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Permit (52) CITY OF TIGARD I ; .. MASTER PERMIT ` '! 8 ` COMMUNITY DEVELOPMENT is Permit#: MST2015-00251 T[CARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/28/2016 Parcel: 2S1080001504 Jurisdiction: TIGARD Site address: 15166 SW 154TH AVE Subdivision: POLYGON AT BULL MOUNTAIN Lot: X Project: Polygon at Bull Mountain, Lot 60 Project Description: New SF. 6/2/2016: REPRINT permit to remove 4th bathroom. 8/4/2016: REPRINT permit to add NC. 8/10/16, REPRINTED to add 2nd water heater. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1611 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 32 Bathrooms: 3 Second: 2171 sf Garage: 665 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3782 sf Value: $461,292.74 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 2 Water Lines: 100 Drains: 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: 5 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,500 sf: 7 201-400 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 3782 Owner: Contractor: POLYGON WLH LLC POLYGON WLH,LLC Required Items and Reports(Conditions) 109 E 13TH ST,STE 200 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175 VANCOUVER,WA 98660 VANCOUVER,WA 98660 PHONE: PHONE: 360-695-7700 FAX: 360-693-4442 Total Fees: $35,544.04 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 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: C:::: — - eil—f/ 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. 4•11•Imimm Plumbing Permit Application Building FixturesRECEN ED FOR OFFICE USE ONLY .. . City of Tigard ' 14.,,o,,,,,i liv. , pon,,,N, IALS-r2ott.5....002_51 i 1,125 Isl3 Ilall 13lvd.. Huard_K.)A r.,,, .,...0 2% ,........ _. .„, . "- . Plan RC%Is;'11 1 . 111.- Phone. 5027182430 Fay ,n-.7o,kt, .1060 1 ,,,I.,,,,,,;,,,,, !. 0,,,,,,, . Inspcenon I me: 0";:4.620.,41.7,,in,ti" cla:TIGARD TIG.ARD ; Rue Ready ii\ . Internet: keg,6,tigard-or.gel I I autak-i' IN-VISION i N,,..111,,,i vothod: , Supplcmenial Information r-------------- -- --- -- 1:43,011.9,1ar "-- --I Ettilt.'' SCIIEDULE New emistrocium [J D , t-hr kpeciol infortnation live checklist_ ,, ___:,7 1 1 El- 1emolision I QR.. l 1-a. li !I otal____", I C„.1 Additirmitilteratiorrrephicement l 0;Other: 1, Nell 1-2-family th6e3lir4fS.1 ifiChlth,-, i 00 11.Mt each today omneetiom !! CATECORNI OE CONSTRUCTION S Is 0 i It bath I 312.70 ' 1 ; -1-"7 78 I 1 V I- .111(1.2-1limi I) dAciling I Li(-on vm en:i;ii.,inclustrid 1 '111; R l'-;)0alh _ - - - — - - - ; - - " ' - -- SI 0 i ii hath ; i iS2i02).2. 1 ii Accessory buildinii Nfiilamii„, g ; d_r „. l- 1.aRh additional bath-Miclicil ! 25 02 I I D Master builder 1, Fill Oilier: ( , 4, 1 1 1 We S'prinklet I,,„.,.._....._so, it i * "'age 2 ' 3011 SITE INFORMATION AND 1 O( 11O\ r .,,,ii,lielliti,s: ---------------------- --------- A ' ir : 1 Joh site addrcss: 15162(0 sw Ik5LAA-t" it':-e.: , C alCh basn or"trim Own - --------- -— -- --- -- - ------ -- -- ----------- --------- ------ - ---- 1 Dry'aell„lcaeh lin0.or trench drain 1 ; 18.70 1, nt 'Figard.OR 97224 I „ 1- 10oting drain mo. linear III - ' f !i."l! s ii02 1 -, 'suitighltigirapt no.: i lleMeet name: Polygon tit Roll Mountain I 1 I Manulacimed hone 11(1111111 1 ; Cross streettdirect ions TO job Me: 5.Iiinholcs 18.76 !! I 1 101111 drain connector9,11111,115 '11111(Ill' 1111111 II I 'OR) 1 9101111 soaet(no linear IL ",.,..) ; Pace 2 ' c..., il Water service riiii linear 11,:".. t Page 2 "Subdivision:Polygon at Bull NIountain 1:-°1110-; (Pl.) I r Filsturc or Clem: 1 his.'nap/parcel no.: i . haat:11m ore\enter , ...../ ; 1 12 51 I 1 1 RESCRIP110,N OF WORK 00904111 tlst' , 1 _ i Ada 2 oct 0 -1-- \A)Cci--e.r if\-- cki--er 1 , ,, , .,,,,,. { „, ,- • 1 Disleaalier Imnhinu immune I 1 25 02 1 1111110 111111) 25.02 I 0:PROPER ry owNEit ' , 0 TENANT cup 1 Islimie: PoRgon WI II"1-1,-C ; i !!' .25 1!).? i 1 i - moor oramlloor 011(9 huh 25.02 , i , I Address: 109 East I3ll'Street _ ., II butte disposi,t1 ; 1 its iSialc/111': Vancouver,%SA 98660 I I it Hbib : ; ":-5 0' 1 . .. ,. [ Phone:(3601695-7700 ; bay( 1 Ice maler APPIiICA 't n 4,-:0N-rAcr pERsoN 1 i inwicePlorlgrca‘c Iran i 2502 ---- , . ! I 90 tutu gas(Sallie S_' ;. Page 2 linsiness name: Poly gm'NA;I U.LIT l , Primer 1 I? ; Comae" lunge: "MuAela(1r01055 ski („,... . „_ ... ii'61drain(commercial" 2.1 ' I 51 l 1 , Address: 1091 ast 13111 St reef , ; Sink/hasintlas Silt I '3.02 CitsiStinc//IP:VailCMINer,W A 98660 Salo units i potable 6 aleil 1 l' I Phone:(360)695-7700 T I :(3:( 11 693-4442 I lac slum crishmver pail I 12.51 I 1 , ; l , 25, 2 1--mail:AngelaGw . rajeskirTpulygonholues.com a inal 0 N\ma closui , - - : CONTEACil.)R i ------2,' ......_' ...,,,,,,,222,_ _ ------------ 2_,....2 _2_22 V, ((trill 11 catCr 2'ti2 ... ,, I !i: -2!''52 1 31,5 4 i ,..„ int;,s name: RD!,Plurobing 3, .. 12r I „ ,,e1.,pip.611"120,,Ary 1 1, 36,29 1 . ;11 Address: PO Roti 85 (alter ,...0 2, 1 15 T 1 City/Shag/71P:Corl)ett OR 97019 Subtotal ! 91 1011011m Pc fn 0 1 IN: S7250 ; P00111':(503)351-3903 l has:( i I-- I Plan 111 1(51 (2510 of porrli it e( I t ( 111,0.: 180345 l Pliinthinu 1 ic.no.: PHI s82 I 1 I 'ytate sun:huge i 12`1,,or permit (cel Aufliorfied signature,: ?1 :, :_ o.„.e.,,..„---- TmTA1 1111 H Z.M1:1 i: , . 1 Ms permit Application espifes if a permit is not obtained within 180 flays I Print name: Brandon Linter !Ian: W—Ci_ )(0 alter it ha,been Aceepted 90 complete. mezhodolotp set.le, I.. -t-onot ttpddlnp indo II S11\ice 4111.1 1-Uwlillny P011 II SR".K1.1,31-Arg,.0,c It,0(i I', :.:' 4,16II,'Or'C05)\1/4 1 1i) CITY OF TIGARD ,i * MASTER PERMIT f Gy/ ' COMMUNITY DEVELOPMENT Permit*: MST2015-00251 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/28/2016 Parcel: 2S1080001504 Site address: 15166 SW 154TH AVE Jurisdiction: TIGARD Subdivision: POLYGON AT BULL MOUNTAIN Project: Polygon at Bull Mountain, Lot 60 Lot: ' Project Description: New SF. 6/2/2016: REPRINT permit to remove 4th bathroom. 