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Permit (35) IL CITY OF TIGARD MASTER PERMIT Ing it ''' COMMUNITY DEVELOPMENT Permit#: MST2016-00362 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/22/2016 Parcel: 2S 106DC 13300 Jurisdiction: Tigard Site address: 17052 SW JEAN LOUISE RD Subdivision: POLYGON AT WEST RIVER TERRACE Lot: 133 Project: Polygon at West River Terrace, Lot 133 Project Description: New SFA. Building/Unit 10.1 BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 3 First: 344 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 34 Bathrooms: 4 Second: 646 sf Garage: 327 sf Front 12 Smoke Dwelling Units: 1 Third: 635 sf Right: 0 Detectors: Yes Total: 1625 sf Value: $202,203.54 Rear: 5 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer 100 Tubs/Showers: 3 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: 2 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 5 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: 2 201-400 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 1625 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 2 Geotechnical Inspection SCOTTSDALE,AZ 85258 Required before foundation PHONE: PHONE: 360-695-7700 FAX: Total Fees: $23,727.67 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„ 0A13,952-001-0090. 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: „d, 1 �`'` Permittee Signature: C1 il/ e97"�l.!('°3i'7l/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_ c / `3- teriiiiim RECEIVE FOR OFFICE 1 SE OV-Ll City of TigardReceived — s " 13125 SW Hall Blvd.,Tigard,OR 97223 AUG 0 6 �O�6 Pl Review �y// P�'t N «, Phone: 503.718.2439 Fax: 503.598.1960 Q Date/By: � 4 Other Pecmi��`, T c } n Inspection Line: 503.639.4175 CITY 17 Y OF TI A pt izIReadYzd, �/� �(p �7� 'Luis I S eIeemPaa2loo rmation Internet www.tigard-or.gov DING DIVISION ®New construction 0 Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all 0 Addition/alteration/replacement 0 Other �. € equipment,materials,labor,overhead,and the profit for the 3N g i �"� work indicated on this application. _❑1-and 2-family dwelling ❑Commercial/industrial Valuation: Sl � J El Accessory building �J Multi-family Number of bedrooms: 3 ❑Master builder ❑OtherNumber of bathrooms:: 5„ t Total number of floors: 3 `St" , Job site address: n 5Z SW Jean Louise Road New dwelling area: 1625 square feet City/State/ZIP:Tigard,OR 97224 Garage/carport area: 327 square feet Suite/bldg./apt.no.: I Project name:Polygon at West River TerC . overed porch area: j� square feet Cross street/directions to job site: Deck area 96 square feet 3 4, + Other struc6ria C) C square feet Subdivision:Polygon at West River Terrace I Lot no.: 133 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 Tax m equipment,materials,labor,overhead,and the profit for the • ' � v l ` tlti � work indicated on this application. ES JQ I u 10 ' Valuation: $ Existing building area: square feet _ New building area: square feet Number of stories: Name:ADVL Land Holdings,LLC Type of construction: Address:7600 E Doubletree Ranch Road Occupancy groups: City/State/ZIP:Scottsdale,AZ 85258 Existing: Phone:(602)694-4031 Fax:( ) New Business name:Polygon WLH,LLC 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 marl Angela.Grajewskr@polygonhomes Coma Y ; x , 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 and administrative fees): $180.00 Phone:(360)695-7700 I Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60 CCB lic.:207247 /j ,/1 Total fee due upon application: $201.60 Authorized signature: _,.,(►L(w/I n( hs This permit application expires if a permit is not obtained (l�/�Q within 180 days after it has been accepted as complete. Print name:Angela Grajewski I Date:1/20/16 *Fee methodology set by Tri-County Building Industry Service Board. I:1Buiding\Permits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) l� � � Mechanical Permit Applica (}l?