Permit (3) CITY OF TIGARD BUILDING PERMIT
11111 x ' • COMMUNITY DEVELOPMENT Permit#: BUP2015-00271
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/22/2015
Parcel: 2S 1060001500
Jurisdiction: TIGARD
Site address: 13127 SW ROY ROGERS RD
Project: River Terrace Northwest Subdivision: Lot: 3
Project Description: Demolition of the 1,378 sq.ft. house and 324 sq.ft.shed. UPON FINAL INSPECTION,DEMO CREDITS FOR
SDC FEES MAY APPLY. SEPTIC TANK TO BE PUMPED AND FILLED OR REMOVED.
Contractor: BULL MOUNTAIN RIDGE LLC Owner: ARBOR ROAD LLC
109 E 13TH STREET BY WEST HILLS DEVELOPMENT CO
VANCOUVER,WA 98660 735 SW 158TH AVE
BEAVERTON,OR 97006
PHONE: 360-695-7700 PHONE:
FAX: 360-693-4442
Specifics: FEES
Description Date Amount
Type of Use: SF
Class of Work: DEM Type of Const: Permit Fee-Additions,Alterations, 09/22/2015 $301.85
Demolition
Occupancy Grp: Occupancy Load:
Erosion Control w/Development 09/22/2015 $80.70
Dwelling Units: 0 Info Process/Archiving-Sm$0.50(up to 09/22/2015 $4.50
Stories: 0 Height: 0 ft 11x17)
Bedrooms: 0 Bathrooms: 0
Value: $15,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $387.05
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
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 y: J Permittee Signature: I J/
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Residential ��� � p�5
City of Tigard S ' g� tin® Re[eBy� ( 4If 1,—, Permit No.: JIl jrs _ t7/
• 13125 SW Hall Blvd.,Tigard,OR 97223 G r``-`, u Review. ,�! {`Y',' )nn C/��y�`�/�
Phone: 503.718.2439 Fax 503.598.1960 ® i 4�ijt®Date/By: OtherPermit.� ��(tr.L1S
1'1 G A R D Inspection Line: 503.639.4175 /^- Q Date Ready/By: �, /// has: ®see Page x for
Internet: www.tigard-or.gov `j``®�N Notified/Method:�++��� I 91( j Supplemental Information
.i)Ay Ern �,/n
ax xu:a: ara .�: T 1wn L«i SJ:?"" i d�" �• 't�
IRla DA rA:I-,AND 2-1',1;1tILY 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
.- work indicated on this application.
® 1-and 2-family dwelling ❑Commercial/industrial Valuation: $15,000
(ElAccessory building ❑Multi-family' Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
Total number of floors:
Job site address: 13127 SW ROY ROGERS RD. New dwelling area: square feet
City/State/ZIP:BEAVERTON OR,97007 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:River Terrace NW(Area 1) Covered porch area: square feet
Cross street/directions to job site:SW Scholls Ferry Road and SW Roy Rogers Deck area: square feet
Other structure area: square feet
RLQLIRED:DADA:COMMERCIAL-LSE HLC,KEISt
Subdivision: Lot no.: Permit fees*are based on the value of the work performed. ._
Tax map/parcel no.:251W08/TL 1600 Indicate the value(rounded to the nearest dollar)of all
a 6 equipment,materials,labor,overhead,and the profit for the
.N OF- - ri d r a work indicated on this application.
41RIrr ,z..:�. -�.,�� ( iiil
Demo existing structure on tax lot Valuation: $
i3'7' "51 +___V"`d t r.I Existing building area: square feet
l •` New building area: square feet
m
Number of stories:
Name:Polygon WLIL,LLC Type of construction:
Address:109 E.13*Street Occupancy groups:
City/State/ZIP:Vancouver,WA 98660 Existing:
Phone:(360)695-7700 Fax:(360)693-4442 New:
' , �" �8 iut • a r
Business name:Polygon WLH,LLC
Structural plan review fee(or deposit):
Contact name:Chris Walther
FLS plan review fee(if applicable):
Address:109 E.13°Street
City/State/ZIP:Vancouver,WA 98660 Total fees due upon application:
Amount received
Phone:(360)695-7700 l Fax::(360)693-4442 y
E-mail: chrisealther@polygonhomes.com �t.
I¢, t ,
Commercial and residential prescriptive installation of
�� roof-top mounted Photovoltaic Solar Panel System.
Business name:Bull Mountain Ridge ITC y Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:109 E.13"Street Solar Installation Specialty Code checklist.
City/State/ZIP:Vancouver,WA 98660 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60
CCB tic.:203735 Total fee due upon application: $201.60
Authorized Sign This permit application expires if a permit is not obtained
within 180 days after k has been accepted as complete.
