Permit (126) CITY OF TIGARD BUILDING PERMIT
ill ■ COMMUNITY DEVELOPMENT Permit#: BUP2016-00327
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/22/2016
Tri A I? C� g Parcel: 2S106DB24300
Jurisdiction: Tigard
Site address: 13015 SW ROY ROGERS RD
Project: River Terrace East No.3 Subdivision: None Lot: None
Project Description: Demo existing 1113 sq ft house and multiple sheds. Property on septic.Upon approved final inspection,SDC
credits may apply to future construction.
Contractor: UNITED EXCAVATORS Owner: POLYGON WLH LLC
4804 NW BETHANY BLVD STE 1-2 PBM 361 109 E 13TH ST, STE 200
PORTLAND, OR 97229 VANCOUVER,WA 98660
PHONE: 503-914-7166 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: SF
Class of Work: DEM Type of Const: Permit Fee-Additions,Alterations, 11/22/2016 $531.09
Demolition
Occupancy Grp: Occupancy Load: Info Process/Archiving-Sm$0.50(up to 11/22/2016 $0.50
Dwelling Units: 11x17)
Stories: Height: ft Erosion Control w/Development 11/22/2016 $107.60
Bedrooms: Bathrooms:
Value: $31,800
Floor Areas:
Total Area:
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $639.19
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking:
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 B : 'O., 4 Permittee Signature: - , ,��i��
i , c
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.
CITY OF TIGARD BUILDING PERMIT
11111-. COMMUNITY DEVELOPMENT Permit#: BUP2016-00327
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/22/2016
T I C A L<.1� g Parcel: 2S106DB24300
Jurisdiction: Tigard
Site address: 13015 SW ROY ROGERS RD
Project: River Terrace East No.3 Subdivision: None Lot: None
Project Description: Demo existing 1113 sq ft house and multiple sheds. Property on septic.Upon approved final inspection,SDC
credits may apply to future construction.
Contractor: UNITED EXCAVATORS Owner: POLYGON WLH LLC
4804 NW BETHANY BLVD STE 1-2 PBM 361 109 E 13TH ST, STE 200
PORTLAND, OR 97229 VANCOUVER,WA 98660
PHONE: 503-914-7166 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: SF
Class of Work: DEM Type of Const: Permit Fee-Additions,Alterations, 11/22/2016 $531.09
Demolition
Occupancy Grp: Occupancy Load: Info Process/Archiving-Sm$0.50(up to 11/22/2016 $0.50
Dwelling Units: 11x17)
Stories: Height: ft Erosion Control w/Development 11/22/2016 $107.60
Bedrooms: Bathrooms:
Value: $31,800
Floor Areas:
Total Area:
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $639.19
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued B /. I'`- :..„,... Permittee Signature: C t <��
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit APPlilitpt°
;' 1: I
ResidentlAl ry ) } FOR 0111(1; 1 til:0.1.1
r.. City of Tigard N IIILV 1 / L�1 l� Dat/B a l�1121 .I PermitNo.: Pro/4 Z`,1C�JJ�eZq
13125 SW Hall Blvd.,Tigard,O 97223 Plan Review Other Permit:6- o/1 /(o�w��/
• Phone: 503.7182439 Fax - 3 8.19® If Date/B
T;CAR[_, Inspection Line: 503.639.4 7$ t 1 i' i ?z,e A 1,..,' Date Ready/Br Ju,iv SS See Page 2 for
Internet: www.tigard_or. I i x ,•I` fi 6 } Notified/Method: Supplemental Information
moi q ,-
Yr1 * i 7 Y : r4}:. moi -F t "11,rT_t " 4. ^rrc k ,9�Y.. E1, w .-ht/ - L I Ei;"15t Kr ^v7qv 7 ) ys M rr@1 ! i 4 . ait 1 w e ; e
❑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 0 Other: equipment,materials,labor,overhead,and the profit for the
i.,-,:2., ,= .fc` :, , 1fi `,ua Y i work indicated on this application.
,1 r � 15rr -,
Valuation: S 31,800
1 I-and 2-family dwelling ❑Commercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
;'".. w 1..., �,+� F uu yli )��3f,Y(0�i4'u CA,s< :' a. r.-,.» 0 c .. r:,, Total number of floors:
Job site address: 13015 SW Roy Rogers Road New dwelling area: square feet
City/State/ZIP: Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt no.: l Project name:River Terrace East No.3 Covered porch area: square feet
Cross street/directions to job site: West of SW Roy Rogers Road,South of Deck area: square feet
SW Scholls Ferry Road Other structure area: square feet
s
j,li a " ;t,ria ' a �e €FPte' i'k`;, 14d ^c
Subdivision: I Lot no.: Permit fees*arc based on the value of the work performed.
Tax map/parcel no.: 25106 Lot 24300 Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
s,� , r 3 ` ' Z " 'ice -• t_.,,Ti-. work indicated on this application.