8/4/2016: REPRINT permit to add A/C. BUILDING Floor Areas Required Setbacks Stories: 2 Bedrooms: 4 First: 1611 sf _ Required Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 32 Bathrooms: 3 Second: 2171 sf Dwelling Units: 1 Garage: 665 sf Front: 20 Smoke Third: 0 sf Yes Right: 5 Detectors: Total: 3782 sf Value: $461,292.74 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Urinals: 0 Tubs/Showers: 3 Sewer Lines: 100 SF Rain Garbage Disp: 1 Water Heaters: 1 0 Storm Sewer 100 Water Lines: 100 Drains: Catch Basins: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Bckflw Prevntr: 0 Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 5 Natural Gas Clothes Dryers: 1 Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Furn>= Gas Outlets: 4 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders 1000 sf or less: 1 Branch Circuits 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 7 201-400 amp: 0 201-400 amp: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 p W/O Svc/Fdr: 0 P 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 Other: N Other Description: All Ecompasing: Y BUILDING INFO Class of Work: Type of Use: NEW Type of Constr: Occupancy Group: SF VB Square Feet: R-3 3782 Owner: Contractor: POLYGON WLH LLC POLYGON WLH,LLC Required Items and Reports(Conditions) 109 E 13TH ST,STE 200 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175 VANCOUVER,WA 98660 VANCOUVER,WA 98660 PHONE: PHONE: 360-695-7700 FAX: 360-693-4442 Total Fees: $35,502.02 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 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: ex/ ��f/QG, " V Permittee Signature: � /�� -'T"�� 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. v" Mechanical Permit ApplicatiltMrx . ii FOR OFFICE 1Sc O LV City of Tigard Received 1,1 " 13125 SW Hall Blvd.,Tigard,OR 97223 i Date/By: - ��, Inv evie I Phone: 503.718.2439 Fax: 503.598.1960 01 I, i. Dann y: �i Date/By: Other Permit: T I G n a2 D Inspection Line: 503.639.4175 Date Read/B Internet: www.tigard-or.gov iReady/By: Cd See Page 2 for Noti6edlMethod: Supplemental Information 'r{ M1 ifftl'„3#:4 '�,f`'� `-'" 14044'1,1°'? 4 C f' Vr,G "'A4;;:'g,,,g"�` .s' -I^"s B,Ye I. i, t-bE EL,?, 5E4,,,40.1.1. 4,04 „tit-zz'tF ;'.rc7.0itt Mechanical permit fees*are based on the value of the work ®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition 0 Other: mechanical materials,equipment,labor overhead,and profit. r Value $s . :+ , .^a :,C M , dSz , % c4s , ;„5: &,yS ; thi* tVW'3 ^ : r � ,� �� , `r S« - , C,''s .�a ,' E � Ar tC 4.'". � � �h4v , et `a1t��,. � u�.A��µ�;4 . ® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special Information use checklisg (]Multi-family , 0 Master builder , 0 Other: , . . Description J Qty. I Ea. I Total �A?�,1 o.T. a k,5.14.p . naI, � J �; ritiV� '-r tb`zl, Heatingle°°"ng: Job site address:15166 SW 154th Ave Air conditioning 1 46.75 46.75 Furnace 100,000 BTU(duets/vents) 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bld ./ Heat pump 61.06 g apt.no.: Project name:Polygon at Bull Mountain Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision:Polygon at Bull Mountain I Lot no.:60 Other 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 1 r$ "' ku`ef-g&4 11§, ;t00 =gONk` het Gas fireplace4nsert 33.39 add AC to existing permit Flue vent for water heater or gas fireplace 2332 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 O ' a tEnvironmental 23.32..''�: -' 1kY'614""2A rab ( .+ . ' '"''`. * '° ""' exhaust and ventilation: Name:Polygon WLB,LLC Range hood/other kitchen Address:109 East 13th Street equipment 33.39 Clothes dryer exhaust 33.39 City/State/ZIP:Vancouver,WA 98660 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:(360)695-7700 Fax ( ) Attic/crawlspace fans 23.32 � 7 t74 . u�4zL O rd y s Y . �� ,1 3;�' - %R..a..rc p.t� x x'1aa N^'6 y"� {- t r+ a 'ts ,Rr ,.. �- �,� .:� r�.r. -� ;�Y .«��EdC; ,��'t�a�>�'�t'�#� � .�,��: Other: 2332 Business name:Polygon WLB,LLC Fuel piping: $14.15 for first four;$4,03 for each additional Contact name:Angela Grajewsld Furnace,etc. Address:109 East 13th Street Gas heat pump Wall/suspended/unit heater City/State/ZIP:Vancouver,WA 98660 Water heater Phone:(360)695-7700 I Fax::(360)693-4442 Fireplace E-mail:Angela.Grajewski®polygonhomes.com Range Barbecue � tYaPp 4 �. er 7' d . F Ecx4kr, ..A...,..-",;,,,,,....‘,z.,° ,, kftZt•�'. ;Y 'T.7•,%•' A`T4 ; P,,,--4`x : . °^� �i.: 1 �, «�',v, Clothes dryer(gas) Business name:Apex Air LLC Other: ka-Address:18004 NE 72°a Ave '�akz . cs `t 1 #� . s 5, ;;= .