Permit (91) CITY OF TIGARD MASTER PERMIT
1114 is
COMMUNITY DEVELOPMENT Permit#: MST2017-00405
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/12/2017
Parcel: 2S106DA02300
Jurisdiction: Tigard
Site address: 13189 SW 169TH AVE
Subdivision: RIVER TERRACE EAST Lot 23
Project: River Terrace East, Lot 23
Project Description: New SFA.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 2 First: 321 sf Basement: 0 sf Left: Parking Spaces: 0
Height: 31 Bathrooms: 3 Second: 646 sf Garage: 326 sf Front: 12 Smoke Yes
Dwelling Units: 1 Third: 637 sf Right: Detectors:
Total: 1604 sf Value: $199,793.26 Rear: 5
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF RainStorm Sewer: 100
0
Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Tvpes 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 1604
Owner: Contractor:
WILLIAM LYON HOMES INC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
BY POLYGON WLH LLC 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175
ATTN BAKER,JASON VANCOUVER,WA 98660
703 BROADWAY ST STE 510
VANCOUVER,WA 98660
PHONE: 602-694-4031 PHONE: 360-695-7700
FAX:
Total Fees: $23,746.37
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 throu. 3AR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: 9 i li--e___ Permittee Signature: .?'47. ."9,"L.1 a Inn/
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 ApplicLO 7 23
ation V
ky n 7...,,,„,,iRECEI '- FOR OFFICE 1 SE O\Ll
III City of Tigard Reee've: a / o /4, PermitN..›.1„,.(570/9..-00e1.0.5"-
Plan
I�(57 0/7- OS'
Date/By: �7
13125 SW HaII Blvd.,Tigard,OR 9,7'223
JUN 2 2017 Plan Revie l �` .i- Other Permit: ��3 /
Phone: 503.7182439 Fax: 503.598.1960 1 Date/BY �O- ,,c'�'
i y t.) 11, ,,L) Date Read J •i 's: See Page 2 for
r j t- ,1,0 Ins ection Line: 503.639.4175 �� 1 1N Ready/By: G
Internet www.tigard or.gov BUiLDI 4{( DiV St Notified/Method.: /7 L Supplemental Information
/ it/1 C -t.e-'
Permit fees*are based on the value of the work performed.
®New construction ❑Demolition
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
, v,{{ �zz:,7,, .-. work indicated on this application. ^//_�
, � m. r� Valuation: $
1-and 2-family dwelling ❑Commercial/industrial
Multi-familyNumber of bedrooms: i 991 -0
❑Accessory building �+ * "
❑Master builder 0 Other:
Number of bathrooms: 3 '7 9 3
O r
4 ,, > ' , f r< ,fa, `� Total number of floors:3/160 9-1 jC!a 0
.., , 2,,,,,,,,,,,,,,.. � e l � � � ifs [ t 3.. moi_
Job site address: /3 187 Sud 'W Ne New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport . , '3 square feet6 3
Suite/bldg./apt.no.: I Project name:River Terrace East J a —Covered porch area? ( square feet G L4.G
Cross street/directions to job site: Deck area: ��qfl llG'' square feet v3 L I
� G/< ava
th�r structure ar�.�: Q G square feet
Subdivision:River Terrace East I Lot no.: 2.3 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
,',%--- L l °' work indicated on this application.
4
Valuation: $
Existing building area: square feet
New building area: square feet
; @STA: p< ! Number of stories:
..! rte .,
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:
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 I Fax::( )
E-mail:Nichole Thorpe
-, - Commercial and residential prescriptive installation of
-. < r . -':` 4 - ` a • = n ;e roof-top mounted Photovoltaic Solar Panel System.
Submit two(2)sets of roof plan with connection details
Business name:William Lyon Homes,Inc
and fire department access,along with the 2010 Oregon
Address: 109 East 13th Street Solar Installation Specialty Code checklist.
