Permit t a .
CIrTY OF TIGARD a/.3�� ,,a w ✓ MASTER PERMIT
14 ., u
: . . _ COMMUNITY DEVELOPMENT Permit#: MST2016-00268
Date Issued: 06/29/2016
T1GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S106DC12600
Jurisdiction: Tigard
Site address: 17164 SW JEAN LOUISE RD
Subdivision: POLYGON AT WEST RIVER TERRACE Lot: 126
Project: Polygon at West River Terrace, Lot 126
Project Description: New SF. 12/13/2016: REPRINT to add A/C.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 809 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 25 Bathrooms: 3 Second: 1049 sf Garage: 437 sf Front: 12 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 1858 sf Value: $230,037.52 Rear: 0
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 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
Drywall-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y 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
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: 3 201-400 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
Ecompasing: Y
Other: N Other Description:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 1858
Owner: Contractor:
ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
7600 EAST DOUBLETREE RANCH 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175
RD,STE VANCOUVER,WA 98660
SCOTTSDALE,AZ 85258
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $30,893.47
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 • •'R• -001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232! or 1.800.332.2344.
Issued By �`3 Permittee Signature:
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.
ECEIV ii I
• DEC 1 3 2016
. Met hanicei?fit RR +•
gg )on t�r1 it l ):t7.I.1
y.•.'. E e patellar Received
t,_7wr� t1�0.:�.-1/o"V�tO-'WO
j i+ 1 u�,, VI r3
1 ' 1a Phone: 503.718.2439 Fax: 503.598.1960 J U N 2 2 2016 /8y; Other Permir.
IIns Lina 503.639.4175
1 1
i C,n r:[) Intuit, www.tigerd.or.gov CITY OF�-(I Z RDIVISION 2` ed rod: ill ra See Page 2 for Stipples tat Information
F ,
Mechanical pennit fees*are based on she value of the work
New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other. mechanics!materials,equipment,labor,overhead,and profit.
V
al
®I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For'pedal fq/beriadioie use rlieck!,,st.
• ❑Multi-family 0 Master builder 0 Other: Description I Qty. [ Ea. [ Total
Heatingjce►ollag:
.. ,
// Air cOnditionLrg 46_
75
Job site address: j 7 i ireI/SW Jean Louise Road Furnace 10k000 000 BTU(ducts/veats) , , 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTUSdum/vents) 54.91
' Beat pump 61.06
Suitt/bldg./apt.no.: { Project name:Polygon at West River Ter Ductwork 23.32
Cross street/directions to job site: Itedronic 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
23.32
Subdivision:Polygon at West River Terrrace l Lot no.: /P-1.4P _
Other the!appliances:
Tax map/parcel no.: Water heater _ 2332
? 33.39
Cue vent terJwatet
Fine vasal for water heater or gas
fireplace 23.32
/� ,
, 1>b r4-1C./------ Log lighter(gas) 2332
Wood/pellet stove 33.39
Wood Sreplacer cert 23.32 ,
Chimney/liner/flue/vent 23.32
2332
w y, °' Environmental exhaust and ventilation:
Name:ADVL Land Holdings,LLC Range hood/other kitchen
equipment 33.39
Address:7600E Doubletree Ranch Road Clothes dryer exhaust 33.39
City/State/ZIT:Scottsdale,AZ 85258 Single-dud exhmtstt(bad morns,
toilet compartments,utility rooms) _ 23.32
Phone:(602)694-4031 Fax:( ) Atlidctawlspace fans 2332
L i. Other 23.32
Business name:William Lyon Homes,Inc. 51415 for first four,$4.03 for each additional
Contact name:Angela Grajewaki Pomace,etc. i
imii
Address:109 East 13th Street G heat P ne f
WalYsussaiddltmit heater
City/State/ZIP:Vancouver,WA 98660 water heater ,
Phone:(360)695-7700 I Fax::(360)6934442 Fireplace
Range
E-mail:Angela.Grajewski@polygonhomes.com Barbecue
r Clothed dryer(gas)
WAR
Business name:Apex Air LLC
Address:18004 NE 72ad 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 lie.:203034 TOTAL PERMIT FEE
rA
4(16
Tbis pemit application expires if a permit is not obtained within t8a
kl'
days atter tt bas been accepted u complete.
