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Permit (16) CITY OF TIGARD MASTER PERMIT ie. .- COMMUNITY DEVELOPMENT II Permit#: MST2016-00038 Al - `' tI Date Issued: 04/13/2016 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 1' ' Parcel: 2S1080001504 /y`0 149 'll Jurisdiction: Tigard Site address: 15394 SW SEINE DR Subdivision: POLYGON AT BULL MOUNTAIN Lot: Multiple Project: Polygon at Bull Mountain, Lot 53 Project Description: New SF. 6/14/2016: Reduce bathrooms from 4 to 3. 8/4/2016:Add A/C and sump pump for storm water. 8/25/16 Add heat pump&2nd water heater. 11/14/2016:Add 4th bathroom. BUILDING Floor Areas Reauired Setbacks Required Stories: 3 Bedrooms: 4 First: 1542 sf Basement: 826 sf Left: 5 Parking Spaces: 0 Height: 32 Bathrooms: 4 Second: 2167 sf Garage: 739 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 4535 sf Value: $550,056.58 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 Drains: 0 Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 2 Water Lines: 100Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 1 Drywell-Trench Drain: 0 Other Fixture Units: Sump pump for storm water MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 6 Clothes Dryers: 1 Natural Gas Heat Pump: Y 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: 9 201-400 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 4535 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 2 A geotechnical report is required before the footing PHONE: 360-695-7700 PHONE: 360-695-7700 FAX: 360-693-4442 Total Fees: $37,680.60 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 througb,/ OA 2-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.198719or 1.800.332.2344. Issued By: (J 1 Permittee Signature: �'� `�/ /( 92?O,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. 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 .7 t _. Transmittal Letter T:G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 •www.tigard-or.gov TO: Tom H. DATE ' ED DEPT: BUILDING DIVISION � ' �" � NOV 1 0 2016 FROM: Angela Grajewski rrY F TIGARD COMPANY: Polygon Northwest BUILDING DIVISION PHONE: 971-212-2144 By: iir" RE: 15394 SE Seine Dr MST2016-00038 (Site Address) (Permit Number) Polygon at Bull Mountain Lot 53 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: `C � Q r opies , 3esetion ,..: Cies:A Description: ;0 N , 0 Additional set(s) of plans. 3 Revisions: add 4th bath 0 Cross section(s) and details. 0 Wall bracing and/or lateral analysis. 0 Floor/roof framing. 0 Basement and retaining walls. 0 Beam calculations. 0 Engineer's calculations. 0 Other(explain): REMARKS: Please pay fees owed with Trust Account. �` SnY 1 Routed to Permit Technician: Date: J f— ) tJ- J /4 Initials: Fees Due ?{'Yes ❑ No Fee Description: Amount D e: �' /9-64S 't /e4/1/ ,1/10 $ 90, c z) e'9-2S / / &---&--- $ 4/s'rz) $ kAo fix,. Special Instructions: Reprint Permit(per PE): es ❑No n Done Applicant Notified:,g- 1 -- Date: /7/j�/ Initials ` I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 -�t,-1� Building Permit Application ,Ii1FI ; R,_„�I, ResidentialFOR OFFICE CSE OyLl City of Tigard N O V 10 2016 PReceived Permit No.: n II 13125 SW Hall Blvd.,Tigard,OR 97223 T / �����`"00 ST' E Date/B view Other Permit: Phone: 503.718.2439 Fax: 503.598.196(8 DateBy. �� �� Inspection Line: 503.639.4175 Iyt}I DjNG iV S OI.,1ateReadyBy: Juris: El SeePage2for Internet: www.tigard-or.gov 1? 1 sa otified/Method: Supplemental Information ., • .4 rg .'x` , 's�._ ._ ;ams& ..aa; 3„t . ' 'll ®New construction 0 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 t t � , Q. work indicated on this application. ® 1-and 2-family dwelling 0 Commercial/industrial Valuation: $545,012 ElAccessory building ❑Multi-family Number of bedrooms: 4 ❑Master builder 0Other Number of bathrooms: �� t y 1 Total number of floors: 2.5 Job site address: i : (i c... .),\,....) �(c>Qu. Garage/carport area: 739 square feet New dwelling area: 4535 square feet City/State/ZIP:Tigard,OR 97224 Suite/bldg./apt.no.: Project name:Polygon at Bull Mountain Covered porch area: 98 square feet Cross street/directions to job site: Deck area: 160 square feet Other structure area: square feet # l: ' l l t • £m' mom;d ' Subdivision:Polygon at Bull Mountain Lot no.: 53 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 ''' „ a " 4 s l "i%;14";17:2;:7';'6471( °ill;rc "' 7'` work indicated on this application. Plan 19A-DL Valuation: $ Addq' 660(4-) Existing building area: square feet New building area: square feet ., x, ,. . Number of stories: Name:Polygon WLH,LLC Type of construction: Address:109 East 13th Street Occupancy groups: City/State/ZIP:Vancouver WA 98660 Existing: Phone:(360)695-7700 Fax:( ) New: Business name:1 '1 ' 1 1 8' ," .max✓ Structural plan review fee(or deposit): Contact name: FLS plan review fee(if applicable): Address: I' East 13th Street II Vancouver 98660 1 1 1 Total fees due upon application: / 1 695-7700 Amount received: E-mail: I ' 1 1 1 ' 1 1 1 1 I Commercial and residential prescriptive installation of me< g f rooftop mounted Photovoltaic Solar Panel System. Business name:Polygon WLH,LLC Submit two(2)sets of roof planwith connection details and fire department access,along with the 2010 Oregon Address: 109 East 13th 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: y �` This permit application expires if a permit is not obtained f v within 180 days after it has been accepted as complete. Print name:Angela Grajewski Date:5/2/16 *Fee methodology set by Tri-County Building Industry Service Board. I:\BuildingTermits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Plumbing Permit Application RECTIVE, Building Fixtures FoR OFFFIf 1. I til C)\l l Reetived (V1 s; '6 `O O✓V City of Tigard NOV 1 0 2016 RecMve Permit A a:: rt 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review i Phone: 503.718.2439. Fax: 503.598.1 c of, ' p Dateirly, Other Permit No:: Inspection Line: 503 639.4175 ate Ready't3 Jura 0 See Page 2 for 1 I C A F� `) Internet: www.tigard-or.gov BUILDING y 1 tai c f( tified/Method: Supplemental Information " yns- f f a" act.... z ►i New construction 0 Demolition Far special information use checklist Description 1 Qty. ( Ea. I Total ❑Addition/aIteration/replacement l 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) ,1, ex-----:.-.,.. 0-0-',6;1,1--!' to e „ �1 . SFR(1)bath 312.70 W 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ©Accessory building 0 Multi-family Each additional bath/kitchen ( 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 ''` .BA i Pa _ i,Irrre T1� '���' Site •utilities: Job site address: ( .5 3 1 `''l x� �� M Catch basin or area drain 18.76 Drywell.leach line.or trench drain 18.76 City/State/ZIP:Tigard,OR 97224 Footing drain(no,linear ft.:) Page 2 Suite/bldg./apt:no.; Project name:Polygon at Bull Mountain 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 Water service(no.linear tt. _) Page 2 Subdivision;Polygon at Bull Mountain Lot no.: L=2 Fixture or item: fax map/parcel no.: c.