Permit (62) .14 CITY OF TIGARD MASTER PERMIT
I ' `; COMMUNITY DEVELOPMENT Permit#: MST2016-00421
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/27/2016
Parcel: 2S106DB08800
Jurisdiction: Tigard
Site address: 17415 SW SABRINA AVE
Subdivision: RIVER TERRACE NORTHWEST Lot: 88
Project: River Terrace Northwest, Lot 88
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1259 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1658 sf Garage: 464 sf Front: 8 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes
Total: 2917 sf Value: $350,245.81 Rear: 10
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 2 Drains: 0
Water Lines: 100 Catch Basins: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Bckflw Prevntr: 0
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
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add!500 sf: 5 201-400 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 SF VB
R-3 2917
Owner: Contractor:
WILLIAM LYON HOMES INC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
109 E 13TH ST 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98660 VANCOUVER,WA 98660
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $33,842.05
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 OA" = .)),...... 8490. 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: f7� /(��fr�
i�G7n A.,/
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.
/--. DT . ,
Building Permit Application
ResidentialFOR OFFICE USE ONLY
City of Tigard Received 0 >/� Permit N .. 73416 _ 46,9:v2,
1111 '� 13125 SW Hall Blvd.,Tigard,OR 97223 S E P 1 2016 Plan Review /
C Phone: 503.718.2439 Fax: 503.598.1960 DateBy: /el-aC,, ) b Other PermiS a, 7/6 403v9,
T 1 G Q R D Inspection Line: 503.639.4175 l 3 s# Date Ready/By: / ....-fi 7uris: H See Page 2 for
Internet: www.tigard-or.govNotified/Method:/a/r, / i 4 Supplemental Information
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1� � 'f`'.�m-'�`a�- € k `�x � �4���a s. °h n�F x 's a"as ¢€r �*� r s';� �5- �� .},„ �i,��, "�z� .�s err-_, r
n' sg ,k i r- o pt 'Ti'PE O itltlt End{ E- ,ite I#� A-1 -`113t X 1 iw
( .�,,r._, ,....,. -. .,..a a .,z-"....,. ..,, ..x. ,e.. .... ..t..t ...w�a ..wpm ,. -?='..�., n,..�... #4t ��' .4.N ..,. .....u . ...... . .emm 4.,,, ..cie s-F.s .. _
®New construction ❑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
'itt sr ii f X�] � �■ 1 2� : f work indicated oJn this applicatioonnn..7
't{a{ S t £ }Y,,*<.:t' ;c.e,�t 3.} £42 O11t.1 W* K .tOV-PA.^ 2�. `�EY;A4 .0 lel°£ft' � ,<.:: ( l��$ ' ✓_`
Valuation: J r7 -41
® 1-and 2-family dwelling 0 Commercial/industrial I ' 1
❑Accessory building ❑Multi-family Number of bedrooms: 4
0 Master builder ❑Other: Number of bathrooms: 3
'a v I m Total number of floors: ✓ i C� J
4?}3uI l 1 :.1 ()R1 {il 'flC1ITr ,. . Y 2. �� 3 ',
Job site address: 1'1 41c Sv\1 SNIT\fia tti t New dwelling area: 29 I square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: 14W14 square feet
Suite/bldg./apt.no.: Project name:River Terrace Northwest Covered porch area: square feet i g,6,---
�€
Cross street/directions to job site: Deck area: square feet it1
Other structure area: square feet
f D Dt� -lLO1ld1 i ISE 11 7ST
Subdivision:River Terrace Northwest Lot no.: 8c3 Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: erials,labor,
$3. = , w i� 5 r ^ ,, ". ,` work indicated equipment, ton this applicationead and theprofit for the
.'.. . ... ......_. .:z 6-*4>`' . , te, -, .. hwaz J .); .a,..::,.i ..
Valuation:
Existing building area: square feet
New building area: square feet
= d �
t' fl >+ ttllE . 1 6 § 1 - : 1`'t 0*M __ 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:
ag
.�Z�`-.,Yr..,�.� � ., . ,..�'sa?" ,�&s c.�.,.�. _� .'!.,.'.`�,a tf-aa�,> �E s^-xx-.z..;�..a_.,.�r�fi m_ .r., ,._.,,24r�_a ,44
����,,r.,-sem -. �s a.� "^5^' ,`u'.t.r_-,-= z - � �.
fiAllatWOMPTPlig
Business name:Polygon WLH,LLC
Structural plan review fee(or deposit):
Contact name:Angela Grajewski
FLS plan review fee(if applicable):
Address:109 East 13th Street
Total fees due upon application:
City/State/ZIP:Vancouver WA 98660
Amount received:
Phone:(360)695-7700 Fax::( )
E-mail:Angela.Grajewski@polygonhomes.com LA " t -r w`
'I'I'';'tftAtita * it* = * 44 ast of or ttt A , q Commercial and residential prescriptive installation of
F i 7,
_ x, i, "mttrogf f roof-top mounted PhotoVoltaic Solar Panel System.
