf �f �
Internet: www.tigard-or.gov Liv, Bf f�! -��a, See Page 2 for
Notified/Method j� / 4 ( fy�,t ,� I
' &11/9/` r_- PP mental Information
w u
sem. - t 1.3 � Jt ,:-.:, ,, , , c 3 I 6 k "40,:).44';'.'M'' t g
®New construction
❑Demolition Permit fees*are based on the value of the work performed.
❑Addition/alteration/replacement Other: equipment
the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
P ` Y x,€ ,u t t p work indicated on this application.
® 1-and 2-family dwelling 0 CommerciaUindustrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms: ��L�''"'''����'''' I
cc 0 Master builder3 3�a,1 6 g�
0Other: Number of bathrooms:
�- Ni' k t' '. i - Total number of floors:
Job site address: ` 'A �o� (� � �� � - *7°
tog 19 S W ti l(•so i G S. New dwelling area: 211 U square feet 33
City/State/ZIP:Tigard,OR 97224 J Garage/carport area: I square feet
Suite/bldg./apt.no.: I Project name:River Terrace East
Hip q
Covered porch area: square feet
Cross street/directions to job site:
Deck area: square feet
Other structure area: square feet
T`i t I ' �� t o > .; wiz �1 .
Subdivision:River Terrace East ��.;�.�
Lot no.: I 0-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
S, work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
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:( )
f New:
7 2 d I A F Fq '
Business name:Polygon WLH,LLC
Contact name:Nichole Thorpe Structural plan review fee(or deposit):
Address• n f3rOaci FLS plan review fee(if applicable):
- C
City/State/ZIP:Vancouver WA 98660 Total fees due upon application:
Phone:(360)695-7700 I Fax::( ) Amount received:
E-mail:Nichole Thorpe �� t
. ,.>` 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: u (, QU and fire department access,along with the 2010 Oregon
b Solar Installation Specialty Code checklist.
City/State/ZIP:Vancouver WA 98660 Permit Fee(includes plan review
Phone:(360)695-7700 and administrative fees): $180.00
I Fax:(360)6934442
CCB lic.:207247
State surcharge(12%of permit fee): $21.60
1/Z Total fee due upon application: $201.60
Authorized signature! M
'— This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
I Print name:Nichole Thorpe I Date:06/16/2017 I *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
' f I i i
Mechanical Permit Application -
FOR(HFI(U. 1 SF(ALI
City of Tigard
- - ...,Cattelly: Perraft1.4Z?5"7: 7/,1,....ekve(L,
13125 SW Hall Blvd.,Tigard.OR 97223.
41 1,„Ri„,,,i,,,, -
Phone: 503.712,2439 Rev: 503398.1960
Thatiltly: Other Permit
IL,A RE) Inspection Line: 503.639.4175
bite Ready/By: 1'16 1 62 SoPasrr
Interact: www,tigard-otgov
NotillediMethocl:
Suppiemsatsd Information
,e:6„4.:ikt$,W7-47e';' -- • .'',EU..1j4,:s*-' :(4CP.00:11-PWAETC*1.104/47-4:118-:t--*°4M:1:1:.;.:
Mechanical permit fees*are based on the value of the work
0 New construction 0 Addition/alteration/replacement performed,Indicate the value(rounded to the nctrest dollar)of all
Demolition 13 Other: mechanical materials,equipment labor.overheat,and profit.
Value:S
*.C.,diaiiiiitiiiiii.;`,71.V.1.0.64:44i-g.Wir-'2,1:- ;,,.,Lr.--.0--, -----.• , , ,- .-—- - ,--,-,--.- .. ..,. . :::..
•ff.-4-,4:4AfAiRP.M41.4,91,1rWi'-F:40."V -M-7.-4"-:::::-'"..••
and 2-family dwelling 0 CommerciaFinduktrial El Accessory building For special information use checilLyt .. ,
1 Multi-family 0 Ivlaster builder 0 Other: Description 1 Qty. I Ea. I Total
;'•••f-i':::ra:'::Ar4"'-74-•c...rio4-o***otiikoitiist:':k.*-1:,kitm "i
:#0414: ,e0z?0...,-' : lie
.,
' Air conditioning i 46.75
jab site address:t 11)1 (Ci 50 12)tToksOn9 est-- Furnace 100.000 BTU fdastents) 1 46.75
Cily/State/ZIP:Tigard,OR 97224
Furnace 100.000+BM Mum/vents) , 54.91
,
Hest pump 61.06
Suite/bldg./apt,no.: I Project name: v_jvtr Thrirace_€49.1.
