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Permit (54) IliCITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2016-00094 Date Issued: 08/03/2016 T1GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S1060003000 003000 Jurisdiction: Tigard Site address: 13757 SW 171ST AVE Subdivision: WEST RIVER TERRACE Lot: Multiple Project: Polygon at West River Terrace, Lot 41 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 633 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 32 Bathrooms: 3 Second: 1017 sf Garage: 418 sf Front: 12 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Total: 1650 sf Value: $204,764.56 Rear: 3.5 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 Rain Storm Sewer: 100 Tubs/Showers: 2 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 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: 2 201-400 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 1650 Owner: Contractor: ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions) 7600 EAST DOUBLETREE RANCH 109 E 13TH STREET 1 A Geotechnical report is RD,STE VANCOUVER,WA 98660 required before the footing SCOTTSDALE,AZ 85258 2 Ersn Cntrl 503-639-4175 PHONE: PHONE: 360-695-7700 FAX: Total Fees: $30,002.03 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 'A- 952-001--00009-0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987.1or 1.800.332.2344. Issued By: :52 ). "767z_e_ V Permittee Signature: �/v //l 71G 6-1-77e/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. - Z_a / Building Permit Application G/ LS 3 9 / 1 FOR OFFIC I l til:()il.l Received City of Tigard RECEIVED Day_ 3//j//(o ? . Permit No ; ,/6� 1 ?V13125 SW Hall Blvd.,Tigard,OR 97223 MAR 0 9 2016 PlanReview " Phone: 503.718.2439 Fax: 503.598.1960 DateB : o ■ mei Penmj��f� /�' 0/ t'!G R(� Inspection Line:' 503.639.4175 r (� TIGARD Date ReadyBy: �> Jurir H See Page 2 for Internet: www.tigard-or.gov "ITY " �I`^, `RD Notified/Method: 5 /Mr Supplemental Information BUILDING DIVISIO • 'L. 67g— m ,� �«,g�.a w. — ,.. _. �,....v :.:. ........ .« ..,.. ®New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the "y work indicated on this applic _• • , • u � ��a-"`'� �® P s ,,„ 'i, .r`"�, tea. ,ma y. .:,zz�xi ., k` . Valuation 0&_761- $ •� • ® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building ❑Multi-family Number of bedrooms: 0 Master builder. 0 Other: Number of bathrooms: 2 5' yTotal number of floors: 2 Job site address: 1} 5�,1_J \ A ' / New dwelling area: t square feet asfl City/State/ZIP:Sherwood,OR 97140 Garage/carport area: ' ' V square feet Suite/bldg./apt.no.: Project name:Polygon at West River Ter Covered porch area: square feet10 1"' Cross street/directions to job site: Deck area: V square feet 33 Other structure area: ', square feet • Subdivision: Lot no.: Lk ( Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no equipment,materials,labor,overhead,and the profit for the work indicated on this application. New Single Family Detached Construction Valuation: $ Existing building area: square feet New building area: square feet :17:" phi , Number of stories: Narfie:rolyg n / 11l (_"1-7,/j i 4,b/'/l/6:5* LL( Type of construction: - Address:109 E 134 Street . _ Occupancy groups: City/Stat Existing: Phone:`rt36 5.7700 Fax(360)693.4442 New 7:1 -sty' z raw -rr- r "r Business name:Polygon WLH,LLC Structural plan review fee(or deposit): Contact name:Maggie Gordon FLS plan review fee(if applicable): Address:109E 13m Street City/State/ZIP:Vancouver,WA 98660 Total fees due upon application: Phone:(360)695.7700 l Fax::(360)693.4442 