Permit (60) CITY OF TIG/ RD x MASTER PERMIT
111 COMMUNITY DEVELOPMENT Permit#: MST2016 00104
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/03/2016
TIGARD Parcel: 2S 1060003000
Jurisdiction: Tigard
Site address: 13770 SW 172ND AVE
Subdivision: WEST RIVER TERRACE Lot: Multiple
Project: Polygon at West River Terrace, Lot 48
Project Description: New SF. 12/22/2016: 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: 23 Bathrooms: 3 Second: 1049 sf Garage: 437 sf Front: 15 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 1858 sf Value: $210,946.59 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 Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 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: 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
Other: N Other Description:
Ecompasing: Y
BUILDING INFO
Claes 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 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: $30,453.27
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•A- 95 :1-0098 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
AIR
Issued By: 7 Permittee Signature: L'A ,/1/L,F€ 7,7CA/
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.
tilliH CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2016-00104
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/03/2016
Parcel: 251060003000
Jurisdiction: Tigard
Site address: 13770 SW 172ND AVE
Subdivision: WEST RIVER TERRACE Lot: Multiple
Project: Polygon at West River Terrace, Lot 48
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 809 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 23 Bathrooms: 3 Second: 1049 sf Garage: 437 sf Front: 15 Smoke
DwellingUnits: 1 Detectors: Yes
Third: 0 sf Right: 3
Total: 1858 sf Value: $210,946.59 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 Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 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: 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
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 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 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: $30,310.91
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 O ' -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: � -.,1-1----C-- Permittee Signature: ,eA/ ,Z--/e 61,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.
• am:. L-® i Y.,
Building Permit Application LS 3 ISI _ -
6Z:TsittNtir;V• RECEIVED Received j Permit N ..
City of Tigard G Da< r jAcn°
13125 SW Hall Blvd.,Tigard,OR 97223 �`v`�A R 1 e) 2.01 V Plan Review/3) f 'If ether pernµt �� j/fj--��(� /
ilig Date/By: oris: )See Page 2 for
Phone:. 503.718.2439 Fax: 503.598.1960 x!"`' �� DazeReady/BY: j
Inspection Line: 503.639.4175 CiTY OF1p 9 R D No eBY�//� tps;Penta2 f o ination
TIC �i I? Internet: www tigard-0r gov BUILDING DIVISION / f¢Ye� �"l
.
Permit fees*are based on the value of the work performed
❑Demolition Indicate the value(rounded to the nearest dollar)of all
®New construction
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
! T 3 ax work indicated on this application.
s
-7---Eockja:-.5-t
n., Valuation � S �
® 1-and 2-family dwelling C:1Commercial/industrial Number of bedrooms:1
0 Accessory building 0 Multi-family
g Number of bathrooms:
0 Othefloors- �a 9 4
0 Master builder n1 Total number of
ress: �. ,. .�F _ I New dwelling area: square feet
Job site address: 1' :� \��� • �� J/ _ `'' Garage/carport area: 45- - square feet
City/State/ZIP:Sherwood,OR 97140 feet Q
Suite/bldg./apt.no.: l Project name:Polygon at West River Ter
Covered porch area: square49
Deck area: 0 square feet O O 9_
Cross street/directions to job site: feet
Other structure area: f, square
Lot no.: g Permit fees*are based on the value of the work performed.
Subdivision: Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: ,_, , ,,,,, equipment,
o. equipment,materials,labor,overhead,and the profit for the
work indicated on this application
„ Valuation:
New Single Family Detached Construction Existing building area: square feet
New building area: square feet
g m 4 � " '` Number of stories• '
' `-� �--dam� Type of construction:
Name? /41,64V L �L.6/N�
Occupancy groups:
Address:l'OLreet
Existing:
City/Stat
Fax(360)693 4442 NewPhone:
..« '� .� n v ��A ° ����� � ';E°k '� ...-s:, k"�' �-s';..,.._ �� T€ '.�' �' � �y,r�K •,ti- ,A,v n , �,> ,,.aM.,.