� Backflow preventer 31.27 `� - Backwater valve 1231 is OF s .; A�i,(��,/) � ( l' Cloth�•washer 25.02 ac.5w Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25,02 ,. �- 1 ,tea. rO 'T Expansion tank 12.51 Name:Polygon WLR,LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub ( 25.02 Address: 109 East 134"Street Garbage disposal 25.02 City/State/ZIP:Vancouver,WA 98660 Hose bib 25.02 Phone;(360)695-7700 Fax:( ) 1 Ice maker12.51 1 i '; V -41‘,,,-,40,'w..AcrY ;t MedicalInterceptor/grease trap 25.02 Business name:Polygon lti'LH,LLC o Fc % „ a gas(value:$ ) Page 2 Primer 12.51 1 Contact name'Angela Grajewski Root drain(commercial) 12.51 Address:109 East 13th Street 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 4polygonhomes.com Urinal 25.02 t. Water closet 25.02 A;-, w.,: ,o,.. , . . :A.. ,A........ t... � ..t -. ; ... Water heater 37.52. Business name:BBL Plumbing Lie Water piping/DWV 56.29 Address:PO Box 85 Other 25.02 City/State/ZIP:Corbett OR 97019 Subtotal Phone:(5113)351-3903 Fax:( ) Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lie.:180345 Plumbing Lie.no.:P111582 State surcharge(12%of permit fee) Authorized signature: a F - TOTAL PERMIT FEE Print Hartle:Brandon Lanier [)ate; This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:t.Buiiding;`•Yertnits,PLMU-PermitApp doe MO i09 440-4616T(70t02 COM EB) CITY OF TIGARD `� " • MASTER PERMIT 14 .t COMMUNITY DEVELOPMENT a��� Permit#: MST2016-00038 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/13/2016 Parcel: 2S1080001504 Site address: 15394 SW SEINE DR Jurisdiction: Tigard Subdivision: POLYGON AT BULL MOUNTAIN Lot: Multiple Project: Polygon at Bull Mountain, Lot 53 Project Description: New SF. 6/14/2016: REPRINT to reduce bathrooms from 4 to 3. 8/4/2016: REPRINT add A/C and sump pump for storm water. 8/25/16 ADD heat pump&2nd water heater. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 4 First: 1542 sf Basement: 826 sf Left: 5 Parking Spaces: 0 Height: 32 Bathrooms: 3 Second: 2167 sf Garage: 739 sf Front: 20 Dwelling Units: 1 Smoke Third: 0 sf Right: 5 Detectors: Yes Total: 4535 sf Value: $550,056.58 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 LaundryTrays: 1 Y Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer 100 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 2 Drains: 0 Water Lines: 100 Catch Basins: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Bckflw Prevntr: 0 Drywell-Trench Drain: 0 Other Fixtures: 1 Other Fixture Units: Sump pump for storm water MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: Y 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: 9 201-400 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 Other: N Other Description: All Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy G NEW p yrou p: Square Feet: SF VB R-3 4535 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 2 A geotechnical report is required before the footing PHONE: 360-695-7700 PHONE: 360-695-7700 FAX: 360-693-4442 Total Fees: $37,590.60 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 trQAR 952-001-0090./ JYou may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: �,►�_/\)(r1- `, Permittee Signature: [_ et- Call 503.639.4175 by 7:00 a.m.for the next available inspection date. Ui1 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. Plumbing Permit Applitutinn Building Fixtures RECEIVED . FOR OFFICE USE . . 14 City or Tig-40 ..g.vpeilvcl '4>a14P , illMi• ,, ,2r,9016-66034' , „....,,,. 13125 S\ Half Rlyd.,,Tigardi OR MIA31 6 2016 Plan,TOvigw- 7 1Ito P°Tiit.N0N1 Phone: 50.3.715..2439 Fax 01598.1060 -I56trifly; : OtIvr P:onnit No.: pLine 5 : 03.639A lt,ITY OF TIGARD . .. • TIGARD Inspection • - D41g-'144YLPY: Twig. 51 See Page 2 kr • Internet .www.tigOr,gov '!" n!!\1Q.DIV' NotifleA/Method: SupplementalInfpronition • : . -.,--' '-:. -•--TiTE.OF i;voRk-z...‘.s: -, .; ::•. ,,.. -,', -• -,:-i - .•.,-, - ::,;,-,-. ,:,::- -. --'TEE*..SCIIFD.BiLE;;',:•.-"-•'•.7.'"-"ff''''S•t• ',J,,,-....'•-•',. E:New construction I 0 Done:IWO for special injOrmagon use checklist . • D.esctiptiOn 1 -Qty. I Ea. l 'NMI 0 AddiOonialterationfreplactinent 0,Otiter. • New,1-1-,family dwellings(ine•lndes.100:ft.fin'each lye ion) .. ...... .. '6-ii.EGiiity,41,:t;CiNkiiiiiaioikei,*,..:g.1;:.0"ti:,iilse:si-Ant: .8FR CO bath 31110 El 1-and 2-family dwelling 0 cinnnteitialliminstfial - •S-FI (2)Ilaffi . .:SFIZ 0 bath 500.32, El Accessory blinding. 0„MtOti4aitily • - .. - •• .Each additional bath/kitchen. • 2502 •• El Master builder . . • Fire...six:Miner( . sg.fi„). ' .Page 2 .. Z:4":.k,,,I.:,•6: :..;-]Wl.kitti ~4)***7. 8;:tiP*Airy.1:61:.-i",i;., Site utiiit1es::. • ••. .: .. :. • .... . . " kb site address; S 39 LI S\IJ sekne, Q. e. - : tatai.basii,,,faivadraiti. • Oryuell,:leackfint,or trench drain. . J188'.77:. .. . .. - • City/State/EP:Tigard,OR 97224 . .. .... . . -1, - -- Footing drairi(no,linear ft..•:. 1. • • Page 2• Sniteiblifg.lapt•no.: Project name:PolygOO•Ut Bull Mountain ' Manufactared home utilities • .50,03 ,• . . . . • Cross ttreeticlirectient to-job site: ' Manholes • 18.76 . ... Rain drain connector • 18.76 • . . .... -... . "• . . . .• , " • . - ' Sanitary seyer(no.linear ft.: y Page-.2 .• . ... , . . •• " .''StOrm sewer(no.Ifilear.11::.. . ) I Page.2 . .. • .Lot . -Water service Mo.linear IL; ) Page 2 SubdivsionPolygon • 1 . ". . . i ; at Bull'MOuritairi ' • no' 9) Fixture or item; . 7.. .• . .„... . , . . • Backflow*venter 31...27 Tax roapipareel.no.: • - . ... ... ... . -r Backwater valve '-'•;•• ••7.t .'"Wli-:•,'IP'''WI'•''••;E:''f.iiikiilifio'k::OF ii•ORk'''-'•44'..k?:447r4p; '•, .•;•il - : . am . . . .• ..:„.„. ...,- ...,....- _.-.,.,..,...,,„,p...„-„cf..--.:.--:, ,....A.,..,,,,,-.7,..-:-K. (kola washer .. 25.02 . i) /4; (-0Pai.e.- H.f-11-7rf,-a7- . --- . . Dishwasher .25.0.2 . • • Drinking.fountain 25.02 Ejectors/swim 25:02 '..-•s:-:.-.1;-.'-,-: PROPERTY OWNER ,N4-,A,:4: ..'.-:F:":::. - ', a TEN ANT,',''' '.1',:.-.:-.'''- Evanston tank .. . • 12.51 . ... .. .I Fixtinvisewei cap 25.02 ' I • - •Naps ;Pnlygen'WOE,LL-C • Fkiortirairraloor.sinkflaib1 25.02 • Address::109 got 136 Street . • Otirbaae disposal • ::1 • 25.02 1 .... ... . C.ity/Statertfp:Va./leo/me%WA 98660. Hose bib 25.02 .._ . .. . . . ... Phone:(360)095-7700 Fax;( ) lee Maker ' 1151 • . ,. . . „. _. .. . .„, irfk,j:ip!,'tal,..iiplittcAisr,r •-,0.•-,-,:t•,,:;::::,.. -;-.e;....::::EcoNtitt..,sdisti*:;;,i,:,p 1nterceptorease trap 24.....02 . 1 ' • - " • ' - . Medical gas(value;:$ .. .:) .. Page.2,., ..•. • BuSiOeSSIlamq:Polygon WLII,LLC "•- - • Primer - • 12.51 ' •Contactnatue:R•togeja.Orajewiki •- -• ••• ....,. . . •. . . . . .. RonfOraia.(commercial) 12..5.1 • Arldress:.109 Bait.13th Street- SinklbasinilityaMry: 254 . ... . . . -. City/SteteMP:.Vauctitivet,'WA:986'60 Solar units(potable Water): . 62.54 ... .. . Phone:(360)-69S-7700 Fax;.:'(360).604442 " :.Tab/shower/shower pan. . -1151. . , . : Uti941 . •25A E-mail:Arigela•Crajeyrskifidpolygorifionies.com - . . . ,. ...•- • . . . , ... . - - • Water closet - ' 25.02 ert.-_-.,,, -.:,.,:,..-.. - -::2.:,-,!.:::;;..;,.--,. ,5,'..,.:to.,4iiiActiokk;,:,-;.,:,;,,,,,,...,..,,,. ,•*,.:......,,.....,,,,,..,_ .„ . . . Water heater :.. 1. . .. 31..5.2 .V7,62) Business name:BDL Plumbing LLeWaterpipinglOWV 56..29. , .. . _ .. ... . ..... . . .. ... 1 Address PO Box 85 .- 'oilier: 1 .25.62 - • - .... - - .. .. City/State/Z1P:Corbett OR 97019Subtotal •- • - ; $ rho*($0.4s1,3903.... 6*:t. ‘• ) Mininuunpermit fee715B.. ... -• . . .. . . . • ••• •• Plan revieW (25%0f Pc1mA fee.) I C.CBLie.f IWO .. . - :Pturnting Lie:nO,::1411:582 . .. .. .• " - • -. • • -• . . - . .,. State stireharge(12%of permit.lee) . ....'- .. . . . . . Authorized signature 6,,,z . /046.-z...,-- TOTAL PFRM1t FEB . 1 . ••••.-• •- - . • • • -• ..• •• • . . ... .• This peraut.appiteat!ort expires it:a pernutts ard pbtatneti within 180 days " Print.anme:,Brridap jAoter • PAW 8/Ho atter Ithas.been accepted as complete.. . Ted eeiho101yt by Trionnity13,uilding Industry Señlta Bahl. . . 1.:*iidini,Nraeit4I-M13,PermiiApp,doc-16/01/09. 