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Permit IN �� CITY OF TIGARD MASTER PERMIT tE ' COMMUNITY DEVELOPMENT Permit#: MST2016-00355 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/22/2016 Parcel: 2S 106DCO2100 Jurisdiction: Tigard Site address: 17015 SW JEAN LOUISE RD Subdivision: POLYGON AT WEST RIVER TERRACE Lot: 21 Project: Polygon at West River Terrace, Lot 21 Project Description: New SFA. Building/Unit 7.2 BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 2 First: 240 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 34 Bathrooms: 3 Second: 562 sf Garage: 294 sf Front: 12 Smoke Dwelling Units: 1 Third: 560 sf Right: 0 Detectors: Yes Total: 1362 sf Value: $171,046.29 Rear: 5 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Fum<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 1362 Owner: Contractor: ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions) 7600 EAST DOUBLETREE RANCH 109 E 13TH STREET 1 Geotechnical Inspection RD,STE VANCOUVER,WA 98660 Required before foundation SCOTTSDALE,AZ 85258 2 Ersn Cntrl 503-639-4175 PHONE: PHONE: 360-695-7700 FAX: Total Fees: $23,000.83 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through R 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: /�✓ �--- L/ Permittee Signature: !� �i'� L', 1--77D/u4 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 �0 T i< — DECEIVE /,� dn1 I FOR OFFICE FSE O\Ll ipt City of Tigard Received DDate/By: J��/u /(e, Permit No. fT�/L_ao3�JC 0 '1 13125 SW Hall Blvd.,Tigard,OR 97223 AUC 0 6 Phone: 503.718.2439 Fax: 503.598.1960 U 2016 Plan Review /�� DateBy: � —� ) _� fV Other PermI;SjL/,J�j`�a�.�IG// t.I G j,R t.) Inspection Line: 503.639.4175 Date ReadyBy: - Juzis: El See Page 2 for Internet: www.tigard-or.gov CITY OF TIGAR j Notified/Method:7/20 0 t *, Supplemental Information f t - °, . tt , s • i t , Permit fees*are based on the value of the work performed. ®New construction ❑Demolition Indicate the value(rounded to the nearest dollar)of all 0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the f to t • work indicated on thi application. Q 1-and 2-family dwelling 0 Commercial/industrial Valuation: $1 ' • /2 )y J C'0 Ll,/S 4• ❑Accessory building Multi-family Number of bedrooms: 2 ❑Master builder 0 Other: Number of bathrooms: 1 3 '-;.'11Z":t7:"Tnif:I.E:tr''.224 irri 7,4943711S74. Total number of floors: 3 j 1. (-) Job site address: „Q 15 SW Jean Louise Road New dwelling area: 1371 square feet City/State/ZIP:Tigard,OR 97224 Garage/carport area: 294 square feet co Suite/bldg./apt.no.: I Project name:Polygon at West River Ter Covered porch area: j,.2.. square feet C.-Z Cross street/directions to job site: Deck area: 72 square feet r4..4 0 ,)V./ Other structure area: 72 square feet Subdivision:Polygon at West River Terrace I Lot no.: 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 tir equipment,materials,labor,overhead,and the profit for the 1 ° € AAlt" ".. % '. work indicated on this application. xs c3 IA : '-r.2 Valuation: $ Existing building area: square feet New building area: square feet t 1. Number of stories: Name:ADVL Land Holdings,LLC Type of construction: Address:7600 E Doubletree Ranch Road Occupancy p y groups: City/State/ZIP:Scottsdale,AZ 85258 Existing: Phone:(602)694031 Fax:( ) New: .