Permit (40) CITY OF TIGARD .MASTER PERMIT
III l' COMMUNITY DEVELOPMENT Permit#: MST2018-00121
and OR 97223 503.718.2439
13125 SW Hall Blvd.,Ti Date Issued: 05/14/2018
TIC;AI%I) 9
Parcel: 2S 106DA 11100
Jurisdiction: Tigard
Site address: 16806 SW BIRDSONG ST
Subdivision: RIVER TERRACE EAST Lot: 111
Project: River Terrace East, Lot 111
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 3 First: 948 sf Basement: 799 sf Left: 3 Parking Spaces: 0
Height: 35 Bathrooms: 3 Second: 1130 sf Garage: 377 sf Front: 8 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
Total: 2877 sf Value: $348,784.78 Rear: 10
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer 100
Drains: 0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 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!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 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 2877
Owner: Contractor:
ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
BY FORSUM,MICHAEL 703 BROADWAY STREET,SUITE 510 1 Geo Tech Report Required
7600 E DOUBLETREE RANCH RD VANCOUVER,WA 98660 Prior to Pour
STE 1
SCOTTSDALE,AZ 85258
PHONE: 602-694-4031 PHONE: 360-695-7700
FAX:
Total Fees: $34,925.96
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-0 1-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
ZfIssued By: �- Permittee Signature: de-. — e2 i'/47.&7:7$ -,
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
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Building Permit Application RECEIVED
Residential MAR 2 o 2013 FOR OFFICE USE ONLY
Cityof Tigard Received 4 permit No• /y 'f
g DateB �� � �� › /!/ / �� OC
II 3 V 13125 SW Hall Blvd.,Tigard,OR 97223GITY OF TIGARD Plan Review ► Other Permit: ,�C,
Phone: 503.718.2439 Fax: 503.598.�DILDING DIVISIO Date/B : b E • �._, / �i 4/
TIGARD
Inspection Line: 503.639.4175 Date Ready/By: / / LMIE ® See Page 2 or
Internet: www.tigard-or.gov Notified/Method O Aar, Supplemental Information
' .TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
®New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit fp, `:
CATEGORY OF CONSTRUCTION work indicated on this application. ' ,7%
Valuation: $
® 1-and 2-family dwelling 0 Commercial/industrial I
❑Accessory building 0 Multi-family Number of bedrooms: 3
Q ❑Master builder ElOther: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors: 'k - 2.S.{
Job site address: i l.11 eL) 0 SV o1rdis( ,-i-- New dwelling area: 2811 square feet I I
. )1. City/State/ZIP:Tigard,OR 97224 J Garage/carport area:
square feet 4/1 iti
,‘ ` Suite/bldg./apt.no.: Project name:River Terrace East Covered porch area: ���square feet —'719
'" Cross street/directions to job site: Deck area: t qj� '� square feet
Other structures area: square feet
REQUIRED DATA:COMMERCIAL-USE CHN.CKLIST
Subdivision:River Terrace East Lot no.: li 1\ Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION.OF WORK work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 TENANT Number of stories:
Name:ADVL Land Holdings,LLC Type of construction:
Address:7600 E Doubletree Ranch Road Occupancy groups:
City/State/ZIP:Scottsdale,AZ 85258 Existing:
Phone:(602)694-4031 Fax:( ) New:
- ® APPLICANT 0 CONTACT PERSON ': BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:Polygon WLH,LLC
Structural plan review fee(or deposit):
Contact name:Nichole Thorpe
FLS plan review fee(if applicable):
Address:109 East 13th Street
Total fees due upon application:
City/State/ZIP:Vancouver WA 98660
Amount received:
Phone:(360)695-7700 Fax::( )
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:Nichole Thorpe
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name:William Lyon Homes,Inc Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 109 East 13th Street Solar Installation Specialty Code checklist.
