Permit (81) CITY OF TIGARD MASTER PERMIT
III im
V.- COMMUNITY DEVELOPMENT
Permit#: MST2016-00425
Date Issued: 11/03/2016
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S03/201 9200
Jurisdiction: Tigard
Site address: 17345 SW SABRINA AVE
Subdivision: RIVER TERRACE NORTHWEST Lot: 92
Project: River Terrace Northwest, Lot 92
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 02 Bedrooms: 4 First: 1254 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1655 sf Garage: 464 sf Front: 8 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 2909 sf Value: $352,021.96 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 Water Lines: 100 Drains: 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: 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'I 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 2909
Owner: Contractor:
ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
BY FORSUM,MICHAEL 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175
7600 E DOUBLETREE RANCH RD VANCOUVER,WA 98660
STE 1
SCOTTSDALE,AZ 85258
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $33,925.98
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 OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: i��illit / - Permittee Signature: mfr/ 7 .�'7C/C� �C'V
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.
L o T 72
.Building Permit Application
Residential rt fi FOR OFFICE USE ONLY
City of Tigard 1
Date/By: /0// /0 4/11----- Permit No A C/6j `1 5
III II 13125 SW Hall Blvd.,Tigard,OR 97223 SEP 2.016 Plan Review �� � ��!�
= 1 OtherPerm�t
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: l 1' { " 1l
Inspection Line: 503.639.4175 CITY x R D Date Ready/By: Juris: H See Page 2 for
T1GARDt1'
Internet www tigard orgov (J 1 e [ t s NotifiedMethod. �//f Supplemental Information rmation
�. ,.�."`sx�2•. �'� k ��� cn -s ;.� .� t: � �-: � `4;itis .cc�,�;f '� T�'�t'�nu��i�'�� ��� ��� � ������?"�
.y' � �. ,P u ,ws�t y� p1,. .a ,naas..., ... > . .:: F^s• * ..-;. ...� : .._
0 New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
it 1 a a ' �- -,
work indicated on this application.
< i s 1 l; _ fA ; * M-
Valuation: $ 35) i 3 I Q
® 1-and 2-family dwelling ❑Commercial industrial
❑Accessory building ❑Multi-family
Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
�p�] [x {�7` ]�yM y�y�{��, Total number of floors:
t.t1 W sk t 5L' f� �D 11rto�o1ior rmotLt ri . 4 ? < . 1// t`j
Job site address: "345 SW Srkbr i\ct Mt New dwelling area: 29 DB square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: 1.1(DL.) square feet
Suite/bldg./apt.no.: Project name:River Terrace Northwest Covered porch area: 1 Lil square feet /6S
Cross street/directions to job site: Deck area: square feet hi,s-
tr
Other structure area: square feet
1QIU D t 3, �LtY3l it $Ex �?L:I .
Subdivision:River Terrace Northwest Lot no.: C) .7 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.: equipment,materials,labor,overhead,and the profit for the
z 3 lyt - - a i f r , work indicated on this application.
�x -. , *z- '`�° E �d a� Vy, lr Lft "'ig 5 -c.:h P ,-., 4_..,..`G r"L.
Valuation: $
Existing building area: square feet
New building area: square feet
tratef 1 �" a' ; ` ''� Number of stories:
....,.,.t .. n+P G".`,.._<<'aS�_ 4_..�.fi£,., a..xa:u ar.�.. a' ..,.. ,s e...sa._ �... . .a.ex' w+_u X .... ..
iVitKci,: 4.
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:
iLtitig •
' i h q, „' k i adl is�'ri, 11th, °* " �I E �' e i s
Business name:Polygon WLH,LLC Structural plan review fee(or deposit):
Contact name:Angela Grajewski
FLS plan review fee(if applicable):
Address:109 East 136 Street
Total fees due upon application:
City/State/ZIP:Vancouver WA 98660
Amount received:
Phone:(360)695-7700 Fax::( ) � ' t3
t
E-mail:Angela.Grajewski@polygonhomes.com wl!k*� $ ° ,•.-4,-,14` Th`
it 2 3,,E : bar VR41 , ;V£. Commercial and residential prescriptive installation of
i��=ez•Ar ,t, ,..:.._ .t _,; � a Tog _. ;_, _ 3. roof-top mounted Photovoltaic Solar Panel System.
