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Permit (174) IN Ai CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2016-00252 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/17/2016 Parcel: 2S108DB02700 Site address: 15312 SW SEINE DR Jurisdiction: Tigard Subdivision: POLYGON AT BULL MOUNTAIN Project: Polygon at Bull Mountain, Lot 25 Lot: 25 Project Description: NeW SF BUILDING Floor Areas Required Setbacks Stones: 3 Bedrooms: 4 First: 1518 sf Basement: 826 sfRepaired Height: 29 Bathrooms: 3 Left 5 Parking Spaces: 0 Second: 2144 sf Garage: 735 sf Dwelling Units: 1 Front 20 Smoke Third: 0 sf Yes Right 5 Detectors: Total: 4488 sf Value: $541,993.12 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Urinals: 0 Tubs/Showers: 3 Sewer Lines: 100 SF Rain Garbage Disp: 1 Water Heaters: 2 0 Storm Sewer: 100 Water Lines: 100 Drains: Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Bckflw Prevntr: 0 Catch Basins: 0 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 6 Natural Gas Clothes Dryers: 1 Heat Pump: Y Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Fum>=100K: 0 Gas Outlets: 4 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders 1000 sf or less: 1 Branch Circuits 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'500 sf: 8 201-400 amp: 0 201-400 amp: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 p W/O Svc/Fdr: 0 p 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener N Other: N Other Description: All Ecompasing: Y BUILDING INFO Class of Work: Type of Use: NEW Type of Constr: Occupancy Group: SF VB SquareFeet: R-3 4488 Owner: Contractor: POLYGON WLH LLC POLYGON WLH,LLC Required Items and Reports(Conditions) 109 E 13TH ST,STE 200 109 E 13TH STREET 1 A Geotechnical report is VANCOUVER,WA 98660 VANCOUVER,WA 98660 required before the footing 2 Ersn Cntrl 503-639-4175 PHONE: PHONE: 360-695-7700 FAX: 360-693-4442 Total Fees: $37,190.64 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-7952-001-0090. 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 -.,, Permittee Signature: f v , '/ z/e.f J7 .2 Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application 0 7--- €Z-5. Residential City of Tigard RECEIVED ��j�� DateB ,,,,/;,,,,,,6,„ / Permit N9"'/S27,2/. ■ 13125 SW Hall Blvd.,Tigard,OR 97223 y d�r �a IIIIII 0 Phone: 503.718.2439 Fax: 503.598.19gp p,/ y Q { Plan Reviev� ]VI!4 I i o I b Dant Rey b/.2.�, ry stt Other Per Ld/4,?eila'(90��y I t G n t:a Inspection Line: 503.639.4175 Date Ready/By: Juris I H See Page 2 for Internet: www.tigard-or.gov CITY OF TIGAR[Dy5 Notified/Method: Supplemental Information TYPE OF'W INC M it0N REQUIRED DATA:1-AND 2-FAMILY DWELLING ®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 ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OFCONSTRUCTION work indicated on this application. ® 1-and 2-familydwellingValuation: $ 26 (� 3 0 CommerciaUindustrial 4� ElAccessory building ❑Multi-family Number of bedrooms: 4 ❑Master builder ❑Other: Number of bathrooms!,%Z JOB SITE INFORMATION AND LOCATION. Total number of floors: 2 a Job site address: 15 3 la cSUJ SC Y/i'n6 /1,_ New dwelling area: 4488 square feet City/State/ZIP:Tigard,OR 97224 Garage/carport area: 735 square feet Suite/bldg./apt.no.: Project name:Polygon at Bull Mountain Covered porch area: 51 square feet Ltq. Cross street/directions to job site: Deck area: 160 square feet/Z.I v Other structure area: square feet sa REQUIRED DATA-COMMERCIAL USE CHECKLIST, Subdivision:Polygon at Bull Mountain Lot no.: Permit fees*are based on the value of the work performed. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF'WORK work indicated on this application. Plan 19D-DL Valuation: $ Existing building area: square feet New building area: square feet N,PROPERTY OWNER 0 TENANT Number of stories: Name:Polygon WLH,LLC Type of construction: Address:109 East 13th Street Occupancy groups: City/State/ZIP:Vancouver WA 98660 Existing: Phone:(360)695-7700 Fax:( ) New: .APPLICANT E CONTACT PERSON;` BUEES* ILDING PERMTI'F Business name:Polygon WLH,LLC "(Pleare refer to fee schedule). . .,. 