Permit Fee(includes plan review $180.00
City/State/ZIP:Vancouver WA 98660 and administrative fees):
Phone:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60
CCB lie.:207247 Total fee due upon application: $201.60
This permit application expires if a permit is not obtained
Authorized signature: /� within 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry
Date:06/16/2017
TPrint name:Nichole Thorpe Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
. .
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received
DatelBr PermitNo.:
.1 13125 SW Hall Blvd.,Tigard,OR
Plan Review
:111 Phone: 503.718.2439 Fax 503.598.1960 aey: Other Permit
TIGAIID pelns cdon Line: 503.639.4175 t Date Rady/By, Juds:
0 See Page 2 for
Internet www.tigard-or.gov ' Nottfied/Method: Supplemental Information
SfitSVIRVIMMASAril*:#01f:044.,MVAW:n.",ififf124fal KIVCI',14#R---,..,0140:4-0.1C- ArVatig*: -....Sii
Mechanical permit fees*are based on the value of Ihe work
ISI New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other mechanical materials,equipment,labor,overhead,and profit
Value:$
M.Y.FS-WrI.M:V14•O1OKtg)i-'::::-•°•::::.(1'1S71:fitd :X4rie.1.7:47Z MEVIgijijimyfW-7 -IiiiiiiittiWAtit.g$440P-Wil
1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For spedal information use checklist
'Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total
1-114t6-41A--gglt*OritkiWC.:X.X.S*0-.41;t:'—lOYM5V•WitV.A:
Heating/cooling
• Air conditioning 1 46.75 46.75
Job site address: I 1 i BI sw k to coil R.,/e,
Furnace 100,000 BTU(ducts/vents) 1 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000H-BTU(ducts/yenta) 54.91 _
Heat pump 61.06
Suite/bldg./apt no.: Project name:River Terrace East
Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 2332
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 1 23.32
Other 2332
Subdivision:River Terrace East • Lot no.:131
Other fuel appliances:
Tax map/parcel no.:
Water heater 2332
_
:;;771;tfa,AWilfiX3riet*:.541,4k0'.9'.k.j.0100;tatigir,PVtilniFitql Gas firePhceinsert 1 3339
Flue vent for water heater or gas
— SIO-a71/13-- li(13- fireplac.e
Log light!.(gas) 2332
2332
Wood/pellet stove 3339
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 2332
2332 Environmental exhaust and ventilation
Name:ADVL Land Holdings,LLC Range hood/other kitchen
equipment I 3339
Address:7600 E Doubletree Ranch Road
Clothes dryer exhaust t 3339
City/State/ZIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) ti 2332
Phone:(602)694-4031 Fax:( ) Atticicrawlspace fans 2332
••::74..:' :i',.;74:ifig-Of:44.448.01*.: Ii- -,.i;:i ;: s--.'SZjet$.1S1AW:?**410,::0,;:::4)J Other 2332
Fuel piping:
Business name:William Lyon Homes,Inc.