440461611101021.CO5iP.W.En) - ) eche t iCal �ermit Applic�tio.i FOR OFFICE USE ONL,l` • City Of TigardCE® Received G Iii ® i I Date/By: p e,• /(p elf Permit No.: M 11' ,,� 2 Q 13125 SW Hall lvd.,Tigard,OR 97223la PVE • ! J O Phone: 503.718.2439 Fax: 503.598.1960 Plan Review Date/By: Other Permit: TIGARD Inspection Line: 503.639.4175 AUG Internet: www.tigard-or.gov G 2016 Date Ready/By: .runs: 10 See Page 2 for CI7 V("I "I � Notified/Method: Information CI GAFit TYPE OF,� - tvtotA,# .c.0). RCL&L'FW SCUEDU E U CHECr IST ®New construction Mechanical permit fees*are based on the value of the work ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF tONSTRJCI.'IOIY<' ® 1-and 2-familydwelling �$ID EQ>JIPIVIENTISYSTEA7SF11 ES* ❑Commercial/industrial ❑Accessory ❑Multi-family building For special information use checklist. Y ❑Master builder ❑Other: Description I Qty. I Ea. I Total ;7013 3IlE INFORMATIOIIJ AND_LOCAIION Heating/cooling: _. Job site address: I P'f��j` 3 5 Y� pe. AirFurnace conditioning0 , 46.75 K— 100,000 BTU(ducts/vents) 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: I Project name:Polygon at Bull Mountain Heat pump 1 61.06 61.06 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.: 5% Other: 23.32 .� Other fuel appliances: Tax map/parcel no.: Water heater 23.32 2IESC3iIP`FION OF WORK Gas fireplace/insert _: 3339 Change 2°d furance for basement to Heat Pump Flue vent for water heater or gas fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent er/flue/vent23.32 ® IPROPRTY OWNER � TENANT_ ; Other: 23.32 .. Environmental exhaust and ventilation: Name:Polygon WLH,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 iggigigag®` ii- ❑;C O ITACP o*or N Other: 23.32 Business name:Polygon WLH,LLC Fuel piping: $14.15 for first four;$4.03 for each additional Contact name:Angela Grajewski 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 eCONTRACTOR Clothes dryer(gas) Business name:Apex Air LLC Other: 14iAddress:18004 NE 72°a Ave 1W I 'PERM[TFEES* Subtotal City/State/ZIP:Vancouver,WA 98686 Minimum permit fee($90.00) Phone:(360)342-8109 I Fax:(360)326-1769 Plan review(25%of permit fee) State surcharge(12%ofpermit fee) CCB lie.:203034 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized Signature: Fee methodology set by Tri County Building Industry Service Board 1 Print name: ia, / Ill �& I Date:8/22/16 I I:\BuildingWensitslMEC_PdeermiitApp_0401133..oc 440-4617T(11/02/COM/WEB) _- q CITY OF TIGARD ...�_v. &ter MASTER PERMIT f COMMUNITY DEVELOPMENT Permit#: MST2016 00038 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/13/2016 Parcel: 2S1080001504 Jurisdiction: Tigard Site address: 15394 SW SEINE DR Subdivision: POLYGON AT BULL MOUNTAIN Lot: Multiple Project: Polygon at Bull Mountain, Lot 53 Project Description: New SF. 6/14/2016: REPRINT permit to reduce bathrooms from 4 to 3. 8/4/2016: REPRINT permit to add A/C and sump pump for storm water. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 4 First: 1542 sf Basement: 826 sf Left: 5 Parking Spaces: 0 Height: 32 Bathrooms: 3 Second: 2167 sf Garage: 739 sf Front: 20 Smoke DwellingUnits: 1 Detectors: Yes Third: 0 sf Right: 5 Total: 4535 sf Value: $550,056.58 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 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 Drywell-Trench Drain: 0 Other Fixtures: 1 Other Fixture Units: Sump pump for storm water 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'I 500 sf: 9 201-400 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 4535 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 2 A geotechnical report is required before the footing PHONE: 360-695-7700 PHONE: 360-695-7700 FAX: 360-693-4442 Total Fees: $37,435.18 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 0 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. op Issued By: P ! - ... Permittee Signature: vAl (/ _ / 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. , Mechanical Permit Applicatio>ri FOR OFFICE fSE ONL1 City of Tigard Received I l ' i;; Date/By: 20 /' *if/ Permit N%./�-r.-CV ,e e903? I3125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie ' Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: TI G Z D Inspection Line: 503.639.4175 . Date Ready/B Internet: www.tigard-or.gov y: saris: See Page 2 for lotified/Method: supplemental Information 4�w... y,!'s� `Y .-,rte a r'�f '.^n,'d E qrQ{"�. G �°`6 `, "^ c arti n`', ,, ''�'6'a`s'.,.', ..` r� < ? 'i (r 'r,."'" ..,. :},,,.-wil ,_., ...',;..:Vq''0-r4`'�9i`' 4'.,h"S�a''.•,3;4 "%'it£��.i� ,zsx; ' jI43`S" ` 4_,f}''iCla�'( F v,f-14r:b —d.On th:; itei `w, Iric:.1'.I ;. ®New constructionMechanical permit fees*are based on the value of the work 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. . Value $5 _tF.LL1if,f i::. 4 1 ni aRi� p� wSiRmLIM 7r "t5J ® 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi family 0 Master builder ❑Other: Description 1 Qty. [ Ba. 1 Total L C� h .`.-,:.nF 9E �.�- Nrry`F,,lk :14,4 t.,Orri,V3tir_,urR 7i,i' gk€`1tG,i Y3 ''w, ?i ; Reating/coolitrg: Job site address:15394 SW Seine Drive Air conditioning 1 46.75 46.75 Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: 1 Project name:Polygon at Bull Mountain Heat pump 61.06 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.:53 Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 . i'L , ,4 5 . :4 e£Y„ M, ig 4w a V " semi 1 Gas fireplace/insert 33.39 add AC to existing permit Flue vent for water heater or gas fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 *'::3,..p` 4 4,;a h i 5) :,V Wil w,t k 3,13 ,; g Other: 23.32 Environmental exhaust and ventilation: Name:Polygon WLR,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 ,.n,xxsr.. AEa¢S`0:16:43A1 , 5.''.1.4;74';'.1413ic ¢ h t � Other: _ 2332 Business name:Polygon WLR,LLC Fuel piping: $14.15 for first four;$4.03 for each additional Contact name:Angela Grajewski 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 Fax::(360)693-4442 Fireplace E-mail:Angela.Grajewski®polygonhomes.com Range , c Barbecue,:.,1.14 -"(5 ya .`� Cg4t. cA iAk. 41.171€1 ,, ' Clothes dryer(gas) Business name:Apex Air LLCOther:, "Other: Address:18004 NE 72nd Ave _A 1 .. _E tc i Mr,,9* r 7.g .i s, , a Subtotal /e, 7S 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) CCB lic.:203034 TOTAL PERMIT FEE c_94.),(2/ This permit application expires if a permit is not obtained within 180 - Authorized signature: days after it has been accepted as complete kl/ ' Fee methodology set by Tri-County Building Industry Service Board Print name:Angela Grajewskl Date:7/19/16 I;\Buitding\PermitslblEc PcrmitApp 040113_doc 440-4617T(1a/02/COM/WE.B) 7-777I-4. , 9% 3k 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 Transmittal Letter 111 1 H 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Tht_ DATE)2ECEIVED: } DEPT: BUILDING DIVISION , �� JUL 1 ���;r (FROM: A i Grafwslo COMPANY: \!A Pot fouit { PHONE:NY. 0 - 5— 00 1 I RE: °O (n ' ( ' ite ' `n t 0 GVW` _ :, H�d�oPO/�o—� oo 3 (Permit Number) • 153 ,, 5-14 _ L.o 5 3 7Project name or subdivision name and lot number) I ATTACHED ARE THE FOLLOWING ITEMS 63J"-it;`, 3 ' ) ;1-)'4 3 z ri,�U'£' v� -":.g', ��ti' .tF:;:44',',' s ',' ! 'f_: Y m S Additional set(s) of plans. Revisions: Cross section(s)and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: s,, A 1 _ ♦ tea � , AA_1g. r / .t• ---MAIM: _.'", il E.44-4,_,0 r,,,. ' 5/ 4---04— --Ka-1- o-i Alliffn Routed to Permit Technician: a 1 -. " P .):j :: tcie Date: Y,k,. ,. es Fees Due: ►i'� Initials: No Fee Descri stion: Amount Due: .1/Al-tlii:--tv-itF4Pk-R9i4 Nii '+- ,t ' � a '-L lam' l�c-'� // $ ��.J-s c o�. ' -�,} : '4'i,* 104-02,f'-0.4.. a � / e? /1C 9/�E- .