Duct work :
23.32
Cross strectidireetions to job site:
Hydronic hot water system 23,32
_..,
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(thel-tYpe,not electric),
in-wall in-duct suspended.etc. 46.75
Flue/vent for any of above I 23.32
1
23.32
Subdivision:• P.A4tir T<,WTXCe-P.0--S4-- Lot no.:10L Other
Other fad appliances:
. ,
Tax map/panel no.:
,Water beater _ (7 '. 23.32
4;:.:1?I--14ii:2' .-'f:f,"..1:.'.',:,-..;:'.30L''.4*12...0:4-.`;00'2.:.W.0*..;•0•'3.# 1.•;grli."4.. t.lk4;;i..,,ki:. a"fire4ilsctinsert 1, 33.39
' Flue vent for water heater or gas
fireplace 23.32
Log lighter(nes) 2332
" - - Woodtpart stove 33.39 - -
Wood fireplacefinscrt 2312
Chimney/liner/flue/vent , 23.32
'•,',....:'.':1,... kt":iR°E***°I**4114.i.'';''' '...:.:': '''. .i:. ' .S.1. 'f'": 1;;*-' E°ffitt:irr:oametat exhaust nod ventilatio„ 2332
Warne:PtPV Lt- Lard Ho ktingS,LLC- Range hoodfoilwr kitchen
equipment ( 33.39
Address: 1(41 DO E. •DOU,191.e:h* [2.•.(kirY_kl tiQael Clothes dryer odt_ aus1 _____I__,;_.3j.,1.9
City/Slate/Zip: SCOttS Ctale Pq 525%
`I Stngle-duct exhaust(bathrooms.
toilet compartments.utility rooms) 1-4- 23.32 _...
Phone:4(P 02. (,061(4:-.4.0.3 Fax:( )
Attickrawlspace fans 23.32
:....;':::.:;..1r:':.;50k:A414.-ItitiNI'''..;.";!..?•:'.X;....S.':: :: . CJ aiiii4..*0:.10kittik:-.:;',;:','''. Other: 2332
Business male: W 1 I I Inn LIN) Iiernes txx.. Fuel Pilli171:4.15 tor first rum:$4.03 far tional
1
Contact name: to i.c.,v1 at--i)norRe_
Furnace.etc. 1
Address:no-6 roactusoul si- Skuk. SID Gat hear mann
wagisuvended(unit healer
City/StareTZIP:Vancouver,WA 9E660 4
Water heater
Phone:(360)695.7700 Fax::(360)693-4442 P ..
i_ . i.
E-mait, 4 . 1 1 0 ourlawaemiaca_____ Barbecue
4 .:A'::: ,, i..,..:W!...,, ,•,';'..c..ijiN.,..:-: ',':k:;:f.....--::',.:::::,-2-..-if,:t.:;:.=.1.e.7A;:::.,i',;7-.::::.1 ,:;.-.-74:15,,.?. Clothes dryer(gas) '
liminess mune:Apex Air LLC Other:
,:f...:::: :...'•!.•T'. :'•7'-ikir**APBC.,AL
Address:18004 NE 72"Ave
Subtotal
_.„....... .
City/State:ZIP:Vancouver,WA 98686
Minimum permit fee 490.00
Pio review(25%of permit fee)
Phone:(360)342-3109 I Fax:(360)31769
Stale surcharge(/2%of permit fce) .
CCB lie.:203034
TOTAL PERMIT FEE
this permit*pilleation expires iii permit is oat obtained within 1110
days atter it too been screptcd as sample*.
Aulhorkecd signature:
* Pas methadolew sot by Tri-County Building ledustry Service Stout
I Print natnen Le\ I Date; gli•ii./4,,, I
1 Nik.d,,,,,Nmit,'Airr,PrrmilAir_NO 1 il dor
44( ,'•T4
,
• fl,1 ,',/ ,: '-' ',:;',' ' F,-7,--c -..,-7--17-77.f.z_T-7-7-_,,-.1:.--!_--7:, - :-.---,J., =,-,---.----.--.-----•- -:-..',..Th--.,-_-.7;1
__ .__ DEleetriCa 1 Periilit A liCatibilil ' •' ' ' ' - ', - • •• :' , :-.-..:F:01.014`.1.6E,
—""- -.- 7 • ' ' ' Recei%;ac21--'..--'-' -----;-:-.:---±24''''''''''':'-'
City of Tigard , .