Business name:William Lyon Homes,Inc Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 109 East 13th Street Solar Installation Specialty Code checklist.
City/State/ZIP:Vancouver WA 98660 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60
CCB lic.:207247 Total fee due upon application: $201.60
Authorized signature: ����c K This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry
Print name:Angela Grajewski Date: 3.124110 Service Board.
I:\Building\Permits\BUP-RESPermitApp.doe 02/24/2011 440-4613T(11/02/COM/WEB)
A 1
1V,echanical Permit Applicar, n FOR OFFICE 1 SF ONLv
' Received
City of Tigard
Date/By: Permit N SA ,/
114 13125 SW Hall Blvd.,Tigard,OR 97223
c Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 E P
_ 6 Date/By: Other Permit:
T I G A R D Inspection Line: 503.639.4175 a — ,e r Date R B Juris:
la See
Internet: www.ti and-or. ov i I ' ` ` Y y' Page 2 for
g g § L- Notified/Method: Supplemental Information
Mechanical permit fees*are based on the value of the work
0 New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
y Value:$
c�e � � �r-. tt„ A.
® 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist
❑Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total
'a a 1 Heating/cooling:
gab a .: � ``�' � �1 � � ; p E a Air conditioning 46.75
Job site address: l�73 S 3 W J Obrk e. Furnace 100,000 BTU(ducts/vents) I46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldgJapt.no.: I Project name:River Terrace Northwest Heat pump 61.06
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 Lot no.:C/2_ Other: 23.32Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
5replace/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
t Other: 23.32
1 Environmental exhaust and ventilation:
Name:ADVL Land Holdings,LLC Range hood/other kitchen
Address:7600 E Doubletree Ranch Road equipment 33.39
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
aF Other. 23.32
� �,
Fuelm r .
Business name:William Lyon Homes,Inc. p p g
$14.15 for Srst four,$4.03 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
Range
E-mail:Angela.Grajewski@polygonhomes.com Barbecue
Clothes dryer(gas)
Business name:Apex Air LLC Other
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
Tv.,
his permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name:Angela Grajewski Date:8/22/16
I:\Building\Permits\MEC PermitApp_040113.doc 440-4617T(11/02/COM/WEB)
0
Electrical Permit Applica#i j - V hFOR OFFICE LSE ONLY
City of Tigarded Permit g:/ o/c',-e V -S
13125 SW Hall Blvd.,Tigard,OR 472235 E P 1 2016 Pial,Review Related Permit U.
' Phone: 503.718.2439 Fax 503.598.1960 DateJB .
Inspection Line: 503.639.4175 CITY OF ! a# a t) Ready Date/By: kris: H See Page 2 for
TIGARD p ;` Notified/Method Supplemental Information
Internet: www tigard-or.gov 3 81 4 "D 1"� "s r t,8 , t,�; __
B eL_t.�x, r 5 tt� �f•, �_. __ �zac,� x:.,�nxi+�-:
_ - .Sc-+ - --.ti_t �-t-:- er-A'r- v`-_. �' w':�:r. t- �`.+: t I r ice..; ,Mr'G �� ��"-e`a'�u�:l
�-✓>_..� ��"�r ...cbl�'��-' ���c���+J� _aYt��..1� �'S�t.]:'�:N.�. .- '.'a.. .=Vii^,-�.. _,: ..?%_�..i.
®New construction 0 Addition/aiterationlreplacement (submit Please check all that apply(sit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stades.
i ❑Demolition 0 Other where the available fault current 0 Marinas and boatyards.
�,z..-..- - ' � 't exceeds 10,000 amps at 150 volts or ❑Floating buildings.
��>� J` �' � ��C�1��� 1-„���-� Commercial-use agricultural
less to ground,or exceeds I4,000 0®1-and 2-family dwelling 0 Commercial/industriat ❑Accessory building amps for all other inshellatMns. buildings.
Multi-family ❑Master builder 0 Other.
❑Fite pump. Cl Installation of 150 KVA or
X-274=4`0�:, 7-�3�s .3A1AIT0� � ( TFdI - °-_ ❑Emergency system_ larger separately derived
: 0 Addition of new motor load of system.
