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I,ohQ - Doo r SITE WORK PERMIT
IN
CITY OF TIGARD S- , �,
COMMUNITY DEVELOPMENT Permit#: SIT2018 00011
-E•E.UAR D 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 •• 5• • ' -001-0010 through OAR 952-001-0090. # .0 may ,btain a copy of the rules 1
or direct questions to OUNC by calling 503.232.1987 or 1.:00.332.2344. / L
Issued By: ittee Signature: -1,./
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�j /e
Residential Sir- WORMECEL V ED FOR OFFICE USE o`l.i
APR 3 0 2018 9 /3o//?
nn�t D �7, _Il III 13125 SW Hall Blvd. Tigard,OR 97223 eview
Phone: 503.718.2439 Fax: 503.598. j y OF TIGARD Date/By: S.�_ Other Permit:
FIG A R[) Inspection Line: 503.639.4175 BUILDING D IVI S 10 N Date Ready/By: / �. Juris: H See Page 2 for
Internet: www.tigard-or.govNotified/Method ►', Supplemental Information
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❑New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement ®Other:retain.wall equipment,materials,labor,overhead,and the profit for the
"` Nc 4M _ i s ", E, �4 o�� r a work indicated on this application.
. 1 and 2-family dwelling �,,,,,;�, :.�.. s , ,.), .�t b�
�� Valuation: $
Commercial/industrial
0 Accessory building ❑Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
it �� � �a
f ' ►,c ` � x
x ¢ k: ���, Total number of floors:
Job site address:/ Z q,7 /A?2,3, / 7 /295: / 9‘,7 4,..25,1/27 New dwelling area: square feet _,.\
1 .
City/State/ZIP:Tigard,OR 97224 /‘. 9 I 7 s,0 �--h-IZ/24e -,61`! age/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'I?/ 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
'xi. ' !1, m�� 3X k,s , . ,V; 1 T, T work indicated on this application.
arr
R ETA114a6 41pn,4 viva/ 5.0-ties Valuation: $75000
Existing building area: square feet
New building area: square feet
; "$ t\ allie ( iriin ! Number 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:
fBusiness name:Polygon WLH,LLC t ,€ s
i s Structural plan review fee(or deposit):
I 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
f Phone:(503)577-4160 Fax::( ) Amount received:
y i
1 f mail:tom dicianno@polygonhomes com "•. ,, , ,;, ,,, *. . S4!
i' K \. 44,44Commercial and residential prescri tive installation of
4v,z' �_��, ��,, .....��a�r: ,, lig 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: 109 East 13th Street Solar Installation Specialty Code checklist.
City/State/ZIP:Vancouver WA 98660 Permit Fee(includes plan review $180.00 1
and administrative fees): _
Phone:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60
CCB tic.:207247 AP1
Total fee due upon application: $20Lfi0 !
',utliorized signature. ! 111.11r This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
LI((( r7 'l Op— *Fee methodology set by Tri-County Building Industry
":•iiia name:Tom Dicianno Date: { Service Board.
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uihg\Permits\BUP-RESPemtitApp.doc 02/24/2011 440-4<613T(11/02/COM/WEB)
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City et Tigard: Site Work Permit Cleanse
Fa ge 2.Supplemental Information
Commercial,Multi-I amity and 011C-and Twtramilv Dinttlitris;
S•0 Permil is rtkownd t:till is lol than SO yailia.IS dump true)).lime)...or its%:him,3 feet dads attj
no be i.upp.- fir.F a utts..sture, It a buildmg vell he cotecneeted ces the IX,:t tnow he elle invered rm. if
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Please 0114tipicte ad items below,unless etherwice:toted
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/.. Thtteavatinn Volume: 12-Ni c . es.;
urodirt r Vol dam,
. (Soil5 venom)required for.-5 000-L: v'.t 15 5 • da
'I Fill Voltaire
trt:i execedirg 12"in depth*hall be compacted Tra i
1_
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Itutu..rtti;lteilla ono
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Site tltifilles Plumbing Work,:
Complete ow Pitoribing Perm)Appbna!mn ftr!Mc unihtio plinating work
Flans Require& See"Site%VA.Permit Application-Man Submittal Requirements-atmelted
Thk'luilowyte nord akq."*.kettpany this applwatton:
• i Site Plan with Vikixsily Map lowing ADA Mr 4r,,o-kine(including ADA')and leganng