�� 1 �;a� ks ix: Subtotal ,/v,`7r- City/State/ZIP:Vancouver,WA 98686 Minimum permit fee($90.00) Phone:(360)342-8109 Fax:(360)326-1769 Plan review(25%of permit fee) State surcharge(12%of permit fee) .,5, 4 if CCB lie.:203034 ivs,f4/D TOTAL PERMIT FEE 5,2, 3(v q This permit application expires if a permit is not obtained within 18ti(/f�V days after it has been accepted as completeAuthorized signature: - I * Fee methodology set by Tri-County Building Industry Service Board Print name:Angela Grajewski Date:7/19/16 , 5t7/AJ V5!' raBuilding1Permits\MEC_PermiiApp_o4o1134oc 440-4617T(11/02/COM/WaB) 7 ) CITY OF TIGARD MASTER PERMIT 1111 sCOMMUNITY DEVELOPMENT Permit#: MST2015-00251 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/28/2016 Parcel: 2S1080001504 Jurisdiction: TIGARD Site address: 15166 SW 154TH AVE Subdivision: POLYGON AT BULL MOUNTAIN Lot: .61---- Project: Polygon at Bull Mountain, Lot 60 Project Description: New SF BUILDING Floor Areas Reauired Setbacks Required Stories: 2 Bedrooms: 4 First: 1611 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 32 Bathrooms: 4 Second: 2171 sf Garage: 665 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3782 sf Value: $461,292.74 Rear: 15 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 6 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Tubs/Showers: 4 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 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Tvpes Air Conditioning: N Vent Fans: 6 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: 7 201-400 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 3782 Owner: Contractor: POLYGON WLH LLC POLYGON WLH,LLC Required Items and Reports(Conditions) 109 E 13TH ST,STE 200 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175 VANCOUVER,WA 98660 VANCOUVER,WA 98660 PHONE: PHONE: 360-695-7700 FAX: 360-693-4442 Total Fees: $35,250.78 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 OA 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: ON �/ L/L'',770 Call 603.639.4175 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 Applicatio � nRECEIi/ED 4s / . is gid 1 FOR 0111( 1 t SI OM.) ' � �� .�fi� � City of Tigard DEC 21 2015 cei" A r `J g DatReeByea��/•2j `� ��', Permit No��!/��.7 13125 SW Hall Blvd.,Tigard,OR 972 Plan Revie IN � �± a p �A f� OF TIGARD , 1 I)Ic. Other Perms '�/C /-5'-e /O 1 Phone: 503.718.2439 Fax: 503.59 Date/By ,+' 9 I I( \R D Inspection Line: 503.639.4175 ING DIVISION Date ReadyBy: inns. ® See Page 2 for Internet: www.tigard-or.gov Notified/Method./Z-//r � Supplemental Information - �-s z. -.. ,' e¢ "`' C P , ... s ';'..e,--,r ,y .,' 17:'' ata? "-'3 '1s: d E s ., v` •-,- e �. e ,� $ �' ...s „, n�%- , q. ,�'- p 4' . SR , " st �ytw "'". ,. €.,&�' E T $e t. ;g�. ®New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the :•• A sl =,,,--;.: work indicated on this application.. -} . ,' Valuational 6) a92$ �J L. ® 1-and 2-family dwelling 0 Commercial/industrial Number of bedrooms: 4 ❑Accessory building 0 Multi-family ❑Master builder 0 Other: Number of bathrooms: c 3 Job site address:15166 SW' New dwelling area: ?3 - 2 square feet 7 City/State/ZIP:Tigard,OR 97224 .Alt Garage/carport. ea: (...Q .05 square feet 1 , • Suite/bldg./apt.no.: Project name:Polygon at Bull Mountain Covered porch area: ` w square feet 3 ) Cross street/directions to job site: Deck area97 / square feet)6 1 1 61 ' Other structure area: r, square feet ems' • Subdivision: Lot no.:60 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.: equipment,materials,labor,overhead,and the profit for the t • , a '' ' work indicated on this application. New Single Family Detached Construction Valuation: $ Existing building area: square feet New building area: square feet c: �, ; 'f. ' I o- , 4 .-,: � s�,n - y Number of stories: Name:Polygon WLH,LLC Type of construction: Address:109 E 13th 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 13th Street Total fees due upon application: City/State/ZIP:Vancouver,WA 98660 Amount received: Phone:(360)695.7700 Fax::(360)693.4442 i E-mail:maggie.gordon@polygonhomes.com , ' .. "' �� -,, Commercial and residential prescriptive installation of € e ::''' • 'me q; t �� ' �" 1 •, ., , --� , •,F _ " � � __ roof-top mounted PhotoVoltuc 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 13th Street Solar Installation Specialty Code checklist. City/State/Z1P: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.:204238 Total fee due upon application: $201.60 Authorized signature: �nf\... This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Maggie Gordon Date: 12/11/15 *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Electrical PermitAppticati°13Et EIVED FOR OFFICE t SE ON Ll City of Tigard(j Itcce fly: Permit Nryd 57 /3 5' / b Receive: d t13125 SW!tall Blvd.,Tigard,OR 97223 DEC 21 2015 Plan Review • ' • Phone- 503.718.2439 Fax: 503.598.1960 Datensy: Other Penna Inspection Line: 503.639.4175 err '`/d ; rq�7R (late Ready/11y: Juiis PI See Page for I \.I.a C '� F \fl D Internet: aunt ti and or 1_oy Notilied/Meihod: Supplemental Information �, � 'lid, -Sea .,�.�.,-- :� } ., s � _. , . ,+ ,is� s�,;z*fi�}r��bz.�`t" •;��r't�- 0"�1� ?��__ , r .. ,r.• .: c - :,� �1,A11�-.$°Fr.1)�7PD f . '= ®New construction ❑Addition/alteration/replacement Please checl,all that apply(submit 2 sets'of plans a'itum checked below). 0 Service or feeder 400 amps or more 0 Building user three stories 0 Demolition 0 Other: ,where the available fault current 0 M. as and boar ants 10 ' i cso. Ic . amps ac 150,tats or 0 Floating huddutgs x)' r ': �IB(Y®+�t!'l OF r019STA1Ci Iii : 000 less to ground.or exceeds 14.000 ❑Commercial-use agricultural ® I-and 2-family dwelling ❑Commercial/industrial 0 Accessory building amps for all other installations buildings 0 Multi-family 0 Master builder 0 Other: 0 Fire pump 0 Installation of 75 K.VA or .:':�4fia ;g n[I•r r r See r1 y�� -�¢Y� h"' y, I f �❑limcrgcney system. larger sepatanelc dein cd ss lcm i-,.7#!``-�•c 'E ��t Wili+�f1Q iAla- )(+�r VN f-, Lf ❑Addition of new motor load or ❑••A.....1..