Permit (36) CITY OF TIGARD MASTER PERMIT
:1111 q
: .. COMMUNITY DEVELOPMENT Permit#: MST2016-00214
;" = Date Issued: 06/02/2016
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 t'
/ / Parcel: 2S108DB07500
Jurisdiction: Tigard
Site address: 15218 SW THAMES LN
Subdivision: POLYGON AT BULL MOUNTAIN Lot: 73
Project: Polygon at Bull Mountain, Lot 73
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: 1108 sf Basement: 812 sf Left: 5 Parking Spaces: 0
Height: 26 Bathrooms: 3 Second: 1396 sf Garage: 385 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 3316 sf Value: $398,572.40 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 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 Water Lines: 100 Drains: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 4 Clothes Dryers: 1
Natural Gas Heat Pump: Y Hoods: 1 Other Units: 0
Fum<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: 5 201-400 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 3316
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: $34,205.60
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 through 0 952-00 - 090. 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: / /� � � "���6ri
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.
ECEIVED ; .. . „ . ,, , ., .„
. ..„... ,, , ,
-
Agetrica 1 Pcyrti it Applica tio I Ott()I F If L
, ...... ...... .......,...„...._...
I ,.. ..
City of TigArd Received ,
Dare.11w/eAlgrAta= PtrThil Y"17 /‘-u2e7/ a--e6,2/7f
13)25-SW)41311 alvd,Tigard,OR 97123 SEP 2 0 2016
Plan Review
Phone: 503,718.2439 Fax: 503598.Cyry tof TaiAor, ogwa , Related Petnit ii-;
Inspeetiori Line: 503,639A175 "'-' Ready OatelBv: Fel Set 1.4.-4 i far
hamlet www,tigard.or,sav BUILDING orkil.q1/1 N.,ifiediu.th-od: NMI 6upplemantal trifonnation
',•.. . ,- . ,l'!....:,..',. .,.1'. _-: ..,: '.• ••?•.',":',.•-••:',J,77.••••••-,••,:',1 -
"-",:f, ;,'••,,;',.:'e.f.5
Or, New construction 0 Atiditionialterationtreplacement Piea. chock all that apply(submit 2 sels of Om winons checked):
0 Service or feeder 400 amps or more 0 Building ow nave sue*,
0 Demolition 0 Other:
_ where the available:fault ctumut 0 Marinas and boatyards.
Lf-,.E141-t„. WEG1)10.,OtCONSIRtiCliON.,._ ,7:'..'..'...-_,..,,_ L.:-: '.-,-7,1 'eXP,.41.5 10,000%nos at 150 volts or 0 Meting buildings,
CI I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building lots to pound,or exceeds port a Commercial-use agrieultural
amps for all other lestallationa buildings.
0 Moiti-fantily 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
10fit.--'017E.ANT#00.1ifictiONWiW14.0Artibl,f/: .,..;!"...I.'' ' ',...".i': 4 ir ir, 0 Emergoit'Y )srettl- larger.separately derived
0 Addition of new motor load of system.
Job#: ; Job site address:I s'2,113 5w lilaxne_s Lail P
..- 100.HP or more. 0"A",-.E".-t-2-,'1,,3',
0 Six or more residential units, occupancy.
City/State/ZIP:Tigard,OR 97224 0 Recreational vehicle parks.
0 Health-care facilities.
0 Supply voltage for more than
SuitellTd-g.„ .#77----1 Project name:pohiriofi 4.--- gvii Niici,rj.„:m , 'on-ardouic-00,4
.)(/' • .''' M1cur'" El Service M.feeder 600 amps or more, 600 volts TwIninal.
Cross street/directions to job site: :::,_ ''',•:,-,..:' ',•-'.. -..7:7.t.:?.Fg$1•$00).417 :7.;--:'-'. -, -v.' .. ..-..•-•
Description 1 Qtv. j Catch 1 Total
_ .
New residential single-or m410- ml 'dwelling unit
StIbdil/iSinri:ppixiciort erbaja 1.-@,.A/D§:iljAtt .Alt Lot#: Includes attached garage.
map/parcel
1,000 sq.fl.or less / 168.54: 4
Tax #:
.,, .
.,1-.15:-•!.f...,4',''.-i,:4;F:lEtiFscrtrlamta-':colf:3479ftv-i:-X::'r::::-;:t ...-4_-_',7'-:,:,..--'',-r.:--e!,':..'' ,?...-si- EU.add'l 500 aq.ft or portion
Dto I: tfot citIct,yitiz- Limited ener&v,residential
(with above sq.it) 75.00 2
Limited energy,multi-family
75.00 2
77-71. . tlti,tot;i:4..,,,!;,,.5,,f77,.... .. residential(with above sq.ft.)
