Permit (75) CITY OF TIGARD MASTER PERMIT
�. ,, COMMUNITY DEVELOPMENT Permit#: MST2018-00281
T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/13/2019
Parcel: 2S106DA20001
Jurisdiction: Tigard
Site address: 16621 SW BIRDSONG ST
Subdivision: RIVER TERRACE EAST NO.2 Lot: 239
Project: River Terrace East No. 2, Lot 239
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1259 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 28 Bathrooms: 3 Second: 1658 sf Garage: 464 sf Front: 8 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
Total: 2917 sf Value: $367,697.85 Rear: 10
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 2 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 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: 5 201-400 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 SF VB R-3 2917
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
703 BROADWAY ST STE 510 VANCOUVER,WA 98660
VANCOUVER,WA 98660
PHONE: 602-694-4031 PHONE: 360-695-7700
FAX:
Total Fees: $35,267.49
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.0.
Issued By: `\_ J�+� Permittee Signature: 1/4
:)\--V,>
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
\\AleV) LOI
ill
Building Permit Application
•
Residential V\% FOR OFFICE USE ONLY
City of Tigard �` ��� ��.,Received
,V i ( � Permit No.:
IN13125 SW Hall Blvd.,Tigard,OR 97223�,�/ {� ,en
`v, ,� ��Tav��—L' `�
1 Plan Review
Phone: 503.718.2439 Fax: 503.598.196 ` ,�� Date/By: to 2S ($ Other Permit tt .-Gc+ 3- ,1
I I G A R D Inspection Line: 503.639.4175 C30\1°1
30\° Date ReadyBy: Jugs: 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method.9 y//9 Supplemental Information
C /4//1-- /'o t16-0 Al
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
®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
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1-and 2-family dwelling ElCommercial/industrial Valuation: $ 30 i LOCI1
ElAccessory building 0 Multi-family Number of bedrooms: LE
❑Master builder 0 Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors: "24 33 g 1
Job site address: ‘+n f) c,v,1 cN rcAC y Si-- New dwelling area: 'ZC f square feet
n City/State/ZIP:Tigard,OR 97224 Garage/carport area: 4(pty square feet l 1—Sc7
ID
Suite/bldg./apt.no.: Project name:River Terrace East Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:River Terrace East Lot no.: —231 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
DESCRIPTION OF WORK work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT 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:
0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:Polygon WLH,LLC (PlegsereferlaI .sclhedule).
Structural plan review fee(or deposit):
Contact name:Nichole Thorpe
FLS plan review fee(if applicable):
Address: 103 Bra cAAjay SI _ IA.(.,k-ci 0
City/State/ZIP:Vancouver WA 9866i Total fees due upon application:
Amount received:
Phone:(360)695-7700 Fax::( )
E-mail:Nichole Thorpe PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic 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: 1 ALi i 0 . Solar Installation Specialty Code checklist.
City/State/ZIP:Vancouver WA 98660 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60
CCB lic.:207247 Total fee due upon application: $201.60
Authorized signature:l���1��w""��� This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Nichole 1 horpe Date:06/16/2017 *Tco n.eth d leby s,t b f Tri-CL,unty D,.:11;.,g)i.1u.l,y
Service Board.
I:\Building\Pennits\BUP=RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
4
Mechanical Permit Application I1( 1 1 S1.Ovl 't
Cityof Tigard Received Penni!No.:
III g Datc,73y:
III13125 SW Hall Blvd.,Tigard.OR 97223 Plan Review,
I. Phone: 503.718.2439 Fax: 501598.1960i..\\10)
L" Other Permit,
PR 1 � nateHy�
t 1,, ,I.t7 Inspection Line: 503.639.4175 �1 Date Ready'By: Inns 63 See Page 2 for
Internet: %vww.tigard-or.gor' r Vt17tr' ifted Method: Supplemental Information
CAIN 1j ins\
-Aw v °� c-►�. 10ZILWAV, .-,PAs—cliAchmerr
Mechanical permit fees*are based on the value of the work
®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor.overhead.and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDETIALEQUIPMENT/SYSTEMS FEES*
,,��1-and 2-family duelling ❑Commercial/industrial ❑Accessory'building For special information use checklist.
