Permit ill '. CITY OF TIGARD MASTER PERMIT
' 111 ' COMMUNITY DEVELOPMENT Permit#: MST2019-00296
T iG.AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/26/2019
Parcel: 2S107AA03700
Jurisdiction: Tigard
Site address: 16855 SW TOWNSVILLE ST
Subdivision: ROSHAK RIDGE Lot: 37
Project: Polygon at Roshak Ridge, Lot 37
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 805 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 23 Bathrooms: 3 Second: 939 sf Garage: 423 sf Front: 8 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
Total: 1744 sf Value: $234,183.03 Rear: 0
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
Drains: 0
Tubs/Showers: 3 Garbage Dist): 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel 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: 3
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 3 201-400 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 1744
Owner: Contractor:
POLYGON WLH LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
703 BROADWAY ST STE 510 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98660 VANCOUVER,WA 98660
PHONE: 360-695-7700 PHONE: 360-695-7700
FAX:
Total Fees: $33,408.22
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 OU NC by calling 503.232.1987 or 1.800.332.2344. d,"/
Issued By: .4.'....;` �` - � i 0.Permittee Signature: C� 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.
\____ _\
"D-3----74—Building Permit ApplicationRECEIV
Residential FOR OFFICE USE ONLY
Received
City of Tigard CIE C 2018 S,T Permit No..1`(1S"� \c1
Date/By:
" 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Q t``''�z^y..�
Phone: 503.718.2439 Fax: 503.598.1960 CITY OF TIG �ateBy: t ) Other Peimi4J1� V��'�.
T I G A R D Inspection Line: 503.639.4175 A Date Ready/By: Juris ® See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVJSI `otified/Method: I Supplemental Information
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 ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY:OF CONSTR C PION
work indicated on this application.
•
Valuation: $ 2
® 1-and 2-family dwelling 0 Commercial/industrial J�, t D�
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms: 3 �f ( ,,
2 . s 7, (/7
JOB STIR 1EC?R'll1A,Tn l,� t� - � ` Total number of floors:
Job site address: b i5 Ss S O W y 1S V I�7New dwelling area: ` q square feet
City/State/ZIP: '�' l l kid 0 O(j `
-L L) Garage/carport area:tisquare feet e6b c
Suite/bldg./apt.no.: ".Jt Project name:Polygonat Roshak Ridge 01V-r(j( V Covered porch area: . square feet
Cross street/directions to job site: Deck area: �?)'1 square feet
Other structure area: square feet
REQUIRED D1) AMM CHECKLIST
Subdivision:l �t Uf 1 r �.(i/tS l Lot no.: 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
y bl pN materials, overhead,and the
profit for the
OF WOR „ ojyVf work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
la PROPER t I?AI R : ❑ TENANT Number of stories:
Name:Polygon WLH LLC Type of construction:
Address:703 Broadway Street Ste 510 Occupancy groups:
City/State/ZIP:Vancouver,WA 98660 Existing:
Phone:(360)695-7700 Fax:(360)693-4442 New:
A LIt ANI `ii..,. , ACI€ PERSONl 1, t4, H FEES.
Business name:Polygon WLH LLC �' '�
Structural plan review fee(or deposit):
Contact name:Amanda Gavin
FLS plan review fee(if applicable):
Address:703 Broadway St.Ste 510
City/State/ZIP:Vancouver WA 98660 Total fees due upon application:
Phone:(360)695-7700 Fax::(360)693-4442 Amount received:
Yf'fny�i
t l ,/��s LTAJC SOLAR PANEL �Y ��° �,l
E-mail:permitsubmittals@polygonhomes.com
® Commercial and residential prescriptive installation of
ask . CONTRACTOR ,P ,,, 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:703 Broadway St.Ste 510 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: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Amanda Gavin Date: 1, 1 - I I *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
r
.....-r---------'
'Iltc
Mechanical Permit Application RECEIV i FOROFFICE USE OLN
City of Tigard
• . 7 .7413125 SW HalBlvd.,Tigard.OR 97213
n EC 06 2018
man Ravtew Prafitt NCt\SCNCSX2sUck...C,.. Diiji t
Othatf PtrAlii:
1 I Phor, 503.718.2439 Fax: 5ft3598.1960 'Wear
!aspect:ion L;Pe' 33f1,39A175 CITY OF TIGA i i.,-R-IYIBY,
TIGARD itinN ' Pi See Pne 1 far
Internet www.tizerd-or.ve 1,1c4ifiediMethad: , Suppternentat Information
BUILDING DIVIS ON _.,... , .. . . .