Authorized signature: * Fee methodology set by Tri-County Beading Industry Service Board
Print name: A notitk ( r eIA)StLt, _Date: 414!1
t:lauildi, P,n,ks C P. tApp_aoin.deo a 17 (1 ro2nrobtnves)
CITY OF TIGARD
MASTER PERMIT
COMMUNITY DEVELOPMENT
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Permit#: MST2016-00268
Date Issued: 06/29/2016
Parcel: 2S 106DC 12600
Site address: 17164 SW JEAN LOUISE RD Jurisdiction: Tigard
Subdivision: POLYGON AT WEST RIVER TERRACE
Project: Polygon at West River Terrace, Lot 126 Lot: 126
Project Description: New SF
BUILDING
Floor Areas
Stories: 2 Bedrooms: 4
First: 809 sf Require ducks
Height 25 Bathrooms: 3 Basement: 0 sf Left: 3 Parking Spaces: 0
Dwelling Units: 1 Second: 1049 sf
Garage: 437 sf Front 12
Smoke
Third: 0 sf
Total: 1858 sf Right 3 Detectors: Yes
Value: $230,037.52 Rear: 0
inks: 1 Water losets: 3 WashingPLUMBING
Mach: 1 Laundry Trays: 0
Lavatories: 4 Dishwashers: 1 Rain Drain: 1
Tubs/Showers: 3 Urinals: 0
Floor Drains: 0 Sewer Lines: 100 Rain Storm Sewer: 100
Garbage Disp: 1 Water Heaters: 1 SF
Footing Drain: 0 Ice Maker: 1 Water Lines: 100 Drains: 0
Hose Bib: 2 Backwater Value: 1 Bckflw Prevntr: 0 Catch Basins: 0
Drywell-Trench Drain: 0
Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Ft_ Tvpes Air Conditioning: N Vent Fans: 4
Natural Gas Heat Pump: N CloOth Dryers: 1
Hoods: 1 Oth
Furn<100K: 1 er Units: 0
Vents: 0 Woodstoves: 0
Gas Outlets: 4
Furn>=100K: 0
Reside ELECTRICAL
Service Feeder
1000 sf or less: 1 TemSrvc/Feeders Branch Circuits
a
0-200 amp: 0 0-200 amp: p
Ea add'I 500 sf: 3 201-400 amp: p W/Svc or Fdr: 0
Mfd Home/Feeder/Svc: 0 201-400 amp: 0 W/O Svc/Fdr: 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
Other: N Other Description: Vaccuum System: N Garage Opener: N
All
Ecompasing: Y
BUILDING INFO
Class of Work:
Type of Use:
NEW
SF VB Type of Constr: Occupancy Group:
Square Feet:
Owner: R-3 1858
Contractor:
ADLEAST
LAND HOLDINGS LLC
DL EAST DO DINRANCH WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
RD,STE 109E 13TH STREET 1 Ersn Cntrl 503-639-4175
SCOTTSDALE,AZ 85258 VANCOUVER,WA 98660
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $30,493.71
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
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
days. ATTENTION: Oregon law requires you to follow the rules adopted byOregonwork will
952-001-0010 through OA' +01-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. the 180
• the Utility Notification Center. Those rules are set forth in OAR
Issued By: A,�
Permittee Signature:
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.
i
e Building Permit Application 2_-O/ /';2 j
E JEIVE xe e I()It 011 ICI:I SI ()N1.1
City of Tigard Date/sy: 0/2 as , PerudtlietS�
.� 13125 SW 1ia11 Blvd.,Tigard,OR 97223�-�� f(`� 2 `� c -ro��`rdt���
2 : i Phone: 503.718.2439 Fax: :3.598.NikU N 6 2 016 �t�„ew 6 '� other Permit ons/
r 1"
c;„t ra Inspection Line: 503.639.4175 __ �^y Date Ready/By: / / ` t,,;,; ��1�,2f�
Internet: www.tigard-or-gov CITY 1GARD Notified/method:
S plemen 2tor
P����” �'3 �B ° SappfemebraF information
$$_ 1✓ t t r, r I v
r T _ 3.t ..� r,� `� y ,A.:�`s�3 s' s�);f Js u ,.F j, , ,, t3,.-,,,---4,F,. .a% •,,,,:,.,. ' "`y' ,t", '� 4 7:-9':'''',i;"-,„:" ..z .