�. ,. z-. -�> fY i 1 1 1. Business name:Polygon WLH,LLC Contact name:Angela Grajewski Structural plan review fee(or deposit): Address:109 East 13th Street FLS plan review fee(if applicable): 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 t t s Commercial and residential prescriptive installation of roof-top mounted Photovoltaic Solar Panel System. Submit two(2)sets of roof plan with connection details Business name:William Lyon Homes,Inc Address: 109 East 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 and administrative fees): Phone:(360)695-7700 Fax:(360)6934442 State surcharge(12%of permit fee): $21.60 CCB lic.:207247 - /l _ Total fee due upon application: $201.60 Authorized signaturet� Il/vAL 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 Print name:Angela Grajewski Date:7/20/16 Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) r { • Mechanical Permit APplil4ati 4 tt t t tet(:1 1 IC I- t til:(�.t i t City of Tigard Received Day: 11=IINCM 13125 SW Hall Blvd.,Tigard,OR 97223 planBx R V g. Plume: 503.718.2439 Fax: 503.59&.1960 SEP 2 2 2016 Dh �ay,, Other limit: f 1,-; i. Inspection Lint: 503.639.4175 Internet www.tigard-tr.gov [ Daze Ready By; Amy 0 iee Page Z for Ci 1`Y OF '1 GA f ' 'NatifiedlMetha: Supplemental lefarmatian 4 a<€. ,., tea,s';'1'Y2E, F; tl °�t :: 5'� O,-< .., I- . hR .44 TSE*s:SCREDU „'V' CIC A , . 4 New construction ❑Addition/alteration/re Addition/alteration/replacement Mechanical ndicat thee•are based de t there of the work P performed.Indictee value{rounded th�nearest dollar)of all {{0� Demolition .,tea .�❑AO en yTr�ry�y{ mechanical materials,equipment.labor, and profit. p, f❑1-and 2-family dwelling 0 Commercial�mdustriat ❑Accessary building For Grjornadon rsi chriig ®Multi-family 0 Master builder 0 Other: Description I Dry. Es. Total - u �t-` EI #R,MA 0 'EY 4 . C:141 $ Hating(t"lin - ,n � Air ccundifwnic ? 46,75 Job site address: no es— 'S h(` eO ► Tr. A&� Furnace 100.000 BTU iductswv ) 1 46.75 City/State/ZIP:Tigard,OR 97224 Y" �'_. Furnace t00.000+BTU{aats/venzs) 1 54,91 Heat Suite/bldg./apt.no.:,t1 Project name:Polygon at West River Ter Duct 61.06 3 Cross street/directions to job site: Hydronic hot water system i 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. I 46,75 Flue/vent for any of above 1 123,32 Subdivision:Polygon at West River Terrrace Lot no.:Z' Other 1 2332 Other fuel appliances:' F Tax map/parcel no.: Water heater f .32 � ,�� ;:k�PSCRIPI7ON OF 'WORK ' ' "',: Gas lime-late/insertS �,39 Flue vent for water heater or gas CMii RIA,4..., N 1 ,in lqfireplace23.32 ra Log lighter(gas) l 2332 Wood/pellet stove h 33.39 Wood fireplace/insert a 23.32 Chimney/liner/flue/vent 23.32 2332 ,z;§ ;47,e:-311:4?(,.;;:';';, . , w ,, .l_ i a ._'.' ittI` �' .�::::1 . " EnYitonrnenal,,,haiist and ventllatioG'. same:AD VL Land Holdings,LLC Range hood/other kitchen Address:7600 E Doubletree Ranch Road equipment 33,39 Clothes dryer exhaust 3339 City/State/ZIP:Scottsdale,Az 85258 Single-duet exhaust(bathrooms, ti S toilet compartments,utility rooms) 23,32 Phone:(602)6944031 Fax;( ) Attic) crawispacc fans 23.32 M 'S' „ ;r. M :.1,GYI..i*:CI`y P tfif)ik . Other 23.32 } } Business name:William Lyon Hornet,lac. Fuel piping: 514.15 for first four$4.03 for each additional Contact name:Angela Grajewski Furnace,etc. Address:109 East 13th Street pump Wait/ ., ,unit heater City/State/ZIP:Vancouver,WA 98660 Water heater Phone:(360)695-7700 Fax::(360)693-4442 Fireplace 1 Range f E-mail:Angela.Grajewskitvupolygonhomec.enm y g Barbecue ., .`-:.. 2 �.., �..;,are+ , i �.a�. s:°ar Cl°thes'd (gas). Business name:Andersen Ieehanrcal,Inc. 1 gafAddress:16285$W 85n Ave cin::7 '':ttit a ,. .. sad.?,..