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 Fax::( ) Amount received: E-mail:Angela.Grajewski@polygonhomes.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*_� CONTRACTOR °.. residential prescriptive installation of .. „' .� Commercial roof-top mounted Photo Voltaic Solar Panel System. Business name:Polygon WLH,LLC Submit two(2)sets of roof plan with connection details Address: 109 East 13th Street and fire department access,along with the 2010 Oregon Solar Installation Specialty Code checklist. City/State/ZIP:Vancouver WA 98660 Permit Fee(includes plan review $180.00 and administrative fees): 4/Phone:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60 CCB lic.:204238 /,/j , G Total fee due upon application: $201.60 Authorized signature: l/.9< G�e f t x(41 /C This permit application expires if a permit is not obtained tJ within 180 days after it has been accepted as complete. +name:Angela Grajewski Date:5/2/16 *Fee methodology set by Tri-County Building Industry Service Board. ,ng\Pennits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Applic tt FOR orFlce [SE 0 Lv City of TigardReceived 71 13125 SW Hall Blvd.,Tigard,OR 97223 • Phone: 503.718.2439 Fax: 503.598.19 aY 1 O 2016 Date/By: Plan Permit No. 17ptJ6 Date `"1,.5 - Other Permit: TI G n R D Inspection Line: 503.639.4175 Date Ready/By: 7uris: Internet: www.tigard-or.gov CITY OF TI AR Supplemental See Page 2 for *; Notified/Method: Information t,EHLDIINI(° DIVISION TYPE OFy WORK.', GOM11�Rt7AL FEE :SCHEDULE`—USE CHECKLIST 0 Addition/alteration/re Mechanical permit fees*are based on the value of the work ®New constructionplacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. ,- , Value: „. CATEGORY:OF'CONSTRUCTION ® ,. and 2-familydwelling . , . . ; RESIDENTIAL EQUIPMENT I SYSTEMS FEES*; ❑Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total JOB BITE INFORMATION AND;°LOCATION' Heatiing/cooling: �� W �^ Air conditioning 46.75 Job site address: I /Q� ,/� Se,( t e Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: Project name:Polygon at Bull Mountain 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 23.32 Subdivision:Polygon at Bull Mountain Lot no.: c a Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 .-,.,' , - K.. 3YESCRIPTION .- WORD Gas fireplace/insert 33.39 ' Flue vent for water heater or gas fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 PROPERTY OWNER Other: 23.32 ; _ .W. ., ❑ TENANT` Environmental exhaust and ventilation: Name:Polygon WLH,LLC Range hood/other kitchen Address:109 East 13th Street equipment 33.39 Clothes dryer exhaust 33.39 City/State/ZIP:Vancouver,WA 98660 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:(360)695-7700 Fax:( ) Attic/crawlspace fans 23.32 Ei APPLICANT',= -',❑'CONTACT PERSON Other: .,n ; 23.32 Business name:Polygon WLH,LLC Fuel piping: $14.15 for first 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 Fax::(360)693-4442 Fireplace Range E-mail:Angela.Grajewski@polygonhomes.com Barbecue CONTE ACTOR Clothes dryer(gas) Business name:Apex Air LLC Other: MECHANICAL PERMIT FEES* Address:18004 NE 72nd Ave Subtotal City/State/ZIP:Vancouver,WA 98686 Minimum permit fee($90.00) Phone:(360)342-8109 Plan review(25%of permit fee) Fax:(360)326-1769 State surcharge(12%of permit fee) CCB lic.:203034 _ TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 C���� r(/fin days after it has been accepted as complete. Authorized signature: l Y- * Fee methodology set by Tri-County Building Industry Service Board Print name: A - (re l e w S V/ 1 Date: 5 t(0 I:\Building\Permits\MEC PermitApp_040113. Imo+ 440-46)• ( TT(11/02/COM/WEB) , _____ EVE i[11t(tl l.i. i: i,i , ., cit- f 'far Reteived 13l?5 S' I1117 It1ad,..Tigard,Oft 97 . EP 2 0 2016 ilatopv(e " $;-- P nil r7S 2e7/ 'ec 25,. Plan Review i�c11ated Pamir a; m ---7------- m =n1=IMIMIIMIMMIIUMIMIM=MIMillMMIMM. Phone; 501778 '439 Pm 501.5t.trt . m,,,,13...... Ittt : w .ti -or,gtw BUILDING ► , ,int'' � , o. r e l for nt 11 Itts 'lion'Line: 5413,6394175 ®� II�h i�� idoti6edt7+AiFthnd: Supplemental Intimation ': `1'PE.OF WOW pp6 a New construction 0 Additiontalteration/replac ement Pleasecl+cc3:all that apply isvbmii 2 s of pleas to/items d eckedl LJ Demolition Other: a Srv)se or feeder 400 amps i t more ti Building over three stories, where the available fault boli o f ©Marinas end boatyards. '- ,� ,,c4TS,00/1' oIr:•Ctl.N g1jC'Ilo,N „_: ..