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Permit (81) CITY OF TIGARD t • r MASTER PERMIT RI miIS - COMMUNITY DEVELOPMENT Permit#: MST2016 00243 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/17/2016 Parcel: 2S106DC01100 Jurisdiction: Tigard Site address: 13704 SW SILENT FOX TER Subdivision: POLYGON AT WEST RIVER TERRACE Lot: 11 Project: Polygon at West River Terrace, Lot 11 Project Description: New SFA. Building/unit 3.2. 1/3/2017: REPRINT permit to correct plumbing fixture count(1 hose bib). BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 2 First: 97 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 35 Bathrooms: 2 Second: 562 sf Garage: 456 sf Front: 8 Smoke Dwelling Units: 1 Third: 562 sf Right: 0 Detectors: Yes Total: 1221 sf Value: $159,644.49 Rear: 10 PLUMBING Sinks: 1 Water Closets: 2 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 2 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 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 3 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 1221 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: $22,276.61 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 throughh 0 2-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. �y5.-"- I7..Issued By: / Permittee Signature: /'✓ Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. i/ Water Meter Fixture Unit Worksheet Please complete the following information: Contractor Name: Billing Address: Phone Number: New Meter Address: Subdivision Name: Lot#: j) Please 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 UnitQuantity Point Value Point Total Bar sink x 1 = Bidet x 1 = Clothes washer j x 4 = t.-I., Dishwasher I x 1.5 = ) , ,— Hose bib ) x 2.5 = _ .‹.— Hose bib, each additional x 1 = Kitchen sink I x 1.5 = J . S' Laundry sink x .5 = 1 Lavatory a. x 1 = oZ Water closet, 1.6 GPF ,. x 2.5 = 4.5— Bathtub/whirlpool x 4 = Shower stall I x 2 = Bath/shower combo 1 x 4 = 44 Irrigation(#of heads in largest zone) x 1 = Total Fixture Unit Points: ,�4.,C Fixture Unit Points: Upto30= 5/8" Over37 = 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 n No ❑ Other: Meter#: Receipt#: Employee Name: I:\Building\Forms\WaterMeters 070116.docx CITY OF TIGARDMASTER PERMIT ill ii 11 r' COMMUNITY DEVELOPMENT *`�/� Date Issued: 08/17/2016 Permit*: MST2016-00243 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S106DC01100 Jurisdiction: Tigard Site address: 13704 SW SILENT FOX TER Subdivision: POLYGON AT WEST RIVER TERRACE Lot: 11 Project: Polygon at West River Terrace, Lot 11 Project Description: New SFA. Building/unit 3.2. 1/3/2017: REPRINT permit to correct plumbing fixture count(1 hose bib). 3/16/2017: REPRINT permit to add NC. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 2 First: 97 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 35 Bathrooms: 2 Second: 562 sf Garage: 456 sf Front: 8 Smoke Dwelling Units: 1 Third: 562 sf Right: 0 Detectors: Yes Total: 1221 sf Value: $159,644.49 Rear: 10 PLUMBING Sinks: 1 Water Closets: 2 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 2 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 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 0 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 3 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 —_— Ottjvr------Otheer SrgatiaM - __om flaw ng- Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SFA VB R-3 1221 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: $22,418.97 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 95 •!70091. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. S Issued By: - 1:6 ::k - Permittee Signature: e4/ /9-7`j/ :7e° ,---76/1// ' 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 Annlicatihk( -1-- ; ' , '.--A 1. I-OU 0111( I_ ( NI.()NJ ) ,..., City of Tigard --- 13125 SW Hall Blvd„Tigard.OR 97223 M A R 1 3 III Phone: 503.718.2439 Fax: 503.598.1960. Revco-cm 5, ,,, /7 ,0,, Plan Review DateiFly: 4 0„„,_x pcnnit, . i Inspection Line: 503.639A 175 i.::,, i -,,. „ . -'7 • ::,7.:c Dalc Readoply. .'w. En Se Page 2 for ' Internet: www.tigard-orgov -, ,, .` ' :- . Notified/Method: Supplemental information " '14,40,.'s4,',...,,,,i,Verf,04. 44 ..W.V .."'-'11fiErialifi.#04•D'''Vlitii:Willitir:*#tiV, 14tRasgtigiazign,i:W060?2,41***414164,,,A01&,v;NIt,•40f1. ..:WV .4.1.004.C.. 4=Ntln:40/4"4",tS .---,'•..,4 .- /4.i.* „-.•,...,,,..,-^,. ,,,,,, ‘ .wors,...,.. 0,4.04M4WW#.4,,,..:.a`4,N11,4",,, ...r'). .4,,t -, -,,,,,...7 y..ir,rAi' ' ...,,v.•,,,,ra.,,t,e,,.re.,..t., ,... Mechanical permit fees*are based on the value of the work : IN New construction 0 Addition/alteration/replacement performed.Indicate the value{rounded to the nearest dollar)of all • El Demolition 0 Other: mechanical materials.equipment.labor.overhead.and profit. Value:S , a OURi#016,..Oft**(#4,' :,44XIMMIR44.?0,,a:,... , and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist #,K14ittlti-family 0 Master builder 0 Other: Description I Qty. J Ea. I Total .:,:,•1:,. ....7,4-...,,,,,.,,,,A,,,ow—&(. 0&iit,,k,t1,4iiiiiikmailiy:-...