- Wit: Subtotal City/State/ZIP:Tiigard,OR 97224 Minimum permit fee 590.00) Phone:(503)992-6664 Fax:(503)5361.6615 Plan review(15%ofptsnail ere) State surcharge(12%of permit fee) ss CCA lie.:168214 / TOTAL PERMIT FEE This permit application expires ifs permit is not obtained within 180 Authorized signature: • days after it has been aeeeptndrs complete. Fee methodology vet by Tri-County Building Industry Service Board Print name:Ange a Grajewski Date:8/22/16 TABuildinsTermitellECJerroitApp 040113:doe 440.4617TO 1102tCOMVE11) Electrical Permit Application Received 1,1 II City of Tigard AUG 0 6 2016 D Permit"riffT 0/6-063 S`-s` 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review • Phone: 503.7182439 Fax: 503.598.196p,Y ` /� DAB Related Permit#: c, Inspection Line: 503.639.4175 (,IT 1/0�TIU/ Ready may; Astir El See Page 2 for Internet www.tigard-or.gov ! otifed/Method t I , I l 11i i Supplemental Information ®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition ❑Other where the available fault current 0 Marinas and boatyards. s 1 ' `-L0 , e 1 s it ,.. ',,L l t "; -_- exceeds 10,000 amps at 150 volts or ❑Floating buildings. ❑1-and 2-family dwelling 0 Commercial/mdustrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural Multi-family 0 Master builder 0 Other. ampsforother installations. buildings. ❑Fin PSP. ❑Installatition of 150 KVA or - E . 11..r1-•)--;Ti`I,ft t-I-Cc a 0711 1, t t,. i rscr'. .F ❑Emergency system larger separately derived I '1 O 15 S, - (6 0% ❑Addition°r f newnone.motor load of system.A Job#: Job site address: Vv V` t'rUJ` looHP ormon. 0 n^,'�",'�1-2">"1-3", City/State/ZIP:Tigard,OR 97224 0 Six or more residential units. occupancy. 4�..-_G�t 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldgJapt#: I Project name:Polygon at West River Ter 0 Hazardous locations. 0 Supply voltage for more than 0 Service or feeder 600 amps or more. 600 volts nominal Cross street/directions to job site: --„e_�,:...._ '�..„'._. .., .a . .-"1Ti f6 � .Anti,' £ -; F Desc iption Qty. Each Total • New residential single-or multi-family dwelling unit. Subdivision:Polygon at West River Terrrace I Lot#: a I Includes attached garage. Tax are el# 1,000 sq.IL (08 5 or less I 168.54 ' 4 map/parcel Ea add'l 500 sq.R or portion I 33.92 33,42 1 .`-.� _.. -f- ''s s� 1ii t e r 4• t C , " '``e Limited energy,residential —7 (with above sq.ft) 75.00 2 big ' c I r Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0Sd Pme 2 - -7 ';<FS7•� fd , y -33111, 0 7 1. �; . Servicesor feedersinstallation,alteration,and/or r relocation Name:ADVL Land Holdings,LLC 200 amps or less 100.70 2 Address:7600 E Doubletree Ranch Road 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:Scottsdale,AZ 85258 601 amps to 1,000 amps 301.04 2 Phone:(602)694-4031 I 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 I 5936 I 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 I 2 Owner signature: Date: 401 amps to 599 amps I 168.54 2 , ;_ , a ; aele .,, —;y Branch circuits-new,alteration,or extension, er panel A.Fee for branch circuits with Business name:William Lyon Homes,Inc. Y a above service or feeder fee, 7A2 2 each branch circuit Contact name:Angela Grajewski B.Fee for branch circuits without Address:109 East 13th Street service or feeder fee,first 56.18 2 branch circuit City/State/ZIP:Vancouver,WA 98660 Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(360)695-7700 I Fax::(360)693-4442 Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email Angela.GrajewsluQpolygonhomes.com only r i r ", Gam; Recurred irrigation 67.84 2 ._ .- �tr Pump or irrigation circle 67.84 2 Business name:Alameda Electric Sign or outline lighting 67.84 2 Address:3415 NE 44th Signal circuit(s)or limited-energy ❑ See Page 2 2 panel,alteration,or extension City/State/ZIP Portland OR 97213 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 6625/hr Phone:(503)319-2192 Fax:( ) Investigation(1 hr min) 90.00/hr Email:solarpdx@a me.com Industrial plant(1 Ir min) 78.18/hr Inspections for which no fee is 90 hr CCB Lic.: 199188 Electrical Licc..