Amount reserved E-mail:maggie.gordon@polygonhomes.coma^ �� � � c roof-top mounted Phot Voltaic prescriptive Paninstallation l System.of Business name:Polygon WLH,LLC Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:109 E 13"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.:207247 Total fee due upon application: $201.60`— Authorized signature: t ., This permit application expires if a permit is not obtained within 180 daysafter it has been accepted as complete. Print name:Maggie Gordon Date:12/11/15 *Fee methodology set by Tri-County Building Industry Service Board. 1:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) REcE°Itch Permit. pl11c�: � c x � City of ingtarti tt -h-i _ r« ,ts7-2.4,/e,v(1 >f I3I25SW'BallBlvd.,Tiggard,{lR 97223 MAR 0 9 201 PL $vzew Phonm 503?102439 frac: 503.596.1960 1}nrlBy Related Puraet#: Inspection line. 503.639-4175 r)ats1By_ mus: 1 SeaPoga 7 roe C ITY O 16II et,„..,, is terttat wroro O6oa 7 t C, TtT' Internet-orwir Ogarel drgor `n` Tt i3.(I3 Nt ILD'1N `1 D :, {a jf slfl$Pll N o44 eAastruction 0 Addlciontalteradon/rep)acentent masa,baek an tt msppir(submit 2 sets afpltsrm xra apses e4): 1:3savix'arreeder400wept orsnare QBaildatgover tatoe 1 tms. ❑rkillalition EJ otl,Ior. Wheoe ti a ava flab a Caul;owleat t]Manna e,t4 Eparyards•.. t exceeds 10,000 amps01150 suits or QFtaating1tu ld'enes. _'" .CA tI tY D 4T?1tIS1-' - km1'0 01,114sr14,0071 CICornmetcrat-uuagrkuhural !:4 1-and 2-family dwelling 0 Cotnmerrci lfi ndustrial 0 Accessory bulli ding snips afar nit at}mrinitaltariai3O ti,dleutgs, El iviufh family ❑Master builder 0 Other: 13 wm poatp: 13 installation of Iso 1(VA cr -'' " .145E S-n'tr;174'kcO tMA 1ON AND LOclitiO Om system. isrgerseparatelydedvad __ 1`'1 I3AQditionornaw installvad)r systeat, b#: 7obsiteaddress: `3 Iv-?'" ' z--��J 3 jl ', looHt'orarare. Cl"A^.")'5;'9:2',"13" O Six or more residential:tunics, gacWmacy City/State/VP:ShrooI Olt 97140 Iir . 7u 5uitt/bldgfapt.tX: Prajeetnaitte: [lliazardourlaaatioas" L3pRtyswhagcax1.amrattisut 0 Smite or feeder 600 amps or nurse. 696 vans non'° Cross sheer/d'irections to job she: ME Bt lP. 11 ' iiwoipuoa I ab. 1' Sam I UM, 1 New residential siogIo-or+eattttt-family dwelling fault. Subdivision:River Terrace Lot#i includes attached 1.000 sq.ft erten168.544 Tax rasp/pared d: Ea.0d41,500 al,ft.or/la/ilea an 33.92 I 13e� 6?Eai£:RYPT8O N OP WORE , Limited energy,residential 75.00 /Sin le Paallly (mita�tovasq.lt.) _ g Limited enema multi-tamity, reiidenttoi(With above sq.ft) ?5.00 2 82enewableEtternY 0 SeePooe2 t PROPERTY 13 It I Ei TENANT • Services or feeders tnstnllatiie, teration,antl/ordreloea#ien Name:Polygon Hones 200 amps or less 100.70 3 201 amps tit400 amps 133.56 2 Address:109;E 136 St 401 amps to 600 amps 200.34 2 City/Stale/ZIF:Vancouver Yl/A 94660 601 aline 10 t,000 amps 301.04 3 Pitons:(360)695-770$ Fax ( ) O-veer 1,000 amps et milts 55,226 2 Temporary services or feeders iaslatfntion,alteration,and/or Email relocation I Owsler installation:This installation is being made on property that I own which is not 200 amps or less 59,36 t l intended far sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125,08 2 401 amps to 599 amps 16854 2 °weer signature: Date: ' ' ;i-App-icieiT 1 3 CQNTACT PERSCYaf Brtrichcircuits—new.n[ttta#tra.