Permit (76) ,, CITY OF TIGARD MASTER PERMIT
74 -' ' COMMUNITY DEVELOPMENT Permit#: MST2017-00299
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/21/2017
Parcel: 2S106DA03100
Jurisdiction: Tigard
Site address: 13137 SW 169TH AVE
Subdivision: RIVER TERRACE EAST Lot: 31
Project: River Terrace East, Lot 31
Project Description: New SFA.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 2 First: 97 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 31 Bathrooms: 3 Second: 562 sf Garage: 456 sf Front: 8 Smoke Yes
Dwelling Units: 1 Third: 562 sf Right: 0 Detectors:
Total: 1221 sf Value: $161,646.69 Rear: 5
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Catch Basins: 0
Bckflw Prevntr: 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: 2 201-400 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 SFA VB R-3 1221
Owner: Contractor:
WILLIAM LYON HOMES INC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
109 E 13TH ST 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98660 VANCOUVER,WA 98660
PHONE: 602-694-4031 PHONE: 360-695-7700
FAX:
Total Fees: $22,789.64
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 through0 R 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.
- ✓ — Permittee Signature: �� r ✓ G G��%���
Issued By: < '
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.
Building Permit Application Z-07-
3
` - t RECEIVED FOR OFFICE 1 SE
City of Tigard Rete/rsV� ����? I Permit 24,,;,1,67).62/?i/,�1 ,
11 13125 SW Hall Blvd.,Tigard,OR 97223 JUN 14 2017 pn1ew //� �))(���yy��'/
Phone: 503.7182439 Fax: 503.598.1960 DateBy: $' '- ) Oilier Permit' D/2'600
r i �\ Inspection Line: 503.639.4175 CITY OF TIGARD DateReadyBy: r/ // Jwis: H SeePage2for
Internet www.tigard-or.gov BUILDING DIVISION Notified/Method: /� II Supplemental Information
E1'1'9/G— Ni 4' /
v ..,.r- ----� ra- " .s .v.. mow. �'�
ic - "`g r' '3 4 "fi�`'� `4 s?L ;` 1,.<s., $ fi x z' K ..vy,._..; :G AFF a{ "q��'"i " �' 'L
.,:, - -..........> , .,a,. .a....,.....n,..�,....,.�`-: �...,;r`.�'�:iu.�u„��1,-"`nvs.�m:f.�� `�...�, �.= �- .'`-� .-s,'. � x.. t..a .,u" ...:a:"..d�
®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 0 Other. equipment,materials,labor,overhead,and the profit for the
,cry r 4 f . k: ,::,,,,-::::;3-;-;;;; work indicated on this application.
�.t��:, �.:,�__���..�.�t�v�.� ��,,•.��:-, � valuation: ���
®
1-and 2-familydwelling 0 Commerciallmdustrial
❑Accessory building 0 Multi-family Number of bedrooms: 215�3�J 1 6 LL 6
T
❑Master builder- 0 Other: Number of bathrooms:
-�. ,z • = ma,.
-12 r . « Total number of floors.
Job site address: /3
137 s N Ie.4
• b�� .-- ,.� New dwelling area: /22.4.11, square feet
City/State/Z1 P:Tigard,OR 97224 i', Garage/carport area: y square feet
Suite/bldgJapt.no.: Project name: Covered porch area: square feet
diver Terrace �ast� �� S 6 a
Cross street/directions to job site: z ck area -7 square feet C).7
itiv
Other structure area: I square feet Y
Subdivision Riv{X Te -ca.ce. -1- Lot no.:, r Permit fees*are based on the value of the work performed.
Tax map/parcel no.: 1 Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
`' m t 4`t y r'" t ` - '''''':i.:::;,;!>.f.:' ' work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
r „` , - Number of stories:, p ,4 «tk t�
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:
' *:z7 " " -7-�-z �, ncra ,^rte,
Business name:Polygon WLH,LLC _, ; -
s—r-0 Structural plan review fee(or deposit):
Contact name:N
FLS plan review fee(if applicable):
Address:109 East 13th Street
Total fees due upon application:
City/State/ZIP:Vancouver WA 98660
Phone:(360)695-7700 I Fax::( ) Amount received.