Business name:Polygon WLH,LLC Structural plan review fee(or deposit):
Contact name:Maggie Gordon FLS plan review fee(if applicable):
Address:109E 13th Street Total fees due upon application:
City/State/ZIP:Vancouver,WA 98660 Amount received
Fax: :(360)693.4442
Phone:(360)695.7700
���� .�. w ���.'u- tar¢ ct"�ti
x ,. tive installation of
E-mail:maggie.gordon@polygonhomes coin Commercial and residential prescriptive
SK v � i -1-:?'":1- -';' ::.'2:::‘''72--'''-' roof-top mounted Photovoltaic Solar Panel System.
Submit two(2)sets of roof plan with connection details
Business name:Polygon WLH,LLC and fire department access,along with the 2010 Oregon
Address:109 E 13th Street Solar Installation Special Code checklist.
Permit Fee(includes plan review $180.00
City/State/ZIT':Vancouver,WA 98660 and administrative fees):
Phone:(360)695.7700 I Fax:(360)693.4442 $21.60
State surcharge(12%of permit fee):
Total fee due upon application: $201.60—
CCB lir.:207247 pp
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete
Authorized signature: V
I *Fee methodology set by Tri-County Building Inaustn'
Print name:Maggie Gordon
Data:12/11/15 Service Board.
dor 02/24/2011 440-4613T(l1/02/COM/WEB)
I.\Building\Permits\BUP-RESPermitApp. t
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City/We/MP:Sherwood 01197140 . Clitealmearetacitaes. 004'041i64381144144Parks•
CI gitppitili,Itagit fiV11101*Illan I
StliteMdg./OPt.18; Project 114tne: t riSorekoor,W6r6004818$or moro- '0'14'834'",'",°- . t
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CresS Streeddirections to job site:
.0...a..... , i coo I 'am .1, 1-4tes 1
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Netr'reeitlential single.or"couttl;fatutly dat.litig.'tiols. t
Subdivision:River Terrace I . Mika itanbed garage.
• . ii.00tiga7.1 sod_onr41‘ ,I wliotti11368.9542 4
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DE,SakEPTFON OtNoliTC . . Lilliigo inerto,p;700e,t4p4 75,00
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Naw 880.8.1e 8416318Y umilo,aamr4matti_fam-#5, 75.00.
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4Y014ER- - 1 - n:littqAtfr ' stiottt..ereidaii.turktf.....16:,..4.6,1iitakirrei.e.,
11rotigon 404to .00.,,,,-6,1.... too,* 3.
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' - • 261 mnin 11400 0818s 1856 2 i
Address:809 g 1311!$t 401-ainpi otioholps 28234 2
cti013-.P4ZIP:Valfwitret'WA 98660 601 amps to1,004trops 301.04
Phone:(3at)#15,7100 Far( ) tJvr OOSmpaOfVOIIS 553.26 2
Temporary services or lenders installation,alteration,Ind/or 1
•
Email: relocation
1
owner lostagatIon;This instanation is being made on properly that r own orth is not 200 imps or le5s 5256 1
intended forsain,lease,root or exchange,according to ORS 447,449,670,and 701. 201 amps Ia 400 amps 125.08 2
2
, 41 arms 0599 amps . 168,54
Owner siEnatut4: Date: 0m. - . •
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,. : , fl:, Att:1400.1.t' . i '. 'fa cotrrAcr PERs914 ranch cir
A:r-forbonch circuits oith ,
Business name Garner Electric Washington,LLC a Pro swine or Feeder lc& 7.42
2
Contact name;Bill Dattiela II.fieforbraneb cinuttsifirlioltr - %
•
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Address:6101 PIE,SI ethne Rd branch circuit
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CiViStatOZIPl Vancouver WA 98668 rEacb''dd'i 6121141 Gircuit 7.42
- . -, Miscellaneous(serviee. or feeder not included)
Phone:(2.43)320.16$7 Fax,.:( ) . Eatb.moutair:Todotir ,..,a,„
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Email:hdarileis@glyettsmcom . . .