I I Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
\ Air conditioning I 46.75
Job site address: 1 U2 A &/ ' NCA " ''J!��, Si- Furnace 100.000 BTU(ducts'ents) I 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100.000+BTU(ducts/vents) 54.91
Mat pump 61,06
Suite/bldg./apt.no.: Project name; R-w•er Terraces-Easy— Duct work 23.32
Cross street/directions to job site: Flydronic 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 I 23.32 •
Other: 23.32
Subdivision: iv�rTyner)"L'.,, " 5, � Lot no.: "2:56\ Other fuel appliances:
Tax map/parcel no.: l Water heater t; 23.32
DEBCIPTION OF WORK Gas fireplace/insert I 33.39
Flue vent for water heater or gas
fireplace 23.32
Lou lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
la PROPERTY OWNER I ❑ TENANT Other: 23.32
�/ Environmental exhaust and ventilation:
Naive: Ps t �!L Ltt_v fio'd,r S 1 11 Range hood/other kitchen i
�� equipment 33,39
Address: `1(oOD E' V l,ofU�")iPAx-rJ?,,lec Wl t Clothes dryer exhaust I 33.39
City/State/ZIP: Sc duh,P t il 2. 5Z Single-duct exhaust(bathrooms,
�L�� toilet compartments.utility rooms) 23.32
Phone:(901�1,4--T0-' Fax:( ) Attic/crawlspace fans , 23.32 .
® APPLICANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name:Polygon WLH,LLC
$14.15 for first four:S4.03 for each additional
Contact name: N I c A0ve, how Furnace,etc.
h b�t�A u � 11
Address: 1/ ..-t1 l v Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98e60 Water heater
Phone:(360)695-7700 Fax::(360)693-4442 Fireplace I
E-mail: ? Range
Barbecue
r .,
CONTRACTOR Clothes dryer(gas)
Business name:Apex Air LLC Other:
Address: 18004 NE 72"d Ave �� Subtotal
City/State/ZIP:Vancouver,WA 98686 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(360)342-1109 Fax:(360)326-1769 State surcharge(12%of permit fee)
CCB lic.:203034 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within ian
days after it has bees accepted as complete.
Authorized sign to : + Fee methnlningy cel by Tri-Coun(y Building lndnst Service Board
Print name .( Date: 4•/7.go.
IlnuitdingU'amitsltEC_PumitApp 040113.doc 440-161TTIIi!02/COM,WEB}
•
_ _,..� ' II.fei"nu�.eeuavrau E E�� -d,+���(,_ o
u x �4 uuflu _ '*����x"r �j3yYv, .4-4� F _ Z _
- eIlCg of Tigard {{��{ Received
�_' � �-3 `� �-��, .� �{;�:
+r 2U 1� Date(By: Permit ii:
13125 SW 11-ill Blvd.,Tigard,OR 97223 APR 18
• o Plan Review
Phone: 503.718.2439 Fax: 503,598.1960
I> BUILDING
' :
Related PcnnitP:
ATtInspection Line: 503.639.4175 CITY Ti GA �atedY :ate/BY: Jurist
I [ See Paget forx1Gj Internet: www.tigard-or.gov 1LD`N O`\f. - ied/Metlo + SupplementalInformation
: ;:M_ ;_ . _ : gRt 'C'` tiz ' ; ;; ; :>
®New construction ❑Addition/alteration/replacemnent Please check all that apply(submit 2 sets of plans w/items checked):
CI Demolition Other: ❑Service or feeder 400 amps or more Q Build ng over three stories.
r^,,.-..Yk'(>';:;liti�=;:'';^s;v::,n:i.:.:....;.:...:.:>.:.,.,.,:nboatyards.
_ _ _ _ where the available fault current ClQ Marinas and
o- :._
,TE .�-,
M ..
:.,....., ,._,.:.,... C;TIONi:>;, �':-";::r'e�;` ' '; "�:<i exceeds 10 0
'- 00 amps 150 volts or
.:-.._.:.... .........................-...._-:....._....,.,_ , ... ......:.. .. . : P Floating buildings
❑X I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
0 Multi-familyampsfor a other installations. buildings.
• 0 Master builder
:.:,::>-.:.::�F::;>:;.:• ......�:-.,..:...:.: _ Pirepump. aA or
.,.,..,.::..,,:._,..,:,...._Other• _,..:..:....,:..:.::•:;........