4 10 i SAM l 4 Commercial and residential prescriptive installation of
p � a 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
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: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
�i ch////fir;rt4041117----
*Fee methodology set by Tri-County Building Industry
Print name: �y Date:��7�/� Service Board
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(�11//02/COM/WEB)
' ,3:1CIFIVIIIA'71)
4' ...41
Mechanical Permit Application' FOR OFFICE USE ONLY
City of Tigard on 8 2;117 Received
Date/By: Permit No.:
IN 13125 SW Hall Blvd.,Tigard,OR 97223 "`" —
Plan Review
13 Phone: 503.718.2439 Fax: 503.598,1,94n,r1-14--v4Do, batelBY: Other Permit
T I G A it D Inspection Line: 503.639.4175 1UV kil i A 13 J-11‘.'" Date Ready/By: kris: El See Page 2 for
Internet: www.tigard-or.gov " ‘,.. ,
It.0 tLiiink-1- nrIcInN Notified/Method: Supplemental Information
: ,.,-,,,a . ‘,:tf,,==4.-'4] 4@,;,-,l'i-i b4.-,','•'-'.:,,,,,•.: '..i.':COMMERCIAL Age.,gaigrOti-:44isrciiiOciisti :t:
,'..t.i.!':-.-Yr!..ti.-:-:::-i.i'..1W.7.:':::•;i'..::';', Tir1T..9F1179WC : 4':: 1'4:9''''; :fl';'1i:- ''''E" I'':''''.:: -Mechanic.al Peintit feeS*are based on theValue of the wotir
El New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. -
Value:$
4C4M19:;:gitIgnift
CATEGORY O1 04*:114i:01:0*geinh'nVi;RIF111 : .g! = !, :,*010441t4t, t1tijiiliONt.4ii.,.$4*7.gi*„§4.1 .4.5-.-:_-.
El 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist
0 Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
••'ff'-,7'.,:r'•'-",:sa's4:-'-'2 '6'jl-..iiii::6,ttkittstitiiiifitioisi.,,*i.:4AtrittrOiC: .1N9WMii14.1;k4: Heafingic°°ling: -
Airconditioning 1 46.75 46.75
Job site address: i 3131 Ss,) oitp‘Nie, Furnace 100,000 BTU(ducts/vents) 1 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:River Terrace East
Duct work 23.32
Cross streetldirections to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 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:River Terrace East Lot no.:31
Other fuel appliances:
-
Tax map/parcel no.: Water heater 23.32
°"°(*3!6S.1*:*it)*:•:::.: ;'I:4V-1":''' 'i24'44i.r ;
Flueventw
acelor insarer heater or gas 1 3339
IASI-1bn- 0 0 lil fireplace 23.32
Log lighter(gas) • 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent . 23.32
„.,:: Other 2332
'I• I:4r*:1!*****.°*swi.:--,.':'•.:::-'.-..f.••: '- '''.,--:''00.,.',,'!. .... ..-.17:'.:1**4:7' i=w1';':'5 ,:.. Environmental exhaust and„niilation:
Name:ADVL Land Holdings,LLC Range hood/other kitchen
equipment i 3339
Address:7600 E Doubletree Ranch Road Clothes dryer exhaust 11 33.39
City/State/ZIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) `I 23.32
Phone:(602)694-4031 Fax:( ) Attic/crawispace fans — 23.32
•:E;'•-i'Y.; :.';-,!k:::•i!:1.i..Da'.!APPLICANT i-.,::,..i,i;':-.,:f.:;,:':!:.:_:.,;; --;i:,ff, :l,.,:.,:tro:*.4:vi:.:**sios::,.-..?i.,,i,L,-.:. Other: 2332
Business name:William Lyon Homes,Inc. Fuel piping:
S14.15 for first four;$4.03 for each additional
Contact name:W i eil(10‘..e,--ciAsofve, Furnace,etc. 1
Address. , maptujol 51- SuiJk-c- S-I 0 Gas heat pump
Wasuspended/unit heater
City/State/ZIP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 Fax::(360)693-4442 Fireplace 1
• Range 1
E-mail: lk r
i 6k 0 kt. 71MAPQ .,,i1)1)40...fr;10(\llOffiej ••Cn/ABarbecue
,!-.!'•'.--2;;',).--,,,,, .• ,, tr:.'1.-....'1;',-,,,,;-:7:-••,.r ;.-:-,CO toit-z'.:-,, r:,..-..,,g-:..-_.: 't-i'Yl•.:'-';';';:-:'''')f f'll. .4'',..;;'--..'':-.:'::'''., Clothes dryer(gas)
Other.