• - ex-rends 10,000 amps at 150 volts or ®Floating buildings, ►tea 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building lets to ,nd.or exceeds 14,E ©Ceonativial-use agricultural 0 amps for all other installations, buildings. Multi family 0 Master builder 0 Other: l�Fire pump. �)nstallation a[150 K VA or 7 3O ;SITE ORMATION:4ND 4)CA'i'I31l' DEm ergency system. larger separately derived Job site address p c,n Dye 0 Addition of new motor Mad of system i S31? SW n r / 'v ,OOHP ur more: ® :A'."6. 1-2•."13", City/State/ZIP:Tigard,OR 97224 I�Six or mire residential units, occupancy, 0 Health-care facilities. l�Recreational vehicle parks. Suite/bldg./apt tt: �p y� D Sn salts e f Projectnanie. 1 20; dr fv uu rANi ,i ©flararduusic anon#, 7 Y or,In'thaa ���J�y_ �� tt�� a �� �a� �Srs�ee ur feeder 500 amps or marc, btl0 volts nominal, Cross street/directions to job site: _'_, Description I Qty, I Earls I Total l ' New residential single-or matin-family dwelling unit Subdivision p o 11 �� a f. t Includes attached arae. �'�,�����,�� 6��Ly u�v��v�i B� _�� Lot#: Z�" garage. Tax map/parcel 11; 1,000 sq,R.or less ' 16$.54 4 ".`;D�iktiG N DE WOE Ea.add'1500 sq..Il.or portion l.2 :33,92 I tai eAlevitg p Limited energy, 2 �/� •L residential (with above sq.ft _� t3� $ 'kO NE1? -_ - ,.. ` �``TEtN sy Limited rside ai energy,r th above sq ft) 75. 2 00 Name ADVL Land Holdings,LLC Renewable Energy fl See Page 2 Address:76.00 Doubletree Ranch Road. Services or feeders installation,alteration,and/or relocation 200 amps or less 100.70 2 City/State/ZIP;Scottsdale,AZ 85258 Phone:(602)694-4031 I.Fax:( ) 2011 amps to 400 amps I33.36 2 Email: 401 amps to 600 amps 20034 2 Owner installation:This installation i$being made on property that I own Which is not 601 amps to 1,000 amps 307,04 2 intendet3 for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. Owner stgnarure: Date:. Over 1,000 amps or volts 552.26 . 2 j e A l?L it A.Nj Temporary services or feeders installation,alteration,and/or . �;'' ' - ..".'� LY➢�7`;Ai�:[": . _ reiocatioa Business name:William Lyon Homes,Inc.. ZOO amps.or less 5936 1 Contact name:Angela Grajewski 201 amps to 400 maps 125.08 2 Address:109 East 13th Street 401 amps to 599 amps 1168.54 2 City/State/ZIP:Vancouver,WA 98660 j Branch circuits—new,alteration,or extension. er panel Phone:(360)695-7700 1 Fax::(360)693-4442 A.:Fee for branch circuits 3vith above service or feeder fee, 7,42 Email:Angela.Grajewskijpolygonbomes.com each branch circuit - B_Fee for branch circuits without : a 4•, L't11cra.$ i.___` ,. _., service or feeder fee,first Business name:alameda electric branch circuit 56.18 2 Address:3415 rte 44th Each add'/branch circuit. 7;42 Miscellaneous(service or feeder not included) Gib)'/StatelZlP: /may/ 1 -y /3 Each manufactured or modular _ / / dwelling service aad'or feeder 67.S4 s Phone:(503}3192193 #I Fax:( j Reconnect only 6677..s404- 3.S4 2: Email:solarpdx®ate,corn . Pump or inigation circle '' CCB Lir,: 199188 Electrical Lie,: c923 Suprv.Lie.: 9,f7 it$ .; Sign or outline lighting filo S4 2 Suprv.Electrician signature,required: Signal circun(s)or limited-enera Print name; i cr / Date: { panel,alteration,or extension. 0 See Page 2 . , ' Each additional inspection over:alionnble in nity of the above. - AirtliflrtZeO signature: Additional inspection(1 hr min) 66 2s hr � w t'rtilt nitre ,..."----------/' -- -- ) . .. ,� Daie,6-143././1: Invesdgatiori(1 hr min) ! 90 Oil In tl L'eoicliag aatst'i%C_Pctraits4pp£IRE'AEdoc Res IRO 7;201.5 . 440-45 t.€T{r +4SfC't}tit•`5Y£S .. ... ' Plumbing Permit Application Building Fixtures Ft)1i; orrl( E 1SL (»t.\ MAY 18 2016 EFiew Permit1111 la 13125 SW Hall Blvd.,Tigard,OR 97223 g{� �y 6 ` l�7 �f+l Mt vOther Permit No.: Phone: 503.718.2439 Fax: 503.598.196- Inspection Line: 503.639.4175 BUILDING 1\/ S «p111e Ready/By: loris: ® Sec Page 2 for T l i':�i,t? Internet: www.ti d-or.