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Permit Support Document CITY OF TIGARD BUILDING PERMIT `'. 8 • COMMUNITY DEVELOPMENT Permit#: BUP201600047 TIGARD 13125 SW Hall Blvd..Tigard OR 97223 503.718.2439 Date Issued: 07/11l2016 Parcel: 2S1070001900 Jurisdiction: Tigard Site address: 16880 SW BULL MOUNTAIN RD Project: Polygon at South River Terrace Subdivision: 1998-005 PARTITION PLAT Lot: 1 Project Description: Demolition of(2)existing structures and removing gravel: (1)4,129 sq.ft.house and (1)2,475 sq.ft.structure. Property is not billed for sewer. UPON FINAL INSPECTION, DEMO CREDITS FOR SDC FEES WILL APPLY. Contractor: WILLIAM LYON HOMES INC Owner: ADLV LAND HOLDINGS LLC 109 E 13TH STREET BY FORSUM, MICHAEL VANCOUVER, WA 98660 7600 E DOUBLETREE RANCH RD STE 1 SCOTTSDALE, AZ 85258 PHONE: 360-695-7700 PHONE: FAX: Specifics: FEES Description Date Amount Type of Use: SF Class of Work: DEM Type of Const: Permit Fee-Additions,Alterations, 07/11/2016 $641.29 Demolition Occupancy Grp: Occupancy Load: Erosion Control w/Development 07/11/2016 $107.60 Dwelling Units: 0 Info Process/Archiving-Sm$0.50(up to 07/11/2016 $2.00 Stories: 0 Height: 0 ft 11x17) Bedrooms: 0 Bathrooms: 0 Value: $41,655 Floor Areas: Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $750.89 Required: Required Items and Reports(Conditions) 1 Ersn Cntrl 503-639-4175 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 EM C Permittee Signature:( �� 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 �� /_S 2 /0 ,/ Residential {', �� IOlt(II-FIt I-: t SI:OAl.l Cityof Tigard �°' Reatv<d 2 g 2p1C1 oateBy: lc'r' Permit No.:�I��, Gl G t--� El ,� • 13125 SW Hall Blvd.,Tigard,OR 972 C3- Q ...tiles Review Phone: 503.718.2439 Fax: 503.598.1960 tither l'ermrt. e Y i 1 i. I., Inspection Line. 503.639.4175 .i `( eadyBy: .ram•—k7-- ®See Page 2 for Internet: www.tigard-orgov A, ©� �\V`� �ed/Me� , .. .(s Supplemental Information S�'�` 1.G'�r TYPE OF WORT '° REQUIRED DATA:I-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. per►' Valuation: $ 1/4 �pS': f� ® I-and 2-family dwelling 0 CommerciaUindustrial / Number of bedrooms: ❑Accessory building 0 Multi-family ❑Master builder CIOther: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address f(l,,etf t[// /1) f /E'ri. New dwelling area: square feet City/State/ZIP:Tigard,OR,97224 Garage/carport area: square feet Suite/bldg./apt.no.: Project name:South River Terrace Covered porch area: square feet Cross street/directions to job site:SW Bull Mountain Road&SW Roy Rogers Ro Deck area: square feel Other structure area: square feet REQUIRED DATA:-a)MMERCIAL-USE CHECKLIST Subdivision: Lot no.: 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.:2SIW Tax Lot 1900 equipment,materials,labor,overhead,and the profit for the _ - DESCRIPTION OF WORK - -- work indicated on this application. -- - - -- Valuation: S Demo of existing structures Existing building area: square feet New building area: square feet t PROPERTY OWNER 0 TENANT-. Number of stories: Name:Polygon WLH 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: - 0 APPLICANT ® CONTACT PERSON BUILDING PERMITFESS* _. -... _ ---:.. "merrier to feesrheilar) Business name:Polygon WLH LLC Structural plan review fee(or deposit): Contact name:Chris Walther FLS plan review fee(if applicable): . Address:109 E I3°Street �75z, !.-_ Total fees due upon application: , 0j City/State/ZIP:Vancouver,WA,98660 Amount received: Phone:(360)695-7700 Fax::(360)693-4442 E-mail:ChrisWalther@PolygonHomes.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* _ Commercial and residential prescriptive installation of CONTRACTOR= — roof-top mounted PhotoVoltaic Solar Panel System. Business name: L, `/U,/ Lye !t G M - Submit two(2)sets of roof plan with connection details y N Q //JC✓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 Iic.i309T15- 0 7,2_4i'7 Total fee due upon application: $201.60 Authorized signature: jog/ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Chris Walther Date:,,,2.. ./y "Fee methodology set by Tri-County Building Industry Service Board. 