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Permit (82) • �t CITY OF TIGARD ' ' MASTER PERMIT I COMMUNITY DEVELOPMENT AV"'yr Permit#: MST2016-00244 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/17/2016 Parcel: 2S106DC01200 Jurisdiction: Tigard Site address: 13716 SW SILENT FOX TER Subdivision: POLYGON AT WEST RIVER TERRACE Lot: 12 Project: Polygon at West River Terrace, Lot 12 Project Description: New SFA. Building/unit 3.3. 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 Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Bckflw Prevntr: 0 Catch Basins: 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: 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:Y 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 throug R• 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: .? Permittee Signature: &tel e -JC' G /(fr / 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. V Water Meter Fixture Unit Worksheet Please complete the following information: Contractor Name: Billing Address: Phone Number: New Meter Address: Subdivision Name: Lot#: )-L, 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 Unit Quantity Point Value Point Total Bar sink x 1 = Bidet x 1 = Clothes washer j x 4 = Dishwasher J x 1.5 = Hose bib 1 x 2.5 = c)..‘- Hose Hose bib, each additional x 1 = Kitchen sink 1 x 1.5 = J .,S -' Laundry sink x 1.5 = Lavatory —.� x 1 = c), Water closet, 1.6 GPF a x 2.5 = 6- Bathtub/whirlpool x 4 = Shower stall 1 x 2 = ,Z. Bath/shower combo 1 x 4 = Lf., Irrigation(#of heads in largest zone) x 1 = Total Fixture Unit Points: a oZ ..c- Fixture Unit Points: Up to 30= 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 ❑ No ❑ Other: Meter#: Receipt#: Employee Name: I:\Building\Forms\WaterMeters 070116.docx illi CITY OF TIGARD MASTER PERMIT I COMMUNITY DEVELOPMENT Permit#: MST2016-00244 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/17/2016 Parcel: 2S106DC01200 Jurisdiction: Tigard Site address: 13716 SW SILENT FOX TER Subdivision: POLYGON AT WEST RIVER TERRACE Lot: 12 Project: Polygon at West River Terrace, Lot 12 Project Description: New SFA. Building/unit 3.3 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: 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'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: $22,050.08 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 throu..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. Ilk Issued By: . - Permittee Signature: d�`f '7 ,G e �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. Building Permit Application Z--C1 Re � ,s «s en g RECEIVEDFOR OFFICE FSE O.\LI City of Tigard Rei°� / ,y f �/� 40 y g Date/By: 47/�� �� 0P,- Permit No/l J� 7 13125 SW Hall Blvd.,Tigard,OR 97223 s °t C Plan Review `� Phone: 503.7182439 Fax: 503.598.1960)U N 0 1 2 016 Date/By: < 91 C ) other Perm—Cia€ i/L`4C�/� c;:1 R t) Inspection Line: 503.639.4175 Date Ready/By: p Juris: See Page 2 for Internet www.tigard-or.gov CITY OF TIGARD Notified/Method:#6-- p//� 4 Supplemental Information M SON /� ®New construction ❑Demolition Permit fees*are based on the value of the work performed. 1:1 Addition/alteration/replacement ❑Other: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the e work indicated on this application. i i ... � � � ::. 1-and 2-familydwelling CommerciaUmd --)) ustrial Valuation: �'S158,86g ) ()� 3 ElAccessory building IDMulti-familyNumber of bedrooms: 2 ❑Master builder ❑Other: Number of bathrooms: 2 :. t i °t ce ." rs Total number of floors: 3 moi"7 7 Job site address: 131 I( SW Silent Fox Terrace New dwelling area: 1221 square feet City/State/ZIP:Tigard,OR 97224 Garage/carport area: 456 square feet Suite/bldg./apt.no.: I Project name:Polygon at West River Ter Covered porch area: 3 square feet C Cross street/directions to job site: Deck area: 72 square feet 9 ) Other structure area: square feet Subdivision:Polygon at West River Terrace I Lot no.: I D 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 . . 