-,:.,',".7e1/44; s-mairqz1/4gwAtiyie'..12,‘zo Heating/cooling: , .‘......„;,.. ,,, -,g• ••;,.3t.-4,10-,0,4di,k1,,,,,,. ..Vti,V . i I i 0,,, _r Air Lonomoning 1 46.75 Job site address/370q SW El en x ericirt Furnace 100.000 BTU(doeuvvenis) , _ 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100.0001 1111)rdoetsh.ents) ..., 54.91 I lest pump 61.06 Suite/bldg./apt.no...3,2. rPr°jcci name TOVir at WeStiliger-reityak, Duct work 23.32 Cross street/directions to job site: 1.1vdron le hot water system 21.32 Residential boiler(radiator or lwdronic) 23.32 Unit heaters(fuel-type,not electric). in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 . Other: • Subdivision: t. PO I0i0ft 0,k weest choxvictiroa, I Lot no.:ii Other fuel appliances: 2332 Tax map/parcel no.: Water heater 23.32 ,014i,,....,,,,'4.,,,', ..c. tVitt..4006,1G161,;,,:o‘'iktiVeMi::"•,-P.,..",r;•14?.‘71;14§, Oas fireplace/insert 33.39 ‘,..wgas • . •.. 1-•.4,--,“,,-,777,47.--'7,- T7-.-.74',3w=v7- 5'.'"''' '''''' " "'''''' • ''''""' ' Flue vent for water healer or gas Acini /4 C fireplace 23.32 IK*Fgrt tat-002.._4_) . 1...AtileLLtrA.a.$) 23.32 Wood/pelletstme .. .. Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 :,.!0..Alt1/4".,10541:004.0100,0KiTtgitit.1.0.r2P1104.#61M.#.*0.V.IA,.. '40., Other: 1 23.32 f**..t...:;,4`,.d&.:,...4,,,. ....... ,,.4,... ... V•41,A.V7t:444.04 'N..:4ft.g"Wtr,*„....1 . . ,-„.4..,,:.,„z.:7.,..1a...i.,...o.va.,,,,3,-?.4.,,,,K, Environmental exhaust and"natation; Name:Polygon Will,IAA: Rangc hood/other kitchen equipment 33.39 Address: 109 East leStreet Clothes dryer exhaust 33.39 City/State/ZIP:Vancouver,WA 98660 Single-duct exhaust(bathrooms. -- toilet compartments.utility moms) 23.32 Phone:(360)69S-7700 Fax:( ) Attic/crawlspace fans 23.32 _i__,Ii. _.1_,_ l'it;:if:16-27,;;;,,ii"11:-.3 -,:'F;.,,f'•-,.,;;;-' ....);:7-;,--iv;,;;:?..i:7.4'.;iii:.,-,141.f•;...„....:I.4;„Vv,...;,1,j::::,-.1-:,:.,4::/;..1,-..;---,,F;:=',.;-::"i;',i Fuel piping; Business name.:Polygon Will,1,1,C 814.15 for first four:84,03 for each additional Contact name: 1\11clbveAttryt Furnace.etc. Address:109 East 13th Street Oas heat pump Wall/suspended/unit heater City/State/ZIP:Vancouver,WA 98660 Water heater Phone:(360)695-7700 Fax:-.(360)693-4442 Fireplace ,...111,01 ,, E-mail: 0 - ,Th) if- fl t9/ / 1 1 Barbecue •-et,(47,.- IV,...4`-,,,...v....,,KAtv,;,•4‘, N. i''' ..1..4.r.--,%Oh alr5V:''An,'r'''',4ef.t949s4teal- Ah).414:-., ,,i.,;.•-•,,... .-w.: 4....,64:: ': - A. 7-A.0-- 14$0, 41..tioy394174, Clothes dryer(gas) I Oth Business name:Apes Air LI.0 er: '. .1•tag;i47 ii11:..'.'i.i '::.":i,").,. ',.0.A::& Address:18004 NE 72"d Ave Subtotal Cit)'?StateiZIP:Vancouver,%VA 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 fee) CCM lie.:203034 _ TOTAL,PERMIT FEE This permit application c spires if a permit is sot obtained within I All days utter it tom been accepted as complete. Authorized signature' • Fee methodology set by i'ri-County Building Industry Service Board Print name: 1 iek. .( Dale; 4.11.It, I iluildirgePr4triii0.41:C.PettnilApp.640111 ii,o: 44S411171'4 114r/COMAVI:ri 1 ipi CITY OF TIGARD MASTER PERMIT ii 2 ' ` COMMUNITY DEVELOPMENT Permit#: MST2016-00243 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/17/2016 Parcel: 2S106DC01100 Jurisdiction: Tigard Site address: 13704 SW SILENT FOX TER Subdivision: POLYGON AT WEST RIVER TERRACE Lot: 11 Project: Polygon at West River Terrace, Lot 11 Project Description: New SFA. Building/unit 3.2 BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 2 First: 97 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 35 Bathrooms: 2 Second: 562 sf Garage: 456 sf Front: 8 Smoke Dwelling Units: 1 Third: 562 sf Right: 0 Detectors: Yes Total: 1221 sf Value: $159,644.49 Rear: 10 PLUMBING Sinks: 1 Water Closets: 2 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 2 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 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 3 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 Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SFA VB R-3 1221 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: $22,050.08 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 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: vle— Permittee Signature: a/i/ .41-/�tt-/6-j7CiA 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 7 �� �� ‘/1 � ifna ": . . RECEIVED ►oR OFFICE l SE o\l_l City of Tigard �i�� 1,11 Ill 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Re �����' ��D"�T— Permit N ‘/ �/6-00,,2r3 ■ Plan Review g,�' I �A/47 �0 Phone: 503.718.2439 Fax: 503.598.1960 JUN 01 2 016 DatWilt: Ctts °d'erPermit: / ot4 I 1(, \R t) Inspection Line: 503.639.4175Date ReadyBy: kris. ® See Page 2 for Internet: www.tigard-or.gov CITY OF TI AR Notified/Method: /Fj/%� "'`° Supplemental Information ;• II IV/g10l .9'/L. "' V6T/ ®New construction 0 Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all 0 Addition/alteration/replacement 0 O� equipment,materials,labor,overhead,and the profit for the . t. .t work indicated on this application. ® 1-and 2-familydwelling Valuation: 864 / 0 CommerciaUmdustrial 1 Sr� ‘ it Lt. +S 0 Accessory building 0 Multi-family Number of bedrooms: 2 ❑Master builder 0 Other: Number of bathrooms: 2 771-7, swti it , Total number of floors: 3 Job site address: I'3 o SW Silent Fox Terrace New dwelling area: 1221 square feet City/State/ZIP:Tigard,OR 97224 Garage/carport area: 456 square feet Suite/bldgiapt no.: I Project name:Polygon at West River Ter Covered porch area: 3 C square feet,c C Cross street/directions to job site: Deck area: 72 square fee c Other structure area: square feet ''',‘'.7.,;4',. s i ¢ r <.