Business name:William Lyon Homes,Inc Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 109 East 13th Street Solar Installation Specialty Code checklist.
City/State/ZIP:Vancouver WA 98660 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60
CCB lic.:207247 /f/� K
Total fee due upon application: $201.60
Authorized signature: 41.1 J// ` This permit application expires if a permit is not obtained
( � within 180 days after it has been accepted as complete.
Print name:Angela Grajewski Date: g1' 80 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
1V:.echanical Permit Application FOR OFFICE l SE O\F1
City of Tigard r"k( � r" Received
g ' DateBy: Permit No./ff/g
1/ -00%2
lig
C - 13125 SW Hall Blvd.,Tigard,OR 97223
Plan Review
Phone: 503.718.2439 Fax 503.598.1960 s E p 1 2 011 Date/BY: Other Permit:
Inspection Line: 503.639.4175 J
T1 G n R D Date Ready/By: Iuris: H See Page 2 for
Internet www.tigard-or.gov 1+.4,
64 cy ()� 3 ,„ Notified/Method: Supplemental Information
i
Mechanical permit fees*are based on the value of the work
1 New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
mechanical materials,equipment,labor,overhead,and profit
❑Demolition ❑Other:
° Value:
$f �� � � '� ,
�m ¢ � w 9F �� �%',Ev .�° g , `o7 4,�k 3 i1 ` � „F
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist
❑Multi-family ❑Master builder 0 Other: Description I Qty. I Ea. I Total
' n Air conditioning i 46.75
Job site address: J?(J/7 3`1J S ok)C m e Furnace 100,000 BTU(ducts/vents) 1 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt no.: I Project name:River Terrace Northwest Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above r 23.32
Subdivision:River Terrace Northwest 1 Lot no.:
Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
R'
t , 1, r Gas fireplace/insert I 33.39
Flue vent for water heater or gas
New construction HVAC system fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
.. . Other: 23.32 t 1
,
Environmental exhaust and ventilation:
Name:ADVL Land Holdings,LLC Range hood/other kitchen
equipment 7 33.39
Address:7600 E Doubletree Ranch Road Clothes dryer exhaust 1 33.39
City/State/ZIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(602)694-4031 Fax:( ) Attic/crawlspace fans \ 23.32
4,ti. ,� :. �i,,. . a s Other: 23.32
Fuel piping:
Business name:William Lyon Homes,Inc. $14.15 for first four,54.03 for each additional
Contact name:Angela Grajewski Furnace,etc.
Address:109 East 13th Street Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 I Fax::(360)693-4442 Fireplace I
Range
E-mail:Angela.Grajewski@polygonhomes.com
u:a3' PitBarbecue
1 � a,`,. R ��•� 3'S s T �. �as � Clothes
r er(gas)
Business name:Apex Air LLC Other:
<h �7°,; 1
Address:18004 NE 72°d Ave Subtotal
City/State/ZIP:Vancouver,WA 98686 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(360)342-8109 Fax:(360)326-1769 State surcharge(12%of permit fee)
CCB lie.:203034 TOTAL PERMIT FEE
"" This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: 1/4..}4,6 * Fee methodology set by Tri-County Building Industry stry Service Board
Print name:Angela Grajewski Date:8/22/16
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)
Electrical Permit Applica F [1 °F' :.O:.
�" �/y �"����N FOR OFFICE LSE ONLY
City of Tigard ReceivedPenn": '$r f"•`00e 2/
N . 13125
Phone:S W0 Hall503.7182439 Blvd.,TigardFax,503.598.196
oR 97 P 1 2 016 Plan Review
0 Dig Related Permit it:
I I GA RD Inspection Line: 503.639A175 QTY - t r o g a,, , •1 Ready Date/By: Iurir. H See Page 2 for
Internetit—
www tigard-or govr. t 3 �, 99 Notified/Method: Supplemental Information
mac. ." --:' dr' '-0 `... ". - -i ' :1,13-�"N 1Ef ca'�' _°" c=_ii__l-ms's•--
. _
.. -,.�,. y..-..-. �_.���.�i._ . te• �^.:....�.'z:r..�•.�.--»z�..�. - _ :.sem^t .� .. ~at�r�.-+��aY �,_�: _' <-'�,'-7�_'.,zs
®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans Wilms checked):~
❑Service or feeder 400 amps or more ❑Building over three stories.
