Permit (26) CITY OF TIGARD BUILDING PERMIT
11111 : COMMUNITY DEVELOPMENT Permit#: BUP2016-00061
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/14/2016
Parcel: 2S1060001600
Jurisdiction: TIGARD
Site address: 17255 SW HOLLY RIDGE LN
Project: River Terrace Northwest,Lot 21 Subdivision: 2002-032 PARTITION PLAT Lot: 3
Project Description: Adding front and rear covered porches and new window openings to sales trailer.
Contractor: POLYGON WLH, LLC Owner: POLYGON NW WHL LLC
109E 13TH STREET 109E 13TH ST
VANCOUVER,WA 98660 VANCOUVER,WA 98660
PHONE: 360-695-7700 PHONE: 360-695-7700
FAX: 360-693-4442
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB DC Provision Review,COM TI-Ping 03/14/2016 $88.00
Occupancy Grp: B Occupancy Load: Permit Fee-COM-New Construction 03/14/2016 $209.80
Dwelling Units: 0 12%State Surcharge-Building 03/14/2016 $25.18
Plan Review 03/14/2016 $136.37
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 03/14/2016 $17.50
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $12,526
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 264
Deck: 0
Garage: 0
Mezzanine: 0
Total $476.85
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 t. -.• ••• 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: / , Permittee Signature: l / `/�_
Call 503.639.4175 by 7:00 a.m.for the next available;;;;;;TZ—1 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
Commercial RECEIVE!) 99 /� FOR OFFICE USE 01N1.1City of Tigard Date/B y p'-a?S AO Permit No.: 1 eo o!
514 i'l 13125 SW Hall Blvd.,Tigard,OR 972 3�q L
I Phone: 503-718-2439 Fax: 50345911941 2016 Date/By:'� �"�j 1 ��Related Permit: ��/�DLA )—
Inspection Line: 503-639-4175 Date Read �I Juris: FB See Page 2 for
TIGARD Internet: www.tigard-or.gov Notified/M tod: , Al AP Supplemental Information
TAIMIKKas 1 Y Ie7IONRE i U5RED DATA:1-AND 2-FAMILY DWELLING
0 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 ❑Commercial/industrial Valuation: $
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: /f-as< i&/444 /qi., Gh New dwelling area: square feet
City/State/ZIP: 7:,vea,,./ !)/ J Garage/carport area: square feet
Suite/bldg./apt.#: Project name: ,v4) /;,,e,- �,��G/� 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: I Lot#:021 Permit fees*are based on the value of the work performed.
Tax map/parcel#: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF
/t'�WORK work indicated on this application.ti
�o,d , 8 SO!leS //moi Valuation: $/ S'- 3-5^
Ani)/,-)e,- C2s,r Y Q-f f e- e-odf!hO kiel"f S . Existing building area: square feet
(,L}1 N 7Dc ec.. c9 9 l ,J 6g . New building area: (Z7� square feet
QROPERTY OWNER 0 TENANT Number of stories:
Name: q94‘90,7 &It) /0,1'JJ l'i Type of construction:
Address: /DGy 3 4e-......4;,-- Occupancy groups:
City/State/ZIP: /4"ve,H,,,,- At.i.A 9,6i, Existing:
Phone:') vyj— 7760) Fax:(34 ) .3 yyA.3._ New:
❑ APPLICANTCONTACT PERSON BUILDING PERMIT FEES*
Business name: (Please refer to fee schedule)
�2 ,W,ler/.4A..--7'
� Structural plan review fee(or deposit):
Contact name:
FLS plan review fee(if applicable):
Address:
City/State/ZIP: ,....54AZ.-- �� Total fees due upon application:
Phone:(j-z '/a eFax: :( ) Amount received:
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mo 'ted Photo Voltaic Solar Panel System.
Business name: 64 �J 444/ 2-L-C Submit two(2) --ts of roof plan with co 'on details
and fire departmen •ccess,alon ' the 2010 Oregon
Address: j0 9 ; / 3.k...4,- Solar Installation Spec: e checklist.
/
City/State/ZIP: 4,_ � 9�� Permit fee(inc .es . .n review
Ai, j�
an :.ministrativ- -es): $180.00
Phone:(3 14—.74,,,e) Fax:O //1"l�.7__ State sur arge(12%of permit fee $21.60
CCB Lic.: ( v '/23k otal 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: / /1L Date: ��/� * Fee methodology set by Tri-County Building Industry
G'L`//�� r!/ Service Board.
1:ABuilding\Permits\BUP_COM_PennitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)
Gu
e•
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
lig 'I Accessibility: Barrier Removal Improvement Plan
Commercial & Multi-Family - Additions or Alterations
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation,alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five percent(25%).
VALUATION: Total of all renovation,alteration or modification being done,
excluding painting and wallpapering: [1] $
MULTIPLIER(25%barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $
ELEMENTS: In choosing which accessible elements to provide under this section,priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: S
(c) An accessible route to the altered area: S
(d) At least one accessible restroom for each sex or a single unisex
restroom: $
(e) Accessible telephones: $
(f) Accessible drinking fountains:and, $
(g) When possible,additional accessible elements such as storage and
alarms: $
TOTAL (shall equal line [2] of Valuation Computation): $
I:\Building\Permits\BUP_COM_PemutApp.doc Rev.12/18/2014
Y
City of Tigard
'Pi ■
COMMUNITY DEVELOPMENT DEPARTMENT
T I G A R D Building Permit Review — Residential
Building Permit #: !�-r tPao/i!r—OOO(¢/
Site Address: rag 3 83,../ . iQW
(� 1-4A--c
Project Name: 0kivai P//4cQ ✓/(/(,v Lot #: /
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review (` ,O /
Proposal: l&hpvu't, 14) GM�ee, --. ,/Oe l?'cA'j , f v fy--e✓fuli t
appraw poi.ii- (C,ALS c26 4.—0000 -)
❑ Verify site address/suite# exists and active in permit s em.