City/State/ZIP:Vancouver WA 98660 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60
CCB lic.:207247 Total fee due upon application: $201.60
Authorized signature: / /
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Nichole Thorpe Date:06/16/2017 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Applica .. -'''. -, FOR OFFICE 1 SE 0\l_�
Ci of Ti and ° " - Received
g DotclBy: Permit No.:
. 13125 SW Hall Blvd.,Tigard.OR 97223 ; :'`' Plan Review
Phone: 503.718.2439 Fax: 503.598.196(1 r < Date/By: Other Permit.
l-i(,lR n Inspection Line: 503.639.4175
Date Ready/13y- loris VI See Page 2 for
Internet: www,tigard-or.gov Notified/vtethod: Supplemental Information
TYPE Or WORK COMMERCIAL FEE` SCHEDULE— 1)SE CNEC'KLIST
Mechanical permit fees*are based on the value of the work
®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONST,- CT—ION ,RESIDENTIAL EQUIPMENT./SYSTEMS FEES'
, 1,1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building ForspeciulInformation use checklist
1 Multi-family 0 Master builder 0 Other: Description Qty. En. Total
JOB.SITE INFORMATION AND:1:OCATION Heating/cooling:
�;
,�tn Air conditioning I 46.75
Job site address: \ PiCI(0 SW ' iC- \SIO(\ Furnace 100.000 BTU(ducts+vents) I 46.75
City/State/ZIP:Tigard,OR 97224` v Furnace 100.000+BTU(ducts/vents) 54.91 ,
Suite/bldg./apt.no.: Project name: Ilcaf pump 61.06
-w.er ����� Fact- Duct work 23.32 _
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
jydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall.in-duct,suspended,etc. 46.75
Flue/vent for any of above 1 23.32
Other: 23.32
Subdivision: IVe,Ir-•TeJrrfxf `E0.5,,..ri-- Lot no.:1 lk
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION-OF WORK. _, Gas fireplace/insert 1 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter(gas) . 23.32
Wood/pellet stove 33.39
Wood Fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Au PROPERTY OWNER 0 TENANT Other: 23.32
he/ Environmental exhaust and ventilation:
I�
Name: rsD�!L Q e tn� N., Range hood/other kitchen I
�rq�_ 1_"i equipment 33.39
Address: tDOD 1 J OIJI�jIPi\Y QCiit Clothes dryer exhaust 0 33.39
City/State/ZIP: Sc - aa,k. i rap (6••-1 c"ice Single-duct exhaust(bathrooms,
d^ `�I, r` v L 7 v
toilet compartments,utility rooms) �" 23.32 _
Phone:,W O'ti _HV t Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT ❑ CONTACT PERSON . Other: 23.32
Business name:Polygon W1,11,LLC Fuel piping:
$14.15 for first four,54.03 for each additional
Contact name: IV l eiV10)4.1.1r1.O1pe/ Furnace,etc.
Address:10 p)Vpod otLytoil S Su A,%'CJ O Gas heat pump
CWall/suspended/unit healer
City/State/ZIP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 Fax::(360)693-4442 Fireplace 1
Range
E-mail: Barbecue
,r,,,..,,,. .. ... CONTRACTOR Clothes dryer(gas)
Business name:Apex Air LLC Other:
Address:18004 NE 72"d Ave ,. ' ` ."Y(_ °
Subtotal
City/State/ZIP:Vancouver,WA 98686 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(360)342-8109 Fax:(360)326-1769 State surcharge(12%of permit fee)
CCB lie,:203034 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete.
Authorized signature: • Fee methodology set by Tri-County Building Industry Service Board
Print name: y Date: q./i./tr
1\Dui ldiogwcrmitsxitis PenniIlpp0401 t3.doc 440-4617T(I t/ovCo\UWEnt
W a.rwy x .a.4 atu,.,ta•,�11,L:1+MYLL4oJEL .. .,
m
tN`s`, _, City of Tigard Received 4 � z �
f E 'i 13125 S'V 14i[IBlvd,Tigard,OR 99,22
Date/By;
Permit q.
VI'A��{ Phone: 503.718.2439 Fax: 503,598:1060 ` '''' PlanReview
i
Inspection Line: 503.639.4175 Date/By: Related Permit M:
IIGAIL7� Internet: wtviv,tig ,gov ReadyDate/By; Saris; t7 See l'age2for
Notified/lure f
t cod;
;�..••4�� er.;;:;q;,_. � Supplemental Information
.,��rzs?'�(,t �3-- �::3 v���.v:"""':M1.tilt..�9"��t'+' t "''ri .::.:.:. .::..t:...,,�;.:........,.,
:7h'h>tYaSrceiFF+ t? f:Z ✓,:Yui:�,.S:.hi•1 t.: L'�1 u':iw J'�3t y -'RI }::�•: �!i-:b:.4::�•r):•F'i {i:'.•.,
.. t. ...t.:'9L'�.e.i„ .. •t.j� ,tet..;:.�u`.}.:: '���,: M 11• .t:` �:id,!:,�
®New construction Addit' t fans vdi ei a:f `"
io»/alteratioll/replacement Please check all that apply(submit Z sets of plans tv/items ohccked):
0 Service or feeder amps or more 0 Build ng over three stories,
❑Demolition ❑Other:
,;ja;°c;;:;"',,:1;�,:,, `ti'` :�." '°�•• -•;,.;y�,t _ ,,,,, ,:,,, where the available fault current CI Marinas and boatyards.