$14.15 for first four;$4.03 for each additional
Contact name:14i OfICA.e,-11A OfVe Furnace,etc. 1
Address: V2) MOtaltA)°I t -\-- •Sdk(--- Si 0 Cras heat punm
Wall/suspended/tmit heater
City/State/ZIP:Vancouver,WA 98660
Water heater
Phone:(360)695-7700 Fair:(360)693-4442 Fireplace 1
Range 1
E-mall AO i Cdk 0 ke, :TX! 1 4c(),13*.ifirnhOnfie5 •f Anil Barbecue
t....-77-t-,:%,4_,.,-.., .,, .. T......t.t; s....:.°-, -' -"-2" - '' .:: .0,-. :,.-i: 4, li,,••••4:;.. 4 Y:...:,,J;‘,..=
."4”.:!',Na...P.7±,.1.71e.'N'i'1^".7.;:frAn -.7.0* t 6 k , 4.i.,.,,,,,,,,,-.,,i.,7,,..,,,,,..,;:-.1,....2.,.=:4E---i Clothes drYer(gas)
—
1 Other:
Business name:pn Not, olvl took tom .1--plc,
:..mt.111:.17 , -1 f..:.:11ziorkors$-:tr-:a... zi:r7,7i
Address: UCtc t\hNi •‘Di\$,. .0.— Dr, SL1kt, 1‘ ,1 Subtotal
City/State/Z2: tVAS WI) 1()v._ CWLM hfutimurn permit fee($90.00)
-
Plan review(25%of permit fee)
Ph°ne:9P))4q3- SlAL Fax:(Si ) CAL\ "4 S-01\7- State surcharge(12%of pennit fee)
CCB lic.:-Loci 001 TOTAL PERMIT ELL
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: thCify4"-rarist---- * Pee methodology set by T ii-Connty13mIding Industry Service Board
Print name:Ak 614 6/ 7l'?ovpe
-, Date:
_
nlitulldingTermitaiEC Pau/AA=040113.doc 41411-4617T ft 1#11/CY1M/W;FRI
Electrical Permit Applicatioad
CI
tyofTiga.�
FOR OFFICE USE ONLY
:II13121 SW Hall$ivd,Tigard,OR 97223 Date/13 . 'annuli:/-/ / r20=111
Phone: 503.718 2439 Floc 503.598. 9b0 Plan Review ...
Inspection Line: 503.639.4175. ReaDatdy • R^-hatedPermit#:
TIGARD tigard_oL 1 LIBCddy the 7onc: See Page 2for
interact q�1vw g0Y Noh6ed/Mathod.
m
ental Information
rte ri --- " --- ' r,- LV :r-W,-(00. , 2- ` 4 _ ;:;`a } -..y J„ 6;il a[Crd'.%.R Tn.'-1. Y
'®New construction 0 Addition/alteration/rePlacement Please check all thatappy(sarbaic erecs ofp]ansWilsonss
checked):
0 Demolition 0 O 0 Service or feeder 400 amps ormore 0 Building over throe stokes.
" `? - • c`"""r 'cam` ' y where the available fault current ❑Marinas and boatyards.
_.--� ��;.: ,,' ": i-k.� I*" i A)ah elft. ? (0)° ;- �':�' 4_= exceeds 10,000 amps at 150 volts or El Floating buildings.
-and 2-familydwelling 0 Commerciallnidustrial 0 Accessory building °to ground,or exceeds 14,000 0 Commercial-use agricultural
MultiY ❑Master builder 0 Oche amps for all other installations. . buildings.•
. v z •._ Fire pump. ❑Installationof I50Id-. - �* '- erg.SB iic r'yt oo€ .vw s 3 }ilz,k ❑gmergecoysystem. largerseparatciyderived
Job Job site addre« CJ�' �-%{'IPat, ❑Addition ofnewmotorToad of system.
�� • \I el-WI f 1V` , 1001-11'or more. ❑"A","B","12","1-3",
City/Ste DP:Tigard, ❑Six ormore residential voim occupancy.
Suite/bldg./apt# ❑Healthcare facilities. ❑Reereationah vehicle parks.
( Project name:give r r� �*_�, ❑ecus ceder ns. ❑Supply voltagefor morethan
Cross street/directions to job site: C per" ❑ �orioaaar eco amps or more. 6�vote nomin4
•
Description I -tibT..-1 Total ;-
New residential single-or multi-family dwelling unit.
Subdivision:
ubdivision 1z4►1 P,r eirra pQ_ 'E +. Lot#Z3, Inrludesattarbed garage
Tax map/parcel##: —' 1.000 sq.ft or less J 168.54 4
Y 7 ' t ��e arm a a - Ea.add'1500 sq.R or portion I 33.92. 1
x-: .. i €_ Limited
- energ};residential '
(with above sq.ft.) 75.00 2
Limited energy,multi-family '
residental(with above sl,ft.) 75.00 2
,7 vera t, t° � at�Ll�If �, Renewable Energy 0 SeePage 2
v.z ii. ;r - ate,�.: .:4rN-,�>t..t4 ----3 -4.
