Permit (55) n CITY OF TIGARD MASTER PERMIT
it ' `• COMMUNITY DEVELOPMENT Permit#: MST2016-00206
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 tie e4 Date Issued: 06/02/2016
Parcel: 2S108DB04800
Jurisdiction: Tigard
Site address: 15095 SW 154TH AVE
Subdivision: POLYGON AT BULL MOUNTAIN Lot: 46
Project: Polygon at Bull Mountain, Lot 46
Project Description: New SF. 8/25/16 ADD heat pump in basement. 10/28/2016:Add 2nd water heater.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 4 First: 1575 sf Basement: 940 sf Left: 5 Parking Spaces: 0
Height: 32 Bathrooms: 3 Second: 1836 sf Garage: 679 sf Front: 12 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes
Total: 4351 sf Value: $528,879.32 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: 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: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N 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'I 500 sf: 8 201-400 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 4351
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: PHONE: 360-695-7700
FAX: 360-693-4442
Total Fees: $37,023.50
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 throu AR 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: L' r Permittee Signature: All l/r'/e/ te1177e2,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.
zaectri.cal rermat Appiication , I ) ( ( 1 ''ION1.1
City of Tigard H Recaved /0 02, 7i' " it b-00 4
11 13125 SW flail Blvd Tigard,OR 97223 A A A Plan R
evit
Phone 503 718 2439 Fax, 503.598.1960 SEP Lu10 Date Pomo
Inspection Line 303 639,4173 Reedy Datollys. Page 2 for
Internet: wwwhprd-or.gos A;„:„."., NonfiediNtethod Soppleintiatel Information
'0;1...4 New construction 0 Additionlalteration/replacement Please dock all tale apply(witimn 2 sets of plan wntewis checked)
0 Service or feeder 400 amps or more 0 Hui over three aorta
0 Demolition 0 Other: where die available faidt current 0 mamma mui bomyards
3,7;z: .'?-:--7,-,ITIC:1229:Mrefiitroiel, exceeds 10,000 leans at 50 volts or 0 Floating bud,I • *
less or
-and 2-family dwelling C3 Commereial/industrial 0 Accessory building to ground, exceeds 14,000 0 Commercial-use agricultural
amps for all other installations buddinp.
0 Multi-family Master builder 0 Other: 0 Fire pump 0 Installation of 150 KVA or
'.;"-L71;:7-?0..,MraiTerNarSin Addition of new load of larger separately 6:11"4
Stem
Job#: Job site address: t S(A) 14rmeN t00Hp or more 0"A","E'',"1-2,"1-3",
0 Six or more residential units oeriaiwirY
City/State/ZIP:Tigard,OR 97224
ereatiewal vehicle parks
0 Health-care facilities 0 Re
Suite/bldg./apt:#: Project name:Polygon at1111411131=1=Por 6.411 0 Hazardous locations CI supply voltage for more than
' 0 Service or feeder 600 amps or more 600 volts nominal
Cross street/directions to job site: rrNirn. las.C114741A7V.Zi,";:i" 751estarlimitE:
Dtscriptiott Qsy. Each Tett]
New residential single-or multi-family dwelling unit.
Subdivision:Polygon at Vtitta*iltiver-T-rerniree raiy4 P4t-n .1 Lot 4: /al.& Includes attached garage.
Tax map/parcel#: 1,000 sq.fl or less 168.54 4
t' 3 Fe.add'l 500 sq.ft or portion 3392
go Limited energy,residential
' 75.00 2
(with above sq ft.)
Limited energy,multi-family
jir / residential(with above si ft)
75.00 2
Name:A Ei-lott-Lang71-6TeirtiKTEr Renewable Energy 0 See Page 2
Address:7600 fs-DonbletrerRanch Road
Services or feeders installation,alteration,and/or relocation
;5
200 amps or less 100.70 2
City/State/ZIP:.Serotridar133751r lir/ Carlf
201 amps to 400 a.mps 133.56 2
Phone:(60.216114-40-34--- Fax:(
Email: 401 amps to 600 amps 20034 2
Owner installation:This installation is being made on property that I awn which is not 601 amps to 1,000 amps 301.04 2
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:
/ relocation
Temporary services or feeders installation,alteration,and/or
Business name:Viiiiient-impurtimttelohk. 1701 AOC revLWILLC, 200 amps or less 59.36 1
Contact name:Angela Grajewski 201 amps to400amps 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,per panel
Phone:(360)695-7700 Fax: :(360)693-4442 A Fee for branch circuits with