Job#: Job site address: I `13 LiS � �✓ ()q
S , �<j 100111'or more. ❑'`A,fi".`I-2: 13",
❑Six or more residential units.
occupancy.
City/State/ZIP:Tigard,OR 97224 ❑Health-care facilities. 0 Recreational vehicle parrs.
'r ❑Hazardous locations ❑Supply voltage for more than
Project name: t l�rt/ N( (t/�61' 600 volts nominal
Suite/bldg./apt.#: ❑Hazard or floc a 600 amps or more.
Cross street/directions to job site: C _
PO fir,Description I Qty. I Each~I Total
New residential single-or multi-family dwelling unit.
Subdivision:,..;04/'rerrcte e. dart(jj(I/pf f Lot#: /2 Includes attached garage.I 1,000 sq.ft or less )• 168.54 4
Tax map/parcel#: _ Ea add'l500 sq.ft or portion ['J] 33.92 1
_ ,�_,
_ '` Limite(with energy,
residential
: - a= ..,_ ovesq.ft.) 00
Limited energy,multi-family 75.00 2
residential(with above sq.ft)
Renewable Energy ❑ See Page 2
:5_ e- g 1rT t - ?��' �� Services or feeders installation,alteration,and/or relocation
Name:ADVL Land Holdings,LLC 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Address:7600E Doubletree Ranch Road 401 amps to 600 amps 200.34 2
City/State/ZfP:Scottsdale,AZ 85258 60]amps to 1,000 amps 301.04 2
Phone:(602)694-4031 Fax:( ) Over I,000 amps or volts i 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. 2 201 amps to 400 amps 125.08 .
Date: 401 amps to 599 amps 16854 2
Owner Signahlre: - •� Branch circuits-new,alteration,or extension,per panel
' : _ -
'' R ,x_- - - ,W.=-',,'fir.`_',,, D*2:-.37:C. 1+,.'',gr`.?0 ? A.Fee for branch circuits with
i
Business name:William Lyon Homes,Inc. above service or feeder fee, 7.42 2 i
each branch circuit I
Contact name:Angela Grajewski B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address:109 East 13th Street branch circuit
Each add'l branch circuit 7.42 2
City/State/ZIP:Vancouver,WA 98660 Miscellaneous(service or feeder not included)
Phone:(360)695-7700 • • ' Fax::(360)693-4442 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:Angela.Grajewski®polygonhames.comReeonnectonly 67.84 2
ff` o a�q 0 ems , T -n- '- 1= Pump or irrigation circle 67.84 2
Sign or outline lighting 67.84 2 ,
Business name:Garner Electric Washington,LLC Signal circuit(s)or limited-energy
.r..,:
Address:6101 NE St Johns Rd panel,alteration,or extension 0 See Page 2 2 ;
Each additional inspection over allowable in any of the above ,
City/State/ZIP:Vancouver WA 98661 Additional inspection(I hr min) 66.2-5/1w
Phone:(253)320-1657 Fax:( ) Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) • 78.18/hr
Email:bdaniels@gweusa.rnmInspections for which no fee is 90.00/hr
CO3 Lic.: C1158 Electrical Lic.: 208174 Suprv.Lica: 4496S specifically listed(h hr min)
Suprv.Electrician signature,required: ,l L f1 �),ej„, - . :„ Subtotal:
Print name: Joan P Albert • J Date: 4/26/2016 _ 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
��' - — =r TOTAL PERMIT FEE:
Authorized signature: <--,p ____.----_-__' _.-- ...:._----....„._____
�”— 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 i
�1:\BaiidinglPe nit+iC PennitApp_ELR ERE.doe Rev 06!172015 440-4615T(11/05/COM/WEB
. ,.
, *Piumbine Permit APPli"PitC'ElVEE)
,. , ,,..
i .