€ i : .-,,ItKR, :jai° 'i Subdivision:Polygon at West River Terrace I Lot no.: I I Permit fees*are based on the value of the work performed. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all ti� &r � equipment,materials,labor,overhead,and the profit for the ,,, 't "'� �` -- •,•",a work indicated on this application. K6 B«g Ltv) . a2 Valuation: $ Existing building area: square feet New building area: square feet E; • • Sik: , 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 FLSplan review fee(if applicable): Address:109 East 13''Street PP ) City/State/ZIP:Vancouver WA 98660 Total fees due upon application: Phone:(360)695-7700 I Fax::( ) Amount received E-mail:Angela.Grajewski@polygonhomes.com , „ . • , Commercial and residential prescriptive installation of , s , t '' fi €; P P - � � _ �� , ;`- roof-top mounted Photo Voltaic 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 Total fee due upon application: $201.60 Authorized signature: a This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Angela Grajewski Date: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) r Mechanical Permit Application I OR OFFICE. 1 SL 0\1.1 City of Tigard I Received • 13125 SW Hall Tigard.OR 97223 UateBy: Permit No Phone: 503.711 Blvd...2439 Fax: 503.598.1960 t Plan Review �� /�190.7v3 Inspection Line: 503.639.41 7S JUN N 01 2016 Datelly: Other Permit: Internet: www.tigard-or.gov nate Ready:Dy: J.,,> H See Naar 2 for CIg t 1 r Notified'Method: I 1 V ICiA t, Supplemental information TYPE OF WORK fAti 1 t COMMERCIAL FEE* SCHEDULE —USE CHECKLIST Mechanical permit fees*are based on the value of the work ®New construction 0 Addition/alteration/replacement El Demolitionperformed.Indicate the value(rounded to the nearest dollar)of all 0 Other: mechanical materials,equipment,labor,overhead,and profit. I CATEGORY OF CONSTRUCTION Value:S RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For spedal injrrmarron use checklist. ❑Multi-family 0 Master builder 0 Other. Description I Qty. I Ea. I Total i JOB SITE INFORMATION AND LOCATION Heating/cooling: Job site address: 3 l *� t)1 1 QC 1. Air conditioning 46.75 1 --TOK ,t CC&C_ Furnace 100,000 BTU(ducts-vents) I 1 46,75 City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(duclvrents) 54.91 Suite/bldg./apt.no.: I Project name:Polygon at West River Ter Heat pump 61,06 Duct work 23.32 Cross street/directions to job site: Hydropic hot water system 23.32 I Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision:Polygon at West River Terrrace I Lot no.: i I Other: 23.32 Tax map/parcel no.: Other fuel appliances: Water heater 23.32 I - DESCRIPTION OF WORK Gas fireplace/insert 33.39 Complete rough of HVAC Flue vent for water heater or gas fireplace 1 23.32 ` )C n 'I lA n . 31 Log lighter(ens) 23.32 (� IV t/ Wood/pellet stove 33.39 Wood fireplace/insert 123.32 i Chimney/liner/flue/vent 23.32 PIEZOPERTY OWNER 0 'PEDANT Other:Range I 23.32 Name:ADVL Land Holdings,LLC Range Environmental exhaust and ventilation: Range hood/other kitchen Address:7600 E Doubletree Ranch Road equipment 1 33.39 Clothes dryer exhaust 1 33.39 Cit}/Stake/LIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms, Phone:{6029 4031 Fax: toilet compartments,utility rooms) 3 23.32 ( ) Attic/erawlspace fans _ 23.32 APPLICANT 0 CONTACT PERSON Other: 23.32 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 bearer Water heater Phone:(360)695-7700 I Fax::(360)693-4442 Fireplace E-mail:Angela.Grajewski Jpolygonhomes.com Range Barbecue I CONTRACTOR Clothes dryer(gas) Business name:Andersen Heating,Inc Other: Address:16285 SW 85th Ave ste 410 MECHANICAL PERMIT FEES* Subtotal City/State/ZIP:Tigard,OR 97224 Minimum permit fee($90.00) Phone:(503)992-6664 I Fax:(503)536-6615Plan review(25%of permit fee) State surcharge(12%of permit fee) CCB lie.:168214 TOTAL PERMIT FEE This petmlit application expires if a permit is not obtained x-ithia 18D Authorized signatua days after it has been accepted as complete. Fee methodology se[by Tri County Building Industry Sen7ce Bo trd Print name: i Date:05/23/2016 M$ulding'Fermits?MEC Fermi,App p70113 doe 446-46 t 7r(11?02tCOM14EB) - Electrical Permit Applicatia City of Tigard , ,,,z e li 1 f i i l �I e l�i U 1 20 16 13125 SW Hall Bard.,Tigard,OR 97223 'JUN !sur IMZENSIMERSEI Phone: 503.71f.2439 Fax: 503.598 Inspection Line: 503.639,4175 le i I r F 1 k Ml1i 'l p � � � I� �� Inland: www.tigard-or,govBUILDING 'MMS , Nott i d: _ _ ":._ -+ New Construction 0 Addition/alteration/replacement a din*all mar aPtily(„tea 4 sets. pleas weirs ted). ❑Demolition [3 Other O Service or feeds 400 amps aa more Cl over three stones where the available fault uuat ❑Marinas and boatyard+. ' _ . „ °, ; 7. . „., .7:' . awceds 10.000 imps m 150 waits a Cl Flaming brdithags. i'...', I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building to ground,or exceeds 14,000 Cl Cwamaci i-use agricultural ❑Multi-family 0 Master builder 0 Other amps for all other Installations buildings ❑Fire pump. ❑Installation of 150 K VA or • , '''.7:71.:22-.',.