above service or feeder fee,
742 2
Email:Angela.Grajewski(4olygonhomes.com each branch circuit
0 Fee for branch circuits without
service or feeder fee,first
56.18 2
branch circuit
Business name:alameda electric
Each midi branch circuit 7.42 2
Address:3415 ne 44th
Miscellaneous(service or feeder not included)
City/State/ZIP:Mara cbrvti ,‘ 4, 2 4.2— /3 Each rrumufactured or modular
67 84 2
dwelling,service andior feeder ,
Phone:(503)3192192 Fax:( )
Reconnect only 67 84 2
Email:solarpdigime.com
Pump or irrigation circle 67 84 2
CCB Lie.: 1991:: Electrical Lie.: c923 Suprv,Lie.: f 7/.5
• -
Sign or outline lighting 67 84 2
Suprv.Electrician signature,required:
Signal circuit(s)or limited-energy
0See Page 2 2
panel,alteration,or extension_
Print name: it„, ii2,400‘,1(
Date: .-C/Z-?/17"1" Each additional inspection over allowable in asyof the above
Additional inspection hr mini 66 25,hr
Authorized signat,ure-:
Print name: I Date /4377-1‘ I Investigation hr n") 000 hr
-atai.aaiprsnmaunx_ososuiAtn..ELR_ERE doc Re+06/17/201 5 440-461 ST(11/09COMAVEB
Plumbing Permit A pplita tiun4
Building Fixtures . , FOR OFFICE I.SE °NEI
S E r„ 1 6 2 0 1 6 ,
11 ‘City or Tigard , : ,7,1'3'.`..! 17 41Mirgr.i. II Pet*M 5.--'-..,2e1/4,-er.-,2e2
, 13125 SW Hell Blyd.,Tigard,OR 9720 ri V i":.'.' '.' : - ;;D 1 .piaamR:vliew. '
....!,:. F
Phone 501718.2439 Fax. 563:sf4i19607-,,i-,. -, ,••••. :: :.,• - 4 • . 0tkrPvonitNa.:
Mapeoion:1„ine:.503,63%4175 - ' ---'' ' ' ' ' '''- Date Readyilay: YUliK fRi S•ee Page 2 ftfr.T I GAR D I•nternet: www.tigardor go% . . Notified/Method: . Supplemental Information •
:.1,•',1''if..'kle.:i.:!:.tt:'.'i? .:.;'.I' ;'.'177r#ij*#it:10'Ri*t4: ;"' ! ll''C4':':'-:''FIIA: :.,.n'•! ;' :::',"'W::-;:;1 .ft-? :":1,M-**E...F-Wfiiiii44-:4r:417: .;.D:4:: :
New construction 0 Demolition• , .
0 AdditioWalterationtreplacement 0 Otber,;..
For specialinformatipn ua*Mist
• D.escriptiOn •Qty. i E . .1. Total
' Nfw T-1-.family dwellings(includes 100 ft RVeach utility connection)
,-...'''14'w0 ,..4.8*".04‘t:0,CX.040trW01:' -1. ,....,:.::,:,,,:'iv,:,,: SFR(1).bath 3 • '.70
. .. .
0 I-•and 2-farinly.d.Welling 0 Complete:jai/industrial .• .SFR(2)bath 437.78
• -• . :SFR(3)bath . 500:32
0 Accessory bUilding 0, 1ulti4bitily
• . Each'additional'bath/kitchen . ..25.02 '.
0 Master builder El'Othet: - Fire sprinkler( sq‘ft) Page.2
056-ii'J..'sliff*tiiiittiqciiiii::taxti&nl,,,,?„---,;45-.4*:::,f: Site utilities:. ' - . •. - ,,
Job site address: 1-trt's: Svj [Sqii/ (hie - . cata basin Or area drain Mill 83 =MI
- Dr).Veil;feackline,or trench drain 18.76 '• .'
City/State/ZIP:Tigard,OR.97224 .. ... - Footing drain no,linear#:.: ) Page 2•
Siiiteibldgdapt.no.: I Project name:Polywinlit Brill-Mountain N.,/ mithetured home utilities 50,9:3
...,..
t;rOse,Streeticlitectiona•to job site: . .., Mai:hetes . 18,76 •
Rain drain 18.76
... ...
• -
Sanitary sewôr(no.linear ft; ) Pa.ge2
- •
.. . .
.'
Storm sewer(no,linear.ft.:.. ) f. Pagel ;
. i
Water service(no.linear R.; ) Page 2
Subdiyision;Polygon at lint Mbontain • Lot Aix': 1.4(p Fixture or item
-..... . - . .... .
Tax map/parcel no,: Backflow*yenta, 31_27 .1
• .. - I,
l';.,....„•."Z•,-;:c..7:,::tp-io:ir:4r::Iif-ijf-ib-*tdi*jikr,J,..vk;:..:„_v.r...Iktytv.::,i,.:,A Backwater valve . . 1,2.51
.. -• ''''''''' ' ''" Clothes washer - _ 15.02
/9'7' 2 . Z:4 c‘ti4. , . .#-CT?).-776 X=- . ..
1Dishwasher 15.0.2!.-•
. .
Drinking fountain 25.02
I . . .
. .
gjectOrS/Surnp .:. ,25.02 . .
1.-11'•:".';:1•••f•,t; ',I;•''-iT.O.:*10;Fie4i!iii.****:'-:0.:-. f.:,:,.ti.: :;..4..1:1-.,,-0 0.ANT...*,,,•:.2:A,:,::,,;;,, E:tpartsion tank ) 12.51 -..
Name P0Iyppl;y4f1.,LE-C
Address:,100 East 136 Street . .
•. ' , Fixture/sewer cap. ______ ______I 25,02
• -Floor dmin/floorsinklbOb I 25.02 1
• .::. Garbage disposal , • 25,02
i
city/State/ZIP:Vatictinver,WA 9/1660. _ .. ... . Hose bib • 25.0,...
.....
.. . . . ...
Phone(340695-7700 Fax;-.( ) ice inaker• • ' " 2.51
-;:iei...,•-e#:..:,. -•;4*,..,*40$04 .fit. .j;•.0:',',:••-•It•Tht'. Af,6iti,,,44:ft4ifistig',.-:„.27A, interceptor/grease trap • 'i.... .,. 1:
• - .MediCal gas (value:$ 7. . ) .. . Page 2 . ..