BuildingFixtures
City of Tigard 4 P 1 2016 Received
Dateey:
13125 SW Hall Blvd.,Tigard,Oft 9 Mao Review
Phone: 503.7182439 Fax 501.51/11-.1?f03•. 1 1(4]./AFt r) DaseBy: Penni'N°-/Y57:20/&Ve9c1[1-..,5
Other Peresit No.:
Inspection Line: 503.639A175.,gi ..(...., r..ii,r,c,,e„Nto Dal!Ready/Dy;. Juria said 41:00021Paga 2 for
Internet www.tigard-or.gov j.),,,ILL 1"..7) 3.};ii ,,-: ,..,. V. k",atthe,di,Met11°t,
•-•'',44 ,4-'''' •<,-- .4- •.4n 4 44,44,"'4:4,43/. '-q44;' = ':W`44,4-1'444k47‘4.' '' '%:1-:*T4P'''.1rit.„,,4404«"414:.744-1,,g''''''t 4.'It.. S,44Z44'404.;11,4"-4-;!:AN--it -4''' , •44. ., F'';' :"=1 ' '
.4-4'.'4,41;4'444:,4, 'z-,,t''..a...-':,-7 A'-A-VIIA."---,7, 4..-, o ,:,,,,,4,..t...; "*,,,,4441.44'".'4'*s4':t4k4,:",r"?`"4.5 : :',.-a-r- • - -1-,,,,,,L,''''4, '' - " ''''- • """-""'" '"
Fel vecial informs:Loa are rkeckrat.
kl<New construction 0 Danolition
DescriPlien I Qty. 1 Ea. I Tomi
0 Addition/alteration/replace/nerd 0 Other: New 1-2-family dwellings(includes 100 It.for each uttlity,connecuon• )
1",a,r5rAS,'474''=''.!',•,''7.Z.',‹.. '''' ''''',.,:w "?';"4'`ACal".01157,47141i, '`:4;, SFR(1)bath 31/70
,...'4.1:4 -rf...-Zr-',-;''''',74,...;4,- >:.Y r•••t,4 4 c.G1 ..'0 t it ..',i t,'4,,,!..44t'.I:, .W,T4.,7....: .W.M.;1:1::,,,itT‘`'..',
1$1 I-and 2-fiintily dwelling 0 commercial/IndustrialSFR(2)bath 437.78
SFR(3)bath 1 , 50032
0 Accessory builcFmg 0 Multi-family
Each additional badVkitchen , 25.02
0 Master bulkier a atter Fire-sprinkler _sq.ft.) Page 2 -
-4 ' ' -' '''•"-''' ''''''''''''',''''''''''7''''';''''fir,r•I''''''' ''-%;71•si-,.ril'i.:, ,i1T,',,;:i',' ,'',?,-.•1"::4',.t..,:.;','",',il'.1-5 site odium=
it.:'4Y1.•;:::',..,-•-••••„,` ...-;.:,,..,...•_;.,,,-7:- i-1.-.:''''',-,•"-tt"..-'4';'"'-'''''''' ''''/.'''''''''''''4'.'4'''''''''':" '' A - Catch basin or area Mart 18.76
ictb site address: )1 LE 5 W Scthrina, 6 Drywcit,leach tin;or trench drain 18.76
City/State/ZIP:Tigard,OR 97224 Footing drahr(no.linear&:.....J Page 2
Suite/bldgiapt.no.: I Ptuject name:'Nefl--tkirare 0 eAVIVIeSt- Manufacture4 home Militia 50.03
Cross street/directiont to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft:_,__) Page 2
Storm sewer(no.linear IL:_J Page 2
Water service(no.linear ft: ) Page 2
Subdivision:11;14..e,1' r(CACe t\)OrtIA,L)J-e„St- I Lot no.:ei/ Fixture or item:
Tax map/parcel noBackflow preventer 31.27
.:
I 12.51
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sumo 25.02
'-.••••••-•°5-:-.''-'*:°:'''.,-.--^ -27:-;-;:'-'1'--E 7;1.t?iil:':?:`,'::9:if7i,.q.'31::::',111;i',',..iiL.:-- 4I,;::-4,- --'.°''.:'-"-!...k°'-' . 12.51 ;
Nan*:AD VU Laid Hildings,LLC 25.02
Floor drain/floor sink/hub 25.02
Address:7600E Doubletree Ranch Road Garbage disposal 25.02
City/State/ZIP:Scottsdale,AZ 85258 Hose bib 25.02
. ,
Phone:(602)(•94-4031 Fax:( ) Ice makCr .12.51
-:''.='1"-!,•-•,'----','•••-!•,':--:••••'-'-'-',•.:-,:-<let,lye,•.;‘,•:',.7.-k2-4":4111',V.e.iffeCa. 1141'.. ..rpt'L';!:-:17?.',',1,;,r-,,•,:!, Interceptorhocase trap 25.02
,,iji.,,:•:),,,, ,,,,L v:f:,.:.:,--.:,.,,,,'Lr,,,:4'-:"..g.'-''''';''''''''''. '''' ''''''.'''' ''''''''''''''1''''''' ' Medical gas(value:S ) Page 2.. '
Business name'4Villiam Lyon Homes,Inc
.. . . _ . , Miter 12.51
Contact name:Angela Grijaiski Roof drain(commercial) 12.51
Address 109 East 130 Street. , Sirdc/basinikvatory 25.02
City/State/ZIP:Vuticouver,WA 98660 Solar writs(potable water) 62.54
Phone:(360)695-7700 4, Fax::(360)693-4442 Tub/shower/shower pan 12.51
_
E-mail:Angeln.Graiewsid@palYiaalkanxteLUrinal 25.02ewu
25.02
1 37.52 .