€trcYttnsion,per panel A.Fee ferrinanch;circnhsnith Business name:Garner Electric Washington,LW aboveserviceorfeeder fee. 7.43 x tads branch circuit Contact name:Bill Daniels B.Fee for branch circuits Ivo/root aerelceOrfeederfee,first l 56.28 2 Address 6101 NE St Jahns Rd hraacltcircuit _ ;: City//State/ZIP:Vancouver WA 98661 Each add9 branch circuit 7.42 2 hifscellaneous(service or Feeder not-included) Phone:(253)320-1657 Fax::(, ) snitmentrfactandocmodular 6784 2 , dtseIlm&sc,:rvlcearnd/or feeder Email:bdanlels@giveusa.rnmgtxt>uructonly 6784 2' Gti1V7 RAt>Ilii# • T wen or in dobe circle 67.84 2 Business name;Gnser Electric Washington,L'LC Sign or°mime lighting 6784 2 Signal cirxatigs)ortimittdenergy C7 SeeFage2 2 Address:6101 NE St Johns Rd patrol,aitrsttlon,or astcnstaat, City/State/ZIP:Vancouver WA 98661 Each additional iwpecllon over nflaty�able in any of the above Additional inspection(1 hr min) 66,25/id Phone:(253)320-1657 Fax:( ) lnvesagation(1 hrmin) 90.00/1ir ?Ilidtaitiel ', Email:bdaniels®gtyeusa.com ruforvdsant(1brmin) ?S.f81hr dean fee is CCB Lie.: CUSS Electrical Lie.:208174 Suprv.Lic.:4496S specifualfy hued(KMuret) 98 O(t+hi ) Supry Electrician signature,required; flif1 Subtotal" Priuttsuaztm:Joan P Albert Date: p'"1!t i k Q Pian Review ReNirat(25%4 ofileniiii fee). State surclearga(}2X ofpumtt fye) Authorized signature: / T()TA1.PECCMIT 1 l.r TLispenult nopficatienesylmairapermittsnee abtainertsVithin tom:. Print name:Bill DanielsTate: dayatter itias Otto arripted as complete. {4 ' Namturoffnspectioaeallovt*:dla`pnnniL 159u'i14aa1Pee6i55:CJmakApp fGtt ESE.dac at,aprOsISt 4404e151(11,49CoM7weo I t 1 i . 1 Plumbingrmit Application Building Fixtures RECEIVED Received Permit No.jl y�'/ fib f#00% ' City of Tigard MAR 0 9 201 Date/$ .14 a 13125 SW Ball Blvd.,Tigard,OR 97223 DatctFi ReviewPlan Other Permit 30.: IA ' Phone: 503.718.2439 Fax: 503.598.1960 d� On, 0 Sec Page 2 for CITY Lir. �1 IQm Li Date Ready/By e e gfor inspection Line. 503.639.4175 a t i S , Naut,edr'Method 1 i i;1 t�17 Internet www•tigard-ar.gov • ;:,,,�,� �'-c �� ��� e i h t . fi •c..,,,,,,'x -f- Furs,ectal in ormatwnri use checklist • New construction ® Demolition Deseri.tion off , Total Other: New 1-2-family dwellin:s(includes 100 each utilit connection) ■ Addition/alteration/replacement312.70 ..fir , x� :. SFR(1)bath a E SFR(2)bath 437.78 11-and 2-family dwelling Commercialkinclustr'ial SFR(3)bath 11' 50032 25.02.1111 Multifamily Each additional bath/kitchen Accessory building fi_ Page 2 II Other: Fire sprinkler(_-,s9- ) al Master builder a 18.76 t : s s a, Catch basin or area drain :... .>,. �� ` L� { 18.76 Job site address: \ Urywett,leach line,or trench drain � Footing drain(no.linear ft.: Page 2 ) Cityl5tatel7.IP:' �iii, � ,, al� • 0 50.03 Project `� $, - Manufactured home utilities Suite/bldg./apt.no>: t' -, i ILL/ ;•r i. � Manholes I8.7b Cross street/directions to job site: Rain drain connector Sanitary sewer(no.linear ft_: ) 11.111 Page18.76 2 Storm sewer(no.linear ft.:___J Water service(no.linear It: ) Page 2 Lot no.: Fixture or item: 3127 Subdivision: Backflawpreventer 111111 12.5 ( Gl no.: , Tax m hart . y s ' 25.02 ' t : t r clothes washer n ) MP , 0� Dishwasher 25.02 ► K- 1111111 25.02 Drinking fountain Ejectors/sump 25.02 _ Y Fxpansian tamr 12.51 Mt Fixturristvrcr cap 25.02 Floor drain/floor sink//hub 25.02 ' Name: P --- `�" I Garbage disposal ® 25.012 Address: 1 25.02 COM ' �LA Ilitir�♦ Hose bib 5 02 ( D l9 t�0 s ,D to to� U Ice maker 11111 Fax: P 11111 25 02 Phone: Inicrceptorte case trap _ • MI s a . . e2 sami Medical gas(value:$ ) Page 12.51 Business name: r•. Tap,i A. o► sa Primer 12.51 Contact name .. G.� Roof drain(commercial) 11111�. � ���'� 25.02 Sink/basin/lavatory Address: Z y Solar units(potable water) =® CStyfState17.1P: ..,,,,,e 'a; ,.v s- Of� ° Tub/shower/shower pan 25:02 Phone:t::11 i ) *0 .