Business name:POlygtot Willi LI,(
Primer - 1.2.51.
.Contacenarne:Angela Grajew.iki .. _. ._ .:. .
. „ Roof drab'(eammetetail 125.1
.Address:109 East 13th Street.
SInklbasirtilavatOrY 25,02
. .
City/State.qfP:Napeonyer,-WA 98.660 • :Solar•Inistpetable-watery . 62.54
.. .
Phone:(300).695-770a Fax::(360)6934442 .Rib/shower/shower pan 12.51 '
25-.0.2
E-mail:.Angela.Orajewskl@polygorthornnt : Urinal .es.co -, "4.---ii%;1* : '.'ate-t.c.1-°s•et . • - : r92.---
Business name:BDL Pluntbfog•LLe. , . .. . _ .. ... -. : Waterpiping/DWV •. 56.20: :
I
Address:PO Bat 85 :- 'Other 1).02 .
.... . .
.. . ..
City/State/ZIP:Corbett pit 97019
I I
Phone (503)351-3903...
Fax ( .. ) . .. . . . :
• Sttbtotal, •
. Minimurrlpermit fee $72-.50
[
CCB Lu.. 14045. . . . .. . -
Plumbing: Lie:on:::PI11582 Plan review. (25%apenni1 fee)
- - -- - - • - :State sUrcharge.(12%of permit:-tee)
Authorized signature: ii..„..L.....t..i.....„. Li.er- . I . TOTAL PERMIT:FEB . i
1.... . .
• This perritit,apolication.expires if.a perinit is arkftibtaiaelI11411111.1113 days
..
I Print name:,..111.7.4sidnri jAnter 1 Dal.." 811(0 it, 1
I Old it:hae.begn neeetited se fortitilete. .
. .. .
*Fed methodOlOgy set bytri-connty Building Industry Senife Bard.
IABuitdinikPerrnifiTali.l:PermitApp:doc-10.1.01M9. 44046161(10/024COMIWER)
71CITY OF TIGARD ► MASTER PERMIT
` I _. COMMUNITY DEVELOPMENT j
Permit#: MST2016-00206
T[C�AR 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 i Date Issued: 06/02/2016
Parcel: 2S108DB04800
Site address: 15095 SW 154TH AVE Jurisdiction: Tigard
Subdivision: POLYGON AT BULL MOUNTAIN Lot: 46
Project: Polygon at Bull Mountain, Lot 46
Project Description: New SF. 8/25/16 ADD heat pump in basement
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 4 First: 1575 sf Basement: 940 sf Left: 5
Height: 32 Parking Spaces: 0
9 Bathrooms: 3 Second: 1836 sf Garage: 679 sf Front 12
Dwelling Units: 1Smoke
Third: 0 sf Right 5 Detectors: Yes
Total: 4351 sf Value: $528,879.32 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: 1 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: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N 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 addl 500 sf: 8 201-400 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 Grou
NEW p y p: Square Feet:
SF VB
R-3 4351
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: PHONE: 360-695-7700
FAX: 360-693-4442
Total Fees: $36,790.68
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: �( 6;6 4(� Permittee Signature: C _r Q--t , �.4",--Q
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 Application
FOR.OFFICE USE O\L1
Cl�T Of Tigard Received �i
iii . 13125 SW Hall Blvd.,Tigard,OR 97 DazeBy: b Permit No.: Ft 5�aO/e2--(U o�
2. Phone: 503.718.2439 Fax: 503.5'... `,: „I :,,�. 4ED Plan Review `
TIGARD Inspection Line: 503.639.4175 Date/By: Other Permit:
Internet: www.tigard-or.gov O 6 Date Re/Metho
1111111 H See Page 2 for
au G 2 Nohfied/Method: Supplemental Information g�t ��r} -Cha'Il►4ERClAi FEE*-:-CI e'cl-O LE ' ;eE
®New construction 0 Addition/ ltt16Nreplacement Mechanical permit fees*are based on the value ar the work
performed.Indicate the value(rounded to the nearest dollar)of all
Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
s C4f'i14ORY QF_CONST RIICTIQN, Value $
— ,_� , _ ig 4 1tE.S�IDE IIID -
® 1-and 2-family dwelling 0 Commercial/industrial •o ' ��'��MS iE
c
❑Multi-family Accessory building •-- --�-
❑Master builder 0 Other: Forspecial
Description I Qty. Ea. Total
s e information'on use checklist.
O$ su.E INTF fMIQI Al_D--L ',ATIOIY
Heating/cooling:
Job site address:l`�I � �`l 194
�! Air conditioning 46.75
°r � ' ` . 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.: I Project name:Polygon at Bull Mountain Heat pump 1 61.06 61.06
Cross street/directions to job site: Duct work 23.32
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.:(.'`r j� Other: 23.32
Tax map/parcel no.: Other fuel appliances:
Water heater 23.32
}gs =`T -r �� I)F l~BITO1."F ORT Gas ventfce/insert 3339
Change rd 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
s- �rAdii ilii-. 23.32
.- �E_ R Other:
- 23.32
Name:Polygon WLH,LLC
" Environmental exhaust and ven6la6on:
Range hood/other kitchen
Address:109 East 13th Street equipment 33.39
City/State/ZIP:Vancouver,WA 98660 Clothes dryer exhaust 33.39
Single-duct exhaust(bathrooms,
Phone:(360)695-7700 Faxtoilet compartments,utility rooms) 23.32
;� t '�- .�,� r., �.- � ( ) Attic%rawlspacefans 23.32
.. 4#0204$5,14 :01#P.
fl,GQ 5s_ 3:_ Other 2332
Business name:Polygon WLH,LLC Fuel piping.