- FT7-. -6.-iiwifk"ik.7:7-3,,77.F:•:7, ?:.7. ,i-7 .7.1.7:;77:_7:7q7 -,!..'.7:PPmfilt F4cD‘z-:,.17-tv':'*ITEPT-er* ...71:5atc:}#157:-.,-.'7::::
, Mechanical permit fees*are based on the value of the wet* i
New ecestraction 0 Addifinniatteraiontreplacement peiforrned.indicate the vette<MAITgitui 4,11 the nearest dollar-I of A 1
0 Demolition 0 Other: • 1 mechanical mxeria1s.equpinett.labor.overhead.Srid profit. 1
— .-:-' i Value:S
,Afi66.kjiiSk...i107•47iiitOidi;i4:::: -,-,f:'::!!, :.,::: ',:--;,±':," ,.L.,,,-: .._ ....,..,..._ _.,,....,...,_.. .„.. .........,..:_. _ ... ..•• .
'. -.-:, ',',.'.------..-7- - ..---,;..,-,:-.,;:,REStDFA114.13(SIIWKVSYSTENKFEES#',','-..'...',
0'I-arid 2-by damrfirrt 0 Commercial/ix:WI/MI-hi:1 0 Accessory building I rorveciul infwirtailart foie ritedifst •
IS1 N4alti-family 0 Masmt Nader 0 Other: Description 1 Qty. -Ea. I Total ,
V. .,iiiis.;.§liffiiitiniiiiikribti•li.kiii.thekiiitiriii::::: ;:ji:-,.,-i:,•::t.!a!,-.'.!.'3:7,e_:.'; l'irloWt°i'ling. . .
Air conditioning i 1 46.75
Jvkb s '.1 2ddlc'b: t \ViiiSCD SW 1-0 W V\S V 1 1 I t_S-i- Farm=100.130.013113 fitC(OeCritS) 1 44.75
Cityl-State/ZIP:.Tigard,OR 97V-4 .J Furtmoe 100.0043+BTU(dtrAsFvents) ' 54-91 t
Heat pump 61_06
i
Staiteini0.,Japt.no.: . Praim T241)1 v)o)ovl NI' 19-osk.ctlii- DWI WM* 23.32 t
Cross streetidirections to job site: P-dy, avat Els,drunic hot‘aulter stem 23.32
i-, Residential bonler(radiator or
bydrottie) I 13,31
,
Linit hem=(fnel-type,not eleetrk)„
. in-wall.in-duct suspended,etc. 46.75 I
Flue'vent for eon of above 1 • 23.32 1
_ Other ' 23.32
Subdi.41)Tr.'- \ucr- Tect-ar_e 9c, Let no.: '771i
Other foe sport:mem . .
Tux raqiparcelno.: Water hearer . 2332
_ .
7.17!..:.:',.c:7"-:: :.:.:;ffj?-i;-:;:,:S:!P...:44ifg(.*,ii*gtiliPtibriCOC-8*.611::k,t;:::117,,..i. 4P:11r.f.taP2.-.?t :::-.',;. ,: Gas Iirefgaoarlasert 33_39 1
_ 1 , . .
• Flue vent f water heater or gas •
fireplace 23.32
- - Log liOter(gas) 23.32
. ,Wood'pellet stow 1 33.39 I
Wood Freplacelinsert 23.32
„ .