°ov � e: Notified.'Method: Supplemental Information 6�"�'i.,t"0'-N t 1 '. F c"' .1.1si of iiia f T4i 7 . t� } { /{ S �+ . i+ ¢�v {' 4 ! - a �,s 4 VF 'TY dl�� i i `' r' x F P�L`j'ySS�HED w. ®New construction ❑Demolition For special information use checklist Description I Q1y. I Ea. I Total ❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CA i t3R'1.O +CONSTR`I3. 'iiiii, r' SFR(I)bath 312.70 ® I-and 2-family dwelling El Commercial/industrial} SFR(2)bath 437.78 SFR(3)bath 1 500.32 D Accessory building ❑Multi-family Each additional bath/kitchen 25.02 ❑Master builder ❑Other: � �,� ,i'V'NtFire sprinkler( sq.ft.) Page 2 d Y+.; .ft+TOR.1 ;`Llt1F?#' .q�t i } flO iz`s. { F f z ,. Site utilities: Job site address: 1 S?. t a- S W e�f,(n 'Y^. Catch basin or area drain 18.76 Drnvell.leach line or trench drain 18.76 City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: ' Project name:Polygon at Bull Mountain Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision:Polygon at Bull Mountain I Lot no.: 01-5 Fixture or item: Tax map/parcel no.: Backflow preventer .r.,L . ( I 31.27 nt.'ti4n:Sa t a iirfA c ,t4thn n Backwater valve ' 12.51 Kv., + , l ,m . ,,n . .>..: rt<e� Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 x . r,. Ejectors/sump 25.02 Y 4 ciJd2:•: � tti.* �,Y s `- Expansion tank 12.51 Name:Polygon WLH,LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:109 East 13th Street Garbage disposal 25.02 City/State/ZIP:Vancouver,WA 98660 Hose bib 25.02 Phone:(360)695-7700 Fax:( ) Ice maker 12.51 Ay4:00/ i tiSali 4; isF.v..tigCTifigit .r.i Interceptor/grease trap 25.02 .. iY,,o,.::.0,, -44VA � ....X.,u...x..,- t. sv,. .i/ . ..,has. c. �,,,: x .R: A>•s ., . Business name:Polygon WLH,LLC Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:Angela Grajewski Roof drain(commercial) 12.51 Address:109 East 13th Street Sink/basin/lavatory 25.02 City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54 Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51 E-mail:Angela.Grajewski@polygonhomes.com Urinal 25.02 q;: i4tpj� 7 k :" garxu.� r " tas.P l° - Vater closet 25.02 3A ma ) ma. at ..,,o.ta n .. ,,:n Water heater I37.52 V Business name:BDL Plumbing LLc Water piping/DWV 56.29 Address:PO Box 85 Other: 25.02 City/State/ZIP:Corbett OR 97019 Subtotal Phone:(503)351-3903 Fax:( ) Minimum permit fee: $72.50 CCB Lie.: 180345 Plumbing Lic.no.:P/31582 Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: n- _-- 1'?w/"` TOTAL PERMIT FEE Print name:Brandon Lanter Date: 5131 (/ This permit application expires if a permit is not obtained within ISO days tp after it has been accepted as complete. "fee methodology-set by Tri-County Building industry Service Board. t: uilding',Permits\PLMU-PermitApp.doc 10101109 440-4616T(10/02/COM WEB} Plumbing Permit AppliAtio.a_ RECEIVED Building:Fixtures- FOR OFFICE ( SE ONLI City-Of Tigard AUG 1 6 2016 :It:et:7! perp*to.: .. . 13125 8W Hall:Blvd..Tigard:OR 97223 Phone 503,718.2439 Fax::503:598M OF TIGARD .g':,17::igw. ith Other Permit No:: inspection 11:Liae: 503.639:4175 " " :''." •• - ' TIGARD - • .. Jura. I: 0 Sce Page 2 fee Internet: ,wwwItgar&orgov. Not tied&et od: . BUILDING DIV.1!10 Plci'Reatilhy: Supplemental Infarmatioa -'''....,';-2•:7.*:;-:' ---,..:,, ,..,-9A-:4. :7-.V,.tN,,,:-...-::,-:]w,:-.,. .3,,;•,':•.:4'7.'3-gg,.',::,-=.,i..:;.z'.'.a:1?- i,---i-,k;:rS:k- ' pie-',:.-rl!';g;4a..f. :'.:L-•-,.,,.:• ,•:,...-,.,5;,-..c,,,ti-.-.,...,..',.1,-,4.;,.ii,..,...,%„ titi... itl''';';•47::1:::::"Q.'-'!"''g7-1::";: Et New construction 0 Demolition• roe special infarnzailan use checklist .„ .- " PeseriptiOn : ' .1 *Qt. I Ea. f Total 0 Additionlaiterationireplacement 0,Othes:„ . New 4-4-fairiljy dwellings(includes W0:11.fereach utility connection) .. ... . - 5•i;t .f-.•'-g!'-•Wil:4-'•'''`C.t.s-7',..'!D'•AliiidiioittiiiNg;Ytitraieill.AtM.P:.:.•:,,'•:• 7'N-V,:..-:: -,:i':','i1g• FR(1)bath 1 31170. •E 43718 l 1-and 2-fardly dwelling 0 OommereinVindastrial •• .SFR(2)bath . • -• •• .: .SFR(3)qbath 500:32 0 Accessory building 0,MnitiLfathily • Each additional bath/kitchen 25":.9 . . 0 Master builder 0'0.041 . Fire sprinkler.( aq:B). Page2 .,1:4•L]ff:Axiiiii;giffg*AtiiifitkrithiYiiiikiztifieis.,:nit,-,,,--,,.