;..:;.'. ,�•: ..tit, ..:. ,
,..,,.r.,,..;.-. _._.".,.,.�;i�..'���I,I�,.,.;;�;:,:�.T;.;;; ;ik,,,...,i, .,_, ;;,,.,1;!; exceeds 10,000 amps at 150 volts or 0 Floating buildings.
0 1-and 2-family dwelling Q Commercial/industrial 0 Accessorybuildingless to ground,or exceeds 14,000 -
❑Commerofal-use agricultural -
❑Multi-family . • 0 Master builder amps for ail other installations, -buildings.
•� :K _..i.. _ - 0 Other: ❑Fire um --
::{j, ? f,;y a3;.r: Sts;�0$:i .....t; t;:.: ,..{ pump. 0 Installation of 150 KVA or
., 0g`l'r01:0. l.tNtiOlifl• 'ID.::'LQt%t •.o ;.:; •r.t:..:;,1 larger separately derived
��.N•'. >''r::i'. •. Li system,
Job#: Job site address) q [ p c+ ❑Addition of new motor load of system. _
(�V�.�W U1t7(1!!1 J 100HPormorc. i�� ...�.,!.1-2,r«1-3,.
City/State/ZIP:Tigard,OR 97224 • Lf 0 Six or more residential units, occupancy,
Suite/bldg./apt.# ❑lleallit-carefacilities. ❑Recreational vebieleparks.
I Project name: 12\Ii -itrya l, Ea 5,4_ ❑Hazardous locations. ❑Supply voltage for more than
El Cross street/directions to job site; Service or feeder 600 amps or more. 600 volts nominal,
Description I..Qty. ,(.:..Each 1 Total
',Ite
Subdivision; ] New residential single-or multi-fancily dwelling unit.
"j�� 'Tt�- A5 1 Lot#: I) ! includes attached garage.
Tax map/parcel#: 1,000 sq,ft,or less 1 168.54 4
.• : Ea.add'1500 sq.ft.or portion
33.92 1
; ; r .k o-tiry :, D.F$ RP •O.Nlil08O :i -i ':`<-:.:: •' .::.....:.:::.:.::::,.::•'. Limited energy,residential
• (with above sq.ft.) 75.00 2
Limited energy,multi-fatnily
y residential(with above sq.ft.) 75,00 2
dIysst F�y�p�r,t pp}>_i��}}. ,.. :� `.:;i 2, a;;� Ren
N Elsa•�.:24t;`�C��1 h.-�t�'1! =c:.;�<-�?eic�'.r:1�, � :1;:t• -
Renewable Ener
V' t_...'i!M,.v!4?` ': ?'. . t I .. ....:., .. „Q,iltV 1 ..; ``0,:q;: !;Y L7 See Page 2
Name: pc Services or feeders installation,alteration,and/or relocation
Dv l-- ► c 1 _i , 200 amps or less 100.70 2
Address; 201 amps to 400 amps 133,56 2
u. ate 0 A f a
City/State/ZIP: SCI Il � '^� 401 amps to 600 amps 200.34 2
r ^ d'''e.1 Y A &52.5 601 amps to 1,000 amps 301.04 2
Phone: U01—(.nq L4—1 j Q 1 I Fax:( ) • Over 1,000 amps or volts 552.26 2
Email: —1 J 1i Temporary services or feeder's installation,alteration,and/or
relocation•
Owner installation:This installation is being made on property that I own which is not 200 amps or less 1 I 59.36
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature;
_ __,: ^• e �, - - Date: 401 amps to 599 amps 168,54 2
{^��o'1-i3�i i+'�. `e•.%�,' L yS^ -<�t...,,{F ;i'i'iSii�?'t:i�i%{::`�1 n .�ttY:ii+)i:• ..:r to .a..