Business name:pirk)krvilzkoci\ kyyl Qookikr.1 -r .9:„::.4;:-.2.4,', :u.**01:414. ipt*oir4Fs..:,:'-':c::.Z. .
Address: rt0C6- W . VR Dr suAkt. WI Subtotal
City/State/ZIP: -VASV)NrD 1 k) q---\vu-A Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone: )141_.3. Sivekl...., F":61.3) 611-\I- cn - State surcharge(12%of pennit fee)
CCB lie.: ) 01 DO) TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
. ...
days after it has been accepted as complete.
Authorized signature: IAL.,/ , 1 ,,,, * Fee methodology set by Tri-Colmty Building Industry Service Board
Print name:Ak i', d ii..... / 0 V (.., Date:
1:\Building\Permits\MEC PermitApp 040113.doc 440-4617T(11/02/091).4/WEB)
Rvecylv-vp
Electrical Permit Application FOR OFFICE USE ONLY
r
City of Tigard U L T ; Z O 1
Received Permit#:
• 13125 SW Hall Blvd..Tigard,OR 9 ! , rp-„p Plan Review
: '. Phone: 503.718.2439 Fax 5C :,'t VI: i Lx i Date/B . Related Permit#:
Inspection Line: 503.639.4175 p r s^ T n o,� Ready Date/By: ra E l See Page 2 for
TIGARD Imemet wvirw.tigard-otgov ijiLt ` t,7 . '_L. 1I 1 NotifiedrMathod
Supplemental Information
•
-- .i:4" -17--::b .V W im` i ;?. xz d t 5i 9 n l h,
®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans wrtems checked):
❑Demolition ❑Other: • ❑Service or feeder 400 amps or more ❑Building over three stories.
Y 's where the available Fault current ❑Zeatins and boatyards.
-1 -'"• --- - _�. .49v z %t ki..5=C. ft :.x ' ''- Z-f$ t i exceeds 10,000 amps at 150 volts or El Floating buildings.
®I-and 2-family dwelling ❑Commercial/iridustrial 0 Accessory building lass m ground,or exceeds 14,000 0 Commercial-use agrloultaral
amp •
❑Multi-family 0 Master builder 0 Other Fire for ell other installations. buildings.
. ���aha ���rtY`� � ❑Fimpump. ❑taataltationof(SOKVAor
`r• �: s1 1 „M t(�p * ..,x.,"'' D Emergency system, larger separately derived
Job site address: }, C{,,
El Addition of new motor load of system.
Job#:
I I W
�
"JJ `] O" ii NC, IOOFIPormore.
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy.
°Health-care facilities. 0 Reonal vehicle parks.
Suite/bldg/apt,#: Project name: ��+ - "�" 0 Hazardous locations. El Supply voltage for more than
p �/v- -e •
'�Y r ��
0 Service or feeder 600 amps or more. 600 volts nominal-
Cross street/directions to job site: 4, :, 141 y _;f ,
Description 1 Qty. I Each Total 1
New residential single-or multi-family dwelling unit.
Subdivision: f %%ter TtIMa r 47 L,s +- I Lot#: 3 1 Includes attached garage.
TTax map/parcel#: 1 l L`�•' 1.000 sq.&or less I 168.54 4
a M1 _* Ea add'1500 sq.ft.or portion �, 3392. 1
. c-�. ._. '; ,-;sem.•'t i l '.. 3 . Limited energy,residential
NtST 1 j) - a DICM (with above sq.f.) 75.00 2
t/�/ t 1 Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
S-- -1,4'.Y rl CA _ - 1 `," rid . - �.- 5r; 1Te6 = = SReenvwebolre fEeneerde8r3s installation,al❑teraStieeon,Paganed/2o_r
relocation
Name: t r ' 200 amps or less 100.70 2
- i t t • , 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: r ti, , .