., i •
.'.---si ri ....Ao✓ c z , ... 3n•,,,,'',.:.,P z, y3 4.l 3 -f..-:-..,4,1,'
.,t 1,i , , t -V:,1-, ";4",1`.1,1%-'"
�f 1` i_
®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 0 Other
equipment,materials,labor,overhead,and the profit for the
_ 2,:::?..":7::::::-,a2;:';':". "s,..,J ��� sJ J 6� (, � i ;',-,--7,7";---w work indicated on this application.
Ell 1-and 2-family dwellingt � d 0 CommerciaUmdttsfrial Valuation: 294,�
❑Accessory building ); 3 7
0 Multi-family Number of bedrooms: 4 r
❑Master builder 0 Other Number of bathrooms: 3
max- -� 7 �„ -
.:,rz5 -.,_`. S.,_kt ` 7u„IJ t� t _n t r, l l F! i2�z , : et 1 `, r s Total number offloors: 2 �e
Job site address: 11 I (pL 5Vv v\Pry,Y1 L IG
(Se. f 11O� New dwelling area: 1858 square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: 437 square feet
Suite/bldg./apt.no.: I Project name:Polygon at West River Ter Covered porch area: -"VW, square feet/01+q
Cross street/directions to job site: Deck area
j square feet 0?..•
Other structure area: square feet
7,, , T s -;7'i'`•-f.:, ,
Subdivision Polygon at West River Terrace -ees5 _. _�� %,-,---,__ ;,
I ��.� I� 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
7 equipment,materials,labor,overhead,and the profit for the
x._,.�,.t.., .. st7 (r�a;r s1 ,. work
-.. >...... �. . ,.,�'' indicated on this application.
Valuation.: $
Existing building area: square feet
New building area: square feet
-7: ,.4 Cj° J 3 J 3 T i Number of stories:
Name:ADVL Land Holdings,LLC _.,._. Type of construction
Address:7600 E Doubletree Ranch Road
Occupancy groups:
City/State/ZIP:Scottsdale,AZ 85258
Existing:
Phone (602)694-4031
Fax ( ) New:
Business name:Polygon WLR,LLC s_ .. ...__ <_ . ._ �.. ? nF_
Contact name:Angela Grajewski Structural plan review fee(or deposit):
Address:109 East 13t°Street FIS plan review fee(if applicable):
City/State/ZIP:Vancouver WA 98660 Total fees due upon application:
Phone:(360)695-7700 ( Fax::( ) Amount received:
E-mail Angela.Gralewsld@polygonbomes.com e
L • Commercial and residential prescriptiveinstallation of
' 1- " -- _._ roof-top mounted PhotoVoltaic Solar Panel System.
Business name:William Lyon Homes,Inc Submit two(2)sets of roof plan with connection details
Address: 109 East 13th Street andfire department access,along with the 2010 Oregon
Solar Installation Specialty Code checklist.
City/State/ZIP:Vancouver WA 98660
Permit Fee(includes plan review
and administrative fees S180.00
Phone:(360)695-7700 Fax:(360)6934442 ):
State surcharge(1 rh of permit fee): $21.60
CCB ria:207247
�� ! r Total fee due upon applpines if a g201.60
ained
Authorized signature: /j'/A` This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Angela Grajewski Date: '-'A'! '10 *Fee methodology set by Tui-County Building Industry
//` ! Service Board.
I:\BuildinglPermitslBflP-RESPermitA.pp.doc 02/24/2011 440-4613T(l 1/02/COM/WEB)
Mechanical Permit Applica . R I
City of Tigard � i� Received ►=a a O f l I( L t ‘,-I..0 Nt 1,1
t ,1N a 13125 SW Hall Blvd.,Tigard,OR 97223 C Daffy: Permit ilio.: -f0/6„Z0 6P
r S Phone: 503.718.2439 Fax: 503.598.1960j UN 2 2 2016 P8°xericw
t _.
T 1 c A R D Inspection Line: 503.639.4175 Date/$y: Other Permit:
1 Internet: Line:www.tigard-or.gov c__�.y -w.ts, , R r Date Ready/By:
? E t ¢ a �.4 s"1 Zed/Method Mill GI See Page 2 for
< E 1 t i D S I O
Supplemental Information
it .x...,6.. e.n...,.i rU,m2,'- Ct o,-1"7-,".t4 � C$Pi :,, ifF ...
