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Permit CITY OF TIGARD `111/1 ' . ' . MASTER PERMIT • COMMUNITY DEVELOPMENT r. Permit#: MST2016-00248 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/15/2016 Parcel: 2S106DC03500 Jurisdiction: Tigard Site address: 13725 SW SILENT FOX TER Subdivision: POLYGON AT WEST RIVER TERRACE Lot: 35 Project: Polygon at West River Terrace, Lot 35 Project Description: New SFA. Building/unit 4.2. 1/3/2017: REPRINT permit to correct plumbing fixture count(1 hose bib). 3/16/2017: REPRINT permit to add A/C. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 2 First: 249 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 35 Bathrooms: 3 Second: 562 sf Garage: 294 sf Front: 12 Smoke Yes Dwelling Units: 1 Third: 560 sf Right: 0 Detectors: Total: 1371 sf Value: $170,692.71 Rear: 10 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 0 Drywell-Trench Drain: 0 Other Fixtures: 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: 1 201-400 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-noa.. oEcompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SFA VB R-3 1371 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: $22,732.83 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 OA 952-0. 0190. Y.0 may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. t Issued By: 4 (e�ll '* - Permittee Signature: OPV 67-7957 -6../64',9-7-7a4/1 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 Applicatiop 1R.0 01:11( i:I. ,1:()N1.1 -11, .'- r') - :', - • arr Ili City of Tigard -.--, /6 /7 ..0;- • lk.n.0,94157;2e/ --PP,.?9:1" • , -, • 13125 SW Hall Blvd..Tigard.M Plan Review 97223 , ,,- Phone: 503 718.2439 Fax: 503.598.1960i,IAk., ..1H3 zulf Onieilly Daleffly: Oilies Perri-in. _ . , I., inSpectionl.ine: 503.639A175 Date iteadyff3y ' -' icrw fa See Pao 2 for Internet; www.tig.ard-or.gov i • : . , 'r ' . :''. \ Notified/Method: Supplemental information , - iih'22"' ''fatigiAltitif -•velafet'' ''''',1 ,,,,,.i,,,..,:xit...?,5,,,mitimitiv.:,,,tgiwit,,,,A,..,..,44:00,,yr.mpicArArgs.„amKw!..e,v,,ro..lst-,Trio,se noototi.00,-.10., ,,,. ...„„.. ...,., .4„,....„.•.: . ,,,.1.4„...el.4,,,"=.,....tro.tow..,..,,,,,,,,,,,,,,,,t....„4„..v„,„,t,"..*,,,,,...,. ,..;......„,„0.3.„..ww.,..m.sim., ,.,,e0,,,,,,,,A„ma - , . ..„_ -„_,,, . .• - •..... ., . • ., , lvtechamcal permit fees*are based ort the value of the work El New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all CI Demolition 0 Other: mechanical materials,equipment.labor.overhead,and profit. Value:$ I0 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special informaien use checklist. XMulti-family 0 Master builder 0 Other: Description I Qty. I Ea. Total :•:?::.`,..?.;fkg:4_, War:100iptfiligtgOitiiii.s.inkitakifiiiiitigiit,04,114#204Vgagand) iltatinRit"ling" :,•,,,,•4::.k•,•,KeAlm-424•MV44'.,,'0,1 ,r,, 'x ,,,..4;+7.,yrirt,E,,,,',7474,,,-,317.7127,V1, •,,x‘e, ., ,., W.,..;.v. ,gg'p, A'A,F6,,.ti , t„ ,V..1,14 Air conditioning ii,, 46.75 Job she address: / 312s so/ 51 kinf Ei,y, ktrcas.t. Furnace 100,000 BTU tducisovents) 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100.000+BTU tdoctovents) 54.91 Suite/Ndgfarn.no.:LIi L 1 teat pump Project namloVije °kit 11\k3-1-f24\jeasirattlxio work 61.06 23.3) Cross strcettilirections to job site: Ilvdronie hot water s-vstem 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-typo,not electric). in-wall,in-duct,suspended,etc. 46.75 Flue/vent for an'of above .., 23.32 Other: Subdivisionyot i_44e(17e,trate j Lot no. "" Other fuel appliances: 23.32 Tax map/parcel no.. Water heater 23.32 '4,','1'..,,Vi;„117';„;',141IttriW,:,',"".''.:"1„7"; 1'..'Iraltitairitgitrailfailing.”. ,..Gas fireplace/insert 33..19 healer or gas 0. fic fireplace , 23.32 Nt 4W-I-16111 . . . . Log lighter(gas) 23.32 . Wood/pellet stove ' . Wood fireplac,c/insen 23.32 Chimney/liner/flue/vent 23.32 iegVilitv..'''77":4'''''';':*'Vilfititiret?titaia140.404%ti-:~WA.'ilVittr4t. °Iller: 23.32 1,:.*,e06. .,.,.... ....,,w' 1.k't 4,.' '...,4,' ' .,4.:444t, •.r...,... 07,6IZ'UN 4.ifii 4 1VT.S.,,•14 4?: 7. --. fVittregg tbr:h .•4., ',.. Environmental exhaust and ventilation: Name:Polygon Wilt LIC Range hood/other kitchen equipment - 33.39 Address..109 East 13*Street Clothes dryer exhaust 33.39 City/State/ZIP:Vancouver,WA 98660 Single-duct exhaust(bathrooms. toilet compartments.utility moms) 23,32 Phone:(360)695-7700 Fax:( ) Attiderawlspace fans 23.32 -_ _ _ __ ':,!•:i51,4'r'`i•tr."..‘t!_'':, i '": : ‘.. '"- ''''''''''',.1..!''''"!'1'"•"''''''"-.'111 :"-V"4`'''.'1,iC":"'.':-; 41''7 '''',.t'll4r11' Other' _ _ __ __ 211.7. Fuel piping: Business name:Polygon WL,H.LIC 514.15 for first four:54.03 for each additional Contact name:tit chokmoviit Furnace,etc. \ Address:109 East 13th Street Gas heat pump Wall/suspended/unit heater City:State/DP!Vancouver,WA 98660 Water heater Phone:(360)695-7700 I Fax::(360)693-4442 Fireplace 'tow E-rnail: \...#2:0‘e,i,..,. 1,1) 1 . (it ._ oljrninery)( „coy) Barbecue 4a}r.:•'-'•"Ni ' 4.,,,,,,AR:::::14,--70,-,..,zp---0 ,, '''ea •:'''r''''' .:!..tV4)40:'iailr.ig440:WA..i&Ci, Clothes dryer(gas) 4...--iit..: ''i.'-''4-4' ; -,i'... .',---•",..,,i-'...i.' „;.,...., 1 4,,,k,,,,,t ' ' •,,,,a. Ant.3,g; • gfAPV44.