ta:.'<q„J.t ilb.'..t,elt�5'aZ51 i :o}..,.,:, u,.TS-`" ]Branch circuits—n
.C. ,�,.i<r.:�a;:'�;•it:,!�..:>,�� ';r:$sit?[:.. ,�Q.;..;>;?�,._.�'„�,��2$,QN;�tj.r etiv,alteration,or extension,per panel
Business name:Polygon WIZ,LLC A_abo esbri eh rifeeie wet,
above service or feeder fee,
Contact name; t 1" each branch circuit 7 42 2
v� R � B.Fee for branch circuits without
Address: 1 1�� ' , service or feeder fee,first
�j � `'2�, ��� branch circuit 56.18 2
City/State/ZIP:Vancouver,WA 98660 Each add']branch circuit 7.42 2
Phone:(360)695-7700 + Pax;:(360)693-4442 Miscellaneous(service or feeder not included)
Bach manufactured or modular
?'?EmEmail \Oho 1Dircz.fl� ` �� dwelling,service and/or feeder 67.84 • 2
l: IQ ri;"ccy� "/-a::;.` •: :., t.:;; 1:r:t:,�rY..: S ; ^ -y t Reconnect only
wt,.,r�^,:i :r- gi.%•;a? ,>t, ,:i ry ' .t ?, 67.84 2
�;•h,t. • ,, ,. ,::�Y:: q. LLC-Oki..:. ...tr , _= ;:- . ::::.:.:: . . :.... Pump':J' ,;:,§r ';. :iJ.r'h;t i„`i: or irrigation circle 67.84
Business name;Garner Electric Washinon,LLC2
Sign or outline lighting 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
Additional inspection(1 hr min) 66.25/1m
Phone:(253)872-6051 + Fax:(253)872-1801Investialion g (1 hr min) 90,00/hr
Email:bdaniols@gweusa.conr Industrial plant(1 hr min) 78.18/lir
Inspections for which no fee is
CCB Lie.: C1158 Electrical Lie.: 208174
Suply,Lie.; 4496S specifically listed(%2 hr niin� 90,00/hr
Su ry Electrician required: t,kart/ A-Ib .i(� c,. ilt,I: ;=, �,.••.L,, •;:til 1=--
psignature, , , ,.W .:.E_t, .::.,.;'.!,;`::;r
Print name: Joan P Albert Subtotal
I Date; 0 Plan Review Required(25%of permit fee):
�„_-.�,, State surcharge(12%of permit fee):
Authorized signature: --- •TOTAL PERMIT FEE:
IPrint name; Bill Daniels This permit npplicntien expires If a permit is not obtained within ISO
Date: days sifterlthas been accepted as complete.
• Number of inspections allowed per permit.
I:lBuildiagltormitsWE,c PertnitApp_nr.Et n118,4e Rev e6/17/3015 440.461ST(1i/05/CO14/WEB
Plumbing Permit Application
Building Fixtures
City of Tigard : ; Received
71
13125 SW Hall Blvd.,Tigard,OR 97223 .
'' Date/By: Permit No.:
Plan Review
Phone: 503.718.2439 Fax: 503.598.11960 Date/By Other Permit No.:
T I G AR D Inspection Line: 503.639.4175 is
wDate Ready/By: Juris: BI See Page 2 for
Internet: ww.tigard or.gov NotiSed/Method: Supplemental Information
: TYPE OF'WORK FEE* SCHEDULE
For special information use checklist.
®New construction ❑Demolition
Description I Qty. I Ea. I Total
0 Addition/alteration/replacement El Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY'.OF-CONSTRUCTION ' _ SFR(I)bath 312.70
SFR(2)bath 437.78
IN 1-and 2-family dwelling ❑Commercial/industrial
SFR(3)bath I 500.32
El Accessory building ❑Multi-family Each additional bath/kitchen L 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOE SITE INFORMATION AND LOCATION..,, Site utilities:
Job site address: \W t n C. s ¶ cCA '"."l( SA- Catch basin or area drain 18,76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.:,_) Page 2
Suite/bldg./apt,no.: Project name: (.\.ear r. v-otw,a, Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18,76
Rain drain connector 18,76
Sanitary sewer(no,linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision (,,\je- rem.ae,1 ,--- Lot no.: f '1` Fixture or item:
Tax map/parcel no.: Backflow preventer 1 31.27
Backwater valve 1 12.51
DESCRIPTION OF WORK
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0,1P1'{OPERT3C OWNER I ' CI TENANT ,.. ..