_.r... _}-� ,.'r � t,tc, f� r... ....,.u_r.:s s ', /.�. :; �t �f ��.v r .a,� t 1 t 1 :=.7'..'_:-,t;-1.?`i rc y. J �
®New construction 0 Addition/alteration/replacement Mechanical *
Permit fees ate basad de the value nearest
the world
❑Demolition ❑Other Performed.Indicate the value(rounded to the
r k. -/•:,:;... mechanical materials, '. en labor overhead, dollar) all
�:i ...'._:,:' . .,�.v a.e-....,.. : I F4"si U a i�. ;,.4.-.--,•::-..•:.,, 7,'.,dYcr3 Value: and.•l.
I-and 2-family dwelling 0 Commercialrndustrial 0 Accessory building "w form _-1.''' .1.:::,:'use
s a
D Multi-family 0 Master builder 0 Other: "on
Forapedotiyornmtlon ilea checklist
i':1 '"C E, li'1: S t q:-,: ti r €i'.. ...-5.7,7:-7 ,--:,-,74, Heath- cool1� Total
Job site address t'�t�!�SW Jean Louise Road Ah dhionin:
I r 46.75 ma
all 46 75 ma
City/State/ZIP:Tigard,OR 97224 Furnace I 100 000 BTU(ducts/years
Furnace 000+BTU ducts/vents) 1111111111211111
MINI 61-06
Suite/bldg./apt.no.: I Project name:Polygon at West River Ter
Cross street/directions to job site:
Ductwork �
H dromic hot water . -. EINEM=
Residential boiler(radiator or 11111,111
Unit heaters(fuel-type,not electric),
in- in . sus. . etc.
Flue/ventfor of above w11w♦Other r��
Lot no.:
Subdivision:Polygon at West River Terrrace
Tax map/parcel no.: i' lOther fuel a•, lances:
Water heater ��_
-, Gas . ,jacevent
watersart
33.39
Flue vent for water heater or gas .ElE113 -
: 2332 11.111
Wood/. stove NMI 3339 MIME
Wood . -.lace/insert a
1 r Chiron /liner/flue/vent all 23-32 1111111
-- 1 l ",, Other 23.32
Environmental exhaust ventilation:
Name:ADVL Land Holdings,LLC
Range hood/other kitchen
Address:7600 E Doubletree Ranch Road ' 'ant 1111
33.39
City/State/Zlp:Scottsdale,AZ 85258 Cl . er exhaust i 33.39 _
Single-duct exhaust(bathrooms,
Phone (602)694-4031 Fax:( ) • ', rooms
toilet
fans
` 23.32 1111
/Aytt�irJcrawl� �13=111111111
—...� ..... a .. ... _,. '� 4 M :5•� Other:
Business name:William Lyon Homes,Inc. 2332
Contact name:Angela Gra jewski 514.15 for first four•54.03 for each additional
Furnace etc. 111111 =
Address:109 East 13th Street Cmc heat.,•,,,,
City/State/ZIP:Vancouver,WA 98660 Wall/ . unit heater ��
I
Phone:(360)695-7700Water heater
Fax::(360)693-4442 F' .lace _ =
E-mail:Angela Grajewsiti�a polygoahomes corn - '_ �
._.. Barbecue
r Clothes as �_,,,, a. t __ . �Business name:Apex Air LLC sF -Address:18004 NE 72°Ave
MIMI
City/State/ZIP:Vancouver,WA 98686 Subtotal
Minimum permit fee($90.00)
IIIIIIIIIII
Phone:(360)3424109 Fax (360)326-1769 Plan review(25%of permit fee)
CCB lic.:203034 State surcharge(12%of permit fee) IIIIIIIIIII
TOTAL PERMIT FEE
� � /L`z /VG��(„ This permit application expires if permit is not obtained within ISO
Authorized signature: I/fA� Jyl1e� days atter it has been accepted as complete.