„Reconnect only 67.84 2
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Address:61111 NE S'e.Johnit 1W lsanoValtaation.or extension. 0 Ste 1'446:2 2
•
. ' . . . .Each indditional inspection over allowable in apysor the above
City/State/ZIP:Vaneouver.AYA 98661
' A.44108OkittiVecli40 0 llt lain) 66,7:$11tr
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11,(. El Plan Review Reonited14.3%of permit Ihe):
PontiMnr4 loan P Albert, Date: a ,,,,„
SlafesurclAirgaltrit4 i 4i(itiiiit fee): '
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Mechanical Permit Application
011.111WrilatallININ
II
City of Tigard
13125 SW Hall Blvd.,Tigard,OR 9 7za3RF:..( EIVD
L.. ,, DaReeet.ived
Sy
Pima Rcwew
ka, Phone: 503.718.2439 Fax: 503.598.1960 M AK 1
n.ri 6
Datear
'
Permt.r4a'/V-ST:v2-0/6_1`--00/aX
Other Pena&
.., ,,„,,,1„ lnspection Line: 503.639.4175 Date Ready Isy:
Internet Ions' 01 See Ptge 2 for ,
www.tigard-or.gov
CiTY ,::-. cd1-Pr) NNi6.61.4014od- I Suppkatentit Information
Mechanical permit fees*are based on the VaitIC of the work 1
ISI New construction 0 Addition/alteration/replacement performed,Indicate the value(rounded to the nearest dollar)of all
0 Demolition
0 Other: mechanical materials,equipment.labor.overhead,and profit.
Value-S
,
Et 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building . For*trial htformettiom use dteridist I
0 Multi-family 0 Master builder 0 Other. Description I Qty. I
, Ea. 1 Total
- -,' , ',- ,,, ,ww Ntastle satarcz cartat-vs,amass..:-,2, -,- s:-4.,e,,--'-,y- '.F
I 46.75
Job site address: ‘''. .".+It.) 5,,,t....) \ - I Furnace 100,000 BTU(duets/vents) 46.75
City/State/ZIP: 5—\..c1.4"-\)J-008, 0 R q1-1\-10 iFurnace 10(.000+BTU watts/vents)
1 54.91
61.06
Suite/bldg./apt.no.: Project name: 90k) t.,,,n cx j-- Li4 -)A----1.-- "eat Pump
t1)uct work 2332
Cross street/directions to jab site: n 4-\(,(_p ydranic hot water system
li . 23.32
,
Residential boiler(radiator or
hvdrom13.32
i .
t c) -
' Unit heaters(fuel-type.not electric).
n in-wall,in-duct,suspended.etc. 46.75
Other23.32
Flue/vent for arty of above 2132
Subdivision:River Terrace I Lot no.:q 5 I :
Other fuel*point' aces:
r
Tax map/parcel no.'
. Water heater 23.32
.., flue veto for water heater or gas
I 23.32
' HVAC fireplace
Log lighter(gas) 23.32
Wood/pellet stove 33.39 _
,
Wood fireplace/insert 23.32
Chintnevilinerifluelvent 23.32
,..-, . - ,p,...b,.--o*:,,,,;V,'t-fii/,'it.0-'1—,` ,S-4.:4‘434.(;-; Other..• 2332
Na......, •-t ---0,--,- "", -4It,-'f-,'.1 -4 --- 4,-,, -',"`--"-4-74 ` -" --- '' Enviiroarticatal exhaust and ventilation:
_
Name:Polygon Range hoodiother kitchen
equipment 33.39
Address:109 E 13th St.Suite 200 Clothes dryer exhaust 33.39
Single-duct exhaust(bathrooms,
r4y/State/ZIP:Vancouver,WA.98660
IC , , toilet compartments,utility rooms) 23.32
1 Phone:(425)586-7700 Attic/crawlspace fans23
, ,32
*AV' ''''I * ''II ''' ' '''' gA.0 '' t -14:22Erlie ' 3 -,•,,. .