• c923/ Suprv.Lic.: 48715 'call listed 1u _ Suprv.Electrician signature,required: ,_ _, wLL Subtotal:— Print nameKi l e R 0 I Date: 05-24-16 ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: ‘eat,7 TOTAL PERMIT FEE: l / , This permit application expires if a permit is not obtained within 180 Print name: A L'✓3A ewcDate: 7 p D Ica days atter it has been accepted as complete. N// ` ( s Number of inspections allowed per permit L-\Butlding\PermitstELC—PernitApp MR FRE.dat;Rev 0617/2015 615T(1 /05/COM/WEB Plumbing Permit Application- ECEIVE Building Fixtures City of Tigardgli Permit No.://j7;7_0/6, O� 13125 SW Hail Blvd.,Tigard,OR 97223 AUG 6 �1 Phone: 503.7182439 Fax: 503.598.(960 than ` Other Permit No.: Received Riew Datefir. Inspection Line: 503.639.4175 CITY OF TIGARD R y/By ban. a See Page 2 for Internet www.tigard-or.gov NottftedlWtethod plemental Information ®New constnraion 0 Demolition For special information ace checklist Description I Qty. { Ea. I Total 0 Addition/alteration/replacement lacement 0 Other: New i-2-family dwellings(includes 100 ft.for each ud'3ity axtnecrion) �. �' ,71 1.: k C'1116,.. SFR II bath 312.70 1 I-and 2-family dwelling 0 Commercial/industrialSFR(2)bath 437.78 {� SFR(3)bath � 50032 560.32 0 Accessory building L Multi-family Master builder ❑ � Each additional bath/kitchen 25.02 M O Fire sprinkler(131 1 sq.ft.) I Page 2 1 a\q 0 �. 6, r07:7...''° '',",Z!,-.7'''FV e, ; s 6 i ` site utilities: sr 110 15 S1� "tan �.v vise ]lob site addd ress: Gaol Catch basin or area drain 18.76 City/State/ZIP:Tigard,OR 97224 Dry leach line,or trench drain 18.76 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: 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 it:_ ) Page 2 j Storni sewer(no.linear it: ) Page 2 Water service(no.linear ft.: ) PaSe 2 Subdivision:Polygon at West River Terrrace I Lot no.: g 1 Fixture or item: Tax map/parcel no.: Backflow31.>7` preventer 31 27 BackwatervalvC 12.51 a 5 .. _ Clothes washer 25.02 t► d:: • Disinvasher 25.02 , Drinking fountain 25.02 F. 51 4 � r Ejectors/sump etc Z� a , i., t-- EXP Name:,A � � DVL Land Holdings,LLC Fa-tine/sewer cap 23:02 - Floor drain/floor sink/hub 25.02 Address:7600 E Doubletree Ranch Road Garbage disposal 25.02 City/StateZiP:Scottsdale,AZ 85258 Hose bib 25.02. Phone:(602)694-4031 Fax:( ) Ice maker 12.51 � R Interceptor/grease trap 25.02 Business mune:William Lyon Homes,Inc Medical gas(value:$ ) Page 2 Primer 1231 Contact name:Angela Grajewski Roof drain(commercial) 12.51 Adder 109 East 13th Street Sink/basin/lavatory 25.02 City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54 Phones(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51 E-mail:.Ao g Je*' P�ygela-Graf is �homes.com Uritis( 25.02 ^ r Wats closet 25.02 a. Wafer Beater 37.52 Business nate.Alliance Plumbing LLC Water piping/DWV 56.29 Address:146 W Historic Colombia River Hwy Other 25.02 City/State/ZIP:Troutdale OR 97060 Subtotal Minimum permit fee: $72.50 Phone:(503)492-3490 Fax:(503)912-6438 Plan review (25%of permit fee) CCB Lica:184601 Plumbing Lic:no.:PI3732 J., State surcharge(12%of permit fee) Authorized signature: 4 TOTAL PERMIT FEE . . .. This application expires Print name:Robert ikshm,a Hate:SI23/20I6 permit � �' permit is not obtained within 180 days after Vitas been accepted as complete. *Fee methodology set by Tri-County Budding Industry Service Board. t:euilatgWenaitAPLMU-PamimApp.doc IOi01/09 i6T(TO M,CO N ME6) S nrrVIIT1 F City of Tigard III a COMMUNITY DEVELOPMENT DEPARTMENT ■ r 1 c n R n Building Permit Review — Residential Building Permit #: Al572o /. , — d e Site