Name:AD.VL Land Holdings,LLC Renewable Energy 0 See Page 2
Services or feeders installation,alteration,and/or relocation
Address:7600 E Doubletree Ranch Road
200 amps or less 100.70 2 •
City/State/ZIP;Scottsdale,.AZ S5258
201 amps to 400 amps 133.56 2
Phone:(602)694-4031 I 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 391.04 2
intended for safe,lease,rent,or exehange,according to ORS 447,449,670,and 701.
Over 1,000 amps or volts 552.26 2
Owner signature: ...... - - - - Date:
Temporary services or feeders installation,alteration anor
P,',:''T;:•"•''-•-•-i :---•: ,.f irAOttidiNt:,..1:'".f-'-''',--•• fr.'r' '' HID-tit)-kfkct.:11,,kligiti,' - •• ' Iv°
Business name:William-Lyon Homes,Inc. . 200 amps or less
1 1 59.36
Contact name:Angela Grajewski
201 amps to 400 snips • 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 I Fax;:(360)693-4442 A.Fee for branch circuits with
above service or feeder fee,
Email:Angela.Grajewski@polygonhomes.com each branch circuit 7,42 2
g,,,g,iiATAg,,,qc00.0;,,ec4543,-:$4**-4:-..ittot...,..s.7!.. .4: :;,.=?::,:,i,,,..._,..,,,,i,...;,nee„,,a_ ::,..,,,,:tz,, B,.Feelfceer obrrafnet•ehdecrircreetiitstirswtithour ,. ,
, 56,18 2
Business name:alameda electric . branch circuit
Address:3415 tie 44th Each 14dg-branch eircuit. 7.42 2.
— , MiseellaneOus(service or feeder not-ineltideti)
City/State/ZIP;sem Thr,1 j ,tj 1,12_ / ' 72.../3 ‘..
elwehllino tale andionir reedit 67.84 -•' 2
Phone:(503).3192192 1 Fax:( ),
" Reconnect 01.11Y 67.84 . ' -- • 2
Email:solarpdx@me.com
'
Pump or irrigation circle 67,84 ' -•; """;-'
...-: :
CCB Lic.: 199188 I Electrical Lic,: c923 Supm Lie,: 9'(7/5 - ,
• .
Signor outline lighting. ,• • . 67.84 • .2 --.:
"
Suprv,Electrician signature,required:
Signal circuit(s)or limited-energy . -,•- ,.,:. ..- , :,:: ,
0 See,Pagel, 1.:: .,, :24,'.•
Print name; tii,c. /2,0a,‘,.."(,, I Date: r/z.?„,/z/ - Panel,alteration,pr ixtension.
Each additional inspection over allovrable iri an*ofthe-aboVi.---
. ...,..
. _
Additional inspection( hr fru ) ] 66_,..5./hr
Authorized signature: ...
, Aim
„4„...-
. ,
900t/hr
prim name; x e, ,,,z __ Da,e,:s_ 43. /4 InveStigarion(1 hr min) '
Vaisildittgyetutibipp ELF(Eitadoc Rev.0417P015 440-4.61,5T{11/05,(COWWEB ,
, .
: • ..„ . ,. .. .
• :., : .
Plumbing Permit Application
ti
He::f
Building.Fixtures
i ? Received
- _ ..
City-or I Tigard , r i Penner i .: 1
13125 SW Hal1.Blti d Tigard,OR 97223 Dare B} �C//.`i�/ 11 9°��(, � /�
• plan_Review.
Phone 0.3 718 2439 Fax _:03,598 1960 , l•; ' b6t lig 11/41
0th r forma No.:
inspection 1 ire 503.639.4;175 •
T I G A tt p 1',it Read ij Alm. 10 See Page 2 fur €.E
Internet. wtvu.ttg�trd:or.gov. ''` Notihed/4tetleon: Supplemental.tnformatieit
3 s t. OF S a t3€ t{ia "c'eFEE* Dtlh *r
":: ..s. .., <� r ..nit:. `i- ORK ;i �I. For special infar/rraiinrr use c/reck/ist
►.:Necv construction , Q I)ercit inion..
Description I Cry. I Ea. I. 'rotal
. 0 Additionlatkeratton/replacement j Other.;. +vew t 2 Gamily dwellings Includes 100 if for each utility connection)
"il y' ( )hath 312.70
( TGDRu!l)F �t?STR[a ION SFR 1
O.1. and 2-family dwelling 0 Commetctal industrial SFR(2 bath 437.78
. . . ............._a_____ . . . SFR(3)bath 500 32
0 Aecessors building [❑Multi4arnilk
Each additional bathikitchen. 25.02 1
❑Master builder 0 Other•:.