%"44.Z,V7.40ahe, - Other: Business name;Apex Air LLC Vanlafiellt******1 Sit:Mggi'.;.45,:=4,:'-,ig,„ Address: 18004 NE 72°4 Ave Subtotal City/State/ZIP:Vancouver,WA 98686 Minimum permit fee(590.00) Plan review(25%of permit fee) Phone:(360)342-8109 Fax:(360)326-1769 State surcharge(12%of permit lee) CCB lie.:203034 TOTAL.PERMIT FEE This perm's application expires if a permit is not obtained within 180 days after it bas been accepted as complete. _ Authorized signature: • Fee methodology set by Tri-County Building Industry Ser.ice floard Print namer-17;Z / Date: 4.fl./to. i InuildiReramiloac,Penminp9..40)11)11.3c 4.th-4rit TT(31 1111I - .t CITY OF TIGARD lCOMMUNITY DEVELOPMENT . '' � j, MASTER PERMIT Permit*: MST2016-00248 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/15/2016 Parcel: 2S106DC03500 Site address: 13725 SW SILENT FOX TER Jurisdiction: Tigard Subdivision: POLYGON AT WEST RIVER TERRACE Lot: 35 Project: Polygon at West River Terrace, Lot 35 Project Description: New SFA. Building/unit 4.2. 1/3/2017: REPRINT permit to correct plumbing fixture count(1 hose bib). BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 2 First: 249 sf Basement: 0 sf Left 0 Height: 35 Bathrooms: 3 Parking Spaces: 0 Second: 562 sf Garage: 294 sf Front: 12 Smoke Dwelling Units: 1 Third: 560 sf Yes Right: 0 Detectors: Total: 1371 sf Value: $170,692.71 Rear: 10 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 LaundryTrays: 0 Y Rain Drain: 1 Urinals: 0 Lavatories: 3 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: Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Catch Basins: 0 Hose Bib: 1 Backwater Value: 0 Drywall-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: 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 P W/Svc or Fdr: 0 Ea add'I 500 sf: 1 201-400 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: Y Ecompasing: BUILDING INFO Class of Work: Type of Use: NEW Type of Constr: Occupancy Group: Square Feet: SFA VB R-3 1371 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: $22,635.47 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 througF(d�A- -001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. .„--/` -.4 Issued By: / ‹.17—e—_—__. Permittee Signature: C,Af /31;4'4_,i C' /7O Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project Approved plans are required on the job site at the time of each inspection. Water Meter Fixture Unit Worksheet `/ Please complete the following information: Contractor Name: Billing Address: Phone Number: New Meter Address: 3PleaSubdivision Name: Lot#: ,3\c- Please se fill in the number of each fixture as detailed on the plans. Multiply the quantity by the point value to arrive at the point total. Add all point totals together for total fixture unit points. Fixture Unit Quantity Point Value Point Total Bar sink x 1 = Bidet x 1 = Clothes washer x 4 = 1.}. Dishwasher I x 1.5 = i .s— Hose SHose bib 1 x 2.5 = ,s- Hose bib, each additional x 1 = Kitchen sink ) x 1.5 = j .3- Laundry sink x 1.5 = Lavatory .. x 1 = 3 Water closet, 1.6 GPF 3 x 2.5 = 7.$ Bathtub/whirlpool x 4 = Shower stall 1 x 2 = a Bath/shower combo i x 4 = 14 Irrigation(#of heads in largest zone) x 1 = Total Fixture Unit Points: ; 6 Fixture Unit Points: Up to 30= 5/8" Over 37 = 1" Up to 37=3/4" Meter Size: Meter Cost: $ ************************************************************************************* FOR OFFICE USE ONLY Fixture Units Points verified with Building(Master)Permit or Plumbing Permit: ❑ Yes ❑ No ❑ Other: Meter#: Receipt#: Employee Name: I:\Building\Forms\WaterMeters 070116.docx IN CITY OF TIGARD MASTER PERMIT �, COMMUNITY DEVELOPMENT Permit MST2016-0 0248 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/15/2016 Parcel: 2S106DC03500 Jurisdiction: Tigard Site address: 13725 SW SILENT FOX TER Subdivision: POLYGON AT WEST RIVER TERRACE Lot: 35 Project: Polygon at West River Terrace, Lot 35 Project Description: New SFA. Building/unit 4.2 BUILDING Floor Areas Required Setbacks Required Stones: 3 Bedrooms: 2 First: 249 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 35 Bathrooms: 3 Second: 562 sf Garage: 294 sf Front 12 Smoke Dwelling Units: 1 Third: 560 sf Right: 0 Detectors: Yes Total: 1371 sf Value: $170,692.71 Rear: 10 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 3 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: 0 Catch Basins: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 0 Bckflw Prevntr: 0 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: 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: 1 201-400 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 SFA VB R-3 1371 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: $22,408.94 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: /(..� ,/ L� Gif+r" _.. Permittee Signature: �iV �7' ��./�9-770 rV 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 Le I=OR OH ICL. l Sl 0\1.1 ' City of Tigard RE NED Received j ' Permit N9 jST /6-.6260?y� II 13125 SW Hall Blvd.,Tigard,OR 97223 1 C Date/By: esw' �- i Phone: 503.718.2439 Fax 503.598.1960 U N 01. 