. Chime-FA int rifluelvent . ' 2132
iiibtre...715,44iittt4.4•.A:...?Fr7T : '..-"i'.":":'-' '.' ''..0:.TiNASif F'--17]: .:!.'.:',f,..,7,:;.' Other
, 23.3'2
Name:. ?0\kr O\/\VO kA- \j1L.,- % 1 fRange hoodiother kitchen 1 1
=Amsted \ 33 19
AdareSS:
1n ,\(k)citrit3JrAAA"\-- - s- e.- W, Clorit dryer e:thutt ' 1 i 33,39
,
CitY/S141t47/P'. \I CANA.GOUL vex' vocual.eAop ...ingle-duct exhaust(bathrooms, i 1
toad compartments.tarty room ) I o 23 32
Pbg>n '$0k)(i9CAC-1/00 I Fax;ta90} (0019)11g LI Artir:lemvvispaat fans i
23.32
i
*.::!_;; .4 .A1*IOcA*'I?:-•::: ::::::.:::..-::',.;:,:. *.lit-"Tp:'.;',.4 El.....tciiit.A0....ttlis0.-; ::1-..'..:;:f.;',.:-. i Other i 2332
1 Fuel*pint:
Business name:.Poligoo WI.14,LW . S14.15 fur first four:S-1,93 fur each xddifionut
•
Ca ota.1 minor \40.1,0,\NvvoLR, ClavI,v, Furrace.etc. I
Address: 1 0 3 ---€:trOaritiDCL t" t Sk•e- 510. Gas hew pump 1
, Wallisaspendedfattit heater / i
City/State/ZIP.Vancouver,.WA N3460 Watabeater ,
Plume:(360)695-7769 I 'Fax:t(36,9i 693-4442 Fireplace
t t-_ x Rano 1 1
E--ImaRRErry 451.L.S.C)CYj, •k-itXtS u-/R0k.t3SOrNNIWYN65..els ni Barbecue I 1 '
5Y.I . .. 4'1 . 4*ttikOPRiiit;.:;; ,:i ,47"., . . -::•15.:7.g. i .. 1 Clothe$drYar(ass) l i
Stein=norm Apm Air LLC Oti.da. 1 *
."T':..:'.-., : .,MEIC.4.1111E/LITFIXF;ES'r:5i,..:,.....
AaMess:1$0114 NE 72'd Are Subtotal
City/StutelZIP-:Yancouver,WA 98656 Minimum permit fee me,00) , I
Plan review(25%(If peanil fee)
Krirom 069)342-8109 . 1 Fmk:(3:68)326-1769
ll
CC'S lie.:20034 Srat surcThOarTA(L12;4:12-PcrInMIT4;EceE)
Alehorized signature; -
......,-......---._ 1 .Dmr• \12- \ L\ 1 ta 1
i
.
. Print name: I t" „„i
4
. . . ,..
,
• .T.:::,,,th,,,,,iiapplarlittiibytafrpriire:ctimfnalyitznitaiss 7nattlestr,171sm,:i=;i:N3 wit:.,7
days aster it has keto Arsepte4i as tormaltte.
nr.uni6gpPn-rnis-MEr."..)1/4ralilkflp_patil 1-3 ddr 44C—,,,,13"7"F fli,q72,COM:VELl'i
t
RECEIVED
: .
Electrical Permit Application ( i p FOR OFFICE USE ONLY
- n r'.6 L U i 0 Received _ -
City of Tigard Date/B : Permit g. s q_ l
- a 13125 SW Hall Blvd.,Tigard,OR 97223i'E'�r of TIGARD plan Review
Phone: 503.7182439 Fax: 503.59$. 1 I Related Permit#:
Date/$y:
TIGARD Inspection Line: 503.639.4175 Ej 1j1 Dl'N 1'\1'U''JQI i; eady Date/By: Jeris. 11✓ See Page 2 for
a Internet: www.tigard-or.gov F!'►+ �j �tk` jJl�jt} otilied/Method: Supplemental Information
,
-,, x��::-..� - -�� _ a .� : ,." _. aET�iNy,. -
�.....Wit.-,. �.,....
®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 mom ❑Building over three stories_
0 Demolition 0 Other:
where the available fault current 0 Marinas and boatyards.
...-,.-....... r, a 011-42 oO M nit- :otrorr_F. _ e.- . ' ,. , exceeds 10,000 amps at 150 volts or D Floating buildings.
® 1-and 2-family dwelling 0 Commercia/bidustrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
❑Multi-family ❑Master builderamps for all other installations. . buildings.