$ 3 F$w. r/ "+ / $ .�"Z ...--.v��r-r�- . Special ---T-�� Instructions: , 0, 002, --- Reprint Permit(per PE): 0 Yes I Applicant Notified:,9, 677— I Date: 7 2 o ❑Done ��b � �`7/7--/t— I Initial I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 r� CITY OF OF TIG!111MASTER PERMIT g 11 -• COMMUNITY DEVELOPMENT i/�' Permit#: MST2016-00038 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/13/2016 Parcel: 2S1080001504 Jurisdiction: Tigard Site address: 15394 SW SEINE DR Subdivision: POLYGON AT BULL MOUNTAIN Lot: Multiple Project: Polygon at Bull Mountain, Lot 53 Project Description: New SF. 6/14/2016: REPRINT permit to reduce bathrooms from 4 to 3. BUILDING Floor Areas Required Setbacks Required ' Stories: 3 Bedrooms: 4 First: 1542 sf Basement: 826 sf Left: 5 Parking Spaces: 0 Height: 32 Bathrooms: 3 Second: 2167 sf Garage: 739 sf Front: 20 Smoke DwellingUnits: 1 Detectors: Yes Third: 0 sf Right: 5 Total: 4535 sf Value: $550,056.58 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 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: N 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: 9 201-400 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 4535 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 2 A geotechnical report is required before the footing PHONE: 360-695-7700 PHONE: 360-695-7700 FAX: 360-693-4442 Total Fees: $37,309.80 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 thro OAR 952-001-1090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. lit Issued By: - Permittee Signature: 44/ �,4/e d V 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. 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 !Pi " Transmittal Letter T i G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Tom H. DATE RECEIVED: DEPT: BUILDING DIVISION Rj1 I 1 FROM: Angela Grajewski/Chris Walther tAY ���� CITY OF T1GARD COMPANY: Polygon Northwest V1S PHONE: 503-312-6213 By szir RE: 15361 LI SW Seine Drive MST2016-000 38 /5.S C{6-5 (Site Address) (Permit Number) Polygon at Bull Mountain LOT ,j 3 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies:` Description: Copies: ; Description: 0 Additional set(s)of plans. 3 Revisions: WIC/4th bath change 0 Cross section(s)and details. 0 Wall bracing and/or lateral analysis. 0 Floor/roof framing. 0 Basement and retaining walls. 0 Beam calculations. 0 Engineer's calculations. 0 Other(explain): REMARKS: Removal of 4th Bedroom bathroom into Walk-in Closet FOR OFFICE USE ONLY Routed to Permit Technician: Date: ( / ( / j C, Initial . Fees Due: JR] Yes ❑No Fee Description: Amount e: $ It x . . $ Special O a- ievt A',$i C 5) Lhf-/6 C 3) 'TICB/Si1-zi/ C') Instructions: 7z,,ty (SJ //4-Arr- vS 3 4J9-76—it et-0 serr' Reprint Permit (per PE): N. Yes No 'Done Applicant Notified: /; /G- 1'�ate: �y / �7 7 _ Initials: P � lo 471/ I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 CITY OF TIGARD MASTER PERMIT a COMMUNITY DEVELOPMENT Permit#: MST2016-00038 Date Issued: 04/13!2016 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S1080001504 Jurisdiction: Tigard Site address: 15394 SW SEINE DR Subdivision: POLYGON AT BULL MOUNTAIN Lot: Multiple Project: Polygon at Bull Mountain, Lot 53 Project Description: New SF BUILDING Floor Areas Required Setbacks Reauired Stories: 3 Bedrooms: 4 First: 1542 sf Basement: 826 sf Left: 5 Parking Spaces: 0 Height: 32 Bathrooms: 4 Second: 2167 sf Garage: 739 sf Front: 20 Smoke Yes Right: 5 Detectors: Dwelling Units: 1 Third: 0 sf Ri 9 Total: 4535 sf Value: $550,056.58 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: Catch Basins: 0 Bckfw 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 Tvoes 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 Tomo SrvclFeeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add!500 sf: 9 201-400 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 4535 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 2 A geotechnical report is required before the footing PHONE: 360-695-7700 PHONE: 360-695-7700 FAX: 360-693-4442 Total Fees: $37,101.28 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. requiresyou ATTENTION: Oregon law to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR lin 503.232.1987 or 1.800.332.2344. - questions to OUNC bycalling•5 -��1-0090. You mayobtain a copyof the rules or direct g 952-001-0010 through Issued By: t , Permittee Signature: f,N ,96-i6° - 70/ 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. - 3 � Building Permit Application T `� /a''/lib ... RECEIVED FOR OFFICE ISE ON 1.1 Cl. of Tigard Received .�/ /� '�//,�.Permit No. Zer4,2 /4 D '&3I' a 13125 SW Hall Blvd.,Tigard,OR 97223 FEB 1 8 2016 Day' . Plan Revie 2 j i C II ,2n/� DDO^ . Phone: 503.718.2439 Fax: 503.598. Dan Re 1 rvi' Pte'' oc(J oC T 1<, R 1, Inspection Line: 503.639.4175 'T O F T1 ' Date Reaay/sy: muris: H See Page 2 for Internet: www.tigazd or.govBUILDING DIVISION Notified/Method: Supplemental Information ....+ New ,..._.'. ,.N.._...... . a' a..,..:._. .cu�_,. _.......i.a.._.,..__ T.. ,......H ....,...�r . ,._. �..v ai. _._..3„ �..„�:,...,. ®New construction ❑Demolition Permit fees**- ees 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 work indicated on this application. .. - Valuation: $ IMInglIM ® 1-and 2-family dwelling ❑Commercial/mdustrial ❑Accessory building 0 Multi-family Number of bedrooms: 4 Number of bathrooms: + ❑Master builder 1 53 0 0 Other • Total number of floors: Job site address: ) 5.6_,I--.42 I . New dwelling area: LI5y q square feetS) ', City/State/ZIP:Tigard,OR 97224 Garage/carport area: y square feet Suite/bldg./apt.no.: I Project name:P©\\i( 13'11 Ct b‘)r\ n Covered porch area: q square feet Cross street/directions to job site: J Deck area: 1U) 0 square feet 6.4 Other structure area: • square feet 4 - Subdivision:Polygon at Bull Mountain I Lot no.:J' 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 work indicated on this .•.lication. ne�. Ln3� IJU-i IQ w • ' Valuation: $ Existing building area: square feet New building area: square feet P' Number of stories: ,.. _.... __,._ ____ _.e_ _ _.,-.... . _,_.__. .._. Name:Polygon WLH,LLC Type of construction: Address:109 E 136 Street Occupancy groups: City/State/ZIP:Vancouver,CA 98660 Existing: Phone:(360)695.7700 Fax:(360)693.4442 New: s Business name: p.1 L `I n C Structural plan review fee(or deposit):. Contact name: M a f \-e. CC\. O FLS plan review fee(if applicable): Address: I 0 Ot 1 City/State/ZIP: V Cur)O���e� W p, 0,G� Total fees due upon application: Phone:31p1D) V int • -1-1-0C) I Fax:N.D) u Ct5-U2:2_2Amount received: E-mail:maggie.gordon@polygonhomes.com COerClal and residential prescriptive installation of IDID ' n _ " -t roof-top mounted PhotoVoltaic Solar Panel System. Business name: 0 ki a�, W LA 'n C Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Cl,Address: t 9 i I3`,4r-\ 5-\- ' ^f, Solar Installation S.•tial Code checklist City/State/ZIP: J an cower (� Pl A 1 Cj .olo 0 Permit Fee(includes plan review $180.00 Phone:61,2Q) to q 5, JC) Fax:(pt) `3 , L\�22 age administrative fees State surcharge(12%of permit fee): $21.60 CCB lit.:204238 Total fee due upon application: $201.60 I This permit application expires if a permit is not obtained Authorized signature: It. • within 180 days after it has been accepted as complete. Print name: Date *Fee methodology set by Tri-County Building Industry ��7_,1-0 1. Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Electrical Permit ApplicatiorlECEIV FOR OFFICE t'S0\l.l ED I•. Received City of Tigard Permit Nes7c20/ _ IIIIII 13125 SW Hall Blvd.,Tigard.OR 97223 FEB 18 2016 °al""' Tigard Plan Review Phone X03.718.2439 Fax 503.59X.1960 Dato/ny: Other Permit I 1. \ I, Inspection Line: 503.639.4175 Date Ready/13y: )iiiix El See Page 2 for CITY OF�`�`!� � Supplemental Information \v\\' Internet: w .[iirard-or.gov Notified'Method: ,..�,.:iG+l�ar!R�-._area`^. .>r; F r•-.� 'a- ,:; #+.•. �1'�V�l D �� 1� a. _ � i' X ii- , c, r?'r3'tE G w .l'LA'1!'>-RFsVi7ENY ®1\t.\\'construction ❑Addition/alteration/rt,placemt.nt Please check ll that apply(submit 2 sets of plans w'items checked below) 0 Service or Feeder 400 amps or more 0 Building oxer three stories ❑ Demolition 0Other. where the available I:udt current� I ;Marin.t. :uu �• I Ixnt .rrds 1 • i W ..< GA"rf;3O©RY Ok;CONSTRi3CTIifj ;,'r`:, exceeds 10.000 amps 1150 volts or 0 Floating buddnies less to ground-or exceeds 14.000 0 Commercial-use agricultural ® I-and 2-family dwelling D Commercial/industrial 0 Accessory building amps for all other installations bidldines 0 Multi-family 0 Master builder 0 Other: ❑Fire pump ❑Installation or 75 K VA or I xa :- ... 0 imrei gene,.system larger separately dem ed:41.2111;i fi . ) ; * sfORMA, T1ON D LOca T1ON;, I�g 9. _� ❑Addition of nca motor load o1 . Job no.: Job site address:15\ 50S se,„„ 100111'or ntulc. uccmpancv ❑Six or moreresidential mins 0 Recreational,chicle parks '" City/State/ZIP: l Cjare:t of: G .f'W-\ ❑11c:0th-care facilities ❑Supply.nbfor,r more than 1 vv 01 lur•udous locations 600,ills nominal Suitt./hldg./apt.no.: Project namc:Ub41gam, (Lk" eikj\' nr-H-n ❑Su,iceorFeeder 600 amps or more ' 011E7IJLE Cross street/directions to job site: DF;escription I Qiv. I Ere. I Total j • New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: 1.ot no.:53 1.(x)0 sy ft or less I68 54 4 ^Ea.add'I 500 sq.II or portion C 33 92 I Tax map/parcel no.: limited energy.residential _;z. �..E_,4'�?�s`•S+,;..` .x:,.«'1-'.. ( 75 UUif.x • 4r NRr 't§rRIP�IQ� d.t�(��t)C' .x -` - _ (with shove sq.rt) limited energy.multi-family 75 Olt New electrical service and wiring residential(with above sq Il) Services or feeders installation,alteration,and/or relocation 200 amps or less IOC)70 2 x `' JtRQP P �. 'a ELR t4'..0 TEN.ANT 201 amps to 400 amps 133.56 a Name: pb,i401 amps to 600 amps 200.34 2 601 amps to 1.000 amps 301 04 2 b 54- Address: ‘ ot ‘,-b l Over 1.000 amps or volts 552 26 , - f G�,�(�Je f t 'W q ]� 't emporary services or feeders installation,alteration,and/or City/State/ZIP: v Z,)f v �7�j�/v�' 'j� relocation Phone: D) tg a5.:454.0 1 lax: v ) lac{ -y / 200 amps or less 59 36 1 201 amps to 400 amps 125 05 Owner installation: -I-his installation is being made on property that I own which is not intended for sale, lease. rent,or exchange.according to ORS 447,449. 670.and 701. 401 amps to 599 amps 168 54 Branch circuits-new,alteration,or extension,per panel Owner signature: Date: A.Fee for branch circuits with • above service or feeder lee.'.: i ijij, rte i © ' 10.4Wr P SQM each branch circuit 7 42 , - Business name: P7-0-0 i 13 Fee for branch circuits uwhoru service or feeder lee.first 56 18 Contact name: m a a e (---)01 branch circuit Each add'I branch circuit 7 42 , i Address: A _ Miscellaneous(service or feeder not included) City/State/ZIP: Qf1l_CJ' 1l" ill ° (n . Each manufactured or modular I •�tG dwelling.service and/or feeder 67 84 I Phone:( ) Pax: :( ) Reconnect on)) 67 54 ' ' 1 e a t r ^h c Pump or irrigation circle 67 54 : - t.-mall Yt.•�g _`-� rJ!' ' Sign or outline lighting 67 84 � � `- I v .CO..TRACP�3 . ' �'' � •' -• Signal circuit(s)or limited-energy Business name:Simply Electric panel.alteration.or extension sage 2 i 2 Each additional inspection over alloyssable in any of the above Address: PO Box 822408 Additional inspection(I hr mm) 66225/hr City/State/Z1P:Vancouver,WA.98682 Investigation(I hr min) 66 25/hr Industrial plant(I hr min) 75 151 hr Phone:(503)849-8202 Fax:(360)314-4945 Inspections for which no fee is 90.00/hr specifically listed(V:hr mm) CCR laic.: 204615 1FIectrical I.ic.: 067 Suprv. I.ic.: 43945 EL'ECTR1C;ki;Pl t ITI7 fEIMS ' O Subtotal Suprv. Electrician signature, required: tfG4; e Plan revue\\ (25%ofpermit fee) Print name: Victor Zarrhitsky Date: 11 17/2015 State surcharge(12%of permit lee). Authorized signature: TOTAL.PERMIT I:1-.1:. This permit application expires if a permit is not obtained within 1a11 days after it has been accepted as complete. Print namc. DDate: ` Number mr inspections allowed per permit. I Amldmu4'crmims'11.C-Permii.\pp doe 07,01;10 440-461 ST(I I,OS VON IiwPIl Mechanical Permit Apnlica trag CE ED FOR c)rl tc L f SL ON LN CitY of Tigai-aFEB 18 2016 may:: N"� fro24/6-A00 3, 3 phi, : . 13125 SW:Ha►S►vd;,Tigard,OR 972?3 Waa Review pPhone 503:71824396Fax: 5Q339L1 OF TiTry DDat°BP-: Other-Permit c , , Inspedrn Line: 503. 34.4175 Auk': H.Seela[z.2far , Internet www. -or.gov BUILDING DIV of DeRay?H}; SopaeatttInr .,ti. �. •"1/44 . .,g, , 4% y...e. YyP-t4.,;18:0,.;i -,J,,,„.• Rt .,,- ,1.;-:"1 a: @&R 9 . - . Mechanical permit ties*air basedon the value:of the work IN 1itty LY)1lsirllaim 0 Addition/alteratitm+rreptacemcid performed.Indicate the value(rounded to the nearest dollar)of all mcc apical materials,equiptrtent,labor,.overhead,and profit .. ❑Demolition ❑Outer _ Value:$ ®1-and 2.#arriiiy dwelling ❑Commercialtmdustrial ❑Accessory building For*eclat Information use dieetttsr Multi-family /529'7...,,4,I ❑ .._ _builder 0OtherDesciconptiittoi nng. Qty. Ea. Total lief Jeo "� ® ,,,, et t e, ; aaz a . i . sr.,.� 4-1 ,. Air dii 46.75 Job site addrzss: Awa-- (�' 3 Se1..0�Q, D C. Furnaa'100,000 BTU(ductal ruts) 1 46.75 Furnace 100.000+BTU(dnetevans) •54.91 Heat pump Suite/bldg./apt. po1y 9)-y-, v„;rl m 23.2 ( Ossstneei/directions to.job site: liydiotuic hot water systtm 2332 Rrsiderthal boars(radiator or hydro dej 2332 Unitbtatts(11-type,not electric). in iiall.in-duct,suspended.ate. 46:75 Fhteivcnt for nY of above 2332 _ . .. 2332 Sub.. oa: _ . ._ . .. Lot : 5 ikhertael applrarttxt;: Tettidelrto Waterhealer 23.32 ..� . i� a e dryer. i t.TM i " ,- , i, Gas tacermsest 33.39 ` "_ ue for wider beater or gas .fireplace 23.32 I.ag.(i5h( ) 23.32 Wd dFpellet.lakve. 33.39 wow:fitep1acern sat , 2332 I Cbiatneyllitierifititivent 23.32. 23:32 ;, _. . . mFat+irosmtritalcrustaudveuti4lioa: _.. hood/Miterkitchen Nam=Polygon Northwest Range n Wu 1 33.39 . Adrhess:,509E 3a$t _Clothes.tlryereadtaust 1 3339 Chit State/ZIP: Singie'dnct exhaust(bathrooms,S aaCouvtr_,OVA 98661 toilet comp.utllity.reoms) 4 23.32. Phone (369)816-7$00 Fast ) Attie/craw fans _ 23.32 23.32 PnepiJilag Northwest 'B t>tanc Polygon $14.15 for Bast tone:S4,03 for each additional .Fumade,e 1 - . t ''nBtirC�. __ _ Gas he t`pntttp.. Addr ens 109 E 13't$t WaA)saspeodeWlrnritteaoir Cir /9 :Vancouver,WA:98661 :Wider beater .:.:. Phonal(360)816-7800 I Fax::( ) 1 I Rangie. . _ . 1 Ti-coat,: Barbocate • Otho-_ Beating,lac $usrr►ess ttaasiC Andersen r t t acv.s w` s a , ?. k Ma 16285 6W:856 Ave.*410 Subtotal Gify/St Tryars,,,UI2:97324 IVfinnmirn permit fee($90.00) Ptah review(23Yo of permit Set) . Fb :(593)992.$64 Fait(503)536-65618: State surcharge(12%ofPermitlee). CCB,X.:16814TOTAL PERMIT FEE This penult apptkatien et**If a permit is nor.