Name:ADVL Land Holdings,LLC Services or feeders Installation,alteration,and/or relocation
Address:7600 R Doubletree Ranch Road 200 amps or less 10070 2
° to` s 133.56 2
City/State/EP:Scottsdale,AZ 85258 401 a tD60D a 200.34 2-
601 amps to 1,000 amps 301.04 2
Phone:(602)694-4031 Fax ( ) Over 1,000 amps orvolts 53226 2
R*Dat: - Temporary services or feeders installation,alteration,and/or
tion
Owner installation:This installation is beingmade on200 ampsso
inttndr�for sal lease, property I own which is not 200 or less 59.36 I
e, rent,or exchange,according to ORS 447,449,670,and 701. • 201 amps to 400 amps
125.08 2
Owner signature: Date: 401 amps to 599 amps
a ��p,,:vA rtcwt r t f r,_. - ti, i68S, 2
-..jam'. ..— �f=- �,..r.—., c, - ', �[1 f � -'.� � ..ii yF r --.s Branelt elrcuits—i ,alteration,or extension,per panel r
..-•�..—_," . r�w art.1«'ee larhranch Cileuita SYfdr
Business name:William Lyon Homes,Inc. above service or feeder fee,
Contact name: N 1 ch o fl
each or brancircuitcir7.42 2
^� ((�� ������ `` �+���,q� B.Fee for branch circuits without
feeder fee,fust
Address: 103 ls..l dkoc t/_ st .),IA.k. . S VD
service
ccucuit 56.18 2
City/State/ZIP:Vancouver,WA 98660 J Each add'l branch circuit 7.42 2
Phone:(360)695-7700 Fax (360)693-44+12 Miscellaneous(service or feeder not included)
Each manufactured or modular
! dwelling,service and/or feeder
Finari!, #Il 67.84 2
k,:-T h ) 1 05 a RS-,-f--Z-1.-.,-,4-;-::5-t, =4 " - E?y i' G3 f�7ti{13. >. '�1 , Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
Business name:Garner Electric Washington,LLC Sign or outline lighting 67.84
a_.. 2
OZ Signal 1.11‘.w.(' s)or limited-energy
Address:t(,j \i c J 4,r i e,1 J 1�� 11 1° panel,alteration,ort eosioa ❑ See Page 2 2
City/State/Z2:'�� v�t '1 Il t ll`�" ( 2�2 """YY Each additional inspection over allowable in any of the above
Phone:(253)320-1557 (,_ f W I F _l J ! 1
Sonat inspection(I brink) 6625/hr
ax:( ) Investigation(1 hr min) 90.00/hr
Rrnm1 bdanie}s@gwensa.com Industrial plant(1 hrmia) 78.18/hr
CCB Lie CUSS Electrical Lic.; 208174 IsInspectioe for•;.. fee is 90.00/hr
1Suprv.Lie.: 44968 a -• listed 41 rein)
7
Qf i7 ed .Iet� i Supry•Electrician signature,required. + ti./ 7J; ��LT. «: Subtotal: g.'
Print name: Joan?Albert Date: 4/26/2016 0 Plan Review ReQuirod(25%of permit fee):
•
e."-- / ------ Steric surcharge(12%of fee):
_
Authorized signature: - - --• ,,.
TOTAL MUM'FEB:
_ Print name: Bill Daniels Date 4/26/2016 This permit application expire if a permitis not obtained within 180
- days u#critilea been accepted as complete.
ill3',4 llsendms1Parn�,g c p pp 1ItF_doa Kw oonmo15 * Nnarberofioepeotiaae allowed per permit
_t 46o.76i51Y►vos,coMtvuse
Plumbing Permit Application
Building Fixtures is :Diz 01-1-ICE I SI" OM.)