Address: ( 7 n( S Sm T.e.cAr) Louise P.S. Project Name: 1'ol9oor% G+ V )4- PlWr T,err icc Lot #: 1) (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: (' IZOw A1)CrUb (20 — 2g) Verify site address/suite#exists and active in permit ystem. l River Terrace Neighborhood: ❑ No Yes,See River Terrace Review Addendum Attached Site Plan Elements: /Three(3)copies of site plan • 0 xisting 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 /North arrow //Utility locations (required for new,may apply for additions) Site address,project or subdivision name and lot number "0-Location'of wells/septic systems /Applicant information(name and phone number) •R'ERintng trees to be retained with drip line,and tree Lot dimensions and building setback dimensions protection measures Lot area,building coverage area,percentage f coverage and Street tree size,type and location impervious area(applicable if R-7,R-12, &R-40) ?trees names /Property corner elevations(2 foot contour lines if more than 4 foot differential) jzf Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No Public Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified 1:1 No Applied For: ❑ Yes ❑ No,stop intake I Land Use Case#: PDt is ' 0O00e1 , Su e zso I5 — 00006, gi Zoning: -2c 7 Setbacks: Front `Z Rear S Side 0 Street Side 3 Garage / 60 Landscape Requirement: 24 % I" Lot Coverage Maximum: 6 0 diZr Building Height: Maximum Height /WA- Actual Heigh ---- ,Z1' , Visual Clearance Easements XSensitive Lands: CIYes I:: No Type e Urban Forestry Plan (2Conditions "Met"prior to issuance of building permit otes: C rlc tII0 of +0 be. ME-I- p iOr 17, j Sys Vol nu_ 0C- b�I !chir1JG �exmifi-. Approved By Planning: /11 0 eau,- G,L0 Date: '/ ‘017,0/4 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\BldgPermitRvw_RES_060116.docx Building Permit Submittal Original Submittal Date: 6`6/too Site Plans: # Building Plans: # Building Permit#: Enter building permit#above. Workflow Routing: 1 Planning 'Engineering 31 Permit Coordinator [ Building Workflow Sign-off: tr 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. Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: ;/ i .. Date: �!�/,Tc Engineering Review ,B'Slope at building pad: "> ❑ Conditions "Met"prior to issuance of building permit ❑ Easements (encroachments)per engineering conditions of approval and plat ❑ Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes No Assess Water Quantity Fee in-lieu: ❑ Yes No LIDA Facility on lot: ❑ Yes No ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: h t,k 14-4%-- Date: `� /4416 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: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: Revision Notice 3: Date Sent to Applicant: (0=tDC Fees Entered: Wash Co Trans Dev Tax: )" Yes ❑ N/A Tigard Trans SDC: 'Yes ❑ N/A Parks SDC: 72I' Yes ❑ N/A 7OK to Issue Permit G� Date: Approved by Permit Coordinator: / /1 3/ I:\Building\Forms\BldgPermitRvw_RES_0601 1 6.docx City of Tigard IN i '1' COMMUNITY DEVELOPMENT DEPARTMENT l c A R D River Terrace Building Permit Review Addendum Building Permit #: /t1STo`6 -- 003.,5 Site Address: 17 0 IS SW Te-bin L o u i 3 e. 00 1 . Project Name: 4" o 6 y 90 ' n+- WC 1 t- IZ‘V r Tom,-?c,e_ Lot #: 2 (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 standardsXYes ❑ 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. deep Balcony w/access 2 Window Projection Vertical Wall Offset a ft. deep min.2ft.,5 ft. wide min.2 ft., Eft.wide Gabled dormer El CI 7 _)2' 2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors. Percentage Shown: I G. 3 /, 3. Entrances:At least one entrance must meet both of the following standards: 