Expansion tank 12.51 ,
Name:ADVL Land Holdings,LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:7600 E Doubletree Ranch Road Garbage disposal 25.02
City/State/ZIP:Scottsdale,AZ 85258 Hose bib 25.02
Phone:(602)694-4031 Fax:( ) Ice maker 12.51
APLICANT 0 CONTACT.PERSON: Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name: Poi c . 1(t'
N i^,w6,A '. Primer 12.51
Contact name: llV L tK r Roof drain(commercial) 12.51
Address: 'b3 V�1(1O.wri 1/! e-kc
- , _< U Sink/basin/lavatory 25.02
City/State/Lit':Vancouver,WA 98660""4 v Solar units(potable water) 62.54
Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51
Urinal 25.02
E-mail:.M 1 GnO`e 0
p \,n frI�y s e jsy� Water closet 25.02
. F_ CO CTOR . . Water heater 37.52
Business name: 64-5 in�ftio 1� ,� � jr Water piping/DWV 56,29
Address: p.o. $., '1I Other: 25.02
City/State/ZIP: ST, P4044ore_ C(1151 Subtotal
(arta $ 14L1 ( j ,,'a,� �.�
Minimum permitfee: $72.50
Phone: .� 1 Fax: .. _
CCB Lie.: 18131a... Plumbing Lic.no.:b y Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: .1;;;LC14„ TOTAL PERMIT FEE
Print name: yam'f"fA`L �„U.1'�l� Date: -3V-1 1j This permit application expires if a penult is not obtained within 18D days
S+ after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:lnuildtoglPecmits\PLMU-PenaitApp.cke 10/01/09 440-4616T(10/02/COM/WEB)
•
r
City of Tigard
IIIa ~ COMMUNITY DEVELOPMENT DEPARTMENT
T I G A R D Building Permit Review — Residential
Building Permit #: Mg-fS= ii,1
Site Address: Ii gOlp SW $IrdiSolrlo Stree-f-
Project Name: 'RAvey T-eArYZI✓Ce - 't Lot #: 1 1 1
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: NeAAJ &T12-
El Verify site address/suite# exists and active in permit system.
X River Terrace Neighborhood: E No 12r Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
.Three(3)copies of site plan NAExisting structures on site
Site plan must be on 8-1/2"x 11"or 11 x 17"paper `]Footprint of new structure(including decks)with finished
,Drawn to scale(standard architect or engineer scale) floor elevations
R orth arrow ' Utility locations&easements (required for new and additions)
►= ite address,project or subdivision name and lot number Sidewalk/driveway approach
, pplicant information(name and phone number) N4-Location of wells/septic systems
.Lot dimensions and building setback dimensions n/Ip-Existing trees to be retained with drip line,and tree
NiVrk:uare footage of buildings to be demolished protection measures
7 .t area,building coverage area,percentage of coverage and Street tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) Street names
Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? s I�No
4 foot differential) If yes,is a storm water quality facility shown? �71/ s Z O o
Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified ' No Received: ❑ Yes ❑ No
,IKI Public Facilities Improvement(PFI)Permit:
Required: ❑ Yes,applicant was notified No Applied For: ❑ Yes ❑ No,stop intake
,Si Land Use Case#: 1)9?-201w- 0000
S Zoning: Q --1 CP D
Required Setbacks: Front g Rear I 0 Side 3 Street Side N Garage 201
X Landscape Requirement: 20
0/0
WLot Coverage Maximum:
El,Building Height: Maximum Height N Actual Height l'
Visual Clearance
, -"Sensitive Lands: ❑ Yes No Type
A Urban Forestry Plan
Conditions "Met" rior to issuance of buildingpermit
p
Notes:
.a. Approved By Planning: AD(�yN,� 0 _ Date: y 125 1 l'
Revisions (after Building Submittal only) J 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:
Site Plans: #
Building Plans: #
Building Permit#: ►;` nter building permit#above.