()FFffl- ttil.U\tl City of Tigard Received 13125 SW Hall Blvd.,Tigard,OR 97223 SEP 2 2 2016 rosy V __) ' 6' Phone: 503.7182439 Fax 503398.1%0 Plan Review inspection Line: 503.639All5 y� • A r �` Dams); Other Permit: i Internet www.n d"or. Y �� a T rIaetC Rt2dy.'BY]:` Jurit; Eiy Pati j �1YLD1NG D1V S1O1, Notified/Method: Suppl entatinforformafson :: a i > :s, • T> ,OF*0. ,,. .s ,,.��I.'L3a :L'SP 3$r 4:, >;.C{flll3Aiti�.RfIAL FE" ra New construction permit fees*are based on the value of the work 0 Addition/alteration/replacement performed.Indicate the value(rounded dcd to the nearest est dollar)of all Demolition 0 Other mechanical c�matenais mem 1mbariverteattand profit. S oG1 G YOC1STT0N gozsgtt ' f IE14f$}Lt !❑i-and 2-family dwelling ❑Commercialindustrtal 0 Accessory building For spedatinformation use cha tar. :4 Multi-family 0 Master builder Dcsaiption ( Oty. . 4441? -4*..4 1 a neatingicuotintu I Ea Total Sob trite address: /O Air conditioning 46.75 / V 4 -Rap, L X IAA f- V.4y1,41 Putnam 100,000 BTU(ducrakents) 1 46.75 City/State/ZIP:Tigard,OR 97224 Furnace-100,000+BTU(ducts/vents) ? 54.91 Suite/bldg./apt.no.:'0 ti 1 I Project name:Polygon at West River Ter Heat pump . 61.06 Dud work t 23.32 Crass street/dueetions to job site: Hydronic hot water system 1 2332 Residential boiler(radiator or bydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etci 46.75 Flue/vent for any of above ___ 23.32 bdi Suvision:Polygon at West River Terrrace 1 Lot no.: 1 J 1 O2332 Tax map/parcel no.: Otber fuel appliances: Gas fireplaeWatex heater i 23.32 Tl zFTIONY OF 1VOItK r` >` ;:t` ' t ,"F, ciinsert , C UY ttra1A/►�► l t for tvatcr hest�r rr gas �'pl.. fireplace ) 23.32 Leg lighter(gas) I 2332 Wood/pellet stove l 33.339 Wood fireplace/insert :: 1 23.32 aper v 23.32 �_ „ Chimnevtl' 'flues ant. ' , ®�i� Olbert 23.32 a , Nam=AD VL Land Holdings,LLC Environmental r kitchen t and ventitatiot i Range hood/other kitch Address:7600 E Doubletree Ranch Road uipment 33.39 Clothes dryer exhaust i 3139 City/State/ZIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms, Phone:(60294-fU31, toilet compartments,utility rooms) I 23.32 , 4�1 9 *1' $-T .! < is1 p i 23 32 Fax:( ) Attietcra is ace farts .. 3,., ,�,,..a. �.�. = � ,,.❑ GY)�k� �P � � Other. i '� .32 1# Business name:William Lyon Homes,Inc. Fuel piping: Contact name:Angela Grajewaki 514.15 for first four,54,03 for 4cit additional Furnace,etc. I Address:109 East 13th Street Gas heat pump i City/StatedZlP:Vancouver,WA 98660Wati/suspendotVunitheater l Water heater i Phone:(360)695-7708 1 Fax::(360)693-4442 Fireplace I E-mail:Angela,GrajewsI polygonhomes.rnmRange I w .: Barbecue ,,. ii: ..,, 14.'te ttet.14�-'4174s'-V Clothes dryer'(gas). Business name:Andersen Mechanical,Inc Other Address: SW 85'a Ave ` ,A Subtotal City/State/ZIP:Tigard,OR 97224 Minimum permit feek$90.o0) Phone:{503)992-6664 1 Fax:(503)536-6615 Plan review(25%of permit fee) CCB Iic::168214Ir State surcharge(12%ofpeiimtit fee) I TOTAL PERMIT FEE ISIS permit apptidttoa expires ifs permit h not obtained sistlue 180 Authorized signature days after it has been atxrpoed wa complete. ' Fee methodology set by Tri-County Buildi 1 Industry Sertiee Board I Print name:Angela Gsajesyski I Date:8/22/16 t; `insiI MEC_rer1„t,vpp wail3.aac 44046371tt1102e awl Electrical Permit Application FOR OFFICE 1 SE ON Ll City of Tigard Received UG 6 2016 Dat/B . Penult#:/17.