+obtained witlda 180 days alter It has been aeapted as eompletr. Authorized signage: ' * Fee methodology set by Tri-County Balding Industry Service Board Priat.naitic Ai tAodaye�` Datc 1/120/2015 L-t d Cjau AFP oiol t3.4oc 440-46t7r(11JG2. Omiwea) 'Plumbing Permit Application ®�� �` r FOR le orlICE 1F o�L1 Building Fixtures U �;� �,,,„No,,yf�p/b'pDD3� Ili City of Tigard FEB 18 2016 r 13125 SW Hall Blvd,Tigard OR 972238.1Dat Review Otheri Permit No.: Phone: 503.7182439 Fax 503.598.19t��y Q f ry-i i)>��Y ReaABY Jude: 121 See p 2 for InterneInspectiont ince: 501639.4175rgv • • . D1Vibi 41 11 ifedFM Supplemental tat lnformaboa lriferrrdt -- . 1 --� - r .,_,:,. i-- 'r-s -` .ares - _7.--7-2f'7-1-7;...17- t J.:,-..._.a^-_cam ^'t�-a'c f' -Z---=,i.n5E-�-,4 _'•&4 �'i " �� � � } - For spend information use checklist New construction ❑Demolition Descri or I W. I Ea. I Total ❑Addition/alteration/replacement ❑Other New 1-2- family dwellings(includes 100 ft for each utility connection) 312.70 �,- is _ L ra-�,+� SFR(1)bath at z 1C't r - ¢tc 5;fev^'3 cgci• I fi=r x.. 1as;...... (2) 437.78 serer - SFR bath ' 1-and 2-family dwelling ❑C.ommercialfindustriSFR(3)bath , 50032 l5 7 L ❑`Accessory building ❑Multi-family Each additional bath/kitchen 25.02 0 Master builder /S3 94- 0 orifi _ Fire sprinkler(__sq.ft) . , Page 2 • = . �' �- -'- Site utilities: rr .�.- !!';;v '. at,):',/7-'._.--�IE ,, �I` . ---- 18.76 y-Y ,';, Catch basin or area dram Job site address: tttaella Vico f�Qr �,�GfC Dryavdl,leach line,or trench drain 18.76 City/State/ZIP: '� v► `_ 1 7 flL\ - Footing drain(no.linear R: ) Page 2 Project name: YD\y C� L Jam'\ (I Manufactured home utilities 50.03 SuitrJbldgJapt no.: � Manholes 18.76 Cross street/directions to job site: Rain drain connector 18.76 Sanitary sewer(no.linear ft.:-__) Page 2 Storm sewer(no.linear ft.: ) Page 2 • Water service(no.linear ft.: ) Page 2 Subdivision: I Lot no Fixture or ri item: f 3127 N,--0- Tax �'t Tax nap/pereel no.: .-a m r r; '-ter' *� gadrwater valve 1231 j ` r ,Jr` - Clothes washer I 25.02 a5.0Z Dishwasher I 25.02 a!'7.0 2 NVQ',/ ~b e a L - 'a t lb Drinking fountain 25.02 Ejectors/sump 25.02 V' Expansion tank 12.51 " � F- /scwcr cap 25.02 Naos-~ Pal Al f ) , tL G, - Floor drain/floor sink/hub 25.02 Address: C i v-.'h 5 Garbage disposal 25.02 2C5,(�L n --1- n v`_21 A q i f i Hose bib I 25.02 7?j.ofL C. 1 Jc.f ' 11281 \ • *0 Fax:( ) Ice maker• 1 Z Phott ,10 ` 1. T � i 'Ff7:1-Gi'-'7,'----f:::;.,.. - lntuxptor/grease trap 25.02 � � _�.�, �---_ � _g,.-e lie. Medical gas(value:S ) �2 Business rtarrrc 3D� L(/Nq,/bj,Y(5,� { Primer 1251 Contact name wapte n (Cti 1'CJt Roof drain(commercial) 12.51 i, 65 � Sink/basin/lavatory 25.02 Address: 1`0 cityrsbalefzlP: Ofte 'Z 7.619 Solar units(potable water) 62.54 a 1251 'Z5.02,_ /� • Phone: ) i -3963Fax :( ) Tub/shower/shower pan Urinal 25.02 E-mail: 1 Ai 1 �1 -'414,N. Wattr ciosct 25.02 n ;ri z•I'S-�_..: - ` r = .. - - - Water heater I I 37.52 22 "1.52 Business name:'3 ) /-AS LJ_ Water piping/DWv 56.29 s other. 25.02 L9 Subtotal Address: L �, ` n Minimum permit fee: ST2S l City/State/ZIP: " �� Pbc/ne:qA) r,n I -3 /`�` F ( ) Plan review (25%of permit S7 30 - CCB Lia t 3� Plumbing Lie. ` Z State surcharge(12%of permit fee) TOTAL PERMIT FEE Authorized sigoatrue --- This permit application expires if s permit is t obtained within 180 days after/ I Date:�`//Z./5- • •Fee methodology sett by Tri-County has been yBBwilding Industry Service Board. L Print rtazne;_/��-=- � r: -t"? p-doe INOIIO9 4404616 W0-!COM/WEB) Albert Shields From: Albert Shields Sent: Wednesday, February 24, 2016 2:51 PM To: 'Maggie Gordon (Maggie.Gordon@polygonhomes.com)' Subject: RE: MST2016-00038, -00039, -00040, -00041 &-00042 Attachments: Conditions -02-24-2016.pdf Maggie,various of the Conditions of Approval under SUB2015-00002, highlighted on the attached conditions list, remain to be Met before we can release these 5 permit applications, meanwhile we will put them on Hold marked "Approved but Not Released." Please let me know when the conditions have been met. Thanks, Albert. 1 City of Tigard a COMMUNITY DEVELOPMENT DEPARTMENT T l G A R D Building Permit Review — Residential Building Permit #: 1IS1;20/(o -f1003F Site Address: ) -3Pt ci V S W Se i (1-Q- D r. 1.0 S 3 Project Name: PO( 9 90 n 01A- (3 U 1 t Mouf1i1-z1 ky) Lot #: 53 (New dwelling=subdivision name;Addition or,Aiteration=last name of owner) Planning Review Proposal: NPAAi g` t"Verify site address/suite# exists and active in permit system. xr River Terrace Neighborhood: ❑ No )21. Yes,See River Ten-ace Review Addendum Attached Site Plan Elements: /Three (3) copies of site plan /Existing 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 /Drawn to scale (standard architect or engineer scale) floor elevations Borth arrow Utility locations(required for new,may apply for additions) Site address,project or subdivision name and lot number Location of wells/septic systems /Applicant information(name and phone number) /Erosion control(including drainage-way protection, silt fence Lot dimensions and biN1.ding setback dimensions design,location of catch basin,etc.) eiLot area,building cov&ii a�ea,percentage of coverage and /Street names impervious area (applicable if R-7,R-12,R-25&R-40) /Street tree size,type and location /Property corner elevations (2 foot contour lines if more than Existing trees to be retained with drip line,and tree 4 foot differential) protection measures 0 Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995): Required: E Yes,applicant was notified E No Received: E Yes ❑ No VPublic Facilities Improvement (PFI) Permit: Required: ❑ Yes,applicant wasnotifiednotified El No Applied For: ❑ Yes ❑ No,stop intake 71 Land Use Case#: S U l7 2OI S-00002 Zoning: R 4 , 5 jzr Setbacks: Front 2.0 Rear G S Side S Street Side 1 S Garage D izr Landscape Requirement: ZLot Coverage Maximum: °/u /215tS uilding Height: Maximum Height 3 0 Actual Height G rr Visual Clearance Easements 12'"Sensitive Lands: ❑ Yes ❑ No Type C�Urban Forestry Plan Conditions "Met"prior to issuance of building permit Notes: Approved By Planning: fi] 0 V 0,4 8 Ido c (A-A- Date: 2/i 8 / j.10 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\B1dgPenmitRvw_RES_O 121 16.docx . Building Permit Submittal Original Submittal Date: 2//��%(� Site Plans: # 3 Building Plans: # Building Permit#: 0-Enter building permit# above. Workflow Routing: [.a"Planning engineering Permit Coordinator3uilding Workflow Sign-off: [a- Sign-off for Planning(include notes from planning review) Route Application Documents: 2"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: 4e":911,7477--e— By Permit Technician: _ Date: v;2/c - /(cv Engineering Review Zr Slope at building pad: ?7e1' o1 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 ❑ No Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No LIDA Facility on lot: ❑ Yes ❑ No E NOT Approved by Engineering: Date: Notes: , _/ i "141111?..3NWT �r 't j Approved by Engineering: Date: Z 1� 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 pproved,NOT Releas d: Date: .2- 24 'c Notes: Gt�� G 2Ce-tCiEvf Q 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: Yes ❑ N/A Tigard Trans SDC: ;ist2Yes ❑ N/A Parks SDC: ?Yes ❑ N/A rOK to Issue Permit / Approved by Permit Coordinator: t%ADate: 1 ' /3 - 10 I:\Building\Fonns\B1dgPennit R vw_RES_012 116.docx City of Tigard 1111 COMMUNITY DEVELOPMENT DEPARTMENT T I G A R D River Terrace Building Permit Review Addendum Building Permit #: ti-Cr.p/, 608---74P Site Address: 153 14" f54 50--S vv S . mn-e or Project Name: PO o n CO- Boit (noun A-Ph'n Lot #: 53 (New dwilliK= subdivision name;,Addition or.Alteration=last name