= {;"<r .°" ; ❑EmcBeacY Warm- /arra separately derived - «x. .. mss. .._... ..„. .._, �� a w, ��.:..,�,..��., ..« �j.L��"y,*�"'(�,�:�a/�/��`gid lob g: lob site address: 1� Si r 1 /. 1 V t' f t O on or new motor toga of "Aran. IDOHPamarc. ❑"A','E","1-2",'1-3; City/State/ZIP:Tigard,OR 97224 J six or more residential emits. aomPanor O Health-care facilities. 0 Reaeariond vehicle parks. Suite/bldg./apt 4: I Project name:Polygon at West River Ter O Hazardous locations. O Supply volare for mom than O Service o feeder 600 amps or more, 600 volm nominal- Cross ominalCross street/directions to job site: ger Desaindos 42. e.er Thud • New residential single-or multi-family dwelling unit. Subdivision:Polygon at West River Terrrace Lot 4: 1 Includes attached garage. Tax map/parcel 4 1,000 sq.ft. or I 168.54 I I ti654 4 :: mix,.,.. „„ �: �, � x Ea..add'1500 sq.R or portion j 33.92 9i I D 9 tin it Iamtt�a rgy,resrdamaf 75.00 2 1�✓ (with above sq.L) Limited energy,multi-family 75.00 2 .__� s n. � ' + residential(with above sq.ft.) Name:ADVL Land Holdings,LLC Renewable Energy 0 See Page 2 Address:7600 E Doubletree Ranch Road Services or feeders installation,alteration,and/or relocation 200 amps or less 100.70 2 City/State/ZIP:Scottsdale,AZ 85258 201 amps to 400 amps 133.36 2 Phone:(602)694-4031 I Fax:( i 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. ' Owner signature: Date: Over 1,000 amps or vola 552.26 2 ,,, Temporary services or feeders installation,alteration,and/or -: 'Y `,•' � �, �? ”; •�. '-r 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 133th Street ' 401 amps to 599 amps 168.54 2 City/State/ZIP:Vancouver,WA 98660 Branch circuits-new,alteration,or extension.per panel Phone:(360)695-7700 I Fax::(360)693-4442 A.Fee for branch circuits with above service or feeder fee, Email:Angela.GrajewskiKpolygonbomes.eom each branch circuit 7.42 2 B.Fee for branch circuits without�' ...service err feeder fee,fust Business name:alameda electric branch circuit 56.18 2 Address:3415 ne 44th Each add'/branch circuit 7.42 2 Miscellaneous scellaneous(service or feeder not included) City/Stale/ZIP:ON10 p Ia, A®1 z /4°77.Z-13 Each manufactured or modular 61.84 2 • dwelling. Phone:(503)3192192 Fax:( ) tng service sed°or fader Reconnect only 67.84 2 Email:solatpdx( me.com Pump or imgation circle 67.84 ' 2 CCB Lic.: (99188 Electrical Lic.: c923 Suprv.Lic.: y g71 S , Sign or outline lighting 67.84 2 Suprv.Electrician signature,required: /� Signal Mrcuigs)or limited-energy ❑Ser Pa a 2 , Print name: k 1 k /22,00., I Date: s-/z3//,/ panel.alteration.or extension. g Each additional inspection over allowable in any of the above Authorized sigrtantre: Additional inspection(I hr min) 66,25/ler Print name: ..r. ^- Dates/Z3//-- Investigation(I hr min) 90 04=hr i I t kit.C_ ez.a _doc Rev 06r1712015 MW615Tt31finaCO/AWEB V 1 j✓`�',"\1. 2.OT �..n. --JJi t1 r e v `} L ZZiy,1(0 Plumbing Permit Application Building Fixtures 1.1 it City WTigard t� 1 Permit No.:/1J7 2sj/4'7''t1 9111111111.11=11111=1111111111111111 13125 SW Hall Blvd.,Tigard,OR 9722111-/ V 2010 RDan Re Phone:503.7182439 Fax:-503.598.1960 ��,-^e ARIL) e/gg7wew Other Pamir No.: Inspection Line: 303.639.4)75 I L) n n t Date heady/By: Luis. H See Page 2 for Internet: Line:ge 3.63 gov I . s i\ii ti f F- NotifiedlMeEhod: Supplemental information a= ' ®New construction ❑Demolition Fos spedat information use checklist 0 Addition alteration/ laceneertt 0 • Description Other: • Ea ] Tow i ropNew l-2-family dwellings(includes 100 ft for each utility cnnaectron) r.. �At +mow e � � SFR(i)bath 7 312.70 ' ® I-and 2-family dwelling ❑Commercial mdustriai SFR(2)bath ' 437.78 y?��•7 ❑Accessory building SFR(3)bad) 50032 mg 0Multi-family Each additional bathtkitchen 25.02 ❑Master builder 0 Other' Fire sprinkler 2 s i -i ,i,, i s •• Site utilities; v , __� . T �� .,�� ,it, /(/fib�- it. Page s 3u. ,�1 r Job site address: ' S W 51 Ie t rl T Off( r(& Catch basin or arca dram 18.76 Drywallleach line,or trench dram 18.76 City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: 1 Project name:Polygon at West River Ter Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector18.76 Sanitary sewer(no.linear ft.:_) Page 2 • ' Storm sewer(no.linear fL:_) Page 2;} Water service(no.linear IL:__) Page 2 Subdivision Polygon at West River Terrrace Lot no.: ( ( Fixture or item: Tax map/parcet no.: Backflow preventer , �- 3127 1 3 I.2.7 r :Z. '.£r y 3 � - '� clothes w valve ... 