Pannit 7 ,) cf ,
q 13125 SW Hall Blvd.,Tigard,OR 0/ 211'
IN
Phone: 503.718.2439 Fax 503.598.1960
DatelS:
T 1 6,A,, Inspection Line: 503.639,4175
Ready Date/By:
Ault Eli See Page2 for
'1, Internet wsvw.tigard-or.gov
liotiffed/Metbod:
Supplemental hiformation
W-;"7- ,h3e,M=SETaltilX" ,CLTY`, 2,..4,..A.:01{..g.i:iigiggia4liaP'15.(egii.aftWiM 21,:l.
IM New construction 0 Addition/alteration/replacement Please check all that apply(submit a sets of plans w/iteint checked):
• 0 Service or feeder409 amps or snore 0 Building over duee stories.
0 Demolition 0 Other:
whom the available fault current 0 Marinas and boalyanis.
-7_50;.•;V.It:tiR ifekitAX011.04.01".:R.i 'VOVAtt 7-OVI.IAMETeriN i.f.i.ISliVV,5., exceeds 10,000 amps at 150 volts or 0 Floating bundiags.
gi I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 El Common in! turricultural
amps for all other installations. •buildings. •
0 Multi-family • 0 Master builder 0 Other:
ijrire pomp.
0 Installation of 150 KVA or
l'.:egoliwo-t7.,.: .:irvtiotiww:14.4:: 1 -i.im!..,.,f!.-:: -,,, onnergenoy system. larger separately derived
0Addition of new motor load of system.
Job it: Job site address // # ' If rd. iii : 1
100HP or more. Cl"A","E","1-2",1-3",
City/State/ZIP:Tigard,OR 97224
Osis or mom residential units. occupancy.
011ealth-care facilities. °Recreational veldt&padrs.
Suite/bIdgJapt#: Project name: 0' ' , errace, ELL4- 13Harandous locations. Ci Supply voltage for more than
0 Service or feeder 600 amps or more, 600 voile Hendee!.
Cross street/directions to job site:
.,-gai404f,'A'Aiefittg:II
Desert, on irrilik7thilillatAillin
New residential single-or muld-family dwelling unit.
Subdivision: r '.kr -Fe mice_ • Lot#: -,..., Includes attached garage.
1,000 sq.ft.or less Int 168.54 13
Tax map/parcel#:
a.add'I soo sq.R.or portion magaiiinu
inkktini,,kwev-„si,a.k.,....totogiwokiwoi ,. ::.i.;i:;:,:;:;;::,,::::ixv,;:,.,„:;.Ng.,::,:;:,.:7: Limited emu.residential
(with above . ft, 1111 75.00
13 .
Limited energy,multi-family
residential with above,,.ft. 111 75.00
111
0.1.474.;'. -4:Zaltaire Mi0.4t1:14100461,7,c!..MMg ServicesRen e wa boll!ft:de le-r4s i ii s t a I 1 a(i 0 n,al0teraStieLP anedt2or relocation'.
Name:, .8, 1
t 40 iall 200 amps or less all t00" IIMIII1E1
Address: —.1 )
201 amps to 400 amps 111111111:111.11113
: / I 110 . # :Mt: jliraMiltritillilli_ _a ...I..* oc' 401 amps to 600 amps lin 20034 Ill
City/State/ZIP:' ji•. Ift,cVde. :4 44 S
601 amps to 1,000 amp IN 301.04 IIIIIIIIE1
Phone: I 2 _41.Lip 1 Ea2raIMIIIIIIIIIIIII. Over 1,000 amps or-volts awiasztaiono
Temporary services or feeders installation,alteration,and/or
Email:
relocation
Ill Min
Owner installation:This installation is being made on property that I own which isnot 200 amps or less 59.36
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps IIIIII 12548 11111111E1
Owner signature:
E
Date: 401 amps to 599 amps 1111111133311.11113 '2?-4%...isr'W----,- ..,--,... • .-----777:------. .--, , _.nay...4i tkra ohluot.77-. --- -7--,.. :t:t*.o.rat.e. ARrFaeendforeirc' neuiwts talwitheration or extension .er,and
Business name: a I. (.114 above service or feeder fee,
each branch circuit 111E1E1
Contact name: 's A
B.Fee for branch circuits without
Address:
service or feeder fee,first
11' Aka dal
lk _.,. .k.,ea blanch circuit II 56.18
1111
City/State/Z1P:Vancouver,WA 98660
Each addi branch circuit 11111111E31111113
Miscellaneous service or feeder not includ
Phone:(360)695-7700 Pax::(360)693-4442
Each manuthetured or modular imminiim
dwellin: service and/or leerier
Email: ' A , .11.t AP, r ki V\ it&' I II Reconnect only 11111■23 El
lk..1-1,.,,'11- 4.MMT,•••...,:.-49,0rot,,,-. , vatitiO-A-11,,,,--4*4..*:AiTs*:-igg Pump or iniptio,ofra. 11111112311111111E1
Business name:Garner Electric Washington,LLC
E2212:211111 67.54 1111111113
Signal circuit(s)or limited-energy
Address:402 i,alley Ave NW Ste 106
.and,alteration or extension. 0 See Page 2 1111E1
Each additional ins*ection over allowable In an of the above
City/State/Z1P:Puyallup WA 98371
Additional inspection(I hr min) 111111 66.25/hr 111111111
Phone:(253)872-6051 Fax (253)872-1801 investigation(1 hr min) IIIII 90.00/h
Email:bdanielsftweusa.co
Industrial plant(1 hr min) Mill 7"8/16. EINE
rn
Inspections for which no fee is
CCB LIe.: C1158 Electrical II Lic.: 208174 Suprv.Lic.: 44965 , k,'Call listed %brinks III 90.00/hr
...._ ..