1:1Building\PermitslBUP-RESPermitApp.doc 02/24/2011 440-4613T(I I/02/COM/WEB) City of Tigard ■ 11 COMMUNITY DEVELOPMENT DEPARTMENT IN T I G A RD Building Permit Review — Residential Building Permit #: ltpaa/O- k7 Site Address: &a90 S6d // P , ed Project Name: /0I -" d77 kYt EA/er �2-a&ot #: (New . .erg=subdivision name;Addition or Alteration=last name of owner) Planning Revie / Proposal: MOe�(/7 ,Sg C� li..l° 4 �erify site address/suite# exists and active permit system. IV River Terrace Neighborhood: [Yes ❑ No Sit Ian Elements: ree(3)copies of site plan xisting structures on site tf S. plan must be on 8-1/2"x 11"or 11 x 17"paper ?IF '.otprint of new structure(including decks)with finished I/ I! awn to scale(standard architect or engineer scale) of floor elevations 11!: •rth arrow lily locations(required for new,may apply for additions) 115 S e address,project or subdivision name and lot number cation of wells/septic systems plicant information(name and phone number) rosion control (including drainage-way protection,silt fence 111 t dimensions and building setback dimensions sign,location of catch basin,etc.) I itt area,building coverage area,percentage of coverage and Street names • pervious area (applicable if R-7,R-12,R-25&R-40) NJ itreet tree size,type and location roperty corner elevations(2 foot contour lines if more than f''°.sting trees to be retained with drip line,and tree 4 foot differential) protection measures ikClean Water Services-Service Provider Lett (lot platted prior to 9/10/1995): Required: ❑ Ye ,applicant was notified No Received: 0 Yes E No 0 Public Faciliti Improvement(PFI) Permit: �� �,,� if 4quired: Yes,applicant was notified ❑ No Applied For: E Yes 12 No,stop �/J� and Use Case#: ,b — O2 _" / ,u�a,�)s c/ OS Voning: "etbacks: Front Rear Side Street Side Garage /landscape Requirement: °o A.ot Coverage Maximum: cluilding Height: Maximum Height Actual Height isual Clearance asements .ppS��ensitive Lands: Id Yes ❑ No Type Lay— ' 4(/ frban Forestry Plan ❑ Conditions "Met"prior to issuance of building permit Notes: e '' A jC$.C'2,6y7C.P c), CZ✓J/10.=e _Approved By PI nn g: �-- - Date: / Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved ❑ Not Approved Revision 2: ❑ Approved 0 Not Approved Revision 3: ❑ Approved ❑ Not Approved 1:\Building\Forms\BldgPermitRvw_RES_070915.docx Building Permit Submittal , Original Submittal Date: Agtjib Site Plans: # 7 Building Plans: # Building Permit#: nt building per�'' above. Workflow Routing: [!7/ISlaening L�'Engineering L�I'ernvt Coordinator D Building Workflow Sign-off: Si ff for Planning(include notes from planning review) Route Application Documents: [z' ngin ering: (1) copy of permit application, (1) site plan, (1) building plan and o . nal plan review routing form. 12 Building: original permit application, site plans,building plans,engineer r and n,, beam calculations and trust details,if applicable,etc. Notes: /le b/1i,J j / ,rr../-0 By Permit Technician: �' Date: ,2ll�� � Engineering Review Slope at building pad: /`J Conditions "Met"prior to issuance of building permit Easements (encroachments) per engineering conditions of approval and plat 7 Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: E Yes ❑ No Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No LIDA Facility on lot: ❑ Yes ❑ No D NOT Approved by Engineering: Date: Notes: Approved by Engineering: il"j Date: ,0.1.z-, ; Revisions (after Building Submittal only) Reviewer Date Revision 1: E Approved ❑ Not Approved Revision 2: E Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review D Conditions "Met"prior to issuance of building permit ;b4Approved,NOT Released: 4�ate: Z-1/;-J L(o j� 7 Notes: fir 5701 ifi 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: 780C Fees Entered: Wash Co Trans Dev Tax: ❑ Yes /A Tigard Trans SDC: ❑ Yes /A Parks SDC: ❑ Yes N/A OK to Issue Permit Approved by Permit Coordinator: Date: /Wj �[r 1:\Building\Forms\Bldg Perm it Rvw_RES_0709I 5.docx Albert Shields From: Albert Shields Sent: Wednesday, February 17, 2016 1:48 PM To: Chris Walther(Chris.Walther©polygonhomes.com) Cc: Monica Bilodeau Subject: Demp Permits, Polygon at South River Terrace,BUP2016-00047, -00048, & -00049 Chris, before we can release these three demo permits we need to receive a report from your project arborist certifying that all required tree protection has been installed at those locations. Meanwhile, we'll put these on Hold as "Approved but Not Released." Please have a copy of the arborist's report sent to me so that I can expedite these permits. Albert Shields 1