-Cr-."2,0/6^AO ' 6 a 13125 SW Hall Blvd.,Tigard,OR 97223'A Phone: 503.718.2439 Fax: 50 . • 359 Phu ' Insp ion Line: 503.639.4175 C9 !` I GA R Dates Related Permit# T I C 1 D Ready DBY i H See page 2 for Int et www.tigard-or.gov .. r l j 1', Notified/Method: Supplemental Information ®New construction ion ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans wrtems checked): 0 Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition 0 Other: e 4 TjT where the available fault current 0 Marinas and boatyards. E- . ..2__ . ,5 _E-g 6 la nr_ .j .iT ri _t,17-1,r i tom. Z� exceeds 10,000 amps at 150 volts buildings- or uildin or ❑Floating gs. 1-and 2-family dwelling 0 Commercial industrial 0 Accessory building less to ground, exceeds 14,000 0 Commercial-use agricultural0 [+]/�Mulh family ❑Haslet builderamps for all other installations. buildings. _0 Other: ['Fire pump° ❑Installation of 150 KVA or .,r ;u. , v...,u"...x y.:1l'?''...t,.,.,� w.,\..�w1k`tl�ZIT-' e.- ori:ce-'1 T,.....';'6.-,.,g" _ .,Ali ❑Em .,. . .. 4�e�-��,�� icy system. largo separately derived Job#: I Job site address: I, 0 52_ slAr( --(C�n 0 motion of new motor load of system. V v �! 100I1P or more. 0"A",`E","1-2","1-3", City/StatelZIP:Tigard,OR 97224 i 0 Six m mors nsidentiaal units. occupancy. LA. 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldgJapt.#: I Project name:Polygon at West River Ter ❑Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps ar mon. 600 volts nominal Cross street/directions to job site: door Qty• Eacb IoW New residential single-or multi-family dwelling unit. Subdivision:Polygon at West River Terrrace I Lot#: 133 Includes attached garage. Tax map/parcel#: 1,000 sq.R or less I 168.54 wit.sq4 .r. - . ..,. a " Limited add'lener y, .2 3 • ,a. . ...,..._�: �I9 i�5 E' ,�t+���?��a��eua��_,�' �,���„� 3.92 (P'7.$� 1 or lied energy,residential )I , R) 75.00 2 Limited energy,multi-family 75.00 2 residential(with above sq.ft) .>._.: 'f. '.5; - s; € r L'-',.' t1 r m r: c, Renewable ergy 2 " "` Et `= .. Services or feedersEninstallation,alteration,❑ SeePage 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 City/State/ZIP:Scottsdale,AZ 85258 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Phone:(602)694-4031 I Fax:( ) Over 1,000 amps or volts 552.26 2 F.mr+il: 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 I intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps I 125.08 I 2 Owner signature: Date: 401 amps to 599 amps 1 168.54 2 ° ..ry: ..,Y.,,;„ r -:,,,J,-,7.-c.-...__14.4-1;w: um asr a. Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name:William Lyon Homes,Inc. above service or feeder fee, each branch circuit 7.42 2 Contact name:Angela Grajewsld B.Fee for branch circuits without Address:109 East 13th Street service or feeder fee,Srst branch circuit 56.18 2 City/State/ZIP:Vancouver,WA 98660 Each add'l branch circuit 7.42 2 Phone:(360)695-7700 I Fax :(360)693-4442 Miscellaneous(service or feeder not included) Each manufactured or modular Email:Angela.Grajewslti®polygonhomes.com dwelling service and/or feeder 67.84 2 Reconnect only 67.84 2 ; „_;_ . 71--7:::€1;i te 5 r,l 1) :t �= Pump or irrigation circle 67.84 2 Business name:Alameda Electric Sign or outline lighting 67.84 2 Address:3415 NE 44th Su' circuits)or limited energy panel,alteration,or extension. 