601 amps to 1,000 amps 301.04 2
Phone: t ,'• ' t Over 1,000 amps or volts 55226 2
Temporary services or feeders installation,alteration,and/or
relocation
Owner installation:This installation is being u:. .property that own which is not200 amps or Iess 59.36 I
intended for sale,lease,rent,or e,xchange,according to •• t and 701. 201 amps to 400 amps 125.08 2_
Owner signature: 401 amps to 599 amps 168.54 2
a .� s�•� l �y or Branch circuits—cit alteration or extension,perpanel
x� ,9vfr:�'�O� �,-Y��:_t� � �.�i:' �L.�5�3��`�v ales €¢ 3'� tl q.�j�^„zt t.4. v f _
. _ A.Fee for branch circuits with
Business name:William Lyon Homes,Inc. above service or feeder fee,
7.42 2
Ntehole, ori Fee orbrancircirc
Contact name: B.Fee for branch circuits without
fee,first
Address: 3 4, Ai C b sb anch circuit or feed� 56.18 2
City/State/ZIP:Vancouver,WA 98660 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(360)695-7700 • ' ' Fax::(360)693-4442 Each manufactured or modular 67.84 2
Email (C I � O it,
+ dwelling,staviceand/or feeder
p Y , ome. Reconnect only 67.84 2
r, , '.. � 'q 4T, _ Pump or irrigation circle 67.84 2
�'-,..,.,m_ .,'s � �� -�3 E.v�,�1 l� �', -.0 Aa-�- rr'ty ryK�`�'`"J£�i.�" �s
Business name:Garner Electric Washington,LW Signor outline lighting 67.84 2
r_.. Signal circuh(s)or limited-energy
Address:o, j 0'Z ��`l�n ,, (�,tQ� S u3 \W) panel,alteration,or extension. 0 See Page 2 2
i •Pu �� P1J NIA.`�" Cl 1354,11.0* I Each additional inspection over allowable in any of the above
City/State/ZIP:' v ' J 1 Additional inspection(i hr min 6625/hr
Phone:(253)320-1657 I Fax:( ) Investigation(1 hr min) 90.00/hr
Email:bdaniels@gwensa.com Industrial plant(1 hr min) • 78.18/hr
Inspections for which no fee is 9000/
hr
CCB Lic.: C1158 Electrical Lic.: 208174 Suprv.Lie.: 4496S s' •e• listed ''h hr mm)
y Suprv.Electrician signature,required: 41 �r ( d ' .-,' - 4> i . P -' ' V- '`LL�?Sl' € rgiilei 1 u3 5C .- .
Subtotal:
Print name: Joan P Albert Date: 4/26/2016 ❑Plan Review Required(25%of permit fee):
•
e' State surcharge(12%of permit fee):
Authorized signature: ""� -- . � TOTAL PERMIT FEE:
This permit application expires if a permit Is not obtained within 180
Print name: Bill Daniels Date: 4/26/2016 days after it has been accepted as complete.
illil ' Number of inspections allowed per permit
2-••Liauildieglparmitin c PermitApp_Lit IItE.doc Rev 06/17/2015 440-4615T(Wo5/COwWE6
Plumbing Permit Apulicatio k ,per.
iE .�
Building Fixtures l OR ()l l It F1 St: trNi.3
r /01 t
Received
City of Tigard `� Date/By: Perm*No.: .
Illi a 13125 SW Hall Blvd.,Tigard,OR 9 -,-Tv a '1'T,` Pian Review t
11 Phone: 543.718:2439 Fax: 503.59E ft E w ate Other Permit No.: I
Inspection Line: 503.639.4175D,,�eBy.
T I G A R 1�: j i s Y a ie RcadyfBy kris: H See Page 2 for
Internet www.tigard-or.gov I Naified/Mothod: j Supplemental Information
Tit'E OF WORK • • FEE'•SCRE1IUts:
®New construction 0 Demolition For special fr11ormatlon use checklist .
Description ( Qty. I Ea. I Total
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
1CATlECoifY;0> Ctli$STRiJCflOI�T FR(1)bath 31210
S
®I-and 2-family dwelling 0 Commercial/industrtai SFR(2)bath 437.78 .
