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Permit ,srP1721 77! , II CITY OF TIGARD -,,...1,-,,,,,,„k, ice„ ` MASTER PERMIT s 2- ?e- /�.r It ' COMMUNITY DEVELOPMENT Permit#: MST2015 00314 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/27/2016 Parcel: 251060002900 Jurisdiction: TIGARD Site address: 13715 SW 171ST AVE Subdivision: RIVER TERRACE NORTHWEST Lot: 1 Project: Polygon at West River Terrace, Lot 38 Project Description: New SF. Model home. 12/20/2016: REPRINT to add A/C. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 3 First: 805 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 26 Bathrooms: 3 Second: 939 sf Garage: 423 sf Front: 20 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Total: 1744 sf Value: $216,540.99 Rear: 15 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 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 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: 4 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'I 500 sf: 2 201-400 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: ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions) 7600 EAST DOUBLETREE RANCH 109 E 13TH STREET 1 Geo-Tech report required RD,STE VANCOUVER,WA 98660 before foundation inspection SCOTTSDALE,AZ 85258 2 Ersn Cntrl 503-639-4175 PHONE: PHONE: 360-695-7700 FAX: Total Fees: $30,671.99 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. 42 Issued By: �--- Permittee Signature: r ,1---/V-'4.../(7 / 7, 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. • ric7- 2.0/5--eo3// .Keichanical Permit Application 1.,..)iz 011 If 1:L',L.ONL.1 ,,, Ron*ad - .1=ISMIllailli Cil:Y.Of Tigard . 11'i"-. •'..110Fd115 6*.*°ialli *44..,432:'1"Figaitic. .5039"1115116*2- 9. et‘. ' 1.* l'''' 1.143".-8 :11;k7 • -- 9:411ff'P6nii : • :•• :.. ... it faspeciiiixt II=-1031119:4115. t- Pol11#4311P: 4.441. 0.Se c Pate!Or 191110c.: www#01011.040, r, El 0 'N . ttpet6e61_14w1rit__ ‘3 ,..,... ., sopu:Th..iiitahironitabA, _.... . . ._..._.• . . 111 '''' • •, ..... ... -. . .... - ._.•-........ ...-. ..... -.,-.,-,-, --:.,.:,. ,, :t 71.1.L;;:,,7;.?StT, G . .:: :7:,_,::::z.•:7-,,..-i-.s.71-f-,:':,..'::::',;:::17.,.. :51,17:-Ar.:72..:,C17(2. 17.7:2..:'-''''''.,''3::„..,.-'4":"''', -7•4 r. r . --- ipfechiatie4 00a:friss,are Used,*.0.ic*td9O.•Of le*co*: 121 - . • ,t, 1.11;411:4 /4eiiointhinition LiAdditiont. .;• ,4,- -. -- - .1)«tisatte4-I:ecru:leo the value(rounded to tfle neartsitteaar)dal chinicel materials.eendeinnent.labor_overbead.end profit .. OPME1.10.9P Q9thu.; _ -_:._-„:- - , .....___ yoliws. _.,,.....,_...„7 - ine --; .: -.T:t7.i::.-f,:77,7:,--:-'•7f;i4`7;*13--i'., .,-;...- :,..f."-,-17S':.t r r ttPin'reihity'c':ITirK7-,-2E7f; :f. al 1.40-2400ib'dwelling 0 etgowerdatiwtotrial 0AccgsstO btiliding •roripgatid tajtipitottguttlie Oecir#st. . alAulti404 E:114144 buhdcr El Other i' Detcriiideni 1 Q4'. f F4L I Total 7---...;i--,...,;.,.. .,:',:f-.!.'f,,,"Tfert4f.,:,..,.. 7,_;7itii,,,TS33_,_.'., . , t,'L.....,..--ir.'L-1::• Afr..66616anint: • / 44.75 1 - -.....A...• mei 'Inuiwillil Illra. o isial# 00315-- gr 11. ...a.-..... "--,norlasiar-dows.00a. 0000010 . - ,iePalIllrKeallLggiM. , • (of Sadb14110.iti52. Ciig-d . - 0.°4004gliCcfions b.):Aksite: Pthie6t."Ine: 1111:Al°tv\ (14. '4 0Ij / -3 7/57 5 Z-c) /7/ .' •- -,piiii :;,!.ca,a.:*)all)take.R.I.) 1 4i.13 Furnace100.6064,13Td Ouctewats1 Best poop. Duii*xi firviroalt.hot water system RegideitunI*tad LtadSsior Or hyditidaY. .1.3491 6'1.06 23.32 144i434*ii4iittl„ittitii0(Pluttolattl0d.4"c"electric). . ' 2323463232.7S• . .Flitatiaat.feitatliof skive 2332 .. _....... 2331 I1.0410.: . . trillietliteriiirtilii nett:._ ... . . ._ • Tg01#01440.1#1-,-• Vethif-'bistrei'.'..:----' '. . • -I 23.32. .., 3139 ' - - -. •-"- - -- - :,^-''-- ..1.-"' '- .•''' ',`._ ..:......_..,____. pi„.„.ncik,..1,10,12abs or pa A-biS /9- C-- seigide 2132 lanit.100404 23.32 - - - iroOditicatbikste: 33.39 'wowwarirtra*r. _ 23.12 brai-aiaifilitiiiillOWvant 23:32 " • 2332 '. : -' ...