0 See Page 2 2 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@me.com Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lie.: 199188 Electrical Lic.: c923 Suprv.Lic.: 48715 s .,'call listed hr mm Suprv.Electrician signature,required: ' w ? a Tr z� � i l e RSubtotal: Print name p � Date: 05-24-16 0 Plan Review Required(25% p�n,;t fee): of State surcharge(12%of permit fee): Authorized signature: ( v%l, TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: i) . ori,/;we Date: 7 2 D /c days after it has been accepted as complete. L\Ba7' P m((c// { ( * Number of inspections allowed per permit �s e p ER Rev 06/17/2015 6157(1 /05/COM/WEB Plumbing Permit Applica a Cha Building Fixtures 1 (-)1. ,,t I I, I 1 ,i (3\1 ) AUG 0 6 2016 R City of Tigardeeetved Date/By.SI No 13125 SW Hall Blvd.,Tigard,OR 97223 yy g� /`�/6''©t!1�6.,� Phone:.,503.7182439 Fax: 50 53 11 `x' �yARI� PlaReviewdiner Permit No.: lnspe�tion Lrne 303 639.4175 Intens www tigard-or gov BUIL )It'u DIVISION trio= B See Page 2for 44-.:41.4:,11; 41;;11:2111*: q u a sz i Supplemententall information ®New construction (]Demolition For sQraa:l information use checklist Q AdditraiJalteration/replaceztietit Other: Description I Qty. I Ea. I Total I ,. . � i a New 1-2-family dwellings(includes 100 ft.for each utility connection) I ? .it,,,,.-V-- .„MN r • -.4.,,,,,. ; _C �1 � SFR(I)bath 312.70 CI I-and 2-family dwelling ❑]Commerciattndustrial SFR(2)bath 437.78 0 Accessory building [`g Muhl-family SFR(3)bath i 50032 500.54 Q Master builder Each additional bath/kitchen 25.02 Fire sprinkkr('(026 sq.ft.) 1 t Page2 ?`S Q : .:�i �c ..:'_�,s. ;�: -•, z,�. �.,;,....._ ` Site utilities: Job site adders: 1-1052- S Scan Lo vise f_oac, Catch basin or area drain 18.76 City/State/ZIPT' Drywetl,teach tine,or trench drain igard,OR 97224 18.76 Footing drain(no.linear R.: ) Page 2 Suite/btdglapt.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 i Sanitary sewer(no.linear ft.: ) Page 2 I Storm sewer(no linear ft.: ) Page 2 Water service(no.linear R.: ) Page 2 I Subdivision:Polygon at West River Terrrace I Lot no.: 133 Fixture or item: Tax map/parcel no Backflow proves .27 - : � ,. -° e, ,' �. I 2.51 Backwatef valve t er 1 3 �� �. 1 1a 51 Clothes washer 25.02 � u. (0.. -) Dishwasher ..... 25.02 ,i Drinking fountain 25.02 I F Ejectors/sump 25.02 'i t r, Expansion tank 2 51 Name ADVL Land Holdings,LW Fixtutdsewer 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 ( ) ICCof 12.51 _. - � � F - !. ` : 1, : Interceptor/grease trap 25.02 1 Business mune:William Lyon Homes,Inc Medical gas(value:$ ) Page.2 r Contact name:Angela Gra' ski Primer I2.5 I Roof drag/(commercial) Address:109 East. 13th Street12.51 Sink/basin/lavatory 25.02 City/State/Z1P:Vancouver,WA 98660 Solar:units(potable water) 62.54 Phone:(360 695-1700 ) 1 Fax::(360)693-4442 TtibJshower7showerpan 12-51 E-mail Angela.Gn Urinal 25.02 jernkil�polygoahomex.tom Winer closet 25.02 3 - W Business nature Alliance Plumbing LLC 37.52 Water piping/D W V 56.29 Address:146 W HistorkColumbia River Hwy Other 25.02 City/State/ZIP:Troutdale,OR 97060` Subtotal ` . Phare:(503)492-3490 Fax:(503)912-6438 Minimum permit fee: $72.50 CCB Ltc 184601 Plumbing Lk.no::PB732 Pian review (25%ofpermitfee) Authorized si State surcharge(12%Of permit fee) TOTAL PERMIT FEE I Print name:Robert Dishmaa I Date:5/'23f2016 This permit application expires if a permit is not obtained within 180 days after it has been accepted as codpiece, *Fee methodology set by Tei-County Building Industry Service Board. t:teuil •App.dac-10/01/09 e40-4616T(taa•K'oMAvm) Cof T>< �'� �Y � a COMMUNITY DEVELOPMENT DEPARTMENT T►G A R D Building Permit Review — Residential Building Permit #: /73 / •-, £9O 2 6 Site Address: 17052. 'W TtCAr) Louise 2d . Project Name: f o 1 y g o n GG+ WeJ i- /Z i\/€,r Te rrm C.Q. Lot #: ) 3� (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review 17,9- 1 33 Proposal: I i' /V gra0 VJ C era e 1 fiVerify site address/suite# exists and active in permit ystem. River Terrace Neighborhood: ❑ No Yes,See River Terrace Review Addendum Attached Site Plan Elements: /Three(3)copies of site plan - Qgxicting 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 /Jtility locations(required for new,may apply for additions) /Site address,project or subdivision name and lot number flLocatiorf of wells/septic systems Applicant information(name and phone number) 'EfE'x1g8ng trees to be retained with drip line,and tree /4Lot dimensions and building setback dimensions protection measures Lot area,building coverage area,percentage of coverage and /Street tree size,type and location impervious area(applicable if R-7,R-12, 49&R-40) L—Xtreet names /Property corner elevations (2 foot contour lines if more than 4 foot differential) 7 Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No Public Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant}� was notified ❑ No Applied For: ❑ Yes CINo,stop intake Land Use Case#: T Q12�11 ' 00ool , SuQ vp ;5 _ moo& je Zoning: (2-2.g Setbacks: Front 17_ Rear S Side 6 Street Side 3 Garage / /,,. �l Landscape Requirement: '2A0 % 1v J4 Lot Coverage Maximum: 6 0 % Jz Building Height: Maximum Height %' Actual Height -- „g1 Visual Clearance /l Easements XSensitive Lands: ❑ Yes 1:1 No Type e Urban Forestry Plan Conditions "Met”prior to issuance of building permit otes: Cnd:Vfio nJ +0 be met prior -+0 i sus von rc c_ n t- bv;I ci;r1� ,erm i-F. Approved By Planning: M 0 Jrl,;c.. t3, Date: g/ 40l / ' Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: El Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw RES 060116.docx Building Permit Submittal Original Submittal Date: 8/6A,C) Site Plans: # 1 Building Plans: # 3 Building Permit#: Enter building permit#above. Workflow Routing: ©-Planning —ngineering Permit Coordinator t.®—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. ,Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable, etc. Notes: � r`', Date:By Permit Technician: D t 9 /y,k, Engineering Review 97 0 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: t1Zc IP . Date: 1 iJ f I b Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: 0 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: C Fees Entered: Wash Co Trans Dev Tax: O."' es ❑ N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: Yes ❑ N/A 1OK to Issue Permit Approved by Permit Coordinator: Date:7/i 5 I eO I:\Building\Forms\BIdgPermitRvw_RES_060116.docx City of Tigard ' COMMUNITY DEVELOPMENT DEPARTMENT 111 i T 1 c A R o River Terrace Building Permit Review Addendum Building Permit #: /`i ((fir/C., — 0036: Site Address: 17 0S2 E W Te-r,,ri L o u i s e iZ a( . Project Name: Poly 90 n Gt+- Wel t- IZ+Vr Ter - Le- Lot #: (33 (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?,l 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. deep Balcony w/ access 2 Window Projection Vertical Wall Offset a ft. deep min. 2ft.,5 ft.wide min. 2 ft., 6ft.wide Gabled dormer ❑ ❑ ❑ 7 , 2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors. Percentage Shown: I &• I 3. Entrances:At least one entrance must meet both of the follo ' g 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 YesNo If yes,all the following apply: // El 25 sq.ft. min. El One street facing entry ❑ 12 ft.max. roof above floor of porch ❑ 5 ft. depth min. El 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: A❑ Covered porch min. 5 ft.wide x 5 ft. deep El Recessed entry area min. 5 ft.wide x 2 ft. deep l Wall offset min. 16 inches /Q Dormer min. 4 ft.wide /Roof eave min. 12 inch projectionoof offset min. of 2 ft. // 0 Roof shingles either tile or wood 2-Gable,hip or gambrel roof design El Roof pitch oriented south min. 500 sq. ft. /❑ Horizontal lap siding min. 3-7 inches wide Accent siding min. 40%of street facade 72rWindow trim min. 2 1/2"wide by 5/8"deep El 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. El Yes El No. 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. ❑ 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. (tiiklAi Width: (Check one) text ❑ 12-foot-wide garage door ❑ 40%max. of street facade !1 1 va El 50%max. of street facade with 7 detailed design elements Notes: Approved By Planning: A46,..:-- 1.; ,,„„.. Date: j to 6 I:\Building\Forms\BldgPermitRvw RES JUI062216.docx Yte ; Electrical Permit Application f = � 'C'4 '- ' 4 FOR OFFICE USE ONLY 11 - City of Tigard 0 Received / !S�G y Pen»it 411/1 S �i(, Dail, 1 • 13125 SW Hall Blvd.,Tigard,OR 97223 N O V 2 0 1 h plan Review` fit Phone: 503.7182439 Fax: 503.598.1960Date/By: Related Permit it: T 1 G A R D Inspection Line: 503.639-4175 m' 't i tt(.., )t M: 1 eady Date/By : heir ®See Page 2 for Internet: www.tigard-or.gov otified/Method Supplemental Information y, t:"`1 fi Orr ....ft :. :mac:x . .. _ T- ,... :V' _P .-y�RPsr�'or.: ,:._- -:5o4..» ®New construction ❑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 stiiries. ❑Demolition ❑Other_ where the available fault current 0 Marinas and boatyards. ` l'W -,...::,.-2 ,,-.-4-••:‘, exceeds 10,000at 150 volts or FI T_ r�:.,a'si� ``..`�_.,,. ��::����� ,r -� �u amps ❑ oaring buildings. @ I-and 2-family dwelling 0 Commercial/indlistrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural ❑Multi-family - 0 Master builder 0 Other: amps for all other installations. boild;ngs- _ _ 0 Fire pump. 0 Installation of 150 KVA or „mss...-:�;:` >`_F�• -- -- Emergency stem. ••_-..„� =J �-:5 .O� ��°� - !] largerseparatelyderived 01 tl!@-1<1eL"'di�T>°F g y sY --� ra .�::::.s`i'r`� Job#: Job site address/1 DSL� 3A/A d1 f LOW_�`p RD loo Addition of new motor load of system. iJ1J1Jt 1 1../�J tAi st. 1J 100HP or more. ❑�A••,"1;,,,`I_2”"I-3", -.• ,State/ZIP:Tigard,OR 97224 0 Six or more residential units. occupancy. ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#:I 0,1 Project name:Polygon at West River Ter 0 Hazardous locations. 0 Supply voltage for more than ❑Service or Seeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: -„ %=��'� - '�' O�:<:�_g rte.,,=-=,. Description I Qty. I Each I Total ..:1 New residential single-or multi-family dwelling unit. Subdivision:Polygon at West River Terrrace Lot#:/2 , Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less I 168.54 4 Ea.add'I 500 sq.ft.or portion 1 33.92 1 ---r--,,--;;:it-2---1., bE9 _ IQ , _, �.s-. . , ,r t,y Limited energy,residential U\r\ arV}U r Q,\I\KJu art \ (J n' (with above sq.R) 75.00 2 J\�. Limited energy,multi-family 75.00 2 residential(with above sq.ft.) h i.:,.... .„,...