SFR(3)bath 1 500.32 ;
Accessory building 0 Multi-family
Each additional bathlkitchen 25.02
D Master builder 0 Other. Fire sprinkler( sq.ft.) Page 2
JOB ]NVFOItiviATION AXRLOCATIONN Site utilities:
Job site address: 11 3 1 �� I i, �(� Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97224 b i Drywell,leach line,or trench drain 18.75
+ Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: p,iver Texpi f I Manufactured home utilities 50.03
Cross street/directions to job site: I Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2 :
Subdivision: ('V,ex- T C. E .l-- { Lot no.:3 1 Fixture or item:
Tax map/parcel no.: Backflow premier t 3127
:- Backwater valve I
12.51
D t;,R,iPTloN-.0[t WORK"
Clothes washer
Ntsp,o n -Qo Loi25.02
J Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
.®itibit4i1 ov i.R. D..'ItNALiIT.:. Expansion tank 12.51
Name:ADPL Land Holdings;LLC Fixture/sewer cap 25,02
Address:7600 E Doubletree Ranch Road Floor drain/floor sink/hub 25.02
Garbage disposal . 25.02
City/StateJZIP:Scottsdale,AZ 85258 Hose bib 25.02 '
Phone:(602)694-4031 Fax:( ) Ice maker i 12.51
,9 ply Interceptor/grease trap 25.02
Business name:William Lyon Homes,Inc Medical gas(value:$ ) Page 2
Contact name:jJ\ hoke. Primer 12.51
+- ,,,,p Roof drain(commercial) 12.51
Address: t b3 �j OC(Lk) Sk&J�JL{-t✓ �S) Sink/basinnavatory 25.02
City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54
Phone:(360)695-7700 Fax::(360)6`93-4442 Tub/shower/shower pan 12.51
E-mail: 1 A ►l I Iii. 1 1t1'AY\OMPS . _vJ 'Urinal
ater closet
25.02
. .f.-7-1.:..!-2,-.:Y.:,.',..- • - . . - - Water heater • 37.52
Business name:Alliance Plumbing LLC Water piping/DWV . 56.29
Address:146 W Historic Columbia River Hwy tuber, 25.02
City/State/ZIP:Troutdale,OR 97060 Subtotal
rPhone:(503)492-3490 Fax:(503)912-6438 Minimum permit fee: $72.50 E
Plan review (25%of permit fee)
CCB lac.:184601 Plumbing Lie,no.:PB732 _ State surcharge(12%of permit fee)
if,d,i,L
Authorized signature: TOTAL PERMIT FEE
Print name:Robert Dishman Date:5/23/2016 This penult application expires If a Permit is not obtained within ISO days
atter b has been accepted as umpteen.
"Fee methodology set by Tri-County Building Industry Service Board.
1.113u0dIneermttePLMU-PenitApp.doc 10/01119 44-4616T(IO/02/COM/ WEB)
City of Tigard
11111 " COMMUNITY DEVELOPMENT DEPARTMENT
C
TICARD Building Permit Review — Residential
Building Permit #: /v[ SSD 7—O ,� 7' /�
Site Address: /. / k) /(CC/7/ /9
Project Name: 01404 -ei-y�CAP EVC Lot #: . /
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review l /
Proposal: / V,o4f) S'1 �P—h 1/ X7/4.
CliLC,_____
V
VJ Verify site address/suite# exists and active in permit stem.
CV River Terrace Neighborhood: ❑ No Yes,See River Terrace Review Addendum Attached
SV1an Elements:
I� ree(3)copies of site plan 'sting structures on site
ite plan must be on 8-1/2"x 11"or 11 x 17"paper TA Footprint of new structure(including decks)with finished
rawn to scale(standard architect or engineer scale) 1 oor elevations
Orth arrow VA tility locations&easements(required for new and additions)
iplicant
o address,project or subdivision name and lot number II idewalk/driveway approach
information(name and phone number) fl` •cation of wells/septic systems
Lot dimensions and building setback dimensions r I1 Atisting trees to be retained with drip line,and tree
• ►i's,uare footage of buildings to be demolished yrotection measures
VA Lot area,building coverage area,percentage of coverage and III eet tree size,type and location
pervious 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? IYJYes ❑ •
4 foot differential) If yes,is a storm water quali facility shown? ❑Yes 1t No ,,
lean Water Services—Service Provider Lett(lot platted prior to 9/10/1995): 0 "✓e°/
Required: ❑ Yes,applicant was notified Z No Received: ❑ Yes ❑ No ua-e.._
AU Public Facilitip Improvement(PFI)Permit: Prj.42U7CP—
/
Required: 01 Yes,applicant was notified ❑ No Applied For: IlYes ❑ No,stop intake
,�,be,,,.2 rl " CO < �' Q i(e— DCS
W 'Zoning: f?—� (� �p
1 � �
,c-( ,b )
'� equired Setbacks: Front Rear Side treetide Garage
/Landscape Requirement:
c:Q 0 %
bn`( of Coverage Maximum: 00
0/0
Y Building Height: Maximum Height opt- Actual Height
110 isual Clearance �
�
III/ ensitive Lands: ❑ Yes LU' No Type
Lid Urban Forestry Plan
❑ Conditions "M prioo,to issuance of buil g permit _l
Notes: ( " GC/k)rtS &// i%/l C�>'' 1?�
Approved By Planning: ' � Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPennitRvw_RES 061417.docx
Building Permit Submittal l/�/
Original Submittal Date: Ct [ /f 1 7
Site Plans: # 3
Building Plans: # 3
Building Permit#: Enter building permit#above.