Business name:Alliance Plumbing LLC water piping/Dwi/ • 56.29
Address:146W Illsitorie Columbia River Hwy Other 25.02
City/State/ZIP:Troutdale.,OR 97060 , Subtotal
50: 5
Phone.(503)492-3490 • Fax (503)912-6438 Minimum permit fee72.
.
Plan review (25%o(permit fee)
CCB Lic.:184601 1 Plumbing tic,no.:PB732 State surcharge(12%0f Permit foe)
Authorized signature: TOTAL PERMIT FEE i
....
This permit application expires If a permit is net*braised within 180 days
Print name:Robert Dishman Date:5/23/2016 after it Isas bee.accepted as cestplete. 1
.Fee indhocicilotwset by Tri-County Building Industry Service Board
1:1ButartneFormitaXPLMU-PartaitApp.doe 10/01/09 440-46167(10/CVCOMPNEB)
City of Tigard
q COMMUNITY DEVELOPMENT DEPARTMENT
IN ...,
r1cARo Building Permit Review — Residential
Building Permit #: /ii-7-.,2 0/6 -' 0 p Qj/ 5`
Site Address: /33471-S— SOSi- S7)Z0 ®/e .
Project Name:
ever `- /n.k7C-C AI,Alkrl'S'74' Lot #: c--?,,q
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: A leed SFR
1/R ierify site address/suite#exists and active in permit stem.
ver Terrace Neighborhood: CI 1a Yes,See River Terrace Review Addendum Attached
Sit Plan Elements:
ree(3)copies of site planta: (sting structures on site
Site plan must be on 8-1/2"x 11"or 11 x 17"paper IV Footprint of new structure(including decks)with finished
rawn to scale (standard architect or engineer scale) :•or elevations
rorth arrow n Utility locations(required for new,may apply for additions
te address,project or subdivision name and lot number 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 rotection measures
PiLot area,building coverage area,percentage of coverage andreet tree size,type and location
Pflpervious area(applicable if R-7,R-12,R-25&R-40) L►dStreet names
roperty corner elevations(2 foot contour lines if more than
4 foot differential)
t1klean Water Services—Service Provider Let o• (lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified I No Received: ❑ Yes ❑ No
Public Facili s Improvement (PFI) Permit:
Required: yes,applicant was notified ❑ No Applied For: Yes ❑ No,stop intake
and Use Case#: e oJC 0- 00,C; 4(.6d2 is exC.1')rr
U[J Zoning.• (Pb
Required Setbacks: Front J Rear /l) Side 3 Street Side 0 Garage rzQO
/Landscape Requirement: QC
.011/Lot Coverage Maximum: -00- ,
I�Building Height: Maximum Height Oil Actual Height a----/-
Visual Clearance
[Easements
Kil ensitive Lands: El Yes �No Type
li Urban Fores Plan
tri'
❑ Conditions " t"prior to issuance of building permit �
Notes: �Sa c; /1 zi-
m /9n6," rrnar- Srfancte
Approved By Planning: '" - Date: /0/f/��
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved El Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Fonns\BldgPermitRvw REs 0912I6.docx
. t
Building Permit Submittal
Original Submittal Date: # G/ 2j,
Site Plans:
Building Plans: # 3
Building Permit#: [IEnter building permit#above.