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: El Yes/ No If yes,all the following apply: ❑ 25 sq.ft.min. ❑ One street facing entry ❑ 12 ft.max. roof above floor of porch El 5 ft. depth min. ❑ 30%min.porch roof coverage 4. Detailed Design:All buildings shall include a min. of five of the following elements on all street-facing facades: ❑ Covered porch min. 5 ft.wide x 5 ft. deep El Recessed entry area min. 5 ft.wide x 2 ft. deep Wall offset min. 16 inches (Dormer min. 4 ft.wide pii Roof eave min. 12 inch projection /❑ Roof offset min. of 2 ft. ❑ Roof shingles either tile or wood 'Gable,hip or gambrel roof design ❑ Roof pitch oriented south min. 500 sq. ft. ❑ Horizontal lap siding min. 3-7 inches wide Accent siding min. 40%of street facade (/Window trim min. 2 1/2"wide by 5/8"deep ❑ Window recess min. 3 inches for all street facing El 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 ❑ No. If No (Check one): /� ttiEl May extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch. l� ❑ May extend up to 5 ft. where the garage is part of a two-story building and there is a window at the second sto above the garage that faces the street with a min. area of 12 sq.ft. Width: (Check one) Pe ❑ 12-foot-wide garage door ❑ 40%max. of street facade iliI ❑ 50%max. of street facade with 7 detailed design elements Notes: Approved By Planning: A4 6 Date: j I:\Building\Forms\B1dgPermitRvw RES RT 062216_docx RECEIVED Electrical Permit Application FOR OFFICE USE ONLY City ofTigard igard j p V 10 2 16 Received / i LI _1 i 10 IN13125 SW Ball Blvd.,Tigard,OR 972 plan Review ':email#: Phone: 503.718.2439 Fax 503.59 / a.-, Date/13 . Related Permit It: T I GtiR D Inspection Line: 503.639.4175 V .k -..7 Ready Date/By: Ms: BI See Page 2 for Internet: www.tigard-or.gov T I Notified/Method: Supplements!Information . -._ A>�-'-l' - � ""�-�$_t e' e'er' a '2. =..�`-`'. ?,.;v_� .^� ,�:.�. g. 4 ';.,.r`=;c�-� {z l,%€^. "'�,. 'e's,.' . k�. -.7=- f7:- ?-.....- .._ zz is r• l.. ..,v,. ka w _-.�.c ®New construction D Addition/alteration/replacement Please check all that apply(submit 2 sets of plans wrirems checked): 0 Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition 0 Other where the available fault current ['Marinas and boatyards. z-f ' ') ''F[ 1 aaft •s exceeds 10,000 amps at 150 volts or ❑Floating buildings. ®1-and 2-family dwelling 0 Commercial/indlistriah 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family - 0 Master builder 0 Other. 0 Fire pump. ❑Installation of I50 KVA or -- a lam7 F�z; 0T�UTFf6MA£[OA : F - _ ❑Emer encr system' Larr �sePIyderived Job site address/ f ❑Addition anew motor load of system. Job#: 10 IS JPS Wo u a'Com,RD. 10011P or more. ❑"A","E","1-2", I-3, City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy. ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldgJapt#: 1,'L Project name:Polygon at West River Ter 0 Hazardous locations. 0 Supply voltage for more than 0 Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: '--: ' ,7 ,-.-..Ya,. 2 Description _.. -. I Qty. I Each I Total New residential single-or multi-family dwelling unit. Subdivision:Polygon at West River Terrrace Lot#:Z k Includes attached garage. Tax map/parcel# 1.000 sq.ft.or less , 168.54 4 Ea.add'1500 sq.R or portion i 33.92 1 Wit- = ^^ r: x >r r Limited energy,residential 75.00 2 .JON VJ ( Q.,Y\eJ , e, (with above sq.R) Limited energy,multi-family 75.00 2 residential(with above sq.ft.) �"t �„ W. - . 