Fire sprinkler( sq.t[.) .Pagel
0 - JOH ikit`liNrORI} ,Tl[}10 :AID LUka4T.JOPi,' „r Slte utilities;
-,-7-,:.,:t,;::,-. . �.i' i
SCath basset or area clraiit 18.76.
Job site addressS
: L S l I C! tl tL .e I
`-� Darn+ell,leach line,or trench drain . 18.76:
City/State/ZIP:.Tigard,OR 97224 t :
. Footing driin(no linear ft::. ) Page 2
Suite/bldg/apt riti.: Project name:Polygon at Bull Moemtarn Manufactured borne Utilities: ..5G4r.3.
Cross streettdiiectiuns to job site
Manholes 1:8.76
...
Rain drain connector 18.76
. .. .. Sanitary sewer Mo linear ft. 1 Pave 2 •
'Storm sewer no linear it: ) ( Page 2 .
. Water service(no linear 1:: ) i Page 2 1
Subdivision:.Polygon at Bull Mountain ' •Lot iio.: —12) Fixture or Item . . ...
fax map/parcel no.:
Backflow pmventer 3127 :I l
x-�'UFreqQR>� ', ?. Bads. ater valve 12.51
r_ � � �,DESERIP''1rIfl ;W
:r. - Clod cs washer .. 25.02 .
llishiyaSher 25.42
prinking fountain 25.02
Ejectors/sump "2502
oftl9P OPR•RTV O'I NER ET,grox.hTE . , z: Expansion tank 12.5:1.
• Nan_te:Polygon%%aI,11,:LLC 1 inure sesvei•cap '>.:42.
Floor sinit(hub 25i02
Address 109.Fast Lath Street
Garbage disposal 25.02
City(Statc.`ZIpi.Vancouver,WA 95660 . . Rose bib • 25.02
Phone (360)695 7700 Fax“ ) ice Maker 1x.51
•
J `' Inter.efor/grease tra .5.02
nom 'd► I #1VI ❑ lCflhTiCT P FRSO1 t • 4 P P
Y
s, tom. e
Bust ess name:Polygon W.LI:1;LLC t�4edical'gas(value: ... ) Paga? .
Prime 12.51 •
Contact name;.Angela.Grajewtsl:i • . .
.
. Roof drain(commercial). 1?5I •
Address;109 East 13th Street Sink:liasin/layatory 2502
City/State.ZIP:'tEancouver,W!A 98660 Solar units(potable watery 62 54
Phone:(3611)0.5.-77.00 1 Fax.:(360){93-4442 Tab/shower/shower pant. j 1`e a1.
E-mail:Angela.Grafe :ski®pa[y+gonitomes.com Urinal 25:sy
,w. - s ,, - . ater closet . .. 25:02
�' .�' _ . �`' � v � �`3�R11�1'Ot :: _ �.� ;.�.�'� ..i, .`� '4�ater heater ( 37:2
`'S�1.§
Business name:BI7L Plumbing L e. ... .. Water pipingrD� V 57.66.22,257,59:z:
6.29
•
f Address:PO Box 85 'Other: .25.02
City/State/ZIP:Corbett-R 97019 r Subtotal
:it _ . ...
Phone{503)351-3903 Fax { )
tintrztrtzri hermit fee X572•50,
Plan r (25°�ofperrnitfee) l
GCB1 rc 18(1345
:Plumbing Lie,no.:P131682
PJ n t,t reg
l surcharge(I2%of pennrt t'
Authorized signature: 4 •
,,,. '"` I .. TOTAL PERMIT FEE
State
Printname::Brandon Linter Date: •8 j 1(p •J Tb t
1 is permit appticatien expires if a permit firm oGtausesl within Ia0 days
atter If Mts.:been accepted as camplefe
*Fey methodology set byTn Cetnnt}.ltutldinglndus=ry Service Bahl.
is.HaildingPerniita\PLM3t=Permatapp:dcc't0ieliis! 44i0;46.1erf10102.OMAITu) -
.t CITY OF TIGARD '$ryas- Jo . MASTER PERMIT
ril 11'''' COMMUNITY DEVELOPMENT Permit#: MST2016-00214
T[ ahlt, 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/02/2016
Parcel: 2S 108DB07500
Jurisdiction: Tigard
Site address: 15218 SW THAMES LN
Subdivision: POLYGON AT BULL MOUNTAIN Lot: 73
Project: Polygon at Bull Mountain, Lot 73
Project Description: New SF. 8/25/16 ADD heat pump in basement
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 4 First: 1108 sf Basement: 812 sf Left: 5 Parking Spaces: 0
Height: 26 Bathrooms: 3 Second: 1396 sf Garage: 385 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes
Total: 3316 sf Value: $398,572.40 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 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
Bckflw Prevntr: 0
Catch Basins: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 4 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: 5 201-400 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 3316
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: $34,073.58
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 95522-000011-0090. 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 a40 , / ' 1 /
Permittee Signature: C —�"7f
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 ONLY
City Of TigardREC Received
® 13125 S W Hall Blvd.,Tigard,OR 97223 VP- Date/By: S 0'2- i t 016 Permit No.: H.5 ••/l—Uoo J
Ey
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175
Internet: www.tlgard-or.gov AUG 2 2 2016 Date Ready/By: Juris: H See Page 2 for
/`
Notified/Method: Supplemental Information
CITy I OF -jciA {L,
.: -'; tl[ }'..a.S +l)(. l eo
®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.
I�ATEGt3R3' OFQ1VSRCTIQl1t s Value $
__..,.._ Q7171IPlMENTIS*11r40EEESi`
® 1-and 2-family dwelling 0 Commercial/industrial
❑Accessorybuilding
Multi-familyEl For special information use checklist
❑Master builder ❑Other: Description I Qty. I Ea. I Total
.. . yoige.i.dirifYFoItMATTL?N ASID-i c.4.u+Tf1157 e
ating/cooling:
`,) Air conditioning 46.75
Job site address: ISL j , SAN).J ,l t., -r1.w 1\C s Lame, 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
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.:1 i Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater
23.32
It?rIESCR �U1�I QF IflRR FTsie 33.39
Flue vent for water heater or gas
Change 2°d furance for basement to Heat Pump fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
::17:ti ®-1 A--pPFZ1---row3 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,
Phone (360)695 7700 Fax ( )
toilet compartments,utility rooms) 23.32
Attic/crawlspace fans 23.32. , ` 0CNAPl _ t
. Other:
2332
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
City/State/ZIP:Vancouver,WA 98660 Wall/suspended/unithexter
Water heater
Phone:(360)695-7700 I Fax::(360)693-4442 Fireplace
•
E-mail:Angela.Grajewski@polygonhomes.com Range
itir _ Barbecue
_: _��... ."m .,-4-``r ! aClothes r3 (gas)
� ... ♦. ,.r, .._; g .3" fv : r--. .eW:: dryer as
Business name:Apex Air LLC Other:
iFA# 1V2E!EOt1;3�1I!C I P �..
Address:18004 NE 72°d Ave s.,�fi ,
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 lic.: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
Print name: ii
I Date:8/22/16 I
[:1BuildingTermits\MEC PermitApp 0401(3. oc 440-461712(11/02/COM/WEB)
a CITY OF TIGARD MASTER PERMIT
1 COMMUNITY DEVELOPMENT Permit#: MST2016-00214
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/02/2016
TIGARD Parcel: 2S108 DB07500
Jurisdiction: Tigard
Site address: 15218 SW THAMES LN
Subdivision: POLYGON AT BULL MOUNTAIN Lot: 73
Project: Polygon at Bull Mountain, Lot 73
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 4 First: 1108 sf Basement: 812 sf Left: 5 Parking Spaces: 0
Height: 26 Bathrooms: 3 Second: 1396 sf Garage: 385 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 3316 sf Value: $398,572.40 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain0 Storm Sewer: 100
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: 4 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Fum>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Tema 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: 5 201-400 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 3316
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: $33,960.19
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 52-001-0090. 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:
Dyti .01,e...../ }-j7-e/
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application L 0 T- /2.3 LS �`ia�i,
Residential RECEIVED FOR OFFICE: I'SE ONLI
Cl of Tigard Received e i,7 dctw
permit
III ■ 13125'SW Hall Blvd.,Tigard,OR 972MAY 18 2016 P1aan Revue , /I �� �i ���
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: v ,3) j/ 6 Other Perr r '�/6---49/
l i c,A I:a Inspection Line: 503.639.4175 CIT"o C TIC A RD Date Ready/By: /// 4 Juris: ® See Page 2 for
Internet: www.tigard-or.gov 11 i�7 ILII Notified/Method:4e2 {D % , I Supplemental Information
BUILDINGDIVISION Ellen.— /VC/E-
t'YPE OF WORK ''; -.".REQUIRED DATA 1-AND 2-FAMILY DWELLING
®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
0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION-
work indicated on this application.
1-and 2-familydwellingValuation: �'39'3�6-5 Jl
® ❑Commercial/industrial
1:1Accessory building 0 Multi-family Number of bedrooms: 4 2 Cf S``c 7 e
❑Master builder 0 Other: Number of bathrooms: .