Workflow Routing: Planning Engineering EYlsermit Coordinator ding
Workflow Sign-off: E.-Sign-off for Planning(include notes from planning review)
Route Application Documents: ,II—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: di----it.,71-e-_____, Date: r'ey' ',
Engineering Review
Slope at building pad: ZZ
❑ Conditions "Met"prior to issuance of building permit
El 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: El Yes No
El NOT Approved b Engineerin:• Date:
Notes: a _s �+ ' LL _0 dr.4106 .. — _
Approved by Engineering: Date: /0--/7-1L
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved El 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:
yP'SDC Fees Entered: Wash Co Trans Dev Tax: no es El N/A
Tigard Trans SDC: V> es El N/A
Parks SDC: e.°Yes ❑ N/A
OK to Issue Permit
/24-3/ ,o'
Approved by Permit Coordinator: 0
Date: /v
I:\Building\Forms\BldgPermitRvw_RES_091216.docx
N.
!PI
pity of°Tigar
a COMMUNITY DEVELOPMENT DEPARTMENT
1 A D River Terrace Building Permit Review Addendum
Building Permit #: h iS 77710
. /(a -_' e)0 11-25
Site Address: /7,, r/ ,340 .g n2 Ale-
Project Name: /'/V-ef' cr c iL)e)rik,25'/ Lot #: (i.--
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan Distr t Design Standards (18.660.070.1):
Is the project subject to the plan district design standards? Yes ❑ No
1.Articulation: a minimum of I 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.
Balcony w/ access 2 Window Projection Vertical Wall Offset a
Porch min. 5 ft. deep ft. deep min. 2ft., 5 ft.wide min. 2 ft.,6ft.wide Gabled dormer
Vle ❑ ❑ ❑ ❑
2. Eyes on the street: a minimum of 12%of each street f cing facade must include windows or entrance doors.
Percentage Shown: Fijryi-: /9%%c j Side: lSy0
3. trances:At least one entrance must meet both of the follo g standards:
Max. 8 ft. setback from longe 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
Ifs,all the following apply:
5 sq.ft. min.
ne street facing entry 2 ft. max.roof above floor of porch
5 ft. depth min. 30%min.porch roof coverage
4. petailed Design:All buildings shall include a min. of five of e following elements on all street-facing facades:
Covered porch min. 5 ft.wide x 5 ft. deep f Recessed entry area min. 5 ft.wide x 2 ft. deep
Wall offset min. 16 inches f ❑ Dormer min. 4 ft.wide
Ve Roof eave min. 12 inch projection3 Voof offset min. of 2 ft:f.
❑ Roof shingles either tile or wood PE/Horizontal
hip or gambrel roof design` s
❑ Roof pitch oriented south min. 500 sq. ft. lap siding min. 3-7 inches wide'S
❑ Accent siding min. 40%of street facade Window trim min. 2 1/2"wide by 5/8"deep'.5
❑ Window recess min. 3 inches for all street facing ❑ Bay window min. 5 ft.wide by 2 ft. deep
❑ Balcony min. 5 ft.wide x 3 ft. deep with inside access ❑ Attached garage is 35% or less of street facade
5. Garages and Carports:May face the front or side lot line on a corner lot.
Setbacks:
• loser to front or side lot line, than longest street-facing wall. ❑ Yes No. If No (Check one):
ay 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
My
above the garage that faces the street with a min. area of 12 sq.ft.
Width: (Check one)
❑ 12-foot-wide garage door u 40%max. of street facade
❑ 50%max. of street facade with 7 detailed design elements
Notes:
r Approved By Planning: i Date: l
1:\Building\Forms\BldgPermitRvw_RES RT_062216.docx
Plumbine Permit ApplicatiRECEIVED
Building Fixtures iOt ()I 11( I 1 ,1 (rm )
City of Tigard NOV 3 2016 n 1/ 7 /L, Permit Nolo S rfo ./o 00,414--
71_
■ 13125 SW Hall Blvd.,Tigard,OR 97223
I Phone: 503.718.2439 Fax: 503.tTy Plan Re�ew Other Permit No.:
OFTIGARD Date/By:
Inspection Line: 503.639.4175 e Ready/By: tags: El See Page 2 for
Internet wwwngard-or.gov BO]DING DIVISION q Notified/Method; Supplemental Information
. . :TYPE-OP•Wlorr _. . . :. ...._ .. ,FF. !. '..