City.of Tigard R Pariah No.: Tie J 2v
1��. 13125 SW Hall Blvd.,Tigard,OR 97223 1 : �� 7
Phone: 543.7382439 Fax 503.598.1960. Plan Review OiherPexmit 140
Inspection Line: 503.639.4175 Da,ReadyiBy, 7-
bele: ®See Pt:ge 2 for
T3 c:AP_0 Internet: wwnv tigard-ongtsv
Notified/Method Supplemental Informatioa
1:. i j ' c':Sri •y; :./�b�yitf%�--•,: _•_t ,.'a _N 4,'-.��
. - 9Y1-f ,L•'.-'F:G.. .%i:y..SaS'-.. ..... ..!1St Tf�+Jfn�L��` ."-t`'..... ...'... ._j=�_. ry'gt�==..:�;_. �. t: tiodiji-aii ,
®New construction 0 Demolition Fer geld k ornuctiorr itse checklist
❑Addition/alteration/replacement 0 Other: .Description New 't`• I ( Total r
New 1-2-family dwellings(includes 14411.for each utility connection)
_i-'--4 7.::-,;'r_ .: :,..33.3,3- _ I • j9;a .:ii a?=Xr-.:•_ `_ SF#t(1)ba$t 312.74 °
_1-and 2-family dwelling ❑Commercial industr'iai SFR(2)batt • 437.78 :
❑Accessory building B{Multi•family SFR(3)bath 4 50032, _
Master builder.' Each adddionsl bath/kitchen 25.02
:,J ❑Othex- Fire sprinkler ft) Page 2 1
Lilt a. . .-:
-• Lil p8 . 41rCOADI�`O:4;;' _.'' • , , _ Site utilities: J
Job site address: [3 1 W SVS Li p oil ti mt, Catch basin or area drain 18.76 .
City/State/ZIP:Tigard,OR 97224 Dryweli,leach line,or trench drain 18.76
cA�� Footing drain(no.linear tt:_) Page 2
Suite/bldg apt no.: I Project name: .iW r VVS
f°Cl
Vim!. Manufacuired home utilities 50.03
Cross streeddirections to job site: f Manholes 18.76,
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) 1 Page 2 l
Storm sewer(net.linear ft.:,_,) Page 2
'Water service(no.linear It: ) Page 2-
Subdivision: RiX 'C'eltNia.Ct_ E4- Lot ncL12.3 Txtur e or item: `
Tax map/parcel no.: Backflow preventer t 1 31.27
z •'s: . 9It:;:''•"'` DESCRIPTI3UTCt)If'N4 - Bad:watei calve } I2.51
Godes washer 25.02 t
Dishwasher - 25.02
Drinking fountain 25.02
r, Ejectors/sump 25.02
•4--7,•- r k 10 : ."•�, -:;-'•,...:.;:;'-'2-;• i' •`lif24*`> .. Expansion tank • 12.51
Name:ADVL Land Holdings;LW Fixture/sewer cap 1 25,02
Address.7600E Doubletree Ranch Road Floor drain/floor sinkRtub 25.02
City/State/ZIP:Scottsdale,AZ 85258 Garbage disposal 25.02
Bose bib 25.02
e Phone:(602)6694-4031 'Fax:( ) Ice maker 12.51
•u: :.` ,_ � R: interieePt°118rease 25.02
Business name:William Lyon Homes,Inc Medical gas(value:S ) Page 2
Contactname:thGDke. Pruner 1251
Address:'"l(b3 Q� , , 'SA- 1-e- hoof drain(commercial)atur _ 12 51
�� S niklinllavatY 25.02
City/State/ZIP:Vancouver,WA 98669 Solar units(potable water) . 62.54 '
Phone:(360)695-7700 - Fax::(360)693-1442 Tub/showeifshe werpan 12.51
E-mail:: I a 1 " • tib 1• . IP •'� Urinal 25.02
-0.°rte-�c.�-�•- �-� •
/. :-... ,,- •_ eta Vater closer 25,02
�'.:'- s.•;..:•+dts�'..�:�� '=:�- •t is 3r ps'�._ � ti` s.- i
.--- Water:heater • • 37.52
Business name:Alliance Plumbing-LLC
Water pip WV 5629
Address:146 W Historic Columbia River Hwy Other: 25.02
City/State/ZIP:Troutdale,OR 97060 Subtotal
Photic(503)092.3490Fax:(503)912-6438 Minamunt permit fax $72.50