� ❑Installation of 150 KV
;'i `> `:a;::; J.O$...SITE JNFOR1'TA`TfO1r1'rAM);LOCA`fION.:.`: ii:`: ..:: ❑Emergencysystem. larger
. ,. ,.� . . g derived
Job#: Job site addressa ^ ) �' ') ❑Addition of new motor load of system.
f(DSl/`t ..J) �J�c'� S- 10011 or more.
City/State/ZIP;Tigard,OR 97224 El six or more residential units. occupancy.
❑health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: ( Project name: i2`J(X-T-,tryace,ES4
0 Hazardous locations. ❑Supply voltage for more than
CI Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site:
: F)v 'SivFJ_R_I}.i7_LE_
Description I Qty. I Each::•:.::it'"Total I;::z
New residential single-or multi family dwelling unit
Subdivision: i\feAr Te J s+– J Lot#:Z Includes attached garage.
Tax map/parcel#: 1,000 sq.S.or less 1 i 168.54 4
-.::.a - -- n 339
... ....:.._,:,. .,..:.;>iP �SGtRIPT'Ol!t:OR:'WO'..T� ':_;',.'::.:.,:•;;;;:i!:;:::.!:::: : ::;:,,:,:•:
2
,�:•:::,.. ., . .�.,.�,,_....�__-. .:..-.... .� ...; :.:.: . ,., ...: Limited energy,residential
(with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
x-Y .h`:„.. - ;t::;-: ;_:.;a::.:,:,<_ _
Renewable
... >P,IFQ��R�- + - _ Energy ❑ See Page 2
.-moi. u04iVE
.. .. .. ,_� N''IVT'`:':;'=;.::°;%:i3 'yt'(;,
Services or feeders installation,alteration,and/or relocation
Name: ic)V _ yy„1' 'i-l-� 200 amps or less 100.70 2
Address: , t 0 I t +'/i ��L1�I 1 L'_� A r 4 1 201 amps to 400 amps 133.56 2
401 amps to 600 amps 20034 2
City/State/ZIP; S/' 1 i 1$ 1 piR, l'S�5(2 601 amps to 1,000 amps 301.04 2
Phone: to 02.–(DC/4;1403 1 I Fax:( �)+�J Over 1,000 amps or volts i 1552.26 2
Email: II Temporary services or feeders installation,alteration,and/or
relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps125.08 I 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
d,;;: _ t.:,.,.:,,;. ,;:tr i'°c'..•':: >,::;:•;:;... . _ -.�s.E ,.,.,. ;: Bran
_ . :,f=;'. : ®tot' LOA IT,.,, ell circuits–neivzalteradon r
...�1 ... ....._> ,,.a.,��`�..-_.. :. .., _. :.1;�.....; ,:,;:.'�;CONTACT;:}';EItSON::.a.::: +o extension,per panel
- AFee far branch circuits with
Business name:Polygon WLH,LLC above service or feeder fee,
7.42 2
Contact name: CA� each breach circuit
`. _ - B.Fee for branch circuits without
Address: 107, 1b�1/y , , t ,_ v service or feeder fee,first 56.18 2
vt�it.�./ � S '�'d?�� branch circuit
City/State/ZIP:Vancouver,WA 98660 J Each add'1 branch circuit 7.42 2
Phone:(360)695-7700 Fax;: 360 - Miscellaneous(service or feeder not included)
{ )6934442 Each manufactured or modular
:.. .. 57.84 •dwelling,service and/or feederEnail: VnVte,�/v A ' tnOr S £_Y� Reconnect only 67.84 22
yfiY1r ' ,_,,.,,c:o .:, . . . .i
pump or irrigation circle 67.84 2
Business name:Garner Electric Washington,LLC Sign or outline lighting 67.84 2
Address:402 Valley Ave NW Ste 106 Signal circuits)or limited-energy See Page 2 2
. panel,alteration,or extension. Ei
City/State/ZIP:Puyallup WA 98371 Each additional inspection over allowable in any of the above
Additional inspection(1 hr mm) 66.25/hr
Phone:(253)872-6051 Fax:(253)872-1801 Investigation(1 hr min) 90.00/hr
Email:bdaniels@gweusa.conr
Industrial plant(1Itriniu) 78.181 hr
Inspections for which no fee is
CCB Lie.: C1158 Electrical Lic.: 208174 I Suprv.Lie.: 4496S specifically listed(i4 hr min) 90.00/hr
Suprv.Electrician signature,required: ) • , ' V ' ' r '- .... .