Demolition 0 Other:
_:..
,.._.- where the available fault current Marinasand
boatyards.
�_�rm--_.: ,,,• ?� ( �� �_-_-_=_ -_�� _ exceeds 10,000 amps at 150 volts or ❑Floating buildings
®1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
0 Multi-family ❑Master builderamps for all other installations. boiMingv.•
0 Other 0 Fire pump. ❑Installation of 150 KVA or
"A� � _ _ -
- -=Y`'. - - - - Einer nem. largerseparatelyderived
�:- Bl .fj�tlGl'�CTIO] `"'��•��Ql�ti�.�`��_>?�:'`-=;� ='"'��",�`.�`� BAY�
ri: --C;,;��:-�_tt�c.=,Cru✓.�..t,'.�.._..�.':i..�-:�_.:-.,.:.. .. ..
Job#: Job site address:�,4 (� Sw S/i l.✓1 /�,�f, ❑Addition ofnew motor Load of 0 system
�"' b L +v ]001 or more.
A,"E.`1-2, 1-3".
City/State/ZJP Tigard,OR 97224 ❑Six or more residential units. occupancy.
❑Health-care facilities. ElRecreational vehicle parks.
Suite/bldg apt.#: Project name:igf r /crt/ ,e/V �ij— ❑l tdous locations ❑supply voitaga fnr more
than❑Service en•feeder 600 amps or more. 600 vows aominaL
Cross street/directions to job site: a- % � = .;
Description I Qb...I . mss==--- MEach r Total I 7�
..
New residential single-or multi-family dwellin unit.
Subdivision: jj.j ,y re47-41- A41{1/4(4 ,!//—(4/ Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.R or less ` 168. 4
_ Ea add'1500 sq.ft.or portion 3392 1
a � ter-� -.. Limited energy,residential 75.00 2
(with above sq.ft.)
Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
Renewable Energy ❑ See Page 2
e � = - . 7"- -:00. -� Services or feeders installation,alteration,and/or relocation
Name:ADVL Land Holdings,LLC 200 amps or less 10(170 2
Address:7600 E Doubletree Ranch Road 201 amps to 400 amps 133.56 2
Ci ate/ZI :Scottsdale, 401 amps to ,600 amps 30034 2
�/StPAZ 85258 1
601 amps to 1,000 amps 303.04 2
Phone:(602)694-4031 Fax:( ) Over 1,000 amps or volts 55226 2
Email. Temporary services or feeders installation,alteration,and/or
relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I 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 16834 2
.. . 0:-IaN:- - ---_ k: GL O2 L, Branch Fee or bran h circ w with
or extension,per panel
Business name:William Lyon Homes,Inc. above service or feeder fee,
each branch circuit 7'42 2
Contact name:Angela Grajewski B.Fee for branch circuits without i
Address:109 East 13th Street service or feeder fee,fust 56.18 2
branch circuit _
City/State/MP:Vancouver,WA 98660 Each add')branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(360)695-7700 • Fax::(360)693-4442 Each manufactured or modular
67.84 2
Email:Angela.Grajewski@polygonhomes.com dwelling service and/or feeder
Reconnect only 67.84 2
j4-4.1 - _ -- .1 ._.. Pump or irrigation circle 67.84 2
Bi*ciness name:Garner Electric Washington,LLC Signor outline lighting 67.84 2
Address:6101 NE St Johns Rd Signalnl,circuit(s)or extension.
0 See Page 2 2 i
panel,alteration,or extension.