t.pnmpltanor i ' Plan
,. ________ _
1 Gradirtd details i tandumpatz liar !
: trunina On-awl Plan and anilli;- 1 Sal I S Repntt ti!mg,....red) I
Retain:rg Stroennui I 1 ,,
*Ones t1 apt*to our,awl Tw.2.1armt.LtweNnus
Platt Submittal: Permit Fee:
I
r
TVFF OF SURNOTIM, .: ii!of Philo 1 Lyitluation: 1 Permit Fee
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'PI City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
T I G A R D Building Permit Review — Residential
Building Permit #: --S/7- GaI ef—00r7 1 i 5a) „moi/tz 772/24-c." Qs v
Site Address: /29/ 7, 4z933, /22'7, A2_9---51S, /a 9&.7, /2 99/i /a 957
Project Name: 7 J e ' Tyr rra.Ge Et5+ k ivl Mal V\in k Lot #: 913-n9
New dwelling=subdivision name;Addition or Alteration_.*last name of owner)
Planning Review
Proposal: R -4Z1iw Ino V c' IRS
X, Verify site address/suite# exists and active in permit system.
'EL_River Terrace Neighborhood: ❑ No X Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
rii ree (3) copies of site plan .lrExisting structures on site
M 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
,®North arrow Utility locations&easements (required for new and additions)
lite address,project or subdivision name and lot number `bZLSidewalk/driveway Nqkpplicant information (name and phone number) ocation of wells/septic systems
tot dimensions and building setback dimensions \OExisting trees to be retained with drip line,and tree
quare footage of buildings to be demolished 1 protection measures
'Lot 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) Street 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: D Yes,applicant was notified No Received: ❑ Yes ❑ No
Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes,applicant was notified kNo Applied For: ❑ Yes El No,stop intake
Land Use Case#: •P D a2,0 �Lj O)D\
5R—zog R'2s LpP) t
ning:
Setbacks: Front g Rear N._ Side CI Street Side N/pc. Garage N/Pt-
[01 Landscape Requirement: 2,0 0/0
Lot Coverage Maximum: SD %
i
X Building Height: Maximum Height / - Actual Height g- ti
Visual Clearance
,t Sensitive Lands: Yes ❑ No Type L(7,n) V( kLA e OtitL 1.-kt'+"
" Urban Forestry Plan
/4 Conditions "Met"prior to issuance of building permit
Notes:
,a Approved By Planning: Date: 4134 1 I
Revisions ( Building after Submittal only Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: El Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_RES_061417.docx
Building Permit Submittal
Original Submittal Date: ii/geifloP
Site Plans: # v---
Building Plans: # c2-
Building Permit#: Er Enter building permit#above.
Workflow Routing: Planning 0–.Erigineering I ermit Coordinator { uilding
Workflow Sign-off: ['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.
O'Building: original permit application,site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: -< '- 1 vim-
Date: y 3c)/1"
Engineering Review 7°'Slope at building pad:
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
Zr 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 No
Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
J2rApproved by Engineering: GK J ba— w L Date: 4 18s
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:
\ LIC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes N/A
Tigard Trans SDC: ❑ Yes N/A
Parks SDC: ❑ Yes N/A
LIDA ❑ Yes N/A
OK to :: :orthnatOr:
roved te: 3/
I:\Building\Forms\BldgPermitRvw_RES 010118.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12967 SW RIVER TERRACE BLVD, September 26, 2018 at
BEAVERTON, OR, 97007 10:08:07 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00524
Inspection Type: Inspector:
199 Electrical final Jeremy Burrows
Result:
PASS
Comments:
No A/C installed
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12967 SW RIVER TERRACE BLVD, September 26, 2018 at
BEAVERTON, OR, 97007 10:08:04 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00524
Inspection Type: Inspector:
699 Mechanical final Jeremy Burrows
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12967 SW RIVER TERRACE BLVD, October 4, 2018 at 9:10:10 AM
BEAVERTON, OR, 97007
Record Type: Record ID:
Residential - Master Permit MST2017-00524
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