-:-'--.,•,-:--,-7.-,-.-',.,7'.., ..7.-:',7.;,-..J.i--","--„:-.'':.1 1!-. :7,•._:__-, 7."-- •u iiiiiiniatti cosustimd indibitinc . . li ;-*30....1421.474i41011"1.4- ItenWh°_Ptik.st*1416** .embibigrit• I 33.39. .24A*41 09 E.014 Si ' . .ablitatkVer 2erthanst I .33-39 'aiitif.'-tgad.Z111171411401tie.WA 9800 . • - Italtiesompaltneats,tifility.rotatis) . 4 23.32, Pane pitologet: Rai t ). ...iiitatisrawingice tang , 11.3.1 2111 Bii4i0i4%iiiiiiiittl'ilortieirtist ._ 414.1.51ar tint fawn 34.03 tae.racti additional Cottiditime, .liusfla6e.eft MiliestAiii)1 IA*St . . . ._. • -. GfJllUW Vallhatiteadoil1italtlicati- i4t0.03e.W.g;tf10.01011.4 Mrk9801 _- . . Tbrii .(361))81648M i lax :( ) ?bailie .1 I .g4001: weasxme• -- - `- '-' ------- -------'---------'l--- --- ,.--7-',,---- Zloty:it ari,er,tgaiy- . _. , men Itadness iiiiic Andersen 11464,1ac )hilil#0ifil$40hipPbtik.410 _ . . taiitOial . -.. . . ,,.. . „ . •••,„ • ...... -..,,--- Minimum'Pernik fie MOO .Cife*PgAtMOlik 010=4- • -- hie review OA atpetark itel Pbati two 9924.464 I Fax (503)536-6611 .. , Stile liectiorig tir4.0r-pentatico 041g.4-14•144 • TOTAL PERNOTYEE. ThiliOhnit Oaaciliai 640#If a icoOtig)i•tib4ird*lb"al days attaklwar 1Wea',militant;aiiipleu- Antbortzed sigutitatt; Fie tanduodoteet tet by Tri-boantyattactwe Ind eno Smite Bawd I ifeitin-inet Miiiiiee --- . Daic 10/0/21115 itiatiivici4tivasa-li..64;440401tienc 44041nt4lintommvEs) • . . CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2015-00314 Date Issued: 01/27/2016 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 251060002900 Jurisdiction: TIGARD Site address: 13715 SW 171ST AVE Subdivision: RIVER TERRACE NORTHWEST Lot: 1 Project: Polygon at West River Terrace, Lot 38 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: 26 Bathrooms: 3 Second: 939 sf Garage: 423 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes Total: 1744 sf Value: $216,540.99 Rear: 15 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 0 Drains: Storm Sewer: 100 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 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: N 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: 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'I 500 sf: 2 201-400 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 8 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: ADLV LAND HOLDINGS LLC POLYGON WLH,LLC Required Items and Reports(Conditions) 7600 EAST DOUBLETREE RANCH 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175 RD,STE VANCOUVER,WA 98660 2 Geo-Tech report required SCOTTSDALE,AZ 85258 before foundation inspection PHONE: PHONE: 360-695-7700 FAX: 360-693-4442 Total Fees: $30,214.68 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 By: 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 City of Tigard Received g MDateB : j /p. Permit No.: 13125 SW Hall Blvd.,Tigard,OR 97223 �\ Plan Review Phone: 503.718.2439 Fax: 503.598.19 y Date/By ) Other Permit: : Ll l Inspection Line: 503.639.4175 Date ReadyB : Jur;S. 0 See Page 2 for Internet: www.tigard-or.gov DEC 3 0 2015 Notified/Method: / Supplemental Information ®New construction ❑ IN. 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 Imp work indicated on this application. ® 1-and 2-family dwelling ❑Commercial/industrial Valuation:' $ ❑Accessory building ❑Multi-family Number of bedrooms: 3 ❑Master builder ❑Other: Number of bathrooms: _2,5_'3 Total number of floors: 2 Job site address 71 67 U _ New dwelling area: I Z—} square feet ] City/State/ZIP:Sherwood,OR 97140 Garage/carport area: (� square feet Suite/bldg./apt.no.: Project name:Polygon at West River Ter Covered porch. , square feet ,3 Cross street/directions to job site: Deck area: f ' square feet Other structure area: G square feet Subdivision: Lot no.:38 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 equipment,materials,labor,overhead,and the profit