❑Other: 0 Fire pump. 0 Installation of I50 KVA or
IVS-VaeranitJOB STPE 1NFORMATIO04_ND Y;OCATIoNi ❑Emergency system. larger separately derived
Job#: I Job site address:I V( C� 1�V1S wit �(--. 0 1001-1 Addition of ore.motor bad of system.
1 I'L D a 100HP or more. ❑"A","E",`1-2","1-3",
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: ;'0I limo'j Qi iS� ❑Hazardous locations El Supply voltage for more than
" '� ❑Service or feeder 600 amps or more. 600 volts nominal
Cross street/directions to job site:
a ireott . *`'.. ..__k`tECWH11_bi)L>s _ �""
Description I Qty. I~ Each i Total
New residential single-or multi-family dwelling unit.
Subdivision:Ib_\1 lfJ,y�,e'vV' "Gf fn c-- , Lot#: 71) Includes attached garage.
Tax map/parcel# V`/ (tack-
1,000 sq.ft or less 168.54 4
x Ea.add'1500 sq.ft.or portion 33.92 1
<f ....I)'4SCR 'EYOIST'MF W RF x _ -� .: I t-
Y �: Limited energy,residential
(with above sq.ft) 75.00 2
• Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
POEERT {' Eli Renewable Energy ❑ See Page 2
-sI- _4 R tv, _ _ . :T`' -�,.._: .,_� Services or feeders installation,alteration,and/or relocation
Name. p01 .. Ma- IN LA LLU 200 amps or less 100.70 2
Address: -1 Y V�V V S� V 0 201 amps to 400 amps 133.56 2
�I ka( (A,v t' > (f(,Q ` 401 amps to 1,6 0 amps m 200.341 2
City/State/ZIP:'V Vh �l ti^Vl/t/�` �Q (((vvv///tttJJJ---IIx//U 601 amps to 1,000 amps 301.04 2
Phone:i 2�fit,) to piS-1' u qu Fax:�0j (,Q 9) Li(,l u'& Over 1,000 amps or volts 552.26 2
Temporary perm
V y t rti,-mo /1 '�7� ����,� relocation services or feeders installation,alteration,and/or
Entail:
Owner I stallation:This installation is being made o pro 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
-- Ca U t o o - SO , Branch circuits-new,alteration,or extension,per panel
.:.,.� � _,'_�_ p �_,_. _ :.�,,,.__._ .. �,��., .,. A.Fee for branch circuits wide
Business name:' X V l O V1,W J 1 LLC above service or feeder fee,
7.42 2
Contact name: y i(--` 6-tot V i,� Fee
forbrbranchan circuit
'
Y B.Fee circuits without
service or feeder fee,first
Address: i o 2D WI V ut(W S 1 0 branch circuit 56.18 2
City/State/ZIP:Vancouver,WA 98660 Each add'I 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
dwelminice and/or feederEmail Fe IrviIVI 1 /tIstp0Vio (Wc /Wr^ y Reconnect only
67.84 2
i _= s _; tGl *kM .1e - ar.
Pump or irrigation circle 67.84 2
Business name:Garner Electric Washington,LLC • Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address:6101 NE St Johns Rd panel,alteration,or extension. ❑ See Page 2 2
City/State/ZIP:Vancouver WA 98661 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 6625/hr
Phone:(253)320-1657 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:bdaniels®gweusa.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
COB Lic.: C1158 Electrical Lic.: 208174 Suprv.Lic.: 4496S specifically listed CA hr mm) 9000/hr
___J
Suprv.Electrician signature,required: " ' Y _.-, .-
,�� y 4.i. ��i/L,iL Subtotal:
Print name: Joan P Albert • Date: 'a'i i V ❑Plan Review Required(25%of permit fee):
f ---,... _ State surcharge(12%of permit fee):
Authorized signature:
f
-•:.,.._._.-.-:----------
,,,::: - . ----_..-_T TOTAL PERMIT FEE:
`"'��� This permit application expires ifs permit is not obtained within 180
Print name: Bill Daniels Date: I a I l 1y) days after it has been accepted as complete. 1
v * Number of inspections allowed per permit
:r:':I:1BUl1dinglPermitin .0 PermitApp_ELR ERE.doe Rev 06/17/2015 445-4615T(11/05/COM/WEB
, • • '
... . ,
ii, ,.!. V 1;1\',.