Fee methodology set by Tri-County Building Industry Service Board
Print name: A nG A rti )Sk/_ I Date: 4014& I
i:HiuildipePenoitslMECPnr_040113 doe ''L
44 /CpM/WF,g)
. •
•
Electrical Permit Applicata E- <:
OFFICE I.S
i
CityofTigard Received L'ONl
,1
13125
S oHall
al$.ia�'Tigard,
Fmc OR 9 iW k L+ 2016 �°'""` �Si �6-'12A,261'
I7ateIB :
Inspection Line: 503.639.4175 Ready AateiBy:
T1Gl;RID Interact: www.tigafd-orgov Ci
0�^� 1 Ry
t.r!��6,.d�"' ff_��;,f�i'#L. NMiie�thad:
c . _,-, 9g-: ...£,z § ,--) �
-J�,, ? - .7 ,�.k� ''''-'3' 41''.,3 '' ,.;?;.° 5"---7.�:i41-''' 3` . -`5`>�C.�) i4. i ?ui.
� _.-�,:k •''I IC�yn ,:
?`e
®New cconstructionu > a,.,❑Addition/alteration/repiacenlent Please cheek all that apply(submit2 sets of plans vacua�.
❑Demolition ❑Other IJ Serviee or feeder 400 amps or mora ❑Building over three strides.
.. . y whore available a ❑ lng boatyards.
h ,� �,; 47. tia-.. �41:1',1Fj_ )}; r, g? I, 7( '-'_:' ''_4"''';--4-..'?'-,:-.'" . ancea 10,000 amps st 150 yobs or ❑Foating tradings
®1-and 2-family dwelling ❑Commercial/iridastriai 0 Accessory building lea to armed,or exceeds 14,000 ❑C0aamareial-use agr;o,dtara2
amps
for all aosue.ter installations. abynsdtadmin.g
s,❑Mwl� Y ❑Master builder
0 ❑Fre pump- 0instalattion
of 150 KVA
or
;, yg 40 - o n :AS .wi1 . 6'ty 2.:a. ,';$- ,.7":,; Q Emergency systemlarger separately derived
Job#: Job site address: I ]/' £ .Sw jun LottS °A300
orenewwto2old9f
QA","a"."I-2","I-3",
City/State/ZIP:Tigard,OR 97224 0 Six or mora residential unitsoccup cy.
Qlfaanh•eese dmillties. 0 acoreittionsi vehicle parks.
Suite/bldg./apt.#: I Project name:Polygon at West River Ter ❑liazardons locations. Q Supply voltap for more than
Q Service or feeder 600 amps or more. 600 volts flowing
Cross street/directions to job site: - .yc>a ,. „r's 6 o A 14.t r d tip,,,i;„_3,,,,..,,,- -,•:-.4 :-,,,,-i�.` ,
Deseritatea QV. I ..= ITotal •
New residential single-
Subdivision:Polygon at West River Terrrace 1 Lot#: /a� Includes ached garage.
multi-family dwelling unit.
Tax map/parcel#: 1.000 sq.R or}ens 1 168.54 4
Ba.add'1500ft.orportion
' _. k. . _-;4 - -t rt2`s:IP',1D-�?g 7"9=k[.� `,,r 3 -. "'s;v"v`."s .--4._r n.3. Limited energy,resldential ) 33.92 I
(with above sq.R) 75.00 2
Limited ener82,multi-family
75.00 2
residential(wide above sq.Q)
' vy tlsl`f31`[I ':.?:16.:!,',',.._5.0,ii:-,.,.�3 .day. I> 9 - r - Renewable Enei Y p See Pape 2r
v Services or feeders installation.alteration,and/or relocation
Name:ADVL Land Holdings,LLC 200 amus or less 100.70 2
Address:7600 E Doubletree Ranch Road 20I m 400 13356 2
401 amps to 600 amps 200.34 2
City/State/ZW:Scottsdale,AZ 85258 601 amps to 1,000 amps 30L04 2
Plume:(602)694-4031 , Fax:( ) Over 1,000 amps or volts 552.26 2
Emai
). Temporary services or feeders Installation,alteration,and/or
relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps125.08 2
Owner signature: Date: 401 amps to 599 amps I I 16834 I 12
..,`,..77:".„'_,..,:2-i.. :' IfS`;: + ._o,r,,s,„,.. ....,:„„I1,.:.-, L ,1_1 0,fp, E- 1l t d'` 8
" „` A leb t$teuia—new,alteration,or extension, panel