5 "' > t p work indicated on this application. K6J�(,� •�y tit vu 3 3 Valuation: $ Existing building area: square feet New building area: square feet �� Number of stories: 4 as 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: ma6 s ;two ' 3 i 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 Phone:(360)695-7700 I Fax::( ) Amount received: E-mail:Angela.Grajewski@polygonhomes.com Commercial and residential prescriptive installation of E ��� :- ?� r � T -� � p . 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 Total fee due upon application: $201.60 Authorized signature: ,-„// This permit application expires if a permit is not obtained WWW within 180 days after it has been accepted as complete. Print name:Angela Grajewski Date:5/20/16 *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Application FOR()FYI( F. USE O\1.1 City of Tigard Received N/ • 13125 SW Hall Blvd.,Tigard,OR Uate.By: Permit NV/17;20/6 o ST //_ 02yV Phone; 503.718.2439 Fax: 503.5RECEIVED tan Rati�ew G� 1 1 ,,i,0 Inspection Line: 503.639.4175 Date'Il}. Other Permit: Internet: ww•w.ti and-or. ov JUNr]ste Rcady'Iiy- (oris. �' �' 01 20 i Notified and etheui- See Page 2 for it Supplemental Information I TYPE SM.upSpee9.-t&iyiky ii( kil L.,' FEE* SCHEDULE-USE CHECi(I.15T " Mechanical ®New construction ❑Addition/alteration/replacement permit fees*are based on to value ofthe work 0 Demoln performed.Indicate the value(rounded to the nearest dollar)of all i 0 Other: mechanical materials,equipment,labor,overhead,and profit. I CATEGORY OF CONsmm.1.10N Value:$ RESIDENTIAL EQUIPMENT/SYSTEMS FITS* la 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist ❑Multi-family 0 Master builder 0 Other. Description I Qty. ! Ea. 1 Total I JOB SITE INFORMATION AND LOCATION Hcating/tooting: 3`1 (� �� sl l en-1- rroK ,.e rrac_Q. Air conditioning 46.75 Job site address: 1 Furnace 100,000 BTU(ducts vents) 1 46.75 City•/State'ZIP:Tigard,OR 97224 Furnace 100,000+BTU tducivventsl 54.91 Suite/hldg./apt.no.: I Project name:Polygon at West River Ter Heat pump61.06 Duct work 23.32 Cross street/directions to job site: Hydropic hot water system 1 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric). in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision:Polygon at West River Terrrace 1 Lot no.: is Other: 23.32 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 i )clf, I) it'k".n 3.3 Log lighter(gas) . 23.32 "t+'J\ Wood/pellet stove 33.39 Wood fireplace/insert = 23.32 Chimney/liner/flue/vent ' 23.32 ®"P OPERTY OWNER I p TENANT Other Range 1 23.32 Name:ADVL Land Holdings,LLC Environmental exhaust and ventilation: Range hood/other kitchen Address:7600 4 Doubletree Ranch Road equipment 1 I 33.39 Clothes dryer exhaust 1 33.39 City/State/'ZIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms, Phone:(602)694.4031 Fax: toilet compartments,utility rooms) 3 23.32 ( ) Attic/crawlspace 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 Walllsuspended/unitbcater Water heater Phone:(360)695-7700 I Fax::(360)6934442 Fireplace E-mail:Angela.Grajewski@polygonhomes.com Range Barbecue I CONTRACTOR Clothes dryer(gas) Business name:Andersen Heating,Inc Other: Address:16285 SW 85'a Ave ste 410 MECHANICAL PERMIT FEES* Subtotal City/State/ZIP:Tigard,OR 97224 Minimum permit fee($90.00) Phone:(503)992-6664 I Fax:(503)536-66I5 Plan review(25%of permit fee) Starr surcharge(12%of permit fee) CCB lie.:168214 1 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 Authorized sigttafur : days after it has been accepted as complete. Fee methodology set by Tri-County Building Industry Service Hoard Print name: I Date:05/23/2016 J C:tBuildingWermits•MEe Perma App 040113 clot 446.4617T(11r4?.'Cl?NME'$) Electrical Permit A Dei r`�. IV I ui? t ri I i( I I wN 1 City of Tigard a a.4EM 13125 SW Hall Blvd_Tigard,OR 97223 J U N 01. 2016 �»> ; �' - Phone: 503.714 2439 Fax 503.598.1964 ■►^j Inspection Line: 503.639.4175 ,.. CI OF _f l(.�AR U acagy Dom," -. Int, wwrv.tigard-or,gav ED I N 3 1,v I ,�1�;,„a, Nodtiedrt dethod: ifl ,5"zea, w Newconstruction ❑Addiition/alteration/repl�xment Psedtedtdl'hatrpyly(w �•haleapinWitco;checked): ❑haService or feeder 400 amps or mono CI Building ower three stories 0 Demolition ❑Other Where the available fault current ❑Kean lad boaryarde, .. _.-... .. «, _°ret.,,'r, ::,`,_ : µ.1,? ^ 0 0 exceeds 100 amps at 150 volts os Elnoslioll buildings. 0 1-unc1-family dwelling 0 Corrtrnerciairilldtrstriat 0 Accessory building less to pound,or exceeds 14.000 ❑Commercud-me egticidtund ❑Multi-family 0 Master builder 0 Other �uower installations festal ati ❑Fire pump. ❑lnstdlas�of 150 i:VA or .. ! � a Fina cy Systmn large'sq a cly derived Job 8: Job site address: ,5I V .DI r n t-> j� I f i'tA additioa new mare tad of system. 1� i 1 lJll.K. IOOHP or more. ❑-A7,']s"."1-2;"13". City/State/ZIP:Tigard,OR 97224 17 six sr more residential units. aearPaaol. ©Heaims,are fatalities. 0 Reasstionel vehicle Pte. Suite/bldg./apt.#: 1 Project name:Polygon at West River Ter ❑Hazardous locations. O Supply vale r«more tion ❑Service or feeder 600 amps a more 600 voht aomtaal. Cross street/directions to job site: 7 �,7;: '-.7,77,,,,,,,,,,7.,-.7,-;,:',.: Qt;. Laeb :rad New residential single-or multi-family dwelling unit. Subdivision:Polygon at West River Terrrace Lot 8:/2__ Incudes attached garage. Tax map/parcel# 1,000 sq.ft.or less 1 168.54 ji 111'654 4 w .` '-,....',:2' Ea.add.!$00 sq.ft or portion I 33.92 33�� 1 C r ry (�J t it- Limited energy,residential75.00 1 2 J (with above sq.R) Limited energy,multi-family 75.00 2 r resident's](with above sg. ) 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 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:( ) 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: ; `n ertioeailoa services or feeders installation,alteration,and/or Business name:William Lyon Homes,Inc. 200 amps or less 59.36 I 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,per panel Phone:(360)695-7700 1 Fax::(360)693-4442 A.Fee for branch circuits with above service or feeder fee, 7.42 2 Email:Angela.Grajewski@polygonhomes.com each branch circuit M� B.Foe for hearth thrills wirhord �. � ,s w. a. service or feeder fee,first Business name:elalneda electric branchcircuit 56.t8 2 Address:3415 ne 44th Each add"branch circuit 7.42 2 Miscellaneous(service or feeder not included) city/State/ZIP:soma fif2M Ia wyt 2=ra /AT 7.W--/3 Each matufactnsed or module: 61.84 2 dwelling,service a Phone:(503)3192192 Fax:( )- rrd`or feeder Reconnect only 67.84 2 Email:solarpdxgate.com Pump or irrigation circle 67.84 7` GCB Lic.: 199188 Electrical Lic.: c923 Suprv.Lic.: tl r7/5 Electrician signature,required: Sign or outline lighting 67.84 2 Sum. Signal circuigs)or limibedtoergy _Print name: k,f{. j2onvy� t Date: c/�3/1.i/ •alteration,or extension. 0 Page 2 2 Each additional inspection over allowable in any a the above Authorized si. :, Additional inspection(I hr min) ' 66.2.5,hr , AIM Print eD kiwis— � !"fs investigation(I hr mm) 90 ow it r�arM res5W tc_ ...'. Flat REda RwWJ1712015 440-4615TO1.10 '�9WF� V 1 1�/,t t„l 1 Su rcrge .z T L ZZ(il(o Plumbing Permit Application Building Fixtures 1 11)a 1)I l li 1 t til t>\1 , City of Tigard �ll eeaeitzd Permit Na./ CSr.2o/6 -.00,2 y'' IN,-- , 13125:SW Hall Blvd.,Tigard,OR 47ZYiN 01. 2016 Date/By:ev Phone:,503.718.2439 Fax:-503.598.1960 tTffieB};RieReview 1 r � Other Pumit Na.: Inspection Line: 503.639.4175 CITY OF.e..t ARD Date Ready/By: ruris. H See Page for F Internet www.tigard-or.gov i1mn nl jSl)NNat,6ed/Mdod Supplemental laformatonIi ii New construction ❑Demolition For sptaert information Erse checklist Description i Qty. I Ea. I Total I Addition/alteration/replacement 0 Other New 1-2-family dwellings(includes 100 ft.for each utility connection) I 3-;, � aIk �a � ,, SFR(f)bath 1 322.70 ® I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath _ 437,78 �4?j`7, SFR(3)bath 500.32 ❑Accessory building 0 Multi-family Each additional bath/kitchen, 25.02 ❑Master builder 0 Other � Fire sprinkler(��sq.ft.) 1 Page 2 I al € t� r �" ',. w 6 .f .tee � .>� r ,.,., m , Site utilities: AIL----2'' S/,,_,41/4.f- eL'itJS Job site address: 13-1 110 5 W 5 i ws)-} 0.g. Ti ria G2 Catch basin or arca drain 18.76 Dryweil,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:Polygon at West River Ter lured 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 fL:_) Page 2 ' Water service(no.linear ft.: ) Page 2 Subdivision:Polygon at West River Terrrace Lot no.: t a Fixture or item: Tax map/parcel no preven ,/' 31.27 '� Backflow ttr ] '1j1.1„ . Backwater valve 12,51 J1 IQ.5t I t..KG Oleg '>Jlh‘� 2 3 C502 3 '' 1 Dishwasher 2lodses washer 25:02 . i Drinking fountain 25.02 1 Ejectors/sump 25.02 f r ) , s A a Expansion tank 12.51 ,°' " » '. � � Name:ADPL Land Holdings,LLC Ratans/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:7600 E Doubletree Ranch Road Garbage disposal 25.02 City/State/ZIP:Scottsdale,AZ 85258 He osebiF: 25.02 I Phone:(602)694-4031 Fax ( ) Ice maker 12.51 1; ;; .;‘, $� ..,y ,..� .: $€ s � a :: interceptorJgrrsse trap_ 25.02 Business name.:,Wiiipm, o �,_ ., i Medical gas(value:$ ) Page 2 Lyon Homes,Inc Contact name:Angela Grajewski Primer 12.51 1 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) l 62.54 Phone:(360)695-7700 Fax::(360)693-4442 Tsib/showerlshower pan 12.51 An elaGrri nhotnes.cotn Urinal 25.02 � E-mail 8 JIn► �1YICa r i Water closet 25:02 .> ..,,rc ` .. ,- s w Water heater 37:52 Business name:Alliance Numbing LLC Water piping/DWV 56.29 Address:146 W Historic Columbia River Hwy Other: 25.02 City/State/ZIP:Troutdak,OR 97060 Subtotal (oO3.41, Phone:(503)492-3490 Fax:(503)912-6438 Minimum permit fee: $7250 CCB Lic.:184601 Plumbing Lic.no.:PB732 Plan review (25%of permit fee) Authorized signature: State surcharge(12%of permit fee) /2.(4 2 ! TOTAL PERMIT FEE 05.85 Print name:Robert Dbhman Date:5/232015 This permit application expires if a permit b not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Thi-County Building Industry Service Board r\BuildinglPs mitai'LMU-t'e,mitApp.doc 10/01/09 440-4616T(10/421CY1M/WEB) f City of Tigard r COMMUNITY DEVELOPMENT DEPARTMENT ■ r l c R n Building Permit Review — Residential Building Permit #: /Yf 7 ,20/6, -- de), y/ Site Address: 31 I ( SW s;i&,i- 1 e x "Fere- Project Name: Po 1,y Jor ci+- vsieJ.r i.VW.r 1 rrtikk_ Lot #: Z-- (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: tJvw £'C J' Verify site address/suite# exists and active in permits stem. , River Terrace Neighborhood: ❑ No Yes,See River Terrace Review Addendum Attached Site Plan Elements: Three(3)copies of site plan 'BExisting structures on site Fite plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished Vbrawn 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 CJ3.,,.,ation of wells/septic systems ".Applicant information(name and phone number) fisting trees to be retained with drip line,and tree ZJLot dimensions and building setback dimensions protection measures /Lot area,building coverage area,percentage of coverage and JZStreet 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 ❑ No Received: ❑ Yes ❑ No APublic Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake gi Land Use Case#: 1,9 g.10 00 001 S u#2,-)-2,0 U 0 0001; , SL Z Zc iJ-- 00003 Zoning: - 2 g /7 Setbacks: Front ea,/i fear /0 Side 0 Street Side 3 Garage i 5,S Landscape Requirement: 2,10 Lot Coverage Maximum: (3 0 % Building Height: Maximum Height J Actual Height AOA I,f Visual Clearance ,ZEasements zSensitive Lands: ❑ Yes A No Type 6 Urban Forestry Plan 0 Conditions "Met"prior to issuance of building permit Notes: EDO�.+ti (1.1fit% he -�-vn� p i.oI h (Ss k.'c9 (sc. 0<- bLA' )c(A✓1 , nii-. Approved 1 y Planning: 410 eace6 Date: G I j/ 1 (G Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\B1dgPermitRvw_RES_060116.docx e Building Permit Submittal Original Submittal Date: rrp,X/ca) Site Plans: # -..7 Building Plans: # `3 Building Permit#: la--Enter building permit#above. Workflow Routing: ©--Planning E-Engineering Et-'Permit Coordinator allii.ilding Workflow Sign-off: [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. E13uilding: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: 0,jZ _. Date: 7.//4_, Engineering Review A❑ Slope at building pad: _4.= Conditions "Met"prior to issuance of building permit 0 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 Appr e)oby Engineering: Date: Notes: AtjefelpeoV. ro-ft-Z- Approved by Engineering: i"01 Jr.) Date: e Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved 0 Not Approved Revision 2: ❑ Approved 0 Not Approved Revision 3: 0 Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit Approved,NOT Released: ////f/i/Date: 6�7•U/js• Notes: G K N" °'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: • r SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: "Yes ❑ N/A pOK to Issue Permit Approved by Permit Coordinator: Date: 011/6 i I:\Building\Forms\B1dgPermitRvw_RES_060116.docx City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT TIGARD River Terrace Building Permit Review Addendum Building Permit #: /1,,577;2// -- 00,29y Site Address: 13 3 1 a S VJ s►Jell t. x re_cr. Project Name: f of y yo r Olt Weir etivv.r re-rrri Lot #: Z (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 ft. deep min. 2ft.,5 ft.wide min.2 ft.,6ft.wide Gabled dormer CI CI 2. Eyes on the street: a minimum of 12%of each street facing façade must include windows or entrance doors. Percentage Shown: 1 7 S 3. Entrances:At least one entrance must meet both of the following standards: pr Max. 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:,Z Yes ❑ No If yes,all the following apply: A 25 sq.ft. min. One street facing entry 12 ft.max.roof above floor of porch /u 5 ft. depth min. ;2'30%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 7f Recessed entry area min. 5 ft.wide x 2 ft. deep Wall offset min. 16 inches ,rpormer min. 4 ft.wide ,zl Roof eave min. 12 inch projection X Roof offset min.of 2 ft. ❑ Roof shingles either tile or wood ?Gable,hip or gambrel roof design CI Roof pitch oriented south min. 500 sq. ft. /❑ Horizontal lap siding min. 3-7 ft.wide ❑ Accent siding min.40%of street façade 71 Window trim min.2 1/2"wide by 5/8"deep ❑ Window recess min.3 inches for all street facing El Bay window min. 5 ft.wide by 2 ft. deep El 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 ZNo. If No (Check one): May extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch. VMay extend up to 5 ft.where thesgarage 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 ;2/50%max.of street facade with 7 detailed design elements Notes: Approved By Planning: /VI rt 71-1, g d Date: (. /1 1:\Building\Fors`BldgPermitRvw_RES_RT_031416.docx Plumbing Permit Appli9,atioq - . , Site Utilities City of TigardReceived Permit No.: ^ �L Nu III 13125 SW Hall Blvd.,Tigard,01‘,:1-942'23 i i Date/By: / /(p t-i raatle-en zi7 $ Phone: 503.718.2439 F 0 .598 1960 Plan Review Date/By: ' _4_ t6 634 Other Permit No.: T I G A R D Y Inspection Line: 503.639.41'75 Date Read/B See Page 2 for Internet: www tigard or.gpy Notified/Method:_ kids ®pplementalInformation TYPE._§t . :..'', ��rti.."`,,,,,;-;;?A' FEE SCHEDULE ®New construction 0 Demolition For special information use checklist Description Qty. Ea. Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) • LATE OR OT CONSTRUCTION SFR(1)bath _.., N 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 ❑ Master builderEach additional bath/kite n 25.02 0 Other: Fire sprinkler(1,221 sq.ft.) Page 2 .SCO SITE It O HATIO ,l "LO A; 'till' --v-1-'- Site utilities: Job site address:13716 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.: I 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.:12 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DP `RWT1O15( OF WOE , Backwater valve 12.51 Multipurpose Fire Sprinkler System Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 i7,?,.PRPFgtl`Y OWN .. 1 --1..,' a% '141ANT: 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 0 APFL1CANT coNT'CT Otte 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 • ,. . . ''. _ _.. 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 Lie.: 184601 Plumbing Lic.no.:PB732 Plan review (25%of permit fee) 7/......--) 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(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: � :. y u_e� Toa ' Iti�tilxSituar Fantage: Pezt Fee* 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 �.. ,'4?'alul�.titin'., ,, i." it Fe,e: 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 each additional$100.00 or fraction thereof,to Other irispeCtalo>as-tQr,Fees Qty., °1Feeleea)� T tal 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 each additional$100.00 or fraction thereof. (minimum charge-1/2 hour) 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*. ()multi by Fixture Type ;Plan Iteviv,v.for P hmUing Iustaltations Fixture Type for Repine/ Plan review is required for any of the following. Work Performed: Capped Added Reteeafe Please check all that apply. Baptistry/Font ❑ Any new commercial building with water service 2"and Bath -Tub/Shower -Jacuzzi/Whiripoot 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 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„ x " Itometric or iser ag " aIfl. Car Wash Drain Garbage Domestic-non-food 0 Isometric or riser diagram is required for new buildings 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 Pe2mit.doc . . . . , . REC IVED - -.---7 E . ... Electrical Permit Application FOR OFFICE USE ONLY City of Tigard N O V 10 2016 D.Rec.i /i[!/Z�f� .�� r 13125 SW Hall Blvd.,Tigard, `� / ■L�1 I card,OR 97223 Plan Revi Phone: 503,7182439 Fax 503.598.1IN f�ARI Mall Related Permit d: Inspection Line: 503.639.4175 �� H See Page 2 for T I GA R D Ready Date/By: !uric: Internet www.tigard-or.gov �T.t1! D Ng WISH d/Method: Supplemental Information 'S-4' i4 i .-n F,* 7: tr 1.+,.`C.'7* - .: 7.3_i37` y til Z-sx_^r v.+`c '_:-a 4 Js=�.�.��.-,y,11 -:j 'Vm,,.. ^•-*, a-W'".. ...a--,'�.,r-.v..'�-t'-`�:�„: -'1-rd^°2` ?�.�"^�'".'.z.�c%.,-'y,.`_�•.S-.:v:..t?,,.v�'k�p�N�E�'� -•�::`.,:0>>..1={._ �. ®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans wiitems checked):^”^ ~ ❑Demolition ❑Offer ❑Service or feeder 400 amps or more ❑Budding over three stories. where the available fault current ['Marines and boatyards. .• -z ar0l d k. -� `., exceeds 10,000 amps at 150 volts or ❑Floating buildings. ®1-and 2-family dwelling ❑Commereialliadtistrial 0 Accessory building kss to$fou or exceeds 14.000 ❑Commercial-use agricultural ❑Multi-family 0 Master builder ❑Otheramps for all other installations. buildings. -.-:.,Mu ::.�:t-milInstallation of 150 KVA or 0 Fire pump. 0 �.- r. •�. . :�: �+�._._.,��. 0_,... _ QN?�l'!�D_"�' £EdhL'�`�� - ❑Emergency tem. '�' �' '��'" larger separately derived 10011P or more.site address: \f SiQ L 1� ❑Addition of new motor load of V.q ap � ,1-eN- rex e ❑s A E Job#: Job City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy. ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: 2 .7 Project name:Polygon at West River Ter O Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: Description I Qty. I~,.rjd, Total 1•. New residential single-or multi-family dwelling unit. Subdivision:Polygon at West River Terrrace Lot#: 1 Z Includes attached garage. Tax map/parcel#: 1,000 sq.ft or less 1 168.54 4 __ Ea.add'l 500 sq.ft.or portion 33.92 7:;"-ie-^1 C `/��'X'W- 1-Itil1ES v �.._�;^,� ' Limited en residential 1 ( v 1 1 r,llA.l_,� `1 Y o energy, ` (with about sq.ft) 75.00 2 Limited energy,multi-family 75-00 2 residential(with above sq.It) ,:?1,,,, d 0 ,, ,4 0Renewable Energy ❑ Page 2 y Services or feeders installation,alteraSeetion,and/or relocation Name:ADVL Land Holdings,LLC 200 snips 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 301.04 2 Phone:(602)694-4031 Fax:( ) Over 1,000 amps or volts 55226 2 Email: Temporary services or feeders installation,alteration,and/or relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 5936 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: Dom: 401 amps to 599 amps 16834 2 = =�4 •E Ems "r �`i v Branch circuits-new,alteration or extension,per panel :.• _ ?�.�., �,z-""� ._ �-`�`�`� �.`�'"�����" 't'-` AFee 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,fast 56.18 2 branch circuit City/State/ZIP:Vancouver,WA 98660 Each add'!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 Grajewsld@polygonhomes.com dwellin service and/or feeder 67.84 2 '-: .� 5='_ ;,.rt �'� Q- i ' ?7r , r circle 67.84 2 Reconnectonly 67.84 2 Pump o irri gat'on Business name:Garner Electric Washington,LLC Sign or outline lighting 67.84 2 Address:6101 NE St Johns Rd Signal circuits)or limited-energy panel,alteration,or extension. 0 See Page 2 2 City/State/ZIP:Vancouver WA 98661 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 6625/hr Phone:(253)320-1657 Fax:( ) Investigation(I hr min) 90.00/hr Email:bdaniels®gweusa.com Industrial plant(l hr min) • 78.18/hr Inspections CCB Lie.: CI158 Electrical Lic.: 208174 I Suprv.Lic.: 4496S spa which� > ) forno 90.00/hr Suprv.Electrician Hired: / - `' ''INal _ .. y signature,req :At " L 'rtir't� Subtotal: Print name: Joan P Albert • Date: 4/26/2016 ❑Plan Review Required(25%of permit fee): l---- _ ® __ State surcharge(12%of permit fee): Authorized sinful/re: ,.-- l — -_ 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 YiBuad'rnglPerrnitaVLC PermitApp ELK ERridoc Rev 06117/2015 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 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 - - -'i '' , - IT ;, ---ups. - v ki,f ( 14 't-4 - 1 . , Electrical Permit Application -,gFoiff ;oicu Lisu:ON I.N. i it:-E-44 S il i • • ' City of Tigard I--- W4 ti I,-. ti rd)7171r1(4 1.a . 11,-- 03:71witoimmill .IN II 13125 SW Hill Blvd,Tikard,OB 97223 . f‘' OF T 1(--',..kti,LI phi,Row., , phone: 503.718.2439 Fax 503.598. D', 1.,- --` baterit 121 bupeption Line:503.639.4175 Internet: www.tigard-or.gov '.e.,.ife'Ddiamteetba:d: • 11111.1... roppirmPontaltorination - ‘:.8:'4;'.7%4:,%•Vr.kli..745..rieWOM'rlfgarr:::. '-:: ni'..7i....'7444,2t.Agfg '• ' Egi New construction 0 AdditiOidaliOintitinfrOlhaldeili Pleaseeheolc nil dia.t apply.(subroit 2 sets offfilansavfnents Checked):' - ' 0 Sari&or feeder 400 amps or more 0 littillding.over three stories: 0 Demolition 0 Other: - where the available faultourroal 13 Maim emilmatfesds exceeds 16,006 neaps ar150 volts or 0 Noutiugboadings. -and 2-family dwelling 0 Commercialimdustrial 0 Accessory building least°ground,or exceeds 14,000 0 Commercial-use agricultural amnsfor all Otherinstallations. haildinza. ) Multi-family 0 Master builder 0 Other: ID Fire pump. 0 Installation of150 KVA).or .P.71‘:'' T'113'1':;''.,.%;r3P ::1:S-; ''. 771. ';'.41e7 tt.ti-7Asia: 0 EmeFifeeeY system larger separately derived DAddilicat of new motorload of system: Job site address;/ 7 Co S ient A• Terreice•• ,,(0)0,„„.. 0*A",137,."1-2","1-3"; -- City/StgerZO:Tigard,01R97224 - 0 six ormore resider:tad units. 0 licaltb-care facilities. 0 Recreational veltic-le Parks. .: $nite/bIdglapt..#: Project name:Polygon tit West River Ter 0flatindeosIoestions. a Sapp&'Voltage for more than 0 Service or feeder 600 amps or mom. 600 volts nominal Cross street/directions to job site: g4.,.eti.: tanatetion tit;1. Each Teed i"". • New residential single-or multi-family dwelling unit Subdivision::Polygon at West River Terrraee I Lot#:ti, Includes attached garage. Tat , ' 1,000 m.It.or less 168.54. 4 O tnaplparc .. . • E...ado500sq.4wpqrti. 13,92 , 1 efi,%. .- mea-riv..,:i7,;:tirootx-oxi , .,,:;,.:i.. ..,3'.9e1a7:''..n.,.0!*4: Limited energy,resideolial ' „ 75,00 COO OM .\(\fairrif V (with above sq.ft.) Lintited energy;niultkinxiily ' 75,00 2 2 i residential 6v(thabovesq.it.) CI Sit P 2 2.1ratilVi711:11 ,1g14,4fAtah'•?;44KW:Wt•Walitar- P.TrgWV:7'-i Services or feeders installadoni.alteration,and/or relocation Name;413VL.Land Holdings,LW 200 amps or lets 100.70 2 r : Address:7600 E.Doubletree Ranch Road 201aps to 400 Mips 133.56 2 • '' 401 amps to 600 amps - 200,34 2 City/State/ZIP:Scottsdale,AZ 85258 . ogn amps to 1,000 amps 301.04 2 . Phone:(602)6.944031 '-' Fax:C. ) - Over 1,000 amps or volts 552.26 2 • TemPararkiervices or feeders installadon,alteration,and/or 'Email: . reloCation . . .. Owner installatiom.This installation is being made on property that Iowa which is not . 200 amps or late 59.36 1 intended for sale,leases rent;or exchange,according to ORS 447,449,670,and 701. 20l amps 1040(1 sitips 7.5.08 2 Owner signatttre:. . . . , . . Date: 401 attipa to 599 amps 168.54 2, • movroodosomwmozonidgotr3rosoistv0 Alltritaciaelflocirer ults-..nert;alietterition,or extension, r panel Bltsinest name::William Lyon Homes,Inc. above service or feeder fee, '7.42 2 . each Numb&cult Contact name:Angela Grajevyski •.11 Fee for branch circuits without. ' service orfeeder fee;first Address:1.09 tast.1311-Street • branch Garda • 56.18 2 City/State/ZIP Vancouver,WA 98660 .. Mich add'1 branch eirenit • 7.42 2 1 " Miscellaneous(service or feeder not included). ... . Phs.:41e:(30)PS-7700 I Fax::(360).6934442 Biehmenufrictured or?nodular - dwelling.service and/or feeder . 67'84 2 Email:Ampla.Grajewski@polygonhomes.cont Reconnect only 67.84 2 Pump or irrigatiOnvitcle 67.84 ' 2 Ensines4:name:SiMply1llectric LLC Sign°towline lighting 67.84 - 2 •• Signal eiguit(s)or limiod7prnagy ,-, . Address:PO Box 822408 Panel,altenition,or extension. ' LI See.,N*2 :2 V C /StatetZ1P: WA 98682 Each additional inspection over allowable in any of the above•ityancouver, , Additional respection.(1!gado) : 66.25/hr Phone:-(503)8494202 • Fax:'(360)3144945 :hivesgidla(1 hrMin) • . . . , IocitisMatplart air mio) . : "78.:1:681;britT Email:simplyelectriepdx®gmaiLcont. insPectionsfor*bleb Tie fee it 00/li 90r CCB Lic.:t 204615 Electrical Lic.; 1067 Suprv.Lie.: 4394S ! .,. i- listed i4hrinta • ''''..';' ,.P....,...:''`#*5.vtl ..-jd.. ...kr..6.;'.. ' 'et';': • %,' SUPT.Electrician signature,required: .t. • i fl Zni.r 44C/411 • Subtotal: Print name: Victor Zarzbitsky 1 Date: I/8/2017 0 Platt Review Required(25%of permit fee): --, State sambarge(12%ofpermit ibey. .4.trthoripod Signature: •. ' . .. 7-1---%, -----C ._. TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180' Print IMMO! Dimitriy Mistchuk Date: 2(8/2017 days after it him been accepted as complete. . . .. * Number of inspections allowedper permit. . htllitlittiagtfarinitstELCjenabitim Et..12._ERE.4oc Rev 06/17/2015 440.16)SAMOSCOSeharim City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13716 SW SILENT FOX TER, SHERWOOD, OR, March 28, 2017 at 5:23:39 PM 97140 Record Type: Record ID: Residential - Master Permit MST2016-00244 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS Comments: No AC at this time. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13716 SW SILENT FOX TER, SHERWOOD, OR, 97140 Record Type: Record ID: Residential - Master Permit MST2016-00244 Inspection Type: Inspector: 699 Mechanical final David Young Result: PASS Comments: No AC installed at this time. Violation Summary: Inspector Contractor