25.0 I a ,1 �V/r "' ,`ri Clothes ua$hcr 25.02 I M� .-Bl ��h‘l 3 2 Dishwasher 25.02 ` Drinking fountain 25.02 Ejectors/sump 25.02 t H Expansion tank 12.51 Name:ADVL,Land Holdings,LLC Fixture/sewereap r 25.02 Floor drain/floor sinic/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 . k >, w Interoeptor/grease „ � t .,• ; trap 25.02 Business name:William Lyon Homes,Inc • Medical gas(value:S ) 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.Grrlesyskr@yolygonhomes cora Urinal 25.02 i- r...... . t ; ,',4� -1 .-,ro.ras water closet 25.:02 Water heater 37:52 , Business name:Alliance Plumbing LLC Watapiping/DWV 56.29 Address:1146 W Historic Columbia River Hwy er: 25.02 City/State/ZIP:Troutdale,OR 97060 Subtotal kç(3•uki Phone:(503)492-3490 Fax:(503)912-6438 Minimum permit fee: S72 50 CCB Lic.:184601 Plumbing Lic.no.:PB732 i/ifitict./.... Plan review (25%ofpermit fee) # State surcharge(l2%of permit fee) 11.(,) Authorized signature: Print name:Robert Dishman TOTAL PERMIT FEE �y,5.8 Date:5/23/2016 This permit application expires if a permit b not obtained within I days atter it bas been accepted as complete. *Fee methodology set by Tri-Canty Building industry Service Board IABuilding errniti?LMU-Pamiiappdoe 10/01/09 440-06161`C1O/02FCOM1WE6) I City of Tigard 11114 COMMUNITY DEVELOPMENT DEPARTMENT ■ r 1 c A RD Building Permit Review — Residential 6'a F .<.,,,,..,.ur . R..,;,k a _,,,,,,, ., ,.;.:we.,,,,,.P,a, a ms.z..,.s�i+..»;-. _ .a,,,Le., r,r 7,.: c.- r _ ,.r _i,i,' ,:,z u._.t,:<Zrs.__.. ae, .. Building Permit #: S% /6 ®V„;2 j Site Address: 131 04 S W s;)en t- x ie.re- Project Name: PO.1. 90 r) e1+- weJI- /Zi vr, r- mice Lot #: / (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: W ew s'c£.. gt Verify site address/suite# exists and active in permits stem. ,`1 River Terrace Neighborhood: ❑ No Yes,See River Terrace Review Addendum Attached Site Plan Elements: Three(3)copies of site plan 'BExisting structures on site Aite plan must be on 8-1/2"x 11"or 11 x 17"paper gtootprint of new structure(including decks)with finished `Drawn to scale(standard architect or engineer scale) floor elevations $North arrow 'Utility locations (required for new,may apply for additions) `Site address,project or subdivision name and lot number -0L.,ation of wells/septic systems Applicant information(name and phone number) *sting 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) 7 Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No APublic Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake X Land Use Case#: ?D P Zoi S — 00001 t Lre) U -- 0 0006 , SL f2 Zc is-- 00003 ZZoning: 2 /7 Setbacks: Front ez/i 2Rear 10 Side 0 Street Side 3 Garage j g,3' Landscape Requirement: `L0 0Lot Coverage Maximum: g 0 0/0 X Building Height: Maximum Height j J Actual Height ilk/jA Vi Visual Clearance i'Easements Sensitive Lands: ❑ Yes g No Type 6 Urban Forestry Plan 0 Conditions "Met"prior to issuance of building permit Notes: j(,rld:4.h))fl.l fits ht Yr)e_-1- p6 at' r� t iss k'c-i ( o(' b , )ctivie, fri t 4-. Approved 1 y Planning: Ari 0 6•14 +€,1 o C62—C ... Date: j I I CO 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\B1dgPermitRvw RES 060116.docx Building Permit Submittal Original Submittal Date: � / Site Plans: # `3 Building Plans: # Building Permit#: ®"Enter building permit#above. Workflow Routing: Planning 9-Tngineering 9-Permit Coordinator C nilding Workflow Sign-off: Er-Sign-off for Planning(include notes from planning review) Route Application Documents: Er Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. E uilding: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: .a By Permit Technician: Date: ' ,/'6 Engineering Review Slope at building pad: a r,„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 Appro d b Engineering: _ Date: Allir Notes: g ,.../� �fel h'Ti � :— Peer�/7/ Approved by Engineering: W4-2 Date: ,��r-xe Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved mow Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit Approved,NOT Released: 1 Date: Zo 1,12/l , Notes: C c.0 t> r I 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: cp SDC Fees Entered: Wash Co Trans Dev Tax: SPes ❑ N/A Tigard Trans SDC: es ❑ N/A Parks SDC: 2:17Yes ❑ N/A ,rtierK to Issue Permit �j Approved byPermit Coordinator: 74 71/6// pp Date: I:\Building\Forms\BldgPermitRvw_RES_060116.docx L City of Tigard 11111 COMMUNITY DEVELOPMENT DEPARTMENT . ■ TI G A R D River Terrace Building Permit Review Addendum Building Permit #: /tS7 20/6 - 06.2 e/3 Site Address: 13 7 Uy ,c vv' S;len+, rt,X Te-cr. Project Name: f o 1 y 0 c of Wei t- ,Zi'v V+_rr c.._ Lot #: 11 (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.,7 6ft.wide 2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors. Percentage Shown: 17 , 5 3. Entrances:At least one entrance must meet both of the following standards: Parallel to street,angle no more than 45°from street, p(Max. 8 ft. setback from longest street- facing wall or open onto porch Entrance opens to a porch:/21 Yes El No If yes,all the following