Fx far bmnoh ehwks t
Business name:William Lyon Homes,Inc. above service or feeder fee, 7.42 2
each branch circuit
Contact name:Angela Grajewskl B.Fee for branch circuits wirhau
Address:109 East 13th Street service or feeder ibe,fust 56.18 2
blanch circuit
City/State/ZIP:Vancouver,WA 98660 Each add')branch circuit 7.42 2
Miscellaneous(service or feeder not included) f
Phone:(360)695-7700 ' I Fax::(360)693-4442 Bach manufectured or modular 67.84 2
Email:Angela.Grajewehi@polygonhomes.com dwelling aervioeaodlorfeter
Reconnectonly 67,84 2
j.'-'.-',..?.-1.--11,7e,.._..," ; aitar,cl:S f j,. _ t1,__. _._1__'_.<<: _,a::i1-,,;:,"`" Plump orarigationcircle 67.84 2
Business name:Garner Electric Washington,LLC Signor outline lighting 67.84 2
'r"'= Signal circult(s)or limited-clergy
Address:6101 NE St Johns Rd panel,alteration or extension. 0 See Page 2 2
City/State/ZIP:Vancouver WA 98661 Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
Phone:(253)320-1657 Fax:( ) Investigation(1 br aria) 90.00/hr
Email:bdartiels@gweusa.com Industrial plant(I hr min) • 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lia: C1158 Electrical Lie.: 208174 J Suprv.Lia: 4496S a listed 4 Iu men)
Suprv.Electrician signature,required: • • ' , f 1/5-44...,.. -•', ..
:' f) Subtotal:
s , `Print atone: loan P Albert Date: 4/26/2016 Q Plan Review Required(25%of prmtit fee):
State surcharge(12%ofpermit Etc):
Authorized signature: '7L:162''
�^ ' Tt71ALPBRMTPFEE:
This permit application expires ifs roman not obtained within 180 -
`.:; Print name: Bill Daniels Date: 4/26/2016 days after It has been at
iit;- a,zp e�d as complete.
,Jr:.,.;',: ,^7 dklingtRa aIMELC Pemu't ELL ERE.da Rev 06117/201$ 4lo4dl ' Humber of}nspeatioas allowed par permit.
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118011dieePamirAPEARTA74412AppAlie 10/01/09 440,16461(10/02/COMME8)
i
s
City of Tigard
COMMUNITY DEVELOPMENT DEP
TIGARD Bu�dingal
B1111
CReview _ Residential
DEPARTMENT
Building g Permit #: rf-i T'a.z
Site Address: _ ��- 6�
Project Name: I � � _ J ,, r7 L
west River �e • .
(New dwelling=subdivision name;Addition
Planning Review Alteration-last name of owner) Lot #: l Z�Q
Proposal: --kA) Vr
gVerify site address/suite#exists and active ine
a River Terrace Neighborhood: P �t system.
0 NoOA Yes,See
Kiver Terrace BeviesvAddendum Attached
Site Plan Elements:
AlThree(3)copies of site plan
Site plan must be on 8-1/2"x 11" kExisting structures on site
Dre scale e on ard architect or 11 x 17"paper
North arrow engineer scale) floor elevations of new structure(including decks)with
elevations finished
Site address,project or subdivision name and lot numbery,�
ti1ity locations(required for new,
.NApplicant information(name and A�Location of wells se ''nay apply for additions)
of dimensions and buildingphone number) wells/septic systems
ISkt
setback dimensions sign ln control(including basin,
Lot area, coverage area,
design, image-way protection, silt fence
percentage of coverage and gn,location of catch basin,etc.)
impervious building area(applicable if y�
R-7,R-12,R-25&R-40) +`xr'treet names
Property corner elevations (2 foot contour Street tree size,
4 rope differential lines if more than type and location
Existing trees to be retained with drip line,and tree
IN Clean Water Services-Service Provider Letter(lot platted protection measures
Required; ❑ Yes,applicantP d prior to
Required:
Facilities es, was notified 9/10/1995):
No Received:
Required: Improvement(PFI) Permit:
0 Yes 0 No
0 Yes,applicant was notified
Land Use Case No Applied For:
a Zoning: ��2_015- 0Yes 0 No,stop intake
.Setbacks: P.-2 S
Landscape Requirement: Front 121 g'Rear
% Side 3 Street Side N
�B��Cnoverage Maximum: � Garage n) A
g Height:
Visual Clearance Maximum Height 3SI �/
i/VEasements Actual Height ±-____2_,7
-1Sr Sensitive Lands:
0 Yes ❑
`I Urban Forestry No Type
try Plan .1\ A
El Conditions "Met"prior to issuance of buil
Notes: p alllh lVl� cm, �g Permit
h(l¢ . _,,,,Iv)-ea
Approved By Planning: , L.,A I .y. I
Revisions (after Building �./
Submittal wly) Date: CO ®'e
Reviewer
Revision 1: 0 Approved
Revision 2: Not❑ Not Approved
0 Approved 0 Approved
Date
Revision 3:
0 Approved ❑ Not Approved
I:\Building1Forms\B1dgPennitRvµ, RES_0121 16.docx
F
1111 City of Tigard
a COMMUNITY DEVELOPMENT DEPARTMENT
T I G A R D River Terrace Building Permit Review
Building Permit .�� .. � .. r • Addendum
Site Address: � �7720/6-, — �0"&�
l
Project Name: �4 &\A/ in L�� r"
(New dwelling=subdivision name;Addition or Alteration=last name of owner) Lot #: 122
Planning Review of River Terrace Plan District Design
Is the project subject to the plan district desi Standards (18.660,070.I.);
design standards?�eS ❑ No
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 eve 3
Balcony w/access 2 Window Projection Vertical Wall Offset a
Porch min, 5 ft. deep
ft. deep min. 2ft., 5 ft.wide
0 min. 2 ft., 6ft. wide Gabled dormer
w
❑ ❑
2. Eyes on the street:a minimum of 12%of each street facing facade must include0
Percentage Shown: 15.1(ID windows or entrance doors.
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,
Entrance opens to a porch:AYeS CINo or open onto porch
If yes,all the following apply:
AOne street facing entry K25 sq.ft. min,
,1Er5 ft. depth min. ,K12 ft.max.roof above floor of porch
>330%min,porch roof coverage
4. Detailed Design:All buildings shall include a min. of five of the followin eleme
'Covered porch min. 5 ft.wide x 5 ft. deep g nts on all street-facing facades:
.Recessed en
area min. 5 ft. wide x 2 ft. deep
❑ Wall offset min. 16 inches
Roof eave min, 12 inch projection ❑ Dormer min. 4 ft.wide
❑ Roof shingles either file or wood ❑ Roof offset min, of 2 ft.
❑ Roof pitch oriented southGable,hip or gambrel roof design
❑Accent sidingmin. 500 sq. ft.
min. 40%of street facade OHOrizontal lap siding min. 3-7 inches wide
❑ Window recess min, 3 inches for all street facing � Window trim m� 2 '/Ztt
❑ Window
wide by 5/8"deep
Balcony min. 5 ft. wide x 3 ft. deepY window min. 5 ft. wide by 2 ft. deep
with inside access Z.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-facingwall. s � �� ' ��� �"�
❑ May extend up to 5 ft.if there is a covered front porch d garage❑ does not ex No. If No (Check one):
❑ May extend up to 5 ft.where the garage is part of a two-story
above the garageenu that faces the trhet with a tend beyond the front porch.
building and there is a window at the second story
Width: (Check one) ' area of 12 sq.ft.
a 12-foot-wide garage door
❑ 50%max. of street facade with 7 detailed desi! ❑ 40%max. of street facade -N (6
Notes: elements -^}
Approved By Planning: '.- .
I:\Building\Forms\BldgPermitRvw RES_RT_0622IS.docx Date: ZZ
—1_____Ak_____
Building Permit Submittal ��
Original Submittal Date: #
Site Plans: #
Plans: e t#above. [��uilding
Building Er-Enter building p -��e it Coordinator
Building Permit#: Engineering[y''Planning tanning review)
Workflow Routing: (include notes from p (1) site plan, (1)building plan and
a Sign-off for Planning
Workflow Sign-off: (1) copy of permit application,
Engineering: form.