CCB Li :1:184601 / # Plumbing Lie.no.:PB732 Plan review(25%of permit fee)i Statesurcharge(12%ofpermit fee)
Authorized signature / , TOTAL PERMIT FEE
Print name:Robert Dishman Date:N2312016 This peremapplication expires If permit's mot Attained.within IN Bays
after Rims been siontMed anxe+steiete- I
*Fee methedklagy sett Tri-County Sudding Industry Service Board
1
1S9suamsV+pmltaIPL W-PernttcApprke taw104 440-462 1
City of Tigard
-II
" COMMUNITY DEVELOPMENT DEPARTMENT
g
T1caRD Building Permit Review — Residential
e
Building Permit #: ,,,,,,p,57-- 7 -024-0<—
Site
w"5j 7' �7 —02'f
Site Address: 1 3 14'j G'1 S iV 1c1 ttn
Project Name: i W-4— Terra! €C'IS -1— Lot #: �T
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review I V ' ,, �7
Proposal: � £F'�I
/n Verify site address/suite#exists and active in permit s stem.
/River Terrace Neighborhood: ❑ No Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
Three(3)copies of site plan elirngstructures 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
North arrow Utility locations&easements(required for new and additions)
Site address,project or subdivision name and lot number Sidewalk/driveway approach
C/Applicant information(name and phone number) gLocation of wells/septic systems
of dimensions and building setback dimensions �es to be retained with drip line,and tree
Square footage of buildings to be demolished , rotection measures
/Lot area,building coverage area,percentage of coverage and SCJ Street tree size,type and location
impervious area(applicable if R-7,R-12, P : R-40) treet names
C `�,
Property corner elevations (2 foot contour es if more than >1,000 sf of impervious area created or replaced? E Y No NM-
4 foot differential) If yes,is a storm water quality facility shown? Yes No
/171 Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995): 1‘f/P4
Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No
XPublic Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified ❑ No Applied For: 4'Yes ❑ No,stop intake
/ Land Use Case#: p1) 4 <) I( ' 00 001 � )3 7,c l b - 00001
7 Zoning: 2-ZS
yf Required Setbacks: Front l Z Rear S Side 0/ g Street Side 3 Garage '20
Landscape Requirement: 2)0 % 3.b 47
ZLot Coverage Maximum: 90
X Building Height: Maximum Height IV/A Actual Height 3(0
71 Visual Clearance
Sensitive Lands: ❑ Yes ❑ No Type
Urban Forestry Plan
Conditions "Met"prior to issuance of building permit
Notes: ilii
Approved By Planning: •' I O"-r\----N. (rte- Date: 1 0/ /1 / 11
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: El Approved ❑ Not Approved
I:\Building\Fomis\BldgPermitRvw RES_061417.docx
Building Permit Submittal
Original Submittal Date: >722--r/72
Site Plans:
Building Plans: #
Building Permit#: W nter building permit#above.
Workflow Routing: 1/"Planning Engineering Permit Coordinator 'Building
Workflow Sign-off: •► Sign-off for lanning(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.
Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: L4 c I Date: 707/E0
Engineering Review
/ o�
Slope at building pad: /7v
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes VNo
Assess Water Quantity Fee in-lieu: El Yes No
LIDA Facility on lot: ❑ Yes / No
❑ NOT Approved by Engineering: Date:
Notes:
Approvedc.t d Date: /70A//
PP byEngineering:ineerin�' g� � l k�. L
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 /
7,-"Approved,NOT Released: 6'0 ` Date: (o/,-.)1/
Notes: f
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:
DC Fees Entered: Wash Co Trans Dev Tax: La Yes ❑ N/A
Tigard Trans SDC: Z.`' Yes ❑ N/A
Parks SDC: 91 Yes ❑ N/A
LIDA ❑ Yes 21\1/A
OK to Issue Permit �/
Approved by Permit Coordinator: /����'�" Date: /! J 14 / I -
I:\Building\Forms\BldgPermitRvw_RES 06141 7.docx
City of Tigard
Il COMMUNITY DEVELOPMENT DEPARTMENT
TIGAR`D IN
River Terrace Building Permit Review Addendum
Building Permit #:
Site Address: 131 V 9 S vv I (9C1 `'in
Project Name: R N•ex T .C X21 i &GiS t" Lot #: 2.3
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan District Design Standards (18.660.070.1.):
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 Gabled dormer
ft. deep min. 2ft., 5 ft.wide min. 2 ft., 6ft.wide
/ ❑ ❑ 7 ❑
2. Eyes on the street: a minim m of 12%of each street facing facade must include windows or entrance doors.v
Percentage Shown: 17, `I
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 es,all the following app y: —0 o 25 sq.ft. min.
One street facing entry ie 12 ft.max.roof above floor of porch
Al 5 ft. depth min. "130%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 ❑ 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 r Roof offset min. of 2 ft.
❑ Roof shingles either tile or wood ,Z'Gable,hip or gambrel roof design
E Roof pitch oriented south min. 500 sq. ft. ❑ Horizontal lap siding min. 3-7 inches wide
AAccent siding min.40%of street facade /0-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 facade
5. Garages and Carports:May face the front or side lot line on a corner lot.
Setbacks:
No loser to front or side lot line,than longest street-facing wall. ❑ Yes 94o. 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.
ay 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 facade
50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: (V) Q A/\..- . ,, Date: j 0/ 1 i /j '1
I:\Bullding\Forms\BldgPermitRvw_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
Transmittal s al Letter
III
-,,,,ARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Tom H. DATE RECEIVE
TNI
DEPT: BUILDING DIVISION r,1'CV Wil L il
FROM: Angela Grajewski
orVIGARD
COMPANY: Polygon Northwest Cx" 0'
ter nth ''1
,:
PHONE: 971-212-2144 By:
RE: 13189,13181,13175,13169,13167,13159
SW 169th Ave
(Site Address) (Permit Number)
River Terrace East Lot 23-28
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies ti,--serip ion '" � /.:, copies: , escr ption , -.
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)
11 :� ` 4 1611'OF USE+ NI.V r NAr - 1 . ¢Yk.r >
Routed to Permit Technician: Date: 2,,—y - Initials:
Fees Due: ❑ Yes N No Fee Description: Amount Due:
$
9
. $
Special
Instructions:
Reprint Permit(per PE): 1 ❑ Yes ❑No I ❑ Done
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:
13189 SW 169TH AVE, BEAVERTON, OR, 97007 June 19, 2018 at 12:33:51 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00405
Inspection Type: Inspector:
299 Final inspection Jeremy Burrows
Result:
PASS - CofO
Comments:
Final erosion control passed
Street tree certificate received
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
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13189 SW 169TH AVE, BEAVERTON, OR, 97007 June 13, 2018 at 11 :48:29 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00405
Inspection Type: Inspector:
199 Electrical final Chip Barnett
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13189 SW 169TH AVE, BEAVERTON, OR, 97007 June 14, 2018 at 10:03:12 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00405
Inspection Type: Inspector:
399 Plumbing final Chip Barnett
Result:
PASS
Comments:
Previous corrections have been completed
Violation Summary:
Inspector Contractor
Plumbing Permit Application
Building Fixtures
`� FOR OFFICE 1 SE ONLI'
IIICity of Tigard . * Il'eceived
- 13125 SW Hall Blvd.,Tigard,OR 97223 .� Date/By. //�t,�� Permit No/4-45-72d,?-0 etv0�
Phone: 503.718.2439 Fax: 503.598.1960 2 a liar Revie 4�� /A
e`
Inspection Line: 503.639.4175 Date/By: o�- $ -1 u `i Other Permit No.:
T I G A R D p ,i v ate Ready/fly.