Workflow Routing: , lanning Engineering Permit Coordinator `Q 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.
building: original permit application,site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: .Ge�9 Date: 477//`//��
C//,
Engineering Review 5_0 e?,0
'Slope at building pad:
Conditions "Met"prior to issuance of building permit
Zi Easements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ALJ No
Assess Water Quantity Fee in-lieu: ❑ Yes ��/No
LIDA Facility on lot: ❑ Yes i IV
Er Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
) (Approved by Engineering: /h at IL U- I Date: 4-/-0.0/6
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
C 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: 4R-Yes ❑ N/A
LIDA ❑ Yes .a N/A
-� OK to Issue Permit
Approved by Permit Coordinator: 4,4SAltY Date: L5o I k
I:\Building\Forms\BldgPennitRvw_RES_010118.docx
r
III City of Tigard
11 'NI
COMMUNITY DEVELOPMENT DEPARTMENT
T I G A R D River Terrace Building Permit Review Addendum
Building Permit #:
Site Address: 10b0(-(9� SVJ $►rc on_ S-fre. -P-"
Project Name: 12\veY -t-f)ffel_ -S-r Lot #: ) 1 i
(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?N.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.
Balcony w/ access 2 Window Projection Vertical Wall Offset a
Porch min. 5 ft. deep 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: - ?j Dip
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,
or open onto porch
Entrance opens to a porch: Yes ❑ No
If yes,all the following apply: $1,25 sq.ft.min.
'One street facing entry 12 ft.max.roof above floor of porch
N---5 ft. depth min. X30%min.porch roof coverage
4. Detailed Design:All buildings shall include a min. of five of the following elements on all street-facing facades:
,-Covered porch min. 5 ft.wide x 5 ft. deep iErRecessed entry area min. 5 ft.wide x 2 ft. deep
Wall offset min. 16 inches ❑ Dormer min.4 ft.wide
.ArRoof eave min. 12 inch projection XRoof 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. 21/2rr wide by 5/8" deep
❑ Window recess min. 3 inches for all street facing El 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 facade
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...Yes ❑ 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 nun. area of 12 sq.ft.
Width: (Check one)
❑ 12-foot-wide garage door ❑ 40%max. of street facade
c54-50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: y4 - v) c _ Date: le2,5- `5
\Forms\B
I:\BuildingldgPermitRvw_RES_RT_121417.docx i
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Transmittal Letter
) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Dianna DATE RECEIVED:
DEPT: BUILDING DIVISION RFCFFVFD
AP;-; 10 2018
FROM: Tom Dicianno {-a
BUi E;ai°.0
COMPANY: Polygon Northwest
PHONE: 503-577-4160 By:a9-,z
RE: 16,?6(0 FRIPAR-E, 5n MST201
(Site Address) (Permit Number)
f4'3r River Terrace Lot
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
-�.,+' �-` � „ r Tz � say ,E
` ..a `� maw . . ,. 4 � . .,�. ..
0 Additional set(s)of plans. 0 Revisions:
0 Cross section(s) and details. 0 Wall bracing and/or lateral analysis.
0 Floor/roof framing. a Basement and retaining walls.
0 Beam calculations. 0 Engineer's calculations.
0 Other(explain):
REMARKS: Thu. Fuv JMr 4494 D&ft6Al
';,� 2I 4 fi as, .u �..sMo
Routed t• Permit Technician: Date:
Fees Due: Yes ■ No Fee Descri'tion: Amount Due:
11311.1.111111.
$
Special
Instructions:
Re•rint Permit •er PE : ❑ Yes No ❑ Done
A• •licant Notified: Date: Initials:
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16806 SW BIRDSONG ST, BEAVERTON, November 19, 2018 at
OR, 97007 11 :40:11 AM
Record Type: Record ID:
Residential - Master Permit MST2018-00121
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:
16806 SW BIRDSONG ST, BEAVERTON, November 19, 2018 at
OR, 97007 11 :40:21 AM
Record Type: Record ID:
Residential - Master Permit MST2018-00121
Inspection Type: Inspector:
699 Mechanical 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:
16806 SW BIRDSONG ST, BEAVERTON, November 26, 2018 at
OR, 97007 2:09:05 PM
Record Type: Record ID:
Residential - Master Permit MST2018-00121
Inspection Type: Inspector:
299 Final inspection Jeremy Burrows
Result:
PASS - CofO
Comments:
Final erosion control passed
Moisture content form received
Moisture barrier acknowledgement form received
High efficiency lighting form received
Insulation certification verified
Blower door and/or duct seal test certificate received
C of 0 left on counter.
Violation Summary:
Inspector Contractor