� .. F-ma • Y � a !#,_ sg .s/ �. Watercoset MIMI 25.02 ,, a � Watehearer aggi a . _ WaterpipingfDWV 56.29 name: f° .ss :.• t �-+ �_'" ,.-� 25.42 a...:. Other. Address: P 3 D l ?:: Subtotal City/State + Minimum permit:fee: $72.50 Phone:(q71) I- 11 Plan review (25%of permit fee) . : CCB Lie.: sk Plumbing Lic.no I „� State surcharge(12%of permit fee) �.� '`/'t ' �"' TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained within 180 days AM.' ,� Data} c M after it has been accepted as complete,.Idustry Service Board- Print name: y� +n"M.,. '. *Fee methodology set hbyas been Tri-County pig 440-46rb10Q`01?CO ''») Lle itdatKtrcro cs'PL'W-Pentit.App.dac 10/009 Mechanical Permit Ap lication IIIIMIMIIIIIM1411M1M11111lMi City of Tigard NErj Rrerivcd Datemy P'intit Ns' S' ' --000jy II1312$SW 11a11 Blvd.,Tigard,OR 97223 Plait Review other Permit: t r Phone: 503.718.2439 Fax: $03.598.1960 MAR 0 9 2016 DareBY: othe 113 See Page 2 for I 1 c >€,;, inspection Line: 503.639.4175 OF Date Ready/By: I Supplemental to rntati. Internet: www.tigard-ar-gooCITY i Nwifie&Mc#h t: . M *°.,. . Mechanical perrrtit fees'are based on the value of the work . New construction. 0 Additlon/alteratiordreplacement performed.Indicate the value(rounded to the nearest dollar)of alt 0 Other mechanical materials. U, .labor,overhead.and rout 0 Demolition tx.�x. �s„= y. .- ,• ..� �y•� El I-and 2-family .�,.� dwelling 0Commercial/industrial ©Accessorybuilding ( For spedufinformation use checklist 0 Multi-family 0 Master builder 0 Other. Description • 1 Qty. Ea. 1 Total 3 w Heatrngtcoo 2 , . ; ;' sr„ .a,,--, `. ..€ Air cmiditioninrt 46.75 Job site address: '% 1 ✓ svp ? I (� 1 Furnace lt5t}000 BTU td€Cctz}ventsl 46.75 �c� �1 ” - \ J(� 1 3 Furnace 190.gt5I} BTU(duets/vents} $4-91 City/State/ZIP: �V .' V Q� lJ T �/ tient pump 61.06 I I Suiteibldgiapt.1x3.: I Project name:.-Pek L` r c Duet work : 23,32 1 I1;pdrotttic hat water system 23.32 I Cross street/directions to job site: ���.,` ' � ` Residential boiler(radiator or hydropic) 23.32 Unit heaters(fuel-type.not electric). in-wall,in-duet,suspended.etc. " 46.75 Flue/vent for any of above 23.32 Other: 23.32 Subdivision:River Terrace tot no.:l,1 1 - Other fad appliances: Tax map/parcel no.: Water heater 23.32 1 , � �� �` Gas frreplaediosed 3334 -z g e + . .1 ,a ,_ .)- 4T, pine vent for water hearer or gas IIVAC I fir slact 23.3 Lolighter(gas) 23.32 Wood//pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.3/ 23.32 '«t s :t'7, ,r14,�4 A ,� ' ` Environmental exhaust and ventilation: Range haod/otlter kitchen Name;Polygon equipment 33.39 Address:109 E 13`"St Suite 200 Clothes dryer exhaust 33.39 Single-duct exhaust(bathrooms, City/State/ZIP:Vancouver,WA 98660 toilet compartments,utility rooms) 23.32 i Phone 1325} 6-77001:11111111111 ' Attic/erawtspaee fans 23.32 2332 - Q .ho Vit' „. ,-. ` ' other 3 ., k .. Fuel piping;_ Business name:Apes Mr LLC 514.15 for first fuar,34,43 for each additional Contact name:Staci Ray Furnace.etc. Gas heat pump Address:2210 W.Main St.Suite 107-272 Wall/suspended/unit heater City/State/!_1P:Battle Ground,WA 98604 Water heater .. Phone:(360)342-8109 Fax:v.