2 016 DaneBy: `t 11 I a)l 1 Other Permii k �6 190 Q �, Inspection Line: 503.639.4175 t� Date Ready/By: �j Juris: H See Page 2 for Internet: www.tigard-or.gov CITY OF TK3ARD Notified/Method:Q// Supplemental Information f 4 t£� P. ®New construction ❑Demolition Permit fees*are based on the value of the work performed. ❑Addition/alteration/replacement ❑Other: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the �� e s s, work indicated on this application. ® 1-and 2-family dwelling 0 Commercial mdustrial Valuation: -110681742 ) 69 ❑Accessory building ❑Multi-family Number of bedrooms: 2 ❑Master builder ❑Other Number of bathrooms: ,t t;--4;77.7-7=T1 Total number of floors: 3 I Job site address: 13/L5 SW Silent Fox Terrace New dwelling area: 1371 square feet City/State/ZIP:Tigard,OR 97224 Garage/carport area: 294 square feetS 0 Suite/bldgiapt.no.: I Project name:Polygon at West River Ter Covered porch area: ) ) square feet S( Cross street/directions to job site: Deck area: 1 72 square feet , .) C. Other structure 7Zl�ic 4 area: E3 uare feet • Subdivision:Polygon at West River Terrace I Lot no.: 35 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 equipment,materials,labor,overhead,and the profit for the r : t work indicated on this application. I (?)U) tit I Z Valuation: $ Existing building area: square feet New building area: square feet 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 WLH,LLC 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 I Fax::( ) E-mail:Angela.Grajewski@polygonhomes.com Commercial and residential prescriptive installation of � 'a ;. R h° _ �_�� „ roof-top mounted Photovoltaic Solar Panel System. Business name:William Lyon Homes,Inc 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.:207247 93Itaizse,w3Total fee due upon application: $201.60 Authorized signature: This permit application ezpires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Angela Grajewski Date:5/20/16 *Fee methodology set by Tri County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Application FOR()UHT. 1'SF'0\1.1 City of Tigard Received 13125 SW Hall Blvd.,Tigard,OR 9 �� DateBy: Permit No. s^Ti,./..�0 v, Phone: 503.718.2439 Fax: 503 i i, 9 Plan Review �+�L� GJ I 1 j;,�R I, Inspection Line: 503.639.4175 I�' 1 Date'By: Other Permit: Internet: %ww.tigard-or.gov J U I y 0 2016 nate Re aay Bit'X !aril I �See Paget for ?dotifed vieilutd: Supplemental information 1 TYPE OF v OFT( Af I r) �� , tt I j�°4(- N. a MMERCLAL FEE* SCHEDULE —USF,CHECKLIST ®New construction 0 Additi alteration/replaeement Mechanical permit fees*are based on the value of the work❑Demolition performed.Indicate the value(rounded to the nearest dollar)of all t ❑Other: mechanical materials,equipment labor,overhead,and profit. 1 CATEGORY OF CONSTRUCTION Value:$ ® 1-and 2-family dwelling 0 Commercial/industrial RESIDENTIAL EQLTPMENT/SYSfEMSFEES* 0 Accessory building Fors dat De information use checklist ❑Multi-family 0 Master builder 0 Other. Description 1 Qty. 1 Ea. ( Total I .OB SITE INFORMATION AND LOCATION Heating/cooling: Job site address: 137 SW s' �� Air conditioning 46.75 1 1 TOK ,.e ('r4C,._ Furnace 100,000 BTU(ducts'vents) 1 46.75 City/State/2IP.Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.`no.: I Project name:Polygon at West River Ter Heat pump 61.06 Duct work 23 Cross street/directions to job site: 32 Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall.in-duct,suspended,etc. 46.75 • Flue/vent for any of above f 23.32 Subdivision:Polygon at West River Terrrace J Lot no.: 35 Other: 123.32 Tax map/parcel no.: Other fuel appliances: Water heater 23.32 1 DESCRIPTION OF WORK. Gas fireplace/insert 33.39 Complete rough of HVAC Flue vent for water heater or gas fireplace 1 23.32 g)Cti) t41 4.1-t in 1 -1 Log lighter(gas) 23.32 u``\J Wood/pellet stove . 33.39 _ Wood fireplace/insert = ; 23.32 Chimney/liner/flue/vent j 23.32 la PLOPERTY OWNER 1 0 TENANT Other:Range i J 23.32 Name:ADVL Land Holdings,LLCEnvironmental exhaust and ventilation: Range hood/other kitchen Address:7600Doubletree Ranch Road equipment i 33.39 E City/State/ZIP:Scottsdale,AL 85258 Clothes dryer exhaust 1 33.39 Single-duct exhaust(bathrooms, Phone:(602)694-4031 toilet compartments,utility rooms) 3 23.32 Fax:( ) Attic/crawlapace fans -, APPLICANT23.32 3.32 ❑ CONTACT PERSON Other: Business name:William Lyon Homes,Inc. Fuel piping: Contact name:Angela Grajewski $14.15 for first four,$4.03 for each additional Furnace,etc. Address;109 East 13th Street Gas heat pump City/State/ZIP:Vancouver,WA 98660 Wall/suspended/unit bcater I Water heater Phone:(360)695-7700 I Fax::(360)693-4442 Fireplace E-mail:Angela.Grajewskir4olygonhomes-corn Range Barbecue ICONTRACTOR Clothes dryer(gas) Business name:Andersen Heating,Inc Other: Address:16285 SW 85th Ave ste 410 MECHANICAL PERMIT FEES* City/State/ZIP:Tigard,OR 97224 Subtotal Minimum permit fee($90.00) Phone:(503)992-6664 1 Fax:(503)536-6615 Pian review(25%of permit fee) CCB lic.:I68214 State surcharge(12%of permit fee) 1 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within ISO Authorized signal days after it has been accepted as complete. iii Fee methodology set by Tri-County Building Industry Service Board I Print name; 1 Date:05/23/2016 I:\BuiidingIPem»ts,MEC PerrnitApp_040113 doe 446-46577-(II V2tCUM VEa) Electrical Permit Applicata , ,it,: (), 111I i °,11)\11 13i5 of Tigard v, Pann>t0:t�ISi�G►/6 0002y i 13h225 SW Hail Blvd.,Tigard,OR 97223J U N 01 2016 Phone: 503.7182439 Fax: 503.598.1960 Inspection Lime: 503.639A 175 CITY OF TARP— Rdy! = See Pape 2 ter Internet www.tiprd-or,gov B1 1 : . Notified/Method; s ppla.stai i.i nachos leo New construction _ .. 0 Addition/alteration/replacement Pts d*d it ttrac,�iwlamn 2 eats, p i w ms che�4 13 Demolition ❑Other: ©Service o feeder 400 amps or more auditing over mace stories. where me available fault current ❑Manna read boatyard+. „.,.... ,Am _r;.. m . ° -x,°,,,:=727:::•,,p cowls 10,000 amps at 150 volts a ❑Floating buildings. tg 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to pound,or exceeds 14,000 0 commercial-use a leu twat ❑Multi-family 0 Master builder ❑Other: amps for . other tatlatians. Fire pampa ❑installation of 150 KVA or r'-^7-, ,..:; .. . ”, "`'. '-a 7:1:7'77:�� - rr0-,Emergmcy*van- 1 y dewed +µ ,ter , O Addition 0f new motor load of Job 0: lab site address; 100f1P err mac. O"A','E: 1-2;`1 3 City/State/ZIP:Tigard,OR 97224 J circ or more residential units. y- ❑Nedmcare facilities. 