Route Application Documents: engineer and
original plan review routing
permit application,site plans,building plans,
�Builchng: originalif a licable,etc.
beam calculations and trust details, pp
46 ..—• Date �' .�_'
Notes:
By Permit Technician. i
Engineering Review
Slope at building pad:
❑ Conditions"Met"prior to issuance of building permit
oachments)per engineering conditions of approval and plat
❑ Easements (encr
❑ Water Quality/Quantity Facility: ❑ Yes 0 No
Assess Water Quality Fee in-lieu: 0 Yes
0 No
Assess Water Quantity Fee in-lieu: 0 No
Date:
LIDA Facility on lot: 0 Yes
❑ NOT A'prove i b Dat
ngineering:
Notes: ,.19_,, --..t" e:
6 r ..� Date:
Date
Approved by Engineering: Reviewer
Revisions (after Building Submittal❑only)
Not Approved
Revision 1: 0 Approved roved
Revision 2: ❑ Approved ❑ Not App
❑ Not Approved
Revision 3: ❑ Approved .. .. .
Permit Coordinator Review
❑ Conditions"Met"prior to issuance of building permitDate:
❑ Approved,NOT Released:
Notes:
Revisions (after Building Submittal SonlyoApplicant:
)
Revision Notice 1:
Date Revision Notice 2: Date Sent to Applicant:
Date Sent to Applicant:
Revision Notice 3: 0 N/A
Wash Co Trans Dev Tax: 0 Yes 0 N /A
0 SDC Fees Entered: Tigard Trans SDC:
Parks SDC: 0 N/A
0 Yes
❑ OK to Issue Permit
Date:
Approved by Permit Coordinator:
I:\Building\Forms\BldgPermitRvw_RES 012116.docx
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
17164 SW JEAN LOUISE RD, SHERWOOD, OR,
97140
Record Type:
Residential - Master Permit
Inspection Type:
199 Electrical final
Result:
CNCL
Comments:
Cancelled by contractor, not ready for inspection.
Violation Summary:
Tel: 503.718.2439
Inspection Date:
December 8, 2016 at 11:24:46
AM
Record ID:
MST2016-00268
Inspector:
David Young
Inspector Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
17164 SW JEAN LOUISE RD, SHERWOOD, OR,
97140
Record Type:
Residential - Master Permit
Inspection Type:
699 Mechanical final
Result:
CNCL
Comments:
Cancelled by contractor, not ready for inspection.
Violation Summary:
Tel: 503.718.2439
Inspection Date:
December 8, 2016 at 11:37:59
AM
Record ID:
MST2016-00268
Inspector:
David Young
Inspector Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
17164 SW JEAN LOUISE RD, SHERWOOD, OR,
97140
Record Type:
Residential - Master Permit
Inspection Type:
699 Mechanical final
Result:
FA I L
Comments:
Tel: 503.718.2439
Inspection Date:
December 13, 2016 at 1:25:56
PM
Record ID:
MST2016-00268
Inspector:
David Young
Provide permit and inspections for AC installed without permit.
Violation Summary:
Inspector Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
17164 SW JEAN LOUISE RD, SHERWOOD, OR,
97140
Record Type:
Residential - Master Permit
Inspection Type:
199 Electrical final
Result:
FA I L
Comments:
AC not on permit.
# 6 ARC fault breaker not tripping.
Upper level main bath fan stuck on.
Violation Summary:
Tel: 503.718.2439
Inspection Date:
December 13, 2016 at 1:28:07
PM
Record ID:
MST2016-00268
Inspector:
David Young
Inspector Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
17164 SW JEAN LOUISE RD, SHERWOOD, OR,
97140
Record Type:
Residential - Master Permit
Inspection Type:
199 Electrical final
Result:
PASS
Comments:
Corrections complete.
Violation Summary:
Tel: 503.718.2439
Inspection Date:
December 15, 2016 at 9:43:59
AM
Record ID:
MST2016-00268
Inspector:
David Young
Inspector Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
17164 SW JEAN LOUISE RD, SHERWOOD, OR,
97140
Record Type:
Residential - Master Permit
Inspection Type:
699 Mechanical final
Result:
PASS
Comments:
Corrections complete.
Violation Summary:
Tel: 503.718.2439
Inspection Date:
December 15, 2016 at 9:45:34
AM
Record ID:
MST2016-00268
Inspector:
David Young
Inspector Contractor