(360)326-1769 Fireplace ape E-mail stare®apex airro.com Barbecue i r r . r Clothes dryer(gas) Other: i Business name:Aix Air LLC ,: `i-,:,-::::.':' r . « 7�,' - SubtotalAddress;220 W.Main St.Suite 107-272 Minimum permit fee(590.00) City/State/ZIP:BattleGround,WA 98604 Plan review(25%ofpe€mit fee) 1 Phone:(360)3424109 Fax:1360)326-1769 State surcharge(12%of permit fee) CCB lie.:203034 AMIIIIIIIIIIIIIIIIIIIIM r - _ _ _ TOTAL PERMIT FEE This prrrait application expires if a permit is not obtained wirhia ISO days after it has been accepted as complete. r Fee mcthodotogy set by Tri-County Building Industry`Service Board Authorized signator . .: 771r --,,v e Date:112812016 i 04m 13 doe 440-41/T 1 t 1:5t 't3ttAt EBt r IIICity of Tigard .1 COMMUNITY DEVELOPMENT DEPARTMENT T I G A R D Building Permit Review — Residential Building Permit #: At 57;.2 e7/6, -- .0 0 9V Site Address: /37c? -- S-7/-0 /f-/--)A4 /1/e Project Name: i0e)/ v.) .2.-- ftz,/ ,&vp„f- `Terroce Lot #: I// (New g= subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: AigeL) SP/C erify site address/suite# exists and active in permits tem. River Terrace Neighborhood: ❑ No gYYes,See River Terrace Review Addendum Attached Site Plan Elements: rp • ee(3)copies of site plan i VIL'A sting structures on site It i e plan must be on 8-1/2"x 11"or 11 x 17"paper 11.'ootprint of new structure(including decks)with finished or 1I P awn to scale(standard architect or engineer scale) fl or elevations Y .rth arrow tility locations (required for new,may apply for additions) ► 7.S'te address,project or subdivision name and lot number i 1 cation of wells/septic systems e7plicant information(name and phone number) 7 rosion control(including drainage-way protection,silt fence dimensions and building setback dimensions sign,location of catch basin,etc.) r of area,building coverage area,percentage of coverage and reet names i pervious area (applicable if R-7,R-12,R-25&R-40) Street tree size,type and location 'rroperty corner elevations (2 foot contour lines if more than g".f sting trees to be retained with drip line,and tree 4 foot differential) protection measures 141) ;lean Water Services—Service Provider Lette (lot platted prior to 9/10/1995): equired: ❑ Yes,applicant was notified I No Received: ❑ Yes ❑ No Public FacilitiX Improvement(PFI) Permit: Required: V Yes,applicant was notified ❑ No Applied For: V147es ❑ No,stop intake V(iLr . and Use Case#: ,b2), .2c —"- e?( )z/ J ��l/A,2z'//&- ,--)6,_19 onin IQ Setbacks: Front /' Rear D Side s Street Side Garage 3 14,// EV/Landscape Requirement: 6267 % gLot Coverage Maximum: 00 Ph3uilding Height: Maximum Height Actual Height VCil tsual Clearance iA/ oasements ensitive Lands: /Yes ❑ No Type LOW--V R // -- / Urban Forestry Plan ❑ Condition "Met"prior to issuance of buil ng permit / Notes: /� //aa 1 u 4 -L�yl�til;c /YI S� ,I .7" �/7cJ/ ✓JLJ�/Civ7Yll 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 1:\Building\Fonns\BldgPermitRvw_RES_012116.docx 1 Building Permit Submittal Original Submittal Date: -3`y//l� Site Plans: # �' Building Plans: # ----J--- Building Permit#: ErEnter building permit#above. Workflow Routing: B Planning 'Engineering Et-Permit Coordinator ®'Building Workflow Sign-off: g--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 riginal plan review routing form. ir Building: original permit application, site plans,building plans, engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: ,�� ` '7s1-e— Date: , /V/f, Engineering Review lope at building pad: „..