®New construction . ❑Demolition For spedal information use checklist
Description 1 Qty. I Ea. I Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
• CATEGORY OF CONSTRUCTION• .. SFR(1)bath 312.70
•i - . . SFR(2)bath 437.78
®1-and 2-family dwelling 0 Commercial/mdustrial SFR(3)bath I 50032
❑Accessory building ❑Multi-family Each additional bath/kitchen 25.02
❑Master builder 0 Other. Fire sprinkler(_sq.ft) Page 2
JOB SITE I NFORMATTON AND LOCATION _ Site utilities:
Job site address:/731 J cVV 300 A in noit /IV.t, Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97 _
224 Footing drain(no.linear ft.:_) Page 2
Suite/bldg/apt no.: Project name: P.,` ,r T,[ 11 f aLP-. 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.:_ ) Page 2
Storm sewer(no.linear ft: ) Page 2
Water service(no.linear ft: ) Page 2
Subdivision:'porToiyGC F N 'V1w,-31r Lot no.41 1 Fixture or item:
Tax map/parcel no.: Backflow pre� 31.27
Backwater valve 12.51
DESCRIPTION OF.WORK
Clothes washer 25.02
(i3n1V6 rtbf C lAa ll t Dishwasher 25.02 ,
Drinking fountain 25.02
Ejectors/sump 25.02
®.PROPERTY OWNER - l El TENANT Expansion tank _ 12.51
Fixture/sewer cap 25.02
Name:ADVL Land Holdings,LLC
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 . . 0 CONTACT PERSON Interceptorlgreasc trap 25.02
Medical gas(value:S ) Page 2
Business name:William Lyon Homes,Inc
Primer 12.51
Contact name:Angela Grajewski Roof drain(commercial) 12.5I
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 Far:(360)693-4442 Tub/shower/shower pan 12.51
Urinal 25.02
E-mail:Angela.Grajewslci@polygonhomes.com
Water closet 25.02
CON RACI OR •
,• Wafer heater 37.52
Business name:Malmedal Enterprises Inc. Water piping/DWV 5629
Address:PO Box 207 Other. 25.02
City/State/ZIP:Banks,OR 97106 Subtotal
Phone:(503)324-0759 Fax:(503-)324-0580 Minimum permit fee: 572.50
Plan review (25%of permit fee)
CCB Lic.:102535 'Plumbing Lie.no.:34-276PB State surcharge(12%of permit fee)
Authorized signature: -c--� TOTAL PERMIT FEE
Print name:Carolina Malmedal Date:0425/2016 This lit application expirrs N a permit is not obtained within 150 days
after it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board.
1:1BuildiugtPermite\PLMU-PermitApp.doe 10/01/09 440-4616T(10/02/COM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
17345 SW SABRINAAVE, BEAVERTON, OR, June 8, 2017 at 1 :20:22 PM
97007
Record Type: Record ID:
Residential - Master Permit MST2016-00425
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS
Comments:
No AC installed at time of final inspection.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
17345 SW SABRINAAVE, BEAVERTON, OR, June 8, 2017 at 1 :23:25 PM
97007
Record Type: Record ID:
Residential - Master Permit MST2016-00425
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
FA I L
Comments:
Seal all penetrations in mechanical room. R302.5.3
Provide UL listed tape for microwave vent. M1601 .4.2
No AC installed at time of final inspection.
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:
17345 SW SABRINAAVE, BEAVERTON, OR,
97007
Record Type: Record ID:
Residential - Master Permit MST2016-00425
Inspection Type: Inspector:
299 Final inspection Chip Barnett
Result:
PASS - CofO
Comments:
Moisture Barrier acknowledgement form received
Street tree cert received
High-efficiency interior lighting form received
CWS approved erosion
Energy trust report received
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
17345 SW SABRINAAVE, BEAVERTON, OR,
97007
Record Type: Record ID:
Residential - Master Permit MST2016-00425
Inspection Type: Inspector:
399 Plumbing final Chip Barnett
Result:
PASS
Comments:
Previous corrections completed
Violation Summary:
Inspector Contractor