apply: A 25 sq.ft.min. AOne street facing entry 12 ft.max.roof above floor of porch /`J 5 ft. depth min. 52`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: gCovered porch min. 5 ft.wide x 5 ft. deep ,4 Recessed entry area min. 5 ft.wide x 2 ft. deep Zi Wall offset min. 16 inches ormer min.4 ft.wide 71 Roof eave min. 12 inch projection /1 Roof 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. /❑ Horizontal lap siding min. 3-7 ft.wide ❑ Accent siding min.40%of street facade 7r 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. ❑ Yes)2rNo. If No (Check one): 0 May extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch. I May 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) 12-foot-wide garage door ❑ 40%max. of street facade ,p150%max. of street facade with 7 detailed design elements Notes: Approved By Planning: 'Vy a n 71—t--.. g d Date: G /11 /6 I.\Building\Forms\BldgPermitRvwRES RT 031416.docx Plumbing Permit ApplicatiOlt , i Site Utilities Cl of Tigard '1 ! l r. Received `.1 g 7/ Permit No.:kS��1��� 2 Date/By: `J 13125 SW Hall Blvd.,Tigard,OR 97223 �G Z >aPlan Review Phone: 503.718.2439 Fax: 50344.19W' 1,1, Date/By 1v--G-a016 Q 4 Other Permit No.: Inspection Line: 503.639.4175 ,. T I G A R U Date Ready/By: Juris 0 See Page 2 for Internet: www.tigard-or.gov ,; ,, Notified/Method: Supplemental Information '. ....„TYPE OF WOtI FIE* SCHEDULE' ®New construction 0 Demolition For special information use checklist. Description Qty. I Ea. Total 0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CQN$T tup*Si t SFR(1)bath 312.70 0 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building ®Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 0 Master builder 0 Other: Fire sprinkler(1,221 s ) Page 2 .100 s1T l R TION AND LOCATION Site utilities: Job site address:13704 SW Silent Fox Terrace Catch basin or area drain 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.: 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.: 11 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 ' Backwater valve 12.51 DESCR UO1$14?F,4'OR1 Clothes washer 25.02 Multipurpose Fire Sprinkler System Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ROPER` OW R ❑ TENANT'' .:- Expansion tank 12.51 Name:Polygon Northwest Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 1..I Al.1CAl © CONTACT PERSON Interceptor/grease trap 25.02 Business name:Alliance Plumbing,LLC Medical gas(value:$ ) 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 C01�RACTOR Water closet 25.02 , Water heater 37.52 Business name:Alliance Plumbing,LLC WaterpP 1 m 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 Plan review (25%of permit fee) CCB Lic.: 184601 Plumbing Lic.no.:PB732 , �� 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. 1:\Building\Permits\PLMU-PermitApp.doe 10/01/09 440-4616T(I0/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Sit+ t t lit es 1� �; TOOL, 11I1a,rc Foota 'P itit Fee: Footing drain-Is`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 Storm&Rain Drain-1st 100' 62.54 � r a � -X I�IF'1l"11II r'VV* $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 Qty "v*- t o I utal each additional$100.00 or fraction thereof,to ,,,, hell`: C�.���or...�I cos � ,� .�ter., 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 ; Phu Rl iew for lurnbing Installations Fixture Type for Replace/ Plan review is required for any of the following. Work Performed: Capped i Added Relocate Baptistry/Font Please check all that apply. Bath Tub/Shower 0 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 0 Medical gas and vacuum systems for health care facilities. -Domestic ® Any multipurpose fire sprinkler system. Drinking Fountain 0 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" 4>' .I1 Ii etl? Ie fit $eIiM raI>tl Car Wash Drain 0 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 -Stall 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 RECEIVED Electrical Permit Application FOR OFFICE USE ONLY City of Tigard N 0 V 1 0 2 016 Received `�iaj . 13125 SW Hall Blvd.,Tigard,OR 97223e� ' Phone: 503.7182439 Fax Iiihr 503.598.1960 7 a` Related Permit#: Inspection Line: 503.639.4175 �" TIGARD eadyDateJBy: lurk: ®See Page 2for Internet wRM1Y_tlgard-or.gov BUILDING BUILDING IFS ii.4 am,6.._.id/Method: Supplemental Information , 4. s —, .nariKyitVi� 4Zi _:fi "vTI . ? g W.CM�- 7tia ®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑Demolition ❑Other: ❑Service or feeder 400 amps or more ❑Building over three strides. where the available fault current 0 Marinas and boatyards. m -ma.*' 'rp as --:--,_„:-;;L: ' r exceeds 10,000 amps at ISO volts or (]Floating buildings. ®1-and 2-family dwelling ❑Commercial/indtistrial 0 Accessory building loss to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all buildings.. ❑Multi-family -- 0 Master budder 0 Other other installations. _ _ ['Fire pump ❑ ❑Tnaaltation of ISO KVA or ...;,. - .c--�;r_ ::b1t]L. d. ,.-'t^IUIW- _ ::; r' � =�'�::.-,:;a�',-��-�. „�,,wii .1 r ...