Plumbing Permit Application-ir. ,*‘,- ..‘c-,A 'c-, . .II-1''
Building Fixtures
i 6 2018
City of Tigard Received
Date/By:III Perin-aN.-"c\ix.- -r)i,>\ct-GL.;AL.s..
. . 13125 SW Hall Blvd..Tigard,OR 9 -
III OF TIGARD
_ _
Phone: 503.718.2439 'Fax: 503.59 Other Permit No.:
Date:By:
.. Inspection Line: 503.639.4175 gli LDING DIVISIOate Ready/By:ND
TICiARD hes: Fa See Page 2 far
Internet: www.tigard-or.gov Notifiedl1v1cthod: Supplemental Information
TYPE OF WORK - FLE* SCHEDULE
ElNew construction lilDerrialition For special information use checklist,
Description I -Qi. 1 Ea. i Total
0 Addition/alteration/replacement Ell Other New 1-2.-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCGON SFR(1)bath 312.70
r (ik 1-and 2-family dwelling El Commercial/industrial SFR 2)bath 437.78
SFR(3)bath 1 500.32
'
[11 Accessory building E--]Multi-family Each additional bath/kitchen 25.02
0 Master builder LI Other: Fire sprinkler( sq.ft) Page 2
JOB SITE INFORMATION AND LOCATION , Site utilities:
Job site address: 10 ss S vo To(A)yis v U,te W, Catch basin or area drain ... 1836
Diywell,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: ?ol(la)ovI,RI-yuc hot kL. Manufactured home utilities 50.03
Cross street/directions to job site: 40(fif alfal- 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: pi vor-1-:evy45,(1 c(At Lot no.: .j1 Fixture or item:
Backflow preventer 1 31.27
Tax map/parcel no.:
Backwater valve \ 12.51
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
9,3 PROPERTY OWNER - fl TENANT - Expansion tank 12.51
Fixture/sewer cap 25.02
Name. YO\,(A?0 OM- ‘./L(..i
-Floor drain/floor sink/hub 25.02
Address: 1 t)2 v-Doi Avvout4e-ii- cii si0 Garbage disposal 25.02
City/State/ZIP: V VI,(i) it VeAr k)G(. CA ce C9(0() Hose bib 25.02
Phone: , Fax:( ) Ice maker 12.51
Interceptor/grease trap
Aa. .APPLICANT . i.--t LONTACT P.r..x.suN 25.07
Medical gas(value:S ) Page 2
Business name:" P i vou± \lc, Primer 12.51
Contact name' yi-Vy),CA,\A 11 01 V t(A.) Roof drain(commercial) 12.51
Address: 1 0.. v1)o(0 ,uty,f,AA (-2-t-- Skil C7\D Sink/basin/lavatory 25.02
City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54
Phone:(360)695-7700 Fax:;(360)693-4442 Tub/shower/shower pan 12.51
E-mail: ?'eVVIiitk'cl410W1,qt171,1S0101/1 OVIliolfUS,toVIA ,
Urinal 25.02
atercloset
25.02
- / - • CONTRACTOR. Water heater 37.52
Business name: G,47....6 k)\,,,Aytjt,‘,A., nr_svv,„s 3,...4,4_,.. Water pipina/OWV 5629
Address: CIA Other: 25.02
City/State/ZIP: 5.-T- f4-w\ oft_ i1131 Subtotal
Minimum permit fee: 572.50
Phone:(„...5b,..3 0.-$(iis 1441 Fax:(11 I)..e.7g.el....07 11/D
Plan review (25%of permit fee)
CCB Lie,: igti 31,0__ Plumbing Lie.no.ft WI/ -
State surcharge(12%of permit fee)
Authorized sivrture: 0. ))44 ?:!)tAy., )4.`""------_ TOTAL PERMIT FEE
Print name: ,S+f,,Vt, w 4....e___ Date:----1 il..1 il rbt This permit applieadon expires ifs permit is not obtained within 180 days
after it has been accepted as complete.
*For methodology act by`hi-County Building Industry Service Board.