Contact name:Angela Gra jewski $14.15 for fust four;$4.03 for each additional
Furnace,etc.
Address:109 East 13th Street Gas heat pump
City/State/ZIP:Vancouver,WA 98660 Wall/suspended/unit heater
Water heater
Phone:(360)695-7700 I Fax::(360)693-4442 Fireplace
E-mail:Angela.Grajewski@polygonhomes.com Range •
-_ Barbecue
+':�`CT* � n } .LL 4,1 -- t
" . Clothes dryer(gas)
Business name:Apex Air LLC Other:
Address:18004 NE 72nd Ave -=�� 3 ., ii � al
City/State/ZIP:Vancouver,WA 98686 Subtotal
Minimum permit fee($90.00)
Phone:(360)342-8109 I Fax:(360)326-1769 Plan review(25%of permit fee)
CCB lic.:203034 State surcharge(12%of permit fee)
TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Authorized Signattffe:�j, days after it has been accepted as complete.
Print name: /tf 9 * Fee methodology set by Tri-County Building Industry Service Board
f tom`` 1Y, I Date:8/22/16 I
1:1BuildiugTemtits\MEC PermitApp 0401(3. oc
440-4617T(11/02/COM/Wm)
CITY OF TIGARD MASTER PERMIT
IN1 q COMMUNITY DEVELOPMENT Permit#: MST2016 00206
Date Issued: 06/02/2016
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S108DB04800
Jurisdiction: Tigard
Site address: 15095 SW 154TH AVE
Subdivision: POLYGON AT BULL MOUNTAIN Lot: 46
Project: Polygon at Bull Mountain, Lot 46
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 4 First: 1575 sf Basement: 940 sf Left: 5 Parking Spaces: 0
Height: 32 Bathrooms: 3 Second: 1836 sf Garage: 679 sf Front: 12 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors:
Total: 4351 sf Value: $528,879.32 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 RainStorm Sewer: 100
0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 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: 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'I 500 sf: 8 201-400 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: I
NEW SF VB R-3 4351
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: PHONE: 360-695-7700
FAX: 360-693-4442
Total Fees: $36,677.29
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. /
Issued By: `' Permittee Signature: 0� 17°/.€'4'fees'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.
L o i G/4 s / ,.5/4VA,
r Building Permit Application RECEIVE Residential
City of Tigard Rece
DateBy: o�ived ,/ � �
I�
Permit N /6
13125 SW Hall Blvd.,Tigard,OR 97223 MAY 17 2016 Plan Revie Jake/
Phone: 503.718.2439 Fax: 503.598.1960 Date/By. 11 L Other PeQ o?p/b..-1:100/6
1 1 c, \R i, Inspection Line: 503.639.4175 ate Read B / loris: RI See Page 2 for
Internet: www.tigard-or.goV CITY OF TIGAI jotified/Method:w/���0 J Supplemental Information
BUILDING DIVISION ief'c- 4-A/6-f&---
TYPE OF WORK REQUIRED-DATA:l-AND 2-FAMILY DWELLING
NG
®New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
El Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1-and 2-family dwelling 0 Commercial/industrial Valuation: ----t' $tt --01.81 .87 /
1:1 Accessory building ❑Multi-family Number of bedrooms: 4 I
0 Master builder 0 Other: Number of bathrooms: .2416
a
JOB SITE INFORMATION AND LOCATION Total number of floors: 3 ,s-030
Job site address: 150195 3W l5(.4 44' 1 'WC New dwelling area: 4351 square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: 679 square feet
Suite/bldg./apt.no.: Project name:Polygon at Bull Mountain Covered porch area: 150 square feet) 06
Cross street/directions to job site: Deck area: 213p square feet f,7s---
Other
$Other structure area: square feeti / Q
REQUIRED DATA:COMMERCIAL-USE C'I1 �I;1ST
Subdivision:Polygon at Bull Mountain Lot no.: 46 Permit fees*are based on the value of the work performed. I
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Plan 17B-DL Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 TENANT Number of stories:
V 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:
C APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:Polygon WLH,LLC (Please refer tofee schedule)
Structural plan review fee(or deposit):
Contact name:Angela Grajewski
FLS plan review fee(if applicable):
Address:109 East 13th Street
Total fees due upon application:
City/State/ZIP:Vancouver WA 98660
Phone:(360)695-7700 Fax: :( ) Amount received:
E-mail:Angela.Grajewski@polygonhomes.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic 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 East 13th Street Solar Installation Specialty Code checklist.
City/State/ZIP:Vancouver WA 98660 Permit Fee(includes plan review $180.00
and administrative fees):
�(�/ one:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60
V Q CCB lic.:204238
A)6
j , _ Total fee due upon application: $201.60
Authorized signature: , This permit application expires if a permit is not obtained
111 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:\Building\Petmits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
,
Mechanical Permit ApplicationREcETTil1!'E
City of Tigard Received
D Permit N -
:i 13125 SW Hall Blvd.,Tigard,OR 97223 MAY 17 2016 Plan Review ��6
• Phone: 503.718.2439 Fax: 503.598.1960 Date/By: other Permit:
ii c, .`1 I Inspection Line: 503.639.4175 , y y ]oris: ® See Page 2 for
111 UI TIGARD Dati R
Internet: www.tigard-or.gov 1 NotiSed/Method Supplemental Information
Bt1ILDING DIvisfo i
;43 ' `, TYPE OF WORK - _ COMMERCIAL FEE'-SCHEDTTLE-•TJSE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction 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.
- �CATEGORY OF CONSTRUCTION
., - RESIDENTIAL EQUIPMENT 1 SYSTEMS FEES*
® 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist
❑Multi-family ❑Master builder 0 Other. Description Qty. Ea. Total
JOB SITE INFORMATION AiND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: 16Ovl z ' 5 151 Ave_ Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./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 Lot no.: 2.1. 6 Other 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
r,,, z a, Y 4 i t r° w, , V_ a i �ig tf ",,� ,,::a,t' Gas fru-place/insert 3339
�!a tk £. e DESCRIPTION OF3ORIC _ r
Flue vent for water heater or gas
fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 2332
Chimney/liner/flue/vent 23.32
Other: 2332
Y„-,, ®�RO'P,ERTY*__'ATE.--- k-t-- mfr""`:,, • 1T N ', . �1 .f---
- — - -= - Environmental exhaust and ventilation:
Name:Polygon WLH,LLC Range hood/other kitchen
equipment 33.39
Address:109 East 13th Street 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
®-~ PLI IPTI r Ii ❑ CONTAPRSON - Other. 2332
d.:f�,R�” .= .. m,� �.�.SP Wiz:g� _ -. �->CT E ... _ :-�.
Fuel piping:
Business name:Polygon WLH,LLC
S14.15 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 .
Range
E-mail:Angela.Grajewski@polygonhomes.com Barbecue
: '2�}, r f, ' ;CON RACTOR ' t ,�J . . Clothes dryer(gas)
Oth
Business name:Apex Air LLCM
r i VIECHANICALP,ERMFF FEES*
_,i 6.x;:..3 ... _-.
Address:18004 NE 72'd Ave Subtotal
City/State/ZIP:Vancouver,WA 98686 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(360)342-8109 Fax:(360)326-1769 State surcharge(12%of permit fee)
CCB lic.:203034TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
/�� days after it has been accepted as complete.
Authorized signature: ��r�r�^'" • Fee methodology set by Tri-County Building Industry Service Board
Print name: i) , A ret
1 tik S Date: 5 3 l b
I:\Building\Permits\MEC PermitApp_040113`d6e 440-46 7T(11/07/COM/WEB)
41/
Electrical Permit lip lica�i�h`��''�''1V FOR OTT] ESTE o,vx.N
City of TigardvtL Y 17 2016 Received
n 13125 SW Hall Blvd•,Tigard,OR 972 Plan Review
Permit o��� �, �
Phone: 503.718.2439 Fax: 503.598.1960ping : Related Permit is
Inspection Line: 503.639.4175 CITY OF TIGARD Readynatwny: writ EI SeePage2 for
'i l GAR i? Internet wtvw.tigard-or.gov , (� T Notified/Metbod: Supplemental laformefion
•
y." - - sQt'ff ji;:: :i t:> ti`iy'•' __ - 'i4 L{?:a'r.�t_':ir'ly:,'�r'3•i'.'.'r;7
._ � . ::_moi- .,:e
:.� p a'ti;. x.,}:.,.:a.t>::.. al.:.': 1,.::
®New construction ❑Addition/alteration/replacement Please check all that apply(submit a sets of plans writers checked):
0 Demolition ❑Other 1:1Service or feeder 400 amps or more 0 Budding over three stories.
where the available fault current ❑Marinas and boatyards.
ja.,; Y r s:,�A _'..-: ���;tQ1A165 .' �14^;; '''v r;;-g..r: exceeds 10,000 amps at 150 volts or 0 Floating buildings.
®I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to around,or exceeds 14,000 0 cmnmereiat-use agricultural
amps for all other installations buildings.
❑Multi-family • 0 Master builder ❑Other: ❑Fire pump. ❑Installation of 150 K VA or
01:,:• :.:r:• a s 0 Emergoney system. larger sepasatcly derived
`: .. ; TOBSIE :'>i!?I?9A J �1[':Aivlp:;J[,+ ?►;ION'''r
Job 1�.�005 so 15U l Addition of new motor bad of system.A',"
#:• Job site address: -iii•A./E.,' 100HP or mora ❑"A","E","t-z"."1-3".
City/State/'DP:Tigard,OR 97224 • ❑Six or more residential trots. :massy.
❑Aeaith-care facilities. 0 Recreational vehicle parks.
SuitdbldgJapt.#: Project name:Polygon at Bull Mountain ❑Hazardous locations. 0 Supply voltage for snore than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: t`"j" "'',: - -
I- Description Qtf. l Erich 1 Total :I'-*
( New residential single-or multi-family dwelling unit.
Subdivision:Polygon at Bull Mountain Lot#: 4-b Includes attached garage.