�„�6�Y'ETO1�C<, _ -- - _-_ ❑Emergem:y system. largerseparate!),derived Job#: Job site address:11)-1 Off-` 5\-tSi n�.N j ter ❑10011Addition more. load of system 1` tit vvv/` Vl 100iiP or more. ❑••A•>,<•E•,`1_2","1.3", City/State/ZJP:Tigard,OR 97224 0 Six or more residential units. occupancy. ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: ,Z Project name:Polygon at West River Ter 0 Hazardous locations. Cl Supply voltage for more than 0 Service or feeder 600 amps or mom. 600 volts nominal- Cross street/directions to job site: - tntin_�>� i1E '-z�.- ..tom— -• Descriptio :v'th a I• Qty. I` .bath I Total New residential single-or multi-family dwelling unit. Subdivision:Polygon at West River Terrrace Lot#: 4 ( Includes attached garage. TeX map/parcel#: I,000 sq.ft.or less 1 168.54 4 Ea.add'1500 sq.ft.or portion ' 33.92 1 �`' �' S �` �-����: 401 Limited enerSS;residential /1�+'�,(' ith above s ft.) 75.00 2 IAA't �` cos'� Limited energy,multi-family residential(with above sq.ft,) 75.00 2 ,I-- t7-40i:A p ,t-b--a---.14 --,ER" 44, _ 1eub 0 ;, Renewable Energy ❑ See Page 2 . 1 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 20034 2 City/State/ZIP:Scottsdale,AZ 85258 601 amps to 1,000 amps 301.04 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 Iess 59.36 1 • intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. - 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 • y r g•; Branch circuits–new,alteration or extension per panel '�- �" A.Fee for branch circuits with Business name:William Lyon Homes,Inc. above service or feeder fee, each branch circuit 7'42 2 Contact name:Angela Grajewski B.Fee for branch circuits without Address:109 East 13th Street service or feeder fee,fust 56.18 2 branch circuit City/State/ZIP:Vancouver,WA 98660 Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(360)695-7700 . • Fax::(360)693-4442 Each manufactured'or modular 67.84 2 dwelling,service and/or feeder Email:Angela.Grajewsld a®polygonhomes.com Reconnect6 7.82 a:V .a txI ^ A '7::::'E"'o A'0- e;p- -, 2 s"-r waz; -' Pump or irrigation circle 67.84 2 Business name:Garner Electric Washington,LLC Sign or outline lighting 67.84 2 r.,: Address:6101 NE St Johns Rd Signal circuit(s)or extend-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(I hr ruin) 6625/hr Phone:(253)320-1657 Fax:( ) Investigation(1 hr min) 90.00/hr Email:bdanielsa®gweusa.com Industrial plant(1 hr min) • 78.18/hr Inspections for which no fee is r hr CCB Lie.: C1158 Electrical Lie.: 208174 Suprv.Lic.: 4496S specifically listed(h hr min) 90.00/ stgpm Suprv.Electrician signature,required: Mil-7P; A1� Subtotal: Print name: Joan P Albert • Date: 4/26/2016 0 Plan Review Required(25%of permit fee): 7.-------- --=:::::-....___ State surcharge(12%of permit fee): Authorized signature: �`_r— 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 has been accepted as complete. Number of inspections allowed per permit :?',1:113uldinglPermitsU•7.0 PermitApp ELR ERE.doc Rev 06/17/2015 440-46l51{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 Transmittal Letter T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Tom H. DATE RtFtV,pi 7 DEPT: BUILDING DIVISION tap OCTED 17 2016 FROM: Angela Grajewski CITY OF TIGARD COMPANY: Polygon Northwest BUILDING DIVISION PHONE: 971-212-2144 By:� ----- ✓✓ ' RE: 13690, 13704, 13716,13724, 13736 SW Silent Fox MST201 00242 1 ? ; 44, Terrace (Building 3) ^Q-t-f r'7 L Co vv (Site Address) (Permit Number) Polygon at West River Terrace Lots 10-14 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: 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. / cs r L.LE- . 0i! 4 Routed to Permit Technician: Date: /O- ) 9 - / Initials: Fees Due: gYes No Fee Description: Amount I3ue: y $ Special (!c S OA; /`1ST / —00,2 Lz, Instructions: Reprint Permit(per PE): ❑ Yes lig No ❑ Done Applicant Notified: /6/C Date: %////00. Initials: I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 1 . . • • - . . .. . i Electrical Permit Application .0 17 FoR officr t:sr.ONI I. , F Ek3 , City ofTigard .,,,,TIcARli IRWM71116,111=WIFISEMI . •. •• N,. .. 13125 S'W Thin Blvd.,Tigard,.012.9M1Y Phone: 503.118.2439 Fax 503.59.. loo r pllpi,,,s1(,)‘N'.Datc43 : EZZLI i,,,, , r, inspeCtiOn Line:$03.639,4175 , 1 III p in 45 ',- ' ''' ReadyDatetBy: IN See Page2fer .• ;''-'.A'''''',. hitemet www.tigard-or.gov '13.01•*-A ' Noed/Method: Supplemental Information • 1.00411.4.0fk.4:,-. -;:c...,,,41iMiiitett—*.10-.: atifW4'34.10011WRA.i.MISTAg X-W,X41::1,...i, :1,;.:-.,-..i.41r.t'f.417'.•i''';'.•.-. '13.),•'1,.:^;;;,. ,..!'. ::.,'-* *:,..4 . New construction 0 Additionialimation/replacernent . Pleasenbeck alt mat appty(submit/sets of.plaits vedtems.enocsody 0 Servirm or feeder 400 mops or more 13 Buildintover three stories. 0 Demolition 0 Other . whims the available butt current o Manna' a and benlYerdx- ROMIV....