F el piping: 23.32
Business name:Apes Air LLC514.15 tor first four;54.03 for tact additional
Contact name:Staci Bay Furnace.etc.
GAS heat pump
Address:2210 W.Main St.Suite 107-272
Wall/suspended/unit heater
CitviState/ZIP:Batik Ground,WA 98604 Water heater -4
-
Phone:(360)3424109 Fax: , 360)326-1769
'( Fireplace —
Range
E-mail:stacihrgapesaireo.cont Barbecue
clothes dryer(gas)
---,. ,--P--,, 1,;--,,,,....,e,--40 IA- <s•----, 4.-t... ..iite..1 -1,04.+1.-L 71.*"," ,?'" % -A", AWA,A,At, A .* . , •` . .
Other:
Business name:Apes Air 1,1-C
Address:220W.Main St.Suite 107-272 Sabtood
Mut' introit permit fee(S90.001
City/Site/ZIP:Battle Ground,WA 98604 Plan review(25%of permit fee)
Phone:(360)3424109 Fax:(360)326-1769 State surcharge(12%of penult fee)
t
- - - - TOTAL PERMIT FEE - - --
1 CCB lie.:203034 Ar AiaIIIIIIIIIIIIIIIIIIIIM
ir
itif Or
--.
or This days
prripiti.pplicalifttioneritinthp:sreabeenif aactepperastedit isassa:...bptila within 184)
Authorized signaur * Fee methodology ad by Tri-County Building industry Service Boma
'. 4 tr, yi ill•or .
Print name:Staci hay Date:1/28/2016
I 43.,15 ,PcrraosIMEC_PanutApp,040 I 13 tkx 440-4617T 44 VOI:COMAKEat
Plumbing Permit Applicatio l t� �,i �'
1miammimmaami
Building Fixtures
City of Tigard DateBy
MAR 1 b ?t11 e Received Permit No.W.S;e/b d /0/47
s 13125 SW Hall Blvd.,Tigard,OR 9722,}.d ..-It; r ,, k Pian Review other Permit No.:li
. Phone: 503318.2439 Fax: 503 598 ,,� ,DateBy
l i. ! ? 6 3 Dare Re uiyBy Jur Bl Set Page 2 for
Inspection Line: 503.6394175 1,rl- i_s Su.4.[mental Inrormatton
I i(,A R l) Internet_ www.tigard-or.gov Noatecd'Method ,
'34
. .:.�. a For special information uI se
y-ch]checklist i Total
II New construction ® Demolition Description
0 Addition/alteration/replacement 0 Other: Newt-2-family dwellings(includes 100 ft.for each utility connection)
•< - SFR(1)bath 312.70
it- y tl v ',,, F - 437.78
SFR(2)bath
Mom 1 and 2-family dwelling f'1 Commercial/industrial six(3)baht 500.32
❑Accessory building El multi-family Each additional bath/kitchen 25.p2
El Master builder
0 Other: Fire sprinkler( sq-fl•) Page 2
V,._. _Sue utilities:
-'-' .. .4 "fit x ''f a € `<r Catch basin or area drain 18.76
Job site address: 1 -1 i` \ (i-2-- ` v (J }, ` Urywep leach line,or trench drain 18.7E
City/State/ZIP:' j ( 000 0 "`/1\tel C") Footing drain(no.linear fl_: ) Page 2
Suite/bldg./apt.no.: Project name: cal 1`?} ak \Klerk Manufactured home utilities 50.03
{ Manholes
18.76
Cross street/directions to job site: ^e rY 18.76
Rain drain connector
Sanitary sewer(no.linear fl-:!) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no,linear ft:___) Page 2
Subdivision: I Lot no.:Ck.. g. Fixture or item:
.Backflow preventer 3127
Tax map/parcel no.: - tzbliztt Backwatcr valve 12.51
. ` a t .: , _ <, , D gothes washer 25.02
; ,.� n, .\
nil Dishwasher 25.02
N Drinking fountain 25.02
Ejectors/sump 25.02
Expansion tank
12.51
` s• u e #„ ( t=,,_ 4 r Fixture/sewex cap .