-.P-r-,,:mi.t,:;.: Site utilities site n, Irib. addressf i s3 setAe_ .,, _ , Catch-has:h&area drain 1816. . Drywell;leachTtne,or trench drain . l&76 City/StaretZIP:.Tigard,OR 97224 , . •- Footing drain(no,linear ft...; ) • Page 2• .8W:1e/bldg./apt.no 1 Project name:PaYg6i?'at13°1 fthli°alit Manufactilted home utilities'. • 50,03 ...„ CrOss;Street/ditecriOnS to-jot)site: ' •ManhOles °:'6 EMI . .. • Rain drain connector 18.76 ' ..;..,. .• -• .... . . I Sanitars,sewer(no.linear ft.: )-, Page:2 .,_ . . • " " 'Stiam sewer(no.linear.II:: . ) [ Page 2 i .. I. /ate'service(no.linear IL; ) .I Page-2 Subdivision;Polygon it.Billl MOuntitili • 1-bit t10.4 2.5" Fixture or item: . .„ . . • Tax map/pa/telt-1o.; Backflow tneyenter 31,27 :1 .••- ,,...:::,T.:•.;,,,,..,::,,.iy,.-.,.;--„,-.--...--4,..-: -- .;--. --. ---,— ._2, __,- ,,,,,,,,,,,..,.; ethy.-,ym-i2:_. ..,,t,...,-;-,% Backwater valve ,..,'..A':*-::!:.,,•,1-4.5•"2.I',V,.: •-..7::'-ift.f.,;.i.,•,'PF..5011!.TWMQP;;Wq1%-7:•'*!-;;Zg:F:.'-:•',. ':4'Ak's':•-•A; • • Clothes washer . . „ 12.51 . . 35.02 . • ] .- . •- Dishwasher 25.02 Drinking fountain 25.02. . . . . . .. . , . . FieetersiSutim 25.02 .. . . . . i &_41:ciiiitTi..ii*iiiiii :::;-'n 2; ,,f'-.1i..--n, :j.:t'..[:C:fEitir40 ::,4:1•. tNpanioil tank . .. . .. - . I 12.51 Name;.Polygon%%l 11 Address;:109 East 13d;Street - • . •-• : ! Fixture/sewer Cap 2 sink/hub 25 02 G.arbaae disposal . .. ' 25,0, Floor : 1 • 1 • 2 .62 Li. citpttattaip:Vanouver, -i.'A 98660 Hose bib 25_02 .... _ _ . Phone (340054706 Fax ( ) lee maker . . I —I 'Z:t.:AW::':;•; :qkt:.;.':..ti=itigki‘,4 •4*-:':::::,...fa,',:i'li::.;-/ti.4-iikek.3.6-t;o14divl';;,;: :-,o2 Intercepterigeasc trap 25:02 . Medical gas(value:$ ., . ) Page 2 1. Business name:Polygon Willi LLC Primer 12.51 • Contnaname:Angela. .ralewSki .„... • . Roofritaip.(cornmemini) 4i 12,51 . Address:.109 East 13th Street- , _ . • SinklbasintlawantV fell .. i 25..02 City/StateqIF:Vapeouver,WA.9860 'Solar aniM.(petable watery 62...5 4Phone:(300'69$-7700: I Fax:' (300)40-4442 .Tliti/showerfshower pan. • 12.51. E-mail:Angeln,qrniewniti@polygorihomes,e0.01 : Urinal Watereloset =.?:'..:43.,•',4--;',.'/`,•,•.=.':.•,r,itl..46'..&%.1'..•••.460;:s.';'. f '..F,A.'erVi- -!.i.-'W '• • -. • - 'f'•:.170:: .,'"g„.4'...,Ml;'-',•.'•;.:A. .-c..:1:.,... ;•i•i.o.,.,, ''•.•.;, 44.,,.,.....,.T.il..s"!••'",..4•7railf7-,-,..e,r,w1:,':::4...,:,..zst-- Water Business name;BOL PluMbing•LLe. .... Address:Ii0 Box 85 : . . .... .. ... . -' •Water piping/MY - 'Other 25.,92. - :25,02 :. I 31.52 '37.62) 50.29 J 25.02 , 1/ City/State/ZIP:Corbett OR 97019 permit fee $72 Phone.:(503)'051,3903... CCB Lot.:180345 .. • • - • _ . . • .. Subtotal , :Plumbing Lic,no,:,piP111582582 . .. . . Minimum ; 5-0 Fax.,.( ‘• ) Minimum . . Plan review (25%of pennit fee) I . . . ltate surcharge(12%Of pen-rig:fee) I . •• Authorized signature • ...: tfre...-- o,e-- 1 . . . TOTAL PERMIT FEB i .... • Thpermit.application aspires Ka pernilt ii ttet Ohtalaell.w44ig 1!0 day Prihr nameBravidan Lnuier 1-Pare: 8/1G, it, I after it:has:been accepted as torapide. *Pee methodelegy set by Tr-County Baildingledustry Sendee Said. blactidieiRetielt4imu,Pcirciopp.dcc TO/01/09. 44D,461.6ri f0/021CO.NVWEB) , Mechanical Permit Applicatio " , FOR OFFICE USE O\L1 City of Tigard t". f teifErl Received c' 1,1 . Dan Reviy: b AP- I ev I Permit No.: ��� '�?5a- 13125 SW Hall Blvd.,Tigard,OR 97223 A Phone: 503.7182439 Fax: 503.598.1960 Uu 2 2 2016 Date/By:ew Other Permit: T I G A R D Inspection Line: 503.639.4175 Ci i y Date Ready/By: Juris: Internet: www.tigard-or.govIH See Page 2 for a�Oz 1-/r ,r,• I t�•dr„l5y ) Notified/Method: Supplemental Information r7 7� / V{ 3 ..nilsWNWAW:-' a E"©P'„�' 43�,aax' Z t 11V# � tet:. r : 1 � „ lrsr S ), , .. J 151'..,r,l ®New constructionMechanical permit fees*are based on the value of the work 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value $gauggisi , G G � G ' s �r ft koil rfy§v" §k.cig.w® 1-and 2-family dwelling ❑Commercial/industrial0 Accessorybuilding For special information use checklist ❑Multi family 0 Master builder ❑Other Description Ea. Total fin � Qty' fi linin t A"_ ; •`, fL23�f �oi 'QTY{l F a ii Axa Heating/cooling: c. ,�-`m,m•,ebe- �, w», x .