1,000 sq.ft.or ess I 168.54 4
Tax map/parcel#: Ea.add'l 500 sq.ft.or portion $ 3392 1
'...aa'b •.'sJ '���;�1)$5' Q11liQR',..pa..tC_ i`a"I ,+?;�:?;'�::>!:%+:`t��' Limited residential
.:.at3�C�4�i.ir'�.'t�ti(�S!;'!.S.,i�121H2.. ..',rt �;�!L;._.:_`+¢_... .. �•^.4--... ._.,.`� '.. .. ..'�`� CIIE[�y. i
(with above sq.ft.) / 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
;t �, :t;:: Renewable Energy 0 See Page 2
: ci>..•�':, _ , -.. i.... `•`'•Is `4,-•`'' ervicesorfeeders installation alteratio and/or relocation
Name:Polygon WLH,LLC 200 amps or less 100.70 2
Address:109 East 13th Street 201 amps m 400 amps . 133.562
401 amps to 600 amps 200.34 2
City/StateIZIP:Vancouver,WA 98660 601 amps to 1,000 amps 301.04 2
Phone:(360)695-7700 Fax:( ) Over 1,000 amps or volts 552.26 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 less 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
X<:, z;, Branch circuits—new,alteration,or extension,per panel
r..•T;x'f•• -? :_.�.-..- "g'_ -"t3:, } titi s•{':;:: .. A.Fee for branch circuits with
Business name:Polygon WLH,LLC above service or feeder fee, 7.42 z
each branch circuit
Contact name:Angela Grajewski 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. Each addl branch circuit 7.42 2
Miscellaneous(service or feeder not Included)
Phone:(360)695-7700 Fax::(360)693-4442 Bach manufactured or modular 67.84 2
dwelling,service andlor feeder
Email:Angela.Grajewsl i(gtpolygonhomes.com Reconnect only 67.84 2
V �e;1g N. 4gi.o: ��tS] •.. ;F02? i ::l : . 'i,
Pump or irrigation circle 67.84 2
Business name:Garner Electric Washington,LLC Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy ❑ See Page 2 2
Address:6101ritlE St Johns Rd panel,alteration,or extension.
City/State/ZIP:Vancouver WA 98661 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 6625/hr
Phone:(253)320-1657 Fax:( ) Investigation(1 hr min) 90.00/br
Email:bdaniels@gweusa.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
s call listed /,lir min 90.00/hr
CCB Lic.: C1158 Electrical Lie.: 208174 Suprv.Lic.: 4496S . ,-.... C .,,:_ -.� ,.,,•
i .`;t:�:4+r ' .`.-0-7 r5r. :i.'_ {•a.f..'.2'fi:r:a\�;
Suprv.Electrician signature,required: -•c r ,Pr t :� Subtotal:—
Print name: Joan P Albert ritiDate:S-3-\(.p 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fix):
Authorized signature: �� ^s-~� ~ TOTAL PERMIT FEB:
—�� This permit application expires if a permit is not obtained within 180
Print name: Bill Daniels/ Dates 3•-yo days after It has been accepted as complete.
• Number of inspections allowed per permit.
L'SamldireermiretF].0 PermitApp ELR Fvndoc Rev06/17/2015 440-4615.1Y11/05/COMttvEa
Plumbing Permit Application CEIV
• Building Fixtures FOR Ol 11( I I Si.. O\l.1
City of Tigard
MAY 17 2 n 16 Received Date,'By: Permit NNo.:/137A9/06„� �
13125 SW Hall Blvd.,Tigard,OR 97223 r� Plan Review Other Permit No.:
Phone: 503.718.2439 Fax: 503.590W OF TIGARD Plan Rev
Inspection Line: 503.639.4175
t t ? J f ..s. hint.
® See Page 2 for
Internet: www.tigard-or.gov iNGyir1Sl®ADatfetftReet!By: Supplemental tufa
rnation
� fi 5 a r �1y ' u py
i?it,tF � � .r , ° ra ( ' .. +7 i " ;>• .
..
.
®New construction 0 Demolition For special information use checklist
Description I Qty. l Ea. I Total
Addition/alteration/replacement ❑Other. New 1-2-family dwellings(includes 100 ft.for each utility connection)
A1LfGOR ? "Lb TC Qltl > SFR(I)bath 31270
; . : ... 4
SFR(2)bath 437.78
® 1-and 2-family dwelling 0 Commerciandustrial SFR(3)bath I 50032
Accessory building 0 Multi-family Each additional bath/kitchen 25.02
❑Master builder 0 Other '
Fire sprinkler( sq.ft.) Page 2
s ` fi ; ' Site utilities:
•- X r• l. F +10 .:41j. . . , did . . *•.