JOB SI€E INFO V/1;1IO AND'LOCATION Total number of floors�L`5...3 37 0
Job site address:15218 SW Thames Lane New dwelling area: 3316 square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: 385 square feet
Suite/bldg./apt.no.: Project name:Polygon at Bull Mountain Covered porch area: 8,,J 6)square feet j3 q(
Cross street/directions to job site: Deck area:aa ` square feet ) ) 0
Other structure area: square feet g I
REQUIRED DATA:COMMERCIAL-USE CHUCKLIST
Subdivision:Polygon at Bull Mountain Lot no.:73 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
DESCRIPTION OF WORK work indicated on this application.
Plan 3B-DL Valuation: $
Existing building area: square feet
New building area: square feet
►�
PROPERTY OWNER ❑SANT: 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:
0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:Polygon WLH,LLC fPteaicrefertajeesc/redule)
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
Amount received:
Phone:(360)695-7700 Fax::( )
E-mail:Angela.Grajewski@polygonhomes.com
polygonhomes.com PIIOTOVOLTAIC SOLAR PANEL SYSTEM PEES*
Commercial and residential prescriptive installation of
._ CONTRACTOR 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):
Phone:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60
CCB lic.:204238
II Total fee due upon application: $201.60
:. ��i
Authorized signatureU I This permit application expires if a permit is not obtained
(` within 180 days after it has been accepted as complete.
Print name:Angela Grajewski Date:5/2/16 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
r— ,
lL'1 VE
Mechanical Permit Applicati I. tlrrlCl: ISI,0NI.1
City of Tigard Received
g Q Date/By: Permit No s " // �t�
13125 SW Hall Blvd.,Tigard,OR 97223 MAY 1 O 2.O 6 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
I I t, \It 1> Inspection Line: 503.639.4175 a Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov CITY OF TIG RD Notified/Method: Supplemental Information
BUILDING DIVISION
." FEE`-SCHE —
`TYPE'OF WORK " .' COMMERCIAL` DULE USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
` CATEGORY OF CONSTRUCTION .,
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB'SITE INFORMATION AND.LOCATION Heating/cooling:
�.=� c� //�� 1 /, n Air conditioning 46.75
Job site address: '✓1(B 5 w Tha YY\e s [...an� Furnace 100,000 BTU(ducts/vents) j 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.: 75 Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION.OF WORK';
' Gas fireplace/insert 33.39
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
Other: 23.32
® PROPERTY`OWNER TENANT 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
E APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name:Polygon WLH,LLC
$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 ,
Range
E-mail:Angela.Grajewski@polygonhomes.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business
name:Apex Air LLC Other:
MECHANICAL PERMIT FEES
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)326-1769State surcharge(12%of permit fee)
CCB lic.: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: tr'4a W * Fee methodology set by Tri-County Building Industry Service Board
Print name: A - A ra 1 e4,0 S� Date: 5 3 (p
I:\Building\Permits\MEC_PermitApp_040113. 440.46 7T(11/02/COM/WEB)
' Electrical Permit A licati0 t' FOR;pBhICL s ONLY
Cio TIgand Received /Sl 4/6,—.ice O� ,
1,1 rt 13125 SW Hall Blvd.,Tigard,OR 972 Plait R '
eview Permit#
p Plan R
C Phone: 503.718.2439 Fax: 503.598.1' Y L 8 2016 nate/B : Related Permit if:
Inspection Line: 503.639.4175 Ready Date/By: Jude H SeePage2 for
fi1G11RD +�� � f
Internet: www.tigard-or.gov CI f Of TIG ARD Nutified/Metbod: • Supplemental Information
,. n -;;;Z:!;-:,:i.:1_ f.. .."::......:.......M ,rfi::::. "'111:
®New constniction ❑Addition/ateration/rep acement Please check all that apply(submit A sets of plans wrtans checked):
0 Demolition ❑Other: - 0 Service or feeder 400 amps or more 0 Building over three stories.
`„_, i_ ____ where the available fault current El Marinas and boatyards.
. . .s, .... .._,......:0V6..,....:i:`.:���.'.��A ,,.<,:::.....:. .-.. ",.,., ._...... exceeds 10,000 amps atlSOvolts oz El Floating buildings
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family • ❑Master builder 0 Other: 0 Fire pump. 0 Installation of 150 K VA or
:: ;i�.."'JOB, .L
........... ..:.:.•:;:.;.... :}SZY% Ii0.-Q,i.*AfttQi!f'4ND::�aT(;QhI :�0.:.' ❑Frnagmeysystan. larger separately derived
❑Addition of new motor load of system.
Job/I: I lob site address: 132_t SW —pAaifyl
e.8 100HP or more. ❑"A", ,"1-z,^l-s
City/State/LIP:Tigard,OR 97224 • ❑Six or more residential writs. occupancy.