❑ River Terrace Neighborhood: ❑ No Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
111 ree(3)copies of site plan g structures on site
P ,ite plan must be on 8-1/2"x 11"or 11 x 17"paper ootprint of new structure(including decks)with finished
K40 rawn to scale(standard architect or engineer scale) oor elevations
North arrow Utility locations(required for new,may apply for additions)
'Site address,project or subdivision name and lot numbersocation of wells/septic systems
Applicant information(name and phone number) —❑Erosion control(including drainage-way protection,silt fence
•t dimensions and building setback dimensions design,location of catch basin,etc.)
•t area,building coverage area,percentage of coverage and ' $treet names
, ifnpervious area(applicable if R-7,R-12,R-25&R-40) ❑Street tree size,type and location
operty corner elevations(2 foot contour lines if more than ❑Existing trees to be retained with drip line,and tree
4 foot differential) . .. protection measures
❑ Clean Water Services—Service Provider kety.r(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 /
notifiedtip ❑ No Applied For: ❑ Yes ❑ No,stop intake
❑ Land Use Case#: f pts . -0(57'OM0 / f,2o(f -00004' -
i � l
❑ Zoning: J_ /� t JU
❑ Setbacks: Front /� Rear /c Side `i Street Side 6 Garage
❑ Landscape Requirement: c90 %
❑ Lot Coverage Maximum: —I % A//�
❑ Building Height: Maximum Height J"//;f Actual Height
❑ Visual Clearance
❑ Easements
❑ Sensitive Lands: ❑ Yes * No Type
❑ Urban Forestry Plan / /
CIConditions "Met"prior to issuance of building permit L 6i'Gi Y-1 c)ff 0 of- M e t-
Notes:
Approved By Planning: Date: z��J -/
Revisions (after Building Sub ' al only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved 0 Not Approved
Revision 3: ❑ Approved 0 Not Approved
1:\Building\Forms\BldgPermitRvw_RES_012116.docx
4 `Y
Building Permit Submittal
Original Submittal Date:
Site Plans: #
Building Plans: #
Building Permit#: ❑ Enter building permit#above.
Workflow Routing: ❑ Planning ❑ Engineering ❑ Permit Coordinator ❑ Building
Workflow Sign-off: ❑ Sign-off for Planning(include notes from planning review)
Route Application Documents: E Engineering: (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:
V 0, Engineering Review ,
❑ lope at building pad: 4� 7,�`3:� `.!T_ `r4,.,_ Wig►
d) Conditions "Met"prior to issuance of building permit
Easements (encroachments) per engineering condition royal and plat .,..( ;; -4 :7
❑ Water Quality/Quantity Facility: /����
Assess Water Quality Fee in-lieu: ❑ Yes ❑ No �/'!"
Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No it/4141
LIDA Facility on lot: ❑ Yes ❑ No
/krNOT Approved by Engineering: = • � _ �
Notes: v .'t, ' .r r
Approved by Engin - / v�b
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 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: ❑ Yes1/A
Tigard Trans SDC: ❑ Yes N/A
Parks SDC: ❑ Yes N/A
OK to Issue Permit /
(2--q//c..•.
Approved by Permit Coordinator: Wet--17-)ate:
1:\Building\Forms\B 1dgPennnit Rvw_RES_0121 16.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
'IN
Transmittal Letter
, , ; i ) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: aa", /(% DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
FROM: / MAR 7 2016
_ ..,--..Z.c le.2, ti iirr----
COMPANY: // .4,7,, ,�� BUILDING DIVISION
PHONE: By':' `
�5�3 3/s'�- Croom/�
RE: //G) - - �,,- 4-s £ ' Jt44](0-rte ' ••ress (Peu
Av► l/k feiotfie. C-.>,, .
number)
ATTACHED ARE THE FOLLOWING ITEMS:
.` ;. ). t Eta �, � 7 � � 1
.., .> 3 �, . � "'„ �,�g�:*x � t i'�.H !' .;.3. k.., S..i�, "` fir.:�'+`.
3 Additional set(s) of plans. Revisions:
3 Cross section(s) and details. 3 Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. 3 Engineer's calculations.
Other(explain):
REMARKS: j7p,-7r ,rie,,, r xs f'o. ‘1.23.1"4 sc%e A.. /
here' FS 74e--srl/�tAtvr- ( ii1.4.r rx.,1-le. ` ,o7.--j /rwN4SileTal 4%7A:Sl
i
1./- fr « ,' hs /p/'ZG A/" /l/!-r/ oe,,,er .t/ _ _ 1•
^f'fb'rrs -44sG L'ti// /.v e e.i- ....S27_3 3/.." /� 40.4e.5 .•-::5 4
Routed to Permit Technici. •. Date: • ,(:„ •f Wft!r
Fees Due: • Yes E' o Fee Descri.tion: Amount lue:
$
$
$
' $
Special
Instructions:
Re.rint Permit •er PE : ❑ Yes ❑No El Done
A. •licant Notified: Date: Initials:
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012