for the work indicated on this application. New Single Family Detached Construction Valuation: $ Existing building area- square feet New building area: square feet Number of stories: Name:Polygon WLH,LLC Type of construction: ` Address:109 E 13rh Street Occupancy groups: City/State/ZIP:Vancouver,WA 98660 Existing: Phone:(360)695.7700 Fax:(360)693.4442 New: Business name:Polygon WLH,LLC Structural plan review fee(or deposit): Contact name:Maggie Gordon FLS plan review fee(if applicable): Address:109 E 136 Street Total fees due upon application: City/State/ZIP:Vancouver,WA 98660 Amount received: Phone:(360)695.7700 Fax::(360)693.4442 E-mail:maggie.gordon@polygonhomes.com Commercial and residential prescriptive installation of roof-top mounted PhotoVoltaic Solar Panel System. Business name:Polygon WLH,LLC Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:109 E 1P Street Solar Installation Specialty Code checklist. City/State/ZIP:Vancouver,WA 98660 Permit Fee(includes plan review $180.00 and administrative fees): Phone:(3 )6 Fax:(360)693.4442 State surcharge(12%of permit fee): $21.60 CCB 110; ?&_,11 i Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name.Maggie Gordon Date:12/11/15 'Fee methodology set by Tri-County Building Industry Service Board. I:Building\Permits\BUP-RESPermitApp.doc 02/24/2011 4404613T(11/02/COM/WEB) Electrical Permit Application FOR OF FWE I.ISE ON'I,N z, c Pernwil No T-w E if City of Tigard I R 13125 SW I loll Blvd-Tigard.OR 97223REGE ke c"c""c Plan PcvicW Phone 503.718.2439 Fax: 503.599.1960 Inspection Line: 503.639.4175 Date Rcadyfliy: 0 See Page 2 for Internet: www.tigard-or.gov "'if plotified/Mcibad. supplemental Inform-liton -I IG N :. ...... Please check all that apply(subinit 2 sets or plans w1itenn checked below). New construction El Addition/alteratioWWkecMcnt 0 Scrxicc or feeder 40D amps or more 0 Builditi,oxer three siones El Demolition F Other: vvhcre dwavailable fanh etiffent 0 Marinas and lumi—r& exceeds 10.000ampsat 150 volts or 0 Floating bijildivig, less it,grourid.or exceeds 14.000 0 Coil)mere ial-usc.1L ricull[trill * I-and 2-('amity dwelling El Commercial/industrial El Accessory building amps for all other installaiions likiddings *Multi-family ❑Master builder 0 Other: El Fire pump 0 Installation ol'75 KVAor ­ #44:�'�yA _-, - - - ­:­.;, I 1 1:'-"i � "�" 1 [:3 rinerpency System. larger sep:u aleft lamed sracm WS!7 Na TO D$ Addition of new motor load of 0 10011P or more. occupancy Job no.: Job silcaddrcss. Osix or more residenfial unit., 0 Recreauonal ehicle parL, 0 1 icalth-care facilities 0 supply.Bulge finomie than City/State (:3 1 hizardous kwalimis noollual Suite apt.no.: Project name: 0 Service or feeder 600 nip.or inure. Cros stret/dilrcctiolis tojob size: peuri lion lw. I fee. 7at.1 I New residential single-or multi-family dwelling unit. 3 zz Includes attached garage. I Lot no.: 13 1.000sq ft.or less 16854 1 Ea.add'I 5Wsq.11.or portion 3392 Tax map/parcel no.: Limited energy.residential 7500 q (with above s- -ft Limited energy.multi-fiamily 7500 2 New electrical service and wiring residential(%vith above sq ft Services or feeders installation,alteration,and/or relocation 200 amps or less IM.70 2 201 amps to 4 4U1 amps to 6W amps -'(X).34 2 Name: P(D\�A wy---- 601 amps to 1.0DO amps 301.04 2 Address: t o Over LOW amps or volts i.S2 26 2 *I'cmpnrary services or feeders installation•alteration.and/or City/State//_IP: \j oxl�clvvef W P� (A blau D relocation Phone: 1-a,,:'2j 'r" 2W amps or less 59 36 L '_01 amps to 400 amps 12503 2] This installation is being made on property that I own which is not I Owner installation:1-h401 amps to 599 amps 1 169 54 2 1 intended for sale,lease.rent,or exchange..according to ORS 447,449.670.and 701. Branch circuits-ncw,alterati orextension, er panel Owner signature:_ Date: A.Fee for branch circuits.with above service or feeder fee. 742 2 W MIN* each branch circuit B.Fee for branch circuits trithow Business name: service or feeder fee.first 56 18 Contact name: add ve, L--,c ocn branch circuit 11 Ilach udd'I branch circuit 742 2j Address: Miscellaneous(service or feeder not included) Each manufactured or modular City/State/71P: 6794 &(1 U dwelling,service and/or feeder Phone: I.