1 Renewable Energy ❑ See Page 2 - --�- - --' -r -M•�•'-�--- �"r' " ' �---'� Services or feeders installation,alteration,and/or relocation Name:ADVL Land Holdings,LLC 200 amps or less 100.70 2 Address:7600 E Doubletree Ranch Road 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:Scottsdale,AZ 85258 601 amps to 1,000 amps 301.04 2 Phone:(602)694-4031 Fax:( ) Over 1,000 amps or volts 552.26 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 c �<:,, , - - - as ,� tp e. Branch circuits-new,alteration,or extension,eer panel �`" '�� '�'r -.,""'�`""'" ��`'��` �0�=` '`'��` A.Fee for branch circuits with Business name:William Lyon Homes,Inc. above service or feeder fee, 742 2 each branch circuit i Contact name:Angela Grajewski B.Fee for branch circuits without I service or feeder fee,first Address:109 East 13th Street branch circuit 56.18 2 City/State/ZIP:Vancouver,WA 98660 Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(360)695-7700 • • ' Fax::(360)693-4442 Each manufactured or modular dwelling,service and/or feeder 67.84 2 I Email:Angela.Grajewski gpolygonhomes.com Reconnect only 67.84 2 - -, ,y,r __ - Pump or irrigation circle 67.84 2 Business name:Garner Electric Washington,LLC Signor outline lighting 67.84 2 Address:6101 NE St Johns Rd Signal circuit(s)or limited energy 0 See Page 2 2 panel,alteration,or exiensirm Each additional inspection over allowable in any of the above City/State/ZIP:Vancouver WA 98661 Additional inspection(1 hr min) 6625/hr Phone:(253)320-1657 Fax:( ) Investigation(1 hr min) 90.0W hr Email:bdaniels@gweusa.com Industrial phmtp hernia) 78.18/hr l Inspections for which no fee is 90.00/hr CCB Lic.: C1158 Electrical Lic.: 208174 ( Suprv.Lie.: 4496S Y lasted(h hr mm) _ FIs: ., e.t,-,...�5L Suprv.Electrician signature,required: .KyP/ / /-� Subtotal: Print name: Joan P Albert • J Date: 4/26/2016 0 Plan Review Required(25%of permit fee): _ — State surcharge(12%ofpermit fee): —~—. TOTAL PERMIT FEE: - Authorized sinFore: 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 AI:lBeIdinglPermits\Ei.0 PermitApp ELR ERE.doe Rev 06/17/2015 440-4615T(11/05/COM/WEB FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT )4 Transmittal Letter - ;G It l D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Tom H. DATE RECEIVED: DEPT: BUILDING DIVISION -RE. CE OCTIVED 17 2016 FROM: Angela Grajewski CITY OFTIGA D COMPANY: Polygon Northwest BUILDING niv s ON PHONE: 971-212-2144 By: RE: 17007, 17015, 17023, 17041 SW Jean Louise RD MST2016-00354► 365, `3( 1-161 (Building 7 ) (Site Address) (Permit Number) Polygon at West River Terrace Lots 20-23 (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,/� s ori l`,S i flo D®35` \£... \\.. :"I � ✓fix . s� ... �.. ,�a�\�.. -11n; Routed to Permit Technician: Date: /2////(v Initials: Fees Due: Yes ❑No Fee Description: Amount Due: $ vz) Special L LE Cr i=ce G,"✓ e'`IS7"o2 / do 'O' Instructions: Reprint Permit(per PE): ❑ Yes 1lo ❑ Done Applicant Notified: ,/91t/((E-" Date: /////PInitials•,y,1� I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 Plumbing Permit Application( �'� Site Utilities RECEIVED FOR OFFICE USE ONLY City of Tigard Received ' 1111 Nu 13125 SW Hall Blvd.,Tigard,OR 9.17k61 /,l l 2 3 2017 Date/By: _-3 / .�� Permit No wGsT05(//6p-t�s� 2 Phone: 503.718.2439 Fax: 503.598.1960 Plan Review Other Permit No.: Inspection Line: 503.639.4175 CITY OF TIGARD Date/By: 9-3-111 re7 T I GA RD Date Ready/By: Juris 66 See Page 2 for Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information TVP .OF WORK - FEE* SCHEDULE ®New construction 0 Demolition For special information use checklist Description I Qty. I Ea. Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEdORVO CONSIRII IbN _ SFR(1)bath 312.70 ❑ 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(1,362 sq.ft.) ,,' Page 2 JE1B:•SITE 1 1PORMATION AND LOCATION, ." Site utilities: Job site address:17015 SW Jean Louise Road 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.: Project name:West River Terrace Area 2 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 I Subdivision: Lot no.:21 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 Backwater valve 12.51 WOW?" 2- , , ,.. .. ,„_,. . ,, + Clothes washer 25.02Multipurpose Fire Sprinkler System Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ?? PROPERTY OWNER 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 ` = ' r® APPL1 ,PERSON Interceptor/grease tra p 25.02s „,, 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 Water closet 25.02 :ya CONTI CTOR Water heater 37.52 Business name:Alliance Plumbing,LLC WaterPip gI t m DW V 56.29 Address: 146 W Historic Columbia bla River Hwy Other: 25.02 City/State/ZIP:Troutdale,OR 97060 Subtotal Phone:(503)492-3490 Fax:(503)912-6438 Minimum permit fee: $72.50 CCB Lic.:184601 Plumbing Lic.no.:PB732 Plan review (25%of permit fee) /s State surcharge(12%of permit fee) Authorized signature: 3 -71-----) TOTAL PERMIT FEE Print name:Gavin Thomes Date:1/13/2017 This permit application expires if a permit is not obtained within 180 days ' after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-PermitApp.doc 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: s . Oty tee Tata]Utilities , quai }}t ' lrmrt Pe 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 P rn :?ee: Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for �� . Fee(ea) T ictal "` each additional$100.00 or fraction thereof,to Other Inspectionsor Fees � ° 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$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Quantity by Fixture Type flan Review for Plumbing:installations Fixture Type for Replace/ Plan review is required for any of the following. 'Work Performed: Capped Added Relegate Baptistry/Font Please check all that apply. Bath Tub/Shower 0 Any new commercial building with water service 2"and Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Drive Thru 0 New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918-780-0040. Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities. -Domestic 5 Any multipurpose fire sprinkler system. Drinking Fountain 0 Any complex structure as defined in OAR918-780-0040. Eye Wash Floor Drain/sink -2" Submit 2 sets of plans with any of the above. -3" 4„ fs met$e or Riser Diagram Car Wash Drain Garbage -Domestic-non-food ❑ 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 Pgmit.doc City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 17015 SW JEAN LOUISE RD, SHERWOOD, OR, May 19, 2017 at 9:22:54 AM 97140 Record Type: Record ID: Residential - Master Permit MST2016-00355 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS Comments: No AC installed at this time. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 17015 SW JEAN LOUISE RD, SHERWOOD, OR, May 19, 2017 at 9:23:56 AM 97140 Record Type: Record ID: Residential - Master Permit MST2016-00355 Inspection Type: Inspector: 699 Mechanical final David Young Result: PASS Comments: No AC installed at this time. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 17015 SW JEAN LOUISE RD, SHERWOOD, OR, May 24, 2017 at 12:51 :49 PM 97140 Record Type: Record ID: Residential - Master Permit MST2016-00355 Inspection Type: Inspector: 299 Final inspection Aaron Cillo-Gobel Result: PASS - CofO Comments: Final erosion control passed Street tree certificate received Moisture content form received Moisture barrier acknowledgement form received High efficiency lighting form received Insulation certification verified C of 0 left on counter. Violation Summary: Inspector Contractor