*Fee methodology set by Tri-County Building Industry
Print name:Chris Walther Date: Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
74 ■ COMMUNITY DEVELOPMENT DEPARTMENT
■
T I G A R D Building Permit Review — Residential
Building Permit #: gGfi R)t S—nO,P-7 f
Site Address: / Je?4- c/() a ;Co'
Project Name: eiVer --Te Cp ino Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Re ew / -- 99 � // /
Proposal: i3'JG� ,eX/i15sn Q ,_S"7.~CC117r+-e On 'r /OI."'
s.
IY erify site address/suite# exists and
aacctiv n permit system.
R ver Terrace Neighborhood: 01Yes ❑ No
Sit Plan Elements:
,,pitee (3)copies of site plan xisting structures on site
SytXplan must be on 8-1/2"x 11"or 11 x 17"paper iceliferprint of new structure(including decks)with finished
STD to scale(standard architect or engineer scale) 9 r elevations
11.! •rth arrow Prrt' tility locations (required for new,may apply for additions)
N'i.5tfe address,project or subdivision name and lot number tri , ation of wells/septic systems
licant information(name and phone number) 1►: ,rosion control(including drainage-way protection,silt fence
of dimensions and building setback dimensions d-::gn,location of catch basin,etc.)
494 area,building coverage area,percentage of coverage and IF eet names
�ipervious area(applicable if R-7,R-12,R-25&R-40) ird S et tree size,type and location
! roperty corner elevations(2 foot contour lines if more than IIGExisting trees to be retained with drip line,and tree
4 foot differential) protection measures
itik4Qean Water Services—Service Provider Lette (lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No
#/ublic Facilities Improvement(PFI) Permit: /
quired: 17 Yes,applicant was notified I?,y No Applied For: ❑ Yes ❑ No,stop intake
zilit
nd Use Case#: j�, o2a S Y�s j ,SJ,C� ,20A=cboc6
1��1.J//�,Z� oning: 7 ' p-lR
/1gfTetbacks: Front Rear Side Street Side Garage
Abitandscape Requirement:
41 41 of Coverage Maximum:
7 ' Building Height: Maximum Height Actual Height
1'I/I isual Clearance
1!I ` asements
T4 ensidve Lands: iYes ❑ No Type ��%Jak� d T
lQ lJrban Forestry Plan /
Conditions "Met"prior to issuance of building permit
Notes: .T Gie,rt b ,fir/�
Approved By Planning: ( - -(/,f^ < <�� Date:
____97q/Z__S--
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: 0 Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved .
1:\Building\Forms\BldgPennitRvw_RES_070915.docx
Building Permit Submittal
Original Submittal Date: 1 4 (5
Site Plans: #
Building Plans: #
Building Permit#: ter building permit# above.
Workflow Routing: Planning ❑ Engineering ❑ Permit Coordinator 0 Building
Workflow Sign-off: -off for Planning(include notes from planning review)
Route Application Documents: Engineering. (1) copy of permit application, (1) site plan, (1) building plan and
gtnal plan review routing form.
21. Building: original permit application,site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes: /14S2 Act ✓/�2 7cir ccei�jr--TL.J ° 71,—t
By Permit Technician: Date: SA5 —
Engineering Review
❑ Slope at building pad:
❑ Conditions "Met"prior to issu u ding permit
0 Easements (encroac ts) per engineering conditions of approval and plat
❑ Water Quali uantity Facility:
As 'ater Quality Fee in-lieu: ❑ Yes ❑ No
ssess Water Quantity Fee in-lieu: ❑ Yes ❑ No
LIDA Facility on lot: ❑ Yes ❑ No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: et.1, ✓ Date: ?1/---/ ". -
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: 0 Approved El 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:
` SDC Fees Entered: Wash Co Trans Dev Tax: CI /A
/ Tigard Trans SDC: ❑ Yes N/A
Parks SDC: ❑ Yes N/A
�OK to Issue Permit
Approved by Permit Coordinator: / atc: i
I:\Bui(ding\Forms\BldgPcrmitRvw_RES_070915.docx
MHA15041 Polygon at Northwest River Terrace(Area 1)-Tree Protection Monitoring
Morgan Holen 9/6/2015
- ----AIIOCATe.I,
Page l of 1
Inspection On Site Recommendation for Resolution
Inspector Item Condition or Comment
Date Contact ,Corrective Action Date
Protection measures satisfactorily in place and in
Close the protection fencing once tree removal is
Tim good repair where needed across the project
Morgan Tree complete.Stumps of removed trees located
9/4/2015 Holen Looney Protection site.A portion of protection fencing open along adjacent to protected trees to remain in the
(NEI) the south side of the site to allow for tree
removal. ground.
General Comments:
None.
Morgan ftolen 8 Associates,LLC
Consulting Arborists and Urban Forest Management
3 Monroe Parkway,Suite P220,Lake Oswego,OR 97035
morgan.holen@comcast.net 1971.409.9354
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13127 SW ROY ROGERS RD, SHERWOOD, OR, June 20, 2017 at 7:47:56 AM
97140
Record Type: Record ID:
Residential - Building BUP2015-00271
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