Permit (83) CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2017 00309
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/22/2017
Parcel: 2S 106DA03800
Jurisdiction: Tigard
Site address: 13059 SW 169TH AVE
Subdivision: RIVER TERRACE EAST Lot: 38
Project: River Terrace East, Lot 38
Project Description: New SFA.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 2 First: 321 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 31 Bathrooms: 3 Second: 646 sf Garage: 543 sf Front: 12 Smoke Yes
Dwelling Units: 1 Third: 637 sf Right: 0 Detectors:
Total: 1604 sf Value: $211,218.93 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 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!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)
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: $23,816.31
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 95' -111-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987, ora1.800.332.2344.
Issued By: /AR `'.� . Permittee Signature: r A//l- 7/04'iTf�
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., T 3F-
.1Artr, I RECEIVED FOR OFFICE I SE O\l_i
Ci of Tigard 0ived Permit N
.74 13125rSW Hall Blvd.,Tigard,OR 97223 JUN 14 2017 Plan Review ,,,a )J'i�Y��`305
. Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Penmt`��44c c,,1 L ok
Inspection Line: 503.639.4175
r i c; i;i CITY OF TIGARD Date Ready/By. / 7uris. H See Page 2 for
Internet www.tigard-or.gov BUILDING DIVISION NotiSed/Method:/�/ �7 � �`, Supplemental Information
L x GnS i;;-,--7," "a7,77-7---77,77---77---,s . ..F ;.; -.±:.,577,,,77,-,1:7-7.77,71z7.
t t7K s @ sa> & t -77,17:::::f5-.!!, ':ms-H'''''''''''''''
t Pemifees*areaeonhvaueofhe workperformed®New construction ❑Demolition
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
Fa . ' " work indicated on this application.
,- ... 4§e tE-' w 'I�.7'-4""'J.. .,,,v.APa.-- .`,,,i• j:n.»e=..'.sae•n7- -
® 1-and 2-family dwelling 0 Commercial/mdustrial Valuation ��
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other Number of bathrooms: 3
4,,,„,,,,„„_,:„.„,.e..„.„.„;`. k-, , i t"x ty " s`i Total number of floors. Z j Got), "a J 7
Job site address: D ' New dwelling area square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: St/ square feet
Suite/bldgJapt no.: I Project name: g /e,r re rrQcc 5ast Covered porch area: R Y`/ ._
square feet C 46
Cross street/directions to job site: Deck area: Cil. square feet 3)J
Others ire area:9 3 square feet
Subdivision RivtX Terra ct.3i-- Lot no.: N 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
Q h work indicated on this application.
Valuation $
I
Existing building area: square feet
New building area: square feet
4 6 � `_ Number of stones:
1. is .� �."'. "'z—
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:
..- r , a,-_-,,-71-,1:C� ,% a'5.,;
-3 t ,a,1 ;
3, bID E# � -xs x+t :��` xa�b"� "�'�t�`,�i? 6 Y�;'�=��"'��3{h`� P ��L� '"�' � e ��[r�� � ., sz.- �- �
€ r ?kms P!,' °� 1€
= � :tip.
Business name:Polygon WLH,LLC
0� Structural plan review fee(or deposit):
Contact name:N
FLS plan review fee(if applicable):
Address:109 East 13th Street
City/State/ZIP:Vancouver WA 98660 Total fees due upon application:
Phone:(360)695-7700 I Fax::( ) Amount received
i {PAF - $ e 3v ��
E-mail:N 0 r I ^ :0.0 ��►� ',A ► , . .. �a ro ,�
I .11 -Commercial and residential prescriptive installation of
__.:;, ..,� ._ . . -: - . � u� ' ��` 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 lis.:207247
Total fee due upon application: $201.60
Authorized signature: OThis permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: J'Ch �yii4/ /'I *Fee methodology set by Tri-County Building Industry
/" 'V r V
Date:����f ! Service Board.