0 Recreational ureide purls. Suite/bldg./apt.0 Project name:Polygon at West River Ter ©l Hazardous locations. 0�aka a more than ❑ rvice Seor feeder 600 amps or more Cross street/directions to job site: tNerr+.ds. Qts. tai Tettl New residential single-or maul-family dwelling visit. Subdivision:Polygon at West River Terrrate Lot 0: Includes attached garage. Tax map/parcel# 1,000 sq.R.arks I 168.54 111,054 4 . :, ~, .a, ,£ , °` , c' Ea.add,500 sq.R.or portion 33.921 10 �j ] 33��. r 1 `k,n It Limited energy,residetroat 75.00 2 J (with above sq.R) Limited energy,multi-family 75.00 2 . ._ m re idential(with above sq ii) Name:ADPL Land Holdings,LLC Renewable Energy 0 See Page 2 Address:7600 E Doubletree Ranch Road Services or feeders installation,alteration,and/or relocation City/State/ZIP:Scottsdale,AZ 85258 200 imps or 100.70 2 Phone:(602)694-4031 ( Fax:( ) 201 amps to 400 amps 133.56 2 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 301.04 2 intended for sale,lease,rent,or exchange,according.to ORS 447,449,670,and 701. Over 1,000 amps or volts 552.26 2 Owner signature: Date: Temporary services or feeders installation,alteration,and/or ,.' .�: ' :',,.. .,'_?..;, � --' .. ' „: .°. ..a ' `-',..:":".t.:..'..!-;:..1:,'„,- relocation Business name:William Lyon Homes,Inc. 200 amps or less 59.36 1 Contact name:Angela Grajewski 201 amps to 400 amps 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,ter panel Phone:(360)695-7700 I Fax::(360)693-4442 A.Fee for branch circuits with above service or feeder fee, 7.42 2 Email:Angela.Grajewskl@polygonhomes.com each branch circuit , . w B.Fee for bunch circuits wirhot x ,... ., .-.1'.:,..........' .. .„.. =victor feeder fee,fust 56.18 2 Business name:*lamed*electric 'branch circuit Address:3415 ne 44th Each add”branch circuit 7.42 2 Miscellaneous(service or feeder not included) City/State/ZIP:Mt R' Ia4.,,,C J,/Z /47 7 07-/3 Each manufactured or modular. 67:84 2 Phone:(503)3192192 Fax:( ) dwelling,servicearaLor feeder Reconnect only 67.84 2: Email:solarpdz@me.cotn Pump or irrigation circle 67.84 ' 2'' CCB Lie.: 199188 Electrical Lic.: c923 Suprv.Lic.: /f71$ Stip[v.Electrician signature,required: Sign or outline lighting 67.84 2 Signal alteration,or limited-energy cunei ❑See Page 2 Print nae: k,k /2e 1 Date: S%3/7.1 t' ; Each additional iaspeetion over allowable In save tie above Authorized signature: Additional inspection(1 hr min) ' 66.25/hr Prim name: .h . Date; Z3Z/2 'invesaganoe(I hr min) 90.00'hi, t�aLc QA-i'REda Rev 06.1.7/W15 1440-4615T(1IA5fLt7L�Uw1 V 1 .f`JI IS'/.► ) f\_ .14 --��WW /l V "�I a tie [_ZIJ y It`ff// -17L 2,Z1d:R 40 Plumbing Permit Apnlicatio r Building Fixtures City of Tigard ,J lJ 1 ..p y: Pain"NnittSro /6-290.;26P1 13125 SW Hall Blvd.,Tigard,OR 97223 E'er Review Phone:503.718.2439 Fax: 503.598 OtherPermit No.: ' Inspection Line: 503.639.4175 t 1 t Ready/By: rte. 13 See Page 2 for i Bt « �t 'kr t Internet www.tigard-or.gov � t 5 tethod: 1 Supplemental information m .. ,.''.W im,. ... ,, t E' ,:• Vii ,,RAN✓.' 40 '.01,4' .Yn `.N `tea.."3"'- 4 g�rma.>-,,,'1{E _ C. New construction �0 Demolition For special ittformafion use checklist } Description { Qty. l Es. I Total Addition/alteration/replacement ❑Other New 1-2-family dwellings(includes 100 ft for each utility connection) i s e . 4 7„: >.We :t '°fie' SFR(I)bath 312.70 ® I-and 2-family dwelling 0 Commercial/industrial Sl t(2)bads 437.78 ❑Accessory building SFR(3)bath I 50032 ��?� , Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other" Fire sprinkler sq.ft) Pa e g 'a 1 ,. g r �#, „�°,,., y �F/ Site utilities: 2 Job site address: 'yl a5 S W 5 i W.0-1. 7 T rra C Q, Catch basin or area drain 18.76 Dryweft,leach line,or Hench drain 18.76 City/State/ZIP:Tigard,OR 97224 j Footing drain(no.linear ft.:�) Page 2 Suite/bldg./apt.no.: 1 Project name:Polygon at West River Ter Mantrfactured 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 It:_) Page 2 Water service(no.linear R: ) Page 2 Subdivision:Polygon at West River Terrrace Lot no.: 35 Fixture or item: Tax map/parcel no.: Backflow preventer , 1 31.27 1 3 27 1` r ry, t7 v Backwater valve ( 12.51 14.5k � _.�._n .: . s.`r: -r �� Clatles►vather 25.02 : 1 1�5 �'�a ��k1 4_a Qin25.02 1 fountain s f Ejectors/sump 25.02 I t ; Z Expnsion lank 12.51 !;:::.-'7;50711-',47,1M- , a Name:ADVL Laud Holdings,LLC Fixture/sewer cap 25.02 Floor drain/for sinklhub 25.02 :, ) Address:7600 E Doubletree Ranch Road Garbage disposal. 25.02 City/State/ZIP:Scottsdale,AZ 85258 Hose bib 25.02 1 Phone:(602)694-4031 Fax ( ) ice maker 12.51 Y n� ;� r `,' r Interceptor/grease trap 25.02 Business name:William Lyon Homes,Inc Medical gas(value:S ) Page 2 Contact name:Angela Grajewski Primer 12.51 Roof drain(commercial) 12.51 Address:109 East 13th Street Sink/basin/lavatory 25.02 City/StateiZ1P: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@lwlygonhomes.com Urinal 25.02 ,„ Water close 25:02 , Water heater 37:52 Business name:Alliance Plumbing LLC Water pipingfDWV 56.29 Address:146 W Historic Columbia River Hwy Other: . 25.02 City/State/ZIP:Troutdale,OR 97060 Subtotal (got, Phone:(503)442-3490 Fax:(503)9124438 Minimum permit fee: 572.50Plan review (25%of permit fee) CCB Lic.:184601 Plumbing Lic.no.:PB732 State surcharge(12%of permit fee) -71.1. I Authorized signature: TOTAL PERMIT FEE 1L45.et Print name:Robert Dishman Date:5/23/2016 This permit application expires if a permit is not obtained within 180 days after it has bees accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board YiauildinePernitairLMU-tamitApp doe W01OlN9 44O-4416T(104.12./COM/WEB) City of Tigard Il COMMUNITY DEVELOPMENT DEPARTMENT 1111111 r 1 c n K n Building Permit Review — Residential ,/.c2?.,.3,v5�'...i.3 ...