y !..,..,e0.7....y.oftrivrAlidi,imm. 1.facaiM:Iel
Suprv.Electrician signature,required: '"Ai'''''p ATM griiM ••• •
Subtotal: 11111111111111
Print name: Joan P Albert -, Date: 0 Plan Review Required(25%of..nnit fee): MIME
State surcharge(12%of permit fee): 11111111111111111
Authorized signature: iMPOsk".."---- - --
TOTAL PERMIT FEE: IIIIIIIIII
Date: rbi8Paintt adele:fritexhLteteaterepletsnclmobretc.dwithlu18°
Print name; Bill Daniels
Rev(WI712°15
- * Number at inspeotions allowed per permit
tlecildiaglltrentsmix Permaime Ma Egad00 440-4615T(1110S/COWNIEE
1 L, it
Plumbing Permit Application .
Building Fixtures
1 OR (1f11( t: 1 Sl: 0\1.1
City of Tigard • Received
illiii 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: PetmitNpai 7:2e,41c,
n Phone: 503.718.2439 Fax: 503.598.1960 •
Pim Review
Inspection Line: 503.639.4175 Date/By: Other Petmit No.:
p
TH,ARD
Internet www.tigard-or.gov
.: eh Luria I H See Pagel for
,/. Supplemental Iaformatien
.,..,,.... c•:' ..;:v.. ,a.:.. ... .:.;..: °::::_.FEE-'i SGf1ED •. : §te :
®New construction . .. .. -�t:;;;": �:-�`;',<.,:�:-. w�:
0 Demolition T :: _ For spedal tnjormolion use checklist
0 Addition/alteration/replacement Description Total
❑Other I Qty, I Ea.
• New 1-2-family dwellings(includes 100 ft.for each utility connection)
,...:. •, :.'-•CATEGORY'OF CONS1RUCTIOTI'' : . .. . . SFR(1)bath
312,70
®1-and 2-family dwelling 0 Commercial/mdustrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 1 500.32
Each additional bath/kitchen 25,02
❑Master builder 0 Other
.IOB,SITE INFORMATIDI Ir4ND•LOCATION Fire utspilities:( sq.ft.) Page 2
ai q Site utilities:
Job site address:t�-I t \ S,.i pirtA s • Catch basin or area drain
1 W i"71 18.76
City/State/ZIP:Tigard,OR 97224 Drywall,leach line,or trench drain 18,76
Suite/bldgJapt no.: I Project name: [[��� .,// Footing drain(no.linear ft.:) Page 2
I"I k,y Tf'VYare.E, Manufactured home utilities
Cross street/directions to job site: 50.03
Manholes 18,76
Rain drain connector 18.76
Sanitary sewer(no.linear It:) Page 2
Storm sewer(no.linear It:) Page 2
�1\I-e,�/--rXYCLC_- e,�
Waterservice(no.linear ft.: ) Page 2
Subdivision:
c�.� I Lot no.:t�'Z Fixture or item:
Tax map/parcel no.: Backflow preventer '
31.27
DESCRiP CION OF.WORK. Backwater valve ( 12.51
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
la:3'ROPERTY OWNER • 0 TENANT Expansion tank
12.51
Name:ADVL Land Holdings,LLC Fixture/sewer cap 25.02
Address:7600E Doubletree Ranch Road Floor drain/floor sink/hub 25.02
City/State/ZIP:Scottsdale,AZ 85258 Garbage disposal 25.02
Phone:(602)694031 Hose bib 25.02
Fax:( ) Ice maker
:' ® APPLICANT12.51
:': . . 0 CONTACT PERSON. Interceptor/grease trap 25.02
Business name:William Lyon Homes,Inc Medical gas(value:$ ) Page 2
Contact name: C L+ k. D G Primer 12.51
Address:."1.� r Firms,-, 1 w Roof drain(commercial) 12.51
t u.�t=i c-t Sui4 e Sink/basin/lavatory44-.41,64.1 / 25.02
City/State/ZIP:Vancouver,WA 98660
Solar units(potable water) 62.54
Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan
12.51
E mail: ��r.h oJe ; �� p Urinal
CON oggI(i.J° home s.t^O(Y1 25.02
Water closed 25,02
Business name:Malmedal Enterprises Inc Water heater c /- 37.52
Address:PO Box 207 Water PrP►nBmWV f i
56.29
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.:34-276IB Plan review (25%of permit fee)
Authorized signature: c:
State surcharge(12%of permit fee)
Print name:Carolina Malmedat ^�—'..� TOTAL PERMIT FEE
Date:04/25/2016 1 T 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 Indusby Service Board.
I ktiU ltangWenmtawtmu-PumitApp.doe 10/01/09 440-4616T(10 02/COM/WEB)
City of Tigard
III ■ v COMMUNITY DEVELOPMENT DEPARTMENT
T I G A R D Building Permit Review — Residential
(N;
Building Permit #: M57-1,0/x_006 js-C,.
Site Address: 61,PG1 I'I SW Bi t ono
Project Name: Q\\J (
(New dwelling=subdivision name;Addition or Alteration=last name of owner) Lot #: O�
Planning Review
Proposal: NevJ < R
Verify site address/suite#exists and active in permit system.
River Terrace Neighborhood: ❑ No X Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
.Three(3)copies of site plan
Site plan must be on 8-1/2"x 11"or 11 x 17"paper 4-1: xisting structures on site
t of
%rawn to scale(standard architect or engineer scale) •,floorsneoow struc
structure(including decks)with finished
-North arrow
Jtility locations&easements(required for new and additions)
ite address,project or subdivision name and lot number
.N;;Sidewalk/driveway approach
,rApplicant information(name and phone number)
E.4 of dimensions and building setback dimensionscation of wells/septic systems
xisting trees to be retained with drip line,and tree
quare footage of buildings to be demolished
protection measures
=� of area,building coverage area,percentage of coverage andiStreet tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40
.Street names
'roperty corner elevations (2 foot contour lines if more than000 sf of i
4 foot differential) impervious area created or replaced? s 7 N�o�lil.
If yes,is a storm water quality facility shown? .\Ye a No �T
Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified -.No Received:
Public Facilities Improvement(PFI) Permit:la-Public ❑ No
Required: ❑ Yes,applicant was notified
XNo Applied For: ❑ yeS ❑ No,stop intake
Land Use Case#: PD1Z2O1lo—00(Dp
la Zoning: p---1 (,21))
Required Setbacks: Front g Rear I
Side 3 Street Side tivf4sc Garage 20 t
Landscape Requirement: 20
,Lot Coverage Maximum: SD %
0 Building Height: Maximum Height N
Actual Height d-29
Visual Clearance
Sensitive Lands: ` Yes 0 No ' ^, _ �""
Urban Forestry Plan Type I.flVv v��U e VIA, l ,t�'
,�- Conditions "Met"prior to issuance of building permit
Notes:
1 Approved By Planning: ( t" /�
E Date: 2
Revisions (after Building Submittal only)
Revision 1: 0 AReviewer Date
pProved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
I:\Building\Forms\B1dgPermitRvw RES_061417.docx
e
-
Building Permit Submittal___E7110-
Original Submittal Date:
Site Plans: #
Building Plans: #
Building Permit#: nter building permit#above.