City/State/ZIP:Vancouver WA 98661 Each additional inspection over allowable in any of the above •
Additional inspection(I hr min) 6625/hr
Phone:(253)320-1657 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:bdaniels®gweusa.com Industrial plant(l hr min) • 78.I8/hr
Inspections for which no fee is 90 00/hr
CCB Lie.: C1158 Electrical Lie.: 208174 I Suprv.Lica: 4496S specifically (ihrmin.) _ 4
f � '' ` i e -2,51- 1:--,,.-',----- 7
Suprv.Electrician signature,required: Mil f tat h-e-. Subtotal:
Print name: Joan P Albert • Date: 4/26/2016 0 Plan Review Required(25%of permit fee):
l - State surcharge(12%of permit fee):
TOTAL PERMIT Pte:
Authorized signature: ��_ �--- -
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 pamut
_ _ I:41 undinglverm-as1FLC PennitApp ELR ERE.doc Rev 06/17/2015 440-4615T(11/05/C014/WEB
•PlumbmQ Permit Application _- -
Building Fixtures ,...,?t,, _ .
illCity of Tigard ateoeitxd Permit a �"/�7 4'/�j"`ll� /
722SEP 1 2016 ' i e j
13125 SW Nall Blvd,Tegaid,OR 9 , P�Review
Phtme: 503.7183439 Fax 503.R846.0 Das Rea aher Peanut No.:
Inspection Line: 503.639.4175 € ( } ' °' p�g�dy/By, lint H See.Parte 2 for
Internet: v nv agard-0r.gO% i a t ,s $ R' °'', Notified/Method:. Se<ppkearatai taformatioa
r_<New constntction 0 Demolition For special Information uses hectlat
Descriptio 1 Qty. 1 Ea. 1 Total
p Addition/siteration/r plaeetrtent 0 New 1-2-family dwellings(includes 100 R for each utility connection)
aiHwrr<�e c , SFR(1)bath 312.70
® I-and 2-family dwelling0 Commeecialtrial SFR(2)bath 437.78
SFR(3)bath 1 50032
'
0 Accessory'bvilding fl Multi-family
Each additional bath/kitchen 25.02 ,
Q Master builder 0 Callen firesprinkler kler(_sq.ft.) Page 2
;Y +'- ' ' '..'�" "°t ..
.
Rte'€ " Site ua'fities:
lob site adds: / 7 ili c W S(MJf i na ' 6 Catch basin or area drain 18.76
Dryweli,leach tine,or trench drain 18.76
raty/State/ZtP:Tigard,OR 97224 Footing drain(no.linear 8.:__) Page 2
Suite/bldg./apt.no.: I Project name: �1(eY-e,,yr ce., 14OftVieSt .: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 R: ) Page 2
Wates service(no.linear ft: ) Page 2
Subdivision:#p tiftif�tXYGf� N oc1 ltojes` I Lot no.: ab Fixture or item:
`
Tax map/parcd no 1 Backflow enter 3127
-,r� ' - , � Backwater valve 1 12.51
';',.°:„"=7::,:;",::i','":4:=1°,-111,
wClothes washy 25.02
.
Dishwasher 25:02
Drinking fountain 25.02 ,
Fjectors/sw ftp 25.02
, s f t o r. ."'
Expansion tank 12.51 .
Axture/sewer cap25.02
Nanus ADVL::Land Holdings,LLC ,
Floor:drainlfloor sink/hub 25,42
Address:7600 E Doubletree Ranch Road
Garbage disposal 25.02
City/State/ZIP:Scottsdale,AZ 85258 Hose bib 25.02
Phone($02)694-4031 Fax:( ) Ice maker 12.51
e c r interceptor/grease hap 25.02
Medical gas(value S ) Page 2
Business treme�Wd[iam Lyon Homes,Inc --
Primer 12.51
Contact name:Angela Graletvalli Roof drain(commercial) 12.51
Addres8 109:East 136 Street:
. - Shit/basin/lavatory 21.02
City/State/ZIP:Vancouver,WA 9866oSolar ung
(368695 (potable water) 62.54 .
Phone: ) 5-7700_ Fax :(360)693-4442. .... . . Tub/shower/shower pan 12.51
Urinal 25.02
ai polygon
E-mail:A eda.Gna hoiaea.coas
.7., Water claret 25.02
, r w, y Watt heaterii '7.52
1 3
Business name Alliance Plumbing LLC Waterpiping/DWV , 56.29
Address 146;W liii toric Columbia River.Hwy Other: 25.02
City/State/ZIP:Troutdale,OR 97060Subtotal
j Minimum pe mit fee $72.50 Phone.(503)492-3490 Fax (503)9124438
44
"!e er
CCB Lie»184601 Plumbing Lie:no.:PB732,,,...
• State surcharge(12%Of permit fee)'
signature:Autliorinxr! Pian review TOTAL(25PERofpMImit FEEEcce) a
5/23)2016 This permit separation expires N a permit 1s not obtained within 180 days
Pnint,name Robert Duman Date: after it bar bee.seeeered as complete.
`Fee methodology set by Tri-County Building ladustry Service Board.