I:\Building\Permits\BUP-RESPermitA.pp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Application Folz OFFICE USE ONLY
City of Tigard -f Received
ge iS r Date/By: Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 '`' plan Review
r Phone: 503.718.2439 Fax: 503.598.190 , Other Permit
. ,,--.4 1,/ ,, ,o X21 1,�, Date/By:
T 1 G A R D Inspection Line: 503.639.4175 ` Date Ready/By: Juris: H See Page 2 for
Internet www.tigard-or.gov v l l 1 %.4 a 4"V,
i ll/l c i r N� Supplemental Information
Tt..:;. : y 0 OF irORK COMMER'4:::}EE* SCHEDULE PCSECiQIST
®New construction 0 Addition/alteration/replacement perf rmed.l Indicate
the*are based de to theue afthe woar
P performed.Indreafe the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
C TEGORY OF UONSTRUCTI011f „ EiVZ7AL EMS FEES'
Value:
- ` RESID EQUfPMENT;rST
Y
® 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
,IOBt.STTE INFIIRMATION ANmt C AT QN
Heating/ lfng:
- Air conditionicoong 1 46.75 46.75
Job site address: 13059 Sys pot,11 W e GI'%'1 t, Furnace 100,000 BTU(ducts/vents) 1 46.75 _
City/State/ZIP:Tigard,OR 97224 1� 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 street/directions 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
Subdivision:River Terrace East Lot no.:36 Other 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION`OF WORK '; Gas fireplace/insert 1 3339
n�i Flue vent for water heater or gas
l t W 11 "� 003O' fireplace 2332
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/ent 23.32
Other: 23.32
':21- PRORERTY OWNER ` ',''':.'.-''':'-'''''''''' ''''''.-CI:-;TENANT , Environmental exhaust and ventilation:
Name:ADVL Land Holdings,LLC Range hood/other kitchen
Address:7600 E Doubletree Ranch Road equipment 33.39
Clothes dryer exhaust t. 33.39
City/State/ZIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(602)694-4031 Fax:( ) Attic/crawlspace fans 23.32
APPLIICANT ` ❑'CO/iITA.CT;EERSOIV .. Other. 2332
Business name:William Lyon Homes,Inc.
Fuel piping:
1` $14.15 for first four,$4.03 for each additional
Contact name:K)1 C�V onex Furnace,etc. 1
Address:1
'p, 22(parA W& 3 Ste- SI 0 Gas heat pump
V Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98660 Water,heater
Phone:(360)695-7700 Fax::(360)693-4442 Fireplace 1
E-mail:A� 1 G� �/y j - Range 1
1�+ tAute, 11 c.+ I)D ri �ytYYle..S • C4:YYl Barbecue
..; 1 1 /NT�c�o
a I R , i_ Clothes dryer(gas)
Business name:Pn VVO\01\ 'yv,} ,Ul,J I-1^ Other:
V"!r 1 it
,, r :. .- _.;MECRAIVICAI>PERNIITFEES* ,,
Address: '��(,� N W V� (��� 'k� l0, Subtotal
City/State/ZIP: f.kt lSh (�GV1(1'1
kL ' Minimum permit fee($90.00)
�jp3) t'L�1 3- 51041_, Fax:(S i�) O 9-17- e Plan review(22%of permit fee)
Phone: State surcharge(12%of permit fee)
CCB lie.:') D,ni TOTAL PERMIT FEE
' 'J__11 This permit application expires if a permit is not obtained within 180
�,} days after it has been accepted as complete.
Authorized signature: M/,✓t+ * Fee methodology set by Tri-County Building Industry Service Board
Print name:MVla d/ - 71,i twp,�,J Date:
I:\Building\Penmits\MEC PermitApp 040113.doc 1111 440-4617T(11/02/COM/WEB)
1
Electrical Permit Application FOR OFFICE USE ONLY
o'l 9 i' ni7
1 k , = - Received
City of Tigard
Datum . Permit fit
, 4 13125 SW Hall Blvd.,Tigard,OB.„974,3 0 „,' r 1 c ,k r.4"..