�,. " -•`� x `//J Catch basin or area drain I 8.76
Job site address: 15O. �j 15L.141-, *v Dr well.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 ft.:_) Page 2
Subdivision:Polygon at Bull Mountain I Lot no.: 46 Fixture or item:
Backflow preventer 1 31.27
Tax map/parcel no
hi y y,V t ` i <aaW xt� r M tgv�
vaBackwater valve
F 12.51
: «o. _ ,,.. :•c
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
-fill;::,"r5^ � 3 t p,a itr a y. . �,yfR .'z Expansion tank l2•5
- rA c s:•vr tr.e. •Wte0 .. y-=;:,$- Fixtur sewer cap 25.02
Name:Polygon WI.H,LLC Floor drain/floor sink/hub 25.02
Address:109 East 13`1 Street Garbage disposal 25.02
City/State/ZIP:Vancouver,WA 98660 Hose bib 25.02
-
Phone:(360)695-7700 Fax:( ) Ice maker 12.51
, i,hzi sWunci-� /S.a Vn ' s e za f• Interceptor/grease trap
25.02
,klc 'C vn. ta..,a. . o..c :.-. ,. S.•i lsra '. .,,, a-o.... ,,. 4',3
Medical gas(value:S ) Page 2
Business name:Polygon WLH,LLC- Primer 12.51
Contact name:Angela Grajewski Roof drain(commercial) 12.51
Address:109 East 13th StreetSink/basin lavatory 25.02
City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54
Phone:(360)695-7700 I Fax::(360)693-4442 Tub/shower/shower pan 12.51
Urinal 25.02
E-mail:Angela Gralewslu(4)pollgonhomec corn
Frtk. i$v�kft"',xssgla � .-bf-Tr(. �' et* ytre '` i � ;A.,,gi Water closet
25.02
�YS-Z�OGdKYf6kF0 s" : S� ..'� fi_..,. ,:;. r: y k, Au �s , ✓^,s1 tc:s water heater37.52
Business name:BDL Plumbing LLc Water piping/DWV 56.29
Address:PO Box 85 Other: 25.02
Subtotal
City/State/ZIP:Corbett OR 97019
Minimum permit fee: 572.10
Phone:(503)351-3903 Fax:( )
Plan review (25%of permit fee)
CCB Lic.: 180345 Plumbing Lic.no.:PB1582 State surcharge(12%of permit feel
Authorized signature: ' /` TOTAL PERMIT FEE
Print name:Brandon Lanter Date: 53
I 1(, This permit application expires if a permit is not obtained within IRO days
after it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board.
Ii,Building\Permits\PL\1U-PermitAPPdoe 10101/09 440.4616T(1O/02/COMIWEB)
-.����
City of Tigard
:71 r COMMUNITY DEVELOPMENT DEPARTMENT
i
T l A a n Building Permit Review — Residential
Building Permit #: /V---07-aa/6 — t0 6,
Site Address: /9çS'Z,U /s/-TA hlv-e
Project Name: P h ,/3 // C n n Lot #: 4/(e
(New subdivision name;Addition or Alteration=last name of owner) `r
Planning Review
Proposal: 4-1•40
V5derify site address/suite# exists and active in permit s3 em.
9E' River Terrace Neighborhood: ❑ No /Yes,See River Terrace Review Addendum Attached
Site Plan Elements: 1
Fp, P ree(3)copies of site plan FJ Iri 'sting structures on site
" e plan must be on 8-1/2"x 11"or 11 x 17"paper FA Footprint of new structure(including decks)with finished
raven to scale(standard architect or engineer scale) t.or elevations
lidlorth arrow % tility locations(required for new,may apply for additions)
to address,project or subdivision name and lot number 1"t cation of wells/septic systems
dOtplicant information(name and phone number) Erosion control(including drainage-way protection,silt fence
dimensions and building setback dimensions sign,location of catch basin,etc.)
area,building coverage area,percentage of coverage and street names
. pervious area(applicable if R-7,R-12,R-25&R-40) Beet tree size,type and location
IP •roperty corner elevations(2 foot contour lines if more than Nu sting trees to be retained with drip line,and tree
4 foot differential) protection measures
OClean Water Services—Service Provider Le`tteot platted prior to 9/10/1995):
Pequired: ❑ Yes,applicant was notified V No Received: ❑ Yes ❑ No
ublic Facilitiy Improvement (PFI)Permit:
Required: V Yes,applicant was notified ❑ No Applied For: /Yes ❑ No,stop intake
Zand Use Case#: SI(6c0/,S -0000q
oning le-171..C-
0
-C-
0Setbacks: Front , Q Rear /S' Side S— Street Side N Garage c,:26
bkandscape Requirement:
g:4 Lot Coverage Maximum: 0/0
II Building Height: Maximum Height 50 Actual Height c97--
_
III i isual Clearance
74 'asements �/ ) I f
FR ensitive Lands: I!4 Yes ❑ No Type 312/2 SI/ �S kk.) —14,2%
Urban Forestry Plan c7 / -
❑ Conditions "Met"prior to issuance ofbuildingpermit / h
Notes: C � LYtS� // Le ii,eJ'- l Z pe,ii i/- 1 tj'c74C(
Approved By Planning: Date: /
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\BldgPenmtRvw_RES_012116.docx
r
Building Permit Submittal
Original Submittal Date: 5//7//4:,
Site Plans: # 3
Building Plans:
Building Permit#: Enter building permit#above. i
Workflow Routing: [Tanning aEngineering Er-Permit Coordinator 0 Building
Workflow Sign-off: Z1--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
oral plan review routing form.
L' Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: _. Date: 4720//
Engineering Review
d Slope at building pad:
53 4O
1E 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 Ct' No
Assess Water Quantity Fee in-lieu: ❑ Yes lia No
LIDA Facility on lot: ❑ Yes 2-"No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: Date: s/gid/
r
Revisions(after Building Submittal only) 'eviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
DC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: Yes ❑ N/A
OK to Issue Permit
pproved by Permit Coordinator: Date: ,51 57;6"
I:\Building\Forms\BldgPermitRvw_RES_012116.docx
IICity of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
I
l ARD River Terrace Building Permit Review Addendum
Building Permit #: %02®/(, 0002-0
Site Address: I cc- Sit) /S M. AEI
Project Name: Polygon at Bull Mountain Lot #:
• (New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan District Design Standards (18.660.070.1.):
Is the project sub'ect to the plan district design standards? ❑ Yes A No
1.Articulation: a .• urn of 1 element per each street-facing façade that has 30-60 ft. of frontage.An additio',
element required for 1. with over 60 ft. of street frontage shall be provided every 30 ft.
alcony w/ access 2 Window Projection Vertical Wall Offset a
Porch min. 5 ft. deep ft. deep min. 2ft., 5 ft.wide min. 2 ft., Eft.wide Gable dormer
O ❑ ❑ ❑ ❑
2. Eyes on the street: a minimum .f 12%of each street facing facade must include windows .r entrance doors.
Percentage Shown:
3. Entrances: At least one entrance mus• eet both of the following standards:
CI Max. 8 ft. setback from longest street fac�� wall CI Parallel to street, .ngle no more than 45° from street,
or open onto po
Entrance opens to a porch: ❑ Yes ❑ No
If yes,all the following apply: ❑ 25 sq.f •n.
❑ One street facing entry ❑ 12 f.max. roof above floor of porch
❑ 5 ft. depth min. ❑ i'/o min. porch roof coverage
4. Detailed Design:All buildings shall include a min. of fi . 'f the following elements on all street-facing facades:
❑ Covered porch min. 5 ft.wide x 5 ft. deep ■ 'ecessed entry area min. 5 ft. wide x 2 ft. deep
❑ Wall offset min. 16 inches ❑ D. er min. 4 ft.wide
❑ Roof eave min. 12 inch projection ❑ Roo' offset min. of 2 ft.
❑ Roof shingles either tile or wood ❑ Gable, •. or gambrel roof design
❑ Roof pitch oriented south min. 500 sq. . ❑ Horizonta ap siding min. 3-7 ft.wide
❑ Accent siding min. 40% of street fa .de ❑ Window • • . 2 '/z"wide by 5/8" deep
❑ Window recess min. 3 inches fo . street facing ❑ Bay window . 5 ft.wide by 2 ft. deep
❑ Balcony min. 5 ft.wide x 3 f seep with inside access ❑ Attached garage is 5% or less of street facade
5. Garages and Carports• ay face the front or side lot line on a corner lot.
Setbacks:
No closer to front o. side lot line,than longest street-facing wall. ❑ Yes ❑ No. If No (Ch. k one):
❑ May extend u' to 5 ft. if there is a covered front porch and garage does not extend beyond i e front porch.
❑ May exte up to 5 ft. where the garage is part of a two-story building and there is a window a the second story
above the • .rage that faces the street with a min. area of 12 sq.ft.
Width. Check one)
❑ 2-foot-wide garage door ❑ 40%max. of street facade
• 50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: Date: sf /4
I:\Building\Forms\BldgPermitRvw_RES_RT_031416.docx
FOR OFFICE USE ONLY—SITE ADDRESS:
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Please complete this form when submitting information for plan review responses and revisions.
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City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
III
Transmittal Letter
T;(;;.F r) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 •www.tigard-or.gov
TO: Tom H. DATE RE(
DEPT: BUILDING DIVISION ++ ��
AUG 222016
CITY OF TIGARD
FROM: Angela Grajewski BUILDING DIVISION
COMPANY: Polygon Northwest
971-212-2144 )C::"--
PHONE: %
RE: I cgc , \i,\J. 61-itkA ',' ‘ f Chi LLp MST201,-0020Qp
(Site Address) (Permit Number)
Polygon at Bull Mountain to
(Project name or subdivision 1 •``, number)
ATTACHED ARE THE FOLLO'�► EMS:
e
0 Additional set(s) of plans. 0 Revisions:
0 Cross s
ection s and details. 0 Wall bracing
and/or lateral analysis.sis.0 Floor/roof framing. 0 Basement and retaining walls.
0 Beam calculations. 0 Engineer's calculations.
3 Other(explain): Additio ral deck details requested by inspector
REMARKS:
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„tti......,:...4....,
Routed to Permit Technician: Date: 2- a.S- -6 tials:
Fees Due: II Yes • No Fee Descri.tion: Amount Due:
- yp ,
$ - -c
$
c Ise $
Special
Instructions:
Reprint Permit •er PE : ❑ Yes 11113 No ❑ Done
Ap p licant Notified: Date: Initials:
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15095 SW 154TH AVE, TIGARD, OR, 97224 May 18, 2017 at 11 :07:06 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00206
Inspection Type: Inspector:
199 Electrical final David Young
Result:
FA I L
Comments:
Outlet box at entry stone work not complete. Abandoned outlet?
All else appears ok.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15095 SW 154TH AVE, TIGARD, OR, 97224 May 18, 2017 at 11 :15:25 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00206
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
FA I L
Comments:
Seal all penetrations in foundation vents. R408.2
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15095 SW 154TH AVE, TIGARD, OR, 97224 May 31 , 2017 at 11 :15:20 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00206
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS
Comments:
Correction from previous inspection complete, un uses outlet box removed.
Violation Summary:
Inspector Contractor