-:,.'v. .,,•§,:ti'E`..;t...1��,[:Y,..,.,,.i�.:z,n_s..M`..._, vd4`§..bebA*.<,v,x:r ... 4,,FkS Building Permit #: /7�r7,20/6 ,., 400,2 Site Address: I ' Project Name: poly 9un, &i+ vsieit- iZ t VV;r C i Lot #: Y (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: t eAlki SC 12, ) Verify site address/suite# exists and active in permits stem. XI River Terrace Neighborhood: ❑ No Yes,See River Terrace Review Addendum Attached Site Plan Elements: Three(3)copies of site plan 'Brxisting structures on site mite plan must be on 8-1/2"x 11"or 11 x 17"paper fd 'ootprint of new structure(including decks)with finished `Drawn to scale(standard architect or engineer scale) floor elevations North arrow );21.1tility locations(required for new,may apply for additions) /Site address,project or subdivision name and lot number -❑Lu,ation of wells/septic systems Applicant information(name and phone number) Elting trees to be retained with drip line,and tree ,,//Lot dimensions and building setback dimensions protection measures /Lot area,building coverage area,percentage of coverage and Xtreet tree size,type and location impervious area(applicable if R-7,R-12,R-25&R-40) /Street names /Property corner elevations(2 foot contour lines if more than 4 foot differential) Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified El No Received: ❑ Yes ❑ No A Public Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified ❑ No Applied For: PP ❑ Yes ❑ No,stop intake X Land Use Case#: Fp 00001 1 tye,24Il 00 ,6 , 51_1Z7.Grs- 0000 3 21 Zoning: c..- 2 s' / Setbacks: Front sear y0 Side Street Side Garager g,S �0/0 /I / � 3 71 Landscape Requirement: L� X' Lot Coverage Maximum: go % Building Height: Maximum Height 3 S Actual Height IV/A V(Visual Clearance -Easements Sensitive Lands: ❑ Yes ,2 No Type 6 Urban Forestry Plan 0 Conditions "Met"prior to issuance of building permit Notes: WO c..0 hi'as to be rn e--- pri'C r $-i i ss k'ct r1 t U t b�i IAA etc, n7 ►-I—. �. Approved By Planning: f O , e,rr, 2 a Date: �� / I (0 Revisions (after Building Submittal only) Reviewer Date Revision 1: El Approved El Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\B1dgPennitRvw RE5 060I16.docx Building Permit Submittal Original Submittal Date: rf'f,� Site Plans: # Building Plans: # _3 Building Permit#: Enter building permit#above. Workflow Routing: u-Planning J-Engineering Permit Coordinator wilding Workflow Sign-off: 0—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 original plan review routing form. Ei Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: L70 - Date: V/ ',/e6 Engineering Review Slope at building pad: a ❑ 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 Appro d Engineering: Date: Notes: 4 ifeC re i-lr/ Approved by Engineering: _ 4 v Date:E 1'71h 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 �PP 71"&er;ate: roved,NOT Released: 771 � 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: SDC Fees Entered: Wash Co Trans Dev Tax: ► es ❑ N/A Tigard Trans SDC: t Yes ❑ N/A Parks SDC: C�Yes ❑ N/A ❑ OK to Issue Permit Approved by Permit Coordinator: Date: I:\Building\Forms\BldgPCrmitRvw_RES 060116.docx • City of Tigard 1111 N COMMUNITY DEVELOPMENT DEPARTMENT 111 T I c A RRD River Terrace Building Permit Review Addendum Building Permit #: AfS7r02-J/W -- p©i,7 Site Address: 137 15 c VW ,S /& + F X l cr, Project Name: fo 19y0 r) c2 f Weir ,ewer Terra t Lot #: 36 (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 subject to the plan district design standards?%Yes ❑ 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 every 30 ft. Porch min. 5 ft. deepBalcony w/access 2 Window Projection Vertical Wall Offset a Gabled dormer ft. deep min. 2ft.,5 ft.wide min. 2 ft.,6ft.wide /..' ❑ ❑ ❑ 2. Eyes on the street: a minimury pf 12%of each street facing facade must include windows or entrance doors. Percentage Shown: // `/.6 3. Entrances:At least one entrance must meet both of the folloo ing standards: Iax. 8 ft. setback from longest street- facing wall Parallel to street,angle no more than 45° from street, or open onto porch Entrance opens to a porch: Yes CINo If yes,all the following appy: )z'25 sq.ft.min. ?);_rOne street facing entry ;:ir12 ft.max.roof above floor of porch 5 ft. depth min. ,30%min.porch roof coverage 4.Detailed Design:All buildings shall include a min. of five of the following elements on all street-facing facades: / Covered porch min. 5 ft.wide x 5 ft. deep f,ti'Recessed entry area min. 5 ft.wide x 2 ft. deep Wall offset min. 16 inches f❑ Dormer min. 4 ft.wide Roof eave min. 12 inch projectionRoof offset min.of 2 ft. Roof shingles either tile or wood ❑ Gable,hip or gambrel roof design ❑ Roof pitch oriented south min. 500 sq. ft. ❑ Horizontal 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 El 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: I- No closer to front or side lot line,than longest street-facing wall. ❑ Yes ❑ No. If No (Check one): �t ❑ May extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front p rch. a, ❑ May extend up to 5 ft.where the garage is part of a two-story building and there is a window at the se and story above the garage that faces the street with a min. area of 12 sq.ft. Width: (Check one) ❑ 12-foot-wide garage door ❑ 40%max. of street facade ❑ 50%max. of street facade with 7 detailed design elements Notes: � ^ 4 Approved By Planning: " 1 t t9Vt....