(Z, ❑ Conditions "Met"prior to issuance of building permit Easements (encroachments)per engineering conditions of approval and plat Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes ❑ No Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No "* LIDA Facility on lot: ❑ Yes ❑ No ❑ NOT Approve a by -ngineering: Date: Notes: , , i _ .Jr r s 1 - s /-itz.7>r' . ejCF —F______ Approved by Engineering: gL 17 Date: , Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit pproved,NOT Released: Date: -3/5 l� 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: p Yes ❑ N/A Parks SDC: 7Yes ❑ N/A ?2 ,0K to Issue Permit - Approved by Permit Coordinator: '* Da� te; 9/6.6/47 1:\Building\Forms\BldgPermitRvw_RES_012116.docx City of Tigard N COMMUNITY DEVELOPMENT DEPARTMENT 4 ■ River Terrace Building Permit Review Addendum TIGARD Building Permit #: A S 7;20/lD i) O 9 J Site Address: /3c7 Sit) / / . -2 Project Name: / . 17 kiPS'�- on:zei �7,7,2ce Lot #: 4/ (New/ ng=subdivision name;Addition or Alteration=last name of owner) Planning Review River Terrace Plan District Design Standards (18.660.070.1): 1.Articulation: a minimum of 1 element per each street-facing facade that has 30-60 ft. of frontage.An additional element required for lots with over 60 ft. of street frontage shall be provided every 30 ft. Balcony w/ access 2 Window Projection Vertical Wall Offset a Gabled dormer Porch min. 5 ft deep ft. deep min. 2ft., 5 ft.wide min. 2 ft.,61ft.wide _ i I 2. Eyes on the street: a minimum of 12% of each street facing façade must include windows or entrance doors. Percentage Shown: Q g 6/„ 3. ntrances:At least one entrance must meet both of the folio 'ng standards: t� Parallel to street,angle no more than 45° from street, Max. 8 ft. setback from longe t street facing wall or open onto porch Entrance opens to a porch: Yes ❑ No IIs,all the following apply: sq.ft. min. ne street facing entry ft.max. roof height above porch 5 ft. depth min. 030%mm. porch roof coverage 4. P etailed Design:All buildings shall include a min. of five—c lie following elements on all street-facing facades: /. overed porch min. 5 ft.wide x 5 ft. deep itecessed entry area min. 5 ft.wide x 2 ft. deep rIall offset min. 16 inches ❑ Dormer min. 4 ft.wide Roof eave min. 12 inch projection ❑ oof offset min. of 2 ft. 101 Roof shingles either tile or wood Gable,hip or gambrel roof design ❑ Roof pitch oriented south min. 500 sq. ft. ❑ orizontal lap siding min. 3-7 ft.wide ❑ Accent siding min. 40% of street facade ICJ Window trim min. 2 1/2"wide by 5/8" deep ❑ Window recess min. 3 inches for all street facing ❑ Bay window min. 5 ft.wide by 2 ft. deep ❑ Balcony min. 5 ft.wide x 3 ft. deep with inside access ❑ Attached garage is 35% or less of street façade 5. Garages and Carports: May face the front or side lot line on a corner lot. Setbacks: N closer to front or side lot line, than longest street-facing wall.efesO f o. If No (Check one): Iity extend up to 5 ft. if there is a covered front porch and garage does not extend beyond the front porch. `lay extend up to 5 ft.where the garage is part of a two-story building and there is a window at the second story above the garage that faces the street with a min. area of 12 sq.ft. Width: (Check one) P2-foot-wide garage door ,p %max. of street facade V4N%max. of street facade with 7 detailed design elements Notes: Approved By Planning: .� -: — Date: StOe l:\Building\Forms\B1dgPennitRvw_RES_RT 012116.docx Plumbing Permit Application,. Building Fixturesi ORuilI( I IS1 0\L1 S`--f' I , 2010 City of Tigard Received /) Date/B 1 Jo- Permit No.AA 5-7", Y spi ■ 13125 SW Hall Blvd-,Tigard,OR 91223 ' Plan R.