Subtoto tal:
Print name: Joan P Albert - I Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: 4.—___.-- ---- TOTAL PERMIT FEE:
This permit application expires If a permit is not obtained within 130
},i J name Rill Daniele I Date: days atter ft sins peen accepter'as complete.
' Number of inspections allowed per permit.
7.ABuilding\PermifslELC Permi[App_ELR ERE.doc Rev 06/17/2015 440-4615T(l1/05ICOivt/WEn
Plumbing Permit Application
Building Fixtures E- �1
City of Tigard P 1 201$ Received
q 13125 SW Hall Blvd.,Tigard,OR 97223
CPR R ateJBy: Permit No.:
11111 = Phone: 503.718.2439 Fax: 503.598.1960 Review
Inspection Line: 503.639.4175 G118 ��Q V�y' Other Permit No.:
TIG\H D , `,, 1NG to Ready/By: Tuns ®See Page 2 for
Internet: www tigard-or gov 1t i1-�SQ Notified/Method:
}�. * Supplemental Informahoo
New construction El Demolition For special information use checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
1N 1-and 2-family dwelling ElCommercial/industrial
SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi-family Each additional bath/kitchen 25.02
❑Master builder ❑Other. Fire sprinkler( sq.ft.) Page 2
JOB 3ITE INFORMATION AND LOCATION Site utilities:
Job site address: l ko�2 i �V 1-LA �S 1_ Catch basin or area drain 18.76
�v� T Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name: ract. _ 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 p„i Jejr "rei,,ro e,e., ,--- Lot no.:i Fixture or item:
Tax map/parcel no.: Backflow preventer I 31.27
DESCRIPTION OF WORK Backwater valve I 12.51
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
El 16101.44w,OVItNER I 0.Trisurrr. 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
®APPLICANT 0.CONTACT PERSON, Interceptor/grease trap 25.02
Business name: PO t�t1 VaL 1� -
Medical gas(value:$ ) Page 2
n` ^,A 1n 0 Primer 12.51
,
Contact name:t V lJV L 4 Com- Roof drain(commercial) 12.51
Address: -1(5 ()YOc 1)0n.. C-r ' ve, V(� Sink/basin/lavatory p,r: / 25.02
City/State/ZIP:Vancouver,WA 98660 4 Solar units(potable water) 62.54
Phone:(360)695-7700 I Fax::(360)693-4442 Tub/shower/shower pan 12.51
Email \C/knO to t Vo\�11Gt2\f7(Y1PC .. Urinal 25.02
1\3 ,� mak <�1 ,�� e �`�� Water closet 25.02
GQ 616k Water heater _ 37.52
Business name: V44. i 14,,40)csit .4 -6,v‘r Water piping/DWV 56.29
Address: p.IS. 3 oxl e"� Other: 25.02
City/State/ZIP: ST. e...,4 o- fit is'i Subtotal
't I Minimum permit fee: 572.50
Phone: O .- .. "V 1 Fax:(li v..-rigs-e 11,0
iPlan review (25%of permit fee)
CCB Lic.: (*IPlumbing Lic.no.P ( State surcharge(I2%of permit fee)
Authorized signature: ,IV(Ticcyt TOTAL PERMIT FEE
I Print name: 7-T cif_ P'W%4_. Date:U-38-I b 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.
I:1BuitdinglPermits`\PLMAU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
r
City Of Tigard
E
COMMUNITY DEVELOPMENT DEPARTMENT
r l c A x la Building Permit Review — Residential
Building Permit _ -�-,�- -.�.__...�a,._�.���__�,�,.��....,. �.�:,e �:�r-��..�. �,__ ,
Site Address: 1(Q(p 2 1 SW Nrcidtro &tret.
Project Name: R IVer -rem N
(New dwelling=subdivision nameh�r Alteration=last name of owner) Lot #: 2 3
Planning Review
Proposal: New
-Verify site address/suite# exists and active in permit system.