••...1-,.....1- ., `� 1 100111'or more. occupancy Job no.: Job site address: ' Q/- '4y. , — • - • 0 Six or more residential units 0 Recreational tehtcle park:: City/State/%I P: T� O' \ Q�Z2 -�)lealth-care facilities ❑IIvarJwalocations ❑Supply,nhaEe lift mole than 600,ohsnominal Suite/bldg./apt.no.: Project name: ,O___,b0 tk Mtn ❑Se.rvice or feeder 600 amps or more Cross street/directions to job slit: Description I Ow. ( Fee. I Total I ' Ncw residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: Lot no.: LQ Ea. sq ft.or less 168 54 ~Ea.add'I 5(X)sq.IL or portion -7—33 92 1 Tax map/parcel no.: Limited t•.r'.rs9a r<. energy.residential Y � L_ ' :I.`0 : F L 'IQi;-1141ti +1ifM l - (with above sq,ft) 75 00 _ ._ .,...,.. . .,. Limited energy.multi-family 75 00 New electrical service and wiring residential(with above sq It.) 1 Services or feeders installation,alteration,and/or relocation 200 amps or less I 00.70 , 1" Q1 R i. -' !`• L .,' .t 'Et?IA4 201 amps to 400 amps 133.56 Name: Pd`�(?f;'}Y� 401 amps to 600 amps 2(x).34 2 t"''11`"—' 601 amps to I,WO amps 301.04 Address: t b a V t,'? 4 ` Over 1.0)0 amps or volts _ 552 26 2 `an� ' y /�_ q Temporary services or feeders installation,alteration.and/or City/Stale/%1P: v W !� relocation Phone: ) [g a 5 OT l'ax:bD) a 5—'44"1.Z-- 200 amps or less 59 36 1 201 amps 1.400 amps 125 03 , Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168 54 intended for sale,lease.rent, or exchange.,according to ORS 447,449.670.and 701. Branch circuits-new,alteration,or extension,per panel Owner signature: «_ .�.. s Date: A.Fee for branch circuits with {ir r b ,< .5. : y � w( �z, '� nit]t '+ t above service or feeder Iet 7 42 ", each branch circuit Business name: V 1:� / ' B.Fee for breach circuits withoutt service or feeder li:c,first ili 18 1 Contac)name: m a / I Ve„ 6101 branch circuit Each add'I branch circuit 7 42 2 Address: i I1 _ Miscellaneous(service or feeder not included) City/State/ZIP: QX1 ' ' ` ` , / V ' n . Each manufactured or modular 1 V`' `'a- dwelling service and/or feeder 67 84 I _ Phone: Reconnect only 67 84 i 2 ( ) Fax: :( ) j L!�1 �b/{ _ _ �� /� �� Pump or irrigation circle 67 R4 2 E-mail: Yl. r�7` l.V r Sign or outline lighting 67 84 2 r. .,':.. #t -..... .e r..,..t r F C ,. .. .. - • , - .: Signal circuit(s)or limited-energy Business name:Simply Electric panel,alteration.or extension Page 2 I . Each additional inspection over allowable in any of the above Address: PO Box 822408 Additional inspection(I hr min) 66 25/hr Investigation(I hr min) 6625/hr City/State/ZIP:Vancouver,WA. 98682 Industrial plant(I hr min) 78 18/hr Phone:(503)849-8202 Fax:(360)314-4945 Inspections for which no lee Is 9().00/hr specifically listed(7,hr min) CCB Lie.: 204615 I Electrical I.ic.: . 067 Suprv. I.ic.: 4394S 'fi.. tistitRICk7, 'PERMIT'.. EES ' ,-i Subtotal Suprv.Electrician signature, rcyuired: e �fG j 5 Plan review(25%of permit fee) Print name: Victor 7arzhitsky Date: I 1 17/2015 State surcharge(12%of permit fee). TOTAL PE_RMIr FEET Authorized signature: 'Phis permit application expires if a permit is not obtained within 1811 days after it has been accepted as complete. Priv[name: Date: • Number or inspections allowed per permit I iistldtneermitmaa.r-perrmit App doe 0,01;10 440-14,1 s-ri 1 I.ut`C OM/WEB iVlechanicalPermit:Aupli_RECEIVED l OR ctrl lc> 1 ON LN . C> of Tigard c JEC 21 2015 . r 13125 SWHaIBld,Irrar4 C3t 9 Phu Rewlew pgwp „ r " Pb K833439 Fa1513 OF TIGARD --- . 03_{34475 3 }}/ ^eCNnorelY ?+� a Seel4te.. t ion SPPementifnto rmfiw 11 ' ' ' w-fgac3-°"" BUILDf N; . --- --. , ;. as ,,,,-.,-...,...„.„-..„-_—_,—_,...,,•::,,,-• -,•-. 5-3:7:-.1-;4,-.-.,..'t t:-i°:d r rte.,,,-s.:i-dr,1.,¢ -e. --- &Y.n.,w-6^,1.,,.....,50-...,41-.7a-- ' &R .B .p - "fit e ii'?-.s. c ,...- „ _.3;� "`„ ,.r . - r y 3,,tt jyt�hapiCg� .BIC baseti:t)O l�Y81fle of the wok_ -.. __.r... _ -_. .. orated.lndicate the value Lmonded to the nearest dollar)of all I'xeW:C0f35a7rGgoil ❑Additions/alttxanort,rnpiatxritettY inerheaieal.andel-Ws.equipment latex overhead.and Profit .. ] L.P .lrliao 0 Other. yet=T 'Fas:764 t tai rest(*dila _ ®1.1:4.0(12-44111.3f dpvzilin$ ❑Cummercial(mdusirlal 0 Accessary bu lding I QIjcI Toia1 Ninth fanny tin ❑Master butltkr ❑thher w- { 4 � _. :3 - iad�i�rdoifryt �su stia:� c �,s�a a ,tez_ � ° �.._ i ._ - . . 3' .!�.�3'� �1n'avtr:�.. 46.73 Job st]ts... . .....Cl„ 5 i - � •i /1 JS- I 4633 • Ftmosatx'100A0013`11J(dari:F.zea�) Pnmace lOQ,i�0+.BTU!d ) 3491 e . _. ...a .Th,D,_.--/ Y , • • 61.06 $ I Ptojaitttame: 1:) 13 v O\\ CTl 'Doi*ask 23.32 2332 'doss sb cdIdift tions to.job site: Nydrooic hot wales srst m . R+esadmsl boiler(radiator or 2332 hydniieic) • thaasibc s(.l4d-t ?>ioc e4ec�lc). _ iri . °w -the. 46.75 Flitelvairt.foraoy of above 2332 . 2132 -- Loma.: , . _ as Of6aa�ad Pldpiarct'• ..... . .r � 1Va 4ie4ler .32 .. W �-t7 —r— r r4 = _ semis fu o ter-water 23.32 33 _4 s beater or#cr water pa 2332 1j ) 2332 _ _ - -. fit- 33.39 V$orid: diced 2332 23:32 2332 ='' . _- '_ ? , , _ 11 - , ~' - . meuta3 exhaust and veolitalion . * 14-51?hwest itergehoodlatberkitchen I 3339 gIcf®9 EVA'StCfofbcs Bryan 1 33-39 1 wand exhanst `iiewre,WA 98b61 • i ipfiampinparanents,utility roans) . 4 23.32. 6-?bOb Pltooc Pate{ } 2132 ,-Atfiefi 1 1 23.32 . ,. iJtbtt 8 _ai 'P.oiios.Northlr e t S1435'tar fast four,54.03 iar'.eaeii additional. Ems:aim 1 - Gat,beetOnluh.. At�±ear.189 N Of St - tltallisaspeaded/rnif beats Wlertrefoei ate; -- - - _.. if (360)816.78N I Far:( ) I ipl ti: , Obey- nmrsnip- c.AaderaeaHam, Aiyiresc 11S 000 Ave *e 410 C 4 :�T3p ,tiR972?4 • -_ Pian rteviow(`2314 of Fritiert iii • PhaiSe:ZS 9661 I Fare{ )536-663$ - State s (t2%orpesn+tt l.303 Yrs:1044 TOTAL P:EEMIIT.FEE_ T ap a5aa es/40.