of owner) Planning Review River Terrace Plan District Design Standards (18.660.070.1): 1.Articulation: a minimum of 1 element per each street-facing facade that has 30-60 ft. of frontage.An additional element required for lots with over 60 ft. of street frontage shall be provided every 30 ft. Balcony vv/ access 2 Window Projection Vertical Wall Offset a Porch min. 5 ft. deep Gabled dormer ft. deep min. 2ft., 5 ft. wide min. 2 ft., 6ft. wide ❑ ❑ 4 ❑ 2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors. Percentage Shown: 13 3. Entrances:At least one entrance must meet both of the following standards: Max. 8 ft. setback from longest street facing wall Parallel to street,angle no more than 45` from street, or open onto porch Entrance opens to a porch: /I Yes ❑ No If yes, all the following apply: W 25 sq.ft. min. One street facing entry ❑ 12 ft. max. roof height above porch 5 ft. depth min. E 30% min. porch roof coverage 4. Detailed Design: All buildings shall include a min. of five of the following elements on all street-facing facades: "Covered porch min. 5 ft.wide x 5 ft. deep Recessed entry area min. 5 ft. wide x 2 ft. deep Wall offset min. 16 inches ❑ Dormer min. 4 ft. wide /Roof eave min. 12 inch projection `Roof offset min. of 2 ft. ❑ Roof shingles either tile or wood Gable,hip or gambrel roof design ❑ Roof pitch oriented south min. 500 sq. ft. ❑ Horizontal lap siding min. 3-7 ft. wide ❑ Accent siding min. 40% of street facade Z Window trim min. 2 Y2"wide by 5/8" deep ❑Window recess min. 3 inches for all street facing ❑ Bay window min. 5 ft. wide by 2 ft. deep ❑ Balcony min. 5 ft. wide x 3 ft. deep with inside access !I Attached garage is 35% or less of street facade 5. Garages and Carports: May face the front or side lot line on a corner lot. Setbacks: No closer to front or side lot line, than longest street-facing wall. ❑ Yes/ZrNo. If No (Check one): May extend up to 5 ft. if there is a covered front porch and garage does not extend beyond the front porch. /I May extend up to 5 ft. where the garage is part of a two-story building and there is a window at the second story above the garage that faces the street with a min. area of 12 sq.ft. Width: (Check one) ❑ 12-foot-wide garage door 40% max. of street facade .? ❑ 50% max. of street facade with 7 detailed design elements Notes: Approved By Planning: ('/ 00/26A_ //Io GLe-gAn.& Date: "2/03/ ) ,(2 I:\Building\Fonns\BldgPennitRvw_RES_RT_0121 I 6.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 'rovides hel.s the review 'rocess and res.onse to our .roSect. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Transmittal Letter 111 T t G A i�n 13125 SW Hall Blvd. .• Tigard, Oregon 97223 • 503.718.2439 • vvww.tigard-pr goy TO: Tom H. DATE RECEIVED: DEPT: BUILDING DIVISION REGFIVC:/-‘' FROM: Angela Grajewski AUG 2 2 2016 COMPANY: Pol CITY ygon Northwest PHONE: rm.- 971-212-2144 RE: \N SeA -1 i MST201 rth� P (Site Address) - W'�� (Permit Number) Polygon at Bull Mountain (Project name or subdivision name anis 1 1 ,er) ATTACHED ARE THE FOL , II WING " S: N.I'::,..0: 4 e "ii a t- ;„ 1 irl 0 Additional set(s of plan�� ' 0 Cross section(s) and detail . = Revisions: ______0 Wall bracing and/or lateral analysis. 0 Floor/roof framing. 0 Basement and retaining walls. 0 Beam calculations. 0 Engineer's calculations. 3 Other(explain): Ad•ttional deck details requested by inspector REMARKS: ..- . '.. F ' 'g ": N�j Routed to Permit Technician: Date: al Fees Due: • Yes • No Fee Descri.tion^ a: apai Ii : Amount Due. • $ S- riii $ Special $ Instructions: Re.rint Permit .er PE): 0 Yes IMI. o Applicant Notified: Date: ni Done Initials: IABuilding\Forms\TransmittalLetter-Revisions.doc 05/25/2012 Aleehanical Permit A ' i Hew'.,1 EOR tIEFICE 1 SE fiNE.V •• - ' CEIVED ' '63' — — '-' City of Tiffard oselyley,VA, P.inals.Ci'S 2o/ —e00. -ef • ,i 25 SW Hfirt Blvd.. ManTFlagvar45,0031,5,981,6 7„,,2230 Eeeie‘ ' I Mono: 503-718,2439 SEP 2 0 2016 .110,:04_,.: _ Other Penult. T r GA RE, Impeclion Line: 303_63 9.41'75 Date Redd:.it"4- .1.0iV '21 SM Page 2 tar , . latemet: www.tigard-or.nov CITY OF Tir2 A i 11/4.itiRD NI:40W Method; Upplanoutat Interinatian BUILDINGDIVisinisi rypE OF 1.voRK —,, COMMERCIAL FEE*SCHEDULE- SE CUE( Mechanical permit The are hased on the value of the work New constmetion 0 Additionlaiterarionfreplacement • performed_Indicate the value(thoudod to the rawest dollar)of ali 0 Demolition 0 Other: mechanical taaterials.equipment,hthor.overhead,arid timid, Value:S , . . , . • CATEGORY OF CONSTRUCTION . - - RESIDENTIAL EQUIPMENT/SYSTEMS FEES* 01-end 24iiin Hy dwelling El Coromehciallindostrial 0 Accessory building i For speiiiti informatian lase cherAtist Wittiti-farnity 0 Masler builder 0 Other; i Dmription kil Qty. Ea. Total -. JOB SITE INFORMATION AND LOCATION IfrathWit"ling 4.A i - ---1 ' Air cod:dinning p4, s 1 46.75 ,, I Job site-addra5: [CD1 Li 5w soine, pr. . Funmv moo Divax,w,,a,40 .. j 46.75 City/Slate/ZIP:Tigard,OR 97224 Furnace,184,4440.ETU fthictgecto 34.9i . „ Heal mond I 1 61.0 4.1,1ii I Suite/b1t.no... Pr12 oject name:INtlygern at Roll"Mountain , 1 uct-work 23.32 (reas strceUdirections to job site: hissfronie hot water systetn 23.32 Residential bailer(radiator or hr./ionic) 2132 ............... - - Enit heaters tfuel-type..not electric), . . well inAnct,suspended,etc. Flucheur for nay of above 13.32 — _„ ., Other Int11.1111 StihthYralorr.Polygon at Bull 8fatintain Lot no.: U6) Other fitel appliances: , . Tax map/pan:el 110.: NYater heater DESCRIPTION OF WORK • • Gas 11teD1acala.4q41 3339 Flue vont rut meter heater ur oas Choir C th t . , ilmOtic4 lo Fairter(eAs) 2132 . „ woodtpati stove ' :3:329 . 1 Wood firearawiasert 23.3.2 Chinartayflinerniudvont l 23213121 4.PROFMTY'Owrak. I 0 TENANT ' Envirinuneathi exhaust cud ventilation: - Name:Po1yen WEB",LLC I Range hood/other kitchen i I t.ti me _..,_,.....,. 1 3:3,39 ! Address:109 East 13th Street Oodles d er calm tou EMI CityrState/Z1P:Vancouver,WA 98660 Sinale-duct exhaust(hathroorna, 1 mike compartments,utility rooms) 2332 Phone:(360)695-7100 Fax:( ) Atrecmula 'CO faux 2132 1 APPLICANT , El co cr vrA •, .rtjts ON uther- 11E2111111111i Fad D1011.4; „ . Business mune:Polygon W1,14,LLC - S14.1 S tor Ilvst faun 84.03The each additional Contact mine:Angela Grajewaki Furnace,etc. I I I . . -Gas hot pomp Address,,;109 East 13th Street Wall&tt ,,andedluoit heater City/Stater/JP;Vancornw,WA 98660 Water heatcr , I — , . . Mime:(360)698-7100 Fax::(340)693-4442 Fireplace Rene E-mail:Angela.Grajewald*polygonhomea.coin Barbecue „„ CONTRACTOR . -- Clothes dryer taas Business name:Apex Air Lik Other ' MECILANICAL PERifff FEES* . Address:18004 NE 124 Ave Subtotal 1 CityiSrate/7_iP:Vancouver,WA 98686 MinimI um panne fee(590.00) - — '- Plan rev/m(25%otparmit fear I Phone:(3403424109 Fax:(360)324-1169 State surcharecis12%or mink fee) 1 CC13 lie.;203034 TOTAL PERMIT FEE 1 rhid;ixrmit optifttiort expires/fa perrair re/foetal/weed Akinda Igo days attarif has beet/accepted as complete, Authorized*warm: ,., * Fee methodology tet ky Ili-004w Btifiding To aoAry 8eMcc Reafti 1 I_Prim 11111111,e7 i .‘ ./ Dale: 4-/ .f(_____ i I,11.4,41,54',,,,t0Artl PertnizApp.G.IW 13*.x: 4046.11T I If Y,24,0,MAVEK,:i rArstrica I.,rerrn it Application 47 I tilt(U I I( I I "I ()NI N. 111 City of pttm 0 DKOBV et, AUMMAIIIIIr ' I tt “4.S .,b 1(0-6 401 io -a, 13125 SW Hall Blvd,Tigard,OR 97223 . __ , Phone 503 718.2439 Fax: 503.598.19LP60S lb 2016 la111.111111111111111111 Raised Nom 0 Inspection Line 501639.4175 , , „,, Ready nutally HMO '‘ "2 for Internet wwros Atgard-or gov Crit ke r::ji- ! .',i„,-,1,"-kr;''',i_,' Nonfiedlittabod Supplemental hiSsrmatioa . . , ,.. , , ..... . .t'. , .,.,:45.? •—:17 : ''''1,7::::;4'7:1 '"?,..7,:....., ` J'L' ‘,--,;;;: ..'''': ...':. ..''