- �`r G Noy/4r,�9 ll Phone: 503.718.2439 Fax: 5035981960 . OtherPennitNo.: Inspection Line: 503.639.4175 - "`' Dale Dale Ready/Dy: huh. 1 H See Page 2 forn Internet: www.tigard-orgov Notified/Method: Supplemental Information ei New construction 9 Demolition Forspeciol inform nseeheckl& Description 1 Qty. I Ea. I Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY'OF CONSTRUCTION" SFR(1)bath 312.70 ®1-and 2-family dwelling 0 Commercial/mdustrial SFR(2)bath 437.78 Cl Accessory building 0 Multi-family SFR(3)bath I 1 1 500.32 ❑Master builder Each additional bath/kitchen 25.02 Other: Fire sprinkler(____sq.ft.) Page 2 • -JOB SITE INFORMATION AND LOCATION Site utilities: Job site addressj3 C1 fl 1j yi" 11--- /".„ Catch basin or area drain 18.76 City/State/ZIP:Tigard,OR 97224 1 Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: + Project name:Polygon at West River Ter 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 ' 1 Water service(no.linear ft.: ) Page 2 Subdivision:Polygon at West River Terrrace + Lot no.: `4L 1 Fixture or item: Tax map/parcel no.: Backflowpreventer 31.27 DESCRIPTION OF.WORK valve i 12.51 4 p(�]� Clothes washer 25-02 °`r ( 71�/9""//1 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 . el.;PROPERTY OWNER - l 0 TENANT Expansion tank 12.51 Name:ADVL Land Holdings,LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:7600 E Doubletree Ranch Road Garbage disposal 25.02 City/State/ZIP:Scottsdale,AZ 85258 Hose bib 25.02 Phone:(602)694-4031 Fax:( ) Ice maker 12.51 ®-APPLICANT 0 CONTACT PERSON- Interceptor/grease trap 25.02 Business name:William Lyon Homes,Inc Medical gas(value:$ ) Page 2 Contact name:Angela Grajewski Primer 12.51 Roof drain(commercial) I2.51 Address:109 East 13th Street Sink/basin/lavatory 25.02 City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54 Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51 E-mail:Angela.Grajewski@polygonhomes.com Urinal 25.02 - CONTRACTORWater closet 25.02 Water heater 37.52 Business name:Malmedal Enterprises Inc SAaterPip r m W V 56.29 Address:PO Box 207 Other: 25.02 City/State/ZIP:Banks,OR 97106 Subtotal Phone:(503)324-0759 Fax:(503-)324-0580 Minimum permit fee: $72.50 CCB Lic.:102535 'Plumbing Lic.no.:34-276PB Plan review (25%of permit fee) C.-- State surcharge(12%of pennit fee) Authorized signature: TOTAL PERMIT FEE IPrint name:Carolina Malmedal I Date:04/25/2016 i This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board- I:1auildinglPermits%PLMU•PemdtApp.doc 10/01/09 440-4616T(10/O2ICOM/WEn) 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 13757 SW 171 STAVE, SHERWOOD, OR, 97140 Record Type: Residential - Master Permit Inspection Type: 699 Mechanical final Result: PASS Comments: Violation Summary: Inspector Tel: 503.718.2439 Inspection Date: December 20, 2016 at 9:33:39 AM Record ID: MST2016-00094 Inspector: Jeff Grove Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 13757 SW 171 STAVE, SHERWOOD, OR, 97140 Record Type: Residential - Master Permit Inspection Type: 199 Electrical final Result: PASS Comments: Tel: 503.718.2439 Inspection Date: December 22, 2016 at 2:47:04 PM Record ID: MST2016-00094 Inspector: David Young This inspection passed previously, see inspection dated 12/20/16. Violation Summary: Inspector Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 13757 SW 171 STAVE, SHERWOOD, OR, 97140 Record Type: Residential - Master Permit Inspection Type: 299 Final inspection Result: PASS -CofO Comments: Final erosion control approved. Street tree certification received. Moisture content form received. Vapor barrier form received. High efficiency lighting form received. Blower door test report received. Insulation certification checked. C of O left on site with contractor. Violation Summary: Tel: 503.718.2439 Inspection Date: December 23, 2016 at 12:50:44 PM Record ID: MST2016-00094 Inspector: David Young Inspector Contractor