- Plan Review
I 1 Phone: 503.7182439 Fax: 51491.81P60 l' 1 t`311 ist''' Datear RelatedPermit ik
Inspection Line: 503.639.4175 ,y-v c'i il.1;' ,;'1'i''7.31,.,) ', Ready Date/By: Mc WI See Page 2 for
TIGARD hitcrnet www.tigar.or. ,i,A ,, ,t
a- gov i:04.,)i Ls If I-'c'.; 1-1' ' - - -' NotiBed/lvfethod: supplemental Information
S:C.i.-::::_z_c;:-V-: .:- .M.--74-f,g,,, j,-V,i:AV,),.N40.,,.i..41 ;e;;11,1t--- ----.. .i',--4`•4:=Pk., :::-t -.-24-L-*' ----4,..-4:,;--4.0-,1 :11.1-41-a4,1,7-1*APW4Wa.
EI New construction 0 Addition/alteration/replacement Please cheek all that apply(submit 2 sets of plans wiltems checked):
0 Service or feeder 400 amps or more 0 Building over&so stades.
0 Demolition 0 Other: •
where the available fault current 0&minas and boatyards.
140;•F =9.Y5TAIX.N,:k4.:1-'(5'7,sVgc-1 -ogrt:t2- 14 ,.,-g.'_---in'Kt. -',-- exceeds 10,000 amps at 150 volts or I:I Floating lmildings.
El 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building loos to ground,or exceeds I4,000 El Commercial-use agricultural
amps for all other installations. , buildings.•
0 Multi-family - 0 Master builder 0 Other 0 Fire pump, °Installation of 150 ICVA or
i*Ki"-.‘•a ti.aN''a,,,:,1‘ ai 7 a-,Ar: .:Cis:4 ka a".,.170,NPA' r•'„,,,L.:: .-:i'''.:`,-,..‘ 0 ElnergeaDY system larger separately derived
Job#: Job site address j351 t,)\ . \ O-til pat, 0 Addition of new motor bad of
10014P or more. system.
0"A",en",
City/State/ZIP:Tigard,OR 97224 0 Six or more residential units. occupancy.
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: I Project name:g.iveA,..-Temall....e &Ai& ID Hazardous localisms. 0 Supply voltage for more than
0 service or feeder 600 amps or more. 6(4 volts nonliad.
Cross street/directions to job site:
Description I Q . I Each Total ''l •--
. New residential single-or multi-family dwelling unit.
SubdivisiOn: 17.4
'4-er TeTrate- E0.54- I Lott 38 Includesattached garage.
1,000 sq.11_or less I 168.54 4
Tax map/parcel#:
Ea.addl 500 sq.ft.or portion I 33.92 1
Limited energy,resideadal
75.00 2
/VI 5 T200 1 1 -. 0 03 0,( with above sq.ft.)
Limited energy,multi-family
75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
Services or feeders installation,alteration,and/or relocation
Name:AD'VL Land Holdings,LLC 200 amps or less 100.70 2
Address:7600 E Doubletree Ranch Road 201 amps to 400 amps 133.56 2
401 amps to 600 amps 20034 2
City/State/ZIP:Scottsdale,AZ 85258 601 amps to 1,000 amps
301.04 2
Phone:(602)694-4031 .I Fax:( ) Over 1,000 amps or volts 55226 2
Temporary services or feeders installation,alteration,and/or
Email: -. relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less
59.36 1
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: Date: • 401 amps to 599 amps 16854 2
,,E,-.0,A44•„,-„1,4,',-;„[..1,1,)-psol...iW,,,,Ktv,54.7,,,,„4kpi.,-:f,:e7;11T,V,T)..,ji;,K6--,71.,..11?il:*.11,,,,,,:,- 1,.-A,,),,,,, AB.r;nd;Viet 7 nert;alteration,or extension,per panel
Business name:William Lyon Homes,Inc. abovebranserver. a
ortfeeder fee,