❑Health-caro facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.II: + Project name:Polygon at Bull Mountain El Hazardous locations. 0 Supply voltage for more than
Cross street/directions to Ob site: ❑Service or feeder 600 amps or more. 600 volts nominal.
. Description I Qb• I Ench I Total I'.-•,
New residential single-or multi-fancily dwelling unit.
Subdivision:Polygon at Bull Mountain ( L°111: "1 3 Includes attached garage.
Tax map/parcel#:
1.000 sq.ft.or less 1 168.54 4
:^ ft.orportion 33.92 1
. :;y„ Ea add'1500 sq. S
..1;.. :r}:ti :1✓ .TC i
_...�... :;�r3 rit< . . .:. :- LSG Ol!I::OF.'°= :O �:: ::
3s.. .. ..,: ,.... . .. _:.. ., ....�'._, .., �..:)t(•_.:. ,�a .. . .. . Limited energy,residential
(with above sq.ft.) 75.00 2
Limited energy,multi-family 7500 2
residential(with above sq.ft)
1�4}�: e - Renewable Energy ❑ Sec Page 2
`i' - OP,•14 O�V1NEIt_ "cy
' "" - •�7.•.'2'l!�/4rl?'':; „='="'i�,°" Services orfecdcrs installationzatteration,and/or relocation
Name:Polygon WLH,LLC 200 amps or less 100.70 2
Address:109 East I3aw Street 201 amps to 400 amps . 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Vancouver,WA 98660 601 amps to 1,000 amps 301.04 2
Phone:(360)695-7700 j 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
;..F>.�atsv �s - :_-•-_• Branch circuits-new alteration orexte
t;,,, ,-l: ;;" :,sv:.'•r , , rasion, er ane[
, . . .._._, ...,..,.,. .,..... ,..-::4��.: ... <i=�„ A.Fee for branch circuitswpii/:
Business name:Polygon WLH,LLC above service or feeder fee,
each branch circuit 7'42 2
Contact name:Angela Grajewslci B.Fee for branch circuits without
service or feeder fee,first
Address:.109 East 13th Street 56.18 2
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 • -: 1 Fax::(360)693-4442 ' Each manufactured or modular 67,84 •
2
Email:Angela.Grajewsld@polygonhomes.com dwelling,service and/or feeder
}:a.:2. '.I� .l'V'a Reconnect only 67.84 2
'h — ,la
O
...,... .,... ,. .. .,-
.• .. ,:, Pump or irrigation circle 67.84 2
Business name:Garner Electric Washington,LLC Sign or outline lighting 67.84 2
Address:6101`NE St Jahns Rd Signal circuit(s)or limited-energy El See Page 2 2
panel,alteration,or extension.
City/State/ZIP:Vancouver WA 98661 Each additional inspection overallowable in any of the above
Additional inspection(1 hr min) 66.25/hr
-
Phone:(253)320-1657 , Fax:( ) Investigation(1 lir min) 90.00/hr
Email:bdaniels@gweusa.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: C1158 Electrical Lic.: 208174 Suprv.Lic.: 4496S seecifically listed Cb hr min) 90.00/hr,
Suprv.Electrician signature,required: `L �//1off "'' ' " .., ar: :t:_3
subtotal:
Print name: Joan P Albert Date6-'3 &\ 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: ---`- TOTAL PERMIT FEE:
z J� This permit application expires if a permit Is not obtained within 180
Print name: Bill Daniels/ Date.3-vo days after It has been accepted as complete.
• Number of inspections allowed per permit.
I:Snuilding\Permits1ELC_PemritApp_ELK fP.Rdoo Rev06/17/20t5 440-4615TO1/05/COM/WEB
• Plumbing Permit Application ��� ,
Building Fixtures REQ, 1OR oil l( t: 1 sl. ONIl
Received Permit No/tr7;2d/6 1:200,71Iii 011 City of Tigard Date By:
13125 SW Hall Blvd.,Tigard.OR 97 Plan Review
Phone: 503.718.2439 Fax: 503.59 18 2016Other Permit No.:
Date/By:
Inspection Line: 503.639.4175Date Ready/By: lune I ® See Page 2 for
1 I . 1.17 g CITY OF TIG ARDSupplemental Information
Internet: w����a dor o�
r a lk l y {t 1 j 4 y S B 't 4! rl .. .. .. i..
Nohfied;'Met
�tr n�i' N.iI . ., ,. „�. . u •'•i, 33 Bt$B 13 C v��Si :7t ....15. FYI m fF4 .,t. ..�.