-7:,iZle,,....7.,,A0:4047-Amorti;t' ;:f::i:' ....,:::14,4,-..:Argagags,. exceeds 10,060 amps at 150 volts or able/sting htultfmgs. la less td,or exceeds , ID Commercial-use ogtieulteral ir and'24amily dwelling 0 Commercial/industrial 0 Accessory building o groun14000. amps for all Othecinstallatione buildings. i . WO-family 0 Master builder 0 Other 0 Pim posy 0 installation of 150 ICV.d.or ir.D.ysyst. pi laAdditioi of new motor load of system.larger separately derived Job#: Job site address:t'.31 0 C\N &VA.fiXTenr 001iP ormorc• n'`A",13","1-2",-`1-3"; 1:3 Six ormore residential units. City/Slate/4P:Tigard,Ott 97#4 0 lieeldWeare faiilities. b Itoomationalvehicle;auks. Suite/bldg./apt.#:' ..L Project name:Polygonal West River Ter01 -ismaxlausbocations, El Supply voltage Stir Mote thasi • 0 Service or feeder 600 amps or more, 600 volts nominal- Cross street/directions to job site: ''',' (4;-'1 . Description 1 ilo; . i.d, Total 1 New residential single-or math-family dwelling unit. ... . . . Subdivision:.Polygon at West Rh*Terrrace Lot#:1 1 Includes attached garage. 1,000 sq.fc,'or Less 1 , 166.54 4 Tax maplparcel fk _ .. .,, . ..„ ,...._ ..,. . . ..., . Ea.411 500 sq.ft.or portitin 1 33.92 I .fra:\' ,..e,J4.•:i::: :‘;:1•*.'iiStOrgietaff0 k:::1.•.1:0.:?..1?.. .',4.'...;'' Lt4M matm/y,residential ' 75,00 2 Contactor Vlanrc., . (witb.bovi.q.11.) Limited.ettergy;Maki-family 75.00 2 residential(with above se.IQ • '43-44AIN:MWOMOWMiti*V04411110011K-014 ;!'::‘,"i'‘.**'.17;::40.41:. Swot.cei or feeders lostallationinilternSeetkof,agancd2/or relocation . N4010;ADVL.LandIfOldingso LLC 200 amps lit ltss 100.70 2 . . 201 amps tO 400 amps 133.56 2 Mess:760 E•Dotibletree Ranch Road • . 401 amps to 600 amps 200_34 2 • City/State/Z1P:Said:Sale,AZ 85258 601 amps to 1,000 amps : 301.04 2 Phone:(602)6944031 '' lax:( ) Over I,PCO amps Or'Adis ' 55226 2 ._ Tenintiorry Services or Is installitioni alteration,and/or Email: relocation Owner installation:This installation is,being made on property that I own which is not ' 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps ' , ". . 12508 2 Owner signature: .. . Date: '401 same to 599 snips 168.54 2 - . V,'',':'gatgtqn4.*t*tr4•Wrl'.zVtfgnMtrXtODW/ggti,,WRS'Ilit.MAN : Anr:eetichforcibreu,-chtilinew4 iairiti"'or"831°14 pr P"el Business name:.William Lyon Homes,Inc. ' . '44ove_. service or feeder fee, 742 2 • each branch circuit Contact namm:Angela Grajewski B.Fee for branch circuits without.: service or feeder fekfirst : $0.18 2 Address:109 Enst.13th Street branch circuit .. ' . City/SUM/ZIP:Vancouver,WA 98660 Each Md..'blench circuit 7.42 2 Miscellaneous(service or feeder not included) .. • rilitk(36069547700 Fax::(360)034442 Each manufactured or modular .... 67.84 2 dwelling,smite and/or kit& . . . Email:Angeta.Crajewski0polygonhontes.corn Recomect only 67.84 2 :-.:, i:i'.'.,:;),*;.!:'•?•',i'ri.,;''.4.‘k4::,Okt:0414tj''.1AlF;qct '4.7` ''::.f'' t'l.'711'''ltia.VS14. Pump or irrigation circle 67.84 2 Business natnez Simply Electric LLC Sign or outline lighting. .., 67,84 2 Neal oimait(S)or iintlied7encrEY 0 seep 'e 2 ' :2 Address:PO Box 822408 One&alteradon,or exsansioo. _ Rath idditiornit inspection over allowable in any of the above /StaltaLP:Vancouver,WA 98682 Additiensj impection(i*min) 66.25f hr Phone:. 03)8494202 • Fax:(360)3144945 ' Investillitien(1 brmin) 90.06/iii . • ' ..industrial:44(1 hrmin) : , WS/lir Email:simplelectricpdx@gmail.corn Inspeetiousfor which nothe is CCE Lie.: 20440 Electrical Lic.: C1067 J S.Itytv.Lie.: 4394S :,- ,...1 listed , armin), 9"Dnir . _ .. `',.g.•'.4'4,";•.1.';-4,f,ift.'0..6.1i.......,:i0(''..z1; Suprv.Electrician signatice,required: t , . r • 4.4.-.4f Subtotal: • . Prird name: Vietor Zambitsky I Date: 1/8/2017 . 0 Flandeview Required PS%of Penni*fee): • ' ' . -.N. State:surcharge(12%of permit fee): Authorized.Signature: (--- „ ,, , . ,...... TOTAL PERMIT FEE: . . ......... this fern*sponendon expires ifs per:talk not Obtained-within 181) PritittatOM Dimitriy.Mishchuk Date: 2/8/2017 •days after it boa been accepted as maples& • ” . * /slumber of inspeetioui allowed perpermit lAnsimineennitsuitt Permimpp Eilt Efe.E.sloc Rev 007/2075 44046157(t1/05/CONAL,WEE City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13704 SW SILENT FOX TER, SHERWOOD, OR, March 28, 2017 at 5:19:37 PM 97140 Record Type: Record ID: Residential - Master Permit MST2016-00243 Inspection Type: Inspector: 199 Electrical final David Young Result: FA I L Comments: Faceplate missing at taped over outlet in kitchen, unable to test. All else appears ok. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13704 SW SILENT FOX TER, SHERWOOD, OR, 97140 Record Type: Record ID: Residential - Master Permit MST2016-00243 Inspection Type: Inspector: 699 Mechanical final David Young Result: FA I L Comments: Furnace intake or exhaust pipe not connected in mechanical room. Manufacturers requirement. Seal all penetrations in mechanical room. All else appears ok. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13704 SW SILENT FOX TER, SHERWOOD, OR, March 29, 2017 at 11 :47:25 97140 AM Record Type: Record ID: Residential - Master Permit MST2016-00243 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS Comments: Corrections from previous inspection complete. Violation Summary: Inspector Contractor