1\Buildteierermfx7LMU-PeimokAppdoc tW/O1)09 44tl-solsniwavcOWWEB)
1
City of Tigard
v COMMUNITY DEVELOPMENT DEPARTMENT
e
T 1 c A Ro Building Permit Review — Residential
e - r
Building Permit #: /47--C77,20/& UQ '-A,1-/
Site Address: 1?0 SO 5v#4-7 o .
Project Name: 'er `7fro ce 30E j 'S7 - Lot #: ea
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: /WO SPIe
iVerify site address/suite#exists and active in permit stem.
River Terrace Neighborhood: ❑ No V Yes,See River Terrace Review Addendum Attached
Sit Plan Elements:
V ree(3)copies of site planvii ;...sting structures on site
Site plan must be on 8-1/2"x 11"or 11 x 17"paper If Footprint of new structure(including decks)with finished
rawn to scale(standard architect or engineer scale) or elevations
OOrth arrow Utility locations(required for new,may apply for additions)
e address,project or subdivision name and lot number AO cation of wells/septic systems
plicant information(name and phone number) foisting trees to be retained with drip line,and tree
t dimensions and building setback dimensions jprotection measures
Lot area,building coverage area,percentage of coverage and g reet tree size,type and location
riV' pervious area(applicable if R-7,R-12,R-25&R-40) LlAStreet names
roperty corner elevations(2 foot contour lines if more than
4 foot differential)
t1ftlean Water Services—Service Provider Lett9t (lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No
Public Facili s Improvement(PFI) Permit:
IZCRequired: VYes,applicant was notified ❑ No Applied For: /Yes ❑ No,stop intake
Land Use Case#: 76,6E' oi,5= UO ' f' a6QOIS- Ci 6a
IVJ Zoning: (
�f
SCJ Required Setbacks: Front Rear �D SideStreet Side AM. Garage dry
�f' .5 I�- g +�l%
0/LanSCJ Landscape Requirement: QC) %
dscape
Coverage Maximum: 00 %
VA Building Height: Maximum Height Height .7t/6"
g > Actual
i'isual Clearance
Iri Easements
Je ensitive Lands: ❑ Yes I (No Type
Urban Forestry Plan
❑ Conditions "At"prior to issuance of building/> permit
Notes: G7PS' �%k?// 273e m nn,-- . f?frb/l / S 2A'c
Approved By Planning: c--� - ' '„ Date: /D//f//
(
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved El Not Approved
I:\Building\Forms\BldgpermitRvw REs o91216.docx
or
Building Permit Submittal
Original Submittal Date: 7 //
Site Plans: # 3
Building Plans: #
Building Permit#: e"-Enter building permit#above.
Workflow Routing: Planning 0—Engineering 'B—Permit Coordinator wilding
Workflow Sign-off: l 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.
EBuilding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: .)' ;lrZ'.T7e-___-- Date: /--:, /,,--;/// s,
,(
Engineering Review
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 Appr• e by Enginee ng: Date:
Notes: ...- ..- .. i i i i �� �__ i
Approved by Engineering: , LP Date: Ap--/9 16
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:
�DC Fees Entered:
` Wash Co Trans Dev Tax: ►'."es ❑ N/A
Tigard Trans SDC: 740 Yes ❑ N/A
Parks SDC: Yes ❑ N/A
•OK to Issue Permit
Approved by Permit Coordinator: Date: /6/)4"./i
I:\Building\Forms\BldgPermitRvw_RES_091216.docx
N
City of Tigard
M COMMUNITY DEVELOPMENT DEPARTMENT
ill i
T 1 c A lz o River Terrace Building Permit Review Addendum
Building Permit #: r2o/6 -a 00 g..2-/
Site Address: /939S-- SO P22 ii'v _
Project Name: P' €- `f rfioc,C' ,j(je) gf- Lot #: ge
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan Disttjt Design Standards (18.660.070.1.):
Is the project subject to the plan district design standards? V Yes El 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. dee Balcony w/ access 2 Window Projection Vertical Wall Offset a
/ p
, ft. deep min. 2ft., 5 ft.wide min. 2 ft., 6ft.wide
Gabled dormer
CIEl ❑ ❑
2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: /'9.. 3 e/z
3
. ntrances:At least one entrance must meet both of the follo • g standards:
iMax. 8 ft. setback from long t street- facing wall Parallel to street,angle no more than 45° from street,
or open onto porch
Entrance opens to a porch: Yes ❑ No
Hies,all the following apply: sq.ft. min.