„_,...... Renewable Energy ❑ See Page 2 C 0 O ` W ..K 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 City/State/ZIP:Scottsdale,AZ 85258 600 1,0000 amps 30034 2 60]amps to ps 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 less 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 16854 2 . " ' E ; Branch circuits—new alteration, or extension ler panel ': _ 1 y —;, "4rte" .Q.4 -Ci-LACP SO AA.Fee for branch crca with t Business name:William Lyon Homes,Inc. above service or feeder fee, 7.42 2 each branch circuit i Contact name:Angela Grajewski B.Fee for branch circuits without Address:109 East 13th Street bervice or feeder fee,first 56.18 2 ranch circuit City/State/ZIP:Vancouver,WA 98660 Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(360)695-7700 ' ' • Fax::(360)693-4442 Each manufactured or modular dwelling,service and/or feeder 67.84 2 + Email:Angela.Grajewsld®polygonhomes.com a Yy _s Reconnect only6724 2 w ` 4 s.,e ° -- `. Pump or irrigation circle 67.84 2 u � Business name:Garner Electric Washington,LLC • Sign or outline lighting 67.84 2 •,: Address:61011E St Johns Rd Signall,alcteration, or limited-energyx eon. 0 See Page 2 2 . paned,alteration,or extension. : City/State/ZIP:Vancouver WA 98661 Each additional inspection over allowable in any of the above Additional inspection(I hr min) 66.25/hr 3 Phone:(253)320-1657 Fax:( ) Investigation(1 hr min) 90.0W hr Email:bdaniels®gweusa.com Industrial plant(1 hr min} • 78.18/hr Inspections for which no fee is CCB Lic.: C1158 Electrical Lic.: 208174 ( Suprv.Lic,: 4496S specifically listed CAhr min) 90.00/hr' A?Q ' .',,,_,,;.',q.,1 ,_," " � 45Tal7k>;7` I jSuprv.Electrician signature,required: �„-.. � Subtotal: Print name: Joan P Albert • Date: 4/26/2016 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): .� -`—�� TOTAL PERMIT r'r:.b: Authorized sigreore: _ This permit application expires if a permit is not obtained within I80 Print name: Bill Daniels Date: 4/26/2016 days after it has been accepted as complete. * Number of inspections allowed per permit 'i'.;;*:::'.. :,::.:-I:1Building\PerroitsdELC PermitApp ELR ERE.doc Rev 06/172015 440-4615T(11/05/COMAVEB 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 ,IN ... Transmittal Letter T t G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Tom H. DA ,. 's F, • DEPT: BUILDING DIVISION OCT 17 2016 FROM: Angela Grajewski C 'OF D COMPANY: Polygon Northwest BUILDING DIVISION PHONE: 971-212.-2144___.__- BY: RE: 17052, 17066, 17070, 17082, 17094 SW Jean MST20 -0035,n "3> 10 I ,:3C Louise RD (Building 10) (Site Address) (Permit Number) ' �7 D e Polygon at West River Terrace Lots 129-133 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: mops 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. ✓fes 62c4.,---e,„--E:6, ,,,J /1S"/- ,0/6 003S Routed to Permit Technician: Date: j o _ j 9 ,LC Initials Ili Fees Due: 'Yes ❑No Fee Description:p Amount ue: f lS i- /"4- / -Vic i $?® U7) $ , * ** $ . "" W i $ Special ('c i i C? /---&--E-s- On/ /y,(7',2O/6 00.3 6.�. Instructions: Reprint Permit(per PE): ❑ Yes SPNo - ❑ Done //� Initials:% Applicant Notified: / f is Date: / IABuildingTormsgransmittalLetter-Revisions.doc 05/25/2012 Plumbing Permit Applicatio, i i 1 Site Utilities FEB2 Q 1�+7 ,111 - City of TigardDate/By:Received c..7</"2--- "I /'7 Permit 014(-7;2e/�Cel> 56 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503.718.2439 Fax: 503.59/1-T9,69 ,+ , Plan Review.a Other Permit No.: Date/By: ,j�1/ i Inspection Line 503 639 4175 T 1 G A R D Date Ready/By: Juris: ® See Page 2 for Internet: www tigard or gov .."1,: k_ B � � Notified/Method::-97� C " s ,tom � l Information.. 