�z:s•rg . r. .,., ,,...:tq ;s i'. `4 x � t .. Job site address: C� i C� ^ - Air conditioning 46.75 iI 33 I Z lii� St'�� �1 Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: Project name:PolygonHeat pump 1 61.06 61.06 '� at Bull Mountain 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 23.32 Subdivision:Polygon at Bull Mountain Lot no.. Z� Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater ea er 23.32 W ,;. 4 z 7 oI4 Oj?WORK;, _ y" £, gag Gas fireplace/insert 33.39 Change 2"furance for basement to Heat Pump Flue vent for water heater or gas fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 OM: - 4 7 4 )l (3PERT 3W1 n ,. ijythT Other: ther 23.32 Environmental exhaust and ventilation: Name:Polygon WLH,LLC Range hood/other kitchen Address:109 East 13'Street equipment 33.39 Clothes dryer exhaust 33.39 City/State/ZIP:Vancouver,WA 98660 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:(360)695-7700 Fax ( ) Attic/crawispace fans 23.32 ? >.. zs ._. �PATC Other 2332 Business name:Polygon WLH,LLC Fuel piping: $14.15 for first 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 Fax::(360)693-4442 Fireplace E-mail:Angela.Grajewski@polygonhomes.com Range Barbecue Z, t . ... .- 04 -1 4 ,:= � < .- �=-zzrI "`4. Clothes dryer(gas) Business name:Apex Air LLC Other: Address:18004 NE 72nd Ave lafta Subtotal City/State/ZIP:Vancouver,WA 98686 Minimum permit fee($90.00) Phone:(360)342-8109 Plan review(25%of permit fee) Fax:(360)326-1769 State surcharge(12%of permit fee) CCB lie.:203034 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signature: Fee methodology set by TriCounty Building Industry Service Board Print name: . / , I Date:8/22/16 I I:\Building\PermitsllvlEC PermitApp_040113. oc 440-4617T(11/02/COM/WEB) . a EIVED F (}FTECT I Si Ai :rity of Tigard EP 2 0 2016 Poem No.: Datealy: l'" '13175 SW Hail Blvd,.-ro d OR: 9722 , . . . . Phone: 501718.2439 Tax: 5FY 0339C001, rang Vid"VC :0110:t Pal0; --- . ' lIMIMIMMIMMMMMlMIl.M. . ., l.MMMl.lM.MM..l...11MM.I' 'T Ri-A RD :1415PeCliC21 LI"': 5°3'639 A 175 I OF TIGARD , tbat:B3. . ,a'd,,,-Bv. ru..ri--- f ES Sxv PA e-*tor - - - • j'f'•473101: wt-NwAtald-tit.80a BUILDING DIVISION, DwaticR ,d; sopt„emencial,,Information I . TYPE OF.woRK .- • . . COMMERCIAL FEE'SCREDilLE -ISE CHECKTIST .„,,,,,, ., , ._ Mechanical permit fees'are based on the value of the work li..4. New cuitstruction 0 Au010011(0fierabolvitillaCeMet0 perilitmed,Indicate the intim troomind to the mrest dollar)of all 0 Donolionn 0 Other . tapphanical materials,equipment.labor,.necitead,and orofit. O . . . .. ,. ., ... ... ., .. ., Volum$ .. ,,-• --'-- , ... ,-..:: . CATEGORY 9F corisri.ittctiolly:.!-•:.:.- - J .- '' . 1 RESIDENtlA L E;014PLEr4t i SISTEMS FEES • 0 I-and 24amily&Ana 0 Commerciatiindastriat 0 Accessory hiding i ' ' F• orspeeitt I infoimation use titecAl& Fq Mutri-family 0 Master Wittier 0 Other; Di-N9(01911 Qty. ; Ea. . Total . . . , ' --'• ' ' ' 30g SITE INFORMATION'iNII'LOCATION ' ' manew-win= _...1 . , . . . . „. . . Alt aandottortmg I :. 4ti!75 ' I '' Job:5'itt'a4(11 .; 5 6 • Furnace 100 000 ilitittlectsiveres) j . , .... . .46..7, ....' City/StaletZIP:Tigard,OR 97224 . Furnace 100.000+fillY tdoesivents), 3491 . , 1V- - . Dem pump ,l 61..06 1. Sinteibirtgiapr no....; Project name:Polygon at Run'Mountain • Duct seedt . 23.12 Croas stmendirections to jab site: liwhank hot waters-vs-vat 2332 - . Rmidential boilcr(radiatnr or . Itydroniel . 4132 _ anti heaters(tbet-tYpe„..not tilectrie),, , . . in-walL irmittet,suspended.etc. Flueivent ibi-onv of above % 2332 : Other Subdivision::Polygon at Bap Mountain Lot no,: - Other fttel appliances: Tax niapipaftel no.: Water heater• Fm 2332 FSCR1PTION'OF 1Y0ilk ' '. • 1 .- '..:. •-• Gas iltaulacelimett ' 3139 Centrari-mr ehao9c Flue vent for waiter beater at gas fireplace 2$32 1 _ , . . , . „. Lo.liebter(gas) 23_32 3339 . . Wont/W(0 stave Wervi fireptaeamaart . 2332 "I . ' I Chnautyllinevilinetama _ • . 