$s permitir net)bgiatd wlBda no days the rkiwi-hem aoxpbedss eamPltie• Anthvrirtd • Fee metodotoal kedbi Iri-Zromry Sanding Industry Service Doted iivtu'{ ad4EC.imris;149¢a11l1:doo 440.1617r(tUe.'CD1t1&'ES) . in Permit A licati N D Plumb � _ _ rolz of l�lc c rye n1 L, `Building Fixtures DEC 21 2015 Received Pc"rtN°44/5170/5/"-D0.25/ City of TigardDate/By:Date/By:I 13pt 125 3. 249 g SW Hall Blvd., Tigard,rdOR OR 5� �" rt� �� t�l� Ph°Review Other Permit tTO: BUILDING DIVISION D .R.mBY >� 101 SecPage2for Inspection Line: 503.639 4175 Supplemental Information - Internet a'w'w.tigBrd-or.gov X, t: z_ = ,;a -:"-:- .--."7;,-'3 P.-- ,'-*_ ,,. ... ter 7,..•- ••_----,--_,-^ ' _,` ,„`a ?-,,� . ,may'F ate_r, -..,- - ,:. rr.. =,c-s L ��i'el�..,+ � �., b;a,e.sr•iv- -.�.r+i4�s�,s �.L�c_ r , �" '�, .....:; .••• ---�,-..--=- -- For special informaion use cheekiest .:` ❑Demolition Description 1 Qty. I Ea I Total ►_New construction El t 0 Other- New 1-2-family dwellings(includes 100 R for each utility connection) Addrtiadaltaat.----Placanen , _ � y„ SFR(I)bath 31270 -=-,s_ •:--•--------,--- ` g G.---';',',--:;::.'..1-2..4-',-5÷:- --.-_,:_.55_,--72-- --:--.a.__ 437.78 - --; _K�€',3 Y - - _—zSFR(2)bath 1-and 2-f>mnly dwelling El Commercialfindustrial SFR(3)bath I 50032 rjkDir_ t3 ❑Accessory building • 0 Multi-familye �,/ Each additional bath/kitchen 25.02 . ❑Master builder ❑Other /d , /tr/V- Fire sprinkler(_sq.R) Page _ site utilities: 4i - � . • Yr ."---_=-.---7.:...7-,,,:77,-. -_1r' 18.76 -=,;r.r • _ t .,.., 1),_‘,..,,,,..„,-4.;_;3„,..._,,, ,,,,-..:- y „-rr1w!�+ '.. basin or area drain Job site address ✓`^' - .C1'146Drywell,leach lino or trench drain 18 76 d _ -Footing drain(no.linear R:_) Page Z City/Stale/ZIP: 1 50.03 SuitdbidiOct-no_ 1 Projext name: \\ Manufactured twine utilities • � 1836 Cross street/directions to job site: ManholRain drain connector 18.76 Sanitary sewer(no.linear ft:___) • Page 2 Storm sewer(no.linear R:_ ) Page 2 • • Water service(no.linear R: Page 2 ILot no.: �0 Fiztare or item: 31.27 ??`r2 Subdivision: glow prevatta 1281 l l2.5\. Tax map/Parcel no. M ;_ valve Clodus veaslra [ 25.02 a5,() _ _�� -_- -�' — - -- �–_ �-. – - - I 25.02 �,--�.1`�2 _ Dishwasher Drinkingfountain 25.02 {� Y� P` 1 V W�/ �^" `v Ejectom/9ump 25.02 - Expansion tank ' 12.51 r- 25.02 Banc r , cron Floor drain/floar sink/hub 25.02 Address. C 1 'tom ' 3 Gmbage disposal t 25-02 2 5 C'L 1 25.02 �L Hose bib 7 5 Pl one/SladdZlP: o• ± ice maker' I 1 12�� Floc( ) _ - -c-r-7,---F::_.; lntweeptor/grease trap 25.02 .. , 1 <' .- �_ .�1 ]Medical gas(value:S ) Page 2 Busi.-._-...-n..7.- ess mmc 3D CW.1, Carl�,� j�Lit Prima 12.51 Contact nameivci_vor)n lS.�.i 1 t e_ Roof drain(commercial) 12.51 Address 7`0 � Sior/besinAavatnry, 25.02 City/Stale/UP: lb H - 25Solar units(potable water) 6234 Tub/siwvra/shower pan. 12 51 'Z5•(72, 1 �3) l -3q63 • Fax :( ) • Urinal 25.02 • Feil: . a i 7 ..Ali2s.. •VI& _ W!tri closet 25.02 3752 731-.52- � Business rumec Z '- - I ivt ILL Wats V - 5629 piping/IW 25.02 Address rp. !_ r s- Odic q Cjty/St t Z1P: Q 90 0'' Ci Kiiel - Subtotal Wfmirruun penin fee S72_50Phots 3) �j 1 -.30.3 l l FarC( ) Plan review apermit 5%of fee) CCB Lie.: L�3I'1C.5" 1 Plumbing Lia» Z sur k State charge(12%of permit fee) � TOTAL PERMIT FEE si Authorizedgaahac 7��permit application espires if a permit is not obtained within 180 drys I /� I Dee: J / /s) atter it has bees accepted as complier- rain= •` c.'--- _ I .Fee methodology set by Tri-Cmorty Building Industry Service Board_ i0/01i09NO-tat5T(tnavcobvwm) - t: $ City of Tigard ■ g IICOMMUNITY DEVELOPMENT DEPARTMENT T I G A R D Building Permit Review — Residential Building Permit #: /f.-Cr iS -' e, ,,,2-5% / r Site Address: /57 ca.) /94/ 4 j,,7 Project Name: e) 1-0i ,amu// % 4`[.Ai2. Lot #: j0 (New U.34(Uitig=subdivision name;.Addition or.AIteration=last name of owner) Planning Review Proposal: /VA) SAC- ' iL Ltd erify site address/suite# exists and active 'n permit system. River Terrace Neighborhood: Er Yes ❑ No Sit Plan Elements: ree (3) copies of site plan !1�'xisting structures on site IJQS• e plan must be on 8-1/2"x 11"or 11 x 17"paper 1r.Footprint of new structure(including decks)with finished P. P awn to scale(standard architect or engineer scale) ybor elevations 7 ' rth arrow tility locations (required for new,may apply for additions) V • e address,project or subdivision name and lot number F.1 .cation of wells/septic systems �i plicant information(name and phone number) VA Erosion control(including drainage-way protection, silt fence [ tot dimensions and building setback dimensions design,location of catch basin,etc.) ilt area,building coverage area,percentage of coverage and reet names pervious area (applicable if R-7,R-12,R-25&R-40) reet tree size,type and location Property corner elevations (2 foot contour lines if more than xisting trees to be retained with drip line,and tree 4 foot differential) protection measures UIQ Clean Water Services—Service Provider Let (lot platted prior to 9/10/1995): /Required: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No IJQ Public Facili�ti Improvement (PFI) Permit: equired: Yes,applicant was notified ❑ No Applied For: ®' Yes CI No,stop intake Z" IYJ and Use Case #: c/6)20/ d .';OO oning: ,e- 14 12( e tb a c k s: Front Rear /5— Side S Street Side /6 Garage p7() /Landscape Requirement: Lot Coverage Maximum: °/o Building Height: Maximum Height 30 Actual Height 30 ,'isual Clearance O./Easements ensitive Lands: Yes El No Type4/7/474-71- ji ! ,• -` Urban ForestryPlan ❑ Conditions "Met"��p''rior to issuance of building permit l 4 Notes: ii? i .rAs Mac" .mil .7/ iPrier- sLo-/CSC/h..p Ly��'cru:74- /SS1h.,n CQ �J Approved By Planning: — 1� �j� Date: lc l AS---- _ Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: El Approved ❑ Not Approved 1:\Building\Forms\BldgPennitRvw_RES_070915.doc x Building Permit Submittal Original Submittal Date: /02//0.5 Site Plans: # Building Plans: # 3 Building Permit#: EEnter building permit#above. Workflow Routing: Planning Br-E-ngineering L ermit Coordinator C building Workflow Sign-off: I Sign-off for Planning(include notes from planning review) Route Application Documents: Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. B---Building: original permit application, site plans,building plans, engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: Ufa _ Date:Technician: /-y.:2-/.4.5- Engineering Review Slope at building pad: C V ❑ Conditions "Met"prior to issuance of building permit ❑ Easements (encroachments) per engineering conditions of approval and plat ❑ Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes Z No Assess Water Quantity Fee in-lieu: ❑ Yes No LIDA Facility on lot: ❑ Yes ��No ❑ NOT Approved by Engineering: Date: Notes: Auvic O- 1,-4'' A-Ua- . / itt LE-7- C---0-2- 1 776.0 t/i " - Approved by Engineering: frk 1 Kr,- lvjtf i ' - Date: 12 J 2 t 5 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: 4t /:_c" 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: yf% DC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: rYes ❑ N/A K/OK to Issue Permit � Approved by Permit Coordinator: "74 Date: 3/2-4//‘ l:\Building\Fonns\BldgPermitRvw RES 0709I5.docx Albert Shields From: Albert Shields Sent: Wednesday, December 30, 2015 4:48 PM To: Maggie Gordon (Maggie.Gordon@polygonhomes.com) Cc: Cheryl Caines; Susan Shanks; Mike White Subject: Permit Applications, Bull Mountain Area 7 -MST2015-00250, -00251, -00252, -00253, Attachments: Conditions- 12-30-2015.pdf Maggie, in reviewing the permit applications for MST2015-00250, -00251, -00252, and -00253 we find that there are two issues with the applications that must be resolved before we can release them for plan review, let alone issuance: 1. Each of these applications calls for an address on "Rio Grande Terrace" but we find no such street on the draft final plat that we have received. Instead, we find that the street on which those lots are located is "154th Ave." If your intention is to establish "Rio Grande Terrace" as the street name please submit to us a plat that is revised accordingly. Please let me know which way you want to go. 2. Multiple Conditions of Approval under the governing Land Use Case,SUB2015-00002 that are required to be met before final plat approval and/or issuance of building permits remain Not Met. I've attached a printout of the Conditions on which I have highlighted those that must be met before we can continue to process these permit applications. We will put these applications on "Hold" until the requisite Conditions have been met. Please let me know if you have any questions. Albert Shields 1 Building Permit Applicatio 3ED, 4S J /S Residential FOR OFFICE USE ONLY :,,_ _ .� � [)�L yy Received rr�� 'City of Tigard C i DateBv/2/ ��3 Permit No S/ d��4�p751 " 13125 SW Hall Blvd.,Tigard,OR 97211..-.- Ilk 4� j plan Review Ocher Per,nit: Q f7 Phone: 503.7182439 Fax: 503.598. i1 Date/Bv: ��i� 45 /U I I G A R D Inspection Line: 503.639.4175 BUILDING D:";L.? �3 Date Ready/By: Jens: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information C R ' ' i � *'9 tQ l1 — 17, ,-�o- . - ',x�� rcar .E.,•,'is £sw ,,� a .f :� # a. _tiV -. . �� ' > _. �.a� aw ,4.+t- '.y, A . 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 ❑Other: equipment,materials,labor,overhead,and the profit for the ra work indicated on this application. ,2 � A,�� __.��. ems..t4y5V 5 t Valuation: $ 0 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building ❑Multi-family Number of bedrooms: 4 ❑Master builder ❑Other: Number of bathrooms: 2.5 . 0.aafits=. F€"*-o TiO AkA ra Total number of floors: 2 . . ,__of -, ;;,, t . a . Job site address: 15166 SW , . ,/. . ley /S 1 J.L New dwelling area: 3--5'2 square feet City/State/ZIP:Tigard,OR 97224 Garage/carport area: " square feet Suite/bldg./apt.no.: Project name:Polygon at Bull Mountain Covered porch area: V square feet Cross street/directions to job site: Deck area: `h5 square feet Other structure area: square feet a-i t § 9 tliizty CCCc*a--- ," tiii." r� , .. ,,.�_,_... _ _ .Mm ,v .. ._n ,,,T , ._,"_.� , , Subdivision: Lot no.:60 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 tAti D m:oi .>Er IU1�1 V44 work indicated on this application. New Single Family Detached Construction Valuation: S Existing building area: square feet New building area: square feet ff �, � 04#t1Y> 1 Number of stories: Name:Polygon WLH,LLC Type of construction: Address: 109 E 131h Street Occupancy groups: City/State/ZIP:Vancouver,WA 98660 Existing: Phone:(360)695.7700 Fax:(360)693.4442 New: Mt* ' I I+iT :4 aa ''', .G � IIiS€„ p.,, 7-N '40114"1,4G: it lfErS, Business name:Polygon WLH,LLC �.� m <, EPlcftcr�rjseCr� t .- f Structural plan review fee(or deposit): Contact name:Maggie Gordon FLS plan review fee(if applicable): Address: 109 E 13th Street Total fees due upon application: City/State/ZIP:Vancouver,WA 98660 Amount received: Phone:(360)695.7700 Fax: :(360)693.4442 >-i ,, .