Workflow Routing: tanning _Engineering Permit Coordinatoruilding
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
r original plan review routing form.
:uilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: /JA j /L-, " Date: i12 /
Engineering Review
JSlope at building pad: 5— t
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
_07Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes 4 No
Assess Water Quantity Fee in-lieu: ❑ Yes 7 No
LIDA Facility on lot: ❑ Yes yr No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: t v It.. ,- ) . Date: S //4./t 7
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
pproved,NOT Released: c�Q'I jKa AFbate: III c//9--
otes:
Cenci,vita- 1 t Iw Ii -AL.
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
11 Tigard Trans SDC: 1 -Yes ❑ N/A
Parks SDC: "'Yes ❑ N/A
LIDA ❑ Yes1T/A
,' OK to Issue Permit /
Approved by Permit Coordinator: ,?\A (fL Date: \\\1,0\\,-A
I:\Building\Forms\BldgPermitRvw_RES_061417.docx
City of Tigard
IN " COMMUNITY DEVELOPMENT DEPARTMENT
S
T c A RD River Terrace Building Permit Review Addendum
Building Permit #:
Site Address: M3-7— 910 &4 �e
Project Name: g*e.-- `��,ct 71— Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan Distfict Design Standards (18.660.070.1.):
Is the project subject to the plan district design standards? Pig 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 . dee Balcony w/ access 2 Window Projection Vertical Wall Offset a
p ft. deep min. 2ft., 5 ft.wide min. 2 ft.,6ft.wide Gabled dormer
❑ El El ❑
2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: /2/- Cl)/
3. trances:At least one entrance must meet both of the folio , g standards:
Max. 8 ft. setback from long street-facing wall
r. Parallel to street,angle no more than 45° from street,
or ope onto porch
Entrance opens to a porch: Yes ❑ No
If s,all the following apply: sq.ft.min.
Fr V ne street facing entry t.max.roof above floor of porch
r 5 ft. depth min. 30%min.porch roof coverage e4 etailed Design:All buildings shall include a min. of five of the following elements on all street-facing facades:
LI Covered porch min. 5 ft.wide x 5 ft. deep ❑ Recessed entryarea min. 5 ft.wide x 2 ft. deep
p
all offset min. 16 inches ❑ P ormer min. 4 ft.wide
IIIVRoof eave min. 12 inch projection IG 'oof offset min. of 2 ft.
❑ Roof shingles either tile or wood II Gable,hip or gambrel roof design
❑ r •of 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
El 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:
N closer to front or side lot line,than longest street-facing wall. El 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 min. area of 12 sq.ft.
W7vtfi: (Check one)
12-foot-wide garage door El 40%max. of street facade
❑ 50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: _ Date: irM
I:\Building\Forms\B1dgPermitRvw_RES_RT_o62216.docx
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
1,1 II v.