.:T..:.: ZZ-, ... * New construction 0 Addition/alteration/replacement Pleas_ g check all that**(submit 2 sets o . »-whitens checked) U Service Or feeder 400 naps or more 0 Budding over three sones 0 Demolition 0 Other: where the available fault current 0 Mamas and boatyards --.--,' '':•":•--4-i •T., -'-'---'-.•''.--'' . - 1 :, '.'-.. ..''-'iii:',.: ”1's*''-„,:t'71-'7;--..itirlArlei4fAali24.1ifiii":1:- exceeds 10,000 amps at 150 volts or C3 Flowing buildings 0 less to ground,or exceeds 14,000 0 Commercial-use*neonatal 7..4 I-and 2-family dwelling In Commercial/industrial 0 Accessory building amps for all other instaihmons buildings 0 Multi-family 0 Master builder 0 Other: Ohre PumP 0 hat***of 150 KVA or •-)1','1'; '"',.2•11111111,111:'7.' .":. '',.-.:','..;.7.‘„:','1;,: '..:-''7:7.:LItFi.7::?-z.;:.L.MT1117-jralrfirl 8 Emergency system load of larrerin leePleeiely derived Job#: Job site address: .,53494. S'iu Sej flt.,De. o lootrpMditi7rorfnn.,—. motor 0!VA-,"E-,-1-r%"1.3", 0 Six Of more residential units ooraPaaM City/State/ZIP:Tigard.OR 97224 Recreational vehicle parks 0 Health-cat.facilities 0 Suite/bldg./apt.4: Project name:Polygon at 10kut-Risier-Zar .3vak 0 Hazafdws locan°ns 0 Supply voltage for more thui CI Service or feeder 600 amps or more 600 voila nominal Cross street/directions to job site: (11VITN tat::;r:,i"gg;jir,r''41'.;T.:' :,,,,777,;C:T2'.7%.04faigaZZ: Qty. Esc* Teta New residential single-or multi-family dwelling unit. Subdivision:Polygon at Went-Riunr—leuzice 11/%11 fV1411 I Lot 4: Includes attached garage. Tax map/parcel 4: 1,000 sq.ft.or less 168,54 4 14 i,,:: .:::z.:: „f,-",:'...::,"1,-,.,...`.Ai......4 ;....,'1..,:,!..7:4;:,,,:z.i'`,::42::tilzr: a addi 500 sq.ft or portion 3392 1 eaeel r taiifiLimited energy,residential (with above sq,ft.) 75,00 2 Limited energy,multi-family 75.00 2 ,' -;•-7-,--.:,-,-- ...— ---..:-.-,---.-,---57,4tiii. .: ):-,---:-... ' --• ,- ---, .• , .,::-....-.,• residential(with above sq.ft) , Name:ADVL d H' dings,LLC Renewable Energy 0 See Page 2 gooyui cLs, Services or feeders installation,alteration,and/or relocation Address:7600 E I o .letret Ranch Road cverke,cod - 200 amps or less 100.70 2 City/State/ZIP:Sc. ' .dale,AZ 85258 201 amps to 400 amps 133.56 2 Phone:(602)6•- • 131 Fax:( ) Email: 401 amps to 600 amps 200.34 2 Owner installation:This installation is being made on property that I own which is not 601 amps to 1,000 amps 301.04 2 ' 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. Over 1,000 amps or volts 552.26 2 Owner signature: Date: :'.:..., . ,„,,,, , . . . : :'77,77`7,..„ ,,,i.- :,,i,:zaii Temporary services or feeders installation,alteration,and/or Business name:William Lyon T'o t GVNO r1 tdouti u....c.. 200 amps or less 59,36 1 Contact name:Angela Grajewski ."' ""' 201 amps to 400 amps 125.08 2 . , Address: 109 East 13th Street 401 amps to 599 amps 168.54 2 City/State/ZIP:Vancouver,WA 98660 Branch circuits-new,alteration,or extension,pr panel Phone:(360)695-7700 I Fax: :(360)693-4442 A Fee for branch circuits with above service or feeder fee, 742 2 Email:Angela.Grajewski@polygonhomes.com each branch circuit 13 Fee for branch circuits without ,,, *: :::...:'..7,:rt';,:;..7.,:7 7.:',".):::17- .:17::::111171:112.-::6117-31rOV4 service or feeder fee,first 56 18 2 branch circuit Business name:*lamed*electric Each addl branch circuit 7.42 2 Address:3415 ne 44th Miscellaneous(service or feeder not included) City/State/ZIP:sows 11,,,I 1 ez,,,Are'/7,12. /d7 7...7- /3 Each manufactured or modular dwelling,service anclinr feeder 67 84 2 Phone:(503)3192192 Fax:( ) Reconnect only 67_84 2 Email:solarpdx®me.com , Pump or irrigation male 67 84 2 CCB Lic.: 199188 Electrical Lie.: c923 Suprv.Lic.: 9,f7/..5 _ Sign or outline lighting 67 84 2 Suprv.Electrician signature,required: ii sinl1 L'Irecruaitt,°;:rie=disTieon7 0 Ste Page 2 2 Print name: t../it ii240,1e--<, Date: rA3-,://-*— panel,Eachadditional Inspection over allowable in a of the above Authorized signature: Additional inspection(1 hr mm) I 1 66 25:hr 1 I IPrint name: ..p._,----"----- - DateS14// Investigatien(1 hr min) 90 00 46. ;hr 1 614tairP4",.. _ELR_ERE.dot Rev 06/17,2015 440-46151(11/05.ACOMAVEB 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 15394 SW SEINE DR, TIGARD, OR, 97224 Record Type: Residential - Master Permit Inspection Type: 199 Electrical final Result: FA I L Comments: Tel: 503.718.2439 Inspection Date: November 16, 2016 at 2:04:35 PM Record ID: MST2016-00038 Inspector: David Young GFCI left side of island from sink side not working. End plug at counter by office not GFCI protected. Outside deck light not wired correctly, turns on/off with deck light switch and kitchen light switch. Missing face plate, not installed in upper level back bedroom bath. Violation Summary: Inspector Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 15394 SW SEINE DR, TIGARD, OR, 97224 Record Type: Residential - Master Permit Inspection Type: 199 Electrical final Result: PASS Comments: Tel: 503.718.2439 Inspection Date: November 21, 2016 at 12:47:32 PM Record ID: MST2016-00038 Inspector: David Young Corrections from previous inspection dated 11 /16/16 complete. Violation Summary: Inspector Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 15394 SW SEINE DR, TIGARD, OR, 97224 Record Type: Residential - Master Permit Inspection Type: 299 Final inspection Result: FA I L Comments: Tel: 503.718.2439 Inspection Date: November 21, 2016 at 1:10:53 PM Record ID: MST2016-00038 Inspector: David Young Seal 3 holes in sheathed wall in crawl space. Seal line set penetration in foundation vent for mini split and electrical conduit. Fix vapor barrier in crawl. All else ok. Violation Summary: Inspector Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 15394 SW SEINE DR, TIGARD, OR, 97224 Record Type: Residential - Master Permit Inspection Type: 299 Final inspection Result: FA I L Comments: Tel: 503.718.2439 Inspection Date: November 21, 2016 at 1:10:53 PM Record ID: MST2016-00038 Inspector: David Young Seal 3 holes in sheathed wall in crawl space. Seal line set penetration in foundation vent for mini split and electrical conduit. Fix vapor barrier in crawl. All else ok. Violation Summary: Inspector Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 15394 SW SEINE DR, TIGARD, OR, 97224 Record Type: Residential - Master Permit Inspection Type: 299 Final inspection Result: PASS -CofO Comments: Corrections complete from previous inspection. Street tree certification received. Moisture content form received. Vapor barrier form received. High efficiency lighting form received. Insulation certification checked. Blower door test report checked. C of O left on site with contractor. Violation Summary: Tel: 503.718.2439 Inspection Date: November 22, 2016 at 9:29:48 AM Record ID: MST2016-00038 Inspector: David Young Inspector Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 15394 SW SEINE DR, TIGARD, OR, 97224 Record Type: Residential - Master Permit Inspection Type: 299 Final inspection Result: PASS -CofO Comments: This inspection passed previously. See inspection dated 11/22/16. Violation Summary: Tel: 503.718.2439 Inspection Date: November 28, 2016 at 7:39:48 AM Record ID: MST2016-00038 Inspector: David Young Inspector Contractor