-a..._.,_ 12-.........------, Date: f j //-6 l:\Building\Forms\BldgPermitRvw REs RT 031416.docx Plumbing Permit Application Site Utilities ' FOR OFFICE t SE ONLY City of Tigard Received I . `` Date/By:gm 111 9 I l Permit No.:t-�y f�t� 13125 SW Hall Blvd.,Tigard,OR` 723 Plan Review ^ : Phone: 503.718.2439 Fax: 503.598.1960 Date/By: 10.6-.aoj6 3 Other Permit No.: Inspection Line: 503 639 4175 T I G A R D Date Ready/By' f J� Suns ® See Page 2 for Internet: www.tigard-or.gov Notified/Method IC 1/ z,,.. TXP .. tt ._ 1 x1 �� IU Supplemental Information w , &. a, i.A4 ;gb F'EE'S SC!EDLt E New construction ❑Demolition For special information use checklist Description Qty. 1 Ea. 1 Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CA100JL' ' oF CONSilltU,CnON SFR(l)bath 312.70 0 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 ❑Accessory building ®Multi-family SFR(3)bath 500.32 ❑Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler(1,371 sq.ft.) Page 2 4038 SITE 1NFOR $IONAND LOCATON .. .. Site utilities: Job site address:13725 SW Silent Fox Terrace Catch basin or area drain 18.76 City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: 1 Project name:West River Terrace Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: 1 Lot no.:35 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DF CR1tPz ON Oh WORT Backwater valve 12.51 '' Clothes washer 25.02 Multipurpose Fire Sprinkler System Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ® 'ROI' RT OWNER i ] =L TENANT Expansion tank 12.51 Name:Polygon Northwest Fixture/sewer cap 25.02 Address: Floor drain/floor sink/hub 25.02 Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 APPLIC N I 0 'CONTACT PERSON Interceptor/grease trap 25.02 Business name:Alliance Plumbing,LLC Medical gas(value:$ ) Page 2 Contact name:Robert Dishman Primer 12.51 Roof drain(commercial) 12.51 Address: 146 W Historic Columbia River Hwy Sink basin/lavatory 25.02 City/State/ZIP:Troutdale,OR 97060 Solar units(potable water) 62.54 Phone:(503)492-3490 Fax::(503)912-6438 Tub/shower/shower pan 12.51 E-mail:robert.dishman@allianceplumbing.net Urinal 25.02 Water closet 25.02 CQNTR CTO =: Water heater 37.52 Business name:Alliance Plumbing,LLC Water piping/DWV 56.29 Address: 146 W Historic Columbia River Hwy Other 25.02 City/State/ZIP:Troutdale,OR 97060 Subtotal Phone:(503)492-3490 Fax:(503)912-6438 Minimum permit fee: $72.50 CCB Lic.:184601 Plumbing Lic.no.:PB732 Plan review (25%of permit fee) 72.__ � State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name:Gavin Thomes Date:8/24/16 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:\Building\Permits\PLMU-PermitApp.doe 10/01/09 440-4616T(10/02/COM/WEB) PagePlumbing2Supplemental Permit ApplicationInformation- City of Tigard - Fee Schedule: Residential Fire Suppression Systems: iaa i t qu t `o Flit t Footing drain-151 100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 ,+? ' . ' YAluat On: - a Tem t vee. r ` .. Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Fee(eal Tat i each additional$100.00 or fraction thereof,to Othersp ct on or I ies t, and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for (minimum charge-1/2 hour) each additional$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. t2uat tixy by Fixture Type s � hntln ipyt ht mInstaatdonS Fixture Type,for Replace/ Plan review is required for any of the following. Work Performed: Capped Added Relocate Please check all that apply. Baptistry/Font Bath -Tub/Shower 0 Any new commercial building with water service 2"and greater,except systems designed and stamped by licensed -Jacuzzi/Whirlpool Car Wash -Each Stall engineer. -Drive Thru ❑ New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918-780-0040. Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities. -Domestic ® Any multipurpose fire sprinkler system. Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040. Eye Wash Floor Drain/sink -2" Submit 2 sets of plans with any of the above. -3" ±e#>l e or s lkser.Dtagr 1mn . Car Wash Drain ❑ Isometric or riser diagram is required for new buildings Garbage -Domestic-non-food Disposal -Domestic-food related that meet the qualifications above. -Commercial-food related -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) ' Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang a to to . ii Sink/Lav -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer-Clothes Water Extractor increase of sewer EDUs,a sewer permit will be issued and Water Closet-Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: \\up-dc2\home\gavin\My Documents\Fire Sprinklers\RT\City of Tigard Pqmit.doc Plumbing Permit Application Site Utilities FOR OFFICE USE ONLI' El l 1 (y� r ,�t I � City of Tigard u*, �. ReceiveDate/Bya PermitNo.:►✓►�' �c, -��,C�q 13125 SW Hall Blvd.,Tigard,OR 97223 l = Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.: Inspection Line: 503.639.4175 N O V 1 4 2016 T 1 G A R D Date Read /B Juris H See Pagee 2 for Internet: www.tigard-or.gov Notifed/Method: Supplemental Information `fYll'E; FO it ®Newconstruction BU1L5 + eSiaFViSIOC" For special information use checklist Description Qty. Ea. Total ❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTR *TION SFR(1)bath 312.70 EII-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 SFR 3,,,,.,01. � 500.32 ❑Accessory building ®Multi-family ach additional bath/kitchen 25.02 0 Master builder ❑Other: ) Fire sprinkler(1,371 sq.ft) Page 2 'SITE FOR ATI0 EOCAT11)N Site utilities: Job site address:13725 SW Silent Fox Terrace Catch basin or are n 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: Project name:West River Terrace 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: Lot no.:35 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 u Backwater valve 12.51 IIIE RIPTI(IIOF Clothes washer 25.02 MST2016-00248 Dishwasher 25.02 REVISED Multipurpose Fire Sprinkler System Drinking fountain 25.02 Ejectors/sump 25.02 tgl PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Name:Polygon Northwest Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 ,,Ii ; PL �F ElONT CT PERSON' Interceptor/grease trap 25.02 Business name:Alliance Plumbing,LLC Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:Robert Dishman Roof drain(commercial) 12.51 Address: 146 W Historic Columbia River Hwy Sink/basin/lavatory 25.02 City/State/ZIP:Troutdale,OR 97060 Solar units(potable water) 62.54 Phone:(503)492-3490 Fax::(503)912-6438 Tub/shower/shower pan 12.51 E-mail:robert.dishman@allianceplumbing.net Urinal 25.02 a er c oset t„ 25.02 cON f RACTUR a - Water heater 37.52 Business name:Alliance Plumbing,LLC Water piping/DWV 56.29 Address: 146 W Historic Columbia River Hwy Other: 1 25.02 City/State/ZIP:Troutdale,OR 97060 Subtotal Phone:(503)492-3490 Fax:(503)912-6438 Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lic.:184601 Plumbing Lic.no.:PB732 State surcharge(12%of permit fee) Authorized signature: r----(..-----17 TOTAL PERMIT FEE Thispermit application expires if apermit is not obtained within 180 days Print name:Gavin Thornes Date: t t/t t I b pp p y after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1:\Building\Permits\PLMU-PermitApp.doe 10/01/09 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Q . Fee tea) Total {$quareFootage: Permit Fee: Footing drain-1'1100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52rmit V'suation: ' Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Other Inspections„or Fes Q � Foil each additional$100.00 or fraction thereof,to and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for (minimum charge 1/2 hour) each additional$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Quantity by Fixture Type 1 bIn Review for Plumbing Installations Fixture Type for Replace/ Work'Performed: Capped Added Relocate Plan review is required for any of the following. Baptistry/Font Please check all that apply. Bath Tub/Shower D Any new commercial building with water service 2"and Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Drive Thru ❑ New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918-780-0040. Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities. -Domestic ® Any multipurpose fire sprinkler system. Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040. Eye Wash Floor Drain/sink -2" Submit 2 sets of plans with any of the above. 4„ Isometric or Riser Diagram`... Car Wash Drain 0 Isometricriserdiagramis required for new buildings Garbage -Domestic-non-food or q Disposal -Domestic-food related that meet the qualifications above. -Commercial-food related -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang -Stall Sink/Lav -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter Washer-Clothes *Note: If the fixture work under this permit results in an Water Extractor increase of sewer EDUs,a sewer permit will be issued and Water Closet-Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: \\up-dc2\home\gavin\My Documents\Fire Sprinklers\RT\City of Tigard Pc2mit.doe FOR OFFICE USE ONLY-SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 114 ,-te Transmittal Letter 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 •www.tigard-or.gov TO: • D T • yVED DEPT: BUILDING DIVISION NOV 14 2016 FROM: GAN 1N "Tr}omes CITY OF TIGARD COMPANY: A LLI ANL£ p,._vMB1 6 BUILDING DIVISIO PHONE: (503) 4s2..-341-o Y: RE: 13'72S Sw S IL 14-T Fax -T' R>Ace 4t 3S ,S72o 1 b -002`t`b (Site Address) (Permit Number) • w‘-sr ave. (Project name or subdivision name an, lot number ATTACHED ARE THE FOLLOWI I : W Additional set(s) ofpl. dir 2- Revisions: PR-C LrA Cross section(s) and d),, .i . Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations Engineer's calculations. Other(explain): n REMARKS: Ho7j, tCA-iio c)c ex/sr,n1 Po 1.2...f .J°r2.rNkLit PLO-IJ e . 0.4oma---) Routed to Permit Technician: Date: t1-1 - 1L ey' Fees Due: 4 Yes ■ No Fee Descri•tion: Amount Due: ��-t S► k� �Qv,s�`o� $ C. oo $ $ $ Special Instructions: Re s rint Permit ser PE : ❑ Yes 0-2 o urA Pone A •licant Notified: Date: _ � I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 .:. ::EV Electrical Permit Application FOR OFFICE USE ON Ll' City of TigardNOV 10 ` Permu I 06 �i1■ 13125 SW Hall Blvd.,Tigard,OR 97223 ( Datea '!/ ' _ ' Phone: 503.7182439 Fax 503.598.1960'Ivry a' 1 I( % Related Permit t! Inspection Line: 503.639.4175 ` Read Dae/B kirk: ®SeePentlnrTIGtRD Internet www tid Orgov d/Method Supplemental Info rmaboaULDpNI s S tea- '. 9, fix;:"'ta e t i.--A-K' ... a..�5--r„x ' •_s.. --` 'ltjr'zR ?s. ty-.TW ,:ilii .., rc. "t. . ®New construction ❑Addition/alteration/replacement x Please check all that apply(submit 2 sets of plans w/items checked):x ❑Demolition 0 Ot1Der. ❑Service or feeder 400 amps or more ❑Building over three stdries. .;;a T,:`�r i; a w, ©~ 0 _ E � � where the available fault current Marinas and boatyards. "a,: . . `' _;� Ve C,t._ 4, _ exceeds 10,000 amps at 150 volts or ❑Floating buildings. ®1-and 2-family dwelling ❑Commercial/indtistrial 0 Accessory building less to ground,or exceeds 14.000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family - 0 Master builder 0 Other _ Fire pump. Installation of 150 KVA or ..