Transmittal a Letter
T t GA R! 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Tom H. DATE RECEIVED:
DEPT: BUILDING DIVISION
FROM: Nichole Thorpe ;;,��� 2017
COMPANY: Polygon Northwest L 11Y
` t
- a+
PHONE: 360-989-40204 BY: '\
t sw L‘`
RE: 13107,131291 13143�c �SW 169TH -- --- _;;;III
(Site Address) ('ermit+umber "
e �
River Terrace East Lot ' — 4'N
�T'
(Project name or subdivision name and lot number) ! \ 2,O1`j �,r�2,6(4
ATTACHED ARE THE FOLLOWING ITEMS: lV/
Copies: Description: Copies: Description:
0 Additional set(s) of plans. 3 Revisions: Bulletin, Plan Sets
0 Cross section(s)and details. 0 Wall bracing and/or lateral analysis.
0 Floor/roof framing. 0 Basement and retaining walls.
0 Beam calculations. 0 Engineer's calculations.
0 Other(explain):
REMARKS: Please pay fees owed with Trust Account.
Adding 3rd Bathroom Option /41 Tia/ City/ 7Ti
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: )J-- j C Initials:
Fees Due: a Yes ❑No FeetDescription: Amount Due:
11r 01ch YeAr. mac. $ 9e
$
$
Special
Instructions:
Reprint Permit(per PE): Yes ❑No ❑ Done
Applicant Notified: Date: Initials:
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
c•C\S cc - .\.,'-. -6)1e1
FOR OFFICE USE ONLY-SITE ADDRESS: \ Cb-** u k SP1"k\'1 e-
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
IN Transmittal Letter
GAI.l) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Tom H. DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
AUG 14 201
FROM: Angela Grajewski
CITY O=FTIGARD
COMPANY: Polygon Northwest BUILDING DIVISION
PHONE: 971-212-2144 By:
/14-57)-.017-( .291/
RE: 13147,13143,13137,13129,13107 SW 169th Ave -2 ,S-
(Site Address) (Permit Number) -29,
River Terrace East Lot 29-33 Does
(Project name or subdivision name and lot number) JO/
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description: '
0 Structual Detail sheets
Additional set(s) of plans. 3 Revisions: included
0 Cross section(s) and details. 0 Wall bracing and/or lateral analysis.
0 Floor/roof framing. 0 Basement and retaining walls.
0 Beam calculations. 0 Engineer's calculations.
0 Other(explain):
REMARKS: Please pay fees owed with Trust Account.
(plans were submitted with out structual detail sheets)
FOR OFFICE UST ONLY . ` .y
Routed to Permit Technician: Date: Initials:
Fees Due: n Yes n No Fee Description: Amount Due:
$
$
$
$
Special
Instructions:
Reprint Permit(per PE): n Yes n No , n Done
Applicant 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:
13137 SW 169TH AVE, BEAVERTON, OR, 97007
Record Type: Record ID:
Residential - Master Permit MST2017-00299
Inspection Type: Inspector:
199 Electrical final Aaron Cillo-Gobel
Result:
PASS
Comments:
This inspection was previously approved. See inspection on 5/15/18
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:
13137 SW 169TH AVE, BEAVERTON, OR, 97007
Record Type: Record ID:
Residential - Master Permit MST2017-00299
Inspection Type: Inspector:
699 Mechanical final Jeremy Burrows
Result:
PASS
Comments:
No A/C installed at this time
Violation Summary:
Inspector Contractor
Plumbing Permit Application
Site Utilities
�' FOR OFFICE USE ONLY'
City of Tigard i r f t 7
Received
11,1
111 13125 SW Hall Blvd.,Tigard,OR 97223'- •- -
017 Date/By: 7//�� Permit NoAw�•-71�,ti ,7
Phone: 503.718.2439 Fax: 503.598e:1'900. - Plan Review ��'L >1r/`vl
Inspection Line: 503.639.4175 Date/By: I ._). j._i �(� Other Permit No.:
TIGARD p
Internet: Line gard-or.gov Date Ready/By: uns See Page 2 for
Notified/Method / )���i� .