Ifauilrling\PermitsTINIU-PcrmitApp,doc 10101109 440-461.6T(10/0250WWEB)
c .
City of Tigard
11111 ~ COMMUNITY DEVELOPMENT DEPARTMENT
T I G A R D Building Permit Review — Residential
AMIN
Building Permit #: N\ST `R- ((0
Site Address: /Z�C -2/0so;J
Project Name: Pdigl( 01 f--nCe-, Lot #: `.--
(Newl' g=subdivision name;Addition or Alteration= ,t e of owner)
Planning Review
Pro p osal: "J?k2 '9r-le.-
r./ address/suite#active in Accela. 'LTJ In River Terra e: ❑ No LTJ Yes,River Terrace Review Addendum
Sitlan Elements: Erosion Control
34eopies of site plan on 8-1/2"x 11"or 11 x 17"paper 4- ained trees with drip line and tree protection measures
wn to scale(standard architect or engineer scale) J F9otprint of new structure(including decks)and FFE
rth arrowty locations&easements(required for new and additions)
Sjt address,project or subdivision name and lot number d walk/driveway approach
1C�
splicant information(name and phone number) II :4:cation of wells/septic systems
11 •t dimensions and building setback dimensions Y.S eet tree size,type and location
II 1.i uare footage of buildings to be demolished eet names
II 'a` sting structures on site IVCorner elevations(2'contours if more than 4'differ tial)
17 Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? IQ Yes ❑E
• ervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility showni3•PilnYes I4 No
lean Water Services-Service Provider Letter of platted prior to 9/10/1995):
it'equtred: ❑ yes,applicant was notified No Received: ❑ Yes ❑ No
LTJ �Public Facil,�Improvement(PFI) Permit:
iti
4d.Use
iked: VU Yes,applicant was notified ❑ No Applie For: V Yes No, top intake
Case#: '1( 2O/ =(�0D LI Zoning: e'12 )2))
e ured Setbacks: Front: S Rear: / Side: Street Side: �� 111I Gara e:
'ad9 9� g
ll ►
ding Height: Max. Height: 6.-44 Actual H • htt:� c=23
LJ Landscape Area: -2Q % ►. Lot Coverage Max:__f 'S✓0/0
Entrance ` ; •.ck no more than 8'from street-facing wall ❑ Parallel to street or offset 45 de. - or less
Windows ❑ Minimum ' . , .rea of all street-facing facades 'Q'
Garage ❑ Garage door is behind wi.- -et-facing wall \\W` ❑ Yes E 1 o,one of the following is met:
❑ Door extends no more than 5'fro and there is . .'ered porch extending beyond garage.
❑ Door extends no more than 5'from wall . •: i e - •- . 12 sq ft.window above garage on 2nd floor.
❑ Garage door width is ❑ 12'or -.. • 50%or less of facade 21. I%or less and includes 7 of following:
❑ Covered porch PI •ecessed entrance ❑ Wall offset ❑ 1'Roo e. .- ❑ Roof offset
❑ Fire •-. es ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof I ormer
a Accent siding Window trim ❑ Window recess ❑ Window projection ❑ Balcon
\ Il1j►`.i isual Clearance lerban Forestry Plan ,'
J nsitive Lands: i Yes CI No Type: kW -- '�c� )"),:i2/10)�
qQ Conditions met prior to issuance of building permit
No s: `�-
Approved By Planning: `C— -- — Date: ?//04
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Fonns\BldgPermitRvw RES_022819.docx
, R
Building Permit Submittal
Original Submittal Date: 1‘.'4.\kgA 1S
Site Plans: # 9j
Building Plans: #
Building Permit#: C"Enter building permit#above.