Al. River Terrace Neighborhood: ❑ No gl..Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
Three(3)copies of site plan y��
ite plan must be on 8-1/2"x 11"or 11 x 17"paper 'bLxtsting structures on site
:Ao rawn to scale(standard architect or engineer scale) floorpelevationsrint of w structure(including decks)with finished
forth arrow Utility locations&easements(required for new and additions)
f ,Site address,project or subdivision name and lot number
pplicant information(name and phone number) idewalk/driveway approach
•t dimensions and building setback dimensions Vocation of wells/septic systems
nira&Existing trees to be retained with drip line,and tree
4Square footage of buildings to be demolished protection measures
>tot area,building coverage area,percentage of coverage and liaStreet tree size,type and location
impervious 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? es No
4 foot differential) Lj '
If yes,is a storm water quality facility shown? UlitsIiEWo
lean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified (5K No Received:
Public Facilities Improvement(PFI)Permit: ❑ Yes ❑ No
Required: ❑ Yes,applicant was notified )6' No Applied For:
❑ Yes El No,stop intake
Land Use Case#: PDR-2o t(p-Co�
Zoning: 12_L}•S(,p D ) i R -1 Cp b )
Required Setbacks: Front �...
g Rear IC Side 3 Street Side Garage 20
li Landscape Requirement: / ) v.
Lot Coverage Maximum:
❑ Building Height: Maximum Height
14 fr" Actual Height$21
ligi'rVisual Clearance
,,Iii Sensitive Lands: 0 Yes /Fr No Type
IXUrban Forestry Plan
C! Conditions "Met"prior to issuance of building permit
Notes: 'r, - Cd ,ham f
prior 1,0 IS,outivy4,
as s--$e t,n1• -_k 17-Ii-if
Approved By Planning: A N i t s
Date:
Revisions (after Building Submittal only)
Revision 1: 0 ApprovedApproved
Reviewer Date
l'Prove ❑ Not A pp roved
Revision 2: ❑ Approved 0 Not Approved
Revision 3: 0 Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw RES_061417.docx
Building Permit Submittal
Original Submittal Date: Lk i' I kC
Site Plans: #
Building Plans: #
Building Permit#: 2/Enter building permit#above. [ Bulldin
Workflow Routing: lPlanning [2/Engineering Permit Coordinator g
Workflow Sign-off: El/Sign-off for Planning(include notes from planning review)
Route Application Documents: 2'Engineering: (1) copy of permit application, (1) site plan, (1)building plan and
original plan review routing form.
E'guilding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
�... i/� Date k. 1 lk t,t.
By
Permit Technician:
Engineering Review /i_ ` ®
Slope at building pad:
❑ Conditions"Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
�r-Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes No
Assess Water Quantity Fee in-lieu: 0 Yes 2r No
LIDA Facility on lot: 0 Yes LB'No
Final Plat Recorded: Date:
0 NOT Approved by Engineering:
Notes: CO DC7` fat— " 41 plait/44J 6, 4 l 'c. A-PP t 1%3 4 d'0 15` 'IL
,la-Aroved byEngineering: 1.it t Gtr) Date: 10 ri i 6
pproved ngin ring: P
Revisions (after Building Submittal only)
Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
Permit Coordinator Review
0 onditions "Met"prior to issuance of building permit
jSrApproved,NOT Released: AL, Date: VD`It l$
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:
eid SDC Fees Entered: Wash Co Trans Dev Tag: Yes 0 N/A
Tigard Trans SDC: 44 Yes 0 N/A
Parks SDC: Yes 0 N/A
LIDA 0 Yes t N/A
OK to Issue Permit / /o�
Approved by Permit Coordinator:
Date.
IABuildingWorms\BldgPermitRvw_RES 010118.docx
City of Tigard
711
N COMMUNITY DEVELOPMENT DEPARTMENT
■
T I G A R D River Terrace Building Permit Review Addendum
Building Permit #: -vac\g-Cjs 1
Site Address: ILete21 &vJ 13takuviD Si-.
Project Name: 2J ( Ter,a akS-}- Np,2 Lot #: 23
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan District Design Standards (18.640.070.1.):
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
❑ ❑ ❑ ❑
2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: t1 '10
3. Entrances:At least one entrance must meet both of the following standards:
gl 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 yes,all the following apply: 25 sq.ft. min.