Demolition For special information use checklist
®New construction Description I Qty. I Ea. I Total
❑Addition/alteration/replacement 0 Other. New 1-2-family dwellings(includes 100 ft.for each utility connection)
' SFR(I)bath 312.70
`:� iCA`CtGORI� tbIYST'1><TJ!L�'NJ1tT;•
,... -..+• •.::
.- `-- - . ': . . . . .-. . = SFR(2)bath 437.78
® 1-and 2-family dwelling 0 Commercial/industrialSFR(3)bath 500.32
❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft.) _ Page 2
• r,. . ,t t j1�Ji �L!E�FC�� ��Dt�. yAf 6 1 °.Pr.
Site utilities:
Job site address:
i5z1a bW ` YVCSM• J Catch basin or
r area drain 18.76
Drvwcll.leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I 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:-1 Page 2
Water service(no.linear ft.: ) Page 2
Subdivision:Polygon at Bull Mountain I Lot no.: 7-3 Fixture or item:
Tax map/parcelno a � '". Backflow preventer I 31.2
7
r A { twt .f il.k sfoyxI::Tf4Sc . a Backwater valve I 1251
; - �. .:- clothes washer .
02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
',t t tI } .3Expansion tank 1251
.. ,,,f<•M. - r
Fixture/sewer cap 25.02
Name:Polygon WLH,LLC Floor drain/floor sink/hub 25.02
Address:109 East 13'h Street Garbage disposal 25.02
City/State/ZIP:Vancouver,WA 98660 Hose bib 25.02
Phone:(360)695-7700 Fax:( )
t.yc.�..t ..Es.., Ice maker
12.51
17-7, 7-7,44$W,--,W1:` .s.� fit t .' ti1kan'4 `} � aRy Interceptor/grease trap 25.02
a -c��'�r<W . ,,,,rei ..f..R ;• a ,,s> /0.[ f", k.r. ,a:,-ice;6 i;s:•,�
2
Medical gas(value:$ ) Page
Business name:Polygon WLH,LLC Primer 12.51
Contact name:Angela Grajewski Roof 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 L Fax::(360)693-4442 Tub/shower/shower pan 12.51
Urinal 25.02
E-mail:Angela Grajewski@pole,ygonnhomer com
ii f 'mayst$Yc ki . � * t , �x5'
Water closet 25.02
' . r.:3� kt,a }6 � rl t-S ,eipt i.:?,thImitzfA'
.. >., F3pvtr+fF�l .c'k r'a-e..Ts}..i. 4.,,...,0e` ?: n to ,k1Na3.i �i.,.::i ,.,-;-: : Nater heater 37.52
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: $72.50
Phone:(503)351-3903 Fax:( )
Plan review (25%of permit fee)
CCB Lic.:180345 Plumbing Lie.no.:PB1582 State surcharge(12%of permit fee)
Authorized signature: � TOTAL PERMIT FEE
I
Print name:Brandon Lanter I Date: 5Il
lc. l This permit application expires if a permit is not obtained within ISO days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
C\Building\Permits\PLMU"PcrmitApp doc 10/01/09 440.4616T110/02/COM/\VEB)
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
■
T 1 A Building Permit Review — Residential
Building Permit #: /7Jr o2p/( — Co�/5V
Site Address: /S /g S -7-4,41,2 Lc
Project Name: Pc 7 /j// &a/>042-4 Lot #: -�j
(New d�✓subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: &/0
P(;ierify site address/suite# exists and active in permit system.
aRiver Terrace Neighborhood: ❑ No VYes,See River Terrace Review Addendum Attached
Site Plan Elements:
r/ 1-ree(3)copies of site plan !!li Irl sting structures on site
riSitte plan must be on 8-1/2"x 11"or 11 x 17"paper I.Footprint of new structure(including decks)with finished
yawn to scale(standard architect or engineer scale) i.or elevations
orth arrow riutility locations(required for new,may apply for additions)
'te address,project or subdivision name and lot number pi cation of wells/septic systems
plic.ant information(name and phonek number) rosion control(including drainage-way protection, silt fence
Ltdimensions and building setbacdimensionssig ,location of catch basin,etc.)
area,building coverage area,percentage of coverage and l eetnnamesi
pervious area(applicable if R-7,R-12,R-25&R-40) feet tree size,type and location
roperty corner elevations(2 foot contour lines if more than NI ri sting trees to be retained with drip line,and tree
4 foot differential) protection measures
Oflean Water Services—Service Provider Le`tte of platted prior to 9/10/1995):
124{equired: ❑ Yes,applicant was notified U No Received: ❑ Yes ❑ No
3ublic Facilitiy Improvement(PFI) Permit:
Required: V Yes,applicant was notified ❑ No Applied For: //Yes ❑ No,stop intake
( and Use Case#: Sk6cQO/S=D1 0R
Zoning: le-271. C—
,
0 Setbacks: Front eq0 Rear /5 Side Street Side /S Garage c7O
bkandscape Requirement:
o
G. Lot Coverage Maximum: /o
►/ :uilding Height: Maximum Height 3(7 Actual Height QC'
Visual Clearance
asements
3) •nsitive Lands: ❑ Yes 021<lo Type
P Urban Forestry Plan
0 Conditions "Met"prior to issuance ofbuilding permit /
Notes: ( lVit E �// e /2%S- /77--/ 1 "Z GAG ecAt//- i t c,7is e
Approved By Planning: --.-=� , Date: ,c/� 4‘2
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
1:\Building\Forms\BldgPerniitRvw RES 012116.docx
Building Permit Submittal
Original Submittal Date: --$j/r /b
Site Plans: #
Building Plans: #
Building Permit#: ErEnter building permit#above.
Workflow Routing: le"Planning Engineering Permit Coordinator EI-Snilding
Workflow Sign-off: 2-Sign-off for Planning(include notes from planning review)
Route Application Documents: B' Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: Date: =5-. .6P./7:6)"<i)45;)S7- L-1-1411-47---
Engineering Review
e
1 Slope at building pad: sa v
TrConditions "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 C/No
Assess Water Quantity Fee in-lieu: ❑ Yes lE(No
LIDA Facility on lot: ❑ Yes PiNo
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: 4AI &O / Date: ( 0A
Revisions (after Building Submittal only) / Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
'ErSDC Fees Entered: Wash Co Trans Dev Tax: Yes El N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: Yes ❑ N/A
OK to Issue Permit
Approved by Permit Coordinator: Date: c//'4,
l:\Bui Iding\Forms\BldgPermitRvw_RES_0I 2116.docx
/ • 4
City of Tigard
71 IX COMMUNITY DEVELOPMENT DEPARTMENT
River Terrace Building Permit Review Addendum
Building Permit #: /`1,S7ap/C ---QQiy
Site Address: /C72'2/6 SA) '--filan 40,1k
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 'simum of 1 element per each street-facing facade 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. l
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., 6ft. wide Gable dormer
❑ ❑ ❑ ❑ ❑
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:
fac wall ❑ Parallel to street, . gle no more than 45° from street,
CI Max. 8 ft. setback from longest street-
or open onto po • 1\\
Entrance opens to a porch: ❑ Yes ❑ No . •
DDD
If yes, all the following apply: El25 sq.f .n.
❑ One street facing entry ❑ 12 f. max.roof above floor of porch
❑ 5 ft. depth min. ❑ i Vs 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 tr. ' . 2 '/z"wide by 5/8" deep
❑ Window recess min. 3 inches fo .11 street facing ❑ Bay window mi•. 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 se 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.
Widt • 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: _______Aille_
1\Buidding\Form s\BIdgPermitRvw_RES_RT_031416.docx
/14srot0/Ce - Uv -/`-/
FOR OFFICE USE ONLY-SITE ADDRESS: I 5-2 ) 8- S LJ .th.akr-7 rS
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City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
N . Transmittal Letter
T I c A R n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 •www.tigard-or.gov
TO:
Tom H. ./ DATE RECEIVED:
DEPT: BUILDING DIVISION I/ RE:GF
AUG 222016
CITY OF '
FROM: Angela Grajewsld �, ; ° �
COMPANY: Polygon Northwest
PHONE: 971-212-2144 B,
RE: I S . liki. a&. i _ MST201(, 00a-ti
( to • a a ress) (Permit Number)
Polygon at Bull Mountain
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
o Additional set(s) of plans. 0 Revisions:
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.
3 Other(explain): Additional deck details requested by inspector
REMARKS:
Routed to Permit Technician: Date: ; -off - ) _ Initials: /'
Fees Due: 1 Yes • No Fee Descri•tion: Amount Due:
i. ' ,n
$
Special
Instructions: IIIIIIIIIIIIIIIIIIMIIIIIIIIIIIIWAIIIIIIIIIIIIIIMMIIIIIIIIIIIIIII
Re•rint Permit .er PE : ❑ Yes pa No ❑ Done
Applicant 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:
15218 SW THAMES LN, TIGARD, OR, 97224 April 21 , 2017 at 1 :59:23 PM
Record Type: Record ID:
Residential - Master Permit MST2016-00214
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15218 SW THAMES LN, TIGARD, OR, 97224 April 25, 2017 at 12:00:38 PM
Record Type: Record ID:
Residential - Master Permit MST2016-00214
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
FA I L
Comments:
Seal mechanical room penetrations to crawl at supply and WH pan drain. R302
Seal around line set penetration at foundation vent. R408.2
Violation Summary:
Inspector Contractor