25 02
Name: pD 3 lf\ _{�Vv\._.A.--(} Floor drainJftoor sinkltrttli 25.02
Address: Cl k% /�/ i l ♦ Garbage disposal 25.02
City/State/ZIP: V l $ i / ip 1 Q Q Hose bib 25.02
'^i.. Ice maker 12.51
Phone:(j Q - (+0 Fax: , W. -.`'1 1 _.
lntcrceptor;b case trap 25.02
,‘,';',:',5=4'...,4,"',i04440",„„1; • ;.. �. . r -. `, .. Medical gas(value:$ ) Page 2
Business name: f f 4 Y't F} IL T1r\NI r‘i t'._ Primer 1251
Contact name: NI 0vil VA.,, r i _..,v-tYst Roof drain(commercial) 12.51
Address: li.. t Sink/basin/lavatory 25.02
62.54
Solar units(potable water)
City/State/Z1P: �-�y <; "1 Sit � ' - 12.51
Tub/shower/shower pan
Phone:(i l j ) '" 1:‘(43-1 Fax::( ) Urinal 25.02
E-mail: 1<, rl► A Ce..:hi f't it.0 0 s :5r.'":::›.4_ Water closet 25.02
c �ro� Water heater 37.52
"
� t�` water ptpingfDWV 56.29
Business name: k. 1/._i'y,":4,.-i'1 P(to.1 y'ltr-ni t . l ._
.t-.7_,) Other: 25.02
Address: ?DI. 13-7zSubtotal
City/Statc/ZIP:j- .y-Ct' t-{v"") Minimum permit fee` $72.50
Phone:(911) I-t 71 Fax:( ) - Plan review (25%of permit fee)
°
CCB Lie.: ID 4 Plumbing Lie.no f State surcharge 12/0 of permit fee)
. TOTAL PERMIT FEE
Authorized signature: -
I This permit application expires if a permit h not ohtsiaed+vttAin t88 days
I Print name: 1\110 a+ti 4, "u c„ ' '-..11,, I Da ///r' }
ttE atter it has been accepted as complete
'Fee methodology set by Tri-County Building Industry•Service Board-
Bi,Didiner imirs\PLMiU-PcYnitApp.duc,1U.10,009444-46[6TtitIJP<scoM.twen)
I:1
City of Tigard
1111 I
r COMMUNITY DEVELOPMENT DEPARTMENT
T I G n R D Building Permit Review — Residential
Building Permit #: /75 j , -- 00/17 X
Site Address: /3- 9--() sa) / ,id , ve..
Project Name: ��� >;r, �,7" � _ a'i/. r �t�r<;� Lot #: �e
(New g= subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: AJet) .S A?
erify site address/suite#exists and active in permits tem.
River Terrace Neighborhood: El No g Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
rp . ee(3)copies of site plan *'..'llisting structures on site
It, i e plan must be on 8-1/2"x 11"or 11 x 17"paper Ii.'ootprint of new structure(including decks)with finished
lV . awn to scale(standard architect or engineer scale) fl or elevations
,I. :rth arrowtility locations(required for new,may apply for additions)
P S.te address,project or subdivision name and lot number cation of wells/septic systems
Vplicant information(name and phone number) 1 rosion control(including drainage-way protection,silt fence
dimensions and building setback dimensions sign,location of catch basin,etc.)