-ax: Reconnect only 6784 2 i _T PUMP Or irrigation circle 6794 2 F.-mail: CA) Sign or outline lighting 6784 -2 M Signal eircuit(s)or limited-energ5 Business name:Simply Electric panel.alteration.or extension Page'_ Each additional inspection over allowable in any or the above Address.PO Box 822408 Additional insriection(I hr min) 66 251 hr City/State/ZIP:Vancouver,WA.98682 Investigation(I lir min) 66.25/hr d Industrial plant(I hr min) 78 It(/hr Phone:(503)849-8202 Fax:(360)314-4945 Inspections for which no fice is 90.W/hr specifically listed(V:hr min) CCB Lic.: 204615 Electrical Lic.: En K lk�067 S.prv. l.i,.: 4394S Subtotal- Suprv. Electrician signature,required: Man revie%%(25%of permit fec) Print name: Victor Zarzhitsky Date: 10117/2015 State surcharge(12%ol'permit Ice). TOTAL PERMITFIT.. Authorized signature. This permit applicatio"expires if permit is not obtained within 180 days after it has been accepted as complete. Print name: Date: Lumber of io.,jx.cliorisallo-ed per perniii te3,utrt}Itesro►b �p'if MY SIS�Q :amt�?S R°a°g 2*e&aS 94vrm9�Pl+a@ pi C4r+s opo aa3 '. sup..... OSi !x ° .�f s s ?: s* r v •'Sv i!IZ89t" ? f'llt6�i `4 ' (QO'QGSk�J'#�A Wei Et j99S6VAY A -�� maw - __ �5 obi��t• V . . - _axpt}: RQ°-.dtY. _.. ....... 6£'f£ sa to mga4 szoia`mg Tj SyF� .......PSL ZEM - '(SuaPtiaari? )sE`�ati 4 Z£"£Z z€tz. - cam;ittfi o00�UOE aii qoo� 9'aH A!g3 A�( o a mppnqo: poyda »i u�a ilg c zpw-t- . my a�vi v❑ laws. MEMO ... =q*0 �q�3g ap�e�a�uo pas'@q am`*sem bawd Ie»�i�}"F _ Al - - K Et 8 865£ S ace3°6£YE 8EL . m .a Plumbing Permit Application Building Fixtures q 1 � Received Permit No-: c T City of'Tigard � I�atdB . 1'i'l� 13125 SW Hall Blvd,Tigard, Plan Rnimv Phone: 503.7182439 Fax: 5�3. .1960 ��j pOdgr Aber eamit No Inspection Line: 503.639.4175 ( ! Date Redyft. J.9k ® See Page 2 for Internet: www.tigerd-oc gay " Nol dfMdhod Supplemental Information New niiorn For mf P ormariorr use cherkfim Dwaiption I QtY. I Ea I Total ❑Addihonlalterafionlre placmnent ❑Other New 1-2-family dwellings(includes 100 ft-for each utility connection) 7 NEW SFR(1)bath 312.70 l-and 2-frizQy dwelling 11 CommmemVmdustrial SFR(2)bath 437"78 ❑Accessory bwl&wg ❑Mul i-fmni)y SFR(3)bath 50032 50v o ' Each additional befb/fdtchen 25.02 ❑Mesta builder ❑Other. Fire sprinkler(__sq.fL) Page 2 Site u litxs- sde a 29ffiesm Catch basin or area drain 18.76 Fo �l. City/Staf MU- ��'}��� Q�1.'�� Yleach tine,or trench drain 'f Footing drain(no.linear R:_) Page age 2 Z Si iWWdgJapL no_ Project name: �� �'�(\ Malmf cured home utilities 50.03 stredldirrctiuM to job site: -C Manholes )8.76 L j Ram dmn connector 18.76 Sanitary sewer(m linear fL._� Page 2 Stn¢m sewer(nm linear ft.: ) Page 2 Water service(no.linear fL:_} Page 2 Subdivision: Lot un.: Fnctart or item: Tax mapfpmcd no.: Beddlow prevcatu 3127 Backvma valve ( 1251 Cloflus washer 25.02 a ,O Disbwasha 25.02 2 ~� Drinking faurdain 25.02 Ejoatars/—W 25.02 EVansion tank 1251 Fodraelsewer cap 15.02 Marne Floor drainl&nor sirMiub 25.02 Address: �' 4 Garbage disposal 25.02 Cit)/Staf mP: Hose bib 25.02 PbomFare( ) Ice nuke" 1251 2 Intmtor/grrrse trap 25.02 Business� MexhCat gas(Value $ ) Page 2 PtmJer 1251 C ° Roof drain(commcciel) 12.51 Addr= n sint/basinllavutary 25.02 City/st"Zip: solar twits(potable watrr) 0-54 Phone;( ) Urinal 25.02 ts- d Fax:( ) Tubfsbowedshowapan. C' 12-51 15.0 E-�ma Wafer clusd 25.02 Wafer heater 37.52 Business DWDCe C,j„ Wdcr pipinl;JDW V 5629 Ad*=r- Otlur 25.02 awsta em- Subtotal > : ) "1 — 03 Far( ) Mlmiumm permit fee: $72-50 CCB Lie- L E1613Z Plan review (25%of permit fie) Plumbing L.ic. State:surcharge(f 21a of permit