Yr ileine street facing entry ft.max.roof above floor of porch
ft. depth min. 30%min.porch roof coverage
4. Detailed Design:All buildings shall include a min. of five of e following elements on all street-facing facades:
eovered porch min. 5 ft.wide x 5 ft. deep Recessed entry area min. 5 ft.wide x 2 ft. deep
Rall offset min. 16 inches ❑ ormer min.4 ft.wide
oof eave min. 12 inch projection .Koof offset min. of 2 ft.
❑ Roof shingles either tile or wood iai Gable,hip or gambrel roof design
El Roof pitch oriented south min. 500 sq. ft. ❑ orizontal lap siding min. 3-7 inches wide
❑ Accent siding min. 40%of street facade (Window trim min.2 '/2"wide by 5/8"deep
❑ Window recess min. 3 inches for all street facing ❑ Bay window min. 5 ft.wide by 2 ft. deep
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:
N closer to front or side lot line, than longest street-facing wall. IIIYes VJ 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.
ay extend up to 5 ft.where the garage is part of a two-story building and there is a window at the second story
above the garage that faces the street with a min. area of 12 sq.ft.
Width: (Check one)
❑ 12-foot-wide garage door 40%max. of street facade
❑ 50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: ..am..- -v!.,,■ Date: 0 I
1:\Building\Forms\BldgPermitRvw_RES_RT_062216.docx
CEIVED
Plumbing Permit Applica ,
Building Fixtures �/) 7
City of Tigard N 0 V 3 2016 n !C 'i /� ff. PermitNo.!4 rut f._f oL4
13125 SW Hall Blvd.,Tigard,OR 97223 _
Phone: 503.7182439 Fax: 503.e lOFTIGARD Daolleview
Date/By: Other Permit No..
Inspection Line: 503.639.4175 pye Ry Juis: Id See Page 2 for
' " Internet www.tigard-or.gov BUILDIM. DIVISION Notifed/Met!>od: Supplemental Information
®New construction [j Demolition For special information use cheats-it
Description I Qty. I Ea. I Total
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUICFION" SFR(1)bath 312.70
®1-and 2-family dwelling 0 Commercial/uxiustrial SFR(2)bath 437.78
SFR(3)bath ' 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other. Fire sprinkler(_sq.ft.) Page 2
. JOB Slit INFORMATION AND LOCATION Site utilities:
Job site address: /7 Vic" c J 506 in oa, &V Catch basin or area drain 18.76
' Drywall,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.:_) Page 2
Suite/bldgiapt.no.: Project name: I'kr T-(Ar(arl_, N V v Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_J Page 2
Storm sewer(no.linear ft: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision:' " tc-17. y.t. N P s� LotWno-'•Pj Fixture or item:
Tax map/parcellno..: Backflow pre enter 31.27
• . DESCRIPTION OF.WOR . Backwater valve 12_51
. . [01\4
(+� K•� Ciotheswasher 25.02
r�C` I\( Dishwasher 25.02
I Drinking fountain 25.02
Ejectors/sump 25.02
®.PROPERTY OWNER 1 El 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 . ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:William Lyon Homes,Inc Medical (value:$ ) Page 2
Primer 12.51
Contact name:Angela Gra jewski 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 a®polygonhomes.com Urinal 25.02
Water closet 25.02
CONTRACTOR Water heater 37.52
Business name:Malmedal Enterprises Inc. Water pipingDWV 5629
Address:PO Box 207 Other. 25.02
City/State/ZIP:Banks,OR 97106 Subtotal
Phone:(503)324.0759 1 Fax (503-)324-0580Minimum permit fee: 572.50
Plan review (25%of permit fee)
" CCB Lie.:102535 Phunbing Lic.no.:34-276PB State surcharge(12%of permit fee)
Authorized signature: C TOTAL PERMIT FEE
This permit application d within 180 days
Print name:Carolina Malmedal Date:0425/2016 after k accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board.
IBurldineermits\PLMU•PeramApp.doc 10/01/09 440-4616T(I0/D2COM/WEE)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
17415 SW SABRINAAVE, BEAVERTON, OR,
97007
Record Type: Record ID:
Residential - Master Permit MST2016-00421
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
17415 SW SABRINAAVE, BEAVERTON, OR, May 23, 2017 at 1 :12:09 PM
97007
Record Type: Record ID:
Residential - Master Permit MST2016-00421
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
Blower door and/or duct seal test certificate received
C of 0 left on counter.
Violation Summary:
Inspector Contractor