Workflow Routing: [ /Planning [Engineering +[Permit Coordinator 131-'l3uilding
Workflow Sign-off: [Sign-off for Planning(include notes from planning review)
Route Application Documents: [SEngineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
❑Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: `'` Date: 'al\Q
EngineeringMNIIIIII
, Review
Ltd Slope at building pad: 4
❑ Conditions "Met"prior to issuance of building permit ,71
❑ Easements (encroachments)per engineering conditions of approval and plat
V Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes Cfr No
Assess Water Quantity Fee in-lieu: ❑ Yes 0/No
LIDA Facility on lot: ❑ Yes Ii(No
C'Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes: ,
[[Approved by Engineering: Date: 7/2z/C9
Revisions (after Building Submittal only) Reviewer Date
Revision 1: D Approved ❑ Not Approved
Revision 2: ❑ Approved 0 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:
Re ion Notice 3: Date Sent to Applicant:
SDC Fees Entered: Wash Co Trans Dev Tax: (l'Yes ❑ N/A
Tigard Trans SDC: [Vyes ❑ N/A
Parks SDC: Yes ❑❑ ;\T/A
LIDA ❑ Yes Lt3" N/A
OK to Issue Permit
/RdDate: ( t I qAproved by Permit Coordinator:
I:\Building\Forms\B1dgPennitRvw_RES 0228 19.docx
City of Tigard
1111 I' COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD River Terrace Building Permit Review Addendum
AMIIIIMMIIIMINIIMPINIF 'wawa
Building Permit #: t , c 'z\Ck . ��
Site Address: Jle , tt.) -Thon vi<k (9F
Project Name: 47 I 01 62711— ' jz;� ,�'�� Lot #:
(New d Al I g=subdivision name;Addition or Alteration= st ame of owner)
Planning Review of River Terrace Plan Distric' t 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.
Balcony w/ access 2 Window Projection Vertical Wall Offset a
Porch mint. deep 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: / Ve
3. trances:At least one entrance must meet both of the folio ng standards:
rA Parallel to street, angle no more than 45° from street,
Max. 8 ft. setback from lonstreet- facing wall
or open onto porch
Entrance opens to a porch: Yes ❑ No
I_f,y sin
,all the following apply: �sq.ft. m .
ne street facing entry ft. max. roof above floor of porch
5 ft. depth min. NJ 30%min. porch roof coverage
4. tailed Design:All buildings shall include a min. of five of ollowing 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
❑ Ill offset min. 16 inches ❑ Dormer min. 4 ft.wide
ROOF eave min. 12 inch projection ❑ ' sof offset min. of 2 ft.
❑ Roof shingles either tile or wood 7 Gable,hip or gambrel roof design
❑ Roof pitch oriented south min. 500 sq. ft. ❑ I..orizontal lap siding min. 3-7 inches wide
❑ Accent siding min. 40%of street facade VWindow 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. , : . -s and Carports: May face the front or side lot 'ne on a corner lot.
Setbacks:
No closer to front or side o i-- than longest street-Vacing wall. ❑ -- Gl No. If No (Check one):
❑ May extend up to 5 ft.if there is a cove : ont porc -. garage does not extend beyond the front porch.
❑ May extend up to 5 ft.where the garage is .., o a ; o building and there is a window at the second story
above the garage that faces the stree a min. area of 12 sq.ft.
Width: (Check one)
❑ 12-foo - •e garage door ❑ 40%max. of street facade
I%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: — - c ,,,,_, 4.
Date: _=�i67
�
1:Building Forms BldgPermitRvw RES RT_121417.docx
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
111 il Transmittal Letter
T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: \rA ` IL (V 07kv V 1/ c V / \/- DATE RECEIVED:
DEPT: BUILDING DIVISION G
RECEIVED
FROM: hyy\t/vci v, Env IA/ JAN 2 8 2019
COMPANY: 'PO 1Y 1J V �) � CITY 01- TIGARD
I D19�G D 0
'iJ
PHONE: V 01 9 I"1 OD By
RE: \WM JV\rVD\ J\J V \ ` ``e t DO- 3 �( C (�16
Site Address) (Permit Number)
\vP V TeNTot.(Ar.A ( ti}.. L )71A—
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. 4 N Revisions: 1,'' i -113
Cross section(s) and details. _ Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS:
FOR OFFICE USE ONLY
Routed to Permit Tec i 'an: Date: /„Gj ( , Initials: A-
-Fees Due: Yes o Fee DescH do : Amount Due:
❑ p
1 ) D & $
$ 75
Special
Instructions:
Reprint Permit(per PE): ❑ Yes1{kNo ❑ Done
Applicant Notified: Date: Initials:
I:\Building\Forms\TransmittalLetter-Revisions_061316.doc