Pet
area,building coverage area,percentage of coverage and 'reet names
i pervious area (applicable if R-7,R-12,R-25&R-40) reet tree size,type and location
roperty corner elevations(2 foot contour lines if more than IJstingtrees to be retained with drip line,and tree
4 foot differential) protection measures
OAlean Water Services—Service Provider Lette (lot platted prior to 9/10/1995):
equired: Yes,applicant was notified I No Received: Yes No
PCI
Faciliti Improvement(PFI) Permit:
Required: V Yes,applicant was notified ❑ No Applied For: Oyes E No,stop intake
Vl4and Use Case#: PA ie (2l `� / SetiA .6)/S- /19(19((?
oning:Sa�
r� � > //
etbacks: Front /'• Rear V Side ' Street Side 3 Garage 3 /j
Viandscape Requirement: 6267 %
IV of Coverage Maximum: 3(7
../.
iilding Height: Maximum Height Actual Height
Visual Clearance
Vasements
ensitive Lands: /Yes ❑ No Type Lok-vdke A24114-
v
Urban Forestry Plan
❑ Conditions "Met",aaprior to issuance of buil ng permit / � , l
Notes: L.-G�Ylsti'15c„2R IYIL{sr�- tea" ✓,C)l h 6zt,Yc ` 4 ii—M171-
Approved By Planning: -.....-- zyi y Date: , Mr
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\B1dgPennitRvw_RES_012116.docx
f'
Building Permit Submittal
Original Submittal Date: 2/4(//,E:
Site Plans: # 3
Building Plans: #
Building Permit#: 4 Enter building permit#above.
Workflow Routing: D- Planning u-Engineering [-Permit Coordinator [- ilding
Workflow Sign-off: ®' Sign-off for Planning(include notes from planning review)
Route Application Documents: et-Engineering: (1) copy of permit application,(1) site plan, (1) building plan and
original plan review routing form.
-uilding: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: ,1% 4, . - Date: _ SA6,
Engineering Review
l'iMSlope at building pad:
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
El NOT Approved bb Engineering: Date:
Notes: Gpl,�/`�'Jpie-' #1-M61' vt>i ,7e,r" 4 /
Approved by Engineering: f/Z Di Date: J?ls'1.4
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El 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: 67,------;ate: -x-,--A,
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:
?tYSDC Fees Entered: Wash Co Trans Dev Tax: MI es ❑ N/A
Tigard Trans SDC: ►:'Yes ❑ N/A
Parks SDC: Ii Yes ❑ N/A
) i!:)K to Issue Permit
Approved by Permit Coordinator: Date: 7��ZG/l(
1:\Building\Forms\BldgPennitRvw_RES_O 12116.docx
MINCity of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
T 1 G A R D River Terrace Building Permit Review Addendum
Building Permit #: S. 0/e . 00 /O
Site Address: /3 %.5 0 0+1 /9V-i2
Project Name: AD !" 77 �Q ,vii- `7a-k,gLot #: �e
(New dwsubdivision 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.
Porch min. 5 ft. deep Balcony w/ access 2 Window Projection Vertical Wall Offset a
W ft. deep min. 2ft., 5 ft.wide
CI min. 2 ft., 6ft.wide Gabled dormer
El min.
❑
2. Eyes on the street: a minimum of 12% of each street facing facade must include windows or entrance doors.
Percentage Shown: ��j 49 /c
3. Erances:At least one entrance must meet both of the folio ' g standards:
Ivet
ax. 8 ft. setback from longe t street- facingwall Parallel to street, angle no more than 45° from street,
or open onto porch
Entrance opens to a porch: Yes ❑ No
If y , all the following apply:
I
sq.ft. min.
,�%� e street facing entry ft. max. roof height above porch
g
r,J'S ft. depth min. 30%min.porch roof coverage
4. etailed Design:All buildings shall include a min. of five of the following elements on all street-facing facades:
overed porch min. 5 ft.wide x 5 ft. deep1:2?"
CIecessed entry area min. 5 ft. wide x 2 ft. deep
all offset min. 16 inches rmer min. 4 ft.wide
Roof eave min. 12 inch projection ' .of offset min. of 2 ft.