7.42 2
Contact name: hilrhok,Thorpt B.Fee for branch circuits-without
senice or fseder fee,first
Address: 1 03 RTOOLCIAlal St Sil. k^t VD branch circuit 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
dwelling,service and/or feeder
Email;; l fe.'• I - 4., 0 p. ,...e A,IMP _. 11111. Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
Business name:Garner Electric Washington,LLC ' Sign or outline lighting 67.84 2
.1- Signal circuit(s)or limited-energy
Address:t L4 D? \icaktu c)\-le.....\,,1\10, s LI3A-P, \lap panel,alteration,or extension. D See Page 2
Each additional inspection over allowable in ally of the above2
City/State/ZIP:'PIA k fall,1 4 p 1 VYitlr ges--) I
Additional inspection(I hr min) 66.25/hr
Phone:(253)320-1657 1 Fax:( ) Investigation(1 hr min) 90.00/hr
Industrial plant(/hr min) • 78.18/hr
Email:bdaniels@gwensa.com
Inspections for which no fee is
CCB Lic.: C1158 Electrical Lic.: 208174J Suprv.Lie.: 4496S specifically listed 14 in min) 90.00/hr
...':•---:s7,")'-t:':i-44 ia E)1.:1-.0.r_ORAVATsifq1V;;t:':6i ii:Vi- -‘''Vi''''
Suprv.Electrician signature,required:•Stal=_Oheikt-----;,-, . Subtotal:
Print name: Joan P Albert •• Date: 4/26/2016 0 Plan Review Req_uir.ed(25%of permit fee):
—-
State surcharge(12%of permit fee):
•
4..."- -------2=----..z.-----_-
'
AuthorizedTOTAL PERMIT'FEE:
..:-.. signature: - ......--
This permit application expires Ifs permitis not obtained within 180
!••
Print name: Bill Daniels Date: 4126/2016 days after It has been accepted as complete.
••••••i.:•'- ---- * Number of inspections allowed per permit
-•-:•;:`1:1Bulltring\PermItsNELC PennhApp FLA EAU=Rev 06/17/2015 440-4615T(11/05/COMME13
T.i.;01....
I
,
Plumbing Permit Application
Building Fixtures OCT 20 /J1 i l OR OH•Jt-F t SL tr,Pt
City of Tigard
i ' :+ y
Rey.
Pemt No.:
Ili,. 13125 SW Hall Blvd.,Tigard,OR Y Man Review
Phone: 503.7182439 FaX 50 � t t,,t,xir +` DatoBy: Other Permit No.:
inspection Line: 503.639.4175
Tt[r ` '!
Date Ready/13r. rata: 53 See Page 2 for
Internet: www.tngard-or:gov Notified/method: supplementat Information
. T. .. ' i"tvetz OF WORK: -
'_FEE* EtCRUM:1Z: -
®New construction 0 Demolition For special btforntarion use checklist. -
Description ] Qty. ( Ea. 1 Toed
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY:OF CONSTRUCTION....'- - SFR(1)bath 312.70 i
0 I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 .
0 Accessory building 0 Multi-family
SFR(3)bath ' 500.32 =
Each additional bath/kitchen 25.02
0 Master builder 0 Other: Fire sprinkler(
'C_,'''''''+N:- :',1°11-, 1NFORMA"ITON AND LOCATION • Site utilities:
s ft.) Page 2
A D
Job site address: 1305-1 S� I l 0°041 V Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/StatePLtP:Tigard,OR 97224 Footing drain(no.linear ft.:_) Page 2
Suite/bidg./apt.no.: I Project name: rDN ' ��Ya r� FS-�-
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 it: ) Page 2 -
Subdivision: (\"Ve1r T Ce_ -I- I Lot no::2)6 Fixture or item:
Tax map/parcel no.: v Backflow pnwenter 31.27
• .
: AESCRIPTION OF WORT_ ve
B ter vat I2 51
Clothes her 25.02
M ST LU t 1 " OD 30 Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
`®.1 f°II OWNER,::: j 0`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 _-
1T. , ,. ,;kms 2 1tSQf 11' . . Interceptor/p:asetrap 25.02
Business name:William Lyon Homes,Inc Medical gas(value:$ ) Page 2
Contact rattle: Primer 12.51
G i e' Roof drain(commercial) 12.51
Address:163 tint,f' ( l 5k SAX,�.�. SIO Sink/basin/lavatory 25.02
City/State/ZIP:Vancouver,WA 98660 �j Solar units(potable water) 62.54
Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51
E-mail: kl Tel O . - h p �� Urinal
Telt �.•W Water clot
2502
25.02
_ .. Watarheater 37.52
Business name:Alliance Plumbing LLC 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 Lic»184601 Plumbing Lie.no.:PB732
Plan review (25%of permit fee)
State surcharge(12%of permit fee) ,
Authorized signature: TOTAL PERMIT FEE
Print name:Robert Dishman iiiiii
(ate:5i33/2816 This petmrtappiicadoa expinn it*permit le not obtained within tau days
litter Minas been accepted as completes
•Fee methodology set by Tri-County Building Industry Service Board.
1.1Butit ugTermits\PL 1•PeermitApp.doc IOIDI/09 44O.4616T(iotO2/COM/WEB)
s
City of Tigard
IIq COMMUNITY DEVELOPMENT DEPARTMENT
0
T1cARD Building Permit Review - Residential
Building Permit #: rj4 s.7-1...(>/ CO 30 9
Site Address: mos-c) a) /( z/7 -e
Project Name: ,/ "7 -cag7L- Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review / `/ oo
Proposal: �. -S'/Yt,al — 7 ji c4�1�d�(J tt`7--
I
-
Ierify site address/suite# exists and active in permit s stem.
vi
River Terrace Neighborhood: ❑ No K Yes,See River Terrace Review Addendum Attached
Sine Plan Elements:
01. ree(3)copies of site plan j Ii sting structures on site
e plan must be on 8-1/2"x 11"or 11 x 17"paper M Footprint of new structure(including decks)with finished
11 awn to scale(standard architect or engineer scale) oor elevations
V► orth arrow I .tility locations&easements(required for new and additions)
/A S1Y S S . walk/driveway approach
.plicant information(name and phone number) EJ moo cation of wells/septic systems
.t dimensions and building setback dimensions 0 t''I'sting trees to be retained with drip line,and tree
*11,►uare footage of buildings to be demolished
otection measures
ri Lot area,building coverage area,percentage of coverage and V .eet tree size,type and location
iinpervious area(applicable if R-7,R-12,R-25&R-40) ff,Street names
Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? s ❑No
4 foot differential) If es,is a storm water .uality facility shown? IVA es ❑No
Clean Water Services—Service Provider Lett (lot platted prior to 9/10/1995): I ems` 1 4 i / Gly
Pequired: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No
ublic Facilitie Improvement (PFI)Permit: /Yes
PF/Q0/ — xrequired: [ yes,applicant was notified ❑ NoApplied For: CINo,stop intake
g(11.
and Use Case#: Phe,26,7 - o 4 Rli, _01t-40 so., PJ�P_�Or s= do 00
oning. P---9- /p K V� - /
VA •e•uired Setbacks: Front ,Q Rear 6— Side treet Side 4-Garage Or
• . andscape Requirement: 0
Lot Coverage Maximum: 7-
U1 •,,
.01 Height: Maximum Height Actual Height
\sual Clearance
10 t-nsitive Lands: CI Yes No Type
Pt Urban Forestry Plan
❑ Conditions "Met"��prior to issuan e of buil ng permit j
Notes: 0jYt,�'/73t r1,c S7... // p� '7p,,,i-- ; c4 c Q
Approved By Planning: ..�.._. . —'' any Date: fed
do. / I 1--
Revisions
-Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved El Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_RES_061417.docx
Building Permit Submittal
Original Submittal Date: 3(���12
Site Plans: #
Building Plans: #
Building Permit#: nter building permit#above.
Workflow Routing: Planning Engineering C . Permit Coordinator Building
Workflow Sign-off: 0Sign-off for Planning(include notes from planning review)
Route Application Documents: Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
-0 Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
. /
By Permit Technician: Date: _ill_9 /
__Ar-
Engineering Review L�
,Slope at building pad: ` b
❑ 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 No
Assess Water Quantity Fee in-lieu: ❑ Yes fZ No
LIDA Facility on lot: ❑ Yes /7 No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: Al kr-2, ' t Date: 8j16 i7
Revisions (after Building Submittal only) Reviewer ate
Revision 1: ❑ Approved El Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: 0 Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions"Met"prior to issuance of building permit
i.approved,NOT Released: C i o —,. ate: 7'/4.//7
.
Notes. CMGt til Yvt S YY1L4' 11 1?A 117 At–
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'es ❑ N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: Yes ❑ N/A
LIDA ❑ Yes "jN/A
OK to Issue Permit /� �e' I
Approved by Permit Coordinator: ft' Date: II'20I(1
I:\Building\Forms\BldgPermitRvw_RES_061417.docx
r
City of Tigard
1111 II COMMUNITY DEVELOPMENT DEPARTMENT
I
T 1 c A RD River Terrace Building Permit Review Addendum
Building Permit #:
Site Address: ( ell c ' ij A /1v-e_
Project Name: " -
` e ,2 Ce ' Lot #: j ij
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan Distrt Design Standards (18.660.070.1.):
Is the project subject to the plan district design standards? IV Yes El 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 Gabled dorm
ft. deep min. 2ft., 5 ft.wide min. 2 ft., 6ft.wide
❑ ❑ El ❑
2. Eyes on the street: a minimum of 12%o each,street facing facade must include windows or entrance doors.
Percentage Shown: /' . L/v
3. E rances:At least one entrance must meet both of the folio g standards:
Max. 8 ft. setback from longest street cing 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: ❑ 25 sq.ft. min.
❑ One street facing entry ❑ 12 ft. max.roof above floor of porch
❑ 5 ft. depth min. ❑ 30%min. porch roof coverage
4. Detailed Design:All buildings shall include a min. of five of the following elements on all street-facing facades:
❑ Covered porch min. 5 ft.wide x 5 ft. deep ❑ ecessed entry area min. 5 ft.wide x 2 ft. deep
❑ all offset min. 16 inches I?] Dormer min.4 ft.wide
V Roof eave min. 12 inch projection ❑ 'oof offset min. of 2 ft.
❑ Roof shingles either tile or wood In Gable,hip or gambrel roof design
❑ r oof pitch oriented south min. 500 sq. ft. horizontal lap siding min. 3-7 inches wide
F Accent siding min.40%of street facade Window trim min. 2 1/2"wide by 5/8" deep
El 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 clo er to front or side lot line,than longest street-facing wall. ❑ Yes No. If No (Check one):
❑ ay 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 e garage that faces the street with a min. area of 12 sq.ft.
Wi : (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: — i„,;> Date: D/
I:\Building\Forms\B1dgPecmitRvw_RES_RT_062216.docx
a
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
N .
1, Transmittal Letter
T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Tom H. DATRECOVER
DEPT: BUILDING DIVISION
AUG 14 2017
FROM: Angela Grajewski CITY OFTIGARD
COMPANY: Polygon Northwest
DIVISIO'
PHONE: 971-212-2144 By.
RE: 13093,13085,13073,13067,13059 SW 169th Ave MST2017-00304 13093 SW 169TH, LOT 34
(Site Address) MST2017-00305 13085 SW 169T", LOT 35
River Terrace East Lot 34-38 MST2017-00307 13073 SW 169T", LOT 36
(Project name or subdivision name and lot number) 1 MST2017 00308 13067 SW 169TH, LOT 37
MST2017-00309 13059 SW 169T", LOT 38
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 US ONLY
Routed to Perm)
echnician: D. -: J)-' /6 -- I-771 tials:
Fees Du Yes ❑No Fee D- 'ption: Amoss' .0ue:
3 )- p < ' ;mow $ j
$
$
$
Special
Instructions:
Reprint Permit(per PE): Yes ❑No n Done
Applicant Notified: Date: Initials:
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
Plumbing Permit Application
Site Utilities FOR OFFICE USE ONLY
City of Tigard 'LI( , Received (74;40/? ��(
111 - Date/By: `�/,// Permit No/� ti�J
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review r
Phone: 503.718.2439 Fax: 503.598.196p Date/By. 1 -C�nj t/o 1.i 411 Other Permit No.:
TI G A R D Inspection Line: 503.639.4175 3 Date Ready/By: Juris: See Page 2 for
Internet: www.tigard-or.gov Notified/Method Supplemental Information
TYPE OF WORK..- FEE* SCHEDULE
®New construction 0 Demolition For special information use checklist
Description Qty. Ea. I Total
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
❑ 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
❑Accessory building ® Multi-family SFR(3)bath 500.32
❑ Master builderEach additional bath/kitchen 25.02
0 Other: Fire sprinkler(.11t372-sq.ft.) i(ePO‘V Page 2
JOB'SITE INFORMATION AND.LOCATION Site utilities:
Job site address: 13059 SW 169" Ave Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name:River Terrace East 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.:38 Fixture or item:
Tax map/parcel no.: Backflow preventer 3127
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Multipurpose Fire Sprinkler System
Dishwasher 25.02
Permit#
Drinking fountain 25.02
Ejectors/sump 25.02
2 PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Name:Polygon Northwest Fixture/sewer cap 25.02
Address:
Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
0 APPLICANT 0 CONTACT i'ERSUN Interceptor/grease trap 25.02
Business name:Alliance Plumbing,LLC Medical gas(value:$ ) Page 2
Contact name:Robert Dishman
Primer 12.51
Roof drain(commercial) 12.51
Address: 146 W Historic Columbia River Hwy Sink/basin/lavatory 25.02
City/State/ZIP:Troutdale,OR 97060 Solar units(potable water) 62.54
Phone:(503)492-3490 Fax: :(503)912-6438 Tub/shower/shower pan 12.51
E-mail:robert.dishmanallianceplumbing.net Urinal 25.02
@
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name:Alliance Plumbing,LLC 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 Lic.: 184601 Plumbing Lic.no.:PB732 Plan review (25%of permit fee)
/ State surcharge(12%of permit fee)
Authorized signature: L-) TOTAL PERMIT FEE
Print name:Gavin Thomes Date: 12/6/2017 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-Permit App.doc 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:
SiteUtilities' kItY. Fee(ea) Total . St'care Footage: Permit.Fee:
Footing drain-1s'100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
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' 37.52Permit Fee:
�?aluation:
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
Other Inspections Or Fees
Qty. Fee fed) Total each additional$100.00 or fraction thereof,to
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:
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 pp y.
❑ Any new commercial building with water service 2"and
-Jacuzzi/Whirlpool
Car Wash -Each Stall greater,except systems designed and stamped by licensed
-Drive Thru engineer.
Cuspidor/Water Aspirator ❑ New exterior plumbing site utilities for any complex structure
Dishwasher -Commercial as defined in OAR918-780-0040.
-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
Disposal -Domestic-food related 0 Isometric or riser diagram is required for new buildings
-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/L.av -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
Water Closet-Toilet increase of sewer EDUs,a'sewer permit will be issued and
Urinal fees assessed for the sewer increase must be paid before the
https://allianceplumbing-my.sharepoint.com/personal/gavin_allianceplum12ng_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:
13059 SW 169TH AVE, BEAVERTON, OR, 97007 May 15, 2018 at 9:21 :44 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00309
Inspection Type: Inspector:
299 Final inspection Allyson Armstrong
Result:
PASS - CofO
Comments:
Collected
High efficiency lighting form
Moisture content acknowledgement form
Moisture barrier acknowledgement form
Air leakage test report
Left C of 0 on the counter
Violation Summary:
Inspector Contractor