4:6 ' . �' �" 6�. , 1 er^�.: 6-•F F * a On Supplementalnform ®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) 10iTi1 1 T Oi li."QNstico SFR(1)bath 312.70 0 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building Z Multi-family SFR(3)bath 500.32 ❑Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler -q 5 Page 2 'f O "i1.,OO t Site utilities: / Job site address:17052 SW Jean Louise Road Catch basin or area drain 18.76 City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: 1 Project name:West River Terrace Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: I Lot no.:133 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 w a,. ' Backwater valve 12.51 36 '; ' T "Ir tI`_ . '' Clothes washer Multipurpose Fire Sprinkler System 25.02 Dishwasher 25.02 Permit#MST2016-00362 Drinking fountain 25.02 Ejectors/sump 25.02 if;PR lPERTY Q01tiI 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: - AP L1C� � g `�q 4,, 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 z .. ... 4 ,ice .:aa :.,A'- 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 Lie.no.:PB732 Plan review (25%of permit fee) /� / State surcharge(12%of permit fee) Authorized signature: / ` ) TOTAL PERMIT FEE Print name:Gavin Thornes Date:2/22/17 This permit application expires if a permit is not obtained within I80 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:vothiesq� Residential Fire Su ression Systems 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 Z , • ' Storm&Rain Drain-1st 100' 62.54 1 ` .. $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 o s 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*. •vuotIty bylttture yp , 14'i(�. C3 $u � tt >�i01P BiturtiTypafott, Plan review is required for any of the following. Work 1Pironn+�. a Please check all that apply. PP Y• Baptistry/Font 0 Any new commercial building with water service 2"and Bath -Tub/Shower -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 ® 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" Car Wash Drain 0 Isometric or riser diagram is required for new buildings Garbage -Domestic-non-food Disposal -Domestic-food related that meet the qualifications above. -Commercial-food related -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang -Stall Sink/Lav -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer-Clothes Water Extractor increase of sewer EDUs,a sewer permit will be issued and Water Closet-Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: \\up-dc2\home\gavin\My Documents\Fire Sprinklers\RT\City of Tigard Pe2mit.doc City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 17052 SW JEAN LOUISE RD, SHERWOOD, OR, 97140 Record Type: Record ID: Residential - Master Permit MST2016-00362 Inspection Type: Inspector: 699 Mechanical final David Young Result: CNCL Comments: Not ready for mechanical final inspection. Mechanical rough in inspection added. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 17052 SW JEAN LOUISE RD, SHERWOOD, OR, 97140 Record Type: Record ID: Residential - Master Permit MST2016-00362 Inspection Type: Inspector: 699 Mechanical final Chip Barnett Result: PASS Comments: No A/C 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: 17052 SW JEAN LOUISE RD, SHERWOOD, OR, 97140 Record Type: Record ID: Residential - Master Permit MST2016-00362 Inspection Type: Inspector: 399 Plumbing final Chip Barnett Result: FA I L Comments: Garage- 1 . ABS pipe penetrating required separation wall. Provide adequate protection of separation wall as per ORSC Chapter 3 2. Provide missing AAV at 2" DWV (ABS) pipe at rear of garage Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 17052 SW JEAN LOUISE RD, SHERWOOD, OR, 97140 Record Type: Record ID: Residential - Master Permit MST2016-00362 Inspection Type: Inspector: 199 Electrical final Chip Barnett Result: PASS Comments: No A/C installed at this time Violation Summary: Inspector Contractor