Demo existing structures and driveway l Valuation: S
Existing building area: square feet
ry ,.: ' ! �
New building area: square feetBti.
e albVIr tdN y9.. i' L { -R :::a•rz .-.-t-4- ;
Number of stories:
Name: Polygon WLH,LLC Type of construction:
Address: 109 E.13th Street Occupancy groups:
City/State/ZIP: Vancouver,WA 98660 Existing:
Phone:( 360 ) 695-7700 Fax:(369 )693-4442 New:
;I!-•;%.:4',',1,--1--'1'',,f Y - tr 'l t.,,,,.,'," C .,'cu� R :,,,4 ..T'�r,--r i,, J ,---,-,-,-,,,-..--,---,-r-,------,,,' 'J ri .4 ,
Business name: Polygon WLB LLC
Structural plan review fee(or deposit):
Contact name: Angie Grajewski FLS pian review fee(if applicable):
Address: 109 E.13th Street Total fees due upon application:
City/State/ZIP: Vancouver,WA 98660
Fax: 36D Amount received:Phone:(360 )695-7700 ( )693 4442
E-mail angela.grajewslu®polygonhomes.com i',r" m ,_: ,.;.
firr'..:;.2', ,
). ,41 ' 3,., 7 C.`,:'f,, �'�'-r ka.i _ °-4, i �.',+x .•:.,. K,.--3_....u'r roof-top
t
Commercial mounted PhOV
residential
taaprescriptive lar Panel System.Of
. '
Business name: [)octad Excavators Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 4804 NW Bethany Blvd Ste 1-2 PBM 361 Solar Installation Specialty Code checklist
Permit Fee(includes plan review
City/State%Z1P: Portland,OR 97229 and administrative fees): $180.00
Phone:( 503 )914-7166 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.:198822 // Bl/7 /"� (/,t - Total fee due upon application: $201.60
Authorized signature: a 1`�;j " ' —t"' v This permit application expires if a permit is not obtained
r
-
within 180 days after it bas been accepted as complete.
Print name: . n re�, S1cDate: tit 11711G .Fee methodology se€by Tri-County Building Industry
Service Board.
1 BBuilding\Permits1BUP-RESPernf' pp,doc 02/24/2011 440-4613T(11/02/COM/WEB)
illilCity of Tigard
a COMMUNITY DEVELOPMENT DEPARTMENT
■
T 1 Gn R n Building Permit Review — Commercial - With Land Use
Building Permit #: LO 0-0 t(c — OG 3 9-7
Site Address: 13015 SW Ro.) �� ^'ts Suite/Bldg#:
Project Name: 'g\ieV� race -Gd`l`.1 .NO .3
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: vi0 hug . a►u1 All tot4ilali►� . on sl4c
Verify site address/suite# exists and active in permit system.
0 River Terrace Neighborhaptd: g Yes ❑ No
Land Use Case#: r 0 R 2 OI(0 -000/3 / .S V Q ZO i b -0 0 Oo ci
❑ Plans Match Approved Land Use:
❑ Site Plan ❑ Landscape Plan ❑ Other:
❑ Urban Forestry Plan ❑ Elevation Plan
❑ Building Height: Maximum Height Actual Height
P1 As ❑ Conditions Met: ❑ Prior to Submittal ❑ Prior to Permit Issuance
❑ Business License:
Exists: ❑ Yes ❑ No,applicant notified to obtain business license
❑ Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No, stop intake
Notes: TY-et ? G"11``'. is iv t V‘,L�
Approved by Planning: %IW diV` Date: fl 1 (,Q
Revisions (after Building Submittal onl I Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: 8/17//0
Site Plans: # '3
Building Plans: # //'-
Building Permit#: Enter building permit#above.
Workflow Routing: IiPlanning Engineering lid' Permit Coordinator
Workflow Sign-off: E Sign-off for Planning(include notes from planning review)
Route Application Documents: ❑ Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: J) t&o 611....k✓��7-
By Permit Technician: C Date: //-7//
I:\Building\Forms\BldgPennitRvw_COM_WithLandUse_060116.docx
Engineering Review
❑ Slope at building pad:
❑ PFI Permit#:
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat (not typical on SDR/CUP)
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ❑ No
Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No
LIDA Facility on lot: ❑ Yes ❑ No
❑ NOT Approved by Engineering: Date
Notes:
Approved by Engineering: �� rt/ Date: 1/:0!
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved El Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
C Fees Entered: Wash Co Trans Dev Tax: El , N/A
?Z1:::gli)
Tigard Trans SDC: ❑ Yes 5N/A
Parks SDC: 0 Yes /A
OK to Issue Permit
Approved by Permit Coordinator: 4 Date: >iJ) #47
I:\Building\Forms\BldgPermitRvw_COM_WithLandUse_070915.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13015 SW ROY ROGERS RD, SHERWOOD, OR, June 20, 2017 at 7:50:04 AM
97140
Record Type: Record ID:
Residential - Building BUP2016-00327
Inspection Type: Inspector:
299 Final inspection David Young
Result:
FA I L
Comments:
Provide approved final erosion control prior to final inspection.
Provide pump and fill receipt for septic or proof of tank removal.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13015 SW ROY ROGERS RD, SHERWOOD, December 27, 2018 at
OR, 97140 12:03:36 PM
Record Type: Record ID:
Residential - Building BUP2016-00327
Inspection Type: Inspector:
299 Final inspection Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor