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Permit , CITY OF TIGARD MASTER PERMIT 1.1 11 . 1: COMMUNITY DEVELOPMENT Permit#: MST2016-00125 Date Issued: 09/15/2016 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S 1060002900 Site address: 13688 SW 174TH LP Jurisdiction: Tigard Subdivision: WEST RIVER TERRACE Project: Polygon at West River Terrace, Lot 83 Lot: Multiple Project Description: New SF BUILDING Floor Areas Required Setbacks Stories: 3 Bedrooms: 4 Required First: 1248 sf Basement: 735 sf Left: 3 Height: 32 Bathrooms: 3 Second: 1666 sf Parking Spaces: 0 Dwelling Units: 1 Garage: 464 sf Front: 12 Third: 0 sf Smoke Right: 3 Detectors: Yes Total: 3649 sf Value: $437,015.87 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Urinals: 0 Tubs/Showers: 3 Sewer Lines: 100 SF Rain Garbage Disp: 1 Water Heaters: 2 0 Storm Sewer: 100 Footing Drain: 0 Ice Maker: 1 Water Lines: 100 Drains: Hose Bib: 2 Backwater Value: 1 Bckflw Prevntr: Catch Basins: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Tvpes Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Furn<100K: 1 Hoods: 1 Other Units: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential UnitService Feeder Temp Srvc/Feeders ---- 1000 sf or less: 1 Branch Circuits 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 6 201-400 amp: 0 201-400 amp: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 p W/O Svc/Fdr: 0 p 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 Other: N Other Description: All Ecompasing: Y BUILDING INFO Class of Work: Type of Use: NEW Type of Constr: Occupancy Group: SF VB SquareFeet: Owner: R-3 3649 Contractor: ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions) 7600 E DOUBLETREE RANCH RD 109 E 13TH STREET #150 1 Ersn Cntrl 503-639-4175 VANCOUVER,WA 98660 2 A Geotechnical report is SCOTTSDALE,AZ 85258 required before the footing PHONE: PHONE: 360-695-7700 FAX: Total Fees: $34,866.67 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 0 : 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: � ��. Permittee Signature: QA/ j�G i�'�/--7a"/ 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 G- �/ l P'.--3 3h/4, +rti'` _1.11 t RECEI Y�� FOR OFFICE t SE b>l.l IN City of Ti mrd D Recrived J'/ ZJ' r' ei.' re�itrro 13125 SW Hall lvd.,Tigard,OR 97223 MAR 2 3 2016 Plan Review ` ' � 16'fi4l�S.' Phone: 503.71 139. Fax: 503.598.1960 Date/By: r Other P f TICi 1 1� Inspection'Lint 03.639.4175 CITVOFTIGARD DateReadyBy: e� lurk: �jc �2for Internet: wwv ard-or.gov Supplemental� en g DUILDING DNISI® ohfied/Method:�s3 �� � Information El New construction ❑Demolition Permit fees*are based on the value of the work performed Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the ......4z,,-,_+ .., z,;.-y.--,..;-'12..)171,-..:-,4:4).;s ` s ` i .�-..Rrf work indicated on this application. ® 1-and 2-family dwelling>_ y L 0 Commercial industrial x Valuatio uli;�r g w_� ilirk�: VIE 0 Accessory building El Multi-family Number of bedrooms: ❑Master builder. 0 Other Number of bathrooms: 3 Total number of floors: Job site address: I ND?f SkNi I i f 111 100 I New dwelling area: square feet City/State/ZIP:Sherwood,OR 97140 11 lJ Garage/carport area: t..0 square feet Suite/bldg./apt.no.: Project name:Polygon at West River Ter Covered porch area: (-_f�J square feet 1 6 c Cross street/directions to job site: Deck area: t<"--) tly,z4� square feet I a... 1 g Other structure area: fa square feet 7 3 1171;;& 9 #i�aj Ys"ry , 'r sem. a "�-� J_ Subdivision: I Lot no.: 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,"" '. �{ r __t : work Indic materials labor,overhead,and the profit for the �k� >. ,, a 'I` .;.'4-:- -'� .,-,..3-t :r... U - . work indicated on this application. New Single Family Detached Construction Valuation: S Existing building area square feet � _9ffi V �f E M1 1 7 5 T- New building area: square feet ;h- � �� z m �: Number of stories: Name: OW nc/ iii . / . Type of construction: I Address: 1/A r r € ,i, i , .1 - A. _1 Z_/. I� _ Occupancy groups: City/State/Z11IP:1 , 1 / e,pA2,.. (13 J-2S( Phone:(oDZ / — ' Fax(360)693.4442 Existing: New: Business name:Polygon WLH,LLC Y=. ,� ., .., F ;<-,Ty� Contact name:Maggie Gordon Structural plan review fee(or deposit): Address:109 E 136 Street FLS plan review fee(if applicable): City/State/ZIP:Vancouver,WA 98660 Total fees due upon application: Phone:(360)695.7700 I Fax::(360)693.4442 Amount received E-mail:maggie Bordon of onhomes.com ' t z.'ire g';'`.(,:7::::-;17,..,--7.-TT.:- 1"»�" -;f4% _, �- ,.,, a �`c -r ,i, .• 7 s t Commercial and residential.p�. :::--,',;7.--:-....7s..,: , =n ,.-� _ 4,e T€ IaicSolar prescriptiveinstallation of ' � >_ � _�.z roof-top mounted Photo Voltaic Panel System. Business name: 3-LLC Gj, j LyeAl ii /?63 //VC.- Submit two(2)sets of roof plan with connection details Address:109E 13th Street and fire department access,along with the 2010 Oregon Solar Installation Specialty Code checklist. City/State/ZIP:Vancouver,WA 98660 Permit Fee(includes plan review $180.00 Phone:(360)695.7700 and administrative fees): Fax:(360)693.4442 .+� State surcharge 12%of permit fee): $21.60 CCB lic.:1"7'47 :7t(�2o21/2 g ( ..-.iv. Total fee due upon application: 5201.60 - Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete_ Print name:Maggie Gordon , Date:12711/15 *Fee methodology set by Tri-County,Badding Industry - Service Board. 1:1Building\Perrnits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) -... Mechanical Permit Application E I t)€ till if I t of;()NI 1 City of Tigard RECEIVED R�rivcxt €3125 SW Halt Blvd„Tigard,OR 97223 Caateil3r. Permit 1#a �y j� Phone: 503.718.2439 Fat: St33.598.€ p 2016 Plan Review � L' '%/ S r ate t Inspection Line: 503.639.4175 M HR 2 F?ateRnr Permit Internet: H�+�a.tigard or.eov Date Ready/By:. NovR[ Bre Pagel for CITY OF TIG Notified/Method: Supplemental lafet,natiott 'W . IIG DIVISIO 124 New construction 0 r�dtlttt tlfa(teratiortlrc lacy rrtertt Mechanical per t fees.are ba r on the value of the work . . :: performed,Indicate the value(rourtdcd to the nearest dotter}01.4 0 Demolition 0 Other: rete equipment,materials, ,labor overhead profit. rofit. Value:S ` k..,41;< „n .° : .,, tri , ..u<;m I-and 2-family dwelling Commercial/industrial 0 Accessory building: z�•• AiFor o rsped�#.fnrarr rkeatlin Multt-lamrlq 0 Master builder0 Other: Description I Ea. I Total :-.:,..-2--‘,<:";-: ea; , F' (' .,R q-'1aP i� A;:• ' � : ,;ae� IIcati eootag r nditioningJob site ardrCssfioie SV'V '^ r'/ b � Furnae€tt,?IXBTU 46.73 56.95CitylStatetZlP: ,i�Oa " ' `' � Furnace 104, t-BTI;€dectsevctrrs3 54.91 Suite/bldg./apt,no.: Project name: PO Kt (A (A ?�, [ l�Irat gamy &(.t , - - l' €3ttc€coctrtc 1 Cross street/directions to job site: 23.32 .ry .,)L 4, LO H dronic hot water system 23.32 ' Residential boiler(radiator or hydronic) 23.32 t Unit heaters(fuel-type,not electric). in-well.in-duet.suspend,etc. 46.75 Fluetvent for am of above 2332 Subdivision:River Terrace Lot no.: 2332 -Tax map/parcel no.: lather fuel appllanees t r8 dg /"....A14:1;;-Nb,-1 � w Water heater 23,32 E f a. 1 _�w�; Gas t#rePPlasthusert HVAC 3339 I((- fare gent for water heater or gas fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood Eip:place/insert 23.32 Chimney/liner/flue/vent 23.32 °.. •a ,:,. ` `-t l ; S ' , ay cher. I 2332 `' �n Environmental exhaust and ventilation: Name:f\t7Lt/ •Lo Id Range hoodiothcr kitchen Address:1(,OD egg equipment 33.39 I�uacC_ fi�t30 City/StaattcTLlP:” Clothes drier exhaust 33.39 ] p, _ �S? Single-ductcRhattst(lsathroams, t Phone /)`!�� /l,l 1 r Fax ( toilet comqartzttents,utility rooms 23.32 4 IK � j At€icicrawlspace Darts 23. 2 i , wvotl Other 2332 Business name:Apex Air LLC Fuel piping: Contact name:Steer Hay Si 4.15 for first fear 34 t}3 for tatcla additional Furnace.etc. Address:2210 W.Main St.Suite 107-272 teas heat Enamp City/State/ZIP:Battle Ground,WA 98604 Watter heater Phone:(360)342-8109 Fax:':(360)326-1761 Fireplace E-mail:stacib apexaireo.cotn Range Barbecue `�)X: �.°.� < �- i- ‘ Ctotitts dryer(east Cniter Business name:Apex Air LI,C Address:220 W.Main St.Suite 101-272 : ` rte ‘ r't 1.':�/.. < : :: „ fisly E City/State/ZIP:Rattle Ground,WA 9860 +atbtoat) 3 Minimum permit fee(590.00) Phone:(360)34241099 Fax:(360)326-1749 Pian review(25%of permit feel CCB lie.:211303 t State surcharge(1246 of permit feel TOTAL PER4II I 1 EE / 7, This permit applicationexp res it a permit is sof obtained wtrhia ISO authorired stgnaf e ' 7 days after it beta acr-tps,at as complete. 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I i 1. kllumbin&Permit Aunlica -, . .. `,, ,, 1 Building Fixtures City of Tigard l I,i' 1 ' 2 I I 1 b > vcd Po'mit No.:�t 13135 SW,f1'021�1vd,7`►ga�8, 73 /����I'�„Fr ��c,� Iii , Pbone: 503.718.2439 Fait; 5744.7 1.960 T t c,;r,n Inspection Lina: 503.6.#9.4173 - • Amery _ Other Paaah?vo: Internet ww>~r p�gatd of gov Aare Read}/By: Auk 1 0 Secl,?agc 2 ter w;:N;,., ...,net Na iiedtvlcthod �y-�}:. _ {;, ),::;t'r'Y•>:w; r �;�;���t'R x c t 6 � �P1cmEatiilIafbx�otio5 ••'eta„'-tivtt!!• .CF .:;?4.. •..Nl,z,n:"-••7 `+'r�jpev.,..S .iiiii!!csf::4;a:' +_!.r�. ° 'r',:::;:..,;s�f�..r,...,,•.. ,..U,.^ _ ;%•-,• ew�etien /t _ 4::.... i 0 Demolition fOr Fel fir caw arse t ❑,A,dt�LtADltlalt+ �d1✓iP lAOfllLept Other I, lion NMI Bo. oto. {,; y r New,l-2-family elwettings(iiadndes,1000 fl for tech utility connection) • t L t :'�':. w_��7+i°:�':,*.:,V•�:r �•:� .,r•; f �t11 312.74 ►%/-aM 2-ngily dwelling 0 Ct fettaU3ndusnje!` _ ,. SPR r1 bath 437.78 . D Acsary building ti 9szodl)r SFR(3)bath 50032 ©Maste builder t �F.tarls additional[start et 25.02 m spdtddert .sq. .:i;•._`2 i F 5i:"..:,;,i••.. Ytixri !•`.,M +� N 4c1 ` o•�•`•i:::h :. .' :F,•?'� 1dte f J +.,®,. lob site address? { :: Catch hunt or arca drain 13(08Q �SWr7� kpop ll;.T6 City/State/2 P: s 18.76 Suite/bldg./apt-no-= Project name:/OD L yG 0 ra /9-7- ntenufactunal home d Page 2 lities 30.03 Cross stmetldimct+ions•tO Job site: (.lf ES-'7.'el EX T�7�gd 18.76 . Rasa drain connector 13.76 SaDitarysewer(uo.Wear it:_,_,) 'age'2 Sanaa sewer(ria linear ft,: 1 Page 2 Water seryice.(tw.'lincxrtf'.:• ) may^: Subdivision: 1 Luno.: . 83 Filtaate or item . . ' �• . ;BE3aactara,mw, svhah 3127x,x map/parcel no.: 12 51iY :, g::1.�:sw h;s;'7 � 5',PiR ,. i-7''.a".; C City of Tigard IN i COMMUNITY DEVELOPMENT DEPARTMENT T, p Building Permit Review — Residential Building Permit #: S'j `c — 0e7,2,---C- Site 47 .Site Address: 13(i 3 ..s iVJ 17 4 ` Lo::p Project Name: {Fe, 14 5 0„ cik iii%z7 s4 R, vz k�,-r- c,;z Lot #: B3 (New dwelling= subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: N e S+(� k Verify site address/suite#exists and active in permit system. ,'River Terrace Neighborhood: ❑ No 'Yes,See River Terrace Review Addendum Attached Site Plan Elements: ,Three(3)copies of site planExisting structures on site Site plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished Drawn to scale(standard architect or engineer scale) floor elevations kl-North arrow X--Utility locations(required for new,may apply for additions) ( Site address,project or subdivision name and lot number .Location of wells/septic systems .Applicant information(name and phone number) inrosion control(including drainage-way protection,silt fence 24-Lot dimensions and building setback dimensions design,location of catch basin,etc.) E Lot area,building coverage area,percentage of coverage and Ztreet names impervious area(applicable if R-7,R-12,R-25&R-40) !Street tree size,type and location NJ-Property corner elevations (2 foot contour lines if more than ,xisting trees to be retained with drip line,and tree 4 foot differential) protection measures ,i Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: E Yes,applicant was notified No Received: E Yes ❑ No k'Public Facilities Improvement(PFI) Permit: Required: Yes,applicant was notified ❑ No Applied For: Yes ❑ No,stop intake kit Land Use Case#: P[7 R:telUI5 —. pO004 / s c�c�c: L$ Zoning: CZ - 7 t5 ._. co A" Setbacks: ,,,,.r..>1,i• Front ID., Rear Is' Side3 Garage Side — Gara e U ..0 Landscape Requirement: o Lot Coverage Maximum: 42), % 5 =a ��a ❑' Building Height: Maximum Height 35 Actual Height 3 7 Visual Clearance I i Easements Sensitive Lands: ❑ Yes a-No Type Urban Forestry Plan conditions "Met"prior to issuance of building permit ' otes: 1.4 mss+ m e L.f- Cv,i d t u ro p.--; - -C--o b ' l d`,,A 1 pr r-.-.n F' 'i J'S iA.&rcG.-2 - Approved By Planning: /i1/J/1 17 A 0iiokerAA 1, Date: 3/21-/ i to 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 012116.docx 4. v Building Permit Submittal Original Submittal Date: c. .42.2/46 Site Plans: # 3 Building Plans: # Building Permit#: erEnter building permit#above. Workflow Routing: I Planning Engineering ermit Coordinator -Building 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. LJ'Building: original permit application,site plans,building plans,engineer and beam calculations and trust details if applicable,etc. Notes: By Permit Technician: � �?____. Date: <3`� j�E� En 'veering Review Slope at building pad: �� Conditions "Met" rior to issu nc"e of building permit p 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 Approved jngi eying: Date: Notes: ,/...) fG�o.e..�j� 11_. -- / Approved by Engineering: 4 Date: ,1--..Z —jig Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit Approved,NOT Released: Date: 5/3-`' /‘rNotes: e~-2-- Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: Revision Notice 3: Date Sent to Applicant: 'SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A Tigard Trans SDC: 'Yes ❑ N/A Parks SDC: 'es ❑ N/A OK to Issue Permit Approved?41 'c://..) i6 by Permit Coordinator: Date: I:\Building\Forms\B1dgPennitRvw_RES 012116.docx s. s City of Tigard a COMMUNITY DEVELOPMENT DEPARTMENT T 1 G A R D River Terrace Building Permit Review Addendum Building Permit #: /t/—Cr-,7--e, Co. e90/.2-5 Site Address: 13(or b Q) S ii.J { 7 Li--tu Loc.p Project Name: .?G11 c ,,, cam-{ WA's t Z;vt-r TP - Lot #: 3 (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review River Terrace Plan District Design Standards (18.660.070.1): 1.Articulation: a minimum of 1 element per each street-facing façade 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 X ❑ ❑ ❑ ❑ 2. Eyes on the street: a minimum of 12% of each street facing facade must include windows or entrance doors. Percentage Shown: I'7 . S `t6 3. Entrances:At least one entrance must meet both of the following standards: C 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: .® Yes ❑ No If yes, all the following apply: (''25 sq.ft. min. k One street facing entry 1Nf"12 ft. max. roof height above porch V-5 ft. depth min. ,IV 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: xf Covered porch min. 5 ft.wide x 5 ft. deep ❑ Recessed entry area min. 5 ft.wide x 2 ft. deep L -Wall offset min. 16 inches E Dormer min. 4 ft.wide XRoof eave min. 12 inch projection ❑ Roof offset min. of 2 ft. ❑ Roof shingles either tile or wood S'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 façade Window trim min. 2 '/z"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. lif Yes g.No. If No (Check one): I "May extend up to 5 ft. if there is a covered front porch and garage does not extend beyond the front porch. 0 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 iit'40%max. of street façade ❑ 50%max. of street façade with 7 detailed design elements Notes: Approved By Planning: 0,ku (,a . Ce.... ...',,,Liz.-- Date: 3 ---R I - 1 l:\Building\Forms\BldgPermitRvw REs RT 0121I6.docx 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 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 •www.tigard-or.gov TO: 1 u - W- DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: R-irtqfhk, aczi-j)(A)Sp. OCT 2 5 2016 COMPANY: Vv l C.4-{r1J--.10Y1 VV) irvc_ CITY OF TIGARD PHONE: a-\ L4� BUILDING DIVIS�IONL,� By RE: t 310/3 Std \1'- ''` Loci, (pern� um2U)I(o- pp L rte Addcg resst 1oJk a A - e;vcr -err. 101- (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Additional set(s) of plans. Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. 5 Floor/roof framing. $D.5 *' Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: rn iss i,no5sorr, op t( , 1tbvni -pVectAxCV 1Q )L ak m.) cis +c t&c t wt Routed to Permit Technician: Date: p-. - _ ERDSIUMNINI Fees Due: ►-I Yes ■ No Fee Descri tion: Amount Due: ManillraMnie $ $ d $$ Special Instructions: Re srint Permit .er PE : ❑ Yes MI i o ❑ Done A I .licant Notified: 6/ Date: / I:\Building)Forms\TransmittalLetter-Revisions.doc 05/25/2012 Plumbing Permit Application Building Fixtures 1012 011ll F ( til t)\1.1 Received City of Tigard y JD` /ci ' Permit Nom c T1 nt6.- b/.2 ■ 13125 SW Hall Blvd.,Tigard,OR 97223:1111 0 Dazed �"G Ow [itJ Phone: 503.718.2439 Fax: 5031598.1960 _Plan Ravin Other Permit No.: Inspection Line: 503.639.4175 t areRy I I , ,tin Internet: www.tigard-or.gov - - Date Ready/By: kid. See Page 2 for Notified/Method: Supplemental Information ,., :- TYPE'OF WORK..,. ....,.. FEE*.WAEDJJ,, ®New construction 0 Demolition For special information use checklist Description I Qty. I Ea. I Total ❑Addition/alteration/replacement 0 Other: New I-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION" SFR(1)bath 312.70 ®1-and 2-family dwellingSFR(2)bath 437.78 0 Commercial/industrial ❑Accessory buildingSFR(3)bath 1 50032 ❑Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fiire . sprinkler(_sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: tQ S �' l.