66G /1111 Supplemental Information
•
TYPE,OF WORK FEE* SCHEDULE
®New construction
❑Demolition For special information use checklist
❑Addition/alteration/replacement Description Qty. Ea. Total
❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION • SFR(1)bath
312.70
ID1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
❑Accessory building ®Multi-family SFR(3)bath 500.32
❑Master builder Each additional bath/kitchen
❑Other: 25.02
JOB SITE INFORMATION AND LOCATION
Fire sprinkler(1,221 sq.ft.) Page 2
utilities:Site utilities:
Job site address: 13137 SW 169"'Ave Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain 18.76
Suite/bldg./apt.no.: I Project name:River Terrace East Footing drain(no.linear ft.: ) Page 2
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
Subdivision: Water service(no.linear ft.: ) Page 2
I Lot no.:31 Fixture or item:
Tax map/parcel no.: Backflow preventer
31.27
DESCRIPTION OF WORK Backwater valve 12.51
Multipurpose Fire Sprinkler System Clothes washer 25.02
Permit# Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
Ili PROPERTY OWNER I Cl TENANT Expansion tank
12.51
Name:Polygon Northwest Fixture/sewer cap 25.02
Address: Floor drain/tloor sink/hub 25.02
City/State/ZIP: Garbage disposal 25.02
Phone:( ) Hose bib 25.02
Fax:( ) Ice maker
12.51
M APPLICANT 0 CONTACT+ PERSON Interceptor/grease trap 25.02
Business name:Alliance Plumbing,LLC Medical gas(value:$ ) Page 2
Contact name:Robert Dishman Primer
12.51
Address: 146 W Historic Columbia River Hwy Roof drain(commercial) 12.51
City/State/ZIP:Troutdale,OR 97060 Sink/basin/lavatory 25.02
Solar units(potable water) 62.54
Phone:(503)492-3490 I Fax::(503)912-6438 Tub/shower/shower pan 12.51
E-mail:robert.dishman@allianceplumbing.net Urinal 25.02
CONTRACTOR Water closet 25.02
Business name:Alliance Plumbing,LLC Water heater 37.52
Address: 146 W Historic Columbia River Hwy Water piping/DWV 56.29
Other: 25.02
City/State/ZIP:Troutdale,OR 97060
Subtotal
Phone:(503)492-3490 Fax: 503
( )912-6438 Minimum permit fee: $72.50
CCB Lie.: 184601 Plumbing Lic.no.:PB732 Plan review (25%of permit fee)
Authorized signature: t- J�7! J State surcharge(12%of permit fee)
T- TOTAL PERMIT FEE
Print name:Gavin Thomes I Date: 12/6/2017 I This permit application expires if a permit is not obtained within 180 days
J after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I_\Building\Permits\PL MU-Permit App doe 10/01/09
440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Q�... Fee(ea) Total -Square Footage: , Permit Fie:
50.03 0 to 2,000 $121.90
Footing drain-1"100' 2,001 to 3,600 $169.69
Footing drain-each additional 100' 37.52 3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52 Valuation: 'Permit-Fee:
Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.each 50 for the first additional$100 00 or00 f action thereof,to
Other d$1.52 for
���pectiol�s or Fees
Q "Fee Total" and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including$25,000.00.
inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
(minimum plan review forrevisions90.00/hr $50,001.00 and up $742.00
for thenal first
rs 00,00or 0.0iand$1.20 for
(minimum charge-1/2 hour)
Subtotal:
Other Fixtures: I I
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*.
Quantity by Fixture Type
Fixture Type for Replaee/ Plan Review for Plumbing g Installations
Work Performed: Capped Added Relocate
Plan review is required for any of the following.
Baptistry/Font Please check all that apply.
Bath -Tub/Shower 0 Any new commercial building with water service 2"and
-Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall-Driveengineer.
New exterior plumbing site utilities for any complex structure
DishwasherC
uspidor/Water AsDpirator Thru-Commercial ❑ as defined in OAR918-780-0040.
❑ Medical gas and vacuum systems for health care facilities.
Domestic
Drinking Fountain ® Any multipurpose fire sprin er system..
Eye Wash ❑ Any complex structure as defined in OAR918-780-0040.
Floor Drain/sink 2" Submit 2 sets of plans with any of the above.
-3"
4„ ,.
Car Wash DrainIsometric or Riser',Diagram
Garbage -Domestic-non-food 0 Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related related that meet the qualifications above.
-Commercial-food
-Industrial-food related
Ice Mach./Refrig.Drains .
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lay -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter
Washer-Clothes *Note: If the fixture work under this permit results in an
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal
https://allianceplumbing-my.sharepoint.com/personal/gavin_alliancepluml2ng_net/Documents/Documents/Fire Sprinklers/RT/City of Tigard
Permit.doc