fee) Audwri and signatum TOTAL.PERMIT FEE IfaIiIC. f 'Mis permit application expires Ka permit is not obtained within 186 days [ — DBte: after it has been accepted as complete "Fee medwdology set by T»-Comity Building Industry Servico Bond" 1: -doe [WIMP 440-46r 6T(1�OMIw.FA) City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT ■ Building Permit Review — Residential Building Permit #: nSFRC)l Site Address: 13 7/S 9W 171 S+ C -r' Project Name: po) . a 1--) elf_ Wej+ (Z(y gr Teyr4 ct_ Lot #: (New d el ing= subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: N424.,/ s le 1` ( Mo(/u H-o rr d Verify site address/suite#exists and active in permit system. J�1 River Terrace Neighborhood: X Yes ❑ No Site Plan Elements: Three(3)copies of site plan xisting structures on site Site plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished XDrawn to scale(standard architect or engineer scale) oor elevations /North arrow Utility locations (required for new,may apply for additions) s)ite address,project or subdivision name and lot number Location of wells/septic systems Lpplicant information(name and phone number) Erosion control(including drainage-way protection,silt fence 1ot dimensions and building setback dimensions design,location of catch basin,etc.) Lot area,building coverage area,percentage of coverage and Street names /4Mfopervious area(applicable if R-7,R-12,R-25&R-40) Street tree size,type and location ot roperty corner elevations(2 foot contour lines if more than Existing trees to be retained with drip line,and tree differentialprotection measures Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No Public Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified El No Applied For: s El No,stop intake Land Use Case #: �n _ ���0� S S � L Zoning: —7 Pp Setbacks: Front 12, Rear Side 3 Street Side Garage 2:.D Landscape Requirement: Lot Coverage Maximum: (Building Height: Maximum Height Actual Height" /r7f Visual Clearance Easements Sensitive Lands: Yes ❑ No Type _ Urban Forestry Plan // Conditions "Met"prior to issuance of building permit Notes: Cu h 7 r)J dl f 7(4 1 V)kl( Approved By Planning: m /' Date: 2, Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved 1.•\Building\Fonns\B1dgPennitRvw_RES_070915.docx Building Permit Submittal Original Submittal Date: I'Ool/5 Site Plans: # Building Plans: # Building Permit#: 0- ,'n_terr budding permit#above. Workflow Routing: __ E_ -- fan-ning__ -C gineering- Coordinator 2i-Baikhng Workflow Sign-off R_5ign-off for Planning(include notes from planning review) Route Application Documents: �eering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. u ding: original permit application, site plans,building plans, engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: � r - Date: Engineering Review ,B'Slope at building pad: ❑ Conditions "Met"prior to issuance of building permit ❑ Easements (encroachments) per engineering conditions of approval and plat ❑ `Fater Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes O No Assess Water Quantity Fee in-lieu: ❑ Yes eNO LIDA Facility on lot: ❑ Yes ,Z No ❑ NOT Approved by Engineering: Date: Notes: Mfl� 15- Approved ~Approved by Engineering: N (Tom.. Date: (, / Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ 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 Noticed: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: Revision Notice 3: Date Sent to Applicant: DC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: Yes ❑ N/A ?`:70K to Issue Permit l� Approved by Permit Coordinator: Date: 11'" 1:\Building\Forms\B1dgPermitRvw_RES_070915.doex Mechanical Permit Applicatinn_ 1,...k(qiii I 1 4,1 11\1 4 RE City of Tigard CEIVED 1312.5 SW Hall Blvd,Tigard,OR 97223 71 _ _ Ph503, 3.2439 Fax: 503,5913.1960 Imsccison' Late: 503.639.4175 I P ° Internet. wwwrigard-orgov SEP 2 2 2016 titec6-meri"43, 9,22 42V- one: Plan Review Other Puma,t:latettL r1(Sy_ Aso el See Pete 2 for Notldeth CITY OF TIGARD . tfibiod:• Supplemental Intormatina w.:5,,,,,,,c,121,,,s,.