}-1n t ^ Catch basin or area drain 18.76 Job site address: '��l-3� '� � `'1�` t �'`U 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.: l Project name:Polygon at West River Ter Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision:Polygon at West River Terrrace I Lot no.:Qv%5 Fixture or item: Tax map/parcel no.: vv✓✓ Backflow preventer 31.27 . . DESCRIPTION OF.WORK Backwater valve i 12.51 Clothes washer 25.02 I 'aC b Y Ci Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 E.PROPERTY OWNER I (] TENANT Expansion tank 12.51 Name:ADVL Land Holdings,LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:7600 E Doubletree Ranch Road Garbage disposal 25.02 City/State/ZIP:Scottsdale,AZ 85258 Hose bib 25.02 Phone:(602)694.4031 Fax:( ) Ice maker 12.51 ®.APPLICANT . CI CONTACT PERSON Interceptor/grease trap 25.02 Medical gas(value:$ ) Page 2 Business name:William Lyon Homes,Inc Primer 12.51 Contact name:Angela Grajewski Roof drain(commercial) 12.51 Address:109 East 13th Street Sink/basin/lavatory 25.02 City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54 Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51 E-mail:Angela.Grajewski@polygonhomes.com Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater t 37.52 Business name:Malmedal Enterprises Inc. Water pipiag/DWV 56.29 Address:PO Box 207 Other. 25.02 City/State/ZIP:Banks,OR 97106 Subtotal Phone:(503)324-0759 Fax:(503-)324-0580 Minimum permit fee: $72.50 CCB Lie.:102535 Plumbing Lic.no.:34-276PB Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: a,„.- I TOTAL PERMIT FEE Print name:Carolina Malmedal Date:04/25/2016 1 This permit application expires if a permit is not obtained within ISO days I after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:lauildingTermits\PLMU-PennitApp.doe 10/01/09 440-4616T(10/02/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 7,1 4 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 RE DEPT: BUILDING DIVISION i r. 1 NOV 14 2016 FROM: Angela Grajewski CITY OF TIGARD COMPANY: Polygon NorthwestBUILDINGO PHONE: 971-212-2144 By: RE: 13688 SW 174th Loop MST2016-00125 (Site Address) (Permit Number) Polygon at West River Terrace Lot 83 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: ► I escription . tt; 0 • „ , Cop d- scri bion y x,,, 0 Additional set(s) of plans. 0 Revisions: 0 Cross section(s) and details. 0 Wall bracing and/or lateral analysis. 2 Floor/roof framing. ,mss F=:--tom r 0 Basement and retaining walls. 0 Beam calculations. 0 Engineer's calculations. 0 Other(explain): REMARKS: Please pay fees owed with Trust Account. seem oringinal submittal was the floor plans for the 2 story, not the daylight basement as this plan is. 1L FOR, ICE USE r ,, y Routed to Permit Technician: Date: ) ) )f- - 1 4 Initials. Fees Due: 121 Yes ❑No Fee Description: Amount4e: e: 4 z o•c )-kr ,p),„ r,v : 3/4g1,,,/ $ ` --- $ .�k h ; ",41K: vA .- $ Special Instructions: Reprint Permit(per PE): ❑ Yes cEi No ❑ Done Applicant Notified: h}-4,fc jc—Date: -&-A-7/9-7 4_.._ ///6,/jp. Initials: .. %' c/ - I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012