Engineering p"-Permit Coordinator ){�
Building
Workflow Routing: Planning $m g
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
P--Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
Date: g727(6f-
By
.2/��
By Permit Technician: /4-..he./4/�
En ineering Review t, 70
AV Slope at building pad:
El Conditions"Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
-0-Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: El Yes
No
Assess Water Quantity Fee in-lieu: ❑ Yes .0" No
LIDA Facility on lot: ❑ Yes 12'No
Final Plat Recorded: Date:
ElNOT Approved by Engineering:
Notes:
M 4 V IN i Date: ( *7j G$
Approved by Engineering: Date
Revisions (after Building Submittal only)
Reviewer
Revision 1: El Approved El Not Approved
Revision 2: El Approved El Not Approved
Revision 3: El Approved ❑ Not Approved
Permit Coordinator Review
Conditions"Met"prior to issuance of building permit
Date:
ElApproved,NOT Released:
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:
►2 SDC Fees Entered: Wash Co Trans Dev Tax: >I- Yes ❑ N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: !Yes ❑ N/A
LIDA El Yes N/A
OK to Issue Permit13
Date:
Approved by Permit Coordinator: Ar 496
I:\BuildingForms\BldgPermitRvw_RES_010118.docx
City of Tigard
e COMMUNITY DEVELOPMENT DEPARTMENT
I
T I GA R D River Terrace Building Permit Review Addendum
Building Permit #:
Site Address: Rc' Svc Bon
S'f Yl
Project Name: \ver Terr-cue Sa
S Lot #: 1 0-2.—.
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan District Design Standards (18.640.070.1);
Is the project subject to the plan district design standards?,Yes ❑ No
1.Articulation: a minimum of 1 element per each street-facing facade that has 30-60 ft. of frontage.An additional
element required for lots with over 60 ft. of street frontage shall be provided every 30 ft.
Porch min. 5 ft. 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
❑ ❑ ❑
2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: 1 g v/O
3. Entrances:At least one entrance must meet both of the following standards:
, Max. 8 ft. setback from longest street- facing wall 'Parallel to street, angle no more than 45° from street,
y� or open onto porch
Entrance opens to a porch:/"Yes ❑ No
If yes,all the following apply: 25 sq.ft.min.
One street facing entry '<12 ft.max. roof above floor of porch
ft. depth min. 30%min.porch roof coverage
4.Detailed Design:All buildings shall include a min. of five of the following elements on all street-facing façades:
,45 Covered porch min. 5 ft.wide x 5 ft. deep Recessed entry area min. 5 ft.wide x 2 ft. deep
Wall offset min. 16 inches ❑ Dormer min. 4 ft.wide
Roof eave min. 12 inch projection Roof offset min. of 2 ft.
❑ Roof shingles either tile or wood , Gable,hip or gambrel roof design
❑ Roof pitch oriented south min. 500 sq. ft. ❑ Horizontal lap siding min. 3-7 inches wide
❑ Accent siding min.40% of street facade ❑ Window trim min. 2 1/2"wide by 5/8"deep
❑ Window recess min. 3 inches for all street facing ❑ Bay window min. 5 ft.wide by 2 ft. deep
❑ Balcony min. 5 ft.wide x 3 ft. deep with inside access ❑ Attached garage is 35%or less of street façade
5. Garages and Carports:May face the front or side lot line on a corner lot.
Setbacks:
No closer to front or side lot line, than longest street-facing wall..rYes ❑ No. If No (Check one):
❑ May extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch.
❑ May extend up to 5 ft.where the garage is part of a two-story building and there is a window at the second story
above the garage that faces the street with a min. area of 12 sq.ft.
Width: (Check one)
❑ 12-foot-wide garage door '40%max. of street façade
❑ 50%max. of street façade with 7 detailed design elements
Notes:
la
Approved By Planning: TAIL I f►.e.P1 Date:21 2.( I li3
I:\Building\Forms\B1dgPermitRvw_RFS RT 121417.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16919 SW BIRDSONG ST, BEAVERTON, November 8, 2018 at
OR, 97007 12:08:08 PM
Record Type: Record ID:
Residential - Master Permit MST2018-00086
Inspection Type: Inspector:
199 Electrical final Jeremy Burrows
Result:
PASS
Comments:
Note: No A/C
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16919 SW BIRDSONG ST, BEAVERTON, November 8, 2018 at
OR, 97007 12:08:10 PM
Record Type: Record ID:
Residential - Master Permit MST2018-00086
Inspection Type: Inspector:
699 Mechanical final Jeremy Burrows
Result:
PASS
Comments:
Note: No A/C
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16919 SW BIRDSONG ST, BEAVERTON, November 13, 2018 at
OR, 97007 3:08:11 PM
Record Type: Record ID:
Residential - Master Permit MST2018-00086
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
No A/C
C of 0 left on counter.
Violation Summary:
Inspector Contractor