„nom�:<c=�, ���r�-;,•=�-'�T -•.._:r,ilb� T7TU1� t9Ds?'�d�A FjI�1�<:..F:�j� - -- _ _ ❑Em system. largerseparatelyderived �m..._� _....... ..__._,,._-:.._._._,.��._..,�...-,_...�...._...<......... :,,,Y::�.:s,..-�:=:�.�i:� �_:=; ;m::.:�a':'� 16125 sM' Si 1-e n4 I) rex ❑Addition system Job#: Job site address: tOOHP or moof ranew.motor load of ❑"A”,->^,"1-z^, I-3^, City/State/ZIP:Tigard,OR 97224 0 Six or mom residential units. occupancy. ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: 4•L Project name:Polygon at West River Ter 0 Hazardous locations. ❑Supply voltage for more than Cross street/directions to job Site: ❑Service feeder600 amps or more. 600 volts nominal. r Description I Qty. I Each I Total I • New residential single-or multi-family dwelling unit. Subdivision:Polygon at West River Terrrace Lot#:3S Includes attached garage. Tax m creel#: 1,000 sq.ft.or less ' 168.54 4 P _ a` 31I'-3.::1 s'TrE} $'' 7L7 Ea.Limitedaddester sq.e er portion ` 33.92 1 � aC choPor energy residential 1' (with above sq.ft) 75.00 2 Limited energy,multi-family 75.00 2 residential(with above sq.ft.) -k . ;- s Renewable Energy ❑ See Page 2 OL'°"'''-jr:'?, s R' r�:;: ':. 7E1 -:-;- r ag - Services or feeders installation,alteration,and/or relocation Name:ADVL Land Holdings,LLC 200 amps or less 100.70 2 Address:7600 E Doubletree Ranch Road 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:Scottsdale,AZ 85258 601 amps to 1,000 amps 30I.04 2 Phone:(602)694-4031 Fax:( ) Over 1,000 amps or volts 55226 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 I 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 � ',_T.� y4 � r 2r� q ® �e Branch circuits-new alteration or extensionper panel �fJ�i'+sa CY` 7 U L - f f p D ' -v .T a_i :). ` A.Fee for branch circuits with Business name:William Lyon Homes,Inc. above service or feeder fee, each branch circuit 742 2 I Contact name:Angela Grajewski B.Fee for branch circuits without I. Ad 10E service or feeder fee,first tires s:. 9 est 13th Street 56.18 2 branch circuit City/State/ZIP:Vancouver,WA 98660 Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(360)695-7700 Fax::(360)693-4442 Each manufactured or modular Email:Angela.Grajewski®polygonhomes.com dwelling,service and/or feeder b7.84 2 r— Reconnect only 67.84 2 y ..1_, :-. n ? x14 :e'lliQilf. _.4.kt t 'A s ' Pump or irrigation circle 67.84 2 Business name:Garner Electric Washington,LLC Sign or outline lighting 67.84 2 Address:6101 NE St Johns Rd Signal circuit(s)or limited-energy ❑ See Page 2 2 panel,alteration,or extension. City/State/ZIP:Vancouver WA 98661 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 6625/hr Phone:(253)320-1657 Fax:( ) Investigation(1 hr min) 90.00/hr Email:bdaniels®gwensa.com Industrial plant(1 hr min} • 78.18/hr Inspections for which no fee is CCB Lie.: C1158 Electrical Lic.: 208174 I Suprv.Lic.: 4496S specifically listed(%hr min) 9000/hr "fix.a- za. ° :-.71741V Suprv.Electrician signature,required: /1 7 e •I _ Subtotal: Print name: Joan P Albert • Date: 4/26/2016 0 Plan Review Required(25%of permit fee): - State surcharge(12%ofpermit fee): Authorized signature: - � '� u:`1 TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Bill Daniels Date: 4/26/2016 days after It bas been accepted as complete. * Number of inspections allowed per permit I:lnuildinglPermasN6r.C-PennitApp ELR IItHdoc Rev 06/17/2015 440-4615T(11/05/COM/WEB FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 1111 Transmittal Letter T t G;A R II) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Tom H. DATE RECEIVED: DEPT: BUILDING DIVISION RECEIV FROM: Angela Grajewski OCT 7 Z016 COF TIGRD COMPANY: Polygon Northwest � �, A BUi�� t� i� PHONE: 971-212-2144 By: RE: 13731, 13725, 13711,13705 SW Silent Fox Terrace MST2016-00247 �i X19, -30 (Building 4) Site Addr- (Permit Number) Polygon at West River Terrace Lots 34-37 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: ` yr/is 1 Copies: DescriptiC Ii.` i z 0 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): Spaced deck detail as requested by field inspector REMARKS: Please pay fees owed with Trust Account./�c= S ds,O fris;o/�- Z2 /? ;04% ONCE`jsKt „n 4:0, Routed to Permit Technician: `�... . Date: ,o / 9-- ) Initials: Fees Due: E Yes ❑No Fee Description: Amount ue: a3V.: A6' ,o N ��1/40 $ 90 $ $ zk ,, Special CO 1-1.-E C7-- r S 0 Al t 1 S7cP-0/(c - )O, 1J 2 Instructions: Reprint Permit(per PE): ❑ Yes S3No n Done Applicant Notified:gA/ a Date: ///�1/4. 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: 13725 SW SILENT FOX TER, SHERWOOD, OR, March 20, 2017 at 9:25:46 AM 97140 Record Type: Record ID: Residential - Master Permit MST2016-00248 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: 13725 SW SILENT FOX TER, SHERWOOD, OR, March 20, 2017 at 9:24:30 AM 97140 Record Type: Record ID: Residential - Master Permit MST2016-00248 Inspection Type: Inspector: 699 Mechanical final David Young Result: PASS Comments: Finish drywall mud and tape in mechanical room. Will check at building final inspection. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13725 SW SILENT FOX TER, SHERWOOD, OR, March 23, 2017 at 12:25:46 97140 PM Record Type: Record ID: Residential - Master Permit MST2016-00248 Inspection Type: Inspector: 299 Final inspection David Young Result: FA I L Comments: Provide address on site for inspections and building final. No inspection done at this time. Violation Summary: Inspector Contractor