Internet: www.tigard-or.gov 4 /y'j� nrs See Page 2 for
Nohfi /Method:
--
TYPE OF OR , z4t. l (i\rka';),! N ,,r ,, Supplemental Information
FEE* SCHEDULE
®New construction ❑Demolition For special information use checklist
❑Addition/alteration/replacement ❑Other: Description Qty. Ea. Total
New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
® 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath
437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
0 Master builder Each additional bath/kitchen 25.02
❑Other:
Fire sprinkleri1.,372'sq.ft.) Page 2
JOB SITE INFORMATION'AND LOCATION Site utilities: / ,7f
Job site address: 13189 SW 169th Ave. Catch basin or afea d�in
18.76
City/State/ZIP: Tigard,OR 97223 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
Water service(no.linear ft.:_) Page 2
Subdivision: I Lot no.:23
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
Dishwasher 25.02
Permit# MST201"/-OOLPIO5
Drinking fountain 25.02
Ejectors/sump 25.02
Z® PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Name:Polygon Northwest Fixture/sewer cap 25.02
Address:703 Broadway St.Suite 510 Floor drain/floor sink/hub 25.02
City/State/ZIP:Vancouver,WA 98660 Garbage disposal 25.02
Hose bib 25,02
Phone:(360)695-7700 Fax:( )
Ice maker 12.51
0. APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:Alliance Plumbing,LLC Medical gas(value:$ ) Page 2
Contact name:Gavin Thomes Primer 12.51
Address: 146 W Historic Columbia River Hwy Roof drain(commercial) 12.51
Sink/basin/lavatory 25.02
City/State/ZIP:Troutdale,OR 97060
Solar units(potable water) 62.54
Phone:(503)492-3490 I Fax: :(503)912-6438 Tub/shower/shower pan 12.51
E-mail:Gavin@AlliancePlumbing.net Urinal 25.02
• CONTRACTOR Water closet 25.02
Business name:Alliance Plumbing,LLC Water heater 37.52
Water piping/DWV 56.29
Address: 146 W Historic Columbia River Hwy
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: '/L State surcharge(12%of permit fee)
TOTAL PERMIT FEE
Print name:Gavin Thomes I Date: 1/22/18 I This 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 Industry Service Board.
1:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-46I 6T(I0/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
site utilities, .. Qty; Fee(tit) < `,tial " Square 'c it es Perniit es
Footing drain-1"100' 50.03
0 to 2,000 $121.90
37.52 2,001 to 3,600 $169.69
Footing drain-each additional 100' 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 $72.50 for the first$5,000.00 and$1.52 for
Fee(ea) Total each additional$100.00 or fraction thereof,to
Other Inspections or Fees and 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.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
each additional$100.00 or fraction thereof.
(minimum charge-1/2 hour)
Subtotal:
Other Fixtures: I 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 Replace! Plan Review for plumbing 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 engineer.
-Drivepra Thru
0 New exterior plumbing site utilities for any complex structure
Di
Cuspidor/Water-Commercialoator as defined in OAR918-780-0040.
DishwasherD
-Domestic 0 Medical gas and vacuum systems for health care facilities.
Drinking Fountain ® Any multipurpose fire sprinkler system.
Eye Wash 0 Any complex structure as defined in OAR918-780-0040.
Floor Drain/sink -2"
3„ Submit 2 sets of plans with any of the above.
-4"
Car Wash Drain Isometric or Riser Diagram
Garbage -Domestic-non-food 0 Isometric or riser diagram is required for new buildings
Disposal -Comicoodrlrela
-Commercial--food related that meet the qualifications above.
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station)
Rec.Vehicle Dump Station Comments regarding fixture work:
Shower -Gang
-Stall
Sink/Lav -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_alliancepluml521'ng_net/Documents/Documents/Fire Sprinklers/RT/City of Tigard
Permit.doc
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13189 SW 169TH AVE, BEAVERTON, OR, 97007 June 13, 2018 at 11 :48:29 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00405
Inspection Type: Inspector:
699 Mechanical final Chip Barnett
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor