Permit (103) CITY OF TIGARD MASTER PERMIT
111
I COMMUNITY DEVELOPMENT Permit#: MST2017-00464
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/10/2018
T I G A I=.I'. 9 Parcel: 2S106DA01400
Jurisdiction: Tigard
Site address: 13243 SW 169TH AVE
Subdivision: RIVER TERRACE EAST Lot: 14
Project: River Terrace East, Lot 14
Project Description: New SFA.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 2 First: 101 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 31 Bathrooms: 3 Second: 646 sf Garage: 543 sf Front: 8 Smoke
Dwelling Units: 1 Third: 633 sf Right: 0
Detectors: Yes
Total: 1380 sf Value: $187,008.87 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
0
Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0
Bckfiw 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 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
Fum>=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:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SFA VB R-3 1380
Owner: Contractor:
ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
BY FORSUM,MICHAEL 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175
7600 E DOUBLETREE RANCH RD VANCOUVER,WA 98660
STE 1
SCOTTSDALE,AZ 85258
PHONE: 602-694-4031 PHONE: 360-695-7700
FAX:
Total Fees: $24,462.18
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain
a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: �� '2� y/%��"""'v�� Permittee Signature: )C �j ,i Ca �
Call 503.639.4175 by 7:00 a.m.for the next available inspection date
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Bnifding Permit Application L07 / v •
R 4entl(al 7 r L ` . i F FOR OFFICE CSE ONLY
City of Tigard 2 a Datei:v l/ 2) /7 /� Permit N° its//K//? !G y
R 13125 SW Hall Blvd.,Tigard,OR 972234 G d 2 �7 pian Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: S OtherPermitli�..a 3 ?
TIC. R!� Inspection Line: 503.639.417$; C y� �"' ,r GAR s"i D Date Ready/By: ,, Juris: H See Page 2 for
Internet: www.tigard-or.gov A BU;LDeNGDIV;3 j' Notified/Method: I-/d 1' Supplemental Information
®New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
r5lz :-,
x work indicated on this appli
cation.� i t �F __ �, ...a ,a„ wrt., Valuation:1-and 2-family dwelling ❑Commercial/industrial $
El Accessory building Multi-family Number of bedrooms: '� 1 g7/ 0
❑Master builder ❑Other: Number of bathrooms���3 1
� �l �.- k Total number of floors: N51,, 3 oL
Job site address: 3 Zi-i SW Itiocittn New dwelling area: �r� square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: 5 / Jqu� square feet 633
Suite/bldg./apt.no.: I Project name:River Terrace East y.$ ..Covered porch area: `/ square feet Cq 6
Cross street/directions to job site: Deck area: 9 #square feet 0 1
O`l Gk c.,3 Vim/
Other structure area: • square feet
Subdivision:River Terrace East I Lot no.:j y 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
Cllr .iSiteS i work indicated on this application.
Valuation: $
Existing building area square feet
New building area: square feet
09y � f ° t R" i.Z rf '' Number of stories:, .,
Name:ADVL Land Holdings,LLC Type of construction:
Address:7600 E Doubletree Ranch Road Occupancy groups:
City/State/ZIP:Scottsdale,AZ 85258 Existing:
Phone:(602)694-4031 Fax:( ) New:
f`<4 a;rTIPA s-z.3., ,.... : ,. Niglarlii
fie.'"�t�
Business name:Polygon WLH,LLC ! "`" Il ,.�°' ` - kI
Structural plan review fee(or deposit):
Contact name:Nichole Thorpe
FLS plan review fee(if applicable):
Address::703 fadiIJ( St. 5u Aja. S'p
Total fees due upon application:
City/State/ZIP:Vancouver WA 9866
Amount received:
Phone:(360)695-7700 Fax::( )
E-mail:Nichole Thorpe *4,44,1=4,-,%yt . ,, ,*: 9 ��t w44,.
... ,,,, •, 4,t,.. iv v Commercial and residential prescriptive installation of
roof-top mounted Photovoltaic Solar Panel System.
Business name: Submit two(2)sets of roof plan with connection details
,dA 1 L I e 'o elr1 and fire department access,along with the 2010 Oregon
Address: �,03 gr w S� �SvtJ.-k. kt) Solar Installation Specialty Code checklist.
City/State/ZIP:Vancouver WA 9866 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60
CCB lic.:207247
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Nichole Thorpe Date:06/16/2017 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 4404613T(11/02/COM/WEB)
i' r,
, 0 V MFS .
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard
r`\l , 2 2017 Received
Ili g M 13125 SW Hall Blvd.,Tigard,OR 97223. . -:; Date/By. ^•'
Phone: 503.718.2439 Fax 503.5981960' , D an e" Other Permit:
Inspection Line: 503.639.4175 i L.::,' Y
T I G A R D Date lieady/By ME H See Page 2 for
Internet www.tigard-or.gov Notified/Method: Supplemental Information
�.t;``iM.L1 F' � .;-•�_; - ;, •:72Pir, iii-fi�?��r:'.01 • :
. . .. ,
, ..
•
Electrical Permit Application , , 'All(, - FOR OFFICE USE ONLY
City of Tigard Received
IreSINEINaiNglil
II 13125 SW Flail Blvd.,Tigard,OR 97211, 'e *I' ' - pitattiew
' I Phonm 503.718.2439 Fax503.598.1960 •"`• ' natelay: Related Para&ft:
Inspection Line: 503.639.4175 Ready Date/By
T : kris: El See Page 2 for
GARP- Internet•www.figard-or.gov NottfredfMethod: Supplemental Information
'5%.:--7'---.7-f---'1;-:-.--:.t'''''-';.;'''-'. --..-''''''-7-55.---:'-'4 "-j-ITO n't.W7,•\",tlal:=Is.:-*,-;-: =••:`3',:7.4-i.';'4-,-.''I.V.4'',,,I. E-1.?*..';',7-=':-. ?•..•LAt•-- -.,.---,: .:•;:Z'ATIVirqi-'„A*,:ftr,,34..i.f.t4,T;--,,iti*,.,,•---
El New construction 0 Addition/alteration/replacement Please-Cheek all dist apply(subMitl sets of plans wiriterns checked):
D Servios or feeder 400 amps or more 0 Building over three stecies.
0 Demolition 0 Other: ' where the available fault current 0 laarinas and boatyards.
'4.•-;:''4';',4"-q'i--72i.kiWYEtifil.KFIMft,416..131-':,c.:Nclikalr--71. -_•;_-,•. .-`,7„-_,,-;.-t,:: , exceeds mono amps at 150 volts or 0 Ploadog buildings.
,...-and 2-family dwelling 0 CommercialiiiithiSirial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
saps for all other installations. . buildings.•
-AltIvhdli-family -- 0 Master builder 0 Other: 0Fire pump. 0 Installation of 150 KVA of
"t•licr- f-A,;.•-;c:4;•,1'71'..- -T0_, `-i9Z'it Q-A,ILO.iV"41_00 424K,M=16=00 rd EA=Y,sY s te z a am.t 0 r load d larger separately derived
system.
Job#: Job site addre.7 1 32;43 ,.14 kA.portiq pae. loom,or more. 0"A", "I-2",'1-3",
El Sbc or more residential units. occupancy.
City/State/ZIP:Tigard,OR 97224
0 Health-care!Whiles. 0 Recreational vehicle parks.
Suite/bldg./apt.it: 1 Project name:gi\lee-7 6e earri_ °Hazardous tocafinas. 0 Supply voltage for more than
E3 Service or foeder 600 amps ormolu. 600 wee pommel
Cross street/directions to job site: —e-f-;iF.''. e':2''-'-- 0.-Y: 11-1,V1`.----.-'1.' ,115. •:. ;„1-1'.
Description Qtr. i Ead I Total •_
• New residential single-or multi-family dwelling unit.
Subdivision: r--,c". 4t Terra te. -Eas+- 1 Lot# —
/ILIncludes attached garage.
• 1,000 eq.ft_or less i 168.54 4
Tax map/parcel#:
Ea.add`1500 sq.ft.or portion I 33.92. 1
="----A'-',1"-- W'i-74':17r-- -ft-'21-151!;•-44.-. q ii.`- 'tIr-AWN21-1'-%4X-'7ial.'*-V- -7:.' .`,--:-A-•'•;Wg:Pr, Limited anew,residential
75.00 2
(with above sq.ft)
•
Limited energy,multi-family
residential(with above sq.ft) 75.00 2
Renewable Energy 0 See Page 2
_-_:1,-.-,..-4_!,ip--if-fi-1174,`*.K911?- 31',E.SiliTi:.'41-:"•-' ,..;=',, -. .-.Z .-i:;..t:•W;1120-',Nle-:=--7:-=7:',,,,'"Zi.:Z Services or feeders installatton,alteration,and/or relocation _
Name:ADVL Land Holdings,LLC 200 amps or less 100,70 2
Address:7600 B Doubletree Ranch Road 201 amps to 401)amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Scottsdale,AZ 85258
601 amps to 1,000 amps
301.04 2
Phone:(602)694-4031 1 Fax( ) Over 1,000 amps or volts 552.26 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 I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701, ' 201 amps to 40D amps 125.08 2
Owner signature: Date: • 401 amps to 599 amps 168.54 2
''..L.f.77-x.,- -_-_, -7.•-,-:"Zi,f1V;ii-5'4,7/..,,:toT.-- -ri.,-7-S--..- *i-T.:1-,';',7,',:7--.YETTANN:ky,-(3trols:e03:,._,,,-;crit_-:,,, AB.7:1;.cterircults—rie7,alteration,or extension,per panel
Bminegs name:William Lyon Homes,Inc. above service or feeder fee,
742 2
each branch circuit
Contact name: ki i ch Dle,71,)0 riit B.Fee for brandi circuits valund
service or feeder fee,first
Address: 103 i3i•Oar,lbo aAn St St6A-t, M branch ohm* 56.18 2
City/State/ZIP:Vancouver,WA 98660 J Each add'l branch circuit 7.42 2
• Miscellaneous(service or feeder not included)
Phone:(360)695-7700 • .•' I Fax :(360)693-4442 Each mamrfactured or modular
dwelling,service amVorlheder 67.84 2
Pmail;; D. • 14!dat„._ 0 go ,i •n AL_ e . lit Reconnect only 67.84 2
7-Z4•:---fit.ir:::.-.----'- '----, '--;--':.:;';:P-:=M:-;ll' ;<;,-?-r).-r-'t-:-4.--T..;:n:'T.e:1'-;- ---7,----.-''e. f.a':".:,,. .-'!: Pump or inigation circle 67.84 2
Business name:Garner Electric Washington,LLC ' Sign or outline lighting 67.84 2
J....
Signal circuit(s)or limited-energy
.Address:k 4 DI. v sa.x.‘" it.,...4.e,‘„skQ4 d.A.e kttp panel,alteration,or toneaslim. El See Page 2 2
Each additional inspection over allowable in any of the above
City/State.IZIP: pck uo ,i ,1 10i I
1 IVIst. 9es) I
'1 L'Le'
Additional inspection(I In min) 6625/hr
I
Phone:(253)320-1657 I Fax:( ) Investigation(1 hr min) 90.00/hr
Industrial plant 0 hr min) . 78.18/lir
P•Trmil'bdaniels®gwensa.com
Inspections for which no fee is
COB Lic.: C11.58 Electrical Lie.: 208174 Suprv.Lk,: 4496S specifically listed A hrtnin 90.00/hr
ii-i- ,,11'1, „,20{-!:.
Suprv.Electrician signatint,required:=---P----'--- •--- I--- :—.
4— . : _.,•----.-----.,---, •••2:st=...._.•,,--.— ---,,.--:--'4,,,-•-• - -•-•,„,-.,,---"-,•-•, --•
Subtotal:
Print mune: Jean P Albert •. - jDate: 4/26/2016 0 Plan Review Required(2.5%of permit fee):
State surcharge(12%of permit fee):
4:---- __ • TOTAL PERMIT FEB:':::::•, Authorized signature: c- ..--------
This permit applica4on expires We par:slims not obtained within 180
Print name: Bill Daniels Date: 4/26/2016 days after lama been accepted=complete.
* Thimberofinspeotions allowed per permit
Aii•I•IPBariiestPermioriELC_Persoitispp ELI.EREtior Ro.,05117/2015 440-46151(11/0S/COMTWEB
tiS.
Plumbing Permit Application milimmilimmol
Building Fixtures ?017
City of Tigard Penni. it He.'47 /7170/4
/
11' 13125 SW Hall Blvd.,Tigard,Olt 972 3 Pian Review
` Phone: 503.715.2439 Fax 503398.1960 may. No.:
i C:;n Inspection Line: 503.639.4175 pate Ready/Br Judy 0 See Page 2 for
Internet www.tigatd-or,gov ••L�.� Notifie twd: Suprplemeaau,n
t Information
: _; ;£yam.2''''r.,::-'1:11-... O1 WO - �";T
d,-' ' _ - - _ -_;h ` A.1 '�4 ..:1:3 ic. f: LrG: .. ,
-.s; .n_r. :.1..y.�;.e-..^_'g in ."...:... a :+: d.Sw '."-t_'.• :- - ._- '-v n :, t -,4,. a ,..
i New construction ❑Demolition For spedsl Infornrallen use checklist
.Description ( Qty. ( Ea. I Total _
❑Addition/eiteratlon/replaeernet t ; 0 Other: New 1-2-family dwellings(includes I00 9.for each utdib,connection)
• ,,:s;::,:::•-- :„ ;r..�/[ 01#iF_=c7ir1yi k • V.�:-'71 : T •• °.-
. SFR(1)bath 312.70 '
�••:. •..41+..,:;„-,A-1..._v�.. •,-moi•.
1-and 2-family dwelling ❑Commercial mdus ial SFR batik 437,78 '
❑Accessory building } Multi-family SFR(3)bath 4 500.32
Each additional bath/kitchen 25,02
Q Master builder-' ❑Other. Fire sprinkler{ s .R.). Page 2
.. . ' -$ 401. YI I 4.130'P 10-CI<. 0i• aQ 1 ~.._- __ Site utilities' t
Job site address: 13Z43' SUQ I toci'�'L (.� Catch basin or area drain , 18.76 .
L 1 Drywell,leach line,or trench drain 18,76 '
City/StatelZtP Tigard,OR 97224 • ` Footing drain(no.linear It:_) Page 2
Suite/bldg./apt no.: I Project name: Ia VV r Te,r i(e. 'T Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76; .
Rain drain connector 6 18.76
Sanitary sewer(no.linear ft:._ . Page 2
• Storm sewer(no.linear it:_) Page 2
1� Lot no., Water service(no.linear ft.: ) Page 2:
SubdivIsiom
RAW r eAr\r L' & T jL/ _ ' Fixture•oriteun f
Tax map/parcel no.: Backflow preventer 1 i 3127 .
�._" ' :°;;p .-' y Backwater valve 12.51
.,t-}.-•!-.7-:',.-
T„•,,<;.".���:,.�:d. �D1�BC1�tIR'I'tQISF�I�WO�tIC'a.:. . .. .. _ �
Clothes washer 25.02
Dishwasher : 25.02
Drinking fountain 25.02
Ejectors/sump ' 25.02
`. 7t :;: fQ9 S-,, - ,'':' ltrfia*: :' : _ Expansion tank 12.51
Name:ADPL Land Holdings;LLC Fiatlulsowsr 25.02.
Floor drain/floor sink/hub 25.02
Address:7600 E Doubletree Reach Road
Garbage disposal 25.02
City/Statc Z1P:Scottsdale,AZ 85258 Hose bib ' 25.02
Phone:(602)694-4031 Fax:( ) Ice maker 12.51
. ,7;:1. -, x' 1.-..--1'.'-. ,.� Interceptor/grease trap 25.02
Business name:William Lyon Homes,Inc Medical gas(value:S ) Page 2
Primer -• 12.51 '
Contact name; 1 C..'f 1 lie. Roof drain(commercial) 12.51
Address:1 b3 P A9�� � Sink/basin/lavatory 25.02
j..e.. c) .0
2
City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54
Phone:(360)695-7700 ' Fax::(360)693-4442 Tub/shower/showerpan 12.51
E-r1a1:'1 i 1 1 - 11 At .7l hj�(�p(' 1,M Urinal = 25.42
- , `. -.--.z -k:'. : - ��, .''"`" . A)01• Water closet 25,02
:M):37 tx :"i +2'';, M.s1`o,�;'r,4 ?e quit „ • a:,;r•
' Water;heater • 37.52
Business name:Alliance Plumbing LLC Qy p p r 5629
Address:146 W Historic Columbia River Hwy Other, 25.02
City/State/ZIP:Troutdale,OR 97860 Subtotal
Phone:(503)492.3499 Fax:(503)912-6438 Minimum permit fee: 57230
CCBUG.:ie 184501 Plumbing Lac,no.:P8732 Plan review(25%,ofpermit fee)
‘,/i/v.1.... ofpe
Authorized sagnasignature: State stlrciterge(12°1. permit fee)
TOTAL.PERMIT FEE 1
Print name:Robert•Disbman Date:5/2312016 This pennitapdieatien expires Ka permit is naS obtained within tee data
air Rion been accepted asample*.
*Fee reeihcdolegy sat by id-County Bader&Industry Service Board
tmulIdi iter .L.Psneir+ip,dae 10101a9 4e046wTOO OMJ a)
City of Tigard
N COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review — Residential
Building Permit #: Of.5T o/7 -001/6'/
Site Address: /,__,'' z-i2 /6,94A AL
Project Name: VPr 73 Lot #: /I/
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: AiilS'/ k---gr/b---- C'heae l /,ti —
54erify site address/suite#exists and active in permit stem.
River Terrace Neighborhood: ❑ No All Yes,See River Terrace Review Addendum Attached
Sean Elements:
ree(3)copies of site plan la- 'sting structures on site
11;11e
awn to scale(standard architect or engineer scale)
plan must be on 8-1/2"x 11"or 11 x 17"paper &Footprint of new structure(including decks)with finished
loor elevations
'ILJOrth arrow WJ tility locations&easements(required for new and additions)
'V to address,project or subdivision name and lot number ILISidewalk/driveway approach
Aa pplicant information(name and phone number) \O:: ation of wells/septic systems
111
it dimensions and building setback dimensions p r i'sting trees to be retained with drip line,and tree
111:�uare footage of buildings to be demolished , otection measures
TI Lot area,building coverage area,percentage of coverage and Y,$treet 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? LJ Yes ❑1N/
4 foot differential) If yes,is a storm water quality facility shown? i ❑Y s JWNo
\lean Water Services—Service Provider Lett r (lot platted prior to 9/10/1995): czyral/eA-- / '/A-`
equtred: ❑ Yes,applicant was notified `No Received: ❑ Yes ❑ No
[1Q Public Facili�ti Improvement(PFI) Permit: PPJ .C)/(e—c'te
equired: R Yes,applicant was notified No Applied For: 'll/YesCI No,stop intake
LCI
Use Case#: �,1,� l STOO/
VJ Zoning: k- �t, Pi
40s
'Required Setbacks: Front Rear ,5— Side 0 Street Side 0Garage �"�
0 Landscape Requirement: ..2 0
Tr/Lot Coverage Maximum: -"ere ,
Building Height: Maximum Height 0.1D1" Actual Height -
taTisual Clearance
01 ensitive Lands: ❑ Yes 'ii No Type
L Urban Forestry Plan
❑ Conditiouf "Mgt"prior to issua e of building permit
Notes: aP! 1 11 t4 ,c7A, o 4 /9-10/2,,f/71- /-cti, C'.
Approved By Planning: �,�� Date: AM
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 "
Original Submittal Date: 7/.2-2—/i2
Site Plans: #
Building Plans: #
3
Building Permit#: nter building permit#above.
Workflow Routing: Planning "AT
Engineering Permit Coordinator Building
Workflow Sign-off: 1
e Sign-off for Tanning(include notes from planning review)
Route Application Documents: pr Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
2 Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes: _
By Permit Technician: i .44...i,L�i...,....—di- Date: ph?1/;
Engineering�� Review
[I Slope at building pad: a
Q---Conditions "Met"prior to issuance of building permit
2"--Easements (encroachments)per engineering conditions of approval and plat
VI-Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes L2' o
Assess Water Quantity Fee in-lieu: ❑ Yes [(No
LIDA Facility on lot: ❑ Yes I2t No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: A. f,y,A- Date: I 2,-r--1/.1 7
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: 0 Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
7 DC Fees Entered: Wash Co Trans Dev Tax: : - es ❑ N/A
Tigard Trans SDC: ! Yes ❑ N/A
Parks SDC: (P,Yes ❑ N/A
LIDA ❑ Yes 'tk'N/A
?CPOK to Issue Permit
Approved by Permit Coordinator: i/ / Date: 12 b l'i
I:\Building\Forms\BldgPermitRvw_RES_061417.docx
City of Tigard
N COMMUNITY DEVELOPMENT DEPARTMENT
ill 111
T 1 G A R D River Terrace Building Permit Review Addendum
Building Permit #:
Site Address: 9 /A r
Project Name: ell/er-- Lot #: )Z-/
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan Dist*t Design Standards (18.660.070.1.):
Is the project subject to the plan district design standards? 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.
Porch min. 5 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
12
❑ CICI ❑
2. Eyes on the street: a minimumof 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: 7.CvA
3. ntrances:At least one entrance must meet both of the foll • g standards:
v7
Max. 8 ft. setback from lon t street- facing wall Parallel to street,angle no more than 45° from street,
or op n onto porch
Entrance opens to a porch: Yes ❑ No
Ifs,all the following apply: /5 sq.ft. min.
ne street facing entry 2 ft.max.roof above floor of porch
5 ft. depth min. 30%min.porch roof coverage
4.etailed Design:All buildings shall include a min. of five of the following elements on all street-facing façades:
�� Covered porch min. 5 ft.wide x 5 ft. deep ❑ Recessed entry area min. 5 ft.wide x 2 ft. deep
❑ , all offset min. 16 inches ❑ P ormer min.4 ft.wide
74 Roof eave min. 12 inch projection E yroof offset min. of 2 ft.
❑ Roof shingles either tile or wood V Gable,hip or gambrel roof design
0/Roof pitch oriented south min. 500 sq. ft. 0 Horizontal lap siding min. 3-7 inches wide
V Accent siding min. 40%of street façade ❑ 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 closer to front or side lot line,than longest street-facing wall. 0 Yes No. If No (Check one):
M❑ ay 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.
Wi : (Check one)
12-foot-wide garage door ❑ 40%max. of street façade
❑ 50%max. of street façade with 7 detailed design elements
Notes:
Approved By Planning: AA, Date: ///2a/i--
I:\Building\Forms\BldgPermitRvw_RES_RT_062216.docx
//c2c/I:\Building\Fomes\BldgPermitRvw_RES_RT_062216.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13243 SW 169TH AVE, BEAVERTON, OR, 97007 August 22, 2018 at
4:53:30 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00464
Inspection Type: Inspector:
299 Final inspection David Young
Result:
PASS - CofO
Comments:
Final erosion control approved.
Moisture content form received.
Vapor barrier form received.
High efficiency lighting form received.
Blower door test report checked.
Insulation certification checked.
C of 0 left on site with contractor.
This inspection is after hours inspection for C of 0 requested by the contractor.
Violation Summary:
Inspector Contractor
rt
RECEIVE
Electrical Permit Application #si FOROFFICE
�1� 7 O USE ONLY
INCity of Tigard MAY Z018 Date/By: .S/o lee i- • ' . 11/-07-;,2e9/7 (,9(,�r/6V
a 13125 SW Ha1I Blvd.,Tigard,OR 97223 Plan Review
I- Phone: 503.718.2439 Fax: 503.598.1 Related Permit#:
OF TIGARD DateBy:
TIGARD Inspection Line: 503.639.4175 Ready Date/By: Ju is: H See Page 2 for
Internet: www.tigard-or.gov BUILDING 1DIVISION0t ed/Method: I Supplemental Information
TYPE OF WORK PLAN REVIEW
®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more ElBuilding over three stories.
0 Demolition 0 Other:
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
®1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
ngs.
0 Multi-family 0 Master builder 0 Other: Ffor all other installations. bua
0 Fire pump. 0 Installation of 150 KVA or
c.
JOB SUE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: Job site address: 3"),L1 ,SV Wilt"c C. ❑A HP more.
Addition new motor load of system.
100HP or m ❑"A","E","1-2","1-3",
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy.
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.it: ,P Project name:River Terrace East 0 Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision:River Terrace East Lot#: 104 Includes attached garage.
1,000 sq.ft.or less 1 168.54 4
Tax map/parcel#: Ea.add'!500 sq.ft.or portion t 33.92 1
DESCRIPTION OF WORK Limited energy,residential 75.00 2
M 51-. J,2 )17 -00 (with above sq.ft.)
{/1 Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
c n1Ya etc c�•cL+n e, Renewable Energy 0 See Page 2
® PROPERTY OVVNER. 0 TENANT Services or feeders installation,alteration,and/or relocation
Name:ADVL 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 200.34 2
City/State/ZIP:Scottsdale,AZ 85258 601 amps to 1,000 amps 301.04 2
Phone:(602)694-4031 Fax:( ) Over 1,000 amps or volts 552.26 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 168.54 2
® APPLICANT 0 CONTACT PERSON Branch circuits—new,alteration,or extension, .er panel
A.Fee for branch circuits with
Business name:William Lyon Homes,Inc. above service or feeder fee,
7.42 2
each branch circuit
Contact name:Nichole Thorpe B.Fee for branch circuits without
Address:703 Broadway St Suite 510 braranor feeder fee,first
bnice ch circuit 56.18 2
City/State/ZIP:Vancouver,WA 98660 Each add']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:Nichole.Thorpe®polygonhomes.com Reconnect only 67.84 2
CONTRACTOR Pump or litigation circle 67.84 2
Business name:Sunlight Electric Inc Sign or outline lighting 67.84 2
Address:2804 NE 656AveSuite D Signal circuit(s)or limited-energy 0 See Page 2 2
panel,alteration,or extension.
City/State/ZIP:Vancouver WA 98661 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(971)222-5758 Fax:(360)326-9660 Investigation(1 hr min) 90.00/hr
Email:sunlight.incl@comcast.net Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 172549 Electrical L. : c230Su)rv.Lie.: 1793• specifically listed('/2 hr min)
/ ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required' .d f Subtotal:
Print name: Chester Garrett T Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: -� 9e15eitlY
TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Peter Kozarez Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Peradts\ELC PermitApp ELR ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13243 SW 169TH AVE, BEAVERTON, OR, 97007
Record Type: Record ID:
Residential - Master Permit MST2017-00464
Inspection Type: Inspector:
199 Electrical final Jeremy Burrows
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13243 SW 169TH AVE, BEAVERTON, OR, 97007
Record Type: Record ID:
Residential - Master Permit MST2017-00464
Inspection Type: Inspector:
699 Mechanical final Jeremy Burrows
Result:
PASS
Comments:
Corrections completed
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13243 SW 169TH AVE, BEAVERTON, OR, 97007 July 23, 2018 at 11 :07:19 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00464
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS
Comments:
Water pressure = 75 psi
Violation Summary:
Inspector Contractor
Plumbing Permit Applicatio E EIVE
Building Fixtures FOR OFFICE USE ONLY
III City of Tigard FEB 2018 Received �/ /
13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: Permit N /2 d 96/
Phone: 503.718.2439 Fax: 503.598. (�'�OF p( Plan Review
Cl-li II TIGARD Date/By: /✓)Qf/t' 4 467 Other Permit No.:
T t G A K D Inspection Line: 503.639 4175 ate Read /B
Internet: www.tigard-or.gov egg q�psi( g Ready/By: Juris: ® See Page 2 for
�D 1ILDITVG DIV!SIO otified/Method: Supplemental Information
TYPE OF WORK. FEE* SCHEDULE
®New construction ❑Demolition For special information use checklist.
Descriptiont
IDAddition/alteration/replacement ❑Other: Q Y 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 E Commercial/industrial SFR(2)bath 437.78
EJAccessory building 111Multi-familySFR(3)bath 500.32
El Master builder Each additional bath/kitchen 25.02
❑Other: Fire sprinkler(j„d82"sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities: /3,0
Job site address: 13243 SW 169T"Ave Catch basin or area drain 18.76
City/State/ZIP: Tigard,OR 97223 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.: 14 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# MS72oll - 00'14)4 Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
►it PROPERTY OWNER I El 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
Garbage disposal 25.02
City/State/ZIP:Vancouver,WA 98660
Hose bib 25.02
Phone:(360)695-7700 Fax:( ) Ice maker
12.51
►® 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
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:Gavin@AlliancePlumbing.net Urinal 25.02
CONTRACTORWater 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: i 1�----) G----
TOTAL PERMIT FEE
Print name:Gavin Thomes Date:2/5/2018 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.
L\Building\Permits\PLMU-PermitApp_doe 10/01/09 440-46161'(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Q y: Fee lea) Total Square Footage:. Permit Fee:
Footing drain-151 100' 50.03 0 to 2,000 $121.90
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' 3752 Valt><arion": ,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
each additional$100.00 or fraction thereof,to
Other Inspections or Fees ` 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.
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 f-o '"Pi11mbingInstallations
Work Performed: Capped Added aeiocate
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
Car Wash -Each Stall greater,except systems designed and stamped by licensed
-Drive Thru engineer.
Cuspidor/Water Aspirator 0 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.
Car Wash Drain • Isometric or Riser Diagram
Garbage -Domestic-non-food El isometric or riser diagram is required for new buildings
Disposal -Domestic-food related
-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/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
Urinal fees assessed for the sewer increase must be paid before the
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Permit.doc