N One street facing entry 12 ft.max. roof above floor of porch
IN-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 >Recessed entry area min. 5 ft.wide x 2 ft. deep
lis'Wall offset min. 16 inches ❑ Dormer min. 4 ft.wide
'Roof eave min. 12 inch projection ❑ Roof offset min. of 2 ft.
❑ Roof shingles either tile or wood K Gable,hip or gambrel roof design
❑ Roof pitch oriented south min. 500 sq. ft. ❑ Horizontal lap siding min. 3-7 inches wide
❑ Accent siding min.40%of street facade ❑ Window trim min. 2 1/2"wide by 5/8" deep
❑ Window recess min. 3 inches for all street facing ❑ Bay window min. 5 ft.wide by 2 ft. deep
❑ 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. aYes ❑ No. If No (Check one):
❑ May extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch.
❑ May extend up to 5 ft.where the garage is part of a two-story building and there is a window at the second story
above the garage that faces the street with a min. area of 12 sq.ft.
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: ____kcykla4 Date• ‘ ► t IS
I:\Building\Fortes\BldgPermitRvw_RES_RT_121417.docx
Electrical Permit Application"MECEIVED FOR OFFICE USE ONLY
City of Tigard Received —,"
IIM
IIII v 13125 SW Hall Blvd.,Tigard,OR 97223 JUN 2 8 2019 Date/B : T`
MIZIOM _e
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#:
Inspection Line: 503.639.4175 CITY OF TIGARD
TIGARD p DIVISION Ready Date/By: Jur s: H See Page 2 for
c; Internet: www.tigard-or.gov BUILDING Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
®New construction ❑Addition/alteration/replacement e�`rl ,,,;"� Please check all that apply(submit 2 sets of plans w/items checked):
❑Demolition 0 Other: r � 0 Service or feeder 400 amps or more 0 Building over three stories.
, where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION :,- - .m exceeds 10,000 amps at 150 volts or 0 Floating buildings.
® 1-and 2-family dwelling 0 Commercial/industrial 0 Acctl spry building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: 0 Fireum .
P P 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
�\12t SOl ❑100Addition of new motor load of system.
Job#: Job site address: 1�t0'Z�1 G( �. loot->P or more. ❑`•A","E",`•t-z",••t-3'•,
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy.
0 Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name: East River Terrace 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 I *
New residential single-or multi-family dwelling unit.
Subdivision:East River Terrace'Z Lot#: 2.31 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
Change contractor on MST`�OI, bou k {with above sq.ft.)
75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
® PROPERTY OWNER. ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name: Polygon WLH,LLC 200 amps or less 100.70 2
Address:703 Broadway St,Ste510 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Vancouver,WA 98660 601 amps to 1,000 amps 301.04 2
Phone:(360)695-7700 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
Branch circuits—new,alteration,or extension,per panel
® APPLICANT 0 CONTACT PERSON
A.Fee for branch circuits with
Business name:Polygon WLH,LLC above service or feeder fee,
each branch circuit 7.42 2
Contact name:Tonja Morris B.Fee for branch circuits without
service or feeder fee,first
Address:703 Broadway St,Ste.510 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:permitsubmittals@polygonhomes.com Reconnect only 67.84 2
CQN1RAcTQ1.. . . . .. Pump or irrigation circle 67.84 2
Business name:Alameda Electric Sign or outline lighting 67.84 2
Address:3415 NE 44u'Ave. Signal circuit(s)or limited-energy
panel,alteration,or extension. 0 See Page 2 2
CityfState/ZIP:Portland,OR 97213 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)319-2192 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:solarpdx@me.com Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: 199188 Electrical Lic.: c923 I Suprv.Lic.: 4871n specifically listed(h hr min) 90.00/hr
ILZ., :::::,),..e„,. ELECTRICAL PERMIT FEESSuprv.Electrician signature,required: -
Subtotal:
Print name: Kirk Rood Date: 05/09/2019 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: ii.,J_ /2.0p TOTAL PERMIT FEE:
This permit application expires If a permit is not obtained within 180
Print name: Kirk Rood Date: 05/09/2019 days after it has been accepted as complete.
* Number of inspections allowed per permit.