-,f„,;4',-.1,,,,,:4....;-1:,(:;:,,,i,',,::‘,,,;1:',:;pti;:„::,:.:4‘..",:;:',,,,,,>:::41,,,,,,,,f A„,,,:?1,),3•R',,,y;,,,,jt:,;:,,,i, sem,ec„,ha.ortica,,1-perinua.-ii,.-rees..o,,,,,are., based...son the.value or the work, t: New-construction 0 Additionialterationfreplacentent pedbnnet Indicate the value(rounded to the nearest dollar)of all chemical materials.-equipment.labor.overhead,and profit .,, ,, .1i1.8t;t,- :•„3'1%;AW,.1kgikiSx.gaii,--;.":41,(44'%--",>,"•2-'4-(5t''''-.5:4'• ,--',',2-',t,",i--7,-:Lerav-:'s('-aite--"essu.-, .-. :.-e.,-- , ,.,---- -- ------- -( „(01.44.40-,,, ..-tm--,mie ,-- , shrformadon use ektrikst 0 L.and 2-familY dwelling 0 Commercial/industrial 0 Accessory building Jnr 0 builder 0 Other: Pef''crir4"/ I Qt)'' 1 EL I Mull eit Multi-family Master Heatiagkoollut: - --------,e,='•-. ,' ':',4 ''-',, ':' "t&''2"',',"i4i '";;:"':if,'"r; Al _ -- - ,^% . - ''-- Att coodniontag 46'7,5 Job site address:, lcl lc 5 n t N-f_, furnace 100.000 Bill niucisivento I Furnace 100.000s 11Th idocis(vents) 54.91 City/StaleiZIP:Tigard,OR 97224 . - lleat maim 61,06 Suite/bldg./mit.no.: j Project liallic:90 ikicryi nit vje,st gNiue ifinr Duct work 2132 ilvdronte her water system 23-32 Cross street/directions to job site: Residential boiler(radiator or hydronic) 23 32 link heaters(1nel-type,not electric), in-wall in-duct,suspended,me 46.75 pluestm got any of above ( 23.32 23-32 Other Subdivist6n; POILmon at Kieriel4ttir li4latet- l'An no-:3?) Other fuel appliances; Waver heater 23.32 fax amp/parcel no. ,,,,_ , . _,_ ,,.,,,,,, ,,„2„,,,,,, ,,,-,,,,,,,w%,;7_<.-,, (34,,s.,r_—,--„a„,,,-,-,,-`,4-_-,0,,,_(sez.,,..,s.-v-z;.-:i3O:71-74s„*-,-„,a,„...,(s,,,,'„„-.,0'*-„;;,--,„-1,,4„„.s,..-.;-10.;;;,,,!,(‘!4;'4,;__-4_-,,,';,,,,s,i::e,,.,.,'.:U..',:...(''4,'i'-4','"k*,i-i,,'''-'',',i i,,,',,s''?,',,,-;'•, ,•i-;,-(,104ss----1,:-,1,%:,'",-(,;-,-.:-•''''_-1-4'"',---4ft--tAvlue fvitaepniorr fiwnnataetr hater or gas 1C°Mr* NACI replace -' 33,39 , 2332 23,32 Log lighter(gas) W lA-:°((mItiPereptkestove leceinsert 233313.329 Chi Ilineriflueivent * 2332 23,32 ,:1:111471*-W31: ::,,i' 1•,;55-"'1 "Environmental eha xust and ventilation: -'. lit2, 1,---:„.44.:,,t,-..,.,,,,,,X,,,4-:t..,;,w ,-4,--4;--: ;,•;,,,,,-,-'',to • ,'''"'" Rant hood/other kitchen i Name:Polygon WLH,LI(' equipment I 33,39 Address: 1(19 East 134 Street _ Clothes dryerexhaust* 1 33.39 Single-duct exhaust(bathrooms. CitylStateiZ IP:Vanentiver,WA 98660 toilet compartments_utility morns) 23 32 Phone:(36005-7700 Fax:t ) Attic/crawl- ,cc fans 23.32 Other 2332 .•-,<,.o..,; •.; ., ., ;, r ro:Ot ',''',".';-,.,'-1*--- ' 4. .14t,'' --"'''''''!1",iit-Itk--1.ti---,A;,•''''',0- '-v• z--- - - —• ---- ----- , Fuel MIX012:- Business name:Polygon WIll,LIC • $14.15 for first four;$4.03 for each additional Contact name:Angela Grajewski Furnace,etc. I .. 1 Gas Address: 109 East 13th Street heat pump • ' '., Wall/suspended/Unit heater Citv/Sta.terlIP:.Vancouver,WA 98660 Water heater , Phone.(360)695-7700 Fax::(360)6934442 Fireplace Range i ( E-mail:Angebt.Grajewskpolygonhontes.coni C16fts drY"(PA° ',(];:;','„- s,!si..;',:et,,*2';'`;'-11'0';- (2 .''','--,X,',1,-1,-;:•:,',',Jamovia.,a1,%4,,Y•ex, ,e,-. ,- - - - , . • . . ,,,, , other ' Business name.Apex Air LLC ,,;,17'''''' ,:174%.,A7,9',,,A„,#,.7)---: 2,-„,:'*,,t,:f '- Address: 18004 N1 72 Ave . ' ' -— ''' Subtotal , 490.00/ City/Stater/AP:Vancouver,WA 98686 Minimum permit fee • , Plan review(25%of permit fee) Phone:(360)3424109 Fax:060)326-1769 ! State surcharge(12%of permit fee) - . TOTAL PERMIT FEE CCB he.:203034 This perntit*foes:non*soros If wain is sot obtained within Ibb days atter it has barn accepted as complete. Authorized signature: - — * Foe methodokw,* .set by Tri-Cotinty Building IbtilotrY Set-rte ettatd Print name77se7Date. 4 il-IC... _1 444-46 t7T 01 mvcomwrni I'meamesmomeemsciumnixeeprei iv doe Electrical Permit ApplicatiRECEIVED FOR OFFICE USE ONLY City of Tigard Received V,•— 1,1 il 13125 SW Hall Blvd.,Tigard,OR 9722 P 2 2 2016 Date/B :f 7 �', V , 1 • Phone: 503.7182439 Fax: 503.598.19 Pian Review Date/B : Related Permit#: Inspection Line: 503.639A175 CITY p-� ( ry T I GAR D Internet N a tigard-or.gov V I I Y V I I l�M L 7 Ready DMeth,y lune: S See Page 2 for Notthed/Method Supplemental Information ®New constructionhec e � .; 0Addition/aJteration/replacefient Please check all that apply(submit 2 sets ofplans w/items checked). 0 Demolition Other: 0 Service or feeder 400 amps or more 0 Building over three stories. ` where the available fault current 0 Marinas and boatyards. ` Ft- � � tOftreG©.1 ggVa t') -'_ _v -E` " .M exceeds 10,000 amps at 150 volts or Q Floating buildings. ®I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural 0 Multi-family El builder- amps for all other installations. buildings. A R ^ _� _ 0 Fire pump. 0 Installation of 150 KVA or R ._.Q1 "$S ID LOtKLiON ❑Emergency system. slarger separately derived Job#: I Job site address: I—Th IS SW 11 i t rp^ 0 Addition of new motor load of system. vv v t V7 100HP or more. ❑system. City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy, ❑Health-care facilities" 0 Recreational vehicle parks. Suite/bldg./apt.#: I Project name:Polygon at West River Ter O Hazardous locations. 0 Supply voltage for more than Cross street/directions to job site: ❑Service or Seeder 600 amps or more. 600 volts nominal. Description I Qty. 1+ Each I :..Total:ItA .l-•_: New residential single-or multi-family dwelling unit. Subdivision:Polygon at West River Terrrace I Lot#:3e, Includes attached garage. Tax map/parcel#: I,000 sq.ftor less Ea add'1 168.54 4 , .47, r =Dkg () d energy, sq.esfta portion 33.92 1 /��\�. � ��... m: ��� ',.�_"�€-� "'�.�g =`� Limited en C/��' UIVIIJII r,heY>residtvttial 75"00 2 (with above sq.ft,) Limited en ,multi-family residential(with above sq.ft.) 75"00 2 `< x Renewable Energy CI See Page 2 Name ADVL Land Holdings,LLC Services or feeders installation,alteration,and/or relocation 200 amps or less 100.70 2 Address:7600 E Doubletree Ranch Road 201 amps to 400 amps 133.56 2 City/State/ZIP:Scottsdale,AZ 85258 401 amps to 600 amps 200.34 2 I 601 amps to 1,000 amps 301.04 2 Phone:(602)694-4031 Fax:( ) Over 1,000 amps or volts 552.26 2 Email: 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 5936 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. - 201 1 • amps to 406 amps 125.08 Owner signature: Date 401 amps to 599 amps 168"54 122 N • As Rr crmic missBranch circuits—new,alteration,or extension,per panel Business name:William Lyon Homes,Inc. A.above servicebranch rifee a fee, above or feeder fee, Contact name:Angela Grajewski each branch circuit 7.42 2 B.Fee for branch circuits without i Address:109 East 13th Street service or feeder fee,first branch circuit 56.18 2 City/State/ZIP:Vancouver,WA 98660 Each add'l branch circuit 7.42 2 Phone:(360)695-7700 I Fax::(360)693-4442 Miscellaneous(service or feeder not included) Each manufactured or modular Email:An ela.Gra'ewski dwelling,service and/or feeder 67.84 2 j g J @polygonhomes.com . _ ��K Q v Reconnect only 67,84 2 ' ,$ 1 & ,-„: Pump or irrigation circle 67,84 2 Business name:Garner Electric Washington,LLC Sign or outline lighting 67.84 2 Address:6101 NE St Johns Rd Signal circuit(s)or limited energy ❑ See Page 2 2 panel,alteration,or extension. , City/State/ZIP:Vancouver WA 98661 Each additional inspection over allowable in any of the above Additional inspection(I hr min) 6625/hr Phone:(253)320-1657 I Fax:( ) Investigation(1 hr min) 90.00/hr / Email:bdaniels@gweusa.com Industrial plant(1 hr min) 78.18/h JInspections for which no fee is 90.00/hr CCB Lic.: C1158 Electrical Lic.: 208174 I Suprv.Lic.: 4496S specifically listed(h hr min) Suprv.Electrician signature,required: <I` .•• ES= = Subtotal: Print name: Joan P Albert Date: 4/26/2016 0 Plan Review Required(25%of permit fee): ��,-_---- _-�..,�� State surcharge(12%of permit fee): Authorized signature: - — TOTAL PERMIT EP..k: Print name: Bill DanielsThis permit application expires if a pacinitis not obtalaed anielswithin ni 80 Date: 4/26/2016 � days after it has been accepted as complete. * Number of inspections allowed per permit I\Building\Permits\ELC PermitApp_ELR ERE.doe Rev 06/17/2015 440-4615T(11/05/COMIWEB Plumbing Permit Applicatl .__', :!,.7.11'., Building Fixtures I OR (,I 1 It 11 sl 0\l-1 SEP 2 0 2016 City of Tigard Received • 13125 SW Hall Blvd.,Tigard OR 9 -,, ` '' Date/By: 77°'Z 7 / Permit No. Phone: 503.7182439 Fax: 503,5 Play Review Jr96 ' Other Permit No.: Inspection Line: 503.639.4175 ���- ` ° - '" - ' �DateByr f;,' \F 1) pDate Ready/By: Julia: H See Page 2 for Internet: www.tigard-or.gov Notified/Method: .. .: • T►'PE-OF.WORIF.,.. ...... Supplemental Information ®New construction - � r'Jt;E*BGI#EDiJJCrE ; •..R, ❑Demolition For special tnformuiion use checklist ❑Addition/alteration/replacement ❑Other. Description I Qty. Ea. I Total New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION" SFR(1)bath 312.70 ®1-and 2-family dwelling SFR 2 0 Commercial/industrial (2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 ❑Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler( sq.ft-) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address:)311 s l- , �lt I`` f �t- pry L rr Catch basin or area drain 18.76 City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain 18.76 Suite/bldg./apt.no.: I Project name:Polygon at West River Ter Footing drain(no.linear ft.: ) Page 2 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 Subdivision:Polygon at West River Terrrace Water service(no.linear ft.: ) Page 2 I Lot no.:30 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF.WORK Backwater valve .1 12.51 fila c;-r,,r r , q� Clothes washer 25.02 / QAC. /J Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ®..PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Name:ADVL Land Holdings,LLC Fixture/sewer cap 25.02 Address:7600 E Doubletree Ranch Road Floor drain/floor sink/hub 25.02 City/State/ZIP:Scottsdale,AZ 85258 Garbage disposal 25.02 Hose bib 25.02 Phone:(602)694-4031 Fax:( ) Ice maker ®APPLICANT12.51 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name:William Lyon Homes,Inc Medical gas(value:$ ) Page 2 Contact name:Angela GrajewskiPri n'ar 12.51 Address:109 East 13th Street Roof drain(commercial) 12.51 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:Angela.Grajewski@polygonhomes.com Urinal 25.02 CONTRACTOR Water closet 25.02 Business name:Malmedal Enterprises Inc Water heater 37.52 Water piping/DWV 56.29 Address:PO Box 207 mer 25.02 City/State/ZIP:Banks,OR 97106 Subtotal Phone:(503)324-0759 i Fax:(503-)324-0580 Minimum permit fee: $72.50 CCB Lic.:102535 Plumbing Lic.no.:34-276PB Plan review (25%of permit fee) State surcharge(12%of Authorized signature: TOTALALPERMITRMIT FEE I Print name:Carolina Malmedal I Date:04/25/2016 I This permit application expires if a permit is not obtained within 180 days 1 aker it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. IABuildirgTermitslPLMII-PemitApp.doc 10/01/09 440-4616T(10Po2/COM/WER) 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 13715 SW 171 STAVE, SHERWOOD, OR, 97140 Record Type: Residential - Master Permit Inspection Type: 399 Plumbing final Result: PASS Comments: Violation Summary: Inspector Tel: 503.718.2439 Inspection Date: January 17, 2017 at 9:44:08 AM Record ID: MST2015-00314 Inspector: Aaron Cillo-Gobel Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 13715 SW 171 STAVE, SHERWOOD, OR, 97140 Record Type: Residential - Master Permit Inspection Type: 699 Mechanical final Result: PASS Comments: A/C installed Violation Summary: Tel: 503.718.2439 Inspection Date: Record ID: MST2015-00314 Inspector: Chip Barnett Inspector Contractor