❑ Roof shingles either tile or wood 7 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 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 facade
5. Garages and Carports:May face the front or side lot line on a corner lot.
Setbacks:
No closer to front or side lot line, than longest street-facing wall.MIAs If No (Check one):
Id hfay extend up to 5 ft. if there is a covered front porch and garage does not extend beyond the front porch.
0y 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)
Ici)t
foot wide garage door �li ‘ii'/o max. of street facade
A max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: — _ 'i Date: 45/
7(0_____
1:\Building\Forms\BldgPernitRvw RES RT 012116.docx
Plumbing Permit Application
Building Fixtures 1(JR Orllt r 1 ;1 ()NI
City of Tigard (. Received
�� (_ i J
Date/BY: w/'-llf&t Permit Na
111 ■ 13125 SW Hall Blvd.,Tigard,OR 9722J`" ��/�f/[�i`t�l
• Phone: 503.718.243960 Fax: 503:5981 - Plan Review
9 Datergy_ Other Permit No.:
i i \tin Inspection Line: 503.639.4175 Date Ready/By: iwis: 21 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
. , . - TYPE-OF WORK .-..... . : .:„_. :. FM SCHED ...A,:,
®New construction 0 Demolition For special information use checklist
Description I 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
®I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
❑Master builderEach additional bath/kitchen 25.02
0 Other Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION'ANND LOCATION Site utilities:
Job site address: 13110 SVJ i r11G-0( L Catch basin or area drain I8.76
City/State/ZIP:Tigard,OR 97224 Drywall,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldglapt.no.: I 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
Water service(no.linear ft.: ) Page 2
Subdivision:Polygon at West River Tern-ace I Lot no.:48 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF.WORK Backwater valve 12.51
� ®�
]g Clothes washer 25.02
C/'''° °] a/ '"r (1 �e Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
El PROPERTY OWNER I 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
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 Fax::(360)693-4442 Tub/shower/shower pan 12.51
E-mail:Angela.Grajewski@polygonhomes.com Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name:Malmedal Enterprises Inc. Water piping/DWV 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
Plan review (25%of permit fee)
CCB Lie.:102535 Plumbing Lic.no.:34-276PB
C State surcharge(12%of permit 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
I after it has been accepted as complete.
.Fee methodology set by Tri-County Building Industry Service Board.
I:\BuildingiPetmits\PLMU•PennitApp.doe 10/01/09 440-4616T(I 0/02/COM/WEB)
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
13770 SW 172ND AVE, SHERWOOD, OR, 97140
Record Type:
Residential - Master Permit
Inspection Type:
299 Final inspection
Result:
FA I L
Comments:
Tel: 503.718.2439
Inspection Date:
December 22, 2016 at 2:35:57
PM
Record ID:
MST2016-00104
Inspector:
David Young
Provide permit and inspections for AC installed without permit.
No inspection done at this time.
Violation Summary:
Inspector Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
13770 SW 172ND AVE, SHERWOOD, OR, 97140
Record Type:
Residential - Master Permit
Inspection Type:
199 Electrical final
Result:
PASS
Comments:
Correction complete, AC added to permit.
Violation Summary:
Tel: 503.718.2439
Inspection Date:
December 23, 2016 at
12:59:15 PM
Record ID:
MST2016-00104
Inspector:
David Young
Inspector Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
13770 SW 172ND AVE, SHERWOOD, OR, 97140
Record Type:
Residential - Master Permit
Inspection Type:
699 Mechanical final
Result:
PASS
Comments:
Correction complete, AC added to permit.
Violation Summary:
Tel: 503.718.2439
Inspection Date:
December 23, 2016 at 1:00:16
PM
Record ID:
MST2016-00104
Inspector:
David Young
Inspector Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
13770 SW 172ND AVE, SHERWOOD, OR, 97140
Record Type:
Residential - Master Permit
Inspection Type:
299 Final inspection
Result:
PASS -CofO
Comments:
Correction complete, AC added to permit.
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 1:02:34
PM
Record ID:
MST2016-00104
Inspector:
David Young
Inspector Contractor