�0: c E-mail:maggie.gordon@polygonhomes.com 4 e $ "a ` ,. , 1 W., C r a ;010 - g Commercial and residential prescriptive installation of ! �f , % 4I 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 136 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 lic.:204238 Total fee due upon application: $201.60 Authorized signature: ,1 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Maggie Gordon f Date: 12/11/15 *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) City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 11111111 Request for Permit Action ,RECEIVE!) l l(;ARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • www.tigard-or.gov NIA( 4 4 alb TO: CITY OF TIGARD CITY OF TI(RD Building Division 13125 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov FROM: ❑ Owner ["Applicant 0 Contractor ❑ City Staff Check(✓)one REFUND OR Name: ��A INVOICE TO: (Business or Individual) 11550r V i Cl1, LLC � U s�}- Mailing Address: 'd0( .i-St 1�� ' 5 L GCL4-i, 41, City/State/Zip: \kine_oukV€X vV PC !g k)0 Phone No.: 3W- 09'5 --1T1O0 PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): ❑ CANCEL/VOID PERMIT APPLICATION. ❑ REFUND PERMIT FEES (attach copy of original receipt and provide explanation below). / ❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below). ® REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit). V Permit#: MTZO 15•CO2-61 Site Address or Parcel#: ''JltP(Q $ i) t5i-1 T l'a- L{ 11rc i D I' L L1 L ' Al,u f Lot#: (oo Subdivision Name: I All(l I L`1 (! 1. 1 EXPLANATION: te.avi(Ian changed -to ao rne,r Dear/c v.)06 h, r, ii. -- _a_ upciited Ctiopti C41 er&, Signature: : Aj Date: V/ /ib Print Name: j Q ' .& I r JQ r / ` Refund Policy ,J 1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of: • Any fee which was erroneously paid or collected. • Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended. • Not more than 80%of the application or permit fee for issued permits prior to any inspection requests. 2. All refunds will be returned to the original payer in the form of a check via US postal service. 3. Please allow 3-4 weeks for processing refund requests. • Route to Sys Admin: Date By Route to Records: Date2/4 By Refund Processed: Date /1/71 By Invoice Processed: Date By Permit Canceled: Date „/A//e9- By Parcel Tag Added: Date By r:\Building\Forms\RegPermitAction_09_314.doc rmit Electrical.Pety o Ti �Applicatin- ECEIVEPI Recoiwd FOR OT'F'porarirll;�•,SONLY � , /5—e)0o25i I l g DateJB . 13I25 SGV Hall Blvd.,Tigard,OR 97223 plan Review Phone: 503.7182439 Fax: 503.598.1960 Date/13 : Related Permit 5: Inspection Linc: 503.639.4175 MAY 2 3 2016 Ready DaI BY June H See Page 2 for T I G:11 DInternEt WNW.tlgard-OC.gOV Notified/Method: Supplemental Information • dr+. [j i+"-ad [� �u jet. -. . . - :�'� �•&�rh�`.:t�:its:',?a':..-....:.,Y'� ._•.�.�.-'�..3.:•CSS .�, ��- �..•:'r_•:.'+:::.�: ®New construction 0 Additi an „Please check au that apply(submit a sea of plans%titans checked): " �� i ❑Service or feeder 400 amps or more ❑Building over three stories. 0 Demolition ❑Offer _ whets are available fault current Q Marines and boatyards. �.4 .x -t K; c�c� �d -^� - it-?}fit.-.?' _ ,,t- gkeeeds 10,000 amps al ISO was or ❑Floating bm7dmgs. �=tom•:_3-=�'y;<'`�::..-1,i'�.,:: `a �„l!;t(�I{' �� MIbNr.;;t�i ,.::........ ..,,..._,;: y ®1-and 2-family dwelling ❑Commercialfihdustrial 0 Accessory buildingR leas to ground,or exceeds 14,000 0 Comms cial-nse agricultural amps for all other installations. holdings. 0 Multi-family - 0 Master builder 0 Other: ❑Fire pump. ❑Installation of 150 K VA or s':,.,:,..; .::.n.r_ - - - - y derived _.. - r �a0.��1,°11S;�INRQILM�:A:+FQTI'I�-�a�'�-J�Z�,�1T•�" • (.,�",: ': . .,;_:-. Emergency (6 I(,(0 -S W 15-1 ❑Addition of new motor load of system. Job s:•�.• Job site address: '�qe1 10011P or mane. ❑"A","E"„"1-2","I-3", Ci /StaterLIP:Tigard,OR 97224 • ❑Sir or more residential units. occupancy. ty ❑health-erre facilities. 0 Recreational vehicle parks. Suite/bldgJapt#: Project name:Polygon at Bull Mountain ❑Haardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal Cross street/directions to job site: .: _ ( >Y. 10 ' • ; • nacrlpliea •1 Qh• I Each •I Total I"' New residential single-or multi-family dwelling unit. Subdivision:Polygon at Bull Mountain Lot#: 0 includes attached garage. I,000 sq.ft or less 168.54 4 Tex map/parcel# , a.adq.ft.or p 33.92 l - ;TI� s } : � Cj: » i i.00;{ i* sV. s " .. Limited energy.residential 75.00 2 effeir1615 'F eeN//,/6%z54+ 0 (with above;sq.ft.) "672-el Limited energy,multi-family 75.00 2 /S�A/G• l , residential(with above sq.ft.) Bennvable Energv 0 Sec Page 2 ' + i. < . .�', ') ' -r.:•=:` : \, :: feeders installation,alteration,and/or relocation fi'.-.....: ' -W t. ,,:,:•' ,, • Services or Name:Polygon WL$LLC 200 amps or less 100.70 2 Address:109 East 13th Street 201 amps to 400 amps . 133.56 2 401 amps to 600 amps 20034 2 City/State/ZIP:Vancouver,WA 98660 601 amps to 1,000 amps 301.04 2 Phone:(360)695-7700 Fax:( ) Over 1,000 amps or volts 55226 2 Temporary services or feeders Installation,alteration,and/or Email: relocation . Owner installation:This installation is being made on property that I own which is not 200 amPs or lass 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 _':'r.":.��ar=:pct.=.;r..wv*. - 'tt °::' - -- - - -.t, ;-:: Bunch circuits—new,alteration,or extension,per panel ,:-�. .•-,a'< .45 .: ..: ,=5', •; .:.. _ i_...'.,,,,„ 3,1 :• ,...,.:.: ,_; A Fee for branch circuits with Business name:Polygon WLH,,LLC above service or feeder tea, 7.42 2 each branch circuit Contact name:Angela Grajewsld B.Fee for branch circuits without service or feeder fee,first 56.18 2 Address:109 East 13th Street branch circuit _ City/State/ZIP:Vancouver,WA 98660 _Bach add'1 branchcircuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(360)695-7700 Fax::(360)693-4442 Each manufactured or modular • 67.84 2 dwelling,service and/or feeder Email:Angela.Grajewski®polygonhomes.com Reconnect only 67.84 2 .s - tr : kalA'iY,4.1i . := r��a��'� } : �:irP: ''. . ;?-r;Y 4 Pu Por irrigation circle 67.84 2 Business name:Garner Electric Washington,LLC Signor outline lighting 67.84 2 ,n_ Signal circuit(s)or limited-energy ❑ Sere Page 2 2 Address:61(11 NE St Johns Rd • panel,alteestion,or extension. City/State/ZIP:Vancouver WA 98661 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(253)320-1657 Fax:( ) Investigation(1 hr min) 90.00/hr Industrial plant(1 hr min) 78.1 Email:bdaniels®gweusa.com 78.1Whr Inspections which no fee is 90.00/hr CCB Lit:.: C1158 Electrical Lic.: 208174 Suprv.Lic,: 4496S s�eCiScallZlisteli ler min _ signature,required: •CJ1(-Pi k :. 1 Sltprv.Electrician � Subtotal: Print name: Joan P Albert Date:S"3'`� 0 Plan Review Required(25%of permit fee): _ State surcharge(12%of permit fee): TOTAL PERMIT FEB: Authorized signature: ; ._:_______.- -' Tbls permit application expires if a permit is net obtained within 180 Print name: Bill Daniels/ Dates-3—A(Q days after It has been accepted as complete. e Number of inspections allowed per permit Linti1dIr lPemdtclbl.0 Pem:itApp MR ERR.doe Rev 06/17t2015 440-4615T(1I/OS/COM/WB Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 15166 SW 154TH AVE, TIGARD, OR, 97224 Residential - Master Permit 199 Electrical ﬁnal PASS MST2015-00251 David Young Corrections from previous inspection complete. Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 15166 SW 154TH AVE, TIGARD, OR, 97224 Residential - Master Permit 299 Final inspection FAIL MST2015-00251 David Young Not ready for ﬁnal inspection. Garage steps and handrail not done, no inspection done at this time. Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 15166 SW 154TH AVE, TIGARD, OR, 97224 Residential - Master Permit 299 Final inspection PASS - C of O MST2015-00251 David Young Final erosion control approved. Street tree certiﬁcation received. Moisture content form received. High efﬁciency lighting form received. Insulation certiﬁcation checked. Blower door test report received. Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 15166 SW 154TH AVE, TIGARD, OR, 97224 Residential - Master Permit 699 Mechanical ﬁnal PASS MST2015-00251 David Young Violation Summary: Inspector Contractor 'Mechanical Permit Applicrim. 14}R OPTIC E ISE ()NIA City of Tigard EIVE lal?S Hail Blvd.,Tigard, �' Darei le/�///P 'Cs / /S O�OC/75/1' Phone- 71&2 39 Fax: , P 2 0 2016 Plan-Review Mashy f2»crat; Ti EGA it D ingpecti€an tine: 563&&9.4175bats R4 tds13y>•. tsri- -E1 Rags 3 rim u ss^st.tillaul s r.gn ______] CITY OF 1 ILAtiu Netit¢illt,i.thad: '*uppletn lInfornaatoo BUILDING nhn3-.. TYPE OF,3i'. fIi . COMMERC L FES*SCHEDULE I.€53 "IrEC'K7..IS"I'. .. Mechanical permit fees*are based on the value of the zsork New cote rructittn 0 Additionr'after4iontreplac neatperformed,Indicate the vent(rounded to Me nom)dollar)of al/ 0 Demolition 0 Other mechanical materia `=irteut,labor,overhead,anti profit :alae, CATEGORY OF CONSTRUCTION STl3t�`CI(It4 • REsiDE= `3'IALEQUIPMENT/SYS SEMS F• EES' 0 1-and 2-family dna elli :g 10 Commerciallindustrial 0 Acces.sosy°building t or spaixti in ltmarion arse e nrcAt MultiFamily0 tslaster builder r 0 Other, f. scription Qty. Ca. "i'oaf - ' ' JOB SITE INFORMATION AND LI/CATION ratttcrriihri i Ail''conditioning �i 1 46.75 1 Job i address: l I �lv �w �., pt.,,, io0,0 0 r tit ) I ,t5 CitytStatzall Tigard,OR 97224 Pomace 100.000+DIU iia t inentrt 34.91 Heal pump .. .. b16. 4:32'26"', Soite/iidgiapt.no.: `j Project name:Polygon at Dull Mountain Hingag trlb. 23 Cross street/directions to j"ol site: livdrenie hot walttcrsystem 2 Residential hailer(radiator or hydrsaialc) 23.32 Hair heaters Obel-type asst eelectrie4 in-wail irnzine suspended.etc. 46.75 :. tth lute sent for trail-of abo e 23:2 Subdivision:tart.Polygon at Bill Mountain Lot ow: / a 23 ,2 ?nisi fueluppi nc a. Tax reapipatz:�el.ctn.: Wier heater 23.32 ` ------ .' -..._.. Gas eirePla"fin-sen 1339 nue veall ftia voter heater or z as fireplace .__ 23.32 I i 1 titan a �A!../., ` _IIIIIIIg .. !,.ori ,._ - _......_4WfallgIIIIIIIIIIIIIIIIIIIIIIIIII t�llx+dI:pelletstove 33..39 Wood fiteplaceinsert 23.32 hstii inirltral x_32 to t 2 .. 1P#ld?3" i$$ ;43 I Other 23 r 'TF A•Ni �`mrt�rcrarnralsr9 ra'haust and �rtt`lttiarr g Nance Polygon% ,U ' Range hood'other kitchen ! Address;109 East 13 Street - § tit nicnt� 33.39 l Clothes:iffier exhaust I 33.39 City/StatcalP:Vancouver,WA$660 I Sineie dtt exhaust(hatitrontais; I toilet compartments,entity rooms) 2132 3 Phone(360) 9S-77110 Fax:( ) Attic/crawts ce fans 23.32 I APFUCAN fl CONTACT'PERSON i«r 1 23'2 Business riatinir Polon WT�11, l ' Fut!pitiM= 514.15 for 11111 fayr;.:$4.03 Rot each addiekttai Contact name:Angela r ajewski lura n z addresc109 East13t#iStreet Gas Beattzntttp allIgus:eadc tiditheater t:ttuiSt ZtP:Vancouver,WA,98660 Wer heater Phone::((360)69S-7700 pax.;(360)693-4442 ' r _..:. Range ■ Milli i-tush,Ang:Graj ekeypiil3 nhntnes.com Barbecue • CONTRACTOR Clothes er(� *usiness name:Apex AirLUC Other MECHANICAL PER.'IIT. EES' Address:18004 NE "Ave Subtotal Ci y/Steti:'7lP.Vancouver,WA 986146 Minimum anait f ($90.00) ; Phu review(.25 ofpermit lee) l Phone:(3601342-8.1119 Fax:(360 3226.--076 I S esur ba�°(L of mutt ) i CCB lic::203034 TOTAL PllliTlT FEE 1 This permit pticatiriat.aper Ka.'permit is not alatyincsi.with n MO d Authorized3t A£ r rata bets nerrpi a€caimplctc F' inei holo y ini by iii-Misty.t3tirtsrstg Is4ustry Scssits Beard Print nrte, ".----- j 1 Date fir . > i ice;-'- r_�'n-;:.P.,.S,t'.i'_h'Ct�;^.:tl� fi�SZit i3..ittY �i i0a2t s 1?.1 - a r- e4--sr- ••"��C- �C��'� �/��/Y' 21 o i.si'„30 126- 1 ext,tf 7-7Z e= �'a