23.32 .:.: .._ .._ • '-'• :- Pi,:#11•OPE-Itty'.0w1VEIL.: • 1 ' '.. £3 TEAT • • Other 2132 Environmental exha list and ventilation: - 1 Name:Polygon WL/4 LLC i . Ranee boodfother kitchen 1i‘ . ....„........,-...—.....—. g 'col Ttlign I Address;1"FA's114a Sfrft1 I Clothes diva-exhaust : 3339 I !'''. I City,SlatealF:Vantouver,WA 98600 11 Single-duet exhaust(batt"cartk 1 7 I tofict conmatituents,tudity rooms) L- 2332 I Phone:(360169$-7700 Fax:( I i Attierrawt5 •cc falls 2132 • — 1 44'..Appliciakii,,---:..: ": : ' 0 .cotirA4,4,,,tios, 9 ',.. f. ,- - 11w: .. 2332. Fuld piping: BaSibtSS name:Polygon WLII,L• LC . •. ' - .,..--- - .. - - . . . IlltIS 6tr tivol four:..$4,10 for earb additional Contact name:A ogee Grajewxki . Forna-e-cic .N, , • , I I ! Gas • Address:;109 East 13th Street beet pump . . • , • - Wall a .,endednom*Attar CityiStateatk Vancouver,WA 98660 • Water heale.i. I Phone:(360i 4.95-770 Fax:1(360)693-4442. ' : Fir9P, Ism . . e H-mail:Angelat.Grajewski*polygonhomes.coin • aw 13tubm.ne --'.. .',.'''' ' '•'''": . - •-• '.... '.- Ctil4TkACTO/I .•:.'. ' ' .--' - ' . ' Clothes drvc ( - III a, 13u.siness name:Apex Ak LLC Chit ,„ ... . MECHANICAL FERktrfFEE , Address 18004 NE 12'Ave Subtotal I City/StatelZIP:Vancouver,WA 95686 . Minimum permit:tee 09001) , Plan tevinve•(25,0 puma fee) Phon1. e:(360)342-8109 Fax GM)3244169 Mate surebiot(22.%0fpe ft0 i CCB fie:,203034 • TOTAL PP*MIT FEE I - 774 potion annlication twpivis Ka noviiiit is not Otained wlitlio iltn ilaysatierit has hem ateeptedottunopterr. Authorized signet 4 . . • Pet ausitodokisy set by Tri-Contaretang todcmy Scrwm gmid Print mne:- I ce1/4 . 4,../ Date: 4,il. /4 j ,t:Vivad.r..5T4,11.,1:,,Alfr_PttratApp-644111,100 440,46M f i Pir2.4:0Wilt,n::, 1 w IIICity of Tigard I COMMUNITY DEVELOPMENT DEPARTMENT T I G R» Building Permit Review — Residential Building Permit #: /fST 20/6 000.q_5-:. _ Site Address: /ST/Q ,,at) Project Name: 11)d , �� „T-7/ 06,e// nio n Lot #: c7c (New s; :J, =subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: /'ve,f/L) k_ Verify site address/suite#exists and active in permit s em. Ya River Terrace Neighborhood: 0 No Yes,See River Terrace Review Addendum Attached Site Plan Elements: 7 P ree(3)copies of sitelan p PI *sting structures on site :4 Site plan must be on 8-1/2"x 11"or 11 x 17"paper P Footprint of new structure(including decks)with finished Drawn to scale(standard architect or engineer scale) i.or elevations orth arrow 1/I Utility locations(required for new,ma a 1 for additions) ite address,project or subdivision name and lot number 1"i cation of wells/septic systems y pp y plicant information(name and phone number) ). rosion control(including drainage-way protection,silt fence .t dimensions and building setback dimensions sign,location of catch basin,etc.) area,building coverage area,percentage of coverage and g2i eet names pervious area(applicable if R-7,R-12,R-25&R-40) I tree size,type and location roperty corner elevations(2 foot contour lines if more than \' 1)1 sting trees to be retained with drip line,and tree 4 foot differential) protection measures �, 11 lean Water Services—Service Provider Le`tteof platted prior to 9/10/1995): /Required: 0 Yes,applicant was notified q' No Received: lig ❑ Yes ❑ No Public Facilitiy Improvement(PFI) Permit: Required: V Yes,applicant was notified ❑ No Applied For: t�Yes ❑ No,stop intake [killand Use Case#: SLti ,QL/S— 0000. 1a Zoning. R1/g- tal Setbacks: Front eq0 Rear /5 Side Street Side Gara e okandscape Requirement: % �� g „:76) !:A Lot Coverage Maximum: cyo VA Building Height: Maximum Height 30 Actual Height 0, 9 t''isual Clearance A Easements F3 •nsitiveLands: ❑ Yes No Type (, Urban Forestry Plan 0 Conditionsereil"Met"prior to issuance of/building permit Notes: --( ‘&i7�61S' // Le j2ieJ Approved By Planning: Date: ,c/416,4 Revisions (after Building Submittal only) Reviewer Revision 1: 0 Approved ❑ Not Approved Date Revision Z: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPerrvtRvw RES 012116.docx 4. u Building Permit Submittal / r Original Submittal Date: -/`�?! I`' Site Plans: # 3 Building Plans: # 3 Building Permit#: EI—Enter building permit#above. Workflow Routing: g"--Planning El-Engineering [ Irermit Coordinator g Workflow Sign-off: 2--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. LTJ'Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: 4 - - Date: 4//7/ Engineering Review Slope at building pad: ,,„„V; �"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: - I I NODate: (f—/27s---A6 Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved ❑ Not Approved Revision 2: ❑ Approved 0 Not Approved Revision 3: 0 Approved 0 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: i::(0 ../ SDC Fees Entered: Wash Co Trans Dev Tax: t— es ❑ N/A Tigard Trans SDC: %Yes ❑ N/A Parks SDC: 14 Yes ❑ N/A (I° OK to Issue Permit �� t7 Approved by Permit Coordinator: Ai Date: I:\BuildineForms\BldgPermitRvw_RES 012116.docx .+i r'. 11114 City of Tigard 4r COMMUNITY DEVELOPMENT DEPARTMENT A River Terrace Building Permit Review Addendum i -st Building Permit #: /1.7,2 9/ — e;02-5-.2.- Site Address: /-C-SQ SA-: Project Name: Polygon at Bull Mountain Lot #: 7S"— (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review of River Terrace Plan District Design Standards (18.660.070.I). Is the project sub.ect to the plan district design standards? ❑ YesNo 1.Articulation: a .simum of 1 element per each street-facing facade that has 30-60 ft. of frontage.An additio►. element required for lo with over 60 ft. of street frontage shall be provided every 30 ft. Porch min. 5 ft. deep ialcony w/ access 2 Window Projection Vertical Wall Offset a ft. deep min. 2ft., 5 ft. wide min. 2 ft., 6ft. wide Gable dormer ❑ ❑ ❑ ❑ ❑ 2. Eyes on the street: a minimum .f 12% of each street facing facade must include windows .r entrance doors. Percentage Shown: 3. Entrances:At least one entrance mus' eet both of the following standards: fac►. wall ❑ Parallel to street, .ngle no more than 45° from street, ❑ Max. 8 ft. setback from longest street- or open onto po Entrance opens to a porch: ❑ Yes ❑ No r • . If yes, all the following apply: ❑ 25 sq.f .n. ❑ One street facing entry ❑ 12 f.max. roof above floor of porch ❑ 5 ft. depth min. ❑ i'/o min.porch roof coverage 4.Detailed Design:All buildings shall include a min. of fi - •f the following elements on all street-facing facades: ❑ Covered porch min. 5 ft.wide x 5 ft. deep ❑ 'ecessed entry area min. 5 ft.wide x 2 ft. deep ❑ Wall offset min. 16 inches ❑ D. er min. 4 ft.wide ❑ Roof eave min. 12 inch projection ❑ Roo' offset min. of 2 ft. ❑ Roof shingles either tile or wood ❑ Gable, '. or gambrel roof design ❑ Roof pitch oriented south min. 500 sq. . ❑ Horizonta ap siding min. 3-7 ft. wide ❑ Accent siding min. 40%of street fa..de ❑ Window tr. " . 2 1/2"wide by 5/8" deep ❑ Window recess min. 3 inches fo .11 street facing ❑ Bay window nu,. 5 ft. wide by 2 ft. deep ❑ Balcony min. 5 ft.wide x 3 ft seep with inside access ❑ Attached garage is 5% or less of street facade 5. Garages and Carports• ay face the front or side lot line on a corner lot. Setbacks: No closer to front o- side lot line,than longest street-facing wall. ❑ Yes ❑ No. If No (Ch. k one): ❑ May extend u t to 5 ft. if there is a covered front porch and garage does not extend beyond .e front porch. ❑ May exte . up to 5 ft.where the garage is part of a two-story building and there is a window a the second story above the :.rage that faces the street with a min. area of 12 sq.ft. Width. Check one) ❑ 2-foot-wide garage door ❑ 40%max. of street facade 50%max. of street facade with 7 detailed design elements Notes: Approved By Planning: e::= ,... _.. -.-:___.___.____ _•_--® C f - Date: 1:\Building\Forms\BldgPermitRvw RES RT 031416.docx City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15312 SW SEINE DR, TIGARD, OR, 97224 November 3, 2017 at 8:37:23 AM Record Type: Record ID: Residential - Master Permit MST2016-00252 Inspection Type: Inspector: 699 Mechanical final Aaron Cillo-Gobel Result: PASS Comments: Corrections completed. A/C installed Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15312 SW SEINE DR, TIGARD, OR, 97224 November 6, 2017 at 2:22:08 PM Record Type: Record ID: Residential - Master Permit MST2016-00252 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